Oops! Breastfeeding nearly doubles the risk of newborn hospital readmission

Newborn child baby having a treatment for jaundice under ultraviolet light in incubator.

For lactivists, breastfeeding occupies roughly the same place as Earth occupied for medieval Catholics in the geocentric theory.

The idea that Earth was the center of the universe was accepted an incontrovertible proof of the importance of man in God’s plan. Never mind that as scientific instruments improved it became increasingly clear that Earth and the other planets revolved around the sun. The medieval Catholic Church clung to the geocentric theory and persecuted those who opposed it because if the Bible were wrong on that point, the faithful might waver in their belief. The laity were instructed to ignore scientific evidence in favor of doctrine.

Aggressive breastfeeding promotion could lead to 60,000 excess newborn hospital admissions at a cost of nearly a quarter of a billion dollars each year.

Similarly, breastfeeding is the center of the mothering universe for lactivists, accepted as incontrovertible proof of the importance of “natural” mothering to Nature’s plan. Never mind that study after study has failed to demonstrate the purported lifesaving benefits of breastfeeding and a growing body of scientific literature is making it clear that aggressive promotion of exclusive breastfeeding has substantial and deadly risks. Lactivists — and the organizations they have captured like the World Health Organization and the Centers for Disease Control — have clung to the belief that breastfeeding has major, lifesaving benefits despite all evidence to the contrary. The faithful are routinely instructed to ignore scientific evidence in favor of doctrine.

The latest addition to the scientific literature is Health Care Utilization in the First Month After Birth and Its Relationship to Newborn Weight Loss and Method of Feeding by Flaherman et al. The results are startling.

Exclusively breastfed newborns had higher readmission rates than those exclusively formula fed for both vaginal (4.3% compared to 2.1%) (p<0.001) and Cesarean deliveries (2.1% compared to 1.5%) (p=0.025). Those exclusively breastfed also had more neonatal outpatient visits compared to those exclusively formula fed for both vaginal (means of 3.0 and 2.3, p<0.001) and Cesarean deliveries (means of 2.8 and 2.2, p<0.001)

Aggressive breastfeeding promotion is making babies sick, so sick that they need to be readmitted to the hospital.

We had data on inpatient feeding for 105,003 (96.6%) vaginally delivered newborns and 34,082 (97.0%) delivered by Cesarean. Among vaginally delivered newborns, readmission after discharge from the birth hospitalization occurred for 4.3% of those exclusively breastfed during their birth hospitalization and 2.1% of those exclusively formula fed during their birth hospitalization (p<0.001)… For Cesarean births, readmission occurred for 2.4% of those exclusively breastfed during the birth hospitalization and 1.5% of those exclusively formula fed during the birth hospitalization (p=0.025)…

This was not an anomalous finding. Breastfed infants had more outpatient visits as well.

Those exclusively breastfed during the birth hospitalization also had significantly more outpatient visits in the first 30 days after birth compared to those exclusively formula fed during the birth hospitalization for both vaginal (means of 3.0 and 2.3, p<0.001) and Cesarean deliveries (means of 2.8 and 2.2, p<0.001)…

In addition to the pain and suffering of the newborns and anguish of the parents, a tremendous amount of money was spent.

…[S]ince the cost of a neonatal readmission has been estimated at $4548.27 a potential savings of $7.8 million might be realized for a cohort similar to ours if the readmission rate of exclusively breastfed newborns approximated that of newborns exclusively formula fed.

To put that in perspective, with 4 million births each year and more than 75% hospital breastfeeding rates, that means we should expect 60,000 excess newborn hospital admissions at a cost of more than $240,000,000 each and every year — nearly a quarter of a billion dollars. And that doesn’t even count the downstream impact of brain injuries, a consequence that was beyond the purview of this study.

These are impressive results of significant harm, made even more disturbing by two important facts.

1. The excess hospitalizations represent iatrogenic insults and injuries.
2. The excess hospitalizations could have been easily avoided by liberal formula supplementation.

We caused this harm and we could easily prevent it.  All it would take is a bottle of formula. That’s what the data shows, but that’s not what the authors suggest.

… Such short-term adverse consequences of exclusive breastfeeding may be viewed as representing an acceptable tradeoff given the magnitude of its reported benefits.

