Joint EMBA and HMBANA statement on milk sharing has been released.

In January 2015 EMBA, in collaboration with the Human Milk Bank Association of North America (HMBANA) issued a statement advising families about the possible risks of buying or sharing breastmilk obtained via the internet.

MILK SHARING

A statement from the European Milk Bank Association (EMBA) and the Human Milk Banking Association of North America (HMBANA)

Human milk and breastfeeding

Human milk (breastmilk) is the normal, optimal and most desirable food for human infants. It provides highly bio-available nutrition as well as an unrivalled combination of immunologic, bioactive and anti-infective components that promote health, protect against infection and support a baby’s immune system. For this reason EMBA and HMBANA and their member milk banks are committed to improving the health of populations through promoting breastfeeding and human milk as the first food for all babies.

Milk Sharing

The sharing of human milk has existed since the beginning of time. Mothers have either breastfed children who were not biologically related to them or expressed and shared milk with a child other than their own. In early times if a baby did not receive human milk they died as there were no safe alternatives. In more modern times breastmilk substitutes have been developed for those times when a mother is unable or unwilling to breastfeed or provide enough of her breastmilk.

Milk banks

Breastmilk is especially critical for the healthy survival of very low birth weight, premature and sick infants. Mothers of these infants may be unable to provide sufficient human milk for their needs particularly in the early days following the baby’s birth. Milk banks affiliated with EMBA and HMBANA follow rigorous protocols to screen donors, test, process and dispense the donated milk and to provide safe donor human milk to these infants.

Milk sharing outside milk banks

In recent years, increasingly, mothers who are unable to breastfeed or supply enough of their milk for their full term, healthy babies have come to use networks developed through the internet to obtain breastmilk. These connect them with mothers who wish to share or to sell their milk.

What are the risks associated with milk sharing?

Human milk, when shared outside milk banks that follow accepted guidelines, does not provide the same safety guarantees and the possibility of serious adverse consequences cannot be ruled out. The main risks of sharing milk are that it is contaminated with pathogenic bacteria as a result of suboptimal collection, storage and transportation or that it contains viruses as a result of the mother having unknown infections which may be transmitted via the milk. These include viral infections such as HIV, Hepatitis or HTLV (Human T Lymphotropic Virus). In addition, the shared milk may contain medications taken by the mother as well as alcohol, nicotine, drugs and other contaminants.

Harmful bacteria ingested in large quantities through breastmilk may lead to severe infections including septicaemia. Viruses such as HIV and HTLV in breastmilk can cause serious illnesses, some of them manifesting several years after contamination. Screening of donors, milk testing and appropriate pasteurization, as routinely done in human milk banks, greatly reduces the risks associated with sharing breastmilk.

Donating to milk banks

Mothers with spare milk have the option to share it with the babies who will benefit the most and this will be by donating it to an EMBA or HMBANA affiliated milk bank. These milk banks do not financially profit from or commercialise human milk and the milk they provide will be life enhancing and often life saving for low birth weight and premature babies or infants recovering from serious gut complications and surgery. The increased demand from neonatal intensive care units for the growing numbers of premature infants will only be met by more mothers choosing to donate their milk to human milk banks. The provision of safe, screened and tested human milk by milk banks has also been shown to promote and support breastfeeding enabling more babies who were born too soon to be discharged home fully breastfeeding and more mothers to continue to breastfeed.

Recommendation

Informal sharing of breastmilk presents health risks to infants receiving the milk and reduces the supply available for milk banks to dispense to very low birth weight and preterm infants. EMBA and HMBANA strongly discourage internet mediated sharing or selling of breastmilk and fully endorse the promotion of breastfeeding and donation of surplus breastmilk to non – profit milk banks. We advise all parents to be aware of the risks involved in feeding a baby with another mother’s milk and before doing so to consult a qualified healthcare professional such as a pediatrician, neonatologist or hospital infant feeding specialist.

January 2015