Professional breastfeeding education and support. Breastfeeding, childbirth and baby care issues.
Showing posts with label infant nutrition. Show all posts
Showing posts with label infant nutrition. Show all posts
Saturday, November 23, 2013
Thursday, November 14, 2013
Rethinking Rice Cereal with Babies
Rethinking Rice Cereal
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Got Breast Milk?
by Deborah Pike Olsen
November 09, 2013
When it’s time for babies to eat food other than breast milk or formula, many parents reach for baby cereal—particularly rice cereal. For years, pediatricians have recommended that babies’ first food be iron-fortified cereal, particularly rice, which has a low risk for allergic reaction.
Recently, concerns have been raised about the levels of arsenic in rice and rice-based products, including baby cereal. New research on the topic from the U.S. Food and Drug Administration (FDA) has led that agency and others, including the American Academy of Pediatrics (AAP), to take a closer look at rice cereal and offer more recommendations on introducing solids to your baby.
What is arsenic?
Arsenic is a chemical element in the earth’s crust, present all around us, in both organic (naturally occurring) and inorganic forms. Both forms can be found in water, air, soil, and foods. Organic forms are released from volcanoes and through erosion of mineral deposits; inorganic arsenic, the more toxic form, is added to the environment through human activities such as burning coal, oil, gasoline, and wood, mining, and the use of arsenic-containing compounds in pesticides, herbicides, and wood preservatives.
The Environmental Protection Agency (EPA) describes inorganic arsenic as a carcinogenic (cancer-causing) agent. Several studies have linked inorganic arsenic with increased risk of skin cancer, as well as cancer of the prostate, liver, bladder, kidney, nasal passages, and lungs. For children, long-term exposure may cause lower IQ scores; exposure in utero and early childhood may increase mortality risk in young adults. Low level exposure can cause nausea, vomiting, stomach pain, circulatory problems, damage to blood vessels, a “pins and needles” feeling in the hands and feet, and redness and swelling of the skin.
Experts currently don’t know what level of arsenic is dangerous to public health. Since 2011, the FDA has analyzed samples of rice and rice products. As FDA Commissioner Margaret A. Hamburg, MD explains, the agency is “committed to ensuring that we understand the extent to which contaminants such as arsenic are present in our foods, what risks they may pose, whether those risks can be minimized, and to sharing what we know.”
Research
The FDA has monitored arsenic levels in food for nearly two decades, with the latest analysis being its most ambitious and far-reaching effort to date. The report provides data on 1,300 samples of rice products, 200 first reported in 2012 and an additional 1,100 tested in 2013. Products included in the analysis ranged from over-the-counter cookies and rice snacks to infant formula and baby cereal, ready-to-eat and hot cereals, rice “milks,” and more.
The FDA measured levels of inorganic arsenic and total arsenic for each product type. The FDA focused on rice because, unlike other crops, rice readily absorbs arsenic from the environment.
Results
FDA researchers found that arsenic levels varied widely from sample to sample within the same product. For the various products, levels ranged from 0.1 to 7.2 micrograms of inorganic arsenic per serving. However, serving sizes also varied.
In the absence of dietary limits, it is hard to know how to interpret these results, but the full text is available online. Readers can consider the relative risks of such products as rice cakes, rice milks, brown rice, and more. (Note that brand details about samples are not provided.)
Recommendations
The Illinois attorney general’s office conducted similar testing in 2012 in conjunction with Consumer Reports. Based on the “troubling” results, Consumer Reports and Illinois Attorney General Lisa Madigan have called on the FDA to set federal maximum levels for arsenic in food, especially baby food, and to caution the public about eating large amounts of rice and feeding it to small children. In fact, the next step in the FDA’s process will be risk assessment.
In the meantime, parents can take the following steps to minimize the risk of arsenic exposure for themselves and their children:
•Choose a different first food for babies. Former chair of the AAP’s nutrition committee Dr. Frank Greer notes that the group has “been trying to move people away from the use of rice cereal for the first weaning food … because it does not really provide that much nutrition.” Some experts suggest starting with meat, poultry, or tofu, which are iron-rich foods. Currently, the AAP’s position on introducing solids is that there is not sufficient evidence to show that introducing solids in any particular order is beneficial. Instead, the organization suggests babies should be offered a wide variety of nutrient-rich foods, including a variety of grains, within the first year to reduce exposure to arsenic from rice. Other good first-food options include sweet potatoes, squash, carrots, avocado, apples, pears, bananas, and peaches.
•For babies with gastroesophageal reflux (GERD) tendencies, consult a pediatrician. While rice cereal has traditionally been recommended as a thickener for these infants, the FDA notes that “wheat, barley and other grain-based infant cereals also readily absorb liquid and are similarly effective for infants with esophageal reflex tendencies.” Parents should talk with their child’s doctor.
•Avoid rice milk for children younger than age 5. Some of the highest levels of arsenic were found in products marketed as “rice milk.”
•Eat a balanced diet, with a variety of grains. Everyone should consume a varied diet. For nutrition guidance, the ChooseMyPlate website can be a good place to start.
•Limit rice consumption. Consumer Reports provides specific recommendations of servings per week for children and adults, noting, “for infants, children, and pregnant women, risks may be heightened.”
Sunday, November 10, 2013
Wednesday, October 9, 2013
Read this before visiting a new Mom & Baby
Going to Visit Family or Friends Who Have a New Baby? Follow These Tips!
Posted on September 30, 2013
Baby in Hat
Your friend or family member has a new baby. You want to visit. You want to help. You want to meet that amazing new little person! Before you go, read this primer on how to be a good visitor to a family with a newborn in the house — the kind of visitor who will make the family feel loved, supported, and forever grateful!
Included are guidelines that apply to all visitors, plus tips specifically for close friends and family, long-term visitors, and friends and family who live far away but would like to help nonetheless.
In the United States, we shower attention on families during pregnancy, but not during the postpartum period — when in fact the postpartum period is the time when families need the support of their communities the most! Be a gentle, considerate visitor who puts the family’s needs first. Your thoughtfulness will be remembered and appreciated for years to come!
WHEN AND HOW LONG TO VISIT
◾Always call/message in advance to schedule the visit. Do not drop in unannounced. Be on time.
◾Front-porch meal drop-offs or short (10-15-minute) visits are good in the first several weeks, when families are overtired and commonly not feeling up to hosting company.
◾Longer visits (30+ minutes) are good in the later weeks/months, when long-term helpers (grandparents, etc.) have left; other visitors have stopped coming; and spouses have gone back to work. Mothers often report feeling isolated after 1-2-3 months at home with a newborn (and any other children), and welcome longer visits in the later weeks/months.
◾Very close friends/family may be invited to come for longer or more frequent visits to help in the early weeks, but should always ask the mother what type of visit — short or long — would be most helpful to her.
◾If the mother will be home alone with the baby most of the time (single parent, spouse deployed or working long hours), she may wish for visitors to stay longer. Ask.
PREPARING FOR THE VISIT
◾If you are ill in any way — even the tail end of a cold — stay home. Visit when you are well.
◾Do not wear perfume, scented body lotions, or aftershave. These linger for hours or days after your visit and are often overpowering for baby and mother, who have heightened senses of smell.
◾Leave your pets at home.
◾Leave your children at home. This is especially important in the early weeks, when the family is likely to want quiet, rest, and minimal outside germs. One exception is bringing your children over for a playdate or outing with the family’s older children, outside or away from the family’s house, which you plan to supervise.
◾Bring food. See “Bringing Food” below.
◾Bring small gifts for any siblings in the house, if you can. Gifts that do not make noise are best. Special food treats are a nice, inexpensive option.
DURING THE VISIT
◾Remember that the purpose of the visit is for you to help the family, not for you to spend time with the baby. Now is the time for you – not the family — to prepare food and clean up any messes made during the visit.
◾Do not expect or ask to hold the baby. (Yes, this can be difficult — new babies are so snuggle-able!) Wait for the mother to offer. Many won’t. One big exception is offering to hold the baby after a feeding so the mother can take a shower or a nap.
◾Wash your hands when you arrive, and let the mother know that you have washed them before touching her baby.
◾Greet any siblings enthusiastically. Give a big hello and lots of love to the older children before fussing over the baby — it will make them feel special during a time when the baby is the focus of most adults’ attention.
◾Do a chore. Do it without asking. Or say, “It would make me so happy if I could [do chore XYZ]. Will you indulge me?” (Saying something like this helps ease discomfort the family might feel about having someone clean for them.) Load the dishwasher. Wash the dishes in the sink. Wipe down a counter. Sweep the kitchen floor. Fold that basket of laundry you see sitting there. Take out the trash. Excuse yourself to the restroom and scrub the toilet or wipe down the counters.
