Dr. Newman, what will it take for you to understand the suffering of mothers pressured to breastfeed?

Time To Listen

“Listen to your patient, [s]he is telling you the diagnosis.”

Those are the words of William Osler often called the Father of Modern Medicine for his contributions to the development of medical education. I first heard them from the chief of surgery at the beginning of my internship. It is almost always true, the patient is almost always telling you the diagnosis, but listening is harder than you might think. It is especially difficult to hear what patients have to say when those words are not complimentary. One of the failings of the medical professional is that some doctors peremptorily dismiss anything that makes them feel bad about themselves.

Prominent breastfeeding proponent Dr. Jack Newman illustrates that shortcoming in attempting to peremptorily dismiss the piece I wrote for TIME, Why I’m Not Celebrating World Breastfeeding Week. In the piece, I’m serving as a conduit for the anguish that floods my email inbox. So many women are tormenting themselves over “failure” to breastfeed when the benefits of breastfeeding in industrialized countries are trivial.

When a patient tells you she has crushing feelings of failure and inferiority because of pressure to breastfeed, it is arrogant to tell her that she doesn’t and she would realize that if she had better information.

Unfortunately, as his response makes clear, Dr. Newman is not listening.

Dr. Newman starts by being fundamentally disrespectful to a colleague … me. His refusal to follow netiquette and link to my piece, his refusal to acknowledge my name, my professional qualifications, and my goal of easing suffering when writing about breastfeeding all speak to fear. What is that fear? It’s the fear that women will find that there IS someone who recognizes the pernicious nature of breastfeeding advocacy; that there IS someone who understands that the “Baby Friendly” Hospital Initiative is a deliberate slap in the face to many devoted mothers; that there IS someone who cares about mothers’ feelings and mental health; that there IS someone who recognizes the cruelty of letting hungry babies cry it out in an effort to “promote” exclusive breastfeeding. Simply put, I have been listening to what women tell me, not ignoring them. If I were Dr. Newman, I’d be afraid of me, too.

But Dr. Newman’s response isn’t inadequate merely because he fails to listen to women.

Dr. Newman acknowledges that, as I wrote, the evidence for the ‘benefits of breastfeeding’ are not well documented and that the studies are flawed, but then insists:

Since when do we need to prove that the normal, physiological method of feeding infants and young children is better than the artificial method, the feeding used made in a factory?

Since always, Dr. Newman. That’s the essence of science. We start any investigation with the null hypothesis (the claim that there is no difference between the two things we are testing) and then we try to disprove it.

Dr. Newman’s statement is actually a two-fer. Not only does it violate a major principle of scientific investigation, but it is also an excellent example of a logical fallacy — the naturalistic fallacy. The naturalistic fallacy is the unwarranted and illogical belief that anything that is natural is better. Hurricanes, earthquakes, and asteroids hitting the earth are natural, but that doesn’t make them good. Heroin, cocaine and tobacco are natural, but that doesn’t make them healthy. Babies starving to death due to inadequate breastmilk is natural, but hardly desirable. Women suffering postpartum depression is natural, but that doesn’t mean we want to exacerbate it.

When presented with information that breastfeeding promotion is causing women (and babies) to suffer, Newman doubles down:

The author bemoans the fact that so many mothers contact her with horror stories about their breastfeeding experiences. I too am upset about all the mothers having terrible experiences. The author blames breastfeeding for these problems, but the truth is that it is not breastfeeding that is the problem. It’s the lack of information, the lack of support from society in general and from health professionals more specifically that is the problem.

You’re not listening, Dr. Newman!

Patients are saying that the flood of information and the way it is presented has made them feel awful. It is the height of medical arrogance to tell a patient that what is hurting her is not really hurting her. If a patient tells you that she has crushing chest pain, you don’t tell her that she doesn’t and she would realize that if she had better information. It is exactly the same with mental anguish, Dr. Newman. When a patient tells you she has crushing feelings of failure and inferiority because of pressure to breastfeed, it is arrogant to tell her that she doesn’t and she would realize that if she had better information.

Newman digs himself in deeper:

There is no question that, with many exceptions of course, most health professionals, including obstetricians and pediatricians, don’t know the first thing about “practical” breastfeeding.

Earth to Dr. Newman! In 2015 the majority of obstetricians and pediatrician are WOMEN, and they know a great deal about practical breastfeeding because WE HAVE DONE IT … unlike you, I might add.

Referring to problems with breastfeeding, Newman claims:

I will state emphatically, these problems could have been prevented had the mothers received good help at the beginning.

You’re not listening, Dr. Newman! Women ARE TELLING YOU that they don’t want your help, they don’t want your pressure, and they certainly don’t want you to tell them that more “help” and more pressure will make them feel better.

Dr. Newman concludes:

The author also suggests that we “push” breastfeeding on mothers. What world does she live in? Formula is being pushed on mothers from day 1 of their pregnancies by formula company marketing, free samples from doctors and in hospital and in the mail. Bottle feeding images everywhere. Breastfeeding should at least have equal time, but it doesn’t.

I’m living in the real world in 2015, Dr. Newman; you appear to be mired in the 1950’s. Breastfeeding initiation rates are above 75%. That’s the MAJORITY, Dr. Newman. Breastfeeding images are everywhere, in blogs, on Facebook, in mainstream media. Breastfeeding women are everywhere, in restaurants, in workplaces, any place where women congregate. Sure, some people don’t like the public visibility of breastfeeding, but that just proves the point that it’s everywhere. It’s difficult to take lactivists seriously when they make claims that are so obviously untrue.

It’s time to listen to mothers, Dr. Newman. Your arrogance is in believing that you, the doctor, know better than they what they are feeling and experiencing. That’s paternalism and it’s ugly.

  • JG

    I really don’t care what any specialist or lactivist says to me. I am due to give birth in a few weeks and will definitely be taking formula with me to hospital. Formula was a godsend when I had my first child, who was nowhwere near satiated with my colostrum after birth. She was then wisked off to special care after developing significant complications a few days later. I was unable to breastfeed her so expressed milk excessively, to the point where I was barely sleeping. By the time we got home from hospital a few weeks later, I was so exhausted and malnourished (as I also lost my appetite from stress), my milk effectively dried up. If it wasn’t for formula she would’ve starved. The hospital where I am due to give birth says they have no formula on site, which I think is very inconsiderate of people who may end up having serious challenges with breastfeeding. I plan to take formula and combine feed my baby, to ensure that I am free to share feeding with my husband, especially as my first child has health problems that requre a lot of attention. Flexible feeding options suit my family situation and I really could care less what these maniacal lactivists think.

    • Young CC Prof

      No formula on site? I’ve heard locking it up like medicine, but refusing to stock it in the first place seems really shortsighted. What about the GD baby who has a blood sugar crash after birth, or does he just get sugar water? What about their older baby patients, what do they eat? Or are parents of sick babies expected to bring all food on top of everything else they have to worry about?

      • Ash

        I’m guessing that formula is not available without an order, and it’s kept locked and had to be logged out–basically it means that it dissuades nurses from giving formula. That’s my understanding of BFHI policy

    • KeeperOfTheBooks

      Hopefully you won’t encounter this, but just a heads-up: a friend gave birth at a BFHI hospital a couple of years ago, and had the nurse tell her that she “wouldn’t allow” her husband to go get formula to feed the baby. Said baby was, no less, under doctor’s orders to have a bottle or two because of jaundice. I believe the doctor raised holy hell about it when the baby ended up having to be admitted due to jaundice which might have been avoided if the nurse had freaking followed the doctor’s orders and gotten the kid a damn bottle, or at least not interfered with the parents doing so, but all the same, what a ridiculous situation to deal with.

      • EmbraceYourInnerCrone

        Wouldn’t allow? Umm yeah NO, I would be packing myself and my baby up and leaving. So the kids own parents are not ALLOWED to feed their own baby!? WTF

  • carovee

    It took a pediatrician to tell me I wasn’t producing milk. It took a lactation consultant (at $100 per visit) to tell me my baby was losing weight. It took my parents giving a crying baby a little water for my baby to stop feeling thirsty and sleep awhile. No amount of information or medical or social support is going to magically produce breastmilk that isn’t there.

    • KeeperOfTheBooks

      Oh, a mere $100 per visit? Is that all? (/sarcasm) The LC group the pediatrician gave me a brochure for charged *$300* for an hour-long diagnostic visit. Said pediatrician’s usual clientele, I suspect, are rather more well-heeled than we are.
      (For perspective, the hospital in which I delivered had perfectly nice “regular” rooms: clean, private, comfy couch for dad/partner, etc, but they also offered an “upgraded” room, complete with Jacuzzi, designer furniture, and mini-office/kitchen area, for a mere $450/night. We opted for the regular room, thankyouverymuch.)

  • Elaye

    I actually believe the pendulum has swung too far in favor of breastfeeding, at least in the academic hospital where I delivered my child.

    As a physician myself, I had all the information available to me about breastfeeding and caring for a newborn infant, and yet as a new mother–exhausted and in pain, in the postpartum period–I did not have enough mental reserve at the time to effectively apply my knowledge. Prior to to delivery, I had exhaustively researched the almost-negligible benefits of breastfeeding. However, since I had the tangible resources to breastfeed, ie. a medical system that provided support, family support, and a 6-month maternity leave that would allow me to breastfeed, I committed myself to doing it, so that I could confer any extra advantage (no matter how small!) to my precious, first-born child.

    I did not realize that the system would be overly supportive of breastfeeding, almost to the detriment of my child and myself. My baby screamed for 48 hours straight, barely soaking a diaper, rooting nonstop, continuously latching onto my painful bleeding breast (which I believe caused a cycle of more pain and decreased milk production). Instead of suggesting that I actually feed my baby with formula, I was told that this nonstop crying and pain was normal, that my milk would eventually come in. I was kept in the hospital longer to monitor my baby for urine output, but no one actually suggested that my child was starving or that feeding her would improve the situation.

    Despite my education, despite my awareness of breastfeeding jaundice, I did not notice as my babies sclera turned yellow…because no one else did and I trusted these professionals! So absorbed was I in fulfilling this quest to breastfeed and confer those extra benefits– less infections, marginally more IQ points– that I did not realize that I was unaware of the bilirubin building up in my baby’s little brain, threatening it with kernicterus, brain damage, death.

    All of the postpartum nurses and lactation consultants tried to help me troubleshoot breastfeeding but it was not working. It was finally a friend, a medical resident who dropped by to visit, who suggested that my baby looked jaundice and spurred some tests. When the pediatrician came in to see her, he was shocked that no one had fed this poor, screaming child.

    When she had her first bottle, she finally fell asleep in my arms. I slept too. Suddenly, the cycle of pain and exhaustion was broken, and as baby slept and rested, and I had time to drink and eat and sleep, I produced more milk and we were actually able to breastfeed.

    Formula actually facilitated this for me, and I think it is ridiculous how so many people demonize it. For me, it was a needed bridge to facilitate breast feeding. For others, like my wonderful mother, it was the only way she could physically feed her children. For others yet, who are not fortunate to have the same luxury of a maternity leave, or social support to help around the house while they breastfeed exclusively, then formula and bottle feeding is the necessary choice to raise their children. In modern society, rife with technological advances that make our daily lives easier and improve our mental and physical health, why would we deny mothers this intervention. Especially since we know that maternal health has a strong association with a thriving baby.

    • Ash

      What happened to you and your son should not be considered acceptable. It’s sad that I would tell pregnant friends to bring ready to feed baby formula with their hospital bag to ensure that formula is easily accessible.

    • lawyer jane

      There is actual research demonstrating the broader truth of your experience: http://healthland.time.com/2013/05/13/can-giving-newborns-formula-increase-breast-feeding-rates/

      Also, a “pre-lacteal feed” is a common practice throughout cultures. The WHO crowd is against it – which might make sense in places with a bad water supply – but it’s commonality suggests its utility.

  • I am truly sorry if my earlier comment has caused offense to some people—I’m on your side! The well-being of the mother is just as important as that of the child. This topic was a revelation to me: I find it scandalous that many women are suffering from such dogmatic pressure from their peers and doctors.

    I have only been on the receiving end of the breastfeeding equation, and some may say that my lack of direct experience disqualifies me from from having a valid opinion. But perhaps the opposite is true: perhaps I can be a little more objective.

