I recently donated 1300 ounces (TEN GALLONS) of breast milk to infants in need.
And I’ve never been more ecstatic to have an empty freezer, because it means:
- No more frozen milk bricks falling off the shelf and crushing my toe when I open the door to grab frozen peas for dinner.
- There is sufficient room for the frozen peas again.
- All of that hard work to establish my milk supply in the beginning has more than paid off because, not only am I able to sufficiently feed my baby, but I was able to lend a hand (boob?) to the nutritional advancement and physiological development of babies across the country.
Talk about WOW.
My veil of naivety about breastfeeding came crashing down the second that tiny mouth to feed became a reality. It didn’t matter that I had read numerous books on the subject beforehand and saw nine lactation consultants within the first few days of motherhood. It is impossible to fully prepare for the whole latching-on, pumping-to-build-your-milk-supply, “is this normal?!”, leaky boob process. Not to mention, my son was almost a month early, which resulted in my body not being ready to produce milk right away AND him having difficulty latching for several weeks and needing a bottle instead. We fed him by plastic spoon for the first two days. After that, being in a panic that I would never be able to feed him properly, I was attached to that pump every two hours as instructed by the nurses, around the clock. This pattern continued for many weeks until I was confident enough in my ability to feed him directly from the tap. As a result, I stockpiled a ton of milk– FAST. So much that we not only filled our freezer, but also my mother-in-law’s.
I’m telling you this because everyone has a different experience with breastfeeding. I think it’s safe to say that, at least in the beginning, it’s a challenge for everyone (IMO, it was effing hard). I have plenty of friends who, though they tried their damndest, were never able to produce enough (or unintentionally lost their supply due to other factors) and instead had to supplement with formula (which does NOT mean you are a failure, by the way). That said, we all know that the first choice for infant nutrition is breast milk; that’s why it’s so commonly referred to as “liquid gold”. Nonetheless, breastfeeding is not easy or feasible for everyone, which is where the awesome –and under-celebrated– process of milk donation and sharing comes in.
So, how does it work?
There are a few avenues for donors and recipients that I would like to highlight:
Milk banks that are affiliated with the Human Milk Banking Association of North America (HMBANA)
Created in 1985 with the mission to “reach the most vulnerable infants first”, HMBANA is a professional organization for supporters of non-profit milk banking. There are currently 24 HMBANA milk banks in the US and Canada, with five more in development. HMBANA provided milk to 39 states and 264 cities, as well as 3 provinces and 7 cities in Canada in 2010. All HMBANA milk banks are non-profit organizations.
Milk that is donated to a HMBANA bank follows a certain process. Once collected, it is mixed with milk from a few other donors to ensure homogenous nutrient distribution, pasteurized, tested for bacterial contamination (discarded as needed), and frozen for delivery to hospitals and individual recipients. Pasteurization does not negatively affect most of the bioactive compounds in the milk. FAQs regarding the pasteurization process can be found here.
HMBANA goals are outlined below, straight from their website:
- Ensure quality control of donor human milk banking among member banks through adherence to these mandatory Guidelines and periodic inspection of member banks
- Annually review Guidelines for donor milk banking practices in North America
- Provide a forum for networking among experts in the field on issues relating to donor human milk banking
- Provide information on the benefits and appropriate uses of banked human milk
- Communicate among member donor milk banks to assure adequate supplies for all patients
- Encourage research into the unique properties of human milk and its uses
- Act as a liaison between member institutions and governmental regulatory agencies
- Advocate for increased use of donor milk by fostering development of new non-profit banks
- Promote, protect and support breastfeeding for mothers and infants
FOR DONORS: Search the HMBANA website for a milk bank near you. Contact them directly to start the process, which is done at no cost to you. There is usually a minimum donation requirement as well as blood testing. You may continue to donate as many times as you like, as long as their donor requirements are met, and they will send you the necessary supplies to do so. HMBANA does not pay donors for their milk.
FOR RECIPIENTS: HMBANA milk is prioritized for the most critical of infants, usually in NICUs across the country, so typically this milk is only provided in a specific inpatient setting. However, milk is sometimes provided to infants at home with feeding intolerances or medical conditions due to prematurity, as well as adopted babies whenever possible. In order to access milk from a HMBANA milk bank, a prescription is required. HMBANA does not charge recipients for milk. A processing fee is charged to the hospitals to help cover the processing costs necessary to ensure safety. To learn more about the processing costs, read an interview with a HMBANA milk bank here.
