I thought this might be of interest to those of you who care about full disclosure from non-profit organizations like the International Breast Milk Project. From the IBMP website (excerpt from a letter by Jill Youse):

“IBMP will publish quarterly donation reports on our website www.breastmilkproject.org, so you can track the ounces coming in and the funding going out. You will know that 100% of your milk is making a difference in the lives of babies orphaned by HIV in Africa.”

The letter is not dated, but it was written on or before June 3, 2007 because the same letter showed up on a thread in MotheringDotCommune’s message board, written by a user called “Jill Youse” on that date (you may need to log in to see it).

This got me thinking… If I could predict what that first quarterly report will contain, I know it will have to include that the IBMP started with at least a 55,000-ounce stockpile of breast milk (on May 31, 2007), and about 5,300 ounces of that were donated to iThemba Lethu in May 2007. Then the IBMP spent less than $2,000 to pay for two milk banks in an unspecified country in Africa (Cameroon? South Africa?). After that, there are no other milk donations to iThemba Lethu (I called and asked iThemba Lethu myself) nor to any other place in Africa (the “About Us” IBMP page doesn’t say they donated any other milk anywhere else either, and I’m sure if the IBMP had donated any other milk, they would have mentioned it by now).

I have no idea how much milk, if any, has been donated to the IBMP after May 31, 2007 from its generous donors, and the only ones who know the answer to that are the IBMP and Prolacta. This is one reason why I’m waiting for that quarterly report. It would be nice to know how much milk is being donated from the donors to the IBMP, how much milk is being sent to Africa from the IBMP, and how much milk Prolacta gets to buy from the IBMP for $1/ounce. And when I say I’d like to know how much milk, I don’t mean in the form of a percentage. I mean actual amounts. Surely this is being kept track of, so that the International Breast Milk Project can know exactly how much to send to Africa and how much money to collect from Prolacta. Hopefully that information will be shared with the public. Soon.

If you donated to the International Breast Milk Project around or after May 31, 2007, keep track of how many ounces you donated/are donating. Add it up and when the IBMP’s quarterly report comes out, see if your donation was a significant proportion of the total. Wouldn’t that be an interesting exercise?

Oh, one last thing before I finish…I found a curious thing, and I want to share it with you. Recently I visited this site and clicked where it said, “Africa Photo Gallery.” Awwww. Aren’t those kids cute? I wonder where they’re from? Where in Africa are they? It doesn’t say.

Happily, I think I figured it out.

On the IBMP FAQ page is this:

23. What will the dollar per ounce contribution from Prolacta to IBMP be used for? o This past year we have partnered with the Lewa Children’s Home Eldoret Kenya to bring clean water and healthcare to children orphaned by disease and poverty. We will help fund a healthcare clinic that will break ground in late 2007 or early 2008. We will be shipping the milk to Eldoret and exploring the possibilities of local milk donations. 100% of the dollar per ounce will go directly to aid the Lewa Children’s Home and healthcare clinic. Click here to view the photo album of the home.

Unfortunately, the above link won’t work if you click it from here, but it will work if you click it from the IBMP FAQ page (as of the date of this post). Go ahead, try it, but remember to come back here. Go to the IBMP FAQ page, scroll down until you reach #23, and click on the link. Did you click on the link to see the photo album of the home? Those children are really precious, aren’t they? Makes you just want to cry, doesn’t it, the way the Lennon classic is juxtaposed with images of the innocent, smiling orphans…

Wait, aren’t those the same kids? With the same music? What are the chances of that?

Well, regardless, it’s really great that the IBMP will be funding a healthcare clinic for the Lewa Children’s Home Eldoret Kenya. Since the pictures are on two websites, it appears as though the home is not only getting support from the IBMP but from Run for Africa as well! Well, good for them. I hope they are; why else would the pictures be on both websites if that weren’t the case?

