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Wednesday, December 22, 2010

More Cesareans Than Even Before.

The CDC has just released the  report on births for the US, and yet again the cesarean section rate has risen. The National C/Section rate went up 2 % from 2008, hitting 32.9% for 2009!!!

Not surprisingly to any natural childbirth advocates, the national birth rate fell by 3 percent less than 2008  with a birth rate of 4,247,694 in 2009, compared with 4,131,019 in 2008.  Is it any wonder that it fell?!  It is a fact that many women are actually choosing to forgo having another baby due to the fear of having a repeat Cesarean Section.  Add to that fact that many women who do decide to have another baby after  a C/Section suddenly discover that they are incapable of getting pregnant again naturally, because the surgical scar can cause infertility problems.  When as many as 1 in 3 women suffer from fertility problems after a C/Section is it any wonder that the American National Birth rate is falling?

Last February  it was announced   that having a VBAC birth (Vaginal Birth after Cesarean Section) was actually safer than they originally thought, especially for women with multiple uterine scars. BJOG  ( an International Journal of Obstetrics and Gynaecology), found that women with 3 previous Caesarean Sections have similar outcome rates of success as women with only one previous Caesarean section in a study of 25000 women attempting a vaginal birth after a Ceasarean section. The study shows that not only did the women with 3 previous C/Section uterine scars have a very similar rates of success in having a VBAC birth, but that the rates of morbidity were also very similar between the women that had a VBA3C and those that chose to be delivered by elective repeat caesarean.  A few month later ACOG made an official announcement that:
ACOG states that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins and unknown uterine scars.  ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor.

Shall we gather here again at this time next year to see if the new official party line has had any effect at all on the rising Cesarean Section rate?  Are you holding your breath?  Me neither.

ACOG can make all the grand pronouncements they want, but if the hospitals and Doctors and Midwives don't listen and change their policies accordingly, then it's all just a  waste of the paper that the studies were printed on.

After I wrote: "New ACOG guidlines for VBAC births"- I sat at the computer and once the initial high of elation had worn off, I had a bit of a sad.  I stared at the words on the screen and thought to myself "how many women out there are reading this news with a sense of unbearable sadness for the births they didn't have.  Couldn't have.  Because last week these people and their grand pronouncements said they couldn't."  Five months ago I fought tooth and nail, and had to signed a stack of waivers pretty much as tall as my eldest son, to have a VBAC birth.  And I live in Canada and have the good fortune to have a Charter of Rights that gives me the legal Right to refuse a surgeons knife, I can't imagine  how my American sisters feel.

We, the women and mothers, have been  telling them for years. We have been in a ridiculous battle against the "powers that be" to be able to birth our babies OUR way.  To follow our intuition and allow ourselves the  dignity of choosing where, when and how we will give birth. It has ALWAYS been OUR births. We shouldn't of needed a big green light from a commercially motivated "association" (just another word for "corporation") to tell us this- to allow this to be denied to hundreds of thousands, if not millions, of mothers!!

Mama Birth said it so well in her article "ACOG Still Sucks"
Thousands of women have fought, bled and died for this change to come about. They have gone through the stigma of birthing at home in order to have a birth that they chose. They have been attended by supportive midwives. Some of them have birthed unassisted. Some of them have had hospital births in hostile environments where they were disrespected but in the process have shown hospital staff that VBAC is possible.
These are the women who deserve the praise for this recent statement.

ACOG. To ACOG I want to say this:

What can you do for all of those women who were denied
VBAC because of you? Can you remove their scars? Can you remove their fears? Can you give them their births back? Can you change what you have already done?

You can do none of these things. Thousands if not hundreds of thousands of women have already suffered at your hands. Many more will because of the refusal of many
OB's within your community to even acknowledge these new recommendations. You can not fix the pain that you have caused.

Thank you
ACOG for changing your policy.

Shame on you for all of the bad births, scars, pain, depression and death that have come at your hands because of your unwillingness to do this sooner.

So will the leopard change it's spots?  Will the American national   Cesarean Section rate fall for this year?  Maybe next year?  Yea, I'm definitely not holding my breath on this one.

Position Statement: Ontario Breastfeeding Committee

The Ontario Breastfeeding Committee
Position Statement on the Use of Donor Human Milk

The Ontario Breastfeeding Committee is the provincial contact for the Breastfeeding Committee for Canada: The National Authority for the WHO/UNICEF Baby- Friendly Hospital Initiative. In partnership with the Breastfeeding Committee for Canada, the Ontario Breastfeeding Committee is responsible for the implementation of the WHO/UNICEF Baby-Friendly Initiative in Ontario and partners with hospitals and community health services to assist and support them to achieve Baby-Friendly designation.

