Friday, October 26, 2012

A storm is coming, what about my freezer stash??

Do you have a story to tell about saving your freezer stash in the wake of Sandy? Please share in comments below. I'll be tweeting them out and posting them on the Human Milk News Facebook page.

What about the freezer stashes? That was my first thought this morning when I heard plans were being made on the East Coast to deal with power outages and possible evacuations as the so-called Frankenstorm approaches. Families will be stressed and worried and will need help to protect their freezers full of expressed breastmilk. And the story of my friend Christine popped into my head.
Illustration via's Frankenstorm Coverage,Oct 26, 2012

See my blog post #FirstWorldProblems: Are we doing enough to protect infants in emergencies for a review of advice published by infant feeding in emergencies experts Karleen Gribble and Nina Berry, who urge emergency preparedness teams in countries like the US, Canada, and their native Australia to provide more specific advice to those caring for and feeding infants during emergencies - particularly those whose infants need infant formula, which is unsafe if prepared without clean equipment using hot, clean water.
As Tropical Storm Irene approached in August 2011, Christine realized she was in a mandatory evacuation zone. She began to make plans to travel with her partner and children inland. Christine discovered standard evacuation advice is short on information for the parents and caregivers of young infants. Traveling across state with a car full of kids and possessions is challenging enough - moms don't need to feel additional anguish over leaving behind or accidentally thawing their freezer stash of expressed milk. Here's her story:

In late August, 2011, Hurricane Irene was making her way up the eastern seaboard.  Being in metro NYC, where hurricanes don't generally strike, I didn't think much of the warnings, but Irene's path was aimed right for Manhattan.  Parts of the city and many suburbs were evacuated with the threat of severe flooding. My concern was the potential for a power outage.  With two small children, a bulldog who can't be without air conditioning for long, and a big stash of frozen breast milk that I had spent countless hours pumping, I didn't want to risk staying through the storm. 
What's a mother to do? Well she packs up her frozen milk and takes it along! Being a bit of a neat freak I have always frozen my milk flat, it makes storing many bags in a small space much easier. When I counted the 60+ bags out, I had around 300 ounces. I know that given good insulation, the best way to travel with frozen perishables is to pack the cooler tightly. I had frozen gallon-sized ziplock bags of water flat (see note below) . I packed my cooler with the flat, frozen bags of milk and makeshift ice packs, and stuffed newspaper in every crevice. My milk was to stay frozen for the near-three-hour drive to our safe haven.

We were fortunate to have immediate access to a freezer upon arrival at my dad's house during that storm. When I peeked in at my milk it was still safely frozen.
Now, just over one year later, we are being faced with Frankenstorm, and once again, there is the potential to be without the luxury of freezer capabilities. And with a bountiful frozen stash explicitly for donating to a very special baby girl, I don't dare take my chances with a power outage.
My preparations include having plenty of newspaper, my go-to soft insulated cooler, and a sign to keep the freezer closed. The power company is pretty good about telling how long an outage will last. And if  it’s more than a day we will move it somewhere there is a working freezer. 
A family's freezer stash is critically important - it might be needed for when primary caregivers go back to work, or perhaps it's being collected for a life-saving donation. And in an emergency, moms need clear instruction on how to keep their stash frozen if the power goes out to their freezer, families if they have transport their frozen expressed milk. And those instructions need to be easy to print and refer to as they're making their evacuation or hunker-down plans.

Christine turned to her social networks and within a few minutes had most of the info she needed to make sure her frozen milk was protected and safe* (See note below on why you should use gel packs instead of frozen water). The info Christine needed wasn't on any official government website. She was able to turn to trusted sources on the Internet because she still had electricity and a smart phone. Christine was able to keep her stash frozen and protected and later donated her milk to a baby in need. 

