Thursday, September 03, 2009

This comment deserved to have its own posting!

Jennifer Yourkavitch comments:
"My husband, enraged, sent the following note to Isotoner Customer Service ( and the CEO (

To Whom it May Concern:

One would think that someone with sense at your company would have done something to prevent an issue like this from even going to court, let alone the state Supreme Court. It's a nice victory in the court of law, but in the court of public opinion I think this makes Totes/Isotoner look backward, discriminatory, insensitive, and at worst hostile to infant nutrition.

A wiser course would have been to implement a policy to allow lactating women to have scheduled breaks, create a space for them to lactate in private, and generally support people who are trying to follow American Academy of Pediatrics and World Health Organization guidance for feeding children in the best possible way--the way they have been fed since humans have been having children. It is the utmost act of love for a parent to nourish their child the best they possibly can. Frankly, I think this mother will have a much happier and productive life away from the toxic atmosphere of your company.

If I were on the Totes/Isotoner Board, I would have recommended firing the manager who made this choice and compromised the brand image of the company in the press, not the lactating mother.

I am systematically divesting my home of all of your products, and will never purchase anything from your lines of products again. I am exploring canceling relationships with firms that carry your products.


Robert Carty
Father, Husband

Lawyer alert!! Isontoner fires worker for taking milk expression breaks...

The judges say that lactation has nothing to do with child bearing...
Can you imagine?
A woman was fired for taking breaks to express milk with a 5 month old baby and the judges pronounce that this is not covered as pregnancy-related.
I would like to see those judges try non-pregnancy-related breastfeeding.
(I know, I know, anyone can lactate, but really....)

My friend and colleague Mary Overfield suggests boycotting. Reasonable.
However, if we are ever going to fix the mess we are in we need the lawyers to get in on this somehow.

Friday, July 31, 2009

WABA World Breastfeeding Week and the US Breastfeeding Committee

Sitting here at the US Breastfeeding Committee, I am happy to share that, in honor of WABA's World Breastfeeding Week theme on breastfeeding and emergencies, FEMA announced that it will be modifying its approach to this issue. This reinforced for me the power of WABA's work, when translated at the national level into advocacy.

Congratulations to USBC, FEMA and WABA on this important first step.

Other exciting announcements were made by CDC representatives who are constantly pushing the envelop and call for much more and better data collection that will drive breastfeeding program improvements, and the many other civil servants in government agencies (AHRQ, HRSA MCH/B, FDA, OWH and USDA) who continue to fight for the best start on life for our children, and for those changes in programs and policies that are necessary to enable each woman to succeed in her intention to breastfeed as the only logical choice for her health and her child's health, development and welfare.

Wednesday, July 01, 2009

Show me...

Just found this sort of feminist down under blog on breastfeeding thanks to Linda Smith.

Hemispheres unite!!

PS I always found a baby bottle with formula sitting around to be a bit offensive....

Friday, June 19, 2009

When will they ever learn? Handing out formula creates mixed feeders... and highest feeding risk for HIV+ moms

Dear friends:
When will they ever learn? Handing out formula for HIV+ moms in low wealth settings is not only risky, but potentially deadly.
Botswana's government meant well when they started handing out formula, but how many crises will be necessary until they stop?
Stock outages, massive diarrheal disease, and more stock outages, and yet it continues.
Please, my friends, help spread that word that such programs breed disaster.

Tuesday, June 16, 2009

Outcome of the meeting in DC...

The meeting ended Friday afternoon, with reports from each working group. According to the organizers, the papers and the outcomes will be published in a supplement to Breastfeeding Medicine.
I think it will be interesting reading.

