Leonard Bruno

Leonard is a website designer and graphic designer for the North Park Group. He has been working with SDCBC for the past year on developing the website.

Father's Role In Breastfeeding

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Breastfeeding is not just between the mother and the baby. Fathers, though not equipped with breasts, have a lot to do to in a successful breastfeeding relationship.

There are tons of reasons for a father to support breastfeeding. First and foremost, breastfeeding is the best way to feed a baby. Breast milk contains the perfect blend of nutrients, and breastfed babies enjoy a host of benefits, from a reduced risk for obesity and allergies to increased intelligence.

Plus, breastfeeding is free, requires no preparation or cleanup, and is a great way for a mother to bond with her baby. Not to mention a breastfed baby’s poop smells a lot better than the stuff produced by a formula-fed baby.

There are tons of things that a father can do to support breastfeeding. Fathers can head off discouragement and deflect negative comments from friends and relatives, especially in-laws.

Fathers can help calm a fussy baby, and once the baby has nursed his fill, dad can take over and burp the baby. A father’s loving arms is a wonderful place for his baby to be. While breastfeeding continues the exclusive relationship the mother and the infant experienced during pregnancy, it is important that a baby has a close, loving relationship with both of his parents. Getting a lot of skin-to-skin contact is good for both the baby and the father. Cuddling, bathing, and reading in a chair while the baby naps on the dad’s chest are all great relationship builders. These will give the dad and the little one a chance to bond in similar ways to the physical closeness breastfeeding brings.

Fathers can spend time just hanging out with the baby so that the breastfeeding mother can rest. Take the baby for walks in a stroller, put him in a sling or carrier and go grocery shopping, or play on the floor together. This will give dad and the baby a chance to get to know each other, while the mother get some rest.

Fathers can bring the new mother food and drink while she is breastfeeding, bring the pillows for help in positioning a newborn, or bring a telephone so that the mother can call her lactation consultant. Breastfeeding is a hard word, and the father is the best person to take on the mother’s chores and help out whenever possible.

Fathers can bottle-feed the baby with breast milk. If expressing milk manually or with a pump works for the mom, dad can introduce the baby to a bottle and start taking over at feeding times. It also helps the mom to get ready to go back to work.

Most importantly, the father be the biggest cheer leader who encourage the mother and remind her that breastfeeding is one of the most important things she can do to get their baby off to a great start in life. Especially in the first few weeks, when lack of sleep and hormonal changes can sometimes make new mothers waver in their determination to breastfeed, a father who suggests that “let’s try that one more time,” or reminds that “they say babies space out their feeding after the tree week growth spurt,” can be invaluable.

A breastfeeding mother needs and deserves to be fully supported, a father who support breastfeeding also need and deserves to be supported. Many hospitals, obstetricians, pediatricians, and breastfeeding lactation centers offer breastfeeding classes, which they encourage expectant fathers to attend. LLL Area Conferences are also very helpful to fathers.

The support of the father is the key to a successful breastfeeding relationship. In light of Father’s Day, happy breastfeeding!



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Breastfeeding myths and mainstays for the obstetrician

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Most ob/gyns are aware of the benefits of breastfeeding and the risks of not doing so. However, many do not appreciate the significant role that they play in supporting their patients’ breastfeeding efforts. Ob/gyns who are aware of some commonly held myths and who are familiar with strategies for breastfeeding can play a crucial role in a new mother’s breastfeeding success.

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Myth #1: Breastfeeding and formula feeding are essentially equivalent.

Reality #1: Breastfeeding has significant benefits to both infants and mothers that are not matched by formula.

