Interesting discussion here.  I remember hearing a researcher from Hartmann labs I think a few years ago who had an idea to develop some sort of small system/machine that would take a mother's own milk and make it into a substance he called "Breast Milk Boost" for use by the VLBW infant.  Don't know where his idea went but it sounds good to me.  My focus here in my hospital is to get policies and procedures and nursing commitment to get EVERY mom of a VLBW NICU baby pumping early and often and hand-expressing to get those milk volumes up so every baby gets it's own mom's milk.  Or chief neo is much in favor.  He donated a creamatocrit machine to the lactation dept. so we could do the analyses for these babies and boost calories.   He is definitely impressed with all the info on NEC and preemies that is overwhelmingly in favor of mom's milk.  But we have to get the square one done before we do square two and three.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Rachel Myr
Sent: Thursday, January 21, 2010 4:34 AM
Subject: Why we discuss in a public forum

Susan Johnson writes: "I think it's most unfortunate we share our thoughts on the "marketing of breastfeeding" in a public forum while industry heads to a back room to discuss.   Why exactly do we do this?"

Good question, Susan.

Here are some possible reasons:
1. We are naive, even stupid, or at least generous to a fault 2. We lack the back room in which to hold our discussion, and we want to air our concerns in a way that exposes more people to them - people like Liz B who gets a prickly feeling she can't quite put her finger on 3. We, in contrast to those who prefer back rooms, have nothing to hide and we are unashamed of that fact

The 'risk' of discussing the marketing of breastfeeding, which should more accurately be termed the marketing of breastMILK, is that we give free input to those who want to make a strategy to win over the skeptics amongst us, and for the record I count myself amongst those skeptics.  The risk of NOT discussing it is that all of us sit here with our prickly feelings and one day we wake up in a world where everyone accepts that it is easier to devise a profit-making national or international collection and processing system for breastmilk so that ill babies can have a better chance, than it is to devise a strategy to ensure that every mother can provide milk for her own baby, even down to the lactoengineering that may or may not be needed for the most vulnerable premature infants.  

The jury is still out on what kind of fortification, if any, is needed if an infant is getting its own mother's milk.  Most women are able to produce in short order far more milk than a 600 or 1500 gram baby needs per day, and the surplus from each mother could be used to produce fortifier that would have to be far better suited to her baby's needs than a standardized product consisting of pooled milk from many donors.  The small minority of women who are unable to produce milk could be supplied with local, fresh donor milk since every ICU would be well versed in the minimal technology needed to ensure proper nutrient concentration and there would always be plenty of women lactating so milk would be readily available.  What is missing from this picture is the step in which the milk becomes the property of someone who will sell it back to the same user who produced it in the first place.

Breastmilk is a natural resource.  Some very intelligent people support the privatization of ownership of other natural resources, such as water.  Others argue that access to clean drinking water is a basic human right and no one should be denied it just because they can't pay the owner of the well, or the spring, or the pipe from the river.  Breastmilk is always produced by an individual, it doesn't flow in rivers that can be diverted to the bottling plant and the means of production are *far* beyond  rocket science.  The more breastmilk an individual removes from her breasts, the more she will produce.  There is no other physical substance on earth for which this is the case, as far as I know.  The way our bodies work is directly in contrast, and possibly in conflict, with basic tenets of the market economy.  Sometimes I think we ought to all sit quietly and ponder that fact until we really understand its significance.  

Rachel Myr
Norway
where milk donors are compensated for their time on a per liter basis, and blood donors are rewarded with great trinkets like Moomintroll coffee cups or bath towels or sports bags, and the costs of supplying blood and donor milk to those who need them are borne collectively by the human fellowship we call 'society' over the public health budget, and nobody is in any serious doubt about the value of either fluid

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