24h-payday

Archive

Archive for the ‘Social Media’ Category

Copy Right! Using Images in Your Presentations and Teaching Materials Appropriately

December 3rd, 2013 by avatar

Today on Science & Sensibility, contributor Andrea Lythgoe, LCCE, birth doula and photographer shares information about using images and text in your work as a birth professional – for teaching, marketing or other purposes.  Using images and other works responsibly is the right thing to do, but you may be confused on how to go about it.  Today’s post will help and on Thursday I share information on how to locate materials that you are free to use. – Sharon Muza, Community Manager

Image Source: http://www.flickr.com/photos/horiavarlan/

Image Source: http://www.flickr.com/photos/horiavarlan/

When you are a childbirth educator or other birth professional, you may find yourself teaching a class, giving a presentation, designing a website or making attractive handouts and marketing materials. You take great pains to make sure that your work is visually pleasing and attractive.

You may be inclined to find images for your work by quickly searching online for exactly the right picture to get your message across.  It’s easy, it’s quick and free.

Photographs, drawings, paintings, music, writing and all other artwork are protected by copyright laws, and you cannot use them without the permission of the artist. Ever. It does not need to say “copyright” in order to be copyrighted. It does not need to be watermarked. It does not need to say “All Rights Reserved.” The copyright exists the moment the work is created. There are serious consequences for taking others’ work without permission.

When you are producing something that will be used for educational purposes, you might wonder if the laws allow you to use copyrighted images under those circumstances. There is an exception to the copyright law called “Fair Use” where it might be acceptable to use them without permission or payment. But what exactly constitutes “fair use” can be very complicated and hazy. I’m not an attorney, but I do have some suggestions to keep you firmly in the realm of safe use.

Don’t use images without permission for commercial use

Don’t use images without permission for anything remotely commercial, unless they are images you acquired under a Creative Commons license.  (See this Thursday’s post for more on Creative Commons.)  If your web site, blog or social media site is promoting your childbirth classes, you’re advertising a commercial venture. If your handout is used during classes that you’re being paid to teach, that’s profit making and probably not OK. If you’re presenting at a conference and being paid to present – ask permission. Even if you are not being paid, check to see if the conference is going to be selling a recording of your presentation. At the most recent Lamaze International conference, a company recorded audio that was synced to the presenter’s Powerpoint, which was then made available for purchase. Any images in those presentations are therefore being resold for profit. This means you need permission for commercial use of those photos, diagrams, and graphics.

Don’t modify anything without permission

Modifying includes cropping, removing a watermark, turning it black and white, making it part of a collage, adding text to turn it into a meme, or anything else you might be tempted to change. As a birth photographer, I am very careful of my client’s privacy and want to make sure that their family’s personal moments are only used in the ways they are comfortable with. I may turn down a request to use a photo in a meme because the parents declined to allow me to give third parties a right to use it. I might not allow you to use it in a poster because the parents would prefer limited exposure. Imagine how upset the parents could be to come across it somewhere they did not expect it. Consider the difficult position that puts me in – it appears that I have violated their trust in allowing me to share their images at all.

Credit appropriately

When you are using images with permission, inquire from the photographer or artist how they would like to be credited.  Most people will be happy with their name and website (linked if possible) near the picture, so people are aware of the source.  Find out how to type the “©” symbol for your particular keyboard/computer/software and use it. Alternately, in your presentation, be sure that the owner of the image is credited on the slide where the image is placed.  Printed marketing materials can include information close to the image or in a discreet location at the bottom if appropriate.

Share on social media appropriately

When you see something you want to share on social media, make sure you share rather than download and post as if it were your own. If sharing is blocked, there’s likely a reason! Don’t share from someone who has obviously uploaded other’s content as their own already, either. As a photographer, I’d love it if my images are seen by a wider audience, but I want that audience to be able to know who created the work. I often see beautiful paintings or photos shared without that connection to the artist maintained.

Do not copy and paste text

When it comes to text, don’t ever copy and paste. Writing your own content is crucial to having your own voice. Plagiarizing content is not a victimless offense. I will never forget an experience I had earlier this year when a woman I had been mentoring posted a link to her new web site asking for feedback on the template she used. The wording was mine. It was the wording I’d spent weeks working on to get just right. And just when I thought I had it perfect, I’d had friends and family read and give me feedback. This triggered another round of edits.

And with a simple copy and paste, this woman had stolen my hard work. I must be honest and tell you that it hurt.

Even if you plan to change a few words here and there, that is probably not enough to make it your own. If you’re using enough of someone else’s words that you need to copy and paste, it’s likely too much.

