Wednesday, November 26, 2008

Melamine in US formulas

photo by Jessie McClain
Melamine has been found in US formulas.
Not too surprising. US infant formula contains Milk Protein Concentrates (MPCs) which include: whey, caseinates, hydrolyzed caseinates, hydrolyzed whey, and milk proteins. MPCs are almost all imported from other countries. Most of it from New Zealand. I wrote the FDA, wondering why they weren't testing it, when the contamination in China was first announced. I never got a response from anyone at the FDA. While the theory seems to be that there was deliberate contamination of the milk by Chinese farmers, I think the contamination may also be the result of ultrafiltration of these MPCs. Some filters used by the dairy industry are made from melamine. It would seem possible that these filters could get worn out with long term use or by chemical cleaning. Even if according to the FDA the levels of melamine in US infant formulas are extremely low, why is contamination continuing to happen? And why is it that now that we are faced with actual contamination, the FDA has changed its tune of no contamination would be tolerated in US formulas to low levels are acceptable? We are now suppose to believe that these low levels do not cause problems. What about high risk infants--premature infants? What is in a can of infant formula? Do parents know the risks? Seems like even the FDA hasn't a clue about the safety of infant formula
Copyright 2008 Valerie W. McClain

Saturday, November 22, 2008

ownership of human milk stem cells

photo by Jessie McClain
While the breastfeeding community mulls over the patent application of a human milk fortifier by Medela, they might also be interested in another patent application. (Although it is not assigned to any company) This patent application is called "Method for isolating cells from mammary secretion." Inventors are Mark Derek Cregan and Peter Edwin Hartmann (filed in December 2004, published March 2007) application #20070059822
When I first glanced upon this document I thought that it was a basic "methods" patent and of course the title is called "Method for...." But curiosity encouraged me to look at the claims in this patent application. Smack dab in the middle of the claims (claim # 18) is the following, "Progenitor cells, preferentially pluripotent or multipotent progenitor cells, derived using a method according to any of the preceding claims 1 through 17." Thus, it would appear to me that one of their claims is to certain stem cells in human milk. Of course I am not a lawyer but it would make sense in this biotechnological/patent world that a claim would be placed on stem cells in human milk.
I am amazed that so few people question the right of claim and monopolization of components of human milk. I guess I shouldn't be surprised. No white person really questioned the claims of ownership of land made in the New World (royal patents of claim). The American Indians who lived on that land, saw, felt, and endured the unfairness of the ownership. How could land be owned? The concept was alien to native Americans. But now we have entered a new frontier and we have been conditioned to accept that corporations can own and monopolize cells in our body. During the 1700 and 1800's, the Indians were told by the White Man/the government that they really didn't need all that land. The Indians were forced from the their lands, often without payment. Thus their ability to live freely was restrained and their lives forever changed. Who owned the land? If you were a native American, no one owned the land. If you were white, you owned and fenced it and kept out everyone else. It is individualism versus a communal view of life. It is view that nature must be conquered, owned, and fought for versus the belief that we are the guardians of nature that is free for all. How little the White Man Culture changes. Instead of land to fight over, we now have the new molecular frontier. We can own your cells because we need it. You don't need it. We will take it from you (or you will be talked into giving it to us) and we will mine it/process it, alter it, and then sell it back to you. Everything has a price. Ethics? Just a game we play with dice because to think too deeply in this corporate culture would be to go mad indeed.
Copyright 2008 Valerie W. McClain

