Dr. Nicole King Warns About Dangers of Baby-Friendly Hospital Initiative at USDA Dietary Guidelines Meeting

On August 11, 2020, Dr. Nicole King, Anesthesiologist, Critical Care Intensivist, Patient Safety Expert and Senior Advisor to the Fed is Best Foundation spoke at the USDA Scientific Report of the 2020 Dietary Guidelines Advisory Committee meeting warning of the dangers and patient rights violations of the Baby-Friendly Hospital Initiative. Watch her address below.

Good afternoon, my name is Nicole King and I am a mother and a physician.  As an anesthesiologist and intensive care physician, I am faced with life and death circumstances every day.  In no way did I ever consider breastfeeding my child would be as stressful as supporting a COVID patient through their critical illness.  Five years ago, I realized how wrong I was.

As a new mother who had had a breast reduction and a physician, I should have known better, but I did not. I fed into the same propaganda, misinformation and fervor around breastfeeding that has grown over the last 30 years as a result of the Baby-Friendly Hospital Initiative and the WHO’s Ten Steps [to Successful Breastfeeding]. I was not informed of its risks and followed the exclusive breastfeeding guidelines, and as a result, my newborn lost excessive weight and was readmitted for dehydration and jaundice.

The current USDA guidelines are filled with the same soft science riddled by confounding factors, that has led to the shaming of women who are unable to exclusively breastfeed for 6 months. The guidelines are an ableist and elitist narrative and read as an invitation to admonish women for failing to produce enough milk for her child. It blatantly ignores research that clearly shows that delayed lactogenesis of mature milk is common, found in up to 40% of first-time mothers and 22% of all mothers, even those who are motivated to exclusively breastfeed.  Never mind the 15% of women who are incapable of sustaining breastfeeding past the first month, even with lactation support.

If you are ill and in the hospital, nutritionists are there to calculate the calories needed to feed you in order for you to thrive and recover. Why then are we so easily fooled into thinking an infant who is building muscle, fat and brain cells can be sustained on far less than their caloric needs, purported by the Baby-Friendly policy? If the “biological norm” is put forth as a reason to exclusively breastfeed, then why are exclusively breastfed infants being admitted daily for dehydration, jaundice, and hypoglycemia? Why do we continue to insist on a policy that increases the risk of harm to infants while vilifying supplementation that prevents serious complications? Every day, I protect my patients with medications, machines and nutritional alternatives to overcome so many failures of the “biological norm.” I do this because I too am human and understand that we care and love for each other regardless of our ability to live up to a standard of perfection. Yet we allow babies to become seriously ill by pressuring mothers to achieve this standard of perfection that millions cannot safely achieve. If judicious and humane supplementation is the difference between a hospitalized and a safely breastfed child, then we have failed all mothers and infants in this country by disparaging its use.

The USDA draft policy continues to ignore these realities and thus fails to protect countless infants.  National guidelines should never encourage a policy that is directly responsible for the leading cause of rehospitalization of healthy term infants. And most importantly, as a national guideline, it should apply to all mothers, regardless of her ability to breastfeed, across all socioeconomic demographics.

As a mother who followed these guidelines and was led to rehospitalize her own infant, I beg you to consider the plight of all mothers and infants in this country. Every infant deserves to be protected from hospitalization and the complications of an exclusive breastfeeding policy.   And their mothers deserve to know that breast milk is but one way to best nourish their children.  The USDA is responsible for every child in the US and their policy should reflect this responsibility.


Dr. Nicole King, M.D. is a patient safety expert and Senior Advisor of the Fed is Best Foundation. She is a board-certified anesthesiologist and critical care intensivist.

