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Ep. 80- Community Milk Sharing: Concerns, Precautions, and Protocols

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This is Maureen Farrell and Heather ONeal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships, and mental health. Plus, we laugh a little or a lot along the way.

So join us for another episode. I don’t know how many times I’ve told my students never hand me a piece of paper. Oh God. Don’t you ever hand me a piece of paper, especially not like as you’re walking out of class. Yeah. No. Who would do that? Would you like us to hand you our med sheet or email it?

Do you want it to be documented that you sent it to me? Then put it in an email. Well, email that shit. I remember when I’m in like middle school, we were just starting to email things to teachers. And you could like change the like timestamp on the email and stuff. And like, teachers didn’t know that yet.

Yeah. I got their number now. Anybody’s figured that out, it’s me. They’re doomed. Exactly. We are those teachers. Good luck. Yeah. Good luck everyone. All right. Well welcome to another episode of The Milk Minute. Yes. Welcome. I didn’t know we’d started. I was making all kinds of noise. That’s what we started with, roll with it.

Okay. Today, Heather. I want to talk to you about sharing milk. Oh yeah. Everyone does it seemingly, but no one seems to know if it’s okay or how to talk to people that when they find out that they’ve been sharing, you know, like what reaction are you supposed to have when you find out that your neighbor’s been sharing their milk with another neighbor?

You know, what are those conversations like? Are some, what if someone comes to you with advice on whether or not they should get milk from another person? Let’s talk about that. Yeah I think let’s break the taboo there and chat about it. But first let’s bring in a listener question. Okay. Today’s listener question is from Becky Newsom Corcoran. I love that name. Becky is part of our Facebook group Breastfeeding for Busy Moms. And she says, I just read that exclusively breastfed babies should take iron supplements after four months. My pediatrician never mentioned this. Is this something most exclusively breastfeeding babies take? My baby is six months tomorrow.

Should I be worried she didn’t get enough iron the last two months? So short answer is no, don’t worry. No, don’t worry. And actually it’s not just exclusively breastfed babies. They do recommend iron supplementation, regardless of whether or not your baby’s getting formula or breast milk. Your baby does carry some residual iron stores from you from when they were in utero, but what we found is that around six months is when that runs out. And let me just put a little disclaimer here, and … this could be because for many, many moons, now there was no delayed cord clamping at birth.

So basically it used to be that your baby would pop out. They’d immediately clamp the cord. Baby would cry and the doctor would congratulate themselves on having the baby transition to extrauterine life so quickly, but what was actually happening is they were immediately cutting off about a third of the baby’s blood supply into the placenta, instead of letting it perfuse into the baby.

It’s somewhere between 80 and 120 milliliters that you’re robbing the baby of if you immediately do. Given sometimes there are some emergency situations where you have to do that. But the recommendation from all of the professional organizations now is delayed cord clamping. We are starting to move in that direction. Protocol wise for most hospitals, but we don’t have research that’s about how that affects iron stores after.

Right. So the research hasn’t quite caught up with that. But what we do know for a fact is that if you do delayed cord clamping, your two-year-old is less likely to be anemic. So we’re seeing the benefits of this up until two years of age. So I imagine that this six month of age recommendation, because it’s somewhere between four and 6 months. It’s probably gonna change, it’s probably going to change.

But currently the recommendation is iron supplementation at six months. Do people do it? No, not most, most don’t. And honestly like the protocol changes, you know, some pediatrician recommended some just draw like a hemoglobin hematocrit and lead levels at nine months. Like, I mean, it’s really just like all over the board, what we do.

So anyway, the gist is don’t feel bad about not doing something you didn’t know you’re supposed to do, and maybe didn’t have to do. Right. And this also varies state-by-state we’ve found. When we’ve talked to other providers, we’re like, are you doing this? Are you doing this? Are you checking this routine? Like, well, in Texas we do this and then, you know, Pennsylvania, they do this.

And we’re just like, okay, so nobody’s doing the same thing. Right? So nobody’s doing the same thing. And a lot of times they’re catching these anemias by happenstance. You know, your kid gets sick, they go to the emergency room, they draw some labs and they’re like, Ermahgerd, they’re anemic. And you’re like, what?

And they’re like, are you exclusively breastfeeding? And they’re like, yes. And they’re like, oh, well you need to be supplementing with iron. And then they do it because they found it. But it’s not, I don’t know. I’m just not buying it. It’s complicated. It’s complicated. And we’re going to do a whole episode on that later.