UN meeting 'Advancing global health in the face of crisis' - only UNICEF speaks to breastfeeding as essential

With thanks to my old friends at UNICEF, in this high level forum, only UNICEF Executive Director Ann M. Veneman mentioned breastfeeding in her panel discussion on "Protecting vulnerable populations."
Notes on her presentation included the following. I added the bolds.
9.2 million children die before the age of 5 years, and that 93 per cent live in Africa and Asia. Around 3 million die in the first 28 days of life. A woman in the Niger had a 1-in-7 lifetime risk of maternal mortality, compared to Ireland, where the risk was much lower 1 in 40,000. When searching for a solution, it was important that policy-makers understood the link between maternal and newborn health. For a start, adequate nutrition for the mother was key to good health in their babies. In turn, early childhood nutrition was important, because one third of deaths in children under 5 were thought to be caused by malnutrition. Poor nutrition also made a person more likely to die of diseases such as malaria, while lack of breast-feeding contributed to 1.4 million deaths. She noted that pneumonia and diarrhoea were among the biggest killers among children –- diseases that were linked to HIV/AIDS, various tropical diseases and the flu. During a time of financial crisis, it was more important than ever to ensure that women and children, along with other vulnerable populations, had access to preventive and basic health services.
read more at: She explained that 9.2 million children died before the age of 5 years, and that 93 per cent lived in Africa and Asia. Around 3 million died in the first 28 days of life. A woman in the Niger had a 1-in-7 lifetime risk of maternal mortality, compared to Ireland, where the risk was much lower 1 in 40,000. When searching for a solution, it was important that policy-makers understood the link between maternal and newborn health. For a start, adequate nutrition for the mother was key to good health in their babies. In turn, early childhood nutrition was important, because one third of deaths in children under 5 were thought to be caused by malnutrition. Poor nutrition also made a person more likely to die of diseases such as malaria, while lack of breast-feeding contributed to 1.4 million deaths.
She noted that pneumonia and diarrhoea were among the biggest killers among children –- diseases that were linked to HIV/AIDS, various tropical diseases and the flu. During a time of financial crisis, it was more important than ever to ensure that women and children, along with other vulnerable populations, had access to preventive and basic health services.

Read more at:

Thursday, June 11, 2009

Meeting continues

I am happy to report that our group - Workplace - was innovative and creative in developing issues. Tomorrow we will do the hard work: develop the action plan!
Wish us luck!


Sitting at a meeting in DC...What will we need to do provoke action?

Recently I have had the opportunity to attend several meetings that MAY have a real impact on the future of breastfeeding...a bit of deja vu...and a bit of hope.
Back in the 1990s following the Innocenti Declaration, there was a spate of activity in an ill-fated effort to implement the four operational targets: a national multisectoral committee and authority; Ten Step in hospitals; Code of Marketing, and; maternity protection laws. The US promised to implement all by, dot, dot...

BUT some good things did arise from that era: the USBC - a collaboration of health organizations with interest in the issue; the Academy of Breastfeeding Medicine to engage physicians in education on breastfeeding; more hospitals practicing more of the Ten Steps, and the family leave act, so that women cannot be fired for taking some leave. Yes this is progress, but miles to go.

A few weeks ago, I was invited to speak at 2 starkly contrasting USG meetings: one entitled A Call for Action on Breastfeeding, the other - Medical eligibility criteria for contraceptive use - my role, the focus on contraceptive use during breastfeeding. The Call for Action, with several of our federal supporters hosting, was full of creative and innovative ideas and ways to increase action on bresatfeeding. I left that one totally enthused and having faith in our breastfeeding-supportive Feds!!!

The second did not go quite like that...although the report is not out, Dr Bob Hatcher went ahead and announce "any contraceptive can be used from birth" or some such, in the OB/Gyn News. It is very interesting what emerges when the audience members have a pre-existing agenda.

So what do we do to get a true representation of leadership so that we can really achieve change?