    OK, just to re-iterate my position: I think there is only LIMITED evidence that breastfeeding (versus artificial milk) has a significant benefit to the health of infants in developed countries. In the best of all possible worlds, I suspect it’s likely that human milk might be preferable, based on its unique components, but so what? If a mother is suffering (physically or emotionally), then her well-being should take precedence over this quasi-religious fetish about the sanctity of mothers’ milk.

    There is only a limited amount of evidence (and rationale) for why breastfeeding may be preferable for women in “developed” countries such as the U.S., but it makes no sense to me why this should be more important than the obvious difficulty/discomfort/pain that some women experience when trying to breastfeed. This whole issue seems to be an example of taking a potentially valid idea and exaggerating it to a ridiculous extreme.

    Medical doctors are well-intentioned, but their job requires them to make decisions and recommendations which are often based on very limited scientific evidence. To me, this should lead doctors to be very cautious about making strong or definitive statements. This is especially true when a decision can have serious negative consequences. A good example is the routine use of radical mastectomy as a preferred treatment for breast cancer, a few decades ago. This practice made theoretical sense at the time, but was not supported by any objective evidence. We now know, based on actual clinical research, that a much less traumatic and disfiguring surgery is often just as effective. I don’t mean to derail the topic, but this issue reminds me of the strange predilection that American doctors have for circumcision—another ingrained practice that seems to have little medical justification.

    I think we may be in a similar situation with regard to the promotion of exclusive breastfeeding by many medical doctors. As far as I can tell, although there is a theoretical rationale for why natural versus synthetic milk might offer some benefits, there is only limited clinical research that shows a clear benefit, and I doubt if we will ever get a definitive answer that applies to all women.

    This issue also needs to be considered in the context of the pain (emotional and physical) that many mothers are subjected to when trying to do what is best for their child. Post-partum depression is a major problem, and it would be a really bad thing if concerns about breastfeeding add to the risk of this condition.

    However, the American Academy of Pediatrics has taken a strong, even dogmatic, position on this topic, and presumably plays a large role in the immense pressure that some women are subjected to. http://pediatrics.aappublications.org/content/129/3/e827.full.pdf I am not a medical doctor (just a scientist), but from my initial reading of some of the relevant research, I strongly object to the dogmatic position taken by the Academy. (Perhaps I’m wrong—if so, I apologize, and would be happy to change my opinion based on compelling evidence).

    Another way of looking at this issue is that it may be an example of the common “more is better” phenomenon, where people take a potentially useful idea and exaggerate it to potentially harmful extreme. A simple example of this is the flawed notion that if vitamins are essential for health, then more is better—hence the $multi-billion “supplement” industry.

    As a final speculation, I wonder if it is just a coincidence that the largely male medical profession seems to have taken such a strong position on different aspects of the human anatomy that are essentially female—the breast and uterus. It’s hard for me to rule out that subconscious sexism isn’t an important part of the American Academy’s position on the sanctity of breastfeeding.

    • araikwao

      Ok, I like this comment!

    • Sarah

      I wish you’d just said this in the first place.

      • Megan

        Me too!

    • EmbraceYourInnerCrone

      Why should it only be(in your words) if the mother is “suffering” that its ok for her to consider not breastfeeding? I did not want to breastfeed, for my own reasons, which are my own business. I went back to work when my baby was 6 weeks old. I never breastfed, My daughter bonded with myself and her father just fine. She did well in school and is doing well in college, at least in part because she is middle class, white, an only child and had two parents who had the time and money to take her to the bookstore, library, museums, camping, nature hikes, the energy to help her with homework and read to her every night.
      People should not have to come up with “acceptable” reasons for not breastfeeding. I Don’t Want To is a perfently acceptable reason.
      And please don’t do the, I am a Man, perhaps I am more objective. EVERYONE has unconcious biases, everyone is exposed to society’s influence on the way they think. People being passionate about a subject because it affects their lives does NOT make them irrational.

  • yellowvalkyrie

    I had my son via c-section (breech) in a “baby-friendly’ hospital. He was born on a Monday morning. He couldn’t latch well. I produced no colostrum or milk until Thursday night. In the meantime he lost 13% of his birth weight. He cried constantly and I didn’t sleep a wink for 3 days straight. My blood pressure reached 198/105. Finally, we started supplementing with formula while continuing to try to breastfeed. I had to use nipple shields to get him to latch. It took at least a month to figure it out. I continued to breastfeed him with minimal supplementation until my milk disappeared around 7 months and we had to use formula exclusively.

    And all of this happened in spite of LOADS of information and support about breastfeeding. I had 3 different books. I talked with lactation consultants daily. I pumped after feedings while my husband topped him off with formula. I cried. My nipples bled. I suffered from PPD and it was made even worse by my guilt over failing at exclusive breastfeeding.

    Sometimes I wonder if I would have been a happier, more bonded new mother if I had just taken up exclusive formula as soon as I saw how much weight he was losing. But I couldn’t do it – the pressure to breastfeed was too intense.

    Lack of information is NOT the problem.

  • MichelleJo

    Dr. Newman has stated his position many many years ago and is not given to change. Please don’t mix him up with the facts Dr. Amy. It’s not fair. He certainly hasn’t changed since my nursing debacle over 17 years ago when a friend stuffed some pages of his nonsense in my face. What gets me most, about him and others like him that their standard ‘speech’ to mothers who ‘think that they don’t have enough milk’ is , ‘if your baby is being fed at least 8 -12 times a day, is soaking five wet diapers and having regular bowel movements, and is gaining weight even at a slow rate, then you have nothing to worry about. Some babies are just fussy babies.’ And that’s where it ends. But my baby wasn’t being fed 8-12 times a day, he was being fed once a day for 24 hours, with intermittent catnaps from exhaustion and pathetic crying in between desperate sucking, he wasn’t soaking five diapers a day, he was barely making one moist, he wasn’t having regular bowel movements – he wasn’t having any at all, and he wasn’t gaining even the teeniest bit of weight, he was losing it. Yet where was Dr Newman then? I never found an answer from him as to what to do if all the things they say are happening are just not.

    • moto_librarian

      Ugh. I am so very sorry that you went through this.

      • MichelleJo

        It really was awful at the time, especially, just like the comment above mine, when you’ve been through nine months of pregnancy, gone through childbirth and are finally holding your bundle of joy, and you enter a nightmare of exhaustion, pain, guilt, that is simply indescribable. You certainly weren’t ‘prepared and informed’ for it like you paid to be for birth. It was a long time ago, and although it is still painful to think of it, I haven’t been raging at Dr Newman for 17years. What gets me is that 17 years later, he is still spewing the same nonsense. As explained in the post, he is just not open to logic, and continues to make life hell for new mothers every single day. This blog is great and is sure to have made a difference to a lot of people, but it is precious too little.

  • Courtney84

    OT update: She’s here and healthy, and so am I. I had a VBAC with an epidural, augmentation, labatolol and a lot of active management of the 3rd stage and slightly beyond. Yay drugs! Yay interventions! Yay for *preventing* severe PPH!

    • Cobalt

      Congrats on the new arrival!

    • Wren

      Congratulations!

    • Young CC Prof

      Awesome! Welcome new SOB baby!!!

    • moto_librarian

      Congratulations! So happy that you are both healthy!

    • Amazed

      Welcome to the little one! Congrats!

    • demodocus

      Congrats!

    • araikwao

      Congratulations!! So glad it went well for you both!

    • Bombshellrisa

      Congrats! Yay healthy baby!

    • Mgan

      Congrats!

    • KeeperOfTheBooks

      Hurray! Big congrats to you and a big “welcome to the world!” to the baby girl!

    • Conga-rats!

  • Anne Catherine

    This post is brilliant as usual.

    It never ceases to amaze me lactation advocates, many with MD’s and advanced degrees like Dr Newman— (even though the evidence is all there) refuse to believe that:
    1. Some women are unable to breastfeed..even with help and support.
    2. That it is okay to overstate the evidence on the benefits.

    • CanDoc

      I read the full list of Facebook replies and was so sickened and disheartened. I typed scathing replies several times, then deleted them because I couldn’t bear to engage those holier-than-thou zealots.
      Sigh.

  • Courtney84

    OT: I’m having a baby today!

    • Sue

      Yay! Best wishes to both of you.

    • SporkParade

      Wishing you an easy birth!

    • E

      So jealous! I’m still barfing away at 11 weeks. Congratulations and here’s to a safe delivery!

      • MichelleJo

        Hope you feel better soon! At 11 weeks birth can seem like the moon when you’re in a bad way. I remember a nurse asking me how far I was when I was seven weeks and I just moaned at her, don’t ask, I’ve got another 100 years. So I won’t tell you that you’ll feel better at 12 weeks and it’s worth it in the end.

    • Cobalt

      Best wishes for a boring birth story and an uneventful hospital stay.

    • yentavegan

      Oh Happy Day!!

    • Amazed

      Best wishes to you! May the god of boring look at you benignly.

    • Dr Kitty

      Good Luck!!

    • Angharad

      Good luck and congratulations!

    • momofone

      Good luck!

    • moto_librarian

      Wonderful! Hope all proceeds very smoothly!

    • wookie130

      Oh, how exciting! Congrats in advance, and when (or if) you have time, please let us know how it goes! 🙂 Best of luck to you, and your little one!

  • yentavegan

    I am active in the lactation support community. I do get phone calls from new mothers who just want to feel supported and who need to feel validated for their choices. Thank You a million times over Dr. Amy for giving me the metaphorical slap across the face to wake me from the hypnotic “breast is best” hypnotic state I had been trapped in. Just this week I listened to the needful voice of a mother who just wanted assurance that feeding her 3 week old formula was an ok thing to do. Her back story is one filled with private anguish that I am not at liberty to expose. Nonetheless I assured her that she was a good and loving mother who made the right choice for her baby. Thank you once again Dr. Amy for educating me and liberating me from the ranks of agenda driven no-nothing lactavists.

    • Sue

      Having the insight to review one’s approach on the basis of reason is an admirable thing.

    • Gatita

      This is wonderful. Bless you for giving that mom the support she needed and not pushing an agenda.

    • wookie130

      I have always admired your open-mindedness and sensibility as someone in the lactation field. You have no doubt helped a lot of mothers in whatever feeding endeavors they’ve pursued.

      • yentavegan

        Thank you for your kind words. If it wasn’t for this blogsite and Dr. Amy I fear I might have been stuck in the world of woo.

    • Busbus

      I had a lactation consultant who told me (after I showed up crying and told her I wasn’t able to keep this up much longer) it was okay to give formula, and reminded me that the majority of babies in the US receive formula by the time they are a few months old. You wouldn’t believe how much that mattered, and how incredibly grateful I was not to be judged. I wish all lactation consultants were like that, and I am so glad you are. What you do is important. Don’t ever doubt that for a minute.

    • Allie P

      I had a lactation consulttant like you. It was AMAZING to be “given permission” to feed my starving baby, and to realize it was neither the end of hte world nor the end of our breastfeeding.

    • Guesty

      Yay for great lactation consultants! The world needs more of them!

  • “Suffering”? Really? Aren’t you being a bit melodramatic?

    Infant mortality is an important threat to the survival of the species, and it seems reasonable to hypothesize that there has been strong selective pressure for the components of milk to be optimized for a given mammalian infant, and that optimal milk composition could be different for different species. Clinical research to test this concept is very hard to do under controlled conditions, so it is not surprising that there is only soft evidence for the benefits of natural milk. Also, it seems likely that the benefits of human milk may be greater for some situations than others, and that “World Breastfeeding Week” may be more relevant in less developed populations.

    Frankly, I don’t see what the fuss is about. Surely, a simple model would be: breastfeed if you can; supplement if you need to. I find it hard to believe that significant number of women are really being traumatized by a “pressure” to breastfeed: is it from peers or from doctors? If it’s from peers, then it’s likely to be just one more way that some women will try to claim superiority over others. If it’s from doctors, then it may simply be a reflection of their inadequate grasp of the relevant science.

    Surely, there are far more important, and potentially harmful, practices that need our attention, such as mothers giving their children wacky herbal (or even homeopathic) remedies.

    • Sarah

      What do you imagine qualifies you to decide whether ‘suffering’ is the appropriate term?

    • SporkParade

      No, she’s not being melodramatic. There’s a reason why women who want to breastfeed but can’t AND women who want to formula feed but don’t both end up with higher rates of postpartum depression. But thanks for taking a moment out of your busy day to tell us silly women what’s we’re really feeling because obviously we are far too flighty to actually make sense of our own experiences.

    • yentavegan

      Thanks for mansplaination.

