Formula Shortage Shines Light on Breastmilk Donation

Debbie Laplaca
Certified human milk banks screen donors, and safely collect, process, handle, pasteurize, test, and store the milk.

"Breast is Best" may be a catchy phase to emphasize that a mother’s own breast milk is often the best choice for baby’s first food but for some, it’s simply not an option.

Is formula the next best first food?

According to the U.S. Surgeon General, the American Academy of Pediatrics, and World Health Organization the answer is no – the next best is safely handled human donor milk.

The recent large-scale recall of popular baby formulas at a time when resources were already stunted by supply chain challenges emptied store shelves and prompted many parents to explore the option of donor milk.

Is donor milk safe?

When obtained through a certified milk bank, the U.S Food and Drug Administration says yes. When sourced through internet social media, the FDA says no, but grassroots milk sharing networks and the many thousands of parents who use them, disagree.

Before deciding whether donor milk is right for your family, the FDA says parents should first consult with the baby’s healthcare provider because the baby’s age and health are factors in nutritional needs.

Who needs donor milk?

There are many reasons donor milk may be the optimal option for parents. It could be as simple as needing a temporary supply while awaiting a mother’s own milk to come in, an adoption, or it could be more complex, such as health conditions with mother or baby.

Human milk banks

If the decision is to use donor milk, the FDA recommends acquiring that milk only from a source that ensures its safety.

Human Milk Banking Association of North America accredits 31 nonprofit milk banks in the U.S. and Canada. Member milk banks qualify for this distinction by following rigorous processes for donor milk safety.

These certified human milk banks screen donors, and safely collect, process, handle, pasteurize, test, and store the milk.

Milk banks often prioritize the distribution of processed donated milk to babies with medical needs, such as those in the neonatal intensive care. The pasteurization ensures it is safe for sick babies.

Parents of healthy babies may also buy from milk banks with a prescription, but it can be costly.

Local milk banks

Human Milk Banking Association of North America accredits only one nonprofit milk bank in New England: Mothers’ Milk Bank Northeast.

This Massachusetts-based bank is certified for its practice of strict screening, processing, and dispensing, which is done in consultation with the FDA, Centers for Disease Control and Prevention, New York State Department of Health, and the blood and tissue banking industries.

Its pasteurized donor milk is primarily given to medically fragile babies in neonatal intensive care units, special care nurseries, as well as well-baby units at more than 100 U.S. hospitals.

Mothers’ Milk Bank Northeast has one Massachusetts dispensary at Northampton Area Pediatrics in Northampton for babies who are not hospitalized, with a prescription from a medical professional.

The banks other New England dispensaries are Glastonbury, Conn.; Lewiston, Maine; Portland, Maine; Belmont and Lebanon, New Hampshire; and Essex Junction, Vermont.

Another other option is to order online for direct shipping to the home.

Using a HMBANA-certified, nonprofit milk bank ensures donor milk is safe but there is a fee for pasteurized human donor milk to cover the costs associated with the process of screening donors, testing, pasteurizing, and shipping.

The donors

At Mothers’ Milk Bank Northeast, donors are not paid but rather give their milk altruistically, which is said to eliminate incentives to tamper with milk or provide inaccurate health information.

Those donors are healthy, lactating women with surplus milk. Some are bereaved and wish to support the nurturing of another child, while some are surrogate mothers. More than 10,000 donors have shipped milk or dropped it off at one of the bank’s 28 deposit sites in nine states.

Mothers’ Milk Bank Northeast donors are screened, in part, through oral and written medical and lifestyle histories, blood tests, and physician letters confirming the donor’s health.

Conditions that disqualify women from milk donation include, but is not limited to, sexually transmitted diseases, illegal drug use, and excessive alcohol consumption.

Milk sharing networks

Another widely used source for donor milk is called informal milk sharing.

The FDA and American Academy of Pediatrics discourage the practice of acquiring human milk directly from individuals or through social networks because it carries the potential risk of inadequate screening or storage. Yet formula shortages and what can be pricey milk bank resources have prompted more people to donate to and source milk from informal milk sharing. One such Internet-based network is Eats on Feets, a world-wide network for those who have made the choice to share breastmilk.

It was founded in 1991 by Shell Walker Luttrell, an Arizona midwife, who had fostered milk exchanges between families within her community. According to Eats on Feets, it became the first of its kind on Facebook in 2010.

Eats on Feets says community-based breastmilk sharing works because parents, caretakers, and professionals help ensure babies have access to “commerce-free and safe donor breastmilk.”

“Every day, donors from around the world selflessly offer thousands of ounces of breastmilk through Eats on Feets directly to the families of babies in need, making a huge difference in their lives,” the website states. “Eats on Feets simply provides a space to initiate contact, a website with safety information, and guidelines for networking through its Facebook chapter pages.”

The Eats on Feets Massachusetts Facebook page has more than 2,600 followers.

The community-acquired donor milk is arranged through direct family-to-family contact, without intermediaries. It is operated by volunteers with no exchange of money for milk through its network.

The network also offers parents guides and resources to prepare and achieve the first of its “Four Pillars of Safe Breastmilk Sharing,” which is informed choice. The other pillars are donor screening, safe handling, and home pasteurization. Human Milk 4 Human Babies Global Network offers similar services to its 80,898 global Facebook page followers. The network has a private Massachusetts-based Facebook page that requires membership for access.