Get a copy of one of Dr. Baumslag's books today here.
November 8, 2017 at 12:38 pm Comments (0)

Should Human Breastmilk be Sold?

Breastmilk is a body fluid. When mothers can’t breastfeed, for whatever reason, and doctors prescribe it for premature or low birth weight infants, who can’t tolerate bovine formula, ideally nonprofit milk banks are able fulfill this need. This is not necessarily what is happening. I am concerned that companies are buying breastmilk from mothers, adding fortifiers to it and selling it at a profit as breastmilk. Milk that has been fortified is no longer human breastmilk: It is formula, which is not the same. Feeding an infant from the breast is very different from feeding an infant bought formula from bottles, if we are considering the health of mother and child. This situation raises a number of questions. Should the sale of human breastmilk be regulated or restricted? Will the sale of breastmilk result in the deprivation of needy infants from poor families? If breast milk production continues should pressure be exerted on the producers to allow the donors a much greater share of the enormous profits reaped by the producers? (Last year Prolacta purchased and sold at least 2.4 million ounces of human breast milk.) We need more nonprofit milk banks to meet the increased need for breast milk for infants who are premature, low birth weight or sick with real breast milk, which has been donated. More people need to be made aware and consider if this situation is in the interests of the mothers and infants or the companies selling formula.

In light of this, we did a survey on a group of participants at the Second World Breastfeeding Meeting in Johannesburg, South Africa to examine some of the factors involved and learn more about how to protect mothers and babies. See the summary of our findings below.

You thoughts and comments are welcome and should be addressed to:


Survey: Analysis of the Sale of Human Breastmilk Globally 6/18/17

World Breastfeeding Conference
Johannesburg, South Africa, December 2016

Human breastmilk (HBM) is a body fluid sold as if it were food and its sale is mostly unregulated in many countries. Few countries have national regulations on how human milk is collected, the screening of who donates, who is the beneficiary, and how the donor milk is processed, distributed, and marketed. Breastmilk is inimitable. Its importance for infant health, growth and development is vital and its unique properties cannot be replicated (Baumslag). The increasing demand and commodification of HBM and the various ways in which the pharmaceutical and infant formula industries commercially exploit the critically important roles of human milk ingredients pose ethical concerns, such as: The practice of purchasing HBM cheaply from mothers in low-income countries or from mothers with economic need and selling it at a large profit; the impact on breastmilk access for lactating infants of donor mothers; and the lack of regulations on the collection, processing and the private sale online of donor human milk. Those working on the needs, supports and the protection of breastfeeding mothers and children are increasingly concerned about the commercialization of human milk and are calling for research, regulation and some protection and recognition (economic or otherwise) of donor mothers in low-income situations.

No formal or methodically gathered data exist to show if, how, or where HBM is sold. Many gray areas exist, such as the legality of selling it, regulatory and monitoring issues, and profiteering practices. There are now both nonprofit and for-profit milk banks worldwide and it is more difficult for milk banks to obtain HBM. Confounding this situation are multiple issues, including: A lack of clear-cut policies in many countries regarding the legality of selling HBM; an absence of regulations and their enforcement on the sale of HBM in countries where it is legal; a widespread need for education of mothers, field workers and medical professionals on the donation and sale of breastmilk; and finally the ethics and exploitation of donor mothers and their infants. More data on these issues are needed for the above-mentioned factors to be addressed.

In view of the sale of HBM (commodification of HBM) a survey was conducted at the Second World Breastfeeding Conference in Johannesburg, South Africa, in December 2016, which was organized by IBFAN and the South African Health Department. The survey was designed to explore the donation and commodification of HBM further, to try to ascertain its prevalence, legality, regulation and cultural attitudes on it. A total of 450 participants from 65 countries attended the conference. The survey instrument was made available through the registration center and participation was voluntary. Not all delegates from all countries participated, due to various logistical factors. Of the total sample of 117 respondents, half were from South Africa, the host country, so although this is not a representative sample, it has provided some indication of the needs and prevailing issues. The other half of the participants came from 33 different countries.


It is important to point out that both the responses provided and the comments reflect the perceptions and knowledge of each respondent. In many cases responses may be accurate, and in some instances, they may not be a true reflection of the facts. The responses reflect a lack of clarity and awareness as to the legality and regulations on the sale of HBM. They also showed the same lack of awareness as to the existence and types of milk banks (nonprofit vs. for-profit). Attitudes to the compensation of donor mothers for their breastmilk varied by geographical location and by culture. Approximately twice as many respondents thought women should not be paid as those who thought they should. A majority of participants expressed the need for more education of mothers as well as health workers regarding breastfeeding itself as well as available options for milk donor mothers.

In summary, the survey demonstrated a pervasive lack of knowledge of the many issues around breastfeeding, HBM donation and commodification, and identified areas for education. The less informed respondents requested more information and saw the benefits of being involved in the education of women so that they are not exploited and can better understand the need to help infants in need of donated HBM for their survival. Most of the respondents felt that it was important to pay donor women if their milk was being sold at a profit by someone else, rather than donated. Some respondents expressed the need to keep milk available for babies rather than for commercial purposes. The survey found cultural differences in attitudes to mothers selling HBM, but some field workers and researchers indicated that lactating women could use the cash for transport and to feed their families. However, many respondents felt that women undervalue their breastmilk and that HBM should not be sold. Areas for future research include: The legality of selling human breastmilk worldwide as a local issue and as an international issue; how best to provide more education to mothers and field workers; regulation and monitoring of the acquisition and sale of HBM by pharmaceutical and food companies in terms of economic exploitation and in terms of ethics; and the impact on the health of breastfed infants of donor mothers. Breastmilk is inordinately undervalued in the USA. In Australia, the GNP value of HBM is 3 million.


Mothers need to be better informed about their rights through education programs. They need to learn about the value of their milk and the inimitable value of breastmilk itself as a human fluid. Mothers also need to be offered other means of earning income instead of being exploited for their breastmilk. This would require involvement by various humanitarian and public health organizations, as well as governments.

There is a need to assess the status of breastfeeding in different countries and especially in rural areas. Information about prevailing regulations, monitoring, the presence and operation of milk banks and the availability of donor milk, and whether the sale of HBM is legal needs to be gathered and made more widely available. There is also a worldwide need to ensure that HBM is treated and regulated as a body fluid, not a commodity. Finally, better professional training and direct counseling services and more information and support for breastfeeding mothers should be provided. However, breastfeeding is far more than a monetary value: it is every baby’s birthright.

Contact for Questions and Comments:

Naomi Baumslag, MD, MPH ; Elisabeth Sterken, IBFAN; Glynnis Mileikowsky, BA

Copyright © 2017 by Naomi Baumslag