Baby-Friendly USA Acknowledges Their Mistakes; Are They Going To Make Real Changes In The New Year Or Are They Providing Lip Service To Mothers?

Dear BFUSA,

Thank you for your long-overdue public acknowledgment endorsing what the Fed Is Best Foundation has been fiercely advocating for over the past 3 years. 

According to your recent blog post you now agree with us that:

1. Delayed onset of copious milk production is common. 

BFUSA: “Delayed lactogenesis is actually increasingly common because the risk factors for it are potentially increasing,” Dr. Rosen-Carole says. “When a baby is born into that situation, the goal is to closely monitor what the baby is doing, instead of giving a bottle right away. “If the baby is hungry and they’re not getting enough milk out of the mother’s breast, then they need to be supplemented,” she says. 

FIBF: We have been passionately educating parents about safe breastfeeding since the beginning of our advocacy over 3 years ago with the current scientific studies that have confirmed over and over again that delayed onset of milk production and low milk supply are common.  We question why it took you so long to acknowledge this deadly and 100% preventable consequence of insufficient breastfeeding? Does this mean you will ban the belly bead stomach models that do not reflect the current science?

Will you please apologize to the thousands of mothers who bravely told their stories of accidental starvation?  You have previously tried to discredit their stories, called them “‘anxiety-provoking,” and characterized our foundation as BFHI detractors— simply because we offer a social media platform for mothers to be heard by you. Have you ever heard a mother break down and scream in horror when she learned her baby was starving to death because she followed your breastfeeding education and protocol?  We have—over and over again, and it is the most haunting sound. It’s what drives us to fiercely advocate for safe breastfeeding because no other health organization is doing so.

BFUSA: Dr. Bobbi Philipp agrees. “If you see signs that the mother’s milk is insufficient, you need to feed the baby,” she says. “And if the mother is really committed to breastfeeding, you’ve got to bridge the gap in a way that you support her, feed the baby, and don’t undermine the breastfeeding. It’s that simple.”

FIBF: Now that you are acknowledging delayed onset of milk is common, something that we have been passionately writing and speaking about for years, we expect that you will stop calling us “fibbers.” Name-calling is what a child having a temper tantrum does, not what a professional organization should do; the appropriate response to being called out and held accountably, is to take responsibility and revise your guidelines based on current research and patient feedback. Continue reading

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Dear Parents, Did You Know Just 2 Teaspoons Of Supplementation Can Protect Your Baby And Your Breastfeeding Journey?*

Written by: The Fed Is Best Foundation IBCLC Team

There have now been six studies showing that in some infants, a little bit of supplementation with two teaspoons (10 mL) of formula or donor breast milk after nursing had no effect on long-term breastfeeding. One study showed it prevented hospital readmissions in all of the supplemented newborns. Another showed it actually helped breastfeeding! 

 Why aren’t medical and lactation professionals recommending this intervention?

Many medical and lactation professionals believe that a tiny amount of formula will contaminate the baby’s gut, causing lifelong health problems. They refuse to admit that formula supplementation can be helpful, and they have baseless concerns that temporary formula supplementation will become routine for all babies.  According to Baby-Friendly USA, “donor [breast] milk takes the fight out of this.” What they mean is that the few babies who are born in a hospital with donor milk can be fully fed, while the vast majority of babies who are born in hospitals without donor milk just have to tolerate hunger and thirst so as to avoid a few teaspoons of formula.  

Did you know two teaspoons of formula or donor milk has seven calories?  

They argue that formula will change the beneficial bacteria in the baby’s gut, but this change is safe and only temporary—and pales in comparison to the risks of potentially life-threatening complications from insufficient colostrum, like jaundice, low blood sugar, and dehydration, which can be caused by acute starvation.   What about sensitizing the infant’s gut to cow’s milk protein?  There is no evidence that early limited formula supplementation has any impact on babies’ future health. If someone has this evidence, please come forward.  In addition, if anyone has is concerned about cow’s milk formula, there are formulas that have those proteins broken down (hydrolyzed) that can also be used. The fact that lactation and medical professionals have not promoted and implemented this life-saving solution shows that the real issue is bias against formula use, pure and simple.  Do they hate formula products so much that they don’t care if your baby suffers from hunger?

The question is, how many randomized, controlled studies support Step 6 of the WHO’s Ten Steps to Successful Breastfeeding to avoid supplementation from birth in order to improve breastfeeding outcomes? None. Absolutely none.

In the meantime, parents and health care professionals can be assured that if a baby shows signs of persistent hunger after breastfeeding, just a few teaspoons of formula or donor milk (if available) can satiate the baby’s unrelenting hunger, will not cause breastfeeding problems, and even reduces the risk of re-hospitalization due to the baby not getting enough milk.

