Public Health Reports / March–April 2011 / Volume 126
Got Milk? Sharing Human Milk
Via the Internet
Sheela R. Geraghty, MD, MS,
Julie E. Heier, BSb
Kathleen M. Rasmussen, ScD,
aCenter for Breastfeeding Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
bDivision of Nutritional Sciences, Cornell University, Ithaca, NY
Address correspondence to: Sheela R. Geraghty, MD, MS, IBCLC, Cincinnati Children’s Hospital Medical Center, Center for
Breastfeeding Medicine, 3333 Burnet Ave., MLC 7035, Location S, 9-242, Cincinnati, OH 45229; tel. 513-636-2526; fax 513-636-4402;
©2011 Association of Schools of Public Health
Human milk is the ideal source of nutrients for infants. Extensive research docu-
ments the many positive health outcomes and economic benefits of breastfeeding
for both mothers and infants. Numerous organizations of health professionals,
such as the American Academy of Pediatrics,1 American Academy of Family
Physicians,2 American College of Obstetricians and Gynecologists,3 American
College of Nurse-Midwives,4 American Dietetic Association,5 and American Pub-
lic Health Association,6 advocate that infants be breastfed throughout the first
year of life. The United States Breastfeeding Committee, which comprises more
than 40 organizations and governmental agencies, is evidence of the country’s
commitment of time and resources to helping the maternal-infant dyad suc-
cessfully breastfeed.7 The U.S. Surgeon General’s Office strongly encourages
the continuation of feeding breast milk to infants, particularly when women
return to work.8
About 70% of women in the United States attempt to feed breast milk to
their infants before being discharged from the hospital,9 and more than two-
thirds of women with children younger than age 18 work outside the home.10
In addition to feeding their children directly “at the breast,” therefore, most
women in the U.S. must extract milk from their breasts by mechanical means.
A woman with a double-sided electric breast pump can easily and painlessly
remove the contents of both of her breasts in approximately 15 minutes.11
Inasmuch as women are separated from their children daily, a child may be fed
directly at the mother’s breast before she leaves for work, be fed the mother’s
refrigerated breast milk that she pumped several days ago by daycare providers,
be fed the mother’s thawed frozen milk that she pumped weeks previously by
the father or other caregiver, and finally be fed at the mother’s breast again
after she returns home. In the meantime, while the mother is separated from
her infant, she must mechanically pump her breasts during breaks to have
enough milk for upcoming days.
In the Infant Feeding Practices Study II, the largest investigation to date
on pumping by U.S. mothers, 85% of 1,564 breastfeeding mothers of healthy,
Public Health Reports / March–April 2011 / Volume 126
singleton infants extracted milk from their breasts
while their infants were 1.5–4.5 months of age. By seven
months postpartum, 92% of the cohort still breastfeed-
ing had extracted milk from their breasts.12 Women who
pump may produce more milk than is needed by their
own infants. The purposes of this commentary are to
describe some of the ways human milk has become a
valued commodity and highlight some of the potential
dangers of sharing raw, unpasteurized human milk.
UTILIZING EXTRA HUMAN MILK
Women with extra milk have to decide what to do with
the surplus, which often fills their entire home freezer.
They may simply choose to discard the milk that they
pumped. Alternatively, mothers may give their milk
to family and friends to feed to their own children.
Women who conduct a simple Internet search will find
that they also can donate their milk to a not-for-profit
milk bank through one of the 10 milk banks belong-
ing to the Human Milk Banking Association of North
America (www.hmbana.org). Similar to blood donation,
members of this association follow strict guidelines
for serologic screening for infectious disease and use
a thorough lifestyle questionnaire. These milk banks
have stringent criteria of pasteurization, storage, and
distribution of donated human milk, which is primar-
ily fed to hospitalized infants with chronic medical
Women who do not want to discard or donate their
milk also have the option of selling it. A first step in
understanding how to share raw, unpasteurized human
milk is simple: just enter key words such as “breast
milk” or “human milk” into an Internet search engine
along with another descriptor such as “buy, purchase,
sell, want, for sale, or share.” This action produces a
variety of links to donor milk banks, classified advertise-
ments, blogs, chat rooms on social networking sites,
and random posts that describe the scientifically sup-
ported and unscientifically supposed characteristics
of human milk.
As an example, the site milkshare.birthingforlife.com
appears in nearly every search for “breast milk” or
“human milk,” along with one of the previously men-
tioned descriptors. This website advertises itself as an
“informational resource” connecting families to one
another. After writing a brief paragraph on why an
individual wants to join the group, that person will find
multiple options on how to send and receive human
milk by introducing the parties to one another. The
website asks for a self-reported health history of the
donor and provides some guidance on the collection,
storage, and preparation of frozen milk. Although this
site does not endorse payment for milk, a one-time
donation through the online PayPal™ payment program
is recommended for website maintenance.
