Following the Council of Trent (1545-63), the breast became more sexu-alized for Western Europeans. Images of Mary breastfeeding became less common. But another trope emerged: the tale of Charity. “Charity," a term of love harkening to the Greek cryarnv, "to treat with affectionate regard," might well be applied to milk donation.
Valerius Maximus, the ancient Roman writer, recounted the tale known today as “Roman Charity." Incarcerated for life, the elderly Cimon was denied food by his jailers (to hasten his death). To save him, his daughter Pero gained access to his cell and offered him her breast milk. The guards, impressed with Pero’s selflessness, released Cimon from prison.
There are many illustrations of this story, including an early fresco from Pompeii, Italy (artist unknown), dating from the first century. Roman Charity was also taken up by artists in the seventeenth and eighteenth centuries.
There are even contemporary versions, such as Romana Caritas (2011) by the Russian artist Max Sauco, known for his work in surrealism and photo manipulation. Many details in Sauco’s work are worth commenting on—from the halo and smoke emanating from Cimon to the phallic wooden post engraved with his name, to the nails and the blood dripping from Cimon’s feet, to the quantity of milk spilled on the ground. And, unlike in earlier accounts, there seems to be a somewhat erotic dimension.
Sauco’s image could be described as a Salvador Dali-Joel-Peter Witkin mashup. Both of those artists dealt with breast milk. Dali’s Fountain of Milk Spreading Itself Uselessly on Three Shoes (1945) references the lactation of Saint Bernard, but the miraculous milk is spent on a parched landscape from a woman atop a pedestal. Witkin created several works
12. Cimon and Pero depicted in a first-century Roman fresco (Pompeii, Italy). Photo by Stefano Bolognini, Wikimedia Commons. https://en.wikipedia.org/wiki/Roman _Charity#/media/File:Affresco_romano_-_Pompei_-_Micon_e_Pero.jpg.
about breastfeeding: Woman Breastfeeding an Eel (1980) and Androgeny Breast Feeding a Fetus (1981). Both reflect Witkin’s surrealist, out-ofbounds style that asks us to examine our own value systems and challenges culturally constructed boundaries between human and animal, life and death, self and other, male and female, and beauty and horror.
The most striking element running throughout these figurations is the depiction of female agency. Pero/Charity is always placed above Cimon, the active partner with the power to pronounce life or death through her gift. On the other hand, it’s complicated because Cimon, like any potential donee, has the power to refuse the gift (and everything it entails). As donor Miranda put it,
I have all this extra [milk] and so I emailed my acupuncturist and tried to give it to them because they had twins and they said, “No thanks!" His wife probably thought it was weird, and I can see that, and I felt a little weird offering. But anyway, I asked Violet, my yoga teacher, if
she wanted it and she was excited and took it and offered free yoga in return, which is pretty great. The thing is that Violet trusts me. She trusts me to treat her baby like I treat my own. I looked on craigslist [a peer-to-peer website for buying and trading] to see what its [s/c] going for, and people were charging like $2 or $2.50. I would not do that though; people who are selling it are doing [it] to supplement [their income], but I don’t need that, it’s not worth it, I can’t see doing it because what I get is a sense of gratification. Giving her my milk is a real privilege. She keeps thanking me, but it’s really my honor to help her baby with his well-being. It is a privilege that she trusts me. It’s very rewarding. And I take that privilege seriously. It’s personal. When you sell it, it’s not voluntary, giving it is important. If I sold it, I would feel like a milk cow. And not to disparage those who chose to do that—because maybe it allows her to have some income to stay home with her baby and that’s great—and maybe I get “paid" by the yoga, but I would do it anyway . . . and it’s a nice trade, but it is totally outside the market. I’m a communist! But I would donate to a bank or stranger too. Not sell it. If Violet offered me money I would be pissed!
Other donors explained how they felt empowered by making and giving milk and by the trust placed in them by donees. Giving milk is not only a form of charity; it is a powerful act and even, as Giles (2010) has suggested in another context, a form of self-care.
15. "I make milk. What's your superpower?,” 2014. Bumper sticker. Photo by James Bielo. Used with permission.
Effie, who is white and middle class, lives in her own single-family home with her husband and two kids in a suburban neighborhood. She is active in the local La Leche League community and would like to eventually join the lll leadership. She is Christian, patriotic, and pro-military. She eats organic foods, avoids alcohol and caffeine, uses cloth diapers, and is suspicious of vaccines. She homeschools her children and practices baby-led “attachment parenting,” which means following the principles of childrearing promoted by the best-selling author and pediatrician William Sears. This style of childrearing asks a lot of mothers and fathers.
In addition to helping me find other donors, Effie was a regular donor to our family. She was an overproducer, making more milk than her baby could consume, and she was a self-proclaimed lactivist, believing wholeheartedly that all babies should be fed breast milk if possible. We were thrilled to find each other.
Over and above the milk itself Effie viewed donation as community making. When I picked up the milk, it was a social event. We visited in the southern sense of the word, which meant that she invited me in and gave me food and drink. I saw the public parts of her house. We talked about our children’s latest accomplishments, our husbands, babyproofing our houses, and day-to-day activities. It was a time for learning about each other while our kids played.
I was careful not to make pointed or sarcastic comments about religion or politics. This was partly because it is considered unseemly to discuss politics or religion with acquaintances in many parts of the South, and Effie never asked me about my religious beliefs or political leanings. But everyone gets the basics (I am nonreligious and left leaning) according to what is said, since we are of course always telling people who we are—ethnically, religiously, economically, educationally, politically, and otherwise—through how we talk, regardless of the content of our conversation. We did, on the other hand, discuss breast milk, the pharmaceutical industry, the politics of formula, public education, and how baby products like diapers, car seats, and bottles are marketed. We agreed that milk sharing was doing an “end run” around for-profit formula companies. She stopped donating only when she became pregnant with her third child.
Counternetwork
This chapter is devoted to exploring the stories of women who, like Effie, are donors. Who are these “milky moms”? Why do they do it? What conditions make donating possible? What does the moral economy of gifting milk look like? What are the political implications? How do people interact with the metastructure (which can, as I suggested in chapter one, be cleaved from the network of people who coalesce around it)?
Sharers coalesce around a metastructure as they question, resist, selectively follow, and bypass institutional authority. Some donors and donees are connected through friends, breastfeeding groups, doulas, midwives, or lactation consultants, but most donors I worked with, those who donated to our family and those I interviewed, do not know one another.
One way to conceptualize this group is as a public. In academic investigations of this concept one work of special note is Jurgen Habermas’s ([1962] 1989) on the historicity of the public sphere, where “public” is built upon ideals of equality, rational discourse, and participation in civic space. Subsequent refinements have advanced how such a public is thought to operate.
In her critique of Habermas’s public Nancy Fraser (1992) wields a feminist sensibility to outline the emergence of postbourgeois, subaltern “counterpublics,” which form their own interest groups. Fraser argues that recognizing a multiplicity of counterpublics whose members and thus voices are subordinated by dominant groups better captures a promise for participatory democracy; subaltern counterpublics can produce counterdiscourses that address and request a response from dominant public discourse.
Michael Warner (2002) describes publics as modern relations among strangers similarly interpolated. These stranger publics are imagined in advance, activated by the uptake of text, and cease to exist when attention is no longer predicated (88). While ephemeral, they contribute to the warp and weft of the social fabric. Counterpublics are those publics that maintain an awareness of subordination with regard to ideas, genre, and modes of address, with participants acknowledging power relationships through their participation in counterpublic discourse; a counterpublic is identified not just through oppositional politics but also through the nonconformist nature of its intervention, in which “the discourse that constitutes it is not merely a different or alternative idiom, but one that in other contexts would be regarded with hostility or with a sense of indecorousness” (119). You can see how counterpublic dissent may proceed through awkward confrontations and hostile encounters, but even outside of oppositional discourse it is a “politics of refusal” enacted by those whose modes of argument step outside of the frame of established debate altogether (Harvey and Knox 2015, 172).
In responding to a hegemonic “breast milk is best” narrative, sharers can be understood as constituting a powerful, and empowering, counterpublic. But to highlight the enactment of a politics of refusal by people connected through a metastructure, I would suggest using the term “counternetwork.” This counternetwork (the set of sharers participating at any one time) is configured against hegemonic norms for baby nourishment (breasts, official banks, and formula), implicitly critiquing medical and pharmaceutical policy. Though people are brought together in uneven, and even stochastic ways, those of like minds about feeding babies, but not necessarily other issues, work together, adding new textures to a body politic.
Because the circulation of milk takes place in particular spaces, at particular times, we can track it ethnographically. The boundaries defining the metastructure are fuzzy because ideas about what makes a good donor or whose milk is most sharable are constantly being (renegotiated. Can the donor consume meat, alcohol, caffeine, or sleeping pills? What about spicy food? Should milk be commodified? With whom should you, as a donor, share milk? Is it better to give your milk to a premature baby, the first person to ask, or to a baby with special needs, or is it better to sell it to someone for an art project? Should colostrum cost more or be held back for special circumstances? Is it acceptable to donate only foremilk? A bigger question concerns who polices these values: there is no center or authority in this counternetwork. It is self-policing. Sprawling. Rhizomatic. Horizontal.
To get at milk sharing we should take it as historically sited, as an event, emerging, extending in time and space, refracting cultural, political, and economic dynamics, and then disappearing. This approach encourages us to attend to the circumstances that enable or discourage milk sharing as a process that interacts with us. Milk means something, but milk sharing “does things,” to riff on J. L. Austin’s (1962) How to Do Things with Words, which argues that linguistic utterances not only have meanings but also consequences, such as engendering particular social relationships.
Configuration
Donors I spoke with highlighted how sharing entails and is entailed by political-economic, cultural, and technological configurations that shape the counternetwork within which identities, desires, and relationships are enacted. The circulation of milk is contingent upon intersecting values promoted by both official and grassroots community organizations. Such values include the virtues of breast milk, laws about milk exchange, and a drive for commodification by for-profit companies (discussed more in chapter five) that are pushing against donation circuits as the practice becomes better known.
As construed by many sharers, “white gold” operates as a mirror image to formulas attempting simulate and sell milk to mothers under the logic of capitalism. To produce milk oneself is itself empowering, and having excess to give to another baby is “fulfilling,” “gratifying,” an “honor,” a way to “pay it forward,” and understood as “giving back to the community.” Meanwhile mothers discuss risk and the ethics of commodification.
