Health Screening for Breast Milk Donations

Whether you’re a breast milk donor or a parent seeking donor milk, health screening is a critical part of making sure the milk is safe. Official milk banks have very stringent screening protocols for donors – and those are a good model to follow in private milk-sharing arrangements as well. Here’s what to know about health screening in the context of donor breast milk:

1. 1Infectious Disease Screening: Milk bank donors undergo blood tests for a panel of diseases. Typically, this includes HIV-1 and 2, HTLV (Human T-Cell Lymphotropic Virus) 1 and 2, Hepatitis B, Hepatitis C, and Syphilis. Donors must test negative for all these. It’s strongly recommended that anyone providing milk outside a milk bank setting likewise shares proof of recent negative blood tests for these infections. These viruses can be transmitted through breast milk, so this is a non-negotiable in terms of safety. If you’re a recipient, don’t be shy about asking a potential donor for copies of their lab results (most understanding donors will appreciate the importance of this).
2. 2Medical and Lifestyle History: Reputable milk banks have donors fill out detailed questionnaires about their health and habits. Certain conditions or behaviors can disqualify donors. For example: - Donors cannot use illicit drugs or tobacco/nicotine products. Smoking, vaping, or drug use can pass substances into milk (or affect milk quality), so these are typically exclusions. Moderate alcohol use usually requires a waiting period before pumping milk (milk bank donors must refrain from chronic alcohol use). - Certain medications may disqualify or pause donation. Donors are usually asked to list all prescription and over-the-counter meds and supplements. Some medications (and high-dose herbal supplements) aren’t compatible with donation, or require “pump and discard” for a period. For example, chemotherapy drugs, certain psychiatric medications, or high-dose iodide are incompatible with donation. Each milk bank has an approved medications list. (If you’re doing private sharing, discuss any regular meds/supplements the donor takes. Some moms pause donations while on a short course of medication, just to be extra safe.) - Donor should be generally healthy. Chronic diseases aren’t necessarily disqualifying if well-controlled, but any acute illness should be reported. If a donor was sick (fever, etc.), they shouldn’t donate milk pumped during that illness unless it’s confirmed safe. - Dietary factors: Usually, diet doesn’t exclude someone (milk is remarkably robust), but if a baby who will receive the milk has allergies (like a severe dairy or soy protein allergy), the donor may need to avoid those foods. So donors often share basic diet info especially if the recipient baby has specific needs (e.g. a dairy-free diet). Vegan donors may be asked to ensure they have adequate vitamin B12 levels, since B12 could be low in their milk otherwise.
3. 3Donor Lifestyle Risk Assessment: Donors (like blood donors) are typically questioned about any risky behaviors or exposures that could affect milk safety. For instance, if a donor or her sexual partner has a history of intravenous drug use, or a recent new tattoo/piercing, those can be cause for deferral due to infection risk. Recent travel to certain areas with high infectious disease risk might also be considered. A donor whose partner is at risk for HIV (e.g. partner has HIV, or multiple partners, etc.) would be deferred. These questions might feel personal, but they’re important for protecting the babies who receive the milk.
4. 4Screening of the Milk Itself: In milk banks, once the milk is donated, it’s pasteurized and then a sample from each batch is cultured to check for bacterial growth before it’s released. In informal sharing, you won’t have the ability to lab-test the milk, so the focus is on upfront screening and safe handling. Some recipients choose to pasteurize donor milk at home (see the Flash-Heating guide above) as an extra safety net, particularly if the donor wasn’t formally screened. Home pasteurization can significantly reduce viral and bacterial load, though it may slightly reduce some beneficial components.
5. 5If You’re a Donor: Expect to be asked these health questions. Honesty is crucial – remember, the recipients are often fragile babies (premature or with medical issues) or other parents’ precious children. Milk banks never pay donors, to avoid any incentive to hide information. In private sharing, there may be compensation, but even so, prioritize transparency about your health. Provide recent blood test results if you can. If you are feeling under the weather or have started a new medication, let the recipient know so you can decide together if the milk should be used.
6. 6If You’re a Recipient (Buyer): Don’t be afraid to screen your donor. Ask about: - Blood test results (HIV, hep B/C, etc.) – ideally done in the past few months. - Smoking/drug/alcohol habits. - Medications and supplements. - Dietary allergens (if relevant to your baby). - When the milk was pumped and how it was stored (fresh frozen within 24 hours is ideal). - If the donor has any health conditions (for example, a donor with a mild cold is usually fine – breast milk even contains antibodies – but a donor with say, HTLV or on chemotherapy should absolutely not donate).

Also, use common sense: meet in person if possible, trust your instincts. Most moms who donate are wonderfully generous people looking to help, but you are ultimately responsible for vetting the milk you feed your baby.

Official recommendation: The FDA and AAP recommend using established milk banks when possible, because of these screening and safety measures. If that’s not an option (banks often prioritize preemies and have limited supply), then rigorous screening and safe handling of donor milk is the next best thing. Many parents successfully share milk informally – just do so as safely and informedly as possible. Remember that formula is a safer choice than unscreened raw milk from an unknown source. So, if you can’t thoroughly screen a donor or pasteurize the milk, it may be better to use formula.

In summary, treat donor milk with the same care you would blood donations: ensure the donor is healthy and low-risk, test for key infections, and handle the milk properly. By doing this due diligence, you can significantly reduce risks and give your baby the gift of safe breast milk from another mother.