Social media is the lifeblood of the natural childbirth and lactivists movements; advocates have been fattened on alternative “facts” and therefore rendered ignorant of the truth and indignant at anyone who dares to correct them.
Consider this Facebook comment from Scarlett Lynsky:
Amy Tuteur- Professional Troll, Woman with a Vendetta. Angry at anyone who breastfeeds or gives birth without medication and anyone who supports them. Just, like, a life of angry trolling on the internet. I hope you get happy someday, Amy, because this is a weird life you’ve chosen.
It’s a perfect illustration of the ignorance, indignation and inability to tell the difference between disagreement and criticism that characterize both lactivism and natural childbirth.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It is infinitely more gratifying to imagine that breastfeeding makes some mothers superior, but the doesn’t make it true no matter how relentlessly social media insists.[/pullquote]
What provoked it? I dared to correct the faux “facts” of lactivist Lucy Martinez Sullivan’s in her HuffPo piece The National Scandal Of Newborn Deaths And Why Support For Breastfeeding Moms Matters.
I posted this meme:
The real scandal here is the way that Martinez Sullivan exploits the tragedies of poor women and women of color to promote full employment for lactation professionals.
The biggest risk factors for infant death in the US are race and class. There is no evidence that breastfeeding make much of an impact on infant mortality and no reason to think it would. Sure, breastmilk can reduce the incidence of necrotizing enterocolitis and thereby lower the death rate for very-low birthweight infants, but that accounts for only a small fraction of infant deaths. Over the past 100 years, breastfeeding rates have dropped dramatically and then risen again; there has been no impact on infant mortality by either of those trends. No one can point to any term infants whose lives have been saved by breastfeeding.
I don’t know if Martinez Sullivan is ignorant of this reality or merely willing to exploit it for her own ends, but I do know lactivist organizations as well as natural childbirth organizations use social media to create a carefully curated faux “reality” and then lash out at those who dare to point out that it isn’t reality at all.
That’s George Will’s point in The ‘alternative facts’ epidemic goes way beyond politics. Quoting Tom Nichols author of The Death of Expertise: The Campaign Against Established Knowledge and Why It Matters, he notes:
Our devices and social media are … producing people who confuse “Internet grazing” with research and this faux research with higher education …
As Carolyn Stewart writes in The American Interest:
We recuse ourselves from reality via the device in our hand, which rewards us for ignoring reality with a series of dopamine-releasing mini-tasks. From Candy Crush and Twitter to work emails, these activities hook us on a seeking-reward feedback loop that is infinitely more gratifying than staring at the commuter sitting across from you. These cyber preoccupations allow us to customize our surroundings, and accustom us to regulating and controlling the information that comes our way. This has several effects: an expanded sense of what falls under our personal social domain, an increased expectation of control over that domain, and a greater sensitivity to input that deviates from our preferences.
Lactivism and natural childbirth webpages, Facebook pages and Twitter feeds encourage lactivists and natural childbirth advocates to believe they have “done their research,” are in possession of “knowledge,” and are battling for the dissemination of knowledge to others. The reality is that they have read propaganda, are in possession of propaganda, and are battling for the dissemination of propaganda to others.
As Will explains:
In today’s therapeutic culture, which seems designed to validate every opinion and feeling, there will rarely be disagreement without anger between thin-skinned people who cannot distinguish the phrase “you’re wrong” from “you’re stupid.”
The Facebook comment above perfectly illustrates the inability of lactivists and natural childbirth advocates to distinguish between “you’re wrong” and “you’re stupid.”
Lucy Martinez Smith wrote a piece that flagrantly ignores facts about breastfeeding in an effort to promote full employment for breastfeeding professionals like herself. Breastfeeding is not perfect; it doesn’t save the lives of term babies; and it has little if anything to do with the tragedy of US infant mortality.
But Scarlett Lynsky heard none of that. She simply cannot tell the difference between “breastfeeding doesn’t save lives” and “you are angry at anyone who breastfeeds and anyone who supports them.” Considering that I breastfed four children, that’s obviously nonsensical, but the a steady diet of social media seems to erode the ability to think logically.
