Wednesday, June 30, 2010

Wordless Wednesday: Animal Nursing

Mother Woodland Musk Ox nursing her baby, Museum of Natural History & Science, Cincinnati, OH

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Tuesday, June 29, 2010

Breastfeeding Portrait Art by Kate Hansen

Artist Kate Hansen recently contacted me about a project she is working on called "Madonna and Child," a combination of portrait art and birth stories. Her art is really beautiful. I know that breastfeeding photographs have become trendy lately and many photographers are doing breastfeeding sessions, but I love the idea of a portrait to capture the breastfeeding experience.

Kate says she was inspired to create this art after the birth of her daughter in 2008. Each portrait is done in crayon and accented with a gold leaf halo. Kate wanted to draw some parallels between our own ideals of what a mother should be and the cultural ideal of motherhood that has been symbolized by the virgin Mary. One of the reasons she wanted to include the birth story is because of the powerful way that birth can affect your mothering, including your ability to breastfeed.

Wouldn't you love to have a portrait like this of you and your nursling? Kate is looking for more mothers to participate in the project and she would like to have more moms of color represented in her work. If you are interested in having your portrait done, you should send Kate several photographs of you and your baby nursing, along with the story of your baby's birth in your own words. Kate will need the photos to be from about mid-thigh up, preferably in sunlight.. Kate prefers that the baby be nude or in a diaper, but is happy to do whatever makes you most comfortable. As payment, Kate will send you a small signed print of your portrait.

Want to get started? Email Kate at

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Wednesday, June 23, 2010

A Crisis in the Crib & A Blogging Challenge

I have written twice, quite briefly, about a campaign created by the Office on Minority Health starring Tonya Lewis Lee about the disparate rates of infant and maternal mortality in this country called "A Healthy Baby Begins With You." The campaign was created to help raise awareness of the fact that black babies are three times as likely to die in their first year of life as white babies. In addition, a recent NY Times article stated that black women in New York are seven times more likely to die in childbirth than white women. In fact, a recent article in a University of Wisconsin alumni magazine offered up the sobering statistic that babies born in Sri Lanka have better health outcomes than black babies born in Milwaukee do.

These unacceptable statistics are what prompted Ms. Lewis Lee and the Office on Minority Health to create the documentary Crisis in the Crib: Saving Our Nation's Babies in 2009. I have been wanting to see the documentary for a while and although there were screenings held in NYC, I never saw any screenings in my area. But the 36-minute documentary is now available for you to watch online and if you are about issues like women's health, motherhood, birth advocacy, breastfeeding and feminism, then you should watch it. And not only should you watch it, but you should blog about it.

I, along with Jill of The Unnecesarean and Courtroom Mama*, want you to take 36 minutes to watch this documentary and then write a blog post about any aspect of the film that speaks to you the loudest. After you've written your post, link to it here by July 2. Jill & Courtroom Mama will choose their favorite post, and on July 4th it will appear on The Unnecesarean blog, along with links to all of the bloggers who participated.

Are you up for the challenge?

*Thank you to Courtroom Mama for writing this excellent blog post and inspiring a host of bloggers to write about this issue that is so important, yet is not being discussed enough. 

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Tuesday, June 22, 2010

Judging Other Moms? Guilty As Charged

There was a recent article in USA Today that posed the question, "Why do mothers judge one another and their parenting?" There were a couple of very interesting and valid points raised in the article. First, I think that often modern mothers find themselves faced with unsolicited and unwanted advice, typically from older women who are often strangers. How many times have you been in the mall and had someone, apropos of nothin', ask you if your baby is sleeping through the night. For some reason, as a culture, we've come to equate "good sleeper" with "good baby" and "good mothering."  I think that for the most part, people mean well when they try to impart this advice on you, but it almost always comes across as mean-spirited. No one wants to feel backed into a corner, explaining or justifying their parenting techniques to a virtual stranger.

The article also talked about perceived judgment about choices that can leave other parents feeling bad about their parenting style. I can remember being at a play date with my son when he was about 7 months old with a few others moms who had babies the same age. We were talking about babies' eating habits and one mentioned that she put cereal in her daughter's bottles and the others chimed in that they did as well. I stayed silent, not wanting to seem critical, but it didn't matter. "Oh, you're one of those who doesn't put cereal in the bottle, huh?" she asked, and they all rolled their eyes. Simply by making a choice that is outside the norm, and which I suspect they knew at some level was a better choice, they felt I had judged them and so they judged me.

I'd like to think I've never done this. I try not to offer advice to anyone unless they ask. I've never corrected anyone who's given me bad advice. I usually just act dumb, smile and nod and get out of there as quickly as possible. I'm not a confrontational person at all in real life and scenarios like this make me very uncomfortable. But what I am guilty of is silently judging, which is why this clip from the Wendy Williams Show resonated with me.

