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Update on Haiti and Breastmilk Donations

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An update to the question of whether or not to donate breast milk to help victims of the Haiti earthquake…
Last month, Unicef and the World Health Organization discouraged donations of formula. Then several groups, including La Leche League (LLL) and the Human Milk Banking Association of North America (HMBANA) issued an urgent call for breast milk donations. The International Breast Milk Project delivered 500 ounces of milk to the USS Constitution to treat infants on board the ship.
But then there was a backlash. There was a report from MSNBC that the milk on the ship was not being used. Furthermore, TIME magazine reported the WHO and Unicef are discouraging breast milk donations because the mainland of Haiti doesn’t have the infrastructure in place to use it.
So where does that leave things? The International Breast Milk Project is not planning another shipment. And the HMBANA and LLL are now saying that breast milk donations are not recommended:
Donor milk, however, is not a solution for the large number of infants and young children affected by the earthquake in Haiti. Members of the public who wish to promote the survival of mothers and babies in Haiti can donate money to the following organizations: UNICEF , Save the Children Alliance, World Vision, and Action Against Hunger. These organizations are using best practice to aid both breastfed and non-breastfed infants. Members of the public can be confident that donations to these organizations will support breastfeeding and help save the lives of babies.
If you want to read more on this subject, visit the Motherwear Breastfeeding Blog or Breastfeeding 123.

Update on Melamine in Infant Formula

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And an update on the China story, read here.

Last week, the FDA reported that it had found trace amounts of the chemical melamine in some infant formulas. From CBS news:
They are Mead Johnson’s Enfamil LIPIL with Iron and Nestle’s Good Start Supreme Infant Formula with Iron. Abbott Laboratories, whose brands include Similac, independently reported that it had detected trace levels of melamine in its formula…
The FDA came under fire recently for failing to set safety standards after large doses of melamine, as much as 10,000 parts per million, caused the deaths of three infants in China and made 50-thousand others sick. But late last week, administration set a safe threshold for either of the chemicals alone at 1 part per million – higher than the amounts they found in U.S. brands. The FDA insists the formulas are safe…
The FDA said it believes the contamination may occur because melamine is contained in a cleaning solution used on some food processing equipment. Parents looking for an alternative might consider this: about 90 percent of all infant formulas produced in the U.S. are made by the three companies whose products tested positive for contaminants.

Here’s the FDA update.
And watch this video from CBS news.

Melamine Found in Some Infant Formula in the US.

