{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T18:42:14Z","timestamp":1786214534154,"version":"build-2736575974"},"reference-count":153,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Implementation of the strong recommendation by the World Health Organization (WHO), the United Nations Children\u2019s Fund (UNICEF), and others, to increase use of donor human milk in cases where breastfeeding cannot be provided, requires a flexible, knowledge-based and risk-informed approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Based on an extensive literature review, we present the evidence for potential biological risks of breastmilk in three scenarios: fresh, unmodified milk from breast to baby (breastfeeding and wet-nursing); expressed and unmodified milk stored at &lt; 4 \u00baC until just before consumption; and milk modified by some form of pasteurization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>With the exception of contamination by some viruses and syphilis, breastfeeding is the safest way to feed a baby, despite its highly variable microbiome and virome\u2013including organisms that, in other circumstances, can cause disease. Wet-nursing, where the donor has been appropriately screened, carries a similar risk profile to mother\u2019s own feeding. Whilst expression and storage of raw milk at &lt; 4 \u00b0C adds a bacterial load, the additional risk, with knowledge and screening of the donor and careful attention to all steps in delivery, seems small and is smaller than using bovine-based formulae\u2014especially in low resource circumstances. Donated milk from unknown donors carries additional risks. A decision to reduce these risks through thermal pasteurization must be weighed against the loss of breastmilk\u2019s natural protective components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Not only have the biological risks of both informal and formal milk sharing for healthy infants been greatly exaggerated, but that they are often quoted without consideration of the overall risks of alternatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344261451926","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T02:56:16Z","timestamp":1786071376000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Benefits and Biological Risks in Breastfeeding and Sharing Human Milk: Have We Got it Right?"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7116-6356","authenticated-orcid":false,"given":"John","family":"Cassey","sequence":"first","affiliation":[{"name":"Surgeon and Independent Researcher, Medical and Educational Sustainable Community Help (MESCH), Charlestown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Banati","sequence":"additional","affiliation":[{"name":"Mothers Milk Bank Charity (Human Milk Emergency Reserve Project), Northgate, QLD, Australia"},{"name":"Faculty of Medicine and Health, Brain and Mind Center, University of Sydney, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Abdul M. 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