As long as the mother’s milk supply is protected by the baby breastfeeding at least eight times a day, or in some cases adding milk expression to the feeding plan, the baby can return to exclusive breastfeeding when the mother’s milk comes in.

Supplementation does not destroy mothers’ confidence in their bodies; it gives them the confidence to know they can care for their babies no matter what happens, and it gives them the knowledge they need to support their milk supply until it increases to meet the baby’s needs.  

Do you want to be successful with breastfeeding while protecting your baby from hunger?  Follow your instinct and your baby’s cues, and don’t be afraid of giving your baby a little extra nutrition until your milk comes in!

The Fed Is Best Foundation IBCLC Team

#JustTwoTeaspoons   #FedIsBest  #SafeBreastfeeding

*Only some infants were supplemented. Babies received 10 mL of formula by syringe after breastfeeding if they met the following criteria: >75th %ile  weight loss for age, irritability such as crying and hungry behavior, and if their mothers requested it. Mothers were instructed to stop supplementing after their milk came in.

Note: if a baby is still showing hunger cues after those 10 mL, you can repeat with another 10 mL until the baby is satisfied. 


Resources

Feed Your Baby—When Supplementing Saves Breastfeeding and Lives

The Newborn Stomach Size Myth: It is NOT 5-7 mL

Fed is Best Feeding Plan – Updated 2018

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

WHO 2017 Revised Guidelines Provide No Evidence to Justify Exclusive Breastfeeding Rule While Evidence Supports Supplemented Breastfeeding

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 us in any of the Fed is Best volunteer and advocacy, groups. Click here to join our health care professionals group. We have:  FIBF Advocacy Group, Research Group, Volunteer Group, Editing Group, Social Media Group, Legal Group, Marketing Group, Perinatal Mental Health Advocacy Group, Private Infant Feeding Support Group, Global Advocacy Group, and Fundraising Group.    Please send an email to Jody@fedisbest.org  if you are interested in joining any of our volunteer groups. 
  2. If you need infant feeding support, we have a private support group– Join us here.
  3. If you or your baby were harmed from complications of insufficient breastfeeding please send a message to contact@fedisbest.org 
  4. 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.
  5. Sign our petition!  Help us reach our policymakers, and drive change at a global level. Help us stand up for the lives of millions of infants who deserve a fighting chance.   Sign the Fed is Best Petition at Change.org  today, and share it with others.
  6. 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 FREE infant feeding educational resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  7. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write to them about feeding complications your child may have experienced.
  8. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  9. Write your local elected officials about what is happening to newborn babies in hospitals and ask for the 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.
  10. 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.
  11. 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.
  12.  Shop at Amazon Smile and Amazon donates to Fed Is Best Foundation.

Or simply send us a message to find out how you can help make a difference with new ideas!

For any urgent messages or questions about infant feeding, please do not leave a message on this page as it will not get to us immediately. Instead, please email christie@fedisbest.org.

 Thank you and we look forward to hearing from you!

Click here to join us!

 

 

 

 

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Baby-Friendly: Failure and the Art of Misdirection

By Alex Fischer, PhD Candidate, Brooke Orosz, PhD, Jody Segrave-Daly, RN, IBCLC and Christie Del Castillo-Hegyi, M.D.

Any good magician will tell you that the secret to their trade is misdirection—making the audience look one way while doing something the other way. And even knowing this, most of us are still baffled by a magician’s tricks. So it’s no wonder that Baby-Friendly USA (BFUSA) has tried to employ that same tactic in their statement titled “Fact vs FIB: The Impact of Baby-Friendly on Breastfeeding Initiation Rates.”  In this statement written by an anonymous author representing BFUSA, they attempt to dispute the findings of a recent study published in Journal of Pediatrics, “Outcomes from the Centers for Disease Control and Prevention 2018 Breastfeeding Report Card: Public Policy Implications” by Bass et al. This study examines the impact of statewide breastfeeding initiation rates as well as the impact of BFHI facilities on continued breastfeeding after hospital discharge (exclusive or combination). The Fed is Best Foundation read this study and agreed: “Baby-Friendly does not work.” These five words are the instigators of the entire statement by BFUSA and its misrepresentation of a very robust scientific study.  Continue reading

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U.S. Study Shows Baby-Friendly Hospital Initiative Does Not Work

by Christie del Castillo-Hegyi, M.D.

On October 14, 2019, the Journal of Pediatrics published astonishing findings regarding the effects of the Baby-Friendly hospital certification on sustained breastfeeding rates as defined by the 2020 Healthy People Goals of: 

  1. any breastfeeding at 6 and 12 months
  2. exclusive breastfeeding at 3 and 6 months. 

