The sale of human breast milk on the internet poses serious risks to infant health and needs urgent regulation, according to a new editorial in BMJ.
The nutritional benefits of breast milk for babies are widely documented, but many new mothers find it difficult or are unable to breastfeed. In addition to social pressure, this pushes some mothers to purchase human breast milk on the internet - a market that has been growing rapidly. Despite appearing as healthy and beneficial products, many new mothers and even some healthcare workers are not aware that this market is "dangerous" and "putting infant health at risk" because it is not regulated, argues Sarah Steele, a lecturer at the Global Health, Policy and Innovation Unit at Queen Mary University London, and colleagues.
Purchasing human breast milk on the internet can be cheaper than buying from regulated milk banks, where it can cost up to $3-4 per ounce, because sellers can cut corners to save on costs such as pasteurization, testing for disease and contamination, and the appropriate collection, storage and shipping of milk. But these are all crucial to ensure that milk is safe for consumers, who also include adults with cancer and fetishes, and also gym enthusiasts.
Milk should be screened for diseases, such as, hepatitis B and C, HIV and human T cell lymphotropic virus and syphilis, explain the experts. Previous research has shown that milk purchased online has more bacterial growth due to lack of pasteurization and poor shipping and storage. One study showed that only 9 out of 101 samples did not have bacterial growth.
Other studies have revealed that 25% of milk samples were delivered with poor packaging and were no longer frozen, and contamination with drugs and other substances.
"Milk bought online is far from an ideal alternative, exposing infants and other consumers to microbiological and chemical agents," write the authors. "Urgent action is required to make this market safer."
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, argue the researchers. Advice on best practice, including storage and use of expressed milk should also be given.
They also call 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.
Legal regulation should also punish those who contaminate milk for profit and to ensure that mothers are protected against exploitation, they add.