What reported benefits? Where is the evidence that breastfeeding reduces hospitalizations, saves lives or saves money? There is no evidence; countries with the highest breastfeeding rates have the highest mortality rates and vice versa. No one can show that changes in breastfeeding rates have any impact on mortality rates. The belief that breastfeeding has lifesaving benefits — benefits that would represent an acceptable tradeoff for 60,000 additional newborn hospital readmissions and nearly a quarter of a billion dollars in healthcare spending — is an article of faith, just like the geocentric universe.

And just like the geocentric universe was promoted by religious leaders who felt they needed it to preserve religious “market share,” the purported benefits of exclusive breastfeeding are promoted by lactivists who also feel they need it to preserve market share.

Lactivists could and should learn the lesson that religious leaders learned: no amount of lying or wishful thinking about the geocentric universe changed the fact that the sun is at the center of the solar system. And no amount of lying by lactivists about the “benefits” of breastfeeding changes the fact that the benefits are trivial, the risks of aggressively promoting breastfeeding are substantial and — unacceptably — babies and mothers are entirely preventable casualties of putting belief before science.

  • Peter Harris

    Perhaps this website should be called the “Dangerous and Foolish OB.”

  • Mariana

    I have enormous guilt that I could have killed my first child because I wanted to breastfeed so badly! She was still losing weight at 14 days! I honestly thought I was doing what was best for her… I used sns to feed her for 6 months, with formula of course, I had almost no milk. She is nearly 7, the smartest kids I have ever seen (and I’m not just saying that because she is my baby). I am so blessed she wasn’t harmed by my craziness.. it could have gone very differently…

    I learned my lesson. Her brother got a liberal amount of formula supplementation and was combo fed until 9 months.

  • ukay

    OT, but related: How are the so called bf-friendly techniques like finger feeding or cup feeding any less confusing to an infant? To a lay person like me, they appear more confusing. Cup feeding seems to be a different mechanism and the babies cannot really regulate their intake with the fingerfeeding? The feeder would have to keep an appropriate speed.

    • yentavegan

      Because these hospitals have on paid staff IBCLC’s who have to justify their line item on the yearly budget and therefore they over intervene , creating more issues than they were originally approached to solve, hence overuse of nipple shields, finger feeding, cup feeding, sns, breast pumps, diagnosis of tongue tie and torticollis..oh the list goes on.

  • Amazed

    OT: Our good not-rapist Brock Turner is appealing his verdict! How did I miss this precious bit of information?

    This case was beyond disgusting.

    • MaineJen

      He needs to go away forever.

      • Charybdis

        And stay there.

        • Merrie

          I’d like to sentence him to a permanent job cleaning gas station bathrooms on the graveyard shift.

  • Zen

    …are you kidding me?

    In no other place in medicine is such a high up-front risk of complications for such a minuscule established benefit considered “an acceptable tradeoff”. These authors need to take a long, hard look at their biases.

    • Daleth

      On a serious note, are there any MD’s here (or MPH’s, or similar) who are planning to write to the journal that was published in to point out the complete insanity of that conclusion?

      • CSN0116

        This should be like a change.org thing. In that, someone drafts a letter to the editor and several academics and physicians can attribute their name to it before it is sent off.

        Emotional appeal from some fed is best “real-life” starvation stories should also be sent to this editor.

        • Daleth

          Yes. That would be great. Is anyone doing this? I don’t have the credentials on the one hand, or the personal experience on the other (I combo fed from day 1 and eventually went EFF), to credibly do this myself.

          • CSN0116

            I don’t know that one has to be terribly credentialed. It’s basically telling the editor that the conclusion that was allowed to be published is an abomination to the study’s very own findings. It is offensive, callous and has the potential to do great harm. He/she needs to consider redacting it, or heavily modifying it. Then he/she needs to be told to select their reviewers much more carefully. If they allow authors to suggest reviewers (as many do), then they may want to better patrol that policy.

            If I can get a few spare moments I’ll do it lol.

          • Daleth

            Oh please do! That would be great.

  • The Bofa on the Sofa

    Maybe not polite enough, because the next morning, they brought baby in with some story about overfeeding her formula and having to tube some of it back out.

    Huh?

    If babies eat too much, they spit it up. If they don’t do that, how can you say they ate too much?

