Thursday, July 14, 2011

"expanding the world supply of human milk..."


















Some 50 years ago, we witnessed a revival of breastfeeding in the USA.  La Leche League came into existence helping protect and promote breastfeeding.  Gradually, breastfeeding made a comeback from the abysmal low initiation and duration statistics of the 1950's.  It took a number of decades, but gradually more and more women in the USA were breastfeeding.  La Leche League literally saved breastfeeding from extinction.

Recently I read a paper published in the International Breastfeeding Journal called, "Milk sharing:  from private practice to public pursuit," in June of this year.  The last sentence in the abstract states, "If undertaken, managed and evaluated appropriately, this made-by-mothers model shows considerable potential for expanding the world's supply of human milk and improving the health of children." (my italics)  Where is breastfeeding?  What happens when we expand the supply of human milk?  More breastfeeding? Or less breastfeeding?  So we create a market and more babies get the product, human milkDoes human milk in the bottle, create better health for humans?  Or is it another case of how we are distancing mothers from babies, creating more emotional disease?

This paper has a number of premises that I must question.  It states, "After only six months, a commerce-free internet-based milk-sharing model is operating in nearly 50 countries, connecting mothers who are able to donate breast milk with the caregivers of babies who need breast milk."  Yes, when you have people who are in public relations directing this model, ideas will go viral.  PR people know how to create an image.  How do we know this is commerce-free?  Are potential recipients screened to protect the donor from gifting milk to industry?  With 2000 human milk patents and patent applications (and climbing), what will prevent industry from having someone pretend they are a mother in need of breastmilk? Industry has the money and woman-power to use the internet to further their need for an expanding world supply of human milk.  What checks and balances do these organizations provide for women so that misuse of mother-to-mother milk sharing is truly mother-to-mother?  Isn't that an impossibility on the internet?  

The conclusion of this article states that, "Mothers are leading in this initiative."  I think that statement is misleading.  My impression is that Eats on Feet was begun by a midwife, who is also a mother.  Eats on Feet then was taken over by PR people.  This in my opinion created friction over various issues, and another organization was born, Human Milk 4 Human Babies.    The PR people created a new organization, Human Milk 4 Human BabiesWho hired the PR people?  Who do they work for?  If one takes a cynical view of the politics behind infant feeding, one might think there is more here than meets the eye.  If mother-to-mother milk sharing is mostly PR with little substance, then who are the real players?  And what reality are they spinning?  Who is buying the PR for promoting the expansion of the world supply of human milk?  The US Government?  HMBANA?  Prolacta? 

Getting an article published in the International Breastfeeding Journal requires having a certain amount of money.  I once inquired about getting an article published there but realized I didn't have enough money to even consider publication.  It was a substantial amount of money for me. (I must admit my income level puts me as one of the many working poor in the USA--our numbers are getting larger and larger).  When publication requires the big bucks, who gets published?  Whose interests are broadcast to the profession and whose are never heard?
Copyright 2011 Valerie W. McClain

15 comments:

  1. Valerie, if your institution holds a subscription to BioMed Central then publication in the International Breastfeeding Journal is free. The University of Western Sydney holds a subscription and so the authors did not make any payment for publication since I hold a position there. I won't respond in detail to the other suggestions of nefarious activity in the blog except to say that in my opinion they are as baseless as the suggestion that something is awry with IBJ. Oh, and comments on papers can be made via the IBJ website.
    Karleen Gribble

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  2. Valerie, as always you ask important questions and make valuable points. However, I believe this time your cynicism is a bit of detraction. I am a "PR person" who volunteered her time for the nascent Eats on Feets Global Network and then through its name change to Human Milk 4 Human Babies. I currently am involved in other volunteer efforts (both breastfeeding related and in other arenas) - this summer one of my volunteer goals is to make sure women are able to feed their babies when they attend our local swimming pools. I can assure you that all of the people involved in HM4HB are volunteers. You ask if women can truly be sharing milk peer-to-peer on the Internet, as if there is something about the Internet that makes direct peer contact impossible. There is nothing inherently bad about the Internet. And public relations is not inherently bad either. The involvement in a volunteer network of someone with a public relations background doesn't automatically equal profit-making or taking. Human Milk 4 Human Babies is entirely run by volunteers. And yes, they are mothers - I had the pleasure of working with upwards of 300 administrators and I can tell you that most of them are lactating, with babes at their breasts as they work at their keyboards, nurturing their children while they help other mothers do the same. I agree with your observation that La Leche League saved breastfeeding from extinction. I think we are witnessing a similar shift now - peer to peer milksharing is taking access to human milk from institutions and putting it back where it belongs - in the hands of mothers. Thanks for all that you do, Valerie.

