Milk sharing, shmilk shmaring

I’ve been trying my hardest to avoid tackling the hot topic of milk sharing (or milk banks), but it seems to be the issue of the day. Hell, even Wired got in on the action. Typically, I’d take the fact that breastfeeding was discussed in Wired as a sign of the Apocalypse, but since the whole May 21 thing turned out to be a bust, I’m not banking on it. (Ha. “Banking”. And we’re talking about milk banks. Get it? That’s the extent of my wit when I’m all doped up on Tylenol Severe Cold.)

The reason I haven’t wanted to touch this topic with a ten-foot pole is that I’m honestly not sure what to think about it. My whole m.o. is wrapped up in this live-and-let-live mentality; it shouldn’t matter that I personally would be skeeved out to feed my baby milk from some random other mama, as long as you’re comfortable with it. I think informal milk sharing between friends or relatives – like my good friend, who donated some of her enviable freezer stash to her sister-in-law – is pretty awesome. But I do have an issue with how a misrepresentation of risk is deluding women into thinking that buying breastmilk off the internet is “safer” than using formula. And since, according to Wired, breastmilk is turning into quite the commodity, I think its time we had a little talk about some harsh realities.

First of all: breastmilk and breastfeeding are two separate concepts. I have seen these two terms being thrown around as if they are interchangeable, and that is just. not. true. Frequent readers of this blog know that one of my biggest complaints about breastfeeding medicine is that we spend so much time, money and energy on (mostly flawed) studies “proving” the superiority of breastfeeding over formula feeding, rather than performing more interesting, controllable, and ultimately helpful studies on the properties of breastmilk that are performing these magical feats. For example, there is strong and ample evidence that breastfed kids have a lower risk of ear infections. But what is providing this benefit? Is it something in the milk itself, or is it simply the delivery system? Is there a study comparing kids fed breastmilk out of bottles to those breastfed, in the most literal sense? And if it is indeed the milk, then wouldn’t it be cool to know what constituent of the milk is protecting little baby ear canals?

This is relevant to the topic of milk sharing, because until we understand the benefits of breastmilk versus breastfeeding, we can’t know the benefits of giving our kids donated milk. And for parents shelling out $32-60 a day to feed their babies human milk, I’m assuming these benefits matter. Even for those who have managed to find generous donors and are getting the milk for free, the potential health costs of unmonitored milk need to be weighed against the benefits.

Speaking of health costs… this is a sensitive subject. But just as I will freely admit that there are risks to formula feeding if one does not handle the formula properly, or uses bad water, or dirty bottles; or a company allows bug parts to get into their supply or what have you, I think we also need to be realistic about consuming a bodily substance from a stranger. Says Wired:

Screening milk donors turns up a surprising number of infectious agents—pathogens that could be passed on to a baby. A 2010 Stanford University study examined data from 1,091 women who applied to donate milk to a bank in San Jose, California. It revealed that 3.3 percent were rejected after their blood samples tested positive for at least one of five serious infections: syphilis, HIV, hepatitis B, hepatitis C, and human T-cell lymphotropic virus. And if these pathogens are in a donor’s blood, they can be present in the milk, too. 

 This doesn’t even begin to explain the potential risks of OTC and prescription medicines, herbal supplements, and diets – things that are considered “irrelevant” in much of the breastfeeding literature, despite a mind-boggling lack of evidence to back this “irrelevancy” up. For example, nicotine does get secreted into the breastmilk of smokers; so do some antidepressants, painkillers, etc. It is up to every mom to decide if the benefits outweight the risks when breastfeeding their own child, but just because I feel that taking Prozac while nursing is cool, it doesn’t necessarily mean you do. And if someone feels that it is perfectly safe to smoke, drink, or take certain meds because Kellymom or LLL or a message board tells them that it is, chances are they won’t think its worth mentioning in a Craigslist ad hawking their own breastmilk. This is not to say that milk donors aren’t altruistic – I would bet that most really are, that they truly want to help babies deprived of breastmilk… but even the milk of human kindness can be tainted with things that we might not want our kids ingesting.