If you're unable to watch the clip, Wendy says she knows she is judged for not breastfeeding her son and for being a work-out-of-the-home mother. She says she judges other moms, too, but always in her head. What will get you the side-eye from Wendy? Still allowing your toddler to sleep in your bed, not vaccinating, and homeschooling.

So although I will never say anything to you, I am probably judging you for some things. Like, if your kid is over the age of 2 and still has a pacifier in his mouth every time I see you. Or if you extol the virtues of using cry-it-out on your 3-month-old. Or if you're giving solids to a baby who's barely 2 months old.

And I know you're probably judging me too. Like when I let my kid drink out of my soda can or give him a Pop Tart (unfrosted!!!) as a snack. Or when you find out he's 2.5 and still breastfeeding or sleeping in our bed occasionally. And that's OK, just keep it to yourself.

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Sunday, June 20, 2010

Men's Attitudes Toward Breastfeeding

Happy Father's Day! I recently read about a study published in the Maternal & Child Health Journal about men's attitudes toward breastfeeding. The study used the Texas sample of the 2007 Behavior Risk Surveillance System to examine whether men's attitudes toward breastfeeding would vary by race, ethnicity, socioeconomic status, and education level.

Some of the study findings weren't very surprising. For example, Spanish-speaking Hispanic men were found to be the most likely to agree that breastfeeding interfered with having a social life for mothers, yet they were also more likely to view images of public breastfeeding as acceptable. In addition, men born in the US were less likely to think employers should accommodate nursing mothers than foreign-born men.

I was surprised to find just how supportive of breastfeeding the men in the study seemed to be. So what did the study reveal? Eighty-four percent of men disagreed or strongly disagreed that mothers should only breastfeed in their homes and 80% disagreed or strongly disagreed that a mother cannot breastfeed and work outside of the home. Only 21% of men felt embarrassed by a woman they didn't know nursing in front of them. Some of the results seemed to be split down the middle, with 48% of men agreeing or strongly agreeing that it was appropriate to show a mom breastfeeding on the cover of a magazine. Similarly, 46% agreed or strongly agreed that it was appropriate to show a mom breastfeeding on a TV show. The men most in favor of breastfeeding in the media? Spanish-speaking Hispanic men.

The other good news included that 75% of the men believed employers should make the necessary accommodations for nursing mothers, including flexible schedules and a private place to nurse or express milk.  Positive attitudes towards breastfeeding and images of breastfeeding were more likely to be found in men under the age of 30, men who were college educated and men who were Spanish-speaking. This makes sense when we think about who has one of the highest rates of breastfeeding in this country: Hispanic women!

Since we all know how influential fathers can be when it comes to whether or not women breastfeed, it's great to see that there seems to be a lot of men who support nursing in public, breastfeeding imagery and continuing to breastfeed while working outside of the home. Let's give some extra props to the dads this year who support their wives, girlfriends and baby mamas to breastfeed.

Is the man in your life supportive? Give him a shout out in the comments!

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Sunday, June 13, 2010

Oooohh, weeee, hey! What up wit dat?

Before Betty White came on the scene, Kenen Thompson as D'Andre Cole was the best thing to ever happen to Saturday Night Live. Seriously. We love this skit so much that even my son is liable to bust out with a perfectly timed, "What up wit dat?"

So when I saw a blog post with the phrase in the title I was prepared to laugh. Unfortunately, there's not much funny about this post. You see, Melissa Nagin is the author of the breastfeeding page and an IBCLC. Her sister recently gave birth in an NYC area hospital and the advice she got from the attending pediatricians was less than stellar. On two separate occasions, Melissa overheard her sister being told that she needed to supplement with formula until her milk came in in order to prevent jaundice.

All together now, "He say, she say, we say, me say, what up wit dat?"

Although jaundice is very common in breastfed babies, it seems there is some serious jaundice phobia in the hospital. According to Dr. Sears, jaundice in the breastfed baby can last up to three weeks and "most newborn jaundice is harmless." So why so much supplementation of the breastfed baby with formula to prevent that something that for the most part is normal and not a cause for concern?

The only theory I can come up with is that this is just another case of hospital overkill due to fear of litigation. The same reason laboring women are required to have IV fluids, are subjected to continuous fetal monitoring and ushered off to the OR if they don't progress within a certain time frame. I know that my son was jaundiced and got formula in the hospital, despite my protestations. When we left the hospital we were instructed to sit outside in the shade or inside near a window so he could get some sunlight. However, no one talked to me about how unrestricted nursing is the best cure for jaundice or checked to make sure that my baby was nursing well before we went home. I still wonder "what up wit dat?"

Was your breastfed baby jaundiced? Did your baby receive formula in the hospital? What advice did you get from your pediatrician?

