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The mothers who share breast milk online

Thousands of women are sharing their own breast milk via social media groups in an effort to help ot..

Thousands of women are sharing their own breast milk via social media groups in an effort to help others, a BBC investigation has discovered.

The Department of Health is now coming under pressure to issue more guidance to these mothers, who are acting outside of NHS supervision.

Some experts fear the unregulated practice could spread infection and viruses such as HIV and hepatitis.

But advocates argue mothers are making an informed choice.

The mother

When Bex Poole, from Wolverhampton, had difficulty breastfeeding her baby son Theo, she was anxious to find an alternative supply.

Theo was not putting on weight at a healthy rate but she does not drink cows' milk herself and was reluctant to supplement her son's diet with formula.

A friend suggested she look at a Facebook page called Human Milk for Human Babies UK, which facilitates breast milk exchanges between those mothers with surplus breast milk and others who need it.

Likes for the page have increased fivefold to almost 18,000 in the past five years.

"My milk wasn't increasing in any way," she said.

"I jumped straight on the page, no hesitation, and appealed for help."

'I had too much milk'

Shortly afterwards, she was contacted by Sarah McHugh, a new mother from Kidderminster, in Worcestershire.

She had struggled to breastfeed her daughter Harriet and had ended up expressing milk to feed her with.

"I ended up having too much milk," she said. "I'm on some Facebook groups for mums who express and breastfeeding mums so I put in a request saying I had some milk to donate."

The women's first meeting took place late at night and had an illicit feel to it.

"There was no other time we could do it," Ms Poole said. "It felt almost like a naughty transaction because her door is a little bit hidden behind some garages.

"Her little one was asleep, she was in her pyjamas ready to go to bed. I picked the milk up and came away but said thank you via text when I got home."

Ms McHugh said she felt happy something positive had come out of the difficulties she had experienced feeding Harriet.

"At the moment there is a very big drive to breastfeed.

"And some people that can't breastfeed or maybe can't make enough milk are feeling they have to explore [avenues such as online milk exchanges]."

Now the pair feel they have struck up a bond as a result of the exchange and Ms Poole's freezer is full of Ms McHugh's breast milk.

Is it safe?

Informal schemes such as this have, however, attracted some criticism from experts who question whether it is safe to feed strangers' milk to babies.

Ms Poole and Ms McHugh said the key to success was making sure you asked the right questions prior to exchange.

"I volunteered quite a lot of personal information," said Ms McHugh. "I said I was fit and well and that I wasn't a smoker and I also donate to the hospitals' milk bank, which I think reassured them."

"There's an unwritten trust among breastfeeding mums," Ms Poole said. "I don't believe a mum would share any milk if they've got problems."

The Facebook site offers guidance for anyone considering using it and urges people to discuss medications, alcohol or drug use. It suggests using a health care provider for further testing if worried and asking for copies of results.

Many countries already test for infectious diseases during routine prenatal/antenatal care, it says, and it suggests looking into home pasteurisation if worries persist.

However, Dr Gemma Holder, a consultant neonatologist at Birmingham Women's Hospital, is concerned mums who exchange milk without medical supervision might risk their babies' health.

She works at the hospital's milk bank, one of 16 official sites across the UK and Republic of Ireland, where donated breast milk is collected on a large scale and sent to sick and preterm babies in hospitals.

The donated milk is carefully vetted in line with NICE guidelines.

"When the milk comes in we first have to screen it for infection," Dr Holder said.

"Mothers who donate milk also have to have their bloods tested to ensure there's not a risk of blood-borne viruses – things like HIV, syphilis and hepatitis B – being transmitted to babies."

The milk is pasteurised before it is frozen, ready for use.

"Fresh donor milk has significant risk of potentially passing on infection, particularly if you don't know how it was handled," said Dr Holder.

"We know from just screening our milk there are bugs such as E. coli.

"We still get a couple of donors a month, for example, whose milk we aren't able to accept. This could be higher in the community, where none of these precautions are in place."

But Dr Sally Dowling, from University of the West of England, in Bristol, points out women have always shared milk with each other.

She said the World Health Organisation (WHO) supports feeding babies milk from another woman as an alternative to breastfeeding by the mother.

"The studies that have have taken place increasingly show that women make all sorts of judgements about risks for themselves," she said.

"They find out about the women whose milk they're acquiring – things like whether they washed hands when they expressed the milk, for example, or any infections or tests the women might have had done.

"Yes, there are some risks but on the whole women are going into this with their eyes open and finding out as much as they can."

