Milk of a woman — Only for a sick person or even healthy?

Question

In says in Shulchan Aruch Yoreh Deah Siman 81 SIf 7 that it's muter to drink chalav isha (the milk of a Woman) as long as it's "pirush" from the body (i.e. it was already extracted and now inside of a vessel). However for a gadol (adult) to nurse from a woman is like nursing from a "sheretz" (a creepy crawler) and is ossur.

Seemingly many poskim understand this as being muter even lichatchila (see Shach Sif-Katan 17 and what the Caf HaChaim brings in Siman 81 Sif-Katan 47). However the Pri Megadim in Sifsei Das Sif-Katan 17 seems to say that it's muter only for a choleh (sick person -- even a choleh shain bo sacana -- one that is not in a dangerous situation in terms of their health). His wording is:

עש״ך ר״ל אפילו חולה שא״ב סכנה ומיהו מההיא דלקמן סי׳ פ״ז ס״ד אין מוכח דשם אסור לבשל בלא אכילה משום מ״ע

We have now many poskim that seem to hold that it's muter lichatchila, and the Pri Megadim that seems to be saying it's muter only for a choleh. Although I can't say with a certainty what the halacha is l'maseh, the majority of the poskim hold it's muter lichatchila. However what is the reasoning behind both sides? Especially that of the Pri Megadim that it's muter only for a choleh.

Answer 1

The reasoning for the opinion that mother's milk is permitted even to a healthy would be because the Torah specifically tells us it is permitted (see Kesuvos 60a), and only directly from the women is forbidden because of "yonek sheketz".

With regards to the other opinion - The Tziyunim Vehago'os on Pri Megadim in the Machon Yerushalayim edition point out that the Pri Megadim is difficult to understand, because from the Shach it seems quite clear that mother's milk is mutar l'chatchila even to a healthy person. They quote the Meged Shamayim who writes after the words of the Pri Megadim "אפילו לחולה שא"ב סכנה א"צ". [I think that stands for "אין צריך", as in him questioning why the Pri Megadim wrote]. They also point to Darkey Teshuva Ois 77, though I could not understand what he adds there.

Answer 2

The Pri Megadim does seem quite difficult to understand. Especially since really he's not arguing with the Shach but rather trying to say that this is how the understand the Shach since he says the words "Rotzeh l'omar" (ר"ל)

I saw however an interesting thing. I don't know if this is an answer to explain the Pri Megadim but could be this is a start. The Caf HaChaim in YD Siman 87 Sif-Katan 29 when discussing the inyun of maris ayin and cooking chalav isha with baser he writes at the end that everything he wrote is l'inyan dina and that in our times chalav that comes from a person is "disgusting" ("mius") and that there would be an issur of bal tishkatzu (one is not allowed to make themselves "disgusting" by eating such things.) Perhaps because of this the Pri Megadim felt the need to write that it's only muter for a sick person (however even a sick person that is not in danger.) Although I don't believe this is a complete answer it's something to think about and could be a way to explain Pri Megadim. It would be important to see if the Caf HaChaim has an earlier makor or if he is saying this from himself.