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Thursday, June 3, 2010

Photo of the Day

Thanks to Leigh of Marvelous Kiddo for letting me know about National Geographic's Photo of the Day archive online. This photo was posted on May 10, 2009 and is of a Mbukushu mother and her child. Typically Botswana is very dry, but the country does experience seasonal floods. With water this high, babywearing is essential for a sleepy toddler!


Wednesday, June 2, 2010

Breast Cancer Vaccine: Medical Miracle or Scary Science?

Dr. Vincent Tuohy of the Cleveland Clinic's Lerner Research Institute thinks he may have found a way to eradicate breast cancer as we know it. Dr. Tuohy found that a single vaccination with the antigen alpha-lactalbumin prevented breast cancer tumors from forming in mice. Because of the favorable results, human trials of the vaccine could begin as early as next year.

So how does this work? Unlike most doctors who work in cancer research, Dr. Tuohy is an immunologist, so his approach to curing cancer has been different. Rather than targeting cancers that are already present and developed, his idea was to attack the tumor before it even has a chance to grow. What we already know about cancer is that  it is an overdelopment of the body's own cells, rather than an invasion of foreign bodies. So this vaccine attacks the healthy cells before they can become cancerous, rather than vaccinating against a virus.

In the research article published in this month's Nature journal, the researchers explain how they came to develop the vaccine.

"We selected a-lactalbumin as our target vaccine autoantigen because it is a breast-specific differentiation protein expressed in high amounts in the majority of human breast carcinomas and in mammary epithelial cells only during lactation. We found that immunoreactivity against a-lactalbumin provides substantial protection and therapy against growth of autochthonous tumors in transgenic mouse models of breast cancer and against 4T1 transplantable breast tumors in BALB/c mice. Because a-lactalbumin is conditionally expressed only during lactation, vaccination-induced prophylaxis occurs without any detectable inflammation in normal nonlactating breast tissue. Thus, a-lactalbumin vaccination may provide safe and effective protection against the development of breast cancer for women in their post–child-bearing, premenopausal years, when lactation is readily avoidable and risk for developing breast cancer is high."

So basically the key to curing cancer is finding a target within the tumor that is not typically found in healthy people. Alpha-lactalbumin is not found in healthy women, except when they breastfeed. So this vaccine will attack the a-lactalbumin. Did you catch that this vaccine would prevent women from being able to breastfeed? From the full text of the article (which I'm able to access through a subscription database):

 "This unique conditional expression of a differentiation protein provides an opportunity for prophylactic breast cancer vaccination of normal healthy women who are either willing to avoid lactation or are past their child-bearing years." [emphasis mine]

It sounds like they've figured out a way to remove healthy tissue before it becomes cancerous that would allow women to keep their breasts and not have to have mastectomies. Sounds good, right?

But what about younger women who have a genetic predisposition to breast cancer? Will they be encouraged to get the vaccine before their child-bearing years are over? And what if they want the vaccine, because in their minds, giving up breastfeeding is a small price to pay to eliminate the risk of cancer AND get to keep your breasts. According to a press release from the Lerner Institute, the strategy would be to vaccinate women over 40. But many women are still having children well into their 40s. These women would also likely have to forget about being able to breastfeed

And what about the most ironic thing of all, that we already know that breastfeeding can reduce your risk of getting breast cancer in the first place? A study at Yale found that breastfeeding for two years cut a woman's breast cancer risk by 50%. 

Where does it end? Dr. Tuohy thinks an adult vaccination program is the wave of the future. Instead of your vaccine schedule ending in childhood, you'd start all over at age 40, getting a vaccine for breast and ovarian cancer and maybe even Alzheimer's one day.

So what do you think about a breast cancer vaccine? Would you get it?

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Tuesday, June 1, 2010

Guest Post: Formula Marketing in Madagascar

I'm pleased to present a guest post today by Caroline, an expat living in Madagascar, about what formula marketing is like in a country where the WHO Code has been adopted. I was particularly interested in hearing about this because of the recent discussion about whether or not Nestle abides by the Code in countries where it has to.

Madagascar is one of the 32 countries in which the International Code of the Marketing of Breastmilk Substitutes (the "Code") is law. The two main infant formula brands that are marketed here in Madagascar are Nestlé and Blédina.  I would say that they each occupy about 45+ percent of the market, although perhaps Blédina, a French brand, has a slightly higher market share (the other 10 percent occupied by France Lait and other smaller brands).

Both Nestlé and Blédina ostensibly adhere to the Code.  Blédina states on its website that it supports the Code's recommendation of exclusive breastfeeding for six months, and is committed to adhere to this recommendation (i)  in accordance with the application clauses found in local regulations or (ii) as it stands, in the absence of regulations.  As the Code is law in Madagascar, both Nestlé and Blédina have taken steps to abide by the letter of the Code (or at least their interpretation of it) here.

