Q & A Library

Breast milk is the best food for babies during the first year of life (at least). It provides all of an infant's nutritional needs and transfers from mother to baby antibodies that protect against a long list of infectious diseases. Over time, breastfed babies are less likely to develop such chronic conditions as diabetes, high cholesterol, asthma, and allergies. And breastfed babies are less likely to become overweight children than their bottle-fed counterparts.

However, for various reasons, not all women can nurse their infants. Human milk banks (both non-profit and for profit) are now working to fill the gap. In addition, thanks to the Internet, women have been making their own arrangements to share breast milk or to hire wet nurses. The milk available from some of these sources may be less than ideal. Even healthy looking milk donors that you know well may have asymptomatic viral or bacterial infections that they could pass on to babies through their milk.

According to La Leche League International, the best resources for human milk are the nonprofit milk banks accredited by the Human Milk Banking Association of North American (HMBANA). These banks screen donors and then pasteurize, laboratory test and freeze milk according to strict standards. (The donors are women who have an oversupply of milk or who have lost a child and are still lactating. They are not paid for the milk they donate.) To get milk from a HMBANA milk bank you need a physician's prescription or a hospital purchase order. You'll pay about $3 per ounce plus shipping charges.

I would be wary of more informal arrangements and of the for-profit milk banks. When you consider the screening process the HMBANA maintains (full medical histories, bloodwork that is repeated every six months, release forms from a woman's physician and her baby's pediatrician), you can see how difficult it would be to put those safeguards in place in a less rigorous setting. Donors to the HMBANA banks are required to remain drug- and alcohol-free and are not permitted to donate any milk collected while they, or any of their family members are ill. They also must avoid a long list of medications while donating. (I've read that if a woman takes just one Tylenol she cannot donate any milk for the next 24 hours.)

If a woman can't breastfeed her baby, banked human milk is the next best thing. But make sure that you get it from a reputable source operating under strict safety standards. Your baby deserves nothing less.

Andrew Weil, M.D.