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Breast Milk Sold on the Internet Often Contaminated

Breast Milk Sold on the Internet Often Contaminated


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New mothers beware: While breast milk is purportedly much better for children when dealing with allergies and the like, a new study has found that milk from milk-sharing sites was often contaminated.

A new study published in the journal Pediatrics found that out of 101 milk samples purchased or acquired through milk-sharing sites, 64 percent of the samples were contaminated with staph. Strep tainted some 36 percent of the samples, wihile almost 75 percent of the samples had some other bacteria in the milk.

In some cases, the amounts detected were enough to sicken a child, and three of the samples contained salmonella.

Oftentimes, mothers will turn to the Internet to purchase or receive breast milk for free, as it's generally less expensive than a milk bank. Milk bought online is usually between $1 to $2.50 an ounce, compared to $4 or $5 from a milk bank.

Unfortunately, the milk sold on these sites is not always sampled for culture growth, while milk banks do test the milk. "A rule of thumb used by milk banking systems in several countries is that if the milk contains more than 10,000 colony-forming units (CFU)/mL total aerobic bacterial count or any pathogenic [gram-negative] bacteria, they would not consider feeding that milk raw to an infant," researcher Sara A. Keim told MedPage Today.

According to the samples, 44 percent of Internet milk had coliform, compared to 25 percent of milk-bank milk. Salmonella contaminated Internet milk (3 percent), but not milk-bank milk. Meanwhile, Staphylococcus sp contaminated 63 percent, compared to 25 percent of milk-bank milk.

Of course, as MedPage Today notes, the Internet-bought milk might be suspected as fraud, as the breast milk can be laced with cow's milk. "We are currently carrying out a second phase of the study to determine that," Keim said. "It's possible that some samples were not entirely breast milk."


Breast milk

Breast milk or mother's milk is milk produced by mammary glands, located in the breast of a human female. Breast milk is the primary source of nutrition for newborns, containing fat, protein, carbohydrates and variable minerals and vitamins. Breast milk also contains factors that are important for implications protecting the infant against infection and inflammation, whilst also contributing to healthy development of the immune system and gut microbiome. [1]


Buying Human Breast Milk Online Poses Serious Health Risks: Experts

A growing market in online sales of often contaminated human breast milk – fuelled in part by bodybuilders and adults with a baby fetish – poses a serious risk to public health, according to experts.

Researchers from the University of London’s school of medicine and dentistry were so alarmed by their initial findings that they wrote an editorial in the British Medical Journal to warn of the dangers of buying breast milk online before their study was completed. The editorial says breast milk sold online should be screened for diseases such as hepatitis, HIV and syphilis.

Lead author Dr Sarah Steele said she feared that babies would die from unscreened milk sold online if the market was not regulated. In one of the studies she cited, more than 90% of breast milk purchased online was found to have bacterial growth. Some of the sellers interviewed included intravenous drug users.

Unregulated websites selling breast milk attract tens of thousand of users in the US, the research found. One site reported growing by 800 users each month. It also reported an emerging market in the UK on specialist sites as well as general retail sites including Gumtree and Craigslist. Premium prices of up $4 (£2.70) per fluid ounce (30ml) are offered by mothers who purport to eat only organic or vegan food, or can boast having “fat, chubby babies”, the researchers found.

The online market caters primarily for mothers who are unable to breastfeed their babies, serving as a cheaper alternative to regulated milk banks, where the milk is always pasteurised. But consumers also include cancer patients who believe breast milk has health benefits and gym enthusiasts who believe breast milk is a natural superfood. A third group of adult consumers are fetishists “who like to be fed like a baby, either from source or from a bottle”, according to Steele.

She told the Guardian: “I reserve my judgment on these things. The focus for us is that people need to be making safer feeding choices. In the adult market there are cancer patients who are desperate to try anything and a lot of people in the body-building and cross-fit communities who really don’t realise the dangers. They think it’s a natural superfood. They don’t realise that it could be contaminated with bacteria.”

Steele explained the dangers: “When sellers freeze milk and send it in the mail it thaws out. That’s when bacteria has time to grow and and become really dangerous, especially for infants.”

She added: “We started this study from a curiosity point of view initially, but the public health data is so definitive on how dangerous it is that we couldn’t wait for the end of our project because that could have taken several years to complete. It was so damning that we felt we had to approach the BMJ and say: ‘This needs to get out there now.’ We don’t want to be writing the report after there has been an infant death in Britain.”

The editorial calls for healthcare workers to be trained to offer advice about how to acquire breast milk safely. Steele said: “We observed that mothers are often in a desperate state and are nervous about talking to healthcare professional about their difficulties feeding. The big danger is that more women turn online and that threatens the health of their infants. And with the adult market growing, we want to make sure people aren’t spreading communicable diseases in new ways, just as we are getting on top of things like hepatitis, syphilis and HIV.”

Steele said the health benefits for adults of drinking breast milk were unproven. “Human breast milk doesn’t really have that many advantages for adults,” she said. “It is certainly not what you need in the context of bodybuilding and cross-fit, as a post-workout recovery drink.”

She pointed out that consuming breast milk was regularly discussed on mainstream online bodybuilding forums.

The paper concludes: “Although breast milk holds many known benefits, seeking out another’s milk rather than turning to instant formula poses risks. When breast milk is screened and treated appropriately, as the World Health Organisation states, it remains second to a mother’s own milk as best for infant feeding. 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.”

A woman breastfeeding her baby. In one study cited by researchers, more than 90% of breast milk purchased online was found to have bacterial growth. Photograph: Katie Collins/PA


Is Informal Breast Milk Sharing Safe? Understanding the Debate

The practice of sharing or donating human breast milk has been a common one across time and cultures for about as long as there have been little mouths to feed. The stigmas associated with it are complicated: coming from a gap in resources, communication and support from the larger medical community, the shame mothers constantly hearing &ldquobreast is best&rdquo might feel for not producing enough (or any milk) for their infants &mdash and, of course, a sheer lack of information about how to do it safely.

