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:
- The revised United States Preventive Services Task Force (USPSTF) guidelines
- Interventions Intended to Support Breastfeeding: Updated Assessment of Benefits and Harms
- Unintended Consequences of Current Breastfeeding Initiatives
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.
What was changed in the revised guidelines that showed breastfeeding promotion can result in injuries and death? I read it including the changed part but I must have missed it.
OT: I’m so sick of the fat/food shaming every time someone publishes a healthy eating article. One dude on the NewsHour comment section was telling everyone who complained that their recent article had some crazily complicated recipes with hard to find or expensive foods that we can eat our terrible “factory food” and die from it.
jayzus, i can hardly read an article (not the comments!) from the blog Dr. A has linked on the sidebar without getting weepy.
I really just wish we could agree, as a society, that people come in all shapes and sizes, and that “skeletally thin” does not necessarily equal healthy.
well, it doesn’t really matter that my mind’s eye thinks I’m 500 pounds, at 280, I really am dangerously obese. My tendency to not eat at all or just my comfort foods isn’t really that great.
I hit rock bottom when the weeping wounds on my legs would not heal, when my moles on my skin itched non-stop, when the blisters between my thighs made me waddle, when I realized that I ate every meal alone because I did not want my family to see how unhealthy my eating habits had become. I hit rock bottom and stopped eating processed foods. I wish I had the self control to every so often indulge in my comfort foods…but I do not. So for me I just gave them all up and instead I got my self back.
Praying strength to you!
that sounds like hard work, hope you are happy as well as healthier now
I tell many of my elderly patients that they are better off with a few extra pounds than at the so-called ideal weight. One bout of serious illness can take 20 lbs off an elderly person, and if they don’t have 20 lbs to spare they can be in trouble. Past a certain age, fat = necessary reserves.
I eat plenty of ‘factory foods’ and ‘poison’ and all that bullshit people use to demonize convenience, and I’m fairly slim. I have a friend who eats fairly similarly but with more beer on top, and is slimmer and looks better in a dress, but is less fit. I have another friend who probably eats more fresh fruit and veg than I do, and exercises a good amount, and is borderline obese, but probably fitter than my slim friend. Genetics play a huge role in how big you are, and how big you are is not necessarily related to how fit you are. I hate that people a: equate slenderness with health, and b: demonize convenient foods.
Why not put out ‘easy healthy’ recipes that use lots of canned and frozen veg, eg? :p
Yes. Slimness does not equal fitness, and also fitness does not equal health or longevity. You can be very fit (i.e. able to engage in sports activities at a high level) and be unhealthy. I had a neighbor who ran marathons (and fast) who died of a heart attack at age ~50. I also have patients who are slender, compete in triathlons, with toned abdominal muscles that make eveyone jealous. As their doctor, I also know that they struggle with eating disorders and have bone density measurements more typical of women in their 80’s.
I think of the Queen Mother. Never thin in her life. Never “worked out”. Lived to 103 or something.
I wish the news hour had rather than salmon with capers and pickled lemons
Recent convo with my 97-year old grandma, when I was driving and we saw two women out running together –
Me: “I could use a running partner”
Her: *snort* “Run!?!? You don’t need to run! I never exercised a day of my life, and look at me!”
She has ONE glass of wine every day at four (though any alcohol will do in a pinch, but only one serving), and she eats in moderation. If someone gives her a box of chocolates, she’ll eat one a day until it’s gone. And, she was born and raised in Miami, and had four kids, so life was her exercise – but all that to say yes, absolutely.
A few years ago, when I was gullible enough to eat up NCB, I also fell into anti- GMO organics. Thank goodness for this site, because waking up to NCB’s b.s. meant also waking up to the b.s. of pretty much anything else sold as “natural.” I’m a couponer, and now I know I can eat all my veggies from BPA-lined cans, and enjoy the fuck out of Velveeta, and I just need to practice moderation and I’ll be fine. And, if I get cancer, it’s not my fault for eating normal food; it’s my fault for being conceived by my mother, who has a strong family history of all kinds of fun cancers. 😉
My impression from reading about supercentenarians (people who live to at least 110) is that living to 80 – 85 is a matter of lifestyle, but once you get beyond that, it’s about genes. You read of the 110 yos who did things like smoked a lot, or eat raw eggs for breakfast, or otherwise have non-kale-containing diets. These folks aren’t worrying about diet and exercise.
Alas, now that the last person who was born in the 1800s has died, my interest in supercententarians will wane. Especially as we lose the last of the 19th century.
