Dear Dr. Wen, you missed an opportunity to educate women about breastfeeding risks

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Dear Dr. Wen,

I just read your piece on NPR, Learning To Care For My Newborn Was A Humbling Experience, and I’m disappointed.

You wrote about how your son suffered breastfeeding complications, and it sounds like he really did suffer, screaming desperately from hunger for 48 hours:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Eli didn’t need to suffer the way he did and for as long as he did; he just needed some formula.[/pullquote]

The night we arrived home, Eli wouldn’t stop crying. Crying is normal in newborns, my husband and I assured each other. We held him and rocked him. Over the next 48 hours, we took shifts, staying up with Eli to try to soothe him through the near-nonstop crying. We called our friends for advice on how to deal with what we now labeled a “difficult baby.”

Things went downhill quickly. Our pediatrician confirmed that he was noticeably jaundiced. In just three days, he had lost 15 percent of his body weight. Though I was feeding him every two hours, it turned out that Eli never had a good latch on my breasts, and I wasn’t producing enough milk. We were told that he might need to be readmitted to the hospital.

Why didn’t you give your baby some formula to ease his suffering and protect his brain from potential injuries due to hypoglycemia, dehydration and hyperbilirubinemia?

You offer a clue as to why you let him scream.

I was overcome with shame and guilt. What kind of mother am I who was barely keeping my own baby alive? What is wrong with my body that something so natural didn’t happen? How could I, as a physician, not recognize that my baby was actually starving — and instead, blame him for expressing hunger in the only way he was able to?

Who taught you to judge yourself by the function of your breasts?

Would you have been equally ashamed to find that your eyes didn’t focus appropriately and you needed glasses or contact lenses to help you see? Probably not. Would you have been ashamed to learn that your pancreas didn’t work and you needed help to control your blood sugar? I doubt it.

The sad truth is that breastfeeding activists (lactivists) have been dishonest about breastfeeding. They’ve grossly exaggerated the benefits, repeatedly ignoring the fact that the scientific evidence is weak, conflicting and riddled by confounders. Even worse, they’ve lied by omission about the high incidence of breastfeeding complications.

It took until 2016 for Allison Stuebe, MD of the Academy of Breastfeeding Medicine to finally acknowledge the suffering of babies like Eli:

… a substantial proportion of infants born in the US require supplementation. Delayed onset of lactogenesis is common, affecting 44% of first-time mothers in one study, and 1/3 of these infants lost >10% of their birth weight. This suggests that 15% of infants — about 1 in 7 breastfed babies — will have an indication for supplementation.

Fifteen percent is an extraordinarily high number of babies. Approximately 4 million babies are born in the US each year of which 1.5 million are first babies. More than 1 million of those women will try breastfeeding and 150,000 babies will have a need for supplementation with formula.

Lactivists been dishonest about the benefits of judicious formula supplementation for these babies. There has been a lot of fear mongering about formula supplementation interfering with women’s ability to breastfeed and “ruining” a newborn’s gut flora such as this, “Just One Bottle Won’t Hurt”—or Will It?” from Massbreastfeeding.org.

You would never know that judicious formula supplementation in the first few days leads to higher rates of exclusive breastfeeding, not lower rates.

Eli didn’t need to suffer the way he did and for as long as he did; he just needed some formula. But you, even with your professional training or possibly because of your medical training, didn’t know about the high incidence of delayed onset of lactation and about the beneficial effects of formula supplementation.

Fortunately Eli survived his bout with dehydration and starvation, but not every baby does. Jillian Johnson’s baby Landon had a very similar experience to Eli, but Landon’s story does not have a happy ending. He died from dehydration.

Landon cried. And cried. All the time. He cried unless he was on the breast and I began to nurse him continuously. The nurses would come in and swaddle him in warm blankets to help get him to sleep. And when I asked them why he was always on my breast, I was told it was because he was “cluster feeding.” …

So we took him home … not knowing that after less than 12 hours home with us, he would have gone into cardiac arrest caused by dehydration …

Sadly, Landon’s tragedy is far from the only death or brain injury resulting from the relentless promotion of exclusive breastfeeding, yet no one seems to care.

Only recently leaders of the Fed Is Best Foundation, an organization devoted to safe infant feeding, met with officials of the World Health Organization and implored them to alert providers and patients to the risks of insufficient breastmilk. Literally millions of breastfed infants suffer (and sometimes die) from the effects of temporary starvation. The WHO officials had the temerity to respond that it’s “not a priority.”

I and 2000 mothers and medical professionals have signed a petition urging the WHO to reconsider. Perhaps you could sign it, too.

Your baby is now thriving:

My hospital has a wonderful lactation consultant and I have a terrific pediatrician; together, they helped us to get back on track…

I am thrilled that he has more than made up for the initial weight loss and is now a happy and chubby 11-pounder.

Your piece makes it sound like that was the inevitable result when the result could have been tragedy. Your piece implies that Eli’s suffering and screaming was a necessary prerequisite to a successful breastfeeding relationship when it was completely unnecessary. Sadly, Dr. Wen, you missed an amazing opportunity to educate women and protect their babies from breastfeeding complications — almost certainly because you didn’t know. And you didn’t know because lactivist organizations are not honest with women.

Babies are suffering and dying. Please help us protect every baby by sharing truthful information about the risks of breastfeeding … as well as the benefits.