Proponents call it “liquid gold.” It’s as expensive as a fine wine, and its sale and trade are about as controversial as a plate of foie gras at a vegan convention.
It’s breast milk. And it’s for sale in Orange County.
In recent years, the importance of breastfeeding has been stressed by both the American Academy of Pediatrics and the World Health Organization. More women are feeding their children breast milk now than in the last few decades.
Numerous studies have shown that breast milk supports brain development, immunity, growth and overall health. At the same time, an increased risk of childhood obesity, diabetes and Sudden Infant Death Syndrome (SIDS) has become linked with formula.
But what if a new mother is unable to produce her own breast milk and doesn’t want to give her baby formula?
There are marketplaces where mothers can sell and buy milk. The question is: Are they safe?
Glenn Snow is co-founder of Only the Breast (onlythebreast.com), a membership-based online breast milk marketplace. Milk buying can be pricey considering the average 6-month-old baby requires approximately 30 ounces of milk per day. The cost of milk on Snow’s site, which averages $1 to $2 per ounce, is far less than the $4 to $5 per ounce charged by the nonprofit milk banks that supply hospitals and neonatal intensive care units. But, Snow’s site doesn’t screen sellers or require tests for diseases as most nonprofit milk banks do.
Members of Only The Breast post ads about their supply and are given tips on the best and safest ways to pump, store, sell and ship the milk. Purchasers are supplied with information on how to screen sellers, ensure safe transactions and pasteurize the milk once it’s received.
“We represent 10 times (the ounces in) the entire breast milk industry combined,” said Snow, who operates the site from Reno. “By serving mothers’ needs and opening supplies, we are saving babies’ lives.”
Snow says Only The Breast has facilitated the sale of more than 87 million ounces of breast milk, with thousands of new sellers and buyers coming in each month, many in Orange County.
Pricing is tricky
There is no standardized “grading system” for breast milk. But other factors can affect price and make a seller’s listing more attractive.
Adjectives like “fatty,” “colostrum-rich” (colostrum is the protein-rich liquid women’s breasts produce in late pregnancy to feed their newborn before their breast milk comes in), and “frothy and white” can raise the potential price of the mother’s milk.
Other sellers promote their healthy diets, age and the age of their current breastfeeding child, which has a direct effect on the milk a mother produces, with nutrients especially suited for a child of that age.
Mothers who deliver fresh milk on demand can ask higher prices, although milk on Only The Breast is seldom more than $2.50 per ounce.
There are also women who use Only The Breast to find needy families and give away their milk for free.
Wrong to profit?
Critics say it’s unethical to pay mothers to produce milk. “We don’t pay our donors,” said Pauline Sakamoto, president of the Human Milk Banking Association of North America and executive director of Mother’s Milk Bank, the San Jose-based nonprofit that manages milk banks in 13 western states, including Orange County locations.
“Women are donating out of the goodness of their hearts,” Sakamoto said. “We have to question the motives of women who would sell their milk. Who is watching the quality of what is being bought and sold?”
Snow disagrees. “It’s unethical not to compensate mothers,” he said, noting that the cost of breast milk from a nonprofit bank makes buying donated milk out of reach for most parents.
Sakamoto says that for nonprofit milk banks, it’s about equity. “We want to get safe breast milk to the babies who need it most,” she said.
The Human Milk Banking Association screens donors, then tests and pasteurizes the milk before shipping it to hospitals and families. Milk is only available by prescription, solely for the use of feeding infants.
Because of this, costs are higher. The $3.75 to $4.75 (for hospital-grade milk) is usually absorbed by Medi-Cal or private insurance.
“If insurance doesn’t cover the cost, we go to bat for our parents,” Sakamoto said.
Under the Affordable Care Act, insurance companies are required to cover the cost of “breastfeeding support, supplies and counseling.” Many people argue that breast milk should be covered, but some insurance companies fight the expense.
The safety of breast milk
In California, breast milk is considered “human tissue,” just like organs or blood. Because of that, Sakamoto says, milk banks are required to be licensed tissue banks and follow all required protocols and guidelines.
That increases costs, but also ensures the proper pasteurization of the end product sent to hospitals and parents. Paying donors would only increase the end cost, she said.
Sakamoto cites a 2013 study out of Nationwide Children’s Hospital in Columbus, Ohio, in which a cross-sectional sample of human milk was purchased over the Internet. The study found that 74 percent of the samples were colonized with harmful bacteria.
Snow claims the methods the study used were flawed, including allowing samples to sit in post-office boxes for days after delivery.
In a 2010 statement, the Food and Drug Administration cautioned against buying and selling breast milk: “When human milk is obtained directly from individuals or through the Internet, the donor is unlikely to have been adequately screened for infectious disease or contamination risk. In addition, it is not likely the milk has been collected, processed, tested, or stored in a way that reduces possible safety risks to the baby.”
Mothers’ milk for men?
Sellers of breast milk also have to consider whom they will allow to buy their milk, because there is another group of buyers in the marketplace: men. Sellers have the option to sell to men, including athletes (who call human breast milk the “ultimate energy drink”) and those who purchase breast milk as a fetish.
Men don’t make up a huge part of the market – only one of the 10 sellers’ categories on the Only the Breast website – but for women with a freezer full of breast milk to sell, male buyers can help turn leftover milk into a tidy income stream.
And sellers have to opt-in to say that they are willing to have men buy their milk.
Donate for a cause
Other mothers are donating milk for premature babies. Prolacta, a for-profit life sciences company in the City of Industry, uses donor breast milk to create nutrient-dense milk for micro-preemies. Using a national network of donor sites, including Milkin’ Mamas in Huntington Beach, the company processes human milk in its pharmaceutical-grade facility, adds fortifiers and sells the milk to hospitals.
Because the milk is fortified, the cost is significantly greater, starting at $14 per ounce, and only available in hospitals.
Mara Snee, a San Clemente mother, has no regrets about donating her milk to Prolacta. With more than 5,000 ounces sitting in her deep freezer, she wanted her milk to go to babies who needed it most. She considered selling her milk, but realized she wanted to help where she could. A friend suggested Milkin’ Mamas.
“They asked all the right questions about medications, supplements, vitamins and anything that might get taken up in the breast milk,” she said, noting that the company also got clearance from her doctor and her baby’s doctor before allowing her to donate.
“Breastfeeding can be so stressful for new moms, and I’ve seen it in my patients and friends,” Snee said. “I think the most gratifying part was knowing that someone would hopefully benefit from something that most days I took for granted.”
Sharing milk
The sale and donation of breast milk can be confusing and controversial, but there is a free option as old as motherhood itself: milk sharing. Before the dawn of formula, lactating women breastfed – or “wet nursed” – the children of women who could not produce enough milk.
Breast milk sharing continues today. With at-home equipment sterilization and milk pasteurization instructions available online, sharing milk safely has never been easier.
Jill Baker, a mother in Newport Beach, never thought she would share her milk. “I thought no way would I give or accept milk that hadn’t been through a vetting process,” she said.
It wasn’t difficult finding women in need, she added.
“A longtime friend couldn’t make as much as she wanted, I offered some of our extra, and she was stoked. The other friend is someone I met through triathlon club. When she got pregnant with her second child, her milk dried up. In her circle, no one thought it was strange (to use another mother’s milk).”
