Yale School of Public Health breastfeeding group doesn’t seem to know much about breastfeeding

silly woman slapping hand on head having duh moment

It happened again! I wrote about something and activists rush to demonstrate exactly what I was talking about.

Yesterday I mentioned the rabid hatred that lactivists direct toward the Fed Is Best Foundation. With three little words, “Fed Is Best,” Christie del Castillo Hegyi, MD and Jody Segrave Daly RN, IBCLC have blown apart lactivist frames with a more accurate frame, one that doesn’t marginalize and silence women who can’t or don’t breastfeed.

The Becoming Breastfeeding Friendly group at the YSPH are apparently unfamiliar with the breastfeeding literature.

In other words, Jody and Christie (both of whom breastfed) are whistle blowers. And like most people who blow the whistle on any industry, they have been subjected to industry sponsored abuse

The Yale School of Public Health has joined the pile on. Surprisingly for a group of people who run a program called Becoming Breastfeeding Friendly, they don’t seem to know very much about breastfeeding.

Let’s state the situation is simple terms. Breastfeeding, which has been promoted as the optimal nutrition for all babies, is actually resulting in the iatrogenic brain damage and preventable deaths of babies. The breastfeeding industry, instead of moving to prevent these injuries and deaths, is reacting with fury.

As I’ve written in the past, it reminds me of the response of Merck when the news became public that Vioxx, a blockbuster pain reliever, was leading to preventable deaths: deny, defy and decry. In this case, they are attacking Kavin Senapathy,who wrote in Forbes about the World Health Organizations declaration that breastfeeding related brain damage and deaths are “not a priority.” Through her, they are going after the Fed Is Best Foundation.

The Yale authors write:

In Kavin Senapathy’s opinion article, the suggestion that the 2017 revised WHO Baby Friendly Hospital Initiative (BFHI) guidelines place newborns at risk of starvation or severe complications is not supported by the evidence of decades of research in the area of breastfeeding and human milk. We are deeply concerned because it could lead to serious misunderstandings for expecting parents and the general population.

The tactic of denial is typically the first step employed by Big Pharma when one of its drugs comes under attack. The drug company claims that the scientific research did not show that the drug was harmful. It’s as if we are supposed to pretend the deaths didn’t happen because they weren’t anticipated by the research.

In the case of Vioxx, the scientific research DID show that Vioxx led to unanticipated cardiac deaths; that research was suppressed. In the case of breastfeeding, the research DOES show that breastfeeding leads to unantipicated brain injuries and deaths; the members of the Yale Breastfeeding Friendly group are either unaware of that research or choose to ignore it.

They write:

We agree with the notion that we must acknowledge the existence of the problem of insufficient breastmilk. However, the article fails to consider that this problem, which is manifested as an inadequate supply of breastmilk needed to properly feed one’s baby (Neifert, 2001; Wilson-Clay & Hoover, 2013), is most often characterized by a phenomenon known as perceived insufficient milk (Safon et al., 2017; Segura-Millán et al., 1994). Also known as insufficient milk syndrome, in the vast majority of cases it is the result of widespread lack of access to both prenatal and postnatal optimal breastfeeding support and lactation management rather than primary biological reasons (Gussler & Briesemeister, 1980; Tully & Dewey, 1985).

Horrifyingly, the group is gaslighting women whose babies have been brain injured and died as a result of insufficient breastmilk. Lactivists have attempted to frame the problem of insufficient breastmilk as a figment of mothers’ imagination.

Sure, insufficient breastmilk is not a problem according to lactivist theory, but then Vioxx was not a problem according to Big Pharma theory, either. But just as in the case of Vioxx, in practice, insufficient breastmilk DOES injure and kill babies and the perception of insufficient breastmilk is NOT a figment of womens’ imagination.

Let’s look at the real evidence, not the theory.

Insufficient breastmilk is common, not rare.

