Dear Lee and all,

This dscussion sparked by Norma's article is interesting.

Lee Galasso wrote:

> IMO, the feeding choices for the
> infant are:  1) milk directly from its own mother's breast
> (breastfeeding);
> 2) its mother's own expressed milk fed by another method; 3) milk
> directly
> from another woman's breast (wet-nursing); 4) another woman's
> expressed milk
> fed by another method; 5) milk acquired from a milk bank; and 6)
> Artificial
> Baby Milk.

I would like to comment in the light of discussions I took part in
while facilitating discussion leading to the updated LLLI policy on
milk donation etc. I found that discussion enlightening and found out
a lot that I never knew before. I was glad to facilitate that
discussion becuase I didn't know much about it and therefore had no
preconceived ideas!

Lee's third and fourth choices would have been mine too, before taking
part in that discussion. Our advisors informed us that there is
currently a flourishing market in ebm sold via the internet. Could be
wonderful! But also, as was pointed out, If a family buys milk from an
unknown source, they have no way of knowing: if it's really milk; if
it's human milk or from another mammal; if it's clean or contaminated;
if the mother who expressed it has various diseases that would rule
her out as a milk bank donor; if she uses substances that would rule
her out for milk bank donation; etc etc.

if a family employs an unknown wet-nurse, they also may be exposed to
risk from her state of health.

What if the other mother they would ask to wet-nurse or give milk is a
trusted friend or close family member? we asked. One advisor pointed
out that close family members and friends may well keep secrets from
each other even more than complete strangers! My imagination then
began to invent scenarios such as.... you ask your sister-in-law to
nurse your baby while you are in hospital - she feels pressured, and
has not told anybody that she had a fling with a dodgy rock star while
your brother was out of town.... As you can see, my imagination needs
to calm down and have a cup of tea - but I see what they meant!

We also heard from those whose babies had survived only because of the
generous help of trusted sources who provided their milk for sick
babies when the mother could not, for serious reasons.

There were huge cultural differences between attitudes to milk banks,
depending largely on whether such milk is sold or provided at no cost
to the family by the health care system in different countries.

The upshot of all this was that in the LLLI policy,  Leaders don't
recommend informal arrangements for milk-sharing. Leaders will of
course give information on the benefits and risks of any such
situation - and we discussed for some time whether *benefits* or
*risks* should be mentioned first! Because there are both, and the
mother will need to find her own balance depending on the situation
she's in. The important fatcor is the role of the LLL Leader as one
who provides information and support so that the mother can make her
own informed decision - I guess that any lactation supporter would
find that a useful standpoint.

Rachel O'Leary
Cambridge, UK
LLLI Board member 2001-2007

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