Milk banking • Donated milk is used to create supplement for preemies, but nonprofit banks bemoan competition.
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A California company is eyeing Utah for its abundance of notoriously health-conscious, breast-feeding moms.
Prolacta Bioscience is canvassing women's events and pediatric offices, encouraging women to give its Helping Hands Milk Bank their excess milk, which it filters, fortifies and sells to hospitals for a profit.
Its Prolact+4 H2MF is the only fortifier made from human milk, instead of cow's milk, and is a protein shake of sorts for premature babies in neonatal intensive care units [NICUs] to supplement breast milk. It aims to more closely duplicate nutrients the babies would have received in utero.
For every ounce of milk collected the company gives $1 to charity. "[Donating milk] is a selfless act, and we'd like to honor that with another selfless act," said Prolacta CEO Scott Elster.
But the company's presence in an increasingly competitive market for human milk has stirred some angst. A nonprofit milk bank says the company's well-funded marketing efforts are straining supplies.
"There was a time, three to five years ago, when I didn't worry about donors. People would just call and it would fly in here. Now we're working really hard to keep our hospitals supplied," said Laraine Lockhart Borman, director of the Denver-based Mothers' Milk Bank, a program of the Rocky Mountain Children's Health Foundation.
The program has long looked to Utah for donations and has a collection site at the Redwood Health Center in South Salt Lake.
Utah mothers breast-feed at rates well above the national average, and many in the predominantly Mormon state shun tobacco and alcohol.
High demand •The immunity-boosting properties, growth factors, hormones and enzymes of breast milk can't be matched by commercial formulas. Donated milk has proven to be a life saver for the 51,000 low birth-weight babies treated in NICUs each year. Neonatologists refer to it as "liquid gold."
Nonprofit milk banks ensure quality control. They pool and pasteurize human milk, a process designed to kill dangerous viruses while preserving the milk's immune properties.
The costs are passed onto hospitals and families who need the milk. Borman's nonprofit charges $3.50 to $4 per ounce.
Nonprofit milk banks last year dispensed 1.8 million ounces, according to the Human Milk Banking Association of North America. But the need is closer to 9 million ounces.
Finding donor moms willing to pump, bag and ship their frozen extras isn't easy, especially considering the growing field of competition, Borman said.
Women also trade and sell their milk directly on social networking sites and online classified like onlythebreast.com some for a profit and others for free. The sales are legal, but the U.S. Food and Drug Administration has warned against them because there's no way to know if the milk was properly screened for infectious diseases or contaminants.
Pumped up for preemies •Prolacta, based in Monrovia, Calif., with 42 employees, started as a milk bank in 1999 with $31 million in venture capital. It was the first to sell its product for a profit, mostly to hospital NICUs. But seeing that hospitals often supplemented human milk with cow-based fortifiers, which sometimes cause allergic reactions and digestive problems, the company set out to develop a human milk fortifier.
Prolacta milk donations go through the same pooling and filtering process that nonprofit milk banks use, but there are added steps, such as DNA testing to ensure the milk that arrives by mail belongs to a pre-qualified donor.
The milk is fortified with minerals such as calcium, magnesium and phosphorous. The resulting syrupy concoction is packed with nearly twice the calories as human milk, Elster said.
Clinical trials were a success, and in 2008 the company began marketing the product, priced at the equivalent of $185 an ounce. While the company notes that it is concentrated and added in a ratio to breast milk, a premature baby can consume $20,000 to $37,000 in Prolact+4 H2MF over the course of an average NICU stay.
Elster said the cost reflects research and development costs. What's more, he said, Prolacta fills a niche that nonprofit milk banks alone can't fill. "We're in the business of saving babies," he said, adding, "We're hopeful, but we haven't made a profit."
A developing track record • Research has yet to determine whether Prolact+4 H2MF is more easily tolerated or packs more nutritional punch than its bovine-based competitors.
A recent study published in the Journal of Pediatrics found it did not promote faster growth in micro-preemies weighing under 2.7 pounds at birth. But when added to human milk, it did reduce the odds by 77 percent of the infants developing NEC, or necrotizing enterocolitis, said Suzette Holt, a dietitian at Mckay-Dee Hospital in Ogden, which participated in the trial.
NEC occurs when the lining of the intestinal wall dies and the tissue falls off. It can be fatal and requires hospitalization costing upward of $70,000, said Holt.
McKay-Dee, the only hospital in Utah using the serum, reserves it for the smallest of preemies and those who have trouble digesting cow-based formulas, said Holt.
The hospital has no firm data suggesting it has led to lower rates of NEC, but its unit has some of the lowest rates in the state, Holt said. "It's a high initial investment but worth it if we don't have babies with these poor outcomes," she said.
Borman doesn't dispute that. But she notes that the study on NEC was funded by Prolacta.
"I'd like to see it replicated," she said. "Meanwhile, we still face ethical issues and a lack of available milk. It's complicated, and I suspect moms could donate to this company and not really know that their milk will be used to pay their stockholders."
Some donor moms agree. Sulaine Turnbull sells her milk directly to two women through onlythebreast.com. The 30-year-old Salt Lake City woman sees it as an opportunity to do something good while socking away money for her 8-month-old girl's college fund.
She'd be happy to donate it directly to a hospital but said, "I find it offensive that a for-profit company would target any moms. It just doesn't feel right."
Elster said Prolacta would consider reimbursing moms. But the prevailing ethical standard is to keep donations altruistic, which protects needy women from exploitation and removes the incentive for donors to take supplements like fenugreek to boost their supply. "We don't know how that could affect preemies, and we can't adequately screen for it," he said.
Deciding to donate
To donate to the Denver-based nonprofit Mothers' Milk Bank, visit http://bit.ly/oCZ7hP. Moms can fill out paperwork and have their blood drawn and tested at its collection site at the Redwood Health Center in South Salt Lake.
To donate to Prolacta's milk bank, visit http://bit.ly/otlktT.
Research has linked breast milk to raised IQs and lower obesity rates in children. The American Academy of Pediatrics recommends that mothers nurse for at least six months, and up to a year if possible.
But for various health- and work-related reasons, many moms can't meet their personal breast-feeding goals. While about 75 percent of American moms nurse, only 44 percent reach the six-month mark, and only 24 percent make it a full year, according to the Centers for Disease Control and Prevention.
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