I’ve given this a lot of thought. The International Breast Milk Project is a project that sends breast milk to feed starving HIV+ orphans in South Africa. It was founded by Jill Youse, a lactating mother who had gallons of surplus breast milk she’d pumped for her daughter. She wanted to do something good with the milk, so she found an orphanage in South Africa called iThemba Lethu which houses children with HIV/Aids, got some money together for shipping, and started donating her breast milk to them. She told her friends and family and they chipped in to help. This was in April of 2006. Now the International Breast Milk Project hopes to donate thousands of ounces every year to needy HIV positive African orphans. Sounds really good, right?

However.

There are details I’ve become aware of (this blogger helped uncover some facts and effected enough change to get straighter answers out of IBMP’s FAQ page) and other things I’ve thought of since first reading about it that have given me pause.

It costs a lot of money to ship, well, anything, to Africa from the USA. Shipping milk is especially expensive because it is so heavy and because a fairly large amount gets consumed by each baby very quickly (about a liter per day per baby). One woman and her family and friends alone wasn’t going to cut it. From everything I’ve read, she turned to non-profit milk banks for help processing the milk (pasteurizing, testing, re-freezing, shipping, etc.) and they refused, probably because processing and shipping the milk is so expensive, and because there are so many needy babies right here in the USA that could use donor breast milk. Also, they just don’t have the monetary resources for such an endeavor.

Since the non-profit milk banks couldn’t help her (probably too much red tape for such a project anyway), she sought help elsewhere. Prolacta Bioscience, a for-profit milk processing entity, offered to process the milk for free. With the support of Prolacta, now the project could get underway. Somehow Oprah found out about what was happening (I wonder how…Was this the plan from the beginning? Donate to Africa so that Oprah would want to showcase the project?), and Jill Youse’s efforts were recognized on her show.

Then the Oprah effect took place: suddenly Prolacta…, I mean, The International Breast Milk Project, was literally flooded with breast milk donations. It’s estimated that over 50,000 ounces of breast milk were donated, with the intent that it would all go to needy HIV-positive orphaned African babies.

All of that donated milk, according to the International Breast Milk Project website, ended up being donated to Africa. But after May 31, 2007, only 25% of what is donated to the International Breast Milk Project goes to Africa. The other 75% of donated breast milk goes straight to Prolacta Bioscience, who then resells for a profit it to NICUs here in the USA as human milk fortifier.

On the IBMP’s FAQ page, it states that Prolacta does not sell human milk fortifier by the ounce, so it’s hard to get a price for it. I called up a local NICU here in Texas and tried to find out what the price for Prolacta Bioscience was. I was told, “I’m very sorry but I’m not allowed to give out that information.” I asked, “What kind of information?” The clerk’s answer, “Any information.” Huh? I’m pretty sure asking about the price of human milk fortifiers used by the hospital doesn’t violate any HIPAA regulations, but whatever. Maybe their legal team advised them not to divulge anything out of fear of being sued. Typical.

Undeterred, I then phoned a pediatrician friend of mine who’s done quite a bit of work in NICUs. He told me that for some preemies who are fed breast milk, sometimes fortifiers (bovine milk-based) are added to the breast milk to boost its calories. He said the two biggest manufacturers of breast milk fortifiers are Similac and Enfamil. He also mentioned that Similac and Enfamil donate large amounts of their products (formula and fortifiers) to hospitals, so that’s usually what the hospitals use when fortifiers are called for. He had never heard of Prolacta Bioscience.

After talking to him, I was even more confused. What’s better, to have two powerful formula companies maintain control over the nation’s (the world’s?) hospitals, thereby standing in the way of baby-friendly initiatives and perpetuating the bottle-feeding culture? Or is it better to allow Prolacta Bioscience to take advantage of the charity of generous lactating mothers in order to try and take over the human-milk-fortifier market? Ye-gads, I’m not sure there’s an easy answer to any of this.

