Why are lactivists flipping out over breastmilk contamination?

iStock_000012952225XSmall

When I first read about the new study that shows that breastmilk sold through unregulated arrangements has a high rate of contamination, I wondered how lactivists were going to handle the issue. Frankly, I thought they were going to ignore it, since it has nothing to do with breastfeeding one’s own baby.

But I was wrong. They freaked out and the freakout tells us quite a bit about lactivists and their fantastical thinking about breastmilk.

The study, Microbial Contamination of Human Milk Purchased Via the Internet, was published online yesterday by the journal Pediatrics. The authors found:

Most (74%) Internet milk samples were colonized with Gram-negative bacteria or had >104 colony-forming units/mL total aerobic count. They exhibited higher mean total aerobic, total Gram-negative, coliform, and Staphylococcus sp counts than milk bank samples. Growth of most species was positively associated with days in transit, and negatively associated with number of months since the milk was expressed, per simple linear regression. No samples were HIV type 1 RNA-positive; 21% of Internet samples were cytomegalovirus DNA-positive.

CONCLUSIONS: Human milk purchased via the Internet exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices…

Lactivists could have pointed out the obvious: any time you have an unregulated trade in bodily fluids (think blood, or donor sperm), you run a great risk that the fluid will be contaminated with infectious agents, may pick up bacterial contaminants, and will spoil when not frozen properly. When it happens with blood, we don’t flip out an insist that those who point it out are attempting to smear blood transfusions. When it happens with with donor sperm, we don’t flip out and condemn sperm donation. We simply implement regulations that require testing of the fluid and mandate proper freezing procedures.

So why didn’t lactivists point out the obvious? Why did they freak out instead? As far as I can tell, it’s because they can’t handle the thought that breastmilk isn’t magical.

The reaction of Allison Dixley, self-proclaimed Alpha Parent, is typical of the hysterical response:

The DFFs [Dumb Formula Feeders] are lapping it up. However the study is little more than a red herring. Sure, breast milk contains bacteria (news flash: it’s meant to!) Notice the story says “Some bacteria may not be harmful” and then goes on to say: “but salmonella is among germs that could pose a threat to infants”

To this, I reply:

http://www.ncbi.nlm.nih.gov/pubmed/18171262

Consider that formula is not designed to carry bacteria yet often carries a wide variety of potentially harmful ones.

Consider that formula contains none of the antibodies that help to counterbalance any iffy bacteria content.

Consider that formula is as prone to contamination (if not moreso through human error and longer preparation chain) as breast milk.

Consider also that mother to mother milk sharing (which this ‘study’ warns against) removes control from medical professionals (the very same medical professionals which carried out this study).

This story may be great DFF fodder, but it contributes little to improving the welfare of babies. The infant feeding hierarchy remains: direct breastfeeding from mom > pumped milk from mom > trusted wet nurse > pumped milk from trusted donor > formula.

Hey, Allison, you didn’t include “pumped milk from unknown donors being paid for it,” which is actually what we are talking about.

And Allison, you might want to go back and review your 4th grade math. When discussing the relative risk of bacterial contamination between breastmilk and formula, we must look at RATE. You remember: the number of incidents over the total number of events. Yes, powdered formula can get contaminated with harmful bacteria, too, but the rate of that happening is so low that when it does, a scientific paper is needed to alert people to it. In other words, it is quite rare. In contrast, this breastmilk study found a harmful virus contamination rate of 21%.

Why is Allison so furious? Apparently because it has been pointed out that breastmilk is not magical and is subject to the exact same concerns that apply to any bodily fluid.

Even some medical professionals manage to miss the point. Alison Stuebe, MD, MSc of the Academy of Breastfeeding Medicine reacts as if the truth that breastmilk is a body fluid like any other is some sort of plot to undermine breastfeeding.:

“Breast milk as bacterial brew” pushes lots of cultural buttons — from the “ick factor” to our reliance on mass-produced and marketed substitutes, rather than women, to nourish our children. Let’s stop pressing buttons, and start looking for solutions, so that more families can achieve their infant feeding goals.

Really?

Why are lactivists so quick to assume that pointing out the obvious about breastmilk is an attack on breastfeeding?

Partly it’s because lactivists view anything that doesn’t validate their belief that breastmilk is always superior as an attack on breastfeeding. But mainly, the hysteria comes from the threat to their own self-esteem. If breastmilk (even improperly stored, contaminated breastmilk) is just a bodily fluid subject to the same principles as other bodily fluids, it isn’t magical. I guess they worry that if it isn’t magical, the fact that breastfeeding isn’t the “superpower” they claim, and just another thing that some mothers do and other mothers don’t.

And that goes for the whole idea of milk sharing as well. It boggles my mind that any mother would give her child the unscreened, possibly contaminated bodily fluid of a stranger that she bought on the internet. The reality is that the benefits of breastmilk are trivial and hardly worth the risk. Indeed, there is no evidence of any kind that infants derive any benefit from the frozen breastmilk of strangers. Yet women have been so brainwashed by the fantastical claims of lactivists that they actually believe they are providing something valuable to their infants.

What’s the take away message from the Pediatrics study? The message is “don’t buy unregulated breastmilk over the internet.” That’s it. It has no implications for breastfeeding at all.

What’s the take away message from the lactivist hysteria over the study? The message is that these women cannot think rationally about breastmilk.

  • Tiff

    I usually stay in the shadows but I can’t resist commenting on this topic. I’ve had heated debates in the past few days with people about donor milk. First, let me say that I’m a mom of four – breastfed three of them for roughly a few months each (stopped because of poor latch and diminished supply) and am currently breastfeeding a five month old. It’s extremely difficult to breastfeed! Very recently, I noticed my five month old was angry during feedings; he would continuously pull away and cry. After roughly six hours of this struggle, (gasp) my husband and I gave him a bottle of formula and he was happy. The next day, I posted on a breastfeeding support site for advice on how to increase my supply and was immediately attacked. The women told me I had no idea what I was talking about, that my supply couldn’t possibly be low (he was born premature, by the way) and that he was, in fact, not starving (I assure you, he was). They told me that whatever I do, don’t give formula. I was then told by another individual that people that give their kids formula don’t deserve to be parents. Seriously. Others mentioned donor milk. Any way, the very idea of this horrifies me. This study is great but it’s sad that women can’t think for themselves enough to realize that giving your child untested breast milk from a strange individual could fatally harm them. I really can’t get past the insanity of it. You’ll find this mentality all over the internet and in “natural circles”, that before you use EVIL formula, try to get your baby strange breast milk. You’ll also be overwhelmed with stories of babies and children with “severe allergies and illnesses” because of formula (as stated, I had 3 on formula and they’ve all thrived beautifully with no allergies and little to no illness, ever). Sickening.

    • The Bofa on the Sofa

      Amazingly, Tiff, what you encounter is what passes for “breastfeeding support” these days. How dare you admit that you need help?

  • I don’t discount breast milk as being like any other bodily fluid, but I do think it’s rather a given that foodstuff needs to be held to higher regulatory practices than a quick sniff test. You’d think that lactivists would agree and push for industry reform but that would be assuming that they’re in it for non-selfish reasons.

  • Sue

    A chiropractic FB page was recently promoting a breast milk sharing scheme. I asked whether the milk was screened. They deleted and banned me. Sigh.

    • I’m shocked, shocked I say!

  • Sorin

    Scholarly article on the results of serological testing of potential human milk donors:

    http://www.ncbi.nlm.nih.gov/pubmed/20231217

    I found a pdf version of the article here:

    http://www.eatsonfeets.org/docs/Retrospective_review_of_serological_testing_of_potential_human_milk_donors.pdf

    I found the results to be chilling, and these are women who are *donating* their milk. I would expect the results to be roughly the same for women who are selling their milk–if not higher.

    • Guesteleh

      Results: Of 1091 potential donors, 3.3% were positive on screening serology, including 6 syphilis, 17 hepatitis B, 3 hepatitis C, 6 HTLV and 4 HIV.

      Conclusions: There is a significant incidence of positive serology among women interested in donating human milk. This implies that there may be significant risk associated with peer-to-peer distribution of human milk from unscreened donors.

      Terrifying. And it was posted on Eats on Feets and women are still willing to share unscreened milk?

      • Sorin

        I was curious about that. Is that their way of protecting themselves should a baby get sick? “Well, we *told* you about the possible dangers.”

        I was thinking about something else. No one would ever think to test a baby for HIV who had no obvious risk factors, and we all know that it can take years for someone who is HIV+ to become sick with an opportunistic infection. So what if (God forbid) a 5, 7, or 10 year old came down with Karposi Sarcoma and was subsequently found to be HIV+? Would anyone ever think that he contracted the virus through breastmilk as an infant? Plus, how would you ever prove it so many years later? HIV, hepatitis, etc. aren’t routinely tested for in babies, so isn’t it possible that a child might have contracted one of them through unscreened donor breastmilk, but no one would ever know because a definitive connection couldn’t be made?

        Terrifying indeed.

        • Young CC Prof

          Actually, I think if a young child of HIV-negative parents turned up positive, there would be a pretty significant investigation. (Whether the mother would remember or admit the key fact is another matter.)

          How would you prove it? Depends whether you still have a list of milk donors.

  • areawomanpdx

    Other than being about dingbats, this comment is totally off topic, and I apologize in advance. But Dr. Amy, would you do a post about people who advise you to “read the package insert” and what tools they are? Anti-vaxxers do it all the time, and I’ve seen this piece of work posted all over facebook today: http://www.sicklycat.com/2012/05/24/21-reasons-to-say-no-to-pitocin-according-to-manufacturer/

    • araikwao

      Skeptical Raptor just did one recently, Google will turn up his blog for you, I’m sure 🙂

    • FormerPhysicist

      OMG the comments there.

      • anion

        Funny. “Natural” labor pain is all in your head and brought on by media-driven fear, but there’s no such equivalency made when it comes to Pitocin, which “everybody knows” is way more painful and horrible.

        (It may well be more painful; I’m not saying it isn’t [I’ve only experienced one Pit-induced labor and no non-Pit labors], just that I find the idea that one kind of pain can be overcome if you’re not afraid of it whereas we must induce as much fear as possible of the other kind to be interesting.)

        • Young CC Prof

          Actually, according to my mother, there wasn’t much difference in pain between the two. First labor was Pit, 12 hours, second was no-Pit, 8 hours. She actually said pushing was much quicker the first time, because the pitocin just opened things right up.

          • Mishimoo

            I had it for 2 of my 3 deliveries and I loved it despite the stronger contractions because I felt like I was finally getting somewhere again. I was expecting it to be this horrible world-swallowing pain, but it actually wasn’t too bad.

      • Tim

        I love how the manufacturers insert and recommended usage is ALL THAT MATTERS when it’s pitocin or cytotec, but off label use of something like domperidone to increase milk supply is A-OK. I’m sure there is 97 other drugs most of these women have used or will use in an off label manner as well, either on their own (taking cold medicine or acetaminophen or NSAIDS for too long or at higher dosages than recommended) or on a Dr’s recommendation.

        • Young CC Prof

          Off-label use of a drug that the US FDA has said is too dangerous to approve even as a GI treatment. To increase your milk, so it winds up getting fed to your baby as well.

          (To be fair, a lot of mainstream GI doctors and many people even at the FDA believe that with severe digestive problems, the benefits of Domperidone outweigh the risks.)

          • Tim

            Yep, and since you’re probably doing it behind your Dr’s back, they have no idea. But that’s ok, off label use of domperidone is awesome, because people who aren’t Dr’s or Pharmacists recommend it. If a Dr or Pharmacist recommends an off label use of a drug that is BAD.
            Now me, something tells me that using a drug that has a well known cardiac side effect profile to do something as ultimately meaningless as increase milk supply, when 1 out of 100 babies born has a CHD, and many go undiagnosed for a time, is insane. But I guess you have to weigh the benefit of a posible 2 IQ points versus the risk of dangerous arrythmias and decide for yourself! I’m sure your local LLL leader can offer valuable advice in this area, owing to her many years working as a top pediatric cardiologist.

