What if we’re doing breastfeeding all wrong?


The central conceit of natural parenting is that the key to healthy, happy babies is recapitulating what our “primitive” black and brown sisters did in nature.

That’s why natural childbirth advocates claim that the best birth is an unmedicated vaginal birth.

That’s why attachment parenting advocates claim that carrying an infant in a sling and sleeping in the same bed lead to a happy child.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Prelacteal feeding is practiced from Africa to Southeast Asia, to Central and South America.[/pullquote]

That’s why lactivists recommend prelacteal feeding, supplementing early breastfeeding with a variety of substances like water and honey.

Wait, what? For lactivists and breastfeeding professionals, supplements are absolute anathema.

It is an article of faith among them that formula supplementation interferes with breastfeeding, dooms exclusive breastfeeding and causes dangerous alterations to infant gut flora. What if they’re flat out wrong? And what if babies are being injured and even die because we aren’t recapitulating nature?

Prelacteal feeding occurs in nearly all cultures.

In Egypt:

Sixty per cent (89/149) of study infants were prelacteally fed sugar-water, teas, or both. Lack of milk in the mother’s breast (74 per cent), and maternal exhaustion or illness following labour (29 per cent) were the two most commonly stated reasons for prelacteal feeding.

In rural India:

A total of 44% of the mothers initiated breastfeeding within 30 minutes with home delivery and 38% with Caesarean section. There was a delay of 2 to 3 hrs in feeding. A total of 19% of the mothers in our study didn’t breastfeed even after 24 hours after the delivery. They were given pre lacteal feeds and discarded the colostrum. A total of 13% of the babies were fed with sugar water alone for more than 48 hours. Honey (6%) and ghee (3%) were also commonly used pre lacteal feeds.

In Ghana:

… [C]olostrum was referred to in Kusaal language as “ first milk, yellow milk, dirty milk or dense milk” interchangeably. During in-depth interviews, the similarity between colostrum and pus or blood was often noted. Breast milk only became pure or clean after it had changed from yellowish to the whiter color of mature milk. While waiting for “clean” milk to flow, women would use a wet nurse to provide breastmilk to their babies or give water with herbs…


Colostrum avoidance has been reported across the globe, in varied places such as India, Nepal, Bangladesh, Indonesia, West Java, the Philippines, Vietnam, Thailand, Bolivia, Guatemala, Guinea-Bissau, Nigeria and Tanzania. Using the term ‘delayed breast-feeding’, Morse et al. found that fifty of 120 cultures described in the Human Research Area Files ‘withheld’ colostrum.

In other words, our “primitive” black and brown sisters were convinced that colostrum was harmful and that supplementation was critical to ensure infant survival.

So why have lactivists discarded this “ancient wisdom”? I suspect it is for two reasons. First, it doesn’t comport with the belief in the near magical properties that lactivists accord to breastmilk and breastfeeding. Second, studies have demonstrated that prelacteal feeding is associated with higher infant mortality. That’s not surprising since the supplements are often contaminated with harmful bacteria, and therefore compare unfavorably with exclusive breastfeeding for women who produce enough breastmilk.

But as far as I can determine, no one has investigated why a practice that breastfeeding advocates see as harmful to both breastfeeding and infants gained such wide currency. Prelacteal feeding is practiced from Africa to Southeast Asia, to Central and South America, suggesting that a variety of peoples independently believed it to be beneficial.

Obviously we cannot know the original reasoning behind the practice, but odds are high that it reflects the fact that 5-15% of women (or more) have insufficient or delayed production of breastmilk. Without supplements, those babies would have died of dehydration. With pre-lacteal feeds, babies lived who would otherwise have died. Over time, that observation was transmuted into a belief that colostrum was harmful and supplements were lifesaving.

We’ve ignored those insights about supplementation, ascribing them to ignorance, in favor of our preferred belief that women in indigenous cultures breastfeed early, exclusively and for extended periods of time. But maybe we’re the ones who are doing it wrong.

We have a huge advantage over indigenous women. We have access to a clean, safe source of supplementation: infant formula. But instead of replacing contaminated prelacteal feeds with formula, we’ve banned prelacteal feeds and the results may be deadly.

Dr. Christie del Castillo-Hegyi has been working tirelessly to alert both women and healthcare providers to the dangers of insufficient and delayed breastmilk production. She has created an excellent presentation.

Dr. Castillo-Hegyi’s first child was profoundly injured by breastfeeding induced dehydration and hyperbilirubinemia. She started reading the scientific literature on breastfeeding and brain injury:

In the September, 2015 issue of Hospital Pediatrics, an article was published describing 11 exclusively breastfed newborn babies who developed profound hypoglycemia between the second and fifth day of life from insufficient breast milk intake…

They subsequently developed long-term neurological disabilities including seizure disorders, motor weakness, visual impairment and feeding difficulties requiring speech therapy.

As a result:

I believe we may be inducing hypoglycemic brain injury to many newborns by asking mothers who may not be producing sufficient milk for their newborn’s physiologic need to exclusively breastfeed. We are potentially putting ourselves at odds with the protective natural instinct to respond to a baby’s cry by telling mothers that their colostrum is enough (which for many it may not be) and by making them fear failure by giving their child supplementation when they need it.

Are we actively and aggressively ignoring what indigenous mothers have known for centuries, that a significant proportion of babies cannot survive without initial supplementation? Are we risking babies’ lives and brain function because lactivists and breastfeeding professionals have become obsessed with the process of breastfeeding, privileging it over the outcome of healthy babies?

I’m not aware of even a single term infant whose life was saved by exclusive breastfeeding, but I’ve read and heard about quite a few whose lives were destroyed by the emphasis on exclusive breastfeeding. At a minimum this obsession with process over outcome is causing terrible suffering for babies who are starving and their mothers who endure their cries of hunger.

Prelacteal feeding is common worldwide, but we’ve chosen to ignore that in favor of a fantasy created by lactivists that breastfeeding is always perfect for every baby. How ironic that lactivists invoke indigenous women as justification for banning supplementation while ignoring one of their central insights … that many babies need and benefit from supplementation.