A Guide to Donating Breast Milk

Are you considering donating your surplus breast milk to preemies or other babies who need it? Here's what to know, from a mom who's done it.

Babies and Breast Milk Donation Illustration
Photo: Valeria Petrone

I've always known that my ample breast-milk supply was an incredible blessing, but in many ways it was also one of my biggest postpartum challenges. Thirty-six hours after giving birth to my second baby, the memories came rushing back: Enormous, rock-hard breasts. Waking up after having soaked myself and our bed with milk. Leaking through breast pad after breast pad. Unintentionally choking my daughter with my forceful flow unless I fed her from an almost horizontal position. Spraying milk across the room when she unlatched, sometimes dousing the furniture or my husband. That strange, tingly, almost painful sensation of my milk letting down at even the slightest thought or glimpse of my baby—or any baby, really.

However, as we welcomed our new daughter, my best friend was at a hospital miles away with her own young daughter, who was recovering from her third open-heart surgery. While I couldn’t be there, I realized there was something I could do to help other families in a similar situation: donate my excess breast milk to babies in neonatal intensive care units. So for the last year, I’ve been pumping for preemies. If you’ve been wondering what to do with the leftover milk in your freezer or are just curious about making a donation yourself, this is how it works.

How Milk Banks Work

I live in Des Moines, and a quick Google search led me to the Mother’s Milk Bank of Iowa. It’s part of the Human Milk Banking Association of North America (HMBANA), which has 26 (and five developing) nonprofit member milk banks in the United States and Canada. HMBANA dispensed more than 5 million ounces of donor milk from more than 9,000 donors in 2016—which was a 20 percent increase over the prior year.

“Our network of nonprofit milk banks focuses on serving vulnerable preterm and otherwise fragile infants who need human milk as medicine,” says Naomi Bar-Yam, president of HMBANA. Donor milk is given to these babies when their own mother’s milk is unavailable or needs to be supplemented, like when her milk is slow to come in or there’s a medical reason that prevents her from breastfeeding. Doctors worry about a devastating intestinal disease called necrotizing enterocolitis, because the risk of it is higher for preemies fed formula than for those receiving breast milk.

To join the HMBANA network, a milk bank goes through a lengthy process to ensure that its facilities for processing and storing donor breast milk meet strict safety requirements and that the milk bank operates ethically within HMBANA’s guidelines. This was important to me because while a few friends asked me directly if they could have some of my milk for their baby, I didn’t want to risk sharing contaminated milk. “We pasteurize our donor milk to eliminate bacteria and viruses,” explains Jean Drulis, director and cofounder of the Mother’s Milk Bank of Iowa. Donor milk is also tested for bacterial growth after pasteurization as a further safeguard to protect medically fragile infants. Donors like me aren’t paid for our milk, so there’s no financial incentive to adulterate the milk (by adding cow’s milk or formula, for example) in order to sell more. By donating to a certified, nonprofit bank, donors ensure that their milk is equitably distributed to the neediest babies, rather than being sold for a profit.

Becoming a Donor

The donor screening process involved a phone interview and filling out a questionnaire on my medical history—including my alcohol consumption and whether I smoke or use drugs. My doctor had to sign paperwork to ensure milk donation was safe for me and my baby, and I had a blood test to screen for HIV, hepatitis B and C, and syphilis. Soon after I was approved, a large box of 4-ounce plastic storage containers arrived on my doorstep, along with detailed instructions for how to pump and store my milk, and labels with my unique donor number.

After I built up a stash in the freezer for my own baby, I started pumping an extra 6 to 8 ounces early each morning. This was partly selfish: It was the only way to reduce my discomfort enough to exercise before she woke up. It was also easy: I could pump that amount in 10 minutes with a hand pump while I caught up on the morning news.

Sure, washing and sanitizing the pump and bottles was a bit of a hassle, but my growing collection of containers in the freezer was incredibly motivating. About every two months, I load up my biggest cooler bag with 200 to 250 ounces of frozen milk and blue freezer packs. With the AC blasting, I drive it an hour away to the maternity ward of a Des Moines hospital, where it then gets transported to the milk bank.

Each milk bank is responsible for screening donors and processing, pasteurizing, and dispensing the collected milk. Hospitals decide which babies qualify, and it’s only given with a doctor’s prescription. “We use it for the highest-risk babies in the most critical time,” says Debra Bogen, M.D., professor of pediatrics at Children’s Hospital of Pittsburgh of UPMC. In most cases, the hospital— not you or your insurance company—picks up the $4- to $5-per-ounce tab for donor milk (which covers the cost of running the milk bank and processing the milk). What other medical expense can you say that about?

Although research has shown that breast milk provides health benefits for all babies, I was careful whenever I mentioned my donations to friends or on social media. I don’t think breast milk is better in every circumstance—and I didn’t want my excess supply to make any mom feel bad. I was donating for infants who needed a safe option before they were healthy enough to consider using formula—or until their own mom could fill their tiny tummy.

My friend Sarah Maxwell was induced at 36 weeks because she had preeclampsia. “I couldn’t join my son Miles in the NICU for the first 24 hours and my milk was slow to come in, so he was on donor milk for the first five days,” she told me recently. “I remember the doctor saying there was nothing better for his body until I was able to fully provide for him.”

Miles didn’t get my milk, but it was comforting to know that my donations were going to babies like him in my community. “A mother’s own milk is best for her infant, assuming she is healthy and is not taking contraindicated medications. The next best choice would be pasteurized donor milk,” says Younger Meek, M.D., a professor at Florida State University College of Medicine, in Tallahassee, and chair of the American Academy of Pediatrics Section on Breastfeeding.

As my daughter approaches toddlerhood, I’m sadder about the prospect of weaning than I was the first time around. And while my friend’s daughter faces long-term health challenges due to her heart condition, she’s now a happy little girl who loves chocolate milk and ladybugs. It’s been an honor to nourish my own baby and watch her thrive—and to know I’ve helped other babies have a better chance of coming home from the hospital too.

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