Milk Bank Myths

My story is part of the Blog carnival organised by World Milksharing Week, to celebrate World Milksharing Week 2013. Click here to read more stories about milksharing. If you’d like to participate too, please visit this page.

I was lucky enough to attend a behind the scenes tour at Mothers' Milk Bank of North Texas (MMBNT) in Fort Worth. MMBNT is one of 13 active milk banks in the US that are a part of the Human Milk Banking Association of North America (HMBANA). All HMBANA milk banks are non-profit organizations, meaning they do not make a profit from the milk they process.

MMBNT was opened in September 2004 and dispenses about 15,000 ounces of milk per month. They have 8 depot locations within the DFW metroplex, including a number of local hospitals. Eighteen depot locations are outside of the DFW area, including Miami and Las Vegas. Milk dropped there is shipped and processed in Fort Worth.

Milk being processed by lab techs

    I learned about several myths while at MMBNT from President Amy Vickers.
  • Myth: Milk banks charge a lot of money for milk.

    Truth: Milk banks typically charge the hospitals that they provide milk to a processing fee. It is often half of what it costs the milk bank to process the milk. Almost 70% of the milk that leaves MMBNT is charitable. Additionally, MMBNT has never had to turn away a baby with a medical need for pasteurized breastmilk.

  • Myth: Donor moms are responsible for blood tests.

    Truth: MMBNT pays for all testing done for moms to become donors. In addition to paying for tests, MMBNT will provide donor moms with containers to put milk into, and pay for boxes and shipping for the milk to arrive at its Fort Worth location if the donor mom doesn't have a depot nearby.

  • Myth: There is a minimum requirement required to donate.

    Truth: This one has an ounce of truth. While MMBNT does have a minimum of 100 ounces to donate, it is 100 ounces over the span you donate, not for the initial donation. Bereaved moms who wish to donate do not have a limit.

  • Myth: Milk banks won't give milk to babies who aren't in the NICU.

    Truth: Milk banks typically don't have milk to give to any infants other than those that are critically ill. Approximately 75% of the milk goes to medically fragile infants in the NICU and the remaining 25% goes to infants sick at home (waiting for organ or bone marrow transplants, etc). 30 ounces of breastmilk can feed 15 NICU babies. There's a medical advisory board (consisting of a neonatologist, social worker, and chaplain) that aids in the decision of who gets the milk available. They don't know how the milk is paid for so they are able to make an unbiased decision based on medical need.

  • Myth: All milk banks are the same.

    Truth: All milk banks are not the same. Banks operating under HMBANA are non-profit organizations and are primarily funded through grants and donations. There are several "milk banks" which are actually depots for a large for-profit company. The company pays the depots, but not the moms pumping the milk. If you decide to donate to a milk bank, be sure it is under the HMBANA umbrella so you know your milk is going to the most critically ill NICU babies.

Interested in learning more about Mothers' Milk Bank of North Texas? Visit their website, read about donor moms experiences on their blog, or interact at on their Facebook page.

Milk Sharing 101

Is your freezer starting to fill up with bags of breastmilk? Is your family running out of room for ice cream? Do you have milk in there that's nearing the end of its recommended 6 month shelf life? If any or all of these sound true, you may be curious about how to get your ice box back. So what do you do with all that milk? You have a couple of options when it comes to milk sharing.
  • Casual Sharing This includes mom-to-mom sites like Eats on Feets or Human Milk 4 Human Babies. Moms may also go through third parties such as doulas, midwives, or birth centers to get breastmilk for their babies. Some donors choose to sell their breastmilk while others give it away for free.

    Many recipients of breastmilk will ask the donor about her lifestyle: does she drink? If so, how often? What medications is she taking? How old is her baby? The recipient may even request blood test results from perspective donors. This is a form of donor screening and is recommended by all groups that facilitate peer to peer sharing.

    Visit Eats On Feets or Human Milk 4 Human Babies for more information. You can also contact your local birth center to see if they have a need for extra milk.

  • Human Milk Banking There seem to be a number of myths about human milk banking. Lets see if I can cover all the pertinent info. Milk banks that fall under the Human Milk Banking Association of North America (HMBANA) are non-profit organizations. They don't make money from the milk they received. They take milk received, pasteurize it, and give it to hospitals for NICU babies. NICU babies are often at risk for developing necrotizing enterocolitis (NEC) [Breastmilk and NEC].

