Because the benefits of breast milk are so great, many moms are turning to other mothers who have an over abundant supply. They are hooking up via Twitter, Facebook, and blogs. “What’s the big deal?” many ask. After all, generations of the privileged were raised on wet nurses.
A study published in 2010 by Stanford researchers tells us the risks. The data comes from a milk bank, which is supplied by selfless mothers donating their milk. To donate milk, mothers must self-identify as low risk for infections (just like when you donate blood), but many are unfortunately not as low risk as they think. In fact, in this study 3.3% of donating moms were positive for one of six very serious infections: HIV, syphilis, hepatitis B, hepatitis C, human T cell lymphotropic virus type 1 (HTLV-1) and human T cell lymphotropic virus type 2 (HLTV-2).
Many women who offer up their milk say that they are screened or were tested in pregnancy, but in reality, even if they were, that was a year ago and screening for hepatitis C, HLTV-1, and HLTV-2 is not even performed during pregnancy (see ACOG guidelines).
What if they say they are low risk? Having worked in STD clinics most of my professional career, I can tell you women who get infected with these infections never, ever felt they were at risk (even those who had what I would definitely call high risk behavior, because no one ever thinks it is going to happen to them). And of course, many make assumptions that their partner is monogamous. When people give me a funny look about that one I just say two words: Tiger Woods. That kind of behavior is not limited to sports stars, not by a long shot.
What is even riskier is the mother who converts to HIV who supplying milk. In fact, the risk of transmitting HIV to a baby by breast milk in the first 90 days after she is infected with HIV is five times higher than if she were already HIV positive during pregnancy. That is why milk banks screen every sample for HIV (and the other infections). Milk bank donors also have to be a non smokers, be vaccinated against rubella and test negative for tuberculosis (TB). Milk banks also pasteurize the milk to kill CMV (a virus found in up to 30% of the population that can be particularly harmful to a preemie) and HIV, although almost all of the nutritional properties stay intact.
Milk banks are run with the same precision as blood banks, hence the expense: $3.50-$4.50 an ounce (although ounce per ounce, donor milk is still a bit cheaper than blood). That is why affording milk bank milk is unreasonable unless covered by your insurance (often for a preemie in the NICU), or if you have the money of a celebrity, like Neil Patrick Harris).
So is donor milk safe? If it comes from a milk bank, absolutely. But otherwise, ask yourself if you would give your baby a blood transfusion from an unscreened donor? Most donors are motivated by altruism, but there is at least a 3.3% chance that milk from an acquaintance could do far more harm than good.
Would you give your baby donor milk from someone you met on line?