Author: Christie del Castillo-Hegyi MD

Co-Founder of the Fed is Best Foundation, Board-Certified Emergency Physician and Investigator of Breastfeeding Complications that Result in Infant Rehospitalization, Brain Injury and Disability

Fed is Best Foundation Presentation to WHO Officials on Breastfeeding Complications, Hospitalizations, Brain Injury and Disability

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Christie del Castillo-Hegyi, M.D., Co-Founder

On Sept. 22, 2017, senior members of the Fed is Best Foundation, and guests including a neonatologist from a leading U.S. tertiary care hospital who wished to remain anonymous and a pediatric endocrinologist, Dr. Paul Thornton, M.D, from Cook Children’s Hospital Fort Worth, lead author of the Pediatric Endocrine Society’s newborn hypoglycemia guidelines met via teleconference with top officials of the WHO Breastfeeding Program: Dr. Laurence Grummer-Strawn, Ph.D., Dr. Nigel Rollins, M.D. and Dr. Wilson Were, M.D. to express their concerns about the complications arising from the BFHI Ten Steps and to ask what, if any, monitoring, research, or public outreach the WHO has planned regarding the risks of accidental starvation of exclusively breastfed newborns. The Foundation members who attended were 1) Christie del Castillo-Hegyi, MD, Co-Founder, 2) Jody Segrave-Daly, RN, IBCLC, Co-Founder, 3) Julie Tibbets, JD, Partner at Alston & Bird, LLP, Pro-Bono Attorney for the Foundation, 4) Brian Symon, MD, Senior Advisor, and 5) Hillary Kuzdeba, MPH, former quality improvement program coordinator at a childrens hospital , managing infant feeding projects and Senior Advisor.

This is a video of the presentation given to the WHO officials:

We believe all babies deserve to be protected from hunger and thirst every single day of their life and we believe that education on Safe Infant Feeding should be free. If you would like to make a donation to support the Fed is Best Foundation’s mission to teach every parent Safe Infant Feeding, please consider making a one-time or recurring donation to our organization.

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Why the Academy of Breastfeeding Medicine Guidelines for “Medically Necessary” Supplementation Make the Baby-Friendly Hospital Initiative Unsafe

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by Christie del Castillo-Hegyi, M.D., Co-Founder of the Fed is Best Foundation

On September 22, 2017, senior members of the Fed is Best Foundation met with the top officials of the World Health Organization (WHO) Breastfeeding Program. We learned that the WHO has never studied the complications of the WHO Ten Steps to Successful Breastfeeding and the Baby-Friendly Hospital Initiative (BFHI). We learned they have no studies commissioned to monitor the complications. Despite being presented data on the complications caused by allowing newborns to fast for days to achieve exclusive breastfeeding, they declined our offer to help make the guidelines safer and more ethical.  To watch the presentation given to the WHO officials, please go to this link. We learned that they have known about the risks of brain injury from exclusive breastfeeding and yet refuse to inform the public and health professionals. We learned that their provision for preventing brain injury consisted of telling health professionals to look out for “convulsions, lethargy and being unable to feed,” which are late signs of newborn brain injury. As a result, the WHO Ten Steps and the BFHI has created to an epidemic of infant feeding complications, hospitalizations, brain injury and disability in the developed and developing world. This constitutes one of the largest and most egregious violations of patient and human rights in the history of public health. They have asked for comments from the public regarding their draft revision of the breastfeeding guidelines, which make no changes to the recommendation, “give infants no food or drink other than breastmilk unless medically indicated,” while providing patients no information on the risks of avoiding supplementation. This is the official response of the Fed is Best Foundation to their request. Continue reading →

World Health Organization Revised Breastfeeding Guidelines Put Babies at Risk Despite Pleas from Experts—Informing the Public “Not a Top Priority”

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By the Senior Advisory Board of the Fed is Best Foundation

