The Elephant in the Room

The Elephant in the Room: Bioethical Concerns in Human Milk Banking ISBN: 9781532371875, Cove International Publishers, e-book by September Williams & Mother’s Milk Bank, San Jose.

The book opens with a forward explaining that human milk banking has a century of history built on the mission of saving infants. However, badly needed development has only recently begun as the result of “the sheer passion of women seeking to help mothers and babies”. The idea is to develop milk banks as an altruistic culture of milk donation, its collection, processing and distribution based on scientific knowledge. Finally in 1985 the Human Milk Banking Association of North America was formed to provide and advance all pertinent information with a basis of the operation “to support the mother’s journey to successfully breastfeed her own infant.” The specifics of the program and relevant features are set forth here under six major headings: I, A Request for Consultation; II, Should we let Babies Starve? Bioethics, Cases & Stories; III, Clinical Medical Ethical Decision Making: the Box Method; IV, The Elephant in the Room: Infant Mortality, Premature Birth and Health Disparities; V, Famine in the Midst of Plenty; VI, Conclusions. There also is an Appendix, an interesting description “About Mother’s Bank San Jose”, which is a ‘working Milk Bank’, and a brief “About the Author”. Each of the almost incredible number of pertinent factors associated with these major headings is presented at some length. Randomly selected are the subjects of the cost of breast milk as a tissue versus as a corporate product; introduction of payment vs altruistic giving of milk and the many ramifications, including a pertinent case involving Cambodian women; a history of commodification of human beings and their parts; numerous cases of horrendous usage of individuals and/or their bodies/tissues without their permission; disclosure as well as existing barriers to it; changing fate of premature babies and increased need of an increasing milk supply and almost countless more factors requiring consideration. Each section is followed by an impressive list of references.

Discussion: The author has made a most interesting case for the establishment of “Milk Banks”, a subject seldom entering the minds of the everyday citizen. Further she has provided a highly detailed and quite all-encompassing discussion of the factors of importance in accomplishing this mission. And she has presented her material in a most readable form in spite of simultaneously fortifying her compelling arguments in a quite scholarly fashion bolstered with 176 supporting references. The only somewhat deterrent feature is the absence of judicious editing of the repetition/redundancy that occurs throughout the book.

4* 5* Subject rating; -1* as explained.

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