Fed is Best Foundation Response to U.S. Delegation Actions at the World Health Assembly

Jody Segrave-Daly, RN, IBCLC and Christie del Castillo-Hegyi, M.D.

The Fed is Best Foundation is dedicated to ensuring safe infant feeding for every single child, a goal that can be achieved with exclusive breastfeeding, combination feeding, exclusive formula feeding and tube-feeding. We have no political affiliation. We support all mothers to help their infant thrive with safe, sufficient and sustainable feeding in order to protect their health and optimize brain development. Recent news has broken about the U.S. delegation at the 71st World Health Assembly opposing the first draft of the Infant and Young Child Feeding resolution. We have provided a line-by-line break down of the first draft of the resolution, which was set to be proposed by delegates from Ecuador, as well as the proposed draft submitted by the U.S. delegation along with our interpretation of the lines that the U.S. delegates opposed.

In an editorial published in the New York Post, two pediatricians, Dr. Alma Golden and Dr. Brett Giroir,  who were key members of the U.S. delegation attending the 71st World Health Assembly, wrote about the rationale for the U.S. opposition of the first draft:

As pediatricians, US representatives at this year’s World Health Assembly in Geneva and supporters of breastfeeding throughout our professional careers, we were shocked to read recent headlines, in the New York Times and elsewhere, claiming that the administration has somehow called into question the importance of breastfeeding for infants.

The administration fully endorses breastfeeding, and the agencies where we work — Health and Human Services and USAID — communicate this unequivocally…We don’t just affirm these priorities in formal conference rooms in Geneva. For years, the US government…has invested millions of dollars to promote breastfeeding both at home and abroad.

All of which is to say: Breastfeeding wasn’t in dispute in Geneva. Rather, we raised objections to an early draft of the resolution we eventually supported, which made references to a controversial 2016 guidance document. The underlying policy goal of this guidance is unsupported by US nutrition guidelines and inconsistent with the practice of most families in our country…

In particular, the guidance recommends that countries impose stringent new regulations on the marketing of any commercially produced foods suggested for children between 6 months and 3 years old. Such restrictions, in our view, prevent parents from having access to all the factual information they might need. The guidance even advocates for the prohibition of free samples of formula — including in countries and conflict zones where supplies of formula could help save babies’ lives.

Most important, there are good and valid reasons, both medical and personal, why some mothers cannot breastfeed, or choose not to breastfeed exclusively. This is particularly true in situations where displacement, other trauma or malnutrition have made it impossible for mothers to breastfeed their children, and these babies’ lives are at risk without formula or other nutritional supplementation. Parents in these dire situations need all the information and choices available.

The issue of child malnutrition occurring in war torn countries has been reported on by CNN reporter Gayle Lemmon in her article, “Don’t make babies rely on breast milk in war zones,” where she interviewed members of Doctors Without Borders who reported taking care of many infants suffering from severe malnutrition as a result of the strict restrictions of the World Health Organization and UNICEF on formula donations.

‘Over the past couple of weeks we’ve seen an increase in the number of malnourished children needing treatment,” Doctors Without Borders’ Iraq country director Manuel Lannaud said in an interview released on the group’s Web site.

The surprising thing is that Lannaud and his colleagues at the humanitarian aid group didn’t place the blame for these underfed little ones just on war and the fact that the city was under siege. They also put the blame on other international organizations and policies that seek to do good.

“It isn’t a problem of access to food. The malnutrition we see here is primarily due to the scarcity of infant formula,” Lannaud wrote. “International organizations like UNICEF and the World Health Organization (WHO) promote breastfeeding … and provide infant formula, but only by prescription. We believe that distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalized for malnutrition.”

Doctors Without Borders says it agrees that breastfeeding promotion is a priority, but one that comes after dealing with the immediate crisis of a baby’s survival. Says Lannaud, if mothers “need formula, we give it to them.”

The mothers who need it are those facing down life-and-death situations each day, often while caring for multiple children in the shadow of war. That giving infant formula to them is so controversial speaks to a policy tripwire few outside the humanitarian realm even know exists: global “breastfeeding first” policies.

The WHO breastfeeding policies are not without flaws and aggressive promotion of exclusive breastfeeding has resulted in harm, namely an epidemic of newborn hospitalizations for jaundice, dehydration and hypoglycemia, known causes of brain injury and developmental disability, in the U.S. and across the globe. In addition, there has been a rise in accidental suffocation of newborns, called Sudden Unexpected Postnatal Collapse, from prone positioning during to skin-to-skin care and breastfeeding, made worse by maternal exhaustion from 24/7 rooming-in, practices encouraged but the WHO Ten Steps and by Baby-Friendly policies. The promotion of exclusive breastfeeding from birth has contributed to an epidemic of neonatal jaundice in the developed and developing world, which has contributed to an epidemic of perinatal brain injury and cerebral palsy particularly in the developing world, where few health care resources are available to monitor and treat exclusive breastfeeding complications. Promoting exclusive breastfeeding from birth over the local, traditional practices of supplemented breastfeeding (with wet nursing, animal milk or sugar water) until the onset of copious milk production has discouraged a practice that breastfeeding mothers used to prevent hunger and starvation-related complications like jaundice, dehydration and hypoglycemia, which now are the leading causes of newborn rehospitalization in the world.

Incidence of severe neonatal jaundice (bilirubin ≥ 20 mg/dL) in Low- and Middle-Income countries. The data reported correspond to hospital statistics. [Greco, et al, Neonatology 2016;110:172-180]

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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 medical director of Baby-Friendly USA, Dr. Lawrence Gartner.

Our full response was sent directly to the author of the letter, the Executive Director of 1000 Days, Ms. Lucy Martinez-Sullivan, who was asked to distribute it to all the signed parties. She confirmed via email that she would forward it. However, not a single party has accepted the invitation by contacting us directly or through Ms. Martinez-Sullivan and nothing has been posted on their individual organizational websites acknowledging their receipt of our invitation.  Our invitation remains open indefinitely. We can be reached at contact@fedisbest.org.

Signed,

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

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.)

