Support for Arkansas Week provided by the Arkansas Democrat-Gazette.

The Arkansas Times and Little Rock Public Radio.

And hello again, everyone, and thanks for being with us.

Baby Formula.

It may be fine or good enough for most infants most of the time, but for those newborns who need the extras that only breast milk provides, there is a breakthrough.

It's an important step for Arkansas, which scores very poorly in most assessments of maternal and neonatal care.

We'll have details of that break for you in just a few minutes.

First, the stalemate in Washington over additional military aid to Ukraine.

After much debate and with our two members splitting on the issue, the Senate approved about $70 billion in assistance and sent the legislation to the House where the speaker promptly declared a two week recess.

The outlook for the Ukraine package in the House, with its narrow and sharply divided Republican majority, remains decidedly uncertain.

We are joined now by Arkansas Congressman French Hill of the Second District, who was in Ukraine only days ago.

Congressman, thanks for coming in.

Steve, good to be with you.

Was the was the president terribly reassured by your message?

You tried to reassure him anyway that the bulk of the Congress and the country U.S. was behind him?

And I think that's right.

The bulk of the United States do not want Putin to win in Ukraine.

The bulk of people in the United States want Europe to do more than their fair share in both military humanitarian assistance to back Ukraine in pushing back against Putin.

So it seems to me that it's clear that America, the indispensable nation for democracy and for military assistance, should be their partner.

And we are.

And I told President Zelensky, as I did last November, there will be a strong bipartisan support for assistance to Ukraine.

What we have to do is craft the way to get it to the House floor for consideration.

And that's what where we find ourselves right now.

Well, are you are you saying then, that a majority of your conference certainly was in the settlement?

A minority of Republican members of the Senate voted for the aid package and it was razor close right in that in the House.

So are they out of step?

Is your conference out of step or a substantial portion of it out of step?

I think look, I think a majority of both parties in the House are for supporting Ukraine, Taiwan and Israel.

I think in the Republican Party on Ukraine, support has waned a bit, which is a little unclear to me.

It's not supported by any facts.

For example, the Europeans are doing double what the United States is doing in support of Ukraine in total.

We're doing more and military assistance, as we should.

We have the largest military, the largest military stockpiles.

But the Europeans are contributing mightily two times more than we are in other areas.

The the money that we're spending is full.

We ordered it and vetted it by inspectors general resident in Ukraine from the State Department, USAID and the Pentagon, the 82nd Airborne and the 10th Mountain Division Review.

Every piece of military equipment and inventory it and catalog it before it goes to the country.

So we are sharing the burden with Europe.

We are auditing and inspecting everything that's going in.

The money is not being wasted.

And the Ukrainians won back 50% of the territory last year that the Russians had taken.

And most importantly, it's not sufficient.

Press coverage has taken control of the Black Sea again from Russia's navy, which is now cowering.

That's behind the, uh, behind Crimea.

This is huge for the economy of Ukraine, because the better the Ukrainian economy does, the less money obviously partners have to provide.

Well, one key factor in the US political and congressional landscape in the way the debate would appear to be the antipathy that Mr. Trump has displayed toward not only the Ukraine mission but to NATO as well.

Is that not a driving factor?

I do think President Trump is a driving factor in Republican politics, but I always remind people there was President Trump that urged European countries to step up their contributions.

Every president since Johnson to Russia to invade.

Well, yeah, but that's ridiculous.

I agree that that was uncalled for.

And in an offhand remark that wasn't humorous at all.

Every president since John F Kennedy has asked the Europeans to do more.

Trump's no different than Kennedy and Reagan from that point of view.

And he did move more troops into Poland.

He did provide more armed assurance to the Baltic nations when he was president.

So.

Look, I'm just going to argue that under Trump, Ukraine was armed.

The Ukrainians had not been armed under Obama and under Trump, NATO's expanded in its military force to the east because of Russians threatening so we can leave it at that.

What we need is for American Republicans in the House to recognize this is in our national security interest to do this just as it is to back the defense of Taiwan and to support our ally Israel.

