Milk as Mutual Aid: Legitimizing Community-Governed Human Milk Sharing as Public Health Infrastructure

Human milk is a critical public health resource, yet access remains uneven despite the well-established benefits of breastfeeding and donor human milk. Although regulated milk banks provide an essential service, many families obtain human milk through informal and community-based sharing networks. These practices have persisted across cultures and generations but remain largely absent from public health policy and professional guidance. This commentary argues that community-governed milk sharing should be understood as a form of mutual aid that emerges in response to gaps in maternal and infant health systems. Rather than ignoring or stigmatizing these practices, society should acknowledge their existence and develop evidence-informed approaches that promote safety, autonomy, equity, and informed decision making. Recognizing milk sharing as community health infrastructure may strengthen infant nutrition security and support family-centered care.