Babies' health not in formula

By Pieta Woolley
September 21, 2006

The Nestlé booth was abuzz with pregnant women and new parents at the Baby and Family Fair on September 16 and 17. The attraction was free Baby Einstein and Disney DVDs, free rice-cereal samples, free infant formula samples, and a send-away card for a free diaper bag, a baby-magazine subscription, and more formula. It was one of the juiciest giveaways at the Vancouver Convention and Exhibition Centre event.

Meanwhile, Douglas College's perinatal program manager, Kathleen Lindstrom, was trying to entice the thousands of orb-bellied women to come to her breast-feeding workshop.

“I said, 'Come find out how to save thousands of dollars a year and feed your baby free,'” Lindstrom recounted to the Georgia Straight. “But I couldn't tear them away from the formula booths. I felt like getting on the loudspeaker and saying, 'Do you not care about what's going into your baby?'”

Lindstrom said she was disgusted that at a trade show designed to “nurture the parent-child bond” she was forced to compete with formula companies. “There isn't close to the same amount of money to market breast-feeding as there is to market formula,” she said. “If there were, we wouldn't have a problem.”

That scene would be illegal had Canada implemented the World Health Organization's 1981 Code of Marketing of Breastmilk Substitutes. The code, which prohibits the direct marketing of baby formula to families, marks its 25th anniversary this year. Breast milk beats formula, according to the WHO, because it promotes cognitive development and protects infants against infectious and chronic diseases, reducing infant mortality. In developing countries, this is especially important, as formula is relatively expensive and water is not necessarily safe.

Handing out formula samples is prohibited in Brazil, India, Bolivia, and Botswana, among other countries, according to Elisabeth Turkin, executive director of the pro-breast-feeding lobby group InFact Canada””and, she said, it should illegal be here, too. “We let companies bombard women from pregnancy with samples, book clubs, ads in parenting magazines,” Turkin told the Straight in a phone interview from Toronto. “Even doctors offer free samples. It's a huge interference on the part of the industry in competing with breast-feeding practices.”

Breast-feeding, which is promoted by Health Canada as the best nourishment for most infants, is still far from universal in this country. About 85 percent of today's mothers try to breast-feed, according to Statistics Canada's 2005 Health Reports. (However, one third of moms can't breast-feed for health reasons.)
But the report found that just 17 percent of women fed their babies exclusively with breast milk to six months, which the WHO recommends. Plus, just nine percent are still breast-feeding even occasionally at one year. Of the women who didn't breast-feed, the number-one response was that bottle feeding was “easier”, followed by statements that breast-feeding was “disgusting” or “unappealing”. Also, the less a family earns, the less likely a mother is to breast-feed.

Along with Nestlé, Abbott Laboratories' Similac and Mead Johnson Nutritionals' Enfamil were at the recent baby fair. Playtex was also there, marketing bottles. None of the companies returned the Straight's calls or e-mails by deadline.
The show's producer, Tracey Anderson of Shake Productions, is familiar with both the popularity of the formula booths and the uproar they cause.

“We get hate mail,” Anderson told the Straight. “People come into our office at the show and tell us they're disgusted with us and that we're antibaby.”

Before each of the four annual shows, Anderson discussed with her two business partners whether to include the formula companies. So far, they've always been included. The organizers provide balance by also including the La Leche League, doulas, Douglas College's perinatal program, and breast-feeding seminars, she said. And the show's mission statement is to provide information, not act as a gatekeeper, Anderson pointed out.

“We try to remain neutral on everything,” she said.

The WHO isn't the only UN agency trying to prevent formula-marketing. UNICEF's Baby-Friendly Hospital Initiative prohibits medical units from handing out free and low-cost samples of baby formula. Canada lags behind most industrialized countries, according to UNICEF, with just eight baby-friendly centres; seven are in Quebec, one in Ontario. The United States has 25; Turkey, 83; Mexico, 692; India, 1,250; and China, 6,312.

InFact spearheads the Canadian Nestlé boycott, which raises awareness about formula-marketing here and in developing countries. In the 1980s, the Nestlé boycott was InFact's only project; now, Turkin explained, it shares the nonprofit's time with National Breastfeeding Week, an annual conference, newsletters, and information campaigns.

“We work so closely with health care and the mothers' sector,” Turkin said. “The information doesn't go to younger people as it should.”

