An Evaluation Of The Real Benefits And Risks Of Exclusive Breastfeeding.

 

by Alexandria Fischer, PhD candidate at the Rensselaer Polytechnic Institute, studying synthetic microbial communities

It’s a mantra we have all heard, on repeat. “Breast is best.” But what does that really mean? Moms are bombarded by messages about the benefits of breastfeeding, such as increased intelligence, less illnesses, and a decreased risk of cancer. But what mothers are not told, is the quantifiable proof of these benefits.

The paper “Is the “breast is best” mantra an oversimplification?“, published in the Journal of Family Practice in July 2018, sought to critically evaluate claims of breastfeeding benefits in an effort to truly understand them. These authors note that the same data has produced a wide range of conclusions about the reported benefits of breastfeeding. They sought to tease apart what variables were truly impacted, and which were not. In this review the authors determined the number needed to treat (NNT) for a myriad of health issues that are often claimed to be reduced by breastfeeding. The NNT simply means how many babies need to be breastfed in order for one baby to benefit. We need to use caution when examining NNTs because they cannot make a causal determination, meaning they cannot be used to say “breastfeeding prevented this infection” they are simply used to determine a correlative relationship.

“The NNT (numbers needed to treat) simply means how many babies need to be breastfed in order for one baby to benefit.”

Since this article was a review of data already available, we know that confounding factors (factors that may influence outcomes outside of the desired variable) are often not accounted for. Knowing this, we can determine that the NNTs determined in this study may be an overestimation of the actual correlation between breastfeeding and health outcomes.

What are the Benefits of Breastfeeding?

Below I have summarized the NNTs found in this study:

  • 2 or 3 babies need to be breastfed to prevent 1 ear infection before two years of age. After 2, this effect disappears.
  • 6-7 babies need to be breastfed to prevent 1 upper respiratory infection
  • 25 babies need to be breastfed to prevent 1 lower respiratory infection
  • 4-30 babies need to be breastfed to prevent 1 gastrointestinal infection in infants younger than 12 months. (This range is large due to discrepancies in the incidence of GI disease, thought to have changed due to the introduction of the rotavirus vaccine).
  • 171 babies need to be breastfed to prevent 1 hospitalization from GI infection
  • 115 babies need to be breastfed to prevent 1 hospitalization from lower respiratory tract infection (this number is noted to have a high likelihood of overestimation due to confounding factors).
  • 25 babies need to be breastfed to prevent 1 case of Necrotizing enterocolitis in preterm infants
  • The SIDS studies were poorly performed in terms of considering confounding factors, but even with this overestimation the data suggest that 3500 babies need to be breastfed in order to prevent 1 case of SIDS.
  • 12,500 babies would need to be breastfed in order to prevent 1 case of childhood leukemia

In terms of allergic disease, the numbers come from data that is poorly controlled and suffers from publication bias. The authors note that these numbers may only apply if there is a family history of each disease. But, if we accept these conditions

        • 76 babies need to be breastfed to prevent 1 case of asthma
        • 36 for 1 case of eczema in the first 2 years
        • 54-70 for 1 case of allergic rhinitis

The authors found no evidence that breastfeeding protects against

        • food allergies
        • dental problems
        • hypertension
        • type 2 diabetes
        • high cholesterol
        • growth
        • and death

Authors noted a small, but clinically insignificant increase in IQ, for an unknown duration, indicating that breastfeeding does not make children smarter.

What do these numbers tell us? What should we draw from them? That the number of babies that need to be exclusively breastfed to benefit one baby is often quite high especially for the most significant claims made (SIDS and leukemia).  We can also note that many of these findings come from studies with poor controls (meaning confounding factors were not examined) and that a large number of claims of health benefits have no evidentiary basis.

What About the Harms?

This study also examined the numbers of babies harmed by exclusive breastfeeding. A summary of those findings are shown below. The number needed to harm or NNH, tells us how many babies need to be breastfed to harm one baby.

        • Late preterm babies (34-36 weeks) are also found to be twice as likely to be readmitted to the hospital from exclusive breastfeeding complications due to insufficient milk intake, as compared to their formula fed counterparts.