You can quote someone – no more than a paragraph or two – but it needs to be clearly attributed as a quote and should be in the context of your own writing. The OWL (Online Writing Lab) at Perdue University suggests:

“Use quotes that will have the most rhetorical, argumentative impact in your paper; too many direct quotes from sources may weaken your credibility, as though you have nothing to say yourself, and will certainly interfere with your style.”

Summary

As you create your web sites, presentations, class materials, marketing pieces and illustrate your own writing with visuals, please remember that artwork, including photographs, is still work, and that the artists have families to feed and clothe as well. They deserve the respect of honoring that work with a respect of their copyright and payment if they request it.

Please don’t look at copyright law as “Can I rationalize this as an acceptable use?” but instead think in terms of “How can I make sure I am using this appropriately?” – As an artist, my livelihood depends on it.

When in doubt, leave it out!

Check back on Science & Sensibility on Thursday, when Sharon Muza will share information and resources on how to find and access Creative Commons images and other works that you might be able to use freely or even modify if needed for your purpose. Let us know in the comments section what challenges you have faced in creating your own presentations and teaching materials, and any solutions you might have found.

 

Childbirth Education, Continuing Education, Guest Posts, Science & Sensibility, Series: Finding and Using Images and Copy, Social Media , , , , , , ,

Purchased Breastmilk Overflowing with Bacteria? The Facts Behind the Sensationalistic Headlines.

October 22nd, 2013 by avatar

 By Suzanne Barston

Suzanne Barston, author of Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, and Why It Shouldn’t and blogger on topics related to infant feeding discusses the new study that examines bacterial levels found in breastmilk purchased online.  Did you bother to look beyond the headlines to see what the research showed.  How will you respond to clients, patients and students who ask you what you think and wonder how safe it is to feed their babies purchased or donor milk?  Suzanne points us toward some great information and takes a level-headed look at what this study actually tells us.  To learn more about Suzanne, please read Walker Karraa’s interview with Suzanne for Science & Sensibility here.- Sharon Muza, Science & Sensibility Community Manager.

© http://bit.ly/Hc2W86

As someone who supports formula feeding parents, I’m used to sensationalized media coverage of studies that confuses real risk with relative risk. It’s taught me to look at research with a critical eye, rather than accepting what the reporters (or even the study authors, at times) claim is absolute truth. 

This week’s splashy headlines involved breastmilk, not formula, but the end result has been quite familiar: frightened parents, frustrated advocates, and confused bloggers. Everyone’s talking about a new study published this week in Pediatrics, which according to its authors “documents the potential for human milk shared via the Internet to cause infectious disease by estimating the extent of microbial contamination among samples purchased via a leading Internet Web site.” Some took the findings of this study – the discovery that most of the obtained samples contained pathogenic bacteria – to be proof that milk donation is a risky business. Others insinuated that this was a social problem; that puritanical/paternalistic attitudes towards breastfeeding and feminine bodily fluids cast unwarranted suspicion on milk sharing, and provoked a dire dismissal of relative risk (after all, formula is subject to bacterial contamination as well).

The “absolute truth”, I believe, is floating somewhere in the middle. As Alison Stuebe, MD, points out on her Academy of Breastfeeding Medicine blog, this study was limited by its methodology. The breastmilk samples were obtained through an online site where milk was not “shared” but rather sold per ounce. In order to maintain anonymity, the researchers only corresponded with donors via email, and cut off communication if the seller asked too many questions. Stuebe explains:

 “It’s highly plausible that milk sent with no questions asked, via 2 day or longer shipment, and (in 1 and 5 cases) without any cooling whatsoever, was collected with less attention to basic hygienic precautions. The bacterial load in study milk samples therefore doesn’t tell us about the relative safety of milk obtained following a conversation between buyer and seller about the recipient baby and then shipped overnight on dry ice in a laboratory-quality cooler. Indeed, when the authors compared online milk purchases with samples donated to a milk bank after a screening and selection process, they found much lower rates of bacterial contamination…”

The other important factor to consider is that we can’t know if any babies would’ve necessarily become ill after ingesting this milk; all we can be sure of is that milk transported across the country from anonymous encounters online has a good chance of containing nasty bacteria. This was an in vitro study of a biological substance – not a study that involved actual cases of sickness caused by contaminated breastmilk.

And that is what is so beautiful about it. This was an in vitro study of a biological substance. It looked at breastmilk unemotionally, separate from the individual producing the milk or receiving it. No babies were harmed or even affected by this research. We don’t need to have a defensive reaction to the results, any more than a formula feeding mother needs to have a defensive reaction about a formula recall due to bugs in the powder. 

