Healthy People 2020-New Health Goals for the Nation Just Released

On December 2, 2010, the new Healthy People 2020 health goals for the nation were released with strong support for breastfeeding. Breastfeeding was the topic that had the largest number of people giving testimony at the HP2020 regional meetings in 2009. The targets have all been increased as follows:

Targets: Current In 10 years
Ever breastfed from 73.9% (babies born in 2006) to 81.9%
6 month duration from 43.4% to 60.5%
12 month duration from 22.7% to 34.1%
3 mo exclusive from 33.1% to 44.3%
6 mo exclusive from 13.6% to 23.7%

Three new goals have been added:
Increase the proportion of employers that have worksite lactation support programs.
Baseline: 25% of employers reported providing on-site lactation/mother’s room in 2009
Target: 38%

Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life
Baseline: 25.6% of breastfed newborns born in 2006 received formula supplementation within the first 2 days of life as reported in 2007-09
Target: 15.6%

Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies
Baseline: 2.9% of 2007 live births occurred in facilities that provide recommended care for lactating mothers and their babies as reported in 2009
Target: 8.1%

The Healthy People initiative sets national objectives with a monitoring process to motivate action. In the last decade, preliminary analyses indicate that the country has either progressed toward or met 71 percent of its Healthy People targets. This is certainly true of breastfeeding initiation which met the 75% goal of Health People 2010. All of the objectives can be viewed at:

Each state has a Healthy People 2020 coordinator which can be found at Advocates should contact their state coordinator to ask what plans are being made regarding the breastfeeding objectives. See how you can get involved with the HP2020 efforts in your state. Now is the time to renew our efforts and use these goals as tools to improve the health of our mothers and babies.


Healthy, Hunger-Free Kids Act of 2010 Passed (Child Nutrition Reauthorization)

On December 2, 2010, Congress passed the Healthy, Hunger-Free Kids Act which reauthorizes a number of child nutrition (and other) programs including the WIC program. It contains numerous provisions that strengthen support for breastfeeding within the WIC program, some of which include:

Strengthening support for breastfeeding by inserting the words "breastfeeding support and promotion: each time referenes to "nutrition education" is made in the legislation. This helps give equal weight to breastfeeding, normalizing it within the program to be addressed each time nutrition education is mentioned.

Provides $90 million for special nutrition education such as breastfeeding peer counselors and other related activities.

Recognizes exemplary breastfeeding support practices at local WIC agencies that demonstrate the highest proportion of breastfed infants or the greatest improvements in the proportion of breastfed infants. Monetary performance bonuses will be given based on performance measurements of breastfeeding, the effetiveness of a peer counselor program, and the extent to which the agency or clinic has partnered with other entities to build a supportive breastfeeding environment for women participating in the program.

This presents breastfeeding advocates with an opportunity to partner with local and state WIC agencies to help improve breastfeeding performance measures. As WIC serves almost half of the infants in the United States, advocates may wish to become more involved with this program to help improve lactation care and services to an important segment of the population.

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Look what’s new in formula marketing tactics!

NABA has been receiving reports of new formula marketing tactics and has created a double-sided page to inform breastfeeding advocates of these new strategies. We may wish to urge hospitals and health providers to avoid, abandon, or discourage the use of these formula company marketing materials and services. The page can be downloaded and given to colleagues and administrators.


Department of Labor releases first set of guidelines for new law on worksite protection of breastfeeding

U.S. Department of Labor has released its first Fact Sheet explaining the March, 2010 amendment to the Fair Labor Standards Act contained in the new healthcare reform law that requires employers to provide breaks for nursing mothers. The law requires employers to provide "reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child's birth each time such employee has need to express the milk." Employers must provide the breaks "as frequently as needed", and must give the employee a private place, other than a bathroom, to take the breaks. The breaks need to be of "reasonable" length. The employer does not have to pay the employee for the break time, unless the employer already provides compensated breaks, and the employee uses one of those breaks to express breast milk. The law applies only to non-exempt employees, and not to exempt employees. Employers with under 50 employees are not subject to the law "if compliance with the provision would impose an undue hardship."

