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Breastmilk Donation: Sharing Liquid Gold

In my work as a Breastfeeding Counselor with Breastfeeding USA, I encounter quite a few questions about breastmilk donation.

If you happen to be a full- or part-time pumper who is able to express more breastmilk than your baby needs, breastmilk donation is an option worth considering.  Read on to learn more about how to share your liquid gold!

Why Donor Breastmilk?

Both the American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend exclusive breastfeeding for the first six months of infancy followed by continued breastfeeding and the introduction of complementary foods; these recommendations follow the growing body of science supporting breastmilk as the ideal food for human infants.

When families aren’t able for whatever reason to meet the breastmilk needs of their infant, using donor milk is an alternative to formula use.

For the most fragile newborns, including premature babies and those with complex medical needs, receiving breastmilk may be even more important.  While mothers should be supported in expressing their breastmilk or nursing at the breast if possible, there are often complications that make it difficult for mothers to provide enough breastmilk for their premature or medically fragile infants.  In the past, neonatal intensive care units (NICUs) have turned to formulas to make up the difference.  However, the evidence is increasingly clear that breastmilk – including donor breastmilk – provides these infants with numerous benefits that formula can not, including a reduced risk of necrotizing enterocolitis, a life-threatening disorder affecting many premature infants.

This has led the AAP to endorse the use of donor milk for NICU babies when possible, but with a bit of a catch.  Because these babies are medically fragile and at greater risk of infection, it is important that the milk they receive be screened and safely prepared through milk banks.

The non-profit Human Milk Banking Association of North America (HMBANA) was established in 1985 to develop guidelines and standards for the safe collection, processing, and distribution of donor breastmilk.  HMBANA non-profit milk banks supply NICUs with donor milk and collect breastmilk from mothers with extra to give.

Of course, premature and medically fragile infants aren’t the only babies in need of donor breastmilk.  A growing number of parents have interest in donor breastmilk for a variety of reasons.  However, milk bank milk is often prohibitively expensive – several dollars per oz – and generally not covered by insurance for out-of-hospital use.  These high costs, due to scarcity and processing costs, lead many to turn to informal milk sharing networks.  The AAP has formally warned against these informal networks, citing the inability to screen donors and ensure the safety of donated milk; however, many parents feel the benefits of donor breastmilk from a trusted source outweigh the possible risks of donor milk or formula use.

How Do I Donate Breastmilk?

Milk sharing is certainly not a new practice; throughout human history, lactating women have breastfed their non-biological children through wet nursing (although it is important to be mindful that much of the history of wet nursing involved women of privilege using women living in poverty, enslaved women, and women of color).

The advent of efficient breastpumps and the increasing number of women who are expressing breastmilk have made milk sharing easier than ever.frozen breastmilk ready for donation

If you are interested in donating your excess breastmilk, there are a few things to keep in mind:

Practice safe milk handling while pumping.  The first step in being a breastmilk donor is, of course, to express your milk!  Following the guidelines for the proper expression, handling, and storage of milk will keep your extra breastmilk from going bad.

Build extra breastmilk stock.  Some women easily pump more than their baby needs.  Others may choose to add in a daily pump specifically for donation purposes.  If you have questions about pumping (how to, how often, etc,), you may find this post a helpful read.

Decide between milk bank donation and informal milk sharing.  Some donating mamas choose to donate to HMBANA milk banks where their milk will be combined and processed with the milk of others and distributed through NICUs to premature and medically fragile newborns.  Others prefer to participate in informal milk sharing networks where they may donate to a family member, friends, or local stranger.

  • HMBANA milk banks are located throughout the US and Canada.  Even if there’s not a milk bank local to you, it’s likely your nearest milk bank will facilitate shipping your milk to the bank.  HMBANA milk banks have donation minimums and require a screening process (this usually involves an online or telephone interview followed by a blood draw).  You can read about my experience donating to a HMBANA milk bank here.
  • Informal milk sharing usually occurs through local networking.  Several groups have been created to facilitate this networking and likely have a chapter near you.  Eats on Feets, Human Milk 4 Human Babies, and Milk Share are the go-tos for informal milk sharing.
  • As a word of caution….some women have asked about posting breastmilk for donation or sale on sites like CraigsList.  I would NOT do this!!!  You are likely to get some unsavory replies!
  • There are also a growing number of for-profit breastmilk collection companies.  These are not without controversy and have been accused of predatory practices targeting women of color and low-income mothers.

How Can I Support Breastmilk Donation?

Whether or not you are able to personally donate breastmilk, you can support breastmilk donation.  Just like breastfeeding, the more we do it and see women doing it, the more normal it will become.

Encourage others to donate.  If you have a friend or colleague wondering what to do with her extra milk, encourage her to consider donating.  Even small donations are accepted in informal milk sharing networks.

Normalize pumping (and breastfeeding!).  We know that nursing in public and talking about breastfeeding are important components in normalizing breastfeeding – which in turn improves breastfeeding rates.  Talking about pumping and milk storage and donation normalizes those practices as well.

Support workplace pumping.  Advocating for breastfeeding/pumping friendly workplace practices is key to increasing breastfeeding rates.  Even if you are not lactating yourself, you can support colleagues who are and lobby for better protections for pumping.

Share information about milk banks and informal milk sharing.  Breastmilk donation is typically a not-for-profit endeavor, so milk banks and milk sharing networks don’t get tons of press.   Simply letting both those looking to donate and looking for donations know that these options exist can be a big help.


Update:  The Academy of Breastfeeding Medicine has just issued a position statement on informal milk sharing for term, healthy infants.  They recommend medical screening of the donor and careful attention to safe milk handling practices and advise against internet based sharing, and particularly against purchasing milk from donors online.  They also note that in-home pasteurization is an option for an added layer of protection but will mean the loss of some of the properties of breastmilk.

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Published in Breastfeeding