Wednesday, January 20, 2010

Emma Kwasnica: on PROLACTA and its "Human Milk Fortifier"

on PROLACTA and its "Human Milk Fortifier"

Today at 12:33pm
http://www.your-story.org/groundbreaking-study-demonstrates-benefits-of-exclusively-human-milk-based-diet-for-very-low-birth-weight-preterm-infants-in-neonatal-intensive-care-units-85269/

I feel it is important to have all the facts on hand before wildly singing the praises of Prolacta (as the original article does - how many times can you count the word "life-saving" associated with the Prolacta product ?). What everyone reading needs to understand (and what they may not) is that Prolacta is a for-profit company, which solicits donor milk from altruistic women (who are UNPAID for the milk they hand over), and that Prolacta creates its "life-saving product" from the ORIGINAL life-saving product --the breastmilk of these generous donor mothers ! Also worthy of note is the exorbitant cost of Prolacta's product. This is born by the hospitals AND by the parents fighting to save the lives of their babies in the NICU (or their insurance company may bear some of the costs, if they are very lucky). Does a family having to bear an approximate $10,000 cost for Prolacta's Human Milk Fortifier used for their baby during their NICU stay sound right to you ?
And what *is* their "human milk fortifier", exactly ? How is it processed ? How *do* they manipulate the caloric value of the donor milk to "suit very low birth weight babies" ? Some transparency, some justification of this high price to pay, is needed. Furthermore, is there any evidence available showing that VLBW babies fare worse if given their mother's breastmilk, ALONE ? ie, do we know that fortifier, of any kind, is truly necessary ? This is one of these examples of putting the cart before the horse; the medical establishment just assumed that fortifier was needed for these tiny babies, not realising that NEC could, perhaps, be far better kept at bay if these babies were exclusively fed their mother's milk (with no additional HMF), and that these babies could, indeed, grow and thrive on mother's milk alone. Did anyone verify that first ? This study is flawed, in that it should be comparing the babies being fed breastmilk + HMF to babies being fed *strictly breastmilk*. Comparing babies fed human milk + HMF to babies fed human milk + bovine-based fortifier is not a useful comparison. We forget that we must always compare the intervention (in this case, the addition of HMF) to the baseline (which is very low birth weight babies receiving *strictly* their mother's breastmilk). Yes, we are "saving" tiny babies earlier and earlier with the advance of technology, but there is evidence to show that the milk of mothers who give birth to premature babies is different, and already perfectly suited to the needs of their tiny baby, born too soon.
I beseech the medical community to explore this first, before unconditionally endorsing the Prolacta product, before touting it as "life-saving" at every turn. I also ask that any woman considering donating her breastmilk to Prolacta look into this company (and its ethics...) very, very closely prior to doing so.

8 comments:

Valerie W. McClain said...

Human milk fortifiers add extra protein, calcium, phosphorus, etc. The human milk fortifier sold by Prolacta states that it has the following essential minerals(less than 2%): calcium glycerophosphate, calcium gluconate, sodium citrate, potasium citrate, calcium chloride, magnesium phosphate zinc sulfate, cupric sulfate. Paula P. Meier in a pamphlet put out by Abbott Nutriton states, " Several studies have shown that these fortifiers are especially important in the formation and development of babies bones." There seems to be a belief that human milk for these tiny babies is deficient in calcium. Yet I believe that one should question this belief. Nestle (Nestec S.A.) owns a patent called, "Osteoprotegerin in milk," patent # 7524815. Nestle states that the "invention pertains to osteoprotegerin obtained from human or bovine milk." The patent states, "In studies leading to the present invention, it has now surprisingly been found that in addition to its presence in e.g. the bone tissues, osteoprotegerin may also be found in human breast milk. In consequence, during breast feeding the mother is obviously supplying the newborn with this bioactive substance in a form that is capable of surviving in the child's gastro-intestinal tract." Nestle will be using this component of human milk to treat various calcium-deficiency diseases. The patent is directed at newborns (and specifies premature neonates) and the elderly who require, "osteprotegerin for the development of bone material and/or the immune system." Interesting to see an infant formula company using a human milk component to treat bone loss, while NICUs add synthetic minerals, particularly calcium, because of the standard belief that premature infants need added calcium. I also have questions regarding the association between the nonprofits IBMP (International Breast Milk Project), HMBANA (Human Milk Banking Association of North America) and Prolacta.

Erebus said...

I am very interested in the progress of efforts to encourage human milk donation at hospitals around New Zealand. The World Health Organisation suggests that we should be feeding human babies their mother's milk and if not, then donor milk, before we even look into artificial feeding. I too, am sceptical that adding things to human milk to make formula out of it actually increases its nutritive properties. I have been led to believe that the composition of human milk allows for maximum bioavailability of the constituants.

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