An abundance of scientific evidence confirms that breastfeeding conveys health advantages to both infants and mothers. Formula-fed infants have a higher incidence of both short-term illness and adverse health outcomes later in life. These adverse effects include, but are not limited to, an increased risk of gastroenteritis (necrotizing enterocolitis), lower respiratory infections, otitis media, and asthma when compared to breastfed infants.1 Formula-fed infants are more likely to experience sudden infant death, childhood leukemias, type I and type II diabetes, and obesity compared to those who are breastfed.1 Mothers who breastfeed have a reduced risk of breast and ovarian cancer, type II diabetes, and maternal cardiovascular disease. Breastfeeding also uses additional calories, which can assist in postpartum weight reduction.1-3 Breastfeeding costs less for families than does bottle-feeding, and the healthcare cost to society also is reduced.4,5

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Strategies for the obstetrician: Information about breastfeeding as the preferred method of infant feeding should be presented at every opportunity, from preconception care through postnatal visits. To encourage conversation, it is helpful to use positively framed, open-ended questions such as: “Are you planning to breastfeed?” or “What have you heard about breastfeeding?” Ideally, this discussion occurs when the father, partner, or other support person is present.

Related: In-hospital formula cuts likelihood of breastfeeding

If the expectant mother indicates she is not planning to breastfeed, the physician should respectfully explore her reasoning and provide supportive information addressing any misperceptions.

leonardbrunoBreastfeeding myths and mainstays for the obstetrician
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"Landscape of Breastfeeding Support" photo project

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As part of the “Landscape of Breastfeeding Support” photo project, the USBC sub-contracted with eight breastfeeding coalitions to create a library of images to capture and showcase “stories” of breastfeeding support in action across four areas that represent the primary factors influencing mothers’ infant feeding decisions: Community, Research, Health Care, and Employment. This Image Gallery is now available as a free resource for the field, featuring more than 10,000 high-quality, high-resolution images. The photos were featured in The Surgeon General’s Call to Action to Support Breastfeeding, as well as at launch events for the document. Upon agreeing to the Terms of Use, any of the images can be downloaded and used in efforts to promote positive and fair portrayals of breastfeeding support in action.


leonardbruno"Landscape of Breastfeeding Support" photo project
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Miracle Milk Stroll

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Much has been said about the benefits of breast milk for babies. It is the feeding method recommended by the American Academy of Pediatrics(AAP) and the World Health Organization(WHO).

But for the 500 premature babies born each year who contract a potentially deadly disease called necrotizing enterocolitis (NEC), breast milk can mean the difference between life and death.


A dozen local mothers joined the second annual nationwide Miracle Milk Stroll this past Saturday to raise funds and awareness for the importance of human milk, including donor milk, for babies with NEC. The San Diego mothers stroll from 6th Avenue Playground, across Balboa Park Bridge to the water fountain in front of the Rueben H. Fleet Science Center, and then back to 6th Avenue Playground.

“We are doing this for more awareness about the life-saving power of human milk for our infants in the NICU,” said Elise Piñon, a local leader at La Leche League and organizer of the San Diego Miracle Milk Stroll, “and for the hospitals to have donor milk available for these infants.”

Miracle Milk Stroll is organized nationally by Best for Babes, a non-profit organization that focuses on education and support for parents making feeding choices for their babies. This past Saturday, thousands of mothers gathered over 100 different locations across the US, Canada, and Puerto Rico to raise funds and awareness for human milk to help save the lives of premature infants from NEC, and help prevent 5,000 babies each year from contracting this often deadly and painful disease.

According to Best for Babes, feeding fragile and compromised babies human breast milk, whether from the mother or a donor, gas been shown to reduce the risk of NEC by 79%. NEC is an inflammation of the bowels that can require multiple surgeries to remove dead tissues, may result in organ failure, months-long neonatal intensive care unit (NICU) stays, and lifelong complications and treatment. It can cost up to $1 million to treat per case and the anguish it causes parents is indescribable.

In its most recent policy statement on breastfeeding and human milk, the AAP states unequivocally that “The potent benefits of human milk are such that all preterm infants should receive human milk…If mother’s own milk is unavailable despite significant lactation support, pasteurized donor milk should be used.”

However, the use of donor breast milk is not a common practice in American hospitals. Many mothers with babies spent time in the NICU are encouraged to pump their breast milk for their babies, for premature babies are often not able to nurse directly. But the option of donor milk is often not discussed.

