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.

Care and Handling While Storing Breastmilk

As a donor, care and handling of breastmilk is sort of glazed over. It seems that the biggest concern is storage time so that it is still good when given to the recipient mom or milk bank. There is a little bit more to it that we need to be aware of.

When donating to a milk bank, there are specific instructions in regards to the containers used and care of pump parts. When I was donating to the milk bank, I was instructed to sterilize my pump parts at least once per day. I was also to collect milk in sterilized containers. They preferred that the milk was donated in the containers they provided since they were rigid. This meant I pumped into bottles that were clean and sterilized, then poured it into their containers.

But, what if you don't fill a whole container in one pumping session? What if you have extra? Can you combine? Are there rules for doing so? These are some of the questions that don't often get answered, but here, I will let you know.

Milk will separate after standing for a while

You can, in fact, combine samples. I'm slightly type A, so for me to have a partial container was not something I'd stand for. It is best for samples to be the same temperature when combined. You should never add fresh milk to frozen milk, and once thawed milk should not be refrozen. Because of this, the best way to combine samples is by saving partial containers in the refrigerator to attain the same temperature before combining. Just remember, if you do this, the fat is likely to have separated so swirl the milk to mix it. Never shake the milk as you can destroy nutrients doing so (see more info here). Once the milk is combined, and your container full, freeze it. You'll always want to freeze the milk as soon as possible to maintain the integrity of the nutrients. Try not to combine several days' worth of samples. It's best if they come from the same day and you don't want to have milk hanging out for several days before it's frozen.

There is also the question of quantity. How much should be frozen together? Should you fill the bags? What about larger storage containers?

When I was pumping for the milk bank, I was shipped 8 oz. containers. I filled these up to the 8 oz. mark. Most containers should not be filled beyond the top mark because the milk will expand as it freezes, but it is usually acceptable to fill it to the top mark. Most commercially available freezer storage bags (use only ones labeled for breastmilk storage) are available in 5-6 oz sizes. Can you fill them to the top mark? Yes. Should you fill them to the top mark? That depends on where your milk is going. With the milk bank, samples are pooled to achieve an ideal calorie, fat, and protein profile, so maximizing space by filling the containers or bags is probably preferred. When donating to individuals, you may want to freeze in smaller quantities. For most babies, it is recommended that that bottles given are no larger than 3-4 oz., smaller for very young babies. You may want to discuss with your recipient what their preferences are. If they are giving smaller bottles, they may want milk stored in smaller quantities so that less is wasted. Once thawed, the milk is on a 24 hour timer in which it must be used. To avoid wasting it, a mom may prefer smaller quantities. Most donors use breastmilk storage bags (unless they are using containers provided by a milk bank) since these do not have to be returned after use.

How should the containers be frozen? Should bags stand or lay flat?

Storing bags standing creates an unusual shape which may
cause storage issues for recipients.

The manner in which the containers are frozen is personal preference, but you may need to discuss this with your recipient. Obviously if you are using containers from a milk bank (or containers for yourself) this isn't an issue, but with bags, they take the shape in which they were frozen, so position may make a difference. I often leave my bags standing. I do this for no other reason than the fact that they stand easily (I've mostly used the Medela Pump 'n' Save bags which stand upright very easily). Other bags many not stand as well. In addition, freezer space may be at a premium for donors or recipients so laying the storage bags flat may be more desirable. If the milk is being shipped, freezing them flat will facilitate easier packing and allow the use of a smaller shipping container.

Remember through the whole process to handle with care. Frozen containers are very susceptible to damage. They may seem solid, but I can tell you from experience, that they will chip and crack if dropped. I have lost far more than I care to admit because the plastic container slipped from my hands. When using bags, it's not uncommon for sharp frozen edges to cause unseen tears or splits in bags. It is often recommend that storage bags be defrosted in a larger clean bowl to avoid spillage and loss. While donors may not need to worry about that, it is important that the frozen bags you are handling don't get banged or scuffed on surfaces to protect them as much as possible from damaging the bag. The more gently they are handled, the more likely they are to remain fully intact.

Lastly, ensure that your samples are received in a timely fashion. It may be a bit of an ego boost to give a large quantity at a single time (believe me, I've been there), but it's more important that it is given in a timely fashion so that it can be used before the expiration date. Don't wait to donate your milk until it is almost expired. The sooner you can get it out of storage, the better.

I hope these tips help! Happy storing!