The Fact Sheet reviews general requirements of the law, time and location of breaks, coverage and compensation, and where to obtain additional information. Advocates may wish to provide copies of this Fact Sheet to employers and mothers to help assure that all are informed of how best to implement this new law.

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First Lady supports breastfeeding at NAACP conference

Building on her “Let's Move” anti-childhood obesity campaign, Mrs. Obama’s keynote address to the 101st NAACP conference described the efforts for improving the health of African American children. Her keynote speech wasn't limited to eating right and exercise, as she stressed the importance of being healthy right from the beginning through the promotion of breastfeeding (see below). Her speech has given breastfeeding another important boost.

"And finally, it’s one thing we can think about, is working to make sure that our kids get a healthy start from the beginning, by promoting breastfeeding in our communities. One thing we do know is that babies that are breastfed are less likely to be obese as children, but 40 percent of African American babies are never breastfed at all, not even during the first weeks of their lives.  

And we know this isn’t possible or practical for some moms, but we’ve got a WIC program that’s providing new support to low-income moms who want to try so that they get the support they need.

And under the new health care legislation, businesses will now have to accommodate mothers who want to continue breastfeeding once they get back to work. Now, the men, you may not understand how important that is. But trust me, it’s important to have a place to go."


US Lactation Consultant Association issued hospital IBCLC lactation consultant staffing recommendations

The US Lactation Consultant Association (USLCA) has issued hospital lactation consultant staffing guidelines to help hospitals provide adequate, evidence-based lactation care and services.

“The development of an effective lactation program is dependent on many factors, including adequate staffing. The recommendations in this paper are given in an effort to assist delivering hospitals to provide appropriate lactation care in the inpatient setting.” This position statement is an important step in securing access to current, evidence-based breastfeeding care delivered by appropriately trained health care providers. The entire document can be downloaded from the USLCA website at:

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Domperidone study needs mothers to complete side effect survey

Researchers at Texas Tech University are conducting an online survey to study the drug safety profile and side effects of the use of domperidone for increasing milk production.

Survey of Domperidone and Metoclopramide Use in Breastfeeding Mothers
Thomas Hale & Kathleen Kendall-Tackett, co-investigators

We are pleased to announce our new online research study, a survey of women’s experience with the drugs metoclopramide and domperidone, which can be used to stimulate milk production. We would like to collect side effect information on both drugs from as many mothers as possible worldwide.

The survey link is:

Please consider asking mothers you have encountered who have used either or both of these drugs to fill out this survey. It represents the collection of important information in our efforts to help breastfeeding mothers overcome barriers.


Paper questions efficacy of infant forumla additives

On June 4, 2010 an important paper regarding federal policy on infant formula additives was released by The Center on Budget & Policy Priorities in Washington DC: The Center’s analysis questions the wisdom of using taxpayer dollars to pay for costly ingredients being added with increasing frequency to infant formula and other WIC foods. These ingredients include DHA and ARA (long chain polyunsaturated fatty acids), prebiotics, probiotics, lutein, lycopene, and betacarotene. WIC spent $850 million on infant formula in 2009 with $91 million of that (more than 10%) traced to the purchase of the higher priced formulas with functional ingredients. The Center, a respected Washington think tank, urges Congress to require USDA to commission independent scientific reviews of the clinical significance and evidence of benefits of “functional ingredients” in WIC formulas and other foods, to protect the Program from costly expenditures, and to keep all consumers more fully informed about these additives. Infant formula manufacturers decide which formulas WIC offers. Neither the FDA nor the USDA determine if additives are beneficial, necessary, or offer the benefits claimed by formula makers. The evidence regarding benefits of DHA and ARA in infant formula is inconclusive, yet the addition of these additives increased the price of formula by 7%-30%. This paper recommends that USDA be given the statutory authority to require the Institute of Medicine to review the claimed benefits of these ingredients so that USDA can base decisions of use on evidence rather than manufacturers’ claims.

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New report examines breastfeeding messaging

Media experts examine breastfeeding messaging and how to make it more effective.

