Friday, December 12, 2014

In all that we do...let it be to help more moms to freely breastfeed and to freely provide their milk

As I drink my coffee this morning, I'm reflecting on the turmoil in the breastfeeding community as we watch the battles of two US corporations over the supply of human milk in that country, with non-profit milk banks caught in the line of fire, and the milksharing community standing by, frustrated.

Zeus forces Heracles on a sleeping Hera.

: The Origin of the Milky Way is a painting by
Italian late Renaissance masterJacopo Tintoretto (1575-1580), in
National Gallery, London,
formerly in the 
Orleans Collection.
I keep coming back to this question - how will all this help more babies get human milk?

The background image for this blog is from the painting, "The Origin of the Milky Way", by Renaissance painter Jacopo Tintoretto. It is a portrayal of the Greek myth of Hera, the goddess of marriage. It's lovely to think of the milk of the goddess, spraying across the heavens, creating what we see as the Milky Way.

It's a little darker, though - the way the story goes, Zeus attempts to feed his illicit son Heracles at the breast of his wife Hera, goddess of marriage, while she sleeps. She wakes up, realizes she's been tricked, and pushes him away. Another version has an abandoned Heracles rescued by Athena, protector of children, who brings the foundling to Hera for milk. Hera nurses Heracles, not knowing who he is. This painting is of the former version with Hera pushing away the baby and her milk spraying across the heavens, creating the Milky Way. Either way Heracles gets his super powers from the milk.

The painting feels especially appropriate this morning. Whose version of the myth is correct? Who's exploiting whom? Where are the mothers in all of this? And the innocent babies? I like that either way, Heracles gets his super powers.

Are mothers today being coerced or tricked to provide milk that they otherwise would provide freely? Some say there's a shortage of milk, others say there's enough milk to go around. We know fragile premature babies in NICUs are going without. It's clear the system is somewhat broken and needs reform, but it's not clear how broken, or how much, or what reforms are needed. Who sorts out all the competing interests, protects mothers from exploitation, and makes sure fragile, vulnerable babies get the human milk they need?

As we struggle with the ethical issues around supply and demand, commerce vs altruism,  this must be core of all that we do:  we must ask ourselves, do my actions support, protect, and promote breastfeeding? Are there negative consequences, whether intended or unintended, that will harm moms, harm babies, harm breastfeeding?

In all that we do, let it be to help more moms to freely breastfeed and to freely provide their milk. Let it be to help more babies be breastfed, to help more babies receive human milk.

Monday, December 08, 2014

Medolac will use some of its 1 million oz stockpile to extract and sell human milk oligosaccharides (Part 1)

Kimberly Seals Aller's post about Medolac's program to purchase milk from black mothers in places like Detroit and my blog post on their stockpile of a million ounces of human milk have both received a tonne of attention. Questions abound, like "what are they doing with all that milk" and "why do they want milk from the black mothers of Detroit?"

Here's one thing Medolac says they're going to do with all that milk...

From Medolac's own website, a news release sent out six weeks ago announcing they will soon be offering "large scale purification of Human Milk Oligosaccharides (HMOs)"

Infant formula  makers tout the benefit of oligosaccharides. 
What the, what?

Oligosaccharides are a component in human milk that we're just beginning to understand as a key reason why human milk confers immune properties on infants. Clearly oligosaccharides are an important ingredient - the infant formula industry has gotten all excited and now puts similar-sounding ingredients on their label as sales tactic.
Medolac will soon have "a radical increase in the volume of purified HMOs available for clinical research." Until now "native" human milk oligosaccharides have only been available "at an extremely high cost and in such limited quantities that human clinical studies have never been an option," says the firm. Owner Elena Medo: "thanks to our partnership with the Mothers Milk Cooperative (MMC) we have greatly increased the supply of donor milk to make this possible."

More is planned.

Medo calls this a "first foray into this exciting area of native human milk components including lipids, proteins, oligosaccharides and active biologics."

Who knows what is coming next, but since we're exploring the use of components of breastmilk for research, I should mention that at least one breast milk researcher has suggested a reason to target black mothers would be to access biomarkers specific to black women that may give clues to their higher rate of breast cancer.  Which might sound like it is good thing if it cures cancer in black women, but the notion that we would harvesting black mother's milk to sell their genetic material to researchers who stand to gain enormous profit from resulting treatments is incredibly exploitive.

And it's not that far-fetched. We've already seen breast pump company Medela team up with researchers to extract stem cells from breastmilk, trumpeting it as "a solution to the ethical dilemma of using human embryonic stem cells." My thoughts turned to Margaret Atwood when I heard of the stem cell research and I contemplated 20-something women's milk being harvested not for their own babies, but to treat Baby Boomer's preventable lifestyle illnesses like heart disease and diabetes – a futuristic Handmaid's Tale. The suggestion that Medolac would buy milk from black women in Detroit drew historic comparisons from the egregiously exploitive days when black slave women were forced to wetnurse their master's white babies – one headline writer has labelled the scheme "Mammy 3.0"

Who knows how how much of this HMO product might be available for sale or what the price will be? I'll bet the margins are pretty darn good. Better if the oligosaccharides are coming from milk that isn't otherwise able to be used. MMC is known to reject some of it's mothers' milk due to high bacterial counts, but says it is too expensive to ship it back to the mothers who sent it in. What happens to that milk? Do they pour it down the drain? Or...

Stay tuned for part two, Medolac could be making lucrative, human-milk-derived fortifer from its 1 million ounce stockpile.

Friday, December 05, 2014

GDP of human milk production in USA? est. $110B

This great article by The Age's economic editor looks at how we undervalue breast milk by not including it in our our GDP. The article notes how odd it is that when a farmer feeds a child milk from her backyard cow, it counts, but not if the child is breastfed.