According to NECSoeicty, the AAP’s call for all preterm babies to have pasteurized donor milk when mother’s own milk is unavailable is being ignored. Nearly 60% of the nation’s NICUs do not use donor milk. “It’s a tragedy that more parents, health care providers, medical directors, and hospitals administrators don’t know about donor milk’s existence, accessibility, safety and lifesaving powers for babies in the NICU,” said Jennifer Canvasser, the founder of NECSociety.

On the other hand, informal milk sharing between mothers, not through a milk bank is discouraged by medical professionals due to associated risks.

Currently there are 15 milk banks nationwide that exist to provide donor breast milk to mothers who aren’t able to provide enough breast milk to their babies. Milk banks screen donor mothers to check for health risks, and pasteurize donated milk to ensure it is safe to be given to babies. California has a Mother’s Milk Bank. More information can be found here.



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SoCal hospitals fight “maternity tourism” to promote breastfeeding

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A couple of weeks ago I was invited to speak at a staff meeting at AHMC, a medical group that owns and runs six hospitals in Los Angeles area. According to the medical director, they have seen a large increase in their Chinese patient population. The patients come to the United States to deliver their babies and then return to China. At Monterey Park Community Hospital, one of the hospitals operated by AHMC, 97% of the obstetrics patients are these Chinese women. While the hospital is promoting breastfeeding, it is reported that the Chinese mothers ask for several bottles of infant formula at a time, and appear upset if the staff don’t accommodate them. It frustrates the staff.

Maternity tourism has long been a problem in Los Angeles. After federal agents raided maternity tourism business in Los Angeles last month, some of the business moved down to San Diego. The business challenges the work of breastfeeding promotion.

Currently in China, less than 30% of newborns are breastfed. Breastfeeding is simply not a common practice. It’s hard for the American medical experts to change Chinese women’s life-long beliefs in a two day hospital stay.

To promote breastfeeding among those mothers who come to the States to give birth is even harder. Maternity tourism is a huge business in Southern California. According to the Chinese government, each year more than 3,000 Chinese women come to the U.S. to give birth, and half of them come to Southern California. To lure potential customers, the maternity travel agencies often say, “You can ask for as much baby formula as you want at an American hospital.” Just “Baidu” (the Chinese “Google”) the key words “giving birth in America” and tons of advertisements pop up. Most of them list “free infant formula” as an advantage of giving birth in the States.

My advice for staff is, first, to have Chinese-language breastfeeding education material available. Then distribute it to the Chinese patients when they come to the hospital for the prenatal tour, not when they are in the delivery room.

I also recommend working with the doctors who care for these patients. There are Chinese-speaking doctors who enjoy working with maternity travel agencies and particularly receive these Chinese patients. When thousands of miles away from home, it’s much easier for Chinese women to trust these Chinese-speaking doctors than English-speaking hospital staff.

It is reported that these doctors are part of the maternity tourism industry, and tend to work with the maternity travel agency instead of the hospital. This is discouraging. But the hospital staff should still put breastfeeding-promotion brochures and hang posters in the doctors’ offices.

Chinese mothers often become upset when their requests for formula are not accommodated. My suggestion is to give them samples that promote breastfeeding, such as lanolin or hydrogel pads, instead of formula. These women pay a fortune just to give birth in the U.S. It is understandable that they want to get something free.

Finally, I think the hospital staff should set a reasonable expectation for their work of promoting breastfeeding to these Chinese mothers. It is indeed hard for American medical experts to change a long-time cultural belief in a short period of time. Chinese mothers often need more encouragement than American mothers to breastfeed, considering the low breastfeeding rate and baby-unfriendly atmosphere in that country.

