Challenging questions and ethical obligations: the ethics of everyday practice > 21 January 2015

Sally Dowling


Regulated and unregulated practices in donating breastmilk: A review of the ethical issues.

Breastmilk is the optimal source of nutrition for babies although there are a range of situations in which breastfeeding is difficult, including prematurity. Human milk is donated in the UK in both regulated and unregulated ways. A network of human milk banks receive and distribute donor milk, primarily to premature and sick infants, supported by NICE guidance (NICE, 2010) and the UK Association for Milk Banking (UKAMB). Variations in the geographical spread and funding of the banks mean that women who want to donate or receive breastmilk are not always able to do so. Discourse around the ethics of the provision and use of human milk in this way often emphasises issues of risk and safety.

There are also ways in which breastmilk is donated informally, often using the terminology of ‘sharing’, usually to full-term infants. Some women feed each other’s babies via friendship groups whilst others contact each other using online (often international) networks specifically set up for the purpose of peer-to-peer human milk sharing. Health bodies in a number of countries have issued warnings against obtaining breastmilk in this way, focussing again on ‘danger’ and ‘risk’. These topics have been the subject of a range of academic papers as well as online discussions, raising questions about the ethical issues and obligations in this area.

This presentation aims to review the different ethical issues involved in both regulated and unregulated practices of milk donation. It asks questions about the nature of donation and whether donors and recipients are viewed differently according to the mode of donation (milk bank vs. milk sharing; donating vs. selling) and the situation of the recipient. Is the ethics of ‘giving’ a body product different when the product is human milk rather than blood or organs? Is this an area which should remain unregulated, as a private practice, or should it be more widely or formally considered?

The main focus will be on informal milk sharing – why and how it happens (the lived experience of donors and recipients) and how both donation and risk are framed and accounted for. Issues for both professionals and non-professionals working with pregnant and lactating women will also be discussed.


Sally Dowling trained as a mental health nurse and spent most of her 21-year NHS career working in sexual health and public health. She came to the University of the West of England in 2007 to study for PhD and has worked as a Senior Lecturer in the Department of Nursing and Midwifery since 2009. Her research interests are in the area of breastfeeding, particularly in relation to women’s experiences and how these are influenced/mediated by social and cultural factors. She has recently been awarded an ESRC seminar series grant (together with colleagues from Cardiff University and the University of South Wales) to run a two year series of seminars looking at the relationship between social science research and breastfeeding policy and practice.

You can follow Sally on Twitter @sallyjdowling

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