'Bye nursery; hello rooming-in!

About Projects Who's Involved Newsroom Resources Contact You are here: Home > Newsroom > Goodbye Nursery, Hello Rooming-in Goodbye Nursery, Hello Rooming-in Hospital goes from 10 percent to 100 percent rooming-in in less than a year April 16, 2013 By Cindy Hutter The traditional hub of maternity floors, the baby nursery, is getting a makeover. The nursery is transitioning from the central place for doctors to evaluate babies and families to ogle at newborns to a specialty care area that rarely is used. The new nursery identity is to support the practice of keeping mothers and babies together 24 hours a day, known as rooming-in. The practice helps mother and babies get acquainted, learn feeding cues and establish breastfeeding patterns. Rooming-in is one of the Ten Steps to Successful Breastfeeding External Link, as outlined by the World Health Organization. Birthing facilities who comply with these steps achieve Baby-Friendly External Link status, a designation indicating a commitment to supporting breastfeeding. “It took a lot of teaching to get staff to understand that that we are not doing the mom a favor by taking the baby away from her during the night for her to sleep,” says Marianne Allen, a clinical nurse specialist for Women and Children’s Services at PinnacleHealth System in Pennsylvania. “It’s a change in the mindset of staff that we serve the mother best by teaching her the skills and giving her the confidence she’ll need to take care of her baby in the days to come once she goes home without the safety net of the hospital. The best way to do that is to have them together.” PinnacleHealth is one of 89 hospitals participating in Best Fed Beginnings, a NICHQ-run nationwide project that aims to help hospitals improve maternity care and increase the number of Baby-Friendly designated hospitals in the United States. A significant component to support rooming-in is providing couplet care, meaning the same staff takes care of the baby and the mother. In many hospitals baby nurses take care of the newborns and postpartum nurses take care of the mothers. Having one person take care of both the mother and baby helps promote family-centered care, which is shown to lead to more successful breastfeeding, higher patient satisfaction levels and improved nursing and medical staff communications, according to the Centers for Disease Control and Prevention. “We had to change the whole culture of our unit in that all the postpartum nurses had to be trained for infant care. It was a yearlong process,” explains Teri Grubbs, BSN, director of Women’s Health Services at University Health System in Texas, another hospital participating in Best Fed Beginnings. “Also moving the lactation nurses out of the nursery and on to the postpartum unit helped to support rooming-in and boost our exclusive breastfeeding rates.” What’s in a Name? One challenge to rooming-in is changing the expectations of mothers who want to send their babies to nurseries, not realizing it can make breastfeeding more difficult later. How have these Best Fed Beginnings hospitals been able to deter moms from sending their babies to the nursery? It’s all in the name. The University Health Center renamed its nursery the Neonatal Observation Unit. PinnacleHealth will call theirs the Holding Nursery (starting May 1), which will be a place for babies to get intervention, not care. Greenville Health System in South Carolina went a step further. They put a self-proclaimed “scary” sign on the nursery door that reads: “Authorized Personnel Only. This space is reserved for flu isolation, MRSA isolation, urgent evaluation for sick newborns and procedures. Healthy newborns are assigned to rooms on the Family Beginnings unit. Please see your nurse for more information.” “Overnight the nursery became empty. I was astounded,” says Jennifer Hudson, MD, medical director for Newborn Services at Greenville. “Nurses said the sign really helped to define the space differently and made it look like a place people didn’t want to put their babies. It was the most effective intervention we had so far.” Greenville’s rooming-in rate went from 10 percent in July 2012 to 100 percent in February 2013. Chart showing the increase in the rooming-in rate from July 2012 to March 2013 at Greenville Health System. Credit: Greenville Health System. Click image for larger version. Chart showing the increase in the rooming-in rate from July 2012 to March 2013 at Greenville Health System. Credit: Greenville Health System. Mothers’ reactions to rooming-in has reportedly been overwhelming positive at the three hospitals, with some mixed reactions from second-time moms used to the nursery. “It’s very empowering for families,” said Hudson. “It’s really a positive when it comes to security and safety. We emphasize that mothers get to watch everything we do for their babies, including the first bath, exams and screening tests. Hourly rounding by nurses will ensure that they get the help that they need while families learn about and bond with their newborns." Terri Negron, RN, director of Nursing at Greenville Health System, adds, “While some second-time moms are apprehensive, first-time moms don’t know any different and when they come back, rooming-in will be an expectation.” All three hospitals say the transition to rooming-in has been a team effort. It required support from nurses, doctors, unit leadership and executive management. Staff had to understand the evidence-based reasons for change, be committed to the idea and embrace the changes. It didn’t happen overnight for any of them. “You have to have the nucleus of nurses that are supportive and believe in it,” says Grubbs. “You start with them and you train them and have success and then you train more and have more success. You continue to open the door.”

