Nestles is in the news again. They’ve just released the results of their latest “FITS” study (Feeding Infants and Toddlers Study). The good news is that babies are breastfeeding longer “In 2008, 33 percent of nine-to-11 month olds are still receiving breast milk compared to just 21 percent in 2002.” The bad news is French fries are still the number one vegetables given to toddlers. Nestles says their study proves that while “caregivers are feeding infants better diets” they may need “more guidance to improve the diets of toddlers and preschoolers.” Having babies breastfeed longer will of course mean less formula sales for Nestles, but not to worry, having seen the handwriting on the wall Nestles has already bought out Gerber so they are perfectly positioned to offer parents of toddlers that much needed “guidance”. (Nestles also made the news this week in California where a grass roots organization is trying to shut down their efforts to create a water bottling plant. Their argument? “Do we want a criminal corporation responsible for the deaths of millions of infants come to Sacramento to make immense profits off our water supply?”)
In other business news Chrysler is being lauded for accommodating mothers with flexible schedules and even a lactation room (at corporate headquarters of course – no word on what accommodations are made for factory workers). With so many layoffs they have learned a lesson that I hope other companies will take to heart. Even if you can’t give raises you can reward women with flex time (which is free) and lactation support. Towards that end three companies in California were commended for “going above and beyond California’s basic legal requirements” in offering lactation support. “Above and beyond” I like that. It makes them sound like super heroes!
Of course all is not well every where in the business world. In Oklahoma where the law merely “encourages” businesses to accommodate breastfeeding mothers in the work place a mother whose job includes 9 hour shifts with no scheduled breaks laments “I’m supposed to choose my job over feeding my child? I don’t think so,” Powell said. “I don’t think they should ask a mother to do that.” As so often happens, as soon as the press got wind of the story her boss promised to accommodate her. I’ve included two other stories about combining work and breastfeeding (one mom describes pumping during board meetings!), the other applauds our own Melissa Bartick (head of the MA Breastfeeding Coalition) for daring to mention “the elephant in the room” maternity leave. Yay Melissa!
I imagine you’ve all heard about the “obese” baby by now, a totally breastfed baby who because he was in the 99th percentile on the weight charts was denied insurance coverage because of his “pre-existing” condition. The parents were outraged but luckily once again the media came to their rescue. As soon as the media coverage began the offending company changed their tune. Sometimes however parental outrage can go a little too far especially if they take matters into their own hands. In India a distraught family went on a rampage in the hospital after being told that the baby had come to visit had died because of suffocation during breastfeeding. Apparently they didn’t buy this theory.
WIC is experimenting with placing their offices in malls which is now affordable to them since so many stores have closed. Speaking of WIC, Hygeia (in what is obviously a marketing ploy) recently pointed out that it is WIC policy to put out bids for breast pumps that need only accommodate 90% of mothers. But they make an interesting point. Not all pumps fit every woman. Hygeia says, “Imagine if 10% of the blood glucose meters were defective and consumers couldn’t return them. Or that 10% of the blood pressure readers didn’t work and the manufacturer said it’s the consumer’s fault for buying the wrong unit at the drug store.”
Checking in with the younger generation while it is disheartening to learn that over 23% of teens think that breast cancer is caused by tanning, only 7% think it can be caused by breastfeeding. An interesting study of UK moms aged 18 to 24 revealed that only 25% trust the advice given by their midwife, GP, or government paid health visitor, preferring instead to get their information from on line chat rooms and family.
No one likes the idea of children starving and to that end a new bill now pending in the Senate from the agricultural appropriations committee of all places would provide over $150 million towards childhood nutrition programs including “$5 million in performance bonuses to state WIC agencies that increase rates of breastfeeding.” If only Latin America had such resources. Over 9 million children face chronic malnutrition and in some spots such as the Dominican Republic the breastfeeding rate is as low as 4%. We can blame the formula companies’ heavy handed marketing strategies for some of those numbers.
Of course there are other reasons to breastfeed besides basic nutrition. A new Australian study links breastfeeding to a decreased risk of asthma. And while we are talking about new studies there is a new one out that reports that about 680 children are admitted to hospitals each year because of injuries from the inappropriate use of car seats. Please remind parents that car seats are for cars, babies however are meant to be carried in arms (not buckets).
Co-sleeping studies in the Journal of Pediatrics and another by the University of Warwick have generated attention. The bottom line remains the same, unsafe co-sleeping habits (being under the influence of drugs/alcohol, sleeping with a baby on a couch, etc.) are in fact dangerous and safe co-sleeping arrangements should be encouraged, but how to get this message across to the public? The Warwick study found that 54% of cot deaths occurred while a baby was co-sleeping with an adult. You can say that half the deaths occurred while babies slept with their parents, as one of the authors of the study points out but “You could also say that half the deaths occurred while babies were alone in their cots, he says, but: “I don’t see anybody saying, ‘Don’t put your baby in a cot.’” However the FSID (The Foundation for the Study of Infant Death) feels that teaching parents about the specifics of safe bed sharing is just too time consuming. According to Joyce Epstein, director of FSID, “this is too complicated. “If you can get people’s attention for more than three seconds you would like to give the whole story every time, but at what point do you lose everybody?” she says. From their perspective, the simple direct message – put your baby to sleep in a cot near the bed, not in the bed, is the key.” But dumbing down the message carries its own risks. Parents who have been warned against the dangers of taking their baby to bed are more likely to fall asleep on the couch with their babies, a practice that carries a great deal more risk than bed sharing.
