Breast milk purchased online could contain cow's milk and other contaminants, research shows. A safer bet is milk from non-profit milk banks, such as this milk at the Mother's Milk Bank of Iowa in Coralville, Iowa. But milk from milk banks is available only by prescription. (Photo: Stephen Mally for USA TODAY) 
 
 Human breast milk has been sold online for years, and health experts have warned about possible dangers. Now they have a new warning: Some of the milk for sale isn't strictly human — it's been topped off with cow's milk. 
 
 That milk could be dangerous for some babies, says Sarah Keim, a researcher at Nationwide Children's Hospital in Columbus, Ohio. 
 
 Keim led a study published Monday in Pediatrics that shows 10 out of 102 breast milk samples purchased online contained at least 10% cow's milk. The added milk could have come straight from cartons or from baby formula, Keim says. 
 
 "It could be very harmful to babies with allergies or intolerance" to cow's milk, she says. 
 
 In a previous study using the same samples, Keim found 75% were contaminated with viruses or bacteria. 
 
 The Food and Drug Administration has warned since 2010 that milk sold or shared online could be unsafe. 
 
 The samples in the study, purchased in 2012, came from several sites, Keim says, including one called Only The Breast that continues to operate and appears to be the leading site for such transactions. Other sites, such as Eats on Feets and Human Milk 4 Human Babies, facilitate the sharing of milk but discourage sales. 
 
 In ads at Only The Breast, thousands of nursing mothers offer to sell excess breast milk for prices that appear to range from $1 to $6 per ounce. Many feature pictures of mothers and children and boast that the sellers eat organic diets, are free of drugs, alcohol and caffeine, and have other healthy habits. Some say they have been screened for drug use and for diseases such as HIV by milk banks — non-profit and for-profit operations that provide milk to premature and sick babies in hospitals. 
 
 In an emailed statement, Only The Breast, a corporation based in Reno, said the site's terms of use forbid members from adding any contaminants to milk sold or donated there. The statement says: "We believe most OTB members are honest, abiding by OTB terms and are simply looking to provide safe milk for babies in need." 
 
 If some sellers are intentionally adding cow's milk to their supplies, the obvious motive would be profit, Keim says: "Sellers might have an incentive to try to increase their production. … It could really add up." 
 
 Who is buying this milk? Most buyers are families who want breast milk for babies and, for whatever reason, don't have enough milk from the babies' mothers, says a recent editorial in the journal BMJ. The editorial, which called online milk sales and sharing unsafe, said buyers also include "a narrow group of adult consumers (including people with cancer, gym enthusiasts, and fetishists)." 
 
 The market for breast milk exists largely because health authorities "have done a really good job over the past 20 years of promoting the benefits of breastfeeding," Keim says. "Unfortunately, some women are very focused on feeding their babies breast milk at all costs." 
 
 Keim's samples did not include milk shared free online. She says such milk is unsafe because it has not been screened for contamination. 
 
 Sites for sharing and selling milk include instructions for home pasteurization — heating the milk to kill harmful microbes — and say it is necessary. But home methods are unlikely to be as reliable as the procedures used by milk banks, Keim says. 
 
 The 18 non-profit banks in the Human Milk Banking Association of North America do not get enough donations to provide safe, screened breast milk to the general public, says Kim Updegrove, executive director of the Mothers' Milk Bank in Austin. Their milk is needed for sick and low-weight babies for whom it is "life-saving," she says. It is available only by prescription. 
 
 Women who have trouble breastfeeding should seek help from lactation counselors and other health professionals rather than turning to the internet for possibly tainted supplies, Updegrove says. 
 
 "Body fluids are dangerous, and milk is a body fluid," she says. The addition of cow's milk is "alarming," because it could cause symptoms ranging from stomach upset to bloody diarrhea and eczema in some infants, Updegrove says. 
 
 Women thinking of selling or donating their milk could do more good by donating to the neediest infants through milk banks, she says. 
 
