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.

We were again told that this was all normal and to continue to breastfeed. Early the following morning our baby was weighed and had lost 9 oz (8.2%) of her body weight from birth. Again, the lactation team reaffirmed that everything was normal and the staff neonatologist thought that it was okay for us to be discharged. She still had not had a bowel movement and her wet diapers were scarce at this point. We were told to “think about” supplementing with formula by the following morning if she did not have a bowel movement. No clear instructions were provided about how much, when and how frequently to do this.

As two tired new parents, we assumed everything was okay. No one talked to us about signs of dehydration or the importance of supplementation in any real actionable way. We were provided with no resources related to “Fed Is Best.”

After being home and continuing to breastfeed for 24 hours, my wife and I began to realize that something was wrong. Her latch continued to weaken. Our baby would sleep for long periods and would not wake for feeds.

We decided to supplement with 10-20 cc of formula as was briefly mentioned by the neonatologist. Even then, we were nervous to do this and did not want to alter the breast milk supply, so we only supplemented three of her feeds over the almost two-day period we were home from the hospital before our first pediatrician appointment.

At our first pediatrician appointment the following day, we found out that our baby had lost 13 % of her birth weight.

We, as parents and physicians, and our pediatrician were very concerned. We were worried that she would need to be readmitted to the hospital for dehydration and that this could have some serious long-term consequences. It was at this point, with the help of an outpatient lactation consultant and the pediatrician that we developed a plan to supplement with 50-70cc of formula every 3 hours and monitor her weight and diapers closely. This was in addition to continuing to attempt breastfeeding and pumping every 3 hours.

Fortunately over the next 24 hours, with the addition of formula supplementation, we saw great improvements. She gained 4 oz by the visit the following day and has grown stronger over the last week as we have continued to supplement with formula for every feed. Our baby’s energy level, diaper frequency, and weight have started to return to normal. I think we have avoided what could have been a very dire situation by intervening when we did. Despite my wife’s best efforts at pumping, she is only making 10 – 20cc of milk every 3 hours at this point, so we’ve now realized that formula supplementation is absolutely imperative.

My wife and I were happy to come across the “Fed is Best” organization when researching what happened to us on the internet. We are both physicians, and we were disappointed in ourselves for not realizing what was happening sooner. But in the whirlwind and fatigue of new parenthood, I can clearly see how things could be missed. We also were disappointed by our “Baby-Friendly” hospital for not seeing what was happening and at least giving us clear guidance on how to intervene if needed. At no point during our hospitalization was there truly any concern, despite the knowledge that my wife’s breast surgery may impact her ability to breastfeed and the scant amount of colostrum she was producing upon discharge. It is almost as if the breastfeeding pendulum has swung too far to one side.

Our daughter is doing great now. At 2 weeks, she was back to birth weight with a combination of mostly formula-feeding and some breastfeeding.

I think the lesson I would pass on to parents is to focus on the well-being of the newborn and not the ability to solely breastfeed. It seemed like before delivery and in the time immediately after there is a lot of focus on breastfeeding and not a lot of focus on strictly feeding the newborn. New families should have a plan in place in the event they are not able to solely breastfeed. This was never discussed with us beforehand. Ideally, FedisBest.org would be a reference that should be shared with new parents in the peripartum period to provide a balanced perspective on feeding and to make new mothers who are struggling with supply or other breastfeeding issues not feel like they are alone.

I would not have left the hospital without a firm plan of how we were going to feed our child before our first pediatrician appointment. Have confidence as new parents to speak up if something doesn’t feel 100% right. Trust your instincts.

In closing, thank you for providing information and advocating on the topic and making us feel like we are not alone in our story. We hope our story can provide information to future parents that may be experiencing similar circumstances.

John and Kristen Waters

The authors have requested pseudonyms to protect their privacy.

Preventing breastfeeding complications from inadequate colostrum intake is the ethical and safe thing to do as no baby should be underfed and forced to cry out in hunger in order to increase exclusive breastfeeding rates before hospital discharge. 


The ‘Second Night Syndrome’ is Abnormal and This is Why

Writing Your Hospital and the Joint Commission About Your Baby’s Feeding Complications

Fed is Best Weighing Protocol

Know Your Risks for Delayed Onset of Full Breast Milk Supply

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. We currently have– Health Care Professionals group, Advocacy Group, Research Group, Volunteer Group, Editing Group, Social Media Group, Legal Group, Marketing Group, Maternal 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 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 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.
  13. If you need support, we have a private support group– Join us here.

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

Donate to Fed is Best

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!

 

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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.

After she drank formula and went on a glucose drip, her fever subsided. My baby was starving!  

I felt cheated from this breastfeeding “system” and “propaganda” as termed by my husband. I also felt very guilty that I didn’t read up more about my risk factors as a first-time mother. It took 7 days for my milk to come in and I decided to exclusively pump after that as I wanted to be sure my baby was getting enough milk. My baby spent 5 days in the NICU and our hospital bills were thousands of dollars all because of an exclusive breastfeeding policy.

 Every time I see the photo of my baby girl, it makes me angry and I will do everything I can to get hospitals to change their breastfeeding protocols and account for their negligence. The marble-size stomach infographic is plastered everywhere in our hospital!

We filed an official complaint with the hospital, and they said they would give us a ‘discount’ on our hospital bills. We were so angry that we were dismissed so we found an attorney to help us. Eventually, we were awarded a malpractice financial settlement. We were also assured our case would set a precedent for the hospital to teach physicians, nurses and new mothers about excessive weight loss while exclusively breastfeeding and the importance of supplementation to prevent breastfeeding complications.

