The following has been excerpted from White Gold: Stories of Breast Milk Sharing (September 2017) by Susan Falls. Falls is a professor of anthropology at the Savannah College of Art and Design.
My son has more than twenty-five siblings—milk siblings, that is. I first learned of milk siblings not by reading about kinship with my Anthropology 101 class but by attending a presentation at the 2010 Visual Research Conference. A group of young women scholars and their professor, Fadwa El Guindi, discussed various ways that people reckon kinship in Qatar. Milk siblingship—when a child receives breast milk from a woman who is not the child’s biological mother and thus enters into a kin relationship with her and her family—is practiced in many parts of the world. I was surprised and very excited to hear this.
Just a few weeks earlier, after having adopted a baby, I learned from my doula that if I was unable to breastfeed our son, I might be able to use donated breast milk. Many people around me were breastfeeding their children, and there seemed to be a general consensus that breast milk was better than formula. So I called the closest milk bank to inquire about getting some milk. To my great dismay I discovered that human milk is extremely expensive—all told, it would be almost six dollars per ounce. Since newborns consume about two to three ounces every four hours and older babies take up to six or eight ounces every six hours, the cost would be exorbitant. Unless, I thought, my insurance would pay for it. I phoned my medical provider and made an inquiry.
“Do you know if there is a generic brand of this medication?” the woman in customer service kept asking me. “No, it’s not a pharmaceutical product,” I replied. “It’s breast milk, you know, from a breast—it does not have a generic brand name. I want to order it from the WakeMed Milk Bank with a prescription from our pediatrician.” This situation was evidently one that her scripted answers to frequently asked questions did not cover. No matter how hard I tried I could not get her to understand my question: did our insurance policy cover the purchase of banked breast milk? It turned out to be a dead end. And there was no way we could spend that kind of money out of pocket every day. That experience did tell me, however, that what I was doing was out of the ordinary.
Serendipitously my doula—a birth facilitator—called that very afternoon to tell me about breast milk sharing. She had met the coordinator of a local milk-sharing group and wanted to introduce us. The group, all volunteer, uses an online forum to help donors find people who need breast milk. Women who have milk to give post information about themselves, the age of their child, the kind of freezer they have, where they are located, and so forth. It is not uncommon for new mothers to store breast milk for later use but then find that they do not need it. Sometimes their child will not “take a bottle” and they decide to donate the milk rather than throw it out. It is after all a precious, life-giving substance that has taken time and energy for them to produce and store. Lactating mothers may provide a one-time donation, large or small, or they may always have extra milk to share and thus become regular, long-term donors.
Parents seeking milk also provide information, sometimes including detailed narratives about why they need it. Sometimes these accounts include explanations about cancer or other medical conditions that hinder milk production, or they discuss the trials and tribulations faced in having or trying to have children (adoptions, failed fertility treatments, miscarriages, severely premature babies, twins or triplets, or prenatal drug exposure). They often refer to breast milk itself with value-giving names, such as “white gold” or “liquid gold.”
Once a match is made, donors and donees (who are of course acting as proxies for their babies) negotiate additional medical or personal questions they feel need to be addressed. My local group’s coordinator, Ashley, provided me with a questionnaire that I was to give to potential donors. These questions helped me to understand the diet, lifestyle, and possible drug or disease exposures donors may have experienced.
I was amazed by how effectively this self-organized network functions. Except for when our son was just born (he drank formula until I got my network up and running, which took me about two weeks), he was fed breast milk until the age of eighteen months. Our adopted daughter also received donated breast milk until she was a bit more than a year old. Neither child, aged three and five in 2016, has experienced much in the way of sickness, which donors and doulas explain as a benefit of receiving antibodies from so many different families.
When I was new to the group I heard that although new mothers probably could make a handsome extra income, it is illegal to buy and sell breast milk. But when I looked into it I discovered that, for the time being, peer-to-peer milk shares are not overseen or regulated by the federal or state governments or by any other agency. A donee might offer the donor something in return for milk, and indeed in our case we often gave donors pumping supplies or flowers but never money. These offerings seemed to be appreciated but were neither required nor necessarily expected.
