Thursday, December 6, 2018

Stretching Conference Dollars in 2019 (Bonus: a list of lactation conferences with links to registrations)

Be sure to scroll to the end of the article for a list of 2019 lactation conferences

As we welcome in the New Year, we welcome new opportunities for education in 2019. The line up of lactation and perinatal conferences is extremely encouraging, but can also be overwhelming and could even break the bank. With so many amazing options, how does one choose which conferences to attend? I hope to break down the process and help everyone with considerations for this daunting task. Let's take a moment to consider some of the major factors that influence decisions and how we can navigate the waters.

The main considerations when selecting which educational opportunity to attend include: cost, location, date, speaker line-up and networking opportunities. Many attendees also make decisions based on who the conference will benefit, or the reputation of the organization hosting the event. Audiences may also select a conference if it provides Continuing Education Units or CEUs to attendees.

I usually attend several low-cost, high-quality, local conferences and one or two international conferences annually. How do I make my dollars stretch and afford me these amazing opportunities? I follow these suggestions:

Get a good value
With conference prices ranging from $65 to almost $1,000, a conference budget is essential. Some of the lower-priced conferences provide a great value with access to amazing speakers. Attendees may miss out on a few perks when attending a smaller conferences. For instance, meals may not be provided, there may not be huge exhibits with all the new gadgets and technology (along with a mirage of free promotional gifts), but if you already have enough canvass bags to fill a closet, you aren't sacrificing much, so I encourage you to take advantage of these steep discounts and amazing deals. Lower prices may also mean fewer speakers or only local speakers. Don't let this persuade you not to attend. Every local area has access to amazing speakers and it is more the quality of the speakers--not the quantity. I have sat in an audience hoping for a lecture to continue all day only to discover the time cut short to allow for additional topics.

Stay local
There are so many reasons to support local organizations. You can network with colleagues while supporting the efforts of those in your area. You will save on travel, hotel and meal expenses. Building bridges and collaborating with the locals are essentials in the perinatal world. You may discover great referrals, businesses and programs right in your own backyard. I always look forward to reunions with my community connections. We are able to move forward together after a rejuvenating event.

Register early
most conferences offer an early bird rate. If organizers can get people to sign up early, they can use the funds to promote the event and pay for expenses they incur early on in the planning stages. Some of these early bird rates offer hundreds of dollars off the regular registration price. Keep in mind, many events also charge a substantial fee for those who procrastinate and register late. Pay close attention to cut-off dates, the early bird really does get the worm.

Volunteer
Some conferences seek additional help in the planning or production phases. Ask the organizers if there are any volunteer opportunities that may result in registration discounts. Bartering with service can be a creative way to earn your ticket and get to know those attending the conference. If you are an extrovert, you will not only benefit from the work, but truly enjoy yourself.

Join the organization 
Most events are hosted by an organization. if the host is a Breastfeeding Coalition, WIC Agency or La Leche League, they offer member discounts. Joining the organization will keep you up to date on their events and secure a discount all while supporting a good cause.

Become an Exhibitor
Conference organizers love the exhibitors. Exhibitors fund much of the event, and provide additional opportunities for the attendees. If you have items to sell, consider renting a booth and becoming an exhibitor. Some conferences offer discounts for exhibitors to attend the conference. You can reclaim your registration cost and promote your business at the same time. Don't have your own merchandise? Consider working for a company. I have hired representatives to tend my booth and often part of their compensation is registration to the event.

Submit an abstract
Do you have research you would like to share? Do you enjoy presenting? Are you eager to add to the knowledge of colleagues? Why not submit an abstract and venture out as a public speaker? You would be surprised to know how many people I know that present at in-services or staff meetings that never considered presenting in a conference setting. Many of these same individuals are now making the rounds and appear on conference flyers everywhere. Take the leap, this may be just the push you need to enter the circuit and share your knowledge and gift with the world.


Take advantage of group rates
Check to see if the conference offers a group discount. If they do, find some friends who would appreciate the information and organize a group to attend.

See if your employer has educational funds
Many jobs encourage education and have funds set aside for their employees. Check with your employer to see if there are any applicable programs that can sponsor your education. Even if your company does not pay for the conference, some will allow you to attend on work time if the training will benefit your place of employment.

Save on travel and accommodations
While not directly related to registration fees, you can save enough on travel to justify the expense of attending your favorite conferences. Booking airfare early, using airline points or taking advantage of sales can help to reduce travel costs. Shop around for your hotel. Oftentimes, you can find your own hotel or airbnb cheaper than the accommodations recommended by the conference organizers. You can also find roommates to share the expense. If you do decide to stay at the hotel hosting, try going to the hotel site directly rather than the through the link provided on the conference registration page. Look for discounts, such as AAA or AARP offered by the hotel. You also may be able to get a discount by calling the front desk and asking for any specials. There may be unadvertised discounts for those who sign up for their rewards program. It never hurts to ask.


Stay home
Want to really save on travel? Attend one of the several conferences offered online. Many "virtual conferences" are available throughout the year and this option affords audiences to hear from international speakers live or recorded. Many of the conferences grant access to the talks for several weeks or months. You don't even need to get dressed for this option. Grab a cup of coffee, stay in your PJs and earn your CEUs from your own home.

