Thursday, March 11, 2010

Triangle Breastfeeding Alliance, Inc.

Start Healthy Stay Healthy

NEW MOMS HER PASSION (A Tribute to Mary Rose Tully)

Posted by NCTBA.org On January - 28 - 2010 ADD COMMENTS

Mary Rose and her husband Doug and granddaughter Anika

Before she helped found the Human Milk Banking Association of North America and before there was a training program named for her at UNC-Chapel Hill, Mary Rose Tully was a new mom in a hospital far from home trying to nurse her son and wishing for a little guidance.

She got the advice she needed from other moms and continued the support by joining Nursing Mothers of Raleigh when she, her husband and son moved to North Carolina. Tully probably didn’t realize even then that helping other women and their babies would become her life’s work.

“She loved children and babies, but what she loved more was making sure mothers had support to feed their babies,” said Mary Overfield, who started as Tully’s friend and became her colleague, “Mary O.” to her “Mary Rose.”

“That was Mary’s passion,” Overfield said. “Not just how cute the babies are, but also she’s about the mothers.”

Tully became an internationally known expert on breastfeeding and breast-milk banking. In the months before Tully’s death Jan. 20 at age 63, six students became the first to enroll in what is now called the Mary Rose Tully Training Initiative, the lactation-consultant training program for graduate students she helped launch at the University of North Carolina.

Her priorities were her granddaughter, son and husband first, “and then every other mother and child in the world,” said Miriam Labbock, director of the Carolina Global Breastfeeding Institute at the Gillings School of Global Public Health at UNC-CH.

Born in Minneapolis, Mary Rose Weber was the oldest of eight children. She left home to study at the University of Idaho, where she met a Navy ROTC midshipman whose girlfriend had broken up with him just before the military ball. The girlfriend of a dorm mate set up Douglas Tully with Weber for that dance.

“I came back and told my friend, ‘I could marry that girl,’” Tully said. And he later did.

Douglas Tully left college before finishing his degree, which in 1968 made him a prime candidate for the draft. The couple planned a wedding based on his leave date and honeymooned by driving from Idaho, where they were married, to Biloxi, Miss., where he was training.

They were eventually stationed at Vandenberg Air Force Base in California where Mary Rose Tully taught first grade at the local Catholic elementary school. Their son, Christopher, was born at the military hospital there. When Douglas Tully’s military commitment was up, the young family moved to Raleigh on the advice of a friend who had already relocated east.

Mary Rose Tully continued her own education while teaching Catholic elementary school. Through Nursing Mothers of Raleigh, she met another young mom, a recent transplant from Denver, and invited her to lunch.

Overfield remembers being surprised by the invitation. “I looked behind me,” she said. “I thought she was talking to someone else. I’d just met her!”

But Tully was talking to her, and along with a lifelong friendship, a professional collaboration had begun. Overfield was a nurse, frustrated by the lack of information and support for breastfeeding mothers.

A call to help

Tully’s membership in the Raleigh group led to her involvement in early breast-milk banking, where lactating moms provide milk to be stored for those who need it – often ill or premature babies but also others who are sick and can benefit from the highly nutritious and easily digested milk. Doctors who were conducting breastfeeding-related studies would contact Tully for help reaching out to mothers. Eventually, Tully was hired by WakeMed and established its milk bank, one of a handful in the country.

She and Overfield wrote curricula, made training videos and collaborated with other experts, and Tully gained an international reputation for expertise in milk banking and lactation consultation. She served in the leadership of several breastfeeding organizations and was the co-author of a library’s worth of research and guidance on the topic. It wasn’t the need for recognition that pushed her, however, but a call to help others.

“Everything she did, whether it was teaching school or working with a new mother, she did with such passion and care,” Douglas Tully said. “When you were with Mary, she gave you her full attention, listening to what you’d say.”

Dr. Laurie Dunn, a neonatologist at WakeMed, said Tully had the ability to bring people and resources together in a way that touched both individuals and policy.

“She always went the extra mile for anyone who needed help,” Dunn said. “She was able to answer the questions and make things happen.”

Tully left WakeMed after more than 20 years to work for UNC, where she served on the faculties of the Department of Obstetrics and Gynecology, the School of Nursing and the School of Public Health. She was also co-founder and senior clinical associate of the Breastfeeding Institute.

Tully was speaking at a conference in August when she began to feel ill. She was eventually diagnosed with pancreatic cancer. The doctors were hopeful, but the disease was relentless. In her final days, she asked that friends and family visit her in her hospital room.