A new report from the Berkeley Media Studios Group commissioned by the California WIC Association looks at factors that may help breastfeeding advocates deliver more effective messages. The concept of re-framing breastfeeding is discussed to help advocates anticipate what people think about the issue and what is needed to help people see the issue differently. In a new analysis, Talking about Breastfeeding: Why the Health Argument Isn't Enough, frames are discussed as the mental structures we use to integrate new information in a coherent manner. Frames used in media coverage foster certain interpretations and obstruct others. Understanding how issues are framed can help breastfeeding advocates assure that their message has the best chance of understanding by the target audience. To see the entire report see


Nestle’s new marketing machination

Nestle enlists an army of mothers as their newest salesforce.

Just a quick heads up on a new and insidious marketing tactic being employed by Nestle, owner of the Gerber brand of formula. The wonderful Blacktating blog informed us on May 14 of a new type of formula marketing tactic employed by Nestle/Gerber, the House Party. House Party is an internet based mechanism to entice people to host a party for a particular product brand, in this case Gerber formula. Prospective hosts apply on-line at the House Party website,, and if selected, the host receives free products for themselves and product samples to distribute to their friends, family, and neighbors that they invite to this party (reminiscent of Tupperware parties). Essentially, Nestle/Gerber recruits salespeople who are not hired employees but peers of the targeted market. Guests at this party receive a Gerber insulated backpack filled with numerous coupons and samples of Gerber products. The host receives a box of gifts for herself and samples including infant formula to display for all participants. Hosts are encouraged to take photos of the party and provide (glowing) comments on how much fun they had and how people gushed over Good Start formula. Who has breastfeeding parties?!!!

This is a clever way to put into practice what a growing body of research is showing about how people process information when making decisions, including health decisions for themselves and their family. Research has shown evidence regarding the striking persuasive power of anecdotal comments from friends and family. Even a weakly offhand positive comment about an inferior product has proven more powerful than research-based evidence and statistics. Mothers are putting more stock in what their friends say about formula than they are in what we say about breastfeeding.

This may make it more important for us to consider alternative interventions to mitigate the effect of powerful anecdotal biases. Anecdotal manipulation of health decisions is a powerful marketing tactic for both infant formula manufacturers and for us to consider when helping mothers make infant feeding decisions. Some health providers ask mothers to "think like a scientist" when presented with information on the differences between health outcomes when using infant formula or breastmilk. In other words, the mother is oriented to think in a different manner to make her judgement and decision. Decision aids are also helpful (videos of mothers talking about breastfeeding, visual aids, etc). Counterarguments to formula feeding also include asking mothers to engage in an exercise to orient their thinking to and write down reasons why the reliability of certain types of information might be called into question. Perhaps we need to direct mothers' thinking in a different manner when talking about breastfeeding, supplementation, and the use of infant formula.

It is so frustrating to me to work with mothers and see them make inferior choices based on what their friends tell them. These house parties represent yet another perfect example of marketing research at its finest. It makes me wonder if we need to really take a closer look at changing the way we approach how we present information to mothers regarding infant feeding. The hours we spend talking about the health benefits can be completely undone at a house party where other mothers gush over how great formula has been to their life. To read the entire blog on house parties see:

As we think about breastfeeding promotion strategies for the nation I wonder if we should consider re-orienting how we approach not only the public but also federal agencies and legislators. These people are just as prone to using anecdotal comments as mothers are. A good example is the letter regarding the National Breastfeeding Awareness Campaign sent to then Sec Tommy Thompson from a lobbyist for the International Formula Council It is full of anecdotal opinions and no science to speak of. Should we be weaving stories into our approach rather than only statistics? Should our work take into consideration the numerous articles on how narratives and stories affect decision making of both mothers and policy makers? How can we reduce the influence of anecdotal reasoning on the decisions of mothers and policy makers and make our voice better heard.

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The Whitehouse Taskforce on Childhood Obesity releases its report, “Solving the problem of childhood obesity within a generation”

The new Whitehouse report on childhood obesity places breastfeeding in a prominent position in the prevention of childhood obesity. Infant formula is implicated as a contributor to the problem.

