Breast milk is considered to be the best for newborn babies and infants due to its nutritional superiority and as it contains numerous antibodies which are essential for the baby. But some women find themselves unable to breast feed. Although some of them turn to clinicians and health visitors for advice, as many as three quarters of new mothers now look to the internet for guidance.
Online these women find sites that facilitate the buying, selling, and trading of breast milk, as well as high profile media sites featuring celebrities who are engaged in this trade. In the absence of warnings about the dangers of buying milk online, this option might seem healthy and beneficial—the better choice if one can’t breast feed oneself. What mothers, and many healthcare workers, don’t realise is that this market is dangerous, putting infant health at risk.
The online market in human milk, growing fastest in the USA, is now also gaining popularity elsewhere, largely among mothers ineligible for milk from milk banks. Milk banks charge up to USD 4 for 30 ml, hence online milk is often the cheaper option. Unlike regulated bank milk, no expense is incurred in routine pasteurisation or testing for disease or contamination, and collection, storage, and shipping requirements are negotiated between buyer and seller, enabling prices to be kept lower.
Troublingly, these cost saving measures lead to a high risk of communicable disease transmission, contamination, and tampering. Unlike donors at licensed milk banks online sellers are not required to undergo any serological screening, meaning that diseases such as hepatitis B and C, HIV, human T cell lymphotropic virus, and syphilis may not be detected. One study comparing milk bought online with that from licensed milk banks found that 21% of the samples bought online were positive for cytomegalovirus, compared with only 5% of bank samples.
Samples bought online also showed higher overall bacterial growth, with only 9 of the 101 samples not having detectable bacterial growth. This is partly owing to the lack of pasteurisation but also to poor shipping and storage conditions. A study of 102 samples purchased online found that 25% of samples arrived with severely damaged packaging and were no longer frozen, leading to more rapid bacterial growth and contamination. Other studies identified occasional contamination with bisphenol A and illicit drugs and tampering including the addition of cow’s milk or water to increase volume. Such contamination cannot easily be detected before infant feeding.
Healthcare professionals should take immediate action and advise mothers on safer infant feeding choices.
This article is based on materials provided by BMJ.