"Gina Rinehart is on to something. The woman who picked the mining boom by betting on iron ore at a time when few realised what was about to happen in China, she is now betting on powdered milk. 
So fast is China's market for infant formula growing that it doubled in five years and is expected to double again in three years. It's why foreign companies are falling over themselves to take over Australian milk producers. 
And it's why the richest Australian is spending half a billion to build Hope Dairies from scratch. Bloomberg reports it'll take up 5000 hectares of Queensland farmland pumping out an extraordinary 30,000 tonnes of infant formula per year, all of it bound for China, gazumping Australia's present milk powder exports to China of 18,000 tonnes per year.
It would be great if it actually helped Chinese infants. But it won't. Infant formula is one of those rare products the use of which usually hurts rather than helps the user. And unlike others such as alcohol and unhealthy foods the user has no choice but to use it...." link to full article
The GDP info comes from the work of Australian economist Julie Smith. You can read more about her work in *this Journal of Human Lactation article and you can see a synopsis in this slide presentation

Smith has estimated the value of human milk production to be Aus. $3B annually for Australia, $110B annually for the US, and $1B annually for tiny Norway. She notes Australia and the US's rates are lower than they could be due to less than optimal initiation and duration rates.

*Full access to the Journal of Human Lactation is one of the many benefits of being an International Lactation Consultants Association member. I think ILCA is a fabulous organization and that's why I spend some of my volunteer time on the ILCA Medialert team. My views are my own and do not represent ILCA.

Thursday, December 04, 2014

Medolac claims stockpile of over 1 million ounces of human milk

At a time when many very sick babies in the USA are not able to access life-saving human milk, there's apparently a stockpile of over 1 million ounces sitting in a warehouse in Oregon.

According to comments made by Elena Medo to a Utah newspaper, her Oregon-based firm Medolac began offering breastmilk-producing women $1 per ounce in May of last year and has since paid out $1 million to hundreds of moms. This ensures Medolac has a strong supply of raw milk to process into its finished product, said to be sterile, shelf-stable human-milk that will last up to three years. At $1 per ounce, $1 million equals 1 million ounces of human milk.

If Medo's name sounds familiar, it's because in 1999 she founded Prolacta, which became the first for-profit company in the US to produce human milk-derived products. Medo, who left Prolacta under a bit of a cloud, doesn't appear to have sold much, if any, of her new company's milk products. I've been unable to find a single hospital in the US that has purchased her product, and I've been unable to find anyone who has received Medolac's milk.

What's she doing with all that milk?

Stockpiling is an age-old tactic that in a free market can artificially create a shortage, raising prices. It's also a good way to swipe contracts out from under a competitor known to sign exclusive contracts with hospitals. Medo could flood the market overnight which could have the effect of lowering prices and jamming up the freezers of Prolacta, described by Medo as her only global competitor, stretching their financial resources as they recalibrate to try to continue operating with lower pricing.

Or, maybe she has another plan for the milk. Medo says Medolac "stands ready to work with government and relief efforts." Back in 2010 the earthquake in Haiti generated a literal outpouring of support from breastfeeding moms in the US who were encouraged by the International Milk Bank Project (IMBP) to donate milk to save babies in Haiti.

Aid agencies quickly got the word out that the efforts were misguided – donor milk needed to be refrigerated and would be a huge drain on resources in an earthquake zone without a power grid. Haiti moms could save Haiti babies by wetnursing, and U.S. moms were encouraged instead to contact non-profit HMBANA milk banks to donate to U.S. babies, some literally dying without donor milk. Medo is well aware that HMBANA benefitted from this unexpected publicity: Prolacta did too. Could she be hoping for an opportunity to sell her stockpile of sterile, shelf-stable milk that doesn't need to be refrigerated, to a developing nation in crisis? The move could push Medolac into the headlines, tugging at breastfeeding mother heartstrings to generate even more supply for Medo's freezers.

Because if you're going to make a profit, it's all about supply and demand. In "The Startup Game," venture capitalist and early Prolacta funder Bill Draper talks about how Medo's company struggled in the early days to secure supply. News outlets and bloggers at the time criticized Medo's deal with the IMBP to divert milk given by moms who thought it was being sent to Africa for AIDS orphans. Draper says supply remained a concern until they set up a system through an affiliate, Two Maids a Milkin' "with an appropriate incentive program."

Prolacta was also criticized over Two Maids, which went on to be the "National Milk Bank." Up until this time, all milk banks in the US were non-profit, and there was nothing to distinguish these new "milk banks" from legit local efforts to collect breastmilk for babies in their own communities whose mothers couldn't produce enough. Prolacta was seen to be profiting on the backs of donor moms who didn't always know the milk they provided for free to save babies, was lining the pockets of investors along the way.

Amy West is one of several bloggers who took on the issue
of Prolacta's deceptive tactics. Read her blog here.
The system worked despite bad publicity, and with its supply side secure, Prolacta moved to tackle the demand side. It set up a central factory to produce a unique product that no one else in the world was making – a concentrated human milk additive that was added to mom's own milk to meet the needs of the smallest and sickest babies, saving their lives, and saving hospitals tens of thousands per baby in expensive surgical costs. Soon Prolacta was shipping the milk additive to hospitals around the country and demand for the $180/oz product started to outstrip supply. As the company grew more successful its ven-cap masters pushed founder Medo out, and after a stint selling human milk analyzers, Medolac was formed.