◾Or, watch the older siblings, or take them out of the house on an outing.
◾Or, offer to take dogs for a walk, if you’re a dog person. Adjusting to a new baby can be hard for pets, too. They need a little extra love at this time, as well!
◾Give advice only if the parents specifically ask for it. Do not criticize.
◾Follow the mother’s cues about how long a visit she’d like. Remember that it can be very difficult for her to ask you to leave once you are there, even if she truly needs privacy to nurse or pump or perform postpartum self-care.
◾If the family has a premature baby in the NICU, they still need support — lots of it! Tell them “Congratulations!” (they do want their new little one to be acknowledged and celebrated). Ask them how they and the baby are doing, and then really listen. Give them gift cards to restaurants near the NICU; gas cards; or a care package of healthy snacks and drinks that do not need refrigeration (dried nuts/fruit/veggies, trail mix, homemade muffins, snack/granola bars, seltzer water, etc.). If they are staying near the hospital, away from home, offer to pick up mail, water plants, care for siblings or pets, or bring needed things from home to the hospital.
BRINGING FOOD
◾Most families welcome food anytime, but it is often especially welcome at these times: after any other long-term helpers (visiting family, etc.) have left; after the first several weeks when other visitors have stopped bringing food; and when the spouse goes back to work or is away on a business trip.
◾Ask whether the family has set up an online meal-delivery calendar, such as Meal Train or Take Them a Meal. If they have not, organizing one is is a great job for a close friend or family member (see below).
◾Check the family’s Meal Train page (or check with the family) for information about food preferences, sensitivities, and allergies, as well as any other preferences (food delivery times, locations, dates). Respect that information.
◾Bonus points: bring a complete meal (main dish, salad/veggie side, and dessert) and/or meals containing ingredients that promote breastmilk production, such as oatmeal (oatmeal lactation cookies are one option), whole grains, dark leafy greens, beans, vegetables, and nuts/seeds.
◾Avoid bringing foods containing large quantities of those herbs which are known to reduce breastmilk production, such as peppermint and sage.
◾If you do not cook, consider bringing a healthy store-bought ready-to-eat meal (such as rotisserie chicken or a complete dinner from the supermarket) or a collection of healthy snacks that the mother can grab and eat one-handed during the day or while nursing, such as nuts or trail mix (unsalted), dried fruit/veggies, healthy snack bars, precut fruits/vegetables, cheese, hummus, and whole-grain crackers. Trader Joe’s and Costco are great places to buy these things inexpensively.
◾Bring the food in disposable containers or in inexpensive reusable Rubbermaid or thrift store dishes that need not be returned.
◾Consider attaching a note to the meal specifying that the dish does not need to be returned and that no thank-you note is necessary.
IF YOU ARE A CLOSE FRIEND OR CLOSE IN-TOWN FAMILY MEMBER
◾Run an errand. School drop-off, grocery store, Target. For example, call and say, “I am going to the grocery store. What can I get you? I will drop it by on my way home.” Note that it is “What can I get you?” not “Can I get you anything?”
◾Be the one to organize a group of friends/family to deliver meals in the first three weeks (or longer). Use an online organizing service like Meal Train or Take Them A Meal. Be sure to include information about food preferences, sensitivities, and allergies. If the meal-receiving family is not large, have meals delivered every other day so that the backlog of leftovers does not overwhelm the refrigerator before the family can get to them. Spread word of the Meal Train throughout the family’s social circle.
◾Help the family write a Chore/Helper List. This is a list of tasks that other visitors can help with, so that when visitors ask what they can do, the family has immediate answers. Place it in a prominent place, like the refrigerator.
◾Help the family research the baby/parenting information they need, if they would like. With a new baby in the house, it can be hard to find time and energy to research lactation consultants, breastfeeding or postpartum support group meeting information, etc. A list of local maternity and parenting resources can be found here.
◾Lend an ear. Ask the mother how she is feeling, then follow her signals. Do not pry. If she wants to talk about her experiences, she will.
◾Observe the mother for signs that she may be developing postpartum depression (PPD) or anxiety (at least 1 in 5 new moms in the United States do). Know the difference between normal new mom stress and a postpartum mood disorder. Be gentle and compassionate with the mother. Ask her what kind of support would help her feel better. If she wants peer or professional assistance, this page has a list of local and national postpartum support organizations. To better understand what a mother with PPD is experiencing, her friends/family may find it helpful to read Brooke Shields’ memoir, Down Came the Rain: My Journey Through Postpartum Depression.
◾Watch the father for signs of anxiety or depression as well. Postpartum anxiety and depression occur in fathers, too. Like mothers, fathers need sleep, good nutrition, exercise, and alone time to stay well. This page has a great list of resources both for fathers experiencing postpartum depression themselves, and for partners of women experiencing PPD. Additionally, Postpartum Men Online Forum is an online community that these men may find helpful.
IF YOU ARE A FAMILY MEMBER VISITING FOR AN EXTENDED PERIOD
◾Come for an extended visit only if the family has invited you to do so. Never invite yourself.
◾Ask if the family would prefer that you stay in a hotel during your visit. Be gracious if they say yes.
◾Offer nighttime help. Offer to stay up late with baby while they catch a few early-evening hours of sleep. Offer to burp/walk/bounce a fussy baby after a midnight nursing/feeding so that the parents can sleep. Nighttime is often a time when help is scarce but dearly needed.
◾Be their personal assistant. Do whatever they indicate they need. Drive them to appointments or support meetings. Run errands. Grocery shop. Pick up prescriptions. Babysit siblings. Cook. Clean. Do laundry. See “During the Visit” above.
◾Encourage them. Tell them that they are doing a wonderful job. Tell them that you are proud of them. Especially for a nursing mother struggling with breastfeeding, the words, “You are doing a great job,” are magical.
◾If you are a generation older, understand that parenting techniques likely have changed since you last cared for babies. Ask the parents about their parenting philosophies. Follow any specific baby-care instructions they provide. Reading (and following) the same baby-care books that the parents are can be helpful.
IF YOU LIVE FAR AWAY BUT WOULD LIKE TO HELP
◾Pay for the services of someone who can help in person: a postpartum doula, a house cleaner, a diaper service, a grocery delivery service. A list of such local resources is available here.
◾Be part of the family’s virtual support team. Let the mother know that you are a friendly, supportive ear that she can call or Skype at any time, day or night.
IF YOUR SPOUSE OR CHILDREN WANT TO HELP, TOO
As stated above, having a crowd of visitors in the house — or running in and out of the house — can be overwhelming for a family with a new baby. But having a work crew tackle the work literally piling up outdoors? Such a help. If you can bring your own tools (for example, rakes and leaf bags for raking leaves) so you have no need to ask where to find supplies, it’s all the more helpful.
◾Pet care. Walk the dogs. Poop-scoop the yard. Change the litter box or the hamster cage.
◾Yardwork. Mow the lawn. Rake the leaves. Shovel the snow off the driveway and sidewalk. Snow and leaf blowers can be grating on the nerves — avoid them.
◾Garden work. Weed. Pick veggies. Especially good for parents of babies born during harvest season!
FURTHER READING
◾Why Are America’s Postpartum Practices So Rough on New Mothers? (The Daily Beast)
◾A Letter to Grandparents by Penny Simkin
◾After the Birth, What a Family Needs (Gloria Lemay)
◾How To Be the Best Post Partum Visitor in 15 Minutes or Less (There Are No Ordinary Moments)
◾The Answer Is Always “YES!” (Or, How To Help a Struggling New Mom) (Dou-la-la)
◾For Parents: Visitors After the Baby? 10 Tips for New Parents (Huffington Post)
◾For Parents: Is DAD the Ideal Postpartum Doula? (The Birthing Site)
◾For Parents: DONA International’s Postpartum Plan (DONA)
This post has been several years in the making. Sincere gratitude to the many mothers who have contributed, both directly and indirectly, the ideas, suggestions, and wisdom reflected within it!
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Sunday, September 22, 2013
Insurance companies may cover breast pumps, supplies and consults
Healthcare Insurers Graded on Support for Breastfeeding Moms: Anthem and Aetna Score Highly
National Breastfeeding Center has released a scorecard of healthcare insurance companies based on coverage policies for breastfeeding support.
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Insurers are now tasked with making sure that healthcare dollars are spent more wisely and invested in long-term preventive care. To do less than their best for their littlest members is simply not good enough.
New York, NY (PRWEB) September 06, 2013
Anthem and Aetna both score highly out of 100 healthcare insurance companies graded by the National Breastfeeding Center (NBfC). Research was conducted to see how the insurance industry is responding to the Patient Protection and Affordable Health Care Act (PPACA), specifically the part of the law concerning coverage of breastfeeding support, a provision which went into effect on August 1, 2012.
“It has been a year since the mandate went into effect," says Susanne Madden, COO, of the National Breastfeeding Center, "so there has been plenty of time for insurers to adjust to the law. We wanted to see how insurance companies are performing when it comes to supporting nursing mothers and their babies." Madden says that the NBfC research uncovered a wide range of insurance company policies and compliance. "We were encouraged to find that some insurers really recognize the importance of improving breastfeeding and support the intent of the mandate by covering fully qualified lactation care providers and effective breastfeeding equipment. But many more provide only the bare minimum required by law, such as a manual hand-operated breastpump and advice given during a well care exam by providers that may have little lactation care experience."
"We weren't surprised to see Aetna near the top of the score card," says Beverly Curtis, the Executive Director of NBfC. Aetna was quick to open its network to lactation care providers who have certification as International Board Certified Lactation Consultants (a designation awarded by an independently-accredited program). Curtis points out, "it is important that insurance companies support care delivered by independently certified professionals as these are the providers best qualified to address and improve lactation care."
Madden said that the Anthem Group of companies came to the top of the list due to such provisions as covering home visits and allowing pumps to be dispensed from both providers and medical supply companies. "Companies should see our score card as a helpful tool for evaluating their breastfeeding support policies," Curtis says, "and like Aetna and Anthem, aspire to be the best in this critical area of mother and infant healthcare insurance coverage.”
NBfC assessed commercial insurance companies’ published policies and guidelines and assigned a grade based on the adequacy of coverage provided. Using The Verden Group’s Policy Search tool to locate official Medical Policies and Google to search insurers’ member and public domains for guidelines and newsletters that contained information about each company’s breastfeeding coverage, “we believe we’ve conducted a comprehensive review of the information available,” says Madden.
Why grade insurance companies on their breastfeeding support policies at all? "The purpose of the mandate is to improve breastfeeding initiation and duration rates," Curtis replies. "It follows that mothers should receive lactation counseling support from a provider educated in lactation care.” Madden agrees and says "It's the best way to insure that the care provided is appropriate to each mother’s concern or issue and that each has access to breast pumps that perform appropriately according to her medical or societal needs. Insurers are now tasked with making sure that happens, and that healthcare dollars are spent more wisely and invested in preventive care. To do less than their best for their littlest members is simply not good enough. We want to bring attention to that," Madden concludes, "and prompt insurers to do even better going forward."
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National Breastfeeding Center (NBfC)
The National Breastfeeding Center (NBfC) provides expertise to corporations/employers, hospitals/health systems, healthcare providers and organizations to improve breastfeeding promotion and support. Our unparalleled experience in the business of medicine, blended with our broad insurance experience and deep clinical knowledge, delivers powerful insights and innovative solutions. For more information on the NBfC, visit http://www.NBfCenter.com.
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Susanne Madden, COO
National Breastfeeding Center
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.Beverly Curtis, Executive Director
National Breastfeeding Center
855-777-6232 2
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Attachments
Insurers Breastfeeding Policy Scorecard Insurers Breastfeeding Policy Scorecard
Healthcare Insurers Scorecard for Breastfeeding Support
Model Policy Model Policy
Guidelines for Insurance Company Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies
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Friday, August 30, 2013
Tuesday, May 28, 2013
Tuesday, May 21, 2013
Traveling as a Breastfeeding Mother
By Nicole Goodman
One of the biggest challenges working mothers face is traveling away from their babies while they’re still breastfeeding. Pumping while on the road – or in the air – can be inconvenient, uncomfortable, and downright unpleasant, but many mothers find that is it worth it so they can continue breastfeeding.
Here are some hints to help you prepare for trips away from your little one. Working mothers going on a business trip or those that stay at home getting away for a weekend can benefit from planning ahead.
Supplies Checklist
Pumping while traveling requires some additional supplies that you may not need when you’re at home:
◾Batttery pack & fresh batteries – Make sure your battery pack works BEFORE leaving and load your pack with fresh batteries.
◾Extra batteries – Depending on length of your trip, it’s always a good idea to carry an extra set of batteries. Remember to keep batteries with your carry-on luggage to avoid any problems with checked luggage.
◾Convertor/adapter – If you are traveling internationally, make sure to pack the appropriate power convertor/adapter plug so that the pump will work at your final destination.
◾Milk storage bags/containers – If you plan to bring milk home after the trip, make sure to pack plenty of storage bags. I like the Medical-Grade, Pre-Sterilized Plastic Storage Bags. Freeze them flat so you can stack them up on the return trip.
◾Ice or cold packs – Especially for long or multi-segment flights, ice or cold packs will help keep milk frozen on the return trip. Some thawing may occur, so put the milk into the freezer as soon as possible. Use the milk pumped on a trip as soon as possible after you return.
◾Cleaning supplies – I LOVE the microwave disinfecting bags. You might not always have access to a place to scrub pump parts while traveling, but most hotel rooms and offices have a microwave. Throw everything into these bags, pop into microwave for 3 minutes, and everything is sterile for their next use.
◾Power cord, tubing, membranes, breast shields & pump parts – A breast pump won’t do you any good if you don’t have all of the essential parts with you! Pack a few extra pump membranes, just in case.
◾Hand sanitizer – It’s always a good idea to pack a little (3 oz or less) bottle of hand sanitizer in your carry-on.
Pack Smart
If you can fit a pump into your small rollerboard suitcase, great! Otherwise, you’ll need to check your suitcase and keep your computer bag/purse and pump as carry-on items.
Do NOT check a breast pump in a suitcase or as a stand alone item. Travel delays happen all the time; luggage gets damaged or lost. The last thing you need is to end up at your destination without your pump!
Be Security Savvy
In the United States, pumping mothers are permitted to travel with breast pumps and breast milk, regardless of whether or not they are traveling with their children. If a security agent says otherwise, ask to speak to a supervisor.
To make the security process as smooth as possible, you should alert the security officers so they know you are traveling with a pump:
◾Pull the pump out of your carry-on bag and place it in a separate bin before it goes through the x-ray machine. Tell the agent that the item is a breast pump.
◾If returning from a trip and carrying breastmilk, place the milk in a separate bin and alert the agents that the liquid is breastmilk. Breastmilk is NOT subject to the three-ounce limitation.
◾If a security agent asks to test the milk, ask to speak to a supervisor. They may want to swab the outside of the milk bags or containers, but they cannot make you open your milk and test it.
A mother may be asked to go through additional screening. I’ve had my pump searched and swabbed and I’ve also been subjected to a pat down. Be prepared for either scenario.
Pumping en Route
Sometimes it’s necessary to pump before you reach your final destination. Because I fly in and out of a small airport, I always have to make at least one connection, which can make for a long travel day. Most major airports have family bathrooms with electrical outlets and they are a great place to pump. On longer or international flights, you may need to pump in your seat or in the airplane bathroom. Ask the flight attendants if they can suggest a pumping location.
Well Worth the Effort!
Pumping while traveling presents some unique challenges, but it’s ultimately worth the extra effort. With a little planning, preparation and patience, you can maintain your milk production while you’re away from your little one and they will be ready to welcome you home at your breast.
Monday, May 6, 2013
Don't be a "Strong Mom"
When Big Pharma “Strong” Arms Mothers, We All Lose
By Contributor on May 6, 2013
Mother feeding newborn sonCorporations have a very bad habit of telling moms how to be. Or better yet, co-opting some very common “mom” archetypes for their marketing pursuits. For decades, we were told “Choosy Moms Choose Jif.” More recently, “It Moms” were more likely to choose a particular fabric softener. This week, infant formula maker Similac has taken on the dubious role of connecting their brand to “Strong Moms” — those supportive, they say, of a less judgmental environment for mothers. This new affinity for strength is being launched with a Strong Moms Summit on May 7th in New York City featuring a number of high-profile mom bloggers.
Please forgive me for being suspect. It is certainly true that there is way too much pressure on mothers today, and we all could take a proverbial “chill pill” on the mommy-bashing. But when a multi-million dollar pharmaceutical giant (Similac is owned by Abbott Laboratories) plows millions of dollars into telling mothers to be “strong” and “non-judgmental,” I think I’m rightfully engaged in a side-eye glance.
Selling women messages that sound good on the surface but actually undermine them has been a corporate tactic since at least the 1950s. We aren’t really being supported to be strong moms–whatever that means anyway — we are being sold the idea of “strong” as a marketing tool for corporate interests. There’s a big difference and all parents should take note of the dangerous undercurrents.
