When Gretty Amaya took an unpaid maternity leave five months ago, she started what she calls a part-time job to help pay the bills. Ms. Amaya, who lives in Miami, has made more than $2,000 so far by pumping breast milk and selling what is left over after feeding her baby daughter.
格莱迪·艾梅亚(Gretty Amaya)在五个月前开始休无薪产假时，为了增加收入，开始从事一项她所谓的“副业”。住在迈阿密的艾梅亚女士，靠卖襁褓中的女儿喝不了的母乳，已经赚到了两千多美元。

Frozen milk from Ms. Amaya — and from hundreds of other women throughout the country — is flown here to what resembles a pharmaceutical factory. Inside, it is concentrated into a high-protein product fed to extremely premature babies in neonatal intensive care units, at a cost of thousands of dollars a baby.
艾梅亚挤出的人乳经冷冻后，被空运到一个类似药厂的地方，全国其他几百名女人提供的人乳也都送到这里。这里把母乳浓缩为一种高蛋白制品，专门提供给新生儿特护病房中的早产儿使用，每个早产儿要为此花费数千美元。
Breast milk, that most ancient and fundamental of nourishments, is becoming an industrial commodity, and one of the newest frontiers of the biotechnology industry — even as concerns abound over this fast-growing business. The company that owns the factory, Prolacta Bioscience, has received $46 million in investments from life science venture capitalists.
母乳是最古老、最基本的营养品，如今已经成为一种工业品，成为生物科技工业最新的前沿产品——尽管这项快速增长的生意存在着不少争议。这家工厂是由普罗拉科塔生物科学公司(Plolacta Bioscience)公司开设的，该公司从生命科学领域的风险投资人那里获得了4600万美元投资。
“This is white plasma,” said Scott A. Elster, the company’s chief executive. He was comparing milk to blood plasma, which has long been collected from donors and made into valuable medical products like immune globulin, which helps fight infections, and clotting factors for hemophiliacs.
“这就相当于白色的血浆，”公司首席执行人斯科特·A·埃尔斯塔(Scott A. Elster)将母乳比作血浆，长期以来，医药业从捐赠者那里收集血浆，制成昂贵的药品，诸如抗感染的免疫球蛋白，以及给血友病人用的凝血因子。
Concentrated milk could be just the start. Researchers say that breast milk, which evolved over eons to provide optimal nutrition and protect babies from infection, is brimming with potential therapeutics, not only for babies but possibly for adults, to treat intestinal or infectious diseases, like the bowel ailment known as Crohn’s disease, for example.
浓缩人乳可能只是个开始。研究人员称，经历了长期的进化后，母乳可以提供最优的营养，保护婴儿不受感染，其中充满各种疗法的可能性，不仅仅可以用于婴儿，或许也可以用于成人的肠道或感染性疾病治疗，比如名为克罗恩病(Crohn’s disease)的肠疾。
“We are at the tip of the iceberg for milk,” said Bruce German, director of the Foods for Health Institute at the University of California, Davis, and chairman of Evolve Biosystems. Evolve and some other small companies like Glycosyn, Jennewein Biotechnologie and Glycom are trying to develop products based on complex sugars that are abundant in breast milk and that appear to nourish bacteria in the digestive tract that are important to health.
“关于母乳的功用，我们还只是看到了冰山一角，”加州大学戴维斯分校健康食品研究院院长、进化生物系统公司（Evolve Biosystems）董事会主席布鲁斯·日耳曼(Bruce German)说道。“进化”以及格里康辛(Glycosyn)、詹内怀恩生物科技(Jennewein Biotechnologie)、格里康姆(Glycom)等小公司都在研发基于复糖的产品，复糖大量存在于母乳之中，可以在消化道内培养菌群，对健康非常有益。
But the commercialization of breast milk makes many people uneasy. They worry that companies might capture most of the excess breast milk and make products that would be too costly for many babies, while leaving less milk available for nonprofit milk banks.