The Let's Move! Campaign was launched by First Lady Michelle Obama in February 2010 with the goal of solving the childhood obesity epidemic within a generation. Within this campaign, President Barack Obama established the Task Force on Childhood Obesity to develop and implement an interagency plan that details a coordinated strategy, identifies key benchmarks, and outlines an action plan to end the problem of childhood obesity within a generation. The action plan defines the goal of ending childhood obesity in a generation as returning to a childhood obesity rate of just 5 percent by 2030, which was the rate before childhood obesity first began to rise in the late 1970s. The report presents a series of 70 specific recommendations, 4 of which involve breastfeeding as an obesity preventive measure.
Recommendation 1.3: Hospitals and health care providers should use maternity care practices that empower new mothers to breastfeed, such as the Baby-Friendly hospital standards.

Recommendation 1.4: Health care providers and insurance companies should provide information to pregnant women and new mothers on breastfeeding, including the availability of educational classes, and connect pregnant women and new mothers to breastfeeding support programs to help them make an informed infant feeding decision.

Recommendation 1.5: Local health departments and community-based organizations, working with health care providers, insurance companies, and others should develop peer support programs that empower pregnant women and mothers to get the help and support they need from other mothers who have breastfed.

Recommendation 1.6:
Early childhood settings should support breastfeeding.

The website for the Let’s Move campaign contains the downloadable report to the president from the Whitehouse Task Force on Childhood Obesity, Solving the problem of childhood obesity within a generation as well as recommendations for families to reduce childhood obesity by providing information on simple ways to make healthy choices for the family. Breastfeeding plays a prominent part in the healthy start section on feeding infants. Infant formula is implicated as a contributor of the childhood obesity epidemic. An 8 page document entitled Does breastfeeding reduce the risk of pediatric overweight provides a compelling case for breastfeeding as one of the first interventions in reducing obesity in children. It includes recommendations from the CDC’s Guide to breastfeeding interventions.

Both documents will be extremely useful in validating the importance of breastfeeding in the national campaign to reduce childhood obesity.

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Support for Employed Breastfeeding Mothers included in Healthcare Reform

The long-awaited healthcare reform bill is now law and contains workplace support language for employed breastfeeding mothers.

The Patient Protection and Affordable Care Act (also known as healthcare reform) that was recently signed into law by President Obama includes workplace support language for employed breastfeeding mothers. The provision states that employers shall provide reasonable, unpaid break time and a private, non-bathroom place for an employee to express breast milk for her nursing child for up to one year after the child’s birth. Employers with less than 50 employees are not subject to the requirement if it would cause “undue hardship.” Since return to employment is a major reason mothers avoid or abandon breastfeeding, this new federal law should help break down some of the barriers to breastfeeding that unsupportive workplaces present to new mothers.

A company needs to change very little to provide lactation support. Basic needs include a clean place to express milk in privacy and break time to express milk approximately every 3 hours during the work period. A model law in Oregon defines reasonable time for milk expression as 30 minutes for every four hours worked. This represents a good match between natural breastfeeding cycles and the rhythms of the workday. Companies that provide accommodations for breastfeeding employees enjoy a return on investment of approximately $3 for every $1 spent. Rates of employee absenteeism for mothers who formula-feed show 3 times more one-day absences from work than breastfeeding mothers. Missed work is expensive to an employer, especially if a temp must be hired. Health claims are reduced, which is a great benefit to employers who are self-insured. If a breastfeeding mother cannot reconcile breastfeeding and working and quits, then the employer can spend thousands of dollars recruiting and training a new employee.

Currently, 24 U.S. states, Puerto Rico, and the District of Columbia have legislation related to breastfeeding in the workplace. The new federal provision will provide a minimum level of support in all states, but it will not preempt a State law that provides stronger protections.

Even though the law is effective immediately, the U.S. Department of Labor must now work to define terms and enforcement procedures. Breastfeeding advocates can refer employers, human resources managers, and breastfeeding employees who are interested in helping to establish worksite lactation programs at their place of employment to a list of frequently asked questions on the US Breastfeeding Committee Web site.

The Colorado Breastfeeding Coalition has helpful videos available on their channel at

The three videos are:

1. Breastfeeding and working - moms share their stories

2. Employer perspective on accommodating breastfeeding employees - an employer and a breastfeeding employee discuss how and why they made their workplace mother-friendly

3. Workplace Accommodations for Nursing Mothers - overview of the law in Colorado - also relevant in other states, as legislation is similar

A useful resource for employers, employees, and lactation consultants is The Business Case for Breastfeeding, published in 2008 by the Department of Health and Human Services. Materials in this program inform and instruct employers regarding how to establish supportive conditions for breastfeeding employees in the workplace and includes a booklet for employees also. Employees whose companies provide breastfeeding support consistently report improved morale, better satisfaction with their jobs, and higher productivity. State breastfeeding coalitions in 32 states (Alabama, Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Nevada, New York, North Carolina, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Texas, Utah, Vermont, Washington, West Virginia, and Wisconsin) have received training and are using this program to approach employers in their state to institute worksite breastfeeding support. Breastfeeding advocates may wish to contact their state breastfeeding coalition and join in this effort.

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New study shows low breastfeeding rates cost the US $13 billion/year

Low breastfeeding rates cost the U.S. $13 billion each year and result in more than 900 preventable deaths, according to a newly published study in the journal Pediatrics.

Despite medical recommendations that urge new mothers to breastfeed exclusively for the first six months of infants' lives with continued breastfeeding during at least the first year, only 32% of babies are exclusively breastfed at three months of age, and that number shrinks to 12% at six months of age. Low exclusive breastfeeding rates are costly to the US in both direct health care costs and in lost productivity.

A cost analysis was conducted for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity.

Results of the study showed that if 90% of US families complied with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants A savings of $10.5 billion and 741 deaths were calculated at 80% compliance.

This study may help insurers and policy makers understand the importance of breastfeeding as a public health issue. Breastfeeding advocates may wish to use this data when needing to validate the economic cost of not breastfeeding and to illustrate that everyone pays when babies are not breastfed.

The study can be found at:

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Soy infant formula associated with high risk of fibroids in women

Women who were fed soy infant formula as babies are 25% more likely to develop uterine fibroids than those who were breastfed or given milk-based formula.

Researchers using a subset of data from a large US study examining environmental risk factors for cancer and other reproductive health outcomes looked at elements associated with the early development of uterine fibroids. Women who were fed soy formula as infants were 25% more likely to have been diagnosed with uterine fibroids by age 35 than women who had been breastfed or fed milk-based formula. Fibroids can cause pelvic pain, heavy menstrual bleeding, and are the leading cause of hysterectomy.

Soy-based foods contain naturally occurring estrogen-like components called isoflavones. Approximately 20% of the US infant formula market is composed of soy formula. Infants fed soy formula ingest relatively high levels of isoflavones. While soy foods make up a large part of Asian adults’ diets, Asian infants are either breastfed or receive very low amounts of soy. Isoflavone levels in US infants blood are 10 times higher than Japanese adults and 200 times higher than infants who are breastfed or fed cow’s milk-based formula.

Millions of female infants in the US are heavily exposed to high levels of isoflavones when consuming soy infant formula, placing them at increased risk for uterine fibroids and potentially other reproductive alterations. The study also found that not only was soy formula a risk factor for developing uterine fibroids but having a mother with prepregnancy diabetes, being born at least one month early, and growing up with low
socioeconomic conditions increased the development of fibroids in early adulthood.

To read the entire study, see:
D’Aloisio AA, Baird DD, DeRoo LA, Sandler DP. Association of intrauterine and early life exposures with diagnosis of uterine leiomyomata by age 35 in the sister study. Environmental Health Perspectives doi:10.1289/eph.0901423

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US Breastfeeding Committee facilitates successful breastfeeding coalitions conference

The third National Conference of State/Territory/Tribal Breastfeeding Coalitions was held January 23-25, 2010 in Washington, DC. This approach to grassroots leadership education is the only event of its kind in the breastfeeding field.

The United States Breastfeeding Committee has taken the initiative of presenting a conference every two years designed to enhance the leadership capacity of the states in developing initiatives to promote breastfeeding. This approach to grassroots leadership education is the only event of its kind in the breastfeeding field. Both new and experienced state breastfeeding coalition leaders are drawn to this event because they know they will learn from the best experts of all—their peers—as well as from nationally recognized experts in the fields of communication. The NCSBC brings together coalition leaders from every U.S. state and territory—including representatives from relevant government departments, nongovernmental organizations, and health professional associations. The conference provides them with an opportunity to further their knowledge and hone skills necessary to more effectively build and manage coalitions within their states.

Handouts of session can be obtained from:

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“Surgeon General’s Vision for a Health and Fit Nation” contains breastfeeding recommendations

The new Surgeon General’s report on obesity contains multiple references to breastfeeding as a primary preventive strategy in reducing overweight and obesity.

The report talks about personal responsibility, about communities working together, and about grass roots efforts. It places the onus for weight loss squarely on the shoulders of individuals and the communities where they live.

The report is broken into sections which include breastfeeding as an important obesity prevention strategy. Exclusive breastfeeding for six months is identified as one of the healthy choices for obesity prevention. Breastfeeding is addressed in the child care, worksite, medical providers, and community support sections. “Hospitals, work sites, and communities should make it easy for mothers to initiate and sustain breastfeeding as this practice has been shown to prevent childhood obesity.” Breastfeeding advocates may wish to use this document as a resource when applying for obesity grant money to facilitate community breastfeeding improvement efforts. To read the entire report see:


Hospital data collection guidelines for new Joint Commission Perinatal Core Measure

New guidelines from the US Breastfeeding Committee have just been published to assist hospitals and maternity facilities in accurately collecting data needed to comply with the exclusive breast milk feeding requirement in the perinatal core measure set from the Joint Commission.

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Formula companies sue each other

PBM Products, maker of store brand infant formula, was awarded $13.5 million in damages in a lawsuit filed against Mead Johnson for false and misleading advertising. Mead Johnson sent an ad to 1.6 million parents with a blurry picture of a toy duck next to a clear picture with the claim that use of any formula other than Mead Johnson’s Enfamil Lipil would result in blurred vision and suboptimal brain development. What the Federal Trade Commission won’t do is done by formula companies to each other.

See for more details.

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Breastfeeding reduces the risk of maternal cardiovascular disease, stroke and heart attack

Researchers have found that mothers who do not breastfeed their infants experience an increased risk of vascular changes associated with future cardiovascular disease. In a study of 297 women, mothers who had never breastfed were five times more likely to have artery calcifications than were women who had breastfed. Read more…
In a study of nearly 300 women, researchers found that 32% of the women who had not breastfed had coronary artery calcification, compared with 17% of the breastfeeding moms. The researchers found calcifications in 39% of the aortas of women who hadn't breastfed, versus 17% of the women who had. They also found plaque deposits in the carotid artery of 18% of the women who had not breastfed and 10% of those who had.  After adjusting for variables such as socioeconomic status, family history, lifestyle factors, risk factors and body mass, researchers concluded that women who had never breastfed were five times more likely to have artery calcifications than were women who had breastfed. After adjustment for age, parity, and study site, significant protective relationships were seen between lactation and multiple markers of subclinical cardiovascular disease, including aortic calcification, coronary calcification, and adventitial diameter. However, after adjustment for other lifestyle and family history variables, a significant association was only seen between aortic and coronary calcification and consistent lactation for 3 months or more postpartum. Calcifications or plaque deposits can build up over time and restrict blood flow, cause stroke or heart attack. This study is consistent with a number of other pieces of research verifying that women who do not breastfeed are at greater risk of clinical cardiovascular disease.

Schwarz, EB, McClure CK, Tepper, PG, et al. Lactation and maternal measures of subclinical cardiovascular disease. Obstetrics & Gynecology 2010; 115:41-48.

Available for download at:

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Local governments urged to support breastfeeding

The Institute of Medicine’s Committee on Childhood Obesity Prevention Actions for Local Governments was convened to identify promising actions that local governments can take to curb obesity among children. The 2009 report Local Government Actions to Prevent Childhood Obesity presents the committee’s menu of recommended action steps for local government officials to consider in their efforts to prevent childhood obesity in their community. Strategy number six is to encourage breastfeeding and promote breastfeeding-friendly communities.

