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

Lactation Consultants help new Moms

Lactation Consultants Increase Breast-feeding

Megan Brooks
December 20, 2013





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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






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Your new baby and visitors

Bringing Baby Home: Four Ways to Manage Visitors

March 19, 2013

Bringing Baby Home: Four Ways to Manage Visitors
Bringing your new baby home for the first time can be one of the most exciting moments in your life! Before you ease into the calm and comfort of your home sweet home, prepare to be greeted by supportive friends and family. At times, it’s lovely to have visitors, but let’s be honest, it can also be exhausting. Blogger Amy Morrison recently shared a post on managing guests after birth. Here are some tips to help you relax and get support needed to ease into motherhood.

1.) Ask For Help
It’s easy to be overwhelmed by all the new responsibilities of being a mom. Don’t hesitate to ask guests for help. They’ll be thrilled to lend a hand and help you and your bundle of joy get comfortable in your new home.

2.) Make the Visit
Every family has one (or five) people who tend to visit for just a bit longer than most might prefer. If you’re not up for a marathon chat, offer to make the trip to see that person yourself (with your little one, of course). This way, you can choose to keep the visit short and sweet, or linger little longer if you’d like.

3.) Spread Out Guests
It’s okay to space out your visitors (and we don’t mean a few hours apart). Feel free to take a few weeks to get the hang of being a mom, and limit the amount of guests you have during this time. You’re a new mom whose life has just taken an exciting turn. Take some time to simply enjoy the giggles, smiles, and incredible little being you have by your side.

4.) Place Your Order
After diaper changes, breastfeeding, cleaning, playing, giggling and cuddling, it’s easy to lose track of your own mealtime. Remember, eating well and staying hydrated is one of the best ways to maintain breastmilk supply. So, say “yes” when visitors offer to bring over food. Moms deserve little treats too!

Infographic: Breastfeeding - It's only natural | womenshealth.gov

Infographic: Breastfeeding - It's only natural | womenshealth.gov

How to be the Best Post-Partum Visitor in 15 Minutes or Less

Resources How To Be The Best Post Partum Visitor In 15 Minutes Or Less How To Be The Best Post Partum Visitor In 15 Minutes Or Less Have a friend who had a baby and you're on the roster to drop off a meal? Here's everything they want you to know and do, but are too shy and polite to say and ask. They are tired. Breastfeeding is still awkward and having people around makes it more awkward. The mother is recovering physically, either from a surgical birth, or from the equivalent of a triathlon where the prize was a grapefuit sized head flying out of her vagina. Either of these things makes you sore and tired. They would like to see you, but don't want to be tired out by a long visit. You are not going to stay longer than 15 minutes, no matter how polite the parents are in saying you can stay longer. If your visit/meal drop off scheduled for 5.30. BE ON TIME. Make plans for 6:15 so that you HAVE to leave. Read More Before you walk in the door, put your game face on. Set a timer, on your phone or watch for 15 minutes. When it goes off, get out of there! Remember that you are going to be a quiet, productive blessing. This visit is NOT about you. It is not about the parents hosting you and putting on a cup of tea so you can sit and visit and hold the baby. Think about how you would feel if you had either had surgery or ran a triathlon. What would you want people to do for you? This visit is about blessing the parents and making their life a little bit easier. Your prize is getting a quick peek at the cute new human. Here's how to play out your 15 minute visit: 1. Bring a healthy meal. Include a salad or fresh vegetables. Only use disposable dishes. There is nothing more annoying than a) having to wash more dishes when you have a new baby and b) having to try to return dishes to all sorts of random people when you have a new baby 2. In addition to your meal, bring cut up veggies and fruit, unsalted trail mix or nuts, or other such healthy snacks for daytime munching for mom to eat while she's nursing. 3. Go into the kitchen and spend 5 minutes clearing off a counter, washing a sink-full of dishes, loading the dishwasher etc. Don't ask permission, just do it. Then set the table for their dinner. 4. Before you leave your house, put some paper towels and some powdered bathroom cleaner like Commet or Ajax in a baggie. Stick it in your purse. While you are at the house, go and use the washroom...and while in there do a three minute bathroom shine-up, using your paper towels and cleaner. 5. Coo over the baby, but wash your hands before touching it. 6. If they want to eat right then, heat the food up and put it on the table, give everybody kisses and then leave. 7. Take the garbage out when you go. In and out. This will be the best visit the parents will have had. They will love you and you will be awesome in their books forever. You can come back and have a longer visit when the parents have adjusted to their new normal.

