CLOSE More women are buying breat milk online, but a study by Nationwide Children's Hospital discovered high levels of bacteria. Courtesy Nationwide Children's Hospital Nationwide Children's Hospital 
 
 Researchers find high levels of bacteria that can make infants sick in breast milk purchased via the Internet. 
 
 Despite safety concerns, new mothers are increasingly buying and selling milk over the Internet. A recent study by researchers at Nationwide Children's Hospital found that 75% of the breast milk they bought online was contaminated with high levels of bacteria. (Photo: Nationwide Children's Hospital) Story Highlights The selling of breast milk to others over the Web has become a growing trend 
 
 Researchers found high counts of harmful bacteria and even fecal contamination in the milk 
 
 The findings were likely the result of poor collection, storage or shipping practices 
 
 Thanks to the Internet, women who produce an abundant supply of breast milk and those in need of it for their babies have more opportunities than ever to connect. But a first-of-its-kind study finds high levels of harmful bacteria and contamination in breast milk purchased via the Web. 
 
 Researchers' analysis of 100 samples of breast milk bought on a public milk-sharing website found three in four samples contained either high levels of bacterial growth overall or contained disease-causing bacteria, including fecal contamination. 
 
 The findings were likely the result of poor hygiene during milk collection, the use of either unclean containers or unsanitary breast milk pump parts, or compromised shipping practices, says epidemiologist Sarah Keim, lead author of the study in November's Pediatrics, published online today. 
 
 Nineteen percent of sellers did not include dry ice or another cooling method when shipping, according to the study. 
 
 It is unknown exactly how common purchasing breast milk online is, but a soon-to-be published journal article by Keim found 13,000 postings on U.S. milk sharing websites in 2011. 
 
 It is "totally normal" for there to be certain bacteria in human breast milk, says Keim, a principal investigator with the Center for Biobehavioral Health at Nationwide Children's Hospital in Columbus, Ohio. Some are "very important and healthy for babies and the development of their immune system and digestive system," she says. 
 
 This study focused on bacteria which "are generally pretty harmless as long as they don't grow out of control" but have also been associated with illnesses in infants linked to contaminated milk, including staphylococcus and streptococcus, says Keim. It also focused on bacteria associated with disease even at low levels, such as salmonella and E. coli. 
 
 Researchers compared the online-purchased breast milk samples to samples of unpasteurized breast milk donated to a non-profit milk bank. 
 
 Twelve such banks throughout the U.S. follow strict guidelines set by the Human Milk Banking Association of North America and provide pasteurized milk from carefully screened donors to fragile and premature infants, primarily in hospitals. Pasteurization kills the harmful bacteria before the milk reaches an infant. 
 
 In all the samples analyzed, the Web-purchased milk had higher bacteria counts and were more likely to contain disease-related types of bacteria, even though the donated milk from the milk banks had yet to be pasteurized: 
 
 -- 72% had any detectable gram-negative bacteria, which are associated with bloodstream infections, wound or surgical site infections, meningitis and fecal contamination vs. 35% of milk bank samples 
 
 -- 63% tested positive for staphylococcus vs. 25% of milk bank samples 
 
 -- 36% tested positive for streptococcus vs. 20% of milk bank samples 
 
 -- 3% were contaminated with salmonella vs. none of the milk bank samples. 
 
 All of the samples tested negative for HIV, says Keim, but the laboratory analysis to determine "the authenticity" of the breast milk is just beginning, she says, adding: "We're a little suspicious of some of the milk." 
 
 "This study confirms what people have suspected in terms of online milk purchases," says Anne Eglash, a family medicine physician with University of Wisconsin Health in Mt. Horeb and a co-founder of the Academy of Breastfeeding Medicine. She was not involved in the new study. 
 
 "You don't know what you're getting, you don't know the quality, how honest people are about how old the milk is, and so many other issues. It's important to realize that this may not be the safest way to get breast milk when you don't have enough," she says. 
 
 But Eglash, co-medical director of the still-in-development Mother's Milk Bank of the Western Great Lakes, cautions against "throwing the baby out with the bathwater" when it comes to the sharing of raw, unpasteurized human breast milk between lactating women and those who cannot, for medical or other reasons, provide their own milk for their healthy, full-term babies. 
 
 "I don't think the message should be that women should never share milk, but that this behavior of buying it on the Web from someone you don't know should not happen," she says. Eglash emphasizes that "you don't want unpasteurized milk that has various bacteria going to an infant whose immune system is vulnerable," but says there are safe ways to share human breast milk with healthy infants who are not your own, as well as pasteurize it at home. 
 
