Archive | Breastfeeding News

Journal of Human Lactation Launches New Podcast Feature!

Written by Karen Wambach

In the first of a new regular feature, The Journal of Human Lactation and Sage Publications has just launched its FIRST PODCAST entitled “On the TRAIL of cancer fighting cells in human milk: The latest research” . These podcasts will feature the author of a JHL paper in a 10-15 minute interview and will be available from the JHL website. The goal is to have at least 1 podcast per JHL issue.

In the current podcast, Editor-in-Chief Anne Merewood PhD, MPH, IBCLC, interviews Italian researchers Riccardo Davanzo MD PhD, and Giorgio Zauli MD PhD, about their paper “Human Colostrum and Breast Milk Contain High Levels of TNF-Related Apoptosis-Inducing Ligand (TRAIL)”, published online in the Journal of Human Lactation. The researchers, in a first-time effort to measure TRAIL in human milk, took samples of colostrum and mature breast milk from new mothers. Researchers then obtained samples of blood from healthy women, and various ready-to-feed infant formulas. The colostrum, mature breast milk, blood and formula were then all tested to measure their level of TRAIL. The researchers found that colostrum and breast milk contained 400- and 100-fold, respectively, higher levels of TRAIL than blood. No TRAIL was detected in the formula.

In the podcast, the authors discuss the implications of their findings with regard to the cancer prevention properties of human milk, and areas of ongoing and future research. High levels of TRAIL protein in breast milk might contribute to anticancer activity.

For subscribers to the journal, read the full study here: “Human Colostrum and Breast Milk Contain High Levels of TNF-related Apoptosis-Inducing Ligand (TRAIL)” by Riccardo Davanzo, MD, PhD; Giorgio Zauli, MD, PhD;Lorenzo Monasta, MSc, DSc; Liza Vecchi Brumatti, MSc; Maria Valentina Abate, MD;Giovanna Ventura, MD; Erika Rimondi, MSc, PhD; Paola Secchiero, MSc, PhD; and Sergio Demarini, MD. Journal of Human Lactation

Karen Wambach is the Director of Research and Special Projects for ILCA. Karen received her nursing degrees from the University of Minnesota in 1982 (BSN), and her MS (1989) and PhD in Nursing (1993) from the University of Arizona. A nurse educator, researcher, and IBCLC, Karen is Associate Professor at the University of Kansas. She has been active in ILCA at the local, regional, and international levels as a presenter, regional conference planner, and member and chair of the ILCA Research Committee. She is a member of the Missouri and Kansas Breastfeeding Coalitions and involved in evaluation of the Kansas Breastfeeding Coalition’s Business Case for Breastfeeding project. A recipient of NIH funding for a randomized clinical trial; her program of research has evolved over the years and now focuses on promotion and support of breastfeeding in vulnerable populations including adolescent mothers and ethnic minorities.


Time Magazine Cover – ILCA’s Response

Written by Lisa Mandell, IBCLC, Secretary ILCA Board of Directors

via Time Magazine

By now, many of you have heard about, seen, and talked about Time Magazine’s recent cover featuring a mother breastfeeding her three-year-old son. The cover photo accompanied a story about Attachment Parenting and Dr. Bill Sears.  There have been numerous blog posts written on the topic already from major media outlets such as USA Today and the Huffington Post, from breastfeeding mothers and from several of our colleagues serving breastfeeding mothers, including the Academy of Breastfeeding Medicine, and Best for Babes.

ILCA would like to remind all of us that breastfeeding beyond infancy is normal, and in many parts of the world, children wean typically between 2 and 5 years of age. As members of ILCA, we do not want to be any part of pitting one mother or her choices in parenting against another mother, as the Time cover encourages. We endeavor to provide and disseminate evidence-based information on breastfeeding, including breastfeeding beyond infancy. We encourage greater support for all mothers and families, from governments, employers, and society. And we welcome the discussion this opportunistic cover has started. Let’s continue that discussion with mothers, clients, friends, acquaintances, employers, health care professionals, even the stranger in front of us in the checkout line. We will help all mothers by continuing to explain the normalcy of breastfeeding, the continued benefits of breastfeeding until the child weans, and the need to support all mothers.

