But traffic to online markets has continued to rise as more moms look to the internet for help.Across the US, online transactions have more than doubled in the past three years, from around 22,000 in 2012 to about 55,000 today, according to Jesse Kwiek, Associate Professor of Microbiology at the University of Ohio and a co-author of the recent Keim study.
For Sakamoto, women selling their excess milk on online exchanges represent "a lost supply" for hospitalized babies in need.
But for women like Ashleigh Baruch, a mother of three who sells her excess milk on Only The Breast, casual sharing sites are a necessary, but imperfect, alternative to milk banks.
For now, the onus of safety checks — through donor blood or milk tests and pasteurization — falls on online buyers.
Only The Breast offers safe buying tips and encourages milk pasteurization, but the site, like others of its kind, operate under the "use at your own risk" model.
Eventually, through Only The Breast, she found a mom a short drive away offering her extra supply for free.
"I thought about the risks a lot," she said of the online-sourced donation, but eventually decided to use the milk after meeting the family.
Pitman, a full-time student who also works as a waitress, said that after breastfeeding became unbearably painful and pumping several times a day too time-consuming for her busy schedule, she switched to formula with her doctor’s support.
She cried for a week over the decision to switch to formula and lied to friends about having a lactation issue to stem what she said was harsh judgement over "not trying hard enough." But her son quickly developed a rash after the switch, and at about for a two-and-a-half day supply, the doctor-recommended formula was difficult to afford.
Unlike the milk traded online, donor banks must meet FDA regulations.
The organization distributed about 3.3 million ounces of milk last year, mainly to infants in neo-natal intensive care units, but it’s always short on supply, says Pauline Sakamoto, president of HMBANA.