Infant feeding and planetary health go hand in hand

I recently woke up to a headline with the words “climate” and “hope” strung together. As author Jeff Brady points out, it’s “…something you don’t hear much when it comes to climate change: hope.” 

Brady goes on to illuminate a recent International Energy Agency (IEA) report that shows “countries are setting records in deploying climate-friendly technologies…” 

There’s more: “While greenhouse gas emissions keep rising, the IEA finds that there’s still a path to reaching net-zero emissions by 2050 and limit global warming to 1.5 degrees Celsius, or 2.7 degrees Fahrenheit. That’s what’s needed to avoid the worst effects of climate change, such as catastrophic flooding and deadly heatwaves,” he writes.

Photo by Mika Baumeister on Unsplash

It’s hard to imagine that we’re in a place where there’s still the potential for “the worst effects.” Are we not already there? 

Not long ago, when extreme weather occurred, we were told it wasn’t possible to link specific events to the climate crisis. Now though, scientists have figured out a model to represent how the climate crisis produces specific weather events like hurricanes and extreme heat.

Extreme weather events and other disasters and emergencies will continue to occur, so it’s imperative that we develop infant and young child feeding in emergencies (IYCF-E) preparedness in the U.S., something we are seriously bad at.  

Jennifer Russell’s, MSN, RN, IBCLC, NHDP-BC, Ph.D. Candidate in Nursing Science from the University of Tennessee Health Science Center co-authored Domestic Preparedness Journal article “Challenges with pediatric mass care feeding,”(p 27-31) details the importance of and how state, local, tribal, and territorial organizations’ (SLTTs) can “safely, effectively, equitably, and quickly provide pediatric feeding support” in emergencies. 

Namely, the authors state: “SLTTs must estimate and plan for the logistical distribution and cost of breastfeeding and re-lactation supplies along with safe alternatives to mothers’ breastmilk and other pediatric feeding items.” The authors bust some common misconceptions about emergency response and offer ways in which we can improve existing guidance. 

Photo by Dave Clubb on Unsplash

In her most recent guest post on Our Milky Way, “Nourishing Children and the Planet”,  Healthy Children Project’s Donna Walls considers the critical weather events of late and highlights the urgency of education, legislation and action.

Walls points out that lactation care providers (LCPs) and health advocates can and should take a leading role in the fight for the health of our planet.  LCPs are important actors within the greater need for national-level policy development, and LCPs’ work helps to mitigate the more grandiose challenges of the climate crisis.  

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The first best food for infants is mother’s own milk. We all know about the benefits for mothers and babies, but we don’t often discuss the benefits for the health of the planet.

https://www.gifa.org/en/international-2/green-feeding/

This is a win-win situation. By providing our infants and children with cleaner, “greener” foods, we also create a cleaner, safer environment for our families, our communities and the world. 

By contrast, commercial milk formulas (CMFs) are harmful to the planet because they require procurement of ingredients and manufacturing and transport of the product. All of these processes use resources and contribute to the increasing burden of greenhouse emissions. Read Powdered Baby Formula Sold in North America: Assessing the Environmental Impact for a detailed look at the environmental and Greenhouse Gas impact of powdered baby formula, which as the authors note, “should be considered when developing and funding infant and young child feeding policies and supportive programs.”

Water resources are scarce in many countries around the world, and yet “about 5000 litres of water are used for every kilogram of milk powder, including producing the milk, then processing the powdered milk, preparing the feeds, and sterilising feeding equipment.” (Linnecar, van Esterik, 2023).  Unnecessary use of precious water resources threatens the very survival of children across the globe.

It’s true that “the few extra litres of water required by a breastfeeding mother are negligible compared to the amounts of water for formula production and preparation.” (Linnecar, van Esterik, 2023

Destruction of natural resources, such as the rainforest for harvesting ingredients as well as ever-mounting pollution from plastics is creating a negative impact on the environment ultimately contributing to rapid climate change. 