Food preparation, storage and safety don’t need to be a personal or political issue. I doubt the local grocer feels offended when spinach gets recalled, but she probably feels concerned. Unlike guilt or shame, concern is a healthy emotion, because it allows for a solution to be found. That’s why this study should be viewed as useful information rather than an indictment on milk sharing as a practice. From it, we can learn that more stringent practices are needed to ensure safety – parents can be informed that there are some risks involved in anonymous online purchase of human breastmilk.

The real difficulty, here, is that the issue of breastfeeding balances tenuously between the medical, the personal, and the political. It may be hard to make peace with the fact that obtaining breastmilk might need to become a sterile, regulated activity, prone to corporate involvement (because anytime money is involved we run that risk, especially when it comes to infant feeding), when breastfeeding is such an intimate, personal act. Ironically, the only other solution offered in response to this study is to make milk sharing more personal – that we urge parents to get to know donors, discuss how the milk will be pumped, stored, and transported, and share locally whenever possible. This certainly might cut down on the risks, but the fact remains that unless the donor is a close friend or relative, you are still asking parents to implicitly trust someone they don’t know very well. 

© http://bit.ly/GZhyXz

Rather than angrily striking out at this research, or accepting it as the final word on milk sharing safety, we could simply use it to ask more questions. How, exactly, should milk be pumped, stored, and transported? There’s been some interesting research on how the freezing process affects the antioxidant and vitamin content of expressed breastmilk, for example – should babies fed expressed, donated milk only be given vitamin supplements? How does this affect infant health in the long term? What about ensuring that foremilk and hindmilk are balanced, by giving donating moms guidance on the best pumping practices? Does the milk of a mom nursing a toddler provide the best nutrition for a newborn, or should donations partnerships be based on age?

Lastly, rather than assuming other modes of milk sharing are safer (even if we intuitively believe that they are), can we study samples obtained from other types of donation arrangements, to put parents’ minds at rest? Do women who pump and store their own milk need to be concerned about bacterial contamination? (The lead author of the study, Dr. Sarah Keim, actually did offer some concrete suggestions to Medical News Today on improving the safety of pumped milk – things like sanitizing all containers and pump parts and freezing or refrigerating the milk within 6 hours.)

We cannot be scared of research, and we can’t get angry at it. But we can get angry at a media that grabs sensational headlines and runs so fast with them that we can’t catch up; we can be scared of an atmosphere that makes moms feel that their choices are limited to the lesser of two evils if they are unable to breastfeed. It’s our job, as advocates and care providers, to ensure that women aren’t given false ideas about risk in either direction, so that their “informed choices” can truly be informed.

Suzanne Barston is a maternal health advocate and freelance writer specializing in parenting, women’s interest, and science/health topics. She is the author of Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, and Why It Shouldn’t and blogs as her alter ego, the “Fearless Formula Feeder”. She’s currently at work on an initiative to improve the perinatal experiences of women by addressing infant feeding intention and outcomes in an evidence-based, holistic manner.

 

Babies, Breastfeeding, Childbirth Education, Guest Posts, Newborns, Research, Social Media, Uncategorized , , , , , , , , , ,

Milkscreen Breastfeeding Assessment Calculator; Reducing Mothers’ Breastfeeding Confidence?

April 23rd, 2013 by avatar

Press time update: Over the course of my research on Monday 4/22/13, I noticed that by the end of the day, Milkscreen’s main website no longer shows links to the Breastfeeding Assesment Calculator. The Facebook page for this product has also been removed.  An email received from the company confirms that the product has been removed from the website and retailers have been instructed to pull the product from the shelves. I can only speculate that this is due to pressure from social media. ~ Deena

_________________

 

© Deena Blumenfeld

I recently became aware of a new product, the Milkscreen Breastfeeding Assessment Calculator by Upspring Baby, designed to help new breastfeeding mothers be more confident in their breastfeeding abilities. This product tells them whether their milk supply is “low, normal or high” and how they can correct problems.  

This product assumes that many mothers are worried about having a low milk supply and therefore this product will reassure mothers that they are normal. To use this product, a mother must pump her milk. Additionally, this product assumes that pumping breastmilk will yield the same quantity as when a baby nurses.  We know: what a mother pumps is not indicative of what she may be producing to feed her baby. 

From the product description: 

“The Milkscreen Assessment home test determines daily breast milk supply. It was created to address the common concern many moms have: how much breast milk do I make and is that enough for my baby? Milkscreen Assessment gives mom confidence to keep breastfeeding by telling her how much breast milk she makes and how that relates to baby’s growth, identifying possible breastfeeding issues and providing recommendations on how to overcome these issues.”

This description may play directly into a mother’s fear that she isn’t making enough breastmilk for her baby. 

