Sun, Mar 22, 2015 page14

• Mothers caught up in debate over breast milk sales

  • By Andrew Pollack / NY Times News Service, CITY OF INDUSTRY, California
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  When Gretty Amaya took an unpaid maternity leave five months ago, she started what she calls a part-time job to help pay the bills. Amaya, who lives in Miami, Florida, has made more than US$2,000 so far by pumping breast milk and selling what is left over after feeding her baby daughter.

  Frozen milk from Amaya — and from hundreds of other women — is flown to what resembles a pharmaceutical factory in City of Industry, California. Inside, it is concentrated into a high-protein product fed to extremely premature babies in neonatal intensive care units, at a cost of thousands of US dollars a baby.

  Breast milk, that most ancient and fundamental of nourishments, is becoming an industrial commodity, and one of the newest frontiers of the biotechnology industry — even as concerns abound over this fast-growing business. The company that owns the factory, Prolacta Bioscience, has received US$46 million in investments from life science venture capitalists.

  “This is white plasma,” Prolacta CEO Scott Elster said.

  He was comparing milk to blood plasma, which has long been collected from donors and made into valuable medical products like immune globulin, which helps fight infections, and clotting factors for hemophiliacs.

  Concentrated milk could be just the start. Researchers say that breast milk is brimming with potential therapeutics, not only for babies, but possibly for adults, to treat intestinal or infectious diseases, such as the bowel ailment known as Crohn’s disease.

  “We are at the tip of the iceberg for milk,” said Bruce German, director of the Foods for Health Institute at the University of California, Davis, and chairman of Evolve Biosystems.

  Evolve and some other small firms like Glycosyn, Jennewein Biotechnologie and Glycom are trying to develop products based on complex sugars that are abundant in breast milk and that appear to nourish bacteria in the digestive tract that are important to health.

  However, the commercialization of breast milk makes many people uneasy. They worry that companies might capture most of the excess breast milk and make products that would be too costly for many babies, while leaving less milk available for nonprofit milk banks.

  When Medolac Laboratories, a competitor of Prolacta, said last year that it wanted to buy milk from women in Detroit, Michigan, it was accused of profiting at the expense of black women.

  “We are deeply concerned that women will be coerced into diverting milk that they would otherwise feed their own babies,” the Black Mothers’ Breastfeeding Association wrote in an open letter in January.

  Medolac, which said it was working with the Clinton Foundation and wanted to encourage breastfeeding by making it financially attractive, dropped its plan.

  Defenders of payments say that if companies are going to profit, it is only fair for them to pay the suppliers for their raw material, especially since pumping takes considerable time and effort. (Prolacta, which started paying only last year, was accused previously of not making clear to women that their milk donations were going to a for-profit company). Moreover, they say, the commercialization of breast milk could increase the supply available.

  The American Academy of Pediatrics says that because of the “potent benefits of human milk,” all premature babies should receive breast milk, preferably from their mothers, but if not, then from donors. However, there is not enough donor milk for that, experts say, partly because many women do not know that they can donate or sell excess milk.

  Elster said Prolacta processed 2.4 million ounces (68 million grams) of milk last year and aimed to do 3.4 million ounces this year. That compares with the 3.1 million ounces dispensed in 2013 by all 18 nonprofit milk banks that belong to the Human Milk Banking Association of North America. Those milk banks do not pay women for milk, but do charge hospitals a few dollars an ounce to cover the costs of screening donors and pasteurizing the milk.

  Some women give milk directly to other mothers who need it, using milk-sharing sites like Eats on Feets. Some sell their milk to other mothers (or in some cases to male body builders who believe it builds muscle), through Web sites like Only the Breast, hoping to receive more than the US$1 an ounce that Prolacta and Medolac pay. Some health authorities say direct sales or sharing pose risks because the milk is usually unpasteurized.

  Prolacta’s products are intended for extremely premature infants who weigh less than 1,250g at birth — babies who can fit in the palm of a hand. Those babies need more nutrition than they can receive from breast milk alone.

  Prolacta makes a fortifier containing high levels of protein, fats and minerals, which is used to supplement breast milk. It costs about US$180 an ounce, and a baby would typically consume up to US$10,000 over several weeks. Generally, the cost is paid by the hospital or insurers.

  However, not all doctors are persuaded, and others say that while they would like to use the product, it is too expensive.

  “I’ve been stymied by the cost equation,” Jae H. Kim of the University of California, San Diego, said.

  He said his hospital spends no more than US$25,000 a year for donor milk for all babies. Adding Prolacta’s fortifier for just the 50 to 70 extremely premature infants, each year would cost more than US$500,000.
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