I See Myself in Other Mother’s Eyes: A Neonatologist’s Fed is Best Story

by Dr. Jessica Madden, M.D.

My oldest daughter, Grace, was born when I was 28 years old. She was our long-awaited first child, the one who I had postponed having for many years so that I could get through a good chunk of my medical training before becoming a mom.  I felt like I was prepared as much as one could possibly be to take care of and breastfeed a newborn.  I had spent years babysitting my siblings and neighbors and had over two years of intense pediatric/neonatal training under my belt. I had read every single “What to Expect” type of book, joined multiple online breastfeeding forums to learn from experienced mothers beforehand, and took all of the prenatal classes at the hospital where I delivered. I knew that breastfeeding was going to be difficult and exhausting at times, and that it might take several weeks for my baby and me to get into a “groove” with it, but I was ready to dive in headfirst. Continue reading

Dangers of Insufficient Breastfeeding Presented at the First Coast Neonatal Symposium

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.

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I Supplemented My Starving Baby When My Hospital IBCLC’s, Doctor and WIC Counselor Told Me Not To

By Kristen, Fed is Best Mom and Advocate

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 

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 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.

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My 6th Lactation Consultant Saved Me When She Focused On My Needs First

By Beth Kao, Fed is Best Mom and Advocate

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

How Even Two Moms Couldn’t Make Enough Milk For Their Baby And Were Forced to Sneak Pumped Breast Milk Into The Hospital

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 the 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. But normal is an ounce or two (right?) not 1/16 tsp. The hospital absolutely refused to face reality. This makes me really sad to write about. But it’s important.

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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.  

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I thank the Fed Is Best Foundation from the bottom of my heart for being a beacon for women like me. For the record, both girls got mostly breast milk and some formula. My first baby never really nursed with me. Baby 2 nursed to 10 months. They are both brilliant and funny and fiery and healthy and sassy and all the best things.

WRITING YOUR HOSPITAL ABOUT YOUR BABY’S FEEDING COMPLICATIONS

Every year, thousands of infants in every country are hospitalized for complications due to underfeeding from exclusive breastfeeding including dehydration, hypoglycemia and excessive jaundice. Many families leave these experiences traumatized and some babies are irreversibly injured. The only way hospitals will know to make their infant feeding policies safer is through patients raising awareness. If your child experienced a feeding complication, please consider writing your hospital’s CEO and your health insurance company. Here is a letter template to help you get the process started. The more detail you are able to provide the better.  For more information on how to gather information about your child’s hospital course and the possibility of injury, please write christie@fedisbest.org.

Write to your hospital

 

 

Fear NOT Facts Contained in Baby-Friendly Formula Feeding Waiver Forms

By Christie del Castillo-Hegyi, M.D., Co-Founder of the Fed is Best Foundation

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.

Here are examples of FEAR not FACTS contained in formula feeding waiver forms that Baby-Friendly hospitals require moms to sign before they allow a newborn to be formula-fed.

1. FEAR: Supplementation CAUSES delayed milk production.

FACT: The known risk factors for delayed milk production include being a first-time mom, cesarean delivery, flat or inverted nipples, higher BMI > 27, prolonged stage II of delivery (when a mom pushes to deliver), having a large baby, excessive blood loss, being an older mom > 30, PCOS, diabetes, hypothyroidism, insufficient glandular tissue, retained placenta to name a few. While supplementation may be ASSOCIATED with delayed milk production, supplementation is in fact a REFLECTION of the need to supplement a baby who is being underfed due to delayed copious milk production.  (Pediatrics 2003, 112 (3 Pt 1): 607-19)

2. FEAR: Not exclusively breastfeeding puts my child at risk of jaundice.

FACT: Exclusive breastfeeding is among the highest risk factors for excessive jaundice requiring phototherapy admissions according to the American Academy of Pediatrics and 10-18% of exclusively breastfed newborns experience starvation jaundice from insufficient milk intake according to the Academy of Breastfeeding Medicine. Exclusively breastfed newborns are at higher risk of jaundice than supplemented and formula-fed newborns due to the smaller volumes of milk they receive as milk helps the baby pass bilirubin into the stool. In fact one of the ways jaundice is treated and prevented is through supplemental milk feeding.
Pediatrics, July 2004, VOLUME 114 / ISSUE 1, BREASTFEEDING MEDICINE, Volume 5, Number 2, 2010