From the product box:

“Problem: About 50% of moms stop breastfeeding because they are concerned they don’t make enough milk for their baby. Solution: Milkscreen Calculator”

How do we know that this percentage is accurate? 

The company does not cite a source for this statement. Moms cease to breastfeed for many reasons, including, but not limited to; going back to work, pain while breastfeeding and personal preference. 

The real data on low milk supply

 An estimated 5% to 15% of all mothers experience either primary or secondary lactogenesis failure, with the actual numbers being unknown. 

Hypoplasia or Insufficient Glandular Tissue is a rare condition that some women may have. and it needs a clinical diagnosis to confirm. Many women with this condition supplement with donated breastmilk or formula while continuing to breastfeed.

I believe that the Milkscreen Calculator doesn’t help to eliminate low production worries, as advertised. I believe that it promotes this fear! 

How does Milkscreen test the breastmilk?

After scouring their website, I am not able to find any information on what nutrients they are testing for or what testing procedures they use because they don’t actually test the breastmilk! A mother doesn’t send the breastmilk to their lab for testing. A mother fills out a questionnaire and enters the amount of milk pumped in three pumping sessions, one hour apart. Milkscreen looks at a mother’s production level as “low, normal, or high” and gives her results and recommendations as to what to do if she’s having a problem, and then makes suggestions as to their other products she might like to purchase. 

From Milkscreen’s FAQ

How accurate is this test?

Milkscreen Assessment is modeled after a scientific paper, published in a peer-reviewed journal, and interpretation and recommendations provided in report are based on published scientific literature found in our list of references. However, each woman will respond differently to pumping breast milk. If a woman gets a result that shows low production, it’s possible that pumping was not as efficient for her as feeding at the breast.  In this case, the report will suggest to explore this possibility with a Lactation Consultant.

When I took a look through their references list, I was unable to find the paper they referred to.. They do offer useful citations and background information, but nothing supports the need or usefulness of this product.

From the video with breastfeeding expert Dr. Landers:

This test is based on data that are normative. Hundreds of mothers have had very special calculations of daily milk supply. Our test takes an estimated amount of breastmilk supply over a shorter period of time and lets a mother know if she’s low, normal or high. Milkscreen calculator is an estimate of the day’s milk production, but in a scientifically studied, peer reviewed paper it’s actually a good approximation….. This test is an accurate estimate of daily milk supply…. It is the growth of the baby that is the most important thing. Gives mom an idea of whether baby’s weight gain is low, normal or high. (Uses the WHO growth chart)”

If the growth of the baby is “the most important thing” why don’t we weigh and measure the baby. That would tell us if the breastmilk supply is adequate.

This product oversimplifies the issue of low milk supply. “Low, normal or high,” doesn’t give a mother any real data to go on.

How do others test* for nutritional quality of breastmilk?

The Mayo Clinic provides us with some insight as to how breastmilk is tested and what it is tested for. They use thin-layer chromatography (TLC)/colorimetry/spectrophotometry (SP)/other methodologies as appropriate. With their testing, they use samples that are 4-5ml of breastmilk.

From the Mayo Clinic:

“The nutritional content of breast milk changes considerably from day 1 to day 36 postpartum. Subsequent to that time the nutritional content is considered to be stable.

Measured nutritional components are glucose, lactose, triglyceride, and protein. Deficiency of any of the measured or calculated parameters is suggestive of decreased nutritional quality of human breast milk.”

Mayo Clinic, Breast Milk Nutritional Analysis

“Several different methods are used in the analysis of human breast milk. The sample is analyzed for triglycerides using an enzymatic method. One aliquot of breast milk is tested for total protein using biuret reagent and titration methodology and for measurement of glucose using a glucose oxidase method. A second aliquot of breast milk is pre-incubated with beta-galactosidase and glucose is measured. Lactose is calculated using results obtained by the methods listed above.”

*These tests are not FDA approved.

What is the rate of false positive / false negative results from the Milkscreen test?

An incorrect assessment can have a huge impact on the mother’s breastfeeding relationship. If a mother is led to believe falsely reassured that she is making enough milk, she may not seek appropriate help from a lactation consultant or other breastfeeding professional and her baby may suffer, Alternately, a mother may choose to supplement with formula when in fact, there was no issue or her supply could have been corrected with professional help.

Breastfeeding confidence 

In the video explaining the science behind Milkscreen, Dr. Landers states;  

“Anything we can do to help a new mom, especially a first time breastfeeding mom, to have confidence in her body’s ability to make milk and nourish her baby would be a huge, huge addition to our tools to help breastfeeding moms and babies. We know from clinical studies that moms stop breastfeeding because they think they don’t have enough breastmilk supply. It’s the mother’s perception of an inadequate supply and that she doesn’t know what she’s doing… Modern women don’t have confidence in that process (supply and demand). So one of the reasons this product is so important is that it is a huge confidence builder for the average mom.’

