Breastfeeding Medicine

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Archive for the ‘ethics’ Category

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

The First 1000 Days

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The Annual ABM Meeting in Chicago this year was amazing–truly one of the best. Kudos to the conference planners, staff, and faculty.  I was particularly interested in 1000 Days: The Window of Opportunity by Lucy Martinez Sullivan, MBA.  Some of you may be familiar with this organization, but since I wasn’t, let me give you a bit of background.  1,000 Days

is a partnership between governments, the private sector and civil society organizations which promotes targeted action and investment to improve nutrition for mothers and children in the 1,000 days between a woman’s pregnancy and her child’s 2nd birthday when better nutrition can have a life-changing impact on a child’s future and help break the cycle of poverty…The partnership serves as a platform to encourage investment and strengthen policies to improve early nutrition in the developing world in alignment with the Scaling Up Nutrition (SUN) Framework, an approach that seeks to coordinate and accelerate international efforts to combat undernutrition.

It really is amazing that this organization is bringing together so many different types of organizations from all over the world to fight malnutrition and undernutrition.  It makes sense that Ms. Sullivan came to speak to a room full of lactation specialists, right?  It makes perfect sense since breastmilk is the normal nutrition for a baby/infant/toddler–and gives that child the best chance of survival.  Nutrition from breastmilk is important for all babies, but especially vital for those born in developing countries since this can mean the difference between life and death. Read the rest of this entry »

Written by NKSriraman

November 5, 2012 at 8:52 am

Conservative rhetoric masquerading as breastfeeding advocacy

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A recent commentary in the National Review titled, “Fire the government wet nurse,” reads, at first blush, like breastfeeding advocacy. Author Julie Gunlock starts out by saying, “Breast milk is magic,” citing benefits for fighting infection and improving maternal health.

But then Gunlock takes aim at the WIC program, arguing that this safety net for poor families “encourages poor women to skip breastfeeding altogether and instead turn to formula for their children’s nutrition needs.” Gunlock notes that only one third of WIC mothers breastfeed for 6 months, and the program accounts for more than half of formula sales in the US. WIC, she argues, is yet another entitlement program that is hurting the very people it is supposed to help.

It’s a tidy argument – that safety net programs cause poverty, rather than help those who are most in need. The only problem is that it’s not true. Read the rest of this entry »

Written by astuebe

November 14, 2011 at 5:10 pm

Posted in ethics, In the news, policy

Improving the world, one breastfeeding dyad at a time

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This fall, I had the honour to represent the Academy of Breastfeeding Medicine (ABM) at the 64th annual conference of the UNO DPI/NGO in Bonn (Germany). The theme of this conference was “Sustainable Societies, Responsive Citizens”. This theme was discussed in plenary discussions, panel discussions, Round Tables and workshops. Emphasis was also placed on youth participation. They partly had their own program but also joined in the regular discussions. There was a large NGO exhibition, and between the discussions and through an official invitation for a reception by the city of Bonn, there was much time to meet with persons of organisations from around the world.
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Written by elienrouw

November 14, 2011 at 6:21 am

Emotional (!) responses to breastfeeding promotion and formula marketing

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Is anyone besides me endlessly fascinated by how emotional we all become about infant feeding?  It’s such a big part of mothering, & I would submit that we get emotional about our kids because they are so precious to us.  (As my 10-year-old would say, well, duh.)

In response to my rant about the formula company putting my name on their advertising rag last week,  a friend I hadn’t heard from in years sent me a lovely private message saying that the “tangle over breastfeeding” left adoptive moms feeling ignored and left out.  “(W)hen (my kids) were babies, I often felt badgered and belittled by the insistence that breast milk was best… We were, after all, feeding our kids.”

I tried to apologize for leaving adoptive moms out of the discussion.

I tried to sum up the public health perspective:  that human babies do best with human milk, and that, in the US at least, we feel we are still working to overcome  decades of cultural “belittling” of breastfeeding —  summed up by Jayne’s comment that  “(t)he only reason breastfeeding is seen as so much harder is because our culture and often our medical professionals totally undermine it.”.

And (rhetorically, perhaps) I asked whether there is a way for the public health community to avoid hurting feelings while still counteracting the cultural forces of formula marketing, back-to-work pressures, and just plain undervaluing women in general.