Last but not least is my favorite story of the week – a funny (though not always flattering) look at the inherent problems of Jewish guilt and the ability to breastfeed. Although breastfeeding advocates are not portrayed in the best regard in this story (it is amazing what you can swallow when it is doused with humor!) her point that it is our culture that should feel guilty, and not individual women, is well taken.
Once again I feel like I am falling way behind in keeping up with my weekly updates. This week’s excuse? My daughter has been home with the flu all week. Not only did I have to tend to her physical needs I had to reassure her almost hourly that no she would not die of Swine flu or H1N1 – (at least not on my watch!).
I hope you all are well, and as always I would love to hear from you.
Kathy Abbott, IBCLC
On Facebook: “Breastfeeding in the News”
How the debate over breastfeeding is driving us crazy
We are Jewish women. We are high achievers. Many things have come easily to us. We can bring home the Faken; fry it up in a pan. Which means that when we fail at something supposedly so easy any mammal can do it, we feel horrible. Breastfeeding is supposed to be a cinch. We educated ladies of Hebraitude know it’s expected of us. The American Academy of Pediatrics recommends exclusive breastfeeding for six months. Research indicates that breastfed babies have less diarrhea and fewer colds and ear infections than formula-fed babies. They’re less likely to die of Sudden Infant Death Syndrome, less likely to have lymphoma. And of course we want our children to grow up strong and healthy enough to withstand our powerful Jewish Mother Guilt Rays.
To a great extent, we’ve gotten comfortable with our ability to tame our Jewish bodies. We can straighten our curly hair; diet or exercise or Spanx our butts into submission; depilate or wax or laser our swarthy body hair into oblivion. So when our bodies betray us, it’s a shock.
My sister-in-law, struggling to nurse twins, called the La Leche League, an international breastfeeding support group, for help. The woman on the phone told her, “Breast milk is like a blood transfusion for a baby. Formula is like a hot dog and fries.” A good friend of mine was told in disbelief by another mom, “Your kids seem healthy and smart, and they weren’t breastfed!” (My friend pointed out that actually, two of her four children had nursed a bit. The woman smiled and said, “Oh, but you cheated with formula, right?”) Another friend called a lactation consultant, sobbing, worried that her newborn daughter (who was born with a pinched nerve in her neck, leaving her unable to nurse) was starving on the meager amounts of breast milk she was able to pump and feed through a tube. The lactation consultant urged my friend not to give her hungry baby formula. “It’s like feeding her poison,” the consultant said in a hushed voice. “It will damage her kidneys and take three months to get out of her system.” My friend worked herself into a frenzy, pumping every two hours, waking the baby constantly to get her to eat, crying regularly.
Jewish mothers, according to our ancient cultural portrayal, are mega-nurturers, urging our babies to eat, eat, eat. If our 90-year-old Biblical matriarch could nurse a child, what the hell is wrong with us? A midrash from the Babylonian Talmud says that Sarah was so womanly, her breasts were two fountains that flowed with enough milk to feed all comers. When this old lady miraculously produced a baby, the story goes, people muttered that Isaac was actually adopted. (Need I add that this tale may resonate painfully with Jewish women who delayed childrearing for work or education, or who may have trouble conceiving and feel berated by the commandment to be fruitful and multiply?) To prove that Isaac was hers, Sarah breastfed all the children in the neighborhood. What kind of loser modern Jewess can’t make enough milk for even one measly baby? And hey, don’t think adoptive moms are exempt; you ladies could damn well nurse if you tried hard enough. That is, if you really cared about your babies and weren’t such selfish bitches. (Memo to the slow: save your email. We call this sarcasm.)
And then there is the One True Breast. One of the many names for God, Shaddai, may be a reference to breastfeeding. (The Hebrew word for breasts is shaddaim.) No one knows the origin of this divine name, but it may well be a reference to an earlier fertility goddess. Part of godliness is nurturing a people from your own body and soul—it’s the mother-child dyad writ large.
Despite some lactivists’ insistence to the contrary, there are women who simply can’t breastfeed, such as those taking certain medications or who’ve had breast surgery. And though making too little milk is generally called “mismanagement” (hey, no judgment there!) it’s a reality. According to Lisa Marasco, an expert on insufficient milk supply and a professional liaison for La Leche League of Southern California/Nevada, reasons for low milk supply can include polycystic ovary syndrome (PCOS), hypothyroidism and severe postpartum bleeding. Interestingly, Marasco points out that fertility treatments may also play a role. “In the past, some women might not have been able to get pregnant or give birth,” she writes. “[I]t may be that just because science can get you pregnant, it can’t make you able to nurse a child.” Postpartum depression or stress can certainly be factors too, and nagging doesn’t help. We’ve all had friends who tried to nurse exclusively, but wound up in a sobbing heap on the bedroom floor at 5 a.m., sending their partners out for formula. Finally, if a baby latches improperly, over the long term he or she may not get enough milk and nursing will hurt the mother like a mofo. Lactation consultants may be able to help. Or not.
In any case, it’s unfortunate that women are guilted for not nursing when a big chunk of blame should fall on our culture. Family-leave policies in the U.S. lag far behind the rest of the industrialized world. A survey of 16 European countries and Canada found that these countries provide an average of 68 weeks of maternity leave, with 33 of those weeks paid. Jewish women, like all women, may well have to return to the workforce sooner than we’d like. That’s particularly true in this economy. And then there’s the fact that not every workplace or life is conducive to pumping. The upshot: don’t judge a woman until you’ve walked a mile in her post-partum granny panties.
