“…the lactivists were never thinking about what the infants of Haiti actually needed; they were thinking of themselves and their personal obsession with breastfeeding.” Dr Amy Tuteur.
A few days ago I wrote about the donations of American breast milk that were left sitting unused inside the freezer of the USNS Comfort and I wondered had those two Styrofoam coolers been filled with donated blood would they have been treated so cavalierly. Now it appears that the very existence of those two coolers is to be considered proof positive that all lactivists are indeed self absorbed “nipple Nazis”.
As they say “no good deed goes unpunished.”
Let’s get a few things straight: first of all, there was already a staff member on board the ship who was donating her own pumped milk. Coast Guard Lt. Teresa Wolf, a physician assistant who was pumping milk for her ten week old baby back in North Carolina when she started donating her extra milk. Secondly yes, the there was an actual request for more donated milk. (This was not the crazy idea of some pump crazed mother a thousand miles away!) The USNS Comfort placed a small request for 500 ounces of milk which was delivered (still frozen) two days later. And thirdly, yes once word got out a grass roots cry for more milk spread quickly across the country. Offers to donate milk came from every corner of the land.
So how did all these good intentioned lactivists end up becoming such villains? As any good lactation consultant will tell you, the number one rule of thumb is “feed the baby.” At no point should a baby be put at physical risk just because of our “personal obsession with breastfeeding”. Donated milk may help a few lucky infants in Haiti, but it is not a panacea for a crisis this large.
Unfortunately there is no one size fits all solution for every baby in Haiti. For some the answer will be to help the mother continue to breastfeed, or even to relactate. This means counteracting local myths that “stress or lack of proper food will cause a mother to produce bad milk or no milk.” Which is exactly what the Save the Children folks are doing with through their radio broadcasts. For others the solution may be to find local women who are willing to wet nurse, but in a country with high rates of HIV this too can be risky.
The risk of using unsterilized bottles will be the same for those using donated breast milk as it will be for those using a can of liquid formula, but with donated milk the immune system will be given a substantial boost. However the risk of infection and diarrhea from powdered formula mixed with unclean water is far, far graver.
We know all this. We know there is no easy answer. We know that there is not enough electricity to run the refrigerators needed to feed all of Haiti’s babies donated milk. And unfortunately some babies will have to get formula, even if it is powdered. Again, the number one rule is “feed the baby”. But does this mean that it was wrong to send two coolers of breast milk to the USNS Comfort? Or was the real fault in not using those few ounces of milk once they got there? Is it wrong to even talk about providing donated milk as a way of helping some infants? Or should we just close the door on that discussion? Is it wrong to warn mothers who are still lactating that weaning from breast milk to formula can place their babies at risk?
So here’s what I think really happened. When Lt. Wolf offered her extra breast milk to feed the newborn on the Comfort someone got the bright idea that a ship board milk bank might be useful and a call went out to states for safely screened banked human milk. Arrangements were made and milk was immediately sent to the Comfort where the staff was happy to receive it. But as soon as those two coolers arrived the big brass found out and immediately went ballistic about all this icky womanly fluid in their freezer and decided to put a stop to it. After all there was no protocol for this sort of thing; the red tape would be endless. Excuses were found – not enough electricity on shore, preserving the cold chain, screening, etc. and then to the embarrassment of all those well meaning breastfeeding groups back at home the whole idea was called off. No more donations would be required thank you very much!
I keep wondering what my dad would have thought about all this. He worked as a refrigeration mechanic on a hospital ship during World War Two. Everybody on board loved him. Why? Because he had the keys to the ice cream! Now if a hospital ship in World War Two had room for ice cream then I think that the USNS Comfort definitely had room for two Styrofoam coolers full of breast milk. I really think they just didn’t want to be bothered with the procedural aspects of handling the situation.
Although I can appreciate the confusion and enormity of the chaos in Haiti at the moment, I still believe this was a knee jerk reaction. They had their hands full to be sure, better to stick with what you know (formula) than try to learn the protocols involved with human breast milk. But as I said before if breast milk was held in as high esteem as blood, then chances are those protocols would have already been in place.
By shining a spot light on this situation now I hope that next time disaster strikes instead of being shunned donations of breast milk will be welcomed. That lactivists will not be considered evil for merely suggesting that human milk may indeed save lives. And that breastfeeding mothers everywhere will proudly be able to answer the call to give comfort to babies when ever it is needed.