The good news is, things are changing. Young and well-educated Chinese mothers are now more aware of the benefits of breastfeeding and are often willing to give it a try. It is our hope that one day they’ll all understand that breast milk is the best gift a mother can offer her baby—even better than American citizenship.



leonardbrunoSoCal hospitals fight “maternity tourism” to promote breastfeeding
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The dangers of casual breast milk sharing

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The dangers of casual breast milk sharing

Breast milk is liquid gold. When having trouble breastfeeding, our great-great-grandmother might have called for a wet nurse. Now the 21st century technology has opened the door for this ancient practice. In today’s e-commerce world, a young mother can easily buy breast milk online and feed her baby.

Over the past couple of years, ordering breast milk online has become more popular. While online sales of human milk is rising in popularity, it’s buyer beware.

Though breast milk is not regulated by the FDA, a 2010 warning clearly states that government’s stance, “FDA recommends against feeding your baby breast milk acquired directly from individuals or through the Internet.”

A recent study published in Pediatrics revealed that some breast milk ordered online contains cow’s milk. The study, led by Dr. Sarah A. Keim of Nationwide Children’s Hospital in Columbus, OH, tested 102 samples of breast milk ordered from popular milk-sharing websites to see what it contained.

Researchers isolated mitochondrial DNA from the samples by polymerase chain reaction, the same technique used for forensic and medical purposes. After two rounds of testing, 11 samples came back containing cow DNA. Ten of the samples actually had been mixed with at least 10% of cow’s milk, a significant quantity.

Further tests ruled out the possibility the cow’ milk was the result of minor or incidental contamination and suggested the tainted breast milk had probably been intentionally mixed with cow’s milk or cow-based baby formula.

“We confirmed that all the samples did have human DNA in them, but they were not 100% human breast milk,” said Dr. Sarah Keim. “This is deliberate adulteration no matter how you look at it.”

She added, “I was surprised that it was that many samples. Even a small amount of cow’s milk could be harmful to a baby with cow’s milk allergies.”

This is not only problematic for infants who are allergic to or have trouble digesting cow’s milk. Children under one-year-old should not be fed cow’s milk according to the American Academy of Pediatrics (AAP.) In addition, previous studies found that some of the human milk sold on the Internet had high amounts of bacteria.

A 2009 study done by Stanford University found that among 1091 women who want to donate breast milk, 39 of them have HIV, hepatitis, or syphilis. In a 2013 study, Dr. Keim and her colleagues also found that 75% of the breast milk purchased through the site OnlyTheBreast.com contained staph, strep, or other bacterial species. If the breast milk donor takes medication, harmful drug can also be transmitted to the baby.

“It’s quite clear that the risks to your infant’s health and safety are significant and appear to outweigh any benefits they might get from breast milk,” said Dr. Keim. “There are multiple dangers, one is the risk of infectious disease.” She said HIV, hepatitis, syphilis, and other infectious diseases can be transmitted through breast milk.

When a mother cannot nurse her own baby, the next best thing is breast milk from another mother. However ordering breast milk online did raise safety concerns. Online sources for breast milk are far different from the network or organized milk banks. A licensed human milk bank has to go through a rigorous process to make sure the breast milk is safe for consumption according to the Human Milk Bank of North America.

To guarantee the baby glean the benefits found in human milk, including all the nutrition, antibodies, and other disease-fighting properties, it is encouraged that mothers turn to a licensed human milk bank.



leonardbrunoThe dangers of casual breast milk sharing
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Extended breastfeeding and higher IQ

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Extended breastfeeding may lead babies to higher IQ and income later in life

We’ve heard it many times already—“Breast is best.” The benefits of breastfeeding for a child, physically and intellectually, have been increasingly well-illustrated by a large body of research in recent years. Now one more study adds to it.

Breastfeeding has many short-term benefits, including protection from infectious disease and reduction in infant death. Now a new study suggests that extended breastfeeding is linked to an increase in intelligence and income.

Prior studies have shown breastfeeding’s positive effects on brain development, and longer breastfeeding specifically has been linked with improved cognitive, motor, and language skills, as well as better memory in the first few years of life. A 2013 study published in JAMA Pediatrics found longer breastfeeding was associated with improved verbal and non-verbal intelligence in elementary age children; breastfed children have an increase of up to 7.5 IQ points.