Lisa Mandell, MBA, IBCLC has been working with breastfeeding mothers and babies for over twelve years, first as a volunteer breastfeeding counselor through La Leche League, and then as an International Board Certified Lactation Consultant. Lisa has a private practice seeing mothers and babies in their homes, and has also worked as a lactation consultant in hospitals and a pediatrician’s office, and teaching breastfeeding classes for a birth center. She has been involved in her USLCA chapter as President, CERP Coordinator, and is currently coordinating work on a mentoring consortium to provide a variety of clinical experiences for aspiring lactation consultants. She is pleased to serve as Secretary on the ILCA Board of Directors.

High Levels of TRAIL Protein in Breast Milk Might Contribute to Anticancer Activity

Press Release from the Journal of Human Lactation

Los Angeles, CA (April 23, 2012)  The benefits of breast milk are well known, but why breastfeeding protects against various forms of cancer remains a mystery. A new study in the Journal of Human Lactation (published by SAGE) found high levels of cancer-fighting TNF-related apoptosis inducing ligand (TRAIL) in human milk, which might be one source of breast milk’s anticancer activity.

Researchers took samples of colostrum, the first milk available to newborns, and of mature breast milk from new mothers. Researchers then obtained samples of blood from healthy women, and various ready-to-feed infant formulas. The colostrum, mature breast milk, blood and formula were then all tested to measure their level of TRAIL. The researchers found that colostrum and breast milk contained 400- and 100-fold, respectively, higher levels of TRAIL than blood. No TRAIL was detected in the formula.

“The important role of breastfeeding in the prevention of cer­tain childhood cancers, such as lymphoblastic leukemia, Hodgkin’s disease, and neuroblastoma, has been previously demonstrated,” wrote the authors. “However, endogenous soluble TRAIL represents a strong candidate to explain the overall biological effect of breastfeeding against cancer.”

Mothers chosen to participate in the study were eligible because they exhibited no signs of eclampsia, infection, or fever, and delivered healthy newborns at term.

The authors wrote, “To our knowledge, this is the first time that TRAIL has been measured in colostrum and human breast milk. This study has revealed much higher TRAIL concentrations in colos­trum and breast milk compared to the levels of circulating serum TRAIL.”

The article entitled “Human Colostrum and Breast Milk Contain High Levels of TNF-related Apoptosis-Inducing Ligand (TRAIL)” by Riccardo Davanzo, MD, PhD; Giorgio Zauli, MD, PhD; Lorenzo Monasta, MSc, DSc; Liza Vecchi Brumatti, MSc; Maria Valentina Abate, MD; Giovanna Ventura, MD; Erika Rimondi, MSc, PhD; Paola Secchiero, MSc, PhD; and Sergio Demarini, MD from the Journal of Human Lactation is available free for a limited time at:

Media may contact the author of the study at

Riccardo Davanzo, M.D., Ph.D., is currently a consultant in neonatology at the Istituto Burlo Garofolo,  Trieste, Italy. His main areas of scientific interest are low-tech intervention in neonatal care (essential newborn care, kangaroo care), neonatal weight loss in the term healthy newborn, breastfeeding (medications for the nursing mother, breastfeeding in the NICU, training of health workers on breastfeeding).

Between 1987 and 1991, Dr. Davanzo took part in an international health cooperation programme in Maputo, Mozambique. He contributed to the preparation of documents for the World Health Organization: Essential Newborn Care (1996), Kangaroo Mother Care. A Practical Guideline (2003), Acceptable Medical Reasons for Use of Breast-milk Substitutes (2009).