Today I am sitting in a meeting called by Ruth Lawrence and Cindy Howard in the name of their journal,Breastfeeding Medicine, sponsored by Kellogg, and self-named "First Annual Summit" on breastfeeding. No organizations or professional groups were invited, so USBC is not here, APHA is not here, among others. So far, we have heard at least 12 speakers, with no time for questions and no program insights. That is not to say that the speakers have not been interesting - they have been quite good: Larry Grummer-Strawn and David Meyers represented their agencies well - intelligent, informative, and insightful. Yay! the other speakers covered a variety of issues - what WIC does, how to lobby, cultural considerations, growth, media. All were good speakers and most quite informative. I am not clear what new will emerge from this handpicked group, but I look forward to the working groups to see what 45 physicians, 12 PhDs, and 13 sundry others (not an LC in sight) will have to say about the nuts and bolts of workplace, public education, healthcare systems and support services - also professional education -and how to create program change nationwide. Well, about 25 of us actally have some real program development roles, so perhaps we can help. We are going to the workgroups now...All remains to be revealed! Here's looking for the best.
Will write more tomorrow!

Monday, May 25, 2009

Martek hexane-derived DHA manufacture may have resulted in fire?

I don't know how to verify this, but I read a report that the Kentucky State Fire Marshall confirmed that a 2003 explosion of a wastewater pretreatment facility was the result of the Martek Biosciences Corporation releasing hexane from its plant. Martek was using these chemicals to produce DHA.

While DHA is a natural ingredient found in human breastmilk that promotes eye and brain development, the Martek product is not natural, but chemically derived from dried biomass, algae, I believe.

Can anyone confirm or refute this report?

Friday, May 22, 2009

More on PBM...

Joe Shields, who is director of public relations for PBM, got back to me, providing the following additional information:

"Thank you for reaching out to PBM regarding the responsible marketing of infant formula.... I just posted a formal response to a May 15 blog posting on the site [Note from blogger: unfortunately, it is too long for blogspot, so I am including some of it here.] for the organization’s consideration ....We believe that mother’s milk is the best source of nutrition for babies. Moms should try breastfeeding because it is considered best for babies by our company and leading experts. In fact, the American Academy of Pediatrics recognizes it as the gold standard in infant nutrition....If parents choose to supplement mother’s milk with baby formula, we believe they should not have to overpay for formula. That’s why we make store-brand formulas for retailers many leading store-brand formulas cost up to 50% less than national brands. In fact, parents can save up to $600 a year by choosing a retailer’s store brand infant formula...The reason why our store-brand infant formulas are less expensive is because we do not give out free formula to hospitals. [Bolds added] We believe only mothers and health-care professionals should make infant-feeding decisions, which is why we do not want to influence that decision-making process at the time of birth."

I am going to be in contact - maybe we can get Marsha involved - and will keep you posted!

Friday, May 15, 2009

BFing good for moms - fine brief by our friend Joan Meek

Who is this masked man?

"Baby Food Co. Seeks To Bar Nestle's Use Of 'Gentle'...Law360, New York (May 13, 2009) -- Infant formula maker PBM Products LLC has asked a federal court to bar Nestle SA and its Gerber Products Co. unit from using the trademarks "gentle" or "gentle plus" to sell baby formula while PBM pursues its case accusing the Swiss company of infringing the three-year-old mark."

Those of us who grew up in the era of Superman and Zorro know that an ostensibly meek and mild character can put on a mask and become a major force for good.

Who is this PBM who is taking on the giants?

From their website I learned that they live in the land of Ben and Jerry's, otherwise known as Vermont, and state: PBM Nutritionals is the only infant formula facility in the US that adheres to both FDA guidelines and a stringent set of quality-assurance regulations set by the International Organization for Standardization.

So I thought I would give them a call and discuss the Code...and I found a very friendly group!
I will keep you posted...

Thursday, April 30, 2009

LA Times: PBM is stepping up to the plate against Mead Johnson's ongoing false and misleading advertising

Lawsuit filed over Enfamil infant formula ads
01:48 PM PT, Apr 29 2009

Infant formula company PBM Products is suing a competitor, trying to stop what the company calls a "false and misleading" ad campaign.

PBM filed suit in U.S. District Court in Virginia against Mead Johnson Nutrition Co. and Mead Johnson & Co., a division of Bristol-Myers Squibb Co. Mead Johnson makes the Enfamil LIPIL Infant Formula product.