“She’d hold your hand and smile,” Overfield said. “And we all got to say goodbye.”

Tully is survived by her husband, son, daughter-in-law and granddaughter, her mother and six of her siblings.

ajpuva@att.net

Breastfeeding is the First Line of Defense in a Disaster

Posted by NCTBA.org On January - 27 - 2010 ADD COMMENTS

January 27, 2010
FOR IMMEDIATE RELEASE

UPDATED STATEMENT:
Breastfeeding is the First Line of Defense in a Disaster

Washington, DC–The Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) strongly affirm the importance of breastfeeding in emergency situations, and call on relief workers and health care providers serving victims of disasters to protect, promote, and support mothers to breastfeed their babies. During an emergency, breastfeeding mothers provide their infants with safe food and water and disease protection that maximize their chances of survival.

This week, the International Milk Bank Project and Quick International Courier coordinated a shipment of milk from the HMBANA member banks to supplement a mother’s own milk for the premature, medically fragile, and orphaned infants aboard the U.S. Navy ship Comfort stationed off the coast of Haiti. This milk will help this small group of infants. In this highly unusual circumstance the infrastructure associated with the Comfort’s resources allows U.S. sourced donor milk to help fragile Haitian babies.

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.

Interventions to protect infants include supporting mothers to initiate and continue exclusive breastfeeding, relactation for mothers who have ceased breastfeeding, and finding wet nurses for motherless or separated babies. Every effort should be made to minimize the number of infants and young children who do not have access to breastfeeding. Artificially fed infants require intensive support from aid organizations including infant formula, clean water, soap, a stove, fuel, education, and medical support. This is not an easy endeavor. Formula feeding is extremely risky in emergency conditions and artificially fed infants are vulnerable to the biggest killers of children in emergencies: diarrhea and pneumonia.

As stated by UNICEF and WHO, no donations of infant formula or powdered milk should be sent to the Haiti emergency. Such donations are difficult to manage logistically, actively detract from the aid effort, and put infant’s lives at risk. Distribution of infant formula should only occur in a strictly controlled manner. Stress does not prevent women from making milk for their babies, and breastfeeding women should not be given any infant formula or powdered milk.

There are ongoing needs in the U.S. for human milk for premature and other extremely ill infants because of the protection it provides from diseases and infections. If a mother is unable to provide her own milk to her premature or sick infant, donor human milk is often requested from a human milk bank. American mothers can help their compatriots who find themselves in need of breast milk for their sick baby by donating to a milk bank that is a member of the Human Milk Banking Association of North America.

For more information about donating milk to a milk bank, contact HMBANA at www.hmbana.org. Additional information for relief workers and health care professionals can be provided from the United States Breastfeeding Committee at www.usbreastfeeding.org, ILCA/USLCA at www.ilca.org or www.uslca.org, or La Leche League International at www.llli.org. A list of regional milk banks is available on the HMBANA Web site at www.hmbana.org/index/locations.

USBC is an organization of organizations. Opinions expressed by USBC are not necessarily the position of all member organizations and opinions expressed by USBC member organization representatives are not necessarily the position of USBC.

United States Breastfeeding Committee (USBC)

The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of 41 nationally influential professional, educational, and governmental organizations. Representing over half a million concerned professionals and the families they serve, USBC and its member organizations share a common mission to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding. For more information about USBC, visit www.usbreastfeeding.org.


United States Breastfeeding Committee
2025 M Street, NW, Suite 800
Washington, DC 20036
Phone: 202/367-1132
Fax: 202/367-2132
E-mail: office@usbreastfeeding.org
Web: www.usbreastfeeding.org

SSRIs Affect Breast Milk Production

Posted by NCTBA.org On January - 27 - 2010 ADD COMMENTS

By Nancy Walsh, Senior Writer, MedPageToday
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.
January 26, 2010

Women taking selective serotonin reuptake inhibitor (SSRI) antidepressants may experience delays in postpartum breast milk production, researchers said.

Delayed secretory activation occurred in 87.5% of a small group of women taking SSRIs, compared with 43.5% of those not taking the drugs (RR 2, 95% CI 1.51 to 2.67, P=0.02), according to Aaron M. Marshall, PhD, of the University of Cincinnati.

The relative risk of delayed activation remained significantly higher (P<0.05) among SSRI users after adjustment for maternal age, obesity, cesarean delivery, infant gestational age, and infant breastfeeding behavior, the researchers reported online in the Journal of Clinical Endocrinology and Metabolism.

An early breastfeeding difficulty faced by many women, particularly those who are primiparous, is milk secretion delayed beyond 72 hours postpartum.

These women also are at risk of early cessation of breastfeeding. In fact, only 11% of mothers in the U.S. breastfeed exclusively for the recommended six months.

Studies in animal models and cell cultures suggested that serotonin (5-HT) is an important local regulator of lactation homeostasis, and the 5-HT transporter is expressed in mammary tissue at the apical membrane of epithelial cells.

Serotonin is controlled intracellularly by a balance between synthesis and degradation, while extracellularly its availability is controlled through recycling by the 5-HT transporter.

The 5-HT transporter also is the target for the most commonly prescribed class of antidepressants in the U.S. and other developed countries. These SSRI antidepressants are typically used to treat postpartum depression.

The investigators conducted in vitro and animal studies to establish that the 5-HT transporter is expressed in breast tissue, particularly in the apical membranes of mammary epithelial cells, and that pharmacologic inhibition of the transporter disrupts tight junctures leading to a local involution-like effect.

To examine the potential effect of SSRI inhibition on milk production in women, Marshall and colleagues enrolled 431 mothers as part of a longitudinal cohort study examining barriers to early lactation success.

All were expecting their first live-born infants, had no known absolute contraindication to breastfeeding, and were at least 19 years old.

Women taking SSRIs were more likely to have scored higher on a depressive symptom scale (as expected), and were somewhat more likely to be obese or to have had a cesarean delivery.

Participating mothers were visited between 72 and 96 hours after giving birth to assess their breastfeeding experience and to determine the timing of secretory activation, and then seen again one week later.

Delayed secretory activation was defined as initiation more than 72 hours postpartum.

Median onset of secretory activation among the SSRI-treated mothers was 85.8 hours compared with 69.1 hours in mothers not using the drugs (P=0.004).

Eight women reported regular use of an SSRI medication. Seven experienced definite delayed secretory activation, and the eighth reported activation at 72 hours and therefore did not meet the defined cutoff for delayed activation.

All women taking SSRIs had experienced secretory activation by their second visit a week after the first interview.

The researchers noted that most studies on the effects of SSRI use during pregnancy and lactation have focused on the risks for developmental defects or whether the drugs passed into milk during lactation.

This study, they said, is the first to report data on another important aspect of SSRI use during the peripartum, the effect on milk production.

They concluded that the risk of delayed secretory activation was twice as great among primiparous women using an SSRI medication, and although the fraction of women taking the drugs was small, the risk was significant and remained so after adjustment for potential confounding factors.

Further examination of this relationship is needed in larger groups of mothers, the researchers said, and in studies to determine if there are differences among the antidepressant medications.

Action Points

  • Explain to interested patients that the use of certain types of antidepressants in the postpartum period may affect the onset of mothers’ milk production.
  • But note that this observation was in a study that included only a small number of women using the drugs, and further research is needed.

Primary source: Journal of Clinical Endocrinology and Metabolism
Source reference: Marshall A, et al “Serotonin transport and metabolism in the mammary gland modulates secretory activation and involution” J Clin Endocrin Metab 2009; DOI: 10.1210/jc.2009-1575.

Website source: https://rexnurse.mednewsplus.com/html/topicdetails.asp?pid=89&section_id=187&topic_id=18149&puid=11536&flag=1%22_blank%22

URGENT CALL FOR HUMAN MILK DONATIONS FOR HAITI INFANTS

Posted by NCTBA.org On January - 25 - 2010 ADD COMMENTS

The Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) are jointly issuing an urgent call for human milk donations for premature infants in Haiti, as well as sick and premature infants in the United States.

This week the first shipment of human milk from mothers in the United States will be shipped to the U.S. Navy Ship “Comfort” stationed outside Haiti. “Comfort” is currently set up with a neonatal intensive care unit and medical personnel to provide urgent care to victims of the earthquake. An International Board Certified Lactation Consultant stationed at the U.S. Navy base in Bethesda, MD is assisting with providing breast pump equipment and supplies to the “Comfort.” Dr. Erika Beard-Irvine, pediatric neonatologist, is on board the “Comfort” to coordinate distribution of the milk to infants in need. HMBANA, USBC, ILCA/USLCA, and LLL are responding to requests to provide milk for both premature infants and at-risk mothers who have recently delivered babies on board the U.S.N.S. Comfort, but an urgent need exists for additional donations.