Even in term infants “exclusive breastfeeding at discharge from hospital is likely the single greatest risk factor for hospital readmission in newborns.” These readmissions are due to hyperbilirubinemia, dehydration, hypernatremia and hypoglycemia from inadequate breast milk intake.

        • For every 77 babies breastfed, 1 is readmitted to the hospital for hyperbilirubinemia, dehydration, hypernatremia, or weight loss.
        • For every 13 babies breastfed, 1 has a weight loss of greater than 10%. These numbers are striking because they illustrate what mothers are not told, that exclusive breastfeeding carries risks.

The authors then talk about where all of this data comes from. The studies are often severely limited, the vast majority of these limitations tend to overestimate the benefits of breastfeeding. Since breastfeeding rates are strongly patterned with socioeconomic status, race, and education levels, all of which are strongly tied with improved health outcomes both in the long and short term, we can conclude that any study that does not control for confounding factors such as these will overestimate any purported benefits. These studies are also observational only, thus causality cannot be determined and the studies can suffer from self-selection and recall bias, limiting the strength of the data they collect and the conclusions they draw from it.

“Exclusive breastfeeding at discharge from hospital is likely the single greatest risk factor for hospital readmission in newborns.”

Finally, the risks of breastfeeding are discussed. The authors note that there is not a lot in the way of data in terms of harms of breastfeeding advocacy, even though the results of these harms are seen in the small amount of data we do have. These risks include hospital readmission due to:

        • underfeeding and dehydration
        • Sudden Unexpected Postnatal Collapse (accidental suffocation) from unsafe sleep arrangements (i.e. co-sleeping during breastfeeding).
        • banning pacifier use given that pacifier use has been correlated with reduced SIDS rates with a NNT of 2733 babies using a pacifier before last sleep to prevent 1 SIDS incident, which makes it a more effective preventative measure than breastfeeding.
        • the emotional toll on some women caused by strain and anxiety related to breastfeeding as well as guilt if they are unable to breastfeed.

So, is breast best? This study seems to suggest it is far more nuanced than simply a “one or the other” choice. These authors call for a more rigorous examination of the risks of breastfeeding as well as shifting the conversation from overstated benefits of breastfeeding to a conversation about what is best for an individual mother/baby dyad depending on their own personal circumstances.


Alexandria Fischer is a PhD candidate at the Rensselaer Polytechnic Institute, studying synthetic microbial communities. She obtained her undergraduate degree at the Colorado School of Mines studying Chemical and Biological Engineering. Alexandria came to know the Fed is Best Foundation when struggling to breastfeed her daughter. There she learned that many of the benefits of breastfeeding are vastly overstated and became a part of the advisory team. As a scientist, she is passionate about communicating science to the general public in an approachable and accurate way. She uses her scientific training to evaluate current infant feeding research for strengths and weaknesses, helping to dispel misinformation commonly circulated in the discourse surrounding breastfeeding.


From  Fed is Best:

The good news is that the risks of exclusive breastfeeding discussed above can easily be eliminated with timely supplementation if breastfeeding is insufficient, safe positioning while breastfeeding and doing skin-to-skin, and having nurseries for mothers when they are not able to safely care for their babies .

Additional information about the risks, read the article, “Baby-Friendly Hospitals Can, Paradoxically, Be Unsafe for Newborns.”


HOW YOU CAN SUPPORT THE FED IS BEST FOUNDATION

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 everything 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.  Thank you for your advocacy!

Donate to Fed is Best

Sign Our Petition!

 

 

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“Just Trust Your Body And There Will Be Enough Breast Milk”— I Was Devastated When I Learned She Was Starving

Corrine

I’ve been trying to write this for two months but my mama bear anger has been difficult to process. I’m done with obsessing now, and I hope telling my story will help me and any other mother who may be  feeling the same way. I want to move on from the anger so I can be the happiest and the best mother for my baby.