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Response to Baby-Friendly USA Regarding Rates of Hyperbilirubinemia Among Exclusively Breastfed Newborns

Starvation jaundice (hyperbilirubinemia) of the newborn is defined as abnormally high bilirubin in a newborn who loses >8-10% weight. It is caused by insufficient elimination of bilirubin due to insufficient caloric intake from exclusive breastfeeding in the first week of life. The Academy of Breastfeeding Medicine jaundice protocol acknowledges that exclusively breastfed newborns are at higher risk of hyperbilirubinemia from insufficient milk intake (“suboptimal intake”) and excessive weight loss. The vast majority of newborn hyperbilirubinemia is caused by starvation jaundice. Their protocol also states that 98% of kernicterus, or the most severe form of brain injury from jaundice, occurs in breastfed newborns. Nearly all of starvation jaundice can be prevented with timely and adequate supplementation. Nearly all newborns with starvation jaundice show signs of poor feeding including excessive crying and frequent, unsatisfied nursing or lethargy before they develop the complication.

Provided by Grace Baldomar Delos Santos whose son developed jaundice and dehydration from insufficient feeding while exclusively breastfeeding. She was not told about the higher risk of jaundice from exclusive breastfeeding nor the risk to her child’s brain.

More recent estimates of excessive jaundice in a Baby-Friendly-certified hospital system, Kaiser Permanente Northern California, which has among the highest exclusively breastfeeding rates at discharge, was published in JAMA Pediatrics in 2016, which showed that 12-20% of newborns developed hyperbilirubinemia of >15 mg/dL. Over 10,000 newborns or 10.1% received phototherapy over a 3-year period. The true need for phototherapy rate was somewhere between 5.7-12%. This rate was modified by the need for recalibration of the bilirubin machines within the time period of the study. Continue reading

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

Christie del Castillo-Hegyi, M.D.

The WHO health policy that has been responsible for millions of preventable hospital admissions of newborns for insufficient feeding complications is Step 6 of the Ten Steps to Successful Breastfeeding: “Give no additional food or fluid other than breast milk unless medically indicated.” Complications of insufficient feeding from exclusive breastfeeding before copious milk production are now among the leading causes of newborn extended and repeat hospitalization, namely jaundice (hyperbilirubinemia), dehydration and hypoglycemia.

In 2017, the World Health Organization published its guidelines updating its recommendations for “Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services,” which outlines the evidence for the WHO recommendations on breastfeeding support for newborns in health facilities based on the Ten Steps to Successful Breastfeeding. Here is the evidence presented to justify the recommendation to avoid supplementation in breastfed newborns.

The WHO guidelines authors went on to conclude the following:

How did very low quality of evidence turn into moderate quality evidence for exclusive breastfeeding particularly when the evidence showed improvement of breastfeeding rates in supplemented breastfed newborns? Continue reading

My Body, My Breast: Stop Asking Me How I’m Feeding My Baby

by Sarah Cunningham

As a new mom who did not successfully breastfeed, I have so often felt like a lesser mother over the past 9 months, self-conscious whenever someone has asked me, “Are you still breastfeeding?” Or, my favorite follow-up question, “Oh no, what happened!?” I have heard so many references to breastfeeding that at times I have felt as though mothering is breastfeeding– and because I am not doing so, I must certainly be less of a mom.

Like for many others, the “breast is best” mantra-turned-guilt-trip started for me before my daughter was even born. In my last group prenatal meeting, one woman said she planned to feed her baby formula, but felt like the healthcare community would only give her information on breastfeeding.

After a deafening silence, the lactation consultant said, “that’s because we now know that breast milk is better.” And as if that icy tidbit wasn’t enough, she went on to caution, “I will just warn you that this is a very pro-breastfeeding area.” I swallowed hard, internalizing this information as a non-negotiable item, like so many women must do.

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Jillian Johnson: My Message To Parents During World Breastfeeding Week

By Jillian Johnson

It took all of the courage I had to put aside the debilitating amount of guilt I carried for five long years to tell sildenafil cost—his birth, the first days of his life and how he died. In fact, I still don’t know where I found that courage, but I am convinced Landon gave me the strength. I wasn’t prepared for the intense scrutiny my story received. I was utterly shocked because people came out of nowhere to discredit my story with a vengeance, but I quickly learned how to be gracious in such a vulnerable time.

After all, nothing anyone could say to me could hurt me more than the death of my newborn baby.

I can remember a very specific time, when I was sitting in the waiting room of the hospital and Landon was on life support. My dad was there with me and we were talking about Landon’s prognosis and I won’t ever forget him telling me what a special little boy he was and that he would do great things. I couldn’t quite wrap my head around what his words meant because Landon was most likely going to pass away, and my dad was talking about how he’s going to do great things. I never dreamed that his death would change the lives of so many people across the globe.

I was taken aback by the countless number of people reaching out to me personally and sending compassionate, supportive messages on Landon’s Facebook page. I spoke with so many people, it became a full-time job. But it was a job I was proud to have. I was shocked and appalled to learn about the number of mothers who experienced near-death with their babies from dehydration while breastfeeding, but because they were able to get help and supplement sooner, their babies survived.  Some of the babies that suffered now have brain damage and disabilities. I also received messages from medical professionals who thanked me for speaking up, for educating and sharing sildenafil cost too. They told me they feared losing their jobs if they spoke out about what they are seeing in hospitals. Some of the nurses told me they left the maternal health field because they could not tolerate seeing babies crying out to be fed while being denied supplementation. They told me they were given scripted responses to memorize to deny supplementation when a mother would ask for it. This is one example of the text.

 I learned there were other infant deaths too, but parents could not share the details because of their medical malpractice settlement restrictions.

Of course, there were despicable and hateful words said to me by breastfeeding zealots. Their comments revealed to me how desperate they are to protect exclusive breastfeeding and depict it as perfect, when in fact it harms some babies when there isn’t enough breast milk.

It was an adjustment to talk about my story as I never wanted to be in the limelight, but each time I spoke, I felt empowered and I received compassionate support from people I didn’t even know!  As I prepared for my first interview with People magazine, my nerves were coming apart. I could barely hold myself together as my husband stood in the kitchen listening to me recount the experience of the night we found Landon not breathing. I just kept reminding myself in my head that the world needs to hear his story and parents need to know how to protect their newborns from accidental starvation while exclusively breastfeeding. I can’t thank all of the staff at People magazine enough for their kindness. They allowed me to be open and speak freely about Landon.

