Concerns raised by Health Canada’s press release (issued Nov. 25, 2010)
Health Canada Press Release can be found here: http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2010/2010_202-eng.php
by Emma Kwasnica on Friday, 26 November 2010 at 17:48
Health Canada is not supporting Canadian mothers in its recommendations issued yesterday. The question is raised as to why Health Canada is advising women to use only processed breastmilk from a milk bank, especially when there is only one milk bank for all of Canada, and that the milk there is reserved for only the sickest premature babies. Health Canada has not, and is not, offering women guidelines and information that support milk sharing, and overtly states in the press release that Canadian women should not share their breastmilk.
Furthermore, the press release issued yesterday contradicts Health Canada's current policy. In 2004, Health Canada recommended exclusive breastfeeding until 6 months of age, and specifically refers to their goal of aligning with the WHO's policy on infant health. The Health Canada recommendation defines exclusive breastfeeding as: "Exclusive breastfeeding, based on the WHO definition , refers to the practice of feeding only breast milk (including expressed breast milk) and allows the baby to receive vitamins, minerals or medicine. Water, breast milk substitutes, other liquids and solid foods are excluded."
Exclusive Breastfeeding Duration - 2004 Health Canada Recommendation
ISBN: 0-662-37809-1Cat. No.: H44-73/2004E-HTMLHC Pub. No.: 4824© Her Majesty the Queen in Right of Canada 2004
The WHO's definition of exclusive breastfeeding includes wet-nursing and using expressed (unprocessed) donor milk from another woman (when a woman's own breastmilk is not available). Therefore, Canadian mothers using other mothers' milk should not only be an acceptable option to Health Canada, but the preferred option over using infant formula.
From page 10 of the WHO document entitled 'Global Strategy for Infant and Young Child Feeding' (http://whqlibdoc.who.int/publications/2003/9241562218.pdf), under the heading "Exercising other feeding options", it states:
18. The vast majority of mothers can and should breastfeed, just as the
vast majority of infants can and should be breastfed. Only under
exceptional circumstances can a mother’s milk be considered unsuitablefor her infant. For those few health situations where infantscannot, or should not, be breastfed, the choice of the bestalternative – expressed breast milk from an infant’s own mother,breast milk from a healthy wet-nurse or a human-milk bank, or abreast-milk substitute fed with a cup, which is a safer method thana feeding bottle and teat – depends on individual circumstances.
19. For infants who do not receive breast milk, feeding with a suitable
breast-milk substitute – for example an infant formula prepared in
accordance with applicable Codex Alimentarius standards, or a
home-prepared formula with micronutrient supplements – should
be demonstrated only by health workers, or other community workers
if necessary, and only to the mothers and other family members
who need to use it; and the information given should include adequate
instructions for appropriate preparation and the health hazards
of inappropriate preparation and use. Infants who are not
breastfed, for whatever reason, should receive special attention from
the health and social welfare system since they constitute a risk
Since banked (processed) human milk is not available to the vast majority of Canadian mothers, and the press release issued yesterday recommends against using another woman's breastmilk, one is left to infer that Health Canada is recommending formula as the next best option to a mother's own breastmilk. This is unacceptable and completely contravenes the WHO recommendations, as well as Health Canada’s own policy on infant feeding.
Yesterday's press release also included concern over pharmaceuticals in breastmilk; this warning is also in direct contrast with Health Canada's own statement on pharmaceuticals and breastfeeding, here:
(i) Drugs. Most prescription and over-the-counter drugs are minimally excreted through breast milk and are pharmacokinetically benign to the infant.
Finally, the press release refers to concerns about food poisoning related to pathogens that might be introduced to breastmilk while being expressed or after it has been expressed. This aspect of your advisory needs to be clarified immediately. Tens of thousands of women in Canada express breastmilk from their breasts and place it in containers and store it in coolers and refrigerators and freezers for later consumption by their own babies. Are you now recommending against this practice?
Health Canada says it is committed to food safety. Every year recommendations for Canadians on preparing turkey for safe consumption are issued.
You do not recommend that Canadians not share their turkey. You provide Canadians with safe turkey preparation guidelines in order to help ensure the safety of the people consuming their turkey dinners.
If you must recommend anything to Canadian woman about the practice of sharing milk, which is a food, please recommend evidence-based procedures for them to follow for the safe sharing of human milk. Do not hesitate to contact me should you require further information on this topic.
Emma Kwasnica, in Montreal