Exclusively Breastfed Newborns Have Double the Risk of Being Rehospitalized

January 24, 2018January 26, 20182 Comments

By Christie del Castillo-Hegyi, M.D.

This week, the journal Academic Pediatrics, published a study conducted by the Newborn Weight Loss research group led by Drs. Valerie Flaherman and Ian Paul, which consisted of 143,889 healthy, term and near-term newborns born at the Baby-Friendly Northern California Kaiser Permanente hospital system from 2009-2013.[1] They included newborns who were discharged from their birth hospitalization without requirement of intensive care, which includes newborns who developed jaundice before discharge. They looked at the effects of mode of feeding, namely exclusive breastfeeding and exclusive formula feeding during the birth hospitalization on the rates of rehospitalization and number of outpatient follow-up visits. In addition, they looked at the effects of percent weight loss on the same outcomes.

Overall, 6.2% (1 in 16) of the healthy term newborns studied were readmitted; 4% were vaginally delivered and 2.2% were Cesarean delivered. This represents 8921 newborns over the five year period, almost 5 babies per day. They showed that exclusively breastfed newborns had slightly more than double the risk of being rehospitalized, even when adjusted for gestational age, birth weight and maternal race/ethnicity. Exclusively breastfed newborns also had significantly more (32% more) outpatient visits in the first 30 days after birth compared to exclusively formula-fed newborns. The leading cause of readmission was for hyperbilirubinemia or jaundice and need for inpatient phototherapy. The purpose of phototherapy is to reduce blood bilirubin levels in order to prevent or limit brain injury, a complication of insufficient feeding and dehydration commonly found in exclusively breastfed newborns before the onset of copious milk production (lactogenesis II).

Continue reading →

Baby boy's first month milestone photos.

I Shared My Story a Year Ago And I Was Told To Go Kill Myself – How I Am Healing

January 19, 2018October 9, 20236 Comments

By Mandy Dukovan, MS, MFT, Marriage and Family Therapist, Fed is Best Foundation Senior Advisor

It’s incredibly hard to put into words all the things that The Fed Is Best Foundation has done for me over the past year. I stumbled upon the Foundation when I noticed a friend of mine “liked” one of their blog posts. I was a first-time mom who was struggling with many different feelings and wasn’t sure who or where to turn to. My son was two months at the time and was just beginning to thrive after I began supplementing him with formula. While I was so happy to see my baby finally gaining weight and thriving, I had haunting memories and raw emotions that I struggled to sort out. I had immense guilt that I didn’t see the signs that my baby was hungry, which tortured me non-stop. I was embarrassed to look at his 1-month picture and now see that he was obviously malnourished, but how on earth did I miss this at the time?

1 Month Old

I was angry that I didn’t follow my instincts that something was wrong with him and was angry that I believed all the terrible things I was told by lactivists that would happen to him if I gave him a drop of formula. I worried that we would not have the kind of bond that babies who were exclusively breastfed (EBF) experienced with their mothers. I now know our bond is much stronger because we bottle-fed him and no longer experienced the immense stress that came each time I tried to breastfeed my baby. I got to a point where I dreaded even trying to breastfeed him, but I was told that was the best thing I could do for my baby, so I kept going at the expense of my baby’s health and my well-being. I honestly believed I was the only mother who had experienced what we went through because I only heard the stories about how amazing and natural breastfeeding was, and every mother could breastfeed if only she tried hard enough.

Since I am a therapist, I knew I needed to share my story. I found courage in my strong desire for other babies and mothers not to struggle. I also found courage in the fact that I needed a reason for all of the suffering—I needed to know that Brock’s struggle was not in vain. I kept telling myself, “If I reach even one mother and prevent even one baby from suffering like Brock, then I have to do this.”

Then I shared my story… Continue reading →

The Shaming Began In My Hospital Breastfeeding Course And Never Stopped

January 11, 2018October 9, 20231 Comment

The shaming began prior to delivery, at the hospital breastfeeding class. A soon-to-be mom asked if she should keep some formula on-hand, just in case she was unable to breastfeed. The lactation consultant (IBCLC) insisted she not keep any formula around because, as soon as you start feeding the baby formula, you will give up on breastfeeding and never forgive yourself! She also said it was rare for a mother to not be able to produce enough milk, which is not true. I told her it was fine to get some formula, if for nothing than to relieve the intense pressure of exclusively breastfeeding that was being forced in our class. The IBCLC also instructed us not to use our pump for at least twelve weeks, and even then, only if we were returning to work–because pumping would interfere our milk supply. I later learned this is also not true.

Continue reading →

I Burned the SNS Supplemental Feeder In Our Backyard-My Story As A Supportive Breastfeeding Partner

January 7, 2018June 13, 20224 Comments

The first weeks of our baby’s life are hazy, but I remember Meredith’s gasps of pain when she tried to nurse. I remember that the baby kept coming off the breast and crying and we had to get her back on. It was a constant struggle of trying to get the baby latched, having to break her latch because of the pain, then her falling asleep, unlatching, then waking up and crying. It was a seemingly endless cycle.

When we brought the baby home from the hospital, she was crying and we couldn’t get her to stop. I realized she was hungry and I gave her a bottle of formula. She drank down four ounces, stopped crying, and went to sleep. I felt relieved because I was able to make my baby happy and comfortable. I told Meredith that the baby drank 4 ounces of formula and she said that was impossible, because an infant’s stomach can only hold 5 ml, according to the nurse who taught our breastfeeding class. We both now know that is untrue.

The next day, we went to the lactation consultant at the hospital. She told us to supplement with formula, but to give no more than 5 ml at once with a syringe—no bottles. She said the baby’s stomach could only hold 5 ml (our baby was 4 days old) and we should feed her with a syringe to avoid nipple confusion. The baby sucked those 5 ml down so quickly, it was ridiculous. I knew that she needed more than 5 ml, but I didn’t feel qualified to disagree with the lactation consultant. Because she worked at the hospital, I assumed she was giving evidence-based advice. So we fed the baby 5 ml at a time with a syringe. When one syringe-full was insufficient to sate the baby, I often fed her multiple syringes at a time, even though I felt like it was wrong to do so. Continue reading →

Smiling woman wearing glasses, peace sign.

Clinicians’ Guide to Supporting Parents with Guilt About Breastfeeding Challenges

December 31, 2017October 9, 20237 Comments

Written by Dr. Ruth Ann Harpur, Clinical Psychologist

A systematic review of the scientific literature indicates that women who intend to breastfeed but who later feed their babies formula consistently report feelings of guilt, anger, worry, uncertainty, and a sense of failure despite the relief that introducing formula after experiencing difficulties with breastfeeding may bring (Lakshman, Ogilvie, & Ong, 2009). Recent research also indicates that this group of new mothers are at particular risk for postnatal depression (Borra et al., 2015).

Clinicians are uniquely placed to provide compassionate care at a vulnerable time for this group of parents. Their attitude and words can invoke a sense of shame, judgment, and failure, or they can inspire compassion, reassurance, and emotional healing.

Continue reading →