Destination: Heartbreak Hurricane Katrina-part 6

In 2004, Volusia County Florida was hit with back to back hurricanes. Charlie hit first and was a surprise visit. I had lived in this area for 26 years and it was the first time I had had to make the decision to get everyone out of bed and sleeping in the hallway. Morning came and with it, I found my neighborhood in complete disarray. Debris everywhere, roads impassable in places and to my complete shock no stores open, no gas stations open. No power. Neighbors were outside talking to each other--that was a shock because in suburbia-land no one talks to your neighbor. Who has time for such pleasantries? With no power, no air conditioning, no refrigerators, no phones, no TV, no jobs; we had all of the outdoors and plenty of time to get to know our neighbors. How were we suppose to know what the heck was going on? I told my youngest that we were camping in the house--we camped for 9 days. It became word of mouth communication--there would be a truck at the Winn Dixie giving out free water. There was a gas station open and we would all line up. It was a challenge--it gets mighty hot in the south without air conditioning or fans. I was lucky, my house withstood the winds and we had little rain so no flooding. Money became very tight but I didn't lose my job. I can't imagine the horror of Hurricane Katrina. Our County suffered from the hurricanes. Some houses didn't get repaired for over a year and some not at all. People lost jobs. We all lost alot of sleep and alot of money. But in comparison to Katrina, it was just the false labor of a difficult pregnancy.

For many people in the US, there is little understanding of the need to regulate and carefully control infant formula in times of emergencies. Why regulate it or control it? Without electricity and without access to clean water, infant formula, particularly powdered infant formula increases the risk of diarrheal diseases in babies with an increased risk of fatalities. Infant formula preparation in times of emergencies is enormously difficult to make safely. Mothers with newborn and young babies should be encouraged to breastfeed, especially exclusively breastfeed. But if these products are given out without discussion and understanding of the realities of disasters, then many more women will use these free products. What happens to these mothers and babies, when donations stop but the need is just as great for these free products? After the worst is over, money is often scarce (even for those of us who are prepared). Social services can be overwhelmed. So how does a mother feed her baby, when the free stuff stops (even on WIC, mothers will still have to buy some infant formula out of pocket).

Out of curiosity I scanned many, many articles on the internet trying to get an idea of how much infant formula was airlifted and trucked into shelters after Hurricane Katrina. Alot...alot and most of it distributed like bottled water. Nestle writes, "Although it is not our normal policy to donate infant formula, Nestle USA has donated a supply of ready-to-feed infant formula and Nestle promotional partner Munchkins Inc is donating baby bottles..." Nestle at least understood the necessity of "ready-to-feed" infant formula. Although not the danger of bottles--WHO organizations recommends cups because bottles are difficult to clean. One of our local WIC nutritionists use to always say to new WIC moms, "if you want ready-to-feed, breastfeed!!" (WIC does not normally provide ready-to-feed formulas). I ran across pictures from an organization called Compassionate Alliance in which they were trucking what appears to be powdered infant formula (along with food and water). Many churches, universities, and charities appealed for infant formula. How much went to shelters? Unknown. Mentioned were pallets of Ross ready to feed, Mead Johnson ready to feed. PBM Products (Bright Beginnings formulas and members mark brand formulas available in WalMart, Target, Publix, etc) contributed infant formula to Second Harvest (the largest domestic hunger-relief organization in USA). All ready-to feed because of the understanding of the limited availabilty of clean water. It was warehoused in Shreveport, Louisiana. March of Dimes mentions a collaboration with Mead Johnson in distributing ready to feed infant formula. Mead Johnson mentioned it shipped infant formula totaling more than $500,000 in value, 2 million bottles or cans of infant formula. GMA (Grocery Manufacturers of America) donated $10 million products including infant formula. PhRMA donated millions of cans of infant formula. Abbott donated 4.5 million in nutrition, medical and pharmaceutical products. Novartis donated $10.5 million in pharma and over the counter products including infant and baby and nutritional products. I even ran across an article that stated that Israel sent infant formula. The USDA sent a tractor trailor full of infant formula. It is difficult to get a good idea of how much infant formula was sent. How many babies needed the infant formula? How many actually got what they needed? How many new mothers or mothers with young babies might have breastfed their infants, if counseled about the risks of infant formula during emergencies? We are seeing rising rates of infant mortality in Louisiana. Those mortality rates are equivalent to or worse than some developing nations. But our nation still has the faith in infant formula. We will ship it and send it everywhere without regulation, given freely in times of disaster. Never seeming to recognize the disaster that follows, the morbidity and mortality of infants fed artificial milks. The free sample, the free product during a disaster serves a purpose in a market economy. Its a hook.....we are grateful to the companies that so kindly provide us with something for free. How kind of them. Of course we don't think about the tax write-off, nor how many people get hooked into having that free product. Like the free cigarettes given out to servicemen years ago, we aren't seeing the connections. We don't see the connections until it is too late. And some never see the connection because they can't picture reality without cigarettes.... or without infant formula.

Copyright 2008 Valerie W. McClain

Destination: Heartbreak Hurricane Katrina-part 5

"You can't make me breastfeed!!!" The woman stood in the doorway of the WIC office shouting the words with defiance and anger. She had just walked in the doorway. We were stunned by her anger. I had never seen this woman before in my life and I wondered how she thought that we could make her breastfeed? How do you make women breastfeed? I certainly would like to see all women breastfeed their babies but making someone do it is beyond my belief system.

Yet, there are people in our society who believe that women should be made to breastfeed their babies. When I had a private practice as a lactation consultant, I had a client who upon hearing that I had one time been employed with WIC, said, "those people should be made to breastfeed." Of course, she wasn't actually breastfeeding. She was pumping and feeding her baby bottles of her milk. She felt she had to give her infant her breastmilk because her physician husband felt that his children deserved the best. But she didn't want to actually, physically put her baby to her breast. But she felt that those people who ask for help from the government should be made to breastfeed. I got the impression that she viewed breastfeeding at the breast as a punishment. And that punishment was suitable for "those" people who asked the government for help. All very astounding to me. I find it hard to view breastfeeding as punishment. I hope that all women and men are educated on the risks of artificial feeding. If after learning those risks, parents continue to make a choice for infant formula, so be it. I believe it is our society's duty to set that education in motion. Instead we have beaten around the bush because people are afraid. Afraid that their jobs are on the line, if they speak the truth. So instead the real issues are skirted, avoided. Melamine in formula in the US. Let's blow it under the table for another time, when it is safer to talk about it. Babies in NICUs dying from e. sakazakki from powdered formulas. Rare happenings? Not so, according to some lawyers looking for business. The rumblings about the safety of infant formula are kept under wraps by an industry that has its tentacles wrapped around many a human milk researcher. It also has its tentacles wrapped around various governmental agencies. How many tons of infant formula were sent to Louisiana by the USDA in the aftermath of Hurricane Katrina? And how many women in the time after the intitial impact of the hurricane, had such easy and free access to infant formula? But heck they were already trapped by their choice.

The choice of using an artificial milk for her infant, destroyed Tifanny Woods and Emmanuel Scott's family. Society scapegoats the victims, and goes on playing the game that breastfeeding is just a "lifestyle choice," without speaking one word about the risks of infant formula.

Copyright 2008 Valerie W. McClain

Destination: Heartbreak Hurricane Katrina-part 4

According to the Justice Policy Institute, "Louisiana has the highest per capita incarceration rate in the country with 814 per 100,000 people. Women are the fastest growing segment of the Louisiana prison population." Both Tiffany Woods and Emmanuel Scott got life terms in prison without parole. Emmanuel was sent to Angola Prison ("The Farm"). Angola was originally a plantation encompassing 18,000 acres that was farmed by slaves prior to the Civil War. It was turned into a prison and developed a reputation for being one of the most violent prisons in the US. Recent troubling events show that some prisoners have been given solitary confinement for over 30 years (Angola 3). Prisoners still work the farm like the former slaves-harvesting cotton, soy, etc.

About a month ago I contacted Tiffany Woods' and Emmanuel Scott's lawyer, Edward Mouton. He spoke about how this case bothered him. In a later email to me, he repeated his concern, "This case still causes me to lose sleep and feel great distress." He had just seen Emmanuel at Angola Prison, "Emmanuel will have only that surreal place to live out his life."

I found that the more questions I asked, the more questions I had regarding this situation. Tiffany had older children besides baby Emmanuel. It took 10 months after the baby's death, before they were charged in his death. They were not charged as being abusive to the older children.