The Ontario Breastfeeding Committee recognizes that:

• human milk is the food for babies
• women should make informed decisions on the use of donor human milk based on accurate and evidenced – based information

The Ontario Breastfeeding Committee recommends that:

• Government facilitate and accelerate the establishment of donor human milk banks in Ontario
• Government provides safe, evidence-based guidelines for human milk sharing.

The Executive of the Ontario Breastfeeding Committee December 15th. 2010

Monday, December 20, 2010

Tis the Season....

.....For computer to go kaput!!!!

In case you hadn't noticed, I haven't posted any new blog articles in about a week.  Unfortunately my laptop suffered a fatal crash and is now hospitalized with a severe case of amnesia.  While awaiting a brain transplant for my poor mistreated friend, I'm using my hubbies old paleolithic laptop which is only firing on about 2 cylinders as it is.  Between the lack of all my research and book marks and  the slowness of this paperweight, and the fact that Christmas is a mere 5 days away.... well.... I don't see me getting any writing done over the next few days.

....But you never know!

I want to wish you all a very Very Merry Christmas and Happy Holidays and
A Fantastic New Year!!!!

Tuesday, December 14, 2010

"The Human Incubator"

This is another brilliant article about skin to skin kangaroo care.  Sometimes we need to questions advanced technology and step back in time to simpler methods- basic methods that answer both the baby's needs and the needs of his mother.

The Human Incubator

A mother uses the warmth of her body to serve as a human incubator as she cuddle her prematurely born daughter in the Philippines.Bullit Marquez/Associated PressA mother in the Philippines used the warmth of her body to nurture her prematurely born daughter.
Sometimes, the best way to progress isn’t to advance — to step up with more money, more technology, more modernity. It’s to retreat.
Towards the end of the 1970s, the Mother and Child Institute in Bogota, Colombia, was in deep trouble. The institute was the city’s obstetrical reference hospital, where most of the city’s poor women went to give birth. Nurses and doctors were in short supply. In the newly created neonatal intensive care unit, there were so few incubators that premature babies had to share them — sometimes three to an incubator. The crowded conditions spread infections, which are particularly dangerous for preemies. The death rate was high.
Dr. Edgar Rey, the chief of the pediatrics department, could have attempted to do what many other hospital officials would have done: wage a political fight for more money, more incubators and more staff.

He would likely have lost. What was happening at the Mother and Child Institute was not unusual. Conditions were much better, in fact, than at most public hospitals in the third world. Hospitals that mainly serve the poor have very little political clout, which means that conditions in their wards sometimes seem to have been staged by Hieronymous Bosch. They have too much disease, too few nurses and sometimes no doctors at all. They can be so crowded that patients sleep on the floor and so broke that people must bring their own surgical gloves and thread. I recently visited a hospital in Ethiopia that didn’t even have water — the nurses washed their hands after they got home at night.
Proof that more money and more technology isn’t always the answer.
Rey thought about the basics. What is the purpose of an incubator? It is to keep a baby warm, oxygenated and nourished — to simulate as closely as possible the conditions of the womb. There is another mechanism for accomplishing these goals, Rey reasoned, the same one that cared for the baby during its months of gestation. Rey also felt, something that probably all mothers feel intuitively: that one reason babies in incubators did so poorly was that they were separated from their mothers. Was there a way to avoid the incubator by employing the baby’s mother instead?
What he came up with is an idea now known as kangaroo care. Aspects of kangaroo care are now in use even in wealthy countries — most hospitals in the United States, for example, have adopted some kangaroo care practices. But its real impact has been felt in poor countries, where it has saved countless preemies’ lives and helped others to survive with fewer problems.
The kangaroo mother method was first initiated in 1979 in Columbia because for lack of incubators.Agence France-Presse A mother and child in Colombia, where the “kangaroo care” method was first used in the late 1970s.
In Rey’s system, a mother of a preemie puts the baby on her exposed chest, dressed only in a diaper and sometimes a cap, in an upright or semi-upright position. The baby is strapped in by a scarf or other cloth sling supporting its bottom, and all but its head is covered by mom’s shirt. The mother keeps the baby like that, skin-to-skin, as much as possible, even sleeping in a reclining chair. Fathers and other relatives or friends can wear the baby as well to give the mother a break. Even very premature infants can go home with their families (with regular follow-up visits) once they are stable and their mothers are given training.
The babies stay warm, their own temperature regulated by the sympathetic biological responses that occur when mother and infant are in close physical contact. The mother’s breasts, in fact, heat up or cool down depending on what the baby needs. The upright position helps prevent reflux and apnea. Feeling the mother’s breathing and heartbeat helps the babies to stabilize their own heart and respiratory rates. They sleep more. They can breastfeed at will, and the constant contact encourages the mother to produce more milk. Babies breastfeed earlier and gain more weight.
The physical closeness encourages emotional closeness, which leads to lower rates of abandonment of premature infants. This was a serious problem among the patients of Rey’s hospital; without being able to hold and bond with their babies, some mothers had little attachment to counter their feelings of being overwhelmed with the burdens of having a preemie. But kangaroo care also had enormous benefits for parents. Every parent, I think, can understand the importance of holding a baby instead of gazing at him in an incubator. With kangaroo care, parents and baby go through less stress. Nurses who practice kangaroo care also report that mothers also feel more confident and effective because they are the heroes in their babies’ care, instead of passive bystanders watching a mysterious process from a distance.
The hospitals were the third beneficiaries. Kangaroo care freed up incubators. Getting preemies home as soon as they were stable also lessened overcrowding and allowed nurses and doctors to concentrate on the patients who needed them most.
Kangaroo care has been widely studied. A trial in a Bogota hospital of 746 low birth weight babies randomly assigned to either kangaroo or conventional incubator care found that the kangaroo babies had shorter hospital stays, better growth of head circumference and fewer severe infections. They had slightly better rates of survival, but the difference was not statistically significant. Other studies have found fewer differences between kangaroo and conventional methods. A conservative summary of the evidence to date is that kangaroo care is at least as good as conventional treatment — and perhaps better.
HERE to read the entire article in the NYTimes

