Friday, July 1, 2011

A breastmilk sharing how-to

This is one in a series of guest posts by other bloggers. Read to the end for a longer biographical note on today's guest blogger, Amy from Anktangle, and see the photo post of her recent hobo-family visit. (A postscript at the end of this article also includes an urgent request for milk donations in the Wisconsin area, so please get the word out about that.)

Amy gives us a tutorial on person-to-person milk donation. As someone who felt somewhat roped into donating milk when Mikko was a baby and pumping felt burdensome, I would have so appreciated this commonsense and compassionate approach to the subject. I'm pumping to donate again this time around, but from a place of volunteering, and these tips are very helpful to keep in mind!

Guest post by Amy from Anktangle

We all know that human breastmilk is the best nutrition for human babies, and it has loads of health benefits for both mom and baby. In some cases however, breastfeeding doesn't work out, it takes longer than usual to establish, induced lactation is unsuccessful, or circumstances arise that necessitate early or temporary weaning. In all of these situations, a substitute for mom's milk would be necessary. According to a joint statement from the WHO and UNICEF:
"The best food for a baby who cannot be breastfed is milk expressed from the mother's breast or from another healthy mother. The best food for any baby whose own mother's milk is not available is the breastmilk of another healthy mother."

The price of purchasing human milk from a milk bank is prohibitive for most families. However, with the increasing popularity of sites such as Human Milk 4 Human Babies, Eats on Feets, and Milk Share, direct (mom-to-mom) milk donation is getting easier. And what a good thing!

I pumped daily and donated milk to several people for the first eight months after my son was born. I started pumping as a way to cope with a large supply of milk that came with a very strong letdown reflex (which often caused my baby to cough and choke on milk). I tried to down-regulate my supply (by only pumping to comfort to relieve the pressure of engorgement) but my supply was abundant, and I was happy to help out by donating milk.

Through my son's pediatrician, I got in contact with my first recipient mother, an adoptive parent who, after having little success trying to induce lactation for her first child, was seeking donations for her second exclusively breastfed baby. Later, when a close friend of mine had her baby and her milk didn't come in, I was happy to give my extra milk to her and her son. There have been a few other instances where I've given one-time donations when friends (or friends of friends) have had emergency situations where they were unable to breastfeed for short periods of time (having surgery, needing to take incompatible medications, etc.). While I don't pump daily anymore, I am still "on-call" for several people in case of supply shortages and other emergencies.

Along with the increasing availability and awareness about providing expressed milk for babies in need comes a whole host of potentially difficult situations in the donor/recipient relationship. As a donor, I have encountered a few situations where it would've been helpful to have someone to ask about what the etiquette should be, or just to talk to when it got difficult. Here are a few tips (based on my experience so far) for navigating the sometimes tricky and often wonderfully rewarding waters of direct milk donation:

  1. Be upfront with your recipient family about whether this will be a one-time donation or an ongoing donation. If you're not sure if you can get into an ongoing donation situation, be honest with the recipient about that from the beginning. They have most likely interacted with several donors, and they'll understand the commitment it takes to be an ongoing donor.

  2. Expect to be asked questions about your health history, vitamin and supplement usage, and lifestyle and dietary habits (including use of tobacco, caffeine, and alcohol).
    • Try not to take it personally! The recipient family is just doing the best they can to provide the best nutrition for their baby.
    • Be sure to mention to the recipient family if you are on a special diet, as some babies have allergies or intolerances that may need to be taken into consideration. (For instance, if you are a vegan, or don't eat dairy or follow a gluten-free diet, your milk may be a better match for a vegan family, or a baby who has a dairy or gluten intolerance.)
    This is entirely based on the recipient's comfort level, so on one end of the spectrum, you may be asked only a few questions, and on the other end, you may be asked to fill out health history paperwork and even provide copies of bloodwork (HIV results, etc.) to prove that you're healthy enough to donate milk.

  3. If you're going to donate on an ongoing basis, agree on the logistics of the milk exchange:
    • Will the donor ship the breastmilk?
    • Will the recipient pick it up directly from the donor's house at regular intervals? How often will that happen?
    • Will the donor contact the recipient when she has milk to offer or will the recipient contact the donor when there is a need?
    • Will the recipient provide milk storage bags for the donor?
    • If you live close enough to each other, does the recipient prefer to pick up smaller quantities of fresh milk on a more regular basis as opposed to larger amounts of frozen milk?
    • Does the recipient have a preference for how many ounces are stored in each bag (for instance, if your recipient family is feeding exclusively donor milk, they may be open to larger quantities in each bag, while the family who is supplementing with donor milk may want smaller amounts to work with in each bag.) As an aside: my favorite freezer bags are the Lansinoh brand, and despite the markings on the bag, they can hold up to 12 ounces of milk, which is pretty great if you're trying to conserve bags!

  4. It's important to regularly check in with yourself on an emotional level, so you're aware of how you're feeling about donating your milk.
    • Regularly reevaluate why you're doing this: is it because you want to, or because you feel obligated? Is it bringing you joy or causing you extra stress?
    • If you begin to feel overwhelmed, burdened, or pressured, it may be time to let an ongoing recipient know that you can't keep up with their need.
    • If you find that the prospect of being an ongoing donor is overwhelming or puts undue pressure on you (or you've tried it in the past, and it didn't work well for you), consider making multiple one-time donations to different families instead. That way, you can donate exactly as much as you want, and as often or infrequently as you like, without feeling beholden to anyone.
    I think as mothers, we often have a desire to be able to take care of everyone, but if you're not taking care of yourself first, then you can't fully give of yourself (and your milk!) to others.

