Milk Donation: A Personal Story

A couple of days ago, a woman reached out on Facebook to a group I'm a part of. She recently gave birth by c-section and was doing okay until she came down with a MRSA infection in her incision. Her OB tried hard to find a treatment that would be compatible with breastfeeding, but it finally came down to her having to stop breastfeeding for a week so she could take some powerful antibiotics to knock out the infection. She made a plea to our group for help getting her donor milk to feed her baby for the week.

I had been pumping and storing milk here and there and had 24 ounces in my freezer that was on the edge of needing to be thrown away. Milk is good in the freezer for about 4 to 6 months, depending on how cold the freezer is, and most of the milk was pumped in December and January. It is now mid-March. I told her, if she wanted, I could ship her the 24 ounces. Better her son drinks it than I throw it away!! And my son doesn't want or need it. That amount should be enough for a day, or most of a day, and several other women local to her also immediately offered what they had. Another friend offered to go pick up all the milk that was offered and bring it to this woman's house. I hope she was able to gather enough donated milk to cover her for the week. I wish I had more to give. I did try to pump some more yesterday but was only able to produce 2 additional ounces with such short notice.

I'm 500 miles away, so I had to ship my milk to her. I've shipped milk once before, when my second son was a baby, across country from California to Florida. The key to shipping milk is that you get it there as quickly as possible, within 24 hours of leaving the freezer, so even if it defrosts on the way, it can still be used at its destination as long as it's been kept cold. Now, you can go all out and use dry ice to really keep it frozen, much they way steaks are shipped, but if you don't have access to dry ice or it's too much hassle, it can be done with stuff you have at home.

Milk donation is an informal arrangement, but you can make certain agreements with your recipient if you want. It's common courtesy for the recipient to ship back any supplies that are reusable (cooler, ice pack) or to pay for anything consumable you need to purchase (if you want them to, such as storage bags and the cost of shipping), but you can make that arrangement with your donee however you see fit and depending on the amount you're shipping, whether it's a recurring agreement (i.e., you'll send milk every month or whatever), and what your and their financial situation is like.

For packing and shipping, you can purchase an inexpensive foam cooler (about $6 - usually either in the freezer section or beverage section of your grocery store) and a few blue-ice packs, like what you'd use to keep a lunch cold. If you'll be doing this regularly, you may want to invest in something sturdier and more insulated, but for a one-time donation, a cheap one will do just fine. Make sure everything is frozen solid and pack it up just when you're ready to leave for the Post Office or UPS store or wherever you're shipping it from. I am shipping such a small amount this time that I didn't want to buy a big 28-gallon cooler, so I found a smaller insulated bag ($4, meant for keeping beer or soda cans cold) to use instead. As long as it closes up all the way around, it should be fine. Remember that most cooler bags are designed to keep food cold for 18 to 24 hours with ice packs, and since the milk is starting out frozen, it should still be cold when it arrives the next day. I also stuck the cooler bag in the freezer for an hour or so before I packed everything so the air inside the bag would start out cold. Cold cold cold!

 Put the ice packs at the bottom, sides, and top of the cooler and the milk in the middle. Remember heat transfer will be highest at the outside, while the inner-most parts will stay coldest; you want the ice packs to melt before the milk! Fill in any empty space with newspaper for additional insulation - you want as little air as possible to minimize heat transfer. Find a box that the cooler fits inside with just a little room around it. Pack the space between the cooler and the box with more newspaper.

Then, take it to the shipping location and ship it OVERNIGHT, not two-day. It needs to get there as fast as possible. Make sure the recipient knows it's coming so she can bring it inside and get it on ice again as soon as possible. When I shipped my milk to Florida, the UPS guy didn't ring her bell and it sat on her front porch for several hours in the Florida sun. The milk was still cold and usable, but the milk at the outside of the pile was defrosted and needed to be used immediately. She was able to refreeze the rest, thankfully. I felt terrible that she didn't know right away that it had been delivered!

My attempt this time around was a bit of an improvisation, because despite visiting three stores with my kids in tow the day before sending the milk, I couldn't find appropriate ice packs (?!?!), so I didn't have time to freeze any additional ones before I shipped the milk. I did have ice in the freezer, so I packed that in Ziploc bags along with the two ice packs I did find, and I prayed that it would stay cold enough. I'd rather overdo it with the ice than have the milk spoil on the way!

I shipped it UPS overnight. They have options for end-of-day, 10:30a.m., and 8:00a.m. I wanted to make sure it got there by the 24-hour mark, but the 8:00a.m. delivery was very expensive, so I chose the 10:30. You can also do USPS next day, which is generally less pricey than UPS or FedEx, but I also wanted them to pack the box securely for me, and it was easier for me to use the UPS Store than the Post Office.

I let my recipient know that the package was on its way and gave her the tracking number so she can keep a lookout for it. After delivery, I nervously messaged her on Facebook to find out if it had arrived safely, and she responded that it had. What a relief!

I'm so happy that my milk found a good home. I was unhappy about having to throw it away, but despite my intent when he was born, I was not good about offering a bottle to Baby Y often, and he won't drink from one. Donating milk is a wonderful way to help another family out, and it was very fulfilling for me to be able to do that again. Of course, donating to someone local, where you just have to drive the milk over to them or have them come pick it up, is much more convenient and better for long-term donation agreements or one-time bulk donations, but if you know someone in need who is far away, it's great to be able to ship milk.