The newspaper reporting Medolac's million dollar payout to moms is in Utah, which is where Prolacta went a few years ago in an effort to secure more supply. Utah has one of the highest rates of breastfeeding initiation and duration in the country – ripe grounds for donor picking. (Human Milk News, 2011, Denver Mothers' Milk Bank, Prolacta vie for Utah #humanmilk donations)

Prolacta continues and has moved to set up supply deals directly with hospitals. It started a few years ago with the Texas Children's Hospital - all milk donated by moms to the hospital goes to Prolacta, and the hospital provides Prolacta products back for its patients. No-one knows the percentage of Texas moms' milk that actually went to help treat Texas babies at Texas Children's, but Prolacta said in August 2013 they had received 55,564 ounces through their Texas Children's donations.*(See update below.) By comparison, the non-profit milk bank in Austin distributed 425,000 ounces of milk in 2013, and North Texas's non-profit milk bank distributed 414,618 in the same period. This means over 5 per cent of the moms with milk to give in Texas were diverted to Texas Children's to provide their milk for free to a for-profit collection scheme instead of giving that milk to their state's non-profit milk banks.

That experiment must have been profitable because Prolacta also started a program for other hospitals to:
"...recruit mothers within the community who have extra breast milk and who want to help make a difference. In turn, Prolacta makes the process simple for participating hospitals by managing the breast milk donor qualification process."

It's described as turn-key with $0 investment. Why is Prolacta so anxious to work directly with hospitals? Well, of course, that's where the breastfeeding moms - the suppliers of the raw product - begin their lactation journey. And in a free market, it's all about securing supply.

The human milk marketplace in the US, however, is far from being a free market.

There are gatekeepers and regulatory pressures controlling the use of human milk in hospitals in the US.  Only a handful of states that regulate milk banks (California, Maryland, New York and Texas – with New Jersey considering legislation) Even fewer regulate purchase or sale of human milk. There are still big hurdles to the distribution of human milk products. It's hard to convince neonatologists – and experts who develop protocols for sick babies – to accept new human-milk products.

The caution stems from the AIDS crisis of the 80s which shut down human milk banks overnight. Since then, despite pasteurization and strict screening protocols – modelled after those in place at blood banks – it has taken decades to regain trust in the safety of donor human milk. The situation is further complicated by competition from infant formula companies whose bottom line is enhanced by expensive, specialized products, and which operate in an environment with little regulation of product quality and marketing. Trust in infant formula products is secured with expensive marketing campaigns disguised as educational seminars that use industry-funded research to sell the benefits of one concoction over another. It's in a formula company's best interests to erode both medical practitioner and public confidence in donor human milk as it competes directly with their products.

The free market is even further fettered by the existence of our pesky network of non-profit milk banks that undermine profit-taking by providing processed milk for a fee that simply covers costs, and relies on moms to freely give milk. Prolacta and Medolac are in direct competition with non-profit milk banks for access to these generous moms for their extra milk. For years Prolacta rode the wave of altruism, with its "milk bank" fronts like the National Milk Bank that at first outright duped women who thought they were donating to a non-profit, and then later through the forging of sponsorship deals with charities. (See Human Milk News Aug 2012:  U.S. company Prolacta milks donors, charity partners)

From Two Maids Milkin'/National Milk Bank
As our venture capitalist noted, the milk started flowing in its direction once Prolacta started providing incentives – indirect payments by offering free breast pumps and then paying charities $1 for every ounce of milk donated (see Human Milk News Dec 2011 Prolacta/IBMP offer $300 pump credit instead of breast pump to donors and Aug 2012  U.S. company Prolacta milks donors, charity partners.)

Medo clearly understands the need to secure supply and her move to pay mothers directly has been successful enough to force Prolacta to also pay moms to keep from losing them (See Human Milk News June, 2014 Prolacta now paying $1/ounce for breast milk.) It's only a shift in tactics, though, as the incentives were already costing Prolacta about the same amount per ounce.

Meanwhile, Medolac is trying new tactics. One big one is targeting the cream of the crop of milk
The milk stash of Stephanie Santiago, who
built this stash todonate to a friend who was adopting.
(Used with permission)
producing moms – the super-producers. Many moms who donate have a few extra ounces a day and they donate relatively small amounts - 200 to 300 ounces - over several months. $1/ounce is hardly worth the effort. But Medolac aggressively courts these so-called super-producers: mothers whose bodies are programmed, either through a quirk of nature, or through the use of artificial stimulation, to make enough milk for twins, or triplets, or more. The existence of these super-producer mothers has long been known to milk bank operators. In 2003 at a human milk banking conference in San Jose, I heard about milk banks in Scandinavian countries who found when they paid for milk they attracted a few of these super-producers who made as much as a litre of milk a day or more, selling it to the milk bank for several years (and providing an excellent opportunity to research the composition of milk made after the first months of a baby's life.) In 2010 when social media allowed milksharing networks to explode, it was not uncommon to see super producers offering up gallons of milk on the milksharing boards. A mom in North Texas holds the Guinness Book of World Records for her donation of 53,081 ounces of milk, or 414 gallons. Had she sold this milk to Medolac for $1/ounce, she'd be quite a bit richer ... but babies in North Texas would not have received it.

It is impossible to tell if the amount of local milk donated is reciprocated by processed milk flowing back to the community for babies in need. Non-profits provide donor milk across the nation even though not every hospital or state has a collection depot or milk bank. There are lots of questions about equity and for-profits complicate the situation. Prolacta's most lucrative product concentrates many ounces of milk to provide a human-milk-derived nutritional supplement for the very smallest, sickest babies. This  product replaces a bovine-based supplement that most agree increases the risk of illness and death - but some wonder if it should be better regulated to prevent it from being overused. And Prolacta's use of infant formula company Abbott to market their products gives pause to many who are familiar with that company's unfettered and predatory marketing practices in both the US and around the world.

