Sorry for the delay this week. I just got back from Rhode Island where I made a tour of their three Baby Friendly Hospitals (I’m preparing to do a lecture on Baby Friendly Hospitals in New England). It was amazing to see how the perseverance of just a handful of women made such a lasting impact not only in their own hospitals but in the state. Rhode Island now hopes to be the first state in the country to be completely Baby Friendly!
Speaking of Baby Friendly the New York State Senate just passed a “Breastfeeding Mother’s Rights Bill along those same lines. Washington State just beefed up their breastfeeding in public laws and are now passing out wallet sized cards telling mothers of their rights in order to diffuse any conflict between mothers and businesses. (The Massachusetts Breastfeeding Coalition also has “License to Breastfeed” cards.) Too bad the mother in the New York IKEA store didn’t have a card like that. Not only was she told to feed her baby in the bathroom, when she left the store the security guards insisted on checking her receipts to make sure she hadn’t stolen anything (talk about adding insult to injury).
On a happier note, Consumer Reports has just endorsed breastfeeding as a way to save $2,000 a year. They also ripped the formula companies for charging higher prices as compared with the discount brands found at bargain outlets. By the way, one of the Baby Friendly hospitals I visited reported that said that even though the doctors there had protested the idea of buying their own formula, because their breastfeeding rates are so high now they only spend $ 500 a year on formula (that’s $ 3 dollars a case – wholesale).
There were a few anecdotal reports: a mother was diagnosed with Reynaud’s via photo’s she sent to her doc from her phone’s camera (why he couldn’t figure it out from her list of symptoms I’m not sure), another mother says her two year old was spared the swine flu because of the immunities in her breast milk, and a shy male came to defense of breastfeeding in public in Canada with a unique solution – temporary booths like the kind they set up during tax season. Bravo to him for this thoughtful idea. Isn’t this one of our main goals – to get the disinterested single male to care about this issue? Also in England the demise of newspapers is reportedly being held at bay by (among other things) photos of babies breastfeeding on the front page!
The debate over whether or not the attention to breastfeeding is causing a lack of support for bottle feeding mothers continues to rage in England and is spilling over here (see the NY Times article). In England breastfeeding activists are getting hit from all sides. “Dr Michele Crossley, a psychologist at the University of Manchester, has just published a paper entitled Breastfeeding As a Moral Imperative, which concludes that “far from being an ’empowering’ act, breastfeeding may have become more of a ‘normalised’ moral imperative that many women experience as anything but liberational“.” Even worst than the barbs from psychologists is the attack from the English midwives, Sue Battersby, a researcher and lecturer in midwifery, will argue that we need to start supporting women who use formula. “Mothers who formula-feed are treated like second-class citizens,” she says. Rather than trying to decide who needs more support bottle or breastfeeding mothers, wouldn’t it be better to acknowledge that all mothers need a hell of a lot more support than they are getting?
But don’t depair, I have saved the best news for last. Here in the U.S. the Joint Commission has just ruled that it will now “requires hospitals to report the rate of exclusive breastfeeding among mothers who intend to breastfeed. The measure does not affect women who do not plan to breastfeed.” Hospitals will now have to start documenting all supplementation of breastfed babies, which means they actually have to start paying attention to the issue! Three cheers for the Joint Commission!!!
And one last matter – I just want to point out that the excerpts below are just that – excerpts – to read the full article click (or paste) the link.
Kathy Abbott, IBCLC
on Facebook: Breastfeeding in the News
The new law, which takes effect S
Breast-feeding a civil right under new Wash. law
unday, builds on a 2001 law that exempted breast-feeding from public indecency laws. But until now, nothing prevented businesses from asking women to leave or to cover up while breast-feeding
Rep. Tami Green, the Tacoma Democrat who sponsored the bill, said the new law will help “jump start the culture of change.”
“Women should feel as comfortable to sit down and breast-feed their child as they would be pulling a bottle out of the diaper bag,” she said.
Laura Lindstrand, a civil rights specialist with the state’s Human Rights Commission, said the agency plans to make wallet cards with information on the new law that women can carry with them.
If a woman is asked to leave or cover up because she’s breast-feeding, Lindstrand said the expectation is that once a woman shows the card, “we’re hoping that will diffuse the situation at that point.”
