Lara Hopkins posted on one phrase, 'generic milk', from the news item about
for-profit milk banking, and the implications of using a term associated
with the pharmaceutical industry to differentiate pooled, pasteurized donor
milk that has been formulated to give a standard fat, protein and
carbohydrate content from the milk that flows spontaneously from a mother's
breast to her child.  
I got stuck on the following sentence from the article:

' "Neonatologists really want a nutritional label," Medo said. "They want to
know that what they are getting today is the same as what they will get
tomorrow." '

Why on earth would a neonatologist want to give a vulnerable baby the same
food day after day, when the normal state of affairs would be for the baby
to be getting the latest edition of its own mother's milk, which is never
the same two days running?  I can't believe that neonatologists are so
ignorant about the importance of the dynamic flexibility of the mammary
glands that are supplying a particular baby.  I really mean this - I can't
believe it.  I think this statement is speculation, based on an assumption
that neonatologists are ignorant, which I don't think they are.
'Nutritional label'?  What is that, anyway?

In my hospital we do use fresh-frozen donor milk, but it is rare for a baby
to get it for more than a couple of days, and these are babies whose needs
over those first few days don't amount to more than a very few milliliters.
By the time the babies need larger amounts, their own mothers have nearly
always brought in a more than adequate supply, following our regime of hand
expression until lactogenesis II sets in, then using a pump if they prefer,
which most do, or continuing to hand express.  Hand expression makes it so
much easier for mothers to express frequently those first couple of days.
They need no equipment other than a tiny cup and a syringe to draw the
colostrum/milk up with, they can do it lying down, and they get the
invaluable encouragement of seeing how much comes out of their breasts.  The
sight of these mothers heading over to the ICU after breakfast, carrying two
or three containers of the milk they have expressed during the night, is
truly something to behold.  They are radiant, and awe-inspiring.  And they
know that what they are providing needs no nutritional label other than
mother's milk.

Rachel Myr
Kristiansand, Norway

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