But, ultimately, the choice to donate your breast milk is a fundamentally human one &mdash coming from an all too real desire to help mothers keep their babies fed &mdash as is the choice to feed your baby with donated milk. With more and more people connecting via the Internet for informal sharing of breast milk , it&rsquos important to fully understand the safety concerns in the medical community about the practice, the ways advocates argue the practice can be made safer and the places where the various camps actually agree.

Where Does &lsquoFormally&rsquo Donated Breast Milk Go?

Families with preterm babies, insufficient maternal supply or other medically necessary reasons are able to access pasteurized donor milk from nonprofit milk banks governed by the Human Milk Banking Association of North America (HMBANA) , Diane Spatz, clinical director of the milk bank and faculty advisor to student nurses for the lactation program at the Children&rsquos Hospital of Philadelphia , tells SheKnows. This is donated milk that&rsquos been thoroughly screened based on their criteria, handled and deemed safe for use on the most fragile little bodies in neonatal intensive care units (NICU).

But, she adds, the costs can be prohibitive. In the absence of insurance to cover the bill, an ounce of donor milk can run for $3-$5 &mdash and growing babies can drink roughly 25 ounces of milk a day, give or take. Spatz notes that insurance often doesn&rsquot cover appropriate breastfeeding care.

Even then, she says families that still need milk for their infants but don&rsquot qualify for milk through the HMBANA, may turn to other measures to maintain their supply. There&rsquos for-profit milk banks and online communities for people who sell their breast milk &mdash which can be controversial on their own, given the complex and often-ignored historical exploitation of women of color as wet nurses . And, once again, can be financially difficult to swing for many families.

Which leads to the growing number of parents who engage in informal sharing through their communities and extended networks &mdash finding them through friends, family, Facebook or other websites dedicated to connecting donors with parents in need.

Is It Safe to Informally Share Breast Milk?

The American Academy of Pediatrics (AAP) and the U.S. Food and Drug Administration (FDA) both discourage informal sharing due to the risks of spreading disease or exposing infants to medications, alcohol, drugs or contaminants.

&ldquoRisks for the baby include exposure to infectious diseases, including HIV, to chemical contaminants, such as some illegal drugs, and to a limited number of prescription drugs that might be in the human milk, if the donor has not been adequately screened,&rdquo per the FDA website . &ldquoIn addition, if human milk is not handled and stored properly, it could, like any type of milk, become contaminated and unsafe to drink.&rdquo

According to recent research presented at the AAP 2019 National Conference & Exhibition that looked at parents views on choosing informal breast milk sharing versus milk banks, researchers found that a number of mothers didn&rsquot report having concerns about the safety of informally donated milk.

Of the 650 mothers anonymously surveyed on Facebook, more than half said they didn&rsquot have concerns and nearly 80 percent said they didn&rsquot screen their breast milk donors because they &ldquotrusted them.&rdquo

&ldquoInformal milk sharing is becoming increasingly popular and widespread,&rdquo said Nikita Sood, researcher at Cohen Children&rsquos Medical Center/Northwell Health in New York in an AAP press release. &ldquoIt is therefore crucial that physicians become aware of this practice and the associated risks so that they can educate patients and address this growing concern.&rdquo

Screening, Stigma and Mom-Shaming

In some circles, informal sharing of breast milk is still considered a &ldquogross,&rdquo controversial or unsafe alternative to the seemingly-highly regulated industry of baby formula, Maria Armstrong, a community breast milk sharing consultant associated with Eats on Feets , tells SheKnows.

Smita R., a New York-based mother of a toddler, was in her early forties when she became a first-time mother. She says she grappled with the choice of whether to give her baby formula or not while she was trying to breastfeed, as the AAP guidelines suggest, for the first six months.

&ldquoI was trying to keep my milk production up and felt like a failure,&rdquo she says. &ldquoUntil someone told me: &lsquoit&rsquos formula not poison&rsquo &mdash it&rsquos so easy to lose perspective. There are so many advantages to breast milk that it almost felt like I&rsquom doing my child a disservice by not making enough.&rdquo

The prevalence of mom-shaming, Smita says, has steered other mothers in her parenting group toward European, non-GMO formula in lieu of informal sharing. And, on some level, that does make sense: Formula is highly regulated with expiration dates, disclosed ingredients and verified reviews versus the challenges of getting donor milk &mdash where you&rsquore dealing with a friend, an acquaintance or near- or perfect stranger who may not be adhering to certain quality controls, she says.

While Armstrong doesn&rsquot favor formula, because of how expensive &mdash and automatically exclusionary &mdash it is, she says she totally supports the existence of traditional milk banks alongside community-based sharing networks that promote safety best-practices.

&ldquoWe started doing our own research on safety and quickly realized that the standard of milk sharing had been set by the milk banks and that we could not just present this information without also presenting why something was considered standard, what that meant, and what the alternatives could be,&rdquo she says. &ldquoFor example, what is unsafe for premature and at-risk newborns &mdash which is the biggest group of milk recipient from a milk bank &mdash can be perfectly fine for a full-term, healthy newborn…Someone who drinks a little bit of wine cannot donate to a milk bank, while a mother who drinks can donate to another mother who also drinks for example. The same applies for herbal supplements.&rdquo

Tests for communicable disease or blood tests can be done privately through a lab or through a supportive pediatrician, she adds. Being a searchable database, she says Eats on Feets has helped facilitate productive conversations between pediatricians and parents &mdash which is a crucial issue advocates have identified when it comes to the larger milk-sharing discourse.

Why Are Parents and Doctors Still Struggling to Have These Milk-Sharing Conversations?

