The danger of buying breast milk over the Internet

Recent research confirms that buying breast milk on the Internet via milk-sharing sites may not be safe. Although breast milk purchased from online sites may be free or as cheap as $1-$2 an ounce, it may carry significant risk for babies. Clearly the benefits of breast milk are vast; pediatricians and health experts recommend exclusive breast feeding until 6 months of age.

However, simply put, breast milk obtained from unknown (or known) individuals online may carry contamination from medications/drugs excreted in the breast milk,  bacterial, or viral contamination. If a mother isn’t able to provide enough breast milk for her newborn or infant, parents must know that milk from online sellers can be contaminated at the time of collection and/or during transport, dangerous especially for babies born prematurely. If buying human breast milk parents should look for a certified milk bank.

Back in 2010 the FDA spoke out against the practice of buying breast milk online, warning parents of potential risks due to bacteria or viral contamination, exposure to chemicals, medications, and drugs. The research out today confirmed these hesitations: nearly 3/4 of the breast milk obtained by researchers online had bacterial contamination and 20% of the samples tested positive for a virus called CMV.

It should be noted that breast milk bacteria (or virus) counts aren’t deterministic for infection, meaning that just having bacteria in a breast milk sample doesn’t mean a baby will get sick from it. How old a baby is, the amount of bacteria in the sample, and the immune status of an infant all also play a part. However, there are reports of premature babies and babies with immune dysfunction becoming seriously ill from donated unpasteurized breast milk so caution is necessary.

To be very clear the breast milk obtained and studied in the new research was NOT from a milk bank. Human Milk Banking of North America (HMBANA)  breast milk banks screen donors for infections (like HIV) and pasteurize the breast milk to ensure improved safety protection. The trouble for many families unable to make enough breast milk with using these banks can be very costly secondary to the handling, screening, and pasteurization. Milk can be several dollars an ounce!

The Internet purchased breast milk:

  • Researchers in Ohio obtained over 100 samples of donated breast milk through an unnamed, online breast milk site for testing. Just Google “buy breast milk” for some examples of online breast milk-sharing sites. In the study researchers requested, paid for, and tested breast milk obtained online. They charted time in shipping, temperature upon arrival and tested milk for contamination with bacteria and viruses. In the study, 74% of the breast milk obtained online was found to have bacterial contamination on testing. Much of the bacteria found in the collected milk was gram-negative bacteria some gram-positive bacteria (“staph”) that tend to live on our skin. Three samples of breast milk collected were contaminated with salmonella bacteria. About 1 in 5 samples tested positive for CMV DNA.
  • Bacterial contamination was more likely the longer it took for the breast milk to arrive. Although 1/2 of the samples arrived within 2 days, 12% required 3 to 6 days. Each additional transit day was associated with an increase in total bacteria count. Some sellers of the milk promoted their diet or exercise habits or lack of using medications. None of these claims was predictive of bacteria counts or presence of CMV (virus).
  • Researchers compared the online-obtained breast milk samples to samples of breast milk obtained (prior to pasteurization) from a HMBANA-member milk bank. The samples found online were significantly more contaminated that those collected for a milk bank. Researchers theorized that because milk donated to a bank are screened and come from women screened and counseled on proper technique for collection, they may send in less contaminated milk overall secondary to improved hygienic handling practices.
  • Researchers confirmed 2010 FDA concerns: “human milk purchased via the Internet exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices.”

This research really provides just some of the first information about Internet-purchased human breast milk. The far majority of moms do breastfeed their babies at the start (77%) but not all moms can produce enough breast milk for their infants. If you’re a mom having a challenge with milk supply or know a mom with  challenge, the first step can always be talking with a lactation consultant for support in enhancing milk production. If a family wants to purchase supplemental breast milk this new research and the current FDA recommendations suggest it’s best to avoid unscreened online Internet donors. My recommendation is if you’re going to get breast milk from someone other than mom, only purchase breast milk from a HMBANA-member milk bank.

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc.

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  • Ron Smith

    Hi, Wendy.

    The only thing that pegs me from the start of your article is something that has always ground me when I hear it in TV ads. Its the ‘Doctors recommend…’ statement that precedes a commercial product sales ploy. When I hear that, I know beyond a shadow of a doubt that the ad is disingenuous and deceptive.

    The part where you state that Pediatricians recommend exclusively for the first six months strikes me the same way. It just grinds on me.

