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Banking on Milk
Options Are Growing for Women Who Can't Breast-Feed

By Shannon Henry
Special to The Washington Post
Tuesday, January 16, 2007

Topaz Weis, 44, and Christie Allen, 27, two mothers in Burlington, Vt., met each other when Weis was looking for supplemental breast milk to feed her baby, and Allen had an oversupply to offer. Weis even gave Allen a key to her house so she could place the precious white bags directly in the freezer.

The practice of giving and receiving milk for a year made friends of the two families. "It's a surreal experience watching our children play together and realizing both of them have gotten breast milk from me," says Allen. No money has exchanged hands. "It's not the kind of thing I can sell," Allen says.

Breast milk, touted by the government and even formula-makers as the best food for babies, is becoming a hot commodity. Ten nonprofit milk banks that match donors to those searching for milk are accredited members of the Human Milk Banking Association of North America (HMBANA). For-profit milk banks and wet nurses for hire are also available. Countless other private transactions go on, many facilitated by the Internet, creating a sisterhood among strangers. Some moms "cross-nurse" with babies of friends and relatives.

But the milk-sharing movement, still largely an underground network, brings up many questions. First, there is worry about the safety of unscreened milk, which can pass diseases such as HIV and syphilis to babies. Others debate ethical concerns, such as whether people should make money selling human milk and how such businesses should be regulated.

For a woman who can't breast-feed (perhaps because she is taking medication that would pass into her milk or because she produces insufficient quantities) but wants to give her child human milk, the first place to go, according to Katy Lebbing of La Leche League International, is a registered milk bank. The 10 HMBANA banks are in states including Delaware, Ohio and North Carolina and serve women across the country. The banks screen donors and then pasteurize, lab-test and freeze milk, all according to the association's specific standards.

If an arrangement with a milk bank isn't practical, Lebbing suggests working out a donation arrangement through a doctor who can test the donor and her milk. The group does not recommend cross-nursing because each woman has her own antibodies, which can affect babies differently. "Breast milk is more than just food," says Lebbing. La Leche League, based in Schaumburg, Ill., comes out even more strongly against hiring a wet nurse. Lebbing worries that women might enter the arrangement motivated by financial gain -- and without concern for the potential impact on their own offspring. "People do crazy things for money," she says.

But donors to nonprofit milk banks are not motivated by money. Parents often find the WakeMed Mothers' Milk Bank and Lactation Center in Raleigh, N.C., through HMBANA, which is headquartered in the same city. Mothers' Milk has about 100 active donors at any one time, according to the bank's Margie Mould. Each week, five to 12 individuals receive a regular supply from them and about 10 others call to get a one-time shipment. They have to have a prescription from a doctor to receive the processed, cultured milk, and they pay $2.90 per ounce, plus shipping. (Some banks charge more.) Hospitals help match donors and recipients.

Many milk banks shut down in the 1980s when AIDS was a new concern, but now more are being opened, both because of increased awareness of the benefits of mother's milk and because screening is more stringent. "I hope to live to see the day where there's a bank in every state," Mould says.

The donation process often starts with a mom who has too much milk. She may have pumped so much that her freezer is brimming with more than her own baby will eat. Or she has lost a baby but is still lactating. Mould says it's particularly healing for grieving mothers to donate their milk, and it's gratifying for her to match donors with babies who have difficulty tolerating other food -- even infant formula.

Weis delivered a baby boy who died at birth. She pumped and froze milk for two months because she and her husband were also awaiting the arrival of an adopted daughter, Kiki. But it took Kiki a mere week to finish what it had taken Weis two months to produce. And Weis didn't want to supplement her own milk with formula. So she began to seek out other milk, from banks and individuals. "I've cooked for milk, paid for milk, did an astrology trade for breast milk," she says. (She has also sought supplemental milk for another baby.)

Allen, a pediatric nurse, had stockpiled 100 ounces of breast milk in her freezer for a cancer survivor while simultaneously feeding her own baby. That woman ended up getting enough milk from other donors, so when Allen -- who had been through a screening process and had her milk tested -- heard about Weis's predicament, she offered the milk to her.

While the Weis and Allen story is clearly one of a mom helping another mom, many of the for-profit exchanges could be scams, says Lebbing, warning that chalk mixed with water is a possible ploy. Such concerns may be overstated by strong advocates of breast-feeding, but a simple Google search reveals how easy it is to find women offering their milk for sale with only their own assurances of its quality.

And there are businesses selling real milk for profit. Robert Feinstock, manager of Certified Household Staffing in Beverly Hills, Calif., matches wet nurses with mothers seeking milk. He says he started offering breast-feeders for hire in 2003 when he heard that some women with breast implants were having trouble nursing. The company's Web site features pictures of household help dressed in Victorian outfits and a list of services including cook, bodyguard, butler and wet nurse. The typical wet nurse in his registry (as with many temporary agencies, they are not officially employed by him) charges $1,000 per week, including the agency's fees. "A wet nurse is a viable entity," Feinstock says.

Even more-ambitious milk-sharing businesses are launching. Prolacta Bioscience, a biotechnology company and for-profit milk bank in Monrovia, Calif., began selling human milk last year. Prolacta provides the pasteurization process and then sells its milk to neonatal hospital units across the country. The price for Prolacta's milk runs between $100 and $250 a day for the milk it collects from unpaid donors, according to the company's chief executive, Scott Elster, for what the company describes as a fortified, concentrated form of milk. Prolacta is funded by well-known Silicon Valley venture capital firms, including Draper Fisher Jurvetson, and so far has raised $12 million in private investment, according to the company.

Elster signed on as CEO in October after working in the plasma division of Baxter International. He says there are many similarities between selling blood products and selling milk. "You have a clear liquid and a white liquid, but the business works the same way," Elster says. He says he intends his company to work as a complement to nonprofit milk banks, not to compete with them.

Jennifer Laycock, who started a Web site and blog at http://www.thelactivist.com a year ago to promote milk banks and breast-feeding, worries about the emergence of for-profit banks. "You get into a slippery slope introducing profit into the game," she says, noting that some mothers may be enticed into selling their milk for the right price and giving their own children formula.

By far the most difficult part of milk-sharing to track or quantify is the casual swapping of milk between moms. Lindsay Ogden of Fort Collins, Colo., has given milk to two moms she met in a breast-feeding support group who had trouble nursing. Among her friends, she says, it's common to nurse each others' babies while babysitting them and to experiment with the ways different children suck. Ogden says she wouldn't let just anyone nurse her baby. But "I have no problem with taking milk from a mama I know and trust," she says. "It's more common than the general public likes to think."

The Internet has become a catalyst for milk-sharing. Many moms are buying milk from one another online, Laycock says, with varying degrees of safety. Some pay for screening, others buy home-pasteurization kits. Still others just take a mom's word that her milk is good. Laycock recently gave a friend a few weeks' supply of her frozen milk, but then when midwives around her small town near Columbus, Ohio, called her for more, she felt uncomfortable. "They didn't know me from Adam," she says of the other mothers.

Laycock's milk odyssey began in 2005, when she had an oversupply for her first child and donated gallons of milk to the Ohio milk bank. It is, she says, simply what people did hundreds of years ago: Mothers helped one another. But the success of modern milk-sharing paired with the frontier-busting ways of the Internet are challenging modern safety standards.

"I wish there was a way to regulate it without shutting it down," Laycock says. "You want to encourage [sharing milk] but not to the extent of taking milk from strangers." ยท

Shannon Henry, a former Washington Post staff writer, is a freelance writer and author living in Denver. Comments:health@washpost.com.

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