Kathy Abbott, IBCLC
On Facebook: “Breastfeeding in the News”
Lactivists solve every problem by throwing breast milk at it.
Amy Tuteur MD
Evidently for lactivists there is no problem so great that it can’t be solved by throwing breast milk at it. Looking at the horrific recent earthquake in Haiti you and I might see death, injury, homelessness and the threat of disease. Lactivists saw a breastfeeding problem. They embarked on not one, but two separate inane campaigns to promote their favorite cause instead of focusing on the real needs of children in Haiti. It is difficult to imagine how people can be so self absorbed.
Haiti is in desperate need of baby formula, but the lactivists actually mounted a campaign to stop shipment of formula to Haiti. Salon’s Broadsheet ran a piece entitled Formula for disaster; do donations of artificial milk help or hurt Haiti’s babies? As the piece reported “RadicalLactivist” Cassaundra Blyth embarked on a Twitter based campaign:
PLEASE! don’t send formula to Haiti! The women & children shouldn’t be victimised twice! Breastfeeding during emergencies is VITAL to health.
That’s right folks; in the midst of the greatest natural disaster in decades, lactivists are concerned that aid workers will use their precious time and even more precious formula to convince breastfeeding mothers to switch to formula. Are these people insane? Haven’t they heard that 150,000 died and hundreds of thousands more are injured. Hasn’t it occurred to them that among the dead and severely injured there are likely to be thousands if not tens of thousands of breastfeeding mothers? How are those infants to be fed?
Breastfeeding is no longer an option for these babies. The ONLY option is formula feeding. Yes, powdered formula can cause harm if mixed with contaminated water. Yes, it would be safer to give those babies pre-mixed formula. But at the moment babies are starving for lack of milk of any kind. Far more babies can be fed with shipments of powdered formula than with pre-mixed formula. Time is of the essence if starvation is to be avoided, and a group of grown women is trying to stand in the way of feeding these babies.
But the inanity does not end there. Lactivists began calling for donations of breast milk:
When lactation consultant Faith Ploude heard that babies in Haiti might need donated breast milk, she made sure to get the word out to her classes at Mercy Hospital in Miami — and her database of more than 1,000 nursing moms.
The La Leche League and the Human Milk Banking Association of North America made similar pleas.
Let’s leave aside the issue that breast milk donations would be pathetically inadequate; one thousand donations of breast milk would feed one thousand infants only once. Consider that buildings from the meanest shack to the Presidential Palace have crumbled and are uninhabitable. People are living in tents if they are lucky or in the open air if they are not. Where are the refrigerators to store the milk? Obviously there are none, and breast milk will spoil immediately if it is not refrigerated, becoming undrinkable and potential dangerous in a matter of hours.
And how is the breast milk to get to Haiti? It has been a nightmare shipping in even the most basic supplies. Breast milk that must be frozen if it is to survive until it reaches the babies.
Red Cross workers are appalled:
“Tell them not to send it,” said Eric Porterfield, a spokesman for the American Red Cross, “I’m 100 percent sure we didn’t ask for that.”
The international Emergency Nutrition Network has asked one group, the Human Milk Banking Association of North America, to retract a press release this week that issued an “urgent call” for breast milk for orphaned and premature infants in Haiti, saying the donations contradict best practices for babies in emergencies.
Such donations pose problems of transportation, screening, supply and storage and create an “unfeasible and unsafe intervention,” according to a statement from the Office of U.S. Foreign Disaster Assistance, or OFDA.
Lactivists embarked on a campaign to interfere with delivery of formula to Haiti and to send breast milk to people who couldn’t possibly use it. Was this well meaning naivite? That certainly played a role, but the lactivists were never thinking about what the infants of Haiti actually needed; they were thinking of themselves and their personal obsession with breastfeeding. They viewed this as another opportunity to self actualize by promoting their pet cause. The human tragedy of the devastation in Haiti was just another venue to showcase their belief that every child must be breastfed. The actual needs of Haitian babies were never considered.
Lactivists need to get a grip. A horrific natural disaster is not an opportunity to highlight the benefits of breastfeeding. It is a tragedy that obligates us to send the people of Haiti what they need, not simply what we’d like to give.
“Why would anyone think it’s a good idea to send perishable, unscreened bodily fluids into a disaster zone?”
