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Another Trip Down Mammary Lane

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I woke up this morning to an article in The New York Times detailing a study in the journal Pediatrics, which found that much of the breast milk to be found through online milk sharing, or unpasteurized milk sold through breast milk banks, is contaminated. Oh no!

It was just a few months ago that I wrote about the topic of milk sharing in these very pages -- My Trip Down Mammary Lane.

You see, my husband and I, with the help of our gestational carrier, became fathers to twin boys on June 9th of this year. In the months prior to their birth, I spent a lot of time driving around New York City and the tri-state collecting breast milk donations. Given that we don't have the equipment to breastfeed, we considered our options and saw donated milk as the best path. Both of us were exclusively formula-fed as babies, and having turned out just fine we had no strong aversion to formula -- it seemed though, that if possible to feed our little human babies human milk, that made more sense than processed milk from a cow. Our boys have been fed nearly exclusively on donated breast milk, from the moments right after birth up until this morning; they're thriving in weight, length, development, and cuteness. And I'm sure they would have been doing just fine on formula too.

In reading the article, though, several questions surfaced for me:

1. Does the study (of 101 samples of donated milk) point to problems in pumping and storage practices rather than the wisdom of sharing? It seems that many of the strains detected would not have had the chance to grow had the milk been properly stored and frozen after being pumped into special zip-lock bags made for milk pumping.

2. Did the study, as a control, analyze the milk that mothers pump, freeze, and give to their own children at a later time? It appears that this did not happen, but it would have gone a long way to establishing issues that are exigent to the pumping and freezing of milk, as opposed to any conclusions about the merits of milk donation as a practice.

3. Neither the study nor The New York Times article points to even one instance of actual harm to a child who received donated milk. I can only assume that had the authors of the study identified such harm, it would have landed in bold print in the abstract of the final report. The same question applies to the Times piece, as I would expect the reporter attempted and was unable to find an instance of actual harm.

Let me be clear -- I'm actually opposed to the selling of breast milk. I think that donating milk is as kind and selfless a thing that a breastfeeding mom can do, and we've been so terribly fortunate to be on the receiving end of a great deal of generosity. But selling milk, usually anywhere from $2 to $6 an ounce (which, at the high end, would amount to more than $2,400 a week for what we're currently feeding our boys), strikes me as a market too far. Something that as an act of donation is generosity defined is to me sullied by the profit motive; in addition, it provides an incentive to mothers who maybe have a particular disease to hide that fact to "make the sale." True milk sharing, however, spreads the benefits of breast milk to those that are either unable to produce or use their own milk, at no cost and to the benefit of kids.

Even though I am not reflexively anti-formula, I do wonder about the corporations that sell American the bulk of it in the form of brands like like Enfamil and Similac. While formula is of course regulated and safe and does the job adequately, I wonder about these companies, who managed to convince doctors (who then convinced mothers) in the late 1960s and 1970s that formula was superior to breast milk. (These claims have been contradicted, and most formula labels now clearly state that when possible breast milk is preferable.) Milk banks, which clearly charge a great deal for milk, are no serious threat to these companies, but something else is: a culture of milk-sharing.

Milk sharing represents an existential threat to these companies' bottom lines. Currently, when a woman chooses not to breastfeed or finds out she can't for some reason, the automatic response is to go with formula. If instead, the automatic response was to look first to to her breastfeeding friends and her community for donations, milk sharing would thrive and formula would quickly become a less attractive option. Mead Johnson, the maker of Enfamil, must cringe at that possibility, and I expect that soon their funds might be found backing studies, sure to come, that will attempt to discredit milk sharing in its various forms.

But they probably don't have much to fear in the short term. I was struck this morning in reading the comments about the Times piece. "Gross!" "Disgusting." "How stupid!!" I'm not sure that this stems from a curious and innate form self-loathing among humans, but it seems to me that feeding your baby milk that comes out the udder of a cow is distinctly more "gross" than that from the breast of a fellow mother -- just saying. For a host of reasons, this topic brings up lots of emotions, each more charged than the next. No one, after all, likes the idea of anyone else telling you what's best for your child. What it comes down to for me is an acceptance that risk exists -- in everything. Every time you strap your kid into that car seat, there's a huge risk. Every time you feed your kid a new food, there's a risk. And whether you feed your kids with your own breast milk, formula, or donated breast milk, there is a risk. Our kids have done amazingly well on the donated milk of nearly 20 donors -- we don't plan to do it for too much longer, but it's been an amazing experience to meet all these women, taking time during an already busy phase of their lives, to benefit babies they'll likely never meet, and we will be forever grateful.

Let's hope that one study, with a small sample and a focus on pathogens found in donated milk, rather than a study of actual harm resulting from such milk, or the practices involved in pumping and storing milk, does not cause the kind of hysteria Americans are occasionally so fond of. Milk sharing is ascendant, and with care and intelligence and a focus on the benefits it provides, while not shying away from potential risks and how to reduce them, it will certainly be here for a long time to come.