The American Academy of Pediatrics, a well-respected group of physicians, has allowed their logo to be placed on the tag of Mead Johnson's Enfamil-infant formula discharge bag. Because The AAP clearly promotes breastfeeding due to the undeniable health benefits; this collaboration sends an opposing message. The AAP, maternity hospitals, obstetricians, pediatricians, and all allied health services should avoid the practice of dispersing formula or discharge bags. These are not free samples meant to assist new mothers. Distributing formula companies' discharge bags or printed materials is only providing free advertisement for the formula companies. Unfortunately this practice undermines new mothers breastfeeding endeavors. www.BabyFirstLactation.com
IBLCE Calls Upon the American Academy of Pediatrics to Terminate Arrangement with Formula Manufacturer
As a certification body, the International Board of Lactation Consultant Examiners® (IBLCE®) typically only issues statements directly related to IBCLC® certification matters.
However, due to IBLCE’s strong support of the International Code of Marketing of Breast-milk Substitutes, IBLCE is compelled to take the somewhat unusual step of calling upon the American Academy of Pediatrics to terminate its recent arrangement with a formula manufacturer which included the printing of the AAP logo on the formula company discharge bags.
This arrangement does not accord with some of AAP’s own policy statements as well as the evidence base regarding the importance, and primacy of, breastfeeding.
Therefore, IBLCE calls upon the AAP to terminate this arrangement and to demonstrate its commitment to optimal health and nutrition by unequivocal support and promotion of breastfeeding.
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Professional breastfeeding education and support. Breastfeeding, childbirth and baby care issues.
Friday, January 3, 2014
Thursday, December 26, 2013
Extended Breastfeeding Benefits
www.baltimoresun.com/health/sns-rt-us-breast-feeding-20131225,0,5236029.story
baltimoresun.com
Longer breastfeeding tied to better development
Shereen Jegtvig
Reuters
11:02 AM EST, December 25, 2013
NEW YORK (Reuters Health) - Children who were breastfed for more than six months scored the highest on cognitive, language and motor development tests as toddlers, in a new study from Greece.
Earlier research tied breastfeeding to better thinking and memory skills. But how it's related to language skills and movement and coordination had been less clear.
The new study doesn't prove breastfeeding is responsible for better development, but it shows a strong association, researchers said.
Most evidence "pretty clearly shows there are significant medical benefits of breast-feeding," Dr. Dimitri Christakis told Reuters Health in an email.
Christakis is a professor of pediatrics at the University of Washington and director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute. He was not involved in the new study.
"I think that the evidence is now of sufficient quality that we can close the book on these benefits and focus instead on how do we succeed in promoting breast-feeding because all of the studies, including this one, that have looked at it have found a linear relationship, which is to say that the benefits accrue with each additional month that a child is breastfed," he said.
For their report, Dr. Leda Chatzi from the University of Crete and her colleagues used data from a long-term study of 540 mothers and their kids.
When the babies were nine months old, the researchers asked mothers when they started breastfeeding and how long they breastfed. They updated the information when the children were 18 months old.
Psychologists also tested children's cognitive abilities, language skills and motor development at 18 months.
About 89 percent of the babies were ever breastfed. Of those, 13 percent were breastfed for less than one month, 52 percent for between one and six months and 35 percent for longer than six months.
Children who were breastfed for any amount of time scored higher on the cognitive, receptive communication and fine motor portions of the test than children who weren't breastfed.
Scores on the cognitive, receptive and expressive communication and fine motor sections were highest among children who were breastfed for more than six months, the researchers reported in the Journal of Epidemiology and Community Health.
For instance, on cognitive assessments with a normal score of 100, toddlers who were never breastfed scored about a 97, on average. Kids who were breastfed for more than six months scored a 104.
Chatzi and her colleagues expected to see more breastfeeding than they did.
"We were surprised by the fact that breastfeeding levels in Greece remain low, even though there is an ongoing effort by the Greek State to promote breastfeeding practices," Chatzi told Reuters Health in an email.
