Donor Breast Milk and Milk Sharing: Is It Safe?

Banked donor milk

Nonprofit milk banks screen donors with a health history and blood tests, pool and pasteurize the milk, and test it for bacteria. Pasteurization keeps much of breast milk's value. - Hospitals use it first for preterm and very small babies, where it lowers the risk of a serious gut infection. - Some hospitals use it as a short bridge for healthy newborns while a parent's supply comes in. - At home it usually needs a prescription. Insurance and Medicaid coverage vary by state; the bank or hospital can help. - It costs more than formula and supplies can be limited, so banks prioritize babies with medical needs.

Informal milk sharing

Families also share milk directly, friend to friend or through community groups. The FDA and AAP advise against using milk from unscreened sources, and strongly against buying milk online, where samples have been found contaminated or mixed with cow's milk or water. The ABM takes a harm-reduction view: if a family chooses to share, there are ways to lower risk.

If you choose informal sharing: - Use a donor you know, not a stranger online, and don't pay for milk. - Ask about health, medicines, alcohol, smoking, vaping and drug use. - Ask for recent blood test results for HIV, hepatitis B and C, HTLV and syphilis, such as from prenatal care. - Learn how the milk was pumped, stored and transported. It should arrive frozen or cold and follow the storage times in the pumping guide. - Talk with your pediatrician first, especially for a preterm, sick or very young baby.

Who uses donor milk

Parents with low supply, parents who can't breastfeed for medical reasons, adoptive and foster families, two-dad families, families after loss of a parent, and NICU families. Some adoptive or non-birthing parents also induce lactation and combine their own milk with donor milk or formula; see the low milk supply guide.

Culture and faith

Some families have religious or cultural considerations about milk from another person, such as milk kinship. Pooled bank milk mixes several donors; ask whether a single-donor option or a known donor fits your family's practice.

Donating your milk

If you have extra, a milk bank can screen you, often with free shipping. Bereaved parents sometimes donate after a loss and find meaning in it; banks welcome that and can support you.

Formula is safe too

Donor milk is not the only safe choice. Standard infant formula is a complete food. Never use homemade formula, plain cow's or goat's milk, or plant milks for babies under 12 months.

When to check in

• Ask the pediatrician or hospital team before starting donor milk at home.
• Mention it if a baby on shared milk has fever, vomiting, diarrhea or a rash. Any fever of 100.4°F (38°C) or higher (rectal) in a baby under 3 months needs a call to the pediatrician right away.