By supporting breastfeeding families,  LCPs can be the first line of defense by reducing pollution and minimizing the powerful effects of the climate crisis. Breastfeeding  is, without doubt, the cleanest, “greenest” form of infant nutrition. 

Ultra processed foods (UPFs) impact on  health

What’s more, we have evidence that breastfed infants consume less ultra processed foods (UPFs) as they get older (Paharia, 2023). 

UPFs not only strain our resources but have been shown to increase rates of type 2 diabetes, obesity, hypertension, cardiovascular disease and dementia further straining resources as communities struggle to care for sick individuals. Shockingly, research shows “67% of children’s calories come from empty ultra processed foods” in the U.S. (Berg, 2022).

Food additives– “any substance not normally consumed as the food itself and not normally used as a typical ingredient of the food, whether or not it has nutritive value” (FAO, Codex Alimentarius, 2021)– frequently found in UPFs, present a myriad of concerns including central nervous system disruptions, hyperactivity or other behavioral or neurological issues in children. (Health Effects Assessment: Potential Neurobehavioral Effects of Synthetic Food Dyes in Children, 2021

Predatory marketing lulls families into believing that these convenient food sources are not harmful. Information and research about the toxicities and harm is usually assigned to the small print or not disclosed at all. 

The Environmental Working Group (EWG) has published information on several food additives that are especially troubling. These include:

  • Nitrates and nitrites- meat preservatives  linked to stomach cancer, esophageal cancer, and possibly brain and thyroid cancers
  • Propyl paraben- a preservative in pastries shown to cause developmental and reproductive harm.
  • Food dyes (especially red and yellow dyes) linked to cancers
  • Potassium bromate- carcinogen found in baked goods
  • BHT and BHA- preservatives in foods are possible carcinogens
  • Titanium dioxide- color additive implicated in DNA damage
  • PFAS- known as forever chemicals used in food packaging which has been shown to leach into foods. These are known to increase the risk of cancer, damage to the immune system and hormone disruption. 
Food additives’ impact on environmental health 

According to Lempart-Rapacewicz, et al, the latest literature classifies food additives as one of the groups of so-called Contaminants of Emerging Concern (CECs), defined by the United States Environmental Protection Agency (USEPA) and United States Geological Survey (USGS).

These chemicals are not naturally occurring, and so require manufacturing resources ie; water, energy, systems for disposal of by-products and waste and packaging materials, to either develop or alter the final product.  Pollution of our air and water are well documented consequences of this type of manufacturing. 

These  substances are also found in sewage where current processes are unable to remove them from the systems, leading to concerns of the micropollutants in the ground and water tables. 

Additives such as ascorbic acid might sound harmless, but when found in large quantities,  alters the pH of water and soil, affecting the basic growing medium for plants and crops. Ongoing research investigates the long-term consequences on plant and crop properties and the effects on biodiversity. Some studies have found mutagenic and teratogenic effects on fish and aquatic vegetation after exposure to food additives. ( Lempart-Rapacewicz, et al, 2023)

Plastic ingestion

Infants and children can be especially susceptible to  exposure to micro or nano plastics–plastics so small they are measured in micrometers or nanometers (microplastics are plastic particles under 5 millimeters in size, and nanoplastics are under 0.001 millimeters in size). They’ve been detected in many of the foods we eat,  in the air we breathe and the water we drink. Micro and nanoplastics are absorbed into our bodies through food packaging or in infants and children through feeding bottles and teats, baby food containers and pouches. Significantly more particles are released when the food containers are heated in the microwave (Hussain, et al, 2023).

Photo by Zeesy Grossbaum on Unsplash

The health effects of ingesting plastics are not completely understood yet, but early research implicates micro and nano plastics in imbalances in the microbiome, altered lipid metabolism, reproductive system, brain and lung dysfunctions. 

More on environmental degradation

In 1962,  Rachel Carson wrote the groundbreaking book Silent Spring, sounding the alarm about the use of pesticides and herbicides. Concerningly, as a nation, we have yet to heed her warnings. 

