I Was Able To Breastfeed My Third Baby Thanks To The Fed Is Best Foundation

During my pregnancy, I began reading the Fed Is Best Foundation’s feeding educational resources and feeding plan pertaining to breastfeeding and combo feeding. I didn’t have successful breastfeeding experiences with my previous children and wanted to try one more time. I went into labor when I was 37 weeks pregnant. My labor progressed extremely quickly. By the time we got to the hospital almost an hour later, it was already too late to set up an epidural. I struggled for hours with laboring and pushing, and both my daughter and I were profoundly exhausted after delivery.

Before I gave birth, I had studied the HUNGRY educational resource flyer for exclusive breastfeeding. My goal was to prevent inadequate weight gain with this baby. After my daughter was born, she was not interested in nursing, and I was worried because she was tiny. Thanks to Fed is Best feeding plan, I felt confident in letting my husband do the first feed with a bottle. I wanted her father to feed her so she could get some strength to nurse later and so I could rest. I loved watching him feed her as I recovered. About two hours later, I tried to breastfeed her again and she had the energy to stay latched and nursed. I was so happy she was breastfeeding! Continue reading

Update on Fed is Best Request for Video-Recorded Meeting with Lactation Consultant Organizations

As of today, March 13, 2018, the Fed is Best Foundation has not received a response to our request for a web conference with the nearly 100 lactation consultant organizations who wrote to us last year requesting a meeting. We asked for the organizations to meet with us via video-recorded web conference to be posted on the Fed is Best website in order to provide parents maximum transparency. We also invited parents of children who have been harmed by the Baby-Friendly Hospital Initiative to be present in light of our discovery of a disturbing lecture on brain injury caused by starvation-related jaundice in breastfed newborns given at a prominent California breastfeeding conference given by the board member of Baby-Friendly USA, Dr. Lawrence Gartner.

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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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Open Letter to Obstetric Care Providers on Counseling Expectant Mothers on the Importance of Safe Infant Feeding

Dear Obstetrician-Gynecologist, Family Practitioner or Midwife,

I am writing to you as a mother and advocate for Fed is Best.

You may have seen the story of Landon Johnson, who was welcomed into the world by his parents in February 2012.  Like most new parents, Landon’s mom and dad were lead to believe that Jillian would produce enough breast milk to meet Landon’s caloric needs.  The hospital where they delivered was “Baby-Friendly” and would only provide formula with a doctor’s prescription.

While in the hospital, Landon cried whenever he was not latched onto his mom’s breast. Jillian described him as inconsolable.  She was told that this was normal.  At less than 3 days of life they were discharged from the hospital after having the appropriate number of wet and dirty diapers.  However, less than 12 hours later, Landon was readmitted to hospital after suffering cardiac arrest due to severe dehydration.  He suffered brain injury and ultimately died in the arms of his parents when life support was terminated.  His is a story that you cannot read without tears in your eyes. Continue reading

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.)

Continue reading

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.

 

Passive Immunity During Pregnancy

The first way for a baby to acquire immunity is called passive immunity, and it occurs during pregnancy.  Over a mother’s lifetime, she is exposed to many different pathogens, and her immune system develops the ability to produce a large catalog of antibodies that can act against them. During pregnancy, these antibodies are transported across the placenta to the fetus’s blood supply. These types of antibodies are called immunoglobulin G, or IgG. They are the only antibody type that passes through the placenta to the growing fetus. They are called passive maternal IgGs, because of how they are transferred to the baby.

IgGs are the most common type of antibody in our bodies. They help protect us, as well as our unborn babies, from viral and bacterial illnesses. Human babies are born with all of the passive maternal IgG antibodies their mother has during pregnancy.  

To provide additional, critical passive IgG antibodies that will pass from the placenta directly to the baby’s bloodstream, mothers should strongly consider following the vaccination recommendations during pregnancy.  This will help protect the baby from infections such as pertussis (whooping cough), influenza, and other illnesses ahead of their scheduled childhood vaccinations and before their immature and vulnerable immune system begins to produce its own antibodies. 