    I’ve been doing this for thirty years and what I came to recognize a long time ago was how Pediatric residents become robots spouting the recommendations they were programmed to repeat, without ever really thinking for themselves. They give no thought to it.

    I remember when fluoridated vitamins were emphatically recommended…until they weren’t. Another example is the whole ‘breastfeeding for a full year’ was countered by the formula industries demand to have that recommendation for formula.

    I do not recommend breastfeeding exclusively until age 6 months and indeed it is uncommon for the children that can wait that long for solids. Third world country recommendations are different as are the nutritional issues there.

    It is these kind of statements that are propagandamatic and preclude more serious consideration of the rest of your article, however correct the rest of it may be. I couldn’t focus on anything else for that one initial tainted statement. Some things I think should be left for each of us to conclude ourselves.

    Respectfully,

    Ron Smith, MD
    www (adot) ronsmithmd (adot) com

    • rtpinfla

      Propagandamatic? Is that even a word?
      Besides that, I agree with every word you said. There is way too much dogma and not enough thinking in medicine anymore. Most guidelines are just that- good guidelines but they cannot take into account each person’s individual situation.
      I remember getting skewered for putting a 65 y/o guy at “serious risk” of GI bleeds as a resident. What did I do? I gave him Motrin for a back strain instead of Vioxx.

      • Ron Smith

        Propagadamatic is a contraction of propaganda and problematic which I claim is allowed within the range of my artistic license. I kinda liked it! Feel free to plaigirize it at no extra charge!

        ;-)

  • Guest

    The only reason new mamas who for whatever reason can’t produce enough milk for their babies feel compelled to go out and purchase the unknown and untested product of other females’ mammary glands, is because of the “breast is best” nazis.

    • James_94

      This is a British article, but it covers that exact point:

      “At the Centre for Parenting Culture Studies at Kent we have been looking for some time at how infant feeding has become an increasingly moralised issue, ever more tied to ideas about good motherhood (and fatherhood). Breastfeeding … has become fetishised to the extent that how (or what) women feed their babies is seen as a marker of how dedicated one is as a mother. Conversely, the failure to breastfeed has been held responsible for wider health inequalities like the prevalence of obesity or cancer.

      The fact that there is a market for breastmilk shows how far parents’ anxieties can be played upon, but it now leaves them in another tricky situation: weighing up the risk of not giving their babies breastmilk against the risk of giving their babies unscreened milk. This problem is apparently well-established, and the Department of Health is currently in talks about what to do about this new phenomenon.”

      the whole article is here: http://www.spiked-online.com/newsite/article/breastfeeding_marketing_mothers_anxiety/14242

  • rtpinfla

    “It should be noted that breast milk bacteria (or virus) counts aren’t deterministic for infection, meaning that just having bacteria in a breast milk sample doesn’t mean a baby will get sick from it”. This is a very important point that gets lost in all the noise. Is there a risk? I suppose there is a slight risk, but it seems there is also a risk anytime we buy produce or hamburger meat from “approved sources”, so there needs to be some context.
    However, I suspect we will see new legislation, sponsored by the makers of Enfamil, outlawing the sale and purchase of breast milk except through official breast milk banks.

    • GT

      “I suppose there is a slight risk, but it seems there is also a risk
      anytime we buy produce or hamburger meat from “approved sources”, so there needs to be some context.”

      Quite so.

      In the United States, using FoodNet data from 2000–2007, the CDCP estimated there were 47.8 million foodborne illnesses per year (16,000 cases for 100,000 inhabitants). 127,839 were hospitalized (43 per 100,000 inhabitants) and 3,037 people died (1.0 per 100,000 inhabitants).

      Does no one remember 2011′s deadly multi-state Listeria outbreak? I’d guess that more Americans died of eating FDA-approved cantaloupe than died of drinking “unapproved” breast milk.

  • Ron Smith

    I understand what you are saying, but the problem word is ‘exclusivity.’ I still encourage breast feeding even up to 1 to 2 years. The WHO recommends in third world countries that even up to three years of age because of the lack of protein in the diet. The US is not a third world country. On occasion I’ve seen mom’s nurse until age 4 or 5. This is emblematic of an extreme and that word ‘exclusive’ makes me think of that kind of extremism.

    • MissMeg

      In the interest of science and infant health, I leave you with this information:

      “Infant formula should not be given to a breastfed baby before gut closure occurs.