Here’s a confession: I have found all four of the incredible babysitters I’ve used in the past 2.5 years through Craigslist. My friends think I’m nuts, but meanwhile, I have managed to find some of the best, most loving, educated and responsible women around to care for my kids. Sure, I had to interview a lot of duds, but even that wasn’t too arduous a process.  But many of my friends feel, understandably, that trusting someone you find on Craigslist with their babies would be utter stupidity. I think that’s probably a common belief. (Yet, how many women would take donated breastmilk from the same site with nary a second thought?) My point, again, is that many people may have great luck getting milk through a free internet site. But we shouldn’t make women feel that they are better mothers because of it. Just because I had a good experience on Craigslist finding childcare doesn’t mean that there aren’t baby snatchers scouring that same site. I felt comfortable with the candidates I found, but that’s partly because I can work from home and keep a close eye on what’s going on, sans teddy-bear nanny cams. I would never tell another mom to use this method of finding a sitter because it was “perfectly safe”, because my situation is a unique one.

Another issue we have to think about is that breastmilk straight from the tap differs from breastmilk that has been stored for days or weeks. Studies (controlled, in vitro studies, not observational ones like the kind most breastfeeding-related beliefs are based on) have shown that certain vitamins and antioxidants do not hold up well when breastmilk is frozen (although in the case of antioxidants, the frozen breasmilk still beat formula. You listening, Enfamil? Similac?). So unless you’re able to afford an actual wet nurse, your baby may not be getting the 24-karat liquid gold. Maybe more like gold-plated.

Now, obviously, one could argue that even gold-plated is better quality than the sterling silver that is infant formula. That’s absolutely your call. I personally like the look of sterling silver, and think it holds up better in the long term, but its a matter of preference. I definitely don’t think the government has a right to interfere in milk donation; parents have a right to buy and sell (or donate and accept) breastmilk just as much as I have a right to choose to formula feed. But I do worry about the repercussions of a formula-is-poison atmosphere as this breastmilk “niche industry” develops. Eavesdropping on a popular adoption baby board recently, I saw a disturbing discussion about donor breastmilk which completely misrepresented/misunderstood the risks of milk sharing, and could easily lead to adoptive mothers feeling derelict for not seeking out a source of breastmilk rather than formula feeding.

All I’m saying is that we need to approach these decisions realistically, with bifocals rather than blinders on. Someone recently commented on the FFF Facebook page that while breastmilk is a nutritionally superior substance, its not a morally superior one. I love this. But when it comes to donor milk, I also want to make sure that parents are fully informed and 100% sure that breastmilk is, actually, the nutritionally superior product – or more accurately, the overall superior product, with all the risks of human-derived bodily substances factored in. I suspect that processed, screened breastmilk from a reputable bank, as described in the Wired piece, is indeed superior to formula. But that still involves quite a bit of scientific intervention (and cost):

Collecting the milk is just the beginning of a lengthy process that also involves analyzing, purifying, and standardizing the product. Once a donation has been tested for microbes and found to be pure, a small sample is analyzed by a machine called a MilkoScan FT 120. It looks like an espresso maker and uses an interferometer to scan the milk. The result is a readout showing the proportion of protein, fats, lactose, and calories, which can vary from 12 to 38 per ounce. To sell to hospitals, banks must provide milk with a specific, consistent balance of nutrients and calories. To achieve that, the banks use a technology called target pooling—blending donations with various nutrient profiles until the optimal caloric value (around 20 calories per ounce) is achieved. Finally, they pasteurize the milk with a special technique that heats it to about 144.5 degrees Fahrenheit, minimizing the destruction of antibodies while killing viruses and other pathogens.

In sum, I think milk sharing is none of my business, or the governments, and is probably totally safe and fine for the most part. Which is what I think the attitude towards formula should be as well. Both are just food. Both need better science and better jurisdiction to make them truly safe and superior products. Neither make you a better parent for using them.

