Christine Bartels has spent more than $25,000 to feed breast milk to her
baby.
What's free for most moms has come at a high cost for the 44-year-old Palo
Alto mother, who wanted her adopted son, Milo, to have the undisputed health
benefits of breast milk. So she paid the Mothers' Milk Bank in San Jose $3 an
ounce for donated breast milk.
That's nearly $100 a day.
A growing number of parents are going to great lengths to feed their babies
breast milk, buying it from licensed banks, accepting it from strangers and
even purchasing it online.
"I decided this was one of my top priorities. I cut back on fancy baby
toys and fancy baby clothes," said Bartels, a single mother and analyst
for Google Inc. who fed her 10-month-old nothing but breast milk for his first
nine months, three months longer than the minimum doctors recommend. "My
general sense is why mess with nature? It's the optimal nutrition."
Doctors are alarmed, however, that parents who are trying to help their
babies could actually be threatening their health by using unscreened milk,
whether from the Internet or friends, that can transmit diseases including
AIDS.
The American Academy of Pediatrics supports the use of banked milk, as does
La Leche League International, the world's largest breast-feeding resource.
For mothers who can't breast-feed or afford banked milk, the group advises
working with a doctor who can help screen donors.
Despite advances in infant formula, the academy calls breast milk
"uniquely superior for infant feeding," citing both immunological
and developmental benefits. Doctors recommend against cow's milk until age 1,
because it is difficult to digest and doesn't meet babies' nutritional needs.
An increasing amount of research shows that breast milk lessens the risk or
severity of diseases, from bacterial meningitis to respiratory tract
infections to some viruses. And some studies suggest that it decreases the
risk of sudden infant death syndrome, diabetes, obesity and asthma.
Rise in demand
Demand for donated milk rose 28 percent last year at the Human Milk Banking
Association of North America, which operates nine banks in the United States,
from Delaware to Denver, and one in Canada.
Much of the 745,000 ounces the association shipped in 2005 was prescribed
for premature or otherwise ill infants, though parents of healthy babies who
are adopted or whose mothers can't breast-feed also can obtain prescriptions.
Up to 15 percent of mothers experience serious difficulties breast-feeding,
said Dr. Joan Meek, editor of the American Academy of Pediatrics' "New
Mother's Guide to Breastfeeding."
The banks -- including the 32-year-old nonprofit Mothers' Milk Bank in San
Jose -- charge a fee, typically about $3 an ounce, to cover their costs. By
contrast, powdered formula can cost as little as 10 cents an ounce.
The banks use questionnaires and blood tests to screen donors for diseases
that can be passed through breast milk, including HIV and hepatitis, and they
pasteurize the milk to eliminate possible bacterial contamination. And donors
must get written permission from their own doctors and their children's.
"We've exploded in demand," said Pauline Sakamoto, executive
director of the San Jose bank, which ships milk throughout the western United
States.
Donors, who use widely available breast pumps, may be able to produce 8
ounces at a time, while a baby can drink from 20 to more than 30 ounces a day.
Many donors are like Kelly Scribner, a 29-year-old paralegal from Hercules
who pumped breast milk at work in hopes her son, Logan, would take it from a
bottle. He refused, but she kept pumping to keep up her milk supply.
"I kept sticking it in the freezer in hopes one day a lightbulb would
go off in his head and he'd take it," Scribner said of her son, now 3.
"We literally couldn't keep food in there anymore."
Scribner found the San Jose bank, passed the screening and shipped a cooler
full of 400 ounces of milk frozen in 6-ounce bags, all with no compensation.
Experiment with formula
Susanna Benningfield, 40, of San Francisco -- who lost her own milk supply
when doctors switched her infant son, Max, to fortified formula when he was
failing to gain weight -- is a grateful milk bank customer.
"Once we switched him to formula, he was a miserable wreck," she
said. "He couldn't sleep -- he had red circles under his eyes and would
wake up racked in pain."
Benningfield lobbied successfully to return Max to breast milk.
"It was like a miracle. Within 48 hours, I had my happy baby
back," she said.
One year and thousands of dollars later, Benningfield is still feeding
17-month-old Max breast milk to help combat continuing gastrointestinal
problems. Doctors recommend breast-feeding for at least one year.
She is also battling her insurance company to pick up the $2,500 monthly
bill. While some insurers cover breast milk, often for premature babies,
others argue that breast milk is simply nutrition, which is not covered.
While the disease-fighting benefits are greater if a mother breast-feeds
her own baby, because she passes on antibodies to germs to which both have
been exposed, Meek said some immunologic benefits remain in donor milk, even
after pasteurization. She said doctors aren't particularly concerned about
allergens passing through milk, unless there's a history of severe allergies
in the baby's family.
