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 (Nestlé) 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

"The Beast is the Breast." Exclusive Breastfeeding Tales

"'I think we've conquered the social media thing," says Barston, who has witnessed the evolution of online discussion of infant feeding go from 'beast is breast'  to 'fed is best' since launching her blog, The Fearless Formula Feeder nearly a decade ago." --interview of Suzanne Barston at mother.ly
 https://www.mother.ly/news/formula-feeding-mamas-need-support

The Fearless Formula Feeder Conquers Social Media or 
The Beast is Breast
 
I think the author of this article, "Formula Feeding mammas don't feel supported--and that needs to change," at mother.ly meant "Breast Is Best" not "beast is breast," but I am not sure.  Was it a Freudian slip?  Did the author know that Suzanne Barston, the Fearless Formula Feeder, who she was interviewing is now a corporate journalist for an infant formula company (AbbVie--parent company is Abbott Labs marketer of Similac infant formula)?  

The Fearless Formula Feeder's constant attacks on breastfeeding advocacy now appear obviously slanted because she really was a shill for an infant formula company.  People believed that her statements were legitimate.  Breastfeeding advocates turned against their own advocates for "shaming" formula feeding mothers.  I can see the infant formula industry clapping their hands in joy.  Not only was this media blast of Barston's encouraging more formula feeding but she turned breastfeeding advocates against each other with accusations of shaming.  Barston is quite proud of herself and her accomplishment and in this article shares the spotlight by giving thanks to the Fed Is Best Foundation.

"According to Barston, moms who physically can't breastfeed or who don't produce enough milk are more supported now than ever before, thanks in large part to the efforts of organizations like The Fed Is Best Foundation and its co-founders, Dr. Christie del Castillo-Hegyi and B. Jody Segrave-Daly, who advocate against formula stigma in an effort to protect babies from dehydration and starvation."

A month later (August 7, 2018) Suzanne Barston is interviewed by PR News (a Public Relations news outlet) and asked, "Why healthcare communication professionals have been slower than other industries to make the transition to social media?"  Her response,

"Typically it comes down to two things: regulations and fear. Social is a wild animal, and once you let it out of the cage, you need to be prepared to fight back. This makes all corporations uncomfortable, but when you add in the intense scrutiny healthcare is under (and I’m not just talking about pharma, but hospitals, insurers, and even individual physicians – have you seen the backlash when doctors advocate for vaccinations, for example?), it brings it to a whole other level." 
 https://www.prnewsonline.com/abbvie-social-earned-media-suzanne-barston

Yes, I would say that the Fearless Formula Feeder let the animal out of the cage.  No wonder AbbVie/Abbot Labs hired her.  She did a great hack job on breastfeeding promotion and now she gets to enter the big time arena, pharma.
I find it fascinating that she gets to play the Fearless Formula Feeder while getting paid by a company that makes its profits from the destruction of breastfeeding.  Who needs ethics these days?

Iatrogenically-caused inadequate breastfeeding in the newborn

Meanwhile,   the Fed Is Best Foundation, social media buddies of the Fearless Formula Feeder, continues to spread the media message that exclusive breastfeeding is not safe.  Their stories of infant starvation caused by exclusive breastfeeding are horrifying.  Yet are these tragic stories the result of exclusive breastfeeding or the result of iatrogenic events?

What is an iatrogenic event?  Here's is a definition,

"When medical or surgical treatment causes a new illness or injury, the result is considered to be iatrogenic." 
https://www.verywellhealth.com/what-is-iatrogenic-2615180

How did the human race survive, if exclusive breastfeeding caused dehydration and starvation in babies?  We know that breastfeeding newborns/infants before the advent of the infant formula industry meant infant survival.  Few infants fed foods or other animal milks back then, survived.

Is dehydration and "starvation" in breastfed infants caused by exclusive breastfeeding?  Fed Is Best uses the term, starvation-an emotive word that is not truly an accurate term. Do formula fed infants get dehydrated?  Yes, they do.  And formula fed infants also starve to death, particularly in famines, wars and disaster zones where the supplies of infant formula are non-existent or severely limited due to the chaos of war, hurricanes, floods, or earthquakes.   

Are the causes of dehydration and starvation in breastfed infants the same as formula fed infants?  Yes and no.

Diarrhea is a known cause of dehydration in infants and children.  It has a high rate of infant morbidity and mortality.  Infants fed infant formula are at a greater risk for dehydration due to the renal solute load (high protein and sodium load) of infant formula.  Cow's milk has a higher renal solute load than infant formula and is the reason why cow's milk is considered an inappropriate substance for infants.  Breastmilk has the lowest renal solute load and therefore is less of a stress on a young baby's immature kidneys.

"There is strong epidemiological evidence that the feeding of cow's milk or formulas with similar potential renal solute load places infants at an increased risk of serious dehydration." --EE Ziegler
 https://www.ncbi.nlm.nih.gov/pubmed/17664905

One would suppose that breastfeeding, particularly exclusive breastfeeding, would lessen the risk of dehydration in newborn infants.  Unless the baby for various reasons has:  a birth defect or infant birth trauma, tongue-tie, excess sleepiness due to maternal medication, first time mother or first time breastfeeding mother of subsequent babies; and is at higher risk for breastfeeding difficulties that could lower milk supplies.  A medical staff that does not prioritize a first-time breastfeeding mother as needing more assistance, or is ill-informed about how to observe actual breastfeeding, looking for suck/swallow patterns creates greater risk for inadequate breastfeeding.  Infants younger than 39 weeks at birth are at a higher risk for complications such as lung immaturity, jaundice, difficulty with feeding, digestive difficulties and various other risks.  Therefore the need is for greater observation of the infant while supporting breastfeeding.  Infants that have sustained bruising during birth, will have higher jaundice levels due to red blood cells being processed out of the newborn's body. 