We Jews are, I think, particularly susceptible to judgment and guilt. We are a competitive lot. Just as we pore over the work of Dr. Sears and Dr. Weissbluth as if it was the Talmud, act as if sleep training and toileting are matters of life and death, obsess about whether our little angel is hitting his developmental milestones faster than the nearest similarly-aged baby at Tot Shabbat, drey about getting our kid into the “right” school, we want to excel at nursing. Recent research showing that formula isn’t poison doesn’t really have an impact on maternal emotions this profound. And we turn our anxieties outward, guilt-tripping other women, because of our own insecurity. The breastfeeder rolling her eyes at the baby with a bottle or pacifier may have her own mishegas. Maybe it’s about feeling invisible, about not having a career, about not feeling able to voice her resentment over feeling distant from her husband because of the intensity of her intimacy with her child. Who knows? I do know that we channel our own ambivalence outward; we turn parenting into a vicious contest. As one doctor I interviewed laughed, “Guilt begins at conception!” We’re all looking for the magic bullet, the amulet, the hamsa, the mezuzah, the one thing we can do to insure safety in an unsafe world. And some of us fixate on nursing as that one thing.
Health Clinic Could Open At Mall
Metro Health Dept. Wants WIC Clinic At Hickory Hollow
ANTIOCH, Tenn. — It’s a trend that’s slowly happening across the country: More and more health clinics are opening up shop in, of all places, aging malls that have few stores.
Now the Metro Health Department is hoping to open a new women, infants and children — or WIC — clinic at Hickory Hollow Mall. Metro Council still has to approve the plans.
Supporters said the mall is a perfect spot since about 14,000 people in Antioch rely on the program. The program provides nutrition education, breastfeeding support and healthy food vouchers for needy women and children.
If approved, this would be the fourth WIC clinic in Nashville
Group Urges City Council to Stop Nestlé Raid on Sacramento Water
Save Our Water, the coalition of grassroots community activists mobilizing against the Nestlé Corporation’s plan to build a new bottling plant in south Sacramento, is asking the Sacramento City Council to quickly adopt an urgency ordinance requiring a special permit for water bottling facilities in the city in order to stop the internationally boycotted corporate giant from coming to the Capital City.
We don’t need a huge corporation such as Nestlé making immense profits off a public trust resource, Sacramento’s water supply, especially at a time when Governor Arnold Schwarzenegger, Senator Dianne Feinstein and California Legislators are campaigning for a peripheral canal to steal more water from the Sacramento River to supply unsustainable corporate agribusiness on the west side of the San Joaquin Valley and unsustainable development in southern California.
Human rights activists and breast feeding advocates from throughout the world have boycotted the Swiss-based Nestlé Corporation since 1977 because of the millions of deaths of infants it has caused over the decades. The boycott, coordinated by groups including Baby Milk Action, International Baby Food Action Network (IBFAN) , Infant Feeding Action Coalition (INFACT) and Save the Children, was prompted by concern about the company’s marketing of breast milk substitutes (infant formula), particularly in less economically developed countries, which campaigners claim contributes to the unnecessary death and suffering of babies, largely among the poor.
Do we want a criminal corporation responsible for the deaths of millions of infants come to Sacramento to make immense profits off our water supply?
Chrysler gets nod from mothers mag
In a year bloodied by drastic workplace cutbacks in jobs, salaries and benefits, Working Mother magazine determined its annual 100 Best Companies list by putting great weight on employers who were flexible.
Flexibility is a cheap and powerful policy that you can give people,” said Jennifer Owens, the magazine’s special projects director. An employer “can’t give you a raise, but can give you some flexibility, and that’s free.”
To Michelle Thomas, an employee at Chrysler Group LLC, that flexibility is priceless. She’s worked at Chrysler for nine years, most recently in a job-sharing arrangement. She and another employee share a human resources position that allows her to work part-time, so she can better care for a 3-year-old son and an 8-month-old daughter.
The Auburn Hills automaker was one of three Michigan companies, including Battle Creek cereal maker Kellogg Co. and Midland’s Dow-Corning, that made the Working Mother 2009 list (www.workingmother.com).
“I had worked full-time for a few months when my first son was born. It was overwhelming. I didn’t have quality time. I was running my errands on weekends,” said Thomas. “This arrangement has been helpful to me to balance my work and my life.”
The magazine’s commentary noted that Chrysler “during a year of challenge and change … managed to beef up its work/life offerings to ensure that employees who needed help could still get it, despite being forced to reduce the size of its workforce in the wake of bankruptcy filings.”
Some of Chrysler’s female-friendly attractions: Chrysler opened a Henry Ford Medical Center clinic and pharmacy at headquarters. Its employee assistance program has grown to offer confidential counseling on emotional, financial and parenting challenges.
Chrysler headquarters offers a lactation room for women who are breastfeeding. Over the summer, Chrysler arranged with the Rochester YMCA to pick up children of employees at headquarters for transport to a daily summer camp.
Those perks are timesavers and anxiety-relievers, and benefit the employer also, since an employee can focus on the job instead of child care.
Studies have shown downsizing takes a toll on employee morale and productivity. In tough economic times, retaining programs such as flexible scheduling, telecommuting and job-sharing help keep employees motivated and build loyalty.
It’s the 12th time Chrysler has made the list, says Lisa Wicker, Chrysler’s director of global diversity, and represents “a message in and of itself that working mothers are important.”
Three firms honored for helping new S.J. mothers
Three employers who have provided support for their breast-feeding employees by going above and beyond California’s basic legal requirements will be honored Friday at the 2009 Mother-Baby Friendly Workplace Awards Luncheon sponsored by the Breastfeeding Coalition of San Joaquin County.