They did so by measuring the relationship between statewide breastfeeding initiation rates data and the above breastfeeding rates. They then measured the contribution of Baby-Friendly hospital designation on these same breastfeeding outcomes.

According to the study authors, the increase in hospital designation in the Baby-Friendly Hospital Initiative (BFHI) began in 2011 when the U.S. Surgeon General issued a call to action for maternity care practices throughout the U.S. to support breastfeeding. The Centers for Disease Control (CDC) became involved in promoting the BFHI policies in hospitals and health facilities, as breastfeeding was thought to be associated with lower rates of childhood obesity. The assumption was that by increasing breastfeeding rates through the BFHI, there would be a concomitant decline in childhood obesity. Upon initiation of this program, the CDC initiated surveillance of state-specific data on breastfeeding outcomes after discharge including BFHI designation rates. This data is made available to the public through the CDC Breastfeeding Report Card, which provides annual reports from 2007 through 2014 and biennial reports from 2014.

As expected, they found that states with higher breastfeeding initiation rates had higher rates of these sustained breastfeeding outcomes. You cannot have high breastfeeding rates unless mothers are given education and successfully initiate breastfeeding. However, when they measured the effects of Baby-Friendly certification, this is what they found.

“Baby-Friendly designation did not demonstrate a significant association with any post-discharge breastfeeding outcome (Figures 1, B and 2, B). There was no association between Baby-Friendly designation and breastfeeding initiation rates.” Continue reading

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National Women’s Health Advocate Describes How A Baby-Friendly Hospital Starved Her Baby

Sarah Christopherson is a mother and the Policy Advocacy Director at the National Women’s Health Network, a non-profit advocacy organization in Washington, D.C. She talks about her breastfeeding experiences and her recent experience in a Baby-Friendly hospital where her child became severely dehydrated and lost 15% of her birth weight while in the hospital. She discusses how policies can negatively affect patient health and how systemic change is needed to support positive patient health outcomes and prevent patient coercion.

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Two Physicians Describe How Their Baby-Friendly Hospital Put Their Newborn in Danger

John and Kristen are both surgical residents who recently had their first child. This is their story.

By John and Kristen Waters

Let me start by saying we are one of the lucky ones. Our first-born was born at term on July 25th, 2019 at 9:43 p.m., a healthy 7 lb, and 10oz. My wife – a general surgery resident – was planning on beginning to breastfeed right after birth. My wife had undergone a bilateral breast reduction about 15 years ago, so issues with breastfeeding were on our radar. Immediately after birth, we were taken from the delivery room to the postpartum unit, where at 2 a.m. my wife and I were given a pile of paperwork and instructions on breastfeeding practices. All the while both of us were seeing double from the long day and night of laboring and delivery.

Over the course of the next 12-24 hours, our baby attempted to latch and breastfeed, continuing to have issues with falling asleep while on the breast. We spoke with a lactation consultant and multiple nurses who stated that things were going fine and that everything was normal. Over this time the rate of wet diapers continued to decrease and our baby did not have a bowel movement.

As we got into our second night of life, our child began to cry hysterically.

Continue reading

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We Were Awarded A Malpractice Financial Settlement Because My Baby Suffered From Starvation In A BFHI Hospital

By A Mother from the Fed is Best Community who wishes to remain anonymous

This is my baby girl in NICU. She developed a high fever, jaundice, and dehydration with a 10.1% weight loss 56 hours after birth while exclusively breastfeeding in a ‘Baby-Friendly’ hospital.

During our stay, the hospital pediatrician saw my baby twice a day but he failed to inform us she had a 7.2% weight loss in the 30th hour of life. Hence, we were not given the information to decide if we should supplement with formula.

According to a review published in the Journal Of Family Practice in June 2018, “exclusive breastfeeding at discharge from the hospital is likely the single greatest risk factor for hospital readmission in newborns. Term infants who are exclusively breastfed are more likely to be hospitalized compared to formula-fed or mixed-fed infants, due to hyperbilirubinemia, dehydration, hypernatremia, and weight loss.” They estimated that for every 71 infants that are exclusively breastfed, one is hospitalized for serious feeding complications.

