Green Feeding

Guest blog post collaboration with Donna Walls,  RN, BSN, IBCLC, CLC, ANLC

At its core, Green Feeding means taking action from birth to safeguard the health of humans and the environment.

Photo by Akil Mazumder

Green Feeding encompasses the promotion, protection and support of breastfeeding as the most valuable natural resource from 0 to 36 months of age.

In May 2019, the International Baby Foods Action Network (IBFAN) in partnership with the World Breastfeeding Trends Initiative (WBTi), published Green Feeding–climate action from birth, issuing a plea for awareness on the impact of infant feeding practices on the environment and to promote breastfeeding which nurtures a healthy population and planet.

Green Feeding practices should continue beyond exclusive breastfeeding. When complementary foods are introduced at six months of age, guidelines include:

  • foods which are naturally occurring foods (such as plants and animals),
  • minimizing processed (foods prepared with salt, sugar, oils such as canned fruits or vegetables or simple cheeses),
  • culturally appropriate, family foods which rarely contain concerning levels of sugar, salt, fats, and toxic additives,
  • and the avoidance of ultra processed foods (foods altered by processing and additives not normally found in foods like dyes, preservatives, stabilizers). Infant formulas fall into the category of ultra processed foods.

 

Human and planetary health interplay 

Breastfeeding is a frequently ignored topic by global climate action leaders despite it being an almost cost-neutral intervention with a huge impact on human and planetary health.

Photo by willsantt

“Recent studies have highlighted the environmental cost of decades of disinvestment in services to support breastfeeding,”  the authors of Support for breastfeeding is an environmental imperative write. “When breastfeeding is encouraged and supported the associated infant and maternal health outcomes produce healthier populations that use fewer healthcare resources.”

Authors of Why invest, and what it will take to improve breastfeeding practices? note that breastmilk is a “natural, renewable food” that is environmentally safe and produced and delivered to the consumer without pollution, unnecessary packaging, or waste.

By contrast, breastmilk substitutes leave an ecological footprint and require energy to manufacture, materials for packaging, fuel for transport distribution, and water, fuel, and cleaning agents for daily preparation and use, and numerous pollutants are generated across this pathway.

Human health is often sacrificed for business interests and profits; the “bottom line” is about dollars and not  families’ precious health.

The Green Feeding advocacy document continues to spell out the interplay between human and planetary health through the lens of healthy infant and young child feeding (IYCF).

As a renewable natural food resource, mother’s milk contributes to local food and water security and biodiversity.

Differently, the run-off of waste from dairy farming used in artificial milk development, threatens our water supply with contamination by toxic chemicals, pesticides and harmful microorganisms.

The global food system, from production through all stages of processing, distribution, food preparation and consumption, accounts for an estimated 19 to 29 percent of global anthropogenic greenhouse gas emissions. Animal-based food products generally have a higher climate impact than plant-based foods, due to emissions from feed production, manure management and, in the case of ruminant animals, enteric fermentation, as noted in The carbon footprint of breastmilk substitutes in comparison with breastfeeding.

Not breastfeeding poses the risk of multiple avenues for exposure to toxic heavy metals like contaminated foods and artificial baby milks and contaminated water.   Municipal tap water, groundwater or well water is used to reconstitute powdered formulas and cereal foods and can contain high levels of toxic chemicals. This same water is used for cleaning feeding equipment and for drinking. The risk is increased because powdered formulas and foods prepared with water are the sole or the major source of food and drink at the most vulnerable stage of infant and young child development.

“Exposure to toxic heavy metals causes permanent decreases in IQ, diminished future economic productivity. Toxic heavy metals endanger infant neurological development and long-term brain function,” according to a 2021 IBFAN report.

Plastic pollution is a huge environmental concern made worse by the need for bottle feeding supplies and consumption of single-use articles.

Green Feeding contributes to the work of social justice and poverty reduction, offering protection to the most vulnerable infants and their families, creating a “level playing field” for family budgets. It challenges inequalities in marginalized households and communities that are most negatively impacted by climate change. The high cost of infant formula and ultra-processed baby foods can overwhelm low and middle income households.

 

Green Feeding begins prenatally

There’s a growing body of research connecting prenatal and early life toxic exposures to poor health outcomes.

