Tag: Baby-Friendly Hospital Initiative

Fed Is Best Foundation Featured in Forbes

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Our co-founder Dr. Christie del Castillo-Hegyi was recently interviewed by Kavin Senapathy of Forbes.com about the Fed Is Best Foundation, The article is being met with an enormous amount of positive feedback, and talks about why our mission is so very important to us, and why we’re determined to spread the word.

For those of you who may be unfamiliar with Kavin, she’s a science and health writer, also known for her work with GroundedParents.com, which focuses on evidence-based medicine and health practices for parenting. We think she did a stellar job on this piece – a huge thank you to Kavin for her hard work and for helping us get the word out! Here is a short excerpt, and a link so that you can read the piece in full: Continue reading →

The Scientific Evidence on the Effects of Underfeeding on the Newborn Brain

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A Review of the Literature by Dr. Christie del Castillo-Hegyi

We have received some questions here at the Fed is Best Foundation regarding the science of infant feeding and preventing accidental newborn starvation from insufficient breast milk intake.  Some have said there is no evidence that insufficient milk intake in newborns causes brain injury, developmental delays and disabilities.  We’d like to take the opportunity to open up a discussion on this very important topic.

The general body of medical and scientific literature largely supports that babies who are not fed enough calories and fluid through breastfeeding can develop excessive  jaundice, severe dehydration and hypoglycemia – all complications that can cause brain injury if not corrected. This isn’t exclusive to humans. In fact, the basic rule of nature is that no creature, particularly mammals, can live without food. Continue reading →

Q&A: One Nurse’s View on Strict Breastfeeding Policies

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Jody Segrave-Daly, our co-founder and the pro-mom advocate known as “The Momivist” regularly interviews nurses about their view and experiences, working with strict breastfeeding-only policies. Here is an excellently informative interview with a nurse we’ll call Sarah, as she’s asked we keep her name and hospital anonymous. 

Jody Segrave-Daly, AKA The Momivist: What are the most common encounters that you see with breastfed babies in the first 48 hours of life,  in your hospital, which has strict breastfeeding policies?

Sarah, RN at Hospital with Strict Breastfeeding Policies: I’ll start with the positive. One thing I really like about hospitals that have these policies, such as the Baby Friendly Hospital Initiative, is the emphasis on skin-to-skin after delivery. Instead of baby immediately being taken to a warmer, baby is placed on mom’s chest. Mothers seem to really enjoy this immediate contact with their babies, babies’ vital signs tend to stabilize better, and breastfeeding is encouraged in the first hour after birth (if baby shows interest). Continue reading →

Markers of Brain Injury is Present in the Blood of Newborns Requiring Phototherapy for Jaundice

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

A study published in the journal Pediatrics and Neonatology in September, 2014 showed that newborns diagnosed with hyperbilirubinemia, or abnormal jaundice, high enough to require phototherapy had significantly higher blood levels of S100b, a protein known to be released by damaged brain cells when significant brain injury occurs.  They studied 62 jaundiced newborns who required phototherapy and compared them to 30 healthy non-jaundiced newborns and compared the relative levels of S100b in the blood, as well as other molecules that are associated with oxidative stress, a phenomenon that occurs when living cells die.  All except 2 babies in each group were breastfed and none had G6PD, a condition that causes abnormally high bilirubin unrelated to breastfeeding-related dehydration.

They found that the babies who had hyperbilirubinemia high enough to require phototherapy (bilirubin levels of 20.58±2.96 mg/dL) had significantly higher levels of S100b than the healthy babies, (S100B levels 87.3± 2.63 pg/mL in healthy babies vs. 124.97 ± 123.05 pg/mL in phototherapy babies; p = 0.032).  They also found higher levels of MDA, a marker of oxidative stress from cell death, in the babies requiring phototherapy as well (5.55±0.6 nmol/mL vs. 7.72±0.75 nmol/mL; p<0.001).  The levels of S100b was NOT reversed by phototherapy, suggesting that phototherapy neither increased brain cell death nor reversed it.  The purpose of phototherapy is to prevent further brain injury caused by hyperbilirubinemia but it does not reverse brain injury.

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High Rates of Newborn Hospitalizations for Jaundice Requiring Phototherapy in a Baby-Friendly-Compliant Hospital System

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By Christie del Castillo-Hegyi, M.D.

The true rates of excessive jaundice and hospitalizations of newborns for phototherapy due to jaundice has been recently published in JAMA Pediatrics published online April 11, 2016. In a study of 104,460 babies born between January 2010 and December 2013 in the Kaiser Permanente Northern California (KPNC) Healthcare System reported than an astonishing 12.4% of babies developed pathological hyperbilirubinemia of greater than 15 mg/dL in the study period, which has been shown in the scientific literature to increase risk of developmental disabilities. This translates to 12,953 babies or almost 12 babies a day.  In addition, 5.7% of babies required phototherapy admission, translating to 5954 newborns or 5 babies a day.

California has a state mandate to require Baby-Friendly certification in all its hospitals by 2020, which requires that >80% of eligible newborns be exclusively breastfed at discharge, the primary quality metric of the BFHI. Many California hospitals are working towards that designation and their exclusive breastfeeding rates at discharge are tracked by the California Department of Public Health. Estimates of excessive jaundice in the KPNC hospital system, which has among the highest exclusively breastfeeding rates at discharge, all except 2 reaching the >80% requirement, was described by this study. Seventy-one percent of these hospitalizations were extensions of the original birth admission, which means pathological jaundice was detected before discharge and the newborn’s hospital stay was extended to reduce the pathological effects of bilirubin, namely brain injury.

Severe newborn jaundice and phototherapy increase the risk of developmental disability

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