Everything wrong with breastfeeding advocacy in a simple hashtag #TheHungerGames

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Talk about having a tin ear.

On the same day that Courtney Jung’s book Lactivism was published, taking the breastfeeding industry to task for grossly exaggerating the benefits of breastfeeding and the fear mongering used to promote it, The United States Committee on Breastfeeding rushes to prove her point with a new campaign built around infringement of the hashtag #TheHungerGames.

The histrionics are par for the course and their growing shrillness reflects lactivists’ fears that their clumsy attempts to manipulate women into fighting with each other are being revealed for what they are: attempts to shame women into breastfeeding.

Shaming women who don’t breastfeed exclusively is what they do and they are going to fight fiercely against any attempt to hold them accountable for it.

Give them an A+ for hypocrisy!

Recent media and social media conversations around breastfeeding—including campaigns launched by formula companies calling to “End the Mommy Wars” — reduce the complexity of parenting in our society to a series of singular, isolated decisions.

That’s right. The folks who think there is only OMG, OMG ONLY ONE BEST WAY to feed a baby, are condemning others for reducing the complexity of parenting to an isolated decision!

Talk about chutzpah. But wait! There’s more:

This thought pattern perpetuates stereotypes that breastfeeding mothers and advocates zealously judge formula feeding mothers. But when we focus only on individual moms’ choices and avoid deeper dialogue for fear of perpetuating “wars,” this deters honest conversations about why families feel so much pressure around their parenting decisions.

Breastfeeding advocates DO judge formula feeding mothers. It’s about 20 years too late to deny it. And just in case you thought otherwise, the USCB mobilized the use of the hashtag #TheHungerGames to drive the point home that shaming women is a major marketing tactic.

I left a comment on their Facebook page:

USBC

You should stop using this hashtag immediately. Bottle fed babies don’t go hungry and it is UGLY to imply that they do.

They responded:

We are sorry you think we are implying that, that is not the intention. Please take the time to learn about the campaign and take action to support mothers www.usbreastfeeding.org/hunger-games

I will not let them off the hook:

It’s obviously the intention. What other “hunger” could you possibly be referring to?

It is this kind of shaming that makes it clear that lactivist campaigns are not about science, but about some women feeling superior to other women.

Not surprisingly, they couldn’t think of an answer.

The hashtag campaign’s attempt at melodrama is laughable:

The Hunger Games: Mockingjay, Part 2 movie opened in cinemas on Friday, November 20, featuring a dystopian world in which teenagers and young adults are randomly chosen and forced to participate in a televised death match. Sadly, many families can attest that this is a powerful metaphor for the parenting experience in the United States.

Families do their best every day with the information and support available to them. Parenting shouldn’t feel like The Hunger Games, where only the privileged survive. We believe that every family should have the opportunity to make informed choices and benefit from a “landscape of support” for those choices. Spreading fear of dialogue is not the solution our nation’s families need to make this a reality.

A dystopian world? You mean the world where some women think it is their business how other women feed their babies?

Fear of dialogue? The only people who fear dialogue are lactivists; they know that truth is not on their side and they know they have spent years shaming women who don’t choose exclusive breastfeeding.

Their tactics are being exposed, they are being called to account and they don’t like it one little bit.

It started with the Similac video The Sisterhood of Motherhood, and it has ratcheted up a notch with the publication of Lactivism and the public discussion that it has engendered.

I have bad news for them. It’s going to get worse. My book, PUSH BACK: Guilt in the Age of Natural Parenting goes beyond Jung’s book (which revealed that lactivism is an industry that exaggerates the benefits of breastfeeding in order to scare women and profit from their fear) is set for publication this spring.

Push Back cover

I just submitted the manuscript for final editing: 412 pages, 90,000 words, 285 footnotes.

It explains not merely the science (or lack of it) behind lactivism as well as natural childbirth and attachment parenting, and not merely the billion dollar businesses that they represent, but it reveals that they are all linked by one overriding imperative: to relegate women to the home. The book is a full throated exhortation to push back against the guilt that is heaped on new mothers in an attempt to profit from them and to divert them into fighting with each other instead of taking their place in the wider world.

The Push Back chapters on lactivism can be summed up in one sentence:

The moralization of breastfeeding has paralleled the monetization of breastfeeding.

Case in point, nearly the entire Board of USBC is made up of lactation consultants, the people who profit by promoting breastfeeding.

Lactivists deployed guilt to make money and now they are horrified to find that the weapon they used to get women to mirror their own feeding choices back to them is being taken away. Shaming women who don’t breastfeed exclusively is what they do and they are going to fight fiercely against any attempt to hold them accountable for it.

  • GiddyUpGo123

    That analogy is so far out there that it boggles my mind. How exactly is parenting like The Hunger Games?

    I’m pretty sure these people haven’t actually seen Mockingjay Part 2, which is not in fact about “a dystopian world in which teenagers and young adults are randomly chosen and forced to participate in a televised death match.” That was just the first and second movies, you dolts.

    It’s a really stupid, nonsensical analogy anyway but I really hate it when someone who doesn’t understand popular culture tires to use popular culture to sell their cause.

    • TheArtistFormerlyKnownAsYoya

      It’s so trite. I think the subject deserves to be taken more seriously than their little tagline implies – I mean really. And it’s the same trite and reductionist attitude taken by the “mommy wars” Similac ad. As if to say “this is all in fun, haha, but no, really, do what WE think you should do”.

  • Anne Catherine

    The USBC Campaign makes no sense…. I really don’t get their point.
    BTW, Dr Amy, I think they took your comment off. Maybe I’ll make one …

  • TheBitchySpider

    I think it’s an apt hashtag. Breastfed babies go hungry, because mummy
    must breastfeed at all cost. Toddlers go hungry, because mummy wants to
    exclusively breastfeed for years. Young children go hungry, because
    mummy starves them into submission, when they refuse to breastfeed.

    • The Bofa on the Sofa

      ,,,and to them, it’s all a game…

  • Hilary

    Wait … so do they support ending the “mommy wars” or not? They start out criticizing the campaign from Similac but then say that parenting shouldn’t feel like a war. I’m so confused … my brain hurts.

