ILCA Statement in Support of the 40th Anniversary of the International Code of Marketing of Breast-milk Substitutes (the Code)


Research tells us that the overwhelming majority of mothers want to breastfeed, but they don’t always reach their breastfeeding goals. Less than half of newborns begin breastfeeding in the first hour of life, and only 44% of infants are exclusively breastfed at six months.1 One of the most significant challenges to improving breastfeeding rates worldwide is the exploitative marketing of commercial milk formulas. 

Around the globe, mothers and other parents experience barriers to lactation, from a lack of skilled support to inadequate workplace provisions. Formula companies are at the ready to exploit these wide gaps. Formula companies’ marketing efforts are aggressive, well funded, and come at families from every angle, including influencing health care providers at sponsoring events and providing branded educational materials, making false claims about the product, providing free samples to hook families (who often can’t afford to continue to purchase the expensive product), and exploiting parents’ desires to do what is best for their children.

The solution to these aggressive marketing tactics exists: the Code.

The aim of the International Code of Marketing of Breast-milk Substitutes and all subsequent relevant World Health Assembly resolutions (which together make up the Code) is to “contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.”2

The Code covers four product areas: breastmilk substitutes, which includes all commercial milk formulas (including follow-on formulas and growing up milks), marketed as appropriate for children up to 36 months of age; any other food or beverage marketed as appropriate for children up to 6 months of age; and feeding bottles and teats

It is important to understand that the Code applies to the marketing of these products, their quality, and information about their use, but does not limit sales of these products, recognizing that they may be necessary in some situations. The Code specifies no promotion of these products to the public in any form, including no samples of the products to families or health workers, no gifts or other financial inducements to families or health workers, no promotion in healthcare facilities or to health workers, no promotion of complementary foods before 6 months, no sponsorships of meetings of health professionals, and adequate and appropriate labeling. The Code states that companies have a responsibility to follow the Code independent of any legal measures to implement the Code. 

The market for commercial milk formulas is huge, estimated at US$70.6 billion in 20193, with an estimated US$16 billion in profits.4 What these companies spend on formula marketing FAR outpaces what countries spend on breastfeeding support: One analysis of just the six largest commercial milk formula companies estimated they spent US$7 billion on marketing in 2015 (US$17 billion if spending on sales staff and administrations is included).5 This spending dwarfs the estimated $653 million annual cost to scale up breastfeeding counselling interventions in 34 countries to meet breastfeeding goals, which would save the lives of 820,000 children and add US$300 billion to the economy annually.6 

However, the existence of the Code is not enough. It must be implemented with legal measures, including steps for monitoring and enforcement in every country. As of April 2020, 136 of 194 countries had enacted legal measures with provisions to implement the Code but only 25 of these countries had measures substantially aligned with the Code; 58 countries still have no legal measures at all.7

As we celebrate the 40th anniversary of the enactment of the Code, we are reflecting both upon the gains the Code has made possible, but also upon the work yet to be accomplished by this important protection.

This is why ILCA:

  • Calls on governments to enact, enforce, and monitor the Code, or strengthen legal measures already in place.
  • Supports existing efforts, like NetCode, to provide resources and support for monitoring and enactment of the Code.
  • Calls on all ILCA members to fulfill their obligations under the Code, and supports members with education and information to do so.
  • Calls on other health care professional organizations to honor and uphold the Code, including educating health workers and ending the practice of allowing Code-violating corporations to sponsor events.
  • Continues to follow the Code in evaluating advertising and sponsorship in the Journal of Human Lactation and at our annual conference, serving as a model to other health care professional organizations.

These efforts are critical to ensuring that formula companies do not continue to put profits before the health of mothers, infants, and young children.


References

1: SEVENTY-FOURTH WORLD HEALTH ASSEMBLY A74/14 Provisional agenda item 16 Committing to implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030), Report by the Director-General. (2021). https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_14-en.pdf

2: International Code of Marketing of Breast-milk Substitutes. (n.d.). https://www.who.int/nutrition/publications/code_english.pdf

3, 6: Rollins, N. C., Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C. K., Martines, J. C., Piwoz, E. G., Richter, L. M., & Victora, C. G. (2016). Why invest, and what it will take to improve breastfeeding practices? The Lancet, 387(10017), 491–504. https://doi.org/10.1016/s0140-6736(15)01044-2

4, 5: Don’t Push It: Why the formula milk industry must clean up its act. (2018). Resource Centre. https://resourcecentre.savethechildren.net/node/13218/pdf/dont-push-it.pdf

7: Marketing of breast milk substitutes: national implementation of the international code, status report 2020. (2020). Www.who.int. https://www.who.int/publications/i/item/9789240006010

Image credit: UNICEF

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Promote the International Code of Marketing of Breast-milk Substitutes: Add a 40th Anniversary Frame To Your Profile Image


Friday, 21 May 2021 marks the 40th anniversary of the adoption of the International Code of Marketing of Breast-milk Substitutes (the Code) by the 34th World Health Assembly.

