Archive for the ‘Breastfeeding’ Category

November 22, 2013

Top Hospitals Putting an End to Formula Marketing to New Moms

Despite a wealth of evidence that breastfeeding provides the most health benefits for infants, many barriers — including rigid work conditions and lack of family or community support — can interfere with a woman’s ability to start breastfeeding, or to keep breastfeeding for at least six months.

Health advocates have long criticized the popular hospital practice of distributing infant formula to new mothers, because doing so descreases the length of time that women breastfeed — even when they have indicated a desire to try breastfeeding, and sometimes instead of providing lactation support (read this previous post, which discusses a report on Chicago hospitals in low-income neighborhoods).

According to the Centers for Disease Control, 77 percent of infants in the United States start out being breastfed, which is an increase over recent years, yet fewer than half are still breastfeeding at the six-month mark.

Many hospitals have banned pharmaceutical or other industries from providing marketing materials directly to doctors, in order to avoid conflicts of interest, but many hospitals still provide free formula samples directly to patients.

A new report from Public Citizen, however, suggests that more of the top hospitals in the country are agreeing to limit distribution.

The consumer advocacy organization looked at the top hospitals in the U.S. News and World Report rankings, both those with the gynecology specialty and maternal/newborn services and those on the general Honor Roll. It then surveyed those hospitals about their policies and practices, and checked against data from the national Ban the Bags campaign, which grew out of a Massachusetts effort to stop aggressive formula marketing.

Some of Public Citizen’s key findings:

  • Sixty-seven percent of top gynecology hospitals in gynecology reported not giving out bags sponsored by formula companies, formula samples, or other formula-related promotional materials
  • An additional 11 percent (5 of 45) limited samples and sponsored bags to those who request them, moms who are already planning to formula feed, or to Neonatal Intensive Care Unit patients
  • Eighty-two percent (14 of 17) of the best overall hospitals reported having a policy or practice against distributing these materials

Public Citizen recommends that the remaining hospitals on these lists also ban formula distribution, and discuss other interventions that public health departments and state legislatures can take to restrict the practice. As the report notes:

Numerous studies show that women are likely to breastfeed less, and for shorter durations, if they receive formula samples and promotional materials in hospital discharge packs. Formula bag distribution effectively influences new mothers to use formula because it sends a powerful message that hospitals endorse formula feeding, even where breastfeeding in hospitals is promoted.

One major effort to improve the support for breastfeeding in hospitals is the Baby-Friendly Hospital Initiative, endorsed by several major medical organizations. The Initiative sets standards for baby-friendliness, including breastfeeding support. The Initiative’s guidelines and evaluation criteria states that in baby-friendly hospitals, staff members should not receive donations from breast milk substitute providers, and mothers and their families should not be given marketing materials for formula or gift packs containing formula. The Baby-Friendly principles have been endorsed by several major medical organizations.

Ban the Bags provides a toolkit for advocating against these formula sample bags, which can be downloaded from its website, as a resource for taking action in your own community. As Ban the Bags puts it: “Hospitals should market health, and nothing else.”

November 7, 2013

Guides to Breastfeeding and Working

The American College of Nurse-Midwives recently published a free guide to breastfeeding and working, which carries tips for preparing to go back to work full-time, what to look for in a breast pump, how often to pump, and how to store milk.

The suggestions are very practical, although some — such as working part-time or working from home for a while — are not realistic for many women, especially in non-office or hourly jobs.

Newer legal protections for breastfeeding workers, however, should make some aspects of breastfeeding and work a little easier to manage. One rarely mentioned benefit of the Affordable Care Act (aka Obamacare) is that the act amended the Fair Labor Standards Act to require employers to provide breaks for nursing mothers to express breast milk for a year after the child’s birth.

Workplaces with 50 or more employees are required to provide “a reasonable amount” of break time for expressing milk as often as needed, as well as a functional space for pumping that is *not* a bathroom.

The employers are not required to pay for the time of these breaks. Employers with fewer than 50 employees might be exempt if they claim it creates a “hardship,” so it’s important to check on if you work for a small business. The Department of Labor provides more resources on this topic for workers and employers.

Some states also have laws that protect breastfeeding women in the workplace. Where the state law does a better job of protecting workplace breastfeeding/pumping, the state law is what applies.

See also: Previous posts and excerpts from “Our Bodies, Ourselves” on breastfeeding.

