522348
research-article2014
JHLXXX10.1177/0890334414522348Journal of Human LactationRosenberg
Letters to the Editor Journal of Human Lactation 2014, Vol. 30(2) 242–245 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav jhl.sagepub.com
Formula Sample Distribution in US Baby-Friendly Hospitals Dear Editor, It was upsetting but not surprising that Feldman-Winter et al1 found that some nurses continued to give women formula at discharge even after formula had been removed from the discharge packs. Oregon PRAMS is a stratified random sample of postpartum women who answer questions about breastfeeding, including whether “the hospital gave me a gift pack with formula.” In analyzing responses by hospital for 2001 births, we found that some women who had had their babies in Baby-Friendly Hospitals reported having received infant formula with their gift pack. Among women who had their babies in Baby-Friendly Hospitals A and B (both of which had been certified as Baby-Friendly in 2000), 16% and 32% of respondents, respectively, reported having received infant formula with their gift pack. The experience at Cooper University Hospital was probably not unique. Their experience reminds us of the need to treat infant formula in the nursery as if it were a medicine: locked up and by prescription only. Kenneth D. Rosenberg, MD, MPH Oregon Public Health Division Portland, Oregon, USA Email: [email protected] Reference 1. Feldman-Winter L, Grossman X, Palaniappan A, et al. Removal of industry-sponsored formula sample packs from the hospital: does it make a difference? J Hum Lact. 2012;28(3): 380-388.
DOI: 10.1177/0890334414522348
Letter to the Editor Regarding “Donor Human Milk Bank Data Collection in North America: An Assessment of Current Status and Future Needs” from the Human Milk Banking Association of North America Dear Editor, Given the importance of donor human milk to the health of very low birth weight and other fragile infants, the board of
directors of the Human Milk Banking Association of North America (HMBANA) must respond to the inaccuracies and unsubstantiated speculations in the recent JHL article, “Donor Human Milk Bank Data Collection in North America: An Assessment of Current Status and Future Needs.” First, the article asserts that a central repository of data concerning HMBANA milk donors and milk bank operations does not exist. In fact, HMBANA has collected such data from member banks since its founding in 1985. These data are used to inform the public about milk banking, analyze trends in demand and supply of donor human milk, respond to local initiatives to establish new HMBANA-affiliated milk banks, and support selected research projects. The article implies that HMBANA and its member banks in the United States and Canada have been unresponsive to a 2010 recommendation of the US Food and Drug Administration (FDA) that HMBANA “develop a donor registry and generate an outcome profile which would identify the benefits of banked milk, mother’s milk, infant formula, and cow’s milk as well as determine the ideal composition associated with growth.” While such a registry would be useful to health care providers, families, and researchers, HMBANA has no access to medical records of individual recipients of milk. Moreover, HIPAA regulations in the United States tightly restrict access to and disclosure of medical records. Of greatest concern is the article’s speculation, presented as a “conclusion,” that “lack of standardization and transparency may deter implementation of donor milk programs in the neonatal intensive care unit setting and hinder benchmarking, research, and quality improvement initiatives.” As to standardization, HMBANA’s annually updated Guidelines1 set forth minimum standards, which are recognized by the FDA as safe for donor human milk. The Guidelines are updated annually based upon advice from the AABB, Canadian Blood Services, CDC, Health Canada, and FDA, as well as published clinical studies. HMBANA milk banks, which are independent entities governed by either hospital administrations or independent nonprofit boards, can choose to operate—and collect data—under higher requirements based on local, state, provincial, or national regulations. Benchmarking is therefore constrained. Lack of “transparency” is not otherwise mentioned in the article, so the basis for this assertion is unknown. HMBANA is fully committed to quality improvement. Analogous to hospital practices, member milk banks conduct an annual self-assessment prior to the visit of an external accreditor charged with reviewing compliance with the Guidelines.
