I n f a n t F e e d i n g A c t i o n C o a l i t i o n , 6 Tr i n i t y S q u a r e Toronto, ON M5G 1B1 Tel: (416) 595-9819 Fax: (416) 591-9355

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Breastfeeding and co-sleepingIs it safe for infants to sleep alone?

arental co-sleeping is a nearuniversal practice. Acrossthe globe, babies and moth-

ers sleep together, and in nature ourmammalian cousins demonstratethe normality of remaining "joined"after the drama of birth separation. Atiny newborn's need for her mother'scloseness and warmth, heartbeatand voice follows a crucial develop-mental patternafter the disruptiveseparation of birth.

Donna Isenor,a mother of threetells us:

"With my first,the baby sleptin our room in abassinet untilhe was 3months old,and thenmoved into hiscrib. I wouldmake the trekto his roomabout 4 times anight, an houreach time, andcouldn't figure out why hewouldn't stay asleep for morethan 2 minutes after I laid himon the hard crib surface afternursing him."

With her third child, Donnaabandoned both basinet and criband finds that her daughter and her-

self, as well as siblings and spouseall sleep much better.

In Canada, like some otherindustrialized countries, health prac-titioners and health ministries pro-mote separate sleeping with the useof nurseries and cribs, and do notcondone bed sharing, assuming thepractice to be "unsafe". Co-sleepingis nevertheless common. In

Northeast England communities, forexample, 65 percent of parentsreported bed sharing; yet fear of dis-approval by health authorities keptparents from being open about thepractice. 1

Dr. James McKenna, anthropol-

ogist and globally renownedresearcher on infant sleeping, andmother and baby co-sleeping, ques-tions why the cultural and biologicalnorm gets challenged yet we neverask: "Is it safe for infants to sleepalone?"2

North American parenting,obsessed with infant independenceand sleeping through the night, has

its roots in a num-ber of religious-cul-tural beliefs whichhave subsequentlyevolved in ouru n q u e s t i o n e dmedicalized app-roach of regardingco-sleeping as ahealth hazard andcausation for infants u f f o c a t i o n .McKenna liststhese influencesas; our fear of chil-dren witnessingsex or touching;our values of inde-pendence andautonomy; the risein parenting

"experts" and decline in confidenceand parental intuition; the use ofseparate rooms; our concept ofhygiene, and the emphasis on thehusband and wife pair at the exclu-sion of children. He comments thatmany of these culturally fixed ideolo-gies are often "mistaken for science

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Breastfeeding Information Resource Centre

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NewsletterSummer / Fall 2003

INFACT Canada Newsletter Spring 2003 · Page 15

Breastfeeding is Protective Against Dental Fluorosis in a Nonfluoridated Rural Area of Ontario, Canada.

Brothwell D, Limeback H. J Hum Lact19: 386-390, 2003

Infants who are fed infant formulas reconstituted with fluoride-containing water have been reportedwith increased incidence of dental fluorosis. Consumption of fluoride may range from 150 to 200 timesgreater for infants fed powdered formulas than for those who are breastfed. The authors set out to studythe relationship between the "prevalence and severity of fluorosis" and infant feeding practices. Therewas no fluoridation in the water system in the community study area (Wellington-Dufferin-Guelph PublicHealth Unit)

Data was obtained for a total of 1,739 children aged 7 to 8 years who were screened for fluorosis andparents filled out a questionnaire regarding early feeding practices. Breastfeeding was reported for 67 percent of the children - 37.3 per cent for less than six months; 24.6 per cent for 6 to 12 months and 7.8 percent greater for more than 12 months. Fluorosis was dose related to the duration of breastfeeding - thelonger the breastfeeding, the lower the presence of fluorosis. Formula feeding was reported by 84 percent of the parents with 93 per cent reporting reconstitution with tap water. Using multivariate analysis theauthors concluded that the longer the breastfeeding, the lower the risk of fluorosis, and that in both fluori-dated and non-fluoridated communities breastfeeding has a protective effect. They also concluded thatthe dental profession should increase efforts to support breastfeeding.

Influence of Breastfeeding on Mental and Psychomotor Development.Gomez-Sanchez M, Canete R, Rodero I, Enrique Baeza J, Aviia O. Clin Pediatr 42: 35-42,

2003

Another study that affirms that not breastfeeding has a detrimental impact on the full potential of cogni-tive development. Using the Bayley Mental and Psychomotor Development Indices these Spanishresearchers set out to determine the impact of breastfeeding and formula feeding on cognitive and motordevelopment at 18 month of age. For infants breastfed for up to 4 months, the mean score in mental devel-opment indices was 4.7 points greater than for formula fed infants. When the infants who were breastfedlonger than 4 months were included in the sample, the difference was 7.2 points. Including parental IQ asa variable still exhibited a positive difference and remained significant for those breastfed longer than 4months. (Note - the authors included those partially breastfed in their breastfeeding cohort - exclusivebreastfeeding may demonstrate an even greater positive effect of breastfeeding on cognitive outcome.)

Solids and Formula: association with pattern and duration of breastfeeding.Hornell A, Hofvander Y, Kylberg E. Pediatr 107: E38, 2001

How is breastfeeding affected when solids are introduced and when formula is introduced? Theseauthors from Sweden studied 506 mother-baby pairs to compare the changes in patterns and duration ofbreastfeeding. They found that the introduction of solids was associated with little or no change in breast-feeding frequency and suckling duration. Frequency remained constant after the first month of introductionand then began to decline slowly and suckling duration started to decline, slowly, after solids were intro-duced. Interestingly they found no effect on breastfeeding duration when solids were introduced. When for-mula was introduced, the impact on sucking and frequency was rapid. Both frequency and suckling dura-tion declined rapidly. As well they determined that the earlier the introduction of the formula, the shorter thebreastfeeding duration. In conclusion they noted that the introduction of solids can be done with the protec-tion of breastfeeding and that health care workers need to be aware of the impact on breastfeeding of intro-ducing formula.

INFACT Canada Newsletter Spring 2003 · Page 2

in this area". Witness the manybooks written to solve aninfant/child's sleep problems and theunderlying assumptions that sleeppractices predispose desired devel-opmental outcomes.

In contrast, in cultures where co-sleeping is the norm mothersexpress horror upon hearing thatbabies may be made to sleep alone.Guatemala ct and a Vietnameseimmigrant mother noted that leavingbabies alone would contribute toSIDS because when you sleep withyour baby you always sleep lightlyand notice breathing changes.Chinese mothers also considerbabies too little to sleep alone andbelieve co-sleeping makes for happybabies. In Africa, separation isunheard of and mothers sleep withtheir children for several years.

McKenna also raises the ques-tion: Does sleeping alone createindividuals who are more independ-ent? Do we get the anticipated out-comes? Research shows us thatquite the reverse is true.

English children who slept alonewere more fearful than children whoco-slept. A survey of college-agesubjects reports males who had co-

slept to have higher self-esteem,and have less guilt and anxiety. Forwomen, co-sleeping was associatedwith easier physical contact andaffection as adults. Other studieshave found that having co-slept pro-moted confidence, self-esteem andintimacy and better relationshipswith teachers and less dependence.

The feeding of baby milks inbottles with artificial teats also con-tributes to our independent sleepingcrisis. This too is an actively promot-ed practice and is often perceived tobe without harm. Studies whichinclude analysis with infant feeding,show that for artificially fed and solesleeping infants, SIDS (or crib deathas it was originally called) is at anincreased risk. The risk of SIDSalso increases with parental smok-ing, legal and illegal drug use, aswell as overdressing children. Whilein societies where co-sleeping isthe norm, SIDS is a rare phenome-non.

A recent longitudinal study3, thatfollowed 154 infants for a period of18 years, notes in its conclusionsthat professionals should be cau-tious about issuing warning to par-ents regarding bed-sharing. "There

North American medicalization of both infant sleeping and feeding raises the important question of how far we have evolved from thebiological norm. Some interesting research shows us the absurdity and severity of solo sleeping and bottle feeding infants.

Human infants are low-solute, frequent suckling species and physiologically adapted for close mother-baby contact, essential for thebaby's optimal development and to maintain the mother's milk supply notes the author. By comparing the sleep logs and interviewing par-ents (253 families) on infant feeding and co-sleeping, the author demonstrates a clear beneficial relationship between bed-sharing andbreastfeeding. At age three months, breastfed infants received night feedings 2 to 3 times per night compared to less than one feed for theformula fed infants. They also found a significant relationship between bed-sharing and duration of breastfeeding and conclude that the datasupports the positive impact of bed-sharing on breastfeeding. Ball HL. Breastfeeding, bed-sharing and infant sleep. Birth 30: 181- 188, 2003

Detailed analysis of the nighttime breastfeeding patterns of 20 co-sleeping mother and baby pairs found that routine bed-sharing infantsbreastfed three times longer than infants who routinely slept separately. The authors suggest that in fact the longer breastfeeding episodescould be protective against SIDS, as breastfeeding has an overall positive impact on reducing the incidence of SIDS. McKenna JJ, Mosko SS, Richard CA. Bed-sharing promotes breastfeeding. Pediatr 102: 662-664, 1997

A meta-analysis and literature review of 23 studies of which 19 studies showed odds ratios indicating breastfeeding as protec

tive against SIDS. The combined analysis determined that bottle-fed infants were twice as likely to die from SIDS.McVea KL, Turner PD, Peppler DK. The role of breastfeeding in sudden infant death syndrome. J Hum Lact. 16: 13-20, 2000

The authors examined sleep arousal patterns for bed-sharing mother and baby pairs and concluded that co-sleeping promotes infantarousals and that these are overlapping more frequently with maternal arousals. The authors suggest that this may be protective againstSIDS as sole sleeping infants may have an arousal deficit and a mother's responsiveness to infant arousals may also be protective.Mosko S, Richard C, McKenna J. Infant arousals during mother-infant bed-sharing: Implications for infant sleep and sudden infant deathsyndrome research. Pediatr 100: 841-849, 1997

is at present no evidence linking thispractice, when engaged responsi-bly, with any sort of problematic out-come.” The authors question theassumption that solitary sleep issafer and more beneficial to chil-dren's well-being. Rather than issuewarnings, a discussion with parentsabout the practice is far more bene-ficial.

"Co-sleeping has openedmy eyes to the need for mydaughter to be close to meboth during the day as well asthe evening hours, eventhough she's sleeping, shestill senses my presence nearher and is calmer, and morerelaxed because of it and Idon't have the worry as towhether she is gettingenough food," notes DonnaIsenor.

1. Hooker E, Ball HL, Kelly PJ. Sleeping like ababy: Attitudes and experiences of bedsharing innortheast England. Med Anthropol. 19: 203-222,20012. McKenna J. Cultural Influences on SleepBiology. In Sleep and Breathing in Children. ADevelopmental Approach. Ed. Loughlin GM,Carroll JL, Marcus CL. Marcel, Dekker Inc. NewYork, 2000 3. Okami P, Weisner T, Olmstead R. OutcomeCorrelates of Parent Child Bedsharing: AnEighteen-Year Longitudinal Study. J Dev BehavPediatr 23: 244-253, 2002

Abstracts

INFACT Canada Newsletter Spring 2003 · Page 3

Safe Co-Sleeping lthough breastfeedingmothers safely co-sleepwith their infants, this age-

old practice is frequently underattack. Safe co-sleeping is oftenconfused by many myths and atti-tudes and evaluated with sleepingarrangements that do place infantsat risk. A case in point is a new studypublished by Dr. James Kemp. TheKemp study notes that the risk ofsuffocation was up to 40 times high-er for infants who sleep in adult bedswhen compared with cribs. What thestudy failed to do was differentiatebetween breastfed and formula fedbabies. In addition, the study did notidentify any risk factors associatedwith parental behaviours includingsmoking, alcohol or drug consump-tion (both legal and illegal) and ill-ness.

