Dear Doctor:

After the hurricane in Houston, a lot of moms donated their breast milk to help the babies. Is that safe?

Dear Reader: For as long as women have been giving birth, they have been sharing breast milk. In earliest history — references to the practice date back to 2000 B.C. — this was in the guise of the wet nurse. That is, a lactating woman who breastfed infants who were not her own. If a mother is unable to either breastfeed or express her own milk, the World Health Organization cites donor milk as the next best feeding option.

That’s because breast milk is the optimal food for infants. Not only is it a source of probiotics for gut health and antibodies to fight off viruses and bacteria, but studies show that breastfed babies get fewer ear infections, have a lower incidence of obesity, and have a lower risk of conditions like asthma, diabetes and eczema. They are less likely to develop gastroenteritis and diarrhea than babies raised on formula, and have a lower incidence of SIDS, or sudden infant death syndrome.

In recent years, we’ve seen the advent of milk banks. These are services that collect breast milk donations for use in hospitals for pre-term infants, and for use by women who can’t produce enough of their own milk. The donations come from women who have undergone medical screening, often including blood tests. The donor milk is then processed and, at several points in the process, tested for pathogens.

This is important because babies can be exposed to infections and diseases, including the HIV virus, via breast milk. Human milk can contain chemical and environmental contaminants, illegal drugs, and even certain prescription and over-the-counter drugs. And like any food, breast milk must be collected and stored properly to avoid spoilage and microbial contamination.

To answer your question, yes, breast milk that comes from a reputable milk bank is safe. Steps are taken to screen the donors and then properly process the milk. And while many women take part in the hundreds of online private milk-sharing networks that have sprung up around the country, the Food and Drug Administration recommends against them.

The FDA cites the lack of rigorous donor screening as a primary concern. Peer-to-peer networks rely on self-reporting of the donor’s physical health. Also, recipients of donor milk within these networks are dependent on each donor’s dedication to following good hygiene practices in both collection and storage.

When it comes to processing donor milk, the milk banks use the Holder method of pasteurization. This involves heating the milk to a relatively low temperature, one that kills pathogens but leaves the beneficial qualities of the milk largely intact.

At this time, there are no universal health and safety guidelines for milk sharing, though a few states have established standards for milk banks to adhere to. If you’d like to learn more about milk banks, or want to find one in your area, the Human Milk Banking Association of North America, or HMBANA, can help. It’s a voluntary professional association that suggests safety guidelines for donor screening, milk collection, storage, testing and distribution. You can find it online at hmbana.org.

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