This year’s recipients, each nominated by an employee, are: In Harmony Music Therapy Services; the Law Office of Michael D. Small; and United Cerebral Palsy.
Study Shows That Diets of Infants are Improving; Concerns Remain for Toddlers and Preschoolers
Study Shows That Diets of Infants are Improving; Concerns Remain for Toddlers and Preschoolers Nestle releases data showing that caregivers are feeding infants better diets, but may need more guidance to improve the diets of toddlers and preschoolers Parents and caregivers are hearing and following the feeding guidance for infants, yet continued work needs to be done to help them also build good eating habits for their growing children, suggests data from the Nestle Feeding Infants and Toddlers Study (FITS) released today at a symposium at the American Dietetic Association's Food & Nutrition Conference & Expo. The study reveals both progress and areas of concern in the diets of young children in the United States. The data show some positive trends versus 2002 when Gerber Products Company, now part of the Nestle family, first commissioned the FITS study. Infants are being breastfed longer; and fewer infants and toddlers are consuming sweets and sweetened beverages on a given day. However, other findings are less positive -- on a given day, many toddlers and preschoolers aren't eating a single serving of vegetables or fruit; and many toddlers and preschoolers are consuming diets with less than the recommended 30-to-40 percent of calories from fat. Most preschoolers are eating too much saturated fat and sodium. The FITS findings suggest that more guidance and support is needed to help caregivers better transition from feeding their babies to meeting the unique nutrition and feeding needs of a toddler or preschooler. As a result, too many young children are mirroring the often unhealthy eating patterns of American adults. Mothers are breastfeeding their children longer. In 2008, 33 percent Of nine-to-11 month olds are still receiving breast milk compared to just 21 percent in 2002. Other survey findings French fries are still the most popular vegetable among toddlers and preschoolers. However, among older babies there were improvements, and French fries are no longer ranked in the top five vegetables among infants age nine-to-11 months, compared to FITS 2002, when French fries ranked among the top vegetables in the diets of older infants on a given day.
Do Women Have a Right to a Breastpump That Works? Asks Hygeia
In the USA, each state is responsible for its Women Infant Children program and encourages breastfeeding through lactation counseling and the purchase of supplies. A state bid notification for breastpumps and supplies was recently issued. “This bid had such an unusual feature that needs further attention. The bid’s breastpump requirement was that the pumps only had to work for 90% of the women. The state felt that it was acceptable for the pumps to fail for 10% of the women,” stated John Estill, CEO of breastpump manufacturer Hygeia.
"Imagine if 10% of the blood glucose meters were defective and consumers couldn't return them. Or that 10% of the blood pressure readers didn't work and the manufacturer said it's the consumer's fault for buying the wrong unit at the drug store. These situations are really unimaginable. Why then, are breastpumps, which are solely designed for women, subject to the reverse - that it's their 'fault' mothers picked the wrong pump and tough luck for them?
The sleep tight fight
A new infant mortality study has again raised concerns about co-sleeping
The pervasiveness of the debate over whether parents should sleep with their baby is evident in the intensity and the immediacy of the response to a new study in a well-respected medical journal that looks at infant mortality trends.
The study notes a rise in incidences of suffocation and strangulation in bed as part of a wide-ranging examination of all causes of infant death, but the only mention of cosleeping or bed sharing is in a chart on the second-last page of the report, and the report’s lead author has been at pains to distance the findings from the ongoing debate that pegs proponents against those who claim the practice is dangerous for children and hinders social development.
Despite that abundance of caution in the study, online communities are abuzz with a slew of blog posts, discussion board conversations and articles scrambling to capitalize or debunk the report’s findings.
One post to a Mothering Magazine discussion board called on the magazine to “come out with some sort of statement against this ridiculous assessment.”
Riled-up mothers and physicians have been weighing in on both sides at blogs like MamaSaga, NewsMomsNeed, Motherwear’s Breastfeeding, Families.com, and The New York Times’ Motherlode.
At parentdish.com, one commenter said this about bed sharing: “Why would you take the chance? Just seems irresponsible to me. I know there are those that are adamant that is best for baby, but it just doesn’t jive with the safety risk as far as I’m concerned.”
Experts who advocate cosleeping say they are surprised by the amount of attention garnered by the study, which was published in the latest issue of the journal Pediatrics.
“This whole discussion is an almost immoral condemnation of bed sharing, and I’m baffled because there’s no causal relationship explained in this paper,” said Dr. Jim McKenna, chairman in Anthropology and director of the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame.
The most contentious aspect of the report is its conclusion, which says that infant mortality rates attributable to accidental suffocation and strangulation in bed have quadrupled since 1984, but goes on to say that the reason for this is unknown. It tracks the decline in cases of Sudden Infant Death Syndrome and an increase in accidental suffocation deaths and those from unknown causes.
Even Dr. Carrie Shapiro-Mendoza, lead author of the study, said it is impossible to know whether deaths caused by accidental suffocation and strangulation have actually quadrupled or whether it reflects a change in categorization. “I wanted to explore whether there was an actual increase in deaths or something else going on. What I think is there’s been a change in how medical examiners and coroners are classifying deaths on death certificates,” she added.
Opponents of bed sharing have been on the offensive since the publication of the report, touting it as clear evidence of the dangers of a practice which is generally agreed to be on the rise both in Canada and the U.S. and which is largely embraced outside the Western world in countries like Japan and India.
“The study supports my biggest concern with bed sharing, which is safety,” said Cheryl Stiles, 29, a Nova Scotia mother whose three-month-old boy has slept in a crib in a separate room since his first night out of the hospital. “I’m a heavy sleeper and I would be so worried about smothering him.”