The suit accuses Mead Johnson of using false implications to undermine confidence in the store-brand formulas that PBM supplies to Wal-Mart, Target and other retailers.

"Mead Johnson stands behind our products, our science, and our marketing," said spokesman Pete Paradossi. "We do not comment on issues in litigation."

PBM alleges that Mead Johnson's national ads tout the Enfamil product as being the only one that contains two specific nutrients, DHA and ARA, that promote brain and eye development in infants. According to the suit, some of the ads suggest that store-brand products will result in fuzzy vision and slower brain development.

But according to PBM, the the store-brand formulas are nutritionally comparable, if not identical, to Enfamil. Court documents filed by the company are available here and here.

-- Tiffany Hsu

Tuesday, April 21, 2009

Two new quotables: The Case for Breastfeeding Reality and more on moms..

Dear Friends:

I was honored to be approached for some input by Jennifer Block who is an excellent writer. "Jennifer Block is the author of Pushed: The Painful Truth About Childbirth and Modern Maternity Care (Da Capo 2007), and the blog Her articles and op-eds have appeared in the Village Voice, ELLE, The Nation, Mothering, the L.A. Times, and the Guardian. She's based in Brooklyn, NY." She did a piece on Babble, the blog for contemporary moms.

Please see what I call her Case for Reality at:

I think SHE should be the editor of the Atlantic Monthly.

Another nice finding was this piece on women's health impact of breastfeeding.

Wednesday, March 04, 2009

Huffington Post seems to be covering breastfeeding issues nicely

With thanks for this commentary on formula risks:

Abbott supporting corporate breastfeeding: good or bad news?

A recent corporate program to support breastfeeding in the workplace is backed by Abbott/Ross. Is this a good or a bad thing?

Our friend Melissa Bartick, MD speaks out on this quite eloquently

Whenever a formula company makes statements in support of breastfeeding, but still includes its logo on every page, this is not good will - this is advertising for formula.

In addition, coming on the heels of a rather fine "Business Case for Breastfeeding", this effort can well breed confusion as to which is which. The Federal Business Case is well done, with no formula advertising, but the Abbott piece will be widely distributed, perhaps more widely than the excellent Federal materials.

Clever marketing strikes again, undercutting breastfeeding.

Tuesday, January 20, 2009

Inaugural Address: Hope and responsibility

Dear Friends:

It is a pleasure to share with you two of the many possible excerpts from today's Inaugural Address. These two are of particular relevance and we go forward with our goals to enable women and families everywhere to Nurture Our Future:

“It is kindness…selflessness…courage… but also a parent’s willingness to nurture a child that finally decides our fate”

"America is a friend of each nation and every man, woman and child who seeks a future of peace and dignity"

Excerpts from the Inaugural Speech of US President Barack Obama, January 20, 2009

Monday, January 12, 2009

Consumers Union calls for more testing of commercial infant formula

This is from the link :

With New FDA Infant Formula Test Data, Consumers Union Urges Expanded Testing, Recalls
Sunday, January 11, 2009