Rather than placing babies atrisk, co-sleeping and breastfeedinghave been shown to lower the risk ofSIDS and is recommended by theUNICEF UK Baby Friendly Initiativeand the UK Foundation for the Studyof Infant Deaths.

According to the UNICEF guide,"Sharing a bed with your baby", co-sleeping can make breastfeedingeasier because it allows an infant tonurse on demand with a minimum ofmaternal disruption. Most infantsalso sleep better when they areclose to their mothers, thus provid-ing essential rest for both motherand child. In addition, mothers whoare breastfeeding automaticallysleep facing their infant, which helpsprotect the baby from being coveredby bedding or pillows.

Scheers NJ, Rutherford GW, Kemp JS.Where Should Infants Sleep? Pediatr 112:883.889, 2003

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INFACT Canada Newsletter Spring 2003 · Page 14

CANADA BREASTFEEDS NEWS

Courtroom to Courtroom in Québechile defending a parking ticket in a Montréalcourtroom, a mother and her 4½ month oldbaby were asked by security to leave the

courtroom audience because they were breastfeeding.Feeling embarrassed and ashamed, upon returninghome she decided to contact The Montréal Gazettenewspaper and the Québec Human Rights Commissionto report the treatment she had experienced.

From one courtroom to another, the mother and her

baby received positive judgement: recognizing that herright to breastfeed her child had been violated. Thejudge acknowledged that each child has the right to thebest possible health, that breastfeeding is a natural act,and should not be considered otherwise (it is not an actof exhibition), and that a woman has the right to breast-feed anytime, anywhere!

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Mothers Read Between the Lines

Thyme For Some Actionhyme Maternity, a Canadian maternity clothingretailer, is currently running a contest in whichthe winner receives an RESP for their child from

the Canadian Scholarship Trust Plan. Numerous mem-bers have reported that a recent company cataloguecontains an application for the contest that includes thequestion "Would you like to receive a free sample ofNestlé Goodstart?". This promotion is a blatant violationof the International Code of Marketing of Breast-milkSubstitutes, and undermines the protection of breast-feeding. It also contradicts statements on ThymeMaternity's website which praises breastfeeding as theoptimal method of feeding a baby. The contest applica-tion, assuming it is shared by Thyme with Nestlé, gives

the infant formula company access to the names,addresses and phone numbers of hundreds, if not thou-sands, of new and expectant mothers. Please contactThyme Maternity and let them know that a company whoclaims to be looking after the interests of mother andbaby has no business doing business with Nestlé.

TThyme Maternity250 Sauvé WestMontréal QuébecH3L 1Z2

customers@maternity.ca

lthough seemingly trivial, advertisements andthe media's portrayal of parental roles have apowerful impact on parental decision-making.

To foster a breastfeeding culture, these latent messagesneed to utilize the scientific evidence that is available forthe promotion of optimal parenting practices - includinginfant feeding.

A case in point is recent TV commercials marketinglibrary services to a mainstream audience that containeda baby bottle prominently displayed. In response,INFACT Canada board member Kim Hancock, theDirector of Library Services for the Western Health CareCorporation in Corner Brook, Newfoundland wrote to theCalgary Public Library to point out that the “image sug-gests that bottle feeding is the 'norm' for infant nutrition."She also points out in her letter that:

"As a public library with a vested interest in a

A population who has been provided with theopportunity to reach their highest potential for lit-eracy, there comes a responsibility to not inad-vertently promote health behaviours / decisionswhich ultimately have a negative impact on IQand reading abilities. The 'Breastfeeding:Bringing Evidence to Practice' conference heldNovember 7-8 2003 provided participants withvalidated medical evidence that formula feedingis associated with lower IQ's."

Hancock went on to say: "I urge you to considerchanging your advertisement to remove theimage of the baby bottle. Alternatives include amother nursing her baby in the library - eitherwhile using the computer, or while reading abook to her toddler while nursing [her] infant."

In order to ensure infantsafety, UNICEF recom-mends the following com-mon sense precautionswhile co-sleeping:

Mattresses should be firm,flat and clean.

Babies should not beallowed to get too warm.Babies should not be over-dressed; bedroom temper-ature should be between16 and 18 degreesCelsius.

Mothers who are ill, or whoare taking medication thatmight affect their ability torespond to baby, shouldtemporarily discontinue co-sleeping.

Sheets and blankets arerecommended over duvetsand quilts.

Mothers should ensurethat infants cannot getstuck between the mat-tress and the wall or fallout of bed.

Ensure that others who aresharing the bed (i.e. part-ner, older children) areaware of the infant's pres-ence.

Pets should not be allowedto share the bed.

For further information about the benefitsof co-sleeping, visit:www.babyfriendly.org.uk/parents/leaflets

For information on how to protect againstSIDS, go to: www.sids.org.uk

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UNICEF UK Baby Friendly Initiative, 2003

Mark your Calendars for

The 14th Annual National Breastfeeding Seminar

Breastfeeding: Understanding the Ethical Issues

June 3 & 4, 2004

Formula Deaths Raise Concerns About Manufacturing Safety

ontroversy and fear aroserecently in Israel and world-wide with the discovery that

a kosher soy formula lacked therequired amount of Vitamin B1 - thi-amine - resulting in the deaths ofthree infants. The deficient formulahas also been associated with thepotentially fatal brain damage in atleast ten other babies. Remedia,the formula produced by theGerman company HumanaMilchunion, boasts H.J. Heinz Co.as a primary shareholder.

Thiamine, an essential B vita-min, is a required ingredient in babyformula needed to support thegrowth and development of thenervous system. Lack of this vita-min over a continuous period ofapproximately 18 days can causesevere brain damage and evendeath. The infants who died hadsymptoms of brain damage - diar-rhoea, vomiting, and restlessness -as did the other children whobecame ill. All had been fed thedeficient Remedia kosher soy for-mula.

Reports indicate that the manu-facturer of the product, HumanaMilchunion, failed to add the proper

amount of 385 micrograms of thi-amine for every 100 grams of formu-la. Instead they added only 29-37micrograms per 100 grams, eventhough the product label indicated385 micrograms. According toRemedia, Humana Milchunion wasunder the mistaken impression thatsoybeans contained enough thi-amine to warrant a removal of theessential vitamin without proper ver-ification.

These tragic deaths again callinto question the safety of formulafeeding and the need to warn par-ents of its risks. Not only does for-mula lack the immunological bene-fits of breastmilk, but it may containcontaminants, such as Enterobactersakazakii. Parents need to be fullyinformed regarding the choice to for-

mula feed. Furthermore, the refusalof many governments to regulatethese products according to theInternational Code of Marketing ofBreastmilk Substitutes, aggrevatesthe problem. Much of the time fam-ilies buy a product without anyknowledge of what it contains. Inaddition to these reoccurring con-cerns about the safety of labelling,the Remedia issue only adds moreuncertainty.

Source: Ran Reznick, Dafna Lutsky,Jonathan Lis, Ora Coren, Haaretz, November9 & 12, 2003, Laurie Copans, November 10,2003, &http://kyw.com/recalls/recalls_story_3130200912.html. Retrieved November 17, 2003

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INFACT Canada Newsletter Spring 2003 · Page 13INFACT Canada Newsletter Spring 2003 · Page 4

SOY FORMULA BOYCOTT IN NEW ZEALAND

roups in New Zealand are calling for a boycott on all infant soy formulas until the public istold which formulas contain genetically modified ingredients. The national government hasrefused to disclose the names of brands containing GM ingredients because the products'

levels of GM contamination are below the legal 1 percent threshold and as such the companiesproducing them have broken no law. Those calling for the boycott argue that it is a parent's rightto know what they are feeding their child.

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Jamaican Health Minister: Globalization a Threat to Breastfeeding

ohn Junior, Jamaica'sMinister of Health, cautionedabout the negative impact of

globalization on breastfeeding dur-ing the launch of Jamaica's NationalBreastfeeding Week in September.

According to an article in theJamaica Observer Reporter,Minister Junior said,

"World Trade Organizationpriorities, and preserving theeconomic interest of the devel-oped world and international co-operation are major areas offocus, many times putting profitahead of mother-to-child publichealth programs. The issuesaffecting mothers and childrenare therefore often suppressedby these realities and, becauseof this, we must guard againstthe weakening of theInternational Code of Marketingof Breast-milk Substitutes whichcould be endangered by theseprocesses."

"The onus is on us to preserveand promote the breast feeding

culture for the health and wellbeing of all our mothers andbabies while at the same timepromoting peace and justice," heconcluded.

Fitzroy Henry, nutritionist anddirector of the Caribbean Food andNutrition Institute (CFNI), echoedJunior's concerns. "In this globalizedenvironment, the need for economicgain puts profit before people -- amajor problem for social sectorssuch as health and the needs ofmothers and children are easilyjeopardized," he warned."Breastfeeding-friendly practicescan be lost while the commercializa-tion of infant-feeding practices,through breast-milk substitutes,could become the norm -- thereforewe must be vigilant."

Henry warns that theInternational Code can be manipu-lated and interpreted as a restrictionof the right of formula manufacturersto compete freely in the market-place. He also maintains that thebaby food industry has attempted to

mislead people into thinking that theCode is no longer valid. Henry urgespublic and private investment in thepromotion of breastfeeding toreverse declining breastfeedingpractices. He recommends that thefinancial case in favour of breast-feeding must be promoted and citessavings and reduced expenditure onformula, lower net food cost tohouseholds, and lower overallhealth care costs.

Based on Henry's figures, thecost of giving breast-milk substitutesto a three-month old infant was esti-mated in 1991 at 90 per cent of thesalary of a minimum wage earner;78 per cent of a community healthaid's salary; 36 per cent of a clerk's;26 per cent of a teacher's and 22 percent of a registered nurse's salary.He argued that it was important forthese estimates to be done again, inorder to see the real cost of notbreastfeeding.Source: Jamaica Observer Reporter,September 18, 2003

Drug Companies Push to Influence Cochrane Collaboration

he Cochrane Collaborationwill debate the issue ofconflict of interest at the

Annual Cochrane Colloquium inBarcelona in November. TheCochrane Collaboration is an inter-national non-profit and independentorganization, dedicated to makingup-to-date, accurate informationabout the effects of healthcare read-ily available worldwide. It producesand disseminates systematicreviews of healthcare interventionsand promotes the search for evi-dence in the form of clinical trialsand other studies of interventions.

The Collaboration's rulebookcurrently stipulates "direct fundingfrom single source with a vested

interest in the results of the review isnot acceptable." Supporters of drugcompany sponsorship believe thatCochrane needs commercial sup-port and could benefit from compa-

ny perspectives. Opponents saysponsorship will influence researchagendas and damage theCollaboration's independence andintegrity.

The Cochrane debate comes ata time when there is a growing bodyof evidence that industry funding isassociated with favourable out-comes. Evidence was presentedearlier this year in two large system-atic reviews. Bekelman et al found a"significant association betweenindustry sponsorship and pro-indus-try conclusions" in biomedicalresearch. Lexchin et al showed thatstudies sponsored by pharmaceuti-cal companies were four times morelikely to have outcomes favouringthe sponsors' products when com-pared with studies funded by othersources.Moynihan, Ray, BMJ Vol 327: 924-927, Oct2003

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Remedia, kosher soy formula marketed inIsriael and found to be deficient thiamaine, anessential vitamin.