Interestingly there are few laws about breast milk. Forty-nine states, including Georgia, have laws that specifically protect the right of women to breastfeed in any public location, but only three states (New York, California, and Texas) have laws related to the procurement, processing, distribution, or use of human milk (but they pertain to milk moving through a licensed milk bank). According to the legal scholar Stephanie Dawson David (2011), human milk is not included under the National Organ Transplant Act of 1984 (which makes the selling of human organs a federal crime), and many states exclude “replenishable” or “self-replicating” body fluids and tissues (such as milk, hair, and sperm) from the scope of laws prohibiting the sale of bodily materials.
So even though sharers often claimed that “selling milk was illegal,” the fact is that under current laws breast milk is treated more like a food than a bodily fluid; buying and selling it is perfectly legal. David (2011), along with others who recognize that current laws offer little protection to buyers who may be harmed by milk bought on informal markets, calls for adopting regulations governing the sale, processing, and shipment of human milk, particularly with regard to impersonal and informal sales, to better ensure the health and safety of children in these transactions. But even if laws with these provisions were passed, they would not apply to milk circulated as gifts.
Although women could make several hundred dollars or more per month selling milk, inside the counternetwork there is a moral measuring of recipients that affects pricing and distribution. For example, Margaret discovered at a support meeting that body builders were buying local milk. A woman in her group was having financial difficulties and asked the others if “it would make her a bad person” if she sold her milk to body builders instead of donating to a needy baby. A few moms admitted that they had already been doing this to contribute to family finances, but most of the others argued, “No way, milk is for babies.”
Margaret’s comments highlight the hierarchy of need that structures the distribution of milk, with mothers who try and fail but who want to breastfeed being viewed as most deserving and those who choose not to breastfeed because of the work involved being viewed as less deserving. The presence on listservs of offers to donate milk that specify a desire to help a baby with special needs or a premature baby index the tacit rules of donate-ability. Body builders who want milk for its supposed role in muscle growth or men who want it to satisfy a sexual fetish are typically the last to be served (and in following an imagined supply gap, offers to sell milk to men are often accompanied by higher pricing).
Reflecting this hierarchy of need, Chrissy, a Human Milk for Human
Babies site administrator, was explicit about HM4HB aims when she told me in an interview that “our mission is to make sharing commonplace and normal. Moms make informed decisions, both donors and recipients. It is a free choice. But bms [breast milk sharing] is gaining popularity, especially in the natural birthing community. And many women want to breastfeed but can’t, so others step in.” hm4hb had its fourth birthday in 2014, and when asked what changes she had observed, Chrissy explained that she had seen the community grow rapidly. When she started there were seven hundred people on the page; by 2014 there were more than twenty-four hundred. The number fluctuates as babies and moms come and go, but there has been a tremendous increase in activity.
The configuration is shaped by technological opportunities and constraints, as well as member participation. Georgia is one of the few states with both a public and a closed group. Many persons expressed privacy concerns to Chrissy, so she started the closed page as an alternative. By 2014 the closed page had about a thousand members. She also expressed concerns about how the architecture of the site was becoming a major issue:
When Facebook modified their algorithm, things changed. So, I can do a repost, and it used to be that a repost would go to all the people that frequently “like” the page, but now, reposts only go to about 10% at a time. So that’s a problem. I mean the whole plan is to make it easy and visible; with the closed group, members control what they see and customize their feeds. So, we are still tweaking and experimenting to find the best way to do this. And why? Because as women and mothers, we have so many options, and so many things that divide us: from birthing, to what kind of diapers to use, to how you parent, but with breast milk sharing, all those differences are put aside. We present a unified front. It is just moms helping moms, or babies who have lost a mother. Or grandparents who suddenly find themselves caring for an infant. Or surrogate fathers. Or adoptive parents. This allows us to come together. It really isn’t just a bunch of creepers out there. These are people with good intentions. It really is all about feeding babies.
We can imagine a sharing community functioning (just not as quickly, widely, or effectively) without Facebook group sites or MilkShare, but none of this would be happening without the pump—the machine that cleaves breastfeeding from breast milk and makes it possible to feed a baby breast milk without the presence of a breast. Pumping allows women to extract milk and to save it for later, to give it away, or to sell it. Guinness World Records, an organization that keeps track of human accomplishments, reports that Alyse Ogletree of Argyle, Texas, used pump technology to donate 53,081 ounces of milk to the Mothers’ Milk Bank of north Texas, giving her the record as Biggest Milk Donor. Perhaps this is not that surprising, given the social value placed on breastfeeding as essential to a woman’s performance as a mother. Those who breastfeed (and by extension those who donate milk) can lay claim to being better women and mothers (Stearns 2010).
Until the 1990s electric breast pumps (developed for hospitals) were unavailable for home use. Today women use hand or electric pumps, even renting or buying “hospital-grade” models secondhand. Valerie explained, “If a baby cannot latch on, moms pump. Or if their baby is in Nicu, they pump so that they’ll be ready when the baby comes home. But pumping has different rules. For one thing, when you nurse, the baby stops when he’s full. But with a pump, you pump until there is no more, and it’s more than the baby would take, so you are pumping more than you need. And when you have too much, there are really only two options. You can give it away to someone who cannot furnish enough, or can’t furnish any! Or dump it down the sink. And that is just wasteful.” But, as Helen explained, “Pumping is a chore! Hooking up your bosoms to a machine and then letting the machine go to town? You feel like a cow! But people do it, and they do it with love when it is for their baby.”
Ancient Greeks used a ceramic guttus, both to empty the breast and feed the infant, before the Romans invented glass milk-extractors sucked by the mother herself. Devices in the form of a smoking pipe became widespread in the seventeenth century, and in the nineteenth century vessels sucked both by mother and infant were developed to facilitate breastfeeding for preterm infants (Obladen 2012). Orwell Needham applied for a U.S. patent for his breast pump in 1854. It has not changed that much since then.
Women commented on the clunky, even “medieval” nature of pump
16. Design for breast milk pump as sketched in patent application by Orwell Needham. http://www.google.com/patents/US11135.
design. “My husband,” donor Kristin pointed out, “is not one to point out gender inequalities. I mean he took a women’s studies class in college and stuff like that, but he is not really a feminist, but even he was like ‘that pump is crazy!’ If those were for men, they would be portable and streamlined. When I started pumping, I heard that there was some competition at mit or somewhere to make a better pump, but I am still waiting for that.” I suspect that few engineering resources will be devoted to pump improvements until there is big money to be made. And electric pumps, medieval as they may be, are effective as is.
Mara told me, “I was paranoid about not having enough milk for my baby, and I was working, I mean I am a teacher, so I was pumping like crazy, like thirty ounces a day and freezing it. Pretty soon I had filled up the freezer, but we realized that there was no way the baby was going to go through all of it. And my wife also had an oversupply, and so we starting donating. After all, it is ‘liquid gold!’”
The pump, unwieldy as it is, is important to those who work. Some donors, like Murial, can arrange their work to fit their pumping needs. “As the mother of a six-month-old,” she said, “I have to pump when I travel. And I travel a lot. But I always call ahead to the airports where I am making a connection to ensure they have a family bathroom where I can do it. If they don’t, and not all of them do, I reroute my flight so that I get a connection in a place that has a family room. I am just not going to do it in the bathroom on the plane!” But some mothers find pumping at work extremely challenging or even impossible.
Even stay-at-home mothers pump so they can have time away (when a babysitter can bottle-feed the baby). Some pump when breastfeeding is not possible due to poor latching, maternal medication or surgery, or infant illness. Pumping and storing may allow a nonlactating partner to feed a child using a supplemental nursing system or bottle. Some mothers generate a stash as a kind of “emotional insurance,” as one donor put it. Others may not like to breastfeed in public, or at all. Those who have experienced sexual trauma may find breastfeeding upsetting and opt to pump and bottle-feed instead. Others pump when engorged but unable to nurse or when using formula. Sidney explained to me that she always breastfed her baby, enjoyed it, and had an easy time with it because “Haley was a good baby, a good nurser, but I always pumped at night and gave her formula instead because she slept longer like that. If I nursed her, she would wake up every two or three hours.”
Cindy Stearns’s (2010) analysis of the way pumps are named and advertised describes a cultural matrix in which breastfeeding, or at least feeding a baby breast milk, is essential to performing motherhood. Pump marketers take advantage of the idea that breastfeeding is ideal, natural, and pure, using names like the Ameda Purely Yours Breast Pump or Dr. Brown’s Natural Flow Electric Breast Pump with “natural” feeding bottles. But there is nothing “natural” about pumping, which is why lactation consultants are hired to teach new mothers how to do it. In fact, as mothers pointed out, while it can be easy and fast, pumping can also be labor intensive, frustrating, and stressful.
Risks
The same forces—technology, modernity, work policy, and so forth— that brought us the modern pump brought us problems with breast milk. Erin, whose daughter was supplied through donations, had to laugh a little about her own preoccupation with pumped breast milk: “Hannah only had breast milk until she was ten months old, and then we took a trip and didn’t have any, so we used formula. We were visiting friends, two gay guys that had adopted two kids, and they had given them formula. Harvey was ribbing us about how we were down on formula. He thought formula was fine and he was kidding us and saying, like an ad tagline, ‘baby formula kills.’” But formula, like milk, does have risks, and the milk versus formula question is not a simple one.
For one thing persistent organic pollutants (pops), which include such scary-sounding compounds as polychlorinated dibenzo-p-dioxins (pcdds), polychlorinated dibenzofurans (pcdfs), polychlorinated biphenyls (pcbs), and organochlorine pesticides (like ddt) tend to accumulate in the food chain over time, with breast milk and breast milk-fed infants at the end of the chain (Mead 2008). Since 1951 ddt and its metabolites have been reported in essentially all breast milk tested worldwide, with additional chemicals showing up since then (including banned pops). What happens is that lipophilic chemicals (most of which come in through the mother’s diet) are stored in body fat over a lifetime, and when that tissue is mobilized to make milk, the body transmits a portion of her (possibly substantial) stores of environmental contaminants to her baby. Advances in Neonatal Care reported (Jorrisen 2007) that on average, a nursling receives fifty times (per kilogram of body weight) the daily pcb intake of adults and that breastfed infants are predicted to have cumulative pcb exposure up to 18 percent higher than those of formula-fed infants, depending on the duration of breastfeeding, yet the analysis of research on breast milk exposure indicates that despite the measurably higher pcb loads, breastfed children continue to fare better than their formula-fed peers.
Not only pops but dangerous metals like lead and mercury, which also accumulate in the body, can contaminate breast milk. However, these metals have been detected in even higher concentrations in commercial formula, and the (competing) protective effects of breast milk may outweigh the potential harm generated by heavy metal contamination.