Start a savings account
Is there a conferences on your bucket list or in a destination location that you really want to visit? Maybe there is a a speaker presenting this year that you have waited your entire career to meet in person--don't despair, prepare. Like the saying goes, "How do you eat an elephant? One bite at a time." Do the math and figure out how much you must set aside weekly or monthly to attend the conference of your dreams. You can also ask friends and family to contribute in lieu of birthday or holiday gifts. Put a contribution jar on the counter and decorate it with motivational words or pictures. Skip the Starbucks and other luxuries in order to feed your jar. It will surprise you how quickly you meet your goal.

Keep receipts
Every little bit helps. If you remember to keep all your receipts, you can claim the expenses on your tax returns annually. Don't be shocked at the end of the year when you add up how much you spent on education. I am proud to invest in my own education, and feel it is the responsible thing to do. As I travel across the nation speaking and teaching the Certified Lactation Educator Training (CLE) to Public Health Agencies, birth professionals and breastfeeding advocates, I know I am equipped with the latest, most up-to-date evidence-based information available because I sought the best teachers and researchers to learn from.

I greatly appreciate those willing to plan and prepare amazing opportunities that benefit me and all other advocates and professionals. I have included links that may help you schedule your conference calendar for 2019. Many of the conferences below are favorites that I attend annually. I also included those that have been recommended to me or have been posted on social media. Please make us aware of additional conferences by posting in the comments. I know WIC and La Leche League has state or regional conferences and would love to have readers share information on those shared as well.

Most of the events listed below are specific to lactation. Some of the larger conferences that include breastfeeding elements have also been included. Some main conferences (such as ABM) are noticeably absent. Only the organizations that had announced their 2019 conferences at the time I composed this article were included. I plan to post conference updates in the comments section when they are announced. Make sure to follow this blog.

Which ones will I see you at in 2019? Maybe we can share a room or register as a group!

Looking forward to 2019 and all the new information we will learn together!


January 16-18, 2019
Deerfield Beach, FL
$450
January 29-31, 2019 
Anaheim, CA
$300
February 7-9, 2019
Oahu, HI
$550
Online
March 6-May 6, 2019
March 15-17, 2019
Pennsylvania, PA
March 20 –22, 2019
Chapel Hill, NC
$350
April 1-June 3, 2019
Online
$225
April 7-10, 2019
Baltimore, MD
$485
April 11-13, 2019
Philadelphia, PA
$475
April 12-13, 2019 
Chicago, IL
$250
April 26-27, 2019
Anchorage, AK 
April 26-27, 2019
Daventry, Northamptonshire
May 3-6, 2019
Nashville, TN
May 16-18, 2019
Scottsdale, AZ
$875
June 8-12, 2019
Atlanta, GA
$749
June 14-15, 2019
Bethesda, MD
June 20-23, 2019
Atlanta, GA
FREE with $65 annual Membership
July 24-27, 2019
Atlanta, GA
October 11-12, 2019
Kingsport, TN
October
25-27, 2019
Vancouver, Canada
Southeastern Lactation Consultant Association (SELCA) Conference
November 9-10, 2019   
Atlanta, GA
November 28-29, 2019
Glasgow










If we do not meet at a conference, I hope you will consider joining me for a three-day intensive lactation education training. 21.25 L-Cerps are awarded by IBLCE. Find out more about the CLE training at https://www.birthingandbreastfeeding.com/certified-lactation-educatortrade.html

One way or another, hoping to connect in 2019,
Christy Jo Hendricks, IBCLC
Birthing, Bonding & Breastfeeding

Thursday, December 14, 2017

Santa Makes Frequent Stops to Pump after Consuming Cookies

There are a lot of trends and promises of "quick fixes" when it comes to breastfeeding and milk supply. Most of these "remedies" have absolutely no research to back them up, but (as with all good myths) there is some truth that has made them seem logical or even probable. Take lactation cookies for instance, the ingredients used in creating them have been promoted as galactagogues for years. Galactagogues are medications, herbs or foods that MAY help increase a woman's milk supply.

Some popular galactagogues include Fenugreek, Blessed Thistle and Fennel. It is important to note that recommendation of a galactagogue should only be made by a Lactation Consultant or Medical Professional.  A list of galactagogues and their effects can be found here.

The main frustration many lactation professionals have with the lactation cookie trend is the simplistic solution to low milk supply it offers. Most women can produce enough milk for their baby if they have a good latch, feed frequently and experience milk transfer during the feeding. The most effective way to increase milk supply is by removing milk from the breast regularly. Unfortunately, most moms will still have concerns about supply. Some of the expensive remedies prey on these concerns.

Supply can drop with the return of a menstrual cycle, if a person experiences extreme stress and with some forms of birth control. Not all low supply is merely perceived. When a breastfeeding woman is concerned about her supply, she needs to be evaluated by an IBCLC.

A mom may also receive reassurance from noticing the following:

  • Baby has 8-10 wet diapers every 24 hours
  • Mom's breasts feel lighter after a feeding
  • Baby is eating 10-12 times every 24 hours
  • Baby gains 4-7 oz weekly
  • Baby is satisfied after nursing
  • Baby is alert when awake
  • Baby has good skin color and diapers are yellow and seedy
  • Mom can see and hear baby swallowing

There is good news for the entrepreneurs that have baked their way into the homes and hearts of families as well as those who consume the confectioneries. We already discussed how stress can affect milk supply and if sitting down and enjoying a warm oatmeal cookie relieves stress, it may help to combat the issue. Oatmeal is also a great source of iron. Anemia (low iron) can result in lower milk supply. Lastly, when we are enjoying our food, we release more oxytocin, a hormone associated with the "let-down."