Lindstrom noted that good information about formula is essential, because, she said, moms who formula-feed in a baby's first few weeks generally are not still breast-feeding at six months.

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Article courtesy of the Georgia Straight.
For more info on InFact's Nestle boycott, check out this .pdf.

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Afghanistan: Life Saver

Young Woman Battles Nation’s Biggest Killer

Tales of suicide bombers and battles with Taliban insurgents continue to dominate the news from Afghanistan, but there remains a far more pervasive threat to human life in the troubled nation.

Afghanistan has the second-worst infant mortality rate in the world. One in six newborns die before their first birthday, and 6 out of every 100 mothers die during childbirth. Cultural constraints mean it is rare for male doctors to assist women giving birth and there are few midwives, especially in rural areas.

But one young woman helping reverse the trend is Zahara Zamani.

While a refugee in Iran, Zahara, 22, says she dreamed of becoming a health professional.

“Sometimes I would see people with health problems, especially women,” she recalls. “I wanted to help.”

A Life-Changing Tragedy

Later, following her return to Afghanistan, she remembers one case that especially touched her — a pregnant neighbor suffering from anemia who went into labor. Her child died almost immediately. Meanwhile the mother experienced massive hemorrhaging and died the next day.

“She was at home with her family. They didn’t understand what was happening. They weren’t educated about anemia. They didn’t take her to the hospital,” Zahara says sadly.

The experience spurred her to complete a World Vision-supported midwife training program based in Herat, western Afghanistan.

Following graduation in 2005, she returned to Jibril, in the Herat Province, where she took a job with a health clinic that serves 40,000 people in the village and neighboring communities.


As a midwife in the town of Jibril, Zahara sees some 50 women
each day. Photo by Mary Kate MacIsaac.


It’s a busy job. Over 120 patients visit the clinic daily; about 50 of them are women seeking Zahara’s advice and expertise. Many travel several miles by foot or donkey to reach help.

Among those who are delighted Zahara has brought her newfound skills to Jibril is Dr. Abdul Wali Alami, director of the clinic.

He recalls the situation before Zahara began working there — women suffering childbirth complications seldom had the support they needed.

“They would cut the umbilical cord with a dirty knife. The women didn’t know about pre-natal or post-natal care. They had no information about it,” he says.

Today, Zahara spends much of her time counseling about pregnancy care, believing that education is the key to reversing Afghanistan’s dire maternal and infant mortality rates.

Since 2004, 82 midwives have graduated from the midwife training program and are at work throughout western Afghanistan. Another 60 students are now in training. It’s expected the midwives’ efforts to educate and assist women through their pregnancies will ultimately slash death rates.

Zahara has become a significant agent of change in the Afghanistan of tomorrow.

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Article courtesy of World Vision International. Please visit to learn more.
You can also read about how a neonatal clinic is reducing infant mortality rates in Afghanistan.

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Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Power to the Working Moms!

I would like to appologize for not posting lately. I returned to work 3 days a week at the end of November and I'm still finding it to be quite an adjustment. I'm enjoying the work and enjoying being out of the house a bit but life has sped up to the point where it feels like we are all running on a treadmill set a tad too fast for us.

I am thankful that I'm only working three days a week. I am thankful that my sister is watching my son so I didn't have to find daycare. I am thankful that I can take the skytrain downtown so my commute is under forty-five minutes.

However, I miss my son. I miss being home to work on the projects I started while on maternity leave. I struggle to get dinner served on time. I struggle to get out of bed in the morning (my son has slipped back into the habit of night nursing four times a night since I went back to work).

I am in awe of those moms who work full-time, dropping kids at daycare, commuting. I don't know how you do it. I hear the big answer is a crock-pot.

I wanted to post some resources for working moms:

• ivillage


• family education

I would love it if you could share some other tips and resources. Please post a comment and let us know what works for you.

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Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Maternal Creation

The folks at Pomegranate Community Midwives are hosting another great event: a community art show and craft fair!

Mothers from the community will exhibit and sell their art and crafts including jewelry, baby carriers, diaper bags, knitted wares, cards and much more. Come out to support our incredible mamas and get ready for the holidays with gifts that are hand made, beautifully designed and carefully crafted.

Friday, November 24th 2006, 4-8pm
Saturday, November 25th 2006, 12-5pm
*free admission

2647 East Hastings Street
Vancouver, BC

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Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

New Book Suggestions

Interested in yoga for pregnancy?

