Thursday, September 07, 2017

Evacuating with frozen milk

Evacuating with your frozen milk?
Hurricane evacuation routes, Google crisis map

Families in Florida and other locations are evacuating now in advance of Hurricane Irma.

Some who are feeding expressed human milk to their infants are concerned about losing their precious stores of frozen milk. In 2011 Human Milk News wrote about families making preparations to ensure their frozen milk stash was safe while they evacuated from Tropical Storm Sandy, drawing on advice from families who had evacuated in the past with their frozen milk stashes.

There are lots of links to good info in that blog post (see below) but the crucial info you need to know right now is here:

Consider your destination and call ahead to make sure there is freezer space for your stash. Use or purchase a well-insulated cooler that will hold all your milk, but not so big that it allows lots of air space. Think about where it will fit in your vehicle – soft-sided may work better. If you have frozen gel packs they can help keep your milk frozen longer but they are not necessary - ice will work.

1) Line the bottom of your cooler with newspaper.

2) Place your milk bags on top.

3) Use crumpled newspaper to take up any extra air space – that is the key to keeping your milk frozen. Do not use a large cooler for a small amount of milk - it will thaw faster.

4) Place a layer of newspaper on top of the milk, and place frozen gel packs* or ice blocks on the top of the newspaper (remember, cold air travels down, so they’re better on top than on the bottom.) Pack tightly but not so tight as to stress the cooler.)

5) Keep the cooler closed until you have reached your destination freezer! Consider sealing it duct tape to improve the seal.

You may have heard of using dry ice to ship donor milk – it is not necessary and could be hard to find during an emergency, delaying your departure. If you do have easy access to dry ice, be sure to keep the dry ice completely separate from the milk with extra newspaper to keep it from ripping open the bags.

Here’s a list of items to add to your emergency preparedness shopping/checklist:

     __ cooler (not much larger than the amount of milk you need to transport)

     __ gel packs

     __ today’s newspaper

     __ duct tape

Don't delay evacuating because of concerns about your milk stash. The sooner you leave, the sooner you can get to a safe location with electricity and freezer space. Families with young children should evacuate early.

Stay safe!

*Note, you can use frozen water in your cooler, but know that human milk freezes at a lower temperature due to its salt content, and gel packs are a better option than frozen water if you have them. BUT -  don't let this slow you down when you have to evacuate - frozen milk packed tight by itself or with block ice in a cooler that isn't opened will last many, many hours. Kittie Franz writes about travelling with your milk in this 2007 Mothering Magazine article.

** What about dry ice? If you have easy access to dry ice, do use it - your frozen stash will last many, many hours. It is not necessary, however, and you will have to take additional precautions to keep the ice from touching your frozen milk bags as they will burst if they make contact. Breastfeeding in Combat Boots has these instructions for soldiers who are deployed and have to ship milk home in the article Shipping Milk.

This post is part of a larger article written in 2011 to support families evacuating in the face of Tropical Storm Sandy. 

Monday, June 26, 2017

Facts not fear: Protecting the one place where fear does not belong

Image result for kimberly seals allers milk bank
Kimberly Seals Allers 
Kimberly Seals Allers, continues to take on the dangerous rhetoric of the Fed is Best Foundation. Human Milk News recently attended the Breastfeeding in Feminism International Conference in Chapel Hill, North Carolina, where she presented on her new book, The Big Letdown -  an excellent read. Kimberly Seals Allers is especially skilled at exposing exploitation of the emotional fragility of new parents.

Facts not fear: Protecting the one place where fear does not belong
Guest post by Kimberly Seals Allers

We live in a world of fear. From the recent terrorist attacks in England to last year’s Orlando nightclub massacre. We have seen how the fear of outsiders has sparked powerful political movements around the world. As a frequent business traveler I sense my own anxiety as I sit on planes and trains, and as a mother I know the feeling that sweeps over me whenever I receive an incoming phone call from my children’s school.