I don’t know if you’ve ever seen that show Recipe Rehab (premise being take an unhealthy meal a family consumes and make it much healthier), but the ingredients they use are usually really obscure and expensive, require expensive equipment like food processors, are very labor intensive and dirty up all the dishes. It’s not good enough to swap out maybe white pasta for whole wheat, throw in some veggies, or buy products with reduced sodium or swap out high fat proteins for easily obtainable ones. Noooo, make your own pasta out of organic quinoa flour, make your own sauce out of scratch, buy this Japanese bread made out of black rice, etc. It also infuriates me, because they practically dish out the whole casserole dish for the original dish and exclaim it has like 3000 calories “per serving” while their rehabbed dish has only 300 but easily fits on a saucer. I’m not sure the healthier recipes are even really lower in calories. I can’t imagine they’ve helped one person actually eat healthier.
*Snort* this reminds me of the last time I stepped into the clinic (for a nasty ear infection). Apparently my bp was high and they sent me home with a bunch of papers recommending exercize and lowering my salt intake and some sh!$.
A) I don’t like salt, so I don’t actually get much when I’m not too depressed to cook.
B) I could have had some elevation because I’d just walked half mile from the larger parking lot, uphill, pushing a double stroller with 60 pounds of kid in it, wearing the diaper backpack, while in pain and morbidly obese. So I could get more exercize.
How infuriating. There are a lot of ways recipes can be made “healthier” without such nonsense; you mentioned a couple. Sometimes, however, only butter or bacon will do.
Yep! What really gets me is when they rehab the family’s Halloween or Christmas recipe – the recipe they eat *once* a year. Come on, don’t screw up a family’s noodle kugel or cream cheese pumpkin bars!
Worst. Show. Ever.
I’d like to see some real research on the effect of careful supplementation in the first couple of days. I was discharged from hospital with a slightly jaundiced and slightly dehydrated 4.5kg baby. As soon as I got home, I supplemented with top ups as well as giving breast feeding a good shot.
Two days later, I had a midwife visit and she was really pleased that the jaundice was gone and babe had only lost a tiny amount of weight. I sheepishly told her I’d been topping up.
She said I did the right thing and that she sees many mums dead set on exclusive breastfeeding that she has to tell to supplement due to the baby loosing too much weight. That the mums are usually upset that they ‘failed’ at EBF and have probably been through a couple of days of hell with a hungry baby. Gotta love a pragmatic community midwife, I wish they could give you this advice before the mum and baby suffer.
Ongoing. Estimated completing June 2018.
https://clinicaltrials.gov/ct2/show/NCT02313181
There is this trial
http://pediatrics.aappublications.org/content/early/2013/05/08/peds.2012-2809
and one other which is confirmatory of the results. Both are small studies, but thought provoking and counter-intuitive (and counter the current mode of thinking) – suggesting that early formula supplementation may help mothers and babies at risk of low milk output, achieve exclusive BF later on.
I find it strange/sad/unsurprising that the outcome that these studies are measuring is exclusive breastfeeding rates, rather than happy, health, sane mother and baby.
For me, supplementing every now and again keeps me sane enough to breastfeed 95% of the time and enjoy it.
The trial in progress will be looking at maternal mental health and infant medical care utilization during the first month of life, which are pretty important metrics, IMHO.
Tracking neonatal complications and readmission is my personal soapbox these days.
Yeah, in fact, Nikki Lee’s comment on there beautifully encapsulates that current mode of thinking.
http://bit.ly/2q25ddj
As for the Penn State/ UCSF study, I’ve been even more curiously awaiting the second phase for years now after a private practice LC forum that I follow was up in arms over this “unethical” experimenting on babies and were rallying in CAPS and !!!!!!s to report the researchers to the Surgeon General. They’d interpreted it as initiating formula supplementation after “75% weight loss from birth” … although they were leaning toward that being a typo and that it was probably intended to be a 25% loss from birth instead since babies would be dead if they’d lost more than 75% of their birth weight.
Ô_o
After sharing the study’s first phase and its resulting NEWT weight loss nomogram tool along with clarification between weight losses of ≥75% from birth and losses of ≥75th percentile on a delivery mode-specific nomogram, everyone scattered and left me just standing there alone in the thread with their pile of pitchforks. I’m seriously considering bumping a 2 1/2 year old post with the results next year, just for giggles.