Downloaded from jhl.sagepub.com at UNIV CALIFORNIA SAN DIEGO on June 4, 2015
research-article2014
JHLXXX10.1177/0890334414522348Journal of Human LactationRosenberg
Letters to the Editor Journal of Human Lactation 2014, Vol. 30(2) 242–245 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav jhl.sagepub.com
Formula Sample Distribution in US Baby-Friendly Hospitals Dear Editor, It was upsetting but not surprising that Feldman-Winter et al1 found that some nurses continued to give women formula at discharge even after formula had been removed from the discharge packs. Oregon PRAMS is a stratified random sample of postpartum women who answer questions about breastfeeding, including whether “the hospital gave me a gift pack with formula.” In analyzing responses by hospital for 2001 births, we found that some women who had had their babies in Baby-Friendly Hospitals reported having received infant formula with their gift pack. Among women who had their babies in Baby-Friendly Hospitals A and B (both of which had been certified as Baby-Friendly in 2000), 16% and 32% of respondents, respectively, reported having received infant formula with their gift pack. The experience at Cooper University Hospital was probably not unique. Their experience reminds us of the need to treat infant formula in the nursery as if it were a medicine: locked up and by prescription only. Kenneth D. Rosenberg, MD, MPH Oregon Public Health Division Portland, Oregon, USA Email: [email protected] Reference 1. Feldman-Winter L, Grossman X, Palaniappan A, et al. Removal of industry-sponsored formula sample packs from the hospital: does it make a difference? J Hum Lact. 2012;28(3): 380-388.
DOI: 10.1177/0890334414522348
Letter to the Editor Regarding “Donor Human Milk Bank Data Collection in North America: An Assessment of Current Status and Future Needs” from the Human Milk Banking Association of North America Dear Editor, Given the importance of donor human milk to the health of very low birth weight and other fragile infants, the board of
directors of the Human Milk Banking Association of North America (HMBANA) must respond to the inaccuracies and unsubstantiated speculations in the recent JHL article, “Donor Human Milk Bank Data Collection in North America: An Assessment of Current Status and Future Needs.” First, the article asserts that a central repository of data concerning HMBANA milk donors and milk bank operations does not exist. In fact, HMBANA has collected such data from member banks since its founding in 1985. These data are used to inform the public about milk banking, analyze trends in demand and supply of donor human milk, respond to local initiatives to establish new HMBANA-affiliated milk banks, and support selected research projects. The article implies that HMBANA and its member banks in the United States and Canada have been unresponsive to a 2010 recommendation of the US Food and Drug Administration (FDA) that HMBANA “develop a donor registry and generate an outcome profile which would identify the benefits of banked milk, mother’s milk, infant formula, and cow’s milk as well as determine the ideal composition associated with growth.” While such a registry would be useful to health care providers, families, and researchers, HMBANA has no access to medical records of individual recipients of milk. Moreover, HIPAA regulations in the United States tightly restrict access to and disclosure of medical records. Of greatest concern is the article’s speculation, presented as a “conclusion,” that “lack of standardization and transparency may deter implementation of donor milk programs in the neonatal intensive care unit setting and hinder benchmarking, research, and quality improvement initiatives.” As to standardization, HMBANA’s annually updated Guidelines1 set forth minimum standards, which are recognized by the FDA as safe for donor human milk. The Guidelines are updated annually based upon advice from the AABB, Canadian Blood Services, CDC, Health Canada, and FDA, as well as published clinical studies. HMBANA milk banks, which are independent entities governed by either hospital administrations or independent nonprofit boards, can choose to operate—and collect data—under higher requirements based on local, state, provincial, or national regulations. Benchmarking is therefore constrained. Lack of “transparency” is not otherwise mentioned in the article, so the basis for this assertion is unknown. HMBANA is fully committed to quality improvement. Analogous to hospital practices, member milk banks conduct an annual self-assessment prior to the visit of an external accreditor charged with reviewing compliance with the Guidelines.
Downloaded from jhl.sagepub.com at UNIV CALIFORNIA SAN DIEGO on June 4, 2015
