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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Advocating For Lactation Consultant Services When You’re A Fearless Formula Feeding Mom

By: Michelle Klimczak, Registered Nurse, Population and Public Health, with a focus on health equity.

We frame infant feeding success as exclusive breastfeeding, so maybe it’s surprising that I got support with formula feeding through local lactation consultants? In fact, I think the support they offered was exactly the kind of compassion, kindness, and respect that new moms deserve. It’s possible to be inclusive.

MicheleSignBlog

When our fourth baby arrived we knew our family was complete, and so I’ve savored every milestone even when it feels a bit bittersweet. He just passed 18 months so a lot of the baby stuff that all 4 of my kids used is now packed up. It’s amazing to think of how I agonized over decisions about strollers and car seats and now those things are just “stuff”. It’s amazing too to think of what was meaningful, like what was actually good advice, what was actually helpful, what was actually supportive. These conversations about support are undoubtedly well-intentioned, but I learned time and time again that there are all kinds of ways to find support for a specific version of mothering, but not much widely available when you don’t match up to that version.

That “version” is largely reflective of the kind of mothering that happens when you have the privileges of wealth, and education, and an able-body, food and water security, and the social status that comes with a hetero-normative/traditional family structure. When you have those privileges, your baby has a pretty good chance of having good outcomes, and so by and large, we try to carry out the practices associated with that version of mothering.

So what happens if you can’t “do the thing”? Well, given that I hold all the privileges I talked about above, it’s quite likely that I never would have had a clue, and could have ascribed my own kids’ greatness to my practices rather than my privileges. But, life has had a way of teaching me big, humbling lessons and as it turns out, it wasn’t that I needed support to do the “right” thing but I did need support (and lots of it) to figure out how to do things differently. All four of my kids were by-and-large formula fed. I desperately wanted to breastfeed because that’s “the thing” but it just wasn’t in the cards. No amount of support would have changed something I couldn’t physically do. The support I needed (and was so lucky to find) helped me figure out the practicalities of feeding and feeling successful.

MicheleSNSblog

Tube feeding my baby formula was the best I could do.

It’s tricky though because I think there’s a general impression that feeding supports should exist to minimize formula use, not support it.

When it was announced that their lactation services would be cut, I was devastated because their clinic was one of the few organizational places where I felt supported and welcome. It was a no-brainer for me to get involved in supporting the rally to advocate for a reversal of the cuts to lactation services because I knew personally and deeply how important it is to have top quality, evidence-based supports for infant feeding.  So, not surprisingly, there were parts of the rally that were hard: the usual “breast is best” messages, speakers making exaggerated claims, and virtually no acknowledgement of how marginalized groups, especially Indigenous communities have been left out of these conversations altogether. Having said that, I painted signs and shirts and hauled stuff and organized my kids to be there because support IS important.

MicheleKhusband

My husband at the rally, made the front page of our paper and I was so proud of him.

Support is important when it centres what is compassionate, and kind, and respectful and acknowledges that women are already the experts in knowing what will be best for their families. Support should be the scaffolding that helps women accomplish their goals, not an excuse to tell us our goals are wrong. Do we need supports that help level the playing field? Undoubtedly, as so many women don’t find themselves in circumstances where a full range of infant feeding options are available.

However, telling women that they should make a specific choice to accomplish the best outcomes places the burden of public health goals on the individual rather than rightly upholding these outcomes as societal responsibility.

 

Overall, we don’t do a very good job of providing comprehensive, inclusive supports to new moms so if you have a chance to stand up for that, I hope you’ll take that chance, and I hope you’ll think of how to cast the widest net possible. I absolutely support your infant feeding practices. I hope you’d do the same for me.

MicheleKSafeFeeding

My first baby suffered an 18 percent weight loss because I do not produce milk. I learned through the devastation of accidental starvation how to support inclusive infant feeding practices.

 

 

 


Michelle Klimczak is a Registered Nurse in Winnipeg, Canada. Michelle began her career in Labor and Delivery in 2008 and has since focused on Population and Public Health, with a focus on health equity. Michelle is a mom to 4 boys, none of whom you could ever guess feeding method in their first years.

