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Thursday, January 12, 2012

Milk Sharing (My Statement)

Addendum1/22/12 : I have been sent updated links and comments in response to this post.  My post is outdated. Until I can update, read through the comments. As I have found out there ARE guidelines from LLL. Not too many people are aware that leaders can discuss the pros and cons of milk-sharing when it is brought up. Per the guidelines it is very appropriate for a leader to refer to a health care professional for a discussion of medical pros/cons of informal milk sharing. That is where I would come in. I want to evaluate why the mother can not meet the needs of her baby (low supply or medication exposure or other reason), can it be corrected and if not discuss the options of what to supplement with (donated milk, home-made formula, commercial formula, cow's milk, goat's milk, or vegan mylks with and how to supplement it (bottle vs supplemental system, etc..). Human Milk 4 Human Babies is a commerce free site on facebook to offer your extra milk or seek potential donors. Look for the global network and your regional group.

From my attendance at the recent conferences it is apparent that even some of the breastfeeding doctors can be adamantly opposed to milk sharing. La Leche League does not support informal milk sharing either.

It would be very reasonable to support milk sharing amongst friends who have known blood tests and are obviously healthy.

If the mother is feeding milk to their own baby, and recipient knows both the donor mother and the baby, it sounds responsible for a breastfeeding group to support informal milk sharing. Then go on to clarify if you must that if you don't know the mother and the baby that carries risks of the unknown.

There is VERY little that makes milk bad. I'd be afraid of the risks of formula and increased illness.

 If you don't know the donor you can get to know them.

The only reason I once heard for La Leche League not supporting the use of donor milk was desiring credibility to new-comers and the public.

There is much more awareness now on the benefits of milk-sharing, it is time to update policy and make a huge positive impact.

I could also accept if a new policy stated that both mothers and both babies be monitored for good health through out the donation period. The donor mother's prenatal labs with HIV should suffice (HIV is a topic for another post). A donor baby who is healthy and growing, labs are not necessary. We just want to see that the baby won't be compromised if mother shares milk. The recipient mother should have an evaluation on why she can't produce enough milk and optimize her own production.

Doctors get blamed for making decisions based on pharmaceutical and financial interest. I have wondered if the hold out for breastfeeding groups to accept donor milk has something to do with collaboration and survival of milk banks.  I don't know if this is fact, so don't quote me. It's just a thought.

Pasteurized milk serve a special community: the preemie babies and research. It is not easy to get pasteurized milk out to the communities healthy babies.

I will take this one step furthur. I have been a Raw food advocate. The same principle applies to breastmilk. While pasteurized breastmilk is much better than formula. Minimally processed breastmilk has the  LIVE enzymes. I also support the use of minimizing the handling of fresh milk.

If anyone has milk to share at this time, I can probably find a home for it.

Finally,

I do not support buying milk from Craig's List and Social Media.

14 comments:

Becky R said...

Great. This should be a valid option for mom's.

mrs mouse said...

Great post! Just wanted to let you and your readers know, if you weren't already aware, that there is a great global network in existence for peer-to-peer milk sharing. It is called Human Milk 4 Human Babies (HM4HB). You can find more information, and link to your local chapter at www.facebook.com/hm4hb. All babies have a right to breast milk! :)

Denise Punger MD IBCLC said...

I am on my local Human Milk 4 Human Babies Group. I recommend the global group as a starting point. Thanks for commenting and adding the link.

Lisa said...

Being a milk donor has been an enriching experience in my life. Thank you for encouraging more woman to consider donating milk. In my area there is no milk bank, and if their was, I could probably not commit to the minimum donation many milk banks require. Informal milk sharing gives me a way to still make a difference.

Denise Punger MD IBCLC said...

Lisa you make a great point!

zinnias said...

The LLLI Board of Directors recently updated LLLI's milk donation policy, with substantial input from the LLLI Health Advisory Council. You can read the current policy here http://www.llli.org/release/milksharing.html

I disagree with your contention that LLLI does not support informal milk sharing. From the policy statement: "When their own mother's milk is unavailable, babies may need human milk donated by other mothers."

LLL Leaders are encouraged to provide information and support to mothers seeking donor milk. They are not told to refuse to discuss the matter. They are advised to talk to the mother in terms of risks and benefits. This policy replaces the previous one which was not as explicit in terms of what the risks and benefits might be but that was intended as a help to Leaders who may not understand all of the benefits/risks.

LLL Leaders are encouraged to share information. However, they are not to use their position as a Leader to push one mom to donate to another and they are advised not to be the "milk broker." Sharing information about milk donation would include sharing information about milk banks and other more informal possibilities.

Arya700 said...

LLL neither encourages nor discourages informal milk sharing. We discuss risks and benefits of all the options when a mother needs or wants to supplement her baby with something other than her own milk.
As always, LLL Leaders give *information* not advice. So we can help a mother gather information, but we cannot and should not push a mother to use donor milk or donate milk. We simply give an array of options.
And I think it's more about liability (if something DID happen with tainted milk) and potential abuse of our position if someone were to feel pressured to donate or use donor milk.

Denise Punger MD IBCLC said...

Definitely should not push it on her.

Keep sending me information you think I should consider.:)

Denise Punger MD IBCLC said...

Zinnias, I have not seen that guideline before. I have gone by personal communication with LLL Leaders. I am not sure if my contacts have read it or are am I over-interpreting what they say to me in personal communication. I will take my time to consider what the statement says and follow through.

zinnias said...

It is a relatively new policy so perhaps that is why not all LLL Leaders know about it. It's interesting to hear that from someone outside LLL like you, who is such an advocate for breastfeeding. I was one of the many Leaders who worked on the previous policy which didn't include the list of benefits and risks. It sort of left LLL Leaders in the dark about what should be discussed with the moms. I was able to participate in the conversation with members of the Health Advisory Council as they were making suggestions for this new policy. It was interesting to watch the policy unfold. The conversation was lively and full of debate, but in the end, consensus was reached and all participants signed off on the policy as it is now. Shortly after that, the LLLI Board of Directors considered then adopted the policy. It was less than a year ago at the March 2011 Board meeting. You can see the list of HAC members here http://www.llli.org/hac.html (though not all chose to participate in the discussion).

Denise Punger MD IBCLC said...

Zinnias, I have noticed that leaders are not aware of the policy or LLL has not gotten the education out. By email and private discussion some other resources and mother's feelings have been shared with me on the topic. As I support milk sharing and getting the word out, I am going to form a presentation based on what I am learning. (Don't know who wants to listen to it!) I meant to do this blog post several months ago. I also plan to update some thoughts on the topic. I have lots of mothers to support and encourage face-to-face in the meantime, till I update my blog.

I looked over the health advisory board. I am fortunate to have met or electronically interact with many of the members. How does one get on the board?

Denise
DenisePunger@hotmail.com

Denise Punger MD IBCLC said...

>And I think it's more about liability (if something DID happen with tainted milk)

I thought this was interesting feedback.

1. When doctors say pump n dump it is because of liability. We get upset with the doctor if it is clearly wrong information.

2. What if the mom uses formula and it is tainted?

As leaders/IBCLC's we give mom options (as stated above). The choices for supplement are milk banks, informal sharing of donor milk, home-made formula, commercial formula (may have other choices depending on circumstances). We don't tell her what to do. As a physician, I don't tell her what to do either. But it is only fair to give ALL the choices and the pros/cons of each choice or refer her to someone who has more information.

Denise Punger MD IBCLC said...

I pursued the Health advisory board and I am on it now.: )
Thank yo for leading me in that direction.

zinnias said...

That is wonderful! Welcome!

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