但母乳的商品化令许多人感到不安。他们担心这些公司可能会获取绝大部分可用的剩余母乳，用以为其他婴儿制造昂贵的物品，剥夺非盈利的“母乳银行”的母乳来源。
“The competition comes in the form of how much surplus breast milk is there in the country and who’s getting it,” said Kim Updegrove, executive director of the nonprofit Mothers’ Milk Bank at Austin. “The nonprofit milk banks have a long history of providing milk to the sickest babies, and provide it based on medical need and not on insurance reimbursement or financial resources.”
“竞争源自这个国家的母乳剩余量，以及由谁来得到它们，” 非盈利机构、奥斯汀“母乳银行”的执行会长基姆·厄普德格洛夫(Kim Updegrove) 说道。“非盈利的母乳银行会将母乳提供给最弱小的婴儿，这是一种悠久的传统，它们提供母乳是基于医学上的需要，而不是基于保险赔偿或经济状况。”
Debate is also intense over whether women should be paid for their milk or donate it altruistically. Opponents of payments, worried about breast milk “farming,” say women might try to increase their milk output unsafely, hide health problems that could make the milk unsafe, mix in cow milk to increase volume or deprive their own babies so they can sell more.
对于女人是否应当出售人乳，抑或应当无私地捐赠出去，也存在激烈的争论。反对出售母乳的人担心母乳的“农场化”，他们说女人可能会用不安全的方式增加母乳产量；隐瞒自己的健康问题，从而令母乳来源变得不安全；在母乳内掺加牛奶；抑或克扣亲生子女的食量，以便多卖一点母乳。
When Medolac Laboratories, a competitor of Prolacta, said last year that it wanted to buy milk from women in Detroit, it was accused of profiting at the expense of black women.
普罗拉特卡的竞争对手美多拉克实验室(Medolac Laboratories)去年称，公司希望从底特律的母亲们那里购买人乳，结果被控告为损害黑人妇女利益而牟利。
“We are deeply concerned that women will be coerced into diverting milk that they would otherwise feed their own babies,” the Black Mothers’ Breastfeeding Association wrote in an open letter in January. Medolac, which said it was working with the Clinton Foundation and wanted to encourage breast-feeding by making it financially attractive, abandoned its plan.
“我们深切担心女人会被胁迫进入提供母乳的行业，从而无法喂养自己的婴儿，”1月，黑人母亲母乳喂养协会(the Black Mothers’ Breastfeeding Association )在公开信中称。当时正在与克林顿基金会(Clinton Foundation)合作，通过提供经济援助来鼓励母乳喂养的美多拉克公司表示，公司只得放弃原计划。
Defenders of payments say that if companies are going to profit, it is only fair for them to pay the suppliers for their raw material, especially since pumping takes considerable time and effort. (Prolacta, which started paying only last year, was accused previously of not making clear to women that their milk donations were going to a for-profit company). Moreover, they say, the commercialization of breast milk could increase the supply available.
母乳交易的辩护者们认为，如果公司要用母乳盈利，那么只有向原材料的提供者付酬才是公平的，特别是吸取母乳十分费时费力（普罗拉科塔公司只是在去年才开始付费的，之前它曾被控告没有对女人们澄清，她们所捐赠的母乳将会被盈利公司使用）。此外，他们说，母乳的商品化有助于增加母乳供应。
The American Academy of Pediatrics says that because of the “potent benefits of human milk,” all premature babies should receive breast milk, preferably from their mothers, but if not, then from donors. But there is not enough donor milk for that, experts say, partly because many women do not know that they can donate or sell excess milk.
