Lactation consultants care about breastfeeding; pediatricians care about babies.

image

To a hammer, everything looks like a nail.

To a lactation consultant (LC), every problem looks like it can be solved by breastfeeding harder.

And just as hammering a screw harder will make things worse, breastfeeding harder in the face of infant weight loss may make things much worse. In the first situation you could permanently strip the threads. The potential consequences in the case of a baby losing weight while breastfeeding are far worse: dehydration, seizures, permanent brain damage, and even death.

Weight loss means that a baby is cannibalizing her own body to fuel her vital organs.

That’s why in any conflict between a pediatrician and a lactation consultant over a baby who is losing weight, you should IGNORE the lactation consultant.

Consider this post that appeared recently on Reddit:

My baby girl just turned 12-weeks yesterday. She was born 16 days early, and only weighed 5lbs 12oz at birth. On May 6th, she weighed 7lbs 12oz. A little light, but no big deal. A few days ago, my wife felt something was wrong, so she made an appointment with a lactation consultant. We went and weighed her there. She was down to 7lbs 10oz.

She feeds all the time, and just isn’t making enough. Breastfeeding alone isn’t working anymore. I desperately want to supplement her with formula (I’d even be happy with just 4-6 ounces a day), but my wife isn’t having it. She completely refuses, screaming to the point of tears when I suggest it…

A pediatrician left an excellent response and I sincerely hope that the father followed it:

… [T]his is a pediatric emergency. Please take your daughter to an emergency room (at a Children’s Hospital if available) or her pediatrician’s office NOW, today! Do not wait until the holiday weekend is over. She needs assessment and treatment immediately! I cannot emphasize this enough. Please get her medical care immediately!

There is no question that this is an emergency. Beyond the first few days, an infant should NEVER lose weight. Weight loss means that the baby has been so deprived of nutrients that she is beginning to cannibalize her own body to continue fueling her vital organs.

Infancy is a period of extraordinarily rapid brain growth and the brain can only grow if nutrients are available in ample supply. When an infant is losing weight, she is potentially losing brain growth and the loss may be permanent. Even if you believe that breastmilk is superior to formula in promoting optimal brain function (I don’t), there is simply no question that adequate formula is far superior in all respects to inadequate breastfeeding.

Malnutrition is not the only problem. Breastmilk is the only source of fluid for exclusively breastfed infants. When they are not getting enough breastmilk, they quickly become dehydrated. Their electrolyte levels can rise very high and high sodium levels lead to seizures, brain damage and death. Indeed a baby can die of dehydration long before it would die from malnutrition.

Sadly, many LC have an unreasoning fear of formula. They have spent so much time and energy demonizing it that they are incapable of recognizing when it might be necessary.

They believe erroneously that inadequate breastmilk is always better than adequate formula. They believe erroneously that formula supplementation interferes with breastfeeding when the scientific evidence shows that judicious supplementation promotes breastfeeding. They believe erroneously that even one bottle of formula harms the infant gut (it doesn’t), failing to realize that when it an infant is losing weight, protecting the BRAIN is more important than protecting the gut. And they believe the biggest breastfeeding lie of them all, the fantasy that all women can produce enough breastmilk when we KNOW that 5-15% or more are biologically incapable of doing so under any circumstances.

Pediatricians, in contrast, have only one goal, keeping babies healthy, growing and able to reach their full physical and intellectual potential. Unlike LCs who have only hammers at their disposal, they have a full tool belt including tools of every type and size. A baby who is losing weight NEEDS supplementation, either formula or donor breastmilk. Pediatricians recognize that an adequate amount of milk is far more important than whether the baby is fed breastmilk exclusively.

There’s another factor that we must consider: letting a baby starve is CRUEL.

Hunger is painful. You might believe that tofu is healthier than steak and that water is healthier than soda, but suppose that you were given only one small piece of tofu and 3 ounces of water each day even though you need 1400 calories and 2 liters of fluid a day to survive. You’d quickly become painfully hungry and desperately thirsty with all the signs and symptoms of malnutrition and dehydration. If meat were available, would you ignore your hunger pangs day after day hoping that more tofu will magically become available in the near future? If soda were available would you ignore you desperate thirst hoping that more water will magically appear? Or would you eat the meat and drink the soda in order to survive?

I’d be willing to bet that you would find your hunger and thirst to be so painful that you would quickly decide that eating and drinking enough is infinitely more important than eating inadequate amounts of healthiest foods. If you wouldn’t allow yourself to starve, how could you possibly think it is okay to let your baby starve?

Lactation consultants mean well, but they’re not medical professionals and have only the vaguest knowledge of infant metabolic needs. They are hammers and everything looks like a nail to them. Pediatricians ARE medical professionals and they have a firm and detailed understanding of infant metabolic needs. More importantly, their primary goal is to meet those needs, not allegiance to any particular feeding method. They are handymen and handy women with every possible tool at their disposal.

Is your baby more than a few days old and losing weight? It’s a medical emergency.

Take your child to a medical professional and follow their medical recommendations. Listening to an LC and letting your baby suffer hunger pangs and desperate thirst in an effort to promote breastfeeding is missing the forest for the trees. It is shockingly cruel and startlingly dangerous.

Never forget: Fed Is Best!

  • Jody Segrave-Daly

    Sadly, I see at least one starving baby a week in my private lactation practice. Starving is when they need to be hospitalization. I see many underfed breastfed babies as well. I have been in this business for 30 years now and my gawd, I was not prepared emotionally to witness so much needless suffering–all from unintended consequences from exclusive breastfeeding, at all costs. Just 10 years ago the babies I would consult with had the exact opposite problem. They were mostly over-fed with formula in the hospital! Moms want and deserve to be supported in a safe way to breastfeed their babies. The BFHI needs a good overhaul, STAT!

    • CSN0116

      Some multifaceted process occurs in women to prompt them to do this to their babies, and it deserves a name all its own. I’ve seen it many times. And the process almost always happens in the same order. There’s a lot of depression and anxiety involved (that previously was not present) that exacerbates it and makes otherwise rational women behave irrationally. It’s also very much sleep deprivation related which is preceded by a constantly screaming, hungry baby. The whole thing is unique yet wildly common at the same time.

      If one were to thoroughly study the mental health of women who want to breast feed but struggle immensely OR fail — I’m pretty sure breast feeding would be contraindicated at the first sign of feeding difficulty. And it’s a shame – lactivists did this. It doesn’t have to be a mind fuck. It can be in moderation and with consideration for individual circumstance, but no. Not for them. And this is what they’ve done to innocent, well-intentioned women as a result.

  • Sandra

    I have a friend whose pediatrician deserves to be fired. The newborn wasn’t breastfeeding well, had jaundice and so they supplemented, a little, to the reluctance of the pediatrician. But then after they left the hospital the pediatrician told them not to supplement anymore or the baby wouldn’t breastfeed. She kept saying, “The baby won’t starve.” And this is after the baby was still not at it’s birth weight as of Monday. Then their next weight check was 1.5 wks later and they exclusively breastfed. I was really concerned, showed them how to use a food scale to weigh their baby, and encouraged them to go in before then for a free weight check at their doctor’s office. I don’t think they did either. When they finally went in for their weight check the baby had significantly lost weight. It was a almost a pound under birth weight at 2 wks. That doctor should be fired. The experiences I’ve had with LC’s has been very positive. They always insisted that the most important thing was to “feed the baby” no matter whether that was by breast or bottle. The baby came first, and I appreciated that perspective.

    • Who?

      What happened after the two week appointment? I wonder if this might be a case of the patient’s parents perhaps not hearing the whole message?

      There’s a discussion going on in one of the other postings about the difference between what doctors think they are conveying to their patient, and what the patient hears and takes away. If at two weeks and a pound down the doctor shrugged her shoulders, then yes she is not performing. If some dramatic action happened, though, I wonder if perhaps your friend wasn’t as tuned in as she might have been to the message being given, or perhaps the doctor wasn’t as clear as she needed to be. If the latter, she might have learnt from the experience.

      Either way, hope the baby starts growing and thrives.

      • Sandra

        I don’t think it was the parent’s fault as they clearly understood what the doctor was saying. They told me what their doctor told them. Not to supplement as the baby wouldn’t want to breastfeed. And that the baby wouldn’t starve. After the baby was almost 1 lb under birth weight at the 2 wk appointment, the doctor said to start supplementing. Duh. I think the doctor shouldn’t have had the appointments stretch out so far. They should have had the baby coming in every couple of days. Now the baby is sleeping at night since it’s not starving anymore. I tried to encourage them to supplement, but their doctor has the authority, not me and they were going by what she said.

  • rachelmarie Acosta

    I saw this post on Reddit and keep checking back to make sure the child is alive and well.

    I think before I saw the Ped response it didn’t realize how serious it was basically the child is in what .03 under 1% growth percentile. So that is what FTT looks like that is scary.

  • prudent planner

    Anyone else really bothered by the latest episode of Grey’s?

    SPOILERS!!
    |
    |
    |
    |
    V

    A pregnant woman goes into labor a home. The baby is a footling breech without a pulse. Then they do a KITCHEN KNIFE HOME CESAREAN.

    I know – I know it’s not real. And every TV pregnancy MUST end in horror. BUT sometimes they do ‘topical’ episodes & home-birth is in the news lately; why not give a home-birth horror story to balance the 35 Hospital horror stories on this show? Dramatic home cesareans are not an option. When the baby has no pulse and you are at home, then the time for options is over.

    • guest

      I don’t know, a kitchen knife anesthesia-free home cesarean sounds like a home-birth horror story to me.

      • prudentplanner

        but everyone lived, no one was injured, and the happy parents held the baby in the recovery area…

        when the first check reveals a baby w/o a heartbeat… the odds of a surviving baby are near zero… right? C-section or Not.

        • Karen in SC

          I agree it was a incredible long shot if not down right impossible, but this was the “rainbow” baby. I don’t think the writers could go there.

          • Dr Kitty

            I gave up on this show some time ago.
            Was this April and Avery?

            In which case it was a plastic surgeon doing an at home CS on an ER doc, who would both be aware of the risks. Not Joe Bloggs carving up his wife with the help of a YouTube video.

            I thought that the episode dealing with their first pregnancy was well done BUT inducing labour of a non viable foetus at a pre-viable gestation and not taking heroic measures IS terminating a pregnancy, and is IMO less humane than foeticide. The show totally presented this option as “better than” an abortion and definitely NOT morally the same as an abortion, so therefore an acceptable compromise for the religious April and atheist Avery.

            Viewers might not be aware that this “compromise” is specifically outlawed in many states which ban abortions after 20 weeks, and I thought is was disingenuous to say the least.

    • mostlyclueless

      I agree with the guest comment, it did seem like a home birth horror story to me. Getting a c-section on your kitchen table with a serrated knife seems…not….great. Even if everyone lives.

    • The Computer Ate My Nym

      There was the woman in Mexico who gave herself a c-section with 2 shots of alcohol as anesthesia. But she was dam lucky to have gotten out of that alive.

    • MaineJen

      Same thing happened on Walking Dead…but the mother didn’t live. I refuse to watch that episode…

  • Jennifer

    I realize asking a medical question in the comments of an online story is not wise. However I was wondering about the science behind overfeeding and this seems like a good crowd to ask. I ffe and am not changing that so I don’t care if bf is protective against being high in infant growth charts. My questions are are there solid studies about frequency of feeding (on a schedule versus on demand)? Also are there good guidelines for how much to feed? I want something based on solid evidence not just “recommendations.” I for some reason cannot find this.

