The Courier Mail reports on the ‘black’ market for breast-milk:
A BLACK market in breast milk has developed in Australia as families desperate to feed their babies the natural elixir are being charged up to $1000 a litre on the internet.
One mother contacted the Gold Coast based Mother’s Milk Bank to ask what the real “going rate” was for breast milk after online sharks demanded the extortionate amount when she placed a web advert seeking human milk.
Mother’s Milk Bank director Marea Ryan told her that the not-for-profit bank sold milk for $50 for 1.2 litres.
The market has developed because of the marketed qualities of breast-milk. So mothers who have difficulty breast-feeding still have incentives to procure breast-milk elsewhere.
If I understand the article correctly, there are concerns that an unregulated market may give rise to health issues of the quality of milk is poor. That is, it should be regulated as a food. However, it appears to be treated as a bodily fluid and so regulated or open markets with transparent standards are shut down.
The Government clearly can’t have it both ways here. If it believes breast-milk is important then ensuring quality supply is available widely is surely a good thing. On the other hand, there may be social norms at work preventing such markets by treating all sale of bodily fluids as a repugnant transaction.
My guess is that they are against the idea because of concerns that some mothers might opt to purchase breast-milk rather than produce it themselves. As an economist, that idea does not trouble me although I think that some regulations might be in order to ensure that mothers do not supply milk onto the market in ways that cause them to deny their own children that milk. Nonetheless, this is not an area where Governments should be dismissive of market opportunities.
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There are other regulatory concerns. Breast milk is marketed (by the breast milk service industry and associated lobby groups, and no doubt by the black marketers) as having all manner of therapeutic qualities, despite the absence of randomised double-blind studies to back up most (if not all) of those claims. (However, on checking the legislation, it seems that breast milk is not regulated as a ‘therapeutic good’ because it is a good ‘which, in Australia or New Zealand, [has] a tradition of use as foods for humans in the form in which they are presented’. Not sure that’s an appropriate exemption in this case.)
Hoo-haa about ‘breast is best’ aside, one of the few credible claims about the magic powers of breast milk is immunity against gastro infections, on the theory that the mother gets the disease first, develops antibodies from her more developed immune system, and then passes them to the baby. Clearly, that advantage won’t flow from the breast milk bank (but mothers could just spit in their kids’ mouths, I guess.)
I’m not sure why you’re troubled by mothers opting to sell their breast milk at a premium and then feeding their baby formula. Only the craziest of breast-milk campaigners think that the advantages of breast milk are anything other than slight. That $1000 a litre (minus $30 or so for formula) could be put to much greater advantage for the baby, surely?
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Julie Smith has done some nice work on breastmilk prices, as well as wet-nurse wages. The difficulty here is that in heavily regulated markets, prices tell you more about regulatory cost than anything else.
Incidentally, Julie also pointed me to a 2008 randomised evaluation of breastfeeding in Belarus, which seems to indicate non-trivial impacts on cognition.
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The Belarus study is randomised, but of course not double-blind. The IQ results are certainly interesting (with the usual caveats about the relevance of IQ) but the study itself notes that there are anomalies: the IQ gains were not evenly spread in the experimental group, but instead clustered in particular areas, suggesting some sort of external effect (spurious or otherwise.) The obvious follow-up (ethics aside) would be to supply bottles for feeding, with formula in the control and expressed milk in the experimental group (perhaps from the Brisbane milk bank?)
Note that the Belarus study found none of the oft-claimed benefits for health or behaviour.. Those null results naturally get much less attention than the IQ result.
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Actually, Jeremy, your study would be feasible (and ethical, IMHO) for mid-stage switchers. For example, recruit a group of mums who planned to switch to formula at 3 months, then offer them something that was formula with 50% probability and breastmilk with 50% probability.
I’d also like to see individual-level randomisation done by something like randomising the midwife-level pressure to breastfeed. Since in reality this varies from light to heavy, it’s hard for me to see why we oughtn’t induce some random variation.
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