With my second baby, it took 5 days for my milk to come in and this time my baby was fed formula after every nursing and I am happy to say we are still breastfeeding at 8 months.


The current data shows approximately 5.7% or 190,000 U.S. newborns a year require hospital treatment with phototherapy for excessive jaundice, the leading complication of inadequate breast milk intake. A more recent study has shown that 6% of exclusively breastfed newborns require readmission, the majority for jaundice and dehydration. Data from the American Hospital Association has shown that the principal diagnosis for the majority of newborn readmission was for dehydration-related jaundice, which increased from 40% of readmissions in 2005 to 48% in 2009 (hemolytic jaundice rates stayed the same at 2.3% of readmissions). Globally, 1.1 million infants a year will develop severe jaundice (>20 mg/dL), which causes irreversible brain injury and impaired brain development. 114,000 of those infants will die from their severe jaundice, particularly in low- and middle-income countries with insufficient resources to monitor and treat complications of early exclusive breastfeeding.

Data from the American Hospital Association showing that the percent of infants readmitted for dehydration-related jaundice increased from 40% of readmissions in 2005 to 48% in 2009. Given that hemolytic jaundice did not increase, staying at 2.3%, only dehydration-related jaundice has increased.

If your baby suffered and was rehospitalized for complications of insufficient breastfeeding, please contact us:
contact@fedisbest.org

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

Knowing if Your Newborn is HUNGRY and Needs Urgent Evaluation / Supplementation

NICU Nurse Discloses Newborn Admission Rates From Breastfeeding Complications in BFHI Unit

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

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

 

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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.

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NICU Nurse Discloses Newborn Admission Rates From Breastfeeding Complications in BFHI Unit

Ella D.

I am a neonatal intensive care unit nurse (NICU) and the hospital I work at delivering more than 2,000 babies annually, over half from high-risk pregnancies.  In our part of the country, “natural parenting” is widely embraced, and it is difficult to find a hospital that isn’t “Baby-Friendly.”  Our hospital administration views the Baby-Friendly Hospital Initiative (BFHI) and the 10 steps to successful breastfeeding designation as a marketing tool, hoping new parents will choose our hospital to deliver their babies.  Any criticism of the BFHI risks a backlash.

COMPLICATIONS on the mother-baby unit

Since our hospital became BFHI certified, NICU admissions for acute starvation while exclusively breastfeeding have escalated to at least 4 admissions weekly. (It should be zero) Fortunately, once the baby reaches the doors of the NICU, we are free from the BFHI protocol.  We are not, however, free from all the indoctrination the parents have already received, and they’ve received an impressive and dangerous amount. We require verbal consent and a physician’s order for donor milk use, but only low birth weight babies qualify for that. We also require a physician’s or Neonatal Nurse Practitioner’s (NNP) order for formula milk use. It is not uncommon for parents to request IV fluids over formula supplementation. 

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I Attempted Suicide From The Pressure Of Breast Is Best

When I first wrote this blog post, I was blown away by how many mothers related to my breastfeeding story. So many women reached out to let me know I wasn’t alone, and shared nearly identical stories. Which made me both relieved, and also very sad that this mental health side of breastfeeding isn’t talked about enough. I don’t understand why so many people act like it doesn’t happen and don’t talk about it. We can SAVE lives if we DO talk about it!

I was just as equally shocked to see how many mothers thought that I should have kept breastfeeding anyway, even if it meant resenting my son, and being nothing more than a food source and a shell of a person. My story has been picked apart by many lactivists, from accusing me of being selfish, to thinking I just didn’t have enough support or encouragement. I had more than enough support for breastfeeding, but very little support for switching to formula when I knew it was best for my own mental health, and for my son. I can’t fathom telling a mom she’d better breastfeed or might as well be dead. I’m not against breastfeeding. I successfully breastfed my second baby for almost a year! But I don’t believe in breastfeeding at all costs, especially at the expense of the mother’s health, and that includes her mental health. A mother’s mental and emotional health are just as important as her baby’s health. Not every mom gets that oxytocin-induced happy breastfeeding experience. Sometimes it’s the opposite, and those moms need support and recognition too.

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False News Report Used to Discredit Baby-Friendly Critic and Pediatrician

Christie del Castillo-Hegyi, M.D.

Another day, another distortion pushed by supporters of the Baby-Friendly Hospital Initiative, who no longer have any reasonable justification for endangering newborns with their policies, namely policies that increase the risk of accidental suffocation, newborn falls and starvation-related brain injury from strict exclusive breastfeeding promotion. Never in the history of Western medicine have we had decades of scientific evidence that a public health policy increases the risk of brain injury, disability and death in infants while millions of dollars are used to promote the policies’ “benefits” while actively suppressing knowledge of its risks. Since they no longer have any defense for their unsafe practices, they use the old and tired argument that anyone who criticizes or raises awareness on the safety issues of their policies must be funded and influenced by formula industry.

The most recent attempt to suppress the opinions of its critics occurred on December 18, 2018 when Women’s eNews published a highly biased and inaccurate article aimed at discrediting one of the BFHI’s critics, Dr. Ronald Kleinman, who published an editorial along with two other pediatricians, Dr. Joel Bass and Dr. Tina Gartley, in the medical journal JAMA Pediatrics regarding the serious safety issues associated with the BFHI protocol, entitled, Unintended Consequences of Current Breastfeeding Initiatives.

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Neonatal Nurse Practitioner Speaks Out About The Dangerous And Deadly 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

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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

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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 adequate milk production are unknown, there are estimates that range from 12-15 percent or more.  

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