Buying and Selling of Breastmilk

An aspect of excess breastmilk distribution that I've overlooked has come at me full force lately. Selling breastmilk. It's something I haven't discussed before, but I feel the need to look at it more in depth and share some insights.

Among many organizations such as Human Milk 4 Human Babies (HM4HB) and Eats on Feets, selling breastmilk is not allowed. Members may be potentially removed or banned if they are found to be selling their milk. Many people believe it is unethical to be selling and turning a profit from a vital need of many babies and feel moms should only donate if they have excess milk. It is often believed that breastmilk is a right and not a privilege so it should be available to all babies, not just for moms that can pay for it when they are unable to produce enough on their own or have medical complications that prevent them from nursing.

On the flip-side of the situation, for many, selling milk is a way to supplement income. Single income families may find it difficult to meet the demands of life and any extra income may help. Those without insurance may need help with medical bills. Some moms may simply want to guarantee they are compensated for the cost they put in to pumping for milk collection bags and pump components since not all recipients offer or are able to help cover costs. There are countless scenarios that exist that may cause a mom to seek this as an option, it's not "one size fits all" and as such, it's often easier to adopt an "all or nothing" opinion on the matter.

Still, there are moms on the buying end that may need consideration. What would make a mom buy milk when they can get it for free? For some, they may be unaware of milksharing organizations like HM4HB or Eats on Feets. They may not find donors on those sites if they are aware they exist. One mom I donated to had no other respondents to her milk requests despite several postings. Buying may be a last option for some moms, but it's there, and when it often costs half the price they'd pay for milk from a milk bank, it's worth it.

I have mentioned in a previous post some of the ugly sides of donating milk from a personal stand point, but when money enters the picture of milk donation, it can get even uglier. There are some truly unethical practices that can and do occur when it comes to the distribution of excess breastmilk. It is eye-opening and moms on all side of breastmilk distribution need to be aware it happens.

Some moms feel they are doing the right thing by donating with no monetary gain when they donate to some milk banks. Sadly, there are many organizations that collect milk that eventually is sent to a for-profit milk bank, essentially, someone is making money off of milk they gave for free and with the best intentions. In some cases, the collection organization is making money when the for-profit milk bank buys it from them (you can read more about that here). The company then goes to sell the milk after processing for a much larger fee. While it is true that non-profit milk banks still charge for their milk, they set prices only to cover their costs and they have programs in place to provide milk to babies in need regardless of their family's ability to pay. Many moms are unaware when they give their milk to some places (those not associated with the Human Milk Banking Association of North America), it is being sold - this is especially important to know if the mom does not agree with selling milk.

On the individual end, there also may be some very unsavory practices when people are involved in selling milk. It's hard to imagine that some people that spend the time to pump milk would have unethical practices, but there may be people to get into selling to turn a serious profit and as a result may alter the make-up of the milk like adding cow milk or water to stretch their supply and therefore their profit, a point that was mentioned in an article I read discussing the ethics of milk selling. Still other people could act as a recipient and turn around and sell milk they received for free - similar to the companies doing it, but this time it's an individual. For this reason, many people try to get to know their recipients as much as recipients try to get to know their donors.

For many, selling milk is a good option, just like selling plasma, for others, it's unethical. Until recently, I avoided thinking about it, but now that I have, I'm more educated on some of the ins and outs. Sadly, there is a lot more grey on the topic than black and white, so forming an opinion may not be as easy as it seems. Certainly avoiding those with unethical practices is key in all areas, as are open lines of communication and making sure you have all the information. Whatever your personal opinions on the topic, it's best to make sure you are as informed as possible, which is the case in so many other situations as well.

Obtaining Liquid Gold

Among mamas that find it extremely important to feed breastmilk to their baby but have difficulty nursing themselves, there is a big problem: Access.

Sad to say, many moms do not have access to donated milk, or they don't know how to gain that access.

Among many health professionals, the only substitute for mamas own milk is milk from a milk bank. The reason for this is because milk obtained from a milk bank is screened and pasteurized for safety. Breastmilk is considered to be "living" because it has many live components like antibodies and beneficial bacteria. As a result, it is highly susceptible to spoilage and is a wonderful site for more "bad" bacteria to grow and thrive. Because this is obviously dangerous to a young baby, pasteurization is used to decrease the risk of pathogens that could cause illness in a baby. While the elevated temperatures required to pasteurize the milk may destroy some nutritious components, it's not enough to make it non-nutritious and still contains many more nutritive and health promoting factors that make it far superior to any formula.

The issue with obtaining milk from a milk bank is two-fold: limited supply and cost. The sickest, tiniest babies and those with the greatest need for it are given preference for receipt of the donated milk. This is certainly as it should be. A full term baby is much more likely to grow and do decently well on formula, whereas preemies in the NICU (neonatal intensive care unit) are at a much larger risk of diseases, especially necrotizing enterocolitis, which literally will kill off the lining of the digestive tract which then can lead to death. In many cases, obtaining a prescription for donated milk is reserved for those in most dire need. Given our advanced medicine today, many immature babies are able to survive when born earlier and earlier in the gestation process and therefore, the demand for human milk is growing as these babies are at the highest risk for infection. This means even less available for otherwise healthy full-term babies. Assuming a parent can obtain a prescription for milk from a milk bank, cost then becomes a limiting factor. Many insurance companies may not pay for human milk, and those that do may limit the amount they will pay for. Given that the milk can cost about $4 an ounce, parents may not be able to afford to give it to their child for any extended period of time.

There are fortunately, a few solutions to the above listed problems. First, donors, donors, donors! There almost certainly will never come a time when milk banks tell mamas they no longer need donors. More donors can certainly ease the lack of supply to support the demand for milk through milk banks. Second, moms may consider milksharing. Milksharing is obtaining donated milk directly from another mama. Certainly, there may be risks associated with feeding donated milk that has not been screened or pasteurized; however, through open communication, those risks may be minimized. There are many milksharing organizations out there that connect potential donors and recipients. Donors may either donated to a milk bank or via milksharing or both depending on their preferences and comfort level.

No matter the method, mamas can obtain this liquid gold for their babies. It's a matter of asking the right questions and knowing their options.