She was always furiously latching and my nipples were cracked and bleeding from constant nursing. She became very sleepy and now I know she was lethargic. Naively, I continued to breastfeed as instructed, and we told everything was fine until she developed a high fever just before discharging. They suspected bacterial infection and my poor baby endured a spinal tap, blood tests, IV glucose, and prophylactic IV antibiotics while waiting for results to come back. There was a very concerned NICU nurse that told me it’s time someone questions the strict exclusive breastfeeding practices of the BFHI. She was the one that told me to look at the weight loss when I was shocked and confused wondering how on earth my little girl caught a bacterial infection. Continue reading

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Weight Loss is Not Caused by IV Fluids: The Dangerous Obsession with Exclusivity in Breastfeeding:

By Dr. Christie del Castillo-Hegyi, M.D.

The Fed is Best Foundation has written about countless cases of serious complications caused by poor standards of breastfeeding management established by multiple exclusive breastfeeding advocacy organizations. The primary causes of these poor outcomes are:

    • the persistent denial of the seriousness of newborn weight loss
    • the lack of transparency about the consequences of insufficient feeding complications in patient education and health professional training
    • and the dangerous obsession with exclusivity in breastfeeding.

Exclusive breastfeeding, according to the WHO, means “the infant receives only breast milk. No other liquids or solids are given – not even water – with the exception of oral rehydration solution, or drops/syrups of vitamins, minerals or medicine.” While breastfeeding is a positive thing to support, the obsession with exclusivity in breastfeeding promotion results in approximately 190,000 newborn admissions a year in the U.S. alone, mostly from complications of jaundice and dehydration caused by underfeeding. This article will discuss the actual reason why exclusively breastfed newborns lose weight and why newborn weight loss is not due to IV fluids given to mothers before delivery. This is to address a commonly circulated unsafe recommendation by exclusive breastfeeding advocates and lactation professionals suggesting we increase the AAP recommended maximum weight loss threshold of 7% and to weigh infants at 24 hours, which would likely increase newborn insufficient feeding complications, hospitalizations, and brain injury.

Part 1: Why a Newborn Loses Weight in the First Days

Let’s start the conversation off with why newborns lose weight in the first days of life. Exclusive breastfeeding advocates have hypothesized that infant weight loss is caused by fluid shifts and “diuresis” or elimination of fluid through urination. Diuresis is defined as overproduction of urine caused by excess body fluid, which should be at least 6-8 wet diapers a day, the normal urine production of a hydrated newborn. In fact, exclusively colostrum-fed newborns, only produce 1-2 wet and dirty diapers a day the first 2 days of life, which is lower than the normal number of wet diapers a day for a hydrated newborn. Therefore, weight loss is not in fact caused by fluid loss. 

Here are some basic facts about newborn nutrition:

  • The caloric requirement of a newborn from birth through the first weeks of life is 100-120 Calories/kg/day, a figure that is determined by the number of living cells a baby has to keep alive. 
  • The fluid requirement of a newborn is more variable, which can be affected by how much fluid reserve they are born with. But according to the pediatric literature it is approximately  60-80 mL/kg/day the first 2 days then 100 mL/kg/day thereafter. 
  • That means a 3 kg newborn needs 300 to 360 Calories per day and 180-240 mL of fluid for the first 2 days and 300 mL thereafter. 

Continue reading

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What Have We Done To Support Breastfeeding Parents When “Breast Is Best” Support Is Letting Them Down?

By Jody Segrave-Daly, MS, RN, IBCLC

We. listened. to. them.

We validated their stories and offered them compassionate and judgment-free support. We didn’t blame them when they were struggling with their breastfeeding journey.  Instead, we apologized for what happened and found a way to help parents breastfeed/chest-feed their babies safely, with confidence and with love. We helped them heal in a safe place while lactivist zealots vehemently judged them and blamed them for not having the right breastfeeding support, the right breastfeeding education, the right nurse, doctor, LC, or hospital. They even blamed mothers for not recognizing HUNGRY signs when their babies were starving while under the trusted care of lactation professionals.

Today begins World Breastfeeding Week 2019.

 I want to bring awareness to what we do every day to support breastfeeding parents successfully at the Fed Is Best Foundation. Our goal is to bring awareness to lactation professionals to inform them of what parents are telling us they need to successfully breastfeed because they tell us no one is listening to them. Continue reading

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A Fully Fed Baby is the Biological Ideal

Abridged Comment Presented on July 11, 2019 at the USDA Dietary Guidelines Committee Meeting in Washington, DC

My name is Dr. Christie del Castillo-Hegyi, Co-Founders of the Fed is Best Foundation, a non-profit organization of health professionals and parents whose mission is to research and advocate for safe breastfeeding practices. We do this to prevent the complications of infant dehydration, excessive jaundice, and hypoglycemia from insufficient feeding, all known causes of brain injury, disability and rare deaths. I have come here representing over 700,000 supporters to raise awareness regarding these complications for the DGA committee as they prepare the infant nutrition guidelines.

Continue reading

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