EFBRI is a modular framework

Module 1 focuses on research. Access the framework and helpful checklist in PDF: EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions, Version 1.1.

Module 2 will focus on interventions (in development by UZH and expected in 2023).

Future modules will be shaped by your needs and globally evolving ethics. Please, help us develop EFBRI by sharing your feedback and suggestions: ethics@lactahub.org.

Discussing the principles laid out in the framework in the light of real-life cases will contribute to a continuously refined understanding of the multifaceted ethical issues of breastfeeding and lactation research and how they can best be solved.

--- Prof. Dr. med. Dr. phil. NIKOLA BILLER-ANDORNO, Director, Institute of Biomedical Ethics and History of Medicine, UZH

Who is EFBRI for? Researchers, reviewers, healthcare practitioners, decisionmakers, policymakers, planners, implementation specialists, educators, funders and other stakeholders. The framework is easy to use and globally applicable.

Why was EFBRI created? To bring established international ethics standards for biomedical research together in one package, relevant for breastfeeding and lactation. By consolidating accepted standards and removing duplication, research processes that involve breastfeeding mothers and children can become more efficient. EFBRI can be particularly helpful in cross-border or collaborative work. EFBRI is also intended to lay the groundwork for best practice ethics in healthcare policy, implementation and funding activities.

The aim? Safeguard the rights and dignity of all people while advancing health around the globe.

Why is EFBRI ‘evolving’? Ethical considerations play leading roles in breastfeeding and lactation research. As ethics evolve globally and EFBRI is applied to new and different situations, the framework will require reviews and updates to evolve in parallel. In the tradition of community science, explicit user feedback and suggestions (email to ethics@lactahub.org) from real-life cases will help EFBRI’s creators build a comprehensive, evergreen resource.

Access EFBRI Version 1.1 (August 2022) in PDF: EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions, Version 1.1

Older EFBRI version

Access EFBRI Version 1.0 (November 2021) in PDF: EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions, Version 1.0

Ethics in Health and Breastfeeding Research Series: Webinar I
LactaWebinar introducing EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions

Prof. Dr. med. Dr. phil. Nikola Biller-Andorno presents and discusses EFBRI.

The Journal of Medical Ethics blog has published a summary of the expert panel discussion: When context calls: EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions. Please access it here: Journal of Medical Ethics blog

Agenda
Update from The Global Health Network and LactaHub
Introduction to LactaHub's LactaEthics vision
Tour of EFBRI on LactaHub
Expert conversation on the practical application of ethical frameworks
Q&As

Speakers
Prof. Dr. med. Dr. phil. Nikola Biller-Andorno, co-creator of EFBRI; Director of the Institute of Biomedical Ethics and History of Medicine (University of Zurich), Switzerland, a WHO Collaborating Centre for Bioethics
Dr. Katharina Lichtner, Managing Director, Family Larsson-Rosenquist Foundation, Switzerland
Dr. Farah Asif, Clinical Research Administrator, Head of the Clinical Research Office, and Secretary of the Scientific Review Committee and the Institutional Review Board, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
Dr. Stephen Ombok Muhudhia, Specialist Paediatrician, Nairobi Hospital, Kenya; Adjunct Professor of Bioethics at Trinity International University; Co-Director of Trinity International University’s Africa Bioethics Initiative program; Member of the Scientific, Ethics and Research Unit (SERU) of the Kenya Medical Research Institute (KEMRI)

Access EFBRI in PDF: EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions, Version 1.1

This LactaWebinar completes the Forum for Global Health Ethics Webinar on Offering Financial Incentives to Participants in Health and Breastfeeding Research.

LactaWebinar recording, 10 March 2022

Access the webinar slides in PDF: LactaWebinar introducing EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions

To stay up to date about future LactaWebinars, please subscribe our LactaNews letter: Sign up LactaNews

Ethics in Health and Breastfeeding Research Series: Webinar II
Offering Financial Incentives to Participants in Health and Breastfeeding Research

Offering financial incentives is a common practice in health research to recruit participants, retain them, and promote health-related behaviours. Nevertheless, the use of these incentives remains controversial in some cases. In this webinar, international experts present their views on financial incentives in health research, discuss the ethical questions around the topic with a focus on breastfeeding research, and answer questions from the audience.

