A recent study found 1 in 10 samples of breast milk for sale online are not what they say they are. But moms are still buying it. Would you do it to feed your baby?
The first time I donated my breast milk over the internet, it was kind of a let down.
Our daughter doesn't love taking bottles while I'm at work, and the 3-ounce bags of frozen milk were starting to pile up. So I reached out to a mother seeking milk through an online parenting forum. After asking me a few questions—Do I smoke? What medications do I take?—we arranged a time for her to pick up 60 ounces. She arrived on our doorstep with a large cooler and an all-business attitude; she pretty much just grabbed my milk and skedaddled.
I realize now that I had unreasonable expectations. In my mind, this was supposed to be much more of a kumbaya/happy vibes-sister wives kind of moment: We were sharing milk! We were in this thing together! Where were the hugs? But she might not have felt totally comfortable obtaining breast milk from a stranger. Or maybe she was tired and stressed, just like any other new mom, and didn't want to hang around and chit chat. And at the most basic level, all she was doing was trying to procure food for her daughter; she doesn't hug the cashier at Target when he rings up her bananas and cereal, so why would she hug me?
The milk market
My own preconceived notions aside, sharing breast milk is nothing to be taken lightly. Diseases such as HIV and Hepatitis can be transferred via breast milk, as can varying concentrations of prescription or illicit drugs. Tightly regulated milk banks exist, and they do screen for medications and diseases as well as heat-pasteurize milk to kill any organisms, but they are few and far between—only 15 across the country—and the majority of their milk is earmarked for NICU babies and other at-risk infants. Oh, and it costs about four dollars an ounce, not counting shipping costs.
So more and more parents are turning to donor milk sourced via Facebook, parenting forums, or milk-sharing sites. Some, like Human Milk 4 Human Babies and Eats on Feets (both of which I subscribe to and have donated through) discourage or flat-out don't allow money to change hands; they also don't screen milk, but rather promote informed choice (According to HM4HB's website, "We trust, honour, and value the autonomy of families and we assert they are capable of weighing the benefits and risks of milk-sharing in order to make choices that are best for them.") They also provide lists of suggested questions to ask donors, tips for safe and sanitary milk collection and instructions on at-home flash-heating to kill bacteria.
Others, like Only the Breast, function like a lactating Craigslist. Woman write their own descriptions and set their own prices. (Examples: "My rich milk makes giants!"; "26-year-old organic momma...soy-free, gluten-free, dairy-free, paleo-style eating, avoid ALL drugs preservatives, chemicals.") For prices ranging from about a dollar an ounce to more than $3.50, parents can obtain milk they might not be able to provide on their own or obtain via donation. Many suppliers offer to produce a doctor's note confirming their health status. (Most women also give a list of caveats, like that they refuse to send photos.)
Sarah Keim, PhD, principal investigator at Nationwide Children's Hospital in Columbus, Ohio, estimates that more than 55,000 individuals are currently participating in the online exchange of human milk. Keim recently collaborated with researchers from The Ohio State University and Cincinnati Children's Hospital Medical Center to test 102 samples of breast milk purchased from milk-sharing websites. After examining the milk via DNA testing, "we discovered fairly high concentrations of cow's milk, or perhaps formula made with cow's milk, in one out of every 10 samples," she says. Though no one can be absolutely certain of motive, Keim theorizes that "when milk is sold for money, there could be an incentive to increase volume."
Unfortunately, this could spell danger for babies who are allergic to cow's milk, or those who can't tolerate formula—the ones whose parents are often online looking for breast milk, notes Keim, whose study was recently published in Pediatrics.
Keim's team is also responsible for troubling research in the past that detected disease-causing bacteria in an astonishing 75 percent of breast milk samples, including salmonella and E. coli. The milk was likely tainted as a result of unhygienic milk collection or poor shipping practices (19 percent of sellers failed to use a cooling method such as dry ice when shipping, according to that study.)
For Keim, the answer is clear: "Patients should be counseled against obtaining milk in this way for their infant." Instead, she suggests that mothers have a candid discussion with their pediatrician or lactation consultant to see if anything can be done to promote their own milk supply; if that isn't working, she recommends a nonprofit bank where milk is screened and vetted. (Visit Human Milk Banking Association of North America for a list.)
If, after weighing the possible pros and cons, you decide to seek out unscreened donated breast milk, certified nurse midwife and breastfeeding counselor Alyson Lippman suggests you employ a combination of thorough questioning, plus momma's intuition. "Ask about their HIV and hepatitis status, if they smoke or take any drugs or medications," she strongly encourages. This can include asking for a doctor's note confiming an all-clear from disease. "Always ask questions and use your best mom judgment. If you're taking milk from someone without asking any questions, yes, you may be getting known benefits beyond formula, like antibodies but you also might be taking very uncertain risks for your baby's health."
Related: Other Mothers' Milk