Anne,
I will attempt to answer your questions.

>It would seem that there is costly duplication of precautions, which
>may be serving to keep the cost of banked milk so high (one of my
>peeves
>is that at >$2.00 per ounce, if one doesn't have just the right
>insurance,
>who the heck can afford banked milk?)

I will once again state that no infant in need of human milk is denied
milk because of inability to pay.  It is important to try and understand
the mechanics of processing and distributing donor milk.  We must screen
and pasteurize for safety reasons.  It is hard enough to get medicine to
accept donor human milk as a choice.  It must be safe.  We do everything
possible to make it safe.  We have never had a problem with donor milk
and we want to keep it that way.  We must do what our (HMBANA) guidelines
recommend in order to be considered reputable.  We help many babies and I
can tell you that we do not make money. Someone has to do the work.  The
screening, collecting and heat treating all take time and people.  We
lose money most of the time and that is because we do not refuse to give
milk to anyone in need.  Think of what it cost for someone to receive a
pint of blood and compare that to what it cost for banked milk.

>If, on the otherhand, screening _and_ pasteurization are both absolute
>musts because pasteurization _doesn't_ kill everything bad - then just
>how safe is the screening?  Asking alone isn't going to be failsafe,
>as
>some women may not know of their own compromised health - some may
>even lie.

This is exactly the reason that we do a blood test.  We pay for the
testing.  The donor does not.  Again a cost that is incurred to assure
the safety of the milk.  We do NOT charge for the milk.  We charge a
processing fee
.
>I guess what I'm asking is - does screening alone ensure a safe
>supply?
>If so, why pasteurize?  Of course, I think that the answer is "no",
>and that
>is why we pasteurize.  But then, does pasteurization alone ensure a
>safe
>supply?

The verbal and written screening alone do not ensure safety.  Again the
blood test is necessary.  We also culture the milk post pasteurization
for bacteria.  Milk is not distributed unless the culture is negative.

I hope this helps.

Darlene Breed
Milk Bank & Breastfeeding Center
Worcester, MA



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