The Ministry of Public Health’s Department of Health (DoH) is urging mothers who are unable to produce enough breast milk to use donated breast milk from breast milk banks.
DoH’s director general Dr. Amporn Benjaponpitak noted that human breast milk purchased online may be contaminated and dangerous.
“You don’t know the origin of the breast milk and whether it’s been screened and pasteurized to kill viruses and bacteria in line with safety protocols. That makes it very unsafe for the recipient babies’ consumption,” she said.
The move comes after news reports about selling and buying human breast milk on the booming online market. A report said mothers in the US have been milking the cash cow by selling their own breastmilk for huge amounts to hungry babies and thirsty bodybuilders looking for a natural pre-mixed protein shake.
The doctor noted that human breast milk that is not screened and unpasteurized poses many risks, stressing that breast milk is a bodily fluid and can directly transmit germs and organisms that can cause diseases including HIV, hepatitis B, hepatitis C and syphilis.
“Women can transmit diseases via breast milk even though they don’t feel sick,” she said.
She explained that an HIV-infected child will usually go on to develop Aids, while infants infected with Hepatitis B virus (HBV) and/or Hepatitis C virus (HCV) will become chronic HBV and HCV carriers. If an infant who is infected with congenital syphilis and is not treated early, damage to the eyes, liver and brain can occur.
Another risk associated with the unscreened breast milk is cytomegalovirus or CMV, which is a risk factor for tuberculosis disease in infants.
Dr. Amporn noted that human breast milk sold online that has gone through substandard storage and shipping can put recipient infants at risk of bacterial infections and illnesses. Infections caused by Listeria and E. coli can lead to vomiting, diarrhea and even sepsis in the neonate.
Using breast milk from other women may also impact on infant nutrition as breast milk composition can change from feed to feed. And the practice may trigger an allergic reaction in the baby, which can cause digestive problems.
“Your breast milk is best for your baby,” she said adding that it has antibodies that help babies fight against infections and develop the immune system. Enzymes found in breast milk help babies to digest.
The doctor urged mothers who are able to produce more milk than their baby needs to donate it to a breast milk bank run by government hospitals or universities.
She also called on mothers who are not able to produce their milk to use breast milk stored in banks, saying milk banks adhere to strict screening and pasteurization process to ensure the safety of donated milk meets international standards.
The pasteurized milk has been stored under conditions which ensure that quality and nutritional value are maintained, with each bottle labeled with an expiration date.
“You can also ask for advice from public health personnel at milk banks. They’ll be able to give you a guide to proper breastfeeding,” she said.
Dr. Amporn recommended mothers breastfeed their infants for the first six months of their life and then add safe and appropriate complementary food to the diet.
“And if you can, keep on breastfeeding your child for up to 2 years and beyond,” she said.
Breast milk from milk banks is safe
Dr. Lalitawadee Tungsuputi, a neonatologist at Queen Sirikit National Institute of Child Health (QSNICH) and chairperson of QSNICH’s Mothers’ Milk Bank, noted that human breast milk that is stored in milk banks is different from breast milk available for purchase online.
“Human milk from breast milk banks is safe. At the institute, milk donors must undergo rigorous screening every time they donate milk. The donated milk is tested and also pasteurized, ensuring that the milk is safe for babies who receive it,” she said.
According to her, breast milk donated by nursing mothers is dispensed by prescription in accordance with the international guidelines and protocols adapted from the Human Milk Banking Association of North America (HMBANA). The pasteurized milk is also analyzed for basic nutritional content. It can be frozen up to six months.
Located in Bangkok’s Ratchathewi District, the QSNICH’s Mothers’ Milk Bank is committed to providing safe, pasteurized donated milk, which is reserved for sick, premature, very low birth weight infants and babies whose mothers are unable to provide sufficient milk. The mothers’ milk bank is linked to Rajavithi Hospital’s neonatal intensive care unit.
“Some mothers are not able to produce enough milk for their baby’s needs particularly in the early days after the baby’s birth. They need to use a service from a breast milk bank,” she said.
She advised using donated breast milk from a milk bank as the first alternative when a mother’s breast milk is not available, referring to the World Health Organization and the American Academy of Pediatrics’ recommendations.
The neonatologist stressed breast milk is the best food for babies and the primary nutrition for newborns. It gives protection against diseases and illnesses and promote normal growth and better long-term development.
In addition, feeding infants with breast milk reduces the risk of necrotizing enterocolitis, a serious condition that affects the intestines of premature babies and can be life-threatening if not treated immediately.
“You can be a donor if you are healthy and have an oversupply of breast milk. You must have delivered a baby within the last 4 months,” she said, urging mothers to donate their milk at QSNICH’s Mothers’ Milk Bank.
Breast milk banks are also found in certain public hospitals and universities including Ramathibodi Hospital, Siriraj Hospital, both in Bangkok, the Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Srinagarind Hospital in Khon Kaen and Songklanagarind Human Milk Bank in Songkhla. Thammasat University Hospital plans to open one soon.
According to her, about 5,000-6,000 infants nationwide feed on donor breast milk from milk banks, accounting for 1% of the 500,000 babies born each year in Thailand.
She noted that Islamic beliefs about milk kinship are a barrier for Muslims to donate and receive donor human milk in Thailand, saying many Muslim women are unwilling to donate their breast milk to a milk bank, citing religious concerns.
Dr. Lalitawadee said breast milk banks screen donors when they wish to donate. They must undergo blood screening for infectious diseases including HIV, HBV, HCV and syphilis and to check that they are not using certain medications and substances contraindicated while breastfeeding.
They must be able to follow strict hygiene guidelines and carry out careful milk collection and storage methods.
“Our staff members will teach donors to pump, store and transport their breastmilk in a clean and hygienic way,” the neonatologist said, adding sterilization of breast pump equipment is very important to protect babies who will receive the donated milk from infection.
Milk banks do not pay donors. The donated breast milk is dispensed to babies who need it free of charge, she noted.
Informal sharing breast milk can be risky
Informal sharing breast milk, a practice that sees other women giving or using donated breast milk, which is often done among family members, trusted friends and online groups, can be unsafe for babies.
“Informally shared breast milk can expose infants who receive it to diseases, drugs or other substances,” Dr. Lalitawadee said pointing out that the milk doesn’t provide the same safety guarantees as that of donated breast milk from milk banks as it’s not tested and appropriately pasteurized to kill potential viral and bacterial contaminants.
She urged mothers who have an oversupply of breast milk and want to help to donate it to a milk bank instead of sharing it.
“Breast milk is the best, but it must be from the babies’ own mothers,” she said.
