Dispelling the Myths Surrounding Donor Breast Milk

As we wrap up our week long celebration of Black Breastfeeding week, we share with you a conversation between Kim Updegrove, Executive Director of Mothers Milk Bank Austin, and Darline Turner, Executive Director of Healing Hands Community Doula Project. The topic is donor breastmilk and for many, especially in the black community, it’s a controversial topic.

Mothers have breastfed their babies since the beginning of time. And while there is little known documentation for the very early times, stories handed down from generation to generation indicate that when a mother was unable to breastfeed her own baby, another mother from her tribe, clan or community would “wet nurse” the child; i.e. another mother would nurse the woman’s child, until mama was able to breastfeed her baby herself, or for as long as the baby needed.

During slavery, wet nursing went from being a kind and loving gesture shared between kinswomen to a forced and oppressive means of subjugation for enslaved women. For enslaved women, all their breastmilk was to be given to the master’s child and they were often prohibited from nursing their own children and kept from their own children in master’s house to ensure that all their milk went to the master’s child. And if an enslaved woman was able to nurse her own child while nursing a white baby, the white baby was never to nurse from the same breast as a black baby. In most cases, black women were forced to nurse their masters and mistresses children while their own children were given poor substitutes such as sugar water, cow’s milk or other concoctions. The hyper sexualization of black women’s bodies, their breast in particular, has also lead to lower rates of breastfeeding in the black community. The development of formula in the early to mid 20th century all but eliminated breastfeeding in black mothers. While black women and infants have survived these practices and many black women are initiating breastfeeding, it is no surprise that start rates of breastfeeding as well as continuation rates of breastfeeding amongst black mothers are much lower than amongst white women today. It is also no surprise that the concept of utilizing donor breastmilk is not as widely received in the black community as it is in the white community (nor is donor breast milk widely offered to black mothers as an option to feed their premature or ill infants). All of these situations-The history of (forced) “donation” of breast milk by black women, the misconceptions that a white baby may somehow ingest and then develop/exhibit “black traits” (all assumed to be negative), or that donor breastmilk is somehow poisoned and will kill black children in a Tuskegee Experiment-like scenario has created a taboo around donor breastmilk donation and utilization, especially in the black community.

So here are the facts. Donor breastmilk is a life saving food for infants who are premature, ill or who cannot receive breastmilk from their mothers. Human breastmilk is the perfect food for human infants, composed of proteins and nutrients specific to human infants and hence easy for a baby’s body to digest and utilize. Most babies fed human breastmilk have little to no difficulty with gas, upset stomach, reflux or vomiting. In fact, in premature infants, human breastmilk prevents a potentially deadly disease called necrotizing enterocolitis, a disease in which portions of infants intestines die. Some infants will undergo surgery to remove the dead parts of their intestines while others simply won’t survive the disease. This potentially devastating situation can be avoided if an infant is breastfed. And if mama cannot breastfeed, she should be offered donor breast milk.

Both Kim and Darline wanted to take a moment and dispel some of the myths surrounding donor breastmilk, and to offer what they hope will be crucial information to any mama who may be considering getting donor breastmilk for her baby, or donating breastmilk to help save the lives of infants in need.

DT: Kim, Why is Donor Human Breastmilk important? 
KU: It turns out that breast milk, even from other women, prevents so many complications and is linked to cures for so many illnesses and issues commonly seen in the neonatal intensive care unit, the special unit in the hospitals for babies born too small, too sick, or too soon. As anxious as a NICU mom is to provide anything she can for her baby, she may face multiple barriers to breastfeeding and pumping. The stress of the NICU alone is enough to delay and even prevent milk from coming in, and not all women respond well to pumps. That’s where donor milk can come in to fill the gap. Donor human milk is the next best thing to mom’s milk, improving survival rates, growth and brain development.

DT: Who is eligible to get Donor Breastmilk? 
KU: Any baby who isn’t able to be fed mom’s own milk, and who is born sick or premature can get donor human milk. The baby’s doctor writes a prescription, and sends it to the Mothers’ Milk Bank at Austin, so that the milk can be dispensed to those who need it. 

DT: How do families get Donor Breastmilk (If needed)? 
KU: Call the milk bank to explore your options. Even if your Pediatrician or Neonatologist doesn’t know how to prescribe donor milk after discharge, the milk bank staff can walk you through the steps to getting it, and advocate on your behalf for insurance coverage of the processing fees. Families without insurance may be eligible for the Charitable Care Program. Call us to discuss options. No baby in need of milk will be denied.