Ooh! Bonus for the Lewa Children’s Home! According to the letter by Jill Youse:

Prolacta has also agreed to donate $1 to International Breast Milk Project for every ounce of donated milk that stays in the U.S. Based on current donations, IMBP will receive $50,000 - $75,000 each year, ensuring a sustainable, steady source of funds to build critically needed healthcare clinics for babies orphaned by poverty and disease in Africa, and will provide a vehicle to help local moms donate milk. 100% of every dollar that each ounce of milk provides will go directly to supporting babies orphaned by HIV in Africa.

Thank goodness for that. Now all we have to do is wait for the quarterly report to confirm that the IBMP has received around $12,500-18,750 from Prolacta for this quarter, ALL (100%) of which should go “directly to aid the Lewa Children’s Home and healthcare clinic.” I’ll bet the Lewa Children’s Home in Kenya could sure use that money. I, for one, want to see that those kids get the money promised to them. Wow, just imagine what 100% of $50,000 (the low end of the estimate given by IBMP) could do for that orphanage in one year!

I don’t know about you, but I’m eager to read that quarterly report confirming that all of these wonderful things are taking place. I wonder when it’s coming out?

Oh, this is sad. I hate to be the bearer of bad news, but it is newsworthy. My aim in informing the world of things related to breastfeeding is in the hopes of effecting a positive change, not to bring anybody down.

But still. It’s very tragic.

According to a new report, the push by some groups to encourage HIV+ mothers in Africa to eschew breastfeeding for formula in the effort to reduce HIV transmission to their babies has backfired miserably. According to the report, the risk of a baby dying from being formula-fed in many parts of Africa is much higher than the miniscule risk of acquiring HIV from their mothers’ milk, had they been breastfed. Breastfeeding, even if it’s from an HIV+ mother, provides immunities and protection to the baby that formula cannot replicate. Moreover, improperly prepared formula in unsanitary conditions often leads to diarrhea, a common cause of death in many parts of rural Africa.

Thank you to Jennifer James of The Black Breastfeeding Blog for providing the link.

Unfortunately, it’s taking a long time for mainstream ideologies to catch up with what researchers in South Africa, like Anna Coutsoudis, have suspected for years: that exclusive breastfeeding is better for babies born to HIV+ mothers in rural Africa than formula. Coutsoudis, the South African hero responsible for creating the iThemba Lethu milk bank in 2001, is a professor of pediatrics and child health at the University of KwaZulu-Natal in Durban and has been involved in pediatric HIV research for over a decade. She has also been a prominent breastfeeding supporter and advocate for baby-friendly hospital policies. Additionally, she has helped to create educational programs to increase awareness of sustainable home pasteurization of breast milk for women who are HIV+, in an effort to increase the waning breastfeeding rate in South Africa.

Ahh, feels good to end on a positive note. It’s a great way to begin World Breastfeeding Week, which starts tomorrow, August 1, and finishes August 7. However, it’s important to note that for many families, every week is Breastfeeding Week.

Edited to add: All of the donations from purchases made in the store for the month of August will go to La Leche League International.

Since I’ve started this site, I’ve received many emails and messages thanking me for helping to expose what Prolacta is doing. I remember when I started doing my research, I read a few posts by other bloggers, and I thought what they were doing was really necessary. I was so grateful for their pursuit of the truth. The more I read, however, the more I wanted more information.

I kept looking, but the internet could only give me so much. I remember so many articles and sites, even Salon, a highly respected news website, quoted Prolacta’s price for human milk fortifier, as “about $35-$40,” (I issued a correction, which was printed in the comments section), but no matter where I looked, I couldn’t get an exact quote anywhere. This is why I started making phone calls. I didn’t want some ambiguous estimate; I wanted to know exactly how much they were charging.

That’s when I called Prolacta, found out their price for human milk fortifier was $184.83/ounce, and became the first person on the internet to write about it. I then called the National Milk Bank to see how they were affiliated with Prolacta, and found out they sold all their milk for $1/ounce to Prolacta. Even though they call themselves a “milk bank,” they do not actually distribute any breast milk to needy babies themselves. They’re essentially just a sugar-coated funnel for acquiring Prolacta’s raw material.

