“Is Baby-Friendly Safe?”: BFHI Safety Issues Discussed at National Neonatology Conference

Las Vegas, Nevada — On September 6, 2018, the national neonatology conference, “The Fetus and Newborn Conference” was held in Las Vegas, Nevada. Among the speakers was Jay Goldsmith, M.D., Neonatologist and Professor of Pediatrics at Tulane University, Member of the American Academy of Pediatrics Section on the Fetus and Newborn who gave a talk entitled, “Is Baby-Friendly Baby Safe?”

In the talk, he discussed the case of an Oregon woman who has filed an $8.6 million lawsuit against her hospital, Portland Adventist Medical Center, and a nurse who cared for her and her baby after accidentally suffocating her newborn after falling asleep with him in her hospital bed. According to the Washington Post, she had delivered her son by cesarean section a few days earlier and was given narcotic pain medication and sleep aids. A nurse gave her newborn to her while she was still drowsy and groggy to breastfeed in her hospital bed. About an hour after being left to breastfeed, the baby was found gray, not breathing with compromised vital signs in the mother’s arms after which he was rushed to the nursery. The baby received CPR and was put on life support but the child sustained severe and permanent brain injury. He ultimately died at 10 days of age. Continue reading

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How I Learned That Fed is Best

by Jen Gamarano

I hate to admit it, but before I got pregnant, and even when I was pregnant, I was already a judgmental mom. I started watching documentaries about natural birth and breastfeeding years before I even entertained the idea of having children because it fascinated me. Women’s bodies are amazing. We are capable of growing, birthing, and feeding a brand new life and I was on board for doing all of it naturally because biology is perfect and I was made to do this – or so I thought. I looked at moms who opted for epidurals and thought “If only they knew about natural birth and how amazing it is”, or those who formula fed and thought  “How sad” because breast milk is magical and formula will never be able to measure up. I hate to admit these things, but I have to admit them so you know just how much this journey has changed me.

Our birth plan was simple – deliver at the birth center with our doula and midwife, stay there for four hours, go home, breastfeed forever, be happy. I’m lucky to have had a fairly short labor of nine hours, but afterwards was nothing like I’d imagined. I ended up transferring to the hospital to repair a third degree tear. Lovely, I know.

We started to breastfeed at the hospital, and it hurt like they all said it would. L. had trouble latching but he was still nursing so I just tried to be patient. I had a rough first few days as my body tried to balance out hormones. I was shaky, hot, sweaty, mad, sad, and all-around miserable. I called the midwife who told me this was normal and advised me to stay in bed and “breastfeed, breastfeed, breastfeed”. So I did. The next day, my son started crying like crazy when I tried to latch him, and refused to nurse for a full 24 hours. The pediatrician told us to supplement with formula and I gave in because I felt sick, tired, and good lord, I wasn’t going to starve my child.

“The next day, my son started crying like crazy when I tried to latch him, and refused to nurse for a full 24 hours.The pediatrician told us to supplement with formula and I gave in because I felt sick, tired, and good lord, I wasn’t going to starve my child.”

When he finally started to latch again, it was clear that I didn’t have enough for him. He would get sleepy after only a few minutes of nursing, sleep for a few minutes, and then wake up crying and wanted to eat again. I spent a couple days feeding him every 15 minutes and didn’t wear a shirt or see anyone during that time. I met with a lactation consultant who listed a whole slew of things that could potentially be wrong with him. I also learned that I had an infection on my nipple and he developed thrush, which made all of this infinitely more complicated and painful. I was still determined to breastfeed, so we saw two lactation specialists, an ENT and Osteopath to evaluate the little guy, and I tried every natural remedy in the book. I took supplements and tinctures, drank dark beer, pumped multiple times in an hour, saw another lactation specialist, ate almonds, stayed hydrated, pumped, nursed, pumped, nursed, until I just couldn’t do it anymore. I got to the point where I just said without emotion “tried it” whenever someone gave me advice to increase my supply. I was exhausted. I woke up to pump every morning and sobbed because I would only get dribbles and my baby just wasn’t getting that ever so magical breast milk despite all my best efforts.

I’ve heard so many different opinions about my son and I on our journey that I don’t think I can definitively say what the root cause of all of this was. The opinion that made me feel the most at ease was from our ENT who flat out said that not every baby is a fit for every breast. Until then, I’d been conditioned to think that since I was a woman, breast feeding would be the most natural thing I’ve ever done. I forgot in all of this that all humans are different and that’s part of the beauty of life. I had to stop blaming my baby, and I had to stop blaming myself for “failing” at this. I had to give up the notion that this was, in fact, a failure, because it wasn’t.

