The Massachusetts Chapter of the American Academy of Pediatrics (AAP) recently featured an article by Mothers’ Milk Bank Northeast CEO Deborah Youngblood. Drawing on insights from Board Member Dr. Brenda Anders Pring, President of the Massachusetts Chapter of the AAP, the piece explores how pasteurized donor human milk can support breastfeeding success and help families navigate early feeding challenges.
Donor Milk to Promote Successful Breastfeeding and Positive Infant Health
By Deborah Youngblood, PhD, CEO, Mothers’ Milk Bank Northeast
In the 2022 American Academy of Pediatrics statement on Breastfeeding and the Use of Human Milk, the AAP recommends that pediatricians actively promote successful breastfeeding. It identifies breastfeeding as the optimal feeding strategy for at least the first 6 months of life.
The policy statement acknowledges that the first 4–7 days postpartum are critical for establishing maternal milk supply and overcoming early challenges. During this time, pasteurized donor human milk can serve as an important bridge. The AAP supports its use when it comes from an accredited milk bank. Despite this, it remains underutilized.
While donor milk is prioritized for very low birthweight babies, it can also be utilized as a short-term supplement for full-term babies while a mother builds her milk supply. Using donor milk instead of formula as a supplement can lead to better long-term breastfeeding outcomes.
Pasteurized Donor Human Milk: The Facts
Pasteurized donor human milk (PDHM) is the standard of care in virtually all Level III and Level IV NICUs across the US. Providers use it to protect very-low-birth-weight babies from the life-threatening condition of necrotizing enterocolitis (NEC).
An exclusive human milk diet reduces the risk of a baby acquiring NEC by approximately 50%. For this reason, donor milk is recommended when there is insufficient maternal milk for these premature babies.
Increasingly, regular postpartum units use donor milk to support maternal breastfeeding goals when a mother’s milk supply is initially limited or she faces other early breastfeeding challenges.
In Massachusetts and throughout the Northeast, Mothers’ Milk Bank Northeast supplies donor milk to the vast majority of hospitals. Based in greater Boston, the nonprofit is the only accredited milk bank in New England and one of the largest in the country.
The milk bank is accredited by the Human Milk Banking Association of North America. This accreditation is required by hospitals. In addition, it is certified and licensed by both the FDA and the Massachusetts Department of Public Health.
Mothers’ Milk Bank Northeast ethically sources and carefully screens human milk from mothers with surplus milk for their own babies, and in some cases from mothers who have lost a baby.
There has never been a documented case of a baby being harmed from donor milk sourced from a nonprofit accredited milk bank.
Breastfeeding Benefits for Both Moms and Babies
Breastfeeding provides significant, well-established benefits for both mothers and babies. Yet establishing breastfeeding can take days or even weeks. As a result, many families need support.
Using donor milk instead of formula during early breastfeeding challenges can lead to higher rates of successful breastfeeding. Parents seeking donor milk as a bridge to breastfeeding can access it through many hospitals, milk bank dispensaries, or directly from Mothers’ Milk Bank Northeast.
Prescribing Donor Milk: What to Know
Donor milk can be a valuable resource in promoting successful breastfeeding. However, providers should carefully target donor milk use in healthy outpatient newborns and clearly communicate recommendations to families.
Some key considerations:
- Donor milk is intended for short-term use as a bridge to breastfeeding for healthy newborns.
- Due to its limited supply and high cost, donor milk is not a practical long-term feeding strategy.
- Donor milk from an accredited nonprofit milk bank is prioritized for hospitalized newborns.
- Outpatient supplies, while often available, are limited, and availability is never guaranteed.
- The AAP does not recommend informal milk sharing because of the risk of infectious disease transmission and other unknown contaminants.
- Outpatient donor milk is not covered by most private insurance plans or MassHealth. Thus, families must pay processing fees out of pocket. Donor milk provided in hospitals is fully covered.
- Donor milk can be costly. However, most families use only a small amount while working to establish their own milk supply.
The Psychology of Support
“I always thought breastfeeding would come naturally, but that wasn’t the case — for me or my daughter. Thankfully, we were able to lean on donor milk in those first weeks of her life. It was such a relief knowing we had options, and that we weren’t alone on this journey.”
— Riley, Donor Milk Recipient
Donor milk can offer emotional reassurance to families working toward breastfeeding. Many recipients describe feeling supported by other mothers and more hopeful during feeding challenges.
Furthermore, studies show that using donor milk as a short-term bridge encourages mothers to continue building their milk supply. In contrast, formula supplementation may lead parents to permanently switch to formula, as it is often viewed as a long-term option.
Encouraging Milk Donation
To ensure safe and abundant supplies of PDHM, lactating women with surplus milk must be encouraged to donate.
Additionally, parents must be educated on the importance of specifically donating to accredited nonprofit milk banks since they provide for our hospitalized population. Pediatricians can play a critical role in providing this education.
Simple steps include sharing information about milk donation on your website and in waiting rooms. Pediatric practices may also serve as repositories for approved raw milk donations or dispensaries of donor milk for patients.