Medolac's other new tactic is a partnership with the Clinton Global Initiative to invite black mothers to sell their milk as a way of boosting black breastfeeding rates. Well-known author and black breastfeeding advocate Kimberly Seals Allers wrote about this for the New York Times parenting blog Motherlode, noting none of the Medolac's product made with milk purchased from black Detroit mothers would be sold back to hospitals serving the black babies of Detroit. I urge you to take a moment here to read Seals Allers' post, and if you're not familiar with how outrageously undermined black breastfeeding mothers are in Detroit, read this too.

Medolac's move into Detroit has been met with a lot of head-scratching, and I have to wonder what Medo is up to. Seals Allers says "these are problems that could best be addressed by women living and working in the community" but I can see Medo considering that publicity about the needs of premature black babies in Detroit could drive yet more offers of milk from sympathetic, breastfeeding mothers in the way they responded to Haiti and the AIDS orphans of South Africa.

Medolac's 1 million ounce stockpile remains a mystery. How many US babies in need went without donor human milk in 2013 because moms were convinced to sell their milk to Medolac? The marketing has been slick and it's clear Medo has learned from past Prolacta mistakes. Instead of a for-profit, her supply-side sister company is structured as a cooperative, promising moms they can save babies, earn money, and even "shape the future of of milk banking." It's clear milk is pouring into Medo's Oregon factory and even though moms are referred to as donors, it's becoming obvious that the moms who are paid to provide milk don't seem to have the same incentive to ask what's being done with it.

We'll never know for sure how many babies lost out because of Medolac's stockpiling over the last 18 months. Some of these moms may have otherwise donated to non-profit milk banks, or informally, through milksharing networks or to friends or neighbours, instead of selling it. Or that milk may simply have gone down the drain. Or perhaps the super-producers simply wouldn't have made as much milk without the incentive to sell it. Despite concerns expressed by HMBANA's milk banks about a shortage of donor milk, there are indications the problem is not a lack of milk, but confusion about why, where and how to donate. Milksharing advocates have been saying for years human milk is not a scarce commodity, but rather "a free-flowing resource and we are dumping it down the drain." Lately Prolacta has been echoing that claim. Well-known blogger Annie PhDinParenting has suggested the problem is that milk is a commodity that doesn't have an advanced distribution channel.

Medo says she wants to change all this. Her pitch is to "Increase the Global Supply and Affordability of Donor Milk" through her "radically different" approach relying on "economies of scale" and "novel solutions...that close the gap between supply and demand."

Medolac has diverted 1 million ounces of human milk away from sick and needy babies by convincing moms they are doing a good thing by selling their milk to a "cooperative"... that believes "mothers should shape the future of milk banking" by participating in "the only paid donation program in the United States."

If a non-profit community milk bank took in a million ounces of milk without disbursing it there would be a huge outcry. And yet, Medolac and its sister company won't say a word about how or where their stockpile will be used.

It's completely unclear who – other than the profit takers – will benefit. What is clear that the milk moms produce for Medolac is not going to sick and needy babies in their communities.

If you have milk to donate, consider contacting a non-profit HMBANA milk bank operating in your community. HMBANA provides milk across the US and Canada and works with teams of volunteers to open new milk banks in cities where there are none. If you can't donate to a milk bank or want your milk to go to families who can't receive milk from milk banks, contact your local milksharing organization.

*Update Dec 8, 2013: On the question of how much milk donated to Texas Children's Hospital's Prolacta milk bank remains in Texas - a TCH video "Spotlight on on Donor Milk Program," released in the same week as a August 2013 Prolacta news release that says Texas Children's diverted 55,000 oz to Prolacta, quotes Nancy Hurst of Texas Children's saying they use "about 3,000 ounces a month." That is about 36,000 ounces per year. So about 35 per cent or almost 20,000 ounces of milk donated to by Houston-area moms is either leaving the state, or is being used for another purpose according to TCH.

Tuesday, August 12, 2014

ILCA embraces milksharing in new emergency feeding guidelines

I'm delighted to see the International Lactation Consultant Association's new position paper on Infant and Young Child Feeding in Emergencies includes a recommendation to explore milksharing or local donations of expressed milk as an option to feed infants during an emergency. The same recommendation reiterates what experts have been saying since Haiti -  international donations of expressed breast milk are not appropriate. 

"... Consider donations of expressed milk or milk sharing from a local source in limited circumstances, such as in an evacuation center where refrigeration is available or where a wet nurse is available but feeding expressed milk is more culturally acceptable. Breast pumps should not be used unless unlimited hot water is available. International donations of expressed breast milk in emergencies are not appropriate; past experience of such donations has been that they detract from the provision of aid. ..."
The position paper was authored by Cathy Carothers, the former President and Marketing Director of ILCA and Media and Public Relations Chair for the USBC, and Dr. Karleen Gribble, Adjunct Research Fellow at the University of Western Sydney, and expert in infant feeding in emergencies. (See Natural disasters - are we doing enough to protect infants, Human Milk News, 2011)

I had the pleasure of hearing Carothers speak about the role of donor human milk in a post-emergency setting at the HMBANA Conference in 2012. It was the Human Milk News live-tweets from that session that prompted Karleen Gribble to activate a Twitter account to participate in the online discussion, and it's exciting and gratifying to see these two experts collaborating on this new policy. ILCA's new position paper has 12 general recommendations/strategies and 10 specific recommendations for IBCLCs including an important call to educate media outlets to broadcast messaging supporting appropriate infant and young child feeding in the lead-up to and during an emergency.