Dr. Davanzo is a member of the International Society for Research in Human Milk and Lactation (ISRHML) and coordinator of the Italian Network of Trainers of Health Workers on Breastfeeding (RIFAM).


Using Text Messaging to Support Breastfeeding in WIC

Written by Maryanne Perrin, MBA, Graduate student in Nutrition Science, and ILCA volunteer

Recently, we talked to a private practice IBCLC and several of her clients about using mobile* phone based text messaging to support breastfeeding.  We’re continuing the exploration of this innovative topic by talking to IBCLCs within the Women, Infants and Children (WIC) program about how they use text messaging to help low-income mothers succeed with breastfeeding. (NOTE: WIC provides nutritional support to over 50% of infants born each year in theUnited   States which means that this federally funded program has a unique opportunity to play a significant role in promoting and supporting breastfeeding.)

The American Red Cross WIC office inSan Diego,California and the Shasta County WIC office in Redding,California both recently began using text messaging within their Breastfeeding Peer Counselor (PC) programs. Jennifer Nolan, Peer Counselor Supervisor and IBCLC (American Red Cross), and Sara Stone, Lead Peer Counselor and IBCLC (ShastaCounty), shared their stories with us…

Getting Started

Shasta County WIC PCs

Both WIC offices received federal grant funding which they used to purchase mobile phones for their Peer counselors (PCs).  American Red Cross has 3 people on the peer counseling team and Shasta County has 8.  When a new mother enrolls in the peer counselor service, each office asks the mother about her communication preferences and no one ever initiates text messaging without first receiving the mother’s approval (depending on an individual’s phone plan, they could potentially incur additional expenses for receiving unwanted text messages).

ShastaCounty also had to request a modification to the contacts database so that “text messaging” was an option for tracking contacts. (Note: they only count the text message as a contact if they get a reply from the mother; unreturned texts are not counted.)  Once the database modifications were made, they became available to other California WIC agencies as well, allowing them to track text messaging use.

A lesson learned in Shasta County was the importance of having an effective phone for text messaging.  Initially they got very basic phones for their PCs, but soon upgraded to phones with full keyboards so that the PCs could be efficient in sending texts.

How Text Messaging Is Used

Both Jennifer and Sara stressed that text messaging is never a starting point for building a relationship with a client, but instead a complementary communication method they use after first establishing face-to-face or phone contact. “We get better participation in our program by using a communication mode that is most comfortable for mothers,” says Jennifer.  Sara echoed this sentiment, describing text messaging as a cultural shift that allows WIC PCs to stay better connected with their clients.  Examples of the types of messages exchanged between PC and mother include:

  • Prenatal contacts that involve inviting the mother to classes or scheduling/confirming appointments
  • Sharing tips about baby’s development and checking in during pregnancy to help build rapport
  • Receiving texts from mother while she is in the hospital to learn about baby’s arrival
  • Asking and answering simple breastfeeding questions or scheduling calls to follow-up on more complicated breastfeeding issues
  • Checking in on postpartum status and sending encourage messages

Why Use Text Messaging?

San Diego WIC office

Text messaging is portable (mobile phones are typically with mothers at home, at work, and in the hospital) and also non-invasive (won’t wake a sleeping baby or interrupt someone during an important meeting at work).  One WIC mother, upon receiving a call from her PC, whispered into the phone, “I’m at work, can you please text me?”

Jennifer says that the majority of their clients use text messaging, and she thinks it has the potential to prolong breastfeeding because it keeps mothers engaged and gets them the information they need (a critical mass of WIC data should allow future analysis of this).  ForShastaCounty, “It’s taken off like wildfire,” says Sara.  Text messaging has grown from 7% of their non face-to-face contacts (phone, email or text) in July 2011, to almost 25% as of February 2012.  Sara’s words of advice to other WIC agencies – “Just jump in and do it!”