Christakis pointed out that in the United States, about 60 to 80 percent of women start breastfeeding their babies, but by four months less than 30 percent are still breastfeeding.
The World Health Organization recommends exclusive breastfeeding - without any formula or solid food - until a baby is six months old, followed by breastfeeding with the addition of appropriate foods through age two.
"One of the reasons we see such a big drop off in the United States and elsewhere around four months is because women return to work," Christakis said.
"The real challenge we have is with sustaining breast-feeding," he said. "I believe very strongly that we need a public health approach to doing so because these are public health issues - improving child cognition and improving in this case as they showed a child's physical development, benefits society as a whole and society has to support women achieving that goal."
"We need to have baby-friendly work places that help women continue to either breast-feed or pump when they return to work," Christakis said.
"There's that African proverb, ‘it takes a village to raise a child,'" he said. "It takes a village to breast-feed a child as well, and all sectors have to contribute."
SOURCE: http://bit.ly/JPdFqm Journal of Epidemiology and Community Health, online December 13, 2013
Copyright © 2013, Reuters
baltimoresun.com
Longer breastfeeding tied to better development
Shereen Jegtvig
Reuters
11:02 AM EST, December 25, 2013
NEW YORK (Reuters Health) - Children who were breastfed for more than six months scored the highest on cognitive, language and motor development tests as toddlers, in a new study from Greece.
Earlier research tied breastfeeding to better thinking and memory skills. But how it's related to language skills and movement and coordination had been less clear.
The new study doesn't prove breastfeeding is responsible for better development, but it shows a strong association, researchers said.
Most evidence "pretty clearly shows there are significant medical benefits of breast-feeding," Dr. Dimitri Christakis told Reuters Health in an email.
Christakis is a professor of pediatrics at the University of Washington and director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute. He was not involved in the new study.
"I think that the evidence is now of sufficient quality that we can close the book on these benefits and focus instead on how do we succeed in promoting breast-feeding because all of the studies, including this one, that have looked at it have found a linear relationship, which is to say that the benefits accrue with each additional month that a child is breastfed," he said.
For their report, Dr. Leda Chatzi from the University of Crete and her colleagues used data from a long-term study of 540 mothers and their kids.
When the babies were nine months old, the researchers asked mothers when they started breastfeeding and how long they breastfed. They updated the information when the children were 18 months old.
Psychologists also tested children's cognitive abilities, language skills and motor development at 18 months.
About 89 percent of the babies were ever breastfed. Of those, 13 percent were breastfed for less than one month, 52 percent for between one and six months and 35 percent for longer than six months.
Children who were breastfed for any amount of time scored higher on the cognitive, receptive communication and fine motor portions of the test than children who weren't breastfed.
Scores on the cognitive, receptive and expressive communication and fine motor sections were highest among children who were breastfed for more than six months, the researchers reported in the Journal of Epidemiology and Community Health.
For instance, on cognitive assessments with a normal score of 100, toddlers who were never breastfed scored about a 97, on average. Kids who were breastfed for more than six months scored a 104.
Chatzi and her colleagues expected to see more breastfeeding than they did.
"We were surprised by the fact that breastfeeding levels in Greece remain low, even though there is an ongoing effort by the Greek State to promote breastfeeding practices," Chatzi told Reuters Health in an email.
Christakis pointed out that in the United States, about 60 to 80 percent of women start breastfeeding their babies, but by four months less than 30 percent are still breastfeeding.
The World Health Organization recommends exclusive breastfeeding - without any formula or solid food - until a baby is six months old, followed by breastfeeding with the addition of appropriate foods through age two.
"One of the reasons we see such a big drop off in the United States and elsewhere around four months is because women return to work," Christakis said.
"The real challenge we have is with sustaining breast-feeding," he said. "I believe very strongly that we need a public health approach to doing so because these are public health issues - improving child cognition and improving in this case as they showed a child's physical development, benefits society as a whole and society has to support women achieving that goal."