    • MI Dawn

      For formula feeding, make enough that the kid *may* finish the bottle or may not. We always used to tell people that a baby’s tummy was the size of their fist, and don’t force them to finish a bottle. While formula is expensive, it’s better to throw what the baby doesn’t want away then force them to finish it. I fed (breast and bottle) on a modified schedule. For a newborn, every 3-4 hours, but if they got hungry earlier during the day, or later (within reason – no more than 5 hours) at night, then I’d feed when they were hungry.

      I’m not sure – and I’d be happy for someone to prove me wrong! – that there’s any good reason to schedule vs demand in any infant, breast or formula. Do what works for your lifestyle.

      • Jennifer

        Ok thanks. I actually do something similar. My son is normal weight (literally 50th percentile) but I switched to ffe for a variety of reasons and for some reason this is my main concern. He has a huge appetite but I guess in a baby that is a good thing? He can go about 2-3 hours sometimes more between bottles but he is only two months and ears about 5 oz per feeding and sometimes up to 8! He also drinks very quickly and rarely spits up after.

        • Amy M

          We always fed on demand, with bottles of formula. The babies would eat until they were full, and then push the bottle away or turn their heads. My MIL occasionally overfed them, and they would just spit up when that happened. It can take a bit of adjusting, but you get to figuring out about how much the baby is likely to eat, so you end up chucking less. Also, we always had a stock bottle in the fridge (made up 2 or 3x/day, I have twins), and we’d just pour out what we thought they’d eat. If they still seemed hungry, we could always pour out some more.

        • KeeperOfTheBooks

          I think it depends a bit on the baby, too. DD had no problem turning her head away from the bottle when no longer interested, for example, so I’d feed her what she wanted. On the other hand, I had a friend who breastfed and pumped whose daughter just plain loved eating; the kid would massively overeat, spit up half of it…and then go back for more! Mom got a bit tired of this, as you might imagine, and ended up pumping exclusively and giving baby what she considered a reasonable serving given size/weight in a bottle. Baby would fuss for a minute or two post-feed, but would be distracted pretty quickly by a paci, something which wouldn’t have been true of a genuinely hungry baby.

          • demodocus

            That’s my bf’d kid, and I *never* comfort-nursed.

          • Jules B

            My combo-fed daughter (formula and breastmilk mixed in a bottle) used to over-eat sometimes…she just loved her food, too. I just started tracking her “average” feed (in Excel, I am such a nerd), so I would have a better idea of the amount she actually needed at any given time. I fed her on a loose schedule, too – bottle upon waking, bottle after first nap etc. She never gave me “I am full” cues so doing it that way seemed best. (Note: At four, she still rarely says “I am full.” Again, she just loves eating!)

          • Sullivan ThePoop

            My son had reflux and did that. His was a type that had to do with an undeveloped esophageal sphincter so the formula got stuck and would come back up just like it went down instead of normal spit-up.

          • Amazed

            On her very first feeding, Amazing Niece vomited. Colostrum, what a joke! SIL’s body thought it should support a sports team during an Olympian event and rose to the task. And the kid had no reflex to stop her from overeating right then, it was just all so new to her.

            Nowadays, she spits the nipple out the moment she’s done. She does the same when she’s cared for by my mom (meaning, a bottle). She also gives a single mighty mewl, just in case her mom or grandmother don’t get it how stupid they are being. How hard should it be to prepare the right amount, she clearly wonders.

          • demodocus

            lol, the mental picture of her indignation!

          • Amazed

            It’s quite funny. She’s signalling us that we have failed again but since she fixed the matter, it isn’t worth it to cry over the spilled milk – literally! Plus, I can already say that she’s going to be our cucumber girl. She doesn’t react to meat in any form but when you hold a cucumber near her nose, she’s all sniffing attention.

      • The Bofa on the Sofa

        I fed our older one a lot, and he got a mix of formula/ebf. I would make up about 7 – 8 oz, but he never finished it. Usually left about an oz. He just quit eating, and I’d toss the rest.

    • demodocus

      I know nothing of the science, but i do wonder how bottles are different than if you have oversupply. My kid could certainly have had too much to eat, and i think regularly did,considering the volume of his spit up.

    • CSN0116

      You’re not going to find any real science on it because it doesn’t exist :/

      I don’t FF on demand because I don’t have time for it. I also find that my babies are much more content when I anticipate their needs. Scheduled feeds also allow me to easily set up nice naps schedules that coincide, thus making my life even easier and the babies even more content. It’s not a rigid thing but works wonders: wake, feed, play, nap (~1.5 hours from last wake), wake, feed (~4 hours apart from last feeding), repeat.

      For term babies I feed every 4 hours all day (sooner if need be though it’s rare) and let them dictate the overnights. I will wake to feed at the 4 hour mark all day long to keep things on track and to make sure that they’re getting their calories (as not to mass make up for them at night i.e. “get days and nights confused”). If baby’s going to give a long stretch, I want it overnight, not during the day.

      My babies take 2 oz right out of the womb. Once they efficiently finish the same size bottle several times in a row, I up the amount offered by 1/2 – 1 oz. The human breast would be signaled to produce more in this scenario, so I mimic that with the bottle. I have never worried about overeating and feel that, medical diagnoses like reflux aside, it’s a myth. Babies will not really do it, and they’ll spit up if they do. Mine never spit up, they would just stop.

      I have always felt that the “average” amounts per age are totally arbitrary. It varies so widely that it’s really not even worth assigning a “normal” because people just get obsessed with trying to follow it. And it’s more about ounces consumed in 24 hours than it is size bottle per feed. Some babies will eat four 8 oz bottles and quit for the day, sleeping all night. Others eat seven 4 oz bottles but need to feed day and night – the overall daily intake is still similar though. I have seen 3-month-olds eat 20 oz per day to 30 oz per day and both be happy and healthy. IMO, once you hit the 30+oz mark, baby is signaling readiness for complimentary solid foods.

      • Jennifer

        This is so incredibly helpful. I am glad I posted.

      • Daleth

        Just posting to second everything you said. That’s exactly how we did it with our twins. They did great and are still doing great at almost two. They loved the schedule, they first slept through the night (almost 9 hours!) at 4.5 months, and they’ve never been overly heavy–they’ve always been higher on the height chart than on the weight chart.

        I agree that “overfeeding” due to bottles is a myth. Mine were slightly premature but even at birth, when they were done drinking from one of those 2oz/60ml formula bottles (in other words when they’d finished anywhere from 17 to 30ml), they would just stop drinking, even though there was still plenty of formula left and gravity was trying to put it in their mouths. A baby who isn’t hungry anymore will stop drinking, no matter how you’re getting the milk or formula to them.

        That said, if the milk is flowing into their mouths too quickly, whether from oversupply or the wrong nipple size or whatever, the baby can choke a bit. But he or she still won’t overeat.

      • Megan

        I have a similar routine as well. Now that my 12 week old reflux baby is under better control with meds (and the passage of time) and is on Alimentum for her CMPI, she is able to take 4 ounces about every 3-4 hours during the day and only wakes for a feed once at night (except during a growth spurt when she may wake twice). I also generally try to follow a sleep, eat, play routine and it works well most of the time. She is pretty good at self-soothing and falls asleep on her own, though I admit some of this may be her temperament. She takes anywhere from 24-27 ounces a day, which is much more than my older daughter took (breastmilk in a bottle) at the same age. I agree there is considerable variation between children, though the guideline is 2.5 ounces per pound in 24 hours.

        • Megan

          Also wanted to add that I literally could not force my daughter to drink any more than she wants to. She will literally clamp down on the nipple so there is no flow. I think the whole business of babies overeating from a bottle is BS. Anecdote only, I know, but my daughter has been 8th percentile for weight eating 24-27 ounces a day and just recently went through a growth spurt, bumping her up to a whopping12th percentile. She is 53rd percentile for height. Her sister who got breastmilk from a bottle was similar and she ate less overall.

          • AirPlant

            I wonder, if bottlefed babies can figure out biting=no milk, I wonder if that is why breastfed babies tend to bite at the end of a feed? Like they still want to suck, but they are done with the milk so they clamp down to make it stop? It makes more sense than pure malice.

          • Megan

            I don’t know really, but I have heard that it is also kind of normal for the clamp down to occur as babies fall asleep. But my daughter will literally just clamp and stop drinking. It’s super easy to tell when she’s done.

          • Allie P

            I don’t think you can overfeed babies. I also hate how big fat breastfed babies is somehow fine, but big fat formula fed babies are “overfed” and “obese”. Sometimes babies are just big. My baby was breastfed and always above 95% in height and between 60-70 in weight. I have big babies. Her sister, combo fed, was the same. Her cousin, breastfed, same.

          • CSN0116

            Ahhh, yes, the “show off your chunky EBF babies here!” posts… eye roll. All chunky babies are worth ooo-ing and ahh-ing over. I always considered it another narcissistic display of “look what my body can do, look at me, look at me, I’m wonderful!”

          • SF Mom & Psychologist

            I am sure my son overate breastmilk constantly. The amount he would spit up after most feedings was astounding. It wasn’t scary or worrisome because he wasn’t in any discomfort and was gaining plenty of weight, but it was an obvious capacity problem. Hilariously, hardcore BF advocates would SWEAR that it was IMPOSSIBLE to overeat breastmilk “because breastmilk has a special ingredient that tells the brain to stop eating so nothing is wasted” (told to me by a promoter). He was (and is, at 7) very oral – binkies, fingers, nail-biting, pencils, etc. So, I think he just sucked and sucked.
            On another note, my nephew has been EBF’d and is as fat as a sumo wrestler. He was 20 lbs. at 4.5 months. And everyone is just thrilled. I can’t imagine the *worries* if he was a FF babe.

          • StephanieA

            Or do what my boys do, keep drinking then spit up because they were full.

        • CSN0116

          Yes, I know of that guideline, but I never understood the 2.5 ounces per pound in 24 hours. So my 9.5 lb at birth babies, who are easily 15 lbs by 2.5 months, should be drinking 40 oz at two months of age?! C’mon…that’s an insane amount of liquid and they have never drank that much. I think the 2.5 rule is only logical for a short time, with small babies, and is therefore yet another poor criteria :/

          • Megan

            That’s why I said there was considerable variation between children. It’s just a guideline and is helpful when viewed as such. It has worked well for my children but I’m sure it is less useful for kids who weigh more as there is only so much a stomach can hold. I doubt anyone thinks 40 oz. a day is a realistic estimate. I’ve found kids tend to top out at around 30-35 oz a day. My anecdata: it’s been accurate for both of my babies but I have small babies. YMMV.

          • CSN0116

            Totally agree. Like all things FF related, I wish there was better mainstream info out there (i.e. the 2.5 oz rule only really applies until X event), because so many people just have no idea πŸ™

          • StephanieA

            Now I’m worried my baby eats too much. Including his feeds after midnight, he’s had 20 oz already and it’s 10 am. This kid just does not stop eating.