Pointing out that breastfeeding is not lifesaving is NOT the same as saying that breastfeeding is hateful. But social media has so warped the senses of lactivists and natural childbirth advocates that they believe they are entitled ignore facts or create new ones to keep the hits of dopamine coming.
Not surprisingly, it is infinitely more gratifying to imagine that breastfeeding makes some mothers superior to others. But the doesn’t make it true no matter how relentlessly your customized social media environment insist that it does.
Totally off topic: Is there anybody in the Southern Los Angeles County area that might have some good recommendations for in-home elder care services? MrC’s mother has gotten to that stage of life, and she’ll be happier if we can keep her in her home, but I’m overwhelmed looking for care providers.
Lucy Martinez Sullivan either failed to read the papers she linked on premature birth or has atrocious reading comprehension skills.
The majority of infant deaths are due to complications of premature birth – but the fastest and most effective way to combat that is to focus on delaying premature delivery (as stated in the CDC vital stats report).
Once a child has been born prematurely (before 34 weeks or under 1500g / 3 pounds 4oz), human breast milk can decrease the risk of NEC and bloodstream infection (from the AAP article)
Breast milk isn’t given because it ‘fuels growth and brain development”. That’s just a lactivist trope.
Hell, every micropreemie in the NICU with Spawn was getting a calorie fortifier of some type and mineral/vitamin fortifiers of other types. And, bluntly, the discussions of brain development went something like this “Hey, the head ultrasound looked good. Let’s discuss the next 10 steps on lungs/heart/intestine/ endocrine system that are creating problems for your kid right now.” It’s not that the neonatalogists don’t care about brain development; it’s not the most crucial priority unless the kid has a brain bleed that is causing issues – or if one of the other systems needed to keep the baby alive is faltering.
Hell, only my oldest was getting anything by mouth right off the bat, and then it was through an NG tube, so it was whatever I could pump (not much until my milk came in like a broken damn halfway through day two) plus formula to meet whatever volume the doctor ordered. MK and YK were on TPN for a few days to a few weeks respectively before the NG tube went in for a few weeks/months, and then they had to show that they could manage suck/swallow/breathe with a bottle before they could attempt to latch onto my breast. MK didn’t need fortified milk, as he was Baby Hulk (5 pounds, 4 ounces at 32 weeks), but YK did, as he was actually on the small side (504g, 24 weeks).
Side note: It’s kinda funny that they’ve kept those same basic sizes, comparatively. MK is 15 years old and 6’1″. YK is 14 and 5’4.5″ (don’t forget the half. seriously.).
Your 14-year-old is taller than I am. :
Yeah, but he’s a boy, and pretty much done growing. Life sucks a lot more for short men than it does for short women. My oldest isn’t much taller at 5’5.5″.
You sure he’s done growing? Men in my family grow a little up until late teens/early twenties. My mom and I, on the other hand, got to our adult heights at about twelve.
My brother is mid-twenties, over 6’6″ and still slightly growing, whereas I hit my adult height at 15 and 5’5″. It’s really fun to watch people’s faces when I introduce my little brother.
My oldest and middle sons amuse themselves in much the same way.
Personally, I enjoy calling my brother-in-law, who’s 2 years my junior, “Little brother.” In part because like your brother, he’s well over 6 feet and I’m the “short” one on that side. (I’m not short, but they’re all freaking tall. Demodocus thought he was average height for a man at 6 feet until last week. o.O)
Well, my grandfather thought that the average life expectancy for men around here was 92… 6 feet tall looks perfectly reasonable in comparison!
Both extremes are present somewhere in my family and my ex-husband’s family. All three of my mother’s brothers were under 5’6″ until about age 21 when they all hit a final growth spurt and ended up between 6’0″-6’2″. My father was done by age 11 or 12. I was done growing by age 13. My oldest hasn’t grown since he was 12. While there’s a lot of tall people in my family, their father’s family is relatively short. My ex-husband is 5’5″. It’s been a year since YK has seen any change in height (and the year before that he grew nearly 6 inches…he was under five feet tall until just after his 13th birthday). So, while it’s possible that he could still grow some, the evidence leans heavily to him being done.
My husband is 5’5″ and is exactly the right height for me. I don’t have to tilt my head to kiss him (less pain!) and we can share a lot of things more comfortably than couples with a significant height difference. No one has the guts to tease him for his height, so I hope your sons aren’t bullied for it either.