DT: Is Donor Breastmilk available to families on Medicaid? 
KU: Yes, Texas Medicaid covers the cost of donor human milk if your baby is sick, premature, or not responding well to formula. The portion of the costs not covered by Medicaid will be covered by the milk bank’s Charitable Care Program.

DT: I want to add here that Mothers Milk Bank Austin is the largest milk bank in North America and supplies donor breastmilk to many hospitals and families around the country. If you are reading this but not from Austin or even Texas, are in need of donor breastmilk but are unsure if Mothers Milk Bank at Austin serves your area, please reach out to to the milk bank. They can answer your questions and guide you to whatever resources you may need related to the donor milk program.

DT: Who can donate breastmilk? 
KU: Donor milk comes from women with extra to share – this extra is sometimes because they have an oversupply of milk while feeding their own baby, they stockpiled milk for a rainy day that never came, they carried a child as a surrogate mother and chose to lactate and pump just for donation, or they lost their child in pregnancy or after birth and donated milk as part of their grieving process. All of these women volunteer to donate milk, and complete a safety screening first. They’re interviewed for health and lifestyle risk factors, their blood is tested to verify that they don’t carry anything that can be transmitted to others, and their healthcare providers verify their health and medical histories. They also commit to avoiding most medications and herbs, and alcohol and tobacco while continuing to donate.

DT: Historically, black mothers have been forced to “wet nurse” other (white) people’s babies. Additionally, given that historically there have been disparities in treatments and experimentation on black and brown bodies, how can black mothers be sure that the donor breast milk they are feeding their babies is safe?

KU: All moms want what is best for their babies. But how do you know what is best, what is bad, and what to believe? The most important thing to understand is that humans are mammals – we make milk for our young just like any other mammal on the planet. We can be short, tall, skinny, fat, brown, black, pink, or white, and our milk is still safe and nutritious for our babies. White mothers make white milk, and black mothers make white milk – it is all the same, and it all helps the babies survive and grow. 

All mothers, with all skin colors, deserve to be healthy and to have healthy children. Donor human breastmilk is donated by healthy mothers who are thoroughly screened to verify their health. The milk is pasteurized and tested to verify that it is safe, and then it is given to babies in need. All milk donors are healthy, all babies are in need, and all milk is safe. 

DT: Just to highlight that point, Donor breastmilk is pasteurized, screened and analyzed prior to being given to any infant. The process is very sterile and donated milk is free of disease. Learn how donor breastmilk is processed for distribution to infants in need here.

DT: So I want to go a little deeper here and address some of the deeper concerns I’ve heard from both black and white mothers. If black infants receive breastmilk from white donors, will they be at risk for developing genetic diseases found primarily in white people such as Tay Sachs or Cystic Fibrosis?
KU: To date, there is no data that genetic diseases are transferred via donor breast milk. Black children would not be at risk for a genetic disease found primarily in white people, and likewise, a white child would not be at risk of “getting” a disease that primarily affects black people such as sickle cell disease. Again, breastmilk donors are healthy women, and if we found that a mother had a condition that may in any way put infants in danger, we would not allow them to be breastmilk donors.

DT: Kim, I have had moms and dads express anxiety that somehow their infants will exhibit characteristics of the breastmilk donors. The concern is that white infants will “act black” and vice versa. We know that this isn’t possible. But to give an analogy, parents should ask themselves this question, Do their children exhibit cow behavior after drinking cow’s milk? Of course they don’t! Children don’t “moo”, eat grass or chew their (non-existent) cuds. Humans also don’t act like goats if they drink goat’s milk. Milk is milk and a human won’t behave like the person or being from which the milk comes.

And there you have it! I want to thank Ms. Kim Updegrove, Executive Director of Mother’s Milk Bank Austin for sharing her wisdom and expertise about donor breastmilk and milk banking. Be sure to visit Milk Bank Austin’s website if you want to learn more about donor breastmilk, if you want to receive donor breastmilk or want to become a breastmilk donor.

Kim Updegrove is a registered nurse and certified nurse midwife (CNM). She previously worked as a CNM, delivering more than 500 babies and providing well-woman care. She also served on the graduate faculty of the Yale University School of Nursing. Kim has devoted her professional efforts to growing the Mother’s Milk Bank Austin since 2002. Updegrove is a past president of the Human Milk Banking Association of North America (HMBANA), and chairs the guidelines committee helping to ensure quality control of donor human milk and cultivates the development of nonprofit milk banks. On days off Kim takes her grandson for hikes, plays tennis and talks to all who will listen about the life-saving powers of breast milk

Milk Bank Executive Director Kim Updegrove.