We cannot ignore the placebo affect. Many moms feel like the cookies help, therefore, they do. Our minds are very convincing to our bodies.

Although there is no scientific evidence that consuming cookies boosts milk supply, there are many anecdotal findings. This is perhaps the most effective advertising boosting the sales of edibles.

So please, if you want a cookies, have a cookie, but if you are experiencing low supply see a Lactation Consultant. In fact, why not sit down and share a plate of cookies over a conversation and consultation.

Looking for a good recipe? Try this one this holiday season, and maybe deliver a plate to your neighbors.

Happy Holidays and Lavishing Lactation from Birthing, Bonding and Breastfeeding.

Wednesday, February 22, 2017

How Formula and Fear Ended My First Breastfeeding Journey

The year was 1997, and I entered the hospital where I was planning to birth my first baby. I had read all the books, taken the classes and prepared to the best of my ability for my impending birth. My rolling luggage contained all the supplies recommended by the Lamaze teacher and close friends. I had a well-thought out Birth Plan. In all honesty, my entire plan consisted of avoiding medications and birthing a baby. I assumed that the hospital staff would fill in any blanks I had forgotten to complete. My "water broke" at home, so the hospital policy stressed the importance of remaining in bed to avoid "severe infection." Since we had not discussed this in prenatal classes, I deferred to the attending nurse.

The contractions were as regular as the hands on a clock, which caused the staff to predict a "fast labor." The nurse approached me and explained that the labor could and should be hastened, so I could deliver my baby before the day was out. I excitedly agreed--not comprehending that I was consenting to Pitocin administration. Almost immediately, I was consumed with incredible pain and fear. My body was reacting in a way that seemed uncontrolled or understood by my mind. I was still trying to focus, but was not as successful as I had been the previous hours.

Again, I was approached with an option of "lessening the pain" and "taking the edge off." The nurse offered a visit from the anesthesiologist who would happily provide the epidural--resulting in a "pain free birth." I declined, not because I did not want the relief, but because I had predetermined my pain management goals.

A few hours of intense labor and my son joined us earth-side. I was holding my perfect little baby and, for a time, everything was well in my world. I cuddled and stared in awe until we slept. I felt completely as ease while my baby and I synchronized our breaths and adjusted to our surroundings.

The shattering news was delivered only a few, short hours later. A new nurse (who replaced my kind, supportive day nurse) brought the discovery to my attention. She entered my room and abruptly stated that my son was jaundiced! I looked at her in confusion because we had not discussed this diagnosis in my prenatal classes. I asked if he would be all right. She said that his numbers were at eleven and he needed formula. She also stated that since my seven pound baby was very large, formula was a necessity. I reluctantly explained that I desired to breastfeed. Her quick, rehearsed response was, "Do you want this baby to live, or do you want to breastfeed?" What a terrifying question to be presented with just hours postpartum. What is jaundice? Why is my baby's weight an issue? There were no explanations, just fear and accusations. I immediately consented to formula--considering the alternative that was provided.   I was extremely vigilant in offering a bottle, along with breastmilk for every feed, until I left the hospital. The following day, I was applauded for my baby's progress, which the nurse attributed to the formula. She discharged me with several containers of formula and admonished me to continue feeding formula to safeguard against tragic results.


I took my bundle of joy and bundle of formula and left the hospital. I religiously offered a bottle of formula several times a day to prevent whatever condition would develop without it. I was too afraid of putting my baby at risk to exclusively breastfeed. I never spoke of my breastfeeding journey with friends. I was too embarrassed about them knowing I almost put my baby's life in danger by my "selfish" desire to breastfeed.

My six week check up resulted in more congratulatory remarks about my baby's development. When asked about feeding, I responded with a pro-formula remark since I understood there was a "danger" associated with exclusive breastfeeding. My schedule of formula feeding was positively reinforced and I conceded that my pediatrician was favorable of formula feeding.

At six weeks, when my baby experienced "frequency days," I was convinced that my milk was insufficient to satisfy my baby. I increased the amount of formula, not realizing that in doing so, I was signaling my body to actually slow milk production. By now the free samples had disappeared and I was investing hundreds of dollars into a breastmilk substitute. I read all the propaganda and purchased the most attractive cans that touted a closeness to breastmilk. Once again, my ignorance won out. I invested in a product that was trying its best to mimic the fluid I had in abundance.



My breastfeeding journey ended so much sooner than I desired. I had a personal goal of nourishing my outside of the womb just as I had for nine months. No one questioned how my body could grow a baby for forty weeks. No one questioned if I was providing adequate nutrition in utero. No one questioned how my body sustained life, but outside of the womb, apparently, my body failed miserably at the task. I questioned everything about my parenting choices. I felt like a failure because I was pronounced a failure. Perception is reality.

My second child made her debut twenty-two months later--at a Baby Friendly designated hospital. My labor plan was supported and within a few hours, I held my daughter skin-to-skin and was breastfeeding. I was prepared to defend my choice this time. I had researched the AAP jaundice guidelines and realized that jaundice was a common condition due to extra red blood cells and I understood what numbers would constitute a legitimate concern. I was ready to confront the fear--but the fear never came. I also anticipated being judged for "giving only breastmilk" to my large baby. After all, she was about the same size as her brother at birth. The judgement never came. My little girl was weighed, her diapers were counted and I was encouraged to "keep up the good work." The following day, an IBCLC visited me to ask how breastfeeding felt and if I was experiencing any pain. She requested that I allow her to observe a feeding session. My little girl latched, sucked and fed for several minutes. The session was used to educate me on signs of milk transfer and recognizing swallows.