'More guidance needed'

The Food Standards Agency says it does not recommend sharing donor breast milk for safety reasons.

"Parents wishing to donate, share or obtain breast milk should contact maternity or other medical services for advice," a spokesman said.

"Some NHS hospitals can provide donated breast milk for your baby."

However, experts have called for the UK government to do more.

Alison Thewliss, the SNP politician who chairs the all-party parliamentary group for infant feeding, believes the rest of the UK should follow the Scottish model.

One Milk Bank for Scotland is part of the health service and ensures breast milk can be collected from donors, processed and distributed using a well-developed network.

Ms Thewliss believes the Department of Health should take overall control of the breast milk donor services in England.

"At the moment, milk banks are often underfunded and running as a project of individual hospitals," she said.

"I would like to see the UK government work with the UK Association of Milk Banks to invest in services to allow those wishing to donate breast milk to be able to do so locally in a safe and regulated way, and for those requiring breast milk for their babies to be able to access it easily".

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Monkeypox: First deaths outside Africa in Brazil and Spain

Brazil and Spain have reported their first monkeypox deaths.

A 41-year-old man in Brazil became the first fatality from the virus outside Africa. Spain announced two deaths soon afterwards – the first in Europe.

Last week, the World Health Organization (WHO) declared the monkeypox outbreak a global health emergency.

But infections are usually mild and the risk to the general population is low.

On Friday Brazil’s health ministry said the victim there had suffered from lymphoma and a weakened immune system, and “comorbidities aggravated his condition”.

Brazil has so far reported 1,066 confirmed cases and 513 suspected cases of the virus. Data from Brazil’s health ministry indicates that more than 98% of confirmed cases were in men who have sex with men.

Shortly afterwards, Spain’s health ministry confirmed Europe’s first death from the virus – a patient who suffered from encephalitis.

A second death linked to monkeypox was confirmed by Spanish authorities on Saturday.

The health ministry said that of 3,750 monkeypox patients with available information, 120 or 3.2% had been hospitalised.

According to the US Centers for Disease Control and Prevention, there are 21,148 cases worldwide.

The monkeypox virus is a member of the same family of viruses as smallpox, although it is much less severe and experts say chances of infection are low.

It occurs mostly in remote parts of central and west African countries, near tropical rainforests.

Health officials are recommending people at highest risk of exposure to the virus – including some gay and bisexual men, as well as some healthcare workers – should be offered a vaccine.

Last week, WHO director general Dr Tedros Adhanom Ghebreyesus said declaring the outbreak a global health emergency would help speed up the development of vaccines and the implementation of measures to limit the spread of the virus.

Dr Tedros said the risk of monkeypox is moderate globally, but high in Europe.

But, he added, “this is an outbreak that can be stopped with the right strategies in the right groups”. The WHO is issuing recommendations, which it hopes will spur countries to take action to stop transmission of the virus and protect those most at risk.


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Covid: Woman caught virus twice within record 20 days

A 31-year-old healthcare worker caught Covid twice within 20 days – the shortest-known gap between infections, Spanish researchers have claimed.

Tests show the woman was infected with two different variants – Delta in late December and then Omicron in January.

This shows that even if you have had Covid before, you can still be infected again even if fully vaccinated, the researchers say.

Reinfections in the UK require 90 days between positive tests.

Based on that definition, health officials say nearly 900,000 people have potentially been infected twice with Covid up to the start of April.

It is difficult to pin down an exact number, because only whole genome sequencing can confirm the infections are caused by different strains, and very few positive tests go through this process.

The Spaniard did not develop any symptoms after her first positive PCR test, but less than three weeks later she developed a cough and fever which prompted her to take another test.

When the tests were analysed further, they showed the patient had been infected by two different strains of coronavirus.

In a presentation at the European Congress of Clinical Microbiology and Infectious Diseases, study author Dr. Gemma Recio said the case highlighted that Omicron can “evade the previous immunity acquired either from a natural infection with other variants or from vaccines”.

She said: “In other words, people who have had Covid-19 cannot assume they are protected against reinfection, even if they have been fully vaccinated.

“Nevertheless, both previous infection with other variants and vaccination do seem to partially protect against severe disease and hospitalisation in those with Omicron,” added Dr Recio, from the Institut Catala de Salut, Tarragona in Spain.

She said monitoring reinfections in people who were fully vaccinated was important, and would help the search for variants which evade vaccines.

