Websites for Sharing Breast Milk Raise Concerns About Health Risks

Andrew Kitchenman | December 2, 2013 | Health Care
Bills call for state regulation, but advocates of increasingly popular practice downplay danger to babies

Dr. Sharon Mass, chairwoman of the New Jersey chapter of the American Congress of Obstetricians and Gynecologists
Are babies being put at risk by the proliferation of unregulated websites that share or sell human breast milk?

Concerns about contamination due to unsafe storage and shipping have doctors and health advocates calling for tighter controls and monitoring of the increasingly popular practice among mothers who can’t produce their own milk.

And those worries have prompted Assemblywoman Pamela R. Lampitt (D-Burlington and Camden) to introduce two bills that would increase public awareness of the potential dangers of informal milk sharing and require state licensure of milk banks.

The health concerns are backed up by research studies, including a recent one published by the journal Pediatrics, which found that human milk purchased via the Internet exhibited high overall bacterial growth and was frequently contaminated with pathogenic bacteria due to poor collection, storage, or shipping.

Medical experts say those concerns would be eased if breast milk was available only through licensed milk banks affiliated with hospitals, which engage in practices such as pasteurization to ensure that the milk is safe.

Dr. Sharon Mass, chairwoman of the New Jersey chapter of the American Congress of Obstetricians and Gynecologists, agreed that breast milk provides a wide variety of important health benefits. She noted that her organization recommends exclusive breastfeeding for all newborns, including those born prematurely, unless there’s a medical reason not to. In addition, Mass said it’s true that some mothers can’t provide their babies with milk.

However, Mass said, women should use milk from licensed milk banks instead of using the unregulated milk-sharing sites.

“If it’s not regulated and it’s not licensed, then we have no idea about the quality or safety of that milk,” said Mass, ACOG’s representative to the United States Breastfeeding Committee, a nonprofit that coordinates national breastfeeding initiatives.

Advocates for informal milk sharing, however, downplay those concerns and say there isn’t enough evidence documenting the supposed health risk.

The administrator of the New Jersey chapter of the Facebook-based Eats on Feets, disagreed strongly with the call for licensing and tighter controls.

“It is unfortunate that the community efforts to provide for one another are seen as threatening enough to make laws about,” said Nicole Lombardo Buratti in a statement. “The families here support each other and exercise their rights as parents to feed their children in the way they believe is safest, considering the known risks of short- and long-term formula feeding and poor health of children.”

But Mass said a wide range of bacterial infections or viruses, including HIV and hepatitis, can be spread through unregulated milk sharing. In addition, her organization is concerned about improper storage.

“It’s just very, very dangerous because people are trying to do the right thing by giving their baby breast milk” but could endanger their child, Mass said.

Mass noted that some women sell their breast milk.

“This would be like people selling their blood online – wouldn’t you rather get it from the Red Cross?” said Mass, who practices in Morristown.

Mass said it’s important to encourage the safe use of breast milk. She noted that breast-feeding is good for both babies and mothers, fostering disease prevention and IQ growth for babies and faster weight loss and cardiovascular benefits for breastfeeding women.

She also cited an estimate that the national economy would save $13 billion annually if more women breastfed, primarily by improving infants’ health.

But Mass said the way to reach that goal is by promoting licensed and accredited milk banks, not informal milk sharing.

Lampitt said news reports about these health concerns prompted her to introduce the two bills dealing with breast milk sharing.

One measure, A-3702, would require the state Department of Health to establish a public awareness campaign informing parents about the potential dangers of informal milk sharing, which the bill calls “casual milk sharing.”

The other bill A-3703, would provide for the state licensure of human milk banks.

The license requirements would be set by the state health commissioner. The rules would include provisions regarding the qualifications of milk-bank employees; procedures for screening milk donors; standards for collecting, processing, storing and distributing the milk; and the maintenance of confidentiality.

Lampitt noted that is a wide range of parents who could need breast milk, including gay couples and mothers who cannot breastfeed because they are taking medication.

“At the end of the day, it’s about giving a baby an opportunity to thrive and to be able to find the nourishment that it needs,” said Lampitt, adding that during Hurricane Sandy she read about how people posting on Eats on Feets were both seeking milk and offering to share their supply before it spoiled due to power outages.

Angela Bond, a consultant for Eats on Feets, said the transmission of disease through informal milk sharing is a “theoretical” concern. She said Eats on Feets hasn’t had a single documented case of an infant who received shared milk contracting a bacterial or viral infection that required medical intervention.

“The term ‘casual milk sharing’ is pretty offensive to those involved – it’s hardly casual,” added Bond, who is based in Phoenix and shared milk through Eats on Feet while nursing her two daughters.

Bond also called any public-awareness campaign unnecessary. “The idea that parents aren’t aware that there’s a risk from milk sharing is a little naïve,” Bond said.

She said it’s too early for states to consider bills like Lampitt’s, saying there hasn’t been enough national research.