"We need to have baby-friendly work places that help women continue to either breast-feed or pump when they return to work," Christakis said.
"There's that African proverb, ‘it takes a village to raise a child,'" he said. "It takes a village to breast-feed a child as well, and all sectors have to contribute."
SOURCE: http://bit.ly/JPdFqm Journal of Epidemiology and Community Health, online December 13, 2013
Copyright © 2013, Reuters
Saturday, December 21, 2013
Lactation Consultants help new Moms
Lactation Consultants Increase Breast-feeding
Megan Brooks
December 20, 2013
Comment
Editors' Recommendations
Primary Care Protocol May Increase Exclusive Breast-feeding
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Pre- and postnatal visits with a certified lactation consultant (LC) coupled with electronic reminders for healthcare providers to discuss breast-feeding at prenatal visits may boost breast-feeding duration and intensity, new research shows.
The American Academy of Pediatrics recommends exclusive breast-feeding for the first 6 months after birth, followed by continued breast-feeding for 1 year or more as other foods are introduced. Yet less than 75% of infants in the United States are breast-fed at all, and fewer than half are still being breast-fed at 6 months, according to the Centers for Disease Control and Prevention (CDC). Under the Affordable Care Act, private insurers must cover professional breast-feeding support without cost-sharing.
In 2 separate clinical trials, Karen Bonuck, PhD, from the Department of Family and Social Medicine, Albert Einstein College of Medicine of Yeshiva University in New York City, and colleagues found that integrating professional LCs into routine care alone or combined with electronic prompted guidance (EP) from prenatal care providers increased breast-feeding at 3 months postpartum.
The studies were published online December 19 in the American Journal of Public Health.
In the Best Infant Nutrition for Good Outcomes (BINGO) trial, 666 primarily low-income women were randomly allocated to 1 of 4 groups: LC alone, LC+EP, EP alone, and usual care (the control group). The LC protocol included 2 prenatal sessions, a hospital visit, and regular telephone calls postpartum though age 3 months or until breast-feeding ceased.
The study team followed-up with the women periodically to assess breast-feeding "intensity," defined as the percentage of all feedings during the last 7 days that were breast milk. They defined high intensity as 80% or more of feedings involving breast milk, medium intensity as 20% to 79%, and low intensity as 19% or less.
At 3 months, high-intensity breast-feeding was greater in the LC+EP group (17.3%; odds ratio [OR], 2.72; 95% confidence interval [CI], 1.08 - 6.84) and the LC-only group (20.5%; OR, 3.22; 95% CI, 1.14 - 9.09) compared with usual care (8.1%).
In addition, women in the LC+EP group were more likely to initiate breast-feeding, do "any" breast-feeding (vs none) at 1 month, and breast-feed exclusively at 3 months postpartum compared with the control group. The EP group did not differ from the control group on any outcome.
The Provider Approaches to Improved Rates of Infant Nutrition & Growth Study (PAIRINGS) study included 275 women from more economically diverse backgrounds (compared with BINGO participants), many more of whom planned to breast-feed exclusively (62% vs 37% in BINGO).
They were randomly allocated to a usual care control group and a group receiving both the LC+EP interventions. For the PAIRINGS primary outcome of exclusive breast-feeding at 3 months, rates were significantly higher with LC+EP than usual care (16.0% vs 6.2%; OR, 2.86; 95% CI, 1.21 - 6.76).
As in BINGO, any breast-feeding and both high- and medium-intensity breast-feeding were more likely with LC+EP than usual care.
Finding Was Robust in Tough Groups
The researchers point out that black/non-Hispanic, younger, overweight and less-educated women are known to have some of the lowest rates of breast-feeding, and together, these women made up a large majority of those enrolled in the BINGO and PAIRINGS trials.
