Still, a company called Prolacta Bioscience, which produces a human-milk fortifier used to supplement breast milk for extremely premature babies, pays $1 an ounce to approved donors.* Some moms also sell their milk outright—either to a co-op like Mother’s Milk Cooperative in Oregon or through the website Only the Breast, kind of a Craigslist for breast milk.
For me, coordinating milk drop-off in the city was enough of a hassle and expense that I soon tried a different route: I found a local mother of a NICU baby to donate to on my own. I met the NICU mom online, through a Facebook group set up to facilitate informal sharing. Every few weeks, she drove to my house and picked up dozens of bags of frozen milk, which helped ease my workload as a donor. (I later learned that milk-bank volunteers may help overtaxed moms like me with milk drop-offs.)
I certainly wasn’t the first person to try this approach. Social media is a major factor deterring potential donors from formal milk banks. It’s often simpler, logistically, to get milk to a local parent in need than to ship it across the country. And there’s no complicated paperwork. There are, of course, no regulations at all.
For Updegrove, informal sharing of this nature is a question of ethics: “how we decide to use the limited resource for the most vulnerable.” She argues that extremely premature and ill babies need donor milk more than healthy, full-term infants. Babies fed breast milk are less vulnerable to illnesses such as diarrhea, ear infections, and pneumonia, and they are less likely to develop asthma or become obese later in life. But among premature babies, the effects can be even more profound; in addition to helping prevent NEC, breast milk can help stave off sepsis and promote long-term development. For these reasons, the American Academy of Pediatrics recommends feeding preemies donor breast milk over formula when mothers’ milk is not available.
The very lack of regulations in informal sharing, though, means that breast milk is often not given to the babies who need it most. “We’ve got babies who would die otherwise if they don’t get human milk,” Updegrove says. Her reasons were convincing enough for me to resume formal donations once my son’s needs eased.
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Although milk banking has sharply increased in the past few years, there are still many hospitals where donor milk isn’t an option—and they tend to care for the most vulnerable babies at the highest risk of developing complications.
“I know this will sound backward to you,” Updegrove says, “but we are working hard to increase the demand.” She is confident that donations will continue to go up as demand increases, because more mothers will learn about the option to donate from hospitals using donor milk.
Expanding the supply of donor milk is about reaching out to women who aren’t yet aware that milk banks exist, says Naomi Bar-Yam, the executive director of Mothers’ Milk Bank Northeast and the current president of HMBANA. “There are a lot of moms who still don’t know about this possibility. So we work hard to educate them,” she says. Beyond recruiting more donors in the short term, banks also focus on strengthening breastfeeding in general—which has ripple effects for donation. Promoting a culture of breastfeeding, Bar-Yam argues, will result in more breast milk out in the world.