Get the lowdown on using donated breastmilk

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Breastmilk is always precious, but even more so when a mum is unable to provide her own.

Hundreds of breastmilk banks have sprung up worldwide, and informal milk-sharing networks on the internet are becoming increasingly popular ways of matching up donors and recipients. So what are you to do if you can’t breastfeed, don’t have enough milk or have too much and want to donate it? Where can you go and what do you need to do? Here’s the lowdown.

Hospital and community milk banks

There are hundreds of breastmilk banks globally (Brazil alone has 212!), but in Australia there are only five formal milk banks: The Perron Rotary Express Milk Bank at the King Edward Memorial Hospital in Perth, the Royal Brisbane and Women’s Hospital Milk Bank, the Royal Prince Alfred Hospital Women and Babies in Sydney, Mothers’ Milk Bank in northern NSW, and Melbourne’s Mercy Health Breastmilk Bank.

All of these breastmilk banks screen their donors in a similar way to blood banks, with a health and lifestyle questionnaire and blood tests for diseases including HIV and hepatitis B and C. “We all ask pretty similar questions,” says Kerri McEgan, unit manager of the Mercy Health Breastmilk Bank and Lactation Department, which has provided donated breastmilk to over 100 babies since it opened in 2011. At the Mercy, donors need to have given birth at that hospital and newborn recipients only qualify to receive donated milk if they are born under 32 weeks and weigh less than 1.5kg. “That’s pretty standard milk bank criteria for two reasons,” says Kerri. “One is medical, as that’s the peak time for necrotising enterocolitis.” This is a serious bowel condition more prevalent in premature babies fed formula compared to donor breastmilk, she explains. “The other reason is supply, as babies over 34 weeks start to consume bigger volumes and most milk banks can’t keep up with that.”

In the hospital nursery setting, Kerri often consults mums who are very grateful to receive donor milk for their tiny bubs. “Many feel disappointed they can’t provide everything their baby needs, but there’s also relief that donor milk has taken the pressure off them and enables them to focus on expressing.”

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Online milk-sharing communities

Many mums have set up informal milk-sharing networks online, including actress Alicia Silverstone via her blog The Kind Life. She started Kind Mama Milk Share in June when a friend struggled to breastfeed after breast-reduction surgery. “There’s no reason why [women] shouldn’t be able to give their babies the most amazing start in life with clean, mean, glorious breastmilk,” the mum-of-one wrote. “I say we help support those mamas and babies who need a hand during one of the most important times in their lives.”

By far the largest milk-sharing network online is Human Milk 4 Human Babies, which has over 15,000 fans on it’s global Facebook page and over 6000 Australian ‘likes’. Women advertise whether they need or wish to donate breastmilk on the network’s area-based Facebook pages and set up their own private arrangements.

There are lots of reasons families seek out donor milk, including supply issues, other breastfeeding hurdles, adoption or surrogacy, maternal illness or, sadly, death. “We don’t question the reason why families seek breastmilk and we don’t prioritise requests or offers,” says mum-of-three April Bevin, one of the network’s volunteer administrators, who has donated over 10L of her own milk.

The biggest criticism of online milk sharing is the risk of disease being passed on to the bubs, as breastmilk is a living bodily fluid. “It’s up to the participants to get to know each other, ask questions and continue engaging with one another until a relationship of trust is established,” says April, who adds some recipients request blood tests from their donors, ask questions about hygiene practices around the expressing and storage of milk, or even flash-pasteurise the donor milk at home. “Generally if a healthy woman is breastfeeding her own child who is healthy and well, a lot of people see that as a good start,” adds April. “Expressing, storing and donating breastmilk takes time and energy, and is not always easy. When milk is shared in a commerce-free environment, the most common incentive we encounter is love and a belief that all children deserve breastmilk.”

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Wet-nursing and cross-nursing

There are many examples of wet-nursing in history, including in ancient Egypt and Greece. During the Renaissance period, wet-nursing was a well-paid profession for poor women – many aristocratic mothers chose not to breastfeed because it was thought to ruin their figures and interfered with social activities such as going to the theatre. By the 19th century, wet-nursing slowly phased out with the invention of the feeding bottle and the use of animal milks. Cross-nursing, however, is still practised today, usually as an informal arrangement between sisters, cousins or friends. If a mum is going to be away from her baby for any length of time, she leaves bub with a close breastfeeding contact who will step in with a breast if needed.

Many mums are happy to help a friend or relative when supply is an issue. One such mum is Bronwyn Hinz – she was able to breastfed her two-week-old niece, who was recovering from a tongue-tie operation. Bronwyn’s sister had insufficient breast tissue and little milk. “The breastfeed was to assess my niece’s sucking strength and provide nutrition,” says Bronwyn, who then expressed milk for her sister to feed using a supplementary nursing system (a tube delivering her milk attached to her sister’s breast). “I was more than willing to help my sweet niece and sister in any way I could.”

The World Health Organization and UNICEF state, “where it is not possible for the biological mother to breastfeed, the first alternative, if available, should be the use of human breastmilk from other sources. Human milk banks should be made available in appropriate situations.” As accessing breast milk banks is quite restricted in Australia, the most common substitute for a mother’s own breastmilk is commercially made infant formula, which is a perfectly acceptable and safe alternative, especially in a country that has access to clean water and electricity to hygienically prepare it. Still, it’s great to know milk sharing is out there, says April. “There are cases that really do touch my heart – there are recipient mothers who struggled with low milk supply, used donor milk with an at-breast supplementer and eventually built their supply to the point they then became donors.” Share and share alike.

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