Crying Over Spilled Milk

At no other time in your life does that cliché hold more weight to it than when you become a breastfeeding mother. Even more so if you are a pumping mom. And, dare I say, even more if you suffer low supply.

There may be no use in crying over spilled milk, but if you reach that point in motherhood, you certainly understand it. I would guess that likely every mom that has pumped has a story to tell about spilling milk and the lament that followed.

I remember one time when I was having a discussion with my sister-in-law as I sat at the table pumping away (yeah, no shame, but really, I did cover myself and block most from view). We were discussing how we both manages to have decent supplies and stating we hardly had a pump session that resulted in less than 5 oz. (times change, and fluctuate, because I can tell you, I've had many since then that were significantly less). In any case, some how, the strap that held the collection/storage bag onto my pump released and the almost full bag dropped to the floor, landed on it's side and ejected almost all of it's contents. After the cleanup and my return to pumping, I was able to squeeze out only another ounce. I was upset. A pumping session that would have resulted in 6 oz. left a meager 1 1/2 oz. At that time, I'd never had such an empty bag after a pumping session. The sad thing is, I was more bothered by my sullied reputation for not pumping a respectable amount. I know I did in fact pump a nice amount, but the loss, in my mind was more about the low total than the actual loss of the milk. Believe me, I know how bad that admission sounds. It makes me seem like a truly horrible person. Even then, I probably didn't realize the real reason I was upset, thinking it was the loss of the milk, or I was in denial about the real reason. The fact of the matter was though, that at the time, I didn't need to pump. I was pumping to create a stash that hardly got used. I was a stay at home mom with my first baby and hardly a reason to leave him. There were all of two times in his exclusive breastfeeding stage where he received bottles. At the time, not only did I not need a sizable stash, but if I lost any, I could always pump more. I had no reason to really be affected by it.

If I'm going to be completely honest I have to admit that I've always taken for granted the fact that I respond well to the pump and that I have oversupply. At least with donating, some good can come of my over-sized ego and sheer narcissism. Even better, those traits drive my competitive side so I try to pump more and donate more, so it's actually resulting in good, right? At least I can try to convince myself of that. Regardless, today, I experienced a huge change in my reaction that maybe means I'm more human than I thought.

I had just finished pumping and was moving the bag of freshly pumped milk to the refrigerator pressing the zipper on the pouch closed as I walked. My three year old appeared in my path and before I knew it, he was reaching up and squeezing the bottom of the pouch expelling milk in the process out of the small portion of the zipper yet to be sealed. Milk squirted out the top of the bag and splattered on the floor. A pain shot through my chest as I looked stunned at what had happened. Tears welled behind my eyes and I started to get choked up. I was so saddened by the situation and couldn't help but to glare at my child who smiled as if proud of what he had done. He then proceeded to lick the milk of the floor and declare, "It's mama milk!"

I certainly have come a long way. In reality, the amount that was spilled was probably less than half an ounce, but it seemed like it may as well have been my whole stash at the time. Things sure have changed over this journey from my first views of breastfeeding, to meeting more breastfeeding and struggling mamas, and now to having participated in donating milk over the past year and a half. I certainly have grown in my views and opinions. I've also learned a lot. I'm much more upset about the loss of milk because I know what some mamas go through to provide it for their little ones. I only hope that I can share that knowledge and the knowledge that even a small amount can be a big help.

Cookies and Milk

I recently received an unexpected surprise. A sweet mama by the name of Kathryn contacted me after seeing my milk donation page, Life Saving Milk, on Facebook and told me about the lactation cookies she makes and wanted to know if I was interested in trying them out. I was thrilled! Many breastfeeding mamas are familiar with lactation cookies, especially if supply has been a problem and they are seeking ways to give it a boost. While the cookies don't make guarantees or medical claims, it's often an easy thing to add to your diet (after all, who doesn't like cookies?) that may help give your supply that little boost it needs.

Kathryn runs a small home-based business, Mason's Milk and Mommy's Cookies, making lactation cookies which she started making for a friend who had supply issues. Kathryn is a milk donor herself. One thing she has made sure to do is make cookies available for mamas (and their babies) that may have food allergies or sensitivities as she and her friend both have certain restrictions in their diets for their little ones. Read more about her story here. She also runs and maintains a Facebook page with the same name as her business.