Phrases like  “they think they don’t have enough milk” and “mother’s perception of inadequate supply” or “doesn’t know what she is doing” reinforce the idea that women are not capable of being knowledgeable or confident about breastfeeding. 

© Deena Blumenfeld

Milkscreen Assessment also claims that if a mother has too much milk, she will likely have growth issues with her baby as well. They attribute this to the foremilk/hindmilk imbalance, including the problem of ‘loose stools’ with the infant.  Current research no longer supports the foremilk/hindmilk theory, and exclusively breastfed babies normally have loose, mustardy stool.  According to Kellymom.com, “Your breasts don’t “flip a switch” at some arbitrary point and start producing hindmilk instead of foremilk. Instead, think of the beginning of a nursing session as being like turning on a hot water faucet.” In other words, there is always fat in breastmilk but the quantity varies dependent upon how long baby nurses. Feeding from a relatively empty breast will yield a higher fat content in the milk. However, it’s the fat over the course of the day, not just in a single feeding which is important.

As educators and professionals, we know to refer a mother who is questioning her milk supply to seek help from a qualified lactation consultant or other breastfeeding professional.  Additionally, we can be sure that our breastfeeding and newborn care classes are evidence based, offer useful information and instill confidence in new mothers so they can start their breastfeeding relationship off on the right foot.  We also make sure that new mothers are aware of support groups and local resources that can help them if they run into problems and concerns. 

Lamaze’s Healthy Birth Practice #6: Keep Mother and Baby Together- It’s Best for Mother, Baby and Breastfeeding is a great resource for parents and includes a wonderful video for use in class. 

Resources and References:

 AAP Breastfeeding and the Use of Human Milk (2012) 

American Academy of Pediatrics, Adequacy of Milk Intake During Exclusive Breastfeeding: A Longitudinal Study, (2011)

Butte NF, Garza C, Smith EO, Nichols BL. Human milk intake and growth in exclusively breast-fed infants. J Pediatr. 1984 Feb;104(2):187-95.

Daly SEJ, DiRosso A, Owens RA, Hartmann PE. Degree of breast emptying explains changes in the fat content, but not fatty acid composition, of human milk. Exp Physiol 1993;78:741-55.

Highlights of, and thoughts regarding the AAP’s Policy Statement “Breastfeeding and the Use of Human Milk”

Hurst, N (2007) Recognizing and Treating Delayed or Failed Lactogenesis II, Journal of Midwifery & Women’s Health

“Hypoplasia/Insufficient Glandular Tissue.” KellyMom RSS. N.p., n.d. Web. 22 Apr. 2013.

“I’m Confused about Foremilk and Hindmilk – How Does This Work?” KellyMom RSS. N.p., n.d. Web. 23 Apr. 2013.
 ”I’m Not Pumping Enough Milk. What Can I Do?” KellyMom RSS. N.p., n.d. Web. 22 Apr. 2013.
“Is Baby Getting Enough Milk?” KellyMom RSS. N.p., n.d. Web. 22 Apr. 2013.
Mayo Clinic, Mayo Medical Laboratories Test ID: BMNA Breast Milk Nutritional Analysis
“What Affects the Amount of Fat or Calories in Mom’s Milk?” KellyMom RSS. N.p., n.d. Web. 22 Apr. 2013.

 World Health Organization on Breastfeeding

Babies, Breastfeeding, Childbirth Education, Evidence Based Medicine, Guest Posts, Healthy Birth Practices, Healthy Care Practices, informed Consent, Newborns, Social Media , , , , , , ,

Getting the Most out of Your Hospital Tour; A Parent Webinar for You and Your Students

April 18th, 2013 by avatar

Taking the hospital tour is considered to be a right of passage for expectant parents choosing to birth in the hospital.  They gather together in a group, a bit nervous, a bit excited, following the tour guide, quietly tiptoeing through the labor and delivery unit, hearing and seeing women in labor, peeking into empty rooms, learning where to park and finding out about the amenities that the facility has to offer.  They smile slightly to themselves and begin to imagine themselves birthing in one of these very rooms in the not too distant future.

A few families may ask questions, inquiring about policies and what they are “allowed” to do once admitted.  In fact, some of these questions may come up in your classes or you may hear stories about what the students learned on their various tours.