My second baby (this past February) had a great latch and sucked very vigorously. Big whoop, my breasts still didn’t let out any milk. No colostrum. And I let the nurse and my husband yank on my breasts and try, as well as the breast pump. My breasts engorged on day 3-4 after birth but no milk ever came out. (Same thing happened with baby one five years ago, but on day 5). The best they could tell me was delayed milk ejection reflex. The google is not very helpful with that diagnosis – most sites say it’s because you’re not relaxed enough. I’m a pretty mellow person so I’m pretty sure that’s not the issue. Happily the lactation consultant who gave me that diagnosis said there’s probably some hormonal disconnect so I’m not blaming some so called inability to relax. My maternal grandmother couldn’t breastfeed so I think it’s something genetic. I wish there was more information about it.
Anyways, long winded personal anecdote as to why lactivist stories like this really upset me. Thank you Dr. Amy for your website, which was so helpful for me in my second time going through the inability to breast feed.
I had a problem that I couldn’t figure out either. My breasts had decent storage capacity – they’d hold 8oz. at one time, they responded well to the pump – if they were engorged in the morning I could get all the milk I had out in 20 minutes or so, and my breasts don’t fit the description of hypoplasia or IGT. They just never “refilled” throughout the day. I attempted all sorts of pumping schedules and putting baby to the breast. The only difference it made was either getting a small amount out multiple times a day or getting a bottle’s worth out once or twice a day. Eight ounces daily was what I could expect regardless. But I was sent home with the idea that since I produced ample colostrum when the nurse squeezed my nipple and my breasts were fairly large, nothing could go wrong and I was all set. I could not find anything to help me explain what the issue was, which I understand if it’s not understood currently, but to stumble upon website after website that told me I just wasn’t committed enough or not taking the right supplements made it rougher on me than it should have been.
I wish we had made contact while you were looking for support/answers. I always suggest to look at the baby. Look for frothy yellow seedy bowel mov’ts twice or more per day. If a parent wants to express milk to bring in a milk supply, I suggest the heavy duty rented hospital grade double pump. That machine is the be all and tell all. If a mother does not produce 2 ounces or more in under 20 minutes , then supplemental alternatives are needed. To torture a mother by asking her to express for 40 minutes every two hours while her infant wails in hunger is ludicrous. You produced 8 ounces per day. Regardless of your breasts capacity to store milk, the milk making cells peaked at 8 ounces per 24 hours. That is 1/4 of what an infant needs for optimal health. Why? because evolution is not a straight line. And you and me and my kids and my husbands all would have been de-selected out of the gene pool 1000 years ago. But we live in the here and now. We have clean water, electricity, fire, refrigerators and safe regulated healthy nutritious alternatives to breastmilk.
There is a serious lack of basic knowledge about breastfeeding problems. It’s not because the research is too hard, it’s because it just hasn’t been done.
I suspect the reason it’s not being done is that too many of the people who think it’s important believe myths about it being perfect. They don’t believe the true incidence of problems, or they think they already have the answers.
This. If you research a problem and how to fix it, you’re acknowledging the problem exists. Too many people have invested too much in its ‘perfection.’
It would be so easy to do studies! Study the current timing before milk comes in. Do a randomized interventional trial on pumping and nursing vs resting and supplementing. Etc.
I’m glad you found the issue pretty quickly and that your LC had sense enough to recognize it. *hugs*
We’ve seen that in our cows. Some cows need an injection of oxytocin to have a let-down. It definitely runs in lines – maternal cow pedigree – and also appears out of nowhere.
It is – no surprise to you, I’m sure – not connected to amount of milk production either. The first cow we had who broke 200 pounds of milk per day needed a shot at every milking.
Giving them a shot is worth it when it’s either two or three shots a day; doing it 8 times a day or more to feed a human baby would be insane.
200 pounds?! Ouchy
Human babies need 2 pounds per day during peak consumption (3-12 months.) Newborns and toddlers, 1 pound per day.
I mean, cows are 10 times bigger than humans, but that’s still amazing.
Do you just have Holsteins or a mix of dairy breeds?
I miss my Dairy Production class days,….
