Mother-to-mother human-milk sharing: what’s not to like?

This is a fantastic guest post from, James Akre. I'm hoping to have lots more of his amazing words to post here in the future!!! 

In May last year I was privileged to deliver the GOLD10 inaugural presentation, which was called: What is the problem with breastfeeding? I concluded with ten proposals for immediate action, for example the need to stop referring to breastfeeding as ‘best feeding’ and define it rather as ‘normal feeding’; and to cease talking about ‘the benefits of breastfeeding’ and focus instead on ‘the risks of not breastfeeding’.

My next-to-last proposal was in two parts: evaluating ‘the amount and value of human milk produced and consumed worldwide’, and ensuring that ‘human-milk banks become a routine component of healthcare infrastructure everywhere’.

The model I had in mind was the classic community blood bank. In a bit more than a century since such banks began functioning, they have become as ordinary as they are indispensable.

I don’t know how you see it, but from both a practical and historical perspective, what began to surface only six months ago – Internet-based, non-commercial, mother-to-mother human-milk sharing – strikes me as being a bit like the fall of the Berlin Wall in 1989 or the Arab Awakening of 2011.

If you think I’m being melodramatic, consider the totally unforeseen consequences of the act of one mother, in October 2010, searching on line for breast milk for her child. Here we are, six months later, with a vast and still-growing milk-sharing system in place in some 50 countries on all continents.

Despite its popularity – indeed, owing to its popularity – this contemporary variation on a practice that is as old as our species has become the focus of stern criticism and woeful warning from public health authorities, notably Health Canada, the French agency Afssaps, and the United States Food and Drug Administration. What is going on here? This is how I would describe the current state of play.

On the one hand, media reports suggest a convergence of well-informed and highly motivated women extending their control over the availability and use of human milk. Caregivers of babies who need breast milk are connecting with mothers who are able to donate breast milk using two Facebook-based networks, Eats On Feets and Human Milk 4 Human Babies.

These networks provide a platform for women to share their milk in a safe, ethical manner. This is done in the belief that they are capable of making informed choices, free of coercion; taking into account information on the benefits and risks; and reducing exposure to pathogens, including by pasteurisation. The overriding operative principle is that all who are involved in milk-sharing take full responsibility for their individual course of action and its outcome.

On the other hand, the formal position staked out by some public health authorities and health professionals can be summarised in three short words: Just say no! Why this dogmatic view?

Well, for starters, it’s the easiest way to reduce to zero milk-sharing’s inherent health risks. But this approach fails to take account of the inherent health risks of a child not receiving breast milk, which appear to have got entirely lost in the shuffle. It is rather a question of relative risk and how to manage it and minimise potential harm.

Despite the mass of scientific and epidemiological evidence to the contrary, in far too many environments breast milk and breastfeeding continue to be seriously undervalued, even as the nutritional merits and supposed safety of infant formula are greatly exaggerated. In these circumstances, infant formula is perceived as the ‘obvious’ alternative to a mother’s milk. But as we observe the rapid, and geographically and culturally diverse, expansion of mother-to-mother human-milk sharing, it is clear that growing numbers of mothers are radically dissenting from this unphysiological status quo.

In demonstrating their heightened awareness about how their babies should be nourished, these mothers are also giving eloquent expression to the World Health Organization’s infant-feeding recommendation, with its explicit nutritional hierarchy, that has been in place since 1986: milk at the mother’s breast; expressed milk from a baby’s own mother; milk from another healthy mother; banked human milk; and, lastly, infant formula. This is just one of the reasons why I always define formula not as the best alternative to a mother’s milk but as the least-bad alternative.

It’s hardly surprising that some in the public health and medical establishment regard this Internet-based milk-sharing model as a challenge, even a threat. It certainly has the right ingredients: a system that operates outside its influence, that can’t be regulated, and where mothers alone exercise control. But rather than resisting and dismissing it out of hand, the constructive approach would be to engage in ways that help make it as safe as possible.

Before closing I would like to return briefly to what I said, during GOLD10 and a few minutes ago, about ensuring that ‘human-milk banks become a routine component of healthcare infrastructure everywhere’. In the light of the mother-to-mother milk-sharing model described above, I want to assure you that I am no less enthusiastic about this proposal today than I was a year ago. If anything, I think it has become still clearer to me why it is so important.

It is at best naïve and uninformed, and at worst intellectually dishonest and culpable, to discourage mother-to-mother milk sharing while instructing mothers to stick with traditional human-milk banks, which follow a careful protocol designed to protect babies. Reality contradicts this dismissive injunction. According to reports, on a good day milk banks manage to cover no more than half the actual demand. Thus, they wisely husband available milk for the most vulnerable babies, especially the very sick and premature. But at US$3-5 a fluid ounce or about 30 ml, even if milk were available, few parents could afford such luxury.

Some observers appear to be anxious that mother-to-mother milk sharing threatens the few under-supplied banks. I don’t have the evidence to demonstrate it, but I am inclined to believe that expanding direct human-milk sharing might well spur human-milk banking by increasing awareness of the significance and availability of women’s milk, persuading more mothers to donate, and thereby increasing the number of banks and available milk volume.

Thus, I see mother-to-mother milk sharing as complementary to donor milk banking and not its competitor. Let us resolve to do everything we possibly can to ensure that this is always the case.

  * * *

1 Commentary prepared by James Akre, Geneva Switzerland, and delivered on line during GOLD11 (Global Online Lactation Discussion) on 13 May 2011 http://www.goldconf.com/hottopics-speakers.html.

A Funny Thing Happened on the Way to the Milk Bank...

This is a wonderful article, written by an amazing woman whom I'm lucky to call "friend".

Enjoy!

A funny thing happened on the way to the milk bank...

By Jodine Chase

Six months ago today on October 27, 2010, a Facebook status update flashed across my computer screen, burning just a little brighter than most. I must see hundreds of Facebook status updates and Twitter messages and email subject lines over the course of a day.

This one, I remembered.

"Human milk sharing, woman-to-woman, goes global" was the title, from Emma Kwasnica's Informed Choice: Birth and Beyond Facebook group. I remember a mental "hmmm" as it slipped on past.

I remember thinking, "it's about time somebody took charge of this and put access to mother's milk in the hands of  the mothers!"

The notion of re-establishing the mother's milk bank in my city was starting to feel very remote after years of effort with little result. It's been 25 years since we had a milk bank here in Edmonton. This Facebook milk sharing page idea seemed so simple, so easy. Just let mothers connect with each other. Let them decide how to screen and whether or not to pasteurize. To heck with jumping through hoops and getting the doctors and the medical professionals on side - just let the moms do it.

Within hours I noticed it had increased from one message to a buzz on my Facebook - people were talking about this, sharing news of the birth of this global milk-sharing network.  Every few hours I'd see another message, status update, post talking about Emma's global milk sharing network idea. It was starting to have a "tipping point" feel about it.

A few days later I met a longtime breastfeeding advocate at a coffee shop - and there she was, talking about this milk sharing idea on Facebook. It had moved from Facebook to face-to-face. Within a few days a local community page was set up, the sure enough, there they were, all the usual suspects, people who have been passionate about the need for a milk bank here, active on the page, offering their time as admins. 

It's six months later. I've seen many matches happen. We've had people post about life and death, "I-have-no-milk-and-this-baby-won't-tolerate-anything-else" needs, and ordinary, "I-just-need-milk-for-a-few-days-until-I-get-over-the-flu-and-rebuild-my-supply" needs. Mothers of preemies with overflowing freezers have donated. Matches have been made where women ship milk via Greyhound and Purolator. We've also had women who have received milk from their next-door-neighbours. Literally, their next-door neighbours.

There's been local news coverage and global media attention. Our federal health department issued a precautionary statement. A paediatrician working to establish a milk bank in Toronto was called upon to explain this upstart global Facebook milk sharing phenomena at the US FDA's day-long milk bank meeting in Washington, D.C. 

Hollywood movie stars talked about donating extra milk stored in their freezers for babies in need, and stars with adopted babies like Neil Patrick Harris and Elton John talked about sourcing human milk on talk shows and in magazine interviews.

I'm not going to pretend it's mainstream. But in the last few months friends and acquaintances and relatives have come up to me in person, or engaged me in chat on FB and shared with me their own stories of wet-nursing, milk sharing, tribe nursing. Stories I'd never heard before. About the time they were sick and a neighbour brought over breastmilk. About the day they had to go to the hospital and a friend wet-nursed their baby. About their own freezer stashes and how they came forward to help women and babies in need. Women younger than me have spoken about doctors asking them to bring milk into hospitals for babies who aren't thriving. Women have said, matter-of-fact, "oh, my sister and I nursed each other's babies all the time.

