Dangers of selling breast milk

• Ice cream, cheese in demand

Demand for human milk is great, especially by women who don't produce enough milk and whose babies refuse milk formula. Registered human-milk banks exist worldwide. Donor milk is collected from various mothers and distributed to mothers who have a prescription for breast milk.

The demand for other mothers' milk is so great that some lactating women in the United States are selling their surplus breast milk (frozen) online for up to US$5 per ounce. The online breast-milk industry is unregulated there.

Human breast-milk ice cream went on sale in London in February, and there is now even breast-milk cheese being sold.

Risk of transmission

One concern about selling breast milk online is that it may contain substances which are present in the mother's blood, namely drugs, viruses and bacteria which can affect the baby who consumes the milk.

Similar concerns exist for mothers who breastfeed their own babies - the breast-fed baby may consume small doses of drugs which the mother uses. Although most drugs the mother uses transfers into breast milk, drugs usually appear in milk in tiny quantities. The breast serves as a barrier to drugs for the baby. But even small quantities of some drugs may harm an infant.

"Can I take this drug if I am breastfeeding?" Pharmacists get this question regularly, especially about over-the-counter products and medicinal herbs. Physicians also consider whether to prescribe some drugs to a breastfeeding mom. Little evidence exists on effects of most drugs on newborns; when there's no evidence on adverse effects of a drug in breast milk. This doesn't mean the drug is safe.

Most health professionals advise breastfeeding women to take only essential drugs. Considerations include:

• How much of the drug is delivered in human milk?
• How well does baby absorb the drug, process and clear it from its body?
• What effects could the drug have on baby?
• How much breast milk does the little person consume?
• How old is the baby? Is it pre-term, jaundiced?

Some drugs make baby irritable (caffeine from coffee), drowsy (ganja, sleeping tablets, narcotics), slow down babies from sucking (phenobarbital), make babies sensitised to the drug in future (antibiotics), reduce the supply of breast milk (some blood-pressure medications, allergy medications, contraceptives, nicotine from cigarettes). Other drugs do serious harm to babies via breast milk. The breastfeeding woman should consult a health professional before taking any drug.

Weigh the risks

Some mothers delay drug treatment until the baby is older. If the mother must be on a particular drug that's potentially harmful to baby, she may have to stop breastfeeding.

If mother's drug treatment is only for a short while, she may choose to build up breast-milk reserves by using a breast pump and, freezing the pumped milk for use during her drug treatment.

In order to keep breast milk flowing, the medicated mother could also pump milk and discard it until drug treatment is over. Then she can continue breastfeeding.

Dr Dahlia McDaniel is a pharmacist with a doctorate in public health. She is the chief executive officer of two pharmacies and a medical practice in Kingston; email: yourhealth@gleanerjm.com.