Short answer: Holsteins
Long answer: We don’t breed to sell genetic material so we don’t adhere very tightly to the herd books. If we were looking to sell semen or embryos, our best bet would be the red-and-white dairy book since we breed pretty awesome red-n-whites and there is no restriction on only using Holstein – or Jersey ect. – sires. My husband has bred a bunch of Mont Belliard sires into the herd with decent results. In what I can only describe as inspired insanity, he crossed red Angus into the herd. (Better results than I would have expected. 5 out of 6 were amazingly good milkers and had phenomenal body comp scores. I should clarify that a “good body” on our farm is a “land-tank” configuration- short, strong legs, roomy chest and strong frame – rather than the traditional dairy look. The problem was that 1 out of 6 went absolutely berserk after giving birth. They bonded instantly with their calf and would fight anyone who tried to remove the calf. So…yeah. We stopped that cold.) We had some Jerseys running around and still have a decent amount of Jersey blood in the herd, but the size difference between a Holstein and a Jersey makes calving difficulties more common so we’re not using as much Jersey. We do get some replacement heifers from a Brown Swiss – Holstein small farm. Those are giant cows who are amazingly sweet – until they don’t want to do something. Then the insane level of stubbornness comes out. I like those…..)
Yeah, the dairy breeds tend to be less homicidally protective of their calves than the beef breeds do.
Odd question for the day: What do you guys do with freemartins?
Now part of me wants baby pictures from the cows in addition to Spawn. 🙂
I love baby cowsies. Especially the Jerseys that look like fawns.
Wow! That is so interesting. I wonder if they will develop a shot for humans? I think my breasts were doing something – they were enormous (I have larger breasts already, but they swelled so much I couldn’t lower my arms fully) and were extremely painful. They told me to take high doses of ibuprofen for pain and swelling. But nothing came out. When I stopped trying to breastfeed I never leaked or had any ill effect (my mom and the LC were scared I would get mastitis).
I think we waited too long to start to supplement with our son – he didn’t poop for days after we got him home. I didn’t want to do that again so we supplemented immediately this time. I was glad because she came out very hungry! Especially compared to my son, who just seemed sleepy all the time. Maybe that’s why my daughter was more vigorous when trying to nurse.
I seriously hate how any problem related to female reproduction is labeled psychological on some level. It was overtly or covertly applied to all my infertility and endometriosis issues, and it was the same song and dance with breastfeeding. When my husband needed jaw surgery or shoulder surgery, no one ever implied it was his personality or stress level impacting his original problem or recovery. No one has ever said as much about my vision being terrible, either. WHY can’t we just stop guilt-tripping women when their bodies don’t perfectly reproduce and feed?!?!?!?
As well, if the substantial weight loss results from delayed onset of lactation, it must be taken seriously from the point of view of the mother, in case this is linked to retained placental fragments. Which would require immediate medical attention (for mother, as well as baby). This uk lactation consultant says many of the same things as Newman (eg the iv fluids business) and says:
http://www.emmapickettbreastfeedingsupport.com/twitter-and-blog/low-milk-supply-101
“If your newborn loses more than 10% of their body weight, we might pay attention”
“Might” worries me more than a little bit!!!!
Heaven knows I didn’t get any in until 4 1/2 days with my 2nd and 5 with my first. No wonder Kid1 lost 11.5% of his mass by day 3. Kid2 was given nothing formula for her first 4-5 days and had no loss. (She got a little breastmilk for the following 2 weeks, because I wanted to see if I hated it as much as when I weaned Kid1, Not quite, but close and with the PPD that was already going strong.)
Kid2 also had no trouble figuring out how to get milk in her tummy either way (Something you can tell when you stop being engorged after a feeding).
^^Agreed.
In fact, if I’m your LC and your newborn loses more than 7- 8% of their body weight, I’m already paying attention.
We “might” pay attention? Why, thank you, Your Goddessness, for deigning to look into the issue – if you do! I mean, it’s just a potential brain damage and a very likely starvation and dehydration, no biggie…
Is this a game for these women? I can’t believe that there were so many milking cows mooing, “What a great informative article!” Wow! Listen, you cows – sorry Mel, not offense to cows! – the very fact that there are so many “You do not have low supply if”s should have told the vast empty space you call your brains that the problem is spread far wider than you’d like to think. Fuck you, you lucky cows who were able to squirt milk into your children’s mouths happily, do you really not realize that while Mom is busy ticking off all the boxes in Emma Picket’s neat little list to overcome hurdles one at a time, the baby will be STARVING and LOSING BRAIN CELLS? What the fuck?
Oh, I forgot. It’s being an alpha player who nailed it and is now happy to offer their experience to the newbies. It’s just a game, after all.
Head, desk. Desk, meet head.
His clinic (the International Breastfeeding Centre) is in the same complex as the Canadian College of Naturopathic Medicine. Take from that what you will.
Depends. My pcp’s office is a couple floors above a reiki office, a hair salon, a lawyer’s office, and what used to be a convenience store. They all rent from a 3rd party, and Dr. N has been there longer than the Reiki lady.
