Friday

Word games: Breastfeeding? Breast Milk Feeding? Human Milk? Human Milk Feeding? Human Milk Products?

                      "No two hemispheres of any learned professor's brain
                       are equal to two healthy mammary glands in the
                       production of a satisfactory food for infants."
                                           --Oliver Wendell Holmes

Mothers willingly sacrifice themselves, their time or their money to give their infants a healthier life. Some mothers breastfeed their infants.  Some mothers pump their breasts to feed their infants.  Some mothers use infant formula.  They make these decisions based sometimes on instinct, sometimes on literature given out by breastfeeding organizations, or the influence of infant formula marketing.  Some mothers make their choices based on spousal or family pressures.  Sometimes their choices are based on seeing others who have breastfed their babies, or bottle fed their breast milk and/or formula fed. 
How much of this decision process is based on truth and how much is based on societal pressures and marketing of products?  What happens when marketing pressures distort our reality of the differences between these choices? What happens when medical authorities are afraid to speak honestly to mothers about the differences between exclusively breastfeeding and providing breast milk exclusively?

I have witnessed the rise in the use of breast pumps.  In fact, like the bottle, it has fast become the standard baby shower gift.  When I was employed as an IBCLC, I began to notice that more and more mothers believed that breastfeeding could not happen without a breast pump.  Women with little to no financial resources bought the cheapest pumps they could find (some second-hand) and many quite useless products.  Did this rise in the buying of breast pumps, increase breastfeeding rates?  Well, initiation rates certainly have increased.  But duration rates are still quite low...meaning in general terms that all these breast pumps may not be sustaining long term pumping or creating more breastfeeding.  Interestingly the categories for statistics on breastfeeding initiation and duration do not include the categories breast milk feeding or exclusive breast milk feeding.  A mother who is pumping will be listed as a breastfeeding mother.  Which is not a problem unless we truly want to come to understanding about whether pumping impacts breastfeeding or whether more moms are pumping than actually breastfeeding.  Are there differences in health effects between exclusively breastfeeding and providing breast milk exclusively?  I suspect there are differences.  Infants being fed pumped milk will have greater exposures to plastics (chemicals considered endocrine disruptors).  If infants fed pumped milk are in daycare settings, they will be exposed to more infections/diseases. Will the question of these differences be researched?  Or will these differences be muted because of the mistaken belief that breastfeeding is the same as human milk feeding.  Thus exclusive breastfeeding will appear less protective and exclusive breast milk feeding will appear more protective?  Should we care about this issue?  Won't we offend mothers who are pumping their milk?  Is the truth important or not?  

The rise of the human milk industry (Prolacta and Medolac) is already creating a lot of confusion.  The hiring of people from the infant formula industry and the partnership of Prolacta with Abbott (infant formula company) creates a merging of mutual interests and beliefs.  Does the creation of human milk products for use in human milk fortifiers, preterm and term milks mean that infant formula will in the future contain human milk components (or maybe already has these components or their genetically engineered versions)?  Or is this all a word game played out by a new industry and an old industry desires to make a profit?  Don't we want a safer infant formula?  And doesn't that mean that human milk components or its genetic equivalent needs to be a part of the newer, safer infant formula?
  
Lately I have noticed that the words, breastfeeding and breast milk feeding (or human milk feeding), seem to be used as one and the same.  I have read various articles not only in the media but in medical literature that use the word breastfeeding when they mean breast milk feeding. These articles and professional papers perpetuate a confusion between a behavior that nutritionally sustains an infant through physical contact and a behavior that produces a product to nutritionally sustain an infant.  Why are these words being used as, if they are synonymous? What is the purpose in this distortion of reality?  Is there a purpose in using words incorrectly or is it just simply a misunderstanding of the impact of words in creating a reality?  Or has the merging of a human milk industry with the infant formula industry created the need to create a language of distortion?

Will breastfeeding organizations ask these questions?  Certainly the infant formula and human milk industries will not question the distortion of our language.  And certainly the breast pump industry has no financial incentive to question the use of breast milk feeding as synonymous with breastfeeding.  So onward we go with the infant formula industry mimicking the properties of human milk, even to the point of genetically engineering human milk components.

Three patents:
Patent #8114441 entitled, "Immune stimulatory infant nutrition," filed in 2005 by N.V. Nutricia (infant formula company).  The patent explains that whey dominant formulas create, "suboptimal intestinal flora."  They believe that whey dominant formulas do not protect against infection like human milk and their new formula will reduce the risks of feeding whey dominant infant formula. The patent states that human milk protects against infections and allergies.  They will be adding oligosaccharides (galactooligosaccharides (GOS) and fructooligosaccharides (FOS).

Patent #8445429 entitled, "Lactoferrin & neuronal health and development in the infant gut," filed in 2010 by Nestec (Nestle).  The patent describes how lactoferrin exhibits antimicrobial activity and is part of the innate defense system.  "Lactoferrin improves neuron density and neuron survival."  and "It protects neuronal cells and delays neuronal cell death."  High concentrations are found in human colostrum, human milk, then cow's milk (debatable whether very much in cow's milk:  some researchers state their is little to no lactoferrin in cow's milk).  They state their source for lactoferrin may be a "milk or whey source: bovine milk, human milk, goat milk, camel milk, horse or donkey milk."  "Colostrum may be used as well."

Patent #8703737 entitled, "Nutritional formulations including human milk oligosaccharides and antioxidants and uses thereof," filed in 2011 by Abbott.  The patent's purpose is to reduce inflammation and the incidence of inflammatory diseases.  The patent states, "...these breast milk components, function as antioxidants and as immune modulators, includes not only protection of breast milk lipids by peroxidation, but may also assist in the regulation of inflammatory response to infection and other injury."  and " HMOs [Human Milk Oligosaccharide's] act in a synergistic manner against respiratory viruses, including RSV when combined with a long chain polyunsaturated fatty acid and/or a carotenoid."  and "The HMO or HMOs may be isolated or enriched from mik(s) secreted by mammals including but not limited to human, bovine, ovine, porcine, or caprine species."  Not sure how one can have a human oligosaccharide from another species of animal--unless genetically engineered.  They also mention that HMOs may be produced by "microbial fermentation, enzymatic processes, chemical sytheses or combinations thereof."

So let confusion rein upon our lives.  What is in that can of infant formula?  Human Milk components?  Genetically manipulated human milk components?  Is a mother breastfeeding or is she breast milk feeding?  Will we understand whether there are differences in health effects from each form of feeding?  Or will marketing make the public believe that all is one and the same?  It's a strange world.

Copyright 2014 Valerie W. McClain


Interesting article entitled, "Formula Ingredients for Infant Health" published in Nutritional Outlook" submitted by rgardner.  It states, "With two-earner households now the norm, millions of moms will continue to opt for the convenience of formula.  This opens enormous opportunity for suppliers of nutritional ingredients, while at the same time placing great responsibility on their shoulders."