PART 1 - Introduction and Demographic Information
6. Please answer questions i and ii:
i. Have you ever purchased infant formula products for your child or a child under your care (under 12 months of age)?
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Yes
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No
If you selected 'Yes', what affected your decision to purchase a product? (suggested word limit 250 words):
I am a Health Professional. In my experience working with Mothers and Babies, many women have used formula before leaving the hospital, on a healthcare professionals advice/recommendation, mostly citing, low supply.
ii. Have you ever purchased ‘toddler milk’ for your child or a child under your care (aged 12 – 36 months)?
Please select one item
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Unticked
Yes
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No
If you selected 'Yes', what affected your decision to purchase a product? (suggested word limit 250 words):
Many women feel that they must or should buy toddler milk, compelled to believe that it is more wholesome that real food.
PART 2 - Is the MAIF Agreement effective in achieving its aims?
14. The MAIF Agreement is effective in achieving its aims.
Please select one item
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Agree
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Please provide more detail about your response (suggested word count 250 words):
If the MAIF agreement was legislated and enforced by law, it would hold more meaning. Currently huge formula companies can 'get away with' anything they like. Advertising such as closest to breastmilk, contains HMO's, orthodontically friendly, anti reflux/anti colic, just like a mothers breast, products that are claimed to increase milk volume... all very misleading and plain false advertisement.
PART 3 - Is the scope of the MAIF Agreement appropriate: is it still meeting the objectives?
15. The scope of the MAIF Agreement is appropriate.
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Strongly disagree
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Please provide more detail about your response (suggested word count 250 words):
Healthcare professionals (RN's, Midwives, Child and Family health Nurses, IBLCLC's, Doctors), do not have enough knowledge or understanding of the physiology of breastfeeding and breastmilk production. Most are educated by advertising, or use their own person experiences to guide professional behaviour. Most new mothers are leaving hospital having had non human milk, introduction and/or oral devices (shields, bottles/teats), often with no plan of weaning off.
Our very own Australian College of Midwives is sponsored by Qiara. Probiotics in my extensive experience create very unsettled babies. Mothers misinterpreted crying as hunger (but it is gastrointestinal pain), this leads to frequent feeding, which leads to more gastrointestinal pain. And the cycle continues and exacerbates. Misleading claims that probiotics helps to cure mastitis, with no understanding of maternal history, full assessment, expressing/haakaa, breastfeeding assessment, and supplements do not account for the physiology and underlying cause of mastitis, a condition that is largely preventable.
The Thompson Method Practitioner Education provides the most expensive and practical breastfeeding education in the world, coupled with observed clinical hours and programmatic assessment aimed at RN's (who work in SCN, NICCU, paediatric ward), Midwives, Child Health Nurses, Doctors (obstetricians, paediatricians, GP's).
Our very own Australian College of Midwives is sponsored by Qiara. Probiotics in my extensive experience create very unsettled babies. Mothers misinterpreted crying as hunger (but it is gastrointestinal pain), this leads to frequent feeding, which leads to more gastrointestinal pain. And the cycle continues and exacerbates. Misleading claims that probiotics helps to cure mastitis, with no understanding of maternal history, full assessment, expressing/haakaa, breastfeeding assessment, and supplements do not account for the physiology and underlying cause of mastitis, a condition that is largely preventable.
The Thompson Method Practitioner Education provides the most expensive and practical breastfeeding education in the world, coupled with observed clinical hours and programmatic assessment aimed at RN's (who work in SCN, NICCU, paediatric ward), Midwives, Child Health Nurses, Doctors (obstetricians, paediatricians, GP's).
16. The scope of products covered by the MAIF Agreement is appropriate.
Please select one item
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Strongly disagree
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Agree
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Unsure
17. The scope of parties covered by the MAIF Agreement is appropriate.
Please select one item
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18. The MAIF Agreement (under Clause 7) restricts the type of information that can be provided to health care professionals on infant formula products. What activities can be done to increase the awareness of the appropriate use of breast milk substitutes amongst health care professionals?
Please provide more detail about your response (suggested word count 250 words):
All health professionals working with pregnant women or new mothers should complete the Thompson Method breastfeeding academy for Practitioners. We have a module on artificial baby milk and cover extensively the information healthcare practitioners need to know. Please contact hello@thethompsonmethod.com for further information.
19. Are the current advertising and marketing provisions covered by the MAIF agreement appropriate?
Please select one item
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Disagree
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Should the scope be changed to include modern marketing techniques, such as targeting advertising on social media platforms? (suggested word count 250 words):
Advertising is the most significant factor persuading new mothers to use something other than breastmilk. Advertising, colours, slogans, false claims. All products should be in plain packaging.
