Breast Milk Banks Struggle to Meet Demand

PHOTO: Milk bank lab assistant prepares human breast milk
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The rising demand for human breast milk in neonatal intensive care units has prompted an impassioned plea from America's milk banks.

Donated milk, dubbed "liquid gold," can save the lives of preterm babies whose moms can't produce milk themselves. But the 1.8 million ounces of milk distributed by non-profit milk banks across the country covers less than a quarter of the 8 million ounces needed, according to the Human Milk Banking Association of North America.

"We need every healthy, breast-feeding mom to say, 'I want to be a donor," said Kim Updegrove, the association's president elect. "Then we'd have enough milk for every preterm baby. Even a small amount is lifesaving."

Human breast milk is rich in nutrients that help tiny preemies grow and antibodies that guard them against infections, which is why more NICU doctors are prescribing it. Now three-quarters of milk bank orders come from hospitals -- up from 60 percent just last year.

"All babies should receive human milk. But because it's a scarce resource, we prioritize it for preterm infants in neonatal intensive care who weigh three pounds or less," said Updegrove. "These babies respond the best in terms of decreased infection rates and shorter hospital stays."

But beyond those who need donor breast milk, few moms know about milk banks. All prospective donors have to do is fill out paperwork online and provide a blood sample at a local lab. The milk banks cover the cost of the screening process and, if approved, the cost of shipping and pasteurizing the milk.

"There's no cost to the donor," said Pauline Sakamoto, executive director of Mothers' Milk Bank in San Jose, Calif., and past president of the Human Milk Banking Association of North America. "We just want her to keep pumping!"

But the recipient absorbs the cost, paying as much as $6 per ounce.

For Julie Palmonka of Tyrone, Pa., banked milk was just too rich. When her baby, Miley, was born weighing just three pounds, doctors prescribed donor milk. But a week's supply cost $750 out-of-pocket, so Palmonka had to find another source.

She took to online milk sharing sites that connect moms in need with moms who have milk to spare. Now she has nine deep freezers in her garage packed full of dairy breast milk, she said.

Rising Demand Could Raise Costs

There are 10 milk banks in the U.S., down from 30 in the pre-HIV 1980s. The virus closed every bank except for one -- the Mothers' Milk Bank in San Jose.

"We've been open for 37 years," said Sakamoto. "And we've never been in this position where we've had to cut back orders to hospitals."

For non-profit milk banks, the rising demand is bittersweet. On one hand, it reflects the growing appreciation for human breast milk's benefits. But it also means the service is getting more expensive. Instead of shipping hospitals a month's supply, the banks are forced to send milk as it become available, increasing shipping costs.

"We're almost to the point of diminishing returns, which would mean having to increase the price," said Sakamoto.

The increased price could mean more moms sharing online -- a practice discouraged by the U.S. Food and Drug Administration because of the risk of disease. While the 10 milk banks under the Human Milk Banking Association of North America umbrella have strict standards for donor screening and pasteurization, informal milk sharing sites do not.

"While it may be compassionate to share informally, it's unsafe medically and dangerous legally," said Updegrove. "You're sharing a body fluid with someone else's child."

Sharing through milk banks, Updegrove said, ensures safe milk gets to babies who need it to live.

"Human milk is not just best for these infants, it's absolutely lifesaving."

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