Naomi Bar-Yam, executive director at Mothers&rsquo Milk Bank Northeast tells SheKnows that the lack of education about human milk &mdash especially among pediatricians &mdash has made it even more difficult for caregivers to have open conversations about milk-sharing in a safe way.

Pediatricians are under-educated about human milk, Bar-Yam says, spending half an hour or less studying the topic in school. She adds that the biggest hurdle in helping parents make better choices about milk-sharing comes from these gaps in knowledge about human milk being paired with the aggressiveness of companies that sell formula.

&ldquoDoctors are getting better at understanding that they&rsquore a part of a team and I hope pediatricians know to refer parents to another specialist if they don&rsquot know much about milk-sharing,&rdquo she says. &ldquoBut there needs to be a shift in how the medical community thinks about these things and there needs to be a distance between the pharmaceutical industry and medical practices.&rdquo

Ruth Milanaik, DO, at Cohen Children&rsquos Medical Center/Northwell Health in New York also said in the AAP press release that dialogues between doctors and patients about their breastfeeding decisions are essential to making informed-decisions for a child.

&ldquoNot only are our patients unaware of the potential risks that they are undertaking when participating in these informal milk sharing practices, they are also often not informing their physicians,&rdquo Milanaik says. &ldquoIn addition to educating patients, physicians must underscore the importance of discussing these habits with medical professionals so that we have the necessary information to make accurate diagnoses should a medical need arise.&rdquo

Overall, Spatz says she still advocates for the use of human milk for babies and underscored its role as a &ldquolifesaving medical intervention.&rdquo Still, she and her team developed a waiver which parents must sign if they wish to opt for informal breast milk sharing &mdash to emphasize the importance of fully understanding what you&rsquore opting to do.

&ldquoParents should be aware of the risks of informal milk sharing and how to minimize risk,&rdquo Spatz says. &ldquoKnow your donor, get their labs, their health history, make sure they know how to properly pump, label, store milk, that they know how to wash and sterilize their pump equipment.&rdquo


Buying breast milk online? Watch out for salmonella and E.coli

Breast milk may be best for baby, but ordering it over the Internet is not necessarily such a good idea.

Researchers recently bought more than 100 samples of expressed breast milk from two milk-sharing websites and then took them to the lab to see what might be growing in them. The results, published this week in the journal Pediatrics, were fairly disturbing.

Three quarters of the purchased human milk was contaminated with gram-negative bacteria that can pose serious health risks in babies, the researchers found. Three of the samples were contaminated with salmonella. E. Coli was also detected in some samples, an indicator of fecal contamination.

“Even at modest levels these bacteria are closely associated with disease,” said Sarah Keim, an epidemiologist at Nationwide Children’s Hospital in Columbus, Ohio, and the lead author of the study.

The contamination levels of the milk weren’t so bad that they would make every baby sick, said Keim. A healthy baby could drink some of the purchased milk and feel no adverse effects, or perhaps just get a little diarrhea. But a baby with a weak immune system or a healthy baby that was exposed to salmonella could end up in the hospital with meningitis after drinking some of the milk samples.

“While there may be some milk out there that is fine, so much of the milk we saw was contaminated,” said Keim. “As a buyer you have no idea what you are getting unless you have a laboratory to test for this.”

As of now, the sale of human milk via the Internet is almost entirely unregulated. Based on the postings on the milk-sharing sites, the sellers are mostly mothers who have a freezer full of expressed milk and aren’t sure what to do with it, Keim said. The buyers are mostly women who have had trouble producing enough milk -- or any milk -- and were determined to feed their babies breast milk.

“It wasn’t everyone, but I saw a number of ads posted where women who were looking for milk said, ‘I just don’t want to feed my baby formula,’” she said.

In 2011, Keim and her team counted a total of 13,000 postings across the four most popular milk-sharing websites from both buyers and sellers.

“We believe there is probably a lot more sharing between friends and relatives that is offline,” she said. “That is likely more common, but it hasn’t been extensively studied yet.”

As far ask Keim can tell, there is no way to vet that the milk you buy from a stranger is safe for your baby. While most sellers are probably well meaning, they may not be collecting their milk or storing it in a way that is sanitary. For example, making sure that the breast pump is thoroughly washed after each use might eliminate much of the bacteria the researchers found.

“If people are going to participate, there are safer ways to do this,” she said.

Follow me on Twitter for more stories on the science of parenting.


Liquid Gold: The Booming Market for Human Breast Milk

To revist this article, visit My Profile, then View saved stories.

In an era when the benefits of breast milk are better understood and more scientifically certain than ever, demand for it has created a niche industry.
Photo: Mitchell Feinberg

To revist this article, visit My Profile, then View saved stories.

It started with a bleary-eyed Google search: "Sell breast milk." Desiree Espinoza had a 2-month-old baby girl but was pumping out enough milk to feed triplets. Ziplock baggies full of the stuff were crammed in her freezer, and unpaid bills crowded her kitchen table. She wasn't sure there was a market for her overflow or whether selling it was even legal. A few clicks later, she found herself on a website called Only the Breast.

The site looks a lot like craigslist, except instead of selling used cars and like-new Ikea furniture, Only the Breast deals in human breast milk. There are hundreds of posts from new mothers eager to turn their surplus into profits. Many kick off with a chirpy headline ("Chubby baby milk machine!"), then follow with a snapshot of their own robust infant and lush descriptions ("rich, creamy breast milk!" "fresh and fatty!"), making a primal source of nutrition sound like a New York cheesecake. The posts are additionally categorized to appeal to a variety of milk seekers, based on a baby's age (from 0 to 12 months), say, or special dietary restrictions (dairy- and gluten-free). There's also a sort of "anything goes" section for women willing to sell to men. Some ship coolers of frozen milk packed in dry ice. Others deal locally, meeting in cafés to exchange cash for commodity. The asking price on Only the Breast runs $1 to $2.50 an ounce. (A 6-month-old baby consumes about 30 ounces a day.)

