Donor Milk and Food Allergies

One of the things that many anti-formula people say is that if you can’t breastfeed yourself, you should use donor milk. Whether this should be from milk banks or informal milksharing is up to debate. Milk banks aren’t really an option for most people, in my area I was told that milk is up to $4/oz. When it’s not unheard of for babies to get up to over 30 oz/day, that’s a lot of money that many people can’t afford. Milksharing can be done well, but there is a risk inherent to it. The milk itself isn’t tested every time, and people can catch diseases even after they’ve tested clean. I haven’t heard of many problems, I’ve only heard of one case where a baby got HIV from a wetnurse and I believe the family didn’t ask if she’d been tested, so whether this is a big risk or not is your call.

One thing that people don’t think about, though, is babies with allergies.

I’m not sure how milkbank milk works for allergies, so I’m not going to comment on it. But I know that for informal milksharing, this is a very real risk. Most allergens can be transmitted in breastmilk and cause problems for babies, and many of them are sprinkled in practically everything we eat. Unless the person you’re getting milk from has the same allergies as your child, it’s impossible to know unless that person is ridiculously gung-ho about it. Even then, things like Silk being recalled because it had almond milk in it can happen. Again- a person with a nut allergy would know well before the milk got to you that this happened and their milk was contaminated, a person without may have no idea until your baby is suffering.

People without any food allergies/insensitivities/intolerances often don’t really appreciate how hard it is to avoid them. I did not realize just how many things we dump wheat into before trying to cut out gluten. Did you know that many soy sauces in the US have more wheat in them than soy? Or that it’s in medicines? Breading on chicken nuggets (a common childhood favorite) is almost always gluten. That may seem obvious, but many people just don’t think about it. I’ve seen someone offer bread to a person who can’t eat wheat after she pointed out she couldn’t have the main course- some people just don’t think. A lot of sauces and soups are unsafe as well, because wheat flour is a common thickening agent used in cooking (my partner’s had to get used to using gluten free flour for this).  Restaurants don’t always respect these food problems, or just don’t realize the severity, or just don’t think. You could get gluten-free pasta with a sauce that’s been thickened by wheat because the server or even chef just didn’t think about it. One time at a restaurant I got chili and forgot to ask if it had gluten in it- it made me incredibly sick, but people who have no problem with gluten would probably never have guessed. Most people don’t realize that they’ve been exposed to an allergen like that until the baby they’re feeding has a reaction.

And wheat is not the only allergen that’s like this by any stretch. It’s just the one I have the most experience with. Corn is really bad thanks to everything we dump corn syrup into, peanut oil is commonly used in things, etc.

Even people who have been carefully avoiding allergens for decades have had times where they get accidentally exposed. Last year, a college student died because he decided to eat a cookie that he thought was peanut-free. It’s not a commentary on non-allergic peoples’ unwillingness to be vigilant or laziness, it’s a commentary of how damn hard it is to avoid allergens in this society. Breastfeeding parents who have a baby with a food allergy can face this-  they eat something they think is safe and it turns out it isn’t, and these are people who know exactly what it will do to their child if they screw up so are incredibly careful.

For babies with serious food allergies, milk sharing is a much bigger risk than it is for most families. There’s still the risk of disease, which can be reduced, but the allergen one is actually nastily hard to avoid. Even for babies who have more minor sensitivities it can be a problem, even if it doesn’t risk rushing your baby to the emergency room, it can still cause behavior and digestive problems and pain- things most parents want to avoid for their babies. Some parents feel the benefits of breastmilk outweigh the risks, and that’s their choice and is fine, but it should also be easy to understand why other parents don’t want to take that risk. I’m sure that there are parents who are biologically able to breastfeed who choose formula for babies with serious allergies because of the risk of contamination.

It also reduces the donor milk that these families have access to. Most of the milksharing I’ve seen, families offer up their stored milk- it’s much less common for a family to continually pump and offer milk in the future. Again, unless either the nursing parent or their baby has the same allergies as your child, milk from before may not be safe. And it’s certainly understandable if the families that are able to offer milk in the future prefer to donate to families that don’t require them to go on a difficult and potentially expensive elimination diet.

There are even babies who actually can’t tolerate breastmilk. Quite uncommon, yes, but it does happen. Obviously donor milk isn’t an option there. It’s possible that breastmilk could be made into a baby formula (I’ve heard of a prescription formula that does this, but I can’t find reference to it on google) that those babies could tolerate, but I don’t know if that’s an option yet and this is something that is very rarely acknowledged when insisting that “Everyone can breastfeed”.

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