The "highly dangerous" practice of buying breast milk online has been highlighted in a report, with experts warning of the dangers posed to infants and adult consumers alike.
"Breast is best" has been the message broadcast for many years but many new mothers are unable to breastfeed. World Health Organization regulations say second to a mother's milk for the health of a child is that of another lactating woman.
However, breast milk banks run by regulated authorities are expensive and some people do not qualify for them – meaning they only have the option of formula or buying online. This has led to an upsurge in the online breast milk industry.
In the US, it has taken a foothold have the past decade, with dedicated websites selling breast milk and sellers going through forums such as Craigslist and Gumtree. In the UK, the practice is gathering speed – in 2014, it made headlines across the country after reality star Josie Cunningham (of "I'll have an abortion to appear on Big Brother" fame) saying she would sell her milk online.
Similarly, the consumption of breast milk has become more prevalent among adults. Bodybuilders, people with specific fetishes and cancer sufferers are all becoming avid consumers of the product.
Findings of an international study in the online breast milk industry has revealed some shocking results – with risks of the practice wide-ranging.
Sarah Steele, one of the authors of an editorial published in the BMJ on the issue, told IBTimes UK: "Our study is a broad study and this is something we felt we had to write quite quickly rather than waiting until the end of our study to publish the results because we were finding from the existing literature that it was highly dangerous.
"There was no way we could wait until the end of a longitudinal study to say by the way you need to regulate this."
Damaged packages and potential of viruses
Findings showed that 25% of the breast milk bought online was in severely damaged packages, while 21% of the samples bought online were positive for cytomegalovirus. Of 101 samples tested, just nine had no detectable bacterial growth. Other studies found contamination with illicit drugs, bisphenol A and the addition of water or cow's milk to increase volume.
Online sellers can provide cut prices because they save on costs like pasteurisation and screening for diseases like HIV and hepatitis B and C.
"To break it down, one of the things we found is that there's a huge risk of gram negative bacteria – which is faecal bacterial – there's also significant viral threats because there's no screening happening," Steele said. "74% of samples were contaminated with bacteria. It's just dangerous."
Another major problem identified was that mothers were turning to the internet, with 75% going online instead of speaking to clinicians or health visitors. Forums and websites promote the sale of breast milk, with companies now paying Google to be the top click when you search for "breast milk".
Mothers unaware of the risks are sold on the idea they are doing the best for their baby, when in fact they could be feeding them a product "riddled with bacteria and viruses".
Indeed, when the product arrives defrosted in badly damaged packages, people will turn to forums to find out if it is still safe. Steele said: "A lot of people rationalise by thinking when it was sent it was frozen and when it's arrived its thawed so it's safe to put in the fridge for a few days. They read online how long can you use thawed milk and a lot of the online websites say 'you have X number of hours' so people think well its unthawed so if I use it today it should be fine."
An industry on the increase
And the growth in the industry is huge. One website, onlythebreast.com, had 27,000 members in June 2014 after launching five years earlier. It sold to between 700 and 800 members every month. However, because a portion of the market is through websites such as Craigslist and Gumtree, the true scale is impossible to quantify.
As well as being dangerous to infant and adult consumers, Steele warned that the risk of exploitation is of big concern. "The connection between this emerging breast milk trade something that needs further research," she said.
"The big risk is that we move not only towards discussing the infant dangers, but we forget that it's actually a lot of women in situations of poverty are the people who are selling their breast milk."
She said it is of paramount important to raise the awareness of the risk to consumers so they can demand companies and sellers be responsible.
In conjunction, the authors believe there should be regulatory framework in place to ensure the safe sale, as well as legal regulation that will "redress against those who knowingly contaminate or dilute milk for profit".
Steele added: "Consumers know that when the person whose actually the end recipient knows that it was produced in suboptimal conditions, in terms of the danger for their feeding and the danger for the person whose providing it, they will be more likely to ensure the conditions under which they're receiving that product are safe for everybody involved.
"For the border message, we're saying we need all of those health professionals and caregivers to be aware this isn't a safe feeding choice."