 The Food and Drug Administration warns against feeding babies breast milk acquired directly from individuals or through the Internet, citing safety concerns; the American Academy of Pediatrics discourages feeding preterm infants human breast milk from unscreened donors. 
 
 Keim, author of the new study, says her findings "may not apply to situations where milk is shared among friends or relatives or donated rather than sold. The potential risks of those situations are less well understood." 
 
 Read or Share this story: http://usat.ly/1gwTueV ||||| Breast milk purchased online could contain cow's milk and other contaminants, research shows. A safer bet is milk from non-profit milk banks, such as this milk at the Mother's Milk Bank of Iowa in Coralville, Iowa. But milk from milk banks is available only by prescription. (Photo: Stephen Mally for USA TODAY) 
 
 Human breast milk has been sold online for years, and health experts have warned about possible dangers. Now they have a new warning: Some of the milk for sale isn't strictly human — it's been topped off with cow's milk. 
 
 That milk could be dangerous for some babies, says Sarah Keim, a researcher at Nationwide Children's Hospital in Columbus, Ohio. 
 
 Keim led a study published Monday in Pediatrics that shows 10 out of 102 breast milk samples purchased online contained at least 10% cow's milk. The added milk could have come straight from cartons or from baby formula, Keim says. 
 
 "It could be very harmful to babies with allergies or intolerance" to cow's milk, she says. 
 
 In a previous study using the same samples, Keim found 75% were contaminated with viruses or bacteria. 
 
 The Food and Drug Administration has warned since 2010 that milk sold or shared online could be unsafe. 
 
 The samples in the study, purchased in 2012, came from several sites, Keim says, including one called Only The Breast that continues to operate and appears to be the leading site for such transactions. Other sites, such as Eats on Feets and Human Milk 4 Human Babies, facilitate the sharing of milk but discourage sales. 
 
 In ads at Only The Breast, thousands of nursing mothers offer to sell excess breast milk for prices that appear to range from $1 to $6 per ounce. Many feature pictures of mothers and children and boast that the sellers eat organic diets, are free of drugs, alcohol and caffeine, and have other healthy habits. Some say they have been screened for drug use and for diseases such as HIV by milk banks — non-profit and for-profit operations that provide milk to premature and sick babies in hospitals. 
 
 In an emailed statement, Only The Breast, a corporation based in Reno, said the site's terms of use forbid members from adding any contaminants to milk sold or donated there. The statement says: "We believe most OTB members are honest, abiding by OTB terms and are simply looking to provide safe milk for babies in need." 
 
 If some sellers are intentionally adding cow's milk to their supplies, the obvious motive would be profit, Keim says: "Sellers might have an incentive to try to increase their production. … It could really add up." 
 
 Who is buying this milk? Most buyers are families who want breast milk for babies and, for whatever reason, don't have enough milk from the babies' mothers, says a recent editorial in the journal BMJ. The editorial, which called online milk sales and sharing unsafe, said buyers also include "a narrow group of adult consumers (including people with cancer, gym enthusiasts, and fetishists)." 
 
 The market for breast milk exists largely because health authorities "have done a really good job over the past 20 years of promoting the benefits of breastfeeding," Keim says. "Unfortunately, some women are very focused on feeding their babies breast milk at all costs." 
 
 Keim's samples did not include milk shared free online. She says such milk is unsafe because it has not been screened for contamination. 
 
 Sites for sharing and selling milk include instructions for home pasteurization — heating the milk to kill harmful microbes — and say it is necessary. But home methods are unlikely to be as reliable as the procedures used by milk banks, Keim says. 
 
 The 18 non-profit banks in the Human Milk Banking Association of North America do not get enough donations to provide safe, screened breast milk to the general public, says Kim Updegrove, executive director of the Mothers' Milk Bank in Austin. Their milk is needed for sick and low-weight babies for whom it is "life-saving," she says. It is available only by prescription. 
 
 Women who have trouble breastfeeding should seek help from lactation counselors and other health professionals rather than turning to the internet for possibly tainted supplies, Updegrove says. 
 
 "Body fluids are dangerous, and milk is a body fluid," she says. The addition of cow's milk is "alarming," because it could cause symptoms ranging from stomach upset to bloody diarrhea and eczema in some infants, Updegrove says. 
 
 Women thinking of selling or donating their milk could do more good by donating to the neediest infants through milk banks, she says. 
 
 "I do believe that most of those women looking to share or sell their milk are compassionate women who want to help other women," Updegrove says. 
 
