HMF

Execs in Desperate Need of Donor Breast Milk (part 4)

Part 4: Milk Money

Will informing donors about the manufacture of costly therapeutics from their milk mean paying them, too?
This question is hard to answer. First, because I have no idea whether Prolacta has far more milk than they need or just enough to squeak by. Of course, if the donor milk supply is exceedingly high, there will never be any need to pay donors.

How much milk?
So, how much breast milk does Prolacta currently have in its possession? For that matter, how much total milk is collected in the US every year? What percentage of that milk is processed and sold back to hospitals at cost by non-profits and what percentage goes to the development and manufacture of Prolacta products? If anyone out there has access to these numbers, I'd love to know them.  I can only find the odd report here and there - nothing comprehensive.

One number I can find is on the IBMP website, which says they've collected 262,682 oz. of milk for Africa. If the milk split described on their How It Works / Donation Process page holds true (25% to Africa and 75% to "critically ill babies in the US," aka Prolacta), than that particular bank has provided Prolacta with 788,046 oz (=6,156 gallons =22,305 L) of breast milk. Add to that 100% of the milk collected at all the other Prolacta milk Banks, and that could be a lot. Or maybe it's barely enough?

How will donors feel?
The next question is - how will donors feel about giving milk to a for-profit enterprise that is also a life-saving one? This is hard to predict. I hold to my statement in Part 2 of this post:  For every mom who wants her milk to be non-profit all the way, there will be others who don't really care as long as they are helping someone with their extra milk (probably the majority of moms) and still others who want to see as many lifesaving medications developed from human breast milk as possible.

Will the milk river dry up if moms learn more about where it's been flowing? I think there would likely still be plenty of donor milk forthcoming. Let's assume, however, that if Prolacta milk banks started being called just that (with little displays of Prolacta products inside and "Prolacta Bioscience" T-shirts and totebags for all the donor moms) that the moms would stop giving milk without compensation. Would it be so bad?

Can Prolacta afford to compensate donors?
Would it really hurt Prolacta to compensate donors? I'm sure they've invested a lot in establishing so many milk banks across the US. With this milk collection infrastructure already in place, it would seem the cost of compensating donors, if necessary, wouldn't break the bank. And what about those T-shirts? Wouldn't Prolcata benefit greatly from being out in the open, happily marketing their brand and making donor moms feel like part of the Prolacta team? If the fear of paying for milk (as other for-profit "bioscience" companies pay for human plasma) is what’s keeping Prolacta in the closet, it hardly seems worth all the hiding.

A recent study published in The Journal of Pediatrics shows the valid medical benefit Prolacta's HMF has for severely premature babies. This paper, paired with their recent agreement with Abbott Nutrition (makers of the Similac cow-milk HMF) will make hiding in the shadows of their milk banks not only wrong but also exceedingly difficult for Prolacta.

Other issues related to compensating donors
Of course, there are more important issues than money when it comes to paying breast milk donors. One is the concern that non-profit milk banks will never see another ounce after donors hear about the awesome deal down the road. I don't think this would be a major problem because many moms feel strongly about giving milk as a charitable donation. Many women in the US who currently breastfeed are well-educated, fairly well-off, and in a position and a mind-set to make this kind of charitable donation.

The non-breastfeeding community
Now let's consider the women in the US who aren't breastfeeding (the majority of mothers), and the general public. Sadly, unscrupulous members of the food industry have been very successful in portraying breastmilk as a questionable, cheap, and even gross alternative to the gold standard of formula to many of these people.

Maybe Prolacta paying moms for milk, because it can be used to make valuable, life-saving medical treatments, would help to change that.  Maybe the only force powerful enough to fully stomp out the bad image of breastfeeding perpetuated by the corporate powers-that-be will come from the corporate powers-that-are-coming - like Zeus defeating Cronus.  It's not ideal, but it's practical.

Placing a monetary (and medical) value on breast milk would have a positive impact on how "Joe Public" regards breastfeeding. Mothers who now consider formula an expensive but worthwhile investment in their child's health (and there are lots of moms like this) may start to think twice when they hear the news that breastmilk is valued at some dollar amount per ounce and used to make medicinal products.

Some of these same moms may also benefit from the extra income their own extra breastmilk could earn. Paid milk donation would then doubly encourage these moms to work hard at establishing and continuing breastfeeding their own children, not only to have highly-valued, premium nutrition for their babies but also to be able to donate milk for extra income. Whatever the motivator is, the numerous benefits of breastfeeding will be enjoyed by each new mom willing to try (and her baby).

Would moms sell their milk and feed formula?
The argument that moms who would have breastfed otherwise will instead sell all their breastmilk and feed formula doesn't make sense. Why would they spend an enormous amount on formula when they can make more breastmilk, which they know is superior, for free. A strict screening process for paid donors and limits to the volume a donor can provide could also be imposed to ensure that this is not a problem.

Other Issues related to compensated donation of human fluids
The arguments against compensation of blood donors don't seem to apply here either - these are the possibilities of over-donation causing severe bodily harm and payment attracting a disproportionate number of desperate, diseased drug addicts.

First of all, moms can't risk their lives by over-donating milk as a blood donor could, and with only one company in this business it would be easy to impose and enforce the limits and pre-screening mentioned above. Milk donation is certainly less physically taxing and risky than blood plasma donation, which is legally compensated by many plasma banks. 

The plasma collection process takes only part of a donor's blood, and it occurs both with compensation (when given to for-profits) and without (when given to non-profits) in the US. Interestingly, the collection of both plasma and blood products without compensation by the Red Cross has also come under fire – demonstrating on a much bigger and more complicated scale how unhappy donors are to find that their donations are being used in an undisclosed or poorly disclosed way to turn a profit. My thanks to a commenter (Lindsay) for bringing this up.

It’s also easier to prevent the spread of pathogens through breast milk (which is naturally safer and can be pasteurized) than through blood. Although I might worry about desperate souls selling off their blood, I find it hard to envision the same people hatching a plan to become pregnant and bear a child for some limited amount of milk money.

Bankers - breast milk bankers, that is
So although I wince a bit at the phrase "corporate breast milk bank," I realize they are already out there. At the same time, I see the potential for positive outcomes from these banks and the company behind them.  Run properly, they could help reshape the way many in our culture view breastmilk and breastfeeding and possibly improve breastfeeding rates, not to mention develop important therapeutics from breast milk both now and in the future.

I just hope that Prolacta is dedicated to biotherapeutics. I hate to think of a future with very expensive formulas made from processed human milk - like a wet nurse in a can (with many key components long since destroyed during processing, plus an unhealthy dose of can-liner chemicals).

If this ever did move away from therapeutics and toward food products, I hope moms would realize that they can make real "liquid gold" far superior to anything processed in a plant. Remember that Prolacata, or any company making pasteurized, processed human milk products still cannot keep many of the critical antimicrobial biomolecules (which our mammary glands originally evolved to deliver) viable and active through processing.

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