The concept of sharing mothers' milk is hardly new. Throughout most of history, wet nurses filled in for mothers who couldn't breastfeed or who chose not to. (The prophet Muhammad had a wet nurse. So did Napoleon, Alice Roosevelt, and Luciano Pavarotti. After the future King George IV was born, in 1762, his wet nurse, Mrs. Scott, became a minor celebrity.)

In the United States, the practice of using surrogate nursers died out in the early 1900s, when formula became popular. But even then doctors were aware that breastfed babies were hardier than those who got formula. In 1911, a Boston physician opened a facility where poor mothers who were nursing their own babies were paid to pump milk for other infants. It was, effectively, the country's first human milk bank.

By the 1980s, there were about 30 milk banks in the United States, all of them not-for-profit. The banks were the answer for mothers whose health issues (prior breast surgery, diabetes, pituitary gland or thyroid problems) hindered milk production, or whose milk had been tainted by medical treatments. They were ideal for mothers whose milk supply was stifled by the stress of premature birth.

Then AIDS arrived, and suddenly bodily fluids were terrifying. The AIDS virus was deadly, and it could be transmitted through breast milk. Milk banks started closing; before long, fewer than 10 remained.

In 1985, the Human Milk Banking Association of North America (HMBANA) was founded to establish safety standards for processing donor milk, and before long, all the banks that had stayed open were doing what dairy farmers had been doing for decades: pasteurizing. The process kills bacteria and viruses, and that safeguard, coupled with scores of scientific studies affirming the benefits of breast milk, reinvigorated interest in donor milk banking.

Today HMBANA comprises 10 nonprofit banks in the United States (and one in Vancouver), each primarily serving a designated section of the country. In 2007 these banks distributed nearly 1.2 million ounces of milk—both to hospitals and to women like Sheila Reigner, in Pennsylvania, who can't nurse because she's undergoing chemotherapy for breast cancer, and Marianna Manley, in Indiana, who can't produce enough milk for her quintuplets.

That 1.2 million ounces is roughly double the amount the banks were distributing a decade ago, and as more hospitals embrace donor milk, demand is bound to keep increasing. Each year approximately 60,000 VLBW babies (very low birthweight—less than 1,500 grams) are born in the United States, and on average, some 51,000 survive. These are exactly the babies who stand to benefit most from breast milk.Yet Audelio Rivera, MD, president of the Mothers' Milk Bank at Austin, has prepared a mathematical model showing that if every surviving baby were given breast milk, milk banks would need to supply more than 8.9 million ounces to compensate for what the babies' mothers couldn't provide themselves.

To collect that much milk, banks would likely have to do extensive outreach; today they operate quietly, with little or no marketing budgets. Few people know of their existence; even those in the business of caring for critically ill infants aren't necessarily aware that this resource is out there. Soon after her baby died at a North Carolina hospital, a woman named Nancy Woodyard returned to collect the milk she'd pumped and take it to a milk bank—only to find that someone on staff had thrown it away.


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