Cinny Kittle, MS Christine Compton Yvonne Snyder, RNC, MSN, IBCLC, CFNP Stephanie K. Whitney

1. Cinny Kittle, MS Christine Compton Yvonne Snyder, RNC, MSN, IBCLC, CFNP Stephanie K. Whitney Jan Wilkes, LD, IBCLC Welcome

2. Babies, Breasts & More – Oh My!

3. How much profit does the infant formula industry make yearly? $2 million $500,000 c. $8 billion

4. How much ABM would a baby have to consume to get the same amount of immune protection as in one ounce of colostrum? 5 ounces 23 ounces c. None of the above

5. 5 times 15 times the chances are equal A child fed artificial baby milk is ___ times more likely to become sick than a breastfed child.

6. every 30 minutes every 90 minutes every 120 minutes How often does an adult feel the urge to eat?

7. 10,000 30,000 50,000 A baby fed ABM will ingest _____ more calories by the time s/he is 8 months old than a child that is breastfed.

8. True or False The levels of nicotine in baby’s blood stream are greater from passive smoking than from breastfeeding from a smoking mom.

9. Jimmy Carter John Kennedy Bill Clinton George W. Bush Who was the first US President to be born in a hospital?

10. Breastfeeding What’s the problem?

11. Throughout the history of mankind, mammals nursed their young.

12. If problems arose, some form of wet-nursing, hand expression, or contrived artificial substitute were used.

13. Alternatives to nursing were relatively limited or dangerously unsuccessful for thousands of years. What contributed to the decline of breastfeeding in our society?

14. Henri Nestlé invents a concoction called farine lactée. In 1867, a premature baby boy was fed this mixture and survived. Nestlé's product soon took-off.

15. During WWI and WWII more and more women entered the work force and were separated from their infants.

16. By the 1940's, the standard was set, with hospital birth being thought to be the ideal. With hospital births came several “interventions” including: medications, confinement to bed, and hospital nurseries with rigid schedules.

17. Birth and infant feeding began to be seen as illnesses that required medical attention.

18. The Breastfeeding Roller Coaster • Breastfeeding rates over the years. . .

19. Made up of eight “process” indicators that are elements of breastfeeding-friendly communities. Information shows where states have had success and shows where more work is needed. Each state has a State Profile that gives specific information about each of the “indicators”. Breastfeeding Report Card Source: Centers for Disease and Prevention. National Immunization Survey, 2004 Births. Washington, DC: U.S. Department of Health and Human Services;2007

20. States can use the data on indicators such as: To help tell the story of breastfeeding To celebrate state successes To identify good opportunities for growth and improvement in breastfeeding protection, promotion, and support statewide Breastfeeding Report Card Source: Centers for Disease and Prevention. National Immunization Survey, 2004 Births. Washington, DC: U.S. Department of Health and Human Services;2007

21. Ever Breastfeed 59.3% Breastfeeding at 6 months 26.8% Breastfeeding at 12 months 14.0% Exclusively breastfeeding at 3 months 21.3% Exclusively breastfeeding at 6 months 5.2% Source: Centers for Disease and Prevention. National Immunization Survey, 2004 Births. Washington, DC: U.S. Department of Health and Human Services;2007 West Virginia Rates

22. Ever Breastfed 73.8% Breastfeeding at 6 months 41.5% Breastfeeding at 12 months 20.9% Exclusively breastfeeding at 3 months 30.5% Exclusively breastfeeding at 6 months 11.3 % Source: Centers for Disease Control and Prevention. National Immunization Survey, 2004 Births. Washington, DC: U.S. Department of Health and Human Services; 2007. U.S. Breastfeeding Rates

23. Number of facilities designated as Baby-Friendly in West Virginia=None Percentage of live births in the state occurring in Baby-Friendly facilities=0.00% To learn more about the Baby-Friendly Hospital Initiative (BFHI) and its designation criteria in the United States, visithttp://babyfriendlyusa.org. Hospital Support

24. Number of IBCLC’s in West Virginia=53 Number of IBCLC’s per 1,000 live births= 2.54/1,000 live births Professional Support

25. A Child’s Right to Nurse – first introduced in 2005: ARTICLE 1. STATE PUBLIC HEALTH SYSTEM. §16-1-19. Child's right to nurse: Location where permitted; right protected.(a) Breast feeding is an important, basic act of nurturing that is protected in the interests of maternal and child health. A mother may breast feed a child in any location, public or private, where the mother and child are otherwise authorized to be.NOTE: This bill protects a mother's right to breast feed a child in any location where the mother and child are otherwise authorized to be. House Bill 2498 – passed March 18, 2007: ARTICLE 8. CRIMES AGAINST CHASITITY, MORALITY AND DECENCY. §61-8-9. Indecent exposure. (a) A person is guilty of indecent exposure when such person intentionally exposes his or her sex organs or anus or the sex organs of another person, or intentionally cause such exposure by another or engages in any overt act of sexual gratification, and does so under circumstances in which the person knows that the conduct is likely to cause affront or alarm: Provided, That it is not considered indecent exposure for a mother to breast feed a child in any location, public or private. WV’s Legislation

26. Ever breastfeed- 41% Breastfeeding at 6 months- 16% WV WIC Statistics

27. Need to investigate cultural and societal issues Need more hospital support Need more work place support Need more legislative support How do we increase WV rates?