Hospital Drops Baby-Friendly Program After Doctor’s Baby Was Harmed

Baby-Friendly: Failure and the Art of Misdirection

Information for Hospitals: Ensuring Safety for Breastfed Newborns

Fed is Best Statement to the USDA Regarding the Harms of the Baby-Friendly Hospital Initiative

 

 

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The Loss Of Our Son Has Devastated Our Family – This Time I Will Be Supplementing With Formula After Every Nursing session

I had a beautiful, healthy pregnancy with Bryson, with the help of Clomid (a fertility drug), like my first pregnancy with my daughter. After about 31 hours of induced labor, Bryson was here. Seven pounds, twelve ounces, and seemingly healthy! He latched like a champ immediately, and we had zero complications of any sort while in the hospital. He had wet and dirty diapers and was breastfeeding well, every 2–3 hours. His discharge weight was 7 lbs, and I had a follow-up appointment scheduled for two days later.

NEWT is the first tool that allows pediatric healthcare providers and parents to see how a newborn’s weight during the first days and weeks following childbirth compares with a large sample of newborns, which can help with early identification of weight loss and weight gain issues. Bryson was discharged with a weight loss of 9.7 percent at 36 hours of age. The NEWT graph indicates his weight loss was excessive.

The first two days at home were easy. He was a sleepier baby than my daughter was, and unless wet or hungry, he was calm. I continued to breastfeed him for 20 minutes every three hours as instructed. I did begin to notice that his newborn onesie seemed quite big on him. His wet diapers did slow down on the third day, and he hadn’t pooped since the third day either. At two in the morning on July 29th, at four days postpartum, I tried to breastfeed again, but he was just too sleepy to nurse, and he would not latch no matter how hard I tried. I tried so many times, different ways, different positions. I thought he would eventually latch but he just wanted to sleep. I thought, well I can’t force-feed him, so I’ll try again after he rests a little more. I tried several times after that, and he was just less and less interested.  He had started to get pale and lethargic. It was also the day of his two-day post discharge checkup at the hospital, so I decided to take him in early, since I was getting concerned. 

During the whole drive there, I felt in my heart that time was of the essence. After the nurse checked him, she said he would have to be admitted, as he didn’t look too good, and his weight had dropped to 6 lbs 9 oz; he had lost over a pound in the four days since his birth. She turned her back, and I noticed he stopped moving. I hesitantly asked, “Is he breathing?” She turned around and yelled, “no!” then fumbled and fumbled to open a plastic bag; I finally screamed at her: “do something!” She picked him up and ran him down the hall. 

Bryson’s weight loss was 22 percent.

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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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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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Dr. Christie del Castillo-Hegyi and Jillian Johnson Speak at the 2020 USDA Dietary Guidelines Meeting

July 17, 2019

 

Washington, DC — On July 11, 2019, Dr. Christie del Castillo-Hegyi, Co-Founder of the Fed is Best Foundation and Jillian Johnson, Fed is Best Advocate and mother to Landon Johnson, who died from hypernatremic dehydration while exclusively breastfeeding, traveled to Washington, DC to provide testimonies to the 2020 USDA Dietary Guidelines Advisory Committee. This is the first year that the Dietary Guidelines for Americans (DGA) have included pregnancy and birth to 24 months.

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I Begged for Food for my Baby and I Begged for Nipple Relief at my BFHI Hospital

It was on December 13th at 2:30 in the morning. My water broke as I was sleeping. I woke my husband up and the panic set in. My son was a scheduled C-Section due to the fact he was breech and he was going to be a big baby according to all the scans. I was scheduled for the 18th, which was my birthday, but he decided to come early. My husband and I rushed to St. Joseph’s Hospital in Tacoma, WA. This hospital was a “Baby-Friendly” hospital, which meant they push things like exclusive breastfeeding, no pacifiers, and no nurseries. I didn’t think much of these things at the time, as I was a first-time mom and hadn’t pondered on them much. On paper, this all sounded great, and I was excited to go there. I had a simple birth plan: no circumcision and I wanted my husband in the operating room. That was it really. I trusted the doctors and nurses there to help me out.

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My Baby Went Through Hell And Suffered Needlessly From Starvation

Jenn T.