All three are important and all for the same reason, which is that you're greenlighting authoritarians or mullahs or people who are against the U.S. national security interests.

Iran.

Russia.

China.

North Korea.

These are partners in an axis of evil, no doubt against Western interests.

The the chemistry of the debates there, will it be altered in any way toward assistance, further assistance by the excuse me, by the death of Mr. Navalny and by the president.

Biden has said that it was, in his words, quote, no doubt that Mr. Putin was behind it.

Will that change?

I don't think so.

I think that's just more to stick.

Despicable behavior by Putin.

He kills people in parks in London.

So why not slowly end up the death of at the hands of an opponent in one of his gulags?

That's no surprise to anybody.

But will it change the debate?

I don't think it'll change the debate because I think the debate in Congress is firm.

We need to provide lethal military assistance along with our European allies, to tell Putin he's not going to take anymore of Ukraine, Ukraine, Ukraine will be a sovereign country.

Ukraine is likely to be a member of the European Union and likely to be a future member of NATO.

He needs to get that thought firmly ensconced in his Putin sized brain and recognize that he's not going to win here.

Are we seeing a it's been argued that today's Republicanism is backing away from the internationalism that has marked its its approach to foreign policy for a century almost, that it's now more.

Well, it's more Trump than Taft.

No.

What's your response?

My response would be that even going back to President Reagan in the early eighties, you know, putting America at the heart of what our goals and objectives are is critical, whether it's domestic policy or international policy.

Okay.

Great question.

Before we end up sending troops or money abroad is what's in it for the United States?

What's in it with our treaty partners?

And we have to remember that we have obligations in Europe, the transatlantic partnership that we've had since 1945.

But we always ask ourselves and what we come out is the answer is we have more jobs in this country, more investment opportunities, more growth of our economy.

If our trading partners are doing well and if they feel protected by America's security partnership, whether it's in South Korea, Japan, Taiwan or in Europe.

And so we come out ahead when we make a rational decision about how to apply our national security interest.

I think a lot of Americans are off track on that, frankly, because of the wars in Iraq and Afghanistan, in the global war on terror.

They've grown up with that for the last two decades.

But that doesn't should not be confused by the fact that we want to preserve our Western democracy, our way of life, the way of life of the U.S. dollar and global capitalism.

And you don't do that by succumbing to the Iranian mullahs or the Chinese communists or the Russian communists.

You don't.

Plainly, there is a pretty sharp division in your conference, certainly in the House and even in the Senate, to how to bridge that.

I think you, Bridget, by arguing that this is in our interest and I personally think that for eight decades we've attempted to counter Russian aggression in space, Russian aggression in the third World, Russian aggression in the Western Hemisphere by state generally.

But it isn't just foreign policy, Congressman.

It's domestic policy to its fiscal policy.

Yeah, well, our fiscal policy is been broken.

I think and we've talked about this before mightily in the last year, certainly since the pandemic, that somehow budget deficits don't matter.

We're running a $2 trillion deficit.

Joe Biden spending $2 trillion more annualized then in 2019.

I mean, that is a staggering amount of money considering we will have $1 trillion in interest paid on an annualized basis for calendar year 24 on our national debt.

So we have a lot of work to do.

We have a budget constraint we need to think through, but we do need to recognize the role the United States plays in the global economy and in the global national security.

Let me shift gears, if I can.

You have just been appointed, sir, to a new standing committee.

Was a special committee.

Well, a new committee, anyway, to look into artificial intelligence, which, well, where to start.

What are you going to do with this committee?

Well, we have a working group in the house Financial Services Committee that I lead on A.I.

And Speaker Johnson has now named a Congress wide bipartisan effort to look at artificial intelligence.

The idea is to look at it from how is it going to enhance our lives?

How is it going to make our businesses, our households, our consumers have more options, more opportunities?

But also, what are some of the downsides, like the recent concern people have about deepfakes, whether it's in a political context or think about a deepfake that I wrote about in Arkansas business just two weeks ago, about someone who thought they were buying a piece of property and the whole thing was a fake and marketed through artificial intelligence.