Are you using text messaging or alternative technologies in creative ways to promote and support breastfeeding within WIC or other settings (e.g. third-world countries)?  If so, we’d love to hear your story!

* Other terms used around the world including cell phone, cellular phone, and hand phone.

By Maryanne Perrin

MBA, Graduate student in Nutrition Science, and ILCA volunteer


Implications of Obesity in Breastfeeding Women

Written by Crystal Karges, DTR, CLEC

With the growing concern of obesity in the United States, the implications for breastfeeding women are not completely understood. The frequency of obesity of adult women in the United States, particularly of those women who are considered to be within the reproductive age (20-39 years old), is increasing rapidly. A recent study has analyzed how a high fat diet may alter lactation outcomes, revealing possible complications for mothers who consume high-fat diets during pregnancy or who are overweight or obese.

Several studies have demonstrated the negative effects of obesity on various physiological pathways. Such outcomes resulting from excessive weight gain during pregnancy include increased risk of developing breast cancer, increased birth weights in offspring, augmented probability of developing obesity or metabolic syndrome in their lifetime, development of gestational diabetes, and the possibility of delayed lactogenesis (failure to lactate for more than 72 hours postpartum). This is particularly important for the breastfeeding mother, as delayed onset of lactogenesis has also been correlated with overall shorter duration of breastfeeding. While it has been determined that obesity is a contributing factor to the interference of normal lactation cycles in mothers, the mechanisms within mammary glands that trigger delay of lactogenesis are yet to be understood.

In this recent study by Hernandez et al, the possible mechanisms by which high fat diets effect lactation outcomes were explored on rodent models. These researchers discovered that the mammary glands of rats ingesting a high fat diet had a significant reduction in the number of intact alveolar units within the mammary glands, which are critical for lactogenesis to occur normally. Additionally, it was also concluded from this study that within the mammary gland itself, there was a decline in genes corresponding with the uptake of glucose and development of milk proteins (an essential step for the synthesis of lactose), along with the increase in genes linked with the inflammatory process (a response activated by obesity). Based on these results, authors were able to determine that the consumption of a high-fat diet inhibits the normal functional ability of mammary parenchymal tissue, hindering its capability of manufacturing and secreting milk.

This information would be relevant to discussing with patients/clients in the prenatal period, particularly in encouraging pregnant mothers to consume a relatively low-fat diet with the goal of optimizing initiation and long-term duration of breastfeeding.

How does this information affect your scope of practice as a Lactation Consultant?

To be directed to the original study, please continue reading here.

Citation: Hernandez LL, Grayson BE, Yadav E, Seeley RJ, Horseman ND (2012) High Fat Diet Alters Lactation Outcomes: Possible Involvement of Inflammatory and Serotonergic Pathways. PLoS ONE 7(3): e32598. doi:10.1371/journal.pone.0032598

Crystal Karges, DTR, CLEC


Can a Change in Pediatric Office Policy Begin to Change the Culture of Infant Feeding?

Written by Jennie Bever Babendure, PhD, IBCLC

In the February issue of Breastfeeding Medicine, Ann M. Witt and her colleagues analyze the impact of integrating lactation consultants into a pediatric practice1.  Although providing referral to or in-office lactation services if requested is not a new idea, what makes this study unique is the systematic change made to schedule ALL breastfeeding newborns with a lactation consultant for their first pediatric office visit.

How did this work?  At the time of the study, the American Academy of Pediatrics (AAP) policy dictated that all healthy term breastfeeding infants be seen at the pediatric office within 3-5 days of hospital discharge2.  In 2009, the study practice changed their policy to routinely schedule these visits with an in-office IBCLC precepted by a physician.  IBCLC’s spent 45-60 minutes with the patient, then discussed the history and breastfeeding evaluation with an available physician who spent about 5 minutes in the room evaluating the patient and deciding on a treatment plan.   Follow up phone calls and in-person visits were scheduled, as well as a routine visit with the primary physician at 2 weeks of age.  More than 45% of patients had multiple visits with a practice IBCLC, and a limited survey indicated high maternal satisfaction with the new policy.  IBCLC’s were employed 4 hours a day 5 days a week in the practice to meet the need for these visits and follow up.  As the physician evaluated the patient at the 3-5 day visit, it was reimbursed as a general medical visit, which sufficiently covered IBCLC salaries.