Photo by Thiago Borges

For example, high urinary metabolite concentrations for several prevalent phthalates were associated with greater odds of delivering preterm, and hypothetical interventions to reduce phthalate exposure levels were associated with fewer preterm births. The most consistent findings were for exposure to a phthalate that is used commonly in personal care products like nail polish and cosmetics, noted by the authors of Associations Between Prenatal Urinary Biomarkers of Phthalate Exposure and Preterm Birth: A Pooled Study of 16 US Cohorts

Things like air pollution, heavy metals, phthalates, plasticizers (PCB) and per- and poly-fluoroalkyl acids (PFASs) which are produced during industrial manufacturing and are widely used in consumer items such as food packaging and non-stick cookware have been known to lead to childhood liver disease, development of diabetes and developmental delays in children.

Endocrine disruptor exposure prenatally and early in life also present a major concern to children. Dozens of these endocrine disrupting chemicals are found in pesticides, personal care products, flame retardants and are found in the air, water and foods. They mimic the female hormone estrogen and thus interfere with the action of the body’s natural hormones which influence reproduction, immunity, metabolism and behavior. More on endocrine disruptors can be found in Endocrine disrupting chemicals and the battle to ban them.

In studies from the University of Rochester Medical School, it was found that wistar rats exposed prenatally to environmental estrogens resulted in damage to the alveolar cells of the breast to the extent that the mother rats were unable to nourish their offspring, as documented in Dioxins In Food Chain Linked To Breastfeeding Ills. 

Authors LaPlante and Vandenberg note reduced milk production in mice exposed to 17α-ethinyl estradiol, and less “mothering behaviors” in rats exposed to environmental estrogens, including reduced nesting behaviors and pup retrieval have also been documented.  These, and other studies, show a concerning trend in the future care of offspring.

 

Eliciting change from the top down 

UNICEF’s 2022 report Places and Spaces: Environments and Children’s Well-Being calls on national, regional, and local governments to make protection of children’s environmental health a priority. Clean air, water and food make up an essential foundation for infant and childhood health. Creating a cleaner, healthier environment begins with the cleanest first food, breastfeeding, and continues with toxic-free foods throughout childhood and adolescence. Taking these steps now reduces the risk of food-induced illnesses including childhood obesity, diabetes, hypertension, asthma, neurodevelopmental delays and immune dysfunction. While we continue to see the predatory marketing of altered foods claiming to offer health benefits, there is no evidence that any of these are superior in any way to clean, naturally occurring foods.

 

Eliciting change from the bottom up 

Anthropologist Margaret Mead said, “Never doubt that a small thoughtful, committed group of citizens can change the world: indeed it is the only thing that ever has.”

Photo by Nandhu Kumar

Advocate for breastfeeding. Join local breastfeeding support groups and talk about the risks of not breastfeeding for mother, infant, and the environment. Connect with “breastfeeding adjacent” groups such as breast cancer advocates or prenatal and infant information groups or toddler play groups.

Talk with local stores selling maternity or infant care products about the opportunity to present this information to customers. Use social media to help spread the word.

Stay politically aware of legislation and contact your local, state or federal representatives and let them know why and how you support breastfeeding and climate-friendly actions. The United States Breastfeeding Committee (USBC) is a great launching pad for this type of activism.

If you, your family or friends need to use infant feeding bottles, teats and other products, find safer alternatives like non-plastic infant feeding bottles and plant-based food storage containers.

Connect with local health food or natural food stores, local organic farms or community assisted agriculture groups to brainstorm ways to distribute recipes and meal ideas for cleaner, healthier foods. Local food pantries can also be a great starting point to connect with community resources to encourage healthier family foods.

Local childbirth education and doula groups can also be a great resource for connecting with pregnant or new families to discuss feeding choices.

Many local gardening groups may have information on growing and preparing natural, organic foods.

Join food cooperatives wherever possible and offer education to families on breastfeeding, clean foods and safer food storage/preparing/serving utensils.

Join civic groups in starting community gardens in public spaces, schools, churches and housing complexes.

 

Additional resources to explore 

Safely Fed Canada

Assessing the environmental impact of powdered baby formula sold in North America

The Unseen Dangers of Ultra Processed Foods

Breastfeeding for the Health and Future of our Nation 

Carbon Footprints Due to Milk Formula. A study from selected countries of the Asia Pacific region

Ultra-Processed Foods and Health Outcomes: A Narrative Review

Food safety, climate change, and the role of WHO

Food safety considerations for commercial complementary foods from global operational guidance on infant and young child feeding in emergencies

Plastic-free parenting 

Ensuring Safe and Toxic-Free Foods Act of 2022

Protecting Brain Development in Children: Neurotoxic Effects of Phthalates and Need for Critical Policy Reform webinar

 

Human milk banks around the world

Of all the known approaches to saving infant lives, human milk has the greatest potential impact on child survival. (PATH) When direct breastfeeding or mother’s expressed milk is not available, donor human milk is the next best option.