          • Heidi

            My baby went through a phase were it was constant eating all day. It lasted a couple of weeks maybe. He shot up from about 30th in height and 20th in weight to 50th percentile in both. I don’t think it’s too unusual. I figured it was the formula variety of cluster feeding.

          • CSN0116

            How old is he? How much is he poised to take in 24 hours? If he doesn’t seem upset or otherwise negatively effected, eff it.

          • StephanieA

            He’s 4 months. I honestly don’t pay close attention to how much he eats in 24 hours, we just feed him when he’s hungry. He tends to snack but usually drinks 4-6 oz at a time. I do know he eats a lot, because we buy more formula per week than we did for our older son. He’s also a big boy- at 2 months he was off the charts for height, 75th percentile for weight.

  • CSN0116

    While pediatricians are certainly about babies, it does not help that they are often grossly undereducated regarding formula feeding. Where I’m from, all of the top ped practices have LC’s on staff, but nobody who is fluent in FF. Unless you have an easy-peasy baby, there is so much more to it than 2:1, mix, and feed. My friends and family have received the shittiest well-intentioned FF advice from their peds. FF often requires the same level of professional attention and education that nursing does, at least in the early days. What’s up with the lack thereof?!

    • Amaya

      We have no LC on staff in my practice of five peds, and we all do formula assistance if needed. I actually just did a demo today, where I make the bottle and have the parent practice. It’s fake formula but in a formula can. Our area is super crunchy, so finding an LC is like finding a Starbucks. Actually, even easier. I have made a handout as well with logical instructions that are easy to follow, spelled out exactly. I have had patients come to me from word of mouth recommendations, escaping their former peds who judged them on formula use.

      • CSN0116

        This is good to hear! How horrible that women’s own health care providers condemn them; I thought that peds were off the Kool Aid :/

      • KeeperOfTheBooks

        Good for your for taking such great care of both your patients and their parents!!

  • mostlyclueless

    OT, except that it also came from a discussion on reddit (https://www.reddit.com/r/BabyBumps/comments/4ly7fd/disobeying_doctors_orders_during_labor/):

    “‘In no other field other than midwifery could my partners and I have entered as amateurs, arranged for our own education, and still have managed to safely produce results that far outstripped those of medical professionals in hospitals with the most up-to-date technology.’ – Ina May”

    Yeah, when your outcome measurements are “baby came out of vagina” rather than “baby came out alive”, Ina May and similar midwives are KILLIN’ IT!

    • Except, of course, Gaskin’s statement which you quoted is, quite simply, a lie. These so-called midwives have much worse mortality and morbidity statistics for mothers and babies than even high risk populations delivered in hospital by medical professionals.

      • mostlyclueless

        I saw a website with some insane made-up statistics from The Farm that claimed intervention rates close 0 and all negative outcomes close to 0 (not sure where it is now). I’m sure if you believe those numbers it seems like the midwives’ special magic woman knowledge is WAY better than actual doctors.

        • The Bofa on the Sofa

          How close to zero is “close to zero”? 1% is close to zero from a certain point of view. #InaMayKenobe

          • SporkParade

            Well, based on how she talks about letting her premature baby die, I think she doesn’t consider baby death to be a negative outcome.

          • Who?

            I’m left with the feelng that as far as Ina May is concerned, if she or her husband had a hand in it, it was good.

            Boring details like injury, illness and death don’t even make the footnotes.

      • Monkey Professor for a Head

        And the only reason they can keep their rates relatively low is by turning to more highly trained professionals when things go wrong.

    • Megan

      “Yeah, when your outcome measurements are “baby came out of vagina” rather than “baby came out alive”, Ina May and similar midwives are KILLIN’ IT!”
      Quite literally, indeed.

  • Here’s a study — it’s a small RCT — that shows offering a small formula supplement from birth helps improve long term breastfeeding rates: http://pediatrics.aappublications.org/content/early/2013/05/08/peds.2012-2809.abstract

    Ironically, ironclad adherence to breast-only may interfere with long term nursing success. There’s similar data for pacifiers (gasp!) too.

    • CSN0116

      It’s like saying water is wet. I’ll never understand how the temporary supplement issue is hard to grasp. It’s logical. In the end, however, it further solidifies the fact that lactivism mirrors religious conviction: even the littlest of behavioral compromise opens the gates to eternal failure and damnation and therefore must be avoided. It’s just a way of controlling behavior to support ideology just as religion does.

      Is lactivism the new opium of the masses? Keep em’ sleep deprived and overworked, remaining steadfast to the ideology with fear of retribution for failure, so that they can’t see how much said ideology is actually harming them… πŸ˜‰

    • Young CC Prof

      Yup, that study is pretty convincing. I’ve read a bunch of “rebuttals” to that in the lactation literature. All of them said basically that study must be wrong because it endorses formula use, none provided any evidence.

    • Puffin

      Yup, imagine that. Starving babies into compliance doesn’t work. Give them sufficient food so they have the energy to learn to nurse effectively once mum’s milk comes in.

  • Anne Catherine

    Great article, again! –

    Below is an interview with a LC with all kinds of ‘factual’ information on how all BF problems are solvable. Never does it mention that formula might be needed (only evaluation by a LC) UGH!

    Read if you want to get cranky!
    https://www.romper.com/p/16-real-breastfeeding-questions-answers-on-supplementing-pregnancy-more-11364

  • Amy Tuteur, MD

    This!

  • Mac Sherbert

    So now I’m wondering if my kid with the near genius IQ would have made it to actual genius status if I hadn’t struggled with giving formula the first few weeks and gone to FF sooner. πŸ˜‰ As my DH’s grandfather was fond of saying “the kid has got to eat something.”

    I think the comparison to healthy eating is spot on. The crunchy eaters always want to say a child won’t starve themselves so only give them xyz. The problem is that kids will starve themselves, especially those with spd, autism or anxiety problems. The last professional advice I read on the subject said it was best to feed kids even the unhealthy foods they like rather trying to force them to eat the healthier foods. The reason is because full kids that aren’t hungry are more likely to eat more and try new foods, but hungry kids will actually start to eat less and less. So anyway I figure that also applies to babies. A baby that is not starving is probably going to be able to BF more efficiently.

    • demodocus

      A friend went vegan not that long ago, and one of hers is *very* picky. Kid will eat chicken, plain pasta, and a couple other things. So far as I know she’s not got any disorders, she’s simply won’t eat many foods. The friend started because its “healthier” (though she’s getting into the moral aspects now, too) but i’m still trying to understand why is it healthier to remove such a huge part of the kid’s diet when there’s precious few things she’ll eat anyway.

      • fiftyfifty1

        “Kid will eat chicken, plain pasta, and a couple other things.”
        Kids (and adults) with such a restrcted variety of foods can have ARFID (pronounced “ARE-fid”). It’s for Avoidant or Restrictive Food Intake Disorder. Many people with it also have coexisting anxiety or ASD, but not all. None of the regular things that parents try to get kids to eat (e.g. rewards, punishments, making them go hungry, presenting the food to them many times, “just one bite” etc), work for these kids.

        • Who?

          Sounds like my daughter used to be. She’s a somewhat anxious spud. Now she eats everything.

          • fiftyfifty1

            If she was able to go from eating very little to eating everything just with time/maturity, then it’s not ARFID. Having ARFID is a whole other level of severity.

          • Who?

            That’s her, exactly. I think she was much happier once she left school and could eat when she liked. Her preference is for snacks/small meals throughout the day. She always ate better over the long holidays when she had more say about when she ate and how long it took. As an adult she knows that what and when she eats influences how she feels, how she can perform at work, uni, her sports etc.

            It’s good that there is more help for parents and kids now.

        • MI Dawn

          My friends’ son is like this. They think it mostly started when he was small and had some severe food allergy reactions. At 25+, he basically eats: hamburgers, hot dogs, chicken, chicken fingers. Pasta with butter. Rice. carrot sticks, celery sticks, some fruits, but I forget which ones. Waffles (his dad makes awesome waffles). He eats no sauces that I’m aware of, nothing spicy, and no other vegetables.

          HIs parents jokingly say he eats either Meal A or Meal B. They aren’t sure if his allergies still are as severe and since he declines to be tested, so it goes. His mom also suspects he has ASD but he wouldn’t have met the (then) criteria as a small child and since he’s basically a functioning adult now, they don’t see the point in finding out.

    • Gatita

      People are very judgemental about kids and diet. My son has had issues with since he was a toddler and has had occupational therapy for it. He is super picky about what he eats and generally prefers junk food because they make that stuff easy to get down. It’s a huge drag. I hope he outgrows that because I was also an extremely picky eater and now I’ll pretty much eat anything. I’m also pretty healthy so there you go.

      • Mac Sherbert

        Extremely judgemental! Ha, maybe it all starts with the obsession over their first foods. The thing about the “junk” food is that it always tastes the same! Fresh fruits and veggies are not consistent in taste or texture and that’s a real problem for kids with autism and anxiety.

        • Gatita

          Also, junk food is literally easier to chew and swallow. It just goes down your throat easier. And that’s a real issue for kids who have as you said autism and anxiety but also apraxia and other motor planning issues.

      • mostlyclueless

        I was so judgmental about picky eaters until my first pregnancy. The only foods I could tolerate were toddler foods — berries, candy, crackers, plain noodles. The idea of eating fish was enough to make me vomit. I’ll never judge a picky eater again.

        • demodocus

          burnt toast, plain chicken, and fruit with my first. This one wants steak and *no* charring.

          • mostlyclueless

            In my first pregnancy I ended 5 years of vegetarianism because I needed to eat some steak. This time around, I so much as smell meat cooking I have to open the windows and hold my nose. Picky, picky fetuses…

          • Dr Kitty

            #1 wanted cheese baps, pineapple ice lollies, melon and mango.
            #2 wanted vanilla milkshakes, KFC and Nando’s chicken, kosher pickles and chocolate.

            Breastfeeding me, meanwhile likes steak, cheeseburgers and Ben &Jerry’s.

          • Monkey Professor for a Head

            Minimonkey was a Nandos fan too! And hated my husbands favourite char Siu pork – he still hasn’t forgiven me for that.

          • Megan

            I ended up giving up being vegan in favor or being vegetarian during my second pregnancy because all I wanted was eggs and ice cream. First pregnancy, I wanted everything sriracha (the hotter, the better) but eggs, dairy and meat mostly repulsed me.

        • The Computer Ate My Nym

          Huh. Practically the same as my list of doable foods during pregnancy. For some reason, I was able to tolerate pasta, fruit, and…that was about it. I wonder if there’s something about pregnancy that makes simple carbs a good thing from the body’s point of view?

          • Charybdis

            With DS it was frozen lemonade, lemon slushes from Sonic, Tex-Mex food and salt-and-vinegar potato chips.

          • guest

            For me, during the period where I had morning sickness the only things I could eat were potato chips, olives, salted lemons, and ginger ale. During the second half of the second trimester and the third, I craved strawberries so much I overcame my aversion to buying produce from carts in the street (I always imagined them to be covered with exhaust from vehicles going by, and this may be true, but it’s also the freshest fruit in town).

      • Erin

        My husband went through a phase of eating a particular brand of tomato soup and nothing else. It didn’t seem to do him any harm, although it drove his parents up the wall.

