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The Catalyst

Competition for breast milk donations pits for-profit vs. nonprofit

By Lauren Sausser
Of the Post and Courier Staff

As hospital neonatal intensive care units across the state face a shortage of breast milk to feed some of South Carolina’s sickest newborn babies, a California company has stepped into the market, making the competition for breast milk donations fiercer.

Columbia-based Palmetto Health hospital system announced Monday it will team up Prolacta Bioscience to collect and pasteurize breast milk donations.

The Palmetto Health Donor Milk Program will allow South Carolina moms to donate their breast milk without ever leaving home, a press release about the new partnership explained. Prolacta Bioscience will collect those donations and process the milk in Southern California to ensure it’s safe for other babies to drink.

Moms won’t be paid for their milk donations, but Palmetto Health receives a $1 per ounce referral fee for every ounce collected. The list price for Prolacta milk, which can only be purchased by hospitals, is $14 an ounce.

“Moms will have a choice to support their hospital with their excess (milk),” said Prolacta CEO Scott Elster.

But one Medical University Hospital physician has raised concerns about the announcement.

Dr. Sarah Taylor

“(Prolacta) is a good company, but it is for profit,” said Sarah Taylor, M.D., an MUSC neonatologist. “That’s important for moms to know that they’re donating to a company that will make money off of that donation.”

Human breast milk is a hot commodity these days — especially for babies born prematurely, Taylor explained.

Research shows that premature babies are already about 7 to 10 percent more likely to develop a disease called necrotizing enterocolitis — an inflammatory reaction of the gut that can cause the intestines to die. The chance of contracting the disease is even greater if premature babies are fed instant formula, Taylor said.

While breast-feeding your own baby is best, sometimes that’s not an option, she explained.

Mothers who deliver pre-term babies are sometimes sick and can’t breast-feed. Others are unable to nurse their children for other reasons.

“When moms aren’t able to make enough milk for their babies, giving donor milk — the milk from another mom — is safer than giving formula for the very pre-term babies,” Taylor said.

To fill that need, MUSC orders about 100 ounces of pasteurized human breast milk a week from a nonprofit milk donation bank in Austin, Texas. Even though the Mothers’ Milk Bank in Austin is a nonprofit, it’s still expensive. Taylor estimated the medical center pays about $5 per ounce for the breast milk.

“Because so many hospitals are giving donor human milk to pre-term babies, there is a shortage in the country,” Taylor said. “We go higher on the Austin milk bank priority list if more South Carolina mothers are donating.”

South Carolina mothers who want to donate breast milk to MUSC must be tested and cleared for donation by a health care professional.

New moms can generally produce about 20 ounces of milk a day, Taylor said. The Austin donation center will pay to ship the frozen milk on dry ice for moms who have accumulated at least 100 ounces of excess breast milk.

“We need moms from our area donating to where the MUSC NICU (neonatal intensive care unit) is receiving milk. That way the moms here are really supporting the Charleston area, the Lowcountry babies,” Taylor said.

Prolacta Bioscience will cover the cost of screening and shipping for moms who choose to donate their milk to Palmetto Health.

While the breast milk donations will not be sent directly to Palmetto Health, the donations will ensure that the hospital system has an opportunity to purchase an equivalent amount through the company. Palmetto Health, an existing Prolacta customer, already receives a discounted price for the company’s products.

“It is something that allows us to reduce the cost of using the product by donating milk from the area,” said Victor Iskersky, M.D., medical director of the neonatal intensive care unit at Palmetto Health Richland.

Palmetto Health is a nonprofit hospital system. Iskersky estimates the system uses about 150 ounces of donated breast milk each week.
“Breast milk is one of our most important medications in the NICU,” he said. “It’s truly an amazing substance.”

While hospital systems may quibble about the best way to do business and compete for potential donors in South Carolina, there’s one thing that they all agree on. Moms should donate or buy breast milk through legitimate milk banks — either nonprofit or for-profit — instead of buying the product from a stranger on the Internet.

“Get it from a bank,” said Monica Pelletier, a La Leche League leader in Mount Pleasant. “They screen every mother and they treat the milk as well.”
Prolacta and the Mothers’ Milk Bank in Austin screen potential donors for a variety of risk factors, including HIV and AIDS. There’s no guarantee that breast milk bought on the Internet is safe.

“It can be very scary,” Pelletier said. While the market for buying breast milk online has soared, an October study published by the American Academy of Pediatrics shows it’s often unsafe.

“Human milk purchased via the Internet exhibited high overall bacterial growth and frequent contamination with pathogenic bacteria, reflecting poor collection, storage, or shipping practices. Infants consuming this milk are at risk for negative outcomes, particularly if born pre-term or are medically compromised,” the study’s authors wrote.

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Editor’s note: The article ran Nov. 19 in The Post and Courier and is reprinted with permission.

November 22, 2013

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