Well, are you ready to talk about sharing some milk here? Yes, I think so. I’m kind of excited. It’s an interesting topic. And I, I don’t know. I don’t know that we’ll get anywhere new, but whatever let’s see where we, let’s see where we go. Well, I’m pretty sure that people are expecting that a 60 minutes special that they did on community milk sharing where the people from 60 minutes went and found like ordered all of these samples online.

And 80% of them had fecal matter in them. And it was like community milk sharing. And you’re basically giving your baby poop. Could be. Can’t, can’t say I’m necessarily going to disprove it today. So stay tuned. There’s poop everywhere. But yeah, let’s, let’s just start from the beginning and then we’ll work up to fecal matter. Or down.

Oh yes, exactly. Okay. So today I’m going to focus on community milk sharing. What does that mean? Right. When I say that, I mean, parents who are sharing their milk with the intention of having someone else’s baby drink that milk or having their baby drink someone else’s milk. Does this include bodybuilders that want to pack on that protein without the fat?

Tangentially. I know mostly I’m focusing on like sharing milk for other babies. Okay. Let’s go there. Maybe we need to interview a bodybuilder at some point. I a hundred percent would like to do that. Thank you. Why not? In person. No, I’m kidding. I just don’t know if I’m prepared for that. I’m prepared and we’ll stick them right here in the middle.

But, you know, this is an unregulated practice of sharing pumped milk. It is not when we’re talking about directly nursing someone else’s baby. Which it kind of gets me excited that it’s unregulated because for me more regulations means less access. Yeah, historically. There’s definitely pros and cons to it. I mean, we know that working in midwifery, right?

Okay. So often we see this among close friends, you know, so-and-so has to go get surgery or I have some extra milk in the freezer. We’ll just share among ourselves. But increasingly we’re seeing parents who are sharing milk with strangers. And so that kind of expands the possibility for risk. It does. Yeah, it absolutely does.

But you know, the cost benefit scenario for every family’s a little bit different. So, so let’s talk about how people do this. What actually used to happen is there used to be a multitude of specific websites for this, like prior to the social media boom. And most of those websites don’t exist anymore, but they were basically like just personal ads for milk.

Essentially. Now we see it mostly through Facebook groups like Eats on Feets or Human Milk for Human Babies exist exclusively to facilitate this process. They take posts from parents who have extra milk to give or parents who need milk and they kind of blast them out over the internet and just facilitate that exchange.

It’s sort of like personal ads. You know, you’ll see stuff like 50 ounces of breast milk, dairy free, and X location pickup only, or like, and they’re like, it’s a match, right? 27-week preemie in need of milk. Any amount helps, must be, you know, medication free or whatever. Swipe right. Right. Kinda. Yeah. I’m, I’m like waiting for the Tinder app for milk.

Really? Tell me if it’s there somebody, cause I didn’t see one when I was looking. It’s about to be when I build it. Yeah. But like when we start this exploration we see goodness. Right? Just like the absolute generosity and goodness of humans who have something that is nourishing and life giving and they want to share it.

Parents helping each other out, making sure the most amount of babies get the most breast milk. And we hear stories of parents who bond with their donors and they become friends. And they’ve got a relationship based on, you know, meeting up weekly to exchange milk and empty storage bags and updating each other, like their little milk siblings on milestones.

And it’s so cute. But then we dig deeper and there are some problems. There are some problems. Yeah. Everything always has problems. And what annoys me is when people are shocked that there’s problems, you know, it’s like, of course there is. It doesn’t, de-value what’s happening and the good stories that are happening at all.

I mean, the same thing is with the, our standard medical care that we receive. There are bad things to the standard medical care that we receive, but we’re still receiving medical care. We just have to go in with informed consent, eyes wide open, and really know what we’re getting ourselves into, which is what we’re doing here today.

Exactly today, we are here to pick apart the simple question, is this safe? And the answer is complicated. Simple question. One-hour long answer. Have fun. Okay. Well, if we wanted to take a commercial break, that would be a good spot. Insert UberLube.

Hey Maureen. I know you’re postpartum and things get a little bit, what’s the word I’m looking for? Dry? In your sex life? Yeah. So what are you doing for that? Well I’m not really doing much of anything right now. Well, what are you going to do if the moment strikes? I guess I’ll use some UberLube. UberLube is the best and feeling is everything.

