Frozen Breast Milk (Getty Images)
Thanks to the Internet, women who produce an abundant supply of
breast milk and those in need of it for their babies have more
opportunities than ever to connect. But a first-of-its-kind study finds
high levels of harmful bacteria and contamination in breast milk
purchased via the Web.
Researchers' analysis of 100 samples of
breast milk bought on a public milk-sharing website found three in four
samples contained either high levels of bacterial growth overall or
contained disease-causing bacteria, including fecal contamination.
findings were likely the result of poor hygiene during milk collection,
the use of either unclean containers or unsanitary breast milk pump
parts, or compromised shipping practices, says epidemiologist Sarah
Keim, lead author of the study in November's Pediatrics, published online today.
Nineteen percent of sellers did not include dry ice or another cooling method when shipping, according to the study.
is unknown exactly how common purchasing breast milk online is, but a
soon-to-be published journal article by Keim found 13,000 postings on
U.S. milk sharing websites in 2011.
It is "totally normal" for
there to be certain bacteria in human breast milk, says Keim, a
principal investigator with the Center for Biobehavioral Health at
Nationwide Children's Hospital in Columbus, Ohio. Some are "very
important and healthy for babies and the development of their immune
system and digestive system," she says.
This study focused on
bacteria which "are generally pretty harmless as long as they don't grow
out of control" but have also been associated with illnesses in infants
linked to contaminated milk, including staphylococcus and
streptococcus, says Keim. It also focused on bacteria associated with
disease even at low levels, such as salmonella and E. coli.
compared the online-purchased breast milk samples to samples of
unpasteurized breast milk donated to a non-profit milk bank.
Twelve such banks throughout the U.S. follow strict guidelines set by the Human Milk Banking Association of North America and provide pasteurized milk from carefully screened donors to fragile
and premature infants, primarily in hospitals. Pasteurization kills the
harmful bacteria before the milk reaches an infant.
In all the
samples analyzed, the Web-purchased milk had higher bacteria counts and
were more likely to contain disease-related types of bacteria, even
though the donated milk from the milk banks had yet to be pasteurized:
72% had any detectable gram-negative bacteria, which are associated
with bloodstream infections, wound or surgical site infections,
meningitis and fecal contamination vs. 35% of milk bank samples
-- 63% tested positive for staphylococcus vs. 25% of milk bank samples
-- 36% tested positive for streptococcus vs. 4% of milk bank samples
-- 3% were contaminated with salmonella vs. none of the milk bank samples.
of the samples tested negative for HIV, says Keim, but the laboratory
analysis to determine "the authenticity" of the breast milk is just
beginning, she says, adding: "We're a little suspicious of some of the
"This study confirms what people have suspected in terms of
online milk purchases," says Anne Eglash, a family medicine physician
with University of Wisconsin Health in Mt. Horeb and a co-founder of the
Academy of Breastfeeding Medicine. She was not involved in the new
"You don't know what you're getting, you don't know the
quality, how honest people are about how old the milk is, and so many
other issues. It's important to realize that this may not be the safest
way to get breast milk when you don't have enough," she says.
Eglash, co-medical director of the still-in-development Mother's Milk
Bank of the Western Great Lakes, cautions against "throwing the baby out
with the bathwater" when it comes to the sharing of raw, unpasteurized
human breast milk between lactating women and those who cannot, for
medical or other reasons, provide their own milk for their healthy,
"I don't think the message should be that
women should never share milk, but that this behavior of buying it on
the Web from someone you don't know should not happen," she says. Eglash
emphasizes that "you don't want unpasteurized milk that has various
bacteria going to an infant whose immune system is vulnerable," but
says there are safe ways to share human breast milk with healthy infants
who are not your own, as well as pasteurize it at home.
and Drug Administration warns against feeding babies breast milk
acquired directly from individuals or through the Internet, citing
safety concerns; the American Academy of Pediatrics discourages feeding
preterm infants human breast milk from unscreened donors.
author of the new study, says her findings "may not apply to situations
where milk is shared among friends or relatives or donated rather than
sold. The potential risks of those situations are less well understood."