Is donor milk an option for adopted infants? And if so, what are some of the questions to ask about the efficacy, safety, and practicality of that option?
What is donor milk?
In short, donor milk is milk from a mother other than the mother who gave birth to the infant. The real question is about the source and regulation of the milk.
Milk that has been directly donated to the recipient is commonly called shared milk or community milk. (Or maybe something else, in your locale.) In essence, this is the expressed equivalent of what in the old days was called wet nursing and is now more appropriately called cross-nursing.
Milk from a formal milk bank is also called donor milk. But formal milk banks dispense milk that has processed. This means that the donor has been meticulously screened for diseases and other factors that could affect the purity of the milk.
In the United States, processing also involves pasteurizing the milk. Pasteurizing occurs in milk banks elsewhere, but not everywhere. (Be sure to listen to my podcast with Kim Updegrove, Executive Director of Mothers’ Milk Bank!)
How do you obtain donor milk?
How you obtain donor milk for adopted infants depends on what type of donor you are seeking.
If you’re seeking milk from a formal, accredited milk bank, it is my understanding that you will need a prescription, even if it’s for an adopted infant. (I will cheerfully take correction on this if I’m wrong.)
What are the benefits of donor milk?
Milk is species specific. Therefore, it only makes sense that human milk is for human babies. There are thousands of studies that show that human milk has multiple benefits.
Admittedly, pasteurized donor milk is not a good as fresh milk from the mother. Pasteurization involves extreme heat, and the storage involves extreme cold. Any time that milk is exposed to extreme temperatures, some of the components are diminished. But it’s still better than formula!
So what about community or shared milk? Again, from the standpoint of nutrition and immunological protection, it’s better than formula.
What are the risks of donor milk?
I’m unaware of any real “risks” of donor milk that has been processed through an accredited human milk bank. Sure, we had plenty of scares in the 1980s with HIV. But to my knowledge, that has never been a problem.
The risks of shared milk are factors to consider. Without the screening, pasteurizing, and formal control of what’s dispensed, there can be some risks.
Now before you send me hate mail, let me say this: I’m not fundamentally opposed to shared milk. In some circumstances, I would cheerfully use it for my own baby.
Parents are easily convinced that if the mother says she’s healthy there’s nothing to worry about. I’d caution that some mothers don’t know if they have a health risk, and others don’t want to reveal health problems to anyone, including family members. Hence, make no presumptions.
Unquestionably, there are risks to using shared milk. The question is, what is the risk/benefit, and can we manage the risk? I encourage you to read an article “Milk sharing: from private practice to public pursuit.” My friend Jim Akre is the lead author for this article which states:
We believe that the level of intrinsic risk is manageable through informed sharing. If undertaken, managed and evaluated appropriately…
And, although my focus here is for adopted babies, I want to quickly address emergency situations. That is, the risks of using donor milk in an emergency situation far outweigh the risks of using formula.
What is the cost of donor milk?
Milk dispensed from a donor human milk bank is about $3.50 per ounce (about 28 ml). However, that number fluctuates from time to time. And, this represents only a processing fee. Meaning, you are paying for the cost to process the milk, not for the milk itself which is donated.
In some cases, your insurance may cover the cost of donor milk, but you’d need to carefully check your policy. Military families may be able to get TRICARE to cover donor milk.
Final Thoughts
In short, yes; donor milk is an option for adopted infants. Each family needs to be aware of the efficacy, safety, and practicality of that option before making a decision.
At the end of the day, however, it your baby — whether biological or adopted. One of your first experiences of becoming an informed parent is likely to be related to the feeding decision.