Yes, we live in times of fear and anxiety—much of which is beyond our control.

But there is one place where fear should not exist. There is one area, where, as women and mothers, that we should insist that fear not enter—that is in the precious act of feeding our babies. From the time they are first placed in our arms, we are anxious that we will do our best. Yes, we are nervous that we will make mistakes. But we should not be made to dread our ability to mother—particularly when it comes to feeding our infants—one of our very first tasks.

That’s why a recent spate of fear-based marketing, particularly from the Fed Is Best Foundation, stoking fears that exclusive breastfeeding kills babies is both erroneous and irresponsible. But it is also the type of insidious marketing that preys on a mother’s existing insecurities that should make all women concerned. If the only way Fed Is Best can make its point is by sensationalizing infant deaths and undermining our confidence in our bodies—then maybe their point needs to be carefully considered.

Or, as women, we insist that they make it with valid facts and sans the fear mongering.

Let’s face it, women are sold fear and anxiety as a marketing tool every day. In fact, the strategy, officially known in business circles as FUD—fear, uncertainty and doubt—was designed by an IBM executive decades ago to persuade buyers to feel “safe” with IBM products rather than risk a crash, virus or server disruption. By the early 90’s it was generalized to refer to any kind of misinformation used as a competitive weapon.

Today, weaponizing fear takes many forms. We fear our faces aren’t pretty enough, so we buy cosmetics. We worry that our body isn’t the right “type” so we are sold diet plans and surgical procedures. We are told our hair isn’t shiny, bouncy or thick enough so we are sold multitudinous hair products. And then we are told to fear that our bodies may not properly do what they are biologically made to do, and we are sold infant formula.

The truth is, our bodies were uniquely made to feed the infants we create. Decades of scientific research proves that formula is nutritionally inferior to breastmilk. Admittedly, societal pressures, structural barriers such as a lack of paid maternity leave, and physicians who receive little to no training in lactation science in medical school, make it very difficult for some women to fulfill their biological norm. Many women who want to breastfeed find undereducated physicians and nurses and limited post-natal support—particularly in the early days after discharge. We have much to overcome.

To be clear, infant formula is necessary. When a mother’s own breastmilk or human donor milk is not available, then infant formula is an important third option that can, at times, save lives. However, women should come to that decision fully informed, not because of marketing efforts designed to incite distrust in their own bodies or threatened with the fear of the death of their infant.

It’s no secret that, especially in the Western world, women already fear they will have insufficient milk. For some, this fear can become a self-fulfilling prophecy because fear and anxiety can literally limit lactation by stifling the letdown reflux that stimulates the milk glands. Feeding into this insecurity by promoting early formula supplementation “just in case” has been a go-to move by the formula industry for years.

As far back as the 1940s, the manufacturers of Borden KLIM evaporated milk ran a radio jingle in the Congo that stoked mother’s fears over insufficient milk. The song went:

The Child is going to die
Because the mother’s milk has given out
Mama o Mama the child cries
If you want your child to get well
Give it KLIM milk

So when Fed Is Best frequently promotes eerily similar headlines claiming, “One bottle would have saved my baby”—it seems to make early supplementation innocuous, while deploying a similar tactic used to spur sales of infant formula. The insidious message is that your breast cannot be trusted but a bottle can—this type of marketing should concern all women.

Instead of fear, we should demand the facts about why physicians and nurses don’t have more education to properly identify lactation dysfunction or failure. We should demand knowledge about other options to increase milk output such as hand expression, which can extract more milk than a pump. If formula must be used, it should be administered as a temporary bridge until a mother’s supply is established, not a breastfeeding killer for mothers who want to nurse. And we should demand standard home visitation immediately after discharge, as is the practice in the UK and other European countries.

Ultimately, women deserve facts not fear. Women have a right to guilt-free, confidence-building information and support. And it’s time that we demand it of everyone—including, and especially, from those claiming to support mothers. We cannot stand by while Fed Is Best insists that fear is best.

