12 Towards Social Maternity: Where’s the Mother? ... 293MacDonald’s story, together with research by others conducted with
milk donors and parents of children in need, indicates that the moti-
vation for sharing goes beyond altruism in at least two ways: through
the psycho-social rewards of benevolence and mutuality and through
opportunities for remuneration (Fentiman 2012 ; Gribble 2014 ;
Ronan 2015). The latter has expanded considerably in recent years,
whether through informal milk exchange websites or via hospital-based
milk banks and private-based human milk fortifier companies such
as Prolacta and Medolac in the USA.^2 It has become clear that many
parents believe their babies could benefit from a regulated market for
selling and buying human milk, through an expansion of the human
milk banking network, through companies manufacturing human milk
products, and through the development of other mechanisms for the
safe exchange of this valuable bodily fluid.
Human Milk as Commodity
As Linda Fentiman has pointed out, an extensive marketisation of
human milk currently occurs, through the work of the Human Milk
Banking Association of American (HMBANA), and the UK and
European Milk Banking Associations (UKAMB and EMBA) among
others globally, including extensive networks in Brazil, other parts of
South America and Northern Europe, and smaller networks in Australia
and South Africa. In 2015 there were 18 milk banks listed across the
USA and Canada with several more in development. This reflects
growing demand for human milk. Since 2011 many banks have been
experiencing shortages and increasing their recruitment programmes,
in large part due to the increase of informal sale and exchange via the
Internet (Bindley 2011 ; Bromberg Bar Yam 2010 ; Bye 2016 ; Dutton
2011 ). Cost recovery is also part of the formal economy. Although the
milk that banks distribute is donated, the cost of screening, pasteurisa-
tion, storage, and distribution is passed on to the parents of infants who
receive it. Donors receive equipment such as breast pumps and storage
bags, and reimbursement for shipping from the milk banks, but usually
no money. Even so, at approximately US$3–5 per ounce, the cost to