In order for human milk to be safe, donors must be screened.  The pool of
donors is initially narrowed by  health-risk questionaire to rule out people
who are taking meds that might be a problem for small babies, and for life
styles that put them at high risk for infectious disease.  The woman's
pediatrician must be querried as to the woman's own baby (who has to be
growing adequately for obvious ethical reasons).  Then blood testing is done
to screen for HTLV, HIV, TB (in some locales), Syphillis, etc.  This process
is so costly that most banks then ask mothers to agree to donate a certain
amount of milk to make it worth running all the screening.  Milk is pumped,
frozen, brought in, thawed, and pooled in batches of 4-5.  Then the pooled
batch is heat treated or pasteurized.  Once treated, bacteriologic samples
are drawn and the milk is re-frozen.  The milk can't be released until the
bacteriology tests come back negative.  Records are carefully maintained so
that if the bacteriology shows contamination, the specific bottles can be
pulled and discarded.  At this point, the milk has to be stored in
non-frost-free freezers with special back up power in case a storm or power
failure (or rolling CA black-outs!) interrupt power.  Then it must be
transported to the baby in need.

I know that while most milk banks dispense the milk at $2.50-$3.00/oz this
price reflects a subsidized price.  Actual price for us in Austin is closer
to $6.00/oz to get us to the end "product."  It is cheap when compared to
the cost of a disease such as NEC, but obviously not affordable for most
people who would be trying to pay out of pocket.  The milk is given on a
triage basis -- at least at our bank.  With the smallest, sickest babies
getting first crack at it (whether they can pay or not).  We have two
ethicists on our volunteer Board of Directors at any given time (currently a
rabbi and a nun) who help us if we must make a distribution decision.  We
work hard to raise funds to supply the babies whose parents can't afford it
and who must have the milk.   We are also working hard to lobby for
insurance coverage of donor milk so women whose infants have formula
intolerance are able to afford to feed their babies.

I'll be darned if I can see how the harvesting of donor milk could be done
cheaply and still have an end 'product' that would be safe enough for
babies.  Esp. if the cost is further elevated by paying the donors for it.


.  Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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