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:

any breastfeeding at 6 and 12 months
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”

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By the Senior Advisory Board of the Fed is Best Foundation

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

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

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

Continue reading →

Grieving mother holds sick infant in NICU.

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

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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 the pediatrician wrote a prescription.)

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Learn The Most Effective Strategies to Successfully Combo-Feed Your Baby

September 5, 2024January 18, 2025Leave a comment

Did you know combo-feeding is the most common way to feed babies worldwide? In the US, 75% of babies and 59% globally receive infant formula during the first year of life, yet it is often overlooked in new parents’ infant feeding education and support. Given these significant statistics, parents shouldn’t have to navigate alone or rely on friends, family, and social media for potentially inaccurate information that could compromise the health of infants or breastfeeding itself. Continue reading →

What Sets Apart The ‘Fed Is Best’ Message From The ‘Breast Is Best’ Message?

August 5, 2024May 7, 2025Leave a comment

In a world filled with infant feeding advice and conflicting messages, a beacon of wisdom and support emerges in “ our newly published Fed Is Best book, The Unintended Harms of the “Breast Is Best” Message and How to Find the Right Approach for You and Your Baby.

Our transformative book promises to navigate the intricate landscape of infant feeding choices, empowering parents with knowledge and judgment-free support. Our highly anticipated book will reshape the conversation around infant nutrition, offering a comprehensive, science-backed, and inclusive perspective on how families can safely and optimally nourish their babies. Click here to purchase our newly published, groundbreaking book!

Let’s Talk About What The Fed Is Best Foundation Stands For

We are committed to providing parents with vital knowledge and education about breastfeeding safely, a mission that sets us apart from other healthcare organizations. The data supports our mission: One in 71 exclusively breastfed babies is rehospitalized for serious health complications of insufficient breastfeeding, which is unacceptable. Click here for a FREE infant feeding plan.

Our book received endorsement from Dr. Marianne Neifert, pediatrician and co-founder of the Academy of Breastfeeding Medicine.

Continue reading →

Mother and newborn baby sleeping peacefully.

My “Baby Friendly” Hospital Harmed My Baby: How Hospitals Can Do Better

May 27, 2024January 18, 20251 Comment

Good information isn’t always enough to overcome bad systems.

By Sarah Christopherson

I wrote this article in late 2018, a few months after giving birth to my daughter. My experience at my â€œBaby Friendlyâ€ hospital was traumatic and it was painful to relive, but I felt like I could help other new parents by telling my story, and it seemed like a good match for the work I was doing professionally to dismantle coercive systems that deprive women of their autonomy.

At the time, I was the policy advocacy director for a national non-profit focused on empowering women as they navigate healthcare in the US. My article was printed in our organizational newsletter in early 2019 and published on our website.

It was shared by Fed Is Best, which also interviewed me. From time to time, I would send the link to expecting parents, not to scare them, but to empower them to stand up for themselves when they sensed that something wasnâ€™t right. It helped me to help others. And telling my story made a difference.

A friend who gave birth in the same hospital texted me, â€œYour article helped me so much when I was having trouble breastfeeding. I look at the pictures of [my sonâ€™s] early days and think about how it would have gotten worse if I hadnâ€™t talked to you and others. I started supplementing with formula early AND I signed that dumb form without blinking. The post-partum period exhausts you so that normal problems you would easily solve seem so much harderâ€¦ and then youâ€™re dealing with some of the most consequential decisions youâ€™ve ever had to make. It was the things Iâ€™d already thought through a bitâ€”like the stuff in your pieceâ€”that I was prepared to tackle.â€

Eventually my non-profit changed leadership and I moved into a different policy field. My infant turned into a happy, healthy, precocious, and articulate 6-year-old bouncing ball of energy. And thatâ€™s where I thought things ended.

Until last week, when I discovered that without my knowledge or permission, my former organization had rewritten my article in January. Theyâ€™d kept my name, my story, and the picture my husband took of me in a hospital gown holding my infant daughter on the day she was born. But theyâ€™d stripped out paragraph after paragraph that cautioned against breastfeeding coercion. Continue reading →

Tina Cartwright, Rebranding Motherhood founder.