Reiki really, really confounds me. It’s like… “I’m not even going to touch you. I’m just going to put my hands *near* you for half an hour. …That’ll be $60.”
“I was going to be a massage therapist, but then there were the lawsuits…”
This one seems nice enough, for a faith healer. She came out of her office right quickly (glass doors) when someone in the lobby slipped on the wet floor. My friend who was driving me forbad me to help since i was pregnant at the time, but she’s a little bit of a 70 yo, so it’s good the reiki lady came out to help the other lady.
They’ll touch your hip pocket alright.
Fair enough, although I’m pretty sure that this particular set-up is just the CCNM and Newman’s clinic. I drive by it when I go to Ikea, but I’ve never approached, for fear of having my chakras being misaligned by the woo…
Gotta protect the chakras!
My gyn now rents her office to a holistic practioner. It REALLY bothers me.
In fairness, rents in Toronto (especially downtown, where most of the hospitals are located) are sky-high, so he may just want a cheaper venue.
It’s across the street from North York General Hospital, and there are medical office buildings all over the neighbourhood. There are options (probably with more parking) available nearby.
Yes. I’m just not sure whether Jack Newman having an office in the same complex as Canadian College of Naturopathic Medicine means anything in particular, unless he’s affiliated in some way with it (as far as I know he’s not, but if something has information to the contrary, I might think otherwise about the location).
It’s not a complex. It’s the college. The external signs all give the college name, none mention his clinic. Both web pages casually mention each other and the local moms say he works out of CCNM. It gives an impression no matter what his intent is.
I believe – not 100% sure – he was at the Hospital for Sick Children in Toronto at one point. Is he affiliated with the College, though? I’m not really sure how doctors’ offices work, whether they just rent or have to share a philosophy with their renters.
He is.
~~~~~~~~~~~~~~~~~~
The College is pleased to welcome the successful Newman clinic to its new location within CCNM’s Robert Schad Naturopathic Clinic. CCNM President Bob Bernhardt expressed delight at the natural fit between the College and the Newman Clinic. “Naturopathic medicine is a distinct system of primary care that addresses the root causes of illness and promotes health and healing using natural therapies,” Bernhardt stated. Breastfeeding ensures that babies’ young bodies are equipped with defences that their mothers’ milk provides and represents a great first step to a life of healthy living focused on care and respect for our bodies’ natural systems.”
Nick De Groot, ND, Dean of Clinical Education, also expressed strong support for the integration of the two clinics. “The Newman Breastfeeding Clinic and Institute both embodies the principles and practice of naturopathic medicine and provides a wonderful opportunity for our interns to learn from world-renowned experts,” says De Groot. “This affiliation allows future naturopathic doctors to play a leading role in this critical area of mother and infant healthcare.”
Jack Newman, MD, FRCPC, clinic founder and pediatrician, started the first hospital-based breastfeeding clinic in Canada in 1984. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa.
Joining Dr. Newman as partner in the institute is Clinic Director Edith Kernerman, a well-known registered lactation consultant. “The new location at CCNM affords us the opportunity to become an educational institution, with teaching and training for midwives, physicians and other health professionals,” explained Kernerman. “Not only do we welcome observers from all over the world, we’re now able to offer naturopathic medical students the opportunity to precept and observe the work we do.”
~ from 2006 press release on The Newman Breastfeeding Clinic’s new location / affiliation
https://uploads.disquscdn.com/images/649ac1f6f91d74cecde3182aa1548411dce3a185005ce890aefdb4eedc099ed6.jpg
The College wouldn’t provide training, though, to midwives and doctors? From what I know, to get a degree in midwifery or medicine, you have to go to a university (we don’t have ‘CPN’ in Canada).
No, not for training in midwifery or medicine.
Newman’s IBC/ Centre for Breastfeeding Education- Lactation Medicine Program provides **breastfeeding-specific** training to individuals with various health science backgrounds, including midwives, physicians, etc. The naturopath students can also precept at the Breastfeeding Centre.
Any medical advice that says, “X is rare” without continuing by saying, “You can tell whether it’s X or Y based on Z” is bad advice.
Car accidents are rare, but we don’t say not to take preventive measures for your kid’s health. Consequence is every bit as much a part of the calculation as frequency.
Nipples and areolas swollen by IV fluids?
My breast and nipples have a very huge variation in shape and firmness during the feeding depending on the amount of milk in them. And by baby doesn’t care.
Can you imagine how dangerously over-hydrated someone would have to be for it to affect their nipples so much that the baby can’t breastfeed?
