Milk Donation: Peer sharing vs Milk banks

Human milk is the highest source of nutrition for infants from 0 to 6 months of age, and continuing human milk feeding with appropriate complementary feed for up to 2 years and beyond. Human milk is species-specific and far superior to all other options available for infant feeding.   

Premature and sick infants are frequently unable to feed directly. The first option is to feed the infant expressed milk from their mother. Pasteurised donor human milk from a regulated milk bank is recommended for supplementary, bridging, or replacement feeding when mother milk is unavailable.   

There are significant differences between the type of milk sharing most health professionals are familiar with: donor milk banking and peer-to-peer milk sharing.   

Milk banks usually operate within the hospital and adhere to strict guidelines and regulations concerning donor selection and screening along with milk processing. This ensures that the human donor milk is safe for premature and sick babies. Screened and pasteurised donor milk is prescribed by a health care professional to infants with complications and comorbidities when their mother’s milk is unavailable.   

In contrast, peer-to-peer milk sharing usually happens within the community, where relationships are a major influence. The trust and beliefs of the individuals involved determine the course of sharing milk.   

Informal milk sharing has occurred throughout history and across cultures.    

When there were no milk banks, peer-to-peer sharing was the only option. On the other hand, this unpasteurised human milk poses a threat to the health of newborns because there is no health history of the donor, no screening of the donors, and no pasteurisation of the milk.  

What is peer milk sharing?    

Peer milk sharing is the donation of breast milk from one mother willing to share it with another mother who requires milk. Informal milk sharing, also known as peer-to-peer milk sharing, refers to human milk given by other nursing mothers within a family or group of friends.   

Some health authorities have been alarmed by direct milk sharing and warned parents to avoid peer-to-peer milk sharing. These authorities have expressed concern that the milk’s potential for disease transmission or contamination is unacceptably high.   

Risks of Milk Sharing    

It’s impossible to tell whether a donor’s health and habits suit milk donation.  

Viruses such as HIV, CMV, Hepatitis B, Hepatitis C, and the human T-cell lymphotropic virus may be transmitted to your child (the donor mother may not know that she has these infections).   

Smoking, alcohol, some medications (both prescription and over-the-counter), herbal supplements, and street drugs can all pass into human milk.   

Milk Bank    

Formal breast milk sharing is currently done through human milk banks located all over the world. However, in most cases, donor breast milk is reserved for sick or premature babies. The safest option is receiving screened and pasteurised human breast milk from a regulated milk bank.   

Human milk banks are vital because they provide human milk to infants without the mother’s milk. Milk banks follow guidelines for Handling, storing, processing, pooling, and microbiological screening of donor milk.   

Pasteurisation of donor milk does impact its nutritional value, but the beneficial properties of human milk are preserved while killing harmful microorganisms. The benefits of donor milk remain enormous, and donor milk is still far superior to formula.   

The primary function of milk banks is to   

Screen donor mothers    

Conduct blood tests for donor mothers.   

Guide and counsel donor mothers for hygienic milk collection and storage.   

Collect the milk from donor mothers    

Pasteurises the donor milk.   

Store donor milk at the appropriate temperature until needed by a baby.   

The HMBANA (Human Milk Banking Association of North America) has developed screening and processing guidelines for donated breast milk supported by the Centers for Disease Control and Prevention and the Food and Drug Administration.   

Without a mother’s milk, regulated Human milk banks offer parents a chance to provide their babies with safe, reliable, and healthy pasteurised human breast milk from screened donor mothers.    

When considering using donated breast milk, mothers should be aware of the risks of peer-to-peer milk sharing and consult their baby’s doctor for a reference to a milk bank.   

It is clear that informal milk sharing poses risks to the baby and might do more harm than good, given the high rate of preterm births in our country and the malnutrition that ensues in the postnatal growth of such babies after birth. On one side, there is an urgent need to establish milk banks across the country; on the other hand. We should encourage more and more mothers to come forward for this noble initiative.   

Name: Elsy Varghese   

Qualification: BSc Nursing, Certified breastfeeding specialist.   

Designation: Lactation Counselor   

Hospital Name: Aster Medcity, Cochin, Kerala. 

Milk Donation: Peer sharing vs Milk banks

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