Mum 2 Mum Breastmilk Sharing Orgs, Genius.....or not?

The concept of breastmilk sharing, whilst not new - is something most of us have heard more about than usual over the last couple of weeks, due to a couple of new organisations setting up to facilitate easy sharing.

The first official share setup I saw was a couple of years ago now at http://www.milkshare.com/, and I briefly toyed with the idea of something similar in the UK.  On several levels it appears the perfect solution, mothers who have too much breastmilk can give it to those who don't have enough - easy!  Liberating for mothers, great for those who have older infants and want to donate and potentially capable of aiding a large mental shift in terms of what we feed our infants.  However there were too many questions I didn't feel comfortable with, and in light of the new orgs - I still have these concerns.

Firstly and probably most obviously what about Breastmilk Banks?  I appreciate they don't by any means catch all areas - but there is surely a risk that those who are within area will either not know of this option (if the orgs do a good job of promoting themselves, this could become an more obvious choice) or it could even become preferable.  Will mothers get more "donor satisfaction" from replying to a real life mum who can express her gratitude for the milk?  Banks are usually run by busy medical staff, who perhaps aren't always as obviously grateful as a specific mother.

As it stands many banks don't have enough milk - the health implications of which are significant.  Hospitals with access to a bank give tiny prematures/NICU babies "first dibs" on the milk, they can then if they have enough extend to older SCBU infants or term babies who need support (perhaps born to a diabetic mother and needs more immediately at birth)  Finally if the bank is full to busting - they can then potentially offer excess to the community.  This rarely happens at the moment because most banks aren't full - although an example today was a message circulated from Cheshire & North Wales that they had an excess of pasteurised donor milk which was available free of charge if a mum needed it.

The trouble for Milk Banks is they're expensive - mums are screened, milk is transported, pasteurised and refrigerated which of course all cost.  If donor numbers fall some banks could easily be put at risk.  And what of the prematures?  For a 26 weeker breastmilk can almost certainly be the difference between life and death, they need such a tiny amount (Just a few mls) that standard donations can help so many preemies!  Will mums of an infant in NICU/SCBU soon be having to hit a website to get donor milk?  then sort screening and pasteurising the milk?  It would seem to me it would make more sense to at least run something like this alongside Bank support, or even by them to ensure they had adequate first? although the latter option perhaps not financially viable?

Which raises other questions - Milkshare gives guidelines about screening and details of how to pasteurise at home, but I can't seem to spot these on the UK sites.  I know whether to pasteurise or not is a topic of hot debate - but as home users are unlikely to be able to implement other techniques for testing milk, aren't most going to do this?  Do doctors freely screen mothers at request?  when it's for a milk bank the hospital sends the relevant forms for the donor to take to a nurse/blood clinic and they take care of screening.   How does this work without this referral (I can't seem to locate this information on the sites either)

So far I'm also a bit concerned at the lack of breastfeeding information accompanying the sharing ie do you really need donor milk?  steps to increase your own supply, relactation etc.  Information of where to get support to potentially rectify the situation or at least only use donor milk as a stop gap; whilst it is a better choice than formula, we should also acknowledge it's not comparable to a mother's own breastmilk.

A lot of mothers also don't know they can use their own frozen breastmilk to give their own child in other ways such as on cereals, smoothies or puddings - perhaps when they return to work etc.  When you think it can save the life of a preemie - it seems worth it, whereas I've seen shares for say a 6 month old on solids who is usually given formula but mum would prefer breastmilk.  One solids are introduced, is pasteurised and likely frozen/defrosted breastmilk more valuable to one infant than to the intended child?  particularly given so many are weaned so much before the immune system fully matures and the child self weans.

I'm not sure - I haven't really made my mind up one way or another yet.  I could have a ponder, read more and see things from a different angle so firmly on the fence at the moment.  What do others think?