Kimberly Seals Allers is an award-winning journalist and nationally recognized infant health advocate. Her fifth book, The Big Letdown—How Medicine, Big Business and Feminism Undermine Breastfeeding was released in January by St. Martin’s Press. Learn more at and follow her on Twitter @iamKSealsAllers.

Wednesday, April 12, 2017

Setting the Record Straight: Breastfeeding Saves Lives, Doesn’t Cost Lives

Image result for kimberly seals allers milk bank
Kimberly Seals Allers 
Kimberly Seals Allers, who put forward a compelling argument in support of black mothers in Detroit when Medolac targeted them for the purchase of their breastmilk, has now taken on the rhetoric of the Fed is Best Foundation. Human Milk News recently attended the Breastfeeding in Feminism International Conference in Chapel Hill, North Carolina, where she presented on her new book, The Big Letdown -  an excellent read. Kimberly Seals Allers is especially skilled at exposing exploitation of the emotional fragility of new parents.

Setting the Record Straight: Breastfeeding Saves Lives, Doesn’t Cost Lives

Getting beyond the headlines to the truth about recent stories of “breastfeeding-related deaths.”

Guest post by Kimberly Seals Allers

Losing a child is a tragedy. As the Internet buzzed recently with the story of Jillian Johnson and the death of her son Landon, our hearts ached. Every mother, every human, feels her pain. Often, the best you can glean from any tragedy are important lessons learned. While it may seem easiest to blame breastfeeding or the Baby Friendly Hospital Initiative, as the click- generating headlines and story promoters simplistically suggest, that would not give the issue proper justice. If the true end goal is to ensure that no mother has a similar experience to what the Johnson family endured, then it is important to consider all the factors that contributed to that tragic loss and how we respond to that loss. We owe baby Landon that much.

Most importantly, we must not allow the media or any organization’s desire to sensationalize a rare occurrence turn into a dangerous, broad-based message that exclusive breastfeeding kills. That is categorically untrue and extremely irresponsible. In fact, decades of global research proves that exclusive breastfeeding consistently saves lives. The World Health Organization reports that over 800,000 babies could be saved worldwide by increasing breastfeeding rates, preventing 13% of all deaths under age five. The Baby Friendly Hospital initiative served over 788,000 births in 2016 alone, providing evidence-based care with positive outcomes. (Note: The Johnson family has not revealed the name of the hospital so it cannot be confirmed that it was indeed a BFHI certified hospital).
Take for example, seat belts. We know seat belts save lives, by and large, yet we also know that people can still die in a car accident while wearing a seat belt. But it would be short sighted to demonize seat belts in general for the specific incidences where unique circumstances meant a seat belt failed to prevent death. We would not condemn all seat belt use, attack seat belt users or criticize all public health campaigns designed to encourage their use, would we?

Yes, Jillian’s story as a rare occurrence must be told. These stories shock us to see the gaps and do better. But we can’t just stand by while sensational headlines and questionable motives trap us into an equally dangerous matrix of fear, divisiveness and emotional manipulation that foolishly paints a broad stroke over an acute complication when decades of scientific evidence proves that breastfeeding—when properly supported—saves countless babies and improves infant and maternal health.

Now for two important acknowledgments: First, we must acknowledge that not all mothers can successfully exclusively breastfeed. While the percent of women who cannot breastfeed due to biological factors is rather small, lactation is impacted by psychological factors such as anxiety and stress and these are mounting in our society leading to increases in incidences of insufficient milk supply.

Second, we have to acknowledge that most physicians simply do not know enough about lactation medicine and we have to start facilitating and demanding that they receive more evidence-based education about a biological norm. Again, we don’t know for sure that Landon was delivered at a certified Baby Friendly Hospital (although that hasn’t stopped the story promoters from blaming BFHI). But perhaps that is more to the point—that all families, regardless of where they deliver deserve physicians and nurses, who are properly trained and certified in lactation science, so they can effectively educate parents to manage breastfeeding, particularly in the early days and weeks after birth. This includes avoiding “one size fits all” breastfeeding advice and being sure to educate parents on the warning signs of a sick infant, beyond counting diapers. That knowledge also includes understanding medical conditions that can impact milk supply including having a C-section, as Jillian did, and certain health conditions such as the hormonal disorder that Jillian had. Physicians need to better understand lactation and lactation failures.

