The Motherwear Breastfeeding Blog

Breastfeeding Promotion Act gets reintroduced, with more to like.

You may already know that on June 11th, Representative Carolyn Maloney and Senator Jeff Merkley introduced the Breastfeeding Promotion Act of 2009 (HR2819 / S1244).

What you might not have noticed is that this version of the bill has a new provision which would make life far easier for mothers who want to pump in the workplace. 

This version requires employers with more than 50 employees to make reasonable efforts to provide a private space and unpaid break time for mothers to pump.  This mirrors laws in a number of states, California and New York among them, that require employers to make some simple and cost effective accommodations for nursing moms.

In addition, the bill would protect breastfeeding mothers under the protection of the 1964 Civil Rights Act, set standards for breast pump manufacture, provide tax incentives for employers that establish private lactation areas in the workplace, and provide tax credits for nursing mothers.

To express your support for the bill, you can sign petitions sponsored by the U.S. Breastfeeding Committee or Moms Rising.  There's also a Facebook group dedicated to promoting the legislation.  And you can see a silly interview with Rep. Maloney and Stephen Colbert. 

Thanks to Angela at Breastfeeding 1-2-3 for some of these links, and to Mama Seoul for the picture of a rally in support of this bill in 2007.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here. 

Guest post: Marsha Walker on "a new low in formula marketing."

Recently, thanks to a reader, I learned that a formula company was titling one of its webpages "the breast milk formula." 

I passed this along to Marsha Walker, Executive Director of the National Alliance for Breastfeeding Advocacy, and she in turn launched a campaign to get the company to change this slogan.  Below, Marsha discusses formula marketing in the U.S., and how you can work to challenge marketing that undermines breastfeeding.

Many of you have seen the recent webpage title appearing on a Mead Johnson website, which stated: ”The Breastmilk Formula-Enfamil.” Word of this hit many of the major breastfeeding listservs and a call by the National Alliance for Breastfeeding Advocacy (NABA) to report this deceptive advertising to the Federal Trade Commission (FTC) resulted in many complaints being sent to the agency responsible for monitoring false and misleading advertising. Several days later Mead Johnson removed the title tab and replaced it with “Enfamil Lipil-Lipil.”  Infant formula marketing rages almost unchecked, other than formula manufacturers suing each other or reporting unfavorable ads to the Better Business Bureau’s National Advertising Division for a ruling.

Formula companies spend millions of dollars in marketing efforts each year, resulting in a can of powdered formula costing $25 for approximately 25 cents worth of ingredients. The duty of a formula company is to its shareholders not to help breastfeeding mothers. US corporate law obligates that management of publicly held companies act primarily in the economic interest of the shareholders not put community interest above corporate interest. Companies work the system to make it easier to transact business and avoid criticism by:

Lobbying

• companies lobby Congress for favorable laws and befriend federal officials
• companies send public relations experts to government agencies for favorable regulations
• companies buy access and influence by contributing to political campaigns

Enticing the experts/disarming the critics

• academic experts are hired as consultants, spokespersons, and advisors and are funded to engage in research. This helps remove the threat that leaders in the field will speak against the product or company, but taints their objectivity
• companies routinely provide funds to researchers, universities, and professional associations. These funds support conferences, projects, publications, internet sites, and meetings. Formula companies do not give away money as a benevolent charity, but in the long term interests of increasing profits. Companies need respectability to buttress their political power and avoid regulatory attention
• manipulating the data is easier if the research is funded by the company that produces the product. Some studies on the addition of the long chain polyunsaturated fatty acids DHA/ARA into infant formula have a 20%-33% loss of the sample population because mothers switch their baby to a non-study formula. There is no explanation for the high attrition rates. Therefore, no side effects are reported to the public. Meta-analyses regarding the addition of DHA/ARA to infant formula shows that these formulas confer no advantage to the infants consuming them, even though the products cost as much as 15%-33% more than standard formulas
• inservices provided to physicians and nurses by formula salesmen in hospitals are carefully orchestrated to present data from company funded studies that show the benefits of the product while distorting the risk
• companies encourage adversarial relationships between health professionals. Potential areas of disagreement are exploited to “divide and conquer,” even at the highest levels of government and within the World Health Organization
• members of government advisory committees frequently have industry affiliations