What’s the point if it doesn’t feel good? Honestly, if there’s not enough lube in the room, it’s just not fun. Yeah and like I always say, when in doubt more lube. Exactly. UberLube was created with sex in mind, but the formula is so pure and perfected why limit it to just one area of your life? So I know I said our sex life was a little dry, but my husband has been working out more and he’s actually been using UberLube to stop chafing.

That’s incredible. I’m going to start using that at my like top thigh area. Exactly. Also my hair is really frizzy and I’m not going to lie. I’ve been in a pinch occasionally and I’ve used a little Uber lube on my frizzy hair and it’s been great. Versatile. We love it. We love it so much. We asked them for our own promo code and they said yes! So enter promo code MILKMINUTE for your UberLube today. That’s UberLube.com with promo code MILKMINUTE.

So let’s start out with our disclaimer, right? The American Academy of Pediatrics and many other organizations officially discourage direct milk sharing, parent to parent milk sharing. But they do say, if you want to share milk or get milk, like let’s go to these official milk banks.

I totally get it. The organizations are citing safety concerns like disease transmission, bacterial contamination, exposure to medications, tobacco, alcohol, drugs, et cetera. But like, let’s dig into that more, right. Because yes, I can blanket say don’t do it. There’s risk, but you know, what’s gonna happen? People are going to do it anyway.

Right. People are going to do it anyway. We just need to figure out how to make it as safe as possible for people because the people that want to do this are experiencing some kind of barrier somewhere to care, or it’s a mindset barrier or a support barrier or a cultural barrier or something is happening. Something big is happening to prevent them from going to a milk bank.

And it could be any number of very legitimate reasons. I mean, frankly, milk banks are not accessible for babies who don’t have a real medical need, unless you have money. And I, and I get that and I’m not criticizing that. You know, if we had a different system of healthcare and health insurance and all of that, this would probably look different, but we’re working with what we have.

And, you know, I, I honestly, I think people should share their milk. I’m going to go out and say it. I think people should share it, but I think they should share with lots of caution and being very transparent. So over the past 10 ish years, there have been a couple of studies that have focused on milk purchased over the internet to test for contamination.

So I want to go into that a little bit, you know, we have to. Yeah. Saying that, you know, around like 2010, 2011, there were tens of thousands of listings, selling breast milk online. And since then we have certainly moved into the millions. I mean, like this has exploded, right. And we’ve gone from, like I said, those milk specific websites, which have shut down.

Now over to social media. So this is a really common thing and it’s something, I mean, I see in my midwifery practice. I’ve picked up milk for clients before, you know, when I’m driving for a home visit and they’re like, Hey, you’re driving by here. Can, can you grab some milk from this person? I’m like, all right, whatever.

But I do want to preface this, talking about these studies, by saying that we see things change when we start to attach a price tag to this and consider it a commodity. Yes. And it’s really complicated. I do not want to say that selling milk is bad, but what we see really often is that people end up in an exploitive situation or an addictive situation.

Yeah. Or like, oh my God. So I just watched Lula Rich. Oh, I need to watch that. Okay. Gosh. And I mean, they literally mentioned how representatives, so if you, if you guys don’t know. LuLaRoe is a pretty horrible multi-level marketing company which is like a really awful pyramid scheme thing. And there’s a documentary on Amazon about it, and it’s really interesting and you should all watch it.

But. I mean, they were literally talking about telling people that they had to do anything, anything they can for their buy-in even selling their breast milk. Sell that milk so you can afford this buy-in so you can be successful selling LuLaRoe. Hearing that isolated out of context feels criminal.

Yeah. Oh yeah, totally. But when I, I mentioned that because people end up in these situations where they have a financial need. You know, and they’re like, what can I sell? I mean, you know, having a yard sale is not going to make very much money, but I have to pay the rent. I have to do this buy-in for LuLaRoe so I can make money for my family.

I have to pay for my kids’ tuition, you know? And so they’re like, oh, got a couple hundred ounces of breast milk in the freezer that I was going to feed to my baby, but now I need to sell. Formulas cheaper. I can sell breast milk, you know? So. Then we have this where maybe that milk was not pumped with the intention of sharing.

People don’t know necessarily what milk they were drinking or making when they were drinking alcohol or smoking tobacco, or maybe they took meds the first six weeks. And you know, now it’s nine months later and they’re selling that milk and they didn’t remember, or we do really have people sometimes that have some, you know, just don’t care and don’t care to be honest about it.

You know, or we have people who are in such a dire financial situation that they feel like if they are honest about that, they can’t sell their milk and then they won’t have the money, you know? So it just gets really complicated. Yes. Yeah. And also there’s like, and you might be mad at me for saying this, but there is an emotional component to making milk that’s yours and pumping it.