What I typically find most insulting is that these corporations are counting on moms not knowing better. That we are so weary from the pressures of motherhood, that we will hang on to any messaging that appears to be a “release valve” without delving one centimeter beneath the surface to find the real facts.
Apparently “strong” does not mean savvy.
Because one centimeter beneath the surface of Similac’s “Strong Moms” Summit and online campaign you will find that framing of infant formula use around a “lifestyle choice” that is not to be judged has been its primary marketing strategy for decades. Ah, choice. It used to be such a powerful word–one that conjured up women’s suffrage, the feminist movement and our battle for reproductive rights. The problem today is that “choice” has been taken out of the context of women’s rights and misconstrued into a dirty and insidious word. In its most disgusting reiteration it is being marketed to women and girls by corporations — in this case, by infant formula marketers, who are more concerned with profits than infant health outcomes. Women have been led to believe that the “choice” between formula feeding and breastfeeding is merely a matter of inclination–a personal decision, a feather in the cap of liberation. And since choices are individual, they have no social consequences; women are therefore relieved of responsibility of considering the broader implications of their decisions. And once I make my choice, no one is to challenge me. We can’t talk about it. And if you do, you are judging me.
This is dangerous territory for all women and mothers as the issue of breastfeeding vs. formula feeding is turned into a mere lifestyle choice as opposed to a child health matter. No wonder Similac is supporting so-called non-judgment.
What is really happening is that by leaving each other alone in our so-called non-judgmental circles, we are simply leaving the current unjust system in place and discouraged from forming opinions about the value of different choices. With this type of continuous marketing messaging, we lose the ability to have critical discussions about where the real choices lie and which “choices” are merely illusions. Most problematically for the future of mothers, it deters us from addressing the systemic problems such as improving child care options, increasing the market for part-time work, the lack of a paid federal maternity leave, and other deep-rooted, anti-family policies that actually devalue mothering and shape our infant feeding choices, and prevent us from being active agents of change because we are being told that many aspects of mothering from our infant feeding to work decisions are “choices” and, therefore, private matters.
Choice becomes the silencer on a dangerous handgun.
In this context, choice is not liberation. It is suffocation. In this context, Similac is asking moms to be strong when they really want us weak and silenced. Framing the infant feeding conversation as an empowerment experience erases the context of corporate interests and deep pocketed marketing machines that have always put profit motive ahead of infant health and the health of mothers and our actual empowerment, for that matter.
Let’s face it, this isn’t the first time that women have been sold on an ideal that sounded good on the surface but was actually manipulated to undermine them. It’s been over 50 years since Betty Friedan’s The Feminine Mystique ripped the veil off the problem behind a very good-looking pretense of waxed floors, perfectly applied lipstick and domestic bliss in the 1950s to help women breakthrough a malaise they didn’t know existed. At that time, the idea that women were naturally fulfilled by devoting their lives to being housewives and mothers was borne out of similar cultural forces and commercial interests. It was presented as if this was the woman’s choice, when in fact cultural forces dictated that preparing for marriage and motherhood even from the teenage years was her only option.
Meanwhile, the dialogue around the real issues that could actually significantly impact our lives and the health of all infants has been suffocated while we clamor behind choice and non-judgment and use it as a shield to deflect our mommy guilt. Our ability to build conversation and support among each other has been quashed because we won’t discuss what we have been told is a private choice. With so much individualism embedded in our views about choice, there is little room for examining interdependence or acknowledging individual fallibility of our choices.
It is women and infants who are paying the price for this so-called freedom of choice.
Until “choice” is presented with accurate information, then choice is just a mirage. What’s more, we have to understand the difference between choice and options. Having unequal options doesn’t make for true choice. And truly strong moms don’t need big pharma’s underhanded and predatory marketing ploys under the guise of a summit. Thanks, but no thanks.
Saturday, February 2, 2013
Tuesday, January 15, 2013
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.
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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?
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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?
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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.
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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
Thursday, January 3, 2013
Too Few Breastfeeding Studies Done
Is the Medical Community Failing Breastfeeding Moms?
By Lisa Selin DavisJan. 02, 20130
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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
Monday, October 1, 2012
October 1st, Child Health Day
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Tuesday, April 24, 2012
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
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
Friday, February 17, 2012
News from the United States Lactation Consultant Association
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United States Lactation Consultant Association | 2501 Areial Center Parkway | Suite 103 | Morrisville | NC | 27560 |
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