美国儿科学会(The American Academy of Pediatrics )称，由于“人乳的潜在好处”，早产婴儿都应当食用母乳，最理想的来源是生母，但如果无法做到这一点，则应食用来自捐赠者的人乳。专家称，但目前没有足够的母乳捐赠来源，部分原因是因为很多女人不知道她们可以捐赠或贩卖多余的母乳。
Mr. Elster said Prolacta processed 2.4 million ounces, or 18,750 gallons, of milk last year and aimed to do 3.4 million this year. That compares to the 3.1 million ounces dispensed in 2013 by all 18 nonprofit milk banks that belong to the Human Milk Banking Association of North America. Those milk banks do not pay women for milk but do charge hospitals a few dollars an ounce to cover the costs of screening donors and pasteurizing the milk.
埃尔斯塔说，普罗拉科塔去年生产了240万盎司，或18750加仑母乳（约合7万升——译注），今年计划提供340万盎司母乳。相比之下，2013年，18家属于北美人乳银行协会的非盈利母乳银行分发了310万盎司母乳。这些母乳银行不向提供母乳的母亲们付酬，但向使用母乳的医院收取费用，主要是筛选捐赠者和对母乳进行消毒的成本费，大约每盎司几美元。
Some women give milk directly to other mothers who need it, using milk-sharing sites like Eats on Feets. Some sell their milk to other mothers (or in some cases to male body builde rs who believe it builds muscle), through websites like Only the Breast, hoping to receive more than the $1 an ounce that Prolacta and Medolac pay. Some health authorities say direct sales or sharing pose risks because the milk is usually unpasteurized.
有些女人通过“Eats on Feets”等母乳分享网站直接向其他有需要的母亲提供母乳。有些女人通过“Only the Breast”等网站把自己出产的母乳直接卖给其他母亲（有时也卖给相信母乳能促进肌肉生长的男性健身者），普罗拉科塔和美多拉克等公司收购母乳的价格是每盎司一美元，在这些网站上出售母乳的价格要高一些。但是有些健康专家称，直接贩卖或分享母乳存在风险，因为这些母乳通常并未经过高温消毒。
Prolacta’s products are intended for extremely premature infants who weigh less than 1,250 grams, or 2.76 pounds, at birth, babies who can fit in the palm of a hand. Those babies need more nutrition than they can receive from breast milk alone.
普罗拉科塔的母乳制品是提供给体重在1250克（2.76磅）以下的极早产儿的，这样的婴儿出生后可以用一只手掌捧起来。除了母乳，他们还需要更多营养。
Prolacta makes a fortifier containing high levels of protein, fats and minerals, which is used to supplement breast milk. It costs about $180 an ounce, and a baby would typically consume $10,000 worth over several weeks. Generally, the cost is paid by the hospital or insurers, not the parents.
普罗拉科塔公司的产品提供了加强营养，包括高蛋白、脂肪和矿物质，作为母乳的补充。这种产品每盎司售价180美元，一个早产婴儿通常在数周时间里要吃价值一万美元的该种制品。一般而言，这笔钱并不由父母支付，而是由医院或保险公司承担。
Although the fortifier is vastly more expensive than formulas or fortifiers made from cow milk, Prolacta argues that it saves money in the long run. Clinical trials it has sponsored suggest that by allowing tiny babies to avoid cow proteins, its product reduces the incidence of necrotizing enterocolitis, a devastating and costly infection that can require the surgical removal of part of the intestine.
尽管这种加强营养品比由牛奶制成的配方奶或者加强营养品昂贵，但据普罗拉科塔公司称，从长期而言，使用它其实是更省钱的。公司赞助的临床试验表明，这种制品因为没有让小婴儿食用牛乳蛋白，从而减少了坏死性小肠结肠炎的发病率，这种疾病后果严重，治疗费用不菲，可能需要动手术切除部分肠道。
Mr. Elster said Prolacta, which is privately held and does not disclose its revenue, is growing 40 percent a year. He said its product was used by about 150 of the 900 neonatal intensive care units that care for these extreme preemies.
普罗拉科塔公司现为私人所有，并未公开自己的收入，但埃尔斯塔表示，公司在一年内收入增长了40%。他还说，在900个早产儿特护病房中，有150个都使用该公司的产品。
But not all doctors are persuaded, and others say that while they would like to use the product, it is too expensive.