Thursday, December 9, 2010

Infant Formula: It's not "Good Enough"

Before the  formula lynch mob hangs me for the following comment, I just want to say something:  This is not about guilt.  This is not about trying to make mothers who've used formula feel guilty.  If you want to debate the "Guilt Issue" go read my article "Breastfeeding: guilt, statistics, support, and making a choice"   and then we'll talk.  This is not about feeling guilty for using infant formula. This is about not having to "choose" to use infant formula. This is about actually having a choice and making the best choice for your baby and your family.

When breastfeeding is difficult, or when it goes terribly wrong, it can be absolutely devastating for mother and baby.  Mothers who have done their research and made the choice to exclusively breastfeed their babies already know that "breast is best", they know that breastfeeding is NORMAL.  More importantly they know about the risks associated with feeding your baby infant formulas. So when nature throws moms a curve and forces them to have to rely on something other than their own breasts to nourish their child, it can be completely overwhelming.

The first thing moms need to do is to get professional help.  See a certified  Lactation Consultant/IBCLC to try to work through the problem:  Is it a poor latch?  Why is baby's latch not good enough?  Is baby tongue tied?  Does mother simply need help with positioning?  For most situations if you fix the latch you fix the supply problems.

But what if the problem isn't so easily fixed?  What if the problem is one that is unfixable?  What then?  Babies need to be fed and when the mother is not able to produce enough milk to exclusively breastfeed, then they have to turn to another source of nutrition. Up until the last 60 or 70 years, the natural thing to do would be to use donor milk or a wet nurse- whether it was your sister, cousin, aunt, mother, friend or another local mother who was already breastfeeding her own baby.  Mother to Mother milk sharing and tribal nursing was so common that is was the accepted method of feeding babies who needed milk.

Now of course we are living in the era of commercially prepared infant formulas.  "Wet nursing" is a word that's fallen out of fashion and tribal nursing, if done at all, is done behind closed doors.  Now if a mother is unable to produce enough breastmilk the medical machine automatically hands her a can of formula and sends her on her way. WHY? Why formula instead of donated breastmilk?  Because infant formula is a huge industry and pays out millions of dollars in advertising and promotions, sponsors medical associations and medical schools, buys doctors fancy briefcases and sports cars, sends hospital executives on Caribbean cruises and gives maternity wards thousands of cans of their product to use and give away.  Money talks, and "Breastmilk" doesn't have any executives to pay off government officials to use their products.

Up until the 1980's there were breastmilk banks scattered all over North America to facilitate the feeding of preterm and fragile infants in hospital NICUs.  Then came the AIDs scare and the vast majority of milk banks closed their doors- leaving just 10 banks in the US and one lonely milk bank in Canada. I plan on doing some investigating into the closure of these milk banks because I'm a firm believer that money talks and if doors were closed, then someone somewhere told them to close and paid for them to stay that way. There is only one industry that stood to gain anything from the closure of breastmilk banks.  Call me a conspiracy theorist, but if it looks like a duck and quacks like a duck, I'm going to call it a duck.