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  3. Hi Valerie,

    I am an admin for the Human Milk 4 Human Babies - Pennsylvania Facebook page and I hope to address some of the questions you raised in this post. I understand your reservations as it is indeed remarkable how quickly the HM4HB network has grown. I view this growth as a testament to all of the amazing women and families around the world who have done their own research and who have determined that breastmilk is indeed the perfect food for their babies, even if they are not able to provide it themselves. The families who share milk on our page may utilize the internet to find each other but the actual meetings take place in person at cafes, playdates, etc. and real relationships and friendships are forged. We trust that women are strong, intelligent and capable of making informed decisions in the best interest of their babes. We encourage families to research the benefits and risks of all forms of infant feeding and to make decisions that are best for them and their children. I suppose it is possible for an organization to pose as a woman in search of milk for her baby, however I would think it would become transparent rather quickly to any potential donors as again, donors and recipients are forming real-life relationships after their initial online contact.

    Mothers are indeed leading this initiative; both the mothers who volunteer their time to run the Facebook pages and the mothers in the communities who are sharing milk. I myself am a mother to a 2 1/2 year old nursling and the other admins of the Pennsylvania page are mothers of nurslings as well. One donates her own milk in her local community and another has received milk from several mothers in her community as she herself cannot produce enough milk to sustain her babe. Dozens of Pennsylvania women and families have shared milk as a result of utilizing our page, and many have returned to the page to offer their thanks and love to the amazing milksharing community that has arisen from this initiative. I would encourage you to take a look for yourself if you wish: https://www.facebook.com/HumanMilk4HumanBabiesPennsylvania

    The Human Milk 4 Human Babies Global Network does not condone or support the sale of breastmilk in any way. If families wish to make arrangements regarding reimbursement or replacement for supplies such as breastmilk storage bags or containers that is up to them. Not one of the admins (or anyone else involved in HM4HB) receives any compensation for what we do aside from the gratification we experience as we witness the babies of our communities thriving on mothers' milk (be it their own mother or a donor). I'd be happy to discuss this further or answer any questions you may have. Feel free to contact me via my Facebook profile: https://www.facebook.com/kinu.nardini

    Sincerely,

    Kinu Nardini

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  4. What PR people? HM4HB (and the spanish speaking network LaSo) is run by a bunch of volunteers. But not naive ones. We stand by our ethics and trust in the wisdom of donor families to weed out the unscrupulous industry recipients. There is still a human component, and our instinct guides us well.

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  5. I am one of the admins of the page HM4HB South Carolina Lowcountry. I am a tandem nursing mother of a 3 year old and a 18 month old. My co admins are also nursing mothers. We are located in different areas and we are all active in our local breastfeeding communities. Although our duty as admins is to facilitate the space and not milksharing, there have never a person from my local community that requested or offered milk on the page, that I didn't know or had people in common with. That is the key of hm4b: we share local, as local as possible. That means that you get to MEET people, to establish relationships with them, to build community.

    About 6 months ago, my daughter was 13 months and I was offered the opportunity to attend a breastfeeding training. I had never left her, and she had never had a bottle, but I decided to do the training because it was a 5 days thing only. I tried pumping and I couldn't get anything, as I had never pumped before. I requested milk in my page, a stash that would help me for the first day or two of the training. I received milk from a wonderful woman with whom I stay in touch with, and we see each other at our LLL meetings, when we are both able to attend.

    Even if me and my coadmins weren't active in our communities, I would still think that this is a family to family issue. Women are, naturally, very protective of their precious milk. They want to know who it is going to, and they also want to make sure the milk will suit well with the child in need. Recipients are very interested in meeting donors as well, they carry out their own screening, this are usually highly educated women that know what they need. It is not a human milk delivery service in which you place a call and you get your milk. It is about going out to your local community, reaching out, meeting people, establishing a relationship of trust, and then sharing.

    Our vision, which you can read in the 'about' section in our website says:

    'We want milksharing and wet-nursing to be commonplace and babies to be fed at women's breasts whenever and wherever they need it.'

    Babies are born to be breastfeed. Breastfeed at mom's breast with mom's milk, breastfed at other woman's breast, breastfed at mom's breast with a at-breast supplementer. We absolutely want for babies to be breastfed!

    It also says in our site that we are completely noncommercial and unfunded. We don't advertise products, professionals or companies, we don't receive any kind of compensation, donation or funding. We certainly don't spend any money on PR or advertising. We are a very large group of women, and we do have in the group a wide range of amazing skills. A Press release, that can be found on the website, was written and then we admins googled all the local media outlets for our communities, and sent the press release. The media jumped on it. Why? I have no idea! Honestly, I was very shocked and surprised. HM4HB SC Lowcountry have been featured in several newspapers and the news, I can assure that I did not pursue that, they found our page and asked for an interview.