Yeah, that’s not going to happen while your kidneys are functioning. IV fluids are given to keep people balanced, not to inflate them like balloons.
I was puffy as hell after my CS with Spawn since my kidney were a bit off from HELLP and I’d been on IV fluids + magnesium sulfate for 48 hours total.
Lots of swelling – but not in my nipples or areolas.
Aw hell, I have a pretty good storage capacity (Like 10+ oz per side before I feel engorged) and somehow, my babies were both able to help with that engorgement.
I don’t know how over-hydrated someone has to be for it to affect their nipples. But I know that every time I get iv fluids, for example when I need medication for flu or allergies (I’m always given iv fluids, even if I haven’t been vomiting) I get very bloated, to the point that my shoes are tight and I can’t button my jeans for a few hours. I usually only get one bag of fluid, but when I had my kids I got bags and bags (at least 12 hours of getting fluids continuously, nearly 24h with my first). I was not in labor (planned csections), I remember peeing a lot and I still came home very bloated. I don’t know if it affected my nipples, but my first kid had trouble latching, and she was a term baby. My second didn’t seem to have so much trouble latching, but my nipples stood up more and I got a lot less iv fluids with him.
I’m not a doctor, but based on my experience, it doesn’t sound too far fetched that a woman who just had a baby and received a lot of iv fluids would be so bloated as to make her breasts hard to latch.
Wouldn’t that have more to do with engorgement, though? Something that happens after birth whether or not you get fluids. I had fluids with both my kids…my first took a bit of practice to get the hang of breastfeeding, but I figured that was just because he was my first baby and we were both new at it! With my 2nd I had IV fluids also, which may have saved me from a c section, because before I got the fluids baby was tachycardic. She had no trouble latching, probably because she was my 2nd and I knew what I was doing.
After Spawn was born, I was the Stay-Puffed Marshmellow woman. I was on strict fluid limitation because the magnesium sulfate needed to prevent seizures and strokes from my elevated BP was causing my body to retain every bit of fluid it could get a hold of.
My eyes were ugly-crying puffy, my hands were puffy, my toes were sausages that I couldn’t bend, and my ankles looked like they belonged to my elderly grandmother.
My nipples and areolas were not swollen outside of pumping. That’s the interesting bit – since I was exclusively pumping, I got really good at estimating my nipple size to within 3mm to grab the right flange.
If Dr. Newman’s hypothesis was true, I’d have had a strange day were I went from barely fitting my turgid nipples into a 36mm flange to my standard 24mm flange on that same day that my toes and fingers became slender again when my OB decided to try an old diuretic BP medication. (Worked like a charm on the BP and the swelling.)
I have never been pregnant but I’ve had many surgeries and IVs. Never once have my nipples and areolas swollen from IV fluids. If that were happening your lips would be swollen duck lips too. Your soft palate would be swollen and you’d be at risk for suffocation. Edema in the breasts from an IV during labor (and other parts of your body, and it happens without labor), sure. But not the nipples/areolas.
I have never been pregnant but I’ve had many surgeries and IVs. Never once have my nipples and areolas swollen from IV fluids. If that were happening your lips would be swollen duck lips too. Your soft palate would be swollen and you’d be at risk for suffocation. Edema in the breasts from an IV during labor (and other parts of your body, and it happens without labor), sure. But not the nipples/areolas.
^^^^^this . OMG Thank you for saying this!!!
Seriously, if I were ever to have a third, given the hellacious after pains, iffy analgesic options and delayed lactogenesis (my milk comes in like blazes day 5) I’d probably opt for the good painkillers, a few bottles of formula and to start BF once the after pains were manageable and my milk was in.
Not to be funny, but Dr Newman has never actually fed a baby.
I found the after pains post second CS to be excrutiating, and not at all relieved by the analgesics I was offered. So that meant severe, 10:10 uterine contractions with each feed for the first 3 days. Not fun.
The wound pain was entirely manageable, but as a primary dysmenorrhoea/ endometriosis person, after pains were not fun (I had opioid analgesia after my first CS, so everything was much more acceptable).
Given that as a breastfeeding mother I was supposed to go home day 2 post op with just paracetamol and ibuprofen (bite me), I have yet to hear a convincing argument from the Lactavist camp for why I should put up with 2-7 days of severe pain in order for my offspring to achieve the ” exclusively BF” label.
Dr Newman- listen to me.
I would rather a small risk to my baby of opioid toxicity than have inadequate pain relief for my severe pain.