Use of these powerful chemicals is negatively impacting plants by causing them to produce less phytonutrients– the vitamins and minerals we need to stay healthy. 

Scientists are finding “dead zones” in bodies of water, areas that are so polluted they can no longer sustain aquatic animals and plants on account of run off of these toxins. Disruptions in the ecosystems have led to the rapidly changing climate and instability of our weather patterns.

Since the publishing of Carson’s book, micro and nano plastics have been found to inhibit the growth of healthy microbiota in aquatic animals and have also been shown to obstruct the digestive system of marine organisms such as mussels and oysters. 

Scientists note increasing contamination of agricultural soils with these particles, reducing plant growth and overall productivity (Amboyne, et al, 2021). Soil contamination negatively affects inhabitants such as earthworms and nematodes resulting in changes in the soil microbiome.

Learning to live in balance
Photo by Derek Owens on Unsplash

On an individual level, tackling the catastrophic challenges spurred by the way we produce and consume food, is insurmountable and requires system-level action;  however, there are resources for families to consult when working to make the healthiest choices for their families. Beyond breastfeeding,  families can check out theEWG’s  “Dirty Dozen” and “Clean 15” listing of foods to find the most budget-friendly way to provide cleaner, organic foods. There is no question that organic foods are the healthiest. 

When we learn to live in balance with the natural world, the health of both flourishes.  It can sometimes seem an uphill battle to create a cleaner, greener world but as individuals, and collectively, it is our privilege and responsibility to do whatever we can. One person at a time, one family at a time, one community at a time. One of my life-long favorite quotes is from Margaret Mead, and it is as important now as when she wrote it in 1978: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed it is the only thing that ever has”. This seems to be the time for those committed to caring for mothers and babies to also commit to caring for Mother Earth as well.

More resources to consult

Global Nutrition Report 

Green Feeding Tool

IBFAN’s Health and Environmental Impacts

Report on CARBON FOOTPRINT DUE TO MILK FORMULA: A study from selected countries of the Asia-Pacific region

Register to attend  Infant and Young Child Feeding in Emergencies: Preparedness Systems for Communities to Keep Our Babies Safe webinar hosted by U.S. Breastfeeding Committee (USBC) and the National Association of County and City Health Officials (NACCHO) on November 1 from 2:00 – 3:30 pm ET. The session will provide an overview of the Centers for Disease Control and Prevention’s (CDC) infant and young child feeding in emergencies (IYCF-E) toolkit, share current research exploring personal experiences and disaster-related factors that influence breastfeeding, describe how NACCHO has supported communities in emergency preparedness for maternal and child population.



Breastfeeding is eco-friendly.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is eco-friendly.

Planetary protection has never been more crucial, and the undeniable relationship between planetary health and human health has never been more evident.

In November 2022, world leaders, policy-makers and delegates from nearly 200 countries attended the COP27 UN climate summit, held in Sharm El-Sheikh, Egypt.

Fabrication of Bodies Joined by a Molecule of Air(2022), by Invisible Flock and Jon Bausor, manufactured by MDM Props Limited in Lebanon, represented by Architect & Engineer Karim Attoui. ©Courtesy of Invisible Flock. https://invisibleflock.com/portfolio/bodies-joined/

Presenters made poignant remarks about the climate crisis we find ourselves in.

“We are on a highway to climate hell with our foot on the accelerator,” António Guterres, Secretary-General of the United Nations said.

Sherry Rehman, Minister of Climate Change, Pakistan argued that  “The dystopia has already come to our doorstep …”

Mark Brown, Prime Minister of the Cook Islands, shared, “Our survival is being held to ransom at the cost of profit and an unwillingness to act despite the ability to do so.”

On Decarbonization Day of the summit, Dr. Abla Al Alfy convened a panel of speakers who presented on the importance of the 1,000 Golden Days and the relationship between the climate crisis and mother baby health. [You can access the United Nations Egypt’s recording here which starts at 19 minutes in.]

