Thinking about breastmilk donation: What are the current issues in unregulated practices of breastmilk donation in the UK?

Dowling, Sally

Abstract

This work draws on a review of the evidence and of the current situation, and on reflection following previous conference presentations and discussions rather than on empirical research, although it forms the basis of developing and on-going research.
There are many ways in which breastmilk is donated informally, often using the terminology of ‘sharing’ and usually to full-term infants. In contrast breastmilk is donated, primarily to premature and sick infants, to ‘milk banks’ (with, in the UK, a network of human milk banks receiving and distributing donor milk). This work is supported by NICE guidance and the UK Association for Milk Banking (UKAMB). Some women – as they have through time and across cultures - feed each other’s babies via friendship groups, whilst others contact each other using online (local, national and international) networks specifically set up for the purpose of peer-to-peer human milk sharing. Many opportunities to donate and receive breastmilk have arisen in grassroots woman-to-woman ways building on the model seen in other forms of parenting and breastfeeding support. Some internet sites also offer milk to sale to a range of recipients, for different purposes.
Health bodies in a number of countries (although not in the UK) have issued warnings against obtaining breastmilk in this way, focussing on ‘danger’ and ‘risk’ and drawing on limited research evidence (Keim et al, 2013); some of these assumptions have been challenged (Stuebe et al., 2014, cited in Palmquist and Doehler, 2014). Recent editorials in BMJ and the Journal of the Royal Society of Medicine have raised issues about the online donation and sale of human milk (Steele et al, 2015a; Steele et al, 2015b). The focus of these publications is also on ‘danger’ and ‘risk’ and on the importance of alerting health professionals to this. Although ideas of risk frame the ‘official’ reactions to sharing breastmilk via the internet, little is known about how individual women understand and make sense of these risks. Although this is currently being addressed by research elsewhere we know little about this in the UK.
The main focus of this paper is on informal milk sharing and how both donation and risk are framed and accounted for. Current thinking about unregulated practices of milk donation will be reviewed. Is this an area which should remain unregulated, as a private practice, or should it be more widely or formally considered? Are there underlying ideas regarding the perception of human milk and cultural unease about women’s bodily fluids which influence discussion of this? Issues for both professionals and non-professionals working with pregnant and lactating women will also be discussed. The ways in which milk donation is both similar and different to other forms of donation will be reviewed, in particular in light of recent publications and the focus on risk.

References:

Keim, A.A., Hogan, J.S. , McNamara, C.A. et al (2013) Microbial Contamination of Human Milk Purchased Via the Internet. Pediatrics, 132(5): e1227-e1235.
Palmquist, A. & Doehler, K. (2014) Contextualizing online human milk sharing: Structural factors and lactation disparity among middle income women in the U.S. Social Science and Medicine, 122:140-147.
Steele, S. Martyn, J. and Foell, J. (2015a) Risks of the unregulated market in human breast milk: urgent need for regulation. British Medical Journal, 350:h1485 doi: 10.1136/bmj.h1485.
Steele, S, Foell. J., Martyn, J.and Freitag, A. (2015b) More than a lucrative liquid: the risks for adult consumers of human breast milk bought from the online market. Journal of the Royal Society of Medicine. 108(6): 208–209.

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives
• Start Date: Aug 23, 2016
• End Date: Aug 25, 2016
• Acceptance Date: Feb 10, 2016
• Publication Date: Jan 1, 2016
• Publicly Available Date: Jun 7, 2019
• Peer Reviewed: Peer Reviewed
• Keywords: breastmilk, United Kingdom, breastmilk donation
• Public URL: https://uwe-repository.worktribe.com/output/918513
• Additional Information: Title of Conference or Conference Proceedings : Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives