Leading Lactation Insights - June 2022
The Leading Lactation Insights newsletter presents the latest breastfeeding topics and clinical practice solutions, addresses coding issues challenging the lactation community, features a lactation service, and announces upcoming webinars and conferences.
The Formula Shortage: Academy of Breastfeeding Medicine Statement
Maria Lennon, MSN, CNM, IBCLC
If you are currently pregnant or expecting a baby:
When making the decision on how to feed baby, be sure to take into consideration potential infant formula shortages. Take prenatal breastfeeding education classes and connect with healthcare providers and hospitals that are supportive of breastfeeding.
If you are currently not breastfeeding or not making any breast milk:
- Consider re-lactating
- Consider using pasteurized donor human milk
- If you’re considering using another mother’s breast milk, make sure you are informed of the risks/benefits regarding safety. Consider donor screening and flash sterilization, Be sure and consult a breastfeeding professional for guidance.
- Don’t use homemade formula unless you’ve checked with your baby’s doctor
- Follow the directions on the package instructions carefully when mixing infant formula
- Don’t give your baby under 1 year of age regular cow’s milk
- You can change brands of formula but check with your baby’s provider first if your baby is on a special formula.
- Don’t use the internet to purchase breast milk or infant formula unless you know and completely trust the seller.
- Do not give a baby under six months of age any water, juice, or tea.
- Talk with your baby’s doctor before starting solid foods or substituting for a formula feeding.
If you’re currently partially breastfeeding:
- Consider increasing your supply to return to full breastfeeding, even temporarily.
- See above guidelines
- If you’re using formula only to fortify your breast milk for a premature baby, talk with your baby’s doctor to see if you still need to fortify or if you can try just using your breast milk
If you are currently exclusively breastfeeding:
- Consider donating any excess milk to a local milk bank.
- You may want to increase your supply to produce more than your baby needs in order to donate excess milk to a milk bank
If you are a healthcare professionals:
- Be sure that you are using the most up-to-date references and evidence-based recommendations for breastfeeding management issues. Supplement with mothers’ milk if needed and available and only use formula supplementation when medically indicated.
- When counseling parents about decisions on infant feeding, be sure to give accurate information about the risks/benefits of feeding infant formula, and be mindful of the current shortage.
- Help the families who desire to breastfeed by giving them current, evidence-based information and support about how to breastfeed and what to do, and give them resources on where to get help if they encounter any difficulties. This is important to avoid them stopping breastfeeding in the first few days and weeks.
- Find out who the local breastfeeding and lactation professionals are in your area and refer to them as needed.
- Access the Academy of Breastfeeding Medicine’s evidence-based clinical protocols at www.bfmed.org/protocols, and share with colleagues.
- The ABM even makes recommendations for communities, societies, and governments to:
- Place systemic supports and resources in place for new and expectant families to meet their breastfeeding goals and decrease the need for unnecessary supplementation.
- Implement hospital initiatives that adhere to the Ten Steps for Successful Breastfeeding,
- Implement paid maternity and family leave, encourage workplace accommodations for breastfeeding and milk expression, ensure access and coverage for professional assistance with lactation issues.
- Oversee and regulate the direct marketing of breast milk substitutes to families and healthcare professionals, and fully adopt the International Code of Marketing of Breastmilk Substitutes (WHO Code).
- Make sure public spaces visibly and actively support mothers who are breastfeeding their babies.
Read the full statement at:
Infant Pain Management: Can We Do Better in 2022?Presented by Sharyn Gibbins, NP, PhD.
Wednesday, June 15th
The Importance and Benefits of Human Milk BankingPresented by Jonathan Bautista
Wednesday, July 20
Deciding When & How Often to Express Human Milk in the Immediate Postpartum PeriodPresented by Darlene Silver, MSN, RN, IBCLC
Wednesday, August 17
Recently Recorded Webinars:
Last Chance to Access 2021 Global Symposium On-Demand
Advancing Lactation Science to Improve Care ~ More than 1,400 registered attendees from all over the world.
Helping All Families Make Informed Feeding Choices – Diane Spatz, PhD., RN-BC, FAAN
On April 20th Diane Spatz, PhD., RN-BC, FAAN presented her webinar titled Helping All Families Make Informed Feeding Choices. This webinar highlighted key findings of the World Health Organization (WHO) and the United Nations Children’s Fund *UNICEF) key report on the 55-billion-dollar formula industry and its negative impact on breastfeeding decisions. Dr. Spatz also provides clinicians with tools to teach families why human milk matters. Click here to listen to this recorded webinar.
Formula Shortage, Milk Banks, Mother’s Own Milk
Jonathan Bautista is the Executive Director at San Jose Mothers’ Milk Bank, and was recently interviewed by Sonseeahray Tonsall with Fox 40 news in Sacramento, CA regarding parents turning to milk banks due to the formula shortage. Click here to see the full interview. Jonathan Bautista will be presenting our July 20th webinar The Importance and Benefits of Human Milk Banking. Click here for more information and to register.
ASPEN – Latest EN Shortage News
ASPEN maintains communications with EN product manufacturers, other professional healthcare organizations, and clinicians to stay up-to-date on the status of enteral nutrition (EN) product shortages. This webpage provides the latest news on EN shortages and is continually updated as ASPEN learns of new or resolving shortages as well as other resources related to EN shortages. Click here for more information.
Happy Father’s Day – June 19, 2022
We wish all the fathers out there a very happy Father’s Day!
Maria Lennon, MSN, CNM, IBCLC
The Formula Shortage: How We Can Help
Families in the United States who feed their babies infant formula are in a crisis. There’s not enough on the shelves of stores and many parents are worried that they may not be able to feed their babies.How did it happen?