I suspect that they didn’t do much thinking about what the Haitians needed, how it would get there and how it would be stored. They were thinking about themselves and how they might self actualize by promoting their personal obsession.
I agree that the lactivists were using their hearts, not their heads, when they decided how to contribute to the relief effort. Expecting anything perishable to survive on that island is silly. But people think about themselves when being charitable all the time, probably without even knowing it.
“Why are they so threatened by formula?”
I’m not sure if they find formula threatening. They do find that breast feeding enhances their own self esteem and they want you to know how important it is so you will think they are superior (or at least they will think they are superior). I don’t think they gave any consideration to what Haitian infants actually might need.
Local Broadcasts in Creole Urge New Mothers to Nourish Infants Through Breast Milk; Cautions Against Baby Formula Made with Dirty Water
PORT-AU-PRINCE, Haiti, Jan. 25 /PRNewswire-USNewswire/ — The global humanitarian organization Save the Children is supporting efforts to promote breastfeeding among new mothers in Haiti to ensure the protection of the youngest and most vulnerable survivors of the devastating January 12 earthquake.
The agency has translated internationally recognized public health messages into Creole, which are currently being broadcast on local radio stations.
Critical Awareness Campaign Available to Health-focused Groups in Haiti
Save the Children is making these critical communications available to other health-focused groups that are also working with local communities affected by the disaster. Its health staff in Haiti will translate other public health messages over the coming days and coordinate with partners and communities to spread the word about keeping children healthy in the wake of the quake.
Save the Children also is training midwives, health workers and nutritional educators to reach out to pregnant and new mothers at makeshift camps in Port-au-Prince, Leogane and Jacmel.
“Newborns and infants are very vulnerable during emergencies, especially from diarrhea, pneumonia and malnutrition. But mothers can take simple steps to protect their baby’s health through exclusive and proper breastfeeding,” said Kathryn Bolles, Save the Children’s emergency health and nutrition director. “Breast milk provides essential nutrients and strengthens a baby’s immunity, protecting the baby from other illnesses.”
Health Risks from Infant Formulas and Other Supplements
The health messages encourage mothers to exclusively breastfeed babies under 6 months of age, and to continue to breastfeed children until age 2.
Mothers are cautioned against giving babies under 6 months of age anything but breast milk — including water, infant formula, powdered milk or solid food — because of the risks from diarrhea, one of the leading killers of children globally, and because of the risk of becoming malnourished, which leaves babies more susceptible to other illnesses.
“Mothers may not be aware of the threats that infant formula and other supplements pose to their babies. Tainted water used to mix the formula and unsanitary bottles or cups can cause a baby to get sick with diarrhea, which can kill,” said Bolles. “We hope more Haitian mothers will hear our health messages and be encouraged to breastfeed their babies. We also are suggesting mothers seek out support and counseling from organizations like Save the Children if they are having difficulty breastfeeding their baby.”
The awareness campaign also seeks to dispel the myths that may discourage mothers from breastfeeding, among them stress or lack of proper food will cause a mother to produce bad milk or no milk. Instead, mothers are encouraged to breastfeed more often, which will allow them to produce more milk for their baby.
Extremely Poor Survival rates for Haitian Children Prior to Earthquake
Even before the earthquake, survival rates for young Haitian children were the worst in the Western Hemisphere, with nearly 1 in 10 children dying before the age of 5 from preventable and treatable causes like diarrhea and pneumonia.
Save the Children supports the World Health Organization (WHO) recommendations that children should be breastfed exclusively for the first six months of life to ensure their most favorable growth and health. WHO, UNAIDS and UNICEF guidelines only recommend “replacement feeding” (breastmilk substitute) when it is “acceptable, feasible, affordable, sustainable, and safe.”
WHO Calls Breastfeeding Best Answer for Newborns in Haiti
Tim King Salem-News.com
Risks of miscarriages and other complications are serious.
| Photo/Video courtesy: UN/MINUSTAH
(PORT-AU-PRINCE/SALEM) – The United Nations reports that about 7,000 women are due to give birth this month in Haiti, as medical teams continue to work around the clock in birthing tents to deliver newborns.
According to UNICEF, there are currently 120,000 pregnant women in Haiti, more than half are in earthquake-affected areas. It is estimated that 15 percent of the 63,000 pregnant women in affected areas are likely to have potentially life-threatening complications.