I researched extensively about birthing and breastfeeding while I was pregnant. I was extremely determined to breastfeed and I learned doing so meant I was a great mother and considering the information regarding the amazing benefits which went largely unchallenged, I just couldn’t understand why any woman wouldn’t want to do this. At no point did I ever read any literature or even speak to anyone who highlighted the difficulties of breastfeeding or that some women were biologically unable to breastfeed. At no point did it ever feel like it was a choice. There was no choice – good mothers breastfeed, they gave their babies the very best- the “gold standard” they called it.  My mindset had also taken on a deep suspicion of formula as an unnatural ‘chemical substance’ and basically a second-best feeding alternative and who wants to give their baby second best. Not only this but I had been repeatedly advised by mothers in support groups not to supplement as this reduced your supply and interfered with the breastfeeding relationship which would ultimately rob your baby of the “best”. There was absolutely no choice.

At no point did I ever read any literature or even speak to anyone who highlighted the difficulties of breastfeeding or that some women were biologically unable to breastfeed. At no point did it ever feel like it was a choice.

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The Breastfeeding Support I Received Almost Killed Me And My Daughter; I’m Still Suffering From Breastfeeding Trauma

This is hard for me to write. My breastfeeding experience is a trauma that I don’t like to relive, but is undoubtedly the biggest cause of my postnatal depression and anxiety (PNDA). But perhaps I can save someone else unnecessary pain and heartache. I know some will disagree, but hopefully my story can be a tiny cog in the wheel of feeding guideline reform.

Going into pregnancy, I knew Fed is Best. I decided I would attempt breastfeeding but if it didn’t work out, there’s always formula. Simple. Now, I’m a scientifically minded person. I respect those in the field and the scientific consensus. As I progressed through my antenatal appointments, it became clear. The general consensus is, breast is best, at all costs, with an inference that ‘formula is dangerous’. By the time my daughter was born, I had made up my mind. If other people formula fed, I wouldn’t judge, but I was going to breastfeed no matter what. I’d get all the help I needed. Continue reading

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My Baby Was Put in a Dangerous Situation By Rooming-In with an Exhausted Mom

By US New and World Report Columnist, Stacy Cervenka with Commentary by Christie del Castillo-Hegyi, MD

Several weeks ago, as I was perusing Facebook, I came across an article on the Fed Is Best Foundation’s page that felt like a punch in the stomach. According to new medical research, the number of incidents where exhausted new mothers drop their babies and the incidence of newborn head injuries had gone up substantially in hospitals that no longer offer newborn nurseries, but instead require mothers to “room-in” with their babies. It further angered me to read that most of these head injuries took place while a mother was breastfeeding.

I was so upset by this article that I couldn’t sleep that night, because all I could think was, “That could have been Leo. Why, why, why was I ever put in such a dangerous and inhumane situation that this could have happened?”

For many reasons, I have only shared this story with close friends and family, but here goes:

My pregnancy with our first child, Leo, was very difficult due to hyperemesis graviderum (HG). I had to take a medical leave of absence from my job and was confined to bed most days. I made several trips a week to urgent care to get IVs, as I couldn’t even hold down water. I lost a lot of weight and was very weak and exhausted. When my water finally broke, I hadn’t slept comfortably in probably six months. I had gotten almost no sleep the night before, as I was crouched in my shower vomiting and dry heaving (as usual). The labor and delivery itself was uneventful, but it was another 28 hours with no sleep or real rest. Our son Leo was born six weeks premature and had some minor issues regulating his body temperature and with his bilirubin.

After Leo was born, per the policy at UC Davis Medical Center, he was expected to “room-in” with us. When I was pregnant, this sounded lovely. Who wouldn’t want all the bonding time possible with their precious new baby? However, the night after Leo’s birth, I was exhausted, weak, and in so much pain, I could barely function. To add to this challenge, my husband and I both happen to be blind. There are thousands of blind parents across the United States who successfully care for their children each day, but being blind does often require us to concentrate more fully on what we’re doing. Doing things nonvisually, especially when you’re doing them for the first time, can require a little more physical and cognitive energy. However, I was just so physically exhausted and emotionally fried. All night long, the nurses kept getting me up to nurse and pump. I was so clumsy with exhaustion. I kept waiting for the point where they were going to insist that I get some sleep and recuperate, but that never came. It became clear to me that the only help the nurses were going to give us was to make sure that I was breastfeeding. When I wasn’t breastfeeding, the lactation consultants wanted the baby to sleep with me, so we could get lots of skin-to-skin. This only ensured that I continued to get no sleep, because I just couldn’t get physically comfortable sleeping with the baby in the hospital bed and I was anxious about crushing him or pushing him off the bed somehow. (This concern may have been unfounded, but the fact was, I wasn’t physically comfortable sleeping with him; my husband and I had never wanted to co-sleep; and I just wanted to get some real rest.)