The following day, I left the hospital with my bundle of joy and bundle of confidence. I was equipped with knowledge and confidence. I knew my body was capable of nourishing my baby. I knew I could provide milk for my offspring just as every mammal does. I was not going to be bullied or scared into making a choice that I did not agree with. I was older, bolder and more educated.

The combination of advocating for myself and a hospital that supported breastfeeding made my dreams a reality. Breastfeeding continued until her first birthday--and a breastfeeding advocate was born.

My third child presented some feeding challenges. We worked through issues with an IBCLC and each problem I encountered was resolved with a solution that allowed me to continue my breastfeeding relationship. When the issue of jaundice surfaced this time, I supplemented for twenty-four hours with my own expressed breastmilk. I was surprised that this little girl trumped her brother in size. Her birth weight prompted the nurse to advice breastfeeding "every chance I got." A quote that was not followed up with any severe warnings or fear mongering. My hospital stay consisted of small snacks, skin-to-skin holds and frequent feeding. My baby and I were only separated when I showered (at which time she transferred from my chest to her father's). I could not help but contrast this scenario with my first birth. I wondered what that event would have looked like had I been knowledgeable and supported.

Yes, hindsight it 50-50, but I hope foresight can be as well. We have come a long way in our birth and breastfeeding practices. The Baby Friendly Hospital Initiative has laid some great ground-work and provided a foundation for providing in-hospital breastfeeding support. The initiatives, protocols, policies--all aided by skilled and educated health professionals are helping to bring instinct and the biological norms back into the highly medicated and routinely intrusive process of hospital birth.

For those who find themselves where I was as a first-time mom, let me offer you the information and support I so desperately needed. First, you need to know you are amazing. You are, after all, capable of making a person! Your body is a super-factory that is able to create the most intricate life form known. Simultaneously, your body is preparing the perfect nourishment for its creation. What a spectacular system you are equipped with.

Secondly, know that you will face adversaries in your quest to breastfeed. There are people who have made a point to question your ability. I am both saddened and angered that instead of celebrating the power and strength of a woman, some choose to undermine and minimize the uniqueness of our gender. I suppose there are many reasons for the skepticism. Some sabotage breastfeeding for a profit, some out of ignorance and a few from habit. Old wives' tales are difficult to shake.

Here are a few reassuring points you need to commit to memory.


  1. Your baby is not born "starving." Although food is often withheld from the laboring woman, the baby's access to nourishment is not interrupted in the womb.
  2. Baby's are not born with an "empty" stomach. There is research on how much fluid a baby's empty stomach can hold and malicious people are using that information to question a woman's ability to satisfy her newborn. Remember, baby's gauge is not on "empty" at birth.
  3. Mammals have milk for their offspring and instinctively nurse. Visit any zoo, wild animal park, pet store, etc. and ask to see the resident "lactation consultant." You will be met with blank stares and confusion. Mammals have been feeding their newborns for generations.
  4. Babies have very tiny tummies. They are born with a desire to suck and suck they will. The more frequently the better. Because the suck reflex exists, if a baby is placed on the breast, he will often begin feeding spontaneously. The baby that is fed frequently, will be satisfied and signal (through hormones and biology) for the mother's breasts to make more milk. 
  5. Moms have thick, rich milk the first few days that is full of protective factors and concentrated nutrients. This milk also has a mild laxative effect that encourages the expelling of meconium and reduces the risk of jaundice.
  6. Since babies have tiny tummies and moms have small amounts of colostrum, the baby can eat constantly and not get overfed.  In fact, when the baby is satisfied, the suck will change from active eating to pacifying--another way a newborn instinctively stops himself from eating to the point of discomfort. 
  7. The best way to make milk is by removing milk. Early, frequent feeds is the key. If a mom and baby are separated at birth, mom should remove milk manually or with a pump within six hours of delivery.
  8. For full-term, healthy newborns, breastmilk intake is not measured. It is preferred to allow mom and baby and partner time to recover and bond. Measuring intake is not necessary since there are more favorable ways to ensure milk transfer.
  9. Babies should have one wet diaper for every twenty-four hours of life until around day six, when they will begin having 8-10 wet diapers daily. 
  10. Initial weight loss is common. Babies should return to birth weight by two weeks of age. It is important to get a good weight at discharge or the first week of life to make certain baby is gaining weight. 

Christy Jo Hendricks, IBCLC, invented the Lactation Lanyard to remind mothers that their milk supply is the standard for feeding, NOT the formula bottles.

The first few days after delivery is mostly about bonding, recovery and feeding. Most women who can birth can also breastfeed. It is the way a mammals body works. There are conditions (like the ones I had after delivering my third child) that require intervention and support.

Warning signs can include:

  • No, or little diaper output
  • Discontent, inconsolable infant
  • Continued weight loss
  • Signs of dehydration
  • High billirubin
  • Constant feeding without satisfaction
The breastfeeding mother may show warning signs:
  • Little or no change in her breasts during pregnancy
  • Breasts that do not feel softer after a feeding
  • Pain while breastfeeding
  • Diagnosis of retained placenta
The above is not an exhaustive list nor is it a list of reasons to abandon the breastfeeding path. These are, however, a few reasons to involve an IBCLC in your journey. Occasionally, temporary supplementation is necessary or even long-term supplementation, but a lactation professional can advise you on how much more milk is needed and what kind of supplementation is available.

