Thursday, February 9, 2012

Feeding Other People's Babies

The other evening, we made a trip to the emergency room because my husband was sick. Fortunately, it wasn't serious, and he's fine, but it was an interesting experience. We left the three kids home with a sitter, hoping it wouldn't be more than a few hours that we would be there. Thank goodness I still had some pumped milk in my freezer from a couple of months ago. I left that and a bottle for the baby, left instructions and dinner for the older kids, and we were off.

While there, aside from worrying about my husband, my mind of course kept dwelling on whether GI was taking the bottle, hoping he wasn't screaming in hunger, hoping the other two kids went to bed nicely, hoping everyone was fine. I didn't get overly engorged - we were there about four hours, so the baby would only have eaten once, maybe twice, in that time anyway - but I did have two let-downs while we were sitting there.

As an aside, I will say straight out that the biggest inconvenience in breastfeeding is that you are tied to your baby. GI would not, in no uncertain terms, take the bottle from the sitter, and so was ravenously hungry when we got back from the ER. If he were regularly bottle-fed, there would have been no problem. However, the incredible benefits to breastfeeding far outweigh, to me, the occasional problem of not being able to be away from him for more than a couple of hours. And, certainly, if I were regularly away from him and regularly pumping, and he was regularly eating from bottles, it wouldn't really have been a problem either. Since I'm with him all the time, I don't have the patience or desire to pump and store milk and have someone else feed him when it really is easier just to nurse him. Other women do prefer to pump milk and have someone else (say, Dad) feed the baby once or twice a day (or night), and that's perfectly reasonable as well, as long as your supply is fine and the baby doesn't have a problem switching between breast and bottle.

But back to the story at hand. The way the emergency room was set up, we could pretty much hear what was going on with most of the other patients behind the other curtains. At the far end of the room, there was a woman with her husband, mother, and newborn baby. The woman had had a c-section, and I assume she was in the ER for some reason related to that. I couldn't hear everything they said, but I felt bad for her. I've been in that same situation. I heard the baby making rooting noises and fussing, and then I heard the nurse tell the mother that she couldn't breastfeed for 24 hours. I almost wanted to offer to nurse the baby for her. I had all this milk collecting in my breasts, and she had a hungry newborn who she couldn't nurse. I decided it would have been too weird to approach a random stranger in the ER and offer to feed her baby, and then the ER nurse brought over a bottle of formula for the baby, but the whole thing made me sad. First of all, even though they tell you not to breastfeed for 24 hours after they give you certain medications, it is often not true that those meds are incompatible with breastfeeding. It's important to check. Find out what they gave you and then do your own research as to whether it's okay to breastfeed. Secondly, since they knew she was breastfeeding, it would have been nice if they gave her meds that they know to be compatible with breastfeeding so there wouldn't be a problem. And, finally, that early in the breastfeeding relationship, giving bottles of formula for a day can be a great stress on the success of future breastfeeding. I'm not saying that being in the ER ruined this woman's ability to continue breastfeeding her daughter, but it certainly made it harder.

As far as offering to feed her baby, well, I've never actually nursed someone else's baby before. I know there are some women who set up baby-sitting shares, where they'll watch each other's babies and even nurse them. But, more often, if you are helping to feed someone else's baby, it's by pumping and donating milk to her, rather than directly nursing her child. I have donated milk in the past, with my abundance after SB was born, and I had every intention of doing the same with my similarly abundant supply with GI. This time, I find it difficult to pump even once a day, with three kids home all the time, so I didn't keep up with the pumping and now just have a small freezer stash. There were two women I thought I would be donating milk to, and I think that if I knew there was someone depending on me to pump for her, I would have, but neither one wanted my milk in the end, so I haven't been doing it.

Aside from donating to personal friends or acquaintances, you can also donate your milk to a mother in need who you don't necessarily know in person. There are a few informal milk-sharing groups out there, where a woman with milk to donate can be connected directly with a woman in need of milk and they can make arrangements for the direct donation of milk between mothers. It's pretty neat. These include Human Milk 4 Human Babies, Milkshare, and Eats on Feets.

