Human Milk Sharing in the United States: A Scoping Review

Area of Science:

• Pediatrics
• Public Health
• Nutrition

Background:

• Human milk is the optimal nutrition for infants.
• Milk sharing is an alternative when mother's own milk is unavailable, despite potential risks.
• Understanding milk sharing practices is crucial for healthcare professionals.

Purpose of the Study:

• To synthesize current literature on human milk sharing in the United States.
• To inform healthcare professionals about family use of milk sharing for infant nutrition.
• To identify gaps in research regarding milk sharing.

Main Methods:

• Systematic search of multiple databases (MEDLINE, Embase, CINAHL, etc.) conducted in June 2021.
• Inclusion criteria focused on milk sharing, excluding milk banks and preterm infants, limited to US studies post-2000.
• Review of 34 articles meeting inclusion criteria from 2,124 initial articles.

Main Results:

• Observational studies predominated (30/34), with participants typically white, married, middle-income women facing lactation issues or excess milk.
• Non-profit milk sharing often occurred online and in-person; for-profit sharing involved shipping and showed evidence of milk contamination.
• No studies documented infant harm from shared milk, but research on milk quality and clinical outcomes is scarce.

Conclusions:

• Limited research exists on the quality and risks associated with human milk sharing.
• No studies have documented clinical outcomes in infants fed shared milk.
• Clinicians should discuss milk sharing with families to mitigate risks, and research on infant outcomes is urgently needed.