And frankly, I’m all for a breastmilk “market”. I imagine that if it is profitable, companies will start analyzing the constituents of breastmilk and discovering exactly what’s in the stuff that makes it so amazing. Considering the breastfeeding experts seem to have little interest in doing so (and would rather keep churning out poorly-designed studies that just provide fodder for lactivist blogs), I’m just glad someone will be performing these studies – even if its for profit-driven reasons. Just like that song in Cabaret says, money makes the world go round – and you know what? I’m fine with it.

Suzanne Barston is a blogger and author of BOTTLED UP. Fearless Formula Feeder is a blog – and community – dedicated to infant feeding choice, and committed to providing non-judgmental support for all new parents. It exists to protect women from misleading or misrepresented “facts”; essentialist ideals about what mothers should think, feel, or do; government and health authorities who form policy statements based on ambivalent research; and the insidious beast known as Internetus Trolliamus, Mommy Blog Varietal.

Suzanne Barston – who has written posts on Fearless Formula Feeder.

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23 thoughts on “Milk sharing, shmilk shmaring

  1. I was asked more than once why I didn't get donor milk for my daughter. I had major concerns about safety, and it would have been insanely expensive. I didn't just need a little bit to supplement. I was making less than a quarter of what she needed. There's no way we could afford to buy that much. Well, I suppose if we didn't pay our rent. We'd be homeless, but at least she'd be breastfed.

  2. Once again, you're a freaking rockstar. Thank you for validating my decision and quieting my fears (and responding so quickly to my frantic email). <3 you.

  3. I don't think i could milk share unless it was a very close friend or relative or equally trusted source… I just wouldn't feel comfortable. However, that's me, and what's good for me, that's not attempting to say that for all 🙂

  4. Thanks for some level-headedness on this issue.

    The militant lactivist community holds that one of the major benefits of exclusive breastfeeding “from the tap” is that the milk is tailored for the baby. This is cited to bash not only formula feeders, but people who mostly or exclusively pump. The interaction between the enzymes in the baby's saliva and the nipple was the reason one of my LCs told me pumping was vastly inferior except to keep up my supply (and even then it wasn't good enough, but that's a separate issue).

    While I can see where the fine-tuning of the BM might be a benefit, I'd like to know if this, too, is being overblown as the cure for all that ails ya (which would mean pumped and, by extension, donor milk isn't the vastly inferior solution I was led to believe), or if this is truly the “magic” responsible for any benefits seen to breastmilk. In which case, I can't speak for anyone else, but if I were paying $30-$60 per day for donor milk, I'd feel pretty ripped off.

    Another question is whether the donated BM needs to be given 24/7 to achieve the desired effect, or if combo-feeding is nearly or even just as good. Since it's so expensive, this would be good for parents to know.

    The lactivist community in general holds itself to be evidence-based. Yet I am hearing more and more lactivists promoting an “anything-but-formula” attitude when they admit that breastfeeding is not possible. These don't seem to be the militants, but rather, the middle-of-the-road folks who are at least willing to help the supposed “tiny minority” of women who cannot breastfeed. Yet you've summed up nicely the appalling lack of science behind the donor milk movement. I'm not against donor milk in the abstract (it's the “wet-nurse” of today, I guess), but I'm detecting a major case of hypocrisy, and would hate to see babies having adverse drug reactions to donor milk mothers' medications/herbal supplements, or worse, catch an incurable disease like HIV because of this extreme pressure to not formula feed.

  5. That Wired article had me scratching my head and saying “YUCK” at the same time. The thought of letting my baby drink milk from some stranger who is selling it on the Internet makes me shudder.

    I just can't believe that the “breast is best” movement has gotten so out of hand that people think that it's better to put their children at risk of incurable, life altering diseases rather than give them a perfectly acceptable and safe alternative: formula.

    Risk of formula: possibly a few more colds and tummy upsets in the first year. Risk of donor milk: HIV, Hepatitis and exposure to who knows what else. I'll take the cold over HIV, thank you.