Because my son was born slightly premature, we spent 4 nights in the hospital with him. About 48 hours after his birth, my husband ran home to get some more clothes for us. I was alone in our room with the baby. While I was breastfeeding him, I fell asleep. A doctor woke me up some time later. The door to my room was wide open. I was sitting up in bed, with my hospital gown completely unbuttoned and my breasts just hanging out with Leo asleep across my lap. I was so freaked out. It was only good luck that he hadn’t fallen off the bed head first. I had fallen asleep sometime in the seconds between unbuttoning my hospital gown and putting Leo to my breast.

I was so upset that I finally broke down crying in front of the doctor. “I’m so tired. This is so hard,” was all I could say.

The doctor, who was a young intern or resident, had the following compassionate response: “What did you expect? Being a parent is hard,” he said.

Even at that time, before I had had time to fully process his comment, I thought, “Wow; thank you for that kind, professional and empathetic response. Is that what they taught you to say at medical school? Here I am in obvious psychological distress and that’s the help you give me?”

As the days wore on, it became abundantly clear that most of the staff didn’t care how I was doing physically or psychologically, as long as our breastfeeding was progressing nicely. My husband was as exhausted as I was and Leo had arrived 6 weeks early, so my mother had not been able to fly from Florida to California right after the birth as planned. You would have to know me to know how completely out of character this was for me to do, but as I was on the phone talking to my mom, I started crying and begging her to fly out to Sacramento right away. “I need somebody here who cares about ME!”

One complicating factor was that my husband and I did not want the hospital staff to be concerned about the fact that we were blind. Although California has laws protecting the rights of parents with disabilities, hospital staff often have negative misconceptions about parents who are blind. Just as with younger parents, single parents, and parents of color, hospital staff are more likely to make blind parents meet with social workers or meet with child welfare staff. My husband and I are both highly educated professionals with no histories of drug use or crime, so we were not concerned that they could take our baby away from us, but they definitely could have complicated our lives for weeks with social worker visits. One of the doctors had already expressed concern about how Greg and I would take care of the baby. So, we felt a lot of pressure to be totally on top of things and to not seem like we were struggling.

I left that hospital exhausted, in terrible pain, overwhelmed, and with significant postpartum depression. I ended up breast feeding Leo almost exclusively for the first month, supplementing with formula until he was three months old, and then just switching to formula, which made everything so much easier and less exhausting. I was finally able to get a real night’s sleep, for the first time in over a year, without having to get up and either nurse or pump. The worst of my postpartum depression lifted like a cloud.

We chose to deliver our second child, Josephine, at a different hospital, Mercy General Hospital in Sacramento. The experience was completely different. The hospital does have babies room in with their mothers, but there was no pressure to breast feed. We told them that we had decided to use formula and they respected that. My husband did all of the diaper changing and even the bottle feedings for the first several days while I just slept and recuperated. I held the baby, snuggled the baby, and loved on her, but no one made me feel like I should be doing more than that. The hospital didn’t allow co-sleeping, so there was no pressure to be either nursing or co-sleeping 24 hours a day. It was just such a better experience and I came out of the hospital with no post-partum depression at all. I was proud of myself for  standing up for what I wanted and making sure my own needs were met, so that, when I did begin caring for the baby, I was well-rested and ready. I was surprised that it was indeed possible to having a positive, even delightful, labor, delivery, and post-partum experience. Who knew it could be like this?

In the time since my son was born, I have learned that my experience and my feelings are common. Many new mothers who were exhausted, in pain, and overwhelmed wish that their hospital had offered a nursery, so that they could be well-rested physically and mentally when they were sent home and fully able to care for their new babies. I am even aware of a hospital in suburban Chicago that reversed its decision to do away with the newborn nursery in favor of babies rooming in with the mothers; the feedback from the women in the community and the women on the hospital’s advisory boards was so negative that the hospital brought the nursery back.