Show your support for the implementation and monitoring of these critical efforts to limit the aggressive and predatory marketing of breastmilk substitutes, including commercial milk formula. Change your profile frame today.

How to Add a Profile Frame on Desktop 

  1. Navigate to your profile page by clicking your name on top blue bar. 
  2. Hover over your profile picture. 
  3. Click “Update”. 
  4. Click “Add Frame”. 
  5. In the search box, type “Celebrating the Code’s 40th Anniversary”. 
  6. Click the frame to select it. 
  7. Use the editing box on the right to adjust the size and placement of your profile picture. 
  8. On the bottom row, next to “Switch back to previous profile in”, click on the drop down menu. 
  9. Choose how long you would like to keep your frame. 
  10. Click “set”. 
  11. Click “Use as Profile Picture”. 
  12. You’re all done! If you want, make a post about your new profile frame to your followers. 

How to Add a Profile Frame on Mobile (iOS)

  1. Navigate to your profile by tapping the person icon on the bottom of the screen.
  2. Tap the photo icon on your profile picture. 
  3. On the menu that pops up at the bottom of the screen, tap “Add Frame”. 
  4. At the top of the screen, click on the search bar. 
  5. Search “Celebrating the Code’s 40th Anniversary”. 
  6. Choose your style by tapping on it. 
  7. Tap the button that says “Make Temporary” and choose “Custom” in the drop-down menu. 
  8. Choose how long you would like to keep your frame. 
  9. Tap “Set”. 
  10. Tap “Save” in the upper right hand corner of the screen. 
  11. You’re all done! If you want, make a post about your new profile frame to your followers. 
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Talking Tongues: New Lingual Frenulum Research Challenges Previous Beliefs


How would it change your practice if you learned that just about everything you think you know about the lingual frenulum is wrong?  

New research to be presented at the International Lactation Consultant Association’s Annual Conference in Texas in July suggests exactly that, with serious implications for lactation professionals’ work.

As a Pediatric ENT Consultant at Starship Children’s Hospital in New Zealand, Nikki Mills, BHB, MBChB, FRACS, Dip Paeds, IBCLC, sees a lot of baby’s tongues. And, she is often asked to perform frenotomies.

Over time, Mills began to have more questions than answers about the procedure.

Why did some of her patients seem to get great benefit from the procedure, breastfeeding more successfully afterward, while others saw no benefit at all?

“As a surgeon who was being asked to divide frenulums in babies, I really wanted to know what it was that I was cutting,” Mills says. “I wanted to understand exactly what tissues I was dealing with and what they did.

“I believed that understanding should be the basis for deciding when a frenulum should be cut—and when it should not,” Mills continues. “For me, it was a fundamental question.”  

But when she went looking for research to answer her questions, Mills came up empty handed.

“No one had ever looked at the anatomy and function of the lingual frenulum in detail,” she says.

She decided it was high time someone did.

So she scaled back her clinical practice and spent the next four years researching.

As part of her investigation, she dissected fresh neonatal cadavers to better understand the anatomy and function of the lingual frenulum.

What she discovered was out of sync with everything she had been taught.

“What I found was very different from what has been the popular understanding of the lingual frenulum,” she says. “It’s challenging because when I present my research, it makes everyone who thinks they understood the lingual frenulum rethink and reframe what they thought.

“We have started to think of any lingual frenulum as a tongue tie,” Mills continues. “We’ve created a situation where normal anatomy is called an anomaly.”

At the ILCA conference, she will explain her published research in detail, as well as its implications for evaluating and treating breastfeeding problems.

In addition, she will present research she has recently published on the effect of positioning on babies who are having difficulty with swallowing and breathing during breastfeeding.

Mills placed breastfeeding parents and their infants inside MRI machines, capturing dynamic MRI images of what happens during sucking and swallowing.