What did the autopsy show? A malnourished baby. But sick infants become malnourished because of their illnesss. Tiffany said the baby was sick. Was there no signs of infection? We do know that cow's milk as well as infant formula can dehydrate an infant rapidly because of their high solute load. It is one of the risks of artificial baby milks that is not discussed often enough with mothers and fathers. Breastfeeding does not carry the same risk. Were these parents made aware of the risks of artificial baby milks? (Tiffany at one time was on WIC--WIC is suppose to promote breastfeeding)

What are the risks of infant formula? Parents need to know that infant formula or any substitute for breastfeeding/human milk carries an increased risk of disease and death. For instance, "Formula-fed infants in the US have a 10-fold risk of being hospitalized for any bacterial infectiona and a four-fold risk of bactermeia and meningitis. " In developed nations "formula-fed infants have a three to four-fold risk of diarrheal illness."

Walker, M. "A fresh Look at the Risks of Artificial Infant feeding," JHL 9(2):97-107 (1993)

According to the Humanitarian Exchange Magazine on infant feeding in emergencies in Lebanon.

"In terms of child survival breastfeeding is crucial: 13% of all under-5 deaths could be prevented if all infants were breastfed--more than any other preventative intervention."

"Moreover, during an emergency people may not be able obtain enough formula to feed their baby adequately because they are cut off from markets or because of cost."

http://www.odihpn.org/report.asp?id=2873

In a document by the Department of Health of Louisiana dated December 9, 2005 regarding Hurricane Katrina and the challenge to health care, "The capacity for serving low-income and uninsured populations has been destroyed or significantly reduced in the affected areas....The Department is working diligently to establish primary care services for those who no longer have access to their normal medical facilities."

http://www.dhh.louisiana.gov/offices/page.asp?ID=156&Detail

The Department of Health states that their capacity to serve the poor was destroyed or significantly reduced. Did Tiffany Woods and Emmanuel Scott refuse to access health care services for their infant as evacuees of New Orleans? Or was the health care services of Shreveport so overwhelmed (5000-30,000 evacuees from New Orleans housed in Shreveport) that this couple was one of the people that fell through the cracks? Two people are in prison for the rest of their lives. Justice? What lessons has a society learned? In an article in the New York Times by Eduardo Porter called "Katrina Begets a Baby Boom by Immigrants dated December 11, 2006, "...hundreds of babies are being born to Latino immigrant workers, both legal and illegal, who flocked to the city to toil on its reconstruction." The article is about women needing jobs, being pregnant, bottlefeeding their babies because they expect to go back to work right away.

And so onward we travel....destination heartbreak....when will we learn?

Copyright 2008 Valerie W. McClain

Destination: Heartbreak Hurricane Katrina-part 3

photo by Jessie McClain

Louisiana justice system gave Tiffany Woods and Emmanuel Scott life imprison with no chance for parole. Ignorance of infant feeding and not accessing the medical system is no excuse in Louisiana. Although one might call this a "catch-22" system. Most Americans are ignorant of the dangers of feeding infant formula or other artificial milks to babies. But that is no excuse in a court of law--despite the fact that almost everyone else is as ignorant. Recently, I was talking to a mother who had her babies in the 70's. She told me that her one baby could not tolerate the infant formula, so she went to 2% cow's milk. Her baby survived and is an adult with her own children. It was her pediatrician's recommendation that she switch. But this was back in the 70's and we were ignorant then (even the pediatricians). This mother told me that this child she had in the 70's, as an adult has had severe allergic reactions to food--passing out and being hospitalized. No connection was made between how this baby of the 70's was fed and her allergic reactions as an adult. I have seen over the years a variety of interesting substances in baby bottles-coca cola, etc. So there is alot of ignorant people out in the world, who could potentially be judged to be abusive to their infants.

Tiffany Woods' baby, Emmanuel, was 3 pounds at birth. In the WIC Program, he would have been categorized as very low birth weight (VLBW) and considered at high risk for nutritional deficiency. According to the WIC manual on counseling protocol for premature/low birth weight babies, he would have been at "increased risk for 'failure-to-thrive' (FTT)" He would have been at increased risk for aversive feeding behaviors-disorganized or dysfunctional suck. Tiffany had an infant that was at high risk for failure-to-thrive. Was she able to access a health care system that had been swamped with evacuees? Did she refuse to get help or were any attempts made at accessing the health care system so difficult that she gave up?

I recently read a myspace blog dated 7/18/08 by a woman from Shreveport, Louisiana entitled, "Idiots with the WIC program." She talks about a woman who went to WIC (newborn baby, mother not working, father recently fired from job) to get assistance in obtaining formula. According to this blogger, the mother was told that she would have to wait 2 months until she could get assistance. So what will this mother do? Feed the infant cow's milk? Waterdown what formula she could buy? And if she does this and her infant dies, will she and the father be sent to prison? Who takes the responsibility for infant feeding tragedies? Should parents be responsible for their ignorance? Might one believe that in a just society, it is the community's responsibility? It would seem that the healthcare system in Shreveport is broken because of a storm named Katrina. How does a city's healthcare system survive the influx of thousands of people in need? How would any city cope with this problem?

Who should be made legally responsible for the rising infant mortality in the South? The court system of Shreveport has determined that individuals are responsible.

Copyright 2008 Valerie W. McClain

Destination: Heartbreak Hurricane Katrina-part 2

The Maternal Child Health Journal in 2007 had an article called,"Health Concerns of Women and Infants in Times of Natural Disasters: Lessons Learned from Hurricane Katrina."

http://www.medscape.com/viewarticle/557388

"Natural disasters such as Hurricane Katrina can result in a substantial disruption of the public health and clinical infrastructures that are necessary for prenatal, intrapartum, and postpartum care. Women remaining in the affected area may need to find a new local source of care, and displaced women will need to find a provider in their new location. Access to existing prenatal care records may be limited, and referral of these women to new providers needs to occur quickly..."

In a letter written by the American Academy of Pediatrics, Louisiana Chapter to The Advocate in October 10, 2007, they say, ""However there are still pediatricians who refuse to accept Medicaid patients because of the less than adequate reimbursement and the fear that more cuts will be made. When the state had budget problems, Medicaid is a big target that is totally unprotected."

A recent news article from the Bradenton Herald in Florida (December3, 2008) entitled, "Baby almost dies from watered-down formula," states, "She [the mother or the baby that nearly died] said she was trying to stretch the allotment of baby formula cans she receives each month from the federal WIC program for low-income families......'WIC only gave me 8-10 cans a month, he goes through 15 cans...'" Baby LaDamian, 5 months old, survived and was expected to be released from the hospital in Tampa.

Tiffany Woods and Emmanuel Scott of Shreveport, unlike this recent Florida family, faced far more tragic consequences regarding their infant, Emmanuel. Tiffany and Emmanuel were from New Orleans, escaping Hurricane Katrina by evacuating to Shreveport. Their son had just been released from the hospital having been premature and only weighing 3 pounds at birth.

Tiffany, according to news articles, found him difficult to feed. [Many premature infants have feeding difficulties and are at risk for failure-to-thrive.] She stated in court testimony, according to one news article that she had run out of WIC and couldn't afford formula. She fed her son cow's milk instead of formula. At 5 months old in November of 2005, baby Emmanuel died. The cause according to a coroner's report was malnutrition and starvation. According to one news article, Tiffany said he was sick. Tiffany and Emmanuel were arrested and charged with the baby's death in September of 2006. In August of 2008, a judge found them guilty in the death of their son. (they declined a jury trial). They were sentenced in September of this year to life in prison for 2nd degree murder.

Supposedly during closing arguments, the Prosecutor said, "This baby didn't die in a hut in another nation, it died in a house in Shreveport, with a refrigerator that was full of beer and food." The couple was tried in a Caddo Parish courtroom in Shreveport, Louisiana. Caddo Parish has a documented black infant mortality rate of 32.7--similiar to some African nations.

The paradox of our land of plenty is that we spend more per capita on healthcare than any other nation in the world but our black infant mortality rate is closer to some developing nations.

The judge in this case did not believe Tiffany's testimony and found the autopsy picture shocking (all failure-to-thrive babies are shocking to look at). I find it disturbing that the autopsy pictures of baby Emmanuel can still be viewed on the internet.

I read many of the internet comments to this news event and was floored by the almost universal condemnation of this couple. I am not sure how we ever get to the truth of any given situation. Was Tiffany not telling the truth to the judge? Was the judge aware of the issues regarding evacuees (it has been estimated that over 5000 evacuees sheltered in Shreveport). How did the clinics in Shreveport, Medicaid and WIC, handle this massive influx of people? How overwhelmed were the families by the stress of evacuation and the lines and waiting? Would they have felt that there is no help, even when you ask for help? Why in Florida do we quickly believe that the white mother who nearly killed her baby by watering down the formula was just ignorant? But a black mother must have been negligent/murderous to give her infant cow's milk? How easy or difficult would it have been to see a pediatrician in Shreveport, if you were an evacuee without money, credit, or any paperwork? Wouldn't some people fall through the cracks? Questions and more questions.