    • Sarah

      Do they bollocks.

      • Hilary

        ??

        • Sarah

          That means no, not likely.

    • KarenJJ

      They support ending the “mommy wars” by being declared the winner and getting a “good mommy” sticker.

      • Sue

        A sticker? Is that all?

        A really “good mommy” would want a baby sling and an apron, no? And a year’s supply of cloth diapers. (I almost said “nappies”).

        • Nick Sanders

          Don’t forget the tacky “boobies” statuette with gem nipples!

      • Charybdis

        No, no, not just a sticker. You get the platinum glitter sparkle boobs with diamonds, rubies, sapphires and emeralds encrusting the nipples as a trophy along with a blue “mothering through breastfeeding” ribbon and a production certificate. Because lactavist breastfeeding support = bullying and shaming those who don’t fall in line with their agenda.

  • Chant de la Mer

    Slightly on topic but not really: Can coconut oil be used as an alternative to lanolin? I have a patient that wants to combo feed but is having some latch problems that chewed up her nipple and we can’t get any lanolin out here so I was wondering if coconut oil would be acceptable. No history of any allergies in either parent or baby’s siblings. We have a nipple shield and she’s pumping but I know it would help with discomfort if she had something on the skin. I already asked my referral doc and she wasn’t sure so I figured if I was going to ask the internet I’d ask the smart part of the internet.

    • Megan

      I doubt it would hurt to try. I used it to lube up the flanges when I pumped and decrease discomfort because I happened to have it. It worked well for me. I’m sure there’s no evidenced based correct answer though.

      • Michele

        +1 to the anecdotal evidence here as well

    • yentavegan

      If mother has thrush the coconut oil is potentially an issue. Nipple shields are a double edged sword. They could exasperate soreness and nipple shields have been known to interfere with milk production. Mom might be able to start a feed using them and then half way through remove them and see if infant can/will latch.

      • Chant de la Mer

        Thanks yentavegan, she’s pretty raw right now, she just needs them until she heals the skin up. She started formula feeding, but then decided to try breastfeeding after getting home so she didn’t get anyway help and her latch was terrible. We got that sorted out and now we just need to get her healed up. Any suggestions?

        • Dr Kitty

          Jelonet dressings, the kind used for burns, are pretty good, but if you can’t get lanolin, that might be a non starter.

          • Dr Kitty

            I got a box of Multi-Mam nipple compresses to keep in the fridge when this baby was still working out the whole latching thing.

            I have to say that they were very good, although I don’t know if they are available outside the UK. I don’t know if I buy all the claims for the product, but they were soothing, easy to use and not too expensive, so maybe worth looking at.

          • Chant de la Mer

            If that is a hydrogel dressing we have that, and I will keep that in mind next time. If it’s something else, then I’m probably out of luck. 🙂

      • Joy

        I know that old style shields did, but I thought the newer thinner ones were much better.

    • CharlotteB

      For what it’s worth, I used a nipple shield for 8 weeks and combo-fed for 10.5 months.

    • Dr Kitty

      It’s unlikely to do any harm.
      Petroleum jelly might also be an option (but wipe it off before feeds).

      I can tell you that coconut oil seems to be working well for my son’s cradle cap. It was the most pleasant smelling oil I happened to have in the kitchen, rather than any special plan to use it.

      • Chant de la Mer

        Thanks Dr. Kitty, I was going to go with petroleum jelly but mom says it really hurts to wipe it off so then I thought coconut oil might be a good option that doesn’t need to get wiped off.

    • Suzi Screendoor

      I was prescribed a nipple ointment by my doctor that was infinitely better than lanolin. It was more like a cream that absorbed in so my nipples weren’t constantly greasy and I think it had antibiotic properties and pain-relievers. Worked pretty much instantly and really sped up the healing. It said on the bottle to apply after a feed and no need to wipe off before the next feed.

      • seekingbalance

        FYI that’s probably APNO. you can google the recipe and have sent by your doctor to a compounding pharmacy. great stuff.

      • Chant de la Mer

        unfortunately we can’t get lanolin where we live so the prescription stuff is just as hard to come by, especially something that needs to be compounded.

    • Sue

      Coconut oil is currently enjoying “miracle food” status, so it could possibly lubricate the nipple and nourish the baby into a genius at the same time 🙂

      • Chant de la Mer

        LOL, maybe it will make up for the ebil formula the baby is getting as well.

    • PInky

      try expressed breast milk on the nipple. Moist healing with EBM costs nothing & works

      • Michele

        In my experience, expressed breast milk doesn’t do a damn thing to help once you’re at the point of “chewed up” nipples.

        • The Bofa on the Sofa

          Actually, there is no real reason to think it would help all that much. Notice that the common feature of all the other treatments is that they are oil based, which helps prevent moisture from evaporating. A water-based topical will just evaporate.

          • Sue

            A paper I found compared ” warm water compresses, tea bag compresses, heat, application of expressed mother’s milk, lanolin, vitamin A, collagenase, dexpanthenol, hydrogel therapy, glycerin gel therapy, moist occlusive dressing, education regarding proper latch-on and positioning, and no treatment.”

            They found ” No one topical agent showed superior results in the relief of nipple discomfort.”
            http://onlinelibrary.wiley.com/doi/10.1177/0884217505276056/abstract.

            and also

            ” Positive Effect of HPA Lanolin versus
            Expressed Breastmilk on Painful and
            Damaged Nipples during Lactation”
            full paper http://www.karger.com/Article/Pdf/318228
            (Trigger warning for pictures)

          • Inmara

            On Medela lanolin tube (Purelan) there are directions for use and they say “Apply expressed breastmilk to nipple, allow to dry and then apply lanolin.” I did it rigorously during first weeks when baby was nursing very often and my nipples were fine. Don’t know how it would go if there would be any problems already.

      • Dr Kitty

        No, milk just dries to a crust.

        Oils and waxes work. Gels work. Liquids do not.
        Honey works for moist wound healing too (but it isn’t cheap, or safe for infants to ingest).

