Electronic BAMS Now Available

Good news comes with the New Year for those who have asked for my large and heavy book, Breastfeeding Answers Made Simple (BAMS) in an electronic format.  Your wish has finally come true. 

Available in two formats, one for the Amazon Kindle and one for all other electronic devices, BAMS can now be ordered directly from the Hale Publishing website: http://www.ibreastfeeding.com/catalog/Digital-Books/c34/index.html   If you have questions or would like to order by phone, call 806-376-9900.  You can also e-mail books@halepublishing.com

Also in the works, a pocket-sized edition of BAMS for those without an electronic reader who would like to have a smaller, lighter book to carry with them when helping mothers.  I am currently in the process of finishing this project.  The pocket guide version will not contain the references and the lengthy explanations.  Instead, you'll find in its pages only the recommended helping strategies to remind you of what to try next.  This pocket guide version should be available for purchase this summer.  Wish me luck!

Biggest BAMS Discount Yet in December

Because so many have asked me how to get a discount on my book Breastfeeding Answers Made Simple: A Guide for Helping Mothers, I wanted to let you know that during the month of December, Hale Publishing has lowered its price by $30.  Usually $79.95, until the end of the month BAMS' sale price is $49.95, which is 37% off, its deepest discount to date.  This applies to orders of individual copies, eliminating the need to wait for a conference or coordinate large orders for a quantity discount.  To take advantage of this sale price, call 806-376-9900 or click here for the Hale Publishing "Specials" webpage.

Newborn Weight Loss and IV Fluids in Labor

Until now, weight loss during the first 3 to 4 days after birth has been considered one indicator of how early breastfeeding is going.  If on Day 4 a newborn’s weight loss is in the average range of 5% to 7%, this usually means breastfeeding is going well.   Nearly all babies lose some weight after birth, because after floating in amniotic fluid for 9 months, they are born waterlogged.  Normal weight loss comes from the shedding of this excess fluid as they adjust to life on the drier outside. 

But when babies lose more than 7% of birth weight during these early days, does this automatically mean they are not getting enough milk?  No, according to a recent study. 

A greater weight loss may be completely unrelated to breastfeeding and due instead to excess IV fluids mothers receive within the final 2 hours before delivery.  According to this study, these excess IV fluids inflate babies’ birth weight in utero and act as a diuretic after birth.  Babies whose mothers received more IV fluids before birth urinated more during their first 24 hours and as a result lost more weight.  Number of wet diapers during the first 24 hours predicted infant weight loss.  This was true whether the babies were born vaginally or by c-section.  Another study published earlier this year had similar findings.

This weight loss has nothing whatsoever to do with breastfeeding and milk intake.  In fact, the authors suggest that if clinicians want to use weight loss as a gauge of milk intake, they calculate baby’s weight loss not from birth weight, but from their weight at 24 hours.  According to their findings, this could neutralize the effect of the mother’s IV fluids on newborn weight loss.

This is one more reason weight loss alone should not be used to determine when newborns need formula supplements.   The Academy of Breastfeeding Medicine put this well in one of its protocols: “Weight loss in the range of 8-10% may be within normal limits….If all else is going well and the physical exam is normal, it is an indication for careful assessment and possible breastfeeding assistance.”

No Such Thing as a Free Lunch

Not long ago I was contacted by an Associated Press reporter who asked for my help with an article she was writing on formula marketing by U.S. hospitals.  She asked me to provide contact information for women whose babies had either been given formula in the hospital or who were given formula marketing bags on discharge.  This was not hard to do, as according to the U.S. Centers for Disease Control and Prevention, 25% of breastfed babies receive unnecessary formula supplementation during their hospital stay.  And a recent article in Pediatrics estimates that 72% of U.S. hospitals distribute industry-sponsored formula sample packs to new parents  

Thanks to my online contacts, within 2 hours 12 local mothers had volunteered to talk to this reporter. I had high hopes, but the article was a disappointment.  Formula company spokespeople were given the last word, noting that “it’s good to have a back-up” and characterizing it as “irresponsible” not to give new mothers free formula in the hospital.   

What was not reported was the true cost of this “free” formula to parents and the impact of hospital formula marketing on breastfeeding.  The most recent study on the effect of hospital distribution of infant formula  found that the mothers who received formula samples at discharge were less likely to be exclusively breastfeeding during each of their baby’s first 10 weeks as compared with women who did not receive them.  For a summary of decades of research on this issue, click here.

