U.S. Study Shows Baby-Friendly Hospital Initiative Does Not Work

by Christie del Castillo-Hegyi, M.D.

On October 14, 2019, the Journal of Pediatrics published astonishing findings regarding the effects of the Baby-Friendly hospital certification on sustained breastfeeding rates as defined by the 2020 Healthy People Goals of: 

  1. any breastfeeding at 6 and 12 months
  2. exclusive breastfeeding at 3 and 6 months. 

They did so by measuring the relationship between statewide breastfeeding initiation rates data and the above breastfeeding rates. They then measured the contribution of Baby-Friendly hospital designation on these same breastfeeding outcomes.

According to the study authors, the increase in hospital designation in the Baby-Friendly Hospital Initiative (BFHI) began in 2011 when the U.S. Surgeon General issued a call to action for maternity care practices throughout the U.S. to support breastfeeding. The Centers for Disease Control (CDC) became involved in promoting the BFHI policies in hospitals and health facilities, as breastfeeding was thought to be associated with lower rates of childhood obesity. The assumption was that by increasing breastfeeding rates through the BFHI, there would be a concomitant decline in childhood obesity. Upon initiation of this program, the CDC initiated surveillance of state-specific data on breastfeeding outcomes after discharge including BFHI designation rates. This data is made available to the public through the CDC Breastfeeding Report Card, which provides annual reports from 2007 through 2014 and biennial reports from 2014.

As expected, they found that states with higher breastfeeding initiation rates had higher rates of these sustained breastfeeding outcomes. You cannot have high breastfeeding rates unless mothers are given education and successfully initiate breastfeeding. However, when they measured the effects of Baby-Friendly certification, this is what they found.

“Baby-Friendly designation did not demonstrate a significant association with any post-discharge breastfeeding outcome (Figures 1, B and 2, B). There was no association between Baby-Friendly designation and breastfeeding initiation rates.” Continue reading

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

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.

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If I Had Given Him Just One Bottle, He Would Still Be Alive.

by Jillian Johnson with commentary from Dr. Christie del Castillo-Hegyi

Landon would be five today if he were still alive. It’s a very hard birthday–five. It’s a milestone birthday. Most kiddos would be starting kindergarten at this age. But not my little guy. I wanted to share for a long time about what happened to Landon, but I always feared what others would say and how I’d be judged. But I want people to know how much deeper the pain gets.

I share his story in hopes that no other family ever experiences the loss that we have.

Jarrod and I wanted what was best for Landon as every parent does for their child. We took all of the classes. Bought and read all of the books. We were ready! Or so we thought….every class and book was geared toward breastfeeding and how it’s so important if you want a healthy child. Landon was born in a “Baby-Friendly” hospital. (What this means is everything is geared toward breastfeeding. Unless you’d had a breast augmentation or cancer or some serious medical reason as to why you couldn’t breastfeed, your baby would not be given formula unless a prescription was written by the pediatrician.)

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Hospital Drops Baby-Friendly Program After Doctor’s Baby Was Harmed

Written by an anesthesiologist and Intensivist physician

“The biggest achievement of my life as a physician was stopping my hospital’s Baby-Friendly program after my child was harmed.”

It was September 20th, and we were headed to the hospital for my induction.  I was nervous, as any first-time mother would be. I was worried that I was doing the wrong thing, even though I knew the literature, and my physicians supported my decision for an elective induction at 40 weeks. I was already dilated to 4 cm and my baby had dropped way back at 33 weeks.  We all thought it would take just a hint of Pitocin, but I labored for 24 hours until my son was born. I was later told that he was born with a compound hand (up by his head), causing the prolonged pushing time and his distress with each contraction.

While pregnant, I had decided to attempt breastfeeding, even though I had had a breast reduction in 2003. I tried to read as much as I could, but honestly, I didn’t have any idea how much information one needed to do something that everyone swore was “best” and “natural.”  My baby was born at 4:14 a.m. I thought this would be ideal, because I would have the support and help as I learned how to be a mother, knowing more staff were available during the day.  As the first day melted into the first night, nursing became more and more painful, and he needed to feed almost continuously. When he wasn’t feeding, he was either rooting or screaming.  

