A mother’s own milk for her child is the biologic norm and the optimum nutrition under almost all circumstances.
If a mother’s own milk is unavailable, despite significant lactation support, supplementation with pasteurized donor human milk (PDHM) from a regulated milk bank is recommended. However, in the current context of the limited availability of PDHM, some parents may decide to give their infant informally obtained unpasteurized donor human milk (UDHM) as an alternative to human milk substitutes (commercial formula). This decision may be based on their perception that the known benefits of human milk, even if it is milk that is informally shared, outweigh the potential risks of formula. Informal milk sharing has become more evident due to increasing public awareness of the benefits of human milk and with the advent of social media platforms that facilitate informal sharing.
Health Canada, the Canadian Paediatric Society, and the Human Milk Banking Association of North America do not endorse the use of UDHM. However, parents' right to make informed decisions regarding the care of their children is generally respected within the context of Canadian law, even if the decision is contrary to medical advice. And while it is not the role of health care providers to promote informal milk sharing, they must be prepared to provide unbiased information on all infant feeding options based on the best available evidence and the guiding principles of patient-centered care, informed decision-making, shared decision-making, and harm reduction.
The practice resource includes sections on:
- ethical and legal considerations;
- risks and benefits of infant supplementation options;
- minimizing risks of informal milk sharing; and
- decision support tools, such as talking points, sample policy, sample acknowledgement of risk form, and family handout.