A key recommendation of the 1989 World Health Organization Ten Steps to Successful Breastfeeding which guides the Baby-Friendly Hospital Initiative (BFHI) is: “give infants no food or drink other than breast-milk, unless medically indicated.” This has led to serious complications from accidental starvation of babies, including dehydration, hyperbilirubinemia (jaundice) and hypoglycemia (low blood sugar) — known causes of infant brain injury and permanent disability. Last week, the WHO issued draft revised breastfeeding guidelines, failing to revise this recommendation. These guidelines define the standard of care for breastfeeding management in all healthcare facilities worldwide. Nearly 500 U.S. hospitals and birthing centers and thousands more worldwide that meet the criteria of the BFHI are certified as Baby-Friendly, adhering to the application of the WHO’s Ten Steps.

On Sept. 22, 2017, senior members of the Fed is Best Foundation, and guests including a neonatologist from a leading U.S. tertiary care hospital and a pediatric endocrinologist, Dr. Paul Thornton, M.D, from Cook Children’s Hospital Fort Worth, lead author of the Pediatric Endocrine Society’s newborn hypoglycemia guidelines, met via teleconference with top officials of the WHO Breastfeeding Program: Dr. Laurence Grummer-Strawn, Ph.D., Dr. Nigel Rollins, M.D. and Dr. Wilson Were, M.D. to express their concerns about the complications arising from the BFHI Ten Steps and to ask what, if any, monitoring, research, or public outreach the WHO has planned regarding the risks of accidental starvation of exclusively breastfed newborns. The Foundation members who attended were 1) Christie del Castillo-Hegyi, MD, Co-Founder, 2) Jody Segrave-Daly, RN, IBCLC, Co-Founder, 3) Julie Tibbets, JD, Partner at Alston & Bird, LLP, Pro-Bono Attorney for the Foundation, 4) Brian Symon, MD, Senior Advisor, and 5) Hillary Kuzdeba, MPH, former quality improvement program coordinator at a children’s hospital, managing infant feeding projects and Senior Advisor.

Emails confirming meeting between the WHO and the Fed is Best Foundation available here.

Continue reading →

Infant Feeding Considerations for Emergency Situations

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By Jody Segrave-Daly, RN, IBCLC, Co-Founder of the Fed is Best Foundation

During an emergency the sudden disruption of electrical power, clean water, and social relief services can impact the safe acquisition and storage of formula or human milk, as well as the ability to heat water for optimal cleaning practices. Consider the options below to help you prepare for and cope with a disaster:

Preparing Safe Food Items

PUMPED/EXPRESSED BREAST MILK

Pumped breastmilk can be stored in sterile (disposable) bags in a portable cooler with pre-frozen water bottles or ice packs for up to 24 hours. Thawing breastmilk may be refrozen if ice crystals are still evident once power returns. Pump dependent mothers should have 1-2 hand pumps in case all other options fail. External batteries or a vehicle charger/power supply for pumping in the car if its safe is helpful for a short period of time. Use the correct technique to maximize hand expression output.

FORMULA

Consider buying 4-7 days worth of pre-mixed, “ready to feed” bottles of formula, as well as a corresponding amount of clean bottles and nipples. Single use bottles of pre-mixed“nursettes” with disposable nipples or bottles with disposable liners may be especially useful for ease of storage and cleaning.

READY-TO-FEED BABY/TODDLER FOOD

To prepare, buy 4-7 days worth of pre-made baby/toddler meals, disposable utensils, cups, and plates. Opened food may be kept up to 24 hours in a portable cooler.

CLEAN WATER

Having an ample supply of clean water is a top priority in any emergency. A normally active person needs at least two quarts (half a gallon) of water each day. People in hot environments, children, nursing mothers, and ill people will require even more. Store at least one gallon per person, per day. You will also need water for food preparation and hygiene. Consider storing at least a two-week supply of water for each member of your family. If you are unable to store this quantity, store as much as you can.

Preparing Safe Feeding Supplies

HOW TO CLEAN FEEDING SUPPLIES (PUMP, BOTTLE, PACIFIER etc.)