Looking at the intersection of gender, reproduction, and environmental degradation, Maia Boswel-Penc’s (2006) Tainted Milk examines the complex relationship between the politics of feminist and environmentalist groups and the lack of public awareness in the United States about the presence of chemical toxins in what is supposed to be an unadulterated substance. The relative public silence about this issue has meant that policy responses to environmental pollutants linked to contaminated milk have been minimal (in Sweden, as a point of comparison, policy limiting pesticide and fire retardant use have made the environment healthier for both infants and adults). While some environmental activists have been reluctant to worry aloud about milk contamination lest it discourage women who do breastfeed from continuing to do so, some feminists have been reluctant to promote breastfeeding as a biologically endowed feature of motherhood because they argue it reproduces an essentialist notion of gender.
And then there are the risks associated with sharing. Shanna, a donor who temporarily turned to donated milk when she was on medication to treat a persistent case of thrush, recognized that the stakes for a donee family are different than for the donor:
The whole donor-donee thing is interesting. I mean back in the day
wet nurses fed babies. So, it has been going on forever, but in a dif-
ferent format. Now there is a step in between. But donating is easy. It is not a big deal[.] But being a donee? Now, that’s a big deal. You have to be careful: What has this woman been eating and drinking? How does she treat her body? What is her lifestyle? Does she have any weird germs? Any bonehead can give, but you have to be brave and savvy to receive. It is like blood! At a milk bank, there are checks. And I do not have a clue about that side yet—I mean how do you gently ask about someone’s hiv status or whether they have ever had syphilis? I mean are you like: “Do you have the clap? ’Cuz, if you do, I don’t want your milk!’” I mean you don’t want to alienate or insult someone who is about to give you a precious gift. That’s pretty tricky. Being a receiver is a wayyy bigger deal.
Shanna is right: issues of disease and contamination are real. Breast milk can carry hiv, hepatitis, and other diseases. Almost every donor we contacted in 2010 provided medical records for us. At times the records had been generated during the pregnancy, while at other times women made appointments with a health care provider to get additional tests. I noticed in the way people were responding to us that over time (as the practice seems to be growing) more sharers seemed to be participating in higher-risk situations. Some donors we contacted in 2012, for example, were not willing to have tests or to disclose medical information. One plainly stated that the request for information was too intrusive. Another told us that her medical information was private, and she was uncomfortable sharing it. Others did not have time to acquire records or to take tests. Some explained that no one else had made these requests and that they would rather look for an easier exchange, one that did not require documentation.
And then there is the possibility of contamination. Research on donor milk contamination has become more vigorous in the last decade. An article in Pediatrics on microbial contamination of breast milk purchased on the Internet, cited in popular media like the New York Times, reported that an analysis of a cross-sectional sample (n = 101) of milk purchased from an online breast milk sharing website, when compared to milk bank samples (n = 20), “exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices,” and the authors concluded that “infants consuming this milk are at risk for negative outcomes, particularly if born preterm or . . . medically compromised” (Keim et al. 2013, e1227).
Keim et al.’s (2013) study was designed to compare the potential for milk bought online versus unpasteurized samples from milk banks to cause infectious disease. Analysis of samples in each set showed that milk bought anonymously online contained gram-negative, coliform, and streptococcus bacteria (the milk bank samples also contained these bacteria, though not salmonella, but at much smaller levels). Studies have also found dangerous contamination in formula (see Langreth and Nussbaum 2011). For breast milk samples bought online, each additional day in transit was associated with an increase in bacterial count. But what long- and short-term risks do these microbe loads represent?
In a separate study, Keim and her team tested 102 samples of milk purchased from online sources and found that 10 samples contained a level of bovine dna consistent with human milk mixed with at least 10 percent cow’s milk, which could be problematic for infants with allergies or intolerance. Adulteration (with cow’s milk, formula, or something else) could be accidental or deliberate, but as the authors point out, “selling rather than donating milk involves a monetary exchange, which may increase numerous risks, similar to those documented for how paying blood donors increases the likelihood of infectious disease markers in the blood supply” (Keim et al. 2015, 4).
However, this contamination study was set up only to approximate “real-life transactions.” Sellers were sent a standard email inquiry expressing interest in buying a small quantity of milk. Communications were confined to the transaction, and all correspondence ceased if the seller asked about a recipient infant or insisted on telephone or in-person communication (57 out of 495 inquiries). Email, PayPal address, and delivery address were anonymous. No instructions were given about shipping methods.
In related research, titled “Breast Milk Sharing via the Internet,” Keim and her team analyzed postings by sharers to discover how participants communicate about health and safety risks (Keim et al. 2014). They found that few donor postings reflected measures that could reduce risk (e.g., good hygiene, specifics about disease screenings, abstaining from substances). And 90 percent of the recipients did not specify health or safety practices. Such data led the team to conclude that a lack of communication may exacerbate the health risks for recipient infants, especially those at increased risk.
This study (Keim et al. 2014) is provocative, but even the authors admit that offline activity was unavailable to them. In my experience this offline activity is where many personal questions related to health, hygiene, disease, diet, and so forth would be asked and answered. And one of the most important aspects of the sharing relationship as advanced by network members and sites like MilkShare is having good communication between participants. What Keim’s study seems to miss is the tacit expectation that donors enter into these discussions privately because some information is not meant for public consumption. Some information is exchanged on a need-to-know basis: for example, if a recipient had a breast surgery that went horribly wrong and she now cannot breastfeed, that may be private. If a donor takes a psychotropic pill for postpartum depression, she may reveal this privately.
Echoing my own observations, Stuebe, Gribble, and Palmquist (2014) argue that the design of Keim et al.’s research—with its anonymous purchase, no-questions-asked format and lack of packaging requirements for shipping—is unlikely to be representative of real parents seeking milk, for several reasons: (1) the vast majority of parents seeking milk, 96 percent in one analysis, use only sites that promote donation (not sales); (2) the authors did not screen donors, whereas real parents typically do; and (3) milk-gifting sites encourage local delivery over shipping, which would reduce the risk of microbial growth during poorly designed transit, resulting in an analysis of a “worst-case scenario” for milk sharing.
Research on milk samples from the kind of sharing I have been describing in these chapters is needed, as is research on the extent to which microbes represent dangers to most babies receiving donor milk (in contrast to those especially vulnerable infants we might typically find in a Nicu). Keim et al.’s study makes me wonder to what extent milk routinely expressed, frozen, bottled, and then given by mothers to their own children across the entire population would not present the same set of microbes. Most of the milk our family received, well over twenty-five thousand ounces, was initially pumped and frozen for someone’s own child.
Keim et al. (2013, ei228) suggest that “informal sharing” is actively hazardous. I would also note that the use of the term “informal” to describe sharing outside of governmental and institutional surveillance carries a strong implication of illegitimacy as compared to the unmarked category of milk bank exchanges, which we must assume constitute formal (and thus legitimate) exchanges. As a solution to the milk supply gap, Keim et al. (2013, ei227) suggest that “lactation support services could begin to address the milk supply gap for women who want to feed their child human milk but cannot [themselves] meet the baby’s needs.” And while such support could undoubtedly help in many cases, there are parents (like my husband and myself) who will never produce breast milk in sufficient quantities, or maybe not at all, no matter how much lactation support they receive. Here I am thinking of women who foster or adopt, or those who have had mastectomies or breast reductions, or who have other physical conditions (such as polycystic ovaries or hypothyroidism) that limit milk production, not to mention male and trans-gendered parents who may want to give their children breast milk but cannot themselves produce it.
So far I have been unable to locate even one example of a child sickened by breast milk donated through a local network, or even from milk sold through an online forum. Not to jinx it, but milk sharing seems to be working well. Risky as it may be from a certain perspective, it seems to have a better safety record than banks or formula. Many I spoke with certainly see it this way.
Science says sharing is risky, but then “so is not giving your baby breast milk,” as Mara put it and as the “breast milk is best” campaign would have us believe. And the sharing community does recognize risk but views potential problems as manageable and that shared breast milk is worth the risk. But as Karleen Gribble (2014) has pointed out in an early published work on milk gifting (not sales) based on written questionnaires administered to donors and recipients recruited via Facebook, risk mitigation can be improved; for example, donors could be better trained in hygienic expression, and health care providers could be trained to discuss risk mitigation with peer sharers. As McKenna commented, “a lot of people ask about moms who do this, about their honesty and safety, but most people are really honest and when asked, are forthcoming. They have nothing to lose by saying, ‘Yeah, I have a glass of wine sometimes,’ or ‘I do [eat] dairy’ and then people can decide whether it is for them.” Donors described all kinds of questions based on variables selected to manage risk: Do you have an organic diet? Are you gluten free? Have you been around pets? Do you take vitamins?
Risk management is highly individuated. Stephanie was able to exclusively breastfeed her son for the first six months and then kept nursing him up to about eighteen months. She recounted,
When he was about four or five months old, he and I were diagnosed with a milk-soy allergy and so I went on a soy- and dairy-free diet. But I am a working mother, so I was pumping at work, and I had built up quite a supply—but since I went dairy- and soy-free, and we both felt better, I did not want to give him the dairy and soy diet milk. So it was just there in my freezer. But I held on to it for a while, because you know, I guess I needed a security blanket. I had a big stash that I could use in a real emergency.
She never did need the milk from when she was eating dairy and soy, but she found a recipient for it who never asked if she was dairy free.
Many moms I spoke with told me they had been anxious about running out of milk and had, especially in the beginning of their child’s life, pumped frequently but then found they didn’t need it. Laura reached out through her local Facebook group when she felt confident that her baby would not need her frozen supply. She described the group as “a natural, positive parenting group.” She wrote in a Facebook posting that she had milk to donate and then described herself: “I do not smoke or drink, and I am healthy.” She explained,
I just listed a few basics. And there was a mom, Gayle, in our group who had a preemie, and the baby was going to be in the Nicu for two or three months. So he was very premature. And she was having trouble getting her supply up, which happens when you are not with the baby all the time. I know that happened to me when I had to go back to work. And anyway, she was going to use the milk for the baby in the Nicu. She came and picked it up here and took it to the hospital where she kept it. We live in the same town, so we had some friendship connections, I mean, our kids were born in the same hospital and we had the same midwife, so our circles were entwined, but I had never actually met her or anything before this.
She expressed surprised that Gayle didn’t ask her for medical records:
I am aware that certain things can pass through. We did have a superficial Q and A session where she asked me about smoking and drinking, and general health and medication. I told her that I had pets—we have two dogs—I am not sure why people want to know that, but I had seen other people mention that, so I mentioned it to her. She asked me a lot of questions about my process—she wanted to know when it was frozen and how it was frozen, and whether or not it had ever been thawed out—so she was definitely concerned with freshness. I told her that I had used a double electric pump and that I had frozen it in a deep freezer immediately and that it had been in there ever since. So, I am not sure how people decide what is good. I mean, what effect does having pets have? I chose to volunteer that information based on what I had seen other people say because I didn’t really know what to say, but I was happy to answer all of her questions. All told, I gave her about 150 ounces.