What changes would you suggest and how could they be implemented? (suggested word count 250 words):
Breastfeeding is recognised as the most effective way to promote child health and survival. Supported by ongoing research, breastfeeding the human baby is a biophysiological endocrine process with associated benefits for both the mother and her baby. The benefits include the growing baby together with the changing physical, emotional, psychosocial, biochemical, and hormonal exchanges. Breastfeeding has evolved to sustain and meet the nutritional needs of the unique newborn and young baby. Despite the benefits, exclusive breastfeeding rates have not increased over 20 years, despite international and national strategies.
Breastfeeding rates around the world remain extremely low. Of the 135 million babies born every year, 64 million women initiate newborn breastfeeding and 48 million women practice exclusive breastfeeding for six months (9). The World Health Organisation states that nearly 2 out of 3 infants are not exclusively breastfed for the recommended 6 months. Suboptimal breastfeeding practices are recorded as being associated with 3.9 million deaths of children who are less than five years old. These figures demonstrate the significance of the low breastfeed rates and why there is an urgent need to address the problem.
As breastfeeding techniques began to be medicalised, practising the “latch”, become a key component of education. This is a forceful technique that inhibits instinctive mammalian behaviours for survival, associated with the anatomical and neurosensory function of fine and gross motor skills. Unfortunately, these “latching techniques” are both complex and difficult to achieve while contributing to maternal wrist, shoulder and lower back pain, changes in the function of the baby’s oral cavity associated with nipple trauma including complications of engorgement, blocked ducts, mastitis increasing the risk of breast abscess if not diagnosed and treated early, consequently increasing the risk of low volume. Breastfeeding education in healthcare is a primary element associated with mothers and babies in all settings, it is an essential core subject to overcome the current low trends .
To reduce the risk of painful nipple trauma and breastfeeding complications, students engage in acquiring the knowledge of an in-depth understanding of the cerebellum together with the cranio-cervical spine and the anatomy and function of the intra-oral cavity of the breastfeeding baby. Understanding and applying this information, students can learn to assist mothers to achieve face-to-breast symmetry by gentle fine tuning. Well placed education has the potential to reduce maternal pain and trauma together with protecting and promoting the valuable benefits of breastfeeding. This is empowering to students and health professionals who now have a meaningful skillset to help Mothers. The value of interprofessional learning is well documented resulting in better consistent information and complementary services .
Breastfeeding rates around the world remain extremely low. Of the 135 million babies born every year, 64 million women initiate newborn breastfeeding and 48 million women practice exclusive breastfeeding for six months (9). The World Health Organisation states that nearly 2 out of 3 infants are not exclusively breastfed for the recommended 6 months. Suboptimal breastfeeding practices are recorded as being associated with 3.9 million deaths of children who are less than five years old. These figures demonstrate the significance of the low breastfeed rates and why there is an urgent need to address the problem.
As breastfeeding techniques began to be medicalised, practising the “latch”, become a key component of education. This is a forceful technique that inhibits instinctive mammalian behaviours for survival, associated with the anatomical and neurosensory function of fine and gross motor skills. Unfortunately, these “latching techniques” are both complex and difficult to achieve while contributing to maternal wrist, shoulder and lower back pain, changes in the function of the baby’s oral cavity associated with nipple trauma including complications of engorgement, blocked ducts, mastitis increasing the risk of breast abscess if not diagnosed and treated early, consequently increasing the risk of low volume. Breastfeeding education in healthcare is a primary element associated with mothers and babies in all settings, it is an essential core subject to overcome the current low trends .
To reduce the risk of painful nipple trauma and breastfeeding complications, students engage in acquiring the knowledge of an in-depth understanding of the cerebellum together with the cranio-cervical spine and the anatomy and function of the intra-oral cavity of the breastfeeding baby. Understanding and applying this information, students can learn to assist mothers to achieve face-to-breast symmetry by gentle fine tuning. Well placed education has the potential to reduce maternal pain and trauma together with protecting and promoting the valuable benefits of breastfeeding. This is empowering to students and health professionals who now have a meaningful skillset to help Mothers. The value of interprofessional learning is well documented resulting in better consistent information and complementary services .
PART 4 - Are the MAIF Agreement processes appropriate?