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Earlier this year a major scandal was exposed among China’s infant formula manufacturers. Companies were adding an industrial chemical called melamine to the milk, in order to disguise test results that measure protein levels. The melamine left more than 50,000 infants sick and killed 4.
At the time, the U.S. Food and Drug Administration assured American consumers that Chinese formula was not for sale in the U.S. But now, the FDA says it has found trace amounts of melamine in some American infant formulas. The FDA says the amounts do not pose a health concern.
So what does this mean for us? If you’re feeding your baby formula, take a few minutes to read the articles below. And if you have any questions, talk to your pediatrician.
Here’s today’s New York Times article.
Here’s a link to the FDA’s page on melamine, as well as some Frequently Asked Questions.
For a more extensive piece, here’s the article from the Associated Press. It has more information than the New York Times article.
Traces of the industrial chemical melamine have been detected in samples of top-selling U.S. infant formula, but federal regulators insist the products are safe. The Food and Drug Administration said last month it was unable to identify any melamine exposure level as safe for infants, but a top official said it would be a “dangerous overreaction” for parents to stop feeding infant formula to babies who depend on it.
“The levels that we are detecting are extremely low,” said Dr. Stephen Sundlof, director of the FDA’s Center for Food Safety and Applied Nutrition. “They should not be changing the diet. If they’ve been feeding a particular product, they should continue to feed that product. That’s in the best interest of the baby.”
Melamine is the chemical found in Chinese infant formula — in far larger concentrations — that has been blamed for killing at least three babies and making at least 50,000 others ill.
Previously undisclosed tests, obtained by The Associated Press under the Freedom of Information Act, show that the FDA has detected melamine in a sample of one popular formula and the presence of cyanuric acid, a chemical relative of melamine, in the formula of a second manufacturer.
Separately, a third major formula maker told AP that in-house tests had detected trace levels of melamine in its infant formula.
The three firms — Abbott Laboratories, Nestle and Mead Johnson — manufacture more than 90 percent of all infant formula produced in the United States.
The FDA and other experts said the melamine contamination in U.S.-made formula had occurred during the manufacturing process, rather than intentionally.
The U.S. government quietly began testing domestically produced infant formula in September, soon after problems with melamine-spiked formula surfaced in China.
Sundlof said there have been no reports of human illness in the United States from melamine, which can bind with other chemicals in urine, potentially causing damaging stones in the kidney or bladder and, in extreme cases, kidney failure.
Melamine is used in some U.S. plastic food packaging and can rub off onto what we eat; it’s also contained in a cleaning solution used on some food processing equipment and can leach into the products being prepared.
Sundlof told the AP the positive test results “so far are in the trace range, and from a public health or infant health perspective, we consider those to be perfectly fine.”
That’s different from the impression of zero tolerance the agency left on Oct. 3, when it stated: “FDA is currently unable to establish any level of melamine and melamine-related compounds in infant formula that does not raise public health concerns.”
FDA scientists said then that they couldn’t set an acceptable level of melamine exposure in infant formula because science hadn’t had enough time to understand the chemical’s effects on infants’ underdeveloped kidneys. Plus, there is the complicating factor that infant formula often constitutes a newborn’s entire diet.
The agency added, however, that its position did not mean that any exposure to a detectable level of melamine and melamine-related compounds in infant formula would result in harm to infants.
Still, the announcement was widely interpreted by manufacturers, the news media and Congress to mean that infant formula that tested positive at any level could not be sold in the United States.
The Grocery Manufacturers Association, for example, told its members: “FDA could not identify a safe level for melamine and related compounds in infant formula; thus it can be concluded they will not accept any detectable melamine in infant formula.”
It was not until the AP inquired about tests on domestic formula that the FDA articulated that while it couldn’t set a safe exposure for infants, it would accept some melamine in formula — raising the question of whether the decision to accept very low concentrations was made only after traces were detected.
On Sunday, Sundlof said the agency had never said, nor implied, that domestic infant formula was going to be entirely free of melamine. He said he didn’t know if the agency’s statements on infant formula had been misinterpreted.
In China, melamine was intentionally dumped into watered-down milk to trick food quality tests into showing higher protein levels than actually existed. Byproducts of the milk ended up in infant formula, coffee creamers, even biscuits.
The concentrations of melamine there were extraordinarily high, as much as 2,500 parts per million. The concentrations detected in the FDA samples were 10,000 times smaller — the equivalent of a drop in a 64-gallon trash bin.
There would be no economic advantage to spiking U.S.-made formula at the extremely low levels found in the FDA testing. It neither raises the protein count nor saves valuable protein, said University of California, Davis chemist Michael Filigenzi, a melamine detection expert.
According to FDA data for tests of 77 infant formula samples, a trace concentration of melamine was detected in one product — Mead Johnson’s Infant Formula Powder, Enfamil LIPIL with Iron. An FDA spreadsheet shows two tests were conducted on the Enfamil, with readings of 0.137 and 0.14 parts per million.
Three tests of Nestle’s Good Start Supreme Infant Formula with Iron detected an average of 0.247 parts per million of cyanuric acid, a melamine byproduct.
The FDA said last month that the toxicity of cyanuric acid is under study, but that meanwhile it is “prudent” to assume that its potency is equal to that of melamine.
And while the FDA said tests of 18 samples of formula made by Abbott Laboratories, including its Similac brand, did not detect melamine, spokesman Colin McBean said some company tests did find the chemical. He did not identify the specific product or the number of positive tests.
McBean did say the detections were at levels far below the health limits set by all countries in the world, including Taiwan, where the limit is 0.05 parts per million.
“We’re talking about trace amounts right here, and you know there’s a lot of scientific bodies out there that say low levels of melamine are always present in certain types of foods,” said McBean.
Mead Johnson spokeswoman Gail Wood said her company’s in-house tests had not detected any melamine, and that the company had not been informed of the FDA test results, even during a confidential agency conference call Monday with infant formula makers about melamine contamination.
The FDA tests also detected melamine in two samples of nutritional supplements for very sick children who have trouble digesting regular food. Nestle’s Peptamen Junior medical food showed 0.201 and 0.206 parts per million of melamine while Nestle’s Nutren Junior-Fiber showed 0.16 and 0.184 parts per million.
The agency said that while there are no established exposure levels for infant formula, pediatric medical food — often used in feeding tubes for very sick, young children — can have 2.5 parts per million of melamine, just like food products other than infant formula.
The head of manufacturing for Nestle Nutrition in North America, Walter Huber, said in an interview that the company took samples alongside FDA officials who visited a manufacturing plant, and that those samples showed similar results to what FDA found for the two pediatric medical foods. Huber added that Nestle didn’t fund cyanuric acid in any of the samples.
The FDA shared its results with Nestle a few weeks ago, Huber said. He said he wasn’t sure whether Nestle had tested other of its products beyond what it did related to the FDA.
Rep. Rosa DeLauro, D-Conn., who heads a panel that oversees the FDA budget, said the agency was taking a “marketplace first, science last” approach.
“The FDA should be insisting on a zero-tolerance policy for melamine in domestic infant formula until it is able to determine conclusively based on sound independent science that the trace levels would not pose a health risk to infants,” DeLauro said.
Rep. Bart Stupak, D-Mich., a frequent critic of the FDA, said: “If no safe level of melamine has been established for consumption by children, then the FDA should immediately recall any formula that has tested positive for even trace amounts of the contaminant.”
Several medical experts said trace concentrations would be diluted even in an infant, and are highly unlikely to be harmful.
“It’s just a tiny amount, it’s very unlikely to cause stones,” said Stanford University Medical School pediatrics professor Dr. Paul Grimm.
Dr. Jerome Paulson, an associate professor of pediatrics at Children’s National Medical Center in Washington, D.C., said he didn’t think the FDA’s decision was unreasonable. He added, however, that the agency should research the impacts of long-term, low-dose exposure, “and not just assume it’s safe, and then 15 years from now find out that it’s not.”

