Some moms just aren't able to breastfeed. Fortunately, these women can still give their babies the breast milk they need.
After Audra Murray's twins were born at 30 weeks, her breast milk took its time coming in. A hormonal condition, coupled with the fact that the babies were too weak to nurse, wreaked havoc on her supply. "My milk took about two weeks to show up," says Murray, 37, who lives in Newton, Mass. "I was pumping every two hours every day, but my milk didn't come in until I took Reglan [a drug that increases the milk-making hormone prolactin]."
She wanted to give her preemies every benefit possible, so instead of formula, Murray chose to give the twins donated milk for their first two weeks of life. She continued to supplement her own milk with donated milk for three months, until her babies were strong and coordinated enough to latch on properly.
There are other reasons a woman may not be able to breastfeed. Mastectomy, breast-reduction surgery, certain communicable illnesses and some medications can hamper breastfeeding or make it unadvisable, says Susan Rothenberg, M.D., associate director of obstetrics at Beth Israel Medical Center in New York. That's why some women, like Murray, opt to use other mothers' milk. Formula just doesn't have the potent health benefits of breast milk—whether it's your own or someone else's.
"Another woman's milk is a great second choice," says Naomi Bar-Yam, Ph.D., executive director of the Mothers' Milk Bank of New England in Newton, Mass. "Breast milk strengthens a baby's immune system in ways that formula can't— and it's more easily digested." Here's a look at the ways you might get your baby the breast milk he needs—even if it isn't your own.
Milk banks There are 12 milk banks affiliated with the Human Milk Banking Association of North America (HMBANA), which sets standards and guidelines for donor milk banking in the U.S. and Canada. In 2008, these banks sent 1.4 million ounces of breast milk to hospitals and individuals in 80-plus cities.
Here's how the process works: Milk banks receive milk from lactating moms who've been screened for health/lifestyle behaviors and communicable diseases. The donor sends her frozen milk to one of the banks, where it's thawed, pooled with other donors' milk and heat-treated to kill bacteria and viruses. The milk is refrozen and prepared for shipment only after a sample has been cultured and shows no bacterial growth. It is then shipped frozen to hospitals and individuals in need. "If your baby is not in the hospital, you'll need to get a prescription from your doctor faxed to us," says Pauline Sakamoto, R.N., P.H.N., M.S., the San Jose, Calif.-based president of the HMBANA. "Then we'll call the mom and ask how much she needs."
As long as there's an adequate supply of donor milk, you can feed your baby for as long as you like. That is, of course, if you can afford it. "Most milk banks charge between $4 and $4.50 an ounce," says Bar-Yam. "That's about $1,000 to $1,200 a week." Most banks will work on a sliding scale for families who can't afford that price, and you may be able to get your insurance company or Medicaid to cover all or part of the cost, Bar-Yam adds.
If you need donor milk, be sure to contact an HMBANA bank (hmbana.org). "Black market" breast milk can actually be bought on the Internet— but stay away from it. "You don't know who you're buying milk from, and you have no idea whether this person has been tested for communicable infections," cautions Liz Maseth, R.N., IBCLC, director of outpatient lactation services at Akron Children's Hospital in Ohio. "And who's to know whether it's even human milk?"
One final word: Milk banks have a limited supply and exist only for babies who truly need breast milk. "They are not designed for moms who don't feel like nursing," Bar-Yam says.
Cross-nursing While on a 2009 humanitarian tour of Sierra Leone in West Africa, actress Salma Hayek caused a media stir when she breastfed a hungry infant. "Cross-nursing, as this practice is called, is the occasional nursing of another mother's infant," Maseth explains.
Cross-nursing is usually practiced between sisters and very close friends and for the same reasons as using donor milk. "It's generally done in tight social circles because you're more likely to be familiar with the health behaviors, such as drinking or smoking, of people you know well," says Michelle Collins, M.S.N., C.N.M., R.N.C., assistant professor of nursing at Vanderbilt University School of Nursing in Nashville, Tenn.
A variation on cross-nursing is milk-sharing, in which lactating women freeze extra milk to give to a relative or friend whose baby needs it. Julie Lifferth, 28, of Smyrna, Tenn., receives milk from her two sisters-in-law because her son was born with a cleft lip and palate. "Parker was unable to latch properly, and I struggled with my supply," she says. Because she milk-shares with relatives, Lifferth has no qualms about feeding Parker other mothers' milk. "They're both healthy, and neither of them drinks, smokes or uses addictive substances," she says. "Milk-sharing is awesome, but I wouldn't be comfortable taking milk from someone I don't know."
Experts agree. "Breast milk is a body fluid," says Rothenberg. "You should use at least the same standards that you would for accepting a blood transfusion." In addition to asking about any medications she's taking, inquire whether the donor has been blood-tested for infectious conditions, as HIV and other diseases can be transmitted through breast milk.
Help another mom: donate your milk Want to share some of your liquid gold with someone who needs it? Contact the Human Milk Banking Association of North America at hmbana.org. Even if you don't live near a milk bank, you're still eligible to donate, and the bank covers all costs related to testing and shipping milk. To donate, you must:
■ Not be using medications or herbal supplements (there are some exceptions, such as insulin and certain birth-control pills)
■ Be willing to donate at least 100 ounces of breast milk
■ Be healthy (i.e., test negative for HIV, hepatitis B and C and syphilis, among other diseases)
■ Not use illegal drugs, alcohol or tobacco
Find out how to make your milk the best it can be—for your own baby or someone else's at fitpregnancy.com/breastfeeding/betterbreastmilk.