But Dr. McKenna said it’s important to note that there is a difference between safe cosleeping and unsafe co-sleeping, pointing to precautions such as avoiding soft bedding, ensuring there is no space between the mattress and the headboard, and avoiding couches and waterbeds altogether. Smoking and substance abuse also contribute to an unsafe environment, he said.
Proponents believe the practice is integral for mother-child bonding and infant brain development, arguing that babies who share a bed with their mother develop healthy breathing patterns, are less at risk of stress disorders and enjoy a more speedy maturation of the nervous system.
“The human infant is the most sensitive primate to the mother’s presence and is born the least mature of all mammals,” said Dr. McKenna. “They rely on the mother to take on a big role in their continuing gestation, to regulate the baby as she did while he was in the womb.”
Edita Orr, 34, a mother of a seven-week-old boy who has experimented with both bed-sharing and the use of a bed-side bassinet, said she was acutely more in tune with her baby while bed-sharing than while her son slept in the cradle. “It was lovely sharing a bed with him. I could tell he felt safe, it reminded him of being in the womb — the touch, the smell, my breath.”
Her son Riley spent the first three weeks sleeping between his mother and father in their king-sized bed, but after many sleepless nights and fears of smothering him, the baby was moved to a bed-side bassinet. “I found he cried more when he moved to the cradle and didn’t fall asleep nearly as quickly,” Mrs. Orr said.
Independent crib sleeping is a largely Western practice, one that some say stems back to the Industrial Revolution when physicians wrongly believed a high infant death rate was due to bed sharing. Modern research has largely disproved this theory and shows that infanticide, and not bed sharing, was responsible for many infant deaths during those years.
Much to the aggravation of bed-sharing proponents, some medical bodies have in recent years urged parents away from sharing a surface with their baby, including the U. S. Center for Disease Control, the U. S. Consumer Product Safety Commission and Ontario’s own former deputy chief coroner James Cairns.
Although the official position of the Canadian Paediatric Society is that the safest sleeping environment for a baby is in a government-approved crib, spokesman Dr. Denis Leduc was quick to add that a separate sleeping situation should not interfere with breastfeeding. Pro-breastfeeding Web sites are quick to point out that frequent feeding is believed to decrease the chance of Sudden Infant Death Syndrome as well as assist in the physical and psychological development of the baby.
“We definitely support cosleeping and bed sharing, especially as a way to encourage frequent breastfeeding,” said Rebekah Smith, program coordinator of INFACT Canada, a breastfeeding advocacy group. “The bottom line is that we want people to have the information they need to make their own decisions and to not feel stigmatized for whatever they choose.”
The truth about sleeping with baby
Time and time again, mothers are warned of the dangers of sleeping with their infants. But has the science been badly misinterpreted? Sarah Boseley reports
The Foundation for the Study of Infant Deaths (FSID) and the department say categorically that the safest place for a baby is in a cot in the parents’ bedroom. Babies must sleep alone. Breastfeeding mothers should wake up, get up in the cold grey dawn, pick them up, settle in a comfortable armchair, feed them and then put them back in the cot and hope they won’t wail piteously for long.
This message was strongly repeated by the foundation on the publication of a study this week by the British Medical Journal which FSID itself funded. “Latest findings by researchers from Bristol University . . . confirm that ‘the safest place for a baby to sleep is in its own cot’. This four-year study . . . found that in half of all unexpected deaths of children in the south-west of England, babies had died sleeping with a parent or carer,” said FSID’s press release.
What is worrying, the release went on, is that 25% of mothers in a survey “were not persuaded that bedsharing can increase the risk of cot death”.
But anyone who read the full paper, by a very experienced and well-respected team from Bristol and Warwick Universities, would be hard pushed to believe it either.
Yes – the study found that 54% of cot deaths occurred while the baby was co-sleeping with a parent. But although the risk was strong if they had crashed out on the sofa, it was only significant among those in a bed if the parent had drunk more than two units of alcohol or had been taking drugs.
Peter Fleming, professor of infant health and developmental physiology in Bristol, one of the study authors, was appalled by the misinterpretation, as he sees it, of the paper in the media this week. “I really felt quite uncomfortable about it,” he told the Guardian yesterday.
“My view is that the positive message of this study is that it says don’t drink or take drugs and don’t smoke, particularly for breastfeeding mothers. We did not find any increased risk from bedsharing. It is a very different message from the one the media picked up.”
You can say that half the deaths occurred while babies slept with their parents. You could also say that half the deaths occurred while babies were alone in their cots, he says, but: “I don’t see anybody saying, ‘Don’t put your baby in a cot.'”
Fleming has a particular reason for worry. The study showed that sleeping with the baby on a sofa really is a risk. Yet seven of the parents whose baby died say they had gone to the sofa to feed, aware that bedsharing is said to be dangerous, and had fallen asleep.
“Any advice to discourage bedsharing may carry with it the danger of tired parents feeding their baby on a sofa, which carries a much greater risk than co-sleeping in the parents’ bed,” says the paper. “Anecdotally, two of the families of Sids infants who had co-slept on a sofa informed us that they had been advised against bringing the baby into bed but had not realised the risks from falling asleep on the sofa.”
But despite Fleming’s concern, the FSID was sticking to the line agreed with the Department of Health yesterday: “The safest place for an infant to sleep is in a cot beside the parents’ bed.” It pointed out that the same sentence appears in Fleming’s paper, but did not mention what follows next: “Based on evidence from research into Sids it is questionable whether advice to avoid bedsharing is generalisable and whether such a simplistic approach would do no harm. Parents of young infants need to feed them during the night, sometimes several times, and if we demonise the parents’ bed we may be in danger of the sofa being chosen. A better approach may be to warn parents of the specific circumstances that put infants at risk.”