Organic Formula and Sugar

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Here’s an interesting story from yesterday’s New York Times. It talks about how Similac Organic formula is sweetened with sucrose. Here’s an excerpt from the story.
Parents may be buying it because they believe that organic is healthier, but babies may have a reason of their own for preferring Similac Organic: it is significantly sweeter than other formulas. It is the only major brand of organic formula that is sweetened with cane sugar, or sucrose, which is much sweeter than sugars used in other formulas.
No health problems in babies have been associated with Similac Organic. But to pediatricians, there are risks in giving babies cane sugar: Sucrose can harm tooth enamel faster than other sugars; once babies get used to its sweeter taste, they might resist less sweet formulas or solid foods; and some studies suggest that they might overeat, leading to rapid weight gain in the first year, which is often a statistical predictor of childhood obesity.
Asked about these concerns, Carolyn Valek, a spokeswoman for Abbott Nutrition, the division of Abbott Laboratories that makes Similac Organic, said that sucrose had been approved by the Food and Drug Administration and was considered “safe and well established.” Ms. Valek said that Similac Organic had no more sweetener than other formulas and that prolonged contact with any kind of sugar could cause tooth decay.
In Europe, where sudden increases in childhood obesity are a pressing public health issue, sucrose-sweetened formulas will be banned by the end of 2009, except when ordered by a doctor for babies with severe allergies. The 27 countries of the European Union adopted the new rules according to the recommendations of the group’s Scientific Committee on Food, which found that sucrose provided no particular nutritional advantages, could, in rare cases, bring about a fatal metabolic disorder, and might lead to overfeeding.

Answering Your Breastfeeding Questions

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I’ve been doing some guest writing on The Nest Baby, a cool site for new moms. Readers have been submitting questions about breastfeeding and I’ve been answering them. You can check out all of the answers on this link. You can also jump right to the specific questions from these links:
Breastfeeding Positions
Breast Lumps and Nursing
Dealing with Thrush
Inverted Nippes
Milk Blisters
Newborn Eating Enough?
Getting Help At Home
Prepping to Nurse?
Prepping to Pump?
Pumping and Work
Pumping Problems
Storing Breastmilk
Travel while Nursing
Weaning and Milk Supply
Pumping Extra Milk
If you have a specific question, feel free to email me any time at mamaknowsbreast@yahoo.com.

Formula Industry Lobbied To Tone Down Government Breastfeeding Ads

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This is a story about big companies and their Washington lobbyists. It could be a story about getting a tunnel built, regulating gas mileage or even securing a military contract. But in this case, it’s about infant formula companies influencing an ad campaign aimed at promoting breastfeeding.
The The Washington Post reported the story yesterday. Here’s a quick summary:
1. The Department of Health and Human Services ran a public health campaign a few years ago to promote breastfeeding. The ads aimed to convince mothers that their infants faced health risks if they did not breastfeed.
2. Some of the original ads showed baby bottle nipples on top of asthma inhalers or insulin dispensers for diabetes. The point of the ads, which included statistics, was that breastfeeding reduces the risk of these diseases.
3. Formula makers lobbied to get the ads changed and they succeeded. The ads were never seen by the public. Instead, they were replaced by pairs of dandelions (ie. breastfeeding reduces asthama), or two scoops of ice cream (breastfeeding reduces obesity), that evoked breasts.
4. Furthermore, HHS did not promote a study by its own Agency for Healthcare Research and Quality (AHRQ) of multiple studies on breast-feeding, which generally found breastfeeding was associated with fewer ear and gastrointestinal infections, and lower rates of diabetes, leukemia, obesity, asthma and sudden infant death syndrome, or SIDS. (To read the report, look in the right hand column of the Post story, in the box that says On The Web, and read “Breastfeeding and Maternal Infant Health.”)
Now here are some paragraphs from The Washington Post story:

