Like many new mothers, Alli Perez of Des Moines took a few weeks to settle into a breastfeeding routine with her newborn daughter, Stella. But soon, Perez, 22, was producing large amounts of milk, and her freezer overflowed with frozen bags of pumped milk.
Perez turned to the Internet to seek out mothers in need of breast milk for their own infants. Over 15 months, she donated 12,000 ounces of breast milk — enough to feed a full-term newborn for as many as 480 days — to the parents of seven Iowa infants.
The sharing of milk among mothers is an old practice. Before commercial baby formula, wet nurses fed infants when needed.
Now, as milk banks across the nation suffer from shortages of donor milk, the Web and social media are making it possible for Iowa
mothers to easily find, share and even sell their breast milk.
Instead of donating to the milk bank, where it is screened for diseases, then pooled and pasteurized with other donor milk, some mothers like Perez are using websites and Facebook groups to find others in need and reach out directly. Others, using Craigslist and sites like Only The Breast, sell their extra milk.
Jill Kvinlaug of Des Moines had difficulties nursing her first son after breast reduction surgery limited her milk supply.
“I didn’t think (breastfeeding) would be as hard as it was, or as disappointing,” she said.
When her daughter, Eleanor, was born last year, a friend, Jourdan Engesser, offered to donate extra milk she froze while nursing her own 3-month-old infant. That, plus more donated milk from another acquaintance, helped supplement her daughter for several months.
But the practice of sharing milk raises safety concerns, some say, for a precious resource that remains unregulated in Iowa.
Mothers warned as milk demand grows
Using milk found on the Internet is “risky and not safe,” said Jean Drulis, the director and co-founder of the Mother’s Milk Bank of Iowa, a program of the University of Iowa Children’s Hospital. The bank is one of 13 associated with the Human Milk Banking Association of North America.
Last year, 25 donors to the milk bank association in North America tested positive for diseases such as HIV, hepatitis B and C, syphilis and human t-lymphotropic virus, Drulis said.
“These are women who were unaware that they had contracted their respective disease, and the health care providers did not know it,” she said.
In 2010, the U.S. Food and Drug Administration issued a warning against feeding infants breast milk acquired directly from women who are not the mother. Women should “only use milk from a source that has screened its milk donors and taken other precautions to ensure the safety of its milk,” the warning stated.
But no federal regulation of breast milk sharing or selling exists, and the state of Iowa’s Department of Inspections and Appeals says that unless the FDA was to declare breast milk a food, the matter wouldn’t fall under the department’s jurisdiction, according to spokesman David Werning.
Demand for breast milk is outpacing the supply at banks across the nation, due in large part to increased awareness of the benefits of breast milk, which provides critical nutrients for newborns, especially premature infants.
Last month, a California breast milk bank held a donation drive, asking mothers to show up, register and donate milk to the bank.
The 10-year-old Mother’s Milk Bank of Iowa, located in Coralville, dispensed more than 80,000 ounces of milk in 2011, Drulis said, with the final 2012 number expected to jump another 20 to 25 percent.
Milk donated to the Iowa bank goes first to premature infants, who need the nutrient-dense, natural milk to meet their high nutritional demands. Other infants may receive donated milk at home with a prescription, and the Iowa bank ships milk to hospitals in other states when supply allows.
Iowa hospitals maintain an inventory of donor milk for its premature newborns.
Dr. Cary Murphy, a neonatologist with Pediatrix Medical Group at Mercy Medical Center, said the hospital, which acts as a collection site for the Mother’s Milk Bank of Iowa, follows the FDA recommendations and advises against feeding babies breast milk acquired directly from individuals or through the Internet.
Issues include trust and health choices
Kvinlaug knew who was donating milk for her child, so she had no safety concerns. Her pediatrician, she said, also felt the use of shared milk in this case was safe.
Perez — whose 12,000 ounces donated would have surpassed the Guinness World Record of 11,115 ounces donated by a Texas mother last fall — offered to show her first recipient blood testing, but the family, whose baby used the milk for one year, declined.
The other recipients never requested health records.
Bianca Brashear, who donated through a MilkShare group she found on Yahoo, sent a copy of her blood work to a milk recipient in Minnesota. Over six months, the Altoona woman donated 550 ounces to that mother and a few friends.
But Brashear isn’t certain she would use donor milk if the tables were turned.
“I think I’d look into it and make sure it was from a trusted source,” she said.
LuCinda Beltman of Waukee said none of the four mothers she found through Human Milk 4 Human Babies (www.hm4hb.net) requested her medical history. She was open about her health, medications and lifestyle choices, such as the fact that she drinks one caffeinated drink a day.
She donated more than 2,000 ounces to her best friend and four mothers she found online, meeting them at local businesses to drop off her donation in coolers.
“It’s a real trust thing. They trust that I’m feeding the milk to my son, so it’s safe,” said Beltman, who took her son on deliveries so the moms could see he was a healthy, happy baby.
Donors like Signe Newman of Des Moines take extra precautions, storing donor milk separate from bags for her own child. Newman, the mother of a 2-month-old boy, saved milk for a mother in her playgroup who is fighting cancer and delivered a baby last week.
Casual sharing vs. milk banks
Some women turn to casual sharing because they don’t qualify to use a milk bank.
Nicole Peterman, co-founder of Human Milk 4 Human Babies — Iowa, drove from Urbandale to Minnesota, Nebraska and around central Iowa to pick up thousands of ounces of donated milk for her son.
“That was our only option because I was hard-set against using formula,” she said. “Everyone thought I was crazy.”
She asked donors about their diet and medications and believes they wouldn’t put their own child in danger if they had a health issue. Because she successfully breastfed her second son, Peterman paid it forward, donating extra milk to five families that are part of a holistic families group.
Beltman, of Waukee, said she understands the concerns that milk bank officials have about potential safety issues.
“I think that as a recipient mom, it would be scary to just openly trust someone. But at the same time, if you do implement screening, it’s going to cost money and less people are going to donate,” she said.
Drulis, the Mother’s Milk Bank of Iowa director, said the Coralville bank doesn’t charge for milk, since it is donated. Hospitals pay the processing fee of $15 per 100 milliliter to recover the nonprofit’s costs for testing, supplies and transportation. For infants at home, parents are assessed a fee if insurance does not cover the cost. Iowa Medicaid also reviews special cases for parents who need the milk.
Drulis believes women who share milk casually do so with only the best intention: to help. Milk banks take that idea to the next level so that it is completely safe, she said.
“Informal milk sharing is a missed opportunity for the vulnerable infants who rely on their life support from milk banks that can’t meet their demands due to inadequate volume of available milk,” Drulis said.