The Motherwear Breastfeeding Blog

Kaiser Permanente announces major commitment to supporting breastfeeding: All 29 hospitals to be Baby Friendly and/or use exclusive breastfeeding as a key performance measure.

Wow. 

As part of an effort to fight childhood obesity, Kaiser Permanente, which according to their press release "cares for more moms and babies than any other integrated health care system" in the U.S. (96,000 births in 2010) announced a huge commitment to promoting breastfeeding yesterday.

Kaiser announced that:

• All of its 29 hosptials will either be Baby Friendly or use the exclusive breastfeeding Joint Commission performance measure by 2013.  13 Kaiser hospitals already are Baby Friendly.
• It will establish a system-wide performance improvement program focused on evidence-based hospital breastfeeding practices
• It will develop and make publicly available a hospital breastfeeding practices guide for use by other systems
• It will include rates of exclusive breastfeeding at discharge as a core quality measure, to be reviewed quarterly

In a year of a lot of good news, this one ranks right up there. 

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New podcast with the author of Pushed: The Painful Truth about Childbirth and Modern Maternity Care

I have a new podcast up on the Motherlove Blog which I think you'll enjoy. 

It's an interview with the Jennifer Block, author of Pushed: The Painful Truth about Childbirth and Modern Maternity Care.

We talked about the reasons for the record-high rates of cesarean birth and induction, the low rate of VBAC, her assessment of where things are trending, and how to avoid getting "pushed" in childbirth.  We also discussed the response of women's organizations to these trends in birth.

A little while back I also did an email interview with Jennifer on the reasons for the high rate of early elective births, for the Best for Babes blog.

You can listen to the interview on the Motherlove Blog, or download it from their free iTunes store.

Rhode Island is first state to end formula "gift bags" at all hospitals

The smallest state will make big news today by announcing that it's first state to ditch the formula "gift bags" provided at many hospitals. 

Multiple studies have shown that those bags do what formula companies want them to do: increase formula use and decrease breastfeeding among moms who receive them.

At an event scheduled for today, the state will announce that all of its hospitals stopped giving out formula bags to new moms.  And an impressive list of state health officials will mark the occaision, headlined by Stephanie Chafee, a nurse and wife of Governor Lincoln Chafee, and Lieutenant Governor Elizabeth Roberts.

Not sure how you feel about those bags?  Check out this podcast interview on the topic with Dr. Alison Steube.

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A lot of breastfeeding developments to be thankful for this year!

This Thanksgiving, I want to express my gratitude for the many developments in breastfeeding in the last year or so.  Here's my list:

Surgeon General’s issued a Call to Action to Support Breastfeeding

Employers are required to accommodate pumping moms

First Lady Michelle Obama promotes breastfeeding

Infant Risk Center opens, providing free medication information to nursing moms

CDC and AAP support WHO growth charts

Insurance coverage for breastfeeding support and pump rentals now required, with no co-pay

Research confirms use of anti-retroviral drugs can prevent most mother-to-child HIV infections through breastfeeding

For the first time, the AAP recommends breastfeeding as protective against SIDS

The CDC pushes for more Baby Friendly Hospitals

Formula discharge bags are on the decline.

Not a bad list, wouldn't you say?  Happy Thanksgiving, everyone!

Enter Motherwear's nursing story/nursing tip contest to win a $50 gift certificate

Motherwear wants to hear your nursing stories and tips!

Send them to customer service and you'll be entered to win a $50 Motherwear gift certificate.  Send in your entries by December 1, 2011.  Motherwear reserves the right to publish stories and tips on their website.

You can read lots of past entries here.

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New post on accupuncture, chiropractic, craniosacral, and co-bathing to solve breastfeeding problems

I have a new post up on the Motherlove Blog which I think a number of you will like.  It's an interview with Nikki Lee, author of Complementary and Alternative Medicine Complementary and Alternative Medicine in Breastfeeding Therapy.   Nikki is a lactation consultant and craniosacral therapist with over 35 years of experience working with new mothers and babies.

I asked Nikki to write about the use of a variety of complementary and alternative therapies to solve breastfeeding problems, including acupuncture, craniosacral therapy, and remedial co-bathing.  I was also very interested in her descripton of a "cathartic triad of behaviors” in babies returning to the breast after a period of refusal.  I think you'll enjoy her answers.

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The fading 'nursing' sign

My daughter has been a big baby sign-er, but she's talking more and more now.  It's bittersweet.  I love hearing her talk, but also did love her signs.

