I gave a talk  last week at the Women’s Economic Forum entitled What the Healthcare Future Requires (coming soon to Youtube).  This week it seems like every news article I come across reinforces the messages in that presentation.  Today it is the reminder to be skeptical.

This week most of the major newspapers featured a story discussing a research study, Microbial Contamination of Human Milk Purchased Via the Internet, which found high levels of bacteria in breast milk bought online.  The USA today article  includes a video.  Both the article and the video skim only the thinnest surface of the research and while seeming to give the reader ‘news’ provides very little information indeed. Some details beyond the headlines:

• A closer look at the study shows that the methods may have resulted in the samples at the highest risk for contamination. The authors bought milk from sellers after communication by email only.  They (the researchers) did not talk further with women who asked about the receiving infant or wanted to talk to by phone or in person and shipments were received to a rented mail box. As a result, the milk purchased may reflect the worst not the average, of breast milk sold online.
• Bacteria is present in all breast milk and more and more research shows this bacteria is necessary for creating a healthy gut and healthy immune system in babies.  The media coverage is not clear about whether or how much of  the bacteria present was this ‘good’ bacteria.
• The authors compare purchased milk to milk donated to a milk bank after a screening and selection process, and found much lower levels of bacteria. It is not compared to breast milk a woman might pump and feed her own baby or to infant formula (powdered formula is not sterile).
• Milk donated to milk banks but this is not a realistic alternative for these women. Donated milk is in short supply, expensive and usually prioritized for the smallest, sickest babies in neonatal intensive care units.
• Pasteurization, which can be done at home, kills bacteria and viruses in donated milk. The media coverage does not mention whether the buyers pasteurize milk once it is received thus reducing the risk to babies. In fact there was no information about online buyers at all in the three articles I read.
• Much of the media coverage includes quotes from professionals that discourage milk sharing. There are milk sharing alternatives to buying breast milk online which, in the best of circumstances, probably presents the most unknowns to buyers. (Not so different from buying anything else on the internet.)
• Ultimately women are buying milk online because they want to provide human milk to their human baby, but they are unable to fulfill that need with their own milk.
• This study reveals an unmet need for human milk for human babies and perhaps points to a need for more regulation but it definitely highlights a glaring gap in directions, information, tools and resources available both for donors and purchasers of human milk.

For more information see the excellent discussion at the Breastfeeding Medicine website. http://bfmed.wordpress.com/2013/10/21/online-milk-sales-beyond-buyer-beware/