This journey made me bake myself an entire humble pie and eat every last crumb. I started to look at breastfeeding and motherhood from a much different perspective. I came to terms with the fact that feeding my baby formula and the tiny bit of breast milk I did have was infinitely better than having a baby that couldn’t thrive and a sobbing mommy. I became grateful that I live in a time where formula exists to provide nourishment to my child.

“I became grateful that I live in a time where formula exists to provide nourishment to my child.”

Every mom out there is incredible. I’m proud of moms who breastfeed exclusively. I’m proud of moms who use formula. I’m proud of moms who do both. I’m proud of moms who have natural birth. I’m proud of moms who use modern medicine to take away the horrible pain. I’m proud of every mom who chooses to do the best thing for her baby and herself. The sisterhood of motherhood is incredible and I’m grateful to be a part of it and share my story.


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 the Fed is Best Volunteer group to help us reach Obstetric Health Providers to advocate for counseling of new mothers on the importance of safe infant feeding.
  2. 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.
  3. 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 resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. 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.
  7. Send us your stories. Share with us your successes, your struggles and every thing 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.
  8. 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.

Donate to Fed is Best

Thank you so much from the Founders of the Fed is Best Foundation!

 

 

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Response to Baby-Friendly USA Regarding Rates of Hyperbilirubinemia Among Exclusively Breastfed Newborns

Christie del Castillo-Hegyi, M.D. and Jody Segrave-Daly, RN, IBCLC

We at the Fed Is Best Foundation give mothers across the globe a platform to tell their stories about how their babies suffered needlessly because they were denied information and supplementation for their hungry babies while under the care of the Baby-Friendly Hospital Initiative/WHO Ten Steps to Successful Breastfeeding protocol. Our Foundation has grown rapidly and demands significantly more time than we currently have because we are a 100% volunteer organization.  We are inundated with messages from mothers, health professionals and media on a daily basis. We try very hard to prioritize what we can do collectively, every single day. Our first priority is to respond to mothers in crisis who contact us needing assistance on how to safely feed their distressed breastfed baby because they were not educated on appropriate supplementation. Baby Friendly USA (BFUSA) found time to critique our interpretation of studies and written materials, so we were forced to take time away from mothers to update written materials and clarify our interpretations. Our goal is to be completely transparent and we have provided our detailed response below with corrections and clarifications given publicly available published data. If there have been errors in interpretation of published information, then we go back to the original published data to provide better data for the public, which we have done below. We believe we have a responsibility to inform parents, the public, medical insurance companies and BFHI hospitals about the risks of exclusive breastfeeding when insufficient. We believe parents deserve to know that the BFHI has an exclusive breastfeeding (EBF) threshold mandate to meet if the hospital wants to remain credentialed. The mandate results in tens of thousands of newborn admissions every year in the U.S. alone, which we chronicle on our page. For the safety of infants across the globe, we will continue to provide education on how to recognize serious complications of exclusive breastfeeding and how every parent can prevent them.

Starvation jaundice (hyperbilirubinemia) of the newborn is defined as abnormally high bilirubin in a newborn who loses >8-10% weight. It is caused by insufficient elimination of bilirubin due to insufficient caloric intake from exclusive breastfeeding in the first week of life. This well-established phenomenon has been discussed by neonatologist Dr. Lawrence Gartner, who is listed as a Director on the Baby-Friendly USA website, in a lecture given to lactation consultants (not just physicians and nurses as stated by BFUSA) at a 2013 California Breastfeeding Conference, previously posted on their website. This public lecture was provided to educate lactation consultants regarding dangerous levels of jaundice that can occur in previously healthy breastfed babies that result from inadequate intake of calories from exclusive breastfeeding. Under Fair Use laws, dissemination of educational material for non-profit educational purposes is protected and we were subsequently asked to post the full lecture by Dr. Gartner via email. The Academy of Breastfeeding Medicine jaundice protocol acknowledges that exclusively breastfed newborns are at higher risk of hyperbilirubinemia from insufficient milk intake (“suboptimal intake”) and excessive weight loss. The vast majority of newborn hyperbilirubinemia is caused by starvation jaundice. Their protocol also states that 98% of kernicterus, or the most severe form of brain injury from jaundice, occurs in breastfed newborns. Nearly all of starvation jaundice can be prevented with timely and adequate supplementation. Nearly all newborns with starvation jaundice show signs of poor feeding including excessive crying and frequent, unsatisfied nursing or lethargy before they develop levels of hyperbilirubinemia that result in impaired brain development. While BFUSA has not previously denied the increased risk of hyperbilirubinemia in breastfed newborns, they have not routinely disclosed them to parents or subscribing hospitals, which has the unfortunate effect of causing hospitalizations that would have been prevented by supplementing a crying underfed newborn. Unfortunately, many parents and health professionals are taught that the signs of poor feeding including crying and hours of unsatisfied nursing are normal, widely known as the “Second Night Syndrome.” These unfortunately are also the earliest signs of other complications like acute bilirubin encephalopathy, kernicterus, hypernatremic dehydration and hypoglycemia, all known causes of brain injury and permanent disability, which can occur if those signs are overlooked as normal and supplementation is avoided in order to meet the goal of exclusive breastfeeding.

