Breastfeeding Medicine

Physicians blogging about breastfeeding

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The well-being of mothers and children is not a tradeable commodity

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Breastfeeding is the foundation of public health and economic development. All major medical organizations recommend 6 months of exclusive breastfeeding, followed by continued breastfeeding through the first one to two years of life and beyond.

Evidence continues to mount that disrupting optimal breastfeeding contributes to disease burden and premature death for women and children. Globally, optimal breastfeeding would prevent 823,000 child deaths each year. In the US, enabling optimal breastfeeding would prevent 721 child deaths and 2619 maternal deaths each year, as well as 600,000 ear infections, 2.6 million gastrointestinal illnesses, 5,000 cases of maternal breast cancer and more than 8,000 heart attacks.

Optimal infant feeding is also essential for economic development. Being breastfed is associated with a 3 to 4 point increase in IQ, leading to better school performance and workplace productivity. As stated by the World Bank’s Keith Hansen, “If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.”

Breastfeeding is vital and essential to protect the world’s children, the most vulnerable who cannot speak for themselves.  Given the essential role of breastfeeding in global health and wellbeing, it is imperative that every nation supports policies and programs that enable women and children to breastfeed. It is therefore deeply troubling that the United States delegation to the World Health Assembly actively undermined efforts to enable optimal breastfeeding, as reported by the New York Times. Read the rest of this entry »

Written by bfmed

July 12, 2018 at 6:43 am

Separation of children and infants from parents – breastfeeding implications

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June 21, 2018 – The Academy of Breastfeeding Medicine, an international physician’s organization, condemns policies that result in the separation of parents from their children.

As the UN High Commissioner of Human Rights has established, “Children have the right to life, survival and development and to the highest attainable standard of health, of which breastfeeding must be considered an integral component.” Mothers similarly have the right to nurture their children: “Restriction of women’s autonomy in making decisions about their own lives leads to violation of women’s rights to health and, infringes women’s dignity and bodily integrity.”

“Separating children from their parents results in toxic stress that impacts breastfeeding and health for a lifetime,” said Timothy Tobolic MD, President of the Academy of Breastfeeding Medicine. “Furthermore, separating a mother from her breastfeeding child violates the human rights of both mother and child.”

Separation of the breastfeeding mother-baby pair further confers risk of acute illness for mother and child. Breastfeeding women who are separated from their infants and unable to drain their breasts will become engorged and are at risk for mastitis and breast abscesses. Unrelieved engorgement will precipitate involution and loss of milk supply.

Infants who are not breastfed face increased risks of ear infections, gastroenteritis and pneumonia. Separation of any infant from their mother also has untold emotional harms on those children. These risks are magnified if they are housed in facilities where proper preparation of formula or washing bottles and teats is not available.

Indeed, in emergency settings, such as refugee camps for migrant populations fleeing oppression, the first principal of the 2017 Operational Guidance for Infant and Young Child Feeding in Emergencies is the protection, promotion and support of breastfeeding. Separating a mother from her breastfed child violates this first principal.

ABM recommends reuniting infants and children with there parents without delay. When mother and child are reunited, the Academy of Breastfeeding Medicine and IYCFE guidelines recommend individual-level assessment by a qualified health or nutrition professional trained in breastfeeding and infant feeding issues. The mother-child pair will need sustained support to reestablish lactation, with access to an appropriate breast milk substitute until the mother’s milk supply is reestablished or until at least six months of age and beyond.

“We agree with President Trump’s executive order to stop the separation of infants and children from their parents.” said Dr. Tobolic. “Families belong together and breastfeeding must be supported for the health of the children.”

Written by bfmed

June 21, 2018 at 1:31 pm

Posted in Uncategorized

The Academy of Breastfeeding Medicine Issues Guidance on Informal Milk Sharing for Healthy Term Infants

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New Rochelle, NY, January 8, 2018—In response to the increasing informal sharing of human milk, the Academy of Breastfeeding Medicine (ABM) has published guidelines to minimize the risk of this practice while enhancing the health benefits. The position statement is published in Breastfeeding Medicine, the official journal of the Academy of Breastfeeding Medicine published by Mary Ann Liebert, Inc., publishers. The article is available free on the Breastfeeding Medicine website until February 8, 2018.

Academy of Breastfeeding Medicine’s 2017 Position Statement on Informal Breast Milk Sharing for the Term Healthy Infant ” discusses strategies to maximize the safety of community-based breast milk sharing, including 1) medical screening of the donor and 2) safe milk handling practices. Donors should have no medical illness where breastfeeding is contraindicated nor on any medication that is incompatible with breastfeeding. Mothers can further reduce the risk of infections by performing home pasteurization of donated milk prior to giving it to her infant; however, pasteurization can decrease some of the beneficial components of human milk. ABM also emphasizes that while informal milk sharing has potential health benefit, “internet-based milk sharing is not recommended under any circumstances.”

“Informal breast milk sharing is becoming increasingly common for healthy term infants as 21st century families desire to feed their infants human milk,” says Dr. Timothy Tobolic, president of ABM. “Physicians and other health care providers can help mothers and families evaluate the risks and benefits of informal milk sharing.”

