I’m an IBCLC who supports the Fed is Best Foundation. Probably many of you who read this are going to roll your eyes and assume I’m just their sock puppet, but for those of you who are still listening, I’m going to tell you why I support an organization who talks about the “risks of exclusive breastfeeding” and states that the Baby-Friendly protocols “endanger newborns.” I know better than to put my name to this because I don’t want to subject myself or my children to what other supporters have faced—unspeakably cruel messages and literal death threats. I wish I were making this up.
I’ve devoted my professional career to helping mothers breastfeed, and I plan to continue to do so until the day I die. So how can an IBCLC support an organization that publicizes scary stories about breastfeeding tragedies? Easy — those are real moms and babies, and they deserve a voice to be heard and not silenced as I have heard suggested many, many times. Many of them did not end in tragedies like Landon Johnson’s, but near misses are still traumatic. Many of their babies have been injured or hospitalized after failure to supplement in a timely manner and pressure to avoid formula. Letting these mothers share their stories is not “inflammatory” or “scare tactics,” and referring to them as such is insulting and dismissive of these mothers’ real experiences.
Future mothers deserve to know all of the benefits and risks of their feeding choices. They deserve informed consent; in fact, it is their right. We don’t hide SIDS from parents because it’s scary, and we should not hide the risks of delayed onset of milk production and low supply, even if there’s disagreement about how common or rare it is. The lactation literature acknowledges that these stories are true and chilling. We certainly tell them all the risks of formula feeding, even the extremely rare ones. The Fed Is Best Foundation’s 730,000 Facebook followers and millions of blog hits in the last three years shows that mothers want to be prepared with all the information, not just the positives of breastfeeding.
“Informed is Best,” right? Breastfeeding is wonderful; it can handle a little tough love.
The fact is that any type of feeding has risks, which is why restaurants put posters up teaching the Heimlich maneuver. The Fed is Best Foundation is not trying to scare mothers into not breastfeeding. They simply find it unethical to downplay the reality that some babies do need or want more than the available colostrum in their mother’s breasts. Discussions about risks should be put into context, not ignored to protect mothers from fear or to improve our hospital’s core metrics. When I talk to a mother about IGT, for example, I also show her examples of mothers with tubular breasts who had normal milk supplies.
Informed consent does not destroy confidence; insisting a mother’s instincts about her own baby are wrong—and pressuring her to ignore them—can.
The founders of the Fed Is Best Foundation believe that avoiding the risks of excessive weight loss, dehydration, jaundice, and hypoglycemia are more important than the risks of using temporary supplementation. The Fed Is Best Foundation also supports having donor human milk available for supplementation as a priority for mothers who want to meet their EBF goals or do not want to use formula. Yes, there are risks to introducing a non-breastmilk fluid. All of them pale in comparison to the risks of hypoglycemia, dehydration, and jaundice from insufficient feeding. These risks include brain damage, life long disability, cardiac arrest, and death. They may not be common but they are real and can easily be prevented with rescue supplementation—or better yet, with not letting babies get in a position where they need to be rescued in the first place. The Fed Is Best Foundation is desperately trying to educate every one of these serious risks because we seem to have forgotten what’s at stake. Do any of the risks of formula include brain damage, cardiac arrest, or death? Nope.
IBCLCs look like ideologues instead of allied health professionals when we blow off these risks simply because we don’t want babies to be “exposed to formula.”
Risks of supplementation can be discussed too of course (but can we please get rid of the ridiculous consent forms for formula?) The mother is asking for an FDA approved food, not a back-alley illegal street drug. If she chooses to supplement, any LC who is not able to help a baby overcome flow dependence, nipple confusion, breast rejection, or to support the milk supply during supplementation needs to educate herself because it’s not that hard. (See how bad it feels to be told you’re not educated enough? So how about we stop treating mothers that way?) Babies were born to breastfeed, and small disruptions are not going to ruin this natural and instinctive process. Any IBCLC who has NICU experience knows that babies can be bottle-fed for weeks or even months and still transition to breastfeeding. What’s more, babies who are not lethargic or frantic breastfeed better, thus stimulating the milk supply more vigorously. Formula can absolutely cause risks to breastfeeding—but it can also be a tool to support it.
Obviously, most babies thrive with exclusive breastfeeding. The Fed Is Best Foundation does not recommend routinely supplementing all babies—only the ones who show signs of needing it. The definition of “need” is probably where the Fed Is Best and the Baby-Friendly differ. A baby who does not meet numerical criteria for medically necessary supplementation may not “need” it to live, but his cries tell us he’s suffering. His mother’s unshakeable anxiety tells her that something’s not right. The Fed Is Best Foundation promotes listening to the baby and the mother. Attempts to “educate” (i.e., pressure) her about cluster-feeding, second-night syndrome, or stomach size usually fail to comfort her. Cluster feeding, which is defined by the ABM as “several short feeds close together,” can be normal, but hours upon hours of breastfeeding followed by continued hunger is not cluster feeding by that definition.
It may be common for babies to do this but commonly does not mean normal or optimal. What’s not normal is expecting a mother to tolerate her baby’s hunger or to go for days without more than an hour or two of sleep. Some of these mothers either blow off LC advice and give large volumes of formula without our guidance on how to support their milk production. Others just push through the exhaustion and keep breastfeeding on demand out of fear that even a small amount of supplementation will hurt their baby or doom their breastfeeding relationship. Historically, mothers have supplemented with teas, broths, animal milk, or milk from another lactating woman, because it’s cruel to ignore a baby’s hunger and crying.
