The shockingly unethical, paternalistic behavior of lactivists like Prof. Amy Brown

Woman liar with long nose

Lactation professionals are beside themselves with fear.

The story of a baby Landon who died from dehydration as a result of exclusive breastfeeding has become a tipping point. For years they have been exaggerating the benefits of breastfeeding, denying the risks and contributing to a wave of newborn deaths from both breastfeeding complications and deaths resulting from breastfeeding promotion efforts that have led to hundreds of smothering deaths and falls of maternal hospital beds each and every year.

Lactation professionals believe that it is okay to withhold critical information in order to convince women to breastfeed.

Baby Landon’s death has brought lactation professionals face to face with the biggest lie they espouse: the lie that insufficient breastmilk is rare when in truth it affects up to 15% of women or more.

Many lactation professionals are simply ignorant. They only know what their teachers — other lactation professionals have told them — which means they don’t know anything about the very real and very deadly risks of insufficient breastmilk. When you live and work inside an echo chamber, it’s hardly surprising that your knowledge is limited.

In contrast, there are quite a few prominent lactation professionals who do know the truth and are desperately trying to hide it. That is both unethical and profoundly paternalistic. They are literally afraid that if they tell women the truth about the risks of breastfeeding, as well as the benefits, women won’t make the choice they prefer.

Their goal is NOT to empower women with accurate information and hope they will choose to breastfeed. Their goal is to hide accurate information from women to ensure that they will breastfeed. They are no different from anti-choice activists who spread scientific falsehoods in an effort to dissuade women from choosing pregnancy termination. It’s unethical and it’s paternalistic.

Consider Prof. Amy Brown. I have engaged with her on the Facebook page of The New Scientist. She absolutely refuses to state a number for the incidence of insufficient breastmilk. Why? I’m going to guess that it’s because she knows that she has no scientific evidence for the typical lactivist lie that insufficient breastmilk is rare. I suspect that she knows as well as I do the the real incidence is 15% or more — and she doesn’t want to be caught telling women the truth. That’s shockingly unethical and disturbingly paternalistic.

I wrote about Brown last fall in connection with the naked misogyny of pressuring women to breastfeed. Brown’s research showed that 80% of women stop breastfeeding because of pain and difficulty. Brown then proceeded to ignore her own findings and substitute the lactivists’ preferred explanation of “lack of support.”

Brown is also the author of the charmingly titled Why Fed Will Never Be Best: The FIB Of Letting Our New Mothers Down. The title is in keeping with what appears to be the cardinal rule of lactivism — never miss an opportunity to shame women who can’t or don’t breastfeed.

Brown repeats the preferred lactivist fairytale that physiological problems are rare and “lack of support” accounts for low breastfeeding rates.

Of course we must ensure that babies are fed. However, although the message may sound comforting on the surface, ‘fed is best’ is simply putting a sticking plaster over the gaping wound that is our lack of support for breastfeeding and mothering in general. We cannot afford to say that how babies are fed does not matter…

Brown offers the standard lactivist lie.

Physiologically speaking only around 2% of women should be unable to breastfeed, but in reality less than half of mums in the UK breastfeed at all past six weeks.

In our discussion on The New Scientist Facebook page, Brown simply refuses to answer the simple question about the real incidence of insufficient breastmilk. I noted that you can tell the the difference between real medical professionals and lactation consultants in the way they deal with this issue. When informed of a preventable death, real medical professionals ask, “How can we avoid this happening to another baby?” Lactation consultants ask, “How can we avoid blame?”

Brown then proceeds to prove my point by trying to deflect attention:

Babies can also die from dehydration if bottles are not properly made up eg too much powder provides too much sodium.

Now … is that the fault of the formula or a lack of awareness that it is an issue …

In both cases better support and education should be given!

I asked Brown a direct question:

What is the failure rate for breastfeeding? Please quote an actual number since this discussion is about the fact that lactation professionals lie about the rate of breastfeeding failure.

She didn’t bother repeating her previous lie of 2%.

Watch her try to wriggle out of giving an actual number.

IMG_2069

…[I]t’s Friday night in the UK and I’ve gone out for dinner.

You know it gets increased by what happens at birth and in early days. I recognise that. Better support would reduce that. Some will need formula. The data is different across countries which confirms this.

So … better recognition when things are not working. Formula if needed. I think we can agree on that?

I asked:

Would you agree with Alison Stuebe, MD of the Academy of Breastfeeding Medicine that as many as 15% of newborns can benefit from formula supplementation?

More comments from Brown, but no answer. I can only conclude that she doesn’t want women to know the truth because that might discourage them from breastfeeding. That’s just as paternalistic as the gynecologist who recommends hysterectomy but refuses to tell the patient the complication rate because that might discourage the her from choosing surgery.

It’s unethical when a gynecologist does it and it’s equally unethical when a lactation professional does it.

The goal of lactivism ought to be empowering women to breastfeed successfully if they can and if they want to do so. The goal should not be getting all women to breastfeed. That harms (and even kills) babies and the only people it empowers are lactation professionals.

One of the greatest ironies of contemporary lactivism is how lactation professionals have eagerly adopted the very traits that they so disparaged in doctors. They believe they know better than women themselves what is right for those women. They believe that it is okay to withhold information in order to convince women to do what they want them to do.

That’s why Amy Brown refuses to give a number for the incidence of insufficient breastmilk. The truth would reveal that breast is not best for a substantial proportion of mothers and babies.

Better to lie and let babies die.

  • Rivkah Rainey

    Great intelligent written material here, Dr. Amy. May you go from strength to strength. I agree this breast is best ideology is unfair to push and yet I was surprised and disappointed in my reaction when my married daughter recently told me she had stopped nursing. It was simply her choice. In hindsight I shouldnt have clicked my tongue but should’ve been supportive and accepting.

  • nikkilee
  • nikkilee

    Today, healthcare professional students got to reflect on their words after describing how they “push” breastfeeding and are “aggressive” about it, because that is what they are being taught to do. I asked them what their own reactions are to treated aggressively or to being pushed. There was the wonderful silence of a message hitting home! I encouraged asking a pregnant woman how she’s planning to feed her baby, or what she’s heard about breastfeeding she doesn’t like, and then having a conversation.

    • KeeperOfTheBooks

      Good!
      Anecdata here, but related: I had a truly horrible time trying to breastfeed my first child. I was absolutely determined to breastfeed, but nothing about it worked: I wasn’t making much milk, DD needed supplementation early via SNS due to weight loss, I kept getting all sorts of infections and an abscess…it was awful. Throughout, rather than support, what I got from the nurses, lactation consultants, and LLL leaders I consulted with wasn’t support: it was shame, disgust, and disbelief, as well as a good bit of gaslighting because breastfeeding always works if you just try hard enough, don’tchaknow. (My personal favorite moment in all of it being when the LLL leader implied that since I said I was doing everything right, my problem must be psychological: did I actually want to have DD?) I finally threw in the towel at 4 months after my 3rd or 4th round of mastitis.
      I decided to FF with our second kid because I wasn’t willing to put myself or my baby (nothing like power pumping while your kid cries because you can’t pick her up!) through that again. The hospital had an IBCLC come in during recovery and ask what I was doing with feeding. I said I was formula feeding after having a ghastly time of it trying to breastfeed the last kid. She said, “Okay, no worries! Congratulations on the cute baby, and if you change your mind, please feel free to call me. I’ll leave my card with you.”
      I still went on to FF, but that one interaction had me willing to consider breastfeeding again just because she treated me like an adult, didn’t talk down to me, and was low-pressure. Believe me, I would not have thought it possible that I would be willing to even try until I had that interaction. THAT’S what respect, basic courtesy, and support can accomplish. I felt like if I tried again but still couldn’t produce, this LC, unlike the last, wouldn’t scold or shame me for failing as a mom by day three of my kid’s life, so I could be vulnerable with her by trying.

      • nikkilee

        Basic courtesy, respect, and support. Yes. Essential elements in every aspect of life.

    • Roadstergal

      Do you tell them that there is little to no objective health advantages to breastmilk over formula for term infants in the developed world, and that EBF for over 6 months increases the risk of food allergy? Do you tell them – as per the papers you cited me below! – that babies need Vitamins K and D from another source?

      Is “having a conversation” code for “bullying and guilting them into breastfeeding by lying about the ‘risks’ of formula and benefits of breastfeeding,” as you have been doing in this comment section?

    • momofone

      What if you accepted her answer without your “conversation”? As in, “Thank you for coming by, but I’m going to be formula feeding.” “Great–let me know if you need anything.”

      Seems like a good “conversation” stopping point unless she requests more information.

      • nikkilee

        Because it is responsible practice to be sure that anyone has all the information before making an important decision.

        • fiftyfifty1

          Just like how when women request an abortion, anti-choice activists insist they need all sorts of “information” about how abortions cause breast cancer and lead to insanity and insist that women sit there and listen to this “information”…except that all of this “information” is bullshit based on poorly designed research and they know it.

        • momofone

          Oh, good! So you’re making sure to present all the information regarding the benefits of formula feeding too then. Right?

  • sdsures

    Formula feeding moms don’t get nearly enough support; they get castigated instead. 🙁

    • Cody

      Agreed. Often they aren’t even told how to prepare bottles, or that they are supposed to use ready to serve, how often to feed etc.

      • sdsures

        Aren’t there directions on the cans?

        • Cody

          Are you assuming that everyone can read and follow directions appropriately? What if people don’t speak English? That’s pretty common. Lots of people make mistakes with this and give powdered too soon. Many people also dilute the formula too much. If hospitals are “baby friendly” then people are potentially going home without instructions.

          • sdsures

            NHS hospitals have pamphlets available in other languages that they disseminate on request.

          • Cody

            We don’t have that sort of program in Ontario.

