Think peer-to-peer donated breastmilk is safe? Think again.

It’s all the rage on natural parenting websites and forums. Feeling guilty that you can’t provide enough breastmilk for your baby? Just get some from your friends on the Internet.

What could be more natural than sharing human milk?

According to Human Milk 4 Human Babies, a large internet milk sharing network:

Breastmilk, the biologically normal sustenance for humankind, is a free-flowing resource and mothers of the world are willing to share it. Milksharing is a vital tradition that has been taken from us, and it is crucial that we regain trust in ourselves, our neighbors, and in our fellow women…

To that end:

HM4HB has a presence in 52 countries around the world. There are 130 Facebook community pages and over 20,000 community page members. These virtual communities are run by 300 hardworking, multicultural administrators who lovingly and graciously volunteer their time to keep HM4HB continually focused on its mission, vision and values. Through our pages, hundreds of babies in need receive breastmilk every single day.

What could be more natural than sharing human milk?

How about sharing human disease?

The dirty little secret of peer-to-peer sharing of unpasteurized breastmilk is that a surprising amount of it is contaminated with dangerous viruses.

That’s what Cohen, et al. found in Retrospective review of serological testing of potential human milk donors.

Of 1091 potential donors, 3.3% were positive on screening serology, including 6 syphilis, 17 hepatitis B, 3 hepatitis C, 6 HTLV [human T cell lymphotropic virus] and 4 HIV.

The authors did not test random women off the street. They screened women who had volunteered to donate to Mothers’ Milk Bank of San Jose, California, USA, a not-far-profit member of the Human Milk Banking Association of North America who had already passed preliminary testing.

Potential milk donors consent to a multi-level screening process according to HMBANA guidelines and do not receive any payment for donating. In brief, this process begins with screening by their obstetricians for history or signs of significant illness, including hepatitis, syphilis and HIV. After being screened again with a questionnaire similar to that used by blood banks, remaining potential donors have blood samples drawn for serological testing for syphilis, HIV, HTLV-l and 2, hepatitis B and hepatitis C.

Nonetheless:

We found that 3.3% of the women who voluntarily sought to donate milk to our milk bank had positive serological screening tests for syphilis, HIV, HTLV-1 and 2, hepatitis B or hepatitis C.

That does not mean that fully 3.3% of the donor women had the disease. Viral screening tests have a significant false positive rate.

Potential donors to tissue banks in the USA were found to have a 3.16% prevalence of positive screening for the same viral agents, with 1.48% confirmed positive. This screening result is similar to what we report here. Although we do not have results of confirmatory testing, we would expect a similar rate of false positives for our screening.

The true incidence of virus bearing breastmilk would be approximately 1.6%. That’s a remarkably high level of exposure to deadly disease.

The conclusion is obvious:

The use of unpasteurised donor human milk from untested women may pose a significant health risk to exposed infants.

And:

There is a clear need to ensure the safety of all body fluids and tissues, including donor human milk, which may be donated from one person to another. In California, where our bank is located, milk banks are considered tissue banks, and therefore are licensed and regulated as such.

That’s why reputable breastmilk banks pasteurize donated milk. Just as you wouldn’t allow your infant to have a transfusion of blood contaminated with HIV, you shouldn’t allow your infant to have a bottle of breastmilk contaminated with HIV.

Who could disagree with that? You guessed it, certain lactation consultants, like Karleen D. Gribble, BRurSc, Ph.D,

… an Adjunct Fellow in the School of Nursing and Midwifery at the University of Western Sydney. Her research interests include adoptive breastfeeding, long-term breastfeeding, nonnutritional aspects of breastfeeding, child protection and breastfeeding, peer-to-peer milk sharing and models of care for traumatized children… Karleen is active in advocacy and teaching in the areas of infant feeding in emergencies and the marketing of infant formula. She is also an Australian Breastfeeding Association Community Educator.

In the article Milk sharing and formula feeding: Infant feeding risks in comparative perspective?, Gribble acknowledges that human breastmilk can carry deadly pathogens, but insists that efforts to regulate it are culturally driven

… [S]haring human milk between women and babies is perceived to be like sharing other bodily fluids or tissue. Because the practice of transfusion and of organ transplantation are heavily regulated by medicine (and for good reason), a culture that considers human milk to be another regulated bodily substance can only conceive of milk sharing as an activity that occurs rarely and under medical supervision.

But, but, but breastmilk is totally different. Yes, it is … it totally is.

… [H]uman milk is not a medicine and, while it is a bodily fluid, it is not like blood. Human milk is a substance created in one body that is excreted in order to be ingested by another body.

Ooh, ooh, ooh, I know another way it is totally different. It is white!

As such, human milk is sui generis, and it is in part because it is unique that there are such stringent cultural proscriptions on its articulations. Ultimately, the FDA, … and Health Canada seem to be operating under what philosopher Rhonda Shaw has identified as the “Yuk Factor”—responding to the dominant cultural meaning of milk sharing rather than the medical issues associated with milk sharing.