Birthing medications and practices impact breastfeeding and inadequately trained medical staff compound the problem.  Is a hospital birth reflective of a normal birth?  Is birth a medical event that must be managed, timed, and quantified?  Does managing birth with drugs and machinery improve health outcomes for mothers and babies?  There is reason to question the current birthing practices used in US hospitals because statistically maternal and infant mortality is increasing, particularly for African American populations.  Despite all the machinery and drugs and testing, birth has become a risky business in the USA.  And likewise exclusive breastfeeding like natural childbirth is medicalized, considered too risky, and cannibalized into a medical version that traumatizes mothers and babies.

For example the standard use of IV fluids in laboring mothers can have side effects to the mother and to the newborn. There are 3 common IV solutions used for laboring mothers who are not allowed anything by mouth (normal saline/sodium chloride, Ringers lactate, dextrose).  Side effects mentioned regarding saline/sodium chloride IV's for adults:  hypernatremia, heart failure, kidney damage, electrolyte abnormalities, etc.  Side effects mentioned for neonates is intraventricular hemorrhage.
 https://www.medicinenet.com/sodium_chloride_solution-intravenous/article.htm#what_is_sodium_chloride_solution-intravenous,_and_how_does_it_work_(mechanism_of_action)?

or

"In neonates or in very small infants even small volumes of fluid may affect fluid and electrolyte balance. Care must be exercised in treatment of neonates, especially pre-term neonates, whose renal function may be immature and whose ability to excrete fluid and solute loads may be limited. Fluid intake, urine output, and serum electrolytes should be monitored closely."
https://www.drugs.com/pro/dextrose-and-sodium-chloride-injection.html

The use of IVs in labor within hospitals is so common that one may be unaware that IV solutions carry risks for some adults.  Consider that the IV solution used for a laboring mother is adjusted to the weight of the mother not the neonate in utero.  After the birth, the newborn appears disinterested in nursing, losing incredible amounts of weight, or is diagnosed with hypernatremia.  The assumption by Fed Is Best followers is that these problems are caused by exclusive breastfeeding.  Reality may be that IVs in laboring mothers have side effects and seems highly likely that side effects may be unrecognized in newborns.  Studies are now showing that the huge weight losses we are seeing in breastfed newborns after birth are related to IV solutions given to laboring moms.  A 150-pound mother loses 1 pound in 24 hours is of little concern. On the other-hand a 6-pound infant loses 1 pound in 24 hours represents a huge amount weight for its body size.  Rapid weight loss in adults may cause electrolyte imbalance, dehydration, fatigue, irritability, muscle loss, etc.  The recommendation for weight loss in adults who want to lose weight is 1-2 pounds a week.  Yet some newborns may lose up to 1 pound in 24-48 hours after birth.  Might IVs be a far more serious risk for newborn problems than pinning the blame on exclusive breastfeeding?  Do many US medical institutions and staff have the knowledge to support exclusive breastfeeding in the newborn period?  Inadequate breastfeeding in the US is caused by iatrogenic factors during the early postpartum period.  Change birthing practices (like standard IV use-let moms drink and eat according to their thirst and hunger) in the US would lower the risks of dehydration and jaundice.  Educate medical staff and parents to recognize the importance of more support and care for first time breastfeeding mothers. 

Organizations that have no credentials in supporting breastfeeding and in some cases are linked to infant formula companies should not have a seat at the table of US government breastfeeding policies.  People who have credentials such as CLC or IBCLC who are involved in these organizations should have their credentials revoked.  It is obvious that these people have chosen to blame breastfeeding for iatrogenic issues that cause inadequate breastfeeding.  They are ill-informed and don't deserve the credentials that they use and it dishonors all of us who have worked for years to promote and protect breastfeeding.

The Beast is the Breast, seems to me to be an accurate description of the fears that these organizations promote.  They fear the Breast because it represents a nature that must be controlled, conquered.  It must be isolated, weighed, measured and lo and behold it is found deficient.  Blinded by our artificial world, they blame the very thing that they should support. 
Copyright 2018 Valerie W. McClain






 

The historic slogan, "Breast Is Best."

                                    "BREASTFEEDING IS BEST"
                                                  --Henri Nestlé, 1867

According to Nestlé, Henri Nestlé wrote a book, Memorial of the Nutrition of Infants, in 1867 in which he stated that, "Breastfeeding is best."  Of course, don't tell this to the Fed Is Best Foundation or the Fearless Formula Feeders of the internet who blame breastfeeding advocates for this slogan.  I guess I understand now why some breastfeeding advocates don't like the slogan either.  But breastfeeding advocates never say that it is because Henri Nestlé coined the phrase and the company plus the rest of the infant formula industry have used this phrase.  Early this morning, I just kept thinking about where the slogan, Breastfeeding Is Best, came from.  Where did I first read it?  And then it dawned on me that I saw it on cans of infant formula.  But I never thought it was a 151 year old infant formula slogan,
http://www.nestle.com/asset-library/documents/creating%20shared%20value/products%20and%20consumers/infant_formula_marketing.pdf

