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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World Health Organization Revised Breastfeeding Guidelines Put Babies at Risk Despite Pleas from Experts—Informing the Public “Not a Top Priority”

By the Senior Advisory Board of the Fed is Best Foundation

A key recommendation of the 1989 World Health Organization Ten Steps to Successful Breastfeeding which guides the Baby-Friendly Hospital Initiative (BFHI) is: “give infants no food or drink other than breast-milk, unless medically indicated.” This has led to serious complications from accidental starvation of babies, including dehydration, hyperbilirubinemia (jaundice) and hypoglycemia (low blood sugar) — known causes of infant brain injury and permanent disability. Last week, the WHO issued draft revised breastfeeding guidelines, failing to revise this recommendation. These guidelines define the standard of care for breastfeeding management in all healthcare facilities worldwide. Nearly 500 U.S. hospitals and birthing centers and thousands more worldwide that meet the criteria of the BFHI are certified as Baby-Friendly, adhering to the application of the WHO’s Ten Steps.

On Sept. 22, 2017, senior members of the Fed is Best Foundation, and guests including a neonatologist from a leading U.S. tertiary care hospital and a pediatric endocrinologist, Dr. Paul Thornton, M.D, from Cook Children’s Hospital Fort Worth, lead author of the Pediatric Endocrine Society’s newborn hypoglycemia guidelines, met via teleconference with top officials of the WHO Breastfeeding Program: Dr. Laurence Grummer-Strawn, Ph.D., Dr. Nigel Rollins, M.D. and Dr. Wilson Were, M.D. to express their concerns about the complications arising from the BFHI Ten Steps and to ask what, if any, monitoring, research, or public outreach the WHO has planned regarding the risks of accidental starvation of exclusively breastfed newborns. The Foundation members who attended were 1) Christie del Castillo-Hegyi, MD, Co-Founder, 2) Jody Segrave-Daly, RN, IBCLC, Co-Founder, 3) Julie Tibbets, JD, Partner at Alston & Bird, LLP, Pro-Bono Attorney for the Foundation, 4) Brian Symon, MD, Senior Advisor, and 5) Hillary Kuzdeba, MPH, former quality improvement program coordinator at a children’s hospital, managing infant feeding projects and Senior Advisor.

Emails confirming meeting between the WHO and the Fed is Best Foundation available here.

Continue reading

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Fear NOT Facts Contained in Baby-Friendly Formula Feeding Waiver Forms

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

The primary reason why newborns experience starvation-related complications every single day as a result of the Baby-Friendly protocol is because the complications associated with the protocol are hidden from mothers who seek to breastfeed.  The primary objective of the Baby-Friendly Hospital Initiative is high exclusive breastfeeding at discharge.  Unfortunately, because the rates of insufficient breast milk and delayed lactogenesis II are high among mothers, the necessary consequences of hospital policies that seek high EBF at discharge rates are higher starvation-related complications like hyperbilirubinemia, hypernatremia, dehydration and hypoglycemia, all of which can cause newborn brain injury and permanent disability.  Below is an example of the way mothers are made to fear formula supplementation while the risks of NOT supplementing are hidden.  This is a waiver form published on the California Department of Public Health Website to provide an example of a model formula waiver form for hospitals.

Here are examples of FEAR not FACTS contained in formula feeding waiver forms that Baby-Friendly hospitals require moms to sign before they allow a newborn to be formula-fed.