At the current time, the infrastructure to deliver human milk on land to Haiti infants has not yet been established. As soon as that infrastructure is in place, additional donations will be provided to older infants.

Mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank of HMBANA. A list of regional milk banks is available at the HMBANA website at www.hmbana.org.

Currently milk banks are already low on donor milk. New milk donations will be used for both Haiti victims as well as to replenish donor supplies to continue to serve sick and premature infants in the U.S. Donor milk provides unique protection for fragile preterm infants. Financial donations are also strongly encouraged to allow HMBANA, a nonprofit organization, to continue serving infants in need.

UNICEF, the World Health Organization, the Emergency Nutrition Network, and medical professionals all recommend that breastfeeding and human milk be used for infants in disasters or emergencies. Human milk is life-saving due to its disease prevention properties. It is safe, clean, and does not depend on water which is often unavailable or contaminated in an emergency. Relief workers, health care providers, and other volunteers are urged to provide support for breastfeeding mothers to enable them to continue breastfeeding, and to assist pregnant and postpartum women in initiating and sustaining breastfeeding.

For more information, contact HMBANA at 408-998-4550 or http://www.hmbana.org/ . Additional information can be provided from the United States Breastfeeding Committee at 202-367-1132 (http://www.usbreastfeeding.org/), ILCA/USLCA at 1-800-452-2478 (http://www.ilca.org/  or http://www.uslca.org/ ), or La Leche League at 847-519-7730 (http://www.llli.org/) .

 Sincerely,

Angela's Signature

Angela Smith, President
ILCA Board of Directors

Milk Bank Locations
http://www.hmbana.org/index/locations

 

For those in the triangle area and surrounding areas
WakeMed Mothers Milk Bank
http://www.wakemed.org/body.cfm?id=135

A Sad Day For Lactation

Posted by NCTBA.org On January - 20 - 2010 2 COMMENTS

A Great Woman

On January 20, 2010, at 3:30pm, the lactation world lost one of our leading modern pioneers.  Mary Rose was a daughter, wife of 42 years, mother, teacher, researcher, advocator, inventor, author, award winner, and most importantly a fighter in every form of the word. Mary was diagnosed with pancreatic cancer in August and had surgery and chemotherapy. Unfortunately, the chemotherapy was not effective and the cancer had spread too far for radiation to be used.  And today she lost her final battle.  Her memory will live on forever in the enormous works she has done for breastfeeding.

Link to obtituary-http://www.legacy.com/obituaries/newsobserver/obituary.aspx?n=mary-r-tully&pid=138730862

Mary Rose Tully, MPH, IBCLC, is a noted lactation consultant, Director of the Department of Lactation Services at the University of North Carolina’s Women’s Hospital, and Adjunct Clinical Instructor (Pediatrics) at the University of North Carolina’s School of Medicine. Her area of research is human breast milk. In the mid 1970s, she helped establish the non-profit Piedmont Milk Bank, now known as the WakeMed Mothers’ Milk Bank and Lactation Center in Raleigh, North Carolina. She is a founding member of the Human Milk Banking Association of North America in 1985 (source http://en.wikipedia.org/wiki/Mary_Rose_Tully)

A Note sent from one of her good friends to announce her goodbye to our world

”Sorry to use our official email listserv for a non-business purpose, but I knew you would all want to know that Mary Tully died at 3:30 this morning (on her 42nd wedding anniversary). She asked that I pass it on to everyone that she would like us to celebrate her life with laughter and with music and not go around all sad-faced and crying. We want to carry on her work helping others in any ways that we can.

Two funds have been established for donations (in lieu of flowers). Go to her Caring Bridge website for the details and the plans for her memorial service at:  http://www.caringbridge.org/visit/maryrosetully

Mary Overfield
A few websites that state her bio:

Breast-Feeding for Over Six Months Aids Mental Health

Posted by NCTBA.org On January - 19 - 2010 ADD COMMENTS
"A good start can have effects years later"

"A good start can have effects years later"

Source- (Reuters Life!) January 19, 2010 —SYDNEY

Children who are breastfed for longer than six months could be at lower risk of mental health problems later in life, according to Australian research.

A study by the Telethon Institute for Child Health Research in Perth looked at 2,366 children born to women enrolled in a pregnancy study in the state of Western Australia.