In the United States, 16.3 percent of children and adolescents between the ages of two and 19 are obese. The prevalence of obesity is so high that it may reduce the life expectancy of today’s generation of children and diminish the overall quality of their lives. While parents and other adult caregivers play a fundamental role in teaching children about healthy behaviors, those positive efforts can be undermined by local environments that are poorly suited to supporting healthy behaviors—and may even promote unhealthy behaviors. Local governments can play a crucial role in creating environments that make it easier for children to eat healthy diets and move more.

The Institute of Medicine’s Committee on Childhood Obesity Prevention Actions for Local Governments was convened to identify promising actions that local governments can take to curb obesity among children. The committee sought action steps that are within the jurisdiction of local governments; likely to directly affect children; based on the experience of local governments or sources that work with local governments; take place outside of the school day; and have the potential to promote healthy eating and adequate physical activity. The 2009 report Local Government Actions to Prevent Childhood Obesity presents the committee’s menu of recommended action steps for local government officials to consider in their efforts to prevent childhood obesity in their community. Strategy Number Six is ‘Breastfeeding,’ and specifically recommends the following action steps:

  • Adopt practices in city and county hospitals that are consistent with the Baby-Friendly Hospital Initiative USA (United Nations Children’s Fund/World Health Organization). This initiative pro­motes, protects, and supports breastfeeding through ten steps to successful breastfeeding for hospitals.
  • Permit breastfeeding in public places and rescind any laws or regulations that discourage or do not allow breastfeeding in public places and encourage the creation of lactation rooms in public places.
  • Develop incentive programs to encourage government agencies to ensure breastfeeding-friendly worksites, including providing lactation rooms.
  • Allocate funding to WIC clinics to acquire breast pumps to loan to participants.

The entire report can be downloaded at

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Nestle bribes bloggers to promote a more positive image

Aware of its poor image in many parenting circles, Nestlé went to the blogosphere to create a more positive image by inviting 20 top mommybloggers to attend a two-day all-expense-paid trip to California to meet with its U.S. CEO, a Nestlé chef, and a fitness expert. If that weren't enough, apparently they sent Omaha steaks to the husbands back home to keep them happy while their wives were away on this "Nestlé Family Blogger Event" junket.

Hoping to use the social media to whitewash its poor behavior, Nestlé’s damage control junket backfired when a storm was ignited on Twitter. Some women, aware of Nestlé's history, declined the trip. But many others accepted, including some breastfeeding advocates. And once the bloggers began posting on their blogs during the trip—and going on Twitter with the hashtag #nestlefamily for others to follow their tweets—the Twittersphere exploded in an hours-long heated debate, with some getting angry, some going on the defensive, and some oblivious to the larger issues. In the end, Nestlé may have created more bad press for itself than good. Hoping to convince 20 mommybloggers to say nice things about their products, they've inadvertently opened the floodgates for hundreds of bloggers and thousands of readers (unfamiliar with Nestlé's formula sales in the developing world or the Boycott Nestlé movement) to learn more about the company's unsavory marketing practices.

In trying to wine and dine the moms and feed steaks to the dads, they've drawn attention to the undisputable fact that by fostering an environment that promotes the use of infant formula, Nestlé is selling preventable illness and death to the millions of babies who could be breastfed but aren't because their mothers have been deceived by slick marketing and empty promises.

For a thorough look at the Nestlé Family event, the Twitter brouhaha, the reactions of some of the leading "responsible motherhood" bloggers—and an examination of the larger issues— there's a detailed recap from Best for Babes at The entire thread of this Twitter Firestorm can be traced through the following:

The blog has played a very significant role in educating moms on the internet about the WHO code, breastfeeding, and attachment parenting. The author of this blog started the Twitter Firestorm about Nestle inviting bloggers as reported by the Huffington Post, which breathed new life into the Nestle Boycott. See: She also succeeded in persuading the BlogHer Ad Network to allow bloggers to opt-out of not only formula, but bottle advertisements so that these unwanted ads do not appear on blogs dedicated to supporting breastfeeding and the Code. See  

The original post on the Nestle issue is here: An open letter to the attendees of the Nestle Family Blogger Event.

