Giving birth is such a special, indescribable time. Those first few exhausted hours gazing into the eyes of your precious, newborn babe are some of the most rewarding a parent ever has. That recovery time on a maternity ward can also be a godsend for a weary mother, especially if she has other children at home.
But one maternity ward in Lancashire is being threatened with closure unless more women give birth there. The trouble is, they’ve made it so difficult to get ‘permission’, that very few do, and those that don’t face anything up to a 37 minute drive to other units.
Chorley is a lovely old market town in central Lancashire and is home to around 33,000 people. Like many areas at present, the hospital is facing budget cutbacks. And though there are many areas that rarefied cash could be clawed back, much of the cuts seem to be coming from maternity services. Already the unit has been reduced to ‘midwives only’ status, which means that only the most straightforward, textbook cases can be booked in there.
But the most alarming change is in the cuts to post-natal provision. Recently Rhona Hartley, Head of Midwifery, said: “I can see no clinical need to extend postnatal care services at Chorley from six hours to even one or two days”. Has she ever given birth herself? Or even attended a birth and watched the first six hours’ aftermath? Sic hours isn’t long enough to recover from a heavy workout, yet alone nine months of stretching and straining and who knows how many hours of contracting and pushing.
Six hours. That’s all our local women will get to recover. To bond with their baby. To establish breastfeeding. Six hours. That’s not even as long as most women labour, and yet they are expected to jump up from their beds and go home.
We think this has to stop, and already a high-profile campaign is under way to Save Chorley Maternity Unit. Led by a soon-to-be mother of ten, Melanie Webster, the Facebook page gathered 400 fans within the space of three days. That clearly speaks volumes about how people feel on this issue. Melanie was told she needed 1,000 signatories before the Trust would even entertain her – wouldn’t it be wonderful if mothers and fathers, grandmothers and grandfathers all over the country spoke out against these cuts, and they were bombarded with TEN thousand signatories instead!
New members join the campaign every day and are encouraged to share their own birth stories on the site, whether good, bad or sometimes ugly. It all counts as evidence to present to the NHS Trust, to show why good post-natal care is so essential. It will be particularly enlightening for Rhona Hartley who, it seems, wouldn’t know compassionate post-natal care if its waters burst over her head…
So what can you do about it? Well, first off, we’d love you to join the campaign. “Like” the page, because every fan of the page is a fan of mothers receiving the care and respite they need and deserve. It also says that every new baby deserves the chance to bond with its mother and learn to feed in a safe and stress-free environment. Secondly, tell all your friends. Share the link with other like-minded individuals, and ask them to sign up too. It’s free and takes only seconds to do. It doesn’t matter if you’re not from Chorley – this is about women’s and babies rights everywhere. In fact, so much so, that the Royal College of Nursing has commissioned Stirling University to come up with a plan. This is a national problem, which needs a national voice.
Because if they get away with doing stopping the care in Chorley, we all know that they won’t stop there.
Can anyone take a few minutes to answer this for research;
There can be many factors that discourage a mother from breastfeeding. We are not talking here about the challenges she may face once she starts, but about the barriers that can actually deter her from even wanting to breastfeed in the first place.
Aunty Lactivist is all of us so please help with any ideas or words of wisdom you might have.
Dear Aunty LactivistI need advice. My booby baby is 27 months. He is my 3rd and my other 2 are 5 and 4 years. All boys.
I suffered with PND and when the baby was 12 weeks old my husband left for another woman. It was totally unexpected and I had a breakdown. I’ve had lots of counselling and have been on antidepressants ever since.
After going to see my GP today because I’ve been feeling like I’m going backwards she has suggested an antidepressant that I can’t take while breastfeeding.
I said I wasn’t sure so she has upped my current one (sertraline) to see if that helps and while i decide what to do.
Hope you’re still with me!
So, what’s best? My health or his health?
And if I decide to stop, how do I start?
HELP!!
What do you think the perfect nursing bra should be like? Let us know and you could win this seamfree nursing bra from Emma-Jane….
Emma-Jane has remained the UK’s favourite brand of maternity and nursing lingerie for over 25 years. As the largest maternity lingerie brand in the UK the company uses its expert knowledge to create lingerie and accessories that are perfectly considered for the new generation of mothers.
Emma-Jane’s Next Generation Seamfree bra (style 361) is a great nursing bra is that only costs £10 and one cup size goes from a B to an F, so mums don’t have to spend more money on new bras as their breasts change size. It makes breastfeeding even more affordable for mums on a budget.
Favourite bras that you wear day in day out need to be comfortable and Emma Jane mixes comfort with support and a fantastic price. The number one reason mums love style 361 is comfort. The ultra-soft knitted seamfree fit and a soft under-band makes it an exceptionally comfortable choice during both pregnancy and breastfeeding.
Mums also love the Emma-Jane Nursing top, a lovely long vest with adjustable shoudler straps and a built in shelf bra that will also hold breast pads. The sides open independantly for nursing and it is made in Coolplus® which is a fabric ideally suited for casualwear because its moisture-wicking properties draw moisture away from the skin.
You must let us know where you have told people in the comments otherwise we won’t know how many entries to allocate you. And you must tell me if you sign up to the newsletter, or if you are already signed up so you can have an extra entry.
This prize draw is only open to people in the UK, sorry!
The winner will be chosen using random.org
You must leave your comments before midnight on the 31st June 2011 to qualify.
Please note that the bra on offer as a prize fits sizes 32, 34, 36, and 38 with the single cup that goes from B to F, so if you fall outside those sizes, it’s not going to be suitable for you. If you need something bigger please look at style 431 which goes from UK 32-40 DD-K or 412 which goes from UK 32-38 B-H but these are not competition prizes!