So we're going to look at what laws and regulatory frameworks do we need to adjust to to address this rapidly growing new frontier, which is artificial intelligence?

Well, is it going to be for your works or is it going to be focused mainly on thinking that artificial intelligence made Taylor Swift mad?

It scared Henry Kissinger?

Mm hmm.

So what are the parameters of the committee?

I think you'll see our work is is is both.

We want to deal with it in a commercial context and protecting people from their image name and like likeness being stolen and misused for political purposes or commercial purposes or entertainment purposes.

But we also need to be thinking about it as it relates to our national security.

And last year we went to MIT, to the Massachusetts Institute of Technology, as the House Intelligence Committee, bipartisan, to listen to the risks that we have to our code breakers and our intelligence gathering, processing and intelligence analytics due to our adversaries having access to artificial intelligence.

So I think you'll see us do it from both a national security point of view and a commercial and household application.

Let me go back to budget just for a second, because you were referring to the the the deficits which are in the trillions.

The secretary of the Treasury complained the other day that Congress has done nothing to act on the administration's program.

Your response?

Well, I don't know which program Secretary Yellen's referring to, so I don't know if you want us to.

Well, there's some revenue enhancements in there that are.

Well, I don't think those revenue handprints have the support in Congress, either in the House or the Senate.

She wants to raise taxes on working families.

She wants to tax and tax investments more for their green energy agenda.

And I just don't think there's support for that in Congress.

I think what we have to recognize is that our revenues right now in this country at a 70 year high, the 2017 tax reforms have seen revenues pour into the federal coffers at a 70 year high in revenue growth.

But what we've what we've seen is an avalanche of federal spending.

Well, to be fair, it also added to the deficit.

Did it answer?

No, it did not.

No, it didn't.

It didn't.

It was it was when you look back over that period of time, those tax reforms have produced more revenues and they have beaten CBO's forecast handily on their original suggestions.

Back in 2017.

So to me, you can't have a deficit running at seven or 8% per year.

When an economy grows 3% per year, you can't have a deficit spending at that rate.

It's just unsustainable.

And that's what Jay Powell told Congress last week.

So I hope what we can do is actually have a bipartisan approach, as we did in the Fiscal Responsibility Act, connected to the debt ceiling, to bring this federal spending back to pre-pandemic levels and have debates about what that should be.

Got to end it there because we're simply out of time.

Thank you, as always.

Thanks for coming in.

Come back soon.

You bet.

All right.

And we'll be right back.

And we are back.

Doctors say it is the best head start a child can get.

The most basic, most natural, most nutritious food that nature can provide.

The problem is too many mothers can't provide it.

A problem that is especially worrisome when newborns need intensive neonatal care.

The solution seems simple enough A holding facility for donor milk.

A milk bank, if you will.

But it took an act of the General Assembly to make it possible.

We're joined now by a primary sponsor of that legislation, Representative Aaron Pilkington of Knoxville, and by Dr. Misti Virmani of the University of Arkansas for Medical Sciences Sciences, where she directs the Milk Bank program.

Dr., I'd like to begin with you, if I may.

What are the properties of mother's milk, of breast milk that make it so important, so crucial, particularly to those infants who are in intensive care?

Well, I treat mother's milk as though it's a medication, so I value mother's milk for good nutrition for all of our infants, but particularly for the babies that I care for in the Nick U at UMass and Arkansas Children's Hospital.

Breast milk.

Mom's milk provides a substantial amount of immune protection.

The antibodies and the immunoglobulins that are present in mom's milk actually kind of invade and get into the baby's body and help develop the organs and the immune structure, the ability to fight off infections and to develop appropriately, but help that baby then grow and develop.

One of the biggest functions is that it helps protect how the intestines work.

And in a premature baby, the intestines are particularly vulnerable to injury from all sorts of things, from infection, but even from having things like cow milk proteins in their body very early on in life can cause injury to the intestine.

That can cause some very serious and even life threatening episodes that we call necrotizing enterocolitis.