In 2010, the Academy of Breastfeeding Medicine acknowledged:

It is important to recognize that not all breastfed infants will receive optimal milk intake during the first few days of life; as many as 10–18% of exclusively breastfed U.S. newborns lose more than 10% of birth weight.

There is a biomarker for insufficient breastmilk.

From a 2001 paper:

High levels of sodium in breast milk are closely associated with lactation failure. One study showed that those who failed lactation had higher initial breast milk sodium concentrations, and the longer they stayed elevated, the lower the success rate.

Insufficient breastmilk is NOT a figment of women’s imagination.

This was confirmed in a 2017 paper that also showed that women who felt they had insufficient breastmilk were more likely to have the biomarker present.

…[E]levated day 7 breast milk Na:K occurred in 42% of mothers with a day 7 milk supply concern, compared with 21% of mothers without a day 7 milk supply concern (unadjusted relative risk, 2.0; P = .008) (Table II). The unadjusted odds of elevated Na:K were 2.7 greater (95% CI, 1.3-5.9) with maternal report of milk supply concern (refer- ence = no concern, P = .01) and further increased after ad- justment for maternal ethnicity (3.4; 95% CI, 1.5-7.9; P = .003).

The potential brain threatening and life threatening consequences include kernicterus, hypernatremic dehydration and severe hypoglycemia.

Kernicterus, thought to have nearly disappeared, is making a comeback.

Dr. Lawrence Gartner revealed to other lactation professionals in a 2013 lecture, 90% of cases of kernicterus (jaundice induced brain damage) are caused by insufficient breastmilk.

The Academy of Breastfeeding Medicine reported in a 2017 paper:

In the U.S. Kernicterus Registry, a database of 125 cases of kernicterus in infants discharged as healthy newborns, 98% of these infants were fully or partially breastfed …

Neonatal hypernatremic dehydration is more common than SIDS.

From 2016 paper :

In a retrospective study in the United Kingdom, the frequency of breastfeeding-associated neonatal hypernatremia was found to be greater than all-causes combined of hypernatremia among late preterm and term newborns.81 In the mentioned report, the incidence of sodium level ≥ 160 was 71 per 100 000 breastfed infants (1 in 1400).

The consequences include death and potentially devastating neurologic injury as this 2017 study explains:

In our study 7 out of 65 patients died as a result of complications of hypernatremia. There was a significant correlation between severity of hypernatremia and mortality (p = 0.001). All who died had serum sodium concentration >160 mmol/L…

All infants in the control group were developmentally normal at ages 6 and 12 months, but in the case group 25% and 21% had developmental delay at 6 and 12 months, respectively. At 18 months the incidence of developmental delay was 3% for the control group and 19% for case group, and at 24 months 12% of case infants had developmental delay versus none for the control group…

Hypoglycemia also injures and kills babies.

A 2017 paper reports that the UK has paid out $250 million dollars for brain injuries due to hypoglycemia, nearly all cases the result of insufficient breastmilk.

I’m going to charitably assume that the Yale breastfeeding group is simply unaware of the depth and breadth of the literature on insufficient breastmilk and the brain injuries and deaths it causes. The alternative would be that the group is actively concealing the latest research findings in order to keep women in the dark about the deadly risks of breastfeeding.

They close their piece with a paragraph that would be laughable if the issue weren’t so serious:

Overall, an extensive review of the literature was warranted but not employed in writing this opinion piece. We need to provide mothers with high-quality, unbiased and uncompromised breastfeeding support both during and after pregnancy…

The people who failed to do an adequate literature review were the folks from Yale.

The bottom line, though, is this: If Yale School of Public Health group doesn’t have command of the breastfeeding literature, especially the latest scientific papers, they have no business criticizing those who do. Otherwise that criticism comes across the same ways as such efforts on the part of Big Pharma do: attempts to silence whistle blowers in order to keep market share.

