Sara Freund’s son, Elijah, has an incurable kidney disorder. His medications suppress his immune system, making him especially vulnerable to contracting the coronavirus.
Throughout the pandemic, the Freunds have been really careful. They sheltered in place in their Wisconsin home to protect Elijah as best as they could. Freund said they even kept Elijah’s older sister, who’s 9, home from school until she was old enough to get the vaccine.
“We live in this world that now everything is making him sick,” she said. “We literally live in our own bubble.”
When the vaccines first became available, Freund was eager to get more protection for Elijah. He was 5 at the time and not eligible.
So, Freund turned to social media to seek out breast milk from vaccinated donors, hoping their milk would have COVID antibodies. She also reached out directly to local nursing moms to explain her situation and eventually found someone who was vaccinated and willing to share her breast milk with Elijah.
”Depending on how much supply we had at the time, he got either 5 or 10 milliliters in the morning and at night while he took his other medications,” Freund said.
Dozens of Facebook groups exist to connect mothers in search of breast milk with those who are giving it away. Not all mothers seek out milk with antibodies, but some make specific requests for vaccinated donors, so Freund knows she’s not alone.
Elijah is now fully vaccinated, but at the time, Freund said, she was looking for a way to “boost his immune system, try to help protect him from COVID as fast as we possibly could.”
While early research on COVID antibodies and breast milk is promising, it’s not yet clear whether breast milk will prevent a child from getting sick. Yet some parents like Freund figure it’s worth a try, even if it comes with risks, for the potential benefits to their children who are too young for the vaccine.
Promising research on breast milk and COVID-19
Human breast milk has many health benefits to both mothers and babies, including protection against infections and other illnesses. Breast milk can contain antibodies against diseases a mother has previously been infected with or vaccinated against.
A recent peer-reviewed study involving 30 women showed the antibodies could be present in milk for at least six months after vaccination. Researchers found antibody levels peaked one month after vaccination, but they persisted for months after that, said Dr. Pia Pannaraj, director of the Pediatric Immunization Advancement Laboratory at the Children’s Hospital Los Angeles.
“Even at three months, we still saw a lot of activity in the milk that would be able to neutralize or kill off the virus,” Pannaraj said.
Babies who are breastfed are less likely to get the flu or respiratory syncytial virus, she said, so it’s reasonable to expect the same for COVID.
“Just the fact that [antibodies] are there would suggest that there would be some protection,” Pannaraj said.
The study also tested milk that had been pasteurized and found similar antibody levels compared to unpasteurized milk.
That’s good news for milk banks, said Kim Updegrove, executive director of Mothers' Milk Bank at Austin and board member for the Human Milk Banking Association of North America.
Milk banks pasteurize donated breast milk to kill harmful bacteria or viruses and make it safer for babies.
“I cannot tell you how much sleep has been lost while waiting for those results because we can't vaccinate infants, right? Not at this time,” Updegrove said.
For parents concerned about the risk of coronavirus transmission through breast milk, the U.S. Centers for Disease Control and Prevention says current evidence suggests COVID-19 infection through breast milk is unlikely.
Additionally, a new study published in the journal Nature in January found no infectious SARS-CoV2 virus present in the breast milk of lactating individuals who recently tested positive. The study adds to the evidence that COVID-19 is not a contraindication to breastfeeding, although the CDC recommends certain precautions.
Some milk banks report record demand during the pandemic
Demand for breast milk is difficult to quantify, especially since informal sharing happens through personal and social media networks. But several people in the breast milk industry say demand during the pandemic is higher than it's ever been.
Across North America, milk banks certified by the Human Milk Banking Association reported an overall 22 percent increase in milk distribution over the past year — from about 7.5 million ounces in 2020 to 9.2 million ounces in 2021.
“We are seeing urgent and, frankly, historic appeals for milk,” said Freedom Kolb, director of The Milk Bank, a nonprofit based in Indianapolis.
Kolb suspects the increase in demand could be due to greater awareness of the health benefits of breast milk for babies, in addition to supply chain issues with formula. The organization prioritizes babies in the neonatal intensive care unit, but also sells milk to parents outside of the hospital.
At milk banks, donated milk from both vaccinated and unvaccinated donors gets mixed together prior to pasteurization. That may compel mothers seeking breast milk specifically for protection against COVID to go through informal networks to find a vaccinated donor.
Another issue is the cost. Pasteurized milk from a milk bank can be expensive and insurance companies may not cover it.
The Milk Bank in Indiana charges $4.50 an ounce, which helps cover the cost of donor screening, microbiological testing, processing, bottling and distribution. A newborn can drink from one to three ounces every few hours. The organization does offer a sliding scale for lower-income parents, which Kolb hopes makes the donated milk more accessible. In 2021, the amount of milk given away for free to families in outpatient settings — more than $225,000 — surpassed the amount that was purchased.
“The milk processing fee is fairly expensive,” Kolb said. “So I can see lots of reasons for folks to look at different channels. What we'd like to say is: Make an informed decision, as much as possible.”
If parents choose to look to sources other than milk banks, Kolb said it’s important that the donor be someone they trust. The Milk Bank encourages people to reach out to their local milk bank first before turning to unscreened donors.
While the benefits of breast milk are well established, there are possible safety risks when using donor milk that has not been adequately screened and properly stored. The U.S. Food and Drug Administration recommends parents consult a health care provider before feeding a baby human milk from a source other than the baby’s mother. The agency advises against the use of breast milk acquired directly from other people or through the internet, due to potential risks.
The FDA does not regulate the breast milk industry, nor get involved in establishing state-level standards. Only a handful of states, including New York, Idaho and California, have safety regulations milk banks must follow.
Nonprofit milk banks that are members of the Human Milk Banking Association of North America must follow the association’s guidelines for screening, processing and testing donor milk, according to the association’s executive director Lindsay Groff.
But not everyone wants milk from vaccinated mothers
Samantha Koren is a mother of two from rural Kansas. She’s vaccinated against COVID-19 and donates milk to both her local milk bank and to local families in need.
“The milk bank that I donate to had no issues with me being vaccinated,” Koren said. “The local parents — I've had some refuse my milk because I'm vaccinated.”
In milk-sharing Facebook groups, it’s not uncommon to find requests from parents seeking milk specifically from unvaccinated donors because they don’t trust the vaccines or worry about vaccine ingredients, like mRNA, ending up in the milk.
Dr. Kathryn Gray, an OB-GYN at Brigham and Women’s Hospital, said that’s not a concern. She’s been studying the effect of the COVID vaccine on lactating and pregnant women and said the vaccine is safe and offers vital protection against severe illness. Breast milk has antibodies against all sorts of illnesses from both prior illnesses and vaccinations.
“Specifically trying to seek out milk from someone who hasn't had the COVID vaccine … doesn't really make a lot of scientific sense,” she said.
Koren said she’s comforted knowing she’s passing along critical antibodies to her child and to other babies who receive her milk. She has even offered a bit of her milk to her two-year-old daughter.
“I am not sure if this helped or not, but I wanted to do what I could to offer her some protection,” Koren said.
CORRECTION: A previous version of this story said the cost of breast milk from The Milk Bank in Indiana was $4.25 per ounce. That was incorrect. The cost is $4.50 per ounce. The story has also been updated to include information about what the costs cover and the amount of donor milk provided free to families in 2021.
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