  6. I read a comment on a facebook breastfeeding 'support' page which said “What sort of mother wouldn't be willing to pay $40 a day to protect their baby from Cancer?” Those sort of comments really make me cringe. Thanks for your balanced view on this and hopefully the increase in milk sharing will promote studies which look into the benefits of the milk and separate it from the benefits of the delivery method (most of which can be achieved while bottle feeding – no matter what is in the bottle) instead of just lumping it all together.

  7. I know my personality is way too anxious to obtain milk from milk sharing. I would worry about the time restraint it would put on the donor and her family. I would worry about the faithfulness of the spouse if there is one a d I would worry about the transport (unless they were my next door neighbor) or a power out if I had a winter storm. I just think formula does the job well enough to not risk it.

    Thanks for the post!

  8. Thanks for this balanced article. I've been a breastfeeder and even a LLL member, and this milk sharing makes me cringe, especially the informal milksharing groups found on social networking sites. The issue isn't simply whether the mother has a disease or takes dangerous medicines, although that is problematic, there is also the issue of whether the milk is collected under sanitary conditions, whether it is stored and transported properly, etc. It doesn't make sense for Lactivists to complain about how Medela breastpumps are unhygienic, and then promote informal milk sharing like it is a good thing.

    For some babies — very premature babies, medically fragile babies — getting breastmilk rather than formula may be very important. That's why I think milk banks which screen and treat milk, such as those that sell to hospitals, are very good things, but this milk is simply too expensive, and there is too little available, for it to be a viable option for a full term healthy baby. Let alone the fact that the benefits of the milk would be far lower for such a baby than for a preemie.

    What's worse than this? Making your own formula out of raw milk or liver rather than feed your child the “crap” that is in commercial formula. A baby may do OK on homemade formula, heck many babies thrived on evaporated milk and Karo syrup formula, as long as they had vitamin supplements, but I don't understand the thinking that homemade is better than the research based formula, carefully crafted to be as close to breastmilk and as highly digestible and nutritious as possible.

  9. @Lisa
    I can only think of snarky responses to that facebook comment.

    Let's see. At minimum wage of $7.25/hour x 8 hours = $58 per day (or, if you take $7.25/hour x 40 hours/week and divide by 7 days, you get $41.43 per day)…I'm guessing the single mom who makes minimum wage wouldn't be willing to because she's rather pay $40 a day to put a roof over her baby's head and food on the table. No sense in worrying about cancer if you and your baby are going hungry.

    Also, for me, it would depend on the cancer and the likelihood of preventing it. I mean, sunscreen is very effective at preventing skin cancer, but I don't think I would spend $40 a day on it. My son is probably not going to get breast cancer or ovarian cancer, so I'm not too worried about those. Colon cancer, on the other hand, runs in my family…still not sure about $40 a day. I mean, that's more than our mortgage payment each month. That's more than daycare. Unless it's a sure thing and he's 100% not going to get cancer, I really don't think I would pay $40 a day. Especially when people complain about how expensive formula is and that only costs me like $25 a week.

    Actually, if I had an extra $40 a day to spend on my son, he would probably have a nice little start of a college fund and we would be thinking about a baby brother or sister since that would cover the daycare costs of another infant. I just really can't imagine spending that much on milk. At that rate, it would actually be more cost-effective for me to stay at home with my son, in which case I might as well work on relactating or something.

  10. i'm been bfing for 10 months now and if something had happened, i would've definitely formula fed before using milk from someone else. even if it had been screened.

  11. I posted this on FB. I've had Lymes for over 20 years yet it took over 3 tests to determine I had it.This is another one that scares me because so many mother's could have it and not know. When I had my daughter I did not know about it and fortunately she is negative. My dr. believes by blind luck the double recurrent mastitis I got and continually being on antibiotics likely stopped the transmission. Still so scary when I think of the donated breastmilk. While I can see it being a great system for premature babies and so forth and I would probably consider it in that case obtaining it on craigslist would not be the way I would go. I am really concerned about people's diets, medications, and other habits and the fact that some disease like Lymes can take a long time to get a positive results. One of the many reasons why I go the route of Organic infant formula. Now let me just say I know that isn't flawless either, but it is USDA organic and FDA approved so I have a better recourse if something did go wrong.