Jessica Martin-Weber, owner of the Facebook support page The Leaky B@@B, recounts her experience during Hurricane Ike in 2008:
You know what stands out most about that experience? Getting stressed about my frozen milk, washing diapers in the bath tub, drinking the ice cold Mexican Coke in the glass bottles someone brought us, the heat, and the FEMA centers running out of food, the giant daily block parties as we all pooled our resources for meals. I had a freezer full of milk when we were hit by Ike and then we were without power for 2 weeks. When I realized I couldn't save my milk I made a trip to an area with power and reached out to get my milk to homes STAT. My milk babies had evacuated so we needed new homes. I used the milk that defrosted in cooking. Still, it remained frozen for a good week. 
Click here for more info from Katy Linda.
Jessica's milk didn't go to waste, and your milk doesn't have to either.  IBCLC Katy Linda has pulled together this information to help you protect your freezer stash.

And if you think you are going to need to transport frozen milk, here are some tips to help you plan.

Travelling with your frozen milk?

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

1) Line the bottom of your cooler with newspaper.

2) Place the frozen milk on top of the newspaper

3) Use crumpled newspaper to take up any extra air space – that is the key to keeping your milk frozen.

4) Place a layer of newspaper on top of the milk, and place frozen gel packs* on the top of the newspaper (remember, cold air travels down, so they’re better on top than on the bottom.)

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

You may have heard of using dry ice to ship donor milk – it is not necessary and probably is hard to find during an emergency – it will keep milk frozen for several days. If you do have easy access to dry ice, be sure to keep the dry ice separate from the milk to keep it from ripping open the bags.

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

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

__ gel packs

__ today’s newspaper

__ duct tape

Stay safe!

*Note, Christine used frozen water in her cooler, but while researching for this blog post we learned human milk freezes at a lower temperature due to its salt content, and gel packs are a better option than frozen water. Kittie Franz writes about this in a 2007 Mothering Magazine article on travelling with human milk. 

This blog post was originally posted without Christine's story and the information about gel packs vs frozen water. It was updated on Sunday, Oct 28, 2012. It was edited slightly in 201y.

Update, Oct 31, 2012: Dr. Karleen Gribble, co-author of "Emergency preparedness for those who care for infants in developed country contexts" writes:

"I've been thinking of the mothers and babies as well as those seeking to help mothers and babies in the areas affected by Sandy. I am sure that there are many doing amazing things.
I'd urge those there, if they can, to keep a record of what they see and hear. The more info we can collect from emergencies about infant and young child feeding issues, the better we can advocate for better planning and response in future emergencies in developed country contexts. And please, if you see or hear of anything! Tell me about it!"
I'd urge those there, if they can, to keep a record of what they see and hear. The more info we can collect from emergencies about infant and young child feeding issues, the better we can advocate for better planning and response in future emergencies in developed country contexts. And please, if you see or hear of anything! Tell me about it!"

Dr. Gribble can be reached here.

Update: Oct 31, 2012: Other blog posts on saving freezer stashes:

- KellyMom: My power went out and I have breast milk in the freezer - Help! - Oct 28, 2012

- CT Breastfeeding Coalition: URGENT: Hurricane Sandy and Emergency Preparation/ Information for: Mothers with Stored Human Milk and Pump Dependent Lactating Moms
- Oct. 28, 2012

- PumpEase: Pumpin' Mama in a Power Outage: Handling Frozen Milk (quick print tip card)  - Oct. 29, 2012 

San Diego Breastfeeding Centre What About my Freezer Stash of Breastmilk during a Power Outage? - Oct 29, 2012

Urgent Update October 31 - HMBANA issues call for milk donations, says disruption from Hurricane Sandy and looming holiday season will result in shortages - preemies in NICUs won't have donor human milk. - see here for news release: (will open as a PDF)

Update, November 1, 2012 An article appeared today in Time Magazine by Bonnie Rochman featuring the moms on the Human Milk 4 Human Babies page who reached out looking for freezers to save their milk stashes, or for recipients for milk that would otherwise go to waste. 