Copyright 2008 Valerie W. McClain

Destination: Heartbreak Hurricane Katrina, part 1

photo by Mariah McClain

How to begin a tale of trial and tribulation? Where does it start and when will it end? What do we believe to be true and how much of what we know is shrouded by the purveyor of reality, Tellyvision. Hurricane Katrina hit New Orleans in August 2005 and the tidalwave of this storm is still flooding communities near and far from its initial impact. Louisiana is one of the poorest states in the USA. Prior to Hurricane Katrina there was a high level of infant mortality, many social services were struggling for survival in the face of the needs of its community. But in New Orleans, despite the poverty, there was always a sense of community. A history of roots connecting a people to the land, to the delta, to each other. Hurricane Katrina destroyed not only homes and businesses but it scattered people hither and yon. Severing ties of generations. Families split apart and made to navigate their lives in unknown seas. Life became a waiting game: waiting for news, waiting for the bathroom, waiting for showers, waiting for food & water, waiting for jobs, waiting for doctors, waiting for medications....waiting, waiting, waiting. Shelter, what is that when it is not your home or your belongings? In a room full of strangers, some helping, some not and the clock ticking slowly, slowly. Safety? Safe from the floods, the winds, and the rain but safety is not just about shelter from mighty storms. Safety resides in governments understanding the needs of its people during times of emergencies. But most important, it is the preparation before the disasters that help a people cope with such an enormous life challenge.

Infant feeding in emergencies requires a great degree of understanding of the risks of artificial milks. Most Americans believe that infant formula is just as good as breastfeeding. They believe breastfeeding is probably better for the baby but it doesn't really matter how a baby is fed. Thus, in an emergency, the first thought is how to get infant formula into the area. Yes, babies must be fed. And a mother who is exclusively formula feeding her infant and goes through such a disaster will need access to infant formula. But she will also need access to clean water, refrigeration for storing the artificial milk, a stove to sterilize bottles and nipples. This mother will also need to be aware of how easily an infant can dehydrate when on artificial milks. Thus her need for quick and easy access to medical help is important. The heat and humidity in the South without air conditioning is hard to bear. Infants and the elderly maybe at greater risk for heat related problems. So keeping an infant hydrated in the midst of such a disaster is vital. Breastfeeding boosts the immune system of the baby, a natural vaccination against pathogens in the environment. Artificial milks do not do this. An infant fed artificial milk is at higher risk for diseases than a breastfed infant, particularly an exclusively breastfed infant. Therefore, the safety of bottlefed infants creates a bigger economic burden on the community, on the government. It seems that our institutions are willing to take on that economic burden without question. Safety of the next generation is a priority in any society. There is talk about preventative medicine--eating nutritious foods, exercise, fresh air, etc. Certainly breastfeeding is preventative medicine. The parents and the community save in a variety of ways-medically, environmentally. Dollars that would be spent on artificial milks can be spent on other items. Yet our communities, our institutions, our government are willing to pay the price of artificial feeding. But are parents really understanding of the price they can pay by feeding their babies artificial baby milks? It is parents who will have to bear the burden of a community unwilling or unable to educate its citizens about the risks of infant formula.

Is there a connection between artificial baby milks and infant mortality? There are studies that show a correlation between the two. In 2005, after Hurricane Katrina, the UN published a report on global inequality. Specifically mentioned was the "growing racial and economic divide in the USA." "America's black children are twice as likely as whites to die before their first birthday."

In a US & World report in June 2, 2007, they state that in the heart of the Mississippis Delta the black infant mortality rate is 17 per thousand. It was mentioned that there is a belief that this rise of black infant mortality rates in Mississippi is related to Hurricane Katrina. In Caddo Parish, (Shreveport)Louisiana the black infant mortality rate is 32.7. While much of infant mortality is caused by prematurity, low birth weight, SIDS, and birth defects. Consideration should be made regarding the lack of breastfeeding among the young, poor, and black women in the South.

In a policy statement by UNICEF called "INFANT AND YOUNG CHILD FEEDING IN EMERGENCIES" they state, "Even in the best, most hygienic conditions, artificially-fed babies are five times more likely to suffer diarrheal diseases,..in emergency situations artificially fed infants are more than 20 times more likely to die from diarrhea and other infectious diseases than infants who are exclusively breastfed." in regard to Indian Ocean Crisis--

Some might say that UNICEF was directing this at developing nations not the USA. But looking at the rising black infant mortality rates in the South, particularly in areas with large numbers of Katrina evacuees, one might say that it is time for our communities to rethink infant feeding practices in the USA.

Copyright 2008 Valerie W. McClain

Melamine in US formulas

photo by Jessie McClain

Melamine has been found in US formulas.

http://tinyurl.com/5vo9rr

Not too surprising. US infant formula contains Milk Protein Concentrates (MPCs) which include: whey, caseinates, hydrolyzed caseinates, hydrolyzed whey, and milk proteins. MPCs are almost all imported from other countries. Most of it from New Zealand. I wrote the FDA, wondering why they weren't testing it, when the contamination in China was first announced. I never got a response from anyone at the FDA. While the theory seems to be that there was deliberate contamination of the milk by Chinese farmers, I think the contamination may also be the result of ultrafiltration of these MPCs. Some filters used by the dairy industry are made from melamine. It would seem possible that these filters could get worn out with long term use or by chemical cleaning. Even if according to the FDA the levels of melamine in US infant formulas are extremely low, why is contamination continuing to happen? And why is it that now that we are faced with actual contamination, the FDA has changed its tune of no contamination would be tolerated in US formulas to low levels are acceptable? We are now suppose to believe that these low levels do not cause problems. What about high risk infants--premature infants? What is in a can of infant formula? Do parents know the risks? Seems like even the FDA hasn't a clue about the safety of infant formula

Copyright 2008 Valerie W. McClain

ownership of human milk stem cells

photo by Jessie McClain

While the breastfeeding community mulls over the patent application of a human milk fortifier by Medela, they might also be interested in another patent application. (Although it is not assigned to any company) This patent application is called "Method for isolating cells from mammary secretion." Inventors are Mark Derek Cregan and Peter Edwin Hartmann (filed in December 2004, published March 2007) application #20070059822

When I first glanced upon this document I thought that it was a basic "methods" patent and of course the title is called "Method for...." But curiosity encouraged me to look at the claims in this patent application. Smack dab in the middle of the claims (claim # 18) is the following, "Progenitor cells, preferentially pluripotent or multipotent progenitor cells, derived using a method according to any of the preceding claims 1 through 17." Thus, it would appear to me that one of their claims is to certain stem cells in human milk. Of course I am not a lawyer but it would make sense in this biotechnological/patent world that a claim would be placed on stem cells in human milk.

I am amazed that so few people question the right of claim and monopolization of components of human milk. I guess I shouldn't be surprised. No white person really questioned the claims of ownership of land made in the New World (royal patents of claim). The American Indians who lived on that land, saw, felt, and endured the unfairness of the ownership. How could land be owned? The concept was alien to native Americans. But now we have entered a new frontier and we have been conditioned to accept that corporations can own and monopolize cells in our body. During the 1700 and 1800's, the Indians were told by the White Man/the government that they really didn't need all that land. The Indians were forced from the their lands, often without payment. Thus their ability to live freely was restrained and their lives forever changed. Who owned the land? If you were a native American, no one owned the land. If you were white, you owned and fenced it and kept out everyone else. It is individualism versus a communal view of life. It is view that nature must be conquered, owned, and fought for versus the belief that we are the guardians of nature that is free for all. How little the White Man Culture changes. Instead of land to fight over, we now have the new molecular frontier. We can own your cells because we need it. You don't need it. We will take it from you (or you will be talked into giving it to us) and we will mine it/process it, alter it, and then sell it back to you. Everything has a price. Ethics? Just a game we play with dice because to think too deeply in this corporate culture would be to go mad indeed.

Copyright 2008 Valerie W. McClain

Human milk fortifiers: confusion is the game

photo by Jessie McClain

Human milk fortifiers are used in NICUs to "fortify" human milk given to premature infants. There is a belief that human milk does not have enough protein, calcium, etc for the premature infant. The evidence is based on research funded mostly by the infant formula industry. This premise is the reason that NICU's fortify a mother's pumped breastmilk. Up until recently all human milk fortifiers were made by the infant formula industry. Thus the fortification has foreign proteins (cow's milk proteins). Prolacta Bioscience now is producing and selling a human milk fortifier that is based on human milk (donor milk). Prolacta Bioscience is the first for-profit donor milk bank. They funded a clinical trial of "Prolact-Plus Human Milk Fortifier" from August 2006 until August 2007. The location of those trials was Shands Children's Hospital-Florida, Miami Children's Hospital-Florida, Joe DiMaggio Children's Hospital-Florida, and Memorial Hospital of South Bend-Indiana. The study director was Martin L. Lee of Prolacta. The study results have been published in Breastfeeding Medicine by researcher Dr. Gary Chan. The study evaluated "the short-term effect of Prolacta-Plus fortified human milk when compared with bovine-based fortification of human milk."

http://clinicaltrials.gov/ct2/show/NCT00486590

There is already confusion among IBCLCs because there has been an assumption that all human milk fortifiers are bovine in origin (made by the infant formula industry). But now we have a human milk fortifier that is based on donor human milk, but is also called a human milk fortifier.

