What Happens When Breast Milk Goes Big-Business?

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Photo: Scott & Zoe/Getty Images

Last week, the New York Times reported that Prolacta Bioscience — which buys pasteurized breast milk and resells it as part of a fortifying formula for premature babies — has raised $46 million from investors. In hospitals, extremely premature babies are treated with the concentrated, high-protein (and highly expensive) formula. Such funds put Prolacta Bioscience at the forefront of research into the therapeutic uses of breast milk.

But while Prolacta’s product helps sick babies — and can give breast-feeding mothers a way to earn money for their milk — not everyone is thrilled about the entrance of big business into what’s largely been community-based, nonprofit work.

One concern is that with cash incentives, companies like Prolacta may draw donors from nonprofit milk banks, threatening the health of preemies whose parents lack the money or insurance for Prolacta’s products. “The nonprofit milk banks have a long history of providing milk to the sickest babies, and provide it based on medical need and not on insurance reimbursement or financial resources,” Kim Updegrove, executive director of the nonprofit Mothers’ Milk Bank at Austin, told the New York Times.

And breast-milk banks were struggling to meet demand well before Prolacta’s latest initiatives. In 2011, Time reported that the rise of online milk swapping had led to “critically low” levels of breast milk and “urgent calls” for donations from members of the Human Milk Banking Association of North America. (Milk banks screen their donors and supplies for safety; they also charge a fee for their milk, whereas milk-swapping is free.)

For moms who want to breast-feed but lack the time and money to do so, getting paid for excess milk is very appealing. The cash influx could provide essential income to poor moms after birth and allow middle-income moms more financial security; the U.S., after all, remains one of the few countries without paid maternity leave laws, and selling milk is a rare opportunity to make money while at home. (Donors to milk banks are not usually paid, though expenses like shipping are covered.) But community organizers have expressed concern that Prolacta and its competitors are exploiting low-income women. Before Prolacta started paying donors last year, the company was accused of not making it clear to women that their donations were going to a for-profit company.

In January, when Oregon-based Medolac Laboratories launched a campaign in Detroit, the Black Mothers' Breastfeeding Association took action. Detroit has the highest infant mortality rate; executive director Kiddada Green said the initiative “reek[ed] of exploitation.”

The organization expressed a series of concerns in an open letter:

As a group of mothers, community activists, and lawmakers in the greater Detroit area, we are writing to you in the spirit of open dialogue about your company’s recent attempts to recruit African-American and low-income women in Detroit to sell their breast milk to your company, Medolac Laboratories.

We are troubled by your targeting of African-American mothers, and your focus on Detroit in particular. We are concerned that this initiative has neither thoroughly factored in the historical context of milk sharing nor the complex social and economic challenges facing Detroit families. It is also troubling that no community organizations serving or advocating for African-American breastfeeding families in Detroit have been consulted in the development of such a program that is meant to benefit those families.

Medolac Laboratories, which had the backing of the Clinton Global Initiatives, subsequently dropped their campaign. For Green, the issue wasn’t that women were being paid to donate milk; it was that the campaign was framed as a community initiative when no community members had even been consulted.

Trusting a business to protect the best interests of low-income women is risky. (The rise of infant formula in the developing world offers a cautionary tale about corporations claiming to help mothers and children, while actually reaping profits at their expense.) Prolacta could drive milk banks to extinction, and then sharply cut pay incentives, meaning only the most desperate women donate and Prolacta can charge a higher premium for their limited product.

Then again, while corporate breast milk raises its own set of concerns, it would also be a mistake to idealize more “natural” approaches. Online milk-swapping is sometimes cheerily touted as the modern-day equivalent of wet-nursing, which ignores the practice's fraught history of forcing slaves to perform as "sucklers" and using poor immigrants whose own children sometimes died of neglect. While not everyone agrees that women should get paid for donating breast milk, it's essential to acknowledge that breast-feeding is work — and it places major demands on women’s time and bodies.

Correction: This article originally claimed that Prolacta recently raised $46 million; in fact, this figure represents total money raised by the company since its founding.