INTERNATIONAL NEWS

Celebrate WorldBreastfeeding

Week 2004

"Exclusive breastfeed-ing: the gold standard -safe, sound and sus-tainable"

hen Nestlé staged anew product promotionat Toronto's Dundas

Square in October, INFACT Canadawas on hand to confront companyrepresentatives. Forthe several Nestléexecutives in atten-dance, it soonbecame obvious thatthe company's claimthat "…there is nolonger any significantboycott activity" is nottrue in Ontario's capi-tal. Waving a seven-foot banner that read"Stop Baby BottleDeaths, BoycottNestlé", INFACTemployees and agroup of boycotterstook to the squareand began handingout leaflets andstickers to those looking for a freesample of Nestlé chocolate milk.

Most were eager to learn whyNestlé was being targeted and wereshocked to hear about the compa-ny's deplorable behaviour. In all,close to a thousand people wereinformed about the boycott, with

many instantly pledging to boycottNestlé. At least one person pouredhis cup of chocolate milk on theground after speaking with anINFACT employee.

Despite the fact that DundasSquare is a public space, the boy-cotters were confronted by securityseveral times, and told they werenot legally allowed to pass outleaflets. This did not stop INFACTfrom approaching people as theyentered and left the square making

sure that everyone Nestlé tried toentice with chocolate milk was givena glimpse of the less savoury side ofthe corporation.

This demonstration was one ofthe first stepstowards whatINFACT Canadahopes will be ar e v i t a l i z e dCanadian NestléBoycott campaign.In the next fewmonths, INFACTwill be monitoringNestlé's activitiesand taking actionagainst the compa-ny whenever pos-sible. To keep upto date with allNestlé Boycottnews, join theINFACT CanadaNestlé Boycott

mailing list by going to the Boycottsection on our website atwww.infactcanada.ca.

Join the Nestle Boycott mailinglist! email us at: ben@infactcana-da.ca for regular updates on thecampaign. Nestle Boycott actionkit coming soon!

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INFACT Canada Newsletter Spring 2003 · Page 5INFACT Canada Newsletter Spring 2003 · Page 12

Norway Leads Industrial Nations Back to Breastfeeding n astounding 99 percent ofNorwegian mothers breast-feed their newborns. Six

months later, 80 percent are stillbreastfeeding. These amazing suc-cess rates are the result of a grass-roots campaign that began morethan thirty years ago. Convincedthat breastmilk was better than for-mula, Elisabet Helsing lead thecampaign by writing a light-heartedguide to breastfeeding in 1970. Sheasked a local health official - ayoung Gro Harlem Bruntland - if shewould consider printing the booklet.The rest, as they say, is history.

Dr. Bruntland went on tobecome Norway's prime ministerand received world acclaim as anarchitect of sustainable develop-ment and head the World HealthOrganization. In Norway, Dr.Helsing's efforts led to the creationof several mother-to-mother supportgroups that ultimately stoked a

national increase in breastfeeding.Government funding supplied train-ing for hospital staff, encouragingthe establishment of baby-friendlypractices.

Today, mothers breastfeed any-where, anytime - on buses, in parks,cafes and stores. Norway's extendedmaternity benefits support breast-feeding mothers, who receive 10months leave at full pay or 12months leave at 80 percent pay.Women who return to work are giventwo hours off a day to breastfeedtheir child, either at home or in theoffice, and women are also allowedto breastfeeding at their desks.

Formula, once a staple inmaternity wards, is conspicuouslyabsent. Formula advertising isbanned. And since formula is rarelyused, stores only stock a very limit-ed amount. The baby bottle, oncean icon on shower invitations and

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Australian Breastfeeding Gets Star Qualityustralian comedian, KateLangbroek, made televi-sion history in September

when she, as a celebrity breastfedon national television. Ms.Langbroek was making her first tel-evision appearance after the birth ofher son six weeks earlier. When hegot hungry, she fed him.

This perfectly normal act hasstirred up quite a controversy inAustralia, a country known for itssupport of breastfeeding. Whilesome entertainers are critical of Ms.Langbroek's actions, Lee King,director of the AustralianBreastfeeding Association, is callingfor more role models.

"In sitcoms and variousshows when there are char-acters having a baby which iswritten into the script, they

should follow on to breast-feed as well," said Ms. King.

Equal Opportunity CommissionerDiane Sisely applauded Langbroekfor claiming her right to breastfeedin the workplace.

"I hope it becomes so unre-markable that there won't behysteria when other womendo this," she said.

Dr. Ingrid Tall, president of theAustralian Medical Association alsosupported Langbroek's actions. Andcommenting on the health impactsof breastfeeding for both mother andchild,

"If a woman doesn'tbreastfeed,” she noted, “itraises her risk of ovarian can-cer and breast cancer. If thebaby doesn't get breastfed

their IQ can be potentiallylowered by a few points andthey are at greater risk ofinfections and [at] a greaterrisk of asthma [and] aller-gies."

Earlier this year, Australian MPKirstie Marshall made internationalheadlines when she was evictedfrom Victoria's Legislature forbreastfeeding her 11-day olddaughter. According to officials,Marshall was removed not becauseshe was breastfeeding, but becauseshe brought a non-elected personinto the chamber.

Source: Daniel Dasey, AAP, September 19,2003Australian Parents websitehttp://azure.bbboy.net/australianparents-viewthread?forum=9&thread=106

A

Canada Health Protection Act alert ealth Canada is currentlyreviewing its various healthlegislations to develop a

new act, the Canada HealthProtection Act (CHPA). As part ofthe process, public consultations willbe held across the country. INFACTCanada members are encouragedto participate in these consultationsto ensure that public health interestsand needs are foremost and are nothijacked by the economic interestsof the pharmaceutical, infant formu-la and food companies. Those of usworking for the protection of breast-feeding need to lobby HealthCanada on the importance of having

our health legislation conform to theWHO International Code ofMarketing of Breast-milk Substitutesand subsequent relevantResolutions of the WHA. Our goal isto ensure that marketing restrictionsand informative labelling be in placeto support breastfeeding and opti-mal complementary feeding prac-tices.

Key issues of concern include:

Advertising restrictions asrequired by the International Codefor infant foods

Labelling (as defined to include all

packaging materials, shelf talkers,brochures and anything accompa-nying the infant formula product)that is informative and does notidealize infant formula and infantfoods No nutrition and health claims forinfant formulas and foods forinfants and young children

Background materials for the revieware on Health Canada's website at:http://renewall.hc-sc.gc.caFor more information, contact theINFACT Canada office 416-595-9819, or email Elisabeth Sterken atesterken@infactcanada.ca

H

INFACT Canada Embarrasses Nestlé

other baby items, is rarely seen. Norwegian mothers say every-

thing about their culture compelsthem to breastfeed. "It's somethingthat is part of being a mother," saidAnne Baerug, the project leader forNorway's National Breast-FeedingCentre.

The Norwegian example pro-vides an excellent model forCanada, which already has year-long maternity benefits in place.What is missing is the structural,financial and governmental supportthat will ensure that breastfeeding isaccepted as the norm. In order tomatch Norway's success, we needpolitical leadership to uphold theprovisions of the InternationalCode, including legislation to banthe advertising and promotion offormula, as well as adequate fund-ing for promotion and training ofhealth care professionals.SOURCE: Lizette Alvarez, New York Times,October 21, 2003

INFACT Canada’s Ben Spurr hands out Nestlé brochures at Dundas Square.

•

•

•

INFACT Canada Newsletter Spring 2003 · Page 11INFACT Canada Newsletter Spring 2003 · Page 6

The Maternity Protection Campaign Kit: A Breastfeeding Perspective

he Maternity Protection Coalition (a joint effort of IBFAN, ILCA, Linkagesand WABA) has put together The Maternity Protection Campaign Kit: ABreastfeeding Perspective with technical input from IMCH and UNICEF.

The kit's aim as an action tool is for groups and individuals wishing to promotematernity protection at the workplace, and lobby for the ratification of ILOConvention 183 (2000) or stronger national laws. Breastfeeding protection sup-ports and encourages maternity protection, and maternity protection supports andencourages breastfeeding. For this reason, the issues have a mutual, beneficialrelationship. The kit highlights this relationship and outlines the ways in whichthese campaigns can work together- length of leave, timing of leave, financial andhealth benefits for example.

The kits are available from INFACT Canada.

T

TOWARDS HEALTHY ENVIRONMENTS FOR CHILDREN: FAQ about breastfeeding in a contaminated environment

n an easy-to-understand,Question & Answer format, anew fact sheet, Towards

Healthy Environments for Children:Frequently asked questions aboutbreastfeeding in a contaminatedenvironment, provides critical infor-mation. It addresses such ques-tions as should mothers worry aboutchemical contamination, why chem-

icals find their way into breastmilkand can chemical pollution harmbreastfed babies. It also outlineshow the media and baby food man-ufacturers use the pollution ofbreastmilk as a pressure point topromote formula.The FAQ fact sheet is a collabora-tive effort between IBFAN, LLLI,Linkages and WABA, and was pre-

pared by Penny Van Esterik of YorkUniversity. It states,

"The existence of chemicalresidues in breastmilk is not areason for limiting breastfeed-ing. In fact, it is a reason tobreastfeed because breast-milk contains substances thathelp children develop astronger immune system andgives protection against envi-ronmental pollutants andpathogens."

Towards Healthy Environments forChildren: Frequently asked ques-tions about breastfeeding in a con-taminated environment, is availablein print form from the INFACTCanada office, and will be availablefor download in a PDF format fromthe INFACT Canada website at:

www.infactcanada.ca

I

of HealthWise that have been dis-tributed across Canada be removedfrom store shelves. Thus far, the let-ter remains unanswered.

Unfortunately, the story doesn'tend there. In October, INFACTCanada received a letter fromLynette Amirault from the YarmouthBaby-Friendly Initiative Committee.Apparently Loblaw's first (and moredamaging) booklet, Baby Mattersis still in wide distribution in theMaritimes through the AtlanticSuperstores chain (a Loblaw's com-pany). In her letter to AtlanticWholesalers, Ms. Amirault wrote,

"We have concerns withthis unsolicited booklet andthe inaccurate and mislead-

WHAT YOU CAN DO:

Obtain a copy ofHealthWise or Baby Mattersfrom Loblaw's store acrossCanada and send your com-ments to: healthwise@aibn.com.

Write Galen Weston andlet him that he shouldn'tmake promises he won'tkeep!

Mr. Galen WestonChairman and PresidentGeorge Weston Ltd.22 St. Clair Avenue EastSuite 1801Toronto, OntarioM4T 2S8

Wyeth convicted of illegal advertisinghe British Court found for-mula giant Wyeth, the par-ent company of SMA

Nutrition, guilty of illegal advertisingon July 8th. Wyeth, the secondlargest baby milk manufacturer inthe world, had challenged the Britishgovernment's right to regulate themarketing of baby milk products.The decision effectively outlawssimilar advertisements by otherbaby food companies.

In his decision, Judge Rosssaid, "The Defendants have deliber-ately crossed the line in an effort toadvertise direct(ly) to a vulnerablesection of society. This is a cynicaland deliberate breach of regula-tions."

The Judge fined Wyeth/SMA atotal of £26,000 ($ 58,000 Cdn.) pluscosts of £34,808 ($ 78,000 Cdn.).

He found that Wyeth/SMA had notexerciseddue diligence and that SMA Director,Graham Crawford, had been "extra-ordinarily evasive throughout hiscross-examination and that hisexpertise was rather less than hewanted me to believe."

In response to the conviction,Patti Rundall, Policy Director ofBritain's Baby Milk Action said,

"This case has serious

implications for infant healthand Trading Standards are tobe applauded for theircourage in pursuing it, espe-cially as they were up againstthe massive legal and finan-cial resources available tothis pharmaceutical giant. Wehope that Wyeth will acceptthe ruling and not cause fur-ther expense to the publicpurse by attempting to havethe UK ban on advertisingscrapped."

