The politics of breast milk, and who can profit

Breast milk freezes well and can benefit premature infants, making it a new frontier for both for-profit and nonprofit suppliers. (Photo by Mark Cato via Flickr; used under Creative Commons license)

LANSING — State lawmakers are considering new regulations for for-profit companies that purchase human breast milk from mothers for use in milk banks.

Legislation introduced by state Rep. Erika Geiss, D-Taylor, would distinguish between nonprofit milk banks, such as those run by hospitals, and for-profit companies, which pay nursing mothers for their breast milk, by, among other things, preventing companies that pay women for their milk from being listed as donors.

Under the bills, for-profit companies would be held to the same guidelines as nonprofits from the Human Milk Banking Association of North America, which outlines procedures for collecting, storing and dispensing human breast milk.

The idea, Geiss said, is to encourage more mothers to donate excess breast milk for use in hospitals and neonatal intensive care units with sick and preterm babies.

“Unlike donating blood plasma or platelets, in most cases milk donation is not an autonomous decision,” said Geiss, adding that women decide to donate only after they have produced enough to provide for their own children.

The legislation, she said, is “to make sure that milk is collected safely and ethically and mothers and their infants are protected; to make sure that the standards for both in our state are in alignment; and that everyone is playing by the same rules.”

Michigan is one of a handful of states that have explored stricter rules for for-profit companies that operate breast milk banks. California, New York and Texas are among states that have taken similar steps.

The House health policy committee heard testimony this week, but did not vote on the bills.

State Rep. Erika Geiss, D-Taylor, is sponsoring bills intended to closely regulate companies that buy breast milk from mothers.

Geiss and advocates call for stricter rules in hopes of reducing Michigan’s high infant mortality rates and to promote breastfeeding among more women, particularly low-income mothers in urban areas.

Michigan had the eighth-highest infant mortality rate in the country in 2013, tied with Maine at 7.1 deaths per 1,000 live births, according to the U.S. Centers for Disease Control and Prevention. That is up slightly from 6.9 deaths per 1,000 live births in 2012.

The situation is worse in cities like Detroit, which had an infant mortality rate of 13.3 percent that same year, according to state health records.

Citing health benefits, the CDC and the American Academy of Pediatrics recommend the use of breast milk as a baby’s sole nutritional source for the first six months, and that mothers continue breastfeeding for at least the first year with the addition of solid foods.

Three-quarters of Michigan infants born in 2011 were breastfed, but the rate fell sharply to 47 percent by 6 months old and 23 percent at a year old, according to a 2014 report from the CDC.

Only 16 percent of Michigan infants were exclusively breastfed at 6 months old.

Geiss said the bills also are intended to prevent for-profit companies from preying on low-income women by offering them money in exchange for breast milk.

Her bill, House Bill 4206, would prohibit a milk bank company from describing women who receive compensation for providing milk as “donors” or their company or milk bank as a “community benefit.”

Exploitation worries in Detroit

Last fall, Medolac Laboratories, a human milk company based in Lake Oswego, Ore., announced a plan to enroll Detroit women in its milk bank, known as Mothers Milk Cooperative. The women were to receive breastfeeding support and compensation.

It canceled the program in January in response to criticism from groups like Detroit’s Black Mothers’ Breastfeeding Association, which questioned the company’s motives and suggested their program was targeting low-income and black women. Medolac denied the claim.

Medolac and another for-profit firm, California-based Prolacta Bioscience, did not immediately respond to messages seeking comment about the bills.

Prolacta Bioscience makes fortifiers from human breast milk for use in hospitals and NICUs.

“As the demand for human milk grows, as we have seen in Detroit and other places, the potential exists for economically disadvantaged women to be exploited for their milk,” said Cindy Duff, a registered nurse and board-certified lactation consultant who supervises the Bronson Mothers’ Milk Bank and breastfeeding center at Kalamazoo’s Bronson Methodist Hospital.

Women living in poverty who have no access to paid medical leave and experience wage inequality might be attracted to companies that offer money in exchange for breast milk, regardless of whether they have produced enough supply for their own children first, Duff testified before the House panel.

“I encourage you to look very carefully at issues of (women’s) health equity,” she said.

Under the bills, for-profit companies also would have to provide breastfeeding education programs in conjunction with hospital- or community-based support groups, provide at least half of its collected breast milk to Michigan hospitals or local nonprofit milk banks and conduct an annual audit.

The regulations wouldn’t apply to mother-to-mother sharing groups.

A second bill, House Bill 4691, would amend the state’s food law to ban direct Internet sales of human breast milk, such as through online classified websites.