The Motherwear Breastfeeding Blog

Top 10 breastfeeding stories of 2011.

Here's my summary of the biggest news in breastfeeding in 2011. I think you'll agree that it was a banner year, especially for the elimination of some important barriers to breastfeeding. 

You can read my lists from prior years here: 2010, 2009, 2008, 2007 and 2006.  Feel free to tell me what I've missed!

Surgeon General issues a Call to Action to Support Breastfeeding. Surgeon General Regina Benjamin kicked off the year by issuing a bold statement in support of breastfeeding.  It outlines steps needed to eliminate the barriers that keep so many mothers from reaching their breastfeeding goals, and forms the basis of the administration's policy initiatives in breastfeeding support (see CDC point below).

Target nurse-ins put spotlight on nursing in public.  In the final week of the year, protests were held at an estimated 100+ Target stores after mother-of-four Michelle Hickman was harassed and humiliated at a store in the Houston area.  Target's slow response and inconsistently applied policy of supporting nursing moms in its stores was a contrast to an earlier protest at Whole Foods, which ended in the store welcoming the protesters and establishing a written policy supporting nursing in their stores.

First Lady Michelle Obama promotes breastfeeding.  Could you ask for a higher profile advocate for breastfeeding than First Lady Michelle Obama?  As part of her Let's Move campaign to combat childhood obesity, she announced that she would work to eliminate hospital barriers to breastfeeding by pushing for an increase in the number of Baby Friendly hospitals.  This announcement became fodder for some high profile voices on the right who viewed it as an example of government over-reaching its authority.

Insurance coverage for breastfeeding support and pump rentals now required.  The U.S. Department of Health and Human Services issued regulations requiring that insurance companies cover "Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment."  On August 1, 2012, these support services will be offered by insurance, with no co-pay or other cost-sharing.

Breastpumps become tax deductible and eligible for FSA accounts.  Reversing an earlier position, the IRS made breastpumps and related supplies tax deductible, and eligible for purchase using funds in an FSA account.  This is a bit complicated, so I recommend starting by reading this post and comments before assuming that you'll be able to benefit.

The CDC pushes for more Baby Friendly Hospitals.  After noting that U.S. hospitals are "a very long way from where we need to be" in implementing practices known to increase breastfeeding success, the CDC announced a new $6 million initiative to support the certification of more hospitals as Baby Friendly.  We currently have less Baby Friendly hospitals than Ecuador, so this is a welcome effort!

Kaiser announces Baby Friendly push at all hospitals.  Anyone noticing a theme here?  Health care giant Kaiser Permanente, which cares for more moms and babies than any other system in the U.S., announced that all 29 of its hospitals will either become Baby Friendly or be evaluated by their exclusive breastfeeding outcomes by the Joint Commission.  

Formula discharge bags are on the way out.  One of the thorniest issues when it comes to obtaining Baby Friendly status is the issue of the formula company "gift bags" given to most women on discharge from the hospital.  But grass roots organizing as well as government pressure has led to a marked decrease in the number of hospitals giving them out.  A study found a doubling of bag-free hospitals in ten states, and Rhode Island recently made news by became the first state to go completely "bag free."

Donor milk starts to become the standard of care in NICUs, shortages loom.  Modern donor milk banking celebrated its 100th anniversary a few years ago, and I think that this year marked the burgeoning acceptance of donor milk as mainstream therapy in NICUs.  Buoyed by research showing that donor milk can save lives, more and more hospitals are making donor milk the standard of care for preemies born before a certain number of weeks gestation or below a certain birth weight.  And the non-profit milk banks have been a victim of their own success; with demand rising they've seen increasingly frequent shortages.

Online mother-to-mother milk sharing continues to grow.  This was on my top ten list last year, but I thought it deserved to be on this year's list, too.  Milk sharing through the internet has grown dramatically, with the organization Human Milk 4 Human Babies now engaging over 20,000 members in 52 countries.

Mothering Magazine shuts down print publication.  The only magazine I know of that put breastfeeding at the top of its agenda shut down as a print publication this year.  For years, Mothering Magazine was the safe, supportive corner of the media universe for nursing mothers.  While mothering.com is still up and offering content on breastfeeding, birth, and other parenting issues, it's just not the same as receiving the magazine in the mail, or seeing it on the news stand.  

So, all in all, a great year for breastfeeding, wouldn't you say?

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2011 in breastfeeding research. And there was a lot of it!

There was a lot of breastfeeding research to report in 2011.  My summary is below.  You can see past annual research summaries for past here:  2009, 2008, 2007, 2006

Studies on babies:

Researchers in Denmark found an association between breastfeeding and lowered risk of epilepsy. The longer babies were breastfed, the greater the protection, and exclusive breastfeeding was also associated with increased protection.

A meta-analysis on SIDS and breastfeeding found that the rate of SIDS was 60 percent lower among infants who had any amount of breastfeeding compared to those who were not breastfed and more than 70 percent lower in infants that been breastfed exclusively for any period of time.

