The American Academy of Pediatrics (AAP) is an association of 66,000 pediatricians based in Illinois.
Direct milk sharing lacks strict testing policies
AAP said recent studies support health benefits for donor breast milk’s use in infants with a birth weight under 1500 grams (3.5 pounds), especially in decreasing rates of necrotizing enterocolitis.
However, accessibility to donor milk in the US continues to be “substantially limited” in terms of supply, cost, and distribution. Some parents have chosen to exchange human milk that is not handled by established milk bank.
Currently, there are 20 donor milk banks in the US and four in Canada that pasteurize milk as part of the Human Milk Banking Association of North America (HMBANA), according to AAP.
HMBANA has strict policies for donor milk collection, including completion of a health screen, blood serologic testing, and instructions on collecting, storing, and shipping milk.
“In contrast, direct milk sharing or other forms of milk collection and distribution are extremely variable in the screening of donors and the methods of milk storage and transportation,” AAP said.
Concerns about contamination
AAP warned in the statement that there will always be concerns about contamination because human milk is a biological product.
“Informal direct milk sharing without pasteurization exposes infants to a range of possible risks, including bacterial contamination and viral transmission, including cytomegalovirus, hepatitis viruses, and HIV,” the association said.
“Even with serological blood testing, infectious complications remain a significant risk in unpasteurized milk,” AAP added.
“Because direct milk sharing is often arranged by using milk from a single donor mother, other contaminants, such as medications or drugs, may be a higher risk than with pooled milk products.”
In addition, AAP suggested policies are needed to provide high-risk infants access to donor human milk on the basis of documented medical necessity, not financial status.