  • David

    Why then Amy Tuteur wrote that “It is important to remember that
    there is no such thing as not enough milk” in How Your Baby Is Born (chapter 30)? Is breastfeeding-associated hypernatremia a recent discovery?

    • Claire

      Well I definitely know that I haven’t changed any of my own opinions in a 20 year time frame. No one ever does that. It’s completely unheard of. Everyone is utterly static and unchanging, so we can be sure that there’s a nefarious reason when someone states a different opinion at opposite ends of a 20+ year time span.

      • David

        It’s not a question of opinion. Medical information must be evidence-based. If the notion that “no such thing as not enough milk” never was supported by statistically significant data, it shouldn’t have been presented as factual by medical
        professionals, even 20 years ago.

        • momofone

          Crazy thought–sometimes evidence supports changing recommendations. I realize that requires stretching those mental muscles, but I think it can be done.

          • David

            True, but was there any (misleading?) evidence supporting the “no insufficient breastmilk” myth?

          • momofone

            Is your issue that Dr. Tuteur’s position was based on misinformation 20 years ago, or that it has changed?

          • David

            My issue is with myself (as a father supporting my wife’s devotion to breastfeeding), for believing without fact checking the information I read in “How Your Baby Is Born”. I should have looked for a more up-to-date reference (you can keep insulting me for that). Still, I’d like to know where the original statement of “there is no insufficient breast milk” came from and why I was misled.

          • Why did doctors back in the 70s tell parents that babies should sleep on their tummies? Ultimately, science is self-correcting, though that isn’t very comforting to laymen who’ve been given what turns out to be wrong advice. But that is why it is key for scientists and health professionals always to be updating their recommendations based on the best available evidence, and also to be transparent about just how evidence-based current recommendations are.

            Doctors themselves have been “misled.” Dr. Tuteur has noted that she bedshared with her children, and was only reluctantly brought around to the idea that bedsharing is dangerous by new available evidence. However, what she can do now is, in the face of the facts, state: My previous position was wrong. And she does.

            You might find this article interesting:

            https://sciencebasedmedicine.org/the-death-of-expertise/

          • It came from the teachers Dr. Tuteur had, as one does in medical school (or any university or post-graduate setting). It came from textbooks. It came from humans who were wrong, and that’s why we did studies to test that knowledge and learn more when we realized what “everyone knows” was not, in fact, accurately reflecting observed reality.

            You were not misled, at least not on purpose. You were wrong, because your expert source was wrong. She, and you, have now corrected that facet of the wrongness. Welcome to being human.

          • momofone

            I haven’t intended to insult you, and if I’ve come across that way, I apologize. I genuinely don’t understand your confusion about how things that might have been recommended based on available evidence (or not) 20 years ago may no longer be recommended. When my mother was pregnant with my brother, and with me, she was advised that she should continue smoking in order to keep our birth weights down. When I was pregnant, 30-something years later, that was not the case. I certainly don’t speak for Dr. Tuteur, but I don’t find the change in her perspective confusing.

          • fiftyfifty1

            ” but was there any (misleading?) evidence supporting the “no insufficient breastmilk” myth?”

            Yes. Incomplete evidence that was wrongly extrapolated. Breastmilk production DOES work in a demand and supply way when everything is going normally. For most women, the more you empty the breast, the more your production ramps up. Many women WERE having problems making enough milk when they fed on the every 4 hour schedule that bottle fed babies used. These supply problems WERE often corrected when women fed more often.

            So this evidence got extrapolated, and extrapolated too far. They started to assume that since most supply problems could be fixed with more frequent feeding, that ALL supply problems would be fixed with more frequent feeding, that insufficient breastmilk was a myth.

            It’s similar to what happened with cholesterol. For a time (maybe even still) there was an over-focus on diet being a cause of high cholesterol. An improved diet will help the majority of people, but for those with genetic anomalies of the cholesterol pathway, diet will have little to no effect.