I Learned To Prioritize My Well-Being Alongside My Baby’s and Shed the Suffocating Cloak of Societal Expectations and I was able to rebrand motherhood for myself

May 20, 2024January 18, 2025Leave a comment

By Tina Cartwright, Founder of Rebranding Motherhood

My journey through childbirth and early motherhood was far from easy, but it was undeniably transformative. It taught me the importance of resilience, self-compassion, and the power of community in navigating motherhood’s most profound challenges. Before reaching this undeniable truth, my birth trauma thrust me into an arduous journey as I entered motherhood.

Birth trauma is tricky because society would love to put a clean, simple definition on it. However, trauma is defined by the individual and what that experience led you to feel afterward. For me, my birth trauma started when I first held my baby. The elusive bond between mother and child didn’t materialize instantaneously for me, unlike the glossy portrayals Hollywood and social media would suggest.

This sanitized imagery further claimed I would be overwhelmed, almost washed over with the deepest levels of instant joy and admiration for my new baby. Within seconds of this stark realization hitting me, I instantly began a silent inner panic that never quieted until I was ultimately diagnosed with PMAD (postpartum depression) and started a formal treatment plan.

Continue reading →

Nurse Takes Formula Away From Parents Who Were Trying to Feed Their Hungry Baby In The Hospital

May 7, 2024January 18, 20251 Comment

My feeding journey was not at all what I envisioned for my little one and me. When I was pregnant with my firstborn, I heard stories from my mom that she never used a bottle with my brother and me. When I researched breastfeeding, parents were told how wonderful and natural it is. I believed breastfeeding would come naturally.

The day my son was born was a whirlwind. I had to have a c-section due to complications, but we were so excited to meet him. The first few days, I tried to get him to latch on, and he would stay for a little while and then unlatch. I felt uneasy that he wasn’t getting enough colostrum, but the medical staff told me I was doing great. My husband and I were so focused on getting breastfeeding down that I forgot to get pictures of me and my little one. My focus was getting him fed the right way. Sometimes, nursing hurt so much that I would dread it when it was time for feeding. The on-site lactation consultant came the day after the c-section. She was with me for an hour and told me everything was wonderful!

After she left, my baby would cry, and I knew something wasn’t right. My husband and I decided it was time to ask for formula. When we asked, the nurse kept asking us if we were sure. As first-time parents, we questioned if we were doing the right thing.

I was so exhausted and needed rest that my husband decided to feed my little one formula. Another nurse came in and said, “Dad! Don’t! Breastfeeding is the way! Don’t do that to your little one. Your wife is doing great.” She grabbed the formula from my husband’s hands and stashed it in a cabinet. My husband and I looked at each other in shock, and I tried to breastfeed again.

We were discharged on a Friday, and over the weekend, my son cried a lot, and I thought he might be a fussy baby. On Monday morning, we saw that my son had orange urine in his diaper. I lost it. I remember holding him and crying, blaming myself. We went to the doctor’s office and were told that he was dehydrated. He also lost a lot of weight, more than he should have, and my doctor suggested it was time to supplement my baby with formula.

Then came the day that changed my mental health forever.

After that, I cried for hours, and I could not get over the guilt. I kept thinking: “Why didn’t I know he was hungry or not getting enough? How could I have let my baby starve?” The guilt stayed with me for months and was the catalyst for my debilitating postpartum depression and anxiety diagnosis.

After that, I became obsessed with feeding my son. I would write down how many ounces of formula or breastmilk he had and at what times. I no longer breastfed, but I pumped, so I knew exactly how many ounces he was consuming. Even when he was a few months older, I would still wake him up to feed him because I thought he would become dehydrated again. I hated when my little one would cry because it would be a reminder of the terrible weekend of his life, and I would break down, and I would cry.

My husband and I hope to have another little one, and I know what I would do differently. I feel guilty that my little one had a rough start on his feeding journey, but I try to remember that we were both learning and following the advice of medical professionals in the hospital.

I can’t tell you how much I appreciate Fed is Best Foundation and their work. I honestly don’t know what would have happened to me without finding your support community. I got so emotional writing my story. Thank you for being there for mothers and babies.

Warmly,

Maria