FREE access to the Journal of Human Lactation
You can read the entire position paper in the Journal of Human Lactation - brought to you for free free for the month of August as part of ILCA's celebration of World Breastfeeding Week.

Want to learn more? ILCA calls on IBCLCs to contact a local emergency organization to sign up for training in emergency preparedness, and to undertake specialized training in infant feeding in emergencies. The Infant Feeding in Emergencies Core Group website provides tools and policy guidance. You can access this hour-long free expert lecture by Gribble at Health E-Learning. UNICEF has a full set of training modules on Nutrition in Emergencies with a separate module on Infant Feeding in Emergencies. he handout from the 2012 HMBANA conference address by Carothers is still up on the HMBANA website, and you can also access this ILCA handout to be distributed to health professionals, Facts about Breastfeeding in an Emergency by Carothers and Kendall Cox. The Louisiana Breastfeeding Coalition also has a helpful collection of links and has a comprehensive list of resources.

Note: I am a member of the ILCA Medialert Team. My views are mine alone and do not represent ILCA.

Tuesday, July 22, 2014

Can't go to #ILCA2014? Attend via Twitter!

The annual professional conference for
all things lactation is taking place this week in Phoenix Arizona. The International Lactation Consultant Association's Real World ILCA 2014 gathering starts tomorrow and continues through Saturday.

Can't go? Bummer! I can't go either. I was planning to attend to live-tweet for @HumanMilkNews, but family events are keeping me close to home.

What's the next best thing? I love following conferences via Twitter. You can do it too, and you don't even need to be on Twitter (but you're going to want to be!!)

You can follow anyone or anything you want on Twitter by heading to the Twitter website and plugging in a search term or a name or Twitter account. Try it: Type in #ILCA2014 in the search window at the top, and hit return. Et, voila!

Didn't work? Here's a handy link! And here's the livestream:

Isn't that awesome! If you're already at the conference, consider joining Twitter and getting in the fun. Check out this how-to from ILCA social media master Jeanette McCulloch:

Conference Twitter 101 for Birth and Breastfeeding Pros: Getting Started

There's also an app! Search for 2014 ILCA and load it on your smartphone or tablet. The tablet version includes a live Twitter feed.

Not at the conference, and scared to try something new?  I've made a custom #ILCA2014 guide that'll get you up and running on Twitter in five minutes flat. The screenshots below are instructions for a laptop.

So jump in! If you're on the #ILCA2014 search page already, on your laptop it'll look something like the screen below. Otherwise, just head to, or download the Twitter app on your smartphone. Sign up! You'll be asked to enter your name, email address, a password and a username. If you're on an iPhone or Android device, the process is similar.

Tips for a username - try something short and descriptive. I use @jodinechase for my personal Twitter account and @HumanMilkNews for the account that pairs with this blog. Jeanette McCulloch, ILCA's social media whiz, uses @JeanetteIBCLC.

If your username is taken, Twitter will suggest another one, but you don't have to take what is on offer. Try your name with a middle initial, or add your credentials.

If you're using a laptop and a browser Twitter will offer you a Welcoming Tutorial. Go ahead and take it. If you're on your phone, it'll offer you the opportunity to download the Twitter app. Do it! 

The Twitter Tutorial gets you set up and on Twitter fast. This is a good place to pause for a moment and absorb two key things about Twitter:

1) It's all about sharing: Chances are you're already on another social network like Facebook and you get the concept of sharing your thoughts or information in status updates. Twitter is like that, except pretty much everything you share goes out into the wide world and is always public. And you can only type out status updates, or posts, or "tweets" that are 140 characters long.

This is 140 characters long This is 140 characters long This is 140 characters long This is 140 characters long This is 140 characters long This is 140 characters long Th

It's all about following: Twitter is all about following the tweets sent by people who share your interests, and exploring tweets about specific interests. People use hashtags - words preceded by the hash mark - to tag and track those tweets. When Twitter asks you to follow 5 people, type the #breastfeeding hashtag in the search window to bring up people who use that hashtag for ideas of who to follow. Take a look at the list of people presented, and click the "follow" on those you know and are interested in.

 Twitter will ask you to follow a few more people, and it will also ask you to type the names in of people you know. You can type in names like Liz Brooks or Karleen Gribble or Jodine Chase, or you can type in Twitter IDs like @HumanMilkNews or @ILCA1985, which is the official ILCA account.

As a last touch, Twitter will ask you to personalize your account. It wants you to add an image - it can be a photo of you, or an avatar or other image, and a short bio. Don't worry if you can't find the right picture or think of a bio of anything now. If you're on an iPhone or Android device you may be offered the option of taking a selfie to use as your photo ID.

And you're ready to begin Tweeting! Note until you confirm your account from your email, you may see the confirmation bar at the top of your screen. Twitter will continue to recommend people for you to follow on the right.

If you want to reply to a tweet, select or hover over the tweet and you will see the Reply, Retweet, and Favourite options.  

Your reply goes directly to Robin B. Frees, whose Twitter handle is @RobinFrees, and if you add the #ILCA2014 hashtag, anyone following will also see it. 

To compose a new tweet, click the compose button at the top right. Don't forget to include any relevant hashtags in your Tweet! Twitter will show you replies with its notification features. 

And that's it! You can now follow the ILCA conference, whether you're at the conference or at home, by searching tweets using the #ILCA2014 hashtag. (Try that on Facebook too!) By retweeting, replying, or typing your own tweets will be able to comment, ask questions, and interact with other conference goers or people who are also following along. Happy tweeting!

Note: I am a member of the ILCA Medialert Team. My views are mine alone and do not represent ILCA.