          • sdsures

            I’m from Winnipeg, so I know how the Canadian system works.

          • sdsures

            Have you considered not being passive-agressive?

      • sdsures

        NHS hospitals have pamphlets available in other languages that they are required to provide on request. In my case, it’s instructions for my CPAP machine.

        • Cody

          Right. Once again that’s lovely for people who give birth under the NHS system but has no impact on the women who don’t.

          • Sarah

            Second time round I left with zero info on formula feeding. I didn’t know it was available on request. Didn;t need it by then, but not a satisfsctory state of events.

          • Cody

            I believe you. This makes me think of other scenarios as well. you obviously have access to a computer and the internet, and based on your response, I’m presuming that you can read and write fluent English. If women like you have trouble accessing information, imagine what it must be like for women who aren’t like us.

          • Sarah

            Yes, exactly. Actually even with those advantages, I still relied on the information the NHS had given me about formula feeding with my first. It’s lucky the information denial happened with my second. No doubt there were first time mothers discharged around the same time as I was with my second who didn’t have literacy and 24/7 internet access to rely on. It’s not the most affluent area.

            And this is in a hospital that, though BFI, is not especially woo wrt feeding, in the grand scheme of things. They did provide formula on my request with no lectures, took the babies for a few hours overnight so I could sleep, I didn’t get groped by any passing LCs etc. They’re one of the more sensible facilities. One imagines it is worse elsewhere.

  • sdsures

    She shouldn’t be allowed to beg off of a debate via social media by claiming the excuse of going out for dinner on the weekend. She’d have to (gasp!) leave her phone behind.

    Granted, it’s nice to unplug from the web in a while. Many people do so on the weekends, to rest their brains.

    But she DID take her phone with her to dinner so she could post the picture of the wine she was having.

  • Sheri Kelly

    After experiencing firsthand lactation consultants who looked me in the eye and said they “didn’t believe” that I didn’t have enough milk for my newborn (even though I objectively did not), I completely understand why such tragedies happen. Hopefully by shedding light on these incidents, so-called “baby-friendly” programs will be ended. Every mother deserves respect, space, and accurate information, so SHE can decide the best way to feed her baby, whether its formula, breastmilk, or some combination of the two.

    • sdsures

      Alternative breastfeeding facts. 🙁

  • J.B.

    The breastfeeding advice I hated the most was “it shouldn’t hurt if latch is right” (or sometimes parsing of pain vs discomfort.) It hurt for the first month. There was nothing I could do about it but wait for my children’s mouths to get bigger. And it took until the second child for someone to recognize that I had vasospasm…yeah, thanks!

    • Cody

      I really sympathize. This is exactly what I’m talking about, why couldn’t this have been addressed properly? How different would the experience have been if you had received a proper diagnosis?

    • fishcake

      I was shocked when it hurt to breastfeed. Even more so when I started bleeding! Never knew a person could get nipple scabs!
      I blamed it on myself because I didn’t know any better.

      • myrewyn

        I was shocked too. My first raised blood blisters on my nipples. He gained weight just fine but it hurt like a &*^% for a few weeks! I don’t remember pain with my second but I can’t say if that’s because I knew what I was doing or if she was just born better at it 😛

        • fishcake

          I think my daughter chomped down because she was hungry and not enough milk was coming out. She was 2 or 3 days old. The positive is that it helped me realize she needed formula!

    • Dr Kitty

      I’m with you.
      I have big, flat nipples.
      With both of mine, who had perfect latches, excellent suck-swallow-breathe co-ordination, were greedy and effective feeders and thrived on my plentiful milk, breastfeeding HURT for the first 4-6 weeks.
      Not “discomfort”- worse pain than from the CS-sections (the after pains in the first week while feeding the second were also far worse than the incision pain).

      There wasn’t anything “wrong”, it just hurt until suddenly it didn’t.
      I was prepared to put up with it the first time because breastfeeding was important to me, and prepared to put up with it the second time because I knew it would probably get better.

      So, although it isn’t anywhere near as reassuring a message as “it only hurts if you’re doing wrong”

      I think “it might hurt for the first 4-6 weeks, but it should get better, and if the pain persists beyond that, or is too much to cope with at any point, don’t feel you have to continue breastfeeding” is probably a much more honest, helpful and realistic piece of advice to give women.
      It’s certainly the advice I give.

      I am not the regional breastfeeding coordinator’s favourite doc on the block, because apparently saying “don’t feel you have to martyr yourself” is “unsupportive”.

  • StephanieA

    I’ve mentioned before that I work at a BFH. I was chastised today for bringing a baby out to the nurses’ station. Mom wanted a shower and had baby in the bathroom with her, so I offered to watch her for a bit. Another nurse was pissed and made a student take baby back. I guess our hospital is in danger of losing is BF designation due to low rooming in numbers. I’m so irritated with my profession right now.

    • J.B.

      OMG because moms can’t even shower! Thanks for trying.

    • Madtowngirl

      You sound like the type of nurse I’d like taking care of me. I’m sorry that you got chastised.

    • myrewyn

      So who was supposed to be watching the baby while mom showered?? I don’t get it. She was still rooming in, just needed a shower!

    • KeeperOfTheBooks

      Good gosh.
      I’m reminded of when I had my first baby at a hospital that was pursuing BFHI status. I didn’t have anyone there as a support person after the day DD was born because DH had to go back to work. The nurses were constantly harping on me to go take a shower, but the bassinet wouldn’t fit through the bathroom doorway, and when the IBCLC came in and found me merely using the toilet with DD left in her bassinet in my room, she scolded me for not staying with DD.
      How the hell was I supposed to a) not leave DD even long enough to take a shower (and of course they couldn’t take her to the nonexistent nursery or the nurse’s station because, apparently, if we were separate for so much as 15 minutes I would never be able to breastfeed) but b) take a shower in a bathroom that c) I couldn’t get DD’s bassinet into was well beyond me. No doubt it made sense to some lactivist or other.

      • myrewyn

        The fuck? No sleep, no showering, no using the toilet even, and you’re supposed to be in a state of bliss with your new baby?

        • Dr Kitty

          With Baby # 1 I was in a shared 4 bedded Bay with a bathroom at the end. So I told the Midwives I was going to have a shower and they offered to have the newborn hearing test done while I did.

          With #2 I was in a private ensuite room and just left the baby in the bassinet when I used the bathroom.
          I was pretty much left to my own devices for hours at a time, so it isn’t like anyone noticed.

          I’m afraid I have always put my babies in their cots/ Moses baskets: bouncers when they were tiny while I showered or used the lavatory.

          Sadly, now they are bigger, one is usually banging his toy car on the shower door while the other one sprays my very expensive perfume everywhere or covers herself in highlighting powder as I shower. I long for the days when I could out them down in a room and they wouldn’t follow!

          • myrewyn

            I’m pretty sure that’s what moses baskets and bouncers are for.

        • sdsures

          Exactly: THE FUCK???

          • KeeperOfTheBooks

            It was completely bizarre. I ended up having an extensive talk with a department head who specialized in patient care about both my experiences with DD and later with DS. She hadn’t realized just how bad things were, or how much communication between caregivers was lacking. Example: pediatrician says to supplement, LC shames me for following ped’s instructions. Nurses say to go take a shower, LC shames me for peeing alone. OB says go walk the halls for a bit, LC and lactivist nurses say not to take DD off the boob. Ped says DD lost too much weight, nurse says no, she hasn’t. Etc.
            (Patient safety issues relating to the BFHI were also a key part of that discussion. Department head was visibly horrified–probably in part by the thought that it wasn’t a question of if, but when the hospital would incur a wrongful death suit, but also because she seemed like a decent human being.)

    • Cody

      Taking the baby temporarily wouldn’t even make your hospital lose its designation. Not everybody has a spouse/mother/relative etc. who can be in the hospital to help.

      A woman who has just had a baby deserves a GD shower and 5 f’ing minutes to herself.

      Good for you! I hope you’ll make the same choice in the future.

  • nikkilee

    Just as there are women who can’t conceive, and women who can’t carry babies to term, and women who need surgery to birth, there are women who can’t make milk. There are few data on this. Marianne Neifert MD estimates that “as many as 5% of women may have primary insufficient lactation because of anatomic breast variations or medical illness that make them unable to produce a full milk supply despite heroic efforts.” [Neifert MR (2001). “Prevention of breastfeeding tragedies.” Pediatr Clin North Am 48(2): 273-97.]

    Dr. Neifert also did this study: “Birth. 1990 Mar;17(1):31-8.
    The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain.”

    “Within three weeks postpartum 85 percent of the mothers achieved sufficient lactation, whereas 15 percent had persistent milk insufficiency despite intensive intervention. Of the study population, 6.9 percent had undergone previous breast surgery. Women with periareolar breast incisions were nearly 5 times more likely to have lactation insufficiency than were those without surgery (relative risk [RR] = 4.55; 95 percent confidence interval [CI] = 2.21-9.43; P less than 0.001). Insufficient lactation was significantly associated with minimal prenatal breast enlargement (P less than 0.02) and minimal postpartum breast engorgement when milk came in (P less than 0.001). Although not statistically significant, women with inverted nipples were more likely to have lactation insufficiency compared with those with normal nipples (RR = 2.94; 95% CI 1.05-8.20; P = .07). The findings from this study indicate that certain biologic and surgical breast variables are associated with lactation insufficiency.”

    So which women are at risk? What OBs routinely do a thorough breast exam to check in the last trimester? Who checks and follows-through after she delivers? Not all women have this follow-up and monitoring.

    More research is required. That isn’t going to happen in the US, with the current attack on education, healthcare and science.

    However, breastfeeding will remain important because for a major percentage (85%?) of women, it will work despite a weakened healthcare system.

