Over the past 100 years, North American milk banking has evolved from an idea to a sophisticated process. The early history of establishment of North American banks, including screening processes undertaken, provides the basis for current procedures in modern banks. Increased research and technological improvements have also dramatically changed modern screening procedures. Human milk banks have waxed and waned through the years due to concerns of safety, lack of information, and assertive marketing of infant formula. With increasing awareness of the benefits of human milk and the safety of the optimal product provided through modem milk banks, demand is increasing, leading to greater interest in establishing additional banks.