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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

ABM Executive Committee urges AAP to discontinue formula marketing relationship

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Thomas K. McInerny, President, American Academy of Pediatrics

Dr. McInerny:

We are writing on behalf of the Academy of Breastfeeding Medicine (ABM), a multispecialty worldwide organization of physicians dedicated to the support, promotion and protection of breastfeeding and the education of our fellow physicians, to urge the American Academy of Pediatrics to discontinue its participation in infant formula marketing in maternity hospitals and pediatric practices.

It has come to our attention that the AAP has contracted with Mead Johnson to provide AAP-branded materials as part of the formula manufacturer’s maternity discharge pack. Such discharge packs have been shown in randomized controlled trials to reduce breastfeeding duration and exclusivity. Based on this Level I evidence, UNICEF, the World Health Organization, the Baby-Friendly Hospital Initiative, the American Public Health Association, the Academy of Breastfeeding Medicine, the Centers for Disease Control and Prevention, and the United States Surgeon General oppose infant formula marketing in health care settings. 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. It is therefore deeply troubling that the AAP has contracted with Mead Johnson to support this practice.

The AAP’s decision to contract with Mead Johnson also violates multiple AAP policy statements. Distribution of discharge packs has been identified as detrimental to exclusivity and duration of breastfeeding in the AAPs Policy Statement on Breastfeeding and the Use of Human Milk.  In its resolution on Divesting from Formula Marketing in Pediatric Care, the Academy advises pediatricians not to provide formula marketing materials to parents of newborns and infants. Both the AAP’s Sample Hospital Breastfeeding Policy for Newborns and  ABM’s Model Breastfeeding Policy prohibit provision of formula marketing materials to mothers.

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. We urge the AAP to discontinue this relationship with Mead Johnson. We further urge the AAP leadership to implement a formal policy prohibiting Academy participation in direct-to-consumer marketing of formula or formula company materials.

Thank you for your consideration.

Sincerely,
Dr. Wendy Brodribb,  President (Family Physician)

Dr. Arthur Eidelman,  Immediate Past President (Pediatrician)

Dr. Julie Taylor,  President-Elect (Family Physician)

Dr. Tim Tobolic, Treasurer (Family Physician)

Dr. Kathie Marinelli,  Secretary (Pediatrician)

cc. Dr. Kinga Szucs, ABM representative to SoB AAP

Written by bfmed

December 26, 2013 at 11:26 am

Posted in Uncategorized

ABM Gold Member Profile: Anne M. Montgomery, MD, FABM

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Anne Montgomery, MD

Anne Montgomery, MD, FABM
Associate Director
Family Medicine Residency
Eisenhower Medical Center

ABM: Why did you become a member of ABM?

Montgomery: I was very involved in breastfeeding support and wanted to be part of a group of similar physicians.

ABM: What is ABM‘s greatest strength?

MontgomeryThe diversity and expertise of our members.

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

Montgomery:  Like many people, I was a “mainstream breastfeeding supporter” til I had my son; breastfeeding him exclusively for 5.5 months then continuing for 4.5 years “radicalized” me. I recognized that not not everyone had the tenacity/stubbornness to overcome all the barriers. As a physician to mothers and babies, it was part of my responsibility to be sure that all babies had the opportunity to be breastfed and that all mothers were supported in their feeding choices.

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

MontgomeryJoin ABM! Don’t be afraid to attend courses aimed at nurses and lactation consultants if that is all that is available in your area.

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

Montgomery: I achieved full professor academic rank in my late 40’s and have taught many residents and students about family medicine including breastfeeding.

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

Montgomery: Starting a new job soon, I don’t know what to expect yet! A brand new family medicine residency program should be interesting.

ABM: What can ABM offer physicians worldwide?

Montgomery: A chance to network with other like-minded physicians, good breastfeeding education, and support for their work assisting mothers and babies.

