Milk of human kindness
I have a freezer full of somebody else's milk. It's not just any kind of milk. It's breast milk, somebody else's bodily fluids, which I plan to feed to my baby. There's nothing wrong with that, is there?
The 'breast is best' brigade starts banging on about the benefits of mother's milk before the first wave of morning sickness. But the assumption is they're talking about the baby's own mother, not someone else who has stored her excess milk in a small plastic bag.
My younger daughter, Jessica, now four months old, is a rather large baby. She's also very hungry, and I'm struggling to keep up. I have nothing against formula milk; I gave it to my first child alongside breast milk. But the World Health Organisation says the next best thing after a mother's own milk is human breast milk 'from another source'. And I had another source; my friend Allie Burrows.
Until Allie's milk arrived, I'd been pumping at all hours of the day, mostly at 3am after getting up to feed my screaming baby. Could I sleep again? No, the fear that I wouldn't be able to express enough milk the next day kept me awake.
Like most women, I express milk for freedom and security. I want to know that if I leave my child for a few hours, someone will be able to feed her. My husband also gives Jessica a bottle each night, giving me time to sleep and them time to bond.
I wasn't sure how my husband would feel about feeding his daughter someone else's milk, so I decided to show him my haul.
'Look what I've got,' I said, flinging open the freezer door.
'Wow,' he said, at the sight of five bulging white bags. 'You've been busy.'
'They're not mine,' I confessed.
'Wow,' he repeated, this time with a pause, 'that's a bit weird.'
As it turns out, a growing number of women are doing the same thing, joining online forums to share their excess supply with needy others. Emma Kwasnica, who lives in Montreal, Canada, was part of the Eats on Feets milk sharing group before leaving to start her own network, Human Milk 4 Human Babies (HM4HB) in March this year.
'Everyone is pumping their milk, thinking the apocalypse is coming ... so they all have this stash in their freezer, and when the milk expires, they dump it,' she says.
Hong Kong has a HM4HB Facebook site, but it's among the less active of the 130 set up worldwide.
However, Hong Kong resident Claire Fraser didn't have to go online to find milk for new baby Jack. 'We were supplementing with formula, but his digestive system was underdeveloped due to him only being three to four weeks old,' she says. 'It was causing him so much gas, he couldn't sleep and was crying out with pain at night, so when Brooke [Holden, another friend] offered her surplus milk, I jumped at the chance. I knew her so I wasn't freaked out giving it to my son. I used Allie's later on.'
Yes, Allie; the same mother who helped me. Another friend, Joy Kwek, also offered milk, which my baby, Jessica, also eagerly drank. To date, she's had milk from three mothers, including her own.
You won't find many health professionals, if any, who are willing to expose themselves to litigation by promoting informal sharing, says Yvonne Heavyside, lactation consultant and founder of The Family Zone.
'The protocol is very much the use of screening, milk banking and pasteurisation,' Heavyside says. 'Having said that, as long as it's on an informal basis, between friends, then we certainly wouldn't discourage it. But we couldn't professionally encourage it.'
The Hong Kong branch of the international lactation support group La Leche League says it endorses the principle of 'human milk for human babies' but has reservations about the safety of informal sharing.
'The priority of La Leche League leaders is to help mothers explore ways to boost their own milk production,' says LLL counsellor Jenny Buck.
The most obvious risk of milk sharing is the potential for contagion, and among the diseases to consider are HIV, hepatitis B and C, syphilis, human T-lymphotropic virus, cytomegalovirus and tuberculosis. The US Food and Drug Administration (FDA) adds chemical contaminants to that list, including illegal and prescription drugs.
And if the milk isn't properly handled it could, like any type of milk, become contaminated and unsafe to drink, the FDA notes.
Milk donated to formal milk banks undergoes stringent testing. Strict rules apply to donors and when the milk is collected it's screened, pasteurised and tested again. There is some debate as to whether home pasteurisation methods are successful enough to eliminate the risk of disease.
Kwasnica, of HM4HB, says that despite the uncertainty, many women are choosing another mother's milk over formula milk. '[The mother] has done the research, and she's decided that human milk is species specific and it's probably the better thing to be feeding her baby than powdered bovine substance,' she says.
Research shows breast milk contains the right mix of nutrients for babies' physical and mental development, and offers greater protection against childhood illnesses. However, not all breast milk is equal, says paediatrician Dr Albert Tam Yat-cheung.
'Although there are many beneficial factors in breast milk that would help the baby, many of them, especially the cellular factors, are person specific. So it's your own mum's white cells, your own mum's lymphocytes and cells, that would be kept. If it's not your own mum's, the baby's immune system is going to push it out, take it as a foreign invader ... [so] it doesn't actually benefit the baby,' he says.
Tam reckons babies fed with milk from multiple mothers are unlikely to develop stronger immune systems.
'It's not very likely that the antibody profile would be very much different between different adults,' he says. 'Although theoretically if they did live in very different communities, it may be a little different, but if we're talking about a similar community, it may not be much different.'
So until a breast milk bank opens in Hong Kong, the only formal choice for mothers here is formula or milk from a trusted source. And it's up to each woman to weigh the benefits and risks of both.
Food for thought
Consider these questions when sharing milk:
Is there a risk of contamination from either breast milk or formula?
Do you trust your breast milk donor to give you full disclosure?
Are you comfortable asking for your donor's recent blood tests?
How much do you know about how the milk was pumped and stored?
Do you know whether your donor drinks, smokes or takes drugs?
For you, do the benefits of donated breast milk outweigh the risks?