So valuable, so valuable is is is breast milk that we were we were literally buying it from other states where we were.

You know, that was one of the interesting things that when I started looking into this, you know, obviously maternal health is a passion of mine, was that we essentially were having to buy it from other states.

So we had a nick here in Arkansas.

But if we needed donor milk, we had to either go to Texas or Michigan.

And it was actually even crazier was we had mothers in Arkansas who wanted to donate their milk and we're sending it to another state and then who knows where that may have gone.

So we could have had Arkansas women helping Arkansas women.

And instead, because of us not having a breast milk bank, we weren't able to do that.

So to me, it seemed like a flaw.

It seemed like we were sending money out of state that we could have kept here within the state.

And so to me, it just seemed like the natural next step in improving maternal health was making sure that we have a milk bank here in Arkansas.

Well, given given our birth rates, if you will.

And can this solve the problem?

Will we run away or will we?

It's just going to be a phased in thing.

Well, I won't solve the problem.

I tell everyone all the time there's no silver bullet, but I think it's an important quiver in the arrow.

And so we may have to continue to buy some.

And anyway.

Oh, sure.

I mean, and also supplies run low, too.

We could have an episode where we have an astronomical amount of babies.

We don't have enough coming into our bank.

So we could eventually, but at the same time too, we could also be producing more that we're end up selling to other states and so that we're able to actually bring revenue into Arkansas by having a robust milk bank.

So, you know, it's just like anything I mean, it's almost like, you know, like gas, You know, some people have more, some people have less.

And so, you know, the you kind of works out that way.

So but we're we're excited.

And I think this is a good first step and we're going to grow the bank and hopefully continue to see it grow.

What was the what was the obstacle?

Was it a legal obstacle here, Mr. Pilkington or Doctor, to both of you?

What what had to happen before this could happen?

Well, I think one was just it wasn't a legal issue.

I think they could have done it at any point.

But I think it was also the financial part about if Uams were to go and establish this bank, would the General Assembly fund it?

Would they give them the necessary, you know, revenue or funds to put it into place and fill it because you have a capital costs like you do with any project.

And so we though saw that it was necessary for the state and we were willing to step up to the plate and give this money to Uams so that we can establish a milk bank.

So it wasn't so much illegal, just financial.

And I think when we saw how much money Arkansas money was going out of state to buy milk, I think it clicked for a lot of people up.

This isn't something that's just good for maternal health.

I think it's financially sound as well.

Yeah.

Doctor, your thoughts?

Yeah, there's definitely a financial benefit to having the milk being come from inside the state.

And as doctor as Aaron Pilkington said, there's a lot of moms in Arkansas who have a lot of milk and want to share of their abundance and be able to help other babies.

And so we've had a large number of women who have inquired about being able to donate their milk.

And we are working our way up and our processing capabilities to be able to provide more and more NICUs with the donor milk that we produce who can donate and watch the screening process.

What are the criteria for donations for accepting donate?

Absolutely.

Any lactating mom who wants to know more about donating their milk can fill out a form on our website that leads them through some of the early questions about who's qualified as a milk donor.

We, of course, want them to be successful in their breastfeeding journey first and foremost, because I want her to be healthy and her her baby to be healthy.

At home.

We ask questions like, Do you smoke or use nicotine containing products?

Do you drink alcohol?

Do you have a history of certain infections, things of that nature that will potentially put the milk at risk or social behaviors that might create some problems with the milk that would be harmful potentially to a newborn infant?

After we go through that screening process, then we send mom for some blood work to make sure things of an infectious nature have been tested for thoroughly.

We also speak to her physician to make sure that there's no medical concerns from her personal physician and that they don't have any labs or any history that would be of concern to us.

Is it necessary to test for a further doctor?

I mean, to test the milk itself, the donated milk itself, it is not necessary to test the donated milk itself before we accept it.

We do test the milk and look at the nutritional content of the milk to make sure that the product that we're producing as the needed nutrients in it to help a newborn baby grow, particularly in the new infant.

And then we also look at the milk after we're done with the pasteurization process to make sure that there's no bacterial contamination and no bacterial growth in the milk that might further harm the baby.