It is also important to note that the Johnson family tragedy happened five years ago. And much has changed in five years. Think of how far we’ve come in cancer treatment, mobile phone technology and even food labeling transparency in the past five years. Meanwhile, contrary to some published reports, BFHI guidelines have always allowed for supplementation when medically justifiable, such as with an infant like Landon who was in distress prior to the emergency C-section. BFHI guidelines also stipulate that a mother’s educated, informed choice for supplementation will not be denied. [See: Baby-Friendly USA. “Guidelines and Evaluation Criteria for Facilities Seeking Baby-Friendly Designation.” Guideline 6.1, p 18-19, Albany, NY: Baby-Friendly USA, 2016].  In other words, no mother who takes in all the facts and still chooses formula will be denied formula. Period. Point blank.

But there is a critical difference between supporting formula use when medically necessary and undermining breastfeeding among all women, all the time, with insidious marketing schemes including back-door, multi-million dollar payments to hospitals for formula marketing rights. The former requires physician knowledge and close monitoring of a specific infant to recommend supplementation as needed. The latter attempts to broadly trip up all mothers before they even start. One requires surgical skill and precision the other just swings a machete. Similarly, using broad-based scare tactics, horror stories and media manipulation to frighten all mothers is equally reckless. The health of mothers and babies is at stake.

However, one of the most painful parts of reading Jillian’s story, for me, is the sense of responsibility that weighed heavy upon her shoulders. Too often in these experiences we hear of mothers who said they read everything, went to classes, etc, only to be let down by the enormity of motherhood and the realities of breastfeeding. This perpetuates the dangerous thinking that it is up to mothers alone to successfully breastfeed or self-diagnose breastfeeding problems. It’s so terribly easy for a patriarchal culture to put all the responsibility on mothers and not chase the real culprits behind why breastfeeding is often so difficult, particularly in the early days. No holding hospital physicians to task for missing early warning signs. No question of how many International Board Certified Lactation Consultants were employed by the hospital to provide sufficient support. No mention of federal and state laws that allow for a 96-hour minimum stay after a C-section birth. No asking about the importance of prompt follow-up home visits (a standard in the UK and most European countries) or where was the social support of other mothers or relatives who could possibly raise alarms.  This is what is most dangerous to us all—the isolation of breastfeeding and the burden mothers are told they must bear alone. It is absolutely unacceptable.

But so is fear mongering.
And parading horror stories and graphic images of sick infants to market your agenda.

Which brings me to a very brief word about The Fed is Best Foundation. I’m all in for sharing stories—even at times, tragic ones— they jar us into seeing how we fail mothers so we can ensure it doesn’t happen again. I am opposed to shaming formula feeders. As a first time mom, my baby was given formula in the NICU. And I refuse to subscribe to the breast vs. bottle wars—that’s a concept pushed by marketing propaganda because it drives profits. All mothers simply want the best for their baby. But I’m deeply concerned by the aggressive and mean- spirited comments posted by the founders on blogs and social media. People are being viciously attacked or blocked simply for expressing counter opinions and sharing important facts. There’s high school-ish name calling that’s downright nasty (please stand by and watch this comments section) and other tactics clearly designed to silence and control women. Is this the best way forward? Adopting tactics of aggression and using cyber bullying is not the modus operandi of a well-intentioned education campaign that merely seeks to caution mothers. With so much at stake, we owe it to our babies and ourselves to question the true intent here.

Succumbing to scare-tactics without carefully considering the systemic failures and all the facts, including examining those who are peddling it, won’t get any of us anywhere in making true changes to the system that failed the Johnson family. That would simply be yet another tragedy.