Tuesday, July 15, 2014

Indy, LLL latch-on events sprouting up across Canada and the US

What's a latch-on?
It's a celebration of breastfeeding! Women gather in the same place and latch on their babies all at once. The idea started in Australia in 1999 when 536 children were latched on and was picked up the following year by Quintessence Foundation. Every year Quintessence hosts the annual Breastfeeding Challenge in October during Canada's national breastfeeding week. By 2003 the celebrations had expanded to sites around the globe.

The world record?
In 2002 a group of moms in Berkeley, California, challenged the Australian record and set a new world record of 1,130 children breastfeeding simultaneously. In 2006 a group of moms in the Philippines set a new world record of 3,738 children breastfeeding at one site and the following year registered 590 sites with over 22,500 women breastfeeding their children. According to Quintessence,
"The organizers of this massive 2007 event, the Children for Breastfeeding and the Nurturers of the Earth in partnership with WABA, explained that "these events were organized because at the time, US lobbyists and businesses were trying were trying to get the Department of Health to water down breastfeeding advocates efforts to strengthen the laws that protect breastfeeding. The battle with the companies reached the Supreme Court and the halls of the Philippine Senate and Congress in public hearings."  This was certainly an impressive effort!" (From History of the Quintessence Challenge)

Big Latch On 
New Zealand has been hosting a latch-on since 2002 and has had over 1,000 moms and children breastfeeding at one site. In 2005 the Big Latch On initiative was started by the Women's Health Action Trust in New Zealand to coincide with World Breastfeeding Week in August. There are now almost 100 sites in New Zealand. In 2011 the movement was brought to the USA by the company Small Beginnings Group and according to their website the The Big Latch On grew with the support of La Leche League to include sites across the US.

LLLUSA and Indy latch-on events
Concern over private ownership and inappropriate corporate sponsorship has led to an pause in the partnership between The Big Latch On and some non-profit organizations. La Leche League USA is hosting latch-on events under its own umbrella "Live, Love Latch" site and there are also independent latch-on events being held:

Latch On Events:
Aug 1
Live, Love, Latch Potluck, Little Rock, Arkansas
La Leche League of Central Arkansas

Aug 2
Live Love Latch, Mobile, Alabama
La Leche League of Mobile and Baldwin Counties

Greater Edmonton Latch On, Edmonton, Alberta

Live Love Latch Family Picnic, Sierra Vista, Arizona
La Leche League of Sierra Vista


World Breastfeeding Week 2014 - Ms. Wright's Way, Granada Hills, California
Ashley Wright

Latch and Link Long Beach, Long Beach, California

3rd Annual Breastfeeding Celebration, Stockton, California
La Leche League of Lodi

Live Love Latch, Ventura, California
Breastfeeding Coalition of Ventura County and La Leche League Ventura

Live, Love, Latch, Fort Collins, Colorado
La Leche League Fort Collins

Live, Love, Latch, Boynton Beath, Florida
La Leche League of Lake Worth/Boynton Beach

MiLLLk and Cookies: A toast to World Breastfeeding Week
La Leche League of Marion County

Live, Love, Latch, World Breastfeeding Rally and Info Fair, St. Mary's, Georgia
South Georgia World Breastfeeding Week Committee

Live Love Latch Family Picnic, Treasure Valley, Idaho
La Leche League of Treasure Valley

Live Love Latch Family Festival, New Albany, Indiana
La Leche League of Southern Indiana

Live Love Latch Family Picnic, West Lafayette, Indiana
La Leche League of Greater Lafayette

Live, Love, Latch, Mankato, Minnesota
La Leche League of Mankato/St. Peter

World Breastfeeding Week Family Picnic, Springfield, Missouri
La Leche League of Springfield

Live Love Latch Kickoff Picnic, St. Louis, Missouri
La Leche League of St. Louis

Mamafest, Rolla, Missouri
Rolla Birth Network

New Mexico
Live Love Latch Ice Cream Social, Farmington, New Mexico
La Leche League

New York State
Live Love Latch Celebration, Twin Tiers, New York
La Leche League of Twin Tiers

World Breastfeeding Week and Live Love Latch Family Picnic, Mason, Ohio
La Leche League Cincinnati

Columbus Latch and Splash, Columbus, Ohio
Clintonville Breastfeeding Support Group

Community Breastfeeding Celebration, Duncan, Oklahoma
La Leche League of Duncan & the Oklahoma Mothers' Milk Bank

Live, Love Latch in the Heartland!, Norman, Oklahoma

Live Love Latch Breastfeeding Family Faire, Rogue River, Oregon
Breastfeeding Coalition of Josephine County/La Leche League of Grant's Pass

The Breastfeed'in, Eugeine-Springfield, Oregon
Daisy C.H.A.I.N. Creating Healthy Alliances

Lancaster Celebration, Lancaster, Pennsylvania
La Leche League Groups of Lancaster County

Live, Love, Latch Picnic, Waynesboro, Pennsylvania
La Leche League of Greencastle/Waynesboro,

South Carolina
Live, Love Latch in the Low Country, Charleston, South Carolina

Latch On Texas, Austin, Texas

Latch On Texas, Dallas, Texas

Latch On Texas, Fort Worth, Texas
Tarrant County Breastfeeding Coalition

Celebration, Lewisburg, Tennessee

RVA Latches On!, Richmond, Virginia
Richmond Health Action Alliance

Skagit Family Jubilee, Burlington, Washington

Contact the editor to add an event.

