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The ethics of donating breast milk
- russnewcomer 11y agoI have a seven month old, and my wife has shared bagged milk that she pumped before we figured out that he can't eat it because he seems to be MSPI. The hardest part about infant nutrition is that passing on knowledge about it isn't a part of modern American culture, and so when we had our son, we felt we had to do a lot of reading and research to figure out what was the best thing to do. And it's tragic, although understandable from a certain perspective, that a significantly lower portion of [statistically speaking] lower-income African American women do not plan to breastfeed. Tragic solely in the cost savings that it could be for them that could help them slowly make their way out of poverty. (Yes, yes, structural societal issues aside, I mean for them individually). It also appears pretty true that almost anything involving infants, birth, and the fuzziness of medical ethics provokes strong reactions from those involved. Hopefully, the focus will remain on doing the best thing, and less on doing the thing that people yell the most about.
- athenot 11y agoLower-income women are also forced to work very soon after birth (at least in the US where there is no guaranteed maternity benefits), in jobs that forbid breastfeeding. Maybe it's because I'm a dad, but I would have no problem if the bank teller happened to have a baby latched onto her breast while she was processing my deposit. Many office jobs would not be significantly impaired if a mom were to bring in her infant. I think it's sad that we've constructed a society that has become very hostile to children (and elderly but that's a topic for a different day). Contrast with rural Asian cultures where you see babies strapped to the backs of their moms while they are in the rice fields or conducting commerce. If anything, carrying a child around during work in those conditions is "more inconvenient" than in our modern places of work.
- pavel_lishin 11y ago> I have a seven month old, and my wife has shared bagged milk that she pumped before we figured out that he can't eat it because he seems to be MSPI. A very cursory google search tells me that MSPI only appears to be related to soy and cow's milk. Am I googling wrongly?
- russnewcomer 11y agoNot googling wrongly at all. Just missing that the proteins that the mother ingests make their way into the breast milk. Therefore, when my wife ate dairy/soy then pumped and bagged the milk, it is no longer usable for our son since it has the proteins from her consumption in it.
- pavel_lishin 11y agoOh, wow - so if she wants to breastfeed, she basically has to avoid soy and dairy? New dumb startup idea: match women like your wife with women who are lactose/soy intolerant (but whose babies aren't), and do a milk swap!
- russnewcomer 11y agoYeah. It's really kind of torturous to try to plan meals (no cheese, and the amount of packaged food we can eat goes waaaaay down), or figure out what she could possibly eat when we go out (especially if we are somewhere longer than planned and need to eat before getting home, that's terrible.). There are informal milk swaps, but part of the deal is that the way the biology works, it's better for the baby to have their own mother's milk ( if you're giving another mother's milk, it's statistically not much different than formula [to anyone reading, I know this is a controversial statement simplifying a complex issue]).
- patorjk 11y agoMy wife had a Caesarean section and was unable to produce milk. She went out and filled our freezer with some milk a friend donated her. I went along with it since I knew it was healthier than formula and didn't want my son missing out on any needed nutrients. However, we definitely got some strange looks from family and friends, with many people thinking it was gross. Hopefully its less weird in the future.
- anon4 11y agoIf people are okay with donating blood, I don't see what's so strange with donating milk. Maybe try explaining it from that angle.
- quesera 11y agoThe American fear of boobs is such a bizarre thing. We will happily artificially impregnate cows and pump them til they're dry to extract an inferior product, but cower in fear of the free, natural, superior option. We've been lied to for decades, and our too-smart-for-that-malarkey grandmothers are dead. This is a good addition to the what-will-future-generations-think-we-were-stupid-about lists.
- niix 11y agoI'm not sure when "weird" became the stigma around feeding baby, but its unfortunate. My wife and I have a 3 month old, and if our baby is hungry - she breast feeds him. (Mind you she is very conservative about the whole process). Its amazing the people that give strange looks in a restaurant, after all everyone else is eating. Why can't our son?
- celticninja 11y agoThe one issue I have with the article was the mention of concern that it was the use of formula that led to the death of the child. All things being equal, and in this instance they were twins, the formula alone was not to blame. Breastmilk is better than formula but formula beats no food at all or too little to sustain a child. This sort of thinking (from the article) actually makes things harder for new mums who can feel pressure to breastfeed and avoid formula. Breastfeeding is not easy nor is it always possible. The whole article could have made the same poi t without blaming formula for contributing to the death of the infant.
- thearn4 11y agoNew first time father of a 3 month old. It's really taken me by surprise how much guilt is thrown at women who either have to or choose to supplement breast milk with some formula. In our case, my wife cannot produce enough to cover him 100%, so we supplement. And he's growing well and extremely healthy so far (shrug). I guess this form of "mommy guilt" is well in line with the trend of every person you meet having their own opinion about every aspect of child raising. Where I'm really starting to think that, outside of the advice of your pediatrician (who should never be ignored), most of it really does not matter at all.