Yeah, it does, though it can work out okay. They’d still tower over OD who’s 5′ 1/4″.
It can, for sure. I have a Thing for short men, m’self… :p
My grandfather became a finger shorter than me in my mid-teens. He’s currenly half a head shorter. AND one of his friends is seriously, seriously short. They’ve always been so slim, albeit muscled, that when they got sent to the Communist concentration camp, people were sure friend would not return alive. He came back, though, while many men who looked a lot stronger and TALLER didn’t. Perhaps it had something to do with caloric intake? When you’re 1,60 meter tall, your needs are different than a 1,80 meter tall’s. And when they give both of you food that only barely suffices to keep YOU alive, the taller men are doomed.
I’m not sure that’s true- I think more or less the sociological issues with being a short man are worse for women as a whole. E.g, being taken less seriously than tall men.
I clicked over to the Facebook link and ugh, the comments. The raging privilege and lack of empathy for other women is sickening — and this is Facebook where their comments are posting with their real names for all their friends to see in their news feed.
There is a place for propaganda, polemic, and other persuasive rhetoric. People are only partly “sapiens”; we respond to emotion and anecdote more readily than to reason, and appealing to this side of human nature is not wrong, necessarily. However, we should never confuse these “biased” expressions with “information” and “research,” and we must try to resist confirmation bias and the Dunning-Kruger effect.
“Blame” is silly. There is no blame when you feed your baby, unless s/he gets sick because you did something stupid like feed the kid your home-brewed fermented tea. Heck, some kids survived off goat’s milk from birth in the days of our glorious past. Both human milk and formula are very good. Is human milk a smidge better? perhaps, but it is not by much and there are lots of reasons why a family prefers to have formula.
I’m absolutely astonished to hear this from a Portland doula.
If you tell me that she’s against Vitamin K at birth and the CDC vaccination schedule, well, knock me over with a feather.
Pinterest has figured out that I’m about to give birth so it’s suggesting all sorts of pins about “seven things you must put in your birth plan!!” and of course it’s declining the Vitamin K, delayed cord clamping, skin to skin, etc. I’m pinning from Skeptical OB and Fed Is Best like mad to try to get more of the science based articles into their algorithms for pregnant moms but it’s just one little me against the tide, I’m afraid.
But delayed cord clamping and skin-to-skin are both, unless I’m very much mistaken, supported by evidence.
“supported” is stretching it. I know that there are effects of delayed cord clamping, but it’s not obvious that it does anything GOOD (I mean, increased hemoglobin at 3 months or whatever – what is the benefit? Only for the anemic, I guess)
And while I agree that skin-to-skin is nice (for those who want it, not everyone does), are there actual health benefits?
Both the RCOG and NICE recommend delayed cord clamping – I’m not an expert, but I trust both those organisations to have reviewed the evidence thoroughly. A Cochrane Review found evidence to support the benefits to babies of skin-to-skin contact after birth – not massively so, but enough to justify doing it rather than not. It seems odd to me to imply (as myrewyn does) that both these things are slightly hippy-dippy and ridiculous things to ask for in a birth plan, as opposed to fairly unremarkable requests that are supported by the scientific evidence.
The problem is when new parents flip out that their infant was taken for something important, like warming or resuscitation, instead of the currently trendy bloody skin to skin or delayed cord clamping which are of little to no benefit. And yes, mighty tantrums have been thrown over this. Maybe I picked the wrong examples but my Pinterest feed is certainly full of woo. It’s like they know I live in Portland…
“The EMS cut the cord so he could medicalize my newborn. Seriously, we should have shot this guy.”
Do you think I’m kidding?
What are the health benefits of skin-to-skin in term babies?
According to NICE, “Skin-to-skin contact with babies soon after birth has been shown to promote the initiation of breastfeeding and protect against the negative effects of mother–baby separation.” (https://www.nice.org.uk/guidance/qs105/chapter/quality-statement-7-skin-to-skin-contact)
Even if that is true, so what’s the big benefit of that?
Suppose there is a baby that does not breastfeed that would have done so with skin-to-skin. And? It presumes that breastfeeding is better than not, and I don’t see a basis for that.
