Wednesday, December 31, 2008

New Years Resolution?

Dear Friends:
As we start the new year, please think about our children, our future, and about families here at home in the US, as well as around the globe.
As you know, my work has always been towards truly enabling women to make unbiased evidence-based decisions concerning how they will nurture and space their children, and to succeed with the best health-supportive actions. Therefore, I have always prioritized research and program change, rather than the so often vain attempts to fight the power of commercial industry in the US and globally.
However...
it seems that here in the US there has been insufficient progress in terms of government and public action to ensure that our children receive the best start on life. While some individuals in USG and state level nutrition leadership are sincerely and actively pushing to learn more about feeding practices and to bring this information to the attention of the public, the greater HEALTH community sits relatively silent. Breastfeeding support efforts of the health care community as a whole and the public health community, specifically, have done little to challenge commercial formula industry's efforts to misinform, lobby, pay off hospitals and government programs, and use legal protection for their efforts to prioritize their profits over the health of our children.
The 2008 news is not all bleak: we have new survey information showing increases in initiation of breastfeeding and data on hospital practices, and new clinical guidance from the USG supporting breastfeeding, and USDA/WIC is launching a massive effort to ensure that WIC provides increased support for breastfeeding while continuing to be the single largest purchaser of commercial, overpriced, rebated formula in the world.
However, the news today includes yet another insight to commercial formula industry efforts to prioritize their income over the health of the public. (post below)
As we start the new year, is there any way we might increase the pressure on commercial infant formula companies to support the health of the public, rather that work against it? Formula is a decent product - if needed - but this industry constantly uses their massive income and resources to mislead the public and to lobby to sustain poor health practices. Their rationale is that they must make money for their stockholders.
Will our new administration have the ..... to stand up to rampant industrial abuse of public health? Will they fight for paid maternity leave so that mothers will have the opportunity to be mothers to their children? Will there be government support to institute and regulate the Ten Steps for breastfeeding-friendly practices in US hospitals? And, will the government establish the multi-sectoral approach (Dept of Education, Dept of Labor, FDA, FTC,etc) to supporting breastfeeding - all four of these actions called for in the Innocenti Declaration signed by the USG in 1990?
What should we resolve to do in the New Year in this regard?
Please comment and let others know what you think we can do, and let me know if I can help in any manner.
Best wishes for the new year....M

Mead-Johnson does it again - GREAT supporters of public health, no?

FDA notes that Mead-Johnson and Nestle have trace melamine in thier infant formulas. Over the past years, dozens of severe cases of commercial infant formula contamination have been reported in the press, and who knows how many additional cases have occurred? This year in the US, we have had deaths and disease from E sakazakii found in powdered formula, and other illnesses from poor preparation.

Now:
http://www.nj.com/business/ledger/index.ssf?/base/business-11/1230702320204430.xml&coll=1
"The New York-based company also lobbied Congress on a bill that would ban the use of a plastic-hardening chemical called bisphenol-A in children's food packaging. The chemical has been used to seal food containers, including baby formula.
Bristol-Myers, the maker of Enfamil infant formula, lobbied to inform Congress that the materials used to line infant formula cans are safe. A 2007 report by government toxicologists said the chemical contributed to irregular development and noncancerous growths in animal studies."
Excuse my sarcasm, but....Isn't it good to know that we are partnering with such a fine supporter of the health of the public? Canada, among others, has taken steps to ban this dangerous chemical from food packaging use...it is currently found in many see through plastics, and leaches out particulary with temperature changes...

Tuesday, December 30, 2008

Mead Johnson for sale - marketed based on the suffering of children...

"Morningstar analyst Debbie Wang says that despite its age, the firm [Mead Johnson] has continued to innovate and grow. She also likes the company's global footprint, especially in emerging markets in East Asia. News reports of deaths from melamine-tainted Chinese infant formula should only help firm up Mead Johnson's brand, she says. (W)e expect the company will take advantage of recent events involving tainted Chinese formula and dairy products in that market as parents turn to foreign brands that offer greater assurance of quality," she wrote in an Oct. 9 note.

