Apropos of the subjects of donor milk, and cost to process, and also
the matter of HIV transmission through breastmilk - it occurred to me
to wonder about whether pasteurization kills _everything_ about which
we would be concerned in breastmilk.  If it does - then (aside from
being understandably overly cautious) why do we screen so stridently?
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?)

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.

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?  If so, then why the costly screening as well?  Is there some
place for a streamlined process which is just as safe, but less costly?

For that matter, is home pasteurization _that_ difficult?  I thought that
it was being advocated in Africa, yet one of the big arguments for only
using banks is that only the bank can ensure proper pasteurization.  I realize
that control is a problem - I'm not advocating that people start cooking
their own milk..I'm just thinking outloud here, wondering about the process
and frustrated by the costs.


Anne

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