    • Empress of the Iguana People

      No one said breastfeeding doesn’t work for many or even most. The problem is a current culture in the US that implies only bad mothers don’t breastfeed, that formula will make your baby fat, stupid, and much more prone to diseases. Being a mother of an infant and a toddler, I can tell the pressure was a major factor in my suicide ideation. You’ve brushed my experience off before. So you can go away now.

      • nikkilee

        No, I am hearing you all.

        There are so many women breastfeeding in the 21st century that now, all its flaws are showing up. We have to face those flaws and get out of the sales pitch.

        Thank you. My teaching is changing.

        • nikkilee

          I apologize for not hearing you completely.

        • Heidi

          Nikkilee, if you want to hear us, shut your internet mouth then. No one asked you to come on this blog and make us feel bad but you went and did it anyway. Even if I blocked you, you still show up on front page with your ignorant bloobity blop that I’m sorry, I just can’t let go unchecked. Maybe one day you will really *learn* that you aren’t helping anyone here. This is not your classroom. This is the one blog where I felt my experience was recognized and not denied. My Facebook gets littered with overhyped crap about breastfeeding all the time. I do my best to hide those people on my feed. I see it on billboards on the way home. The damn formula canister has to remind me. But you come here just to shit all over the one place I had felt people listened and took me seriously. I can only speak for myself, but I wouldn’t doubt other women don’t feel this way, too.

          Infertility is higher than 5% of the population. I do not understand people like you claiming a rather definitive number about insufficient milk supply as if we know that much about breastfeeding and then whining out the other side that breastfeeding doesn’t get enough in the way of research and money? I am not infertile, I do not have PCOS, my breasts don’t seem to be lacking glandular tissue, but here I am, as was my mother, not able to produce enough. I don’t think medical science necessarily has an answer for me yet. Honestly, I’m pretty okay with that, too. My baby is here and fine. Since there’s not an infinite amount of money to go around for research, I’d rather it be spent on much more important issues.

          Even if people agree that maybe I am some super rare phenomenon who didn’t make enough milk (but I get the impression most of you types don’t think that. I just wasn’t “supported enough,” or I was too quick to give in because I was just too paranoid about starving my baby or whatever bullshit reason you give.), they still have to make sure I know that supposedly I’m giving my baby an inferior form of nutrition. Not even just a little less good, but you know, but far, far, far from the “best.” And of course, since I committed myself to being a mother, it’s my responsibility to always give my baby the best. Reality is, I don’t give him the “best” nor does anyone else give their child the “best” at all times. I don’t thoroughly analyze every decision I make for my child to be sure it’s the best. I make good enough and adequate decisions that take ME (shock!) into account, too.

          • guest

            Totally agree on making good enough decisions that take me into account. I get so sick of the idea that we must always give our kids the best and put them first in everything. While I spend a fair amount of time putting my kids needs before my own, I still try to balance that with what I want. I think that is a fairly typical experience and I get irritated when people try to pretend it’s always about the kids all the time. We all know that isn’t the case.

          • The Bofa on the Sofa

            I get so sick of the idea that we must always give our kids the best and put them first in everything. While I spend a fair amount of time putting my kids needs before my own, I still try to balance that with what I want.

            I contend that it is often in the child’s best interests for parents to strike a balance in sacrifice.

            Consider the baby who has been screaming for 3 hours straight. All the baby’s basic needs (clean diaper, has been fed) are met. The parents are exhausted and frustration levels are raising high.

            The best approach for consoling a screaming baby is cuddling, holding, singing, etc. But with the parents at wits end, they set the baby in the crib and leave the room to calm down.

            They have not done what’s nominally best for the baby, they have failed to attend the baby’s needs while attending their own.

            And in doing so, may have prevented something more serious than crying (like a shaken baby).

            Or the mother that forgoes a middle of the night feeding to sleep while dad gives a bottle of formula. That 4 hour stretch of sleep can do wonders for the mom, which helps the relationship with the baby.

            Hell, we give babies ouchies in the form of shots to prevent further disease.

            These are just a couple of examples, but show that “what’s best for the baby” is far bigger than simply “Do I breast feed” or whatever. You have to take multiple confounding factors into account and look at a bigger picture.

          • KeeperOfTheBooks

            YES. This.
            My OB prescribed me Reglan when I didn’t have enough supply. I chose not to take it. Even assuming for the sake of argument that breast is best, Reglan can seriously exacerbate PPD, which I ended up having very severely anyway. I find it improbable that DD would have done better having a full supply of breastmilk for a few months, followed by spending the rest of her life dealing with “Mommy killed herself because having me gave her PPD,” than how things actually turned out.

          • sdsures

            YES!

          • Roadstergal

            And what kind of lesson is that for the kids? They learn from example. If they see you driving yourself insane, they’re going to learn to do that themselves in other situations. If they see you taking time for yourself, balancing your own needs with the needs of your loved ones – well, that’s a powerful and good object lesson.

          • sdsures

            Would it help to put a piece of masking tape or duct tape over the part of the formula can that says “breast is best” so you don’t have that fucking phrase always staring at you when you’re feeding your baby?

          • Heidi

            Well, he’s 15 months now so our infant formula feeding days are over, thankfully! I actually had a Brezza a few months in so I didn’t look at the container much. I poured the powder in and threw the canister away.

          • fishcake

            Would you recommend the Brezza?

          • Heidi

            If you have a baby who doesn’t like cold bottles, yes. If my baby hadn’t had an aversion to cold formula, I’d have gone with a formula pitcher probably.

          • fishcake

            Thank you!

          • nikkilee

            I agree. . .so hurtful to the mothers who are using formula. I never thought about that before. I kept coming back to this forum for a reason.. . . sorry.

        • Roadstergal

          Hey, it’s Nikki Lee again! Have you had time to come up with an example of the health advantages that all of these many late 20th/early 21st century babies, with all of the breast milk that they’re getting, have over my ’70s majority-formula-fed generation? Come on, if it’s worth all of this trouble, there must be some massive population-level improved outcomes!

        • fiftyfifty1

          “There are so many women breastfeeding in the 21st century that now, all its flaws are showing up”

          Women have known for time immemorial about breastfeeding’s flaws. It’s only in the last ~20 years that a group of people (lactivists) stopped listening and started claiming there were no flaws, or that these flaws were vanishingly rare or caused by “lack of support”.

        • Who?

          Hold on. Back in the day everyone breastfed, or baby died. Or they fed them on sugar water or whatever food they could get down them.

          It is just crass to suggest that widespread breastfeeding is some modern phenomenon.

          • nikkilee

            Historically, breastfeeding rates started plummeting in the 1930s and by 1971, less than 20% of babies were being breastfed at all. Currently, rates have increased far beyond that.

          • Roadstergal

            Yes, they have! (In the US, BTW.) I’ve mentioned those stats multiple times before. So show us a benefit on public health in the US (based on the generation born in the ’70s vs the generations since) that all of this additional breastfeeding is conferring.

            To the point of this sub-thread, there’s a shit-ton of recorded history prior to 1930, and there are countries other than the US. Not sure you’re aware of those two data. All of the ‘flaws’ of breastfeeding are, and have been, well-known because of that. It’s the lactivists who have tried to erase that knowledge.

          • Historically, women fed babies with breastmilk when they could, and fed them cow’s milk, goat’s milk, gruel, sugar water, or whatever else they could otherwise. A lot of babies died this way. This is a known fact to anyone who has done any sort of historical research at all. Why do you think infant mortality was so high before modern medicine? Some of it was infection and disease, but some of it was plain old starvation and/or malnutrition.

            If your ‘history’ is less than 100 years old, you really need to increase your scope.

          • nikkilee

            History goes back to the beginning of time. There were feeding bottles made of lead, and breast shaped, found in tombs from Cleopatra’s time. Breastfeeding has gone in and out of fashion over time also. I picked an arbitrary place to start.

          • Roadstergal

            You picked an arbitrary place to start – AND THEN WIPED OUT THE EXISTANCE OF BREASTFEEDING BEFORE THEN.

            I know you’re mean and greedy, and play at disingenuous in the service of the meanness and greediness, but this is above and beyond.

            Now answer the question I’ve been asking for months. It’s an easy way to take the high ground intellectually and morally.

          • Breastfeeding has always been “in fashion”, just whether mom did it or a wet nurse did it has changed a lot over time and culture (for those wealthy enough to afford a wet nurse, anyways). No one chose to feed babies anything else unless they had no other choice until very recently, because formula is a recent invention, and before that there really weren’t good breastmilk substitutes.

            Yes, there are baby-feeding devices from all times, because mom dying and/or not having milk was really common. What is your point? That modern obstetrical care and formula prevent a lot of disasters from happening? We knew that already. You cherry-picked a point in history to try to prove a point; it wasn’t arbitrary. The fact that your point remains unproven doesn’t change the dishonest nature of your attempt.

    • No one is saying breastfeeding isn’t worth paying attention to or supporting? The point is that formula feeding is also worth paying attention to and supporting, and of those 85% who can make enough milk, not all of them will want to exclusively breastfeed, and that’s okay too. Some will use only formula and some will combo feed, and all of it is okay.

      Unless you’re arguing that just because someone can biologically do something, they should do it? Because that’s a really horrible argument.

      • nikkilee

        No, that IS a horrible argument.

        My concerns are that folks should know that milk is more like blood than formula. It does make a difference, in risk reduction, as a modifiable risk factor in public health.

        However, it is possible to be kind about the presentation. And stop the sales pitch.

        Don’t we all make choices every day, even though we know the possible risks? People smoke. They choose to eat this thing instead of that thing. “I should. . .what? Loose weight. . .exercise more. . . breastfeed. . . eat organic. . .quit smoking. . . clean out that room?” We live our lives the best that we can.