Joyce Epstein, director of FSID, says this is too complicated. “If you can get people’s attention for more than three seconds you would like to give the whole story every time, but at what point do you lose everybody?” she says. From their perspective, the simple direct message – put your baby to sleep in a cot near the bed, not in the bed, is the key.
The new study, she says, is just one study (although in a Lancet 2006 paper the Bristol team also found a link to drink and drugs). George Haycock, professor emeritus of paediatrics at St George’s hospital in London, who is FSID’s scientific advisor, points to nine previous studies that have looked at co-sleeping and cot death and concluded that sharing a bed is risky.
“You can’t say there is no risk,” says Haycock, even if it is small for non-smokers. And he is tacitly critical of the “breastfeeding lobby” for defending bedsharing, when there is no concrete proof that it increases the numbers of women who breastfeed.
But Fleming says this study breaks new ground. Nobody in the past has gathered reliable information about drug-taking. “The advantage of this study is that because we did a death-scene evaluation, three to four hours after the baby died, we were able to look at all sorts of factors which in the past we couldn’t look at.” When the researchers talked to the parents, offering sympathy without blame and the possibility of explanations for their tragic loss, the parents told them everything, including what they had drunk and what drugs they took the night before. “People are very willing to share that information with you at that time,” he says. “You get the real picture.”
The paper adds that the findings may explain some of the quirky cultural associations between co-sleeping and Sids. Among black African populations in the United States and Maori and Aboriginal people, where babies commonly sleep with their parents, cot deaths are high, yet in other bedsharing communities, such as Japan, Hong Kong and among the Bangladeshi and other Asian peoples of the UK, deaths are low. The difference is in their smoking, drinking and drug habits.
FSID’s raison d’etre is to eliminate sudden unexpected infant deaths and that is what they believe their advice on putting babies in cots, on their backs, “feet to foot”, on a firm mattress with no pillow, will help do. But other organisations think there may be real benefits to taking your baby into your bed. The National Childbirth Trust (NCT), the country’s leading parenting organisation (and champions of breastfeeding), openly defends bedsharing.
“The study shows that risks for babies whose parents did not smoke or consume alcohol or drugs but who did share their bed with their baby were not different from that for babies in a separate cot,” says its head of research Mary Newburn in a statement responding to the BMJ publication.
The NCT’s position is a response to the real world of its members. “Many parents share their bed with their baby when they are young and this can be done safely,” says Newburn. “It is clear from surveys that around half of parents sleep with their babies at some point in the first six months, and around a quarter do so routinely, so we need to help them to do this in the safest way possible.”
Rosie Dodds, NCT senior public policy officer, says they understand FSID’s position. “They are really worried about the number of babies dying and want everybody to be as safe as possible,” she says. “But there are likely to be advantages to babies sharing a bed with parents.” Although she acknowledges that there is no scientific evidence establishing that bedsharing increases breastfeeding, there is an association, and breastfeeding on its own has been shown to lower the risk of cot death.
Deborah Jackson, author of Three In A Bed, says she thinks we are, in the UK, “fixated on the bad aspects of sharing a bed with the baby”, which is strange because “the history of bedsharing or shared sleeping places with the baby is as old as humanity itself”.
Her research, together with her own experiences of bedsharing with her three children, have persuaded her it is profoundly beneficial for both mother and child. The mother is aware of her baby as she is sleeping and reacts to her. “[Once] I was asleep,” says Jackson. “[One of my children] was sleeping next to me. I suddenly sat up in the night and held her over the bed and she was sick,” she says. Somehow she had known the baby was about to be unwell.
But there are clear dangers if the mother has been drinking or taking drugs. “All the things that make it good can make it really dangerous if you are not incredibly sensible. That’s true of everything in parenting,” she says.
Cot death is devastating and everybody is on the same side – they want to see fewer tragic families who have lost their babies. But there is clearly not one single road that everybody can march down together. In the end, a single prohibitive message for parents may even be counter-productive. This may be one of those cases where the public should be given credit for their intelligence and allowed to make up their minds on the basis of rather fuller information.
Peaceful revolution: Why support for breastfeeding matters more than ever.
my boss thought it was the height of humor to serenade me with mooing sounds as I emerged from his office (the only room with a door in our open studio) holding my precious stash, headed for the refrigerator. So much for commanding respect as a professional.
At least I had access to a private office. My sister, who works in retail, gave up after 5 months of pumping in a dirty public bathroom. Another friend is a traveling sales representative and had to pump in her car.
Women are being forced by attitudes and circumstance to choose between feeding their children what Nature intended and some powder in a can whose safety we pray we can depend upon.
The State of California, that perennial hotbed of radical ideas that eventually become mainstream (organic food, hybrid cars, anyone?), has instituted worksite protection legislation for working/nursing mothers, that among other things, requires that employers provide “lactation accommodation,” i.e., they need to provide mothers with a reasonable amount of time to express milk and provide a convenient, private location other than a bathroom to do so. We could also add a similar requirement for public “mother’s rooms” to building and zoning codes, providing accessible and clean, safe places to nurse or pump in places like shopping malls and airports. Melissa Bartick MD in these pages has documented the success of this legislation and suggests that the same be included as part of national health care policy reform, along with the elephant in the room, paid maternity leave.
