When moms cannot breastfeed or cannot provide her own pumped milk for her baby – whether it’s because she is having difficulty with her milk supply or her baby is premature or has other medical issues – the next best choice is donor breast milk. In the past, moms might have chosen to use a wet nurse or have another family or tribe member nurse their babies. But in 21st century Western culture, wet nurses just don’t exist and informal milk sharing is discouraged. Enter the human milk bank – a modern equivalent of the wet nurse.
Like a blood bank, a milk bank pre-screens moms for safety, collects milk from multiple mothers, combines the milk, and processes it for use by others. The milk pasteurization process preserves nutrients and antibodies while making sure no pathogens persist in the pooled milk so it’s safe for consumption. This is especially important for babies whose health may already be compromised. Milk banks are sometimes for-profit and sometimes operate as non-profits.
Because one in eight babies is born prematurely, and because premature babies tend to have more health problems than those born at term, human milk is an essential part of their diet. While moms of premature babies can pump, the fact is that only about half of these women can provide enough breastmilk for their babies. With donor milk, their babies can receive the antibodies and growth hormones in human milk to help them thrive.
Other reasons babies might receive donor breast milk include failure to gain weight appropriately, malabsorption syndromes, allergies or intolerances to formula, infectious diseases, and death of the mother. Babies with the highest medical need are prioritized to obtain milk before healthy babies (since donor milk is dependent on a fairly small pool of donors).
Reasons moms may need to provide donor milk rather than their own breastmilk include delayed establishment of milk supply because of premature delivery, multiple birth, maternal illness that precludes breastfeeding or pumping, medications incompatible with breastfeeding but essential for mom’s health, and chronic infection (like HIV) with which breastfeeding is contraindicated.
Because the collection and processing of milk is labor-intensive, milk banks do charge a fee for their product. Milk banks typically work with the hospital to coordinate services. Several states – California, Kansas, Missouri, New York, Texas, and Utah, as well as Washington DC – allow Medicaid funds to cover the cost of donor breast milk. Private health insurers vary, so working closely with your insurance company will help you determine if you have coverage for donor milk.
If you are interested in donating milk, strict protocols for collection are typically used, so contacting a milk bank before you start pumping and storing milk is best. Moms who are using herbal supplements or taking medications are usually not able to donate their milk. A thorough health evaluation will be conducted of any potential donor. Non-profit milk banks do not pay moms for their milk, where some for-profit milk banks will compensate mothers for the milk they produce. Reasons why women donate their milk vary from person to person. If you have oversupply, this may be a great way to do something worthwhile with all that extra milk! In addition, moms whose babies have died may find solace and closure by donating their breastmilk.
You can learn more about milk banking – whether you want to donate or think you might be eligible to obtain milk for your baby - through the Human Milk Banking Association of North America at www.hmbana.org.