When my son was a day old, I noticed that the swelling on his head was much larger than expected at 24 hours out, and it was red and bruised in appearance.  We figured out that he had a very large cephalohematoma (a collection of blood between a baby’s scalp and the skull that often happens during a difficult or prolonged birth).  Despite the lack of any operative interventions during birth, this happened. Things happen. As a physician, as an anesthesiologist, and now as an intensivist, I know this, but what I still can’t understand is why these six red flags didn’t concern any of my or his providers:

  1. Breast reduction
  2. Constant crying
  3. Excessive weight loss
  4. Not sleeping/settling after nursing
  5. Painful nursing
  6. Cephalohematoma and jaundice

During this first day of my son’s life, a lactation consultant came by to see us.  This was requested because of my history of breast reduction. She determined the unbearable pain I was experiencing was likely due to a tongue tie. As this was new territory for me, I assumed that my baby’s care team’s assessment and the plan was correct.  As we planned for the frenectomy the following morning, not one person mentioned anything about pain management other than nipple cream. All I heard was feed, feed, feed; don’t you dare fall asleep with the baby; don’t you dare give him a pacifier, and the baby is crying because “he needs to be burped,” “he isn’t swaddled tightly enough,” and “he’s hungry, just feed him again.”  

On the second night, the pain wasn’t better despite the clipping. My son had to take his hearing test multiple times because he wouldn’t stop screaming; we couldn’t get newborn photos offered by the hospital because he wouldn’t stop screaming; we couldn’t walk down to the breastfeeding class because he wouldn’t stop screaming; and at one point in time when the LC came back in for another 15-minute session, all she said was “well I don’t know what’s wrong with him.” Daddy, both grandmothers, and I just said yes, ok, and we didn’t think there was anything to do but do what they said: “just feed the baby.”

This is the NEWT tool that is used to track excessive weight loss while exclusive breastfeeding. My son was placed in a very dangerous zone and I wasn’t informed at our discharge.

He lost 8.4 percent of his birth weight at 36 hours of age, but a conversation about supplementation never happened. Looking back, I could just kick myself for not knowing where he fell on the jaundice nomogram (a tool that determines how severe a baby’s jaundice level is).  But in this position, I was just a mother, not a physician. And in all honesty, if I didn’t know to ask these questions, then who would?  The pediatric nurse practitioner who discharged us came into my room and gave an impassioned and detailed discharge diatribe about exclusive breastfeeding, and about how I should spend all of my time topless and feeding constantly until my supply was established.  So on Wednesday afternoon, we went home with a follow-up clinic appointment 36 hours later with no mention of supplementing, despite all of the very dangerous red flags.

At 24 hours of age, my son had a high intermediate risk for hyperbilirubinemia using the BiliTool.

The next 36 hours were pure hell.  Absolute misery. My newborn would not stop crying…ever.  I would just latch and latch and latch, bleeding, crying, and at one point in time missing a small part of my left nipple.  The grandmas wanted desperately to give a pacifier and help feed him, but it had only taken 48 hours in the hospital and the raw fear of new motherhood to turn me into an avid exclusive breastfeeder.  They said I should do this so I have to do this.  I follow the rules, I do what is best, I am a doctor, I have to do this, they said I had to…it was a spiral. 

We found out if we pushed him in the stroller fast, he would stop crying temporarily. I was four days postpartum, in my pajamas, practically running around the neighborhood trying to not have to breastfeed my baby for at least a little while—because I just couldn’t anymore.  After an aggressive stroller walk, he became listless and was not actively screaming. I convinced myself he had cried himself out and needed rest. I cringe to think what his blood sugar level might have been at that moment.  

