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FATWA

FATWA

Regarding the use of pasteurized donor human milk in the Muslim faith

The Minnesota Milk Bank for Babies (MMBB) collaborated with local Muslim leaders and scholars, neonatologists from Children’s Minnesota and M Health Fairview, the Minnesota Breastfeeding Coalition (MBC) and community health leaders from Brighter Health Minnesota, to foster a dialogue that led to the first US fatwa (a formal ruling or interpretation of Islamic law) supporting the use of pasteurized donor human milk for Muslim babies. This initiative developed to address a health disparity seen in hospital NICUs and to ensure that all premature infants have access to the best nutrition available. The fatwa is available on Brighter Health Minnesota’s site at, Islamic Fatwa for Pasteurized Donor Breastmilk.

Frequently asked questions about pasteurized donor human milk (donor breast milk) for babies of the Islamic Faith

Human milk protects from infection and promotes infant gut health. Compared to formula, breast milk reduces the risk of severe infection or illness, including infection of the blood (sepsis) and NEC (necrotizing enterocolitis). NEC can be deadly, especially for the smallest and sickest infants.

Donor milk is easier to digest than formula, plus it contains nutrition and immune factors not found in formula. Most of the nutrition and immune factors in breast milk are still in the donor milk even after it is heat-treated. When donor milk is available, studies show that more babies leave the hospital receiving their own mother’s milk.

Pasteurized donor human milk is breast milk from healthy mothers who give their extra milk to a milk bank to help other babies. The milk bank combines milk from three to five donors and then heat-treats (pasteurizes) it to remove harmful bacteria and viruses, making sure that the milk is safe for even the tiniest, sickest babies. A similar process is used to make cow’s milk at the grocery store safe.

Donors are carefully screened. The milk bank tests the mothers, heat treats the milk, and tests the milk again for safety and nutrition.

Some Muslim families have asked if giving their baby donor milk will create a kinship between the donor family and the infant who drinks the donor milk. Medical experts met with the Minnesota Islamic Council to pose this question and ask for clarification. After much discussion, the religious experts issued a fatwa to provide guidance for Muslim families on using donor milk. The fatwa says, “The benefits of pasteurized donor human breast milk are such that all babies, particularly preterm, low birth weight, and ill babies, should be given this milk when that of their own mother is not available. “

The fatwa gave three reasons they came to this ruling:

  1. “Milk sharing is regarded as a virtue in Islam. Breastfeeding is strongly encouraged, and many verses in the Quran emphasize this.”
  2. Kinship can occur if the baby directly suckles from the donating mother’s breast (wet nursing) and completes at least 5 feedings. However, with recent advances in milk banking, breast milk is combined from multiple donors. “In accredited milk banks across the country…. Breast milk is pooled from 3-5 donors. This makes it less likely that a baby will be fed a large amount from one donor… these factors decrease the likelihood of the establishment of kinship.”
  3. “For some babies, human breast milk serves therapeutic/medicinal purposes and is preventing dangerous illnesses from forming in the baby’s digestive system or gut, according to the Fatwa Committee’s decision. Regardless of the donor’s religious beliefs, the use of heat-treated donor milk for that specific reason aligns with Islamic Sharia’s law goals, which prioritize the preservation of human life. Surah: Al- Ma’idah Ayah 32 “Whoever saves one-it is as if he had saved mankind entirely”

Wet nursing is when a mother nurses a baby that is not hers, sometimes for payment. (Milk donors are not paid for their milk.) Informal milk sharing is when a mother gives milk she has pumped to another mother to give to that mother’s baby. For both of these types of milk sharing, the baby typically consumes a large amount of milk from a single mother. The milk is ‘raw’ and is not screened or pasteurized.

For medically fragile infants, pasteurized donor human milk (PDHM) is the safest choice for preventing infection, and because each bottle has small amounts of milk from several mothers, it is nutritionally balanced. Most hospitals will not allow wet nursing or knowingly administer milk from another mother in the NICU, but do have donor milk available.

The American Academy of Pediatrics (AAP) recommends donor milk for premature or ill babies when their mother’s milk is in low supply or is not available. Some hospitals may offer donor milk to more infants as it helps promote exclusive breastmilk feeding at discharge.

Some mothers can’t make all the milk their babies need. Families can use donor milk as a bridge to feed the baby until the mother’s own milk increases.  The primary goal of breastfeeding is to provide optimal nutrition and important antibodies to the baby for their health and well-being. While direct breastfeeding from the mother or feeding mother’s pumped milk are the best options, donated breast milk can still offer significant benefits while the baby’s mother works to provide more of her own milk. Donated human milk can help protect a baby’s health and even save their life.

Nonprofit milk banks in the United States are accredited by the Human Milk Banking Association of North America (HMBANA) and are registered with the Food and Drug Administration (FDA). There are strict rules for the screening, processing, testing, and distribution of donated human milk to ensure safety. This process is similar, but stricter, than the process for donating blood.

The fatwa committee found that, “regardless of donor’s religious beliefs, the use of heat-treated donor milk for that specific reason aligns with Islamic Sharia’s law goals which prioritize the preservation of human life”.

Donors follow strict screening and testing processes. A trained health care worker reviews any medications they’ve used and discusses alcohol use with the donor. The Milk Bank accepts milk only if donors wait 6-12 hours after an alcoholic drink to express their milk, by which time their blood and milk levels should be near zero or zero. Women have a blood test and are intensively questioned to make sure they are free from any diseases, including sexually transmitted diseases. The donors know their milk is fed to tiny and sick newborns and do everything they can to make sure their milk is healthy.  Also, the milk is combined from several donors, a step that further dilutes any substance in the milk.

When a woman eats any meat, including pork, it is fully digested in her intestinal tract to amino acids (the building block of proteins), so those proteins do not pass into her milk.

The freezing, thawing, heating, and re-freezing of the donor milk disrupts all human cells.  Any genetic material (DNA or RNA) is disrupted, unwound from its structure and so damaged that it cannot transmit genetic information to another person.

More Resources

Below is a video about the development of the fatwa in English. Translations of the video are available in Somali and Arabic.

For Healthcare Professionals:

An educational handout about pasteurized donor human milk for Muslim families was developed for use in the public domain. You are welcome to download, print, and use this handout unaltered for non-commercial use in your facility. Space was provided in the lower right corner to add your facility’s logo.

Download pdf, About Pasteurized Donor Human Milk.

View the press release from Children’s Minnesota.

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