    I do not know why the authors of that BJ commentary wrote about it, I do not know them, although I am translating the commentary to Spanish and I am super excited about it. I do know why in Argentina, where I am from, the biggest breastfeeding expert, a WHO consultant, supports milksharing. His pregnant dying daughter in law was performed a c section and died hours later. This man took it upon himself to get breastmilk for his pre-term grandson. He didn't find that milk in milk banks, but he did find it in informal milksharing, so he has become a supporter. I do not know if there is people seeing a business opportunity, I do know that there are hundreds of us that are in this for pure emotional reasons, and to help the families and babies in need.

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  6. Valerie,
    I'd love to know where you got all your information from. From what I can tell, you made quite a few assumptions with no actual research. I'm not quite sure you even looked up HM4HB to see how it works. Since you must not have researched very hard, I'll provide you with a little information regarding milk sharing.

    As a mother who was lucky enough to pump over 14 oz of colostrum, I logged onto my local HM4HB page and posted my offer of ~14oz colostrum + 50 oz of newborn aged breastmilk. I was then sent a message from a woman who was flying in to adopt a son in the next week and while she had induced lactation, she couldn't provide colostrum. We exchanged several emails and I met her with my package of liquid gold. Her and her husband cried when they saw what I brought. Do you think someone from prolacta would cry at the sight of colostrum? Or these mystically public relations people you speak of. No, they wouldn't. This family sent me pictures of their son when he was born and we exchange messages quite often via facebook.

    Now, on the topic of these mystical PR people...there are none. I cannot speak for Eats on Feets, but Human Milk 4 Human Babies is run solely on volunteers. Each state has several women who donate time and money to promote HM4HB in their communities by attending events, passing out flyers and bookmarks and checking the webpage for day to day activity to ensure posts are missed. I'm not quite sure what the downside is to a midwife or any birth worker being involved in HM4HB is - if anything they're the first to know when mothers have or need breastmilk.

    I beg you to look into Human Milk 4 Human Babies and see what really happens behind the scenes and on their facebook pages. There is no secret PR, no secret income - just mothers (and some fathers) sharing milk to provide the best infant nutrition possible.

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  7. Hello Valerie,

    Just wanted to clarify that Human Milk 4 Human Babies facebook pages are all run by volunteers (I am one of them, I am an admin for the Washington state page), I am a 27 year old stay at home mama of a 20 month old who still nurses. There are about 300 of us who volunteer to admin the pages and are all mamas/midwives/doulas/lactation consultants and definitely not PR people, and none of us are paid.

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  8. I too am a breastfeeding mother and an admin for the Human Milk 4 Human Babies Arizona page. We are all volunteers. All women who work continually to increase awareness about breastmilk and milk sharing. We are mothers, doulas, midwives, friends, and neighbors who are passionate about what we do and quite frankly, your article is nothing less than offensive.

    I have donated over 13 hundred ounces of my own milk to babies who otherwise may not have had breastmilk, and I have a freezer full more at home that needs to be donated. I donate because I have the extra, and I know it's what's best, that my milk will do another child so much good.

    I wish, just wish, that I had known about milk sharing before. It would have saved me a lot of cried tears.

    HM4HB is a truly beautiful thing.

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  9. First, for those who wish to post a comment, I will publish most comments (unless they are advertisements or crude language). Due to my job commitments and various personal reasons I am not always on the computer. Nor do I have a cell phone that connects to the internet. So my response time for publishing your comments may seem slow. Yesterday I was away from the computer for most of the day. A number of comments from readers were doubled, so I presume that some people believed that their was some sort of malfunction or that I wasn't going to post their comments. I do believe that all sides of an issue should be presented and am happy to post your comments.

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  10. To Karleen Gribble,
    I am not employed by any governmental, educational, or medical institutions. Thus, publication at the IBJ is a moot point because of the cost. In my opinion, money has become the deciding factor for what information is published. Most if not all government, educational or medical institutions have some level of industry-funding. Either up-front or behind closed doors. That funding influences what is or is not published. I have actually commented to many articles in the IBJ in the past. But will no longer comment to any article in the IBJ. I wrote about my experience with the IBJ on this blog and will just give you a short answer to the whys of not commenting at the IBJ website. I made some comments to an article (happened to be about milk banking). The comment was published. After my comment was published, the authors changed the wording of their article. That change made my comment look ridiculous. I wrote the editor. The editor admitted that she had allowed the authors to make changes and she published a comment that stated that changes had been made. That did not really satisfy me. If I hadn't reread the article and complained to the editor, no reader would have had a clue that changes had been made. Since the article was on milk banking and I later learned that the editor is involved in a milk bank, I find myself concerned about built-in bias of this on-line journal.

