Donated Human Milk – Why It Should Be The First Alternative For All Babies

Donated Human Milk – Why It Should Be The First Alternative For All Babies

It’s well known human breast milk is the optimal nutrition for all babies, especially sick and preterm infants.

Recently, a respected medical journal, The Lancet, published a report that found increased breastfeeding rates worldwide could prevent the deaths of almost 825,000 children under the age of 5, and 20,000 deaths from breast cancer every year.

Today, however, fewer women are exclusively breastfeeding for the first 6 months of their baby’s life, especially in high-income countries such as Australia, the UK, Canada, and the US.

Donated Human Milk – Why It Should Be The First Alternative For All Babies

Despite leading health organisations advocating screened donor milk as the next best available option for babies, many countries are failing to provide this option. Accessibility and acceptance of donor breast milk remains controversial in many countries.

A Brief History Of Milk Sharing

Mothers providing breast milk for babies who are not their own, is not a new concept. In many cultures, for centuries, mothers have nursed other women’s babies in various situations, whether or not the babies had access to their own mothers’ milk .

Until the invention of the feeding bottle in the 19th century, wet nursing was considered the safest and most acceptable alternative to mother’s own milk.

Wet nursing in Europe increased from the 11th century as human populations settled and urban areas increased. Wet nurses from the country were preferred over women from towns and cities, as it was believed they were healthier.

Eventually wet nursing became a job for many women. They provided milk for babies whose mothers were ill, or unable to produce enough milk, or for babies whose mothers had died.

Artificial Feeding

By the 19th century, artificial feeding had become a feasible substitute for wet nursing. Improvements in infant formulas, as well as bottles and teats, meant artificial feeding gained popularity very quickly. Wet nursing fell out of favour and infant formula quickly filled that void.

By the mid 1900s, doctors were recommending formula to mothers who were having breastfeeding difficulties in the first few days after birth. As a result, formula was considered a safe alternative to breast milk, and became more widespread, and breastfeeding rates declined steadily until the 1970s.

Milk Banking

Because breast milk was known to be beneficial for sick babies, lactating women were encourage to express their milk and donate it to hospitals. The first human milk bank was opened in Austria in 1909, followed 10 years later by the first bank in America, and then by more banks in Germany.

By the 1930s, milk banks were distributing sterile containers to milk donors, and picking up donated milk daily. Milk banks continued to open and operate until the 1980s, when the fear of HIV transmission was so great that many milk banks closed.

Why Is Milk Donation More Important Than Ever?

Breast milk is species-specific nutrition. This means it’s perfectly engineered by a mother’s body to ensure her baby has the exact nutrition required for growth and development.

There are literally hundreds of substances in breast milk that haven’t been identified by researchers, and can’t be replicated.

The many benefits of breast milk include:

  • Providing antimicrobial and anti-inflammatory substances
  • Promoting long-term health
  • Reducing incidence of infections and diseases in premature babies (bacterial meningitis, respiratory tract infections, necrotising enterocolitis, and urinary tract infection)
  • Reducing the rates of Sudden Infant Death Syndrome (SIDS)
  • Reducing the incidence of many diseases, such as Type 1 and Type 2 diabetes, leukaemia, Hodgkin’s disease, obesity, and asthma.

You might be interested in reading what’s in breast milk and what’s in formula.

Brazil Dramatically Improves Infant Mortality Rates With Milk Donation

In the 1980s, Brazil decided to make a concerted effort to reduce their high rates of infant mortality. At that time, only 2% of babies under 6 months were exclusively breastfed.

Since then, the country has worked hard to normalise breastfeeding and milk donation. The formula industry is strictly monitored in Brazil, to prevent the industry from influencing breastfeeding mothers.

Of the 292 human milk banks in the world, 220 of them are in Brazil. As a result, the infant mortality has fallen by 75% in the last two decades.

Human milk banks not only reduce the rate of infant mortality, as seen in Brazil, but offer mothers the chance to provide their babies with an alternative to infant formula that provides the same benefits as direct breastfeeding.

Currently, donor milk is seen as useful only for premature or sick babies, but it has the potential to support women in boosting exclusive breastfeeding rates worldwide.

Why Isn’t Milk Sharing More Acceptable?

Women decide to stop breastfeeding for a number of reasons. Most are directly related to lack of support from qualified lactation consultants, who could help address issues that commonly lead to weaning.

Mothers might have poor supply, or have medical reasons for being unable to breastfeed. They might be sick, or simply wish to supplement feed their babies. All of these mothers often have only one option before them – infant formula. It’s promoted and sold as the next best alternative to a mother’s breast milk – simply because it’s the only alternative that’s promoted.

There are a number of milk banks around the world, but they are used specifically for sick and premature babies. A small number of mothers will offer to wet nurse, or donate breast milk, but this usually occurs within their own circles, or via social media networks such as Human Milk For Human Babies and Eats on Feets.

What Do We Think Of Milk Sharing?

Ask other women about their thoughts on milk donation, and usually their response is not positive. Some women see it as disgusting, other women feel it would be too difficult to do on a regular basis.