Each of the children underwent a mental health assessment when they were aged 2, 5, 8, 10, and 14.

The researchers found that breast-feeding could help babies cope better with stress and may signal stronger mother-child bonding, which could provide lasting benefits.

“Breast-feeding for a longer duration appears to have significant benefits for the … mental health of the child into adolescence,” researcher Dr. Wendy Oddy, who led the study, wrote in the Journal of Pediatrics.

Of the children in the study, 11 percent were never breast-fed, 38 percent were breast-fed for less than six months, and just over half were breast-fed for six months or longer.

The mothers who breast-fed for less than six months were younger, less-educated, poorer, and more stressed, and were also more likely to be smokers than the mothers who breast-fed longer.

They were also more likely to suffer from postpartum depression and their babies more likely to have growth problems.

At each of the assessments, the researchers found children who were breast-fed for shorter periods of time had worse behavior, which could translate into aggression or depression.

But for each additional month a child was breast-fed, behavior improved.

The researchers said breast-feeding for six months or longer remained positively associated with the mental health and well-being of children and adolescents even after adjustments for social, economic, and psychological factors as well as early-life events.

“Interventions aimed at increasing breastfeeding duration could be of long-term benefit for child and adolescent mental health,” the researchers concluded.

18th Annual Lactation Consultant Comprehensive Update

Posted by NCTBA.org On January - 19 - 2010 ADD COMMENTS

 

Limited to 40 participants!

Monday – Friday, April 26 – April 30, 2010

Registration: 8:00am (daily)

Program: 8:30am – 5:00pm (Monday – Thursday)

8:30am – 4:00pm (Friday)

Location

The Andrews Center

3024 New Bern Avenue

Raleigh, NC 27610

Program Description

The Lactation Consultant Comprehensive Update is an in-depth overview of human lactation and breastfeeding management. It is designed to prepare experienced clinicians to provide optimal breastfeeding care to mothers and babies, as well as prepare those clinicians who may be sitting for the IBLCE Exam. During the five day program, there are lectures, group discussions, small group activities, slides, videos, and extensive written handouts that reflect the areas addressed by the International Board of Lactation Consultant Examiners Blueprint for Certification Examination. Each topic is related to clinical practice by experienced lactation consultants and other health care professionals with specialized expertise.

For more infomation see Brochure: http://www.wakeahec.org/coursecatalog/brochures/lccu10flyer.pdf

This was sent out  to California Coalitions after a set of wild fires to remind everyone of the information that has been established about breastfeeding in emergencies.

Safe Infant Feeding During Emergencies

WHO guiding principles for feeding infants and young children in emergencies.
http://whqlibdoc.who.int/hq/2004/9241546069.pdf

Emergency Nutrition Network
www.ennonline.net

UNICEF website on emergencies and nutrition
http://www.unicef.org/nutrition/index_emergencies.html

United States Breastfeeding Committee
www.usbreastfeeding.org

International Lactation Consultant Association
http://www.ilca.org/katrina/InfantFeeding-EmergPP.pdf

Center for Disease Control
www.bt.cdc.gov/disasters/foodwater.asp

La Leche League International
www.lalecheleague.org/emergency.html

Wellstart International
http://www.wellstart.org/Infant_feeding_emergency.pdf

SUPPORT FOR BREASTFEEDING IS CRUCIAL FOR INFANT HEALTH
IN THE AFTERMATH OF NATURAL DISASTER
S

Under normal conditions in developed countries like the US, infants who are not breastfed are much more susceptible to infections and other illnesses. As a result, they are 3 times as likely to require hospitalization and 21% more likely to die in the first year of life. The costs of these excess illnesses are considerable for families, insurers, and taxpayers.
In the aftermath of emergencies like hurricanes Katrina and Rita, helping mothers successfully initiate and continue breastfeeding is even more crucial. Children in vulnerable situations have special needs for the infection-fighting factors, the optimal nutrition, the reliable food source, and the comfort provided by breastfeeding. In contrast to powdered formula, which needs to be mixed with water, human milk provides ample hydration and spares infants exposure to water contaminated during the destruction caused by natural disasters. Direct breastfeeding also prevents the illnesses attributable to bottles and nipples “washed” in unclean water.
Most mothers in the US want to breastfeed, but many quit sooner than recommended, citing lack of sufficient societal support as one key reason. Women warrant extra support during crises like hurricanes and floods. Every effort should be made to rapidly reunite and keep infants with their mothers, provide space where they can feel comfortable nursing, and welcome moms to breastfeed whenever and wherever their babies show signs or hunger or distress.
Relief workers and health care providers should encourage mothers delivering during the crisis to breastfeed, help moms initiate breastfeeding immediately after birth, recommend exclusive breastfeeding for approximately 6 months, and assist mothers who recently stopped to restart breastfeeding (“relactate”). Myths such as “stress makes the milk dry up” and “malnourished mothers cannot breastfeed” must be dispelled with accurate information. Feeding the mother is the safest, most effective way to ensure adequate infant nutrition during emergencies.
For more information about safe infant feeding in natural disasters follow the links at www.bfmed.org. The Academy of Breastfeeding Medicine (ABM) is a worldwide organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation through education, research and advocacy.
——————————————————————————–

