This is copied from Motherwear Breastfeeding Blog, please go here to read rest of articles and her many other great articles.

The top ten breastfeeding stories of 2010

Another year is ending (my fourth writing this blog!) and it’s time to summarize the big events in the breastfeeding world this year.  If I’ve forgotten something please leave a comment letting me know!

If you’re feeling nostalgic, here are my summaries from 2009, 2008, 2007 and 2006.

Health care reform gives most moms workplace lactation accommodation – A little noticed provision of the gigantic federal health care reform law gave most mothers the right to pump in their workplace and the space to do it.  It will take a while for employers to catch up with this requirement, but it was a huge step forward.  Another provision requires private insurers to pay for breastfeeding support in some cases, though it’s not clear how this will be implemented.  The IRS wasn’t quite as friendly, denying flexible spending account holders from using their tax sheltered funds to pay for breastpumps.

Eats on Feets enables mother-to-mother milk sharing through Facebook.  Sparking lots of discussion – from cheers of support to an FDA warning – a network called Eats on Feets began spreading across Facebook, enabling moms to connect and share milk.

CDC supports the WHO growth charts.  The CDC and the AAP voiced its support for the WHO growth charts which are based on the norm of the exclusively breastfed baby.  As pediatricians begin adopting the charts, fewer exclusively breastfed babies should be seen as faltering in growth after the 3rd or 4th month.

Study shows increasing breastfeeding rates could save $13 billion, save 900 lives annually – A analysis co-authored by Dr. Melissa Bartick found that increasing breastfeeding initiation and exclusivity rates could save the U.S. billions and save nearly a thousand lives annually.  Unrelated but important

Michelle Obama became a champion of breastfeeding, noting that it is an important piece of the fight against childhood obesity, and that disparities persist between African American and other moms.

Study shows medication can halt 99% of mother-to-child HIV transmission in developing world.  Mother-to-child transmission of HIV through breastfeeding is a major cause of new infections in the developing world, and research from Botswana showed that use of antiretroviral drugs can prevent over 99% of these infections.

Formula company sells human milk product – This one might not seem that significant, but it certainly raised a lot of eyebrows.  Prolacta, maker of a human milk fortifier for preterm infants that is actually made with human milk, announced that its fortifier would be sold by Abbot Nutrition.

Medication and breastfeeding information now free to all – The Infant Risk Center began providing information on medications and breastfeeding previously available only to those who owned a copy of Medications and Mothers Milk.

Breastmilk donations for Haiti – There was a lot of confusion over the donation of breastmilk to Haiti following the country’s disastrous earthquake.  First there was a call for donations, and then a call to stop sending donations.  Either way, it did focus our attention on the importance of breastfeeding in emergencies.

Formula company launches a ‘feeding expert hotline,’ and test calls suggest that some of the advice it was dispensing was dangerous to breastfeeding.  Their ads on Babble also caused a stir.

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USBC members and state coalitions:

The Department of Labor (DOL) has published a Request for Information (RFI) about the nursing mothers law in the Federal Register. The RFI contains the Department’s preliminary interpretations of the law and seeks public comment over a 60 day comment period (deadline is February 22, 2011).

Link to RFI: http://edocket.access.gpo.gov/2010/pdf/2010-31959.pdf

A USBC task force is forming now to review the RFI and prepare our comments, and we are also working with other partners on new ways to get the word out. We intend to publish USBC comments early enough so that others may use them as a template, if desired.

The DOL has also established a new webpage that contains basic information about the law and includes additional resources (such as a link to the USBC website): www.dol.gov/whd/nursingmothers. USBC’s website FAQ page is also undergoing revision as we speak.

Other related news/links:

Obama Memo to Office of Personnel Management:

http://www.whitehouse.gov/the-press-office/2010/12/20/presidential-memorandum-delegation-certain-functions-and-authorities

Fact Sheet on “Obama Administration Actions to Support Women Who Choose to Breastfeed”:

http://www.whitehouse.gov/sites/default/files/rss_viewer/Breastfeeding_factsheet.pdf

White House Blog on “New Efforts to Support Working Mothers”:

http://www.whitehouse.gov/blog/2010/12/20/new-efforts-support-working-mothers

It has been eventful week (and year) for breastfeeding! We wish you the best for the holiday season, and look forward to continued collaboration in the new year.