How did this impact breastfeeding?  In 2007, all infants were seen in the office by 2 weeks of age unless jaundice or weight gain problems were identified in the hospital.  The practice employed an RN, IBCLC 3 days a week to provide phone support for breastfeeding problems as well as in-person consultations.   When researchers compared infant feeding method  in retrospective chart review between 2007 and 2009 patients, they found that non-formula feeding (breastfeeding) went up by 10-15% at all time points from 2-9 months, demonstrating a significant increase in breastfeeding intensity following the intervention.

When I first read this study, I was struck by the brilliant simplicity of this idea.  By integrating lactation consultants into the existing medical structure, mothers and babies got automatic breastfeeding help and follow-up, and physicians could follow AAP policy and monitor jaundice and weight gain as well have a large influence on the on-going health of their patients with minimal input of time or cost and no additional formal training.  As I continued to think about this study, I realized that this policy has a much broader impact.  By making this systematic change to their office policy, they have changed the culture of infant feeding in their practice.  Routinely scheduling the first office visit with an IBCLC sends a strong message to patients.  It says:  “Your physicians know you want to breastfeed, and feel breastfeeding is so important to your child’s health that we will do everything we can to help you through the challenges.”

I can’t help but imagine the impact if all pediatric practices were to adopt this model.  Would these actions speak louder than our words?  Would they whisper or shout: Breastfeeding is a public health issue3, we’re here to help you make it happen.

1.  Witt AM SS, Mason MJ, Flocke SA., Source1 Department of Family Medicine CWRU, Cleveland, Ohio. Integrating routine lactation consultant support into a pediatric practice. Breastfeeding Medicine 2012;7(1):38-42.

2.  BREASTFEEDING SO. Breastfeeding and the Use of Human Milk. Pediatrics 2005;115(2):496-506.

3.  BREASTFEEDING SO. Breastfeeding and the Use of Human Milk. Pediatrics 2012;129(3):e827-e841.

Jennie Bever Babendure, PhD, IBCLC

I am a mother of 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates.


Why Beyonce Nursing in Public is So Significant

Written by Robin Kaplan, M.Ed., IBCLC, Owner of San Diego Breastfeeding Center and Co-Editor of Lactation Matters

Last week I came across an extremely well-written article by Kimberly Seals Allers of, called Dear White Women: Beyonce is OUR Breastfeeding Moment. Please Step Aside.  In her article, Kimberly discussed her disappointment with the media coverage of Beyonce, one of the most iconic and popular African American women at this current time, nursing in public.  While this was a wonderful moment for all breastfeeding advocates, it truly was a significant event for African American women, who have statistically had low breastfeeding initiation and duration rates.  Here is my interview with Kimberly Sears Allers.

Kimberly Seals Allers and her children

Robin: Why is Beyonce breastfeeding in public so significant for the African American community?

Kimberly: Beyonce breastfeeding in public is particularly significant for our community because we just haven’t had as many high profile African American celebrities come out and support breastfeeding. Like it or not, role models matter. Celebrities can help create a lifestyle cache and trendiness, particularly among young women, that helps broaden our ideas about who breastfeeds in the black community. When you look at the high infant mortality rate among African American infants, and we know how critical breastfeeding is to saving these babies lives and reducing their risks of respiratory infections and childhood obesity, the possibly the power of one highly-visible black celebrity breastfeeding could potentially save one more infant, and help one more baby become a healthier child is significant beyond words for me.

