Article by Prof Armand Goldman "The Immune System in Human Milk: A Historic Perspective"
Article by Prof Armand Goldman "History of the International Society for Research in Human Milk and Lactation”
As 1970s dawned, a group of young scientists with quite disparate expertises had become interested in the largely neglected field of human milk and lactation. This was an interesting group of researchers. By and large they had not trained with mentors who were interested in the field. In different ways, each had become attracted to this area of research even though funding for the studies from federal resources was hard to obtain because of the lack of enthusiasm for the field among study sections of the National Institutes of Health of the United States or their counterparts in other countries. Another feature was their appreciation of many scientific disciplines was their ability to work with others in the field.
In the latter part of the 1970s, the interests of those scientists in the United States began to coalesce. The upshot was an initiative generated by an administrative scientist at the National Institute of Child Health and Human Development. Thorsten A. Fjellstedt was a tall, angular, visionary. His original training was in Microbiology, but his bent was to reach out into many aspects of child health and to aid in the development of outstanding science. Fjellstedt recognized through his review of research grants sent to the institute that there was a growing research interest in human milk and lactation, but the problem was how to channel support toward scientists who might conduct excellent science in the field. Fjellstedt convinced his co-workers to call for research proposals in the area of human milk. The call for these proposals consolidated the interest in the field and encouraged graduate students and postdoctoral fellows to join into the research.
As research in the field of human milk began to gain momentum, a need for a meeting of these pioneers in the field was recognized. Thorsten Fjellstedt played a pivotal role in organizing the agenda and participants for the conference. The conference was held in Elk Ridge, Maryland in 1982 to examine methodologies in human milk banking. It was soon recognized that all aspects of the methods used to analyze human milk required intensive study. A committee on methods chaired by Robert G. Jensen was formed. The other members included Stephanie Atkinson from McMaster, Cutberto Garza from Baylor College of Medicine, Bo Lönnerdal from the University of California at Davis, Margaret C. Neville from the University of Colorado, and Mary Francis Picciano from the University of Illinois. Later on, Armond S. Goldman from the University of Texas Medical Branch in Galveston and Margit Hamosh from Georgetown were added to that group.
Plans were laid for a second conference that would focus upon laboratory research methodologies that would be held under the auspices of the National Institute of Child Health and Human Development. Robert Jensen was the principal organizer. An isolated, pastoral site in Winter Park, Colorado, was chosen for the site by Margaret Neville, who also played a major role in organizing the scientific program. About 50 scientists, many of whom became the core of the Society for the next decade, gathered for the event in August 1984. It became clear at that conference that methodologies originally designed to measure the function or components of other systems were not necessarily ideal for studies of human milk and lactation. The presentations from the meeting were organized into a publication that appeared in 1985 (1) and proved to be a valuable source of information and lead to an increase in interest in the general topic. The workshop atmosphere of the conference engendered a spirit of intellectual challenge and camaraderie that paved the way for the succession of research conferences devoted to human milk and lactation that were to come. Also, it appeared that a critical mass of investigators could be mobilized to warrant the creation of a new research society that would be devoted to human milk and lactation. In fact, many of them played important roles in the development of the Society.
The Steering Committee recommended that the next conference be devoted to the effect of environmental and maternal factors upon human lactation. Margit Hamosh was asked to organize the conference. Armond Goldman was asked by Hamosh to help with the organization of the conference. Salvador Villalpando and Samuel-Flores Huerta from the Unidad de Investigacion Biomedica in Mexico City graciously arranged for the meeting to be held in the picturesque, Spanish Colonial setting of Oaxaca, Mexico, where the more ancient Mitex and Zapotec civilizations were centered. The conference was held after a delay due to an earthquake in Mexico City in January 1986. As with the Winter Park Conference, there were intense and vigorous presentations and discussions. The main areas of interest were ethnic-cultural determinants of lactation, lactation performance, effect of nutrition upon human lactation, drugs and toxins in human milk, and host defense factors in human milk (2). The con ference also attracted many colleagues from Hispanic America and some from Europe. As with the preceding conference, the publication of the proceedings attracted great interest and encouraged the creation of an international society.
Armond Goldman was asked to organize the third conference. He in turn asked Stephanie Atkinson and Lars Å. Hanson from Göteborg, Sweden, to help design a conference that focused on the effects of human milk upon the recipient infant. A European site for the conference was favored to attract Europeans into the new research society and to encourage collaboration between groups on both sides of the Atlantic. Fortunately, Gerd Harzer , a German scientist who was studying certain components in human milk, learned about the idea and he volunteered to arrange the meeting to be held in Konstanz, West Germany, in September 1986. At the conference, over 60 scientists addressed the nutritional, epidemiological, metabolic, hormonal, immunological, and toxicological aspects of the issues. The site in Western Europe was ideal from many points of view. As with the Oaxaca conference, the cultural setting facilitated an exchange of data and ideas and permitted vigorous but friendly debate that became a hallmark of the Society. Questions pinpointed at that meeting resonate with us as this history is being written. Will investigations of the physicochemical structures of components in human milk lead to a discovery of new functions of the components? How do the components interact? What animal models are suitable for testing the effects of human milk upon the recipient? How do the components interact with the mucosa of the recipient? Are there systemic effects of human milk, and, if so, what bioactive factors in human milk are responsible for those effects? The publication of the conference (3) was widely distributed and, as with the first publications, generated more interest among members of the research community.