That night was astronomically worse.  I was feeding continuously and I knew this wasn’t normal, so I called the breastfeeding support line and it went to voicemail.  I got online and tried calling breastfeeding support groups. No one answered. His father took him outside and walked up and down the street over and over again, but he kept screaming, and we were afraid we would scare people.  So we just continued to feed, feed, feed, feed. It had now been five days since I last slept. 

The next morning we were at his follow up appointment. His weight loss was down to 9.7 percent and his transcutaneous bili was very high, and they had to send a blood test.  While there I met with the LC who attempted to have me pump with miserable results. Her response was literally, “that is all?” We fed him those few MLS in a syringe and for the first time he settled down.  But the lab test resulted in immediate readmission for bili lights.  His total bilirubin was 21—a number that I will never forget.  A number that is as infuriating as it is horrifying.  But what is so dumbfounding in retrospect is that not one person thought to check his blood sugar or sodium levels at that time, or at any time during his hospitalization.  If only I had had the capacity to use my doctor brain then, but I simply couldn’t. I was just trying to survive.  

The crazy thing about all of this though, was that since he had not lost over 10% of his birth weight, they did not insist on supplementation.  And since I was still in “follow orders” mode and could not string together a coherent sentence, I thought I should continue to exclusively breastfeed.  I was judged and admonished by the pediatric nurses for this because now I was “one of those mothers,” when really I was just trying to be who they wanted me to be on the postpartum floor. 

At one point in time, I crouched behind the bili light bassinet and broke down and cried. 

Somehow over the next 36 hours, I was convinced to supplement with a bottle under the bili lights. The LC who came by to do a weighted feed scoffed at this and left, while the pediatric nurse yelled at me because I had left two drops of blood on the bathroom floor, and told me to clean up after myself.  I had somehow failed at every aspect of new motherhood, and I just wanted to go home.

We went home and tried to breastfeed for one more day, hoping my supply would increase. It didn’t.  I exclusively pumped after that, which only ever resulted in 2–3 ounces total in 24 hours. We followed up for another bili check, and he improved dramatically once he was fully fed with formula. I called the LC clinic one last time, but when they suggested I utilize an SNS to supplement, I knew that direct breastfeeding was simply not going to happen.  I did however go see my OB because of my bleeding, to make sure that I didn’t have any sort of retained placenta to “blame” for my measly supply. I did not. I simply didn’t have breast milk. I stopped pumping at six weeks because you can only pump for so long for all of 2–3 ounces a day.

When he was about four weeks old, I was pumping and googling and came across a video created by Dr. Christie regarding insufficient breast milk intake and the risks associated with it.  As I watched this presentation, I started crying because I felt like she was telling my story, and I was overwhelmed with emotion. I was dumbfounded. I could not believe the risks associated with what had happened to us.  I needed to reach out. And so I did.  

From there I started to peripherally follow The Fed is Best Foundation.  I felt emboldened to fill out a survey of my experience at the hospital. I received a call back from the nurse manager.  I gave a detailed account and offered to come and talk to their breastfeeding focus group. She seemed receptive, but I was never asked to come to this meeting.  It was at this same time that I was learning more about the Baby-Friendly Hospital Initiative through the Foundation. I was shocked to find out that the hospital we delivered at was applying for this certification.  I had no idea.

You see, the part of this story that is unique is that this hospital was my hospital.  I had worked there as a physician in some capacity for seven years at the time my baby was born.  This was my medical home. These were my people, and I was shattered that this happened to me…to us…in the place I loved so much. 

I tried to work through it personally, but when my baby was four months old I knew I had to do something else. I had to. I knew I couldn’t let this go.

You see, in my life as a physician, I was a passionate patient safety advocate and spent almost as much time writing and implementing policy as I did performing clinical anesthesia.  I had personally implemented two patient safety programs in this hospital over the three years prior to my son’s birth. I knew how to adopt a new policy or program, while also confirming that unexpected or unusual complications did not occur out of proportion to the benefit of the program.  