See also: Who own's breastfeeding, or why I'm troubled by the Big Latch On this year

Wednesday, July 09, 2014

25 years of milkbanking in Mumbai

Lokmanya Tilak Hospital NICU
This is a wonderful article on India's oldest milk bank at the Lokmanya Tilak Hospital in Mumbai. It was originally funded by a private company and when that ran out its founder, Dr. Armida Fernandez, had to convince the local hospital to pick up the funding: 
"Dr. Fernandez had to get creative in her argument. She cited the popular Hindu myth of the god Lord Krishna, who was separated  from his biological mother at birth and nursed by another woman. The example, at once familiar and reverent, struck home, and eventually, the breast milk bank was allocated money from the hospital’s budget."
Read the whole article below:

Friday, June 20, 2014

Prolacta now paying $1/ounce for breast milk

And, here it is.

Prolacta is now paying $1 directly to moms for every ounce of breastmilk they provide to the company. Prolacta has long provided a breast pump purchase credit to moms, offering $200-300 cash in exchange for a commitment to provide several hundred ounces of milk. (See: Prolacta/IBMP offer $300 credit instead of breast pump to donors, Dec 2011)

And the company has also been paying $1/ounce to several charities as a way of encouraging moms to provide the milk needed to make their $180/ounce fortifier product. (See: US company Prolacta milks charity partners, donors - Aug 2012.)

Prolacta has been talking about moving to a direct-to-mom cash payment model for a while, and now that competitor Medolac has entered the market, it makes sense for Prolacta to formalize its milk compensation program. (See: Significant corporate developments in the human milk marketplace, Oct 2013)

In a way it's more honest and direct than past compensation models. A clear choice is forming now for moms:

• Get paid $1/ounce from Prolacta and know your milk is eventually going towards the only human-derived human milk fortifier for sick babies in the NICU - 100 per cent human milk saves lives. At a very high price.

• Get paid $1/ounce and upstart Medolac promises it will process your milk and turn it into a shelf-stable, sterile product. "Promises" being the key word; they don't appear to be selling milk yet, so presumably it is in some sort of storage facility as they sort out their processing and delivery systems, and negotiate contracts with hospitals.

• Donate to a HMBANA milk bank belonging to the growing network of non-profit milk banks, which serve just under half the NICUS in Canada and the US. You'll receive no money, but you will know your milk will be pasteurized, retaining many of its critical immune properties, and will be used to help sick babies.

• Give your extra milk to a close friend, relative, or someone in your community, or connect to a recipient in need via peer-to-peer milk sharing networks.

• Sell your extra milk in a private arrangement.

Moms with extra milk are clearly in demand! How will this new Prolacta pay model impact the supply of milk to our non-profit milk banks? Will it reduce the amount of milk shared through peer-to-peer networks?

Monday, June 09, 2014

Montreal's milk bank increases donor human milk options for babies

The Montreal Gazette has an excellent article exploring the new Hema-Quebec milk bank as one more option for families who can already access human milk through milksharing networks. The milk bank will provide milk for premature infants born before 33 weeks gestation. Goldfarb clinic's Carole Dobrich is quoted noting the lack of support and guidelines for milksharing from Health Canada. Mika Puterman of Montreal Milkshare and Emma Kwasnica, who founded HM4HB while living in Montreal, are also quoted. Kwasnica also discusses cross-nursing, which she says is still taboo:
“It seems somehow the idea of expressing your milk, putting it in the freezer, and giving it to another woman — that’s okay. We can talk about and show that, take pictures of that,” she said. “But nursing another woman’s baby ... it’s an intimate act that you feel like you’re sharing with someone else. And it’s a lot more personal than just expressing your milk and handing a frozen cartridge of it off to another family.”
Read the whole story here:

Alternative routes to breast milk for Quebec babiesA new milk bank for premature babies complements long-standing traditions for mothers in search of options

Alternative routes to breast milk for Quebec babies

Valérie Laramée, whose surgery left her unable to produce enough milk but nonetheless wants it for her baby, found a network of donor mothers online.
Photograph by: Marie-France Coallier , The Gazette
MONTREAL — The benefits of breastfeeding are trumpeted far and wide these days, after falling out of favour in Quebec and elsewhere mid-20th century. For mothers who want breast milk for their babies but can’t provide enough themselves, options for obtaining it are increasing.
With Héma-Québec’s recent opening of the province’s first milk bank in decades, premature babies in Quebec who have a doctor’s prescription now have access to pasteurized human milk. ... link to full story

Wednesday, May 07, 2014

Canada now has 4 donor human milk banks, yet preemies in NICUS are still going without

Canada now has 4 donor human milk banks, yet preemies in NICUS are still going without

Join hundreds in 11 cities across Canada in the 1st Miracle Milk Mother's Day Stroll May 10 

Help raise awareness, money, and milk for premature babies in our NICUs

It's every pregnant woman's worst nightmare - rushing to hospital in labour with a due date far in the future, giving birth early to a tiny and fragile premature baby, and watching that baby begin its fight to survive. One in 12 Canadian births is premature, and the sickest and most fragile of those babies are hospitalized for weeks and months in neonatal intensive care units. And some don't go home. Prematurity is the leading cause of neonatal death (after congenital malformations.)

Yet, more preemies are surviving now in Canada because they're less likely to suffer from a painful and debilitating disease called necrotizing enterocolitis (NEC). Babies who are fed exclusive diets of human milk - from mom, from donors, or from both - have a much lower risk of contracting NEC. There are hundreds of cases of NEC annually in Canada and it kills dozens of preemies each year. Ontario has 15 NEC deaths a year. A single case can cost well over $100,000 to treat. (See Best for Babe's Fast Facts: Miracle Milk for more info.)