Now, there are other aspects of the program to Mr. Pilkington beyond just the donation and the processing of the milk, there's an educational function that anyway, you hope to see.

Yes, Clive.

Yeah.

And Dr. Vermont, he's been great.

And kind of helping develop these programs.

Um, the hope is that we can have classes about lactation, about the benefits of breastfeeding, helping new mothers who are struggling, maybe with being able to breastfeed their child, but who want to giving them the tools and resources they need so that they can they can feed their child the way they want to.

You know, also the you know, the use of telemedicine.

And as that has become more and more used in rural areas, you know, the hope is that we can actually use telemedicine to reach those far out places and rule Arkansas when they're struggling with breastfeeding to telehealth in to UMass and get the services they need and the education they need so that they can they can perform the way they want to.

Yeah.

Doctor, what from a clinical standpoint, what what what are the advantages here that that that we can see in terms of Arkansas is absolutely abysmal a neonatal standing now so infant mortality and maternal mortality in Arkansas are incredibly high, much higher than we would ever want and higher than the national standards.

Breastfeeding for infants helps reduce particularly preterm infants, helps to reduce the risk of death and sepsis.

It's most important for us to be able to provide the mother's own milk, if that's at all possible.

And so all of our NICUs work very hard to promote and support that.

But when it's not, donor milk is a safe option.

Being breastfed or fed from their mother means that these babies also, when they go home, even healthy term babies have a lower risk of sudden infant death syndrome, and the longer they breastfeed, the healthier they are.

But the importance of the benefits expense extend to mother as well.

Mothers who breastfeed after they've been pregnant have lower risk of things like stroke and heart attack, lower risk of developing diabetes, and they have healthier lives long term.

So we help support maternal health, both in the short term and in the long term by encouraging and supporting breastfeeding more broadly.

Yeah.

Representative Pilkington, you said earlier this was a passion of yours neonatal care, maternal maternal care.

As a clinical professional, yourself administrator, right.

What do you anticipate this is going to do?

I mean, can you see this in the in the near term making a difference?

Oh, yeah.

I think think of the near term when we look at some of the outcomes.

I'm hoping to see improvements, especially with those nick babies, those really vulnerable population.

I think those well, you know, this helps.

Linda discussion about why breastfeeding is so important.

The benefits of it.

I think to me, you know, I was a young guy when I first kind of stumbled into this, you know, you don't know about all the benefits.

And we've actually passed legislation to make sure that we're trying to teach more in the classroom about the benefits of breastfeeding, things like that, because long term, if we want a healthier Arkansas, I think the more women who are breastfeeding their babies, the better.

And so obviously that's not possible for everybody, but for those who can, we hope that we do.

So I think in the near term, I think with those Nikkie babies, you're going to see improvement.

But I think in the long term you will see an improvement in that maternal health.

Like I said, this isn't a silver bullet, but it's one of the arrows in the quiver that help us kind of reach the better maternal health outcomes that we're hoping to reach.

Well, I hesitate to say it for fear of looking cynical here, but there are some fiscal implications for this for the Arkansas state treasurer in terms of the Medicaid program and for private insurance as well.

Preemies can cost an awful lot of money and something that can cut and reduce that cost is speaks for itself 100%.

You know, those those high risk pregnancies, those high risk births, they cost they cost not on the state, but private insurance, a lot of money.

And then, of course, treating and taking care of those babies in the long term are also very expensive.

Anything we can do to improve those outcomes and get them better, faster, we should always look at as a definite benefit.

And this is one of those things.

So, you know, I would be curious to see the data in five, ten years about how much we could or could potentially save by making those health improvement outcomes improved.

Good.

Representative Pilkington, thanks for coming in, Doctor.

Thank you for being with us as well.

Thank you.

Come back soon and good luck with the program.

That does it for us for this week.

As always, thanks for watching.

See you next week.

Support for Arkansas Week provided by the Arkansas Democrat-Gazette, The Arkansas Times and Little Rock Public Radio.