August 16, 2012

Mayor Bloomberg and the Debate (and Truth) over Breastfeeding and Formula

En Español

Women who choose to breastfeed need better support — on that point, there is no doubt.

Even when a woman wants to breastfeed, she may be forced to contend with numerous barriers, including: lack of family/community support; lack of workplace supports such as breaks and privacy; absence of paid maternity leave; expense of lactation support and pumping equipment (costs which are lessened, finally, thanks to the Affordable Care Act); limited education about breastfeeding among medical professionals; and limited breastfeeding education and hospital support that is culturally and linguistically appropriate. Any one of these can reduce the chances for successful and sustained breastfeeding.

Recently, New York City Mayor Michael Bloomberg provoked a fair bit of outrage with the launch of Latch on NYC, a voluntary hospital program that aims to promote breastfeeding. New York City hospitals that join the initiative agree to not distribute free formula or display formula-related advertising materials. These hospitals will also restrict staff access to formula, ensuring that it is provided only if a mother chooses to feed her baby formula or if supplementation with formula is medically indicated. In other words, staff will no longer provide formula as the default.

The idea of eliminating formula freebies and advertising in hospitals, and reducing non-necessary formula supplementation, is not particularly new or controversial in public health and breastfeeding support circles. The Baby Friendly Hospital Initiative (see detailed guidelines and evaluation criteria for hospitals seeking this designation), the 2011 Surgeon General’s Call to Action on Breastfeeding, and the World Health Organization’s International Code of Marketing of Breast-milk Substitutes all encourage hospitals to adopt similar measures.

What raises people’s ire, it seems, is the perception that the NYC program limits a mother’s choice, for whatever reason, to use formula. As Gayle Tzemach Lemmon wrote for The Atlantic, “it infantilizes women by telling them they are no longer adult enough to decide for themselves what is best for their families and themselves.”

New York City is trying to address such concerns and has published a document to make the provisions more clear. Here’s an excerpt:

Myth: The city is requiring hospitals to put formula under lock and key.
Fact: Hospitals are not being required to keep formula under lock and key under the City’s voluntary initiative. Formula will be fully available to any mother who chooses to feed her baby with formula. What the program does is encourage hospitals to end what had long been common practice: putting promotional formula in a mother’s room, or in a baby’s bassinet or in a go-bag – even for breastfeeding mothers who had not requested it.

That last phrase (emphasis mine) is a key point. As it turns out, giving formula to mothers who have indicated they want to breastfeed is all too common in hospitals. Offering a bottle when a mother needs help getting the baby to latch on or if she isn’t sure if she’s producing enough milk is simply easier and less costly than providing an on-call lactation counselor or developing a program with volunteer peer counselors who can offer support.

WBEZ in Chicago did a report on hospital breastfeeding rates that showed the difference a hospital initiative in support of breastfeeding can make. Not surprisingly, many hospitals lacking lactation consultants are in low-income neighborhoods, so those mothers are more likely to be steered toward formula even when their hospital chart indicates a preference for breastfeeding. Following the report, a Chicago hospital on the Southwest Side with the lowest newborn breastfeeding rate in the area — only 7 percent of newborns breastfed there — took steps to improve the statistics.

More from Latch On NYC:

Myth: Mothers who want formula will have to convince a nurse to sign it out by giving a medical reason.
Fact: Mothers can and always will be able to simply ask for formula and receive it free of charge in the hospital – no medical necessity required, no written consent required.

Myth: Mothers requesting formula will be subject to a lecture from the nurse.
Fact: The City’s new initiative does not set a requirement that mothers asking for formula receive a lecture or mandated talk. For the last three years, New York State Law under the Breastfeeding Bill of Rights, has required that mothers simply be provided accurate information on the benefits of breastfeeding. This requirement has not changed under the City’s new initiative.

Myth: Latch on NYC is taking away and/or jeopardizing a woman’s right to choose how to feed her baby.
Fact: The initiative is designed to support mothers who decide to breastfeed. For those women, the program asks hospital staff to respect the mother’s wishes and refrain from supplementing her baby with formula (unless it becomes medically necessary or the mother changes her mind). It does not restrict the mother’s nursing options in any way – nor does it restrict access to formula for those who want it.