- quesera 11y agoIt depends on your circles. The guilt is misdirected frustration with uninformed mothers who think formula is good enough, or frustration with the eh-too-hard-lets-order-something-cute-from-mini-boden set. But in most circles, formula is extremely common. In other cultures, if mom is unable to produce enough milk, there were other moms to help. That's too weird for us now, so it's formula or some other second rate substitution.
- russnewcomer 11y agoFirst time father with a seven month old here. I observe there is frequently more attachment to an idea (don't formula feed!) than there is the ideal (baby should be as healthy as possible). But I also observe that part of that is driven (at least, in America, where you seem to also be located) by the conceptual societal framework that has led kids to understand you should only be with people who don't criticize you, and my wife and I heard from several people while she was pregnant that we 'need to find our tribe,' where we try to exclusively spend our social time in a sub-group of people that share our philosophies on child-rearing and related fields. I reject this line of thinking as needlessly polarizing, and I think that if you only are with your tribe, you're going to be messing up your kid the same way everyone else in that tribe messes up their kids (and I also observe that every generation of Americans since the 'Greatest Generation' complains about how their parents raised them, I don't expect my children's generation to be any different)
- austenallred 11y agoI actually have a friend who is in the latter stages of importing donated breast milk from Cambodia. At first, when he told me about it, I was a little bit disgusted, but the more I think about it the more I realize it could be a net win for everyone. He described it as: 1. Breast milk is, hands down, the best nutrition a baby can have. Babies in the NICU need it, there's a massive shortage, and we can't match its nutritional value with formula, period. 2. A woman will continue producing breast milk as long as she continues either feeding or pumping, even if her child is too old. 3. There's a desperate shortage in the US, because people don't want to take the time to come to the donation facility for the blood tests, and those are very expensive to do by mail. Basically, what he's doing is paying women in Cambodia for their breast milk. A woman in Cambodia will donate her milk for a few dollars a day, and it completely changes her lifestyle. Women are willing to come to their facilities to be tested, and are willing to go through background checks that make sure they're not neglecting their in doing so. They can then export the breast milk to places that have shortages (like the US), and make a profit. Domestically it's regulated by the FDA like a foodstuff (beans or corn), and it can be homogenized just like cow's milk. It takes a while to get over the weird factor, but it seems like economically it's a win-win. I'd be curious to see if anyone else would consider this exploitative. I've gone back and forth.
- JoeAltmaier 11y agoI'm not so much struck by the exploitative idea (every American thinks that anything they don't want to do, but somebody else is willing to do, is exploitation) but instead by the American attitude of buy-it-instead-of-making-it. Seems nothing is immune to commerce.
- quesera 11y agoSome women have extreme difficulty producing milk. It's a real problem. In my anecdotal observation, however, it's far more common to decide against it due to discomfort or inconvenience, often prompted by an initial difficulty getting started. We just aren't taught how to do it any more. We have formula for that.
- legulere 11y agoI'm wondering wether pasteurized human milk really provides that much advantage over formula. Isn't it the bacteria that's providing all the benefits for the immune system?
- kchoudhu 11y agoMy daughter was born via c-section, so there was a short period between her birth and my wife's milk coming in when my wife was driven to tears by her inability to provide nutrition to the child. The coin has recently turned, however, with my wife now having a slight overproduction problem: after freezing the excess over the course of the month, there was literally no more room in our freezer for normal food. We'd love to see the excess used productively (she's literally pumping and dumping gallons of the stuff every week). Unfortunately, the litigious nature of US ensures that this is a non starter, as we are unable to find anyone willing to give us an assurance that we are free of liability if a child became ill after drinking my wife's milk.
- Mz 11y agoIn addition to women who can't produce enough: There are preemies who have difficulty latching on. Suckling at mom's breast is far more work for the baby than a bottle is -- again, for preemies or babies with health issues, this is a real problem. When I had minor issues with breast feeding, I was able to resolve them myself in spite of nurses being zero help. When someone close to me had trouble breastfeeding, I did not know the answer but was able to be emotionally supportive of her and helped her get over any guilt or bullshit social messages about how this should be easy and natural for both her and baby. She also was able to find solutions in spite of the stupid things people around her were saying. I suspect this is easier for women in cultures where women have more babies on average and breastfeeding is more the norm. It is a situation where you have much better odds of being personally acquainted with someone who had the same issue and can tell you how to fix it. I was appalled by the really crappy attitudes I was surrounded by and the dearth of practical solutions. Perhaps importing breast milk makes that problem "worse", but you at least are able to feed your baby, which is actually the more important issue.
- pvaldes 11y agoBeware!. I can see some big problems here that have to be carefully managed. For some reason the article do not even mention that: "Despite the ban on persistent organochlorines (OCs) in most of the developed nations, their usage continued until recently in many Asian developing countries including Vietnam, for agricultural purposes and vector-borne disease eradication programs." "This result suggests recent usage of DDTs in both north and south Vietnam" (2004) "Analysis of infant exposure to DDTs via breast milk suggested that the daily intake rates are close to or above the threshold for adverse effects on children health" Source. http://www.sciencedirect.com/science/article/pii/S026974910300472X http://www.sciencedirect.com/science/article/pii/S0269749103...