Perhaps there is some explanation, if not an actual answer, in the State of the World’s Mothers 2011 report.  (For those who haven’t already heard, the US comes in at #31 among 43 developed countries surveyed.)

And I think the US Surgeon General’s Call to Action to Support Breastfeeding (full statement here)  is an important start toward improving our situation in this country, beyond the simple repetitive  “breast is best” message that seems to have so hurt and angered my friend.

Happy Mother’s Day to all of us!   Love your kids, nurture them … feed them.  It’s what we do.

Kimberly Lee is a neonatologist and member of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by neobfmd

May 3, 2011 at 5:00 pm

Do I laugh or cry?

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I just sent the following email to a company called Remedy Health Media:

I was shocked today to find a magazine full of advertising sitting in the doctors’ lounge at (our community hospital) with my own name on the front (“Compliments of”).

The magazine contains, among other things, an article subtly undermining the health benefits of breastfeeding.

I don’t know where this came from, and especially how it acquired my name, but I respectfully request that it be stopped immediately.

I really don’t know whether to laugh or cry —  it is such an egregious thing to see my own name on a formula-advertising rag.

The article in question — “Choose Breast and Bottle Happily”starts out with “both choices have pros and cons”, points out that “breastfed babies may be healthier”, outlines the AAP guidelines … & then goes on to say how stressful it is to breastfeed.

Of course it’s stressful to breastfeed — it’s stressful to have a new baby — and of course “nursing a baby requires a lot of energy, time, support and other resources that aren’t always available to new mothers.”

But does that mean that I’m going to personally advertise formula as a solution?

I don’t think so… but we’ll see if I get a say in the matter.

Kimberly Lee is a neonatologist and member of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by neobfmd

April 29, 2011 at 11:56 am

Posted in Breastfeeding, ethics

Attachment, development and the Surgeon General

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It will not be denied, that a child, before it begins to write its alphabet and to gain worldly knowledge, should know what the soul is, what truth is, what love is, what powers are latent in the soul.

Mohandas Gandhi, 1927

One of the most significant statements in the recently released Surgeon General’s Call to Action is the recommendation that our society “work toward establishing paid maternity leave for all employed mothers.” 1 The acknowledgement that the absence of paid leave is a barrier to breastfeeding is of monumental significance.   Without paid leave, it seems highly unlikely that our society will ever be able to come close to achieving the now universally accepted recommendations to breastfeed exclusively for 6 months, and to continue to breastfeed after the addition of complementary foods until the infant is at least one year of age.   Although strategies that enable mothers to express their milk while at work are certainly laudable, it is far more preferable to put the infant to breast than to offer breast milk in a bottle.   In other words, it is best to keep mothers and infants together as much as possible, for as long as possible.   This can only happen by guaranteeing employed mothers a paid maternity leave. Read the rest of this entry »

Written by gcalnen

March 8, 2011 at 9:30 pm

Posted in ethics, policy

Is breastfeeding promotion bad for mothers?

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That’s the provocative question behind the headline, “Breast not always best for mums,” reported at, a New Zealand news site. The article reports on recent research by psychologist Leanne Taylor-Miller. Taylor-Miller set out to study cesarean birth, and she found that 8 of 32 women interviewed were psychologically distressed by their experiences with breastfeeding.

One mother has dubbed midwives and health workers “the breastfeeding Gestapo” while others have spoken of being left broken-hearted, and feeling they have failed as mothers.

Tayler-Miller suggests that it’s time to rethink the way we talk about infant feeding:

I understand why breastfeeding is promoted. However, I think it needs to be acknowledged that there is potentially a significant negative impact on women who cannot breastfeed, and I don’t feel that’s been addressed. I think that is potentially a big problem.