I then called iThemba Lethu, the orphanage in South Africa that the International Breast Milk Project donates to, and found out it only houses six children and has its own in-house milk bank (established 2001), which essentially makes the International Breast Milk Project an enormous waste of time and resources (which, other bloggers already had pointed out, would have been the case anyway since it costs so damn much to ship anything that far, let alone frozen milk). I found out that, as of this date, the IBMP has only sent Africa a little over 5,000 ounces of breast milk (all to iThemba Lethu), after they promised they’d send 55,000 ounces PLUS 25% of what was collected after May 31, 2007 (and in my opinion, it’s not very likely the IBMP will finish sending even just the 55,000 ounces by year’s end, allowing them to collect even more donations in the interim).

The Lactivist was the one, along with some other curious souls, that got Prolacta, I mean, the IBMP, to admit that they were only going to send 25% of the milk donations collected after May 31, 2007 to Africa, even though nobody ever mentioned any of this when they were showcased on Oprah. Lauredhel astutely noted in a recent post that the new president of the California chapter of The International Breast Milk Project, April Brown, is none other than Prolacta CEO Elena Medo’s daughter. (I’d actually missed that tidbit when I first read the OC Register article, so thank you, Lauredhel, for pointing it out!)

On the MilkShare Yahoo group, someone posted a link to my site and the Lactivist’s to try to warn potential donors not to fall for these scams. Since that post was made, I’ve received even more mail.

One letter in particular caught my eye, and I want to share it with you.

The email is from Betty (name changed), a woman who donated to the National Milk Bank. She says she was never told her milk would be sold for a profit, or even sold at all. She writes me:

I wish I could find others who have actually gone through this… This really actually hurts me. I didn’t bargain for this. My heart is still sick. I don’t know what to do. I feel very betrayed. All they had to do was provide disclosure…then I would have NOT chosen them…But instead, they gave ‘just enough’ information to get me interested. I should have known it was all too good to be true….*sigh* oh well…I have a pump and endless supply of bottles now. I guess that’s supposed to help me feel better.

The whole reason I picked the National Milk Bank and not a HMBANA bank is because I didn’t WANT the mothers to have to pay for the milk and one of the lovely ladies at NMB assured me that it was as a prescription in the NICU so it was covered completely. …

I know there’s problems inherent with ANY organization, but I just wish there was full-disclosure. I’m VERY into informed consent, and there is NO WAY IN HELL I would have donated had I known they would alter my milk other than pasteurizing it and NO WAY IN HELL I would have donated if I had ANY inkling (my biggest nightmare now) that they were turning my milk into Human Milk Fortifier. If I wanted someone to make a profit, I’d sell it myself.

Betty also shared with me an email she got from the National Milk Bank after she and her husband started making inquiries about what happened to her donated milk and how the National Milk Bank operates. As you read, notice how the writer, a National Milk Bank employee, evades revealing too much truth. My comments are in [brackets]:

Hi Betty,
We received a message from your husband earlier today and wanted to get back to you, but [insert some generic excuse here for why they screened Betty’s husband’s call and didn’t return it].

Prolacta Bioscience is who we work with and where the milk goes, once it has been donated. [Notice the use of the words “who we work with,” not “who we sell our donated milk to.” Often, those selling their milk to Prolacta will say that they are “partnering” with Prolacta, or some other garbage term that disingenuously represents what they’re actually doing.]

Once there, [what followed this was essentially a three-sentence advertisement for Prolacta human milk fortifier. *yawn*].

Another thing I would like to share with you is that in order for the babies to receive the milk, they must have a prescription from their NICU doctor. No prescription equals no milk. [Five more sentences of utter rubbish not relevant to anything at all.]

In answer to your concern, we do not sell our milk to the public. [Here they should have added, “We sell it to Prolacta for $1/ounce.”]

However, we do receive a profit, and the small profit we receive allows us to cater to our moms the way we do. [What?! They’re a for-profit entity? Just like Prolacta? *Break to check nationalmilkbank.com* Yup, nowhere on the website does it say it is a non-profit anymore. Funny that. I will update my links page now.]