Robin: In your opinion, how could this media event been covered more appropriately?

Kimberly: For years I have been writing that black mothers are absent from the mainstream “mommy” conversation in this country and it seems our invisibility has carried over with this instance. The media was, for the most part, negligent by not connecting the dots between Beyonce as a black woman breastfeeding an African American child–both of whom are statistically less likely to breastfeed or be breastfed, and highlighting the particular significance for black women who have had historically low breastfeeding rates for over 40 years. This was also a rare, and unfortunately missed, opportunity for those who speak for the breastfeeding movement to connect those dots for them and millions of others. When we have the opportunity for a national microphone, I believe we have to hold our own leaders and the media accountable for thinking about all the issues and looking at these news events from all angles.

Robin: How can lactation consultants better support African American breastfeeding women in our communities?

Kimberly: The most important thing is to understand the cultural nuances of breastfeeding for an African American woman. Breastfeeding is not about simplistic messaging that breast is best; we know that and want that. But many of us are first generation breastfeeders with little or no multi-generational support. Help us with the how. Studies show that our male partners, grandmas, aunties and extended family members have a greater influence on our decision and breastfeeding duration than other women… so target the whole family. Understand the power of media stereotypes, our own internal stereotypes about who breastfeeds in our community, the residual effects of our breastfeeding experiences during slavery, and the role of aggressive infant formula marketing. Educate us so that when our mother or grandmother question if the baby is getting enough, we have an educated answer. Empower us to have more confidence in our bodies and our ability to “do this” even if, and especially if, we don’t have much social support. Having a broader understanding of what this woman is dealing with, beyond the latch issue, a lactation consultant may actually be there to assist, which can mean so much in terms of true support.

Robin: Now, please tell us all about your new project, Black Breastfeeding 360°.

Kimberly: I’m so excited about this! For years, I’ve been frustrated by the superficial news coverage of breastfeeding issues in our community. There is always reporting of the low statistics, with little or no insight into the complexities I previously mentioned or the lack of role models or the lack of social support. So I created Black Breastfeeding 360° as an online content library for media professionals to get everything they need to know on the full spectrum of the black breastfeeding experience. And I created BB360° as a place for women, mothers, and fathers to learn, share and hear the breastfeeding experiences of others. BB360° features articles and commentaries that any media outlet can use for research or download for free use in their publication.  It features audio and video clips of real mothers, fathers and grandparents talking about their true thoughts and feelings about breastfeeding, and it features practical tips and resources specifically written for any black woman nursing her child or even thinking about it. I was supported to create BB360° through my Food & Community Fellowship with the Institute of Agriculture and Trade Policy, funded by the Kellogg Foundation, and I’m so grateful. It’s my baby and I’m breastfeeding it, so I know it will be healthy and robust.

Kimberly Seals Allers is a leading voice on African American motherhood,  author of The Mocha Manual™ series of books and founder of, a parenting and lifestyle destination and blog for African American moms and moms-to-be. An award-winning journalist, Kimberly is also a popular public speaker and consultant on the mom of color market, and fiercely committed to reducing the high infant and maternal mortality rates and increasing the low breastfeeding rates in the African American community.

In 2011, Kimberly was named an IATP Food and Community Fellow, funded by the Kellogg Foundation, with a mandate to increase awareness and reducing the barriers to access to “the first food”—breast milk, in vulnerable communities.

In addition to her popular blog on, Kimberly blogs about the African American parenting experience for Babycenter’s and is a regular commentator for and

Her first book, The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins) a hip, funny and informative pregnancy guidebook for women of color, put her on the map as a pregnancy and parenting expert with real-deal insights. The book was nominated for an NAACP Image Award and later turned into The Mocha Manual to a Fabulous Pregnancy DVD, available at Her book series also includes The Mocha Manual to Turning Your Passion into Profit, and The Mocha Manual to Military Life—A Savvy Guide for Girlfriends, Wives and Female Service Members.