Final plans were made to form the International Society for Research in Human Milk and Lactation. All participants in the first three conferences were invited to join the new society. Elections were held. In 1988, Margit Hamosh became the first President, Leif Hambreaus (Sweden) the first President-Elect, and Kay Dewey (University of California at Davis) became the first Secretary/Treasurer. The members of the first Executive Committee were Lindsey Allen (University of Connecticut), Stephanie Atkinson, Armond Goldman, Lars Hansen, Ruth Lawrence (University of Rochester), Bö Lonnerdal, Audrey Naylor (University of California in San Diego), Mary Frances Picciano, Guy Putet (Hopital Edouardo Herroit in Lyons, France), and Richard Schanler (Baylor College of Medicine, Houston).
The Laws and By-Laws of the Society were designed principally by Margaret Neville with some assistance from Margit Hamosh and Armond Goldman. The document provided the framework for the subsequent operation and development of the Society. The goals as enunciated in that document were to formulate excellent science in the field of human milk and lactation, bring together investigators in all aspects of the field to accomplish the first goal, and aid in the development of young researchers to carry on these endeavors into the future. Indeed, the intertwining of renewal and continuity ran through the document and through the minds of those who founded the Society. It was understood at the beginning that the Society would be composed of individuals who were devoted to research into the subject and were poised to make contributions.
Over the next 12 years, international conferences were held in Costa Rica (1988), Asilomar, California (1990), Stockholm, Sweden (1992), Tlaxcala, Mexico (1995), Plymouth, Massachusetts (1997), and Irsee, Germany (1999) (see Appendix A for the Organizers). In addition, annual symposia were held in conjunction with the national Experimental Biology meetings. The Society also helped to spawn the Milk Club, a group of academic pediatricians who meet annually at the conjoined meetings of the American Pediatric Society and Society for Pediatric Research.
The Society was well served by a succession of excellent officers and members of the Executive Committee. The Presidents following Margit Hamosh were Leif Hambraeus, Cutberto Garza (Cornell University), Mary Frances Picciano (Pennsylvania State University), Armond Goldman, Salvador Villalpando, and Richard Schanler. The Secretary/Treasurers following Kay Dewey were Nancy Butte (Baylor College of Medicine, Houston), Armond Goldman, Ruth Lawrence, and Frank Greer (University of Wisconsin, Madison). These officers along with the member of the Executive Committee (see History of the Executive) provided the leadership for the Society and in doing so ensured that the members of the Society would be able to participate and have opportunities to become leaders in their own right.
The members of the Society recognized in 1994 that it was essential to establish an ethical code for the operation of the Society. The code was prepared principally by Jean-Pierre Habicht (Cornell University) and accepted by the Society after considerable review. The guidelines have been used since then by the Society to design their meetings and deal with donors and their donations.
The Society also decided in 1994 to create an award to recognize senior scientists who had made outstanding contributions to the field of human. The award was named in honor of Icey Macy for her pioneering studies of lactation performance and Paul Györgi from Philadelphia for his research concerning host resistance factors in human milk. The first award was given to Dr. Robert Jensen from the University of Connecticut, a founder of the Society, for his many discoveries concerning lipids in human milk. The second awardee, Dr. Stuart Patton from the University of San Diego, was recognized for his many salient studies including the structure and components of milk fat globules. The third awardee was Dr. Margit Hamosh from Georgetown. Hamosh, one of the founders and first President of the Society, was recognized for her excellent research into lipids, enzymes, and immune factors in human milk and the way that the recipient infant deals with and is affected by those agents.
The Society had from its inception encouraged the development of young investigators. In 1999, a Young Investigator Award was named after Paul Erhlich, the Nobel Prize Winning Scientist from Germany, who first discovered that the mammary gland was an immunological organ, and Otakar Koldovsky from the University of Arizona, who conducted pioneering studies on hormones and growth factors in human milk and their fate in and effects upon the recipient infant. The first winner of the named Erhlich-Koldovsky Young Investigator Award was R. Perez-Escamilla from the University of Connecticut for his investigations concerning lactogenesis.
Since the Society was established in 1988, the membership grew steadily and involved scientists from many different disciplines including anthropology, biochemistry, immunology, lactation performance, maternal and child health, metabolism, molecular biology, nutrition, physiology, toxicology and related areas. The group remained highly interactive, attractive to new scientists in the field, and dedicated to the promulgation of excellent science in human milk and lactation. As the Society entered into the 21st century, there was a spirit of optimism that there were many new opportunities to explore the mysteries of the human mammary gland and it secretions. Finally, the group looked forward to creating a new history of scientific camaraderie and accomplishment in research in human milk and lactation.
Contributed by Dr. Armond Goldman