Got Breast Milk? | Development | Hudson Valley | Chronogram Magazine
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Got Breast Milk? 

Last Updated: 10/25/2015 10:23 am
Eight-month-old Calev was adopted into the Rabe-Simon family and - has been entirely breastfed with donated breast milk.
  • Eight-month-old Calev was adopted into the Rabe-Simon family andhas been entirely breastfed with donated breast milk.

When Jed Ilany decided it was time to have a baby, he looked in Connecticut for an agency. He and his husband, Ben, live in Manhattan, but surrogacy isn't legal in New York. They were matched with Kim, a military wife with a young son who was putting herself through school. She had always wanted to help a gay couple have a baby. The Ilanys both fertilized an anonymous donor egg, and lucked out with a healthy transfer to Kim on the first try. About halfway through the pregnancy, Kim and the Ilanys were issued a pre-birth order so both Ilany dads would be on the birth certificate. When June was born last March, the nurses gave the Ilanys syringes of the warmed breast milk they had purchased to feed her.

The Ilanys' doctors, midwives, and pediatricians all agreed that breastfeeding is the healthiest start for a baby, but of course, the Ilanys couldn't do that alone. It was agreed that Kim would provide milk, but hearing and touching the baby stimulates those production hormones, and Kim didn't want to form a bond by breastfeeding and holding the baby. Knowing they might need supplemental breast milk, they sought guidance from the hospital. With a prescription from their pediatrician for 12 ounces of donor breast milk, they made their way to the Hudson Valley Milk Bank in Irvington.

Started in 2009 as the first community-based milk bank in New York, it's a storage and distribution site for pasteurized human milk from Ohio Health Milk Bank and the Mothers' Milk Bank of Northeast. Housed in the office of family nurse practitioner and lactation consultant Julie Bouchet-Horwitz, the goal was simply to make breast milk easily available to hospitals for premature babies. "We now have research that confirms preemies fare better on human milk," says Bouchet-Horwitz.

They handed out just 25 ounces that first year to parents sent by the hospital, coolers in hand, and demand rose each year. Eventually, Bouchet-Horwitz advised hospitals on getting their own storage and distribution licenses, which are free through the Department of Health. Because breast milk is regulated in New York State as a tissue (as opposed to a food in other states), it's not difficult to add to a hospital tissue license. Right now, there are 16 such licenses locally in the works. That means demand for milk from the Hudson Valley Milk Bank is going down, but Bouchet-Horwitz doesn't mind. "I opened the bank so hospitals could see the benefits. Now I'll just keep it open for my clients and the community." That might be the homebirth community or women who have had a mastectomy or breast reduction surgery. Soon, it will double as a depot for the future New York Milk Bank, the first comprehensive human breast milk bank in New York.

Mother's Milk

When Alexa and Abram Markiewicz's son, Asa, was born by emergency C-section at 26 weeks, just shy of 2 pounds, Alexa produced only drops of milk. The Markiewiczes knew that breast milk was ideal for Asa's delicate digestive system, but the NICU, where Asa stayed for over two months, would only allow him supplemental breast milk that was from a bank. The guidelines around breast milk are even stricter than blood, both in donor screening and in product processing. While there have been no reported cases of infection from breast milk, like any other bodily fluid, it carries pathogens. Donated milk from a bank is inspected, pooled with other donors, pasteurized, and then checked for bacterial content. "That's why there's been zero percent infection rate," says Bouchet-Horwitz. "We're feeding the sickest babies, so we can't take any risks at all." But at nearly $5 per ounce, the Markiewiczes felt it was cost prohibitive. Even though a newborn will only take 1-2 ounces each feeding, they're fed about five times per day. Tiny Asa only needed 2ml every 6 hours, so Alexa could keep up with that. But they knew, at home, Asa would need another option.

The Markiewiczes didn't have anything against formula, but never used it since they could get donated breast milk for free. Coworkers offered their babies' leftovers. At first, Alexa felt slightly disgusted by the idea until Abram pointed out that wet nurses have been around for several thousand years. They vanished around 1900 with advancements in the feeding bottle. They decided to research it. Alexa calls Bekki Hill the unofficial Milk Sharing Guru of the Hudson Valley. "Bekki taught me how to ship breast milk, the best way to bag and store it, sharing etiquette, suggestions for increasing milk supply, and she was available via text 24/7," Alexa says. "After about a month of networking, I had five consistent donors."