'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.”

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

Breastmilk is a gift

www.askthelactationconsultant.com

6 minute film on the billion dollar formula industry

Breast is Best

www.bottledupthefilm.com

Breast pump basics

Breast Pump Basics a. Breast shield: Cone-shaped cup that fits over the nipple and surrounding area. b. Pump: Creates the gentle vacuum that expresses milk. The pump may be attached to the breast-shield or have plastic tubing to connect the pump to the breast shield. c. Milk container: Detachable container that fits below the breast shield and collects milk as it is pumped. Consumer Updates RSS Feed2 Share this article (PDF 508 K)3 On this page: Choosing the Right Pump for You Should You Buy or Rent? Keeping It Clean These days, many new mothers return to the workplace with a briefcase in one hand—and a breast pump kit in the other. For those moms working outside the home who are breastfeeding their babies (and those who travel or for other reasons can’t be with their child throughout the day), using a breast pump to “express” (extract) their milk is a must. The Food and Drug Administration (FDA) oversees the safety and effectiveness of these medical devices. New mothers may have a host of questions about choosing a breast pump. What type of breast pump should they get? How do they decide ahead of time which pump will fit in best with their daily routines? Are pumps sold “used” safe? back to top Choosing the Right Pump for You Kathryn S. Daws-Kopp, an electrical engineer at FDA, explains that all breast pumps consist of a few basic parts: a breast shield that fits over the nipple, a pump that creates a vacuum to express the milk, and a detachable container for collecting the milk. There are three basic kinds of pump: manual, battery-powered and electric. Mothers can opt for double pumps, which extract milk from both breasts at the same time, or single, which extract milk from one breast at a time. Daws-Kopp, who reviews breast pumps and other devices for quality and safety, suggests that mothers talk to a lactation consultant, whose expertise is in breastfeeding, or other health care professional about the type of breast pump that will best fit their needs. Questions for new moms to keep in mind include: How do I plan to use the pump? Will I pump in addition to breastfeeding? Or will I just pump and store the milk? Where will I use the pump? At work? When I’m traveling? Do I need a pump that’s easy to transport? If it’s electric, will I have access to an outlet? Does the breast shield fit me? If not, will the manufacturer let me exchange it? back to top Should You Buy or Rent? There’s also the decision of whether to buy or rent a breast pump. Many hospitals, lactation consultants and specialty medical supply stores rent breast pumps for use by multiple users, Daws-Kopp notes. These pumps are designed to decrease the risk of spreading contamination from one user to the next, she says, and each renter needs to buy a new accessories kit that includes breast-shields and tubing. “Sometimes these pumps are labeled “hospital grade,” says Daws-Kopp. “But that term is not one FDA recognizes, and there is no consistent definition. Consumers need to know it doesn’t mean the pump is safe or hygienic.” Daws-Kopp adds that different companies may mean different things when they label a pump with this term, and that FDA encourages manufacturers to instead use the terms “multiple user” and “single user” in their labeling. “If you don’t know for sure whether a pump is meant for a single user or multiple users, it’s safer to just not get it,” she says. The same precaution should be taken for “used” or second-hand pumps. Even if a used pump looks really clean, says Michael Cummings, M.D., an obstetrician-gynecologist at FDA, potentially infectious particles may survive in the breast pump and/or its accessories for a surprisingly long time and cause disease in the next baby. back to top Keeping It Clean According to FDA’s recently released website on breast pumps4, the first place to look for information on keeping the pump clean is in the instructions for use. In general, though, the steps for cleaning include: Rinse each piece that comes into contact with breast milk in cool water as soon as possible after pumping. Wash each piece separately using liquid dishwashing soap and plenty of warm water. Rinse each piece thoroughly with hot water for 10-15 seconds. Place the pieces on a clean paper towel or in a clean drying rack and allow them to air dry. If you are renting a multiple user device, ask the person providing the pump to make sure that all components, such as internal tubing, have been cleaned, disinfected, and sterilized according to the manufacturer’s specifications. Cummings notes that there are many benefits to both child and mother from breastfeeding. “Human milk is recommended as the best and exclusive nutrient source for feeding infants for the first six months, and should be continued with the addition of solid foods after six months, ideally until the child is a year of age,” he says. The benefits are both short- and long-term. In the short-term, babies can benefit from improved gastrointestinal function and development, and fewer respiratory and urinary tract infections. In the long-term, children who have been breast fed may be less obese and, as adults, have less cardiovascular disease, diabetes, inflammatory bowel disease, allergies, and even some cancers. Cummings adds that moms and their families benefit by the bonding experience and economically as well, since a reduction in acute and chronic diseases in the baby saves money. For women considering this option, FDA ‘s website5 offers resources and information on breast pumps and breastfeeding. These include information on the selection and care of the pumps, in addition to describing signs of an infection or injury related to their use. This article appears on FDA's Consumer Updates page6, which features the latest on all FDA-regulated products. January 14, 2013