What’s most important for parents to know, though, is that this is not just about breastfeeding.  The reason formula companies work so hard to establish these unholy alliances with hospitals is that they know from their own research that due to fear of adverse reactions, most parents will continue to buy the formula their baby is given first. 

The “free” formula included in those stylish marketing bags is each brand’s most expensive type.  A cost analysis done by the outstanding nonprofit organization Ban the Bags found that formula-feeding families who use the high-priced formula in these marketing bags will spend $700 more during their baby’s first year than if they bought the generic store brand.  This is the true cost of these bags to families.  No wonder formula companies are so anxious to get this product into their hands! 

What’s in it for hospitals?  In many cases, in exchange for acting as formula marketing agents (and therefore endorsers of infant formula) hospitals receive unlimited free formula for their use.  And when formula flows like water on maternity floors it’s more likely to be fed to newborns unnecessarily to the detriment of breastfeeding: a double benefit for the formula industry. 

How can we convince hospitals that it is inappropriate and unethical to give formula samples to new parents?  In many ways, as Ban the Bags points out, this practice is like giving out free Big Macs on the cardiac floor.  Babies who receive infant formula have poorer health outcomes and higher health-care costs than exclusively breastfed babies.  It makes far more sense for hospitals to focus their energies on marketing health, not commercial products.  Click here for some ideas from Ban the Bags on how to sell this idea to your local hospital.

One last thing.  If you received a formula marketing bag from your local hospital, don’t forget to write a letter of complaint to the hospital's administration.  Patient satisfaction has a huge effect on hospital policy decisions.  Use your influence for the benefit of all new parents.

Settling in to My New LLL Home

In a previous post, I described being booted from La Leche League (LLL) of IL, where I had worked as a Leader since 1982, for the crime of working as both a LLL Leader and a Breastfeeding USA (BFUSA) Breastfeeding Counselor.  My accreditation with another organization was not surprising.  Those who know me can testify that if breastfeeding is involved, you can count me in!

When I published my post, I was flooded with invitations from LLL Leaders and Area administrators who warmly welcomed me and extended their unconditional support.  So many people wrote that it was impossible for me to respond personally to them all.  If you were one, please accept my deepest thanks! 

Although I had many LLL Areas to choose from, I decided what was most important to me was not the quality of its beaches (as one Florida Leader offered as an incentive) but whether my presence was likely to bring the LLL International (LLLI) hammer down on my new Area.  I did not want to join a new team only to make their lives miserable by becoming a liability. 

So when I received an invitation from LLL of Connecticut, I knew that this was a match made in heaven.  These amazing ladies have become known for standing their ground against unreasonable LLLI policies and directives.  Of course, disagreeing with LLLI’s administration these days is almost guaranteed to result in sanctions and threats, so when the LLL of CT Area team made its concerns known publicly, LLLI wrote them a letter accepting their resignations, which they had not offered.  But LLL of CT has long been registered as its own nonprofit organization with the team as its legal representatives.  This allowed them to thumb their noses and continue their work.  They also bought their own liability insurance, so that could not be used as a weapon against them.  When LLLI tried to convince other CT Leaders to take their places, these Leaders made it clear that this team had their full support.

I have a feeling I’ll fit right in with LLL of CT, which just yesterday became my official LLL Area.  After all, as the saying goes, “Well-behaved women rarely make history.”  As you might expect, my opinion on the issue that led to my actions has not changed.  If anything, I am more convinced than ever that LLLI’s directive that Leaders must choose between LLL and BFUSA is divisive and therefore destructive to breastfeeding. 

In recent weeks, people on the inside have confirmed that the goal of this directive is to undermine BFUSA, which includes ex-LLL Leaders among its founders.  LLLI is headed down a slippery slope.  In Illinois, nearly half of its Leaders have resigned in the last two years.  It’s clearly time for it to look in the mirror and reevaluate its Leadership and its strategies.

I heard that one aspect of my actions was particularly upsetting to LLLI: my announcement on Facebook about my new BFUSA Breastfeeding Counselor status.  Should I take this to mean that it’s all right for LLL Leaders to be involved with both organizations as long as they don’t say so publicly?  Can we expect this to become LLLI’s version of “Don’t Ask, Don’t Tell?” 

If LLLI wants to grow and thrive, booting out those who question it is exactly the wrong approach.  LLL Leaders have never been easily cowed.  Those who breastfeed long term are clearly comfortable following a different drummer.  They are not women who can be bullied into following directives that are obviously wrong.  Take it from one who knows… or ask the Leaders in my new LLL Area.