I never found out what the price of the human milk fortifier Prolacta sells was, but I’ll keep looking.

Something struck me, though, as I was perusing the FAQ page for the International Breast Milk Project. It mentioned that for the 75% of donated milk that Prolacta gets to keep, Prolacta pays the International Breast Milk Project $1 per ounce. (The money gets used by the IBMP to fund breast milk banks in Africa, which is in the long-run a lot more cost-effective than shipping milk from the USA to Africa.) What occurred to me as I was reading this was, why doesn’t Prolacta pay the donors $1/ounce? Wouldn’t it be a lot cleaner for them, image-wise? They wouldn’t have to hide behind a charity to try to legitimize their business this way. Just be up-front and tell women, “We’ll give you $1 for every ounce of breast milk you donate to our company.” Prolacta already sets up all prospective donors with a free hospital-grade pump, at-home blood testing, free shipping for the milk, DNA testing for the milk received and each mother who donates (to make sure what they’re donating is actually human milk and not cow milk poured into Lansinoh bags, among other safeguards). Prolacta is already paying $1 for every ounce received from the International Breast Milk Project. Why not give it directly to the women who donate? It seems more fair that way; they’re the ones doing all the hard work. Perhaps they should keep both options open: one for the women who would like some of their milk and efforts go to help African orphans, and the other for women who need the extra cash. This could be a win-win, with a little tweaking (like maybe making 100% of what’s donated to the IBMP go to Africa, for example). Perhaps if a member of Prolacta’s executive team gets wind of this idea, maybe it’ll come to fruition.

Another item of interest: my pediatrician friend went over the information provided by Prolacta for the human milk fortifier made from 100% human milk. He said it seemed like the osmolality of their human milk fortifier was a little high to be safe. Translation: the concentrated human milk seems a little too concentrated, which could potentially cause problems like dehydration or renal failure or worse, like depletion of the free water in the baby’s blood causing really bad things like swelling of the brain and brain damage. (Makes me wonder how safe the formula-company-made milk fortifiers are…) He also noted that there weren’t any clinical trials of Prolacta’s product in use that he could find, which further made him suspicious of recommending it for any of his patients. Hmmm… Seems like this human milk fortifier made out of 100% human milk, while it sounds like a great idea to the uninitiated, might need a few more years of research.

Important note: Although what I’ve written may make it sound like I don’t agree with the International Breast Milk Project, I have to admit that even 25% of what’s donated to the IBMP going to Africa is still better than 0%. Without Jill Youse’s idea, ZERO babies in Africa would be benefiting from this. I’m not blogging about all this to give Jill Youse a hard time. I think her original idea of sending breast milk to Africa is a commendable one. I do think it’s important to bring up these questions, though, especially for those who would want to become donors to the project.

Personally, if I had a large stash of milk to donate, I’d probably find someone right here in my hometown, a local mom, who could use it for her baby. It’s a lot more cost-effective, I’d know exactly where my donation was going, and while it’s admirable to look out for babies halfway around the world, there are babies right here who need breast milk too. I know first-hand the heartache of not being able to provide all the breast milk my baby needs, and I also know the profound, down-on-my-knees gratitude I’ve felt at receiving donated milk for my daughter. To ease even one mother’s suffering – I don’t think I’d be able to pass up that opportunity.

To donate breast milk locally: http://milkshare.birthingforlife.com/. Milkshare is an online service that can hook up women who need breast milk for their babies with those who have a surplus of it. Please read up on the risks and benefits of receiving raw breast milk on the MilkShare site before signing up as a recipient. (Breast milk donors can sign up free, but breast milk recipients must pay $15 for the service – an absolute bargain, if you ask me.)

This entry was posted on Sunday, July 1st, 2007 at 6:52 pm and is filed under Oprah, National Milk Bank, Milk Banks, For-Profit, Non-Profit, Prolacta, Africa, International Breast Milk Project. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.