Attachment parenting?

An environmental look at breastfeeding?

You're sure to find something great to read in this list of books that have been recommended by our Sweet Home visitors.

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Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Attention all breastfeeding mothers

Take part in the Quintessence World Record Challenge on Saturday, Sept. 30 starting at 10:15 a.m. at BC Women's Hospital. The challenge is for the most babies breastfeeding simultaneously in a set geographic area. There will be lots of door prizes and light refreshments. Come to the Chan Centre located near West 28th Avenue at Oak Street. For more information please call (604) 875-2282 or visit http://www.babyfriendly.ca.

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Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Why Choose Homebirth?

The article below comes from the Mothering.com website and you will note that some of the information is specific to the United States. I felt it was worth sharing despite the American focus. In most provinces in Canada, midwifery is covered by our medicare system. If you have questions on homebirth or midwifery care, please see our links section or drop me a line.

There's no Place Like Home
The advantages and joys of giving birth where you live.
By Pam England

"I know that I'm healthy and everything's going well with my baby and I know everything's going to be fine."

Those words, uttered by an extremely pregnant Dawn Louro on CBS's Morning Show in February, sound more innocuous than momentous. But in some ways, they are revolutionary. Because Ms. Louro's calm assessment of her pregnancy came only weeks before she gave birth on television, before an audience of millions. At home.

In some circles, laboring or birthing at home is considered quite radical. Most first-time mothers probably doubt that they know enough to give birth anywhere, much less at home. They are surprisingly out of touch with the innate, miraculous processes involved in giving birth. Even though those mothers do not know birth technology either, they know it is out there. Daughters of our technological age, users of cellular phones and computers, understandably have faith in technology.

In addition, women who plan to labor and give birth at home typically get little support and a lot of anxious skepticism from those around them. Under such circumstances, it is not surprising that so few women today give birth at home.

But that may at last be changing and more than 20 years after Mothering first began writing about the possibility and the pleasures of delivering your child in his or her own home. Oprah Winfrey has done shows about alternatives to hospital birth. Chris Bohjalian's book Midwives has been a national bestseller. And then there was Ms. Louro's labor. "I just want it to be in my own home environment," Ms. Louro told the CBS correspondent. "I want to be able to get up, walk around, and have my whole family around me after the baby is born."

As a childbirth teacher, one of my greatest challenges is to inform people objectively about their choices and give them respectful support in their decision-making, so they are not left feeling coerced or guilty about whatever informed choice they eventually make. That is what I wish to do here. Homebirth may not be right for you, for reasons of physical health or personal philosophy. It also may be the perfect choice for you, but one you hadn't considered until now. In a childbirth class I taught recently, the topic arose spontaneously. A couple, one of whom was a physician, said they were thinking of a homebirth. The class erupted into animated discussion, provocative questions, and a sense of hopeful excitement.

At the end, one mother turned to me and sighed happily, "I feel more relaxed just knowing that a homebirth is a possibility," she said, "whether or not I choose it."

IS HOMEBIRTH SAFE?

The Farm is a 1,700 acre commune in Summertown, Tennessee, founded in 1971 by Stephen and Ina May Gaskin. The trained and skilled midwives there have professional consulting relationships with physicians and refer mothers with complications or risk factors to the hospital.

In 1992, a major study compared 1,700 homebirths attended by The Farm midwives to a sample of 14,033 physician-attended hospital births. The findings were dramatic and heartening: The cesarean rate among mothers who received prenatal care at The Farm was only 1.5 percent compared to 16.5 percent in the doctor-attended group. The transfer-to-hospital rate was 13.5 percent. There was no significant difference between the two groups for perinatal death, bleeding, birth injury, or respiratory distress syndrome.

This excellent outcome for those choosing homebirths has been found in other studies as well. In a famous 1977 project, Dr. Lewis Mehl studied birth outcomes from the medical records of 1,146 elective homebirths in the San Francisco area. The results: the perinatal mortality rate among women who elected homebirth was 9.5 per 1,000 births and compared to a rate of 20.3 per 1,000 among California women who gave birth in the hospital. In other words, as Dr. Mehl concluded, "the [homebirth] outcomes were better than average and the complications rates lower than expected."

