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Subject:
From:
Karleen Gribble <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 5 Nov 2008 14:09:39 +1100
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I would love, love to get data on this. If anyone ever hears of anything 
published about this please let me know. The NYT  reported babies dying from 
"heat exhaustion" and that on their "formula delivery runs" that health 
professionals found babies being fed just water....no stats, just hidden 
harm and death. Nina Berry and I wrote a abstract for a book chapter on the 
institutional disadvantage that placed babies affected by Hurricane Katrina 
at such great risk...it wasn't accepted so I'll paste in below.
Karleen Gribble
Australia

"Katrina's babies - how they were put at risk"
"Breastfeeding is a natural "safety net" against the worst effects of 
poverty. If the child survives the first month of life (the most dangerous 
period of childhood) then for the next four months or so, exclusive 
breastfeeding goes a long way toward cancelling out the health difference 
between being born into poverty and being born into affluence .... It is 
almost as if breastfeeding takes the infant out of poverty for those first 
few months in order to give the child a fairer start in life and compensate 
for the injustice of the world into which it was born." James P. Grant, 
former Executive Director, UNICEF

 In time of crisis, upheaval or disaster, infants are particularly 
vulnerable. In the days immediately following Hurricane Katrina many infants 
became seriously ill and a number died from dehydration. These deaths were 
entirely preventable even given the unforeseen magnitude of the disaster and 
the poor responses of authorities. Breastfeeding would almost certainly have 
protected the health of these infants. Artificial (bottle) feeding put large 
numbers of babies in New Orleans at risk.

Hundreds of thousands of babies in the United States become ill1 and 1000 or 
more die every year because they are not breastfed.2 Katrina brought the 
significance of low breastfeeding rates into stark relief as the world 
watched news reports of desperate mothers pleading for help for their 
dehydrated, artificially fed babies. In emergencies, breastfeeding provides 
infants with a safety net. However, Louisiana has amongst the lowest 
breastfeeding rates in the US and in all geographic locations, those who are 
poor or African American are the least likely to breastfeed 3 and so they do 
not have the benefit of that safety net. The suffering caused by lack of 
breastfeeding in the wake of Katrina uncovered inequities in the health 
system that were a result of systemic discrimination on the grounds of race 
and poverty.

Some of the reasons for the poor breastfeeding rates were a result of 
long-standing practices and structures. For example, women of low 
socioeconomic status receive services from the Special Supplemental 
Nutrition Program for Women Infants and Children (WIC). The mandate of WIC 
is to improve the nutritional status of babies and young children. However, 
WIC is the largest purchaser of infant formula in the US and women who 
participate in WIC are less likely to breastfeed than their sisters who are 
eligible for WIC assistance but do not participate.4

However, there is also evidence that practices did not change even as the 
disaster unfolded. One would have to wonder if this was due to the ignorance 
of health care and emergency workers. Right up until Katrina hit, women and 
their babies continued to be routinely discharged from maternity hospitals 
not breastfeeding. In spite of what had become clear in the days immediately 
following Katrina, hurricane preparation guidelines continued to urge 
mothers to stockpile infant formula rather than encouraging them to seek to 
continue or re-establish breastfeeding.5 Thus, when Hurricane Rita hit the 
Coast of Texas only three weeks later, many more babies were put at risk as 
artificial feeding remained the norm. While there are established guidelines 
for infant feeding in emergencies6 disaster response teams in the US remain 
un educated in the dynamics and support of re-lactation and the health 
system continues to not adequately inform and support mothers to enable them 
to breastfeed their babies

Health professionals have a responsibility to explain the risks associated 
with health interventions.7 Weaning (and the use of pharmaceutical 
preparations in place of human milk) is a health intervention and mothers 
are entitled to know that artificial feeding will put their babies at risk 
of dehydration and even death in the event of an emergency such as Katrina. 
Katrina uncovered injustice in the US health system that results in failure 
to provide adequate effective support to women to breastfeed their babies. 
This injustice is demonstrated in that the babies of women who were poor and 
or black were over-represented amongst those who felt the impact of Katrina 
most acutely.

1. Scariati PD, Grummer-Strawn LM, Fein SB. (1997). A longitudinal analysis 
of infant morbidity and the extent of breastfeeding in the United States. 
Pediatrics 99: e5.

2. Chen A, Rogan WJ. (2004). Breastfeeding and the risk of postneonatal 
death in the United States. Pediatrics 113: e435-e439.

3. Centre for Disease Control. (2005). Breastfeeding: Data and Statistics: 
Breastfeeding Practices - Results from the 2004 National Immunization 
Survey. http://www.cdc.gov/breastfeeding/data/NIS_data/data_2004.htm

4. Ruowei L, Darling N, Maurice E, Barker L, Grummer-Strawn LM. (2005). 
Breastfeeding rates in the United States by characteristics of the child, 
mother, or family: the 2002 National Immunisation Survey. Pediatrics 115: 
e31-e37.

5. FEMA, American Red Cross. (2004). Preparing for a Disaster. 
http://www.fema.gov/pdf/library/pfd.pdf

6. Seal A, Taylor A, Gostelow L, McGrath M. (2001). Review of policies and 
guidelines on infant feeding in emergencies: common ground and gaps. 
Disasters 25: 136-148.

7. Beauchamp TL, Childress JF (2001). Principles of Biomedical Ethics. 
Oxford University Press: Oxford.


----- Original Message ----- >
> We never really got good information about how many babies got sick and 
> died
> during the aftermaths of these storms, and it would be an interesting 
> study.
> Certainly it would paint a picture many of us would like to forget.
>

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