Why is Donor Milk So Expensive?

What is the value of having access to safe donor milk? For families with a preterm infant in the NICU, it can be priceless, yet to many, the cost of pasteurized donor milk (at $3 to $5 per ounce) may seem excessively high.  We reached out to Mothers’ Milk Bank Northeast to learn more about their cost structure. Keep in mind that other non-profit milk banks may have different costs to process milk, and that pharmaceutical companies like Prolacta and Neolac (doing business at Medolac) include a profit margin in pricing their products.

By Naomi Bar-Yam Ph.D., Executive Director, Mothers’ Milk Bank Northeast

We often hear this question from milk donors, who wonder why the milk they donate for free costs recipients anywhere from $3.00 – $5.00 per ounce, depending on the milk bank. Families who need milk for their babies, of course, ask this question as well.

HMBANA milk banks are all non-profit organizations. We do not charge for the milk itself, since we do not pay our very generous donors. However, HMBANA milk banks take many steps to assure that the milk our recipient hospitals and families receive is safe, and we charge to help cover these costly steps.

Direct Milk Processing Costs

Donor Screening:  Each donor is screened carefully to assure that her milk is safe and that she and her baby are healthy enough to make this donation. This involves:

1. A telephone screen conducted by a trained staff member.
2. Paper (or electronic) health forms and consents sent to the donor and reviewed by our donor intake team.
3. A blood test to assure that the donor is not carrying diseases such as HIV, HTLV, Hepatitis  B and C and syphilis known to transmit though human milk (even though these diseases would be killed in our pasteurization process, we do not want to take chances.) costing between $100 and $125 per test, depending on which lab the milk bank uses.
4. Once the donor has completed all of these steps, two members of our intake team review her chart to assure that we do not miss any potential problems.

The range for these steps in the process is approximately $100 – $125 for labs + 1.5 to 2 hours of staff time.

Active Donors: Once a donor is screened and approved for donation, we must receive her milk. This involves:

1. When the donor is ready to ship the milk to us, the milk bank pays for all boxes and shipping costs (Fed Ex Express, so that the milk arrives frozen).
2. Our donor intake team is available to answer questions about breastfeeding in general and specific milk donation questions throughout the time a donor is active.

The range for these steps in the process is approximately $50 – $75 for shipping one cooler of milk + staff time (approximately 30 minutes to ship or receive a cooler).

Milk Processing: Once the milk is received, it must be processed. This involves:

1. A staff member first logs the milk into our freezer and computer system and a sample of the milk is sometimes sent out for culture.
2. Each day, our milk pasteurizing techs carefully mix, pour, pasteurize, cool down and refreeze milk. One sample bottle from each basket of milk (anywhere from 39-58 bottles, depending on the size of the bottle) is sent out for culture. Milk banks process 6-10 baskets per day. These cultures of raw and pasteurized milk cost about $11 each. These steps are necessary to assure that we do not dispense milk with bacteria or other pathogens to the fragile premature and sick babies we serve. The small bottles that store the finished product cost $0.90 each.

The range for these steps in the process is approximately $35 – $81 for culture and bottles to process approximately 100-200 ounces + labor (Mothers’ Milk Bank Northeast has 2 full-time staff dedicated to pasteurizing milk from our donors). 

Indirect Milk Processing Costs

Research: Milk banks are also involved in research to add to our knowledge of human milk, pasteurization processing and other related areas. Costs of some research are paid for by researchers’ budgets. Individual milk banks frequently cover the costs of research directly related to donor milk screening, pasteurization and safety measures. These costs often involve staff time and milk testing.

Overhead: In addition to direct costs of mail, blood tests, milk cultures, and shipping, milk banks must cover basic office expenses of rent, utilities, office supplies, staff salaries as well as equipment such as freezers, refrigerators, pasteurizers, and lab supplies such as masks, gloves, cleaning supplies.

Milk Money Fund: Milk banks are committed to making milk available to babies in need regardless of their parents’ financial situations. They provide milk on a sliding scale and sometimes at no cost when needed. These costs are included in our yearly budgets.

We are grateful to our many dedicated donors and office volunteers without whom we would not be able to operate. They also reduce our operating costs, allowing us to make donor milk available to a growing number of babies and families in need.

Naomi Bar-Yam, Ph.D. has training in social work and social policy. She has been working in maternal and child health for over 25 years, teaching, writing and researching. Naomi is the founding director of Mothers’ Milk Bank Northeast.