Should I Use Donor Milk for My Baby?

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I am expecting my first child via surrogate. Obviously, breastfeeding is not an option for me (well, at least in that I’m not interested in trying to induce lactation), and my surrogate does not wish to pump, which I 100% respect. I am fully at peace with formula feeding, but recently began wondering whether I should look into donor breast milk instead or in addition. I know it would confer many, but not all, of the benefits of breastfeeding. Do you have any data on this subject?
—Another Emily

First, congratulations! This is exciting.

Before talking about donor milk, I want to point back to my writing about the data on the benefits of breastfeeding. I mention this because I think it is important to have a context for what we mean by “all of the benefits” of breastfeeding. It’s not that there are none, but they are more limited than is often discussed. There are some possible gastrointestinal benefits early in life and perhaps a reduction in ear infection risk.

The most significant benefit of breast milk is a reduction in the risk of necrotizing enterocolitis (NEC), a serious intestinal disease that impacts preterm babies. It is for this reason that NICUs often use human donor milk for infants if their own mothers cannot pump for them. This donor milk is extensively screened and, typically, pasteurized to remove bacteria and viruses. In the unlikely event that your child is born preterm and has to spend time in the NICU, having access to donor milk may be important.

However, outside of this setting, the benefits of breast milk are fairly small. In addition, the market for donor breast milk outside the NICU is a bit of the wild west. There are some organizations (e.g., Mothers’ Milk Bank California) that can help moms who need donor milk outside the NICU access it. These typically require a prescription for ongoing access. Otherwise, you can search around online for people selling their extra milk. This is not recommended. The risks associated with non-regulated donor milk (infection, etc.) are potentially high and likely vastly outweigh any small benefit.

Bottom line: embrace your formula plans.