但他们并没有说服所有的医生，有些医生称，他们倒是愿意使用这种产品，但它实在太贵了。
“I’ve been stymied by the cost equation,” said Dr. Jae H. Kim of the University of California, San Diego. He said his hospital spends no more than $25,000 a year for donor milk for all babies. Adding Prolacta’s fortifier for just the 50 to 70 extremely premature infants each year would cost more than $500,000.
加州大学圣迭戈分校的基伊·H·基姆(Jae H. Kim)医生说，“成本平衡令我困扰。”他还表示，自己的医院每年花费不到2.5万美元，用来处理捐赠而来的母乳，提供给所有婴儿。然而如果仅仅是对50到70名极早产儿使用普罗拉科塔的加强营养品，每年就要多花50万美元。
Each batch of milk arriving at the $18 million factory here, outside Los Angeles, is tested for viral infections, nicotine, drugs of abuse, dilution and adulteration by cow’s milk. The women who supply the milk take blood tests for infectious diseases, must provide notes from doctors saying they and their baby are healthy and must furnish DNA samples to verify that their milk came from them.
每一批母乳都来到洛杉矶城外那座价值1800万美元的工厂进行检验：是否有病毒感染、是否含尼古丁、过量药品、是否经过稀释、是否掺加牛奶。提供人乳的女人要经过血检，以便排查传染病，还必须提供医生证明，证实她们和她们的婴儿身体健康，并需提供DNA样本，以便验证人乳的来源确实为她们本人。
“Even the vitamins you take you have to report to them,” said Ms. Amaya.
“连你吃的维生素都得申报，”艾梅亚说。
Prolacta now faces competition from its own founder, Elena Medo, who left in 2009 and started Medolac, which is based in Lake Oswego, Ore. Prolacta sued Ms. Medo in January, accusing her of “absconding” with its customer list. Ms. Medo called the suit “extremely anticompetitive and certainly unjustified.”
普罗拉科塔如今面对竞争，对手正是该公司的创始人伊莉诺·美多(Elena Medo)，2009年，她离开普罗拉科塔，在俄勒冈州的奥斯威戈湖创立了美多拉克。1月，普罗拉科塔控告美多携带公司客户名单“潜逃”。美多说这起案子“完全是反竞争的，根本不公平”。
Medolac’s first product, which it sells to hospitals, is donor milk that is sterilized rather than pasteurized, so it does not have to be frozen or refrigerated.
美多拉克的第一件产品是卖给医院的，它使用经灭菌处理的捐赠母乳，而非使用巴氏消毒法，因此无需冷冻或冷藏。
A third competitor could be Glenn Snow, who founded the milk-selling website Only the Breast. He has started a company, International Milk Bank, to buy the milk offered on that website and turn it into products for hospitals.
第三个竞争者可能是母乳交易网站“Only the Breast”的创始人格伦·斯诺(Glenn Snow)，他已经开了一家名为“国际母乳银行”的公司，通过网络购买母乳，并将它制成产品，卖给医院。
“It’s a fascinating industry, and it’s brand-new,” he said.
“这是很棒的产业，而且是崭新的，”他说。
The next frontier could be the complex sugars in milk. Glycosyn, Jennewein and Glycom, which has worked with Nestlé, are trying to synthesize them to make products that would nurture a healthy gut “microbiome.” Prolacta and Medolac say their ability to collect milk nationally will allow them to extract those sugars from the milk.
下一项研究前沿是人乳中的复糖。格里康辛、詹内怀恩与格里康姆与雀巢公司合作，试图人工合成这些复糖，令产品中含有有益健康的“微生物菌群”。普罗拉科塔和美多拉克称，在未来，他们在全国收集人乳的能力可以令他们足以将这些糖类从人乳中提取出来。
Until now, “there’s never been enough milk in one place to be able to do it,” Ms. Medo said.
迄今为止，“在单一地点收集的母乳数量都足以进行这项研究，”美多说。