It appears to me that the Fed Is Best Foundation and the Fearless Formula Feeders believe it is a sentence used by breastfeeding promoters to shame women who use infant formula.  No, nada, we all use this slogan around the world.  Is it to shame mothers who don't breastfeed?  No it's what we call, the power of advertising!  Having an advertising slogan last a century and a half and still impact the public is pretty amazing.  Although it actually scares me.  What other thoughts that rattle around in my brain are really just some corporate slogan to influence me and make me buy a product? Think of all the people influenced by Nestlé since 1867.  It's a mindset, we are the empty slates in which corporate influence marks its territory.  One world brain stumbling through life repeating corporate slogans over and over again.  I have heard some people say breastfeeding is better, to make moms feel better about their choice.  But actually Nestlé has the very best.....chocolate (I remember this slogan from my childhood in the 1950s and can even see the commercial cause I loved the commercial and begged my mom for chocolate milk--never remember my mom buying chocolate milk.  Although I did beg my mom for Tang, and other various advertised products.  My Mom bought Tang, "The Breakfast Drink," (advertising slogan remembered from my childhood) but I really was not impressed.  I liked mixing it up and using more powder than I was suppose to or just eating the powder cause it was tangy.  The power of advertising to children on TV.  

I  was fascinated by Nestlé's pdf file in which they state, 

"DOES   support WHO's global public health recommendation calling for exclusive breastfeeding for six months..."

http://www.nestle.com/asset-library/documents/creating%20shared%20value/products%20and%20consumers/infant_formula_marketing.pdf

So an infant formula company supports exclusive breastfeeding for 6 months but Fed Is Best and Fearless Formula Feeders do not support WHO's global public health recommendations on exclusive breastfeeding.  Rather interesting that the infant formula industry would support the WHO Code, while these organizations promote their unscientific views of infant feeding.  Of course maybe this is just words by Nestlé with no real intention of support of the WHO's global public health recommendation of exclusive breastfeeding.  And maybe after these Public Relation organizations saturate their media messages on the internet, this infant formula company will change its tune and no longer support the WHO's global public health recommendations. 

So next time someone tells you that "Breastfeeding Is Best" makes formula feeding moms feel bad and shamed.  Tell them to blame Nestlé!  We are all trapped by the influence of corporate advertising.  And sometimes we get trapped for 151 years!!
2018 Valerie W. McClain



 

Infant feeding: Survival or Choice?

"If a multinational company developed a product that was a nutritionally balanced and delicious food, a wonder drug that both prevented and treated disease, cost almost nothing to produce and could be delivered in quantities controlled by consumers' needs, the announcement of this find would send its shares rocketing to the top of the stock market."  --Gabrielle Palmer, The Politics of Breastfeeding. (page1)

I read The Politics of Breastfeeding, when it was first published.  It seems like a life time ago.  I loved the book and shared it with a number of people I knew.  I never got it back but understood why someone would keep the book. So I bought another copy, a newer edition.  The above quote from Palmer's book was one of my favorites and of course she states after that sentence, "Women have been producing such a miraculous substance since the beginning of human existence."   

The statement is certainly a true statement. Yet the statement troubles me now.  The problem is that various multinational companies are mining human milk for the components that make it such a miraculous substance.  Through patenting, they can claim that genetic engineering duplicates the substance.  Of course anytime you mine a natural resource there will be costs passed onto the consumer.  So what was once a free resource has a price.  The infant formula industry is just part of many industries competing for patents on the components of human milk.  There is the vaccine, drug, food and supplement industries that somehow obtained that precious liquid, isolated its components, studied those components, and then proclaimed that they have found the magic bullet to create health.  

The good men and women of science believe in isolation, that separation from the whole can make powerful medicine.  Yet nature does not do isolation.  Isolation in nature is failure, life depends on multiple interconnections.  We see this when looking at the human body.  The organs and tissues of the body work in synchrony, disturb one organ or tissue and its impact is felt throughout the body.  Or consider how one simple act of spraying DDT to kill bugs, results in dead song birds.  Or dumping toxins in a river ends up with human clusters of cancer or birth defects.  The web of life is a complex system.  Disturb one small part of it and we often witness the ripple effect of the consequences of that disturbance. The sad thing about human disruption of nature is that often we do not see the consequences until it is too late. 

Life is complex and the wonder of it never ceases to entertain me.  The internet entertains me, for it too is a web, a web of ideas that ripple across the world.  The impact of those ideas can be beneficial or detrimental to our society.  We can easily get a distorted view of various subjects or we can see our politics more clearly.  I recently read a NY Times article, Breast-Feeding or Formula?  For Americans, It's Complicated by Christina Caron (July14, 2018)

 https://www.nytimes.com/2018/07/14/health/trump-breastfeeding-history-nyt.html

It was an attempt at being a balanced article on breastfeeding and infant formula.  Yet I immediately began to suspect that this article had an agenda.  The author gives us a little history,

"Wet nursing, which began as early as 2000 B.C., was once a widely accepted option for mothers who could not or did not want to breast-feed, but it faced criticism during the Middle Ages and the Renaissance. The profession eventually declined with the introduction of the infant feeding bottle in the 19th century."

