<<I'm curious as to why smoking is a contraindication to donation when it isn't considered a contraindication to breastfeeding? Is it the usual story of premature babies being more vulnerable? (But then, surely we'd advise a smoker with a premature baby to breastfeed?)>>

Hi Sarah

Firstly, I was very interested in the post about your milk donation experience – I DO hope that none of my donors goes through so much stress and strain to get her milk to us . In fact, we mostly collect, but the beauty of having a milk bank in every town would be the reduced driving around.

Secondly, the smoking issue.  I’m sure there are *either* heartfelt opinions about the need for donors to be ultra pure *or* perhaps even scientific studies about this, but I haven’t investigated how logical it is that smokers (if well supplied) are not accepted as donors.  I roll my eyes about similar issues, which include:

Women who’ve lived in UK being barred from giving milk in USA...... Meantime the UK recipients of donor milk are doing just fine;
Women who’ve lived in Africa being barred from giving milk in UK..... meantime the African recipients of milk are doing just fine;
The discrepancies in alcohol limits on screening forms, ranging from zero drinks through 1 –2 drinks per week to 1-2 drinks per day;
Barring mothers of babies older than 6 months from donating, when any human milk just has to be better than infant formula in almost any instance. 
[However I suspect that is for practical reasons – if a mother hasn’t expressed milk in quantities before her baby is 6 months old, even the most willing mothers will struggle to get into a milk-donation routine, and will only cost us money in the end for the blood tests.  Seems to hold more often than not].

I too have been wondering how the smokers in our prem ward are encouraged to provide milk for their babies, and yet we are not allowed to accept it for the motherless babies; similar for mothers on galactagogues.   

Was anyone on this list at the milk banking meeting in Seattle last year?  I heard there were discussions about looking more sensibly at the rules for donating, but have not had anything further.  I follow the protocols laid down by our doctors but there is a part of me that’s saying, “And the alternative to this donor’s milk that you are rejecting is *powdered infant formula*?????”  (our only option).

Best wishes
Jacquie Nutt IBCLC
Drops4Life




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