Dying for Milk: The Pam and Chaz Floyd’s Story

By Pam Floyd, Mother and Fed is Best Advocate

Twenty-five years ago, Chaz, the son of Pam Floyd, was born and developed hypernatremic dehydration from insufficient breast milk intake while exclusively breastfeeding. Chaz developed brain injury from dehydration and now lives disabled with cerebral palsy. Their story was published on the front page of the Wall Street Journal. She was subsequently interviewed on 20/20, which prompted a similar feature on ABC’s Prime Time Live. Pam contacted the Fed is Best Foundation to share her story again to warn mothers of the dangers of insufficient feeding.

Chaz develop hypernatremic dehydration from insufficient feeding while exclusively breastfeeding

“25 Year Anniversaries Should Be Celebrated Not Served As A Warning”

Twenty-five years ago my son almost died.  He was only six days old. I had chosen to breastfeed, as everyone around me kept reminding me that ‘breast is best.’  So I followed their advice, and I exclusively breastfed. Even though I felt like something wasn’t quite right those first few days, everyone assured me everything was fine.  The nurses in the maternity ward suggested that since I was a new mother, I wasn’t able to appreciate how much he was getting. The home health nurse that visited me, courtesy of my health insurance, the day after I left the hospital, reassured me that as long as he was getting six to seven wet diapers a day, then he was getting enough. And the nurses in my pediatrician’s office told me not to worry, that he was a big baby that he would eat when he got hungry. And my personal favorite, “the great thing about breast milk is that you never have to worry about how much or how little he’s getting. Because he’ll always get what he needs.” Well, that works great, if your milk comes in.  My colostrum wasn’t enough for my son, Chaz. And my body never produced enough milk to keep a 10 lb. 4 oz. baby boy healthy.

Then when my son’s eyes started rapidly zig-zagging back and forth on that sixth day of life and I called the pediatrician’s office to tell them he was having a seizure, they told me that I didn’t know what I was talking about and that sometimes newborn’s eyes do that as they often wander.  Well, the pediatrician finally agreed to see us. We were immediately sent to the emergency room. Then we were transferred to the children’s hospital. There, my son was put into a drug-induced coma until his seizures were under control. His diagnosis was a stroke due to hypernatremic dehydration.  Children’s Hospital had me use their hospital grade breast pumps those first few days. The most I ever pumped was 3 cc’s. About a teaspoon. Usually, I just came back with mist. Or what looked like spit. There was never milk. I never got engorged. I never leaked. There was never any milk.

I got mad about this.  Especially when I found out that it can and does happen regularly.  It didn’t show up in any of my baby books or videos. So I called our local newspaper, The Virginian Pilot, and asked them to write an article about it, they did, it was called, “Mother Knows Best.” That was later revived by a journalist from The Wall Street Journal in an article entitled, “Dying for Milk: Some Mothers, Trying In Vain to Breast-Feed, Starve Their Infants — `Yuppie Syndrome’ Among Well-Meaning Parents Stems From Bad Advice — A Generation of Perfectionists.”  We made the front page with that one. Of course, that set off a media frenzy.
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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 Objectives Baseline (%) Target (%)
Increase the proportion of infants who are breastfed (MICH 21)
Ever 74.0 81.9
At 6 months 43.5 60.6
At 1 year 22.7 34.1
Exclusively through 3 months 33.6 46.2
Exclusively through 6 months 14.1 25.5
Increase the proportion of employers that have worksite lactation support programs (MICH 22) 25 38
Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life (MICH 23) 24.2 14.2
Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies (MICH 24) 2.9 8.1
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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Markers of Brain Injury is Present in the Blood of Newborns Requiring Phototherapy for Jaundice

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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