Thank you for entering everyone, the competition is now closed (I kept it open an extra day when I realised there is no 31st June!)
Aunty Lactivist is all of us so please leave a comment if you can help this mum with ideas or experience.
Dear Aunty Lactivist
Can anyone give me some advise?
My little one is 16 weeks now and exclusively breastfed, but I want to be able to express so I can go out once in a while and my hubby can bottle feed her.
My problem is that she won’t take a bottle, we have tried several times with either tomme tippe closer to nature or avent bottles both no.1 teet but she gags andjust keeps turning her head away until she gets hysterical and I end up breasytfeeding her in the end… anyone had any simular issues and got through it??
L
The Psychologist says Stanley Milgram’s The Individual in a Social World is “…a joy to read. The general scope of Milgram’s vision, and ease of his prose make this an essential book for anyone with an interest in (social) psychology.”
I’ve been asked to put this on Lactivist, please follow the link at the bottom of the page to sign the petition. Lisa
To: Mothercare
Please read the following letter I have drafted to send to Mothercare in light of their actions to potentially harm mothers’ breastfeeding relationships. Whether these actions are a maliciously deliberate sabotage attempt to generate more profits, or simply (hopefully) a misguided accident that they will be willing to correct, will undoubtedly be measured in their response to this letter. I would appreciate your signatures, as I am not sure if they will listen to an individual, but a wealth of concerned individuals may raise their attention.
Dear Mothercare,
I was shocked and dismayed, when taking my eldest son to the toilet in the Nottingham branch Mothercare, to notice six (I think) leaflet holders on the wall. I forget what five of them were, but I can tell you what they weren’t: Breastfeeding advice. There was nothing, absolutely nothing, on that wall about breastfeeding. However there WAS a wad of leaflets giving advice about how to bottle feed. It is absolutely unacceptable that there is bottle feeding advice and no breastfeeding advice on that wall. If providing feeding advice there should ALWAYS be a balance, it is shockingly irresponsible to have a situation in ANY of your stores in which mothers can only access information about bottle feeding in a passive suggestion that breastfeeding is not a feeding method worth considering.
I also have two objections to this leaflet’s content: firstly it states “Most babies feed from a bottle at some point, whether it’s with breast milk or formula.” While this is of course sadly the case in this country, this sentence does nothing to advise or support bottle feeding parents, and only serves to normalise bottle feeding even more which is very irresponsible at a time when health organisations all around the world are doing their best to promote breastfeeding due to its lifesaving health benefits. I strongly feel this sentence should be removed, especially considering the fact that it serves no positive purpose to bottle feeders and only appears to be a space-filler.
Secondly, it says “Breastfeeding is best for baby – if at all possible breastfeed for the first 6 months.” Just because breastfeeding is so rare past the 6 months mark in this country does not mean it should be, and of course we have the World Health Organisation recommendations to back that up. This sentence should read “If at all possible, breastfeed exclusively for 6 months and partially until at least 2 years” – as per the recommendations of the WHO. Mothercare is a shop, not a health organisation, so you should only be passing on the advice of the WHO, not fabricating your own.
The leaflet does then make reference to a breastfeeding leaflet, but as I say there was no sign of such a thing in the store. But knowing that one must surely exist I hunted on the Mothercare website until I found pdf files of the leaflets. This is the one I found in the store about bottle feeding:
The points I would like to raise with the breastfeeding leaflet are:
“But breastfeeding is a skill and it can take a while for you and your baby to feel comfortable and confident with it.” While this isn’t gravely terrible, I feel that this negative portrayal of breastfeeding being a difficult skill to acquire is at risk of scaring people away from trying it, and this message can be worded in a much more accurate and positive manner, such as “Breastfeeding is the most natural thing in the world and by far the easiest way of feeding your baby, but here are some guidelines for anybody who needs help establishing that breastfeeding relationship.”
“He should have all of the nipple and most of the areola in his mouth” – women with saucer-like areolae will read this in dismay wondering how on earth they will be able to fit most of their large areolae in the baby’s mouth or assuming they must be doing it wrong when in fact they may well be doing it right. Another sentence that should be reworded to give the correct advice. Instead of me telling you what this advice should be, I suggest you consult a qualified lactation consultant and acquire an approved source of information, not a self-proclaimed “breastfeeding expert” without any specific breastfeeding/lactation qualifications to back it up, as I have a feeling you may have done.
“His nose and chin should be pressed against your breast” – Nose should not necessarily be pressed against the breast. This is false information.
“Your baby is feeding well and getting enough milk if he settles well after feeds; he generally lasts 3-4 hours before he is hungry, and he cries to be fed again.” – Absolute rubbish to suggest all breastfed babies should last between 3-4 hours between feeds, my five month old still doesn’t go this long and he is a great weight and thriving. Women will read this and assume there is a problem when there isn’t. Breastfed babies often feed a lot more frequently than this, especially in the early months, as breast milk is digested a lot faster than artificial milk, and this is in no way a sign that your baby is not feeding properly. Additionally, crying is a late response to hunger and there are many cues prior a parent should look out for before waiting for a baby’s cry. This is irresponsible and incorrect advice.
“Your baby is not feeding well if: he falls asleep at the breast but then wakes and cries when you try to settle him; his nappies are dry or his urine is concentrated or smelly; his weight gain is poor. If so, try expressing your milk with a pump – this lets you check your milk supply”. – This is shocking, detrimental advice. I dread to think how many poor mothers have given up breastfeeding as a result of the false information that if they don’t get much out with a pump they have a low supply. There are many women out there with brilliant (sometimes even overactive!) milk supplies who cannot get a drop out with any brand of breast pump. The amount of milk you can express with a pump is in NO WAY a reflection of the mother’s milk supply, and this is shocking, dangerous and absolutely false advice to be putting out there to vulnerable, trusting mothers, as such a mainstream and influential store. (That is IF there are actually any breastfeeding leaflets out there amongst all the bottle feeding information – as this was most certainly not the case in Nottingham, and no, there were no empty slots for the breastfeeding leaflets either!)