Post natal-care is also proving to be a challenge in a country where the medical infrastructure has been destroyed leaving only a few hospitals functional and many medical personnel themselves dead or injured.
The World Health Organization’s doctors like Dr. Evelyine Ancion Degraff, say that only breastfeeding can boost the baby’s immune system and improve its chances of survival in situations like Haiti.
“Breastfeeding is the most important thing for the newborn in this situation. Newborns have very weak immune systems. It hasn’t yet developed. So newborns have a difficult time defending themselves against pathogens. But breast-milk can provide all the antibodies the baby needs to protect itself from disease.”
But UNICEF has said that some new Haitian mothers who have not felt good both physically and mentally are concerned about breastfeeding their newborns out of fear of passing on their “bad health.”
WHO is also working to vaccinate mothers and newborns against prevalent diseases such as neonatal tetanus. For the 7,000 Haitian women who will give birth in the next month, the risks of miscarriages and other complications appear great. The UNFPA (United Nations Population Fund) predicts there will be at least 1,000 miscarriages this month.
The agency started distributing emergency reproductive health kits to pregnant women which contain plastic sheets, sterile blades to cut the umbilical cord and blankets for the newborn.
More advanced kits containing emergency Caesarean section equipment were distributed to birthing tents at field hospitals. Local dads like Sejouste Walkin, say it makes a big difference, at least for now. “Thank god we have this international aid to help us with this birth. For the moment at least, we are still alive, but who knows about tomorrow.”
Unsanitary conditions in these make-shift “tent cities” where the majority of displaced Haitians now live only make the situation worse, says local mom Christianne Raphael.
“It is really starting to stink around here, there are many flies and we get sick. People are going to the bathroom right on the ground. So it is hard for us to even breathe.”
Haitian women were also given “dignity kits” containing sanitary towels, hygiene materials and underwear.
According to UNICEF, Haiti had the highest rates of infant (under 5 years) and maternal mortality rate in the western hemisphere even before the earthquake. The maternal mortality rate stood at 670 deaths every 100,000 pregnant women.
You Tube : Haiti Maternity Pkg.
A video of the report above can be seen on this You Tube link. It includes a first hand look at birthing tents, tent cities, and victims.
‘Boro natives’ nonprofit aids Haiti
Medical teams in rural area to help quake recovery
About a week after a major earthquake hit Haiti, a group of medical professionals decided not to focus on the big cities affected by the 7.0-magnitude quake but a rural town south of Port-au-Prince
A team from Aid for Haiti has spent the past week providing medical care to the residents of Petit Goave.
Founded by two Murfreesboro natives, the medical ministry has seen about 300 patients a day, according to Elliott Tenpenny, a physician who helped start the organization.
“There are cities along the southern peninsula of Haiti that are pretty much inaccessible to the larger relief efforts,” he said.
Aid for Haiti’s initial team included two doctors and four others including a nurse and a paramedic. Tenpenny said that team will be returning this weekend, and another team is headed to Petit Goave Thursday.
“There (are) some very dedicated Haitian nurses that lost everything in the quake that are staying there and helping night and day,” Tenpenny said.
Aid for Haiti was started in 2008 by Tenpenny and Caleb Trent, who is also from Murfreesboro. They traveled to Haiti several times helping treat patients with severe iodine deficiency in remote areas.
A team from the nonprofit arrived in Haiti a week after the earthquake struck.
The massive quake shook Port-au-Prince and surrounding areas Jan. 12, killing an estimated 100,000 to 200,000 people. The aftershocks that followed contributed to thousands of injuries.
Tenpenny, who is an emergency medicine physician at the Mayo Clinic, said initial injuries of victims included broken bones, head injuries and skin abrasions. Now, the team is seeing conditions like gangrene, which is a decay of body tissue.
“They have delivered quite a few kids,” he said about the team’s work.
He said many babies “have been born in terrible conditions” and umbilical cords have been cut with unclean objects causing infections. Some mothers’ breast milk has dried up.
“The babies could be newborns and have not had anything to eat for 10 days,” Tenpenny said, thus making it hard for their young immune systems to fight diseases.
He said a Haitian government official told them they were the only medical team in Petit Goave. Operating out of an old abandoned hospital, about 300 to 400 people wait to receive assistance every day starting as early as 6 a.m.