For many months, there has been exceptional pressure on the US and global supply chains due to COVID-19, the resulting staff shortages, increased demand for products, the war in Ukraine and the scarcity of some commodities. The shortage of infant formula products was compounded when Abbott Laboratories, the maker of Similac infant formula, issued 3 product recalls and shut down a factory due to serious contamination concerns. As Abbott is the exclusive supplier for more than half of WIC agencies, many mothers and babies all over the country have been affected. This shortage has led to panic buying and hoarding; in response, retailers began limiting amounts of formula that consumers could purchase to small amounts that would only last for a few days of formula feeding. Additionally, some families, whose babies are required to be on special formulas, have reported that they been unable to locate any formula and their babies are at risk for illness or even hospitalization.
How bad is this crisis?
It’s severe. As of May, over 40% of infant formula products are out of stock across the country and some areas of the country are in worse shape than others. All formula companies in the US have ramped up production but it is not enough to meet the needs of infants and children. Specialty formulas have been especially hard to find. Babies who have allergies to cow’s milk and/or soy allergies often cannot drink alternatives and they are at risk for severe illness and hospitalization.
What does this mean for parents, families, mothers, and babies?
Parents of formula-fed infants are anxious, under a great deal of stress and are struggling to find ways to feed their babies. They are travelling all around to stores only to find the shelves empty. They are spending hours on the computer trying to order products online. Some parents have even resorted to preparing non-nutritious homemade infant formula, watering down the formula they have on hand, or mixing foods not intended for infants - all of which is very risky and can be harmful to infants’ health.
How can Breastfeeding Advocates help during this crisis?
- Educate parents on their options and let them know where to go for help. Let mothers know that lactation care providers are expert resources for infant feeding. Publicize the list of IBCLCs and Breastfeeding Medicine specialists in the local area.
- Send the Academy of Breastfeeding Medicine statement (see “Tools You Can Use”) to healthcare professionals in the area who care for mothers, babies and children.
- Encourage mothers who are having trouble with breastfeeding to seek out the care of a Lactation Consultant. The United States Lactation Consultant Association has a directory of IBCLCs by location that parents can use as a resource: www.uslca.org/find-an-ibclc.
- Ask mothers who have excess milk and whose babies are growing well to consider donating to a milk bank.
- Reviewing options with parents who may be partially or exclusively formula feeding and who are looking to increase or re-establish a milk supply.
- Working in collaboration with the baby’s primary care provider.
- See the US Lactation Consultants’ Association position statement for more information.
This month's spotlight: Amanda Ho, RN, BScN, IBCLC from Toronto, Canada
Amanda Ho is an experienced NICU nurse and passionate lactation consultant who is always eager to help new parents and families as they begin their breastfeeding journey. Currently, she is very busy working at two community hospitals – Mackenzie Health’s Cortellucci Vaughan Hospital and also Markham Stouffville Hospital, both in Ontario, Canada – as well as at Jack Newman’s International Breastfeeding Centre in Toronto.
Originally from Hong Kong, Amanda’s family arrived in Toronto when she was eight years old. She notes that she originally aspired to become a nurse because her sister was often sick as a child and was in and out of hospitals. Amanda says, “although those times were traumatic, the nurses made a huge difference by being patient, kind, and caring. This left an enduring impression on my family and I.” As a result, Amanda received her BSN with honors from York University in Toronto and became the first generation in her family to achieve a post-secondary degree. She decided to pursue a career in healthcare and says that neonatal nursing changed her life in ways she never expected, in particular that it was incredibly rewarding to see fragile babies that could fit in the palm of her hand fight for their lives every day. “I felt privileged to be part of such a miracle,” Amanda says about her experience witnessing this journey of growth and development on a daily basis. “And it left a lasting impact on me.”
After working as a NICU nurse for about 8 years, Amanda took a special interest in infant feeding and fell in love with breastfeeding and health teaching. This coincided with noticing a lack of breastfeeding support and resources available for moms in the community, which motivated her to become an IBCLC. This led to recognition in 2011 at her local hospital for not only achieving an increase in breastfeeding rates and overall patient satisfaction, but also for consistently receiving excellent patient feedback.
Currently, Amanda notes that the majority of her professional challenges are COVID-related, including the ways that they are able to provide care, a lack of in-person support, pauses on breast pump rental programs, and the overall bandwidth of nurses during the pandemic. Because of this, many breastfeeding clinics, the HBHC program, and home visits have stopped, with many new parents feeling less prepared to care for their newborn and much more apprehensive about breastfeeding. To combat this, Amanda has ambitious plans for developing and implementing an interactive lactation curriculum for both patients and staff in the hospital setting. She would also like to help Cortellucci Vaughan Hospital achieve Baby-Friendly designation while continuing to improve upon their lactation program, including introducing personalized CVH prenatal classes and hospital tours and allocating more resources and opportunities for staff lactation training and support.
Professionally, Amanda also plans to continue establishing herself and her private business, Flowerbud Lactation, as well as mentoring aspiring lactation consultants with a desire to make a difference. Outside of work, she enjoys painting, hiking, and volunteering with organizations in need, particularly women’s and youth shelters. Thank you, Amanda, for all that you do to help families in your community!
Thank you to this issue's contributors!
Maria Lennon, MSN, CNM, IBCLCNurse-Midwife, Perinatal Education Consultant - Sedona, AZ
Katie McGee, RN, BSN, IBCLCEducation Consultant - Westchester, IL
Kim Colburn, BPCMedela U.S. Medical Education Specialist
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