For more information, visit theIBFAN website at www.ibfan.org

Source: IBFAN(www.ibfan.org/english/news/press/press31july03.html) Guardian 03.08.01, Birmingham Post03.07.31, Food Navigator 03.08.05

T

Wyeth, makers of SMA, convicted ofillegally advertising directly to par-ents in the UK.

ing information surroundinginfant nutrition. This bookletundermines breastfeedingand gives incorrect anddeceptive information tomothers."

On October 10th, INFACT senta follow-up letter to Mr. Westonand included Lynette's letter. Ourrequest, "…that any outstandingcopies of HealthWise and BabyMatters booklets be removed fromstore shelves across Canada andthat Loblaw Companies Ltd. com-ply with the International Code ofMarketing of Breast-milkSubstitutes."

We await his reply.

INFACT Canada's next 18-hour LactationManagement Courses will be held in TorontoJanuary 29 - 31, 2004 May 14 -16, 2004

For more information, to register for a Toronto course, or to booka training in your area call INFACT Canada - 416-595-9819

intervention, of humanitarian aidworkers to breastfeed - a freeand sustainable act.

Human rights are always ofgrave concern. Women con-tinue to suffer injustices inpublic places because theyasert their assertion of theirright to breastfeed theirbabies. Globally, the struggleto achieve adequate materni-ty benefits as well as work-place accommodation forbreastfeeding women contin-ues.

The issues that werehighlighted by the theme ofWorld Breastfeeding Weekreaffirm the necessity for the

breastfeeding com-munity to think glob-ally and act locally.Increasingly, there isa need for people toconsider the issuesthat affect us world-wide and use theknowledge gained toaid in the society inwhich they live.Through the protec-tion and encourage-ment of a supportiveview of breastfeed-ing, we can achievecultures that enableall women to breast-feed. In the end weall benefit.

INFACT Canada Newsletter Spring 2003 · Page 7INFACT Canada Newsletter Spring 2003 · Page 10

Loblaws falls short on promise to be Code compliant.n April 30th, 2003,INFACT Canada staffmember Suzanne Elston

joined members of Greenpeace atthe Loblaw Companies AnnualGeneral Meeting. INFACT hadbeen invited to the event to helpGreenpeace launch its new book-let, "How to Avoid GeneticallyEngineered Foods." Greenpeacehad purchased shares in the com-pany to enable them to addressthe shareholder's meeting.Holding a Greenpeace proxy,Suzanne was able to ask Loblaw'sCEO Galen Weston if he wasaware that the booklet BabyMatters which had been freely dis-tributed in Loblaw's stores acrossCanada, violated the World HealthOrganization's InternationalCode of Marketing ofB r e a s t - m i l kSubstitutes.

Mr. Westoninvited INFACT tomeet with Loblaw'sVice President ofIndustry & InvestorsRelations Geoff Wilson,and Senior Director ofPharmacy FrankKwiecien, to discuss howLoblaw's could becomeCode compliant. At a meetingon May 9th, Mr. Wilson and Mr.Kwiecien were provided withsubstantial information about theInternational Code and its impor-tance to infant health. It was clear-ly outlined how the Loblaw'sbrochure, Baby Matters, violatedthe International Code. Wilson andKwiecien were encouraged toseek alternative advertisers for thebooklet and were provided with afew Code-friendly suggestions.

Subsequent to the meeting,further information was sent toclarify the roles and responsibili-ties of retailers, and reiterateexactly what was and wasn'tacceptable in terms of advertising

and content in any future publica-tions.

INFACT had no further contactwith Loblaw's until June 26th,when In Store Solutions contactedINFACT asking for final commenton the Summer 2003 issue ofHealthWise - Loblaw's in storehealth promotion publication. Thisissue, entitled, All About Baby,contained a number of significantviolations of the InternationalCode including misleading andinaccurate information regardingbreastfeeding and ads for formulaand infant feeding paraphernalia.

INFACT responded by careful-ly pointing out where the bookletwas in violation of the InternationalCode and how the language of thearticles it contained was detrimen-tal to the support of breastfeeding.The content errors were corrected

and a negative article on breast-feeding was replaced with infor-mation from the La Leche Leaguewebsite. However, whenHealthWise was finally printed,the booklet still contained two full-page ads for formula and a full-page advertisement for Avent,makers of baby bottles and otherrelated equipment.

What's puzzling is whyLoblaw's went so far to improvethe content of the booklet, andthen fell short of fully complyingwith the International Code in itsadvertising. The changes thatwere made held up the publicationof the booklet for several weeksand involved fairly extensive (andlikely expensive) revisions. Butbecause of the advertising, the

final product violates theInternational Code and

Loblaw's inherentresponsib i l i ty

as both a manu-facturer and dis-

tributor of infantfoods - something

that Galen Westonpromised would not

happen. As Article 11.3of the International Code

clearly states,

"Independent of anyother measures taken for

implementation of thisCode, manufacturers anddistributors of products with-in the scope of this Codeshould regard themselvesas responsible for monitor-ing their marketing practicesaccording to the principlesand aims of this Code, andfor taking steps to ensurethat their conduct at everylevel conforms to them."

On July 16th, INFACT Canadasent a letter to Mr. Weston,requesting that the 250,000 copies

Continued on pg. 11

OWorld Breastfeeding Week 2003 Summary

xamining this year’stheme, Breastfeeding ina Globalized World for

Peace and Justice, enabled thebreastfeeding community torecognize and focus locally onglobal issues surrounding theprotection and support ofbreastfeeding. It provided anoccasion to consider the chal-lenges and opportunitiesraised by globalization, whileidentifying the tools that areavailable to alleviate thesechallenges. Identification ofthese tools for action aids inour understanding of theirpractical application andimplementation.

Globalization hasexpanded the powerof corporations tomarket and advertisetheir products andfemale breasts havebecome key market-ing tools. Becausethe breast hasbecome so linked tosexuality, manywomen object tobreastfeeding, despitethe importance to theirbabies. Corporatedominance has madethe regulation of themarketing of breast-milk substitutes moredifficult, encouragingfalse health claims, the dissemi-nation of misleading information,and marketing promotions thatidealize bottle feeding.

Furthermore, globalizationdeepens concerns about thecontamination of breastmilkthrough global pollution. Despitethis, breastfeeding is the optimal

food for infants and young chil-dren. When compared withother foods, all of which are con-taminated, breast

feeding offers additionalimmunological benefits that otherfoods cannot provide. As well,mothers and babies in situationsof poverty and emergencies donot need cases of formuladropped as humanitarian aid.Instead, they need to be support-ed, without intervention from theinfant formula industry with out

E

NEWSHA TAZAKOLIAM/GLOBE AND MAIL

Mother breastfeeding her child in war-torn Iraq

Celebrate WorldBreastfeeding Week

2004

"Exclusive breastfeed-ing: the gold standard -safe, sound and sustain-able"

INFACT Canada Newsletter Spring 2003 · Page 9INFACT Canada Newsletter Spring 2003 · Page 8

Breastfeeding Challenge Update

his year's QuintessenceBreastfeeding Challengewas bigger and better thanever before. More than

2200 breastfeeding pairs and theirfamilies participated in the event thattook place at 134 sites in 20provinces, territories and statesacross North America. Challengeorganizer Frances Jones says thatshe is delighted with the numbersthat show a dramatic increase overlast year and is pleased that eightUS states joined the Challenge forthe first time.

"The Challenge fosteredmore discussion aboutbreastfeeding issues thanwe've ever had before," saidJones. "The ideathat all these differ-ent sites and organ-izers put theirhearts and soulsinto promotingbreastfeeding andsupporting womenis inspiring."

"Some breastfeed-ing women are stilltoo uncomfortableto nurse in public,"she added."Women should bewelcomed to breastfeedanywhere and anytime. TheChallenge reinforces theneed for community sup-port."

Plans are already underway fornext year's challenge. Organizershope to simplify the process andsave a few trees by offering onlineregistration. The goal is to haveevery province, territory, and stateparticipate.

Whitehorse wins again!

Top honors in the BreastfeedingChallenge were awarded to

Whitehorse again this year. BrendaDedon, Community Health Nurse atthe Whitehorse Health Centre andcoordinator of this year's challenge,credits lots of advertising and build-ing on last year's success as thekeys to the Whitehorse victory.

"Nothing succeeds likesuccess. Being last year'swinner helped," said Dedon."The trick is to have lots ofverbal contact with breast-feeding moms through publichealth centres and clinics."

Dedon reports that they hadplenty of repeat customers, withbabies ranging in age from 9 days to27 months. What's particularly

exciting is that the majority of thebabies (56%) were more than sixmonths old, and half of thosewere over a year. Dedon notes thatmany of the parents who participat-ed last year were inspired to contin-ue to nurse in order to participate inthis year's Challenge.

"We are seeing a trendtoward longer feeding sincemost moms have a year off,"said Dedon.

In total, the Yukon reported 48mom and baby couples, along withfamily members, for the Challenge,with 36 located at the Whitehorse

site, making them the winner asregion with the most women breast-feeding as a percentage of the birthrate.

Victoria is victorious!

Victoria won the day for havingthe largest number of breastfeedingmoms at one site. In total, 109moms and 112 children and theirfamilies gathered at Victoria's MossStreet Market, an open-air venuethat sells organic produce andcrafts. This year marked the thirdChallenge event for Victoria. For thepast two years, organizers haverented a local high school auditori-um. The goal was to get the eventout into the open. Challenge organ-

izer Eva Bild says wordof mouth was animportant factor in theirsuccess. The localpress also took a keeninterest. Two radio per-sonalities promotedthe event beforehandand acted as hosts.They were joined bythree city councilorswho performed theduty of official witness-es.

Bild says that hav-ing the Vancouver Island HealthAuthority and BreastfeedingMatters, a local promotion group,provide sponsorship for the eventreally made a difference and provid-ed the essential funding for advertis-ing.

The Breast is Best in Peterborough

A total of 43 breastfeedingmothers and their babies gatheredat the Peterborough Galaxy movietheatre for the Challenge. Theatreowners donated the theatre andtreated moms to an afternoon mati-nee. The event got a boost from TheWolf - a local radio station. Wolf DJ

TJay Sharp was on hand to act as anofficial witness and he delightedeveryone by donning an INFACTCanada Joey T-shirt. During theevent, a copy of the "BreastfeedingAnswer Book", was donated to RobDevitt, CEO of the PeterboroughRegional Health Care Centre. MPPeter Adams made an appearanceand gave a brief speech aboutcreating a supportive communityfor breastfeeding women, and ateam of local high school stu-dents helped countdown theChallenge.

INFACT Canada memberMelisande Neal MC'd the event.She said that the framed appreci-ation certificates, given to the offi-cial witnesses, help carry themessage of breastfeeding sup-port into the community. PeterAdams, who also officiated at lastyear's event, has received manycomments about last year's cer-tificate that is proudly displayedin his office.

Peeling it off in Peel

Peel Region's event beganwith a breastfeedingwalk throughStreetsville MemorialPark and then movedindoors to theStreetsville Kinsmenand Seniors Centre,thanks to the rain. Intotal 41 nursing pairsand their familieswere treated to pre-sentations by FatimaCampos and PennyVan Esterik. Bothwomen addressedbreastfeeding as aglobal issue. Pennyemphasized the lackof breastfeeding sta-tistics in this country.

"It's quite shocking thatwe are unable to get compa-rable statistics for Canada,"she said. "Our informationshould comparable to

WHO/UNICEF to see how weare doing."

Families gather at Toronto's HolyTrinity

INFACT Canada hosted thedowntown Toronto site at the pictur-esque Church of the Holy Trinity. A

group of 24 mother and baby pairswere joined by a host of fathers,grandfathers, siblings and friendsfor our inaugural event. We wereparticularly pleased with the amountof media coverage we received from

CTV, CityTV and Now Magazinethat helped to further the promotionof breastfeeding awareness. Thanksto everyone who attended.

Hamilton Latches On!