Demanding these changes may be the most difficult thing we face. After fighting so many years for equal opportunities at work, we now find ourselves asking for special treatment as women, something we fear will undermine years of struggle. The argument for staying at home versus working is pointlessly destructive. We’ve been brainwashed into thinking we need to do it all, balance it all, without complaint. Business guru Jack Welch depressingly insists there is no work/family balance. He’s only showing what a dinosaur he truly is. Complain and demand we must. Breastfeeding is the first step on the road back to healthy eating. Babies, it’s time for a change.
Breast feeding key to reducing malnutrition in Latin America
“In times of crises, we call the three ‘F’s, – the fuel, food and financial crisis – governments should be encouraging mothers to breastfeed, ” said Enrique Paz, UNICEF’s health and nutrition advisor for Latin America.
Over nine million children under five in Latin America suffer from chronic malnutrition
The problem is particularly prevalent in Central American countries such as El Salvador, Guatemala, Honduras, and Nicaragua, where malnutrition is a leading public health concern and is as widespread as it is in Africa or South Asia. “Sixty per cent of mums in Latin America are not breastfeeding their babies.”
Across Latin America, there are vast disparities in breastfeeding rates. In the Dominican Republic, only four per cent of babies are fed exclusively with breast milk, compared to Peru where the figure rises to 63 per cent.
MILK FORMULA POPULAR
There are cultural barriers to overcome too in persuading mothers to choose breastfeeding over milk formula.
In some Latin America countries, like Colombia, feeding babies with milk formula brings social status and is seen as a sign of being rich.
“We’re losing ground,” he added, referring to aggressive marketing campaigns carried out by milk formula manufacturers.
“Recently we’ve seen pockets of acute malnutrition in rural areas in Guatemala, where astonishingly some kids don’t have anything to eat, and in excluded populations in urban areas in Buenos Aires and Brasilia,” said UNICEF’s Paz.
Providing pregnant and breastfeeding women and infants with potentially live saving minerals and vitamins in tiny amounts, also known as micronutrients, is seen as a cheap and effective way to combat malnutrition.
Vitamin A tablets, costing just two cents each, and other food supplements such as iodine, sugar, folic acid, zinc and iron, are becoming increasingly available in rural health clinics in countries like Peru and Bolivia.
In the city streets of Bolivia and Argentina, apple sellers also stock micronutrients, while in Chile fortified flour has helped to significantly reduce malnutrition rates.
‘Obese’ Baby Denied Health Insurance
When four-month-old Alex Lange was born, he was a normal 8 1/4 pounds. He’s been on a strictly breast milk diet since birth and is now in the 99th percentile for height and weight of babies his age. Yet Alex hasn’t been able to get medical insurance because companies say he has a pre-existing condition — obesity.
Understandably the Langes were upset. “I could understand if we could control what he’s eating. But he’s 4 months old. He’s breast-feeding. We can’t put him on the Atkins diet or on a treadmill,” Alex’s father, Bernie Lange, told the Post. “There is just something absurd about denying an infant.”
Rocky Mountain Health Plans medical director Dr. Doug Speedie explained that their decision was based on current industry standards. ” If health care reform occurs, underwriting will go away,” he said, referring to the process that insurers go through when they decide whether to accept or deny someone for coverage. “We do it because everybody else in the industry does it.”
But after the story broke, Rocky Mountain announced on Monday that they “will now provide health plan coverage for healthy infants, regardless of their weight.”
New study shows lower asthma rates in infants related to breastfeeding
Source: Government of Australia
Findings from a two-year study on asthma and wheezing illness in one year olds and kindergarten children, released today by the Australian Institute of Health and Welfare, show that within the first three years of life, almost 17% of Australian infants experienced asthma or wheezing illness.
However breastfeeding within the first 12 months of life may offer a protective effect against asthma or wheezing in infancy, which increases with increasing breastfeeding duration.
WELLSTON, OK — An Oklahoma mother claims her employer is trying to keep her from breastfeeding her twelve-week-old baby. Oklahoma has two state laws that are supposed to protect breastfeeding women, but neither states anything about feeding during working hours. It’s something state agencies hope to change.
“At first when I came back it wasn’t an issue, because I was going to the bathroom, but it was really cold, and I’m sorry, the bathroom’s nasty,” she said. “So, I started breastfeeding her in the back, and someone complained.”
Her bosses told her she wasn’t allowed to breastfeed at work anymore.
Feeding during breaks isn’t an option either because Powell says she has no scheduled breaks.
She says her daughter refuses a bottle and will go an entire nine hour shift without eating; a painful amount of time not only for baby, but mothers as well.
There are laws on the books in our state, but they don’t require employers to allow breastfeeding; it only encourages them to do so.
“Am I supposed to choose my job over feeding my child? I don’t think so,” Powell said. “I don’t think they should ask a mother to do that.”
News Channel Four did hear from the owner of the convenience store.
He said the company wants to do the right thing and will do whatever needs to be done to accommodate Powell.
Lincoln pushes for nutrition program extension
The agricultural appropriations bill now pending in the Senate would provide nearly $150 million in child nutrition initiatives aimed at fighting hunger and promoting health among children in Arkansas and around the country, Sen. Blanche Lincoln said.
I am proud my first legislative effort as chairman of the Agriculture Committee would help to improve the health of our children and prevent needy children from going hungry. The Committee will work with USDA and the administration on a reauthorization that improves access to healthy meals, reduces hunger, and improves school meals and the health of infants, school children, and pregnant and nursing mothers.”
$5 million in performance bonuses to state WIC agencies that increase rates of breastfeeding.