I am so glad that I have found the Fed Is Best Foundation and that they are doing work to bring attention to the negative repercussions of mandating that babies room in with their mothers and that mothers be solely responsible for their newborns’ care in the hours and days after their babies are born.

I am an active, engaged mother. Like most moms, I make sacrifices for my kids on a daily basis to give them every opportunity I can. But I need to be the one to determine which sacrifices are worth the costs to me and my family. In our case, it is worth the sacrifice to stand out at the bus stop in the snow to get my kids to swimming, gymnastics, ice-skating, and cooking classes. It is worth the sacrifice to me to sometimes pass up career opportunities that would mean less time with my children. But sacrificing my physical and mental well-being in the first 48 hours after giving birth for something of questionable or minimal benefit to my baby is not worth it to me.

According to a 2016 Cochrane Review looking at the effects of rooming-in on breastfeeding, the Cochrane reviewers found that there was no difference found between the two groups in the proportion of infants receiving any breastfeeding at six months of age (risk ratio (RR) 0.84, 95% confidence interval (CI) 0.51 to 1.39; one trial; 137 women; low-quality evidence). The rate of exclusive breastfeeding on day four postpartum before discharge from hospital was significantly higher in the rooming-in group 86% (99 of 115) compared with separate care group, 45% (17 of 38), (RR 1.92; 95% CI 1.34 to 2.76; one trial, 153 women; low-quality evidence), which likely reflects higher motivation among the mothers to comply with the Ten Steps guidelines. However, the authors concluded,  “We found little evidence to support or refute the practice of rooming-in versus mother-infant separation. Further well-designed RCTs to investigate full mother-infant rooming-in versus partial rooming-in or separate care including all important outcomes are needed.”

It is absolutely fine if mothers prefer to room in with their babies. Hospitals should have supports in place to help them do so. But there also needs to be newborn nurseries, so that the many mothers who need to recuperate from pregnancy, labor, and delivery can do so in a safe and respectful manner.

In order to combat the rise in infant falls, head injuries, and postpartum depression, women need to feel comfortable asking for what they need while they are recuperating from pregnancy, labor, and delivery. They need to be listened to, cared for, and respected. The lives and health of both mothers and babies depends on it.


Stacy Cervenka is journalist for the U.S. New and World Report. She has worked in the field of public policy since 2006. She has served as a legislative assistant to former U.S. Senator Sam Brownback, a government program analyst at the California Department of Rehabilitation, and as the executive officer for the California State Rehabilitation Council. She has worked primarily on issues surrounding disability employment policy, disability rights, adoption and foster care, juvenile justice, child protection, labor and transportation. Stacy is currently a full-time mom, while working part-time from home as the grant administrator for the Nebraska Commission for the Blind. She also serves as the Chair of the National Federation of the Blind’s Blind Parents Group and sits on her local public transportation agency’s advisory board. She is currently developing an online travel and tourism forum specifically for people who are blind called the Blind Travelers Network. She lives in Lincoln, Nebraska with her husband Greg and children Leo and Josephine.

 

 

 


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!

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I Hid The Bottle That Saved My Baby’s Life From Hypoglycemia

By Cassandra M., Fed is BEst Mom and Advocate

When I was pregnant, I was 100 percent sure I wanted to breastfeed my baby. I read countless books and attended a prenatal lactation class to help me prepare for breastfeeding. I learned a lot of things, including that the size of a newborn stomach is no greater than an olive (so untrue), and that colostrum is all they need eat during their first days.

“Just trust your body.”

Breastfeeding was described as a natural process and all mothers will make enough milk for their baby.

My baby was born by cesarean after 15 hours of an induction for a vaginal delivery. When my baby was born he was much larger than we thought and he weighed 9 pounds 8 ounces! I breastfed him all of the time because the nurses told me he needed extra colostrum from being so large to prevent hypoglycemia.