Because most previous research has been done with bottle-feeding infants, these MRI studies represent a leap forward in understanding what happens during breastfeeding.

“We wanted to understand and define the impact of different breastfeeding positions on tongue position and dynamic airway collapse with the tissues above the voice box, and also with milk flow,” she explains. “What happens when the baby is positioned in different ways?

“When a baby is having trouble breathing, breastfeeding is often the first thing to go,” she continues. “Parents are told they must bottle feed. I wanted to know, what can be done to modify positioning to create a greater possibility of supporting safe breastfeeding in at least some of those babies?”

Mills will present these findings, along with tips for how IBCLCs can apply them when working with babies with Laryngomalacia and other challenges.

From her unique perspective as a clinician and a researcher, Mills will discuss:

  • How the field of lactation support is getting it wrong when it comes to the lingual frenulum.
  • Why assessing lingual frenulum in isolation is a costly mistake.
  • How her new data inform decisions about when frenotomy is indicated and when it is not.
  • The results of her dynamic MRI studies of babies feeding at the breast, the first of their kind, and implications for using positioning to help babies with sucking and swallowing difficulties.

This year’s conference will be hybrid, offering both online and in-person options in Houston, Texas, US. To learn more about the #ILCA21 conference, offered both virtually and in person, visit here.

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ILCA Board Nominations Now Open


The perspective of each IBCLC is unique. Your viewpoint is shaped by whether you practice in the community, in a health-care facility, or as a researcher. In your region of the world, you may hold a different vantage point based on the cultural needs and practices of the families that you serve. And yet there are common threads we all hold as providers and for the breastfeeding mothers and chestfeeding parents we serve. 

The ILCA board is where we weave together all of these perspectives to inform the best possible support for you, the lactation profession, and the global breastfeeding community.

Board nominations are now open. We welcome you to take a moment to consider who in your community can best represent your unique needs while holding the vision for our diverse global profession. Our goal is to ensure a board that can truly capture all the threads that make up the lactation consultant field.

Candidates must self-nominate. Required qualifications include:

  • Membership in good standing for two years (immediately prior to the date nominations are called)
  • IBCLC in good standing
  • Strong interest in the growth and development of ILCA
  • Demonstrated leadership

Learn about all of the qualifications and time commitment here in the job description and complete the application here.

Questions about your membership status or the application process? Contact our helpful support staff at info@ilca.org.

The deadline for applications has been extended to 7 June 2021, 23:59 New York EDT; 8 June 2021 5:59 Geneva CEST / 13:59 Sydney AEST.

Our nominations task force, led by Past President Mudiwah Kadeshe, MSN, RN, LNC, IBCLC, looks forward to learning more about you.

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Beyond Borders: Creating Collaborations that Work


What do you do when your job is to help breastfeeding families in your local area—but your local area comprises three states, two countries, and two languages?

If you’re Elsa Quintana, you become an expert in collaboration—in envisioning it, in building it, and in funding it.

Quintana, BA, IBCLC, BCJ, works at the intersection of three locales—far west Texas (United States), extreme southern New Mexico (United States), and Ciudad Juarez, Chihuahua (Mexico). 

She navigates three state governments, two national governments, and two languages in her job of facilitating lactation care for families across multiple borders.

At this year’s International Lactation Consultant Association’s conference, Quintana will share tips and strategies for harnessing the power of collaboration, no matter your setting.

“We are unique in that we have two countries and three states that are all about five minutes from each other,” Quintana says. “But we have all found a way to pull together and it truly works. At the conference, I want to share our story because I believe it has lessons that can be used in many other places. I’m hoping to inspire people to see what’s possible where they are.”

Quintana served for many years as the State Coordinator for the WIC Breastfeeding Peer Counselor Program in New Mexico, where she and her program have received awards and recognition locally, nationally, and internationally for their efforts to increase breastfeeding rates in the state.

She currently contracts with the New Mexico Department of Health to teach a bilingual 100-hour certification course for community health workers.

Working within the Binational Breastfeeding Coalition (BBC), Quintana worked on a three-year grant project called Breastfeeding on the Border.

The project brought together WIC peer counselors, community health workers, and professionals across borders to better serve lactating families.

Breastfeeding on the Border successfully established community lactation support groups, which connected resources and built networks within communities. The result is sustainable, community-driven supports that are culturally informed and not susceptible to rises and falls in government funding.