    Of course, it’s not like breastfed babies don’t eat too much. One of my baby stories is when I was visiting a friend on New Years Eve, and they had a baby born Thanksgiving weekend. So 5 wks old or so.

    She had just fed the baby, I was holding it, suddenly the baby went with projectile spewage. I mean, volcano level spewage. I was able to catch it all in the blanket, but man did it all come right back out.

  • Young CC Prof

    240 million dollars. And 60,000 hospitalizations per year. This is stunning. An article in any other area of medicine finding so many preventable complications and hospitalizations would end with a ringing call to action. This one ends with a thud.

  • aurora

    And this is why I am packing a bag of ready to feed formula for my c section in May.

    • Hannah

      I did the same. Couldn’t breastfeed due to lupus medications, but just in case they gave me crap. We didn’t use it, but we did end up giving it to the couple next to us on the ward after the hospital starved their baby into collapse twice in a row. I now tell everyone to always pack formula. Would never trust a hospital to give it after that.

      • Roadstergal

        Holy shit. It’s utterly unconscionable that these things happen in the ‘civilized’ world.

    • ukay

      Excellent idea! After secretly feeding our baby formula a nurse, who had shamed a mother the day before for not breastfeeding, praised us for intervening before it got „dangerous“. As if it wasn‘t actually their job! Still aghast at this negligence.

      • ukay

        Wanted to add that it is really shameful that we have to resort to those measures though.

  • MeMe

    Maybe these costs will prompt insurance companies to do something about it, if there’s anything that can be done.

    • AndreaRealMPH

      I’m not optimistic. The lactivists have convinced the insurance companies that breastfeeding saves zillions much later in life.

      • Roadstergal

        Let’s send this paper to our insurance companies?

  • Ash101

    What the fudge kind of conclusion is this? Who the hell are Flaherman et al. that they can seriously call this an “acceptable tradeoff!!???”

    How can they just say, ‘oh, babies fed in this manner have to go to the hospital more, no biggie,’ and ignore the fact that people go to the hospital because THEY ARE SICK, IN PAIN, or in some other sort of mental/physiological DISTRESS.

    Seriously. I do not have time for these “scientists.” They are a joke to their profession and to human decency. SMDH

    • NoLongerCrunching

      I was very surprised by her saying this. She is highly supportive of babies being fed adequately (see her study on Early Limited Formula Supplementation). My guess is that it was put in there for two reasons — 1: so that lactivists who have a lot of power will be placated enough take it seriously, and 2: that it is a tongue in cheek way of highlighting the absurdity of the idea that hospitalization is a reasonable tradeoff for EBF (note the term “reported benefits” of EBF rather than “benefits”).

      • Tigger_the_Wing

        Oh, I do hope it was sarcastic!

  • LaMont

    OT: Still sorta squeeing about this: https://www.nbcnews.com/news/world/new-zealand-prime-minister-jacinda-ardern-announces-pregnancy-n839051

    Yay for women demanding the support in the workplace and home that they need and deserve! Yay for a young, non-religious woman kicking ass!

    I hope everything goes well for the second head of government to ever give birth in office!

  • mabelcruet

    I went to my ‘Controversies in Obstetrics’ study day (and kept quiet because I’m not an obstetrician). One of the sessions was about infant weights and looked at the differences between reference charts, like the Chitty charts, and standard charts (the whole thing was about Intergrowth 21 vs GROW optimal weight assessment). Anyway, the speaker declared ‘Breast is best’ to absolutely no discussion or argument (audience 99% midwife or obstetric, and me), and then said, and I paraphrase slightly: the USA CDC infant weight reference charts are all wrong, because their babies are mostly bottle fed and we all know bottle fed babies are fat, so their reference weights are too high and actually show infant obesity, not ideal infant weights. Hmmm….

    • BeatriceC

      We need an eyeroll react here.

      • mabelcruet

        I honestly don’t know enough about the mechanisms for estimating fetal weights in clinical practice, I can barely get my head round all the Hadlock methods etc, but to me it was a very black and white statement-American babies are bottle fed and are fat, so disregard the CDC ideal weight references because they are wrong. As a pathologist I weigh and measure everything, but its not the absolute weights that count, its the ratios (brain weight to liver weight ratio, placental weight to fetal weight ratio) that count, but I have to be very careful to include references in my commentary because all heck breaks loose if I call the baby IUGR or SGA when the obstetrician or midwife hasn’t.