 

Women vaccinated during pregnancy pass protective antibodies to babies (CDC.gov)

 

Maternal IgG antibodies are temporary though, and they gradually disappear within four to six months after birth. Fortunately, immediately after birth, the baby begins to make their own IgG antibodies in response to viruses and bacteria in their environment and through childhood vaccinations. The immune system is constantly maturing, but children under two are most vulnerable. By five years of age, children have been exposed to many viruses and bacteria and have also received many important vaccinations; therefore they are less vulnerable to serious infections. Premature babies are particularly vulnerable, as they don’t receive the 40 weeks gestation time to receive the full maternal passive immunity that a term baby does. (Most antibodies are transferred in the last four to six weeks of pregnancy.) Maternal IgG antibodies passed through the placenta are very effective in protecting neonates and infants against most infectious diseases. This is why term human babies can be fed properly prepared formula and thrive without the passive immunity that breast milk provides. Evidence has shown, however, that human breast milk, whether through direct breastfeeding, expressed breast milk or human donor milk is critical to preterm babies as it reduces the risk of developing a deadly infection called necrotizing enterocolitis, which affects a baby’s intestines.

 

Passive Immunity Through Breastfeeding

The other way a baby can acquire passive immunity is through breast milk. Colostrum is the first milk a woman produces when she begins to breastfeed, and it contains a large number of antibodies called secretory immunoglobulins ( over 90% are IgA; IgM and IgG are present in tiny amounts) You’ll see this abbreviated as IgA. (First we discussed passive IgG; now we will discuss IgA.) These IgA (mucosal) antibodies in human milk line the mucous membranes in the baby’s mouth, upper airway, throat, ears and intestines; here they guard against germs entering the mucosal lining, which is the first port of germ entry, by neutralizing the pathogen. Secretory IgA antibodies can survive being broken down by gastric acid and digestive enzymes in the stomach and intestines. Human babies are not able to absorb these passive maternal antibodies from colostrum or breast milk directly into their bloodstream. Instead, the IgA antibodies protect against infections by working inside the baby’s gastrointestinal tract and respiratory system. 

This passive breastfeeding IgA immunity is dose-dependent, meaning the more breastmilk your baby receives, the more protection they have.  The dose-dependent protection continues until the baby is weaned. This passive immunity is invaluable for premature newborns and newborns born in impoverished countries where there is limited access to clean water for safe formula preparation, often leading to severe diarrhea and death. 

Breast milk immunity offers protection from respiratory and gastrointestinal illnesses; this does not mean prevention. This population-based study in the Netherlands found that exclusive breastfeeding for 4 months was associated with a reduction of severe respiratory and gastrointestinal morbidity in infants. However, breastfed babies can still get sick, because young children get lots of colds, some as many as eight to ten each year, before they turn two years old.

For mothers who don’t plan on breastfeeding exclusively for the first 6 months, breastfeeding during the first months is still beneficial, because this is when the baby’s immune system is the most vulnerable. Human milk also contains infection fighting components that are not antibodies. (*see the full description below )

The second way a baby develops immunity is by ACTIVE OR ACQUIRED IMMUNITY (germ exposure and vaccination) 

 A baby’s immune system is at its most vulnerable right after birth. Since passive immunity from both IgG and IgA forms of maternal immunity is temporary, and breast milk antibodies can only protect the respiratory and GI tracts while breastfeeding is occuring, these measures are not enough to fully protect a baby from infectious diseases. At six months, a baby’s IgG antibodies that were acquired passively from their mother are gone. Their immune systems have started to produce their own IgG antibodies from the germs they are encountering in their world and through vaccinations. This is known as active or acquired immunity, the type of immunity that the body develops after germ or vaccination exposure. To continue the process of protection, babies need to acquire vaccine-induced immunity, and fortunately, vaccination is a safe and effective way to achieve it by boosting immature immune systems without getting the disease. Active immunity is long-lasting, and sometimes lifelong.