      • monojo

        A million times this. Note also the attempt to hijack the conversation with the, “Surely there are more important things to concern yourself with…” Vomit.

    • FormerPhysicist

      Natural selection only selects for ‘good enough’. And only for good enough for that particular environment.

      • Young CC Prof

        Also, women in the state of nature produce an average of 8 babies each and bury half of them. Most of the deaths are due to infection, but inadequate nutrition claims quite a few.

        I really don’t like that life plan.

        • Sarah

          Stop being so melodramatic. I don’t see what the fuss is about.

        • Don’t worry: you’d have pretty good odds that one of those births would kill you, so you wouldn’t have to hang around to watch your kids die!

    • LibrarianSarah

      Oh look another condescending, middle aged, white male coming in to set us hysterical women straight. Tell us more about how women should feel about women’s issue oh all knowing white dude. Seriously, you are the worst.

      • mostlyclueless

        “Calm down girls! I don’t feel the way you feel, so your feelings must be wrong.”

        • LibrarianSarah

          I’m not patronizing and sexist! My girlfriend/wife/female friend agrees with me!

        • Kq

          Oh god that’s perfect

    • Young CC Prof

      “optimal milk composition could be different for different species.”

      Really? Pure cow’s milk isn’t the same as human milk?

      Newsflash: human milk was first analyzed in a laboratory over 100 years ago, resulting in a recipe for infant formula with the same balance of fat, protein and carbohydrates as actual human milk. Subsequent generations of formula have mimicked it ever more closely, with the most recent addition being DHA.

    • lilin

      “Frankly, I don’t see what the fuss is about.”

      Translation: ‘Frankly, I don’t know anything about this subject and therefore it can’t possibly be important.’

    • The Computer Ate My Nym

      Infant mortality is an important threat to the survival of the species

      A species with more than 7 billion living individuals can not be said to be “threatened”. But yes, infant mortality is an important issue in public health especially in less developed countries. One major threat to children in much of the world is vertical transmission of HIV, including through breast feeding. Demanding that women must breast feed if they can is as ridiculous as demanding that they avoid c-sections at all costs. Each woman must decide for herself what is right in her individual case.

      If it’s from peers, then it’s likely to be just one more way that some women will try to claim superiority over others. If it’s from doctors, then it may simply be a reflection of their inadequate grasp of the relevant science.

      Times like this I feel just a little sympathy for the NCB movement. Talk about a mess of patriarchy: If a woman feels pressured by her peers, it is because her peers “want to feel superior” but if her (I presume you are picturing male) doctor is pressuring her then it must be that she has an “inadequate grasp of the relevant science”? Perhaps the problem is her doctor has an inadequate grasp of the relevant science and an unfortunate desire to feel superior!

    • Kq

      “I find it hard to believe that significant number of women are really being traumatized by a “pressure” to breastfeed: is it from peers or from doctors? If it’s from peers, then it’s likely to be just one more way that some women will try to claim superiority over others.”

      It’s almost like you’re not a woman or a mother and have no idea what it’s actually like! Of course you can’t simply *believe* what women and mothers are*saying,* that’s just silly

      • lilin

        Hey! Just because he has no experience and has done no research doesn’t mean he doesn’t know better!

        • Kq

          Who better to speak to a woman’s suffering – oh, I mean “suffering” – than an aged man – oh, I mean “paternalistic mansplaining jerk”

          • Bombshellrisa

            Chronic #newmanitis with a history of #mansplaining

          • Sue

            That’s what’s known in the trade as a “Spot Diagnosis”

    • demodocus

      Yes, the herbal and homeopathic remedies are a problem but not as a big a problem as starving children in the Democratic Republic of the Congo. Or helping child survivors of sexual abuse. Perhaps we should only focus on that.
      Being a lesser problem in the world does not mean it is an irrelevant problem. Some blog entries are all about helping a person sew sharp points on their quilts. If you want to focus on damn-fools who believe in homeopathy, go right ahead. It shows up a lot on the blog sciencebasedmedicine. Or start a blog about starving, abused children in wartorn regions of the world. If you’re just here to tell us how getting depression over breastfeeding is a non-issue, then you can go play in traffic.

      • monojo

        Saying, “There are more important things to worry about,” is nothing but an attempt to derail the discussion. And even if it wasn’t, it’s ridiculous, as if someone couldn’t care about two causes at once. That tactic has always infuriated me.

        • Roadstergal

          “Saying, “There are more important things to worry about,” is nothing but an attempt to derail the discussion.”
          Has it been titled the Dawkins Gambit yet?

    • araikwao

      You find it hard to believe? Have you been around any expectant or new mothers lately? Been near an LC or midwife? The abject disgust toward (or complete omission of) “artificial feeding” is everywhere. I’ve seen it as a mother, heard it from my peers and witnessed it as a medical student. Women generally feel guilty if they need to feed their babies formula, and for what? Because they are choosing another safe and appropriate feeding method that doesn’t fit in with the naturalistic fallacy.

      • Squillo

        I’ll never forget a friend apologizing to me as she fixed a bottle of formula for her son, but breastfeeding just hadn’t worked out for them. Why the hell would she feel the need to apologize to someone with absolutely no vested interest in how she fed him?

        • araikwao

          Because the guilting (yes, I made it into a verb) is that strong. It is dreadful.

          • Squillo

            Indeed. The killer thing is that this particular mother has an older kid with developmental disabilities, and she and her partner are amazing parents to him. Apparently you have to be perfect to be a mother and not feel guilty. Who knew?

    • Angharad

      Thanks, I thought I was suffering and in mental anguish and sobbing over my inability to nurse my daughter. I thought I was traumatized by being accused of poisoning my daughter and repeatedly told that I had caused her allergies. I’m so glad now I know it was all in my head!

    • Guesty

      “Suffering”? Really? Aren’t you being a bit melodramatic?

      What a great question! Why don’t you attach something to your nipples until they bleeds repeatedly over the course of several weeks and then have someone tell you you’re not trying hard enough and your kid is suffering because of it. Then come back to us and tell us whether you think that counts as “suffering.” Really.

    • Megan

      “Aren’t you being a bit melodramatic?”

      This, coming from an anti-GMO activist…

    • Who?

      Just let me fix that for you:

      Breastfeed if you want to, and can do so; otherwise formula feed.

      And if you think you’re getting pushback here for preferring breastfeeding, go and chat to some loony ‘all natural’ parents about the revolting concoctions they submit their babies and children to, up to and including potentially listeria-ridden raw milk. And then you’ll experience pushback.

    • skram08

      Thank you for telling us silly women what’s what.
      I simply can’t know my own experiences with regard to breastfeeding, what with my lady brain being at the mercy of all those hormones and such.

    • Squillo

      Why do you find it hard to believe that lots of women experience pressure to breastfeed? You haven’t seen it yourself? Or you don’t believe the claims of women who comment on posts about attitudes toward breastfeeding who claim to have suffered from pressure?

      I experienced no shaming and no one ever asked me to cover up or to leave an area while I was breastfeeding. Should I then discount the claims of many women who have?

    • anotheramy

      “Breastfeed if you can, supplement if you need to” sounds great in theory, but in practice, women are being told that you don’t need to supplement/ shouldn’t supplement because almost EVERYONE can produce enough milk. And if you can’t, it’s because you’re doing something wrong, uninformed, lazy, or too selfish. It’s not caused by something like biology or bad luck. Well lactavists “gussy up” those words a bit, but the point that comes across is it’s a moral failing or maternal incompetency to not exclusively breastfeed an infant. That’s the mindset Dr. Amy speaks out against. the standard recommendation for those of us with low milk supply is to nurse, supplement, then pump after every feeding and to keep track of diaper output so you know baby is getting enough, plus extra appointments for weight checks for baby. I tried that routine with a newborn for 6weeks. The word “suffering” describes it well. But I also felt if I didn’t do all that, I was being lazy, selfish,depriving my child, etc. … the pressure Dr Amy describes is real. I wish it wasn’t.
      My first child was born in 2008, my third in 2014. The pressure to breastfeed has grown over those years, in my experience.

    • Fallow

      Please just shut your goddamned fool mouth. It’s obvious you don’t care that there are thousands of personal stories at your fingertips (try Google, you’ll see) from women who have felt this way. YOU are the one with the opinion that matters. You and your nonlactating man breasts. All those women’s stories just got to step aside now that someone with a dick is here.

    • DelphiniumFalcon

      Oh thank heavens you’re here!

      I almost went an entire twenty four hours without a man telling me how to conduct my life! Can’t have that. Might start developing independent thought or something!

    • monojo

      1. In what world is infant mortality a threat to the species?

      2. A giant, magnificent eyeroll and a million lols to anyone who can read an article about doctors dismissing women’s concerns and then come here and dismiss our concerns. F*ck you, guy.

      • The Bofa on the Sofa

        1. In what world is infant mortality a threat to the species?

        And even if it were, who the fuck cares?

        Infant mortality is bad because babies are dying. That is horrible, and it needs to be prevented for that reason.

        I personally don’t give a rat’s ass about “the species.” Seriously, why would I care if the human race were to fail to thrive in 10 000 years? I won’t be here, and any descendents will be so distant and dispersed that I won’t have any personal connection.

        I am all for avoiding people being killed, but the human race? Meh. If people choose to have a non-thriving birth rate, so be it.

    • Who?

      My favourite bit is ‘…there is only soft evidence for the benefits of natural milk’.

      But of course we all know it is better, don’t we? Soft evidence is better than none at all, isn’t it? Especially when we want to tell others what to do at no cost to ourselves.

      After all, it’s natural! There was natural grated processed cheese at the supermarket this morning, no doubt superior to the other brand of exactly the same thing that didn’t claim to be natural. Nothing in the packaging information indicated what made it natural, it just said it was. Awesome. Made the choice of the other one so much easier. I also refuse to buy anything marked ‘organic’ or ‘gmo free’ just because I can.

      Frankly, I don’t understand why calling out breastfeeding absolutism in support of women who don’t want to breastfeed, including by giving them a judgment-free space in which to formula feed, is a bad idea.

      We can tackle some of the other all natural nutjobs another day.

      • Sue

        Well said.

        AND, the reason there is only soft evidence for BM benefit is that modern life has so many modifications in lifestyle that the type of milk given to infants is no longer a major determinant in health outcomes. We have good shelter, hygiene, nutrition, antibiotics, injury prevention, modern obstetrics, cars, smartphones, vaccination, fresh foods (if we want them) – all these things mean that the type of milk fed to infants is less crucial. It makes sense.

        Why can’t we acknowledge that as a good thing?

        • Mattie

          although tbh cars are probably doing more harm than good =P

    • Rebelle

      I agree with this guy.

      I chose not to breastfeed after two days because I could not tolerate the lactation consultants and the BFI that was used in the hospital I gave birth at. If they weren’t so goddamn pushy and full of lies and drama about breastmilk being a magic elixir, then perhaps I would have cared more.

      I have multiple chronic health problems that made it downright uncomfortable to breastfeed. They didn’t give a rat’s ass that my arms went numb, or that I had to be careful with my C-section incision because it takes me forever to heal. I also have cardiovascular and endocrine problems. After it became apparent that my health problems would be taking a backseat to breastfeeding, I decided to stop to the b-b-buts of the staff. I had to yell at the nurse and demand to speak to the team leader before I was given any formula.
      It really went that far.

      The thing that struck me was how much more they cared than I did. I could see it wasn’t going to work out so I made a choice not to. I think they were stunnrd that I didn’t want to breastfeed at all costs.

      I think women should put their mental and physical health before breastfeeding since formula is so excellent. That’s what I did, and I was so
      HAPPY!

      Seriously, I also think lactivists should think twice before trying to use the tactics of guilt, shame and obligation to promote breastfeeding because there I think it will result in an increasing number of women opting out because we’re not falling for their lies anymore.

      My position on breastfeeding now is that it isn’t worth it at all, simply because of the abuse you receive if it doesn’t work out or when you decide not to continue.

      I could care less what other people do so long as they leave me alone but if a pregnant woman asked me for advice, I’d say formula over breast any day.

      Also, I really do believe I’m just as awesome as women who breastfeed,

    • Sue

      “I find it hard to believe that significant number of women are really being traumatized by a “pressure” to breastfeed”

      On the contrary – I’ve seen direct evidence that women from a wide range of backgrounds and cultures are subject to the “do I have enough milk?” insecurity. As a clinician, I once had to advise a mother from China whose chubby infant looked like a mini sumo wrestler. She was supplementing with formula because “I don’t have enought milk”.