          • Karen in SC

            excellent, excellent snark!

          • Tim

            It’s just crazy to me that people are so hellbent on “breast is best” that they would overlook something like that. How can you possibly justify it when CHD’s are so common?

          • Jessica

            The one complaint I have about the LC I used is that she recommended domperidone to me when I met with her at five days postpartum. There were no concerns about my supply; just a baby who took some time to learn how to nurse and transfer milk. (In fact, I ended up with a nice oversupply that took six months to regulate.) I did not feel comfortable taking domperidone. When my son was two months old his pediatrician detected a heart murmur and ordered an echocardiogram; turns out he has a bicuspid aortic valve. I don’t know whether the domperidone would have been an issue with his heart defect, but good grief – quite a risk to take!

          • antigone23

            I discussed this with my endocrinologist. She actually prescribes domperidone to patients with severe GI issues who respond to nothing else and instructs them to get it from Canada, but she thought doing so for breastfeeding purposes was ludicrous (and she breastfed both her babies and is hugely supportive of it).

          • Young CC Prof

            Actually, my GI doctor once prescribed me Domperidone and told me to get it from Canada. (The mail-order pharmacies that require a written prescription are pretty reliable, as I understand it.) It didn’t fix my gastoparesis, but I’m glad he let me try.

          • araikwao

            Funny, in Australia and NZ, domperidone is used for GI motility/nausea, and I’ve definitely heard of it being used as a galactagogue in the hospitals in NZ. Guess we don’t mind an arrhythmia here or there…..?!

          • Young CC Prof

            Actually, the risk of heart issues with domperidone is pretty small, as I understand it, and a lot of people were puzzled when the FDA refused to approve it. The cases that freaked out the FDA were the deaths of two folks who were already hospitalized and in bad shape.

            In an adult with no history of heart problems and major GI problems, the risk/benefit analysis is pretty clearly in favor of trying it. In a new baby, it might be different, I don’t know if there are studies.

          • araikwao

            Interesting to know the background to the difference in practice, thanks!

          • Tim

            I think in her post about this, the “anonymous cardiologist” said that she didn’t think it was necessarily a “bad” thing to use, just that if one is going to use a knokwn QT prolonging drug, one should be screened by a cardiologist beforehand, and monitored periodically throughout. So this assumes that your Dr’s known you’re using it, are on board, and are taking care of things. Which does not happen if you’re a mom in nebraska ordering it on the internet from india. And if you’re passing that through to your child, who is 3 months old with an undiagnosed heart problem… just doesn’t seem worth it just to breastfeed.

          • Young CC Prof

            And if you’re ordering it online from India, who knows what’s in it? There are fairly reputable online pharmacies, but they all require written prescriptions from your own doctor.

            Now, domperidone is pretty cheap to make, so I imagine you’d either get what you paid for or get nothing at all, pills made of starch. With a more expensive drug, a clever evil pharmacy might make something cheap that has some of the same effects.

          • michellejo

            What did? Or are you still suffering. Would love to know.. as a eight years long sufferer.

          • Young CC Prof

            Didn’t find any drugs that worked. The tests found severe reflux, moderate hiatal hernia, and relatively mild gastroparesis, so I finally wound up having Nissen Fundoplication. Didn’t speed up digestion, but it did resolve the reflux, and then I was able to put on some weight.

            Of course, I’m now in my 7th month of pregnancy, so the 24/7 reflux is back. But at least I’ve got some weight on me and the baby’s growing. Hopefully I’ll feel better after delivery.

  • batmom

    A bad result of bad-mouthing formula: So my cousin has a two-year-old, who thankfully is perfectly fine. My cousin had to go back to work when her daughter was seven months old, and her job didn’t accommodate pumping well enough for her to keep up her supply.

    But she’d heard formula was bad, so she weaned her daughter to organic cow’s milk.

    • Mac Sherbert

      I guess she missed the rows of organic baby formula at Babies R Us. It’s sad formula is made out to be so evil.

  • Deborah

    That woman is a twit. Saying that breastmilk is meant to contain bacteria therefore it’s ok to give breastmilk from a stranger, which may be colonised with the cytomegalovirus and/or salmonella, is more than bad advice.- It is ridiculously stupid and reckless. And as for DFF (dumb formula feeders) – her term for women who have chosen to feed their babies this way for whatever reason, I can only say what a sad day it is for women when we have these supercilious, sanctimonious, cows in ivory towers, whose whole sense of self is wrapped up in tearing down other women and mothers, spewing forth such vitriolic and malicious claptrap. Shame.
    And this from a woman who happily breastfed 8 babies.

    • Young CC Prof

      Yep. Ordinary bacteria that live in your house, in the dirt and on healthy people’s skin are a normal part of life. Exposure to them helps develop an infant’s immune system.

      Tetanus, salmonella and certain viruses are NOT a normal part of daily life, and infants should be protected from them as long as possible!

      • anion

        There’s a reason we don’t feed honey to newborns; would TAP recommend doing that?

        • BeatlesFan

          Probably. Honey is natural and therefore a wonderful thing, right?

          • EmbraceYourInnerCrone

            Sure.. and the Clostridium botulinum spores that can be in it are perfectly natural too…(/snark I realise you know this!)

  • Young CC Prof

    You know, this whole discussion is inspiring me to donate to a medical milk bank, assuming that I manage to breastfeed and manage to build up my supply to the point I can spare it. What I said about not wanting to pump? I take it back. I’d pump for my own preemie, and I think I’d do it for other people’s preemies, too.

    And, you know, assuming I pass the medical screening.

  • Laura

    I breastfed because it was easy for me and I was too cheap to buy formula. Had I had problems producing, we would have absolutely just FFed. I had an oversupply until I quit pumping at 11 months and gave away my leftover milk when my daughter fully switched to whole milk because otherwise I would have thrown away about 150 ounces. I gave it to a former roommate, who uses a mix of her milk and formula with her baby (she does okay with supply, but he more than tripled his weight in 6 months and at 9 months is 2 lbs heavier than my 15 month old so he is CONSTANTLY eating). She actually knows me (and my husband) and knew she could trust my storage & sanitizing of pump parts. She knows what meds I take and that I didn’t drink and pump. I would NEVER have given milk to a stranger (and my friend wouldn’t ever take milk from one).

  • S

    Could someone address the idea that exclusively breastfed infants are less susceptible to diseases transmitted via breastmilk because of their wondrous gut flora? A subset of the “breastmilk is magical idea,” i guess. I don’t understand immunology so would appreciate a science-based debunking. Thank you!

    • Trixie

      This one is actually true, when it comes to HIV. Exclusive breastfeeding until 6 months reduces the risk of transmission by 3-4 times compared to combination feeding. http://www.who.int/bulletin/volumes/88/1/10-030110/en/

      Of course in the developed world this is a risk we should never take anyway. It’s just the least-bad option in a bad situation. Breastfeeding a child when you are HIV positive is something that is never worth the risk if you have continual access to safe formula and the ability to prepare it safely with clean water.

      But in the absence of safe formula and/or anti-retroviral drugs, if a mother is HIV positive, and has no other way to feed her baby, it is better to exclusively breastfeed for 6 months, than to breastfeed with any other supplemental foods or formula. The risk of transmission of HIV is still less than the risk of death from diarrhea, pneumonia and malnourishment under those circumstances.

  • troublesometots

    I think a good policy on Craigslist in general is – no liquids. Seriously you don’t want to buy anything liquid on Craiglist.

  • anh

    this fanatical obsession with breast milk has gone past absurd and veered into the pathological arena. How sick can you be to feed your child the bodily fluids of a stranger when there is a perfectly awesome substitute? Formula too expensive? WIC will have your back (once you get past the guilt) as will food banks and churches and shhhh, your pediatrician has plenty of free samples (although they aren’t allowed to offer them to you)

    I realized how sick things had gotten when I was pumping at work one day. I work for the gov and a woman from a visiting facility was there, talking about how her son had had some health problems. I asked what was up. Turns out a woman at her facility had been stealing breast milk. She’d been sneaking in and skimming and ounce or two from several women and replacing it with water. This woman’s son lost 2 lbs over a month. Another woman was pumping for her premie and thank God her babies were ok. The women who pumped with her started locking up their milk as a result. The milk thief apparently had made a comment “well, we’re not all blessed to be big producers”. The fanatical obsession with breast milk so rampant in our society pushed this woman to larceny which put other babies in grave danger.

    • Guesteleh

      Holy shit!! I hope they at least fired her.

    • Therese

      That is crazy. But how could a baby lose 2 lbs in a month from just having a couple ounces of breastmilk a day replaced with water? You’d think baby would just nurse a little extra when mom was home. Surely baby was acting like he was starving and mom was choosing to ignore the warning signs.

      • Wren

        An ounce or two from each pumping session and water filling up the belly instead could take a while to figure out.

        • Young CC Prof

          Yeah, unlike adults, babies actually do get satisfied on liquids alone, so you could easily not notice a problem until the baby stopped gaining weight or became lethargic or something. Even then, you SEE the baby eating, you KNOW he’s being fed enough. The idea that your expressed milk was adulterated with water by some nut job at work is not the sort of thing that jumps to mind if you notice your baby acting differently or losing weight.

      • anh

        yes, it’s the same principle as parents who water down their baby’s formula. In our jobs we work more than 12 hours a day often, so her son was getting 4 feedings a day with 50-75% less calories. The baby’s belly was full so he wasn’t acting starving (although way to place the blame on the mom)

        • anion

          Heck, this is why so many diets recommend the drinking of lots of water; to fill the stomach and trick you into feeling less hungry.

          It certainly wouldn’t occur to me that some entitled POS was stealing my milk and watering it down; I wouldn’t automatically assume I was working with the kind of psychopath who would willfully endanger the babies of others.

    • anion

      “Well, we’re not all blessed to be big producers, so those of us who aren’t are entitled to steal from you and cause harm to you and your babies.”

      I hope that thief got fired. That is absolutely disgusting.

    • Jessica

      OMFG. That is horrible.

  • WhatPaleBlueDot
    The infant feeding hierarchy remains: direct breastfeeding from mom > pumped milk from mom > trusted wet nurse > pumped milk from trusted donor > formula.

    Hey, Allison, you didn’t include “pumped milk from unknown donors being paid for it,” which is actually what we are talking about.

    No. She included it. Any mom who shares breastmilk is a “trusted donor.” Breastmilk is magical and all women capable of making breastmilk are magical beings.

    • The Bofa on the Sofa

      For some reason, I have Doug Henning going through my head…

      “Life is magic, and magic is an illusion, so life is an illusion. Thank you.”

      It works better if you can imagine Doug Henning’s voice.

      • anion

        …and his moustache.

        • The Bofa on the Sofa

          How about just saying his hair, in general?

          • anion

            It was bouncin’ and behavin’.

          • The Bofa on the Sofa

            No, that was just him bouncing, in his flying yogi transcendental meditation days.

    • AmyP

      “Breastmilk is magical and all women capable of making breastmilk are magical beings.”

      I was recently in an online discussion on the subject of informal milk sharing, and you’d be surprised how close the pro position is to what you just said.

      As I recall, the idea is that breastfeeding women are generally better mothers and better people, so it’s quite safe to use informally acquired donor milk.

      Gah!

      • Guesteleh

        Which is why babies are never born addicted to meth. Oh wait…

    • Young CC Prof

      Wonder if any of those trusted donors are HIV denialists…

      • Guesteleh

        You know the story of Eliza Jane Scovill? http://en.wikipedia.org/wiki/Eliza_Jane_Scovill

        • Young CC Prof

          Yeah, that’s exactly what I was thinking of. They’re all dead now, sadly.

        • Vyx

          I grew up with the child of an HIV denialist who lost legal custody of her child to the state after demanding the right to breastfeed him despite her positive status. She believed that the she had received a false positive test, and refused antiretrovirals for many years. Three years ago, she was diagnosed with PCP and AIDS. While she still feels her previous decisions were justified, she’s much more equivocal in her stance than she used to be.

