Carrie Arnold charts the history of donated breast milk in the US.
The diarrhoea struck every summer like clockwork. Although people of all ages in the city of Boston were affected, it was most likely to affect babies, and most likely to kill them, too. In the days before home refrigerators, the summer heat made food spoil faster, especially cow’s milk, which was popular for children whose mothers couldn’t produce enough breast milk. To help save the babies of Boston, the Floating Hospital for Children launched North America’s first milk bank in 1911.
Just two years earlier, the world had welcomed the first milk bank, in Vienna, Austria. Of course, giving a baby another woman’s milk had been going on since the dawn of time. Friends or relatives would spontaneously breastfeed another woman’s child if the mother wasn’t around. Other times, families would hire wet nurses or use enslaved women to feed their children. Few breast milk alternatives existed, other than milk from cows or other animals.
In 1914, “donor banked milk” entered the medical literature when a physician noted that sick children “do very much better if they are fed wholly or in part on human milk”. This marked the shift of donor breast milk from being simply a practical source of nourishment to being a medical food. The first milk banks were associated with hospitals, and users of banked milk needed to be close by since pasteurisation and freezing weren’t possible at the time. Without the widespread use of electric breast pumps, donors needed to either express their milk by hand or collect what dripped out of one breast while the infant was feeding on the other.
By the 1980s, the number of milk banks in North America had grown dramatically, according to the Human Milk Banking Association of North America (HMBANA). But as researchers realised that HIV could be transmitted through breast milk, most banks shut their doors. The increase in specialty infant formulas further contributed to the decline, and by the early 1990s only a handful of milk banks were left.
However, improvements in medical technology meant that more premature infants were surviving, so the need for banked donor milk began to rise once again. Better pathogen screening and pasteurisation processes assuaged worries about contaminated milk, and by 2011, 133 US hospitals were using pasteurised donor milk as a treatment for extremely-low-birthweight infants whose mothers’ own milk wasn’t available.
With the cultural emphasis now on ‘wholesome’ or ‘natural’ foods, the use of donor human milk continues to rise as parents turn against infant formula. A surge in research showing human milk has tremendous medical benefits, especially for preemies, is also driving this expansion. Today, HMBANA operates 19 milk banks in North America, with another nine in development.
“We are seeing communities recognise why breastfeeding is so important,” says John Honaman, Executive Director of HMBANA. “Being concerned about the public health of your community means that local moms are meeting local needs, and we find that the best way to do that is with a local mothers’ milk bank.”