Breastfeeding Medicine

Physicians blogging about breastfeeding

Every time a baby goes to breast, the $70 billion baby food industry loses a sale

with 12 comments

On Sunday, the most shared story in the New York Times was about breastfeeding – specifically, about how the US government threatened multiple countries with trade sanctions and withdrawal of military support if they backed a resolution calling for more support for breastfeeding mothers and their babies.

According to the Times:

American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children.

Why would the US government stand in the way of global breastfeeding advocacy? There are a number of theories – but my money is on the $70 billion baby food industry – upon whom the US dairy industry relies to convert massive milk surpluses into profitable products. In a face-off between a powerful industry lobby and global maternal and child health, the powerful industry carried the day.

This is the critical take-home message for anyone who cares about the health of moms and babies: When it comes to global infant and young child feeding, industry profits take precedence over public health. Read the rest of this entry »

Written by astuebe

July 8, 2018 at 9:46 pm

Separation of children and infants from parents – breastfeeding implications

with one comment

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

Breastfeeding, advocacy and women’s rights

with 2 comments

In June 2015, I heard a fantastic talk by Keith Hansen, Vice President for Human Development at the World BankGroup, at the Academy of Breastfeeding Medicine summit. Hansen spoke eloquently about the importance of breastfeeding for both global health and economic development; he said, “If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics.”

I’d brought my teenage son with me to Washington, and when we met up for lunch, I shared Hansen’s quote. He responded, “If breastfeeding were invented today, there would be an outrage, because of feminism.”

It took me a few seconds to fully process this response, as I began to consider the implications of a newly-discovered practice that would require one half of the population to engage in thousands of hours of unpaid work, at all hours of the day and night, for the greater good. There would, indeed, be an outrage. Read the rest of this entry »

Written by astuebe

May 9, 2018 at 8:38 pm

Postpartum Mood & Anxiety Disorders in Breastfeeding Mothers: To Treat or Not To Treat

with one comment

May 2nd is World Maternal Mental Health Day.  Here in my home state, The Governor and General Assembly, back in 2015, declared May as Maternal Mental Health Month in the Commonwealth of Virginia.  The Blue Dot Project has defined this year’s Maternal Mental Health Week (#MMHweek) by removing the stigma of perinatal mood and anxiety disorders. Women (and men) all across the world are posting their stories (with a pastel blue dot) about the trials and tribulations of parenting, while showing the face of postpartum anxiety and depression.  #noshame #realparenting

On my iPhone early this morning, I saw a #MMHW post where a women posted a picture of her feeding her child with a bottle. She told her story about the guilt she felt (and still feels) about not being able to breastfeed her child and how that exacerbated her depression.  What followed were comments by so many other moms, how they also felt that guilt when their ‘body didn’t work’ making them unable to breastfeed their child.  Many of these women commented on how they felt shame when giving their child a bottle in public. Read the rest of this entry »

Written by NKSriraman

May 3, 2018 at 8:13 pm

Breastfeeding Mitigates a Disaster

with one comment

Holocaust Memorial day, or as it is called in Israel and worldwide  as “Yom Hashoah”,  is combination of the most depressing sadness as we  of 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 Nazi 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 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 7 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 of itself  defies comprehension, for as we know the policy of the Nazis was to send any women diagnosed as pregnant directly to the crematorium. Some of the women  even escaped  detection and “selection” for death  by the infamous Dr. 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 till term or near term. Read the rest of this entry »

Written by aeidelmanmd

April 12, 2018 at 5:22 am

Posted in Uncategorized

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

with one comment

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

leave a comment »

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

On finding #MyPeopleABM: Physicians share what ABM means to them

with one comment

Jennifer Caplan, MD, FAAP, IBCLC
North Scottsdale Pediatric Associates, AZ USA
I joined ABM after going to an AAP conference in 2008 with my nursing baby. At the conference, I ended up spending almost the entire time with the Section on Breastfeeding because my baby was not interested in staying with my husband—so I brought her with me. And I felt more comfortable hanging out with the breastfeeding crowd. I ended up riding in an elevator with some of the organizers and one of the women told me I should join ABM.

I had been so energized by the discussions at that conference—learning how to do frenotomies, hearing about the “Ban the Bag” efforts in Massachusetts, finding out about Baby Friendly Hospitals for the first time. So, I joined ABM and attended my first conference in 2009.