When Hill's first daughter lost weight dramatically as a newborn, Hill sought help from several lactation consultants. "Everyone was stumped." It turned out Hill had insufficient glandular tissue, a condition where there aren't enough breast cells to make milk. With each of her three children, she could make some milk, but not enough that they could thrive. Back then, the only resource available was a Yahoo group called Milkshare. There, Hill found a doctor in Manhattan with milk available. The night before her husband got on the train with insulated freezer bags, Hill lay awake, her mind filled with question marks. "I didn't know her, and we were going to feed our baby her breast milk. I had to walk myself through the logic of it: She'd provided copies of her blood work; she was healthy; this is the same milk she feeds her babies."

It was because of her own doubts that Hill and a friend started Modern Milksharing, a national online support system. What started as a blog became a Facebook group, now known as a resource for the logistics and etiquette around milk sharing. Hill eventually became a lactation consultant so she could work with families locally. Usually it's just a phone call in which milk recipients ask questions. Why is this safe? How is it safe? What do I need to do it safely? Hill says, "Safety is a big concern because this is what you're feeding your baby." A recent study published in Pediatrics showed that breast milk purchased from the Internet was sometimes tainted with cow's milk, presumably to stretch profits. Buying breast milk privately is generally considered an unsafe practice. The assertion is that shared milk is safer because it's usually pumped for women's own babies.

Alexa goes further, crediting shared breast milk for Asa's eventual health. Last August, Asa turned two, with no long-term disabilities identified. "It's almost unheard of for a baby with his pulmonary history to not have asthma or need breathing treatments." Mother's milk contains antibodies to help protect a baby in a particular environment. "[Because the baby receieved] milk from 20 different moms, I suspect he was passed antibodies for many more illnesses and diseases than I could have provided with my milk alone."

Breast is Best

When she finished her maternity leave and went back to work, Kelly Hidalgo's baby began nursing only at night. She pumps milk for him at work, but it chills in her freezer unused. "I would feel bad when parents worried about their milk supply, and I was overproducing myself," Hidalgo says. So she started checking milk sharing Facebook groups, like Eats on Feets, for local calls for milk.

It's time consuming. A pumping session might take twenty minutes, several times a day. Yet, whether to a bank or informally sharing, breast milk donors gift their milk without compensation. The reasons motivating women to donate breast milk often boil down to two. Most of the calls to the Hudson Valley Milk Bank are from women desperate for freezer space who feel wasteful throwing the milk away. Some women pump to donate, and like Hidalgo, liken it to giving at church. They might choose to give informally if they don't meet a bank's requirements for minimum donation or screening.

Informal milk sharing communities ask donors to self-screen. The motto at Eats on Feets is "Know Thy Donor." "Donors and recipients are encouraged to speak in depth with one another to make sure that donated milk is safe and acceptable with respect to lifestyle," says Jean Garretto, an Assistant Midwife who runs the Eats on Feets New York group. Having just given birth, donors often have copies of recent blood work on hand. Hidalgo offers recipients her health history and diet, which she says most parents feel too awkward to ask. With most deliveries, Hidalgo packs a cooler filled with ten 5-ounce bags of her frozen, labeled breast milk and meets up with the moms for playdates.

Jed puts June in the Baby Bjorn, some ice packs in an insulated bag, and heads out on the subway. After the initial prescription for milk bank milk, when the Ilanys need to supplement their supply from Kim, they turn to informal sharing. At the women's apartments, they chat about how fast babyhood goes. "It's like meeting an immediate friend," says Jed. "I feel so indebted and grateful to these people. I'm trying to do the best for my baby, and they're doing something that I could never do myself."

For Hidalgo, the donation is an opportunity to rewrite history. She was on the other side of the table when her older son wouldn't latch, but a lot of these resources for milk sharing weren't out there six years ago. "Breast is best," Hidalgo recites. "And if you can't do that, you feel like a failure." Hidalgo says it contributed to postpartum depression until she came to terms with the fact that she was providing her baby with what she could. "I remember that feeling." So she plans to keep pumping even while weaning. "People think I'm a little crazy, but you get connected with these people. You're helping support them a little bit, and it feels good to do that."

Resources

Eats on Feets, Facebook.com/eatsonfeetsny

The Hudson Valley Milk Bank, Hudsonvalleybreastfeeding.com

Modern Milksharing, Facebook.com/modernmilksharing

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