Is donor breast milk safety safe while breastfeeding?

What does the evidence say about donor breast milk safety while breastfeeding?

1. FDA recommends using donor milk only after consultation with the baby's clinician and only from a source that screens donors and applies collection, handling, processing, testing, and storage safeguards. It does not recommend milk obtained directly from individuals or through the Internet. 1
2. CDC advises avoiding Internet milk purchases and notes that nonprofit North American milk banks use evidence-based testing and processing standards. Because supplies often serve hospitalized or medically fragile infants, banked milk may not always be available for healthy infants. 2
3. The American Academy of Pediatrics clinical report supports pasteurized donor milk when maternal milk is insufficient for high-risk infants, especially those under 1,500 g or with severe intestinal disorders. It distinguishes established milk-bank safeguards from unpasteurized direct or online sharing. 3
4. Investigators anonymously purchased 102 samples advertised online as human milk. Eleven contained bovine DNA, and ten had levels consistent with at least 10% cow's milk product, demonstrating that buyers could not verify composition. This study assessed purchased online milk, not accredited milk-bank products. 4
5. CDC reports that pasteurized donor human milk plus a multinutrient fortifier is the recommended first alternative for very low birth weight infants when maternal milk is unavailable or insufficient. This recommendation is specific to advanced neonatal care and does not define feeding for every healthy term infant. 5

How donor breast milk safety changes by nursing stage

• Early weeks. When donor milk is being considered, clarify why it is needed, whether maternal milk is available, and whether the infant is premature, very low birth weight, medically fragile, or healthy. Hospital milk-bank supplies may be prioritized for higher-risk infants.
• Established nursing. Use only the storage, thawing, and feeding instructions supplied by the hospital or milk bank. Pasteurization and screening reduce important hazards but do not make every donor-milk product nutritionally interchangeable for every infant.
• Weaning. Growth and intake still need follow-up. Very low birth weight and preterm infants often need a multinutrient fortifier with donor milk, while healthy term infants may have different options. Informal or Internet milk should not be assumed equivalent to banked pasteurized milk.