Previously I talked about how a shortage of human milk has led some mothers to purchase human milk from sellers who advertise over the Internet (see this blog Feb. 16, 2013). I pointed out that while milk obtained from milk banks affiliated with the Human Milk Banking Association of North America (HMBANA) is always pasteurized before it is distributed, unpasteurized human milk from unregulated Internet sites or from unscreened donors might pose a health risk to the infant. At the time, there was no evidence to support or deny the latter assertion.
Now there is. In a study just published in Pediatrics, researchers from Ohio State University ordered samples of human milk from individual sellers who advertised human milk for sale on two of the major Internet sites for milk sharing. For comparison, they also obtained samples of unpasteurized human milk donated to an HMBANA-affiliated milk bank. All samples were tested for bacteria and several viruses (HIV-1 and cytomegalovirus). 74% of the Internet milk samples (and 35% of the unpasteurized milk bank samples) were contaminated with pathogenic bacteria. No samples from either source were HIV-positive, but 21% of Internet samples and 5% of the milk bank samples contained evidence of cytomegalovirus contamination. In general, samples obtained over the Internet also contained higher mean bacterial counts than the milk bank samples.
The study clearly points out the potential risks involved in accepting unpasteurized human milk from unscreened donors who advertise over the Internet. Human milk banks affiliated with the HMBABA pasteurize all milk before it is distributed. In addition, the milk banks screen their donors carefully and instruct them in the proper shipping guidelines (milk is to be frozen, delivered overnight). In contrast, there was wide variability in how milk obtained from individual sellers over the Internet was shipped; over 10% of the milk samples took more than three days to arrive.
How many infants are put “at risk for negative outcomes”, as the authors so elegantly put it, by human milk purchased over the Internet is probably unknowable. Again, I say “buyer beware”.
Note: only the abstract of the research article is available for free; the full article is available for $12. I’d like to see all scientific research articles supported by grant funds available free of charge.