Do parents understand what their infants are receiving? Or are they under the same impression as many IBCLCs that this is just another "formula" product? The confusion is rather advantageous to both Prolacta and the infant formula industry. But it leaves many of us in the dark about the reality of such fortification.

Copyright 2008 Valerie W. McClain

Human milk in a bottle

photo by Jessie McClain

What was the intent of the WHO Code? Protection of breastfeeding. Is breastfeeding equivalent to humanmilk feeding? Technically and emotionally it is not equivalent. Nor does the Code on Marketing of breastmilk substitutes state or imply that humanmilk feeding requires protection. Yet, we seem to have set up a system in which we are protecting humanmilk feeding which is quickly supplanting breastfeeding. There are a number of documents written by UNICEF that state that the PRIORITY is BREASTFEEDING. If that is not feasible, then the mother's pumped milk should be "substituted" for breastfeeding. If that is not possible, then donor milk is to be used. Infant formula's use is the last resort when breastfeeding fails. This is not options of equivalency. The priority is breastfeeding and the protection is breastfeeding not humanmilk feeding.

What is different about the process of feeding a baby at the breast versus feeding pumped humanmilk to a baby? Putting a baby to the breast is a very different experience from putting your breast into a tunnel of plastic. Humanmilk feeding means that one has to find the time to be away from the baby to pump. Thus, to pump invites a degree of separation both mentally and physically between a mother and her baby. (separation may have already happened as for example the birth of a premature infant). Time to pump, means time not with the baby. The mother pulls out a machine. The cold air hits her skin as she puts the plastic funnels on her breast. Her milk pools in the plastic bottle faster and faster, little clumps of milk fat splattered on the sides of the bottle. Cap it, refrigerate it, freeze it, and feed it to baby at a later date. Not fresh for baby today. The mother is pressed for time...hurry, hurry...get it done...so much to do. The mechanical breathe of the machine eventually stops. She looks at the picture of her baby by her pump, and feels the saddness of separation.

Breastfeeding is different. A mother sees, feels, or hears her baby's discomfort. She offers her breast to ease the discomfort the baby feels. She feels her baby's soft skin, she smells her baby, she takes in the presence of her infant. Mom talks to her little one and the baby hums back between gulping the milk. The infant also feels, hears, smells, and sees the mother. A knowing passes between them, a reconnection-a rebirth. They are connected, they are in love with each other. They are one but not one. Many times a day, this process of knowing occurs. Human love and trust are cemented in the repetitive bonds of breastfeeding. Humanmilk feeding can not mimic the touch, the smell, the intimacy of breastfeeding.

This does not negate the dedication, the devotion and love that mothers who pump and store their milk have for their infants. There is so little support in our society for breastfeeding or humanmilk feeding. The question that we should ask ourselves is why do women nowadays feel that they have to have a breastpump. What wonderful marketing was used to create that belief?

Copyright 2008 Valerie W. McClain

Breastpumps, a risk factor for breastfeeding failure

photo by Jessie McClain

Are breastpumps a risk factor for breastfeeding failure? What is the cause of so many women initiating breastfeeding but then quitting within a short period of time? There are certainly multiple causes in our society for breastfeeding failure. We are a society enthralled by our gadgets, our things. Our social lives seem to be based on our monetary standing in the community. Our knowledge is based on what certain powerful and monied groups want us to know. We are dependent on the media for our knowledge and the media is owned by powerful interest groups. So women believe what they have been "educated" to believe. If you are going to have a baby, you either need that product called a breastpump, or that other product called infant formula. Life is about products. If you are wealthy, you get the expensive pump. If you are poor, you buy what you can afford or use a second-hand pump. You take the two-hour breastfeeding class (maybe, if you have time), and often those classes show you the wonderful array of breastfeeding equipment you can buy or rent. The pregnant mind becomes fixated on the belief that gadgets will solve any breastfeeding problem. Sore nipples? Get a pump. Engorgement? Get a pump. Need time away from baby? Get a pump. However did those women breastfeed in those olden days when pumps didn't exist? So every pregnant woman intent on breastfeeding gets a pump--good pumps and bad pumps. And the sad fact is that women don't understand that there are risks. What are the risks? Some women get a poorly working breastpump and believe that the reason they aren't getting any milk or a specific amount is because something is wrong with their body. How could this wonderful technology be the reason for little or no milk? I once did a home visit in which the $20 battery operated pump (yes this was about 10 years ago) the mom was given had no suction. The mother was basicly hand expressing into the pump to get any milk. She thought she was doing something wrong--nope. She was doing something very right--hand expression. It was the device that was defective, not her. But had she not called for help, would she have continued pumping? Would she have quickly given up on breastfeeding believing her body was defective? Technology/gadgetry without good consumer information and knowledge creates enormous problems. When I first started working in the WIC Program in 1994, I found that pumps were being given out to anyone who asked for them. I talked to my supervisor about it, and we instituted a requirement that in order for a pump to be given to a client the pump had to be taken out of its package, shown how to assemble it, and shown how it worked. The client was given information sheets on cleaning the pump, storing milk, and anything else that pertained to her request. Breastpumps like infant formula were kept out-of-sight from WIC clients because the priority in the Program was to have women breastfeeding. Breastpumps like infant formula require access to refrigerators for storage (meaning the client had to have electricity and we had pregnant women who were living in cars), access to running water and stoves for cleaning and heating. Teaching hand expression was far more valuable for women whose access to modern conveniences was limited.

Over the years, I saw women get damaged nipples from pumps, abrasions on the areola from pump flanges to small or not centered correctly, mastitis--from pumping excessively and then stopping, pumps put together incorrectly, moms focused on pumping rather than breastfeeding, and mothers assuming that pumped milk is a good indicator of milk supply. How many women quit breastfeeding because of these issues? Are we willing to look at this technology and realize the risks? Or is this situation imitating childbirth in the USA, where moms opt for the technology without realizing the risks? Epidural classes? Breastpump classes? What do we believe? Breastpumps are aids to helping moms sustain breastfeeding. There are risks whenever we step between a mother and her baby. Breastpumps don't solve breastfeeding problems, mothers and their babies resolve these problems by learning to be together. We are living in a culture that does not support mothers and babies being together. Women are made to feel that to be a worthwhile member of our society, they must go back to paid employment as rapidly as possible. There is a belief that babies don't miss their mothers. And that mothers shouldn't miss their babies. The priority is economics not the mental and physical well-being of mothers and babies.

So some breastfeeding advocates believe that the WHO Code has nothing to do with breastpumps and the only concern is baby bottles and nipples that breastpump company markets. Thus, the WHO Code document is examined and we do not look at the "intention" of the Code (which is to sustain breastfeeding not human milk feeding). Instead, the belief is that we only look at the precise wording of this document and not the intent. Maybe the document should be changed to humanmilk feeding rather than breastfeeding. Maybe the reality is that in our society the best we can hope for is humanmilk feeding and breastfeeding is a wonderful but impossible goal.

copyright 2008 Valerie W. McClain

Breast pump companies and the WHO Code

photo by Jesse McClain

There is a belief in breastfeeding organizations that the WHO/UNICEF Code (International Code of Marketing of Breast-milk Substitutes) does not pertain to breast pump companies. In examining the original document written in 1981, I am rather surprised that breastfeeding advocates have come to that conclusion. In the beginning of this document breast-milk substitute is defined as, "any food being marketed or otherwise presented as a partial or total replacement for breast milk, whether or not suitable for that purpose."

http://www.who.int/nutrition/publications/code_english.pdf

Thus, I suppose a strict interpretation would be that legally this document is only directed at "food." Although it is also directed at bottles/bottle nipples. So it isn't just about food but also products involved in delivering alternative food to the infant/child. In 2003 UNICEF wrote a document called, "Global Strategy for Infant and Young Child Feeding." On page 10 of this document under the title, "Exercising other feeding options," they state: "For these few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative-expressed breast milk from an infant's own mother, breastmilk from a healthy wet-nurse or a human-milk bank, or a breastmilk substitute fed with a cup, which is a safer method..." I would interpret this to mean that any mother who is not breastfeeding directly is using other feeding alternatives. And, thus pump companies are marketing alternatives to breastfeeding and therefore must comply with the WHO Code. UNICEF created this Code to "emphasize the importance of maintaining the practice of breast-feeding." (1981) Hasn't UNICEF in later years showed us that the view is that infant feeding options go in descending order of choice with breastfeeding the priority? Thus products marketed that endanger the practice of breast-feeding must be regulated? While breast pumps were created to maintain breastfeeding, they are a two-edged sword. The use of pumps carries a degree of risk. And the risk of breastfeeding failure is higher, if the pump was unnecessary from the start. If one takes a more flexible view of the WHO Code, I believe that one could present a good case for breast pump companies having to comply with the Code. So why are breastfeeding organizations taking a strict view of the Code and letting the pump companies off the hook? Possibly their legal advisers, view the law strictly and believe that all other legal adviser's and the courts would take a similar view. I would suggest that that is not necessarily true. It is also possible that this strict view is a reflection of the fears of "opening up a can of worms." Many breastfeeding organization events/conferences, professional journals and individual IBCLCs are funded by breast pump companies. Pump companies would not be happy about some of the rules of the Code (no advertising products to the public, no promotion of products to health-care facilities, no gifts or personal samples to health workers).