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December 14, 2010

The Accreditation and Approval Review Committee (AARC) on Education in Human Lactation and Breastfeeding is one step closer to launching accreditation services! One stage in the process is to have public review and comment on their Standards and Guidelines. The document has been submitted to the Standards Committee of the Commission on Accreditation of Allied Health Education Programs (CAAHEP) for their review. It will be available on the AARC website at www.aarclactation.org from December 15, 2010 to January 15, 2011. Please visit the AARC website during that time to review AARC’s Standards and Guidelines and to submit your comments.

After this period of public comment and review, the final AARC Standards and Guidelines will be submitted to CAAHEP for review at their April, 2011 board meeting. CAAHEP’s approval of the document will open the door for AARC finalizing the remaining steps that will lead toward the launch of accreditation.

Allow me to take this opportunity to also invite any course directors interested in academic accreditation to please email info@aarclactation.org so that we may keep you updated on progress over the ensuing months.

Sincerely,

Cheryl Benn, IBCLC
AARC Chair

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A mountain of medical evidence shows that breast milk provides significant health benefits to both mother and child.

Tell the IRS they should follow medical opinion, not overturn it!

Take Action

Dear Fawn,

When my son was a baby, my breast pump was such a fixture in our house that my husband and I started to think it was talking to us. As the engine hummed, he swore the pump said, “More milk!” and I conveniently heard it whisper, “Cookies, cookies!”  Despite my love/hate relationship with that pump, I was grateful that it gave me the opportunity to follow my pediatrician’s advice and continue to feed my son breast milk while I was at work.

So imagine my (and millions of other mothers’) dismay upon learning that the Internal Revenue Service – yes, the tax folks! – had determined that “breast-feeding does not have enough health benefits to qualify as a form of medical care” and, as a result, will not allow breast pumps and supplies to be purchased using funds in pre-tax medical savings accounts.[1]

This decision completely defies logic!  Particularly since every major medical authority, including the American Academy of Pediatrics, recommends breastfeeding exclusively for the first six months and support for breastfeeding for the first year and beyond.[2]  These recommendations are based on the overwhelming evidence that it provides health benefits to both mother and child. And the Food and Drug Administration already considers breast pumps medical devices and regulates them as such.[3]

Time to re-think this one, IRS!  Add your name to our petition calling on the IRS to reverse their decision on breast pumps now: http://action.momsrising.org/go/530?akid=2437.1697377.B9FjH6&t=3

Your signatures on our petition will let the IRS know that the public rejects their conclusion that breast milk is not a significant health benefit.  And our grassroots muscle will provide critical back-up to the efforts of Senator Jeff Merkley (OR), Congresswoman Carolyn Maloney (NY), and 41 other Members of Congress as they appeal to the IRS to reverse this decision.[4]

The medical evidence that breastfeeding is good for children’s health is overwhelming and pretty easy to find.  Researchers have found that breastfeeding is beneficial for both mother and child.  Children who are breastfed have decreased risk of infections, diarrhea, sudden infant death syndrome, obesity, type 1 and 2 diabetes, asthma, and childhood leukemia. Women who breastfeed have a reduced risk of breast cancer, ovarian cancer, type 2 diabetes, and postpartum depression.[5]

Not only did the IRS seem to ignore the mountain of evidence about the benefits of breastfeeding, they also appear to hold other products to a much lower standard! Currently, the IRS allows products such as acne cream and denture adhesives to qualify for tax breaks.[6]

Sign our petition reminding the IRS to leave medicine to the experts! http://action.momsrising.org/go/530?akid=2437.1697377.B9FjH6&t=6

Together, we are a powerful voice for women, children, and families.

– Ashley and the whole MomsRising Team

P.S. Check out MomsRising’s “Breastfeeding & Work” resource page: http://action.momsrising.org/go/531?akid=2437.1697377.B9FjH6&t=7 This page includes information about new protections for nursing moms at work, resources to share with your employer, and more.

P.P.S. For more analysis (and venting!) about this IRS ruling, check out Michelle Brandt’s fabulous blog, “Really, IRS?”:http://action.momsrising.org/go/532?akid=2437.1697377.B9FjH6&t=9

CITATIONS

[1] New York Times, “Acne Cream? Tax-Sheltered. Breast pump? No.”