Lamaze International is offering a Parent Webinar: Getting the Most out of Your Hospital Tour next Wednesday, April 24th. at 12 PM EST.  This one hour webinar is being presented by Allison Walsh, IBCLC, LCCE.  This engaging learning opportunity can help parents to prepare for their tour,  ask questions that count and really understand what they need to do to have an active, upright birth within the hospital setting.

http://flic.kr/p/6s15sQ

I encourage childbirth educators to inform their students about this webinar opportunity and suggest your CBE families register now.  The webinar will be made available in recorded form in a timely fashion after the live presentation is completed.  As an educator, I see lots of opportunities to bring this webinar into your classroom for discussion, watch snippets of it throughout your series, or ask your students to do a fun role play, incorporating what they learned from the webinar.

Some CBEs and L&D nurses may be the tour guide at the hospital, and this webinar can help them to offer an effective and evidence based tour that thoroughly meets the need of participants.

Tweet about this opportunity, post it on Facebook and share with students and your community of pregnant families, encouraging them to register now!  By attending this free webinar, families will become more informed maternity care consumers and in a better position to “Push for Their Baby.”

The Lamaze Parent blog, Giving Birth With Confidence highlighted this webinar in a comprehensive blog post yesterday that you may also want to share with your families.

To learn more about the Parent Webinar: “Getting the Most out of Your Hospital Tour” and to register, please click here.  See you at the webinar!

Childbirth Education, Continuing Education, Evidence Based Medicine, Giving Birth with Confidence, Healthy Birth Practices, Healthy Care Practices, informed Consent, Maternity Care, Patient Advocacy, Push for Your Baby, Social Media, Webinars , , , , , ,

Defeating the Formula Death Star, One Tweet at a Time: Using Social Media to Advocate for the WHO Code

March 26th, 2013 by avatar

by Jeanette McCulloch, IBCLC and Amber McCann, IBCLC

Jeanette McCulloch and Amber McCann recently presented a session at the 8th Breastfeeding and Feminism Symposium on March 21, 2013, speaking about the ways that social media can be used to support breastfeeding by protecting and promoting the WHO code.  They share their presentation today on Science & Sensibility to encourage all of us to be active participants in promoting action steps that help mothers and babies.  Sharon Muza, Community Manager, Science & Sensibility.

© http://flic.kr/p/e2E4Cu

Reaching breastfeeding women today means being savvy about the use of social media. While breastfeeding organizations – long without sufficient marketing resources – are stepping up to increase online efforts, formula companies are better funded and are developing sophisticated tools for reaching mothers using the Internet. Nestle, in particular, has launched a well funded social media center that has the effect of undermining women’s breastfeeding efforts. This “Formula Death Star,” though, is not going unchallenged. Using the unprecedented capacity of social media for advocates to educate and mobilize concerned consumers, a rag-tag group of rebel forces – online WHO code activists – are working to protect the WHO code and breastfeeding mothers everywhere. 

Meeting Women Where They Are At Means Using Social Media

Social media represents a revolution in communications that rivals the introduction of the printing press. Ninety-three percent[1] of the “Millennial Generation” (those born after 1982, who have come of age in a time of dependence upon technology) are communicating online, and in the United States, for example, nearly 3 of 4 are using a social networking Website, such as Facebook, Twitter, or Pinterest.[2]  Social media is widely accessed by women 18 – 29, regardless of race, ethnicity, or socio-economic status.

These changes are having a significant impact on how we talk about, learn about, and share information around birth and breastfeeding. More than half of all women responding to one survey expressed their intention to share their birth experience, as it happens, on social media.[3] Moreover, time online increases after the birth—44% of US women spend more time online after a new baby is born—and the likelihood that a new mother will seek breastfeeding information and support online is high.[4]

Women Are Seeking Information about Health Care – Including Breastfeeding – Online

Research tell us that health care providers continue to be the “first choice for most people with health concerns, but online resources, including advice from peers, are a significant source of health information in the United States.”[5] Eighty percent of US Internet users have sought health care information online, and birth and related topics are an area of focus. Consumers using social media are not only seeking information online, but are sharing their knowledge with others. As connectivity soars through increased Internet access and the rise of the smartphone,[6] so does altruistic sharing of what mothers learn online.[7]

Formula marketers are fully aware of these changes. As advocates for breastfeeding mothers, we argue that it is our responsibility as advocates to understand these changes. We also can take advantage of unparalleled opportunities social media provides for advocacy organizations to engage in dialogues with mothers and affect change.

What is the WHO Code?

The International Code of Marketing of Breastmilk Substitutes (commonly called the WHO code) was written with the goal of reducing the impact of predatory marketing worldwide of formula and related products to new and expectant mothers.

