Contamination of informal donor milk

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Parla.
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Contamination of informal donor milk

Post by Parla. » Tue Oct 22, 2013 8:39 pm

For those interested -

http://pediatrics.aappublications.org/c ... 7.abstract

I'll leave it for the more informed to comment.

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Post by mooki » Tue Oct 22, 2013 8:46 pm

I actually havent read much about it yet but saw a bit about it from Karleen on FB.

This is an interesting blog in relation to the study
http://bfmed.wordpress.com/2013/10/21/o ... er-beware/

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Post by Penguin » Tue Oct 22, 2013 8:56 pm

Karleen commented on FB - I'll see if I can find it.
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Post by Penguin » Tue Oct 22, 2013 8:58 pm

Karleen - I hope you don't mind me quoting you
I've read the paper. The problem for the authors was that they wanted to obtain milk for testing without revealing that they wanted the milk for an experiment. This required them to hide their identities and everything that they did associated with that made it more and more likely that they would get milk with problems.
*They had to buy the milk. They could not use the milk gifting sites because they don't allow for anonymity and would require one of the investigators to use their own identity or at least would require the fabrication of an identity (which would not be permitted by ethics committees). This introduced risks inherent to the purchase vs donation re motivation and capacity to safely donate. The altruistic motivation that underlies milk gifting makes milk gifting inherently safer than milk buying.
*The couldn't mention a baby in their request for milk and in fact if the woman selling the milk ever asked about a baby or anything about them at all they stopped communication. They got milk shipped to a PO Box. This behaviour is quite different to how milk recipients usually behave and IMO it made them sound like a man with a milk fettish seeking milk- men do look for milk like this and are mostly given short shrift by donors. This likely would have weeded out any milk sellers who had an altruistic motivation as well as a commercial one.
*They didn't discuss safety of expression or shipping method with the donor (just said, send how you like to) so no due diligence at all.
*They only got milk shipped which is obviously less desirable than in person donation (which is how the majority work).
Basically all the safety aspects that milk recipients apply to screen their donors- an altruistic motivation; building a relationship of trust based on knowledge of the donor, their situation, their health record; discussion of aspects of safety; in person pick up etc were removed. If the investigators had deliberately sought to screen to get the milk most likely to have problems they could not have done a better job. Breastmilk is robust but it is not magic, if it's not treated properly it can be contaminated.
All that said, I think it's good to have attention to hygiene given. Indeed in my research I identified that many donors were not following recommended expression practice and recipients were rarely asking about hygiene (http://www.tandfonline.com/doi/abs/10.1 ... 013.772994). It's well known that issues of hygiene are poorly attended to (think of the campaigns necessary to get doctors and nurses to wash their hands in hospitals). It's good to be able to show that it does matter how breastmilk is treated. However, I can see potential for harm even outside of milk sharing, like the mum whose workmates won't let her store her milk in the fridge or the daycare that won't feed ebm to babies because it is dirty dangerous stuff. No thanks to health professionals who seek to demonise breastmilk with misleading alarmist statements!
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Post by Penguin » Tue Oct 22, 2013 8:58 pm

snap mooki - sorry I didn't see your post
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Post by breastfeedingisnormal » Wed Oct 23, 2013 6:48 am

I've read the paper, too. In addition to the problems Karleen points out (this is not donor milk, it's purchased milk), it's worth noticing that the authors compared their informally purchased milk with banked human milk. Mothers who use informally SHARED milk, don't usually have access to banked human milk. They are choosing between formula and shared milk. There are some pretty good studies that have observed serious contamination problems with formula milk too.
What the study does tell us is that all mothers need to be actively taking precautions to prevent contamination of their babies' milk.
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Post by mooki » Wed Oct 23, 2013 8:15 am

awesome penguin, I think karleen sums it up pretty well. i actually tried finding that quote but couldnt. lol

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Post by Penguin » Wed Oct 23, 2013 2:19 pm

breastfeedingisnormal wrote:
What the study does tell us is that all mothers need to be actively taking precautions to prevent contamination of their babies' milk.
What a novel concept. Managing the risks of one's own particular circumstances? Fancy that. [/sarcasm]
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Post by Penguin » Wed Oct 23, 2013 2:23 pm

Sorry BiN, I just reread my last post and it might sound catty. I'm agreeing with you in case my non-verbal post didn't express that very well.
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Post by breastfeedingisnormal » Wed Oct 23, 2013 8:32 pm

I got that Penguin, no need to worry. :wink:
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Post by Penguin » Wed Oct 23, 2013 10:17 pm

My lack of patience for tripe and fondness for sarcasm seems to get me in trouble frequently on the internet, so I think I over compensate by stating the obvious...
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Post by katw » Sat Oct 26, 2013 12:08 pm

"Growth in samples was positively correlated with days in transit" - fancy that! :? The study could certainly have been designed better!
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