        I have been deaf (symbolically) and ignorant.

        • fiftyfifty1

          “Breastmilk: more like blood than formula.”

          • Heidi

            And she thinks that makes it seem more appealing? It makes me picture feeding a baby a bottle of blood, which I’m pretty sure is not a good idea (possibly too high in sodium, probably neglible carbs unless maybe you were an untreated diabetic, not containing appropriate amounts of vitamins or minerals?), and it makes me a little queasy.

          • Roadstergal

            Little fat, little carbs…

            Breastmilk can contain pathogens, however, add they keep reminding us at the annual BBP refresher. (Technically not covered by BBP without visible blood in it – strawberry milk, mama! – but as they keep reminding us, OPIM anyway.)

          • Charybdis

            Yeah, what’s up with that lactivist thinking? Blood in your breastmilk? No problem! Let baby nurse away. Mastitis? Let the baby keep your breast drained…pus in the breastmilk won’t hurt them any! Do you win the bonus prize if your milk contains both blood AND pus?
            Heaven forbid you mix up a bottle of formula and feed it instead. How is breastmilk containing blood and/or pus from an infection the “superior” substance then?

          • sdsures

            I’m not sure I can finish my breakfast.

          • FormerPhysicist

            Mmmmm, baby vampires.

          • Gæst

            Mmmmm!

        • Heidi

          Except it’s not really that modifiable is it? If 15% of women at least can’t do a thing about their insufficient supply (referring to your post that said, “whereas 15 percent had persistent milk insufficiency despite intensive intervention”), that means some percent of women only got a full supply after 3 weeks of intensive intervention (and babies can’t go without enough food for 3 weeks so there’s already a hole there). It doesn’t really work that well for 85% of women. It works for some percent of women lower than 85%. What does intensive intervention mean? A round the clock nurse/pump schedule that allows for little to no sleep? Taking a prescription drug that comes with risk of heart attack/death? Dragging a baby to lactation consultant appointments several times a week? (I refused to drive for weeks after birth because I was not well rested enough to drive, especially with a newborn.) Then what is the percentage of women who shouldn’t breastfeed because of medications, like those for arthritis or depression? Should women be in mental and/or physical pain just to breastfeed? I say absolutely not!

        • I’m glad you’re learning and incorporating that into your work! It is possible to be kind in the presentation, but I think it’s more important to be accurate. Make a note that 15% of women will never be able to breastfeed. Make a note that formula is a perfectly good way to feed a baby- the only things that breastfeeding is correlated with are a slight reduction in diarrhea and colds in the first year of life. Make a note that breastfeeding can be hard and painful, but also very rewarding, and that you would be happy to help those who want to to do it better. Help teach women how to prepare formula and sterilize bottles, because those are skills that aren’t taught enough- even people who intend to breastfeed may need the information, especially if milk is slow to come in.

          Don’t ever say that formula is the inferior option. Don’t ever imply that women who don’t breastfeed are not doing their best for their babies, or love their babies less, or are in any way shortchanging their babies. If you do that, and make sure to recommend formula to babies that are clearly not getting enough to eat, you’ll be an amazing lactation consultant. Remember, all else being equal, breastmilk is a teeny tiny bit better … but all else is never equal, and it’s not worth stressing about if breastfeeding doesn’t work out.

          • nikkilee

            May I have permission to share what you have written, minus your ID, with a class I am teaching?

            Personally speaking, I have always used formula as part of my lactation practice. When a baby hasn’t gained enough weight, when mother’s milk supply isn’t where it should be, then formula is necessary. Sometimes if a mother can get a full night’s sleep, which could mean someone else giving a bottle of formula during the night, her energy is restored. A full night’s sleep and some formula use has sometimes moved the mother closer to the breastfeeding relationship she wants. The answer is, “It all depends on the situation.”

          • Heidi

            So you say here sometimes formula is necessary. However, you post badly done study after badly done study to “prove” that formula is inferior. Even when evidence clearly states otherwise (one example I clearly remember is obesity in China being attributed to worse eating habits and NOT formula, clear as day in the abstract), you claim it causes obesity, diabetes, cancer. You make false claims about its ingredients. You make exaggerated claims about what breast milk actually contains. You make absolute statements that breast milk never causes harm (yeah, let’s see, rare but galactosemia means breast milk can cause death). Now we know at least 85% of women, like me, will never have the option to exclusively breastfeed their child. Another significant percent of women would have to bend over backwards (“intensive interventions”) to eventually exclusively breastfeed. In the meantime, if they’d like to keep their child alive and not brain damaged they are going to need to supplement. And maybe they either don’t have the luxury to dedicate to intensive interventions or they find it too much. Then we have some women who are triggered because of past sexual assault so breastfeeding is not healthy for them, we have women who need drugs incompatible with breastfeeding, we have women who develop PPD from breastfeeding. Add all these up, and it’s somewhere well below 85%. Already 15% is NOT rare, it’s a very significant number. What’s your real goal? Because ****you**** are hurting women. By telling somewhere over 15% of us that even if it’s not by choice, we are giving our children such an inferior product, you hurt us.

            You are such a hypocrite and you are always contradicting yourself. You can’t say it’s bad to make breastfeeding a sales pitch when you are doing it yourself!

          • Of course. It’s not like Feminerd is my real name anyways 🙂

            EDIT: Of course, if I’m being used as a negative example, I’ll be annoyed … don’t do that.

          • nikkilee

            No, not at all. . . your response is lovely.

        • Roadstergal

          “It does make a difference, in risk reduction, as a modifiable risk factor in public health.”

          There you go, making claims without evidence. What public health measure can you point to that is better with milk than formula, in the absence of confounding factors?

        • MaineJen

          No, milk is more like milk. Milk is not like blood.

          • sdsures

            Go home, nikkilee, you’re drunk.

        • The Bofa on the Sofa

          My concerns are that folks should know that milk is more like blood than formula.

          Wow, that is one of the stupidest disconnects I’ve ever heard.

          Let’s grant for the moment that it’s true. And?

          Why does it matter whether it is more like blood? Is that desirable, for baby food to be like blood?

          This is a new low in silliness, even for you.

          • nikkilee

            Human milk and human blood are both alive. Both contain an assortment of white blood cells.

          • Roadstergal

            If your milk contains the same concentration of white blood cells as blood, see a doctor, you have a nasty infection.

            Sure, you get some cells shed into milk. They’re dead and digested as far as the baby’s system is concerned. Overall a good thing, as most parous women make alloantibodies against their baby’s HLAs. (Not a great thing if you need a kidney later in life, but that’s part of the sacrifice of being a mom that you can’t get around.)

          • MaineJen

            Pregnancy is one of the best (worst?) ways to acquire HLA antibodies, second only to having a prior organ transplant 🙂

          • Roadstergal

            I tested serum from a set of healthy multiparous women at work with the Labscreen single antigen, to see if I could find a few to serve as positive controls. I could have cast a smaller net – they were alllll well sensitized…

          • MaineJen

            We use a pool of patient serum for our in-house positive control, and at least half of them are multips.

          • fiftyfifty1

            “Not a great thing if you need a kidney later in life, but that’s part of the sacrifice of being a mom that you can’t get around.”

            Ain’t it true? Having the sort of complex immune system that must tolerate what is basically invasion by foreign tissue for 9 month stretches has its downsides.

          • swbarnes2

            Umnm, no. You are laying again. No surprise, you are fundamentally dishonest.

            And for the thousandth time, since you can’t show any long term clinically relevant benefits to breastmilk, why does it matter?

          • nikkilee

            Study of the human micobiome is an expanding area of research.

            “The infant microbiome plays an essential role in human health and its assembly is determined by maternal– offspring exchanges of microbiota. This process is affected by several practices, including Cesarean section (C-section), perinatal antibiotics, and formula feeding, that have been linked to increased risks of metabolic and immune diseases. Here we review recent knowledge about the impacts on infant microbiome assembly, discuss preventive and restorative strategies to ameliorate the effects of these impacts, and highlight where research is needed to advance this field and improve the health of future generations.”

            (snip)

            After birth, maternal breast milk promotes the colonization and maturation of the infant gut microbiome. Breast milk contains bacteria [53–61] that have been shown to vary from colostrum to late lactation [62] and by gestational age [62], maternal health status [56], and delivery mode [56,62]. The breast-milk microbiota is dominated by a few genera (Staphylococcus, Streptococcus, Serratia, Pseudomonas, Corynebacterium, Ralstonia, Propionibacterium, Sphingomonas, and Bradyrhizobiaceae) [55]. Bifidobacterium and Lactobacillus spp. are also found in breast milk and transfer of these microbes to the neonatal gut has been demonstrated using culture-and strain-level discrimination [60,61], indicating that breastfeeding is a postnatal route of mother–infant microbial exchange. However, the origin of these microbes, and the complex dynamics of their transmission (e.g., vaginal/fecal to breast, infant mouth to breast, breast to infant mouth and gut) and their site-specific colonization in the infant remains to be determined.

            Importantly, breast milk also contains prebiotic human milk oligosaccharides (HMOs) – sugar polymers that promote the growth of specific microbial communities, including Bifidobacterium spp. [63–67]. Bifidobacteria in the infant gut are important for inhibiting the growth of pathogenic organisms, modulating mucosal barrier function, and promoting immunological and inflammatory responses [68]. The synergy of the probiotic and prebiotic components of human breast milk provides breastfed infants with a stable and relatively uniform gut microbiome compared with formula-fed babies [63–65]. While consumption of infant formula containing probiotics has also been shown to promote the development of a neonatal gut microbiome similar to that of breastfed infants [69], maternal breast milk remains the ideal source of nutrition for infants.”