  12. Dang it, another eaten post.

    Anyway, FFF, I totally agree with what you wrote so well here. I did not feel strongly enough about breastmilk to even consider this option for my children. However, if they had gone to the NICU and the hospital offered donated milk that had come via milkbank (and had been tested/pasteurized, etc) I would have been ok with that.

    As far as a link between cancer and breastmilk? What's their angle, the anti-oxidants? I doubt that anti-oxidants consumed as a baby is going to do anything to protect against cancer 50 or 60yrs later. If people consciously choose to eat anti-oxidant rich food throughout life, and give it to their children, that's a more likely way to gain anti-oxidant protection against DNA damage.

    Not anonymous, having issues posting here via Google. Amy M.

  13. I know that you are trying to walk a fine line and still promote that breastmilk is likely a superior substance. I don't really agree with that position though, which of course makes me not well liked amongst the AP/natural parenting crowd.

    My breastmilk was a vastly inferior substance for my child. But even if that weren't the case, the ear infection and GI issues still seem to be overblown. My understanding is that the ear infection link is from giving babies bottles at bedtime, not the actual formula.

    I don't want to come across as anti-breastfeeding. I'm not. I don't care how you choose to feed your child as long as they are fed. But I am dubious about any of the *scientific* claims about the superiority of breastmilk. The line that irritated me the most in the article was the scientific certainty with which breastmilk's magical properties were asserted. Certainly the media has made that position their preferred one. But I thought that the studies showed something altogether less clear cut. And I believe that the risks of donor milk are FAR greater than any *perceived* risk of formula.

  14. When I did casual donation, I was actually a bit weirded out that my donees didn't want blood tests even though I offered. If I were accepting donor milk, I'd sure as fuzz want a blood test! (the lady I donated to, her son had some violent allergic reactions to formula, every kind she tried -even the hypoallergenic- and she gave up after about 7-8 kinds)

    If I were in a position that I couldn't nurse, or had to supplement, I honestly don't know what choice I'd make. I tend not to think about such things until they happen.

    On one hand, yes, its gross that its another human, on the other, we don't know the cow we're getting milk based formula from. However, the dairy industry is regulated and casual sharing of milk is not.

    I'll tell you one thing, there's NO way I'd spend $60 a day to feed my kid breast milk. Formula is expensive, but it isn't THAT expensive.

    I think you summed up my feelings with this: “Both are just food. Both need better science and better jurisdiction to make them truly safe and superior products. Neither make you a better parent for using them.”

  15. Thank you for tackling this issue so thoughtfully. I have so many of the same concerns as you do. Mainly, I'm sad that low-income mothers, if unable to breastfeed, may be convinced into spending way too big a portion of their income on feeding their babies, believing the hype about breastmilk's superiority. What makes me even sadder is the guilt these same moms might feel if they are unable to afford donor milk, while knowing that it's an option available to them, if only they could afford it. We have enough guilt surrounding bottle-feeding without this to add to it.

    I exclusively pumped forever, it seemed, but when it was time for me to stop, I never once considered donor breastmilk. It didn't seem safe too me. Not only are there all the risks of disease and substances like alcohol to be wary of, but there is also the issue of how well the milk was handled and stored. Was the pump thoroughly cleaned? Was it refrigerated or frozen immediately in sterile bags? Was it out of refrigeration very long on its way to the donation center? You get my drift. There are too many unknowns for me. Formula just seemed safer.