Data shows that most moms want to breastfeed. Who are we to downplay their desires. We should do all we can to support the goals of women in our society, who, after all, are creating society. To effortlessly dismiss a woman's goal of providing human milk to her newborn or to sabotage her goals with fear and false information is disgraceful.

I have spoken with many women who feel robbed of the breastfeeding experience and others that are angry that they did not have the support or education that would have resolved their issues. The groups that are preying on these women to gain followers or instigate more anger and resentment are indeed deplorable. I hope we can see our government, communities, families, health agencies and medical professionals working to support breastfeeding and empower moms rather than stripping them of their goals and power.



Monday, February 13, 2017

Breastfeeding Truths Come Under Attack--IBCLC Fights Back

I have comfortably watched from the sidelines as an ER doctor in Arkansas and one of her cohorts have taken a strange position in regards to breastfeeding. As far as I could tell from her blogs and postings, the doctor and her son suffered an unnecessary tragedy related to insufficient milk transfer right after delivery. No one accurately diagnosed her condition of retained placenta or evaluated the infant for milk transfer and growth. The consequences were dire. The infant did not thrive and the mother may have felt helpless and frightened. I have empathy for her. I share in her frustration. I am angered that the medical professionals and system let her down. What I do not understand is why she isn't lashing out at them. Why doesn't she insist on more observation, better care of moms in the postpartum period, regular assessments of the dyad. She stresses that she wanted to breastfeed, so it seems that it would be logical to take a pro-breastfeeding stand and help others that come after her avoid the same fate. Instead, she is working tirelessly to destroy the Baby Friendly Hospital Initiative, discredit the American Academy of Pediatricians, slander La Leche League International, and question the advice of Academy of Breastfeeding Medicine. The list of her antagonists goes on and on. Her message is destructive. Not only is she pedaling false information, she is also seeking ways to gain notoriety and attention by attacking pillars in the lactation community as well as stellar programs that exist to support and educate families.

Well, I have finally come in her cross-hairs and can no longer sit idly by.  Perhaps I should have spoken up sooner, but I truly felt the anger and accusations she was spewing would be her own downfall. I am responding now because I need to share truth and light in order to dispel shadows and doubt, besides, It is time for me to continue my campaign of evidence-based education backed by references and research.




When my product was recently mentioned in her blog, my first instinct was to ignore the post and focus on helping families. In fact, I would not have conceived this post if the complaints had just been aired on her editorial page. I know my product is well-respected by professionals and health organizations. I know it contains sound advice, backed by science. Unfortunately, I fell compelled to to respond now because a misled individual has gone to great lengths to discredit my work and the evidence behind it. She submitted a claim to the US Consumer Product Safety Commission accusing my product of leading to her son's starvation. Her reasoning is faulty to say the least. I am sharing the Open Letter I sent in response to the ridiculous and almost scandalous complaint she submitted. Let's end her tirade once and for all. Let's call out those who pretend to support breastfeeding but try to sabotage its success. Let's expose lies and half-truth.We cannot embrace "alternative truths" when it comes to infant feeding and public health. There is so much more I could say, but for now I will share my response to an invalid complaint about a powerful visual and important teaching tool that is empowering moms around the world.

For those who desire to see the "complaint" so you can understand my thorough frustration and confusion of why she projects blame on a teaching tool (that was not even widely marketed during the time she experienced) her for her child's condition, well, please refer to the claim she submitted here:

https://www.saferproducts.gov/ViewIncident/1600450

Now for my complete response:

US Consumer Product Safety Commission
Attn: Clearinghouse
4330 East West Highway
Bethesda, MD 20814-4408

January 29, 2017

Dear US Consumer Product Safety Commission and Reviewers:
I appreciate and respect the authority of your office and understand the gravity used in evaluating the safety of products. I recently received a notification that an invention I manufacture and market, the Lactation Lanyard, has been mentioned in a complaint. I am writing to clarify the utility of the product, the evidence that supports its use, and the fallacious nature of the accusations launched against this important teaching tool.

I understand that the complaint has been published and a response from myself or my company is not required, but I would be remiss if I did not respond to the false accusations directed at my product. I assure you that this is not an anonymous complaint by a “concerned citizen” but rather a spiteful person searching for an outlet for her anger and frustration.  I feel compelled to address the complaint and expose the misleading (and selective) information that the author of the submission provided on your form.

The individual who submitted the claim against my product has suffered a personal tragedy (as documented in her submission and on social media) and is trying desperately to find someone or something to blame for her circumstances.
She has gone to great lengths to skew information, and now I fear she has stooped to using your office to submit a frivolous complaint in an effort to execute a personal vendetta against lactation professionals. She has been making these claims on social media and appears frustrated that they have not been taken seriously by a wide audience.