[2] American Academy of Pediatrics (AAP), Breastfeeding Recommendations

[3] Food and Drug Administration, Breast Pump Information Page

[4] Congressional Letter to IRS Commissioner, November 23, 2010

[5] Agency for Healthcare Research and Quality, Breastfeeding: Maternal & Infant Health Outcomes

[6] New York Times, “Acne Cream? Tax-Sheltered. Breast pump? No.”

Like what we’re doing? Donate: We’re a bootstrap, low overhead, mom run organization. Your donations make the work of MomsRising.org possible–and we deeply appreciate your support. Every little bit counts.

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Mother’s milk and safe milk sharing:
Health Canada’s advisory lacks scientific basis

December 7, 2010

The recent media focus on the mothers’ movement Eats on Feets has resulted in a Health Canada advisory warning mothers against the use of another mother’s milk unless it comes from a donor milk bank.

Health Canada’s advisory raises some important questions about the lack of scientific basis for their claims regarding the “risks” of human milk sharing.

The Health Canada advisory flies in the face of the recommendations by both UNICEF and the World Health Organization, that when a mother is unable to provide her own breastmilk, the milk of another mother is safer than the use of an infant formula. These principles are outlined in the World Health Organization and UNICEF Global Strategy on Infant and Young Child Feeding and the Baby-Friendly Initiative. Although these initiatives were endorsed by Health Canada, why are these important principles now deemed “risky”?

Health Canada claims

There is a potential risk that the milk may be contaminated with viruses such as HIV or bacteria which can cause food poisoning, such as Staphylococcus aureus. In addition, traces of substances such as prescription and non-prescription drugs can be transmitted through human milk. Improper hygiene when extracting the milk, as well as improper storage and handling, could also cause the milk to spoil or be contaminated with bacteria and/or viruses that may cause illness.

When mothers need a breastmilk replacement how does Health Canada consider the use of commercial infant formula products to be safer that the use of peer-to-peer informed milk sharing?

INFACT Canada is concerned that the Health Canada warning will dissuade mothers from providing human milk for their infants and encourage the use of commercial infant formula. The other alternative when mothers need a replacement for their own milk is the use of commercially produced infant formula. The risks associated with the use of infant formula products have been well documented. Mothers aware of these risks do not wish to expose their infants to such risks. These include increased prevalence of a range of infectious diseases and health conditions – ear infections, gastrointestinal infections respiratory infections, necrotizing enterocolitis, sepsis, meningitis, diabetes, childhood cancers, obesity, allergies – formula fed infants grow and develop differently from breastmilk fed infants, including cognitive and neural development.

While implying that formula is a preferable alternative to shared human milk, Health Canada fails to inform mothers that the risk of contamination by lethal and dangerous bacteria may exist in all powdered infant formula currently marketed in Canada. Has Health Canada warned parents that tins of powdered infant formula are not sterile and may contain Enterobacter sakazakii, a virulent and highly pathogenic contaminant that can lead to serious infections causing meningitis, necrotizing enterocolitis, sepsis and even death? Has Health Canada mandated that infant formula labels have warnings about the lack of sterility and that products must be carefully reconstituted at 70 degrees C to destroy the lethal Enterobacter sakazakii as recommended by the World Health Organization?

Additionally the Health Canada warning does not address the presence of the bacterium Salmonella species, a major cause for gastrointestinal infections, present in powdered infant formula. Should parents not be informed of the rather frequent recalls of infant formula products – the most recent for the presence of beetle parts in the formula? Furthermore there are many industrial contaminants found in infant formula such as heavy metals, plasticizers, including the plastic BPS present in concentrated formula.

Infant formula does not have the immunological constituents to alleviate against the risk of the built-in microbiological contaminants and the bacterial and viral contaminants related to formula preparation, handling, storage and feeding.

Health Canada’s advisory does not provide mothers with the information needed about the safe peer-to-peer informed sharing of milk. Nor does Health Canada provide access for mothers to the donor milk from milk banks that it deems safe and acceptable.

Currently there is only one milk bank in Canada at the BC Women’s Hospital and Health Centre in Vancouver. Donor milk from the BC Milk Bank has very limited access and is available on prescription only for high needs infants.

Although Health Canada’s policy statements recommend that infants be exclusively breastfed for the first six months of life and sustained breastfeeding to two years and beyond, adequate support systems need to be in place for mothers to achieve optimal breastfeeding practices. Mothers need to be able to access supplementary human milk for their infants for the full recommended time that infants and young children require human milk for optimal health, growth and development. A variety of social, cultural, health or economic reasons may necessitate that mothers have access to human milk in order to achieve this.

