New AAP resolution

This may seem like a dry, legalistic-sounding (maybe even boring) document but it says something that I find really exciting:

Resolve that the Academy advise pediatricians not to provide formula company gift bags, coupons, and industry-authored handouts to the parents of newborns and infants in office and clinic settings

Until we have donor milk readily available for all babies that need more milk than their mothers provide, formula will have an important role in safely feeding babies. However, doctors shouldn’t be the (inadvertent) salespeople for the formula companies. Free samples from doctors effectively promote that particular brand of formula, generally a more expensive brand than a family might otherwise choose. Literature from formula companies generally doesn’t have good breastfeeding information. Families can get much better basic information and support from many other sources. There is no need at all for industry-authored handouts. I’m excited that the AAP is encouraging pediatricians to (as the Ban the Bags folks would say) “market health and nothing else”. To read more about this issue in general, check out Ban the Bags.

Good news/bad news or environmental contamination of breastmilk

You may have heard in the news that mothers’ milk is contaminated with toxic chemicals. It is true. It is also true that everyone agrees that breastmilk is the first choice food for babies. All major public health organizations promote breastfeeding. Even though we live in a world where harmful chemicals are in our environment and in our bodies and in our breastmilk, breastfeeding is still the first choice food. Even when a mother’s milk is known to contain particular contaminants, breastfeeding is still almost always the best choice for her baby.

Unfortunately we know that mothers’ milk is contaminated with a long list of harmful chemicals (persistent organic pollutants (POPs) and heavy metals are most often mentioned). Breastmilk is contaminated because mothers are exposed through what they eat, drink, breathe and touch. The fact that these chemicals appear in mothers’ milk is a reminder that mothers (and all people) are exposed. Steps to protect breastmilk are the same steps that are needed to protect everyone. Rather than thinking of breastmilk as a separate problem, we need to think about it as one small facet of the bigger problem. While all of us are exposed to toxic chemicals, babies are particularly vulnerable to the effects of many of these chemicals. As part of taking care of their future health, it is important to stop ignoring or accepting this contamination of their food.

While we know that babies do best with breastmilk, they would almost certainly be healthier in the long run if there were fewer harmful chemicals in that milk. So what can families do to give their babies the healthiest start on life that they can?

1) Become politically active because we can not protect just our own family. Some chemicals that are found in breastmilk got into the environment when they were used in another country. Many chemicals are in the water and air. An individual mother will not be able to stop all of her exposures with her individual lifestyle choices. We have to all work together to find alternatives and limit the ability of companies and individuals to expose all of us to harmful chemicals. When your babies are small it can be hard to find the time to be an activist. A good starting place is to donate to reputable environmental organizations and then follow up on any easy action steps they send to you. Some possible organizations are Environmental Working Group, League of Conservation Voters, Sierra Club, Environmental Defense Fund, Physicians for Social Responsibility.

2) There are some lifestyle choices that can decrease chemicals that a mother (and her breastmilk) are exposed to. This is a topic where there are always new recommendations and new information. An easy way for new parents to stay on top of research and recommendations is to check helpful websites like the Planned Parenthood Green Choices, the Environmental Working Group guides to personal care products, water, and produce, or the National Library of Medicine Household Products database. There is so much information here that it is easy to become overwhelmed. It is a good idea to work on one thing at a time, choosing what is manageable. If the idea of looking at these websites is overwhelming, take a look at the list of ideas at the end of this essay – then look up that topic on one of the websites and make their suggestions part of your lifestyle. (Of course in the better world that I dream of for our children, no mother should need to be up-to-date on toxicology research just to protect herself and her milk – see my first point above).

Some starting points:
- Choose foods that are low in pesticides.
- Eat organic meat, eggs, and dairy.
- Join a CSA farm.
- Learn about which fish are safest to eat.
- Use safer plastics.
- Choose safer sunscreen, shampoo, soap, detergent, makeup.
- Learn about food packaging and which options are safest.
- Check your home for sources of lead exposure.

Where to go to learn more?
MOMS: Making Our Milk Safe
American Academy of Pediatrics: Breastfeeding and the Use of Human Milk
Pediatric Environmental Health (AAP)
International Lactation Consultant Association position paper
Having Faith and Raising Elijah by Sandra Stiengraber
Slow Death by Rubber Duck, book by Rick Smith and Bruce Lourie

Breastfeeding and the law – where to get information?

It can be hard to know how a breastfeeding mother and family will be affected by laws. First of all it can be hard to find out what the laws say.  Then knowing what they say isn’t enough – most of us that aren’t lawyers (that is, most of us) need help understanding what the laws mean. This website by Jake Aryeh Marcus, breastfeedinglaw.com, has both the texts and the explanations to help. Check it out!

Doulas are awesome…

I don’t think I can say this often enough: The easiest way to get breastfeeding off to a good start is a birth that is as natural as possible. Of course a natural birth doesn’t guarantee that breastfeeding will be trouble-free and birth interventions don’t mean that breastfeeding won’t go just fine. It is just that for most babies, they breastfeed best when they are born alert and fully ready. Research shows that having a doula at your birth makes natural birth more likely.

Even when a birth ends up being physically difficult, doulas can help new mamas feel better about the experience. And any time a mother feels good about herself it is easier to learn a new skill (like breastfeeding) and feel confident taking care of her baby.

Having said that, check out this new website for a local doula group:
http://www.madisondoulacollective.com/

And the general local doula directory:
http://wisconsindoulas.net/

Working and pumping: where to find out more about the law

Last year a new law was passed that requires employers to provide a space and break time for breastfeeding mothers to pump for their babies. These links have information about what the law provides and how to file a complaint. One nice thing about the law is that it acknowledges the variation between mothers in how often and how long they need to pump (“Employers are required to provide a reasonable amount of break time to express milk as frequently as needed by the nursing mother.  The frequency of breaks needed to express milk as well as the duration of each break will likely vary.”)

Fact Sheet #73: Break Time for Nursing Mothers under the FLSA

FAQs about break time for nursing mothers

How to file a complaint

Great latch article

My friend Nora just gave me a heads-up on this article by Fleur Bickford on the Best for Babes site. There are so many unhelpful things out there about latch – so many detailed instructions about specific positions that don’t actually work for all mothers and babies. Many of these detailed instructions seem to put mothers and babies out of sync with one another – but successful breastfeeding depends on mothers and babies working together. We are learning more all the time about how babies use their hands, how they get information from touch and smell, how they will try to adjust themselves to be comfortable. Mothers can support these inborn skills to help babies succeed at breastfeeding. Fleur Bickford’s article pulls together the thoughts that many people have been having about babies’ inborn breastfeeding skills in a user-friendly way.  It’s good stuff!