Buying breast milk online is risky, experts warn

Many mothers who want to but can’t breastfeed their infants buy human breast milk on the Internet, not realizing that the unregulated online market is “dangerous” and can expose babies to health risks, according to an editorial in BMJ.

The authors, from the Global Health, Policy, and Innovation Unit at Queen Mary University of London, United Kingdom, note that many healthcare providers also may be unaware of the hazards.

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Risks from milk not bought from regulated milk banks include disease transmission, contamination, and tampering. Unregulated milk often costs less than milk from licensed banks, which charge as much as $4 per ounce, but the savings result from not routinely pasteurizing the milk or testing for disease or contamination, the authors of the editorial point out. Online sellers don’t have to undergo serologic screening, and “collection, storage, and shipping requirements are negotiated between buyer and seller” to keep down the price.

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As a result, diseases such as hepatitis B and C, human immunodeficiency virus, human T cell lymphotrophic virus, cytomegalovirus, and syphilis may go undetected. A 2013 study found that 74% of milk samples bought on the Internet had high levels of potentially harmful bacteria. The Internet samples had higher mean total counts of aerobic, gram-negative, coliform, and Staphylococcus bacteria than milk bank samples; Only 9 of the 101 samples purchased online had no detectable bacterial growth. Moreover, 21% of online samples contained cytomegalovirus compared with only 5% of milk bank samples.

Poor shipping and storage conditions as well as lack of pasteurization contribute to microbial contamination. Other problems that have been found with online milk include chemical contamination (bisphenol A and illicit drugs) and tampering (adding cow’s milk or water to augment volume).

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The editorial urges healthcare providers to learn more about the workings of the growing online breast milk market so that they can better inform parents about safe feeding alternatives for their infants. It also advocates more training in this area for healthcare professionals and greater response by professional organizations.

The authors issue an urgent call to regulate online breast milk markets “to ensure the safe collection, processing, shipping, and quality of human milk.” Regulation must include legal sanctions against people who “knowingly contaminate or dilute milk for profit” and protections against exploitation for women who produce milk for sale, they note.  

Although appropriately screened and treated breast milk is second only to a mother’s own milk for feeding infants, the authors affirm, human milk presently available online “is a far from ideal alternative.”