Breastfeeding nipple shield info

Support for Using Nipple Shields Posted on February 27, 2013 by bfcpgh By Wendy Eson A nipple shield is a thin piece of flexible silicone designed to help a baby who is having trouble latching onto the breast. It is worn over the mother’s nipple during breastfeeding. It is important to assess the need for a shield on an individual basis. Nipple shields are not considered a routine part of breastfeeding and are to be used under the supervision of a lactation consultant. Ideally, they are for short-term use. In addition, they are often helpful in getting a baby back to breast after the introduction of bottle-feeding. They are not designed for nipple pain. BREASTFEEDING SITUATIONS WHERE A SHIELD MAY BE HELPFUL •A baby who is born preterm or late preterm, which is 34-37 weeks gestation. These babies often have trouble with latching at the breast and can tire easily during feeds. There is evidence that nipple shields help these babies keep more active at the breast. •A mother with flat or truly inverted nipples. Caution should be used in determining flat nipples. A good majority of new mothers have some fluid retention in their breasts shortly after giving birth. This is especially true for a mother that has received a lot of IV fluids in labor or certain medications. Nipples in these mothers often appear “flat” due to retained tissue fluid. The areola is also firm, making it difficult for a baby to latch. Mothers should be taught to soften the areola by compressing it with the fingers (Check out this link on Reverse Pressure Softening). This helps move fluids back toward the chest wall and softens the areola. It also draws the nipple out, making latch easier for baby. Mothers can also be shown how to form the end of the breast into a wedge or a “breast sandwich.” This helps baby take in more of the areolar tissue, ensuring a good deep latch at the breast. •A baby who has become accustomed to the firm texture of a bottle nipple. In this instance, a shield can be a good tool in getting baby back to breast. •Rarely, a shield can be used for sore nipples. Once latch has been reviewed and corrected and other issues have been ruled out, a mother with sore, cracked nipples may benefit from a shield as nipples are healing. Having a baby at the breast with a nipple shield is better than not having a baby at the breast, however the shield must be used correctly. Mother’s should observe for good urine and stool output and appropriate weight gain. If this is in order, mother can be assured that baby is effectively transferring milk from the breast. Mother’s should be taught to observe for a good latch with a shield. The baby’s lips should be well flanged, with chin in deep to the breast. If baby is just on the tip of the shield, causing the shield to indent around the nipple, baby may get less milk. Additionally, mothers need to watch for clogged ducts, as the shield can cause reduced milk transfer. A mother whose breasts still feel full after feeding with a nipple shield may consider pumping afterwards to effectively empty to the breast. HOW TO WEAN BABY FROM A NIPPLE SHIELD By definition, to wean from something is to detach from gradually. A mother should allow herself and baby several weeks to come off the nipple shield. Here are some helpful tips: •Always ensure proper latch, bring baby in close and wait for a wide open gape. •With your index finger and thumb, compress the area around the areola to make a breast sandwich or wedge. This makes the nipple firm. Once baby is brought on deep, hold the sandwich until you feel baby suckling well. •Consider pumping to elicit let-down, providing baby with a quick reward. Pumping also helps to elongate the nipple. •Feed baby when somewhat sleepy and not too hungry. They are often easier to put to breast and willing to nurse. •Try latching baby with shield and removing it once let-down has happened. Swiftly place baby back at breast. This “bait and switch” may take several attempts. If baby becomes frustrated with this, allow him to nurse with the shield. The goal is to have a happy baby at the breast. •If it is easier to latch baby at breast with the shield for nighttime feeds, aim for removing it during some of the daytime feeds. DO NOT CUT OFF THE TIP OF THE NIPPLE SHIELD! THIS MAKES FOR SHARP EDGES AND CAN HURT THE BABY. Be patient with yourself and baby as you wean from the shield. Enjoy the time when baby is at the breast and commend yourself for giving your baby the benefits of breast milk!