The formula industry’s intervention — which did not block the ads but helped change their content — is being scrutinized by Congress in the wake of last month’s testimony by former surgeon general Richard H. Carmona that the Bush administration repeatedly allowed political considerations to interfere with his efforts to promote public health.
Rep. Henry A. Waxman’s Committee on Oversight and Government Reform is investigating allegations from former officials that Carmona was blocked from participating in the breast-feeding advocacy effort and that those designing the ad campaign were overruled by superiors at the formula industry’s insistence.
“This is a credible allegation of political interference that might have had serious public health consequences,” said Waxman, a California Democrat…
Gina Ciagne, the office’s public affairs specialist for the campaign, said, “We were ready to go with our risk-based campaign — making breast-feeding a real public health issue — when the formula companies learned about it and came in to complain. Before long, we were told we had to water things down, get rid of the hard-hitting ads and generally make sure we didn’t somehow offend.”
Ciagne and others involved in the campaign said the pushback coincided with a high-level lobbying campaign by formula makers, which are mostly divisions of large pharmaceutical companies that are among the most generous campaign donors in the nation.
The campaign the industry mounted was a Washington classic — a full-court press to reach top political appointees at HHS, using influential former government officials, now working for the industry, to act as go-betweens
Two of the those involved were Clayton Yeutter, an agriculture secretary under President George H.W. Bush and a former chairman of the Republican National Committee, and Joseph A. Levitt, who four months earlier directed the Food and Drug Administration’s Center for Food Safety and Applied Nutrition food safety center, which regulates infant formula. A spokesman for the International Formula Council said both were paid by a formula manufacturer to arrange meetings at HHS….
The industry substantially increased its own advertising as soon as the HHS campaign was launched. According to a 2006 report by the Government Accountability Office, formula companies spent about $30 million in 2000 to advertise their products. In 2003 and 2004, when the campaign was underway, infant formula advertising increased to nearly $50 million.

So there you have it. Washington D.C. at its finest. For me, while I think breastfeeding is best, I still it as a matter of personal choice. A mom has to decide what will work best for her and her baby. Even so, it is sickening to see the inner workings of the formula industry. Of course we’re talking about businesses here. And businesses is designed to maximize profits. It’s just a shame that for some companies, doing so can have serious health consequences for our children.

FDA Warns Nestle Over Baby Formula

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If you’ve been using Nestle’s Good Start Infant Formula with Iron to feed your baby, you may want to think twice.
The U.S. Food and Drug Administration issued Nestle a warning letter on November 27th after a sample failed to meet proper nutrient levels. It seems the sample, collected in May, did not meet minimum requirements for calcium and phosphorus.
Nestle has said that its tests found that its product is fine. Here is a quote from a Reuters news story:
“We are working with FDA to better understand how issues relating to analytical testing methods might explain the differences noted in these two nutrients,” the company said.
The Dairy Reporter.com reported that Nestle stands by its product.
“We have had two independent tests done by absolutely top quality laboratories and we have not been able to confirm the findings of the FDA,” said a Nestlé spokesperson. “There is no question of a recall. We are in contact with the FDA and discussions are in progress.”
Nestle has had problems with its formula in the past. It was first accused, in the 1970′s, of unethically pushing formula on women in developing countries and thus discouraging them from breast feeding. Check out Breastfeeding.com for background on the boycott. This will lead you to Baby Milk Action, a group devoted to boycotting Nestle.
Nestle has 15 working days from receipt of the letter to respond. So that brings us to some time this week. Let’s see what happens. I have calls in to both the FDA and Nestle to see what’s happening. I’ll keep you posted.
And PS…thanks to Micky at Mocha Milk for first pointing out this story.

Breastfeeding Bill of Rights For New York?

