Dr. Jack Newman, breastfeeding and iatrogenic injuries


There he goes again.

Dr. Jack Newman has a disturbing tendency to rationalize or ignore the iatrogenic injuries and deaths causes by relentless promotion of breastfeeding.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Worst case scenario if you give a baby an unnecessary bottle of formula is — nothing! Worst case scenario if you fail to give a baby a needed bottle of formula is brain damage and death.[/pullquote]

Sadly, he resembles many physicians who refuse to take responsilbity for the preventable errors that are so prevalent in today’s medical system. Like the classic paternalistic doctor, he is sure that he knows best. Hence he refuses to acknowledge harmful errors, tries to blame others for the injuries and deaths, and justifies it all by implying that individual harms are acceptable in light of the overall good.

In a May 5th Facebook post, Dr. Newman wrote:

In many hospitals, 10% weight loss is used as an accurate measure of how the breastfeeding is going in the first few days after birth. In fact, it is nothing of the sort. All too often it results in babies getting unnecessary supplementation, often by bottle, and the mother and baby do not get the help they need to succeed in breastfeeding…

He presents NO data and NO scientific citations to support his claims (not surprisingly since there aren’t any). Instead he offers bizarre attempts to deny reality: the scales are wrong, people don’t use the scales properly, babies start out over-hydrated, babies can’t latch because women’s nipples and areolas are swollen from IV fluid.

He refuses to acknowledge the obvious: that breastfeeding, being a natural process, has an entirely natural failure rate.

Everything we know about human and animal reproduction teaches us that there’s an incredible amount of wastage and death associated with creating the next generation — from miscarriages, to pregnancy complications, to prematurity and infant anomalies. The historical reality of cemeteries filled with the bodies of babies and mothers who died in childbirth or shortly thereafter is testament to the fact that pregnancy, childbirth and breastfeeding are not perfect and that high rates of death are entirely compatible with robust population growth.

There is simply no question that babies are being injured and killed by overzealous breastfeeding promotion.

The evidence for iatrogenic injuries and death from breastfeeding promotion include:

Together these papers showed that the premier effort to promote breastfeeding, the Baby Friendly Hospital Initiative doesn’t work, ignores the science on pacifiers, formula supplementation, and Sudden Infant Death Syndrome (SIDS) and leads to preventable infant injuries deaths when babies fall from or get smothered in their mothers’ hospital beds. These injuries and deaths did not happen until hospitals and providers began aggressively promoting exclusive breastfeeding.

We are also seeing babies injured or dying as a result of dehydration and starvation as a result of insufficient breastmilk (which occurs in up to 15% of first time mothers) and profound hypoglycemia (low blood sugar).

In the face of this scientifically documented reality, Dr. Newman offers a wall of denial.

What the baby needs [who has lost 10% body weight or more] is not automatic supplementation, but rather, first and foremost, the baby needs help getting a good latch. This requires good help from hospital staff and midwives, which may include reverse pressure softening of the nipples and areolas so that the baby does get a deep asymmetric latch and gets milk from the breast.

Unfortunately, in too many hospitals, the automatic first reaction is to give the baby a bottle of formula. And that definitely does not help improve the baby’s latch.

Why not give a baby a bottle of formula? Isn’t it more important to preserve the baby’s brain function than to preserve breastfeeding? The worst thing that will happen if you give a baby an unnecessary bottle of formula is — nothing! The worst thing that will happen if you fail to give a baby a needed bottle of formula is brain damage and death.

There’s something very ugly about promoting a process instead of an outcome. It is indisputable that a baby needs adequate nutrition. He or she cannot grow or thrive without it, and even a short term failure to receive adequate fluid and nutrition can result in permanent brain damage and death. A baby does NOT need breastfeeding; he or she can easily grow and thrive without it.

Lactivists like Dr. Newman have propagated the lie that insufficient breastmilk is merely an excuse for not breastfeeding, since every woman can make adequate milk if she just breastfeeds harder. This ugly edifice of denial is beginning to crumble under a large and growing body of scientific evidence demonstrating that aggressive promotion of breastfeeding leads to iatrogenic injuries and deaths.

Preventable infant injuries and deaths are a terrible indictment of the current system. The truth is that breast is not best for all babies. Lactivists’ insistence on promoting a process (breastfeeding) over outcomes (healthy babies) has led us to this point and we need a serious adjustment in the way we treat and counsel new mothers.

Instead of measuring breastfeeding rates (process), we should be measuring jaundice rates, dehydration rates, readmission rates, injury rates and death rates (all outcomes). We should recognize and acknowledge that hospital readmissions for jaundice and dehydration, as well as brain injuries and deaths are iatrogenic injuries. We are CAUSING them and therefore, it is up to us to PREVENT them, not to deny that they are happening.

The job of health care providers is to nurture babies, NOT to promote breastfeeding. The sooner that Dr. Newman and other lactivists recognize this, the sooner we can put an end to preventable iatrogenic injuries and deaths.