            They say at the end the impact these things may contribute to disease at the population level.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464665/

          • Roadstergal

            If they did impact disease at the population level, we’d see stark improvements in health between the formula-fed generation of the 70s and the increasingly breastfeed generations since. Come on, point out a few. Otherwise, “may” turns into “doesn’t.”

          • Heidi

            Wasn’t she leaving? She must be really desperate for business.

          • Azuran

            So, you are advocating things that are totally unproven, and may or may not be found to be maybe somewhat significant in 10-20 years.
            That’s not science based.
            You’d be the first one to be outraged if a doctor made recommendation based on something as vague as this.

          • swbarnes2

            As Roadstergirl and I have told you a hundred times already…if these effects were so important, you’d be able to show clinically relevant improvement in health outcomes in breastfed babies. You can’t.

            Dishonesty really is fundamental to your character. I’ve called you a liar to your face now a dozen times, and you don’t care. You sincerely don’t even understand why that’s an insult.

            This is my strategy, BTW. Every time you enter a thread, I’m going to call you a liar. Because you are. And when you say absolutely nothing at all in your defense, (and no one else is jumping up to defend you either) people are going to figure that you are okay with that label.

          • myrewyn

            I’ve been curious lately what the Dunedin Multidisciplinary study might show on the topic of breastfed babies vs formula. I had a long flight recently and watched a documentary on this study (hooray for lots of in flight choices now and not having to watch a dumb romantic comedy). Literally one of the VERY FIRST things they said they looked at was cesarean section vs vaginal birth and there was no measurable difference among the children. These are some of the most well tracked and documented people on the planet. Surely something would have turned up with breastmilk if there was anything there.

          • Azuran

            Presence of white blood cell is not the definition of ‘alive’.
            If we follow your logic, spit and urine are also alive.
            Is breast milk ‘more’ alive if there is more white blood cells?

            And even then, being ‘alive’ does not even mean anything. Should we eat raw meat straight off the back of still living animals? Because then we’d be eating living meat, is that better?

            Also, babies don’t eat blood. Milk can’t be injected intra-veinously. They are, actually, extremely different substance. You should educate yourself more. This ‘alive’ thing and ‘like blood’ are both total bullshit.

          • Empress of the Iguana People

            …depends on how badly you crack. 🙁

          • nikkilee

            The white blood cells in fresh human milk are alive; they move around.

          • MaineJen

            White blood cells do not move by themselves

          • Roadstergal

            Citation or GTFO. Prove to us that you weren’t taken in by that video of fat globules floating around under a microscope. Because we think you were.

          • nikkilee

            Transfer of living protection and programming: Cells of human milk

            Human milk contains a variety of cells, including macrophages, T cells, stem cells, and lymphocytes.87-93 In early lactation, the breastfed infant may consume as many as 1010 maternal leukocytes per day. The relative quantity of these cells differs among mothers and is reported to differ in the milk of infants who develop allergy.87 About 80% of the cells in early milk are breast milk macrophages, which originate as peripheral blood monocytes that exit the bloodstream and migrate into milk through the mammary epithelium. Phagocytosis of human milk components transforms these monocytes into potent breast milk macrophages with unique functional features, including the ability to differentiate into dendritic cells that stimulate infant T-cell activity.89,93 This capability provides broadly powerful protection against pathogens while stimulating development of the infant’s own immune system. In women infected with HIV-1 and HTLV-1, however, the activity of these cells unfortunately enables mother to infant viral transmission (see article by Lawrence in this issue). Stem cells have also been identified in human milk;88,90 their function is under investigation.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/

          • nikkilee

            Humans carry around loads of living bacteria that are crucial for good health, and through breast-feeding, infants make some of their first contact with beneficial microorganisms that will colonize their body. Scientists have discovered that breast milk contains more species of bacteria than originally expected — more than 700 varieties.

            http://www.livescience.com/25984-breast-milk-bacteria.html

          • nikkilee

            Living cells
            Fresh milk contains thousands to millions of live cells
            per milliliter. Among these are leukocytes that protect
            the infant from infection, and stem cells that may act as
            an internal building and repair system 6.

            Hassiotou,F. et al. Adv Nutr 5, 770-778 (2014).

          • nikkilee

            “Human milk contains a complex immune system that consists not only of a host of soluble direct-acting antimicrobial agents, anti-inflammatory factors, and immunomodulating agents, but also of living cells.”

            https://link.springer.com/chapter/10.1007%2F978-3-642-60614-4_10#page-1

          • Who?

            Let’s assume, to be friendly, that all of this is true.

            I have a question:
            So what?

          • Roadstergal

            None of your citations that are actual papers reference cells ‘moving around’ by their own power in milk as proof that they’re alive, which is the claim your making. One of them even noted that the stuff you see moving under a microscope is drifting fat globules.

            The Ballard and Morrow paper is a great reference for components of human milk that have no impact on infant health. Again, as you haven’t shown any positive differences in outcomes between formula and breastmilk for term infants in the developed world, it’s just a long list of things that don’t matter for babies to eat.

            Here’s a hypothesis that’s consistent with current data. The pressure to EBF for a year at least is responsible for the increase in food allergies in the US from the ’70s to current day. The introduction of common allergens between 4 and 6 months has been shown to reduce the risk of allergies to the introduced substance in interventional trials, and on a population level, the formula-fed generation of the ’70s had way less food allergy. Go on, tell your students that.

          • nikkilee

            The recommendation from every single health organization in the world, and of every health profession related to care of mothers and babies recommends EBF for about 6 months, not a year.

          • Except for an awful lot of NCB-types, who adamantly argue for EBF for a year and continued suckling after that, up to 3-4 years sometimes.

            Sure, they’re not generally actual medical professionals, but they do have a lot of clout on new mothers.

          • Who?

            I am sure nikkilee will tell you that all the responsibility for that falls on to the mothers-it is up to them to Do Their Research.

            So if they follow the advice, and it doesn’t go well, it is their fault for not Doing Their Research. And if they don’t follow the advice, and it doesn’t go well, they should have followed the advice.

            Heads the lactiviists win, tails the mothers lose.

            Same tune and chorus as the homebirth hobbyists, just a different lyric in the verses.

          • swbarnes2

            “Food before one is for fun” was not invented by formula companies.

            Kellymom does’t go on and on about how bio-available iron is in breastmilk because it’s a fun trivia fact, or talk about delayed cord clamping because it’s a super life saving technique that stupid doctors are ignorant of. They have pages on those topics to reassure moms who want to go against the recommendations, to convince them that their kid will be fine if they delay solids.

            But you are still fundamentally dishonest, so you won’t listen to anything anyone has to say.

          • nikkilee

            ACOG is recommending delayed cord clamping; many OBs are doing that in my city.

            “The American College of Obstetricians and Gynecologists (ACOG) now recommends a delay in umbilical cord clamping for all healthy infants for at least 30-60 seconds after birth given the numerous benefits to most newborns.”

            http://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Delayed-Umbilical-Cord-Clamping-for-All-Healthy-Infants

            As for solids, a heathy baby will start grabbing food off the plate when they are are ready, as some here have described. It’s a developmental event, like starting to walk.

            The iron in human is in a bioavailable form.

          • momofone

            My son, when he was a healthy four-month-old, grabbed for my keys. I didn’t realize that meant he was ready to eat them.

          • Empress of the Iguana People

            And there’re asterisks that are often missed by new parents. Not everybody reads the footnotes, so the really important ones do need to get pointed out. My daughter drank 12 ounces of formula for breakfast just before her 4th month appointment. Her ped recommended we start solids within a couple weeks, and my daughter began to grab my peanut butter sandwiches and gum them to death. Considering my EBF firstborn was doing the same shortly before he was 4 months old, clearly results will vary.

          • nikkilee

            Isn’t phagocytosis cell movement?

          • Yes, and? So? They’ll be dead when they hit the boiling acid pit that is the human stomach, so it’s not like they matter in any way. It’s why drinking blood isn’t a death sentence for humans- it doesn’t matter if the blood is incompatible with our own (Rh factor, A/B/O, etc) because it all gets destroyed in the stomach anyways.

          • Roadstergal

            They’re probably a mixture of live, apoptotic, and dead, but they’re definitely not ‘moving around’ under their own power in milk. They’re not sperm. 😀 That’s why I suspect so strongly that she was taken in by that video that the girl with the quack dad posted.

          • Well, yeah, but even aside from the fact that they can’t move on their own, it doesn’t freaking matter! I agree that it’s probably that stupid video, but even if it’s not, the critical point is that white blood cells aren’t at all relevant to breastmilk’s “goodness”, right?

          • Roadstergal

            Yeah. She’s just building up a long list of things that aren’t important to infant health. In the absence of any real health differences between formula-fed and BM-fed term infants in the developed world, we can say, thanks to Nikki Lee, that:
            -Stem cells
            -Bacteria
            -Lymphocytes
            -Other random white blood cells

            aren’t important to have in the primary feeding source of infants.

          • Azuran

            So? That still doesn’t make breastmilk alive anymore than it makes urine alive. That’s not how any of this works.

          • Azuran

            Also, do you know WHY there are white blood cells? Because of bacteria in the milk.
            Your milk doesn’t contain WBC to be ‘alive’ or to feed your baby of anything. It has WBC because it isn’t sterile, there are bacteria in your milk and those WBC are preventing your breast from turning into pus bags (Pus is basically a huge accumulation of WBC, yummy).
            It’s not for the baby. It doesn’t make your blood alive and it sure as hell doesn’t make milk ‘special’ or more like ‘blood’
            Do you even know that cow’s milk is tested for WBC and milk that has too much of it is actually considered improper for comsomation and thrown away?

          • nikkilee

            Human milk contains about 700 types of bacteria; everything that I learned was sterile in nursing college has its own microbiome including the placenta, amniotic fluid, and human milk. This is a new area of exciting research. We have 3 to 5 pounds of bacteria in our gut; these bacteria keep us healthy and do other things.