Covid reinfections rose sharply in December 2021 after the much more infectious Omicron variant emerged, and there was another increase when a slightly different version of it, called BA.2, appeared in early March.

Before that, 1% of all cases recorded in the UK were labelled as second infection – but that has now gone up to 11%.

Most are likely to be people infected by the Alpha or Delta variants and then infected again by the more contagious Omicron.

Scientists predict that eventually everyone will catch Covid twice, and probably many more times over the course of their lifetime.

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Poverty, crime linked to differences in newborns’ brains

Poverty and crime can have devastating effects on a child’s health. But a new study from researchers at Washington University School of Medicine in St. Louis suggests that some environmental factors influence the structure and function of young brains even before babies make their entrances into the world.

A study published online in the journal JAMA Network Open found that MRI scans performed on healthy newborns. At the same time, they slept indicated that babies facing social disadvantages such as poverty tended to be born with smaller brains than babies whose mothers had higher household incomes.

MRI scans of full-term newborns born to mothers living in poverty revealed smaller volumes across the entire brain — including the cortical grey matter, subcortical grey matter and white matter — than found in the brains of babies whose mothers had higher household incomes.

The brain scans, conducted only a few days to weeks after birth, also showed more miniature folding of the brain among infants born to mothers living in poverty. Fewer and shallower folds typically signify brain immaturity. The healthy human brain folds as it grows and develops, providing the cerebral cortex with a more extensive functional surface area.

A second study of data from the same sample of 399 mothers and their babies — this one published online in the journal Biological Psychiatry — reports that pregnant mothers from neighbourhoods with high crime rates gave birth to infants whose brains functioned differently during their first weeks of life than babies born to mothers living in safer neighbourhoods.

Functional MRI scans of babies whose mothers were exposed to crime displayed weaker connections between brain structures that process emotions and structures that help regulate and control those emotions. Maternal stress is believed to be one of the reasons for the weaker connections in the babies’ brains.

“These studies demonstrate that a mother’s experiences during pregnancy can have a major impact on her infant’s brain development,” said Christopher D. Smyser, MD, one of the principal investigators. “Like that old song about how the ‘knee bone is connected to the shin bone,’ there’s a saying about the brain that ‘areas that fire together wire together.’ We’re analysing how brain regions develop and form early functional networks because how those structures develop and work together may impact long-term development and behaviour.”

Babies in the study were born from 2017 through 2020, before the COVID-19 pandemic. Smyser, a professor of neurology, paediatrics and radiology, said that babies are fed when they arrive for scans because they tend to fall asleep after eating to scan newborns during the first few weeks of life successfully. They are then snugly swaddled into blankets and a device that helps keep them comfortable and still. The brain scans take place while they sleep.

In the study involving the effects of poverty, the researchers focused on 280 mothers and their newborns. First author Regina L. Triplett, MD, a postdoctoral fellow in neurology, had expected to find that maternal poverty — referred to in the paper as a social disadvantage — could affect the babies’ developing brains. But she also expected to see the effects of psychosocial stress, which includes measures of adverse life experiences and anxiety and depression.

“Social disadvantage

affected the brain across many of its structures, but there were no significant effects related to psychosocial stress,” Triplett said. “Our concern is that as babies begin life with these smaller brain structures, their brains may not develop as healthy as the brains of babies whose mothers lived in higher-income households.”

In the second study, which implicated living in high-crime neighbourhoods as a factor in weaker functional connections in the brains of newborns, first author Rebecca G. Brady, a graduate student in the university’s Medical Scientist Training Program, found that unlike the effects of poverty, the results of exposure to crime were focused on particular areas of the babies’ brains.

“Instead of a brain-wide effect, living in a high-crime area during pregnancy seems to have more specific effects on the emotion-processing regions of babies’ brains,” Brady said. “We found that this weakening of the functional connections between emotion-processing structures in the babies’ brains was robust when we controlled for other types of adversity, such as poverty. It appears that stresses linked to crime had more specific effects on brain function.”

Reducing poverty and lowering crime rates are well-established goals in public policy and health. And the researchers believe protecting expectant mothers from crime and helping them out of poverty will do more than improve brain growth and connections in their babies. But if social programs that aim to help people reach their full potential are to succeed, the researchers said the policies must focus on assisting people even before they are born.

“Several research projects around the country are now providing money for living expenses to pregnant mothers. Some cities have determined that raising pregnant mothers out of poverty is good public policy,” Smyser said. “The evidence we’re gathering from these studies certainly would support that idea.”


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