Too Few Breastfeeding Studies Done

Is the Medical Community Failing Breastfeeding Moms? By Lisa Selin DavisJan. 02, 20130 Share inShare2 Tamar Levine / Gallery Stock Email Print Share Facebook Twitter Tumblr LinkedIn StumbleUpon Reddit Digg Mixx Delicious Google+ Comment Follow @TIMEHealthland The doctor blamed it on the baby. “She’s not absorbing your milk,” he told Colleen Kelly, in the days after he daughter was born, as the baby lost too much weight and cried constantly. Lactation consultants said, “She’s not latching properly.” Kelly drove through rural Maine for hours to attend breast-feeding support groups and La Leche League meetings, yet the baby went from eight to six pounds and was diagnosed as “failure to thrive.” The baby’s kidneys were x-rayed and blood taken, but doctors found nothing wrong. Not once in her travels did someone suggest that perhaps the problem was Kelly herself, rather than her baby or her ability to latch on. She told doctors that her mother hadn’t been able to produce enough breast milk—could that be happening to her? No, they said. That was an old wives’ tale. But they never even looked at her breasts. “It was clear that none of the doctors or nurses knew enough about breast-feeding to figure out what was happening,” Kelly says. That’s because lactation is probably the only bodily function for which modern medicine has almost no training, protocol or knowledge. When women have trouble breast-feeding, they’re either prodded to try harder by well-meaning lactation consultants or told to give up by doctors. They’re almost never told, “Perhaps there’s an underlying medical problem—let’s do some tests.” (MORE: Breast-Milk Donors Come to the Rescue of a New Mom with Breast Cancer) When women have trouble breast-feeding, they are often confronted with two divergent directives: well-meaning lactation consultants urge them to try harder, while some doctors might advise them to simply give up and go the bottle-and-formula route. “We just give women a pat on the head and tell them their kids will be fine,” if they don’t breastfeed, says Dr. Alison Stuebe, an OB who treats breast-feeding problems in North Carolina. “Can you imagine if we did that to men with erectile dysfunction?” ED, she points out, is within the purview of many doctors’ services, and insurance will cover Viagra, but lactation dysfunction? It doesn’t even exist as a diagnosis, no accompanying health insurance code for which doctors can bill. Within the database of federally funded medical research, there are 70 studies on erectile dysfunction; there are 10 on lactation failure. No one argues that breast is best, but the truth is that breast-feeding is very difficult for many women, and for some, medical problems make it almost impossible without intervention. With the recent bans on giveaways of formula samples in some hospitals, it’s all the more important that the medical community have the tools and knowledge to help mothers breastfeed—or to figure out why they can’t. Until doctors and nurses are properly trained to help, women like Kelly will experience all of the pressure to breastfeed, with none of the support to figure out how. (MORE: 20 Ways To Make Breast-Feeding Easier) What do doctors learn about breast-feeding in medical school? “We learned that it’s what’s best for baby,” said my own pediatrician. “But that’s it.” They’re introduced to evidence that prolonged breast-feeding reduces the possibilities of obesity, SIDS and allergies, but the science of it, what’s happening at the anatomical level? Not so much. “It’s an hour, or a half a day, and [students] don’t remember anything,” says Dr. Todd Wolynn, a Pittsburgh pediatrician and executive director of the Breastfeeding Center of Pittsburgh. There were years, he says, when there was literally nothing said about breast-feeding at all. Why so little heed? “When most of the people who are currently leaders were in training, breast-feeding was really uncommon,” says Stuebe. Many teaching in medical schools today were raised in the better-living-though-chemistry age, when infant formula was thought to trump the attributes of breast milk. (Formula was certainly an improvement over the non-pasteurized cow’s milk that killed many infants at the turn of the 20th century, when breast-feeding was not in vogue). “It’s generational for doctors to think it would be necessary to know anything about breast-feeding.” It didn’t help that formula companies famously sidled up to doctors and nurses and insinuated themselves into hospital protocol; there’s a reason that, until the bans enacted in the last few weeks in some cities, new moms left the hospital with so much Similac swag. In addition, doctors practicing today don’t know where to place breast-feeding problems—breasts are attached to the women, so shouldn’t they be the province of OBs, say pediatricians. And OBs note that breast-feeding is for infants; shouldn’t the baby’s doctor handle it? This leaves breast-feeding problems either to the rare family physicians, or more commonly to lactation consultants who can assist with technical issues—improving the baby’s latch and such—but can’t write prescriptions, check hormone levels or offer a diagnosis. (MORE: Bloomberg’s Breast-Feeding Plan: Will Locking Up Formula Help New Moms?) That’s what a breast-feeding doctor—an OB, pediatrician or family physician with a subspecialty in breast-feeding medicine—would