But does the benefit last to adulthood? The answer is “yes!” The latest addition to this perspective is a long-term study of infants born in Brazil in 1982. Published in Lancet Global Health, the provocative longitudinal study interview 5,914 new mother about their plans for breastfeeding and then followed up to see how they did. Researchers recently followed up with the grown children, who were asked to complete IQ tests and answer questions about income and educational achievements. The researchers were able to collect data from 3,493 participants.

The study subjects were then divided into five groups based on how long they were breastfed. They took into account 10 “social and biological variables” that might affect IQ. These included family income at birth, parental schooling, maternal smoking during pregnancy, maternal age, birthweight, and how the baby was delivered.

Controlling for other facts such as parental income and birthweight, researchers found that the connection between breastfeeding and IQ may persist for many more years than previously had been shown—in fact, it may last right up through adulthood. The researchers from the Federal University of Pelotas in Brazil found that the longer a child is breasted, the higher his or her IQ through age 30, and the higher his or her earning power at that time. Babies who were nursed for 12 months or longer had higher IQ scores and earned more than those who had just been breastfed for a month.

The study provides the first evidence that prolonged breastfeeding not only increases intelligence, but last until at least the age of 30 years.

“The result of our mediation analysis suggested that IQ was responsible for 72% of the effect on income,” said Dr. Bernardo Lessa Horta who lead the probe.

In comparisons of participants who were breastfed for 12 months or more with those breastfed for less than one month, the increase in monthly income was roughly R$300 (US$95), or 20% of the average income level.

The study said that weather a mother was rich or poor, or had high or low social status, made little difference to the results. Longer breastfeeding led to increased adult intelligence, longer schooling and higher adult earnings, regardless of family background.

Horta said, “What unique about this study is the fact that, in the population we studied, breastfeeding was not more common among highly educated, high-income women, but was evenly distributed by social class.”

Breast milk may be the best a mother can give her child, even better than a rich family or a higher social class. One more reason to breastfeed, moms.




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Not just for babies: 9-year-old girl thrives on donated breast milk

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Not just for babies: 9-year-old girl thrives on donated breast milk

Breast milk is not just for babies. In Beaumont, Texas, a 9-year-old girl with genetic disorder thrives on donated breast milk.

Her name is Annabel Shelander. She has a rare condition that keeps her from consuming and digesting food naturally. Every day, she sits on her older sister’s lap, watching “Barney” on an iPad while a nurse funneled breast milk into her stomach.

As unconventional as it might seen now, the feeding process used to be much more painful for the girl, who was fed nutrients through an intravenous line that ends just above her heart.

The solution pumped through the line, called total parenteral nutrition, made Annabel gag and wretch.

That all changed last month when her mom, Cathy Shelander, approached Beaumont Breastfeeding Coalition members about milk donations.

Cathy said she and a friend were talking about Annabel’s condition and they came up with the idea about breast milk.

It wasn’t a totally strange concept for them, because Annabel was prescribed breast milk when she was 3 years old. But it’s different now since she is older.

Cathy said Annabel’s doctors were shocked when she told them that she had decided o feed Annabel donated breast milk because it is not regulated by the FDA.

In the five weeks since Annabel has been taking the donated milk, Cathy said her daughter has seen marked improvement.

The Beaumont Breastfeeding Coalition does not fill requests for donor. The group is more of a network for nursing moms to give and receive support. Some of its members tok it up themselves to independently help Annabel.

Cathy said she is cautious when taking the donated milk. She meets with the women ahead of time and make sure she is not taking from their baby.

The girl with genetic disorder may be an extreme case, but breast milk is for sure not only for babies. There is a lot of official support for extended breastfeeding, which means breastfeeding a toddler past age one. UNICEF and WHO have long encouraged breastfeeding for two years and longer, and American Academy of Pediatrics is now on record as encouraging mothers to breastfeed for at least one year and then for as long after as the mother and baby desire.

Breastfeeding to 3 and 4 years of age has been common in much of the world until recently in human history, and it is still common in many societies for toddlers to be breastfed.

