Donating breastmilk in the UK: Regulated and unregulated practices: A review of the (ethical) issues

Dowling, Sally

Abstract

Breastmilk is the optimal source of nutrition for babies although there are a range of situations in which breastfeeding is difficult, including prematurity. Human milk is donated in the UK in both regulated and unregulated ways. A network of human milk banks receive and distribute donor milk, primarily to premature and sick infants, supported by NICE guidance (NICE, 2010) and the UK Association for Milk Banking (UKAMB). Variations in the geographical spread and funding of the banks mean that women who want to donate or receive breastmilk are not always able to do so. Discourse around the ethics of the provision and use of human milk in this way often emphasises issues of risk and safety.

There are also ways in which breastmilk is donated informally, often using the terminology of ‘sharing’, usually to full-term infants. Some women feed each other’s babies via friendship groups whilst others contact each other using online (often international) networks specifically set up for the purpose of peer-to-peer human milk sharing. Health bodies in a number of countries (although not in the UK) have issued warnings against obtaining breastmilk in this way, focussing again on ‘danger’ and ‘risk’. These topics have been the subject of a range of academic papers as well as online discussions, raising questions about the ethical issues and obligations in this area.

This presentation aims to review the different ethical issues involved in both regulated and unregulated practices of milk donation. It asks questions about the nature of donation and whether donors and recipients are viewed differently according to the mode of donation (milk bank vs. milk sharing; donating vs. selling) and the situation of the recipient. Is the ethics of ‘giving’ a body product different when the product is human milk rather than blood or organs? Is this an area which should remain unregulated, as a private practice, or should it be more widely or formally considered? Finally, issues relating to the perception of human milk will be briefly raised – as both ‘white/liquid gold’ and ‘matter out of place’ (Douglas, 1966) – drawing on ideas of cultural unease about women’s bodily fluids.

The main focus will be on informal milk sharing – why and how it happens (the lived experience of donors and recipients) and how both donation and risk are framed and accounted for. Issues for both professionals and non-professionals working with pregnant and lactating women will also be discussed. The paper draws on a review of the evidence rather than on empirical evidence although it is hoped that a small scale research study will have commenced by the time of the conference and early findings can be discussed.

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: Maternal and Infant Nutrition and Nurture International Conference 2015
• Start Date: Jun 10, 2015
• End Date: Jun 12, 2015
• Publication Date: Jun 10, 2015
• Publicly Available Date: Jun 6, 2019
• Peer Reviewed: Not Peer Reviewed
• Keywords: breastmilk, donation, ethics
• Public URL: https://uwe-repository.worktribe.com/output/832882
• Additional Information: Title of Conference or Conference Proceedings : Maternal and Infant Nutrition and Nurture International Conference 2015