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Yes, 'Fed Is Best'. But There's Something Fishy About That Article

MINA BAIE

Many of us have seen the horrifying story of infant loss that has gone viral this week. I've seen posts on it in several parenting groups, where it has elicited outrage, heartbreak, and fear from readers. Losing a child is every parent's worst nightmare, and I can't imagine the added torture of knowing that your child's death was completely preventable. This story makes my stomach turn, partly because it hits a little too close to home for me.

 My daughter was severely underweight for months due to a tongue and lip tie that went unnoticed by three pediatricians, four nurses, a midwife, and three different hospital lactation consultants. As my baby fell further and further off of her growth curve, despite round-the-clock nursing, she became miserable, stressed, frantic. Those months were harrowing, and I will forever be grateful that we finally went to see an IBCLC, who quickly identified several structural issues that were preventing milk transfer. She was our angel. And my daughter began to thrive almost immediately after our first visit. 

The mother who authored this article, Jillian Johnson, was not so fortunate. Help arrived too late. In the article, she describes the guilt and anguish she still carries with her five years after her baby's death. She agonized over what could have been, if she had just given her sweet baby one bottle of formula. All of the doctors, nurses, and- apparently- even an IBCLC around her in the hospital insisted her baby's latch was "great", while missing several major red flags that indicated problems. 

Johnson even dismissed her own gut instinct that something was wrong, because she believed so strongly that 'breast is best' and felt discouraged from supplementing with formula by staff at the "baby friendly hospital". I feel so deeply for this mother, and I hope that in sharing her story, her grief is lifted from her in some small way. 

Still, after reading the article and a few other connected pieces about the Fed Is Best organization, I am left with several questions, and I don't think we have all the information. Some points of the story don't add up, and there is some bad advice and misinformation being given out which makes me question the organization's agenda. 

Was the consultant Jillian saw in the hospital an actual IBCLC, and not just a 'lactation consultant'? There are lactation certifications that can be earned in a single weekend, but the breadth of knowledge attained in these programs pales in comparison to that of an International Board Certified Lactation Consultant. 

Why was baby released without sufficient diaper output? While the article describes diaper output as inconsequential- wet and dirty diapers are of huge importance and a baby with low output requires careful monitoring). 

If doctors were aware that the mother was pre-diabetic, had PCOS (a well-known and documented cause of low milk supply), and that she had an emergency C-Section (commonly known to delay milk coming in)- Why did nobody check for adequate milk production? 

If baby Landon nursed 9 out of his first 24 hours (!!!), and cried nonstop, why did nobody stop and think, "hey something might be going on here."? 

There were too many risk factors to ignore in this situation. Each of these signs can be normal for a healthy baby, or they can mean something more serious. And when there a whole bunch of raised red flags, the odds are good that a baby is struggling. 

The article asserts that the baby was closely monitored, but that the medical professionals insisted everything was fine, until he quite suddenly went into cardiac arrest due to dehydration. 

I can't help but wonder whether we are being given the full picture, or if this mother's tragedy is being used to spread fear and doubt among new parents. Healthy, full term babies will give pretty obvious signs that they are slipping into dehydration- rust colored stool, lack of wet and soiled diapers, a sunken fontanelle, reduced elasticity of the skin, listlessness, lethargy, lips and mouth that are dry to the touch, reduced capillary refill, and on and on... Healthy babies just don't go down suddenly without warning signs that are clear to qualified, caring medical professionals. So, was there an underlying health issue? Was the staff in this baby friendly hospital grossly negligent? Did this mother and child fall through the cracks of a bad system? I don't know. But I do know that exclusive breastfeeding did not cause this tragedy. And the suggestion to follow each nursing session with a bottle, as this organization advocates, IS bad advice for almost all parents who choose to exclusively breastfeed. The practice of 'topping up' can undermine the breastfeeding relationship, and is simply not necessary for the vast majority of breastfeeding parents. Situations like these are in the extreme minority, and shouldn't be used for an anti-breastfeeding agenda. 

This is the fact: parents who are committed to breastfeeding should be seen by an IBCLC at the VERY FIRST SIGN of trouble. Unless baby is nursing like a champ, putting out plenty of wet and dirty diapers, sleeping well, and appearing content and alert while awake, a visit from an IBCLC should be- and needs to be- standard procedure. If the nursing parent experiences misshapen nipples, mastitis, chronic engorgement, or severe pain that goes beyond mild discomfort in the first week of nursing, a visit from an IBCLC needs to be standard procedure. 

Unfortunately, doctors, nurses, and hospital lactation consultants are notorious for missing issues that undermine a successful breastfeeding relationship. 

Solid breastfeeding support is part of good perinatal care, and we need to demand it. The US is sorely lacking in this area compared to other developed nations, and sadly, our babies ultimately pay the price. 

But there was something else at play in this situation that I want to address. Something that imposed pressure on this mom to ignore her instincts and push on with exclusive breastfeeding when her baby was clearly distressed. We in the breastfeeding advocacy community need to get a handle on our messaging, and stop moralizing infant feeding methods. Breast is not best for everyone! I think we can safely say that it certainly wasn't best for this poor mother and her newborn, but yet partly out of fear and shaming, she waited to supplement until it was too late. Breastfeeding is the baseline for mammals- in fact, we mammals are even named after our practice of nursing from Mammaries! And this very normal, nourishing act should be supported and celebrated publicly. But! formula is a perfectly good option as well. And it saves lives. And we should all be very grateful to have this source of nutrition readily available- instead of calling it inferior, dangerous, and even poisonous, as I've heard from some in the 'breast is best' movement. You can't continuously call something inferior and then be surprised when stressed out new parents hesitate to feed it to their hungry newborns... you just can't! And as long as supplementing is taboo, there will be babies who go hungry because of it. 

To new parents: if your baby is crying constantly- especially in the first few days- something could be very wrong. Please seek help from an IBCLC, and above all else, feed your baby. 

I sincerely hope that the Great Infant Feeding Debate can be laid to rest soon, so that we can all just get on with it and focus on what's best for our families. 

What are your thoughts on infant feeding support in hospitals and in parenting communities? Did you feel supported? Judged? Fearful? Let us know in the comments section! 

Check out this link for more information on the Fed Is Best organization: 

http://www.acsh.org/news/2016/10/05/fed-best-great-message-not-so-great-science-10240

#fedisbest #breastfeeding