48 ISLAMIC HORIZONS NOVEMBER/DECEMBER 2016 HEALTH & WELL-BEING The Unbreakable Relationship Are Muslims aware of the Islamic bioethical perspectives on human breast milk banking? BY MOHAMMAD H. BAWANY, AHAMED MILHAN, AND AASIM I. PADELA R esearch has demonstrated the many positive health benefts that breast-feeding confers upon infants, from lower incidence of various infectious diseases to benefts in mother-child bonding. Studies about premature infants have linked breast-milk feeding with enhanced short- and long-term health outcomes for premature infants when compared to infants fed with formula (Feldman and Eidelman, 2003; Furman et al 2003; Hylander et al, 2003; McGuire and Anthony, 2001; Schanler et al, 2005) . When a mother sufers from lactation failure, the inabil- ity to nurse her newborn, she has the ability, if she so chooses, to procure breast- milk from other sources. In the West, this alternative source is ofen a milk bank ofering pasteurized donor (or purchased) human milk (PDHM). In the U.S., a system of 10 human milk banks function to collect and store PDHM from lac- tating mothers who have extra milk afer feeding their own infant. Afer medical history screening and labo- ratory blood testing for viral and bacterial diseases, including HIV and syphilis, the milk is collected and cold-stored until it is ready for processing. Before distribution, it is subjected to defrosting, pooling, pasteur- ization, and cultures to rule out bacterial growth (Human Milk Banking Association of North America, 2009). Pasteurized donor human milk also has demonstrated health benefts for newborns (neonates), compared to babies fed formula. PDHM seems to reduce the rate of several neonatal infections (Narayanan et al, 1980; Narayanan et al, 1981), including clearly reducing the risk for necrotizing enteroco- litis, a destructive intestinal bacterial disease (Lucas and Cole, 1990). Milk banking is also common in other developed and developing countries. For example at the International Congress of Human Milk Banks in 2001, France was reported to have 18 milk banks while Brazil had 154 (Ghaly, 2012). In the Muslim world, milk banks are rare and highly controversial. Tis is because kinship might result from individuals sharing the same milk nurse. According to Islamic law, consump- tion of breast milk from the same milk mother leads to a special type of kinship that bars marriage between individuals who shared the same milk. As the Qur’an states: “Prohibited to you [for marriage] are your mothers, your daughters, your sisters, your father’s sisters, your mother’s sisters, your brother’s daughters, your sister’s daughters, your [milk] mothers who nursed you, your sisters through nursing… (4:23 — Sahih International).” Further, a hadith cites a case where a man was advised to divorce his wife afer being informed they shared a milk mother: “Narrated ‘Abdullah bin Abi Mulaika: ‘Uqba bin Al-Harith said that he had married the daughter of Abi Ihab bin ‘Aziz. Later on a woman came to him and said, “I have suckled (nursed) ‘Uqba and the woman whom he married (his wife) at my breast.” ‘Uqba said to her, “Neither I knew that you have suck- led (nursed) me nor did you tell me.” Ten he rode over to see God’s Apostle at Medina, and asked him about it, who replied, “How can you keep her as a wife when it has been said (that she is your foster-sister)?” Ten ‘Uqba divorced her, and she married another man (al-Bukhari volume 1, book 3, hadith 88). Tese and other scrip- tural sources ground the notion of milk kinship in Islamic law. Te general rule, as mentioned in another prophetic narration, is: “…what becomes mahram (forbidden for mar- riage) through breastfeeding is that which is mahram through blood ties” (al-Bukhari volume 3, book 48, hadith 813). Tus, a boy nursed by a woman other than his own mother will be prohibited from marrying the woman who breastfed him, her mother, daughters and sisters, and whoever else she nursed (Shah, 1994). Te breast-mother’s sisters become his maternal aunts, and her husband’s brothers become