Of course an issue that overshadows this quite a bit is the fact that one pump company has decided to patent their invention of a human milk fortifier using human milk--Medela. They have patent applications in the US, Australia. etc. They had a European patent on the fortifier but lost the patent because they didn't pay the fees on time. But, of course, these patent applications will never be discussed publicly in breastfeeding organizations. Was it Shakespeare that said, "The world is a stage."? Find a mask and play the game.

copyright 2008 Valerie W. McClain

of truth, silence, slander, and propaganda

photo by Jesse McClain

I received another email from the anonymous commentator who called me a lunatic, a crazy, an uneducated bigot. This person believes I should publish her comments (maybe it's a him, but I doubt it). If this person wants to be published in my blog, then they need to reveal their name. This new email states that I "slandered the good name of Jennifer Laycock." Slander is usually defined as "verbal" lies against someone to hurt their reputation. Libel is usually considered "written" lies against someone to hurt their reputation. I believe that my statements in this blog were truthful not lies. I would suggest that readers reread my comments. Nothing was said against Jennifer. She is obviously an excellent writer, a lactivist, a caring person. But something bothered me about her writing and when I dug a little deeper I found to my dismay that she makes her living in the public relations field. Readers may want to read "The Lactivist Project" at:
http://www.searchengineguide.com/ebooks/30DayBook.pdf
Is stating someone's occupation slander? Or is this anonymous writer trying to tell me that Jennifer Laycock is not in public relations? What is truth? And can we write and speak the truth in this society? When I was "allowed" on Lactnet, I was told that I was libeling people because I wrote about how human milk research was funded by the infant formula industry and questioned a HMBANA milk bank's "in-kind" funding from Dannon (Dannon is part of Groupe Danone-infant formula company in Europe). From my perspective, it looks like one can only be considered a breastfeeding advocate, if one keeps silent about the connections between human milk research and the infant formula industry. One can only be acceptable if one criticizes Nestle, as if Nestle is the only infant formula company in the world. Not that Nestle does not deserve criticism but that the best propaganda is finding and focusing on one "enemy." No self-criticism allowed. One is ethical because one is on the "right" side of the argument. We don't have to follow any rules because we are the good guys. In politics and religion this creates intolerance and wars of righteousness. Life is truly not that way. Ethics is for everyone, no one side has everything right (including myself). Knowledge, the search for truth, has to allow a hearing of all sides. Scientific/medical knowledge becomes more faith than fact, when we close the doors to open discussions and publications. Intolerance of others, ostracism of those we disagree with, breeds poor thinking and even poorer decision-making. Speaking of intolerance, there is no more a divisive slogan than the current mantra from breastfeeding organizations that "breastfeeding is normal." Then, one who does not or cannot breastfeed must be "abnormal." Divisive? You bet. What is the truth? Lactation is a normal biological process that occurs after pregnancy. But, breastfeeding is not "normal" in US culture. If it were normal, would women have to protest being thrown out of various establishments for breastfeeding? Would the percentage of exclusive breastfeeders be so low? Would formula feeding be so much a part of our culture? Instead of an honest statement of our cultural abnormality, we make statements that subtly blame the women who do not or cannot breastfeed. It is propaganda pure and simple. And it is divisive.
While I am accused of slander anonymously, that very same person calls me a lunatic, crazy, an uneducated bigot. Who is slandering/libeling who?

of lunatics, crazies, and uneducated bigots

photo by Jesse McClain

I recently received an anonymous comment to "Human Milk is NOT invention." The commentor obviously felt quite strongly that I was a lunatic, a crazie[not my spelling, I like to spell crazy with a "y"], an uneducated bigot, and ended with a "SHUT THE HELL UP." Getting an email like that makes me feel like a kid again. Name-calling always invokes the "sticks and stones may break my bones but names will never hurt me." Of course, name-calling hurts and that is it's purpose. But if I say my childhood mantra of sticks and stones I always feel better. As for shutting the hell up, I have to say that breastfeeding organizations have done an excellent job of shushing me for as long as possible. Although one might call that shushing ostracism or silencing of a critic.

The main thrust of the anonymous comment besides name-calling was to state that "these patents were to protect breastfeeding rates," and that, "pro-breastfeeding researchers should be applauded for these patents." There are no references to these comments. While I would love to believe that pro-breastfeeding researchers are patenting human milk to protect it from the infant formula industry, I have not heard of this before. Nor is there any public record of this being done that I have seen. Silence has been the main response to human milk and human milk component patents from breastfeeding organizations. I have been told by those who answered my emails that this issue is not of concern to them, maybe they will look at this issue sometime in the future...maybe.

Human milk research is funded by the infant formula industry. Human milk research is also funded by universities that are funded by the infant formula industry. The US Government funds research on human milk. But the infant formula industry has a large presence in the government. (Mead Johnson is on the list of CDC Foundation donors) I welcome any information that shows me that human milk researchers are patenting to prevent the infant formula industry from patenting. But I do have alot of questions. The infant formula, pharmaceutical, supplement, and food industries have over 2000 patents and applications on human milk/human milk compenents. There are an enormous amount of components to human milk (some not even discovered yet). Who are the researchers who own these patents to protect breastfeeding? Who is financially backing them? Why is this not public record? Why the silence?

Copyright 2008 Valerie W. McClain

Human milk is NOT Invention

photo by Jessie McClain

Human milk, as invention, seems so far-fetched, so unbelievable. Yet, obviously some people on this planet believe that human milk (its components) can and should be patented. There is money to be made and the raw material is FREE for the taking. There is no need to feed or take care of the human animal, like the dairy cow industry. So essentially, the only problem is convincing the female human animal to freely donate. No problem there, just set up a PR campaign that convinces women that everyone is donating to this good cause. One of the fascinating things I noticed about some of the lactivist blogging sites was the CDC advertisements. Yes, just a coincidence. Interesting, though, that one of the CDC Foundations projects is testing human milk for toxins. So one might suppose that the CDC has an interest in having some of that breastmilk for its "studies." I do have to note that the media loves the contaminated breastmilk headlines and plays that theme regularly. But women should take note how little US media mentions contaminated infant formula. The Chinese infant formula scandal is minor news and even breastfeeding advocates on blogs say that they don't want to offend formula feeding mothers by discussing it. I guess that blows my mind. The death of infants and the hospitalization of thousands of infants will upset infant formula feeding mothers, so we won't talk about it. This is a prime example of codependent thinking. There is a problem, we won't talk about it and it will go away because we don't talk about it. This is the same thinking regarding the patenting of human milk. We won't talk about it and therefore the problem does not exist.

Despite the patenting of human milk, women are still donating their milk. So mothers don't seem to be concerned about patenting or have no knowledge of patenting. Mother's Milk Banks (a HMBANA trademark) are increasing around the country. According to news reports I have read, the difference between the HMBANA milk banking system and Prolacta is that HMBANA milk banks are non-profit. Prolacta makes money, a business.

There is a patent application called, "Oligosaccharide Compositions and Use Thereof in the Treatment of Infection," #20070275881. Patent inventors to this invention are Ardythe Morrow, David S. Newburg, and Guillermo M. Ruiz-Palacios. This patent application is based on research done on human milk oligosaccharides but is not about using the real components. I believe the patent application mentions cloning, a genetic engineering technique. David Newburg is inventor to two other patents on a human milk component-HMFG (owned by John Hopkins/Senomed). Interestingly, he is on the planning board of the relatively new HMBANA Mother's Milk Bank of New England. So exactly why does a milk bank have researchers involved in their planning that have patented human milk components? Is there some entrepreneaurship being developed? Are donating mothers to this non-profit aware that the use of their milk may go to research that is financially beneficial to the researchers or to some un-named company?

What is the difference between a non-profit milk bank and for-profit milk bank when researchers are given access to donated milk and use that resource to create patents? Frankly, I see no difference. Its all about entrepreneurship. It's all about the belief that human milk should and can be patented. What is this drive to get women to donate their milk? Is it about the poor NICU babies or orphaned babies in Africa? I believe it's about research that leads to patents...and many of those patents are about creating a better infant formula. How does this preserve, protect breastfeeding, if our milk banking system is feeding the infant formula/pharmaceutical industry?