The findings were "robust in what is traditionally thought of as a difficult-to-support breast-feeding population," Dr. Bonuck noted in an interview with Medscape Medical News.
Although neither trial came close to attaining exclusive breast-feeding for 6 months, as advocated by the American Academy of Pediatrics, about 95% of women in the 2 trials at least started breast-feeding, which exceeds the goal of 82% that the CDC has proposed in its Healthy People 2020 report, Dr. Bonuck points out.
"This study is significant because it shows that integrating lactation consultants into prenatal care increases breastfeeding rates among low income racial/ethnic minority women," Tonse N.K. Raju, MD, chief of the National Institutes of Health's Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in news release.
"We need additional studies to see if this and other interventions can enhance breastfeeding by these women beyond a few months," Dr. Raju added.
This research was supported by the National Institute of Child Health and Human Development and the National Institute on Minority Health and Health Disparities. The authors have disclosed no relevant financial relationships.
Am J Public Health. Published online December 20, 2013. Abstract
Comment
Wednesday, December 11, 2013
Tongue-ties interfere with successful breastfeeding
Low-risk snip may help tongue-tied infants breastfeed
Is this baby tongue-tied? Few doctors agree on how best to find out, say breastfeeding experts.
Is this baby tongue-tied? Few doctors agree on how best to find out, say breastfeeding experts.
Photo Credit: © 2013 Thinkstock
Lack of training remains an obstacle to treatment of a relatively common cause of breastfeeding problems, warn experts.
An estimated 4-10% of babies have "tongue-tie," or excess tissue anchoring the tongue to the floor of the mouth. Also known as ankyloglossia, the condition can make it difficult for some infants to breastfeed, resulting in slow weight gain, colic and early weaning. It's also linked to poor milk supply, nipple trauma and infections in nursing moms.
But the simple fix — a quick snip of the offending tissue with surgical scissors or a zap with a laser to release the tongue — seldom features in pediatric literature or training.
Called a frenotomy, the voluntary procedure has almost "no risk if done correctly" and often results in immediate improvements in both the ease and comfort of feeding, says Lawrence Kotlow, a pediatric dentist from Albany, New York. He performs the surgery six to eight times a day.
"It doesn't require anesthesia or stitching, it takes maybe 20 seconds to do, the baby is put on the breast immediately afterwards and most parents find a significant difference because now the baby can have a deeper latch."
Even so, it can be difficult to find a physician to perform the procedure, as both diagnosis and treatment of tongue-tie remain a longstanding source of controversy in the medical community.
The Canadian Paediatric Society hedges that the procedure "cannot be recommended," except in cases where "the association between significant tongue-tie and major breastfeeding problems is clearly identified and surgical intervention is deemed necessary."
Similarly, a recent CMAJ Practice article suggests reserving the procedure for newborns with feeding difficulties caused by "severe" tongue-tie.
A systematic review of 17 studies suggested that "frenotomy is a safe procedure that may facilitate breastfeeding in women who may otherwise have given up," but acknowledged that most studies were not randomized and therefore not a good indication of "any true benefit" (Arch Dis Child 2011;96:A62-3).
One such trial recently showed that frenotomy for infants with mild or moderate tongue-tie "did not result in an objective improvement in breastfeeding" at the end of a five-day period.
However, the study's authors noted that 17% of those randomized to "usual care" did not last five days before the mothers demanded a frenotomy, and 15% switched to bottle feeding. After the five days, most women in the comparison group opted for a frenotomy for their infant.
According to the authors, it's unclear "how many women would have given up breastfeeding if frenotomy had not been available in a few days' time."
In the absence of clear cut evidence, few doctors outside of specialty breastfeeding clinics even assess for tongue-tie, says Dr. Howard Mitnick, a breastfeeding management expert at the Goldfarb Breastfeeding Clinic at Jewish General Hospital in Montréal, Quebec. His clinic is "overwhelmed" with frenotomy referrals from across the province. "There are major chunks of Canada where no one's doing them … because you don't look for something you can't deal with."