Click to see Jillian Johnson Interview by People Magazine

 

The interview requests with people from all over the world continued. I was surprised when I heard from the producer of The Doctor’s Show. I was beyond nervous because I had no idea what I would be going into or up against. Thank goodness I had Dr. Christie with me. Having her beside me giving her her own personal story reminded me of why I had to just go out there and say what needed to be said. It was powerful and the emotions that came from it were indescribable. I have the utmost respect for Dr. Travis Stork and Dr. Nita Landry because they wanted to help us share our experiences to help educate others. I know Dr. Landry must’ve been able to tell how nervous I was. As the segment taping started, she reached over and grabbed my hand and told me she believes in me and what I’m doing. She told me she respected me and that I was going to do great. I won’t ever forget the photo that was taken after the taping as well. I haven’t been able to quite place what his emotion was, but Dr. Stork’s facial expression was one of shock. I don’t know if he was simply feeling sadness after listening to us or if he was in disbelief of the practices that are causing harm to babies. But I appreciated the kind words exchanged as I left the stage.

I attended a large Neonatal Symposium where Dr. Christie presented sildenafil cost which included all of the clinical information that I didn’t know about.  Wow, talk about heavy emotions. I had to leave the room for some time because I couldn’t listen to some of the discussion and comments being made. At one point the entire room went silent when Dr. Christie presented a video of a baby who was in distress from inadequate breast milk intake in the hospital that was aired on TLC’s “Rattled” television episode. One of the IBCLCs asked Dr. Christie if she knew the risks of using formula, yet the IBCLC didn’t have the basic understanding of knowing the deadly consequences of not supplementing a starving baby. After Dr. Christie’s presentation, many physicians and nurses came up to her to thank her for answering the questions they had and for providing the most current research about exclusive breastfeeding complications.

As the year continued I became part of The Fed Is Best Advocacy Group, a large group of health professionals and parents who have infant feeding stories similar to mine who are working on multiple advocacy and outreach projects. One of them was meeting with what is clomid to discuss our concerns about the Ten Steps and accidental starvation.

Caloric

I continued to receive messages from people all over the world who were very kind and thoughtful, offering me support, telling me their stories and asking me many questions. This is an example of just one letter I received that was very moving to me:

Dear Jillian,

I think it’s important that I provide additional information to clarify Landon’s story, to debunk some of the mistruths that were written, and to answer some of the common questions, so that other parents are informed about the risks of exclusive breastfeeding.

  • The first mistruth is Landon died from suffocation.

The truth is I was reading a breastfeeding book that my hospital recommended to us in our breastfeeding class. I was searching for answers about why my baby was “cluster-feeding” all of the time. That book told me I would make all of the milk my baby needed and it reassured me that I was doing everything right. That book told me to trust my body, keep breastfeeding my baby as much as he wanted and my milk would come in. I believed that book. While reading, I noticed he was still. I picked him up and he was limp. My husband was training to be an EMT and began doing CPR on him immediately, until the paramedics arrived and took over. At the hospital, Landon was diagnosed with severe dehydration, and they could not get an IV line in had to use intraosseous access which is a canula that went directly into his bone marrow. 

  • The second mistruth is that it is rare for exclusively breastfed babies to suffer from dehydration.

The truth is dehydration is common while attempting to exclusively breastfeed. This most commonly occurs because a mother is not producing enough colostrum or breast milk for her baby. 

  • Third mistruth is that Landon had a metabolic disorder.

The truth is his newborn screening for inherited metabolic disorders was normal and is confirmed in his medical chart. He had every test imaginable in the NICU and every one was normal, except for his brain injury from severe dehydration. He developed pneumonia after his body began to shut down while on the ventilator. His NICU admission blood work and chest x-ray confirms this.

  • The fourth mistruth is that Landon had something wrong with him in the hospital.

The truth is I didn’t have a emergency c-section. I learned this when reviewing my medical chart. I was in labor at home and was progressing beautifully. I arrived at the hospital and was dilated at 5 cm. I asked for an epidural and then my water broke. Landon’s heart monitoring showed some distress when my water broke so my obstetrician said his cord could be in trouble and together, we decided not take any chances and began to prepare for my surgery. His heart rate stabilized with positioning his head off the cord and positioning my body. Forty two minutes later, Landon was born. He came out with an immediate cry and had Apgars of 8 and 9. He did receive a small IV fluid bolus for grunting, which health professionals say is a common treatment used in newborns.

FullSizeRender (5)

Landon was required to have 2 hours of observation in the special care nursery per the hospital’s protocol. He was brought out to us and was cleared to be in my room at all times. He had normal vital signs and exams, at every shift, as documented in his medical chart. But what wasn’t normal was his constant breastfeeding. According to the experts at The Fed is Best Foundation, if he were sick or unstable, it would be impossible to have any energy or stamina to constantly breastfeed. 

JillianLandonPoem

Landon shortly after birth. He was just perfect in every way.

Many people asked why I didn’t feed my baby formula if I thought he was hungry when we got home. The truth is I didn’t have any formula and even if I did, I had no idea how to supplement or how to prepare it because I was never taught how to in my breastfeeding education class. My hospital told me a mother shouldn’t have formula at home and I believed them. I trusted them and my goal was always to exclusively breastfeed my baby.

We have been through some very dark times. But it’s also through these dark times that I am reminded that I was the one chosen to be the mother of such an important little guy. Somehow, I was the one that would have to be strong enough to go through his death, knowing that it didn’t have to be this way. He didn’t have to die. Yet the Baby-Friendly exclusive breastfeeding education and policies, which we learned from the WHO have never been tested or monitored for safety, continue to be promoted for babies all across the globe.

JillandLandon1

Landon on life support after going into cardiac arrest from severe dehydration from insufficient exclusive breastfeeding.

My message to parents during World Breastfeeding Week is this.

