Monday, December 31, 2007

More questions about LAM

Thanks to Marianne Vanderveen-Kolkena for raising these questions. Perhaps you have shared her concerns...

Dear Marianne: Thank you for your interest in LAM. You raise relevant questions and I will do my best to answer:

1. Question: As far as I remember, I was taught that it is also necessary not to leave to many hours between feedings, so a night feeding ought to be part of the daily routine.In your explanation, I didn't find anything about not spacing feedings to wide apart. If you would breastfeed exclusively, but had a baby that sleeps through the night, then you could have an ovulation without bleeding first, right...? What is your opinion on this..?

Answer: The definition of Full Breastfeeding used in the LAM research was: feeding on demand, with no frequent intervals of >4 hours during the day or 6 hours during the night. The genesis of this definition would take a book of writing, but in the clinical trials of LAM, this is what we told women IF they asked. As to sleeping through the night, many women would consider 6 hour interval as sleeping through the night. Some women reported a midnight feed, and a 6 am feed, for example, and felt that they were sleeping through the night. Many women in the study occasionally had intervals of 8 hours at night, and this was not associated in any way with fertility in our study. Our recommendation is to feed physiologically, and on cue, and, if this is done, babies will wish to feed at least once during the night.

2. Question: Isn't is so, that estrogens have a higher chance of bringing the menstrual cycle back, if prolactin doesn't peak regularly enough?

Answer: This actually is a physiologically complex question. Here goes: Prolactin rise is associated with successful breastfeeding, and successful breastfeeding is associated with fertility suppression. There are some who assert that there are additional and alternative mechanisms that also are associated with the fertility suppression, mediated by the hypothalamus. Estrogen rise is associated with lack of regular rises in prolactin, however, estrogen rise is not necessarily a proxy for fertility return. In a fully lactating woman, a small estrogen rise is met with a paradoxical re-suppression of signs of fertility. For adequate ovulation to occur, there needs to be regular pulsatility of LH and FSH as well as declines in the rate of breastfeeding and its many hormonal effects. Estrogen, per se, does not bring back the cycle, but is a part of the cycle, and estrogen withdrawal causes the bleed. So, in a nutshell, if breastfeeding continues to be full, the chance of a small estrogen rise exists, but it is generally not adequate for ovulation. In general, in a fully lactating woman, a withdrawal bleed will occur prior to the first fertile cycle, and this phenomenon is the basis for LAM.

Thank you for your interest in LAM!!

Friday, December 14, 2007

Children's author rejects formula money - how can we in public health accept it?

Industry news is that Nestle is planning to purchase Bristol-Meyer-Squibb nutrition products. This will include Mead Johnson, if it goes through, returning us to asymmetry in the US formula market, with Nestle owning 2 of the 3 major producers.
Meanwhile, authors of children's and teen books have rejected Nestle monies. How can we, who say we support the health of the public, still be seen to partner with the infant formula industry?
What was necessary for us to stop accepting tobacco money? Was it the number of deaths? If so, we should have stopped working with the formula industry decades ago....

Nestlé Children's Book Prize winner refuses Nestlé money - Sean Taylor rejects cheque
Press release 12 December 2007

See on-line version for links to supporting documents and images of Nestlé baby food marketing malpractice at:

Children's author, Sean Taylor, was announced today as the Gold Medal Winner of the Nestlé Children's Book Prize, under-5 category, for his book When a Monster is Born illustrated by Nick Sharratt (Orchard Books). In an open letter Mr. Taylor indicated that he would not accept the prize money for the award which is sponsored by Nestlé. He commented:

"Being on the short list for the 2007 Nestlé Children’s book Prize is a significant honour for me, especially since so many children around the country have been involved in choosing the winning books. And I am delighted to accept the award offered to me.

"However, because of questions surrounding Nestlé’s marketing of breast-milk substitutes, I do not feel able to accept the prize money.

"This has not been a decision I have taken lightly. It has involved conversations with Baby Milk Action (a campaign group against Nestlé), Nestlé themselves, and an authoritative third party with experience in the field (who wishes to remain nameless)."

Baby Milk Action is concerned by Nestlé’s record of aggressive marketing of baby foods, which contributes to the unnecessary death and suffering of infants around the world. Companies should be abiding by international marketing standards adopted by the World Health Assembly, but Nestlé, the market leader, continues to produce systematic and widespread violations of the marekting requirements. These are defended at the most senior levels of the company.