When Googling looking for these leaflets I stumbled across a parenting forum thread and one mother had posted that she had seen an old version of these leaflets with an extra bullet point advising parents to read a book of a self-proclaimed ‘breastfeeding expert’ who in fact has no experience or qualifications in breastfeeding or lactation besides a past as a general midwife. (As I am making this letter public I will avoid mentioning this author by name). This woman is renowned in the breastfeeding field for giving terrible, detrimental advice about breastfeeding under the guise of being an expert, and I am wondering if this nugget of information means you have been using this woman as a source for your poor information. In the interests of your reputation, if nothing else, I suggest you seriously research true experts in the field and take your advice from respectable sources.
It is with perhaps naïve hope that I am, for the record, assuming that all of the above has occurred as an innocent result of a lack of proper research and education on your part, rather than the alternative, an underhand method of sabotaging breastfeeding relationships in order to switch more women over to using breast pumps unnecessarily and/or formula feeding in order to generate greater profits for yourself. If the points I have made – backed up with the signatures of this petition of agreement – are ignored or rejected then the only reasonable conclusion that I can draw is that the latter explanation is the reality of what you are doing. If this is the case, Mothercare, I assure you this will not be the end of this and you are in serious danger of tarnishing your respected brand.
These are the Lactivist goodies available from Cafepress, so wherever you are in the world you can shop Lactivist. Most designs are printed on t-shirts (babies, toddlers, kids and adults) hoodies, hats, bibs, bags and mugs – if you want me to put one of the designs on anything particulary, just email me moomum@lactivist.co.uk.
Are you interested in infant sleep? Are you a first time mother? Do you have a child aged between 6 and 36 months? We are currently carrying out research to learn more about what methods mothers recommend to manage common infant sleep difficulties. We are also interested in mother’s thoughts about the reasons why infants may have difficulties sleeping at times. If you are interested in learning more about this research and completing a short questionnaire please click on this link: https://www.surveymonkey.com/S/NCGMPB9
More information:
Title: What do mothers believe that may be helpful to manage infants’ sleep difficulties?
You are being invited to take part in a research study. This study is an educational study, for the purpose of a Doctorate Course in Clinical Psychology. Before you decide whether or not you wish to take part in this study, it is important for you to understand why the research is being done and what it will involve. Therefore, I am providing you with the following information. Please take time to read this information carefully and discuss it with others if you wish. Please ask me if there is anything that is not clear or if you would like more information. Take time to decide whether or not you wish to take part. You do not have to make an immediate decision.
What is the purpose of the study?
The purpose of this study is to learn more about mother’s beliefs about infants sleep and what strategies they suggest could be used to help manage infants’ sleep.
Why is the study important?
Settling and waking difficulties are extremely common among infants and young children. There is a range of advice available for mothers on how to manage infants’ sleep. However, it is important to learn more about mothers’ own beliefs about infant sleep and what may help. The findings of this study may help improve our understanding of what approaches are helpful to manage infant sleep.
Why have I been chosen?
You have been chosen to take part in this study because we are interested in gathering information from mothers who have infants aged between 6 and 36 months old.
Do I have to take part?
It is entirely up to you to decide whether or not to take part in this study. If you decide to take part please continue to read this information sheet. If you agree to take part you are still free to stop completing questionnaires at any point and you do not have to give a reason. No one will know if you have decided not to take part.
What will happen to me if I take part?
If you agree to take part in the study, your participation will involve reading three short descriptions of children with sleep problems. You would then be asked to complete some questionnaires about each child’s sleep difficulties. You will be asked what approach you would recommend to the mother in each story to manage their infant’s sleep. You will also be asked some questions about how you cope with difficulties and about your general levels of worry. You will also be asked about the sleep patterns of your own child. The questionnaires will be anonymous and will be stored in a secure setting. Your identity will remain unknown to others and no-one will be able to tell that you have answered the questions. You do not have to answer questions that you are not comfortable with.
What do I have to do?
If you agree to be part of this study, you will be asked to read the descriptions of children with sleep problems and complete the questionnaires. This should all take approximately 20 minutes. All completed questionnaires will be anonymous.
Will the information that I give be kept confidential?
Yes. Any information given will be kept strictly confidential. Your identity will remain unknown to others and all questionnaires completed and information used in the write up of this study shall remain anonymous. All questionnaires will be stored securely and destroyed on completion of the research in line with the Data Protection Act of 1998. The storage of completed interviews will be kept in a manner that does not identity you in any direct way. Data obtained during this study may be looked at by responsible individuals from the Health Promotion Department, from regulatory authorities or from the NHS trust, to check that the study is being carried out correctly. All will have a duty of confidentiality to you as a research participant and nothing that could reveal your identity will be disclosed.
What will happen if I don’t want to carry on with the research?
If you change your mind about taking part in this study you do not have to complete and return the questionnaire to the researcher. No one will know if you have done this.
What are the potential benefits of taking part?
The study will help you personally, but the information I get will help us to get a greater understanding of what factors influence mothers’ use of sleep strategies for infant sleep. This may provide further information about how sleep strategies we suggest can be improved. This may help reduce levels of stress for parents and allow children to sleep better.
What are the possible disadvantages and risks of taking part?