      • fiftyfifty1

        “Junk food” isn’t junk. My best friend since 1st grade is 6’2″, a former All American athlete and obtained her undergrad degree from an Ivy League school and her doctorate from a different Ivy League school. She grew up on a diet consisting of breakfast cereal, chips, crackers, chocolate milk, fast food hamburgers and a daily brightly colored, artificially flavored, children’s chewable vitamin . Today she pretty much eats the same way. She can choke down iceburg lettuce if drenched in Ranch Dressing. She will take a couple of bites of pealed apple if it is very cold. Her diet may not be “ideal”, but then again you can’t argue with thriving.

        • StephanieA

          My husband and I were talking about this the other day. It’s amazing how well people can do on a ‘junk food’ diet. I have a very uneducated theory that activity is what (helps) prevent the so-called diseases of affluence. Humans have thrived on such varied diets, from mostly meat to mostly carbs. It seems like energy balance is important.

          As someone with a history of eating disorders, I eat whatever I want and just try to obey hunger signals. It seems to work well, my baby is 4 months today and I’ve been back at pre-pregnancy weight for awhile.

          • IrΓ¨ne Delse

            Activity is important, but so is genetics. We all know people who eat huge quantities while staying thin, and others who put on weight with just a whiff too much. I happen to be in the second group, and it’s a struggle.

          • StephanieA

            Definitely. Ive always been interested in obesity, nutrition, etc. So these are things I’ll think about randomly, and I agree that genetics plays a big role. I used to nanny for a family with 4 kids who all ate lots of junk food. One of the boys was overweight, the other kids weren’t. He took after his dad.

          • fiftyfifty1

            “Humans have thrived on such varied diets, from mostly meat to mostly carbs.”

            Exactly. Some people think we have to eat “just so” with “a rainbow at every meal” and all organic. They are afraid of whatever macronutrient is currently demonized (used to be fats, now it’s carbs). The truth is that our bodies are more like the sort of all-purpose furnaces that will burn anything burnable as the fuel. Beyond that, it’s true that we need some vitamins and minerals and essential amino acids. But those can be had easily unless you are in a famine (or have created a false famine for yourself by restricting).

          • demodocus

            and dark greens are *so* hard to convince most kids and quite a few adults to eat.

          • The Computer Ate My Nym

            This is one of those things that makes me feel like a hopeless weirdo: I’m fine with most dark greens. I don’t like the really bitter ones, but chard, spinach, broccoli, zucchini…I like all those. What I can’t stand are foods with a certain consistency, mostly “pudding-like”. I don’t like even being around ketchup because it has a strong smell and won’t eat any of the other “classic” condiments (though I do like salsa). All of which made me difficult to cook for even for a picky child when I was younger. Fortunately, my parents were willing to more or less shrug and say, “have an orange” if I wasn’t into whatever was on offer that day.

          • demodocus

            I was a weird child who liked broccoli. πŸ™‚ Toddlerboy is unsure about it at the moment, but we try not to push.

          • Megan

            My daughter LOVES “brocci” and so do I. We are also both fans of chard. I also enjoy Tuscan kale and collard greens. I remember hearing something about there being a genetic tendency to liking the taste of cilantro or not. Maybe it’s the same way with cruciferous veg?

          • guest

            Because they’re gross! One thing that really irritated me when I was first learning to cook for myself and trying to create healthy meals was the insistence that corn and potatoes don’t count as vegetables (I get that they are a starch, but they are also vegetables) and the idea espoused in some places that you *have* to eat leafy greens to eat healthily. Lettuce? No nutritional value. Celery? No nutritional value. Beets? Mostly sugars. Fruits? Too much sugar. Etc. If the rule is five helpings of fruit or vegetables a day, whatever fruits and vegetables a person likes should “count.” Otherwise just call it what it is”Eat four servings of leafy greens a day and then you can have an apple.”

          • StephanieA

            And since most foods are fortified now, you most likely will get all the nutrients you need even if your diet isn’t ‘healthy.’

        • Dr Kitty

          My sister used to have a housemate with ARFID.
          He ate a particular brand of cheddar cheese, a particular brand of white bread, a certain brand of breakfast cereal and potatoes (boiled, mashed or French fries- not baked or roasted). He would drink water or a particular brand of milk.
          No meat, no vegetables, although he did take a multi-vitamin.

          Other than being an absolute nightmare if they wanted to go out for a meal as a group, it was’t an issue.
          He was perfectly healthy and excelled at his studies. He has ASD, but it hasn’t impacted him negatively.

          Most of the world exists on a single staple grain with occasional meat, fruit or vegetables.

          The reason why the Irish potato famine was such a big deal was because for a significant proportion of the population potatoes were literally ALL they ate, with nettles, cabbage, seaweed, fish, milk, butter or bacon being occasional treats rather than daily staples.

      • Jules B

        My daughter, who just turned four, has always been a “good” eater, as they say. Will eat anything and often in large quantities (she is very active, so she builds up an appetite I think. Her weight is at the 50-60th percentile). I feel like it is just the luck of the draw, because I certainly didn’t DO anything as a parent to “make” her like food and want to try new foods etc. She literally came out of the womb like that (which, ironically, was part of the issue we had with breast-feeding…my supply was low but I think maybe do-able with a less “hungry” baby…her demand for foodfoodfood was just so high).

    • AirPlant

      You know, I am actually a very picky eater. Whenever people talk about starving a kid into submission I think back and I cannot remember ever giving in. Mom would sit with me until bedtime or try to force feed whatever it was that I was refusing and it made exactly zero difference. I am now a grown ass woman and I still refuse huge swaths of food. Trying to eat them literally starts me gagging. It is embarrassing to be a picky adult, and I have tried to fix it, but it is just like my body does not recognize some things as food and reacts just like I was trying to eat tree bark.
      .
      That in mind, when I try to imagine what I would do with a picky eater I honestly come up blank. I hate the idea of giving into the all carb diet of childhood, but I hate the idea of starving my child even more.

      • Mac Sherbert

        You have to get sneaky and what I try to do is choose the healthiest option of a particular “junk”. Fruit treats? Fine, but they’ll be the ones made of only fruit/veg juice, etc.

        Also, instead of punishing I’ll do rewards. If you try pineapple 12 times you can xyz.

        However, the truth is that it is exhausting and no one understands. They just want to say it’s because you’re a bad parent. My DH has a brother and a sister who aren’t picky eaters, but my husband is well known for only eating rolls…SAME PARENTS!

        • AirPlant

          Oh yeah, my brother will eat anything! It is amazing because he is actually rocking the autisms and he couldn’t care less what he eats.
          .
          I am lucky that my aversions are not really healthy/ junk foodrelated, I just have trouble with strong flavors. I can’t eat pepper or spicy food or anything with a lot of different flavors mixed in like sausage or lasagna. For the longest time I couldn’t stomach cheese. Most snack foods are actually right out because they are just too damn salty. I end up eating a lot of broccoli and a lot of milk and unthinkable amounts of toast and it works for me, but I really wonder what I am missing sometimes.
          .
          I am hoping that my imaginary future picky eater will be along the same lines and we can go along our bland and merry way, but children have a way of making everything harder so I will probably end up with one who only wants to eat tomato soup and grilled cheese, two foods that I find repellant.

      • Charybdis

        My brother with Asperger’s is a really picky eater. Always has been; combine the stubbornness of a picky child with the intense reactions of someone on the autism spectrum and we had some legendary “food fights” in the family.

        My dad had major food allergies; his big ones were wheat, onion, chocolate and pineapple. He also had milder allergies to a whole host of other things that he could eat in a rotation. Mom would use barley flour to bake cakes and cookies, gravy was thickened with cornstarch and no onion was used in cooking.

        So I grew up with picky eaters and dietary restrictions being my “normal”. DH is also a picky eater who has the same reactions to foods as AirPlant does, he eats plain pasta with browned ground sirloin (pasta and meat bits), grilled chicken (salt and pepper only, no marinades) and plain rice, plain baked potatoes, corn on the cob (no butter), etc. It is not weird to me to cook plain stuff for him, as I can add flavors, sauces and seasonings to mine.

        DS is picky, but will eat chicken, fish, drinks fruit/veggie juice combos, loves yogurt, milk (from whole all the way to skim), cheerios, grilled cheeses, quesadillas (plain) and pepperoni pizza. His diet is gradually expanding as he gets older and he is starting to take his BJJ training more seriously, so he is more willing to try stuff.

        • guest

          I have always assumed picky eating was normal, to be honest. My parents did try to force us to eat the family meal whether we liked it or not. There were a lot of Sundays where I sat in front of a plate of cold eggs for a long time. I had all kinds of rules about what to eat and how to eat it as a kid. Rice had to have ketchup on it. Salad was only acceptable with homemade dressing (which was mayo and ketchup mixed together, and when I got old enough, I made it myself and added a few more flavorings). But anything that was small and round in texture/shape, it gave me the creepy-crawlies. So no beans, peas, raisins, or cream of wheat could cross my lips. For whatever reason my parents didn’t push back on this restriction much, and gradually I started eating them – but without chewing them. (I guess the idea of them “bursting” in my mouth was the problem.) And as an adult, I just as gradually began to chew them before eating them. But I still can’t stand Cream of Wheat or raisins. And there are other things I still won’t eat, but in general, I eat a wide variety of foods (and I’m willing to try anything I know I don’t have an intolerance to at least once). But I always thought everyone was like this, just with their own rules and preferences.

      • Jules B

        My sister only ate peanut butter toast, plain noodles with butter, and apples (plus a variety of different kinds of “junk food”) for the majority of her childhood. She still does not ever eat a lot in one sitting, nor does she eat a huge variety of foods (although the variety is more than when she was five). She is perfectly healthy (runs marathons etc). I think some people are just not “into” food that much.

      • Deborah

        I was always a bit baffled by “the children in Africa would gladly eat your peas”. I used to think “well they can have them!”
        Then of course I used a similar argument with my own children years later “the kids in Africa would give their right arms to be able to go to school”……

        • demodocus

          Mom only used that one on us once. Can’t remember if one of us actually said “then we should mail it to them” or if the expressions said something.

      • Kelly

        I have a picky eater. I will give her what she likes and then a very small amount of something she doesn’t or has not tried. My rule is that she has to eat both before she can get seconds of what she likes. That way she gets some food in her but she does not fill up on it without eating what she does not normally eat. I do wonder if part of it is texture because she will eat the pouches of fruit and vegetables but will not eat them whole.

      • The Computer Ate My Nym

        I remember getting into squabbles about what I would and would not eat as a child as well. No amount of force, reward, punishment, or pressure could make me change my mind. The one thing that “worked” for me was simply to have food around and sometimes I’d think about a food and decide that I wanted to try it. For example, I specifically remember the day that I realized that I liked all the ingredients in pesto and decided I should give it a try. Shocked my family, but it turns out I rather like it.

        • KeeperOfTheBooks

          That’s the only thing that worked for DH. He had a similar “aha” moment with chicken pot pie: was convinced, having never tasted it, that he’d absolutely hate it, until one evening when he realized he likes chicken, gravy, pie crust, peas, and carrots, so why wouldn’t he like cpp? Gave it a try, now it’s a favorite. If they’d forced the issue, he’d never have willing put a bite of it into his mouth.