  • KarenJJ

    Interesting reaction. Unsurprising. Considering that they identify with the idea of ‘natural’, perhaps they should consider the alternative used by many, many of our ancestors: pre-chewed food. I wonder which option ends up more dangerous for a newborn.

    • Burgundy

      I heard from a friend that some vegetarian churchy moms she knew were doing that with their babies, instead buying a food processor.. GROSS!

    • fiftyfifty1

      Babies typically get their mouth flora from their mothers, so not much new would be transferred there. Even if people other than the mother were chewing the food, at least the food is typically eaten by the baby right away, as opposed to being allowed to sit like these milk samples and have time for bacteria to multiply to unsafe levels.

      • indigo_sky

        It can transfer cavity causing bacteria to the baby. American dental association recommends letting baby drink out of your cup or share your spoon for this reason, and I would imagine actually pre-chewing the food would be much worse. I think all kids are probaby colonize with these bacteria eventually, but studies have shown that kid who are colonized earlier are more likely to end up with cavities than those colonized later

        • Antigonos CNM

          I would wonder how much nutritional value is lost to the recipient who gets the pre-chewed food, as well as the possibly deleterious effects of someone else’s saliva.

        • indigo_sky

          Coming back much later (because I just noticed on while commenting elsewhere with disqs that I had a reply here) to clarify that there should have been an “against” or a “not” or something in there that I apparently left out. The ADA recommends against sharing cups and spoons rather than telling you to do it, as I somehow wrote.

  • Guesteleh

    Woman who runs milk sharing service says researchers got tainted milk because sellers thought they were supplying men with milk fetishes. Seriously. http://www.businessweek.com/articles/2013-10-22/online-breast-milk-markets-faces-germs-and-hygenie-issues-in-new-pediatrics-study

    Another woman says she’ll continue sharing milk because she meets her donors face-to-face and trusts them. Because no one who seems nice in person could ever have an undiagnosed STD, history of drug abuse or a husband who cheats on her. http://ideas.time.com/2013/10/22/why-i-still-trust-online-breast-milk-sites-for-my-baby/?xid=gonewsedit

  • Zornorph

    The moment I saw that study posted, I knew there would be a first-class lactavist freakout. A few ‘crunchy’ people in my life suggested I should try and obtain donor milk to feed my baby – even to the crazy expense of having it flown in to my little island! I was like, even if I wanted to pay that money (and I don’t), there is no way I would trust that. Even if I totally trusted the donor, the risk of improper packaging, milk unfreezing on the way, I’d be crazy to feed my baby that. I knew right from the start that I would be feeding him formula and he’s doing great on it.

  • Lisa from NY

    After the Chernobyl incident all the breast milk was radioactive.

    http://www.ncbi.nlm.nih.gov/pubmed/3189457

    • Zornorph

      Think of all the Spider-Mans that could have been out there fighting crime if more people had been able to feed their babies Chernobyl mama’s milk.

  • Tara

    I wonder if the “natural” childbirth/rearing movement(s) doesn’t have a lot more to do with fear than ego. I feel like these women recognize that parenting is really, super hard. They’re afraid they might mess up. Many of them have never experienced the kind of lack of control that comes with the territory. It’s so hard to be constantly making decisions in the moment about what is best for your child! Then along comes Ina May/Dr. Sears/Le Leche League to tell them that it’s actually really EASY. All you have to do is have a natural homebirth/wear & sleep with your baby/nurse all the time and your child will end up perfect and you’ll never have any problems!!! I’ve read some of Dr. Sear’s books and he actually says that if you attachment parent you will most likely never have to discipline your child. I am serious. It completely defies logic on every level but this is the advice he gives at the beginning of his book on discipline.

    • Zornorph

      I don’t know that I agree; most NCB people seem to suggest that parenting is actually harder than it really is in my experience. And that you must sacrifice your whole life to give your sacred offspring the optimal start in life and if you don’t , you are a horrible, selfish parent who should not have been allowed to spawn.
      Now, they do say if you follow all the NCB ‘rules’ you won’t have most of the problems that lesser parents do, but then they make the rules so hard that there is always one thing that you will slip up on, thus disqualifying yourself from have the perfect baby. Your 5yo is being a brat? You didn’t baby-wear enough! That’s what you get for pushing him around Disney World in a stroller.

      • anion

        God, I always thought I was the only one who couldn’t figure out why being a mom is supposed to be this impossible, never-a-free-moment task. I mean, of course some days are harder than others, and I’m not saying people who find it difficult are doing it wrong or something, but really…it’s not all pleasure but it’s not really all *that* difficult.

        Granted, I’m lucky in that my children are extremely well-behaved and have been since they started having “good” or “bad” behavior (as opposed to being babies who acted the way babies act). I don’t claim their excellent behavior is all down to me–some kids are just easier than others–but I know my husband and I had something to do with it.

        For me the difficulty in parenting lies in the vulnerability and unpredictability, in the “hostages to fortune” aspect and the worries about their future and being upset when other kids are miserable to them, that sort of thing. The actual tasks of parenting are not really that hard.

        Again, just my experience, and I’m not saying people are wrong for finding it challenging or that challenges don’t exist, just that so much NCB/AP/whatever “wisdom” seems to compare being a parent to cleaning the Augean Stables or something, a constant, exhaustive, mind-numbing effort without even a ten-minute break throughout the day.

        Perhaps I’m just lazy, and that’s why. 🙂

        • fiftyfifty1

          I think it highly depends on the situation. If you have an easy-to-recover-from birth, a calm baby, a copius milk supply (or use formula), and a couple of reliable relatives to help now and then, having a baby can be easy-peasy. Get the opposite, and it is really hard.

          • anion

            I had and have zero relatives willing to help; I’ve always been envious of people who have parents who actually want to babysit (my mother made a big deal when I was pregnant about how she was going to take two weeks off work when the baby came, then told me her vacation had been cancelled–turned out she did take it but used it to remodel her kitchen). 🙂 I can count the times in the last twelve years that a relative agreed to watch the girls on one hand.

            I think babies are always difficult, even easy babies, because of the adjustment and the feeding and diapers etc. etc. I mean more with toddlers and older children. Like I said, I’d never say that if it’s difficult you must be doing it wrong, but I don’t understand why the general expectation is that it’s this Sisyphean task and it’s nearly impossible for the average person to handle it. If you’ve ever read the STFUParents blog you see a constant stream of “It’s the hardest job in the world! It’s a constant source of stress and aggravation and mothers are heroes for daring to attempt it and are geniuses for everything they do!” and that’s just not been my experience. As Antigonos CNM says above, the general consensus seems to be that if it’s not excruciatingly difficult you must be doing it wrong, and I just find that odd.

          • Wren

            My relatives are largely on another continent, so help from them has been rare. My husband works very long hours, so help from him is also on the rare side. I actually found babies easier than toddlers, especially my second. I had two in diapers for a year but my second was an amazingly easy-going baby as long as she could breastfeed regularly. The only real issue I had then was PPD after her birth. Then she hit the toddler years and it all got harder.

          • anion

            The hardest thing about my second was that she screamed if she wasn’t being held. If she was asleep and I put her down she woke up in less than a minute and screamed. We finally co-slept because there was no other way for us both to sleep (I mean, she would scream for hours–no “crying herself to sleep,” and if she did exhaust herself she’d sleep for five minutes and wake up to scream some more. Drives with her were a nightmare). I know co-sleeping isn’t the best thing to do and would never tell people to just do it, but she literally would not sleep any other way.

            The hardest with my first was toddlerhood (once I got over my own PPD and the shock of having a baby–I don’t deal well with change), especially when she started learning to walk. I spent hours stooped over behind her, holding her hands up, walking in circles around the living room and kitchen. 🙂 My back does not miss those days (even though my heart does).

          • Mishimoo

            Yes! I totally get you on the co-sleeping thing. I hate it because I know how dangerous it is, I’d never recommend it, BUT it’s the only way I had any sleep after our current bub arrived. He’s been sleeping mostly in his bassinet since 8 weeks, but we still have rough nights because he is so hungry. He’s nearly 4 months now and I’m hoping to sneak him into his own room because he is too big for the bassinet now.

          • anion

            The scary thing is, I might have tried harder once we got past the first couple of months to stop co-sleeping if I’d realized how dangerous it was/is, but the information I found on it said that it’s not really dangerous if you’re actually breastfeeding (i.e. the risk drops significantly if you co-sleep and breastfeed as opposed to co-sleeping and formula feeding, so it’s barely a risk at all).

            I actually loved co-sleeping but it terrifies me in retrospect; at the time I thought it was really safe to do. (I did make sure there were never covers above my waist and that her head was always on my upper arm to prevent roll-over accidents, and luckily I’ve never been an “active” sleeper, but still. I had no idea at the time how risky it was.)

        • Wren

          A lot of it comes down to the combination of your personality and your child’s. Avoiding unusual health issues is helpful too. My son isn’t too hard, though he can push my buttons and did need a lot of stimulation when very young. My daughter, on the other hand, has bladder issues that have effectively meant I’ve got a child in the middle of potty training for the last 4 years. Medication and plans to approach this have helped, but it has been exhausting and the laundry is never ending.

          • anion

            Very, very true. Like I said above, it could be I’m just lazy. 🙂 I tend to be a fairly laid-back person and don’t get stressed really easily, and I don’t obsess about being The Right Kind Of Mother or doing everything according to the book or what other mothers do. (I am in no way implying that you do, btw, or that anyone here does, I’m speaking in generalities, and thinking more specifically about the kind of pressure some moms exert on others about how if their kid doesn’t have the right activities or study aids or toys or clothes or food they must be doing a bad job.)

            It’s not that I don’t think being a parent is difficult in general, just that I haven’t found it to be constantly stressful and near-impossible. Everyone is different and everyone’s situation is different; my statement was more about the idea that if you’re not always on the verge of a nervous breakdown without a moment to yourself you must not be doing it right.

            I can imagine how difficult and exhausting your daughter’s issues are. I hope it gets better for all of you soon.

      • Antigonos CNM

        I get the feeling that, if you find parenting easy, the assumption is that you must be doing it wrong. You gotta suffffferrrr, doncha know? So make it as difficult as possible.

        I wonder how many of these SuperMoms will hit their kids over the head later with a variation of “how I SACRIFICED for you when you were small and now you don’t even appreciate it!”

        I think of this sometimes when I remember a women’s class in certain aspects of Judaism, and the rabbi teaching it said, when one of the students wanted to add all kinds of additional stringencies to the performance of a mitzvah, “You are required to keep the commandment, not to make it so hard that it is impossible to keep”.

        • Zornorph

          I’m very careful when I tell people I’m having an easy time of it. Lots of people do not want to hear that, especially from a single person and a man at that.

          • araikwao

            Oooh, yeah, if you said ANYTHING in my presence about how well your son sleeps overnight, I would punch you. Or at least want to. I’d probably miss anyway, I’m that sleep-deprived I can hardly see straight. 😛

          • Amy M

            I am sorry. I remember how hard it was when mine didn’t sleep through. It will get better, really. :).

          • auntbea

            Apparently the second is the opposite of the first, so you should probably just stick to one. 🙂

          • Zornorph

            True, but I’m likely to go back to the well for another one. I’m prepared for a screaming horror. 🙂

    • Certified Hamster Midwife

      So it logically follows that if you ever have to discipline your child, it’s just that you failed as an attachment parent. Got it.

  • An Actual Attorney

    I’m sorry if I missed someone already mentioning it, but I loved this Gawker summary:

    http://gawker.com/breast-milk-acquired-via-internet-is-probably-unclean-1449482918

    “If you are a person who has the energy and drive to hunt down sacramental breast milk on the Internet, you are a person who does not need to worry about the harm that a bottle of formula might do to your baby.”

    • guest

      that’s funny! and probably true enough!

    • Young CC Prof

      I wish I could like this more than once. Correlation and causation, people!

