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August 28, 2018

New guidelines for informal breastfeeding

7 Fun Things to do In Between Breastfeeding

The Academy of Breastfeeding Medicine’s 2017 Position Statement on informal breastmilk sharing discusses strategies to maximize the safety of community-based breast milk sharing, including the medical screening of the donor and ensuring safe milk handling practices. ABM also emphasizes that while informal milk sharing has potential health benefits, internet-based milk sharing is not recommended under any circumstances.

“Although milk banks increasingly support hospitalized, high risk infants, informal breast milk sharing is becoming increasingly common for healthy term infants as 21st century families desire to feed their infants human milk increases,” says Dr. Timothy Tobolic, president of ABM.

Yet the majority of the medical community, including myself, warns against it. "We support breastfeeding, but if you can't nurse, we recommend breast milk from a milk bank, or that you use formula," says Ari Brown, M.D., a spokesperson for the American Academy of Pediatrics. 


What is informal milk sharing?

Back in the day, before commercial formula, before homemade, stove top formulas of evaporated milk, dextrose-maltose and pablum, mothers fed their babies from their breasts. If the mother did not survive, the infant or child was given to another lactating mother or it too would certainly die.  

The practice of wet nursing, which is directly breastfeeding a non-biological child, has been used for thousands of years and evolved well into the 19th century when most wet-nursed infants were sent far from their families to live with their wet nurse for up to the first three years of their life. These women might be breastfeeding as many as eight children and the unrelated nurslings were called “bosom buddies.” Flash forward to the 1960’s, when it was called cross nursing. If a new mother was unable to successfully latch her infant, the baby would likely be given to a more experienced mother and that mother’s more experienced baby would go to the new mother. Communal care meant communal breastfeeding. These were times before we knew about HIV and Hepatitis and viral transmission through breastmilk.

Community based: With regard to community sharing, there are now multiple websites that describe their mission to provide a pathway for community milk sharing. It becomes the user’s responsibility to seek out the listed donor, usually lactating women who have surplus milk after feeding their own infant. You then must review health histories, medications, and social practices...quite a responsibility!

"A mother's milk is specific for her baby and changes as the baby grows," explains Karen Zeretzke, a New Orleans-based spokesperson for La Leche League International, an organization that supports regulated milk banks but cautions against informal sharing. "Donor milk may also pass along viruses, which a baby can't fight because he hasn't received that mother's antibodies."


I encourage donating and receiving milk through a milk bank such as HMBANA, Human Milk Banking Association of North America. They employ very strict procedures for accepting milk from donors, and the milk is put through a pasteurization process to help protect immune-compromised babies, who are often the recipients of milk bank donor milk.  “The components of donated milk are unmatched by any commercial formula; immune properties, growth factors, hormones, enzymes and many other factors that optimize the health of infants are present,” explains Laraine Lockhart Borman, Director of Outreach: Mothers’ Milk Bank (MMB), a program of Rocky Mountain Children’s Health Foundation, a non-profit donor human milk bank in North America. Healthy babies can receive HMBANA milk, dependent upon supplies available.  Check with your insurance company about possible reimbursement.

Please don’t allow another woman to breastfeed your baby or give her milk to your baby.  Even the most well meaning sister or best friend could do more harm than good without knowing it.


Paula Zindler
RN IBCLC



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