Exploring Safe Practices for Donor Breast Milk and Infant Nutrition
Parents and caregivers around the world are increasingly turning to donor breast milk when direct breastfeeding is not possible. Understanding how to use donor milk safely, and how it fits alongside breastfeeding, formula, and other feeding options, can help protect infant health while supporting families’ needs and circumstances.
When a baby cannot receive enough milk directly from their parent, donor breast milk may be considered as an additional option. Around the world, families weigh questions about safety, screening, pasteurization, and cost, as well as how donor milk fits into overall infant nutrition during the first months of life.
Donor breast milk safety: key risks and protections
Donor breast milk safety depends on how the milk is collected, stored, processed, and distributed. Human milk can carry viruses and bacteria, and it can be affected by medications, drugs, or environmental contaminants. Safe systems therefore focus on careful donor screening, hygienic expression and storage, and laboratory testing to reduce the risk of transmitting infections or harmful substances to infants.
Accredited human milk banks typically follow strict protocols. Donors usually complete health questionnaires, provide blood samples for infectious disease screening, and agree to avoid certain medications, alcohol, nicotine, and illicit drugs. Collected milk is frozen quickly, stored at appropriate temperatures, and labeled with traceable information. Before distribution, many banks pasteurize and microbiologically test pooled milk to ensure it meets set safety standards. These steps create a structured, monitored pathway from donor to infant.
Human milk bank vs private sale: safety issues
Families may encounter two very different routes when seeking donor milk: regulated human milk banks and private sale or informal sharing arrangements. Human milk banks, often linked to hospitals or non-profit organizations, generally prioritize medically vulnerable infants, such as those born prematurely or with certain health conditions. Milk is usually dispensed under medical supervision, guided by clinical indications and local policies.
Private sale or informal sharing, often arranged via social media or online groups, operates with far less oversight. Milk may not be formally screened, and storage and transport conditions can be inconsistent. There is also a risk of mislabeling, dilution, or contamination, even when all parties intend to act in good faith. For these reasons, many professional health organizations caution against purchasing or informally obtaining breast milk from unknown individuals and recommend structured milk bank systems when donor milk is considered.
Pasteurized donor milk benefits for infants
Pasteurized donor milk offers particular benefits for some infants, especially those born very preterm or with serious medical conditions. In hospital settings, donor milk from screened and pasteurized supplies is often used when a parent’s own milk is not yet available or sufficient. Even after heat treatment, donor milk still contains many bioactive components, such as certain proteins, enzymes, and protective factors, although some are reduced.
Research suggests that, for very preterm infants, human milk nutrition (from the parent or donor) is associated with a lower risk of some serious gut conditions compared with formula feeding. Pasteurization helps inactivate many viruses and bacteria, improving safety, while maintaining a human-milk-based diet. Outside specialized hospital settings, families who use regulated donor milk may value its human origin and its compatibility with breastfeeding goals, while still recognizing that it is not identical to fresh milk from the infant’s own parent.
Breastfeeding and infant nutrition alongside donor milk
Breastfeeding and infant nutrition are broader than the choice between human milk bank vs private sale. When possible, direct breastfeeding or expressed milk from the infant’s own parent remains the primary recommendation of most global health authorities, because it is tailored to the baby and does not require additional processing. However, this is not always feasible due to medical, practical, or social reasons, and families may consider formula, donor milk, or a combination of options.
Donor breast milk safety and pasteurized donor milk benefits should be viewed as part of this wider feeding picture. Health professionals can help families weigh the role of donor milk, formula, and breastfeeding support, considering the baby’s gestational age, growth, underlying medical conditions, and the family’s circumstances. Decisions are often revisited over time as the infant grows, the parent’s milk supply changes, and access to resources such as lactation support or local services evolves.
Cost and access also influence how families use donor milk. Regulated human milk banks incur expenses for screening, processing, pasteurizing, and testing, and these costs are reflected in how milk is billed to hospitals, insurers, or families. Informal private sale may appear less expensive in some settings but lacks standardized safety controls, which can carry its own risks and potential downstream health costs.
| Product/Service Name | Provider | Key Features | Cost Estimation* |
|---|---|---|---|
| Pasteurized donor milk (non-profit milk bank) | HMBANA-affiliated or similar non-profit milk banks | Screened donors, pasteurized, lab-tested, priority for medically fragile infants | Often around US$3–US$5 per ounce, sometimes billed through hospitals or insurers |
| Hospital-supplied donor milk | Public or private hospitals | Dispensed under medical supervision, usually for inpatients | Effective cost to families varies widely; hospital charges may exceed US$5 per ounce depending on health system |
| Pasteurized donor milk (for-profit supplier) | Commercial human milk companies (e.g., specialty NICU products) | Human-milk-derived products, often for very preterm infants, distributed to hospitals | Frequently higher than non-profit bank milk; exact prices vary by contract and country |
| Informal or private-sale breast milk | Individual sellers via online or local networks | Typically unregulated, storage and handling vary, limited or no formal testing | Commonly advertised in ranges of about US$1–US$4 per ounce, but prices and practices are highly variable |
| Commercial infant formula | Infant nutrition brands | Industrially produced, standardized nutrient content, widely available | Depending on brand and region, often roughly US$0.15–US$0.30 per prepared ounce |
*Prices, rates, or cost estimates mentioned in this article are based on the latest available information but may change over time. Independent research is advised before making financial decisions.
Because systems, subsidies, and insurance coverage vary greatly between countries, the out-of-pocket cost of donor milk may be minimal for some families and prohibitive for others. When considering any option, it can be helpful to ask local healthcare teams or milk banks how milk is funded, which infants qualify for priority access, and what alternatives—such as lactation support or formula—are available if donor milk is not accessible.
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.
In summary, safe practices for donor breast milk and infant nutrition involve careful attention to screening, handling, pasteurization, and the context in which milk is used. Regulated human milk banks offer structured safeguards that are not typically present in private sale or informal sharing. When donor milk is considered alongside breastfeeding support and other feeding options, families, together with healthcare professionals, can work toward choices that respect both safety and their individual circumstances.