Wednesday, April 16, 2014

Who owns breastfeeding? Or, why I'm troubled by the Big Latch On this year

This is just a quick post based on news today that I find disturbing.

The interwebz are buzzing with the news that Mother's Milk Cooperative, the sister company of Prolacta founder Elena Medo's new venture, Medolac, will be sponsoring the Big Latch On this year. (See Significant corporate developments in the US human milk marketplace, October, 2013)

Earlier this spring I wrote a lengthy post to Lactnet, which is available in their public archives, where I observed that Medolac's entry into the human milk marketplace is really shaking things up:
"... There seems to be a growing divide between commercial and not-for-profit interests. On the commercial side we're seeing a battle of "titans" as Medo seeks to redeem herself after having lost control of Prolacta. She's been exceptionally clever in identifying strengths, weaknesses, opportunities and threats and answering/exploiting with her new corporate model. ... "

I love the Big Latch On. I have participated in a similar event, the Breastfeeding Challenge, founded in Canada in 2001 by the Quintessence Foundation, for many years. Like the Breastfeeding Challenge, the Big Latch On is a grassroots effort with a simple goal - to encourage women to gather in public to celebrate breastfeeding. I love and support grassroots breastfeeding initiatives that support breastfeeding and that support donor human milk. This blog stems from that love.
Simple, grassroots, driven by altruism.

The Mother's Milk Cooperative may have a crunchy grassroots sounding name, but take a closer look. Unlike milksharing initiatives, MMC did not rise up out of the grassroots. Rather, it was conceived to provide the supply side for Medolac. Sure, it will be paying a dollar an ounce to mothers, but the profit margin on its products will be significant, and I am concerned its model has the potential to be exploitive of mothers who would otherwise donate excess milk but are forced by economic circumstances to instead sell it.

Medolac recently hired a former infant food manufacturing company executive as their regulatory affairs advisor. When for profit companies step up to promote, support, and protect breastfeeding, I become very concerned.

Because a for-profit company's first priority is, above all else... profit. And so I'm concerned that profit is being sought at the expense of mothers and babies and the Big latch On is being exploited by for-profit interests.

Update July 15, 2014: LLLUSA is running Live, Love, and Latch events as a latch-on alternative, and a number of independent latch-on events are also taking place. Click here for a list: Indy, LLL latch-on events sprouting up across Canada and the US

Update July 23, 2014: Quintessence Foundation has launched Express Support:
On August 1st we are holding an important event- a chance to express your support for breastfeeding women around the world as well as non-profit milk banks.Some groups are doing “latch on” events, others a coffee group. How can you support women in your community? http://www.expressyoursupport.ca

14 comments:

Adrianne said...

Jodine,

While I appreciate your natural curiosity about what we do, without sounding too harsh - you need a fact check. How would you know a thing about any of our business costs, profit margins, how grassroots we ARE, and so much more. As the CEO of the MMC, I am pretty sure we will qualify as Grass Roots as long as I am still working in our warehouse, packing boxes, making phone calls and designing our website. LOL

I'm pretty sure the only way we could be MORE grass roots is if we were actually located in a field.

Here are some facts you might find interesting:

FACT: The current milk banking system serves approximately 3% of only the most critical need (VLBW infants).

FACT: There is NO such thing as competition in milk banking until EVERY need is met, and EVERY nursing mother is aware of milk banking.

FACT: We have designed our model to make both companies products MORE affordable to ensure that more babies that desperately need these products can get them.

We are working day and night to resolve this shortage that DAILY results in infants dying. Creating a sustainable business model that supports moms and babies not only makes sense, but is making a huge difference.

Through the producer processor model we operate under (which is found commonly with cooperative businesses) we are reducing the cost of donor milk, increasing availability, improving quality, and supporting our donors.

Many of whom come from the milk sharing community, where they are relieved to have a formalized process to sell their milk.

All due respect, posts like this only create paranoia and negativity. Next time just shoot me an email with questions for heavens sake.

In milk banking, ultimately we are all fighting the same fight. Just imagine what could happen if we started working together.

People will always have an opinion on how things should be done differently. I have some ideas of my own, starting with the way our organizations have been represented here. I applaud your curiosity but would encourage you to reach out to us to get the facts next time.