        • BeatriceC

          Oh! I’m sorry if I wasn’t clear. The eyeroll reaction was for the stupidity towards the CDC charts, etc., not at anything you said or thought.

          But yeah, there may be problems with the CDC growth charts, but being based on formula fed babies isn’t one of them.

          • mabelcruet

            No, I understood what you meant by eyeroll, don’t worry-I know you weren’t getting at me! I’m sure my eyes rolled at the comments the speaker made-even from my very limited knowledge about living baby weights I thought the conclusions reached seemed rather generalised and a bit of a leap

          • Dr Kitty

            But the UK doesn’t use CDC growth charts!
            The red book and every paeds Ward I have ever been in used the newest WHO charts based on EBF infants!

    • Roadstergal

      Yes, we all know that the hot dogs and hamburgers in formula make US infants obese.

      I’m sure if they were challenged on the ‘mostly bottle fed,’ they’d move the goalposts to make it true (excluding babies who got anything in addition to breastmilk before one year, and excluding babies who get breastmilk in a bottle, hey presto).

    • MaineJen
      • Aww, so cute!

      • mabelcruet

        I just made a very high pitched squeaky noise! Those chubby cheeks are just so squishable

        • MaineJen

          I miss his little sausage fingers. 🙂 He’s 8 now.

      • The Vitaphone Queen

        AWWWWW!!! MESSY HAIR AND A WINNIE THE POOH DIAPER!!!

      • The Vitaphone Queen

        Hey, MaineJen, now that he’s 8, does he like Pooh? Please don’t tell him I asked this. Unless he does like Pooh.

        • MaineJen

          He went through a Pooh phase a few years ago; now it’s all Minecraft, Lego and YouTube videos (yes, I do monitor, don’t worry) 🙂

          • The Bofa on the Sofa

            That sounds exactly like our 9 and 7 yos.

            Put it all together and they are watching Lego Minecraft videos on YouTube. Which we’ve done.

          • Tigger_the_Wing

            Sounds just like my 6- and 7-year-old grandsons. I had no idea how much Minecraft Lego there was out there, until this Christmas. Now it’s all in here…

    • Caylynn, RD, MPH

      Here in Canada we reject the CDC charts because they don’t match the Canadian population, and, if I’m remembering my undergraduate nutrition assessment course correctly, are (were?) based on cohorts from the late 70s, when most babies were formula fed, and the growth rates of formula-fed vs breast-fed babies were different. But that was so long ago, that maybe I’m not remembering the correct details.

      We used the WHO growth charts, adapted for Canada, up here in Canuck land. The WHO charts seem to work pretty well – the referrals I receive for failure-to-thrive are appropriate and I don’t receive referrals for babies at the 97th+ percentile for weight when they are only at the 3rd percentile for length until they are at least 15 months. Some physicians become concerned at that point, especially when a quick nutrition check indicates the 15 month old is receiving mostly “junk” food at that point.

      WHO growth charts adapated for Canada for the curious: https://www.dietitians.ca/Dietitians-Views/Prenatal-and-Infant/WHO-Growth-Charts/WHO-Growth-Charts-Set-1.aspx

    • StephanieA

      Whaaaa? My oldest was purely formula fed and was getting frequent weight checks at a year because he was so skinny (he’s fine). My younger son is huskier, it’s almost like genetics matters. And won’t babies just throw up when they overeat? Also, I work with nurses who have massive breastfed babies, like 30 lbs at a year. No one tells them their babies are too fat, because it’s breastmilk!

      • seenthelight

        One of my breastfed daughters was a ham hock, while the other was the tiniest thing. Genetics indeed.

        • Merrie

          Well, my combo-fed baby is a real porker and his EBF siblings were not as big. He was born weighing almost 9 lbs while the other two were right around 7 1/2 lbs, and he has continued on that growth curve, and the reason he’s combo fed is because I couldn’t keep up with the amount he wanted to drink. He has a giant appetite so he got formula, rather than getting formula and it making him big.

      • Lilly de Lure

        Mine too (although he was IUGR to begin with), happily on the 30th percentile now, albeit still a stringbean but so muuch for the too fat EFF baby!