The Swiss Medical Weekly published a viewpoint on the topic of the webinar. Please access it here: Swiss Medical Weekly

Agenda
Introduction and short update on EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions
Experts present their views and share their experiences
Q&A with the audience and the experts
Wrap up and closing remarks

Panelists:
Mary Ani-Amponsah, Researcher, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, and Country Representative for the Council of International Neonatal Nurses, Ghana
Farah Asif, Clinical Research Administrator, Head of the Clinical Research Office, and Secretary of the Scientific Review Committee and the Institutional Review Board, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan
David B. Resnik, Bioethicist at the National Institute of Environmental Health Sciences, National Institutes of Health, USA
David Yanagizawa-Drott, Professor of Development and Emerging Markets at the Department of Economics and Managing Director of the LRF Center for Economics of Breastfeeding, University of Zurich, Switzerland

Chairs:
Nikola Biller-Andorno and Tania Manríquez Roa, Institute of Biomedical Ethics and History of Medicine, University of Zurich, Switzerland, a WHO Collaborating Centre for Bioethics

This webinar is part of the Forum for Global Health Ethics Webinar Series and completes the LactaWebinar on EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions.

Webinar recording, 13 April 2022

Access the webinar slides in PDF: Offering Financial Incentives to Participants in Health and Breastfeeding Research

To stay up to date about future LactaWebinars, please subscribe our LactaNews letter: Sign up LactaNews

EFBRI was created by Institute of Biomedical Ethics and History of Medicine (University of Zurich).

Creators: Mirriam Tyebally Fang, M.B.B.S (NUS), M.R.C.S (Edin.), and Nikola Biller-Andorno, MD, PhD, MHBA

Published exclusively on LactaHub – A Resource for Evidence-Based Breastfeeding Intelligence

LactaHub is a partnership project of The Global Health Network (University of Oxford) and the Family Larsson-Rosenquist Foundation.

DISCLAIMER. EFBRI – An Evolving Ethical Framework Informing Breastfeeding Research and Interventions is provided in good faith. It is not a legal document and does not supersede any national or international legal regulations. The resulting framework, intended for researchers, reviewers and funders, is a synthesis of relevant Swiss and international norms related to breastfeeding and lactation research. It is a guide for globally accepted best practices and in accordance with Swiss and international research ethics standards yet does not intend to replace any national norms, cultural values or country-specific review processes. The framework lays out rules and principles but does not claim to specify Good Clinical Practice or safety standards. The framework focuses on human participants only but does not cover animal ethics or environmental ethics. The framework will be refined as necessary based on periodic reviews. Therefore, we cannot guarantee its status as definitive guide and do not assume any liability. Liability claims against the authors and/or the publisher regarding damages whether material or immaterial caused by the use or non-use of the provided framework are excluded as a matter of principle.

Recommendations for more useful content on LactaHub

Breastfeeding and Breast Milk – from Biochemistry to Impact. Published by the Family Larsson-Rosenquist Foundation at Thieme, the evidence-based reference book presents a holistic, scientifically robust overview of key topics written by experts from a range of disciplines, including medicine, sociology, political science, culture and economics. The book is published open access on LactaHub and explores factors surrounding the influence of breastfeeding and breastmilk on children’s health and development. It is a valuable resource for decision-makers and healthcare providers alike.

LactaPedia – A Glossary of Lactation for Science and Medicine is a go-to source for standardised, research-based terminology for lactation, breastfeeding, and breastmilk, developed by The University of Western Australia.

INTERGROWTH-21^st Preterm Postnatal Growth Standards and Feeding Protocol are globally validated growth standards, feeding protocols, clinical tools and practical training materials created to improve preterm infant health outcomes globally. INTERGROWTH-21^st is coordinated by the University of Oxford.

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