Since I simply cannot please everyone - I stay focused on what we are committed to: making donor milk more affordable and accessible to babies who desperately need it.

I will let The Big Latch On speak for themselves on why they decided to work with us. In regards to why we partnered with them? I think they have a great event, and they needed help, so we stepped up. That's it. Not very exciting I know. I will keep you posted if anything exciting and more scandalous comes up.

Thanks for the mention.

All the best,
Adrianne

Jodine Chase said...

I appreciate the opportunity for public dialogue. I think transparency is critical when considering ethical partnerships between not-for-profit and for-profit entities. Is there anything that is not factual about my post? Mother's Milk Cooperative (MMC) has been described as a sister company by Medolac, and Medolac's owner, Elena Medo, has said, on the public record, that MMC provides the supply side for Medolac's business model. I welcome more details on costs, revenues, and profit margins. I do understand the producer processor model and I've been following MMC's rhetoric regarding a commitment to mother and baby - "not just the bottom line." I certainly have noticed a movement towards more transparency from the early Prolacta days - as Elena Medo's daughter you and she both moved quickly to clarify your personal relationships; personal and business relationships between the supply side and the producer had to be outed by bloggers back in the early Prolacta days. I have no doubt that the lessons learned from Prolacta - the huge backlash in the early days when pseudo "milk banks" were set up to entice moms to donate without adequate disclosure - has resulted in this change in tactics, and MMC is one result of the lessons learned. And it is certainly no secret that there is a gap between the supply of human milk and the demand for human milk by the institutions treating our sickest premature babies. Equally, it is no secret that in a market economy, when demand exceeds supply, securing supply is critical to success (and let's not forget that other pesky free market theory about how prices go up when demand exceeds supply.) So - competition for the provider of the milk - the mother - is becoming fiercer by the second as Medolac moves to compete with Prolacta and with our HMBANA non-profit milk banks and with milksharing recipients to meet the need. MMC is Medolac's solution to this supply side pressure. What we are now seeing with your partnership with the Big Latch On is Medolac's MMC moving to secure brand loyalty, increasing the chances that mom's milk will flow in your direction.

Michelle Sharit said...

Jodine, I so appreciate your post on this topic. I never want to be in the position of learning about a for-profit company from only the company's spokespeople and promotional materials. Especially when it involves mothers and babies! We always need to be advocates for them, and your informative post raises important concerns. Thank-you!

Angela Shifflett said...

I've watched the Prolacta debate, in particular, with a mild sense of bafflement over the years. While I do think transparency is important, I don't understand the simple assumption of "for profit = evil". I'm coming at this issue as a former LLLLeader of 10 years and long-term, exclusive breastfeeding mother of 3, as well as a mother to a former 24-week preemie who quite possibly wouldn't be here without the help of Prolacta breastmilk fortifier. We were the first "test case" at our hospital, after I pushed *hard* to get Prolacta for my daughter to avoid any artificial milk supplementation. As someone who had been in the breastfeeding community for a long time, I knew the risks to a preemie - NEC being the one that most scared me - who wasn't exclusively breastfed. I was treated like I was paranoid and crazy for being so outspoken in my desire to avoid cow's milk-based fortifiers, but at the end of my daughter's 93 day NICU stay, the LC pulled me aside and applauded my efforts, as my daughter's course (feeding-wise) was shockingly smooth, and they attributed it to being solely breastfed, with the help of Prolacta. It was very, very expensive at the time, and we were lucky that our hospital decided to pick up the cost, but we would have somehow managed ourselves if necessary. I thought it was that important. I, for one, am glad if they're doing well as a company, because it means they'll continue to be there for babies in my daughter's situation. They are helping to save lives, and I'm profoundly grateful.

Dreamom said...

Adrianne - I have to say that while your condescending reply was probably meant as a rebuttal to the post - you have done little than to support (with information, language and attitude) all that the post was communicating.

I feel it necessary to point out one glaring (and a little embarrassing for you) mistake in your wording. You said " we are reducing the cost of donor milk, increasing availability, improving quality, and supporting our donors."

