NJBFC Opposes Assembly Bills Concerning Human Milk Sharing and Milk Banks
Below is the letter sent to Assemblywoman Pamela Lampitt, sponsor of A3702 and A3703
December 6, 2013
Assemblywoman Pamela Lampitt
1101 Laurel Oak Road, Suite 150
Voorhees, NJ 08043
Dear Assemblywoman Lampitt:
The New Jersey Breastfeeding Coalition (NJBFC) is a collaboration of health care professionals and community representatives whose mission is to identify and reduce medical, social and economic barriers to breastfeeding in the state of New Jersey through education and outreach. The NJBFC lauds you for your concern for the health and safety of our state’s infants, which clearly motivated you to propose A3702 and A3703, bills that would establish a public awareness campaign on casual milk sharing and the licensure of human milk banks in the state. However, the NJBFC must oppose A3702 because human milk sharing is not a significant public health threat. We oppose A3703 because increased regulation of human milk banks will increase the cost of donor human milk and may deter the establishment of nonprofit human milk banking in New Jersey.
The NJBFC believes that breastfeeding is the optimal and unequaled form of infant feeding. The Coalition has not endorsed informal human milk sharing, however, because we recognize that it may pose some risk of bacterial or viral infection to the recipient infant. Nonetheless, we believe a public awareness campaign on milk sharing is an unnecessary and unwise use of state funds because there is no evidence in NJ or nationwide that infants are being harmed by milk sharing. In addition, international health authorities have recognized that donor human milk confers benefits. For example, in the Global Strategy for Infant and Young Child Feeding, the World Health Organization and UNICEF state that all infants should be breastfed, and that donor milk is the next alternative to the mother’s own expressed milk when direct breastfeeding is not possible.
The lack of harm from milk sharing may be due to the components of breast milk. Milk freshly pumped by a mother for her own baby or for sharing is never sterile; it contains bacteria as well as an amazing panoply of anti-infective factors including phagocytes, immunoglobulins, natural probiotics and other substances that protect infants from disease. Commercial infant formula, the most commonly used alternative to breast milk, does not contain these protections. Indeed, commercial formula powder sometimes contains pathogenic bacteria or is mixed with water that is contaminated. It has been estimated that over 700 infants die from formula feeding each year in the US.
A public awareness campaign is also unnecessary because major health organizations already provide sufficient information about the risks of milk sharing. For example, the website of the U.S. Food and Drug Administration contains warnings about “Use of Donor Human Milk”. Experts within the American Academy of Pediatrics warn against the use of unpasteurized donor human milk. La Leche League International, the worldwide expert in breastfeeding information and support, also publishes information on the risks of sharing breast milk. In fact, even Eats on Feets, one of the most popular human milk sharing organizations in the US, recognizes and addresses the potential for risk. It publicizes its own “Four Pillars of Safe Milk Sharing” which provides prospective recipients information on informed choice (including risks and benefits), donor screening, safe handling of the milk and pasteurization. t
What the Coalition has seen is that human milk sharing is rarely “casual” as A3702 suggests, but better described as “informal” since it is practiced outside medical institutions. However, this does not mean that mothers are unaware of the well-publicized potential risks. The NJBFC believes that mothers have the right to use this widely available information to make informed choices on how to feed their children.
Human milk sharing is likely being practiced by a very small minority of the mothers of infants in this state who have been unsuccessful at breastfeeding or have low milk supply, but who also know that breast milk is the unequaled and optimal infant food. Also, human milk is sometimes sought for infants whose birth mother has died, or who are adopted or placed in foster or guardian care.
The most recent data available from the US Centers for Disease Control and Prevention reveal that while 71.5 % of New Jersey mothers did some breastfeeding in 2010, only 32.3% were exclusively breastfeeding at three months and only 10% at six months. These statistics show that exclusive breastfeeding rates are lagging far behind our state’s own Healthy New Jersey 2020 goals. They also highlight the critical need for better breastfeeding support in this state. If more women could breastfeed successfully, there would be less demand for milk sharing. It would be more effective to establish educational programs aimed at reducing social, cultural and other barriers to breastfeeding than to legislate an unfunded program to inform mothers about “dangers” of milk sharing that have not actually materialized.