Out of the event came an invitation to ask Nestle questions. She sent them 17 questions to follow up on statements they had made during the event and associated twitter storm. The questions, as well as links to all of the posts with their answers and an analysis of the answers, can be found here: Follow-up questions for Nestle. The posts analyzing their answers are as follows:

In addition to the posts, there was also a guest blogger who wrote a post about Nestle's online breastfeeding advice:



All infant formula contains fluoride at tooth-discoloring levels

All infant formulas, whether ready-to-feed, concentrated or organic, contain fluoride at levels which can discolor developing teeth, reports the October 2009 Journal of the American Dental Association (JADA). Researchers measured fluoride content of 49 infant formulas.

The research team concluded that, "Most infants from birth to age 12 months who consume predominantly powdered and liquid concentrate formula are likely to exceed the upper tolerable limit [of fluoride] if the formula is reconstituted with optimally fluoridated water (0.7 - 1.2 ppm)." All 6-month-olds and younger will also exceed the lower "adequate intake" (0.01 mg/day) from all formulas (concentrated or not) risking moderate dental fluorosis from formula, alone.


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Children who suck their fingers or use a pacifier for more than three years are three times more likely to develop speech impediments

Researchers from the United States and Chile studied 128 three- to five-year-olds. They compared the children's history of thumb and finger sucking, breastfeeding and use of pacifiers with evaluations of children's speech. They found that the use of bottles, pacifiers and other sucking behavior apart from breastfeeding could increase the risk of speech disorders in young children. The study appears in BMC Pediatrics which is an open access journal.

The entire study can be accessed at


Breastfeeding cuts breast cancer in high risk women by 59 percent

The new study, published in The Archives of Internal Medicine, used information from 60,075 participants in the second Harvard Nurses’ Health Study. Among women whose mother or sister had breast cancer, having ever breastfed was associated with a 59% reduction in incidence of premenopausal breast cancer (hazard ratio, 0.41; 95% confidence interval, 0.22-0.75). Lactation was not related to incident premenopausal breast cancer among women without a family history of breast cancer.

See: Alison M. Stuebe; Walter C. Willett; Fei Xue; Karin B. Michels. Lactation and Incidence of Premenopausal Breast Cancer: A Longitudinal Study Arch Intern Med, Aug 10/24, 2009; 169: 1364 - 1371.

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Nighttime formula-Enfamil RestFull: help or hazard

Mead Johnson is marketing a “new” infant formula called RestFull as an alternative to adding rice cereal to formula bottles to make babies sleep longer at night. From the Mead Johnson website, “For moms and healthcare professionals who recommend adding rice cereal to infant formula to keep babies feeling full longer, Enfamil has a nutritionally balanced alternative, Enfamil RestFull.” The formula maker states that, “Enfamil RestFull is designed to help babies feel full longer and sleep better.” This effect is due to rice starch that has been added to the formula. What parents and clinicians may not know is that Enfamil RestFull is the exact same formula as Enfamil AR (used for reflux) with a different label and different indication for use.

Does the formula actually work? There are 52 reviews of this formula on the Mead Johnson website. Twenty-three of the reviews say that the formula did not improve their baby’s sleep and others actually complained that the formula upset the infant’s stomach, gave him more gas, and kept him up longer from the GI distress.

Is the formula safe? There is a demonstrated relationship between SIDS and an infant not rousing to breathe at night. Would a formula designed to keep a baby asleep longer increase the risk for SIDS? Will this formula cause sleep-deprived breastfeeding mothers to supplement with RestFull in hopes of capturing a few more hours of sleep? Since there is a paucity of any data on the side-effects of this formula which have been noted as constipation, gas, spitting up, wakefulness and since there is no data regarding its possible relationship to the increased risk of SIDS, clinicians may wish to approach this formula with caution.

The marketing text implies the promise that parents will sleep longer at night because their infant will not wake to feed. The formula is the exact same composition as Enfamil AR. Does this qualify as false, misleading, and deceptive advertising? Sounds like it. Write to the Federal Trade Commission at and complain that parents may be deceived into purchasing this product—a product whose claims that may not be grounded in fact, a product that may not actually work and is unable to deliver what it claims, a product that may be potentially hazardous, and a product with advertising that may cause consumers to purchase it without knowing that it is the same composition as Enfamil AR.

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— 2011 —