Dr. Christie del Castillo-Hegyi was invited to present her research on the brain- and life-threatening consequences of insufficient feeding of exclusively breastfed newborns at the First Coast Neonatal Symposium held by the Department of Neonatology at the University of Florida at Jacksonville on April 24, 2017. Here is the video of the lecture presented.
Note: A segment of the lecture was excluded due to copyright laws and will be posted once permission is granted to publish it.
My son was born weighing 7 lb 5 oz. Within his first week he lost 11% of his body weight. Babies at Risk; Loss of 10% Birth Weight By week three we had been to approximately 7 weigh-ins and saw 3 lactation consultations. I had two lactation consultants texting me around the clock, day and night to ensure I was successful at breastfeeding. My lactation consultants were aware that I had a breast reduction several years ago that impacted my supply with my first baby. She lost a pound in her first week of life but at that hospital, the doctor had me supplement my baby immediately. Babies At Risk; History of Breastfeeding Failure
Babies At Risk Stanford Medicine Breast Surgery : Many women with breast reduction report they were not well informed about the risks of under-production, and therefore anticipate they will be able to exclusively breastfeed. They typically feel their milk “come in” and can easily express small volumes. Due to the disruption of the collecting system, it is the exceptional mother who can exclusively breastfeed. This may be a risk for any mother with peri-areolar incisions. Mothers should be encouraged and taught proactive measures to maximize production, and yet be provided realistic expectations, close follow-up and clear indications of inadequate milk intake.
At his three week weigh in, he had actually started to LOSE weight and he was 7 ounces below his birth weight.
When I finally got pregnant via IVF with my son Ike, I decided that I wanted to breastfeed him. Why? Immunological benefits, possible lower obesity and diabetes risk, possibly smarter… As a scientist, I didn’t quite buy the higher IQ selling points of breastfeeding, but the immunological benefits seemed plausible to me. My two siblings, who seemed to have far fewer instances of illness and health issues, were breastfed while I was exclusively formula fed, so anecdotally, it seemed that breastfeeding made a positive impact on health. I delivered my son at a hospital that was touted to have one of the best birth centers in the Bay Area. One of the key takeaways from the birth center tour was that breastfeeding was specifically embraced and emphasized, so I put on my birth plan that I planned to breastfeed.
Labor and delivery was difficult. After 27 hours of labor, nearly 4 hours of pushing, and a failed vacuum extraction, Baby Ike was delivered via C-section. When the nurse handed Ike to me to breastfeed him, he would not latch, but would push me away and scream like I was trying to murder him–and this would happen each time I tried to breastfeed him. Despite this, the nurses had me adhere to a breastfeeding schedule every 2 hours (because, they reminded me, my birth plan stated that I wanted to breastfeed). Each time the nurse or my husband handed Ike to me to breastfeed, I was filled with dread. I fought the urge to break down into tears as Ike pushed me away and arched his back while screaming as I tried to coax him into latching onto my breast.
“I think our baby hates me,” I said to my husband after the umpteenth failed breastfeeding attempt.
My milk did not come in while I was in the hospital recovering, and did not come in until 9 days post-partum. Since my baby wasn’t latching, a breast pump was delivered to my room to help stimulate milk production. I was not given instructions on how to use the pump and I used the wrong size flange and made the mistake of turning the suction power all the way to the highest level. I also was pumping dry breasts for over 45 minutes which led to sore, cracked nipples and not a drop of milk! So I hand expressed as much colostrum into a 1 cc syringe and fed my newborn whatever I could squeeze out of my breasts. Continue reading
We’ve had two sad experiences with the ‘Baby-Friendly’ aspiring hospital, Massachusetts General Hospital. Both issues involved two things: the fact that I had breast reduction surgery and unknown/limited milk supply and the fact that my wife induced lactation.
With our first baby, my wife breastfed her immediately after birth while I recovered for a minute (fast, unmedicated, and awesome labor). She then refused to latch on to my breasts and the hospital encouraged (kind of forced) my wife to put the baby to her breast. She was in med school and had wanted to pump and never wanted to be the primary nurser. She started to cry because we were offered no information or choice in the matter. I was encouraged to continue putting a crying, non-latching baby to my breast over and over. It was horrid. We left the hospital with the advice to “Keep switching her back and forth,” which resulted in her becoming malnourished.
This experience greatly impacted our experience of early parenthood. We felt that we had no choices and that the hospital was myopically focused on breastfeeding and not on baby feeding. They kept saying, “You never know! You might have a full breast milk supply!” But after surgery, my chances of full milk supply were very, very slim. I was pumping and getting a dime size (flat) drop of colostrum.
They kept saying that it’s normal to have very little colostrum. The hospital absolutely refused to face reality. This makes me really sad to write about. But it’s important.
During our second baby’s birth (same moms, same roles) we brought my wife’s pumped milk and she actually left the hospital to take care of the older kiddo. The nurse really really didn’t want me to give the new baby our pumped milk. I ended up sneaking it to her from a little cup. I had to sneak around to feed my baby.
Once again the hospital nurses (all lactation consultants) kept having me nurse and kept telling me it was okay if the baby didn’t get any milk in the first 24 hours.The thing is, I didn’t want to deprive her of milk. I wanted to start her off strong, with milk from both moms and I did. To deny a newborn baby food and fluids is cruel and is child abuse.
The primary reason why newborns experience starvation-related complications every single day as a result of the Baby-Friendly protocol is because the complications associated with the protocol are hidden from mothers who seek to breastfeed. The primary objective of the Baby-Friendly Hospital Initiative is high exclusive breastfeeding at discharge. Unfortunately, because the rates of insufficient breast milk and delayed lactogenesis II are high among mothers, the necessary consequences of hospital policies that seek high EBF at discharge rates are higher starvation-related complications like hyperbilirubinemia, hypernatremia, dehydration and hypoglycemia, all of which can cause newborn brain injury and permanent disability. Below is an example of the way mothers are made to fear formula supplementation while the risks of NOT supplementing are hidden. This is a waiver form published on the California Department of Public Health Website to provide an example of a model formula waiver form for hospitals.