have done in Kelly’s case: a complete physical and medical history (yes, in fact, it is relevant if your mother couldn’t make milk) on mom and baby to see if any physical or anatomical factors were affecting supply. In the mother, they might check the shape of her breasts, to see if they were hypoplastic—a tubular shape that can indicate underdevelopment of the glandular tissue needed to make breast milk—or evaluate her hormone levels, ask if her breast size had increased during pregnancy. Perhaps they’d prescribe a galactogogue, a drug that promotes lactation. Today there are 88 physicians in the entire world who are fellows of the Academy of Breastfeeding Medicine, and have “demonstrated evidence of advanced knowledge and skills in the fields of breast-feeding and human lactation.” But Kelly’s doctors weren’t trained in human lactation, and they told her what many women with lactation failure have been told before: “We’ve never seen this before. You’re the only one.” Yet Kelly is clearly not alone. Dr. Amy Evans, a pediatrician and medical director of the Center for Breastfeeding Medicine in Fresno, CA, says that as many as five percent of all women have underlying medical conditions that prevent or seriously hinder lactation: hypoplasia, thyroid problems, hormonal imbalances, insufficient glandular tissue, among others. But even Dr. Wolynn, who is also a certified lactation consultant, seemed skeptical when I related Kelly’s tale—usually women struggle because they haven’t had enough support in the first few days after giving birth, in his experience. “Very few women really can’t breastfeed,” he said. “That’s very, very, uncommon.” It’s a “normal mammalian function,” he said. Almost everyone can do it. (MORE: Q&A With Breast-Feeding Mom Jamie Lynne Grumet) Because the complexities of lactation failure are so little studied and so often misunderstood, women can often feel that they are at fault, rather feeling like they are suffering from a medical issue for which they need and deserve professional help. Dr. Marianne Neifert writes in her article, Prevention of Breastfeeding Tragedies, “The bold claims made about the infallibility of lactation are not cited about any other physiologic processes. A health care professional would never tell a diabetic woman that ‘every pancreas can make insulin’ or insist to a devastated infertility patient that ‘every woman can get pregnant.’” Luckily, doctors are beginning to take breast-feeding on. Wolynn, Evans and Stuebe are all fellows of the physicians’ organization Academy of Breastfeeding Medicine (ABM). At Wolynn’s practice, all six of the pediatricians on staff are also certified lactation consultants. ABM has developed 25 protocols to guide physicians in treating breast-feeding problems. They’ve successfully lobbied to include breast-feeding issues on the exams for the American Board of Obstetrics and Gynecology and the American Academy of Pediatrics. And the Affordable Health Care Act advises that, as of August 1, health insurance companies should provide “comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breast-feeding equipment.” Of course, we’re low on those trained providers, but there are more every day, as medical schools begin to adopt breast-feeding curricula. “It’s probably the most promising times we’ve seen,” says Wolynn. “We’re in the early phases of what I’m hoping in the next five to 10 years will be more appreciated and more considered a real subspecialty,” says Evans. “It’s a whole new area of medicine.” (MORE: Why Most Moms Don’t Reach Their Own Breast-Feeding Goals) Still, there’s work to be done. Health insurance companies need to reimburse doctors for the time they spend attending to breast-feeding issues, to cover galactogogues, and to cover donor breast milk for women with lactation failure. And if we’re going to remove formula samples for women to promote breast-feeding, we better come up with a plan to feed the babies of that 5% of women who can’t sustain them—with 4 million births a year, that’s 200,000 moms who need extra help. Doctors practicing today—especially those treating pregnant women and new mothers—need to know that lactation failure really does happen, and to be familiar with the potential causes of it, so that they can intervene early. Perhaps most importantly, we need to stop demonizing mothers who can’t breastfeed, guilting them into starving their kids with insufficient milk supplies rather than supplementing with formula. Yes, breast-feeding can help prevent SIDS, obesity, childhood leukemia, asthma, and lowered IQ…but none of those matter if your baby is failing to thrive because of malnutrition. In Kelly’s case, once the baby was admitted to the hospital, she began to use formula, fed through a syringe—she was told to avoid bottles because the baby would reject the breast. She stuck with formula, her baby gained weight, and today, “she’s happy, healthy and fine,” Kelly says. But her guilt and shame continued long after the baby recovered. It wasn’t until weeks later, in another doctor’s office, that Colleen happened upon an article that calmed her: some women, it said, can’t breastfeed, for physical reasons. If only her doctors had read that article, too. MORE: Can a Formula Company Really Promote Breast-Feeding and Fight Child Obesity? Read more: http://healthland.time.com/2013/01/02/is-the-medical-community-failing-breastfeeding-moms/#ixzz2GyaT1Ekh