[i] American Academy of Pediatrics, Section on Breastfeeding. Breastfeeding and the Use of Human Milk
Pediatrics 115 (2) : 496-506.

Breastfeeding in Emergency Situations

Breastfeeding is particularly important in emergency situations because of the increased risk of diarrhea diseases and other infections, inadequacy and contamination of complementary foods, and the bonding, warmth and care provided by breastfeeding which is crucial to both mothers and children in emergency situations. The risks associated with bottle and formula feeding are dramatically increased due to poor hygiene, crowding and limited water and fuel. The role of breastfeeding is even more important in emergency situations where it may be the only sustainable element of food security for infants and young children. Exclusive and prolonged breastfeeding is often the only form of family planning available to women in emergency situations. Last but not least, women need validation of their own competence, BF is one of their important traditional roles that can be sustained during a stressful situation.

Misconceptions about breastfeeding in emergencies

  • Women under stress cannot breastfeed
  • Malnourished women don’t produce enough milk
  • Weaning cannot be reversed
  • General promotion of BF is enough
  • Human milk substitutes (infant formula and/or milk) are a necessary response to an emergency


Women under stress CAN successfully breastfeed

Milk release (letdown) is affected by stress. Milk production is NOT. Different hormones control these two processes. The treatment for poor milk release is increased suckling which increases the release of oxytocin, the letdown hormone. Research suggests that lactating women have a lower response to stress, so helping women to initiate or continue to BF may help them relieve stress.

Malnourished women DO produce enough milk

It is extremely important to distinguish between true cases of insufficient milk production (very rare) and perceptions. Milk production is relatively unaffected in quantity and quality except in extremely malnourished women (only 1% of women). When women are malnourished it is the mother who suffers, not the infant. The solution to helping malnourished women and infants is to feed the mother not the infant. The mother will be less harmed by pathogens and she obviously needs more food. By feeding her, you are helping both the mother and child and harming neither. Remember that giving supplements to infants can decrease milk production by decreasing suckling. The treatment for true milk insufficiency is increased suckling frequency and duration.

A mother who has weaned CAN redevelop her milk supply

With enough nipple stimulation and milk removal, it is possible for women to re-lactate, that is to redevelop a milk supply. The stimulation can be provided by a willing baby or even older child, by hand expression and stimulation and/or pumping. The process may take several days or even a couple of weeks. Mothers need much encouragement, a reasonable supply of food and water and protection from stress to the extent possible. Babies, of course, need to be fed in the least hazardest manner until the milk supply returns.

Breastfeeding women need SPECIFIC ASSISTANCE; general promotion of breastfeeding is not enough.

Lessons learned in development programs show that most health practitioners have little knowledge of breastfeeding and lactation management; these lessons apply equally to emergency programs. Women who suffer through violent situations leading to displacement and emergency situations are at increased risk of breastfeeding problems. Mothers need help, not just motivational messages. Relief agencies and field workers need training on how to counsel mothers to help them optimally breastfeed; how to assess proper positioning and suckling and remedy when needed and breastfeeding
physiology. In some situations, breastfeeding specialists may be useful. Maternal perception of risk of breastmilk insufficiency is an important factor in a women’s decision for early termination of breastfeeding. These perceptions may be intensified by the stress of emergency situations. Our first concerns should be ensuring optimal breastfeeding behaviors, which may require the selective feeding of lactating women and trauma counseling for women who may believe they “don’t have enough milk”. Policies and services which undermine optimal feeding such as giving food supplements to infants <6 months and using bottles for ORS delivery, should be avoided. Successful breastfeeding will contribute to the restoration or enhancement of woman’s self-esteem, critical to her ability to care for herself and her family.