MY EXPERIENCE included a 15 minute introductory interview and pre-screening questionnaire over the phone, a few days after which a packet of paperwork and instructions, sterile 6 oz milk bags, pump cleaning equipment and donor labels, as well as a styrofoam cooler with a prepaid Next Day Air UPS shipping label, were sent to my house. I had the required bloodwork done at an approved laboratory, and had my midwife and pediatrician sign a simple form. There was a minimum donation requirement of 200 ounces, which could not be older than 3 months. Once I had all of this completed, I packed the cooler full of frozen milk, covered it in crumpled newspaper, taped my paperwork to the top, and dropped it off at UPS. I received a thank you call the next morning from the milk bank, to confirm that it had arrived safely. Easy peasy lemon squeezy.
Milk banks that are NOT members of the HMBANA
If there are no HMBANA milk banks in your area, and you want to use another bank, there are some other options to consider. Note that I do not have experience with these and cannot comment on their efficacy or reputation. However, many non-HMBANA milk banks appear to be affiliated with for-profit organizations such as Prolacta Bioscience or Mother’s Milk Cooperative/Medolac. It seems that these organizations use most, if not all, donated milk to manufacture high-profit human milk nutritional products for infants.
The International Breast Milk Project was created to provide breast milk to ill or malnourished infants in South Africa; however, after partnering with Prolacta in 2010, 25% of milk donated to IBMP goes to South Africa, while the remaining 75% goes to Prolacta for manufacturing of Human Milk Fortifier supplements for children in domestic NICUs. I was able to find one individual’s (The Lactivist blog) take on this arrangement here.
Some non-HMBANA milk banks:
Mother’s Milk Cooperative (Medolac)
National Milk Bank (Prolacta)
Helping Hands Milk Bank (Prolacta)
Tiny Treasures Milk Bank (Prolacta)
Informal or Private Arrangement Milk Sharing (PAMS)
PAMS is essentially modern day wet-nursing. Milk sharing has been done for many centuries, in many cultures. In the United States, wet-nursing is much less common today than is the use of infant formulas, despite studies that have suggested a higher risk of various health outcomes among formula-fed versus breast fed babies. In fact, wet-nursing is often considered so “unconventional” now that when it does happen and people know about it, it becomes newsworthy. PAMS does not support exchange of money for breast milk, and assumes no liability for the health outcomes of the milk that is shared as there is typically no screening done for donors. It is the responsibility of the donor to ensure their health before donating, and the the responsibility of the recipient to take steps needed to ensure the safety of milk they accept (i.e. via home pasteurization).
The following are a few milk sharing networks that connect donors with recipients.
Human Milk 4 Human Babies (HM4HB)
FOR DONORS AND RECIPIENTS: Through one of these networks, find your local community and post your offer or request accordingly. The page administrator will see to it that your offer or request is shared on the page, at which point you will be contacted directly by any interested parties. You are then responsible for setting up the milk exchange; the network does not do this for you.
TIPS: Only interact with individuals with whom you are comfortable. You do not have to respond if you are uncomfortable and should report any suspicious activity to the page administrator and/or network. You are not expected to offer your milk on a first come, first serve basis, nor can people put “dibs” on your milk. Recipients should ask any questions they wish to be answered by the donor up front. You have the prerogative to choose where your milk goes, and from whom you receive your milk. Lastly, when meeting a stranger to exchange milk, choose a safe public place to do so, as is smart with any transaction of goods.
MY EXPERIENCE began when I had donated all that I could to the HMBANA milk bank and still had ~1000 ounces left of milk that was nearing 6 months old (remember, the milk bank I chose only accepted 3 month old milk). I found HM4HB through an internet search, did more research into the informal milk sharing process, and posted my offer on the Facebook page. Within a couple of hours, I had four people message me. They shared various details about their particular situation and I ultimately chose two families to receive 500 ounces each. Both donations would go to adopted children; one had not been born yet, and the other was recently united with her family through the “stork drop” adoption process. I met them both at our local police station and they were both extremely grateful, one of them even slipping me a thank you note inside some replacement Lansinoh bags (a common “currency” in the informal milk community).
I would say that milk donation is up there on the list of “top coolest things I’ve ever done”, and I would do it again in a heartbeat if I were to accumulate excess milk. In the meantime, I will be a fierce advocate for both donors and recipients, but most importantly, for the little babies who benefit so much from this process.
Some additional good-reads on infant feeding and milk sharing options:
- Milk sharing and formula feeding: Infant feeding risks in comparative perspective?
- American Academy of Nursing on Policy: Position statement regarding use of informally shared human milk
- Sharing breast milk: wet nursing, cross-feeding, and milk donations
- La Leche League: Becoming a Donor to a Human Milk Bank
- Journal of Pediatrics: Contemporary Ethical Issues in Human Milk Banking in the United States
- Newsweek: The Booming Market for Breastmilk