      • Box of Salt

        Pinky “try expressed breast milk”

        It’s magic. Breastmilk fixes everything!

    • TheBitchySpider

      Tell the woman to stop torturing herself and to give the baby a bottle.

      • Chant de la Mer

        She’s combo feeding, baby is getting formula as well. The mom decided she wanted to try breastfeeding and things were going well except a poor latch that chafed the skin. Once the skin heals up everything should be ok, now that the latch is sorted out.

    • Chant de la Mer

      Quick update: skin is healing up, the coconut oil did the trick and helped soothe and prevent more chafing. Thanks everyone for the help!

    • Jennifer R.

      You’re not going to get any useful advice here about breastfeeding, this is a formula-feeder only site. Find someone who actually knows about breastfeeding. Also, the nipple pain could be due to an undiagnosed tongue tie which needs to be addressed by a doctor (ENT). Tongue ties can interfere with both breast and bottle feeding, and later on solids and speech. Here is a list:http://ttbsg.weebly.com/provider-list.html

      • Montserrat Blanco

        Well, so I guess the discussion below about different solutions did not happen…

        This is not a FF site. A lot of the regulars and the blog author have breastfed our kids. Some of the regulars, as Dr Kitty for example are currently breastfeeding and say so without any kind of problem.

        Go to “educate” someone else. I really do not need anybody telling me what a place I regularly visit is.

        • Jennifer R.

          I wasn’t talking to you.

          • Montserrat Blanco

            Well, that is all you have to say about my answer??? Pretty poor, in my opinion.

            No, you were not talking to me specifically, you posted on a public website where I regularly comment and I answered your post. That is the thing about the internet, it is public, everybody can see it, everybody can write.

            I answered because I found your post patronizing and incorrect. Because yes, a lot of the regulars do have experience breastfeeding, some of us also have medical training, some of us have obstetrics/midwifery/pediatrics training as well and there is a lot of people that could have answered that post, and actually did answer that post much better and helped a lot more than you did.

            So, yes, I answered a post that was not written specifically to me.

          • Amazed

            No, you were just lying about this site and us. Of course you weren’t talking to a regular. It’s much easier to spout your lies and bigotry, much like your beloved Dr Becky.

            I haven’t seen you around before. You seem to have arrived just when her bullying and cowardice were revealed here. Coincidence?

        • Monkey Professor for a Head

          I’m actually breastfeeding right now while reading this – I need something to keep me awake during the 4am feeds. I’ve been reading this blog since I was pregnant with mini monkey and it hasn’t discouraged me from breast feeding. It did help take some of the pressure since I knew there was a good alternative if breast feeding didn’t work.

      • Amazed

        “this is a formula-feeder only site”.

        Is it, you breastfeeding champ? Or is it just the conclusion you arrived to since breastfeeding mothers here don’t feel the urge to preen how wonderful they are for breastfeeding, aka they aren’t breastfeeding advocates and champions like yourself, oh Breast Pro?

      • Monkey Professor for a Head

        When you say “they are telling you to tell her to stop trying” without specifying who you are talking about, it implies that everyone, or at least multiple people are advising stopping breastfeeding. But if you actually read the comments you’ll see that only one person suggested using a bottle. Everyone else has been discussing treatments for cracked/painful nipples.

        So did you make a mistake by implying multiple people were advising bottle feeding, or were you deliberately trying to deceive?

        • Jennifer R.

          The way Disqus threads things, it was hard to tell what replies there were other than the ones telling her to give up. I see that some were addressing the OP but looked like they were in response to other posts. My mistake.

          • LibrarianSarah

            Maybe you should not assume you know more about the culture of the site or the point of view of people who comment on it than the regular commenters? You know what they say what happens when make assumptions. You make an ass out of you and umptions.

            Plenty of people on this site (including Doctor Amy!) exclusivity breastfed their kids so it would be ridiculous to say that this is a “formula-feeder only” site. But I guess it is a lot more fun to burn strawmen than argue with actual people.

      • Chant de la Mer

        She’s already using bottles and I didn’t need advice on breastfeeding just on whether coconut oil was a safe alternative to lanolin since we couldn’t get lanolin but had coconut oil. The issue was not a tongue tie it was a bad latch that has been sorted out and now the skin just needs to heal up and likely mom will breastfeed just fine for the next few months.

  • no longer drinking the koolaid

    I wonder what would happen if someone reported this to the copyright unit of the studio that produces the Hunger Games franchise.

  • Amy Tuteur, MD

    https://www.facebook.com/Villagepeds/posts/732173070220228?hc_location=ufi

    It’s great to know that lactivists don’t judge./sarcasm

    Here’s Dr. Becky from Village Pediatrics and Breastfeeding Medicine in Tennesse:

    “It is NOT my stated objective to make everyone happy…

    I make the rules about where I spend my time and energy. If you don’t like my rules, I am not the pediatrician for you. I will tell you this as gently as I can, but I WILL tell you. And I will not apologize for it…

    If you choose not to breastfeed your baby before you have even tried you don’t get my precious time and energy. Period.”

    • Sarah

      I’m genuinely devastated to be missing out on her input.

    • AllieFoyle

      Well, she sounds pleasant. I wonder what her other rules are?

    • yentavegan

      whoa what a b!tch.

    • Megan

      I’d have a few choice words for her…

    • Sarah

      Given that this is the South, is this her way of trying to put low income black patients off?

      • Nick Sanders

        On one hand, all the commenters do seem to be white, on the other, she also deleted a comment by a white woman who ran a PPD support group and called her a bully, rather than respond, so it could go either way.

        • Sarah

          Perhaps she doesn’t like the wrong kind of white person either #noblacksorpovvos

      • Kim

        I live near her. Honestly, while there are a ton of low-income people, there are not many black people. I doubt it’s at all racial.

        • Nick Sanders

          I’ll take your word for it, then. I live halfway across the state.

          • TheGiantPeach

            The Source of All Knowledge says that the African American population in Elizabethton, TN is around 2.5%.

        • Sarah

          You think it would be more likely to marginalise lower income whites then?

      • Steve Griffin

        Given that this is the South, is your instant judgment that everything that goes on there is racism?