October 1st, Child Health Day

United States Lactation Consultant Association Press Release

Date: October 2012 Contact: Scott Sherwood For immediate release Tel. 919-861-4543 Email:executivedirector@uslca.org Child Health Day The United States Lactation Consultant Association (USLCA) joins the nation in celebrating Child Health Day on Monday, October 1. For 90 years, the United States Health Resources and Services Administration (HRSA) has set aside the first Monday in October to focus the nation's attention on children's health. It is sobering to consider that for the first time in history type two diabetes is emerging as a significant chronic disease in children and childhood obesity continues its upward trend. Breastfeeding is the primary way to promote optimal health for children. Breastfeeding offers varying degrees of protection from obesity, diabetes, infections, some childhood cancers, and Sudden Infant Death Syndrome (SIDS). An analysis of studies related to breastfeeding and obesity found a 30% decrease in the odds of overweight for a child breastfed for 9 months when compared with a child never breastfed. Additionally, a study published in the journal Pediatrics found that the risk of SIDS almost doubles in infants who are not breastfed. School performance is important to children's health and well-being. Several studies have found that breastfed children have higher IQs and do better in school from the early grades through adolescence, even when parents' IQ and education and the child's living conditions are taken into consideration. According to the Center for Disease Control and Prevention's 2012 Breastfeeding Report Card, breastfeeding initiation is on the rise. This is good news. However the number of babies who are exclusively breastfed for six months as recommended by the American Academy of Pediatrics and other major health-related organizations remains low. From the first prenatal appointment, to the mother's return to school or work, and throughout the baby's first year, breastfeeding must be promoted, protected, and supported until it becomes the cultural norm. It is everyone's job to promote breastfeeding, support mothers, and protect families. As Surgeon General Dr. Regina Benjamin says,"The time has come to set forth the important roles and responsibilities of clinicians, employers, communities, researchers, and government leaders and to urge us all to take on a commitment to enable mothers to meet their personal goals for breastfeeding." International Board Certified Lactation Consultants (IBCLCs) are health care professionals with the expertise to help families at every step of the way. IBCLCs teach breastfeeding classes, work in hospitals to help get mothers and babies off to a good start, problem-solve in out-patient sites such as physician offices, health centers, WIC sites and home care to help overcome breastfeeding trials, and work with employers to facilitate a successful back-to-work experience. IBCLCs help mothers achieve their breastfeeding goals and can help meet national goals related to child health. For more information or to locate an IBCLC, visit www.uslca.org