      It may be hard to understand this if you have never experienced it, but it is real and widespread.

      As far as the “natural milk as an ideal food” thing – sure breast milk would have been ideal for pre-technological females and babies. Having said that, ancient man suffered huge infant and maternal mortality – the “species” survived by having lots of children. Now, however, we benefit from a huge range of “unnatural” improvements in shelter, nutrition, communication and transport, which means that infant milk no longer has much influence on infant outcome in wealthy societies like ours. Antibitoics and modern midwifery and obstetrics, however, make a HUGE difference, which is why almost all our babies survive, so we no longer need to have lots of them.

    • E

      On some level, you are right. If we don’t internalize the message, no one can hurt us. But as for the pressure not existing, think again.

      1. When I told my employer that I hoped I could get an elective cesarean with my first because I wasn’t too keen on the idea of pushing a baby out of my va-jay-jay (a statement at the time, early in my pregnancy, that I naively had no idea was politically charged), she stopped what she was doing, her face taking on a look of absolute horror, and she said: “You wouldn’t do that, right? I don’t believe it. You’re too good of a person.” Inside, I squirmed because I really did want to do that, and the horrible thought crossed my mind that I had already failed at this mom thing.

      2. When I told my cousin who had been my maid of honor at my wedding that while I had every intention of breastfeeding, I didn’t think that women should have to breastfeed and that I thought some of the supposed benefits of breastfeeding were hype ( a statement that I had naively thought showed both my own dedication to my unborn child and my dedication to women’s rights and emancipation), I caused her to cry, call me selfish, walk out on me in the restaurant, and refuse to speak to me for six months. I spent the evening sobbing on the bathroom floor asking my husband if he thought I was indeed selfish.

      3. In the first few days of breastfeeding my nipples turned an erie gray and hurt so bad I couldn’t even bear to wear a shirt. I saw a chunk of my nipple come off before my infant daughter vomited blood all over the bed. I cried because I had just fed her and now that she vomited she was hungry and needed to be fed once more. My mother had volunteered to stay a few days to help out and had seen all of this. My husband told me to rest and ran downstairs to make up a bottle of formula. My mother tried to stop him. “What are you doing? Giving my granddaughter poison?” My husband said that he had never wanted to hit anyone before in his life until that moment.

      So yeah, when the people you love and the professionals you trust tell you that you are bad for not living up to a certain ideal, even if you’re strong and know that they are wrong, it’s still incredibly hard. And most of us aren’t that strong especially when we’re recuperating from painful deliveries and are experiencing an influx of new hormones and new parent insecurities.

      • KeeperOfTheBooks

        Dear. God.
        Especially at #3.
        I hope you’ve been able to get to a happier, more peaceful place, and that your husband tossed your mom from the house after that comment. What. The. Hell.
        I am so sorry.

      • The Computer Ate My Nym

        Yow! I’m sorry you went through all that! In case it still needs to be said: You are NOT selfish. You are a good person and a good mother who was doing her best. I only wish people had the sense to let you alone to do what you saw fit instead of nagging you.

        I can’t believe #3: Feeding a baby essentially pure blood is ok, but formula is poison? Talk about confused priorities. I hope you’ve recovered from that, both physically and emotionally.

      • Daleth

        Omg. You poor thing! It sounds like you are surrounded by (with the exception of your husband) lunatics! #3 is beyond the pale, and who in GOD’S NAME would start crying and refuse to speak to a cousin/friend because of their completely non-judgmental opinion on breastfeeding? THAT IS INSANE.

    • Gatita

      I hear what you’re saying but I have to point out that the crazy tends to get bundled together. Latctation consultants will often also push things like no vaccines, herbs, cranial-sacral therapy, cosleeping and other dangerous practices. So yes, calling out hyperbole around breastfeeding is important as part of an overall push against woo.

      • yentavegan

        I have lost all respect for so many heretofore comrades over cranial-sacral therapy. You are quite right in your assessment. The crazy does get bundled together.

      • Young CC Prof

        If it gets people to question their preconceived notions and truly evaluate evidence, calling out one woo may indeed be calling out all woo.

    • Taysha

      As long as women are encouraged to turn up their nose at other women for their practices, including how they feed, diaper, and treat their children, then no, there is nothing more important.
      Follow them on all fronts and bring them down from the mighty heights of bullying others to find some meaning to their life.

    • Wren

      I think there is a fallacy here. Nature does not optimise anything. Everything is a compromise, such as the female pelvis. Wider would be better for childbirth while narrower is better for bipedal motion. Breast milk would certainly be pushed to be good enough, but not optimal. It would be constrained by previous evolution, the impact on the mother and likely a number of other factors.

      • Well said. Perhaps “optimized” is too strong a word, but I think you’ll agree that there has probably been a genetic selection for milk components that are “good enough”, and that these would vary for different species (e.g. goat, seal, or mouse). Cows’ milk, for example, differs significantly from human milk in its carbohydrate components. It’s plausible, but unproven, that these carbohydrates may play a role on determining the kind of microbes that populate the human gut, which in turn may affect long-term health.

        (BTW let me stress that these are hypothetical considerations, and certainly not sufficiently proven that they should influence breastfeeding practices, but they may help to inform the design of superior formula in the future).

        • Wren

          You say this as though formula was not already based on everything we currently know about breastmilk (including carbohydrate components) and isn’t changed with new information about breastmilk.
          Given that evolution is constrained by so many factors and “good enough” is likely all it will ever get, isn’t it possible that formula could actually be more optimised than breastmilk itself? In terms of allowing others to care for the child for longer time periods, reducing physical impact on the mother and in some cases safety formula is already the preferable choice.
          (Not that it should matter, but I breastfed both of my children and have no problem with breastfeeding.)

          • There is still no synthetic formula that replicates the composition of typical human milk, but whether these differences are significant is still an open question.

            You raise an important question—whether human milk is even optimal for infant development. It seems quite plausible to me that in the future there will be a range of formulas adapted for infants of different backgrounds (genetic, nutritional, health, environmental).

          • The Bofa on the Sofa

            So given all these uncertainties, doesn’t it seem pretty crazy to make breastfeeding a huge national priority, to the point of shaming women who choose not to?

            Consider your original comment, “Aren’t you being a bit melodramatic?” I’d actually turn that around – the ones who make the big deal out of breastfeeding are the ones being melodramatic. As you agree, the differences are so minor that even today they are “an open question.” Yet they are harassing women incessantly over their choice not to breastfeed. It doesn’t make sense.

          • Wren

            Given that it is literally impossible at this point to determine which children were breastfed, and how long, once they are past that stage, what is the value in promoting breastfeeding above formula feeding in western societies?
            I see every reason to promote those policies that make it possible to breastfeed, but why the breastfeeding itself?

          • DelphiniumFalcon

            Thank you for seeing why we do get upset about this. At the risk of sounding a bit on the melodramatic side, there are lives at stake as has been related by many of the stories shared here. Either from post partum depression increasing suicide risk or babies developing jaundice or other health issues from starving, they’re both important and should be respected as human beings. Not a pair of breasts and a breast milk recepticle.

            Going from another post, mothers can have nutrient and vitamin deficiencies that aren’t investigated because they don’t produce life threatening symptoms. If the mother is deficient she won’t be able to pass it on to their baby.

            I’m extremely vitamin D deficient for example. I was at a 9 when the low acceptable range is 30. I wouldn’t be able to pass vitamin D to any hypothetical infants. To get my levels up u had to take a 5,000 mg pill once a week for six weeks to try to get it up to that. We’ll see in October if it works.

            I could put them out in the sun but they will likely be extremely fair skinned like myself and my husband isn’t much darker. I don’t want to risk a sunburn on an infant’s delicate skin, especially with those risk factors.

            I’ve likely been vitamin D deficient for years but I thought I was just out of shape when I got muscle aches and easily fatigued.

            There are a lot of women who are also iron deficiency anemic and would chalk their fatigue up to the stress of caring for a newborn. Now the infant is iron deficient.

            Now you might say, “That’s stupid, they have lab test for that!” They do, yes. But if it’s not a pressing matter most of us won’t go get checked out. My Vitamin D issues were only caught by chance when doing a 24 hour urine collection to see if we could identify why I produce kidney stones. It’s not considered routine. Different doctors may also order different prenatal tests. Or some women will have very little, if any, prenatal care in the first place.

            Tests that aren’t considered routine or preventative usually aren’t covered well by insurance. Tests for vitamin levels can vary widely from $75 to $500 before insurance pays into it depending on the type of test and how common the test is.

            So then it’s a question of do I really want to spend all that money to just be told to eat better and exercise more like most Americans are told and will likely be told to me? A lot will say no and never know about minor deficiencies that can crop up and possibly get worse when resources have to be used for breast milk.

            So in an ideal situation with an ideally nourished mother then breast milk would be the logical choice. Unfortunately we have bad diets, poverty effecting food choices and proper nourishment, and disorders that can cause issues absorbing or using vitamins.

    • wookie130

      I don’t know if “traumatized” was a correct way of stating it my own situation with my first child, but I can tell you as a woman, and a first-time mother dead set on breastfeeding her daughter, the post-partum hormones are raging, the weepies sneak in, and at 2:30 a.m., when your daughter won’t latch, and you have zero let-down (which later you discover is due to IGT, and an almost bare supply of milk), one feels like a complete failure, a shitty mother, less of a woman, and a whole host of other things…and we have lactivism to thank primarily for these feelings. I finally got over it, and accepted that formula was going to be the only way my daughter could eat, but it did take a good long time to get over the weepies, and shake the feeling that I was doing wrong by her. I now know better, and felt good about feeding my second child formula from the get-go. But it took a lot of perusing the SOB blog, and the FFF’s blog to get there.

    • Allie P

      Try all the LCs and info at “baby friendly hospitals” who tell you that breastfeeding prevents all manner of maladies and offeringa bottle will destroy your milk supply and make your baby (and you) fat, sick, cancerous, dumb…. It’s on every poster on every wall. I had to explain to three different LCs, one from the hospital, one from my pediatrician, and one from my OB, that I was supplementing and I didn’t want to hear a lecture about it.

  • Amy Tuteur, MD

    Can’t tell, can you?

    • MLE

      It’s the fast one in the front.

    • Liz Leyden

      The one on the right. It’s always the one on the right.

      • Box of Salt

        Your right, or their right?

    • ladyloki

      Plot twist – all were formula fed!

  • Amy

    You know what? Even Modern Alternative Mama agrees with you on this one, Dr. Amy.

    http://www.modernalternativemama.com/2012/03/10/im-tired-of-lactivists/

    • Daleth

      Whoa. But did you see what she gave her starving baby when her milk supply was low? Not formula. No. An ounce of diluted RAW cow’s milk. Omg. Because apparently listeria is preferable to formula?

      But I do appreciate that even she sees the problem here. That is refreshing.

      • RMY

        I swear natural death is better than artificial safety and health in the minds of some people.

      • Amy M

        She did mention that her oldest child was supplemented with commercial formula.

        • yugaya

          Isn’t that the born in the hospital kid that she wrote that horrid piece about how …she would prefer that child dying over the perfectly homebirthed one? I can see her feeding THAT child what she believes is poison and not suitable for her more precious homebirthlings.

          • Chi

            Yep. It’s almost like she was like ‘oh well this one’s ruined anyway, what’s a bit of poison?’

            Seriously? Formula, which is made from cows milk, tested rigorously so that it meets strict nutritional standards, is ‘poison’, yet raw milk, which COULD actually poison your baby with toxic bacteria is a-ok?

            Goddamn people need to stop buying into this natural fallacy shit. It’s arrogant to think that you alone can be one with nature and that when you are she is a benevolent being who just wants to love and nurture you.

            Newsflash, she’s a bitch and out to get all of us.

    • LibrarianSarah

      I guess Satan is making a snowman right now.

      • RMY

        Don’t get too excited, she gave her baby raw milk, so she supplemented the stupidest, riskiest, frankly worst way possible.

        • LibrarianSarah

          Yeah I noticed that but, you know, baby steps

    • RMY

      Even a broken clock is right twice a day…

    • S

      I wonder whether she would feel the same if she had not personally experienced low supply.

    • Sarah

      I like the bit where she says breastmilk functions as a baby’s immune system, for which there is no substitute.

      Except VACCINATION.

      • Angharad

        Or, you know, their immune system, which generally stops being so fragile after around 3 months.