And the work that goes into it, it’s a different kind of work. It’s it’s work that feels personal and there are hormones involved and people literally do get a little bit OCD addicted to the process of pumping when you’re pumping that much with and getting a reward every time. You know, and it’s not for the purpose of feeding a baby and bonding it’s for the purpose of like desperation and or feeling like this is your purpose kind of deal.

Yeah. It gets really psychologically complicated. Yes. You know, when do you stop? Who stops it? And it just, it’s messy. It’s very messy. And so I wanted to establish that before I talk about these studies, because it is pretty likely that we’re seeing a higher incidents of contamination in breast milk that is being sold for money versus milk that is being donated.

And I’ll talk about a little of that here, but there’s just not a lot of data. So let’s, let’s get into some numbers. Oh, okay. So I’m going to start with a study from 2012; this group bought a PO box in Ohio, you know, and just started purchasing samples online, you know, anonymously. And I think we had about 102 samples send them out.

Yeah. So, I mean, it’s, it’s it’s not enough that I can definitively say this is like true of everything, but, you know. So we found that 74% of that internet milk was colonized with gram negative bacteria. Don’t love it. Which is like strep. Yeah. It had staph, yeah. Generally had higher and then they, I’m sorry, they compared this milk to some milk bank donations also.

So in the comparison, the internet milk had overall higher levels of aerobic bacteria, gram negative bacteria, coliform, staph counts, all of that. And whether or not that’s because people just like were pumping for home use versus NICU use or something who knows? Question mark. Yes. Does it matter? Don’t know, we don’t have the answer to that, but so, but it’s just like part of the picture, right?

So have you ever ridden an elevator, poke the button on the elevator, gone home, forgot to wash your hands, ate a Cheeto and licked your finger? You just ate staph. Right. It doesn’t matter. I don’t know. Not sure. Of course the growth of this bacteria was related to how many days it was in transit. Right.

Because it’s hard to keep things fully frozen in transit. None of the samples in this study were HIV positive. That was good. It is good. 21% of them had cytomegalovirus. What? That’s, I guess that’s not that surprising. It’s not, I mean, it’s pretty common actually in adults, but like, was it active?

Right? I don’t know. You know, or would that be considered an inoculation? Who knows? This is the problem, this study. This is like the one study, you know, and it just, I think it brings up more questions than answers. I’ll just keep asking the question until you kick me out of the alcove. Fine. Three of the internet samples had salmonellae.

And none of the milk bank ones did. That I don’t love. Me neither. Right? How many? Three out of a hundred. So about 3%. Okay. I mean, I don’t love it though. That’s the thing. So that same study then tested for tobacco contamination. So out of the 102 samples, none of the ads indicated tobacco use. 58% of the samples had detectable nicotine or cotinine, which could have been like secondhand contamination.

4% of those had high enough levels to indicate active smoking from the parent who is lactating. Four of those? 4%. 4%. Yeah. Well that poses a lot of questions about the safety of pumped milk in a home where someone else is smoking. Yeah, exactly. So, you know, a lot of those people might say I don’t smoke, but if the two other adults they live with do, you kind of may as well.

Right. Especially if they smoke in the house. And does it make a difference in baby? Well, I mean, we talked about our tobacco episode. Yeah. So, I mean, it does, to an extent it’s a risk analysis at that level. 5% of the samples had, oh, I’m sorry and then 12 of those hundred sellers said that they avoided caffeine just FYI, but 5% of those 12 samples had caffeine levels consistent with a cup of coffee within two hours of expression.

So I’m not saying you need to like have a conclusion here, but this is just something to be aware of. There was a different study in 2015 that tested breastmilk purchased over the internet for cow’s milk contamination. Oh, and 11 of, I think it was also around a hundred samples, 11 of them tested positive for bovine DNA and 10 of those were contaminated high enough to have at least 10% liquid cow’s milk mixed in the sample.

That I really hate because then it’s compromised and not safe at all. Yeah. So I, more than all of the bacteria and the tobacco and the caffeine, like this concerns me because it’s one thing to think somebody just you know, it wasn’t clearly analyzing their diet or maybe didn’t think to mention something in their posts, but it’s another to purposely mix cow’s milk into human milk and advertise it as human milk. Yeah. That’s not safe for your baby for so many reasons. So many reasons that we won’t get into now, but nutritional deficits and all kinds of bad GI things and just not, not good.