      • Chant de la Mer

        I’m a picky eater too with a picky child. I used to be all worried about it and try to get him to eat new things but now I just don’t really care anymore. I cook the food I cook and make sure he gets a balanced (by the week) diet and make sure to offer food he likes as well as new stuff. I remember what it was like as a young child and not having control of my food and how hard that was for me. Also I can’t really complain about it in my kids when I’m setting the example! I have texture issues and hate onions so that limits the foods I will cook, can’t expect my kids to do as I say not as I do so I just roll with it and feed them the veggies and fruits they like and try to do home cooked meals as often as I can manage to cut down on sodium and sugar intake.

    • Who?

      This is really interesting. My two children-particularly number 2-were very fussy eaters. I gave them what I knew they liked, for instance would provide mashed potatoes and packet gravy every night for a week, alongside the meal I prepared for us, which they were welcome to try/eat/share.

      They both eat really well now, as adults. And cook. Arguing about food every meal is too demoralising and doesn’t help them improve their attitude to food.

    • Ariana Ramos

      Neither me nor my brother were really picky eaters but both had a staple kind of food we could not stand. I hate cheese, any kind of cheese, and I still won’t eat it except if is melted (like, in a pizza). I can’t stand ham and sausage. My brother has no problems with cheese but wont eat yogurt or drink milk to save his life.

      Not the end of the world right? I mean, its totally possible to have a varied diet without those foods right? Not according to all my extended family that grilled my mother about it. They still mock us because of it too cause sure that will make me like smelly cheese =p

    • IrΓ¨ne Delse

      I tend to take with a grain of salt the claims about healthy eating, because i think about one of my siblings who, between the ages of 3 and 14, never once ate any fruit or vegetable, and very little milk products. My parents tried for years to get him to at least try, but he would be sick. They felt a lot of guilt, but what could you do?
      Now, as an adult, he’s the healthiest of us four. And he expanded his diet to something a lot more balanced, as soon as he was old enough to make decisions for himself.

      • Mac Sherbert

        My DH is still very picky in adulthood and never eats fruit…maybe a salad every now and then and his blood work always comes back good. It drives me crazy because if I ate like him…

    • Petticoat Philosopher

      Yes, kids will starve themselves–perhaps not to the point of medical emergency but certainly to the point where they will have a difficult time focusing in school, regulating their moods and emotions, controlling impulses etc. which is of great concern to me as someone who works with older kids in a school setting. I have had to explain this to several people who actually believe that poor children in public schools ought to be essentially coerced into eating the foods that they deem “healthy,” by making it the only food available. Because, yes, this is a thing that some people think would be a remotely moral thing to do. And no child will starve herself, right?

      Okay, probably not if they’re literally going to die but, before that point, hunger can do a lot of damage and not only through direct physical effects. Poor children, particularly poor children of color, are often punished more harshly than their white, affluent counterparts so academic performance and behavior problems caused by hunger can seriously ruin their lives. (And yes, the fact that this is the case is horrible and we should all fight it but, unfortunately, the school-to-prison pipeline isn’t going away tomorrow. So, ya know, make sure kids eat. It’s a good idea for all kinds of reasons!)

      Don’t get me wrong. From experience, I definitely think that many school systems can do a better job at creating healthy meals that are appealing to kids. I would like to see this happen. But it would not take the form of forcing kids to eat like California celebrities by removing all other options. And, until school lunches improve, I just want to see the kids I work with (first as a teacher and now as a master’s student in social work) with full bellies.

      It amazes me how many people think that it is acceptable to use a person’s youth, poverty, physical dependency, or any combination thereof, to force someone to eat according to their ideology, using starvation as a tool.

      • This, exactly. And the way that people conflate “morality” with “middle class orthopraxy” really bothers me. Health does not equal morality, and you’re not actually a better or more virtuous person if you prefer kale smoothies to pop tarts. Telling a kid his or her food preferences are wrong just seems to be setting up a lifetime of anxiety around food, not to mention class resentment, because come on, if you set up a kid to believe that the foods their parents can afford are not only unhealthy but actually bad or immoral, you’re asking them either to reject their entire home life, or to resent the hell out of you for judging them so harshly. It’s why Jamie Oliver’s incredibly misguided attempt to TV-shame Kentucky school kids into eating more correctly failed so spectacularly.

        • Dr Kitty

          Yup.
          My daughter’s school has a “no treats” policy, so you aren’t supposed to send sweets, chocolates, cookies, cake etc in their packed lunches.

          I am afraid I ignore this.
          There is nothing wrong with Oreos or raisin oatmeal cookies or chocolate cake or a small bar of chocolate in and of themselves. I control the portion size, I know how often she eats them, and I’m trying to set an example that all things in moderation are acceptable when it comes to food. I really don’t like the good food/ bad food model they seem to be pushing.

          • guest

            My elementary school instituted a similar rule when my brother was there (after I had graduated). My mother forgot and sent three Peppermint Patties with him one day, and the lunch aid confiscated them. He cried (I think he was seven), and he didn’t get them back at the end of the day, either. The next day, my mom sent them again, only unwrapped so that they looked like Oreo cookies – because cookies were okay, but candy was not.

          • The Bofa on the Sofa

            I’ve sent lunches to school with a few jelly beans for a treat.

            Seriously, if the school has time to police what’s in the kids’ sack lunches, they have way too much time on their hands.

          • guest

            Agreed. Plus, I thought we had done away with the idea that sugar causes hyperactivity?

          • Charybdis

            We had some knock-down, drag-out fights with DS’s kindergarten teacher over his lunches. He always takes his lunch (picky eater) and Mrs. J. was insistent that he *not* eat what was packed in his lunch because *she* wanted him to expand his menu choices.

            In kindergarten, his lunch consisted of: cheese, crackers, applesauce, yogurt and milk (chocolate milk on Fridays, purchased at school from the lunch line). He would eat his lunch and often drink two milks. We got a call one evening from Mrs. J. saying that she was concerned about DS’s diet and wanting to know what we were going to do about it.
            We basically said “Nothing. His lunch has protein, carbs and fruit, he is growing fine, his pediatrician is not concerned about his lunch choices (we asked), so as long as he is eating most to all of his lunch and drinking milk, he’s fine.”

            Mrs. J. did not like this particular answer, or was not used to getting pushback from parents because DS began reporting that she would inspect his lunchbox contents; just his, not anyone else’s. Once, she confiscated his lunch and tried to force him to eat a sandwich instead. She also implied that DS *might* need to be held back and repeat kindergarten, because reasons.

            She retired at the end of DS’s kindergarten year, thank the Lord. We like to joke that DS broke her, although we probably helped some, because we would not cave to what SHE deemed *best* for DS.

          • sdsures

            Geez. Things aren’t like they were when I was a kid (80s-90s). Made lunch at home: sandwich, veggie, fruit and a treat.

          • Megan

            Exactly. My daughter loves fruits and veggies and will devour whole wheat pasta and yogurt so she always gets healthy foods at every meal but she also gets a mini cookie after dinner if she wants it and some (gasp!) regular non-organic GMO Goldfish for snacks some days because she likes them. I don’t try to force her to never have treats but I always serve them alongside healthy foods and she usually goes for those first. I think though, I am also just lucky to have a kid who loves her produce. I call her my little fruit bat.

          • FormerPhysicist

            I HATE that policy. I make a chocolate tofu pudding for my kids – yummy, easy, and packed with protein they will eat and that doesn’t send other kids to the hospital. (They won’t do lunch meat, and all nuts are banned.) It got almost to the point of my withdrawing youngest from the preschool before the director backed down on “pudding” for lunch. Maybe I should have just labeled it tofu mole pate?

          • Dr Kitty

            Right- recipe please!

          • FormerPhysicist

            http://www.fixmeasnack.com/2009/06/chocolate-cinnnamon-pudding/

            To give credit where credit is due. I don’t use the agave, and we prefer it with semi-sweet instead of milk chocolate.

          • Nick Sanders

            I second Dr Kitty’s request for the recipe!

          • FormerPhysicist

            In the reply to Dr. Kitty

          • KeeperOfTheBooks

            Third the recipe request!

        • demodocus

          actually, i prefer kale smoothies to pop tarts, but mostly because i hate pop tarts and I rather like kale. Mind, a hamburger, fries, and a milk shake will win every time with me. πŸ˜‰

        • KeeperOfTheBooks

          This was something I’ve struggled with as a parent. I grew up pretty poor, but with parents with very broad palates, as mine is. As a result, there were exactly two things I consistently refused to eat as a kid: hot dogs (the smell made me gag) and raw cucumbers (ditto). I’d eat, and usually enjoy, anything else.
          Then I married a fairly picky eater, and had another. I had far, far too many fights with DD over food before I relented some in the last six months, fights that I suspect, as you suggest, actually set her up for more food anxiety than she’d already have. It was after I chilled out a bit, let her eat what she wanted (within reason–chocolate isn’t a main course, but mac and cheese at least has starch, protein, and calcium), and stopped engaging in drama over food that she began to ask to try the occasional new thing. I don’t see her as ever having the fondness for pickled herring that I had at 3 :p, but hey, she recently tried a new kind of cheese and also blackberries, so there’s progress!

          • I think it’s hard for naturally picky eaters to understand naturally adventurous eaters and vice versa. Good for you, for stepping back and seeing what was going on with your daughter. That kind of perspective taking is not easy to do, especially around something as fraught with worry (health, social meaning, etc) as food and mealtimes.

          • KeeperOfTheBooks

            I agree. DH will look on in horror as I dig into a wedge of brie (“it smells like old gym socks!”), while I remember being fairly young–7-8, maybe?–and even then thinking that brie was just about the best aspect of a particularly tedious garden party my parents brought us to every year. It’s almost like speaking an entirely different language.
            Thanks for the kind words. πŸ™‚

        • guest

          Orthorexia is the fashionable eating disorder today.

          But speaking of kale and pop tarts, I have a cockatiel who doesn’t like many foods besides his seed/pellet mix. No matter what I offer, there are just two other things he goes for: kale and…pop tarts. I never intended to feed him pop tarts, but I made some for myself one day and something about the smell made him come running over to steal bites from my plate. Kale he likes raw, which disgusts me.

          • Kerlyssa

            my cats won’t eat anything other than dry food. no wet food, no fish, no human food whatsoever… except cheezit zings. extra spicy, or no go. i actually do restrict those pretty hard, because of the high salt content, but. weird.

          • guest

            Pets can be just as weird as people. Fresh produce is considered an important part of the parrot diet, but I can’t force-feed a cockatiel. He gets kale whenever I have it, and I still offer some other things. But he’s so crazy for pop-tarts, it seems cruel not to let him have a treat now and then. (It’s a very rare treat as I’ve gone off pop-tarts for myself.)

          • Puffin

            I’ve been trying to get my almost 20 year old cockatiel to eat fresh foods since he was 8 weeks old and I’ve tried to get him on a pellet diet so many times. I’m feeding the other birds (who do eat their fresh foods) at the same time so it’s not much of a waste so I just continue to offer. Sometimes he’ll pick at some apple or carrot, but the only thing he’ll consistently try besides seed mix is pasta. Which just is not that good for him.

            But I figure of he’s made it to 19 refusing all the healthy food I offer, he’s got a right to lots of pasta in his final years.

