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New American Academy of Pediatrics Recommendations Aim to Ensure Safe Donor Human Milk Available for High Risk Infants Who Need it

A new policy statement from the American Academy of Pediatrics (AAP) supports using donor human milk to help boost the health of small, preterm babies when needed, but calls for screening, pasteurization and distribution through established donor milk banks to ensure safety.

The policy statement in the January 2017 Pediatrics, “Donor Human Milk for the High-Risk Infant: Preparation, Safety, and UsageOptions in the U.S.” (published online Dec. 19), advises against using Internet-based or informal human milk sharing. These sources of human milk carry the risk of bacterial or viral contamination, or exposure to medications, drugs, herbs or other substances.

Most donor milk is distributed by milk banks through hospital neonatal intensive care units. With limited supplies, some parents are obtaining donor human milk directly from other parents or from Internet sources that may be less safe since they vary widely in screening of donors and methods of milk storage and transportation.

“The use of donor human milk can save babies’ lives, but we need to make sure it is provided safely," said Steven Abrams, MD, FAAP, lead author of the policy statement and a past member of the AAP Committee on Nutrition. “The way to provide milk safely is through established milk banks that perform adequate safety checks and screening. Using milk from informal or online sources is simply too large a risk for infants, who could be exposed to bacteria and viruses like cytomegalovirus, hepatitis viruses, and HIV.”

Human milk offers advantages for all newborns, but particularly benefits infants weighing less than 1,500 grams (about 3.5 pounds), according to the AAP. Studies show infants fed human milk have lower rates of necrotizing enterocolitis, for example, a life-threatening intestinal disorder that primarily affects premature babies.

Mother’s own milk is always preferred, in part because some of breastmilk’s beneficial biological components may be reduced after pasteurization. But donor human milk can be an effective alternative when maternal milk isn’t available or falls short of the infant’s needs, according to the AAP. Reliably safe supplies of donor human milk from established milk banks are still limited, however.

The AAP statement also calls for developing public policy to increase and expand access to safe donor milk including improved governmental and private financial support for donor milk banks.

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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit

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