Thursday, September 11, 2014

Tips on Breastfeeding: How distorted information benefits industry

                    "The question is whether any civilization can wage relentless
                war on life without destroying itself, and without losing the 
                right to be called civilized."  --Rachel Carson

Where do parents get their information on breastfeeding?  Who should parents trust for accurate and non-biased information on breastfeeding?  Why should parents question the source of information on breastfeeding?  

It is obvious to most parents that information from the infant formula industry on breastfeeding is often misinformation that benefits the industry.  As adults we understand the concept of "follow the money."  Although sometimes the slanted information is so subtle that it is difficult to see.  But most of us understand advertising.  And breastfeeding information from the infant formula industry is a form of advertising.  Surprisingly most of us think we are not influenced by advertising.  Yet studies show that advertising works.  So more of us are actually influenced by advertising while believing that we aren't influenced.  I guess we could call it denial.  And we all in some degree of denial about how influenced we are by advertising.

I happened to browse a few infant formula websites on "tips on breastfeeding."  I didn't realize that Abbott has a "commitment to breastfeeding education."  (information for health professionals).  And Mead Johnson can educate mothers on expressing breast milk, "expressing breast milk is a great way to catch a break, get some sleep or let dad or another caregiver have a hand in feeding.  It gets your baby used to the idea of a bottle, and of getting nutrition from someone other than you."  I am vaguely amused by an infant formula company's commitment to breastfeeding education.  It has this Orwellian feel.  The reality is that breastfeeding is the competitor to the infant formula industry (and to the human milk industry).   Breastfeeding education in the hands of the infant formula industry is for lack of a better word, crazy.  Almost as good as having fast food companies give us nutritional education.  Oh yeah, that also is being done in the US.  We have to hope that consumers are educated enough to question this kind of education that benefits industries.  Mead Johnson's education on expressing breast milk as a great way to catch a break is some kind of American male fantasy.  Pumping is work and time away from the baby, another chore added on to the many chores that women seem stuck doing (as household chores seem to still be mostly relegated by whether you are male or female).  Why is babyhood a commitment to the idea of getting babies used to a bottle not the breast?  Why are man more interested in feeding the baby a bottle than doing household chores so that mom can breastfeed her baby?  Oh yeah, household chores seem to still be women's work--at least in most American households.  And oh how quickly men lose interest in feeding the baby a bottle after they have done it a number of times.  Yes, I get it, babies are cute and men envy women's ability to nourish a baby.  Mammary-envy is alive and well.  Breastfeeding, nourishing a human being, is a powerful gift.  In our male-dominated society it seems to be an imperative to disturb or destroy that relationship.  In a society governed by industry, profits, its needs and wants; the disruption or destruction of breastfeeding will be a part of our reality. 

But it is not even the infant formula industry who is trying to guide breastfeeding education in our society.  We now have milk banks who financially need mothers to make a commitment beyond breastfeeding to breast milk feeding.  Prolacta,who calls itself a for-profit milk bank, offers its breastfeeding tips for an increased milk supply.  

First on their list is to, "drink lots of water to avoid dehydration."  Huh?  Say what?  The principle of increasing milk production is to breastfeed more often.  Or use a pump, if a baby is refusing to nurse.  Drinking extra water does not increase a milk supply.   Mothers do need to be aware of the need for more water during exercise or when temperatures are high.  But increasing water consumption does not increase milk production.  

Second suggestion from Prolacta is "Healthy Choices."  They suggest eating lots of fruits, vegetables, and whole grains.  They also suggest a calorie range.  Eating healthy foods is a good idea but it does not increase a mother's milk supply.  Breastfeeding more frequently or pumping when infant's absolutely refuse to breastfeed increases a milk supply.  

Third on the list is "Eat Frequently."  They suggest 3 small meals with healthy snacks. And again having a healthy diet and eating frequently does not increase a milk supply.  Breastfeeding more frequently or pumping increase a milk supply.  Eating healthy meals and snacks is something all people should be doing.  Good nutrition makes people feel better and benefits the immune system.  Eating well may improve the quality of the milk but it doesn't increase a mother's milk supply.  Only breastfeeding more often or pumping if the baby refuses to nurse more often will increase a milk supply.

The fourth breastfeeding tip for an increased supply is to, "Pump Often."  They state, "Breast milk is produced on a supply and demand basis, so if you pump more often, your body will naturally make more milk." they finally have gotten to the principle of increasing milk production.  But dear reader is this really a breastfeeding tip or a breast milk pumping tip to increase milk production? 