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WHO 2017 Revised Guidelines Provide No Evidence to Justify Exclusive Breastfeeding Rule While Evidence Supports Supplemented Breastfeeding

Christie del Castillo-Hegyi, M.D.

The WHO health policy that has been responsible for millions of preventable hospital admissions of newborns for insufficient feeding complications is Step 6 of the Ten Steps to Successful Breastfeeding: “Give no additional food or fluid other than breast milk unless medically indicated.” Complications of insufficient feeding from exclusive breastfeeding before copious milk production are now among the leading causes of newborn extended and repeat hospitalization, namely jaundice (hyperbilirubinemia), dehydration and hypoglycemia.

In 2017, the World Health Organization published its guidelines updating its recommendations for “Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services,” which outlines the evidence for the WHO recommendations on breastfeeding support for newborns in health facilities based on the Ten Steps to Successful Breastfeeding. Here is the evidence presented to justify the recommendation to avoid supplementation in breastfed newborns.

The WHO guidelines authors went on to conclude the following:

How did very low quality of evidence turn into moderate quality evidence for exclusive breastfeeding particularly when the evidence showed improvement of breastfeeding rates in supplemented breastfed newborns? Continue reading

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Jillian Johnson: My Message To Parents During World Breastfeeding Week

By Jillian Johnson

It took all of the courage I had to put aside the debilitating amount of guilt I carried for five long years to tell sildenafil cost—his birth, the first days of his life and how he died. In fact, I still don’t know where I found that courage, but I am convinced Landon gave me the strength. I wasn’t prepared for the intense scrutiny my story received. I was utterly shocked because people came out of nowhere to discredit my story with a vengeance, but I quickly learned how to be gracious in such a vulnerable time.

After all, nothing anyone could say to me could hurt me more than the death of my newborn baby.

I can remember a very specific time, when I was sitting in the waiting room of the hospital and Landon was on life support. My dad was there with me and we were talking about Landon’s prognosis and I won’t ever forget him telling me what a special little boy he was and that he would do great things. I couldn’t quite wrap my head around what his words meant because Landon was most likely going to pass away, and my dad was talking about how he’s going to do great things. I never dreamed that his death would change the lives of so many people across the globe. Continue reading

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Fed is Best Foundation Response to U.S. Delegation Actions at the World Health Assembly

Jody Segrave-Daly, RN, IBCLC and Christie del Castillo-Hegyi, M.D.

The Fed is Best Foundation is dedicated to ensuring safe infant feeding for every single child, a goal that can be achieved with exclusive breastfeeding, combination feeding, exclusive formula feeding and tube-feeding. We have no political affiliation. We support all mothers to help their infant thrive with safe, sufficient and sustainable feeding in order to protect their health and optimize brain development. Recent news has broken about the U.S. delegation at the 71st World Health Assembly opposing the first draft of the Infant and Young Child Feeding resolution. We have provided a line-by-line break down of the first draft of the resolution, which was set to be proposed by delegates from Ecuador, as well as the proposed draft submitted by the U.S. delegation along with our interpretation of the lines that the U.S. delegates opposed.

In an editorial published in the New York Post, two pediatricians, Dr. Alma Golden and Dr. Brett Giroir,  who were key members of the U.S. delegation attending the 71st World Health Assembly, wrote about the rationale for the U.S. opposition of the first draft:

As pediatricians, US representatives at this year’s World Health Assembly in Geneva and supporters of breastfeeding throughout our professional careers, we were shocked to read recent headlines, in the New York Times and elsewhere, claiming that the administration has somehow called into question the importance of breastfeeding for infants.