"Citing new data about infant formula that was quietly posted by the Food and Drug Administration over the holidays, Consumers Union (CU), publisher of Consumer Reports, urged FDA to move quickly to expand testing of infant formula for melamine and related compounds, and to recall all contaminated products.In a letter to HHS secretary-designate Daschle and current FDA commissioner Von Eschenbach, CU called FDA’s November risk assessment, which allows infant formula containing up to 1 part per million of these chemicals on the market “highly flawed.”Consumers Union noted that FDA posted new test data on infant formula on December 22, which showed that a melamine derivative, cyanuric acid, had been found in two additional samples of formula-- bringing the total to 4 contaminated samples out of 89 tested. “That is almost 5 percent of tested samples contaminated, a relatively high rate,” stated Urvashi Rangan, Ph.D., a senior scientist at Consumers Union. Three of the four positive samples found by the FDA are Enfamil with Iron or Enfamil Lipil with Iron milk-based powder, and the fourth is Nestle Good Start Supreme with Iron milk-based liquid.“The FDA needs to step up and expand melamine testing. The failure to properly inform people about these findings undermines consumer confidence in a fundamental product that millions of parents depend on,” Rangan said.FDA states that the amount of melamine and related compounds found in the formula, which range from .137 to .412 parts per million, are safe. However, Consumers Union called the FDA risk assessment from November 2008, which stated that up to 1 part per million of melamine in formula is safe, “flawed” and said it ignored key scientific data. An FDA risk assessment issued just eight weeks previously in October 2008 had stated that no amount of melamine in formula could be considered safe.“In its October assessment, FDA cited both a cat and a rat study in which a combination of melamine and one of its derivatives, cyanuric acid, caused kidney damage in the test animals at the lowest doses administered. FDA could not identify a ‘no effect’ level for these two compounds in combination, “ stated Michael Hansen, Ph.D., also a Consumers Union senior scientist.“Now FDA has found melamine in one sample of Nestle formula, and cyanuric acid in three samples of Mead Johnson’s Enfamil formula. What if a parent fed both of these formulas to their baby? These two chemicals appear to be far more toxic in combination than either one is separately. Yet FDA has set its safety limit based on exposure to just one of these chemicals alone,” stated Hansen."

Sunday, January 11, 2009

FDA testing - to date - of melamine or cyanuric acid in US manufactured infant foods...

Four out of the 89 US Manufactured Commercial Infant Formulas tested by the FDA were positive for Melamine or Cyanuric Acid with variable amounts. But what amount is "safe"?

3/20 Mead Johnson formulations
1/5 Nestle formulations
0/37 Abbott Labs formulations
0/ 37 PBM formulations (Parents choice and unlabelled)

Three Mead Johnson products: 2 Enfamil Lipil w Iron and 1 Enfamil w Iron, 12.9 oz can milk-based infant formula powder(ENFLIP QGN89 0744 18508 A AND ENFLIP QGN91 0440 18608B AND QGN92/ USE BY 1 NOV 2009) Mead Johnson Nutritionals were Negative for Melamine and Positive for Cyanuric Acid.
One Nestle product: Nestle Good Start Supreme with Iron 250 ml can milk-based liquid infant formula (8267572123 / USE BY 23 DEC 2009) was Positive for Melamine and Negative for Cyanuric Acid.

None of the less expensive , so-called generic, brands were found to contain even trace amounts of either contaminant.

The levels found were considered safe because FDA set the standard based on the assumption that these levels are safe...hmmm.

Wednesday, January 07, 2009

New formula advise merits very careful discussion before use

An article published in Letters in Applied Microbiology noted that

--"Cronobacter is a recently defined genus of bacteria and was previously known as Enterobacter sakazakii. " (New name for E sakazakii!!)
--"These bugs will grow at 25°C or 37°C, but less so when the formula is made up using apple or grape juice than when made up using water or milk."

It is startling and amazing that such advise would be offered without careful study of the implications of adding additional fructose to the formula.
It may kill Cronobacter by being acidic, but what will the considerable amount of extra sugars do to the infant? Excess sugars breed other problems and other bacteria in the gut, let alone the nutritional issues....

Tuesday, January 06, 2009

"Selling breastfeeding in the US is a minefield"

I wanted to thank the person who made this comment. Yes it is a minefield. But the questions I think we need to ask are: how does something so positive become an object of explosive response? and how do we create the proper message for the proper audience?

The minefields we encouter are composed of normal human emotions, among them are fear of change, and need for acceptance/lack of self-efficacy.

Fear of Change: We currently live in a bottle feeding culture: breastfeeding is change. We currently still live in a somewhat Victorian culture with body exposure having only one general interpretation - sex. We currently burden new mothers with an unbelievable set of expectations to return to work, etc: breastfeeding is an economic change as well.