It is very important for me to say that Landon didn’t die from exclusively breastfeeding. He died from not having enough milk. No doctor, nurse and IBCLC from my Baby-Friendly hospital recognized he was starving because they were all taught the same universal breastfeeding education from the Baby-Friendly Hospital Initiative, which is deeply flawed. When I had my second child, I nursed, supplemented and pumped at every feeding. The most milk I ever got was 1.5 ounces every 24 hours, and my daughter never transferred any measurable breast milk when doing weighted feeds. It took 6 days for my milk to even come in. It wasn’t until I had my second baby that anyone mentioned that I had insufficient glandular tissue, in addition to my PCOS diagnosis.

Modern medicine has been duped by the WHO BFHI protocol and our society is paying the price. My baby paid the ultimate price.   

I ask every licensed medical professional to review the WHO Ten Steps breastfeeding policy and ask for the safety data and then make changes to improve this policy so that babies and mothers are protected and can go on to safely breastfeed their babies.

The fed is best foundation


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 the Fed is Best Volunteer group to help us reach Obstetric Health Providers to advocate for counseling of new mothers on the importance of safe infant feeding.
  2. 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.
  3. 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 resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. Write your local elected officials about what is happening to newborn babies in hospitals and ask for 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.
  7. Send us your stories. Share with us your successes, your struggles and every thing 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.
  8. 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.

Donate to Fed is Best

Thank you so much from the Founders of the Fed is Best Foundation!

 

Hypernatremic Dehydration is Common and Occurs to a Third of Healthy Newborns

Christie del Castillo-Hegyi, M.d.

Newborn hypernatremia is a serious complication of early exclusive breastfeeding of newborns caused by insufficient feeding of milk. It is defined as an elevation of blood sodium levels (≥ 145 mEq/L) in response to insufficient fluid intake and most commonly occurs at day 3-4 of life, typically the point of greatest weight loss of a newborn. It is the most severe complication of dehydration and excessive weight loss and increases the risk of brain injury, developmental delay/disability, seizure disorder, vital organ injury and death. Oddie et al. showed that up to 98% of hypernatremia occurs in exclusively or near-exclusively breastfed newborns and the study group found the diagnosis of hypernatremia was rare.[1] However, since blood sodium levels are not universally-screened, which could result in missed cases of hypernatremia, it has been unclear just how common the condition is among newborns.

Steph Montgomery’s daughter jaundiced, dehydrated and hypernatremic at day 5 with 20% weight loss due to insufficient breast milk intake from low supply

A recently published prospective study of 165 healthy newborns ≥ 35 weeks gestational age looked at rates of hypernatremia (>145 mEq/L) in the first 3 days of life.[2] They examined multiple variables that predict hypernatremia as well as the threshold weight loss values at which increased hypernatremia risk occurs. The results were astounding.

The study found that out of 165 newborns 51 or 30.9% developed hypernatremia.

The majority of cases occurred by 5% weight loss, the lowest percentage weight loss occurring at 4.77% weight loss, especially for male infants delivered by cesarean delivery to a mother with higher education level.

The study found that the variables that predicted higher odds of developing hypernatremia were the following:

Risk Factors for HypernatremiaIncreased Odds of Newborn Hypernatremia
Greater weight loss (mean 8.6%±2 vs. 6%) 

70%

Male gender

192%

Higher maternal education

86%

Multiparity (not being a first-time mom)

263%

Cesarean delivery

39%

 

Hypernatremia is a known complication of newborn weight loss and male newborns may be at higher risk due to a higher metabolic requirements relative to females. Surprisingly, although primiparity (being a first-time mom) is a risk factor for delayed or insufficient lactogenesis II,[3] multiparity in this study was a risk factor. The authors hypothesized that first-time mothers may have received closer monitoring. They also found that high maternal education was a significant risk factor for neonatal hypernatremia as mothers with higher education are more likely to exclusively breastfeed.

Analysis of the data shows that the majority of hypernatremic babies were breastfed or mix-fed. It is unclear whether the volumes of supplementation were restricted in mix-fed newborns or if they started off as exclusively breastfed and subsequently met medical indication for supplementation since the data was collected right before discharge. 96.1% of hypernatremic newborns were breastfed, 74.5% exclusively breastfed, 21.6% mix-fed and 3.9% were exclusively formula-fed. Exclusively breastfed and mix-fed newborns had hypernatremia rates of around 37% while exclusively formula-fed newborns had a rate of 6.25%. This yields a 5.84-fold higher risk of hypernatremia for exclusively breastfed newborns relative to exclusively formula-fed newborns. Mixed-fed newborns (which may have included exclusively breastfed newborns who required supplementation before discharge) were at 6-fold higher risk of hypernatremia.

Feeding Method (FM)FM among hypernatremic newborns (% of total) n = 51Risk of hypernatremia per FM: hypernatremia cases/total (%) 
Exclusively breastfed

38 (74.5%)

38/104 (36.5%)

Mixed-fed (upon discharge)

11 (21.6)

11/29 (37.9%)

Exclusively formula fed

2 (3.9%)

2/32 (6.25%)

 

This is the first study done to show the true incidence of hypernatremic dehydration among healthy term and near-term newborns. This is alarming data as prior studies have concluded that hypernatremic dehydration is rare occurring to less than 2% of admitted newborns.[4]  Other studies have shown abnormal developmental scores among newborns who develop hypernatremia even with appropriate correction. Among them include a study showing newborns who developed hypernatremia ≥ 150 mEq/L, over half had abnormal developmental scores at 12 months of age.[5] Another showed 25% percent of newborns with hypernatremia had developmental delay at 6 months, 21% at 12 months, 19% at 18 months and 12% at 24 months of age compared to a rate of 0.3% for non-hypernatremic infants.[6]

The largest study to date of weight loss in healthy, term exclusively breastfed newborns at a large Baby-Friendly-certified health system showed that greater than half lost > 7% of birth weight.[7] Ten percent weight loss is still commonly viewed as “normal” and “safe” for newborns to lose with little to no data supporting it. Among hypernatremic newborns, the mean weight loss was 8.6% +/- 2.7. Given that blood sodium levels are not universally-screened, a true hypernatremia incidence of 31% (36-38% among breastfed newborns) predicts that many more cases of hypernatremia are left undiagnosed and untreated potentially resulting in occult brain injury. The signs of hypernatremic dehydration predicting poor outcomes are poor feeding, seizures, fever and lethargy.[6] Given that the signs of poor feeding can be subtle and commonly missed among health professionals (or even normalized by the BFHI guidelines)[8] and given that parents are given little to no education on the signs and consequences of hypernatremic dehydration, there are likely many cases of hypernatremia among breastfed newborns that are being missed resulting in cases of brain injury that could go undetected for several years until a child begins to miss developmental milestones.