So I went to my best friend.  A woman who was my peer, my boss, and the strongest woman I know.  I broke down with raw emotions to her and asked her for guidance. She led me to the hospital’s patient advocate director, and that is where this story takes a beautiful turn.  

She and I pored over our medical records.  She arranged for me to meet with the nursing staff, the pediatrician who admitted my son to the hospital, and—the most terrifying—with the physician who had brought the BFHI to our hospital. These meetings were nausea-inducing and difficult.  But in dissecting the records and talking through everything with them, I was able to build a case worth taking to our hospital leadership. I was granted a personal meeting with the Executive Officer of the hospital and brought with me my story and lots and lots of medical literature supporting my concerns about safety.  In the end, we decided to abandon our BFHI accreditation application.  

I continue to be involved with the Fed is Best Foundation, though I often try to stay behind the scenes due to the nature of my profession and the viciousness of the online community.  My contribution is mainly through following and reviewing the literature and posting passionate and honest posts on my Facebook page so that other women can derive strength and validation from my story.  Through my work with Fed is Best, I now know far more about breastfeeding than I ever knew before, and I was able to safely provide breastmilk for my second child when she was born.  I also advocate and support all women in their breastfeeding goals, and provide them with safe resources when they need help that I cannot provide. 

This organization is not about demonizing exclusive breastfeeding or glorifying formula. It’s about feeding our children and avoiding preventable complications from insufficient breast milk intake. 


Please join our Health Care Professionals Advocacy Group

U.S. Study Shows Baby-Friendly Hospital Initiative Does Not Work

Baby-Friendly USA Acknowledges Their Mistakes; Are They Going To Make Real Changes In The New Year Or Are They Providing Lip Service To Mothers?

Continue reading

Because of the support I received from Fed is Best we were able to understand that a feeding tube was not a failure.

 

After having difficulty breastfeeding my older son, I was determined to have a healthier feeding experience the second time around. I learned, through incredible suffering with PPD, that the most important thing was a healthy baby and mother. This time, I had a plan: I was going to give my baby both breastmilk and formula.

My second son was born on his due date. The birth was without complications, and he latched within an hour of being born. I did have some damage to my nipples initially, but we met with a lactation consultant shortly after discharge and she was incredibly helpful. She helped me position my son correctly, and I stopped experiencing pain when he latched. My nipples were healed within a week, and my son regained his birth weight as well. By the time he was two weeks old, he took in 2.5 ounces after about ten minutes of nursing, as measured by a weighted feeding. 

To be sure I was successful with breastfeeding, I sought out every resource imaginable. A nurse came to our home for two months, and my son was gaining so well, we were discharged from her services. Every week, she weighed my son, checked his vitals, and tracked his growth. In fact, she was impressed with his weight gain.  For a while, he gained over eight ounces a week. He would not take much from a bottle, but nursing was so easy that I really didn’t mind. I was on an extended leave from work and thought we had time to figure out bottle feeding.

Right around this time, my son became extremely gassy with mucousy diapers. He was very fussy and would not sleep well. I had to hold him for all of his naps, his overnight sleep was interrupted, and he was constantly uncomfortable from stomach pain. His head broke out in a scaly rash, and he scratched it so much, he made himself bleed from his fingernails. 

Scaly rash from a dairy allergy

I tried block feeding thinking he was getting too much foremilk. I held him upright after every feed and applied various shampoos and creams on his rashes, but nothing helped him. On the day he turned three months old, his pediatrician diagnosed him with a milk protein allergy.  I began drastic changes to my diet and tried supplementing with a special formula, but he still was not taking a bottle—even a bottle of breastmilk. He began nursing for shorter periods but more frequently. Eventually, he went from nursing for ten minutes to just four.

At four months old, his pediatrician diagnosed him with failure to thrive. I was devastated. It’s hard to be home with your baby, doing everything possible to feed and love them so they thrive, and then hear the word “failure.” I’m still trying to think of an alternative label. I continued making changes to my diet hoping to provide him relief so he would sleep.