"Donor", according to the dictionary (the pesky limiter of our language that it is) means "A person who donates something, especially money to charity". "Donates" means "Give (money or goods) for a good cause, for example to a charity". Do you see how your use of these words to refer to your producers and product are not appropriate? You yourself say "Many of whom come from the milk sharing community, where they are relieved to have a formalized process to sell their milk." Regardless of the price you pay for the product you buy from your producers - it is not donating. It is selling. Someone other than the end recipient (the baby) is profiting. Is that bad? No. Women should have the freedom and option to sell their milk if there is a market to do so. My concern is that when the language of donating is being used in that context that someone is fooling themselves. From what I am reading in your own words I am going to say that you are fooling yourself here - you seem to desperately want to be a part of and identify with human milk donating. Accept that you are not in that field. You are in business. You buy and sell a product. Own it. That is not a bad thing - it is a very real part of our society. It is NOT, however altruism or donating.

That, however, brings us back to the original post. Although your company was the focus of the post as the sponsor of the event - I think the post would read the same way if the sponsor was a fast food chain, or baby food maker. The one added nuance is that they would be more removed from the event as their product is so different from the focus of the event. Your involvement is more akin to MacDonald's sponsoring breakfast programs in schools (which I understand they do). They are, as a company, using their position and opportunity to sponsor (while meeting a need) to a potential market. That is what you are doing here. The question is - should they? Should you? Regardless of what we think they will, and so will you - the good thing is there are people like Jodine, like moms speaking out about MacDonald's in the schools highlighting that so that people are aware.

That is another aspect of being in business, Adrianne. If you could accept your role in the economy in that way, you might be happier, and not see the need to lash out when random people talk about your company on blogs.

I think your idea of being located in a field is a great one. I look forward to hearing about your warehouse moving.

Jodine Chase said...

Thanks for this, Angela. I'm really glad that you were able to ensure your baby received human milk. I am frustrated that our fragile network of non-profit donor milk banks, still recovering from being under siege when the AIDS crisis shut them down overnight in the 80s, and drastically underfunded and unsupported by many in the medical establishment in the years following the crisis, was unable to answer the call for human-derived fortifier products when it came in 2003 (and possibly earlier, but that was when I first heard it in person.) I don't think Prolacta, or Medolac, or any for profit company is inherently "evil." Transparency is indeed important, and a lack of transparency erodes trust. In the early years of Prolacta's existence, many women who provided the milk for the products made for babies like yours did not know their donation was going to for-profit company. Then there was the affiliation with a non-profit who collected milk from American donors with a promise to send it to orphans in Africa, but instead a good chunk of that donor milk went to Prolacta, not something that was disclosed to donors the outset. Prolacta has since changed its approach, but only after significant pressure from bloggers and then mainstream media who in turn influenced potential donors. I think much of the skepticism and concern now about Prolacta founder Elena Medo's new venture is directly related to her former company's behaviour in the early days. We're used to private enterprise being involved in the production and marketing of life-saving drugs. But how many of those drugs are made from breastmilk - a living fluid made by women's bodies to nourish their own babies? The ethical implications of the commercialization of human milk are significant and we should be scrutinizing, and yes, criticizing when scrutiny unearths concerns.

Laura Moore said...

I love how helping babies and saving lives turned in to a fight! Like really? Their is a shortage in the US babies are dyeing cus there isn't enough breast milk. These are the most stickiest of sick babies. If MMC helps one life I am happy. Something needs to change something has to happen to provide the milk and change the shortage. No other plans ideas or have helped to change the shortage. Give MMC a chance to save some lives before you try and damage them.

Joanne Edwards said...
This comment has been removed by the author.
Joanne Edwards said...


I feel it is very important that I say something on this discussion but where to start. The Big Latch On is not a non profit, it has been a large very expensive project mostly funded by own resources for the last five years. When the breastfeeding community was asked over 12months ago to support the Big Latch On we collected about $200, then again this year the campaign to save the event again failed. When faced with the very real possibility of closing this event down and all the good work it does fortunately I am just very stubborn and passionate. I have found a solution which enables the event to continue, with me remaining as Global Coordinator - MMC are WHO Code Compliant and passionate about helping mums and babies, my other options would have been bigger organisations, far more removed from mums and babies and mostly probably not WHO Code Compliant and where the voice of the Big Latch On would have been lost. I feel sad that you are only troubled about the Big Latch On now it has been enabled to continue but not when it was facing closure. I wish you well Joanne

Jodine Chase said...