Kimberly Seals Allers is an award-winning journalist and nationally recognized infant health advocate. Her fifth book, The Big Letdown—How Medicine, Big Business and Feminism Undermine Breastfeeding was released in January by St. Martin’s Press. Learn more at and follow her on Twitter @iamKSealsAllers.

The International Lactation Consultants Association has put together this list of resources on neonatal hypernatremia. 

Tuesday, April 05, 2016

California bill aims to stop profiteers from selling human milk out of state

Tomorrow at 1 pm PDT in Sacramento there is a public hearing on Senate Bill 1316, to amend laws governing the operation of human milk banks in California. The aim is keep the supply of donor human milk from being controlled by for-profit interests.

Milk purchased in California is sold at a profit, out-of-state. 
The bill addresses deep concerns about some of California's most vulnerable residents, premature babies in Neonatal Intensive Care Units, who may be going without life-saving donor milk.

Why? Several for-profit companies that market competing products made from human milk are in a battle to secure supply (See Human Milk News: Milk mongers sell mix of fear and doubt)  They're fighting over mothers who have extra milk to give, offering incentives and cash, along with promises that the milk will save the lives of tiny babies. They have stolen the language of non-profit donor milk banks - they call the people they buy milk from "donors" and encourage them to contribute "life-saving donations." One has even styled itself as a "public benefit" corporation operating a milk "cooperative."

Sick babies in NICUs need human milk, and if their own mothers can't make enough, donor human milk fills the gap. Without human milk the risk of diseases like necrotizing enterocolitis or sepsis is much higher, leading to serious illness and even death. Usually women with extra milk donate it, but some women are drawn to the incentives offered by the for-profits, and reassured by their promise that it will still be used to save babies. This leaves fewer women giving their milk to California's non-profit milk bank.

What do the companies actually do with this milk? Non-profits gently pasteurize the milk, leaving many nutrients and immune properties intact, and provide it at cost directly to NICUs for babies in need. California-based Prolacta pays $1.00/ounce, and for every 10 ounces purchased, it produces a single ounce of a specialized product that sells for $180/oz. The product is meant to be added to human milk as a special fortifier for very low birth weight babies, but what if there isn't enough human milk to begin with? Non-profit milk banks argue milk needs to go directly to babies first, and any milk left over can then be used for specialized products. Another company, Medolac, sterilizes the human milk it purchases, removing the life-saving properties so valued for babies in the NICU, and offers it for sale to the general public. Medolac also sucks components out of human milk using a "commercial scale proprietary purified bulk process" to be sold to scientists for research. Yet another company is harvesting human milk and selling it to bodybuilders.

Some in California have had enough of unfettered commerce taking milk from babies and selling it for profit, especially when it's going out of state. Bill SB 1316 would require for-profits to stop co-opting the language of non-profits - they wouldn't be allowed to use the term "donor" or "community benefit" when describing their transactions. They would be required to explain exactly how they are going to use the milk they purchase - no more blanket "saving babies" rhetoric. They would also be restricted from purchasing milk from mothers with newborns - families will have to wait until their own babies are six months of age or older and able to start complementary foods, before they can sell extra milk. This last measure is designed to address the concern, which we heard about last year in Detroit, that low-income families may be encouraged to sell milk for extra income while providing their own children with free or subsidized infant formula through WIC. This last measure will also help preserve the supply of donor milk for babies in need, as when the financial incentive is removed, only families with truly more milk than their own baby need will be likely to donate it.

Update: We've removed the Call to Action for now, but stay tuned for new info on how you can help move this forward!

Update 2:  Here are the

Update 3: Link to the televised proceedings (begins at about 45 minutes.)

Read more:
Breast Milk Becomes a Commodity, With Mothers Caught Up in Debate - New York Times, March 2015
What Happens When Breast Milk Goes Big-Business? - NYMag, March 2015