There are no real risks to taking part in the study. However, completing this questionnaire may potentially lead to questions or concerns about your infant’s sleep. Therefore, a list of sources of support and helpline numbers will be provided for you if you require any additional help and support. You are free to change your mind about completing this questionnaire at any time during the study.
Who is supervising this study?
My research supervisor, Dr Kenneth Mac Mahon, who works for the University of Glasgow, will supervise me.
What if there is a problem?
If you wish to complain, or have any concerns about any aspect of the way you have been approached or treated during the course of this study, you can contact my supervisor, Dr Kenneth MacMahon at the University of Glasgow (Tel: 0141 232 7700), who will be able to advise you on the appropriate complaints procedure, should you wish to use this.
What will happen to the results of the research study?
The results of this study will be given to the University of Glasgow as part of an educational research project required for completion of a Doctorate in Clinical Psychology course that the researcher is involved in. It is intended to publish these results in the relevant psychology journals and make them available in the University library. You will not be identifiable in any publications and the information you have given is entirely anonymous, ensuring that your identity will remain unknown to others. A written summary of the results will be given to you by the researcher if you so request. You can request a copy of the results from your Health Visitor or Group Leader or you can request a summary of the findings via the researcher’s email.
Who is reviewing and paying for this study?
This study is being funded through the University of Glasgow and has been reviewed by a Research Ethics Committee. The committee has approved the research.
I particularly like the closing sentence – “Shame on you Nestlé. The real comprehensive nutrition system? A pair of lactating breasts.”
Infant formula is a medical necessity for those who are unable to breastfeed their infants. There are a host of medically sound reasons why a mother, in conjunction with her physician would choose to utilize infant formula in lieu of breast milk. The regulated manufacturing of infant feeding products has come a long way in recent years, and has saved many lives. When viewed in this capacity, formula is a wonderful thing.
What is not so wonderful is the societal pressure on women to choose bottle feeding as an option of convenience. For years, women in industrialized nations were told that it was a more high tech, simpler solution than breastfeeding their infants. Bombarded with images of bottle feeding from childhood, our society has come to view it as the norm. Over the course of the last few decades,the “breast is best” mantra has been prevalently bestowed on new mothers, and fewer women are choosing elective formula feeding. Formula has been largely demonized by healthcare providers and better educated mothers, and is often viewed upon as downmarket.
The environmental toll of formula manufacturing is heavy: dairy production destroys land and pollutes air and water. The waste created by packaging, bottles and nipples is staggering. Artificial feeding means the use of more diapers, sanitary napkins and tampons. In developing nations, it increases the odds of an infant contracting food-bourne illness, and increases infant mortality rates. The multimillion dollar television ads that formula companies place during your prime-time viewing are always images of a cherubic caucasian baby, and a smiling mother – not of dying infants and destroyed agricultural property.
Shameful.
The increasing trend to return to breast feeding is not in the best interests of the large corporations who command vast profits from the production and sale of infant formula. Flagging sales and decreasing market segments require innovation and rebranding magic.
How do you create appeal for a product that is more and more becoming a virtual societal pariah?
You respin what has previously been spun successfully.
Meet Nestlé’s latest weapon in their war against breastfeeding:
That, dear friend, is NOT a Nespresso maker or Keurig.
Those are not pods of designer coffee.
It is a very costly formula making machine: BabyNes
Not only is it designed to appeal to the crowd who would already be buying similar products for themselves, but it bills itself as a revolutionary “comprehensive nutrition system.”
Comprehensive Nutrition System? Who are they trying to fool?
Apparently the wealthy and those caught up in gadgetry.
One of these units, which debuted for the first time in Switzerland today, will run you approximately $287 USD. Single serving pods of formula will roughly double existing formula costs, as they will come in at $56 – $64 for a pack of 26.
Can you picture the inevitable launch in North America, complete with contests in parenting magazines and on the internet, give aways by OBGYNS and peds who finance their golf club memberships via the push of formula on otherwise healthy nursing pairs? Television commercials that appeal to mothers who cannot afford these things, but will spend their money on them anyway, because of the media’s emphasis on convenience, safety and hygiene?
Shame on you Nestlé. The real comprehensive nutrition system? A pair of lactating breasts.
The full research is below but these are 2 important snippets:
Mean, unadjusted total Medicaid expenditures for infants in the breast feeding cohort were approximately $102 less than for infants in the formula-feeding cohort ($484.80 +/- 964.14versus $586.67 +/-1,222.36, not statistically significant). Mean pharmacy payments, a subcategory of total Medicaid expenditures, were significantly lower for the breast-fed cohort than for the formula fed cohort ($16.83 and $37.56 respectively, p<0.0001). Compared with the formula-feeding cohort, adjusted pharmacy payments for the breast-feeding cohort were $29.82 (95% CI: $21.14 – $38.50) lower for males and $12.16(95% CI: $5.90 – $18.41) lower for females.
The average formula-fed infant required 21% more Medicaid expenditures and the infant-mother pair required 14% to 19% more WIC dollars than the average breast-fed infant-mother pair.
Authors’ conclusions
The study results show that breast-feeding reduces WIC costs and Medicaid expenditures in the short term, so examination of a longer time period may reveal greater savings. In order to achieve valid conclusions, it is important to consider the problem of incomplete Medicaid expenditure data and breast-feeding infants receiving care from providers who use revenue billing codes (which tends to result in a higher level of payment). The lower pharmacy costs associated with breast-fed children could mean a substantial saving for the Medicaid programme if more low-income mothers chose to breast-feed their infants.