If you accept the city’s clarifications, it’s more clear that the goal is to change hospital practices, not individual preferences. But as noted above, there are many other barriers to breastfeeding that such initiatives do not address. Over at RH Reality Check, Marianne Møllmann writes about the lack of paid parental leave and other real societal supports for breastfeeding.

Regardless of your personal choices around breastfeeding, it’s clear that women overall need better supports for making that choice. To further explore this topic, here’s a presentation OBOS Executive Director Judy Norsigian delivered at the third annual Breastfeeding and Feminism Symposium on the cultural, social and economic issues that prevent women who want to breastfeed from doing so. Also see our previous blog posts on breastfeeding.

End of English post.

El Alcalde Bloomberg y el Debate (y la Verdad) sobre la Lactancia y la Fórmula

Las mujeres que eligen amamantar sus bebes necesitan mejor apoyo — sobre este no hay duda.

Aún cuando una mujer desea amamantar, tiene que enfrentarse a varias barreras, incluyendo: falta de apoyo familiar y de la comunidad; falta de apoyos en en trabajo como pausas y privacidad; falta de baja de maternidad con beneficios; el costo del apoyo de lactancia y los sacaleches (costos que, finalmente, resultan más bajos gracias la Nueva Ley de Asistencia Asequible); limitación de educación sobre la lactancia entre profesionales médicos; limitación de educación y apoyo de lactancia en los hospitales que sean culturalmente y lingüísticamente apropiados. Cada cual puede reducir la oportunidad de seguir el amamantamiento.

Recientemente, el alcalde de Nueva York Michael Bloomber provocó un poco de indignación con el lanzar de Latch on NYC, un programa voluntario nuevo para hospitales que intenta promover el amamantamiento. Hospitales en Nueva York que se juntan a la iniciativa aceptan no distribuir fórmula gratis o exponer publicidades relacionadas a la fórmula. Estos hospitales también aceptan limitar el acceso de sus empleados a la fórmula, asegurando que solamente se provee cuando una madre lo elige, o si el suplemento con fórmula sea médicamente indicado. En otras palabras, la fórmula ya no será provista automáticamente.

Eliminar la fórmula gratis y sus publicidades en los hospitales, y reducir el suplemento no necesario, no es una idea nueva o controversial in el círculos de salud pública y apoyo de lactación. La iniciativa Baby Friendly Hospital Initiative (ver las directrices y los criterios de evaluación para hospitales buscando esta designación), la Llamada para Acción sobre la Lactancia del Director general de Salud Pública, y el Código Internacional de Publicidad de Sucedáneos de la Leche Materna de la Organización de Salud Mundial promueven que los hospitales tomen medidas similares.

Lo que molesta a la gente, me parece, es la percepción que el programa da NYC limita a la decisión las madres, por cualquier razón, de usar la fórmula. Como escribió Gayle Tzemach Lemmon en The Atlantic, “infantaliza a las mujeres, diciéndoles que ya no son tan adultas para decidir para ellas mismas lo que es mejor para ellas y sus familias.”

La ciudad de Nueva York está dirigiéndose a tales preocupaciones y ha publicado un documento para aclarar las provisiones. Vea un pasaje:

Mito: La ciudad está obligando que hospitales pongan la fórmula bajo llave
Verdad: Bajo la iniciativa voluntaria de la ciudad, los hospitales no tienen que poner la fórmula bajo llave. La fórmula seria completamente disponible a todas las madres que eligen alimentar a sus niños con fórmula. Lo que intenta el programa es acabar con algo que ha sido practica común: poner fórmula promocional en el cuarto de la madre, o en la cuna del bebe, o en una bolsa para llevar– aun para las madres que estaban amamantando y que no la pidieron.

Esa ultima frase (con mi propio énfasis) es un asunto clave. Resulta demasiado común que los hospitales le dan fórmula a madres que ya han indicado que quieren amamantar. Ofrecer una botella cuando una madre necesita ayuda con pegar su niño al pecho, o si está insegura de la cantidad de leche que está produciendo es más fácil y menos costoso que proveer un asesor de lactancia o desarrollar programas de consejeras coetáneas voluntarias que pueden dar apoyo.