Wet nursing was widely accepted because; if a mom refused to breastfeed her infant, the baby died.  If a mom died in childbirth, the need for someone to nurse the baby was imperative.  Who hired wet nurses?  Wealthy women.  I would not describe the history of infant feeding as one of options.  Rather I would describe it as survival.  In the text book, Breastfeeding and Human Lactation, 2nd edition (page 5)

"Wet-nursing may not have been the earliest alternative to maternal breastfeeding, but it ws the only one likely to enable the infant to survive."


Choice is the current ideology (promoted by the infant formula industry). Making it seem as, if women have always demanded options in infant feeding is not particularly accurate.  To ignore the connection between breastfeeding and infant survival, is to ignore a crucial fact regarding the history of infant feeding.  But choice as the bedrock of infant feeding,  does serve the purpose of this NY Times article.

The article goes on to telling an abbreviated history of infant feeding and the information seems geared towards sending a message that the US policy on breastfeeding is based on the need for choice and has always been that way.

"A couple of years later, in 1981, the W.H.O. voted 118 to 1 to adopt a nonbinding code restricting the promotion of infant-formula products. The United States, under President Ronald Reagan, was the lone dissenting vote.

The decision drew a chorus of critics, much like the Trump administration’s recent stance on the marketing of powdered formula to women in developing countries.

Elliott Abrams, then the assistant secretary of state for international organization affairs, said in 1981 that it was a free-speech issue."

But the article never mentions the Senate hearings lead by Ted Kennedy, a Democrat, in 1978 regarding the marketing of infant formula in developing nations which lead to talks which eventually resulted in the creation of the WHO Code. And yes I know a Republican administration (Reagan) refused to sign the WHO Code.

  

 Instead the impression left by this NY Times article is that politically the US has always been against the WHO Code.  The article leaves me with the belief that one side of the story is being told.  Might we believe that this is an issue of infant survival? The WHO Code was designed to save infants from illness and death.  Why do some Americans (and the industry) say this is a free speech issue? When a product sickens and kills some infants, how many infants should we accept as collateral damage?  (considering that 4-6 infants per year are damaged and/or die due to the intrinsic contamination by Cronobacter sakazakii in powdered infant formula, and many more from Salmonella)

The author briefly mentions the tragedy of the infant formula company, Syntex, that decided to delete salt from their formulas, Neo-Mull-Soy and CHO-free. It was believed that 22,000 US infants were affected by this change in formula.  Babies suffered serious health consequences due to the salt deletion.  Two mothers waged a campaign that eventually saw the creation of the Infant Formula Act of 1980.  Here is an article on the mothers who helped change US law regarding the regulation of infant formula.
 https://www.washingtonpost.com/archive/politics/1980/10/11/how-two-angry-mothers-beat-uncle-sam-at-his-own-game/e26a2490-72e6-4720-8d57-5c1b6887e536/?noredirect=on&utm_term=.c80256834a33

Fed Is Best movement emerges as the last topic of the author's history of infant feeding.  The author seems to believe that since the Infant Formula Act of 1980 that formula in the US is safe and bottles are safer because they are BPA-free.  Let's not bring up the fact that there are studies that the BPA-free plastics are not any safer than the BPA bottles.
https://www.scientificamerican.com/article/bpa-free-plastic-containers-may-be-just-as-hazardous/

The author mentions that Similac has organic formula.  Interesting that the author mentions a specific company.  I question this statement since I believe this "organic" product has the Martek oils made from algae and fungi.  These oils are genetically engineered, use hexane for extraction and are not considered organic by organic standards.
https://www.organicconsumers.org/news/brand-name-organic-infant-formula-ingredients-processed-toxic-chemical#close

The author states, 

"What is often missing from the debate over breast vs. bottle is the fact that so many women do both. Breast-feeding is still considered the gold standard, but formula supplementation is commonplace, especially as women return to work after maternity leave. For many mothers, this is the best of both worlds."

Mothers can have it all, the best of both worlds? Or does one negate the other?  Certainly, the infant formula industry can have it all.  The last statement the author makes in the article,

“Malnutrition and poverty are the precise settings where you absolutely do need to breast-feed,” Dr. Michele Barry, senior associate dean for global health and director of the Center for Innovation in Global Health at Stanford School of Medicine, told The New York Times. “Because that’s the setting where access to safe and clean water for reconstituting powdered formula is often impossible to find.”

Choice in infant feeding decisions is predicated on the belief that safe and clean water exists in every town in the US and other developed nations.  Yet tell that to the moms in Flint, Michigan where the levels of lead in their water require the use of expensive filters or buying bottled water.  Or tell that to the families that live down river of the teflon manufacturing plants.  Or tell that to people who read their water department statements.  Cryptosporidium is a parasite that infects water causing diarrhea and other ailments.  It is commonly found in lakes and streams contaminated by animal feces. In immune-compromised individuals it is so serious it may cause death.  It is suggested that severely immune-compromised individuals boil their water. Disinfection is difficult to do because the egg cell is immune to chlorination.  
http://www.health.state.mn.us/divs/eh/water/factsheet/com/cryptosporidium.html

Some babies born prematurely are considered immune-compromised.  Babies not breastfed may be considered immune compromised depending on your viewpoint.  The risk is the water and even if a formula fed infant is not considered immune-compromised, there is an obvious risk of diarrhea.  And diarrhea in an infant is a known-killer.  This article is from 1988.  Has water supplies in the US improved since 1988 or are we faced with another important element of our infrastructure that is broken? 
https://www.nytimes.com/1988/12/09/us/infant-diarrhea-kills-hundreds-yearly-in-us.html

The last quote from Michele Barry failed to mention that she is the director of the Yale/Stanford Johnson & Johnson Global Health Scholar Program.  One might presume that Johnson & Johnson funds this Scholar Program.  Johnson & Johnson sells pharmaceuticals and seems very involved in research regarding hiv/aids in Africa (they are working on a vaccine for hiv). Hm, now why would Michele Barry be interviewed for an article on infant feeding history that also involves the Fed Is Best organization?  