A graduate of New York University and Columbia University Graduate School of Journalism, Kimberly is a divorced mom of two who lives in Queens, New York.


Breastmilk Oligosaccharides and Their Effects on Necrotizing Enterocolitis

Written by Crystal Karges, DTR, CLEC

Just when the benefits of breastfeeding couldn’t seem to get any better, new research is revealing even more reasons for mothers to breastfeed.  Increased knowledge and understanding about the various properties and components of human breast milk, and the interaction with the newborn gut, make for profound evidence for its unsurpassed advantages.

A newly published study by Dr. Lars Bode, assistant professor in neonatal medicine and pediatric gastroenterology and nutrition at University of California San Diego (UCSD) School of Medicine’s Department of Pediatrics, has evaluated the effects of how a particular human milk oligosaccharide (HMO) can considerably decrease the risk of necrotizing enterocolitis.

One of the most recurrent and deadly intestinal disorders in premature infants is necrotizing enterocolitis (NEC), and it has been demonstrated that an estimated five percent of all premature infants born with a low birth weight acquire NEC.  While the mechanism behind NEC is not widely understood, the devastating effects are undeniably seen, with statics disclosing the fatality of this condition and the rigorous complications for survivors.

Amidst the difficulties associated with this complex condition, there are promising discoveries being made about the properties of breast milk that have been shown to counteract the outcomes correlated with NEC.  In his latest research findings, Dr. Bode and his colleagues discovered that out of the estimated 150 oligosaccharides unique to human milk alone, one oligosaccharide in particular (Disialyllacto-N-tetraose) is accountable for the advantageous effects of decreasing the risk of NEC in neonatal rats.  In contrast, infant formulas, which are supplemented with galactooligosaccharides (GOS), have a negligible influence on NEC in neonatal rats.

These findings not only elaborate on the numerous advantageous of human milk, but also illustrate how it functions in providing health benefits outside of nutrition and sustenance for the infant.  Sharing research such as this with clients and patients will continue to encourage and empower new mothers to breastfeed their infants.

For more information about Dr. Bode’s lab site, continue reading here.

About SPIN at UC San Diego

Premature infants who receive human breast milk have the best outcomes – medically, nutritionally, and developmentally. Within the Neonatology Division at UCSD’s Department of Pediatrics, the Supporting Premature Infant Nutrition (SPIN) program was developed to address the challenges of helping mothers produce sufficient breast milk for their premature infants, and to improve the manner in which neonatal intensive care units (NICUs) support optimal nutrition and growth in their most vulnerable population of patients.


Crystal Karges, DTR, CLEC


Do Children See Breastfeeding?

By Jennie Bever Babendure, PhD, IBCLC

With the recent push to Bring Breastfeeding back to Sesame Street, and deletion of breastfeeding images by Facebook, this month’s article seems particularly timely. In countries where the act of breastfeeding is often done behind closed doors and breastfeeding imagery is controversial—what do children say about how babies are fed?

In the Dec 2011 issue of BIRTH, Angell, Alexander and Hunt explore this issue looking at infant feeding awareness in primary school children1.  In this small pilot study in southern England, 56 children ages 5/6, 7/8 and 10/11 were read a story about a hungry newborn baby, and asked to finish it with drawings and text about how the baby would be fed, then invited to talk about their work with a researcher.

36% of the children depicted breastfeeding, with 13% of 5/6 and 7/8 year-olds and 83% of the 10/11 year-olds referring to breastfeeding in their drawings or text.  The younger children tended to be confident and articulate in their descriptions of breastfeeding, while the 10/11 year olds were more hesitant. The 10/11 year-olds were more likely to illustrate mothers in awkward poses in their drawings, and to use euphemisms and gestures to describe breastfeeding.   They were also more likely to indicate they had learned about breastfeeding in school, while the younger children demonstrated detail from personal experience.