Allow me to share some background information. The person who submitted the claim is part of an organization called “Fed is Best.” Her counterpart wrote a blog post attempting to discredit my lanyards and the established research that validates their utility. This new complaint issued to the Safety Commission appears to be yet another effort to grow an audience for their blog which recently featured complaints about the Lactation Lanyard. The picture of the Lactation Lanyard was removed from the editorial when I threatened a cease and desist letter. Even in the poorly written narrative, the author admits that the stomach capacity of a newborn is unknown, which is not entirely accurate. I am frustrated that this individual continues to spout misleading information in hopes of winning people over to her cause. In this case, the means definitely do not justify the ends. 
Blog by Jody Segrave-Daly, RN, IBCLC

Allow me to address each aspect of her accusations systematically. I believe once the scientific evidence is reviewed, it will be clear that there is absolutely no basis for her claims, and her complaint to the Commission will be disregarded.
First, the Product Detail section on the US Consumer Product Safety Commission report contains false information. The submitter states,

“The lactation lanyard and keychain are visual tools used to convince mothers that their newborns are not in need of supplemental feeding. It claims a newborn stomach size of 5-7 mL when in fact the scientific data has shown it is 20 mL. This is leading to dangerous newborn starvation and brain injury…”

My product is indeed a visual tool that shows the approximate intake of a newborn at day one and at day three, based on the anatomy and physiology of human newborns. The card attached to the lanyard also states that a newborn should be fed frequently and that the stomach grows as milk supply increases. The product comes with an instruction card and website address where we offer additional resources.  The lanyard in no way communicates that a mother should never supplement; that is a medical decision to be undertaken by the patient and her medical, nursing and lactation team. In reference to the last statement in the Product Detail, a visual aid cannot lead to starvation or brain injury; neglect and withholding nourishment can, and we would never condone anything remotely associated with that advice.

The complaint stresses the stomach size on day one. Immediately following birth, families are usually followed by a health professional whether a physician or medical staff in a hospital, or a midwife at a home birth or birth center. Families are cared for and educated by qualified staff who assess a baby for anything out of the ordinary. Knowing many hospitals and birth centers utilize the lanyards encourages me that these professionals share in the belief that breastmilk is the appropriate and sufficient nutrition for newborns, and will advise a family if supplementation becomes necessary. Dyads are closely monitored by health professionals during the postpartum stay, and surveys include tracking weight and output regularly.

The first 24 hours postpartum is mostly about rest and recovery. Newborns take in small quantities of milk during each feed. The exact amount measurable in milliliters is a moot point. When a mother is feeding from her breast, there is no need to use a feeding device and measure intake. Health care professionals have many ways to assess milk transfer, including documenting diaper count. Even though I will share references for the approximate capacity of a newborn on day one, the reality is we are not actually measuring 5-7 mL and feeding with a syringe, but rather feeding at the breast and ensuring milk transfer is occurring. The measurement of 5-7 mL thus reflects the stomach size and not the exact amount of milk transferred.

I am completely bewildered by the author’s paragraph on the Incident Details of the report. It is highly concerning that a Health Care Professional (stated in the submitters report and on her bio), would draw such utterly unscientific conclusions regarding a simple product. The author states:

Lanyards “…prevent them from supplementing newborns who are crying inconsolably for milk when there is not enough. The most recent scientific data shows that in fact, the newborn stomach size is 20 mL using ultrasound and autopsy…these…are leading to accidental newborn starvation and its complications, namely severe dehydration, hypernatremia, hypoglycemia and excessive jaundice which are all know causes of brain injury and permanent disability”

Again, there is not now, nor would there ever be a recommendation to “prevent them from supplementing newborns who are crying inconsolably for milk when there is not enough.” That would not only be barbaric, but unprofessional and dangerous. I will not justify the author’s accusation with further answers.

To address the author’s assertion about the newborn’s stomach capacity, there have been numerous studies performed a variety of ways that give approximations of a newborn’s stomach capacity, but all offer margins of error. There are no perfect studies, and each resource reiterates that the capacity is an estimate.

I will address the three resources the author cited as her evidence of the dangers of the Lactation Lanyard. I believe it will shed light on the situation and reveal the nature of her complaint.

The author confidently states that the “most recent scientific data shows that in fact…” But she neglects to mention that the “new” scientific data is a review of six previous studies. The studies cited were from 1920, 1987, 1988, 1992, 1997, 2000, 2001. Thus, even though the article was written in 2013, it was based on research from as early as 1920. Dr. Nils Bergman, the author of the article cited as documentation for the 20 mL stomach capacity, arrived at that volume based on an average. It is also important to mention that not all stomachs were measured right at birth. The author’s conclusion stated the need for shorter intervals in feeding since a newborn has a small stomach capacity.  I do not believe Dr. Bergman would approve of his research being used to justify a greater volume of feeds since his research centers on promoting frequent feeding, skin-to-skin and Kangaroo Mother Care. The point made in the article is regarding feeding intervals, it is not focusing on stomach capacity.

The abstract clearly proclaims, “There is insufficient evidence on optimal neonatal feeding intervals, with a wide range of practices. The stomach capacity could determine feeding frequency. A literature search was conducted for studies reporting volumes or dimensions of stomach capacity before or after birth. Six articles were found, suggesting a stomach capacity of 20 mL at birth.”

Dr. Nils Bergman’s brilliant work is worth reviewing Bergman, Nils J. "Neonatal Stomach Volume and Physiology Suggest Feeding at 1-h Intervals." Acta Paediatrica 102.8 (2013): 773-77. Web.

The following studies suggest a stomach capacity of approximately 5-7 mL.