20. The MAIF Agreement complaints processes are appropriate.
Please provide more detail about your response (suggested word count 250 words):
The World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF), launched the Baby-friendly Hospital Initiative (BFHI). This 10-step program summarizes policies and procedures for all facilities providing newborn services. In theory this is has been a brilliant initiative targeting critical management procedures and key clinical practices, however research has demonstrated that BFHI accreditation has little effect on breastfeeding rates. The BFHI is too simplistic, not addressing many factors associated with early cessation of breastfeeding. The first concern is that practitioners continue to be educated with applying forceful techniques involving the mother and her baby to achieve “the latch” and other variants. These practices over time have been embedded into Health Professionals breastfeeding education. The medicalisation of breastfeeding is a major concern when women describe professional information and education as confusing, contradictory, lack of availability of skilled assistance, inadequate guidance with the promotion of forceful practices. Forceful practices interfere with instinctive maternal and infant connections increasing the risk of early breastfeeding cessation. Breastfeeding plans are often complex, unachievable, and unsustainable, to the point where Mothers feel like they have failed.
The second problem with current breastfeeding education, is that no program around the world, has a competency-based assessment. While the International Board of Certified Lactation Consultant Examiners requires that students prove hours of practice, prior to sitting the international exam, these hours do not necessarily equate to evidenced based or ‘good’ practice’. While peers may review practice, there has been no benchmark set for practice review against a competency standard and is therefore at risk of personal bias. This lends to practices that are confusing, contradictory, and leading to practitioners of various capabilities. Furthermore, “the latch”, is still engrained into education, which is increases nipple trauma and further complications and furthermore treats women as a ‘tick box’, all the same.
Another problem is that there appears to be little recognition that breastfeeding is an instinctively natural transition from pregnancy, labour and birth for the healthy mother and baby. An intervention in labour increases the risk of disrupting initial mother-baby contact and initiation of early breastfeeding. The increasing various inductions of labour, major abdominal surgery - caesarean section, infant extraction by forceps or vacuum, opioid administration in increasing anaesthetics and post-operative requirements are predictors to long-term breastfeeding success. This rapid and increasing list of other birth interventions make breastfeeding difficult for the Mother and her baby.
The second problem with current breastfeeding education, is that no program around the world, has a competency-based assessment. While the International Board of Certified Lactation Consultant Examiners requires that students prove hours of practice, prior to sitting the international exam, these hours do not necessarily equate to evidenced based or ‘good’ practice’. While peers may review practice, there has been no benchmark set for practice review against a competency standard and is therefore at risk of personal bias. This lends to practices that are confusing, contradictory, and leading to practitioners of various capabilities. Furthermore, “the latch”, is still engrained into education, which is increases nipple trauma and further complications and furthermore treats women as a ‘tick box’, all the same.
Another problem is that there appears to be little recognition that breastfeeding is an instinctively natural transition from pregnancy, labour and birth for the healthy mother and baby. An intervention in labour increases the risk of disrupting initial mother-baby contact and initiation of early breastfeeding. The increasing various inductions of labour, major abdominal surgery - caesarean section, infant extraction by forceps or vacuum, opioid administration in increasing anaesthetics and post-operative requirements are predictors to long-term breastfeeding success. This rapid and increasing list of other birth interventions make breastfeeding difficult for the Mother and her baby.
21. The MAIF Agreement guidance documents are appropriate to support interpretation of the MAIF Agreement?
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Agree
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Unsure
22. Have you lodged a complaint with the MAIF Agreement Complaints Committee?
Please select one item
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Yes
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No
24. The MAIF Agreement complaints process is independent.
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25. The MAIF Agreement complaints process is transparent.
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26. The MAIF Agreement complaints process is administered in a timely manner.
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27. Publication of breaches of the MAIF Agreement is an appropriate enforcement mechanism.
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Please provide more detail about your response (suggested word count 250 words):
Needs to be implemented into law, with significant penalty.
PART 4 continued - Is the voluntary, self-regulatory approach fit for purpose or are there alternative regulatory models?
28. The MAIF Agreement’s effectiveness is not reduced by its voluntary, self-regulatory approach.
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29. What are alternative approaches for regulating infant formula in Australia? In your response, please include how your suggested alternative approach improves outcomes and what would be the impacts of your suggested alternatives on relevant stakeholders? How could negative impacts be managed?
(suggested word count 500 words):
Thompson method Education is the key to prevention. Targeted at both Healthcare Professionals and Educators who provide prenatal education to pregnant mothers, to understand the transitions from pregnancy, labour/birth, and breastfeeding. How oral devices affect oral function. How formula impacts breastfeeding and infant gut microbiome for example. How to breastfeed. What to do when things don't go to plan. Our programme for mothers is well tested and very positive.