And then to move down a lot of articles mentioned that whole fecal matter thing that you talked about on 60 minutes, I was not able to find a full-text study. It might’ve been 2020. It’s really hard to say where that came from. Like I found a bunch of different stuff that mentioned it, many articles, none of them cited a full text link that I could actually read through and figure out what that was about.

Couldn’t find it. So I will say that is unconfirmed, but also like, I wouldn’t be that surprised because there’s poop everywhere, guys, poop everywhere. Anyway, so to my understanding, there has not been a comprehensive study also into medicine contamination of breastmilk. Or of breast milk, like of studying these contaminants in breast milk that has just been donated without monetary compensation.

So we’re missing a bunch of pieces here and I get that that creates a risk in itself in not knowing, but I feel like that’s kind of why there’s so much like negative attention on this is that like, there’s a lot of unknown. There’s definitely too much unknown to have any kind of protocol in place or official recommendation other than a hard no, from anybody.

Right. You know, and also there’s a baby on the other end of this. You know, like we talked about in our milk exploitation episode about the fact that when you attach a monetary value to your milk, does your baby get the milk? Are you taking the milk from your baby to give to another baby? And if you’re mixing it with cow’s milk, are you, what your baby drinking then? What’s your baby drinking?

And is somebody trafficking you and forcing you to milk yourself to sell this? So many ethical things go through my mind. I do not as a person support paying for milk other than from a milk bank, unless you’re a bodybuilder and you are a full-grown adult and you want to make that choice. Maybe barely then can I support it.

But if there’s a baby on the other end, that truly needs milk, like really, really needs the milk and they’re getting less than par milk or maybe even dangerous milk for money, which could also be hurting the person donating in some way. I can’t get behind it. It’s tough. It’s a really tough one. I did find an unexpected study when I was looking through, which was interesting.

It was about the psychosocial dimensions of milk sharing. Oh, now you have my attention. Yeah, I know. So this study surveyed about 200 people who participated in milk sharing. And those who received really strong partner support for milk sharing and the people, the recipients who screened donors regarding their health, that was all associated with more positive, emotional responses surrounding the experience.

And based on some of the stuff that they found out, they recommended healthcare professionals screen parents with lactation difficulties for emotional distress that can lead to postpartum mood disorders, which makes sense. But just to especially focus on those lactating parents, if they’re not making enough milk. And it recommended that they, those healthcare providers give their patients information on milk sharing in a non-stigmatizing way because their patients are going to milk share.

And if they present that information in a way that doesn’t present shame, then we see better outcomes because then we have patients coming to their doctor saying, Hey, how can I do this safely? Hmm. They won’t give you a recommendation. No, but anyway, that was what that study recommended, which I liked. I’m like, thank you.

Yes. This is what we’re about. That makes sense. Okay. So we’ve talked about a lot of risk here and also that we don’t know what a lot of it means. Great. Now what? Now what? Okay. So here’s my recommendation. First, if you’re deciding to receive or donate milk, you have to start with a conversation with the person on the other end of that transaction.

Especially if you’re trying to screen donors. If they shy away from discussing their health status or their medical information, that’s going to be a red flag. You know, the reality is if you’re deciding to donate milk and you’re not comfortable talking about medications you take, your diet, your lifestyle, probably don’t share your milk.

Yeah. It’s a bigger deal than you think. And if the first time that you’re considering the weight of this decision is when someone’s questioning you with a look of desperation in their eyes, because they don’t have enough milk to feed their own child, then you probably don’t have any business doing that at this moment.

Maybe regroup, really think it through and you know, do it later the right way. Yup. Yeah. Cause I just, if somebody is willing to share boob juice and not also like share labs, then that’s a no. Sorry. I mean, I, and, and maybe you don’t like that, but, and like what kind of labs? I mean, you know, if somebody is like, Hey, I just want to like, you know, see a like sexually transmitted disease test for you.

And I want to know if you have HIV and I want to know, you know, I want to see a drug screen, like if that’s okay, they’re allowed to ask for that. And I think people should be asking for that. See, for me, I want a contract in place like a signed contract, if I’m the donor, especially. So if I know that I’ve done everything in my power to donate milk the right way, I would still especially request a contract to protect myself.