        • Nick Sanders

          Well, not everything, but quite enough of it that it’s a reasonable question.

        • Sarah

          What would you like me to call a stance that will, unless the breastfeeding demographics in her area are very different to the norm, lead to her disproportionately excluding black families and favour higher income white ones? Do tell.

      • TheGiantPeach

        While Tennessee is typically considered the south, Elizabethon is in Northeast TN, in Appalachia, where there are very few blacks overall. In most Appalachian counties African Americans represent less than 5% of the total population. If she is using this as a way to drive off patients, it’s more likely to be low-income white patients.

        • Sarah

          Yes, I think someone else mentioned that. Similarly objectionable. However, apparently there are some black people in the area, less than 5% doesn’t mean they don’t exist (lactivist logic!) and this is a policy that is likely to disproportionately affect those few black people there are in the area.

          • TheGiantPeach

            I’m not saying they don’t exist, my point is that she’s probably not using this policy as a way to deter the few black people in the area. It would be a lot of effort for a very small gain. And I agree that her policy is objectionable, no matter the motive. I am from not far from there, and have lived in Southeastern KY and WV my entire life. Life here is hard enough for most people, they don’t need someone like her to make things even harder.

          • FrequentFlyer

            I think this doctor is like a bratty child on the playground. She wants to have a super special club that only certain kids can join. It doesn’t matter what race the other kids are. It is just for children who are like her and who will be most likely to let her boss them around. Anyone she identifies as an outsider has cooties and can’t be in her club.

          • Sarah

            I don’t see how you can say what she probably is or isn’t doing. Only speculate, same as me. If there are some black people in this area, and she knows anything about breastfeeding demographics (she may not, of course, although that would be no excuse) then they’re disproportionately likely to be deterred even if her ‘target’ is more likely to be poor whites. Can’t see any way round that. You’re right though, of course, that trying to exclude purely based on class rather than on race- not like there’s no overlap there anyway- is no more acceptable.

          • TheGiantPeach

            Do you know anything at all about this area of Appalachia?

    • OttawaAlison

      In her long winded rant she mentioned something about not playing well with others, hence why she’s in a practice by herself.

      • Dr Kitty

        She might be one of those people who went into paeds because they aren’t good at relating to adult humans.

    • RMY

      Isn’t being a doctor about serving human need instead of surrounding yourself with people whose personal decision you approve of? I didn’t go to medical school, so I may have it wrong. Also there’s one commenter who is thanking her for bullying her into continuing breastfeeding. That’s not how my doctor works, he gives me information and then lets me make the choice I think it’s best without guilt, only information.

    • Who?

      ‘Precious’ is right. She’s a birthzilla in the making.

      I wonder what her other rules are.

    • Allie

      She shouldn’t be licensed to practice, with an attitude like that.

    • Elaine

      Kind of like the skeptical ob saying “If you chose to avoid hospitals, you are not the patient for me”.

      Health care practitioners routinely try to avoid patents who insist on practices they consider unhealthy/ risky.

      Being formula fed in infancy is also associated with a 1.6-fold risk (95% CI, 1.2–2.3) of type 2 diabetes, compared with being breastfed

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812877/

      • Nick Sanders

        That’s a meta-analysis, which is a good sign, but I must ask, how did the studies it’s based on control for confounding variables?

        • Sue

          It’s not actually a meta-analysis in itself, it’s a review of selected studies, including some meta-analyses. The don’t give the search strategies, and there are only 75 references (not a lot for a review), including one entitled “Early skin-to-skin contact for mothers and their healthy newborn infants.”

          There is certainly over-interpretation – for example, in the section on obesity, “In meta-analyses, children formula fed in infancy were 1.1 (95% CI, 1.0–1.1)21 to 1.3 (95% CI, 1.2–1.5)22 times as likely to become obese as children who had ever been breastfed.” The first paper found the outcomes to be EXACTLY the same, while the second (with CIs 1.2 to 1.5) found outcomes to be ALMOST exactly the same.

          The reference from Pediatrics 2002 on cognitive function stated that:
          “Although the majority of studies concluded that breastfeeding promotes intelligence, the evidence from higher quality studies is less persuasive.”

          This is all well-summarised by the statement in the extensive review I posted earlier, which found, for chronic diseases:
          “The small number of
          observational studies on any single outcome suggests cautious interpretation at this time.”

          • araikwao

            Thank you for a valuable summary. I wish I could make this a featured comment, although I suspect it would be ignored by those who were in danger of experiencing cognitive dissonance.

          • Sue

            Thanks – it’s generally worthwhile looking up the actual studies when people cut and paste links.

          • Nick Sanders

            Ahh, thank you.

      • KarenJJ

        Yep “associated with”. As someone with an immune system issue myself I had issues breastfeeding and also my kids had a high chance of inheriting my issues. So was formula feeding the cause of Type 2 diabetes, or the outcome of susceptibility to Type 2 diabetes. Nobody knows yet. Health professionals can’t tell people that their kid will avoid Type 2 diabetes by breastfeeding.

      • Sue

        Elaine, clearly not a registered health care provider, says “Health care practitioners routinely try to avoid patents who insist on practices they consider unhealthy/ risky.”

        Except, they don’t.

        Otherwise, there would be no respiratory physicans for smokers, no Drug and Alcohol or Pain specialists, and not many GPs or emergency physicians at all.

      • Sue

        Even the review that went to great lengths to look for evidence of beneficial effect from BFing made this observation about BF and subsequent chronic disease:

        “The small number of
        observational studies on any single outcome suggests cautious interpretation at this time.”

        So, no.

      • seekingbalance

        see previous gagillion postings/comments/studies about relevance of an association….

        that said, I think a closer analogy would be: should I turn away overweight people with diabetes who eat fast food? people who didn’t use a condom then contracted an STI?? no! my job is to support you to be in your best health that you can be. even if you don’t meet some definition of perfect behavior–recognizing that that’s just one definition anyway and that there’s no such thing as perfect and that your life is not mine to live. I’m just your consultant and advisor. if you’re asking me to DO something to/for you that I consider risky (ie, prescribe a med that you really want but that I don’t agree is indicated), that’s a different story….