I would rather my baby have formula than I be expected to feed them without adequate analgesia.
And I’m a mother who breastfed two children to beyond a year.
I want to breastfeed, I like breastfeeding, I’m good at breastfeeding, and STILL the BFHI, minimising neonatal risk from opioids at the expense of maternal pain policies, make me want to NOT breast feed.
Stick that in your pipe and smoke it.
Deal with that first.
Of course, if he believed what he was saying, he would have fed a baby with an sns.
“Supplementing while the baby is still on the breast is important because, aside from the baby getting more milk even as the baby is being supplemented, but very importantly, breastfeeding is so much more than breast milk. It is a close, intimate relationship between two people who are usually very much in love with each other. The value of that relationship is not measured by how much breast milk the [parent] can produce and it is important that people start seeing breastfeeding in its different forms.”
‘First thing is to get a good latch’. What if there is one already? Then feed more often. What if the feedings are already back to back around the clock?When all the drugs that were pumped into the mother’s system clear, the baby will be happy to nurse. What if the mother had no drugs? It’s possible that the delivery room scales are not calibrated with the postpartum ward. But they are, the babies are weighed on both an hour apart. The baby looks a bit yellow which could mean jaundice which can make the baby too sleepy to nurse properly. But the baby is wide awake and screaming and wildly sucking on anything within an inch of it’s mouth. That’s not a sign of hunger. As long as the baby is producing 5 wet diapers a day he is getting enough. But the baby is not making any wet diapers. If it’s a first baby, the mother may not be familiar with the absorbency of diapers. But it’s the mother’s second baby. If a mother rejects every piece of advice given to her it is a sign that she doesn’t truly want to nurse. Nursing only works if the mother wants it to and is willing to do what it takes for the health and wellbeing of her newborn. If she knew all the benefits of breastfeeding, and the lifelong health problems bottle fed babies suffer from, and she cared about her own child she would want to nurse… Way to go Newman et al. Instead of your anxiety-no endorphins – pain – more anxiety – more pain ‘loop’, how about underfed-guilt induced non intervention – starvation- more guilt induced non intervention – seizures – guilt induced self blaming – intensive care recovery – guilt induced get it right this time underfeeding…. Hey Jack, where are you ?, Oh, he’s moved down the ward to the next ignorant mother to save her baby from death by the silicon nipple.
Honestly. “The scales are wrong.” Really? Really???
This test is occasionally administered incorrectly, so we’re going to avoid false positives by never administering it at all, or by ignoring all positive results. Totally logical!
Unfortunately, this is truly what many BF support people do say, when confronted with the “mother worried about baby that might not be feeding well and has lost XYZ% of body weight”;- “scales might be wrong”. Yes, they can be wrong; the direction of error could go both ways (baby could be fine, happily; or baby could be even worse off than we thought). Any measurement is prone to error but the margin of error isn’t a reason to discard the data entirely but to strive to take more accurate measurements through whatever techniques are available to do that (using more accurate technology, having machines calibrated regularly, optimising the methods for using the technology, eg weighing on a firm surface not carpet). Etc.
But unfortunately in BF world, data is not to be trusted so we must discard (or not collect) data in the first place. V worrying mindset sadly.
Exactly this. It’s like when midwives tell women that their baby could be smaller than estimated in utero, thanks to margin of error, so go ahead and deliver vaginally at home.
Margins of error go both ways! Sure, your baby could be x% heavier than the weight on the scale, but could also be x% lighter! If they wanted to be honest about margins of error, they would just give the range.
And LOOK at the baby.
A very yellow, drowsy baby who is reluctant to feed with a weight loss of 9% would worry me more than an alert, baby-coloured baby who happily suckles and a has a weight loss of 11%.
There’s always room to remember measurement error. For example, if the scale shows a large percentage loss in a short period of time, but the child appears happy and energetic, with no signs of dehydration, it might make sense to consider what scales were used and whether they were used correctly. Similarly, if baby is visibly dehydrated, you should be concerned even if there isn’t much weight loss.
Measurement error is a possible explanation for data points that really make no sense in the context of other available data. It is NOT the go-to answer for any data points you don’t like.
But seriously, what are the chances that the scale is significantly way off? They seriously make it looks like all their scales are unreliable, half broken antiquities. If you think it’s a problem with the scale just use another one and weight the baby ffs, don’t just throw the result out the window saying that the scale is wrong.
But that would let objective reality interfere with their ideology, so it’s VERBOTEN. Another way of expressing this idea, popular with the midwives in my hospital: Numbers would just confuse you as a new mum. Why thank you, that’s really the perfect thing to say to a maths PhD whose everyday work is in data analytics.