Dr. Nevein Dous, UNICEF health specialist, covered infant mortality rates, micronutrient deficiencies, mental health challenges, among other global health challenges and called for the integration of services rather than siloing health strategies.

WHO

Frederika Meijer with UNFPA Egypt highlighted UNFPA’s work confronting medical violence and reducing the country’s cesarean section rate which soars over 60 percent.

Meijer brought light to the need to create resilient health systems that will withstand the inevitable shocks of the climate crisis.  She noted the important role skilled midwives play in the reduction of unnecessary c-sections, giving way to the work of Dr. Kawther Mahmoud, President of the Nurses Syndicate, Assistant Undersecretary for Nursing and head of the Central Department for Nursing in Egypt, who helps lead the national plan for the midwife.

Many presenters emphasized the importance of family planning counseling and the environmental and health implications of pregnancy spacing.

Dr. Naeema Al-Gasseer’s remarks drew attention to a recent WHO report which states that “Almost the entire global population (99%) breathes air that exceeds WHO air quality limits, and threatens their health.”

Dr. Camilla Kingdon, President of the Royal College of Pediatrics and Child Health, further described that 26 percent of child deaths under 5 years of age have an element of environmental cause like heat waves, water scarcity, vector-borne diseases and flooding. UNICEF has identified that air pollution will be the leading cause of death for children by 2050, she shared. Additionally, there is a clear link between air pollution and miscarriage. Dr. Kingdon went on to describe the prevalence of visible air pollution particles on the placenta.

WHO

In connection to these harrowing accounts, Healthy Children Project’s Dr. Karin Cadwell presented research on the environmental impact of powdered baby formula milks in North America. Read about that work here.

Healthy Children Project’s Dr. Kajsa Brimdyr acknowledged the mess we are in and noted how many solutions that may contribute to planetary and population health are expensive and complex. Skin-to-skin contact (SSC) in the first hour after birth though, is simple and easy, inexpensive, is appropriate for all dyads, and touts priceless benefits.

Brimdyr noted just some of the benefits: SSC in the first hour after birth decreases infant mortality by 25 percent in low birth weight (LBW) infants, decreases transfers to the NICU,  decreases maternal stress and depression, improves paternal parental stress, and allows baby to self attach to the breast improving maternal confidence in breastfeeding and increasing breastfeeding rates overall.

The effects of SSC in the first hour extend far beyond the first hours, the first days and first weeks of life. Feldman et al. (2014) followed mothers and their premature infants who had been in SSC and control groups for 10 years. They found that children who had been in the SSC group had better cognitive development, better autonomic nervous system functioning, and mother–child interactions were more reciprocal 10 years later.

Photo credit: United States Breastfeeding Committee

Silke Mader of the European Foundation for the Care of Newborn Infants (EFCNI) and her colleagues are fighting for SSC and breastfeeding support for all dyads. Mader calls for a zero separation policy which is supported by evidence even in the context of the pandemic, she reported. Mader added that fathers and partners are not second-class citizens and should be included in the policies that help shape proper parent infant bonding.

As the climate emergency becomes more and more bleak, breastfeeding is a safeguard for infant and young child health. Read our coverage on infant and young child feeding in emergencies (IYCF-E)  in Prioritizing infant and young child feeding in emergencies during National Preparedness Month and beyond and National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies.

COP27 held the first-ever Youth-led Climate Forum ensuring that young people have a place in the conversation about the climate crisis. More on that here.

 

More resources to explore  

RCPCH Climate Change Working Group

Baby Milk Action’s coverage on COP27

Breastfeeding can help tackle climate crisis but it’s on governments, not mums to save the world

The climate crisis is a health crisis short video

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us: Where have you seen predatory marketing of breastmilk substitutes?