Thursday, November 20, 2008

Human milk fortifiers: confusion is the game

photo by Jessie McClain
Human milk fortifiers are used in NICUs to "fortify" human milk given to premature infants. There is a belief that human milk does not have enough protein, calcium, etc for the premature infant. The evidence is based on research funded mostly by the infant formula industry. This premise is the reason that NICU's fortify a mother's pumped breastmilk. Up until recently all human milk fortifiers were made by the infant formula industry. Thus the fortification has foreign proteins (cow's milk proteins). Prolacta Bioscience now is producing and selling a human milk fortifier that is based on human milk (donor milk). Prolacta Bioscience is the first for-profit donor milk bank. They funded a clinical trial of "Prolact-Plus Human Milk Fortifier" from August 2006 until August 2007. The location of those trials was Shands Children's Hospital-Florida, Miami Children's Hospital-Florida, Joe DiMaggio Children's Hospital-Florida, and Memorial Hospital of South Bend-Indiana. The study director was Martin L. Lee of Prolacta. The study results have been published in Breastfeeding Medicine by researcher Dr. Gary Chan. The study evaluated "the short-term effect of Prolacta-Plus fortified human milk when compared with bovine-based fortification of human milk."
There is already confusion among IBCLCs because there has been an assumption that all human milk fortifiers are bovine in origin (made by the infant formula industry). But now we have a human milk fortifier that is based on donor human milk, but is also called a human milk fortifier.
Do parents understand what their infants are receiving? Or are they under the same impression as many IBCLCs that this is just another "formula" product? The confusion is rather advantageous to both Prolacta and the infant formula industry. But it leaves many of us in the dark about the reality of such fortification.
Copyright 2008 Valerie W. McClain

Tuesday, November 18, 2008

Human milk in a bottle

photo by Jessie McClain
What was the intent of the WHO Code? Protection of breastfeeding. Is breastfeeding equivalent to humanmilk feeding? Technically and emotionally it is not equivalent. Nor does the Code on Marketing of breastmilk substitutes state or imply that humanmilk feeding requires protection. Yet, we seem to have set up a system in which we are protecting humanmilk feeding which is quickly supplanting breastfeeding. There are a number of documents written by UNICEF that state that the PRIORITY is BREASTFEEDING. If that is not feasible, then the mother's pumped milk should be "substituted" for breastfeeding. If that is not possible, then donor milk is to be used. Infant formula's use is the last resort when breastfeeding fails. This is not options of equivalency. The priority is breastfeeding and the protection is breastfeeding not humanmilk feeding.
What is different about the process of feeding a baby at the breast versus feeding pumped humanmilk to a baby? Putting a baby to the breast is a very different experience from putting your breast into a tunnel of plastic. Humanmilk feeding means that one has to find the time to be away from the baby to pump. Thus, to pump invites a degree of separation both mentally and physically between a mother and her baby. (separation may have already happened as for example the birth of a premature infant). Time to pump, means time not with the baby. The mother pulls out a machine. The cold air hits her skin as she puts the plastic funnels on her breast. Her milk pools in the plastic bottle faster and faster, little clumps of milk fat splattered on the sides of the bottle. Cap it, refrigerate it, freeze it, and feed it to baby at a later date. Not fresh for baby today. The mother is pressed for time...hurry, hurry...get it much to do. The mechanical breathe of the machine eventually stops. She looks at the picture of her baby by her pump, and feels the saddness of separation.
Breastfeeding is different. A mother sees, feels, or hears her baby's discomfort. She offers her breast to ease the discomfort the baby feels. She feels her baby's soft skin, she smells her baby, she takes in the presence of her infant. Mom talks to her little one and the baby hums back between gulping the milk. The infant also feels, hears, smells, and sees the mother. A knowing passes between them, a reconnection-a rebirth. They are connected, they are in love with each other. They are one but not one. Many times a day, this process of knowing occurs. Human love and trust are cemented in the repetitive bonds of breastfeeding. Humanmilk feeding can not mimic the touch, the smell, the intimacy of breastfeeding.
This does not negate the dedication, the devotion and love that mothers who pump and store their milk have for their infants. There is so little support in our society for breastfeeding or humanmilk feeding. The question that we should ask ourselves is why do women nowadays feel that they have to have a breastpump. What wonderful marketing was used to create that belief?
Copyright 2008 Valerie W. McClain

