Mothers should know they have three options to provide human breast milk before using formula. This will help her provide the best nutrition for her baby.
• A mother can express her milk and feed that to her baby if she’s not feeding at the breast.
• If she has a delay in her supply, she could supplement with donor human milk while boosting her own supply.
• Wet nursing or informal milk sharing is another option.
• The fourth choice, according to The American Academy of Pediatrics and the World Health Organization, is formula.
This matters because, while both formula and human breast milk provide calories, they are vastly different kinds of foods. Human breast milk is the only substance on the planet that has the immune factors, growth factors and the unique balance of micronutrients that human babies need. This is important for the newborns’ pure and still maturing gut lining, and especially important for preterm babies.
All babies deserve to have access to human breast milk. There is a network of 23 non-profit Mothers Milk banks in Canada and the United States. (I wish there were more.) These are the centers that supply Pasteurized Donor Human Milk (PDHM) for Neonatal Intensive Care Units (N.I.C.U) in hospitals.
These centers have specific processes for screening the donor and assuring the cleanliness of the milk. You can receive milk from them if you need to augment your supply, even if your baby is not preterm or in the N.I.C.U. There is cost to cover processing and shipping. It would be good to know if the hospital where you plan to give birth has this in their N.I.C.U. Provide your own breast milk and if necessary, look into the Milk Bank network to supply more breast milk.
As an individual, you can also donate your milk to these banks. There is a process of screening to become a donor. In the New England area, we have a Mother’s Milk Bank in Newton, Massachusetts.
Another option is informal milk sharing. The concerns about the donor mother’s health, use of tobacco/medications/drugs, the cleanliness of the milk collection and the like are important considerations. With informal milk sharing, that ‘screening’ will be your responsibility. To be fair, there are worries about contamination with formula, too. Parents need to be diligent about clean techniques for preparation.
In some cultures, wet-nursing (having another mom nurse) the baby is acceptable. In times of emergency or disaster (especially when water is contaminated) wet nursing is preferable to formula feeding.
Whatever amount of human breast milk you can provide for your newborn, from your own body and/or supplemented by donors, is always valuable. Formula is also a choice, though for good reason, the fourth choice.
If you have concerns about your ability to make milk or to breastfeed your baby, talk to an IBCLC sooner than later. That way, you can make a plan for how to provide breast milk.