Thank you, Lara, for this. I don't think that anyone on this list is
suggesting that formula is better than or equivalent to human milk in a
purely scientific model - babies who don't breastfeed are in a deficit
situation to begin with. But mothers don't just look at that when making
decisions for their families. They may be looking at what is the greatest
risk to the entire family at this time and how do I reduce that risk?

We all weigh risk vs benefit all the time, for ourselves and our children.
Horseback-riding is a very dangerous sport. And yet we bought our daughter
a horse and she galloped around and flew over jumps. She fell off horses
more than once and even ended up with a concussion one time (while using a
helmet.) I myself ended up in the hospital twice with nasty horse-related
injuries. Some people would call that irresponsible - there is no
compelling reason for her (or I) to be riding horses. But that was a choice
that we made. We let our kids ride bikes, ski, swim, snowboard, do
gymnastics -  and everyone applauds them for being daring and athletic and
we weep for them when some end up badly injured or even in an early grave,
but we don't usually blame the mothers for letting them do these dangerous
things. But if the same mother gives her baby formula, some would take her
to task for being irresponsible and some would even accuse her of child
abuse. We say we don't like the "mommy wars," yet I have seen them far too
often. For many outside of the lactation bubble that we all live in, so
much of this just doesn't make sense, based on their own personal
experiences. We need to be careful how we present our message about the
value of human milk.

As far as comparing blood banks to milk banks, that just doesn't hold up.
Blood donation is open to men and women, young and old. Yes, there is
testing and requirements, but once you become a qualified donor, you tend
to come back again and again, for many years, sometimes for your whole
life. Donating blood once every two months takes about 45 minutes. Donating
enough milk to replace all the formula being used right now would
necessitate many, many mothers to be pumping milk for many hours in
addition to feeding their own babies. I don't really see that happening.
Also, blood costs a lot of money, hundreds of dollars for each pint. Are
folks really going to be able to pay that much for human milk? I would
rather just concentrate on helping moms breastfeed their own babies and,
quite honestly, look to local volunteer milk-sharing if more is needed. Is
there risk in that? Yes, but less risk, I believe, than in feeding formula
if someone takes reasonable precautions.

Yes, there is a lot of research out there supporting the value of human
milk and the risks of formula, most strikingly for preterm infants as they
are the most fragile and unable to cope with assaults on their tiny bodies.
Something to consider. There may come a time when there is not a huge
statistical difference between health outcomes for breastfed babies vs
those who are partially or completely formula-fed. Live by the research,
die by the research - moms may do a risk analysis and decide that, all
things considered, formula feeding is a risk they are willing to live
with.  We may understand that human milk is the gold standard, but what
most people see is that standards are changing all the time.

So I go back to the point that what may seem glaringly obvious to some
makes no sense to others. More mothers will breastfeed when they are
convinced that there is a definite downside for their children and even
themselves if they do not, and not just related to health. More women will
breastfeed when they see it fitting easily into their lives, whether they
stay at home with their children or have separation on a regular basis.
More women will breastfeed when they can do so comfortably, in private or
in public. More women will breastfeed when they can get to the point where
it just feels so good and so right and so much a part of being a mother.
My job is to support them and help them get to a place where this all makes
sense. And that is why I don't tell them that formula is poison or swoon
when I see them feeding fruit-loops to their toddlers. I do offer education
and help them to evaluate the choices that are available to them. It is
about normalcy and trying to do something simple and sane and "human" in an
increasingly crazy and inhumane world. I don't think that any of us
disagree about that and it doesn't have anything to do with research.

Off to bed.
Sharon Knorr, IBCLC, Colorado



On Tue, May 15, 2012 at 12:45 AM, Lara <[log in to unmask]> wrote:

> Kim Ann Lorber <[log in to unmask]> wrote:
>
> > > "I just don't see how it can possibly be valid to assume, in the
>  absence
> > > of considerably more research into the matter, that donor milk must
>  be so
> > > far superior to formula that we should be going to any lengths to
>  provide
> > > it instead."
> >
> > I would also have to say "oh geez" to parts of this conversation that has
> > been going on! How can we possibly think that modified COWS MILK is
> better
> > for  HUMAN infants than donor HUMAN MILK??? (Yes, I am yelling!) Can't
> > believe I have  gotten so worked up over something on Lactnet! What you
> > seem to be asking for is like asking for research to prove breastfeeding
> > is better than  formula. Again I say--  Why would modified COWS MILK be
> > better for HUMAN infants than donor HUMAN MILK??? Would we also say
> > MODIFIED HUMAN MILK is better for BABY COWS than DONOR COW MILK???
> > questions?
>
> For me, the key phrase is "going to any lengths".
>
>  For individuals making decisions in this world (not an ideal world
> where donor milk is free and plentiful), a number of factors come into
> play. Fifteen to eighteen dollars buys a whole can of formula (maybe a
> week's supply) (if no subsidy available), or a single feed of milk bank
> milk (if no insurance reimbursement, which I gather is very heavily
> restricted and only approved for limited time periods when available).
> Parents with a healthy term infant who have none of their own breastmilk
> available may do their sums and find that the cost of providing milk
> bank milk to age 12 months would mean separation from a baby many months
> earlier than would otherwise be the case. Or for some parents, it could
> mean not being able to feed/shelter the rest of their family at all.
>
> Lara Hopkins
>
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