The buying and selling of human breast milk online is a practice seemingly gaining popularity among new mothers, due in large part to the much-touted benefits of mothers’ milk over formula substitutes. However, such transactions are unregulated and therefore not always safe, according to a new warning.
In an editorial published Tuesday in The British Medical Journal, a trio of public health experts aired concern over the potential for breast milk contamination and transmission of diseases to infants.
“Although breast milk holds many known benefits, seeking out another’s milk rather than turning to instant formula poses risks,” the authors wrote. “At present, milk bought online is a far from ideal alternative, exposing infants and other consumers to microbiological and chemical agents. Urgent action is required to make this market safer.”
The warning comes amid a growth in sales of breast milk.
Using specialty websites, such as Only the Breast, and even general-purpose ad sites, including Craigslist, women who produce extra milk are selling their surplus to mothers who are unable to express it on their own, explained Sarah Steele, a lecturer at the Global Health, Policy and Innovation Unit at Queen Mary University London. Some mothers even sell their milk to bodybuilders and other fitness enthusiasts who seek extra nutrients.
In one of the few studies to examine the online sale of human breast milk, researchers led by Sarah Keim of the Center for Biobehavioral Health at Nationwide Children’s Hospital in Columbus, Ohio, found that more than 75 percent of 101 breast milk samples purchased were poorly shipped or stored and had high levels of bacterial growth that would make a baby sick — including fecal matter and salmonella. Nearly a quarter of those samples tested positive for cytomegalovirus, which is related to the viruses that cause chicken pox and herpes simplex.
“You just don’t know what’s in the milk,” Steele told Al Jazeera. “Moreover, the most well-meaning person may very well have a virus they don’t know they have.”
Steele and her colleagues say federal and state regulators ought to issue guidance for mothers on safety issues surrounding purchased or donated breast milk, because so many mothers are turning to the Internet for information and don’t know the risks.
In 2010 the U.S. Food and Drug Administration issued a statement urging caution to mothers who planned to feed their babies purchased or donated breast milk because “the donor is unlikely to have been adequately screened for infectious disease or contamination risk. In addition, it is not likely that the human milk has been collected, processed, tested or stored in a way that reduces possible safety risks to the baby.”
Though the FDA doesn’t regulate the trade of human breast milk, it has recommended that mothers who want to use donor milk should consult the Human Milk Banking Association of North America, which supports nonprofit human breast milk donation through a network of 18 milk banks in the U.S. in Canada. The association pasteurizes donor milk and tests it for bacterial growth as well as diseases and viruses.
But Keim says breast milk banks that operate on a nonprofit model tend to reserve their milk for critically ill babies at hospitals. Otherwise, they sell it to mothers for about $4 an ounce, a prohibitively high price that has pushed women to purchase it for less online.
Because these mothers are not required to consult a regulated center, like a blood bank, they can purchase breast milk with relative ease.
“Individuals are able to easily, privately exchange milk outside any sort of organized infrastructure for the collection of milk,” said Keim. “So that makes it extremely difficult for an entity like the FDA or even the states to regulate.”
California, Texas and New York are the only states with laws requiring certain standards for donor breast milk, according to the National Conference of State Legislatures (NCSL).
While no organization tracks the online sale of breast milk, Steele said Only the Breast informed her that it had 27,000 active members in 2014, and was adding 700 to 800 new members each month.
In their ads, donors often emphasize their health, diets or exercise habits, said Keim, but rarely do they mention more important issues — such as their disease status or whether or not they properly sanitize their breast pumps.
One ad on Only the Breast reads, “Great milk, great taste, low lipase, fit producer with more milk than can feed my family.”
“Organic, dairy-, soy- and gluten-free mommy fresh milk if local or frozen if needing to be shipped,” says another.
Still another reads, “Healthy, educated, 27 year old mom of two. Milk bank qualified, looking to sell in bulk. Athletes welcome.”
Only the Breast did not immediately respond to a request for comment from Al Jazeera, but cautions online that unpasteurized milk “may have bacteria” and that all donated milk should be pasteurized before use.
Only the Breast was founded by a mother named Chelly who says her goal is to help other moms gain access to vitamin-rich breast milk.
“We believe that if one mom has extra breast milk and another does not have enough, there should be a place for them to connect that is clean, safe and private,” she writes on the website.
However, experts say the pressure for mothers to breast-feed is misguided if it causes them to put their babies’ health in danger.
“Hopefully we can help women make choices that aren’t so desperate as getting milk from a stranger,” Keim said. “If we don’t do those things, this issue isn’t going to go away.”