Milk Banking and Co-nursing: Breast Really Is Best

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Milk Banking and Co-nursing: Breast Really Is Best

New mothers are constantly surrounded by an ever-present chorus of breastfeeding proponents who enthusiastically proclaim that “breast is best.” Groups such as La Leche League extol the supposed virtues of the magical elixir, such as fewer bouts of diarrhea, protection against infection, and easy digestibility. The popular sentiment in parenting circles is that exclusive breastfeeding for a year or more is the absolute bare-minimum requirement for women who want to be considered caring and knowledgeable mothers.  

But what about mothers who can’t do it?

The deafening cries of lactivists sometimes ignore one biological reality: some women simply can’t breastfeed. Perhaps they don’t produce enough milk. Perhaps their baby was born prematurely, before their milk came in. Perhaps they take medications that they would pass to the child through the milk. Perhaps they can’t meet the nutritional demands of twins or triplets, or they had to return to full-time work, or they suffer from one of dozens of medical conditions that make breastfeeding difficult, painful, impossible, or ill-advised.

The parenting establishment is still very concerned with seeing that every baby is breastfed, but nowadays it’s less and less concerned about exactly whose breasts are doing that feeding.

Any Boob Will Do
While some women don’t produce enough breast milk, others produce a surplus. Milk banks, which accept and store breast milk, distributing it to babies who need it, are a logical conclusion to this biological imbalance. Lactating mothers who have an abundance of milk express it and donate it to a nonprofit milk bank, such as one that belongs to the Human Milk Banking Association of North America (HMBANA). Per rules developed by the Centers for Disease Control and the American Academy of Pediatrics, donors to milk banks must be healthy nonsmokers who do not take medications or vitamins, and may also be required to undergo blood tests for tuberculosis, HIV, Hepatitis B and C, or syphilis. The donated milk is frozen, pooled together with milk from other donors, and then pasteurized to kill any contaminants. Once tests and cultures show no bacterial growth, the milk is refrozen and shipped to hospitals or directly to infants with a prescription. Sometimes, health insurance even covers the cost of the milk (about $3 per ounce, including processing and shipping fees).

Modern Americans may be shocked by milk sharing, but the idea of a baby’s consuming milk other than its mother’s is hardly new. For most of human history, wet nurses (nannies paid to nurse other women’s babies) were a common and accepted part of life. Infants born to wealthy or noble families were often wet-nursed so that their mothers could resume ovulating and bear more children. Wet nurses were common in the United States even up until the early twentieth century. After World War II, when commercial formula became readily available, the practice died out, although wet nursing and cross-nursing (women’s nursing each other’s babies) are still practiced in most rural areas of the world, and even in some urban areas where employing a wet nurse is seen as a status symbol.

Even today, many women participate in far more casual milk-sharing arrangements. Just as the rate of breastfeeding has risen in America in recent decades, the practice of cross-nursing has also seen increased popularity, as has the custom of women’s giving their breast milk directly to friends, relatives, or other women who need it. Many women admit to nursing a friend or relative’s baby occasionally or in times of crisis, but cross-nursing has become much more common simply as a way for moms to share feeding duties whenever they’re watching each other’s children in a day care or share-care situation. Cross-nursing allows parents to leave infants for longer periods of time while knowing that they’re still getting breast milk instead of formula, and it allows mothers to accommodate both their work schedules and their infants’ nursing schedules. Even traditional wet nursing has become more widespread in the United States, with one high-end staffing agency in Los Angeles reporting an increased demand for lactating nannies, especially from mothers with breast implants.

Nursing Goes Back to Before
Although Americans tend to feel squeamish about any exchange of bodily fluids (and mothers tend to be highly possessive toward their own babies), the reality is that as long as both women produce enough milk and both infants are healthy, there’s really no risk to nursing another woman’s child or allowing her to nurse yours. Thousands of generations of wet-nursed babies can attest that any breast milk can and will suit any child. Hollywood stars Salma Hayek and Jenna Elfman have made milk-sharing headlines this year, Hayek for breastfeeding a poverty-stricken child in Sierra Leone, and Elfman for donating her extra milk to a child born addicted to methamphetamines.

In many cultures, children who partake of milk from the same woman are considered as close as family, often called “milk siblings.” In Islamic cultures, milk siblings’ special relationship makes them close enough that they cannot marry each other. Studies have shown that even in America, co-nursing is likely to be more widespread than people think; many women practice it privately among friends or with family.

For several reasons, HMBANA and La Leche League don’t explicitly endorse the process of cross-nursing. LLL cautions that there is always a possibility of transmitting infections through breast milk, and that a mother’s depleting her supply of milk for an unrelated infant could put her own baby at risk of malnutrition if there isn’t enough left over. Many mothers are also turned off by the practice, fearing that allowing another woman to breastfeed their baby could disrupt the bonding process or interfere with the infant’s regular nursing routine.

Parents and pediatricians are in virtual agreement that breastfeeding is the ideal nutrition for all infants. Whether or not to do it remains a mother’s personal choice, but the ability to share milk in these ways only increases access to breast milk for infants who might otherwise not get it. Throughout history, examples of women breastfeeding have become some of our most moving examples of charity and compassion, such as the indelible image from John Steinbeck’s The Grapes of Wrath in which a young mother breastfeeds a sick old man on the brink of starvation. Breastfeeding may have left the realm of the personal and become firmly ensconced in the political arena, but we can all agree that healthy, happy babies and healthy, happy parents are always the ultimate goal. If that can be achieved through cross-nursing, milk banking, or any other arrangement that gets more breast milk to more babies, then we should all agree with that, too.