The authors argued that the breast-feeding method produced a net month saving of $9.83, which, applied to the 17.5% of Colorado WIC infants breast-fed for 6 months, can lead to a saving of $25,803 per month. In addition to producing monetary benefits, breast-feeding produces intangible benefits for the mother and infant, as well for society.
So why is the UK government scrapping Breastfeeding Awareness Week?
Economic benefit of breast-feeding infants enrolled in WIC
Montgomery D L, Splett P L
Health technology
Breast-feeding versus formula feeding in infants.
Type of intervention
Breastfeeding; Primary prevention.
Hypothesis/study question
The general objective of the study was to determine whether, within a low-income population served by WIC (Special Supplemental Nutrition Program for Women, Infants and Children), breast feeding is associated with a reduction in Medicaid expenditures during the first 6 months of life. Formula feeding was explicitly stated asa comparator.
Economic study type
Cost-effectiveness analysis.
Study population
Breast-fed and formula-fed infants. The average age of mothers was 25 for the breast-feeding and 22.2 for the formula-feeding group, (p<0.001). The two groups were comparable in terms of education background. 70% of the breast-feeding group were white women and 55.7% of the formula-feeding group ,(p<0.001). The women in the breast feeding group had a higher rate of employment (43.1% versus 32.3%, p<0.001) and were less likely to smoke (13.7% versus 26.2%, p<0.001).
Setting
Community. The economic study was carried out in Colorado, USA.
Dates to which data relate
The resources were measured using data for the period 1 August 1993 – 31 December 1993. 1993-1994 prices were used.
Source of effectiveness data
Effectiveness data were derived from a single study.
Link between effectiveness and cost data
The costing was undertaken retrospectively on the same patient sample as that used in the effectiveness study.
Study sample
Using the Colorado WIC database, infants were identified as possible subjects if they were: (a) born between August 1, 1993, and December 31, 1993; (b) enrolled in WIC within 1 month of birth; (c) either formula-fed exclusively or breast-fed exclusively for at least the first 3 months of life; and (d) classified as a normal, singleton birth (born after 37 weeks of gestation with a birth weight above 2,500 g and born without any severe medical conditions).
Breast-fed infants were further identified as to duration of exclusive breast-feeding (3, 4, 5 or 6 months of exclusive breast-feeding) based on redemption of WIC wouchers for infant formula. It is not evident that the initial study sample was appropriate for the clinical study question;it was not reported whether power calculations were used to determine the sample size.
The breast-feeding cohort and the formula-feeding cohort consisted of 406 and 470 infants respectively. Infants were excluded if (a) birth certificate or Medicaid records indicated congenital anomaly, or less than 37 weeks of gestation; (b) the Medicaid record indicated that medical services were provided by a health maintenance organization or a federally qualified health centre (where Medicaid payments for services were not related to intensity of service provided);or (c) Medicaid records indicated other third-party reimbursement for any medical service during the study period.
Study design
Single centre cohort study. The cohorts were identified and tracked prospectively for 6 months. No information about loss to follow up was reported.
Analysis of effectiveness
Not reported.
Effectiveness results
The effectiveness results were not explicitly reported.
Clinical conclusions
The study considers that breast feeding is at least as effective as formula feeding in terms of health benefits for infants.
Measure of benefits used in the economic analysis
Since the authors assumed that there was no difference in effectiveness or clinical benefit between the intervention and comparator, the economic analysis was based on the difference in costs only (cost-minimization) plus a benefit to cost ratio calculation.
Direct costs
Discounting was not applied due to the short period of the study (<1 year). Costs and quantities were not reported separately. The type of costs included in the study were as follows: the food costs for the women and infants in the two groups plus the administrative expenses for 6 months, minus manufacturers’ rebates for formula, plus Medicaid expenditures for health care initiated in the first 6 months of each infant’s life for: procedure, revenue, diagnosis-related-group, non-diagnosis-related-group and pharmacy. The quantity/cost boundary adopted was the health service. The estimation of quantities and costs was based on actual data. The source of quantity/cost data was the Colorado WIC database and the Medicaid records. The dates of the price data were 1993-1994.
Statistical analysis of costs
WIC costs and Medicaid expenditures were summed for each mother-infant pair and compared between the cohorts by means of t tests and analysis of covariance. Regression techniques were used to estimate total Medicaid expenditures for each feeding method when adjusted for other variables. The sex of the infant and number of prenatal visits were found to contribute significantly to total Medicaid expenditures. Analysis of covariance was used to estimate the total difference in Medicaid expenditures between the breast-fed and formula-fed cohorts, adjusted for sex of the infant and number of prenatal visits.
Indirect Costs
Not reported.
Currency
US dollars ($).
Sensitivity analysis
A simple sensitivity analysis was carried out on administrative costs.
Estimated benefits used in the economic analysis
Not applicable.
Cost results
The 6 months food cost was $299 lower for breast-feeding mother-infant pairs than for the formula-fed cohort ($269 versus $568, p<0.0001). With the addition of a 26% administrative cost adjustment, 6 months food cost remained less for the breast-fed cohort than for the formula-fed cohort, $339 versus $715. The 6 months, post-rebate (manufacturer’s rebate) WIC food cost for the formula-feeding cohort, before adjusting for the programme’s administrative cost, was $18.63 less than the food package cost for the breast-feeding cohort. When administrative costs were added to food package cost (calculated with 26% administrative cost of pre-rebate food package), the food cost of the formula-feeding cohort was higher by $59 than that of the breast-feeding cohort. Mean, unadjusted total Medicaid expenditures for infants in the breast feeding cohort were approximately $102 less than for infants in the formula-feeding cohort ($484.80 +/- 964.14versus $586.67 +/-1,222.36, not statistically significant). Mean pharmacy payments, a subcategory of total Medicaid expenditures, were significantly lower for the breast-fed cohort than for the formula fed cohort ($16.83 and $37.56 respectively, p<0.0001). Compared with the formula-feeding cohort, adjusted pharmacy payments for the breast-feeding cohort were $29.82 (95% CI: $21.14 – $38.50) lower for males and $12.16(95% CI: $5.90 – $18.41) lower for females.