The code was written and adopted in 1981 by the World Health Organization by a vote of 118 to 1 (United States was the lone dissenting vote). Thirty two countries have adopted the code as national law, with 76 others adopting portions of the code. Ethically and morally, the code should be considered worldwide, even where it has not yet been adopted as law.[8]

Despite common misconceptions, the code does not limit access to or use of formula or related products. The code addresses marketing. And for good reason. When marketing spending on formula goes up, breastfeeding rates go down.[9]

Formula Companies Are Making Significant Investments In Social Media

Savvy institutions understand what we’d teach you in any social media 101 presentation: social media is an unprecedented tool for listening to and engaging with an audience. Nestle has become a leading example of the use of social media both to reach consumers and to manage conflict and dissent.

Nestle is the world’s largest food company and also one of the world’s most controversial.[10] Nestle was founded on the formulation of artificial infant milk, made of cow’s milk, wheat flour and sugar.[11]

But they are not alone in their use of social media to reach parents. Research conducted in 2011 – before Nestle doubled their social media budget – found that 10 out 11 brands commonly available in the US have a social media presence. Examples of their use included Facebook pages, Twitter accounts, YouTube channels, mobile apps, sponsored reviews on blogs, and interactive web sites.[12]

How Do the TOP Breastfeeding Profiles Stack Up?

Nestle and other formula companies have built these audiences using significant budgets. While overall marketing budgets are not generally available, at least $50 million was spent on formula advertising in 2004[13]  and Nestle has been quoted saying they have doubled their social media spending in recent years.[14] Compare this to the resources of top breastfeeding organizations, groups like La Leche League International, which is by far the best resourced breastfeeding organization in the US. In 2011, LLL International had total revenues of $1.5 million and spent a little over $115,000 on “public relations, external relations, and advocacy.”[15]

Other organizations, like KellyMom, BestforBabes, and the relatively new Breastfeeding USA have small budgets and rely largely on volunteer efforts. The result? Although all of these organizations make a significant impact on the women they reach, compare the total number of all of their followers on Facebook – about 145,000 as of this writing – to that of Nestle Good Start at five million followers.[16] 

Rebel Forces vs the Death Star

Nestle has combined its significant financial resources with social media experts and tools that have made it a shining example of how corporations should handle social media. Nestle’s “Digital Acceleration Team” has a trained staff monitoring each and every mention of Nestle’s brands. Team members identify negative “emerging issues” based on the volume of mentions and respond to those with a high level of engagement using a scripted playbook for team members.[17]

The Formula Death Star, as it has become known to WHO code activists, can feel overwhelming, both because it limits our capacity to reach families and because it can feel impossible to influence change at the world’s largest food company.

However, Nestle developed these tools in response to their inability to manage an onslaught of angry advocates and consumers on social media. In 2010, Greenpeace activists were able to secure significant changes in how Nestle sources palm oil, all thanks to a YouTube video spoof that garnered over 1.5 million views, along with a resulting social media campaign that netted more than 200,000 e-mail complaints.[18] Policy change at Nestle based on calls from consumers is possible.

Examples of Efforts to Support the WHO code Online

Although Nestle may have the Death Star, rebel forces are pulling together to provide much needed social media support for the WHO code.

A recent campaign demonstrates the power of using social media tools to organize individuals, even without an official organizing body like Greenpeace. A blog post[19] exposing that Pan American Health Office – the regional representative in the Americas for the World Health Organization – accepted more than $150,000 in donations from Nestle sparked outrage among activists concerned that the fox was helping to buy the hen house. Within days, a private Facebook group experienced rapid growth to 400 members, now at 900 members as of this writing. Each day, members were given specific action steps, including suggested scripts for tweets directed at PAHO and WHO.[20] Members provided impromptu trainings on Twitter use and etiquette, researched the money trail, and quickly developed strategy, including a decision to target WHO and call for a rejection of the Nestle funding.

The result: A relatively small group of consumers and advocates – through the use of Facebook and Twitter alone – were able to force the World Health Organization to respond. But more importantly, advocates began to organize and mobilize a group of motivated individuals, who will come to the next battle more organized and prepared to engage. 