Recently the Canadian (and US) governments have been talking about the need for Breastmilk Banks, about how vitally necessary breastmilk is to our most fragile citizens.  Dr. Sharon Unger was quoted in The Toronto Star in November as saying:
“We’ve long, long, long wanted a milk bank in Ontario,” says Dr. Sharon Unger, a Mount Sinai neonatologist.
“Our hope is that we would supply milk to all of Ontario, so we’d have depot sites or collection sites throughout the province and we’d be a central processing plant,” says Unger, who is medical director of Toronto’s Milk Bank Initiative.
The group is currently in negotiations with the provincial health ministry to fund the project. Unger says a final price tag has not been determined, but that it would be a multi-million-dollar venture.
“It does of course cost more to process human milk than cow’s milk,” she says.
...and as I said at the time:
Applause, yes applause.  It's a wonderful thing that the media has jumped on the band wagon and is making public announcements like this, I mean,  any publicity is good publicity KWIM? Horray for Breastmilk!
But I have to admit that it irks me.  Mothers and Doctors, like Dr. Jack Newman, have been crying out for Milk Banks for Years- YEARS!!!! Not only that, but Canada does have a Milk Bank in Vancouver BC... a milk bank that they have been trying to close down for years!!  I wrote an article on the topic just a couple of months ago: Canada Needs Milk Banks!!!
And I still agree, We NEED milk banks!!!  But you know what? If we wait around for the government to get off their bureaucratic asses to build even ONE milk bank.... I'll probably already be a grandmother!!!  And when we get milk banks, will they help the babies that are healthy but need milk?  Will they give milk to mothers with low supply?  Adoptive mothers?  Mothers with babies that have special needs like Anaya? NO, they won't.

So we return to the original topic:  What if the mother isn't able to exclusively breastfeed?  What if she has low supply? What if the problem isn't so easily fixed?  What if the problem is one that is unfixable?  What then? Up until recently your only choice would of been feeding your baby infant formula.  Not much of a choice is it?

Now  you can choose to feed your baby donated human milk.  Mothers have had enough of waiting for the bureaucrats and money grubbers to build milk banks.  Now mothers have taken back their autonomy and are supporting other women and families.  Milk Sharing is the wave of the future.  Milk sharing is making a difference and helping families and babies.  And Human Milk 4 Human Babies is leading the way!!!

Here is another amazing story of one mothers struggle to breastfeed her baby and how milk sharing made a huge difference in her life!!!

Ruby's  Story
By Kim Parent

"I can’t remember when I made the decision to breastfeed my daughter – I just know that not breastfeeding never occurred to me. There were many compelling reasons to nurse, including cost, health benefits, and convenience. My partner and I collected books about breastfeeding during pregnancy and we educated ourselves about the subject. I learned what myths and traps to look out for, and prepared myself to stand up against the well-meaning medical staff who might want to supplement my baby with formula. Fortunately I had a trouble-free birthing experience.

However, within the first week it became obvious that something wasn’t right. Ruby would not keep her latch for more than a minute or two. She would unlatch, crying and screaming, over and over again. After several tearful days, we called an IBCLC. She was finally able to tell me why my daughter was so upset: I have breast hypoplasia, also known as IGT (insufficient glandular tissue). Hypoplastic breasts never fully develop, and they lack an adequate amount of milk-producing mammary glands. I was heartbroken.

My lactation consultant wrote a plan of action that would hopefully allow me to increase my supply while supplementing my daughter. With great effort, I was able to approximately double my milk production, to a maximum of a few ounces per day - not nearly enough to meet Ruby’s needs. We were supplementing with approximately 20 ounces of formula per day. We were not prepared to accept that formula was “good enough”,  being fully aware of the risks associated with artificial feeding. We could see that her little body was having trouble digesting the formula. She was very constipated, and she would scream and cry for hours. We tried many different brands, but her symptoms were always the same. I turned to my lactation consultant for advice on donated breast milk.

In all of Canada, there is only one milk bank, located in Vancouver, BC. Currently they cannot keep up with the demands of their own NICU. Even if there was enough milk available, the cost can easily be prohibitive. At $1.25 per ounce (which is much less than the cost of banked milk in the U.S.), it would cost us at least $750 per month to feed Ruby exclusively breast milk.

For our family, the answer was informed, mother-to-mother milk donation, not unlike wet nursing. We found several online resources to facilitate this, including the Human Milk 4 Human Babies Global Network on Facebook. Thanks to fifteen generous women, my daughter has received thousands of ounces of breast milk. She has not had a drop of formula in over three months! She is a different baby now – no more colic, spitting up, or constipation. She is hitting all of her developmental milestones and is just a radiantly beautiful and happy little girl. I still grieve the exclusive breastfeeding relationship that I had planned to have with her. However, I finally feel confident that she is receiving the best nutrition that I can possibly provide for her. I am eternally grateful to the amazing families who have helped us and for the support I have received from those around me.

Ruby at 3 weeks old

Ruby at 3 weeks old - at this point she had been supplemented with formula for over 2 weeks

Ruby at 3 months
Ruby at 3 months old, exclusively breastfed!

At 6 months old- exclusively breastfed!

A beautiful healthy Ruby at 6 months old!!

