Another Mother’s Breastmilk
Donor milk, milk banks, wet nursing and informal milk sharing
Throughout human history, people have lived in tight-knit communities and shared the responsibilities of raising children. Mothers have always worked and young infants typically stay within reach of the breasts in-arms or a baby carrier while they go about their day. Older babies and toddlers however might be gathered together to be cared for as a group - what we know as a creche - to allow women to focus without constantly supervising groups of children. Often older girls and even grandfathers would be responsible for supervising smaller children. And a lactating member of the community would make her breast available to any babies and toddlers whose own mother was busy elsewhere.
Recorded history shares tales of wet nurses (lactating women who breastfed the babies of other mothers). Wet nurses were commonly employed by households where mothers died in childbirth or families who needed to produce (living) heirs and spares to grow the family’s wealth and status. In many affluent societies, only the poor peasant woman would breastfeed her own babies. This might seem harsh through our modern lens but young children were often sent away from cities to be raised in the country, where there was less risk of disease. Infant mortality was high and any child living to age five was an achievement: it was probably easier for mothers to grieve lost children who were barely in their care.
(The discussion of colonisation, wet-nursing and associated trauma is a huge topic deserving of its own space. Here I am reflecting upon history in Europe. That is not to dismiss the experience of women in other parts of the world. )
The industrial revolution saw a huge change in how and where people lived. Cities drew people away from traditional farming lives in the country, where babies were always nearby and mothers would feed them between daily tasks. In factories, mothers worked extremely long hours, without breaks, and babies were frequently left at home in the care of (slightly) older children. Often sedated with opiates to keep them quiet, they were fed animal milk (cow, goat, horse, donkey or sheep) and various concoctions known collectively as “pap”- anything from flour and water to bread soaked in milk. Feeding vessels were difficult to clean, even if the soap and water needed were available. Many, many babies died. For women without reliable contraception, while there would always be sadness, there might also be relief.
Babies born to unwed mothers were frequently abandoned. Women who already had far more children than they could feed would often make the same desperate decision. Eventually, homes like the Foundling Hospital in London began to appear as sanctuary for these children. Initially, babies were sent to wet nurses in the country for the first four or five years, before returning to the city for basic education, followed by employment in service or by apprenticeship. In some cases, the women who bore these babies (with new identities as widow women whose babies had sadly died) would find work as wet nurses to the rich and go on to have successful and respectable lives.
With the improvements in bottle design and development of formula, the wealthy realised the benefit of not needing to accommodate wet nurses, when a more lowly paid nursery maid could bottle feed their babies instead. As understanding of hygiene improved and the role of bacteria was learned, less babies died from infection. By the mid 20th Century, after the surge of women joining the workforce to replace the men fighting and lost in two world wars, bottle feeding was common and wet nurses redundant in western society.
However, breastfeeding women never stopped supporting each other through breastmilk. Only when the AIDS crisis hit in the early 1980s did hospitals discontinue “pooling” breastmilk. Milk expressed by mothers with oversupply topped up the babies whose mothers had too little. As the Women’s Liberation Movement in the 1960s and 1970s encouraged women to return to work or study, other mothers would provide informal childcare and cross-nursing was occasionally part of the arrangement.
While in countries like Australia milk banking ground to a sudden halt as fear of HIV took hold, other countries continued to support milk banks. Brazil has 217 milk banks, plus another 126 milk collection points, with at least one bank in each of the country’s 26 states. In Australia, we currently have a handful and most limit access to the very premature or sick babies in their hospital.
Mothers Milk Bank Australia-wide
The Perron Rotary Express Milk (PREM) Bank Western Australia
In 2021 the Red Cross started to coordinate programs in Sydney, Brisbane and Adelaide. Hopefully more mothers will be able to donate in the future. and more babies will be eligible for donations.
As the value of breastmilk itself steadily grew in the late 20th century and early 2000s, mothers who were not able to fully breastfeed found other women with enough to share. This happened quietly in the background, through networks of mothers (whose partners often transported small coolers of milk on their way to or from work!) The internet increased awareness, as women shared stories and inspiration. Social media allowed them to become organised, through groups like Human Milk For Human Babies and Eats On Feets.
The use of donor milk through informal milk sharing is a grey area for health authorities. While milk banks routinely pasteurise donations and practice strict infection control, mother to mother donation operates on a trust basis. At the same time, while the sale of human milk is banned in Australia, in countries like the US it is not. Stories of tainted, diluted or substituted products being sold are scary and cause hesitation. It is generally accepted that altruistic donation doesn’t have the same risk. How the risk stacks up compared to the same risk of commercially available infant formula has not been evaluated. Recalls of contaminated batches are common. In 2008, 300,000 children in China were poisoned after drinking infant milk formula that contained melamine, a chemical used in plastic. So deep was the fear created that Chinese parents are still privately importing Australian infant formula. The industry here has ridden the coat tails of that mistrust and created marketing and branding of Australian products being safe.
Ideally, every local community would have a freely available milk bank with tested and pasteurised breastmilk accessible by all parents for all babies. The market for infant formula could be halved or even disappear altogether. However, this is not a priority. Until it is, mothers will find a way.
Human milk has much to offer which is simply not present in manufactured infant formula.