Photo by Samer Daboul

As such, the 2018 WHO/UNICEF implementation guidance on the Baby-friendly Hospital Initiative stated that “Infants who cannot be fed their mother’s own milk, or who need to be supplemented, especially low-birthweight infants, including those with very low birth weight and other vulnerable infants, should be fed donor human milk.” The American Academy of Pediatrics, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition, and other national and global policy groups also call for use of donor human milk as the feeding of choice, if mother’s own milk is insufficient, unavailable or contraindicated. (WHO)

Now, WHO is in the process of developing guidelines on donor human milk banking.

The ISRHML Trainee Interest Group recently presented A Global View of Human Milk Banking with Kimberly Mansen (PATH), Dr. Victoria Nakibuuka (Nsambya Hospital), Debbie Stone (Rogers Hixon Ontario Human Milk Bank), and Dr. Maryanne Perrin (The University of North Carolina Greensboro) which brought to light several, wonderful resources and is the inspiration for  this week’s post.

Let’s take a look at some human milk banks around the world.

This tableau map depicts publicly known human milk banks. If you know of a milk bank that is not shown on the map, you can fill out this form and/or email kamundson@path.org or humanmilkbankmap@gmail.com.

Brazil 

Donor milk banking thrives in countries such as Brazil, where there has been a concerted effort at the Health Ministry level to incorporate milk banks into health policy. (Arnold, 2006)

 

Uganda

In commemoration of World Prematurity Day, Uganda introduced its first human milk bank at Nsambya Hospital on the 26th of November 2021 at Pope Square. [More here.]

 

Canada 

The Rogers Hixon Ontario Human Milk Bank in Ontario has dispensed over 1 million ounces of human milk. The Rogers Hixon Ontario Human Milk Bank is a non-profit organization and a joint initiative of Mount Sinai Hospital, The Hospital for Sick Children (SickKids) and Sunnybrook Health Sciences Centre. It is a member of the Human Milk Banking Association of North America.

 

Ukraine 

The first and currently only Ukrainian Human Milk Bank was established in Kiev at the Perinatal Centre where approximately 80 percent of all premature babies in the city are born.

 

South Africa

The South African Breastmilk Reserve (SABR) has set up a total of 44 in-hospital human milk banks in public and private hospitals across South Africa.

 

Vietnam

The first human milk bank in Vietnam was officially opened on February 17, 2017, at the Danang Hospital for Women and Children. This facility is supported by the Vietnam Ministry of Health and the Danang Provincial Department of Health, and is the first human milk bank in Vietnam to be operated within the public health system and to international standards. (PATH)

Take a virtual tour of the bank here.

Also consult:

Efforts to curtail dubious marketing practices of commercial milk formula industry

The commercial milk formula (CMF) industry uses marketing tactics similar to those of the tobacco, alcohol, and ultra-processed food industries.

Photo Credit: Boston Public Library
Date: ca. 1870–1900 https://ark.digitalcommonwealth.org/ark:/50959/3b591d51p Please visit Digital Commonwealth to view more images: https://www.digitalcommonwealth.org.

Earlier this winter, the Lancet published a three-paper series outlining the multifaceted and highly effective strategies used by commercial formula manufacturers to target parents, health-care professionals, and policy-makers.

“The industry’s dubious marketing practices—in breach of the breastfeeding Code—are compounded by lobbying of governments, often covertly via trade associations and front groups, against strengthening breastfeeding protection laws and challenging food standard regulations,” the Lancet summarizes.

Two new publications corroborate WHO findings on the digital marketing of commercial milk formulas in Mexico:

In another recent publication, Pediatricians’ Reports of Interaction with Infant Formula Companies, the authors found that: “Of 200 participants, the majority reported a formula company representative visit to their clinic (85.5%) and receiving free formula samples (90%). Representatives were more likely to visit areas with higher-income patients (median = $100K versus $60K, p < 0.001). They tended to visit and sponsor meals for pediatricians at private practices and in suburban areas. Most of the reported conferences attended (64%) were formula company-sponsored.”

The authors write that “Seventy percent of countries follow the World Health Organization International Code of Marketing Breast Milk Substitutes that prohibits infant formula companies (IFC) from providing free products to health care facilities, providing gifts to health care staff, or sponsoring meetings. The United States rejects this code, which may impact breastfeeding rates in certain areas.”

The Lancet series authors provide recommendations to restrict the marketing of CMF to protect the health and wellness of mothers and babies, and ultimately society and the planet.