Subscribe: Wired Features PodcastIntrigued, Espinoza tapped out her sales pitch: "Mostly organic raised breast milk. I have over 500 oz saved and I need to get rid of it. During the week I only eat organic." A few days later, she was in business, selling the milk at $2 an ounce to a couple of customers in the Phoenix area where she lives, including a mother with a newborn and a man who claimed breast milk helped his immune disorder. "There's no way I could get a job with an infant, so this helps pay for diapers and clothes," she says. In three months, the 19-year-old college student earned enough to buy a new laptop and the dress she wore to her wedding to the baby's 22-year-old father, a recent college grad. She plans to continue selling for a year, and if she can pump a steady 30 ounces a day, she could take in about $20,000.

Only the Breast represents just one facet of the emerging market in human milk. In an era when the benefits of breast milk are better understood and more scientifically certain than ever, demand for it has created a niche industry. Besides sites like Only the Breast, that demand is being met by a handful of all-volunteer women's groups that help organize free milk donations via Facebook and their own websites. Two prominent ones, Human Milk 4 Human Babies and Eats on Feets (a play on Meals on Wheels), connect thousands of women, facilitating the donation of raw or home-pasteurized milk to new moms in need.

There's also a well-established brick-and-mortar network of so-called milk banks. These nonprofit operations collect milk from donors and process and pasteurize it to meet certain quality and safety standards. The milk is sold mostly to hospitals and parents of sick or premature infants at around $4 an ounce. A newer player is Prolacta Bioscience, a for-profit enterprise that operates somewhat like a pharmaceutical company, with a large-scale plant in Southern California. Prolacta produces its own enhanced breast-milk product, a syrupy fortifier specifically for hospitalized newborns, at a cost of $135 per baby, per day. With 58 hospital contracts and an ambitious distribution strategy for the next year, Prolacta envisions a multimillion-dollar opportunity for its products.

Most body fluids, tissues, and organs—semen, blood, livers, kidneys—are highly regulated by government authorities. But not breast milk. It's considered a food, so it's legal to swap, buy, or sell it nearly everywhere in the US. This accounts, in part, for the widely varying quality and safety standards in the online market for milk. For their part, Prolacta and nonprofit milk banks have rigorous screening processes for potential donors, including tests for drugs, hepatitis, and HIV. But Only the Breast and the volunteer sites, which see themselves more as communities than commodity markets, don't screen donors or assume responsibility for the milk they help disseminate.

Whatever the source of the milk or its channel of distribution, the trend is clear: Human milk is being bought, sold, donated—and gratefully received—on an unprecedented scale. And as demand grows, the competition for every ounce is getting more fierce.

The overall benefit of feeding babies breast milk instead of formula has been well established. In 2007, the US Department of Health and Human Services issued a report showing that babies who are formula-fed instead of breast-fed are at an increased risk for asthma, acute ear infections, diarrhea, and SIDS. 1 The advantages of feeding breast milk to babies are touted by some to be lifelong, potentially lowering the odds of obesity and boosting IQ by as much as 5 points.

Researchers have only recently begun to identify the mechanisms underlying breast milk's powerful effects. Look at it through a microscope and you can see that breast milk is abuzz with white blood cells, pearly fat globules, and fuzzy balls of protein. At higher magnification, you can make out the millions of Y-shaped molecules that are an infant's primary defense against infection: antibodies. Produced by the mother's immune system in response to the pathogens in her environment, these antibodies are passed along to the baby to fight off illness. Mothers' milk has other protective properties and potential uses as well. Sugars called oligosaccharides, long thought to have no function, since infants can't digest them, are now known to adhere to a baby's intestinal lining, allowing good bacteria in while repelling harmful bugs, like a discerning bouncer at a hip club. Fatty acids called DHA and AA serve as brain food, stimulating neurological development. One fatty acid-protein hybrid nicknamed Hamlet (Human Alpha-lactalbumin Made Lethal to Tumor Cells) has been found to kill 40 different types of cancer cell lines in the lab and is being researched as a treatment for patients. Breast milk also contains a host of stem cells. While scientists don't know yet what they're doing there, researchers suspect they may have the ability to differentiate into disease-fighting agents and could one day be harvested to treat an array of ailments, thus sidestepping the ethical concerns of harvesting stem cells from human embryos.

The multitasking magic of breast milk has proven difficult to replicate. J. Bruce German, a professor of food chemistry at UC Davis, has studied breast milk for two decades with the aim of mimicking certain effects. "The features that make human milk so unusual are that it's personalized and it's active," German says. "So almost by definition there's nothing on the horizon that would satisfy those criteria."

While the scientific understanding of human milk is still evolving, the American Academy of Pediatrics recommendation is straightforward: Mothers should feed their babies nothing but breast milk for the first six months and then continue nursing for at least another six. But the physical demands of breast-feeding and the time required to keep up with it can be daunting for new moms. (Breast-feeding can take as much as four hours a day a pumping session takes, on average, 15 minutes and yields 6 ounces.) According to the Centers for Disease Control and Prevention and a report called the Ross Mothers Survey, breast-feeding at birth is up from approximately 25 percent in the early 1970s to 75 percent in 2007. But less than half of all mothers make it to the recommended six-month mark, and just a fifth stick with at least some breast-feeding for an entire year. Still, those moms who don't breast-feed want what's best for their babies, and many are willing to do whatever it takes to get it—including buying it from strangers online.

The online purveyors of mothers' milk see themselves as brokering an entirely wholesome trade. "We love that our site has already helped so many moms and babies, and we hope we can continue to connect them together for years to come," says Chelly Snow, cofounder of Only the Breast. She came up with the idea after giving birth in January 2009 and reading articles online about the benefits of breast-feeding. She kept spotting the same sort of posts in the comments section of these articles: "I need breast milk. Where do I get it?" and "I have too much. What do I do with it?" Both craigslist and eBay had long ago banned the sale of bodily fluids. Snow saw buyers and sellers who weren't connecting, and the idea for a website that filled that gap—and her bank account—was born.