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USLCA

Message from the President This is a great time for IBCLCs. With the Affordable Care Act including lactation care as a covered health benefit, the services of IBCLCs may be accessible to more mothers than ever before. USLCA is advocating for IBCLCs and bringing information to you as it becomes available. At the Board of Directors meeting held just prior to the ILCA conference, we updated our mission, vision, values, and strategic plan. You will note the strong emphasis on the IBCLC. Take a look at the new Mission, Vision, and Values Statement: MISSION To advance the IBCLC within the United States through leadership, advocacy, professional development, and research. VISION The IBCLC is the recognized professional authority in lactation in the United States. VALUES: 1. Uphold high standards of professional practice 2. Respect and promote cultural diversity 3. Collaborate with integrity in relationships 4. Operate nationally while being mindful of regional, local and Individual needs 5. Demonstrate responsibility to our community by promoting the best lactation care for the foundation of good health

The Florida Breastfeeding Law & You

You have the right to breastfeed in public - it is the law.
Florida Legislation February 1993
Section 1. The breastfeeding of a baby is an important and basic act of nurture which must be encouraged in the interests of maternal and child health and family values. A mother may breastfeed her baby in any location, public or private, where the mother is otherwise authorized to be, irrespective of whether or not the nipple of the mother's breast is covered during or incidental to the breastfeeding.
House Bill  #HB 231 Fl. ALS 4; 1993 Fl. Laws ch. 4; 1993 Fl. HB 231 Fl. Stat. 383.015 /
800.02 - 800.04 / 847.001(later 827.071)
 For further info please contact The Florida Lactation Consultant Association
www.flca.info
or www.babyfirstlactation.com

My Breastfeeding Unsuccess Story

For many years I wanted to become a mother. I dreamt about staying home on a maternity leave and taking care of my newborn. I pictured myself sitting in the perfectly decorated nursery, with a celestial theme, and rocking my baby gently while I nursed him.

For years before this scenario could become a reality; I was working as a nurse. First, as a neonatal transport nurse, and then as a neonatal nurse practitioner. Many years were spent taking care of others' babies; both preemies and seriously ill term newborns. I felt that I had a calling to be a nurse; yet I was personally left feeling void without my own child.

After a first timester miscarriage two years prior; I became pregnant. Even though I was labeled advanced maternal age; I had a great pregnancy and thoroughly enjoyed impending motherhood. I took a several week long childbirth education class and learned all about being in labor. I feared the probable pain associated with delivery but still was very excited.  I neglected to take a breastfeeding class, in part because I had worked with many mothers of preemies, and had assisted many to provide the skin to skin technique. After all; breastfeeding is natural. There can't be that much to it that would make you need a class?  Oh, was I wrong and misinformed to say the least.

My son was born at very close to term. Brad came into this world via a stat-emergency cesarean section. His heartrate had dropped during my labor. My OB later discovered that Brad had an umbilical cord around his neck; known as a nuccal cord. Because of my age I was considered high-risk. So I had all the prenatal diagnostic tests while pregnant. Not that any results would alter my pregnancy, however, I am the type of personality that does better with prior information.  After Brad was born, the neonatologist discovered that Brad had an undiagnosed cleft palate. Funny; no family history so I never considered that one. I still attempted to breastfeed my newborn in the hospital; but he would never latch. So by the time I took him home from the hospital he was partially dehydrated with impending hyperbilirubinemia (jaundice). As we were being discharged a nurse handed me an unopened package that contained the Haberman Special Needs Nurser.
When we got home I proceeded to re-hydrate Brad, even going so far as to calculate out how many mL's per kilogram per day of fluid he was receiving. The neonatal nurse practitioner part of me was taking over. And, yes, I started a "chart" on Brad. I even counted his respirations. Signs of a nervous mom, or just a bad combination of mom/nurse? Thankfully Brad did well, although I needed to use formula because my milk never came in. Because my son wouldn't or couldn't latch; I knew to rent a hospital grade double electric breastpump. Because I didn't get support at that time from a Lactation Consultant; I didn't know how often to pump. Also, because I negelected to take a breastfeeding class; I was unaware of the need to pump frequently. That situation prompted me to go into a post partum depression, I had been a failure at having a vaginal birth and also a failure with breastfeeding.

Several great things have happened since that period in my life. I recovered from my PPD, my son Brad has thrived and grown into a fine, young man. Yes, he is handsome. But because of my ordeal I have now become a Certfied Childbirth Educator, first a Certified Lactation Counselor, and now a IBCLC (International Board Certified Lactation Consultant).
Last year I ventured into a private business known as BabyFirst Lactation & Childbirth. I truly recommend that all pregnant mothers take prenatal educational classes. I also recommend that breastfeeding is the absolute best way to nourish your baby. Breastfeeding is my passion and I desire to help you reach your personal breastfeeding goals.  ~Amy www.babyfirstlactation.com

Breastmilk vs. Formula

Supporting Studies on Infant Formula Marketing

Reference these studies when you talk to the media, healthcare providers, or hospital administrators.

