Online market in human breast milk puts infant health at risk, warn experts
Strict regulation is required to protect infant health, say University of London researchers writing in The BMJ
With no official breast milk banks in Hong Kong, the informal sharing of breast milk is not uncommon among local mothers. But while the nutritional benefits of breast milk for babies are widely documented, experts warn that the unregulated market in human breast milk is “dangerous” and “putting infant health at risk”.
In an editorial published yesterday in The BMJ (formerly known as the British Medical Journal), a team led by Sarah Steele, a lecturer at the Global Health, Policy and Innovation Unit at Queen Mary University London, said the informal sharing or selling of human breast milk has a high risk of communicable disease transmission, contamination and tampering.
Unlike donors at licensed milk banks, mothers who share or sell their milk informally are not required to undergo any serological screening, said the experts. This means that diseases such as hepatitis B and C, HIV, human T cell lymphotropic virus and syphilis may not be detected.
It is not known how big the unregulated online trade of breast milk is in Hong Kong, but in China a booming online trade has been previously reported. According to a CNN article in 2013, the market price is around 5,000 RMB for a month's supply of human milk. In contrast, a month's worth of conventional baby formula costs around 2,000 RMB in China.
Unlike Hong Kong, however, China does have official breast milk banks, the first launched in March 2013 at the Guangzhou Women and Children’s Medical Centre. All donors have to provide physical examination results before donating their breast milk, which is disinfected and frozen immediately.
“Milk bought online is far from an ideal alternative, exposing infants and other consumers to microbiological and chemical agents,” wrote Steele and colleagues. “Urgent action is required to make this market safer.”
The World Health Organisation recommends mothers exclusively breastfeed infants for the child’s first six months to achieve optimal growth, development and health. However, many new mothers find it difficult or are unable to breastfeed.
In addition to social pressure, the authors noted that this pushes some mothers to purchase human breast milk on the internet – a market that has been growing rapidly.
“What mothers, and many healthcare workers, don’t realise is that this market is dangerous, putting infant health at risk,” the experts said.
In countries such as the US where milk banks charge up to US$4 per 30 millilitres of breast milk, online milk is often the cheaper option because sellers can cut corners to save on costs such as pasteurisation, testing for disease and contamination, and the appropriate collection, storage and shipping of milk, said the authors.
They highlighted that previous research has shown milk purchased online has more bacterial growth due to lack of pasteurisation and poor shipping and storage. One study showed that only 9 out of 101 samples did not have bacterial growth.
Another study of 102 samples purchased online revealed that 25 per cent of milk samples were delivered with poor packaging and were no longer frozen, leading to more rapid bacterial growth and contamination.
Still other studies identified occasional contamination with bisphenol A and illicit drugs and tampering, including the addition of cow’s milk or water to increase volume.
The experts argued that healthcare workers should be offered training on the online market so they can provide good advice and offer safe alternatives to new mothers, especially those who experience problems or are unable to breastfeed. Advice on best practice, including storage and use of expressed milk should also be given.
They also called for professional bodies, institutions and trusts to provide accurate information, advice and guidance, and legal regulation to enforce the safe collection, processing and shipping of human breast milk.