1. FEAR: Supplementation CAUSES delayed milk production.

FACT: The known risk factors for delayed milk production include being a first-time mom, cesarean delivery, flat or inverted nipples, higher BMI > 27, prolonged stage II of delivery (when a mom pushes to deliver), having a large baby, excessive blood loss, being an older mom > 30, PCOS, diabetes, hypothyroidism, insufficient glandular tissue, retained placenta to name a few. While supplementation may be ASSOCIATED with delayed milk production, supplementation is in fact a REFLECTION of the need to supplement a baby who is being underfed due to delayed copious milk production.  (Pediatrics 2003, 112 (3 Pt 1): 607-19)

2. FEAR: Not exclusively breastfeeding puts my child at risk of jaundice.

FACT: Exclusive breastfeeding is among the highest risk factors for excessive jaundice requiring phototherapy admissions according to the American Academy of Pediatrics and 10-18% of exclusively breastfed newborns experience starvation jaundice from insufficient milk intake according to the Academy of Breastfeeding Medicine. Exclusively breastfed newborns are at higher risk of jaundice than supplemented and formula-fed newborns due to the smaller volumes of milk they receive as milk helps the baby pass bilirubin into the stool. In fact one of the ways jaundice is treated and prevented is through supplemental milk feeding.
Pediatrics, July 2004, VOLUME 114 / ISSUE 1, BREASTFEEDING MEDICINE, Volume 5, Number 2, 2010

3. FEAR: Not exclusively breastfeeding will cause my baby to be underfed

FACTS: In the largest studies of supplemented/formula-fed vs. exclusively breastfed healthy, term newborns from a large Baby-Friendly Hospital system, the exclusively breastfed babies lost almost twice as much as the supplemented/formula-fed babies. 10% of vaginally-delivered and 25% of cesarean-delivered EBF newborns lost excessive weight of >10% while NONE of the formula-fed newborns experienced this complication. In fact, exclusive breastfeeding at discharge is associated with an 11-fold higher risk of rehospitalization for dehydration and underfeeding.

Early Weight Loss Nomogram of Formula-Fed Newborns. Hospital Pediatrics May 2015, VOLUME 5 / ISSUE 5

Early Weight Loss Nomogram of Exclusively Breastfed Newborns.  Pediatrics January 2015, VOLUME 135 / ISSUE 1

Rehospitalization for Newborn Dehydration. Arch Pediatr Adolesc Med. 2002;156:155-161

4: FEAR: Supplementing will CAUSE low blood sugar and colostrum protects my baby from it.

FACT: In a study of newborns fed antenatally expressed colostrum along with direct latch feeding of colostrum when compared to those who did not receive expressed colostrum, the babies fed expressed colostrum in fact had higher rates of hypoglycemia requiring admission.  Lancet 2017, 389: 2204-2213

So NO, colostrum does not protect against hypoglycemia. In fact in the most recent study of EBF newborns, 10% had blood glucose levels low enough to increase risk of lower long-term academic achievement. An even older study on low blood sugar in EBF newborns, 53 out of 200 or 26.5% developed low blood sugar within the first 6 hours of life. What protects against hypoglycemia is providing a child their full caloric requirement, which is 100-120 Cal/kg/day to prevent them from running out of caloric reserve.

Study of Asymptomatic Hypoglycemia in Full Term Exclusively Breastfed Neonates in First 48 Hours of Life Journal of Clinical and Diagnostic Research. 2015 Sep, Vol-9(9): SC07-SC10
Association Between Transient Newborn Hypoglycemia and Fourth-Grade Achievement Test Proficiency: A Population-Based Study JAMA Pediatr. 2015;169(10):913-921.
Nutritional management of newborn infants: Practical Guidelines. World J Gastroenterol 2008 October 28; 14(40): 6133-6139      

5. FEAR: Introduction of cow’s milk will lead to cow milk protein allergy.

FACT: In a study of over 13,000 children, earlier introduction within the first 2 weeks of life of cow’s milk REDUCED their risk of cow milk protein allergy by 19-fold.

Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy.  J Allergy Clin Immunol. 2010 Jul;126(1):77-82.e1.

6. FEAR: Exclusive breastfeeding is the ideal way of feeding every baby and there are no risks associated it, only risks of NOT doing it.

FACT: The most significant risks to a newborn’s life and brain come from the fasting conditions imposed by exclusive breastfeeding before full milk production and these risks are hidden from mothers to gain compliance with exclusive breastfeeding.