    There are 17 HMBANA milk banks in the US & Canada, of which 14 are in US (2 in Texas!). Because the HMBANA milk banks are spread not found in every region, many are willing to send you shipping material and pay shipping costs for your breastmilk. There is a screening process for prospective donors to go through which includes blood work; however the milk bank pays for this as well. There are certain things that milk bank donors should not consume because the milk typically goes to babies in such a fragile state.

    Please note that there are several milk banks which are for profit, but do not readily state that on their website. In fact, these milk banks appear to be non-profit at first glance. They're quite misleading. If you are interested in donating to a human milk bank, visit HMBANA's website to find info about a non-profit human milk bank.

The choice to supplement with donor milk or formula is one that must be made carefully. Each choice has its pros and cons. Each mom must weigh the options for eah and make the best decision for her family. The decision for me was to supplement using donor milk. My experience with milk sharing has all been peer to peer. I knew my donor and trusted her completely. When I was the donor, I was open about medications taken, alcohol and coffee consumed, and diet. I would want someone to do the same for me.

Coming Full Circle: My Milksharing Experience

My story is part of the Blog carnival organised by World Milksharing Week, to celebrate World Milksharing Week 2013. Click here to read more stories about milksharing. If you’d like to participate too, please visit this page.

Monday was the first day of World Milksharing Week. This year's theme is Sharing Milk, Nurturing Community. The goal of World Milksharing Week is "Life and Love in Every Drop." In the event that a mother isn't able to produce enough milk for her baby, I believe that human donor milk should be the next option rather than a breastmilk substitute like formula.

My milk sharing experience began as a recipient. My son was 4 days old and had lost nearly a pound since birth. My doula was nursing her 9 month old and gave us some of her milk to help supplement while my milk volume increased. She was generous enough to share her milk with us for the first 4-5 weeks of his life as we wanted make sure he was gaining weight adequately. I remember crying while thanking her for her gift. While we could've used artificial baby milk to supplement, my son was a late term preemie (36w4d) and it was of utmost importance that he receive the benefits of breast milk, even if it wasn't MY breast milk. Our rough start story is here, if you're interested in reading it.

I returned to work at 12 weeks and pumped 3 times day to provide for my son. Since I had started pumping to increase my milk supply since E was 4 days old, I had quite a freezer stash built up already. I was a milk hoarder, I didn't want to give it up because of my past supply issues. Eventually, our freezer was full of breast milk and there was no room for any food. I wanted to donate to another mother and baby in need. I had been taking fenugreek supplements for months to help my supply, and knew this disqualified me from donating to my local milk bank.

My doula put me in touch with a mom of a newborn who had given birth by emergency c-section. She was having issues with her milk volume increasing. Her baby was hungry and not reacting well to formula. She was almost out of donor milk. I contacted her and we set up a time for her to come by and pick up the milk. I was very upfront with her about consuming caffeine, dairy, soy, fenugreek, and the occasional bit of alcohol while breastfeeding and pumping. She didn't mind and took all the milk I had stashed away over the months: a whopping 191 ounces. She had almost a gallon and a half of human breast milk for her baby! I received a very sweet and unexpected thank you note in the mail from her a few days later.

This is what 191.5 ounces of frozen breastmilk looks like

Since that initial donation, I have donated another 200-300 ounces in my almost 22 months of breastfeeding. Another large stash went to a friend's sister who was unable to produce milk for her son, and some to the same friend's sister-in-law who needed to occasionally supplement her twin girls. I have also donated to a local birth center that wanted to have some on hand for moms and babies in need.

I vividly remember my doula's reaction to my tearful thank you. It didn't seem like it was a big deal to her; she was simply giving me something she had a surplus of. I noticed myself having the same "it's no big deal" attitude when getting thanked by the recipients.I may have seemed like a life saver to them, but I was glad to have the freezer space back for ice cream. I had come full circle.

Donor Milk: The Documentary

Living in the metroplex certainly has it's perks. A main perk is that something is always going on. There are restaurants to try, sports teams to cheer on, and independent documentaries about breastmilk banking to see. Tonight, I was lucky enough to go see Donor Milk: The Documentary.

The film focuses on two milk donor/recipient pairs. Each of the donors had suffered the loss of a premature infant after birth and decided to donate her milk. One donated hers through casual milk sharing (aka not through a milk bank), while the other went through a milk bank. The film touched upon the importance of human milk being provided to premature NICU infants. There are visits to multiple Human Milk Banking Association of North America milk banks and their milk pasteurizing process is gone over. I thought that part was pretty cool and would've loved to see more about it.