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Prioritizing infant and young child feeding in emergencies during National Preparedness Month and beyond

September is National Preparedness Month. We’ve spent a lot of bandwidth covering our country’s deficiencies in handling healthy infant feeding in emergency situations. There was National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies, Guiding resources for infant and young child feeding during emergencies, Spotlight on Infant and Young Child Feeding in Emergencies during National Breastfeeding Month, Toxic Stress, Resilience Building, COVID-19 and Breastfeeding, and Underdeveloped plans for infant and young child feeding during emergencies.

In preparation for Hurricane Katrina– which the Federal Emergency Management Agency (FEMA) called “the single most catastrophic natural disaster in US history”– the government organized an alternate site for the Super Bowl but failed to employ an infant feeding in emergencies (IFE) plan. In the aftermath of the catastrophe, pets and exotic animals were accounted for, but mothers and infants were separated from one another as hospitals were evacuated. If you haven’t the time to sift through our coverage on emergency preparedness and response, those accounts pretty much sum up where our priorities lie.

Photo by João Henrique do Carmo: https://www.pexels.com/photo/child-breastfeeds-from-her-mother-5839104/

With the deficit clearly illuminated, we’re glad to report solutions and resources for infant and young child feeding in emergencies (IYCF-E) that have begun to emerge as emergent situations increase in frequency and severity.

During World Breastfeeding Week, we shared work being done in Timor Leste as reported by Dr. Magdalena Whoolery in Strategies for Infant and Young Child Feeding in Climate-Related Emergencies.

We covered Doula and Program Coordinator at Birthmark Doula Collective & New Orleans Breastfeeding Center Malaika Ludman’s, MPH, CLC work in Infant and Young Child Feeding in Emergencies in Louisiana: Lessons Learned from a Post-Hurricane Laura Response During the COVID-19 Pandemic.

Julia-Lorraine Mercedez Moore, a WIC peer counselor in Pickens County, S.C., talks about supporting breastfeeding through the pandemic in South Carolina WIC peer counselors help families through COVID and beyond.  

In New Mexico Breastfeeding Task Force’s efforts to support human milk feeding in alternative housing environments, task force members describe how to best support families in crisis.

Beyond Our Milky Way coverage, there’s fantastic work and opportunities for action to amplify.

CHEERing is an ISO certified, Greek-registered NGO dedicated to improving maternal child health and promoting preventive health in refugee populations. They provide direct support in refugee camps and shelters; training for agencies, including medical professionals and volunteers who work daily with refugee populations, and evaluation and monitoring.

The Global Breastfeeding Collective created an advocacy brief, Breastfeeding in Emergency Situations, which details a call to action that focuses on establishing proactive versus reactive feeding systems.

Photo by Mehmet Turgut Kirkgoz : https://www.pexels.com/photo/a-woman-breastfeeding-her-child-11779231/

The IFE Core Group by the Johns Hopkins Center for Humanitarian Health at Johns Hopkins Bloomberg School of Public Health, the Friedman School of Nutrition Science and Policy at Tufts University and the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill has compiled a repository that provides peer-reviewed journal articles that cover emerging evidence in emergency settings such as natural disasters, conflicts, displacement including refugee settings. Access the repository here.

This summer, the CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) released a toolkit with information and resources for emergency preparedness and response personnel, families, and the public to ensure that children are fed safely when disaster strikes. You can access the toolkit here.

Image credit: United States Breastfeeding Committee

The United States Breastfeeding Committee (USBC) is a leader in helping pass legislation that would better protect young families in emergencies. USBC’s Take Action Center offers an easy way to engage in formalizing legislation. You can contact your legislators about the DEMAND Act (S. 3601/H.R. 6555) here.

Read other USBC coverage on IYCF-E in Disasters Don’t Wait: We Must Make Babies a Priority in Emergencies and The Four Pillars of Infant Nutrition Security in the United States.