 Did you know breastfed babies produce higher levels of antibodies in response in response to some immunizations?

Vaccines are tested again and again to be sure they are safe for children and nursing mothers. If you are concerned about whether or not a particular vaccine is safe to receive while breastfeeding, check the CDC’s list of vaccines that are safe for nursing mothers and babies.  Because breastfeeding provides passive antibodies to a baby, breastfeeding is not a substitute for immunization. During the first months prior to receiving vaccinations, babies are counting on their parents, family, friends, caregivers, doctors, nurses, lactation consultants and anyone else around them, to protect them from diseases they may not be able to fight off. Everyone being up to date with their recommended vaccines is the best way for a community to support a newborn’s health.

A common question I receive is: “Can I breastfeed while I am sick with the flu?”

The answer is yes, even if you are taking Tamiflu. The flu is not transmitted through breast milk. Breastfeeding can continue while taking precautions to avoid spreading the flu to the baby. The CDC has excellent guidelines about breastfeeding while having the flu.

If a mother is sick from an illness, how long does it take for the antibody to be produced in her breast milk?

This picture is one of many popular memes floating around on social media. Unfortunately, the information is incorrect and misleading about the timeline for antibody production.

To be fully informed and to take proper precautions, a mother should know there is a delay between the first exposure to the pathogen and the acquisition of immunity. This process, called the primary response, can take up to fourteen days for optimal antibody production. If a person is exposed to the same pathogen again later, the response is much faster and stronger; this is called a secondary response. 

To provide additional protection for your baby, hand-washing is an excellent way to help prevent the spreading of germs. According to the CDC, “Regular hand-washing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others.” It’s quick, it’s simple, and it can keep us all from getting sick. Hand-washing is a win for everyone—except the germs.

Hand-washing is a win for everyone—except the germs.

Another social media post that went viral is a picture of the color changes of pumped breastmilk from a mother who said her baby was sick. Can this be true?

This study found leukocytes increase when a baby has an active infection but does that mean a color change occurs?  It’s not very likely.  Color changes in breast milk are from colorful foods, stages of breastmilk, medication, vitamins and sometimes from cracked nipples.

What about the back-wash idea in which a baby’s saliva is sucked into valves within the nipple and the mother’s body produces an immune response that is secreted in her breastmilk.  

The idea that a baby’s saliva can trigger changes in breast milk was popularized in 2015, and several mothers have posted viral images and claims similar to the above, but even scientists who study breastmilk say the idea that baby saliva changes breast milk is still a hypothesis that needs to be proven or disproven with high-quality research. 

*Please Note: Human milk also contains the following protective components:

  • Oligosaccharides and mucins that adhere to bacteria and viruses to interfere with their attachment to host cells.
  • Lactoferrin to bind iron and make it unavailable to most bacteria.
  • B12 binding protein to deprive bacteria of needed vitamin B12.
  • Bifidus factor that promotes the growth of Lactobacillus bifidus, normal flora in the gastrointestinal tract of infants that crowd out harmful bacteria.
  • Fibronectin increases the antimicrobial activity of macrophages and helps repair tissue damage from infection in the gastrointestinal tract.
  • Gamma-interferon, a cytokine that enhances the activity of certain immune cells.
  • Hormones and growth factors that stimulate the baby’s gastrointestinal tract to mature faster and be less susceptible to infection.
  • Lysozyme to break down peptidoglycan in bacterial cell walls.

Jody is a champion for debunking pseudoscience in the breastfeeding community because parents need to be truly informed when making parenting decisions. She is also a staunch advocate for protecting underfed breastfed babies and is the reason why she co-founded the Fed Is Best Foundation. She provides parents with the most up to date scientific resources and includes her extensive neonatal nursing knowledge and infant feeding clinical experiences, to help parents make the best infant feeding decision that works for them.

Additional references:

Immunity Types

An Introduction to Active Immunity and Passive Immunity

 Natural Passive Immunity

Human milk: Defense against infection. 

Infant gut immunity: a preliminary study of IgA associations with breastfeeding.