Human milk substitutes (infant formula and/or milk) are NOT always needed

Providing infants and young children caught in an emergency situation with substitutes for human milk is extremely risky. It should be undertaken only after careful consideration and full awareness of the problems that may result. Good guidelines exist on the use of human milk substitutes and other milk products in emergencies: the 47th World Health Assembly Resolution WHA 47.5 (May 9, 1994); UNHCR guidelines on use of milk substitutes (July 25, 1989); the International Code of Marketing of Breast-milk Substitutes, WHO (1981). Common elements of these guidelines are that human milk substitutes must be:

    • limited to special circumstances as defined in WHA 47.5;
    • guaranteed for the lifetime of emergency;
    • not used as a sales inducement (therapeutic feeding, never in general distribution);
    • accompanied by additional health care, water, fuel, and diarrhea treatment;
    • include plans for the re-establishment of optimal feeding from the outset of the emergency.

These guidelines should be disseminated and followed by all agencies working in emergency situations.

Optimal Feeding Practices in Emergencies:

  • Initiation of breastfeeding within one hour of birth
  • Effective infant positioning (latch-on)
  • Frequent, on-demand feeding until 6 months of age
  • Exclusive, breastfeeding until 6 months of age
  • Continuation of breastfeeding after beginning the addition of appropriate weaning foods at 6 months of age
  • Sustained breastfeeding well into the second year of life or beyond
  • Increased breastfeeding frequency and continued feeding during illness.
  • Increased breastfeeding frequency after illness for catch up growth.

Originally prepared by Wellstart International’s Expanded Promotion of Breastfeeding Program (1996); revised and updated, 2004. For further assistance, consultation and/or training please contact Wellstart International at info@wellstart.org

Emergency situations are usually initially confusing and chaotic. Determining who needs what is an essential early step. For protecting and supporting breastfeeding the first step is to identify infants who are or should be breastfed and further noting any infants who are temporarily or permanently without their mother. Ultimately three groups can be established: one needing only breastfeeding support, a second requiring more intensive re-lactation help and a third in which substitute feeding is deemed necessary and will need to be very carefully managed and monitored. The triage diagram below may be helpful. It is from: Infant Feeding in Emergencies: Policy, Strategy & Practice. Report of the Ad Hoc Group on Feeding in Emergencies: May 1999 and has been made available by the Emergency Nutrition Network on their website: http://www.ennoline.net/ife/index.html

Feeding Infants Under Six Months in Emergencies: a Triage Approach to Decision-Making


Tens Of Thousands Of Pregnant Women At Risk

Posted by NCTBA.org On January - 17 - 2010 1 COMMENT

16 Jan 2010 21:03:27 GMT

Source: CARE International – UK

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author’s alone.


IconPort-au-Prince, Haiti (Jan. 16, 2010) – CARE warns that pregnant women, breastfeeding mothers and young children are at greatest risk after Tuesday’s devastating quake that devastated the capital city of Port-au-Prince left nearly three million people in need of assistance. There is an estimated 37,000 pregnant women among the affected population in urgent need of safe drinking water, food and medical care. Half of Haiti’s population is younger than 18 years old.

Hospitals and medical centres have been destroyed, and remaining centres are overwhelmed treating people injured from the quake. With limited or no access to health facilities, pregnant women are at an even greater risk of complications and death related to pregnancy and childbirth. Haiti already has the highest rate of maternal death in the region: 670 deaths per 100,000 live births.

“There are a lot of pregnant women in the streets, and mothers breastfeeding new babies,” said Sophie, Perez, Country Director for CARE in Haiti. “There are also women giving birth in the street, directly in the street. The situation is very critical. Women try to reach the nearest hospital, but as most of the hospitals are full, it’s very difficult for them to receive the appropriate care. Mothers and their babies could die from complications without medical care.”

In general, approximately 15% of all pregnant women will experience a complication requiring medical interventions. This is even worse in a disaster situation. The majority of maternal deaths result from hemorrhage, infection, miscarriage, prolonged/obstructed labour and hypertensive disorders, many of which could be avoided with medical care.

CARE, which focuses on empowering women and girls as part of our global fight against poverty, has partnered with the United Nations Development Fund for Women (UNIFEM) in Haiti to help meet the urgent needs of pregnant and lactating women after the earthquake. CARE has extensive ongoing health programs in Haiti, and will work with the local government to rebuild their health capacity.