Breastfeeding...It's only natural

HHS offers moms knowledge, help, and support through a new breastfeeding initiative, It’s Only Natural Today, Surgeon General Regina M. Benjamin, MD, MBA announced the launch of It’s Only Natural, a new public education campaign that aims to raise awareness among African American women of the importance of and benefits associated with breastfeeding and provide helpful tips. It's only natural. mother's love. mother's milk “One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed,” said Surgeon General Benjamin. “By raising awareness, the success rate among mothers who want to breastfeed can be greatly improved through active support from their families, their friends and the community.” Breastfeeding offers mothers and their babies a healthy start. According to the Centers for Disease Control and Prevention, nearly 80 percent of all women in the United States—regardless of status, race, or income — start out breastfeeding. Among African American women, the breastfeeding rate is almost 55 percent — up from just 35 percent in the 1970s. However, while these rates are improving, breastfeeding rates among African American women remain lower than the rates of other ethnicities in the U.S., particularly among those living in the south. This gap may indicate that African American mothers face barriers to meeting breastfeeding goals and need additional support to start and continue breastfeeding. It’s Only Natural was specifically designed to provide materials that reflect the experience of African American moms. It’s Only Natural was developed to equip new moms with practical information and emotional support from peers, as well as tips and education about the benefits of breastfeeding and how to make it work in their own lives. All of the material is uniquely crafted for African American women. Materials include: •video testimonials from new moms talking about the challenges they have overcome, providing breastfeeding tips, sharing their individual stories, and much more; •articles on a variety of topics ranging from laws supporting breastfeeding to how to fit breastfeeding into your daily life; •two fact sheets, which contain proper holding and latching techniques, as well as information on managing discomfort and how much milk is enough; and •radio public service announcements. To learn more about the campaign, visit www.womenshealth.gov/ItsOnlyNatural. ###

Nightwaking Info

Nightwaking By Teresa Pitman "I slept like a baby." It's a phrase we use to describe a particularly sound sleep. But any parent knows that sleeping like a baby really means waking every few hours...all night long! Babies' sleep cycles differ from those of their parents. Babies spend more time in rapid eye movement (REM) sleep, when they are more likely to waken, and less time in deeper sleep states than children and adults. They also cycle between light and deep sleep stages more quickly than adults do. Nature has designed babies to awaken more frequently to ensure their survival; feeding around the clock gives them the nourishment they need to sustain the rapid growth of infancy. Coping with nightwaking Since babies do wake up at night, parents need strategies to get the rest they need. Keeping baby close, in a crib or bassinet, will make nighttime feeding easier and allow new moms to get a better night’s sleep. Nursing the baby in bed allows mom to relax while feeding the baby. When the baby is close by at night, you can respond quickly before she fully awakens. This tends to help babies fall back to sleep more readily after they've been fed. On the other hand, some babies do fuss a bit as they surface from a light sleep phase, without really waking up. If her eyes are closed and she seems to be trying to get comfortable, don't disturb her by picking her up right away. It might be more helpful to just pat her back gently. You'll soon know if she’s going to "really" wake up. Many parents feel that keeping nighttime interaction very low key encourages their baby to go back to sleep promptly: keep lights, diaper changes and conversation to a bare minimum. Catch up on your sleep by napping when the baby sleeps if you can. Partners can also spell each other off for short periods. Should you train your baby to sleep? Parents, understandably, look forward to getting more rest. But many young infants — particularly those who are breastfed — really need their night feedings, so younger babies should not be pushed to sleep through the night. Reducing the number of feedings will also reduce the milk supply, and it may not be possible to make up the extra milk during the day. After the middle of the first year, some parents may want to teach their baby to sleep more independently. The goal of most sleep-training methods is to have the baby learn to fall asleep on his own, so that when he wakes at night, he won't need his parents to settle him. While some parents have had success with this method, others report that their babies cried for long periods without sleeping any longer. Babies all have their own individual temperaments, and while some adapt