      • Roadstergal

        How did this get to be such a Thing, that some IgA floating around in breastmilk became JUST THE SAME AS THE WHOLE IMMUNE SYSTEM?

        • Young CC Prof

          People who don’t know the immune system has multiple components? Or know what IgA is?

        • DelphiniumFalcon

          Because then they’d have to admit that the immune system is a complex interplay of biological machinery that they can’t hope to know everything about in an afternoon on Teh Googles.

          Which means they’d have to admit all the bullshit spouting from their facehole about how vaccines don’t work is not extensively researched and based on knowledge and evidence. Just shoddy Wikipediaing.

    • monojo

      OT: Is there a dedicated place to discuss the unabashed nonsense and idiocy that spews forth from MAM’s computer?

  • Amy

    Wait a minute…..you don’t need to prove something……and THAT is science? Apparently, Dr. Newman learned a different definition of the word science than I did.

  • Azuran

    I find that lactivist also have a biaised way of what ‘support’ actually is. The only thing they see as support is someone pushing to keep EBF your baby. Giving more and more ridiculous tricks to try and increase your production and stuff. They don’t see bringing up formula or combo feeding as ‘support’.

    Of course, some women probably stopped breastfeeding because they lacked support. That is indeed sad.
    Helping a woman who has some problems with breastfeeding to find solutions is support.
    Pushing an exhausted woman to pump 24/7 to keep EBF her starving baby at all cost is not support. That’s abuse.
    Helping that woman come to term with reality and help find whatever really works for her and her baby, no matter what that is, THAT’s support.

  • Chi

    So I was perusing the comments on Dr Jack’s post (which was a really bad idea because seriously some of them made me want to be able to throat punch people through the internet). And someone shared this article:

    http://www.integritycalling.com/#!shame-filled-bottles-of-formula/c1a1n/55c080c00cf2dce5af6816fd

    Apparently, according to this blogger, it’s NOT our bodies failing us when we fail to breastfeed, it’s the SYSTEM. So, basically the same shit as Dr Jack, but maybe SLIGHTLY less paternalistic.

    Um, lets see. I have inverted nipples. The system didn’t cause that. Pretty sure it didn’t cause my daughter’s tongue tie, weak suck reflex and the fact that she never got the ‘hang’ of breastfeeding either.

    So am I in that rarefied 5% of women who legitimately can’t breastfeed? Or am I just making excuses?

    When will people learn that it’s not JUST failure to produce enough milk that ends breastfeeding relationships? There are SO many other things that can go wrong, and no amount of support or knowledge can make them better.

    Dismissing the pain of women who struggled to breastfeed, despite ample support, despite all the knowledge in the world, and then SHAMING them because they didn’t try hard enough or gave up is EXACTLY what we’re trying to prevent by pointing out the hypocrisy and vitriol of the lactivist crowd.

    Because we’re human too. And we deserve to be treated as such.

    • Sarah

      Analyses like that always gloss over those of us who just don’t want to breastfeed too. We are an inconvenient truth, especially when we’re familiar with the research and have enough social science training to laugh in the face of people claiming to reliably control for social class. She mentions that the vast majority of Australian pregnant women want to breastfeed but the majority aren’t doing so exclusively after a few weeks, which is true. I’m sure plenty of them needed support and didn’t get it, which is a huge problem for sure. But no consideration at all of the possibility that maybe some of them stopped because they realised they didn’t fancy doing all the night feeds once they actually experienced it? Or the cluster feeds, or any of the other things that are perfectly normal when establishing breastfeeding but women might decide aren’t worth it? No, it must be because of the system. Changing your mind is impossible.

      I don’t want my daughters to get maternity leave instead of formula samples. I want them to be able to choose both, either or neither. They’re not mutually exclusive.

    • RMY

      I ignore all articles that say “loosing” when they mean “losing” as it shows a lack of focused review, and this article falls under that category.

      • Young CC Prof

        Also, “midwifes,” spelled that way at least twice. Random typos or misspellings I can handle, repeated misspelling of a key word indicates you may in fact not know anything about the subject.

        That’s got to be parody. No one could seriously take that beautiful photo of a mother and newborn, beaming with joy, and complain because the baby has a blanket on it.

    • SporkParade

      Is it me, or is she conflating “wanting to breastfeed” with “wanting to breastfeed exclusively?” Because those aren’t the same thing at all. I am beginning to wonder how many women who might otherwise BF switch to formula simply because breastfeeding “supporters” seem to think that, once you’ve given one bottle, you’ve already “failed.”

      • Tiffany Aching

        Yes. This purity trope is really disturbing, and counter-productive.

      • Chi

        Exactly. I’m sure I read somewhere that there’s been a study that seems to implicate that if women supplement early, it can actually EXTEND the breastfeeding relationship.

        Lactivists scream that supplementing kills your supply. But I think the stress of worrying about making enough, coupled with sleep deprivation and a whole HOST of other factors are more likely to dry you up faster.

        But what if we ALLOW new mothers to take a little of that pressure off themselves. What if we say that breastfeeding ISN’T the be-all and end all and that a nourished, happy baby is the best result regardless of method? What if instead of sneering at a mother when she buys a can of formula, or pulls out a bottle, we just smile at her and accept her choice?

        Of course that’ll never happen because we’re always going to have smug, self-righteous lactivists shoving their ‘breast or bust’ mentality down people’s throats.

        • Young CC Prof

          That study specifically endorsed supplementing with small quantities at the first sign of excessive weight loss in newborns, rather than waiting until the baby actually suffers from insufficient intake. Not just “supplement,” weigh the baby and give 5-10 mL of formula after each feeding if necessary.

  • Courtney84

    I’m sure I’m being overly sensitive because I am very pregnant, but some lactimonious jerk just made a reply to my comment that makes me want to bang my head against a wall. I posted about my child’s growth problems on breast milk and how he was later diagnosed with FPIES. She informed me that actually kids with FPIES are supposed to stay on breast milk because they are allergic to milk and soy and baby formula makes things worse. Is this not the embodiment of what is wrong with the breast is best movement? He’s not intolerant of milk or soy! He can’t have corn (which is ubiquitous) or sweet potatoes. My kid went from 45th percentile for height to 0.4 percentile. we worked with an LC, our fam practice doc, and then a pediatrician and then an allergist but this stranger knows that what my poor hungry, shrinking child needed was to stay on breast milk despite the fact that he grew on a corn free milk based formula ? WTF is wrong with people?

    • SporkParade

      That’s insane. I assume she’s mixing up FPIES with MSPI, but even so, my experience with MSPI just makes her sound even more insane.

      • Courtney84

        A lot of kids with FPIES to solids also have MSPI. Mine did not. And I’m sure parents buy NeoCate and other rx amino acid formulas for the fun of it, and not because kids with MSPI often struggle on breast milk since it can be very difficult to eliminate all traces of milk and soy from the lactator’s diet.

        • SporkParade

          You would be surprised, but there are actually parents who buy hydrolyzed formula because they are convinced that regular formula will give their child allergies.

    • Cobalt

      I don’t think that’s oversensitivity, pregnancy induced or otherwise. I think that’s what happens when someone puts sponsored guidelines (that will harm your child) over the health of the actual child.

    • RMY

      I don’t know. I know women who are so attached to breastfeeding, they’ve cut out entire food groups (dairy is the first example that pops into my mind) when they find out their 2.5 yr old has an intolerance to them instead of just weaning. Not that everyone should auto-wean at a particular age, but the benefit to child/cost to mother ratio seems very skewed in that situation.

      • Young CC Prof

        Yeah, I’ve heard of that. One problem that LEAPS to mind is adequate nutrients for the mother. It’s one thing to eliminate one food, but when you’re really cutting your diet so badly…

        • RMY

          If you cut out all dairy, that’s a pretty good way to make yourself lactose intolerant from what I’ve heard.

          • SporkParade

            Interesting. I don’t suppose you have a citation for that?

          • RMY

            It’s what I was told in school growing up. Dr Google thinks my teachers lied to me and that it’s primarily genetic or in response to another intestinal condition.

          • Angharad

            I’m not sure if lactose intolerance has a different mechanism, but my daughter’s allergist encouraged us to give her early and frequent exposure to the common allergens that she isn’t already allergic to. She said it could help accustom the body to them so it wouldn’t see the proteins as threats.

          • SporkParade

            Yeah, it’s a different mechanism. Lactose intolerance is what happens when the digestive tract doesn’t produce enough lactase to digest the lactose in dairy. This leaves the lactose for the gut flora, which have a field day, resulting in bloating, watery stools, etc. It’s actually the default situation for mammals; humans are unique in that a mutation developed in cold climates that allowed us to continue producing lactase as adults.

          • Angharad

            That’s actually really cool. I learned something today!

          • Liz Leyden

            Some adults, anyway. Lactose intolerance is common among African-American adults.

          • SporkParade

            If I remember correctly, the majority of humans are lactose intolerant to some degree, Europeans being the exception.

          • DelphiniumFalcon

            If I remember right from my biological anthropology class, only Northern Europeans and a tribe or two in Africa are not lactose intolerant. The tribe in Africa that I can’t remember the name of to save my life raise a lot of cattle as a primary source of protein and Northern Europeans did the same. So with a relatively cheap source of fats and sugars in cow’s milk as well, anyone that kept their ability to digest lactose into adulthood by continuing to produce the right enzymes were the ones that prospered and spread the predisposition for lactose tolerance.

            But it’s been like five years and I sold my books back so I can’t go cross reference my textbook.

          • An Actual Attorney

            I cut out dairy for a bit with Actual Kid. I still chow on cheese and yogurt pretty much all the time.

        • yentavegan

          I have frequently come across mothers who cut out dairy, wheat, corn, tomatoes, peppers, oranges, beef, soy, artificial sweeteners,and tree nuts, peanuts and chocolate all because some lactation specialist told them it would help with the baby’s rash or sleeplessness or food intolerances. The mother herself is frazzled from hunger, pumping and dumping ( because she believes she accidentally ate an offending food) and on the verge of a breakdown.

          • Courtney84

            We were at a loss for why he wasn’t really growing and why we were struggling so much. He nursed like a champ for 6 weeks and I had an incredible supply. Things started going hay wire at that point – low supply, weird feeding behaviors, breast refusal even when there was milk. We started bottle feeding breast milk, the went to combo feeding, and eventually the pumping regime with a child who didn’t sleep and was always hungry had me a) really blue and b) imagining my son and I were a tiger and her cub and I would imagine swatting the cub with my paw and send it rolling across the bed in a ball (I never physically acted put against my child, just imagined it). We went to all formula and things dramatically improved until he was starting solids. If I’d have known what 2 foods to eliminate I might have done it, but we were so exhausted I don’t now that I could have implamented a corn free diet at the time.

    • yentavegan

      You are not being overly sensitive. Anyone who advises a mother to keep on doing whatever is not working, ( and clearly having an infant fall so far below the growth scales) has an ideological agenda. Thankfully your good sense and love for your infant overrode any undue loyalty to the lactavist vision of “good mothering through breastfeeding”.

  • Francesca Violi

    Italy 2015 to Dr.Newman: with 3 children born in 2006-2009-2010 I have never ever seen any formula sample; here “liquid gold” is actually formula, at least as far as the price is concerned (most expensive in Europe). No one ever tried to push formula on me, quite the other way around, especially with son n.1 – back then I knew nothing and I bought anything nurses and midwives told me, up to disregarding that one breast, where I had previous surgery, produced only few grams of milk (because weighting the baby before and after nursing is evil). My baby since 3 months was always unsatisfied and upset after feeding, crying, not sleeping well, and gainging little weight, despite all my effforts of latching him super often to improve my supply etc. In all my meetings with the consultory nurse (public service for newborn and mothers) she never ever mentioned supplementing, myself in the first place never considered the option, I wanted so badly to conform to what was presentend like the only right pattern, no pacifier, no bottle, no supplementing… When I weaned him, I never saw an iinfant eating so much, poor thing, I still feel guilty. By baby n.2 though I knew better and did what suited best for my new baby and my family, that was breast+formula supplementing and we lived happily ever after.

    • Amazed

      God, it must have been terrible wondering why your baby was so clearly miserable and then realizing that you’d been starving him all along.

      I wonder… New mothers cannot really be expected to understand what the problem is. But doctors, nurses, midwives, LCs? Do they not see or do they convince themselves that the blue dress is gold?