Formula was depicted by 55% of children evenly distributed across age groups, many of whom also described breastfeeding or solid foods. Although the researchers identified little difference between the responses of boys and girls, the impact of school-based teaching was evident in the responses of the 10/11 year-olds as children from urban schools seem to have more detailed working knowledge of breastfeeding gained from school curricula than did rural school children.

This study is consistent with others that demonstrate a greater awareness of bottle feeding among both children and adults.  The authors point out that while bottle feeding imagery is everywhere, most children and adults in the UK have never seen a friend or family member breastfeed.  I would venture to guess that the same is true in the US.   Despite the fact that my 5 year old son has been proudly pointing out nipples on mother animals in his picture books since he was old enough to talk, and has a good working knowledge of the mechanics of a breast pump, I was a bit surprised to learn that I am the only person he has ever seen breastfeed.

Importantly for the authors and for breastfeeding advocates, these findings demonstrate a real opportunity.   In spite of the awkwardness of the 10/11 year olds in discussing breastfeeding, the school-specific differences in breastfeeding knowledge suggests that they are receptive to learning about infant feeding.   Angell, Alexander and Hunt conclude that in the UK, an evidence-based standardized infant feeding curriculum in primary school may be a promising first step to breaking down culturally entrenched barriers and increasing the success of later breastfeeding promotion efforts.  Should the US and other countries follow suit, this type of education could have wide-reaching influence both on attitudes towards breastfeeding and on public health for generations to come.

1. Angell C, Alexander J, Hunt JA. How Are Babies Fed? A Pilot Study Exploring Primary School Children’s Perceptions of Infant Feeding. Birth 2011;38(4):346-353.

Jennie Bever Babendure, PhD, IBCLC

I am a mother of 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates.


Breastfeeding During a Disaster – Typhoon Washi

Written by Crystal Karges, DTR, CLEC

There is nothing more significant or essential during the occurrence of natural disasters or catastrophes than maintaining breastfeeding between a mother and her nursing baby.  The number of emergency situations occurring world-wide that have affected mothers and infants has increased over the last several years. This can prove to be both challenging and difficult as families who have survived such unpredictable incidences are often displaced from their homes and have suffered the loss of family and property.  Additionally, the incredible stress and anxiety resulting from experiencing such a trauma can undoubtedly be enough to sever a mother’s desire to continue breastfeeding. Perhaps the most susceptible victims in the repercussions of such calamities are infants, thus increasing the need to breastfeed during emergency situations.

Recently, residents of Cagayan de Oro City in the Philippines suffered the disastrous effects from Typhoon Washi, leaving countless families without homes or shelter and claiming many lives.   Amidst this tragic situation, mothers have regained hope by continuing to provide nourishment for their babies by sustaining breastfeeding.  One mother in particular, who survived the flashflood along with her husband and six-month old, shared of her decision in continuing to breastfeed her baby during this chaotic event: “I don’t feel shy or embarrassed breastfeeding in the evacuation center.”

Efforts from organizations such as UNICEF, have worked to promote breastfeeding during emergency situations, such as the devastating Typhoon Washi, by establishing breastfeeding areas within evacuation sites and conducting counseling for mothers to encourage continued breastfeeding or to assist with re-lactation.  Promoting such practices, along with the recommendations from ILCA (International Lactation Consultant Association), is critically important in ensuring that infants affected by these disasters will have adequate nutrition, as well as immunological protection.  IBCLCs, International Board Certified Lactation Consultants, can play a crucial role in humanitarian relief efforts to areas that have suffered natural disasters by implementing these necessary recommendations.

Though disastrous situations cannot be predicted, knowing the essentials on infant feeding in emergencies feeding can be life-saving.  Continue reading here for more information on ILCA’s Position of Infant Feeding in Emergencies.

What has been your experience in counseling the nursing mother during an emergency situation?

Crystal Karges, DTR, CLEC


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