SALISBURY, Md. -- This time last year, Mother's Milk Bank in San Jose may have been able to send a month's worth of donated breast milk to hospitals in Alaska or Hawaii in a single shipment. Now many of those same hospitals can only get their milk by the week.
"We're just struggling to keep up," said executive director Pauline Sakamoto. "Our freezers are empty, but the demand is skyrocketing. It's just exponentially growing, so it's imperative for us to find more milk."
From hospital milk banks to pages on Facebook, more new moms are using another mother's donated breast milk to feed their babies. About 2.18 million ounces of breast milk were distributed through the Human Milk Banking Association of North America (HMBANA) in 2011, said Sakamoto, a member and spokeswoman. That's up from 1.5 million ounces in 2009 and 1.8 million ounces in 2010, she said.
Sakamoto said the numbers are up because more hospitals are using donor milk for pre-term infants. She also said donor milk goes to mothers with delayed lactation who use donor milk to tide them over until Mom is ready.
The San Jose facility is one of 12 milk banks affiliated with HMBANA, which also has presence in cities including Denver, Indianapolis, Boston, Iowa City, Kalamazoo, Mich., Raleigh, N.C., and Fort Worth and Austin.
The latest to join is St. Luke's Heart of America Mothers' Milk Bank in Kansas City, Mo., which opened its doors in May and became affiliated with HMBANA on Aug. 10, said Dr. Barbara Carr, a neonatologist with St Luke's.
"We have about 10,000 ounces in our freezer now that needs to be processed," Carr said. "This is going to the most fragile babies that are born."
Additional banks are planned for Orlando, Portland, Ore., and Missoula, Mont. Another milk bank to serve both Wisconsin and Illinois is also coming, though a city hasn't been picked yet, Sakamoto said.
Hospital donor milk is meant to supplement a baby's nourishment until some other feeding source can be arranged, so that the child will continue to grow, Sakamoto says.
Getting milk from a milk bank requires a prescription from a doctor. A pediatric ICU unit will order the milk, and it's sent overnight by mail, arriving frozen, Sakamoto said. Donor milk is screened for bacteria and viruses and then pasteurized.
That medical scrutiny is the reason that the milk from banks is not free.
Milk banks charge $3 to $5 per ounce, and that pricing is based on blood testing of donor moms, screening of the donated milk for bacteria and milk pasteurization, according to Sakamoto.
Sakamoto also noted that alongside the growth in the organized non-profit milk banking industry, there's also been more visible growth casual milk sharing.
Casual milk sharing is geared for women who can't produce enough milk for their full-term babies, while hospital milk banks are often dealing with sick and premature infants, said Emma Kwasnica, a self-described breastfeeding activist from Vancouver.
Kwasnica, 34, is the founder of Human Milk 4 Human Babies, a network of milk-sharing moms connecting exclusively through Facebook. She started in November 2010 under the name Eats on Feets but in March 2011 changed the name to make it more recognizable globally.
At first, Kwasnica matched moms who came to her, asking for milk or offering to share. After making about 20 matches, she decided to start setting up localized Facebook pages in her area.
"It just took off," she said. "All these women locally came forward and said, I'll run the page."
Now, 350 women are overseeing more than 120 individual Facebook pages for every U.S. state and 52 countries. She says they're not a formal organization, but a platform for moms to connect. Because women do not report back, they don't have hard numbers on donations. Also, no money can exchange hands between moms.
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"You can find a mom within a few miles of home," said Kwasnica, a mother of three young girls. "It's very different than the anonymity of sharing milk online and shipping it out. ... They're meeting at play groups and they're handing over a cooler of frozen breast milk."
Kwasnica said there are some risks to milk sharing that are not present in the more clinical hospital milk banking industry.
"But it's relative risk," she said. "How much risk is there when there's a woman down the road from you who you know, her children play with your children, you've been to her home? For many women, it seems safer to get to know a mom and use her milk."
Sakamoto says there is no rivalry between milk-sharing moms and formal milk banking, and that women have milk-shared "from the earliest of ages."
Still, she did say that today's informal milk-sharing moms should be aware of possible disease transmission, as well as potential legal risks.
"Before, with casual sharing, you knew the woman," Sakamoto said. "She might be a sister, or somebody you knew really well. In the age of the Internet, you only know then by what you read on the computer."