I want to thank Nancy Wight for sharing her references to her comment that,
"Contaminated breastmilk has also killed premies."  Nancy made this comment
in response to my post in regard to enterobacter sakazakii contamination of
powdered infant formula killing premies.  The need for balanced reporting in
science is a vital component in getting to the truth of any situation.

The common factor in both contaminated "expressed" breastmilk and
contaminated infant formula seems to be hospitalization and the high risks of
nosocomial infections, particularly for the tiny premies.  Dr. May of LaTrobe
University has a chart of isolated contaminants from expressed human milk
that caused infection that is also illuminating. see table 5
http://www.latrobe.edu.au/microbiology/milk.html

I believe that this information in regard to breastmilk should make us very
aware of the risks of infection in the hospital setting and that infection in
some cases was pinpointed to incompletely sterilized breast pumps.  It seems
in principle,  that the quicker an infant can get to his/her mother's breast
to receive milk, the safer that infant will be from the risk of contaminated
breastmilk.  One of the problems of feeding infants breastmilk through
plastic tubes is the fact that the fat of the milk sticks to the tubing.
There are alot of protective factors in that fat, and thus the infant who
needs those protective factors is not getting it all.  This is partly one of
the reasons stated in a human milk fortifier patent I read
recently-emulsifying the fat to ease dispersal of the fat.

On the other hand contaminated infant formula, not only can be contaminated
in the hospital but also at the factory.  Which means that risks of infant
formula are increased substantially. According to the FDA report I read,
enterobacter sakazakii was not cultured off of hospital equipment used but
from the the infant formula powder itself.  Thus contamination is at the
factory.  The milk/the product, itself, was contaminated.  This has been an
ongoing problem since the late 80's.

There is an absolute difference in saying that contaminated breastmilk kills
premies and saying contaminated "expressed" breastmilk kills premies.  In my
opinion the first statement is erronous and the second statement is accurate.
 The first statement illicits a emotional response from many of us.  The
second statement clarifies that anytime we get away from actual feeding at
the breast, we increase risks--particularly in the hospital.

As for CMV and herpes, it is rather ironic that there are quite a few patents
(30-60) patents on using various recombinant human milk components to treat
CMV and herpes.  These patents are based on research of what the real human
milk components can do.  Premature infants, particularly, seronegative
premies, are at risk from CMV from "donor" milk that is CMV positive. But is
the risk the milk or the method of feeding and the fact the milk is not from
the infant's mother?

At a UC Davis Children's Hospital web site in August of 2000, they announce a
clinical project in the planning stages called, "Prevention of Nosocomial
Infections in Extremely Premature Infants with Oral Administration of
Recominant Human Lactoferrin" by Michal P. Sherman, MD.  The project was
initiated by the biotech company, Agennix.  They were seeking approval from
the FDA as well as grant support through the Orphan Drug Products Program at
the FDA.  I wonder if they received approval and what the results were.
http://neonatology.ucdavis.edu/NEOFRONT/resprogram.htm

I agree with Nancy who wrote, "We will lose all credibility however, if we
stick our heads in the sand when bad things happen."  Credibility is
important.  But is breastmilk itself a risk or is it the artificial way in
which that milk has to be delivered to the premie in the hospital setting
that is the real risk?
 Valerie W. McClain, IBCLC

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