28. Importance of Breastfeeding— Why do we need to Increase Breastfeeding Rates?

29. Human milk is best for human babies. Cows milk is best for baby cows. Most ABM’s are derived from cows milk.

31. Babies fed ABM are more likely to: Have a higher incidence of many acute illnesses such as: a. Otitis media b. Upper respiratory and wheezing illnesses c. Diarrheal illnesses d. NEC in premature babies e. RSV e. Dental Caries f. And bottle-fed babies have a higher incidence of SIDs compared to breastfed babies g. Also breastfed babies enjoy an enhanced vaccine immune response

32. Children fed ABM are more prone to chronic illnesses. a. Allergies b. Eczema c. Asthma d. Crohn’s disease e. Juvenile DM f. Multiple Sclerosis g. Childhood cancers. h. Obesity which often leads to other chronic illnesses. Numerous studies have shown that breastfed babies have better cognitive development and Higher IQ’s than babies fed ABM.

33. Mothers who do not breastfeed have a higher incidence of: a.Pre-menopausal Breast Cancer b. Ovarian Cancer c. Uterine Cancer d. Osteoporosis Also, in times of natural disasters, or of unclean water sources, a breastfeeding mother is able to continue to provide milk for her baby.

34. 1. Mothers make the decision about their feeding method early. 2. Framing the Question about infant feeding is important. 3. Important that the HCP give the expectant mother current and accurate breastfeeding information. 4. Important for HCPs to educate themselves and become knowledable in how to handle breastfeeding problems. Sources of good breastfeeding information covering various topics include: a. La Leche League International b. AAP c. CDC d. International Lactation Consultant Association e. United States Breastfeeding Committee f. Well Start International Healthcare Providers can make a major impact on breastfeeding by supporting the breastfeeding mother and baby.

35. Interview and choose the baby's Health Care Provider carefully. Make sure they are knowledgeable and supportive of breastfeeding. Most HCP say they are supportive of breastfeeding. But many are only supportive IF breastfeeding is going well. Dr. Jack Newman has an excellent handout on questions Mothers should be asking when choosing a HCP.

36. S/he gives you formula samples or formula company literature when you are pregnant, or after you have had the baby. 2. S/he tells you that breastfeeding and bottle feeding are essentially the same. 3. S/he tells you that formula x is best. 4. S/he tells you that it is not necessary to feed the baby immediately after the birth since you are (will be) tired and the baby is often not interested anyhow. 5. S/he tells you that there is no such thing as nipple confusion and you should start giving bottles early to your baby to make sure that the baby accepts a bottle nipple. How To Know A Health Professional Is Not Supportive:

37. 6. S/he tells you that you must stop breastfeeding because you or your baby is sick, or because you will be taking medicine or you will have a medical test done. 7. S/he is surprised to learn that your six month old is still breastfeeding. 8. S/he tells you that breast milk has no nutritional value after the baby is 6 months or older. 9. S/he tells you that you must never allow your baby to fall asleep at the breast. 10. S/he tells you that you should not stay in hospital to breastfeed your sick child because it is important you rest at home. 11. S/he does not try to get you help if you are having trouble with breastfeeding.

38. Economic Benefits of Breastfeeding

39. Annual costs: ♦$291million spent on infant diarrhea ♦$225 million spent on RSV ♦$660 million spent on ear infections ♦$124 million spent on insulin-dependent diabetes Total annual cost of NOT breastfeeding: $1.2 to 1.3 billion Source: The Economic Benefits of Breastfeeding, USDA, March 2001 Additional Medical Costs of NOT Breastfeeding

40. All REDUCED by ……

41. BREASTFEEDING

42. Minimum of $1500 for formula per year/per child Cost to support a breastfeeding mother enrolled in the WIC Program is 55% less than a mother who uses formula. A woman breastfeeding for at least 6 months saves approximately $630 yearly. Other Costs of NOT Breastfeeding

43. ♦Less illness among breastfed children of employees = less absenteeism ♦Lower health costs for employers ♦Improved employee productivity Cost savings of $3 per $1 invested by employers that are breastfeeding supportive. Source: HHS Blueprint for Action on Breastfeeding, US Dept. of Health and Human Services, 2000 Economic Benefits for Employers

44. Environmental Costs of not Breastfeeding

45. Breastfeeding is probably the most overlooked means of contributing to the health of our planet.

46. ♦Creates Toxins ♦Contaminates Water ♦Contributes to Air Pollution ♦Consumes Energy Source: Breastmilk: A World Resource, World Alliance for Breastfeeding Action Producing Artificial Baby Milk:

47. It takes 200 to 450 years to break down paper, bottles, nipples, diapers and ABM cans that end up in landfills. If the 550 million tins of ABM sold each year in the US alone were stacked end to end, it would circle the earth 1-1/2 times! Did you know. . . .

48. No Water No Waste No Energy No Pollution No Irrigation No Transportation No Packaging Totally Environmentally Friendly Breastfeeding:

49. It is a health issue for mother and infant, a social issue and an environmental issue. Breastfeeding is not just a lifestyle choice.

50. WV Legislature (through WIC) allocated funding to support lactation training for healthcare and service providers November 2007 – 76 completed training May 2009 – another training to be offered Identifying and requesting funding from other sources to support efforts to increase breastfeeding in WV Progress in WV