Copyright 2008 Valerie W. McClain

Chinese infant formula tragedy, Milk Protein Concentrates and globalization

photo by Jesse McClain, sunrise in paradise


The media blitz of the 2008 Olympic Games in China was overwhelming. I felt somewhat caught up in the fanfare and hopes of some fabulous athletes from around the world. So it is with great irony that it seems that the infant formula tragedy that was onfolding was covered up because of the Olympics. Tragedy compounded upon tragedy. We, who are living on the other side of the world, feel somewhat untouched by it. Legally Chinese infant formula cannot be sold in this country. And according to the FDA, they have been reassured that no ingredients that goes in US infant formula is made in China.
So we distance ourselves from the tragedy. It couldn't happen here. We are safe, everything is inspected.
Sanlu Group of China is the name of the infant formula that seems to have been mostly effected by the contamination, but other Chinese infant formulas were contaminated. A massive recall of many Chinese infant formulas has increased the sales of imported brands of formula, such as Mead Johnson, Wyeth, etc. A number of people have been arrested because it is believed that the formula was watered down first and then melamine (a plastic resin) was used to artificially boost the protein levels in order to pass inspection. Fonterra, who owns 43% of Sanlu and is one of the largest dairy cooperatives in the world, has claimed that this was sabotage. They, too, had to issue a recall on a powdered milk for pregnant women called Anmum.
I was somewhat startled by the fact that Fonterra was so involved in dairying in China as well as manufacturing of milk powder. New Zealand Milk Products is part of the marketing arms of Fonterra. New Zealand Milk Products has a division in the USA. Coincidently, I remembered an infant formula patent called, "Powdered human milk fortifier," that mentioned that it would get its casinates, whey, hydrolyzed caseinates , hydrolyzed whey, milk products, and mineral enriched proteins from New Zealand Milk Products of California.
That got me reading about something called Milk Protein Concentrates (MPC)...used in processed cheeses and in the infant formula industry. According to some US dairy organizations MPCs are not recognized as food and the FDA does not inspect them. MPCs have been used as glues and in the fabric industry. The US imports MPCs. They are not tariffed. I did not write down the metric tons of this product that come into this country but we import alot and it is an ingredient of infant formula. American farmers feel that it has a direct financial impact on them. For some background:
http://waysandmeans.house.gov/legacy/trade/107cong/tradebills/hr1786nationalmilk.pdf

According to a Cornell University dairy workshop, the US is Fonterra's largest economic partner. So it is a small world. We are a global community. Our food passes from one country to another. Many companies use ingredients from other countries. Infant formula feeding is part of our global economy, its safety and value marketed by huge industries who make billions. One would suppose after this tragedy, that governments would make a bigger effort to promote breastfeeding. Yet much of the news releases say nothing about breastfeeding, its protective value. Breastfeeding is each country's national treasure, a child's rightful inheritance of health and safety from this all too cruel world.
Copyright 2008 Valerie W. McClain

Masks, mirrors, and gold

photo by Jesse McClain, New Smyrna Beach sunrise

Loreena McKennitt in "Marrakesh Night Market" sings, "Would you like my mask? Would you like my mirror?" and later, "The truth is measured by the weight of your gold." The sounds and the words seem to directly play to my mood. I feel a little lost, what world is this? Where nothing is as it seems? How did I get to this place where it is a marketer's masquerade ball? Where everyone knows what is going on but me? I think back to all that has happened to me and my sense of confusion. And I realize that when I start to feel confused, it is because I am being told lies, stories to suit the whim of the teller or the organization. In 2005, I was kicked off Lactnet for comments made in a post about Thomas Hale's book being marketed by Abbott. Everything I said was twisted and sandwiched in the imaginary words of reading "between the lines." I reread that post the other day and I am still struck by the craziness of the accusations and how quickly I was booted off that all so public listserve for lactation consultants. It was done in silence, no one publicly said I was kicked off. No one seemed to notice. Funny how it is around this time that Medela was trying to patent their human milk fortifier in Europe. On Lactnet human milk component patenting became a forbidden topic in 2004 and then I was kicked off quietly and quickly in 2005. Mere coincidence? Of course, let's put on our masks and put up the mirrors.

Silence regarding the patenting of human milk components says alot about breastfeeding advocacy. Having an ethical tenet requiring IBCLCS to respect patenting says it even louder. I do finally get it. The majority of people in breastfeeding advocacy support patenting of human milk. Why else this push to sell human milk banking to mothers--lactivism. While lactivism is defined by Wikipedia as breastfeeding activism, one might want to note that alot of lactivism seems centered on funding/supporting human milk banking. I support human milk banking but I don't support it in the present atmosphere of patenting components or the broad claims on something called human milk "compositions." While the infant formula industry puts their claims on various components of human milk, companies like Medela and Prolacta make claims on all of human milk. How do you judge that? Thank you Nestle and Wyeth for only taking small parts of human milk and claiming it as yours? And thank you Medela and Prolacta for claiming you own whatever composition you make up? Medela compromised and stated that some of their claims could be bovine, too. So its all one big grab bag. Breastfeeding advocates believe that this doesn't stop women from breastfeeding. No it only stops women from making a living from selling their milk, they cannot commercialize the product their bodies make, only Nestle or Wyeth or Medela or Prolacta. Yes, let's continue to donate to the enrichment of the corporation. For donating your milk, we may let you breastfeed in public. Let the masquerade ball begin....

Copyright 2008 Valerie W. McClain

The Mark, "Got Breastmilk?"

photo by Jesse McClain

One would think that the ownership of the trademark (mark). "Got Breastmilk?" by the California Milk Processor Board (which is the PR group that represents such companies as Dean Foods and Nestle) would make blogging news or at the very least should make news with breastfeeding advocates. Silence.....is anyone out there? Only in the PR world, would such news rocket through the blogging world, going viral, going viral, gone viral. But hm, reality doesn't go viral....silence. This is not what the "company" wants to project: a PR campaign creates retaliation. Nope. No talk, more silence. Reality on the internet, it doesn't exist, its just a PR game and we don't even know the players. Maybe we should call it "mothers of invention." Oops can't say that...it might be a trademark. I started reading about the California Milk Processor Board and how much money they collect from California Dairy Farmers (a few millions) and somehow they seem to have quite a bit of money to play with for "advertising." I am hoping to order a T-shirt from them that has all those cute little cows and says "got breastmilk?" Maybe the T-shirt with the California Real Dairy seal of approval (Real Dairy--Nestle but the seal of approval is a PR campaign for the California Milk Processors Board) and "Got Breastmilk?" How about the Nestle patent called "Osteoprotegerin in milk." (EP1757619 and US patent application # 20050288219) Inventors are Karine Vidal et al. The abstract in part states, "The present invention pertains to osteoprotegerin obtainable from a milk source, in particular human and bovine milk." This component will be used for bone remodeling and to boost immunity. Hm...tell me again why premmies don't get enough calcium from human milk? Meanwhile Nestle will patent a component of human milk that builds/remodels bones. Oh, I forgot advocates for breastfeeding don't want to hear about this nor do they have the need to question how Nestle so easily got human milk and are able to patent off it. La-dee-dum....questioning is bad...don't ask questions. If we want companies to be transparent, don't ask questions. Yes, ethics is a game, throw the dice and which player wins? I am afraid moms and dads are the real losers in this game of chance.

Copyright 2008 Valerie W. McClain

Trademark ownership of "Got Breastmilk?" and PR promotion

photo by Jesse McClain, sunrise

On September 9, 2008 the California Milk Processor Board filed for the trademark, "Got Breastmilk?" Two registrations: #77565484 and 77565459. Written on the registrations are, "G & S: promoting awareness of the benefits of breastfeeding for mothers and babies." The California Milk Processor Board which in reality represents the food/dairy industry--Dean Foods, Nestle, etc--now has registered this trademark. Of course the legal questions are when did they ever use this trademark and do they ever plan to use it? Does the Trademark Office really believe that the Dairy Industry is promoting awareness of the benefits of breastfeeding? Do they really believe that the Dairy Industry plans to create goods and services that promote breastfeeding?

I hope that people will read Jennifer Laycock's response to my comments yesterday. Jennifer wrote, "What is the motivation for a company to operate with openess and transparency when someone with no facts to back them up can introduce questions and accusations like you have?

The motivation for a company to operate with openeness and transparency is called ethics. Ethics means that you willingly answer questions and respond to accusations. What Jennifer seems to be implying is that asking questions will make companies less transparent. And what company are we talking about?