Studies on the prevalence of formula sample distribution in the U.S.

1. Sadacharan, R., Grossman, X., Sanchez, E., & Merewood, A. (2011). Trends in US Hospital Distribution of Industry-Sponsored Infant Formula Sample Packs. Pediatrics, 128(4), 702-705.

Study of 1239 hospitals in 20 states found that most US hospitals continue to distribute industry-sponsored formula sample packs, but trends indicate a significant change in practice; increasing proportions of hospitals eliminate these packs. Change was more significant in states where higher proportions of hospitals had already eliminated packs in 2007. Based on the CDC’s breastfeeding report care for 2010, average breastfeeding initiation rates were significantly higher in the states with the best-record of banning samples when compare to those with the worst records (81.5 percent vs. 67 percent). Similarly, the rate of breastfeeding at six months was higher in states with the best record of banning sample bags (52.7 percent to 37 percent).

2. Merewood, A., Grossman, X., Cook, J., Sadacharan, R., Singleton, M., Peters, K., et al. (2010). US hospitals violate WHO policy on the distribution of formula sample packs: results of a national survey. Journal of Human Lactation, 26(4), 363.

Cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007. Found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant. Most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of public health and healthcare provider organizations.

3. Merewood, A., Fonrose, R., Singleton, M., Grossman, X., Navidi, T., Cook, J. T., et al. (2008). From Maine to Mississippi: hospital distribution of formula sample packs along the Eastern Seaboard. Archives of Pediatrics and Adolescent Medicine, 162(9), 823.

Studied 21 eastern states and the District of Columbia. Rates varied by region. Found that 94 percent of hospitals distributed formula sample packs. Regional trends were evident. The proportion of distributing hospitals ranged from 70.4 percent (New Hampshire) to 100.0 percent (4 states-New Jersey, Maryland, Mississippi, and West Virginia-and Washington, DC). The proportion of hospitals that do not distribute sample packs has risen significantly between 1979 and 2006.

Studies on the effects of industry-sponsored formula samples on breastfeeding

1. Rosenberg, K. D., Eastham, C. A., Kasehagen, L. J., & Sandoval, A. P. (2008). Marketing Infant Formula Through Hospitals: the Impact of Commercial Hospital Discharge Packs on Breastfeeding. Am J Public Health, 98(2), 290-295.

Among women who had initiated breastfeeding, 66.8 percent reported having received commercial hospital discharge packs. Women who received these packs were more likely to exclusively breastfeed for fewer than 10 weeks than were women who had not received the packs

2. Donnelly A, Snowden HM, Renfrew MJ, Woolridge MW. Commercial hospital discharge packs for breastfeeding women. Cochrane Database Syst Rev. 2000

Nine randomized controlled trials involving a total of 3730 women from North America were analyzed. Commercial discharge packs reduced exclusive breastfeeding.

3. Wright, A., Rice, S., & Wells, S. (1996). Changing Hospital Practices to Increase the Duration of Breastfeeding. Pediatrics, 97(5), 669-675.

Duration of breastfeeding was longer in women who did not receive commercial discharge packs with formula samples or coupons for formula samples.

4. Perez-Escamilla, R., Pollitt, E., Lonnerdal, B., & Dewey, K. (1994). Infant feeding policies in maternity wards and their effect on breast-feeding success: an analytical overview. American journal of public health, 84(1), 89.

A meta-analysis of 18 studies showed that commercial discharge packs have a detrimental effect on exclusive breastfeeding at one month and any breastfeeding at four months.

5. Dungy, C. I., Christensen-Szalanski, J., Losch, M., & Russell, D. (1992). Effect of discharge samples on duration of breast-feeding. Pediatrics, 90(2), 233.

Women who received a manual breast pump in their discharge bags instead of formula samples were more likely to exclusively breastfeed their babies for a longer number of weeks (4.18 weeks compared to 2.78 weeks).

6. Snell, B., Krantz, M., Keeton, R., Delgado, K., & Peckham, C. (1992). The association of formula samples given at hospital discharge with the early duration of breastfeeding. Journal of Human Lactation, 8(2), 67.

