Dear friends,
Being a long time LLLleader, I respectfully disagree with this LLL policy to not recommend informal milk exchange or wetnursing. Though I am fully aware of any kind of scary outcome from some infected or otherwise compromised woman, I als am very well aware of the fact that we hardly ever question the safety of any given mother to breastfeed her own child, and of the fact that using non-human milk food for the human infant has many more, very much better documented and fairly less hypothetical hazards. In this I stick with the WHO recommendations to use a human milk scource before a non-human alternative. Ofcourse, in doing so I will inform the mother of all possibilities with every pro and con of every option and ways to work as safe as possible. Mothers are self-responsible adults, who can make their own well-informed choices, given they have all information needed. Disadvising instead of fully informing is not in tune with overall LLL phylosophy.
Warmly,
Gonneke, IBCLC, LLLL, MOM -who once nursed her sister's daughter-, in southern, frozen-mist white Netherlands
--- On Thu, 1/1/09, Rachel O'Leary <[log in to unmask]> wrote:
From: Rachel O'Leary <[log in to unmask]>
Subject: [LACTNET] milk sharing, wet nursing, role of lactation helper
To: [log in to unmask]
Date: Thursday, January 1, 2009, 12:52 PM
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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