Wednesday, December 8, 2010

INFACT Canada: Health Canada's advisory lacks scientific basis

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.


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


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

  • There are very few drugs that are contra-indicated during lactation. Most drugs do not enter her milk.
  • Eats on Feets advises mothers on how to screens donors for prescription and non prescription substances.
  • 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.
  • INFACT Canada •

Why we Share: A Personal story of Milk Sharing

With Human Milk 4 Human Babies being in the news all over the globe recently, the media keeps asking "Why?"   Why are mothers willing to share their breastmilk, and why are mothers looking for breastmilk to feed their children?  Health Canada and The American Food and Drug Administration are issuing warnings about  sharing breast milk with women online. The following is an amazing story of one mothers struggle to nurse her baby and how donated breastmilk saved her sanity and possibly her sons life.

Our Story Using Donor Breastmilk

by Lynn Heinisch on Monday, 06 December 2010 at 03:46
There has been so much said about milk sharing, positive and negative, that I feel as though I should try and get our story out there.

Finding Breastmilk donors wasn't scary to us, my husband and I, because. . . .we MET online. This was back in 1997. Back before the whole internet boom, before it was common to meet people on line. And for my friends and family, it was scary. I didn't understand why, as if you knew me and you trusted me, you should trust my judgement.

Fast forward to 2008:
We, my husband and I, decided we wanted to have a family. We did our research and decided on a hospital birth attended by a midwife. For that we had to drive to Princeton, NJ. It was what we wanted, so it wasn't a big deal for us . . .until the miscarriages started. First one. Then two. Then three. I was told the same thing every time:

"Some times these things happen"
"Most women have at least one miscarriage."
"Don't worry, it'll happen."

I didn't believe them. I went and was worked up for 'infertility.' Invasive testing. Tons of blood work. They didn't see 'anything wrong with me' so on we went to try Clomid.

I was so low. So tired. On our second round, I got pregnant. I got excited. I saw a heartbeat. I was further excited! The risk of miscarriage drops drastically with a heartbeat, right? Then. I miscarried. They asked me to 'harvest' my child and bring it to them so they could test him because I refused a D&C while there was still a heartbeat.

After that, we were done. I couldn't take any more. I was exhausted. Then I got pregnant again. It was twins. I lost one of the twins and after that, I had a very normal pregnancy. My son had a single artery cord and when he was born was IUGR.

He lost weight at the hospital, which is normal for breast fed babies, and I was constantly harassed about wanting to breast feed. He was too tiny, my breasts were too big, my nipples too large, his mouth too small. And I was told to supplement. I had a sign on his 'warmer' that said 'no bottles, no pacifiers.' but I found out they (they nurses) gave him a bottle. Any time he was taken away to do whatever he came back with a pacifier. I should of know better.

He screamed. Oh, did he scream. I was told 'babies cry.' That some don't 'tolerate' formula, but it's 'normal.' I was given the go ahead to take him off formula at 6 weeks.

 At eight weeks he was still screaming. Still nursing constantly. He was 10lbs 6oz. I was proud. I did it. I got him to breastfeed. I got him to thrive.

We came back two months later and my son had lost weight. Over two pounds. I was told to give up breast feeding again. I said no. I said there has to be something wrong. I asked if I should remove food from my diet. If he was allergic to something in my milk. I was told no, no, no. Even my midwife said no.

We did bloodwork. My midwife kept accusing me of having IGT. I found it hard to believe that I could have IGT as I have DD breasts. So, I didn't believe her. I didn't have PCOS. If I did, I would have trouble getting pregnant, not STAYING pregnant, right? It had to be something else. I caved and we tried formula again. I gave him two oz and the screaming started. My husband gave him another two oz and the diarrhea started. Watery, mucousy diarrhea. I called the pediatrician right away and told them he wasn't tolerating it.

"He needs to adjust to the formula, try a different kind."

I was sent back to the store to find 'allimentum' and stat bloodwork was ordered as he didn't tolerate that either. His sed rate was 19, 20 was 'high' but his liver functions were dangerously high. We were sent to CHOP, Childrens Hospital of Philadelphia. It was during this time that I looked at gluten. I figured it couldn't hurt. So I eliminated it from my diet, but the doctors at CHOP weren't impressed. I was told in the ER that I should give up breastfeeding and I asked him how much medical training he had in breastfeeding. He admitted to me about 2 hours.

Liam- two hours before being admitted to CHOP
Little Liam being admitted to CHOP

We were shown to our room, I informed the nurses right off the bat that we were attachment parents, that we were cosleepers, my son was intact and was not to be retracted, we wore him. All things I'm sure were foreign to them. We weighed his diapers (to see how much urine he was putting out) and we weighed him pre and post feeds. I tried explaining to them we nursed to sleep, and they didn't understand that. They didn't understand why I didn't put him in a crib.