      • Dr Kitty

        As an NHS GP I literally do not get to choose my patients. They choose me.
        And I can’t fire them unless our relationship has irretrievably broken down (which usually means threats of physical violence or actual physical violence on their part).

        Homeless patients, patients in halfway houses, patients who are convicted violent criminals, patients with addictions, patients with severe mental illness, patients who’ve sued every previous GP, patients with rare and complex conditions on medications that blow our drug budgets, patients who refuse to take medications as prescribed…I have them all.

        • Monkey Professor for a Head

          I’ve only ever worked in public hospitals so it’s obviously a different picture to the US, but I’ve certainly never seen a patient turned away due to unhealthy behaviour. I did the math once when I was working in St James hospital in Dublin (very socially deprived area) – 40% of the patients that my team had admitted in the previous 24 hours were there as a direct result of alcohol and drug abuse. If you added in smoking the percentage would have been much higher. We treated these people all the same.

          • Dr Kitty

            Ah James’s.
            Where you had to be buzzed into the infectious disease ward because the heroin addicts with HIV and Hep C kept having their dealers visit them (or collect debts with threats of violence).

          • Monkey Professor for a Head

            It was special alright. I have a weird fondness for the place, which I suspect may be a form of Stockholm syndrome. I’ve given up on working in the Irish healthcare system, but I did learn a lot there. Like how to spot the DTs from across the room. And how to recognise a heroin addict by their voice.

          • Dr Kitty

            Doing all your med school placements in Tallaght, James’s and the Coombe can leave you with an interesting, if skewed view of people.
            Teetotal non smokers might as well have been unicorns!

            My super power as a junior doctor was knowing who needed to be written up for Librium despite “only a few beers at the weekend”.

          • Monkey Professor for a Head

            And if in doubt, give Pabrinex!

          • Dr Kitty

            True, very true.

          • Nick Sanders

            Their voice?

          • Monkey Professor for a Head

            They almost all had a distinctive nasal quality to their voice. No idea why.

        • Sarah

          Shh, America is the world.

      • demodocus

        OBs work in hospitals, where their tools are. You don’t *need* them if everything works out perfectly, but if something wrong happens, then they need their tools. If you want me to make you a quilt but you don’t let me have scissors or a needle, don’t complain because the resulting blanket doesn’t match your daydreams.

      • fiftyfifty1

        “Health care practitioners routinely try to avoid patents who insist on practices they consider unhealthy/ risky.”

        Bullshit. I have “fired” exactly 2 patients in my entire career. One groped me when we were alone in the exam room. Another made a credible threat of harm to my staff.

    • seekingbalance

      although I respect that clinicians have a right to choose who they provide their services to, this attitude does embarrasses me as a fellow MD, that one of my purported cohort would be so dismissive of people without learning each family’s needs and goals. and I do support breastfeeding–as ONE good way to feed a baby, not the only way. I’m also an IBCLC–though in fairness, I got that cert in response to encountering all the militant BFing advocates and because I wanted to support families in infant feeding without forcing any one choice on anyone….

      her statement also makes me think about clinics that refuse to treat families who decline vaccination for their children (for non-medical exemptions). I feel really conflicted about this. I did bring up the topic at a clinic providers’ meeting, to suggest that we might consider this policy, though I never felt strongly enough to really push it. the thing is, those kids don’t choose not to be vaccinated and I believe that their parents are already putting them at a disadvantage health-wise, so I had a hard time feeling that we should neglect them. and here in oregon it would mean that they would likely get their care from one of our many NDs or chiropractors, and wouldn’t I rather have them at our reliable “regular” medicine clinic?… on the other hand, I was caring for some very immunocompromised families, and the thought of an unvaccinated kid who turned out to have whooping cough or influenza hanging out in the waiting room and passing it along to a vulnerable person who was just there for a checkup (or a broken arm) is infuriating to me. the big difference I see though between excluding a family from your clinic for formula feeding and excluding a family from your clinic for non-vaccination is that the formula-feeding family isn’t contagious in the waiting room. a family’s feeding choices really don’t directly affect anyone else wandering around their community. except, wait–if a breastfeeding woman sees a formula-feeding baby, she might lose the will to produce milk and immediately stop breastfeeding. so maybe formula feeding is contagious too??!!! eeek! 😉

      • Charybdis

        My son’s pediatrician and the others in his practice group have stated on their website that they are NOT accepting patients who do not vaccinate. I was quite happy and pleased to hear/see that. I’m also fairly sure that if there was a real, medical reason to not vax/delay vax, they would be okay with it, BECAUSE IT IS A TRUE, MEDICAL REASON. Immunocompromised kids, bad reaction to a vaccine or an allergy to a vaccine can and do happen. These are the people who rely on herd immunity to keep them safe. The “I don’t believe in vaccines, I don’t think they are necessary, my child is too *special* to get vaxxed” folks, are finally beginning to get some pushback and I am glad to see it.

      • Jennifer R.

        Her specialty is breastfeeding medicine – why would someone who isn’t breastfeeding even want to see her?

        • Monkey Professor for a Head

          She’s a paediatrician right? So I’m assuming that she sees patients outside the initial few years where they are breastfeeding. Otherwise her practice would be extremely limited.

          • Jennifer R.

            Probably in her area, but we have one in our area who only sees patients with breastfeeding concerns and she has a 4-6 week wait to see her she is so full of patients.

          • Monkey Professor for a Head

            I’m just confused by what a doctor would offer with regards to breast feeding over and above what a lactation consultant does. And does she continue seeing the child after the breast feeding issues have been resolved? Would the parent have to find a new paediatrician after the child is weaned.

        • Sarah

          Because her specialty is also paediatrics. She evidently doesn’t restrict herself solely to children being breastfed, hence she talks about having children as patients whose mothers have what she has decided is an acceptable reason for not breastfeeding. As such, your argument fails.

    • Tiffany Aching

      It seems incredibly unethical to publish such a statement. I am pretty sure that if a pediatrician did that in France, he would face sanctions from le conseil de l’ordre des médecins – which is a professional organization that has regulating powers over physicians.