USBC Deputy Director Amelia Psmythe Seger’s ‘The Four Pillars of Infant Nutrition Security in the United States’

Our headlines are overloaded with tragedy, perversion, inequities, the unthinkable yet preventable.

Journalist Mary Pilon says in Throughline’s Do Not Pass Go episode “It’s a shame to waste a crisis. A crisis can also be a moment when you look at things and make changes and improvements.”   

And so, from that vantage point, we are honored to be republishing United States Breastfeeding Committee Amelia Psmythe Seger’s piece The Four Pillars of Infant Nutrition Security in the United States originally published here last month. 

“We will get through this because we must. Together we must ensure we build an infant nutrition security system worthy of parent’s trust,” she writes. 

In celebration of World Breastfeeding Week and National Breastfeeding Month on the horizon, there’s no better time than now to take action.  #TogetherWeDoGreatThings

 

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The Four Pillars of Infant Nutrition Security in the United States by Amelia Psmythe Seger, Deputy Director USBC

Throughout its 22-year history, the U.S. Breastfeeding Committee has been working towards the policy, systems, and environmental changes that build a landscape of breastfeeding support.

The catastrophic infant formula shortage demonstrates the value of this work and the need to build a robust infrastructure for infant nutrition security in the U.S. that holds all families in care.

This infrastructure includes four pillars: Parents, Programs, Policies, and a Plan for emergencies.

Parents:

Parents are critical stakeholders in infant nutrition security. The Parents pillar includes people of all races, genders, caregiving roles, routes to parenthood, immigration status, religious or political views, and infant feeding methods. Everyone who loves and cares for a young child belongs. Welcome.

Parents deserve the full support of a robust national infant nutrition security infrastructure. Without it, many are forced onto painful and difficult paths of infant feeding and care. The U.S. needs equitable programs, policies, and a plan for emergencies that centers on the most impacted.Parents and caregivers whose infants rely on formula are the highest priority right now. They need help finding formula, advice on switching between formulas, reassurance that reliable supplies are on the way, and an answer to the question: what should I feed my baby if I cannot find formula?  With appropriate caution, the American Academy of Pediatrics (AAP) published an article on what to feed babies of different ages and situations in an extreme emergency (such as this). Babies under six months should truly only consume human milk or infant formula. In considering very short-term alternatives, the stakes are so high that a physician should monitor the baby.

Parents who are breastfeeding or feeding human milk are in anguish right now, too. Many are feeling pressure to share their milk without acknowledgment of how hard this society has made it to establish and maintain milk supply. Few families have access to lactation support providers, paid family leave, and workplace accommodations to pump breast milk during the workday. In this context, many turn to formula as their backup plan, and it is very scary for them to see that their safety net is in tatters. To answer questions related to human milk, the Academy of Breastfeeding Medicine (ABM) published a guide. This ABM guide addresses pregnancy, low milk supply, re-lactation, options for donation or safe milk sharing, and healthcare guidance and training.

Additional burdens or blame should never be placed on the families and caregivers whose hands are literally full of babies and toddlersWhen capacity allows, however, the collective potential power of parents is significant. Consider if parents insisted on being at the table with the commercial milk formula industry, playing a role in ensuring industry quality, safety, and ethics. They are key stakeholders, after all, so this should be encouraged. Parents could also insist the U.S. enhance our nonprofit milk banking system to ensure an affordable, plentiful donor milk supply for medically fragile infants and those whose parents cannot or do not wish to breastfeed. This would diversify the infant food supply and provide parents with more options.

Programs:

Federal programmatic funding needs to be expanded considering setbacks caused by the pandemic, including the current infant formula shortage.

Federal funding supports quality improvement investments to implement maternity care best practices in hospitals, especially while recovering from pandemic-induced breakdowns in those settings.

Expansion of this funding supports state and community efforts to advance care coordination and strengthen lactation support through policy, systems, and environmental change interventions to reduce or eliminate breastfeeding disparities along the fault lines of income and race.

