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During the ongoing baby formula shortage, you may be looking for alternatives, assuming that you either are an infant yourself or have to feed an infant. And despite what actress Bette Midler may have recently tweeted, you may not necessarily have breast milk “on demand,” as I described for Forbes on May 15. After all, breasts are not latte machines. And you can’t simply buy a pair of breasts if you don’t happen to have them. So perhaps you’ve been considering getting breastmilk from somewhere or someone else, especially after seeing breast milk sharing conversations on social media. Keep in mind, though, that such sharing may be quite daring. Without proper precautions, such sharing at breast, so to speak, could bring a number of different risks.
This CBS Cincinnati LOCAL 12 news segment reported on how a number of parents and caregivers have been looking to breast milk sharing groups on social media:
Putting something found on social media into you or your infant’s bodies can in some cases be like finding a doughnut on a subway floor and eating it. You don’t know where it’s been and have got to be careful about what you hear about and find on social media or the Internet in general. Sharing breast milk ain’t the same as sharing photos, opinions about the Kardashians, or weed whackers.
Remember breast milk is a body fluid. And there’s a reason why you probably don’t readily share bottles of other types of body fluids with people whom you don’t know well. A jug of any body fluid usually doesn’t make for a good housewarming present. Plus, body fluids, such as breast milk, can carry various dangerous pathogens and substances depending on who produced it and how its been handled.
Of course, all body fluids are not the same. They can differ in how likely they are to carry different pathogens and substances. Nevertheless, you’ve got to closely screen anyone donating breast milk. In this case, screening doesn’t mean simply looking through a person’s dating profile pics or asking that person, “where do you see yourself in five years” or “what are you passionate about in life?” It means knowing the health and health-related habits of the breast milk donor. That’s why the Academy of Breastfeeding Medicine in 2017 put forth guidelines on how any human milk bank should screen all potential breast milk donors. The guidelines start off by saying, “Donors should be in good health.” This doesn’t mean that you should ask the donor to do push-ups or run through an obstacle course. However, it does mean that the donor shouldn’t be suffering from significant medical conditions at the time.
The guidelines also stipulate that the donor should not taking any medications or herbal preparations that may be problematic for the baby. It’s important to get a verifiable list of all the medications and supplements that the donor is taking and look up each on the Drugs and Lactation Database, otherwise known as LactMed. For each medication or supplement, LactMed includes a summary of how it should be used during lactation, the levels that may be present in the mother, milk, and infant, and the potential effects on lactation, breastmilk, and breastfed infants.
Moreover, the donor should be negative for the following viruses: human immunodeficiency virus (HIV), Hepatitis B virus, and the human T-cell lymphotropic virus type 1 (HTLV-1). Such viruses could end up in breast milk and in turn infect the infant. This shouldn’t be a take-the-donor’s-word-for-it situation. Looks aren’t enough either. You can’t simply say, “oh that person doesn’t look hepatis-y.” Instead, a negative designation must be based on an official lab test result that has been performed recently.
Finally, the guidelines listed several “social practices” that the donor shouldn’t have. One is using illegal drugs, marijuana, tobacco, or any other nicotine-containing products such as nicotine gum, nicotine patches, or e-cigarettes. Another is consuming alcohol above certain limits. This includes over 1.5 ounces (or 44 mL) of hard liquor or spirits, 12 ounces (355 mL) of beer, 5 ounces (148 mL) of wine, or 10 ounces (296 mL) of wine coolers each day. A third is either engaging in activities risky for HIV transmission or having a sexual partner over the 12 months who may have been at higher risk for getting or having HIV.
Of course, doing all of this screening and taking proper precautions requires time, effort, resources, and expertise. That’s why the U.S. Food and Drug Administration (FDA) “recommends against feeding your baby breast milk acquired directly from individuals or through the Internet.” This is because, “When human milk is obtained directly from individuals or through the Internet, the donor is unlikely to have been adequately screened for infectious disease or contamination risk. In addition, it is not likely that the human milk has been collected, processed, tested or stored in a way that reduces possible safety risks to the baby.”
Even if the donor meets all the aforementioned criteria, that donor may not be pumping, handling and storing the breast milk properly. For example, the U.S. Department of Health & Human Services (HHS) Office of Women’s Health advises against keeping breast milk at room temperature for longer than four hours or in the refrigerator for longer than four days after pumping. If any of these limits may be exceeded, it’s better to freeze the breast milk as soon as possible after pumping. Naturally, everyone should avoid touching the breast milk directly and thoroughly clean any containers or other objects that may come into contact with the breast milk.
The following Good Morning America segment mentions some of the precautions and procedures that legitimate human milk banks go through to ensure that the breast milk is safe:
Again, just because a place calls itself a milk bank doesn’t mean that it’s legitimate or follows proper procedures.
That’s why the FDA recommends that before you even consider using someone else’s milk, talk to your doctor, a real medical doctor. Your doctor can then help decide whether donated milk is the best route for you and, if so, help identify a proper human milk bank. Your state’s department of health and the Human Milk Banking Association of North America (HMBANA) can offer additional guidance as well.
This baby formula shortage does have many parents and caregivers scrambling for alternatives. But the formula isn’t just finding any source for breast milk.