Summary

The recommendation of the author was to screen for hypernatremia at weight loss cut-offs depending on a newborn’s risk factors. For the highest risk category of males born by c-section to a multiparous, highly educated mother, it was recommended to begin screening for hypernatremia at 4.77% weight loss.

Hypernatremic dehydration is a devastating unintended consequence of current initiatives aimed at increasing exclusive breastfeeding rates at discharge, the quality metric of the Baby-Friendly Hospital Initiative. Given the high incidence of hypernatremia among healthy, term and near-term newborns, particularly among exclusively or near-exclusively breastfed newborns before copious milk production, we recommend screening for hypernatremia above 5% weight loss and sooner among  high-risk newborns who are exhibiting signs of persistent hunger and distress. Unrestricted supplementation for mild hypernatremia (145-146 meQ/L) can prevent need for hospitalization and the negative consequences on subsequent brain development.

References

  1. Oddie, S. J., Craven, V., Deakin, K., Westman, J. & Scally, A. Severe neonatal hypernatraemia: a population based study. Arch. Dis. Child. Fetal Neonatal Ed. 98, F384-387 (2013).
  2. Ferrández-González, M. et al. Weight loss thresholds to detect early hypernatremia in newborns. J Pediatr (Rio J) (2018).
  3. Dewey, K. G., Nommsen-Rivers, L. A., Heinig, M. J. & Cohen, R. J. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics 112, 607–619 (2003).
  4. Moritz, M. L., Manole, M. D., Bogen, D. L. & Ayus, J. C. Breastfeeding-associated hypernatremia: are we missing the diagnosis? Pediatrics 116, e343-347 (2005).
  5. Koklu, E. et al. A review of 116 cases of breastfeeding-associated hypernatremia in rural area of central Turkey. J. Trop. Pediatr. 53, 347–350 (2007).
  6. Boskabadi, H. et al. Long-Term Neurodevelopmental Outcome of Neonates with Hypernatremic Dehydration. Breastfeed Med (2017). doi:10.1089/bfm.2016.0054
  7. Flaherman, V. J. et al. Early Weight Loss Nomograms for Exclusively Breastfed Newborns. PEDIATRICS 135, e16–e23 (2015).
  8. Kellams, A., Harrel, C., Omage, S., Gregory, C. & Rosen-Carole, C. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med 12, 188–198 (2017).
  9. Ben, X.-M. Nutritional management of newborn infants: Practical guidelines. World Journal of Gastroenterology 14, 6133 (2008).

 

My Son Became Severely Jaundiced and Dehydrated in a Baby-Friendly Park Slope, Brooklyn Hospital

By Fed is Best Mom and Advocate, Lilian B.

My son John was born at 42 weeks and one dayat Methodist hospital in Park Slope, Brooklyn, via uneventful vaginal delivery. His APGAR score was 9 or 10. He was strong and beautiful. My labor was quick, and once I got an epidural, it was a breeze. My water broke around 7pm at home. An hour later contractions began in earnest. Once my midwife told me I was ready to push, it only took 20 minutes to get him out. Once the bliss of easy labor wore off, my hospital nightmare began.

See, I was born with tuberous breasts. This is a breast deformity, characterized by severe hypoplasia (lack of tissue), a narrow breast base, and puffy painful nipples that droop downward, due to a lack of any breast base. It’s a poorly understood and studied deformity, but anecdotally, it can make breastfeeding difficult, if not impossible. On top of the deformity, I had two cosmetic surgeries to correct the appearance of my breasts.

Naturally, I had major anxiety about whether I would or wouldn’t be able to breastfeed.

Day One

Shortly after John was born, I tried to get him to latch, but he wouldn’t latch. He sucked various parts of my chest and fell asleep. He slept soundly from 5am to almost 2pm. While he slept, I attended a lactation workshop. When I got back from the lactation workshop, I called one of the lactation consultants to come to my room.

The LC arrived around 2pm. John was a bit lethargic, and he tried to latch to seemingly anything except my breasts. She showed me how to latch him properly, and he suckled, but to me it didn’t look like he was swallowing anything. The LC expressed colostrum from my nipples, which really hurt. I think it was all the colostrum I would ever produce… John ate the colostrum from a spoon and fell asleep again.

Around 4 pm, a nurse came in and checked his skin. To my surprise, she said he was jaundiced and may need therapy. I had never heard of baby jaundice. The resident didn’t even ask if he was eating or doing well.

I kept putting baby John on my breasts throughout the afternoon and early evening, and he would suckle away, but again, it didn’t seem like he was really getting anything. I tried to hand express colostrum like the LC had done, but nothing was coming out. He would fall back asleep after 10 minutes of nursing.

My husband and I dozed off. Suddenly we awoke to three people in our darkened room: two residents and a nurse. They announced that John’s bilirubin levels were now in the high risk zone, and he would be taken away from me and put into a glass box under UV lights. I was so disoriented, I just said OK.

One resident left, and the remaining resident explained to me that I was O Positive and John was A Negative blood type, which resulted in higher levels of bilirubin. I asked if there was anything I could do to help my baby, and the resident explained that the best thing for him was to eat. My heart sank. This is precisely what I can’t do: I explained to the resident my deformity and multiple surgeries, using medical terms. He just replied something about it being possible to breastfeed even after surgery, and left.

After the second resident absconded into the night, only the nurse remained. She explained that they would bring John back to me to breastfeed throughout the night. In desperation, I pleaded with her to feed him formula. I explained my surgeries and deformity again, this time in tears. She told me to take a hot shower or use a warm compress on my breasts to stimulate milk production, and she too disappeared into the night.