My son was born on February 18, 2019. He was 6 lbs 10 oz and had a little trouble regulating his temperature at birth. But after 24 hours, he was okay. I was always told breast was the best way to go. I never breastfed my 9 year old so this was my first experience with it.

My son had latching issues at first and it caused major pain and bleeding. But after latch correction and using nipple shields, the pain dissipated. When we left the hospital, my son weighed 6 lbs (9.3 percent weight loss) and at his checkup the next day, he had gained half an ounce.

At home I was feeding straight from my breasts, every time. My son was content and seemed happy.  He smiled and was great the entire time, so I thought. I didn’t pump to see how much milk I had because the hospital where I delivered told me pumping in the first 6 weeks could cause confusion for the baby with latching.

Now fast forward to when he was 21 days old. He had his three week checkup and he was extra sleepy that morning. When we got to the doctor, and not only did he lose weight, (down to 5.5 lbs), but he also had a temperature of 92 degrees. He was hypothermic! So they sent us urgently to the children’s hospital in Nashville. Continue reading

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An Evaluation Of The Real Benefits And Risks Of Exclusive Breastfeeding.

by Alexandria Fischer, PhD candidate at the Rensselaer Polytechnic Institute, studying synthetic microbial communities

It’s a mantra we have all heard, on repeat. “Breast is best.” But what does that really mean? Moms are bombarded by messages about the benefits of breastfeeding, such as increased intelligence, less illnesses, and a decreased risk of cancer. But what mothers are not told, is the quantifiable proof of these benefits.

The paper “Is the “breast is best” mantra an oversimplification?“, published in the Journal of Family Practice in July 2018, sought to critically evaluate claims of breastfeeding benefits in an effort to truly understand them. These authors note that the same data has produced a wide range of conclusions about the reported benefits of breastfeeding. They sought to tease apart what variables were truly impacted, and which were not. In this review the authors determined the number needed to treat (NNT) for a myriad of health issues that are often claimed to be reduced by breastfeeding. The NNT simply means how many babies need to be breastfed in order for one baby to benefit. We need to use caution when examining NNTs because they cannot make a causal determination, meaning they cannot be used to say “breastfeeding prevented this infection” they are simply used to determine a correlative relationship.

“The NNT (numbers needed to treat) simply means how many babies need to be breastfed in order for one baby to benefit.”

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Fed is Best Foundations Statement to USDA Healthy People Goals 2030

Christie del Castillo-Hegyi, M.D.

From December 2018 to January 2019, the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 published the proposed Healthy People 2030 Objectives for public comment. Of note, the proposed Healthy People 2030 objectives saw a marked change from the 2020 objectives, namely a reduction of the breastfeeding objectives from 8 goals to one, namely, “Increase the proportion of infants who are breastfed exclusively through 6 months” (MICH-2030-15 ). Among the objectives that were dropped from the list were:

  1. MICH-23 – Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life.
  2. MICH-24 – Increase the proportion of live births that occur in facilities that provide recommended care (i.e. Baby-Friendly Hospital Initiative-certified hospitals) for lactating mothers and their babies.
Healthy People 2020 ObjectivesBaseline (%)Target (%)
Increase the proportion of infants who are breastfed (MICH 21)
Ever74.081.9
At 6 months43.560.6
At 1 year22.734.1
Exclusively through 3 months33.646.2
Exclusively through 6 months14.125.5
Increase the proportion of employers that have worksite lactation support programs (MICH 22)2538
Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life (MICH 23)24.214.2
Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies (MICH 24)2.98.1
We applaud the removal of the last two objectives as patient safety issues have emerged from those two objectives, namely increased rates of neonatal jaundice, weight loss, hypoglycemia and dehydration readmissions. We have submitted the following statement regarding the Healthy People Goals for 2030 requesting for a revision of the current proposed objective and the addition of two new objectives.

Exclusive breastfeeding at discharge is a major risk factor for severe jaundice and dehydration. Both conditions can require in-hospital treatment and can result in permanently impaired brain development. Photo Credit: Cerebral Palsy Law

 

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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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