UCSF

Human milk is being exchanged today in ways that are increasingly fraught and contentious. Non-profit milk banks are working hard to keep up with increasing demand from neonatal intensive care units (NICUs) for banked donor milk (BDM); informal exchanges have exploded through the use of Facebook platforms designed for milk sharing and other websites designed for milk selling; and for-profit entities are competing for donated human milk and for hospital-customers of banked donor milk. In this contested space, issues of safety, and the ethical procurement and distribution of human milk are ubiquitous.

This dissertation follows a multi-cited ethnography of non-profit human milk banking, informal milk sharing and the use of human milk in biomedical innovation both in for-profit and academic settings. Drawing on both feminist science and technology studies and situational analysis, I argue that there are two key issues that make contemporary forms of human milk exchange particularly contentious, what I call “the two donor dynamic” and “the problem of commodification”. I argue that the ways value is constructed in the different forms of exchange under consideration negotiate these issues in unique ways that set out moral/ontological understandings about human milk.

Non-profit banking establishes value through logics of surplus, scarcity, safety and care where (for example) donors are cared for and understood as breastfeeding mothers first and donors second and recipients are prioritized according to medical need because of the scarcity of BDM. Informal sharing networks are establishing themselves as forms of biosocial affective economies where a mother’s too much or too little milk can be experienced as breastfeeding problems and informal exchange as a form of relief. I argue that corporate entities and academic centers developing products from human milk employ promissory understandings of breast milk as that which is both best for a baby and possibly offering biomedical advancement (and sometimes profit).