We are able to supply our moms with …[Spare me your sales pitch. What you should be writing is “our donors supply us with our paycheck.”]

In addition, we are not established under a hospital or a medical office which makes it very difficult to claim non profit due to the guidelines and strict adherences to follow under government regulations. [Or, to put it more succinctly, “we make a profit off the milk donations we receive by appearing to look like a non-profit, but actually, we’re not.”]

If we can answer any other questions or concerns, please email or call us at 866-522-6455. Thank you and have a blessed day. [Nice touch. I’ll bet that last sentence alone is enough to make your donors forget they were conned.]

[Name removed]
National Milk Bank

If you’ve had a similar experience with Prolacta, The National Milk Bank, the International Breast Milk Project, or a midwifery/birth center, please post a comment or write me privately. With your permission, I’ll post it here.

Remember how I talked incessantly about the International Breast Milk Project? And then I talked some more? Well, I’m not done talking.

Here’s the summary of what I’m about to say: the 55,000 ounces of breast milk the IBMP promised to send to Africa? They haven’t been sent yet.

Want to know how I know?

It all started when a reader commented on my blog. MaryJaneLouise wrote:

From the IBMP’s website:“To date, we have collected nearly 55,000 ounces of breast milk.”

Sounds impressive, no? Well, divide by 25 ounces (low average daily consumption for a baby) and you get 2,200 baby-days of feeding. Still impressive. Divide by 365 days in a year, and you get…….. 6. 6 baby-years worth of donations.

Her math was right (except that she had to divide by six again because there are six children in the orphanage, which would have resulted in one year’s worth of donations), so, intrigued, I did a few calculations of my own using what I knew at the time. I answered her comment with this one:

That’s interesting… When I called iThemba Lethu, the director of the milk bank, Penny Reimers, told me that a shipment from Prolacta lasted them about four months. She said the last shipment was the 55,000 ounce one, and she also mentioned that it took four months to finish it even including the South African milk donations…She told me each child drank about a liter of milk a day, so roughly 34 ounces each child/day. Multiply by six and you get 204 ounces per day consumed by the whole orphanage. Take 55,000 ounces, divide by 204 ounces/day and you get 269 days, which is almost nine months.I don’t see how they could drink 55,000 ounces in four months, especially with the extra donations coming from their local bank. I didn’t think much of it until you mentioned this. Maybe she estimated wrong and each child is drinking two liters a day instead of one? Then the numbers she gave me would make sense. Still, that’s an awful lot of milk for one baby to be drinking.

Something’s not adding up… Maybe some of the milk is being stolen?

Also, Mary Jane, Prolacta’s last shipment of 55,000 ounces was a lot but it’s an anomaly. On the IBMP page, they mention that their next shipment will be 5300 ounces in late April: http://www.breastmilkproject.org/about_us.php. Late April has come and gone and that shipment hasn’t gotten there yet, at least according to the director of the iThemba Lethu milk bank (I called very early this morning to interview her). Anyway, if iThemba Lethu goes through 55,000 ounces in four months for six kids, then 5300 ounces will last them about a tenth as long.

None of this is to take away from the fact that Penny Reimers expressed nothing but complete gratitude toward Jill Youse and Prolacta, as I would if I were in her situation. However: everything I’ve written, I stand by.

I was not satisfied with this, though. I wanted to know why there was such a large discrepancy between what was reported and what I had calculated.

So I called South Africa again, this morning. Penny Reimers, director of the iThemba Lethu milk bank, is the person I spoke to. She is a very kind and gentle soul and had nothing but positive things to say about the project. It was an absolute pleasure to talk to her, and I have nothing but admiration for the work she does in the iThemba Lethu milk bank and with the kids in her care.

