Breast milk provides all the nutrition a baby needs for their first 6 months. Human donor breast milk from a 'milk bank' is a great alternative if a baby is not able to get it straight from the source. If you are considering donor milk, it is important to know the benefits and risks first

What is donor breast milk?

A mother's breast milk is the best possible nutrition for a newborn baby. When the baby is not able to receive their mother's own milk, human donor breast milk expressed by another woman from a 'milk bank' is a very good alternative, especially for sick or premature babies.

Women breastfeeding other mothers' babies is not a new concept. Informal sharing of breast milk has been documented in maternity wards in Australia since the 1940s. Since 2006, several formal milk banks for premature and sick babies have been established around the country.

Parents usually source donor breast milk through:

• milk banks — usually connected to a hospital neonatal intensive care unit (NICU), for very sick or premature babies
• informal networks on social media

If you are considering donor milk, it is important to know the benefits and risks first.

Why give a baby donor breast milk?

Sometimes it is hard for mothers of premature babies to produce enough milk. Breast milk contains antibodies to protect children against infections and diseases, while helping them to grow and their brains to develop. Giving donor breast milk to sick or premature babies helps nourish them and protect them from disease.

Research shows that, compared with infant formula, human donor milk can reduce the risk of infections and a severe gut disorder in low birth weight babies.

But a baby does not have to be 'premmie' or low birth weight to receive donor breast milk. Donor milk can help when a baby is born via a surrogate, is adopted or fostered, or is the child of same-sex parents.

How do donor breast milk and milk banks work?

Usually, breastfeeding women express breast milk, freeze it and deliver it to the milk bank. Sometimes the milk bank can pick it up. Formal milk banks screen women to make sure they are healthy (see 'Is donor breast milk safe?', below).

The milk bank may supply sterilised collection bottles, labels and breast pumps, and will provide instructions for women on how to transport and store the milk safely. The milk bank pasteurises the milk to kill any viruses or bacteria. Milk banks do not pay donors.

These milk banks provide human donor milk to hospital neonatal intensive care units (NICUs) in Australia:

• New South Wales, Queensland and South Australia: Australian Red Cross Lifeblood's Milk Bank
• Queensland: Royal Brisbane and Women's Hospital Milk Bank
• Queensland and northern New South Wales: Mothers Milk Bank Charity
• Victoria: Mercy Health Breastmilk Bank
• Western Australia: PREM Bank

It is also possible to source donor breast milk informally, through social media networks. These groups put parents in touch with donors and they share breast milk privately. But there are some important safety issues to consider.

Is donor breast milk safe?

Breast milk is a human bodily fluid that can, in rare cases, transmit viruses like HIV and hepatitis C, bacteria and other germs.

Although there have been very few cases of adverse events in babies being given donor breast milk, formal milk banks must test and pasteurise donor breast milk to make sure there is nothing in it that could harm a baby. They also screen donors to make sure they do not have any medical conditions or lifestyle factors that could affect their breast milk.

Donor breast milk from private networks, however, is not properly processed or pasteurised. The networks typically provide guidelines about screening donors and storing and transporting breast milk safely. It is important to understand the possible risks before you use a donor’s milk for your baby.

Can I donate breast milk?

Milk banks typically use donors whose own babies are under 7 months and who have not started on solids. It is usually best to wait until breastfeeding is well established, 4 to 6 weeks after birth. If you have a lot of extra milk that you have expressed and frozen, contact your nearest milk bank to see if they would like to take it.

The milk bank will do a blood test and ask you questions about your lifestyle — as though you were donating blood. Here are some examples of what you might be asked:

• whether you have a health condition and if you have ever tested positive for diseases such as HIV, hepatitis B or hepatitis C, tuberculosis or cancer
• what medicines you are taking
• how much alcohol and caffeine you consume
• whether you smoke, use nicotine patches or use drugs
• whether you lived or travelled in the UK for 6 months or more between 1980 and 1996

What is wrong with baby formula?

Nothing. Sick and premature babies need extra nutrition and fluids so they can 'catch up' in terms of growth. Breast milk is best, but it is not always an option for parents. Special formula designed for pre-term babies will also meet their nutritional needs if the mother is unable to, or chooses not to, breastfeed.

For other babies, commercial infant formulas contain enough nutrients for healthy growth. Formula is the only safe milk alternative to breast milk for babies under 12 months.

More information

• If you have any questions about breast milk, contact the Australian Breastfeeding Association National Breastfeeding Helpline on 1800 686 268.
• The Mothers' Milk Bank Charity is based in Queensland but services other states and territories.
• Read more about the Red Cross Milk Bank, which services New South Wales, Queensland and South Australia.