Jennifer Tow raises the question of whether anyone has studied the effects
of milk donation on the mother's own child.  I'm not familiar with it if
they have, but there are definitely some points that could stand some
scrutiny.  
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.  
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.  They were unable to continue pumping enough for
both the bank and the baby while using up their backlogged stores, and they
seemed unable to focus on anything but the product, rather than the process.
Some other mothers have been plagued with plugged ducts and recurring
mastitis due to their chronic oversupply, driven by pumping and
necessitating continued pumping.
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.  
I know many women who have donated milk over many months, and who have
simply had a couple of sessions every day with the pump, while continuing to
breastfeed their own children on cue, and it looked to me as though it
wasn't interfering with their interaction with their own children.  A lot of
these women are breastfeeding peer counselors, and the role breastfeeding
plays in their lives is more conscious than for many other mothers.
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.  

In the discussion about paying donors, I think it has the potential to do
more harm than good, especially in the US where there are very likely women
who would give brand X to their baby in order to make money selling the Real
Thing to someone else.  The whole picture looks a lot different when your
frame of reference includes paid maternity leave for everyone for many many
months, publicly funded maternity care for everyone, ditto pediatric care.
We do not have a two-tiered health care system here.  We have one tier and
it is publicly owned and run, and while there is a co-payment system for
outpatient care for ill adults, all maternity care is entirely covered, as
is all care for children up to the age of ten.  There is also no opportunity
to shop for a pediatrician, as no healthy child has a pediatrician.  The
ones we have are all busy caring for the sick children, while PHNs do the
well child care.  Blood banks are part of the public health system and
donors are given a towel or a wine glass or a pocket tool set or some such
token, as a thanks for giving blood, and the blood is provided to the
patients who need it, without anyone ever seeing a bill.  Milk donors are
provided with a hospital grade pump, collection containers, and a sum of
money per liter of donated milk which is meant to compensate them for the
time it takes to express, not for the milk itself.  In a society where
pretty much everyone has enough to get by, the offer of money is less
fraught with danger.

So, I am not uncomfortable with altruistic donation of breastmilk.  I am
quite uncomfortable with private entities profiting off of mothers'
altruism.  I visited the 'National Milk Bank' website and found that it did
not answer my main question, that being, who's behind it?  Next question is,
why don't they want their names publicly associated with it?

Rachel Myr
Kristiansand, Norway

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