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Update on December 11, 2006: I just got an email from State Senator Liz Krueger, saying she found this post on my blog. She wrote, “I wanted to thank you for helping spread the word.”
I’ve breastfed The Bear all over New York City. We’ve done it in Central Park, playgrounds and restaurants. Today alone, I breastfed in a coffee shop, during a kiddie music class and at a preschool meeting. In general, I’m shy. But with breastfeeding, I just don’t care. If The Bear is hungry, I’m not going to make him wait.
So I’m fortunate that New York has a law that allows a mom to breastfeed in any public or private location. But according to State Senator Liz Krueger, it’s time for New York to take things one step further. (Thanks to Tanya of The Motherwear Breastfeeding Blog for pointing this one out). Krueger has introduced a bill she’s calling the Breastfeeding Mothers’ Bill of Rights.
The Press Release outlines these objectives:
Before You Deliver: The right to information free from commercial interests, which provides the nutritional, medical and psychological benefits of breastfeeding; An explanation of some of the problems a mother may encounter, and how to avoid or solve them.
In the Maternal Healthcare Facility: The mothers’ right for her baby to stay with her after delivery to facilitate beginning breastfeeding immediately; to insist the baby not receive bottle feeding; to be informed about and refuse any drugs that may dry up breast milk; 24 hour access to the baby with the right to breastfeed at any time.
When You Leave the Maternal Healthcare Facility: The right to refuse any gifts or take-home packets, distributed by the maternal healthcare facility, that contain commercial advertising or product samples; access to breastfeeding resources in one’s community.

Sounds like a good idea if you ask me. When The Bear was born in a New York City hospital, I had a strange experience the second night we were there. The nurse wouldn’t let me take him out of the nursery because he had been having a spitting up problem and they wanted to keep an eye on him. I was fortunate that they were exceptionally vigilant, but I also felt compelled to feed him after a certain number of hours had passed. I asked the nurse if I could sit in the nursery to feed and she said that wasn’t possible. I don’t remember the reason she gave. I waddled back to my room, determined to make a stink if they didn’t let me have him within the hour.
Quite honestly, I wish I could remember how this situation resolved itself. Chalk it up to post-partum fuzz. I think I eventually demanded that they let me have him. I knew it was important to keep feeding him regularly, and I was confident (second child) that I would be able to rush him back if there was a real problem.
Krueger’s bill could have helped in this area since it would require “24 hour access to the baby with the right to breastfeed at any time.” But let’s be real, the burden would still fall on moms to speak up. That’s what we as moms do after all. We advocate for our kids. It’s a life long enterprise. And it starts on day one.
Nevertheless, if you live in New York, let Senator Krueger know that you support her. Give her office a call.

Bottle Versus Breast

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A couple of weeks ago I got a call from a reporter, Mackenzie Carpenter, at the Pittsburgh Post Gazette. She was working on a piece about the “politics” of breast feeding and bottle feeding. It was pretty cool to get her call. As a former reporter, however, I was agonizingly aware of every word I uttered during our conversation. This was the first time I was ever interviewed, and I wasn’t ready for it.
I asked Mackenzie to go easy on me, and she reassured that I shouldn’t worry. Today I got an email from her telling me the piece ran in yesterday’s paper, but that unfortunately my quotes got cut by her editor. Oh well.
Anyway, the story’s headline pretty much sums up the piece– “Bottle vs. Breastfeeding: Cultural Confusion Engulfs Moms No Matter Which Method is Used.” The basic idea is that moms face societal and personal challenges whether they breast feed or bottle feed.
Here’s my take on it. As moms, we question our child rearing choices all the time. Is the baby getting enough to eat? Am I reading enough to the baby? Does he have the right toys? Should he have a play date or is it ok to just be around his older brother? Bottom line, it’s all too easy to feel guilty about the choices you make, and I think breast feeding and bottle feeding are simply an easy flash point for all of that parental guilt to come to a head.
I’m not sure I said anything remotely like that when Mackenzie interviewed me. In fact, when we spoke I was so tired, and so busy breast feeding The Bear to keep him from crying, that I can hardly recall anything I said.
In any case, it was fun to talk to her on the phone. Hopefully, I’ll be a bit more mentally prepared for the next time the phone rings!

Pumping and Flying Update

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Update: a new rule effective August 4, 2007 does away with the limits on the amount of breast milk a mom can carry on board a plane.
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A little update from the TSA…
I got an email this morning from the Office of Public Affairs at the Transporation Security Administration. The PR person who wrote to me wanted to add that if you are traveling with your baby, you CAN bring ice through the security checkpoint to cool the formula or breast milk you might be bringing on board. The ice exemption also applies to medications that need to be cooled.