You know what confuses new moms? Not getting any numbers at all, and thinking the numbers must be fine because no one has said anything to you.
You know what keeps new moms from being confused? Having the facts beforehand, so they can put numbers in context.
Thing is, I did know of the context, and mentioned it, so they had to somehow prevent the actual measurements from emerging. So they just said “nah” when I requested a weighted feed. Unluckily for me, my C-section incision was on their side in keeping me from walking to the scales…
One would hope the baby scales in the ped’s office are better calibrated than the one in your bathroom. *snort*
It’s not a huge leap from this to “if we don’t test your glucose, we won’t find GD and you won’t be risked out of my care.”
Rule 10 of the House of God :
If you don’t take a temperature you can’t find a fever.
This is apparently now:
If you don’t weigh the baby you can’t detect weight loss.
Dr T… I have a feeling you could do an updated post re-writing all the Rules for NCB/AP/Lactavists.
“Gomers don’t die” would become “Some babies die”.
“Gomers go to ground” would be “Babies know when to be born”
Lord knows what you’d turn “every body cavity can be reached with a 14G needle and a good strong arm” into!
This is maybe the most irritating part of lactivism for me. It’s one thing to hear about breast milk being akin to unicorn tears from Random Internet Stranger or Pushy Lady at Target. If those types of sources were lactivism’s only mouthpiece, then I could have easily ignored it and found more balance in my first few months of parenthood. But it also comes from doctors, nurses, hospital staff, pediatricians and their staff–the very people you instinctively turn to in order to wade through the woo and learn to do what’s right for your baby. That’s where the real damage comes from, especially in BFHI facilities. These are the folks with blood on their hands, yet they take no responsibility and continue to sow misinformation, guilt, and suffering.
The original driving force behind the natural childbirth movement was medical paternalism, doctors (overwhelmingly male) who believed they knew what was best and refused to listen to patients. Which makes it doubly ironic how ultra-paternalistic “maveric” doctors are now seeing such success in naturalistic circles.
Lactivism: 2 parts pseudoscience, 1 part wishful thinking, 1 part orthorexia, with a pinch each of sexism, racism and class bias.
I would like to add to your spot on definition. Lactivism now has corrupted the word” diversity” to alienate and dismiss anyone who questions their motives/agenda. I function as a volunteer in lactivist circles. How can I promote diversity if breastfeeding is defined as an all or nothing pursuit. Why am I expected to boycott infant formula and bottle manufacturers on the grounds that they advertise their product. So many parents/lactation promoters quietly confess that the first few weeks after birth they “topped off” with formula and then went on to breastfeed exclusively for months. If we have no reliable source for infant formula due to the outlawing of advertisements how does that help parents world wide?
The elephant in the room: what’s the DOWNSIDE of supplementing with formula when the weight loss is more than 10%?
The answer to that will be as bad as “the nurses don’t know how to use the scales….”
There’s always (nonsense) virgin gut theory. But the real reason is that it gives parents the idea that the occasional bottle of formula is an option, and that a baby who drinks bottles can be happy and healthy. Which is obviously true, but does not “support” exclusive breastfeeding.
Also, hospitals are now tracked and rated on exclusive breastfeeding at discharge, but not on neonatal readmission. Which amounts to an actual financial incentive to ignore nursing problems until discharge. Most staff wouldn’t do it deliberately, but it does shape policy.
Even Marsha Walker, the author of “Just One Bottle Won’t Hurt… or Will It?” states:
“…if breast milk were again given exclusively, it would take 2-4 weeks for the intestinal environment to return again to a state favoring the gram-positive flora (Brown & Bosworth, 1922; Gerstley, Howell, Nagel, 1932)”
Soooo…even the infant gut is de-virginized, it’s still back to normal in two weeks, so where is the “hurt”?
[from https://massbreastfeeding.org/wp-content/uploads/2013/05/Just-One-Bottle-2014.pdf%5D
I love seeing citations from the 1920s and 1930s…
But yes, _even if we accept their bullshit as read_, there’s absolutely no reason to not supplement early on.
The annoying thing is that his advice and videos on determining whether baby has a good latch and whether baby is actually transferring milk are pretty good. In fact it’s one way I was able to tell I needed to temporarily supplement (the other being rising bilirubin levels).
But I think as a pediatrician he should focus on making sure baby gets enough to eat and not necessarily how baby eats (as you said, outcome vs process).