Other donors reported similar experiences with donees who either did not care or did not know to ask about their donors’ health status. Sarah told me,
It occurred to me to talk to her about health issues, so I went to my lactation consultant, Jaye, and she was like “I should really find out about this,” and she went and found a long questionnaire for me, and I filled it out and gave it to Kelley, the donee, mainly because I had to have a blood transfusion after my C-section. And I knew that was the only risk because I am very healthy generally. But she did not ask for anything, and she seemed very appreciative that I had filled out these questions for her. So, we met a bunch of times and talked about hanging out—we never did, you know you get so busy with a baby—but it was a really friendly and enjoyable acquaintance. So she knew me, and we did have friends in common.
But, really I got involved because I just felt so lucky that it was going well for me, and I could make that choice because I had time to pump, and I realize that not everyone does—it was an opportunity for me to help, and it seemed so easy. I loved it. I mean I just hook up to a pump and watch a show, and just like that, I am helping someone else!
Donating like this is very personal and because of that, it is very safe, and it is also about the community helping each other. Sure, you can go to a bank and get milk that has been mixed together and tested and all of that stuff but it’s not the same. Here you can feel really good: you know the person and her baby!
Not everyone can or wants to meet a sharing partner in person. Some donors felt that the relationship would be too charged. Mara explained,
I never met the donees. I let my partner deal with that because it is very emotional. I mean it is a lot of hard work: I was pumping every time I had a free second because I was so concerned about the baby, and I do want to share it, and I was so happy to be able to do that. I was so proud to be feeding three kids but at the same time, I mean, it is a body fluid. It is part of me and I am passing it on. It is like giving away a piece of yourself. There is an intimacy to it. It’s a complicated gift.
The value of community building and developing personal relationships and trust inside the network is not to be underestimated. Since most shares are local, the knowledge that develops is reminiscent of what Julia Elyachar (2010) describes as “secrets of the trade,” which are not the property of individuals but emanate from the conduits through which actors emerge. These “secrets,” like trading photos of babies, exchanging medical documentation, asking about a person from a shared midwife, visiting someone in their home, or knowing someone virtually on a parenting group website, are missing from scientific studies of milk sharing. To successfully enter the counternetwork, donees and donors must pick up tacit knowledge of what to expect and how to ask questions in an appropriate way. Donors expect to learn why parents need milk. And donees like Amy, who needed milk because breast reduction surgery resulted in a low supply, always sent Sarah, her donor, pictures of the baby, saying, “Look at those rolls!” We also sent our donors photos of our children and kept in touch with them about their progress.
Politics of Refusal
Mothers often appealed to forms of knowledge making outside of rational scientific methods, such as instinct and feelings of trust, to decide with whom to share. These other forms of being or knowing underpin identities enacted in a relational, counternetworked practice. While the hegemony of “breast is best” shapes the larger context, there are all kinds of idiosyncratic reasons women get involved, at times paying no heed whatsoever to scientific or institutional authorities. Donors share to “pay it forward,” to cope, to advance a political agenda, or to perform friendship or kinship.
Miranda said she was “fortunate enough to exclusively breastfeed my son until introducing solids, but I pumped every day and donated to a friend with supply problems.” Sarah not only donated to strangers-who-became-acquaintances but also cross-nursed babies of two friends (and they nursed her own son). Mara donated to four anonymous donees but also had three friends who had babies around the same time she did, so she pumped for them as a supplement. “One anonymous donee,” Mara explained, “asked for a lot of information, but the others did not ask for anything. I had disclosed that I take an asthma medication to a friend and she was like if ‘it’s good enough for your baby it’s good enough for mine’! Another friend said, kind of joking, ‘you’re not taking any heavy drugs or anything are you?’”
This last remark goes to the unspoken trust operating between friends or family. Donees often assumed that a friend or sister would not harm a child by doling out “bad” milk by failing to disclose medication (legal or illegal), drinks (coffee or alcohol), or disease. Frankly it did not even cross my mind to ask my sister for medical records or tests. Danielle explained that when her sister got pregnant and had a baby at eighteen, the baby was adopted by another family, and at the same time her cousin Pamela also had a baby. Pamela pumped and shipped milk to the family who adopted the baby. “It was all in the family, it was a full circle,” she said.
For others, sharing helped them “to cope” with loss or grief. Katherine told me, “I had never even heard of this before we (she and I) started doing it, but since then I had another friend who became a donor. But her case was tragic. She had a great pregnancy, but when she gave birth, the baby was stillborn, and of course, it was really traumatic. But instead of taking medicine to stop her milk from coming in, she let it come. And she pumped for about five or six weeks, and donated the milk. It was just really sad, but that is something she did to help cope with it.” Others, like McKenna, said donating helped them cope with grief in the way that organ donation may feel therapeutic. McKenna moved to Georgia because her military husband was stationed here. McKenna, a stay-at-home mom to two young children, also works as a midwife. She raises goats, chickens, and vegetables and sells beauty products. Because she is deeply involved with the birthing and women’s community, she could help my family find donors. When I explained why I was conducting interviews, she wanted to participate because she thought this book was a “great idea because a lot of people do not even know that sharing is an option.” I had to agree; whenever I told friends what we were doing, they were at least surprised, often curious, and at times more than a little skeptical.
McKenna’s participation started out with allo-nursing with a friend. “I got involved with this,” she explained, “because my daughter, Hanna, had been nursed by friend of mine, and so she became ever more near and dear to my heart because this experience was just so super special, and now we have an even closer relationship. Because it is just such a special gift. It’s from your heart, from your body.” But her introduction to more intensive milk sharing was unanticipated, the result of a connection to an awful situation:
Then, I really got involved in being a regular donor. My donee was a close friend, and after she gave birth she was in a car accident. Well, I say she was in a car accident, but really [what] she had was an undiagnosed heart issue. She had noticed something was wrong but at the time, it was just so close to the baby being born, that her doctor attributed it to the pregnancy. Then, about three or four months after giving birth, she was dropping off her dad at the airport and she got pulled over. That made her heart race, you know, the sirens and everything, which would make anyone’s heart race, and the stress was just too much. And she ended up pulling over, of course, and the officer didn’t know what was going on. How could he have known? But anyway, when he got out of his car, she fell over and ended up hitting the gas and driving her car over to the other side of the road into oncoming traffic. He just thought she was resisting arrest or trying to escape and he went back to his car and called it in and waited for back up, really just doing his job, he did what he thought he needed to do. But all that time, she was having a heart attack. So, by the time they got to her it was really too late. When they called me, she was still alive, but only by life support, so she did not make it. I was just called in to say goodbye.
She was a close friend; she had even been at my birth. So, I guess [donating] was my mission, or maybe just my way of coping with hurting, and I wanted to try and help, make sure her baby and Blake, her husband, had everything they needed.
Blake was living up in Savannah with his mom, Brandy, so we just started a whole collection and it was so heartening to see how many people came forward. Women offered twenty ounces, a hundred, whatever they had that they could give, and the baby made it a year with all donated milk. I had already been involved with [the] birthing and breastfeeding community, but really this is how I got into the sharing part. This is really when my crusade began.
As with McKenna, donors wanted to know where their milk was going. Many, like Rainey, resisted the alienation that could, would, happen when milk went to an unknown baby through a bank or for-profit company. She had moved from upstate New York to the area with her husband; Robert had a job as a caretaker at a large country estate near Hilton Head. Their family lived in a medium-sized house on the estate. Rainey was a stay-at-home mother to four children, who had the run of the farm, especially while the owners were away, which according to Rainey was most of the time. She was heavily involved in local Christian church activities and a homeschooling group. She prizes education, reading, spending time outside, and being involved in her community. Her children, who ranged in age from one to eight, were well mannered, poised, and healthy.
They always called me “Miss Susan” (for those readers who are not from the South, some young children here are taught to respectfully refer to adults with “Miss” and “Mister” and the adult’s first name) and ran out to meet me at my car, asking if they could help bring in anything, telling me about their latest exploits and discoveries, and asking about the baby. She had breastfed each of them for two years. She shared much in common with others I would meet over the next years.
When I met her, she was breastfeeding her youngest child, then just over a year old, but she made about ten ounces a day for us: “I am just one of those lucky women who produce an overabundance [of breast milk] and don’t want to see it go down the drain.” With her third child she had contacted a milk bank and went through the signing up and testing process so she could donate the overage, but she experienced problems.
She was concerned when she learned what the bank planned to do with her milk. In her discussions with the bank she had discovered that they planned to use two-thirds of the milk for research, while only one-third went to Africa. And while she was thrilled that some was going to Africa (to feed to babies diagnosed with hiv, she assumed), she did not like that it was mostly being used for research, especially since she was not privy to what the research projects were or what they were being used for. “And I already know that milk is good for babies!” she explained. She wanted to have more control over how it was being used; she decided to look for a family with a baby who would consume all of the milk.
I spent many mornings driving to Rainey’s in South Carolina with my son. I always took him, not only so he could have a pleasant outing and play with her children but also because there was, I must admit, a performative side: I wanted Rainey to see that he was thriving, partly, I was sure, due to the donated milk he was consuming. I wanted her to know that her milk was being put to good use. Over time, visits became more relaxed, longer, and more sociable. As a new mother, I was happy to ask for, and receive, advice from someone with experience. She helped me understand not just how to defrost and best preserve milk—the basics— but also what to do when the baby had a high fever, how to make and freeze baby food, and how to use breast milk in ways that I would not have imagined.
The morning I picked up the first donation, we hugged, and she told me how thankful and blessed she was to be able to give milk to us. She impressed upon me how important she felt it was to give children breast milk, and she said she admired how hard I was working to ensure a good start for our baby. I was happy to hear this, but I very surprised at how thankful she was to be doing this. Meanwhile I had been frankly wondering to myself how I was going to be able to thank her! Several months later she became pregnant with her fifth child. She stopped donating but did make it a personal mission to find a replacement. At the time of writing we remain in touch and she is awaiting baby number six.
Others helped make breast milk sharing possible by setting up or serving as administrators on social media sites, being active in lll, and making matches. For example, the Facebook page Milky Mommas, founded in 2011 by Christine, is a forum for all things breast milk and beyond. “How did you get into this?” I asked her. “Have you ever been a donor yourself?” She replied,
I have donated milk personally a few times. I have wet-nursed while babysitting twice, and I pumped within my first week postpartum, after my second baby, to donate to another newborn born the same week who was diagnosed ftt [failure to thrive] when his mom struggled with breastfeeding. We were connected through our ibclc [international board certified lactation consultant]. I am about to make a donation to a mom for whom I served as birth doula. She struggled with fertility before conceiving the baby, whose birth I attended, and then became pregnant again by total surprise at only four months postpartum! Her milk dried up, but her goal was still to give her daughter breastmilk until at least a year.