  • Curtail the power and political activities of the CMF industry
  • End state practices that do not uphold, or that violate, the rights of women and children
  • Recognise, resource, and redistribute women’s care work burdens in support of breastfeeding
  •  Address structural deficiencies and commercial conflicts of interest in health systems
  •  Increase public finance and correct the misalignment between private and public interests
  • Mobilise and resource advocacy coalitions to generate political commitment for breastfeeding

In Mexico, UNICEF and Instituto Nacional de Salud Pública have designed infographics for policymakers as well as parents and caregivers to educate on the impact of digital marketing.

The partners are also working on proposed modifications to current Mexican regulations that involve commercial formula milk and ultra processed food marketing to infants and young children. Further, development is underway for a mobile app tool for monitoring the Code in Mexico.

Legislation in El Salvador was recently passed–“Love Converted into Food Law, for the Promotion, Protection, and Support of Breastfeeding.”

PAHO is monitoring the implementation of the Baby-friendly Hospital Initiative in the Americas BFHI requires full compliance with the Code and subsequent WHA resolutions.

In other efforts to protect parents and babies, Breastfeeding Advocacy Australia released a video on how the organization monitors predatory marketing. Find it here. You can find their Facebook group here.

Also read:

Follow IBFAN’s coverage of the 43rd Codex Nutrition Session of the Committee on Nutrition and Foods for Special Dietary Uses here.

Breastfeeding is ours. Breastfeeding belongs to us.

–This post is part of our 10-year anniversary series “Breastfeeding is…” When we initially curated this series, we planned for 10 weeks, but breastfeeding is so many things that we just couldn’t fit it all in, which means we have two bonus weeks in our anniversary series.–

Breastfeeding is ours. Breastfeeding belongs to us.

Nicole Starr Photography Originally featured on Our Milky Way in ‘ Non-profit Julia’s Way proves babies with Down syndrome can breastfeed’

For decades, the 55 billion dollar formula milk industry has positioned itself as an ally to parents. 

Through conniving tactics, like the distortion of science to legitimize their claims, the systematic targeting of health professionals to promote their products, and the undermining of parents’ confidence in breastfeeding, the industry impacts the survival, health and development of children and mothers, disrupts truthful information– an essential human right as noted by the Convention on the Rights of the Child, disregards the International Code of Marketing of Breast-milk Substitutes, and exploits the aspirations, vulnerabilities and fears at the birth and early years of our children solely for commercial gain. (WHO/UNICEF, 2022, p. x) [More at WHO report exposes formula milk marketing, offers steps forward

Far before the advent of formula milks and their subsequent marketing campaigns, breastfeeding sustained the human species. When breastfeeding wasn’t possible, wet nursing was the primary alternative feeding option. [Stevens, et al 2009

For generations, cultures across the globe have honored breastfeeding as a central part of their identities, and now they’re reclaiming these traditions after being challenged by the formula milk industry and other forces.

Photo by Mehmet Turgut Kirkgoz : https://www.pexels.com/photo/a-woman-breastfeeding-her-son-12359528/

HealthConnect One’s program manager Brenda Reyes, RN, CLC describes that reclamation of Latino/Hispanic birth and breastfeeding traditions in Reclaiming Latino/Hispanic birth and breastfeeding traditions for instance. 

In It’s Asian American Native Hawaiian and Pacific Islander (AANHPI) Week: “Reclaiming Our Tradition”, To-Wen Tseng covers just what the title suggests. 

Navajo Breastfeeding Coalition/Dine Doula Collective, Amanda Singer, CLC discusses the revitalization of Indigenous breastfeeding in Honoring Indigenous Milk Medicine Week: “Nourishing Our Futures”

Hispanic Health Council’s Breastfeeding Heritage and Pride (BHP) Program manager and lactation consultant Cody Cuni, IBCLC, BS reminds us in Hispanic Health Council’s Breastfeeding Heritage and Pride (BHP) Program heals, empowers and celebrates through peer counseling model that breastfeeding has always belonged to the people.

Photo by willsantt: https://www.pexels.com/photo/woman-breastfeeding-her-toddler-under-the-tree-2714618/

Cuni offers commentary on her and her colleague’s responsibility to help facilitate breastfeeding without capitalizing, claiming and dominating. She sees her role as an empowerer. 

Without diminishing the need for larger structural supports, let us also remember and celebrate the innate power we hold as individuals who can nourish and nurture our young and ourselves through breastfeeding. 

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Our 10-year anniversary giveaway has ended. Thank you to everyone who participated!

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.