Corporate Public Relations/Masters of Spin

• industry front groups are used to appear to the public as independent supporters of the formula agenda
• new public relations opportunities are seized upon immediately, such as pressuring UNICEF to accept donations of baby formula to feed infants of HIV positive mothers in Africa
• a technique called “crisis management” was activated when the Baby Friendly Hospital Initiative was introduced into the US in 1991. An expert work group was formed and funded by the Department of Health and Human Services without industry representation. One company met secretly with the conveners of the work group and threatened to engage in direct to consumer marketing of infant formula if they lost their access to market formula through hospitals. It also engaged in a slick marketing campaign to hospitals claiming the BFHI was punitive in nature.

Giving Gifts

The giving and receiving of gifts is a complex relationship with the expectation on the part of the giver that the recipient will engage in a reciprocal behavior. One nurse manager stated that all of the food and gifts were accepted as perks for the nurses to help retain them as employees! These gifts are not free. The mothers who purchase formula buy the trinkets, food, educational offerings, and lavish entertainment accepted by so many health care professionals. Formula salesmen have unlimited access to maternity units in many hospitals, violating the vendor policy of the institution. This constant, “helpful” presence allows the salesman to be perceived as a member of the health care team who in some instances actually determines what infants are fed in the hospital nursery. The purchasing of loyalty is a prime goal of the formula industry.

Voluntary Codes

The International Code of Marketing of Breastmilk Substitutes (the Code) is an important tool and the foundation for ethical practice, but it is voluntary on the part of industry. The Code was created in 1981 by the World Health Organization and UNICEF as an international guideline for manufacturers to follow. It aimed to curb the unethical marketing practices that were resulting in the illness and death of thousands of infants each year. The Code has not been legislated in the US which allows egregious marketing practices to continue unabated. Companies fear regulation above all else.

What Can Be Done?

Learn to work the system.

• Report all unethical marketing practices to NABA (email).
• Report offending advertising to the Federal Trade Commission
• Ask all birthing hospitals to eliminate distribution of commercial discharge bags supplied by infant formula manufacturers. See www.banthebags.org
• Request that clinics, obstetrical, and pediatric offices refrain from distributing gifts from formula manufacturers
• Support organizations like NABA and Best for Babes. Best for Babes placed a full page ad in the June 2009 issue of Fit Pregnancy magazine to help mainstream breastfeeding and offset formula marketing efforts. NABA has 2 publications available on the extent of formula marketing in the US.

"The Breast Milk Formula?"

Speaking of deceptive marketing:

Reader Anna emailed me to point out that the formula company Enfamil is marketing one of their formulas as "The Breast Milk Formula" in the title of their one of their webpages.

This is the most blatant form of unethical marketing I've ever seen from a formula company, and unfortunately there are many examples to chose from.  And of course it's a clear violation of the International Code of Marketing of Breast Milk Substitutes.

It's this kind of advertising which leads to a near doubling in the number of people who say that formula is as good as breastmilk.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Beware the pregnant woman...

...who extols the virtues of BPA.

Remember Bisphenol-A, the component of some polycarbonate plastics linked to reproductive disorders, developmental toxicity, and cancer?  The one found, until recently, in nearly every brand of baby bottle?  The one still in infant formula containers and canned food containers?  The one banned from baby bottles in Canada, significantly reduced from products in Japan, and increasingly banned in the U.S.?

I don't usually think that toxins in plastic are funny, but I actually laughed out loud when I saw this Washington Post story last week about the plastic industry's strategy to counter the anti-BPA movement:

The notes [from an industry meeting on BPA] said the executives are particularly concerned about the views of young mothers, who often make purchasing decisions for households and who are most likely to be focused on health concerns.

The attendees estimated it would cost $500,000 to craft a message for a public relations campaign, according to the notes. "Their 'holy grail' spokesperson would be a 'pregnant young mother who would be willing to speak around the country about the benefits of BPA,' " the notes said. [emphasis added]*

Let's just remember for a moment that it was you - mothers, armed with information - who got out way ahead of the FDA, the industry, and the retailers, and voted with your feet.  By buying glass and BPA-free plastic bottles, you got every major manufacturer of baby bottles to produce a BPA-free product.  The FDA was in recent years more interested in the plastics industry's view than the science, though this seems poised to change with pressure from Congress and a newly appointed commissioner. 