Regarding A3703, the proposed licensure of human milk banks, this legislation would be prospective in its application as we know of no human milk banks currently operating in the New Jersey. The NJBFC opposes the establishment of statewide licensure because it will create unnecessary level of regulation that will add to the already significant cost of donor human milk and possibly stifle the establishment of nonprofit human milk banking in the state. We are also concerned that having licensure standards set in law will prevent any future human banks from responding quickly to changes in the state of scientific knowledge about human milk and on best evidence-based practices for collecting, storing and distributing it.
There are currently 13 nonprofit human milk banks in the United States. They operate under strict quality control guidelines developed by the Human Milk Banking Association of North America (HMBANA). Around the world, donor human milk banks enjoy an unparalleled record of safety. There has never been a recorded case of a patient becoming seriously ill from donor milk from a recognized milk bank.
Because of HMBANA’s strict standards for collection, screening of donors, and the transporting, processing, testing and distribution, donor human milk is quite expensive. Recipient hospitals are currently charged a processing fee of approximately $5 per ounce to cover these costs, plus the cost of shipping. It is available only by doctor’s order or prescription. Today, existing milk banks are struggling to recruit more donors to meet the increasing demand for donor milk for seriously ill infants.
Imposing an additional layer of regulation on future milk banks will create extra costs that will increase the fee for donor milk, which is often not covered by health insurance. It may also deter interested parties from establishing a milk bank here and may hamper a milk bank’s ability to respond quickly to advances in milk banking knowledge. It would be more helpful for the Legislature to create incentives to encourage the establishment of a nonprofit human bank in New Jersey and inducements for mothers to donate milk for the treatment of ill infants.
The New Jersey Breastfeeding Coalition wishes to work with you to develop positive initiatives to support breastfeeding in the state in order to decrease the demand for human milk sharing and to increase the availability of banked human milk for sick and premature infants. I hope that we can meet at your convenience to discuss this possibility. Please feel free to contact me if you have any questions about this position.
Ellen Maughan, IBCLC
Bond A. Got breast milk? Buying human milk online from strangers or even sharing among friends puts babies at risk of disease. AAP News. 2008;29:24.
Chen A, Rogan WA. Breastfeeding and the Risk of Postnatal Death in the United States. Pediatrics, Vol. 113(5) May 1, 2004, pp e435-e439. http://pediatrics.aappublications.org/content/113/5/e435.full.html
Gribble KD, Hausman BL. Milk sharing and formula feeding: Infant feeding risks in comparative perspective? Australasian Med J http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395287/
Infact Canada Mother’s milk and safe milk sharing: Health Canada’s advisory lacks scientific basis. http://www.infactcanada.ca/whatsnew/milk-sharing.html
La Leche League International. http://www.llli.org/release/milksharing.html
Massachusetts Breastfeeding Coalition. Is it safe to share breastmilk? http://massbreastfeeding.org/index.php/2005/is-it-safe-to-share-breastmilk/
Riordan J, Wambach K. Breastfeeding and Human Lactation, 4th ed. Sudbury: Jones and Bartlett, 2009.
Public Health Reports. Got Milk? Sharing Human Milk Via the Internet. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056026/
U.S. Centers for Disease Control and Prevention. Breastfeeding Report Card 2013. www.cdc.gov/breastfeeding/PDF/2013BreastfeedingReportCard.pdf
U.S. Food and Drug Administration. Use of Donor Human Milk. http://www.fda.gov/ScienceResearch/SpecialTopics/PediatricTherapeuticsResearch/ucm235203.htm
World Health Organization and UNICEF. Global Strategy for Infant and Young Child Feeding. http://www.who.int/maternal_child_adolescent/documents/9241562218/en/index.html
Two Hospitals Become First in NJ to Receive Baby-Friendly Designation
The New Jersey Breastfeeding Coalition warmly congratulates South Jersey Healthcare Elmer Hospital and Capital Health Medical Center Hopewell on their designations as New Jersey’s first two Baby-Friendly® hospitals.
