The Motherwear Breastfeeding Blog

Breastfeeding in emergencies.

It's been a week of disasters in Burma and China, and I've been thinking a lot about the victims of these horrific events. 

I traveled in Burma in the early 1990's with a good friend.  The country was beautiful (especially Pagan, shown to the right) and the political repression was palpable.  One memory:  My friend became quite ill, and we found a doctor who came to our hotel and treated her.  When we asked how much we could pay her, she refused to accept anything.  We were so grateful for her help, and asked for her address so that we could send her a gift when we got home.  She wouldn't give us her address, telling us that she didn't want to be seen as connected in any way to people outside the country. 

But back to the disasters, and the importance of breastfeeding in emergencies.  In a disaster such as the one in Burma, breastfeeding can be a life-saving act.  Why?  In emergencies formula is often not available.  If it is available, water supplies are often compromised.  Formula mixed with contaminated water can cause diarrhea and dehydration, which can quickly become life-threatening to infants.  Power to sterilize and refrigerate formula is also often not available.

Sometimes, well meaning humanitarian efforts result in such an influx of formula that efforts to protect and support breastfeeding are disrupted.  This is such a concern that in 1994 the World Health Organization adopted the following policy, urging member states to "exercise extreme caution when planning, implementing, or supporting emergency relief operations, by protecting, promoting, and supporting breastfeeding for infants," and to ensure that formula is distributed only under specific conditions.

Still, there is a lot of confusion about the role of breastfeeding in these situations.  INFACT Canada has a great write up taking on myths about breastfeeding in emergencies, which I've posted below:

MYTH 1:  Malnourished mothers cannot breastfeed.

In virtually all cases, a sub-optimally nourished mother can breastfeed her child.  The important response is to feed the mother so that she can feed her child.  It is far safe and more effective to provide nutritional support for the mother than to risk her infant's health by feeding breastmilk subsitutes.  Mothers in these situations need help and support to enable them to breastfeed.

MYTH 2:  Stress makes a mother's milk dry up.

Although extreme stress or fear may temporarily reduce a mother's milk supply, this response is often of short duration.  On the other hand, breastfeeding produces hormones that have a calming effect on mother and baby and creates an inseparable bond between the mother and her child.  There is virtually no abandonment of babies in emergency situations when mother and baby are breastfeeding and kept together.

MYTH 3:  Babies with diarrheal disease need water or tea.

Breastmilk contains about 90% water.  Exclusive breastfeeding provides all the water, nutrition and immunology a baby needs, without the risk of contamination.  Feeding an infant water can introduce disease-causing bacteria and other contaminants, especially if safe water is scarce or unavailable.  It is only in the case of severe diarrhea that infants may need rehydration fluids in addition to breastmilk.

MYTH 4:  Mothers cannot resume lactation once breastfeeding has stopped.

Mothers and babies can restart breastfeeding even after a period of not breastfeeding.  Increased skin-to-skin contact and frequent access to the breast helps to increase milk supply and enables mothers to resume full breastfeeding.  This can be critical for babies during emergencies.

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Happy Mothers' Day!

Just a quick post to wish everyone a great Mothers' Day!

I'm posting pictures here of the very cute babies who came to my breastfeeding support group last week.  It's pretty remarkable that none of them cried for their web debut picture.

If you're looking for a little activism in your Mothers' Day celebration (after all, the holiday began as an effort to promote peace), check out this e-card from Moms Rising and sign their petition to support newly introduced legislation which would provide paid maternity/family leave.

I hope that you all have a wonderful day!

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I can buy colostrum at Whole Foods?

I was in Whole Foods last week and did a complete double take.  There, in the supplements section were several brands of colostrum for sale.  And to make it even stranger, next to the colostrum was a bottle of lactoferrin (another component of breastmilk) for sale.

I checked out the bottles and of course found it was bovine colostrum and lactoferrin on the shelf.  But this experience really got me thinking about the complete acceptance we have of cow's milk and the at best uneasy relationship we have with human milk.

As I'm sure you know, we're the only species that drinks another mammal's milk.  I consume it daily in many forms.  But it wasn't until a friend pointed out to me that the milk I drink was made to meet the exact nutritional and immunological needs of a baby cow, that I started to look at my morning cereal differently.  What messages was this milk sending my body about the way to develop, say, a baby cow's brain, or fend off a disease that a baby cow might be subject to in a pasture in another state?

I'm not arguing that we shouldn't drink cow's milk, or that we shouldn't make formula.  But I do object to the squeamishness we have about human milk when cow's milk is treated as normal.  Your thoughts?

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Breastfeeding rates hit a 20 year high.

New data from the CDC shows that breastfeeding initiation rates hit a 20 year high of 77% in 2006.  And there were especially big gains for African American women.  The Associated Press reports:

About 77 percent of new mothers breast-feed, at least briefly, the Centers for Disease Control and Prevention said.

"It looks like it is an all-time high" based on CDC surveys since the mid-1980s, said Jeff Lancashire, a CDC spokesman...

