Susan Burger wrote:
> Dear all:
>
> I'm always surprised by questions that seemed to have been fundamentally answered by panels of experts such as the WHO.  Human donor milk IS listed higher than formula by the WHO for a variety of reasons beyond whether or not the milk has been pasteurized.  One study was listed in one of the Lawrence books -- a randomized trial of pooled human milk versus formula given to bottle fed premies.  There was a 10 IQ point difference in this RANDOMIZED double-blinded trial.
>
I seem to have phrased my question badly, considering that no one has
really answered it.  Of course pasteurized human milk is preferable to
currently available formula, because it's the perfect 'infant food'.
However, breast milk obtained by direct breastfeeding is much more than
just an infant food.  In several hundred years, I would not be shocked
to learn that manufactured infant milks have matched more and more of
the components of breast milk, and that they have reached about the
level of pasteurized human milk.  This is where they would have to stop,
though.  The living components they can't match.

Perhaps my point/questions would be clearer by considering the following
sequence:
A. direct breastfeeding
B. feeding of expressed, unpasteurized breast milk
C. feeding of pasteurized breast milk
D. feeding of ABM/formula

We've seen lots of studies that show the difference in terms of
long-term health between A and D.  I'm wondering at which step in the
above sequence those changes happen.  The companies that base their
business  on breast milk feeding would like us to think that A and B are
just about equivalent in terms of long term health, but do we really
know this?

In terms of risk, I'm not questioning whether formula or pasteurized
breast milk is higher risk,  What I am questioning is whether
pasteurized or unpasteurized breast milk from a source other than the
mother is a higher risk.  To decide this, we have to balance the
(probably slight, if the donor is known to be healthy) risk of disease
transmission in breast milk with what seems to be a completely unknown
risk of pasteurized breast milk.

Christine Bussman

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