        • Amy Tuteur, MD

          It’s still presented as factual even though we have ample evidence of babies being brain injured and dying as a result.

    • Amy Tuteur, MD

      That’s what I was taught, a lactivist lie. I wrote about my regret last year:

      “I have very few regrets about the years that I practiced medicine, but there is one thing that makes me embarrassed every time I think about it.

      I was taught that “all breastfeeding women make enough milk.” It was a lie, but I didn’t know it at the time. My experience of breastfeeding my own children did nothing to disabuse me of this falsehood. I had a booming milk supply when I breastfed my own children, routinely pumping 10 oz. at each session.

      The consequence was that I counseled women to breastfeed without giving them accurate information to help them. Even worse — and this is the source of my guilt — though I never told anyone outright that I thought they were lying about low milk supply as an excuse to stop breastfeeding, I didn’t believe them. I’m ashamed to think that when I should have offered support, I offered judgment instead.”

      http://www.skepticalob.com/2016/06/you-get-what-you-expect-rachel-obrien-ibclc-and-the-psychology-of-low-milk-supply.html

  • Snapdragons

    Please do not judge me harshly for this. I come from an immigrant family. Breastfeeding is the norm for the women in my family, and the culture in which they were raised.

    To put it bluntly, there were no other good options

    My aunt told me the story of how after two months of exclusively breastfeeding her first child, she became ill, her milk supply dried up completely, and she was unable to continue. She had to switch to formula. This was by no means a convenience. She had too travel several hours to the nearest city where she could buy imported formula. She had to find money to buy the formula, which meant going without basic necessities like shoes. And she had limited access to water and electricity, which made cleaning bottles and mixing formula a real PITA. And she never spoke of this with anyone but her husband, because she felt great shame at not being able to feed her child.

    She wanted me to know this story, so that I would not feel alone and ashamed if I, too, could not produce milk for my baby.

    Now that I live in the US, and I am pregnant with my first child, I hear breastfeeding promoted everywhere I go. When I see the nurse practitioner for prenatal care, I am asked if I plan to breastfeed and receive a lecture on the importance of breastfeeding exclusively. When I see the OBGYN specialist, the same. When I see the local social worker at the public clinic, the same. At the WIC office, the same. At the local hospital’s childbirth and newborn care classes, the same. To attend the state-sponsored support group for new mothers, I have to sit through a two hour class on the importance of breastfeeding. When the baby is born, they send a lactation consultant to the hospital, and then again a week later to do a home visit.

    By the time my baby is born, I will have sat through over thirty separate lectures or classes on the importance of exclusive breastfeeding. I will have been questioned over thirty times about if I plan to breastfeed exclusively.

    You know what I have not heard, even once? An answer to my question of what happens if I cannot produce enough milk, or when to take my baby to the clinic if we have feeding problems. Instead, I am handed a phone number to call to find a lactation consultant.

    I also find it extremely condescending that at the public clinics, new mothers are asked if we have ever even considered breastfeeding. Most women there come from similar backgrounds. Of course we have considered it. Our mothers did it out of necessity, and most of us would avoid the extra cost of formula if we could.

    But you know the saying – wish in one hand, spit in the other – sometimes our best intentions don’t work out. I don’t understand the refusal to even talk about the possibility of using formula. It’s taboo to say. 🙁

  • MaineJen

    Oh FFS. “Silly little woman, that starving baby is all in your head!” “You may *think* you’re not making enough milk, but you’re not educated enough to know better!” “You don’t need formula! Here, have some more support instead.”

    Paternalistic, much?

    • Lilly de Lure

      It’s an interesting (if depressing) phenomenon isn’t it. The whole original point of a lot of feminists promoting the Natural Childbirth stuff in the late 60’s-early 70’s was to give women a say in how their birth was managed rather than having them completely in the power of a one size fits all medical model. 40 years on and what have we got – pregnant, labouring and post natal women are STILL being disregarded, disrespected and slotted into a one-size fits all model, but this time it’s (mostly female) midwives and lactivists calling the shots. We’ve gone straight from being bossed around and shamed by a patriarchy to being bossed around and shamed by a matriachy without drawing breath.