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

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

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Written by bfmed

August 28, 2013 at 9:11 am

ABM Gold Member Profile: Lori Feldman-Winter, MD, MPH, FABM

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Dr. Lori Feldman-Winter

Lori Feldman-Winter, MD, MPH, FABM
Professor of Pediatrics
Children’s Regional Hospital at Cooper, Cooper Medical School of Rowan University

ABM: Why did you become a member of ABM?

Feldman-Winter: I wanted opportunities to network with colleagues that had a shared interest and learn from others work.

ABM: What is ABM‘s greatest strength?

Feldman-WinterThe members are definitely what makes this organization special. Each member makes their own unique contributions and we all learn from each other.

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

Feldman-Winter:  For too many years breastfeeding fell outside the realm of mainstream medicine and physicians were unprepared to support mothers decisions to breastfeed. Through organizations such as ABM physicians are much more knowledgeable and skillful in their support, but we still have a long way to go!

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

Feldman-WinterFirst take courses, especially those geared for physicians such as the WEPNTKAB course. Then join organizations such as the ABM to gain a better understanding of the field from the physicians’ perspective. Then get involved, there are so many opportunities to make a real difference.

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

Feldman-Winter: I have dedicated a large part of my career in breastfeeding medicine to physician education. Being part of the inaugural group of FABM’s is one of the highlights of my career.

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

Feldman-Winter: In my current work as a consultant to NICHQ Best Fed Beginnings Project, my biggest challenge is to convince physicians all over the country that they need to make changes, including getting the required education, to help their hospitals achieve Baby-Friendly designation. The resistance to change is sometimes overwhelming. Somehow we need to convince all physicians to acknowledge that we all have much to learn about breastfeeding, and that it is a vital component of healthcare.

ABM: What can ABM offer physicians worldwide?

Feldman-Winter: The clinical protocols are helpful to set a global agenda for optimal evidence based care.

Thank you, Dr. Feldman-Winter.  We look forward to featuring additional Lifetime and Gold Members on the ABM Blog each week.

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

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ABM Lifetime Member Profile: Nancy E. Wight, MD, IBCLC, FABM, FAAP

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Nancy Wight

Nancy E. Wight, MD, IBCLC, FABM, FAAP, San Diego Neonatology, Inc. Medical Director, Sharp HealthCare Lactation Services

ABM: Why did you become a member of ABM?

Wight: I was inspired by the quality and vision of the founding members and wanted to be a part of the journey.

ABM: What is ABM‘s greatest strength?

WightIt’s members and all they do in so many arenas (clinical care, research, teaching, mentoring, health planning, etc. etc.)!

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

Wight:  As a physician, I care about the health of my community in all its forms and breastfeeding is the best health insurance.

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

WightJoin ABM, join ILCA, join your local breastfeeding coalition. Find a breastfeeding ‘champion’ in your area to act as a mentor for you.

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

Wight: I am most proud of the fact that as a clinician and educator I have influenced others to follow in my footsteps and EXCEED my accomplishments.

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

Wight: Keeping up with the incredible increase in human lactation research and literature over the last 10 years while working full-time (including nights!) as an ‘elder’ clinical neonatologist.

ABM: What can ABM offer physicians worldwide?

Wight: A vast wealth of peer knowledge and support.

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

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

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ABM Gold Member Profile: Featuring Paula K. Schreck, MD

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ABM: Why did you become a member of ABM?

Paula K. Schreck, MD Breastfeeding Coordinator St. John Providence Health System

Paula K. Schreck, MD
Breastfeeding Coordinator
St. John Providence Health System

Schreck: I became a member of ABM as I first began building my career in Breastfeeding Medicine. The promise of fellowship with other like-minded MD’s was compelling as was the access to up-to-date science and information.

ABM: What is ABM‘s greatest strength?

Schreck: ABM’s greatest strength is its membership.

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

Schreck:  The palpable difference in the health of the breastfeeding mother and baby dyad motivates and inspires me in my work.