One sign I'm particularly distressed to see go is "nurse."  Here she below, demonstrating it.  In the last week or so it's started to turn into "nuh, nuh." 

Milk banks facing "unprecedented" shortage

A while back I interviewed Pauline Sakamoto, director of the Human Milk Banking Association of North America, on the Motherlove Blog.

She talked about the increase in demand for donor milk over the last ten years, and how milk banks sometimes struggle to meet the demand.

But recently, as hospitals have rapidly been changing their policies to make donor milk the standard of care for  preterm babies under certain gestational ages and weights, the rate of increase has become even steeper. 

The result, according to this article on MSNBC, is an "unprecedented" shortage in donor milk:

“For the last four months, everyone has been struggling to find enough milk,” says Pauline Sakamoto, executive director of the Mothers’ Milk Bank in San Jose, Calif. 

Donors are willing, but demand is growing faster than supply. The total supply increases 8 percent to 10 percent every year, Sakamoto says, but “the demand has just outpaced our ability to collect the milk. It’s mainstream medicine now.”

Just last year, the banks had enough milk to supply babies who weren’t even in the hospital, such as infants whose mothers had a double mastectomy or the full-term babies who couldn't keep formula down but whose mothers couldn't breastfeed, says Sakamoto, herself a former donor. “I can’t serve them anymore. And as a nurse and as a mom, I can’t handle that.”

With regard to mother-to-mother milk sharing, the donor milk banks are urging qualified moms to consider milk banks:

Many informal milk-sharing website have sprung up in recent years, but both Updergrove and Sakamoto urge women to consider donating to the nonprofit milk banks instead, because they prioritize the highest-need cases. For a healthy full-term infant, Updergrove points out, an extra 200 ounces of milk represents only about eight meals. For that struggling preemie, it means so much more, she said: “You could save a lot of lives by donating your milk to the milk bank.”

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As formula use increases rapidly, China considers new limits on advertising

As rising affluence, changing patterns in women's work, and aggressive formula marketing have been driving up formula use (and presumably driving down breastfeeding rates), China is considering new limits on formula marketing for products aimed at babies 0-6 months old.

Business Week reports:

The government is canvassing public opinion on a draft plan, the ministry said in a statement on its website yesterday. The United Nations Children’s Fund said it supported measures to curb the use of infant formula, whose sales in China more than doubled in four years.

“There is a hyper-aggressive push to get the emerging market hooked on infant formula,” said Dale Rutstein, Unicef’s chief of communications in China. “Our biggest concern is that the advertising of breast-milk substitutes is very aggressive.”

China is a signatory to the International Code of Marketing of Breastmilk Subsitutes, but enforcement is lax, and formula use is on a steep upward curve.  It's not clear to me if this new proposal is to enforce compliance with the Code, or a new effort with different requirements.

Formula use in China was in the news quite a bit a few years ago, when formula contaminated with melamine sickened 53,000 and killed four infants.  

On this news, the share price of Mead Johnson, which is described in the article as "expanding city-by-city in China," fell 4.3 percent.  China is its biggest market, according to the article.

Interestingly, the share price of breastfeeding...

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Bone analysis reveals 18th and 19th century breastfeeding patterns

Here's one for the true breastfeeding nerds (myself included): 

A new study of 18th and 19th century bones sheds light on the effect of economic change on breastfeeding patterns in London at that time.

The study used a method called stable isotope ratio analysis to examine the ribs of 72 skeletons (yikes) of babies and children who died in Spitafields, London.  The authors concluded that 18 were being exclusively breastfed, and the rest were either not breastfeeding at all or were being mixed fed.  One common breastmilk substitute at the time:  flour and water.

Both wealthy women (who sometimes hired wet nurses) and poor women (who were starting to work outside the home in the new, industrialized economy) did not breastfeed, or did not breastfeed exclusively. 

I'm not convinced that this information can be generalized, because the bones analyzed came from a population that died early, but it's an interesting project, nonetheless.

The authors note: 

Artificially fed infants had higher mortality rates than breastfed infants in the first six months of life," writes Nitsch. "The mortality of infants who were dry fed from birth was estimated to be particularly high, usually above 50 per cent and sometimes reaching as high as 90 per cent, due to earlier exposure of the infant to pathogens from contaminated foods, a higher risk of malnutrition, and the loss of immunological protection.

Image source: Wikimedia Commons

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