Despite being pretty fascinated by the pasteurization, what I took away from watching the documentary and listening to the panel after the movie was the urgent need for donated breastmilk. A statistic in the movie said that HMBANA needs 8 million ounces of breastmilk for all the NICU preemies that weigh under 1700 grams [not 100% sure of the babies' weight, going from memory alone - please correct me if I'm wrong], while they collect 1 million ounces per year. The difference is staggering.

As someone who received donated breastmilk through casual sharing from my doula, I planned on "paying it forward" and donating my unused frozen milk. In the 15 months of nursing E, I've donated approximately 500 ounces of my own milk through casual sharing. I was interested in the milk bank, but after reading about their limitations (no alcohol, certain medications are restricted, no alcohol...), I backed away. I was having the occasional glass of wine or beer, but more importantly, was taking lots of fenugreek to help my supply. I felt I wouldn't pass their screenings and never bothered to pursue it.

My largest haul - 191.5 ounces

After tonight, I've changed my mind. These little babies need mom's milk, even if it's not from their own mom. I remember how I felt after having E 3.5 weeks early, combined with the stress of not being able to feed him - and he wasn't even in the NICU! If my doula hadn't suggested giving E her pumped milk, he would've been on formula. While that wasn't the worst thing in the world, it probably wouldn't have been ideal for a late preterm baby who missed almost a month of development in utero.

Whenever baby number two happens (and if you follow the blog on Facebook, you know that's on my mind), I will see if I can donate whatever pumped milk the baby doesn't drink to the milk bank. If the milk bank can't/won't take it, then I will give it to a mom in need via casual sharing.

If you're a pumping mom who has extra frozen milk and needs the freezer space back for ice cream, please contact your nearest milk bank. Even if they are out of state, many milk banks will provide you with shipping materials and reimburse you for the shipping costs.

And if Donor Milk: The Documentary premieres near you, please go see it. It really is an eye opener. I took away a lot from tonight. I cried, I learned, I empathized, and I loved on E more than usual when I got home.

Breastfeeding by the Numbers

A breakdown of our nursing relationship. Some of these numbers are approximations generated from careful mathematical equations and formulas.

14: number of ounces E lost in the first few days of life
65: number of ounces of donated milk we used
0: ounces of formula E has had
3: number of times I wanted to quit breastfeeding in the first month
3: number of lactation consultants we saw
2: number of times we battled thrush in the first month of life
4: E's age (in weeks) when we first nursed in public

1: number of nursing covers owned
4: E's (in months) when I first NIP without a cover
0: number of nursing covers used (occasionally)
3: number of times pumped during a 9 hour work day when E was exclusively breastfed
1: number of times pumped during a 24 hour day (currently)
3: number of pump parts and bottles purchased
2: number of hands free bras owned
450: number of times in nearly 1 year of working away from home that I went into my pumping "room" (glorified closet) and made my baby's breakfast and lunch
2: number of times I have been walked in on

6: number of pictures of me nursing floating around the internet
6: number of nursing bras owned
5: number of nursing tops owned
0: number of nursing tops used (currently)
3: number of plane trips (roundtrip) E has taken
4: number of states nursed in
1: number of countries nursed in
6: number of months I wanted to breastfeed (original goal)
6.5: E's age (in months) when solids were first introduced
4: number of teeth that have come in
12: number of months I wanted to breastfeed (modified goal)
0: number of ear infections E has had
500: number of ounces of milk donated

Number of months nursing: 14 and counting


Have you heard about this blog: Don't Have a Cow Man? A man is attempting to live on his wife's breastmilk alone for a month. His wife is a doula and childbirth educator and has a lot of milk stored in their freezer. They are unable to give it away (various reasons listed on their blog), but have not had any interested parties follow through so he is going to see how long he can live on breastmilk alone.
I don't agree with this for a number of reasons. While it may be a pretty cool experiment, I have a very hard time believing that they couldn't find anyone to take the milk. I've donated milk through HM4HB and Eats on Feets and there are a number of women who do not ask for medical records. I've dealt with moms who are okay with me taking the occasional analgesic or fenugreek. Most who use informal donor/recipient sites know that it is very much a "buyer beware" situation and to really trust the mom donating to them. That being said, a number of moms are really in need of milk for their babies and they are willing to pay to get it shipped to them.

 I also don't know how reliable the "experiment" is. If it were a true experiment, it would be randomized and be a little bit more formal. Anybody with an internet collection can create a blog (case in point: yours truly) and have their own little corner of the internet. Who knows if this is even true...?