Need for Acceptance/Lack of Self-Efficacy: Storms occur when widely different weather fronts come into contact. This is the situation in the US with infant feeding. On one hand, we have the glorious, shiny labels and commercials of the formula industry saying all is well and this is what your friends do. On the other hand, we have breastfeeding advocates who have clear visions of what they and their friends are doing. When these come in contact, we get stormy weather. Everyone seeks acceptance and when there are two "camps" folks tend to join one or the other. If each woman were fully enabled to learn about infant feeding, what it means in daily life, what it means in terms of thier child's health, what it means in terms of their risks of diabetes, breast cancer, etc.

Carolina Breastfeeding Institute, among many others, seeks to enable and empower each individual to come out of the storm and decide for herself based on unbiased information concerning her and her family's health, lifestyle, goals, and rights. My thought is that we need to use all possible information if we wish to be heard by all audiences.

Monday, January 05, 2009

New Studies underscore the need for PAID MATERNITY LEAVE in the US

Studies suggest that, adjusted for socio-demographic and health factors, taking maternity leave before and after the birth of a baby is a good investment in terms of health benefits for both mothers and newborns.

One study found that women who started their leave in the last month of pregnancy were less likely to have cesarean deliveries, while another found that new mothers were more likely to establish breastfeeding the longer they delayed their return to work. The authors also note that the US falls far behind other developed countries on paid maternity leave. In most other cultures women are expected to rest in preparation for this major life event. Only five states - California, Hawaii, New Jersey, New York, Rhode Island - and the territory of Puerto Rico offer some form of paid pregnancy leave, and none offer full replacement of salary.

Concerning breastfeeding, 82 percent of mothers established breastfeeding within the first month after their babies were born. Women who took less than six weeks of maternity leave had a four-fold greater risk of failure to establish breastfeeding compared with women who were still on maternity leave at the time of the interview. Women who took six to 12 weeks of maternity leave had a two-fold greater risk of failing to establish breastfeeding. Also, having a managerial position or a job with autonomy and a flexible work schedule was linked with longer breastfeeding duration in the study. Overall, the study found that returning to work within 12 weeks of delivery had a greater impact on breastfeeding establishment for women in non-managerial positions, with inflexible jobs or who reported high psychosocial distress, including serious arguments with a spouse or partner and unusual money problems.

Guendelman S, Pearl M, Graham S, Hubbard A, Hosang N, Kharrazi M.Maternity leave in the ninth month of pregnancy and birth outcomes among working women. Womens Health Issues. 2009 Jan-Feb;19(1):30-7.

Guendelman S, Kosa JL, Pearl M, Graham S, Goodman J, Kharrazi M. Juggling work and breastfeeding: effects of maternity leave and occupational characteristics. Pediatrics. 2009 Jan;123(1):e38-46. Summarized and adapted from:

Friday, January 02, 2009

M-J's golden bow - reinforces the need for us to clarify OUR Golden Bow and to rebirth efforts to promote, support AND PROTECT breastfeeding in 2009!

What can be done when our industry "friends" use similar symbols?!?


We must continue to use our own bow, with is symmetrical and present it with the meanings that we apply to it:

1. It is symmetrical both ways, indicating the importance of both the mother and child.

2. The knot is large, as it indicates the support of father, family and society without whose support breastfeeding cannot succeed.

3. One streamer is for continued breastfeeding with age-appropriate complementary feeding

4. The other streamer is for 3-5 yrs. birth spacing to allow this baby to be the baby as long is needed and to allow for maternal health and nutrition recovery.
Breastfeeding needs better protection from wealth and power lobbies. the Code is not legislated in most countries, and even where legislated, rarely fully enforced.
We need a rebirth of effort on all fronts in 2009.

Profits for commercial formula industry will increase this year....

“The price of powdered skim milk, used in infant formula, dairy products and processed foods, has fallen to roughly 80 cents a pound today from about $2.20.”

Commercial formula now costs about $7-12 a pound. The profit was huge, but now will be unbelievable...

This, in all probability will lead to increased profits by formula industry giving them immense amounts to spend on advertising in the near future…stay tuned.