These women are talking about it now because it feels safe  to talk about it. It doesn't feel icky or taboo anymore. It doesn't feel as if no-one else will understand - now when there's people talking about this global milk sharing network right on your Facebook. Your sister is doing it, your daughter is doing it, and you find out about it because she talks about it on Facebook. It MUST be "normal." That's the real power, I think, of this global milk sharing network on Facebook - the power to bring all these stories out of the closet.

Emma Kwasnica, six months ago today you put out your call. You asked mothers to organize themselves on Facebook to create a women-to-women milk sharing network. And they have. Today Human Milk 4 Human Babies is a global milk sharing network with almost 300 administrators, 125 community pages in almost 50 countries around the world.

There has been a seismic shift in attitudes about human milk and there is no going back from that. Authorities are concerned about safety and are scrambling for alternatives including improving access to human milk through "official channels."

Will there be more milk banks because of this global milk sharing movement?

I hope so.

But with mothers sharing milk openly and freely, connecting via Facebook and using other social media tools, will milk banks even be needed? I almost hope...not.

Front page of the Toronto Star this morning, "Donor Breast Milk is Greatest Gift for Sick Babies" http://www.parentcentral.ca/parent/babiespregnancy/babies/breastfeeding/article/896373--donor-breast-milk-is-greatest-gift-for-sick-babies

AIM submission to Health Canada on Infant Nutrition

A group of mothers on Facebook have formed the Association of Informed Mothers - AIM. This group was initially created to write a submission to Health Canada in response to their draft document "Nutrition for Healty Term Infants: birth to 6 months". This document will replace the current Canadian Guidelines that are in place, and while they have made some excelent changes, some areas of the draft document were very poorly worded, or incorrect. The following is AIM's submission to Health Canada and we would like to invite everyone who agrees with our document to sign your name to the bottom of it as an interested member of the public. If you wish to have your name added to the submission please  go to the facebook note HERE  and comment with your name, city and province. this document will only be open for signatures till 9pm this evening. so please feel free to share it out on your groups etc to spread the word!

A huge thank you to all the moms who poured their heart and soul into this document!
Dani

********************************************

The Association of Informed Mothers (hereafter called AIM) is a stakeholder group of mothers who support and advocate for mothers' rights to make fully informed choices for the health and well-being of both themselves and their families. To do this, mothers need access to information that is in the spirit of full disclosure and is provided free of influence by organizations, third parties, or persons that hold a conflict of interest. It is AIM's belief that Health Canada is responsible to provide information to the citizens of Canada that comply with these points.

AIM fully supports INFACT Canada's submission to Health Canada's Committee reviewing the guidelines for "Nutrition for Healthy Term Infants". AIM strongly believes that INFACT Canada's submission is of great value to the Health Canada Committee, as the information it provides is accurate, does not create a conflict of interest and is well researched. (A copy of INFACT Canada's submission is included at the end of this document).

AIM also fully supports UNICEF's submission to the Health Canada Committee. Health Canada has agreed to follow the World Health Organization's (WHO) infant feeding recommendations, and therefore any statement made by Health Canada should be aligned with UNICEF's submission (A copy of UNICEF's submission is included at the end of this document).

The following is a list of AIM's key concerns with Health Canada's draft document "Nutrition for Healthy Term Infants - birth to six months". AIM has specified a list of changes to be made to the document. These changes are required for the draft document, in order to provide the information parents need to make fully informed decisions for their family.


1. The language of the Health Canada draft document needs to be changed to reflect the normalcy of breastfeeding. Statements such as "the benefits of breastfeeding" should be changed to "risks of artificial feeding methods" or "the importance of breastfeeding". Breastfeeding is the biological norm for all human children, referring to its outcome as "benefits" implies it is outside and/or above the norm. For further information of the use of language and its effects on normalizing breastfeeding, please refer to the article "Watch your Language", written by Diane Weissinger, Journal of Human Lactation, Vol. 12, No. 1, 1996.

2. It is legally and ethically advisable for Health Canada to omit statement #5: "Commercial infant formulas are the only acceptable alternative to breastmilk." from these guidelines. To make such statements is unethical, inadvisable, and untrue. The inclusion of statement 5 directly contradicts Health Canada's acknowledgement and public acceptance of the WHO Infant feeding guidelines, which state that "For those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk substitute fed with a cup,which is a safer method than a feeding bottle and teat – depending on individual circumstances."apps.who.int/gb/archive/pdf_files/WHA55/ea5515.pdf

Statement #5 is also contrary to UNICEF's recommendations for infant feeding, and undermines the use of donated and banked breastmilk. 