At 21 days, there was a significant relationship between receipt of a gift pack and the decline of exclusive breastfeeding among a group of low-income Hispanic women. A larger proportion of breastfeeding women who received a gift pack either began by supplementing with formula or changed to bottle-feeding by three weeks.

7. Bergevin, C., Dougherty, Y., & Kramer, M. S. (1983). Do infant formula samples shorten the duration of breast-feeding? The Lancet, 321(8334), 1148-1151.

New mothers receiving formula giveaways were less likely to still be breastfeeding at one month and more likely to have introduced solid foods by 2 months These trends became more significant in three vulnerable subgroups: less educated mothers, primiparas, and mothers who had been ill post-partum. Results suggest that infant formula samples may shorten the duration of breast-feeding and hasten the age at which solids are introduced.

Selected studies on health benefits of breastfeeding

1. Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Agency for Healthcare Research and Quality Publication, U.S. Department of Healthcare and Human Services. Retrieved 2 November, 2011, from http://www.ahrq.gov/downloads/pub/evidence/pdf/brfout/brfout.pdf

Found that a history of breastfeeding was associated with a reduction in the risk of acute otitis media, non-specific gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma (young children), obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. For maternal outcomes, a history of lactation was associated with a reduced risk of type 2 diabetes, breast, and ovarian cancer. Early cessation of breastfeeding or not breastfeeding was associated with an increased risk of maternal postpartum depression.

2. Harder, T., Bergmann, R., Kallischnigg, G., & Plagemann, A. (2005). Duration of Breastfeeding and Risk of Overweight: A Meta-Analysis. American Journal of Epidemiology, 162(5), 397-403.

Meta-analysis of 17 studies shows that a longer duration of breastfeeding is associated with a larger decrease in risk of overweight.

3. Arenz S., Ruckerl R., Koletzko B., Von Kries R.(2004).Breast-feeding and childhood obesity: a systematic review. International Journal of Obesity and Related Metabolic Disorders, 28, 1247-

Children who are breastfed are 22 percent less likely to be obese.

4. Labbok, M. H. (2001). Effects of Breastfeeding on the Mother. Pediatric Clinics of North America, 48(1), 143-158.

Breastfeeding reduces the risk for postpartum blood loss by increasing the rate of uterine contraction, premenopausal breast cancer, and ovarian cancer. In addition to reducing the severity of anemia, breastfeeding may cause changes that help to protect mothers against bladder and other infections. Epidemiologic studies seem to indicate that women who breastfeed may be at reduced risk for spinal and hip fracture after menopause. In addition to the direct health effects, breastfeeding seems to provide a sense of bonding, a sense of well-being, and an improved sense of self-esteem for many women.

Studies on the economic benefits of breastfeeding

1. Bartick, M., & Reinhold, A. (2010). The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pediatrics, 125(5), e1048-e1056.

Finding that if 90 percent of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80 percent compliance).

2. Oliveira, V., Prell, M., Smallwood, D., & Frazao, E. (2001). Infant Formula Prices and Availability: Final Report to Congress. Retrieved 2 November, 2011, from http://www.ers.usda.gov/publications/efan02001/efan02001.pdf

Finds that the average price of brand name infant formula is close to two thirds more than store brand formula. Parents who use brand name formula may spend $700 per year more than those who use store brand formula.

3. Weimer, J. (2001). The Economic Benefits of Breastfeeding: A Review and Analysis. Food and Rural Economics Division, Economic Research Service, U.S. Department of Agriculture. Food Assistance and Nutrition Research Report No. 13. Retrieved 2 November 2011, from http://www.ers.usda.gov/publications/fanrr13/fanrr13.pdf

A minimum of $3.6 billion would be saved if breastfeeding were increased from current levels (64 percent in-hospital, 29 percent at 6 months) to those recommended by the U.S. Surgeon General (75 and 50 percent). This figure is likely an underestimation of the total savings because it represents cost savings from the treatment of only three childhood illnesses: otitis media, gastroenteritis, and necrotizing enterocolitis.

4. Cohen, R., Mrtek, M. B., & Mrtek, R. G. (1995). Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. American Journal of Health Promotion, 10, 148-148.

Finds that one-day absences from work to care for sick infants occurred more than twice as often among formula-feeding mothers than breast-feeding mothers.

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