Is all donor human milk the same? Guest Blogger, Hope Lima, Ph.D., IBCLC
Having to supplement your newborn when you had planned on exclusively breastfeeding (or the infant had an allergic reaction to formula!) can be a stressful time. Enter donor milk. Donor milk is the practice of providing milk to a child that has been provided by someone producing extra milk. Historically, this came in the form of wet nursing (nursing somebody else’s child). In the United States, there are a few ways that donor human milk can be accessed.
Milk Sharing. Milk sharing is the act of obtaining or providing milk within a community setting. Mothers who are producing extra milk can be matched to mothers who are not producing enough. This process has become more popular (https://www.liebertpub.com/doi/full/10.1089/bfm.2013.0114?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed) and can be facilitated by organizations like Human Milk 4 Human Babies (FB page: https://www.facebook.com/hm4hb/) or Eats on Feets (http://www.eatsonfeets.org/). This milk is not screened or monitored. However, recent research has found that most mothers are willing and open about their medical and social history (https://link.springer.com/article/10.1007/s10995-013-1387-6). Here is a cool story about milk sharing that was in the news! https://www.youtube.com/watch?v=NmuvY1-E7IU
Non-profit Milk Banks (HMBANA Milk Banks). Human Milk Banking Association of North America (HMBANA) Milk Banks are the non-profit milk banks in North America. These milk banks screen donors, both verbally and serologically, pasteurize the milk using a well-established pasteurization method (Holder pasteurization) to ensure that pathogens are destroyed, and screen the milk for pathogens after pasteurization. In this process, mothers are not compensated for providing their milk. Some milk banks have enough milk to provide to infants who are not hospitalized. However, the priority of HMBANA milk banks is to service medically fragile infants in the NICU. Hear more about how HMBANA milk banks work here: https://www.youtube.com/watch?v=KfpEYza2-Jw
For-profit Milk Banks (Prolacta, Medolac, Ni-Q, etc.). For-profit Milk Banks screen their donors and pasteurize their milk. There are a few main differences between non-profit and for-profit milk banks. The main difference is that for-profit milk banks compensate their donors for the volume of milk that is donated. The inclusion of compensation has some researchers concerned about the possibility of adulteration of the milk to artificially increase the volume (e.g. adding cow’s milk). Another difference is that some of the for-profit organizations use a pasteurization method other than Holder pasteurization that makes the donor milk shelf-stable. This method is not well researched. Current research shows that shelf-stable milk has less of an essential amino acid, lysine, and loses many of the important immune components found in human milk after processing. You can read more at these three sources, if you would like: https://academic.oup.com/cdn/article/1/8/e001438/4735239, https://journals.lww.com/jpgn/Abstract/2018/11000/Nutritional_Comparison_of_Raw,_Holder_Pasteurized,.22.aspx, https://journals.sagepub.com/doi/full/10.1177/0890334417710635.
Hope Lima, Ph.D., IBCLC is a private practice, international board certified lactation consultant (IBCLC) in the Rock Hill, South Caroloina area. You can find her at https://www.hopefeedsbabies.com/ and at Hope Feeds Babies Lactation, LLC on Facebook and Instagram.