          • Azuran

            That’s cute, guess what, doesn’t matter. Doesn’t make milk magical.
            Stop using nonesense to try and make breastfeeding better than it is.

          • Roadstergal

            You get a certain level of immune cells because, well, they’re everywhere (except for certain restrictions in the eye and the brain, and stomach acid isn’t too hospitable). It’s their job to go everywhere and do surveillance, after all, so they’re present throughout the skin and nipple that touches the kid (and also in saliva and urine and tears and you name it), and they can generally slough off and get around (like the stem cells you can isolate from breast milk). Oodles of immune cells in bodily secretions, as you note, is a sign that all is not well…

            I like ‘assortment,’ though. Like a little edible arrangement of lymphocytes.

          • myrewyn

            I don’t think alive is the word you are looking for. “the condition that distinguishes animals and plants from inorganic matter, including the capacity for growth, reproduction, functional activity, and continual change preceding death”

          • nikkilee

            Living white blood cells (granulocytes, macrophages, lymphocytes and monocytes) can be seen moving around when a fresh drop of human milk is viewed microscopically. Along with epithelial cells and stem cells.“Breastmilk is a novel source of stem cells with multilineage differentiation potential.”
            Stem Cells. 2012 Oct;30(10):2164-74
            Hassiotou et al.

          • Roadstergal

            OMG, are you talking about that ‘live blood analysis’ of fat globules that was circulating on the Facing Books recently? That’s amazing. 😀

          • nikkilee

            No.

          • momofone

            Translation: Yes.

          • Roadstergal

            Also, BTW, I can isolate B-cells, T-cells, monocytes, and neutrophils from urine. Should I pee in babies’ mouths, to give them the benefit of this wonderful living fluid?

          • Heidi Fritz

            Anytime I get a zit, I’m gonna save the pus for the poor formula fed babies!

          • Nick Sanders

            Isn’t white blood cells in cow’s milk one of the reasons PETA and that ilk argue you shouldn’t drink it, calling it “pus”?

          • Empress of the Iguana People

            I almost downvoted because that made me almost upchuck. blech!

          • Roadstergal

            Hey, flash edit!

            I reviewed that paper before, Nikki Lee. Is your memory that short? You still haven’t actually read it?
            In brief – non-embryonic/fetal stem cells are an active area of research, because of squeamishness/lack of funding/bans when it comes to embryonic/fetal stem cell research, so people look in all kinds of adult fluids to try to find some. Partially differentiated stem cells may indeed slough off after breast tissue remodeling, and this one paper suggests that they can be coaxed into a few lineages in ex vivo culture with specific stimulations. Once in a baby’s stomach, however, they’re dead and digested just like any other incidental cells (OMG WBC!) that happen to make it there, and do fuck-all.

            If this pans out, and breast milk turns out to be a good source of stem cells, that would be an argument against breastfeeding – why waste such useful cells by having baby digest them? :p

            Note – they didn’t identify the stem cells by watching them move around under a microscope… :p

          • nikkilee

            Then you must have read this one too, and realized that human seems to play a role in gene expression, and metabolic programming.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830559/

            There is lots more published about this.

          • Roadstergal

            Yes, and unlike you, I know what micro RNAs are.

            You’re doing a very good job of pointing out features of breast milk that have no impact on infant health. You see, given that you haven’t shown any actual averages of breast milk over formula for term infants in the developed world, that’s exactly what you’re showing – that WBC, miRNA, and stem cells don’t matter.

          • swbarnes2

            For the thousandth time, an honest person would be able to connect this to a proven health benefit. You can’t. You aren’t honest. You are a plagiarizer and a liar.

          • The Bofa on the Sofa

            Pus contains cells, too. I don’t want my kids eating that, either.

        • swbarnes2

          Sigh. If breastfeeding is a public health issue, you can easily point to the public health measurements which have been greatly improved by the substantial increase in breastfeeding since the 70’s.

          But you won’t. You are so fundamentally dishonest (as proved by your transparently absurd plagiarism last time you were here), you don’t even understand why it’s wrong to make false statements.

      • Roadstergal

        “Unless you’re arguing that just because someone can biologically do something, they should do it?”

        She’s not arguing that. It’s what she believes, and it’s her goal, but she’ll gaslight and guilt rather than saying it outright.

        • She might be learning! I hope. I’ve seen the gaslighting and guilting, but this particular thread seems free of it so far, at least what I’ve seen (Disqus being what it is, I make no claims I’ve seen it all). We shall see, but I’m willing to give someone who says she is learning the benefit of the doubt until she proves otherwise.

          • Roadstergal

            I wish I could believe that, but she’s still going on about breastfeeding as a public health issue and comparing it to smoking.

    • Charybdis

      Screw the “What OB’s routinely do a thorough breast exam to check in the last trimester”; what about midwives? Do midwives do this? Do they even THINK it might be a problem? I’m talking about the CPM’s here, as well as any other non-medically trained midwives. Although, woo-infested CNM’s could be included as well.
      The NCB crowd, the “your body was MADE to bear children”, the “ALL women make enough breastmilk to sustain their progeny, anybody who says differently is simply a scaremongering, breastfeeding-oppressing, mother’s intuition-denying, baby-gut-destroying, lazy, uneducated formula SHILL group, also don’t address this issue at all. Because doing so somehow will introduce doubt into the mother and they can’t have that.
      If the lactivists/NCB/EBF brigade outright refuse to accept that upwards of 15% of women will have supply issues and other breastfeeding problems, why would it ever occur to them to do some preemptive breast screening/evaluation during the last trimester? You would think they would be all over that, but no.
      And then, these lactivists , who are the ones who are big believers in “mama intuition”, are the first to pooh-pooh a mother who thinks her baby is still hungry after breastfeeding. “He is on my breast for HOURS and will cry inconsolably. Doesn’t sleep for very long , fussy, ALWAYS on my breast, I think he’s hungry. Plus, whenever I pump or hand express, all I get is drops. Or something like 1/2 an ounce in an hour. I don’t think I’m making much milk.” Or God forbid, the mother mention the fact that the pediatrician is concerned about her baby’s falling off the growth charts and wants her to start supplementing with formula.
      Oh, tut-tut-tut, you silly mama! A pump can’t drain your breast as efficiently as the baby will, nor can you hand express as efficiently either. All that is an indication of is “how much you can pump/express” and you can’t judge your milk supply by that. Just count the number of wet/dirty diapers and as long as the baby is producing enough of those, everything is fine. The pediatrician is worried about his weight loss? All babies lose weight in the beginning. It’s nothing to be concerned about. Just keep nursing. Get a wrap so you can wear the baby while he breastfeeds constantly. Dehydrated? Nonsense. He’s still peeing, right? If you are dehydrated, you can’t/won’t pee, so obviously your baby is getting milk. Supplementing? Oh, no! That is absolutely NOT NECESSARY. The doctor doesn’t know a thing about proper infant nutrition and is obviously clueless about breastfeeding and how EBF babies grow, act, eat, etc.
      So if the High Priestesses of Lactivism don’t/won’t do, support, encourage, recommend, insist on a comprehensive breast exam/evaluation of an expectant woman who plans on breastfeeding, then they cannot bitch that the OB’s don’t do so either. And then, the Priestesses would have to actually address things like IGT, prior breast surgeries, inverted nipples and minimal/non-existent milk production, among other problems.
      And they won’t allow that.

    • Sarah

      Sorry, just to be clear, are you defining sufficient lactation after THREE WEEKS as ‘working’?

    • nikkilee

      Dear Forum: Now the discussion has moved into a different vein and I must leave you. Thank you for telling me like it is.

      • Roadstergal

        Dear forum: you have asked me to support my claims re: the superiority of breastmilk over formula for term infants in the developed world, and I can’t. *flounce* -Nikki Lee

        • nikkilee

          No. . . that debate has gone on many times here, and I don’t want to do it again.

          The evidence stands.

          • Sarah

            Indeed it does. It doesn’t stand for what you say it does, though.

          • Who?

            You haven’t done it yet. All you do is assert as though the invariable superiority of breastfeeding is a foregone conclusion, and then fail to provide a shred of evidence to support it, and then get snippy.

          • Roadstergal

            Note her comment below comparing formula feeding to smoking.

            It would be risable, if she didn’t have the ear if so many vulnerable women, convincing them that feeding their baby a substance painstakingly engineered and manufactured to be safe and healthy is, instead, just like sticking a cigarette in its mouth.

            How much infant starvation is Nikki Lee herself directly responsible for? That’s why she gets on my tits.

          • Roadstergal

            The evidence stands – and it’s that you’ve consistently failed to show that breastmilk has any health advantages over formula for term infants in the developed world.

            And yet you continue to peddle your bullshit and guilt-trip vulnerable women.

          • Heidi

            I knew it was too good to be true. She isn’t really going to go away.

          • Roadstergal

            …Yeah.

  • Gene

    OT: has anyone seen this? Was on my FB feed (I think George Takai posted it). Some nice pics, but I see way too many BLUE babies. #7 especially.

    http://upshout.net/birth-photography-2017-contest-winners-iapbp/?utm_content=inf_10_3298_2&utm_source=TSE&utm_medium=CPC&utm_campaign=tse&tse_id=INF_b3b7be50080d11e79b1a07d5f3e08d7d

    • Dr Kitty

      What about the pure white baby at #3?
      Most of the waterbirth babies are not a good colour.

      Personally, I find it hard to see the “raw beauty” of a woman screaming in agony in the front seat of a car, even if it is beautifully shot.

      • Poogles

        “Most of the waterbirth babies are not a good colour.”

