At the European congress of perinatal medicine in Oslo last week I heard a
number of presentations about breastfeeding.

One excellent one was by the Norwegian researcher Marit Aralt Skaug who just
got her doctorate, on contamination in breastmilk.  She spoke about
ochratoxins in breastmilk.  Ochratoxins are naturally occurring
environmental toxins made by molds, and while the molds (like soil fungus)
do not themselves pass into our milk, the toxins they produce are
heat-stable so are not destroyed by pasteurization or cooking of foods, and
do indeed appear there.  All of us have these potent carcinogens in our
bodies, because we ingest them with our own food, especially certain grains
(the ones grown without fungicidal sprays have the highest amounts) and
animal foods from livestock that ingests those grains.  (Marit Aralt Skaug
is a strong supporter of breastfeeding, and she has also looked at toxin
contamination in artificial baby milks.  Knowing they are there as well
doesn't mean we can ignore them in human milk!)  She looked at which foods
were most commonly consumed by women whose milk had the highest ochratoxin
levels, and found that fruit juices and liverpaste made from pork livers,
were the among the worst culprits.  The ochratoxin levels in food are not
currently monitored here.

I attended a lecture sponsored by Nestle, to hear what the speaker, J.
Räihä, said.  It was about a landmark development in treatment of the
proteins in bovine milk, so that they can now produce formulas with less of
a protein overdose, and with a whey:casein ratio that is more similar than
before to breastmilk.  The speaker quoted the first manufacturer of an
artificial formula for babies, whose aim was to market a product that was
'the nutritional and biological equivalent of breastmilk'.  The speaker said
that while the nutritional aspects of commercial formulas are much improved
over the first attempts, 'I doubt we will ever be able to synthesize a
biological equivalent to breastmilk'.  It was some comfort to know he
realizes it.

I asked one of the four Nestle reps who was present, handing out souvenir
bags with all kinds of scientific-looking printed matter from the company,
whether they plan to continue marketing the old inferior formulae, and she
said that in the Nordic countries, this new product will be replacing the
older version.  She carefully did not mention what plans they have for the
rest of the world, one can easily imagine attempts at dumping, or even
selling the new one at much higher markups in N. America while continuing to
peddle the other stuff for people who don't have the money to go that 'extra
step' for the reduced protein one.

I also read Nestle's very classy publication about their corporate strategy,
on offer at their gigantic stand in the commercial exhibit, and learned that
in countries who have not ratified the WHO code as law, Nestle voluntarily
adheres to it anyway.  Only thing is, they are lying, because in Norway,
which has not ratified the code as law, they are still actively seeking
direct contact with pregnant women and new parents through an advert for
their company (no specific products mentioned in the ad) in a publication
distributed by hospitals to new mothers.  In the ad they offer readers a
phone warmline on infant nutrition, where calls are answered by 'Nestle's
health visitor'.

All in all this congress was much more commercialized than I am used to from
other similar events here.  In order to get fed, one had to show up at a
sponsored symposium each day.  I bought my own food.  All coffee was
provided by Nestle in special cups with their brand and logo very
conspicuously present.  I didn't drink any of that either, and in my own
talk, on BF in Norway, I addressed the issue of selling one's integrity for
a cup of coffee.  Not many people were in attendance but those present
didn't seem at all offended.

There was one quite good session with talks about milk banking, where I
learned that this is the only country where donor milk is not routinely
pasteurized.  Makes for a lot of work to test and keep track of donors, but
we think it is worth it.  Milk that has too high a bacterial count to be
used in small babies is pasteurized and then given to the regular
post-partum ward to use in those cases where supplementation may be
necessary temporarily.  We do distinguish between milk from CMV-positive
mothers and CMV-negative, and small/young premies don't get CMV-positive
milk from donors.  I believe they are given their own mother's milk
regardless of her CMV-status.

Rachel Myr
Kristiansand, Norway

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