  • The Computer Ate My Nym

    Know what surprises me? That it was all actually breast milk. Did they check to see if any of it was actually formula or cow’s milk? Because it’s not like the FDA is going to audit the senders any time soon…

    • Jocelyn

      This thought has never even occurred to me, that people might be sending just regular cows’ milk. But with the prices so high per ounce, it would be a really lucrative market for a fraudster.

      • Lisa from NY

        I heard babies can tolerate goats milk. Is that true?

        • Zornorph

          My ex wife was raised on goats milk. Of course, given what a nutjob she turned out to be, this would probably not be a good advertisement for feeding your baby goats milk.

          • AmyP

            My grandma was also raised on goat’s milk back in the mid-1920s. (She was a twin.)

        • Young CC Prof

          The macronutrient balance of plain goat’s milk isn’t right for a new baby, too much fat and protein, not enough sugar. However, apparently it kept alive any number of motherless children over the centuries.

        • Certified Hamster Midwife

          The friend who introduced me to this site* also sent me to a paleo diet forum where people discussed a baby formula consisting of raw goat’s milk with liver pureed into it. I think the liver was raw. I’ve blocked much of it out.

          * – I’m childless. I think this friend might secretly hate me.

          • Laura

            I have a paleo friend who thinks formula has to many chemicals so she supplements her nursing with a homemade formula of goats milk, carrot juice, flax seed oil & nutritional yeast. There is no talking to people like that.

          • Certified Hamster Midwife

            Raw goats milk I’m sure.

          • anion

            Good lord.

        • Tim

          It’s more suitable than cows milk, but by no means is it as suitable as infant formula, which is actually made for human consumption and all. anyone who says otherwise is a lying liey liar.

          • Antigonos CNM

            Camel’s milk is also supposed to be superior to cow’s milk for infants. Go buy a camel and let it live in your back yard. And good luck milking it.

          • Young CC Prof

            If I’m ever stranded in the desert with a motherless infant and no formula, I’ll remember that.

          • KarenJJ

            I’ve absolutely done this and I highly recommend it. Only the best for my darling little Quinoa and yes the bruises I get each day from milking it are totes worth it. I only occasionally get a broken bone or crush injury. She’s already speaking at least two languages (English and another language that sounds very spiritual to my ear) and can count sequentially all the way to 33! Plus she’s great at giving to the poor brown people we encounter on our daily cultural walks and is soo empathetic she cries when she sees them.

          • anion

            Quinoa? How dull. I prefer unique names, like Khi’nnwoah. 😉

        • araikwao

          See The Pediatric Insider blog, he addressed it in a post a while back.

        • antigone23

          They might be able to survive but goat milk is way too high in protein and sodium and low in carbohydrates, iron, vitamin c, and folate when compared to human milk and formula, which has a nutrient profile that mimics human milk. Goat milk is closer to cow milk than it is to human milk. The high protein and sodium causes strain on the kidneys and the lack of some nutrients causes deficiencies. Yes, human babies have managed to survive on goat’s milk, cow’s milk and other various concoctions, but there is really no reason to take dumbass risks like these when there is a safe substitute that will not strain your baby’s kidneys or deny them important nutrients – formula.

    • nomorequestionscatherine

      I was thinking the exact same thing. Or checking for proper calorie range per ounce. They charge per ounce so I can see someone watering it down to get more $$

    • The Computer Ate My Nym

      Having read the article, I don’t think they tested the quality of the milk itself, only the bacterial and viral load. Anyone out there with the equipment needed to do the testing? You could probably get a paper out of it…

    • guest

      The researchers had the same thought!

      From this link: http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/42394
      “It is conceivable, however, that the samples bought by researchers in
      this study were not breast milk or were diluted with, perhaps, cow’s
      milk. ‘We are currently carrying out a second phase of the study to
      determine that,’ Keim said. ‘It’s possible that some samples were not
      entirely breast milk.'”

  • yentavegan

    I am a community volunteer breastfeeding resource. I have spoken about the issues and problems with casual milk sharing and cross nursing.
    Breastmilk is an intimate body fluid.
    Although I can justify to myself why I would have nursed another woman’s child if push came to shove; we are clearly not fighting off invading marauders or the zombie apocalypse with no other means to keep an orphaned infant alive other than casual milk sharing/cross nursing.
    although i secretly believe that my breastmilk possessed immeasurable benefits nutritionally and emotionally I doubt that enough of it’s magic goodness would survive pumping, storing, freezing, thawing, purchasing to make it worth while.

    • Wren

      I almost nursed my nephew once. He was only 6 weeks old and had never had a bottle when my sister was unexpectedly called away so I looked after him along with my own 7 month old. He got hungry about 10 minutes before she got back. I had her permission to feed him, but hadn’t yet done so when she came back.

      Other than that, starvation situations would be the only time I could imagine breastfeed isn’t another woman’s baby. Donating milk to actual milk banks seems like a good thing to me, but donating over the internet? Not so much.

      • I had her permission to feed him

        I’m quite curious about this.

        How common is it for mothers to nurse another’s baby, either as a one-off or an ongoing arrangement?
        What is the etiquette involved – how do you even get onto that topic?

  • Amy Tuteur, MD

    The money spent on donor breastmilk would provide more benefit to a child if it were put in a bank account and saved so the child could afford a top notch college.

    Breastmilk is not a magic elixir. People are acting as if it’s the difference between success or failure in life when really it isn’t much more than a status symbol for parents of a certain class.

    • AmyP

      I think that one of the things going on here is that WHO statements that are aimed at the developing world are getting glommed onto by lactivists in the US. Our conditions in the US could not be more different than those in countries where diarrheal illnesses from bad water kill babies and children, but US lactivists act as though we’re all in the same boat. Preferring wet nurses over formula only makes sense in environments where diarrhea kills lots of babies, and fast.

    • InfertileChick

      I’m 34 and was never breast fed by my mother. I was exclusively formula fed. I’m healthy, married, have a beautiful and smart daughter, have a few really close friends, and I’m the Sr. Director of an IT group for a well known national Life Insurance Company.

      Does TAP think my mother should feel guilty about her ability to breast feed me? It’s not as if my mother (now 60) stays up at night thinking “if only I would have breast fed, my daughter would I have better relationships. Even BETTER health. Be VP instead of Sr. Director by now.” I mean, come on lady! I am the product of a “Dumb Formula Feeder and, I dare say at the risk of sounding snotty, I turned out pretty well. I wonder how much MORE awesome I would be if only my mother fed me breast milk.

      WHAT is the measurable difference in breast milk for a person who was brought up in an middle to upper class white neighborhood with lots of love and attention?

      • guest

        devil’s advocate, but I’m 41, was never breast fed by my mother, was diagnosed with lymphoma at age 27 (and my sibs, also never breast fed were diagnosed with two other cancers at ages 14 and 36), i’m married, have a beautiful child but struggled with terrible infertility and recurrent miscarriage, i have a few really close friends, and am on the faculty at an academic medical center.

        I say that not to say those things were caused by formula, but to reply in parallel to your comment and to say that anecdotal data is anecdotal data. it’s fairly meaningless.

        one thing seems for sure: TAP DOES think our mothers should feel guilty about not breastfeeding all of us because she is a hatemonger. Her stance has nothing to do with the benefits or negatives of breast milk. she’s frightening and appears to offend even ardent lactivists.

        The truth is no one knows the difference in providing breast milk versus formula for someone brought up middle to upper class with lots of love and attention. In population-based observational studies, there is a modest association with a number of benefits. No one has conducted more rigorous trials, and therefore we are all left to guess or infer from the limited available data as well as we can.

      • Stephanie

        Well, maybe if your mother had breastfed you, you would have embraced your natural mama powers and properly given up your career to AP your child properly. After all, you are damaging your daughter with every minute you spend away from her. A breastfed mama would understand and make the sacrifices required to properly take care of her child.

      • bad@it

        Shoot, if you wait long enough, your mom, like mine, may forget how they feed their babies. She may stay claiming she nursed all of them, or maybe not. I’m thinking of forgetting about how I fed mine as well. All the children grew and have reasonable intellect and good health. Isn’t that what matters?

  • Just me

    Yah guest I read your blog and I immediately thought of you when this study hit the news. Still can’t fathom why you used donor milk. And your baby dropped off the charts. When I read that I kept thinking “should have used formula….” Regardless of your and your husband’s degrees I think you took great risks in using donor milk. I would never have done that. BS/MS in chemistry, not that it matters.

  • Trixie

    I was a donor for a real, actual milk bank. In addition to lifestyle and health screening and blood tests, there were strict rules I had to follow in regards to labeling my milk, not donating any milk with a certain amount of days/hours of consuming various medications and even herbs (for one, it’s interesting to note that you can’t donate milk if you consume fenugreek or other galactogogues, because some of them can apparently be harmful to preemie stomachs). I monitored my caffeine and alcohol consumption to make sure there would be low levels of caffeine in my milk and no alcohol whatsoever (I could still drink, but had to wait at least 12 hours between my last drink and pumoing). Then, I had to follow strict guidelines for storing the milk in the freezer, cleaning my pump, shipping it properly, etc. When the milk gets to the milk bank, it’s screened again, and then pasteurized.

    I feel good about having been a milk donor to a real bank. Of course, I wasn’t paid, but I got satisfaction from knowing that my milk was going to the babies for whom it would make the biggest difference — tiny preemies and otherwise medically fragile babies for whom there really was a measurable advantage in getting breastmilk over formula.

    The sad thing is that many milk banks are experiencing shortages as the unregulated Internet trade in milk has siphoned potential donors away. Thus the neediest babies continue to suffer from a shortage of donor milk while babies who would be just fine on formula get potentially dangerous unscreened donor milk. It really is maddening.

    • anion

      I wish I had known about donating like that when I was nursing my second. I would have been happy to pump some extra for preemies, but I honestly had no idea it could be done like that (as in, to a hospital, with proper protocols in place) or that there was a demand for it.

    • The Bofa on the Sofa

      Thanks, Trixie, for doing that. You did a good thing.

      • Trixie

        Well, I don’t donate blood as often as I should, and I’m O-, so this was my contribution to society instead. I was fortunate to have had an easy time with nursing, and had a bit of an oversupply. I sent about 500 oz over the course of 5 months, until I got tired of pumping. And they were totally cool with me saying, “I’m just tired of pumping!”

        • anh

          I’m O- as well. I always enjoy being treated like a minor celebrity at blood drives (I sometimes get an extra cookie or two!)
          then I traveled to sketchy places and now no one wants my blood 🙁

          • auntbea

            I’m A+, which makes me a pretty crappy donor, but I make up for this disappointment by believing it is a comment on my intellect.

    • theadequatemother

      Trixie, can you share with us what the protocol/ guidelines were for storing milk and pump cleaning? Just cos I find that sort of info is hard to find, often contradictory and I am now a bit wigged out that I’m going to be feeding my baby an e coli stew.

      🙂

      Thanks

      • Trixie

        Well, it’s been about 2 years, and I don’t have the handouts anymore. From what I recall, it was more stringent than whatever is normally recommended for personal breastmilk storage/use. So I wouldn’t start freaking out.

        Because remember, we’re dealing with already vulnerable babies here, not healthy full term infants. IIRC, I had to sterilize the pump parts by boiling fairly frequently, and wash with fresh hot, soapy water after every pumping session. Either milk was to go directly into the freezer in dedicated commercially available breastmilk storage bags or containers they provided, or you could store it in the fridge for I think 24 hours and combine milk from various pumping sessions within that 24 hours. But you couldn’t mix fresh warm milk with already cold milk; they each had to be chilled separately before being combined. Milk donated had to be less than 2 months old, and they preferred if you stored it in the back of the freezer or kept it in a chest freezer. It had to be labeled with your donor number, date, and approx. number of ounces.

        You had to accumulate a certain amount before they’d send you the pre-paid insulated shipping container. Then you’d fill it up and drop it off at the FedEx store for overnight delivery.

        There was a bunch of other stuff, like I had to wait 24 hours to donate if I’d taken an Advil, even though Advil is perfectly fine to take while breastfeeding your own healthy baby. You couldn’t donate within 28 days of receiving an MMR vaccine either.