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

SchreckStart by attending an ABM Annual Meeting.

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

Schreck: My greatest accomplishment is the creation of my outpatient breastfeeding clinic. Its success has brought breastfeeding into the spotlight in my hospital system.

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

Schreck: Taking four hospitals through Baby-Friendly at the same time.

ABM: What can ABM offer physicians worldwide?

Schreck: Inspiration, information, and fellowship.

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

Join us at the 18th Annual International Meeting to be held November 21-24, 2013 in Philadelphia.

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Written by bfmed

July 12, 2013 at 11:39 am

President’s Corner – Breastfeeding Mitigates a Disaster

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BREASTFEEDING MEDICINE
Volume 8, Number 3, 2013
ª Mary Ann Liebert, Inc.
DOI: 10.1089/bfm.2013.9989

PRESIDENT’S CORNER

Arthur I. Eidelman
Holocaust Memorial Day, or as it is called in Israel and worldwide ‘‘Yom Hashoah,’’ is a combination of the most depressing sadness, as we memorialize the 6,000,000 murdered victims of Nazi Germany and their European collaborators, and, paradoxically, a celebration of those individuals who somehow survived the horrors of mass murder and ethnic cleansing. The realization that 1.5 million infants and children were singled out for elimination by the Nazis so as to prevent the chances of a historical continuity of the European Jewish community is somehow counterbalanced by the miraculous stories of infants surviving, especially in the most unlikely circumstances and conditions.

This past Yom Hashoah (April 8, 2013) I had the opportunity to view a documentary entitled ‘‘Geboren in KZ’’ (‘‘Born in a Concentration Camp,’’ a film by Eva Gruberova and Martina Gawaz for GDR Television), which recounts the unbelievable story of seven infants who were born in 1945 in the Dachau, Germany, concentration camp. The fact that the mothers of these infants were able to conceal their pregnancies and reach term without being detected in and of itself defies comprehension, for as we know the policy of the Nazis was to send any woman diagnosed as pregnant directly to the crematorium. Some of the women even escaped detection and ‘‘selection’’ for death by the infamous Dr. Josef Mengele in
Auschwitz before being transferred to Dachau. No less miraculous so was their ability to maintain a minimal degree of nutrition to sustain their pregnancy until term or near term. Months later, when Dachau was liberated by the U.S. Army, the GIs to their astonishment discovered among the 30,000 survivors of the camp seven mothers and their seven infants ranging in age from 1 to 6 months (three boys and four girls).
To their wonderment they found that the infants were relatively thriving with few if any discernible medical problems. The film documents visually the U.S. Army’s surprise and the images of the healthy infants. Almost in passing, when they asked how the babies survived the unbearable conditions in the concentration camp, the answer they received was simply that the infants were breastfed, with two of the mothers acting as wet nurses to supplement those mothers whose milk supply was marginal. Not only did all the infants survive, after liberation they grew normally, ultimately married, and raised their own families, truly a testimony to their fortune in defying their presumed proscribed fate and the Nazis’ nefarious plan for a final solution to the Jewish problem.

And yes, they were breastfed successfully and thus survived the most disastrous medical and nutritional condition imaginable. The infants’ survival once again provides evidence of what should be axiomatic for all those who have been charged with the responsibility for organizing our communities for potential disasters, what is termed ‘‘disaster preparedness response and recovery.’’ As clearly stated in the ABM Statement entitled ‘‘Position on Breastfeeding’’1: ‘‘In situations of disaster or food insecurity, infants who are not breastfed have a markedly higher risk of infant mortality and morbidity from infectious diseases.’’ This conclusion was confirmed in a recent published study2 that analyzed the effect
of breastmilk substitutes and the incidence of diarrhea in infants after the 2006 earthquake in Java. The authors concluded that ‘‘there were strong associations between receipt of breast milk substitutes and changes in feeding practices and between receipt of infant formula and diarrhea. Uncontrollable distribution of infant formula exacerbates the risk of diarrhea among infants and young children in emergencies.’’