It’s painful for the baby to suffer from hunger or thirst, even for a few hours. Pain is recognized by the Joint Commission as a vital sign. Sleep deprivation is a torture technique banned by the Geneva convention.
Every breastfeeding organization acknowledges that formula should be used when medically necessary (if expressed or donor milk is not available). But medicine is used not only out of necessity; it is also used for comfort, pain relief, and distress, even in the absence of life-threatening conditions or the presence of potential side effects. I’ve heard LCs justify withholding formula because “we don’t give ice cream to diabetics if they ask for it.” Seriously? Ice cream is not a medical treatment. The Fed Is Best Foundation does not advise supplementing if the baby is safe and the mother feels breastfeeding is going well, but if a mother says she or her baby needs it, her decision should be respected. Likewise, breast pumps should be offered to all mothers who want them, whether or not the LC thinks she has a good reason. As long as she gets information on how to hand-express, the difference between direct breastfeeding and pumping, what to expect when pumping in the early days, and how to minimize the risk of engorgement, what is the harm? Her body, her choice.
The Baby-Friendly Hospital Initiative wants to support mothers who state on their admission intake that they want to exclusively breastfeed, which is great. However, her statement is not a legal contract and a mother can change her mind based on her baby’s current behavior. Temporary supplementation does not prevent her from going on to exclusively breastfeed, which allows her to meet her goal, though maybe not in the way she had originally planned.
A mother doesn’t check her civil rights at the door when she enters the hospital; she still has the agency to make parenting decisions and decisions about her body. We certainly stress that when it comes to mothers who want to avoid birth interventions.
Another reason why I feel the Fed Is Best Foundation does an admirable service to breastfeeding moms and babies is their online support groups. Since I joined some of the groups, I’ve had a front-row seat to the anguish and loneliness many of these moms feel while learning to breastfeed. The Fed Is Best support group embraces these mothers and treats them respectfully and compassionately while helping them reach their own feeding goals. The group feels like a very safe space due to the judgment-free atmosphere. The volunteers in the group spend hours of their free time, day and night, helping mothers with breastfeeding when no one else will hear their concerns. This is pretty much exactly what my LLL group did — meet mothers where they are, and support them in their breastfeeding goals. We did not bash formula, nor did we pressure mothers to breastfeed.
Even the parents in the group who are exclusively formula feeding pitch in to provide support and suggestions to help mothers breastfeed—this is what happens when women support women instead of tearing each other down!
I’m not the only IBCLC who supports the Fed Is Best Foundation, there are many of us, but we are afraid to speak out because our lactation professional community can be so vicious towards people who don’t agree with them. If you don’t believe me, try having an online conversation with your colleagues about nipple shields! IBCLCs can support breastfeeding and also support supplementing babies who still act hungry after multiple breastfeeds, because (a) it’s humane, (b) waiting until something is “medically necessary” is not a risk some of us feel comfortable taking, with vulnerable newborns, and (c) we support and respect what mothers are telling us about their own bodies and babies. I want to implore other IBCLCs to look for the common ground between us and the Fed is Best Foundation. Disagreements are unavoidable, but we should all be on the same team when it comes to protecting babies and supporting mothers’ choices in feeding them. If we don’t find common ground, we risk completely alienating the millions of mothers who have embraced Fed is Best, thus depriving them of all the support IBCLCs can offer, making our profession stronger and more respected by mothers and health care professionals.
Thank you for reading,
HOW YOU CAN SUPPORT FED IS BEST
There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:
- Join us in any of the Fed is Best volunteer and advocacy, groups. We currently have– Health Care Professionals group, Advocacy Group, Research Group, Volunteer Group, Editing Group, Social Media Group, Legal Group, Marketing Group, Maternal Mental Health Advocacy Group, Private Infant Feeding Support Group, Global Advocacy Group, and Fundraising Group. Please send an email to Jody@fedisbest.org– if you are interested in joining any of our volunteer groups.
- If you need support, we have a private support group– Join us here.
- If you or your baby were harmed from complications of insufficient breastfeeding please send a message to firstname.lastname@example.org
- Make a donation to the Fed is Best Foundation. We are using funds from donations to cover the cost of our website, our social media ads, our printing and mailing costs to reach health providers and hospitals. We do not accept donations from breast- or formula-feeding companies and 100% of your donations go toward these operational costs. All the work of the Foundation is achieved via the pro bono and volunteer work of its supporters.
- Sign our petition! Help us reach our policymakers, and drive change at a global level. Help us stand up for the lives of millions of infants who deserve a fighting chance. Sign the Fed is Best Petition at Change.org today, and share it with others.
- Share the stories and the message of the Fed is Best Foundation through word-of-mouth, by posting on your social media page and by sending our FREE infant feeding educational resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
- Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write to them about feeding complications your child may have experienced.
- Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
- Write your local elected officials about what is happening to newborn babies in hospitals and ask for legal protection of newborn babies from underfeeding and of mother’s rights to honest informed consent on the risks of insufficient feeding of breastfed babies.
- Send us your stories. Share with us your successes, your struggles and everything in between. Every story saves another child from experiencing the same and teaches another mom how to safely feed her baby. Every voice contributes to change.
- Send us messages of support. We work every single day to make infant feeding safe and supportive of every mother and child. Your messages of support keep us all going.
- Shop at Amazon Smile and Amazon donates to Fed Is Best Foundation.
- If you need support, we have a private support group– Join us here.
Or simply send us a message to find out how you can help make a difference with new ideas!
For any urgent messages or questions about infant feeding, please do not leave a message on this page as it will not get to us immediately. Instead, please email email@example.com.
Thank you and we look forward to hearing from you!