Here’s what I learned from our conversation:

• iThemba Lethu has received a total of four shipments, including the one Jill Youse sent to Africa with Penny’s husband while he was on a business trip to the U.S.A. This first shipment was raw breast milk which the iThemba Lethu milk bank pasteurized in-house.
• In our last conversation, she’d told me the last shipment she got was the 55,000 ounce one, but she told me now she must have been mistaken because she doesn’t think in ounces. She thinks in liters. She was confused, checked her records and found out that actually the last shipment arrived on Mother’s Day, May 18th, and that it had 5,343 oz in it. This was the purported April 2006 shipment the IBMP talks about on its About page. So it had arrived! Good.
• She said this shipment of 5,343 ounces was so massive that she thought it was 55,000 ounces. Her words, “It filled three freezers-worth completely.”
• When I asked her how many freezers-worth the other two shipments from Prolacta filled, she said it was less, that it was more like two freezers-worth and change. In other words, the other two shipments were less than 5,343 ounces.

This explains the discrepancy. This explains why it is that such a small orphanage can go through the donated milk so quickly even when adding in the local donations. She clarified this for me and said each shipment lasted about 3-4 months’ worth, including local donations, and that not every child gets fed breast milk. It sounds like she’s managing her milk bank very efficiently, without much waste. The milk would be consumed faster if she fed every child milk, which she does not because she needs to ration it for the very needy cases.

Since the IBMP made their promise to send 55,000 ounces of donated breast milk, they have sent the one shipment of 5,343 ounces in May 2007. Their rate of shipments to Africa is about two shipments a year so far.

Why is it important to know all of this? Because the International Breast Milk Project got 55,000 ounces of donated milk because of Oprah. On Oprah’s show, it was stated that the donated milk would go to Africa, not 25% of it. The IBMP promised that all those 55,000 ounces would be sent to Africa, and that thereafter, 25% of what is donated would be sent. At the current rate and quantity that the IBMP is sending milk (an average of two shipments a year), it would take almost five years to send the originally promised 55,000 ounces to Africa. I don’t know if pasteurized frozen milk can sit for that long in a freezer without becoming freezer-burned, but I’m guessing no. One year, maybe. Five? No. I’m also guessing they’re not going to pro-rate the milk they receive after May 31, 2007 to make sure all 25% of what’s donated gets to Africa like they promised. This gives them a five year gap of slop which seems a little bit excessive to me.

From IBMP’s FAQ page (emphasis mine):

Will all of my milk be sent to Africa?

o Although our objective was to collect and send 10,000 ounces of milk, we had an unexpectedly incredible and overwhelming response: 55,000 ounces were collected through May 31, 2007. All 55,000 ounces of this breast milk collected through May 31, 2007 will be shipped to Africa for babies orphaned by HIV.

This is either a bald-faced LIE, or the milk the orphans will be getting will be very old by the time it arrives. The only other way their statement could remain true is if the IBMP either steps up its shipment frequency or shipment amount, by a lot. Keep in mind that any donation made now to the IBMP will be 75% straight to Prolacta and only 25% to Africa. Though by the looks of things, I don’t see how they’re going to ship all 55,000 ounces to Africa by the time one year is up. I think what they’re expecting is that people will forget all of this and assume all the 55,000 ounces have been donated. They haven’t been. I give the IBMP until May 31, 2008 to see if all 55,000 ounces have been donated. They’ve got plenty of time. We’ll see if it happens. Even so, it gives them a year’s head-start, in which they could collect 100% of all donations and keep them for Prolacta, and no one would ever be the wiser. Do the math yourself and see what you come up with. (Edited 7/26/2007)

I asked Penny Reimers if I could donate milk directly to iThemba Lethu instead of through the International Breast Milk Project, and she said that if I wanted to, I was certainly welcome to. If you want to donate milk to the iThemba Lethu breast milk bank directly, and you have the means, do so. Then you’ll know for certain all your milk will be used for at least one of the six orphans in iThemba Lethu. They have pasteurization capabilities in-house, so you can send the milk raw, as long as it is frozen when it arrives. Penny mentioned that DHL and FedEx and another courier donated their shipping services. Perhaps if you ask them, they’ll foot the bill for your personal donation as well.