Again, we are back to, “I agree it’s nice if you want to do it, but what are the health benefits?”
Boy, that’s some more serious begging the question.
Moreover, what does “soon after birth” mean? How soon does it have to be?
I’m somewhat disappointed, Kim. You told me that there was a Cochrane Review that supported skin-to-skin. But now you are just spouting NICE guidelines. I’d love to hear what that CR really says.
Here you go:
http://www.cochrane.org/CD003519/PREG_early-skin-skin-contact-mothers-and-their-healthy-newborn-infants
There are, however, still many things wrong with this, mainly: SSC was defined in various ways and different scales and times were used
to measure different outcomes. Women and staff knew they were being
studied, and women in the standard care groups had varying levels of
breastfeeding support.
They also note that there is no variation depending on the time after birth and the time of the skin to skin care.
Basically, they are saying that they recommend it in healthy babies because there might be benefits and there are no downsides. It’s not overwhelming evidence.
Just to address this point for a moment; “Suppose there is a baby that does not breastfeed that would have done so with skin-to-skin. And? It presumes that breastfeeding is better than not, and I don’t see a basis for that.” But if you’re a mother who really wants to breastfeed, then it *is* important. I don’t
Sorry, got cut off there. I don’t get the demonising of women who put a request in their birth plan that is at worst unexceptional and is in fact regarded in the UK as good practice by the main professional bodies (RCOG and RCM).
We don’t demonize women who want to do it. But we like science based information. The NCB is way overstating the benefits and people are severely overreacting when things don’t go their way (like saying they should have shot the man who cut the cord)
Well, myrewyn implied that they were unscientific things to ask for in her original comment. You can’t really expect the average expectant mother to say, “The Cochrane Review – generally regarded as the gold standard of evidence – recommends this, but actually I’m going to discount this recommendation because the studies looked at weren’t consistent or reliable.” Obviously you would want to prioritise the baby’s safety over early skin-to-skin contact, and saying you’d shoot the person who cut the cord seems excessive, but neither of those things were mentioned in the post I replied to originally. All I’m saying is that if you’re looking for examples of nutty things to include in a birth plan, neither a request for skin-to-skin nor delayed cord clamping are outrageous.
they’re not outrageous, but unfortunately a lot of people are getting the impression that they are super important, which CAN make them want to prioritize them over things which are more important to the baby’s safety and wellbeing (like being warmed or resuscitated).
Also, wanting to the shoot the person who cut the cord SEEMS excessive? I hope we can all agree that actually is excessive. That’s exactly why we’re saying that some people have gotten a greatly inflated impression of how important skin to skin or delayed cord cutting are.
But why does someone say such a thing? Wanting to shoot the EMS who cut the cord? Because she’s been taught that keeping the cord is so very important. Certainly by the same people who encouraged her to have a homebirth with a midwife, a situation that placed the baby in danger and prompted them to call said EMS in the first place. To actually harm your own child and then think that the person you called to SAVE them should be shot because he cut the magical cord IS excessive. And the preciousness of cord and the supposed benefits of the delayed cord clamping for healthy, term infants are mostly preached by the same people who are more likely to insist that letting nature do its job is the wise, sensible way to go. That’s the problem. Also, it’s quite arrogant of NICE to focus on things like delayed cord clamping and skin to skin when there are more pressing problems in their system, like preventable stillbirths because the medical system is all for maximizing natural birth.
What I had in mind mostly was a situation like one from the comment section here a while back (I’m sure I can’t find it now) where a L&D Nurse gave an example of a woman who was very upset that her newborn who needed a little extra care was taken to be warmed rather than allowing skin to skin, not realizing that the nurses could warm the baby more safely and effectively than she could with him lying naked on her chest. So my objection to these articles with the beautiful Pinterest-ready photos is that they promote these rigid birth plans and the resulting upset when things don’t go as planned. Was it also here on Skeptical OB that there was an article about women with birth plans being, in general, less satisfied with their “birth experience” than women without one? I can’t recall for sure — I read a lot.
I hate seeing those pictures of waterbirth babies going skin-to-skin against mom’s clammy, wet body, with a wet towel draped around them. There is no question that a proper warmer – or even skin-to-skin with someone out of the dizam tub – would be more effective at warming the baby!
