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Surrogacy and Donor Breast Milk: Here’s What You Need to Know

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Lindsay Modglin is a nurse-turned health and wellness writer with a professional certificate in scientific writing from Stanford School of Medicine.

Expanding your family through surrogacy is an exciting option that becomes more popular with each passing year. Advancing technology and social change has led to more parents pursuing assisted reproductive technology to conceive. With the legalization of gay marriage, an increased average age of first-time parents, and a 75% surrogacy success rate, more families are using gestational surrogacy than ever before.1

Surrogacy stats

“Donor Concierge has seen a 200% increase in clients looking for a surrogate in the last 5 years,” according to Gail Sexton Anderson, founder of Donor Concierge, a leading egg donor and surrogate fertility concierge service

Once parents do get through the surrogacy matching and into the pregnancy phase, they have a chance to start thinking about what will happen once the baby does arrive. Families who choose to have a child via surrogacy are presented with slightly different considerations, especially when it comes to what feeding methods are available to their babies. While baby formula may initially be the only option that comes to mind, having the surrogate supply pumped milk or using donated breast milk are other alternatives to consider. Whether they use a surrogate’s milk exclusively, or as a supplement to a healthy baby formula, this is a conversation expecting parents need to flush out before the baby is born. Sexton Anderson, from Donor Concierge, reminds us that these parents deserve to feel equally supported in their journeys and included in transparent conversations about family building, feeding and beyond.

What is surrogate milk donation?

Following a surrogate pregnancy, the surrogate may choose to pump and provide breast milk for the baby. This is a common practice, with many choosing to do so for the initial days of the baby’s life and others choosing to do so for an extended period. This breast milk may be used to supplement baby formula or may make up the baby’s entire diet. This provides the baby with the nutritional benefits associated with breast milk, from someone that the intended parents may already have developed a trusting relationship with. 

While some intended parents know from the beginning that they want to provide their baby with breast milk, others may be unsure. If using surrogate donor milk has already been decided prior to choosing a surrogate, it should be discussed in the initial meetings to ensure you’re matched with a surrogate who is on the same page. Any agreement regarding breast milk should be included in the gestational carrier agreement between the surrogate and intended parents. 

“It’s important that the surrogate is fully onboard with the decision to pump and provide breast milk,” says Marni Denenberg, Director of Private Client Services at Donor Concierge. “Every post-partum body is different and the surrogate herself is in the best place to decide if she wants to pump for her intended parents and for how long.”

How the surrogate can benefit by providing donor breast milk

While surrogates may or may not choose to donate breast milk after delivery, there may be additional benefits for those who choose to do so. These include:

  • Uterus returning to its pre-pregnancy size quicker
  • Decreased risk of breast and ovarian cancer
  • Increase calorie burn
  • Extra financial compensation

How does surrogate milk donation work?

Surrogates will pump and freeze the expressed milk in breast milk storage bags. If shipping is necessary, they will pack the frozen milk tightly in a styrofoam cooler and place it inside a shipping box with ice packs or dry ice. For safety purposes, the package is then shipped via overnight or 2-day expedited shipping to ensure that the contents arrive within 48 hours of leaving the surrogate. 

How much does surrogate milk cost?

While the specific costs are dependent on the agreement between the intended parents and surrogate, typical compensation is approximately $250 per week. This is in addition to the cost of shipping and replacement materials, such as milk storage bags and pump parts. It’s common for the intended parents to order supplies online and have them shipped to the surrogate, although some choose to have the surrogate order their supplies and the intended parents reimburse them. 

Benefits of using donor breast milk

Donor milk provides infants with the benefits of breast milk, including optimal nutrition, easy digestibility, and immune-boosting properties. Babies born prematurely or with health concerns may gain increased benefits from the use of donor milk.

Alternatives to surrogate milk

Some surrogates don’t wish to provide breast milk at all, while others may be willing to do so for only a short period. In these situations, there are other options for parents to obtain donor milk—regardless of whether or not a surrogate was used to expand their family. “We recommend that families discuss their options with their intended pediatrician,” says Denenberg. 

Nonprofit breast milk bank

A nonprofit milk bank is a safe, regulated option to provide your baby with breast milk. Breast milk is collected from approved donor moms and screened for disease and drugs. The milk is then pooled with donations from several different mothers, which ensures that nutrients are evenly distributed to provide the best nutritional value for the receiving babies. The milk undergoes a pasteurization process, which eliminates harmful bacteria and viruses while retaining the majority of the nutrients and antibodies. Before packaging and freezing the milk, additional testing is done to ensure that there is no bacterial growth in the pasteurized milk.

As we already mentioned, getting donor breast milk from a certified donor milk bank is a safe alternative to breastfeeding and baby formula. But it may be more difficult to achieve. Milk banks prioritize hospital needs and infants with medical conditions, so a prescription from a medical professional is generally required to receive donor milk from a certified milk bank.

Milk share programs

Milk share programs tend to be locally based, although there are some online resources. They tend to be a popular option due to their convenience. It’s not uncommon for local moms who overproduce to donate breast milk to other families; however, this is a non-regulated option that comes with additional risks and concerns. Speak to your pediatrician if you are considering this.

Baby formula that meets US FDA requirements

Speak to other moms to gain insight into the formula market and then ask your pediatrician for recommendations in choosing the best formula for your baby. Formula can be used for supplementing with breast milk or as the sole source of infant nutrition.

Considerations when looking into donor milk

When considering the use of donor milk for your baby, it’s important to understand the potential risks. While a certified milk bank screens and tests the donors and the milk, there is no testing done on surrogate donors or milk donated via a milk share program. This increases the risk of disease, drugs, alcohol, and bacteria that may pass through breast milk.

It’s important to discuss these risks with your partner and intended pediatrician before deciding whether or not this is a good option for your baby.

 Sources:

1- Surrogacy Success Rates | AFS

The content on this site is for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis or treatment. Discuss any health or feeding concerns with your infant's pediatrician. Never disregard professional medical advice or delay it based on the content on this page.
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