Chapter 50 Immune Defenses

Mucosal immunity: integration between mother and the breast-fed infant

Breastfeeding after maternal immunisation during pregnancy: Providing immunological protection to the newborn: A review

Breast Milk as the Gold Standard for Protective Nutrients

Cells of human breast milk

Evolution of the immune system in humans from infancy to old age

https://microbiologynotes.com/differences-between-primary-and-secondary-immune-response/

Influenza (Flu)

Changes in immunomodulatory constituents of human milk in response to active infection in the nursing infant 

Future Research in the Immune System of Human Milk

https://fedisbest.org/2019/03/an-evaluation-of-real-benefits-and-risks-of-exclusive-breastfeeding/

Feed Your Baby—When Supplementing Saves Breastfeeding and Lives

The Newborn Stomach Size Myth: It is NOT 5-7 mL

What is “Cluster Feeding” and Is It Normal?

The ‘Second Night Syndrome’ is Abnormal and This is Why

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

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

 

 

 

 

 

 

 

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.
The theory behind triple feeding is based on the first two rules of lactation management: feed the baby and maximize the milk supply.  
  1. When a baby is not transferring milk effectively, he is not stimulating his mother’s milk-making hormones adequately, and milk remains in the breast. This causes a reduction in her milk supply and does not provide a full feeding for the baby.
  2. Giving the baby frequent opportunities to breastfeed despite the low milk transfer is thought to help the baby improve his latching and milk transfer skills, and avoids bottle preference.
  3. Pumping after nursing will remove most of the milk from the breasts, thus helping to increase the mother’s milk supply to a sufficient level (a full milk supply is about 25-32 oz/day).  When successful, this will allow her to gradually wean the baby from supplementing and return to fully feeding at the breast. 
  4. Immediate supplementation is necessary to provide the baby’s full feeding, as babies have caloric, nutritional, and hydration needs that cannot wait until the breast milk supply potentially increases. 

Unfortunately, triple feeding has become the default method that is recommended by medical and lactation professionals for a large number of breastfeeding challenges, with no regard to the maternal complications that will eventually occur, or the likelihood of it solving the problem of low milk supply. It is imperative for all mothers to know that triple feeding is not sustainable for longer than five to seven days, and it cannot be recommended unless the mother has a full-time helper. If triple feeding is working, there will be evidence with increased milk supply/volume. This is how we know it is working. If there is no increase, triple feeding will not work for this mother, and her breastfeeding plan will require changes. Most likely it will be a combo-feeding plan. 

Before triple-feeding is recommended, medical and lactation professionals must make careful considerations because of the daunting amount of time that is necessary for every feeding. The things that need to be considered are:

  1. Does the mother have full-time in-house help?
  2. Does she have any preexisting history of mental illness?
  3. Does she have the best mammary physiology and general health profile to sufficiently increase her milk production?  (The word “sufficient” is subjective and is determined by both the baby’s needs and the mother’s goals.)
  4. Does she have a high-quality electric breast pump?
  5. Does the proposed triple feeding plan allow for sufficient sleep, nutrition, and self-care to support her basic physiological needs?

Of course, every mother and baby have unique needs and require individualized breastfeeding management and support. The plan must also be flexible enough to meet unexpected needs. It is very important for the health care professional involved to inform parents that they may find themselves unable to follow the triple feeding plan perfectly. A backup plan should be provided until changes can be made that the parents are confident they can follow. Mothers need to know they can stop at any given time, and that there is no guarantee triple feeding will provide the results they are looking for. This is part of informed consent. 

Complications of triple-feeding: mental health, bonding and preventing accidents

Jessica Montgomery talks about how triple feeding stole her ability to enjoy her baby and did not increase her milk supply.

Literally everything I read about breastfeeding said that undersupply was rare. After she was born, my milk didn’t come in right away. When it did, it was not enough, and she lost weight and had to be re-hospitalized for jaundice, dehydration, and hypoglycemia. 