 "I do believe that most of those women looking to share or sell their milk are compassionate women who want to help other women," Updegrove says. 
 
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 A study published today on the safety of human breast milk bought over the Internet found that 10 percent of samples contained added cow's milk. The discovery that purchased samples of human milk may be purposely "topped off" with cow's milk or infant formula confirms a danger for the large number of babies receiving the purchased milk due to medical conditions. These babies are also vulnerable to the risk of infectious disease from bacterial and viral contamination of such milk, which was identified in a prior study by the same research team led by Nationwide Children's Hospital. 
 
 "We found that one in every 10 samples of breast milk purchased over the Internet had significant amounts of cow's milk added, and this poses a risk to infants with an allergy or intolerance to cow's milk," said Sarah A. Keim, PhD, principal investigator in the Center for Biobehavioral Health in The Research Institute at Nationwide Children's and lead author on the study. "If a baby with cow's milk allergy were to drink this milk, it could be very harmful." 
 
 The team's previous research found that 21 percent of individuals seeking human milk online did so for a child with a pre-existing medical condition. And 16 percent of these parents specifically sought out the purchased human milk due to their baby's formula intolerance. 
 
 Also troubling is their prior discovery of bacterial or viral contamination in more than 75 percent of milk samples purchased online, which became the first data to confirm the Food and Drug Administration's 2010 warning of possible contaminants in unpasteurized human milk obtained from sources other than the baby's mother. 
 
 The study published today in the journal Pediatrics is the first to document that milk purchased online is frequently adulterated with intentionally added ingredients. 
 
 "We were concerned that, because money is exchanged in these transactions, there might be an incentive to boost milk volumes in order to make more money," Dr. Keim said. "Cow's milk and infant formula resemble human milk and could potentially be added to boost volumes without the recipient knowing. Mothers who consider purchasing breast milk over the Internet should beware -- when you obtain milk from an unfamiliar source, you cannot know for sure that what you are getting is safe for your baby." 
 
 Dr. Keim's team at Nationwide Children's collaborated with researchers from The Ohio State University and Cincinnati Children's Hospital Medical Center to purchase and test 102 samples of breast milk advertised on milk-sharing websites. The team compared the purchased samples with their own preparations of human milk diluted with cow's milk to approximate the amount of contamination required in order to test positive for bovine DNA. 
 
 All purchased samples did contain human milk, but 11 also contained bovine DNA, 10 of which had results consistent with more than minor, accidental contamination with cow's milk. The findings suggest that a notable number of sellers intentionally added cow's milk or infant formula to the breast milk. 
 
 "Pediatricians who care for infants should be aware that milk advertised as human is available via the Internet, and some of it may not be 100 percent human milk," said Dr. Keim, who also is a faculty member at The Ohio State University. "And patients should be counseled against obtaining milk in this way for their infant." 
 
 In a recent survey Dr. Keim conducted of 499 women, published in Breastfeeding Medicine, 25 percent of women considered milk sharing and almost 4 percent of women shared milk among friends or relatives or had a preterm infant who received donor milk. She suggested that women with extra milk could help a baby in need by donating their milk to a non-profit milk bank instead of selling it over the Internet. 
 
 "Quality, timely lactation support for moms who want to breastfeed their babies could help avoid the need for many mothers to seek milk online," said Dr. Keim, who is continuing a variety of investigations into the phenomenon of Internet-based human milk donation and purchasing. "Women who have difficulty making enough milk for their child should work with their pediatrician to identify safe, healthy ways to feed their baby. The risk of contamination and added cow's milk makes it unsafe to purchase breast milk over the Internet." 
 
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 Abstract 
 
 BACKGROUND: The US Food and Drug Administration recommends against feeding infants human milk from unscreened donors, but sharing milk via the Internet is growing in popularity. Recipient infants risk the possibility of consuming contaminated or adulterated milk. Our objective was to test milk advertised for sale online as human milk to verify its human origin and to rule out contamination with cow’s milk. 
 