easily to a new sleep routine, others seem to need nighttime comforting for a longer time. Parents are all different, too. Some just don't believe in leaving their baby to cry, night or day. Others don't feel nightwaking is much of a problem — especially if the baby only wakes up once or twice for a quick feeding and goes right back to sleep. What works for your family? Sleep researcher and anthropologist James McKenna says parents often feel pressured to get their baby sleeping through the night. "If one thing has damaged parents' enjoyment of their babies, it's rigid expectations about how and when the baby should sleep," he says. "There is nothing wrong with a baby who wakes at night and wants to be with his parents." How you handle nightwaking will depend on your own needs and feelings as well as your baby's temperament and sleep habits. Some parents adapt easily to their baby's nightwaking and continue to function well during the day; others feel desperately exhausted. Some babies will easily learn to settle themselves with just a little nudge from mom and dad; others will become frantically upset if left alone and will cry, literally, for hours. Each family has to work out an approach that best meets everyone's needs. Nightwaking is a challenge for many new parents. Any strategies that help you get enough sleep — bringing baby into bed, napping when the baby naps, taking turns in the night or encouraging baby to sleep longer — can be lifesavers. The good news is that all babies eventually develop more mature sleep patterns, though there is plenty of individual variation in the timing. And, one morning, you'll wake up and realize that it finally happened: your nightwaking baby slept all night. Myths about nightwaking Myth: Most babies are sleeping through the night by two or three months. Some do, but plenty don't. In one survey, less than one-third of babies slept through until morning by four months of age (and nearly one in four took more than a year). Myth: Once the baby sleeps through the night once, nightwaking is over. Baby's patterns are always changing. Many babies who sleep through early on begin waking again later. Myth: Giving the baby cereal will make her sleep through the night. All the available research shows that this is not so. In fact, many older babies who are enjoying a wide variety of foods still wake up at night. Copyright Teresa Pitman. Used with permission. Originally published in Today's Parent. Teresa Pitman is the author of 15 books, including co-author of The Womanly Art of Breastfeeding, 8th revised edition. . . . . . . . . . . Facebook Tumblr Twitter .. Get Involved Join

We must encourage breastfeeding

Best for Babes Newsletter Facebook Twitter RSS Search our site: Ways to help! Beating the Booby Traps that prevent Moms from achieving their personal breastfeeding goals! homeAbout UsMission Credo FoundersBettina’s Story Danielle’s Story Board of Directors Press Events GET HELPExpecting Moms New Moms Nursing in Public Nursing at Work Harassment Hotline C.A.R.E.-WHO AllianceCorporate Media Breastfeeding Organizations Team BfBTeams Join Team BFB Donate/Find a Participant Upcoming Events Sponsors Team BfB – FAQ’s Sign In Take Action donate shopSignature Apparel Nursing Tops and Gowns Baby Gear Posters Pumping Bra The Miracle Milk™ Bracelet Thank You/NIP Cards blogBabeworthy Celeb News Science News Advocacy Support 360 Booby Traps view your cart | checkout Is Breastfeeding a Legal Right? Civil Right? Or a Social Responsibility? By Danielle Rigg, JD CLC | Posted on April 3, 2013 | 1 Comment | Print Page “What kind of a society raises its children on food that will shorten their lives?” I dug this quote up one day while looking for examples of other public health crises that have benefited from celebrity leadership. Turns out they were words first spoken in connection with Farm Aid, but they so perfectly capture the reason why we need a popular cause for healthy infant feeding, that it’s now plastered to my wall. We are what we eat. The food we are given as infants, children and adults, can do one of three things: (1) help us to thrive, (2) sustain us or (3) jeopardize our health. Unfortunately, most of the commercial food supply in the U.S., including infant formula, falls into the latter two categories. And the consequences are horrendous — America spends $2.7 trillion each year on health care costs trying to stop a rising tide of epidemic noncommunicable illness — diabetes, obesity, cancer, heart disease, Crohn’s disease just to name a few. And we are no healthier for it; our mortality rank is 50th in the world, our Infant Mortality rate is 41st, and our Maternal Mortality rate is 50th –WAY behind other developed nations. For many Americans who don’t die, living with disease and chronic suffering has become the NORM. We are one of the unhealthiest populations on the planet despite our spectacular spending on “health care.” READ: Americans Under 50. Read: The Cracks in the Foundation & The First Food. Call me crazy, but the goal last time I checked, was not just to grow or survive, but to flourish and thrive. What