In the absence of power or hot water you can still take steps to make sure your feeding supplies are sufficiently clean:

You will need:
  • High quality paper towels
  • liquid dish soap
  • antiseptic wipes
  • disposable gloves
  • hand sanitizer
  • 1 large plastic bowls for washing
  • 1 plastic bowl for rinsing
  • 1 large container with lid for storage of clean feeding supplies.
Steps:
  • Clean prep surface with antiseptic wipes and wash hands
  • Place parts in a clean wash basin (large plastic bowl) used only for washing infant feeding equipment.
  • Fill wash basin with CLEAN water and soap.
  • Wash and scrub using clean paper towels.
  • Rinse using CLEAN water
  • Pat dry with clean paper towel / let air dry completely
  • Store in clean and closed plastic bin.
REFRIDGERATOR / FREEZER

Consider filling the freezer by stacking one gallon zip-lock bags partially filled with water. This will help keep the freezer cold if power goes out, and will also give you extra water in case of emergency. Freeze individual water bottles to place in portable coolers and to drink when thawed.

BOILING WATER

Boiling is the safest method of treating water to kill microorganisms. In a large pot or kettle, bring water to a rolling boil for 1 full minute. Let the water cool before drinking. The taste of boiled, stored water will improve if you put oxygen back into it by pouring the water back and forth between two clean containers.

CHLORINATING WATER

When no other options are available, you can use household liquid bleach to kill microorganisms. Use only regular household liquid bleach that contains 5.25 to 6.0 percent sodium hypochlorite. Do not use scented bleaches, color safe bleaches, or bleaches with added cleaners. Use bleach from a newly opened or unopened bottle as the potency of bleach diminishes over time. It is not recommended to use chlorinated water for mixing infant formula, however it is still safer than preparing formula with untreated, contaminated water.

Add 16 drops (1/8 teaspoon) of bleach per gallon of water, stir, and let stand for 30 minutes. The water should have a slight bleach odor. If it doesn’t, then repeat the dosage and let stand another 15 minutes. If it still does not smell of bleach, discard it and find another source of water. Other chemicals, such as iodine or water treatment products (sold in camping or surplus stores) that do not contain 5.25 to 6.0 percent sodium hypochlorite as the only active ingredient are not recommended and should not be used.

Additional Resources:

https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
https://www.cdc.gov/healthywater/pdf/hygiene/breast-pump-fact-sheet.pdf
https://www.fema.gov/pdf/library/f&web.pdf?fref=gc&dti=217577232092793
https://www.qld.gov.au/emergency/dealing-disasters/formula-emergency
http://www.fearlessformulafeeder.com/2011/11/formula-feeding-in-disaster-situations-is-there-a-dose-of-reality-in-your-emegency-kit/

Click below for a printable version of this article
Infant Feeding Guide in Emergency Situations

I See Myself in Other Mother’s Eyes: A Neonatologist’s Fed is Best Story

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 by dr. Jessica Madden, M.D., Neonatologist

My oldest daughter, Grace, was born when I was 28 years old. She was our long-awaited first child, the one who I had postponed having for many years so that I could get through a good chunk of my medical training before becoming a mom.  I felt like I was prepared as much as one could possibly be to take care of and breastfeed a newborn.  I had spent years babysitting my siblings and neighbors and had over two years of intense pediatric/neonatal training under my belt. I had read every single “What to Expect” type of book, joined multiple online breastfeeding forums to learn from experienced mothers beforehand, and took all of the prenatal classes at the hospital where I delivered. I knew that breastfeeding was going to be difficult and exhausting at times, and that it might take several weeks for my baby and me to get into a “groove” with it, but I was ready to dive in headfirst.

“In my work as a neonatologist I have taken care of countless babies around the U.S. who have had to be admitted to the neonatal intensive care unit (NICU) for breastfeeding failures. The most common breastfeeding problems I encounter requiring hospital admissions are dehydration, hypernatremia (high sodium levels), hypoglycemia (low glucose levels), and jaundice (patients often have some combination of these 4 diagnoses).” Continue reading →