 METHODS: We anonymously purchased 102 samples advertised as human milk online. DNA was extracted from 200 µL of each sample. The presence of human or bovine mitochondrial DNA was assessed with a species-specific real-time polymerase chain reaction assay targeting the nicotinamide adenine dinucleotide (NADH) dehydrogenase subunit 5 gene. Four laboratory-created mixtures representing various dilutions of human milk with fluid cow’s milk or reconstituted infant formula were compared with the Internet samples to semiquantitate the extent of contamination with cow’s milk. 
 
 RESULTS: All Internet samples amplified human DNA. After 2 rounds of testing, 11 samples also contained bovine DNA. Ten of these samples had a level of bovine DNA consistent with human milk mixed with at least 10% fluid cow’s milk. 

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 Buy, sell or donate breast milk with our discreet classifieds system. 
 
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 Looking to make a few extra bucks while clearing out your freezer? 
 
 The vast majority of OTB members are honest, abiding by OTB terms and are simply looking to provide safe milk for babies in need. However in light of cowâ€™s milk contamination of some breast milk samples purchased via the internet, Only The Breast reiterates our long-term guidance that all OTB sellers should follow best practices using aseptic technique for expressing, handling, and storing human milk which also addresses shipping freezing , and all buyers must follow safety guidelines for peer to peer donor screening . Additionally it is expressly forbidden in our terms of use to add any form of contaminants such as bovine i.e., cowâ€™s milk. 
 
 Proper DONOR SCREENING is crucial, and must be followed before feeding milk to babies in need. Studies show that unpasteurized milk may have bacteria . IT IS ADVISED THAT ALL MILK MUST BE PASTEURIZED BEFORE USE. Please see our at home pasteurization tips. 
 
 WARNING DO NOT ACCEPT COURIER SERVICES, these are almost always scams to get you to send them money. Never wire funds like with Western Union. SIGN IN AND CHECK YOUR PAYPAL BALANCE, to be sure that funds have been sent and you haven’t sent a fake email. 
 
 Listing milk for more than $1/oz is likely to receive only responses from scammers. 
 
 WARNING DO NOT ACCEPT CHECKS, FAKE CASHIER CHECKS & MONEY ORDERS ARE COMMON, and BANKS WILL CASH THEM AND THEN HOLD YOU RESPONSIBLE when the fake is discovered weeks later. 
 
 More info on how to recognize and avoid scams 
 
 Only The Breast is not affiliated with any breast milk banks or human milk processing companies other than thoseÂ identified on the About Us page of the Only The Breast website. Any other statements of affiliation not made by Only The Breast, Inc. should be reported via the notification procedures. 
 
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– Women who purchase breast milk online likely have their baby's health in mind, which makes the findings of a study published today in Pediatrics so concerning. Researchers led by Nationwide Children's Hospital bought 102 samples of milk via milk-sharing websites and discovered that 10 of them "had a level of bovine DNA consistent with human milk mixed with at least 10% fluid cow's milk," they write in the study. That's a concentration high enough to indicate the cow milk was intentionally added, either straight from the carton or by way of baby formula. "This poses a risk to infants with an allergy or intolerance to cow's milk," says researcher Sarah Keim, in a press release. One milk bank director tells USA Today infants could experience bloody diarrhea or eczema as a result of ingesting it. The newspaper reports that one of the sites the researchers purchased the milk from is Only The Breast, which bills itself as a "community for moms to buy, sell, and donate natural breast milk" at prices that USA Today noted were typically $1 to $6 per ounce. The site referenced its terms of use in an emailed statement, pointing out that members were barred from adulterating the milk. Why might someone do so? Profit. "Because money is exchanged in these transactions, there might be an incentive to boost milk volumes in order to make more money," says Keim, who advises pediatricians to caution mothers against sourcing any needed breast milk this way. USA Today notes these particular samples were used in a 2013 study by the team, which found that 72% of those samples contained bacteria; the types of bacteria they identified were pretty off-putting.