I can only speak about the Mothers Milk Bank at Austin (MMBA), but what a
pleasure it has been creating this service in our community!  Human milk is
a truly miraculous substance with nutritional, prevetative and medicinal
uses, and the impulse to provide it to babies, children and adults who need
it is commendable. However, I agree with those who have written to remind
what damage a casual exchange could do to the barely established public
trust in milk banking -- esp. if someone came to harm.

In Austin, a coalition of  nurses, neonatologists, donor moms, moms of
preemies, LLL volunteers, Health Dept. reps  and LCs worked together for 18
months to learn about milk banking, and then to raise money and community
awareness to start our bank.  At every stage we checked our plans with the
Human Milk Banking Association of North America (HMBANA) to make sure that
safety and compliance with public health requirements were in place.
Because human milk is used for fragile or compromised individuals,  our
primary ethical concern was to insure that we would not do harm,
inadvertently, to anyone.  It has been wonderful how the Austin and Central
Texas community has rallied to support the bank.  We've raised hundreds of
thousands of dollars to fund and set it up -- mostly grants and donations.
None of this money would have been forthcoming without the safety standards
being in place, and this is still the first consideration for most people --
both donors  of milk and money as well as recipients.  And even with the
money, our costs are barely covered.  We know that the cost ($2.50 per oz)
is considerable, but there is published research (in JHL) to document the
health care cost savings even at that price.  The MMBA  has the policy, and
I would assume the other banks do too, that no baby in need is ever turned
away due to lack of ability to pay.   Ways can be found.  We have a state
legislator in Texas  who is hoping to introduce legislation to get 3rd party
coverage for donor milk, so there are avenues available to pursue change in
this area.

Our experience in Austin proves that a community can give birth to a
non-profit milk bank, and that a milk bank can satisfy both safety and
ethical concerns.  Looking at the untold number of volunteer hours put into
the creation and on-going operation of our bank, I find it hard to be
patient with the implication that it is a "business" in any other sense than
it is run in an orderly, accountable way.  Watching the neonatologists and
the nurses come in on their days off, roll up their sleeves with the WIC
peer counselors and volunteer moms,  and spend their day off pasteurizing
milk has been an inspiration in terms of generosity and follow-through.

I might add that I have had 2 home births, and that one of our retiring
Board members trained as a midwife.  There is no animosity toward or lack of
appreciation for non-traditional birth on our board, and there is a
permanent board seat for LLL.  We also have a board member who is a Catholic
nun (one of our two ethicists) whose order began in Europe several hundred
years ago with the operation of foundling homes which employed wet nurses
rather than "hand-feeding" the orphans, thus guarenteeing that some of the
poor unfortunates survived. It is a treat to hear her talk about how her
participation in the MMBA brings her order "full circle."  While I fully
sympathize with the disappointment and frustration which I'm sure prompted
the remarks stemming from the failure of a casual milk exchange, it does
injustice to the countless volunteer hours that many well-intentioned people
all over the country donate to this cause to paint milk banks and
milk-bankers as corperate oportunists.

 Further, I have great professional respect for Lois Arnold, who for years
kept milk banking before the public eye through countless articles and talks
on the subject at a time when virtually no one was interested in the idea.
When I compose my speaker bibliographies for talks on our milk bank, most of
my citations begin with "Arnold,L:"  I want to publically thank Lois Arnold
for her contribution to lactation science and milk banking in  particular.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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