Christine then explained that she was a matchmaker for donation relationships: “In addition to my personal donations, I’ve helped to facilitate informal milk donations during emergency situations for babies who lost their mothers, or whose mothers were incapacitated. For example there we had a situation where a six-week-old breastfed infant mother returned to work, and on her first day back, collapsed unexpectedly, and passed away; I believe [our group] sent over five hundred ounces to the father in the Augusta area.”
Another time a mother experienced sepsis after a uterine infection, and her baby had to be kept away from her for two weeks while she was hospitalized and heavily medicated. Her baby “did not do well on formula,” so Christine collected and shipped three hundred ounces of milk to northern Michigan, where the family had gone to recover.
I was already familiar with Christine’s third example because I knew other people, including McKenna (above), who had donated milk to them. I had been told several versions of the story about a mother who had gone into cardiac arrest when she was pulled over for a traffic violation (all basically in agreement, but differing in a Rashomanlike way, as we might expect, in details), but in Christine’s words, “The emts were not able to intubate her in a timely manner. She was removed from life support a few days later. Her exclusively breastfed three-month-old son became the recipient of many milk donations over the following months. I helped with finding donors, receiving shipped milk, arranging logistics for milk to be transported from throughout this state and others, and also with storing it until it could be passed on to the father.” This story is a remarkable in many ways: when her death was announced on the local parenting boards, many people—friends and strangers— stepped in to help the grieving father with food, child care, supplies, and breast milk, and it shows how this group did far more than simply move milk.
Christine is what my family calls a “nexus person.” She knows lots of people in various social groups and is able to bring them together, so it is not surprising that she founded a Facebook group. She explained to me that she wanted it to “provide information and support for women who are or are interested in breastfeeding or breast milk feeding. We have around 2,500 members currently, and a lot of milk-sharing arrangements originated within the group. Like right now, I am assisting a mother who travels between Savannah and Charleston, who has a baby around eight months old. Her baby is going to a gastrointestinal specialist up there because he cannot tolerate formula. He has had many health issues since cessation of breastfeeding. He needs breast milk!”
With women moving away from their own natal families and having children later in life, there is less support for them when they are learning to breastfeed. The rise in occupations such as doula and lactation consultant testify to this. And at times new moms may feel isolated. Christine told me,
I started Milky Mommas because my daughter was almost five months old and the only knowledgeable breastfeeding support I had was my ibclc and my mom, who breastfed her three children a quarter of a century plus ago. I wanted to get a few women I knew in the same place to talk, to share our experience, and support each other. I thought if I could get a dozen women on the site, then it would be a success. But, there must have been a lot more like me, because everyone kept adding more women who added more women. At one point, we had thousands, and then restructured it to make it more manageable, deleting a significant portion. Then the site began to grow again. Now I have a team to help me run things! So there are really a lot of people out there involved. And you know, I didn’t personally know the mom who passed away, I was introduced to her story through a mutual friend on the site. I helped get the donations, and the mutual friend took them back to the family. It is very heartwarming and fulfilling to be part of such an amazing act of love and giving. It makes me so proud of our village of women and the community impact we can have.
Some women became donors after having been donees themselves. Jaye, who was herself an ibclc, was breastfeeding her son Nero, who was born with a tongue-tie:
I finally got an emt to [clip the tie] when he was about nine days old, but up to that point I had been hand expressing into his mouth because he just could not suck, and so at about six days or so I developed mastitis [a painful inflammation of the breasts], and my nipples were torn up, and I got an infection so I started pumping because I knew that hand expressing was not going to allow me to make enough milk and it had become clear that my supply was already going down, probably because not enough milk was being removed, or maybe stress was causing my supply to decrease. Anyway, I stared pumping around the clock and I also reached out and was able to augment with donor milk. All in all I had five donors. One was my sister in
Charleston. Then some acquaintances around here (in Atlanta), and then I got some from a local ob (my friend that made the connection). She went and picked up the milk and brought it to my house—I never actually met the mom.
So, I was pumping, breastfeeding, and using donor milk. I was using donated and pumped milk using an sns. We had ot [occupational therapy] after the tongue-tie but we were using a bottle because he still was not sucking strongly enough. At three months post-OT, he stopped needing extra milk and my supply increased as we finally got it figured out.
But then I had leftover milk, and I was so grateful and I wanted to say “thank you” and I wanted to pay it forward. So when he was eight months old, I reached out on Facebook and I found a mom in need, we met, and I told her that I had a freezer full and I gave it to her. She had a breast reduction before her kids and found that she really could not make enough—she almost could—but she was going to use donor milk as a supplement. I became a regular donor, and I also got another mom to donate to them weekly. We got ten to twenty ounces each to her each week, so between twenty to forty ounces a week, to her for several months. It was really cool to see the baby growing and doing well and I liked the mom a lot. So it was all just coming around full circle. I have a few bags in my freezer but my supply is dwindling, so I am waiting on Facebook to see if anyone has a need.
Pumping and giving are understood as a form of affective labor, of power, and of gratifying altruism, so there are strong emotional ties that bind donors with donees.
Agency
But what about agency within the counternetwork? To what extent is breast milk sharing a self-conscious effort? The degree of agency has implications for the possibility of progressive social action, for notions of responsibility, and for consciousness. Christine’s and McKenna’s stories certainly suggest that sharing is part of a broader strategy for being part of a community. My own understanding of agency has always included some element of intentionality (see Gell 1998, 16). Many donors plainly stated that they are promoting breastfeeding and breast milk by actively transgressing mandates against sharing issued by institutionalized medicine: they are unruly, cyborgian, lactivist.
The question of agency is important because, among other things, it is future oriented. Now that venture capitalists have entered into the milk race and scientists are working to replicate milk in a lab, the pressure against the sharing counternetwork is bound to increase.
Unequally distributed capital and power shapes how people share milks, filtering who is in or out. Describing his donor pool, Brian mentioned having at least ten different donors, some of whom were regular, long-term donors and others who just gave a few ounces. His explanation was reminiscent of my own experience: “The donors were of a Republican persuasion. They were all stay at home moms and most of them seemed to be doing well [financially]. The doctor was doing very well, the tree farmer seemed to be doing fine, and my colleague’s wife [who became a donor], well, I happen to know he comes from a family of means, but they are Christian proselytizers, and they live modestly but are pretty conservative. I mean, my colleague is a huge Rick Santo-rum supporter so that kind of tells you about his politics.”
This profile of his donors surprised Brian and caused him to “recalibrate” some of his ideas:
Where were the liberals I expected to see? To me, there are two things here, one is my own surprise, which reflects a certain bias on my part, and two, is that the inclination of donors comes from their world view, so what does it say, that here are all these conservatives donating? Is it personal action and philanthropy? I suspect it is deeper than that, something about an idea about the world. But I don’t know. One thing I learned from this is that there is a community built up around a need and facilitated by the Internet with people from all political stripes that want to help other people.
When I asked April to describe her donors, she related a similar experience. Their first and most prolific donor, Ashlee, was a military wife living at Fort Stewart, a huge military installation only about forty miles west of her home. She recalled meeting Ashlee for the first time. They had agreed to meet at the local mall, somewhere April said she would
not normally go: “We were both a bit wary, or nervous, and we both came with our families. We met at an indoor playground with the kids and it was very friendly. But it was funny too, especially when we learned that she assumed we would not be Caucasian. She did not say this, but I think she thought our names were odd.”
April said of her donors, “They were married. And I’d say they were mostly Republicans, but at least one was not. Several were very religious, and by that, I mean Christian. And we had two military families. Racially, most, but not all, were white. I believe one was Hispanic. But interestingly, at the midwife clinic where I had Stella, I noticed that a lot of the patients were military, Republican, white, and rural. Our donors had similar characteristics.”
Her next family owned a small farm in rural Georgia, an hour or so away. They also shared with “a lawyer who shipped often from North Carolina, and aside from those three keeping up our supply at the beginning, we had quite a few one-time or small-quantity donors. Two we met on the highway for the exchange (one of those gave us the mother lode!) and we also got some from a doctor in Charleston, and a local photographer. The photographer ended up taking our baby photos of Stella. And then there was another lawyer, and a few others. I’d guess we had at least twelve or fifteen different donors over the two years that we were involved.”
When I raised the issue of rejecting donors with April, she explained that she “did not follow-up on a couple of people on the online milk sharing board, but it was usually because I wanted to pass on an offer if someone else was in greater need, for example, if they had a younger baby or if their baby was allergic to formula. Occasionally I passed on a donor because the quantity was too small to warrant shipping costs (which we always paid for).”
When we were looking for donors, several didn’t work out. We had at least one donor who wanted us to buy an electric double breast pump for her in exchange for milk and one who called us near the end of our experience with an offer to sell us her supply; we chose not to participate in these opportunities. I was concerned about the incentive for adulteration that commodification might present, and I did not have the money to buy a double pump based on a promise of future milk.
This decision was partly made because we had talked with women who wanted to become donors and expected to build up a stash for us but found that they were, in the end, unable to do it.
The smell, color, texture, and flavor of everyone’s milk was slightly different, and although my children seemed to prefer some donor milk to others (and we jokingly called Stephanie’s very blue milk “top shelf”), we never encountered a lipase problem or milk rejection situation. But April did: “Stella rejected milk from one donor—the pediatrician from Charleston. We kept it and mixed with other milk as a backup, and eventually used most of it. But [the donor] really was put out by our needing medical records and additional tests. She gave us a copy of her pregnancy test results, but was unwilling to do more. I guess she thought it was overkill.” And, as a donor, she was in a position to choose what to give and what to keep. The same can be true for donees.
17. Still from the film Go West (1925). Friendless, played by Buster Keaton, travels west to make his fortune. Once there, he tries his hand at bronco busting, cattle wrangling, and dairy farming, eventually forming a bond with a cow named Brown Eyes.
Hui
The Maori filmmaker Barry Barclay (1990) argues for filmmaking as hui, the term for a gathering or meeting; film assembles people in all stages of production, from preproduction consultation to audience reception. A community coalesces around the film.
Lesley Stern (forthcoming) describes how objects in films animate relationships: in Buster Keaton’s 1925 film Go West, a stone lodged in a cow’s hoof activates a relationship with Friendless, the cowboy.