I was willing to do anything to increase my supply and hoped to eventually be able to exclusively breastfeed. I saw two lactation consultants (IBCLCs) and both gave me different versions of the “triple feeding protocol” to try. I was supposed to complete the following three steps every 2-3 hours around the clock:

  1. Breastfeed baby for at least 10-15 minutes per breast, using breast compressions.
  2. Supplement baby pumped breast milk, and then formula if pumped milk is not enough. If the baby is able to latch, use a supplemental nursing system, to supplement at the breast, with a tube placed and taped next to my nipple. If she wouldn’t latch, I was supposed to finger feed, cup feed, or use a slow flow bottle.
  3. Pump for 15-20 minutes with a double pump or for 15-20 minutes on each side if using a single pump or hand expressing. If the baby didn’t empty my breasts I was supposed to do this right away, and if not, I was supposed to wait an hour after nursing to pump. 

Triple feeding was my life for months, and my mental health seriously suffered. I couldn’t keep up and that made me feel so guilty, and honestly, it didn’t really do much for my supply. I lost so much time being with and bonding with my baby.

After my second baby was born, I met with a breastfeeding medicine physician who told me that triple feeding was too exhausting for most moms, and it wouldn’t fix my low supply issues because I was diagnosed with insufficient glandular tissue (IGT). I stopped pumping, ditched my SNS, and started combo-feeding my baby. It was amazing for my mental health and literally changed my life. 

Bethanne talks about having a psychotic break from severe sleep deprivation while triple feeding her daughter.

I was a first-time mother and was 100% committed to exclusively breastfeeding.  She was born at 36 weeks and was very sleepy. She latched poorly, so the LC prescribed triple feeding. I had plenty of help at home and thought everything was going well. I was profoundly exhausted because I didn’t sleep in the hospital at all. I didn’t recognize my mind was shutting down. I became confused and wasn’t eating or drinking much. I began hallucinating. My husband called my OB who told him to bring me to the hospital. I was admitted for observation, and the psychiatrist diagnosed me with severe sleep deprivation and anxiety. I had IV fluids and sleep medication and slept for 8 hours straight. When I woke up, my milk was in, but I was very frail and kept crying. I decided I would become a pumping and formula feeding mother so I could get some sleep. I tell every mother I know not to triple feed because of the hell I lived through. My OB filed a formal complaint about the LC who prescribed triple feeding to me.

According to Dr. Marianne Neifert, “the rigors of a triple feeding schedule aren’t for every woman: some are too exhausted or have too many other responsibilities to devote the necessary time and energy to this demanding regimen. Dr. Neifert states, “if a mom’s emotional well-being is at risk because she keeps trying and trying and it’s still not a rewarding experience, we have to assess whether it’s realistic for her to exclusively breastfeed. Many moms who are having a great deal of trouble and are ready to quit will breastfeed longer if they see it as doable for them” — doable, in other words, by combining breast- and bottle feeding.

Sleep deprivation has very serious consequences. As health professionals, we need to protect maternal mental health when developing complicated breastfeeding plans. Very serious sleep deprivation conditions while triple feeding has resulted in postpartum depression, anxiety, psychosis, deteriorating physical health, and serious accidents.

In Part 2 of this blog, we will share stories from mothers describing how a modified triple feeding plan worked for them. It’s important to recognize that every infant feeding situation requires individualized care for the best outcomes.

 


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!

 

 

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?  

They argue that formula will change the beneficial bacteria in the baby’s gut, but this change is safe and only temporary—and pales in comparison to the risks of potentially life-threatening complications from insufficient colostrum, like jaundice, low blood sugar, and dehydration, which can be caused by acute starvation.   What about sensitizing the infant’s gut to cow’s milk protein?  There is no evidence that early limited formula supplementation has any impact on babies’ future health. If someone has this evidence, please come forward.  In addition, if anyone has is concerned about cow’s milk formula, there are formulas that have those proteins broken down (hydrolyzed) that can also be used. The fact that lactation and medical professionals have not promoted and implemented this life-saving solution shows that the real issue is bias against formula use, pure and simple.  Do they hate formula products so much that they don’t care if your baby suffers from hunger?