3. FEAR: Not exclusively breastfeeding will cause my baby to be underfed

FACTS: In the largest studies of supplemented/formula-fed vs. exclusively breastfed healthy, term newborns from a large Baby-Friendly Hospital system, the exclusively breastfed babies lost almost twice as much as the supplemented/formula-fed babies. 10% of vaginally-delivered and 25% of cesarean-delivered EBF newborns lost excessive weight of >10% while NONE of the formula-fed newborns experienced this complication. In fact, exclusive breastfeeding at discharge is associated with an 11-fold higher risk of rehospitalization for dehydration and underfeeding.

Early Weight Loss Nomogram of Formula-Fed Newborns. Hospital Pediatrics May 2015, VOLUME 5 / ISSUE 5

Early Weight Loss Nomogram of Exclusively Breastfed Newborns.  Pediatrics January 2015, VOLUME 135 / ISSUE 1

Rehospitalization for Newborn Dehydration. Arch Pediatr Adolesc Med. 2002;156:155-161

4: FEAR: Supplementing will CAUSE low blood sugar and colostrum protects my baby from it.

FACT: In a study of newborns fed antenatally expressed colostrum along with direct latch feeding of colostrum when compared to those who did not receive expressed colostrum, the babies fed expressed colostrum in fact had higher rates of hypoglycemia requiring admission.  Lancet 2017, 389: 2204-2213

So NO, colostrum does not protect against hypoglycemia. In fact in the most recent study of EBF newborns, 10% had blood glucose levels low enough to increase risk of lower long-term academic achievement. An even older study on low blood sugar in EBF newborns, 53 out of 200 or 26.5% developed low blood sugar within the first 6 hours of life. What protects against hypoglycemia is providing a child their full caloric requirement, which is 100-120 Cal/kg/day to prevent them from running out of caloric reserve.

Study of Asymptomatic Hypoglycemia in Full Term Exclusively Breastfed Neonates in First 48 Hours of Life Journal of Clinical and Diagnostic Research. 2015 Sep, Vol-9(9): SC07-SC10
Association Between Transient Newborn Hypoglycemia and Fourth-Grade Achievement Test Proficiency: A Population-Based Study JAMA Pediatr. 2015;169(10):913-921.
Nutritional management of newborn infants: Practical Guidelines. World J Gastroenterol 2008 October 28; 14(40): 6133-6139      

5. FEAR: Introduction of cow’s milk will lead to cow milk protein allergy.

FACT: In a study of over 13,000 children, earlier introduction within the first 2 weeks of life of cow’s milk REDUCED their risk of cow milk protein allergy by 19-fold.

Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy.  J Allergy Clin Immunol. 2010 Jul;126(1):77-82.e1.

6. FEAR: Exclusive breastfeeding is the ideal way of feeding every baby and there are no risks associated it, only risks of NOT doing it.

FACT: The most significant risks to a newborn’s life and brain come from the fasting conditions imposed by exclusive breastfeeding before full milk production and these risks are hidden from mothers to gain compliance with exclusive breastfeeding.

A review of 116 cases of breastfeeding-associated hypernatremia in rural area of central Turkey. J Trop Pediatr. 2007 Oct;53(5):347-50. Epub 2007 May 12.

Hypernatremic Dehydration in Breastfed Term Infants: Retrospective Evaluation of 159 Cases. Breastfeed Med. 2017 Jan/Feb;12:5-11.

Long-Term Neurodevelopmental Outcome of Neonates with Hypernatremic Dehydration. Breastfeed Med. 2017 Apr;12:163-168

Of Goldilocks and Neonatal Hypernatremia. Academy of Breastfeeding Medicine Blog.