On the other hand, most people see no problem in donating blood, organs, eggs, or sperm. These acts of donation are seen as helpful, selfless acts that improve or even save lives. This is exactly what donating breast milk does for babies and young children!

Changing Our Views On Milk Sharing

The World Health Organisation (WHO) and UNICEF jointly developed the Global Strategy for Infant and Young Child Feeding to demonstrate the impact feeding practices have on the health, growth, and survival of babies and young children.

The Global Strategy promotes the use of breast milk from a healthy wet nurse, or from human milk banks as the best alternative to mother’s breast milk.

Yet in Australia, Europe, and America, there is very little awareness of milk donation and banking . Australia has 5 milk banks, North America has 16, and Europe has 203 (across 50 countries).

Women are continuously exposed to the message that breast milk is the optimal source of nutrition for their babies, and when breastfeeding doesn’t work out, they feel they have failed. Infant formula is promoted as their only alternative and, for many mothers, this isn’t good enough.

Stories Of Milk Sharing

Women who donate milk report feeling a great sense of worth, and satisfaction that they’re helping other mothers provide optimal nutrition to their babies. These women are usually long-term donors, who store and donate milk over a number of years while they’re nursing their own babies.

Ariane’s story: My first milk donation was when my firstborn was 4 months old. I was part of a group of women donating to a newborn whose mother had passed away. It was a great honour to be part of that group, and I’ve made many friends.

I’ve gone on to donate to nearly 10 families – some long-term donating relationships and some one-off donations. The donations were needed for a variety of reasons. I enjoy being able to help other families, as I’ve been assisted in my parenting journey many times by those around me. We can donate blood, sperm, eggs, and organs – why not breast milk?

Jen’s story: I wish milk banks were more widely available. I was treated like I was daft, when I asked about it while still in hospital. I was blessed to receive milk from a couple of close friends, but it wasn’t enough for the amount of top ups required.

Once I had breastfeeding established I went on to donate to several families, some acquaintances, and others strangers. I also wet-nursed my niece a couple of times.

Amber’s story: I donated my milk to 5 different babies in need, both long-term (1.5 years) and short-term. I helped coordinate a group of women to ensure a baby never needed formula due to the mother having IGT (Insufficient Glandular Tissue).

I also wet-nursed a set of twins I cared for, to assist their mama so she didn’t have to pump. Being a breast milk donor helped encourage me to become an egg donor too.

Alex’s story: I donated through my hospital, to babies in special care. There was only a small window for donation – when my babies were 0-6 months – and the first 2 months were devoted to recovering from birth and establishing supply. I always did a ‘drop and run’ outside the hospital, but once I had to go into special care to deliver the milk. Being up there (I’d never been there before) made it really hit home how important it was for these tiny and very vulnerable babies. I felt blessed to be able to provide the milk, and figured it was the least I could do.

Natalie’s story: I was very lucky to have a regular donor and some one-off donations that kept us going. It was such a blessing to receive milk. It really did feel like the gift of life, and knowing my son was still able to have breast milk really helped my mental health at a very difficult time.

Cate’s story: I have IGT (Insufficient Glandular Tissue) so have an undersupply that could never meet my baby’s nutritional needs. With the help of donor mothers on social media I was able to avoid formula completely, until he weaned from top-ups at around 19 months old. My heart will always be so full of gratitude for those selfless, generous mothers.

Emmaline’s story: When my eldest was born he had a bad case of jaundice, and needed extra milk to help him recover. Of course I was told, and believed at the time, that the only way to do this was to express the few mls that I could, before my milk had come in, and then supplement with formula. I really wish I had known that donor milk was another option, as I hated giving my newborn formula.

If the hospital had a milk bank I could have accessed, it would have been amazing. Or if they had just asked me if I knew anyone who could have donated, I could have asked my sister in law, who was breastfeeding a 5 month old at the time, and had a huge stash of breast milk in the freezer. I really think we need more milk banks, better educated health professionals. Informal milk sharing needs to be normalised. If it was something everyone did, then my sister in law would have just offered, and I wouldn’t have even had to ask.

Emily’s story: I had low supply, and my twins reacted badly to formula. While I was at home, we could feed around the clock, and this kept supply up, together with medications.

When I looked at starting work, I sourced donor milk from 3 donors, to keep in the freezer while I pumped at work. I couldn’t pump as much as the babies needed, so in the end I stopped work again. The donors provided recent blood test results, and we had frank discussions about health and safety before the donation. The donors were lovely women, and we still stay in touch.

The decision to source donor milk is often a challenging one, as there is little chance of accessing screened milk through national milk banks, unless your baby is sick or premature. Most women are unaware of informal milk sharing networks in their area, or that this is even an alternative they could choose instead of using formula.

While there is considerable cost in setting up and running milk banks, this cost should be offset by improving the health of all babies, who are entitled to receive optimal nutrition. As the situation in Brazil has shown, when breastfeeding and breast milk are seen as the norm, and not as one alternative for infant feeding, it changes the social and cultural viewpoint.

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Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.

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