I still very much appreciate The Politics of Breastfeeding.  The last few sentences in the book state,

"A creature from another planet visiting the Earth might ask, "If women are the ones that keep the human race going, why do they get the rough deal?"

Why indeed?  Why is women's history so unknown?  Why does a NY Times reporter distort the history of infant feeding?  Perhaps she needs to read, The Politics of Breastfeeding?  Maybe we should develop a book campaign and send this book to Christina Caron as well as the founders of Fed Is Best?  I imagine they wouldn't read it--too political?  Telling half the history, leaving out the reality is another political choice.  Getting half the story does not illuminate the issue but mentioning all those wonderful products (Similac, bottles) we now have certainly tells us that consumerism is the prime directive.  Choice in products becomes the reality of our world.  
2018 Valerie W. McClain

Grassroots organizations or astroturf? How US Breastfeeding Policy Is Influenced.

"Journalism is printing what someone else does not want printed:  everything else is public relations."  --George Orwell

Suzanne Barston, CLC (Certified Lactation Consultant) is employed by AbbVie, a spinoff company from its parent company Abbott Labs.  And silence rains upon the land.  No one's talking, including breastfeeding advocacy organizations.  I did ask the certification organizations for the credential CLC, if they would care to comment.  Nope, nada and they can't even tell me whether Suzanne Barston is still certified or not.  Fascinating how blinded organizations are in regard to the infant formula industry and its influence.

Speaking of influence, exactly who influenced the US Health Department regarding the US position on breastfeeding at the World Health Assembly in May of this year?  Could it have been a task force meeting held in February by the US National Institute of Child Health and Development?  The Task Force was created regarding research on pregnant and lactating women (PRGLAC).

"The 21st Century Cures Act established PRGLAC to advise the Secretary of Health and Human Services (HHS) regarding gaps in knowledge and research on safe and effective therapies for pregnant women and lactating women.  PRGLAC is tasked with identifying these gaps and will report its findings back to the Secretary." https://www.nichd.nih.gov/About/Advisory/PRGLAC

**The US Secretary of Health and Human Services is Alex Azar, previously President and CEO of ELI Lilly and Company (US Division) and delegate in May of this year to the World Health Assembly's meeting on breastfeeding.  The US threatened various delegates about their support of breastfeeding.  And made various proposals to change the language of breastfeeding support.

The people who attended the February meeting held by the NICHD that reported to the Secretary of HHS, Alex Azar, included 3 members of the Fed Is Best Foundation-Beth del Castillo, Dr. Christie del Castillo-Hegyi, and Jody Segrave-Daly, RN, IBCLC. Representatives from various companies were there:  Novartis, Eli Lilly, and various government representatives of the CDC, FDA and NICHD.  Also various representatives from US hospitals, for example well-known in breastfeeding research, Diane Spatz.
https://www.nichd.nih.gov/sites/default/files/2018-03/PRGLAC_PostMeetingParticipants.pdf

Representatives from Lippe Taylor, a PR company also attended this meeting.  Their clients just happen to be, Nestle, Gerber, Pfizer, Reckitt Benkiser (Mead Johnson), P&G, Johnson & Johnson, Myriad, etc. Also the American Gastroenterological Association (AGA) which has an interest in the gut microbiome.
https://lippetaylor.com/

I have no idea how one gets an invitation to these meetings (not always the same people invited).  I am particularly curious how the FIB (Fed Is Best) Foundation was able to get seats at this particular meeting.  I certainly don't consider Jody Segave-Daly, RN, IBCLC to represent my views or those of IBCLCs I have known over the years.  And I most definitely feel that Dr. Christie del Castillo-Hegyi has little understanding of breastfeeding research.  Although she obviously is quite brilliant, having co-invented a patent with Edward A Berger, well known US government molecular biologist, using a genetically engineered monoclonal antibody against hiv.   

"A neutralizing monoclonal antibody (MAb) with potent and broadly cross-reactive activity would have great potential value in protocols aimed at preventing HIV infection before or immediately after exposure, for example in neonatal transmission, post-exposure prophylaxis, and as a topical inhibitor. Such a MAb may also be useful in treating chronic infection (D'Souza et al. J. Infect. Dis. 175:1056-1062, 1997). "  US Patent #8420099 owned by the United States of America as represented by the Secretary of the Department of Health and Human Services

MAb's can be created by using human milk fat globule and injecting into mice.  
https://www.researchgate.net/publication/20495176_Antibodies_to_Human_Milk_Fat_Globule_Molecules

Although this patent does not appear to use these older techniques to create MAb's.  But surprised that Dr. del Castillo-Hegyi can be an expert in molecular biology while also attending medical school.  Yet fail to understand breastfeeding research.