It is very difficult to decide which variety to choose as she offers over 20 varieties of cookies! Many of these varieties are available free of allergens (as needed) and organic whenever possible (this is slightly restricted if allergies are a concern). Comparatively, Mason's Milk cookies are priced significantly lower than some popular commercial brands and according to Kathryn, contain far more galactagogues (supplements, often in the form of herbs and seeds, that may boost milk supply). While certain galactagogues may work individually, many mamas find that they work better in combination with others (of course, it's always a good idea to check with a lactation consultant or health care provider to see if any of these should be avoided should you have any medical conditions that cause them to be contraindicated). Kathryn also offers a dry mix in addition to all the premade cookies so you can make some up yourself.

I decided on the American cookies (blueberries, white chocolate chips, and cranberries) and received them  a few days after they'd been shipped out and I was pleasantly surprised at the speed of delivery. As recommended, I transferred the bag of cookies to a zip top bag to maintain freshness. I forgot about the recommended schedule for the cookies, which is available on the website, and went to munching. They were delicious! Certainly difficult to maintain the one cookie a day (after the first couple of days) recommendation. What can I say, they are yummy and I have no self control.

After my limited exposure (and my slip-up on the consumption schedule) it's hard to say if they helped boost my supply. It was also that time of the month and I, like many women, experienced a dip in supply so sadly, it was a bad time to judge that. I suppose I'll have to think about getting more cookies.

For the most part though, for a breastfeeding mom with supply issues, one that wants to boost supply for donating, or really, any mom that wants a good excuse to eat tasty cookies, I'd definitely say check them out.  Use caution though, as I mentioned before, certain galactagogues can be contraindicated so be sure what you are getting. Also, if donating to a milk bank, they may have restrictions about consumption of supply boosting supplements so be upfront with them about what you are taking, even in the form of cookies or teas. Happy munching!

Pumps, Pumps, Pumps

It seems these days that when a mom is expecting and planning on breastfeeding, a breast pump soon becomes a "must have" item. A lactation counselor I know says it's actually better to wait until after the baby is born to find a pump that will suit your needs when they arise. Part of this is because in the first couple of weeks it's important to establish breastfeeding with the baby and not worry about pumping. If needed, that can come later. Some women never have need of a pump. With new changes to healthcare requirements, pump ownership may become more popular. And of course, if you are like me, you'd encourage pump ownership simply for the sake of donating. This was the main use of my pump with my second.

I received my pump as a gift from my mother-in-law. She's an IBCLC and made sure to get me a high quality pump. I use a Medela Pump In Style Advance. It really is a wonderful work horse. It's the only pump I can comment on as far as quality and how it works since it's the only one I've used, but it's not the only pump out there. It is very popular for a reason, but there are other choices.

The first thing to think about when you are considering a pump is that some moms don't respond to the pump well or at all. That's ok. Our bodies are made to respond to a suckling baby, not plastic cones mimicking the movement. Unfortunately, many women don't realize this and think that if they only pump a small amount that they are having supply issues. Pumping small amounts is never an indication of supply problems. The normal amount women pump is 1/2 - 2 oz. for both breasts combined per session that lasts 20-30 minutes. Many women find that as time goes on, they respond better and better to the pump (usually after multiple daily pumping sessions), but not all women find this to be true. It's important not to be discouraged. If you need to pump and provide expressed milk for your baby, consider increasing the number of pumping sessions. If you are simply building a stash or pumping to donate, just go with whatever works into your schedule. Any little bit helps. No matter your pumping situation, if you encounter problems, low yield, pain while pumping, etc., always seek the help of a lactation consultant. They are trained to not only help with breastfeeding, but also pumping and may be able to help you with positioning, making sure parts are sized correctly for you, etc.

So, when comparing pumps, here are a couple of things to consider. Think about what you want and what will work best for you.

Type of Pump
There are two basic types of pumps hospital grade and personal. Hospital grade pumps are typically the most powerful pumps available. They are owned by hospitals and other pump locations/nursing centers and typically rented out. Most moms don't use these for an extended period of time - usually only if providing for a baby that must remain in the NICU. If a pump is needed for extended use, like for moms that go back to work or those donating, a personal pump is usually preferred. These are a bit less powerful and vary based on manufacturer, but they are smaller and more convenient to carry around.

