Study Shows Buying Breast Milk Online is Likely to Cause Illness in Infants

Results from a study led by researchers at Nationwide Children’s Hospital found more than three-fourths of breast milk samples purchased over the Internet contained bacteria that can cause illness, and frequently exhibited signs of poor collection, storage or shipping practices.

The study, published online today and in the November issue of Pediatrics, is the first to examine the safety of selling breast milk to others over the Internet, a trend that has become more frequent in the past several years. It is unknown exactly how common purchasing breast milk online is, but an earlier study cited 13,000 postings were placed on U.S. milk sharing websites in 2011.

The research team from the Center for Biobehavioral Health at The Research Institute at Nationwide Children’s Hospital purchased breast milk listed for sale on public websites and then analyzed it in the lab. The research was completed in collaboration with Cincinnati Children’s Hospital Medical Center and The Ohio State University.

“We were surprised so many samples had such high bacterial counts and even fecal contamination in the milk, most likely from poor hand hygiene. We were also surprised a few samples contained salmonella,” said Sarah A. Keim, PhD, principal investigator in the Center for Biobehavioral Health. “Other harmful bacteria may have come from the use of either unclean containers or unsanitary breast milk pump parts.”

Individuals posted classified ads on websites describing the breast milk they wanted to sell or why they were seeking breast milk. Researchers responded to ads from sellers who did not ask about the infant receiving milk and who did not require a phone call before a transaction was made.

Researchers analyzed 101 samples bought online and compared the findings to 20 samples obtained from a milk bank. In the U.S., twelve non-profit milk banks follow the Human Milk Banking Association of North America guidelines and provide pasteurized milk from carefully screened donors to fragile and sick infants. Because the milk banks pasteurize their milk, harmful bacteria are killed before the milk reaches an infant, unlike milk purchased online. Even before pasteurization, the milk bank samples were less likely to contain several types of bacteria and had lower bacterial growth in many instances.

Shipping practices also played a role in the levels of bacteria in the milk purchased online. The longer the shipping time, the more contaminated the milk. Nineteen percent of sellers did not include dry ice or another cooling method, and the temperature of the milk was outside of recommended range for storage. Researchers found particularly high levels of one or more types of bacteria in 17 percent of the samples.

Information provided by sellers in their classified ads online, such as “I eat an organic diet” or “great quality” had no direct implication on the safety of the breast milk. However, sellers often did not include information about the use of hygienic milk handling or storage practices, screening for diseases transmissible by milk, or limiting or abstaining from legal or illegal drugs.