At this point, you are probably thinking that I am making this up. It is difficult to imagine anything  as moronic as insisting that efforts to remove HIV, hepatitis and syphilis from donor breastmilk is culturally driven.

Unfortunately, Gribble is spewing her stupidity to the general public as well as in esoteric journals. An article on the website Megaphone Oz, No use crying over shared milk, includes this:

The risks of milk sharing include the transmission of bacteria and viruses such as CMV, HTLV and HIV. But in Australia, these risks are incredibly rare says Dr Karleen Gribble from the University of Western Sydney’s School of Nursing and Midwifery…

“You’re really at a greater risk of being struck by lightning,” Gribble says.

Apparently Gribble has problems with basic arithmetic as well as basic logic. The risk of being struck by lightening is in the range of 1/1,000,000. The risk of unpasteurized donor breastmilk being contaminated with deadly pathogens is 1.6/100. Therefore, the risk of contaminated breastmilk is 1,000 times greater than the risk of being struck by lightening, but what’s a few zeros among friends.

Yes, sharing breastmilk is totally natural, but so is sharing deadly pathogens. It is only a matter of time before babies begin getting ill and dying from hepatitis and HIV contracted from peer-to-peer donated breastmilk.

  • RoobiiGloom

    As an adoptive mother, and a biological mother that breastfed AND formula fed her own children, I did my research and weighed the pro’s and con’s .
    My 6 1/2 month old son has been fed 100% peer to peer donated breastmilk since he was placed in our custody at 5 days old.
    I have no regrets, and will continue to provide him with donated milk as long as our donors are willing to give it.
    My children were born in hospitals, and all are vaccinated. They attend public school. We have a TV, computers, ipads. My husband and I both have higher educations, and he is a high level exec at a very well know tech company. I work in mental health.
    The information was OVERWHELMINGLY pro feeding donated breastmilk over formula, and I scoured the internet while we waited for our match.Just as some find home birth an unacceptable risk to take, I find formula an unnecessary risk to the health of my child when I have other options afforded to me.

  • nickandderyl

    ok, just give them salmonella from the water used to mix the formulas in the hospital or in the can of powdered milk being used to feed multiple babies in the NICUs…didn’t think of that did you?

    • PrimaryCareDoc

      Are you saying that water in the USA is routinely contaminated with salmonella?

      Also- any NICU baby is not getting “powdered milk.” They are also not getting powdered formula.

    • Young CC Prof

      NICU babies are fed formula out of single-use sterile ready-mixed bottles, if they aren’t fed their own mothers’ milk. Trust me.

  • nickandderyl

    What if the hospitals actually reported the unnecessary c-section rates accurately…same logic.

  • nickandderyl

    According to the WHO most of the bacteria and viruses are killed in the infant digestive tract. This is why screening both donor mother and her infant are done.

    • Dr Kitty

      Screening is done by reputable milk banks.
      Craigslist…no so much.

  • nickandderyl

    The more you do to milk the less nutritious it is. Testing of women and of the donor infant should be enough to ensure clean milk. A lot of the bacteria people are writing about are also in the birth mother’s milk and they help the infant’s immune system to develop.

    • Mishimoo

      Yay, salmonella and e. coli! Om nom nom nom, healthy.

  • nickandderyl

    The CDC says it is nothing like blood and does NOT need to be treated as such. May the rest of your education was that good…scary!

  • nickandderyl

    Yeah…”official-looking: exactly. If you don’t know how to find the REAL Official websites, then don’t post from Google who is not even aloud to be used as references for school work. The WHO actually states that the transmission rates from expressed breast milk are very low. You need to research things like “peer-to-peer breast milk sharing in hospitals and find the .ORG sites.

    • AlisonCummins

      Google is not a source that can be quoted. It’s a search engine. You might be thinking of Wikipedia?

      Please explain my errors and cite better references than the WHO.

  • nickandderyl

    And as a Lactation Professional, I would say your numbers are way off! Do more research! Correctly!

  • nickandderyl

    You need to find the REAL information on how much transmission there is through breast milk. The Lack OF RESEARCHED PROOF OF TRANSMISSION may surprise you. Also, there has never been a recorded case of an health provider contracting ANY disease from handling breast milk even without gloves.

    • Young CC Prof

      An adult handling milk with unbroken skin versus a baby with an immature immune system drinking large quantities of it. Yup, clearly equal risk there.

  • nickandderyl

    Exactly! Thank you!!!

  • nickandderyl

    This article is completely biased and unethical per medical and nursing standards. If you really want to know the truth about something that has been happening in all cultures successfully since the dawn of human existence then don’t be reading a “.com” website that any Tom, Dick , or Harry that say they are a specialist can post on without question. If you truly want expert advise look for “.org, .gov, .edu” type sites. I am a Lactation Educator and this article is pure crap and totally one sided. Most of these women that were tested were out to be paid for their milk which is also unethical in the professional view. Get the correct information before commenting on something you know nothing about!

  • http://www.facebook.com/kathleen.neely Kathleen Elizabeth Neely

    my sister grabbed my newborn ( we actually had babies the same day) and started breastfeeding him. I told her to stop. she did. end of story.

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