Carolina11

He loved breastfeeding and would want to nurse all of the time. But then he began to scream frantically if he wasn’t breastfeeding and wouldn’t stop.  The nurses checked his glucose level and he had hypoglycemia. They gave me a bottle of formula to feed him right away because hypoglycemia can cause brain damage if not treated immediately. The nurses did an excellent job keeping my baby safe, but I was in shock and confused about why my body wasn’t making enough milk.

Even though I fed him that first bottle, I refused to give him an additional one. It gives me chills every time I remember how I was so brainwashed to ‘trust my body’ and I was allowing  my to baby starve. Finally, I accepted I would need to feed him a bit of formula after each breastfeeding session. My husband confessed to me he had a plan to feed him while I was sleeping.

Carolina33

Someone took this picture while I wasn’t looking, because I was trying to hide the bottle (the bottle that was saving my baby’s life) from all pictures.

 

5 days passed until my milk came in,  however, I had to supplement him on and off for two weeks after birth because he demanded so much milk.  Why was I not able to exclusively breastfeed my baby from the very beginning? What was wrong with my body? I began to search for answers.

Mothers are taught that it is rare to have insufficient breast milk. But research shows delayed milk production affects at least 1 in 5 women in the first days of an infant’s life, which puts her child at risk of dehydration and underfeeding from exclusive breastfeeding. These complications can result in jaundice, low blood sugar, dehydration and hypernatremia, all threats to the newborn brain. Learn your risks for delayed onset of breast milk supply. Almost all feeding complications can be prevented with close monitoring for signs of hunger and insufficient feeding and supplementation when breast milk is not enough until breast milk supply is sufficient.

Then I discovered the Fed is Best Foundation. I learned science based education, and I got really angry at all of the wrong information I had been given. I am a proud member of their support group and they help countless mothers safely breastfeed.

Since then, I try to inform mothers about the real truth of delayed onset of milk supply, so no other baby has to go through what my baby and thousands of babies are going through. I personally inform mothers every chance I can, and I have written several letters to hospitals. I warn my friends and use social media to report bad practices. No mothers wants to harm their baby as a result of being given false information.

My  story ends with a perfectly healthy baby boy, who is now 18 months old. He was exclusively breastfed until he was 6 months old and breastfed until he was 16 months old. You can still successfully breastfeed even though you might have to supplement at the beginning but I was always told you couldn’t.

Please, please, stop just trusting your body and trust your BABY and accurate science-based information instead. Your baby is counting on you to take the best care of them.

Carolina22


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!

 

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Feed Your Baby—When Supplementing Saves Breastfeeding and Lives

Jody Segrave-Daly, RN, MS, IBCLC

Mothers are taught that it’s rare to not produce enough milk to exclusively breastfeed in nearly every breastfeeding book, mommy group and hospital breastfeeding class. The truth is, we have limited studies that provide an accurate percentage of the number of mothers who can produce enough milk for their baby for the recommended 6 months. Although actual rates of failed milk production are unknown, there are estimates that range from 5-15 percent or more. 

  • Dr. Marianne Neifert, Clinical Professor of Pediatrics at the University of Colorado Denver School of Medicine, who co-authored a 1990 study of 319 breastfeeding women found 15 percent of the women were unable to produce sufficient milk by three weeks after delivery.
  • Data from the Infant Feeding Practices Study (IFPS) II, a study of U.S. women, showed that one in eight women experienced early, undesired weaning from disrupted lactation due to physiologic reasons. According to the study, pain, difficulty with latch and insufficient breast milk supply were the most common reasons for early weaning.
  • Dr. Shannon Kelleher talks about these staggering numbers in her publication,  “Biological underpinnings of breastfeeding challenges: the role of genetics, diet, and environment on lactation physiology,” where she says the prevalence of lactation insufficiency may be much higher, as 40–50% of women in the US and 60–90% of women internationally cite “not producing enough milk” or that their baby was “not satisfied with breast milk” as the primary reasons for weaning prior to 6 months.