Learn more about Canada's milk bank
closures and the struggle to reopen them
in Birthing Magazine here.
Yet, up until 2012, there was only one single donor human milk bank in Canada, in Vancouver, and it did not begin serving premature babies in the NICU until 2009. After our network of milk banks closed almost overnight in the midst of the AIDS crisis in the 80s, new infant formulas tailored specifically for premature babies filled in the gap. Many women have difficulty establishing their milk supplies after a premature birth, and without ready access to donor milk, it became a rare thing in the NICU for a baby to receive only mother's milk. But over the years we learned an exclusive human milk diet was an important component in avoiding NEC illnesses and deaths. In 2010 the Canadian Pediatric Society issued a formal call for a network of donor milk banks across the country.

The result? Almost as fast as Calgary's milk bank closed in the mid-80s, a team of experts and volunteers led by Jannette Festival mobilized money and milk donors and Calgary's milk bank opened in 2012. In March, Toronto's milk bank celebrated one year of operation after years of delay (see Human Milk News: Toronto's sparks controversies over delays leading to baby deaths) and Montreal's milk bank is opening officially later this May. There is an active effort to open a milk bank in Saskatchewan, and in Halifax babies in NICUs are now receiving donor human milk from other areas as plans move forward for a local milk bank to serve the region.

New moms see plenty of formula ads but
little or no information about milk banks
This is great news for some of Canada's premature babies and their families. But more needs to be done. Fewer than half of the country's NICUs have access to donor human milk today. After decades without public awareness, and with donor milk mainly used in the NICU, away from regular maternity wards, most moms giving birth to healthy newborns have no idea that donor human milk banks are even a thing! Very few hospitals in Canada offer donor milk for healthy babies when mom's own milk isn't quite enough. New moms are surrounded by infant formula marketing materials but there are rarely pamphlets or posters explaining the need for donor milk in hospitals, public health clinics or pediatricians offices.

As a result, moms who are able to avoid the booby traps that keep them from meeting their own breastfeeding goals often have copious supplies of milk - and no idea what to do with the extra! They may hear about a friend or a neighbour in need, or they may encounter a milksharing network and then their freezer stash is put to good use instead of being tossed down the drain. But most moms with healthy babies have no idea just how sick those babies in the NICU are, and how great the need is in the NICU for donor human milk, or how to sign up to donate at one of Canada's mlk banks.

This lack of awareness has resulted in a critical shortage of donor milk for babies in NICUS. The number of women who start out breastfeeding in Canada is around 90 per cent. In the Calgary milk bank's first year of operation lots of publicity and support caused the bank to exceed its donor goal. A collection depot was opened in Edmonton, and Alberta's hospitals started changing their protocols to use the new supply of donor milk. But now that all of Alberta's level III NICUs are using donor milk, demand is up and the pressure is on for more donors. Alberta is in the middle of a baby boom with about 55,000 babies being born each year and we have the highest prematurity rate in Canada.

Founder Jannette Festival marks the
Calgary Mothers Milk Bank's 1st anniversary.
The Calgary Foundation has stepped up to the plate with a grant to help Calgary's breastfeeding moms learn about the need, but even though there are about the same number of babies born in Edmonton as Calgary each year, without dollars and with volunteer resources stretched thin, awareness is lower and donations from Edmonton are only a quarter of what they are in Calgary. Same number of babies born, 1/4 the amount of donor milk. See the problem?

What is being done? A team of volunteers, moms, celebrities and breastfeeding advocates from across North America has mobilized to change the situation. Even as milkbanking experts from across Canada and around the world were meeting at the Human Milk Banking Association of North America (HMBANA) conference in Victoria, B.C. April 28-29 to talk about how to increase donor rates, the Best for Babes Foundation was applying its considerable marketing expertise to raise awareness for the need.

In only six short weeks since Best for Babes launched the 1st North American Miracle Milk Mother's Day Stroll volunteers stepped up to organize 70 Stroll sites across North America, including 11 in Canadian cities. There are even 2 Strolls taking place on military bases in the UK. Registration fees and t-shirt sales have already raised $15,000, and more donations of money and milk are expected to continue to pour in as the day of the Stroll approaches.

In recent years the US, like Canada, has seen pediatricians call for preterm babies to have pasteurized donor milk when mother’s own milk is unavailable. But Jennifer Canvasser, who lost her son to NEC last year, says 60% of US NICUs aren't using donor milk. "The call is being ignored," Canvasser says. "It’s a tragedy that more parents, health care providers, medical directors and hospital administrators don’t know about donor milk’s existence, accessibility, safety and life-saving powers for babies in the NICU.”

This Saturday, May 10th, hundreds of Canadians will be donning their black and pink Miracle Milk t-shirts and strolling to raise awareness, money and milk for this very important cause. Canada's Stroll sites will drive donations to Canada's milk bank network as well as to the fund set up by the Best for Babes Foundation to benefit Canvasser's NEC Society, HMBANA, and other educators.

While several hundred people is hardly a blanket of black and pink from coast-to-coast - it is a very important first step. Best for Babes Foundation co-founder Danielle Rigg says, "our goal with this event is to create a North America-wide consumer-driven platform to raise awareness, funds and milk donations to help make human and donor milk the standard of care in NICUs everywhere to help reduce suffering and deaths. Human milk saves lives. We don’t really need more science. What we need are more solutions to help more moms get more Miracle Milk to more premature, sick and fragile babies.” 

Canada's Strolls are taking place in Vancouver, Edmonton, Calgary, Grande Prairie, Lethbridge, Regina, Saskatoon, Toronto, Ottawa, Kitchener/Waterloo and Guelph

I'll be there. What about you? Register or donate here, or click through to your local stroll site for more information on how to donate money or milk to your local milk bank.

 Rogers Hixon Ontario Human Milk Bank
Alberta: Calgary Mothers' Milk Bank

British Columbia: B.C. Women's Milk Bank