parent doesn’t want the latter option — for their babies to reach their optimal potential health, physically and emotionally, for a lifetime? None. That’s right. None. Show me the right-minded mother who wants to see her child’s health compromised by the food she puts in its mouth. She doesn’t exist. But show me the mother who makes feeding decisions based on inaccurate or incomplete information, or the mother who chooses breastfeeding but is Booby-Trapped by poor care, advice and support from the medical and legal system and her community and employer and is forced to formula feed by default, or the mother who doesn’t want to, or can’t breastfeed, but is not given the option of using the next best substitute, donor human milk – she exists, by the millions each year. savethechildrenbfreportWhich is why ‘What your infant is having for dinner’ is not a topic over which moms, businesses or even politicians should be arguing. The debate is over and the evidence is clear: Breastfeeding, followed next in order of preference by pumping or donor milk, is the undisputed “first food” and the foundation of human health and thriving. Yes, infant formula has a place and purpose when breastfeeding or donor milk is not feasible (and believe us, sometimes it really is not and we understand! Read: It’s Not Just About Breastfeeding.) But breastfeeding (and human milk) is first on the list because it is a highly cost-effective way to help PREVENT illness – in both baby and mother, long and short term. Period. If more mothers were supported to reach their personal breastfeeding goals, it would slash billions from the nation’s health care burden, (Read: $13 Billion for Breastfeeding), and it would save and improves lives. Read: Save the Children’s Report. Given our poor collective health and economy, the only question on the table should be how can we as a society pull together to see to it that as many moms as possible are no longer being Booby-Trapped and get the full panoply of support that is required to help them succeed at breastfeeding– at birth, at home, in the workplace, and in public? We should be rolling out the red carpet for moms for paying it forward for us all, we should be throwing open every door for them and thanking them, definitely not shaming them. To be sure, we need a national law that protects a woman’s right to breastfeed and have access to donor milk. This law could be passed as an amendment to existing federal law e.g., the Civil Rights Act, the Pregnancy Discrimination Act, or the American With Disabilities Act, or as a stand-alone. Pipedream? Maybe. But worth fighting for. It is extremely time-consuming to fight to protect mothers and babies on a state level, 50 times over. Moms across the country are organizing under our Take Action wing and other groups to amend laws to make this a reality. Read: Texas Moms Fight for Better Breastfeeding Law. But it’s going to take more than laws to change consumer attitudes and create the kind of total seal change in the way we view and support breastfeeding and moms that we so desperately need. If that’s all that it took, then decades after being told about the health benefits of eating more vegetables, most Americans would be heeding that standard — we still don’t eat enough. And legislation making sexual harassment a form of discrimination would have sufficed to eradicate it from our work spaces — it still takes oodles of employee training, education, and cultural indoctrination to reset behavioral norms. Since we entered the breastfeeding conversation in 2007, Best for Babes has consistently framed breastfeeding as more than a question of the legal right to nurse in public or even as a reproductive right. As a behavior that benefits our collective and individual welfare, breastfeeding is also a shared responsibility, and as such, a human and a civil right. Looking at breastfeeding through the human rights lens helps us go beyond the “legal” issue and get to the moral issue that will drive systemic and cultural change: human milk is so precious and beneficial to us all, that helping moms to breastfeed or have access to donor milk, if needed, is more appropriately a question of social responsibility –like preventing forest fires, educating children, or fighting poverty, hunger and disease. By definition, human rights (and its subclass of civil rights) protect our inalienable rights to dignity, safety, health and life, and to be treated fairly and as equals. Protecting a mom’s basic human right to nourish her baby optimally, and a baby’s basic human right to be nourished optimally, falls squarely within those parameters. Seeing breastfeeding as a human rights issue for children is not a novel concept. The Convention on the Rights of the Child is an international treaty declaring eating a human right for a child. Not surprisingly, the U.S. along with Somalia, are the only countries who have not signed on. Our mother’s and babies should not be discriminated against for exercising their human and instinctive right to breastfeed. And yet, as our Nursing In Public Harassment Hotline proves, daily and in