How To Safely Donate & Receive Donated Breast Milk

If you’re considering donor milk for your baby (or you’re producing enough milk to donate!), read our recommendations for how to do it safely.

Every mama has a different breastfeeding journey. For some, breastfeeding comes easily while other moms might face more challenges when feeding their babies. One thing that’s for certain is both moms and babies benefit greatly from breastfeeding.

If you’re considering donor milk for your baby (or you’re producing enough milk to donate!), read our recommendations below. We hope this helps you in your journey.

Breast milk is precious to all infants’ survival and continued health, especially premature babies and babies who are not well. Moms who have trouble providing breast milk to their babies can seek the next best alternative: another mom’s milk that was donated and pasteurized by an accredited milk bank.

Mamas may consider donor breast milk when faced with situations such as:

  • Low milk production and needs to supplement her own milk with donor milk

  • Adopted or fostered babies

  • Have had a double mastectomy and can’t produce milk

  • Had previous breast or other surgeries that affected milk supply and needs to supplement

  • Diagnosed with insufficient glandular tissue and needs supplemental milk

  • Treated with certain medications that are not recommended for breastfeeding

  • Mother has infectious illness that could be passed to baby through breast milk

Although donor breast milk is the best alternative for feeding babies, it does not have all the same benefits of breastfeeding. Breast milk changes every day to meet the changing needs of your baby based on age. In other words, preterm milk is different from term newborn milk (preemie’s tummies might be bothered by term milk), and that is different from the milk of a mom whose baby is 3 months old, 6 months old, 12 months old, or is weaning. Donor milk is usually a “pooled” collection of milk from several mothers and the donors may not have babies the same age as yours. And, because donor milk is heat pasteurized, some of the protective factors are lost.

What is milk sharing? 

Milk sharing is giving or using donor breast milk when a mom has trouble producing milk. Typically, we are referring to mothers’ expressed donor milk, however directly breastfeeding another mother’s baby (wet-nursing) is also a method of milk sharing. The three most common types of Milk Sharing in the U.S. today are:

  1. Formal Milk Sharing: 

Formal milk sharing refers to donor milk distributed by milk banks. If breast milk is not readily supplied from their own mothers, a hospital can order pasteurized human donor milk (PHDM) from a Human Milk Banking Association of North America (HMBANA) certified milk “bank.”

A few things to know about HMBANA-accredited milk banks:

  • They are non-profit; milk is donated, and donors are not paid.

  • The donors are strictly screened and tested for diseases such as HIV or Hepatitis B and C – any blood-borne disease.

  • The milk is handled hygienically and pasteurized – killing all known pathogens in breast milk.

  • Donors are screened for use of certain prescribed medications and illegal drugs, smoking and use of tobacco products, and regular intake of 2 or more ounces of alcohol per day.

  • Donors are also screened for receiving a recent blood transfusion, blood product, organ or tissue transplant.

  • The screening and pasteurization processes are strict to avoid any possible transmission of disease.

Milk from milk banks are prioritized for:

  • Hospital needs: Neonatal Intensive Care Units (NICU’s), supplemental milk for babies whose moms aren’t fully lactating, ill infants, infants of mothers who are ill.

  • Infants in the home with medical conditions related to prematurity and feeding intolerance.

  • When possible, healthy babies whose mothers are unable to provide breast milk for a reason other than a medical condition.

  • Some milk is used for research purposes, and some milk is also given to adults with health problems (such as cancer) who are prescribed breast milk as part of their treatment.

There are a few established for-profit milk banks who now pay mothers for their donated breast milk. This practice has been criticized by some who are concerned, “that women will be coerced into diverting milk that they would otherwise feed their own babies.” Medela supports the guidelines of the Academy of Breastfeeding Medicine (ABM) and American Academy of Pediatrics (AAP) in donating or receiving milk from a HMBANA non-profit milk bank because of the strict standards for both donors and recipients.

  1. Informal Milk Sharing: 

Some moms give their milk directly to the parents of babies in need, an exchange known as informal or casual sharing. The intent behind casual sharing is a caring act of sisterhood.
Informal milk sharing is mom-to-mom milk sharing done informally in the community – through websites dedicated to milk sharing, families assisting with milk sharing, or other social media connections.

However, mamas should be aware that there are many documented risks to using unscreened, unpasteurized milk from unscreened donors.

  • It is unregulated and untested; the milk could have harmful substances like medications, drugs of abuse, nicotine, or alcohol.

  • Several studies showed that in some instances, internet purchases of human milk had cow’s milk, water, or other liquids added to increase the volume. There is no way for mothers to ensure that the milk purchased is actually human milk at all.

  • One recent study found that infectious agents were present in the majority of the milk samples. Other studies confirm that viruses and bacteria are commonly found in unscreened milk.

  • Repeated freezing-thawing cycles may alter the integrity of the milk’s components. There is no way to know that how purchased human milk has been stored or maintained before it reaches the consumer.

At Medela, we support the recommendations of ABM and AAP and believe that it’s important to receive donated breast milk tested from an accredited milk bank to be absolutely sure that it’s safe for your baby.

  1. Wet Nursing:

A wet nurse is a woman who directly breastfeeds another woman’s child. Wet nurses are employed when the mother is unable or elects not to nurse the child herself. Wet-nursed children may be known as “milk-siblings,” and in some cultures the families are linked by a special relationship of milk kinship.

There are many internet ads of lactating women who are willing to “wet-nurse” another’s baby for a fee. This practice is fraught with risks and is not recommended for the same reasons that informal milk sharing is not recommended.

In short, we – along with ABM and AAP – recommend that mamas who have trouble breastfeeding get lactation support and consult healthcare providers before seeking donor milk. And when you do decide to receive donated breast milk, don’t forget to seek it only from HMBANA-accredited milk banks!

You can also reach out for extra help and assistance through Ask the LC, which can save you time while addressing common questions and concerns via e-mail with a board-certified lactation consultant. For even more helpful resources, download the Medela Family app