I eliminated all foods known to cause allergies, but it made no difference. I lost 25 pounds. I was not thriving either. 

Diagnosed with failure to thrive.

Throughout these challenges, I sought support from the Fed is Best Foundation’s parent support group. The moderators helped ground me when I felt overwhelmed and afraid. The members were wonderful about offering me support for nursing and providing me with tips for bottle feeding. I also began infant feeding consultation with Jody, one of the founders of the Fed is Best Foundation. 

After our consultation, Jody suspected that my baby might have a tongue restriction. She sent me back to my pediatrician, who referred me to a pediatric ENT to have a tongue-tie revision. I had relief from the mild pain of nursing, but my baby still did not nurse significantly longer which meant I was still nursing at least every two hours. Jody suggested alternative ways to supplement my son in addition to breastfeeding. I tried an SNS system, a cup, a spoon, and using a syringe. She recommended asking my pediatrician about fortifying my breastmilk with an amino-acid based formula to help him gain weight. My pediatrician agreed and prescribed 24-calorie fortification. His weight gain was minimal, and the conversations with specialists started to include the phrase “feeding tube.” Jody listened to my worries and answered every question I could think of while preparing me for each doctor’s visit.

Diagnosed with a tongue tie by a pediatric ENT physician.

I was afraid. I knew I wanted my son to be healthy, but putting a feeding tube into his body was terrifying. Still, my husband and I were spending so much time trying to get him to eat. We’d try the bottle, then syringe-feed him the formula, and then I would nurse him; we were trying everything to get as many calories into him as possible. He continued to have issues related to his allergy, and I knew my breast milk was still causing him problems. He was weak and stopped rolling over. When he was awake, everything centered on desperate attempts to get him to eat. Then, in early January, he lost weight despite us trying so hard to avoid putting a feeding tube in.

We were seeing multiple doctors and going to appointments all over the state. We were spending all day either feeding him or holding him so he could sleep. We had every resource imaginable.  It wasn’t enough.

The next day, his pediatric gastroenterologist admitted him to the hospital. They placed the tube, and we spent five nights there while his team of doctors figured out the right amount of specialized formula to feed him. I pumped for comfort, but I let go of the idea of breastfeeding him. It wasn’t helping him, and I just wanted a healthy baby. 

By the time we were discharged, he’d gained over ten ounces. Before the tube, that would have taken three to four weeks. 

The day we came home from the hospital, my son started babbling more. His time awake increased. We could play with him, read to him, and spend time together as a family. A month into having the tube, he is rolling over again, sitting up, and is almost caught up developmentally. We began feeding therapy and have seen some small successes in a short time.

I finally see my son thriving. I see him laughing again. Because of the support I received from Fed is Best, we were able to understand that a feeding tube was not a failure. When it came time to get his tube, it was a decision made after careful thought and preparation, rather than one that was made under dire circumstances. 

I don’t know what the future holds for my son, but I know he will thrive and grow. I know he will laugh, play, and be the happy baby he deserves to be. That is because he is now thriving while being fed formula, and because we know Fed is always best, including when it’s from a tube. 

Finally thriving with love, tube feeding, and complementary foods. #FedIsBest

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:

  1. Join us in any of the Fed is Best volunteer and advocacy, groups. Click here to join our health care professionals group. We have:  FIBF Advocacy Group, Research Group, Volunteer Group, Editing Group, Social Media Group, Legal Group, Marketing Group, Perinatal 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. 
  2. If you need infant feeding support, we have a private support group– Join us here.
  3. If you or your baby were harmed from complications of insufficient breastfeeding please send a message to contact@fedisbest.org 
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  9. Write your local elected officials about what is happening to newborn babies in hospitals and ask for the 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.
  10. 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.
  11. 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.
  12.  Shop at Amazon Smile and Amazon donates to Fed Is Best Foundation.

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 christie@fedisbest.org.

 Thank you and we look forward to hearing from you!

