As a young girl, I knew something was wrong with my breasts when they began to develop. I had asymmetric tubular breasts, and it quickly became my biggest insecurity. At the age of 20, I saw a doctor who told me a breast augmentation would “fix” them. Trusting her medical opinion I had breast augmentation surgery. Now they were double the size and sagging from the weight of the implants. It was worse than what they originally were, making my anxiety and insecurities heightened. After a few years, I decided to get them removed by another doctor who specializes in reconstruction surgeries. I got the implants taken out, a lift of the skin and fat removed from my stomach to fill the empty pouches. With two surgeries comes many scars and of course trauma to the breast tissue.
“Tubular breasts” is the name of a condition caused by breast tissue not proliferating properly during puberty. The condition is also called tuberous breasts or breast hypoplasia.
While not extremely common, tubular breasts cannot be considered rare because many women don’t seek treatment. While tubular breasts don’t pose any direct threat to your health, some womenmay seek to correct it. Tubular breasts can also present problems for women who wish to breastfeed. (source Healthline)
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.
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.
In October of 2017, I was skimming Facebook and came across a question in one of my favorite Infant Safe Sleep support groups. A new mother was having a hard time with breastfeeding and was looking for an evidence-based breastfeeding group that supported safe sleep for infants. When she got very little feedback, I began to think about creating a Facebook support group for safe sleep practices and breastfeeding because I knew there were plenty of mothers who wanted to exclusively breastfeed while practicing safe sleep.
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.
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. Continue reading →
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.
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 →
This story is for you mommas whose mental health feels like it comes second to breastfeeding, when it should be first.
I have a long history of mental illnesses in my family. I inherited most of them. While they do not define me, they are a part of me. I have Bipolar 1 Disorder, Generalized Anxiety Disorder, Borderline Personality Disorder and a Panic Disorder.
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:
MICH-23 – Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life.
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
Increase the proportion of infants who are breastfed (MICH 21)
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