A study published in Pediatrics found that breastfeeding was associated with higher academic achievement in boys, but not girls.  The authors found that predominant breastfeeding for six months or longer was associated with increased math, reading, writing, and spelling scores for boys.

Another breastfeeding/intelligence study found that longer duration of breastfeeding, as well as higher levels of long chain fatty acids in breastmilk (colostrum), were associated with higher mental and psychomotor development at 14 months.

A study found that your children of mothers who had gestational diabetes are less likely to become obese if they are breastfed.

A study in the Journal of Nutrition found that babies who were breastfed had greater leg strength as adolescents. 

Another study found that breastfeeding protects against asthma.

Ear infections are on a steep decline, and increasing breastfeeding rates could be one of the reasons why.

Breastfeeding associated with stronger cardiovascular health at age five.  Strangely, breastfeeding for less than three months or more than six months showed no effect.

Breastfeeding appears to program infants' metabolism.  Breastfed infants in this study had a distinct growth pattern and metabolic profile than formula fed infants.  These differences faded by age three, though blood pressure remained lower in breastfed children.

Breastfeeding is associated with fewer behavioral problems at age five.  They're less likely, according to this study, to lie, steal, be anxious, or hyperactive.

Breastfed children scored higher on math and reading assessments at ages 5, 7, 11, and 14.  Interestingly, breastfeeding for as little as four weeks seemed to have an effect.

Studies on breastfeeding itself:

Two studies (here and here) found that receiving IV fluid during labor can inflate a babies' birth weights, making it appear that they are losing an excessive amount of weight in the first few days, as they shed this fluid. 

A randomized, blinded, controlled study on tongue tie found that fretonomy (clipping the frenulum) decreases nipple pain.  The researchers had intended to determine if it also increases the duration of breastfeeding, but nearly all of the mothers in the "no-clipping" group ended up chosing to have the procedure done, so they couldn't compare!

The U.K. showed a big jump in breastfeeding rates.  One of you suggested that this may have to do with increases in immigration from countries where breastfeeding rates are higher.  Demographics as destiny, again!

Six months of exclusive breastfeeding is just fine for babies, another study found.  This study found that milk supplies were perfectly adequate - in fact, higher than the literature previously reported - and that when moms are well supported, babies gain just fine.

Formula discharge bags are on the decline, a study found.  The percentage of hospitals refusing to distribute the bags in 10 surveyed states doubled (from 14% to 28%) between 2007 and 2010.

A study in Pediatrics found that babies who are fussier get solids earlier than babies who are not.  Babies who were viewed as fussy by their mothers were almost twice as likely to get solids.  In the sample of mothers in the WIC program in North Carolina, "nearly 20 percent of 1-month-olds were fed solid foods or juice. By three months, 70 percent of the children were eating something in addition to milk or formula."

A study from St. Jude's Children's Hospital concludes that childhood cancer survivors should be advised to breastfeed because it breastfeeding has “the potential to influence positively bone mineral density, metabolic syndrome risk factors, cardiovascular disease and secondary tumors - conditions negatively affected by childhood cancer.”

Studies on mothers:

A study from the American Society of Plastic Surgeons found that mothers who have had breast implant surgery and who believe that breastfeeding will cause their breasts to sag are far less likely to succeed with breastfeeding than those who don't hold this belief.  The authors note that "although breasts sag more with each pregnancy, breast-feeding doesn't seem to worsen these effects in women with or without breast implants."

In the first study to show differences in brain activity among moms feeding formula or breastmilk, a study found that breastfeeding mothers showed greater responses to their infant's cry in brain regions related to caregiving behavior and empathy than mothers who relied upon formula as the baby's main food source.

A study found that breastfeeding problems are associated with postpartum depression.  Of note, research has also shown that breastfeeding - when it's going well - is protective against postpartum depression.

Longer breastfeeding duration is associated with higher levels of ghrelin and pancreatic peptide YY at three years postpartum.  This is protective against metabolic syndrome.  This research adds to Dr. Alison's Steube's work drawing connections between breastfeeding and lowered risk of heart disease and metabolic syndrome. 

Few babies in childcare receive pumped milk.  The study pointed to lack of overnight storage of breastmilk as one factor.  They did find a high rate of comfort with the idea among the providers surveyed.

A study found that breastfeeding does not protect mothers against multiple sclerosis relapse.  I found this really disappointing, as prior research had been suggesting the opposite.

Low levels of oxytocin in late pregnancy is linked to higher risk for postpartum depression.  Oxytocin is a key hormone of lactation, so it's not a huge leap to suggest that this is one reason why breastfeeding lowers the risk of postpartum depression.

In a novel set of studies, nursing mothers were viewed as less competent and less likely to be hired than other women.

A study found that mothers who have longer maternity leave initiate breastfeeding at higher rates, and breastfeed longer.

And, finally, a few eyebrow-raising studies:

A study showed that nursing mothers do have a "mama bear" instinct while breastfeeding (see picture of bear in my yard!)