If you are reading this in South Africa and have a stash of breast milk to donate, please consider donating to the iThemba Lethu milk bank. All local donations (given in South Africa directly to iThemba Lethu and not through IBMP) will go to help at least one of the six orphans at iThemba Lethu, and it will help keep your milk bank strong.

Personally, I’m a big advocate of local donation, wherever you are. On my links page is a plethora of articles and pages about milk banks around the world. If you are in North America, please remember that donating to a HMBANA milk bank is the only way you can be sure your milk will be distributed for no more than it costs to process it. As always, MilkShare is another option for those of you who would prefer to meet your recipients through informal milk donation. But make sure you meet them, because you never know where Prolacta might be hiding.

I thought I knew all there was to know about the International Breast Milk Project. Apparently, there’s more.

The International Breast Milk Project was a project created by Jill Youse to donate breast milk to HIV+ orphans in an orphanage in Africa named iThemba Lethu. On the IBMP’s “About” page, they state, “The International Breast Milk Project is the first organization in the world to provide donor breast milk from the United States to babies orphaned by disease and poverty. The first batch of donor milk arrived to the iThemba Lethu orphan home in April 2006.”

Upon reading this, you might get the impression that these African orphans would never receive breast milk if not for the valiant efforts of Jill Youse and the International Breast Milk Project.

That’s exactly what Prolacta wants you to think. The rest of the story may surprise you.

iThemba Lethu, the orphanage made world-famous by the hoopla surrounding the International Breast Milk Project, has received breast milk, donated from South African moms and pasteurized by their own South African breast milk bank, since August 2001. The bank was funded entirely by UNICEF, and the person who made this happen is a South African woman named Anna Coutsoudis. At times, the South African breast milk bank has even had more milk than the children needed.

Prolacta had nothing to do with this.

So why create the International Breast Milk Project in April 2006 at all? There was no dire need for it. The African orphans of iThemba Lethu were already receiving plenty of donated breast milk. They were thriving, not starving, like the International Breast Milk Project has implied. The South African milk bank didn’t need rescuing; it was tremendously successful all by itself, for almost five years before Jill Youse came along. The children were all getting the breast milk they needed, and pretty efficiently, too, with a local milk bank supplied by South African donors. A milk bank that often enough had more milk than the children needed. They didn’t need milk from the United States, though of course they weren’t going to turn it down.

Here’s another question. Why, instead of creating the International Breast Milk Project (which was totally unnecessary since the problem it addresses had already been solved), didn’t Jill Youse create the United States Breast Milk Project, whereby she donates breast milk to needy orphans right here in the USA? Aren’t there HIV+ orphans in this country who need breast milk and aren’t getting it? Hmmmm… Maybe because giving away Prolacta’s product for free in this country would set an undesirable precedent for the company’s future. After all, if you just give it away, then why should anybody pay for it? How do you determine who’s destitute enough to receive free milk and who must fork out the $184.83 per ounce? Prolacta’s target market is, after all, babies in the NICU, all of whom can be considered “in-need.”

Or maybe it had nothing to do with that, and everything to do with the positive public relations shipping milk halfway around the world would generate. Yep, that’s probably more like it.

The great irony here is that the International Breast Milk Project may actually undermine South Africa’s existing breast milk bank in the long run. If iThemba Lethu gets all its milk from the International Breast Milk Project and not from South Africa’s own breast milk bank, what motivation do South African women have to continue donating? What incentive is there for the milk bank to continue to improve, if all the work of acquiring and pasteurizing the milk is done beforehand? Do this for long enough, and the old “Give a man a fish vs. Teach a man to fish” parable comes to life in reverse. With enough free milk from the International Breast Milk Project, the art of milk banking in South Africa may eventually die off.

It would be one thing if the International Breast Milk Project had been created in the absence of an already existing milk bank. But that’s not the way it happened.

Edit (7/24/2007): It has recently come to my attention that iThemba Lethu houses a total of six children. SIX. From all the media coverage, you’d think there were hundreds, if not thousands, of HIV+ babies in the orphanage receiving breast milk from the International Breast Milk Project, but it’s only six??? Six children who were already being provided with breast milk from their homeland? How much sense does it make to create a multi-million-dollar program to feed six infants breast milk from another continent when they’re already getting breast milk from their own in-house milk bank?