  16. Very interesting topic.
    Here is my take, as a mom of very premature kids. I never wanted to breastfeed, but I wanted to provide breastmilk. I don't believe in Dr. Sears, but I do believe the studies surrounding NEC and breastmilk. Studies show that preemies given breastmilk over formula while under 40 weeks gestation have a 4% less likelihood of contracting NEC (a disease that kills the intestines of many preemies born under 2000 grams). Hence, I tried to pump while in the NICU. I think milk banks should be geared towards these babies at risk for NEC, b/c of the studies. That's where I draw the line. It's not about IQ or Ear Infections for those tiny ones, it's about life and death. For all others, do whatever suits your health, happiness, and lifestyle. I never breastfed and never wanted to. Once we were out of the “NEC” woods, I stopped pumping. I could go on and on, but I'm delighted to find this forum.

  17. This post is relevant for me. I breastfeed, but due to some issues with my baby, I almost exclusively pump. We've been successful at this and it's MUCH less stressful than trying to get her to nurse.
    Before this was figured out, I had low supply issues and my LC actually suggested going to a milk bank or using informal milk sharing ahead of using formula. First, who in the world (aside from Ricky Lake & Neil Patrick Harris) can afford milk from a milk bank? Second, I was absolutely not comfortable with using unscreened milk for my baby, so formula it was.

    Today, I make more than enough milk, but am unable to freeze it. Rather than throw it away, I found a lady who is more than happy to take my extra milk. It's never more than 2 days old and I'm crazy about food safety, so the milk's just fine. I find it odd that she's completely cool and trusting to take my milk, but I think she comes at it from the angle that I'm okay with giving it to my baby, so why wouldn't it be okay to give it to hers? I don't get it, but to each their own.

    Next, I have major issues with the idea of buying breastmilk from anyone other than a milk bank. I could see that it would be tempting for a mother who desperately needs the money to adulterate the milk somehow, either by watering it down or adding something to it. Plus, if a woman makes plenty of milk, what's to stop her from selling all her milk for $4/ounce, feed her baby the cheapest formula on the market and pocketing the rest? $4/ounce x 30 ounces/day adds up to a ton of money.

    As an aside, I have a serious problem with the whole “straight from the tap is superior to expressed” business. It's insulting to me that people denigrate the hours a day I spend alone & uncomfortable, and the endless bottles I have to wash (both for pumping into and for feeding), calling all that effort “second best.” Are you kidding me?! I, and all the mothers here, are doing the absolute best for our babies. How can that be second, third, or in the case of formula, “fourth best?” By feeding your baby formula, you are making an educated decision, based on your situation, as to how to feed your baby successfully. How in the h**l is this fourth best? That logic just kills me. Ugh. Sorry about that final rant, but I find it interesting that I feel more comfortable around formula feeders than around breast feeders, since like you all, I feel the need to explain why my baby isn't nursing. It sucks.

  18. Before I ran into my supply issues I fully intended to be a milk donor. Not an informal one though. I figured I'd been through exhaustive medical tests for immigration, I know I'm pretty healthy. And since I planned to start early on I could do it for the local hospital. But it was not to be. When my supply wasn't enough I considered using informal donor milk for my baby…for about 2 seconds. While she was fine on formula (other than constipation) onions, garlic, broccoli, tomatoes, citrus and a few other things in my diet caused vomiting, pain, scabby rashes and other problems in her until she was 6 months old (at 11 months we still have problems with tomatoes, onions and citrus and she can't eat broccoli). I'm happy doing an elimination diet, but the idea of having to call a donor because my baby is vomiting or breaking out in a weeping rash was not appealing.
    Thank you for mentioning the separation between breast milk and breast feeding!
    I actually fully believe that a lot of the more esoteric benefits said to come from breastfeeding don't come from the breast milk, they come from the 'extra' skin to skin. And that is something any parent, birth, adoptive, mother, father can do. Hug babies more. We are social animals. Extra touch is good for us.

  19. So here is what my book “Breastfeeding After Reduction” by Diana West, La Leche League International has to say about milk sharing:

    “Although wet nursing and informally donated mother's milk are also ways of obtaining human milk, the risks of communicating serious diseases through untreated milk are too great to suggest these as viable options. Milk banks are presented as the preferred method of obtaining human milk because their facilities collect, process, and store human milk in a standardized manner.”

