Human milk is the ideal source of nutrients for infants. Extensive research documents the many positive health outcomes and economic benefits of breastfeeding for both mothers and infants. Numerous organizations of health professionals, such as the American Academy of Pediatrics,1 American Academy of Family Physicians,2 American College of Obstetricians and Gynecologists,3 American College of Nurse-Midwives,4 American Dietetic Association,5 and American Public Health Association,6 advocate that infants be breastfed throughout the first year of life. The United States Breastfeeding Committee, which comprises more than 40 organizations and governmental agencies, is evidence of the country's commitment of time and resources to helping the maternal-infant dyad successfully breastfeed.7 The U.S. Surgeon General's Office strongly encourages the continuation of feeding breast milk to infants, particularly when women return to work.8
About 70% of women in the United States attempt to feed breast milk to their infants before being discharged from the hospital,9 and more than two-thirds of women with children younger than age 18 work outside the home.10 In addition to feeding their children directly “at the breast,” therefore, most women in the U.S. must extract milk from their breasts by mechanical means. A woman with a double-sided electric breast pump can easily and painlessly remove the contents of both of her breasts in approximately 15 minutes.11 Inasmuch as women are separated from their children daily, a child may be fed directly at the mother's breast before she leaves for work, be fed the mother's refrigerated breast milk that she pumped several days ago by daycare providers, be fed the mother's thawed frozen milk that she pumped weeks previously by the father or other caregiver, and finally be fed at the mother's breast again after she returns home. In the meantime, while the mother is separated from her infant, she must mechanically pump her breasts during breaks to have enough milk for upcoming days.
In the Infant Feeding Practices Study II, the largest investigation to date on pumping by U.S. mothers, 85% of 1,564 breastfeeding mothers of healthy, singleton infants extracted milk from their breasts while their infants were 1.5–4.5 months of age. By seven months postpartum, 92% of the cohort still breastfeeding had extracted milk from their breasts.12 Women who pump may produce more milk than is needed by their own infants. The purposes of this commentary are to describe some of the ways human milk has become a valued commodity and highlight some of the potential dangers of sharing raw, unpasteurized human milk.