- So we're walking through New York City.

I saw a formula advertisements in places like Chinatown, Harlem, Spanish-speaking neighborhoods in the Bronx.

I lived and worked near Sloan Kettering, which is the Upper East Side, and you didn't see posters advertising infant formula.

You saw breast is best posters, lactation rooms, There was lactation consultants.

But breast milk is the best substance to feed a baby and to really keep it healthy.

- Dr. Steven Townsend was, at the time, not an expert in breast milk, but as he walked through New York City with his pregnant wife he was really affected by seeing these inequalities in who was being provided what information.

- The response was to go out and try to do something about it.

How can I figure out what's powerful about human milk and then distribute that equally to everyone rather than having resources limited to specific people.

- Dr. Townsend is now one of the leading breast milk researchers in the world.

He's a professor of organic chemistry at Vanderbilt University studying the chemistry of breast milk.

What makes it so good for babies and why that's so hard to replicate in formula.

When he entered the field, people didn't know much about what makes breast milk so unique.

- We know a lot about human milk proteins and human milk fats, but people never really jumped into the sugar area.

And so that's where we came in, because if you compare cow's milk to human milk, cow's milk is the basis of formula, they have about equal amounts protein, equal amounts fat, but it turns out that human milk contains complex sugars.

We call them human milk oligosaccharides.

And it turns out that if you look at cow's milk, they're not there.

So cow's milk barely has any complex sugars.

And so we knew that this was gonna be a compound that explained a lot of the differences between breast milk and cow's milk.

- Cow's milk has plenty of simple sugars, like lactose, but not much in the way of complex sugars.

But the milk of primates, like us, contains loads of them and they seem to be really important for infant health.

We already knew that human milk oligosaccharides seem to promote the growth of good bacteria.

But more recent research has shown that it also can stop the growth of bad bacteria.

One oligosaccharide called 2 prime fucosyllactose helps good bacteria called bifidobacteria grow in babies guts and it stops pathogens from binding to the gut lining.

There are hundreds of oligosaccharides out there, but 2 prime fucosyllactose is currently the only human milk oligosaccharide being added to formulas today.

And all of those oligosaccharides are just different combinations of five possible sugar types.

- So you have glucose, galactose, N-acetylglucosamine, fucose, sialic acid.

And then those five building blocks can ultimately be turned into 200 different compounds, ranging from very small sugars to massive polymers.

What we like to do is figure out why is breast milk special.

Ultimately provide that information to the community.

And then when it comes to companies that wanna make better formulas, which they all do, I think what we wanna do is provide them with useful information.

But then even in real time what mom makes the baby needs at that moment, the sugar composition changes from day one to day 10 to month 10.

What baby is drinking at the beginning of nursing for one nursing session changes by the time they're done drinking.

- A mom can produce around 200 different oligosaccharide in her breast milk and not all moms produce the exact same sugars.

And on top of that, mom's breast milk is changing from one minute to the next, which formula can't do.

That's why Dr. Townsend thinks it's probably impossible, at least in our lifetimes, to replicate that.

But there are ways we could improve formula for parents who need or choose to use it.

- In reality, you should have infant formula product A with sugar one, and maybe this is needed for black babies who are premature.

Formula product sugar number three, this is for babies of European descent who might have Celiac's disease.

And I'll tell you, it's far easier for them to just say, here's 2 prime fucosyllactose.

This is the most common sugar in the milk of white women worldwide, so that's where we're gonna put in formula for everyone and let's go make a bazillion dollars.

But they're not even putting close to the amount of sugar in that mom actually produces for the baby.

So I read these labels and it has like milligrams added to the formula.

Babies drink like 10 to 25 grams per day from mom.

So I would argue that what they're even adding to formula at the moment is irrelevant.

- So formula companies are incorporating some human milk oligosaccharides, like 2 prime fucosyllactose, but they have a long way to go to catch up with the latest science.

Although the health benefits of breast milk are clear, formula is still a good option and parents need to decide for themselves and their babies what's best.

Breastfeeding, formula, or a combination of the two.

And there are a lot of parents who don't have the option of breastfeeding, they're unable to, or they're not able to as much as they would like to.

- There's entire populations of people who can't breastfeed.

And then just personal choice.

Because ultimately I'm the type of person that dials it back to every mom has to make a call for themselves.

I can provide data in one direction, but in reality, everyone needs to do what's best for their own dyad, for that mom and that baby.

And in reality, people will be okay.

And so breastfeeding is one area of bullying, because people really go after other people, apparently, when they don't breastfeed.

And so, that becomes personal to me, because I wasn't breastfed.

I'm the oldest of five.

I was born in '83.

My mom always talks about when she gave birth to her children, the second that they took the baby to clean them off, they handed her a pill to stop lactation, sent you home with some formula.

- Many women historically, and even today, have not been provided the latest scientific information on the health benefits of breast milk.

There could be an entire video series on how racism and classism continue to affect breast milk marketing and resources.

It's incredibly complicated.

By working to understand the differences between breast milk and formula, and then getting that information to the public and to formula companies, Dr. Townsend is working toward dismantling the inequalities he saw years ago in New York City.

- One thing that I think is powerful is that I have this place as a person who's a dude, who's a black dude, who's going around the country talking about breastfeeding.

I gave a seminar, I guess it was a couple of weeks ago, at UNC.

And so I'm one of the faculty members I was talking to, she was like, yeah, I appreciate your seminar, but really for one major reason.

And it's because when I just went to the bathroom there was a group of six men talking about breastfeeding in the hallway.

And so I think that the more that we can do research that really resonates to the community, then we can bring everybody to the same page, we can all support each other to do what we need to do.

(gentle music)