Other sites function more as blogs or personal
diaries posted by individuals that invite replies from
others. The blog www.breastmilkdonations.com is one
such networking site where the author states, “As long
as there is a need and a mommy willing to help, I will
just be a click away.” This site also matches potential
milk donors and recipients after the interested parties
provide the author with their contact information. The
site describes how to pump, freeze, and ship milk, giv-
ing specific instructions on how to label the FedEx®
box. The author of this blog also provides her own
instructions on how to pasteurize breast milk in one’s
kitchen using a large stock pot, Mason canning jars,
a candy thermometer, rubber gloves, aluminum foil,
and plastic wrap. The site www.breastmilkmonger.com
describes shipping methods as well, and also provides
a primer on how to avoid legal issues when selling
breast milk. The site recommends that a mother ask
for compensation “for her time” rather than the “milk
itself” so as not to enter into the “illegal activity” of sell-
ing bodily fluids such as blood or sperm. This website
recommends that each seller of milk create an hourly
rate based on the time it takes the mother to pump a
given amount of milk.
Searches through classified advertising sites such as
www.isell.com, www.bst.com, www.oodle.com, and www
.sell.com yield multiple ways to buy and sell milk. The
buyer and seller never need to converse through a third
party, nor do they communicate directly. Women with
too much milk simply place an advertisement. On our
search of these sites, we found milk priced from $1
to $10 per ounce, often accompanied by pictures of
milk in assorted storage containers next to the adver-
tisement. Buyers simply read the online descriptions
of the milk and choose from the many options avail-
able. On one of the classified advertising sites, there
were more than 20 milk sellers from which to choose.
Some sellers were listed as “temporarily sold out” and
gave time estimates when the supply would again be
available. After deciding on which milk to purchase,
the buyer simply highlights the chosen entry and then
clicks on the “Buy Now” or “Add to Cart” function. At
the subsequent “Checkout” screen, all of these sites
ask for credit card or PayPal payments. Shipping costs
are included in the purchase and overnight shipping
is often available. There was no option for returns of
milk on any of the sites.
Sharing Human Milk Via the Internet 163
Public Health Reports / March–April 2011 / Volume 126
PROCEED WITH CAUTION: OBTAINING
HUMAN MILK ON THE INTERNET
The public health implications of human milk sharing
are entirely unknown. The “milk” that the buyer gets is
an unregulated, untested commodity. Although most
mothers probably are honest and send only the milk
that they pumped from their own breasts, the market
for human milk is usually priced by volume. A buyer will
never know if a seller has added a potentially harmful
substance to the milk to increase the volume, and, thus,
the monetary value. Even the addition of cow’s milk
proteins may be harmful for some infants.13–16 Infec-
tious agents found in milk, such as human immunode-
ficiency virus,17,18 group B streptococcus,19–22 Klebsiella
pneumoniae,23 cytomegalovirus,24–27 and herpes,24–30 can
potentially sicken the recipient. Harmful environmen-
tal chemicals potentially may be found in milk stored
for long periods of time in plastic containers,31–34 and
repeated cycles of refrigeration-freezing-thawing may
alter the integrity of milk’s bioactive factors.35–41 Mul-
tiple medications appear in breast milk and make it
contraindicated for feeding to infants. Drugs of abuse
can also be present.42 Those who regularly “shop” for
milk may feed a single infant the milk of multiple
women, which may lead to numerous potentially harm-
International health organizations state that only
under exceptional circumstances should a mother’s
milk be considered unsuitable for her own infant and
a “healthy wet-nurse” act as a potential alternative.43
However, there is no further explanation given by the
World Health Organization or the United Nations Chil-
dren’s Fund to further define the practical implications
and safety of this practice. Experts within the American
Academy of Pediatrics recommend against the sharing
of any raw, unpasteurized human milk.44
In the U.S., as long as women continue to pump,
there will be extra milk. Health-care providers must
be aware that any infant could be receiving the milk
of another mother and should ask about milk sharing
when taking a feeding history. Epidemiologic studies
should elicit information about the feeding of another
mother’s milk to document the scope of this practice.
Collaboration between clinicians and researchers is
essential to understand not only the risks involved in
this practice, but also how to educate the public about
the best use of expressed human milk.
Kathleen Rasmussen was supported by the U.S. Department of
Agriculture Hatch #399-7427, and Sheela Geraghty was supported
by the National Institutes of Health #K23ES014691.
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