Would you give your baby another mom’s breast milk? Would you pay for breast milk? Would you donate or sell your milk? The World Health Organization and the American Academy of Pediatrics recommend the use of donated breast milk as the first alternative when maternal milk is not available. A decade ago, I only saw donated breast milk used in our neonatal intensive care unit (NICU) at St. Louis Children’s Hospital. But today there is nothing taboo about giving your baby breast milk from someone other than mom. I’ve seen it– as soon as moms learn they can’t provide breast milk for their baby, they are on their phone finding breast milk. Some call their sister, or a friend or neighbor, but many will buy milk online or through an organization like Milk Share.

The growing demand for breast milk has resulted in for-profit companies like Prolacta Bioscience and Only the Breast. The market for human milk has expanded beyond just sick babies– cancer patients, athletes, health enthusiasts and even adult men are buying breast milk. Search Craig’s List and you’ll find it– women selling breast milk by the ounce with or without stipulations attached.

Before you buy, sell, or donate, or accept free breast milk, learn the facts and science behind this industry.

The for-profit breast milk industry has enraged emotions among the selfless women who donate milk free-of-charge. Human Milk 4 Human Babies (HM4HB) is a not-for-profit milk sharing program that opposes the sale of human milk. They feel it is a human right for babies to be fed human milk. We don’t allow for the sale of organs, bone marrow, or whole blood in the United states, so why should we permit the sale of breast milk? Naysayers note that wet nursing for profit has been present throughout antiquity. And it is legal to sell plasma in the United States. In some states it is even legal to sell your own urine.

At St. Louis Children’s Hospital we use pasteurized, donated human milk from a not-for-profit bank associated with the Human Milk Banking Association of North America. This milk is donated, pasteurized, packaged, and sold to hospitals for a cost that covers their cost of processing. We primarily use donated human milk in our neonatal intensive care unit.

If you are looking for breast milk for your baby, ask yourself these questions:

– How is this milk pasteurized and stored? A study published in the medical journal Pediatrics found high rates of bacterial contamination in human milk purchased online. The authors concluded: “Human milk purchased via the Internet exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices. Infants consuming this milk are at risk for negative outcomes, particularly if born preterm or are medically compromised. Increased use of lactation support services may begin to address the milk supply gap for women who want to feed their child human milk but cannot meet his or her needs.”

– How is this milk tested for infectious diseases and chemicals? Certain infectious diseases can be transmitted through breast milk, including HIV and CMV. Also concerning is nicotine, caffeine, and alcohol that can be in donated milk depending on the mother’s diet. Prescription and illicit drugs can be passed into human milk in concentrations dangerous to infants. The American Academy of Pediatrics has a list of common chemicals transmitted into human milk and causes for concern. Most milk banks will test for these chemicals. Before you accept donated milk or purchase milk, be sure to inquire as to the testing procedures used.

– What is the risk/benefit ratio to your baby from drinking human milk? We know that there are clear advantages of human milk over formula for certain babies, especially premature infants, immunocompromised infants, and infants with digestive problems. What’s unclear is how important donated breast milk is for healthy babies. Most studies on breastfeeding are done on women feeding their own babies, not babies being bottle fed human milk produced by a woman other than their mother. The potential benefits of human milk need to be balanced with the risks of drinking milk contaminated with bacteria, viruses, and chemicals.

– What are the policies regarding donor milk at your hospital or birthing center? Many community hospitals and birthing centers are not set up to accept, store, and dispense donor breast milk to infants. Although they may permit you to give donor milk, they will likely require that it is pasteurized and tested. If you plan to use donor milk at a community hospital, you will probably need to acquire it yourself and bring it to the hospital.

Want to donate or sell your breast milk? Breast milk donation is a generous and selfless act that can be lifesaving, especially for sick infants. Before you donate or sell, consider the following:

– Who is really drinking your milk? There is a growing market for breast milk for people other than babies: chemotherapy patients, people with digestive and nutritional problems, athletes, health enthusiasts, and people with sexual fetishes. Are the people buying your milk really going to feed it too a baby? If not, does this bother you?

– Are you donating to a person or company that is going to resell your milk for-profit? If you are donating your milk, make sure that your buyer is not simply reselling your milk. If you are privately donating through an organization like Milk Match, you might be giving milk to someone who simply sells it online. Large,for-profit companies like Only the Breast will gladly accept donated human milk and then resell it for profit. Prolacta Bioscience is a large for-profit human milk processing company. Prolacta Bioscience has collection depots in major children’s hospitals and reputable facilities. Prolacta Bioscience then buys the milk from these depots. If you are donating milk to be used by sick infants, be sure to donate it to a bank associated with the not-for-profit organization The Human Milk Banking Association of North America.