Sharing breastmilk: Making the most of liquid gold

​Breast milk sharing is rapidly gaining popularity in NZ, and for good reason. Everyday kiwi women who are complete strangers are connecting through Facebook pages like mothersmilknz and human milk 4 human babies NZ where women can both donate and seek out breast milk for their infants.

These pages are not only a great village of support for new parents, but they also offer another option to formula where cost is no barrier. For parents that cannot provide breastmilk for their infant but feel strongly about exclusively feeding their baby breast milk, this option can feel like a blessing. 

There are polarising opinions about breast milk sharing, which can sadly lead to parents seeking donor milk in secret, feeling that many people will judge them with their opinion that it’s disguising and wrong. However, not all of us feel this way and alternatively, know that breast milk is the ideal food for all babies and the biological norm.

Sharing of breast milk is not a new phenomenon. It was a standard practice in 1975 in hospitals until the rise of HIV and the introduction of formula, which resulted in the shelving of this practice. Wet nursing was also practiced and still is in some cultures where family and close friends will feed each other’s babies from the breast for convenience. Historically, wet nurses were employed by wealthy families when mothers did not want to suffer what some perceived as the indignity of breastfeeding.
The health benefits of breastmilk are of specific importance for premature infants whose mothers desperately want to provide breast milk for their infant in the NICU (Neonatal Intensive Care Unit) but physically cannot produce milk in the volumes, in the time that is demanded of them.

Donor milk is treated like gold in the NICU due to the protective components of breast milk, which includes immunoglobulins, anti-bacterial proteins as well as the many oligosaccharides which provide bioactive factors, prebiotic, immunomodulatory & antimicrobial effects.

Immunocompromised premature infants are transitioned onto milk feeds quickly to protect their vulnerable digestive system from a serious medical condition called NEC (necrotising enterocolitis) that is associated with high mortality and morbidity rates. Donor breast milk is also hugely beneficial in aiding the rapid growth for these babies which is required for their progression through the NICU and therefore earlier discharge home with their caregiver.

The first New Zealand milk bank was opened in 2014 in Canterbury to provide breastmilk for babies whose mothers are unable to provide their own and priority is given to this group of vulnerable infants. Donor milk is pasteurised to prevent transference of disease form donor to recipient by heating the milk in a water bath to 62.5 degrees for 30 minutes and then quickly chilling the milk to 4 degrees. Miraculously this time and temperature combination does not destroy the all of the immunological protective benefits of breastmilk. Due to the success of the Canterbury Milk Bank, more funding has become available and another milk bank could potentially be opening in Auckland.

Donor milk banks ensure quality control by maintaining standards during transportation and storage, formal screening and guidelines for pasteurisation of donor breastmilk. Unfortunately these standards are not met when mothers freely share breastmilk on social media. We cannot ignore the risks that are associated with feeding babies unscreened or unpasteurised donor breastmilk, and this poses similar risks as blood products. 

For parents who choose to give their baby another woman’s liquid gold, safety is left to the common sense of the donor and recipient. However, below is a list of guidelines how this can be done more safely based on ADHB's recommendations:

1. Try to minimise the number of donors
2. Choose a donor who is feeding a baby of similar gestational age to yours to ensure that composition of breastmilk is the most appropriate
3. Recipients should ask a few lifestyle questions of the donor or donors
4. Blood tests would be ideal but not always necessary
5. Home pasteurisation

Some questions a recipients might like to ask her donor:

1. Do you have any a chronic illness for example insulin dependent diabetes?
2. Have you had an intimate relationship with someone who has hepatitis or HIV?
3. Have you had a tattoo in the last 6 months?
4. Are you taking any prescription medications?
5. Do you drink more than 3 servings of coffee or caffeinated drinks per day?
6. Do you drink alcohol?
7. Do you smoke?
8. Do you consume illegal or recreational drugs?
9. Are you a vegan?
10. Could you have been exposed to BSE disease in the United Kingdom?
11. Have you received an organ donation?
12. Is your own baby in good health and growing well?​

If the donor agrees to provide a blood sample, below are the recommended tests:

• HIV 1 and 2
• Human T cell lymphotropic Virus 1 and 2
• Hepatitis B and C
• Syphilis
• Cytomegalovirus​

Pasteurisation of milk at home – here is what you need to do…it's easy!

1. Fresh or frozen breastmilk is stored in a clean (sterile) glass jar
2. Place the glass jar into a pot of water and bring the water to the boil
3. Once the water begin to boil remove the jar of breastmilk
4. Cool to room temperature and give to your baby within 6 hours​

Thanks on behalf of the receipts to those generous milk donors out there that have provided or are providing for other babies, you are saving lives and making lives better. Hopefully, this information will help make it safer for babies and help reduce any stigmatisation around the art of sharing liquid gold.
If you have excess milk and think you would like to donate your milk, your efforts would be greatly appreciated, please follow the links below.
[email protected]
https://web.facebook.com/mothersmilknz/
https://web.facebook.com/hm4hbnz

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