Synthesis of costs and benefits
A benefit-cost ratio was calculated. The benefits (Medicare expenditures) were divided by the (WIC) costs of the programmes to produce a ratio score which showed the monetary value of outcomes produced with each dollar of input. Post-rebate breast-fed cohort ratios ranged from 1.02 to 1.73 compared with ratios of 1.59 to 1.75 for the formula-fed cohort. These results do not, however, reflect the finding that both Medicaid and post-rebate WIC costs were higher for the formula-fed alternative. The average formula-fed infant required 21% more Medicaid expenditures and the infant-mother pair required 14% to 19% more WIC dollars than the average breast-fed infant-mother pair.
Authors’ conclusions
The study results show that breast-feeding reduces WIC costs and Medicaid expenditures in the short term, so examination of a longer time period may reveal greater savings. In order to achieve valid conclusions, it is important to consider the problem of incomplete Medicaid expenditure data and breast-feeding infants receiving care from providers who use revenue billing codes (which tends to result in a higher level of payment). The lower pharmacy costs associated with breast-fed children could mean a substantial saving for the Medicaid programme if more low-income mothers chose to breast-feed their infants.
The authors argued that the breast-feeding method produced a net month saving of $9.83, which, applied to the 17.5% of Colorado WIC infants breast-fed for 6 months, can lead to a saving of $25,803 per month. In addition to producing monetary benefits, breast-feeding produces intangible benefits for the mother and infant, as well for society.
CRD COMMENTARY – Selection of comparators
The reason for the choice of comparator is clear.
Validity of estimate of measure of benefit
The health benefits of the intervention and the comparator were not explicitly analysed. As such, the authors conducted an economic evaluation which had some characteristics of cost-benefit analysis (e.g. benefit/cost ratio, net benefit)and others which resembled cost-minimization analysis. However, in terms of cost-benefit analysis, health benefits were not explicitly analysed but, rather, the conversion from health outcomes to dollar values was represented in Medicaid expenditures alone. In terms of cost-minimization, the authors did not adequately demonstrate that the effectiveness of breast-feeding was identical to formula-feeding. However, the results suggest additional benefit for breast-fed infants.
Validity of estimate of costs
Resource quantities were not reported separately from the prices, but adequate details of methods of quantity/cost estimation were given. All the important cost items were included.
Other issues
The results of the study need to be validated, for example with a cohort study which employs a longer period of follow up using appropriate methods to assess differences in the health outcomes of the two populations.
Implications of the study
The study supports the view that the breast feeding of infants is associated with both health and economic benefits.
Source of funding
Supported in part by grants from The American Dietetic Association Research Foundation and the Colorado Breastfeeding Task Force.
Bibliographic details
Montgomery D L, Splett P L. Economic benefit of breast-feeding infants enrolled in WIC. Journal of the American Dietetic Association 1997 97(4):379-385
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn.
Aunty Lactivist is all of us, so if you can help at all with words of wisdom, links to other sites or yor own experience please leave a comment.
Dear Aunty LactivistCan you point me in the direction of some research or guidance please about skin to skin contact straight after a c-section. I KNOW the benefits but need something more definite than my fluffy explainations. I suppose I am really thinking of early establishment of breastfeeding, rather than waiting the hour plus they say.A
Aunty Lactivist is all of us so if you can help at all with ideas or links please leave a comment.
“Dear Aunty Lactivist
Hi I wondered if anyone can help? When i went to a weaning class a few months ago i remember being told that if i am still breastfeeding at 6 months then i need to start to give my baby vitamin drops?”
Lactivist t-shirts in sizes 1-2 and 3-4.
The supplier of the blank t-shirts in the bigger sizes has stopped making them in unbleached cotton. I have a fair few in stock as I bought the last blanks but after that I will not be doing these sizes so get them while you can. I can find organic blanks in size 12-18 months and 3-4 years but nothing in between so to make it easier to run Lactivist I’ll stop at 18 months when these big ones are sold out. There will still be t-shirts in all sizes availaible on Zazzle and Cafe Press and I’ll be adding to the designs available when I get a chance.
Lactivist Future
This is my last year of running Lactivist voluntarily, to put it bluntly I have to earn some money, unless we win the lottery or a rich husband comes along and marries me I need to provide for my son. I’m having to cut down the amount of time I spend on Lactivist as I need that time to do paid work.
Things that have really helped recently have been all the volunteer admins on the Lactivist Facebook Page which is now incredibly vibrant and busy. I could do with more help on the Lactivist blog – www.lactivist.net so if anyone has experience of wordpress and has time to keep a blog updates with breastfeeding information, events and links then please email me – moomum@lactivist.co.uk.
My plan at the moment for next year is to keep a shell of Lactivist open, selling just a handful of t-shirt designs in the 3 smallest sizes and shopping bags and stopping badges, keyrings, postcards and hats. This would make it a whole lot easier to run and give me a lot more time. But, when I get a moment I’m going to produce 2 new designs – one for cloth nappies and one for babywearing, in the hope of opening up the market a bit.