    Informally donated human milk is listed as an unacceptable food for human infant feeding, along with unaltered milk from other species, soy beverages, homemade formula, water, glucose water, juice, or tea.

    I'm really undecided on this issue because I resent others telling me what to do with my baby, but like you it REALLY concerns me that informal milk sharing is constantly being blasted about the internet as the superior alternative to formula, yet there is plenty of evidence of serious risk which is lost among the lies about formula.

    But this new development of selling human milk informally instead of giving it away really concerns me. Profit motive = corruption. Women who donate breastmilk are almost certainly acting altruistically, and probably wouldn't purposely give you anything that would harm your baby (although could easily be unaware that they have a harmful disease or that their prescriptions could be harmful), but women who sell it are trying to make a buck and may or may not be honest. Who is to say what you just bought is 100% breastmilk? What stops the person from thinning it out or adding in cheap formula? Or even powdered cow's milk or something else you shouldn't be giving to a baby? And I could easily see them lying about what drugs they're taking, their diet, or forging test results showing they are disease-free. This isn't a church bake sale. This is A LOT of money.

  20. “Informally donated human milk is listed as an unacceptable food for human infant feeding, along with unaltered milk from other species, soy beverages, homemade formula, water, glucose water, juice, or tea.”

    See, this is what bothers me about the oft-cited WHO recommendations in which formula “comes in last” as the “fourth choice.” Those are only the ACCEPTABLE food sources for human infants. There are still so many other food sources that don't get listed. If you count just the things listed by Antigone, formula is #4 out of 12, not #4 out of 4. Big difference!

  21. It also really strikes me that decisions about infant feeding are (and have been) a major source of classism. In Victorian England, rich women would hire wet nurses, not only if the had problems breastfeeding, but if they wanted to be able to get pregnant again right away (for example to produce heirs for their husbands). The wet nurse would then leave her baby in the care of “baby farmers” who might wet-nurse the babies or feed them other things. In other cultures even today, wet nurses are a sign of affluence.

    Back in the post-WWII era, formula became the preferred choice among middle-class and wealthy women. Low-income women breastfed because they couldn't afford formula.

    Now we've seen that reversed. Breastfeeding is most prevalent among middle-class and wealthy, educated, older, white moms. The price of human milk is so high that only the wealthy can afford it if they don't produce enough. And free donor milk faces absolutely no regulation unless the donee can afford to pay for testing.

    Beyond the actual cost of human milk, low-income women face class-based barriers to breastfeeding, such as little or no paid maternity leave and lack of access to pumping facilities and breaks to pump or nurse their babies. Yet at the same time that they lament these barriers, breastfeeding advocates say that women “need to be better-educated” about the benefits of breastfeeding, which I think in plenty of cases means “poor women and minorities need to be told what's best for them.”

    I also think there's a point (not sure exactly where) where legitimate public health and evidence-based medicine stop and breastfeeding becomes simply a trend, the popular thing that “all the cool moms are doing” and that will eventually be replaced by something else that puts it even farther out of the reach of lower-income women and minorities. Donor milk? Exclusive pumping? Perhaps a return of wet-nurses?

  22. I don't even have a second thought about this… I'm sorry, but there is NO WAY IN HELL I'd give my baby donated milk from an informal bank. I combination feed, and when I was having trouble, a bunch of women on a parenting group I belong to offered me their milk. To me, that's about the same as letting them have sex with my baby, in terms of risk… HIV, Hep B and C, Syphilis, blah… NO WAY.
    This said, my long-term best friend did nurse my baby a few times when I was in hospital. I know her and her husband very well, and I had no problem with it, because it was the only way my son would go to sleep.
    My line of reasoning is that if I wouldn't sleep with them unprotected, there's no way I'm giving their milk to my BABY. FFS! It's crazy! Breast milk isn't best if it gives your baby bacterial poisoning or HIV. NUTS!

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