They didn't get babywearing either

I eventually had to talk to the resident and tell them they weren't respecting our beliefs. It was then they backed off. I never got weights threw the night, they assumed I wasn't making enough and that I had IGT. Lactation came in. She told me to give up. That I could pump around the clock but because she thought I had PCOS and IGT that I wouldn't produce more milk.

I showed her.

I pumped every chance I got and I started producing more.

She was shocked.

We were discharged after five very long days. I felt horrible as my husbands first fathers day was spent at CHOP or running home to feed our dogs or do diapers. I left feeling defeated. I had decided to blog my time in CHOP, mostly for sanity, but so people could know our son was sick. It was easier for me to tag people in a note so they knew what was going on rather then call everyone. It also saved me from having to repeat myself which is something I really hate to do.

It was then, after my son was 'diagnosed' with Failure to Thrive that I met Molly. Molly is one of my donors and Molly blogged about me. She read my note on Emma's page and her frustrations with CHOP inspired her to help us. Molly's blog put us in contact with another mother who had a large stash and offered her milk to us. I had two friends who gave us about 50 oz each, but this woman, this woman was a milky goddess.

She had to of given us over 1000 oz of milk. Easily.

She was embarrassed that she produced so much so I have never shared her name with anyone. It was then my son started to thrive. I noticed a change in him. He was happier, but he still cried when he got the bottle of EBM. He nursed
more. He gained weight. But he would always have bad tummy pains after the EBM. I always thought, at the moment, they had broccoli. But it wasn't that. It was gluten.

We were now being seen at our pediatrician weekly for weight checks. He gained. Kept gaining. Then I felt comfortable enough to take him off of the EBM and solely go back to breast. We never looked back. My sons last bottle of donated breastmilk was the last week of July.

liam at 7 months old

Our pediatrician was uncomfortable with the EBM at first. She warned me about viruses and diseases and I told her I was more comfortable with the EBM then the Formula. I also told her we screened our donors. She asked me a few questions and smiled. She wanted to make sure we were being smart. And I would like to hope that todays mothers ARE being smart.

In June my son weighed 8 lbs.
In September 14 lbs
In October 17 lbs
And now weighs almost 20 lbs
Liam's pic taken two weeks ago!

Tomorrow the FDA will address 'informal milk sharing.' I use quotations because I don't personally see it as 'informal.' I see it as women, reaching out to women and becoming friends. I still have contact with all my donor moms, some are closer then others, but I still know them. I want my child to grow up and know them. I want people to stop looking at me like I have a third eye when I mention breast milk saved his life.

I'm sure the FDA will try and outlaw this. Because they see children like my son expendable. They don't care about my son. The AAP doesn't care about my son. If they did, they would of listened to me at CHOP. They would of sent us to gastric. They would of tested my son for Ciliac, for allergies. But they didn't. They didn't believe a mother.

So forgive me if I don't believe you. Like you, I'll make my own informed decision. And if it's different from yours, I don't really care.

Saturday, December 4, 2010

Rethinking Swaddling

It seems that every time you see a "birth" on TV the baby is immediately mummified in blankets and hats and handed to the fully clothed mother to smile and coo at.  Wrapping babies up tightly in a blanket is known as "Swaddling", and until recently was considered the normal way to keep babies warm after birth and it is still the generally accepted practice in most hospitals.

While considered the norm, many doctors are speaking out against swaddling and studies are proving over and over that swaddling is not only NOT helpful in warming the baby, it also negatively effects the baby's ability to breastfeed naturally and properly, and can increase risks of SIDs.

Babies are meant to be with their mothers, and the best way of nurturing a baby is to maintain skin-to-skin contact between the baby and it's mother.  This is known as "Kangaroo Care" . The baby, wearing only a diaper, is held upright against the parent’s bare chest. The term kangaroo care is used because the method is similar to how a baby kangaroo is nurtured by its mother - from the safe environment of the womb to the safe environment of the pouch where further maturation of the baby occurs. Skin-to-skin contact promotes more consistent heart and respiratory rates; it stabilizes oxygen needs; it aids in stabilizing blood sugar levels; it regulates body temperature; and improves weight gain and helps increase breast milk supply.

Dr. Nils Bergman, the father of modern "Kangaroo Care"  developed and implemented Kangaroo Mother Care (KMC) for premature infants right from birth. This resulted in a five-fold improvement in survival of Very Low Birth Weight babies raising the survival rate of these tiny preterm infants from 10% to 50%.

But Kangaroo Care isn't just for preemies. Skin to Skin contact is vitally important for all infants.