When working with moms who needed to increase their milk supply, my first suggestion would be to increase breastfeeding time.  Pumping was not one of my suggestions unless the baby was refusing to breastfeed.  Adding pumping to a mother's life with baby, puts the mother's supply out of sync with the baby's needs.  When moms have an oversupply, they are often at risk for engorgement and/or mastitis.  Breastfeeding exclusively is a balanced system. Adding pumping to a balanced system is a risk.

There are 16 Breastfeeding tips.  Not surprisingly the fifth suggestion is to "Get in a Routine."  Pumping requires a routine, scheduling.  Breastfeeding is not so easily made into a routine because it is about human behavior and the needs of a baby.  Routine usually means a clock approach to life.  Now its time to eat, now its time to sleep, and now its time to play.  Babies don't know clock time.  And breastfeeding, while about feeding is not solely about feeding.  It is about comfort and connection.  How do we schedule the human need for love and connection?  If it is needed and denied, do we perceive the crying of the infant to only be about hunger or indigestion?  When the reality is that the need for love and comfort is as strong as the need for food.

Prolacta obviously has confused breastfeeding tips with breast milk pumping tips.  Their suggestions are not geared for mothers who are exclusively breastfeeding and not pumping.  Yet Prolacta, like the infant formula industry has chosen to educate parents on breastfeeding.  Yet their suggestions are not about breastfeeding but about breast milk feeding.  Breast milk feeding benefits their industry.  Their tips are about obtaining an optimal supply of donor milk.  

Breastfeeding is not breast milk feeding.  And while it takes enormous dedication to pump milk instead of breastfeeding, it does not make them equivalent actions.  Are we moving towards a breastfeeding society or to a breast milk feeding society?  Do babies benefit or does an industry benefit, when breastfeeding and breast milk feeding are considered one and the same thing?  Should the human milk industry educate us on breastfeeding?

Time for a patent or two!!  Just happens to be Prolacta's patents.  Both patents are entitled, "Compositions of human lipids and methods of making and using same."  Both patents (#8377445, #8821878), are owned by Prolacta and invented by Elena M. Medo and Scott Eaker, filed in 2007 and 2013 respectively.
Elena Medo is no longer with Prolacta and has formed another company called Medolac (for profit milk bank). She established a company called Neolac in 2009 when she left Prolacta.

Both patents appear to be one and the same, just filed on different dates (patents are for 20 years based on the filing date--so having filed another same or similar patent extends a monopoly).  The patents state, 

"The disclosure features methods of making compositions that include a human lipid.  The methods can include:  obtaining whole human milk;  separating the milk into a cream portion and a skim portion;  processing the cream portion; and pasteurizing the processed cream portion."

"Nutritional support can be administered to the patients in need of it, e.g., enterally or parenterally (e.g., by a process called total parenteral nutrition [TNP])."

Science Daily just had an article entitled, "Human milk fat improves growth in premature infants." (dated Augsut 15, 2014)

"Researchers at the USDA/ARS Chidren's Nutrition Research Center at Baylor College of Medicine and Texas Children's Hospital have now successfully incorporated a cream supplement into premature infants' diets that improved their growth outcomes in the NICU.  The report appears in the Journal of Pediatrics."  

And while some people would call this article news, I would call it advertising.

This article never mentions that two of the authors of this report in the Journal of Pediatrics are employed by Prolacta (Martin L. Lee and David J. Rechtman) and two other authors (Amy Hair and Cynthia Blanco) received financial support and speaker honoraria from Prolacta.  The study was funded by the USDA, ARS, and the National Center for Research Resources General Clinical Research.  Prolacta provided the product.  None of the authors of this study are inventors to the Prolacta patents.  But the study does not mention the patents.

From my perspective, I do not understand the ethics of an industry that makes profits from women who donate (some compensation is offered--breast pump or $1 per ounce of milk provided)?  I also don't understand the enthusiasm of some breastfeeding advocates for this endeavor.  Interestingly at Fearless Formula Feeder's website, their seems to be a lot of enthusiasm for the recent product of Prolacta, human milk-based infant formula.  I don't understand that either, since many of the people supportive of fearless formula feeding don't believe that infant formula has any risks at all--unless you live in some undeveloped nation.  So why would this group be enthused about an infant formula made from human milk?  If we believe that infant feeding choices are equivalent choices, then who needs human milk infant formula?  In the context of public relations and social media I understand the game playing.  As long as we continue to believe that breastfeeding and breast milk feeding are the same and can be used interchangeably, industries will continue to profit.  Breastfeeding is not just a method of giving nutrition, but about how human beings learn to love and connect to one another.  The sad thing is that this understanding of breastfeeding is lost by industries trying to educate the public about breastfeeding.  And the reality is that both the infant formula and human milk industries survival is based on breastfeeding not surviving.
Copyright 2014 Valerie W. McClain