Friday, March 14, 2014

Breasts and Bottles: Donor Milk

I recently read about a mum (on a blog far, far away), who described herself as "crunchy", so crunchy in fact that, even though she couldn't produce breastmilk herself because of a congenital abnormality in her breast tissue, she's insisted on exclusively feeding her child donated milk. For the last six months, numerous strangers have regularly pumped and delivered their extra milk to her and her little girl.

I'm a breastfeeding fan and was incredibly sad to turn to formula feeding for my boy. But I have to admit that I'm not altogether sure how I feel about donor milk generally or this mum's own story in particular. If I'm being honest, it makes me feel uncomfortable. What's your initial reaction?

When Dear Boy was only six weeks old and we were struggling with breastfeeding, a local woman died during childbirth. It was an awful situation, but her tiny daughter survived and the internets did what they do best and rallied so much support for the bereaved family. A call-out from our hospital for milk donations for them on Facebook nearly broke my heart. In my own freezer was a tiny, dwindling stash of my own milk - the last of my milk really as my own supply began to fail. I couldn't give it away. I thought seriously about it, but just couldn't give it away.

When Dear Boy was just a few days old, and he slept and didn't feed and I wept as I had colostrum syringed from my breast and when my milk came in pumped the scant few mils I was given, another woman was in a similar situation. Her baby was sleeping and refusing to feed, but she was pumping almost purely for relief. She would come into the mothercraft room with three or four bottles full of breastmilk, adding them to the treasure trove taking over a whole shelf of the locked fridge. I always wonder if she received the same message I did on Facebook and if she looked at her milk stash and decided differently to me. If she would be willing to give her milk away to feed another child.

In Australia, most major hospitals run a milk bank, specifically for premature and unwell babies. They encourage the mums from the birth centre with an over supply to donate colostrum and early breastmilk, as they're better tolerated by a premature baby's underdeveloped gut. The milk there is screened and pasteurised to make sure the babies are not accidentally exposed to anything that could compromise their health further. But what about if your baby is born healthy and you end up being unable to breastfeed or just don't want to? What resources do you have then for giving your baby breastmilk?

A little bit of digging revealed quite a few breastmilk donation networks operating in Australia, with groups like Human Milk 4 Human Babies and Eats on Feets providing community milk sharing opportunities. Most of these are informal and facilitated via sites like Facebook, with the organisations taking a very hands-off approach and letting the mothers sort themselves out. Essentially you join a page and put up a notice that you either need milk or have extra to give away and people reply. Some offer pumped milk and others offer the... errr... full service. I'm not entirely sure what the modern name for it is, but wet-nursing is the one that springs to mind.

My own mum was fairly crunchy herself, and helped to start a chapter of the Nursing Mothers Association of Australia (which changed it's name to Australian Breastfeeding Association in 2001 long after restrictions on using the word 'breast' or 'nipple' in promotional material was lifted) in our home town in the early eighties. According to her, wet-nursing was pretty normal:
"I regularly used to settle other peoples babies by breast feeding them, if I was minding them for a couple of hours. I am pretty sure you and your brother would have been fed by [a friend] ... I don't think we thought twice about it. It was never an issue with my circle of friends. Might have only been a country thing."
Is it a country thing? Is it a rich or poor thing? I know historically it was pretty common, and fraught with all kinds of power and race issues. But this modern day version seems to be a return to a much more community minded sentiment. Breastmilk for all! Natural! Share! That's great!

It still gives me pause though. 

Perhaps it's a post eighties and nineties AIDS epidemic thing when we were taught to keep our bodily fluids to ourselves (anyone else remember that grim reaper bowling ad? No? Just me?) that niggles at me about wet-nursing and milk donation without a middle-man woman and a screening process of some kind. At the moment, there aren't any national health policies on wet-nursing and private donations in Australia. Anyone can do it and there aren't any safeguards. It's all a matter of trust. As much as I would have loved to offer breastmilk to my boy long term, could I have let another woman feed him directly? I'm not sure. Would you feel comfortable with that?

The other part that niggles at me is the idea that's drummed into you when you're being encouraged to breastfeed - "your milk is perfectly designed for your baby". For nine months, you've developed a biological relationship that means everything your body produces is exactly what their little bodies need. What happens when you feed your baby milk that nature designed for another child? Is that still better than formula? According to Dr Ben Hartman, who established Australia's first milk bank in Western Australia, maybe not. Yes, donor milk is much better than formula for a premature baby, but there's no evidence that proves it's better for a full-term baby (quoted in this article here). What I'd like to know is if another mother's milk still provides the same long role-call of benefits if it's not specially designed for that child's immune system, etc. 

There's no agenda here. I'm really just interested in why the idea of milk sharing makes me feel uncomfortable. Am I trying to feel better about having to give our boy formula because I didn't even think of this option when he was small? I don't know. Maybe. Probably. Do you think you'd be okay with milk-sharing or wet-nursing?

3 comments :

  1. This is a thought-provoking post. I think my choices would vary with specific circumstances. How well I know the donor, for instance. I do think that some of our squeamishness is misplaced though. In the end, I think the most important thing we can do is support each other in our varied choices. You've done a great job of expressing your opinions humbly and respectfully.

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  2. Some great ideas tossed about here! I am breastfeeding my 6th child at present and I love it. I know how weird the whole milk sharing thing can be. It is so personal! I still have a few bottles of milk from the first days in my freezer. Despite them being well overdue at 15 months, I cannot bring myself to part with them! As for milk sharing, I think if I had a very premmie or serious situation I would do the human milk thing just because that is so perfect for them. Having said that I have also formula fed and found this was great. I didn't get sick babies as so many negative flyers would have me believe. Equally, we have had several rounds of gastro that my breastfed baby has miraculously missed, even when I was vomiting in a bucket as she breastfed from me! I guess the answer lies in personal preferences. Wet nursing sustained millions of people from the dawn of man and is probably the reason we are here today as descendants! Great piece and lovely blog!

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  3. Wow I have never actually thought about this and if I am completely honest it would make me a bit uncomfortable feeding my kids another mum's breast milk and even more another mum breastfeeding my child. But then there are situations that I can totally see the benefit and would never ever judge anyone for doing so. It just would nt be for me if I could help it. I couldnt breast feed my boys, even with medication I just didnt produce enough milk. xx

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