      • Francesca Violi

        Actually it was the pediatrician who at a certain point told me to start weaning him, and quickly (he was over 5 months by that time). I did, but still, it took me very long afterwards to realize, and admit, what had been going on.

      • KeeperOfTheBooks

        That it is. DD was a huge, hungry baby, and I produced very little. While I started supplementing in the hospital, I would spend most days freaking out over every half-ounce of formula I gave her after nursing. “Oh no! She ate three ounces after a feed today, and only ate two and a half yesterday! My supply is clearly decreasing even more! And now she wants more food, and is crying her hungry cry, but if I give her more I’ll ruin her health and intelligence even more than I already have!”
        In retrospect, totally stupid, but that’s what happens when you have a mom who’s exhausted, stressed, dealing with untreated PPD/A (mustn’t leave the baby long enough to see a doctor, it’ll wreck my supply!), and been thoroughly taught that formula is the Worst Thing Ever.
        And yet, at the same time, what crazy privilege, only I was so nuts from all the pain/stress/fear/depression that I couldn’t see it at the time. The “worst thing ever” was for DD to be thriving on something other than my milk. You know, I’d say that a massive percentage of the world can only dream of living in a place where that’s true.

  • Sue

    I wonder if this Newman person has ever had trouble with (cough) – um – developing tumescence? Cos, you know, everything natcheral should work perfectly!

    • NoLongerCrunching

      If he has, I’d recommend he use a penile pump 8-12x/day. If he gets sore, cabbage leaves should clear that right up! Also, he should make sure not to let his wife have any …um, silicone substitutes, or she might get vagina confusion.

  • Froggggggg

    Formula advertising? Not legal in Australia, except for toddler formula. You get the lactivists bleating even when supermarkets or pharmacies advertise formula in their specials… shouldn’t be allowed, breaking the rules, blah blah blah (yeah, because someone out there is surely going to decide to formula feed just because they can get $2 off a can this week!?). Formula samples? Good luck with that one. I think you can at least buy some sample sizes now, but when my babies were little, those were nowhere to be found, and forget free samples… probably rarer than hen’s teeth if they existed at all. No, you were forced to get a whole can only to find your baby couldn’t tolerate it. Wasteful, expensive, upsetting.

    And as others have pointed out, there was/is little information on how to formula feed while there are breastfeeding classes, groups, info sessions etc. before and after birth. Formula feeding? Ask a random health professional such as a GP or one of those baby nurses we have in Australia (early childhood health nurses)… at best you’ll get something like “just choose any brand, follow the instructions on the can and see how you go”, but more likely a lecture on why you shouldn’t formula feed. I’ve heard of people who asked and were told that the health professional was “not allowed” to give any advice on formula feeding. I don’t know if it’s true, but it wouldn’t really surprise me… or maybe some people just use a statement like that to conceal their own anti-formula stance.

    Equal time for breastfeeding would actually mean a drastic reduction in the time it gets. Let’s try it!

  • Squillo

    What’s the big deal? Dr. Newman should feel free to breastfeed his children.

  • demodocus

    A) My year old son’s male ped helped us figure out this breastfeeding thing way more than the LCs we saw at the hospital.
    B) I barely saw a single formula ad outside of the circulars our local stores send out, tucked into the middle.
    C) My hospital and ob’s office gave us no formula samples, but did send us home with sample nipple cream and a back-is-best sleep sack.
    D) The baby bottle piggy bank we were given had no effect on my resolve to bf, but thanks for thinking I’m that weak-minded. A boob-shaped bank would have been very tacky.
    E) I know 1 woman who used formula from the beginning, and one other from the point where her oncologist said it was a bad idea. (No, she could not have waited like that one woman in his book. Stage IV ovarian does not have a great survival rate, especially when it’s traveling up the freaking umbilical cord) I know 7 who nursed several months. Doesn’t sound like peer pressure is pushing towards formula among my friends.

    • Tiffany Aching

      Is there really a woman in his book who delayed cancer treatment to go on breastfeeding ? Because being breastfed is more important than having a living mother ? That’s really crazy.

      • demodocus

        I’m fairly certain, but it’s been a year and a half since I read the book and gave it back to the friend who loaned it.
        eta: If memory serves, she had a more mild form of breast cancer than my sister’s ovarian.

  • missnina

    Lack of information? Really? My prenatal care group had classes on breastfeeding, lots of pamphlets and literature, but bottle feeding was never even mentioned. Bottle feeding moms have to find their own information while there are so many resources dedicated to getting moms breastfeeding.

  • Adrienne

    Slow clap for this one, Dr. Amy! Love your articles on breastfeeding!

  • LeighW

    I’m reminded of the doctor I had when my daughter was born. I left my first post-partum appointment in tears because he told me if I couldnt commit to breastfeeding it was clear I was too young and immature to raise a child. When I told him I swiched to formula because I didn’t produce enough, he said he didn’t believe that for a second since “you could feed the whole ward on your own”.*

    When my son was born I had a wonderful OBGYN who didn’t push for either, and was horrified that I’d been treated that way by the previous Dr.

    (*I’d always been well endowed, but ballooned up to 34G while pregnant).

    • Hannah

      Sound like he’d been learning from Dr Newman.

    • Bombshellrisa

      That was a horrible way to be treated, I am so sorry that happened. And glad to know you had a better doctor the second time around.

  • KarenJJ

    Dr Jack Newman fits right into the sort of doctors I’ve seen over my lifetime:

    1. “Anemia of chronic disease?” (written on the pathology report) “Maybe your red blood cells don’t last as long as others?”

    2. “Anti-histamines don’t seem to help with the rash? Maybe you just need to be on them for longer. Here’s some stronger ones”

    3. “You get hot, sore swollen joints for no particular reason? Here’s a referral to physio.”

    4. Dr: “Wow, is that rash itchy?” Me:”Not really”. Dr: “You poor thing. Here’s some anti-histamines”.

    These are all things that were said to me by doctors. Some several times. They were all trying to fit me into some preconceived idea of what was wrong and weren’t listening to me and were minimising my distress (my sore joints were incredibly painful and I wasn’t able to walk on them for days, they also remained weak for a few weeks after a flare – I’d need to grip the rail to get up and down stairs).

    Finally someone in my family found a doctor that said “that’s not right? A rash like that is normally incredibly itchy. Something’s going on”. Eventually I also saw a doctor, who also wrote a paper on how difficult to diagose it is (they were quite excited to find a “kindred” that had been dealing so long without treatment that said “what happened to your family is an indictment of the medical profession”.

    So that’s where this type of thinking can lead and doctors can be as prone to trying to get reality to fit their preconceived ideas as the next person.

    • Sue

      Good point, Karen, but bad enough that you turned out to have a relatively rare condition. Breast feeding struggles are many orders of magnitude more common, so there’s even less excuse to misunderstand or be dismissive.

    • Mattie

      I’m not sure what you suffer with, I have Ehlers-Danlos….the ‘mascot’ of which is a Zebra. The reason it’s a zebra is because doctors are taught that ‘when you hear hooves, think horse not zebra’ this is so that they don’t automatically diagnose rare or unusual disorders when it’s more likely to be something more common. However some doctors, yours included, seem to forget that sometimes it is zebras…zebras do exist.

      • KarenJJ

        I occasionaly joke that I was diagnosed as being about 6 different varieties of horse before someone figured out I was a zebra 🙂 I’ve heard the ‘zebra’ thing before. I have a periodic fever syndrome, although some have also been investigated with Ehlers-Danlos as part of this.

  • Cartman36

    Dr. Newman says that Dr. Amy “often speaks out against breastfeeding”. Apparently, he hasn’t read anything she has written.. ever…

    • Young CC Prof

      No, it’s just a language barrier. To his subculture, admitting that the health benefits are small, or talking honestly about problems with breastfeeding is speaking against breastfeeding. Because you have a moral obligation to tell all expecting and new mothers that breastmilk is miracle juice and that it will almost certainly work out fine unless she does something wrong.

      • KeeperOfTheBooks

        Right. It’s like when my MIL came to help for a while after DD was born, and she commented that I might consider introducing DD to a bottle by about 3-4 weeks so that if DH and I wanted to go out for an evening or something, someone could feed DD. At the time, I was horrified because she was OBVIOUSLY trying to SABOTAGE my breastfeeding relationship, don’tchaknow. She certainly wasn’t, oh, speaking from experience when she said that date nights are really important for parents…

        • Sue

          Great illustration – she wan’t trying to sabotage your breastfeeding relationship, but to nurture your marital relationship! Wise MIL!

          • EllenL

            I’m glad someone cares about the marriage bond. Lactivists act like they couldn’t care less. “Nothing must interfere with breastfeeding!” Least of all the needs of husbands/partners.

          • KeeperOfTheBooks

            Right. You read their blogs, and their answer to “Mom and Dad need couple time” is either
            a) “don’t go on a date that lasts more than an hour and a half so you don’t miss a feed” (the hell? So, rush out, inhale dinner, run back home? Oh yeah, that’ll certainly be the relaxing evening we need.) or
            b) take baby with you on the date. (Yes, because I know my DH and I can have deep, good conversations when we’re trying to keep a shrieking infant quiet at a nice restaurant. Plus, I’m sure everyone else who’s dropped a decent amount of cash here totally wants to hear a crying baby while they eat. Also, we all know how well babies do in movie theaters.) or
            c) just eat dinner after the baby’s fallen asleep on your bed, and then have sex on the living room floor before going in to cosleep. (Um. Yeah. That was one thing when DD was a little infant and still sleeping in her bed in our room, but long term, nopity nopity nope nope nope. Also, at-home date nights are great sometimes, but it’s not the same as dressing up and leaving the house together to go somewhere nice.)

          • Amy M

            And then there’s the advice they give to the all-too-common lament of: My husband isn’t happy about our cosleeping arrangements.

            It’s always “You know best Mama!” and “Tell him its only for another year, until toddler has weaned” or “He’s being selfish, and a good dad would put his wants and needs aside so the baby can have the best.” I’ve wondered how many of those marriages last.

          • KeeperOfTheBooks

            Exactly.
            You know, one of the hardest transitions for me has been from a wife to a wife and mother. I’m still fighting to balance those two aspects without losing myself, either. Having a kid in our married space–i.e., the bedroom–for more than infancy would mess with that. It’s not even so much a question of spontaneity as just plain having our own space in which to be spouses and lovers and not Mommy and Daddy. I love my daughter with all my heart, but I love my husband even more, and our marriage needs us to have time just spent together, even if it’s only reading with the lights on for thirty minutes before lying down and chatting about what we read. Sure, we could do that in the living room instead, but…it’s just not the same somehow.

      • Amy

        This. It’s like when conservative Christians say that Christians in the (Christian majority) US are “under attack” because some of us don’t think that government buildings and agents are appropriate places to post religious texts, and because retail workers wish people happy holidays during the holiday season.

  • Sarah

    I’ve been thinking for a while we need a pithy name for men who think themselves entitled to preach to women about breastfeeding, minimise our feelings and experiences and generally police what we do or don’t do with our breasts. Then it hit me. They’ve got a bad case of Newmanitis. There are only two known cures: either being subjected to forcibly induced lactation, or shutting the fuck up.

    • Amazed

      Preach sister!

    • Bombshellrisa

      Newmanitis with a history of chronic mansplaining (in which case, I have known many of these guys. They are the ones who read Penny Simkin and Ina May Gaskin)

    • Rosalind Dalefield

      Tit-heads.

      • Sarah

        That would also work.

    • Amy

      It’s a subset of mansplaining.

  • Amy Tuteur, MD

    My experience with lactivists:

    • Rosalind Dalefield

      Brilliant!

  • Young CC Prof

    Dr. Neuman’s post is a PERFECT example of the party line on breastfeeding. Couldn’t breastfeed? Feel bad? Well, you should feel bad, but that isn’t important. What’s important is that the only reason you couldn’t breastfeed is that you weren’t adequately supported, or gave up too soon, or saw a formula advertisement in the grocery store. This is the sort of mentality that’s driving the so-called breastfeeding science, premise before conclusion.

    We should know what the true incidence of insufficient supply is, and what the risk factors are, and which factors are modifiable. We don’t, because the folks controlling the research just know that insufficient supply is very rare.

    We should have trials of different interventions to see which ones truly improve long-term breastfeeding success rates. We don’t, because obviously if you failed, whatever intervention you got was the wrong one.

    We should have properly established protocols for supplementing newborns who require supplementation while still supporting a breastfeeding relationship. We don’t, because obviously exclusive breastfeeding is the important goal, and if you can’t attain that, your babies don’t matter anyway.