        • Trixie

          Also, I was allowed to take the mini pill.

  • Rochester mama

    I don’t understand why we are so concerned with babies getting “best” when after they start eating solid foods it gets so much more relaxed. No one feels guilty buying bagged spinach or broccoli when the “best” thing would be to plant a vegetable garden and eat the spinich within 6 hours of picking.

    • Wren

      Clearly you have not been hanging around with the most sanctimommy mommies. Buying bagged spinach? Bagged in plastic?! How could you? Only locally grown organic vegetables which never go near plastic is suitable.

      • Rochester mama

        Yes I have a few nutty baby lead weaning types in my circle…but you don’t see hospitals sponsoring toddler nutrition classes or mothers posting about giving into Big Bakery and buying goldfish crackers

        • Stacey

          Not yet. Just wait.

        • Sullivan ThePoop

          I imagine if everyone could and wanted to breastfeed they would move on to something like this.

          • Amy Tuteur, MD

            Imagine if highly paid working mothers decided that it was more cost effective to pay for donor breastmilk instead of breastfeeding. The alpha parents would then wail about the contamination of donor milk.

          • Sullivan ThePoop

            I think they have proven that they will keep moving the goalpost indefinitely.

        • sleuther

          Big Bakery! LOL. You win at the internets. 🙂

    • Karen in SC

      I don’t even feel guilty about frozen or canned veggies either. Take that, TAP!

      • Wren

        Actually, aren’t frozen veggies supposed to be better than your average supermarket veg because they are frozen fresher?

        • Karen in SC

          Maybe but I don’t care! I just want the convenience!! I’m so selfish!!!

          • auntbea

            I just put broke down and put pre-cut veggies on my grocery list because I can’t be bothered to cut them. It’s really quite pitiful.

        • anion

          I know that’s true of peas. I’m not sure about other veg. But unless you’re picking peas yourself and dropping them right into the pot, frozen peas are better (they start losing nutrients very quickly, so freezing them within a couple of hours, which is the standard, is better than even waiting overnight until they’re in your local store–and they can be a few days old, even, in the store).

    • Therese

      Actually, there was a campaign among lactavists to stop referring to breast milk as “best” for exactly this reason. The idea being that breastmilk was average and formula substandard, rather than breastmilk best and formula average, because yeah, most people don’t always worry about feeding their kid the “best” nutrition.

  • Mariana Baca

    “direct breastfeeding from mom > pumped milk from mom > trusted wet nurse > pumped milk from trusted donor > formula”

    Is this baffling to anyone else but me? It is preferrable for a baby to be regularly fed by a non parental unit (wet nurse) than by either parent using formula? Don’t all the bonding advantages go out the window on that one? And donated milk is preferable to formula barring something like allergies or other health issue? If it is not “tailor made” for your baby, how is it better than formula just because it came from a breast?

    I guess my hierarchy would be:

    direct breastfeeding from mom > pumped milk from mom > formula > properly screened donor milk if there is a need

    • Elizabeth A

      I’ve donated breastmilk, and I gotta say, that’s my hierarchy. Formula BEFORE donor milk for my kids, unless there’s a medical need for donor milk.

    • Amy

      I think it might make more sense in a developing country with trouble accessing clean water and rampant diarrheal deaths among infants and small children, although in that case, I think there would be a lot of issues with pumped milk (you would have problems then with milk storage and keeping parts clean).

      It’s largely a misapplication of a public health message that is meant for much poorer countries with different problems than most of us have.

    • PJ

      I don’t get why anyone would even think to construct a hierarchy between breastmilk from the breast and from a bottle. It impacts on a child’s life exactly how?

      • sleuther

        It impacts the sanctimommies’ blog stats, basically. And their egos.

      • Mariana Baca

        It seems like it would at least be easier — but nutrition wise, can’t imagine there being a difference.

  • guest

    I know I will be in the minority here, but I relate our story. My husband and I (MD/PhD couple) have used a mixture of my pumped milk and donated milk for our child due to latching issues, my persistent low supply, and my having recurrent mastitis in one breast that led me to wean on that side. At first we used milk from a milk bank, but at $5 per ounce it was cost prohibitive. We then connected via friends with a woman who had recently given birth and had oversupply. At our request, she completed the same blood testing that milk banks require, plus PPD testing for tuberculosis. We interviewed her extensively about her lifestyle and risk factors and she agreed to repeat blood testing every three months. We discussed protocols for handing and shipping. After getting past the “yuck” factor, we felt relieved that we could offer our child exclusive breast milk for the first year, which has undeniable (if arguably modest) benefits. Now that our child is a year old, we offer a mix of formula and breast milk (plus solids of course), some of the milk mine (although i am thankfully weaning now) and some from the same donor we’ve been using all along.

    I don’t see us as completely around the bend. I see us as trying to offer what science suggests is the best milk/food for an infant. Is the data good? No. Because it is impossible to conduct prospectively designed randomized trials. So it’s observational and has many confounds. But the extant data still suggests human milk is somewhat better than formula and so that’s what we have tried to provide.

    It is too bad there is no better regulated way to meet the demand for milk at a more reasonable cost. Based on what’s occurring in a frightening and unregulated way across the internet, there are many parents who would be interested. We were lucky that we could write our own prescriptions for a potential donor and screen them rigorously ourselves. Others are left to play Russian roulette with their child’s health. What a shame.

    • Stephanie

      Just one question. How do you know she completely followed the protocols you set in place at each session?

      • Mel

        That would be my concern also. Raw milk is an excellent medium for microbiological growth.

      • guest

        I don’t. At some point, there had to be a level of trust.

    • amazonmom

      You rigorously screened the donor and established standards with the donor. Not a problem.

      • guest

        thank you.

    • moto_librarian

      I guess I don’t really understand how the modest benefits of breast milk make it worth the hassle of securing donor milk. As you have noted, the data from most studies isn’t great, largely because of confounders. If your baby was a preemie, I could understand going to these lengths, because that is the one group of infants that reap real benefits from breastmilk, notably by helping to lessen the chances of necrotizing enterecolitis.

      If you really think that parents who use unscreened milk over the internet are doing so because they lack a better alternative, you are ill-informed. Formula is unquestionably better and safer than this when you live in the developed world.

      • guest

        eh, for us the hassle of screening the donor felt worth it. we worked for five years and through six consecutive miscarriages to conceive this little one, and rational or not would go the extra mile to provide even a possibly modest benefit for her. others might not (and almost certainly don’t) feel the same way and/or it might not be the right thing for their family, and that’s ok too. to our thinking, we suspect there are a lot of unknowns about the benefits of breast milk. and we wanted to err on the side of assuming there are likely more benefits than is known (similar to the idea that whole foods have many more phytonutrients than have been identified and therefore a multivitamin supplement does not equal the nutrition you would achieve through a whole foods diet). but who knows. perhaps by the time our daughter has a daughter more will be known.

        unscreened milk is not better than formula. you and i completely agree on that. what is a shame is that there is no system in place to begin to offer screening so that milk could be safely shared for those who wished to partake of that on either the giving or receiving side.

    • Jessica

      For a healthy full-term infant, exactly what benefits does breastmilk from a stranger confer over formula?

      As far as I know (and please, someone, correct me if I’m wrong) but all of the research that lactivists rely on to tout the superiority of breastmilk is for a mother feeding her infant HER milk, not something shipped from a stranger hundreds of miles away.

      • guest

        ” For a healthy full-term infant, exactly what benefits does breast milk from a stranger confer over formula?” because there is no research on it, we’re not sure. there was almost certainly less immunological benefit than fresh milk would provide. probably less exposure to allergens than formula might offer. we also were not able to offer my milk from the breast, since the kid could not latch. so apparently some of the dental/speech, and maybe even flora benefits from direct nursing on the nipple were lost. you do what you can.

        • Jessica

          I’m not reflexively anti-donor milk; we used donor milk (from a milk bank) in the first couple of days of my son’s life. (Then a day or two of formula, then nothing but breastmilk until he was six months old. He’s 16 months old and still nurses twice a day. So I hope it’s understood that I’m pretty pro-breastfeeding.)

          Still, the benefits of breastmilk to formula in terms of improved outcomes for infants are pretty small and greatly overstated, and that’s for infants getting their mother’s milk. The risk of unscreened, unpasteurized donor milk from a stranger who lives far away is almost certainly much higher than the benefits that *might* be conferred by the use of that milk, and certainly higher than the risks of properly prepared commercial formula in the United States.

          The issue as I see it is that parents are spending a lot of money, time, and emotional energy to provide a specific type of liquid to their child versus another, and they’re doing so despite a paucity of research that shows any benefit whatsoever to doing so, and growing evidence of real and demonstrable risks. It’s ridiculous that this is what parents are reduced to doing because of the vilification of formula in our society!

      • Ceridwen

        There is some evidence that not all women produce the components of the milk that help prevent NE in premature babies, and among those who do, levels vary from one woman to another. So in the very limited case of a preemie with a mom that doesn’t produce milk with the right stuff, milk from a woman other than mom might actually be more beneficial. But that’s still very preliminary and not exactly the sort of thing they are referring to.

    • Sorin

      I’m interested in your use of the word “exclusive.” Breast milk is good. This is true. Is exclusive breast milk better? Scientists don’t know. (And the answer is probably “no.”)

      I’m always curious when people use the word “exclusive” because it is often said with a sense of pride. But it’s not as though an ounce of formula negates the positive benefits of formula. In fact, lactivists often urge women to feed the baby breast milk because it is liquid gold; therefore, every drop is helpful. I guess I’m wondering what you feared would happen if the baby received a bottle of formula every now and then.

      In my mind, all bets are off when the kids starts eating solids anyway (no more “pure gut”–if one believes in that sort of thing). What’s really the difference between a mashed up sweet potato fed to a six month old and a bottle of formula?

      • The Bofa on the Sofa

        Thanks. This is such a big thing. Who CARES whether the baby is “exclusively breast fed” for 6 mos? Current recommendations from the AAP are to introduce solids in the 4 – 6 mos timeframe. Thus, the AAP not only does not insist upon exclusive breastfeeding for 6 mos, they actually recommend that you DON’T do it!!!!!!!

        Given that, why is exclusive breastfeeding for 6 mos even a benchmark? As Dr Amy has noted, it’s because we let the lactivists dictate the terms of the discussion.

      • Wren

        One of my children was exclusively breastfed to 6 months and refused anything but breastmilk directly from me or water for drinking until she was cut off at almost 3. Then it was just water until shortly before turning 6, by her own choice.
        I would have gladly given her a bottle, believe me.

        • Sorin

          Oh, man. That would have driven me nuts. I had such a terrible time nursing my first–cracked, raw nipples, pain, etc. DH giving her a bottle was the only way I got a little bit of relief. Fortunately, she took it just fine and had no problems switching between breast and bottle. DS (3 months) is the same way.

          I feel for you!

          • Wren

            Don’t feel too bad for me. She was the child who had clearly read the manual on nursing before birth. I had one bout of mastitis during that 35 months, but other than that no real problems at all. She latched straight on from literally 2 minutes after birth and I never really had cracked or anything. My milk never dried up between mine, so I think that made it easier.
            My son would take either up until 9 1/2 months, when he dropped the breast without warning. He was tongue-tied and my concerns about something being wrong largely got ignored, so it was painful all the time with him. She was a huge relief.

      • Guest

        Maybe I am just not all that sensitive to the phrasing, but the word exclusively breastfed means simply that, hasn’t gotten formula. I see it as an accurate description rather than a stamp of approval. Of course, I am also a breastfeeding mother who could give a rats ass about how people feed their children as long as they *do* feed them.

        That being said, I am a “bad” breastfeeding mother who introduces solids before six months, so even though my babies didn’t get formula, I wouldn’t count as exclusively breastfeeding either. Heh.