I remember lying in the hospital cot, despondent and crying. My husband spooned me and cried with me. I remember saying, “They keep telling me to breastfeed, but my breasts aren’t real. They’re basically prosthetic. There’s nothing coming out of them.”

Hours passed and I kept going into the hallway to try to look at baby John. I could see him in the glass box, with a blindfold on. It hurt my soul to think about how confused and alone he must feel.

Later I checked on him again, but this time I could see he was crying. That was the last straw. I called the nurse and demanded they give him formula. She told me that only the chief resident or pediatrician can authorize formula, and he was tied up in an emergency C-section. Are you kidding me, I thought.

Finally, hours later, a 20-something child shows up in my room in the dark. She tells me that the benefits of breastfeeding include lower rates of diabetes, obesity and heart disease, as well as higher IQ. Was I sure that I wanted formula? I told her yes, because my baby is alone in a glass box and screaming for food, which apparently he needs to survive. She said OK.

Day 2

Eventually the sun came up, and I expected to wake up relieved. The morning nurse came in and shattered my relief. She said that she attempted to give John formula but he wouldn’t latch onto the nipples for the bottles they stocked. The nipples were the long skinny kind, and John had a good natural latch. “This baby knows what’s best: breastfeeding” she declared in seeming triumph.

She then proceeded to explain to me that I really should work on feeding him, because he needed to eat to get rid of the bilirubin. It was only then that she explained that high bilirubin levels can lead to brain damage. But I ought not to worry, because her own children looked like oompa loompas when they were born and now they’re very intelligent. Oh good, thanks, I thought.

My parents, sister and brother-in-law came to Brooklyn that day to visit me. They were shocked to find John in a glass box and me sobbing in my hospital room, since they heard that yesterday’s birth had been super easy. Yes, the nurses eventually wheeled John’s glass box into my hospital room, because his non-stop screaming was disturbing the other babies in the nurse’s station. This gave me relief in a sense. I played music for him and held his hand. But it was awful to watch him cry.

Thankfully, my sister was lactating at the time, and she breastfed John. She told me his latch was deep, perfect and painless, unlike her own son, who had a tongue tie and a shallow latch. I saw him take big gulps, and when he unlatched there was a dribble of milk down his cheek. I wept tears of joy.

The Fed is Best Foundation supports safe, laboratory-tested donor milk supplemental feeding. Had John’s mother been provided formula when requested, she may not have needed to supplement her son through casual donation. 

It was against hospital policy for my sister to feed John, as the morning nurse had told me, when I made the mistake of mentioning it. So literally I guarded the door while my sister fed my child to keep him alive. It was freaking nuts.

A lactation consultant came in after visiting hours and showed me how to use a hospital-grade pump, which she wheeled into my room. I pumped and pumped but literally nothing came out. The LC was able to hand express a few watery drops of milk from my breasts, and she declared that they were so “full and healthy-looking. Surely your milk would come in.” Again, I explained my deformity and surgeries. She asked me what my surgeons had told me, and I said they weren’t sure what my outcome would be, but it was theoretically possible to breast feed.

My sister had hand pumped another 2 oz or so and left it in the hospital room for us before she went home. Later that evening, when my baby woke up hungry, I pipette fed him the breast milk. Unsurprisingly, his bilirubin levels dropped significantly since he had finally eaten, and they told me that I would likely be released the next day. I only had 2 oz of breast milk for the night. Once it was gone, I had no plan.

Day 3

The next morning, the nurse announced that John’s bilirubin levels had inched up again, but since he was a day older, he was technically out of the danger zone. She encouraged me to keep breastfeeding, and told me we would be OK. Throughout that day, I kept pumping and getting nothing. The LC kept telling me, “Pumps don’t work for some moms. The best pump in the world is a baby!”

I kept putting him at my breast, and I could tell that he was suckling but not gulping, as he had done at my sister’s breast. I pipette fed him formula while he suckled. He still refused to latch onto the formula bottle nipple. I left the hospital feeling as if I was stepping into a void, where nobody would hear me cry.

The third night was restless. John kept waking up crying. I didn’t have formula at home, so I was just putting him on my breasts. He would suckle and fall asleep after 10 minutes. An hour later the same thing would happen.

Day 4

In the morning, I was overjoyed to see the pee strip on his diaper had changed colors! He must have gotten some milk and peed! But when my husband and I removed the diaper, we saw that the urine looked like it was slightly bloody. My husband googled it, and found “brick dust” indicates severe dehydration.

I panicked. I told my husband to go out and buy formula. ANY formula. ANY bottle. Because of the jaundice, we had our first pediatrician appointment that morning. When his pediatrician came into our exam room, she found me frantically squirting formula into John’s mouth, since he wouldn’t latch onto that nipple. He was sort of gagging on it, swallowing some, and the rest was spilling all over him but I didn’t care.

Thankfully, my pediatrician just seemed grateful that we would be switching to formula. She told us to research anatomical bottles, that John might have better luck with a different type of nipple. Until then, I had no idea that baby bottles came in different nipple formats. I’d always thought of them as universal.

He latched right on, guzzled formula as heartily as he could, and then unlatched. He burped like a trucker, with a stream of milk dribbling down his chin. He looked happy, like he had when my sister fed him. He went right to sleep and stayed asleep for hours.  The jaundice faded in a day and a half. John had lost 10% of his weight, but he put it right back on in the first week. He was super cute, alert, and clearly thriving.

Phototherapy-requiring jaundice as well as infant hunger and dehydration are improved with ad-lib supplementation.

Still, I wouldn’t let the guilt leave me. I spent weeks taking supplements, and pumping. The most I ever got was one ounce A DAY, which I dutifully fed him. I paid for a consultation with a lactation doctor, who helped me buy domperidone. As soon as I started to take the domperidone, I got a horrible headache and much of my visual field became watery and blurry. By then my husband was back at work, and it was just really scary not to be able to see, so I gave up on it immediately. I returned the hospital grade pump I rented. And I never looked back.