WBEZ en Chicago hizo un reportaje sobre la prevalencia de amamantamiento en los hospitales que demostró la diferencia que puede hacer una iniciativa de apoyo de lactancia. Muchos de los hospitales sin asesores de lactancia se encuentran en comunidades de bajos ingresos, y estas madres probablemente serán dirigidas hacia la fórmula, aun cuando su historial medico indica que prefieren amamantar. Después del reportaje, un hospital en el lado sudoeste de Chicago con la prevalencia de lactancia de recién nacido más bajo en el área — solamente 7% de los recién nacidos se amamantan allí– tomó medidas para mejorar sus estadísticas.

Más de Latch On NYC:

Mito: Madres que desean la fórmula tendrán que convencer una enfermara a firmarles un consentimiento con alguna razón medica.
Verdad: Las madres que desean la fórmula pueden y siempre van a poder simplemente pedir la fórmula y recibirla gratis en el hospital– sin ninguna necesidad medica, sin ningún consentimiento firmado.

Madres que piden la fórmula serian regañadas por la enfermera.
Verdad: La iniciativa nueva de la Ciudad no tiene ningún requerimiento que las madres que piden la fórmula deben recibir un sermón o alguna conferencia obligada. Para los últimos tres años, la ley de Nueva York bajo la Declaración de Derechos de la Lactancia solamente requiere que las madres sean provistas con información correcta sobre los beneficios del amamantar. Este requerimiento no ha cambiado bajo la nueva iniciativa.

Latch on NYC está quitando y/o poniendo en peligro el derecho de la madre de elegir como alimentar a su bebe.
Verdad: La iniciativa esta hecha para apoyar a las madres que eligen la lactancia. Para esas madres, el programa le pide a los hospitales que respeten los deseos de la madre y que no alimenten a su niño con fórmula ( a menos que resulta médicamente necesario o si la madre cambia de opinión). No limita sus opciones de lactancia en ninguna manera– ni tampoco limita el acceso a fórmula para todas las mujeres que la desean.

Si aceptamos las clarificaciones de la ciudad, vemos que la meta es cambiar las practicas en los hospitales, no las preferencias individuales. Pero como ya se notó más arriba, hay muchas más barreras contra la lactancia que tales iniciativas no enfrentan. En el blog RH Reality Check, Marianne Møllmann escribe sobre la falta de baja por maternidad con beneficios y otros apoyos sociales verdaderos de la lactancia.

A pesar de nuestras decisiones personales sobre amamantar, es claro que las mujeres en general necesitan mejores apoyos para elegir la lactancia. Para explorar este tema, aquí está una presentación dada por Judy Norsigian de OBOS en el tercer Simposio anual sobre las razones culturales, sociales, y económicas que previenen la lactancia en mujeres que desean hacerlo.

August 2, 2012

World Breastfeeding Week

August 1st through 7th, 2012 marks the 20th anniversary World Breastfeeding Week, an international event intended to promote breastfeeding around the world.

The observance is headed by the World Alliance for Breastfeeding Action, along with UNICEF and the World Health Organization.

To learn more about breastfeeding and how you can support women’s choices to breastfeed, check out:

April 6, 2012

Breastfeeding in African American Communities

Shafia Monroe of the International Center for Traditional Childbearing was recently interviewed for a nice piece in The Skanner on the topic of Breastfeeding: A Wellness Issue for African American Families. Currently, black women start and continue breastfeeding at at much lower rates than other measured races/ethnicities. According to the CDC, rates are:

Breastfeeds Intitially Still Breastfeeding at 6 months Still Breastfeeding at 1 Year
American Indian/Alaska Native 69.8% 37.1% 19.4%
Asian or Pacific Islander 80.9% 52.4% 29.7%
Black (non-Hispanic) 54.4% 26.6% 11.7%
Hispanic 80.4% 45.1% 24.0%
White (non-Hispanic) 74.3% 43.2% 21.4%

In the interview, Monroe talks about health benefits of breastfeeding, notes the lower breastfeeding rates among black women, and encourages black women to breastfeed for a year or longer. She says:

…we only hear people telling black women to get a mammogram—I’ve never heard anyone tell black women that if you breastfeed for one year it can reduce your breast cancer risk. So that’s important…

By breastfeeding, it delays your onset of Type 2 diabetes. This can be major, when you have a high diabetic rate within the black community in Portland, and more black women dying from late-stage breast cancer.

Monroe goes on to note that breastfeeding needs to be made “more acceptable in the normal life of African American families, so they feel there’s no shame that comes from doing it. And that the black community should embrace women who breastfeed and make them feel comfortable in all areas.”