Although Hamilton's event washeld on October 2nd, and therefore

not officially a part of theChallenge, the City of Hamilton'sPublic Health and CommunityServices Department,Breastfeeding Promotion WorkGroup hosted a "Latch In" thatattracted 63 nursing mothers and9 non-nursing mothers. A sup-porting cast of siblings, fathers,grandparents and friends,brought the attendance figures toover 200. It is interesting to notethat non-nursing women of child-bearing age were invited.Organizers hope that event willencourage these moms tobreastfeed any subsequent chil-dren.

The event included 11 dis-plays featuring family-friendlycommunity resources that wereset-up in the theatre lobby. Dr.

Moyez Ladhani, Deputy Chief ofPediatrics from St.J o s e p h ' sHealthcare, andJennifer Mossop, abreastfeeding momand newly electedmember of theOntario Legislature,both gave briefspeeches before themain event. (In total,organizers collectedmore than 48 doorprizes, including 20free movie passesand resources fromINFACT Canadathat were awardedat the event.

Cheryl Morrow, one of the eventorganizers reports, "Some of themoms asked us if we could do thisevery week they had such a goodtime!"

Whitehorse’s winning team

DJ Jay Sharp shows breastfeeding form

Toronto’s Breastfeeding Challenge at the Church of the Holy Trinity

INFACT Canada Newsletter Spring 2003 · Page 9INFACT Canada Newsletter Spring 2003 · Page 8

Breastfeeding Challenge Update

his year's QuintessenceBreastfeeding Challengewas bigger and better thanever before. More than

2200 breastfeeding pairs and theirfamilies participated in the event thattook place at 134 sites in 20provinces, territories and statesacross North America. Challengeorganizer Frances Jones says thatshe is delighted with the numbersthat show a dramatic increase overlast year and is pleased that eightUS states joined the Challenge forthe first time.

"The Challenge fosteredmore discussion aboutbreastfeeding issues thanwe've ever had before," saidJones. "The ideathat all these differ-ent sites and organ-izers put theirhearts and soulsinto promotingbreastfeeding andsupporting womenis inspiring."

"Some breastfeed-ing women are stilltoo uncomfortableto nurse in public,"she added."Women should bewelcomed to breastfeedanywhere and anytime. TheChallenge reinforces theneed for community sup-port."

Plans are already underway fornext year's challenge. Organizershope to simplify the process andsave a few trees by offering onlineregistration. The goal is to haveevery province, territory, and stateparticipate.

Whitehorse wins again!

Top honors in the BreastfeedingChallenge were awarded to

Whitehorse again this year. BrendaDedon, Community Health Nurse atthe Whitehorse Health Centre andcoordinator of this year's challenge,credits lots of advertising and build-ing on last year's success as thekeys to the Whitehorse victory.

"Nothing succeeds likesuccess. Being last year'swinner helped," said Dedon."The trick is to have lots ofverbal contact with breast-feeding moms through publichealth centres and clinics."

Dedon reports that they hadplenty of repeat customers, withbabies ranging in age from 9 days to27 months. What's particularly

exciting is that the majority of thebabies (56%) were more than sixmonths old, and half of thosewere over a year. Dedon notes thatmany of the parents who participat-ed last year were inspired to contin-ue to nurse in order to participate inthis year's Challenge.

"We are seeing a trendtoward longer feeding sincemost moms have a year off,"said Dedon.

In total, the Yukon reported 48mom and baby couples, along withfamily members, for the Challenge,with 36 located at the Whitehorse

site, making them the winner asregion with the most women breast-feeding as a percentage of the birthrate.

Victoria is victorious!

Victoria won the day for havingthe largest number of breastfeedingmoms at one site. In total, 109moms and 112 children and theirfamilies gathered at Victoria's MossStreet Market, an open-air venuethat sells organic produce andcrafts. This year marked the thirdChallenge event for Victoria. For thepast two years, organizers haverented a local high school auditori-um. The goal was to get the eventout into the open. Challenge organ-

izer Eva Bild says wordof mouth was animportant factor in theirsuccess. The localpress also took a keeninterest. Two radio per-sonalities promotedthe event beforehandand acted as hosts.They were joined bythree city councilorswho performed theduty of official witness-es.

Bild says that hav-ing the Vancouver Island HealthAuthority and BreastfeedingMatters, a local promotion group,provide sponsorship for the eventreally made a difference and provid-ed the essential funding for advertis-ing.

The Breast is Best in Peterborough

A total of 43 breastfeedingmothers and their babies gatheredat the Peterborough Galaxy movietheatre for the Challenge. Theatreowners donated the theatre andtreated moms to an afternoon mati-nee. The event got a boost from TheWolf - a local radio station. Wolf DJ

TJay Sharp was on hand to act as anofficial witness and he delightedeveryone by donning an INFACTCanada Joey T-shirt. During theevent, a copy of the "BreastfeedingAnswer Book", was donated to RobDevitt, CEO of the PeterboroughRegional Health Care Centre. MPPeter Adams made an appearanceand gave a brief speech aboutcreating a supportive communityfor breastfeeding women, and ateam of local high school stu-dents helped countdown theChallenge.

INFACT Canada memberMelisande Neal MC'd the event.She said that the framed appreci-ation certificates, given to the offi-cial witnesses, help carry themessage of breastfeeding sup-port into the community. PeterAdams, who also officiated at lastyear's event, has received manycomments about last year's cer-tificate that is proudly displayedin his office.

Peeling it off in Peel

Peel Region's event beganwith a breastfeedingwalk throughStreetsville MemorialPark and then movedindoors to theStreetsville Kinsmenand Seniors Centre,thanks to the rain. Intotal 41 nursing pairsand their familieswere treated to pre-sentations by FatimaCampos and PennyVan Esterik. Bothwomen addressedbreastfeeding as aglobal issue. Pennyemphasized the lackof breastfeeding sta-tistics in this country.

"It's quite shocking thatwe are unable to get compa-rable statistics for Canada,"she said. "Our informationshould comparable to

WHO/UNICEF to see how weare doing."

Families gather at Toronto's HolyTrinity

INFACT Canada hosted thedowntown Toronto site at the pictur-esque Church of the Holy Trinity. A

group of 24 mother and baby pairswere joined by a host of fathers,grandfathers, siblings and friendsfor our inaugural event. We wereparticularly pleased with the amountof media coverage we received from

CTV, CityTV and Now Magazinethat helped to further the promotionof breastfeeding awareness. Thanksto everyone who attended.

Hamilton Latches On!

Although Hamilton's event washeld on October 2nd, and therefore

not officially a part of theChallenge, the City of Hamilton'sPublic Health and CommunityServices Department,Breastfeeding Promotion WorkGroup hosted a "Latch In" thatattracted 63 nursing mothers and9 non-nursing mothers. A sup-porting cast of siblings, fathers,grandparents and friends,brought the attendance figures toover 200. It is interesting to notethat non-nursing women of child-bearing age were invited.Organizers hope that event willencourage these moms tobreastfeed any subsequent chil-dren.

The event included 11 dis-plays featuring family-friendlycommunity resources that wereset-up in the theatre lobby. Dr.

Moyez Ladhani, Deputy Chief ofPediatrics from St.J o s e p h ' sHealthcare, andJennifer Mossop, abreastfeeding momand newly electedmember of theOntario Legislature,both gave briefspeeches before themain event. (In total,organizers collectedmore than 48 doorprizes, including 20free movie passesand resources fromINFACT Canadathat were awardedat the event.

Cheryl Morrow, one of the eventorganizers reports, "Some of themoms asked us if we could do thisevery week they had such a goodtime!"

Whitehorse’s winning team

DJ Jay Sharp shows breastfeeding form

Toronto’s Breastfeeding Challenge at the Church of the Holy Trinity

intervention, of humanitarian aidworkers to breastfeed - a freeand sustainable act.

Human rights are always ofgrave concern. Women con-tinue to suffer injustices inpublic places because theyasert their assertion of theirright to breastfeed theirbabies. Globally, the struggleto achieve adequate materni-ty benefits as well as work-place accommodation forbreastfeeding women contin-ues.

The issues that werehighlighted by the theme ofWorld Breastfeeding Weekreaffirm the necessity for the

breastfeeding com-munity to think glob-ally and act locally.Increasingly, there isa need for people toconsider the issuesthat affect us world-wide and use theknowledge gained toaid in the society inwhich they live.Through the protec-tion and encourage-ment of a supportiveview of breastfeed-ing, we can achievecultures that enableall women to breast-feed. In the end weall benefit.

INFACT Canada Newsletter Spring 2003 · Page 7INFACT Canada Newsletter Spring 2003 · Page 10

Loblaws falls short on promise to be Code compliant.n April 30th, 2003,INFACT Canada staffmember Suzanne Elston

joined members of Greenpeace atthe Loblaw Companies AnnualGeneral Meeting. INFACT hadbeen invited to the event to helpGreenpeace launch its new book-let, "How to Avoid GeneticallyEngineered Foods." Greenpeacehad purchased shares in the com-pany to enable them to addressthe shareholder's meeting.Holding a Greenpeace proxy,Suzanne was able to ask Loblaw'sCEO Galen Weston if he wasaware that the booklet BabyMatters which had been freely dis-tributed in Loblaw's stores acrossCanada, violated the World HealthOrganization's InternationalCode of Marketing ofB r e a s t - m i l kSubstitutes.

Mr. Westoninvited INFACT tomeet with Loblaw'sVice President ofIndustry & InvestorsRelations Geoff Wilson,and Senior Director ofPharmacy FrankKwiecien, to discuss howLoblaw's could becomeCode compliant. At a meetingon May 9th, Mr. Wilson and Mr.Kwiecien were provided withsubstantial information about theInternational Code and its impor-tance to infant health. It was clear-ly outlined how the Loblaw'sbrochure, Baby Matters, violatedthe International Code. Wilson andKwiecien were encouraged toseek alternative advertisers for thebooklet and were provided with afew Code-friendly suggestions.

Subsequent to the meeting,further information was sent toclarify the roles and responsibili-ties of retailers, and reiterateexactly what was and wasn'tacceptable in terms of advertising

and content in any future publica-tions.

INFACT had no further contactwith Loblaw's until June 26th,when In Store Solutions contactedINFACT asking for final commenton the Summer 2003 issue ofHealthWise - Loblaw's in storehealth promotion publication. Thisissue, entitled, All About Baby,contained a number of significantviolations of the InternationalCode including misleading andinaccurate information regardingbreastfeeding and ads for formulaand infant feeding paraphernalia.

INFACT responded by careful-ly pointing out where the bookletwas in violation of the InternationalCode and how the language of thearticles it contained was detrimen-tal to the support of breastfeeding.The content errors were corrected

and a negative article on breast-feeding was replaced with infor-mation from the La Leche Leaguewebsite. However, whenHealthWise was finally printed,the booklet still contained two full-page ads for formula and a full-page advertisement for Avent,makers of baby bottles and otherrelated equipment.

What's puzzling is whyLoblaw's went so far to improvethe content of the booklet, andthen fell short of fully complyingwith the International Code in itsadvertising. The changes thatwere made held up the publicationof the booklet for several weeksand involved fairly extensive (andlikely expensive) revisions. Butbecause of the advertising, the

final product violates theInternational Code and

Loblaw's inherentresponsib i l i ty

as both a manu-facturer and dis-

tributor of infantfoods - something

that Galen Westonpromised would not

happen. As Article 11.3of the International Code

clearly states,

"Independent of anyother measures taken for

implementation of thisCode, manufacturers anddistributors of products with-in the scope of this Codeshould regard themselvesas responsible for monitor-ing their marketing practicesaccording to the principlesand aims of this Code, andfor taking steps to ensurethat their conduct at everylevel conforms to them."