The designation, awarded by Baby-Friendly, USA, recognizes birth centers that provide the highest level of care in infant feeding. To be deemed a Baby-Friendly® birth hospital, the facility must demonstrate adherence to the “Ten Steps to Successful Breastfeeding” as outline by UNICEF and the World Health Organization (WHO). The Ten Steps are a roadmap for birth facilities in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies or feeding formula safely.
South Jersey Healthcare Elmer, which reports 327 births last year, learned in February that they had achieved Baby-Friendly® status. Capital Health Medical Center Hopewell, which delivered 2500 babies in 2011, learned in March.
The US Centers for Disease Control reports that less than 3% of hospitals providing birthing services in the United States are Baby Friendly designated.
For more information:
SJH Elmer Hospital Earns International Award as Baby-Friendly® Birth Facility
Capital Health Receives Baby Friendly Designation
Breastfeeding Advocates Denounce Newark Partnership with Nestle
To the dismay of state and national breastfeeding advocates, Newark Mayor Cory Booker accepted a $100,000 donation in February to Let’s Move! Newark from Nestle Nutrition USA to provide anti-obesity education as part of its Let’s Move! Newark campaign.
According to information released by the city, the donation will fund a two-year pilot program to be presented in Newark’s 15 Family Success Centers featuring an education program designed to teach parents how to improve their children’s nutrition by promoting better dietary choices and more physical activity.
Breastfeeding advocates and organizations are condemning Newark’s acceptance of the grant from Nestle as an obvious conflict of interest and an effort to undermine breastfeeding. Nestle is one of the world’s largest manufacturers of infant formula and a well-documented violator of the World Health Organization’s Code for the Marketing of Breast-milk Substitutes. Numerous studies have shown that formula-fed infants are more likely to become overweight or obese during childhood and adulthood. Nestle also is a leading maker of candy.
Let’s Move! Newark was established in 2010 by Mayor Booker as part of First Lady Michelle Obama’s Let’s Move! National campaign to address the high rates of childhood obesity in Newark’s children. As compared to 21% of 3-5 year-olds nationally, 45% of Newark’s 3-5 year-olds are overweight or obese. Mrs. Obama has promoted breastfeeding as an important part of anti-obesity strategies.
Chatham-based lactation consultant Maria Parlapiano, RN,IBCLC, has spearheaded efforts to fight the Nestle sponsorship. She started a petition against Newark’s actions on Change.org which has gained over 2,000 signatures. The New Jersey Breastfeeding Coalition has urged all of it members to sign the petition and to contact the city of Newark to protest Nestle’s involvement in Newark programs.
For more information:
Coalition Statement on Time Magazine Cover Photo
The New Jersey Breastfeeding Coalition (NJBFC) believes is that breastfeeding beyond infancy into early childhood is biologically normal and is an act of feeding, nurturing and love between a mother and her child. Though not pervasive in the 21st century United States culture, nursing beyond the first year has been a common practice around the world and has been a part of normal mammalian practices for 65 million years. Nursing past infancy is also in accord with the health recommendations of the World Health Organization and the American Academy of Pediatrics. Breast milk continues to provide numerous health benefits to young children and continued nursing lowers the risk of many diseases and forms of cancer in the nursing mother. Children who have breastfed beyond infancy form secure bonds of love and trust which serve them positively throughout their lives. The NJBFC is saddened that excessive negative public reaction to this cover photo has led to criticism of committed parents who nurse their children past infancy and practice attachment parenting within a culture that unfortunately fails to support normal biological practices and evidence-based health choices.