To help meet the specific needs of pregnant women, new mothers and children, CARE is focusing on the following as part of its immediate emergency response:

-distribution of water purification tablets to provide clean water, particularly for pregnant women and children who are particularly susceptible to water-borne illness such as diarrhea;
-distribution of emergency food rations;
-distribution of infant kits for mothers with newborns and young babies;
-distribution of hygiene kits that include basic hygiene items such as soap and toothpaste, but also sanitary napkins and panties for women.

After disasters, CARE normally also provides safe delivery kits for women and health centers to facilitate safer, cleaner deliveries. We are working together with partners to determine how to procure these items as quickly as possible.

“It is also particularly crucial that new mothers continue breastfeeding, which provides the safest nutrition to their babies,” said Perez. “There is an urgent need for clean drinking water and additional nutritious food so new mothers do not become sick, dehydrated or malnourished, which may prevent them from breastfeeding.”

CARE’s immediate response is focused on delivering food, clean water, emergency supplies and temporary shelter, and helping the local government rebuild the health-care system. Today, CARE is distributing an eight-day supply of water purification tablets at three health centers for 12,000 people. CARE has launched a US$10 million appeal for a three-year emergency relief and recovery program for the affected population.

For more information or to arrange interviews with staff in Haiti:

Melanie Brooks (in Geneva): +41 79 590 30 47, brooks@careinternational.org
Brian Feagans (in Atlanta): +1 404-457-4644, bfeagans@care.org
Stephanie Libby (in Atlanta): +1 404-979-9182, slibby@care.org

About CARE: Founded in 1945, CARE is one of the world’s largest humanitarian aid agencies. In nearly 70 countries, CARE works with the poorest communities to improve basic health and education, enhance rural livelihoods and food security, increase access to clean water and sanitation, expand economic opportunity, and provide lifesaving assistance after disasters. CARE has been working in Haiti since 1954, providing projects in HIV/AIDS, reproductive health, maternal and child health, education, food security, and water and sanitation.

CARE International UK is a member of the Disasters Emergency Committee (DEC), which has launched an appeal for money to support the relief work in Haiti. To make a donation to the DEC Haiti appeal visit www.dec.org.uk or call 0370 60 60 900, donate over the counter at any post office or high street bank, or send a cheque made payable to ‘DEC Haiti Earthquake Appeal’ to ‘PO Box 999, London, EC3A 3AA’.

[ Any views expressed in this article are those of the writer and not of Reuters. ]

January 13, 2010
FOR IMMEDIATE RELEASE

Exclusive Breast Milk Feeding Core Measure:
USBC publishes guidance for hospitals

Washington, DC–The United States Breastfeeding Committee (USBC) has published guidelines to aid hospitals and maternity facilities in accurate collection of the data needed to comply with The Joint Commission’s new core measure on exclusive breast milk feeding.

Download PDF document

After March 31, 2010, The Joint Commission’s Pregnancy and Related Conditions core measure set will be retired and replaced with the new Perinatal Care core measure set. The new Perinatal Care core measure set is available for selection for hospitals beginning with April 1, 2010 discharges.

The Perinatal Care core measure set comprises the following measures:

  • Elective delivery
  • Cesarean section
  • Antenatal steroids
  • Health care-associated bloodstream infections in newborns
  • Exclusive breast milk feeding

USBC’s guidelines offer suggestions on how to accurately collect data on exclusive breast milk feeding, with samples from hospitals that already collect this data. USBC encourages sharing of the document and hopes that widespread use will enable hospitals to accurately and easily collect the required data, and to ultimately improve quality of care related to infant feeding.

The document is provided at no charge and may be freely duplicated and distributed.

United States Breastfeeding Committee (USBC)
The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of 41 nationally influential professional, educational, and governmental organizations. Representing over half a million concerned professionals and the families they serve, USBC and its member organizations share a common mission to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding. For more information about USBC, visit www.usbreastfeeding.org.

United States Breastfeeding Committee
2025 M Street, NW, Suite 800
Washington, DC 20036
Phone: 202/367-1132
Fax: 202/367-2132
E-mail: office@usbreastfeeding.org
Web: www.usbreastfeeding.org

  Most Recent 3 Articles
Strange Breastfeeding News
CALIFORNIA WIC SPEAKER IN CONGRESS
Adolescents' Perceptions of Inpatient Postpartum Nursing Care
-  Original Theme Modified and Site Maintained by InternetFD  -
18494
Designed by website templates