On July 16th, INFACT Canadasent a letter to Mr. Weston,requesting that the 250,000 copies

Continued on pg. 11

OWorld Breastfeeding Week 2003 Summary

xamining this year’stheme, Breastfeeding ina Globalized World for

Peace and Justice, enabled thebreastfeeding community torecognize and focus locally onglobal issues surrounding theprotection and support ofbreastfeeding. It provided anoccasion to consider the chal-lenges and opportunitiesraised by globalization, whileidentifying the tools that areavailable to alleviate thesechallenges. Identification ofthese tools for action aids inour understanding of theirpractical application andimplementation.

Globalization hasexpanded the powerof corporations tomarket and advertisetheir products andfemale breasts havebecome key market-ing tools. Becausethe breast hasbecome so linked tosexuality, manywomen object tobreastfeeding, despitethe importance to theirbabies. Corporatedominance has madethe regulation of themarketing of breast-milk substitutes moredifficult, encouragingfalse health claims, the dissemi-nation of misleading information,and marketing promotions thatidealize bottle feeding.

Furthermore, globalizationdeepens concerns about thecontamination of breastmilkthrough global pollution. Despitethis, breastfeeding is the optimal

food for infants and young chil-dren. When compared withother foods, all of which are con-taminated, breast

feeding offers additionalimmunological benefits that otherfoods cannot provide. As well,mothers and babies in situationsof poverty and emergencies donot need cases of formuladropped as humanitarian aid.Instead, they need to be support-ed, without intervention from theinfant formula industry with out

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NEWSHA TAZAKOLIAM/GLOBE AND MAIL

Mother breastfeeding her child in war-torn Iraq

Celebrate WorldBreastfeeding Week

2004

"Exclusive breastfeed-ing: the gold standard -safe, sound and sustain-able"

INFACT Canada Newsletter Spring 2003 · Page 11INFACT Canada Newsletter Spring 2003 · Page 6

The Maternity Protection Campaign Kit: A Breastfeeding Perspective

he Maternity Protection Coalition (a joint effort of IBFAN, ILCA, Linkagesand WABA) has put together The Maternity Protection Campaign Kit: ABreastfeeding Perspective with technical input from IMCH and UNICEF.

The kit's aim as an action tool is for groups and individuals wishing to promotematernity protection at the workplace, and lobby for the ratification of ILOConvention 183 (2000) or stronger national laws. Breastfeeding protection sup-ports and encourages maternity protection, and maternity protection supports andencourages breastfeeding. For this reason, the issues have a mutual, beneficialrelationship. The kit highlights this relationship and outlines the ways in whichthese campaigns can work together- length of leave, timing of leave, financial andhealth benefits for example.

The kits are available from INFACT Canada.

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TOWARDS HEALTHY ENVIRONMENTS FOR CHILDREN: FAQ about breastfeeding in a contaminated environment

n an easy-to-understand,Question & Answer format, anew fact sheet, Towards

Healthy Environments for Children:Frequently asked questions aboutbreastfeeding in a contaminatedenvironment, provides critical infor-mation. It addresses such ques-tions as should mothers worry aboutchemical contamination, why chem-

icals find their way into breastmilkand can chemical pollution harmbreastfed babies. It also outlineshow the media and baby food man-ufacturers use the pollution ofbreastmilk as a pressure point topromote formula.The FAQ fact sheet is a collabora-tive effort between IBFAN, LLLI,Linkages and WABA, and was pre-

pared by Penny Van Esterik of YorkUniversity. It states,

"The existence of chemicalresidues in breastmilk is not areason for limiting breastfeed-ing. In fact, it is a reason tobreastfeed because breast-milk contains substances thathelp children develop astronger immune system andgives protection against envi-ronmental pollutants andpathogens."

Towards Healthy Environments forChildren: Frequently asked ques-tions about breastfeeding in a con-taminated environment, is availablein print form from the INFACTCanada office, and will be availablefor download in a PDF format fromthe INFACT Canada website at:

www.infactcanada.ca

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of HealthWise that have been dis-tributed across Canada be removedfrom store shelves. Thus far, the let-ter remains unanswered.

Unfortunately, the story doesn'tend there. In October, INFACTCanada received a letter fromLynette Amirault from the YarmouthBaby-Friendly Initiative Committee.Apparently Loblaw's first (and moredamaging) booklet, Baby Mattersis still in wide distribution in theMaritimes through the AtlanticSuperstores chain (a Loblaw's com-pany). In her letter to AtlanticWholesalers, Ms. Amirault wrote,

"We have concerns withthis unsolicited booklet andthe inaccurate and mislead-

WHAT YOU CAN DO:

Obtain a copy ofHealthWise or Baby Mattersfrom Loblaw's store acrossCanada and send your com-ments to: healthwise@aibn.com.

Write Galen Weston andlet him that he shouldn'tmake promises he won'tkeep!

Mr. Galen WestonChairman and PresidentGeorge Weston Ltd.22 St. Clair Avenue EastSuite 1801Toronto, OntarioM4T 2S8

Wyeth convicted of illegal advertisinghe British Court found for-mula giant Wyeth, the par-ent company of SMA

Nutrition, guilty of illegal advertisingon July 8th. Wyeth, the secondlargest baby milk manufacturer inthe world, had challenged the Britishgovernment's right to regulate themarketing of baby milk products.The decision effectively outlawssimilar advertisements by otherbaby food companies.

In his decision, Judge Rosssaid, "The Defendants have deliber-ately crossed the line in an effort toadvertise direct(ly) to a vulnerablesection of society. This is a cynicaland deliberate breach of regula-tions."

The Judge fined Wyeth/SMA atotal of £26,000 ($ 58,000 Cdn.) pluscosts of £34,808 ($ 78,000 Cdn.).

He found that Wyeth/SMA had notexerciseddue diligence and that SMA Director,Graham Crawford, had been "extra-ordinarily evasive throughout hiscross-examination and that hisexpertise was rather less than hewanted me to believe."

In response to the conviction,Patti Rundall, Policy Director ofBritain's Baby Milk Action said,

"This case has serious

implications for infant healthand Trading Standards are tobe applauded for theircourage in pursuing it, espe-cially as they were up againstthe massive legal and finan-cial resources available tothis pharmaceutical giant. Wehope that Wyeth will acceptthe ruling and not cause fur-ther expense to the publicpurse by attempting to havethe UK ban on advertisingscrapped."

For more information, visit theIBFAN website at www.ibfan.org

Source: IBFAN(www.ibfan.org/english/news/press/press31july03.html) Guardian 03.08.01, Birmingham Post03.07.31, Food Navigator 03.08.05

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Wyeth, makers of SMA, convicted ofillegally advertising directly to par-ents in the UK.

ing information surroundinginfant nutrition. This bookletundermines breastfeedingand gives incorrect anddeceptive information tomothers."

On October 10th, INFACT senta follow-up letter to Mr. Westonand included Lynette's letter. Ourrequest, "…that any outstandingcopies of HealthWise and BabyMatters booklets be removed fromstore shelves across Canada andthat Loblaw Companies Ltd. com-ply with the International Code ofMarketing of Breast-milkSubstitutes."

We await his reply.

INFACT Canada's next 18-hour LactationManagement Courses will be held in TorontoJanuary 29 - 31, 2004 May 14 -16, 2004

For more information, to register for a Toronto course, or to booka training in your area call INFACT Canada - 416-595-9819

hen Nestlé staged anew product promotionat Toronto's Dundas

Square in October, INFACT Canadawas on hand to confront companyrepresentatives. Forthe several Nestléexecutives in atten-dance, it soonbecame obvious thatthe company's claimthat "…there is nolonger any significantboycott activity" is nottrue in Ontario's capi-tal. Waving a seven-foot banner that read"Stop Baby BottleDeaths, BoycottNestlé", INFACTemployees and agroup of boycotterstook to the squareand began handingout leaflets andstickers to those looking for a freesample of Nestlé chocolate milk.

Most were eager to learn whyNestlé was being targeted and wereshocked to hear about the compa-ny's deplorable behaviour. In all,close to a thousand people wereinformed about the boycott, with

many instantly pledging to boycottNestlé. At least one person pouredhis cup of chocolate milk on theground after speaking with anINFACT employee.

Despite the fact that DundasSquare is a public space, the boy-cotters were confronted by securityseveral times, and told they werenot legally allowed to pass outleaflets. This did not stop INFACTfrom approaching people as theyentered and left the square making

sure that everyone Nestlé tried toentice with chocolate milk was givena glimpse of the less savoury side ofthe corporation.

This demonstration was one ofthe first stepstowards whatINFACT Canadahopes will be ar e v i t a l i z e dCanadian NestléBoycott campaign.In the next fewmonths, INFACTwill be monitoringNestlé's activitiesand taking actionagainst the compa-ny whenever pos-sible. To keep upto date with allNestlé Boycottnews, join theINFACT CanadaNestlé Boycott

mailing list by going to the Boycottsection on our website atwww.infactcanada.ca.

Join the Nestle Boycott mailinglist! email us at: ben@infactcana-da.ca for regular updates on thecampaign. Nestle Boycott actionkit coming soon!

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INFACT Canada Newsletter Spring 2003 · Page 5INFACT Canada Newsletter Spring 2003 · Page 12

Norway Leads Industrial Nations Back to Breastfeeding n astounding 99 percent ofNorwegian mothers breast-feed their newborns. Six

months later, 80 percent are stillbreastfeeding. These amazing suc-cess rates are the result of a grass-roots campaign that began morethan thirty years ago. Convincedthat breastmilk was better than for-mula, Elisabet Helsing lead thecampaign by writing a light-heartedguide to breastfeeding in 1970. Sheasked a local health official - ayoung Gro Harlem Bruntland - if shewould consider printing the booklet.The rest, as they say, is history.

Dr. Bruntland went on tobecome Norway's prime ministerand received world acclaim as anarchitect of sustainable develop-ment and head the World HealthOrganization. In Norway, Dr.Helsing's efforts led to the creationof several mother-to-mother supportgroups that ultimately stoked a

national increase in breastfeeding.Government funding supplied train-ing for hospital staff, encouragingthe establishment of baby-friendlypractices.

Today, mothers breastfeed any-where, anytime - on buses, in parks,cafes and stores. Norway's extendedmaternity benefits support breast-feeding mothers, who receive 10months leave at full pay or 12months leave at 80 percent pay.Women who return to work are giventwo hours off a day to breastfeedtheir child, either at home or in theoffice, and women are also allowedto breastfeeding at their desks.

Formula, once a staple inmaternity wards, is conspicuouslyabsent. Formula advertising isbanned. And since formula is rarelyused, stores only stock a very limit-ed amount. The baby bottle, oncean icon on shower invitations and

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Australian Breastfeeding Gets Star Qualityustralian comedian, KateLangbroek, made televi-sion history in September

when she, as a celebrity breastfedon national television. Ms.Langbroek was making her first tel-evision appearance after the birth ofher son six weeks earlier. When hegot hungry, she fed him.

This perfectly normal act hasstirred up quite a controversy inAustralia, a country known for itssupport of breastfeeding. Whilesome entertainers are critical of Ms.Langbroek's actions, Lee King,director of the AustralianBreastfeeding Association, is callingfor more role models.

"In sitcoms and variousshows when there are char-acters having a baby which iswritten into the script, they

should follow on to breast-feed as well," said Ms. King.

Equal Opportunity CommissionerDiane Sisely applauded Langbroekfor claiming her right to breastfeedin the workplace.

"I hope it becomes so unre-markable that there won't behysteria when other womendo this," she said.

Dr. Ingrid Tall, president of theAustralian Medical Association alsosupported Langbroek's actions. Andcommenting on the health impactsof breastfeeding for both mother andchild,

"If a woman doesn'tbreastfeed,” she noted, “itraises her risk of ovarian can-cer and breast cancer. If thebaby doesn't get breastfed

their IQ can be potentiallylowered by a few points andthey are at greater risk ofinfections and [at] a greaterrisk of asthma [and] aller-gies."