Since she and her husband, Glenn, launched the site a year and a half ago, Only the Breast has attracted roughly 3,000 members (posting is free but both sellers and buyers must register to make contact). The couple, who run the business out of their Walnut Creek, California, home, plan to bring in revenue by selling ads. For now, though, they post their own endorsements for such things as prenatal vitamins and baby sign-language classes. They have yet to turn a profit, but their enterprise has already expanded, with recently launched sister sites in the UK and the European Union.

Meanwhile, the donation-based milk-sharing sites—particularly Eats on Feets, which attracts a lot of Whole Foods-shopping earth mamas—see what they do as the continuation of an age-old practice. Women have breast-fed one another's babies for millennia, they point out, and Internet-enabled milk swapping is just a 21st-century update. The FDA doesn't see it in such benign terms. In November 2010, the agency issued a stern press release warning about the risks of feeding someone else's bodily fluids to your baby: "When human milk is obtained directly from individuals or through the Internet, 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."

Despite the FDA's caution, there have been no reported cases of infection from breast milk acquired online. And those who use these sites say it's not really the government's place to step in. Also, by skirting the steep cost of screening and processing, which FDA-endorsed banks must bear, women who sell their milk on these sites can charge a relatively low price. As a result, they say, they can have a far greater impact on children's health than they would if they donated to a milk bank.

The online outlets also funnel donated milk to women like Kristen Conklin-Leveille, a 24-year-old from Ballston Spa, New York, who developed a staph infection soon after giving birth, rendering her unable to breast-feed. She tried four different kinds of formula, but her 2-month-old son had trouble digesting them. She tried goat's milk, but he refused it. She looked into buying from a nonprofit milk bank, but at $5 an ounce, it could have cost $150 a day, or more than $50,000 a year. Desperate, she posted a plea for milk donations on the Eats on Feets message board and breast milk started trickling in. "A lot of women told me, 'I was going to give this to a milk bank,'" Conklin-Leveille says, "ɻut Iɽ rather give it to you.'"

Women may prefer to donate their milk to other moms than to give it to a milk bank, which will sell it for $4 an ounce. And mothers seeking milk are happy to take those donations, especially since health insurance doesn't cover breast milk. "Until we have national regulations where insurance companies pay for donor milk across the board, we're going to continue to have more and more of this informal sharing," says Lois Arnold, program coordinator for the National Commission on Donor Milk Banking, a program of the American Breastfeeding Institute. No wonder milk banks are struggling to maintain their supply.


Breast milk at any cost?


We’ve been told breast is best, but at what cost? (Sarah L. Voisin/THE WASHINGTON POST)

An article published Monday in the journal Pediatrics reported that breast milk available for purchase on the Internet has been found to have dangerous bacteria in it — including salmonella. Should that surprise us? Probably not.

What should surprise us, or at least make us think for a moment, are the risks that parents are willing to take to get their babies breast milk.

Forget the mommy wars. Mothers today are going through the milk wars. Starting before our children were born, we were told that “Breast is Best” by doctors, nurses, lactation consultants and the American Academy of Pediatrics.

There is good science behind breastfeeding, and there are good support systems available to women who need them. But there has been a cultural shift toward uber-motherhood that has helped make breastfeeding a competitive sport.

That’s why I was not surprised when it was reported that the breast milk that parents are buying on the Internet — from strangers, not subject to any oversight — is often contaminated.

Have we gone too far in our efforts to push for breast milk at any cost?

In the struggle to make the most perfect world for our children, women lug breast pumps to work, spend endless exhausted hours hoping their baby is getting enough milk, fret over the contents of their freezers — or, if they can’t produce milk themselves, rely on other moms, or sites that sell other women’s breast milk.

Of course, women have been nursing other women’s babies forever. But have we really reached the point where we think it’s okay to google and buy breast milk?

There are safe milk banks from which breast milk from donors who have been screened is available. But there are very few such banks, and the milk is relatively difficult to obtain most is earmarked for babies with major health issues.

Nancy Mallin, an international board certified lactation consultant with the Breastfeeding Center of Greater Washington, said that she has never advised parents to buy milk over the Internet, but has advised them to use milk from a certified milk bank. But there is a “woefully inadequate number of milk banks,” she said.

She encourages women to not give up. “Almost every woman in a U.S. hospital attempts to breastfeed their baby,” she said. “Then, a week later, those rates plummet.”

Nontheless, more women are breastfeeding now than in previous years. According to the Center for Disease Control report card, of the number of infants born in 2010, 49 percent were still breastfeeding at six months, up from 35 perent in 2000. And the number of babies breastfeeding at one year increased from 16 perent to 27 percent for that same period.

But what isn’t good is societal pressure that makes women feel they must breastfeed or irreparably harm their children.

I’ve watched many friends lose sleep and precious bonding time with their babies because they could not produce enough milk and felt feeding their babies formula was like feeding them arsenic. One finally quit trying when it was recommended she try a drug to boost her milk supply that wasn’t yet approved in the U.S. Another was depressed because she was spending more of her day with a breast pump and Mother’s Milk tea than she was snuggling her three-month-old.

Banks weren’t available options, and these women stopped short of turning to internet-ordered breast milk. But there were those who felt they had no other alternative, and now they are faced with the knowledge they could have made their babies very sick from doing what they felt was very right.


Breast Milk Sold on the Internet Often Contaminated - Recipes

RACHEL'S HAZARDOUS WASTE NEWS #193
---August 8, 1990---
News and resources for environmental justice.
------
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944 Internet: [email protected]
==========

HUMAN BREAST MILK IS CONTAMINATED.