7. FEAR: Just one bottle will ruin my child’s future health.

FACT: Just one bottle can save a child’s life and save them from a lifetime of disability.

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

Letter to doctors and parents about the dangers of insufficient exclusive breastfeeding

#FactsnotFear #FedisBest #BFHIShowMeYourFacts


The Fed is Best Foundation is dedicated to the prevention of newborn and infant starvation from insufficient exclusive breastfeeding. We do so by studying breastfeeding stories sent by mothers and the scientific literature on breastfeeding complications that lead to infant brain injury and death. Since the beginning of our campaign almost two years ago, we have received tens of thousands of newborn and infant starvation stories leading to the complications of hyperbilirubinemia, dehydration, hypernatremia,  hypoglycemia and failure to thrive. These complications occur because the current breastfeeding guidelines have not been studied for safety, operates with little awareness of the caloric and fluid requirements of newborns nor the amount transferred to babies until complications have already occurred. “Just one bottle” can save a child from these tragedies as it is often a mother’s first clue that a child is in fact starving from exclusive breastfeeding.

If your baby is experiencing distress and signs and symptoms of starvation, we encourage you to advocate for your child. We encourage mothers to notify hospital administrators if you are being pressured to avoid supplementation to alleviate your child’s hunger. You have the right to feed your child and your child has the right to be fed. No one but your baby knows how close they are to empty. The only way they can communicate distress is by crying. Listen to your baby and listen to your instincts.

Our message is simple. Feed your baby. Feed them as much as they need to stay safe and satisfied. Only they know what they need.

#FedisBest
Click on the infographic below to print for your reference.

For more information on how to protect your baby from feeding complications due to early exclusive breastfeeding, please read and download the Fed is Best Feeding Plan, a way to communicate your feeding choices to your health care providers.

In addition, please read and download the Fed is Best Weighing Protocol to prevent newborn dehydration and failure to thrive.

Lastly, for more detailed information, please watch our educational videos on Preventing Feeding Complications.

Our full list of parent resources can be found on our Resource Page.

If you wish to help parents learn how to protect their newborns from accidental starvation, please share this story and sign our petition to demand that the CDC, the AAP, the U.S. Surgeon General and the WHO/UNICEF Baby-Friendly Hospital Initiative warn parents about the dangers of newborn and infant starvation from insufficient exclusive breastfeeding. Go to https://fedisbest.org/sign-our-petition/.

 

 

 

Why I’m Angry With My Baby Friendly Hospital in Texas

As mothers, we always want the best for our babies and we worry what we do is never enough. 6 years ago, I had my first child when emergency C-section delivered her.  She was 8 pounds 12 ounces and healthy.  I was immediately told by my OB-Gyn to supplement her since she was such a large baby for 37 weeks.   The hospital had LCs and we requested to see her several times but she was a no show. We figured out fast we were on our own with breastfeeding, however we did take our OB-Gyn’s advice and started supplementing right at the start to maintain her glucose levels.  She never perfected her latch, so I exclusively pumped and she got everything she needed and we both liked our routine.

6 years later, I delivered my son early for pregnancy complications at 36 weeks but he was much smaller weighing 6 pounds 11 ounces. This time breastfeeding protocols were very different.  Formula was considered evil and no one could supplement their babies and exclusive breastfeeding was the only way to breastfeed my baby. However, after day one things gradually started going downhill.  My son latched very well and it was determined he was nursing perfectly. He nursed every one to two hours and we even had the second night “cluster” feedings we were informed about.

Little did I know, he was starving and not cluster-feeding and I had no idea!   But as you can see in this photo- he. was. starving!

 

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Just One Bottle Would Have Prevented My Baby’s Permanent Brain Damage From Hypoglycemia

Written by Holly Lake

I wish I had known about the Fed Is Best Foundation before my 1st son was born. I felt enormous pressure to exclusively breastfeed at my hospital. My son was born at 37 weeks, weighing 5 pounds,13 ounces and he struggled to latch-on and breastfeed at each feeding. When I told the midwife, she came back with a leaflet which described how to hand express. She told me to express 1 mL of colostrum into a syringe and feed that to my baby whenever he struggled to latch.  I asked her if 1 mL was enough and she said it was because his tummy was very small and this amount would be fine until my milk came in. Note: 1 teaspoon equals 5 ml.