I'm glad you commented, Joanne, and I appreciate you shedding some light on the nature of the Big Latch On event. I am left with more questions, though, and I'm hoping you can answer them. Your indiegogo campaign, (which I wasn't aware of until the MMC sponsorship announcement) was to cover expenses including becoming a registered charity? And with the campaign not generating enough funds you've decided to continue the event as a for-profit venture?

Jodine Chase said...

Laura, hi, glad you dropped in.

I haven't actually used the word shortage - the need to secure a supply doesn't necessarily mean there is a shortage. If you're going to sell 100 units of a product and you need 120 units of the raw material to make the product, you need to secure the supply of 120 units before you can guarantee the sale. There may be 1000 units of raw product out there, you only need 120. Or there may be 100 units out there, and then you have a shortage.

When a sick baby in the NICU doesn't have access to human milk there's clearly a shortage for that baby. But it may not be because there aren't enough potential donors out there to fill the need. It could be that potential donors aren't aware of the need. Or there's little incentive for them to provide their extra milk, either financial, or through altruism. Maybe they want to but there are too many barriers. There may be other barriers that are keeping babies from getting donor milk - the hospital may not use donor milk.

Interestingly, most of the players vying for supply are the record as saying they don't believe that human milk is scarce. Emma Kwasnica said it rather famously when she founded the global milksharing network HM4HB, "milk is not a scare commodity, it's a free flowing resource and women are willing to share." She went on to say that moms were dumping their milk down the drain. Recently Prolacta has started making the same observation, even using the same "down the drain" talking point. Mother's Milk Cooperative and Medolac don't believe there is a shortage of milk either. HMBANA talks often about milk being a scarce resource and about the need to husband it to ensure the sickest babies receive it. This is one of the foundations for their dislike of milksharing - the perception that it takes away from their ability to secure their supply for the sickest of babies. (Some also worry that lack of screening or careful handling/processing will result in a baby becoming sick and the resulting publicity will cause parents and doctors to turn away from, or not trust human milk.) Medolac is on the record as not approving of milksharing either and certainly they would not be unaware of the reality that discouraging milksharing means fewer milksharing recipients, and so greater potential supply for other producers.

I wrote about some of the supply side issues a while back in a critique of a 2011 Bloomberg article on the emergence of milksharing and milk selling entities on the Internet. Check it out. http://bfnews.blogspot.ca/2011/12/bloomberg-human-milk-article-misses.html

In that article there's a reference to a brilliant analysis by one of my favourite bloggers, Annie PhDinParenting. She points out that the problem is not a scarcity, it is that the commodity, or resource, does not have an advanced distribution channel.

There are so many factors at play here. I think it's important for all of the players to be as transparent as possible - so the moms who have extra milk can get answers so they can be sure that their milk is being used the way they want it to be used.

SimplyMama said...

I am but one mama yet my heart would be broken were I required to pay for donor milk. I'm not sure the big latch on being sponsored has that great of an impact on the individuals and communities participating but I know that my mama heart wishes milksharing to be known and free. I breastfed my lo fir 2.5 years yet I have IGT and needed donor milk the first year. Let's focus on the beauty of breastfeeding and sharing love and milk between mothers and babies. That's where the true profit lies. <3

SimplyMama said...

I am but one mama yet my heart would be broken were I required to pay for donor milk. I'm not sure the big latch on being sponsored has that great of an impact on the individuals and communities participating but I know that my mama heart wishes milksharing to be known and free. I breastfed my lo fir 2.5 years yet I have IGT and needed donor milk the first year. Let's focus on the beauty of breastfeeding and sharing love and milk between mothers and babies. That's where the true profit lies. <3

thereforeislimitless said...

Jodine, thank you so much for writing this up and for your willingness to participate in this dialogue! Your responses were so thoughtful and your work on this issue is totally appreciated.