Monday, 16 July 2012
Now, we all know that formula itself is not bad or evil. If it weren't for formula my little one wouldn't have survived his initial days as a preemie baby. I myself was given formula from about one month on.
We also know that there are too many resources to list here explaining why breast-milk is best. It's practically common knowledge that when possible babies should get breast-milk. In case you weren't aware, you can see the CDC site and the WHO site for the official recommendations. Some more in depth lists of breast-milk benefits can be found on the Dr. Sears site and too many others to list.
I am unable to produce a full diet of milk for my son, and so my baby and I have been truly blessed to receive milk donations from other breastfeeding moms. For mothers who are simply unable to produce enough, or any, milk of their own donated milk can be the answer.
What is it?
Donor milk is simply human breast-milk that has been expressed or "pumped" by a one woman and shared with someone else, usually for the benefit of a child not her own.
Actually, people donate milk for purposes other than feeding babies too! Human milk is used in some burn units, organ transplants, and is even patented for use in meat-packing plants to kill E. Coli bacteria! It can also be used to treat gut and bowel syndromes, renal failure, metabolism problems, ulcers, immunodeficiency diseases, burn victims, and infectious diseases such as intractable diarrhea, gastroenteritis, infantile botulism, sepsis, pneumonia, and hemorrhagic conjuctivitis in both children and adults.
Why would you use it?
Above I've listed some reasons people use donated breast milk, but for this discussion we are referring to milk used to nourish a child.
Some families choose breastfeeding for health benefits only to find out that breastfeeding exclusively (or at all) is not an option for the mother. I know, I know, you've heard that "everyone can breastfeed" but this simply isn't true. There are many women who struggle to produce milk. This could be because of the mother's health issues, prior surgeries, problems with the health of the child interfering with milk transfer and ultimately the mother's supply, absent mothers, non-biological mothers (adoptions), maternal death, etc.
From a purely nutritional standpoint formula is of course a viable option to provide the baby with nutritious sustenance. To achieve the more psycho-social benefits of breastfeeding there are tools like supplemental nursing systems.
However, some people still wish to provide breast-milk, or find that their babies are unable to tolerate formula well. For instance, some babies with GERD have worse reflux when fed with formula.
For more information on why breast-milk would be an important consideration you can see the links provided above.
Where do you get it?
I believe the best and safest way to obtain donor breast milk for your baby is from women in your own social-mommy-network. To me, this feels safe (more on safety later), and it's the method I use to find milk for my son. I put the word out when we are low on milk and mothers in my support network (or their friends) offer up any extra milk they have.
By far, most of our donors are working mothers who have a huge pumped supply in the freezer and they don't want to have to "toss it" when it reaches the expiration date. They would rather give the milk to another child who can use it. Some of our donors have continued pumping the extra milk just for the purpose of donating it! Sometimes when we are in extreme need of milk a mom (usually a closer friend) will pump especially for the purpose of giving the milk to my cutie-bug. Honestly though, we normally get enough of the larger donations from moms who are already pumping anyway that there isn't a great need for people to go out of their way to have special pumping sessions for us.
Even though the majority of moms who donate to us are friends, or at least friends of friends, the majority of our milk volume comes from really large batches received through community groups like Human Milk for Human Babies, or Eats on Feets. Both of these groups can be found in local communities all over the place by searching facebook, or searching their websites (linked above).
Human breast-milk can also be found through "milk banks" that basically sell breast-milk. Banks are perhaps the safest option, but they are also the most difficult way to obtain milk. First you have to have a prescription, then you have to have money, and then you have to meet the requirements to receive the milk. Because of low supply, the banked milk is given to babies with severe health problems first. This milk is pasteurized for safety, and some moms have pointed out that the pasteurization process takes away some of the immunological benefits of the milk.
How much does it cost?
This is a tricky question to answer. First, let me say that donor milk from a bank, while hard to get to begin with, is the most expensive option. Sometimes insurance may help. I don't know much about the process though, so if you are interested and need help figuring it out let me know.
True donor milk, from one mom to another, should always be "free" because assigning a monetary value to the milk invites scams. You don't want to pay by the ounce, because some people thin or stretch the milk out to make money, and this can be dangerous for your baby.
However, even "free" donor milk has a high price! It takes allot of time to search out donors and arrange for obtaining the milk. Driving around to pick up the milk uses gas and puts miles on your car. Plus, it's a nice gesture to provide a courteous thank you note or little gift to the donating mother. This doesn't need to be anything expensive, and it certainly isn't required, but I like to do it anyway. Just think, each bag of milk you receive had to be pumped. This woman spent time hooked up to a machine to provide this milk! She could have easily tossed it, used it to make soap, or just left it in her freezer til it went bad. Instead she shared her liquid gold with you! Give her a card, or a little box of chocolates... whatever is within your means, and expresses your gratitude.
How do you know it's safe?
I think this is one of the most important questions! I would be remiss if I did not tell you that the FDA does not support the use of donor milk unless it comes from a milk-bank. This is primarily because of the risk of transferring infectious diseases and the potential risks of medication (or recreational drugs) in the donating mother's milk.
Those two very real possibilities make the use of donor milk seem a little frightening. However, the way you obtain your milk can go a long way to limiting these risks!
Always accept only milk that was (a) originally pumped for the donating mother's own child OR (b) pumped specifically for your child by a mother who is currently breastfeeding her own child. This means that the milk you are giving your child was considered safe enough for the other mom to provide her own baby. Normal people are not going to poison their own children, and therefore you are mitigating risk to your own babe.
You should always have a list of questions to ask a donating mother. Here are the ones I ask:
- Do you have any infectious diseases? Specifically do you have HIV? (If they say yes, either pass on the milk or check with your pediatrician. Dr. Newman has a site where you can email him questions about what is safe.)
- Are you currently on any prescription or over-the-counter medications? (Check the list for breastfeeding safety, and crosscheck against your own medications for any contraindications! Dr. Hale has a great site about this, and Kellymom.com has extensive info. Most medications are safe.) *Be very careful if the mother has been treated for cancer with chemo!
- Do you consume recreational drugs, or have you ever? (You want the answer to be NO. If they have ever consumed any you should either pass on the milk or talk to a professional. This is another time to use Dr. Newman's link above.)
- Do you consume alcohol, and if so how much? (You want their answer to be acceptable to you. You can check out #5 on this list of myths from Dr. Newman. I feel it's acceptable as long as we aren't talking about binge drinking or alcoholism.)
- Are you breastfeeding your own child? Were you when this milk was originally pumped? (To me this is the most important question. I never take milk that was not intended to be "shared" with the mother's child.)
- What are the conditions of the milk currently? (Frozen, Fresh, Deep Freeze, etc. I use KellyMom's excellent page as my own guide.)
- When was it pumped? (Compare to normal guidelines based on the answer to earlier question.)
- Why are you donating the milk? (If their own baby won't drink it as why. Sometimes moms have a high lipase issue where the milk needs to be scalded to avoid a strange taste/odor. This milk is perfectly safe, but some babies refuse it anyway. If you have a high-lipase donor give a small batch of milk to your baby and be sure it's palatable before accepting a huge donation. I've had high-lipase donors who scald the milk before freezing and we've never had a problem. If you scroll down, this page has information about lipase.)
- You may want to ask about other things, like caffeine consumption, diet (organic, steroid free, dairy-free, etc.), or any other thing that might make you hesitant to use the milk.
Kellymom.com has a great resource page with links to many sites supporting and explaining the use of donor breastmilk.
Please comment with any questions you have, or any information you think could be added to improve this resource!
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