In addition, Quintana helped create a unique presentation series called “Look Who’s Talking.” These talks brought renown speakers such as Kathleen Kendall Tackett and Laurel Wilson to share information with BBC, whose membership includes lactation professionals, nurses, social workers, pediatricians, therapists, dentists, and others. The speakers presented to packed rooms, while even more attendees watched online.

The Look Who’s Talking presentations and other education efforts under the project shared one simple goal: to get a variety of professionals who serve childbearing families all on the same page about lactation basics.

“That way, the same message is being delivered in many settings across the communities,” Quintana notes.

Bringing together diverse professionals from different states and different countries around the same goal may sound like a huge task, but Quintana says it comes down to perseverance and believing in your mission.

“Every time I talk to other lactation professionals, they ask, ‘How in the world do you guys do it?’” Quintana says. “They are especially surprised that we have been able to fund some of our initiatives, like the high-level speakers we’ve brought in.

“The keys are developing good contacts, networking, and looking for shared goals,” she continues. “Maybe you’re looking for ways to provide lactation support, and another organization in your community is talking about adolescent pregnancy. How can you share resources? You are always looking to partner and invite.

“It can be done, and you can do it,” she encourages. “When you have a passion to help families, you don’t see bridges and interstate lines and borders. You just see a parent who needs help.”  

From her unique perspective, Quintana will share tips on:

  • Networking and finding shared goals
  • Finding your setting’s unique opportunities
  • Understanding your audience’s needs
  • Collaborating to find funding
  • Navigating bureaucracy
  • Not getting discouraged

This year’s conference will be hybrid, offering both online and in-person options in Houston, Texas, US. To learn more about the #ILCA21 conference, offered both virtually and in person, visit ilca.org/conference.

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Call for Papers: JHL Call for Special Issue on Laws and Policies Related to Infant and Young Child Feeding


The Journal of Human Lactation (JHL) is soliciting manuscripts for their February 2022 special issue on a wide variety of topics pertaining to laws and policies related to infant and young child feeding. 

Submissions can include original research, literature reviews, case studies, and insights into practice and policy. Examples of topics include, but are not limited to, the following:

  • The International Code of Marketing of Breast-milk Substitutes: Describe how it is applied in 2021; which countries follow it; which countries have laws that are actually enforceable and how that is done with outcomes; how they are actually enforced when this does happen (in your own country and/or compared to other countries); describe companies/organizations that operate on the “edges” of the International Code (i.e. breast pump companies that are not code compliant; non-profit foundations that were founded by executives from and funded by profits from Code non-compliant companies that fund Infant and Young Child Feeding-related research).
  • Paid parental leave: Describe the laws in your country and how changes in policy/law have influenced infant and young child feeding standards over time; describe how changes in policy/law have influenced breastfeeding initiation and exclusivity rates.
  • Workplace lactation support: Implementation of work environment policy for working lactating mothers; employers’ responsibility to make lactation room(s) available for employees or any similar policies and how has that affected Infant and Young Child Feeding; consider state, provincial and/or federal laws concerning workplace lactation support that do not include means of enforcement or where they do not even exist and the ramifications.
  • Government regulations: Lack of, or conversely presence of policy intended to increase access to the care of an International Board Certified Lactation Consultant® (IBCLC®) care; consider how governmental guidance specific to one country or region that may be implemented in other parts of the world can actually cause harm.
  • Breastfeeding in public: Consider whether laws are needed based on current policies and laws; write about the existing laws; on-going issues with complaints about public indecency.
  • Education policy: Discuss whether funding (and where it might come from) should be provided to assist persons working with childbearing/childrearing families in communities with low rates of breastfeeding (i.e., exclusive to 6 months; duration to one year or more) to become IBCLCs; examples of model programs; how to create model programs.
  • Funding regulations or policies for health care practices: The influence of insurance regulations/policies/national health care practices influence infant and young child feeding practices in your location.
  • Licensure of IBCLCs: Obstacles that have arisen in states/provinces where human milk feeding advocates have introduced legislation to license IBCLCs; places obstacles to licensure have been overcome; how this was accomplished. 
  • Drug regulations: In the US there are regulations concerning the use of Domperidone; how this affects practice; other issues globally pertaining to drug regulations and lactation.

The submission deadline is 1 October 2021.

For more information, please visit the JHL journal homepage here.

Please send email inquiries about specific ideas for manuscripts for this special issue to the Editor in Chief at jhleditorinchief@gmail.com.