I believe that many talented and gifted women donate their services to organizations, like Jennifer does for the Ohio Breastfeeding Coalition. The problem as I see it, is that being part of the PR industry, known to make and shape the public viewpoint, could cause a number of people to wonder about the organizations they represent. Is "all the world a stage?" What is the reality? We are so very critical of the PR put out by the infant formula and dairy industries. Are we doing the same thing? And why? Do we have so little faith in breastfeeding's ability to sell itself? Do we have to social market/sell breastfeeding to the public? Whose version of a breastfeeding society is being marketed? Is it an industry viewpoint (as in Medela or Prolacta), a non-profit organization's viewpoint, one particular group's viewpoint, or a personal viewpoint that gets marketed to the public? Who has the power and/or money to get their viewpoint marketed? These are important questions. But I fear in the society we now live in, this is all swept under the table. No questions, just faith that what is going on is reality. I frankly don't know what to believe or who to believe. And you know what I don't think I am alone in that assessment.

Copyright 2008 Valerie W. McClain

The PR Game

photo by Jesse McClain "Sunrise New Smyrna Beach"

I've been reading a fascinating book called, "Toxic Sludge is Good For You!" by John Stauber and Sheldon Rampton. At one point in the book they write about how Nestle in 1980 hired Rafael Pagan and Jack Mongoven to manage the image of Nestle because of the Nestle Boycott. They developed dossiers on groups-clergy, labor unions, etc supportive of the boycott. The boycott ended in 1984 but in 1989 the boycott was renewed. Nestle then hired "Ogilvy and Mather Public Relations to develop a strategy called 'proactive neutralization,' which included plans to monitor Nestle's critics..." The back cover of this book explains what this book is all about, "This book names names and reveals how public relations wizards concoct and spin the news, organize phony 'graassroots' front groups, spy on citizens, and conspire with lobbyists and politicians to thwart democracy." I highly recommend reading this book to get a good understanding of the PR Game. Should we be shocked that Medela has hired Ogilvy Public Relations? Ogilvy and Mather and Ogilvy Public Relations are part of one huge company.

To my surprise the other day, I realized that there are many players in the PR Game. Jennifer Laycock, of the lactivist blog, is hailed at one website as "Marketer of the week-Jennifer Laycock Unleashed." They ask, "Your biggest disaster? That would have to be my Bento Yum experiment. I was writing an article series based on a hobby site and the community discovered I was a marketer and turned on me like rabid dogs."

http://eimr.blogspot.com/2008/08/marketer-of-week-jennifer-laycock.html

Jennifer teaches a workshop on "viral marketing and link baiting." She was a guest blogger in a discussion on , "Church Marketing Sucks."

http://www.prwebdirect.com/releases/2008/8/prweb1170594.php

Now my question is, who hired her to do the lactivist blog? Who? Prolacta? Medela? A non-profit breastfeeding organization? Shouldn't we be happy that we, too, have our own PR people? Which story to believe? Is the big story of "Got breastmilk" a fabrication? Is the California Milk Processor Board really going after someone in Alaska for using the "Got Milk" trademark? AT the US Patent & Trademark Office the trademark was filed in1993 and states "No claim is made to the exclusive right to use 'milk' apart from the mark as shown." (trademark #1903879) The California Milk Processor Board owns the trademark and a man named Jeff Manning, a PR man was board director for some time (no longer). Manning is credited with the slogan, "Got Milk." While the California Milk Processor Board seems to represent dairy farmers, its board seems to represent Dean Foods, Nestle, etc.) So is this one PR stunt versus another PR stunt? How do you get to the truth? There is the rub.....Obviously, we are a society that loves our lies. We don't demand the truth from our politicians, our non-profit organizations, and we definitely don't demand that corporations tell the truth.

When I tried to sign up at various "lactivist" private group internet discussions a few years ago, I was refused permission to be on those group lists. I felt very offended. But now I understand. Lactivism seems to have started out as a PR stunt. Where does the truth reside when everyone is playing this game? Does it serve breastfeeding promotion? Or do we get lost in the subterfuge, the lies, and the games?

Copyright 2008 Valerie W. McClain

Words, just words

Medela is defined in wikipedia as a "breast pump company" and also "a fossil genus of spiders in the family Philodromidae." I always wondered what medela meant and now I know. I thought at one time that the breast pump company must be owned by someone named Medela.

I like spiders and the webs they weave. Outside my window the Golden Orb spider spins her web, thick and yellow. I have gotten entangled many a time in its web and everytime a sense of panic overcomes me. I find myself hopping on one foot, tearing at the yellowy strings , and getting more and more panicked. Yet, I like spiders and I am fascinated by them. Entanglements....

Medela, the breast pump company, seems to have spun a web of entanglements in the breastfeeding advocacy community. I spent this morning looking at various breastfeeding organizations in various states and lots of them list Medela as a "resource." One website I looked at listed Medela as a "professional resource." One website listed Medela as a resource but there were no other companies/businesses listed only non-profit organizations. Strange, how these websites don't see Medela as a business, a manufacturer, a maker of breastpumps and accessories. When I read the JHL (Journal of Human Lactation) some years ago, Medela often had the whole back cover...advertisement??? resource????

I have been told they still advertise in this LC professional journal. Not all professional journals accept such advertising. It is difficult to exist without it. How many Conferences, educational gathering has Medela funded or partly funded? How many organizations have been gifted with products from Medela? I know years ago that La Leche League had a breast pump program that helped leaders give pumps to those who needed them but couldn't afford them. We, in breastfeeding advocacy, are surrounded and enveloped by their generosity. How many IBCLCs owe their economic survival to Medela? But we are also ensnared at the same time. Caught by this generosity, how do we view our world, our entanglements? Medela is no longer a business out to make a profit, it is our educational resource, our professional resource. Words, just words...

Copyright 2008 Valerie W. McClain

More on Medela

Besides the patent at the European patent office and application at the US Patent Office, Medela has patent applications for "Human milk fortifiers and methods for Their production," at the World Intellectual Property Organization WO2006/026878 and at the Australian Patent Office #2005282182. One would think this be a cause for alarm in breastfeeding organizations and breastfeeding advocacy communities, but silence reigns supreme.

I think after 9 years of beating my head against the wall, I finally get it. It's called: "We don't care, we don't know, it doesn't matter, and this doesn't mean anything." Corporations love the silence because a population silenced is a good and captive audience. So onward with life as the corporate world plays the game. Patents? Who cares? So what that Medela and Prolacta have put claims on human milk? This is promotion of human milk. Yes, we IBCLCs are acknowledging their claims because life in the USA is about owning property. Ownership is power. Patents are ownership. Patents are about the right to exclude others from using their property. Patents are monopolization. Let's here it for corporate life and our media manipulators.

Yes, "Business Backs Breastfeeding." Thank you Abbott Nutrition. Thank you Medela. Thanks to the Working Mother Media for "helping women discover the joy of working motherhood every day." Thanks to the corporate world, mothers know their place in society. Be joyful at work, motherhood is wonderful when you join the corporate ladder of success. Medela hired Ogilvvy Public Relations, so the public will know their relations. Ogilvvy also has contracts with the US Government (regarding medicare and medicaid, letting the public know what the government wants them to know). I think at one time Nestle used Ogilvvy. Brave New World, its looking mighty old to me and not so brave.

Copyright 2008 Valerie W. McClain

Medela's patent withdrawn in 2007

The Medela patent EP1637043 at the European Patent Office on a human milk fortifier was withdrawn in 2007 because the examination fee was not paid on time. The navigation of the European patent office website is very complex and I just found that particular information this morning. Of course that still leaves the patent application at the US Patent Office (and the possibility that a patent or application exists at the Australian Patent Office). To view patents at the European Patent Office:

http://ep.espacenet.com/

To view patents or applications (Medela application on human milk fortifer #2008187619)at the US Patent Office website:

http://www.uspto.gov/patft/

One of the claims on the European patent state that a component in the human milk fortifier might be bovine. Hence my belief that in order to produce such fortifier it would have to be licensed out to the infant formula industry.

Human milk fortified or designed by companies is what?? Human milk?? When it competes with breastfeeding (as has happened with preterm infants), should the companies be absolved of the WHO Code because some or one of the components are human milk? Do breastfeeding advocates believe that because it contains some human milk, it is getting us closer to a breastfeeding society? Or, are designer human milks actually 10 steps away from breastfeeding? Do these questions seem like they are not relevant to the present situation? The future is far closer to us, than we like to believe. If time and energy is not devoted to this shifting perspective of infant feeding, then we will certainly see breastfeeding become a thing of the past. Designer human milk engineered especially for your baby! Impossible you say......who would think cloned milk and meat would be on our dinnertable in 2008? But there you are, our reality is melting like the polar ice caps into a sci-fi comic strip.