‘Welcoming a new baby into the world can be a time fraught with uncertainty for so many families. One thing is sure, families come into this period already experts in what will work best in their circumstances. It’s such a privilege to be part of the Fed Is Best Foundation, centering and supporting the infant feeding choices of families worldwide.”


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

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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My Lactation Consultant Slapped My Nipple And Called My Nipple Shield A Cheater

I’d heard pretty much since starting puberty that breast is best. It’s in movies, books, social media, health class, and even in my own family. So, you can imagine my surprise to be sitting across from a very concerned doctor with a starving infant hearing that my breast milk wasn’t enough.

My baby gained only 7 ounces in 1 month.

I wanted to breastfeed because I wanted to do what was absolutely best for my son, no questions asked. But before he was born, the intense pressure to exclusively breast feed was causing anxiety attacks, frequently. I have flat nipples but I was assured breast feeding would be no problem.

Then I had my beautiful baby boy. We immediately had issues with breastfeeding. One lactation consultant slapped my nipple trying to get it to poke out and called the nipple shield a “cheater”. So I didn’t use one after that. We were not allowed to give him a pacifier. It was four days of pure hell in the hospital with both of us crying.

I was told over and over my body would produce enough milk for my baby and to just keep breastfeeding.

We went home and it wasn’t much better. So, every time I held him he’d cry, and then I’d cry because I’d have to feed him. I began dreading my child. No parent should have to dread their child. Continue reading

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Fed is Best Foundation Response to U.S. Delegation Actions at the World Health Assembly

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

The Fed is Best Foundation is dedicated to ensuring safe infant feeding for every single child, a goal that can be achieved with exclusive breastfeeding, combination feeding, exclusive formula feeding and tube-feeding. We have no political affiliation. We support all mothers to help their infant thrive with safe, sufficient and sustainable feeding in order to protect their health and optimize brain development. Recent news has broken about the U.S. delegation at the 71st World Health Assembly opposing the first draft of the Infant and Young Child Feeding resolution. We have provided a line-by-line break down of the first draft of the resolution, which was set to be proposed by delegates from Ecuador, as well as the proposed draft submitted by the U.S. delegation along with our interpretation of the lines that the U.S. delegates opposed.

In an editorial published in the New York Post, two pediatricians, Dr. Alma Golden and Dr. Brett Giroir,  who were key members of the U.S. delegation attending the 71st World Health Assembly, wrote about the rationale for the U.S. opposition of the first draft:

As pediatricians, US representatives at this year’s World Health Assembly in Geneva and supporters of breastfeeding throughout our professional careers, we were shocked to read recent headlines, in the New York Times and elsewhere, claiming that the administration has somehow called into question the importance of breastfeeding for infants.

The administration fully endorses breastfeeding, and the agencies where we work — Health and Human Services and USAID — communicate this unequivocally…We don’t just affirm these priorities in formal conference rooms in Geneva. For years, the US government…has invested millions of dollars to promote breastfeeding both at home and abroad.

All of which is to say: Breastfeeding wasn’t in dispute in Geneva. Rather, we raised objections to an early draft of the resolution we eventually supported, which made references to a controversial 2016 guidance document. The underlying policy goal of this guidance is unsupported by US nutrition guidelines and inconsistent with the practice of most families in our country…

In particular, the guidance recommends that countries impose stringent new regulations on the marketing of any commercially produced foods suggested for children between 6 months and 3 years old. Such restrictions, in our view, prevent parents from having access to all the factual information they might need. The guidance even advocates for the prohibition of free samples of formula — including in countries and conflict zones where supplies of formula could help save babies’ lives.

Most important, there are good and valid reasons, both medical and personal, why some mothers cannot breastfeed, or choose not to breastfeed exclusively. This is particularly true in situations where displacement, other trauma or malnutrition have made it impossible for mothers to breastfeed their children, and these babies’ lives are at risk without formula or other nutritional supplementation. Parents in these dire situations need all the information and choices available.

The issue of child malnutrition occurring in war torn countries has been reported on by CNN reporter Gayle Lemmon in her article, “Don’t make babies rely on breast milk in war zones,” where she interviewed members of Doctors Without Borders who reported taking care of many infants suffering from severe malnutrition as a result of the strict restrictions of the World Health Organization and UNICEF on formula donations.