Since giving up on breastfeeding, I started to look at some of the studies that supposedly validate the benefits of breastfeeding. I was shocked by how few studies had any adequate controls for class and socioeconomic status.  I am upper middle class and privileged, as are many of my friends. Some of them are downright rich. Their mothers all formula fed in the 80’s, and yet, none of my friends are obese, dull, or have diabetes. I began to seriously doubt the data that is out there.

As a philosophy major, I am accustomed to analyzing magical thinking, that is, thinking that is not supported by the evidence. The vain hope behind much of the magical thinking that I see is a desire to return to nature. Nature is best. Nature is right. Nature is true. And if we stop being artificial, we as humans will be better off. Biological systems work, BUT they are not necessarily efficient or good.

If your baby is hungry, feed her. And if other moms guilt you, remember that they are scared and alone too.

#FedisBest

— Lilian B.

Here’s John now!


There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:

  1. Join the Fed is Best Volunteer group to help us reach Obstetric Health Providers
  2. Make a donation to the Fed is Best Foundation.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.
  3. 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 resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. Write your local elected officials about what is happening to newborn babies in hospitals and ask for 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.
  7. Send us your stories. Share with us your successes, your struggles and every thing 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.
  8. 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.
  9. Shop and Fed is Best Foundation will earn cash back! We hope to develop our online safe infant feeding classes with these funds.
  10. If you need support, we have a private support group – Join

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

Donate to Fed is Best

Celebrating The Fed is Best Foundation’s Second Anniversary!

We want to celebrate the tremendous progress that Fed is Best has made in its second year as a non-profit organization. Thanks to the donations of our Fed is Best parents and health professionals as well as the grass-roots efforts of our supporters, we have permanently changed the dialogue around infant feeding to prioritize safe, sufficient and sustainable feeding for every  baby, every time, tailored to each mom and baby.

We want to celebrate with you our brief history!

Fed is Best Followers and visitors Grow by Leaps and Bounds

Fedisbest.org since its opening has received 4.6 million visits since it launched July 2016 and 500,000 visits in the last year. In total, Fed is Best and the campaign preceding the establishment of our non-profit has received over 7 million views. Our Facebook following has grown by almost 200,000 in one year and our followers span the globe. We have grown our Fed is Best Parent Support group with the help of our faithful volunteers and admins to create a truly safe space where mothers of every kind, whether they formula-feed, breastfeed, combo-feed or tube-feed, truly support each other without judgment or a feeding agenda. In addition, our health professional organization, including pediatricians, neonatologists, other physicians, nurses and lactation professionals has grown in order to provide support for professionals advocating for safe infant feeding practices in hospitals and hospital policy.

Google Analytics Data from July 11, 2017 to July 19, 2018

Fed is Best Foundation Facebook Followers

Fed is Best Foundation Meets with the Top Officials of the WHO Breastfeeding Guidelines Program

Provided by Hanna Awadzi, pictured in photo. Ms. Awadzi is a professional journalist from Ghana whose first-born daughter Avery suffered from severe starvation-related jaundice and hypoglycemia while exclusively breastfeeding with insufficient milk. Avery subsequently developed cerebral palsy. Bilirubin toxicity and hypoglycemia are known causes of brain injury and cerebral palsy.

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.

A full account of the meeting can be found what is clomid. We presented data on the high rates of complications in exclusively breastfed newborns from research conducted at BFHI hospitals and the expected prevalence of brain injury and long-term disability resulting from those complications. The neonatologist in attendance reported on the experiences of neonatologists with the BFHI  stating, “we are seeing these cases almost every day every where around the country. The focus [of the BFHI] is only on the number of women who are exclusively breastfeeding at discharge and not at all on safety.” During this meeting we uncovered that the WHO has never studied the complications associated with the WHO Ten Steps and has no program to monitor complications caused by the BFHI. Dr. Rollins informed us that every health professional trained in the Baby-Friendly protocol has been taught to look out for danger signs of an underfed breastfed baby at risk of brain injury which include, “convulsions, lethargy and inability to feed.” Unfortunately, the evidence presented showed that these are signs that brain injury is already present.

Fed is Best Foundation is Featured on the Cover Article of TIME Magazine, “The Goddess Myth”

On October 19. 20187, The Fed is Best Foundation was featured in the cover story of TIME Magazine, an article by Claire Howorth, exploring how modern-day expectations of motherhood are hurting mothers and babies. She explored how social media, popular media and parenting books, which have created a culture that idealizes natural parenting choices, natural birth and exclusive breastfeeding, can result in mothers experiencing anger, shame and guilt when things do not go as planned. The anti-shame backlash against this cultural phenomenon included Fed is Best.

“There is a backlash beyond the bookshelf too. Last year, Dr. Christie Del Castillo-Hegyi, an emergency-room physician in Arkansas, founded Fed Is Best. The organization, run by a group of doctors, nurses and mothers, raises awareness of feeding options. It wants the BFHI to reconsider its stringent rules and to inform mothers on what Del Castillo-Hegyi says are under-recognized risks of exclusive breastfeeding, ranging from jaundice to starvation. She would know. Several years ago, in her quest to exclusively breastfeed, she nearly starved her infant son to death. Some of the mothers who work with Fed Is Best have had similar experiences, in a few cases leading to their babies’ death. They are determined to keep such tragedy from striking others. “If you have leaders telling you this is what’s best, it becomes ideology, policy, identity,” says Del Castillo-Hegyi. “I can’t even think of something more vulnerable than motherhood. And if motherhood means ‘exclusive breastfeeding,’ then a mother will do anything.”

Fed is Best Raises Awareness at the NIH Task Force on Research for Pregnant and Lactating Women

On February 26, 2018, Dr. Christie del Castillo-Hegyi, Co-Founder of the Fed is Best Foundation traveled to the NIH to raise awareness on the gaps in breastfeeding protocols, research and education that is leading to common and serious complications in exclusively breastfed newborns. She directed her address to the Task Force as well as U.S. Health Secretary, Alex Azar. She submitted the Fed is Best petition including comments from thousands of families and health professionals who have witnessed infants harmed by the WHO breastfeeding guidelines.

