I think that Jennifer and Rachel are raising very important questions  
which
must be addressed, especially as milk banking becomes more common
in North America and the world.



> I've had calls from mothers who were donating significant amounts  
> of milk,
> and their babies were showing signs of suffering from the classic  
> oversupply
> syndrome - not happy at breast, mother never feeling as if her  
> breasts were
> well drained after feeding baby, and the stooling and growth  
> pattern we
> associate with oversupply.
Milk banks must teach mothers these signs and mak sure milk bank  
nurses stay
in touch with mothers during their donation time to make sure  
situations like this
don't arise.
Does anyone know how common this problem is? Do milk banks have policies
in place to prevent it?

> I've also had calls from milk donors who were concerned that their  
> supply
> was in danger because they had begun feeding their own baby  
> expressed milk
> they had in the freezer because it had been returned to them by the  
> bank due
> to excessive numbers of white blood cells.  They were so concerned  
> with not
> wasting the milk, which was rapidly approaching its 'best before'  
> date, that
> they temporarily stopped breastfeeding or reduced it significantly  
> in order
> to use up the frozen stuff.
I have often wondered whether we don't sometimes take the "milk is  
liquid gold,
don't waste a drop" concept a little too far. Pumped milk is second  
best, especially
for our own babies when mother is available.

> I don't think there is much focus on any aspects besides  
> cleanliness of the
> collection process here.  We just haven't thought enough about what  
> pumping
> for a bank does to the mother and baby dance, as Jennifer so  
> appropriately
> terms it.
With all the scientific knowledge and intuitive understanding we have  
of the breastfeeding
dance, I don't think it will be hard to come up with a preliminary  
set of guidelines for
milk banks and for mothers. Then it will become part of breast donor  
education, like
cleanliness of collection and where to drop off your milk. It will  
also become part of
the work that intake nurses, or whoever, do with mothers who are  
donating milk.

> I'm most concerned about what it does to a woman's perception of
> breastfeeding and of her breastfed child, when her own milk is very  
> much a
> commodity.
The commodification of breastmilk has been a problem since there have  
been
wet nurses. Several recently published books look at the history of  
wet nursing and
various laws and policies that have been enacted over the centuries  
that address
different aspects of this issue. Various religious traditions also  
have laws that address
this both from a practical and a more theoretical frame(how do we  
think about what it means
for a mother to nurse another child?) While these laws and ideas were  
thought about
centuries, and even millennia ago, they demonstrated a clear  
understanding of all the issues
we talk about now, in terms of bonding between mother and baby, the  
risk to families, mothers
and society of making mother's milk a commodity. As we begin our own  
discussions of these
issues it would behoove us to learn from our ancestors.

Naomi Bar-Yam


--------------------------------
Naomi Bar-Yam Ph.D.
[log in to unmask]
617-964-6676

Researcher, Writer, Educator
in Maternal and Child Health
--------------------------------



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