      • guest

        i didn’t mean “exclusive” as a source of pride or a brag, i actually thought it was the terminology used to describe the no-formula situation. i may be wrong but i thought that both are true – there are benefits to any breast milk and there are additional benefits to “exclusive” breast milk. i was under the impression that one main point of providing “only” breast milk has to do with gut flora, which are different for breastfed versus combo fed babies. had it not been for that, i would have combo fed from the start, it would have been much easier. i think there has been some research on this, but can’t vouch for its quality. we held off on formula until around 11 months because i had a strong supply of breast milk from myself and the donor with the idea that if cow’s milk shouldn’t be offered b/c of allergy risk until after 1 year, than formula made from cow’s milk might also increase risk of allergies. but i think if i’d been able to get to six months with a full supply of my own milk and then my supply had then dropped, we wouldn’t have worked to find a screen a donor, we would have added formula. since we already had a working system in place, we kept it.

        • araikwao

          No cow’s milk as a drink until after 12 months is not about allergy, but rather that it contains too much protein and sodium. Infants with cow’s milk protein allergy can be symptomatic even if exclusively BF..

          • guest

            thanks for the correction. I must have misunderstood my pedi. she had raised some concerns with regular formula because we have a strong family history of allergies, so when we did consider formula, we were considering a hydrolyzed one to reduce that issue. but it’s totally possible that something got lost in translation and i misunderstood.

    • DiomedesV

      1. The primary benefits of breastmilk are immunological. How is donated breastmilk (frozen, presumably; pasteurized?) providing immunological benefits to a baby?

      2. The period of greatest benefit to the baby from passive immunity is the first 3 months. Why continue to offer donated breastmilk after 3 months? Why not just combo feed with the milk you have? Especially since there really are few immunological benefits after 6 months.

      3. Why is a one-year old on formula? Unless your child has a major health problem, s/he should be weaning.

      4. What you described has little in common with a scenario where people are accepting milk from 20-30 women that they’ve “screened” largely by looking at them and ticking off: a) white, b) well-dressed, c) no tattoos.

      5. “Somewhat better” probably doesn’t justify the risks you took, and definitely doesn’t justify the risks other people are taking. As a taxpayer, I’d rather see my money go to supporting milk banks that provide breastmilk for the neediest infants, rather than condoning the fetishization of the breast so common among upper-class parents whose children are in no way in need of whatever “somewhat better” breastmilk may provide.

      • guest

        1. baby probably got some immunological benefits from the donor’s milk…better to get mine, since baby and I shared the same environment, but figured the extra boost from afar wasn’t hurting any.

        2. I was trying to follow AAP guidelines on breastfeeding to the best i was able, using screened milk in place of just mine. not the same, I realize, but as close as we could come. if they had a policy statement that said donor breast milk is bad, even when screened, I would have abided by that too, but they don’t. My pedi was supportive when at first we had a close friend provide milk during hurricane sandy as we waited for mine to come in (had just delivered).

        3. she hasn’t quite reached one yet, but is very petite. we will follow pedi’s recommendations re: weaning for her particular case.

        4. you are right. using 20-30 donors gives me the heebie jeebies too. scary stuff.

        5. i’m not sure that we did was all that risky. we screened rigorously, shipped overnight with dry ice, and were quite careful. as for the milk banks, i wish they could be expanded to accommodate more young babies and preemies. it would be great, for example, if all hospitals had enough pasteurized donor milk on hand to be able to offer it when babies lost excessive weight just after birth before mom’s milk came in, as an alternative to formula. if people didn’t want it, that would be fine, too, but it would be great if it were an option.

        • DiomedesV

          Fair enough. I definitely understand the petite issue, I faced the same thing. However, given that your daughter was getting your own milk, I’m still not convinced that donor milk to avoid more formula was worthwhile. I think people make this kind of calculus out of unreasonable fear of formula.

          • guest

            donor milk to avoid formula maybe made less sense after 6 months, but by then we had a screened single donor in place, so we kept it. this individual was also nursing and storing milk for her own baby, which gave us some comfort that she would be motivated to use the hygenic standards and protocols we had discussed and she agreed to.

        • antigone23

          My understanding is that milk banks screen/test the milk itself, not just the donor. That is a key difference. The FDA has explicitly warned against obtaining milk from individuals, rather than milk banks (http://www.fda.gov/ScienceResearch/SpecialTopics/PediatricTherapeuticsResearch/ucm235203.htm) and just a quick search of articles on the topic have indicated that AAP spokespeople have also warned against it. I have a book from La Leche League that also warns against it. I have no problems with donor milk, in theory, but leaving it in the hands of individuals is unnecessarily risky. As someone pointed out upthread, the proliferation of informal milk sharing has actually drawn donations away from legitimate milk banks and the vulnerable, sick babies they support. I support milk banks and I wish that the milk sharing sites would be shut down and their donors redirected to milk banks. Yes milk from milk banks is prohibitively expensive, because of the rigorous standards they practice to protect babies. If there is a medical need, it should be covered by insurance.

      • Trixie

        To the point of breastmilk retaining immunological benefits after pasteurization and freezing — I was told by the milk bank that their process does preserve most of the immune benefits. I’m not really qualified to discuss the specifics of why.

        • DiomedesV

          That may be true. I have to be honest that I don’t know very much about storing and reusing breastmilk. But I find it hard to believe that, when a baby is getting some breastmilk from mom, that replacing formula with donor milk makes any difference.

          • Trixie

            I believe that when it comes to preemies and necrotizing enterocolitis, that a diet of exclusive breastmilk lowers the risk more than a combination diet, although a combination diet is still better than just formula.

          • DiomedesV

            We’re not talking about a premature infant.

    • fiftyfifty1

      “Because it is impossible to conduct prospectively designed randomized trials. ”
      Not impossible: PROBIT.

    • Mac Sherbert

      “Others are left to play Russian roulette with their child’s health. What a shame.”

      Not they aren’t. They can go to the store and buy formula.

  • amazonmom

    Haha! I met my infant feeding goals by using formula! That’s the thing that these breastmilk obsessed people don’t get! I’m not secretly wishing I was an exclusive breastfeeder. It doesn’t matter what happens in public policy, my breast function, it just doesn’t matter. I’m using formula as supplementation if needed. My feeding goals will be met for my son when he gets enough to eat. Simple, but some will never get it will they. I sure hope my wishes will be respected without a fight at the hospital when I have my son.

    • anion

      Be prepared for lectures and horror stories about the harms of formula (all of which are ridiculous). Hopefully it won’t happen, but it sure happened at the hospital where I had my second; I was breastfeeding but was furious at the tone of the teacher who gave the “Infant Class” for brand-new mother there, who reduced a couple of formula moms to tears.

      Again, it might not happen, and I hope it won’t, but forewarned is forearmed, right?

      Best of luck to you and your baby!

      • amazonmom

        Yeah, my post has an element of fantasy to it! After working in the NICU in the hospital for 7 years I’ve gotten to know just how nuts the lactivists can get. I’m seriously considering banning all lactation staff from my room during my stay. When my daughter was born a staff member lied about her weight loss to prevent me from supplementing. Apparently ” all you NICU people do is shove formula down their throats”

        • Karen in SC

          Some lactivists really believe that FF babies are at risk of dying. Apparently related to the risk of infection but no links have been posted to any scientific studies, that I recall anyway.

          • amazonmom

            When I got a tech to tell me DD had lost 16 percent of body weight I lost it a little. I demanded that I would now be running the show or else I would get the NICU medical director involved. All of a sudden my plan to feed formula until I actually got milk was ok! It helped that I had his number on my phone ready to send….

          • Sullivan ThePoop

            There is an epidemiological study that found that formula fed babies were more likely to die, but the causes had nothing to do with formula so it must have been confounders.

  • Amy M

    I work in a lab, and occasionally deal with human blood products. Usually animal blood products, but sometimes human….we have to get trained every year on the protocols for dealing with human blood products, and even though everything we use is screened and clean, we are trained to treat it like it is contaminated with HIV. This goes for ANY human bodily fluid (though I don’t come in contact with any others) in this setting, and (I have no doubt) in hospitals and other medical settings. As far as I am concerned, breast milk is the same as blood and should be treated accordingly. If you don’t know what is in it, assume the worst and protect yourself (and in this case, your baby). We do know what is in formula. Can formula get contaminated? Sure, but it’s a pretty rare occurrence, especially when the mother is aware of proper formula prep techniques, and it sure as hell isn’t going to be contaminated with HIV.

    • MichelleJo

      As a phlebotomist, I would say that around half the training is about avoiding contamination. Doing a blood test is a twenty step procedure, only one of which is actually drawing the blood. The rest of it is to avoid contamination or infection, in the blood, patient, or phlebotomist. I doubt that people donating milk for $$ are anything like aware of all these steps (even with them all, we still have scares), or even have the stuff available that is necessary to keep to them.

      And although this involves needles, which dealing with breast milk is not, the rules for dealing for urine samples are just as stringent, including the provision that the fluid never comes into contact with an non-sterile surface or human touch. The lids have different holes, needles and stickers to ensure this. I’m pretty sure that there is no breast milk special receptacle container widely available.

      • Dr Kitty

        I’m afraid I dip urine in my consulting room and transfer it into culture bottles on a daily basis. Spills are inevitable. I take a pragmatic soap and water and hydrogen peroxide approach to cleaning.

        The joys of General Practice include people bringing you samples of body fluids in inappropriate containers, which you then have to decant into the right jar or bottle.
        Tupperware boxes, jam jars, plastic butter tubs, shampoo bottles- you name it, someone has probably brought it to me filled with urine, faeces or sputum…and occasionally other body fluids too.

        I send clean catch samples of breast milk in universal specimen jars (same ones as I use for sputum, skin scrapings or toenail clippings) all the time. So far the lab has not complained.

      • anion

        An OT aside: I had surgery for a ruptured ulcer a couple of years ago, and was in the hospital for two weeks and was subject to pretty much daily blood draws. I practically cried with relief every time a phlebotomist was sent to draw my blood instead of a nurse or doctor, because you guys not only managed to find my veins the first time, you managed to not cause incredible pain or hematomas. (One MD resident actually stuck the needle in, missed the vein, and without withdrawing the needle just went digging around in my arm until he managed to find one. It was horrific.) Not to mention how friendly and funny the phlebotomists all were.

        So thank you, phlebotomist, for your skill and care. You guys rock.

        • MichelleJo

          Nice to be appreciated! Especially as phlebotomists are pretty much at the bottom of the totem pole of medical professionals and some superiors take pleasure in reminding us of that!

        • Mishimoo

          I’ll second this! I love phlebotomists, they always listen properly when I warn them that I’m a hard stick and point them to the best vein.

  • AL

    The replies to Dixley’s post are full of denial and ignorance. It’s embarrassing. Really? Formula is in the bottom of the hierarchy? You’d rather feed them contaminated human milk than formula in which the water is typically boiled first before it’s used?

    I felt so guilty that I had to mix feed my older son formula and breastmilk (Low production due to NICU stay) and was determined to exclusively breastfeed my younger one. All that irrational guilt went out the window when I heard this horrific story through a friend of mine. Apparently one of her clients who is/was anorexic was imposing her body image/feeding regiment on her INFANT. At 9 months old she weighed 13 lbs, and was still in newborn clothing. She would feed her 12 oz of milk a day and would sometimes water it down, and would also give her chamomile tea to kill her hunger pangs. Someone thankfully reported her to CPS and she’s doing well and looks like a normal 2 year old now, although I don’t know how much damage is still left from the starvation she suffered.

    So really after that story, I let go of my guilt. I fed my child formula because I wasn’t producing enough and I didn’t want him to starve, which is the same reason a lot of formula feeding moms choose to use formula. And you know what, he’s only 3 and he taught himself how to read, so he doesn’t seem to have missed any of those IQ points from the missing breastmilk ounces.

    I’m now pregnant with my 3rd and you know what, it’s great to not have that pressure on myself this time around. I also work full time and I honestly HATE having to pump. I don’t mind nursing one bit but the chore of pumping is not something I’m looking forward to again. So we’ll see what happens but I do not have the mindset of BREASTMILK ONLY this time around, and really, it’s freeing.