We do not want to discourage breast feeding. Breast feeding is a highly desirable practice, despite the presence of toxic chemicals in human milk. Breast feeding gives an infant immunity against gastrointestinal diseases and respiratory infections it may also offer protection against food allergies. The emotional bonding that takes place between mother and child can be exceedingly important as well. [2] Furthermore, the alternatives (prepared formulas) are all less healthy.

Still, it is important for Americans to recognize the consequences of allowing the chemical industry (and, more recently, the incineration industry) to expand unchecked, and contamination of breast milk is one well-established consequence. The problem is not widely acknowledged or often discussed, perhaps because it forces us to ask ourselves, what kind of people allow their infant children to ingest low concentrations of a hundred industrial poisons with every mouthful of their mother's milk?

Scientists first discovered that human breast milk was contaminated with DDT in 1951. [3] DDT, like many other chlorinated organic chemicals, is soluble in fat but not very soluble in water, so when it enters the body it is not easily excreted and it builds up in fatty (adipose) tissue. The main way that females excrete such chemicals is through their breast milk. Breast milk contains about 3% fat (average) and fat-soluble chemicals collect there. Unfortunately, this contaminates infant children who breast feed.

(When examining data on milk contamination, be aware that concentrations are sometimes given as ppm [parts per million] for fat, or ppb [parts per billion] for whole milk fat concentrations are about 30 times higher than whole milk concentrations, so, for example, 2.5 ppm in fat is approximately equivalent to 75 ppb whole milk.)

The most extensive survey of the milk of American women was conducted by U.S. Environmental Protection Agency in 1975. They took samples from more than 1000 women, but analyzed them for only a few pesticides. They found DDT in 100% of samples PCBs in 99% of samples dieldrin in 83% of samples. EPA says DDT, dieldrin and PCBs are all "probable carcinogens" in humans.

There has been only one study of non-pesticide organic chemicals in the milk of American women. [1] It found 192 organic compounds, many of them well-known industrial poisons like carbon tetrachloride and benzene (both known human carcinogens). We list the 192 compounds in footnote 1. From reading the scant literature on this topic, one draws the unmistakable impression that further study would reveal more contamination.

Table 1 shows how grossly contaminated the milk of American women is, based on just four pesticides. The first column names the pesticide column 2 gives typical levels of contamination reported in scientific studies column 3 gives the FDA's "action level" for each pesticide this is the level at which the FDA can (if it chooses to) take commercial cows' milk off the shelves because of excessive contamination column 4 shows the allowable daily intake of each pesticide for an adult (expressed in micrograms of pesticide per kilogram of body weight). [There are 28 grams in one ounce a kilogram is about 2.2 pounds.] The last column shows the actual daily intake for a nursing infant in America. It is clear that the actual daily intake by an infant exceeds an adults's allowable daily intake by anywhere from a factor of 6 to a factor of 14.

No allowable daily intakes have been calculated for infants, but it is known that infants are much more susceptible to toxic chemicals than are adults because an infant's kidneys, liver, enzyme systems, and blood-brain barrier are not fully developed. Furthermore, a newborn has very little body fat available for storage consequently, the fat soluble chemicals are circulated in the blood throughout the body for a longer period and may interfere more intensely with normal enzyme activity.

These disturbing data are one more reason why the U.S. should begin now to institute a policy of "zero discharge" for all industrial chemicals (see RHWN #154, #155 and #187).
--Peter Montague, Ph.D.

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[1] Edo D. Pellizzari and others, "Purgeable Organic Compounds in Mother's Milk." BULLETIN OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY Vol. 28 (1982), pgs. 322-328, analyzed 12 samples of human milk from New Jersey, Pennsylvania and Louisiana the following chemicals were identified (the percentage in parentheses indicates what percent of the 12 samples contained each chemical):

Halogenated compounds: Chlorodifluoromethane (8%) chlorotrifluoromethane (33%) dichlorodifluoromethane (16%) chloromethane (16%) chloroethane (16%) trichlorofluoromethane (58%) dichloroethylene (8%) Freon 113 (75%) methylene chloride (75%) chloroform (58%) 1,1,1-trichloroethane (75%) carbon tetrachloride (42%) trichloroethylene (75%) chloropentane (16%) dibromochloromethane (8%) tetrachloroethylene (58%) dichloropropene (8%) chlorobenzene (42%) chlorohexane (33%) iodopentane (8%) 3-methyl-1-iodobutane (16%) chloroethylbenzene (8%) dibromodichloromethane (8%) dichlorobenzene (75%) chlorodecane (8%) trichlorobenzene (8%). Aldehydes: acetaldehyde (33%) methyl propanal (16%) n-butanal (50%) methyl butanal (16%) crotonaldehyde (8%) n-pentanal (58%) n-hexanal (75%) furaldehyde (16%) n-heptanal (58%) benzaldehyde (75%) n-octanal (25%) phenyl acetaldehyde (8%) n-nonanal (50%) methyl furaldehyde (8%) n-decanal (16%) n-undecanal (16%) n-dodecanal (8%).

Ketones: acetone (75%) methyl ethyl ketone (42%) methyl propyl ketone (16%) methyl vinyl ketone (8%) ethyl vinyl ketone (33%) 2-pentanone (33%) methyl pentanone (16%) methyl hydrofuranone (8%) 2-methyl-3-hexanone (8%) 4-heptanone (8%) 3-heptanone (33%) 2-heptanone (50%) methyl heptanone (16%) furyl methyl ketone (8%) octanone (16%) acetophenone (75%) 2-nonanone (33%) 2-decanone (8%) alkylated lactone (8%) phthalide (8%).

Other oxygenated isomers: C4H6O (8%) C4H8O (16%) C5H10O (42%) C6H8O (8%) C6H10O (16%) C4H6O2 (8%) C6H12O (16%) C7H12O (33%) C7H10O (16%) C7H14O (16%) C6H6O2 (8%) C8H14O2 (8%) C8H16O (16%) C7H8O2 (16%) C7H10O2 (8%) C9H18O (25%) C8H6O2 (8%) C10H12O2 (8%) C10H14O (8%) C10H16O (16%) C10H18O (25%) C10H20O (16%) C10H22O (8%) C9H8O2 (8%) C11H20O (8%) C10H10O2 (8%).