According to Nestlé Global Public Affairs Manager, Dr. Gayle Crozier Willi, Nestlé is 'widely boycotted'.

Nestlé is also accused of failing to act on reports of child slavery in its cocoa supply chain.

In his letter, Mr. Taylor commented: "In the light of these conversations, it is apparent to me that many of Nestlé’s controversial activities took place in the past and that the company has taken steps to improve its practice." However, a new global monitoring report launched this month shows on-going aggressive practices. Nestlé defended the practice of branding babies in China from birth shown on the website just yesterday.

Mr. Taylor concluded:

"Nevertheless, it is my view that their interpretation of the International Code of Marketing of Breast-milk Substitutes sets up the risk that profit is put before infant health. And, in addition, it seems that the actions of some of their employees on the ground are inconsistent with company policy as set out in the Head Office.

"For these reasons I do not feel that Nestlé are the most appropriate sponsors for this major children’s book prize."

For the full text of the letter and further comment see Baby Milk Action Campaigns Coordinators blog via the on-line version at:

Nestlé is sponsoring the children's book prize organised by the Booktrust. The book prize is a scheme where short-listed books are distributed to a number of schools, whose students vote for their favourites. Campaigners say Nestlé involvement is an attempt to divert criticism from its activities, improve its image amongst students and reposition itself as a responsible company.

Mike Brady , Campaigns and Networking Coordinator at Baby Milk Action, said:

"The global monitoring report just launched by the International Baby Food Action Network (IBFAN) shows that Nestlé's claim to have changed only goes as far as tactics - the strategy of undermining breastfeeding to increase sales of formula remains unchanged.

"I appreciate the difficult situation Mr. Taylor was put in by the choice of Nestlé as a sponsor for this prize and applaud him speaking out publicly about his concerns. Let us hope the organisers and the public take notice and Nestlé will again appreciate that its cheque book does not buy it a good image. It must abide by internationally-agreed standards."

The main element of the sponsorship appears to be providing public relations services to the prize through the PR company, Spreckley's.

Spreckley is a specialist in:

"CRISIS AND ISSUES MANAGEMENT – All businesses face problems at some point and the best strategy is to be prepared. We can help clients devise a crisis and issues strategy plan, as well as providing counsel and advice when incidents arises."

In addition to its aggressive marketing of baby foods, Nestlé has been taken to court in the United States by the International Labour Rights Fund (ILRF) for failing to act to end child slavery in its cocoa supply chain in the Ivory Coast (click here for details). Nestlé has also refused to support moves to bring farmers within the Fairtrade scheme in Ivory Coast, meaning registered farmers are unable to sell all of their produce within the scheme. Nestlé buys the surplus on the open market at lesser prices, according to ILRF. If cocoa is bought within the Fairtrade scheme the farmers are guaranteed a fair prize and are paid a community surplus used to ensure children go to school.

In 2003 the Booktrust scrapped plans for a Nestlé teenage book prize after leading authors said they would refuse to accept it. This has gone ahead with a charitable trust backing it instead.

Tuesday, December 11, 2007

Well deserved award given to the Infant Formula Industry

The IFM group has received an award for its successful effort to downgrade the OWH ad campaign!!
Scroll down to the bronze award at this Web site:
My response:
With thanks to Diane Farsetta for presenting the infant formula industry with the Bronze Falsies Award, this is only the tip of the iceberg. This industry not only actively fights excellent health messages with the clout of its lobbyists and big profits, it also has an ongoing apparent policy of false advertising (e.g., many formula companies have been reported to the FTC for false advertising; their response has apparently been to continue the ads to their planned obsolescence and then to offer a quiet apology to the FTC), has threatened sovereign governments that have attempted to mute the false claims (e.g., India; Peru; and in Philippines the US Chamber of Commerce sent a letter to the President of that country threatening the withdrawal of all US business unless the government allowed the ongoing misleading formula advertising claims), and continues practices in the US known to undermine breastfeeding (e.g., "rebates" to WIC so that WIC moms - who do not receive suffienct supplies but rather a supplemental supply - will feel loyal to their brand, along with other practices reported in a GAO report; handing out “free” bags to new moms as they leave the hospital – a practice studied and shown to undermine breastfeeding, etc, etc.) There many other practices I have experienced or observed here and abroad over the years. Clearly when it comes to infant feeding messages, profit wins over our children’s health, and the asymmetry of messages in the media continues.

If you would like any additional information ,please let me know, or contact my colleagues at NABA-REAL.