    You know what sabotages breastfeeding? Lactivists who took research resources and did nonsense with it.

    • Kelly

      I hate that the argument is all about knowledge. I have all the knowledge in the world about breastfeeding and tried so many different things. I am also a stay at home mom so I supposedly have all the time in the world. Breastfeeding did not work for me. Pumping made me a terrible mom. It is not about any of that, it is about the fact that breastfeeding is a terrible option for my family. Formula is the best option for us and I can’t wait to see my kids grow up and be able to say that no one can tell the difference. My kids rarely get sick because neither their father or mother get sick often. They have a much higher chance of doing well in school because both of their parents have college degrees. The kids will be fine.

      • Chi

        I had the help of TWO LCs (although one just showed me posters of proper technique so I don’t know if that counts as ‘help’), a midwife and my GP/Pediatrician.

        NOT ONE of them could help me with the simple fact that my inverted nipples and my daughter’s weak suck reflex combined to mean that she wasn’t getting what she needed, and so failed to thrive.

        But you know what I had the knowledge and ability to do? GET SOME DAMN FORMULA AND FEED MY STARVING BABY.

        Lack of knowledge had nothing to do with my choice to use formula, nor did lack of support (though some people in the local breastfeeding community were less than supportive when I started combo feeding, before I was basically forced to leave the community and exclusive formula feed).

        I chose to formula feed because it gave my daughter something that I clearly lacked. It made her feel full, and happy and allowed her to sleep so she could grow. Risks of formula? There was a bigger risk to not using the formula, the risk that my baby would starve to death.

        I chose the lesser evil. And today I have a happy, healthy 16 month old girl.

    • MJ

      This is a really good point. I experienced d-mer with all three of my babies, although it was less pronounced with the second and third. If you don’t know what d-mer is, you’re not alone. When I was breastfeeding my first 11 years ago it didn’t even have a name and nobody, including my otherwise excellent and sensible midwives and maternal child health nurses knew what it was. Dysphoric Milk Ejaculation Reflex – it means that for the period when I was actively feeding my children I became depressed. Really, really depressed. From the moment they latched til they got back off again. In all other respects I could feed like a lactivist’s dream. I was able to get through OK, but for many other women with d-mer the depression is debilitating and they simply cannot continue to breastfeed. This is something that is genuinely affecting women’s ability to breastfeed, as well as their confidence in their parenting and yet, last time I checked we knew next to nothing about it medically. Why aren’t we researching this kind of thing?
      And jeez, I absolutely hate to think what Dr Newman would say to a mother with d-mer “you’re not really depressed, you just haven’t seen enough pictures of babies and boobs”.

  • Wombat

    The comments on that page… (just one example: “Yes, and let’s get that commercial back that compares formula feeding to riding a mechanical bull while pregnant. Women won’t breastfeed unless we shame them into it!”).

    They should be satire. They’re not. There are a few sane people. They’re massively drowned out by the angry, thirsting-for-blood/bm-zealots.

    Scary.

    • I know. I had to walk away from the computer before I exploded.

    • Susan

      Um, that was definity intended as satire

      • Wombat

        My bad on one of the few anti comments then. I suppose you blended in a little too well with the crazy.

        Replace yours with “one risk as explained by Dr. Humphries which I linked above, is that formula fed babies have more frequent and severe adverse reactions to vaccinations than breastfed babies” then.

        • Susan

          I was just as disturbed by the comments and wrote what I did because I wouldn’t be suprised if feeling self righteous is the primary motive behind some lactivism.

          • Chi

            Of course it is. They NEED the validation to make any struggles they experienced worth it. And if they have to tear down a mother who chose, to their mind, an easier path to get that validation, so much the better because that only serves to make them feel more righteous, because they followed the accepted norm and didn’t ‘give in’.

            It’s kind of disgusting actually.

  • ladyloki

    Sort of OT but why is it that the only way moms can supposedly bond with baby is to breastfeed, but when people say they want to pump/formula feed for dad/grandparents/other family to bond they are told that they don’t need to feed to bond.

    So what is so different about the way a mom bonds to a baby and the way everyone else does? Why does a mom need her boobs but anyone else can bathe, dress, cuddle, etc and bond?

    • Nick Sanders

      Because, uhm… REASONS, THAT’S WHY!

    • Angharad

      Yeah, it’s weird how apparently it’s so much more difficult for mothers to bond with their babies than for anyone else. My daughter LOVES her grandma and grandpa and aunts and uncles and her dad, and none of those people ever gave birth to her vaginally (or otherwise) or breastfed her.

      • Chi

        I know right? My daughter loves me, but she is a daddy’s girl through and through. Given the choice between me and her father, she’ll choose her father every time.

        However, when she’s upset, she wants her mummy. Bonding problems? I don’t think so. She was bottle fed and she bonded with me and others just fine.

        • Angharad

          I know this is heresy, but I combo fed for six months, and I actually felt like bottle feeding was the more “bondy” of the two feeding methods. I could look her in the eye, have a hand or two free to stroke her hair, face, or arms (once she started holding her own bottle), lay her on my lap and kiss her feet, etc. She never really got very good at nursing so once she latched I would have to remain completely motionless so I didn’t unlatch her, and there was never any eye contact (her face was toward my body). I liked feeling like I was nourishing her in a special way that was just for the two of us, but honestly I liked the experience of bottle feeding better.

          • demodocus

            lord knows I certainly bonded more while just snuggling than over nursing. I had to ignore him to tolerate it.

          • Chi

            I had the same thing! When I was breastfeeding, my daughter would look anywhere but AT me. As soon as we switched to the bottle, suddenly I was getting eye contact, smiles around the bottle, etc. And bottle feeding just allowed me to APPRECIATE her more. I could see how she was growing, see her personality starting to develop. Bottle feeding was definitely more magical for me.

    • RMY

      These are people who think mom has a *special* bond with a baby that nobody else gets. Just listen to their nomenclature – they often speak of their “breastfeeding relationship.”

      • Bombshellrisa

        The Womanly Art of Breastfeeding refers to breast feeding mother and her baby as a “couple”. Yuck. I actually wrote a letter to the hospital system and railed against that book being on the required reading list for OB patients.

        • LeighW

          Required reading list?? Wtf?

          • Bombshellrisa

            Yes, this practice caters to the Microsoft, Google and Amazon employees and their spouses. It was disheartening to see the reading list and class suggestions, everything is geared to a super privileged crowd.

          • Sarah

            Vomit. The NHS has her share of problems, but thank Ina May no practice could pull that kind of shit here.

          • Bombshellrisa

            It’s sad because the hospital system itself is excellent. The big hospital downtown sees over 10,000 babies born a year and the NICU is top notch. BUT the smaller hospital that is closer to me is baby friendly and has a Starbucks in the lobby. It looks like a ski lodge in Aspen. My doctor moved to the practice there and I moved with her. I loved the lactation consultant I met with, she is no lactivist, but the breast feeding support group that meets at the hospital has to be seen to be believed.

        • araikwao

          That book’s title is mildly nauseating to me. So you’re less accomplished if you don’t BF? And somehow, calling it a “womanly art” makes it sound condescending. Bleccch.

        • ladyloki

          Um…no. My husband and I are a couple. I will never be a couple with my children. Even though they are adopted, I’m not pulling a Woody Allen.

        • yellowvalkyrie

          OH LORD that book. I received it as a gift, and never got past the anecdote about seeing a formula-feeding mom run out of formula on a delayed plane flight, and rather than having any empathy for this other mom the writer just smugly described how happy she and her “nursling” were while this other mom was “hysterical.” And this was when I was still totally on the lactivist bandwagon. It still rubbed me the wrong way.

          • Bombshellrisa

            Pretty smug, wasn’t it?
            All the anecdote did (besides infuriate me) was make sure to get those individual serving size packets and tuck them into my carry on. Problem solved.

  • ladyloki

    His lackeys are saying flat out that women need to be shamed for not breastfeeding. That says all I need to know about what this man promotes.

  • Jessica F. Stone

    I’ve noticed that lactivists have a serious persecution complex. They claim that they get yelled at constantly for breastfeeding and pressured to use the bottle. I have serious problems accepting these claims.

    • Cobalt

      Every know and then it happens. There are pushy grandmothers who raised their kids on formula (and saw those kids turn out just fine) who would really like to feed the baby and don’t have great boundaries. Some people also don’t like to handle breast milk (I’m one. I don’t mind my own, but I feel weird handling someone else’s.).

      On the other hand, there are also plenty of grandmothers pushing “breast is best”.

      Lactivists only “see” one of these issues, though. They are the other one.

  • Megan

    I’m so tree of hearing that I would’ve been successful at breastfeeding if I’d only “had more education and support.” Without going into detail, let’s just say I was very educated and supported. And breastfeeding still didn’t work. Four LC’s and all the help in the world at home cannot create glandular tissue!! (Though I guess he would just say I got help too late.) So sick of this argument. I’d love to hook Dr. Newman up to a breast pump for 5-6 hours a day on top of nursing and feeding pumped breastmilk (the so-called “triple feed”) while he takes care of a newborn and recovers from a Csection. Who has time for bonding with baby when you’re busy with all that?

    • Johanna Sargeant

      Just FYI, Jack Newman states, “Do what you can. A mother exhausted from pumping is probably no further ahead with milk production. And yes, it is not necessary to express your milk if this is a burden and makes you want to stop altogether.”

      • Sarah

        It’s probably all her fault if she’s finding it a burden, though.

        • DaisyGrrl

          Well, duh. If she had done it properly from the outset it wouldn’t be a burden! /sarcasm

      • Megan

        So then he’d totally support that I switched to formula because the burden was too much, right?

  • Kimberly Kjellberg

    By reading the Facebook comments I learn that if there is an option to breastfeeding we should all stay in diapers and never learn to walk.
    I don’t really see the connection, but maybe it’s just because I raised on formula.. or not. The comments are about 5 hours old right now if anyone wants to read them.

    Also what’s with the extremes? Why has it to be “If breast isn’t best it’s useless” which seems what they are getting out of it.

    • Sue

      Strange thing, this “less than 100% equals zero%” that many anti-scientists conclude. Like anti-vaxers – if a vax is <100% effective, it must be useless. "If you can't promise me it's 100% safe…". Sigh.

  • Sarah

    Men like Jack Newman actually make me delight in purchasing formula. Usually I just buy it and don’t really think much about it, it’s a part of my weekly shop the same as apples or chicken. Next time, I’m going to do it with pride. The thought that he doesn’t like the way I’m using my breasts and there’s nothing he can do about it is a source of great delight to me.

    • Cobalt

      I’ve said it before, but these people make me want to buy a truckload of Pediasure and Ensure and put the whole family on formula.

      • Sarah

        Live the dream.

  • fiftyfifty1

    From his blog:

    “many mothers have terrible breastfeeding experiences. I know, I see them in our clinic every day. And I will state emphatically, these problems could have been prevented had the mothers received good help at the beginning. Furthermore in our clinic, we manage to help many women have a beautiful breastfeeding experience after a terrible beginning. I wish I could say we can help all mothers, but sometimes they come to us much too late.”

    Wow. Sounds exactly like every quack under the sun:

    “Our amazing cure can fix absolutely every case (those that aren’t successful just came to us too late).”

    • Sue

      Woo bingo.

  • Sarah

    Basically, what he’s saying is that you bitches need to do what I think is best for you. It is literally impossible that you could just not like breastfeeding.

    • Sarah

      Even if you don’t , suck it up. Whose boobies do you think those are?! Yours?! Ha!

      • Sarah

        No pun intended I assume!

  • DaisyGrrl

    Dr. Newman was on the expert panel that developed Health Canada’s infant nutrition guidelines. He is aware that (per these guidelines), breastfeeding initiation rates are very high in Canada at 88.4%. He is aware that breastfeeding is the cultural norm here. He has campaigned hard for the adoption of BFHI in hospitals.

    He has also participated in shaming women who don’t breastfeed. He does it in this very post. For him to say that formula feeders aren’t shamed while using such blatantly manipulative language for formula is so hypocritical that I just can’t even begin to find the right words.

    • Mishimoo

      It’s standard gaslighting from what I can see.

