More moms turn to breast milk sharing, but is it safe?

baby milk bottle on white background

Nine days after she gave birth, Erica Fleischer brought her newborn daughter to the pediatrician for her first well-visit with concerns about her weight gain.

“She hadn’t lost more than 10 percent of her weight, but I had a sense she wasn’t gaining any,” Erica, who lives in Chicago, said.

Her instincts were correct. Her daughter weighed the same amount as the day after she left the hospital. Erica immediately saw a lactation consultant who told her that her daughter was only taking an ounce of breast milk at each feeding.

So she started to pump more and take medication prescribed by her midwife to raise her prolactin levels. Her baby also had a laser procedure and craniosacral therapy to release her lip tie but nothing worked.

“If I pumped after every feeding, I was just able to get enough to feed her,” she said.

Erica’s doula suggested that she either turn to a donor milk bank or ask other moms she knew if they had extra milk. Since most milk banks will provide donor milk only for premature or sick infants and only with a doctor’s prescription, Erica decided on the latter.

The first donation came from a friend. She also obtained breast milk from moms she met through her synagogue’s listserv. Additionally, she met women on the Eats on Feets and Human Milk 4 Human Babies Facebook groups and received milk from those with whom she shared mutual friends.

But the biggest donation was from Alison Hightower, a mom Erica met in another Facebook group. Alison, who was pumping for her newborn in the NICU, offered Erica the excess milk she had stored— about 300 ounces worth. And when Alison’s baby came home from the hospital and was able to latch on, she offered to continue pumping so Erica could feed her daughter.

“I feel so touched that these other women would give me their milk and go out of the way to help me,” Erica said.

Aside from a small amount of formula, Erica was able to feed her daughter breast milk until she turned one.

“As a society, if we are really promoting breastfeeding to such an extreme, then I think this has to be a part of it. There has to be a way for women who can’t breastfeed or breastfeed enough to be able to provide breast milk for their babies,” she said.

Breast milk sharing is on the rise.
Breastfeeding continues to be a public health priority in the U.S., and rates are increasing. But for women who are unable to breastfeed or struggle with low milk supply, experts say they’re tapping into their village for a boost.

In fact, a recent study out of the University of Central Florida found that women sharing breast milk with other moms who are either friends, friends of friends or those they meet through online and in-person communities is a thriving practice. The same study found that cross nursing— women breastfeeding other women’s babies— is also common.

Milk sharing isn’t just something moms who can’t produce enough milk are doing. Both heterosexual and same sex couples who use a surrogate may also arrange to receive as much milk as the surrogate can pump.

“It’s just part of their contract,” said Cindy Shelton, a registered nurse and an international board-certified lactation consultant at Los Robles Hospital in Thousand Oaks, Calif.

“The positive spin on it is that more women recognize the importance of breast milk for feeding their babies,” said Dr. Joan Meek, chair of the American Academy of Pediatrics’ section on breastfeeding and a professor of clinical sciences for the Florida State University College of Medicine.

According to the American Academy of Pediatrics, a mother’s milk is the best choice, followed by donor milk and then infant formula.

Yet with only 14 milk banks in the U.S., and a limited supply of donations, obtaining it can be a challenge.

“It ends up getting prioritized to the premature and critically ill babies and those that have medical conditions for which human milk is a necessity for them,” Meek said.

Nevertheless, about 30 percent of milk banks do offer breast milk to moms whose babies are already home from the hospital or who are adopted, for example, said Pauline Sakamoto, president of the Human Milk Banking Association of North American. Purchasing donated milk can also be costly, running anywhere between $3.75 and $5.50 an ounce.

Breast may not always be best.
Experts say milk banks are the safest choice since the facilities review donors’ medical history, screen for infectious diseases like HIV and hepatitis and pasteurize the milk to destroy pathogens.

When moms share milk informally however, it’s impossible to know with certainty the donor’s health status, if she takes prescription medication or even if she had one too many cocktails before pumping. Since babies don’t have fully developed immune systems, there’s a potential that they’ll be exposed.

“The younger that child is, the greater that potential risk is,” Meek said.

The milk moms receive may not be a perfect match for their babies either, since a mother’s own milk is consistent with her baby’s age and stage of development.

“There are changes that take place in the milk so you’re missing out on those potential benefits,” Meek said.

It’s important to note, however, that milk banks do not always age match perfectly either.

Because moms and their babies live in the same environment and are exposed to the same pathogens, “the mother’s own milk is actually tailored through a pretty elaborate system and produces specific antibodies and immune protective factors to those things in their environment,” Meek said.

Since milk shared among moms is not pasteurized, there could also be bacteria in the milk from pumping, storing and transporting it. Plus, moms may not be diligent about washing their hands, and cleaning and sanitizing pump parts.

“Sometimes we don’t always have the same habits,” Shelton said.

What is the future of milk sharing?
Although there are currently not enough milk banks or donations to serve all women and their babies, experts say as the demand grows, so will the supply.

For moms who are having breastfeeding challenges, working with a lactation consultant first to exhaust all of their options is a good idea. An extra pumping session, more skin-to-skin contact, a flexible work arrangement, a prescription medication or herbs may be the answer.

“Mother’s own milk is preferred so everything we can do to get that mother’s milk to her baby would be ideal,” Meek said.

Ultimately, just as moms make the decision to breastfeed, formula feed, pump or a combination of all three, using milk from another mom is an individual choice.

“That’s a decision that each mother has to look at her own circumstance and who the potential donor might be and weigh those risks and benefits,” Meek said.