Pumping Mechanism
There are three different types of "pumping mechanisms" as I'll call them for pumps. Pumps come in manual, single electric, or double electric. A manual pump is just that. It is a pumping mechanism with a "trigger" like you find on spray bottles. The top attaches to a bottle or other collections container. As you pull on the trigger, milk will be drawn out and collected in the container. Manual pumps are great for their compact size and affordability  Many moms will get one of these as their starter pumps or if they are only going to be pumping a limited amount. Single electric pumps are electric pumps that will pump one breast at a time. They are electrically run so they are more powerful than a manual pump. Pumping may take more time since only one breast can be pumped at a time, but the cost savings can be a bonus. Double electric pumps allow for pumping both breasts simultaneously. These pumps are the most popular for working moms and other moms that pump multiple times a day because of the time savings. Some offer the ability to pump only one or both breasts at a time which is a nice feature.

Pumping System
Electric pumps come in one of two types of systems. This is a very important aspect to examine when choosing a pump and is often the most overlooked. Pump systems are either open systems or closed systems. While the style of system may or may not affect the efficiency/efficacy of pumping, it makes a difference to many moms who may be looking for a deal on pumps. An open system pump is a single user pump. It should always be purchased brand new and never sold or donated. With proper use, no milk should ever get into the electronics, but it is built without a mechanism to block any contamination of the parts so it they are never to be given to another user for hygienic purposes. Many "experiments" have been done where pumps of this style have been opened up and growths found which can not be cleaned out. It sounds gross, but since the pumped milk never comes in contact, it doesn't affect the milk, but it can pose health risks if shared by another mom. Similar to toothbrushes - you can reuse yours over and over, but you wouldn't want to use someone else's. These pumps may be more affordable or effective depending on the manufacturer and since some moms plan to use pumps for multiple children (and often run it down anyway after multiple kids), the single user requirement is a non-issue. Closed system pumps have a sort of cut-off that prevents anything from entering the electronics chamber in the unlikely event that milk or other contaminants go beyond the pump attachments. This is the system used for hospital pumps which is what allows them to be rented and used by multiple moms. Each mom simply purchases a new attachment kit. In the case of closed system personal pumps, these pumps can be used by multiple moms, purchased used, sold or donated after use. In most cases, these pumps are safe to use as long as the new user purchases their own pump attachments. Users may find that these pumps are more expensive than others depending on the manufacturer.

In addition to what I mentioned above, different pumps will have additional features or traits that make them more able to tailor to your needs. Some of these features may include a battery pack, car hook-up, and hands-free features. Some pumps come with parts and additional "goodies" that should factor into cost such as storage bottles, bottle cooler, and pump attachments.

In many cases, moms find that you pay for what you get. As a general rule, more expensive pumps are often more efficient and easier to use, but that doesn't mean there aren't other good quality pumps at lower prices. It's a good idea to talk to pumping moms that will have the same type of pumping requirements or habits to see what they use and which ones they like. Another option is to consult a lactation consultant as they will be able to help you choose a pump that suits your needs as well. Happy pumping! And remember, if you have extra stash or can donate some extra pumping time, NICU babies and other babies that are unable to get milk from their own mom will greatly appreciate your efforts and donations.

The Ugly Side of Milk Donation

I wish I could say that donating milk is an entirely altruistic endeavor. Maybe it started that way, but to be honest, I've noticed some traits developing in myself that aren't desirable or respectable. It's sad, really, but it's the truth. Through this journey I have found that at times, donating milk has made me judgmental, competitive, guilt-ridden and full of self deprecation. All things I'd rather leave behind, but it's not really that simple.

I am surrounded by breastfeeding moms. I subscribe to breastfeeding blogs. I frequent breastfeeding support sites and follow breastfeeding information, support, and activism Facebook pages. Such activities mean that I have a truly enviable support network and access to awesome resources. The judgment creeps in though. It's horrible. I know moms that could be donating but aren't and it bugs me. I don't know their life, I don't know their story, but I can't help but wonder why they aren't donating. It's even worse, when I hear about moms with oversupply that don't donate. When they talk about methods to decrease supply, it really gets me. I feel anger creeping in. It's not fair to them, but there it is. Many don't have the time. Many don't know about donation. In the moment though, none of that matters. I just feel it. I have to remind myself to keep my mouth shut (aside from the occasional nudge to consider donation) and later, I can rationalize it to myself again that they aren't bad people. They have their own lives and stories and it may not work for them. And that's ok.