Currently, several provinces are researching the creation of milk banks, and the Canadian Paediatric Society is calling for the development of milk banks across Canada. The use of donor milk, whether through formal or informal channels, is vitally important to the health of infants whose mothers are not able to exclusively breastfeed, and is fully supported by WHO. It is the recommendation of AIM that Health Canada develop guidelines to address the use of donor milk, outlining the risks and benefits of using donor milk vs infant formula, and provide the information necessary for parents to make fully informed decisions about feeding their infants.

3. Health Canada should remove all sections in the draft document that discuss the use of artificial breastmilk substitutes. Those sections addressing commercial infant formulas should be made into a separate document or included in an appendix on the use of artificial feeding methods and products. Full disclosure of information about the risks of using commercial infant formulas and safe feeding methods is imperative in order for parents to be fully informed when making infant feeding decisions. By placing nutritional information about infant formulas side by side with breastfeeding, Health Canada is creating the false impression that they are equal and interchangeable methods for feeding infants. This is untrue, misleading, and does not meet the principle of full disclosure, nor does it give parents the proper information upon which to base their decisions. 

4. We submit that Health Canada should make its stance clear by making an official statement affirming that Canada is both a signatory to, and is compliant with, the World Health Organization International Code of Marketing Breastmilk Substitutes and subsequent resolutions. 

The Government of Canada is a signatory to the International Code for the Marketing of Artificial Breastmilk Substitutes and as such is required to pass legislation which provides for the enforcement of all provisions of the Code. Health Canada not only has a responsibility to remind all levels of government of this requirement, but also to ensure that all health care and related facilities within Canada are compliant with the Code. To ensure this compliance, Health Canada must immediately inform all physicians, nurses and health care facility administrators of the full range of provisions of the Code. Upon completion of dissemination of this information Health Canada must ensure that all professionals and facilities in Canada meet the requirements of the Code. INFACT can assist in this matter through the provision of information and resources.

On May 21st, 2011 it will be 30 years since Canada and 118 other countries signed the WHO Code, yet the Canadian government continues to refuse to pass legislation to protect and enforce the Code. 


5. The Baby Friendly Hospital Initiative (BFHI) is integral to ensuring mothers and babies are provided with the minimal support and information needed to begin their breastfeeding relationship at birth. The Baby Friendly Hospital Initiative (BFHI) should be fully endorsed by Health Canada. All Canadian hospitals should be informed of all BFHI recommendations and should be striving to attain BFHI status by a set date. BFHI should be recognized by Health Canada as the minimum requirement, not a luxury.

6. The Health Canada draft document should focus on the need for better breastfeeding and lactation education for all medical professionals (doctors, nurses, midwives etc.), and any personnel that come into regular contact with new mothers (social workers, etc). Health Canada should also advise provincial and territorial health policy makers that breastfeeding support and education at these levels are seriously lacking, and that this lack of education negatively impacts the ability of medical professionals to support mother and baby dyads. Health professionals who are unable to provide educated lactation support should be advised that mothers must be referred to professionals that are fully trained, rather than giving misleading and/or inaccurate advice that is detrimental to breastfeeding success.

7. The statement made in the draft document: "4. In Canada, all infants need supplemental vitamin D. " is incorrect and misleading. Health Canada cannot accurately state that ALL infants need to be supplemented with Vitamin D. Instead, AIM recommends that Health Canada set up prenatal maternal testing for Vitamin D levels. If mothers are shown to be deficient in Vitamin D, prenatal supplementation has been shown to optimize vitamin D levels in infants. Canadian mothers are at higher risk of being Vitamin D deficient due to northern latitude and long winters with little sun exposure. Therefore, it is the recommendation of AIM that Canadian mothers be advised by Health Canada to take a Vitamin D supplement along with folic acid to ensure infant health after birth.

8. AIM does not agree with the current American Academy of Paediatrics recommendation that breastfed infants should be supplemented with iron. Breastmilk has been proven to contain adequate iron to support infant health, except in cases of severe maternal anemia. It is AIM's recommendation that Health Canada encourage prenatal testing to address maternal anemia before birth. 