So, they really think that you're going to fall for an ad campaign featuring a pregnant mom who loves to feed her kids endocrine-disrupting plastic?  They've got a lot to learn.

*For fun, feel free to suggest a slogan in the comments section!

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

A "Call to Action on Breastfeeding"

The US Department of Health and Human Services, Office on Women’s Health wants to know what you think DHHS should do in the next decade to promote and support breastfeeding in the United States.

The Office of Women’s Health is looking for comments in the following twelve areas:

1. Maternal and Infant Care Practices: Prenatal, Hospital, and Post-Delivery Care
2. Access to Lactation Care and Support
3. Health Professional Education, Publications, and Conferences
4. Use of Banked Human Milk
5. Worksite Lactation Support, Onsite Child Care, and Milk Expression
6. Paid Maternity Leave
7. Portrayal of Breastfeeding in Traditional Popular Media and New Electronic Media
8. Support for Breastfeeding in Public Settings
9. Peer Support and Education of Family Members and Friends
10. Community Support for Breastfeeding in Complementary Programs (e.g., Early Head Start, Home Visitation, Parental Training)
11. Research and Surveillance
12. Other Areas

Comments are requested until 31 May 2009.  Here's the link where you can make your voice heard! You can read the comments left so far.

This is your opportunity to help influence and shape the decisions that may affect breastfeeding promotion and support in the United States for the foreseeable future.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Miss any of these podcasts?

A couple of years ago, when Motherwear asked me to create podcasts for the blog, I almost said no.  I felt nervous about doing recordings, and wasn't sure what people would want to hear.

The president of Motherwear had me meet with the owners of a big yarn store in our area, who do a weekly radio show about knitting.  Their show is produced as a podcast and is very popular.  I went with them to the radio station to watch them record it.  It actually looked like fun, and I committed to giving it a try. 

The funny thing is that I really enjoy the process of putting these podcasts together.  I like reading the books, coming up with questions, and talking with authors.  I've had a chance to talk with people I might never have contacted.

Can you guess which one is the most frequently downloaded from the iTunes store?  A breastfeeding welcome here sticker goes to the first person to guess correctly (leave your guess as a comment).  And if you're feeling friendly, please go to our iTunes store and write a review! 

• Breastfeeding and early sexual abuse, with Penny Simkin
• African American moms and breastfeeding, with Kathi Barber
• How do other mammals do it? With Dia Michels
• What's the problem with those formula company bags? With Alison Stuebe
• Starting solid foods, with Ellyn Satter
• Breastfeeding in the movies, with Sarah Rubenstein Gillis
• Low milk supply: Could it be your hormones? With Lisa Marasco
• So, you want to work in breastfeeding support (just me)
  
• Nursing in public and the law, with Jake Marcus
• Making more milk, with Diana West
• Hathor the Cow Goddess, with Heather Cushman-Dowdee
• Postpartum depression and breastfeeding, with Kathleen Kendall-Tackett
• MilkShare, with Kelly Faulkner
• The Milk Memos, with Cate Colburn-Smith

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

California legislation would require insurance to pay for breastpumps, lactation consults.

Two new bills in the California legislature would require insurance companies to pay for breastfeeding help. 

AB 513 requires the rental of breastpumps and for consultation with board-certified lactation consultants.  AB 514 (not amended to reflect this yet) requires employers to provide two paid 20 minute breaks for mothers to pump at work. 

California law currently requires employers to provide a reasonable amount of unpaid break time and a sanitary place to pump.  It looks like the intent of provision giving mothers access to rental pumps is to help them pump at work, since there's no mention of medical necessity.  As far as I know, these would be the first laws of their kind in the U.S.  For more information on breastfeeding and the law, check out this podcast.  The video below makes the argument for these changes to the law.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

The gift that isn't.

Many thanks to Heather, the artist formerly known as Hathor the Cow Goddess, for permission to post this!  Visit her new site, Mama Is, for more great comics.

If you like this strip, you'll love the podcast interview I did with Heather.  And if you'd like to learn about formula diaper bags given away at hospitals, listen to this podcast.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

Are you a card carrying mom?

I've been working to distribute our breastfeeding coalition's business cards with the new nursing in public law.* You can download a pdf of the card we made, or download it as an MS Publisher file to get your own printed.