        Of course waterbirth advocates will just tell you that that’s the “normal” color for waterbirth babies. Oy,

  • Gæst

    When was the last time we ever heard of a baby being harmed due to improper formula preparation, and it wasn’t related to the family being unable to afford formula? Not very often – and yet we heard about breastfed babies being harmed all the time. Yes, it’s possible to prepare formula incorrectly, but it takes a major mistake to cause harm. Most of the time when formula is prepared wrong what the family needs is *financial assistance.* Not sanctimony about how “see, formula is BAD.”

    • Roadstergal

      Exactly this. Formula issues are usually ‘family needs money and/or better water,’ not ‘family needs a guilt-trippy lecture.’

    • KeeperOfTheBooks

      They may also need education on formula prep, to be fair.
      I have a college degree plus some grad school. I also have a LOT of experience in cooking. Nevertheless, I made a serious error when prepping bottles for DD for the first couple of weeks she was bottle fed: I scooped the formula into the bottle or container, and then added water to the appropriate ounce line. Why? Well, when you cook, you virtually always add liquids to dry ingredients rather than vice versa in order to prevent lumps; I figured that lumps in a bottle would be bad, and called on my past cooking experience, rather than the back of the formula container, to tell me how to prepare a bottle.
      I grant this was a less-than-brilliant move on my part, but in my defense I was dealing with extreme sleep deprivation, sundry infections, and pretty severe PPD/PPA–I often couldn’t sleep even when baby slept because OMG SHE MIGHT WAKE UP or OMG SHE MIGHT STOP BREATHING. The sleep deprivation/inexperience (she was my first)/depression and anxiety also played a roll in my leaving bottles at room temperature for hours and hours before feeding them to her, rather than disposing after an hour.
      I did bring this whole scenario up after the second baby in order to point out to the nurses that I was, ostensibly, better-educated than most of their population and could still make such stupid mistakes, so why not teach moms proper bottle prep before discharge? However, the lactivist solution to this was that they shouldn’t educate me on how to prepare a bottle of formula properly because if they did, I’d…use formula.
      *facepalm*
      I swear, it’s like the people who insist that if they just never have the sex talk with their kids, their kids won’t have sex til marriage.

      • Gæst

        It’s an error in formula preparation, but was it really a serious error? What harm did your daughter suffer in the weeks you were making this error?

        Not that I’m against bringing back formula prep as a part of standard childbirth education classes (not that I could afford any), but your anecdote supports my original point: When was the last time we heard of a baby being harmed by formula prepared incorrectly in this way (as opposed to intentional dilution because of poverty)?

        • KeeperOfTheBooks

          Long-term harm? Probably none. I do suspect that she had a rather upset tummy much of that time, though. I can’t remember when I changed the way I did formula prep, but it was later on in her first year. She was my first, so I simply didn’t know that that. much. screaming. wasn’t normal, and when I told the ped that she screamed all the time, the ped essentially said that babies cry a lot.
          Again, in retrospect and with the benefit of experience, most babies don’t cry THAT much! She pretty much had a 20-30 minute window of not screaming per wake cycle, which is nuts. I came damn close to going over the edge from the screaming; I wouldn’t be shocked if it might have pushed another mom clean over it.
          Long story short: I don’t think the formula being prepared like that as such would cause long-term damage, but I think that the incessant crying and screaming from an upset tummy due to improper prep might lead a caregiver to lose it on the baby. Should they? Of course not! But, well, if you’re the primary caregiver and don’t get out of the house much and don’t have much non-scream time, you can see why someone in an already bad state might snap, even while you deplore that they did. There’s also still the matter of how long to keep it at room temp before tossing it: since the nurses at the hospital never mentioned it even while I was using formula in an SNS there, I didn’t, in my sleep-deprived state, realize for ages that um, duh, toss it after it’s been out for a while, don’t just stick it in her mouth for the next feed!

        • Empress of the Iguana People

          ‘though i added water first, then formula, little girl was seriously constipated because it was summer and she was sweating. I added an extra half ounce, and all worked out.

          • Gæst

            But you did it wrooooooooong! Formula is eeeeeeeevil! My daughter was also constipated as an infant (to the point of not wanting to eat, and she *needed* to eat because of weight gain issues). Her ped okay’d a little bit of camomile tea (cooled) to help. I think it was the extra water that helped.

          • Empress of the Iguana People

            lol, I told her ped, and she okayed it.

    • Sarah

      I was under the impression that the formula guidelines, at least in the UK, were intended to protect against the very, very rare but very very dangerous nasties that can be present in powdered formula. For that reason I never minded ensuring the water was more than 70 degrees when preparing bottles from scratch- I was told, at least, that the idea was for the water to be hot enough to kill anything that might be in the powder.

      It was incredible the number of people I knew who weren’t aware of the guidelines though. I don’t just mean people who decided they were comfortable with a very low risk, I mean people who weren’t following guidelines because they didn’t actually know that the NHS recommends against using only cool boiled water. We definitely have an issue with education about formula prep.

      Add this of course to people who either by necessity or through ignorance were doing things like using bottles for longer than recommended, and that potentially explains at least some of the hospitalisations for gastric problems in formula fed babies. Obviously in a country like the UK, where formula use is linked to social class, some of that will be explained by general disadvantage too.

      • Empress of the Iguana People

        Um, how long are bottles supposed to be used? I know the nipple packaging says to replace every 2 months.

        • fiftyfifty1

          There are 2 potential problems with bottle nipples as they age:
          1) the hole tends to get stretched out over time, so slow flow nipples get faster. This is not a problem for most babies–as they get older they actually like a faster flow. But it may be a problem if you try to use a hand-me-down nipple on a newborn. What you think is slow flow may be too fast for the newborn to handle.
          2) a REALLY old nipple can fall apart into pieces. This happens quicker with the rubber ones than with the silicone. But it’s obvious, they start to look frayed.

          Just occasionally check the nipple to make sure it isn’t falling apart, and if it’s not, you don’t need to change them. Ours lasted a whole year.

          • Empress of the Iguana People

            Those I do replace regularly, I was wondering about the bottles.

          • fiftyfifty1

            Never, in my opinion.

          • Daleth

            Never, in my opinion

            Especially glass bottles. If they don’t chip or crack, they’re good forever. We’ve had the same bottles for more than two years (our toddler twins still like bottles of milk) and I wouldn’t hesitate to use them on a subsequent baby or give them to someone with a new baby.

          • Gæst

            I loved the glass bottles, but sadly my babies hated them. Sigh. The plastic Avent bottles lasted 3.5 years with no sign of wear, though, and although I threw out the nipples I passed them on to another family.

          • Dr Kitty

            Of all the bottle brands I tried (and I tried a lot) the Medela ones designed to be used with expressed breast milk were the least durable. They cracked in the dishwasher, the measurement markings wore off, and my son broke three of the collars that hold the teats on by throwing them out of his highchair.

            My favourite are MAM- I like the self sterilising anti-colic ones, but they make glass bottles too (which I won’t chance because of kiddo #2’s said habit of chucking them). The designs are cute and they seem nigh-on indestructible.

            A year after purchase I still have original teats and bottles on the go.

          • Heidi

            So we used the 5oz. Medela bottles primarily and they are still in good shape although some of the markings are wearing off and I only had them because of the pump and he seemed to do well with them. But all they are is a standard bottle and cost way too much for what they are. However, I ordered some bigger Medela ones thinking he’d need them as he got older (joke’s on me, he would only take 4 oz. at the most his whole bottlehood) but I started using the big bottles with the caps to shake his toddler formula in and store in the fridge and found the markings are totally NOT accurate. 8 oz. is more like 9 oz. I fill the water up to about 7 oz. now to make an 8 oz. cup of toddler formula. It’s not concerning now that he’s a toddler and drinking watered down milk or slightly concentrated milk isn’t a big deal but I couldn’t believe how off they were. I’ve bought dollar store bottles and they weren’t off.

          • J.B.

            Only if you put the bottles through the dishwasher, be sure to swipe them first with a bottle brush. Otherwise interesting things stick to and start growing on the sides. Not that I know this from personal experience or anything.

            We used our bottles for 2 kids, replaced the nipples somewhere in there (kids wanted faster flow anyway.)

        • Heidi

          I wonder if she was referring to a bottle with made formula in it? As in people might let a bottle of formula set out for too long.

          • Sarah

            Yes!

        • Sarah

          Made up bottles I mean. People sometimes make one up then use it over several hours, either through ignorance or forced economy.

          • AnnaPDE

            Made up bottles are considered fine for 12-24 hours in the fridge. Once there’s backwash in them (i.e. baby had the nipple in their mouth) the guideline is to discard after one hour. Some doctors I know were perfectly fine with putting it back into the fridge for up to 6 hours and at least in the cases I know, no problems ensued.

          • Sarah

            Yes, I sometimes used the WHO prep guidance myself- 24 hours in the fridge. That’s not what I’m talking about, though. I’m referring to making up bottles and drinking them over several hours, leaving them out in the middle.

      • Gæst

        US guidelines are to use boiled, cooled water, though. Is that to be accounted for by our “general disadvantage”?

        • Sarah

          I have no idea about anything American in this respect.

          The UK guidelines are to use water that has been boiled, then cooled for no more than 30 minutes.

          http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/making-up-infant-formula.aspx

          My understanding is that this is because of e sakazakii. I have heard, however, that in France the advice is to use cooled boiled water, and the reason for this is because they weighed up the potential danger from the bug against more burns from more people handling hotter water.

          • Empress of the Iguana People

            My kid’s NICU and ped said cooled boiled water, too. ‘Though apparently the bug Dr. S is concerned most about begins with an l

          • Sarah

            I’m no expert, and obviously water, access to the means to boil it etc are not uniform throughout the planet. There are also presumably public health consequences to advising people to handle hotter water more often.