  • Allie

    “Overall, an extensive review of the literature was warranted but not employed in writing this opinion piece. We need to provide mothers with high-quality, unbiased and uncompromised breastfeeding support both during and after pregnancy…”

    Are they actually serious? This is like saying “la la la, let’s all bury our heads in the sand and hope everything works out,” or “let’s not review the literature, we don’t want a little thing like reality get in the way.”

    • CSN0116

      This is not a well-written response by Yale. Spelling and grammatical errors abound, not to mention content.

      That said, I *think* what the authors are saying here is that, “Overall, an extensive review of the literature was warranted but not employed in writing this opinion piece.” is actually in reference to the *Forbes* piece and NOT in reference to what they have authored here.

      I think this because the Yale authors refer to Kavin Senapathy’s Forbes piece as opinion. I don’t think they view this piece as an opinion piece of their own. In short, Kavin was giving opinion; they are sharing fact (according to them).

  • namaste

    Here’s a message for the folks who spend their lives obsessing over how people they’ve never met feed babies they’ve never seen: Get a hobby, Join a book club, Play a sport, just for christ’s sake, GET A LIFE. You need one. In a major way.

  • Empress of the Iguana People

    Bf’ing is fine. Formula is fine. Mixing the two is fine. These well-meaning, oblivious fools’ attacks are not fine.

    • Tigger_the_Wing

      Exactly. I once saw an ‘infographic’ purporting how to tell the difference between a bottle containing expressed breast milk and one containing formula, presumably so that the reader would know not to criticise the woman using the former.

      When I told my daughter this, her response was “If you filled the bottle, then it contains whatever you put in it. If you didn’t fill the bottle, then it’s none of your bloody business!”

      • No, no, you still judge the woman for giving her baby a bottle, because direct breastfeeding is better than pumping. The WHO says so! But you have to differentiate between the Slightly Inferior Mothers and the Really Bad Mothers, which is why you carefully examine total strangers’ bottles. You need to know how much sanctimony is appropriate.

        • Tigger_the_Wing

          Sigh. I’ll never get the hang of this, will I? Wrong mindset altogether. After all, all five of mine got whatever they (and I) needed, and so not all of them were exclusively breast fed for thirty years.

        • Who?

          Sounds exhausting.

          Minding one’s own business is restful, though I see for some people it could take practice.

          I’m aware of the irony in suggesting others should mind their own business as we pile on Yale’s bit of nonsense, but if Yale wants to publish, Yale can live with both any credit they are offered, and some blowback.

          • Tigger_the_Wing

            Piling on Yale for their nonsense is exactly what we should do. They’re the ones not minding their own business. They should stay out of promoting something that they have admitted they know nothing about.

          • Yeah, I’m thinking that publishing a paper is a little different than filling a bottle for a baby.

          • Tigger_the_Wing

            Coming up: an infographic to help nosy parkers be able to tell whether the water in that toddler’s cup is organic spring water from the Himalayas, or evil GMO tap water.

            Perhaps I shouldn’t have typed that. If I can imagine it, so might they.

          • Roadstergal

            Oh god, I just realized that there is probably Non-GMO Project Verified WATER out there. :/

          • Heidi

            I know our co-op sells alkaline water and I betcha it’s got a Non-GMO label on it. Nah shit.

      • CSN0116

        How are the natchurals and lactivists not troubled by expressed milk? How is it acceptable (to most of them, I know the hard-cores only accept from-the-tap)? How is it acceptable in public health campaigns? How is it “as healthy”?

