Don’t buy breast milk on the Internet, and other helpful tips

Last week was a bad week for breast milk. On Monday, news broke that the bulk of this “liquid gold” sold on the Internet was actually teeming with bacteria. In undercover sting mode, scientists bought and tested samples of breast milk from popular craigslist-like websites, and reported their findings in Pediatrics.  

Now that everyone has gotten over the fact that breast milk can be had for around $1.50 an ounce (and of course it can — welcome to the Internet), we can discuss whether it’s a good idea to feed your baby bodily fluids bought from anonymous strangers online. If you’re still wondering, I’ll make this short and sweet: No.

The results were, in a word, disgusting. Staphylococcus species and gram-negative bacteria were in the majority of the Internet milk samples. A little under half of the samples held coliforms, an indicator of fecal material. Salmonella species, a family that includes the bug that’s sickened nearly 340 people on the West Coast, flourished in three of the samples. “We were pretty surprised at how poor the quality was,” says study coauthor Sarah Keim of Nationwide Children’s Hospital in Columbus, Ohio.

Bacterial counts aside, buying breast milk online is a bad idea for many reasons. The milk could have come from a woman who was drunk or took drugs — legal or illegal — that harm babies. The milk might have been watered down, or spiked with formula, or produced by a cow. In fact, Keim and her colleagues are currently testing the samples for signs of authenticity. As the shameful melamine-in-formula scandal reminds us, some people are not above tampering with baby food to make money.

While I think it’s great that this study has called attention to what’s become a very risky online marketplace, I bristled at some of the trumped-up coverage. This study, like any other, comes with caveats that leave lots of room for more research. For instance:

The study is small. The researchers compared 101 samples of internet milk with 20 (unpasteurized) samples donated to a milk bank. While those numbers can point us in the right direction, they can’t offer the statistical heft needed to make sweeping conclusions.

In an effort to maintain anonymity, the study probably excluded sources of higher-quality milk. Fifty-seven sellers weren’t included in the study because they asked about the infant who needed the milk or wanted to talk on the phone. Some of these sellers might have been women who wanted to make sure their precious product didn’t wind up in the hands of a grown man with a breast milk fetish. I’m looking at you, Mr. Looking for Warm Sweet Milk Right from the Source. The researchers’ requests for small amounts of milk — not enough to feed a single baby for a day — might have raised some scrupulous moms’ suspicions.

The study’s subjects were colonies of bacteria, not babies. The scientists don’t know whether these Internet milk samples would have actually sickened an infant. Some of the bugs in the Staph and Strep families are fairly harmless bacteria that live on skin. Nursing babies get a healthy dose of these guys each time they latch on. My microbiologist friend (and fellow nursing mama) points out thatStaph lurks in the noses of 80 percent of people at one point or another. She says she would have been surprised if the study hadn’t found Staph in breast milk.

Keim says she’s unaware of any reported cases of babies getting sick from Internet-obtained milk (with the caveat that such illness may have been mild or unreported). Some of the bacteria, including Salmonella, can be dangerous and should be taken seriously, but the point is that not all bacteria are equally harmful.

Also, these tests didn’t have the resolution to identify and separate innocuous — or even beneficial — bugs from the bad. Breast milk is a haven for beneficial bacteria, and scientists are just starting to uncover all of the benefits of bacteria that move from mom to baby via milk.

The study focused on breast milk for sale. It’s not clear whether the results would hold for donated breast milk. I know women with freezers full of frozen milk, carefully collected to feed their own baby, who no longer need it. Many such women can’t donate it to a milk bank for various reasons but still want to give it to a baby in need. These sorts of donation arrangements — brokered by websites that allow donations but not selling — might be less risky, particularly if health information can be shared.

So where does this all leave us? Well, until we can effectively match people selling contaminated breast milk with grown men who want to play baby, the online breast milk marketplace is risky. And for mamas who express milk to feed their own child, the results are a good reminder on basic hygiene. Wash your breast pump parts and hands regularly, keep the milk cool and take the same precautions as you would for any food prep. But don’t think that the situation is completely sterile. Bacteria are involved in this process, and that’s mostly a good thing.

Of course, these tips are utterly unhelpful for women who want to feed their baby breast milk but have trouble making it themselves. And that’s a very tough spot to be in: New mothers repeatedly hear that “breast is best,” and some of the more militant breast feeding advocates liken formula to poison. But for all the talk of how natural and intuitive it’s supposed to be, breastfeeding can be really, really hard. All too often, women don’t get the help they need.

Nancy Mallin, a lactation consultant at the Breastfeeding Center for Greater Washington, says things have to change. “It shouldn’t be so hard,” she says. We need more support for new moms who are struggling with breastfeeding, and for those who can’t breastfeed, we need more regulated milk banks that provide safe milk from known donors. Because the solution here isn’t to police the quality of milk for sale on the Internet. It’s to stop women from having to turn there in the first place.