When it comes to feeding young infants, it is hotly argued that “breast is best.” Many new mothers, however, are unable to breastfeed or find the practice difficult. As a result, some mothers purchase human breast milk online with the belief that it is better for their baby than formula. But in a report published in The BMJ, experts claim such breast milk can pose serious health risks to infants.

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One study found that 74% of online breast milk samples contained high levels of potentially harmful bacteria, including bacteria known to cause pneumonia and meningitis.

The potential benefits of breast milk for infants’ health are well documented. According to the American Academy of Pediatrics, breastfeeding can protect infants against a wide range of conditions, including diarrhea, urinary tract infection, childhood overweight and obesity and diabetes.

Medical News Today have also reported on a number of studies revealing other potential benefits of breastfeeding, including better immune system development, increased growth of friendly gut bacteria and even increased intelligence later in life.

Because of the numerous benefits associated with breastfeeding, the practice has become a major focus of campaigns around the world. The first week of August, for example, is dedicated to World Breastfeeding Week – an annual campaign that aims to encourage breastfeeding and support women in doing so.

Despite such campaigns, there is no denying that some women find breastfeeding difficult or are unable to breastfeed. This could be due to low milk production or a number of health conditions. But report author Sarah Steele, of the Global Health, Policy and Innovation Unit at Queen Mary University of London in the UK, and colleagues say the strong focus on breastfeeding can push such women to search the Internet for alternatives.

“Online these women find emotive, moralizing discourse around breastfeeding and often fear-inducing warnings that formula is inferior to human milk for infant feeding,” they note.

“They may also find sites that facilitate the buying, selling and trading of breast milk, as well as high-profile media sites featuring celebrities who are engaged in this trade. In the absence of warnings about the dangers of buying milk online, this option might seem healthy and beneficial – the better choice if one can’t breastfeed oneself.”

But Steele and colleagues say what mothers and some health care professionals fail to realize is that using breast milk from such sites is putting infants’ health at risk.

Unlike breast milk banks, the online market for breast milk is unregulated, meaning the milk does not undergo pasteurization, is not tested for contamination and disease, and may be stored incorrectly.

“Unlike donors at licensed milk banks, online sellers are not required to undergo any serological screening, meaning that diseases such as hepatitis B and C, HIV, human T cell lymphotropic virus and syphilis may not be detected,” note the authors.

In October 2013, MNT reported on a study published in Pediatrics in which researchers found that 74% of online breast milk samples contained high levels of potentially harmful bacteria, including bacteria known to cause pneumonia and meningitis.

What is more, 64% of breast milk samples tested positive for Staphylococcus – bacteria known to cause septicemia and other conditions – while others contained salmonella and traces of feces.

“Other studies identified occasional contamination with bisphenol A and illicit drugs and tampering, including the addition of cow’s milk or water to increase volume (as milk is sold online per ounce),” say Steele and colleagues. “Such contamination cannot easily be detected before infant feeding.”

Such findings raise concern; the online breast milk market is growing – particularly in the US. One study found that in 2011, there were more than 13,000 online listings for human breast milk in the US.

The report authors comment:

Although a narrow group of adult consumers (including people with cancer, gym enthusiasts and fetishists) buy milk online, most buyers are parents who require other women’s milk for supplementation or as the sole source of nutrition for their infant.

At present, milk bought online is a far from ideal alternative, exposing infants and other consumers to microbiological and chemical agents. Urgent action is required to make this market safer.”

Steele and colleagues say there are a number of ways in which health care professionals can encourage mothers to make “smarter and safer” infant feeding choices.

The authors say they should increase their awareness of the online breast milk market and how it works, allowing them to pass such information onto new mothers and other caregivers. They recommend that training in this area be offered to all health care workers.

“In pediatrics, general practice and community care, post-birth check-ups offer an excellent opportunity to inquire about feeding difficulties and practices,” the authors note.

“New mothers experiencing difficulties breastfeeding, and those who cannot breastfeed, can learn of options that are much safer than the online market in breast milk. Health care professionals should also provide advice on the best storage and use of expressed milk.”

In addition, the authors say the online breast milk market needs to be regulated in order to ensure the milk is safe for human consumption.

The authors recommend that such regulation should also include punishment for those who knowingly contaminate or tamper with human breast milk to make a profit, and it should protect mothers against exploitation from this market.

“Although breast milk holds many known benefits, seeking out another’s milk rather than turning to instant formula poses risks,” says Steele and colleagues. “When breast milk is screened and treated appropriately, as the World Health Organization (WHO) states, it remains second to a mother’s own milk as best for infant feeding.”