A Nurse Speaks Out About The Emotional Distress Parents Endure From Mandated Exclusive Breastfeeding Policies

“The sight and sound of babies crying out for food and fluids are why I decided to speak out. Babies are denied food and fluids to promote exclusive breastfeeding.”

As a mother-baby nurse, I’ve seen many preventable episodes of emotional distress for families in my thirty-year career. Unfortunately, The emotional distress increased significantly when the Baby-Friendly Hospital Initiative was implemented at my hospital. Some episodes of emotional distress are unforgettable, so I felt compelled to speak out about them, hoping to bring about the much-needed change to protect newborns from hunger and maternal mental health.

Mothers are incredibly vulnerable after giving birth, as their bodies transition physically and hormonally. They have a new life to take care of while recovering from birth and require compassionate, respectful, and individualized care. However, the Baby-Friendly breastfeeding protocol is one-size-fits-all and does not allow individualized care. Mothers must follow the BFHI protocol regardless of how they feed their baby or how complicated their birth was. We know as health care professionals that no protocol can be safe and effective without individualized care.

 Evidence based medicine cannot replace clinical judgment or account sufficiently for the complexity of individual cases. The limitations of EBM must be acknowledged and addressed so that it can be used effectively and without compromising patient care. -Mark R. Tonelli, MD, MA

Continue reading

The Baby-Friendly Hospital Initiative is The Worst Thing I Have Experienced in my 20 Years as a NICU Nurse

Dear Parents,

It’s taken me years to find the courage to contact the Fed is Best Foundation with my experiences of working in a baby-friendly hospital.  “Baby-Friendly” is the worst thing I have experienced in my 20 years as a NICU nurse. My colleagues and I have tried many times to express our concerns with the number of NICU admissions we receive. Eighty percent of our admissions are because of baby un-friendly protocols for hyperbilirubinemia, hypoglycemia, excessive weight loss, and dehydration in our hospital from insufficient breastfeeding. We are a small unit, and we have had around 150 plus admissions last year from insufficient feeding. Sadly, we’ve had bad outcomes.

Continue reading

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.


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.


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.


Continue reading

Neonatal Nurse Practitioner Speaks Out About The Dangerous Practices Of The BFHI

by Christine K.

When the Fed Is Best Foundation launched two years ago, a few nurses sent us messages about their experiences working in a Baby-Friendly Hospital Initiative (BFHI) hospital. They shared common concerns about watching exclusively breastfed babies crying out in hunger from not enough colostrum while being refused supplementation just so that high exclusive breastfeeding rates were met. Two years later, we now receive messages from nurses, physicians, lactation consultants, and other health professionals, regularly. They express their concerns while asking for patient educational resources. They tell us their stories and they need support and direction on what to do about unethical and dangerous practices they are forced to take part in. We collected their stories and are beginning a blog series on health professionals who are now speaking out about the Baby-Friendly Health Initiative (BFHI) and the WHO Ten Steps of Breastfeeding.

Christine K. is a Neonatal Nurse Practitioner currently working in a BFHI Hospital with 25 years of experience. She has worked in both BFHI and non-BFHI hospitals and talks about her concerns about taking care of newborns in the Baby-Friendly setting.

Regarding Unsafe Skin-To-Skin Practices

In BFHI facilities, skin-to-skin is mandated. The protocol calls for skin-to-skin at birth, for the first hour, then ongoing until discharge. New mothers are constantly told that it is important for bonding, for breastfeeding, for milk production and for temperature regulation of the newborn. Baby baths are delayed for skin-to-skin time and nurses are required to document in detail the skin-to-skin start and end times. There is no education on safety regarding skin-to-skin time, only that it is to be done. I have been responsible for the resuscitation of babies who coded while doing skin-to-skin. One died, and the other baby is severely disabled. Mothers are not informed of the risks of constant and unsupervised skin-to-skin time. Mothers have complained to me that they felt forced to do skin-to-skin to warm up their cold or hypoglycemic infant because they are told skin-to-skin time will help their infant resolve these issues when in fact it doesn’t. There is also no assessment of the mother’s comfort level with constant skin-to-skin. It’s very discouraging to hear staff say things like, “That mother refused to do skin-to-skin,” like it was a crime or an act of child abuse. The judgment is harsh on mothers who fail to follow the protocol. I have noticed that partners are pushed to the side, especially in the first hour of life, not being able to hold their newborn, due to this strict policy. Their involvement has been discounted in the name of the exclusive breastfeeding protocol. Continue reading

Nurses Are Speaking Out About The Dangers Of The Baby-Friendly Health Initiative

When the Fed Is Best Foundation launched two years ago, a few nurses sent us messages about their experiences working in a BFHI hospital. Some of the nurses felt comfortable speaking out because they left their jobs or retired early, as they did not want to be part of the restrictive breastfeeding policies that were implemented. They shared common concerns of watching exclusively breastfed babies being refused supplementation, while babies were crying out in hunger from not enough colostrum which resulted in NICU admissions.

Two years later, we now receive messages from nurses, physicians, LC’s and other health professionals, regularly.  They express their concerns while asking for help and for patient resources. They tell us their stories and they need support and direction of what to do about unethical and dangerous practices they are forced to practice. We collected their stories and are beginning a blog series of health professionals who are now speaking out about the Baby-Friendly Health Initiative and the WHO Ten Steps of Breastfeeding. Continue reading