There are some limitations to this research – first and foremost, all 32 mothers had cesarean births, and breastfeeding difficulties may be less common among women with vaginal births. All mothers gave birth in 2005, and changes in support for breastfeeding mothers may have addressed some of these problems in the past 6 years. But after reading a related discussion on an Australian mothers’ bulletin board , I was convinced that she had hit a nerve. I couldn’t help but wonder whether we need to refine the way we talk with mothers about breastfeeding.
Read the rest of this entry »

Written by astuebe

February 21, 2011 at 11:21 am

WABA Global Breastfeeding Partners’ Forum

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The World Alliance for Breastfeeding Action (WABA) is organizing the Global Breastfeeding Partners’ Forum (GBPF) on October 17 to 18 in Penang, Malaysia. This two-day forum will have as main theme “Enabling Mothering: Keeping mothers and babies together”, focusing on the expanded Baby Friendly Hospital Initiative (BFHI)  and maternity protection and support for working women. WABA’s Core Partners, participants and speakers from around the world will be sharing new technical knowledge and programmatic updates in the areas of the expanded BFHI maternity protection. Among the purposes of this meeting is to further collaboration with WABA’s Core Partners and other participants to plan and advance the common vision and strategic direction of the breastfeeding movement.

The Academy of Breastfeeding Medicine is a Core Partner and the physicians’ arm of WABA. ABM representatives will be actively participating in this forum looking for strategies to help promote effectively the expanded BFHI among physicians around the world. Physicians are key care providers to increase the BFHI and achieve the Innocenti Declaration goals globally. All ABM physicians should enthusiastically embrace the tenets of the Innocenti Declaration as the premium policy for infant and child health promotion and a necessary public health strategy around the world.

We invite all ABM members to sign the ABM/WABA Physician’s Pledge to Promote, Protect and Support Breastfeeding. The Physician’s Pledge is a vehicle for all physicians to declare their support for the Innocenti Declaration Goals and to “go on record” as a breastfeeding-friendly practitioner. Please fax your signed Physician’s Pledge to ABM at its USA headquarters, 914-740-2101, or mailed to: Academy of Breastfeeding Medicine, 140 Huguenot Street, 3rd floor, New Rochelle, New York 10801, USA.

Ana M. Parrilla-Rodríguez, MD, MPH, is a public health physician, breastfeeding researcher and clinician, and associate professor of the Maternal and Child Program at the University of Puerto Rico School of Public Health. She is a member and a Fellow of the Academy of Breastfeeding Medicine.
Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by Ana Parrilla-Rodríguez, MD

October 27, 2010 at 10:35 pm

Nestle, AAP Partnership half-baked

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Would the American Cancer Society sign on a tobacco giant to fund a prevention campaign?  Or would the American Diabetes Association get in bed with Krispy Kreme? Until this week, I thought not, but the American Academy of Pediatrics has teamed up with Nestle — makers of Baby Ruth, Butterfinger, and Haagen-Dazs — to battle childhood obesity.

Would that this were an April Fool’s joke. PhD in Parenting broke the news earlier this week, linking to an announcement on the AAP web site about the Health Active Living for Families (HALF) initiativeIn an open letter to the AAP, Birthing Beautiful Ideas outlines the many, many ways that Nestle’s marketing of both infant formula and processed baby food directly contradict the AAP’s stated policies and goals for infant and young child feeding.

What’s more, this partnership violates the spirit, if not the letter, of the Council of Medical Specialty Society’s Code for Interactions with Companies. The Code outlines ethical guidelines designed to avoid a conflict of interest between Medical Societies, such as the AAP, and for-profit companies that may support their programs:

We adopt this Code to reinforce the core principles that help us maintain actual and perceived independence. Adopting this Code helps to ensure that a Society’s interactions with Companies will be for the benefit of patients and members and for the improvement of care in our respective specialty fields.  (Emphasis added)

Of note, the code explicitly prohibits direct support from a company in developing a guideline for clinical practice:

7.3. Societies will not permit direct Company support of the development of Clinical Practice Guidelines or Guideline Updates.

The AAP has signed onto the code, and, best I can tell, Nestle is a Company. So why is the Nestle Nutrition Institute funding development of a comprehensive program to educate parents and children about nutrition?

The AAP should not be taking money for an anti-obesity project from an institute whose parent company sells candy and ice cream — and hawks flawed advice designed to undermine breastfeeding mothers.

If the AAP is really “dedicated to the health of all children,” they should send that check back to Nestle and start over. American families deserve nothing less.

Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician, breastfeeding researcher, and assistant professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine. She is a member of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by astuebe

October 7, 2010 at 10:12 pm