Monday, October 21st 2013

American Academy of Pediatrics Study Unwittingly Validates “Four Pillars of Safe Breastmilk Sharing”

Maria Armstrong and Shell Walker

***Eats on Feets is referenced this week in a study published by the American Academy of Pediatrics (AAP) entitled “Microbial Contamination of Human Milk Purchased Via the Internet”. The authors purchased milk from two websites which sell breastmilk to explore the potential for contamination. Results showed of the 101 purchased samples from the internet and shipped in various ways and distances, compared to 20 rejected milk bank samples, two classes of bacteria had statistically higher growth. The viral content was not significant. The following is an elaboration on the response requested by media outlets.***

Eats On Feets is uniquely dedicated to safe, ethical, and informed breastmilk sharing between families. Eats On Feets also fervently opposes the selling of breastmilk. It is our firm belief that the selling and buying of breastmilk carries undue medical and ethical risks.

In order to provide the breastmilk sharing community with current research and information, Eats On Feets created and maintains the "Resource for Informed Breastmilk Sharing" and "The Four Pillars of Safe Breast Milk Sharing." We consider the latter to be fundamental for all individuals and entities involved in the safe use of donor milk. These resources are under regular scrutiny from members of the medical and research community, and concerns are immediately addressed (and welcomed!) to ensure the accuracy of this resource. The AAP’s publication validated the Resource and Four Pillars, while providing opportunity to clarify the third pillar, “Safe Handling,” to more precisely impart the need for the cleaning of equipment and the use of impeccable shipping methods.

Three important notes should be made about this study: 1) The authors specifically excluded potential donors attempting to engage in informed practices, such as “Know Thy Source”, to avoid seeking approval of their study by an ethics committee. 2) The authors themselves state that the presence of bacteria is not predictive of infant health risk. Only two of the four screened microbial groups were statistically significantly higher than samples obtained from a milk bank (because their pre-screened donors had failed their own quality measures). Specific pathogenic species were not isolated, making the results rather ambiguous. 3) When necessary, proper home pasteurization is, contrary to the authors’ assertions, possible in most homes in the United States by Holder method on stove-top or by single bottle pasteurizer.

The methodology, analysis, context, and ethics of this study are questionable. The study attempts to implicate all non-milk bank use of donor milk. In fact, it only addresses the use of donor milk obtained in a deceitful and unethical manner on behalf of the recipient (the researchers), and shoddy methods (the donors). These practices do not apply to the breastmilk sharing community.

Eats On Feets remains committed to the altruistic sharing of breastmilk between families, and asserts that it can be done safely and ethically. Until the Human Milk Banking Association of North America, the AAP, and social policy makers are willing to commit to practical and feasible means of meeting the needs of their communities, there will remain a need for community based milk sharing. Eats On Feets will continue to do its part in contributing to safety through reasoned and ethical research, distribution of educational materials, and advocacy.

The AAP Article detailing the study can be found here: Microbial Contamination of Human Milk Purchased Via the Internet

Q: Are you worried about safety?

A: Of course we are concerned about safety! Which is exactly why we created the Four Pillars of Safe Breast Milk Sharing. And, if like was practiced in this study, we would also be concerned if babies were being fed cow’s milk that was shipped across the country, in unstable conditions, and left sitting thawed in a P.O box.

Q: But how do you know that families are doing this safely?

A: Doing what safely? Sharing breast milk? Humans have been sharing breast milk since the beginning of time. This study does not address milk sharing, it addresses milk selling. Milk selling increases the risks of using donor milk. If someone is attempting to make money by selling breast milk, how do we even know that what they are selling is actually 100% breast milk? How do the researchers of this study even know if what they bought was 100% breast milk? It certainly wouldn’t be the first time that someone tried to increase profits by diluting their product. And if the milk was diluted with something else, like cows milk or formula, how would that skew the findings?

We frequently poll the users of our network, we constantly provide them with updated guidelines and information. The consistent feedback and analysis of the polls is that breast milk sharing is happening safely. We cannot say the same for breast milk selling and purchasing, which is why we do not allow the selling of breast milk through our network.

Q: What do you think about this study?

A: We have a lot of thoughts about this study. We are wondering if anybody has looked into where the money for this study came from and if the funder collaborated with Grant Medical Center to initiate the use of donor milk and the formation of the Mother’s Milk Bank of Ohio. If the answer is “yes” we wonder if there should be some red flags raised. We are also wondering if any of the researchers who designed this study are also associated with the milk banks.

Q: What are your concerns about this study?

A: We are concerned that the research seems to have been funded by one of the founders of the Ohio Milk Bank and that the methods of the study are questionable and that the actual conclusion of the study does not match the sensational title of the article. We are concerned that this study is purposefully intended to attack safe community based breast milk sharing.

Q: Who regulates breast milk sharing?

A: Since breast milk is considered to be essentially safe, neither milk banks nor individuals are regulated by the government.

Q: What about sick babies? Are you concerned that some of this milk will go to them?

A: Sick babies really need access to free breast milk! We encourage all users of donor milk to follow the Four Pillars of Safe Breast Milk Sharing. This may be why there have been zero reports of negative outcomes from milk shared on our network.

Q: What do you think about this report?

A: Though it is clear that the report does not apply to normal community based milk sharing we think that it proves the importance of our Four Pillars of Safe Breast Milk Sharing.

Q: How do you think this will impact milk sharing?

A: Except for the fact that we will even more emphatically caution against the selling of breast milk and continue to endorse the Four Pillars of Safe Breastmilk Sharing, it will be milk matching as usual.

Q: Are you worried that they found bacteria in the breast milk?

A: It is normal and even beneficial for bacteria to be in breast milk. By following the Four Pillars of Safe Breast Milk Sharing, parents can ensure that it stays at acceptable levels.

About Eats On Feets
Eats On Feets is uniquely dedicated to safe and ethical breast milk sharing. By designing the original working model for running a Facebook based milk sharing network, authoring original documents and making accessible extensive research, they have influenced milk sharing policy and have become known as the go-to organization for information regarding the safety and mechanisms of breast milk sharing. Their network has facilitated the sharing of tens of thousands of ounces of donor breast milk with zero negative outcomes.

To learn more about the latest breast milk controversy, please contact
Eats On Feets Global Breast Milk Sharing Network
Shell (Walker) Luttrell 602-242-4446
Maria Armstrong 503-804-5640
**To find a local administrator from your community to speak with, find your local EOF page**