The administration fully endorses breastfeeding, and the agencies where we work — Health and Human Services and USAID — communicate this unequivocally…We don’t just affirm these priorities in formal conference rooms in Geneva. For years, the US government…has invested millions of dollars to promote breastfeeding both at home and abroad.

All of which is to say: Breastfeeding wasn’t in dispute in Geneva. Rather, we raised objections to an early draft of the resolution we eventually supported, which made references to a controversial 2016 guidance document. The underlying policy goal of this guidance is unsupported by US nutrition guidelines and inconsistent with the practice of most families in our country…

In particular, the guidance recommends that countries impose stringent new regulations on the marketing of any commercially produced foods suggested for children between 6 months and 3 years old. Such restrictions, in our view, prevent parents from having access to all the factual information they might need. The guidance even advocates for the prohibition of free samples of formula — including in countries and conflict zones where supplies of formula could help save babies’ lives.

Most important, there are good and valid reasons, both medical and personal, why some mothers cannot breastfeed, or choose not to breastfeed exclusively. This is particularly true in situations where displacement, other trauma or malnutrition have made it impossible for mothers to breastfeed their children, and these babies’ lives are at risk without formula or other nutritional supplementation. Parents in these dire situations need all the information and choices available.

The issue of child malnutrition occurring in war torn countries has been reported on by CNN reporter Gayle Lemmon in her article, “Don’t make babies rely on breast milk in war zones,” where she interviewed members of Doctors Without Borders who reported taking care of many infants suffering from severe malnutrition as a result of the strict restrictions of the World Health Organization and UNICEF on formula donations.

‘Over the past couple of weeks we’ve seen an increase in the number of malnourished children needing treatment,” Doctors Without Borders’ Iraq country director Manuel Lannaud said in an interview released on the group’s Web site.

The surprising thing is that Lannaud and his colleagues at the humanitarian aid group didn’t place the blame for these underfed little ones just on war and the fact that the city was under siege. They also put the blame on other international organizations and policies that seek to do good.

“It isn’t a problem of access to food. The malnutrition we see here is primarily due to the scarcity of infant formula,” Lannaud wrote. “International organizations like UNICEF and the World Health Organization (WHO) promote breastfeeding … and provide infant formula, but only by prescription. We believe that distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalized for malnutrition.”

Doctors Without Borders says it agrees that breastfeeding promotion is a priority, but one that comes after dealing with the immediate crisis of a baby’s survival. Says Lannaud, if mothers “need formula, we give it to them.”

The mothers who need it are those facing down life-and-death situations each day, often while caring for multiple children in the shadow of war. That giving infant formula to them is so controversial speaks to a policy tripwire few outside the humanitarian realm even know exists: global “breastfeeding first” policies.

The WHO breastfeeding policies are not without flaws and aggressive promotion of exclusive breastfeeding has resulted in harm, namely an epidemic of newborn hospitalizations for jaundice, dehydration and hypoglycemia, known causes of brain injury and developmental disability, in the U.S. and across the globe. In addition, there has been a rise in accidental suffocation of newborns, called Sudden Unexpected Postnatal Collapse, from prone positioning during to skin-to-skin care and breastfeeding, made worse by maternal exhaustion from 24/7 rooming-in, practices encouraged but the WHO Ten Steps and by Baby-Friendly policies. The promotion of exclusive breastfeeding from birth has contributed to an epidemic of neonatal jaundice in the developed and developing world, which has contributed to an epidemic of perinatal brain injury and cerebral palsy particularly in the developing world, where few health care resources are available to monitor and treat exclusive breastfeeding complications. Promoting exclusive breastfeeding from birth over the local, traditional practices of supplemented breastfeeding (with wet nursing, animal milk or sugar water) until the onset of copious milk production has discouraged a practice that breastfeeding mothers used to prevent hunger and starvation-related complications like jaundice, dehydration and hypoglycemia, which now are the leading causes of newborn rehospitalization in the world.

Incidence of severe neonatal jaundice (bilirubin ≥ 20 mg/dL) in Low- and Middle-Income countries. The data reported correspond to hospital statistics. [Greco, et al, Neonatology 2016;110:172-180]

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Moms Thank The Fed Is Best Foundation For Safe Infant Feeding Support

Every day we hear stories from parents who were able to feed their babies safely and confidently with our help.  These stories are the fuel that fills our hearts and motivates our volunteers and advocates to continue our important work to teach parents and healthcare providers about safe infant feeding, and giving babies what they need to thrive and have the best possible start.

