Category: Baby Friendly USA

Breastfeeding pressure is real, and research suggests it’s linked to mental health conditions in mothers

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Families are under enormous pressure to exclusively breastfeed from major health organizations such as the WHO, Baby-Friendly USA, CDC, AAP, ACOG, WIC offices, and the majority of US  hospitals.  

The “Breast is Best” public health campaign has permeated US culture and influenced hospital policies; even though US families face impossible barriers to breastfeeding exclusively, the pressure remains, and it is up to families to meet the unattainable guidelines for the majority of families.

By the way, there is no evidence that Baby-Friendly policies are effective for increasing long-term breastfeeding rates.

It has been shown in ample research that exclusively breastfeeding can cause serious complications for infants experiencing insufficient milk intake, a concern we discuss daily. The same pressure to exclusively breastfeed has now been linked to mental health complications, according to a recent research paper published in Research Psychiatry.

Breastfeeding pressure even has a pseudonym, “BRESSURE,” but it’s not funny. 

 

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The Illusion of Choice: Baby Friendly USA Says Newborns “Should” Room In With Their Mothers

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by Jody Segrave-Daly, Veteran NICU/Nursery nurse, IBCLC retired and Cofounder of the Fed Is Best Foundation 

The standard of care for most hospitals, especially those who are Baby-Friendly certified, is that mothers stay with their baby after birth in their room, 24 hours a day, which is known as rooming-in.

Baby Friendly’s recent blog says that mothers have choices about nursery care in their Baby-Friendly certified hospitals; but then they say babies SHOULD stay in the room, no matter how they are being fed. This statement gives parents mixed messages and implies they don’t really have a choice at all. In many hospitals, it is not just implied; nurseries have been eliminated outright. 

“Regardless of whether a mother is breastfeeding or formula feeding, they should room-in with their newborn.” 

 – Lori Feldman-Winter, MD, MPH 

According to the World Health Organization, rooming in began as a way to promote early breastfeeding and to encourage bonding. Step 7 of the Ten Steps to Successful Breastfeeding calls for hospitals to “enable mothers and their infants to remain together and to practice rooming-in 24 hours a day.” 

Despite the WHO’s 2017 expert panel’s finding that 24/7 rooming-in was ineffective at promoting sustained breastfeeding after discharge (but recommended it any way) and published tragedies of harmed infants while rooming-in, The World Health Organization and UNICEF continue to include rooming in for healthy newborns in the Ten Steps to Successful Breastfeeding policy.

Since adopting the rooming-in policy, inexcusable consequences such newborn falls from parent beds and near deaths and deaths from accidental suffocation while breastfeeding or doing skin-to-skin care (known as Sudden Unexpected Postnatal Collapse or SUPC) have skyrocketed, highlighting the urgent need for families to have access to nursery care. 

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How Do Misogyny and Feminism Impact the Breast is Best Narrative?

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Is Modern Day Breastfeeding Advocacy really feminist?

Breastfeeding advocacy is often characterized as feminist, and many people in the current breastfeeding advocacy community would describe themselves as feminists. Feminism, after all, is not just about demanding equality to men; it is about valuing women—our brains, bodies, and work—as much as we do men’s.[1] Breastfeeding and the provision of human milk is work, and many feminists—rightfully—expect that work to be valued.[2]

Modern breastfeeding advocacy started in the 1950s; La Leche League International (LLLI) began as a grassroots organization of women who wanted to breastfeed their babies and assist other interested mothers in doing so. Founders Marian Tompson and Mary White had experienced breastfeeding problems with their first children, leading to unwanted weaning; after successfully breastfeeding subsequent children and learning that many other mothers had been in the same position (bottle-feeding formula out of necessity rather than choice), they organized a group dedicated to helping others who wanted to breastfeed successfully. 

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The Ten Steps to Ethical, Successful, And Inclusive Infant Feeding

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In most hospitals and prenatal educational materials, exclusive breastfeeding (EBF) is the recommendation for infant feeding. EBF is promoted as the only healthy way to feed a baby, with partial breastfeeding, temporary supplementation, and formula feeding falsely characterized as “suboptimal.” Other infant feeding options, such as exclusive pumping or formula supplementation, are discouraged, even when requested by parents. But does this narrow definition of healthy infant feeding support patient rights and ethical infant feeding principles? No, it does not. 

 Infant feeding support in postpartum units should consider ethical principles of autonomy, beneficence, justice, and non-maleficence when considering the extent to which lactation should be promoted. 

What Are The Principles of Ethical Infant Feeding?

Autonomy: The parents choose how they intend to feed their baby at each feeding, and maternal bodily autonomy is affirmed and respected.

Beneficence: The benefits of infant feeding types are provided to the parent to help them make an informed decision. Healthcare providers must not decide what is best for the parent.

Justice: Do not assume a feeding method. Ask the parent how they want to feed their baby. Affirmative consent must be obtained before touching a patient’s body. 

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Is Formula More Dangerous than Irreversible Brain Damage?

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Is that some kind of sick joke? Infant formula is safe nutrition—scientifically created to replace human milk and thus consists of fluids and nutrients necessary to nourish a baby. Brain damage is irreversible.  That should be glaringly obvious, but it looks like the AAP Breastfeeding Section responsible for the recently released “Breastfeeding and the Use of Human Milk” (June 2022) has lost sight of this critical fact.

Let’s focus on this appalling statement:

“The need for phototherapy in an otherwise healthy infant without signs of dehydration and/or insufficient intake is not an indication for supplementation with formula unless the levels are approaching exchange transfusion levels.”

Hyperbilirubinemia (excessive jaundice) and Phototherapy

To explain why we are horrified, let’s look carefully at what the statement means. Jaundice is a common and usually benign condition experienced by about 60% of healthy newborns. It is caused by a substance called bilirubin, a breakdown product of fetal red blood cells after birth to transition to mature red blood cells. However, if a baby’s bilirubin levels are greater than a certain level and continue to climb, the risk for brain damage increases.

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