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What Is Human Donor Milk and Why Might My Baby Need It?

  • By Margaret Parker, MD, MPH, and Rebecca Mannel, BS, IBCLC, FILCA

Human milk is the best food for babies, and it’s really good for babies with health problems or babies who are born early (preterm babies). Preterm babies can have more lung, stomach, and gut problems; more infections; and more risk of sudden infant death syndrome (SIDS). Preterm babies are also at risk of a very serious illness called necrotizing enterocolitis (NEC), where all or part of the gut gets infected and can die. These babies will need medicines and may need surgery to remove damaged gut. Babies who are fed their own mother’s milk or donor milk are much less likely to have NEC or these other problems.

A mom’s own milk is the first choice for her baby, except for rare times when it cannot be used. Some moms have trouble making enough milk or may be too sick to provide milk. In cases like these, nurses, doctors, and lactation consultants may suggest donor milk because donor milk is advised by the World Health Organization (WHO)3 and American Academy of Pediatrics (AAP)4 when moms cannot provide their own milk.

In many countries, donor milk is stored in milk banks, like human blood is stored in blood banks, and the hospital orders it when they need it.

Common Questions

Q: How do I know it’s safe?
A: Milk banks screen donors carefully, and in most countries they pasteurize (heat shock) to get rid of germs. If you are in a place where this is not common, ask the hospital about how the milk is kept safe and healthy.
Q: What kind of women donate their milk?
A: Like blood donors, milk donors come from all backgrounds. Some mothers have too much milk and like to help others. Sometimes a mother whose baby died might donate milk to help her get through her loss by helping other babies.
Q: How will donor milk be fed to my baby?
A: This will depend on how your baby is fed, but just like your own milk, donor milk can be tube fed or given by a cup, spoon, or bottle.
Q: A friend says she will donate her milk for my baby. Is that OK?
A: It’s safest to use milk from a milk bank or the hospital, because some diseases and medicines can pass through the milk and affect the baby. Some women get milk over the Internet, which can be risky if you don’t know anything about the person giving the milk. A sick or preterm baby should be given milk that has been screened and tested.
Q: What if the hospital where I have my baby does not use donor milk?
A: Talk to your baby’s doctor, nurse, or lactation consultant about how they can get donor milk for your baby even if there is no program in place.
Q: Is donor milk given to my baby instead of my own milk?
A: No, mother’s milk is the first choice of milk for your baby. Donor milk will be given only when there is not enough of your milk to feed your baby or in a rare case when a mother’s own milk is not safe.

 

Things to Think About When Asking for Donor Milk

  • Donor milk can be costly, but it is often paid for by the hospital.
  • Some hospital policies call for donor milk when there is not enough of mothers’ own milk only for the smallest and sickest babies. Hospitals may not be able to give donor milk to all the babies.
  • Muslim families may worry about milk kinship and donor milk. In some Muslim nations, hospitals work with families to find a donor they know. In Europe, the European Council for Fatwa and Research has said that donor milk can be given to Muslim babies without kinship rules, when the family does not know the donor.
  • ​When preterm babies receive mom’s milk or donor milk, they may need extra protein or other substances added to help the baby grow properly. Your doctor will decide what may be needed based on how your baby is growing.

Websites for More Information about Donor Milk

References

1. Schanler RJ. Outcomes of human milk-fed premature infants. Semin Perinatol. 2011;35(1):29-33.
2. Schanler RJ, Lau C, Hurst NM, Smith EO. Randomized trial of donor human milk versus preterm formula as substitutes for mothers’ own milk in the feeding of extremely premature infants. Pediatrics. 2005;116(2):400-406.
3. Saadeh MR. A new global strategy for infant and young child feeding. Forum Nutr. 2003;56:236-238.
4. American Academy of Pediatrics. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841.
5. El-Khuffash A, Unger S. The concept of milk kinship in Islam: issues raised when offering preterm infants of Muslim families donor human milk. J Hum Lact. 2012;28(2):125-127.