Alcohols: methanol (8%) isopropanol (75%) 2-methyl-2-propanol (8%) n-propanol (8%) 1-butanol (25%) 1-pentanol (33%) à-furfuryl alcohol (16%) 2-ethyl-1-hexanol phenol (8%) 2,2,4-trimethylpenta-1,3-diol (8%) à-terpineol (8%).

Acids: acetic acid (16%) decanoic acid (8%). Sulfur compounds: sulfur dioxide (8%) carbon disulfide (75%) dimethyl disulfide (50%) carbonyl sulfide (8%). Nitrogen compounds: nitromethane (8%) C5H6N2 (8%) C5H8N2 (8%) C4H4N2O (8%) methyl acetamide (8%) benzonitrile (25%) methyl cinnoline (8%).

Esters: vinyl propionate (25%) ethyl acetate (8%) ethyl-n-caproate (8%) isoamyl formate (8%) methyl decanoate (8%) ethyl decanoate (8%).

Ethers: dimethyl ether (8%) dihydropyran (16%).

Epoxides: 1,8-cineole (8%).

Furans: furan (8%) tetrahydrofuran (8%) methyl furan (16%) methyl tetrahydrofuran (8%) ethylfuran (16%) dimethylfuran (8%) 2-vinylfuran (8%) furaldehyde (16%) 2-n-butylfuran (8%) 2-pentylfuran (58%) methylfuraldehyde (8%) furyl methyl ketone (8%) à-furfuryl alcohol (16%) benzofuran (25%).

Alkanes: C3H8 (8%) C4H10 (50%) C5H12 (75%) C6H14 (75%) C7H16 (58%) C8H18 (58%) C9H20 (75%) C10H22 (58%) C11H24 (58%) C12H26 (58%) C13H28 (25%) C14H30 (25%) C15H32 (16%). ALKENES: C3H6 (16%) C4H8 (42%) C5H10 (25%) C6H12 (75%) C7H14 (75%) C8H16 (75%) C9H18 (58%) C10H20 (50%) C11H22 (50%) C12H24 (8%) C13H26 (8%) isoprene (8%).

Alkynes: C5H8 (16%) C6H10 (8%) C7H12 (25%) C8H14 (25%) C9H16 (33%) C10H18 (16%) C12H22 (8%).

Cyclic: cyclopentane (50%) methyl cyclopentane (50%) cyclohexane (42%) ethyl methyl cyclohexane (8%) C10h14 isomers (8%) C10h16 isomers (other) (33%) limonene (75%) methyl decalin (8%) à-pinene (8%) camphene (8%) camphor (8%).

Aromatics: benzene (75%) toluene (75%) ethylbenzene (75%) xylene (75%) phenyl acetylene (8%) styrene (75%) benzaldehyde (75%) C3-alkylbenzene isomers (75%) C4-alkylbenzene isomers (50%) methyl styrene (16%) dimethyl styrene (42%) C5-alkylbenzene isomers (16%) naphthalene (50%) C6-alkylbenzene isomers (8%).

[2] D.B. Jelliffe and E.F.P. Jelliffe, HUMAN MILK IN THE MODERN WORLD: PSYCHOSOCIAL, NUTRITIONAL AND ECONOMIC SIGNIFICANCE (NY: Oxford University Press, 1978).

[3] E.P. Laug and others, "Occurrence of DDT in Human Milk." ARCHIVES OF INDUSTRIAL HYGIENE Vol. 3 (1951), pgs. 245-246.

TABLE I: Typical levels of pesticides and PCBs in human milk in the U.S., FDA Action Levels, Allowable Daily Intake, and Actual Daily Intake of Breast-Fed Infants.

Pesticide Typical Levels (whole milk) FDA Action Levels for whole milk (cows') Allowable Daily Intake (Adult) Actual Daily Intake (Infant) Actual Daily Intake by Infants over the Allowable Daily Intake for Adults
-------------------------- parts per billion --------------------------
Dieldrin 1-6 9 0.1 0.8 8 times higher
Heptachlor Expoxide 8-30 0.3 0.5 4.0 8 times higher
PCBs 40-100 63 1.0 14 14 times higher
Total DDT 50-200 38 5.0 28 5.6 times higher
Source: Walter J. Rogan and others. "Pollutants in Breast Milk," NEW ENGLAND JOURNAL OF MEDICINE Vol. 302 (June 26, 1980), pg. 1451, Table 3.

Descriptor terms: ddt dde pesticides tolerance levels risk assessment human breast milk lactation food safety infants children pcbs heptachlor epoxide allowable daily intake adi zero discharge heptachlor carcinogens dieldrin surveys statistics studies


Buying human breast milk online poses serious health risk, say experts

A growing market in online sales of often contaminated human breast milk – fuelled in part by bodybuilders and adults with a baby fetish – poses a serious risk to public health, according to experts.

Researchers from the University of London’s school of medicine and dentistry were so alarmed by their initial findings that they wrote an editorial in the British Medical Journal to warn of the dangers of buying breast milk online before their study was completed. The editorial says breast milk sold online should be screened for diseases such as hepatitis, HIV and syphilis.

Lead author Dr Sarah Steele said she feared that babies would die from unscreened milk sold online if the market was not regulated. In one of the studies she cited, more than 90% of breast milk purchased online was found to have bacterial growth. Some of the sellers interviewed included intravenous drug users.

