HIV-Positive Woman Donated Breast Milk Over Social Media

Key Takeaways - Unpasteurized breast milk can be contaminated with viruses or bacteria if improperly stored. - In this report, public health officials from California detailed how multiple infants may have been exposed to HIV from donor milk obtained via social media. - HIV antibodies were detected in a sample of the donor milk, but all of the potentially exposed babies tested negative for the virus. Health officials from California warned on the dangers of acquiring breast milk outside of vetted channels after multiple infants were potentially exposed to HIV from donor milk obtained via social media. It's unclear if infants actually drank the milk in four of the five cases, and they all tested negative for HIV, reported Akanksha Vaidya, MD, MPH, of the Santa Clara Public Health Department, and colleagues in Morbidity and Mortality Weekly Report. In the fifth case, the family had never used the breast milk and still had it kept frozen. This allowed investigators to test for HIV antibodies, which turned up low levels of virus (<30 copies/mL), though the researchers noted that antibodies don't necessarily indicate infectious virus or transmission risk. Their investigation started in early October 2025 when the Santa Clara Public Health Department was notified of a pregnant woman who received a positive HIV test result at a prenatal screening. At the time, the woman was breastfeeding her 2-year-old daughter and said she had been donating breast milk through social media groups since May of that year. (A prenatal test in 2023 was negative for HIV.) Roughly 2 weeks later, the woman's pretreatment HIV viral load was 119,000 copies/mL, and she was counseled to stop breastfeeding. Her daughter began receiving postexposure prophylaxis on October 31 and tested negative for HIV shortly thereafter and again in January of this year. The report, said Vaidya and co-authors, highlights the risk of unpasteurized breast milk obtained through social media -- which can be contaminated with viruses or bacteria if improperly stored -- and also presents an opportunity for patient education. Accredited milk banks, they noted, pasteurize their product and screen donors for infectious diseases and medications that can transmit to infants. While medical groups such as the American Academy of Pediatrics recommend breastfeeding for various health benefits, it's not recommended for mothers with an HIV viral load of more than 50 copies/mL due to the risk of transmission. Children exposed to such milk are recommended to get tested for HIV immediately after their last exposure, and at 14-21 days, 4-6 weeks, and 4-6 months after the last breastfeeding. The health department faced several challenges during their investigation, Vaidya and colleagues noted, which included being accepted into closed social media groups, facing skepticism from contacted parents, and being barred from posting messages in social media groups about safety risks associated with sharing breast milk through these groups. The HIV-positive mother provided the name of one parent who received her breast milk, and the investigators were able to identify four other parents through responses to the mother's posts. After being blocked from the social media groups where the donor had offered her milk, investigators had to contact the four families through direct messages on social media using newly created profiles naming the health department, or through contact information from electronic medical record searches or public health databases, Vaidya and colleagues noted. The investigators used names, phone numbers, birthdays, and photos on social media to match contacts to database records. In addition to emphasizing the importance of patient education on risks associated with unpasteurized breast milk, Vaidya and colleagues pointed to the unique role social media can play in public health investigations. "Despite barriers to contacting parents who had received the donated breast milk, [the health department] was able to identify and test infants at highest risk for potential exposure to HIV," they wrote. "Social media groups can be used to focus public health interventions toward persons informally exchanging breast milk that has not been properly screened." At the same time, Vaidya and colleagues noted, "reaching these communities can be challenging, particularly because contact through social media can appear unofficial." "Social media presents a novel means for disease investigation," they added, and "health officials might benefit from additional training on how to conduct investigations through verified profiles in such groups."