        Expressed milk undergoes a ton of chemical changes just via collection. Then it is put into plastic bags and bottles, which seep chemicalz into it. It is is cooled, frozen, re-heated …all the while fucking with it. It is only “good” in a freezer for so long. This indicates that it “loses” stuff over time, and a bag of breast milk sat frozen for 2 days is “better than” a bag sat frozen for 2 months. It is shaken all around. And breast milk is this ever-changing thing, “designed for a baby’s specific in-the-moment needs,” then how is feeding something a week or month old sufficient? How is feeding donor milk sufficient? And that’s before we even delve into the lack of baby-to-mother contact which is purported to facilitate all the “bonding” and “IQ” stuff.

        • Tigger_the_Wing

          Well, if they didn’t encourage expressing, how else would they ensure that mothers spend all their time thinking of nothing but breast milk?

          It’s a religion. Religions are full of contradictions that believers simply hand-wave away.

        • oscar

          Yes, the chemicalz. I loathed breast feeding but because my second child was so small (2.5 kg at term – placenta was fine, doc said he was “small but perfect” and that since my girls were both 3 kg I probably just make small babies) I pumped for a few months “just in case”. I had oversupply so we stored some in freezer bags, about 5 L worth. We NEVER used it because when we defrosted a bag, it tasted and smelled HORRIBLE. We didn’t even try to give it to our son.

          • Young CC Prof

            Apparently some women have breast milk that is high in lipase, which changes the taste a lot if expressed and stored.

          • swbarnes2

            Yeah, apparently there some kind of test you are supposed to do before building a stash like that…and if your milk has too much lipase, you need to heat inactivate it before freezing.

            I’m pretty sure the heat required to denature the lipase is going to be not so great for the antibodies either. It’s not like breastmilk evolved to have molecules that are resistant to scalding, since scalding and freezing breastmilk is obviously really unnatural.

          • Roadstergal

            That’s actually been looked at… 😀 JOURNAL OF FOOD SCIENCE—Volume 62, No. 5, 1997. IgG is the most stable, soluble IgA next, soluble IgM the least (from someone who has pulled her hair out trying to purify intact IgM, it falls apart if you look at it). Um… depends on the heat inactivation conditions for lipase, then.

            Interesting that the paper calls out rotavirus protection from soluble IgA as a key benefit to breast milk. “An effective vaccine against the human serotypes of rotavirus has not yet been developed.” Well – done, then!

          • oscar

            Yes, as two immunologists, if we’d known that we’d have to scald the milk before freezing it, we would have just chucked it all away!

          • oscar

            Wow, how interesting. We thought it was the plastic bags!

      • KeeperOfTheBooks

        Preeeecisely. And then the only appropriate questions are “Would you like to feed baby in this chair? It’s more comfy,” or possibly “Can I get you some water/coffee/tea/wine while you get Junior his dinner?” (Come to think of it, those are also about the only appropriate questions if mom’s getting ready to nurse Junior, either.)

  • Young CC Prof

    Do lactivists even hear themselves? If a woman went to a male doctor, complaining of extremely painful periods, and was told that she had “perceived dysmenorrhea” and that she needed more community support to get over her shame about menstruation, I bet these researchers would write an article fit to skin that doctor.

    But that’s exactly what they say to women who complain about insufficient milk, with clear and measurable evidence of excessive neonatal weight loss or poor growth.

    • AnnaPDE

      I get your point, but “well, menstruation is painful, take some Ibuprofen early on to take the edge off and otherwise suck it up” is still pretty standard advice.
      The old, male, and slightly paternalistic IVF specialist I saw for conception difficulties was the one who picked up on my endo after years of worsening periods, and suggested to get rid of that first. (He ended up only getting to bill that surgery, as it made all the expensive IVF we were planning on unnecessary… Talk about working himself out of a job.)

      • Who?

        It’s sad that’s still standard. I was told in my late teens, (back in the late 70s) by the family doctor, to take aspirin and learn to control my temper.

        So I did that for a bit while I was still at school. My mother was of the view that I’d fallen into a bad mindset about my period and if I was just a bit more stoic it would bother me less.