Objects shape how life happens. We intend ourselves into the world through objects: diamonds, shoes, demolition derby cars, and bags of frozen milk. We embrace, push away, engulf, make, know, or nudge each other through them. Our very identities depend upon our engagement with objects—creation, production, circulation, consumption, divestment, or even rejection. Without them we do not exist. We are transitive in this sense.
Katherine Carroll (2015b) has found that Nicu mothers may worry that donor milk will interfere with mother-infant bonding, challenge their new and thus fragile sense of motherhood, or lead their children to reject their breast and the milk it provides. The power of others’ milk is threatening. Avoid! Sharers, on the other hand, tend to celebrate milk’s power to assemble.
Hoping the baby wouldn’t wake up, she read a few pages of Stewart’s Ordinary Affects (2008) while waiting for the Other Mother to arrive. Witch’s water pooled in the gas station parking lot adjacent to a busy strip mall. A familiar souped-up Hummer pulled up. “Hi, I have ’em in the back!" They got out, gave each other a hug, then chatted as they scooped baggies of milk out of one cooler and into another. When they were done, she placed cardboard and a hunk of dry ice on top of the baggies. She often thought of the Other Mother, especially later when she defrosted the bags for her son. Milk = hui.
Charlotte gave birth to a baby girl, but when the nurse first brought the baby to her to nurse, it did not go well. “It is not as easy as you would think,” she told me. “And I had a feeding nurse and everything.” Despite the idea that babies and their mothers “just naturally” know how to breastfeed, Charlotte said, “at least in my experience, they don’t!” She tried. She tried hard. And Charlotte, who has a PhD in art history from an elite academic institution and is the executive director of a respected regional cultural center, is a woman of no small force. Despite her best efforts, she was unable to produce enough milk for her Ava. She supplemented with formula, she told me, much to the raised brow of her “more bohemian friends who made me feel like I wasn’t trying hard enough, like I was not being a good mom.”
Because of her experience having friends react to supplementing with formula as tantamount to a kind of moral failure, when I explained that I was writing about my own experience, Charlotte had many questions: Why didn’t you use formula? How did you find people? Were they people you already knew, like a relative? How much did you pay them? Was it like a wet nurse? What were the women like? Do you really think it is better than formula? Charlotte had no idea that such a thing was possible.
This chapter presents stories of women and men whose children are donees. Paying attention to the circumstances that enable or discourage sharing shows how it shapes and is shaped by participants. Donors highlight how sharing entails and is entailed by cultural configurations, technological innovations, and the management of risk, all of which underpin the sharing within which identities are enacted. Donors also become entwined in donees’ stories and subjectivities, themselves shaped by circulation, technology, and risk.
Since milk sharing has no formal structure, central authority, or institutional rules, participants can change roles over time. Sometimes donors become donees, or donees become donors, or doulas or lactation consultants take on the role of either when they give birth themselves. But in the end, reminiscent of the mother::child dyad, donors and donees are in a sense co-constitutive. It is important to keep in mind, however, that the playing field is far from even. The “network” metaphor connotes horizontality, but there are important differences in participants’ ability to “hook in” and to shape how milk sharing works. Filters based on class, health, maternal status, and so forth shape, if not determine, who participates and in what capacity. But the organization and power structure of the community are quite flexible. Because participants have the potential to take on various roles, the counternetwork can be described as a heterarchy.
The term “heterarchy” was introduced in the mid-i940s by Warren McCulloch (1945), a neurophysiologist and early cybernetician (influenced by Peirce’s work in developing a triadic logic). Decades later the term was taken up in anthropology by archaeologists such as Carole Crumley (1995).1 According to Crumley and Marquardt (1987, 158), “Hierarchies (as opposed to other kinds of structured relations) are composed of an array of elements which are subordinate to others and may be ranked.” We are so accustomed to thinking about hierarchy as an ordering principle (in language, logic, and sociopolitical life) that “hierarchy” now acts not as one possible mode of ordering but as a pervasive structural metaphor and a definition for order itself. In fact, “when hierarchy and order are considered interchangeable, the popular understanding of chaos—the word of Greek origin for confusion or lack of pattern or plan—opposes hierarchy” (Crumley 1995, 2). But this opposition is false; many structures, from neural networks to cities, can be perfectly orderly while not organized hierarchically. It is worth quoting Crumley (1995, 1-3) here at length:
This conflation of hierarchy with order makes it difficult to imagine, much less recognize and study, patterns of relations that are complex but not hierarchical. . . . Heterarchy was first employed in a modern context by McCulloch (1945). He examined alternative cognitive struc-
ture(s), the collective organization of which he termed heterarchy. He demonstrated that the human brain, while reasonably orderly, was not organized hierarchically. This understanding revolutionized the neural study of the brain and solved major problems in the fields of artificial intelligence and computer design. To date, it has had little impact on the study of society. . . . Heterarchy may be defined as the relation of elements to one another when they are unranked or when they possess the potential for being ranked in a number of different ways. . . . While hierarchy undoubtedly characterizes power relations in some societies, it is equally true that coalitions, federations, and other examples of shared or counterpoised power abound. The addition of the term heterarchy to the vocabulary of power relations reminds us that forms of order exist that are not exclusively hierarchical and that interactive elements in complex systems need not be permanently ranked relative to one another. In fact, it may be in attempts to maintain a permanent ranking that flexibility and adaptive fitness is lost. . . . Hierarchical relationships among elements at one spatial scale or in one dimension (members of the same club) may be hierarchical at another (the privilege of seniority in decision making). [emphasis added]
In this framework elements shift and change according to context; decisions are made on the basis of superlocal considerations and power is relational. I am especially intrigued by milk sharing as a highly flexible and adaptive heterarchical counternetwork not only insofar as it is highly efficient (once our family started making connections, not one day went by when we were unable to provide our children with donated milk, and we continued to receive offers after we had stopped pursuing donations) but also in that it shows us, especially as milk sharing becomes more well known and overtly contested by powerful institutions, how “atomized, mundane acts can shift into the realm of contentious politics” (Bayat 2010).
Breast Milk Is Best
“A diamond is forever” is one of the most successful advertising taglines ever written; almost all American adults are familiar with it, the major-
breast milk is best 113
ity of American women own at least one diamond, and most engagements are accompanied by the purchase of a diamond (Falls 2014). Another is Nike’s “Just Do It!” Like these commercial examples, the phrase “breast milk is best” has had tremendous success. I heard countless people use these exact words to describe why they gave or sought milk. Contributing to the construction of breast milk as type, “breast milk is best” is tantamount to “white gold.”
We know by looking at the phenomenal rise in breastfeeding rates since the 1970s that institutional efforts to increase breastfeeding have worked, creating a strong imperative to provide babies with breast milk. In fact some women, like Charlotte, report that as a result of the cultural pressure to breastfeed no matter what, they have been made to feel guilty or as if they were somehow lesser parents as a result of doing anything else.
Dr. Martin, a local neonatologist, expressed concerns about the mandate placed on moms to breastfeed as she reflected upon an open secret in her Nicu: “With the ‘breast milk is best,’ maybe there is a point of too much pressure. When is too much? I ask myself that sometimes because I have seen Nicu moms—who are told to go home and pump—bring in formula and say that it is milk, or bring in a ton of breast milk when just the day before they had not been able to pump or anything, and I know [the milk they bring] is from a sister or friend, and we just go with it.” Feelings of both guilt and gratitude loom large. Some moms felt that their devotion, love, or desire to be a good parent was challenged when they couldn’t exclusively breastfeed. As donor Claire recognized, on behalf of her donee, “It is just very difficult for those who cannot generate their own supply.” Or, as recipient Kristina put it,
My firstborn was premature and he was also on Nutramigen [a formula that markets itself as “a hypoallergenic formula proven to manage colic due to cow’s milk protein allergy”], which he projectile vomited across the room. And it was really bad. My second one, I breastfed for over a year with no problems, and the same with my third. My fourth was in Nicu for eight days because he was premature, and I was going up there to the hospital and doing my best to breastfeed him, but when you are not with the baby it is hard to keep up, and it was just not happening, so after that . . . we used formula, which I hated to do, but it was alright. And then this one, my fifth, was fine at first, but then we started having issues. Except this time I went to donor milk. These moms are so awesome, and I just have had a great experience. Some people ask about disease or dangers but they [the donors] are not out [to get] anything, they just do it for the babies. All I provide is the bags, and I talked to some of them about this; I wish I could do more. Because this just means the world to us.
When I asked her what her husband thought about sharing, she said, “At first, he thought it sounded crazy! ‘You are gonna go get milk from some other lady?’ But, when he saw that the baby was feeling so much better, he was like ‘Here is some gas money! Go get what you need.’” Kristina explained to others in her breastfeeding group that “their idea that sharing milk is weird is just because of our day and time: what is weird about it? We are just not used to thinking about it like this. Hey, they all drink cow’s milk! But then I think, well, just look at me! I never even knew [sharing] was an option. And I have five kids! Sure, I knew all about the banks, and I did look into that when my first was having such a rough time [with formula]. I called around and did research, but what I discovered was that it was very expensive, if you can even get it. And there was no way we could pay that. But in all my searching for the right bank, I never saw anything about sharing for free. But that was in 2006, so I think that more people are into it now, but back then, it just wasn’t available. Now that I know it’s an option, I hope more people do it.”
Kristina is inspired by the altruism and affective labor she attributes to her donors. She believes “they would not do it [donate] if they were having problems,” meaning that if donors had health issues that would create problems for babies, they would not participate. She is hoping to develop a frozen supply so she can donate:
I am taking Reglan, to up my supply, and I am almost to where I am caught up with him. But gosh, I would love to help someone else. I want to find a baby I can donate to regularly, like our regular donor does for us. I live near a lot of people who are interested in doing this, but it’s not easy. Like I have this one girl that lives just down the road, and she gave me some in the beginning, but then she had to go out of town and it was just too much for her to keep up the amount by pumping while she was on the road, so she called me and explained that she might not be able to provide us with forty or fifty ounces a week like she wanted to. But it seems like there are more people who need it than there are people who want to donate. There really is a lot of need. I check all the local sites on Facebook, all the ones near me, in Georgia or even Florida or Alabama, but I mean I have five kids so it is hard for me to go too far. Then again, I will do what I have to do. I don’t want to see him suffering.
Many women described variations on affective states such as care and love, gratitude, and the desire to help, as well as the relationships between demand and supply and the pressure to conform to the breast-milk-is-best dictum. As April recounted,
When I tell people about milk sharing, they are like, “Oh my God! I threw so much away! I wish I would have known—I would have given it to someone!” Anyway, I found it really confusing to know whether breast milk really is better from the literature available, so I just went with what I thought was the right thing. They need to study these donation babies. I wanted the breastfeeding connection, but then again, is it the milk or is it the action? How long is long enough? But gosh, it was painful. Cracked nipples, blood, pumping! But later, it became really pleasant. And the imperative! They make you feel like you are not doing right by the baby if you do not breast feed, even though God knows I tried. I found that La Leche League does not really make allowances for people who are more moderate. I find them too militant. The group here made me feel like I didn’t try hard enough, but then they do not have experience with breast surgery. I don’t think they really know enough to say. I tried to read the books and all but I never read anything about donation.