IKEA Sends Mother and Infant to Bathroom to Breastfeed
The IKEA in Red Hook, Brooklyn is the latest retail establishment that needs reminding: Yes, women have the right to breastfeed their infants in public. No, you cannot banish them to the restroom. Yes, people will get angry when word gets out.
- She posted to a local listserv:
On Wednesday I was in IKEA Red Hook in the middle of breastfeeding, fully covered, when I was told I had to stop doing “that” and go to the nearby family bathroom. The IKEA employee and security guards were extremely rude to us. I was hustled off to the bathroom and then had to wait because someone else was using it. I was humiliated, my daughter was upset from being interrupted in the middle of her feed. When eventually I gave up and headed for the car to finish feeding, the security guards who had seen the entire event insisted on checking my receipts. I’m putting together a formal complaint to IKEA. I was wondering if this has happened to anyone else?
Doctors Diagnose Nipple Pain with Camera Phone
Taking photographs or video of unusual symptoms on an ordinary camera phone can help doctors diagnose uncommon problems, say researchers in an article published on bmj.com today. For example, doctors in Norway describe the case of a 25 year old pregnant woman who reported frequent episodes of severe nipple pain.
The pain came whenever her fingers, toes or nipples got cold, such as when walking barefoot on a cold floor or taking a shower, and typically lasted between five and 15 minutes and was so painful as to bring her to tears.
She presented three photographs from her camera phone showing the colour changes of a typical episode.
With the help of these photographs, doctors diagnosed Raynaud’s phenomenon of the nipple. The patient was given treatment, her symptoms completely resolved within one week, and she was able to continue breastfeeding with no side effects.
In Support of Bottle Feeding : New York Times
A review of breastfeeding data by researchers at the University of Cambridge concludes that the increased attention to Breastfeeding Moms – more support and time from midwives and pediatricians, more web advice – means a corresponding lack of information and support for Bottle Feeding Moms. And since the majority of infants (even those who are primarily breastfed) will receive some formula during their first year, it makes medical sense to pay some attention — with information on how often and how much to bottle feed, how to sanitize bottles and prepare formula — to the mechanics of bottle feeding.
Breastfeeding moms need quiet space to do their job
As I am a shy guy, if the mom sees I had an unintentional “peek,”it makes me feel rather low! Usually, this is the point of no return and I sit at the very edge of the opposite side of the bench and look the other way. If I turn and leave, I feel rude. If I stay, I want to make certain that mom will feel secure that I don’t mean to intrude or invade her personal space. My only issue I have is the feeling of extreme embarrassment. I don’t know why. Invasion of her privacy? There have been a few times I would apologize to the mother, and begin to move away, but would feel slightly better after receiving a positive reply.
How difficult would it be to have some office dividers and some comfortable chairs in a few locations throughout the public area?
This would be similar to tax season where you see the temporary offices setup for filing your taxes, but much smaller and containing a minimum of two chairs. This would be very easy to implement, and give a clean and private place to feed. Place a “breastfeeding friendly” sign with a picture of a breastfeeding mom and child with a green circle around it. Just another thing for people to complain about.
HIV Drugs Provide Breast-Fed Babies With Some Protection
Treating infected mothers, giving meds to infant both beneficial in African study
The researchers found that giving daily antiretroviral syrup to breast-feeding infants or putting their HIV-infected mothers on highly active antiretroviral drugs significantly lowered the child’s chances of contracting the virus that causes AIDS. The chance of a mother with HIV transmitting the virus through breast-feeding is about one in five.
The breastfeeding debate is not a war between women
Hyping up a “war” between women doesn’t help. The real “enemies” here are not other women (whether midwives, or mothers who do breastfeed), but a society which fails to value and support this skill and the commercial manufacturers of formula who aggressively market a product which even they admit is inferior to the real thing.
Indeed, yesterday’s Times of London free-standing features section (Times2) grabbed me by the nipples with a full-page close-up shot of a baby breastfeeding (one can envision dyspeptic U.S. editors holding multiple meetings just on the image), then made a strong case (not entirely new) that women worldwide are conned by the purported benefits of breastfeeding. The supposed ills of formula-feeding (fatter, dumber, more diabetic kids, etc.) is folderol, this argued, with some very solid questions raised about the premises of many breastfeeding studies.