"The very best environment for a baby to grow and thrive, is the mother's body," says Dr Nils Bergman, "When placed skin-to-skin on the mother's chest, the baby receives warmth, protection and food, and its brain can develop optimally. Not feeding the baby often enough and leaving it to sleep alone after a feed can result in the baby getting colic", he adds. "The mother's skin is the baby's natural environment, and both physically and emotionally the healthiest place for the baby to be".

Dr. Jack Newman of the Newman Breastfeeding Clinic & Institute in Toronto is a huge supporter of mother & baby skin to skin contact and strongly promotes it in his clinic and when training and working with medical professionals in the birthing industry.

"To appreciate the importance of keeping mother and baby skin to skin for as long as possible in these first few weeks of life (not just at feedings) it might help to understand that a human baby, like any mammal, has a natural habitat: in close contact with the mother (or father). When a baby or any mammal is taken out of this natural habitat, it shows all the physiologic signs of being under significant stress. A baby not in close contact with his mother (or father) by distance (under a heat lamp or in an incubator) or swaddled in a blanket, may become too sleepy or lethargic or becomes disassociated altogether or cry and protest in despair. When a baby is swaddled it cannot interact with his mother, the way nature intended. With skin to skin contact, the mother and the baby exchange sensory information that stimulates and elicits “baby” behaviour: rooting and searching the breast, staying calm, breathing more naturally, staying warm, maintaining his body temperature and maintaining his blood sugar."
Nancy Mohrbacher in her blog  writes an excellent article that outlines the many reasons why the tradition of Swaddling babies is dangerous and needs to come to an end:

Rethinking Swaddling

There’s no doubt that babies seem calmer and sleep more when swaddled.  But is this a positive or a negative?  The research provides some surprising answers, starting with the first days after birth.
Swaddled babies arouse less and sleep longer.1 That may sound good, but in the early hours and days after birth this can lead to less breastfeeding, which is associated with greater weight loss, more jaundice, and a delay in milk production.2
Swaddling delays the first breastfeeding and leads to less effective suckling.  In a study of 21 babies after a vaginal birth,3 researchers divided them into two groups.  One group was laid skin-to-skin on mother’s body, examined briefly, then returned to skin-to-skin contact for two hours.  The other group was shown to the mother, examined, and swaddled with hands free and then returned to mother.  The swaddled group showed delayed feeding behaviors, suckled less competently at their first breastfeeding, and established effective breastfeeding later.

But what about after hospital discharge?  Once a baby is breastfeeding well, is there any reason to avoid swaddling?  While swaddling may be helpful when used occasionally, routine swaddling during the first months associated with greater risk of:
  • Respiratory illness10 
  • Hip dysplasia11
  • SIDS in prone sleeping positions12
  • Overheating13
Evidence is also growing that babies’ hand movements aid them in finding the breast and latching. 14 Swaddling during breastfeeding to restrict babies’ hands may contribute to breastfeeding problems.
After reading the research, my own opinion of swaddling has changed.  In most cases a mother’s body is her newborn’s best “baby warmer.”  When babies get fussy, it may be best to limit swaddling and suggest instead parents consider alternatives, such as skin-to-skin contact and baby carriers.

 HERE to read Nancy's entire article

For more information about swaddling please read my article "In the Pouch"

Wednesday, December 1, 2010

The Paradigm shift is afoot!

This is an excellent article about the shift in thinking that is happening and needs to happen in the realm of feeding our babies.  It isn't enough to talk about "Breast is Best" with hollow slogans and parroted words that have been plagiarized by the infant formula companies. Women, babies and their families need to learn the truth: Breast is Normal.  Yet finding support to breastfeed is anything but.

So while most provinces provide seriously inadequate breastfeeding support, and even less funding for education and clinics, and the Government of Canada blathers on about the need to put milk banks in every province, it falls back onto the mothers to educate and support themselves and each other through this adventure in babyhood. And if that support includes sharing breastmilk with mothers that need it?  So Be It.

It's time for the paradigm shift.  It's time for breastfeeding to be normal and breast milk to be the norm, regardless of who's breastmilk it is.

A Paradigm Shift is Afoot: from "combination feeding" with formula to informed milk donation

There has been a rather seismic movement afoot (pun intended) in the online breastfeeding community, as it were, over the last few weeks. If you're not in the loop, the gist of the situation is that a breastfeeding advocate named Emma Kwasnica has galvanized a Facebook-centered milksharing network online: Eats on Feets. Such a thing isn't 100% new, as a site called MilkShare has been working at the same for a while now, and those in the know might be able to find donors on boards like (I've unloaded my freezer to several strangers on MDC myself). But this is taking flight like nothing has before, and I think it has everything to do with harnessing the power of Facebook and social networking in general, and how integral it has become to many of our lives.

Other bloggers have done a great job detailing the phenomenon that is Eats on Feets, such as The Motherwear Breastfeeding Blog and One of Those Women. There's much to discuss, including the (over)reaction of the Canadian government - and I won't try to reinvent the wheel here; check out their posts! But this awesome recent development ties into something I've been struggling to write about recently anyway, which is the matter of supplementation, which, in our current Western society, is set by default to formula.