Like April, mothers who can produce only a low supply, are not able to pump at work, or are suffering from genetic or medical conditions preventing them from producing any or enough milk may also chase donated milk. Caretakers of a baby whose mother has died, or fathers who cannot produce milk, grandparents who find themselves caring for a baby, adoptive or foster parents, and others may all want to feed their baby breast milk. And given the imposing push for milk against formula by pretty much every authoritative institution out there, who can blame them?
Leah described an experience similar to others I heard: “My daughter is two now, and even though I had a low supply from the beginning, we have continued to nurse throughout with the help of donor milk. So, we had to use an sns for the bulk of the time.” While many mothers stop breastfeeding at the milestone age of one, feeling like they have “made it,” others like Leah continue nursing until age two and even beyond. In my own experience our first adopted child was allergic to cow’s milk, so we kept using donated milk until he was about eighteen months old and was able to tolerate goat’s milk.
Our second baby was able to drink cow’s milk (and consume other milk products, like yogurt), and although we stopped actively seeking donated milk when she reached the milestone age of one, we continued to provide her with the milk we still had combined with cow’s milk until we ran out, around the time she turned a year and a half. These milestone ages were turning points for others as well. April said she was
starting to feel guilty [asking for donated milk] because Rory was getting older, so I was no longer vying to be the first in line. My goal had been a year but at nine months she was eating food and so I didn’t feel right taking it. But then we were on the last layer in the fridge, but someone contacted me and said she had a two-month supply and would we take it? Rory was taking about twenty-four ounces a day, and this was still a lot, and this woman was pumping at work and had an oversupply and was looking for someone to use it because her donee had fallen through and she was on the way to Florida. She was emptying her freezer anyway and said, “I will be in Savannah at five o clock, I have my records and can be at exit so and so,” and so, in this case, she actually found us.
This was somewhat unusual, but in April’s own mind, although Rory’s need had decreased, the milk might be wasted if they did not receive it. She sent her husband to the exit to pick it up.
The fact that our daughter was able to easily transition from donor milk to cow’s milk was part of our decision to stop seeking milk, but we recognized families with infants in our network who might need the milk more than we did. For example, I knew from Facebook that Amanda’s daughter Marjorie has cystic fibrosis, a genetic disorder that causes her body to produce an excess of thick, sticky mucus. When I talked with her, Amanda explained that the disease primarily affects her daughter’s lungs and pancreas, with her pancreas being severely insufficient. Marjorie has to take pancreatic enzymes with every feeding so her body can properly digest and absorb her food. Her body requires extra calories to make up for nutrients lost to inefficient digestion and to compensate for the extra effort her body needs to digest food and to breathe. Amanda explained,
Factoring in the need for extra food plus just the amount of stress created in just caring for her cystic fibrosis, I wasn’t producing enough of my own milk. She was consistently under the 3% line for weight. We were pushed, hard, to use human milk fortifier (which is quite pricey) and to supplement with formula. I had nursed my first daughter for a year and with Marjorie I wanted to go even further. I loved the nursing bond and providing antibodies for my special needs daughter who requires all the protection and help she can get. But it was difficult. By four months, I was having to pump most of her feedings. At six months, I wasn’t producing enough milk on my own and began supplementing with formula, which I hated to have to do. Two friends knew of our struggles and how stressful things were for us. They stepped forward and began bringing me bags of their precious milk. We have had many friends and family offer various kinds of help throughout our journey with our daughter’s cystic fibrosis, but this was truly a unique way to help our little girl. I was nervous to reach out further to strangers, but I joined HM4HB on Facebook and a local mom donated almost forty ounces to me. Hopefully one day we’ll have another child and I can bless another family with my milk. It’s an overwhelming feeling of love and support, and I’d like to extend it to others.
Amanda’s comments demonstrate that milk sharing is a form of affective labor, which colors the emotional experience of participation in what Carroll has called “care work” (Carroll 2015a).
A Deserving Baby
Because we were constantly studying the local milk-sharing websites, we came to know other families like Amanda’s, if only vicariously. In 2010 our quest for donated milk was thwarted on multiple occasions by Jennifer and Robert, who needed milk for their son, baby Joah. Jennifer, we came to know, had a low supply due to breast-reduction surgery, but she was impressively active in finding donated milk for her baby. We thought we were being pretty vigilant and had a good system for checking the boards, but she was even better! She frequently replied more quickly than anyone else to postings that offered of a good-sized stash, and we quickly realized that she was willing to drive anywhere, much farther than we could reasonably do (and we had more or less decided that we, or actually my husband, would drive up to four hours for a large supply and even farther for a very large load, while I would take the children with me on shorter runs). At one point Jennifer even held a party for local donors, which we thought was a wonderful strategy for meeting and thanking all of the counternetwork moms but also for ensuring Joah had a steady supply.
When we had our second child in 2012, we were astonished to see that Jennifer and now baby Leona were back in what we joked was a competition. It really felt like that at times. April had also used this language when she described her last donor, who “was so excited to find someone who could use her milk. She had so much, and had taken so much care, labeling everything and freezing it just right, and really it seemed like she found us! But at the beginning you have to work hard, and search, and we felt like we had to compete to get it, but it always worked out. I mean in the beginning, we were so vigilant.” Like April, we never actually ran out, though we came close a few times. Other donees reported a similar dynamic of hustling to ensure a solid supply, worrying when the freezer was getting empty, but then always, or almost always, finding a donor before running out.
Finding donors or making what some participants call a “milky match” required constantly checking Facebook and MilkShare. Some donors had very specific ideas about who would get their milk, which is part of the reason that parents seeking donor milk often revealed why they needed it, describing their own medical or social conditions or their babies’ allergies, illnesses, or diseases. Posted donee narratives take on a somewhat regular character: mothers looking for breast milk strive through these narratives to appear, well, motherly, appreciative, and truly needy. Missy’s request is not atypical: “Hi! I have twin ten-month olds who I have been giving donated milk to almost exclusively through the generosity of HM4HB mothers! I can’t breastfeed because I am being treated for cancer myself. We will be in [the area] visiting relatives and would greatly, greatly appreciate any donations to see us through our time in [the area]! We can meet or drive for donations! Thank you!”
Melody also expressed a need for breast milk, a need that, if unmet, would force the use of formula: “Hello there! I am a mother of a beautiful baby girl named Elly who is six months of age. We live in [small town]. My supply has basically dried up. We depend on donor milk to help feed my sweet girl that precious breast milk. I supplement with formula when necessary. Any sized donations in a 150-mile radius would be greatly appreciated!! I can replace bags. Please pm me or tag me in this post if you can help!” In our own posts, we usually stated that our adopted children were using donated milk; at least two of our donors were themselves adopted and had looked specifically for adoptees to donate to.
Other donees mentioned problems pumping at work when they made a public request for help. This is a class concern; working women across the board may have little time or privacy at work, although those with higher-status jobs tend to have more say in their working conditions and thus are better positioned to pump at work.
For some parents a minor breastfeeding issue that still allowed them to feed might be exacerbated by having to pump at work. Kaya, for example, was able to easily breastfeed Jolene, her first child, but when she had her second baby two years later, even though she had experienced a really healthy pregnancy, she was unable to breastfeed: “Parker came out really fast and had some jaw issues, so she just had trouble latching on. I ended up pumping and giving her a bottle, and that went fine, but then she was unwilling to go to the breast after that. So, when I had to go back to work, part time, I just wasn’t able to keep up.” Donor milk makes up the difference created by the resulting (and frustrating) loss of supply.
Kaya, a well-educated and savvy archivist at a research center, reads the link between women’s bodies and political economy pretty plainly: “The breast milk issue is policy related. All of the major health institutions, the ama [American Medical Association], who, and so on, are all recommending breast milk, but American labor policy just does not support it. Most women have to go back to work after they run through what little maternity leave they have. And once that happens, it is very difficult to continue breastfeeding.”
Some parents, like Kaya, are prevented from breastfeeding due to the requirements of their employment. Brianna, one of our regular donors, for example, was deployed to Iraq while her child was still at the breast. The last time I picked up a donation from Brianna she asked me if I could help her find a donor for her young daughter. Here was a woman who not only had a willingness to breastfeed and a more than sufficient supply of breast milk but was compelled to stop breastfeeding because of her military obligations. I asked if there was not some way that she might extend her maternity leave; Brianna explained that it was possible but that unfortunately her family could not afford it. They were hoping that her husband could be stationed doing drone strikes from a facility in the United States since that specialty paid well. Only then could she afford to return home to care for her young children.
But even mothers who can stay at home might turn to donated milk to supplement a low supply. After having breast surgery Caroline was unable to produce enough milk for her son. She began using formula but then discovered through casual conversations with other mothers after lll meet-ups that there was a milk-sharing community up and running. Caroline was able to supplement her own supply “without resorting to formula” until Velma was a year old and started drinking cow’s milk. Caroline explained that, while she was nervous at first, she found sharing to be “strange but also wonderful.” And it was fulfilling an imperative she felt “to provide healthy nourishment to my baby—an imperative that came from doctors but also from random strangers who suggested that of course breastfeeding is the best.” She reported that, not unlike being pregnant, which apparently prompted strangers to comment on her body and even touch her belly, having an infant with you invites unsolicited comments about the importance of breastfeeding, which she was doing, but not without some help.
I agreed with her that it just seemed “more natural” to feed a baby breast milk, especially when you read the ingredients on a package of formula, although we suspected that formula would be fine, if necessary. Caroline and I had to laugh together because as formula babies ourselves, we seemed to have turned out all right. We also had to laugh about the quality of “formula poo,” which as any new parent can tell you becomes a major topic of observation and conversation. Formula poo is drier, thicker, and pasty (or pebbly), brownish, and, well, malodorous, whereas breast milk poo is mushy, yellow, and lightly fra-granced (with a sweeter note). This difference is partly the result of different proteins in each: formula contains more casein, which takes longer to digest and thus is denser and smellier. Whey-heavy breast milk slides through the digestive system more easily, with concomitant results. The scientific community might view our conclusions as folk wisdom, but we read this poo oracle as a sign that we were doing the right thing, that breast milk is indeed superior to formula.