When not being disturbed, mothers and babies often enjoy breastfeeding a lot, and that is why breastfeeding continue past six month. Why stop an enjoyable relationship? And continued breastfeeding is good for the health and welfare of both the mother and child.

Breast milk has as much value after six month. Breast milk is milk. Even after six months, it still contains protein, fat, and other nutritionally important and appropriate elements which children need. It still contains immunologic factors that help protect the child even if he is 2 or older. In fact, some immune factors in breast milk that protect the baby against infection are present in greater amounts in the second year of life than in the first. That is since children older than a year are generally exposed to more infections than young babies. Breast milk still contains special growth factors that help the immune system to mature, and the brain, gut, and other organs to develop.

It has been shown that children in daycare who are still be breastfed have fewer and less severe infections than the children who are not being breastfed.



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Infant Starved to Death while His Mother Used Breast Milk for Online Porn

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This is a news story that ruined my Friday morning: an infant starved to death while his mother used breast milk for online porn.

The sad incident happened in Glendale, Oregon. The parents of this 7-week-old boy have been arrested on charges of murder by abuse after a medical examiner determined the child died from starvation. Investigators said the mother used her breast milk for online pornography instead of feeding the child. The baby died on January 22. That night, an ambulance and sheriff’s deputy responded to a report of an infant in distress. Medics found the infant unresponsive to treatment. He died on the scene. Detectives arrested the baby’s 22-year-old mother and 27-year-old father last week.

The story really upsets me. It’s not “the mother is horrible” angry. It’s much more than that. In this case, I think the mother is as much a victim as her baby boy. Pornography is an industry that essentially exploits women. The mother is now 22 years old and has been doing online porn “for years,” according to the sheriff. Which means she has been a porn actress since she was a teenager, when she was only a child herself. A teenager who acts in pornography is no doubt a victim.

The story upsets me mainly because, what kind of images is modern media presenting to breastfeeding mothers? Why would people associate breastfeeding and breast milk with pornography?

I’m saying this with no exaggeration. Japan is the country with world’s largest pornography industry. If you search for “breast milk” or “breastfeeding” in Twitter Japan, half of the results you’ll get are pornography sites. A while ago, one of the largest Chinese-language newspaper here in North America described breastfeeding photos as “R-rated image” in its reporting. In America, many Hollywood movies—from David Dobkin’s “The Change-Up” to Adam Sandler’s “Grown Ups”—make nasty jokes about breastfeeding.

Breasts are designed for feeding a child. But too many people seem to consider that breasts are designed for pornography or the satisfaction of admiring them. They just can’t get over the idea that breastfeeding equals to exposing breasts equals acting sexually.

It’s time for us to normalize breastfeeding and disconnect breastfeeding from sexuality.

This is why I’ve always been against describing breastfeeding as “sexy.” Las year, a press release on behalf of the Alaska State House majority called breastfeeding “smart and sexy,” and I thought it was very inappropriate.

And this is why I’ve been calling mothers to breastfeed in the public. People, especially our children, need to see breastfeeding in public. When youngsters grow up surrounded by sexualized images of breasts but never, or only rarely, see the normal, natural act of breast-feeding a baby, it’s not possible of them to have healthy ideas about breasts.

This is also why I’ve been encouraging mothers to share their breastfeeding photos. I think we need to see more breastfeeding pictures. From cliched poses to Facebook bans, our society apparently has a problem with realistic images of breastfeeding and postpartum bodies. Breastfeeding is simply not represented properly in popular culture. It has yet to be normalized. When breasts appear online, on television, or in print media, it is often associate with the idea of sex. How ironic that women are shamed if they do not breastfeed, but also shamed if they breastfeed in public?

Breastfeeding will not be seen to be normal until we see more breastfeeding photos and more women breastfeed in public. Mothers, please join me and breastfeed in public. When you do so, you’re helping normalize breastfeeding.



leonardbrunoInfant Starved to Death while His Mother Used Breast Milk for Online Porn
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