Copyright 2008 Valerie W. McClain

Medela's Human Milk Fortifier European Patent

Medela own's a European patent EP1637043 called "Human Milk Fortifiers & methods for their production." The inventors are Peter Hartmann et al. They also own a US patent application #20080187619 entitled with the same name and the inventors the same. This patent and its USA application seems to be making claims on components directly or indirectly derived from human milk. Thus Medela, well-known, respected breast pump company has now entered into the field of transforming breastmilk into an acceptable liquid for use with preterm infants. The question is will Medela manufacture this specialized human milk? Or will they license it out? Who has the facilities? Prolacta is already in that business and Medo owns a patent application on a standardized human milk for use in human milk fortification. So it seems very unlikely that Prolacta would be a part of this venture. It would seem far more likely that this venture will be licensed out to one of the infant formula companies.

While some might feel this endeavor--human milk fortification-- is supporting breastfeeding, I do not believe it is supportive of breastfeeding. We are already witnessing Medela's disregard of the WHO Code regarding bottles and bottle nipples. It would seem logical, particularly if they license this patent out to an infant formula maker (possibly more than one infant formula company) that the disregard would become even greater.

The need for a human milk fortifier for preterm infants is based on research that was mostly paid for by the infant formula industry. If a premise is based on monetary interests, might it be imperative that independent research revisit the question? Part of the problem of feeding human milk to premature infants is the plastic feeding tubes--the fat of human milk adheres to the tubing causing losses in energy, protein, etc. Nestle's answer to this problem is to add lecithin to human milk. I have a simpler answer to the problem. How about letting mothers of preterm infants breastfeed their babies? I recognize this is dependent on the stability of the premature infant and also whether the premature infant is younger than 34 weeks gestion. But the emphasis in US hospitals is to get moms pumping (important) but vastly more important is infant/mother contact through breastfeeding (or attempts at breastfeeding) in the hospital setting. When I worked in the WIC Program (1994-1998) breastfeeding mothers of preterm infants often had little to no breastfeeding within the confines of the NICU. I am hopeful that has changed. The emphasis was on pumping and it seems to me that even now the main emphasis is pumping and storing milk. Fortifiying the milk means to many moms that their own milk is not adequate. Thus the fortification of human milk in the early days, sets up the belief in the inadequacy of breastfeeding to sustain the growth of the infant once it goes home from the hospital. Is this really a truth? Or is part of the problem of preterm human milk caused by the inadequacy of feeding infants by artificial means--the plastic tubes, the bottles, the pumps?

We are poised at the beginning of a new industry, the human milk industry. What makes breastfeeding advocates believe that this endeavor will support breastfeeding? The basis of this industry is about the inadequacy of human milk. Thus this new industry will manipulate it to the tune of the infant formula research that shows that preterm human milk is inadequate. Is this the truth?

Copyright 2008 Valerie W. McClain

Truth or Dare: Vitamin D and breastfeeding

The current recommendation from the AAP on breastfeeding and vitamin D is that "all infants, including those who are exclusively breastfed, have a minimum intake of 200 IU of vitamin D per day beginning during the first two months of life." When an organization like the AAP makes such recommendations/policies there are winners and losers. Who are the winners and do we really want to know the losers? Winners, of course, should be our babies, our children; since this impacts their health. Are they the winners? Does supplementation of vitamin D in the exclusively breastfed infant helpful or hurtful? Is it needed? Is it needed for all or selectively? Frankly, its hard to get a good picture on this because like anything decided in the US, economic motivation is of prime consideration. The economic winners in this policy are companies that make vitamins but also the infant formula industry. (Mead Johnson/Abbott also make vitamin drops for infants)

In 2000, a study was published in the Journal of Pediatrics by researcher Shelley R. Kreiter called, "Nutritional rickets in African American breast fed infants." It made alot of headlines around the country. I remember reading the study because I had been a WIC Breastfeeding Peer Counselor Coordinator in a Florida county from 1994-1998. Breastfeeding rates for African American women in my area were very, very low. Those who did breastfeed, most often were also using infant formula. Most did not breastfeed for long. So I was very interested in how this study defined breastfeeding. The definition of breastfeeding in research is crucial in making decisions of causation. How can researchers know that breastfeeding is the cause of the rise in rickets, if the mothers were also using infant formula, water supplementation, or foods or other drinks? In this particular study, if memory serves me there was no definition of breastfeeding. So we, the readers, do not know if breastmilk was the only source of nutrition for these infants. I would suspect NOT, because initiation rates in North Carolina for African American infants in the WIC Program ranged from 18% - 30% from the years 1993-1999. Duration rates at 6 months for the WIC Program during those years hovered at around 10%. With such low duration rates, I would believe that there was alot of supplementation going on (supplementation of formula/foods cause milk supplies to drop and is often instrumental in mother's weaning because of low supply of breastmilk). If there is no definition of breastfeeding in research, then how can we believe that the rickets were caused by African American women breastfeeding their babies? We might suspect this is a cause but until we have determined that the only food or drink these babies got was breastmilk, then how can we logically, scientifically say that their is a deficiency in breastmilk? The definition of breastfeeding is critical to the understanding of causation and in this study like the studies on hiv, the researchers saw no reason to define breastfeeding. Even WIC does not define breastfeeding in its data. Breastfeeding initiation is "ever" breastfed. Ever breastfed is dependent on the accuracy of the mother's memory and the accuracy of the WIC clerk. One might assume that breastfeeding mothers who get the "full" breastfeeding packet are exclusively breastfeeding but I learned quite quickly that often clients on the WIC full breastfeeding packets would also have infant formula (either gifted to them from the hospital/doc's office, friends/family, or bought out of pocket). So reading WIC stats does not give people outside the system a real understanding of what is going on regarding infant feeding and particularly if they aren't aware of differences in breastfeeding practices, the need for definitions. One of the authors of this study, Dr. Robert P. Schwartz (funded in other studies by Mead Johnson, Genentech) is interviewed about this study and he tells the story of how he obtained the WIC statistics--a WIC Representative gave him the breastfeeding data for part of the study (not the cases themselves but the data regarding the rise of breastfeeding rates in the North Carolina WIC population). I am somewhat amazed that WIC gave away their data. I think that is somewhat unusal.

http://www.ahrq.gov/about/evaluations/pharmportfolio/pharmportfolio3d.htm

The editorial in the Journal of Pediatrics 2000 in that particular issue of the Kreiter et al study was "Vitamin D-deficient rickets: The reemergence of a once-conquered disease." At one point it states, "The reappearance of rickets may be an unintended consequence of an admirable health initiative the promotion of human milk feeding." I find the sentence rather jarring, admirable? human milk feeding? Interesting spin....There were 3 authors to this editorial and one, Reginald C. Tsang was the author of a book called, "Vitamin & Mineral Requirements in preterm infants published by Mead Johnson.

In 2001, the CDC convened a Vitamin D Expert Panel meeting to determine the CDCs final report on vitamin D supplementation of breastfeeding infants. Some of the experts/researchers have industry funding or patents that would suggest to me that vested interests may have had a part in the conclusions that were drawn. Michael F. Holick was listed as a professor at Boston University School of Medicine. No mention of his inventions to patents on vitamin D compounds or test kits to determine vitamin D levels. (patents 4661,294, 6455714, 6291693) His test kits are based on ELISA antibody tests (remember antibody tests???? false positives). Another expert was Bruce W. Hollis, who just also happens to have a patent on a test kit for vitamin D (patent # 5821020). He was listed at this CDC panel meeting as a professor of Pediatrics at the Medical School of the University of South Carolina. Frank R. Greer, CDC expert panel member, has represented the National Dairy Association's 3-A-Day for stronger bones program. He is also the secretary/treasurer to the ISRHML (International Society of Researchers of Human Milk and Lactation). He was listed as a professor of pediatrics at Meriter Hospital, Wisconsin. Bonny L. Specker, another expert, has been funded in her research by Carnation/Nestle, on Mead Jonson Advisory Board 2004, National Dairy Council. Nancy F. Krebs has had her research funded by Mead Johnson. Of note is some very thoughtful statements made by Ruth Lawrence regarding the situation of vitamin D use for exclusively breastfed infants. (how will the gut of the exclusively breastfed infants respond) But the decision was made to supplement all breastfeeding infants.

http://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/Vitamin_D_Expert_Panel_Meeting.pdf

I thought it of interest that a patent published in 1981 by Abbott Labbs (patent #4308264) on vitamin D(calcitriol 1.alpha.,25-dihydroxycholecalciferol) makes some interesting statments.

"Approximately one-third of premature infants, one-third of infants with birth asphyxia and one-half infants of insulin-dependent diabetic mothers have neonatal hypocalcemia."

"Late neonatal hypocalcemia usually occurs in full term of premature infants who have been started on feedings and show signs or symptoms of hypocalcemia only after several days or weeks of feedings."

An infant formula company describes low calcium problems and patents a vitamin D to solve the problem. But they don't blame the infant formula, calcium problems are the result of birth asphyxia, prematurity, and mostly diabetic mothers. Funny, how this all gets turned around 30 years later and the reasoning becomes that breastfeeding is one of the causes of rickets in African American infants.

Copyright 2008 Valerie W. McClain