  • Amy M

    It’s awful that he’s dismissing the mental health of women as unimportant. I don’t know if he truly thinks that women are just silly-billies who are easily swayed into behaving a certain way by a few advertisements. If women were really empty-headed ninnies that need to be told how to do everything the right way, then sure, a bottle-feeding ad might lead to them using a bottle. He’s completely discounting practical (which he claims he knows so much about) reasons for a woman might not choose to breastfeed–working being one of the biggest. But he probably thinks women should just stay home anyway. Does he really believe that women have difficulty breastfeeding because of lack of information? Or does he know that by suggesting that, he is perpetuating the problem? If the latter, then he’s truly a misogynist who cares nothing for women’s health and is AOK if a few women are depressed/anxious’/suicidal because of the message he is sending.

    • DelphiniumFalcon

      Having my constant exclamations that something was terribly wrong and having my psychiatrist brush it off was the beginning of my suicidal streak. I had a plan and I was going to do it. I didn’t tell anyone because I didn’t want to be locked up. But my assertions that something was terribly wrong with me was brushed off and me needed to excersize more. I was already in PE every other day at school and in dance classes the other days. I nearly killed myself after my warning signs were ignored because I didn’t get the help I needed.

      My mom has depression and had extremely awful PPD and was right on the low end of postpartum psychosis. She said it was the worst episode of depression she’s ever had in her life, including the time before she was medicated. She was scared of herself.

      Knowing what it was like to be ignored and told I just needed to excersize more with run of the mill depression, I can’t imagine what would happen if a woman in a state like my mom’s was told she just needed to try harder to breastfeed.

      Actually, unfortunately we do know what happens to these women. They end up plastered on all the news stations as a monster when she kills her baby after her pleas for help were brushed aside. Or the tragedy of a murder suicide with not only a dead baby but also a dead mother.

      Those cries of “I can’t do this” could be that of a mother frustrated and at her wits end. Or they could be the pleas of a woman in the depths of PPD that doesn’t know how else to express her distress. Unless a woman is able to pull herself out of it long enough, NOT a common outcome and should never be expected, to articulate what is happening to her in no uncertain words or a family member spots what’s happening, this new mother is in constant danger.

      And the reason why so many women that are at risk for harming themselves or their children are that they have thoughts of self harm or of harm against their children. Admitting the latter doesn’t bring understanding. It causes the woman to be seen as a monster. The mother, at least in my mom’s case, is afraid her child will be taken away forever if she admits these terrifying thoughts. It makes her wonder if she IS a monster. So she suffers in silence.

      How do you know if a mother crying her eyes out over being a failure at breast feeding is at their wits end and frustrated or a mother with PPD that may do something to themselves or their child? You won’t if you tell them they’re not trying hard enough and ignore their cries for help. And it might be the final push to put them over the edge and feel hopeless enough to give in to their altered state of mind. Then they’re another statistic and another monster with the whole story being ignored.

      Neither woman should be ignored. Both are calling out for help to someone who is supposed to be in charge of their care and recognize signs of distress. But some believe they can tell these silly, emotional women they’re just overreacting and aren’t trying hard enough. There will be consequences regardless after that. It just depends if they’re going to end up on the evening news or not.

      • Rosalind Dalefield

        I had PTSD after my first delivery, as a result of the negligence of the midwife who made it a near-disaster through her determination to get the baby out vaginally, and her inability to recognize a posterior presentation. By sheer good luck I breastfed easily but weaned my baby at 6 months because the psychiatrists would not give me any medication while I was breastfeeding. It was wean the baby or kill myself. I weaned the baby. He’s done just fine.
        What pisses me off is that when I suffered acute depression during my fourth pregnancy, a psychiatrist at another hospital was perfectly happy to put me on an antidepressant that I could take throughout pregnancy and lactation, because it had been known for 20 years to be safe in pregnant and lactating mothers. I went through so much suffering because of the idiots who wouldn’t help me at the first hospital.

        • DelphiniumFalcon

          I’m so sorry you had so many people throw your needs to the side so casually. They really don’t understand how much any sort of mental issue can effect the whole body.

          Thank goodness you found a doctor that actually lives in the modern age of proven anti-depressants for pregnant and lactating women!

        • Amazed

          That sounds terrible. I am so glad you found someone who knew what they were doing, even if it was so late in your troubles.

      • KeeperOfTheBooks

        Thank you. So much. You get it. You definitely get it. I wish you hadn’t had the experiences that have led you to get it as well as you do, but I admit I’m glad that you could use them to understand those of us who’ve been there.
        Seriously. Thank you.

        • DelphiniumFalcon

          I figure the more we talk about these things the sooner the stigma can end.

          Until the stigma is a thing of the past people will continue to die as surely as they do from cancer.

          A mother with PPD with thoughts of harming herself or her child isn’t a monster and isn’t crazy. She’s a woman in the absolute depths of a severely pathological process with physical causes that needs treatment. You don’t tell a diabetic they’re not wanting the insulin bad enough and if they tried harder they’d find their pancreas worked all along.

          I’m thankful that despite how hard it must be to talk about that you’re brave enough to describe your experiences and how it felt to be ignored and so helpless. And also thankful that someone in the profession told you that you weren’t broken. Just ill and illness needs to be treated.

          • KeeperOfTheBooks

            Yes. Exactly. Someone with mental illness is just that–ill. They need help. Not judgment, nastiness, ignorance–HELP. Just like someone with diabetes needs insulin, or help processing it. Yes.
            I don’t know if you read Dr. Grumpy at all? He writes mostly funny stories about being a practicing doc, but every so often he’ll write some non-humorous stuff. A while ago, he wrote this piece (http://drgrumpyinthehouse.blogspot.com/2014/11/happy-pills.html) about how we should deal with mental illness, about how it’s viewed in the medical profession, and about his own experience with it. Worth a read, if you have a minute or two. It’s spot-on.
            Sadly, even though I love my OB, I was too far in the depths last time to reach out to him for help. It made “sense” to me at the time that he’d be horrified by hearing about my obsessive and suicidal thoughts (it wasn’t to the point of action, but I was certainly thinking about it WAY too much), and that his first step would be to call CPS and have DD taken away. Sigh. Yeah, this time we’re going the pre-emptive route on that stuff, thankyouverymuch.

          • Kelly

            It is terrifying. Thankfully, my husband was very supportive and did not dismiss me as crazy. I am thankful he works in the medical field and got enough training in his classes to understand things like PMS and PDD.

    • KarenJJ

      Yes. All that information was not going to fix my undiagnosed chronic health issues. Information pamphlets don’t help me make more milk..

  • KBCme

    I could have continued breastfeeding after the 10 weeks or so that I did. But it would have meant 6+ hours of pumping/nursing a day. More support or help wouldn’t have changed that fact. I decided I’d rather spend the time playing with my baby rather than attached to a pump. I was happier and more relaxed by formula feeding and therefore a better mom to my kids. I fell into the woo for awhile and felt a lot of guilt for formula feeding, but not anymore.

    • Amy M

      I had a number of reasons why I didn’t breastfeed, but the biggest was that I went back to work when my babies were 3mos old. I believe, at least where I live, that I’m in the majority: more women with young children work than stay home, at least around here. Unless Dr. Newman wants to subsidize longer maternity leaves, there’s really nothing he could say or do to get formula feeding rates down.

    • Rosalind Dalefield

      I couldn’t pump at all unless I had the baby latched onto the other breast. If I tried to pump without the baby suckling the other breast, I just bruised my nipple but nothing would come out.
      Interestingly there is a parallel in cows. Although Bos taurus cows (European breeds) let down easily without a calf being present, Bos indicus cattle won’t let down unless their calf is at least present, and in some cases unless their calf is suckling another teat. So I’m more a Bos indicus than a Bos taurus!

      • Young CC Prof

        I could pump, but it was half an hour on the pump every time, and I hit a supply plateau after like a week, I could not produce more than half a liter a day. Tried more frequent pumping to get past the plateau, got bruised nipples. So, since my baby was still refusing to latch at all, I quit.

        I did notice, however, that pumping went ever so much better if I could convince him to at least poke at the nipple with his mouth beforehand.

        So. Proof by example, sometimes a mother can make milk, but nursing still doesn’t work.

  • Amy Tuteur, MD

    I posted the link to this on Newman’s Facebook page. Let’s see if he takes it down.

    • Sarah

      The unsubstantiated garbage on that thread made my head spin. “At least one baby has died from formula.” “Maybe we should change the wording from ‘the benefits of breastfeeding’ to the ‘dangers of formula feeding.’ And yet, they’re not “shaming mothers.” Thank you for posting your link to this amazing response.

      • DaisyGrrl

        I liked the woman who decided to write a blog post rebutting Dr. Amy Turner. I was like, “who’s that?”

      • sdsures

        I better not read that thread. *goes to look anyway*

    • Sue

      It was still there when I visited. I felt obliged to join the thread 🙂

    • Guest

      I saw your post there before, but now it’s gone. It looks like he deleted it. What a coward!

  • I wish more doctors took to heart the core of this post “listen to your patients” – they live in their bodies and those bodies live in context of their lives. The choice is never the same for any two women – the costs, the benefits are always different. She is not a statistic.

    • Angharad

      Yes! It’s especially hard for anyone who is overweight to find a doctor who will really listen. My husband is quite overweight, and we had a hard time finding him a doctor who would actually investigate the causes of any health problems he had, instead of just saying he should eat less and exercise more (no, it turns out pneumonia is not caused by being fat).

  • Sarah

    If I had listened to my lactavist friends, my son would likely have been admitted due to a failure to thrive. A hundred years ago, he and my daughter likely would have died from malnutrition (not to mention my daughter may not have survived or grown up without a mother due to pre eclampsia). We have to respect nature and physiology, not blindly trust them. That would be folly.

  • sdsures

    Would it be sexist of me to point out that as a man, Dr Newman cannot possibly understand how some women suffer as a result of the pressure to breastfeed, not only psychologically but physically, because, well, men cannot breastfeed?

    When is the last time a man, otherwise healthy, suffered cracked and bleeding nipples? Mastitis?

    • Bombshellrisa

      Or had to endure recovering from a second or third degree tear and having to try to get comfortable while sitting for a long time nursing or pumping. While wearing a gigantic pad. At 3am when your longest stretch of sleep in weeks has been 49 minutes. I know that my illustration is only relevant the first few weeks, but those are stressful weeks. The important thing is to feed your baby AND to be as healthy physically and mentally as you can. If formula feeding makes it so other people can help with feeding and it allows you sleep, time out to breathe and the ability to feel whole, that is worth it. (Don’t even get me started on how crucial it is for a woman to have sleep when most go back to work so soon after giving birth. No sleep, cracked bleeding nipples and mental fatigue are not good)

      • sdsures

        “If formula feeding makes it so other people can help with feeding and it allows you sleep, time out to breathe and the ability to feel whole, that is worth it.”

        This.

        Somethig that’s bothered me with people who insist on EBF: where is there any time for the spouse to interact with the kid and feed it? Relegating Dad to purely nappy duty seems cruel.

        • Box of Salt

          sdsures “where is there any time for the spouse to interact with the kid and feed it? Relegating Dad to purely nappy duty seems cruel.”

          Bathtime.

    • Mac Sherbert

      Right! My DH is wonderful, but even he cannot relate to how sleep deprived I was while BF DD. Not to mention that since I was the only source of food or comfort she refused care from anyone, but me. So, even when someone would attempt to take her to allow me to sleep I couldn’t because there just weren’t enough doors to keep the crying down. (and let’s face it when your are BF and you hear a crying infant your body responds!) I was afraid to even drive my son to preschool for fear I would fall asleep while driving. Recovering from birth, BF and caring for a young child is not for the faint of heart.

    • KeeperOfTheBooks

      I’m not sure, TBH. He certainly can’t understand it first-hand, for obvious reasons, but I should think he could at least listen to what we have to say. Like, oh, as a *random* example, my awesome OBGYN. You know, the guy who is completely supportive of breastfeeding–had DD put on the breast in the OR, did my postpartum checks while she nursed, etc–but who also realizes that the important thing is a fed (whatever the mechanism) baby and a mom who’s doing as well as she physiologically and psychologically can during those rough first couple of months.
      I suppose what I’m getting at, in a rambling way, is that while as a man, he can’t experience this personally, he can still understand, from a scientific/social perspective, the facts: breastfeeding isn’t always best, constantly telling someone who’s at the end of her tether that she’s Doing It Wrong/Not Trying Enough is a REALLY bad idea, psychologically, and that for God’s sakes’, isn’t it time we laid off of beating each other up over what are, in the end, trivialities compared to the horrors Dr. Amy posted about yesterday?