Hanson, L., Korotkonva, M., The Importance of Colostrum, Breastfeeding May Boost baby’s Own Immune System. (2002). Pediatric Infectious Disease Jour; 21:816-821

Silverman, W.A.: Dunham’s Premature infants 3rd Edition. Paul B. Hoeber, Inc., Medical Division of Harper and Brothers. New York. 1961. Pp. 143-144

Scammon, R.E. and Doyle, L.O.: Observations on the capacity of the stomach in the first ten days of postnatal life. Am. J. Dis. Child. 20:516-538, 1920

Spangler, A., Randenberg, A., Brenner, M., Howette, M., (2008). Belly Models as Teaching Tools: What is Their Utility? Journal of Human Lactation. May 2008, vol 24; no 2

These studies demonstrate that there is plenty of scientific research that can be found supporting the 5-7 mL stomach capacity reference. There are also many studies that suggest that a newborn can hold a larger volume of fluid. I concur that this is certainly a possibility. What a newborn can consume and what a newborn should consume is also worth mentioning. Newborns, along with the general population, have physiological capacity and an anatomical capacity.

Even if a newborn’s stomach can hold more (as in the case of the autopsied newborns where the procedure to measure stomach capacity took a measurement when the stomachs began to bulge), it does not necessarily mean it SHOULD hold more. Nutritionists promote small, frequent meals as the ideal eating pattern for humans, a practice that seems to naturally begin at birth.

It also stands to reason that if women have small amounts of colostrum on day one, the baby must need small amounts of colostrum on day one. All of the emphasis on research and science laboratory studies is important, but it is equally important to consider the anthropology and biological norm of infant feeding.

The Lactation Lanyards have many uses, including supporting the evidence that newborns consume small amounts of colostrum. This information empowers mothers and gives them a more accurate consumption goal than the 2 oz. formula bottles distributed in many hospitals. If families are not shown the volume for an average feed on day one, they are apt to consider the formula bottle as the standard of feeding rather than the anatomy of the infant.

Even though research has validated the small stomach capacity of a newborn, perhaps the most compelling argument for educating families on the infant’s stomach capacity is corroboration by the most trusted health care agencies and organizations in the United States.  The following agencies accept the information shared on the Lactation Lanyards.

The Academy of Breastfeeding Medicine documents infant’s intake in the first 24 hours to be between 2-10 mL per feed.  BREASTFEEDING MEDICINE Volume 4, Number 3, 2009 © Mary Ann Liebert, Inc. DOI: 10.1089/bfm.2009.9991

American Academy of Pediatrics Section on Breastfeeding documents a newborns intake on days 1-2 will be between 5-10 mL


American Pregnancy Association: “It is normal to make only 1-4 teaspoons of colostrum per day.” http://americanpregnancy.org/breastfeeding/colostrum-the-superfood-for-your-newborn/



The support of professional organizations and well-documented research has spawned the development and spread of this valuable teaching tool. Many pharmaceutical companies have similar products to our Lactation Lanyard (see below), yet I did not see any reports on these products.  I am surprised to be personally targeted; it appears that the author’s complaint may be with me personally rather than truly concerned about a product I created. Why have none of these other teaching tools been reported?

The first picture is of the Lactation Lanyard, the following pictures are samples of other very similar items. 

  

The Lactation Lanyard is a portable teaching tool used by health professionals, perinatal professionals, public health educators and breastfeeding advocates. Lactation Lanyards come equipped with double-sided colostrum card and informational card. It also displays the website which provides additional education and resources. www.Birthingandbreastfeeding.com
 Belly Beads http://www.sbbreastfeedingcoalition.org/about-us
Baby Bellies Pocket Keychain

Many items are also sold internationally



Baby Bellies Display

Cascade Health Care Products https://www.1cascade.com/baby-bellies-display



Colostrum the Gold Standard Visual Aid

Many educational pamphlets and posters are available from companies that support health facilities. A few examples are provided below. 



 http://blog.medelabreastfeedingus.com/2015/04/the-size-of-your-babys-stomach-breastfeeding-in-the-early-days/



These complaints seems to stem from the offense the author takes regarding breastfeeding promotion and public health advocacy in regards to breastfeeding supporter. I am assuming that she is unaware that the formula companies also use the same research to educate families about the infant’s small stomach. 

A large formula manufacturer, Gerber, states:

“Your baby’s tummy is tiny at birth—the size of a marble—and grows to the size of an egg around day 10. Many babies eat a lot quickly, so spit-up is common, and often the result of overeating or air entering the stomach during feeding. ‘Happy spitters’ spit up one to two mouthfuls during, or shortly after, each feeding and show no sign of discomfort.
As your baby’s stomach grows and her digestive system matures, the rate and frequency of spit-up will decrease. Your baby will likely outgrow spitting up around the time he can sit up, but it can continue through the first year in some babies.” (www.Gerber.com)


Below are two samples of parent education provided by Similac, one of the top three formula manufacturers in the United States.


 If the author desires to take on the Lactation Lanyards, she must also work to discredit the American Nurses Association, Department of Women’s Health, AAP, ABM, Public Health Agencies, WIC, La Leche League, hospitals, formula companies and many educational institutions. There are a plethora of products and information sheets that she will need to prove provide “unsafe information.” We believe we are in good company and do not feel threatened by the baseless rhetoric being directed at our teaching tool.

In addition to Dr. Nils Bergman’s research, the author of the complaint offered two additional pieces to justify her submission to the Product Safety Commission. One such documentation, I will not address as it is her own blog about her story—hardly evidence-based research. The second is equally subjective, but I will address it as I feel it may be the main reason for her witch hunt.