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How I Learned That Fed is Best

by Jen Gamarano

I hate to admit it, but before I got pregnant, and even when I was pregnant, I was already a judgmental mom. I started watching documentaries about natural birth and breastfeeding years before I even entertained the idea of having children because it fascinated me. Women’s bodies are amazing. We are capable of growing, birthing, and feeding a brand new life and I was on board for doing all of it naturally because biology is perfect and I was made to do this – or so I thought. I looked at moms who opted for epidurals and thought “If only they knew about natural birth and how amazing it is”, or those who formula fed and thought  “How sad” because breast milk is magical and formula will never be able to measure up. I hate to admit these things, but I have to admit them so you know just how much this journey has changed me.

Our birth plan was simple – deliver at the birth center with our doula and midwife, stay there for four hours, go home, breastfeed forever, be happy. I’m lucky to have had a fairly short labor of nine hours, but afterwards was nothing like I’d imagined. I ended up transferring to the hospital to repair a third degree tear. Lovely, I know.

We started to breastfeed at the hospital, and it hurt like they all said it would. L. had trouble latching but he was still nursing so I just tried to be patient. I had a rough first few days as my body tried to balance out hormones. I was shaky, hot, sweaty, mad, sad, and all-around miserable. I called the midwife who told me this was normal and advised me to stay in bed and “breastfeed, breastfeed, breastfeed”. So I did. The next day, my son started crying like crazy when I tried to latch him, and refused to nurse for a full 24 hours. The pediatrician told us to supplement with formula and I gave in because I felt sick, tired, and good lord, I wasn’t going to starve my child.

“The next day, my son started crying like crazy when I tried to latch him, and refused to nurse for a full 24 hours.The pediatrician told us to supplement with formula and I gave in because I felt sick, tired, and good lord, I wasn’t going to starve my child.”

When he finally started to latch again, it was clear that I didn’t have enough for him. He would get sleepy after only a few minutes of nursing, sleep for a few minutes, and then wake up crying and wanted to eat again. I spent a couple days feeding him every 15 minutes and didn’t wear a shirt or see anyone during that time. I met with a lactation consultant who listed a whole slew of things that could potentially be wrong with him. I also learned that I had an infection on my nipple and he developed thrush, which made all of this infinitely more complicated and painful. I was still determined to breastfeed, so we saw two lactation specialists, an ENT and Osteopath to evaluate the little guy, and I tried every natural remedy in the book. I took supplements and tinctures, drank dark beer, pumped multiple times in an hour, saw another lactation specialist, ate almonds, stayed hydrated, pumped, nursed, pumped, nursed, until I just couldn’t do it anymore. I got to the point where I just said without emotion “tried it” whenever someone gave me advice to increase my supply. I was exhausted. I woke up to pump every morning and sobbed because I would only get dribbles and my baby just wasn’t getting that ever so magical breast milk despite all my best efforts.

I’ve heard so many different opinions about my son and I on our journey that I don’t think I can definitively say what the root cause of all of this was. The opinion that made me feel the most at ease was from our ENT who flat out said that not every baby is a fit for every breast. Until then, I’d been conditioned to think that since I was a woman, breast feeding would be the most natural thing I’ve ever done. I forgot in all of this that all humans are different and that’s part of the beauty of life. I had to stop blaming my baby, and I had to stop blaming myself for “failing” at this. I had to give up the notion that this was, in fact, a failure, because it wasn’t.

This journey made me bake myself an entire humble pie and eat every last crumb. I started to look at breastfeeding and motherhood from a much different perspective. I came to terms with the fact that feeding my baby formula and the tiny bit of breast milk I did have was infinitely better than having a baby that couldn’t thrive and a sobbing mommy. I became grateful that I live in a time where formula exists to provide nourishment to my child.

“I became grateful that I live in a time where formula exists to provide nourishment to my child.”

Every mom out there is incredible. I’m proud of moms who breastfeed exclusively. I’m proud of moms who use formula. I’m proud of moms who do both. I’m proud of moms who have natural birth. I’m proud of moms who use modern medicine to take away the horrible pain. I’m proud of every mom who chooses to do the best thing for her baby and herself. The sisterhood of motherhood is incredible and I’m grateful to be a part of it and share my story.


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!