These cards are sometimes affectionately called "licenses to breastfeed," and while you certainly do not need a license to breastfeed in public, the cards can come in handy if you're ever confronted about it.

I thought I'd list some other states' "licenses" here. 

• Texas' card, in English and Spanish (pdf)
• California's card - in English and Spanish
• Missouri's card - two sided! (pdf)
• Florida's card (pdf)
• South Carolina's card
• Massachusetts card  (pdf)
• Baby Talk's license to breastfeed covering many states (pdf). May be a little out of date.

And here are a few other fun ones:

• Thank you for breastfeeding (pdf) cards from Militant Breastfeeding Cult.
• "Oops, you caught me breastfeeding" (pdf) cards from Mommy Guide 

Have I missed your state or organization's card?  Post a comment with a link, or email me and I'll put it up.  *If you live in my area and want some cards, email me.

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.

January's Carnival of Breastfeeding: Breastfeeding goals.

Welcome to this month's Carnival of Breastfeeding!  This month's theme is breastfeeding goals.  Be sure to check out what other bloggers have to say on this topic at the bottom of this post.

I have a whole lot of breastfeeding goals for this year.  Some of them are:

Finish Spanish for Breastfeeding Support.  Last week my co-author and I finished a final draft of a book which will help breastfeeding support people communicate with mothers in Spanish.  It should be out by this summer, and I'm very excited to have reached this stage.  I'm setting up a website for the book, which will have a 'how do I say this?' forum, extra exercises, and links to breastfeeding resources in Spanish.  Here are a few audio clips from when we were recording the audio portion.

Recruit mothers for a breastfeeding/biopsy study.  As I've mentioned before, I'm helping Dr. Kathleen Arcaro at the University of Massachusetts recruit mothers for an important study on breast cancer.  If you know of a nursing mother who has recently had, or expecting to have, a biopsy, please ask them to contact me.  I've set up a website for this and other studies using breastmilk.

Distribute pumps to WIC.  As a result of some fundraising, my breastfeeding coalition recently purchased three pumps for area WIC offices.  They'll loan them out to mothers who might not otherwise be able to afford to rent one.

Hold a breastpump training.  My breastfeeding coalition is also planning to hold a training on breastpumps conducted by Medela in March.  Email me if you'd like more information (use link on sidebar).

Get the word out about Massachusetts' new nursing in public law.  I recently had 500 business cards printed with sections of our new law on nursing in public.  Our coalition will distribute them, and I'll be trying to think of other ways to raise awareness of the new law.

Help get pumping rooms set up at the University of Massachusetts, Amherst.  For a while a group has been working on setting up pumping rooms at UMass.  So far there is one, newly designated room, and we're hoping for many more.  A list of other campus lactation programs is here. 

Get trained to accept breastmilk donations.  Our breastfeeding coalition has gotten a freezer set up to accept breastmilk donations (see thrilling picture to the left), and as soon as we get trained in how to operate our 'milk depot,' we'll start to receive and ship approved donors' milk to the Mothers' Milk Bank of New England.

Do more podcasts.  You gave me some great ideas for podcast topics last year, and I'm planning on doing them on tandem nursing, extended breastfeeding, sexual abuse and breastfeeding, and breastfeeding and African American moms.

And finally, cut back a little!  I'll be turning over the leadership of our coalition, as well as the responsibility of the newsletter for the Mothers' Milk Bank of New England.  Here's the current newsletter.

Check out these posts from other bloggers participating in this months' carnival (updated throughout the day):

• Zen Mommy's 2009 breastfeeding resolutions
• Secrets of Orual's breastfeeding goals
  
• Hobo Mama's breastfeeding resolutions
• Breastfeeding 1-2-3 on the goal of exclusive breastfeeding for the first six months
  
• Blacktating's breastfeeding goals
  
• Milk Act's breastfeeding goals
• Beautiful Letdown's breastfeeding goals
• Mama Knows Breast's breastfeeding goals
  
• Breastfeeding Mums breastfeeding goals
  

Want to get email updates from the Motherwear Breastfeeding Blog?  Subscribe here.  Want an RSS feed? Subscribe here.  Want to subscribe to our breastfeeding podcasts on iTunes?  Click here.