Mothers who wish to provide only human milk for their infants have no other means to access human milk than to establish their own method of safe milk sharing. Eats on Feets is a community-based movement of mothers meeting the needs of their infants based on a health screened and informed decision making process. Importantly many women have more than enough milk and have a deep desire to share with mothers and infants needing their milk.

Conclusions

Assessing and analyzing the risks (see ANNEX) of peer-to-peer informed milk sharing demonstrates the risks to be negligible. Peer-to-peer informed milk sharing is by far the safer means to provide replacement feeding when mothers own milk is unavailable.

However the risks of feeding infant formula to infants are well documented. Many mothers do not wish to expose their infants to the increased risks of infectious diseases, chronic diseases and growth and development anomalies, which have lifelong implications.

INFACT Canada urges Health Canada to provide guidelines to address the need for mothers who wish to donate their life giving milk to mothers who know this to be critically important for the health and well-being of their infants. Health Canada must recognize that informed milk sharing is not “dangerous” and must recognize that the alternative of using infant formula comes with a long list of documented negative consequences.

INFACT Canada urges Health Canada to facilitate a milk banking system across Canada that will provide full access for all mothers who wish to donate their milk and to mothers who need to make use of donated milk beyond the current limited “on prescription only.”

INFACT Canada urges Health Canada to establish centres where mothers can go to have their milk screened so they can feel comfortable and confident sharing their milk. As well Health Canada should review the capacity of blood banks to also screen human milk.

INFACT Canada urges Health Canada to provide the necessary funding and programme leadership to improve support systems for the establishment of lactation in the early weeks and months to help mothers overcome difficulties they may encounter.

Mothers need effective support systems to achieve the Health Canada recommendations for exclusive and sustained breastfeeding to ensure the highest attainable standard of health for their children. We will all benefit.

Elisabeth Sterken, MSc, RD
Executive Director
INFACT Canada
esterken@infactcanada.ca

With thanks to:
Jennifer Abbass Dick RN, BNSc, MN, PhD student, IBCLC, RLC
Linda Smith, BSE, FACCE, IBCLC, FILCA for their helpful comments.

ANNEX

It is important to compare the perceived risks and dangers of peer-to-peers informed milk sharing to the risks of providing infant formula as a replacement for a mothers own milk.

Peer-to-peer informed milk sharing

Viral and microbiological risks

• Mothers are screened and share their health data.
• The numbers of Canadian women of child bearing age who are HIV+ are few.
• The probability of an HIV+ mother, who has given birth, breastfeeds and donates her milk, is highly improbable. Moreover HIV+ mothers receive anti-retro-virals which significantly reduce the viral count.
• Human milk contains a multitude of complex antiviral and immune substances demonstrated to inactivate viruses such as HIV and reduce microbiological contaminants.
• Providing human milk exclusively is the best protection against viral and bacterial contaminants passing via the infant gut. Human milk provides a protective layer in the infant gut. It is in fact the introduction of infant formula into the infant gut that creates the risk of transmission. Mixed feeding of formula and human milk has been shown to be the greatest risk for viral transmission. The cow’s milk proteins in infant formula are a cause of gut damage providing a passage for viral (HIV, hepatitis B and C, HTLV 1 and 2, syphilus) and bacterial contaminants.
• Mothers can flash pasteurize donated milk to ensure that there are no viral or bacterial contaminants.(ref: Israel-Ballard K, Donovan R, Chantry C, Coutsoudis A, Sheppard H, Sibeko L, Abrams B. (2007). Flash-heat inactivation of HIV-1 in human milk: a potential method to reduce postnatal transmission in developing countries. J Acquir Immun Defic Syndr. 45: 318-23.)

Passage of prescription and non prescription drugs

• Eats on Feets screens mothers for prescription and non prescription substances.
• There are very few drugs that are contra-indicated during lactation. Most drugs do not enter her milk.
• If a mother is breastfeeding her own child she will be aware of any contra-indicated substances. If her milk is safe for her own child it will be safe for the child she is donating her milk to.

Improper hygiene, storage and handling

• Human milk is the most effective and efficient protection against microbial contaminants. It contains, IgA, IgM, IgG, IgE, IgD factors, lactoferrins, lysozymes, oligosaccharides, immunoglobulins, interferon, mucins, bifidus factors, to name a few and many as yet undiscovered factors. It takes a lot to “spoil” human milk.
• Mothers are aware of the normal principles of hygiene, storage and handling.