Like I want to do good. Money or no money exchange. I want to protect myself from this do gooder thing that I’m about to partake in. And if there is a bad outcome with that baby that I donated milk to, I don’t want that coming back to me in any way. I really feel like with the lack of breastfeeding and breast milk education, it could be very easy for someone to turn around and point to you if that’s the most recent change that has happened in that child’s life was that they got donor milk and then this bad thing happened, whether or not it was your milk is irrelevant at that point, because now you’re standing on a pile of shit. And I mean, people are quick to blame peppermint gum for a supply issue.

You don’t think they’re going to turn around and point a finger at you if their baby has like explosive diarrhea after drinking your milk? Right? I mean, we need transparency and you know what I’m about to surprise you with something. Oh, the Academy of Breastfeeding Medicine, published guidelines for healthcare providers on how to counsel people around sharing and receiving milk. Do it! It’s great.

They said that donors should be in good health, should only be on medications or herbal preparations that are compatible with breastfeeding, and that, and I will add that you can double check this on LactMed on the LactMed website or by calling the infant risk center, and ABM also says that we should be reviewing the donor parents prenatal labs, postnatal infectious screening tests. The donor parents should be negative for HIV, Hep-B, and human T lympho trophic virus, which is a rare thing, but also a serious cause those are some of the diseases that would be more likely to transmit through milk.

And then they kind of have this interesting guideline for what they call social practices. We’re going to be like recreational drugs here, guys. So basically they say that you’re not a suitable donor if you use illegal drugs, marijuana, smoke or use tobacco products, use nicotine gum patches,, e-cigarettes, if you consume more than 1.5 ounces of hard liquor, more than 12 ounces of beer. At a time?

I think daily, is it, or more than five ounces of wine or more than 10 ounces of wine coolers. They’re real specific. Interesting though, that they say it’s okay if you like have a little bit of alcohol anyway. Yeah. Daily, it says daily. And basically if you engage in any social activities that put you at risk for HIV, or if you have had a sexual partner who has tested positive in the last 12 months for HIV you should not donate milk.

I mean, yeah. Yeah. But it’s nice to just, I mean, I really appreciate that ABM went out there and they were like, Hey, people are going to do this. So let’s just write a protocol. For sure. And, you know, I mean, most people that would know the status of their HIV did receive prenatal care because that’s part of the prenatal care panel.

So if you were, so that’s a good tell if they don’t know their HIV status and they can’t prove it from the past six months to a year, then there’s a pretty good chance they were the kind of person that maybe didn’t seek out prenatal care, does not take health as seriously. And honestly, it’s really easy to get an HIV test. Right. There, like over the counter tests.

Oh yeah. Really? Really, I mean, they’re not as accurate. I don’t know about every state, but like I have a bunch like sitting in my house that were given to me as part of a harm reduction package to hand out to people. Whoa. Yeah. So like, and planned parenthood does them for free. There. Yeah. It’s an easy thing to get.

It takes time though. So if somebody refuses to get that test, like these are red flags and I hate to say it. If the one person that has milk for you in your area is somebody who’s saying, I don’t have to give you that information, but think twice then. And yeah, if it’s a friend-to-friend thing, does it put a damper on the do gooder vibe?

Yeah. It does. It doesn’t feel good to have your friend be like, yeah, but do you have HIV? It’s like, well of course, Becky, I don’t have HIV. And it’s like, okay, well, okay, well I love my baby more than I love you. And they’re like, well fine, fuck you then I’m not giving you any of my milk. And it’s like, but do you have HIV?

Why what’s the big secret, Becky? So, you know, that brings me into this very nicely. It’s a hard topic to approach with people, especially friends. So sometimes it makes it easier if you frame it around a healthcare provider and say, Hey, when I talked to my doctor and midwife about this, they said, I should ask you these questions. You know, that might smooth it over.

I mean, it helps, right. Or just, just saying like, Hey, you know, I don’t really suspect that you have HIV because there’s a huge stigma around it. There shouldn’t be. Totally different topic for a whole nother day. I have a lot to say about it, you know, but you can say like, Hey, I’m not going to judge you about your answer, but I need to know this because it affects my baby’s health and your health, like, yeah. I’d like to know. And you could also blame your own anxiety, you know, which is fine. You could be like, listen, I’m already struggling from the anxiety of not having enough milk, and this is nothing against you, but it will prevent me sleeping at night and having peace about this decision and feeling better about myself.

If you just share your labs with me. And they don’t have to. And that’s fine. And if they choose not to share their private health information, you don’t get to be butthurt about it. You just get to go find a different donor or figure out an alternative. So here’s an alternative. Another option to reduce the risk of infection is to perform at home pasteurization of donated milk prior to feeding.