  • FormerPhysicist

    Honest question – does stomach acid make a significant difference? Lots of comparisons to sexually transmitted diseases and IV drug use with shared needles. But IV is, well, IV. And sex, well, how likely transmission is depends on a whole host of factors (including how rough the sex is). Swallowed milk goes into a very acidic stomach. Different, obviously, but is it a significant difference?

    I would never take the risk, I’m just curious about transmission vectors.

    • Guesteleh

      It’s known that HIV can be transmitted through breast milk, which is why in developed countries HIV positive women are advised to use formula (recommendations are different in the developing world due to lack of access to medication, contaminated water, etc.). Hepatitis is not considered to be transferable through breast milk, according to the CDC. Salmonella and other food borne illnesses aren’t destroyed by stomach acid and can cause illness if they are present in breast milk.

      • MichelleJo

        Yeah, whenever I hear the oft-repeated claim that babies get their mother’s anti-bodies through breast milk so are less likely to get sick, I point out that if they can get anti-bodies, they can get viruses the same way. They kind of flounder at that one. Because your average breastfeeding mother has no clue on the subject of immunology and what the antibody business is all about anyway.

        • Young CC Prof

          My personal favorite was the nut who insisted that antibodies created by natural infection could be transferred to your baby by breastfeeding, but antibodies created by vaccination couldn’t. And also that antibody transfer before birth was impossible, but antibody transfer after birth through breastfeeding was perfect and uninterrupted, even in older babies and toddlers. HEADDESK.

    • KarenjJ

      What I understood was that small babies up to a certain age can absorb things like anti-bodies from breastmilk and after a while the stomach just starts processing the anti-bodies like any other protein for food (same as eating steak). I wonder if that makes babies more at risk from things passed along in breastmilk then older children?

      This was what one of my specialists told me and was the reason why I shouldn’t breastfeed while on medication, but also why I have to inject my medication because it wouldn’t survive the stomach.

      • quadrophenic

        Curious about what medication you’re on. I’m on enbrel (protein, injected) and I don’t breastfeed on it but I guess Thomas Hale’s book says it’s theoretically ok because of the size of the molecule so some women use it while nursing. I feel like I know exactly how safe formula is, but I don’t know how safe breastfeeding on enbrel is, so formula wins out.

        ETA: I was on enbrel. Had to stop while pregnant, but apparently some use it in pregnancy too. But there’s no alternative to gestating your baby, so there’s a different balance at work there.

        • KarenJJ

          Similar to enbrel – I’m on anakinra. Some people have breastfed while on it and I had some mixed info. In the end I went with the paediatric immunologist who looked into it further for me. Anakinra was meant to theoretically be OK, but formula also seemed to be OK and I found breastfeeding to be a difficult enterprise.

  • Antigonos CNM

    We were taught that breast milk itself was sterile, although the nipple it was sucked through carried all the flora found normally on the skin, of course. The “cleanliness” of breast milk, and the absence of the necessity to refrigerate it [at a time when mothers would mix a 24 hour supply of formula, sterilize it in bottles and refrigerate them] was supposed to be one of the big selling points of breastfeeding: sterile, always available without time lost for preparation, and at the right temperature, too!

    Even during periods when the use of wet nurses was common, usually a mother would vet the prospective wet nurse for health and other qualities before letting her baby suck the “alien” milk. What is coming over the internet is completely unregulated; I can’t see how anyone could possibly trust it.

    • araikwao

      The understanding has changed, and now the selling point is about the wonders of the probiotics contained in breastmilk: living food and whatnot.

  • Women need to know about the risks – this highlights the risks that seemed absolutely plausible before the study was done, but were not quantified. I would like to think that women would be pushing for regulation of this industry (I’m pretty sure the women who run the websites don’t do it for free, and it also sounds like the donors also don’t do it for free). Formula strikes me as an absolutely reasonable alternative to using donor breast milk.

    • The Bofa on the Sofa

      I would like to think that women would be pushing for regulation of this industry

      What “industry” are you talking about? This is black market.

      There are milk banks, and they are absolutely regulated. The problem for these people is that they are not run by idiots, and their diligent screening is costly (the milk is usually free-comes from donations). Therefore, they don’t waste their precious product by sending it off to everyone who wants it, and limit it to use in situations where it is highly needed.

      What they need to do is to have more extensive donation to the currently existing milk banks to make EBM so plentiful that more people who want it can get it.

      • Just because it’s black market doesn’t mean its not an industry. The crunchies use the word “industry” like its a bad word – all the while ignoring the very real fact that the alternatives are also “industries” – they’re just absent the regulation.

        • The Bofa on the Sofa

          If you regulated it, it wouldn’t be through the black market any more.

      • Stacey

        One problem is that there is always going to be a limited source of milk. Think about how many moms actually BF, and then realize that only a small # of them will pump and donate, especially for free. Adding payment increases the pool of willing donors, but also adds cost and risk.

        Another issue is that milk banks are costly ventures. You cannot do a milk bank halfway, since milk is a body fluid, you need to do all the testing, screening, and storing, to high standards. Then there is insurance and staffing. If you don’t and hurt someone, you can lose everything in a lawsuit.

        There is a reason that the banks currently only give milk to preemies and others with medical need. There just isn’t enough to go around. Having milk banks that provide milk for any baby, regardless of need, would also increase demand considerably, as moms that wouldn’t use peer to peer would see it as an alternative to formula. This would make the desire to profit even greater. The desire for profit can be a good thing in business, but it can also cause issues and promote unethical situations.

        Maybe if BF was very popular, and there was a dedicated, well organized, volunteer group (like LLL) willing to do much of the leg work, maybe then it would be a more likely proposition. Otherwise I just do not see it happening on a large enough scale to provide milk for those that want it.

        This is why there is formula.

        Instead of milk banks, it would be more reasonable to tackle the issue of peer to peer milk sharing in a harm reduction manner. This would be hard, because the people likely to participate in this are likely to disbelieve anything you tell them. They think its safe already, so why would they need to do anything more?

        • The Bofa on the Sofa

          Another issue is that milk banks are costly ventures. You cannot do a milk bank halfway, since milk is a body fluid, you need to do all the testing, screening, and storing, to high standards. Then there is insurance and staffing. If you don’t and hurt someone, you can lose everything in a lawsuit.

          Right, that is what it takes to regulate it properly, which is why you can’t do that with “over the internet” trade.

          We have a regulated breast milk sharing “industry.” It is just very complicated and expensive. These women want no part of it.

        • guest

          “he people likely to participate in this are likely to disbelieve anything you tell them. They think its safe already, so why would they need to do anything more?”

          eh, i bet they all don’t think it’s perfectly safe (we didn’t), even if they underestimate the risks. i suspect many would be thrilled to have a safer alternative.

  • anne

    This reminds me of a blogger who was considering donating her breast milk after her child died. Of course she smokes a lot of pot but who cares! It’s breast milk!

  • Sorin

    “It boggles my mind that any mother would give her child the unscreened,
    possibly contaminated bodily fluid of a stranger that she bought on the
    internet. The reality is that the benefits of breastmilk are trivial and
    hardly worth the risk.”

    This.

    No one would think it’s a good idea to grab a syringe, suck the blood out of a random stranger (no matter how “clean” she looks), and inject it into a baby (or anyone, for that matter). Feeding your baby unscreened breastmilk is the exact. same. thing. It’s a bodily fluid. Full stop.

    I’ve mentioned before that SIL fed her baby 100oz of unscreened donor milk from someone her midwife swears is “safe” and “clean.” I absolutely cringe at the thought, and I want to scream, “How can you be sure?!” Maybe this woman thinks she is, but what about her husband? Ever taken health class? SIL has to trust that not only is the mother not engaging in any risky behaviors, but her husband isn’t as well (operating on the assumption that it’s a heterosexual couple engaging in sexual intercourse).

    When DH found out what his sister did, he asked me, “Um, what are the risks of feeding the baby formula?” Me–“None.” I’m absolutely appalled that anyone would ever feed a baby unscreened donor breastmilk.

    I look at my fat ‘n happy three month old who is both breast fed and formula fed, and I feel sorry for the women (like SIL) who have so bought into the “breast is best” rhetoric that they are willing to risk their babies’ lives.

  • stacey

    Waiting for the lactivists to parachute in and tell us we are all mean, ignorant, and the million reasons we are wrong.

  • Busbus

    On a local mom’s message board in my (very crunchy) town, there was this woman a few weeks ago who basically posted how she hasn’t slept more than 2 hours in 9 months, and she can’t take it anymore, and she is too exhausted to pump, and PLEASE can someone bring her some pumped breast milk so her husband can feed the (9 month old) baby so she can finally take a nap…

    Umm, lactivism makes people go nuts.

    • moto_librarian

      And that is awful. Inexcusable, really.

    • Sorin

      I feel sorry for women like this. She clearly believes that a 9 month old must be parented like a newborn, which leads me to believe that she’s bought into a lot of the “natural parenting” rhetoric. As a result, she’s sacrificing her own health and sanity thinking that she’s doing the “best” thing for her child.

      I don’t want to assume, but I imagine that if anyone suggested some night weaning techniques, that poor person would be chastised for being a cruel and “unnatural” parent.

      • anion

        Am I the only one thinking something is wrong, if a nine-month-old is still nursing that constantly? (I assume it’s almost-constant nursing, or she’d be able to pump her own breastmilk for her husband to feed the baby.)

        • I don’t have a creative name

          Maybe she’s not feeding solids yet, since baby needs all this extra bf unicorn poop magic. I would hope that’s not the case – the kid would be starving.

          • Wren

            My oldest was still nursing and pretty much avoiding all solids at 9 months. Then we both got hand, foot and mouth which tanked my supply and scared him off the breast (the sores in the mouth are very painful) and he discovered chocolate ice cream. By 12 months he was eating almost everything.
            All that to say I wouldn’t swear a 9 month old on no solids is starving or that the mother hasn’t tried to feed solids. It took from 6 months to 9 1/2 months for my son to get into solids.

          • Niemand

            Mine discovered solids when we visited Mexico and she stuck her hand in a plate of refried beans…and discovered that it was tasty. She was right around 9 months at that time and I was starting to worry about whether I was going to be able to wean her before she left for college. Most babies do get it if offered the opportunity. But breast milk isn’t actually complete nutrition for older babies and they can start to get vitamin deficiencies if not supplemented at all.

        • Sorin

          My perfectly unscientific opinion? By that point (assuming the 9 month old is at an appropriate weight), nursing that frequently has become a habit.

          Physically speaking, a 9 month old is capable of going longer than two hours without eating. Nursing, particularly through the night and also particularly if one is co-sleeping, can become a habit. I read a great analogy that basically said–if every time you woke up, someone waved a slice of your favorite pizza in your face, wouldn’t you continue to wake up just so you could take another bite?

          I know with my 3 year old, she continued to wake twice per night to be fed until she was almost 11 months old (and we weren’t even co-sleeping). I finally wised up and realized she was doing it out of habit. I won’t make the same mistake with my newbie, and I will night wean him as soon as he is physically able to go through the night without eating.

          Let’s not also forget that babies/children need deep, restorative, REM sleep to grow and develop properly, which can’t be obtained if they wake every two hours.

          • Ceridwen

            This is actually a frustrating issue for me because while in theory they can go longer without eating, there are circumstances that can make night weaning a lot more difficult.

            My daughter decided at about 3 1/2 months old that it would be fun to reverse cycle. So instead of eating most of her calories during the day, she eats them at night. We went from having a 5-6 hour block of her sleeping to her waking every 2 hours to eat. And she is *really* hungry. She’s eating full meals, not snacking, and doing anything else during that time has her livid. If she wakes sooner than 2 hours for some reason, she can easily be put back down without nursing in almost all cases, and she does not (and will not) nurse to sleep at bedtime or for naps, so it seems unlikely to be strictly a habit to me.