This whole thing certainly isn't doing anything to normalize breastfeeding. It seems like it would be a great blurb on the news, "Man lives on his wife's breastmilk alone! Story at 11" and then the newscasters would shake their heads after the report as if to say, "Oh those crazy breastfeeders!" It may even deter someone away who is thinking about breastfeeding because it's just far enough out there. Breastmilk on a cut, sure. A grown man trying to survive on breastmilk alone for a month? I don't know if it's some kind of publicity stunt, but it really seems like a waste of milk considering there are infants who are in desperate need. I guess it's their milk and they can do what they want with it...

What are your thoughts on this whole thing?

Edit: The blog has been removed and the milk has since been donated to quadruplets in California. See more details here

Thank Yous

In my last entry, I wrote about giving my freezer stash to a new mom who was having supply issues. Today I received a thank you note in the mail from her. It was very sweet and unexpected. I might have gotten a little choked up. In the eight months since having to supplement with donor milk, the importance of the donation itself has gotten fuzzy.

Now that I think about it, I remember feeling overwhelmed with gratitude for my doula for sharing her milk with us. E was really not doing well weight wise and he was more dehydrated than we realized. A few hours after we started supplementing, he was having lots of wet and soiled diapers. I am pretty sure I cried out of relief and pure exhaustion.

The note that made me ferklempt

I got a text from her today saying that things are getting better and her supply is getting better. I really hope she doesn't have to struggle as much as I did. I am very blessed to have so much extra milk that I am able to help out another mom who is in the same boat that I once was. I'm glad to provide her with encouragement like I had during what the longest few weeks of my life. Without that support (and donor milk) I know I would not be where I am today with regards to nursing.

And Jamie, I'm sorry I never wrote you a thank you note. I hope you know that I am very thankful.

Sharing & Dates

It's really funny how everything comes full circle. This past weekend, I gave almost all my freezer stash to a mom having supply issues. Eight months ago, that mom was me. I was frustrated, tired, hormonal, and ready to give up. Luckily, I had an amazing support system and a doula who was nursing her son. We used her donor milk for the first few weeks of E's life to supplement while my supply got established. I was more than happy to "pay it forward" to a mom who was having almost the exact same issues I was. We had a lengthy phone conversation where she told me she was nursing and then pumping while someone else syringe fed her baby girl. That was my experience too.

This is what 191.5 ounces of frozen milk looks like. That's roughly a gallon and a half of breastmilk!!

I chose to use donated breastmilk over formula because I didn't want to fall into the formula trap. I knew I could easily become lazy and feed the baby formula rather than get up at 3:30 to nurse him. I was determined to breastfeed and my support system was determined to make sure I stayed on track during moments of weakness. Because E was three and a half weeks early, I felt that he would benefit more from donor milk than from formula. I realize my baby wasn't being fed my breastmilk, but he was getting antibodies and nutrients that were made from a human.

I think milk sharing is great. I have been on both ends of the equation. It's a great feeling to know that my milk is going to help out another baby. That being said, I do think it's important to get milk from a reliable source and full disclosure (antibiotics, caffeine, milk, etc.) on the part of a donor. Milk banks are wonderful, but can be expensive at $1-$2 an ounce. I completely understand why some moms turn to organizations like Eats on Feets and Human Milk 4 Human Babies.

On a lighter note, D and I got to go to dinner alone on Saturday night! We had a late date night, our first since March. It was really nice to get away just the two of us. We both got to eat a hot meal at the same time (a rarity these days) and be D and Naya, not Mom and Dad. Of course we talked about E for most of the night. We also decided to make it a point to go to have a date night once a month if possible. It's important to both of us to keep our relationship a priority while still being focused on raising our son. Now if we could only find a happy medium...

For those of you that have children, how do you balance between being mom and dad and husband and wife? Share your secrets!!

If you live in the DFW area and are free this Friday morning, the Big Pink Bus for Milk for Thought will be in the Mid-Cities area. It will be at Harris Methodist HEB hospital. Click on the link for more info.

My Breastfeeding Story

Since this year's World Breastfeeding Week theme is about sharing your experience, I thought I'd kick off the week by posting my story nursing E. To say it was difficult would be an understatement. I had been warned that breastfeeding was hard, but I didn't think it would be this hard.

E was born 3.5 weeks early at a hospital. I had an amazing labor and delivery experience (yes, I just called my labor experience amazing) and was able to bring E into this world naturally without any medical intervention. It was the best possible start for our nursing relationship. Somewhere after that things went awry.

Being naturally well endowed in the boob area, there was some initial difficulty in getting E to latch correctly. With the help of my fantastic doula Jamie , I was able to establish a good latch and E drank and fell asleep. A few hours later we moved to a postpartum room and I thought I was feeding E correctly. He had not had his first wet or soiled diaper, but the nurses assured me that this was not unusual. We woke every few hours to feed. E would feed and fall asleep.

