Laura Moore emerged from a coma in the fall of 2006 to see her baby boy for the first time in an isolette incubator. She could hardly see the baby's face for all the feeding tubes and ventilators attached to him.
Four days earlier, Moore had been rushed into emergency C-section when she had developed a life-threatening case of pre-eclampsia that sent her into kidney failure. It was six weeks before her due date, and her premature baby had been born at a tiny four pounds; since then he had dropped to just over three.
"Breathe baby, breathe!" Moore, who was 23 at the time, said to her newborn through the glass. "Mama is going to do everything she can for you."
One of the things that she couldn't do was feed her baby breast milk, because her milk hadn't come in yet.
Breast milk — known to have benefits for any newborn — can make the difference between life and death for premature babies, whose number one killer is an intestinal disease that results from difficulties digesting formula.
About one in every eight newborns in the United States is born preterm — or before 37 weeks in utero — which comes out to 500,000 infants a year. A developing baby goes through critical growth in the final weeks in the womb, including the development of organ systems, the brain, the lungs and the liver. Preterm complications account for 35 percent of infant deaths, according to the CDC.
Yet, despite the life-saving properties of breast milk, not all premature babies are able to receive it. Elena Medo is looking to change that. She’s the founder and chief executive of Medolac Laboratories, which converts raw milk into a clean, shelf-stable product that is stored in foil pouches.
To secure the supply for Medolac, Medo established the Mother’s Milk Cooperative (MMC), which does something that no milk bank has ever done before: it pays women for their milk.
MMC pays nursing mothers $1 an once for their oversupply — milk that they produce in addition to what their babies can eat — which nursing women typically pump and freeze.
The average contributor to MMC makes about $800 a month, according to Medo. In the last year, it has paid out over $1 million to donor moms.
It's a simple supply-and-demand equation that, proponents say, provides life-saving milk to babies, and pays women for a rare commodity while providing extra money to their families. Milk-for-sale, however, goes against a tradition of altruistic donor moms who, for decades, have given their excess milk for free to hundreds of milk banks across the country, providing over 3 million ounces to hospitals a year.
“It’s a nice altruistic thought that mothers are just expected to give it, but there has been a severe shortage in hospitals for years,” said Medo.
Securing the supply
Medolac's partner milk bank, Mother's Milk Cooperative, based out of Lake Oswego, Oregon, operates with Amazon-esque convenience. Moms register online and provide medical history and a blood test. Once accepted, MMC ships a cooler from its 5,000 foot warehouse, complete with milk bags. Moms fill the cooler with the minimum requirement of 500 ounces, schedule a FedEx pick up, and wait for their “milk money” to hit their bank account.
Since opening on Mother’s Day in 2013, Mother's Milk Cooperative has amassed over 2,000 member moms that contribute an average of 800 ounces a month. Nursing moms typically produce 20-30 ounces a day, so donors have to work to produce that much.
But the extra income lets moms "stay home a bit longer with their babies, support the added expenses of a growing family, or even save for a family vacation,” says Medo.
It can also give moms an incentive to nurse longer, and add to the milk supply.
Despite his low birth weight and lung problems, Laura Moore's baby boy didn't qualify for donor breast milk when he was born in 2006. Because breast milk is in short supply, only the most critical newborns qualified. Moore took steps to stimulate her own milk production, and fortunately was able to provide her own milk after a week.
She saw the difference immediately: her son pinked up, he put on weight, and he went home with his parents before his due date. Moore felt moved to donate her excess breast milk with her next two children to help babies like her preemie. But when her last baby was born earlier this year, she needed to return to work after a few months to help pay the bills.
She came across MMC and realized that instead of going back to work as a photographer, she could stay home with her new baby and three older kids and still pocket extra cash by selling her excess milk.
It should be noted that Moore's excess milk is no trifling amount — she's a "super producer" who is going for the world record of milk donated in a single year. The record is 58,000 ounces, she's at 45,000 and is on track to break the record by January or February.
At $1 an ounce, she says she brings in about $50 a day after feeding her own son, or between $1,500 and $2,000 a month.
"I'm not getting rich," she says. "But I get to breastfeed my baby, and stay home with my kids.”
Payment for breast milk also acknowledges the time and effort that milk donors put in.
The economics of breast pumping includes time and money, says Moore, who pumps five or six times a day, for a total of about 2.5 or three hours. She uses a hospital-grade pump that retails for thousands, but she snapped up one for $500 on eBay. She estimates that she pays an extra $100 a month in groceries to make as much milk as she does.
High tech and controversy
Medolac's product is a first of its kind — cheaper than donor milk, Medo says, in part by eliminating expensive overnight frozen shipping to hospitals.
Paying for milk is also supposed to address the issue of scale — providing more life-saving milk to babies that need it. Still, the pay-for-milk model raises some concerns in the milk banking community, which has traditionally relied on generous moms to give milk free-of-charge.
"Nonprofits don't pay donors, and that decision was made very carefully," says Kimberly Updegrove, president of the Human Milk Bank Association of Northern America (HMBANA). "Paying donors carries a risk."
Risks include the temptation to add things to milk — like water or cow's milk — to bump up volume, or hide information that might taint the milk supply, like drug use and drinking.
Perhaps the biggest concern is that mothers might deny their own newborns milk in order to sell it.
"Donors give altruistically for the next generation. Nonprofits will stick with their receipt of milk donations rather than purchase," said Updegrove.
Medo says that the lab tests its milk carefully for additives and uses a pasteurization process to ensure the milk is safe and preserved. The milk is briefly heated to a high temperature, preserving a lot of the nutrients and making the liquid commercially sterile.
Updegrove is not so sure. “Without research, I would not trust any process," said Updegrove. "The concern is always for the safety of the infant."
Medo’s procedure has FDA approval. “You don’t get research published overnight,” she said but assured that it was forthcoming. “We are very committed to evidence-based medicine.
She also has a much bigger vision in mind. Less than 1 percent of breastfeeding moms are currently donating, and she calculates that if 8,000 nursing women donated, the U.S. would solve its shortage. From there she hopes to go global, setting up local milk coops overseas to address the 100 million gallons need for the 15 million preterm babies born globally.
Still, Updegrove is dubious that $1 an ounce creates a financial boon. She has worked in health care for 30 years, and most women who have excess milk have at most 20 or 30 ounces a day.
Brooke Dahl, a 24-year old mother of two from Minnesota, paid off a vehicle with her milk money, and saved up enough to pay her mortgage for a year so that her husband could quit his job and go back to school full-time.
Dahl started out pumping 3 ounces a day, but with practice worked up to 12, and now she averages $750 to $1,200 a month, she says. She feeds her 7-month-old baby, and, incredibly, has supported her family since June on her milk money alone.
Dahl is an extreme case in that she's a self-described super-budgeter and couponer. But she says that selling her milk has allowed her husband to quit a graveyard shift job and finish his degree in accounting. She hopes to breastfeed and sell her milk until her husband graduates next spring.
She calls it "dual empowerment": "It's breast food to babies that need it, and money to moms that need it."
Dahl makes light of comments that she's a "dairy cow." Emotions and opinions run high when it comes to breastfeeding, and Moore says that she has been accused of being a "prostitute" or "selling her body," especially on social media.
But she acknowledges that breastfeeding isn’t easy, and it's not for every mom. "You have to work at it, and you have to be passionate about breastfeeding." When she heard about the super-producing Laura Moore, she laughed.
"If I produced that much, I could eat whatever I want," said Dahl. "She's a boob goddess."
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