Birds can "lactate," too.  The study analyzed the genes and proteins of the "milk" of pigeons, flamingoes, and male emperor penguins, produce a "milk" with antibodies and fats which serve the same function as mammalian colostrum. These three species are the only ones known to produce this "milk."

An analysis showed that the longer a species nurses its young, the larger brains they have. 

Stem cells in breastmilk can be "programmed" into other cell types. 

The researchers who discovered HAMLET (Human Alphalactalbumin Made Lethal to Tumors) have succeeded in mapping how it kills tumor cells.  HAMLET has been shown to kill over 40 different types of cancer cells, including tumors in the lungs, kidneys, prostate, ovaries and bowel.  The Lund group believes that the protein complex is not formed until the milk is in the baby’s stomach.

A study of 18th and 19th century bones demonstrated the value of breastfeeding in protecting infants.

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Favorite posts from 2011

In case you missed them, here are some of my favorite posts from the Motherwear Breastfeeding Blog in 2011:

A visit to the Mother's Milk Bank of San Jose

"There is no nutritional emergency"

What's in donor milk?

First baby wearing second baby

What did your cankles have to do with your baby's weight loss?

"Booby Traps" in your OB or midwife's office

Breastfeeding and race:  Why we need more lactation consultants of color

Can you "supplement" your baby with Vitamin D by increasing your own levels?

Can you guess which role I had in the Passover play?

Six misconceptions about extended breastfeeding

Cows engineered to produce "human milk," and why Bessie will never, ever replace you

Lactation after Loss: A brochure to support mothers experiencing perinatal loss

Seven reasons why breastfeeding is usually easier the second time around

When the Booby Fairy doesn't arrive:  New podcast on insufficient glandular tissue.

New podcast on Baby-Led Weaning:  Can you really skip the purees? 

How do other mammals nurse?

Joint Commission urges moms to "speak up" to get evidence-based care.  But isn't that their job?

Review and give away:  Breastmilk jewelry

Wikileaks shows U.S. Embassy lobbied against Philippines formula law

Breastfeeding, the second time around

Here's how I know that it can hurt to nurse when you're teething

I can nurse, too

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New post on cultural issues in the hospital, at Best for Babes

I have a new post up at Best for Babes which I want to point you to. 

It's about how cultural differences can be overlooked in the hospital setting, and the impact that has on breastfeeding.  It's a topic I love thinking and learning about.

It starts with a story about a mistake I made a few years ago.  Check it out!

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Breastmilk study paper published

If you've been reading this blog for a while you may know that in recent years I've had the privelege to be involved with a research project at the University of Massachusetts which uses breastmilk to study breast cancer.

I'm very pleased to report that the first paper to come out of one of these studies has recently been published.  The results, which were announced to great press attention earlier this year.

I was just explaining this research to a friend of mine, and I thought I should do the same here, especially because the paper is pretty technical.

Dr. Kathleen Arcaro (at right, visiting one of my breastfeeding groups) studies breast cells for evidence of DNA changes which might be associated with the development of breast cancer.  She gets breastmilk samples (that's where I come in), extracts the breast cells which are naturally present in the milk, extracts the DNA from those cells, and looks for "methylation" of specific genes.  She's looking for methyl groups which attach to some important genes, such as tumor suppressor genes which, as the name suggests, inhibit the growth of tumors.  That's a gene you want functioning, right? Well these methyl groups can "turn off" the functioning of those genes, increasing your risk of developing cancer.  Your DNA can get methylated through behaviors - smoking, poor diet, environmental exposure, for example.  So Kathleen is looking for

Why would we want to know about this?  Because 1) it's possible to reverse methylation, through behavior changes and through emerging drug therapies, and consequently reduce cancer risk, 2) anti-methylating drugs may be able to reverse the course of cancer someday, 3) because this research could yield a method of giving mothers a personalized assessment of their risk of breast cancer, just by analyzing a sample of their breastmilk, and 4) because one day mothers might be able to send a milk sample for analysis in lieu of having a biopsy (and being told, as they often are, to wean first).

The beauty of this research (or one, I should say), is that when you look at breast cells in breastmilk you get cells from all parts of the breast.  The alternative, a biopsy, can only look at cells in one part of the breast.

We're recruiting for several studies locally now, so if you're in Western Massachusetts, check out this page to donate!

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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!

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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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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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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Formula companies and WIC: An investigative report

A new article, published on the Women's E-News site, reports on the relationship between the WIC program and formula companies.  It was written in partnership with The Investigative Fund at The Nation Institute.

The article, titled "Infant Formula Companies Milk U.S. Food Program," looks in particular at the 2010 fight (which I wrote about here) regarding a proposed provision of the WIC reauthorization bill. 

If you want to know more about the relationship between the nation's largest purchaser of formula - you, the taxpayer, through the WIC program - and formula company influence in Washington, I'd recommend this detailed and current article.

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