CERP: yes
All human babies have the right to receive exclusive human milk. This can be accomplished in a variety of ways – exclusive feeding at the parent’s breast/chest, exclusive expressed human milk delivered to the baby via a feeding device, or pasteurized donor human milk delivered via a feeding device. However, there has been much attention placed on the traditional practice of cooperative infant feeding, sometimes referred to as informal milk sharing or community milk sharing. Cooperative feeding is when lactating individuals provide human milk directly to another family in need, without going through the donor milk bank process. The increasing popularity of cooperative infant feeding via social media, the growing attention on the importance of human milk exclusivity, the increasing awareness of the potential health risks of artificial milk, and the inability for donor milk banks to provide milk for more than those in critical need has led professionals and families to an impass. While cooperative infant feeding is gaining popularity among families, finding policy and recommended practices can be difficult. The Academy of Breastfeeding Medicine only references mother’s own expressed milk, donor human milk, or hydrolyzed or standard infant formulas for breastmilk feeding in regards to supplemental feeds. The World Health Organization, states in its Global Strategy for Infant and Young Child Feeding, “for those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breastmilk substitute…depends on individual circumstance.” There are also significant equity issues at stake. Many families live in food deserts, without proper access to health care and lactation support or donor milk, who need human milk for their babies. There are also family structures whereby access to milk at the breast/chest may be limited. Many families are told by healthcare professionals to avoid cooperative feeding in all cases, even though the data is not supportive for that recommendation. Most cooperative infant feeding organizations recommend the practice of using The Four Pillars of Safe Milk Sharing. These are informed choice, donor screening, safe handling, and home pasteurization. This presentation will cover in detail the myriad of concerns of professionals, the information all families need to know about cooperative infant feeding, milk sharing and social media, and lactation professionals’ scope of practice issues regarding community milk sharing.