But back to milk siblings.
When we picked up the milk from one of our first donors, she asked for a photo and the full name of our son and provided us with the same, explaining, “Now that the children are milk siblings, we will need to know these things.” In my ignorance I thought Anuka, an architect from Egypt who was living in Atlanta with her husband and two children, was just trying to be kind by finding a way to sentimentalize or just normalize what seemed like a pretty odd situation. How charming, I thought, and I sent her a specially selected photo of our baby. Little did I know that she was drawing on a venerable cultural tradition of “nurture kinship” whereby even strangers can be transformed into kin (and vice versa), a concept very different than that of kinship by blood, an ideology that despite anthropological critiques by Schneider (1968) and others remains hegemonic in the United States.
According to the Qatari women’s presentation at the Visual Research Conference, the Quran explains the role and obligations of milk siblings in no less than three places (El Guindi 2011). Islamic law allows for women to cross-breastfeed babies, who may then become their children’s relatives, with all that entails (for example, veiling customs, rules about who one can marry, and even inheritance or property rights). Other research shows milk siblingship to be “a strikingly widespread phenomenon, practiced by peoples from the Balkans to Bengal, from Marrakech to Mandalay,” that creates lasting connections, shapes social distance from one group to another, and can be used to control others’ behavior (MacClancy 2003). On my way to the airport after the conference my cabbie, an Egyptian named Fadil, confirmed that although the practice seems to be less common in some places, milk siblingship is still alive and well in Egypt, at least among his people. When I returned home I found a post on Juan Cole’s blog Informed Comment that went beyond what Fadil had explained: Cole (2010) argues that Saudi clerics who are promoting kinship by sharing breast milk, while tinkering with the rules of traditional milk siblingship to apply to adults instead of children under the age of five, are doing so as a sign of modernization—not conservatism—in order to allow non-kin women and men to congregate. So the practice apparently continues to be both strategic and binding. And while very different in origin from Muslim milk siblingship, breast milk sharing in the American context is also a thoroughly modern affair.
After Anuka’s first donation we kept in touch with photos and emails about our kids’ development. When our son turned one, she wrote us a lovely letter wishing him a happy birthday and asked if she could send him hand-me-downs (which we naturally said we would love to receive). When she decided briefly to return to Cairo during the Arab Spring we periodically touched base with her to make sure she was safe. We continued to stay in touch and spent the day together when she and her children visited us in the fall of 2016.
I knew that this would probably be a unique experience. I live in Savannah, Georgia, where the population is not especially diverse. There are few Muslims here, and I did not expect to have many, or any, other donors who would offer milk siblingship. And while this expectation was borne out, others were not. I expected, for example, that most of the women involved in the group (and we met more than fifty when all was said and done) would be “lefty,” highly educated, Volvo-driving types. They were instead often “righty,” conservative, Christian homeschoolers who were wary of government and Western medicine.
Although many health professionals warn about the dangers involved, social media–enabled, person-to-person breast milk sharing is now going global. And while there are risks in accepting and giving a child another woman’s milk, many people find these risks manageable. It is likely that as more parents—those with a need for milk or those who have milk to give—become aware of milk sharing, the practice will become more common. As milk sharing expands I suspect there will be vigorous pushback from institutions such as the Human Milk Banking Association of North America (hmbana) that may have much to lose—from money to access to human milk donations for research to a sense of authority—by the mainstreaming of milk sharing. I must agree with Akre, Gribble, and Minchin (2011), who suggest that people involved in milk sharing are likely be undeterred by unsupportive or even critical public health voices; I suspect that donors will continue to provide breast milk to those who prefer to nourish their children with human milk rather than formula.
Having weaned my own kids, I turned my energies to exploring more systematically what these exchanges might suggest about the larger political, economic, and cultural contexts in which they take place. Anthropologists are tasked with the study of powerful but hard-to-see structures, such as policy, ideology, or even design conventions. I had stumbled upon what seemed a relatively invisible phenomenon, but I have since discovered that there are quite a few of us, using various methodologies and different theoretical lenses, working to understand what milk sharing is and what we can learn from it. I am convinced that studying milk sharing will provide many interesting revelations.