Tuesday, November 4, 2008

Breastpumps, a risk factor for breastfeeding failure

photo by Jessie McClain
Are breastpumps a risk factor for breastfeeding failure? What is the cause of so many women initiating breastfeeding but then quitting within a short period of time? There are certainly multiple causes in our society for breastfeeding failure. We are a society enthralled by our gadgets, our things. Our social lives seem to be based on our monetary standing in the community. Our knowledge is based on what certain powerful and monied groups want us to know. We are dependent on the media for our knowledge and the media is owned by powerful interest groups. So women believe what they have been "educated" to believe. If you are going to have a baby, you either need that product called a breastpump, or that other product called infant formula. Life is about products. If you are wealthy, you get the expensive pump. If you are poor, you buy what you can afford or use a second-hand pump. You take the two-hour breastfeeding class (maybe, if you have time), and often those classes show you the wonderful array of breastfeeding equipment you can buy or rent. The pregnant mind becomes fixated on the belief that gadgets will solve any breastfeeding problem. Sore nipples? Get a pump. Engorgement? Get a pump. Need time away from baby? Get a pump. However did those women breastfeed in those olden days when pumps didn't exist? So every pregnant woman intent on breastfeeding gets a pump--good pumps and bad pumps. And the sad fact is that women don't understand that there are risks. What are the risks? Some women get a poorly working breastpump and believe that the reason they aren't getting any milk or a specific amount is because something is wrong with their body. How could this wonderful technology be the reason for little or no milk? I once did a home visit in which the $20 battery operated pump (yes this was about 10 years ago) the mom was given had no suction. The mother was basicly hand expressing into the pump to get any milk. She thought she was doing something wrong--nope. She was doing something very right--hand expression. It was the device that was defective, not her. But had she not called for help, would she have continued pumping? Would she have quickly given up on breastfeeding believing her body was defective? Technology/gadgetry without good consumer information and knowledge creates enormous problems. When I first started working in the WIC Program in 1994, I found that pumps were being given out to anyone who asked for them. I talked to my supervisor about it, and we instituted a requirement that in order for a pump to be given to a client the pump had to be taken out of its package, shown how to assemble it, and shown how it worked. The client was given information sheets on cleaning the pump, storing milk, and anything else that pertained to her request. Breastpumps like infant formula were kept out-of-sight from WIC clients because the priority in the Program was to have women breastfeeding. Breastpumps like infant formula require access to refrigerators for storage (meaning the client had to have electricity and we had pregnant women who were living in cars), access to running water and stoves for cleaning and heating. Teaching hand expression was far more valuable for women whose access to modern conveniences was limited.
Over the years, I saw women get damaged nipples from pumps, abrasions on the areola from pump flanges to small or not centered correctly, mastitis--from pumping excessively and then stopping, pumps put together incorrectly, moms focused on pumping rather than breastfeeding, and mothers assuming that pumped milk is a good indicator of milk supply. How many women quit breastfeeding because of these issues? Are we willing to look at this technology and realize the risks? Or is this situation imitating childbirth in the USA, where moms opt for the technology without realizing the risks? Epidural classes? Breastpump classes? What do we believe? Breastpumps are aids to helping moms sustain breastfeeding. There are risks whenever we step between a mother and her baby. Breastpumps don't solve breastfeeding problems, mothers and their babies resolve these problems by learning to be together. We are living in a culture that does not support mothers and babies being together. Women are made to feel that to be a worthwhile member of our society, they must go back to paid employment as rapidly as possible. There is a belief that babies don't miss their mothers. And that mothers shouldn't miss their babies. The priority is economics not the mental and physical well-being of mothers and babies.
So some breastfeeding advocates believe that the WHO Code has nothing to do with breastpumps and the only concern is baby bottles and nipples that breastpump company markets. Thus, the WHO Code document is examined and we do not look at the "intention" of the Code (which is to sustain breastfeeding not human milk feeding). Instead, the belief is that we only look at the precise wording of this document and not the intent. Maybe the document should be changed to humanmilk feeding rather than breastfeeding. Maybe the reality is that in our society the best we can hope for is humanmilk feeding and breastfeeding is a wonderful but impossible goal.
copyright 2008 Valerie W. McClain