Sunday, April 10, 2016

Part 2-The Battle for Control of "Donor Human Milk"


"The ultimate goal is to understand the role of human milk oligosaccharides for infant physiology and to provide human milk oligosaccharides to those infants that cannot be breast-fed and need to receive formula instead."--Lars Bode
http://biomedsci.ucsd.edu/faculty/faculty_descrip.aspx?id=297 

When one considers the essence of the infant feeding dilemma, it appears to me to be what human milk researcher, Lars Bode, stated in the above quote.  The improvement of infant formula is based on the need to to make it closer to human milk.  And the reason stated is because there will always be infants that cannot be breast-fed.  Human milk is the gold standard.  It is the reason why the infant formula industry funds human milk research.  

Should we question this endeavor?  I think so.  There are some assumptions that need to be addressed.  Is it really possible to imitate nature?  Human milk has thousands of components that work intricately and synergistically together.  How does one imitate the component or should we say components?  Bruce German et al's research abstract from Nestle's Nutrition Workshop estimates that there are 200 unique oligosaccharides in human milk (abstract entitled:  "Human Milk Oligosaccharides and bioselectivity as substrates for intestinal bacteria").  How do we manufacture this component?  Chemical synthesis?  Genetic Engineering?  How do we know it's safe?  What is the track record of use for such components on infants, our most vulnerable population?  How does reductionism (reducing human milk to its components) explain health effects?  Is there one magical bullet?  Is there a synergy between various components in human milk that account for health effects?

What about the belief that infant formula is a necessity because there will always be women who can't or don't want to breastfeed?  How many women can't breastfeed?  Do we know the actual numbers?  How many women don't want to breastfeed?  And how many of these women who can't or won't breastfeed do we need to sustain the infant formula industry?  And doesn't society by its lack of support for breastfeeding create the increasing numbers of those women who can't or won't breastfeed?  What about donor milk and our newly formed human milk industry?  Do we really need formulas based on other animal or plant proteins? 

Surprisingly this relates to the current battle on access to human milk between the human milk industry (called for-profit milk banks) and HMBANA (not-for-profit milk banks).  How so?  HMBANA milk banks feel that the for-profit milk banks are limiting their access to donor milk.  The complaint appears to be that it is the fault of for-profits that they have a shortage of donor milk.  

Yet, part of the mission of HMBANA milk banks is to "encourage research into the unique properties of human milk and its uses."  The Mother's Milk Bank of San Jose provided 31 batches of donor milk to Lars Bode and fellow researchers for a paper that was published in the JHL (Journal of Human Lactation) 2014 Feb;30(1):54-61.  [The Mother's Milk Bank of San Jose is one of the listed supporters of the proposed legislation that limits for-profit milk banks access to human milk.]
http://jhl.sagepub.com/content/30/1/54.abstract 

The paper is entitled, "Human milk oligosaccharide composition differs between donor milk and mother's own milk in the NICU and the paper was published in Feb of 2014.  Lars Bode is the one and only inventor to a patent application #20130315990 filed in Feb of 2012.  The patent application is entitled, "Disialyllacto-N-Tetraose (DSLNT) or varients, isomers, analogs and derivatives therefore to prevent or inhibit bowel disease."  And it states, "We discovered that certain Human Milk Oligosaccharides protect the breast-fed infant from NEC."  One of the claims is that the invention may be added to infant formula, breast milk or baby food.  The application is owned by the Regents of the University of California.  Since they don't manufacture infant formula, I imagine this invention will be licensed out.

If there is a shortage of donor milk, why is the Mother's Milk Bank of San Jose giving or selling (?) their donor milk to researchers.  Do mothers who donate to HMBANA milk banks understand that their donated milk may not go to NICU babies but may go to researchers?  Some of those researchers will patent based on that donor milk and some of those researchers have associations with the infant formula industry.  For instance Lars Bode is co-inventor to a patent owned by Nutricia (an infant formula company), entitled, "Gangliosides with a modified acyl function."  (patent #7851450)  The patent states, "The biological functions of gangliosides extensively described in literature are mainly associated with the composition of the oligosaccharide chain." 

Is there a real shortage of donor milk?  I find myself upset that a donor human milk bank declares that there is a critical shortage of donor milk.  But then is able to give or sell their donor milk to researchers.  Researchers who are funded by the infant formula industry.  Are potential donors to HMBANA fully informed that their donated milk may be used for research purposes?  For many years HMBANA has had researchers who have known associations with the infant formula industry on their Board of Directors.

This legislative battle is a lose-lose situation. Both sides are not really interested in the protection of breastfeedingInstead the focus is on human milk feeding which we now call breastfeedingThere is no right side to this issue.  I am not for or against either side.  I think its a mess of vested interests and the grand loser is breastfeeding mothers.
Copyright 2016 Valerie W. McClain

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