13 Bio-Intimate Economies of Breastmilk ... 335milk where formal milk banking and pasteurisation is unavailable
is that it occasionally causes issues with supply. In addition to health
screen requirements for CMV, a small percentage of women who offer
to donate are unable to due to the fact that they are either taking con-
traindicated medication, have had a blood transfusion within the last
six months, or have lived in the UK and are therefore declined for the
risk of Creutzfeldt-Jakob disease. The other most common cause of not
being accepted is latent CMV. In the NICU, it appears that women will
only offer their milk if they know they do not have many of these risks
factors. Only around a quarter of women screened are able to provide
donor milk for the unit. Given the high rates of CMV, there is reason
to pursue the case for a milk pasteuriser and full milk banking facilities.
If more donor milk were available, then the range of babies that could
receive said milk would increase.
A study by Esquerra-Zwiers et al. ( 2016 ) explored the decision-
making process of mothers as they provided consent for the use of
donor milk. Most of the mothers in the Esquerra-Zwiers et al. study,
like the mothers in the New Zealand NICU, ‘wanted the best for
their baby’, and relied on their health professionals’ advice that donor
breastmilk was better than infant formula, especially for preterm
infants. Many of these mothers wanted to provide their own breast-
milk for their baby and felt uncomfortable with the prospect of giv-
ing someone else’s milk. Like recipients of online peer-milk sharing,
the mothers wanted assurance that the donor’s profile, as well as her
lifestyle choices, diet, and health, were considered. For some mothers,
issues around insufficient milk supply produced additional emotional
anxiety, as they already felt that their bodies had ‘failed’ them by hav-
ing a premature birth. A key concern for mothers in the NICU then,
as noted above with regard to online peer-milk sharing, relates to
trust; trust in the donor that she is not at risk, and trust in the health
professionals to ensure the milk is safe.
The majority of mothers in the NICU who received donor milk for
their premature baby express relief that this option is available. One
woman had no desire to breastfeed her infant or express, but was happy
for the baby to have donor milk as recommended by medical staff.
Situations such as this precipitate discussion among staff, whose job it is