Do you have a story to tell about saving your freezer stash in the wake of Sandy? Please share in comments below. I'll be tweeting them out and posting them on the Human Milk News Facebook page.

Thursday, October 18, 2012

National Breastfeeding Conference, Toronto, Oct 18-19, 2012

I'm at the National Breastfeeding Conference in Toronto to learn, and to speak about social media and breastfeeding. The theme is Breastfeeding: A Public Health Imperative.

I'll be live-tweeting using the hashtag #nbc2012.  -- Jodine

Tuesday, October 09, 2012

Hospital keepsake for newborn babies is an effective marketing tool for infant formula companies

From "A Mother is Born" blog post
What Not to Say To A New Mother: Hospital Edition
by Meredith Fein Lichtenberg
It's important to see the lengths infant formula companies go to in order to market breastmilk substitutes.

Take a look at this bassinet card Meredith Fein Lichtenberg writes about in her recent post "What Not to Say To a Mother: Hospital Edition" and making the rounds on Facebook thanks to Unlatched.

These bassinet cards are printed up by the hundreds of thousands and given free of charge to hospitals because infant formula makers know it keeps hospitals from having to spend precious dollars to print out their own ID cards. The front of the card is the standard ID card for babies in bassinets - the one that has the baby's name, date and time of birth, and weight. The card is what most parents take home with them as the only keepsake they have with that information. I remember being warned about these cards when I was first in hospital 30 years ago, when the concept of rooming in was new and babies were routinely kept in the nursery overnight and fed formula by the night nurses so new moms could sleep. Breastfeeding moms were advised to take in a marker and write "breastfed baby only, no formula!" on the cards.

The cards are clearly an effective marketing tool if they are still being used all these years later.

The card above is designed to convince mothers to keep feeding their babies Similac if breastmilk happens to have been supplemented with infant formula. Brief supplementation after birth, if medically necessary, will be ordered by health care providers. If donor milk isn't available infant formula will be used. The infant formula used is usually the formula provided to the hospital through an exclusive contract with a formula maker - in this case the hospital is using Abbott's Similac. Those contracts are a gold mine for infant formula companies as parents typically continue to use the same brand of formula when they leave the hospital.

Abbott Nutrition, the maker of Similac, is undermining breastfeeding by using this bassinet card to convince parents that their health care provider knows best and they shouldn't try to change the feeding "orders."  The words on the back of the card:

"Deciding what to feed is an important decision, one that should be made by those who know your baby's nutritional needs best. Don't make any changes in the feeding that has been specified for your baby without talking with your baby's doctor, nurse or nutritionist. Provided as a keepsake from Abbott Nutrition, Makers of Similac." 

Some parents may interpret this to mean the health care provider, who ordered what was intended to be supplemental infant formula for a brief period, believes that infant formula is better than breastfeeding for their baby. Note the card suggests advice from a nutritionist?

This is what is on the back of a bassinet card
Edmonton mother Rebecca Cameron received from the
Royal Alexandra Hospital. A similar card is shown
in the Alberta Breastfeeding Committee/IBFAN brochure on
WHO Code violations in Alberta.
And who employs a team of nutritionists available night and day to help moms making infant feeding decisions? Why, Similac! Last year over on my other blog, Jodine's World, I wrote about how ads for Similac's 24/7 advice hotline showed up alongside Babble's breastfeeding advice for new moms.

And it's not just Similac's maker Abbott Nutrition using this aggressive marketing tactic. Mead Johnson, makers of Enfamil, also offers nutritional advice and a 1-800 line on their bassinet name tags - every baby born in a hospital with an Enfamil contract in Canada gets this keepsake card to take home with them. On the back:
"Infant Nutrition Questions? Our trusted team is here to help. Call our experts at 1-800-361-6323 weekdays 9AM to 6PM ET or visit anytime."
Nothing like getting breastfeeding support from the people who have a vested interest in seeing your breastfeeding relationship fail!