Earlier this year, Australian MPKirstie Marshall made internationalheadlines when she was evictedfrom Victoria's Legislature forbreastfeeding her 11-day olddaughter. According to officials,Marshall was removed not becauseshe was breastfeeding, but becauseshe brought a non-elected personinto the chamber.

Source: Daniel Dasey, AAP, September 19,2003Australian Parents websitehttp://azure.bbboy.net/australianparents-viewthread?forum=9&thread=106

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Canada Health Protection Act alert ealth Canada is currentlyreviewing its various healthlegislations to develop a

new act, the Canada HealthProtection Act (CHPA). As part ofthe process, public consultations willbe held across the country. INFACTCanada members are encouragedto participate in these consultationsto ensure that public health interestsand needs are foremost and are nothijacked by the economic interestsof the pharmaceutical, infant formu-la and food companies. Those of usworking for the protection of breast-feeding need to lobby HealthCanada on the importance of having

our health legislation conform to theWHO International Code ofMarketing of Breast-milk Substitutesand subsequent relevantResolutions of the WHA. Our goal isto ensure that marketing restrictionsand informative labelling be in placeto support breastfeeding and opti-mal complementary feeding prac-tices.

Key issues of concern include:

Advertising restrictions asrequired by the International Codefor infant foods

Labelling (as defined to include all

packaging materials, shelf talkers,brochures and anything accompa-nying the infant formula product)that is informative and does notidealize infant formula and infantfoods No nutrition and health claims forinfant formulas and foods forinfants and young children

Background materials for the revieware on Health Canada's website at:http://renewall.hc-sc.gc.caFor more information, contact theINFACT Canada office 416-595-9819, or email Elisabeth Sterken atesterken@infactcanada.ca

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INFACT Canada Embarrasses Nestlé

other baby items, is rarely seen. Norwegian mothers say every-

thing about their culture compelsthem to breastfeed. "It's somethingthat is part of being a mother," saidAnne Baerug, the project leader forNorway's National Breast-FeedingCentre.

The Norwegian example pro-vides an excellent model forCanada, which already has year-long maternity benefits in place.What is missing is the structural,financial and governmental supportthat will ensure that breastfeeding isaccepted as the norm. In order tomatch Norway's success, we needpolitical leadership to uphold theprovisions of the InternationalCode, including legislation to banthe advertising and promotion offormula, as well as adequate fund-ing for promotion and training ofhealth care professionals.SOURCE: Lizette Alvarez, New York Times,October 21, 2003

INFACT Canada’s Ben Spurr hands out Nestlé brochures at Dundas Square.

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Formula Deaths Raise Concerns About Manufacturing Safety

ontroversy and fear aroserecently in Israel and world-wide with the discovery that

a kosher soy formula lacked therequired amount of Vitamin B1 - thi-amine - resulting in the deaths ofthree infants. The deficient formulahas also been associated with thepotentially fatal brain damage in atleast ten other babies. Remedia,the formula produced by theGerman company HumanaMilchunion, boasts H.J. Heinz Co.as a primary shareholder.

Thiamine, an essential B vita-min, is a required ingredient in babyformula needed to support thegrowth and development of thenervous system. Lack of this vita-min over a continuous period ofapproximately 18 days can causesevere brain damage and evendeath. The infants who died hadsymptoms of brain damage - diar-rhoea, vomiting, and restlessness -as did the other children whobecame ill. All had been fed thedeficient Remedia kosher soy for-mula.

Reports indicate that the manu-facturer of the product, HumanaMilchunion, failed to add the proper

amount of 385 micrograms of thi-amine for every 100 grams of formu-la. Instead they added only 29-37micrograms per 100 grams, eventhough the product label indicated385 micrograms. According toRemedia, Humana Milchunion wasunder the mistaken impression thatsoybeans contained enough thi-amine to warrant a removal of theessential vitamin without proper ver-ification.

These tragic deaths again callinto question the safety of formulafeeding and the need to warn par-ents of its risks. Not only does for-mula lack the immunological bene-fits of breastmilk, but it may containcontaminants, such as Enterobactersakazakii. Parents need to be fullyinformed regarding the choice to for-

mula feed. Furthermore, the refusalof many governments to regulatethese products according to theInternational Code of Marketing ofBreastmilk Substitutes, aggrevatesthe problem. Much of the time fam-ilies buy a product without anyknowledge of what it contains. Inaddition to these reoccurring con-cerns about the safety of labelling,the Remedia issue only adds moreuncertainty.

Source: Ran Reznick, Dafna Lutsky,Jonathan Lis, Ora Coren, Haaretz, November9 & 12, 2003, Laurie Copans, November 10,2003, &http://kyw.com/recalls/recalls_story_3130200912.html. Retrieved November 17, 2003

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INFACT Canada Newsletter Spring 2003 · Page 13INFACT Canada Newsletter Spring 2003 · Page 4

SOY FORMULA BOYCOTT IN NEW ZEALAND

roups in New Zealand are calling for a boycott on all infant soy formulas until the public istold which formulas contain genetically modified ingredients. The national government hasrefused to disclose the names of brands containing GM ingredients because the products'

levels of GM contamination are below the legal 1 percent threshold and as such the companiesproducing them have broken no law. Those calling for the boycott argue that it is a parent's rightto know what they are feeding their child.

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Jamaican Health Minister: Globalization a Threat to Breastfeeding

ohn Junior, Jamaica'sMinister of Health, cautionedabout the negative impact of

globalization on breastfeeding dur-ing the launch of Jamaica's NationalBreastfeeding Week in September.

According to an article in theJamaica Observer Reporter,Minister Junior said,

"World Trade Organizationpriorities, and preserving theeconomic interest of the devel-oped world and international co-operation are major areas offocus, many times putting profitahead of mother-to-child publichealth programs. The issuesaffecting mothers and childrenare therefore often suppressedby these realities and, becauseof this, we must guard againstthe weakening of theInternational Code of Marketingof Breast-milk Substitutes whichcould be endangered by theseprocesses."

"The onus is on us to preserveand promote the breast feeding

culture for the health and wellbeing of all our mothers andbabies while at the same timepromoting peace and justice," heconcluded.

Fitzroy Henry, nutritionist anddirector of the Caribbean Food andNutrition Institute (CFNI), echoedJunior's concerns. "In this globalizedenvironment, the need for economicgain puts profit before people -- amajor problem for social sectorssuch as health and the needs ofmothers and children are easilyjeopardized," he warned."Breastfeeding-friendly practicescan be lost while the commercializa-tion of infant-feeding practices,through breast-milk substitutes,could become the norm -- thereforewe must be vigilant."

Henry warns that theInternational Code can be manipu-lated and interpreted as a restrictionof the right of formula manufacturersto compete freely in the market-place. He also maintains that thebaby food industry has attempted to

mislead people into thinking that theCode is no longer valid. Henry urgespublic and private investment in thepromotion of breastfeeding toreverse declining breastfeedingpractices. He recommends that thefinancial case in favour of breast-feeding must be promoted and citessavings and reduced expenditure onformula, lower net food cost tohouseholds, and lower overallhealth care costs.

Based on Henry's figures, thecost of giving breast-milk substitutesto a three-month old infant was esti-mated in 1991 at 90 per cent of thesalary of a minimum wage earner;78 per cent of a community healthaid's salary; 36 per cent of a clerk's;26 per cent of a teacher's and 22 percent of a registered nurse's salary.He argued that it was important forthese estimates to be done again, inorder to see the real cost of notbreastfeeding.Source: Jamaica Observer Reporter,September 18, 2003

Drug Companies Push to Influence Cochrane Collaboration

he Cochrane Collaborationwill debate the issue ofconflict of interest at the

Annual Cochrane Colloquium inBarcelona in November. TheCochrane Collaboration is an inter-national non-profit and independentorganization, dedicated to makingup-to-date, accurate informationabout the effects of healthcare read-ily available worldwide. It producesand disseminates systematicreviews of healthcare interventionsand promotes the search for evi-dence in the form of clinical trialsand other studies of interventions.

The Collaboration's rulebookcurrently stipulates "direct fundingfrom single source with a vested

interest in the results of the review isnot acceptable." Supporters of drugcompany sponsorship believe thatCochrane needs commercial sup-port and could benefit from compa-

ny perspectives. Opponents saysponsorship will influence researchagendas and damage theCollaboration's independence andintegrity.

The Cochrane debate comes ata time when there is a growing bodyof evidence that industry funding isassociated with favourable out-comes. Evidence was presentedearlier this year in two large system-atic reviews. Bekelman et al found a"significant association betweenindustry sponsorship and pro-indus-try conclusions" in biomedicalresearch. Lexchin et al showed thatstudies sponsored by pharmaceuti-cal companies were four times morelikely to have outcomes favouringthe sponsors' products when com-pared with studies funded by othersources.Moynihan, Ray, BMJ Vol 327: 924-927, Oct2003

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Remedia, kosher soy formula marketed inIsriael and found to be deficient thiamaine, anessential vitamin.

INTERNATIONAL NEWS

Celebrate WorldBreastfeeding

Week 2004

"Exclusive breastfeed-ing: the gold standard -safe, sound and sus-tainable"

INFACT Canada Newsletter Spring 2003 · Page 3

Safe Co-Sleeping lthough breastfeedingmothers safely co-sleepwith their infants, this age-

old practice is frequently underattack. Safe co-sleeping is oftenconfused by many myths and atti-tudes and evaluated with sleepingarrangements that do place infantsat risk. A case in point is a new studypublished by Dr. James Kemp. TheKemp study notes that the risk ofsuffocation was up to 40 times high-er for infants who sleep in adult bedswhen compared with cribs. What thestudy failed to do was differentiatebetween breastfed and formula fedbabies. In addition, the study did notidentify any risk factors associatedwith parental behaviours includingsmoking, alcohol or drug consump-tion (both legal and illegal) and ill-ness.

Rather than placing babies atrisk, co-sleeping and breastfeedinghave been shown to lower the risk ofSIDS and is recommended by theUNICEF UK Baby Friendly Initiativeand the UK Foundation for the Studyof Infant Deaths.

According to the UNICEF guide,"Sharing a bed with your baby", co-sleeping can make breastfeedingeasier because it allows an infant tonurse on demand with a minimum ofmaternal disruption. Most infantsalso sleep better when they areclose to their mothers, thus provid-ing essential rest for both motherand child. In addition, mothers whoare breastfeeding automaticallysleep facing their infant, which helpsprotect the baby from being coveredby bedding or pillows.

Scheers NJ, Rutherford GW, Kemp JS.Where Should Infants Sleep? Pediatr 112:883.889, 2003

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INFACT Canada Newsletter Spring 2003 · Page 14

CANADA BREASTFEEDS NEWS

Courtroom to Courtroom in Québechile defending a parking ticket in a Montréalcourtroom, a mother and her 4½ month oldbaby were asked by security to leave the

courtroom audience because they were breastfeeding.Feeling embarrassed and ashamed, upon returninghome she decided to contact The Montréal Gazettenewspaper and the Québec Human Rights Commissionto report the treatment she had experienced.

From one courtroom to another, the mother and her

baby received positive judgement: recognizing that herright to breastfeed her child had been violated. Thejudge acknowledged that each child has the right to thebest possible health, that breastfeeding is a natural act,and should not be considered otherwise (it is not an actof exhibition), and that a woman has the right to breast-feed anytime, anywhere!

