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

My Son Was Exclusively Breastfed and Was Admitted with Hypernatremia and Jaundice the Next Day After Discharge

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By Brooke Orosz, Ph.D. Professor of Statistics and Math, Fed is Best Advisor

My son was born 2 years ago today. In my seventh month, he was diagnosed with a condition called intrauterine growth restriction, basically his placenta wasn’t working right, and he was growing too slowly as a result. To prevent complications, he was delivered by c-section at 37 weeks. He weighed just 4 pounds 15 ounces and appeared to have no baby fat at all, but he was vigorously healthy, and was able to spend his hospital stay with us rather than in NICU. We were absolutely over the moon.20

At 48 hours old, his bilirubin was just over 10. Shortly before his discharge at about 80 hours old, a staff member weighed him and discovered that he had already lost 11% of his body weight, but they did not tell us this. Despite several risk factors, no one suggested an additional bilirubin measurement before going home or counseled us on the risks of severe jaundice. We left the hospital with the impression that everything was going perfectly.

The next morning, we went to the pediatrician, who sent to the hospital for another bilirubin check. An hour later, he called us and told us to drive our son to the regional NICU. At readmission, he had lost 14% of his body weight, his sodium level was 159, and his bilirubin was over 19. He had to stay in the hospital overnight, and we had to leave him behind.

 

My Son in the NICU Admitted for Hypernatremic Dehydration and Jaundice

I cannot praise enough the NICU staff, a doctor, several nurses, a social worker and an LC. They acted swiftly and effectively to save my son’s life, preserve his brain function and restore his health, and treated his father and I with extraordinary compassion on the worst day of our lives. I wish I remembered their names so I could name them, instead I will merely thank the NICU staff of St. Barnabas Hospital.

The hospital where he was born was Clara Maas. I cannot name one single staff member who was clearly negligent, I think it was more a case of him slipping through the cracks. The on-staff LC never checked on us after the first day, and I still don’t know exactly who knew what, when or who made which decision. Nevertheless, they allowed an at-risk newborn (37 weeks and Small-for-Gestational-Age) to go home without double-checking that he was safe or providing any special instructions for his care. Personally, I would not deliver another baby there.

Details of the incident have been reported to Clara Maas hospital in a formal complaint, and to the Joint Commission.

My Son at 2 years of Age

 

Brooke Orosz, PhD is a professor of mathematics and advisor to the Fed is Best Foundation. After her son’s crisis, she was stunned to learn that readmissions for nursing problems are commonplace, and that they are not tracked or penalized by health authorities. Since then, she has used her knowledge of statistics to study the problem and to advocate for evidence-based feeding protocols that put the baby’s safety and comfort first.

Questions to Ask Your Health Providers to See if They Believe that Fed is Best

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Mothers have reported feeling unprepared for their birth and postpartum experiences and that their newborns experienced complications from underfeeding due to excessive pressure to exclusively breastfeed.  It is important to know your health providers, their perspectives on infant feeding, supplementation and keeping your baby safe from complications and hospitalization.  These are a list of questions to ask your health provider to see if they and their hospital believe that Fed is Best.

 

What do I do if my milk does not come in and my child is not getting enough milk?

If they are unwilling to discuss this possibility and are unwilling to tell you how to protect your child from complications, then they are not being honest with you and are violating a basic ethical obligation required of all health providers. They should be able to tell you that supplementation with formula or safe, tested donor breast milk can protect your child from complications if your breast milk is not enough.

 

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Keeping Your Baby Safe by Knowing Normal vs. Abnormal

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

In order to provide mothers and health professional a quick guide to preventing newborn brain injury in the first days of life, the following is a short slideshow on the scientific literature regarding the thresholds that predict newborn brain injury and developmental delay and disability in the first days of life related to insufficient feeding.

All complications of underfeeding, including jaundice, weight loss, hypernatremia, dehydration and hypoglycemia can be prevented with feeding sufficient milk before the complications occur. The scientific literature shows that by the time a child develops abnormal jaundice, hypernatremia or hypoglycemia, the brain injury that follows is irreversible and can result in long-term negative consequences to brain development, even when corrected.

We advise parents and health professionals to be knowledgable about what constitutes safe and unsafe lab values and weight loss so that all newborns can be protected.

 

Breastfeeding Before Babies: The Baby-Friendly Hospital Initiative’s Unwillingness to Change or Accept Responsibility

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BY CHRISTIE DEL CASTILLO-HEGYI, M.D., Co-Founder of the FEd is Best Foundation

Every patient-healthcare provider relationship is governed by four central principles of medical ethics, which are the following:

  1. Beneficence – Health care providers have the duty to provide care in a way that benefits a patient, increases their safety, their immediate and long-term health, and their comfort.
  2. Non-maleficence – First, do no harm. This principle requires that health professionals do not intentionally harm or injure a patient either through acts of commission or omission. If an intervention causes more harm to a patient than doing nothing, you do not intervene.
  3. Respect for Patient Autonomy – With any health care decision, the patient has the right to full disclosure of the risks and benefits of any intervention, regardless of how rare, so that they may act in their own or their children’s best interests to get the best outcomes with the least risk involved. Patient autonomy can only be fully realized if they are given honest and complete information on any and all the risks and benefits, whether common or rare, so that they may voluntarily choose, free of coaxing or coercion, in order to optimize their own or their children’s health outcomes.
  4. Respect for Human Rights – In 1948, the United Nations published the Universal Declaration of Human Rights, which subsequently charged governments, doctors and health workers to protect the human rights and human dignity of all people. It provides special protection of the physical integrity of those who are unable to consent, which includes children. These human rights include the right to food and water to prevent starvation and the associated injury to the brain and vital organs.

The Baby-Friendly Hospital Initiative has violated all four of these core principles of medical ethics through its policies and has reiterated its commitment to defending its dangerous policies over their commitment to patient safety in their recent dismissive response to Landon Johnson’s accidental starvation death caused by the Baby-Friendly policies. Continue reading →

Si Yo Le Hubiese Dado Sólo Una Botella, Él Todavía Estaría Vivo

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escrito por jillian johnson con el comentario del Dr. Christie del Castillo-Hegyi, M.D.

Landon tendría cinco años hoy, si estuviera aún vivo. Es un cumpleaños muy duro. Es un cumpleaños importante. La mayoría de los niños estarían comenzando el jardín de la infancia a esta edad. Pero no mi pequeño. Quise compartir durante mucho tiempo lo que le pasó a Landon, pero siempre temí lo que dirían los demás y cómo me juzgarían. Pero quiero que la gente sepa cuánto más profundo es el dolor.

Comparto su historia con la esperanza de que ninguna otra familia experimente la pérdida que sufrimos. Continue reading →