Ruth Lawrence stated in her text book, Breastfeeding:  A Guide for the
Medical Profession 4th edition, page 101

"Fats are also the most variable constituents in human milk, varying in
concentration over a feeding, from breast to breast over a day's time, over time
itself, and among individuals."

An old edition of a great text, but I am assuming this essential fact about
human milk has not changed since this edition was printed.  Thus scientists are
monitoring toxins with one of the most variable constituents of human milk.
Does this make for good science?

This "might" not matter if we are doing research to pick up general trends in
regard to toxins in the environment.  But, if this biomonitoring is done on
individual women to determine whether or not she should breastfeed, then I
believe we have a problem.  I recognize that this isn't being done at the moment,
but from where I stand it is quite obvious this will be one of the
ramifications of monitoring.

Sandra mentions the amount of fluid needed to monitor toxins in blood and
urine.  I believe this is the reason for the POOLING OF BREASTMILK in all the
studies done on environmental toxins.  This is why in my opinion we cannot assume
that these numbers taken from these studies represents anything other than an
average which can be dramatically high because several samples maybe high in
toxins.  Human milk may have more toxins in it during the initiation of
breastfeeding and weaning because cell junctions are more open at those times.  Thus
one sample of milk means what?  What does it really tell us?

While Sandra states that four ounces of expressed breastmilk is easy to
obtain.  Four ounces from some mothers is easy.  But for other mothers 4 ounces of
milk, particularly early postpartum maybe a hardship.  Of course one assumes
that anyone donating milk for research would more than likely find expressing 4
ounces relatively easy.  But, if monitoring becomes standard practice in the
USA, we will have mothers who may find getting 4 ounces very difficult,
invasive, and exhausting (feeling very much like those who donate blood and urine).
If this becomes a standard, this 4 ounces may indeed be taking food out of an
infant's mouth and into a researcher's lab.

Mary mentions the civil liberties aspect of such monitoring and that is an
important point.  When you donate human milk, you have no control over how the
institution uses that milk.  How is it that we have 700 patents on human milk
components with 200 more applications in the US patent office?  How did
researchers obtain their samples to do this research?  How is left over milk treated?
 Thrown out?  The market value of just one component of human
milk-lactoferrin is worth $3000 per gram in research (can only be used for research). How do
programs store human milk--under lock and key or does everyone in that
institution have ready access to samples?  What are the legal rights of donors?
Shouldn't they have a right to any profits, if the researchers use that milk to
patent a component in that milk and it becomes a useful product to society?  Is
it ethical to patent components of human milk?  Will biomonitoring of human
milk. impinge on a mother's right to privacy?  Many, many questions and I truly
believe that these questions have to be asked and answered before we readily
accept biomonitoring of human milk.
Valerie W. McClain, IBCLC

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