The percentage of black infants who were ever breast-fed rose most dramatically, to 65 percent. Only 36 percent were ever breast-fed in 1993-1994, the new study found.

For whites, the figure rose to 79 percent, from 62 percent. For Mexican-Americans, it increased to 80 percent, from 67 percent...

The latest CDC report found rates of breast-feeding were also lowest among women who are unmarried, poor, rural, younger than 20, and have a high school education or less.

I should note here that these statistics show an increase in the number of women who initiate breastfeeding.  Sustaining breastfeeding, especially exclusive breastfeeding, is a different story.  But any upward trend is something to celebrate, right?

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Judge declines to rule on FLDS mothers' request to remain with nursing babies.

Tell me what you think of this issue.  From the Salt Lake Tribune:

The Texas judge overseeing the polygamous FLDS sect's case today refused to make any ruling that would allow breast-feeding mothers to remain with their children in state custody.

Walther was addressing a request for temporary restraining orders filed by attorneys for four of the nursing mothers, but on behalf of all mothers there.  The request asked the court to stop Texas child-welfare workers from separating mothers and children, to allow private prayer, and to give the women and children telephone access to their lawyers.
   
The judge said she would leave it up to CPS officials and the attorneys to work something out on the breast-feeding. The attorneys, however, replied that they have so far been unable to come up with a workable agreement.
   
CPS officials plan to separate 68 women with children under five from their kids once DNA samples are taken. The sampling began today.

In a separate article:

[Judge] Walther acknowledged the nutritional and bonding benefits of breast-feeding.

"But every day in this country, we have mothers who go back to work after six weeks of maternity leave," she said.

...The judge's decision drew a rapid response from breast-feeding proponents, who began rallying around the FLDS mothers. Nicole D. Hoff, a certified lactation counselor in Texas, set up an instant Web site - http://fldsbreastmilk.blogspot.com.

"While we may not agree or understand the circumstances, I think we need to fight for the right of the children to have the best care and nutrition, which includes breastmilk," she said in a message on the site.

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Sign this petition to get BPA out of baby bottles.

By now you've probably heard about Bisphenol-A, the estrogen-mimicking component of some polycarbonate plastics which is found in most baby bottles and some formula cans.  I posted about its health effects last year.

BPA has been in the news quite a bit this week, with a Los Angeles Times article reporting that the National Institutes of Health now expresses "some concern" that BPA may harm fetuses and infants, and with the news that the Canadian government yesterday banned BPA from baby bottles, deeming it a toxic substance.  There were reports that Walmart has started pulling bottles with BPA off shelves.  Nalgene announced that it would get rid of BPA in its bottles and started pulling remaining stock off the shelves, and Senator Charles Schumer announced he'd introduce a bill in the U.S. Senate to ban BPA from bottles, dental sealants, and food containers. 

The plastics industry representatives, through the years of debate, has maintained the BPA is safe, but it seems pretty clear that the market is going to have the last word on this one.  Nearly every family I meet these days has heard of BPA, and all of those Avent bottles I used to see pumping moms use have been replaced by Born Free and Medela bottles.  I might add that I started noticing moms making this switch before the federal reports started coming out.  We're such smart cookies.

So, while it seems to me that the manufacturers are already backed into a corner, we might as well take the opportunity to wag our finger at them.  After all, as late as Thursday a representative of the plastics industry was offering his "reassurance" that products made with BPA are safe.

Check out this Moms Rising petition which they'll send to the manufacturers of the major manufacturers of baby bottles, asking that they discontinue using BPA in their bottles.

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"Good Night" thickened formula.

Thanks to Heather at Hathor the Cowgoddess for this one:

Cow and Gate formula company just introduced a formula called Cow and Gate Good Night Follow-on Milk.  For those of us in the U.S. who aren't familiar with the term, consider yourself lucky.  "Follow-on milks" are formulas marketed to families for use from six months.  They also allow formula companies in the U.K. to get around restrictions on advertising of formula.  So far they haven't caught on here, in spite of some marketing efforts.

First problem with this idea:  there's no evidence that babies whose feedings are "thickened" before bedtime sleep any better. 

But let's just say for a moment that this new formula does work and babies sleep longer.

Is that a good thing?  There is evidence that babies' natural tendency to wake during the night is protective against SIDS.  La Leche League says, "Breastfed babies sleep less soundly than artificially fed infants and are more likely to sleep with their mothers; thus, they may be more easily aroused when they experience a stop-breathing episode."   

Whether you're a breastfeeding or formula feeding mother, I'd treat this new product with a thick dose of skepticism.

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Quick, name the four countries that have no paid maternity leave. Then sign this petition.

Here's a quick quiz:

Which are the four countries in the world that do not provide paid maternity leave, according to Moms Rising?*

Answer:  Papua New Guinea, Swaziland, Liberia, and the United States of America.