The question of why more black women don’t breastfeed is an important one. The CDC identifies a number of potential factors, including “social and cultural norms, social support, guidance and support from health-care providers, work environment, and the media.” Christine talked about the need for support at work and among friends and family members in a previous post as well. Kimberly Seals Allers at BlackandMarriedWithKids asks, Is Slavery Behind Our Low Breastfeeding Rates?, exploring the ways women in slavery in the U.S. were forced to stop own breastfeeding infants and forced to breastfeed white infants.

A couple of online resources are intended to support black women in breastfeeding. One is Black Breastfeeding 360, which has tips, information, and women’s stories about breastfeeding. Another is the Black Women Do Breastfeed blog and Facebook page, which also feature black women’s stories of breastfeeding, including how they overcame challenges they faced after choosing to breastfeed their children. Finally, the federal Office on Women’s Health has a PDF guide, Your Guide to Breastfeeding for African American Women, which teaches about the importance of breastfeeding, how to do it, and how to handle some common challenges.

Relatedly, Kimberly Seals Allers (of Black Breastfeeding 360) has a great piece on media and other coverage issues around this topic, in Dear White Women: Beyonce is OUR Breastfeeding Moment. Please Step Aside. She writes:

…with all the news reports about Beyonce, and all the breastfeeding “advocates” talking about its impact on the nursing world, not one advocate mentioned the particular significance to black women — which is so striking since many claim to be interested in our breastfeeding plight.

Shame on you…some of you white breastfeeding advocates, one of you, should have pointed that out. If not for us then please for our babies. Black babies are still 2.4 times more likely to die before their first birthday and the CDC says increased breastfeeding among black women could reduce this needless disparity by as much as 50%.

Having Beyonce as our black breastfeeding moment potentially means that more African American women will know that breastfeeding is mainstream and beautiful and actively practiced by the celebrities we admire. The celebrities from our community. It means that more black women, particularly young women, may consider breastfeeding their babies–something our community urgently needs.

August 23, 2011

El CDC Dice que la Mayoría de Hospitales No Apoyan Adecuadamente el Amamantamiento

Escrito por Rachel. Traducido del orginial en inglés August 9, 2011.

OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.

La semana pasada, el Centro para el Control y la Prevención de Enfermedades dio a conocer un reporte que muestra una baja tasa de amamantamiento en los Estados Unidos, así como la importancia de tener hospitales que asuman un papel positivo en animar y apoyar esta práctica. La información del reportaje viene de una encuesta nacional sobre prácticas y políticas de maternidad.

Los investigadores encontraron que aproximadamente el 90% de los hospitales reportan que proveen educación prenatal para el amamantamiento para enseñar técnicas para amamantar, pero menos de la mitad siguen el resto de las recomendaciones de Los Diez Pasos para Amamantar con Éxito, la lista de políticas y acciones requeridas para ser un hospital o un centro de natalidad adecuado para los recién nacidos. Solo alrededor del 3.5% de los hospitales implementan al menos 9 de las 10 prácticas, las cuales son consideradas como las causantes del aumento en la tasa del amamantamiento, gracias al apoyo que reciben las madres.

Entre los pasos menos seguidos están el tener una política modelo para el amamantamiento (14.4% lo hizo); limitar el uso de formula, agua, o suplementos de glucosa en bebes saludables y apropiadamente amamantados (21.5%); y proveer apoyo adecuado de amamantamiento para madres que están dando de lactar, cuando el hospital les da de alta (26.8%).

Información adiciónale sobre el tema:

August 9, 2011

CDC Says Most Hospitals Do Not Properly Support Breastfeeding

Last week, the Centers for Disease Control and Prevention released a report pointing to low rates of breastfeeding in the United States and the importance of having hospitals play a positive role in encouraging and supporting the practice. Data in the report comes from a national survey of maternity care practices and policies.

The researchers found that about 90% of hospitals report providing prenatal breastfeeding education teaching breastfeeding techniques, but fewer than half follow the other recommendations in the Ten Steps to Successful Breastfeeding, the list of required policies and actions for being a Baby-Friendly hospital or birth center. Only about 3.5% of hospitals have implemented at least 9 of the 10 practices, which are thought to increase breastfeeding rates by supporting mothers.