Here is a typical supermarket aisle for infant formula.

Note that there are no special promotions of the stuff and it is not on a special display.  There is also no billboard advertising of infant formula (stage 1 or 2) that I have ever seen here. Also of note: all the puréed food in jars is labelled as being for babies 6 months and up.

The exact same jars are labelled as being for babies age 4 months and up in France and elsewhere in Europe!

However, sometimes mistakes are made.  A few weeks ago, I was in the store that also happens to be the official distributor for Nestlé here in Tananarive and what do I see?  This display.

In it are all the Nestlé products available in the store, including KitKat, some breakfast cereal, infant cereal, and Guigoz Stage 1 and 2 infant formulas.  Around the display is a yellow ribbon with the Nestlé logo and "Pour une croissance saine" written all around the ribbon.  Ironically, I also saw a billboard behind the cashier's desk, marked "for employee use only" with clear instructions from Nestlé as to what constitutes a violation of the Code.  So clearly, the store was making an effort.  I asked to speak to the store manager and told him that I appreciated his store's efforts to adhere to the Code and that the ribbon constituted point of sale advertising of infant formula and was therefore in violation of the Code.  He said he would take it up with Nestlé and apparently he did because Nestlé called me a week later.  We discussed the issue and they removed the ribbon.

But Nestlé and Blédina don't need to advertise their infant formulas directly.  They have much more insidious ways of advertising their products.  This Blédina sign hangs outside virtually every pharmacy in Tana.  It doesn't say anything about infant formula.  There is even a disclaimer in tiny letters underneath stating "Ces produits ne sont pas des substituts de lait maternel" (translation: these products are not breastmilk substitutes).

All Blédina has to say is that this sign is meant to advertise Blédina's complimentary food: cereal and purées for example, and is not intended to advertise formula.  The disclaimer in tiny letters is their proof.  And yet, all most people need to see is the Blédina sign to think infant formula.

Take a look at this calendar produced by Nestlé and sitting on a cashier's desk at a store

It's just a photo of some building blocks along with the statement "Nourishing children in Africa for healthy growth."  Wow.  Now that's good.  Nestlé can deny that it advertises formula at all because nothing in the ad says anything about what IS being advertised.

And then there are the ads of products that Blédina and Nestlé will argue do not fall within the scope of the Code.  Here is a photo of a billboard ad for Blédina's "lait de croissance" - literally, growth milk, intended for children age one and up.

As far as Blédina is concerned, we are no longer talking about infant formula or any breastmilk substitute, as this milk is for toddlers.  Yet the World Health Organization recommends breastfeeding for a minimum of two years, so how can this milk NOT be a breastmilk susbtitute?

Nestlé advertises its Nido powdered milk extensively.  Nido is not infant formula.  Yet, as shown recently on my blog, shops will systematically place it alongside the infant formula. And since it is much cheaper than infant formula, Malagasy people will buy it instead, thinking that it is formula.  Nestlé has refused to put a label on Nido to indicate that Nido is not intended for babies under one year of age, stating that since Nido is not a breastmilk substitute, Nestlé has no obligation under the Code with respect to Nido.

Then there is a problem with baby bottles.  The pharmacy closest to our home has these displays of their Avent products.

Note that the Code only covers bottles and teats, so Avent has conveniently placed the most emphasis on its associated products: bottle sterilizers, bottle warmers, diaper bags, breast pumps and breastmilk storage containers.  I explained to the pharmacist in this pharmacy that their Avent display sign promotes bottles and is therefore in violation of the Code.  He was surprised.  He thought the Code only covered formula and that's it.

Which brings me to the last point.  Even though the Code is law in Madagascar, so many people who ought to know better really don't have a clue about the Code or what it covers.  Malagasy women generally breastfeed for two years. The percent who breastfeed exclusively for six months was around 67 percent in 2004.  The main reasons for not breastfeeding exclusively are (1) having to work and (2) misinformation and ignorance.  Under misinformation and ignorance, we have the women who are too poor to even consider buying formula but who try to feed their baby other things (rice water, for example).  And there are women who are moving out of poverty and into the middle class who see prominent displays of bottles in the pharmacy, who see the Blédina signs everywhere, who see the healthy white toddler in the billboard ad and who decide that infant formula must be a good idea.

So even in a country where the WHO Code is law, formula and bottle companies still manage to promote their products and convince women to breastfeed less.

Caroline is a lawyer, writer, teacher and lactivist.  She lives in Tananarive, Madagascar with her husband, 5-year old daughter and 1-year old son.  Caroline writes about lactivism, intactivism, cultural aspects of parenting, green parenting, bilingualism and multilingualism, alternative and foreign education systems, and anything else relevant to globetrotter parents on her blog, The Globetrotter Parent

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