FROM the 1950s onwards, it became common practice to feed formula milk to babies, even newborns. Many women considered breastfeeding to be outdated or unnecessary, or they were ill and unable to feed their babies in the natural way. Later, research showed that human milk was best for its nutritive value as well as bonding between mother and baby.

The WHO recommends that breastfeeding be carried out at least for the first six months, and then, preferably, for another 18 months; ie, for a total of two years. This is the exact period stipulated in the Quran for breastfeeding (2:233).

Therein lies a problem. Some mothers die soon after childbirth or they are so ill that they have no or very little milk. Some children are also born preterm or are very fragile and unable to accept formula milk. On the other hand, some babies are stillborn or die early, leaving the mother not only distressed but unable to use the milk she is producing. The Quran proposes a solution based upon a carefully designed agreement between the two families concerned. The woman who can offer her milk feeds the child for at least two years and is compensated by money or equivalent for her invaluable services. This results in a bond between the child and this mother that is almost the same as a mother and her biological child. More importantly, the children of this foster mother become foster siblings to the child, and marriage between the two is forbidden.

To manage the problem of lack of human milk for babies who need it, human milk banks have been around since 1909, and the experience has been very useful. Hu­­m­an milk banking involves a detailed, intensive process that includes rigorous screening. All milk must be properly collected, stored, pasteurised and cultured in accordance with clearly defined guidelines.

Milk banks need careful guidelines.

Milk banks are operating in 35 countries, but the only Muslim country with extensive usage is Iran. Singapore started using them in 2017, and Malaysia is planning for 2025. In Malaysia, “after a series of consultations with the Islamic authorities, milk kinship is no longer an issue”. In Pakistan, a milk bank was inaugurated at the Sindh Institute of Child Health after obtaining a fatwa from a Darul Uloom, but this facility was closed within a week when the fatwa was revised.

Why are milk banks not common in Muslim countries? The reason is that Muslims believe that if a child drinks the milk of a woman who is not its biological mother, a “milk relationship” would be established, creating a potential marriage problem. Ulema also object to this practice on grounds that this would become a commercial practice, and women would offer their milk in order to earn money.

In this controversy, a major point has been missed. This has been highlighted by the scholar Javed Ghamidi, who suggests that the ‘milk kinship’ between feeding mother and baby is established only when the woman has decided that she will feed this child and takes it to her breast. The entire process is extremely sensitive and involves considerable emotion and planning. The baby, as it grows up, remains attached to the foster mother and its foster siblings as if they were its blood relations. This is a carefully established arrangement. None of these elements are present in the operation of a milk bank. The late Egyptian scholar Yusuf al-Qaradawi also saw no religious problem in establishing or using these banks and issued a decree to the effect in 1983.

Ayatollah Ali Khamenei is of the same view, saying that milk kinship is formed only if the baby is breastfed.

On the issue of women making this an earning practice or the process becoming commercialised, Ghamidi says that there is nothing wro­ng with making payments to the women who are providing milk. In Islam, even after divorce, the ex-husband is supposed to make payment to the ex-wife if it is decided that she will breastfeed the baby. Any process can be exploited through unethical means. Milk banks need careful guidelines, SOPs and trained and sensitive staff as well as individuals with counselling experience.

Kuwait operates a modified version of the bank. Milk would be obtained from one woman for a single baby, thus making it easier to avoid possibility of marriage between ‘milk siblings’. The donor and the recipient baby’s biological mother or father also meet. Indonesia is also planning to establish similar milk banks. In all countries with sizeable Muslim populations, religious scholars of all sects were consulted in the early stages and only then were milk banks set up.

Pakistan would do well to study models from Iran and other countries and consult stakeholders as well as non-traditional scholars. In this, as well as in other issues, the three basic Islamic principles of public interest, necessity and doing no harm must be applied.

The writer is an individual contributor with an interest in religion.

Published in Dawn, July 19th, 2024