It should be clear that the key word in this quote is ‘‘uncontrollable,’’ meaning the non-medically indicated distribution of formula frequently by well-meaning non-governmental organizations that are insufficiently sophisticated or versed to understand that their actions are counterproductive for infant health. No less so are the actions of the formula companies’ distribution policies, which reflect at time marketing opportunities rather than legitimate public health needs. Binns et al.3 emphasized this in their recent article entitled ‘‘Ethical Issues in Infant Feeding After Disasters,’’ which summarized the issues in two pithy sentences: ‘‘Mothers who are injured or short of food can still continue breastfeeding and don’t need formula’’ and ‘‘Where formula must be used, health workers need to follow the highest ethical standards to avoid promoting infant formula to vulnerable communities in the post recovery phase.’’

Gribble4 further highlighted and extended this concern regarding the inappropriate behavior of formula companies and public health officials to the frequent detrimental role of the media, particularly in its encouraging harmful aid in the form of infant formula and in reporting incorrectly that stress5 interferes with the success of breastfeeding. Gribble,4 in analyzing the consequences of the 2008 earthquake in China and the cyclones in Myanmar, described the successful activities of an interagency called the Infant and Young Child Feeding in Emergencies (IYCF-E), which developed an ‘‘Operational Guidance for Emergency Relief Staff and Programme Managers.’’6 The Guidance functioned in part on the following principles that served as a basis for the actions of both the agencies and media communications:
1. ‘‘Babies fed anything other than breast milk are particularly vulnerable in emergencies.’’
2. ‘‘Use of infant formula or other milk products is dangerous in emergencies and should be avoided.’’
3. ‘‘The way to help babies survive in an emergency is to help their mothers continue breastfeeding.’’
4. ‘‘Donations of infant formula are not needed and are unhelpful.’’
5. ‘‘Aid organizations need help from media immediately after the start of the emergency to prevent arrival of
donations of infant formula.’’

Natural disasters are inevitable and part of the realities and vagaries of living on earth. Our role as caretakers is to prepare for them and not compound their consequences by disrupting the natural order of infant feeding (e.g., breastfeeding and the use of human milk). It is hoped that we will not need another round of evidence from manmade disasters such as the Holocaust of World War II to convince us that survival even in the most deprived circumstances is dependent on maintaining that maternal–infant dyadic breastfeeding nurturing relationship. Those infants who were born into the horrors of the Nazi camps and survived proved it, and that should be enough to convince the doubters. The lessons of the Holocaust are many, and we are charged to remember those who went through that hell and their message of hope for future generations.

References
1. Academy of Breastfeeding Medicine Board of Directors. Position on breastfeeding. Breastfeed Med 2008;3:267–270.
2. Hipgrave DB, Assefa F, Winoto A, et al. Donated breast milk substitutes and incidence of diarrhea among infants and young children after the May 2006 earthquake in Yogyakarta and Central Java. Public Health Nutr 2012;15:307–315.
3. Binns CW, Lee KK, Tang L, et al. Ethical issues in infant feeding after disasters. Asia Pac J Public Health 201;24:672–680.
4. Gribble KD. Media messages and the needs of infants and young children after Cyclone Nargis and the WenChuan earthquake. Disaster 2013;37:80–100.
5. Hill PD. Psychological distress and milk volume in lactating mothers. West J Nurs Res 2005;27:676–693.
6. IFE Core Group. Infant and Young Child Feeding in Emergencies: Operational Guidance for Emergency Relief Staff and Programme Managers version 2.1 February 2007. http://www.ennonline.net/pool/files/ife/ops-guidance-2-1-english-010307-with-addendum.pdf (accessed April 11, 2013).
—Arthur I. Eidelman, MD, FABM, FAAP
President, Academy of Breastfeeding Medicine
PRESIDENT’S CORNER 345