droves, moms are being harassed and discriminated against for following an innate and prescribed behavior that will help ensure their and her baby’s best health. Civil rights are also intended to guard against infringements by both government and the private sector that compromise an individual’s freedom of thought and choice. In the current climate, that freedom is being severely compromised. The infant feeding industry has been hijacked by big business (Big Formula) for the benefit of profit and shareholders. Their predatory and unfair marketing practices rob moms of the freedom to make an informed feeding decision and are largely responsible for the inordinate number of breastfeeding failures. Study after study points to the corrosive effect of formula marketing on breastfeeding initiation and success. Read: the Save the Children Report citing unfair formula marketing as a major barrier to breastfeeding. Read: What is the WHO-Code? And we will emphasize here again, that it is not formula per se, but the aggressive marketing of formula that subverts and sabotages breastfeeding that is the problem. Getting back to framing breastfeeding as a civil liberty, formula manufacturers love to ring the Freedom of Choice bell and co-opt that argument to fit their bill. Big Formula spends billions per year ($50 Billion) to perpetuate a marketing fiction to convince moms that choosing their product is a testimony to the exercise of that freedom. Read: Defeating the Formula Death Star. They want moms to believe that formula-feeding is about exercising personal choice, about which a new mom shouldn’t feel guilty, and over which they emerge as her new “BFF” and “savior.” Nothing could be farther from the truth. True “friends” don’t wreck your chances of succeeding at something, throw their arm around you when you predictably fail, tell you not to feel guilty — “after all you tried Sweetie,” then take your money with the other. The formula industry plays the guilt card like Yo Yo Ma plays a Bach Cello Suite and their rewards are equally grand. The “we are here for you mom” campaign yields approximately $8-$10 billion per year profit. Breastfeeding advocates, educators, scientists, and practitioners, make next to nothing when moms achieve their personal goals. We can attest to that personally. So what kind of a society are we? America is a country that prides itself on liberty and freedom and change and great reversals of course to fulfill those promises –cue the Women’s Suffrage and the Civil Rights Movements. We can do this! Let’s make healthy food for infants, children and adults top of our national priority list – a shared responsibility for the betterment of our individual and collective health –and precipitate our laws, policies, and norms to shift to accommodate our shared goal. Let’s no longer seek to ostracize mothers who breastfeed but rather embrace, cheer and celebrate them! Let’s no longer longer tolerate infringements on our personal freedoms and on our personal health for the benefit of big business. Imagine the laws and the infrastructure that might follow that paradigm shift — paid parental leave? On-site daycare? Routine post-partum home visits by qualified lactation professionals covered by all insurance? Greater access to breastfeeding care for low-income and minority women? More affordable and accessible healthy foods? These practices are already standard in many countries that score high on health indices and on quality of life indices. Reframing breastfeeding as a social responsibility — not just a right — will help to deliver the change we need. What are we waiting for? Do you think breastfeeding is a social responsibility and a human right? To learn more about how you can get involved or support the Mother of All Causes visit www.bestforbabes.org/take-action. You might also like: A Mom With a New Baby Needs Your Help! Science You Can Use: Can skin-to-skin and laid-back ... Real Princesses Do Breastfeed, Even Twins! Should World Breastfeeding Week & Awareness Month be Moved? Lack of Breastfeeding is a Key Factor in Autoimmune & ... LinkWithin Related Posts Plugin for WordPress, Blogger... This entry was posted in Advocacy, Aggressive Formula Marketing, Main Content, Take Action and tagged Best for Babes Take Action, Booby Traps, Breastfeeding Civil Right, Breastfeeding Human Right, Breastfeeding Social Responsibility, Convention on the Rights of the Child, donor milk, Farm Aid, First Food, Human milk, predatory formula marketing, Rights of the Child, Save the Children Breastfeeding Report, thrive. Bookmark the permalink. ← From Karo Syrup to Goat Milk – The Formulas Change, but the Booby Traps Remain the Same One Response to Is Breastfeeding a Legal Right? Civil Right? Or a Social Responsibility? Jennie Bever Babendure says: April 3, 2013 at 9:53 pm Beautiful post! Sharing widely!!! Reply Leave a Reply Your email address will not be published. Required fields are marked * Name * Email * Website Comment You may use these HTML tags and attributes:

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What is the WHO Code and why is it important?

