The weirdest parking lot exchange that Warren Jones ever engaged in involved a very unlikely commodity.
Consider the players: Jones, an Anchorage dad of two, a Facebook connection and 70 ounces of frozen breast milk in the parking lot of the South Anchorage Costco, delivered by the woman's sister's husband.
"It was really awkward for both of us," Jones said of the exchange.
But it's what Jones had to do to make sure his then-4-month-old son, Rowan, had access to the breast milk he needed.
In Alaska and across the country, Jones' story is not unique. In recent years, as evidence-based science comes out explaining the benefits of feeding infants breast milk and social norms begin to change, more families in Alaska are reaching out -- in ways both formal and not -- to make sure their babies are getting the nutrition they need.
In the case of Jones -- a stay-at-home dad whose wife left for a work trip unexpectedly -- he needed to find a way to feed his infant son who had been fed breast milk exclusively. Jones wife, Sacha, didn't have enough of her own supply stored up, and when formula gave Rowan a reaction so severe he was vomiting blood, Jones turned to a Facebook page to help find breast milk for his son.
The page "Human Milk 4 Human Babies -- Alaska" is where he went. The page was started in 2011 by two moms, encouraged by the work the national organization was doing, who decided to start their own chapter. Since then, the page's administrator, Sarah Lewis, said the group receives several hundred requests each year from people looking to share or receive breast milk. Lewis said she's not sure how many of those requests actually translate to milk donations that occur between parents. But she knows for the ones that do, it means a lot; for everyone from mothers with adopted babies who want to feed them breast milk to women who are undergoing chemotherapy and cannot breastfeed their children.
Lewis said she's been impressed by the interest, which has grown even more in recent years.
"I'm so glad that people are tuned in to the cause, should they ever need it," she said.
More formal groups
The Facebook page is just one of the informal ways people are sharing breast milk. Some post listings on Craigslist, others meet through informal groups for postpartum moms, others through family and friends.
Jen Aist, lactation consultant and manager of maternity outpatient clinics and services for Providence Alaska Medical Center in Anchorage, was hesitant to endorse any informal method of sharing breast milk. She was especially leery of any sort of milk-sharing transaction set up over Facebook or Craigslist and does not support it.
"There's just zero oversight," she said.
Lewis, of the milk sharing group, acknowledged the issues inherent to sharing human breast milk with strangers. However, the group uses the "informed consent" model. Parents are encouraged to ask any and all questions about the breast milk's provenance; even asking for health records is not out of the realm of possibility, she said. If there's any hesitancy, parents are encouraged to "go with their gut" and are under no obligation to share the milk.
Jones, who accepted 70 ounces of milk for his son, said he was leery of the setup at first. But left with few other options, he went through with it. He talked with multiple people involved in the transaction and felt safe about the situation.
"You would have had to have had three people conspiring to poisoning someone else's child," Jones said.
He said Rowan, now 3, ate the milk up happily, without any ill effects.
Milk bank donations
Beyond the informal groups, there are formal ways to go about sharing breast milk. The reasons for sharing can vary. Some have more milk than their children can eat; others are done breastfeeding but want to contribute to the bank.
Aist said Providence collects about 20 gallons of milk a month in donations, about the same amount needed to keep the Neonatal Intensive Care Unit -- the unit tasked with caring with sick or preterm infants -- in adequate stock, though Alaska milk does not stay in Alaska.
The milk Providence receives goes through a thorough screening process. Mothers are interviewed first, have to provide two letters from doctors proving they are in good health, and complete a blood test to make sure the milk they donate is disease-free. The milk is frozen and shipped overnight to Colorado, where it is then screened and pasteurized. Aist said in all the years human milk has been been banked, no babies have ever contracted illness from it.
In recent years, as more hospitals adopt "baby friendly" approaches to care, she's found that more parents are accepting of feeding their children donated breast milk. In the NICU, where parents are asked if it's OK to feed the milk, she said parents have started to lose the "ew" factor as education increases.
"We're definitely moving beyond that," she said.
While the milk needs are adequate for the NICU, getting milk for healthy full-term babies remains a challenge. Aist said one mother, who adopted her baby, fed the infant using milk she received from a breast milk bank, but that it was contingent on whether or not NICU needs were met -- not just locally but on a national level.
It was also expensive. The banked breast milk costs $6 an ounce. With healthy newborns drinking on average about 20 to 30 ounces of milk a day, those costs can quickly trump the cost of high-end formula.
But for moms like Lena Jacobs, sometimes the act of just sharing milk can be a blessing. Jacobs' son, Seketl'e, became sick just 12 days after birth in August 2011. While doctors in Anchorage tried to care for him, they encouraged Jacobs to keep pumping breast milk so her supply would be up and she could continue feeding him once he recovered.
But Seketl'e, who was experiencing liver failure, wasn't able to get a liver transplant in time and died just weeks after being admitted to the hospital.
Jacobs ended up donating her milk to Providence, a total of two full camping coolers of breast milk. Later she received a note letting her know where her milk had gone, noting it went to struggling babies in NICUs across the country.
Now Jacobs has an 11-month-old daughter, Enaaseyh. If she had not been able to breastfeed her, she would have happily accepted milk from others. To Jacobs, it's just the best food you can feed your child. And the process of donating her milk was only positive.
"It was really healing," Jacobs said. "It left me feeling good that my son's milk was able to help another sick baby."