The submitter shares a story about her son. It appears that she experienced a personal tragedy. The narrative on the report to Commission mirrors the story she shares across social media. Her story clearly states that she was followed by a lactation consultant and a pediatrician following the hospital birth of her son. She explains the feelings she encountered on day four, when she realized she had been starving her baby. There is not one mention of my lanyard in her story. There is not one reference to its use in leading to dehydration. The second part of her story reveals that she was diagnosed with retained placenta, a condition that results in inhibiting milk production (along with other complications). It is pertinent to note that it would not matter if her baby’s stomach capacity was 5 mL or 30 mL, the newborn was experiencing weight loss and dehydration due to little or no milk transfer, not because he had a small stomach. There is absolutely no parallel that can be drawn between our product and her baby’s consequences.  I can only speculate how she must have felt allowing her child to go hungry. She may have been failed by her medical team and may have ignored her own instincts—but whatever led to her withholding food from her newborn is in no way associated with a lanyard. She will have to come to grips with her own feelings and emotions. As a doctor, she is no doubt aware that complications and poor outcomes occur in spite of the best available care. Sometimes, there is not one to blame. https://fedisbest.org/2015/04/letter-to-doctors-and-parents-about-the-dangers-of-insufficient-exclusive-breastfeeding/

I can respect the concerns this individual shares. As a medical doctor working in an emergency room, she undoubtedly faces many difficult situations and hopes to avoid others going through what she experienced. I only hope she channels her energy in a positive, honest way. I question her lack of scientific evidence and knee-jerk reaction to attack those she perceives led to his condition—the science just does not back up her accusations.

According to the About Section on the Fed is Best Foundation’s Facebook page, “Christie del Castillo-Hegyi, M.D investigates the real-life breastfeeding stories of mothers through social media and holds the largest collection of breastfeeding stories in existence on her Facebook page.” I have no idea if her claims are true, but I do know she solicits stories from her followers that include “unacceptable outcomes” from breastfeeding and requests they sign her petition to “Protect Newborns from Brain Injury Caused by Insufficient Breast Milk Intake.”
 Her hobby of collecting stories has apparently caused her to put metaphoric rhetoric above science. She is creating her own truth—a very dangerous practice.

I believe I have done due diligence in refuting the complaint issued against the Lactation Lanyard. Not only did the submitter not prove the lanyards to be a safety concern, she used your organization and submission process to pursue a vendetta as publicly as possible. She has wasted everyone’s time engaging is this dispute.

I personally feel that Dr. Castillo-Hegyi acted irresponsibly in abusing the Public Safety Commission Office by submitting an unfounded, frivolous complaint. She has selfishly added to the demands of your office and consumed a considerable amount of my time in her efforts at self-promotion. I understand from the description on your website that this complaint should have never reached your office.
The U.S. Consumer Product Safety Commission (CPSC) is an independent federal regulatory agency that was created in 1972 by Congress in the Consumer Product Safety Act. In that law, Congress directed the Commission to "protect the public against unreasonable risks of injuries and deaths associated with consumer products."

From the statement on the complaint form, the submission was regarding information and how one individual was able to twist it to her perception. Your office handles complaints about a product. If your office is now in the business of handling complaints about information shared, then perhaps it is time for me to issue a counter-complaint about Dr. Castillo-Hegyi who apparently is offering fear-based education and is negligent in respecting the policy statements of her medical professional associations that recommend exclusive breastfeeding for the first six months as the optimal feeding advice.

In closing, I realize the US Consumer Product Safety Commission receives numerous complaints and must take each one seriously. However, I was disappointed that there does not seem to be an independent investigation prior to publishing complaints. A quick Internet search would have verified our tool has not been responsible for any harm and promotes the same information shared by our US health agencies.

I can sympathize with the doctor’s predicament, and her desire to find a cause for her son’s condition, but I do not respect her accusations against a product that promotes breastfeeding and supports every major health organization’s recommendations (WHO, CDC, AAP, ACOG and many more).
While the physician submitting a complaint was undoubtedly beside herself when her child became ill, my Lanyards cannot be faulted.

The author of the complaint shares her personal story as validation that the Lactation Lanyards caused dehydration in her infant. Let me reiterate: the Lanyards come equipped with a double-sided instruction card that explains that an infant’s stomach grows rapidly and babies must be fed frequently.

The size of the infant’s stomach is a moot point. No matter how small a newborn’s stomach size is, if a mother is not producing any milk due to retained placenta, the baby will become dehydrated. It is my professional opinion as an International Board Certified Lactation Consultant (IBCLC), that this scenario occurred due to insufficient milk transfer due to low milk supply. The diagnosis of retained placenta is of utmost concern. I am perplexed that a family doctor would try to blame a three dimensional teaching tool on her child’s condition. She shares the rest of her story (most likely what lead to low milk supply) here: https://fedisbest.org/2016/10/the-rest-of-my-breastfeeding-story/

This complaint appears to be an attempt to promote her blog and discredit science for personal gain and notoriety using the US Consumer Product Safety Commission platform. I am sorry your office was summoned for this purpose.

Thank you for your diligence in accepting complaints and rebuttals in an effort to improve safety for everyone.

Normalizing Breastfeeding through Education and Support,




Christy Jo Hendricks, IBCLC, RLC, CLE, CCCE, CD(DONA)


Medical professionals, health agencies, lactation consultants--should always assess the needs of the dyad. When supplementation is necessary or desired, a medical team should provide evidence-based, scientific information. We cannot neglect families by pretending to know what is best for their situation, nor should we use fear to force persuade them to breastfeed or formula feed. Human milk will always have benefits for humans--it was designed that way. Each mammal produces species-specific milk for their offspring. We must empower women who desire to breastfeed and support them to the full extent.