Defeating The Formula Death Star: Using Social Media to Advocate for the WHO Code Posted April 1st, 2013 by Jeanette McCulloch and Amber McCann As presented at the 8th Breastfeeding and Feminism Symposium: March 21, 2013 “Oh no. It looks like the Death Star.” – WHO Code advocate Last year, the world’s largest infant formula company, Nestle, rolled out a new center for managing its social media, described by Reuters as Nestle’s site for reaching consumers and “engaging with the online enemy.” Nestle’s new “digital acceleration center,” designed to both reach consumers and manage conflict, “looks like mission control” with walls of screens where red lights flash when online dissent is detected. Advocates for the fair marketing of formula were disheartened but not surprised to see this well-funded effort to reach mothers and diffuse controversy. How infant feeding choices are marketed matters. It matters enough that formula companies are reported to spend more than $50 million annually in the US alone. It matters enough that the World Health Organization developed an entire set of rules (known as the WHO Code) around how formula should – and should not – be marketed worldwide. Now, the efforts to ensure accurate information about feeding choices have moved online to social media. Those that defend those rules – WHO Code advocates – are working to ensure that those rules are upheld online. But defenders of the WHO Code are up against formula companies that are better-funded and are using the most up-to-date tools and strategies for reaching mothers using the Internet. Sound like David and Goliath? Once you see the technological power of the digital acceleration team, you will see why the online efforts of the formula companies feels like the Death Star of the Star Wars franchise fame. This “formula Death Star” is not going unchallenged. Using the incredible capacity of social media for the advocacy, education, and the mobilization of grassroots efforts, a rag-tag group of rebel forces–online WHO Code activists–are working to protect the WHO Code and breastfeeding families everywhere. What is the WHO Code? The International Code of Marketing of Breastmilk Substitutes (commonly called the WHO Code) was written with the goal of reducing the impact of marketing practices that aim to mislead new and expectant mother into believing that infant formula is nutritionally, immunologically, and otherwise comparable to breastmilk. Despite common misconceptions, the code DOES NOT limit access to or use of formula or related products. The code addresses marketing–and for good reason. When marketing spending on formula goes up, breastfeeding rates go down. The WHO Code was written and adopted in 1981 by the World Health Organization by a vote of 118 to 1 (the United States cast the lone dissenting vote). Thirty-two countries have adopted the code as national law, with 76 others adopting portions of it as law. Ethically and morally, the code should be considered worldwide, even where it has not yet been adopted as law. As providers who work with women, we believe in their capacity to make the best choices for their families, when presented with evidence-based information. If that’s our goal, we have two options: • We can increase marketing budgets for breastfeeding to the levels of formula companies. In the past years, they have spent at least $50 million..OR • We can uphold the WHO Code. We want to make abundantly clear that our support of the WHO Code comes from a desire to ensure ALL families have good information, not from any motivation to instill guilt or shame in families who use formula. The WHO Code does not limit options for mothers. It takes away the barriers to informed choice. As Bettina Forbes of Best for Babes puts it: “The only people who should feel guilty are those who know about the negative impact of formula marketing and do it anyway.” Meeting Us Where We Are Means Using Social Media Social media represents a revolution in communication that rivals the introduction of the printing press. For those of us of childbearing age, the notion of checking into Facebook on our iPhones, tweeting a photo of our dessert or going to Pinterest for a classic recipe instead of our family cookbooks, is second nature. Ninety-three percent of the “Millennial Generation” (those born after 1982 and who “get” technology because they grew up with it being an integral part of their lives) are communicating online, and in the United States, nearly 3 of 4 of them are using a social networking Website, such as Facebook, Twitter, or Pinterest. While the stereotype of the white, suburban mom certainly exists, we access social media widely, regardless of race, ethnicity, or socioeconomic status. We as mothers are the “power users” of social media…and marketers know it! These changes are having a significant impact on how we talk about, learn about, and share information around birth and breastfeeding. More than half of all women responding to one survey expressed their intention to share their birth experience, as it happens, on social media. Moreover, time online increases after the birth—44% of US women spend more time online after a new baby is born, and the likelihood that a new mother will seek breastfeeding information and support online is high. We Are Seeking Information About Health Care — Including Breastfeeding — Online Research tells us that health care providers continue to be the “first choice for most people with health concerns, but online resources, including advice from peers, are a significant source of health information in the United States.” Eighty percent of U. S. Internet users have sought health care information online, and birth and related topics are an area of focus. We are using social media not only to seek information online, but we are also sharing our knowledge with others . . . and our iPhones make it as easy as sending a tweet or replying to a Facebook status update. The savvy marketers at corporations who produce infant formulas are fully aware of these changes. We argue that it is our responsibility, as advocates for breastfeeding families, to understand these changes. We know that there is POWER in using social media to reach and rise up and converse with mothers to affect change. Formula Companies Are Making Significant Investments In Social Media Savvy institutions understand what we’d teach in any “Social Media 101” presentation: social media is an unprecedented tool for listening to and engaging with an audience. Nestle has become a leading example of the use of social media both to reach consumers and to manage conflict and dissent. Nestle is the world’s largest food company and is also among the world’s most controversial corporations. Nestle was founded on the formulation of artificial infant milk. However, Nestle is not alone in its use of social media to reach parents. 