The Four Pillars of Safe Breastmilk Sharing

The use of healthy, commerce-free donor milk is a natural option when a baby cannot receive milk from their own lactating parent. No entanto, there are risks associated with feeding a baby anything outside of the closed biossistema of mouth-to-nipple. This includes storing and feeding expressed milk to one’s own child, donating expressed milk that will not be used, and storing and feeding donor milk. From expression to feeding, and especially in the context of donating since the intended recipient baby may not have the same anticorpos as the donor, steps can be taken to reduce the exposure to patógenos. Both donors and recipients can screen each other using this document and The Four Pillars of Safe Leite materno Compartilhamento.

The Four Pillars of Safe Breastmilk Sharing came out of the extensive research that is compiled in this document and they form the foundation from which families can learn how to safely share human milk. These four pillars provide evidence-based information for the support of safe community-based and private arrangement milksharing. The Four Pillars of Safe Breastmilk Sharing are not only useful to parents and caretakers, but also to pediatricians, parteiras, and those active in birth and parenting communities.1 By understanding the easy-to-implement principles of the Four Pillars of Safe Breastmilk Sharing, they too can help babies in their communities by supporting safe community-based and private arrangement milksharing.

The Four Pillars of Breastmilk Sharing

Informed Choice

  • Entendendo as opções, incluindo os riscos e benefícios, de todos os métodos de alimentação infantil e infantil
  • Know thy source

Donor Triagem

  • Donor autoexclusão para, or declaration of, medical and social concerns
  • Communication about lifestyle and habits
  • Screening for HIV I and II, HTLV I e II, HBV, HCV, Sífilis, e rubéola

Safe handling

  • Inspecting and keeping skin, hands, and equipment clean
  • Properly handling, armazenando, transporting, and shipping breastmilk

Casa pasteurização

  • Heat treating milk to address infectious pathogens
  • Informed choice of raw milk when donor critério are met

Are there risks to using privately arranged donor milk?
Some argue that even after donors are screened, a small number of pathogens can still remain in the milk2 and that therefore raw donor milk is never safe.3 No entanto, when considering pasteurized milk, there are also risks that need to be evaluated, and in situations where donor milk has been pasteurized, patógenos podem (ré-) contaminar leite.

Informed milksharing4

Para nosso conhecimento, there are no documented cases of disease transmission or bacterial infection associated with informed milksharing at this point.

The article The Four Pillars of Safe Breastmilk Sharing was published in Midwifery Today. Primavera 2012. The photo was taken at our very first Eats on Feets gathering in Arizona where donors and recipients could meet and share milk!

Próximo: Quem precisa de leite de doadora?

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  1. Eats on Feets – Safe Milksharing ↩︎
  2. Ronald S. Cohen, e outros. 2009. Revisão retrospectiva de testes sorológicos de potenciais doadoras de leite humano.imagem em pdf Os testes de triagem são projetados para ter uma incidência relativamente alta de falsos positivos, a fim de evitar quaisquer falsos negativos. Enquanto falsos positivos acontecem com muitas pessoas, eles tendem a ser mais altos em mulheres grávidas ou grávidas recentemente. Do ponto de vista de um banco de leite que testará as doadoras regularmente, faz sentido excluir qualquer pessoa com histórico de falsos positivos, pois o custo de buscar confirmações em todas as oportunidades de teste não é apenas proibitivo para uma organização sem fins lucrativos, também pode levar a problemas logísticos com o leite recebido da doadora. Este estudo não acompanha o status sorológico real dos rastreados, mas, mesmo pelos valores mais otimistas, é bem provável que muitos não tenham de fato nenhuma infecção atual. ↩︎
  3. Os testes de triagem são projetados para ter uma incidência relativamente alta de falsos positivos, a fim de evitar quaisquer falsos negativos. Enquanto falsos positivos acontecem com muitas pessoas, they can occur more often during pregnancy. Do ponto de vista de um banco de leite que testará as doadoras regularmente, faz sentido excluir qualquer pessoa com histórico de falsos positivos, pois o custo de buscar confirmações em todas as oportunidades de teste não é apenas proibitivo para uma organização sem fins lucrativos, também pode levar a problemas logísticos com o leite recebido da doadora. This study does not follow up on the actual serological status of the subjects but, mesmo pelos valores mais otimistas, é bem provável que muitos não tenham de fato nenhuma infecção atual. ↩︎
  4. Donated breastmilk is, in most situations, milk expressed and/or stored for her own child. After blood screening of donors and education on safe expressing/handling/storing techniques, the risks to milksharing are minimized. To suggest that this milk is not safe for sharing is to suggest that it is not safe for parents to feed their own babies with their expressed milk. We question this line of logic. ↩︎