Federal investments enhance and deepen partnerships to integrate infant feeding and lactation support services into emergency response systems and food security programs during acute disasters and prolonged public health crises.

This funding supports critical national monitoring and public reporting activities, including annual analysis of the National Immunization Survey (NIS), administration of the bi-annual Maternity Practices in Infant Nutrition and Care (mPINC) Survey, bi-annual production of the National Breastfeeding Report Card, and administration of the longitudinal Infant Feeding Practices Study. All of which is especially needed in light of recent updates to the Dietary Guidelines for Americans, which, for the first time, provides nutritional guidance for infants and toddlers.

Policies:

Due to major policy gaps, families face obstacles that make it difficult or impossible to start or continue breastfeeding. Policymakers must choose to prioritize the policies and investments for infant food security so that we never find ourselves in this situation again.

Critically needed policy solutions are waiting for Congressional action:

  • Establish a national paid family and medical leave program. The FAMILY Act (S. 248/H.R. 804) would ensure that families have time to recover from childbirth and establish a strong breastfeeding relationship before returning to work.
  • Ensure all breastfeeding workers have time and space to pump during the workday. The Providing Urgent Maternal Protections (PUMP) Act (S. 1658/H.R. 3110) would close gaps in the Break Time for Nursing Mothers Law, giving 9 million more workers time and space to pump. Contact your legislators about the PUMP Act!
  • Invest in the CDC Hospitals Promoting Breastfeeding program by increasing funding to $20M in FY2023This funding helps families start and continue breastfeeding through maternity care practice improvements and community and workplace support programs.
  • Create a formal plan for infant and young child feeding in emergencies. The DEMAND Act (S. 3601/H.R. 6555) would ensure the Federal Emergency Management Agency can better support access to lactation support and supplies during disasters. Contact your legislators about the DEMAND Act!

Additional areas for policy development

The U.S. has not regulated the marketing practices of the commercial milk formula industry, unlike 70% of the world, which has implemented at least some part of the WHO’s International Code of Marketing of Breast-Milk Substitutes. In the absence of regulation, these marketing practices are predatory.

Diversify the nation’s production of infant formula. Plainly it is a mistake to allow 42% of the infant formula in this country to be produced not only by one company but by one factory of that company. Infant formula companies are part of an infant food security system, but we don’t have to be so dependent on that industry.Enhance the national network of nonprofit donor milk banks. Support innovative partnerships across existing structures, taking a cue from a national model such as what exists in Brazil. Consider: Red Cross has the infrastructure to support donor screening; WIC offices or community health clinics could be donor drop-off sites; more hospitals could provide space and equipment for donor milk processing and distribution, as some have done. Models exist to create an affordable and plentiful alternative to commercial milk formula when a parent’s own milk is not available.

Plan:

All nations should have a robust plan for infant and young child feeding in emergencies that includes three phases: preparedness, response, and resiliency. The USBC-Affiliated Infant & Young Child Feeding Constellation has published a Joint Statement on Infant & Young Child Feeding in Emergencies (IYCF-E) in the U.S. context.
Emergency preparedness includes building a lactation support provider directory and a system to track the inventory of national resources such as infant formula.Emergency response for infants, young children, and their families must include priority shelter, trauma-informed care, lactation support providers in every community; access to breast pumps, and milk storage and cleaning supplies; non-branded infant formula, clean water, bottles, and cleaning supplies.

Emergency resilience includes trauma-informed care that centers on the needs of communities that have been historically undersupported, and disproportionately impacted in emergencies.

Every system is perfectly designed to get the results it gets. The insufficient system we’ve had, led to this crisis. It was predictable, and thus it was preventable.

Now that there’s a mass mobilization of activity – from neighbors driving many miles to find spare formula tins, to the President invoking the defense production act – we must collectively build the resiliency to support a community during a flood, a region during a power outage, or a nation during a pandemic and supply chain crisis. We will get through this because we must. Together we must ensure we build an infant nutrition security system worthy of parent’s trust.