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I was discharged hours later not feeling confident my baby was getting enough colostrum.  A midwife came out to see me at home on day 3 because I said I was worried about his feeding. He became extremely yellow (jaundiced), not very responsive (lethargic) and would let out random high pitch screams and would sleep all of the time and never wanted to feed by this time.  He also would have random body spasms which doctors shrugged off as normal baby reflexes (later we found out different).  The midwife said I could wait and see how he did overnight or go to hospital.  I chose to take him to hospital. When arriving, we found that he had lost 12% of his body weight and his blood sugars levels dropped dangerously low to 0.2 mmol/L (4 mg/dL) and was he was jaundiced. Continue reading

Why Were My 35 Week Premature Twins Fed More on Their First Day of Life Than my Full Term Breastfed Baby

I have three beautiful children: one nearly three year old boy, and one set of boy/girl twins, who are just three weeks old. If I could go back and change my eldest son’s first feeding  experiences on this earth, I would. I would have been happier and my baby healthier if he had just been fed while attempting to exclusively breastfeed.

When I was pregnant with my eldest boy, I fully intended to breastfeed him. We were delivering in a Baby-Friendly Hospital. I had never heard the term “Baby-Friendly” before becoming pregnant, but when my husband and I attended the hospital tour, we were told that the Baby-Friendly label meant that the hospital had achieved what was considered the gold standard in breastfeeding support. We attended the available lactation, birth, and parenting courses at the hospital. Whenever I was asked if I was planning to breastfeed my son, I proudly said, yes, I would. I was 34 years old, and I had never really considered infant feeding practices before becoming pregnant. From the information presented, it was obvious that breastfeeding was optimal.

I was told that babies did not need very much food in the first days of life. I was told that I would always make enough to feed the baby. I believed that the information I was receiving in these courses was truly the gold standard.

My son was born naturally after an unmedicated labor. He was placed on my bare chest, latched and I was told that we were doing great. I would nurse him and then he started screaming after each nursing session. Later, I learned that newborns aren’t meant to continuously scream after attempting to feed. They are meant to be satisfied and then sleep. The crying and screaming means something is wrong. I did not realize that my colostrum might not be enough to keep him fully fed before my milk came in. If I was informed that different babies have different caloric requirements at birth, and that my colostrum might not be enough right away, I never would have consented to not feeding my newborn for any period of time.  Continue reading

My Daughter Starved Because of My Determination to Exclusively Breastfeed and Lack of Knowledge on How to Supplement

By Jamie Nguyen

As new parents, my husband and I relied on professionals: doctors, nurses, lactation consultants to guide us in providing the best care for our newborn. But what happens if most of these professional have bought into a dangerous lie? The lie that all moms, except in very rare cases, are able to produce enough milk for a newborn baby.

After a long unmedicated labor that lasted over 36 hours, my daughter Noemie was born on November 2nd 2016. She was perfectly healthy and weighed 7 lbs 3.5 ozs. My goal was to exclusively breastfeed and the staff at the Baby-Friendly hospital were very supportive. Noemie lost 4% of her weight in the first 24 hours and we were told that it wouldn’t be anything to worry about until it got to more than 7%. However, she had become very fussy and inconsolable, but as we were new parents we just assumed that this was normal baby behavior. Having taken a breastfeeding class, I simply trusted that my body would make enough milk for her. I had been told that not being able to make enough milk was very rare. I asked to see a lactation consultant as I had previously had breast surgery to remove a benign lump from my right breast. The lactation consultant told me that I should have no problem breastfeeding from just my left side. She reassured me that my milk would “come in” sometime over the weekend at day 4 – 5. We were told to get a weight check at the pediatrician’s office on day 4.

Born healthy at 7lbs 3.5 ozs.

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