Unregulated websites selling breast milk attract tens of thousand of users in the US, the research found. One site reported growing by 800 users each month. It also reported an emerging market in the UK on specialist sites as well as general retail sites including Gumtree and Craigslist. Premium prices of up $4 (£2.70) per fluid ounce (30ml) are offered by mothers who purport to eat only organic or vegan food, or can boast having “fat, chubby babies”, the researchers found.

The online market caters primarily for mothers who are unable to breastfeed their babies, serving as a cheaper alternative to regulated milk banks, where the milk is always pasteurised. But consumers also include cancer patients who believe breast milk has health benefits and gym enthusiasts who believe breast milk is a natural superfood. A third group of adult consumers are fetishists “who like to be fed like a baby, either from source or from a bottle”, according to Steele.

She told the Guardian: “I reserve my judgment on these things. The focus for us is that people need to be making safer feeding choices. In the adult market there are cancer patients who are desperate to try anything and a lot of people in the body-building and cross-fit communities who really don’t realise the dangers. They think it’s a natural superfood. They don’t realise that it could be contaminated with bacteria.”

Steele explained the dangers: “When sellers freeze milk and send it in the mail it thaws out. That’s when bacteria has time to grow and and become really dangerous, especially for infants.”

She added: “We started this study from a curiosity point of view initially, but the public health data is so definitive on how dangerous it is that we couldn’t wait for the end of our project because that could have taken several years to complete. It was so damning that we felt we had to approach the BMJ and say: ‘This needs to get out there now.’ We don’t want to be writing the report after there has been an infant death in Britain.”

The editorial calls for healthcare workers to be trained to offer advice about how to acquire breast milk safely. Steele said: “We observed that mothers are often in a desperate state and are nervous about talking to healthcare professional about their difficulties feeding. The big danger is that more women turn online and that threatens the health of their infants. And with the adult market growing, we want to make sure people aren’t spreading communicable diseases in new ways, just as we are getting on top of things like hepatitis, syphilis and HIV.”

Steele said the health benefits for adults of drinking breast milk were unproven. “Human breast milk doesn’t really have that many advantages for adults,” she said. “It is certainly not what you need in the context of bodybuilding and cross-fit, as a post-workout recovery drink.”

She pointed out that consuming breast milk was regularly discussed on mainstream online bodybuilding forums.

The paper concludes: “Although breast milk holds many known benefits, seeking out another’s milk rather than turning to instant formula poses risks. When breast milk is screened and treated appropriately, as the World Health Organisation states, it remains second to a mother’s own milk as best for infant feeding. 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.”


Health experts say online sale of breast milk is dangerous and must be regulated

The online sales boom in often contaminated breast milk poses serious risks to children's health - as well as that of gym junkies and cancer sufferers - and needs urgent regulation, public health experts say.

Breast milk sold on the internet was generally not screened for diseases and contamination, adulterated with water and cow's milk, and tainted with high levels of bacteria, researchers from the Queen Mary University of London said in the latest British Medical Journal.

The trade of breast milk sold online is flourishing. Credit: Oleg Kozlov

Lead author Sarah Steele said she was so alarmed by the team's early findings that she was prompted to publish an editorial calling for regulators to take urgent action and issue public warnings, fearing a baby could die.

She said mothers struggling to provide breast milk for their babies were increasingly turning to the internet where the breast milk trade was flourishing. The market was most rapidly expanding in the United States, where one website, OnlyTheBreast.com, has amassed 27,000 users.

"In the absence of warnings about the dangers of buying milk online, this option might seem healthy and beneficial -the better choice if one can't breast feed oneself," she wrote. "What mothers, and many healthcare workers, don't realise is that this market is dangerous, putting infant health at risk."

She said online breast milk was cheaper than traditional milk banks, which could charge up to $US4 an ounce. But the trade-offs were risky.

Black market breast milk vendors did not have to bear the cost of routine pasteurisation or testing for disease or contamination, her research showed. These cost-saving measures led to higher risks of disease transmission, contamination and tampering.

"Unlike donors at licensed milk banks online sellers are not required to undergo any serological screening, meaning that diseases such as hepatitis B and C, HIV, human T cell virus, and syphilis may not be detected," she said.

But Lisa Amir, a breastfeeding expert at La Trobe University, said Dr Steele was "over-exaggerating" the risks associated with "not a very big industry".

She said instant formula had risks as well, including the growth of bacteria.

"She's correct to say if someone buys milk off the internet, they don't know where it's coming from," Dr Amir said. "But I think she's over-emphasised it, a kind of scare-mongering."

A separate study showed 5 per cent of samples from licensed milk banks tested positive for cytomegalovirus, compared with 21 per cent of samples bought online.

Further, 90 per cent of samples bought online showed higher overall bacterial growth.

Another study found a quarter of 102 samples bought online arrived in severely damaged packaging and no longer frozen, which could lead to rapid bacterial growth and contamination.

And in a third study referenced by Dr Steele, researchers detected traces of chemical Bp and illegal drugs in milk purchased online. Some of the samples were mixed with water and cow's milk to boost volume.

The risk of disease transmission via tainted milk should also be a concern for bodybuilders, who consider it a superfood, and cancer sufferers, who mistakenly believe it has health benefits.

The Australian Breastfeeding Association said for mothers who did not have enough breast milk, another woman's milk was the next best alternative. But there were risks.

"The association strongly encourages mothers to ensure that they are well informed of the potential risks and benefits of donated human milk, methods available for minimising risks, and to make decisions based on their own individual circumstances," it said.

Since 2006, when Perron Rotary Express Milk Bank was set up in Perth, four banks have opened, including one at the Royal Prince Alfred Hospital's neonatal intensive care unit.

Facebook groups such as Eats on Feets or Human Milk 4 Human Babies allow Australian mothers to trade milk, but take no responsibility for outcomes and do not screen donors or provide absolute guidelines.

The World Health Organisation says: "The choice of the best alternative – expressed breast milk from an infant's own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup, which is a safer method than a feeding bottle and teat – depends on individual circumstances."