A hospital lactation consultant came to the room the following morning and took a look at his chart. She then told me, "If you don't supplement your baby with formula he will not survive." She didn't explain what was going on at all. I told her I didn't want that and I would continue to wake him every few hours and feed him. She left the room very abruptly. She never asked to see him feed or offered help with my latch - just told me I was going to kill my baby. As a first time mom, I was petrified. My milk hadn't come in yet and I did not want to cause nipple confusion by introducing a bottle of formula.

I kept doing what I thought was best, which was putting him to the breast. We were discharged from the hospital the next day and brought him home. A few days later we were back at the hospital for a bilirubin test. Because he was a late term preemie, we had to get retested even though his levels were normal. The test was followed by a weighed feeding, which I did not know about. E had lost almost 10% of his weight in the few days since his birth! The LC gave me a nipple shield and also showed me how to feed him expressed breastmilk with a cup. I was beside myself at the fact that my child was hungry and had lost so much weight.

We called Jamie on the way home and she came over later that day. She brought with her a general plan of action and some of her own expressed milk. In the meanwhile, my milk had come in and I was engorged and sore. My husband had rented a hospital grade pump for me and had just brought it home.

The three of us (with the help of some of Jamie's doula and lactation savvy friends) came up with a plan. I would nurse E every 1 to 2 hours, waking him up if necessary, and then I would pump milk using the rented pump. Meanwhile, my mom (who had arrived from out of state) or my husband would syringe feed E with either my or Jamie's expressed milk. We would do this after every feed. In case you have never been around a newborn or have forgotten their schedule, they eat every 2 hours. Their stomach is the size of a marble and empties frequently.

Thus began our routine for the longest few weeks of my life. I would nurse E, then pump while he received expressed breast milk by syringe. We did this after every feeding. Every two hours. All day and night. I wanted to give up. I was sleep deprived, hormonal, and felt betrayed by my body. At least twice I told my husband I wasn't doing it anymore and to go get formula from the store.

One breakdown was worse than the other. It happened two days before Christmas. D called every local lactation consultant he could get a hold of. Some weren't available, some never called him back. Finally one was available. She came to our house and she helped me so much more than the others I had seen. She showed me the side lying position which helped with the overnight feedings - this was a game changer for me! She showed me different holds and what would work for me and how to do them with my Boppy. She was an angel. What helped the most was her showing me how to nurse in my home with my things. This wasn't an office visit, this was my couch, my bed, my stuff.

Things got a little easier after that. E was putting on weight like a champ, about a pound in 10 days at one point. Right around his one month birthday, we cut down the amount of supplements from after every feed to 3 times a day. At about 5 weeks we were able to stop supplementing all together. He received only breastmilk (mine or Jamie's) this entire time.

It was as if someone flipped a light switch at 6 weeks. It just got incredibly easier. I felt comfortable enough to nurse E in public with a coverup. We hit another rough patch when I came down with a case of thrush. E seemed fine, but I was in a world of pain when we would nurse. We made our way through that with the help of gentian violet.

E is now almost 8 months old and loves solid food. He still drinks milk, but rarely from a bottle as he prefers to nurse. It saddens me to think that we may be in the twilight of our nursing relationship. I worked so very hard to get here that I don't want it to end. I also miss the time we have together since I work full time outside the home. I don't mind all the feedings, even the middle of the night ones (thanks to the side lying position). it gives a chance to love on my baby boy.

So there you have it. That's what we went through to get to where we are today. I could not have done it without the support of my doula Jamie, my mother, and my incredible husband who knew not to stop when I said when. Looking back, a lot could have been done differently. It was a learning experience. All I can take away from everything was what to do differently for number two. I still feel physically ill when I think back to how terrible the first few days of E's life were and I think I always will. Writing all this down and sharing it in such a public way has been extremely cathartic.

This entire experience has made me become a "lactivist". I am a huge proponent of breastfeeding support for moms, nursing in public, and extended breastfeeding. I'm pretty sure I've been unfriended by a few people on Facebook for all the pro-breastfeeding stuff I post. That being said, I still feel that breastfeeding is a choice that every woman must make for herself. A woman is not a terrible mother if she is unable to or chooses not to breastfeed her child. I may not agree with her decision, but I do not know her situation or reasoning. Who am I to judge and chastise? 

Pardon any random capitalization or autocorrects, I wrote this on my phone while pumping. What's your breastfeeding story? Did it come to you naturally (lucky!!) or was it a challenge?