Among the least-followed of the ten steps were having a model breastfeeding policy (14.4% did so); limiting use of formula, water, or glucose supplements for healthy, full-term breastfed infants (21.5%); and providing adequate breastfeeding support to breastfeeding mothers at hospital discharge (26.8%).

For more information, see the CDC’s press release, Vital Signs report, more detail on the survey results in the MMWR publication, and advice for what state and local governments, hospitals, doctors and nurses, and mothers and their families can do to encourage hospital support of breastfeeding.

August 1, 2011

Yes! HHS Approves IOM Recommendations for Preventive Care for Women

Today, the U.S. Department of Health and Human Services announced that it is adopting the Institute of Medicine’s recommendations for preventive care services for women. This will ensure that women have access to the following services under health insurance plans without having to pay a co-payment, co-insurance or deductible:

  • well-woman visits
  • screening for gestational diabetes
  • HPV testing
  • STI counseling
  • HIV screening and counseling
  • contraception methods and counseling
  • breastfeeding support, supplies, and counseling
  • screening and counseling for domestic and interpersonal violence

Coverage for these services is expected to begin Aug. 1, 2012.

There is one caveat for some women regarding access to contraception without a co-pay — a provision that “Group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, are exempt from the requirement to cover contraceptive services.”

An announcement at the site indicates that public comment is welcome on this provision. Although I haven’t yet been able to locate it on, instructions for comment and more detail about the exemption is provided in this document.

July 20, 2011

Institute of Medicine Recommends Birth Control as a Covered Preventive Service

Good news! You may remember that the health care reform legislation enacted last year included provisions for preventive health care services to be fully covered without requiring patients to have copayments.

It was not clear, however, whether birth control would be included as a preventive service. It seems obvious to us, but the Institute of Medicine was asked to make some recommendations about which preventive services for women should be included, and included birth control in those recommendations, released yesterday.

If they are adopted, preventive services including birth control could become much more affordable and accessible to women in the United States.

The Institute, after reviewing the rate and consequences of unintended pregnancy, effectiveness of birth control, and cost and access concerns, concluded:

The committee recommends for consideration as a preventive service for women: the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.

In addition to copay-free coverage of birth control, the Institute recommended:

  • screening for gestational diabetes
  • human papillomavirus (HPV) testing as part of cervical cancer screening for women over 30
  • counseling on sexually transmitted infections
  • counseling and screening for HIV
  • lactation counseling and equipment to promote breast-feeding
  • screening and counseling to detect and prevent interpersonal and domestic violence
  • yearly well-woman preventive care visits to obtain recommended preventive services

You can view the Institute’s press release, recommendations, report brief, and full report, “Clinical Preventive Services for Women: Closing the Gap,” online. The Department of Health and Human Services will still need to adopt this list of recommendations for the care to be covered under the Affordable Care Act.

Some other coverage and discussion of this topic:

Seen other good links on this news? Leave ‘em in the comments!

June 30, 2011

Mujeres Usan el Internet para Comprar y Vender Leche Materna

Publicado por Rachel / del orginial en inglés June 14, 2011

OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.

Yo no suelo tener la revista “Wired” en mente cuando busco interesantes historias de salud femenina; simplemente me encontré con su reciente artículo virtual sobre la leche materna humana.

En Oro Liquido: El Mercado Floreciente para la Leche Materna Humana (Liquid Gold: The Booming Market for Human Breast Milk), la autora Judy Dutton explora cómo y por qué las mujeres van a las páginas de la internet para comprar, vender y donar leche materna a otras mujeres (y algunos hombres), e investiga las preocupaciones de seguridad y los beneficios de la leche materna.  Ella también examina si se debe permitir que las personas vendan leche materna directamente a otros individuos sin el uso de un banco de leche materna.

Según el artículo, aparentemente la leche materna es considerada comida en los Estados Unidos y no es regulada como lo son los tejidos y la sangre; la compra y venta de la leche materna es aparentemente legal en la mayoría de estados.

Dutto explica algunas razones por la cual las mujeres podrían querer usar la internet para este fin.  Algunas mujeres prefieren donar leche directamente a otra mujer en lugar de que esta sea revendida por un banco de leche.  Otras razones incluyen la posibilidad de solventar dificultades financieras por la venta de leche sobrante, los chequeos y las restricciones propios de una donación a bancos, los altos costos asociados a la compra de leche a un banco de leche, la falta de cobertura de seguro para obtener leche donada, y el actualizado atractivo, en el siglo 21, de esta antigua practica de dar de lactar a los bebes de otras mujeres.

