[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-281280-105":53,"doc-detail-281280-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","comment-open-response-to-repeating-the-errors-of-the-past-the-hazards-of-a-commercial-human-milk-industry","COMMENT OPEN - Response to “Repeating the errors of the past: the hazards of a commercial human milk industry”","","This commentary response addresses Professor Modi’s critique on the harms of commercial human milk industry practices, presenting GAMBA’s concerns about for-profit marketing of human milk products. It argues that unsubstantiated health claims can mislead clinicians and families, and that donor human milk (DHM) must not be treated as equivalent to mothers’ own milk. The response further highlights ethical and financial risks of commercialization, discusses fortifier production by for-profit firms, and critiques broad claims regarding the safety of formula and the comparative risks of DHM versus formula in preterm feeding contexts.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/comment-open-response-to-repeating-the-errors-of-the-past-the-hazards-of-a-commercial-human-milk-industry/281280/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/comment-open-response-to-repeating-the-errors-of-the-past-the-hazards-of-a-commercial-human-milk-industry/281280.png","ImageObject",442,249,{"name":88,"@type":89},"Ezra","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-19","2026-09-16",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is GAMBA’s position on non-evidence based marketing of human milk products by for-profit companies?","Question",{"text":109,"@type":110},"GAMBA considers it essential to advocate against such marketing, since unsubstantiated health claims can influence doctors and families and potentially undermine breastfeeding of infants by their own mothers.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How should donor human milk (DHM) be understood in relation to mothers’ own milk?",{"text":114,"@type":110},"DHM should not be perceived as equivalent to mothers’ own milk; it is intended as a bridge until the mother has sufficient milk.",{"name":116,"@type":107,"acceptedAnswer":117},"Why does the response criticize commercialization of human milk products and fortifiers?",{"text":118,"@type":110},"The response argues commercialization introduces financial drivers that undermine ethical obligations, and that for-profit production of HM fortifiers can reduce the pool of milk donors and create inequitable DHM supply for vulnerable infants.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},281280,1790906347,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":9},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","[www.nature.com/pr](www.nature.com/pr)  \nCOMMENT OPEN   \nResponse to “Repeating the errors of the past: the hazards of a commercial human milk industry” Modi (2024) from the Global Alliance of Milk Banks and Associations  \nAnna Coutsoudis1, Rudolf Ascherl2, Enrico Bertino3, Nadia Garcia-Lara4, Guido Moro5, Sushma Nangia6, Jean-Charles Picaud7, Natalie Shenker8,9 ✉ , Marta Staff10, Aleksandra Wesolowska11 and Gillian Weaver9  \n© The Author(s) 2024, corrected publication 2024  \nPediatric Research; [https://doi.org/10.1038/s41390-024-03259-4](https://doi.org/10.1038/s41390-024-03259-4)  \nMother’s own milk is the first choice in preterm infant feeding. When mother’s milk is not available or is insufficient, donor human milk (DHM) from a well-established Human Milk Bank (HMB) is recommended by scientific organizations including the World Health Organisation (WHO), the American Academy of Pediatrics ([https://www.aap.org/](https://www.aap.org/)), and the European Society of Pediatric Gastroenterology Hepatology and Nutrition ([http://](http://)[ ](http://)[www.espghan.org/](www.espghan.org/)).  \nAs the Global Alliance of Human Milk Banks and Associations (GAMBA), a global collaborative network, we would like to concur with the following points made by Professor Modi in her commentary of the harms of human milk commercialization:1  \n1. It is essential to advocate against non-evidence based marketing of human milk products by for-profit companies. Unsubstantiated health claims can influence doctors and families to purchase their products, thereby potentially undermining breastfeeding of infants by their own mothers.2  \n2. We need to continue to be vigilant that DHM is not perceived as equivalent to mother’s own milk. Except in the rare cases where not possible, DHM should certainly be conceived only as a bridge until the mother has sufficient milk, given the superiority of mother’s own milk.3  \nWe would however seek to differentiate non-profit human milk banking from commercialized companies. Differences abound between sectors in numerous ways, but most critically in the support of the milk donors and the underpinning commitment of milk banks to the protection and support of maternal lactation and breastfeeding. Milk banks have an ethical obligation to safeguard the health of women who donate their milk, and to ensure that DHM is predominantly used as abridge to breastfeeding. Commercialization of human milk  \nproducts introduces financial drivers that undermine both ethical obligations.  \nFurthermore, human milk (HM) fortifiers are currently solely produced by for-profit companies using large volumes of milk. Despite a number of trials showing no impact of HM fortifiers on supporting growth or reducing NEC impact, feed intolerance, lateonset sepsis or death,4,5 their ongoing production reduces the pool of milk donors available to non-profit milk banks, leading to the ongoing unequitable supply of DHM for vulnerable infantsand absorbing valuable financial resource that could be invested by NICUs into lactation support.  \nWe believe that some of Modi’s points need clarification:  \n1. Modi asserts that “safe formulae are now available”. We cannot agree with this broad sweeping statement as formula feeding is associated with risk compared to the gold standard of exclusive breastfeeding with mother’s own milk, particularly in resource-limited settings. Formula feeding is suboptimal in terms of the risk of necrotizing enterocolitis (NEC), poorer cognitive development, and generally increased morbidity and mortality. Infants that receive formula feeds are more likely to gain weight rapidly, but this may not be the most important marker of positive health outcomes in this population, with a growing emphasis instead on body length and head circumference as markers for appropriate growth.  \n2. There is insufficient evidence to support Modi’s suggestions about the possibility of harm from supplementing mother’sown milk with DHM compared to supplementing with ","cbCaisXqMzri89E1","https://ap.wps.com/l/cbCaisXqMzri89E1","pdf",380499,"English","# COMMENT OPEN\n## Response to “Repeating the errors of the past: the hazards of a commercial human milk industry”\n## Key points raised by GAMBA\n## Clarifications and critiques of Modi’s statements","[{\"question\":\"What is GAMBA’s position on non-evidence based marketing of human milk products by for-profit companies?\",\"answer\":\"GAMBA considers it essential to advocate against such marketing, since unsubstantiated health claims can influence doctors and families and potentially undermine breastfeeding of infants by their own mothers.\"},{\"question\":\"How should donor human milk (DHM) be understood in relation to mothers’ own milk?\",\"answer\":\"DHM should not be perceived as equivalent to mothers’ own milk; it is intended as a bridge until the mother has sufficient milk.\"},{\"question\":\"Why does the response criticize commercialization of human milk products and fortifiers?\",\"answer\":\"The response argues commercialization introduces financial drivers that undermine ethical obligations, and that for-profit production of HM fortifiers can reduce the pool of milk donors and create inequitable DHM supply for vulnerable infants.\"}]","COMMENT OPEN - Response to “Repeating the errors of the past: the hazards of a commercial human milk industry” | PDF",1789565312]