Fed is Best Co-Founder Gives Grand Rounds Lecture at CHRISTUS St. Vincent in Santa Fe, NM Launching the first Q.A. Project to Optimize Newborn Breastfeeding Support

On May 2-3, 2018, Dr. Christie del Castillo-Hegyi, Co-Founder of the Fed is Best Foundation had the honor of giving the following presentation to the largest hospital in Santa Fe, NM, CHRISTUS St. Vincent whose safety and quality improvement program is leading the way toward optimizing newborn breastfeeding support. The Grand Rounds conference was held over two days and were attended by approximately 80 physicians, nurses, lactation consultants and other health professionals who contributed to a very positive discussion of safe breastfeeding support in the newborn period.

The Royal College of Midwives Announce that All Midwives are to Support Mothers Regardless of their Feeding Choice

On June 12, 2018,  The Royal College of Midwives confirmed that ‘the decision of whether or not to breastfeed is a woman’s choice and must be respected’, in a new position statement on infant feeding. The statement recommends that balanced and relevant information be given to parents choosing to formula feed their babies, whether exclusively or partially, to enable them to do so safely and with support to encourage good bonding.  The RCM advises that breastfeeding mothers and their partners should be given information and support to help manage the physical, mental, emotional and societal challenges of breastfeeding.

Gill added that the RCM believes that women should be at the centre of their own care and as with other areas of maternity care midwives and MSWs should promote informed choice. ‘If, after being given appropriate information, advice and support on breastfeeding, a woman chooses not to do so, or to give formula as well as breastfeeding, her choice must be respected. We recognize that some women cannot or do not wish to breastfeed and rely on formula milk. They must be given all the advice and support they need on safe preparation of bottles and responsive feeding to develop a close and loving bond with their baby.’

We are thrilled to see such a statement made to protect a woman’s infant feeding choice, recognizing that not all mothers can or want to breastfeed, and that all mother’s need support  to feed her baby safely and sufficiently so that they may thrive and reach their full potential.

The Fed is Best Foundation Story is Featured on CNN.com and New York Times

On the day of our second anniversary, July 11, 2018, we were honored with the publication of a CNN.com article documenting our work as a fledgling organization, “The ‘breast is best’ policy backlash,” by Elissa Strauss.

“In 2016, del Castillo-Hegyi paired up with Jody Segrave-Daly, a newborn nursery and newborn intensive care unit nurse and certified lactation consultant, to form Fed is Best. The nonprofit is aimed at helping fill in the gap in breastfeeding education by teaching parents methylprednisolone vs prednisone of hypoglycemia, jaundice and dehydration and encouraging them to supplement with formula whenever necessary.”

Soon thereafter, we were recognized as the most recent addition to infant feeding history by New York Times reporter, Christina Caron in the article, “Breast-Feeding or Formula? For Americans, It’s Complicated.”

The ‘Fed is Best’ movement emerges

“But now a new movement called Fed is Best has arisen because of the pressure placed on women to exclusively breast-feed, sometimes to the detriment of their infants. The movement seeks to educate families about all of the safe feeding options available to them, and the complications that can arise when exclusively breast-fed newborns don’t receive enough breast milk.”

Our Most Important Achievements are the Babies we Help and the moms We Support

Here are a few.

#FedisBest


There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:

  1. Join the Fed is Best Volunteer group to help us reach Obstetric Health Providers
  2. Make a donation to the Fed is Best Foundation.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.
  3. 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 resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. Write your local elected officials about what is happening to newborn babies in hospitals and ask for 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.
  7. Send us your stories. Share with us your successes, your struggles and every thing 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.
  8. 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.
  9. Shop and Fed is Best Foundation will earn cash back! We hope to develop our online safe infant feeding classes with these funds.
  10. If you need support, we have a private support group – Join

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

Donate to Fed is Best

My Lactation Consultant Slapped My Nipple And Called My Nipple Shield A Cheater

I’d heard pretty much since starting puberty that breast is best. It’s in movies, books, social media, health class, and even in my own family. So, you can imagine my surprise to be sitting across from a very concerned doctor with a starving infant hearing that my breast milk wasn’t enough.

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My baby only gained 7 ounces in one month.

I wanted to breastfeed because I wanted to do what was absolutely best for my son, no questions asked. But before he was born, the intense pressure to exclusively breast feed was causing anxiety attacks, frequently. I have flat nipples but I was assured breast feeding would be no problem.

Then I had my beautiful baby boy. We immediately had issues with breastfeeding. One lactation consultant slapped my nipple trying to get it to poke out and called the nipple shield a “cheater”. So I didn’t use one after that. We were not allowed to give him a pacifier. It was four days of pure buy cialis

I was told over and over my body would produce enough milk for my baby and to just keep breastfeeding.

We went home and it wasn’t much better. So, every time I held him he’d cry, and then I’d cry because I’d have to feed him. I began dreading my child. No parent should have to dread their child. Continue reading

My Baby Was Starving – She Lost 17 Percent Of Her Body Weight While Exclusively Breastfeeding

My daughter was born after 14 hours of labor with no issues, in a baby friendly hospital, and with what all of the medical professionals assured me was a perfect latch. The nurses kept telling me she would fall asleep soon, that all newborns do, but she was up for 7 hours after birth, most of the hours latched onto me. By the next morning, my nipples were already raw. I had lanolin I had brought with me that I applied as much as I could, but my daughter was literally on my breast for 5 hour stretches. sildenafil over the counter, that I was doing a great thing by breastfeeding her, and we were sent home with no concerns being expressed, despite her 10 percent weight loss that I was told was normal. (This is not normal.)

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Cara continued to stay at my breast nonstop the next day and night. By day 4, she was finally stopping after 5 or so minutes and I assumed my milk must have come in. She also began to sleep much more, which I thought was because she was finally getting full.

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We had a weight check in later on that day with the lactation consultant. sildenafil citrate 100mg The LC told me I needed to get a pump, suggested a variety of measures to boost supply, and put me on a triple feeding schedule (breastfeed, give a bottle, pump and repeat). She said to not let her have any more than 20 ml of formula at a time or I would risk ruining my breastfeeding relationship. She also scheduled an appointment for me to come back the next day but never once told me that I should see my pediatrician for an urgent evaluation.  Continue reading