Some people may have first heard of the FIB Foundation, when Suzanne Barston introduced Dr. Del Castillo-Hegyi on her Fearless Formula Blog in 2015.
http://www.fearlessformulafeeder.com/2015/05/interview-with-dr-christie-del-castillo-hegyi/

I recently ran across an article by Dr. del Castillo-Hegyi and Jody Segrave-Daly, RN, IBCLC  on the World Health Assembly (WHA) breastfeeding decision.  I am amazed that they had so much information.  Information that I hadn't seen anywhere else regarding the suggestions by the US delegates in changing the language of breastfeeding support at the WHA.  They make the following statement,
"Two pediatricians, Dr. Alma Golden and Dr. Brett Giroir,  who were key members of the U.S. delegation attending the 71st World Health Assembly, wrote about the rationale for the U.S. opposition of the first draft"
https://fedisbest.org/2018/07/fed-best-foundation-response-u-s-delegation-actions-world-health-assembly/

Dr. Brett Giroir is Assistant US Secretary of the Department of Health and Human Services.  He is co-inventor to various patents owned by Baxter, Cytokine Pharma Science and Xoma Technologies.  Xoma technologies collaborates with many pharma companies including: Bristol Myers Squibb, Abbott, Elli Lilly and Company as well as the FDA.

Dr. Alma Golden works for USAID and is involved in faith-based organizations for family planning, HIV/AIDS in order to advance global health.

So I suppose I don't really wonder why the US delegates to the WHA seemed so breastfeeding unfriendly, lots of money riding on whether women breastfeed or not.  Read an article in Chicago Business from July 9, 2018.  It states,

"The Trump's Administration's moves to weaken a resolution promoting breastfeeding at an international forum had a potential local beneficiary, North Chicago-based Abbott Laboratories."
http://www.chicagobusiness.com/article/20180709/NEWS03/180709922/trump-s-moves-to-weaken-breast-feeding-standards-could-impact-abbott

I am left with a lot of questions about those who seem to influence US breastfeeding policy.  I understand industry's interest--its about the money.  But the FIB Foundation's interest in dismantling breastfeeding advocacy not just in the USA but world-wide is a curious thing.
Valerie W. McClain Copyright 2018



 

Corporate Journalism and the Fearless Formula Feeder

"Authenticity.  Listening.  Finding unique angles.  Those are the keys for journalists seeking earned coverage via social media, according to Suzanne Barston, manager, corporate journalism, corporate communications at AbbVie.  As founding partner of AbbVie's StoryLab, Barton is responsible for creating stories around the company's therapeutic areas, pipeline and philanthropy."
--Jim Aikon, "How AbbVie Leverages Social for Earned Media."  8/7/18
http://www.prnewsonline.com/abbvie-social-earned-media-suzanne-barston 

Reading this article was an eye-opening experience, particularly since I have written in this blog about Suzanne Barston, otherwise known as The Fearless Formula Feeder.  She is the author of the book, Bottled Up:  How the Way We Feed Babies Has Come to Define Motherhood and Why It Shouldn't.   When her book came out;  she did the usual publicity tour of talk shows, book signing, etc.  I remember watching her on one talk show and thinking how does someone who is virtually unknown able to garner so many public and media appearances?  For that matter how did she get published?  I chalked it up to her being a writer and editor for health and parenting publications.  But of course now I wonder about her employment with Abbvie.  Was she employed by Abbott Labs or Abbvie during the time she blogged and wrote her book?  Or was this job the ultimate reward for attacking breastfeeding advocacy, by a company that is a spinoff of Abbott Labs, manufacturer of Similac?

 In 2011 Abbott Labs announced in the NY Times its intention to become 2 separate companies, a spinoff.  This became official in January of 2013.  Abbot Labs is considered the parent company.

 "A spinoff retains its assets, employees, and intellectual property from the parent company which gives it support in a number of ways, such as investing equity in the newly formed firm, and providing legal, technology, or financial services."
--definition of spinoff,  https://www.investopedia.com/terms/s/spinoff.asp

Corporate Journalist, Suzanne Barston, states in a session brief about her talk. Speak Softly and Carry a Big Narrative:  When Quiet Stories Speak the Loudest,  posted at epharma,

"Complicating things further, patients and external audiences are more media savvy than ever.  They can smell the complexity of marketing behind our best efforts;  taste the inauthenticity in our paid influencer communications."

and last sentence regarding her intended talk,

"In this session, we'll examine how unbranded, journalistic content boosted a company's reputation in a tangible way, despite less-than-perfect metrics, and show how in the end, authentic storytelling is worth more than SEO [Search Engine Optimization-common term used by social marketing sites]."
https://lifesciences.knect365.com/epharma/agenda/3#think-like-a-patient_speak-softly-and-carry-a-big-narrative-when-quiet-stories-speak-the-loudest

Reading that last sentence I wonder whether her "authentic storytelling" that boosted a company's reputation is about her blog-The Fearless Formula Feeder? As a corporate journalist, she is concerned that media savvy people may "taste the inauthenticity in our paid influencer communications."  Well, I am tasting it and I am a bit angry.  Our corporate journalist totally denied and dismissed the breastfeeding advocates who smelled something fishy about her blog.  I wrote about it back in 2014, 
http://vwmcclain.blogspot.com/2014/07/marketing-infant-formula-with-magic-of.html

