The mothers’ milk bank dilemma

What is it about?

Breast milk is the safest and most nutritious food for newborn babies, especially those who are premature or seriously ill. When a mother cannot breastfeed her own baby, a milk bank — which collects, screens, and stores donated breast milk from other mothers — can save the baby's life. Pakistan had such a facility at a major children's hospital in Karachi, but it was shut down after a religious ruling declared it incompatible with Islamic law. The concern centered on a classical Islamic concept called milk kinship, which holds that a baby who is breastfed by a woman other than its mother becomes related to that woman and her family in ways that affect future marriage eligibility. This paper takes both the medical and the religious concerns seriously. It examines how other Muslim-majority countries have found ways to operate milk banks within Islamic legal frameworks, argues that saving infant lives is itself a profound Islamic ethical obligation, and proposes a practical path forward for Pakistan — one that brings together medical professionals, religious scholars, and policymakers to find solutions that honor both faith and the health of children.

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Photo by Luiza Braun on Unsplash

Photo by Luiza Braun on Unsplash

Why is it important?

Pakistan has one of the highest infant mortality rates in the world, and premature and low-birth-weight babies are among the most vulnerable. Donor breast milk has been shown internationally to significantly reduce illness and death among these infants, and milk banks are considered an essential part of neonatal care by the World Health Organization. The closure of Pakistan's only hospital milk bank following a religious fatwa represents a direct and measurable impact of religious authority on public health policy — and it is an impact that falls most heavily on the most fragile and vulnerable patients imaginable. What makes this paper important and timely is that it does not dismiss either side of the debate. It takes Islamic jurisprudence on milk kinship seriously as a genuine and complex legal tradition, while also making a clear evidence-based case for the life-saving importance of donor milk. Crucially, it shows that Muslim-majority countries including Iran, Malaysia, and Egypt have developed policy frameworks that address the milk kinship concern in ways that are both medically functional and religiously grounded. This comparative evidence is directly relevant to Pakistan and has not been sufficiently highlighted in Pakistani policy discussions. The paper will be of interest to scholars of Islamic bioethics, public health researchers, pediatricians, policymakers, and religious leaders engaged with the intersection of faith and healthcare in Muslim-majority societies.

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