 It should be noted this can decrease some of the nutritional benefits of breast milk, but any breast milk you’re getting from a milk bank is pasteurized. Okay. Right. And in our milk bank episode, they did say that like some was at 30% of the IGA was maintained after pasteurization. It’s good enough that they feed it to preemies.

So let me tell, let me tell you how to do this. Okay. So ABM, this is how they recommend it. The recommendation for home collected animal milk, like goat milk, and cow milk, whatever is to heat it to 161 degrees for 15 seconds. If you have a food thermometer, you can easily do that with breast milk in a double boiler setup.

So ABM has their own like very specific protocol that I think they’ve written mostly to make it like accessible if you don’t have a lot of equipment. So pasteurizing removes potentially harmful bacteria and viruses. So they say first, put your milk in a heat resistant glass jar. The amount of milk should be only between 50 and 150 milliliters to ensure that it is all evenly heated.

So if you have more, divide into more than one jar. Put the jar in a small pan of water, make sure the water is about two fingers width above the level of milk in the jar, so that it’s all evenly heated. Heat the water with a very hot setting on your stove until it reaches a rolling boil. Right? So big bubbles in the water stay close because this should only take a few minutes, right? You have a little pan, don’t use your big stockpot. And if you leave it boiling too long, that’s going to just damage more nutrients in the milk. So essentially immediately after the water comes to a boil, take the jar out of the boiling water, put it in a container of cool water and let it stand in the cool water until it reaches room temperature.

So this is the way you can do it with no thermometers, no equipment, no double boiler. Just stuff you have at home. Which led us just state that this does not remove any medications that might be in the milk or tobacco or whatever. Chemicals are not going to be affected by this. This is more of like a bacteria profile thing.

Yup. And then basically they just say you can safely feed your baby this milk at room, you know, whether it’s like at a heated temperature or at room temperature within six hours, or you can refrigerate or even refreeze the milk. You can refreeze? That’s what they say and that’s what they do at the milk banks too.

That’s true. Yeah. And I, I think this is really useful information to have, we will post a link to this position statement. And really the take home here is that there are risks, and this is something where you have to do an individual risk assessment of your baby, your baby’s individual health status, the health status of your donor, and figure out something that works for you.

Don’t be afraid to write a contract. Don’t be afraid to ask for medical records. And I mean, good luck. Yeah. I actually accepted milk from a friend of mine cause I wanted to make it to a year of offering breast milk, but she said it was old. She was like, it’s beyond the 12-month stage. And I was like, ah, and then by that point, Heidi was just kinda like doing her own thing and she had some breast milk and some formula until she was one, but mostly formula after that 10-month point.

And I had it in the freezer that whole time, but I just didn’t feel like using it. Like I had it and I just didn’t feel like it that’s okay too. Yeah. And personally I’ve shared my milk. I have directly nursed a couple of babies. I have given frozen milk to friends. I’d almost rather directly nurse someone else’s baby then you know, have the liability of sharing. Yeah, I mean, but this is all within my very close community. I have not. I did once try to share some milk through human milk for human babies. Nobody wanted it. Whatever, that’s fine.

In what scenario were you breastfeeding directly somebody else’s baby? I both times, because, well, let me think. Twice because friends had to go to the hospital. And once because a friend, I was watching her baby and she went to go vote and her baby woke up as soon as she walked out of the house and she hadn’t left milk. They were only going to be gone like a half an hour. And I was like, Hey, can I nurse your baby? Is that okay? And she was like, oh yeah, nurse her.

It’s fine. And it was really funny because her breasts are very small and mine are really big. And I sent her this picture and it was like, I mean, her baby was like four weeks old, tiny baby, you know, six-pound newborn or whatever. Smaller than one of my breasts, really. I sent her a picture and her baby had these like wide open, surprised eyes.

Cause she, she also like, didn’t have a strong let down and we all know about my situation. We’ve heard your situation on the mic. And I sent her it and she laughed her ass off. She was like, this baby has never had to deal with such boobies before in her life. That’s fantastic. Yeah. And once I gave some bagged milk to a friend who was just trying to manage, supplementing weight gain confusing, you know, and I was like, ah, I’ve got like 10 ounces in the freezer. Let me just, I’m not whatever you can have it if you want it.

And sometimes just having it in the freezer is enough to help you relax enough to pump your own damn milk. Yeah. And I mean, I just like, not too long ago, another friend thought she was going to have to go to the hospital and get a CT scan and she was freaking out and I was like well, one, you can breastfeed after that, but also like just, I have milk.