After I wrote my blog post about Similac's 24/7 hotline, I heard from a mom who had phoned for advice ('s Similac hotline a big fat #fail.) She reported an immediate offer to ship free infant formula by overnight courier when she expressed concern her baby wasn't getting enough breastmilk (the number one concern of breastfeeding moms - and the solution is not to breastfeed less!) This mom was also told that after six months a quality infant formula would offer the same benefits as breastmilk.

These bassinet cards are a violation of the International Code of Marketing of Breast-milk Substitutes, commonly referred to as the WHO Code. Hospitals who are accredited under the Baby Friendly Initiative adhere to the WHO Code and do not allow this sort of aggressive marketing tactic.

Here in Canada the Canadian Pediatric Society and Health Canada have called for hospitals to become accredited through the Baby Friendly Initiative. In the US a growing number of hospitals are turning to the Baby Friendly designation as both the CDC and the US Surgeon General renew their push for implementation of these practices.

The US Centre for Disease Control actually has breastfeeding friendly bassinet card PDFs you can download (girl / boy). I've often thought community breastfeeding coalitions and organizations could produce their own cards with local support and help information - but of course that requires money and it seems only the infant formula companies have a marketing budget big enough to cover this cost  - hence the need for an International Code to govern their marketing practices!

Thanks to the many moms who shared their baby keepsake cards with me, thanks to Unlatched for sharing this image on Facebook and provoking me to blog on this issue, and to A Mother Is Born author Meredith Fein Lichtenberg for giving me permission to use it.

Monday, October 01, 2012

Over 6,000 ounces of donor milk distributed to Alberta babies so far this year

Calgary Mothers' Milk Bank director Jannette Festival
with Alberta Breastfeeding Committee conference
delegate Stephanie Harries
At the Alberta Breastfeeding Committee's (ABC) annual conference, held this year in both of Alberta's major cities, Calgary Mothers' Milk Bank director Jannette Festival provided an update on the status of donor human milk in the province.

When the Calgary Mothers' Milk Bank opened its doors this spring Festival forecast between 80 and 100 donors would provide milk in its first year of operation. The milk bank is on track to exceed that forecast with over half of 160 applicants already approved and dozens more on track for approval. The milk bank moved quickly after setting up operations - they pasteurized their first batch of milk on April 3, 2012 and made their first delivery to the Foothills Hospital on April 13, 2012. The average donation is 400 ounces and the bank had already logged 10,000 ounces by June, 2012. They are on track to process 22,000 ounces this year.

This interactive map shows the locations of the
milk bank, hospitals providing pasteurized
human donor milk, and collection depots in Alberta.
ABC Conference attendees in Edmonton were excited by the news that the Grey Nuns began officially using donor human milk on September 5th 2012, with the Royal Alex coming on board at the end of September, ending a brief period of bureaucratic delay that saw milk available in Edmonton only if families paid the milk bank processing fees directly.

Calgary hospitals have already used 3,600 ounces and Edmonton is close behind with 3,100 ounces. Another 2,000 ounces has been provided to Toronto, which is set to open its own donor milk bank later this fall. There is a small percentage of milk that shows a high bacterial count after processing and  it is not suitable to be used as donor milk in the NICU - that milk is used by researchers.

Donors come from across Alberta, and even as far away as Ontario. The milk bank is always looking for donors and is currently a little short of milk - there is a lag between when they first apply and when they make their first deposit.

A collection depot is set to open in Edmonton early October at the Grey Nuns. This will cut the time and expense of moving each individual Edmonton donor mom's milk down to Calgary. The Breastfeeding Action Committee of Edmonton raised funds for the depot earlier this summer.

Also overheard at the conference - exciting talk of moving to fill the need for collection depots in Grande Prairie, Red Deer, and Lethbridge.