    • TheBitchySpider

      If Dr. Becky isn’t willing to do her job, then her license needs to be revoked.

    • Jennifer R.

      I don’t think she realizes that many in Tennessee carry concealed weapons and that the East Tennessee hill country is not kind to people who treat them poorly. I’m just saying she had better wear a bullet proof vest making those kinds of statements publicly.

  • demodocus

    And I thought the car commercials referencing the hunger games were silly.

    • Liz Leyden

      Remember Starbuck’s Tribute Blend coffee, which was released just after the first Hunger Games movie?

      • demodocus

        Fortunately no, lol

  • PrimaryCareDoc

    This is from the website: “Recent media and social media conversations around breastfeeding—including campaigns launched by formula companies calling to “End the Mommy Wars”—reduce the complexity of parenting in our society to a series of singular, isolated decisions. ”

    So the campaigns by the formula companies reduces the complexity of parenting, but co-opting a movie hashtag promotes it?

    I’m so confused. Honestly, I’m so confused by this whole thing. Maybe I’m old and I just don’t get Twitter and hashtags, but I have no fucking idea what this Hunger Games/breastfeeding connection is. I have no idea what the campaign is doing.

    • RMY

      Well the hunger games is very popular with young people, do they want to use that hangtag to indoctrinate young adults and teens. At least that’s my only way of making sense of it. The Hunger Games is a movie and book franchise about a dystopian future where teens are forced to fight to the death in a reality-show type event. It came out on book 2008-2010 and I’d considered young adult literature.

      • PrimaryCareDoc

        Oh, I know what the Hunger Games is. I’ve read the books. I just don’t get the connection between it and breastfeeding.

        • Monkey Professor for a Head

          It seems darkly ironic when you think about the world in which the book is set. In the poor districts there would likely be little or no access to formula. They might sell it on the black market but it would probably be too expensive for most. If a mother was unable to breastfeed (which would be reasonably common due to malnutrition) and if they couldn’t find a wet nurse then the baby would probably die.

          • ForeverMe

            Maybe that’s their point? I know that some people advocate breast feeding because “if we don’t, we’ll lose the ability to in the future.”

            Or maybe because they’re both about food/feeding?

            Honestly, that’s so confusing. Why are they using that # ? Does anybody know?

    • Allie

      I don’t get it either, since the only babies going hungry are the ones whose moms can’t produce enough milk but who refuse to use formula regardless. Imagine how livid they’d be if formula companies co-opted the hashtag to make that connection.

    • Chi

      Well the tagline of the Hunger Games is “May the odds be ever in your favour” so maybe they’re trying to say hopefully you’re one of the lucky ones who finds breastfeeding easy?

      I don’t know. The whole thing makes no sense to me either.

  • Dr Kitty

    Who owns the copyright on the Hunger Games?
    I’m guessing they aren’t thrilled about this hashtag.

    Also, why pick “hunger games” unless to imply a tenuous link with babies being hungry or to try and be current?
    Why not “Battle Royale” or “fight to the death” or “thunder dome” or “Gladiator”?

    • RMY

      Battle Royale didn’t have its finale in theaters right now. I think they’re just using it to reach fans of the movies.

      • Mariana Baca

        Fury Road?

    • Sarah

      Thunder domes would work.

    • Chant de la Mer

      Sesame street already took hungry games. It’s actually a pretty cute parody, Cookie Monster goes around hungry and eats stuff in a hungry game.

      • demodocus

        Cookie-ness 🙂

        • Chant de la Mer

          yes that’s right, cookie-ness! lol

          • Mishimoo

            I was watching that with my youngest just the other day!

    • Sue

      Or even “The Imitation Game”.

      I read the Hunger Games books along with my daughter. The themes have nothing all to do with parenthood or BF, so I agree with Kitty, the “hunger” message is certainly there.

      Ironically, babies are much more likely to be hungry for lack of breast milk than for lack of formula (in wealthy societies).

  • Josie

    The obsession with breastfeeding is becoming like a cult…or it already is one.

    Check out this link..

    http://www.thejournal.ie/hse-report-baby-mark-molloy-death-2403796-Oct2015/

    To summarise a baby died and the nurses gave the bereaved parents a booklet about breastfeeding! I’m seriously hoping it was a mistake which would be bad enough but I think they did it on purpose.

    “After the baby’s death, Roisin Molloy said a midwife gave them a document which had a memory booklet with a lock of hair and hand and foot prints, but also information on breastfeeding.”

    • demodocus

      ugh

  • Inmara

    Are they really writing this all with a straight face?

  • PrimaryCareDoc

    Wait. They feel that “The Hunger Games” is a metaphor for parenting in the USA in 2015.

    That’s quite a stretch.

    • mostlyclueless

      Because feeding your child formula is tantamount to forcing them to fight to the death for the entertainment of a privileged class. DUHHHHHHHH

      • Amy M

        I think they are trying to equate the mommy wars (which many lactivists insist do not exist) with The Hunger Games….as in parenting is competition. I guess the last one standing is the one whose child gets into Harvard?

        • mostlyclueless

          Oh ok. So having someone criticize your parenting choices (mommy wars) is tantamount to being forced to fight to the death. That makes perfect sense, lactivists.

          • Amy M

            Oh I don’t agree with them, just that’s how I’m interpreting it. It’s totally ridiculous.

          • mostlyclueless

            I know, I’m just saying that no matter how they try to spin it, it’s a preposterous and gross and ridiculous comparison. Nothing about breastfeeding or formula feeding is like The Hunger Games and they’re embarrassing themselves by trying to draw a comparison.

          • Amy M

            Absolutely!

    • NoLongerCrunching

      Personally I felt hungry… for support from other people. I felt very alone in figuring out how to raise my children.