 Read or Share this story: http://usat.ly/1FeAFUn ||||| A study published today on the safety of human breast milk bought over the Internet found that 10 percent of samples contained added cow's milk. The discovery that purchased samples of human milk may be purposely "topped off" with cow's milk or infant formula confirms a danger for the large number of babies receiving the purchased milk due to medical conditions. These babies are also vulnerable to the risk of infectious disease from bacterial and viral contamination of such milk, which was identified in a prior study by the same research team led by Nationwide Children's Hospital. 
 
 "We found that one in every 10 samples of breast milk purchased over the Internet had significant amounts of cow's milk added, and this poses a risk to infants with an allergy or intolerance to cow's milk," said Sarah A. Keim, PhD, principal investigator in the Center for Biobehavioral Health in The Research Institute at Nationwide Children's and lead author on the study. "If a baby with cow's milk allergy were to drink this milk, it could be very harmful." 
 
 The team's previous research found that 21 percent of individuals seeking human milk online did so for a child with a pre-existing medical condition. And 16 percent of these parents specifically sought out the purchased human milk due to their baby's formula intolerance. 
 
 Also troubling is their prior discovery of bacterial or viral contamination in more than 75 percent of milk samples purchased online, which became the first data to confirm the Food and Drug Administration's 2010 warning of possible contaminants in unpasteurized human milk obtained from sources other than the baby's mother. 
 
 The study published today in the journal Pediatrics is the first to document that milk purchased online is frequently adulterated with intentionally added ingredients. 
 
 "We were concerned that, because money is exchanged in these transactions, there might be an incentive to boost milk volumes in order to make more money," Dr. Keim said. "Cow's milk and infant formula resemble human milk and could potentially be added to boost volumes without the recipient knowing. Mothers who consider purchasing breast milk over the Internet should beware -- when you obtain milk from an unfamiliar source, you cannot know for sure that what you are getting is safe for your baby." 
 
 Dr. Keim's team at Nationwide Children's collaborated with researchers from The Ohio State University and Cincinnati Children's Hospital Medical Center to purchase and test 102 samples of breast milk advertised on milk-sharing websites. The team compared the purchased samples with their own preparations of human milk diluted with cow's milk to approximate the amount of contamination required in order to test positive for bovine DNA. 
 
 All purchased samples did contain human milk, but 11 also contained bovine DNA, 10 of which had results consistent with more than minor, accidental contamination with cow's milk. The findings suggest that a notable number of sellers intentionally added cow's milk or infant formula to the breast milk. 
 
 "Pediatricians who care for infants should be aware that milk advertised as human is available via the Internet, and some of it may not be 100 percent human milk," said Dr. Keim, who also is a faculty member at The Ohio State University. "And patients should be counseled against obtaining milk in this way for their infant." 
 
 In a recent survey Dr. Keim conducted of 499 women, published in Breastfeeding Medicine, 25 percent of women considered milk sharing and almost 4 percent of women shared milk among friends or relatives or had a preterm infant who received donor milk. She suggested that women with extra milk could help a baby in need by donating their milk to a non-profit milk bank instead of selling it over the Internet. 
 
 "Quality, timely lactation support for moms who want to breastfeed their babies could help avoid the need for many mothers to seek milk online," said Dr. Keim, who is continuing a variety of investigations into the phenomenon of Internet-based human milk donation and purchasing. "Women who have difficulty making enough milk for their child should work with their pediatrician to identify safe, healthy ways to feed their baby. The risk of contamination and added cow's milk makes it unsafe to purchase breast milk over the Internet." 
 
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– With the rise of sharing breast milk, a disturbing new study finds that 72% of samples bought online contained bacteria that could cause infections and 21% contained viruses. In 74% of the 101 samples purchased anonymously from two popular websites, the total bacteria count was significantly higher than the level generally considered safe. Bacteria found included E. coli, staphylococcus, streptococcus, and even salmonella, the Wall Street Journal reports. The FDA does not regulate the breast milk market, though it discourages sharing, the New York Times reports. Breast milk can be sold or donated on dozens of websites, and while some suppliers hand off the milk in person, others ship it. Problems during collection (improper hand-washing, dirty breast pumps or containers), improper storage (19% of the samples in the study were not cooled), and long shipping times (some of the samples took as long as six days to arrive) likely contributed to the health hazards. Another potential problem: Researchers say they are "a little suspicious of some of the milk," and are now working to determine if it's authentic breast milk, USA Today reports. In response to the study, at least one site that sells milk will stop allowing mothers to purchase from other mothers; donors will instead sell to a company that processes breast milk.