9. The statement by Health Canada in section 2.7: "The impact of cesarean birth on breastfeeding appears to have changed over time. In most cases today, cesarean birth does not impede breastfeeding" is incorrect and needs to be removed. There is no evidence to support this statement, and strong evidence to contradict it. Health Canada needs to set up separate guidelines that examine and make recommendations about medical interventions during pregnancy and childbirth such as chemical inductions, the routine use of IVs, epidurals, invasive testing and pain medications during labour, the use of surgical interventions, such as forceps/vacuum extractions and cesarean sections, and early cord clamping and their effect on maternal and fetal outcomes, with special attention given to breastfeeding initiation and longevity . Perinatal practices are one of the most powerful indicators of long term breastfeeding success and are therefore vitally important considerations.

10. In section 9 the Draft Document states that "9. At six months, infants need complementary foods along with continued breastfeeding to meet their nutrient needs". This statement gives the impression that breastmilk is no longer adequate after 6 months and that it suddenly loses it's ability to nourish an infant at this time. This is inaccurate. It should also be noted that not all infants are ready for or require complementary foods at a set age, i.e. 6 months. A statement that "Infants should not be given complementary foods before 6 months, but after that time introduction solids may begin" would be preferable.

It is the opinion of AIM that the committee responsible for these guidelines is lacking oversight by the public and should include members that are involved in stakeholder groups or members of the general public who are interested in the outcomes of the draft document and Health Canada's new guidelines. 

Currently breastfeeding initiation rates in Canada are excellent. However, by 3-6 months the percentage of mothers exclusively breastfeeding their babies drops radically. This extreme drop in breastfeeding rates directly affects the health and wellbeing of mother-baby dyads and is an accurate indicator of the lack of information and lactation support currently available to families across Canada. It should be noted that the recommendation of exclusive breastfeeding to six months is often undermined or outright ignored by health care professionals who encourage or recommend or demand supplementation with infant formula before the baby has even been released from hospital. Evidence-based information and education provided to parents and health-care professionals is integral to the increase of long-term breastfeeding rates in Canada. As members of AIM, and as mothers, we have a vested interest in increasing breastfeeding information and education available to healthcare providers and families across Canada. We therefore respectfully request that Health Canada review our submission and make the changes necessary to bring Canada in line with the World Health Organization, and to maintain its place as a key player in the forefront of worldwide health.

We thank you for the opportunity to provide our recommendations. We would like to be included as a stakeholder in any future consultation on these or similar guidelines. 

Association of Informed Mothers

Danielle Arnold
Brantford ON

Milk Sharing: circle that we create is never ending.

Thank you to Ana in Wisconsin for allowing me to share her amazingly beautiful story.

Hello! My name is Ana, and this is my milk donation story.

My beautiful daughter Clara was born on March 2nd of last year. Her pregnancy was blissful and I spent many happy months looking forward to finally meeting this amazing little person and starting on our long nursing relationship together! Her older brother had been a champ at the breast from the very start and had nursed all throughout the pregnancy, so I was also looking towards tandem nursing my baby girl and her 3 year old brother!

Her birth was a bit rough, but when she was finally in our arms all was peace. She latched right on and fed hungrily from the very get go :) No problems at all. So we thought....

3 days later, as we prepared to go home her blood work started coming back showing signs that her liver was in distress. 2 weeks in the NICU and a zillion tests later, she was diagnosed with Biliary Atresia, a rare but serious liver disease.

We were transported to Children's Hospital to await the first of her major surgeries. All went well, and we were given hope that the procedure (which involved taking 1/2 her liver, portions of her bowl, and rerouting her intestine) would allow her body to function properly. She was 3 weeks old at this point and still nursing great.

However in the months that followed, as we watched our sweet baby grow more and more yellow, watched as her belly swelled, and as she grew weaker by the day...we knew that the surgery hadn't been a success. Her weekly blood tests showed marked worsening of her condition.

And that 9 day early separation from the breast, despite my fervent pumping, and the stress of living in a hospital and watching my precious girl bet cut apart and sewn up again started to take it's toll on my milk supply.

But after 6 weeks, we went home. And still, we nursed. I laughed about it. After all I'm a LC! If anyone could do this, it was me!!

Then month 4 hit. She was hospitalized with a massive infection and we started to move towards full liver transplant.