The question is, how many randomized, controlled studies support Step 6 of the WHO’s Ten Steps to Successful Breastfeeding to avoid supplementation from birth in order to improve breastfeeding outcomes? None. Absolutely none.

In the meantime, parents and health care professionals can be assured that if a baby shows signs of persistent hunger after breastfeeding, just a few teaspoons of formula or donor milk (if available) can satiate the baby’s unrelenting hunger, will not cause breastfeeding problems, and even reduces the risk of re-hospitalization due to the baby not getting enough milk.

As long as the mother’s milk supply is protected by the baby breastfeeding at least eight times a day, or in some cases adding milk expression to the feeding plan, the baby can return to exclusive breastfeeding when the mother’s milk comes in.

Supplementation does not destroy mothers’ confidence in their bodies; it gives them the confidence to know they can care for their babies no matter what happens, and it gives them the knowledge they need to support their milk supply until it increases to meet the baby’s needs.  

Do you want to be successful with breastfeeding while protecting your baby from hunger?  Follow your instinct and your baby’s cues, and don’t be afraid of giving your baby a little extra nutrition until your milk comes in!

The Fed Is Best Foundation IBCLC Team

#JustTwoTeaspoons   #FedIsBest  #SafeBreastfeeding

*Only some infants were supplemented. Babies received 10 mL of formula by syringe after breastfeeding if they met the following criteria: >75th %ile  weight loss for age, irritability such as crying and hungry behavior, and if their mothers requested it. Mothers were instructed to stop supplementing after their milk came in.

Note: if a baby is still showing hunger cues after those 10 mL, you can repeat with another 10 mL until the baby is satisfied. 


Resources

Feed Your Baby—When Supplementing Saves Breastfeeding and Lives

The Newborn Stomach Size Myth: It is NOT 5-7 mL

Fed is Best Feeding Plan – Updated 2018

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

WHO 2017 Revised Guidelines Provide No Evidence to Justify Exclusive Breastfeeding Rule While Evidence Supports Supplemented Breastfeeding

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!

 

 

 

 

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 safely breastfeeding.

Dental Health Isn’t Important For Pregnant Women

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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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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

Is Breast Milk Stealing The Spotlight Of A Novel Anti-Tumor Compound?

BY ALEXANDRIA FISCHER, PHD CANDIDATE AT THE RENSSELAER POLYTECHNIC INSTITUTE, STUDYING SYNTHETIC MICROBIAL COMMUNITIES

The “magic” of breastmilk is never-ending, plastered everywhere on social media with little regard to true scientific analysis. The idea that breastfeeding prevents cancer is a huge promotion point for why mothers should breastfeed at all costs. But while the cancer-preventing benefits are overblown, there is an even bigger claim surrounding the anti-cancer properties of breastmilk; that breast milk kills cancer, in and of itself.  This is a claim that I have seen made many times, so I decided to dig into the research and see where this claim came from and how truthful the claim is.

So where did this idea that breastmilk can kill cancer cells come from? It’s actually a long, and interesting accident of science.  In 1995 researchers were studying the adherence of bacteria to lung cancer cells in the presence of human milk fractions [1]. Fractionation is simply the process where the different molecule types in any substance are separated from one another. One of the tested fractions showed not only inhibition of bacterial adherence but also induced apoptosis of the tumor cells. Apoptosis is just a fancy word for cell death. This fraction was α-lactalbumin, an abundant protein in milk. However, α-lactalbumin in its natural state has no effect on tumor cells.  So what happened in the 1995 study? It seems that the researchers fractionated the milk at a low pH (acidic) implying that there was some kind of change in the structure of the protein. Further work showed that a reaction between the α-lactalbumin and oleic acid (acids lower pH) form the HAMLET compound [2]. HAMLET stands for Human α-lactalbumin Made LEthal to Tumors. HAMLET is an incredibly interesting compound that induced cell death (apoptosis) in cancer cells but not human cells.

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