  • Megan

    Sometimes I really do think it is a game to lactivists. But for moms like myself who do not have sufficient supply, our health and the health of our babies is on the line. It’s ironic to me that they chose to use the title of a movie where children die as a hashtag for their cause. My daughter was hospitalized with jaundice and FTT after I tried to EBF and no one would tell me her weights or suggest some formula supplementation. At a 1 week followup visit we found she had lost 18% of her body weight and we struggled to get her back on track for months using donor milk from a good friend of mine. I now wish I’d done formula. The propaganda is disgusting and they really do endanger babies’ lives with their “formula is poison” rhetoric. They have done nothing to make me want to breastfeed the baby I have on the way. If anything, they’ve driven me to consider EFF from the start.

    • NoLongerCrunching

      I am so sorry. It’s unconscionable that HCPs let your daughter get to that point.

      • Megan

        Thanks. This time around I’m insisting on being told daily weights. And I won’t let our followup be 5 days after discharge. I have moments where I feel totally ready to just EFF (or at least combo feed from the start) and enjoy my baby, but sometimes my resolve falters, like when pregnancy hormones get the best of me or I get studies in my inbox saying my I’m dooming myself to get diabetes if I don’t breastfeed. The rhetoric is strong and instills great guilt, and yet I have guilt over what happened to my daughter because I didn’t give her formula too. Mostly I just feel sad that my body didn’t “work” like it’s supposed to and probably won’t this time either. And I’m a physician who has read the literature and understands that breastfeeding is way oversold!! But logic doesn’t hold as strongly in pregnancy and postpartum hormone land I guess!

        • yentavegan

          Megan, I am not a doctor. I am a village busy body/ lactation yenta. I am offering a suggestion to forgo daily weigh ins with your next baby. I am offering the suggestion to not allow yourself to be influenced by lactavist malarkey. If you did not produce a copious milk supply with your previous child there is no reason to assume that you will produce more this time around. Supplement as needed.
          And your body is not broken, there is nothing wrong with you. We survived as a species because of advancements in science, not in spite of them.

          • Megan

            What’s the issue with daily weights, may I ask?

          • Amy M

            Can’t speak for yentavegan, but I would think it could be something that you get hung up on, which wouldn’t be good for you. There’s a podcast called “The Shortest Longest Time” which I don’t actually recommend, as there’s a bunch of woo mixed in with some really interesting stuff. There was one episode on there about a woman who literally was obsessed with weighing the baby, and weighed him constantly and if the number increased by a tenth of an oz, she was ok, but if it decreased by that much, she despaired. She finally realized she had PPA/PPD, but it was triggered by breastfeeding troubles.

          • Megan

            I’m only talking about being told the weights they are checking daily in the hospital anyway and making sure we have our first followup visit in a reasonable amount of time. If I were to try to breastfeed again with my history of low supply I would not feel comfortable “flying blind” without this basic info.

          • Amy M

            Oh I wouldn’t either, but that’s a reason I can think of why someone might want to avoid weight checks. My babies were late pre-term, so the health insurance sent a home-visiting nurse—she came 2x/week for the first 4 weeks, and 1x/week for another 3 I think, to make sure the babies were gaining properly. Since we decided, upon leaving the hospital, that they would be exclusively bottle fed (whatever I could pump, and the rest formula), they were gaining fine. I only have the twins, but if I were to have any more children, I’d probably go straight to formula, as 1)pumping didn’t work out last time and 2) I’d have to return to work within 3 or 4 mos anyway.

          • yentavegan

            For your first baby, breastmilk production could not be built up to be the sole source of nutrition for your infant. All things being equal, why stress yourself out wondering if this time around something will be different. For every mother I had ever been a go-to resource for , a vital question I ask is what was your initial – filling up with milk experience.
            If mother never had a whoosh of early milk , if mother never experienced big enormous filled to the brim itching to be released breasts of milk and her infant is not gaining weight even though mom is nursing 10-12 times a day…that is a major red flag .

          • CharlotteB

            Dumb question, but without regular weigh-ins,, how would you know you needed to supplement? My kid nursed 24/7 (which all the breastfeeding stuff says is normal), so without periodic weight checks I wouldn’t have known for sure that he needed more.

            I didn’t do daily weights or anything or go out of my way to get him weighed, though. I do think that if a HCP is weighing your kid you have a right to know the result, but if a doctor or nurse says they need to weigh the baby, why decline?

          • yentavegan

            Not at all a dumb question! Breastmilk /breastfeeding amounts can be assessed by watching the baby for signs of satiation, frequent yellow stools ( for the first few weeks baby stools during every feed) breasts are full and heavy before a nursing and within 15 -20 minutes (max) breasts are comfortably softer and then fill up again before the next 2 hours

          • CharlotteB

            Hmmm, for me, with a first baby, I couldn’t tell when the breasts were full or empty. (That may have been because of low milk supply, but at the time i didn’t know what things should feel like).

            I can see where obsessive weigh-ins could be problematic, but (to me) avoiding them completely would have been a disaster.

          • Inmara

            That was exactly my case: baby latched just fine, nursed for long sessions and his cries were seemingly colic-related. Only weighing before and after feeding and weighing of diapers revealed that he doesn’t get enough milk (and it showed in his weekly weight gain too). To avoid weight checks and rely on “satiation cues” and count of diapers is actually a widespread tactic of lactation consultants, to deter women from supplementing (because that’s what every sensible pediatrician will advise if weight gain is out of normal range).

          • CharlotteB

            I was thinking it was a tactic to keep you from supplementing. I had an LC double-count a diaper because she said it felt heavy–my son was already bordline on the diaper count, so that brought it up to normal. She also told me NOT to supplement and to give baby a pacifer and wear him…I liked the scale better. Less hassle.

          • yentavegan

            You are so right Inmara. When baby is gaining weight on breastmilk/breastfeeding weigh ins are not helpful. If mother is not sure I respect the mothers hunch and agree with her own assessment. Rarely does a mother think her baby is doing great but in reality the baby is not .

          • StephanieA

            That’s been my experience- my Baby Friendly hospital discourages weighing before and after feedings because moms ‘get too attached and read too much into the weights.’ Colostrum is not usually abundant and it would probably upset and deter mothers from breastfeeding if they knew their babies really aren’t getting a lot those first couple of days.

          • Megan

            This was my experience too. I actually specifically asked for weights and they consistently blew me off and would not answer. That’s withholding information that is important for making decisions about my child’s care and I found it to be manipulative.

