Putting on my hat as if I were counseling a mother about shared milk:

On the topic of shared milk, I would treat as I would treat any other topic.  Providing the evidence on risks, the evidence on benefits, the evidence for how one might reduce the risks and let the mother decide how she felt about balancing those risks -- just as Liz Brooks mentioned.  

The public health part of me is was the one that was feeling cranky about the topic. I feel the topic of milk sharing is being approached with the same abstinence only approach that we have adopted with bed sharing.   Because public health professional do not distinguish between bed sharing and room sharing, many parents actually end up adopting a riskier approach --putting the baby in a separate room --- for which the attributable risk of SIDS was found to be 36% higher, while the attributable risk of SIDS was only 16% than sleeping in the same room on a separate surface.  And they lie routinely to health care practitioners.  With HIV the abstinence only approach has not worked either.   Women ARE going to share milk and have ALWAYS shared milk.  We should be providing clearcut guidelines for making the practice safe or at the very least SAFER.  For some reason, we seem to forget that we have all sorts of ways to process foods and liquids to eliminate or drastically reduce the risk of pathogens.  Why not human milk?  We don't regulate sex, or kissing, or coughing on the subway, yet all these practices can transmit disease.  We still allow powdered formula to be sold even though the cans clearly state "not sterile" and E Sak has definitely been shown to cause disease in infants.




Susan E. Burger, MHS, PhD, IBCLC

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