Breast milk is so in vogue that a for-profit Southern California company,
Prolacta Bioscience of Monrovia (Los Angeles County), began marketing it this
year to neonatal intensive care units, at about $35 an ounce. Prolacta, which
does not sell to the public, offers fortified breast milk, pinpoints the
caloric content of its milk and provides additional screening for drugs. It
receives milk from donors at banks it has established, including one scheduled
to open in Santa Rosa.
Unsafe sources
Parents who can't afford milk bank prices and get unscreened milk from
friends or via the Internet are raising red flags with doctors who say
informally sharing milk is just too risky. In addition to disease, alcohol and
some legal and illegal drugs can be passed along through breast milk.
"Unfortunately, this has been somewhat the result of the improved
education we've provided to moms about the benefits of breast-feeding,"
said Meek, an Orlando pediatrician. "For moms who can't (breast-feed) or
who can't produce enough milk or choose not to, it does put them in somewhat
of a difficult situation."
But "there's just no way of knowing and too much potential risk
involved" in getting milk from a stranger, Meek said. "You don't
even necessarily know that you're getting human milk."
Experts also worry that mothers could sell their milk to the detriment of
their own babies.
Breast milk can be found for sale on the Web for $1 to $2 an ounce, though
mainstream sites such as Craigslist prohibit the sale of bodily fluids,
including milk.
In California, anyone storing or shipping breast milk is required to be
licensed as a tissue bank or face misdemeanor charges. New York is the only
other state that regulates breast milk.
One Web site with regular traffic, www.radioball.net,
started when a Massachusetts blogger jokingly offered last year to sell his
wife's breast milk.
"I'm somewhere between surprised and horrified. ... I essentially took
over the market for breast milk," said Brendan Melican of Worcester,
Mass., who never sold the milk but has allowed other sellers to use his site.
"It's capitalism at its best, and its worst."
There are more sellers than buyers on Melican's site, and it's unclear how
many people are buying unscreened milk. Three sellers contacted by The
Chronicle said they hadn't found a serious taker.
A fourth, single mother Brandi Archer, 19, of Greensboro, N.C., said she
changed her mind after being contacted by three men who didn't seem to have
babies. Sellers routinely advertise "no perverts." She did also hear
from two women who said they wanted milk for their children.
But "they didn't ask me if I smoke, if I drink, if I'm a drug addict,
if I had any communicable diseases. That got me a little worried," said
Archer, who had considered earning some cash as she weaned her 1-year-old.
"For all they know, I could be some crackhead looking to score to get my
next fix. That's when I decided this isn't right."
Reaching out
Other mothers argue there are safe ways to share breast milk, even with
strangers.
Jenn Connel of Paxton, Mass., started www.feedmybaby.com
when she was pregnant with her first son in 2003. Connel had undergone a
double mastectomy and desperately wanted to give her son breast milk.
She initially was soliciting monetary donations to pay for banked milk and
was surprised when women offered their milk, even more so when her doctor
recommended she take it and helped her set up a screening process modeled on
the methods used by milk banks. Connel even bought a pasteurizer.
"I felt if I didn't somehow make an effort to provide at least a small
amount of breast milk for my kids, I had failed as a mother," she said.
"This is how I recovered from my surgery. Dammit, I had cancer but I'm
not going to let it stop me from doing what's best for my kids."
Connel, who also gave her second son donated milk, estimates 50 women
throughout the country have shipped her donated milk on dry ice.
"If you're dedicated and interested in doing this safely, it can be
done," she said. "If you're going to do it stupidly, don't do it.
Feed your child formula."
Inspired by Connel's success, another Massachusetts mom started www.milkshare.com
last year to give women who want to share milk tips on doing it safely. Kelley
Faulkner, who has a congenital breast defect that causes a low milk supply, is
feeding her son breast milk from 20 donors.
The online trade in breast milk is an outgrowth of informal milk sharing
that has long existed among friends and relatives, dating back to wet nurses.
Helping a cancer patient
In a modern-day version, Fiona Wong of Emeryville agreed to donate milk to
Jeanine Ierulli three years ago after a mutual friend connected them when
Ierulli was diagnosed with neuroendocrine cancer. Ierulli wasn't allowed to
breast-feed her premature newborn son, John, while undergoing chemotherapy.
Wong, now 34, who was still breast-feeding her 1-year-old son, agreed to
pump milk for John every day for eight months, despite the fact that she had
never met Ierulli, who lived in Mill Valley.
"Being able to donate my breast milk, which I'm producing as I walk
and breathe, is awesome," Wong said. "It's something you produce for
free. Why wouldn't you want to share it?"
Ierulli died in August 2004 at age 44.
Her sister, Christine Colasurdo of San Francisco, said the gift of breast
milk helped alleviate Ierulli's suffering.
"It was important to her," Colasurdo said, "that someone is
thinking of you and understands your needs as a mom and is willing to go the
distance to help you with that instinctive need to feed your child."
E-mail Janine DeFao at jdefao@sfchronicle.com.