Wonder what it looks like in our peer developing countries?  Here's what Moms Rising reports that families are guaranteed in our neighbor to the north:

Canada gives the birth mother fifteen weeks of partial paid leave for physical recovery, and then also gives another thirty-five weeks of partial paid parental leave that has to be taken before the child turns one. These thirty-five weeks of parental leave can be taken by the mother or the father, or can be shared between the two. The pay during the fifty weeks total of leave related to a new child is 55 percent of the average gross salary over the past twenty-six calendar weeks. All in all, there are fifty weeks of partially paid leave available for new Canadian parents to spend with their child.

Sounds pretty good from here, right?  But Canadians are probably envious of France, which provides three years of paid parental leave with guaranteed job protection, or Sweden, which provides 16 months of paid parental leave which must be shared by the baby's father.  Swedish families are also legally entitled to work reduced hours until a child turns eight.

I felt sick to my stomach recently when a friend here in Massachusetts told me of a co-worker who went back to work at three weeks because she couldn't afford to miss work.  I frequently meet mothers who have to return at six weeks.  Obviously, this is unhealthy for both mother and child, but it is reality for many working mothers.

I was one of the extremely fortunate employees who got paid maternity leave from my employer, and the following year my former state (California) passed landmark legislation requiring 50% compensation for six weeks.  It's a far cry from Canada or Europe, but it showed that it's possible to enact policy that recognizes the needs of families.

In this election year, we have an opportunity push this issue onto the candidates' agendas. 

So, sign this petition sponsored by Moms Rising to let your representatives know that this issue is important to American families.  It includes a nice statement about the relationship of between paid family leave and breastfeeding - a right guaranteed in workplaces in 107 countries.  Can you guess who doesn't?

* Data from a Harvard University/McGill University study of 173 countries.  Australia guarantees one year of unpaid leave, and is currently debating a paid maternity leave policy.

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A day when I didn't love NPR.

I listen to NPR all the time.  I turn it on first thing in the morning, and I listen to it throughout the day at home and in the car.  I consider several hosts to be close personal friends who just haven't had the chance to meet me yet.

So I was pretty disturbed yesterday when I heard a piece on the program Day to Day, titled "Study puts breastfeeding benefits in question."  At first I thought it was an April Fool's Day joke.

In it Dr. Sydney Spiesel speaks about a study done in Belarus about the benefits of breastfeeding.  The study showed significant benefits in reduction of gastrointestinal disease and eczema, but failed to show other benefits.  Dr. Spiesel focused on the absence of positive outcomes related to mental health in children.

There were several things that disturbed me about this piece.  First, the title of the piece is pretty darn misleading.  It makes it sound as if the segment will raise questions about all of the benefits of breastfeeding, when in fact the piece was largely about the fact that the study didn't find benefits one outcome - mental health.

Second, since when does one study trump thousands of others?  Some of you have seen me cite, over and over, a meta-analysis from the U.S. Department of Health and Human Services released last year which looked at over 9,000 studies - from the developed world alone - and found significant effects on incidence of many health problems, including diabetes in children and breast cancer in mothers.  Again, I just don't understand how a single study, however large, could be given so much weight when there are thousands of others which reach different conclusions.

Next, the host, Madeleine Brand, first asked Dr. Spiesel how he would be changing his advice based on this study.  I would hope that my doctor wouldn't base his advice to me on a single study when the body of research on a topic is so large.  Then she wrapped up the segment by asking if this study means that mothers shouldn't feel guilty if they don't breastfeed.  He answered affirmatively.  But is it really a doctor's job to tell us how we should feel about a behavior? 

Finally, the study in question is part of the PROBIT series of studies.  To learn about how these studies are funded and the affiliations of the researchers involved (trust me, it's relevant), don't miss this post on the International Breastfeeding Symbol Blog.

Fortunately, I wasn't the only one bothered by this story.  The show got lots of emails about it, some of which they read on the air today.

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Vermont Human Rights Commission finds that airline violated the law when forcing mother off plane.

Most of you probably recall the case of Emily Gillette (shown to the right), the New Mexico mother who was forced off of a Freedom Airlines plane in 2006 because she refused to cover up or stop breastfeeding.  The incident occurred in Vermont, a state which protects nursing mothers' rights to breastfeed in public places.  The case sparked the first nationwide nurse-in at Delta ticket counters.

The Vermont Human Rights Commission ruled this week that Freedom Airlines discriminated against Gillette.  The parties now have six months in which to reach a settlement agreement.  Though the flight Gillette was taking was a code-share between Delta Airlines and Freedom Airlines, the Commission did not charge Delta with discrimination. 

The Burlington Free Press reports:

"We are delighted that the commission found against Freedom," said Beth Boepple, a Manchester-based attorney who represents Gillette. "We're disappointed in the decision regarding Delta, but we understand why the commission arrived at that decision, even though we don't necessarily agree."

Freedom and Gillette have six months to negotiate a settlement. Boepple said Gillette's goal is to see airline policy put into place that protects other women from similar events; a written policy put into place that trains and educates employees; and to receive monetary compensation to at least cover legal and travel costs.

A ruling against Delta obviously would have had more far-reaching implications, but this news is still a positive step and may make other airlines take the issue seriously.

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