          • MI Dawn

            I had a cat like that! Nothing but dry food – he’d turn his nose up at anything moist except tuna fish (we’d let him lick out the can.) He also adored goldfish crackers and would bat them around the room before pouncing on them and eating them. But, this was also the cat who was a capnip fiend. Somehow got onto a 9 foot high shelf (which we thought was safe), knocked down the entire box, scarfed it down, and was buzzed all day.

          • Megan

            Both of my cats adore cheesy “junk” foods: Cheetos, cheese popcorn, goldfish…

          • AirPlant

            Cats man. Mine will yowl plaintively at the slightest hint that bread exists in their immediate world. I try to remind them that they are carnivores, but they are utterly indifferent to logic

          • That’s hilarious. Kale is my mental shorthand for “sanctimoniously healthy,” and pop tarts are my mental shorthand for junk food, though I actually love both. I have cockatiels too, and they are pretty committed to their bird food as yours is. We’ve given them all kinds of fruit and veggies but they really only like bird food and cilantro.

          • MaineJen

            I had a cockatiel once…he loved broccoli and…onion rings. Well, really the breading around onion rings. πŸ™‚

          • Stephanie Rotherham

            Hee, the only greens my rabbit will eat is chopped kale! She’ll chew the bars of her cage and throw a huge bunny tantrum if offered anything else like spinach or rocket; I can get her to have a little so long as most of her portion is kale. She’ll take some herbs like basil and coriander, but she’s mostly indifferent to carrots other than the tops and fruits other than apples. She also barely eats her hay but goes grumpy if her pellets are late. She also loves Parma Violets (little round chalky sweets, a bit like Lovehearts) and will steal them from me.

            When our dog was alive he would eat most anything; but when he asked for a bit of banana, he would always take a mouthful then spit it out and ask for more next time. It was so funny.

          • Heidi

            My guinea pig was supposed to love vegetables and parsley but she would never have any of it! In fact, she’d run far away from the parsley and refuse to go near it. It was pellets, alfalfa, yogurt drops, granola/candy bars made for guinea pigs, and oranges.

        • Angharad

          This is actually something I feel really strongly about. I had an eating disorder in college because I felt so strongly that being thin and eating healthy were morally good. I’m trying really hard to raise my daughter so she won’t think sugar, or a limited palate, or really any other preference related to food, is morally bad. We don’t use foods as rewards (my daughter’s current reward of choice is cotton balls, which she loves to pick apart), and we always offer her unlimited amounts of at least one food she finds acceptable at mealtimes. When she’s full of rice and strawberries, eating a food she dislikes (chicken or vegetables) is less stressful because she doesn’t have to worry about either choking it down or starving.

          • We do something similar, only it’s stickers instead of cotton balls. And I was blessed with a kid who never met a food he wouldn’t try, so I just make sure there’s at least one “sure thing” on the table at every meal, which he’s welcome to have after he’s tried everything. I think I’d switch it up to something more like what you do if he was pickier or warier, but so far this seems to be working.

      • Mac Sherbert

        YES! This whole forcing healthy foods on kids at school drives me crazy. You explained it so much better than I could have.

        Edit: I am fortunate that I can pack a lunch for my otherwise I know he would eat nothing, literally nothing at school.

      • Stephanie Rotherham

        This, exactly. I used to get packed lunches (usually peanut butter and crackers, or ham or cheese sandwiches) because I was such a picky eater I would rather have gone hungry than eat school food.

        I remembering loving my mum’s mashed potatoes when I was little (still do, really, especially with sweetcorn) so much that, when presented with a family friend’s alternative when they were looking after me, I could barely choke down a mouthful.

        I’m still picky but now that I can cook my own food I can control what goes in and leave out what I know for certain I won’t like, and maybe add in things I can try.

      • MaineJen

        I knew a little girl once who accidentally choked on a marble (!!), and then refused solid food for several weeks. She would only drink ensure-like shakes, and she began to lose weight. It got to the point where her mom, and NP, was frantic and actually took her to the hospital where she worked, to show her what tube- and IV-feeding was like, to try to persuade her to eat. The girl still refused.

        The only thing that finally worked was a change of scenery…she went on vacation with her grandparents and one night, in a restaurant, decided it was time to start eating again. She was seven years old, and she absolutely would have starved herself to the point of danger, by sheer force of will.

        • IrΓ¨ne Delse

          Oh, gosh, this reminds me the time I nearly choked on a fish bone. The bad experience put me off fish for years after that.

          • AirPlant

            Same, but with onion rings. πŸ™

  • Amaya

    I deal with this all the time. I am a pediatrician and I have had to get harsh with some parents who just refused to see what was in front of their face. As their child is my patient, I had to do what I had to do to try and open their eyes. I now have literature with me at all times on what malnutrition and starvation does to infants. 99.9% of the time those possibilities are scarier to them then feeding formula, thank goodness. I have had a few fathers who had to formula feed on the sly because their wives were being 100% unreasonable. Kudos to those guys for doing what was best for their child.

    • Montserrat Blanco

      “I had a few fathers who had to formula feed on the sly”

      How can those mothers be SO unreasonable???? And how do you actually manage to do that????? Where do you keep the bottles, the formula, etc? It sounds crazy.

  • D/

    Honestly I see a lot of these kind of situations. *Many* families are hesitant to feed formula to their breastfed babies, hesitant even to the point of not seeing what’s actually in front of them. I’ve had more than a few mothers not make the connection that their baby hasn’t just not gained weight over weeks (or more) of time, but that they’ve also “lost” that pound (or pounds) that should have been gained during the interval since the last weight check.

    The weights described in the post plot out as attached.

    This baby needs to be fed and has needed to be fed for some time. Even if they had been sent straight from the Ped’s office for a consult with me, I’d have been on the phone with the doc to discuss the feeding/ follow-up plan for this kid before the visit was ever finished, and any decent LC would be doing the same!

    Thanks for putting your comment on that reddit thread @NoLongerCrunching … You are spot on!

    • Gatita

      Thank you for the chart. I think when people see that red line they’ll understand exactly what’s going on.

      • Inmara

        I wonder why pediatricians don’t explain more about growth charts, I regularly refer people from internet forums to WHO growth chart calculator so they can see themselves how baby is doing.
        When I look at the growth line of my baby during first 3 weeks, I feel guilty because he declined from 25th at birth to around 10th. Then we finally started to supplement and he climbed steadily to 50th where he’s still at 10 months. Our pediatrician was relieved that we started formula on our own, she has seen babies who are still at their birthweight at 1 month check-up and moms continue to believe in breast-is-best mantra.

        • Kelly

          Every pediatrician I have been to have showed me where my child’s growth was on the chart and explained it to me. I didn’t know that that didn’t happen any where.

          • MI Dawn

            Yeah, mine always did the plotting and showed me all the dots, explaining what they meant, with both kids. And they always knew I was a nurse, but this was part of their routine with everyone.

            (Both of my kids docs were very pro-breastfeeding, but encouraged supplementing as needed. BF babies were seen at 3 days post birth, then 2 weeks and 2 months for weight checks at minimum – some were seen more if there was a concern. I had great peds for my kids.)

        • Megan

          I give the parents printouts to take with them.

      • D/

        You’re most welcome.

        Growth expectations are part of every breastfeeding conversation I have with families and growth charts are one of the first tools I introduce with nearly every out-patient I work with.

        • The Bofa on the Sofa

          In the mom’s group my wife went to, they focused a lot on weekly growth. Everyone weighed their baby each week. It wasn’t about where anyone was on the curve, it was looking for growth and gaining weight.

          A few oz a week was expected. If they didn’t gain, the lc would get involved to keep them growing.

          Weight gain was a huge issue of concern.

          • D/

            Yep, Any family that I work with beyond the initial hospital hospital stay gets my standard spiel on breastfeeding “priorities”:

            ● Feed your baby until they grow appropriately.
            ● Protect the milk supply.
            ● Keep a manageable plan that lets you enjoy your baby while working toward your ultimate breastfeeding goal.

            That said, the first priority is the only non-optional one if I’m your LC … other than the ‘enjoy your baby’ aspect of the third, that is πŸ˜‰

          • guest

            Yup. My daughter was below the 0 percentile when she was born, off the chart – because she was premature. But she was in good shape otherwise, and the thing that mattered was that from where she was, she needed to gain until she got on that chart. And she was 15th percentile for a long time, but it was no problem, because she was on that chart and maintaining that percentile over time.

    • moto_librarian

      My pediatrician explained that it didn’t really matter what percentile the baby happened to be situated on the growth chart, but that the baby needed to remain on a consistent trajectory. That’s why it was such a big deal when our younger child fell from the 25th percentile to the tenth, to the fifth, to the first. It will be interesting to see where he is at his four year-old checkup on Friday.

      • Megan

        That’s what happened to my daughter. She dropped from 25th to 13th to 8th. GERD and CMPI are now treated and as of yesterday she’s at the 12th. I hope she continues to improve though my older daughter didn’t have either and she is a 15th percentile baby too. They are probably petite too.

    • NoLongerCrunching

      When parents are resistant, I have the most success when I explain to them about what a threat their baby’s lack of energy is to developing a good milk supply. I also ask them what exactly are their concerns about formula so I can address them. I recently had a mom who was scarred to use formula because she thought it would increase the risk of her baby developing type one diabetes, which she suffered from. I printed out information about the lI prinack of evidence for that.

      • D/

        Yes. My approach is the same, and I find it generally successful too. Although the degree to which I am proactive about discussing any of their formula concerns is a new development for me in just the last couple of years. The situations in which I have not been able to address a baby being fed enough have been *very* rare and were, unsurprisingly, complete disasters.

        Those few cases have made such an impression on me that in my private practice I do not accept self-referrals without the baby having a **LICENSED** primary care provider. I know Dr Amy offers us regular reminders of the $ motive driving LCs, but I can confidently say that there’s not enough money in every bank account in my entire county to wade off into the land of woo and starving kiddos without professional medical backup!

  • Amazed

    When they say, “We’re all women and we should all just support each other and each other’s choices and always be ready to admit that there is another point of view” and then start on about breastfeeding being the absolute best and everything else should be tried before doing anything that might harm “the breastfeeding relationship” (another way to show just how inferior “formula-parenting” is), I am all, No, no, no.

    When you’re willing to defy the basic law of nature – that every living thing needs nourishing specific to its kind before anything else, it isn’t an alternative PoV.

    When you’re advising women to starve their baby into give up on weaning (despite all shouts for baby-led weaning), it isn’t an alternative PoV.

    When you say it isn’t possible for a kid to go truly starving while being EBF despite knowing that there is a percentage of women who simply cannot produce and babies who cannot suck, then it isn’t an alternative PoV.

    That’s evaluation. Saying that BF matters before anything else. And that isn’t right. Everyone is entitled to their PoV but there are simply some evaluations that cannot be allowed to go into the public space as being legit and unchallenged because PoV. It’s not acceptable to bury new parents under dangerous unscientific propaganda. It isn’t acceptable to stick your nose into another family’s decision on how to feed their kid, provided that the kid is fed food that isn’t harfmul. It isn’t human to starve a baby and pretend that a few grams less for an emaciated baby aren’t an emergency.

    Learn the difference between PoV and estimation, natcherel feeding folks. They ain’t the same.

    • Jules B

      It really is the propagandizing that bothers me, because when you are a new parent, the learning curve is steep (especially in North America where people often reach adulthood never having cared for an infant before). New parents are tired and overwhelmed and I feel like Big Boob (aka the breastfeeding industry) takes advantage of that weakness. It’s so not right.