A review of 116 cases of breastfeeding-associated hypernatremia in rural area of central Turkey. J Trop Pediatr. 2007 Oct;53(5):347-50. Epub 2007 May 12.

Hypernatremic Dehydration in Breastfed Term Infants: Retrospective Evaluation of 159 Cases. Breastfeed Med. 2017 Jan/Feb;12:5-11.

Long-Term Neurodevelopmental Outcome of Neonates with Hypernatremic Dehydration. Breastfeed Med. 2017 Apr;12:163-168

Of Goldilocks and Neonatal Hypernatremia. Academy of Breastfeeding Medicine Blog.

7. FEAR: Just one bottle will ruin my child’s future health.

FACT: Just one bottle can save a child’s life and save them from a lifetime of disability.

If I Had Given Him Just One Bottle, He Would Still Be Alive.

Letter to doctors and parents about the dangers of insufficient exclusive breastfeeding

#FactsnotFear #FedisBest #BFHIShowMeYourFacts


The Fed is Best Foundation is dedicated to the prevention of newborn and infant starvation from insufficient exclusive breastfeeding. We do so by studying breastfeeding stories sent by mothers and the scientific literature on breastfeeding complications that lead to infant brain injury and death. Since the beginning of our campaign almost two years ago, we have received tens of thousands of newborn and infant starvation stories leading to the complications of hyperbilirubinemia, dehydration, hypernatremia,  hypoglycemia and failure to thrive. These complications occur because the current breastfeeding guidelines have not been studied for safety, operates with little awareness of the caloric and fluid requirements of newborns nor the amount transferred to babies until complications have already occurred. “Just one bottle” can save a child from these tragedies as it is often a mother’s first clue that a child is in fact starving from exclusive breastfeeding.

If your baby is experiencing distress and signs and symptoms of starvation, we encourage you to advocate for your child. We encourage mothers to notify hospital administrators if you are being pressured to avoid supplementation to alleviate your child’s hunger. You have the right to feed your child and your child has the right to be fed. No one but your baby knows how close they are to empty. The only way they can communicate distress is by crying. Listen to your baby and listen to your instincts.

Our message is simple. Feed your baby. Feed them as much as they need to stay safe and satisfied. Only they know what they need.

#FedisBest
Click on the infographic below to print for your reference.

For more information on how to protect your baby from feeding complications due to early exclusive breastfeeding, please read and download the Fed is Best Feeding Plan, a way to communicate your feeding choices to your health care providers.

In addition, please read and download the Fed is Best Weighing Protocol to prevent newborn dehydration and failure to thrive.

Lastly, for more detailed information, please watch our educational videos on Preventing Feeding Complications.

Our full list of parent resources can be found on our Resource Page.

If you wish to help parents learn how to protect their newborns from accidental starvation, please share this story and sign our petition to demand that the CDC, the AAP, the U.S. Surgeon General and the WHO/UNICEF Baby-Friendly Hospital Initiative warn parents about the dangers of newborn and infant starvation from insufficient exclusive breastfeeding. Go to https://fedisbest.org/sign-our-petition/.

 

 

 

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Breastfeeding Before Babies: The Baby-Friendly Hospital Initiative’s Unwillingness to Change or Accept Responsibility

BY CHRISTIE DEL CASTILLO-HEGYI, M.D., Co-Founder of the FEd is Best Foundation

Every patient-healthcare provider relationship is governed by four central principles of medical ethics, which are the following:

