Hi Christine,
"EBM" stands for "expressed breastmilk" and the term doesn't differentiate
between the same milk when it is fresh (raw), or after it has been
refrigerated or frozen, or after it has been pasteurised.
I take your point that pasteurisation is a form of processing, but it
doesn't create a "formula". I'm a bit puzzled about what you mean is my
definition. So I'll explain. A formula is (literally) a *recipe*, in which
changes are made to the major and minor components. My definition is that a
"formula" is a "recipe" - and in a recipe there is more than one ingredient.
In the case of artificial baby milks, their manufacture involves using a
formula (recipe) to modify the proteins (e.g. reducing size of curd),
changes to the sugars with different ones added, and removal of some fats
and replacement with other fats. This doesn't happen when EBM is
pasteurised and so it isn't a "formula" - whether the word is used as
meaning "recipe" or the product made from the recipe.
In an ideal world, babies would always receive raw milk from their mothers
or another healthy, disease-free woman or women. As donor milk today
usually comes from strangers, screening programs and pasteurisation have
been set as the standard to prevent contaminated milk (e.g. staph overload,
viruses) from going to a baby. You have mentioned that there are various
studies about the reduction in particular components and the useful
percentage which remains after pasteurisation. (If anyone wants to look at
these, they can be found on Medline or PubMed databases.
Perhaps some day there will be studies such as the ones you have suggested,
comparing long-term outcomes of raw milk vs pasteurised mother's milk
(remembering that there are no protective mechanisms at all in artificial
baby milk). Such studies would be very difficult to design, however, because
of a multiplicity of factors, such as duration of the intervention (often
very short), what milk was given after that and for how long, and lifestyle
factors in childhood and adolescence.
(This is probably a digression, discussing cow's milk, but I'm responding to
your comments.) I appreciate your family's difficulties with bovine milk,
though I'm not sure how taking it unpasteurised would be better for them,
unless it is mainly a matter of taste. Cow's milk proteins are still cow's
milk proteins. I don't know what effect homogenisation has on bovine milk,
other than taste. (Sorry, I am not sure what it tastes like as I have to
avoid cow's milk because of distressing symptoms.) I do sometimes buy UHT
(ultra heat treated) goat's milk - and yes, it tastes vile, and not like the
pasteurised goat's milk that isn't UHT, which tastes just fine.)
Pasteurisation of cow's milk and other dairy products was gradually
introduced to protect against bovine tuberculosis (TB) in humans, which was
the main concern, though not the only one. It went hand in hand with
culling of infected cows, inspection of dairies, transport regulations, and
other measures. (In humans, bovine TB usually affects other organs, rather
than the lungs.) TB eradication programs have been effective, but there is
always the risk that they have missed remote or isolated areas. This is why
we don't hear of babies and others contracting TB from dairy products - i.e.
because of these measures, backed up by pasteurisation. Improving the safety
of dairy products unfortunately didn't halt the decline in breastfeeding in
the early-20th century, as mothers and their advisors (lay or professional)
gained confidence in the safety of animal milk.
Sorry, this is a long post.
Virginia
In Brisbane, where it is still very hot and steamy.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
On 9 Mar 2010 Christine Bussman wrote:
Virginia Thorley wrote:
> Christine B. wrote: "My own (unconsidered) opinion has been that
> pasteurized breast milk is basically the very best 'formula'."
>
> No, breastmilk, expressed or otherwise, is definitely NOT the "best"
> formula. For a start, it is not a "formula". A "formula" (or recipe)
> is subject to human error at every stage of its manufacture, whether
> in the factory or the kitchen. This error can be through measurement
> inaccuracies (about which there are numerous studies) and through
> contamination. Even before the measurement is done, there is the
> assumption that mixing up bottles to the same recipe, at any time of
> day, based on age or weight, is what babies need.
>
I'm sorry, but by your definition I would say that _pasteurized_ breast milk
is formula. The pasteurization is a 'manufacturing process' and there could
easily be mistakes in temperature or time measurement.
Also, this is the first time that I have heard the term 'ebm' used to refer
to pasteurized breast milk. This is a place where I would suggest that we
need to be careful, because we don't know what changes have been made. Yes,
several people have pointed out helpful studies that show that particular
components are not greatly affected, but no one posted a study comparing
long term health effects of the use of pasteurized breast milk as opposed to
breast milk in its natural state.
I think that we're running into a difference in presuppositions in this
whole discussion. Most seem to assume that pasteurization is a relatively
minor change. From my family's experience, even the type of pasteurization
can make noticeable differences in cow's milk. My family consumes quite a
bit of dairy, but I refuse to buy UHT/ultra-pasteurized dairy because it
usually tastes aweful and sometimes makes family members ill. I would buy
unpasteurized dairy for my family if I could find a safe and reasonably
convenient source. This experience makes me much more suspicious about the
pasteurization of breast milk.
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