      • Amazed

        Indeed. I’ll make a step further and say that propaganda bothers me mainly because in most cases, without it no one would have thought about the ludicrous ideas it enforces. I mean, come on! Someone like you (if you work in a field that has zero to do with medicine) or I (a translator, if you please) would have drawn a connection between a kid’s regression and the MMR vaccine if Fakefield and his cohort of Google masters hadn’t said it was there? We would have thought that food designed to be as close to breastmilk as possible and keep the kid 1) alive and 2) thriving is murdering them slowly if the milky woman wasn’t there to enlighten us? Please.

        First they plant a seed that would have never found a place in us without their help – and then they bring forth the propaganda. Disgusting.

        • Jules B

          Very good points. I mean, like many folks my age, I was given formula as a baby. I turned out fine (at least if you do not dig too deeply, haha). If I had not been exposed to the lactivist propaganda, I would had zero guilt about giving my daughter formula when it became needed.
          Just like you cannot pick out the highschoolers or adults who were FF vs BF, you cannot even distinguish between *babies* who are getting formula, or just breast milk or both. They all just look like healthy, happy bouncy, giggly babies.
          It truly is propaganda if it is able to get us to ignore the actual reality in front of our eyes.

          • Amazed

            Well, when Auntie’s (not so) Little Treasure and Miss Impatience (her mom had contractions in her eight month and each time she rose from bed, kid dashed for the exit, which in turn made mom lie back down. It all ended up with a (hospital) placental abruption.) are together, you certainly can’t say which one is FF and which one is the BF one. They’re both big, chubby, and extremely sunny, smiling children. In fact, when my SIL first saw Miss Impatience, she couldn’t wait for Amazing Niece to get to this age, she found the FF missy extremely charming.

            So no, no great difference here. No difference at all since no one is crying their head off with hunger. I am against posting kids’ pictures on the internet, else I would have had a good laugh watching Nikkilee trying to find out which one is the great BF kid and which one the lowly spawn of FF.

        • Chant de la Mer

          That’s it exactly. If it wasn’t for all the propaganda I wouldn’t have thought twice about supplementing my second child. With 20/20 hindsight, he really could’ve used a couple of days of supplementation to help with his weight and bili. I thought it was true that if one drop of formula passed his lips that it basically ruined any good the breastfeeding did. I’m not an idiot, I have damn good critical thinking skills but I didn’t have much knowledge of the biological side of things and just didn’t know any better. That makes me so angry since breastfeeding was something that I wanted to do and enjoyed doing but the only common education out there thinks that any exposure to formula will keep me from breastfeeding. Well thanks to this blog, I was much more knowledgeable the next time and happily supplemented baby #3 for about 4 days then EBF for 6 months (well we started solids around 4.5 months) and then supplemented with formula when I went back to work because i had a hard time pumping. If I had stayed home for a whole year then I would’ve breastfed until 1 year. Basically formula was demonized and could’ve helped my second child, and it did help my third one. It’s utter bullshit that anyone should be told that it’s a binary set, breastfeed or formula and that the only correct answer is breastfeeding. You are entirely correct that none of this nonsense would be anywhere if it was for the seeds that they plant about the wonders of breastfeeding and how formula will corrupt your child.

  • CSN0116

    I think of breast milk as superior to formula in the same way that non-highway travel is superior to highway travel (95% of motor vehicle fatalities occur on highways): if someone has an easy, accessible way to avoid highway travel, and copious amounts of time to spare, then she is statistically better off choosing it, if she values her life that is; she’ll reduce her risk of dying by over nine times.

    But do people actually wake up and give a flying fuck about this shit on a daily basis? No. People look for convenience and ease with a desirable outcome, despite “risk.” And highway travel with a special snowflake in the back seat is far more dangerous than formula feeding!

    Moral of story – I take highways whenever possible because ‘ain’t nobody got time for that,’ and I EFF for the same reasons. Both choices represent an “inferiority coupled with heightened risk” for which I do not give two shits about… also for the same reasons.

    Final moral of story – This woman needs to get off the rural back roads and jump on the FF highway… yesterday.

    • Roadstergal

      “95% of motor vehicle fatalities occur on highways”

      And there are factors that go into this that make it more complicated – the % of travel on highways in the US is high, most people commute (tired/brains turned off/etc) on highways, and so on. So the risk for yourself taking a freeway vs surface street trip is not as simple as the gross statistics.

      Starving your baby to avoid formula feeding is like the people who hear that most accidents occur within 5 miles of your home (or whatever the precise statistic is), and think they’re in the clear if they register their car to a home in another state. :p

      • CSN0116

        Ha! Great addition!

    • Jules B

      I know you were making an analogy, but it is funny to me that so many of the breast is best folks have no issues putting their kids on cars. Don’t they care about their children?? πŸ˜‰

      • CSN0116

        It was part analogy part fact. People abhor formula but only because they’ve lazily had the rhetoric hand-delivered and spoon-fed to them. Anything that requires independent research and investigation is out of sight out of mind. When you ask a lactivist to prove how breast milk is superior in a developed country with clean water they just post links to the CDC, AAP and WHO. If you actually read those studies they’re lackluster at best, and at worst they actually show that formula is superior! But people are incapable and unwilling to learn anything for themselves.

        There are a host of things that can and will kill your child before its first birthday and what milk they’re fed doesn’t even pop up on the list. If you cared that much about your child’s survival and quality of life, you would modify numerous things about your lifestyle FIRST. But, alas, reducing moral superiority to a biological function is just so. much. easier.

  • Tori

    I had the opposite experience – lactation consultant had us supplement at just before 3 weeks postpartum when baby had lost about 20 grams and wasn’t near birthweight. We worked out I had IGT among other factors, and despite everything my supply didn’t change much. When we saw the paediatrician at about 7 weeks (hadn’t seen them since discharge, we don’t have wellness checks with paeds but with child health nurses in my country), and told them about the supplements which had gone up and up, the paed said that he wasn’t worried about the weight gains except for the day we’d started formula. At the time I felt so frustrated (and a little judged), particularly as he’d recommended that LC! But I’m sure he wasn’t concerned about the weights because of the supplements – at the appointment I didn’t go into detail about baby’s lethargy or dark urine. I wish I’d been backed up by the paed more though, as I was judging myself enough for breastfeeding not working out as I hoped.

  • Gatita

    As I said on the other post, there’s something funky going on here. If the parents were taking baby in for wellness checks the failure to thrive should have been caught by the pediatrician. It sounds like this baby hasn’t been seen by a doctor since birth. Which means there’s some kind of ideological weirdness going on.

    • AirPlant

      Ah cults! Medical care=bad, reddit=good.

    • Allie P

      I believe that they are having regular care. We never got to the point where the pediatrician *forced* me to give my older daughter formula. They advised it. Then they advised it strongly. I listened to the LC instead. She was several weeks old. It was my mother who cried and begged and told me that it was NOT NORMAL for a baby too look so hungry, to cry so much. I believed her. I gave her formula. She slept. She grew. We kept breastfeeding (for ten months!) despite my lactation consultant’s dire warnings.

      I realized how much I’d been lied to by the lactation industry. I found SkepOb. When I had my second daughter, I had formula ready when I went to the hospital. I told all three LCs (hospital, OB consultant, Pediatrician consultant) where to shove it. I breastfed and then gave formula if she was still hungry. My pediatrician and my OB privately and sheepishly told me they were so relieved that I wasn’t making myself or my baby miserable for ideology. We went months without needing any formula at all. My baby has never been hungry a day in her life. I just finished nursing her (she’s almost eleven months old).

      • Allie P

        And it’s so confusing because you have the ped telling you one thing, then the LC, who the hospital/OB/ped HIRED telling you something else. And she’s “the expert”. And she TELLS you she’s the expert! I wish the peds knew the snakes they were inadvertently sending into your grass.

        • demodocus

          leave my garter snakes out of this.

          • Chant de la Mer

            oh the garter snakes are fine, as long as they don’t touch me, it’s the lactasnakes you gotta watch out for!

      • Gatita

        I think though that your daughter was never as bad off as the baby described in that Reddit post. According to the pediatricians in the thread, the baby in the Reddit post has fallen off the growth curve. I would think that any pediatrician that saw the baby in the office would immediately declare that an emergency. The baby is 12 weeks old and I looked up the standard well-baby visit schedule and the baby should have been to the doctor at least three times in that time. But dad hasn’t mentioned any warnings from a doctor. It just feels off to me.

        ETA: D/ above posted a weight chart showing the baby’s weight trajectory. At 8 weeks the baby who had already fallen below the 1st percentile. That should have been caught. If it wasn’t it’s because either they have a crazy incompetent doctor or they didn’t take the baby to the doctor at all.

        • Allie P

          Yes, we corrected course at three or four weeks, not TWELVE. Christ.

    • An Actual Attorney

      Maybe not. Our wellness checks were at 2 weeks, one month, two months, and will be at 4 months. So she would fall in the three month range. I’m assuming he, like I am, is from the US, since his profile has many comments about the upcoming election. (He’s a Bernie Bro). But, I’m still skeptical it’s real.

      • Heidi

        I do know that our pediatrician had our baby in an extra time just to be sure he was gaining well because he was born small and lost 7% of his birth weight at the hospital. I know 7% is acceptable but I’d much rather be safe than sorry! I would hope that if the baby wasn’t gaining great to begin with, the pediatrician would want to do a weigh check every week or two.

        • An Actual Attorney

          With our first, we were back and forth more often for weight issues. This one, just on the regular schedule, since she’s gaining weight like a champ even though she was preemie. Hmmm, maybe because I shook myself out of the breast-is-best fog and feed her formula early and often.

      • Roadstergal

        “He’s a Bernie Bro”

        Is this an Oregon story? :p I sense some intersectionality…

      • Gatita

        D/ above posted a weight chart showing the baby’s weight trajectory. At 8 weeks the baby who had already fallen below the 1st percentile. That should have been caught. If it wasn’t it’s because either they have a crazy incompetent doctor or they didn’t take the baby to the doctor at all.

        • An Actual Attorney

          I stand corrected. That is concerning. I would certainly expect a ped to note that.

    • Anne Catherine

      I think that quite a few pediatricians have drank the (breastfeeding) kool-aid–I don’t find it all that surprising: Below is a post I found and copied a while ago (can’t remember the source).

      “My first weighed in at a healthy 8.5 pounds then promptly lost over a pound when she refused to learn how to nurse. She was a struggle for a couple months (she finally regained birth weight at two months of age). I am very glad I had a supportive pediatrician who was
      willing to continue to support breastfeeding instead of supplementing.”

    • Young CC Prof

      Actually, my friend’s son’s pediatrician let failure-to-thrive slip for far too long. He went weeks gaining nothing, and the ped didn’t act until the child actually lost. Then some moron put her on that triple-feeding torture, instead of doing the rational thing. Then, possibly because of the triple-feeding torture, the already-underweight baby wouldn’t take a bottle. She fed that baby every two to three hours for a year and a half trying to make up for her son’s starvation as a newborn, and it was all on the pediatrician who let things slip much too long.