  1. Beneficence – Health care providers have the duty to provide care in a way that benefits a patient, increases their safety, their immediate and long-term health, and their comfort.
  2. Non-maleficence – First, do no harm. This principle requires that health professionals do not intentionally harm or injure a patient either through acts of commission or omission. If an intervention causes more harm to a patient than doing nothing, you do not intervene.
  3. Respect for Patient Autonomy – With any health care decision, the patient has the right to full disclosure of the risks and benefits of any intervention, regardless of how rare, so that they may act in their own or their children’s best interests to get the best outcomes with the least risk involved. Patient autonomy can only be fully realized if they are given honest and complete information on any and all the risks and benefits, whether common or rare, so that they may voluntarily choose, free of coaxing or coercion, in order to optimize their own or their children’s health outcomes.
  4. Respect for Human Rights – In 1948, the United Nations published the Universal Declaration of Human Rights, which subsequently charged governments, doctors and health workers to protect the human rights and human dignity of all people. It provides special protection of the physical integrity of those who are unable to consent, which includes children. These human rights include the right to food and water to prevent starvation and the associated injury to the brain and vital organs.

The Baby-Friendly Hospital Initiative has violated all four of these core principles of medical ethics through its policies and has reiterated its commitment to defending its dangerous policies over their commitment to patient safety in their recent dismissive response to Landon Johnson’s accidental starvation death caused by the Baby-Friendly policies. Continue reading

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Just One Bottle Would Have Kept My Baby Off Life Support: The Failure Of Baby-Friendly (BFHI) Care In Canada

My husband and I were the happiest people on earth to have just welcomed our healthy baby boy Ian into the world [born in an Ottawa Baby-Friendly hospital].   We were anxious first time parents. We had taken all the prenatal classes. I read the book “What to Expect When You’re Expecting” and we felt well-informed to approach this new chapter in our lives.  We made the decision that I would be breastfeeding as that was the “right” thing to do for our baby.  My baby latched on automatically and the nurses were impressed with how he was eating because he fed about every hour and would feed for at least 45 minutes.  I was nervous that I was not doing something right, and I continuously asked each and every nurse that came in to check on us if I was doing it right. I even asked them to just watch us while he fed and see if it was going okay. They all consistently replied, “You are doing great.”

katina2 (1)

Ian at 12 hours old.

The next morning came and I participated in a breastfeeding class held in the hospital by a lactation consultant (LC).  The class had about 20 new moms with their babies there and the LC asked us to have our babies latch on  and feed while she teaches and does her presentation.  Again, Ian automatically latched to me and the LC was impressed and commented that I was like a pro already and that he latched perfectly and was doing well.  I brought forward my concern to her as well, saying that he latches on about every hour or so for 45 min or more and she said, “That is great, he is a good eater!”  About 30 min into the 1 hour class,  all the other moms were sitting with their babies resting in their laps as they had all finished their feeding, but Ian was still latched onto me until the end of the class. The LC never brought anything up about the fact that if a baby is feeding for more than 30 minutes that means that they are probably not satisfied.   Furthermore, I asked the LC if I could start pumping and she told me “no,” that I had to wait 6 weeks before pumping and giving him a bottle because otherwise he wouldn’t want to breastfeed anymore and it would disrupt our breastfeeding.  So I kept my pump away as I was told, but this meant I had no idea how much milk I was producing (which later I found out was almost nothing). Continue reading

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If I Had Given Him Just One Bottle, He Would Still Be Alive.

by Jillian Johnson with commentary from Dr. Christie del Castillo-Hegyi

Landon would be five today if he were still alive. It’s a very hard birthday–five. It’s a milestone birthday. Most kiddos would be starting kindergarten at this age. But not my little guy. I wanted to share for a long time about what happened to Landon, but I always feared what others would say and how I’d be judged. But I want people to know how much deeper the pain gets.

I share his story in hopes that no other family ever experiences the loss that we have.

Jarrod and I wanted what was best for Landon as every parent does for their child. We took all of the classes. Bought and read all of the books. We were ready! Or so we thought….every class and book was geared toward breastfeeding and how it’s so important if you want a healthy child. Landon was born in a “Baby-Friendly” hospital. (What this means is everything is geared toward breastfeeding. Unless you’d had a breast augmentation or cancer or some serious medical reason as to why you couldn’t breastfeed, your baby would not be given formula unless a prescription was written by the pediatrician.)

Continue reading

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