“The problem with the studies is that it is very hard to separate the benefits of the mother’s milk from the benefits of the kind of mother who chooses to breastfeed. In the U K, for example, the highest class of women is 60 percent more likely to breastfeed than the lowest, so it is not surprising that research shows that breastfed infants display all the health and educational benefits they were born into.
“In other words, breastfeeding studies could simply be showing what it’s like to grow up in a family that makes an effort to be healthy and responsible, as opposed to anything positive in breast milk.”
Consumer Reports Best Baby Products Book Recommends Parents Breastfeed and Buy Store-Brand Baby Formula
For more than a year now, Consumer Reports has been urging parents to save money on baby formula by purchasing store brands at retailers such as Walmart, Sam’s Club, Target, Kroger, CVS, Babies R’ Us, and Walgreens. In a recent blog posting, the publisher announced the availability of the new 10th edition Consumer Reports Best Baby Products, available in its online bookstore* and in bookstores nationwide. The guide offers a number of ways to “save money on baby stuff,” including recommendations to breastfeed and buy store-brand formula:
“Breast-feed if you can. It’ll save you $2,000 a year, the money you’d spend on infant formula.”
Consumer Reports recommends** buying store-brand formulas because they are nutritionally comparable to Enfamil(R) LIPIL(R) and other name-brand formulas:
“We found that the store brand of formula at a local Wal-Mart (Parent’s Choice) cost 50 percent less per ounce than a leading national brand (Enfamil). According to the FDA, all formula marketed in the United States must meet the same nutrient specifications, which are set at levels to fulfill the needs of infants.”
Exposing the myths of breastfeeding
Mothers are constantly urged to breastfeed yet there is little evidence to suggest that it is better than formula milk
Formula-fed babies are fatter, more stupid, more diabetic, they have more asthma, eczema, and chest and ear infections, to name but a few of their misfortunes listed in the NHS leaflets I was given repeatedly when pregnant last year.
Confused, I decided I needed to talk to the person acknowledged as one of the world’s most authoritative sources of breastfeeding research: Michael Kramer, professor of paediatrics at McGill University, Montreal.
So, with my NHS leaflet in hand, I put its list of health benefits to Kramer. Does breastfeeding reduce a child’s risk of obesity? “The evidence is weak”, he says. Allergies? “Weak.” Asthma? “Weak.”
“There is very little evidence that it reduces the risk of leukaemia, lymphoma, bowel disease, type 1 diabetes, heart disease, blood pressure . . .”
That was nearly everything crossed off. What about maternal benefits? The NHS told me that it would protect me against breast and ovarian cancer, and osteoporosis. “The breast cancer data is pretty solid, but on ovarian cancer and osteoporosis it is far iffier.”
The WHO pointed me to a review of the research it conducted in 2007. When I looked at this, it concluded that the long-term gains of breastfeeding were mostly “relatively modest”, and also warned that because none of the studies it looked at dealt with the problem of confounding, the results could be explained by the “self-selection of breastfeeding mothers”.
What does it really matter, though, if “breast is best” is a catchier slogan than “breast is probably only a bit better”? If claims are exaggerated, if women aren’t trusted with the truth, what’s the harm? I put this to Wolf.
“People never say ‘don’t take your baby on a car journey’, even though the risk of a car accident is far greater than not breastfeeding. But when it comes to a mother’s time, nothing we can ask is too much.
“Let’s think about what would happen if we asked fathers to do this, if there were somehow evidence that babies who are looked after by their fathers at home for six months do better. We would see a lot more critiquing of the science, a lot more people saying the benefit is marginal, a greater reluctance to offer the advice.”
Breastfeeding ‘saved my daughter’
A breastfeeding mother who contracted swine flu, together with her husband and their eldest daughter, believes her youngest child was spared the virus because she was breast fed.
Rosemarie Azzopardi said that when she got sick and took antiviral drugs she decided to keep breastfeeding her two-and-a-half year old daughter and, that way, transmitted her immunity to the child.