Click here to join us!

 

 

 

 

 

Will Breast Milk Protect My Baby From Getting Sick? Passive Immunity 101

Written by Jody Segrave-Daly MS, RN, IBCLC

As a veteran neonatal nurse and lactation consultant, I am often asked by parents to explain how the antibodies found in breastmilk work to protect their babies. Published research on immunology is extremely technical and difficult to understand, and unfortunately, the information that is readily available (especially on social media) contains a lot of false and conflicting information. So I’m here to share evidence-based information about this very important topic in a way that is easier for most parents to understand.

How does the immune system work?

Our immune system is very complex, but generally speaking, it is responsible for fighting off both germs that enter our bodies from our environment, and also for protecting us from diseases like cancer that occur within our bodies. I will be focusing on how the immune system fights off germs, which it does by producing antibodies.

What is an antibody and what does it do?

An antibody is a protein that is produced by the body’s immune system when it detects the surfaces of foreign and potentially harmful substances, also known as pathogens. Examples of pathogens are bacteria, fungi, and viruses, which are all microorganisms. The antibody response is specific; it will seek out and neutralize the microorganism and stop the invasion. There are five classes of antibodies: IgM, IgG, IgA, IgD, and IgE.

There are two ways babies acquire and develop immunity:
  • The first way is through passive immunity (temporary)
  • The second way is through active or acquired immunity (lifelong) 

Note: Antibody types and where they are acquired from are denoted by color throughout the blog.

Continue reading

Baby-Friendly USA Acknowledges Their Mistakes; Are They Going To Make Real Changes In The New Year Or Are They Providing Lip Service To Mothers?

Dear BFUSA,

Thank you for your long-overdue public acknowledgment endorsing what the Fed Is Best Foundation has been fiercely advocating for over the past 3 years. 

According to your recent blog post you now agree with us that:

1. Delayed onset of copious milk production is common. 

BFUSA: “Delayed lactogenesis is actually increasingly common because the risk factors for it are potentially increasing,” Dr. Rosen-Carole says. “When a baby is born into that situation, the goal is to closely monitor what the baby is doing, instead of giving a bottle right away. “If the baby is hungry and they’re not getting enough milk out of the mother’s breast, then they need to be supplemented,” she says. 

FIBF: We have been passionately educating parents about safe breastfeeding since the beginning of our advocacy over 3 years ago with the current scientific studies that have confirmed over and over again that delayed onset of milk production and low milk supply are common.  We question why it took you so long to acknowledge this deadly and 100% preventable consequence of insufficient breastfeeding? Does this mean you will ban the belly bead stomach models that do not reflect the current science?

Will you please apologize to the thousands of mothers who bravely told their stories of accidental starvation?  You have previously tried to discredit their stories, called them “‘anxiety-provoking,” and characterized our foundation as BFHI detractors— simply because we offer a social media platform for mothers to be heard by you. Have you ever heard a mother break down and scream in horror when she learned her baby was starving to death because she followed your breastfeeding education and protocol?  We have—over and over again, and it is the most haunting sound. It’s what drives us to fiercely advocate for safe breastfeeding because no other health organization is doing so.

BFUSA: Dr. Bobbi Philipp agrees. “If you see signs that the mother’s milk is insufficient, you need to feed the baby,” she says. “And if the mother is really committed to breastfeeding, you’ve got to bridge the gap in a way that you support her, feed the baby, and don’t undermine the breastfeeding. It’s that simple.”

FIBF: Now that you are acknowledging delayed onset of milk is common, something that we have been passionately writing and speaking about for years, we expect that you will stop calling us “fibbers.” Name-calling is what a child having a temper tantrum does, not what a professional organization should do; the appropriate response to being called out and held accountably, is to take responsibility and revise your guidelines based on current research and patient feedback. Continue reading

Mothers Describe Their Triple Feeding Experiences And The Impact It Had On Their Mental And Physical Health

Written by The Fed Is Best Foundation Lactation Consultant Team

Part 1: What is “triple feeding?” 

