19 Jul 2010
K AND I both work part-time at a local newspaper and, once in a while, she arrives at the office, waves me over with an excited grin, and shows me the stash she has brought for me: packets of frozen breastmilk.
With an abundant milk supply, K has more than enough for her nursing five-month-old boy.
Running out of space in her fridge for expressed breastmilk (EBM), she had been on the verge of throwing the older packets away when I mentioned that my own milk supply was not keeping up with my eightmonth-old son Lucien’s demand.
She was so generous as to offer them to me immediately. EBM can be stored in the household freezer for up to four months, depending on the mode and temperature of storage.
On cloud nine, I carried the packets filled with liquid gold home with me. Lucien would drink everything up greedily.
What is wrong with letting Lucien drink formula, you may ask? Nothing, really. But experts have advocated for some time now that breast is best. Studies show that breastfed babies tend to have better immune systems and IQs.
Some time after K and I started our little arrangement, I found out that there was a term for it: Milk-sharing. To be precise, such informal milk-exchange practices between friends is called “casual milk-sharing”.
To me, that had the same ring as “casual sex”, and there is a reason. Health-care professionals have expressed concern over how drugs and viruses can be passed through the sharing of human milk.
In 2005, the non-profit La Leche League International, the world’s largest resource for breastfeeding-related information, released guidelines on human milk-sharing, after a spate of reports about mothers sharing milk with strangers or even buying it over the Internet.
The guidelines advise mothers with inadequate milk supply to turn to accredited humanmilk banks as the best alternative, as these would have screened the donors strictly for diseases and drug use, as well as pasteurised the milk for safety.
A mother who is unable to use a milk bank is encouraged to use the services of a doctor knowledgeable about managing human-milk donations to help screen and advise mothers.
The guide quoted Ms Lois Arnold, chief executive of the National Commission on Donor Milk Banking in the United States, as saying: “Because some individuals may have a viral or bacterial infection but remain asymptomatic (without symptoms) they may never know they are infecting another party.”
The more I read up on milk-sharing, the more my eyes were opened to its risks. And while I wanted my son to have the goodness of EBM, I didn’t want to expose him to any latent infections.
However, a check with the Health Promotion Board (HPB) and the Association for Breastfeeding Advocacy (Singapore) (Abas) – an alliance of healthcare institutions, groups and individuals committed to breastfeeding awareness and support here – revealed that there are no milk banks here. Nor, it seems, are there plans to set up one.
Dr Yong Tze Tein, president of Abas and obstetrics & gynaecology consultant at the Singapore General Hospital, remembers a “small milk bank” at Alexandra Hospital “long ago”, but confirms there are no formal options for mothers who want to donate or get human milk for their babies. There are simply no facilities to store, keep or dispense the milk, she says.
On the issue of casual milk-sharing and donor-screening, she says the necessity and frequency of rigorous blood tests to ensure that donating mothers are free of virus are relative, depending on a mother’s background. She adds: “It’s all about likelihood. (Even with Singapore’s mandatory HIV tests for pregnant women), you might not be infected then, but you could get into trouble sometime in-between.”
Another concern with milk-sharing is that the donating mum might not be producing the appropriate type of milk for the baby consuming it.
Says Dr Yong: “Ideally, the ages of the babies of the mothers who are donating and receiving the milk should be the same.
In the case of an eight-month old drinking milk meant for a five-month-old, the difference is not that much. But it is important that premature babies should have milk meant for a premature baby, not from an older, full-term baby.”
Asked if Singapore needs a milk bank, she replies that there may not be a large-enough base of users and donors to make it viable.
“There must be supply and demand, facilities, people to run it, and strict controls. As it is, we are already struggling to get mothers to breastfeed.”
She points to the HPB’s National Breastfeeding Survey conducted in 2001, which showed that 95 per cent of some 2,000 mothers attempted to breastfeed.
But, by the time their babies were six months old, the breastfeeding prevalence rate had dropped to 21 per cent.
The World Health Organization recommends that babies should be breastfed exclusively for six months to confer the maximum benefit of breastfeeding on both mother and child.
Still, I cannot help but wonder if a breastfeeding survey conducted here today will paint a more optimistic picture.
When I surf motherhood forums, it is not uncommon to find local mums discussing among themselves what to do with their excess EBM (use it for a bath, a la Cleopatra? Serve it to the pets?).
Already, other countries in the region are cottoning on to the benefits of running a milk bank. In 2008, it became mandatory for hospitals in the Philippines with maternity services to set up a human-milk bank on their premises.
Manila’s St Jose Fabella Memorial Hospital runs a well-known milk bank with pasteurizing equipment and freezers that can preserve milk donated by volunteers for almost six months, ready to be drawn on by mothers of newborn babies.
Two months ago, mothers interviewed by The Brunei Times called for Brunei to consider setting up a national milk bank for mothers unable to produce their own milk, saying that breastmilk was crucial for newborn babies’ development.
And just last month, a Newsweek report headlined “Others’ Milk” revisited the issue of women seeking alternative sources of breastmilk.
While some mothers cringe at the thought of feeding their child anything but their own breastmilk, I will always be grateful to K for her gift to Lucien. And, at the end of the day, I am willing to wager my bottom dollar that she is more wholesome and leads a healthier lifestyle than I do.
But I cannot deny that the medical risks involved in our milk exchange – which still represents the epitome of selfless friendship to me – niggles me now.
If we – and, by we, I mean private individuals and public institutions – can find a way to work together to raise awareness about this issue, perhaps the day will come when a milk bank here might mean that mothers like me no longer need to suffer doubt or take risks again.
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