Hi, I was wondering if you could help me. I am a freelance journalist (and breastfeeding mother) who is trying to find out why the uptake of breastfeeding is so low amongst UK mothers. I would be really grateful if one of your experts would be willing to email me back. Also, do you know of any breastfeeding mothers who would be willing to talk about their experiences of breastfeeding – how the system helped, how it didn’t. I can be contacted via the above email address or by mobile on 07985 930 446. I’m trying to write this as a feature on the back of the government’s plans to axe the national breastfeeding week, so would be very grateful if somebody could respond as soon as possible. Thanks in advance. Sincerely Daria Neklesa
Breastfeeding: it’s a divisive subject, even among mothers. But aside from the question or whether or not to breastfeed there is the issue of whether or not women should do it in public. After all, we’re told that it’s “best for baby” and the UK now has legislation in place designed to protect breast-feeding mothers in public spaces. Yet the issue remains contentious with complaints of indecency and inappropriateness being aimed at a group of women who are typically very discreet when it comes to attaching baby to breast in public spaces.
Perhaps this is why young mothers interviewed in a recent BBC documentary were avoiding breastfeeding completely; because of their fear of the reactions they could garner (“I’ve got a baby, so obviously I’ve had sex. Now I’m getting my boobs out in public, so they’ll think I’m easy, too.”) Were these girls overreacting? I decided to contact the UK Lactivists (a genius name that, surely, doesn’t need explaining) to find out how they felt about breastfeeding in public – after considering my own experiences of feeding my son, some five years ago. The next three stories, while mine, are sadly repeated by almost every breastfeeding mother I’ve spoken to.
The first happened in a large Easton supermarket when my son was about two months old. I was halfway round the store, my trolley was already loaded with chilled goods, and I realised that my son was hungry. I toddled off to the baby feeding room (also known as the disabled toilet) and found it filthy and smelling horrendous. My complaint to a staff-member saw me furnished with a stepping-stool in the dairy aisle and I was left to get on with things. For the next thirty minutes I huddled over my baby (as much for warmth as for modesty) while almost every man who walked past me offered to lend a hand.
The second story takes place in one of the UK’s most notably “baby friendly” companies. They provide feeding mothers with private rooms that are furnished with expensive rocking chairs and, in the really good stores, free nappies and baby food. Especially around my first Christmas with my son, these rooms were a haven of peace and relaxation where I would dig in and get comfortable, able to take my time without being hassled, stared at or bothered. But, after three visits and two collective hours of feeding and winding in the same day, a comfy chair and soft décor only go so far – serene contemplation turned very quickly into boredom and loneliness.
Finally, we have the Swedish furniture shop experience. Upon telling a staff member that I needed to feed my child, they pushed my trolley for me to the bed section, right out in the shop floor and asked if I fancied making myself comfortable there. If not, I’d be welcome to use the staff lounge. The bed section, however, was just fine for me, especially as a female staff member was standing discreetly off to one side to redirect approaching customers. No boredom, no bystanders, no being closeted away.
After making contact with the UK Lactivist group and asking what their experiences were, the answers were largely the same: almost all of the respondents noted having been stared at, challenged or hassled while feeding their children in public spaces. Ally, a Lactivist member, says this:
“…it was only last week that I run into a tough situation. My son was screaming for food and the nearest place to feed him was Marks & Spencers. I went in and asked if there was an area I could feed him, and the lady told me there were feeding facilities for us upstairs, which I thought was fab … in actual fact, it was a TOILET with a very basic chair. I was mortified. Feed my baby in a toilet? I ended up feeding him in the cafe, which I found embarrassing to say the least. It was heaving and everyone was staring. Not good.”
And Sam, another group member, offered her account, too:
“…in the waiting area for children’s outpatients of all places! I was greeted with a smile by one mum until I started feeding my son – when I glanced back at her she was glaring at me. The second time the mum sat opposite me moved as far away from me as possible – not sure how she even saw since we were hidden behind his pushchair… The first time I fed him in public was after I changed his nappy. It was a standard toilet/ nappy change room but was also described by the supermarket in question as a “feeding room” and had a simple chair in it. Sorry, not feeding my son in the same room as a bog, thank you very much – I went and sat in the car instead.”
And in response to the question “Have you ever felt judged during your breastfeeding relationship?” several respondents have given up public feeding completely. For example:
“Yes, I will not feed in public now, ds2 is now 13 months and people stare. Also feels like lots of pressure from all sides that once baby has teeth it is too old to bf, nobody says it to my face, but I now wouldn’t tell people I still feed unless they ask. Not because I am worried about their opinion, I just can’t be bothered with the look of disgust on some peoples faces!” (Claire)
But there is also a feeling of having been segregated from other shoppers by the advent of the baby room, as if by removing breastfeeders from their shop floors, commercial spaces are able to avoid the issue of harassment entirely. And yet, time and time again breastfeeding women are expected to sit – sometimes for up to an hour – in an uncomfortable chair with a baby in their arms next to a toilet. Aside from the fact that it’s boring, insulting and will separate you from the people you went out with, there’s no way the facilities can be described as hygienic, pleasant or relaxing. Would you expect a bottle-feeding mother to get on with it in a toilet? Would you eat your lunch in there? At a time when the numbers of new breastfeeders are rapidly falling, it serves only to discourage new mothers from taking up the breast and underlines the implication that breastfeeding is something that should be kept private – that the sexualisation of breasts is utter and unfailing.
Apart from being cheaper and more convenient, the benefits of breastfeeding have been well-catalogued by medical research: emotional and health benefits for mother and baby.; examples include lowering of stress and a reduction in female cancers later in life – and more benefits are seemingly still being discovered. And while the NHS now has breastfeeding lessons in place for new mums, the World Health Organisation promotes breastfeeding on a global scale and organisations like La Leche League and the NCT offer free advice and support to mothers, none of these are able to offer help to mums who feel judged and uncomfortable in the UK’s public spaces.