10 out 11 infant formula brands commonly available in the United States, have a social media presence. Examples of their use included Facebook pages, Twitter accounts, YouTube channels, mobile apps, sponsored reviews on blogs, and interactive websites. How Do the TOP Breastfeeding Profiles Stack Up? Nestle and other formula companies have used large budgets to build their audiences. While overall marketing budgets are not generally available, at least $50 million was spent on formula advertising in 2004 and Nestle has been reported to have doubled their social media spending in recent years. Compare this to the resources of top breastfeeding organizations. La Leche League International, the breastfeeding advocacy organization with the most significant financial resources had total revenues of $1.5 million in 2011 and spent a little over $115,000 on “public relations, external relations, and advocacy.” Other organizations, like KellyMom, Best for Babes, and Breastfeeding USA have small budgets and rely largely on volunteer efforts. The result? Although all of these organizations make a significant impact on the women they reach, compare the total number of all of their followers on Facebook: about 145,000 as of this writing, to that of Gerber (the Nestle owned brand that manufactures Good Start formula) at more than five million followers. Nestle has used its significant financial resources to hire social media experts and develop tools that have made it a shining example of effective corporate social media strategy. Nestle’s “Digital Acceleration Team” has a trained staff that monitors every mention of Nestle’s brands across various social media platforms. Team members identify negative “emerging issues” by the volume of mentions and respond to those with a high level of engagement with a scripted playbook for team members. http://www.youtube.com/watch?v=ktsMa8hfgY0 The Formula Death Star, as it has become known to WHO Cde activists, can feel overwhelming, both because it limits our capacity to reach families and because it can feel impossible to influence change at the world’s largest food company. However, it is encouraging to remember that Nestle developed these tools in response to its inability to manage an onslaught of angry advocates and consumers. In 2010, Greenpeace activists were able to enact significant changes in how Nestle sources palm oil, thanks to a YouTube video spoof that garnered over 1.5 million views, along with a resulting social media campaign that netted more than 200,000 e-mail complaints. Policy change at Nestle, based on calls from all of us, is possible. Examples of Efforts to Support the WHO Code Online Although Nestle may have the Death Star, rebel forces are pulling together to provide much needed social media support for the WHO Code. A recent campaign demonstrates the power of social media to organize individuals, even without an official organizing body like Greenpeace. A blog post exposing that the Pan-American Health Organization — the regional representative in the Americas for the World Health Organization–accepted more than $150,000 in donations from Nestle sparked outrage among activists who were concerned that the fox was helping to buy the hen house. Within days, a private Facebook group was birthed and experienced rapid growth to 400 members, now at almost 1000 members as of this writing. Each day, members were given specific action steps, including suggested scripts for tweets directed at PAHO and WHO. Members shared impromptu trainings on Twitter use and etiquette, researched the money trail, and quickly developed strategy, including a decision to target WHO and call for a rejection of the Nestle funding. The result: A relatively small group of consumers and advocates, through the use of Facebook and Twitter alone, were able to force the World Health Organization to respond. More importantly, the group began to organize and mobilize motivated individuals (including breastfeeding professionals, volunteers, families, researchers, and advocates!) who will come to the next battle more organized and prepared to engage. How The Rebel Forces Can Defeat The Death Star As the Greenpeace example shows, social media provides all of us with a unique opportunities to influence how companies do business. With ongoing support to the rebel forces, much-needed pressure can be put on Nestle to change its policies; but this will not come without significant work. Some areas that need support: Ongoing consumer support and education around the WHO Code: In our experience, families generally are unaware of the WHO Code, or, if they have heard of it, they believe that it limits access to formula rather than limiting the marketing of breastmilk substitutes. The importance of the WHO Code needs to be distilled into social media-friendly images and infographics to build awareness and support for all future efforts. Ongoing education of maternal health advocates. The WHO Code is about more than just breastfeeding. Anyone concerned with infant and maternal health should be aware of and providing support for the adoptions and enforcement of the WHO Code worldwide. Bring even more social media savvy to the table. After Nestle’s run-in with Greenpeace, it brought in a top notch social media strategist to revamp its approach and provide training for its social media team. Nestle uses sophisticated tools to monitor and respond to issues. The Friends of the WHO Code–and any group hoping to use social media for impact–needs people on hand who are savvy in the use of social media and the funding for some basic tools to make the job collaborative. Keep doing what we know best. One the greatest results of the PAHO/WHO crisis was the assembly of a worldwide community with much work still to do. This and other groups need to use traditional community organizing strategies, incorporating social media to create a more level playing field. To learn more about what you can do to help promote the WHO Code through social media, join the group “Friends of the WHO Code” on Facebook. An earlier version of this post originally appeared in Science and Sensibility. You might also like: Read more: http://www.momsrising.org/blog/defeating-the-formula-death-star-using-social-media-to-advocate-for-the-who-code/#ixzz2PGC4jDLa