You can have it if you need it. So calm down enough that you can figure out your situation. You don’t have to worry about that part. Like worst case my husband will put it in a cooler and drive it to your house. Yeah. It’s okay. Right. I was never in the situation where I could, where I had enough milk that I could share.

Like I was adjust enough-er, which was fine. It just really never came up for me and I took, but I totally would. I would breastfeed Lyra if I had milk left. Not that I’d need to, because you’ve got more than enough with her this time. But yeah, I think it’s just your best judgment. Like of course, for example, I know that Maureen has a very good grip on her own health history, and it’s important to her.

And I know what her prenatal care was like. Yeah, I’ve got at home HIV test guys. Right. If you have the kind of friend who has at-home HIV test kits, and you’ve seen them pump, and you’ve seen that they wash their hands before and how they care for their pump parts. And, you know, you’re in a situation where you could use 10 extra ounces just to like, as a buffer to get through, go for it.

But if you’re online finding a person you’ve never met before, who’s refusing to share records and setting off your little spidey instincts, think twice, find an alternative. And, and like for most babies, formula is okay. Yeah. I’m going to say, yeah, there is the rare case where we need to be off formula on breast milk for some really complex medical issue.

And usually you can use a milk bank for that. Well, my situation over here with me, I think of formula as medication. And in a situation where you yourself are indisposed, in surgery and some like, and you don’t have milk for your baby, that is a good time to bring in some formula. If you have no other option. If the option is sketchy, breast milk that you bought offline where you don’t know the health profile and formula, I’m going with formula.

Yeah. And, and you know, if that’s not the decision that you make out there, but like we said, this is, this is a personal decision and I just want you to feel like you’re fully informed when you make it. Right. And we did want to be brave and share our opinions of it as well, because I think we probably are on a spectrum here of what we’re okay with.

And I would say that Maureen and I aren’t even the same on that. And that’s completely fine. So wherever you are, that’s fine. Just be safe and protect your own ass and the ass of your tiny, cute baby, that little, tiny ass cheeks. The little peaches, peaches on top of the legs, which I love so much, it feels like marzipan when you squeeze it, it’s the best. So cute.

My daughter still has the marzipan butt even though she’s two and a half, but she’s getting so muscular. I mean, if you guys haven’t seen my daughter’s calves. Oh my gosh. Like my friend Callie lifts weights all the time. She’s a beast. And my daughter was wearing her little kitten, heel, plastic kitten, heels, Cinderella shoes.

And she was like leaning over with her foot, cocked to the side. And I didn’t even notice when I posted it on Facebook and my friend Callie commented. I’m just here for Heidi’s calves. I was like, oh, dang. Like the definition in those little toddler calves are for real. Well, she spends most of her time running, climbing, jumping, or kicking.

Yes. All of that, man. I, there was one time I brought Griffin to a yoga class when he was like a year old and it was not like a mommy and me. I just like didn’t have a babysitter. And my friend was the instructor thankfully, and she was like, let’s just do what the baby’s doing for a few minutes. You know, great.

And it was hard. All of us were like, damn that core. Cause he was like rolling around, all his limbs in the air flailing and you try to do that. And you’re like, well, that is just, that’s easily, the hardest one that they do. Bear crawling. Oh, bear crawling for obscenely long periods of time. Oh yeah, hours.

It’s crazy. Yeah. Anyway, butt cheeks, calves, milk sharing. That’s where we are. Feel like we’ve covered it all. Oh, I have an award. Oh yeah, yeah, yeah.

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Okay. Today’s award goes to Jordan LaQue. First of all, love that last name. She is a member of the Breastfeeding for Busy Moms group on Facebook, and she just completed her third donation of breast milk. 500 ounces off to babies who need it. Oh, nice job. Yeah, I remember she specifically said she is pumping just to donate this time and is trying to make a commitment to just continue donating cause she believes in it so deeply.

That’s great. Yeah. All right, girl, you get the quincentennial queen award. We love that. That word means 500 in case you didn’t know, we looked it up on Google. Anyway, the quincentennial queen, we are super proud of you. Way to go and put the extra effort in for those babies who need it.

Yeah, that’s amazing. Just imagine all of them happily sucking down your delicious, sweet, magical milk. Way to make it weird, Heather. Oh, I got more where that came from. Stick around. I got more. Thanks for listening to another episode of The Milk Minute Podcast. The way we change this system that is not set up for lactating parents is by educating ourselves and our friends and our partners and our children.

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