However, Lactivists are challenging businesses such as shops, restaurants and cafés to protect breastfeeding mothers by declaring themselves to be “safe spaces”. This means that breastfeeders are welcome anywhere that the public have access to, even if more secluded facilities are available, and that a “baby feeding room” sign will never be stuck on the door of a disabled toilet. By asking businesses to challenge the harassment that breastfeeding women experience, they hope to make breastfeeding a more reasonable option for new mums to consider, giving women a haven to sit, feed and enjoy their surroundings without fear of the reactions of others.
Lou LaRoche is launching Bristol: Hollaback! a campaign the end street harassment in August 2011.
Critics say move may undo years of work, just as message on benefits of mothers’ milk gets through
By Susie Mesure
Sunday, 22 May 2011
pa
The benefits to babies of breastfeeding are unequivocal, according to campaigners
“Breast is best” is the simple message healthcare providers like to drum into new mothers’ exhausted brains. Their jobs will get a little harder this year after the Government controversially axed its support for National Breastfeeding Week, which was due to run next month.
Campaigners last night warned that the move, which will save just a few hundred thousand pounds, risked undoing years of good work just at a time when the message on the benefits of breast milk were starting to get through.
The decision means there will be no UK-wide campaign to remind parents that breastfeeding is the easiest way to give your baby a head start. The latest research, released earlier this month, revealed that breastfed babies are less likely to have behavioural problems by the age of five than those given formula milk.
The Royal College of Midwives (RCM) said it was “disappointed” by the U-turn, which increases pressure on local support groups to step in instead. Janet Fyle, the RCM’s professional policy adviser, said a national campaign “galvanises everybody, from professionals to mother-to-mother groups”. She warned: “It is not cost effective to drop something with which you have had some success. The Government needs to look at all the very good work that it has done to generate interest in breastfeeding, and the help that support groups have received.”
Belinda Phipps, chief executive of the National Childbirth Trust, a charity that supports new mothers, called the Government’s move “frustrating”. She said mums wanted to breastfeed but often found they struggled because they lacked support. She called for “better training” for midwives and more support for organisations such as the NCT, which has its own training scheme for breastfeeding counsellors.
“The evidence of the health benefits of breastfeeding is unequivocal. But as a society we have a funny attitude towards breastfeeding because breasts are used for sex, so I can see why [promoting breastfeeding] is not a total win-win for government,” Ms Phipps added.
Although the latest infant feeding survey, due out shortly, is expected to show a slight increase in the numbers of women breastfeeding, it remains a contentious issue. World Health Organization recommendations state that mothers should exclusively breastfeed their babies until they are six months old, but existing figures show that barely a third of British babies are exclusively breastfed at one week and just a fifth at six weeks. By the time babies are four months old, the figures plunge to 7 per cent, giving the UK one of the worst breastfeeding records in the developed world.
Campaigns have featured the likes of Nell McAndrew, the glamour model, who breastfed her son well into toddlerhood. The year that McAndrew fronted National Breastfeeding Week, a third of mothers from C2DE backgrounds said that seeing her extol the virtues of breast milk had made them think more positively about it.
The Department of Health yesterday defended its decision. A spokesperson said it valued work being done by other organisations to promote breastfeeding, adding: “During this transition phase, we will be considering how infant nutrition will be delivered to support better health outcomes.”
Among those stepping into the breach is the retailer Mothercare, which intends to team up with the RCM to host in-store advice clinics for new mothers during what would have been National Breastfeeding Week, from 19 to 25 June. The NCT will also be running special events.
Please bring something to sit on, there are a few walls dotted around but may be taken up by shoppers, bring a small placard if you would like and most of all bring your baby and boobs!
We will be meeting at 12.30 ready to breastfeed at 1pm.
Local newspapers will be there and possibly also some news television cameras!
Lets pray for sun! Its going to be an awesome day!!
“Dr. Frederick Leboyer was the first physician to challenge society’s deeply held beliefs about awareness in the newborn. His pioneering works on birthing, including “Birth Without Violence”, have forever revolutionized the course of prenatal care and the way babies are introduced to the world. He also pioneered introducing infant massage to the Western world.”
“Birth without Violence revolutionised the way we perceive the process of birth, urging us to consider birth from the infant’s point of view. Why must a child emerge from the quiet darkness of the womb into a blaze of blinding light and loud voices? Why must an infant take its first breath in terror, hanging upside down as its vulnerable spine is jerked straight? Why must the infant be separated from its mother after spending nine months inside her nourishing body?”
There is a chance to meet Frédérick Leboyer at the Pinter & Martin home/offices on the 28th May 2011. Mr Leboyer will read from his classic book and answer questions. The reading will be followed by drinks and a light buffet dinner and guest will have the opportunity to get books signed. The admission fee goes towards author’s fees and expenses.
This is an interview with Frédérick Leboyerin 2006. He is an amazing man with a vast expanse of knowledge – anyone who says ‘pregnancy is not a sickness’ gets the thumbs up in my book!
To win a copy of Birth without Violence just comment below with your top tip for a calm birth. Each tip gets you one entry and you can get extra entries for tweeting and sharing on Facebook, blogs and forums – please let me know how many entries you are claiming in your comment.
Comp ends on the 28th May 2011 and is only for people in Europe – sorry!
The winner will be drawn at random and notified by email.
Care Instructions – Shopping Bag 
“Any old Cow” Short Sleeved T 6-12 months 
Mummy Milk Rocks – Shopping Bag 
“Any old Cow” Short Sleeved T 3-6 months 
Any Old Cow – Shopping Bag 
Recent Comments