      • Chant de la Mer

        That’s crazy. I’m not a ped, but I can do well child checks starting at 2 weeks and any visit where the child hasn’t gained weight means that followup is needed. Which means regular weekly or even daily visits to monitor weight gain as well as other stuff to find out why baby isn’t gaining weight if the reason isn’t already known. (preemie, twins, already dx with failure to thrive, metabolic disorder, etc.) I can’t diagnose any of these but I can discover problems and monitor and my oversight doctor can take it from there.

  • Zornorph

    Honestly, I just want to fly up there and slap somebody. I know I shouldn’t feel that way, but I do.

  • Sarah S

    This makes me happy that the LC I saw with my first baby was also a pediatrician…

    We decreased formula gradually, so that baby would still get enough while challenging my body to produce more milk. We also had weekly and biweekly weigh-ins. (My baby was gaining ~10 oz/week even when I reduced formula–he was fine). And she told me flat out that I would probably need to supplement a few oz/day until solids were well established. I combo fed him until he was 11.5 months when my supply gave up the ghost (pretty sure going back to work had something to do with it). At which point he was old enough for whole milk anyway.

    With my younger child I just did weekly weigh ins with his regular doctor when I decreased formula (milk came in late). Using the same techniques I was able to stop formula completely at about a month old. But then again, my initial supply was better this time around so he needed less overall, which made it less that my body had to pick up the slack to make. I’m glad–would have been disappointed if I’d had to supplement again long term because I enjoy nursing.

    • Allie P

      Ditto!

  • Alison Sandman

    The more I read these stories the luckier I feel– the hospital lactation consultant was the person who suggested I supplement, and showed me where in the room they kept the formula. Then after the baby was fed and happy she asked if I wanted suggestions about breastfeeding.

    • Erin

      Agreed. The Nurse/lactation consultant (she was both) in NICU was the best thing about my Maternity hospital experience. She was understanding, sympathetic and pushed what was right for us, whether that was breastfeeding or formula or both. On learning I was finding it triggering, she suggested giving up first of all, saying that continuing might be way more damaging than giving up. On my stubborn refusal she worked on ways to try and get around the triggers with me and held my hand whilst I sobbed my heart out pumping for the first time. She also liberated my son from NICU a day before they intended to (paperwork not medical need) and helped get me out of that hospital and back to my husband/friends/support network before I did something really stupid.

      I can’t really say thank you enough, although I tried with two separate thank you letters, one to her and one to the hospital plus a mention of how amazing she was in my feedback form.

  • Montserrat Blanco

    I love the analogy with the tofu and water versus meat and soda.

    Signed: a woman belonging to the 5% that refuses to feel guilty each time she prepares a bottle.

    I even will admit that I did not follow every single piece of advice by LCs and that might explain my failure to produce enough milk. Having a healthy mom is more important than having breastmilk in my honest and humble opinion and yes, recovering properly from HELLP was more important than the breastmilk.

    • Heidi_storage

      There is no need to put yourself through misery by following “every single piece of advice.” Teas, oatmeal, and brewer’s yeast are not exactly slam-dunk proven to increase your supply, and you do NOT need to suffer through a given amount of pain/inadequate supply to prove that you tried hard enough!

      • Montserrat Blanco

        I did put myself through some misery and I am not proud of it at all. I should have spent that time holding my son in kangaroo care and not pumping, but I did follow some of the advice. In any case, domperidone was out of the question as were herbs and supplements. Thanks to this blog I learnt about the possible issues with domperidone and decided to skip it.

        As I said, I refuse to feel guilty.

    • Allie P

      Dude, it’s not even soda! It’s like…. organic home squeezed orange juice vs enriched OJ from concentrate.

      • Roadstergal

        Yeah, it’s like tofu vs seitan.

    • StephanieA

      I’m in that 5% with you. The majority of my coworkers breastfeed, and we were talking about our babies at work the other day. Coworker told me to not to feel bad for formula feeding, because she was too (due to baby’s GI issues). I told her that I don’t feel bad at all for bottle feeding. Not one little bit. I’ll proudly shake up my powder in bottles of water in public any day, ha.

      • Inmara

        A friend of mine started to supplement when baby approached 6 months, her supply just wasn’t enough for his needs. Apparently her friends and relatives were disapproving, so she told me apologetically that she just made more vegetable purees etc., and went through with some supplementing until weaning. FFS, you fed your child, why do you need to justify yourself?

        Fortunately, I haven’t had a single person making snide remarks; some are asking questions, like “Are you still breastfeeding?” but I just flat out answer that I’m not and that’s the end of conversation.

  • Taysha

    It was disheartening that in a thread with so many people begging for him to take his child to the pediatrician, he only replied to the comment that rah-rah’d his wife breatfeeding and promoted an LC over a medical professional.

    • NoLongerCrunching

      Link?

      • Heidi
        • Charybdis

          It says “Hey, thanks for the reply. My wife’s doing everything the consultant suggested, so far. Pumping more and feeding whenever our baby wants it. I guess I can wait a few days to see if it actually works.”

          Why ask for, and receive advice if you are not going to pay attention to it? I mean, it’s bad enough you are asking Teh Interwebs, but to blatantly ignore the advice from medical professionals stating that this is an emergency and to get the baby to a doctor/hospital ASAP because your wife is upset at the suggestion is barking mad.

          • The Bofa on the Sofa

            Pumping more and feeding whenever our baby wants it.

            I don’t understand. The original claim was that “She feeds all the time, and just isn’t making enough.” So now they are only going to feed “whenever the baby wants it”? How is that any different from before?

          • Roadstergal

            It seems like the whole problem is that the baby wants [needs] more food than is being provided by the boobs, so they really are _not_ feeding whenever the baby wants it…

          • As the baby becomes progressively more dehydrated and starved, it will become more lethargic, and therefore demand less and less.

          • Amazed

            It makes his caving in to his wife’s tearful insistence look more palatable, The two posts make me think that his rational mind is making a failed attempt to get through the “Mommy knows best!” rhetorics.

          • An Actual Attorney

            Scrolling through his profile, looking for an update, I realized he’s either an asshole with no respect for women, or someone who thinks himself a creative writer. I won’t copy here, because it’s pretty foul. Read if you want for yourself: https://www.reddit.com/user/alpha_helix_87

            So, my supposition is that either he made it all up or he puts all this baby stuff in the mental box of “women stuff I don’t really care about.”

          • Amazed

            I vote for asshole. That’s just by scrolling through his huge drivel of a longest post. I’d say he wants to be an alpha (he even called himself one) but he isn’t. Just an asshole.

          • Valerie

            That post is not original- it has been copy-pasted around. Hard to tell what his intent was of repeating it there (perhaps mocking?) because the thing he was replying to was removed. Pretty nasty, though, in any case.

  • sdsures

    Spelling mistake alert: it’s “cannibalize”. Just noticed.

    I feel sorry for the dad. I hope he gets that baby to the hospital ASAP. His wife is clearly not thinking straight.

  • NoLongerCrunching

    I’m an IBCLC with 10 years of experience. LCs who are reading this, please do not sacrifice babies for ideology. Yes breastmilk is better than formula, and we have all dedicated our lives to helping mothers breastfeed, but babies and mothers should not suffer when there’s not enough milk to allow the baby to grow normally. Normal growth is defined by LLLI as gaining 1 ounce a day after day three.

    Formula is not as good as breast milk, but that does not mean it is bad. It is food, nothing more, nothing less. Babies should not go hungry to punish formula companies for predatory marketing.

    Also consider that a lethargic baby is not going to be able to stimulate the breasts enough for the mother to develop a good milk supply. Mothers cannot pump around the clock for longer than about three days before becoming delirious with fatigue. Sleep deprivation is a torture technique that is banned by the Geneva Convention.

    It is the height of malpractice and cruelty to risk dehydration, seizures, and failure to thrive. Besides that, it is agonizing for the mother to watch her baby starve and feel helpless to get the baby enough food.

    Put babies’ health first. Put mother baby-bonding second. Work on the breastfeeding after the situation is stabilized.

    • Montserrat Blanco

      Thank you for writing this.

      • NoLongerCrunching

        You’re welcome. I also posted on the thread and mentioned we were discussing the situation here. Madness.

    • Amazed

      That’s a great post. I hope it makes him reconsider, although you aren’t the first professional to have said so.

    • Allie P

      LETHARGIC BABIES CANNOT SUCK. Yes yes yes yes yes. I think my milk came in better because I supplemented, and my baby was strong and ready to suck, not weak and sleepy.

      • Mac Sherbert

        Yep. I had to supplement my sleeping baby, but once she woke up…we nursed for 18 months.

    • indigosky

      I still disagree that formula is not as good as breastmilk. Have yet to see any actual scientific evidence that it is.

      • NoLongerCrunching

        Even Dr Amy says that it’s (marginally) better. How much better is debatable. I mostly added that for any zealots who might be reading; they’ll be more likely to listen if I don’t challenge the central premise of our career. The longer I do this, the more I think that the most important thing is that babies get fed and mothers feed in the way they want. I support any mother who wants to use formula for any reason.

    • fiftyfifty1

      I’m glad you wrote this, because it needs to be said.
      At the same time it makes me sad. It comes with a huge dose of walking on eggshells—repeated apologizing about how Breast is Best, and obligatory tut-tutting about the “predatory” formula makers, and begging that since starvation is torture and deadly, oh pretty please might we consider formula? Is this seriously the state of IBCLCs? We gotta do the little appeasement dance so as not to offend their cult like beliefs?

      • Megan

        It’s not just IBCLC’s. I have FP colleagues like this too. It’s really sad. I wish people would read the actual science.

        • D/

          OT from main post, but here’s a more scary than sad FP for you that proclaims its breastfeeding and attachment parenting friendliness … AND now their newest claim to fame:

          http://www.csfmed.net/no-more-vaccines-at-cool-springs-family-medicine/

          You couldn’t pay me enough money to take any newborn/ kid of mine into this practice’s waiting room or to take on any of their clientele as an independent IBCLC.

          • Gatita

            I thought this must be a joke but apparently not. Their offices are next to While Foods, of course.How long before the office is ground zero for a measles outbreak?

          • An Actual Attorney

            I don’t understand how an actual MD thinks like this.

          • Nick Sanders

            That’s (sort of) in my home town. It’s in a very, very upscale neighborhood. Their clientele is probably 100% yuppies, and would be even if they weren’t a woo pedlar. So, it’s not exactly surprising that they have their head wedged deeply up their ass.

            If going through the downtown interstate traffic didn’t turn me into a nervous wreck, it’d almost be worth the hour’s drive over there to yell at them. The scary thing, was that when I checked google maps, they are across the street from a high school.

    • Jules B

      I pumped around the clock (every 3 hours), in between nursing sessions, for five straight weeks. I was a mess, and totally incapable of caring for my infant, quite frankly (luckily my S.O. was on paternity leave for 10 weeks). It was bonkers. I really wish someone had told me that pumping in that kind of schedule was counter-productive, to say the least. Instead, everyone just said “Do more.”

    • yentavegan

      Nolongercrunchy! I am so glad to have found you. Your posts make me feel like I am not a traitor to the cause. I am a 30 year volunteer to LLL. I am frustrated at how often I read about the lactavists doubting reports of infant weightloss . The lactavists blame inaccurate scales or IV fluids artificially inflating the weight of the newborn, rather than owning up to the reality of lactation/breastfeeding/breastmilk insufficiency.