How The Rebel Forces Can Defeat The Death Star

As the Greenpeace example shows, social media provides advocates with a unique opportunity to influence how companies do business. With ongoing support to the rebel forces, much-needed pressure can be put on Nestle to change their policies. But this will not come without significant work. Some areas that need support:

  • Ongoing consumer support and education around the WHO code. In our anecdotal experience, mothers generally are unaware of the WHO code, or if they are aware, think that it limits access to formula (rather than limiting marketing of breastmilk substitutes). The importance of the WHO code needs to be distilled into social media friendly images and infographics to build awareness and support for future efforts.
  • Ongoing education of maternal health advocates. The WHO code impacts more than just breastfeeding. Anyone concerned with infant and maternal health should be aware of and providing support for the adoptions and enforcement of the WHO code worldwide.
  • Bring even more social media savvy to the table. After Nestle’s run in with Greenpeace, they brought in a top notch social media strategist to revamp their approach and provide training for the digital engagement team. Nestle uses sophisticated tools to monitor and respond to issues. The Friends of the WHO Code – and any group hoping to use social media for impact – needs people on hand who are savvy in the use of social media and the funding for at least some basic tools to help make the job collaborative.
  •  Keep doing what we know best. One the greatest impacts of the PAHO/WHO crisis was to bring together the community that will need to continue to take action. This and other groups need to use traditional community organizing strategies, with social media as the tools they use to create a more level playing field.
To learn more about what you can do to help promote the WHO Code through social media, join the group “Friends of the WHO Code” on Facebook.
References

[1] Howe N, Strauss W, Matson RJ. Millennials Rising: The Next Great Generation. New York, NY: Vintage Books; 2000.

[2] Lenhart A, Purcell K, Smith A, Zickuhr K. Social media and mobile Internet use among teens and young adults. Pew Internet and the American Life Project. http://web.pewinternet.org/~/ media/Files/Reports/2010/PIP_Social_Media_and_Young_ Adults_Report_Final_with_toplines.pdf. February 3, 2010.

[3] Social media giving birth to new generation of parents-to- be. Chicago Tribune Website. http://connect.mayoclinic.org/ news-articles/863-social-media-giving-birth-to-new- generation-of-parents-to-be/portal.

[4] Bartholomew M, Schoppe-Sullivan S, Glassman M, Kamp Dush C, Sullivan J. New parents’ Facebook use at the transition to parenthood. Fam Relat. 2012;61:455-469.

[5] Fox S. The social life of health information. Pew Internet and American Life Project. http://www.pewinternet.org/~/media// Files/Reports/2009/PIP_Health_2009.pdf. May 12, 2011.

[6] Smith A. Cell Internet use 2012. Pew Internet and Ameri- can Life Project. http://www.pewinternet.org/~/media//Files/ Reports/2012/PIP_Cell_Phone_Internet_Access.pdf. June 26, 2012.

[7] Kibbe D, Kvedar J. Building a research agenda for participatory medicine. J Particip Med. 2009;1:16.

[9] http://www.bestforbabes.org/what-is-the-who-code

[12] J Hum Lact. 2012 Aug;28(3):400-6. doi: 10.1177/0890334412447080. Epub 2012 Jun 6. Milk and social media: online communities and the International Code of Marketing of Breast-milk Substitutes. Abrahams SW.

[14] http://uk.reuters.com/article/2012/10/26/uk-nestle-online-water-idUKBRE89P07Q20121026

[16] www.facebook.com/Gerber

[17] https://www.youtube.com/watch?v=ktsMa8hfgY0

[18] http://mashable.com/2010/05/17/nestle-social-media-fallout/

[19] http://lactationmatters.org/2012/11/08/if-you-dont-advocate-for-mothers-babies-who-will/

[20] http://lactationmatters.org/2012/11/14/world-wide-impact-in-10-minutes-or-less-using-social-media-for-powerful-change-2/

About Jeanette McCulloch and Amber McCann

© Jeanette McCulloch

Jeanette McCulloch, IBCLC, has been combining communications work and women’s health advocacy for more than 20 years. She is a co-founder of BirthSwell, which is working to improve infant and maternal health – and the way we talk about birth and breastfeeding – by making social media accessible for birth and breastfeeding professionals. She is a board member of Citizens for Midwifery, and is active in local, statewide, and national birth and breastfeeding advocacy projects.

© Amber McCann

Amber McCann, IBCLC is a  board certified lactation consultant with the Breastfeeding Center of Pittsburgh. She is particularly interested in connecting with mothers through social media channels and teaching others in her profession to do the same. In addition to her work as the co-editor of Lactation Matters, the International Lactation Consultant Association’s official blog, she has written for a number of other breastfeeding support blogs including for Hygeia, The Leaky Boob, and Best for Babes and is a regular contributor to The Boob Group, a weekly online radio program for breastfeeding moms. Amber is particularly interested in the impact of the WHO Code and has worked on grass-roots campaigns to support its efforts online.

Babies, Breastfeeding, Continuing Education, Guest Posts, Healthy Birth Practices, Healthy Care Practices, Infant Attachment, Newborns, Social Media, Uncategorized , , , , , ,