      ” *Once dietary supplementation begins, the bacterial profile of breastfed infants resembles that of formula-fed infants in which bifidobacteria are no longer dominant and the development of obligate anaerobic bacterial populations occurs. (Mackie, Sghir, Gaskins, 1999)

      * Relatively small amounts of formula supplementation of breastfed infants (one supplement per 24 hours) will result in shifts from a breastfed to a formula-fed gut flora pattern. (Bullen, Tearle, Stewart, 1977)

      * The introduction of solid food to the breastfed infant causes a major perturbation in the gut ecosystem, with a rapid rise in the number of enterobacteria and enterococci, followed by a progressive colonization by bacteroides, clostridia, and anaerobic streptococci. (Stark & Lee, 1982)

      * With the introduction of supplementary formula, the gut flora in a breastfed baby becomes almost indistinguishable from normal adult flora within 24 hours. (Gerstley, Howell, Nagel, 1932)

      * If breast milk were again given exclusively, it would take 2-4 weeks for the intestinal environment to return again to a state favoring the grampositive flora. (Brown & Bosworth, 1922; Gerstley, Howell, Nagel, 1932)”

      Quoted from:
      http://drjaygordon.com/pediatricks/startingout/supplement.html

  • Ron Smith

    Think herbs at the health food store are any different? Some of them are absolutely contraindicated with some medications used in Geriatrics.

    To think that vaccines are any different than the claims that many of these ‘natural products’ tout for ‘boosting one’s immune system’ is an example of the same extremism harkened by breast feeding exclusively till age 6 months or continuously till age 4 years (which I have see).

    • MissMeg

      I’m not recommending herbs or any other product for that matter.
      It just amazes me how we generally don’t consider the content of various substances we put into our children’s bodies.
      If we are going to be concerned about buying breastmilk from another person – and I do NOT recommend this – then we should also take a good hard look at other substances.

      • James_94

        Well, yeah. I would not recommend buying unknown and untested “vaccines” from anonymous people over the internet either. You should have some idea what you’re putting into your baby’s body. Which is why you trust your doctor, and not some anonymous internet weirdo.

  • Ron Smith

    Chickenpox parties were well known prior to the chickenpox vaccine and I’ve seen many parents expose their children that way in my thirty years as a Pediatrician.

    There is little difference in the effect on and response from the immune system between infecting your child with the live, virulent varicella and the varicella vaccine…except of course that the live virus is forever carried in the nerves in your child’s body for the res of their life and can come back at any time as shingles.

    • James_94

      “There is little difference in the effect on and response from the immune system between infecting your child with the live, virulent varicella and the varicella vaccine”

      Children who receive the vaccine miss fewer days of school, have less scarring, and are less likely to end up in hospital or dead than those who actually end up infected with chicken pox.

      Research published in the medical journal Pediatrics reveals that the annual number of deaths attributed to chicken pox in the U.S. has fallen to an average of 14 annually since the vaccine was approved in 1995. Prior to the vaccine, the average was 105 deaths annually.

      Some would say that saving the lives of 91 children (more than 4 Sandy Hooks worth of children) annually, every single year, was a GOOD thing.

      • Ron Smith

        Hi, James.

        You mistake my meaning. I’m very much for vaccinations and agree with you wholeheartedly.

        The point that I was trying to make is that there is little reason to choose ‘varicella parties’ or herb shop ‘immune boosters’ over vaccinations. I suspect that if you could get the vaccinations themselves from the herb shop too, but under some kind of marketing gimmick, that those who wouldn’t get them in my office would flock there.

        You are exactly right about the deaths and the vaccine has been a very good thing.

        Warmest regards,

        Ron Smith, MD
        www (adot) ronsmithmd (adot) com

  • Guest

    You look like a lovely lady but that profile pic makes you look like you’re in jail.

  • nf

    Just a thought: what guarantee do purchasers of breast milk over the internet have that the product they purchased is human milk and not that of another species?

  • buzzkillerjsmith

    Is this some kind of joke? I don’t believe people would do this.

    • James_94

      New mothers who have swallowed the propaganda that they’re wrecking their baby’s entire life if they don’t have enough milk to breastfeed exclusively, will go to ridiculous lengths to get their baby breast milk, ANYBODY’S breast milk. Even if they have to buy it from complete strangers over the internet.

      Read “Miss Meg”‘s link above, from a pediatrician who basically states that if you give your child JUST ONE bottle, EVER, you have pretty much ruined them, for life.

      It’s pretty sad, actually.

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