Adding to the confusion, there's no standard way in which physicians diagnose the condition. Some doctors identify tongue-tie based solely on anatomical criteria, such as the degree of fusion between the tongue and the floor of the mouth. Others look for signs of limited function, such as an inability to raise or stick out the tongue.
In both cases, it's hard to attribute feeding problems to tongue-tie without a "baseline expertise" to rule out other possible causes, says Mitnick. "Lots of the women I see are struggling with breastfeeding, and the baby has the anatomy of a tongue-tie, but it's not a tongue-tie problem; it's a confidence, knowledge or positioning problem."
According to Dr. Jack Newman, founder of the International Breastfeeding Centre in Toronto, Ontario, "most physicians have no idea how to diagnose a tongue tie, at least the more subtle ones."
"We see babies in our clinic who have very significant tongue ties, yet the parents were told by the doctor that there was no tongue-tie," he wrote in an email. "And most physicians will not release a tongue tie because they don't know how."
The fact that dentists and lactation consultants often know more about the condition than physicians can further complicate the issue.
"If the family doctor doesn't recognize it, and a nonphysician says it's there, you run into a conflict," says Kotlow.
Ultimately, the losers in these scuffles are the babies and parents, who may spend months bouncing from one provider to another in search of a solution.
Mitnick argues that the wait-and-see attitude adopted by many physicians puts mothers at unnecessary risk of having to supplement poor milk supply with formula or giving up breastfeeding entirely. "We know very well that if babies are not exclusively breastfed there are genuine medical concerns, so if the alternative is frenotomy, it should be seriously considered, especially when the risks of the procedure are so low."
DOI:10.1503/cmaj.109-4675
— Lauren Vogel, CMAJ
Copyright 1995-2013, Canadian Medical Association. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
Friday, December 6, 2013
Monday, December 2, 2013
The co$t of infant formula
Budgeting for Baby: The Cost-Saving Benefits of Breastfeeding
September 3, 2013
Budgeting for Baby: The Cost-Saving Benefits of Breastfeeding
Of course, there are many benefits of breastfeeding to consider for both mom and baby, but what about cost? We all know that starting a family means a significant financial commitment – in other words, babies are expensive. No matter what your budget is like, it’s important to plan ahead and prepare for the lifestyle change that a new baby brings.
Whether you’re about to welcome a little one into the world or thinking about your current breastfeeding journey, you might be wondering how much breastfeeding costs. But first, take a look at the cost of not breastfeeding:
Powdered formula, the least expensive type of formula, usually costs between $20 and $30 per large can and formula-fed babies will likely need about 1-1.5 cans of formula per week. Feeding formula means spending $80-$150 or even upwards of $250 per month if your baby requires special formula due to allergies or other special nutritional needs. This means that in one year, your family could spend $960 (low end) to $3,000 (high end) on formula.
Compare that to breastmilk – perfect, complete nutrition without having to mix bottles or carry extra feeding gear – which is totally free. The Surgeon General of the United States notes that following optimal breastfeeding practices can save $1,200–$1,500 in the first year of your baby’s life when compared to buying formula. With that in mind, even spending a couple hundred dollars on a breastpump and supplies winds up costing considerably less than purchasing formula for your baby. We all know about the health benefits of breastfeeding, but don’t forget that healthier infants can also require fewer doctor visits, which lowers healthcare costs (and less time out of work for mom + dad). You can find more of the Surgeon General’s cost-saving benefits of breastfeeding here.
We can also take a look at the big picture. A study published in the Official Journal of the American Academy of Pediatrics found that the United States could save $13 billion per year (in direct and indirect health costs) and prevent almost 1,000 infant deaths if 90% of families chose to breastfeed their babies exclusively for 6 months.
Breastfeeding saves money (and lives) while creating a lifelong bond between you and your little one.
What made the biggest impact on your decision to breastfeed?
Saturday, November 23, 2013
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