#fedisbest #safebreastfeeding #thrivingisbest  #fedismaximum

Read on for their words of thanks and encouragement:

Do you have a #fedisbest story? We’d love to hear from you. Send us your stories.

There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:

  1. Join the Fed is Best Volunteer group to help us reach Obstetric Health Providers
  2. Make a donation to the Fed is Best Foundation.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.
  3. 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 resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. 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.
  7. Send us your stories. Share with us your successes, your struggles and every thing 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.
  8. 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.
  9. Shop and Fed is Best Foundation will earn cash back! We hope to develop our online safe infant feeding classes with these funds.
  10. If you need support, we have a private support group – Join

We believe all babies deserve to be protected from hunger and thirst every single day of their life and we believe that education on Safe Infant Feeding should be free. If you would like to make a donation to support the Fed is Best Foundation’s mission to teach every parent Safe Infant Feeding, please consider making a one-time or recurring donation to our organization.

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Starvation Jaundice and Bilirubin-Induced Brain Injury in Breastfed Newborns

Lecture Delivered by Dr. Lawrence Gartner, Director of Baby-Friendly USA

We have uncovered a lecture provided to lactation consultants at a prominent breastfeeding conference given by Baby-Friendly USA Director, Dr. Lawrence Gartner, who discussed the risk of brain injury from starvation-related jaundice, called kernicterus, 90% of which occurs to breastfed babies who lose excessive weight, according to his lecture. Yet despite this training, no information on the risk of preventable brain injury from starvation-related jaundice in breastfed newborns exists in patient-directed breastfeeding literature published by breastfeeding advocacy groups other than our own.

 

 

 

 

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The Fed is Best Foundation’s Top Priority is Saving Babies’ Lives

Christie del Castillo-Hegyi, M.D., Co-Founder of the Fed is Best Foundation

In response to a letter written by 1000 Days director, Lucy Martinez-Sullivan and follow-up editorial from Kimberly Seals Allers, we wanted to take an opportunity to set the record straight.The mission of the Fed is Best Foundation is to protect infants from complications and injuries resulting from accidental starvation under currently promoted breastfeeding policies. In order to protect infant safety and ensure the patient and human rights of mothers and babies, we have built a non-profit organization committed to: (1) the study of exclusive breastfeeding complications that can result in brain injury and, in the most severe instances, death; and (2) raising public awareness to signs of infant hunger and the consequences that can result based on peer-reviewed research.

As part of our public health awareness commitment, the Fed is Best Foundation has developed and compiled extensive resources for parents and health professionals to promote safe breastfeeding and safe infant feeding policies based on evidence, including, the science of infant feeding, the caloric and fluid requirements of newborns and the caloric yield of exclusive breastfeeding. These core matters of infant feeding are shockingly absent from current breastfeeding curricula and protocols. Our Foundation is not against breastfeeding; it is for safe breastfeeding and close monitoring to prevent complications and injuries to infants reported in the medical literature, the media and by the thousands of mothers who have sent us their stories, which we receive each and every day. Continue reading

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Why the Academy of Breastfeeding Medicine Guidelines for “Medically Necessary” Supplementation Make the Baby-Friendly Hospital Initiative Unsafe

by Christie del Castillo-Hegyi, M.D., Co-Founder of the Fed is Best Foundation

On September 22, 2017, senior members of the what is clomid. We learned that the WHO has never studied the complications of the WHO Ten Steps to Successful Breastfeeding and the Baby-Friendly Hospital Initiative (BFHI). We learned they have no studies commissioned to monitor the complications. Despite being presented data on the complications caused by allowing newborns to fast for days to achieve exclusive breastfeeding, they declined our offer to help make the guidelines safer and more ethical.  To watch the presentation given to the WHO officials, please go to this link. We learned that they have known about the risks of brain injury from exclusive breastfeeding and yet refuse to inform the public and health professionals. We learned that their provision for preventing brain injury consisted of telling health professionals to look out for “convulsions, lethargy and being unable to feed,” which are late signs of newborn brain injury. As a result, the WHO Ten Steps and the BFHI has created to an epidemic of infant feeding complications, hospitalizations, brain injury and disability in the developed and developing world. This constitutes one of the largest and most egregious violations of patient and human rights in the history of public health. They have asked for comments from the public regarding their draft revision of the breastfeeding guidelines, which make no changes to the recommendation, “give infants no food or drink other than breastmilk unless medically indicated,” while providing patients no information on the risks of avoiding supplementation. This is the official response of the Fed is Best Foundation to their request. Continue reading

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