  5. Similarly, it's very important to regularly check in with yourself physically:
    • Making milk is exhausting when you're doing it for your own baby. Making extra milk for another baby, and spending time pumping, freezing, shipping, etc., can definitely take its toll on your body and your energy level.
    • Changes in milk supply happen daily, and circumstances in your life may
      decrease your milk supply. I remember a few times when my son or I would
      get sick, or he would go through a growth spurt, and all of a sudden I wasn't able to pump as much as I could the day before. I began to worry that I wouldn't be able to provide enough milk to the baby I was pumping for. In those instances, it was extremely important for me to follow my final point:

  6. Keep an open line of communication with your recipient family. Let them know if/when:
    • Your supply drops;
    • you or your nursling is sick;
    • you're going out of town (and will/will not be shipping or bringing back milk);
    • you're feeling overwhelmed or overly burdened;
    • or when it's time for you to stop donating.
    I was lucky enough to be good friends with the recipient of most of my donated milk, so I think that made it easier for me to talk to her about dips in supply and illness. Ultimately, I began to find it impractical to continue my daily pumping routine, and I let my friend know when that happened. At the same time, she told me that her milk supply had nearly caught up with her son's needs, and they were supplementing with my milk less and less already. It was a natural transition for all of us (a weaning, of sorts), and I found that when I stopped pumping, my body was finally ready to stop making so much extra milk.
    While it can sometimes be tricky, sharing breastmilk is a huge and wonderful gift you can give. Breastmilk is often referred to as "liquid gold" and it is certainly an invaluable resource to a family who needs it. I've found it to be a truly rewarding experience—in a way that I can't quite describe accurately in words—to give of myself in this way to another mom and baby. I hope you'll consider donating your milk if you have any to spare!

    Do you have any experiences as a breastmilk donor or recipient? What tips would you give to donors?

    Amy writes about the things she holds close to her heart: family, delicious food, and many aspects of natural parenting. She is passionate about natural childbirth, breastfeeding, gentle and intuitive parenting, and respecting all people, no matter how small. She's figuring it all out as she goes, following her instincts with her son as her guide. She blogs at Anktangle.

    Photo courtesy Amy

    Just as I was scheduling this guest post on milk donation, I received the following note from Elizabeth of Mum & Roo:

    "I'm from Wisconsin (USA), and a fellow Wisconsin mom has cancer and has been fortunate enough to have been able to feed her 5-month-old daughter donated breastmilk since weaning her at 3 weeks old, but now she has only one day's worth of milk left, and her donors are no longer pumping. I know it's last minute, but I am asking fellow breastfeeding bloggers to help."

    So a group of bloggers have gotten together to write posts about milk sharing (thank you, Amy, for this one that was already in my queue!) — if you would like to write a post on the topic this weekend or within this next week, please link up your post at the linky below. You can also grab the blog hop code to place on your own blog. It will update automatically with everyone who links up. (Just click "Get the code here" and be sure to paste it into html view in WordPress or in Blogger.)

    And, if you're in the Wisconsin/Minnesota/Midwest area, please consider going to the Facebook page of Tania, the woman who needs the milk, and sending a message if you can donate expressed milk. (You can click the "Message" box in the top righthand corner.)

    Even if you're not in that geographical region, can you please put a link on Facebook and Twitter and let any breastfeeding moms in that area know of the need?

    Read more about milk sharing at Mum & Roo, and meet her and her baby, Reyna, and learn about Tania and her husband's (!) concurrent battles with cancer.

    Thank you so much! Tania's adorably breastmilk-fed daughter, pictured in her profile, thanks you as well.


    mamapoekie said...

    lovely article! Have shared on my HM4HB page and will share in Sunday Surf!

    I Thought I Knew Mama said...

    I will be sharing this in my Sunday Surf also!

    melissa said...

    What wonderful advice from Amy! I have donated to one family, and I didn't do a very good job of checking in with myself emotionally. It was a long term milk sharing relationship and as time went on I began to feel increasingly taken advantage of. I'm still happy I donated, and would do it again, but in the future I'll make sure I'm doing a better job of taking care of my emotions.

    Jennifer said...

    My body doesn't produce milk normally. My brother's wife has oversupply. She very graciously gives me her extra. It's great because I know her lifestyle & health. We have a good arrangement where she pumps when she has so much milk her baby can't latch or when she's uncomfortable, but she's not working to up her supply to provide any set amount for us. I'm grateful for anything she has to offer. I also know how exhausting & time consuming pumping can be--thanks for this article, I'll be sure to check in with her often and make sure she's still happy to do it. I don't want to burden her.

    JoyFilled said...

    This is a great post. I have donated locally a few times (large, one-time quantities). I pump along with nursing my other children. It's definitely work. I never found any advice like this when I started, either, however, thankfully my donors weren't demanding or expecting more than a one-time donation or anything. Most of them were women I just came in contact with through someone else anyway.

    I have a HUGE supply (I was nursing three children and still had plenty left to pump, for example) and I figure that if God gave me this much, the least I can do is share it with those other babies who need it and those mommies who desperately want to give it to them.

    I recently watched a blog discussion about milk donation and the woman was pretty adamant that milk banks should be priority over mom-to-mom donation. Unfortunately I think that kind of attitude can discourage donation all-together, because pumping is HARD WORK as it is. Happy to see this post, and see mom-to-mom donation talked about, as it's a very real option that so many people don't even know about (or really understand).

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