And then there are the subjective, anecdotal reports from women who have chosen a homebirth. According to a wide-ranging 1992 survey, "91 percent of . . . women who had had their last baby at home said that they would prefer to have their next baby at home, compared with 15 percent of those who had had their baby in a hospital. Among the few women who had experienced both a homebirth and a hospital birth, 76 percent preferred giving birth in their homes."

THE ECONOMICS OF HOMEBIRTH

Homebirth is significantly cheaper than a hospital birth. But that doesn't mean it will save you money. Why is that? Consider the following: In 1997, a normal hospital birth cost between about $4,000 and $6,000, with a complicated birth costing many thousands more. In comparison, most homebirth midwives have an inclusive fee of about $2,000, which not only covers labor and delivery but also all prenatal care and several postpartum visits.

In some states, homebirth midwifery is covered by private health insurance. Unfortunately most HMOs do not yet reimburse licensed homebirth midwives, which in effect limits consumers' freedom of choice. It is extremely difficult for some people to make a "choice" which requires substantially greater out-of-pocket expenses.

If your healthcare coverage is limited only to in-hospital birth, write the benefits manager at your place of employment; they seem better able to exert leverage on insurance companies and HMOs than can individual consumers. Issues like this also are being considered in some state legislatures. Write a letter to your local representative or call and make your opinion known.

FINDING A MIDWIFE

Rare is the doctor who will actually attend a homebirth. But a few do. To see if any practice in your neighborhood, contact HomeFirst Health Services through their Web site: www.homefirst.com.

It's extremely likely, however, that you'll need to find a midwife to attend your birth. Midwives come in several varieties. Nurse midwives have an RN and have completed postgraduate training at an institution accredited by the American College of Nurse Midwives (ACNM). Direct-entry midwives have trained as midwives but without obtaining an RN (which is the usual route of entry in many countries overseas, including most of Europe). The Midwifery Education Accreditation Council (MEAC) has begun accrediting direct-entry midwifery training programs. Two other organizations offer certification to direct-entry midwives: The ACNM and the North American Registry of Midwives (NARM). Not all midwives are certified.

How can you find a midwife who is compatible with your personality and birthing goals? Begin by asking friends or acquaintances who've had a successful homebirth for a recommendation. You can also contact one of the national midwifery agencies for referrals (see below). But most important is to meet and develop a rapport with any midwife you're considering. She will, after all, be key to the success of your home delivery. You should feel you can trust and rely on her. And, as her client, she will probably wish to feel the same towards you.

THE LAST WORD

Almost every homebirth that I have attended has been a profound experience for everyone involved, including me. After the last such birth, I formulated a few principles regarding homebirth. They can, I think, stand as a summation of why the experience affects people so powerfully, and why it is a moment few new parents ever will forget:

• Pregnancy and birth are natural physiological events, so normal birth does not belong in hospitals.
  
• The natural course of labor is already perfect, and should be interfered with as little as possible.
  
• Pain is part of an essential and healthy feedback mechanism in labor. Women can learn to cope with it, especially with the proper encouragement and support.
  
• Medical management of pregnancy and birth should be limited to those which are medically complicated.
  
• Unnecessary medical interventions complicate normal labor, creating additional risk and the need for more intervention.
  
• Comfort and security help mothers cope with labor. Comfort and security exist at home.

Pam England is a certified nurse midwife in Albuquerque, New Mexico, where she directs the Art of Birthing Doula Training Program. This story was adapted from her book Birthing From Within (Partera Press, 1998). To order a copy, call Partera Press at 505-268-8206 or visit the Web site: www.birthpower.com

To Learn More

These are a few excellent books and articles that address homebirth:

Declercq ER, Paine LL, Winter MR. "Home Birth in the United States, 1989-1992. A Longitudinal Descriptive Report of National Birth Certificate Data," Journal of Nurse Midwifery, 1995; 40 (6): 474-82.

Duran, AM. "The Safety of Home Birth: The Farm Study," American Journal of Public Health, no. 82 (3):450-453.

Goer, Henci. Obstetric Myths Versus Research Realities: A Guide to the Medical Literature (Bergin & Harvey, 1995)

Hannon, Sharron. Childbirth: A Source Book for Conception, Pregnancy, Birth, and the First Weeks of Life (M. Evans and Company, Inc., 1990)

Mehl, Lewis, et al., "Outcomes of Elective Home Births: A Series of 1,146 Cases," Journal of Reproductive Medicine, no. 19 (5):281-290.

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Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!