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  11. Jodine,
    Thank you for your comments. Are you the only volunteer mother in HM4HB who works in the public relations industry? Some of the administers of various pages for HM4HB, seem to not know that you work in the PR industry. I certainly am not saying or suggesting that someone like yourself is making profits off your volunteerism. What I am saying is that people working in the public relations field have contracts with various institutions (such as government)or industries which may influence how they perceive a situation or how they want the public to perceive a situation. What we do for employment often will create a built-in bias or create blinders. No one (myself included) is devoid of those biases or blinders. Your expertise in the field of public relations may have opened doors that are not readily available for those who do not have that expertise. How much of this rapid growth of mother-to-mother sharing is a reflection of the power of public relations and your expertise in this area?

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  12. Maybe it is your own bias Valerie, since you have responded to the comments made by what you perceive as 'professionals' and completely ignored the rest, the 'mothers' and you remained untouched by the evidence shown to you that this is made by mothers, and you do not understand our passion, If you did, you would not have left our comments unanswered. The bottom line of your logic here, is that Jodine is miracle PR women, and the rest of the women of the world are dumb and have fallen into milsharing because of her PR, and not because HM4HB provided a long awaited community place where donors and recipients could meet. Many admins don't know that Jodine helped with PR because Jodine stepped down. And no, there was no other PR person in our group.

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  13. Valerie, you ask how much of the rapid growth of mother-to-mother sharing is a reflection of the power of public relations and my personal expertise in this area. I think it's important first to clarify that I am no longer an HM4HB volunteer, although I am involved in this year's World Milksharing Week which is an initiative launched by HM4HB. As for how much my own expertise is responsible for the rapid growth of peer-to-peer milksharing? I think almost nil. I just happen to have brought that professional skill set to the table as a volunteer. It's always a mistake to assume that lactating women don't have careers beyond their motherhood. There is a pretty wide range of skills amongst the HM4HB volunteer base. As Agustina noted above, most of the initial news coverage of a global Facebook-based milksharing network came from an initial press release crafted before I got involved, and distributed by network volunteers. And when Agustina writes, " we admins googled all the local media outlets for our communities, and sent the press release..." she's referring to one of the many powerful tools the Internet allows us to exploit - crowd-sourcing. It's not about public relations. It's about networks and how the Internet changes the way we think about them and use them to interact. You and I have never met "in real life" but we know a wee bit about each other because we both inhabited the same virtual space for many years because of our shared interest in lactation. The award-winning Listserv LactNet is an early example of the power of Internet-based networking. It's not about public relations, it's about crowd-sourcing. It's about Facebook, the latest iteration of this giant virtual network that has both changed the way we interact with people we already know, and has allowed us to connect with like-minded individuals around the globe. It's not about public relations, it's about social media. These are the real transforming phenomena. Milksharing was already happening - at least in my community, and likely in yours, too. You can refer to my Birth Issues article from 2005 on the need to re-establish a milk bank in our community, where I describe women with freezers full of milk. "From time to time donation requests are carried via Edmonton's lactating underground and women empty their freezers to meet the need. In recent years women have offered donor milk for a baby whose mom was unexpectedly hospitalized, for a cancer patient unable to tolerate any other food, and for a foster baby failing to thrive." Milksharing has been occurring since the beginning of time, with varying degrees of public acceptance. Celebrity activities like Selma Hayek's famous decision to place another mother's child to her breast, and Alysia Reiner's decision to share milk with a friend in need, made it newsworthy. So-called "mommy bloggers" extend the reach of these Hollywood celebrity stories by passing them on to their followers, who see popular culture embracing a practice that they might have thought taboo. And social media - Facebook - allowed moms to create the virtual space that makes it easy for mothers *who are already sharing milk,* to connect. You are so right when you say no-one is devoid of the bias and blinders that come from the paths we choose to take in life. In connecting with other human beings we create spheres of influence and we bring those biases and blinders into our spheres. We all have a responsibility to consider who we influence, and how we influence, and to use our powers for good.

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  14. Dear Valerie,

    All your objections have been answered in many articles around the electronic and even other media world, since the birth of this network (in the spirit of full disclosure, I was a volunteer with hm4hb and LaSo, facilitating the opening of three different communities across continents. I, too, am involved currently with World Milksharing Week).

    At a time at which, presently, over 50 countries and over 130 communities thrive based on the direct and informed decision of donating and receiving the same food one feeds their own child as far as the biological norm goes, and in effect reaching a child (or thousands, at this point of HM4HB's existence?!) whom for no matter the reason - I might add! - does not have access to it is quite cynical, at best. Not just of the actual state of affairs in and of themselves, but of of human capabilities, kindness, and intelligence as well.

    I hope you'll take some time and experience what these communities are like and be moved and recharged with generous energy from the impact these women and families make. I invite to take a listen or read some of what so many of the parties involved experience and are described as: 'life changing, to say the least!'

    Warmly,

    Ilse Fisher

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  15. Hello Valerie,
    thank you for providing us with so much information on breastfeeding and on lactating women and how it all started in the states and no being followed by women all over the globe.

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