Tag: WHO

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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:

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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.

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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!

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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.

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Breastfeeding is a human right.

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

Breastfeeding is a human right. 

Breastfeeding is often presented as a choice, but in many societies, infant feeding is impacted by systems of oppression and lack of supportive measures like paid parental leave, rather than simply being a product of parental choice. 

Source: United States Breastfeeding Committee

Michigan Breastfeeding Network Executive Director Shannon McKenney Shubert, MPH, CLC has put it this way:  “In my 12-year career in the field of human milk feeding, I have never once met a birthing parent who ‘chose not to breastfeed.’ In this country, whether to breastfeed is not a choice. In this country, whether to breastfeed is a question of ‘Within all the systems of oppression that I navigate, what is the best combination of things I can do to ensure the survival of my baby, myself and the rest of my family?’” 

Access to unbiased information and support and protection to make informed decisions about proper infant and young child nutrition is a core human rights obligation and must be projected as such in international human rights law, as articulated in a Global Breastfeeding Collective (GBC) convening this fall. 

What’s more, children have the rights to life, survival and development, and the highest attainable standard of health, all protected under the Convention on the Rights of the Child.

More specifically, under Article 24 of the Convention on the Rights of the Child, children and families explicitly have the right to have information about the advantages of breastfeeding and to be supported in making choices about the best nutrition for children as part of the right to health and health care.

Source: United States Breastfeeding Committee

Strangely, children’s rights and women’s sexual and reproductive rights communities often find themselves polarized on the issue. Because the mother and child are often regarded as separate entities, issues that impact women and children can appear as though one right is above the other. But a mother and her child should be extolled as an inseparable dyad, and human rights and health advocates must continue to articulate and emphasize this important point. Breastfeeding as a human right is not an either/or argument.

Source: United States Breastfeeding Committee

Marcus Stahlhofer, WHO Maternal and Newborn and Adolescent Health and Aging, lays out how approaching breastfeeding as a human right:

  •  helps to provide legitimacy and accountability for state or government action or inaction and helps set benchmarks to assess these actions,
  • enhances multi-stakeholder engagement through indivisibility and interdependence of human rights including involvement of global, regional and national human rights mechanisms,
  • elicits a paradigm shift that transitions from nutrition and health needs to legal entitlements and associated obligations, and 
  • empowers people to demand that their rights are not negatively interfered with, such as through breastmilk substitutes and commercial milk formula (BMS/CMF) marketing.


Stahlhofer has pointed out that BMS companies use human rights arguments effectively by drawing on ideas around freedom of expression, right to intellectual property, women’s rights to autonomy, bodily integrity, and free choice to justify their predatory practices. 

There are key human rights tools and mechanisms that health advocates can employ specific to infant feeding. Some of them include:

The Academy of Breastfeeding Medicine (ABM) issued a position statement in regard to breastfeeding as a human right. 

“The ABM asserts that it is a moral imperative to protect the mother’s and child’s basic rights to breastfeed for their own health and wellness, as well as that of the nations in which they reside. Given the importance of breastfeeding and human milk in reducing infant mortality, governments should include breastfeeding as a leading health indicator and work toward eliminating disparities in breastfeeding outcomes and increasing rates of breastfeeding,” it reads in part. 

The White Ribbon Alliance (WRA) Charter on the Universal Rights of Women and Newborns created a proclamation on the universal rights of women and newborns. Find that here.  

You can also explore GBC’s collection of documents that support breastfeeding as a human right here.

Source: United States Breastfeeding Committee

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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: What does breastfeeding support look like in your community?

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.

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