          • Gæst

            The story in the US is that using water that hot changes the nutritional composition of the formula, and we apparently think that’s more dangerous than e sakasakii. I don’t have scientific data for this, but it’s definitely what is recommended here.

          • Sarah

            It definitely changes the texture if you use it too hot, I did an experiment with freshly boiled water just out of interest. Makes it lumpy. I’d never heard anything about heat changing the composition, but that’s not to say that UK and US formulas are the same.

          • maidmarian555

            I’ve always used freshly boiled water and never had a problem with lumps at all. I make it hot and then stand the bottle in a bowl of cold water to cool it down.

          • Sarah

            I used Aptamil for this, six scoops. Maybe that’s what it was.

          • maidmarian555

            How odd. We use Aptamil (although he’s been on either an 8oz or 4oz serving for a long time).

      • AnnaPDE

        The Aussie guidelines say “cooled boiked water”. I haven’t heard of a single case of contaminated formula powder around here.
        I suspect there is an element in the UK guidelines of making formula inconvenient by scaring parents into jumping through hoops.

    • Valerie

      There is another category of babies who are harmed when their crunchy parents mix their own formula recipe with goats milk or almond meal rather than feed a commercial, nutritionally complete one.

      • Gæst

        Yes, that happens, too, but it’s not so much improper formula preparation so much as refusal to use formula. It is very complicated to create homemade formula that is just as safe and nutritious as commercial formula (though it can be done), whereas commercial formula is really quite easy to prepare. Homemade formula is an infrequent fringe practice, and the people doing it aren’t doing it because they didn’t get information on how to safely prepare formula in the hospital.

        But there’s a lot of anxious quibbling over boiled cool water vs. boiling water, how to properly measure a “scoop,” and how the water must be added first (not actually true: the water should be *measured separately* and only if you’re measuring with the bottle do you need to add it first), and ultimately most of that is inconsequential. One can safely prepare formula using only the package directions. It’s not a bad idea to try it out in advance, before sleep deprivation sets in, but frankly, a sleep deprived person is going to find something to mess up simply because they’re sleep deprived.

        Anything related to the proper use and cleaning of bottles applies to both formula and breastfed babies, as every baby might need a bottle of pumped milk on occasion. I’m not sure there are clear standards for it anyway, since all the medical professionals I was in contact with thought sterilization was entirely unnecessary.

  • Nick Sanders

    The Snopes article is attracting a bunch of people downplaying the situation, or ignoring it entirely. And plenty on people of the “formula is evil” mindset. I’m trying to counter what I can, but I’m also in over my head, so if anyone feels like helping, please check it out:
    https://www.facebook.com/snopes/posts/1017420895069096

    • myrewyn

      Ugh, I read for about thirty seconds and couldn’t stomach it any more. Hopefully someone with better internet debating skills than me will go help you out. I absolutely can NOT believe what people will say about Landon’s poor mother.

  • Heidi_storage

    Is Wikipedia edited solely by activists? The breastfeeding page discusses the (exaggerated) benefits of breastfeeding and the risks of formula, but there’s no mention of breastfeeding risks. Hypernatremia? Jaundice? Dehydration? Failure to thrive? Pshhhh, what are those?

    • Young CC Prof

      It’s not just Wikipedia. Most official sources are like that, accurate information is incredibly difficult to find even if you look for it.

      Actually, the fact that many purported benefits of breastfeeding may be due to socieconomic confounding is getting out there. And I think most expectant mothers understand that it is possible not to make enough milk. But the fact that insufficient intake can become a medical emergency during the first few days of life? Until Landon’s story went viral, that was practically a state secret. I sure didn’t know.

  • Amy Tuteur, MD

    A new low for lactivists. They are circulating baby Landon’s autopsy report and arguing that it shows his mother accidentally suffocated him.

    https://uploads.disquscdn.com/images/5a1f1034b8c0de2915d892a71e4ff1a16ee43e279a4c5e5a44944851fb9dae7a.jpg

    • Krista

      Does that lactivist have any medical training at all? I mean, I’m only a trained medical assistant and I can see that that report, clear as day, says Landon died in exactly the way Jillian said he did.

      • Empress of the Iguana People

        Pneumonia is totes the same as having been actively suffocated by your parent.
        /sarcasm

    • Gene

      Yeah, if their ascertations were correct, a cause of death would have been mechanical suffocation. What evil evil women.

    • BeatriceC

      I didn’t think it was possible to shock me anymore. I was wrong.

    • Young CC Prof

      Uh, yeah. Baby developed hypernatremic dehydration, the electrolyte imbalance triggered a cardiac arrest, baby was resuscitated, but too late, diagnosed with severe hypoxic brain injury due to the cardiac arrest, developed pneumonia due to being on a ventilator, finally discontinued life support.

      Which is exactly what Jillian said.

    • Steph858

      Even if the lactivists’ conclusions are true (NOT saying they are, BTW, but for the sake of the argument I’ll say ‘OK, let’s say that baby Landon’s cause of death was accidental suffocation caused by an unsafe sleeping position’), aren’t these the same people who advocate co-sleeping, 24/7 rooming-in for drugged-up exhausted new mums and other such unsafe practices on the basis that they supposedly ‘promote breastfeeding’? So whether baby Landon died as a result of dehydration (insufficient breastmilk) or suffocation (unsafe sleep practices as promoted by lactivists), the lactivists are to blame either way.

      • Empress of the Iguana People

        You *know* it was unsafe because he died, whereas if your baby survived, you were clearly doing it “right” /sarcasm
        we’re all prone to gaps in logic, this is one of theirs. 🙁

        • Steph858

          Ah, I see. So Lactivists aren’t above employing the ol’ ‘Heads I win, tails you lose’ then.

        • KeeperOfTheBooks

          Precisely. Even if he’d died of suffocation from cosleeping in the mythical pillowless, blanketless bed next to mom, she would be to blame because she was overtired when sleeping with him, or some such. Yes, because Good Moms are NEVER overtired when parenting a newborn! (/sarcasm, to state the obvious)

  • Gene

    Had another FTT baby. Was down 15+% from BW. Called in by PCP. I mentioned admission and the PCP said, “Oh, only if labs are abnormal”. Seriously, if a 160lb adult lost 25lbs in a week, you would “see what the labs show”??? Kiddo thriving on formula after a few days. Mom never made more than a few ounces while admitted.

    Fed is better than dead!

    • Young CC Prof

      At 15% weight loss, why would you wait on labs? Why is the baby not already being fed while you discuss the next move?

      • Gene

        It was an expect call. Kiddo en route from outpatient office.

  • Sarah

    Too busy to back up any of her claims, but not too busy to shit stir. How very convenient!

  • fiftyfifty1

    It would be so much better if they just faced reality. Just tell women the truth–there is no downside to topping the baby off with a bit of formula until milk comes in. It ensures the baby won’t get dehydrated, and it helps prevent nipple trauma. Milk doesn’t come in because of nipple stimulation. It comes in because of hormones whether you put the baby to the breast or not. Only later does supply and demand fine tune production. Here’s the best advice for a successful start to motherhood: rest up, recover, enjoy your baby, and top off whenever desired.

    • Michelle Windsor, rnc

      Well said, fifty Fifty! There is no harm whatsoever. Btw, there is no nipple confusion either. Baby will still bf, then top off w/ formula. Mom and baby get some sleep-safely in their own beds. Mom won’t be excessively sore and breasts have time to refill. Additionally, baby won’t be too weak to suck (as a result of starvation). It’s too bad that professionals and hospital employees are too afraid to tell parents. Informed consent is what should be required if you want to exclusively bf, just as they feel it is necessary to inform parents of the “dangers” of formula. Exactly what are the dangers? I am an RN in labor and delivery. I also have worked postpartum. I know all too well how moms and babies are suffering instead of bonding with one another.
      I am so proud of Jillian and her husband for sharing their heartbreaking and traumatic loss of Landon so that other parents would see that this could happen to anyone. Thank you! I am so very sorry for their loss. I am also so very angry and disappointed in everyone involved in caring for Landon. How many more red flags did these so called professionals need? Or were they afraid to order formula in the baby friendly hospital? They know who they are and I hope they’re not able to sleep at night.
      I also wish I could thank Dr. Amy Tuteur and Dr. Christie Del Castillo-Hegyi and Jody Segrave-Daly, RN, IBCLC for giving a voice to our tiny patients and for parents to seek support and to have a platform in which to get their story out there so others won’t feel alone.
      I don’t know how much more suffering needs to happen before someone realizes that there is a huge problem with the BFHI.
      Thank you for taking the time to read this.
      Michelle Windsor, RN

      • Roadstergal

        *ovation*

    • Wasnomofear

      As my friend who just suffered an abruption and lost the baby, bless them, can tell you, you definitely don’t need nipple stim for milk to come in.

      • Kelly

        I am so sorry for your friend. Losing a baby is hard enough without having your body remind you.

      • Empress of the Iguana People

        poor family. my condolensces

    • StephanieA

      I just received BF education at my BFH. Our LC claims that there are studies that show that frequent nipple stimulation increases later milk production, is this not true?

      • Empress of the Iguana People

        Not exactly. Your milk will come in (or not if you’re the type who never makes any) with or without stimulation (which always sounds a bit sexual to me, but whatever). If you don’t bf or express, you’ll dry up after that, but it takes time.

        • swbarnes2

          Right, but “coming in” is different from “having a larger supply”. People in other threads have said that milk coming in is related to the drop in progesterone that accompanies the loss of the placenta. Pumping can’t change that, but it can increase prolactin, which I think would increase supply once you get going.

          Of course, the important question is. how much of an increase giving the amount of work it takes? And it might be worth it for the mother of a premie who isn’t nursing, but that doesn’t mean it’s going to help with a baby who will be immediately nursing.