Donor milk for premature infants

Breastmilk is the healthiest and best source of nutrition for babies, however not all mothers are able to nurse. As an alternative, some mothers look to donor milk from all sources - friends, family, hospitals and online. However researchers and health officials have warned against the practice of obtaining donor milk directly from individuals or the internet. So we've asked Diane L. Spatz, PhD, RN-BC, FAAN, a Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania School of Nursing, two frequently asked questions:

1. What is informal milk sharing and the risks?
2. How can I speak to my doctor about donor milk?

Transcript

Carolyn TenEyck (CT): You hear a lot in the news lately about the dangers of sharing donor milk, can you talk to us a little about that and help the public understand the safety and quality and importance of that for moms who either can’t breastfeed or choose not to.

Diane Spatz (DS): Sure. So when we think about understanding the differences  between mom’s own milk and donor milk and what some may call informal milk sharing or private arrangement milk sharing, the thing that one has to remember is when we’re talking about a mom providing milk for her baby, her and her baby are always in sync. She is going be the ideal person to provide the ideal nutrition for her child.

Now if for some reason the mother was not able to make milk for her baby, when you think about the difference between donor milk and informally shared milk - donor milk the mothers who have gone through a very thorough screening process. It’s more thorough than giving blood, so the mother has to do a health history, they have to provide a health history on her baby, they have to undergo laboratory testing of their blood to make sure that they are free of disease.

The milk also is checked and is also pasteurized. With pasteurization, you are destroying any potential germs that might be in the milk. You actually check the milk after it’s been pasteurized to ensure that nothing is growing in the milk.

So with informal milk sharing, when mothers don’t go through an approved milk donation process that means there could be harmful bacteria or germs in that milk. And so that is the danger when moms are casually or informally milk sharing. The reality is, is that some women choose to do this, mostly in the community setting because they can’t get access to donor milk. Right now in the United States,  only about 40% of NICUs even use donor milk. And if every NICU used donor milk, as per the American Academy of Pediatrics recommendations, we would have a shortfall of donor milk. And that is why sometimes you will hear people informally milk sharing. I think it is really important for a family to understand what the differences are. And understand that after years and years of research behind donor milk being both a safe and efficacious product for feeding babies.

CT: Very good. Empowering parents with practical advice. You see this everyday. How would you advise them to talk to their nurse practitioner their doctor about donor milk for their child?

DS: So first and foremost, I want to make sure that we are clear that donor milk is not a replacement to mom’s own milk.So the first thing is that I want to make sure we empower the mother to be able to provide their own milk for their baby. If they were not able to provide a 100% of their own milk for their baby, I would encourage the mother to know the facts. Do her research.

Go to the provider, whether it is a physician or a nurse practitioner and speak to them about the facts that they would like to have donor milk for their child. One of the things that we do for our mothers who deliver with us in our center is we  actually bring up the topic of donor milk before they even deliver. So we want them to know that their own milk is the best, but if for any reason they encounter a problem, we have donor milk as a bridge. 

So if I was advising a family who was pregnant, I would ask them to  do their research on the hospital that they are delivering at, make sure that the hospital has lactation support available, make sure that the hospital has donor milk available, if the need would arise.