Dear all:

I always remember the horrendous logistics of iron supplements which did not require a cold chain.  Unlike vitamin A supplements that could be delivered once every six months at an immunization day event where you already had an infrastructure in place, iron supplements needed to be distributed to women at a health center throughout their pregnancy.  So, if you talked about the number of iron tablets, you might be under the impression that many more women were being reached than is the case.   If a woman took iron tablets for six months of her pregnancy -- it would be around 183 tablets.  Bottles of breastmilk pose the same problem.

So, I did my own calculations of how many infants would be served by the 65,000 bottles or 267,682 ounces, that IMBP claims was delivered to Africa by Prolacta.  Initially, this sounds like a lot.  I calculated this in two ways - assuming that babies take 8 bottles per day or assuming that they drink an average of 30 ounces per day.  I'll give the "by bottle" calculation method the symbol B and the "by ounce" calculation method O.

So, you could feed either 8,125 [B] or 8,922 [O] babies for one day with that milk.  Or to round off, less than 9,000 babies.

You could feed 271 [B] or 297 [O] babies for one month. Or to round off, less than 300 babies.

But... babies need to drink milk for six months exclusively so, 

You could only feed 45 [B] or 49 [O] babies exclusively for six months. Or to round off, less than 50 babies.

We all know, however, that babies should continue to consume mother's milk for 24 months.  So, that means, that even fewer babies would receive breastmilk for the entire recommended period.  

Typically when you are comparing interventions, you do a cost-effectiveness analysis based on ALL the real costs of delivering the intervention compared to the number of recipients from that intervention.  I remember DHL deliveries without a cold chain costing $100s of dollars.  So if you think the cost of the Human Milk Banks of North America is high at $3/ounce, imagine how much more it costs to ship milk internationally.

Then, if you look at the claim (link: http://www.breastmilkproject.org/hiw_donationdiagram.php
) that Prolacta WILL start providing $1 per ounce of the milk

I took the number of ounces shipped to Africa so far --and because Prolacta states that they will keep 75% in the US, the amount of ounces they would have collected so far would be three times higher -- or 803,046 ounces.  When I was Director of Nutritional Programs at Helen Keller International I would say that would be a reasonable operating budget for a small country office for projects that reached millions of beneficiairies -- or more intensive projects that reached about 100,000 beneficiaries.  

Linda, have you received the $803,046 dollars for the in-country build up of the local donor milk banks?

Best regards, Susan Burger

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