With her baby fast asleep in the stroller, Valerie Githinji made her way up to the nurses' station in O'Bleness Memorial Hospital's maternity ward. She came bearing gifts. Stored in the bottom of the stroller, in a white plastic bag, were several containers totaling 200 ounces — more than a gallon and a half — of frozen breast milk. Githinji, an administrator with Hocking College, has been donating her extra breast milk for about four months. “Every time I feed my daughter, I tell her, ‘We're feeding you and the world,’” she said with a laugh.

瓦樂麗．季欣吉的貝比在嬰兒車裡酣睡，她正要前往歐布萊尼斯紀念醫院產房護理站。她隨身帶著禮物：放在嬰兒車底一個白色塑膠袋中分幾個容器裝的200盎司（超過1.5加侖）冷凍母乳。季欣吉是霍金學院行政人員，她已經捐自己過剩的奶水約4個月。她笑著說：「每次餵女兒時，我就告訴她：『我們不只要餵你，還要餵全世界。』」

This drop-off brought her total donation to nearly 8 gallons, but this trip was made specially in response to a call put out by the Human Milk Banking Association, which sets standards for milk banks in Canada, Mexico and the U.S. The organization has been asking mothers to give whatever they can to help meet an increased demand for donated breast milk. Part of the demand comes from hospitals. More neonatal intensive-care units are keeping inventories of human donor milk, and most breast milk donated to the Human Milk Banking Association goes to premature babies.

加上這次「伴手禮」，她總共捐了近8加侖母乳，但此行是特別響應「人乳銀行協會」的呼籲而來，該會在加拿大、墨西哥和美國為母乳制訂標準，並籲求媽媽盡可能捐奶，以滿足日增的需求。部分需求來自醫院，有愈來愈多新生兒加護病房必須存放捐贈的母奶，捐給人乳銀行協會的母奶大半供給早產兒。

Several banks recently had such low supplies they've had to turn away people seeking milk for their infants, said Jean Drulis, director of the Mother's Milk Bank of Iowa and president of the milk banking association. Some banks are sharing their supply temporarily to fulfill requests. “As the word spreads about the availability, so will awareness about the demand,” Drulis said. “We know there are more donors.” The organization is also encouraging new mothers to start donating.

愛荷華州母乳銀行主管兼人乳銀行協會總裁琴恩．德魯利斯（見圖／美聯社）說，最近有幾家銀行母乳存量偏低，使一些上門為寶寶找母奶的人空手而回。有些母乳銀行只好暫時分享他們的庫存以滿足各方需求。德魯利斯說：「當供應母乳的消息一傳開，需求自然提高。我們知道應該會有更多捐助者。」該組織還鼓勵新手媽媽開始捐奶。

Last year, the association's 10 banks dispensed more than 1.8 million ounces, up from 400,000 ounces 10 years ago. Another factor in increased demand is more awareness among parents. Some parents are offered the milk when supplementation is needed, while others are starting to request it. That was the case for Molly Jamieson, of Iowa City, Iowa, who got a prescription for donated milk when she wasn't producing enough for her now 8-week-old son. “I had no clue about (donated milk) until it was offered to me,” said the surgical oncology nurse. “I feel really lucky.”

去年，該協會10家銀行總共配發了180多萬盎司母乳，比10年前的40萬盎司增加不少。造成需求增加的另一個因素是父母有更深入的認識。當有些家長在急需母乳補充時獲得捐贈，其他人也會開始提出請求。愛荷華州愛荷華市的莫莉．賈米森就是其中一個例子，當她奶水不夠，不能親自哺育現已8周大的兒子時，醫生建議她接受捐贈的母奶。這位腫瘤外科護士說：「我根本不知道有關（捐贈母乳）的事，直到我身受其惠，我覺得自己實在太幸運了。」

Githinji started pumping extra ounces to prevent engorgement, which is when breasts overfill with milk to the point of discomfort. Once she realized she could donate her milk, she loved the idea. She even wrote a poem about it, called “To the l'il baby I'm helping to grow well.” Milk donated to a milk bank is sent to the nearest processing plant.

季欣吉為了避免乳房腫脹，開始抽取好幾盎司過剩的奶水，乳房腫脹時乳房會溢出奶水，使人感到不適。當她知道自己可以捐奶時，她很喜歡這個點子，甚至寫了一首詩，題為〈獻給我所幫助成長的小寶寶〉。捐給母乳銀行的母奶立刻送到最近的加工廠。

Donors are not paid for their milk, and milk banks, which are all non-profits, don't charge for the milk, but they do pass on the processing costs. Making sure the milk is safe for babies to consume involves extensive donor screenings, pasteurization and transportation fees. Iowa, for example, sells donated milk for just over $4 per ounce. “There hasn't been a safety issue in our 25-year history,” Drulis said. “There's a price for that.”

捐贈者是無償捐母奶，至於母乳銀行，由於全是非營利機構，因此也不收費，但他們要轉收加工費用。為了確保母奶可供嬰兒安全食用，需通過繁複的篩選手續，還有巴氏殺菌和運送費用。以愛荷華州為例，每盎司捐贈的母奶賣4美元出頭。德魯利斯說：「過去25年來，我們從未發生任何安全問題，那總要付點代價。」

Some women opt for a free alternative called informal sharing, which means that women who have extra milk simply give it to mothers who need it. Organizations like Eats on Feets and Human Milk 4 Human Babies help these moms connect on Facebook. But the U.S. Food and Drug Administration recently came out against informal sharing, saying the milk hasn't been “adequately screened” and is unlikely to have been “collected, processed, tested or stored in a way that reduces possible safety risks.”

有些婦女選擇加入所謂非正式共享的免費替代方案，換言之，有多餘奶水的婦女直接把母乳送給有需要的母親。像Eats on Feets 及Human Milk 4 Human Babies等機構可以協助這些媽媽在臉書上互相聯絡。但美國食品藥物管理局最近出面反對這種非正式的母奶分享方式，指稱母奶未經「適當篩選」，也不可能「以降低可能的安全風險的方式收集、處理、測試或儲存。」

Part of the U.S. Surgeon General's recent “Call to Action to Support Breastfeeding” specifically mentions the need to identify and address obstacles to greater availability of safe donated human milk. For now, though, it's up to individual mothers to fill the need. Those like Githinji will continue to offer her gift, one extra pump at a time. “These milk donors are truly remarkable,” Drulis said. “The service they're doing to mankind is just amazing. It's totally altruistic.”

美國醫事總署署長最近「呼籲以行動支持母乳哺育」，其中明確提到必須認清並清除更廣泛提供安全捐贈母奶的所有障礙。但現在仍得由母親自行設法滿足這項需求。像季欣吉這種媽媽仍將繼續捐贈她的禮物，一次多抽取一點奶水。德魯利斯說，「這些捐母奶者實在了不起，她們提供人類的這項服務超讚。這是完全無私利他的舉動。」