It was during this hospitalization that our kind, wonderful group of doctors and advisers sat us down and told us that there was a good chance that she would not make it. Her body wasn't responding to treatment, and she wasn't the ideal candidate for transplant as it was. She continued to grow weaker. Suckling at the breast became a massive exertion that would leave her exhausted and expend more calories then she took in. With a failing liver, food absorption was enough of a problem already! So we put in a Nasal Gastric feeding tube to ease her struggle. And I pumped. God, did I ever pump. I had to get up every hour on the hour with her throughout the night to medicate and care for her as it was, so I pumped then too.

But despite my knowledge as a LC, and seasoned nursing mother, my milk dwindled. I didn't sleep. I cried. My baby was dying front of my eyes and I couldn't even give her the one thing she needed most. Due to the extensive injury and openness of her bowl, formula wasn't even an option. We tried out of desperation and it was very quickly obvious that it hurt her, and I took it off the table of her nutritional care options entirely.

So I put out the call. And it spread. It spread like wild fire.

As I type this, I'm sitting here crying a waterfall of tears remembering each and ever woman, many of whom I didn't even know at the time, showing up at my door with coolers full of their own liquid gold. Women from other states driving up to deliver milk. Friends, relatives, sisters in motherhood. Giving my child the gift of life. And this TRULY is what it came down to. My sweet Clara's life would not have been as long without all of that precious breast milk.

It was a gift that I can never repay. These women gave selflessly, expecting nothing in return. Holding me and crying with me and essentially nourishing my child as their own.

I wish I could say that this story has a happy ending. That Clara's transplant was a success. But after 6 months of fighting and pain and suffering we were told she was not a candidate for transplant at all.

So, we took her home.

And there she rolled in the grass, she played with soft kittens, she snuggled up on our warm chests every night. It was the most joyful time of my life.

She lived 8 long beautiful months and she took her last breaths in the comfort and security of our arms November 6th.

As I came slowly out of the shock and grief in the weeks that followed, I realized that my freezer still held the milk that ongoing donations had piled up and had sustained my Clara.

So again. I put out the call.

And late one December night I drove back to Children's and walked up those familiar steps into the NICU to deliver a cooler of milk to yet another mother. And I held her, and she held me, and we cried.

This is the gift that keeps on giving. And to each and every mother out there who is sharing her milk I say THANK YOU!! You are sharing life. You are sharing love.

Thank You.

Much mama love,

Ana

Risks VS Risks- Lets Be Perfectly Clear

Today the CMAJ- the Canadian Medical Association Journal- released an article about breastmilk banks and milk sharing entitled  "Milk Sharing: Boon or Biohazard".... Biohazard?  Are they really calling breastmilk a biohazard?  Apparently they are.

Milk sharing: boon or biohazard?

More than two decades after fears of HIV transmission forced the closure of all but one of Canada’s 23 milk banks, regulators, medical professionals and mothers remain divided on the safety of sharing breast milk.
Increased public pressure, regulatory oversight and evidence of the efficacy of modern screening and pasteurization processes are speeding efforts across the country to reopen milk banks to serve hospitalized babies — paradoxically at the same time health officials are warning mothers against the dangers of informally sharing their breast milk.
Confounding the debate is the Janus-like nature of the milk itself. Today, breast milk’s nutritional merits as a food are difficult to separate from its “ick” factor as a body fluid capable of transmitting disease, says Dr. Sharon Unger, a neonatologist at Mount Sinai Hospital in Toronto, Ontario, and professor of pediatrics at the University of Toronto.
Up until the AIDS crisis hit Canada in the 1980s, human breast milk was more valued for its antibiotic properties than feared for its infectious potential, says Maureen Fjeld, a Calgary-based lactation consultant who witnessed the rise and fall of Alberta’s milk banks.
While health officials offered many justifications for the closures — among them, that women had access to electric breast pumps and therefore didn’t need the banks — “the reality was they were scared of infecting someone as the blood banks had done,” says Fjeld.
The BC Women’s Milk Bank in Vancouver, British Columbia, was the sole survivor of the closures, and today carefully rations its supply to only the most vulnerable hospitalized babies. Sunnybrook Hospital in Toronto, Ontario, ships donor milk from the United States to feed its sick and premature babies. Other hospitals and mothers have no choice but to rely on formula when natural sources of breast milk run dry.