You can also donate excess pumped milk to a milk bank affiliated with HMBANA. They have a screening process to make sure your milk is healthy for the preemie babies it is usually fed to. This usually just involves a blood test and a questionnaire to make sure you are healthy and not using any medications that might be harmful to a baby.

So, why donate milk, anyway? Isn't that kind of... gross?

First of all, milk is milk. Human milk is meant to feed human babies. And while the best milk for a given baby is his own mother's milk, any breastmilk (provided it isn't carrying a life-threatening disease or harmful chemicals or drugs, of course) is better for any baby than artificial milk, excepting very specific and special circumstances. The hierarchy of the best food for a young baby is: 1) His own mother's milk directly from the breast; 2) His own mother's expressed milk; 3) Expressed milk from another woman; 4) Formula/artificial baby milk.

Thus, if a woman is unable to produce enough milk herself to feed her child, the most desirable alternative for feeding that baby is donated human milk from another lactating mother. There are many women out there with excess milk in their freezers, or women who desire to do something useful with their life-giving milk, but they don't know what to do with it or who to give it to. I hope naming those resources above will be helpful.

Why donated milk instead of formula? Isn't formula good enough?

Well, yes and no. Formula is adequate to give your baby the nutrition he needs to grow. However, there is so much more to breastmilk than just nutrients, and more and more studies about breastmilk show that breastmilk is about far more than just feeding. To put it very succinctly, babies are born without gut bacteria. We need to populate the gut with the "good" bacteria, that help digest food and protect against infection. Human milk works in various ways to promote the growth of good bacteria, prevent inflammation and tissue damage to tender newborn guts, and to directly protect against invading infectious agents. Formula does not do any of these things. Young babies who receive even one bottle of formula in the early days and weeks of life will have a different gut flora (population and type of bacteria) than exclusively breastfed babies. This can cause inflammation and other undesirable effects on the "virgin" gut of a young baby. (Please note, the "virgin gut" can be reclaimed by exclusively breastfeeding, but it takes time, something like 6 weeks.) Once you introduce solid foods, the gut is no longer "virgin," anyway, but in those first six months, and especially in the first 10 days before the baby's immune system starts up, breastmilk is very important. Formula is adequate, but breastmilk is normal. Please see this excellent explanation from the Lakeshore Medical Breastfeeding Medicine Clinic and Dr. Jenny Thomas, MD, IBCLC, FAAP, FABM (how's that for a bank of initials after her name!).

It wasn't so long ago that it was reasonably common to for one woman to nurse another's baby. In other cultures, it still happens. Human milk is human milk, after all, and doesn't it make more sense to feed a baby milk from another woman of his own species than the milk from a totally different animal?

I've thought about it a lot over the course of nursing two babies, and I think that, if I were asked, I would happily feed another woman's baby. That's assuming, of course, that the baby would be willing to have me nurse him! I certainly would have no problem pumping a bottle for another baby if I were asked to help out.

By the way, it is possible to ship frozen breastmilk, although the less time the milk is out of a freezer, the better. I once shipped milk overnight from California to Florida in the middle of summer and it was still usable when it arrived, but we cut it kind of close. Donating/receiving milk locally, where it would only be out of the freezer for a short while, is preferable. The Milkshare website has a good couple of pages on storing, freezing, and shipping breastmilk intended for donation.

And remember that supply is governed by demand, so if you do decide you want to start pumping and storing for donation, you should be able to increase your supply over time in order to continue to provide milk for your own baby as well as putting some aside for another baby in need.

1 comment:

  1. So, a) as an aside, all human milk is kosher. b) I have nursed other people's kids. It wasn't really a big deal. It is only embarrassing when they grow up. c) My mom and her friend had a babysitting/feeding share relationship, when one went out with her husband the other would watch and feed the baby.
    My mom was a radical nurser for her time, she breastfed for THREE months!
    I miss it. :::sigh:::