Competition for breast milk stirs up concerns

SALT LAKE CITY, Utah - A California company is eyeing Utah for its abundance of notoriously health-conscious, breast-feeding moms.

Prolacta Bioscience is canvassing women's events and pediatric offices, encouraging women to give its Helping Hands Milk Bank their excess milk, which it filters, fortifies and sells to hospitals for a profit.

Its Prolact (plus)4 H2MF is the only fortifier made from human milk, instead of cow's milk, and is a protein shake of sorts for premature babies in neonatal intensive care units (NICUs) to supplement breast milk. It aims to more closely duplicate nutrients the babies would have received in utero.

For every ounce of milk collected, the company gives $1 to charity. Donating milk "is a selfless act, and we'd like to honor that with another selfless act," said Prolacta CEO Scott Elster.

His company, based in Monrovia, Calif., prices its fortified product at the equivalent of $185 an ounce. While the company notes that it is concentrated and added in a ratio to breast milk, a premature baby can consume $20,000 to $37,000 worth of the milk during an average NICU stay.

The company's presence in an increasingly competitive market for human milk has stirred some angst. A nonprofit milk bank says the company's well-funded marketing efforts are straining supplies.

"Three to five years ago ... I didn't worry about donors. People would just call and it would fly in here. Now we're working really hard to keep our hospitals supplied," said Laraine Lockhart Borman, director of the Denver-based Mothers' Milk Bank, a program of the Rocky Mountain Children's Health Foundation.

The program has long looked to Utah for donations and has a collection site at the Redwood Health Center in South Salt Lake.

Utah mothers breast-feed at rates well above the national average, and many in the predominantly Mormon state shun tobacco and alcohol.

Commercial formulas can't match breast milk's immunity-boosting properties, growth factors, hormones and enzymes. Donated milk has proven to be a life saver for the 51,000 low birth-weight babies treated in NICUs each year. Neonatologists refer to it as "liquid gold."

Nonprofit milk banks ensure quality control. They pool and pasteurize human milk, a process designed to kill dangerous viruses while preserving the milk's immune properties.

The costs are passed onto hospitals and families who need the milk. Borman's nonprofit charges $3.50 to $4 per ounce.

Nonprofit milk banks last year dispensed 1.8 million ounces, according to the Human Milk Banking Association of North America. But the need is closer to 9 million ounces.

Finding donor moms willing to pump, bag and ship their frozen extras isn't easy, especially considering the growing competition, Borman said.

Women also trade and sell their milk directly on social networking sites and online classified like onlythebreast.com -- some for a profit and others for free. The sales are legal, but the U.S. Food and Drug Administration has warned against them because there's no way to know if the milk was properly screened for infectious diseases or contaminants.

Prolacta started as a milk bank in 1999 with $31 million in venture capital. It was the first to sell its product for a profit, mostly to hospital NICUs. But because hospitals often supplemented human milk with cow-based fortifiers, which sometimes cause allergic reactions and digestive problems, the company set out to develop a human milk fortifier.

Prolacta milk donations go through the same pooling and filtering process that nonprofit milk banks use, but adds steps such as DNA testing to ensure that milk arriving by mail came from a pre-qualified donor.

The milk is fortified with calcium, magnesium and phosphorous. The resulting syrupy concoction contains nearly twice the calories as human milk, Elster said.

Clinical trials were a success, and the company began marketing the product in 2008. Research has yet to determine whether Prolact(plus)4 H2MF is more easily tolerated or packs more nutritional punch than its bovine-based competitors.

A recent study published in the Journal of Pediatrics found it did not promote faster growth in micro-preemies weighing under 2.7 pounds at birth. But when added to human milk, it reduced infants' odds -- by 77 percent -- of developing the sometimes-fatal illness NEC, or necrotizing enterocolitis.

(Contact Kirsten Stewart at kstewart(at)sltrib.com.)

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