‘Everybody wants it’: The thriving breast milk market
The women went to great lengths to get the breast milk. Meaghan Rice drove her Chevy Equinox eight hours in a single day. Allison Mulvaney met a stranger in the parking lot of a Trader Joe’s (“You got the stuff, in the cooler?”). Alyssa Llenas scoured Facebook groups, responding moments after another mom posted about having extra milk.
“Everybody wants it,” Llenas said. “Sometimes I would message them, and they would say, ‘I already have two moms that messaged me before you.’ ”
These moms are among thousands across the country who have gone online to find breast milk because they have difficulty breastfeeding. They are joining Facebook groups such as the donation-only “Eats on Feets” and “Human Milk for Human Babies,” or buying online from specialty websites with names such as “Only the Breast,” which advertises breast milk “high in fat and protein content,” and “100% Organic.”
Sarah Keim, a researcher at Nationwide Children’s Hospital in Ohio who has studied the breast milk market, said her team has counted tens of thousands of posts per year offering to buy, sell, or share breast milk on these sites, which offer access to the Internet Age’s version of the traditional wet nurse.
However, this is in effect an underground market that is not regulated by federal law and most states. The milk is unscreened and unpasteurized, which is why both the Food and Drug Administration and the American Academy of Pediatrics advise against using it. While research shows that screened and pasteurized donor milk is good for babies who are born premature, very little research exists about its effect on full-term babies.
“If we’re talking about healthy babies that are at home with their families, there really is no research to show that it’s beneficial to provide donated milk,” said Dr. Mandy Brown Belfort, a neonatologist at Brigham and Women’s Hospital. “I would very strongly advise people not to purchase milk online.”
But the Internet is the only place where some women can find what they see as a critical elixir for their newborn babies. They take part in a complicated calculus, often trusting altruistic strangers and the advantages of a mother’s milk — any mother’s milk — over mainstream medical advice.
Some of the women who used donor milk spoke about the shame and anxiety they felt about not being able to produce a steady stream of breast milk themselves. Mothers of new babies, they had internalized the medical consensus that “breast is best” to help their babies grow, fight off infection, and develop a healthy gut.
Providing their infants with another mother’s milk assuaged some of that guilt.
“I was crying at the doctor’s office, I was crying at home. I was grieving that loss of what I expected,” said Mulvaney, who is 36 and lives in Hingham.
She was not able to breastfeed her oldest child, but she found mothers online who were willing to donate and ended up feeding her son milk from about five different mothers, as well as formula. She knew that a disease such as HIV could be passed through breast milk, but she was consoled by the fact the mothers were feeding their own children the same milk.
“I knew the risk, and then I made that personal choice,” said Mulvaney. “Because there are risks, I would not feel comfortable telling other people to do it.” Mulvaney got the vast majority of her milk from Jodi Slade, a 36-year-old mother of two in Middleborough who was overproducing. Her husband had encouraged her to try selling her breast milk, but she didn’t feel right about that.
“This is maybe one of the nice things I’m doing in life,” Slade said with a laugh, “and it might help me get into heaven or something.” She ended up donating to five women, including multiple times to Mulvaney.
For her part, Mulvaney never told her doctor she was feeding her child with milk from donors. “I just felt like I would receive judgment,” she said.
Other mothers agreed: They had considered the health risks and decided breast milk, even from another mother, was the best option.
“Obviously, whatever the mom decides [is right]. But for me, the breast milk is essential for all the nutrients and all the things it supplies the baby,” said Rice, who is 34 and lives in Barrington, N.H. She said she tended to accept donor milk only from mothers who also gave to established milk banks, which have strict rules about who can donate.
Llenas, who is 22 and lives in Dorchester, had been resolute that she would breastfeed, but she was never able to produce enough milk. Pasteurized donor milk from a milk bank was too expensive. Safely screened, it costs up to $4 per ounce, a hefty sum for a baby who might drink 30 ounces a day. Formula was expensive too, and in Llenas’s mind, worse. So she turned to the online network of donors.
“It was really hard to get over taking a stranger’s milk, or the feeling that I had failed and I had to give him another mother’s milk,” Llenas said. Ultimately, she said she received about 10,000 ounces of milk from 30 different women over the course of a year, and then occasionally supplemented her son’s diet with formula. She often asked intimate questions of the mothers she got donations from, and they answered, sharing bloodwork and STI tests.
“The mothers, I feel like they’re superheroes,” she said.
Mothers have used wet nurses for centuries, and just a few decades ago women formed milk banks to share breast milk, according to Kara Swanson, author of “Banking on the Body: The Market in Blood, Milk and Sperm in Modern America.” But the HIV crisis changed that. Most milk banks closed, and the survivors joined the Human Milk Banking Association of North America, which runs banks across the country with rigorous screening, pasteurization, and testing.
A major risk of unscreened breast milk is that women will transmit diseases through it, such as HIV or syphilis, according to Keim, the researcher at Nationwide Children’s Hospital. Another is that bacteria can flourish in breast milk that is not properly collected, stored, and shipped. One study conducted by Keim’s team found high levels of pathogenic bacteria, including salmonella, in samples of milk bought online. In that study, researchers determined that more than 70 percent of samples they bought from online sites would not meet the Milk Banking Association’s health requirements.
In one of her studies, Keim found about 10 percent of the milk samples purchased online were topped off with cow’s milk. And another study found nicotine in breast milk from women who claimed in their ads they were nonsmokers.
“In general, given the risk that we document, not just from bacterial contamination — from other problems that we saw with the milk too — it really looks like this isn’t a good choice for any baby,” Keim said.
But some women believe that it is the best choice they have. And some women pumping their milk have successfully made money from their labor.
Caitlyn Woodward-Samson, who lives in South Grafton, advertised her milk for $2 per ounce on “Only the Breast” and ended up selling it exclusively to one mother for 10 months. (She sent along her bloodwork beforehand.) They developed a rapport, meeting at restaurants and in parking lots, joking about the sketchy exchanges. She made more than $5,000, she said, which she used to buy a season pass to Disney World for her family.
“I wasn’t in it for the money,” said Woodward-Samson, a general manager in retail. “I wanted to support another mom.”
Breastfeeding can come with high stakes and unexpected challenges: About 60 percent of mothers stopped breastfeeding earlier than they wanted to, according to a 2013 study in Pediatrics. Some experts say that’s the issue to focus on, not Facebook groups hawking breast milk or coolers full of liquid gold. New mothers need hands-on guidance, but they also need structural support to make breastfeeding work, said Brown Belfort, the Brigham physician.
“How do we as a society do better at helping women with their own lactation?” she said. “It’s probably cheaper to pay somebody maternity leave than to buy all that donor milk — and more beneficial.”