And besides, Velma was healthy and happy, partly, Caroline believed, due to the high-quality breast milk she was drinking. Caroline pumped and breastfed and had located several regular and some large one-time donors, and she had purchased a big freezer in which to store her supply. She also had some “fly-by donors” who gave her smaller amounts; these women were passing through town and pumping while away from their baby at home. She met a few of these near 1-95, the highway that runs along the East Coast from Maine to Miami, to drop a fresh supply that they would not be able to freeze or use. She discovered that donors were sometimes even more thankful to her for taking the milk than she was for receiving it. My experience was not dissimilar.
Others in the network addressed the issue of gratitude. Naomi told me that it is vital that “people who do this appreciate that those who are donating are taking time from their family and lives to be helpful to others. Those who use the milk are so grateful, but it is hard to have to count on others to feed your child. Every time you use donor milk, there is a little bit of sadness that you can’t provide for your child, along with the joy and appreciation that there are good people out there doing this for others.” But she was also awash in thankfulness:
It meant a lot to us to have donors. I literally cried when we got some of our donations. I was terrified to go through what we went through with our first. We know now that he was in pain constantly from the formula, which caused screaming and no sleep. He would only sleep for half an hour or an hour at a time, day or night until he was two-and-a-half years old. It caused me to have postpartum depression, as I never slept, and just held a crying child a lot of my time. So it was a really big deal for us to try and avoid formula, in case she has the same food intolerances/allergies.
Not everyone who shared their feelings experienced the sadness Naomi felt for a perceived failure to meet expectations or the guilt that plagued Charlotte. April found that in swallowing the “breast milk is best” rhetoric and related guilt, she discovered a liberatory moment:
Maybe I should have worked harder, but it worked out. I wanted it to be easy, so if I have another [child], I may see a lactation consultant beforehand. But I was so happy that we could be part of this [sharing community] and, well, am I too bourgie [bourgeois]? I could still have a glass of wine and plus Gerald could help feed Rory. Does that sound wrong? I really wanted to do it! But I tried to appreciate the freedoms I had, and see it as sweet, and find ways to give back to the moms. I would not go back and not have the [reduction] surgery now; I was so self-conscious and it was so painful, and I couldn’t even run, and that sucked, and I was frustrated, but I have no regrets now.
These comments point to the special relationships that develop among participants. Many donors I met expressed intense thankfulness at not only being able to donate but also at the fact that donees like myself were taking the time and energy to look for milk. There was a lot of warm hugging and mutual support, ongoing photos and updates about weight and health, and so on. In the beginning I wondered if my own stories were unique, but when I started interviewing others I discovered that they were decidedly not.
One father underscored the wonderful sense of adventure I felt in sharing: “I had a great time collecting the milk with Carson. It was fun and had a purpose. I had fun with the people. I enjoyed visiting with them and it was almost like a distant relative relationship. I would drive up to an hour and a half [to pick up milk]. . . . I loved this because it meant that I had an opportunity to bond with Carson. . . . I always took her with me and it was a special time for us to be together, she was little and liked to sleep or ride in the car.”
Then again, like relationships with distant relatives can be, contact between donors and donees was fleeting and serendipitous. The relationships created around the technologized exchange of milk were often brief. I found few examples of friendships outlasting the donation schedule, even when feelings were wholehearted and donation persisted over many months. But most women did at the every least report feeling on “common ground as women,” “part of a larger community of parents,” or “part of a village that was coming through for the children.” And, as I explained, most interviewees were white, married in a heterosexual relationship, and middle class. Echoing my own experience with these gratitude-filled relationships, April said,
Some people were wealthy and others were struggling, but nobody seemed really bad off. We had some upper middle-class people, you know, two-car professional families with multiple kids, a big tv, a house, that kind of thing. And military—lot of military! And then the farm people. But, they had nice cars, and Christmas cards where everyone is wearing J. Crew outfits. Probably about half were clearly Republicans and no advanced degree, but we also had a doctor and a lawyer. Actually the group as a whole reminded me a little of the people at the midwife clinic. There were people drawn to natural birth, kind of like yuppies but over thirty with money and a good education, left leaning and liberal who don’t want an epidural—I guess I would call this group slightly bohemian. And then there were the hippy [sic], incense people that wore wraparounds and asked a lot questions about eating placentas. And then there were the really young ones, with little education, who were stay at home, back-to-basics moms, and it seemed like they were very Republican. They were usually white, but not hillbilly, and not urban yuppies either. The milk donation thing followed along these lines. But I never discussed politics, because we are quite liberal, and we really only talked about milk, how the babies were developing, how cute Rory was, that kind of thing. The other moms liked to hold Rory—Amy especially, and Rory liked her—and she sent us notes telling us how honored she was to give her milk to a deserving baby. They were as excited and felt as good about this as I did!
But what about the donees? Like the donors, they were also primarily white, married, and middle class but were decidedly less Christian, with a tendency toward higher education and left-leaning politics. Carolina, Kaya, Naomi, April, Miranda, and I, for example, all work, have college or postgraduate degrees of some kind, are married to white-collar professionals who also have college or postgraduate degrees, and are overtly liberal in our political and cultural views. We also all have the time, money, know-how, and energy to do research on donor milk and on formula and to pursue donors using Internet technology.
Some donors, like Myra, only gave once, gifting their entire overage to one person, in this case our daughter. “My son never really took to a bottle when I went back to work,” she explained. “He just he waits for my lunch break! So I had a freezer stash that needed a home. It makes me so happy to know that your daughter has thrived on my donor milk!” Donees, on the other hand, may assume the role of milk recipient for a year or more, so their activity “becomes more professionalized,” as my husband described it, once donees learn the ropes and get a routine. One of the benefits of knowing the “secrets of the trade” is that families can move around the country, even the world, and be able to access milk because the underlying infrastructure has been replicated in locations all across the United States and indeed around the world.
For example, when we traveled to visit grandparents, we easily used the HM4MB and MilkShare sites to locate donors in California and Arizona. Women not only provided an ample supply for us while we were there but gave us enough extra to save in a freezer for future trips to the West Coast. Interestingly these donors did not conform to the donor profile I had come to recognize in my own regional counternetwork. Our donors out West, for example, worked, were not overtly Christian, and were highly educated. We also did not engage in the forms of sociality one might expect to see in the South, where any person to-person exchange or business is not necessarily but very likely to be preceded by small talk and storytelling, with milk exchange being no different. Milk sharing brings together people who may never otherwise have a chance to sit down and get to know one another, in an atmosphere of generosity and common ground, and thus can foster new social relationships based on experience rather than stereotype. I suspect and would indeed not be at all surprised if the demographics of the milksharing community with its epicenter in Savannah, Georgia, turn out to be somewhat regionally specific.
Then again, even as cultural and political regionalism is real, the composition and the landscape of family forms in the South, as in the United States in general, are undergoing transformation. New religious configurations, the growing acceptance of alternative family forms, and emerging reproductive technologies all have a place in shaping milk sharing in and around Georgia.
In Georgia, with a total population of around 9,687,653 people, 54 percent identify as white and 31 percent identify as African American, while only 9 percent identify as Hispanic (the fastest-growing group). Only 27,057 people are Arab Americans, and of these, half are Egyptian (less than 1 percent of the total population counted in the 2010 census); on a national scale Muslims made up 0.8 percent of the population in 2010 (with 2.6 million people) and are predicted to constitute 1.7 percent by 2030 (largely due to immigration and a higher-than-average fertility rate) (Pew Research Center 2011). And although there are relatively few Muslims living in the South, milk sharing offers them opportunities to continue participating in “milk siblingship” (Altorki 1980; Cole 2010; Parkes 2004, 2005).
Milk sharing can also pose significant concerns for both donors and donees who are Muslim. Just consider the complications that may be posed, for example, if a Muslim family receives donated milk from a milk bank: banks often mix together three separate milks from anonymous donors. Just who and where are their newly minted milk siblings? Participation by Muslim families in national and international milk sharing networks may affect the kinds of relationships being negotiated, as does the shifting panorama of family forms.
Same-sex sexual activity became legal in Georgia only in 1998, and while some cities such as Atlanta maintained a domestic partnership registry for same-sex couples, until the landmark Supreme Court decision of Obergefell v. Hodges (Kennedy 2015), Amendment 1 to Georgia’s constitution made it illegal for the state to perform or recognize same-sex marriages or civil unions.2 But many same-sex couples live in Georgia (the gay population constitutes about 3.5 percent of the total population), no state laws prohibit same-sex adoption, and plenty of gay couples in Georgia are raising children.3 On a national scale the 2010 national census reported 270,000 children living with same-sex couples, 110,000 of whom were adopted (a 100 percent increase over the 2000 census reports but still less than 1 percent of the total child population). Some of these parents are unable to produce breast milk but are subject to the “breast milk is best” messaging and concomitant condemnation of using formula. They may want to give their children donated breast milk.
Drawing on new reproductive technology, some couples, or even singles, use in vitro fertilization, which can result in multiple births (famously difficult to keep up with through breastfeeding, especially when there are more than two infants). Other would-be parents, like Rob and Chance, choose surrogacy, hiring a woman to be implanted with a fertilized egg or eggs (using their own or donated sperm and/ or egg) and carry the fetus to term. Gestational surrogacy involves implanting the surrogate with an egg (usually an intended mother’s, but the egg could also be a donor egg) that has been fertilized in vitro (usually by an intended father’s sperm, but it could be donor sperm), a situation in which the surrogate is not genetically related to the embryo.
With traditional surrogacy a surrogate egg is fertilized (naturally or artificially), so the surrogate is genetically related to the embryo (which results in a more complicated legal situation). Although the practice of surrogacy in the United States remains somewhat problematic because it is highly contested legal terrain, there were more than two thousand surrogate babies born in 2014. There is a wide range of legislation on surrogacy: the state of California has the most permissive laws, New York bans it, and in Washington dc it can even carry criminal penalties. Interestingly many American surrogacy agencies say that most of their clients—gay, straight, married, or single—are international, with foreign couples headed to the United States for surrogate pregnancies (Lewin 2014). The cost of an American surrogacy can be as much as $150,000, and many Americans have opted to pay surrogates abroad in places where it is legal but much less expensive, for example, in India, Russia, Mexico, or Thailand, thus participating in what some scholars call a subset of medical tourism: “fertility tourism” or “reproductive tourism” (Matorras 2005).
And, as Elly Teman (2010) argues in her ethnographic study Birthing a Mother, a surrogate mother, what one of my donors called a “surro-mom,” performs an elaborate distancing act in order to emotionally detach from the baby while forming close and at times enduring relationships with the intended mother. And indeed Patty, a surrogate mother I interviewed, had continued a relationship with the intended fathers of her “surro-baby” by providing donated milk and was attempting to become pregnant with her intended fathers’ second baby.