Disclosure: this page is published by Vyarna OÜ, which sells a freeze-dried human milk complement made from screened providers' milk. That gives us an interest in this topic; the recommendations below are quoted from the authorities, not from us.
American Academy of Pediatrics (2022): exclusive breastfeeding for about six months; pasteurised donor human milk "is recommended for very low birth weight infants when the mother's milk is not available"; informal milk sharing "may be associated with infectious risks as well as contaminants" [2].
US FDA: "does not recommend feeding your baby breast milk acquired directly from individuals or through the Internet"; if you use milk from a source other than the baby's mother, use only a source that "has screened its milk donors and taken other precautions to ensure the safety of its milk", after consulting a healthcare provider [4].
Neither body recommends donor milk over formula for healthy term babies. Neither says formula is inferior for them. The donor-milk recommendation is specific to the smallest, sickest infants.
Milk banks. Non-profit banks screen donors, pool and pasteurise milk, and supply hospitals, mostly for premature infants. Supply is limited and prioritised clinically.
Informal sharing. Milk given or sold between individuals, often arranged online. This is what the FDA statement is about. The donor may be entirely healthy; the point is that nobody has checked [4].
Commercial products. Companies that source milk from screened donors or compensated providers, process it (pasteurisation, freeze-drying, or both) and sell it. Vyarna is one. The FDA's test — screening and other safety precautions — is the right one to apply to every company in this category, and each should be able to say exactly what it does.
Pasteurisation and freeze-drying both reduce some components. A 2024 review found freeze-drying lowers some enzymes, vitamin C and immunoglobulin [3]. Donor milk that has been processed is still human milk, but it is not identical to milk straight from the breast, and the difference from formula is narrower than the phrase "liquid gold" suggests.
A manufactured product, regulated as a food for infants, designed to meet an infant's complete nutritional needs for the first year. It is standardised, shelf-stable, and available. In the US, 86% of babies born in 2023 were breastfed at some point, but only 30% were exclusively breastfed at six months [1] — formula is what most of the difference is made of.
For a healthy term baby whose mother's milk is not available or not sufficient, formula is the standard and well-supported option. Screened donor milk is a reasonable addition or alternative if you can obtain it from a source that meets the FDA's test and you understand what its processing has done to it. Milk from individuals or the internet is the option both authorities advise against.
Whichever you choose, it can sit alongside any breastfeeding you are able to do — see combination feeding.
For very low birth weight infants, the AAP recommends pasteurised donor milk when the mother's own milk is unavailable. For healthy term babies there is no equivalent recommendation; formula is the standard alternative and milk-bank donor milk is generally prioritised for hospitals.
The FDA does not recommend milk acquired from individuals or through the internet because the donor is unlikely to have been screened for infections, medications or substances. Screened milk-bank donor milk is a different matter and is what the AAP's recommendation refers to.
Milk banks sell pasteurised donor milk, usually by prescription and mostly to hospitals. Some companies sell processed donor or provider milk directly. The FDA's test for any source is whether it screens donors and takes other safety precautions.
Donor milk is human milk from someone other than the baby's mother, usually pasteurised and sometimes freeze-dried; formula is a manufactured, regulated product, most often based on cows' milk, designed to meet an infant's full nutritional needs. Formula is nutritionally complete and standardised; donor milk carries human-milk components but varies by donor and is reduced by processing.