The really sad thing about this is that her blog has been quite influential.  Her blog influenced quite a few breastfeeding advocates and some breastfeeding organizations to tone down their advocacy for fear of causing shame in formula feeding mothers.  But she also was politically influential.  In a position paper written by Jennifer Doverspike in 2013 to the The Federalist, a Republican conservative think tank organization, Doverspike writes in the second paragraph of her 6 page paper,

"Don't believe me?  Just ask Suzanne Barston, the founder of a website dedicated to freedom in infant feeding choices.  Her blog, Fearless Formula Feeder (Tag line: Standing up for formula feeders...without being a boob about it) is about the battle to destigmatize formula feeding.  When Mayor Bloomberg announced his Latch On NYC initiative in 2012, Barston went nuclear."
--Jennifer Doverspike, The Literal Nanny State--Breastfeeding and Public Health Officials, The Federalist  
http://thefederalist.com/2013/10/29/literal-nanny-state-breastfeeding-public-health-officials/

Doverspike continues on to discuss the WHO Code as restrictive to access of formula, formula advertising and samples given to mothers.  She states, "The WHO Code appears to be organized around a simple, if dubious, premise:  It's always the evil corporations' fault."  Then she writes about Iran taking control of the import and sale of infant formula (only available by prescription).  She considers this madness.  She considers it an encroachment on personal freedom.

No, Jennifer Doverspike, this is not about personal freedom, its about corporate freedom to influence generations of parents to use their products no matter what the risks.  Her introduction of don't believe me, read The Fearless Formula Feeder website seems rather ironic.  Maybe it would be more truthful if this paper had just given out the Abbot Labs or Abbvie websites rather than Suzanne Barston's website.  Has this paper influenced US politics?  I would say so after reading about the performance of the US delegation to WHA (World Health Assembly) regarding support of breastfeeding.  This Republican Administration appears to be under the sway of this particular paper.

Doverspike gives breastfeeding its token benefits but states they are exaggerated.  Her concerns are supposedly about the USA becoming a "Nanny State," where personal choice becomes limited.  Yet I have to wonder, if the real concern is about propping up a billion dollar industry, so that there is no governmental oversight, no regulations? 

She states that the benefits of breastfeeding are exaggerated.  She ought to read a few infant formula patents in which the infant formula company just has to use a synthetic/genetically engineered imitation of a human milk component to improve or make a safer product.  Interestingly I have read various breastfeeding advocates who state there are no benefits to breastfeeding.  Ignorance versus ignorance seems to be the way of our media-crazed social marketing internet.

Well, Fearless Formula Feeder, aka corporate journalist (although I fear I will never like the word-journalist-any more);  how do you sleep at night?  Any regrets?  It feels like a con, smells like a con, by god we have been conned.
Copyright 2018 Valerie W. McClain

Down the Rabbit-Hole-part 2: "Money is the mother's milk of politics."

                 
"But there is a 'creation myth' that is blind to both, nature’s creativity and biodiversity as well as to women’s creativity, intelligence and knowledge. According to this 'creation myth' of capitalist patriarchy, rich and powerful men are the 'creators'. They can own life through patents and intellectual property. They can tinker with nature’s complex evolution over millennia and claim their trivial yet destructive acts of gene manipulation as 'creating' life, food and nutrition."  --Vandana Shiva, "Tackling 'Monocultures of the Mind'"
https://www.commondreams.org/views/2013/04/24/tackling-monoculture-mind

Glued to my seat, I stare at the computer screen.  I learn that some Americans are deeply surprised that breastfeeding is political.  And some people are surprised and shocked that US delegates to the World Health Assembly in May had tried and partly succeeded in watering down (only minor changes they say) an international resolution supporting breastfeeding.  Why am I not surprised?  The only thing I am surprised about is that it took 2 months for this information to make it to the US new's cycle!

The Trump/Republican Administration has its priorities.  Chaos becomes a priority, a smokescreen that hides intention.  Changing stories, repetitive lying is designed to create a level of mental chaos on one's opponents and everyone is an opponent.  People have to make sense out of the decision-making of this Administration.   And the reality is that this Administration is not about sense.  It's about distraction and chaos.  Trying to make sense of it, is a fruitless task.

Having lived 60-some years on this earth, I have on occasion met people who are driven to create chaos in their lives as well as in everyone else's life.  I learned to not waste my time analyzing their behavior, trying to make sense out of senseless actions.  Instead, I realized that there is no appeasement with those who choose to rein chaos down on your life.  Walking away, keeping a distance has been a solution.  But what to do when those who are governing a people are intent upon reining havoc upon their nation as well as other nations?  

The Business of Patents

Over the years I have been told many things in regard to my "obsession," about human milk component patenting.  I have been told by some breastfeeding advocates that patents don't mean anything. so I suppose that comment means I am wasting my time by writing about it.  Yet corporations spend thousands upon thousands of dollars in fees to the US Patent Office and thousands of dollars in IPR (Intellectual Property Rights) lawyers, and court proceedings. An international patent is estimated to cost over $100,000.  A US patent can cost from $12,000 (less complex patent) to $20,000 (software patents) in filing costs alone.  Then there are attorney fees ranging from $5000-$15,000.  Large corporations have multiple patents and patent applications.  Court costs for patent infringement cases can cost a million or so dollars. So if money has any meaning, then patenting appears to me to be a huge investment by corporations.  So patents on human milk components have a economic and political impact.  And that impact can be and is already showing to be a negative impact on the promotion of breastfeeding.