Please note, my friends, that Mead Johnson products, along with Nestle, in the US were found to have trace melamine....

Why is Bristol-Meyer selling off this lucrative arm? Maybe they sense the fact that mothers are becoming better informed...Let's hope.

Monday, December 15, 2008

National Quality Forum endorses exclusive breastfeeding

The National Quality Forum (NQF) is a not-for-profit public/private membership organization created to develop and implement a national strategy for health care quality measurement and reporting. NQF was created as a mechanism to bring about national health care policy improvement.

Therefore, it is a boon to breastfeeding that this group calls for all healthy babies (non-NICU) to be exclusively breastfed throughout their hospital stay and at discharge. They note that this will mean facility, integrated system, and/or community quality improvement changes.
We of the breastfeeding support community know that institution of the Ten Steps will certainly pave the way!
Kudos to NQF for the recognition of this important intervention as part of perinatal care standards. To see all the perinatal quality improvements, see:
http://www.qualityforum.org/news/releases/102708-endorsed-measures-pc.asp

Monday, December 08, 2008

News coverage of watered-down formula disturbed me in many ways...

It was very sad, indeed, that a young mother watered down WIC formula to make it last a month. To me, this highlights so many issues that are not being well addressed, and that were not well addressed in the coverage:
1. WIC was designed as a supplemental program, and is not meant to meet all the needs for a month. Was this mother properly informed about this? Clearly not. She may have received some information, but it clearly was not communicated.
2. Since WIC is a supplemental program, is there discussion with the client about planning for the end of the month? Is each client counseled to develop a plan and have the plan checked with the nutritionist?
3. Was sufficient attention given to informing this mother and all mothers about the cost savings of breastfeeding?
4. Some blogs following the news coverage assume that she may have tried breastfeeding and not succeeded. There is nothing in the press coverage on this. If it so, then the support she received may not have properly addressed her issues. Was the possibility of breastfeeding fully considered by those who treated her baby? Did they try to help her re-lactate?
5. Is every mother informed of the risks of formula use by WIC, along with risks and benefits of breastfeeding?
6. Why doesn't media highlight the risks of formula use in general in the coverage of these disasters? In no society is the mother at fault when she is deserted in this manner with misperceptions and misinformation.
I find it terribly sad that we leave young mothers to fend for themselves without proper information and support, and then we label them as ignorant or as failures. It is our fault, we who design and oversee these programs; we who endorse a society that is product driven, rather than health driven; we who think of ourselves and our own, and not of those who are lost in the commercial media blitzkrieg; we who have forgotten that the beginning of life dictates so much about the future generation and how they will go forward...

Monday, December 01, 2008

Melamine, E sakazakii, BPA hit the US... and iron

Having promised you - and me - that I will not spend inordinate time bashing the formula industry's practices, and that I would spend my time building the environment that enable breastfeeding, I am still struck that, due to the realities of commercial formula, there is often little difference between the two.

The formula industry advertises its product as "safe." There is no such thing as a totally safe commercial product for a vulnerable population. Pharmaceuticals undergo much greater quality control and sterility in processing, and yet mistakes are made.

The mix of dehydrated cow's milk and additives is an excellent medium for bacterial growth. The surprise is that outbreaks are not more often diagnosed - perhaps this stems from the belief that frequent diarrhea and infections are "normal" in infants. We clearly have an under-reporting of negative episodes.

So, back to the product on hand - the one with traces of melamine, occasional deadly and frequent less illness-creating factors. It's an okay food for human beings who are built to take a lot. But infants, as resilient as they may be, do not have adult defenses. We need a much lower tolerance for recalls and contaminants in the foods we feed to infants than we have today.

Unfortunately, we seem to add stuff to formula all the time. Iron is a fine addition for the older child, but is good food for gut infections in the youngest. Now, research is showing damaging impact of too much iron on the brain in the early weeks/months. Does your WIC program use formula with iron at all ages?

Next post will be back to what we can do creatively to ensure an enabling environment...