        Then when I went to uni realised everyone had easier, less painful, lighter, shorter and more regular periods than I did, so I took myself off to the free clinic, aged 19, where my close to 35 year love relationship with the contraceptive pill began. That thing revolutionised my life, as a Mirena and hrt are now doing.

        • FormerPhysicist

          That’s still being told. Well, ibuprofen is recommended instead of aspirin. I had to push for my teen to be put on hormone regulation (aka the pill) and I really think they did it only because they expect her to become sexually active.
          But two to three days a month lost for period pain isn’t okay.

          • EmbraceYourInnerCrone

            I got them to put my daughter on the Pill when she was 15, she had such heavy periods and such painful periods that she came close to passing out the first day of her period every month( I was the same and so was my mother)
            I wish someone had done the same for me, I finally got the Pill when I was 20 and it was awesome. DEvo Provera for all it’s side effects was also awesome – no periods YAY!

        • Lilly de Lure

          Yep, still the standard advice – it’s taken me 20 years of complaining about menstruation pain (vomiting, passing out – the works) to get someone to take it seriously enough to refer me for a proper gynae appointment for them (I tried the pill but it plays havoc with my seizures so no dice for me there). Although in the meantime they’ve upped the ante on painkillers so that’s something – although living on tramadol 3 days a month when working and looking after a 1 year old is not exactly ideal!

      • Young CC Prof

        I think the worst problem isn’t the doctors who perpetuate that thinking, but the women who never go to a doctor at all because they think what they’re experiencing is normal and unavoidable. I was 30 years old when I learned that, although some “moodiness” is normal, feeling like you are at the bottom of a black pit for several days beforehand isn’t. No one ever observed the premenstrual depression, only the irritability that resulted from pushing through it to try to act normally, and it never occurred to me to mention it.

      • KeeperOfTheBooks

        I know it sounds odd, but I adore my older, male, and slightly paternalistic OB. He’s paternalistic in the sense of “old enough to be my dad, and genuinely cares very, very much about his patients and babies like you’d expect a good dad to,” not in a patronizing way–basically, a bit like you’d expect in a functional parent/adult child relationship. I even put up with the asinine BFHI hospital at which he delivers in order to keep delivering with him. (His outright rudeness about their BFHI policies does help. *snerk*)

      • Zeldacat

        Never have or will breastfeed but I know the difference between manageable period pain and the horrific sort. My friendly largish fibroid is the probable cause and thank the Divine the ultra low-dose pill takes care of pain and heavy periods. I thought for years that my body just hated the pill (tried a bunch but had problems with them all) but they hadn’t invented this one yet.

        Also thanks to my doc who doesn’t see why I should have more periods (or fake ones) if I don’t want to and worked with the pharmacist to prescribe me enough packs to go a few months at a time. My insurance company didn’t want to but we fooled them!

        • AnnaPDE

          That’s awesome. I’ll keep that pill on the radar, though Dr Kitty’s mention of Qlaira really works well for me right now.

    • Dr Kitty

      Look, here’s how I see both BF and period pain.

      Most women have minor pain and manage, so if you’re seeing a doctor it is fair to assume that your pain is severe and you are not managing. There may be pathology, there may not be, but if we start from the POV that your experience suggests a problem it is more helpful than if we ignore and minimise your experience and insist there is no problem.

      So I’m happy to prescribe hormones and painkillers and arrange imaging and gynae assessments for the patients who complain of severe period pain, and I believe women who tell me that they aren’t making enough milk despite their best efforts and support them with combo feeding or EFF (and sometimes even work out that their best efforts are self sabotaging and suggest some things they can try so they can BF more, for longer).

      It’s not helpful to tell women with endometriosis that most women have manageable periods, and it’s not helpful to tell women with insufficient milk supply that most women breastfeed easily when they have some support.

  • Natalya Soshnina

    Thanks for this post!