¿Qué piensa usted? ¿Deben los individuos poder comprar y vender leche materna? ¿Cómo se siente en cuanto a los riesgos de contaminación y la falta de control en las ventas o donaciones personales? ¿Es esto algo que usted consideraría hacer? ¡Háganoslo saber en los comentarios!

Información adiciónale sobre el tema:

June 14, 2011

Women Take to the Web to Buy, Sell Breast Milk

I don’t typically have “Wired” magazine in mind when I look for interesting women’s health stories, so I just stumbled across their recent piece on the online market for human breast milk.

In Liquid Gold: The Booming Market for Human Breast Milk, author Judy Dutton explores how and why women come to online sites to buy, sell and donate breast milk to other women (and a few men) as well as safety concerns and the benefits of breast milk. She also examines the question of whether individuals should be allowed to sell breast milk directly to other individuals, without going through a breast milk bank.

According to the piece, breast milk is apparently considered a food in the U.S. and so is not as regulated as tissues and blood are; buying and selling breast milk is apparently legal in most states.

Dutton explains a few reasons why women might want to go online for this need. Some women prefer to donate milk directly to another woman rather than have it be resold by a milk bank. Other reasons include the ability to alleviate financial difficulties by selling extra milk, screening and restrictions involved in donating to banks, the high costs associated with purchasing milk through a milk bank, lack of insurance coverage for obtaining donor milk, and the appeal of this simple 21st century update of the age old practice of women feeding each other’s babies.

What do you think? Should individuals be able to buy and sell breast milk? How do you feel about the risk of contamination and the lack of screening in person-to-person sales or donations? Is this something you would consider? Let us know in the comments!

February 14, 2011

Quick Hits: News Coverage of Nitrous Oxide for Birth, IRS on Breast Feeding Supplies

The IRS has ruled that breast pumps and supplies that assist in lactation do quality as medical care and are therefore deductible medical expenses that can be paid for through Flexible Spending Accounts (FSAs) and other medical spending accounts.

The American Academy of Pediatrics had previously requested that the IRS rule that these supplies be added to the list of qualifying FSA items, but received a denial stating that breastfeeding did not constitute medical care. The new ruling does not decide that breastfeeding is medical care of an infant, but rules that the supplies are medical because “they are for the purpose of affecting a structure or function of the body of the lactating woman.” The AAP has applauded the change as “an important victory for the health of women and children across the country by making breastfeeding a more practical option for new and working mothers.”

In other news, the Associated Press has covered the issue of access to nitrous oxide for women in labor. The piece explains that some institutions (including my own) are currently working to make nitrous oxide an option; it’s commonly available to laboring women in some other countries. The item notes at the end that “the federal Agency for Healthcare Research and Quality is reviewing the effectiveness and safety of nitrous oxide compared to other pain relief methods” – I’m on the team for this project at work, so we’ll be sure to let you know as soon as that report is available.

February 1, 2011

La Cirujana General lanza llamado a la acción para apoyar la lactancia materna

Escrito por Raquel; traducido por Ema Rosero del orginial en inglés Jan 24, 2011

OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.

La semana pasada la Dra. Regina M. Benjamín, Cirujana General de los Estados Unidos, expidió “Llamado a la acción en apoyo a la lactancia materna de la cirujana general” (The Surgeon General’s Call to Action to Support Breastfeeding). El informe describe los obstáculos y las tasas de lactancia materna en los Estados Unidos y los beneficios de salud, los beneficios económicos, sicológicos y ambientales de la lactancia materna. El informe es un llamado de acción a toda persona para tomar medidas que faciliten las opciones disponibles a madres para amamantar a sus bebés.

En lugar de únicamente invitar a las mujeres a amamantar a sus hijos(as), el informe hace un llamado a que los padres y las abuelas sean educados sobre la lactancia materna, a que se fortalezca el apoyo comunitario entre madres, a que las madres aborden cómo  está mercadeando la leche de fórmula, asegurar que guarderías que cuidan infantes apoyen la lactancia, que haya consultores(as) de lactancia accesible para madres y que se continúen haciendo estudios de investigación.

