Eats on Feets and the 4 Pillars of Safe Milksharing
My breastmilk days are long over to be clear; breastfeeding is a fond memory of a growingly distant past. I was blessed and lucky. I nursed my 4 babies well past the AAP's recommendation of breastfeeding for at least one year (at the time). I didn't have any problems that I can remember and I didn't need to express milk because I was able to stay at home. Milksharing was not on my radar at the time. I did cross-nurse someone else's baby though!
My initial interest in milksharing came from my work and passion as a birth doula. Unfortunately, I had clients who had feeding or supply issues for various reasons, and it was often a frustrating experience for them, and for me, to be offered formula as the only alternative, whether short term as the issues were being resolved, or long term in case of unresolvable issues. At the time, donor milk was not as available in the hospital for healthy term babies as it is now, and home birth midwives and birthing centers could usually only connect their own patients when there was a need.
In 2010, I met Shell Luttrell, a now retired traditional midwife from Phoenix, AZ. Shell had a local and active milksharing community called Eats on Feets, that used a Facebook Page as a way for people to connect. A very long and sprinkled with activism story short, the idea of having more communities like hers all over the world inspired many of us. It seems to me now that all it took was one evening of brainstorming and Eats on Feets Global, the grassroots milksharing network, was born. I set up the Oregon chapter and many other chapters that same night, and it quickly took off, growing to hundreds of members in a couple of days.
With the unexpected rapid growth of this network and the eagerness with which families were jumping on milksharing also came the questions about safety. How safe was it, really, when the milksharing happened outside of Shell's own direct midwifery community? People were asking questions about expressing, storing, shipping, feeding options, bacteria, screening, blood tests, mitigating diseases with pasteurization, and much more. We needed answers; parents needed answers.
For countless hours, Shell and I, with a handful of dedicated helpers, poured ourselves over the information available to us. We talked with scientists, doctors, and the researchers of the very studies that we were reading, and we quickly realized that we needed to make all this information more accessible. There was so much to read that we felt this was an impossible task for any, often sleep deprived, new parent to do, especially in acute need situations. We also wanted to make the information more easily available to medical, birth, and lactational professionals so that they could support community based breastmilk sharing and their clients or patients.
After many months of research, we finally created the Resource for the Informed Sharing of Human Milk. This resource is unique in its kind: It is a searchable database, containing current information and research on donor milk, milksharing, safety concerns, and informed choice processes. It is complete with full research papers, references, links, and official recommendations.
That said, while the database is extensive and relatively easy to navigate, we still needed something more accessible for families. It boiled down to this:
Informed choice
Donor screening
Safe handling
Home pasteurization if needed
These became the Four Pillars of Safe Breastmilk Sharing – milksharing that can be done safely on the community level, between informed families, with support from medical, birth, and lactational professionals.
Why is this so important? Human milk is an amazing substance. Fresh human milk contains thousands of distinct bioactive molecules that protect against infection and inflammation and contribute to immune maturation, organ development, and healthy microbial colonization. In every single drop. The inherent anti-microbial properties of freshly expressed breastmilk protect the milk from a significant increase in pathogens for up to 8 hours at room temperature under clean conditions. This is impressive and speaks to the remarkable power of human milk! Even after pasteurization, many of these benefits remain, providing crucial protection for babies in neonatal intensive care units.
Human milk is an amazing substance.
Most donors pump for their own baby and donate what they won't use. Some donate after a loss as a gift in memory of their baby; others had a baby in the NICU and started pumping early on, resulting in having more milk than their baby will ever take. In any event, proper screening and handling are important when using community-acquired donor milk to feed our tiny humans. Asking questions is encouraged from recipients as well as donors so they know how their milk will be used. Parents and legal guardians can easily do this with the 4 Pillars and the information on our website. It is solid, accessible, and even shareable in print form via downloads.
A lot has changed in the last 15 years, for sure. Today, most of my hospital clients have access to donor milk while still at the hospital. But when they get home, then what? Donor milk from the milk bank is expensive. Nowadays, I can offer an alternative to formula: I can talk to my clients about getting milk from someone else, even if just a small amount, and I can talk to them about this option prenatally so that they feel less stressed if they have a rough start.
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