 

 

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I Was Able To Breastfeed My Third Baby Thanks To The Fed Is Best Foundation

During my pregnancy, I began reading the Fed Is Best Foundation’s feeding educational resources and feeding plan pertaining to breastfeeding and combo feeding. I didn’t have  successful breastfeeding experiences with my previous children and wanted to try one more time. I went into labor when I was 37 weeks pregnant. My labor progressed extremely quickly. By the time we got to the hospital almost an hour later, it was already too late to set up an epidural. I struggled for hours with laboring and pushing, and both my daughter and I were profoundly exhausted after delivery.

Before I gave birth, I had studied the HUNGRY educational resource flyer for exclusive breastfeeding. My goal was to prevent inadequate weight gain with this baby. After my daughter was born, she was not interested in nursing, and I was worried because she was tiny. Thanks to Fed is Best feeding plan, I felt confident in letting my husband do the first feed with a bottle. I wanted her father to feed her so she could get some strength to nurse later and so I could rest. I loved watching him feed her as I recovered. About two hours later, I tried to breastfeed her again and she had the energy to stay latched and nursed. I was so happy she was breastfeeding! Continue reading

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

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

We at the Fed Is Best Foundation give mothers across the globe a platform to tell their stories about how their babies suffered needlessly because they were denied information and supplementation for their hungry babies while under the care of the Baby-Friendly Hospital Initiative/WHO Ten Steps to Successful Breastfeeding protocol. Our Foundation has grown rapidly and demands significantly more time than we currently have because we are a 100% volunteer organization.  We are inundated with messages from mothers, health professionals and media on a daily basis. We try very hard to prioritize what we can do collectively, every single day. Our first priority is to respond to mothers in crisis who contact us needing assistance on how to safely feed their distressed breastfed baby because they were not educated on appropriate supplementation. Baby Friendly USA (BFUSA) found time to critique our interpretation of studies and written materials, so we were forced to take time away from mothers to update written materials and clarify our interpretations. Our goal is to be completely transparent and we have provided our detailed response below with corrections and clarifications given publicly available published data. If there have been errors in interpretation of published information, then we go back to the original published data to provide better data for the public, which we have done below. We believe we have a responsibility to inform parents, the public, medical insurance companies and BFHI hospitals about the risks of exclusive breastfeeding when insufficient. We believe parents deserve to know that the BFHI has an exclusive breastfeeding (EBF) threshold mandate to meet if the hospital wants to remain credentialed. The mandate results in tens of thousands of newborn admissions every year in the U.S. alone, which we chronicle on our page. For the safety of infants across the globe, we will continue to provide education on how to recognize serious complications of exclusive breastfeeding and how every parent can prevent them.

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. This well-established phenomenon has been discussed by neonatologist Dr. Lawrence Gartner, who is listed as a Director on the Baby-Friendly USA website, in a lecture given to lactation consultants (not just physicians and nurses as stated by BFUSA) at a 2013 California Breastfeeding Conference, previously posted on their website. This public lecture was provided to educate lactation consultants regarding dangerous levels of jaundice that can occur in previously healthy breastfed babies that result from inadequate intake of calories from exclusive breastfeeding. Under Fair Use laws, dissemination of educational material for non-profit educational purposes is protected and we were subsequently asked to post the full lecture by Dr. Gartner via email. 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 levels of hyperbilirubinemia that result in impaired brain development. While BFUSA has not previously denied the increased risk of hyperbilirubinemia in breastfed newborns, they have not routinely disclosed them to parents or subscribing hospitals, which has the unfortunate effect of causing hospitalizations that would have been prevented by supplementing a crying underfed newborn. Unfortunately, many parents and health professionals are taught that the signs of poor feeding including crying and hours of unsatisfied nursing are normal, widely known as the “Second Night Syndrome.” These unfortunately are also the earliest signs of other complications like acute bilirubin encephalopathy, kernicterus, hypernatremic dehydration and hypoglycemia, all known causes of brain injury and permanent disability, which can occur if those signs are overlooked as normal and supplementation is avoided in order to meet the goal of exclusive breastfeeding.

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Jillian Johnson: My Message To Parents During World Breastfeeding Week-Just One Bottle

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 Landon’s story—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. Continue reading

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