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JHL Offers Open Access Case Study Collection


If an IBCLC® you knew helped a client with a history of breast cancer induce lactation for an adopted infant, wouldn’t you want to hear the story?

How about if a friend had been involved in a study measuring COVID-19 antibodies in human milk during the newborn phase? Definitely a great story to hear!

Case studies—stories—of others’ successes and challenges have so much to teach.

Now, you can access the full text of five new case studies here free of charge in a collection recently released by the Journal of Human Lactation. The case studies will remain open access through 15 June.

Topics include:

Maternal Transfer of Cetirizine Into Human Milk. A study in which levels of the drug found in the common allergy medication Zyrtec were measured in human milk, filling a previous gap in data.

Severe Lactational Mastitis With Complicated Wound Infection Caused by Streptococcus pyogenes. Management of a severe case of mastitis at two weeks postpartum has a positive outcome, with the pair nursing successfully into toddlerhood.

Induction of Lactation After Adoption in a Muslim Mother With History of Breast Cancer: A Case Study. Details the protocols used to successfully induce lactation and discusses the benefits to both parent and baby.

Induced Lactation in a Mother Through Surrogacy With Complete Androgen Insensitivity Syndrome (CAIS). A mother through surrogacy, with XY karyotype and CAIS, is able to partially breastfeed, supporting the concept of helping more nontraditional parents with lactation.

Early Identification of IgA Anti-SARSCoV-2 in Milk of Mother With COVID-19 Infection. Do mothers with Covid-19 infection produce milk that has antibodies that could protect their nursling? This case study suggests the answer is yes.

Each case study in the collection gives detailed information about the issue, history, management, and outcome.

Want to read more great content from the Journal of Human Lactation? ILCA members can access the full Journal of Human Lactation for free! Join online today.

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IBCLC Care Awards: Applications Now Open


Let potential clients know that your Hospital-Based Facility or Community-Based Agency recognizes the role of the International Board Certified Lactation Consultant® (IBCLC®) in protecting, promoting and supporting breastfeeding by applying for the IBCLC Care Award.

The IBCLC Care Awards are promoted to new families and the general public which means your facility can enjoy the benefits of positive public relations in your community, including:

  • Enhanced attractiveness to potential patients
  • Competitive edge in recruiting lactation consultants, nurses, midwives, mother support counselors and other medical staff
  • General good will in the community by providing excellent care in helping new families reach their breastfeeding goals

Visit the IBCLC Care Directory to see which Hospital-Based Facilities are already benefiting from the IBCLC Care Award program!

Hospital-Based Facilities and Community-Based Health Agencies that staff currently certified IBCLCs can apply online to become a recognized IBCLC Care Award facility. Learn more about the qualifications and complete the online application here.

Applications will be accepted online starting January 2021 through 5 March 2021. Please contact us at admin@ilca.org if you have any questions.

The award was created by International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association (ILCA). Learn more and apply here.

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IBCLC Day 2021: Honoring You


It would be difficult to think of a year when being an International Board Certified Lactation Consultant® (IBCLC®) has been so challenging—or so important.

In 2021, birthing and lactating families all over the world have faced unprecedented hurdles as they’ve brought their babies into the world amid the COVID-19 pandemic. They have needed the help of IBCLCs like never before, to navigate obstacles none of us could have imagined.

At the same time, IBCLCs have had to dive deeper into their own creativity to find ways to connect with and support families, amid lockdowns, quarantines, and social distancing. And you have risen to the challenge, innovating, persevering, and caring like never before.

On 3 March 2021, we welcome your community to celebrate YOU by thanking IBCLCs.

We hope you will also take this opportunity to celebrate the IBCLCs that have made a difference in your life, through mentorship, community, or support.

Show your IBCLC pride! Starting now, use our IBCLC Day frame on your Facebook image to help build recognition for your profession.

Find the IBCLC Day frame here.

Find IBCLC Day images for you and your community to share here.

We have also welcomed code-compliant organizations that would like to provide special offers to IBCLCs for #happyIBCLCday to do so on our event page. Feel free to check out what they have shared with you here. We also hope that you will share with us what you are doing in your local community to celebrate!

#happyIBCLCday

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Understanding Why Parent-Infant Separation Became the Norm During COVID-19


Early in the COVID-19 pandemic, a troubling trend emerged—as hospitals struggled to understand the new risk, birthing parents and their infants were routinely being separated. Parents were told not to breastfeed or chestfeed, or counseled to only feed expressed milk.