 Yes, Dr. Sharon Unger is speaking up again.  Apparently the fact that Eats on Feets very own Emma Kwasnica has verbally bested her in her own area of expertise in front thousands of people on CBC Radio show The Current has not diminished her lust for punishment, nor her insatiable appetite for spreading false truths and making up pretend facts on a whim.  Unger is back with more of her ridiculous diatribe that, along with Health Canada's own brand of chauvinist misogyny, suggests that women are fools, incapable of monitoring their own health or making informed choices.

Let me take you on a tour of this article- I'll probably break off now and then to rant a bit, I hope you don't mind.

After giving  the history of the closures of the Canadian Milk Banks in the 80's the article goes on to wax eloquently about the newly published idea that Canada needs Milk Banks- yes applause applause... of course the fact that the provincial breastfeeding associations, INFACT canada, Dr. Jack Newman, and every group that is focused on breastfeeding, and the general public has been screaming for years that we need Breastmilk banks is never mentioned.  Unger then goes on to graciously tell the reader about the wonders of Milk Banks- about the fact that “Association banks dispense more than one and a half billion ounces of human milk every year and they’ve never had a case of disease transmission,” says Unger.....  of course then she drops the hidden bomb:

“All our ducks are in a line, as far as safety goes. The next thing I think governments are looking for is the long-term health outcomes and cost savings of reopening the banks.”

Because formula companies provide their products to hospitals for free, public funding for milk banks requires proof that there are health benefits and costs efficiencies to be achieved from using donor milk, says Unger.
To that end, the Canadian Institutes of Health Research have funded a team of Toronto neonatal experts to conduct a five-year study of the health and financial impacts of donor milk compared to preterm infant formula as a substitute for mother’s own milk for very low birth weight infants. Initial findings are expected within two years, says Unger.

Did you spot it?  The hidden agenda?  The feet dragging excuse to burn more of the taxpayers money? So because they're getting formula for free, they feel the need to "PROVE" that Breastmilk is better and worth the "COST" of creating breastmilk Banks?!? So they are taking 5 years,(meaning another two years from now) to study something, (and spending probably millions of dollars on)  that has already been PROVEN a hundred times over and over!!!! Thank you Canadian Government for wasting the our money. No doubt they could of funded the opening of at least one breastmilk bank with the money they spent on a useless study that's already been done by WHO, UNICEF and several major medical associations.  Not only that, but they are putting the health of fragile infants in jeopardy while they twiddle their thumbs (while no doubt looking for a way to make a profit off the generous donations of mothers who just want to help babies)( I'm just sayin', if the shoe fits...?)

That’s too long for mothers who are worried about health risks associated with recent recalls of infant formula. Many now turn to their peers for milk when their own supplies run low — a practice regulators and health professionals such as Unger call “dangerous.”
Informal breast milk exchanges have exploded online, linking women from around the world. One such group, called Eats on Feets,(YAY EOF!)  has become the world’s largest human milk sharing network, with some 87 regional chapters in 18 countries. Each chapter connects hundreds of mothers through the social networking site Facebook.
Led by Montreal, Quebec-based mother and breastfeeding advocate Emma Kwasnica, it claims to serve women that milk banks “won’t touch” because their babies are too healthy.
“Whether it’s for cultural reasons and they just don’t understand how to breastfeed, because so few of us do anymore, or it’s a physical condition or stress that’s preventing them from bringing in a full supply, these women have no other option,” Kwasnica says. “At first, people are grossed out, but turning to other women is not so hard to understand. After all, we’ve been wet nursing since the beginning of time.”

 The harbingers of doom then go onto point out the terrible dangers that are imminently awaiting every mother that feeds her baby donated breastmilk:

The potential to thus expose children to viruses, bacteria and traces of prescription and nonprescription drugs has prompted Health Canada and the United States Food and Drug Administration to release warnings against both voluntary and paid exchanges (www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2010/2010_202-eng.php and  www.fda.gov/ScienceResearch/SpecialTopics/PediatricTherapeuticsResearch/ucm235203.htm). 

But lets talk about these potential risks.  The big viruses that seem to worry Health Canada are HIV, HTLV, Hepatitis B&C, and Syphilis.  First off Hep B&C do NOT pass through breastmilk and neither does Syphilis. and Flash Heating done at home  (As Emma Kwasnica goes on later in the article to discuss) on your own stove destroys both HIV & HTLV viruses.  So the risk is practically 0.  Ok how about bacteria?  Health Canada seems to think that women do not know how to pump or express their milk in a clean and safe manner.  HC warns against donated milk because bacteria that might get into milk that's pumped/expressed and then stored in a fridge or freezer. Yet thousands of women in our country pump and express milk for their own babies daily....why is this milk safe for their baby but not for someone elses baby?  If Health Canada is so worried about unsafe pumping then why are they not putting together information for the public about the safe methods of pumping/expressing and the storing of breastmilk? 