          • Megan

            (And I don’t mean pre- and post-feeding weights. I mean her daily weight. They wouldn’t even tell me that.)

          • StephanieA

            That’s insane. I always tell parents their babies’ weight, some are interested and others aren’t. That seems so manipulative.

          • Megan

            But if I’m using it as a tool to monitor need for supplementation, what’s the big deal in asking for the daily weights they check anyway? FWIW, my milk never really “came in,” it trickled in about a week postpartum (initially attributed to large PPH but I’m not sure I do t have IGT) so if it goes that way again this will all be moot. Logically I know I probably should just EFF and be done with it.

          • demodocus

            Yenta might be just trying to help make sure you don’t fall into crazy levels. Anyway, I’m seriously thinking of going EFF just because I dislike bf’ing so much. Just don’t make yourself nuts, ‘kay? Cause we like you and we don’t want you to get depressed.

          • Megan

            I have enlisted the help of my husband and best friend to help me not drive myself nuts (or any more nuts than I am already anyway!) I made my friend take a screenshot of our text conversation where I swore not to do the crazy pumping thing and that I would supplement as soon as it seemed necessary. Thanks for the support. I was having a hormonal kind of day and was second guessing myself.

          • demodocus

            *hugs* Good luck with everything!

          • ForeverMe

            I second demodocus 110%! ( “Yenta might be just trying to help… Just don’t make yourself nuts, ‘kay? Cause we like you and we don’t want you to get depressed.”)

            I really enjoy your posts and can tell you’re a great mother and doctor. But sometimes those hormones + no sleep = well…… you know. A not-normal-you.

            I fell for the EBF woo with my little ones (now 4 & 7). And this was after law school & working in a dr office.) Looking back, I made questionable decisions.

            OTOH, my 20 year old DD was EFF. (No typo- I was pregnant at 15.) She’s fine. So are the other FF people I know, incl. my husband- also an attorney (& if BF added IQ pts., thank goodness he wasn’t! He’s formidable as-is!) ; )

            Geez, my much-older sisters were fed canned, condensed (“PET”) milk with vitamin drops. Today, one is an RN; the other a CPA. Of course, I’d never condone that today. But thank goodness we have a healthy alternative.

            If my tubal somehow fails, I’m EFF. For *my* health. if any guilt starts, I plan on remembering what I wrote here. maybe it’ll help you (if needed) or someone else, too.

            Enjoy your baby. Love your baby. That’s what’s important. (Oh, and sleep. Try to get sleep. Sleep’s important. 😉 )

          • NoLongerCrunching

            No deal at all. Ask for whatever you want. It’s your baby and no one has the right to withhold information from you. In my experience, there’s no problem with supplements from day one, if you keep the amounts small enough that the baby wants to still breastfeed, and you pump a few times a day to assure adequate stimulation. When your milk comes in, you can wean off the supplements as desired.

          • D/

            If you decide to breastfeed, feed your baby whatever is necessary for adequate intake, do what you can to provide adequate breast stimulation, and see what happens. Whatever your production is going to do will be largely declared in the first 2 weeks or so.

            Don’t second guess your instincts in wanting/ needing that reassurance of serial weights checks until you see how your breasts respond. At every visit I discuss newborn weight measurements with every family … “Here’s your baby’s weight, this is the range of normal for your baby’s size/ age, and here’s what we should expect for the next check.” If weights are reassuring, you should share in that reassurance. If they are not reassuring, what *exactly* is being done about it?

            Now indefinite daily weights, unnecessary pre-/ post-feeding weights, keeping detailed phone-crashing breastfeeding app logs until the kid’s months old? … Not necessary and actually becomes OCD-ish for many moms.

            And this? http://milksense.com/ … Full-scale breastfeeding crazy in a box for only $180.00!

        • Elaine

          I know a lady who wasn’t able to produce much of a supply but still breastfed. She said she was the appetizer and then formula was the main course.

          • Inmara

            That’s exactly how my husband described our feeding schedule! Since 2 months, unfortunately, baby insists on main course only (i.e., bottle) during the day and breastfeeding is like snacking from the fridge during nighttime (and occasionally to soothe after crying).

        • Sarah

          You want to EFF, do it. Millions of us do and find it works brilliantly. I don’t appear to have caught diabetes yet either, although perhaps I’ve just been fortunate not to be around any vaccinated folks shedding it…

        • seekingbalance

          I say this in full support of EFF or combo feeding–whatever works for your family–so I hope it doesn’t come off as flippant…. if you’re worried that not breastfeeding might lead you to be more at risk of diabetes, would you consider taking those extra hours of the day that you would have spent pumping and agonizing about milk production and instead them for exercise, sleep, and chopping up vegetables for extra-healthy meals? and just generally taking the excellent care of yourself that you deserve–in so far as that’s possible in balance with having a newborn? 🙂 I bet that time could be far better spent toward diabetes prevention and overall well being than just in breastfeeding! all the best with your pregnancy and next baby!

    • StephanieA

      I’m so sorry that happened to you and your baby. Nowhere near as extreme, but my son lost 10% pretty quickly and the only reason I was aware was because I made a point to ask (I know most believe that 10% isn’t a huge deal, but I was not okay with it). They wouldn’t have told me otherwise. He was showing all signs of being hungry, and this combined with the weight loss should’ve prompted some kind of discussion about his feeding. I have one on the way as well, and I think we are going to EFF right away.

    • Allie

      Our LO was jaundiced too, and I’m so grateful for the sensible nurse who looked at her and said “why don’t you give her some formula?” She went and got it for us, suggested how much to try, and it was wonderful. The transformation was visible, like when you water a droopy houseplant and it spring back. She got color in her cheeks and had the energy to keep practicing until she learned to latch. I ALMOST succumbed to regret that I destroyed her gut flora with those bits of formula that got us through the first week, but then I discovered this site. I would definitely recommend combo feeding for sure.

  • The Bofa on the Sofa

    One of Jung’s comments has really stuck with me. It is something like, “The increase in breastfeeding is not the result of the La Leche League promoting it. It’s due to the industry behind it”