http://www.startribune.com/1244/story/757300.html
October 21, 2006 – 11:35 PM
Got (extra) milk? At the U, it's a warm commodity
Some Minnesota moms' breast milk is going to a for-profit California
company, which modifies it and sells it to hospitals. But skeptics
wonder if the company's high-tech treatment of the milk --and its high
prices -- are necessary.
Maura Lerner, Star Tribune
When it comes to feeding newborns, experts agree, there's nothing like
mother's milk. But now, a Minneapolis hospital has teamed up with a
California biotech company to try to improve on Mother Nature.
The University of Minnesota Medical Center is collecting the "raw
material" -- breast milk -- from nursing mothers who are willing to
donate what they don't need.
Then it's shipped to Prolacta Bioscience of Monrovia, Calif., where
it's modified and sold back to hospitals for $26 to $43 an ounce.
It's a high-tech twist on a story as old as Moses.
For thousands of years, surrogates were used to nurse motherless
babies. Today, donor milk is being used to help premature and
critically ill infants in newborn intensive care units.
"We've known for a long time that breast milk has a lot of healing
qualities," said Lora Harding Dundek, who runs the donor milk program
at the university hospital.
For years, some nursing mothers have donated excess milk to nonprofit
milk banks. Those centers typically supply it to hospitals for about
$3.50 or $4 an ounce.
But the university's hospital decided to open the state's first milk
bank in collaboration with a for-profit company. Prolacta re-engineers
breast milk to ensure that every ounce has a precise number of
calories and nutrients.
Skeptics wonder whether the high-tech treatment, and the high prices,
are necessary. "Nonprofit banks have been providing milk for many,
many years ... [and] the babies have thrived on it," said Mary Rose
Tully, past president of the Human Milk Banking Association of North
America, a network of nonprofits.
"When you introduce a profit motive, you're introducing a whole
different ballgame," Tully said.
A better breast milk?
Doctors have known for years that mother's milk is one of the best
ways to treat premature and sick newborns, said Dr. Michael Georgieff,
a University of Minnesota specialist in newborn nutrition.
Among other things, breast milk helps fight off infections, which can
be extremely dangerous to such fragile infants.
The problem arises when mothers can't -- or for some reason won't --
provide the milk themselves.
That's when Georgieff may prescribe donor milk.
But "human milk is highly variable in its content," he said. One ounce
might contain 15 to 24 calories. And for premature infants, "15
calories per ounce just isn't going to cut it," Georgieff said. So it
would be helpful, he said, to know exactly "what we're giving the
kids."
That's where Prolacta comes in. Founded in 1999, it developed a way to
pool milk from multiple donors and process it so that each ounce
contains 20 calories, and has an identical amount of nutrients. It
also produces a human milk "fortifier" that's less likely to cause
digestive problems than the commonly used one made of cow's milk, the
company says.
"This is the first time you're able to treat a preemie with a complete
human-milk solution," said Scott Elster, Prolacta's chief executive
officer. He said research suggests that it's better for babies, but
the company is only now "doing the studies to determine that."
Prolacta began selling the products, which are considered foods rather
than drugs, in April.
Donors don't get paid
This summer, the U's children's hospital agreed to become one of
Prolacta's suppliers. The hospital receives $2 an ounce, which Dundek
says should cover its costs and maybe more.
"We're hoping that eventually ... we can actually make some money on
this," she said. The profits would go to breast-feeding support
services for new moms, she said.
All donors are screened to make sure they're healthy. The company even
does "DNA fingerprinting" on the donors, Dundek said, "to make sure
that everything in there is her milk ... or hasn't been topped off
with a little Kemps."
Donors aren't paid, she added, because "we don't want to provide any
incentive to give us milk instead of giving their baby milk."
Peggy Lin, a 37-year-old attorney from St. Paul, is one of the donors.
She started in August, a few months after daughter Josephine was born.
"I have been lucky enough -- this is my third daughter -- to have a
lot of milk each time," she said. "This time, I was really determined
to find something to do with it."
Lin started pumping milk after returning to work. "Every day, whatever
we don't need for bottles goes in the freezer," she said. She
considered a nonprofit milk bank -- the closest one is in Iowa City --
but chose the Minnesota program for its convenience. Every few weeks,
she drives to the hospital and trades her frozen supply of bottles for
empty ones.
"They just gladly accept whatever extra you have," she said.
Some, though, worry that donors may be misled in the process.
"My big issue is that mothers are not being told that their milk is
being sold for such a high amount," said Katy Lebbing of La Leche
League International, which promotes breast-feeding. At $43 an ounce,
it could cost more than $1,000 a day to feed a 10-pound baby with
Prolacta -- 10 times the amount charged by nonprofits. "If you just do
that math, that's quite a difference in money."
But Dundek said she tells potential donors they have options,
including a nonprofit milk bank in Denver.
"We say if you're not comfortable with doing it this way, here's the
contact information for Denver," she said. "Then it's up to those
women."
Maura Lerner • 612-673-7384 • [log in to unmask]
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