Tenpenny said, “the biggest need is donation of supplies and cash.”
He said the group plans to continue to send mission teams through April.
COAST GUARD PHYSICIAN ASSISTANT DONATES BREAST MILK TO HELP HAITIAN NEWBORNS
Jan 31st, 2010
PORT-AU-PRINCE, Haiti – Coast Guard Lt. Teresa Wolf, a physician assistant, is deployed with Port Security Unit 307 in support of relief operations in Haiti. One of the loved ones she left behind was her 10-week old girl Chloe Daniel.
After learning of the severe needs of the hospital ship USNS Comfort, the Goldsborough, NC mother began donating breast milk to the ships Pediatric Ward aboard the USNS Comfort.
“It’s the right thing to do,” said Wolf. “Babies get so much more nutrients from breast milk. It’s good for the eyes, brain … everything.”
A week into mission, crew of Comfort sees rare cases
About 120 children are on board Navy ship
ABOARD THE USNS COMFORT — When he wants to take a break, Chief Petty Officer Mike Davenport picks up a stethoscope.
The 37-year-old respiratory therapist from Frederick, in charge of about 90 medical personnel on the USNS Comfort hospital ship off Port-au-Prince, has been on board for a week, trying to keep his staff together and make them work effectively as a team. He regularly works 14- and 16-hour days, and for down time, he still wants to help.
“I take advantage of the opportunity to practice respiratory therapy whenever I can,” said Davenport, a father of four children and the husband of another respiratory therapist at National Naval Medical Center in Bethesda.
Davenport, who is assigned to the Comfort but also works at Frederick Memorial Hospital, compared the first week of the Comfort’s medical mission to “putting a puzzle together.”
On Tuesday afternoon, that puzzle included just over 360 patients on board, down from 375 on Sunday. On Monday, the Comfort took on 62 patients and discharged about 40. Some burn victims were being evacuated to the University of Miami Hospital.
The 62nd patient to come on board late Monday was a baby boy born the day before the Jan. 12 earthquake.
A cluster of doctors bunched around the boy’s bed in the casualty receiving area, while his 22-year-old mother looked on. The baby’s yelps of pain punctuated the somber atmosphere of the pediatrics bay.
The boy’s father died in the earthquake. The baby stayed with his mother in the street. The woman could produce very little milk and her baby was severely dehydrated by the time he was aboard the Comfort.
“I would say within about a day or so, he would have died,” said Kensington’s Capt. Daniel Shmorhun, one of the doctors attending the child.
To help solve the problem, Shmorhun said, lactating members of Comfort’s crew are pumping breast milk that will be stored for the babies on board to drink. A supply of breast milk from the U.S. is also supposed to be brought in soon. “We’re creating a breast milk bank,” Shmorhun said.
About 120 children are on board the ship as of Tuesday morning, according to Shmorhun, roughly a third of the patients on board.
Some of the cases are things medical personnel rarely or never encounter. One small boy suffered a leakage of cerebrospinal fluid out of one ear during the earthquake, and through a combination of heat, time and humidity, fungus crept up to the source of the fluid before he was rescued. The child had mold in his brain.
The medication the doctors would prefer to try to help with his condition was in the United States, said Alayna Schwartz, a perioperative nurse from Germantown. The child also ripped out IV needles.
“I don’t know if we can fix this kid. We can’t fix this kid,” Schwartz said, taking a break to eat a hamburger Monday afternoon.
Medical supplies sometimes ran low to the point where sometimes the staff was “hoarding” them, she said. Supplies come in daily.
One patient was initially going into the OR for an amputation just above his left ankle. Doctors discovered that there was dead tissue and gangrene up to mid-thigh.
“That’s where the maggots come in,” Schwartz said, explaining that larvae had been found in the leg.
Most of the leg was removed.
Schwartz worked the 6:30 p.m. to midnight shift Sunday. She said she was determined not to break down.
It isn’t just patient care that increases stress for medical personnel on the Comfort. Davenport missed his youngest son Jaiden’s third birthday on Thursday. When he talked to Jaiden on the phone, his son asked him: “Daddy, are you fixing boo-boos?”
Since he can’t be at home with his wife and children, the stethoscope and his patients are his “release,” as the hospital continues to settle into its role in helping a shattered nation.
“The flow seems to be smoothing out a little bit,” Davenport said. “I think it’s getting a lot better.”