Tuesday, September 25, 2018

A critique of Fed Is Best's emergency considerations



"Breast-fed infants are better protected against infections of the GI, respiratory, and urinary tracts as well as other diseases compared with those who are formula-fed (Cleary T. D. "Human milk protective mechanisms" Adv Exp Med Biol 2004; 554:145-54). Salminen and co-workers have attributed this effect at least partly to differences in microbiota composition (Salminen S. J., Gueimonde M., Isolauri E., "Probiotics that modify disease risk". J Nutr 2005; 135:1294-8)."

and

"Given the characteristic gut microbiota of breast-fed infants and the associated health benefits such as protection against infections, there is a real need to develop formulas with similar properties to human milk to ensure that infants who cannot be breast-fed obtain at least some of the beneficial effects conferred by human milk."
--Both quotes from Nestec (NestlĂ©) patent #9131721, entitled, "Gut microbiota in infants," filed in 2008. 

The Fed Is Best Foundation has put out a pamphlet for mothers who are formula feeding, supplementing, combo feeding or exclusively pumping and living through emergency situations.  It was written by co-founder of the Fed Is Best Foundation, Jody Segrave-Daly, RN, IBCLC.  One of the major problems with this particular information and their pamphlet is a lack of understanding of who is hardest hit by emergency situations.  
https://fedisbest.org/resources-for-parents/infant-feeding-considerations-in-an-emergency-situation/

Those who are of middle or higher incomes can easily buy supplies in preparation for a hurricane or other emergencies.  If they have to evacuate, they have the money or credit availability to travel, buy gasoline, pay for lodging and survive without a paycheck for a number of weeks.  Most lower income families live from paycheck to paycheck.  So going out to the store and buying extra formula and bottled water may be next to impossible because they don't have the extra money to buy extras of anything.  Their credit may be maxed out and their car barely running.
https://www.cnbc.com/2017/08/24/most-americans-live-paycheck-to-paycheck.html

Segrave-Daly recommends that a mom who is pumping buy 1-2 hand pumps.  Depending on the pump that could cost at minimum $60 (not a battery-operated pump).  Not sure how an unemployed mom or a family of low income could afford that along with all the necessities needed to prepare for an emergency?  She mentions batteries for a hand pump.  Batteries are very expensive.  Any emergency that goes on for weeks (Hurricane Maria in Puerto Rico--no power for many for as long as a year).  Batteries are the first thing to go off the shelves of local stores--so finding batteries after a storm is usually an impossibility.  Same story for gasoline after a hurricane or emergency, no gas and if electricity is out no pumps at gas stations work.

I have lived in Florida since 1978 and been through a number of hurricanes.  The worst one was Charlie and I had no power for 11 days.  No stores or gas stations were open for some 2-3 days, no phones-cause cell phone towers came down.  September in Florida is one of the hottest months of the year.  No ice for coolers for several days.  Many roads impassable because of downed trees and power lines, traffic lights not working and many people did not understand that meant intersections were 4-way stops.  This area was hit by Matthew (category 3) in 2016 and Irma (category 3) in 2017.  We had mostly wind damage but flooding in some areas.

Fed Is Best emergency pamphlet mentions buying 4-7 day supply of ready-to-fed bottles of formula (mentioning single use bottles of formula).  Very expensive and depending on where one lives of limited supplies in stores.  The pamphlet mentioning buying extra bottles and nipples.  Also mentioned is buying a 4-7 day ready-to-feed toddler foods.  Expensive products to buy and families living pay check to pay check may find this impossible to purchase.  Also this supposes that the emergency situation lasts only 4-7 days.  We know that some emergencies may last much longer.

The pamphlet suggests storing a 2-week supply of clean water.  This may be an impossibility.  Those families with wells rather than city water supplies may have wells that don't work because pumps need electricity.  And wells may be contaminated and need to be tested.  Even city water supplies can be contaminated.  

The most careless suggestion in this pamphlet is about cleaning bottlefeeding supplies without power or hot water.  I consider it pretty risky to clean bottlefeeding supplies in cold water., particularly if a mom has a newborn or preterm infant.  A camping propane stove or barbecue grill (used outside-concern about carbon monoxide) can heat up water easily for washing bottles and nipples.  But may be an impossibility for low income families, if they have already spent most of their money on extra formula and bottles. 

The pamphlet mentions using a freezer with frozen ziplockbags of water.  I had a very large chest freezer and by day 4-5 with frozen 1/2 gallon containers of water it would be totally defrosted.  So thinking that a freezer will store your formula or breast milk is dependent where you live--tropics/subtropics, on the length of power outage, whether you have a generator (and gasoline is available--generators need to be outside because of carbon monoxide), and availability of ice.  

While it is not surprising that there is no suggestion or encouragement on Fed Is Best website and pamphlet to exclusively breastfeed, I find it very troubling.  I can only believe that the author, Jody Segrave-Daly has never really experienced living through a hurricane or a seriously large emergency situation.  Nor does she have an understanding that her suggestions reflect a limited view of breastfeeding, pumping, formula feeding and its true effect on families of limited means.  I think Hurricane Florence will be a lesson for many people regarding the length of an emergency situation and the health repercussions.  I can only hope that health workers/researchers will carefully track infant feeding as related to  infant mortality and morbidity in North and South Carolina.  The presumption that there will always be electricity, grocery stores open, gas stations open and that an emergency will only last 4-7 days is short-sighted.  The belief that infant formula will always be available and that clean water will be available no matter what emergency is a blindness to reality.  But then the Fed Is Best organization is quite blind to everything but their mission;  all babies using infant formula or pumped human milk and maybe breastfeeding a little bit.
Copyright 2018 Valerie W McClain






No comments:

Post a Comment