El continuo apoyo de madres en lugares de trabajo y en la comunidad es importante porque los factores por los cuales mujeres dejan de amamantar más temprano de lo que ellas quisieran se debe a factores externos tales como la falta de descansos para empleados durante horas laborables y la falta de instalaciones para extraer la leche materna en los lugares de trabajo. Al presente tres cuartas partes de las mujeres estadounidenses que intentan continuar lactando pero menos de la mitad, han continuado amamantando por un mínimo de seis meses. La Dra. Benjamín indicó lo siguiente:

Existen muchas barreras para madres que quisieran lactar por lo que estas madres no deberían confrontar estos desafíos a solas. Así usted sea un/a médico/a, un miembro de familia, amigo/a, o empleado/a, uno puede colaborar en ayudar a las madres que desean dar de pecho a sus bebés.

En la medida en que nos mantenemos vigilantes con respecto al retroceso de provisiones para la reforma de salud, hemos de mantener los ojos abiertos con respecto a la lactancia materna ya que la legislación aprobada el año pasado incluyó para enmendar la Ley de Normas Razonables de Trabajo (Fair Labor Standards Act)  para asegurar que los empleadores provean descansos razonables para madres lactantes y en áreas privadas que no sean los baños.

January 31, 2011

Public Comment Solicited on Reasonable Break Time for Nursing Mothers

Last year, the Fair Labor Standards Act (FLSA) was amended to require employers to provide a reasonable break time and a non-bathroom private place for nursing mothers to express breast milk for one year after their child’s birth. The requirement became effective when the Affordable Care Act was signed into law on March 23, 2010.

A notice in the December 21, 2010 Federal Register indicates that employers have asked for further guidance on this measure, and asks for public comment on aspects such as what is “reasonable” break time. The National Partnership for Women and Families translates the key questions for public comment into the following terms, less technical than wading through the Federal Register document.

1. Have you ever had to use a room connected to a bathroom to pump breast milk at work? Was it completely closed off or private? Was it a good or bad environment — and why?

2. Have you ever had to pump breast milk in a room normally used for something else — like a locker room, storage room or closet, or a manager’s office? Was it a good or bad environment — and why?

3. Have you ever had to pump breast milk in a shared space — one shared by other employees or employees from other nearby employers, like in a shopping mall or airport? What provisions for privacy worked or didn’t work?

4. Have you tried to keep breastfeeding/pumping in a job that requires you to be on the move—like driving a vehicle, visiting clients off-site, or patrolling a neighborhood? How did you make this work and how did your employer help (or fail to) support you?

The organization also provides a way to submit comments directly through their website. You may also submit your comments individually by going directly through, where the link to a PDF of the Federal Register document detailing questions and issues related to the provision is available for download.

Comments are due by February 22, 2011.

January 24, 2011

Surgeon General Releases Call to Action to Support Breastfeeding

Last week, U.S. Surgeon General Dr. Regina M. Benjamin issued “The Surgeon General’s Call to Action to Support Breastfeeding ” [PDF]. The report describes barriers to and rates of breastfeeding in the United States and the health, economic, psychosocial and environmental benefits of breastfeeding.  The report is a call to action for all people to take steps to make the choice to breastfeed easier for mothers.

Rather than simply exhorting women to breastfeed, the report calls for educating fathers and grandmothers about breastfeeding; strengthening of community-based mother-to-mother and peer support; addressing the way infant formula is marketed; ensuring that maternity care providers and systems are supportive of breastfeeding and lactation consultants are accessible; improving maternity leave and workplace support for lactating mothers; and conducting further research.

The inclusion of workplace and community supports is important, because the factors that lead many women not to breastfeed or to stop breastfeeding earlier than they would like are often external ones, such as a lack of sufficient breaks and facilities for pumping milk in the workplace. Three quarters of U.S. women currently attempt breastfeeding, but fewer than half have kept it up by six months. As Dr. Benjamin stated for the press release:

Many barriers exist for mothers who want to breastfeed. They shouldn’t have to go it alone. Whether you’re a clinician, a family member, a friend, or an employer, you can play an important part in helping mothers who want to breastfeed.

As we keep watch on efforts to roll back provisions of health care reform, this is yet another issue to keep an eye on, as the legislation passed last year included a provision to amend the Fair Labor Standards Act to ensure that employers provide reasonable break time for nursing mothers in a private place other than a bathroom.

Additional resources for mothers and employers are provided at