It is shameful how the IBMP and Prolacta can get away with all this subterfuge.

I did a quick Google search to see if Prolacta Bioscience was up to its usual shenanigans again. Apparently, it is. In addition to soliciting breast milk donations directly on prolacta.com through milkbanking.net, creating the National Milk Bank to funnel all the milk donated there into Prolacta, and hijacking the International Breast Milk Project so that 75% of all donations to the IBMP go to Prolacta, they’ve got yet another scheme. They “partner up” with a birth center or lactation center so that breast milk donors are duped into trusting Prolacta.

The donated milk gets processed as human milk fortifier (a product that has not been proven safe yet; published medical journals regarding its safety either do not exist or are very obscure) and the recipient gets charged $184.83/ounce.

Here are some examples of organizations that sell their their milk to Prolacta, same as the National Milk Bank and International Breast Milk Project do:

• Milkin’ Mamas Breast Milk Bank
• The Mother’s Touch Lactation Consulting
• The Birth Connection Milk Bank (alternative site)
• The Family Birth Center
• Southcoast Midwifery and Women’s Healthcare
• Miami Maternity Center

If you donate to any of the above places, to milkbanking.net or the National Milk Bank, know that your all your milk will go to Prolacta Bioscience. Prolacta will then process and sell the milk for $184.83/ounce. If you donate to the International Breast Milk Project, 75% of your donated breast milk will stay in the United States to be sold for $184.83/ounce.

Edited (7/26/2007): Please read or listen to this public radio report on Prolacta that confirms much of what I’ve already written.

If you want to donate to someplace where your milk will actually help a baby (and not a for-profit corporation), consider donating to a HMBANA bank. They have no affiliation with Prolacta Bioscience, and can only charge recipients what it costs to process the milk, which is usually around $3.50/ounce.

If you’d like to donate your breast milk directly to a baby in need, join MilkShare. Milkshare is a group created by Kelley Faulkner in 2004 to hook up women with surplus breast milk with women who would like donated breast milk for their babies. It is a low-cost alternative to milk banks for the recipients, as they only have to pay for shipping for the milk. For donors, it can be very satisfying to be able to know exactly who the recipients of their milk are.

It seems that this subject is one that I cannot stop blogging about. There is still so much to say. It bugs me that the National Milk Bank sells every single ounce of donated breast milk they receive to Prolacta Bioscience (I’m not even sure the National Milk Bank wasn’t created by Prolacta; maybe it was! Update: apparently it was.) Yes, all the milk goes to “help treat babies in the NICUs,” but only if someone can foot the bill for it, and the price is very steep ($6.25/milliliter, or $184.83/ounce). Milk from non-profit milk banks also goes to “help treat babies in the NICUs,” and for far less money (around $3.25/ounce). The same stringent quality control and the same outcomes for patients who receive breast milk come from non-profit milk banks as from for-profit ones, with the only difference being that everyone can benefit from non-profit milk banks. The same cannot be said for for-profit ones.

Considering that none of the donors are getting compensated for their trouble and that they’re not even being told the whole story of what happens to their milk when they donate to the National Milk Bank or the International Breast Milk Project, you could say I’m a little ticked off about the whole thing.

Would it bother me as much if the donors were compensated and made aware of how much of a profit would be made? Maybe not, but that scenario is unlikely to happen. Actually, it still would bother me, because Prolacta’s product is so egregiously overpriced for a product that’s marketed “for the nutritional needs of premature and critically ill infants” that it seems almost criminal. Speaking of which, for me to find out the asking price of Prolacta’s human milk fortifier took some substantial investigating. It’s not like they list prices on their website. Many articles and and blogs mistakenly report the price to be around $35-40/ounce, which is only an average taken after you’ve added in your own pumped breast milk to their human milk fortifier. The actual price is $6.25 per milliliter, or $184.83 per ounce. It’s supposed to be a secret, so…. Tell everyone you know, especially anyone considering donating to the National Milk Bank, The International Breast Milk Project, and Prolacta Bioscience. If word gets out about their prices and what’s really happening to the milk that comes into their hands, their supply will drop in a hurry, forcing them to revise their business practices.