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FOR IMMEDIATE RELEASE
CONTACT: Megan Renner, 301-807-4963 (cell), mrenner@usbreastfeeding.org
Healthy People 2020 Objectives Combat the Barriers to Breastfeeding:
USBC Publishes New Resource to Address Hospital Barriers
Washington, DC–Social and environmental support for breastfeeding has been brought to the forefront of our nation’s public health priorities with the launch of the Healthy People 2020 (HP2020) agenda by the U.S. Department of Health and Human Services.

HP2020 objectives will continue to track national breastfeeding rates, but new objectives will also address recognized barriers to breastfeeding success. New targets will focus attention on worksite support and maternity care practices: areas that often present obstacles for breastfeeding mothers.
HP2020 has raised existing targets for breastfeeding initiation, duration, and exclusivity, reflecting our nation’s ongoing commitment to the medical recommendation of six months of exclusive breastfeeding followed by continued breastfeeding for the first year of life and beyond. According to the most recent data from the Centers for Disease Control and Prevention (CDC), 75% of new mothers initiate breastfeeding, but only 13% of infants are breastfed exclusively for six months, while 22% continue some breastfeeding to one year. HP2020 targets aim to increase these rates to 81.9% initiating breastfeeding, 23.7% breastfeeding exclusively through six months, and 34.1% continuing at one year.
The new objectives will take on some of the most challenging barriers to breastfeeding success faced by U.S. mothers. One goal addresses worksite lactation support programs, a topic that has received much recent attention with the passage of the workplace breastfeeding support provision in the Patient Protection and Affordable Care Act. Women now comprise half of the American workforce, with nearly four out of ten women serving as the primary breadwinner in their families. Returning to work can be a major hurdle for new mothers struggling to balance working and breastfeeding: in 2009, only 25% of employers reported providing an on-site lactation/mother’s room, according to the Society for Human Resource Management (SHRM).
Two new objectives address maternity care practices, including a target to reduce formula supplementation within the first two days of life. The CDC reports that 25.4% of breastfed infants receive formula before two days of age, despite medical recommendations against routine supplementation with formula, glucose water, or water. Early supplementation decreases a mother’s milk production and can lead to negative health outcomes for the infant.
Another new goal aims for 8.1% of live births to occur in facilities that provide recommended breastfeeding care. Currently less than 4% of U.S. births occur in facilities that have earned the Baby Friendly designation, meeting standards set by UNICEF and the World Health Organization to provide an optimal level of breastfeeding care.
The CDC’s 2007 Maternity Practices in Infant Nutrition and Care (mPINC) survey of all birth facilities in the U.S. showed that the average score was only 65 out of 100. The United States Breastfeeding Committee (USBC) has just published a new resource for maternity facilities choosing The Joint Commission’s new Perinatal Care Core Measure Set. This toolkit will also be invaluable for facilities striving to improve mPINC scores: Part 1 is designed to aid in accurate collection of data on exclusive breastfeeding, while Part 2 focuses on improving adherence to evidence-based best practices.
USBC Chair Robin W. Stanton, MA, RD, LD, applauds the focus in HP2020 on increasing awareness of the social and environmental determinants of health. “In order to reach their own infant feeding goals, mothers need focused support from health care providers, employers, families, and communities,” says Stanton. “The federal recognition of this need marks an important step for breastfeeding advocacy to ensure that all mothers are empowered to succeed.”
For more information on Healthy People 2020, visit www.healthypeople.gov. USBC publications, including an analysis of the barriers to exclusive breastfeeding, can be downloaded from USBC’s Publications page. To locate health care providers and knowledgeable breastfeeding support personnel that can offer assistance and answer questions about breastfeeding, visit USBC’s FAQ page.
USBC is an organization of organizations. Opinions expressed by USBC are not necessarily the position of all member organizations and opinions expressed by USBC member organization representatives are not necessarily the position of USBC.
The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of more than 40 nationally influential professional, educational, and governmental organizations. Representing over a million concerned professionals and the families they serve, USBC and its member organizations share a common mission to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding. For more information about USBC, visit www.usbreastfeeding.org.

United States Breastfeeding Committee

2025 M Street, NW, Suite 800
Washington, DC 20036
Phone: 202/367-1132
Fax: 202/367-2132
E-mail: office@usbreastfeeding.org

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