Triple feeding originated in the NICU and was used for premature infants. It is now being used for full-term babies, especially in home environments. Triple feeding is a breastfeeding plan in which, for every feeding, a mother feeds her baby at the breast, followed by immediate pumping, and then giving any expressed milk (and/or formula supplement) to the infant by a bottle, cup, syringe, or through a tube at the breast. Triple feeding requires a considerable amount of effort and time, and there is little time between feedings for the mother to take care of her own basic needs, such as sleep, eating, and hygiene.

Many mothers who have followed this regimen say that they were given little guidance on how long to triple feed and when to stop.  As a result, these mothers have endured the equivalent of caring for triplets (feeding a baby at the breast, “feeding” the pump, then feeding a bottle). In addition, there are pump parts to wash up to eight times a day, and sometimes other children to care for.

“I didn’t eat or drink for days because of the time constraints of triple feeding. By the time my baby was admitted to the hospital on day 5 of life, I lost consciousness and then broke down in the corner of his room from profound exhaustion. I’m a doctor and had done surgical and anesthesia residency. I’m used to sleep deprivation. Those five days were hell on earth. Not only did it not work, I unknowingly starved my baby under the care of lactation professionals.  They knew I had a breast reduction, but I was told to triple feed without a back up plan. That week of my life lives over and over in my head all the time.” —Dr. N. King 

Why is the triple feeding strategy recommended by medical and lactation professionals?

The common reasons for prescribing triple feeding are:

  • Poor latching, lack of sustained suckling, oral anomalies, and insufficient milk removal.
  • Delayed onset of full milk production and excessive infant weight loss or failure to gain weight.
  • Chronic low milk supply for poor breastfeeding management, hormonal insufficiency, insufficient mammary physiology, and unknown mammary dysfunction.

Continue reading

Dear Parents, Did You Know Just 2 Teaspoons Of Supplementation Can Protect Your Baby And Your Breastfeeding Journey?*

Written by: The Fed Is Best Foundation IBCLC Team

There have now been six studies showing that in some infants, a little bit of supplementation with two teaspoons (10 mL) of formula or donor breast milk after nursing had no effect on long-term breastfeeding. One study showed it prevented hospital readmissions in all of the supplemented newborns. Another showed it actually helped breastfeeding! 

Why aren’t medical and lactation professionals recommending this intervention?

Many medical and lactation professionals believe that a tiny amount of formula will contaminate the baby’s gut, causing lifelong health problems. They refuse to admit that formula supplementation can be helpful, and they have baseless concerns that temporary formula supplementation will become routine for all babies.  According to Baby-Friendly USA, “donor [breast] milk takes the fight out of this.” What they mean is that the few babies who are born in a hospital with donor milk can be fully fed, while the vast majority of babies who are born in hospitals without donor milk just have to tolerate hunger and thirst so as to avoid a few teaspoons of formula.  

Did you know two teaspoons of formula or donor milk has seven calories?  

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3 Harmful Dental Myths For Pregnant and Nursing Women

Dr. Amanda Tavoularis – dentably.com

There’s a lot of information out there for pregnant and breastfeeding women, but unfortunately, not all of it is good. Oral health and visiting the dentist is one such area where there is a lot of misinformation. It’s not only frustrating to be told a dental myth, but it can also be harmful if you don’t recognize the truth behind it. I’ve practiced dentistry for over 20 years, so I’ve heard my share of dental myths and have worked to help spread good information. I’ve put together the top myths I hear pregnant and nursing women being told and hopefully can add some good information that will help women make informed decisions with their dental health. The end goal is to keep your mouth healthy, while also having a safe pregnancy and practicing safe breastfeeding. Continue reading

Lies, Slander And Lack Of Accountability By Lactation Consultant Serena Meyer

Dear Serena Meyer, RN, IBCLC:

Your post has made unsubstantiated accusations and we would like to respond with the truth. Please start by reading our actual statements and the science we present, which can be found in our FAQs.  [Note: since Ms. Meyers has now edited her original post and deleted over 200 comments, screenshots of the post are included below.]

