Official Journal of the United States Lactation ... - Clinical Lactation

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Good Mojab, C. (2000). The cultural art of breastfeeding. Leaven, 36(5), 87–91. Hunt, L.M. (2001). Beyond cultural competence applying humility to clinical settings. Up front. Retrieved from: http://www.parkridgecenter.org/Page1882.html Kiselica, M. S. (1995). Multicultural counseling with teenage fathers. Thousand Oaks, CA: Sage Publications. Lauwers. J., & Swisher, A. (2005). Counseling the nursing mother, 4 th ed. Sudbury, MA: Jones and Bartlett. Lu, M.C., & Halfon, M. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30 Mohrbacker, N(2010). Breastfeeding answers made simple. Amarillo, TX: Hale Publishing. Ordway, M.R. (2008). Synthesizing breastfeeding research: A commentary on the use of Women’s ways of knowing. Journal of Human Lactation, 24, 135-138. Riordan, J., (2010). Breastfeeding and human lactation, 5 th Ed.. Sudbury, MA: Jones and Bartlett. Scott, J.A., & Mostyn, T. (2003). Women’s experiences of breastfeeding in a bottle-feeding culture. Journal of Human Lactation, 19, 270. Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117. Thulier, D. (2009). Breastfeeding in America: A history of influencing factors. Journal of Human Lactation, 25, 85. Zimmerman, G.L., Olsen, C.G., & Bosworth, M.F. (2000). A “Stages of Change” approach to helping patients change behavior. American Family Physician. Retrieved from: http://www.aafp. org/afp/20000301/1409.html Jeanette Panchula has been a La Leche League Leader since 1975, an IBCLC since 1985 and most recently worked as a Senior Public Health Nurse in California. She works part-time as a consultant for the Maternal, Child and Adolescent Health Divisions of the state of California and Solano County. She enjoys speaking/ teaching about breastfeeding and communication to hospital staff and peer counselors alike. 20 Clinical Lactation 2012, Vol. 3-1
The Nutritional Adequacy of Infant Formula Share this: George Kent, Ph.D. Government agencies that regulate infant formula have been concerned about its safety, worrying about things like contamination with bacteria and insect parts. Questionable formula has been subject to government-ordered recalls. This attention reinforces people’s confidence that national governments are ensuring the quality of infant formula. However, national regulatory agencies generally just assume that various versions of infant formula and other foods are safe for children (Kent, 2011). While many others have commented on safety issues relating to infant formula, few have paid attention to another important point. Safety is about ensuring that the product does not cause direct harm—but that is not enough. There are things infant formula is supposed to do. The quality of infant formula depends not only on its safety, but also on its nutritional adequacy. Keywords: Infant formula, safety, nutritional adequacy, Codex Alimentarius Clinical Lactation, 2012, Vol. 3-1, 21-25 The Regulatory Context At the global level, the primary agency concerned with food quality is the Codex Alimentarius Commission, created by the Food and Agriculture Organization, and the World Health Organization in 1963. It issues nonbinding guidelines regarding food composition and safety. In 1976, at its 11 th session, the Codex Alimentarius Commission issued a Statement on Infant Feeding. It said: …it is necessary to encourage breastfeeding by all possible means in order to prevent that the decline in breastfeeding, which seems to be actually occurring, does not lead to artificial methods of infant feeding, which could be inadequate or could have an adverse effect on the health of the infant (Codex Alimentarius Commission, 1976). At this session the Commission also adopted a Codex Standard for Infant Formula. The standard, designated as CODEX STAN 72-1981, includes a list of required ingredients and various required quality-control measures. In 1983, the 15th Session adopted amendments to the sections on Food Additives and Labeling. A further amendment to the Labeling section was adopted in 1985 by the 16th Session. Amendments to the vitamin D and B12 amounts were adopted by the 17th (1986) and 22nd (1997) sessions respectively (Codex Alimentarius, 2007). This core statement of the required ingredients for infant formula is generally accepted throughout the world. The permitted nutrient ranges allow a variety of quite different formulas. The requirements are widely regarded as a minimum standard. Some countries have adopted more stringent requirements. The primary source of binding regulations regarding foods is national governments. In the United States, the responsibility for regulating children’s foods, such as infant formula, is the Food and Drug Administration (FDA), located in the U.S. Department of Agriculture (USDA). The Federal Food, Drug, and Cosmetic Act defines infant formula in Title 21, Section 321(z) of the United States Code. It is: …..a food that purports to be or is represented for special dietary use solely as a food for infants by reason of its simulation of human milk or its suitability as a complete or partial substitute for human milk (21 U.S. Code 321 (z)). Section 350a of the act provides specifications regarding adulteration, quality-factor requirements, manufacturing regulations, product testing, and record keeping. It sets out a list of required nutrients and their minimum and maximum quantities. The list includes protein, fat, essential fatty acids (only linoleate is in the list), fifteen different vitamins, and eleven different minerals. The 1 Kent@Hawaii.edu © 2012 United States Lactation Consultant Association 21
Page 1 and 2: March 2012, Vol. 3, Issue 1 Print I
Page 3 and 4: International Lactation Consultant
Page 5 and 6: Table of Contents 9 “Don’t Slee
Page 7 and 8: Editor-in-Chief Kathleen Kendall-Ta
Page 9 and 10: “Don’t Sleep with Big Knives”
Page 11 and 12: precisely the point. There needs to
Page 13 and 14: Working with Families of Different
Page 15 and 16: primarily Hispanic mothers had excl
Page 17 and 18: through a variety of experiences. I
Page 19: time to really listen, think the so
Page 23 and 24: now categorise food in terms of its
Page 25 and 26: So long as feeding with infant form
Page 27 and 28: three weeks, two months, and four m
Page 29 and 30: Diane Powers, BA, IBCLC, RLC, is a
Page 31 and 32: anyway. But those who are dependent
Page 33 and 34: Rats are often used to study how ma
Page 35 and 36: For Further Reading Blum, D. (2002)
Page 37 and 38: the American Academy of Pediatrics
Page 39 and 40: Marketing via the Web and Social Me
Page 41 and 42: The California Maternal Quality Car
Page 43 and 44: To see more of our books and order

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