Want to donate your milk to a place where it will actually do some good? Find the non-profit milk bank closest to you.

Or donate your milk directly to a mom in your neck of the woods.

Before I continue with this, I need to point out that when I say “non-profit” milk banks, I mean all milk banks that are members of the Human Milk Banking Association of North America.  When I say “for-profit” milk banks, I’m referring to The International Breast Milk Project,  the National Milk Bank, and any other milk bank or organization that serves a for-profit company.  Although The National Milk Bank and International Breast Milk Project are technically non-profit entities, they both serve Prolacta Bioscience, a for-profit company specializing in processing and selling a product made out of donated human milk.

Non-Profit Milk Banks

For-Profit Milk Banks

Overall, I’d say that while it’s great that research is conducted a lot more quickly with for-profit milk banks, non-profit milk banks are better for society overall. Obviously anyone working for Prolacta Bioscience, the National Milk Bank, or the International Breast Milk Project would disagree with this assessment, but you’d probably be hard-pressed to find anyone outside these contrived organizations who’d say for-profit milk banks are a good idea for the majority of babies.

I touched on this a little bit in yesterday’s post, but I feel like it needs a little more fleshing out. Milk banks, regardless of for- or non-profit status, collect, pasteurize, and distribute milk to needy babies throughout the country. No matter what kind of bank the milk is dispensed from, it is very pricey. Even non-profit milk banks charge upwards of $3.25/ounce to cover processing fees. (That’s about $12 for a four-ounce baby bottle, and how many of those does your baby gulp down in a day?)

The National Milk Bank, which calls itself non-profit, sells the milk it gets from generous, unsuspecting donors to Prolacta Bioscience. Prolacta Bioscience then sells the donated breast milk at an undisclosed amount for a profit. The company claims that it doesn’t sell the milk by the ounce, like non-profit milk banks do, that the price “depends on the gestational age and size of the neonate.” Some digging around revealed that all of that is true. They don’t sell their products by the ounce, they sell it by the milliliter, which, for anyone that’s ever taken a science course, is a lot less than an ounce. The price? $6.25 per milliliter. This makes the price per ounce more like $184.83.

$184.83. Per. Ounce.

This isn’t a fair comparison, however. Prolacta’s product is not usually used full-strength; it needs to be mixed with human milk, with the cheapest possible scenario being 20% Prolacta human milk fortifier mixed with 80% mother’s pumped milk. For a theoretical 3-pound baby in the NICU:

• Assume a 3 lb NICU preemie gets fed a total of six ounces of milk a day (a conservative estimate)
• Supplement the mother’s milk 80/20 with Prolacta human milk fortifier (80% breast milk, 20% Prolacta human milk fortifier)
• 80% of 6 ounces = 4.8 ounces mother’s milk
• 20% of 6 ounces = 1.2 ounces Prolacta human milk fortifier
• Cost for 1.2 ounces Prolacta human milk fortifier = ($184.83/ounce X 1.2 ounces) = $221.80
• Over $200 for ONE DAY, assuming the baby doesn’t drink more than six ounces.

By contrast, if the same 3 lb NICU preemie were to get fed a total of six ounces of milk per day from a non-profit milk bank capable of providing 24 calorie/ounce milk (Mother’s Milk Bank of Austin is one of those, as are many others), it would cost $3.25/ounce X 6 ounces = $19.50. Probably most middle-class parents would be able to afford that out of their own pockets, but even if they couldn’t, a non-profit milk bank would make sure any infant that needed it would receive it anyway. There is no such guarantee from a for-profit company like Prolacta.

So let’s recap. For equivalent products and circumstances (3 lb preemie consuming only 6 oz breast milk per day):

This, by the way, is a fair comparison. Food for thought.

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.)