Have you ever donated milk or nursed someone else's baby? Have you been the recipient of donor milk? Tell us about your experience in the comments!

Pumping Tips for Stay-at-Home Moms

With my second and third babies, I intended to pump milk and build a freezer stash so that the baby could have a bottle once in a while if my husband and I went out. What I found was there's not much time or motivation to pump when you're with your baby 24/7, since preparing a bottle is more trouble than just putting baby to breast, and when exactly are you supposed to pump when you have to feed your baby every couple of hours?

I actually did manage to fill a few freezer bags with pumped milk with my second, which I ended up donating because we had so few opportunities to actually give the baby a bottle. My husband worked long hours, we didn't have a budget for hiring a babysitter and going out often, and the few times we did go out, the baby wouldn't take the bottle anyway!

With my third, I resolved to pump for donation and, again, so we could leave him with a sitter, and that time I found even less opportunity and motivation to pump and ended up not putting much aside. He did get some bottles of expressed milk as a newborn, but after a few months, he, too, no longer took a bottle.

So, this time, I vowed I would find a way. One of the biggest difficulties many women have with breastfeeding is the feeling of being "tied" to the baby. You can never go out without the baby because you have to feed him. It's frustrating. Pumping and storing milk toward this eventuality can help. I bought myself a Hygeia EnJoye double electric pump, revived my hand expression techniques, and promised myself and my baby that I would find one time a day to pump and that he would get bottles often enough that we could leave him with a sitter and go out.

Now, obviously the situation is different if you work outside the home and are away from your baby on a regular basis. In that case, the baby is receiving bottles almost every day, and you're pumping instead of feeding during the time you're away from baby. That's not to say it's easy! Just different.

Here are tips for pumping/expressing milk when you stay at home with baby!

• Pick a time of day when you're pretty sure you'll be able to take 15 to 20 minutes to express milk on a nearly daily basis. Many women have more luck pumping first thing in the morning, so if that's an option, it may be a good choice. I tend to pump in the afternoon, but that's just easier for me because we're not rushing to get out the door.
• You may not need a fancy electric pump if you're only pumping once a day. Hand expression can be very effective for many women (myself included). You may also want to try a manual pump, which generally run $30 to $50, rather than a pricey electric pump. Check out my video on hand expression (NSFW) if you're not sure how to do it.

• You can start pumping as soon as your baby is born, if you want, but wait to introduce the bottle until breastfeeding is established, usually around 3 to 4 weeks of age.
• Give the baby a bottle at least every other day or so. This is the mistake we made with both baby #2 and baby #3: If you don't keep giving a bottle, the baby will forget how to use it or will simply refuse to take it, preferring your breast (understandably so). Have someone else give a bottle when the opportunity arises. I had my 7-year-old feed the baby one evening while I made dinner, for example. Baby may not take a bottle from mom but might from someone else. I did manage to give him a bottle myself the other night, but it sure felt weird to me!

• If you have trouble producing for the pump, or you have trouble finding a time between feedings to pump, you can try pumping while you nurse. Latch baby on one side and use the pump on the other side simultaneously. I find this to be extremely effective. Your baby will achieve the letdown for you, and you don't have to keep baby waiting to eat while you pump! It's a win-win. It is, admittedly, somewhat awkward, though, and it may take a few tries to get the hang of it. You can also use this method to help your body "learn" to respond to the pump if you're having difficulty getting letdown for the pump alone, and you can use it to help increase your supply if you're having supply problems.

• Massage and do breast compressions while you pump. If you are pumping just one side, or you have a hands-free pumping bra (highly recommended if you're double-pumping), use a free hand to compress and massage the breast while you pump. Find the full ducts and put pressure there to push the milk forward. This can greatly increase the amount you extract. I find using a combination of pumping and hand expression yields the highest volume in the shortest time for me. Milk removal is the trigger for milk production, so the more you remove, the more you'll produce!
• Remember that your supply will adjust to the demand. You can pump extra and have enough to feed your baby, but only if you pump consistently to tell your body you need that extra milk.
• At first, you may find it difficult to express a large volume of milk. Pump as much as you can, then keep pumping for a few minutes after you've "run dry" to let your body know you want it to make more milk. You should find your milk volume increasing if you pump daily. Be sure you are hydrated!

Milk Donation

If you find you are expressing considerably more milk than you need, even after giving a bottle every couple of days, you can use that excess milk to help another baby in need, either by donating through the Human Milk Banking Association of North America (HMBANA), which provides donor milk to babies in the NICU, or through a private milk sharing arrangement. You can find local-to-you mothers in need of donor milk by visiting Eats on Feets, Human Milk 4 Human Babies, or Milkshare.

Private, mother-to-mother milk sharing is controversial and not regulated or endorsed by the FDA, but it is legal and completely up to you and your milk recipient whether you want to enter into such an arrangement. Milk donors typically do not charge recipients for their milk but may ask the recipient to cover costs such as storage bags and shipping (if applicable). Milk donation is totally voluntary. Some recipients may ask that you be screened for diseases that can be transmitted through breast milk (a simple blood test). As a donor, you are doing a great favor to a baby and mother in need, but you also have a responsibility to ensure that your milk is safe for another baby to drink, meaning you should use best practices in expressing and storing your milk to ensure it is not contaminated or soured.

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.