Being at an ABM conference is amazing. I’m really not a conference person—networking does not come easily to me, I don’t really like the marketing/advertising hall, but I do love learning about new things. ABM is the only conference I really enjoy going to. I always come away from the conference with at least a dozen new ways to practice and a new energy to spread my knowledge to others. And I love the people I meet at ABM conferences—so many perspectives, so many different ways they express their passion for supporting the mother-baby dyad. After another couple conferences, I had been convinced to become a lactation consultant.

I usually make it to the ABM conference, but even in years where I don’t go, I still get a lot out of my membership. I probably use the protocols more than anything else—always the most up to date, comprehensive source on breastfeeding topics. I enjoy seeing the new research coming out in the journals. And just knowing I’m a part of an amazing group that is a political force for advancing breastfeeding and advocating for women is important to me. Read the rest of this entry »

Written by drmilkarizona

May 5, 2017 at 5:06 pm

Surgeons who pump: #ILookLikeASurgeon

with 2 comments

If you follow trends on social media, you have seen the viral tweets and pics from women surgeons who have copied the New Yorker magazine cover showing three women leaning over an operating table.   These posts share two common hashtags:  #ILookLikeASurgeon and #NYerORCoverChallenge.  As an admin for the 7,000+ member Dr. MILK online physician mother breastfeeding support group, I wanted to see this picture taken from the perspective of a multi-tasking surgeon mother who fits in pumping her milk between cases and a very hectic schedule.  I asked our members to try and coordinate OR schedules and pumping schedules to make this happen.  Three superstar OB GYNs from Baylor College of Medicine created this pic while at Texas Children’s Pavilion for Women in Houston, TX.  They don’t literally pump their milk while leaning over an operating table, but this picture represents the duality of surgeon moms who balance patient care needs with meeting the nutritional needs of their infants.  Their stories of breastfeeding/pumping challenges and successes will hopefully encourage mothers of all walks of life to confront and remove barriers to maintaining a milk supply while at work and #normalizePumping.

Here’s what their workday looked like when they managed to take this picture:  One doctor had a delivery and then a c-section while the second had a fetal surgery.  The third surgeon was performing a robotic hysterectomy.  They tried to coordinate the photo between the delivery and c-section but timing wasn’t right, and then just before the fetal surgery the three women rushed into an empty OR to make it happen.  Read the rest of this entry »

Written by drmilkarizona

April 28, 2017 at 12:16 pm

ABM Releases Revised Supplementation Protocol

with 3 comments

During a time of abundant research surrounding the long term implications of feeding practices in the neonatal period on maternal and child health, it is of utmost importance that healthcare professionals are guided by the best available evidence regarding infant feeding while caring for breastfeeding dyads. We know that despite the recommendations against routine formula supplementation, this practice is commonplace in hospitals worldwide for a myriad of reasons. In developing ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate (Read the protocol here) newborn physiology and management of breastfeeding mothers were highlighted to impress upon healthcare professionals the delicate balance involved in helping mothers establish exclusive breastfeeding in the early postpartum days. Many mothers set out with the goal of exclusive breastfeeding, but still in many countries, few reach their feeding goals. Studies clearly demonstrate that when healthcare teams have a clear understanding of these topics, provide antenatal education, and implement supportive hospital practices, the need for supplementary feedings in term neonates is rare.

Preventing the need for supplementation altogether should be a common goal for all members of the healthcare team. It has been well established in the literature that exclusive breastfeeding protects mothers and infants from various poor health outcomes, is cost effective, and is the physiologic norm. Thus, the authors of this protocol dedicated substantial time and focus on practices that have been shown to reduce this need, which include many of the ten steps required by the Baby Friendly Hospital Initiative. The revised protocol contains an algorithm for caring for the breastfeeding dyad before and during the birth hospital stay and responding to common concerns.

It is important to recognize true medical indications of supplementary feedings as well as the preferred choice and volumes of supplement, which are appropriately outlined in this protocol, re-emphasizing that, while there is a time and place for formula use, a mother’s own expressed milk or donated human milk in volumes that mimic normal breastfeeding physiology are preferable to breast milk substitutes. The preference for donor human milk over formula use has been suggested by the Academy of Breastfeeding Medicine for years, and is further supported by emerging research on the long term health consequences of the infant microbiome and the role that breast milk substitutes may have on individual health outcomes years down the road.

Educating ourselves as healthcare providers about how best to support mothers in their breastfeeding journey is crucial to their success in meeting their personal feeding goals. This revised clinical protocol highlights supporting evidence and contains information and strategies needed to provide state-of-the-art care and support.

Written by drharrel

April 4, 2017 at 12:22 pm