This next bit really gets me steamed:

Some mothers may not know they’ve picked up an infection post-screening, she (Unger) says. “What if a woman has a cold sore or herpes lesion on her breast? She may not be aware of it, but such a virus can be fatal to newborns. Why would you take that risk?” 

 Really?  REALLY?!  Does Unger think that women are so ridiculously stupid that they can't be responsible for their own health and making informed decisions based on their health?  What mother is going to give infected milk to a baby?  What mother is going to pump milk with an open infectious sore on her breast?!  Does Unger really have that low of an opinion of her own sex?  Apparently Unger and Health Canada believe that women don't give a shit about what they feed their babies and couldn't care a less about keeping them healthy.  Apparently the fact that women are choosing to feeding their babies donated breastmilk instead of infant formula BECAUSE they have informed themselves of the RISKS is beyond the comprehension of them both.

Yes, Risks.  Let's talk about the risks of feeding Infant formula.

Kwasnica counters that formula feeding may be just as risky, if not more so. “These babies are getting constipated and sick. They’re pooing out blood and not gaining weight. We know formula rips up the insides of their intestines and opens their guts up to pathogens. We know it’s been linked to diabetes, respiratory illness, gastrointestinal illness and heart disease, to name a few. We’ve got to talk about relative risk, and not consider it lightly, before freaking out about sharing breast milk.”
Health Canada has already weighed the relative risk, says Unger. “Sharing unprocessed breast milk is dangerous. There’s a reason infant mortality has dropped, and a lot of it has to do with current public health practices. I have faith in those practices, and for all formula may not be as good as mother’s own milk, it is safe.”

 “Sharing unprocessed breast milk is dangerous."- Really?  Prove it.  Show me a study that's been done that proves that unprocessed breastmilk is dangerous to babies- a study that has been done with babies that have been fed unprocessed human milk.


"There’s a reason infant mortality has dropped, and a lot of it has to do with current public health practices." Ummmm explain to me how the drop in infant mortality has anything to do with milk sharing?  Infant mortality has dropped due to better medicine and medical technology and better hygiene in hospitals and homes.

"...for all formula may not be as good as mother’s own milk, it is safe.”    REALLY? Would you care to put your money where your mouth is Unger? I'd like to see you prove that- Prove it. Show me the studies that PROVE that Formula is "Safe". Show me the studies that PROVE that Milk sharing carries more risk than formula. PROVE IT.... We want studies. We want facts. If you can't provide them then shut the hell up.

Health Canada needs to address the sharing of breastmilk with full disclosure and full transparency.  Health Canada needs to Ratify the World Health Organizations Global Strategy for Infant and Young Child Feeding- just as they say that they do on their Health Canada Web site.  The WHO hierarchy of infant feeding  states that commercial infant breastmilk substitutes are ranked fourth:


1-breastfeeding from the baby's mother,
2-breastmilk pumped by the mother and fed by cup,
3-Breastmilk from a wetnurse or milk bank
4-Infant Formula

Someone needs to tell HC that there is no difference between wet nursing and using unprocessed donated breastmilk.

 

I have been a part of Eats on Feets since the very beginning, and have worked to help mothers find breastmilk for their babies long before that.  I have witnessed dozens if not hundreds of milksharings happen online. I've read the stories of mothers who are desperately in need of human milk for their babies meet mothers who have milk to spare.  I've heard the amazing stories of babies who were once sickly little waifs who've blossomed into chubby cherubic jolly infants due to the fact that their mothers cared so much that they went and found someone to donate breastmilk to them.  I have seen friendships grow between strangers and watched bonds of sisterhood bloom between mothers who didn't know each other a mere few weeks before.  This isn't about women being uninformed.  This is about women doing what they need to do, with full disclosure and full awareness of the facts. This is about INFORMED Sharing.  This is about women taking responsibility for their families health, taking matters into their own hands and doing what needs to be done to keep their babies healthy and happy and chemical free. The way it should be.

"Lets analyze a milk share study"

WE are currently editing this blog post- sorry for the inconvenience, I'll have it back up asap!!!!!!

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

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!!