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Mothers Read Between the Lines

Thyme For Some Actionhyme Maternity, a Canadian maternity clothingretailer, is currently running a contest in whichthe winner receives an RESP for their child from

the Canadian Scholarship Trust Plan. Numerous mem-bers have reported that a recent company cataloguecontains an application for the contest that includes thequestion "Would you like to receive a free sample ofNestlé Goodstart?". This promotion is a blatant violationof the International Code of Marketing of Breast-milkSubstitutes, and undermines the protection of breast-feeding. It also contradicts statements on ThymeMaternity's website which praises breastfeeding as theoptimal method of feeding a baby. The contest applica-tion, assuming it is shared by Thyme with Nestlé, gives

the infant formula company access to the names,addresses and phone numbers of hundreds, if not thou-sands, of new and expectant mothers. Please contactThyme Maternity and let them know that a company whoclaims to be looking after the interests of mother andbaby has no business doing business with Nestlé.

TThyme Maternity250 Sauvé WestMontréal QuébecH3L 1Z2

customers@maternity.ca

lthough seemingly trivial, advertisements andthe media's portrayal of parental roles have apowerful impact on parental decision-making.

To foster a breastfeeding culture, these latent messagesneed to utilize the scientific evidence that is available forthe promotion of optimal parenting practices - includinginfant feeding.

A case in point is recent TV commercials marketinglibrary services to a mainstream audience that containeda baby bottle prominently displayed. In response,INFACT Canada board member Kim Hancock, theDirector of Library Services for the Western Health CareCorporation in Corner Brook, Newfoundland wrote to theCalgary Public Library to point out that the “image sug-gests that bottle feeding is the 'norm' for infant nutrition."She also points out in her letter that:

"As a public library with a vested interest in a

A population who has been provided with theopportunity to reach their highest potential for lit-eracy, there comes a responsibility to not inad-vertently promote health behaviours / decisionswhich ultimately have a negative impact on IQand reading abilities. The 'Breastfeeding:Bringing Evidence to Practice' conference heldNovember 7-8 2003 provided participants withvalidated medical evidence that formula feedingis associated with lower IQ's."

Hancock went on to say: "I urge you to considerchanging your advertisement to remove theimage of the baby bottle. Alternatives include amother nursing her baby in the library - eitherwhile using the computer, or while reading abook to her toddler while nursing [her] infant."

In order to ensure infantsafety, UNICEF recom-mends the following com-mon sense precautionswhile co-sleeping:

Mattresses should be firm,flat and clean.

Babies should not beallowed to get too warm.Babies should not be over-dressed; bedroom temper-ature should be between16 and 18 degreesCelsius.

Mothers who are ill, or whoare taking medication thatmight affect their ability torespond to baby, shouldtemporarily discontinue co-sleeping.

Sheets and blankets arerecommended over duvetsand quilts.

Mothers should ensurethat infants cannot getstuck between the mat-tress and the wall or fallout of bed.

Ensure that others who aresharing the bed (i.e. part-ner, older children) areaware of the infant's pres-ence.

Pets should not be allowedto share the bed.

For further information about the benefitsof co-sleeping, visit:www.babyfriendly.org.uk/parents/leaflets

For information on how to protect againstSIDS, go to: www.sids.org.uk

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UNICEF UK Baby Friendly Initiative, 2003

Mark your Calendars for

The 14th Annual National Breastfeeding Seminar

Breastfeeding: Understanding the Ethical Issues

June 3 & 4, 2004

INFACT Canada Newsletter Spring 2003 · Page 15

Breastfeeding is Protective Against Dental Fluorosis in a Nonfluoridated Rural Area of Ontario, Canada.

Brothwell D, Limeback H. J Hum Lact19: 386-390, 2003

Infants who are fed infant formulas reconstituted with fluoride-containing water have been reportedwith increased incidence of dental fluorosis. Consumption of fluoride may range from 150 to 200 timesgreater for infants fed powdered formulas than for those who are breastfed. The authors set out to studythe relationship between the "prevalence and severity of fluorosis" and infant feeding practices. Therewas no fluoridation in the water system in the community study area (Wellington-Dufferin-Guelph PublicHealth Unit)

Data was obtained for a total of 1,739 children aged 7 to 8 years who were screened for fluorosis andparents filled out a questionnaire regarding early feeding practices. Breastfeeding was reported for 67 percent of the children - 37.3 per cent for less than six months; 24.6 per cent for 6 to 12 months and 7.8 percent greater for more than 12 months. Fluorosis was dose related to the duration of breastfeeding - thelonger the breastfeeding, the lower the presence of fluorosis. Formula feeding was reported by 84 percent of the parents with 93 per cent reporting reconstitution with tap water. Using multivariate analysis theauthors concluded that the longer the breastfeeding, the lower the risk of fluorosis, and that in both fluori-dated and non-fluoridated communities breastfeeding has a protective effect. They also concluded thatthe dental profession should increase efforts to support breastfeeding.

Influence of Breastfeeding on Mental and Psychomotor Development.Gomez-Sanchez M, Canete R, Rodero I, Enrique Baeza J, Aviia O. Clin Pediatr 42: 35-42,

2003

Another study that affirms that not breastfeeding has a detrimental impact on the full potential of cogni-tive development. Using the Bayley Mental and Psychomotor Development Indices these Spanishresearchers set out to determine the impact of breastfeeding and formula feeding on cognitive and motordevelopment at 18 month of age. For infants breastfed for up to 4 months, the mean score in mental devel-opment indices was 4.7 points greater than for formula fed infants. When the infants who were breastfedlonger than 4 months were included in the sample, the difference was 7.2 points. Including parental IQ asa variable still exhibited a positive difference and remained significant for those breastfed longer than 4months. (Note - the authors included those partially breastfed in their breastfeeding cohort - exclusivebreastfeeding may demonstrate an even greater positive effect of breastfeeding on cognitive outcome.)

Solids and Formula: association with pattern and duration of breastfeeding.Hornell A, Hofvander Y, Kylberg E. Pediatr 107: E38, 2001

How is breastfeeding affected when solids are introduced and when formula is introduced? Theseauthors from Sweden studied 506 mother-baby pairs to compare the changes in patterns and duration ofbreastfeeding. They found that the introduction of solids was associated with little or no change in breast-feeding frequency and suckling duration. Frequency remained constant after the first month of introductionand then began to decline slowly and suckling duration started to decline, slowly, after solids were intro-duced. Interestingly they found no effect on breastfeeding duration when solids were introduced. When for-mula was introduced, the impact on sucking and frequency was rapid. Both frequency and suckling dura-tion declined rapidly. As well they determined that the earlier the introduction of the formula, the shorter thebreastfeeding duration. In conclusion they noted that the introduction of solids can be done with the protec-tion of breastfeeding and that health care workers need to be aware of the impact on breastfeeding of intro-ducing formula.

INFACT Canada Newsletter Spring 2003 · Page 2

in this area". Witness the manybooks written to solve aninfant/child's sleep problems and theunderlying assumptions that sleeppractices predispose desired devel-opmental outcomes.

In contrast, in cultures where co-sleeping is the norm mothersexpress horror upon hearing thatbabies may be made to sleep alone.Guatemala ct and a Vietnameseimmigrant mother noted that leavingbabies alone would contribute toSIDS because when you sleep withyour baby you always sleep lightlyand notice breathing changes.Chinese mothers also considerbabies too little to sleep alone andbelieve co-sleeping makes for happybabies. In Africa, separation isunheard of and mothers sleep withtheir children for several years.

McKenna also raises the ques-tion: Does sleeping alone createindividuals who are more independ-ent? Do we get the anticipated out-comes? Research shows us thatquite the reverse is true.

English children who slept alonewere more fearful than children whoco-slept. A survey of college-agesubjects reports males who had co-

slept to have higher self-esteem,and have less guilt and anxiety. Forwomen, co-sleeping was associatedwith easier physical contact andaffection as adults. Other studieshave found that having co-slept pro-moted confidence, self-esteem andintimacy and better relationshipswith teachers and less dependence.

The feeding of baby milks inbottles with artificial teats also con-tributes to our independent sleepingcrisis. This too is an actively promot-ed practice and is often perceived tobe without harm. Studies whichinclude analysis with infant feeding,show that for artificially fed and solesleeping infants, SIDS (or crib deathas it was originally called) is at anincreased risk. The risk of SIDSalso increases with parental smok-ing, legal and illegal drug use, aswell as overdressing children. Whilein societies where co-sleeping isthe norm, SIDS is a rare phenome-non.

A recent longitudinal study3, thatfollowed 154 infants for a period of18 years, notes in its conclusionsthat professionals should be cau-tious about issuing warning to par-ents regarding bed-sharing. "There

North American medicalization of both infant sleeping and feeding raises the important question of how far we have evolved from thebiological norm. Some interesting research shows us the absurdity and severity of solo sleeping and bottle feeding infants.

Human infants are low-solute, frequent suckling species and physiologically adapted for close mother-baby contact, essential for thebaby's optimal development and to maintain the mother's milk supply notes the author. By comparing the sleep logs and interviewing par-ents (253 families) on infant feeding and co-sleeping, the author demonstrates a clear beneficial relationship between bed-sharing andbreastfeeding. At age three months, breastfed infants received night feedings 2 to 3 times per night compared to less than one feed for theformula fed infants. They also found a significant relationship between bed-sharing and duration of breastfeeding and conclude that the datasupports the positive impact of bed-sharing on breastfeeding. Ball HL. Breastfeeding, bed-sharing and infant sleep. Birth 30: 181- 188, 2003

Detailed analysis of the nighttime breastfeeding patterns of 20 co-sleeping mother and baby pairs found that routine bed-sharing infantsbreastfed three times longer than infants who routinely slept separately. The authors suggest that in fact the longer breastfeeding episodescould be protective against SIDS, as breastfeeding has an overall positive impact on reducing the incidence of SIDS. McKenna JJ, Mosko SS, Richard CA. Bed-sharing promotes breastfeeding. Pediatr 102: 662-664, 1997

A meta-analysis and literature review of 23 studies of which 19 studies showed odds ratios indicating breastfeeding as protec

tive against SIDS. The combined analysis determined that bottle-fed infants were twice as likely to die from SIDS.McVea KL, Turner PD, Peppler DK. The role of breastfeeding in sudden infant death syndrome. J Hum Lact. 16: 13-20, 2000

The authors examined sleep arousal patterns for bed-sharing mother and baby pairs and concluded that co-sleeping promotes infantarousals and that these are overlapping more frequently with maternal arousals. The authors suggest that this may be protective againstSIDS as sole sleeping infants may have an arousal deficit and a mother's responsiveness to infant arousals may also be protective.Mosko S, Richard C, McKenna J. Infant arousals during mother-infant bed-sharing: Implications for infant sleep and sudden infant deathsyndrome research. Pediatr 100: 841-849, 1997

is at present no evidence linking thispractice, when engaged responsi-bly, with any sort of problematic out-come.” The authors question theassumption that solitary sleep issafer and more beneficial to chil-dren's well-being. Rather than issuewarnings, a discussion with parentsabout the practice is far more bene-ficial.

"Co-sleeping has openedmy eyes to the need for mydaughter to be close to meboth during the day as well asthe evening hours, eventhough she's sleeping, shestill senses my presence nearher and is calmer, and morerelaxed because of it and Idon't have the worry as towhether she is gettingenough food," notes DonnaIsenor.

1. Hooker E, Ball HL, Kelly PJ. Sleeping like ababy: Attitudes and experiences of bedsharing innortheast England. Med Anthropol. 19: 203-222,20012. McKenna J. Cultural Influences on SleepBiology. In Sleep and Breathing in Children. ADevelopmental Approach. Ed. Loughlin GM,Carroll JL, Marcus CL. Marcel, Dekker Inc. NewYork, 2000 3. Okami P, Weisner T, Olmstead R. OutcomeCorrelates of Parent Child Bedsharing: AnEighteen-Year Longitudinal Study. J Dev BehavPediatr 23: 244-253, 2002

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