You (Serena Meyer) wrote:

Have you heard about Fed is Best? It’s an organization that believes that breastfeeding essentially starves babies, there is a lot of vitriol about breastfeeding and brain damage and death. It makes me feel pretty argumentative.

Every statement issued by the Foundation is cited. We rely on scientific evidence, not “belief.” We have never said breastfeeding starves babies; we have provided factual educational information that exclusive breastfeeding with insufficient supply or transfer can lead to acute and/or prolonged starvation. “Starvation” is a medical diagnosis, not “vitriol” or fear-mongering. Continue reading

Baby-Friendly: Failure and the Art of Misdirection

By Alex Fischer, PhD Candidate, Brooke Orosz, PhD, Jody Segrave-Daly, RN, IBCLC and Christie Del Castillo-Hegyi, M.D.

Any good magician will tell you that the secret to their trade is misdirection—making the audience look one way while doing something the other way. And even knowing this, most of us are still baffled by a magician’s tricks. So it’s no wonder that Baby-Friendly USA (BFUSA) has tried to employ that same tactic in their statement titled “Fact vs FIB: The Impact of Baby-Friendly on Breastfeeding Initiation Rates.”  In this statement written by an anonymous author representing BFUSA, they attempt to dispute the findings of a recent study published in Journal of Pediatrics, “Outcomes from the Centers for Disease Control and Prevention 2018 Breastfeeding Report Card: Public Policy Implications” by Bass et al. This study examines the impact of statewide breastfeeding initiation rates as well as the impact of BFHI facilities on continued breastfeeding after hospital discharge (exclusive or combination). The Fed is Best Foundation read this study and agreed: “Baby-Friendly does not work.” These five words are the instigators of the entire statement by BFUSA and its misrepresentation of a very robust scientific study.  Continue reading

Nurses Quit Because Of Horrific Experiences Working In Baby-Friendly Hospitals

Photo Credit: Victorian Agency for Health Information

We regularly receive messages from nurses, physicians, LCs and other health professionals. They express their concerns while asking for help and patient resources. They tell us their stories and they need support and direction of what to do about unethical and dangerous policies they are forced to practice. We collected their stories and are beginning a blog series of health professionals who are now speaking out about the Baby-Friendly Health Initiative and the WHO Ten Steps of Breastfeeding.

Dianna Talter, Pediatric Emergency Department Nurse

I am a pediatric emergency department nurse traveler and sometimes, I worked on the mother-baby unit. I will never work on a mother-baby unit again because of the terrible conditions that mothers and babies are forced to endure because of the “Baby-Friendly” (BFHI) protocol!

Mothers were expected to assume full responsibility for their babies and themselves while they were recovering from birth. Mothers were profoundly exhausted and would fall asleep in bed holding their babies. I was taken aback at the number of crying breastfeeding babies who were hungry. To meet the metrics of exclusive breastfeeding rates (80%), we could not supplement the babies and our goal was to get them discharged as exclusively breastfeeding.

Now I know why the emergency department admissions have climbed significantly for hyperbilirubinemia, hypernatremia, hypoglycemia, and seizures. I have worked in a pediatric emergency department for 20 years, and I am appalled at the lack of comprehensive breastfeeding education that is provided to mothers. They are not taught about the signs that their baby is not getting enough milk. These parents are GOOD parents and were following their breastfeeding education guidelines. It’s pure insanity! 

I took care of two babies who died needlessly from complications of acute starvation. One baby had a glucose level of 14, sodium level of 160, and was seizing. We did everything we could to save the baby, but it was too late. Her parents were failed by the current breastfeeding education, which is based on the BFHI/WHO Ten Steps. The other baby was stabilized in the ED and was transferred to the PICU [pediatric intensive care unit] only to die the next day.

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