            The thing that pisses me off about it is that there is almost ZERO advice for how to get her to go back to a more appropriate schedule. Asking about it will get you referred to a Kellymom page that just tells you you should be happy about it! We’ve recently (at nearly 6 months old) started to make progress toward getting her back to eating more during the day but it’s been with no help from the breastfeeding advocates.

          • AmyP

            I wonder if starting solids (when the time comes) will help clue her in to the fact that day is day and night is night?

          • Certified Hamster Midwife

            Well, obviously she’s ready for college now.

          • Certified Hamster Midwife

            > I read a great analogy that basically said–if every
            > time you woke up,
            > someone waved a slice of your favorite pizza in your > face, wouldn’t you continue to wake up just so you
            > could take another bite?

            Well, I know what I’ll be dreaming about tonight.

        • Young CC Prof

          Yeah, I’d guess either the constant feeding has become a habit, or the baby is not getting enough to eat.

      • AmyP

        “She clearly believes that a 9 month old must be parented like a newborn, which leads me to believe that she’s bought into a lot of the “natural parenting” rhetoric.”

        Or PPD. Or both.

      • KarenJJ

        Wow. Kids at that age are eating all sorts. My kids were already eating corn on the cob, cut up bits of steak, pieces of fruit and veg and even hot chips. Even my nephew, big fan of breastmilk and no huge fan of food, was really enjoying bread and bananas and sucking on chop bones.

    • The Computer Ate My Nym

      A nine month old should not be exclusively breast fed. A baby that age can start developing vitamin and mineral deficiencies from exclusive breast feeding. Iron and vitamin K come to mind, but I could have that wrong. I hope someone responded, “Have your husband take the baby out to buy a little baby cereal and then he can feed her that while you have a nap.”

  • stenvenywrites

    WAIT! You mean people purchase bodily fluids from strangers over the internet and it doesn’t work out well? How can that BE?

    • stacey

      You don’t say!
      What a shocker!

  • quadrophenic

    It’s not just denial of the vulnerabilities of pumped milk. Once you admit donor milk may not be safe, you validate the use of formula for those who truly cannot breastfeed. Even they claim 2% of women can’t (although that number is far from trustworthy). The answer is always “if you truly can’t breastfeed or have low supply, there’s donor milk!” If that milk isn’t reliably safe, you now have a legitimate reason to formula feed. So this reality now undermines her whole philosophy that no one ever has a good reason to formula feed, ever.

    • Jocelyn

      Oooh, good point. That IS what they say, and now there’s this study to contradict them.

  • Guest

    Wait, what? Does she really refer to people who use formula to Dumb Formula Feeders? Holy s**t. I am lucky and happy to have breast fed three babies, but don’t really give a crap how other people feed their kids and don’t know much about this lady’s blog. That is just in humane, stupid, self important drivel.

    • Tim

      She sure does, because she’s a worthless bitter trash heap of a human. Actually, that’s unfair to trash heap who was a great fraggle rock character.

    • Poogles

      “Does she really refer to people who use formula to Dumb Formula Feeders?”

      Well, Dr. Amy added the [“Dumb Formula Feeders”] to the above post. From some searches on TAP, it looks like “DFF” stands for “Defensive Formula Feeders”…though I would not be surprised in the least if she has also used “dumb” instead of “defensive”.

      http://www.thealphaparent.com/2013/01/how-to-spot-defensive-formula-feeder.html

      • Amy Tuteur, MD

        I can’t decide whether that’s better or not.

  • anion

    1. Isn’t one of the big pro-breast statements supposed to be that by breastfeeding, your body magically knows exactly what nutrients etc. your baby needs at any given time and can adjust itself accordingly? So how would donor breastmilk be like your own milk, if the baby’s mouth has never actually touched the breast of the donor mother?

    2. Man, I won’t even buy preserves sold by nice ladies who brewed them up in their kitchens, I’m so worried about botulism etc. I certainly wouldn’t give a stranger’s raw bodily fluids to my baby. (Anybody remember the 80s movie Baby Boom, with Diane Keaton? Where she makes homemade baby foods and sells them? The movie shows her spooning hot applesauce from a stovetop pot into a plastic tub, placing a lid on it, and setting the tub in her pantry with a bunch of other tubs. Like a storage system for incipient death, right there in her home. *shudder*)

    • Jocelyn

      I took a cooking class in college where our teacher told us about a friend of hers whose whole family (husband and children) died from getting botulism from food the friend had canned. I’m still freaked out about that story, and don’t know if I’ll ever be able to bring myself to try out canning.

      • anion

        Yep. I love to cook. I cook dinner every day. I bake my own bread. I bake other things–cakes, pies, whatever else–at least once or twice a week. I’ve used slow cookers, pressure cookers, deep fryers (I use mine at least once a week), all sorts of kitchen machines and gadgets; I’ve performed almost every sort of cooking process or method. But canning or preserving terrifies me and I won’t do it. All it takes is one speck of dirt or dust, one sneaky germ…no way.

        • Therese

          You do know that the cans are submerged in boiling water for like 20 minutes, right? I don’t think your statement that it just takes one speck of dirt is correct at all!

          • anion

            Apparently that’s not an absolute guarantee:

            http://www.pickyourown.org/botulism.htm

            But this is one area where I don’t really care if I’m entirely accurate, to be honest. It scares me and I don’t wanna do it, and I won’t buy it from other people.

            (My “one speck of dirt” comment wasn’t meant to say if a speck of dirt gets in there that’s it, it was more that one speck of the wrong kind of dirt can cause a problem.)

        • Young CC Prof

          I’ve done jelly a lot. Actually doesn’t frighten me at all, boiling jelly is about 225 farenheit, and the jars are held under boiling water until immediately before use. Even if dust lands on the jelly while you’re doing it, it’s instantly sterilized.

          Also, even if you screw up, the sugar content is so incredibly hypertonic that nothing can possibly live in there.

      • me

        I canned tomatoes from my garden a few years back. I was meticulous and followed USDA guidelines. Now, tomatoes are highly acidic (and even so, you still add a certain amount of lemon juice), so they are one of the safer foods to can. Other, less acidic foods? Not too keen on trying that, even if I had a pressure canner.

        • anion

          You are far braver than I! 🙂

      • Certified Hamster Midwife

        I keep waiting for this to happen now that canning is trendy, but haven’t heard of any cases.

      • Trixie

        If you follow USDA guidelines for canning tomatoes, which include acidifying with additional lemon juice before processing in a hot water bath, or pressure canning, then you won’t get botulism.

  • Mel

    My DH is a dairy farmer born and raised. I’m a city kid. On our first date, I asked him what he thinks about drinking raw cow milk. He looked at me and said “My family and I drank it growing up, but I think most of the people who drink it are bat-shit crazy. We live and work on the farm. I’m covered in cow manure every day. I’m exposed to all of the bacterial load the cows have to offer anyways I’m not gonna get anything from the milk that I don’t get from the manure. When we have anyone over who doesn’t live on the farm, we buy pasteurized milk.” My in-laws, who live and work on the farm, drink raw milk. My husband and I drink pasteurized since I work in the city and have minimal exposure to the manure….well, except for a few bad chore days…..

    Human milk is a raw milk. If you are breastfeeding your baby, the kid is going to be exposed to the same bacteria you are exposed to. Since your body is pumping antibodies and what-not into the milk, it’s a wash or even a small benefit to the baby. The benefit disappears as soon as you get milk from someone with different bacterial load. The problem becomes really bad when the person has a communicable disease. Or doesn’t use aseptic technique.

    • Young CC Prof

      That’s exactly what I say about raw milk. If you have one cow or small herd of cows, you might get sick the first time you drink it (and yes, back in the day that would sometimes kill babies/toddlers) but once you got over that you were OK. If you just go and buy it, you’re taking the same risk with every bottle.

      • Antigonos CNM

        Drinking raw milk was at one time a great way to get TB; why did Pasteur develop his technique, after all?

        I have had two experiences with milk banks. The first was when I was in Cambridge, and we had mothers who said they had “too much” milk for their babies and were dripping all the time. We would bring them sterile bottles, and return the milk to be Pasteurized for use in the prem nursery and NICU [more because of the difference in fats making breast milk more digestible than formula than for any other reason]. The second was at the Hadassah Hospital, when we had “extra” breast milk from women who had delivered there. In both instances we had full medical histories on the contributing women, and we could rely on the processing of the milk. No way we would have taken milk from any anonymous source.

        • Mel

          It amazes me how quickly society has forgotten how easily milk spread tuberculosis. I had a nasty case of diarrhea a few months ago that would not go away. When I was meeting with my GP, she noticed the farm flag on my medical records and wanted to know if I drank raw milk. I said no – too many memories of microbiology lab + way too much lactose for my lactose-intolerant body. She looked a bit disappointed; it would have been much easier to track if we could just test the milk instead of a stool sample.

        • Therese

          If formula is designed to be as compatible as possible with the infant gut then why is breastmilk poo still so different from formula poo? What is it that breastmilk contains or lacks that causes such a difference?

    • Trixie

      Humans don’t wade around in their own poop all day the way cows do, though.

      • Certified Hamster Midwife

        Not anymore. We evolved coming in contact with poop or poop-contaminated water quite a bit, though.

      • Mel

        US dairy producers had a hard time controlling Johne’s infection in cattle. While exposure to manure can transmit Johne’s, producers had gotten safeguards in place to minimize that route of infection. It took a few more years to realize Johne’s infected heifers pass the bacterium through colostrum to calves. Johne’s infection rates on farms plummeted once colostrum from first-calf heifers was discarded and replaced with colostrum from Johne’s-negative second-calf or older cows.

  • kumquatwriter

    “Dumb Formula Feeders.”

    Because, like, omigod, she’s totally not judging! Or putting other women down!

    • AllieFoyle

      Well, to be fair, DFFs hardly count as women.

    • stacey

      She thrives on both judging and putting people down. It is her entire schtick

  • AllieFoyle

    1 in 5 chance of giving the baby CMV? Not to mention whatever the heck else is in there that you don’t know about it? Yeah, that’s worth it.

    • guest

      you would only give CMV if person had been just exposed themselves. them just being postive would confer transmission.

      • AllieFoyle

        It says 21% positive for CMV DNA. I’m sure the seroconversion rate is much less than 100%, but still, DNA is the infectious agent. They aren’t just talking about antibodies.

  • moto_librarian

    So she TAP actually refers to women who formula feed as “Dumb Formula Feeders?!” Wow. Well, I may be a “dumb formula feeder,” but I’m pretty sure that my baby’s not going to get HIV or Hepatitis from Similac or Enfamil.

    Allison, if I were you, I’d start rethinking my definition of “dumb.”

    • PJ

      I think the way people like her fetishise breastmilk is weird. Breastmilk is nice, but like every other part of the human body it is imperfect. Do these people think women’s breasts somehow bypassed the evolutionary process? Do they think other animals feed their animals with magical milk, or is it just humans who have milk superpowers?

      • moto_librarian

        That’s a very good point. How do they know that cow’s milk doesn’t give my kid some special powers too?

        • Busbus

          But don’t you know that cow’s milk is for cow babies..!? Pffrrrrrrrrrmpf…!

          • moto_librarian

            I prefer to think that my special snowflakes can now speak cow fluently.

          • Wren

            Hmm…we do call my daughter “Moo”. However, she’s the one who never did drink cow’s milk or formula.

        • auntbea

          I spent my entire childhood drinking cow’s milk and now i can lactate!

          • Young CC Prof

            But can you digest cellulose?

      • S

        I think it’s more that they don’t understand evolution.

    • Burgundy

      You can “inactivated” HIV with a stove top, don’t you know?

    • Poogles

      “So she TAP actually refers to women who formula feed as “Dumb Formula Feeders?!””

      Well, Dr. Amy added the [“Dumb Formula Feeders”] to the above post. From some searches on TAP, it looks like “DFF” stands for “Defensive Formula Feeders”…though I would not be surprised in the least if she has also used “dumb” instead of “defensive”.

      http://www.thealphaparent.com/2013/01/how-to-spot-defensive-formula-feeder.html