Babies were spending the first days of their lives unable to be in contact with their lactating parent.

Nearly a year later, that situation in many places still stands. Despite scientific evidence that infants kept together with their mother or other lactating parent are at no greater risk for SARS-CoV-2 infection than those cared for separately, routine separation is still happening.

Why is this the case? In her new webinar, available to ILCA members here, Dr. Cecília Tomori, PhD, MA., Director of Global Public Health and Community Health at the Johns Hopkins School of Nursing, draws on her dual training in anthropology and epidemiology to answer this critical question. 

UNDERSTANDING THE BACKDROP

To understand why separating birthing parents and their infants was an automatic response from many guiding bodies and institutions, one has to understand an invisible historical backdrop, according to Tomori.

Healthcare policy does not take shape in a vacuum, nor is it ever simply the result of a neutral examination of hard scientific data. “It really is drawn from how we approach the evidence, and these things are social,” she says.

In this case, much of the world approached the evidence about COVID-19 and parent-baby separation from a single perspective: they assumed that separating parents and infants is a neutral, default act with no potential for harm.

Why? As Tomori explained, that attitude is the result of decades of industrial capitalism and colonialism that led to a medicalization of birth and parenting and to the view of parents and babies as completely separate. 

Shored up by cultural beliefs about independence, by the mid-20th Century this added up to a loss of the previous understanding of birthing parents and their infants as a dyad—they were no longer seen as an interconnected unit that needed to stay together.

By the late 20th Century, parent-infant interdependence and breastfeeding had been “rediscovered,” but in a very medicalized version. And importantly, medical training in much of the world is still rooted in the previous paradigm.

It is this view of separation as the default, according to Tomori, that has led to damaging separation policies and practices during the pandemic. Keeping parents and babies together is seen only as a threat—in this case, as a potential source of SARS-CoV-2infection.

Tomori acknowledges that it can be hard to grasp how such large, unseen forces are at work when one of your clients is told they cannot keep their baby with them, or is urged to express milk instead of nursing. But she argues that it’s important to understand the assumptions behind the policies in order to evaluate what is truly happening.

HIDDEN HARMS

When policies are made based on the belief that separation is benign and that proximity only represents a threat, the threat of very real, cumulative harm due to separation is ignored.

Keeping babies and their birthing parents together is the evolutionary and biological norm because human infants are comparatively immature and vulnerable. Unlike many other primates, they are unable to cling to their parent and unable to maintain their temperature. Proximity to their parent—and breastfeeding in particular—are unique adaptations that allow the parent to co-regulate the baby’s system. Separation prevents this.  “Evidence for this is vast,” Tomori notes.

One other harm from separation is totally overlooked as well. Since breastfeeding is often seen only as nutrition, providers miss the fact that “breastfeeding is a major adaptation for protection from infectious disease,” Tomori says. “This is repeatedly overlooked … and that’s a really major oversight during a pandemic, when you’re looking at an emerging infectious disease.”

Another major oversight? Providers who advocate separation assume it will lessen the infant’s exposure—but in fact, the opposite may be true. Infants require extensive care, and if their parent is not able to do it, healthcare staff or another caregiver will need to do it instead. Each new contact the baby has can increase exposure. The baby may end up with more exposure and less immune protection from breastfeeding.

INEQUITIES EXACERBATE HARMS

The harms of separation are extensive and cumulative, according to Tomori—and they are also uneven. They do not affect all parents and babies equally.  

Why? Because far from being a “great equalizer,” as some suggested early on, COVID-19 has instead revealed and worsened preexisting inequities between groups.

Who are the parent-baby pairs most likely to be harmed by separation? Those whose essential worker status forces them to attend jobs, those who are least able to follow recommendations to avoid exposure, those with underlying conditions due to historical inequities, those with less access to culturally competent, skilled birth and lactation support, and those for whom power dynamics make it more difficult to challenge medical advice.

“Separation has a disproportionate effect on the most vulnerable mothers and infants,” Tomori says.

What are your setting’s policies and practices around separation during COVID-19? For tips on how you can take action to support parent-infant togetherness, check out the first blog in this series here.

Ready to learn even more? ILCA members can access Tomori’s webinar at ILCA Learning: WEBINAR – Protecting Mother-infant Contact and Breastfeeding During the COVID-19 Pandemic.

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