ASCO Breast: Even ‘Tweens Fear Breast Cancer
Among the girls ages 8 to 18 surveyed before an assembly at 13 schools in Philadelphia, Atlanta, Washington D.C., and Los Angeles, more than 23% believed that infection, drug use, stress, and tanning cause breast cancer.
From 10% to 20% said they thought caffeine, antiperspirants, or getting bumped or bruised in the breast were causes. According to 7%, breastfeeding increased the risk of breast cancer.
New mothers shun the NHS and log on to swap baby tips
Few new mothers trust official advice on childrearing, and they’re turning to chatrooms and family for help
With so much conflicting guidance, new mothers are shunning official medical advice
, only 3 per cent putting their faith in anything the Government or the Department of Health has to tell them. Only one in four says she trusts the information provided by her health visitor, midwife or GP, leaving family members, friends or chatroom contacts to pick up the slack
When it comes to coping with sleepless nights, problems with breastfeeding, or getting their baby into a routine, nearly three-quarters of mums aged 18 to 24 said they had found solace online. Josie George, mum to 15-month-old Kai, said she found her various health visitors’ opinions “well-meaning but useless”, and that the conflicting advice they had offered about her son’s sleeping problems had been “overwhelming and very confusing”.
She added: “The only place I’ve ever found any help is online, from people who have been through the same situation. [Online] you have the ability to connect with people who aren’t just giving you their opinion but are sharing their experience.”
The survey of 1,150 mums, by the baby product manufacturer Philips Avent, singled out lack of sleep as by far the biggest concern in early parenthood, followed by breastfeeding. More than one-third said confusing advice, particularly about feeding and sleeping routines, had marred their experience of becoming a parent.
Vicki Scott, a midwife who counsels Philips Avent, said the quality of advice provided by health professionals had deteriorated. “Midwives don’t have time to understand problems before dispensing advice,” she said.
LIZ RYAN: Breastfeeding in the boardroom
“Do you remember that meeting in Salt Lake,” asked Steve, “when you brought the baby?”
Of course I did. How could I forget? Our company was in the midst of a tumultuous strategy-setting exercise, and I was out on maternity leave — as much leave as I could wangle, given the pace of the job. Those weeks of maternity-leave-on-paper-only mostly consisted of me dashing to work with the baby mid-morning, promising myself I’d stay half an hour, tops, and leaving five hours later.
That baby spent so much time in the office that they made him an employee badge with his little photo on it.
Little Eamonn was only 6 weeks old — he had to nurse every couple of hours. I didn’t want to leave the meeting to nurse.
When the conference began, I would push my roller-chair all the way into the corner, cover up with a huge flannel blanket and nurse as inconspicuously as I could. As the talks wore on, I got bolder. By the third day, I was nursing him right at the conference table, whether the person who was holding forth on strategic options was one of our division presidents, or me.
I got pretty good at a three-step maneuver prompted by baby Eamonn’s hungry whimpers.
Step one: Grab the baby.
Step two: Toss the blanket over a shoulder, simultaneously yanking the sweater up to access the milk supply.
Step three: Baby on the tap, blanket down! The whole routine took three seconds.
Thirteen years later, I’m not sure that breastfeeding in the boardroom has gained much ground in corporate America, if any.
But I remember how good and how reasonable it felt to do two important things — one left-brain and one, well, right-breast, perhaps — at the same time. I remember feeling that as much as we try to convince ourselves that there are two realms — the sterile spreadsheet-y analyze-and-conquer realm of business and the milky, fleshy, natural world of babies and real life — the demarcation is fictional.
The divide we have talked ourselves into is entirely imaginary. Professionalism is an attitude, and a nursing executive mom is exactly as professional as a laser-pointing CFO. They may even be the same person.
Newborn’s death triggers hospital ruckus
Doctors said the infant, born on Friday to a woman called Mehroonisa, died due to suffocation during breastfeeding. However, the family staying on Entally Convent Road refused to buy this theory.
On Sunday afternoon, the boy’s relatives went on the rampage at the female ward and broke window panes and furniture. Unable to handle the rampaging mob, the hospital authorities called up the police, who rushed to the spot immediately. Seeing them, the mob relented. No arrests have been made
Car seats can be dangerous outside the car
More than 8,700 infants end up in the emergency room each year because their car seats are used improperly outside the car, according to study presented Monday at the American Academy of Pediatrics’ annual meeting in Washington.
Most of the injuries in Parikh’s study occurred when car seats fell off tables, countertops or other high surfaces. In some cases, babies who weren’t securely buckled fell out of the seats. Babies also were injured when car seats flipped over on soft surfaces, such as beds and couches, where infants can suffocate, he says.
Most injuries were to the head, although babies also suffered fractured arms and legs. About half the injuries occurred at home. About 8% of the babies, or about 680 a year, needed to be admitted to the hospital, the study says. Three died during the study period of 2003 to 2007, Parikh says.
Parikh says hospitals, medical societies and manufacturers should warn parents about the dangers of misusing car seats. If parents need to use the seats outside the car, he says, the seats should always be placed on a hard, flat floor, where there is no danger they will topple over.
Spending too much time in car seats can cause other problems.
Physical therapists are seeing more babies with “container syndrome,” or weak muscles and flat heads caused by too much time spent lying on their backs, says Colleen Coulter-O’Berry of the American Physical Therapy Association.
And a study in Pediatrics in August found that car seats can make it difficult for babies to get enough oxygen, which led the authors to suggest that the seats be used only while infants are in cars.
Car seats reduce the odds of a baby dying in a crash by 75%, according to a February study in the American Journal of Public Health. Car accidents are the leading cause of accidental death in children over age 1, according to the pediatrics academy.
Kathy Abbott, IBCLC
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