Some refer to the choice to supplement (often electively, but sometimes out of necessity) as "combination feeding" or "mix feeding". It sounds innocuous enough, right? I've heard it referred to as "the best of both worlds", and despite the crystal-clear recommendation from both the AAP and the WHO to breastfeed exclusively for a minimum* of six months, the number of women who breastfeed at all are combination feeders. By a huge majority....
Here's my loose hypothesis: the prevalence of combination feeding is yet another result of the well-intentioned but deeply flawed "Breast is Best!" message backfiring. How so? It's tricky, but think about statements like "Every little bit counts - it's liquid gold, after all!" and "Any breast milk is better than none!" Such sentiments abound. Are they true? Well . . . yes. But I think there's a perception out there that breast milk is so powerful that even one feeding a day is enough to confer its benefits. Breastmilk, an omnipotent panacea of mythical, even supernatural proportions - surely it will cut through all the well-documented risks of commercial, artificial infant milk. Right?

IS some breast milk better than none? Well, I'd be hard-pressed to say no. Yes, it is. But saying "yes" is so far from saying that some breastfeeding is even close to the same as exclusive breastfeeding. The immunological benefits of breastmilk are some of its most powerful, the introduction of formula actually negates these very benefits. Look at this recent study from BMJ, examining the protective effect of exclusive breastfeeding on infections in infancy. It concluded that "Partial breastfeeding was not related to protective effect."

And here's another piece on a larger study released earlier this year:

"Significantly, the study showed no health benefits for infants who received formula along with breast milk, even when partial breastfeeding extended a full six months . . . . None of the antibodies found in breast milk are able to be duplicated in manufactured formula, resulting in a significant lack of protection for formula-fed babies against infectious diseases. Formula is unable to match the complexity of breast milk, the consistency of which adapts over the first few months of a baby's life, changing to fit the baby's needs as he or she grows."
Allow me to repeat that - I apologize for belaboring the point, but I want to make sure it's not missed: "The study showed no health benefits for infants who received formula along with breast milk, even when partial breastfeeding extended a full six months."...

Where does this leave us? Despite the overbearing harpy cliche, I'm coming to feel that breastfeeding advocates, including lactivists and educators as well as some medical professionals, ARE extremely sensitive about pressuring new moms, and want so badly to be reassuring and accepting and above all, non-judgmental . . . so much so that they/we end up understating the risks of formula feeding. Do what you can. Of course some breast milk is better than none. It's okay. You do what you can.

It's a conundrum. We DO need to be supportive. We DO need to be inclusive. We DO need to be non-judgmental. But we also need to make sure that mothers have all the relevant information, all the facts, in order to make empowered choices. Choice, yes, but informed choice. We need to not undermine parents right out of the gate by telling them that (as I witnessed from a professional firsthand) The breastfeeding bag they give you at the hospital has a bottle of formula in it, and that's there to tell you that hey! it's okay to do both! You don't have to choose!

As anyone reading this blog is likely aware, in addition to the risks for the infant, supplementation not done carefully leads to diminishing supply, and if the mother is not aware of how this works, mom's assumption is that something is wrong with her, that she "just couldn't make enough milk", and the slippery slope to total cessation of nursing has already begun. There has to be a way of being compassionate and inclusive without saying things like, as I have also heard with my very own ears from a pro, "If you want to nurse for 6 weeks and then start using formula, that's okay! Whatever works for you! If you want your husband to give a bottle of formula overnight so you can sleep, that's okay! Whatever works for you!"

But there ARE cases, as we know, where supplementation IS necessary. There is no denying that. We want to reduce these cases, but there absolutely are times when it is needed, such as moms with hypoplasia/IGT, or with some BFAR moms, for instance. And here's where the paradigm shift comes in.

It's time that donor milk becomes a real possibility for mothers.

Despite formula companies spending millions to convince you that their product is the "next best thing" to human milk, the WHO designates formula as fourth best - dead last, in other words. The first choice is simply mother breastfeeding her own child, and then pumped milk from the same mother to her own child. Then, third best, is donor milk from another mother, not formula. Yet when supplementation proves to be necessary (either temporarily or long-term), the default in our society is to go directly to formula. Then begins a cycle of figuring out which formula is less difficult for the baby's system. Do we try the "gentle" variety? What if milk is the problem - do we do soy? If that's not working, on to the hydrolyzed and painfully expensive kinds. What if donor milk was a viable option? What if it wasn't just a vague possibility - difficult to pull off in the short term and even harder to do over any substantial length of time - what if donor milk was, instead, the default?
HERE to read the entire article on Doula-la-la