Written by bfmed

January 8, 2018 at 6:23 pm

ABM Ethics Committee Formal Grievance Review is Ongoing

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November 9, 2017 – The Academy of Breastfeeding Medicine has a formal process in place to address any member grievances, including potential conflict of interests. These routine procedures are outlined in our bylaws and our Code of Ethics. Both documents are available to all with no restricted access at www.bfmed.org.

Last week, the grievance review process was activated. Today, the Board of Directors discussed this ongoing matter in person at the regularly scheduled board meeting.

The Ethics Committee is actively reviewing ABM’s Conflict of Interest policies. The results of this policy review and any recommendations will be shared with membership following the January meeting of Board.

 

 

Written by bfmed

November 9, 2017 at 7:45 pm

Posted in ethics, Uncategorized

CDC issues guidelines on breastfeeding and Ebola

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Both families and physicians are anxious about the potential impact of the Ebola virus for mothers and infants.

The CDC has recently issued guidelines for field and partner organizations regarding how to advise breastfeeding women with probably or confirmed Ebola infection:

“When safe alternatives to breastfeeding and infant care exist, mothers with probable or confirmed Ebola virus disease should not have close contact with their infants (including breastfeeding).

In resource-limited settings, non-breastfed infants are at increased risk of death from starvation and other infectious diseases. These risks must be carefully weighed against the risk of Ebola virus disease.”

The Ebola virus has been detected in the milk of infected women. For mothers who recover from Ebola, it is not known when it is safe to resume breastfeeding. The CDC recommends waiting to resume breastfeeding until milk can be shown to be Ebola-free in laboratory testing.

As the Ebola outbreak continues to evolve, the Academy of Breastfeeding Medicine recommends consulting CDC guidance on how to minimize risk for infants of affected mothers.

Written by bfmed

October 30, 2014 at 7:26 am

ABM Gold Member Profile: Touraj Shafai, MD, PhD, FAAP, FABM

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ABM: Why did you become a member of ABM?

Medical Director, Inland Empire Children's Medical Group and BF Clinic

Touraj Shafai, MD, PhD, FAAP, FABM Medical Director, Inland Empire Children’s Medical Group and BF Clinic

Shafai: To improve my knowledge about benefits of breastfeeding to both mother and baby and to society.

ABM: What is ABM‘s greatest strength?

ShafaiAs an organization ABM has the greatest collection of knowledge than any other organization.

ABM: What inspires you to promote, protect and support breastfeeding?

Shafai:  To educate moms regarding the benefits of breastfeeding so our newborns can achieve their fullest potential.

ABM: What advice can you offer to physicians who are interested in learning more about breastfeeding?

Shafai: To become a member of the ABM and attend the Annual Meetings of the Academy.

ABM: What accomplishment are you most proud of in your career?

Shafai: To receive a PhD in biochemistry following my MD degree which provided me with critical thinking and gave me the tools in research and improving patient care.

ABM: What is a current challenge for you in your work?

Shafai: To get rid of some of the hospital policies such as the old hypoglycemia and jaundice policies that are obstacles to breastfeeding.

ABM: What can ABM offer physicians worldwide?

Shafai: Many pediatric residents and medical students express a desire to learn more about breastfeeding. Unfortunately this is not available in their training programs. We should be able to fill this gap and provide them with the information that they need.

Thank you, Dr. Shafai.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each month.

Join us at the 19th Annual International Meeting to be held November 13-16, 2014 in Cleveland, OH, USA.

Written by bfmed

January 29, 2014 at 12:11 pm

Academy of Breastfeeding Medicine urges AAP to end formula marketing partnership

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New Rochelle, NY, December 27, 2013—The Academy of Breastfeeding Medicine today asked the American Academy of Pediatrics to end its formula marketing relationship with Mead Johnson.

“AAP participation in formula marketing undermines consensus medical recommendations for exclusive breastfeeding for the first six months of life and is harmful to the health of mothers and infants,” wrote Wendy Brodribb, president of the Academy of Breastfeeding Medicine. “We urge the AAP to discontinue this relationship with Mead Johnson.”

In an email message to members of the AAP’s Section on Breastfeeding, AAP President Thomas McInerny stated, “The inclusion of formula in hospital discharge bags, along with the AAP educational materials Mead Johnson purchased, has sparked considerable discussion. The Academy has initiated conversations with Mead Johnson to ensure the AAP is not connected with distribution of formula samples in the future.”

The ABM executive committee urged the AAP to set strict guidelines regarding formula marketing, stating, “We further urge the AAP leadership to implement a formal policy prohibiting Academy participation in direct-to-consumer marketing of formula.”

As reported last week in The New York Times, the AAP has contracted with Mead Johnson to provide educational materials for the formula manufacturer’s hospital discharge bags. Rigorous studies have found that mothers who receive bags containing formula samples and coupons introduce formula earlier than mothers who receive non-commercial information.

Furthermore, families who plan to formula feed from the start perceive the brand-name discharge bags as an endorsement from their health care provider, leading them to spend hundreds of dollars on pricey brand-name formula, rather than equivalent generic products.

“Concern about these harmful effects of formula marketing has led two thirds of America’s 45 top hospitals to discontinue formula advertising in their maternity wards,” Dr. Wendy Brodribb, ABM President wrote. “It is therefore deeply troubling that the AAP has contracted with Mead Johnson to support this practice.”

Written by bfmed

December 27, 2013 at 2:01 pm