Those waterbirth photos so frequently show babies with seriously alarming skin tones ranging from blue to grey to white. (And a clueless mom and midwife in the background.)
I don’t expect expectant mother to have read the cochrane review. However, I expect their healthcare provider to have done it and to give grounded information. Which is often not the case with the NCB community.
In no way do I wish to demonize a woman who wants some immediate snuggles with her healthy, term infant upon delivery. I’ll go ahead and demonize the birthzillas though, who treat the L&D staff like the enemy.
Which is why I asked what are the _health_ benefits.
Unless the argument is that women who are intent on breastfeeding and fail are more likely to suffer PPD…
You have to wonder about confounding factors. Seems to me that skin to skin is especially pushed in hospital that are also usually baby friendly and will push for breastfeeding. Breastfeeding itself also require closer contact between mother and baby, so a breastfeeding mother is probably more likely to do skin to skin than a formula feeding mother. Mother’s who have birth complication or c-section are also more likely to have trouble breastfeeding and less likely to be allowed to have skin to skin.
I seriously doubt that there is a baby out there that failed at breastfeeding or has attachment problem because they didn’t have skin to skin.
that’s… pretty… nebulous. So it boils down to feelings and assumes the mother wants to breastfeed — and also on the shaky evidence that a brief separation harms breastfeeding.
They’re nice-to-haves if everything is going well, but not worth being upset about if they don’t or can’t happen due to other circumstances. It certainly doesn’t make sense that they should be included in a birth plan!
Because, yes, there are benefits probably (skin-to-skin definitely, delayed cord clamping is much iffier), but they’re very minor. And skin-to-skin can wait until baby is not covered in muck and blood IMO!
They aren’t ridiculous to ask for if you can. But there isn’t really any huge benefits to get overly concerned about them.
As Bofa said, while there are effects of delayed cord, it’s not sure if it actually does do anything significant.
As for skin to skin, there are other equally good way to keep a baby warm. I doubt babies who don’t have skin to skin are more likely to die or get infection.
I have nothing against someone who wants them, if your baby is healthy they don’t hurt and might have some minute benefits. But as is often the case, the NCB community is just taking it to a ridiculous level.
When delayed cord clamping was recommended, we pediatricians worried about increases jaundice, hypoglycemia, and polycythemia, which if extreme can cause seizures /stroke like event. Clinically, and scientifically has not seemed to be an issue. That’s why doing well designed, repeatable studies is so important. I also remember being nervous when we started having babies sleep on their back–are we going to see aspiration pneumonia? But the practice is rediculously compelling, cutting SIDS deaths nearly in half. Now if we can eliminate bed sharing…
“Science is a process, not an ideology”
-Hank Green
Isn’t DCC associated with an increased risk of jaundice for term infants?
Yep. I had never heard of it but my husband stumbled upon it and I researched it and decided to big ol’ nope requesting it based on the increased risk of jaundice.
Thanks for this, I knew I had also read something like this but could not remember the details.
And I’ve read somewhere recently that 30-ish seconds is the optimal time for the delay. When I get home, I’ll see if I can find that…..
“But delayed cord clamping and skin-to-skin are both, unless I’m very much mistaken, supported by evidence.”
“Delayed” cord clamping is the standard, and has been for as long as I can remember first aid … you wait until the cord has stopped pulsing, then place the clamps and remember to cut BETWEEN the clamps. It usually stops pulsing in a couple of minutes, which can be misconstrued by the patient ad “quick”. There is no advantage to leaving it attached after the pulsing stops because there will be no further blood moving.
The only reason you would not wait is if there is a need to get the baby far enough away from the mom to provide immediate emergency care to one or both of them. A baby born in fetal distress, a gush of blood following the baby … it’s clamp and cut time. There were studies and the differences, if corrected by removing infants with emergencies requiring immediate clamping, were minor.
The skin to skin … if it’s a preemie or born in a hostile environment AND you don’t have a NICU and incubator handy, tucking the baby inside the clothing of an adult that can provide warmth helps survival.
NOTE: It doesn’t have to be the mother. Any large warm person who can sit quietly and be a warmer will do. My dad was a preemie, and tiny, and spent his first weeks of life sleeping with the nuns who ran the hospital.