“People sometimes pass comments because I still breastfeed but, this way, I helped my daughter who falls within the vulnerable group of potential swine flu victims,” she said, taking the opportunity to advocate the importance of breastfeeding.
She was diagnosed on July 5 after catching the flu from her husband who had just returned from Spain with his friends. When she realised her husband had it she was particularly worried about her two young daughters. And when the health authorities confirmed she too had caught it, she locked herself in a room for fear of transmitting the virus to the children.
Her health improved within three days of being administered antivirals. Her eight-year-old also got the flu and is fine today while her youngest was spared thanks to her breast milk, she believes.
Let the breastfeeding rebellion begin
Now academics both here and in the US are starting to ask whether the pressure on women to breastfeed is becoming counterproductive. At a seminar at Aston University later this year, Sue Battersby, a researcher and lecturer in midwifery, will argue that we need to start supporting women who use formula. “Mothers who formula-feed are treated like second-class citizens,” she says
Dr Michele Crossley, a psychologist at the University of Manchester, has just published a paper entitled Breastfeeding As a Moral Imperative, which concludes that “far from being an ’empowering’ act, breastfeeding may have become more of a ‘normalised’ moral imperative that many women experience as anything but liberational”.
Even breastfeeding promoters are concerned. Pam Lacey, chair of the Association of Breastfeeding Mothers, says: “We have women phoning up all the time saying, ‘I can’t do this. I’m a terrible mother.’ We don’t want mothers to feel guilty if they don’t do it. It’s the system that has failed them by failing to support them.”
A British academic who is currently researching breastfeeding and maternal identity says: “It has become a war. ‘Did you breastfeed? What kind of person are you?’ It has become an index of your capacity as a mother.” She would only speak anonymously because she is concerned about attacks from the pro-breastfeeding lobby. “Breastfeeding has become so strongly tied to what it means to be a good mother. There is no space to say, ‘It didn’t work for me’.”
Both here and in the US very few mothers are entirely comfortable about their breastfeeding decisions and many admit they wish they didn’t have to do it. Some see the promotion of breastfeeding as part of the problem.
New York Senate passes bills to expand health care, new moms’ rights
Provide women with more information and education about the health benefits of breastfeeding. The Breastfeeding Mothers’ Bill of Rights would require that new mothers be informed of breastfeeding options before they deliver, during their hospital stay and after they go home. While in the hospital, they would have 24-access to their baby to breastfeed, and the infant could not be given a bottle without the mother’s consent. The bill would ban companies that make and sell formula from pressuring new mothers in hospitals.
National Hospital Inpatient Quality Measures- Perinatal Care Core Measure Set
UPDATE JULY 2009: In late 2007, The Joint Commission’s Board of Commissioners recommended retiring and replacing the Pregnancy and Related Conditions (PR) measure set with an expanded set of evidenced-based measures. A technical advisory panel (TAP) comprising experts in the perinatal care field was convened in February 2009 to select the replacement set of measures from among those endorsed for national use by the National Quality Forum. This expanded measure set, now referred to as Perinatal Care (PC) comprises the following measures.
This expanded measure set, now referred to as Perinatal Care (PC) comprises the following measures.
- Elective deliveries
- Cesarean sections
- Antenatal steroids
- Health care–associated bloodstream infections in newborns
- Exclusive breast milk feeding
Refinement of measure specifications has begun and will continue through most of 2009. It is anticipated the PC measure set will be available for implementation by Joint Commission listed vendors by October 1, 2009 to support hospitals’ data collection beginning with April 1, 2010 discharges. If you have any questions about this measure set, please submit your question online.
Joint Commission approves breastfeeding measure
The new measure, which is part of the Joint Commission’s new Perinatal Care measure set, requires hospitals to report the rate of exclusive breastfeeding among mothers who intend to breastfeed. The measure does not affect women who do not plan to breastfeed.
The exclusive breastfeeding measure was pioneered as part of a quality improvement effort in California, where public health officials found huge differences in exclusive breastfeeding rates from hospital to hospital. In some cases, nearly all breastfed infants were being supplemented with formula. In the top ranked hospitals, including San Francisco General Hospital, fewer than 10% of breastfed infants received supplements. Public reporting of differences in formula use has led hospitals to review their routines and improve quality of care.