‘Over the past couple of weeks we’ve seen an increase in the number of malnourished children needing treatment,” Doctors Without Borders’ Iraq country director Manuel Lannaud said in an interview released on the group’s Web site.

The surprising thing is that Lannaud and his colleagues at the humanitarian aid group didn’t place the blame for these underfed little ones just on war and the fact that the city was under siege. They also put the blame on other international organizations and policies that seek to do good.

“It isn’t a problem of access to food. The malnutrition we see here is primarily due to the scarcity of infant formula,” Lannaud wrote. “International organizations like UNICEF and the World Health Organization (WHO) promote breastfeeding … and provide infant formula, but only by prescription. We believe that distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalized for malnutrition.”

Doctors Without Borders says it agrees that breastfeeding promotion is a priority, but one that comes after dealing with the immediate crisis of a baby’s survival. Says Lannaud, if mothers “need formula, we give it to them.”

The mothers who need it are those facing down life-and-death situations each day, often while caring for multiple children in the shadow of war. That giving infant formula to them is so controversial speaks to a policy tripwire few outside the humanitarian realm even know exists: global “breastfeeding first” policies.

The WHO breastfeeding policies are not without flaws and aggressive promotion of exclusive breastfeeding has resulted in harm, namely an epidemic of newborn hospitalizations for jaundice, dehydration and hypoglycemia, known causes of brain injury and developmental disability, in the U.S. and across the globe. In addition, there has been a rise in accidental suffocation of newborns, called Sudden Unexpected Postnatal Collapse, from prone positioning during to skin-to-skin care and breastfeeding, made worse by maternal exhaustion from 24/7 rooming-in, practices encouraged but the WHO Ten Steps and by Baby-Friendly policies. The promotion of exclusive breastfeeding from birth has contributed to an epidemic of neonatal jaundice in the developed and developing world, which has contributed to an epidemic of perinatal brain injury and cerebral palsy particularly in the developing world, where few health care resources are available to monitor and treat exclusive breastfeeding complications. Promoting exclusive breastfeeding from birth over the local, traditional practices of supplemented breastfeeding (with wet nursing, animal milk or sugar water) until the onset of copious milk production has discouraged a practice that breastfeeding mothers used to prevent hunger and starvation-related complications like jaundice, dehydration and hypoglycemia, which now are the leading causes of newborn rehospitalization in the world.

Incidence of severe neonatal jaundice (bilirubin ≥ 20 mg/dL) in Low- and Middle-Income countries. The data reported correspond to hospital statistics. [Greco, et al, Neonatology 2016;110:172-180]

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My Baby Was Starving – She Lost 17 Percent Of Her Body Weight While Exclusively Breastfeeding

My daughter was born after 14 hours of labor with no issues, in a baby friendly hospital, and with what all of the medical professionals assured me was a perfect latch. The nurses kept telling me she would fall asleep soon, that all newborns do, but she was up for 7 hours after birth, most of the hours latched onto me. By the next morning, my nipples were already raw. I had lanolin I had brought with me that I applied as much as I could, but my daughter was literally on my breast for 5 hour stretches. Everyone assured me that she was cluster feeding, that I was doing a great thing by breastfeeding her, and we were sent home with no concerns being expressed, despite her 10 percent weight loss that I was told was normal. (This is not normal.)

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Cara continued to stay at my breast nonstop the next day and night. By day 4, she was finally stopping after 5 or so minutes and I assumed my milk must have come in. She also began to sleep much more, which I thought was because she was finally getting full.

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We had a weight check in later on that day with the lactation consultant. We found out she lost 17 % of her body weight. The LC told me I needed to get a pump, suggested a variety of measures to boost supply, and put me on a triple feeding schedule (breastfeed, give a bottle, pump and repeat). She said to not let her have any more than 20 ml of formula at a time or I would risk ruining my breastfeeding relationship. She also scheduled an appointment for me to come back the next day but never once told me that I should see my pediatrician for an urgent evaluation.  Continue reading

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