I have to dismiss this attitude that patenting means nothing.  In an editorial in Intellectual Asset Management (july/August 2012) titled, "Key issues in building a strong life sciences patent portfolio," the article states,

"Patents are the engine that drives venture capital investment and initial public offer funding, as well as mergers and acquisitions in the life sciences industries.  Venture capitalists, Big Pharma and the stock market all need to be convinced that a start up has enough IP protection to gain an edge over its competitors."

In the Boston Business Journal, Joe Hadzima, Jr., Senior Lecturer at MIT Sloan School of Management states,

"Twenty years ago patents weren't very valuable in the sense that they were not upheld in court that often.  Today as a result of changes in the patent laws, inventors are more often prevailing in multi-million dollar lawsuits.  For example, the holder of a patent on the bar code process has reportedly received over $450 million in royalties and judgments."

While many people may think that patents are meaningless, it is quite apparent that in the business world they have monetary value.  Dismissing the thousands of patents based on human milk component research as meaningless seems rather peculiar.  Particularly when some of those patents are owned by the infant formula industry.  Protecting the enormous investment in patents would seem like a probable outcome, particularly when a world organization asks for support for and promotion of breastfeeding.  No corporation wants to throw money away on its investments by supporting the competition.  And breastfeeding is the competition
   
"Money is the mother's milk of politics" *

"Money is the mother's milk of politics."  This quote was used in an article that went on to discuss how 3 infant formula companies (Abbott, Nestle, and Mead Johnson which is now Reckitt Benckiser) spent $60.7 million on lobbying US lawmakers  during the last decade.
 https://maplight.org/story/infant-formula-makers-sweetened-mothers-milk-of-politics-with-60-million-in-lobbying-funds/ 

So not only does the infant formula industry use advertising to consumers to influence the buying habits of families but they also lobby the government in order to influence policy.  This influence peddling is not new but is an ongoing situation in which corporate interests influence health care policies.  Another form of influence is when heads of various governmental agencies have corporate backgrounds. For example the current head of the Department of Health and Human Resources, Secretary Alex Azar was President of Eli Lilly from 2012-2017 and also was on the Board of Directors of the organization BIO (Biotechnology Innovation Organization-trade association supporting biotechnology-genetic engineering-Monsanto). During his confirmation hearings for the job of Secretary for the Department of Health and Human Resources, he was questioned about his role in Eli Lilly's gaming of the patent  system by extending their erectile dysfunction drug-Cialis by testing it on pediatric patients who had a rare muscle-wasting disease.  
https://www.politico.com/story/2018/01/08/trump-azar-patent-drug-company-268942

As Secretary of the Department of Health and Human Resources, he is in charge of the reunification of immigrant families seeking asylum at the border.  He made statements about this reunification process that, "There is no reason why any parent would not know where their child is located."  And stated that the Department of HHS was acting out of "generosity for immigrant children."  All of these statements contradicted by the facts brought out by various news organizations and the ACLU.

Secretary Alex Azar was the head US delegate to the May meeting at the WHA (World Health Assembly) in which Ecuador was to introduce a supportive statement regarding breastfeeding. Most of us have heard the rest of the story.  Ecuador felt threatened and backed down and the Russian delegates made the introduction to support breastfeeding.  The US delegation says they did not threaten anyone.  But obviously something happened.

The US Deputy Secretary to Secretary Alex Azar is Eric D. Hargan who previously has been shareholder in a lobbying firm, Greenberg Traurig LLP.  Some of the lobbying firm's clients were Bayer (a pharmaceutical company that also manufactures infant formula), Albertson's Grocery, Samsung. etc.
https://www.opensecrets.org/revolving/rev_summary.php?id=71406

According to the Washington Examiner on the WHO meeting on sugar taxes,
"Eric Hargan, the U.S. deputy secretary for health and human services, reported that he was the commissioner who blocked advocacy for a levy on sugar on the said panel, arguing it was not clear that imposing taxes on sugary drinks like sodas and fruit juices would improve public health."
 https://www.washingtonexaminer.com/opinion/trump-administration-blocks-who-from-calling-for-sugar-taxes

Those who were appointed to the US Health and Human Services agency seem to side with business interests at the WHO.  One would suppose that this agency would be supportive of health promotion not business promotion.  But not to many people realize that the US Department of Health and Human Service owns patents.  They even own a patent on human lactoferrin (a component of human milk).

Patent #5948613, in which they state the following,

"Another embodiment of the present invention relates to a method of treating a condition in a patient characterized by a deficiency in lactoferrin by administering to the patient an amount of human lactoferrin according to the present invention in sufficient quantities to eliminate the deficiency. The conditions include neutropenia, AIDS, skin infection, gastrointestinal bacterial overgrowth syndrome, vaginal infection and septic shock."

The patent was filed in 1996, so it is a dead patent.  A patent is valid for 20 years from date of filing, although extensions are possible.  Fascinating that the US Department of Health owned a patent that stated that human lactoferrin, a component of human milk, could eliminate a variety of health issues including AIDs.  Yet, they are not supportive of breastfeeding by women who test positive for hiv.  Maybe they forgot to read their own patent? Or maybe it is that money is the mother's milk of politics?
Copyright  2018 Valerie W. McClain

* "Money is the mother's milk of politics," is attributed to statements made in 1960's by California Democrat, Jesse Unruh, who died in the 1980's.