When I was donating to the milk bank, I had them send me the larger containers since I ran out of the small ones they originally provided me with. They informed me that some moms need the bigger containers. I was one of those moms (insert a prideful beaming me). I looked at the amounts that others were dropping off as I'd log my donation in their book when I dropped it off and I was smug about my donation being larger than most of the others. Yep, I'm a bad person. I even called the milk bank and asked them how much moms donated on average. I wanted to make sure I was a top donor. I got a round-about non-specific and non-helpful answer (in all honesty, it's hard to say since the number of one time donors is far greater than the number of repeat donors. Who knows if they actually keep track of the averages like that?). I was determined to be one of the best donors they had. More recently I came across the news report about the mom that had recently broken the record in the Guiness Book for milk donation. I was impressed. And it made me want to do more. I needed to beat that record! But I couldn't. My little one was already over a year and the milk bank doesn't take donations after the baby is a year old. For a flash, I thought I needed to have another baby so I could beat that record. How messed up is that???? Then I decided I'd just pump, pump, pump, and donate record breaking amounts to local moms, until I came across this story of a mom that had donated over 15,000 oz. via milk bank donations and milk sharing and realized that I was nowhere near close to that and needed to up my game again if I was going to be among the top donors. Now, competition in this arena isn't necessarily a bad thing. If it means that you are doing a little bit extra to donate more, it's all the better. In some cases, something's gotta give. If you spend so much time focusing on pumping and donating, your life and family may ultimately suffer. Granted, I didn't go as far as to boost up the galactologues and increase my supply dramatically, but if someone went as far as to do that just for donation, their pocket book would suffer more than it already does if the cost of pumping supplies wasn't being covered. Priorities are important. Family is important. It's not fair for your family to suffer for your pride or that competitive edge.

Seeing reports of moms donating more is double sided. On one hand, the competitive side kicks in. To balance that out, the guilt and self-deprecation seep in too. When I see that someone is able to do so much, I wonder why I am not doing that too. What's wrong with me that I haven't done more? Why did I spend that time reading or playing a game when I could have been pumping? Why did I drop pumping sessions? How selfish am I? It goes on and on. It's not a pretty side of self-reflection. I feel guilty every time I take a break for myself. I feel guilty for not pumping more. I feel guilty that I used to pump 20 oz. per day and now I'm down to about 6. It's my fault too. If I pumped more, I'd get more. I can make excuses and rationalize, and even if those reasons are valid, I still feel like they are just excuses. It's tough. I'm not expecting sympathy, but many times, I've skipped a pumping session and beat myself up about it. I'm constantly thinking I need to go back to pumping as much as I used to so I can be giving more. I feel guilty and selfish. It doesn't go away. Despite the upset I feel towards others that don't donate at all, I still feel like what I'm doing is inadequate.

The whole situation can get ugly. It's important to keep things into perspective and acknowledge limits. Maybe had I set goals and limits from the start it would be easier than this emotional roller coaster. I don't know. I'm attempting to turn my experiences into something positive. I try very hard to not be negative towards other moms that could donate but don't, I try to gently encourage moms to donate that can, I try to spread the word and not brag (too much) about what I've accomplished (there are certainly others that have and will put me to shame). It's a side of milk donation and myself that I never expected to see, but there it is. It keeps creeping back no matter how hard I try to suppress it. It's always there hanging over my shoulder. My hope is that despite my shortcomings, my efforts to encourage others and educate about milk donation do some good.

Has it really been that long?

A few days ago, my youngest turned 20 mo. I can't believe he's so close to turning two! In my mind, I'm still in baby phase. Not infant phase, but he's still my baby.

With a 20 mo. old, that also means I've been donating for over a year and a half! That's truly exciting on it's own! I first donated to a local mom while I waited for paperwork to go through with the milk bank. Then, it was 10 mo. with the milk bank starting from when my youngest was 2 mo. old. I continued to donate to the local mama as long as she needed it. When my baby was a year old, I stopped donating to the milk bank (since they give to premature babies and those in the NICU, they don't use mature milk) and began seeking out other local moms that were in need of milk. Through various channels, I found several and have continued my milk donation journey.

To date, I have donated over 4700 oz. to the milk bank and over 2200 oz. to local mamas. Granted, that's no Guinness Record, but I'm sure the recipient babies don't mind. As a result of donation, I've gained 5 "milk children"  from local donations and countless anonymous ones via the Milk Bank.

I love being able to help babies in need when I've been blessed with a good supply. I'll keep on going as long as I can. I have no idea when the journey will end and when my little one will wean, but the day will come. It certainly is sad, but I hope through all of this, I've been able to inspire others to donate or at least spread the word about donation so more babies can benefit.