    • asrai

      Even the CDC admits using the WHO charts for infant is better.

      https://www.cdc.gov/growthcharts/who_charts.htm

    • Wren

      My first, breast milk only as a baby, tended to be above 97th percentile for height at around 75th for weight. He’s still tall for his age and neither skinny nor fat. My second, breast milk only as well as she wouldn’t even consider a bottle of breast milk let alone formula, was 1 lb smaller than her brother at birth (and shorter) and over 1 lb heavier than his weight at the same age by 12 weeks. She’s generally been around 50th percentile for height and weight, though as a very active kid (currently involved in 5 sports!) it’s mostly muscle.

      I am pretty sure the differences in height and weight between my two are down to genes, not what they ate as babies.

      • Tigger_the_Wing

        My five were a mixture; some got supplementary formula whilst in the special care unit, some didn’t. Some had no formula at all, some switched to formula after being breast fed for a while. They range in age from 25 to 36, and I defy anyone to tell by looking which was which. I’d even supply baby photos, but they wouldn’t help either.

        As well as the wide age range, there is also a wide range of heights. A pædiatrician once told me that my kids could turn out any height at all, since I’m on the 95th centile for my age, and my husband is on the 20th (we’re almost the same height). Our shortest son is 5’7″ like me, the tallest is 6’2″. It is definitely down to genes – I’ve had no control over their diets for many years! Oh, and they were all registering as underweight for their heights, regardless. When you have more than one kid above the 95th centile for height and on the 3rd for weight, people tend to notice – and then they observe the same ratio in their Mum (and their Dad, although not that tall, is also very skinny) and they just sigh. Our food bills were huge when all five lived at home. They could eat like horses and not gain weight. All sporty, of course.

        • Peter Harris

          Clearly, you know nothing about Genetics.

    • maidmarian555

      I have made the mistake of over feeding my babies at different times. My son was with breastmilk, the incident with my daughter was with formula. On both occasions, they spewed the excess milk right in my face. My son sprayed it out of his nose directly into my mouth! Overfeeding an infant is not a mistake you make repeatedly, I can assure you.

  • Zornorph

    Hey, at least those babies didn’t get their gut cherries busted.

  • Resident

    My head exploded when I read that conclusion

    • CSN0116

      It’s devastating to read.

  • CSN0116

    And according to Minchin, a quarter of a billion dollars pales in comparison to the cost of treating NEC as a result of formula feeding.

    Just so we’re all clear here.

  • CSN0116

    Their concluding paragraph made me throw up in my mouth.

    Another thought: so we just showed that cesarean-born babies are less likely to be readmitted to a hospital and have less doctor visits within 30 days post-birth. Win for cesareans! That’s what I took from this LOL

    • Young CC Prof

      I would guess that’s just because c-section mothers have a longer initial stay.

      • CSN0116

        Yeah yeah, that’s the plausible explanation 😛 I like the “c sections are better” one lol

      • CSN0116

        And isn’t that amazing on its own? That we boot moms and babies before lactation is established/problems can be identified or flushed out and leave them to their own devices with the shittiest advice ever that “all women can breast feed” and “just keep putting baby to breast”.

        No wonder it results in a shit show of re admissions.

        • Caylynn, RD, MPH

          Yes! And in primary care (which is where I work), the dietitians and family doctors (or nurse practitioners) have a heck of a time convincing mothers to supplement when it’s necessary, because they’ve been taught that formula is evil and breast is best. Even when their infant has been diagnosed as failure-to-thrive. Granted, since I work with marginalized and vulnerable populations, there are often other issues at work with failure-to-thrive, but not wanting to supplement plays a huge role.

          Then there are the moms on domperidone who are having side effects but insist on staying on it because of the whole breast is best brainwashing they’ve received.

          • CSN0116

            Simply tragic.

        • Young CC Prof

          My son was readmitted the day after discharge. With my daughter, I was obviously much better informed, the pediatrician was watching her extra carefully for jaundice, and she would have been fine even with early discharge, I think.

          However, that’s not what happened. I developed complications after delivery and we had to stay 5 days. So many things about that were horrible, but the one thing that I really liked about staying longer was that by the time we went home, her weight was going back up and her jaundice was nearly gone. Her body had clearly figured out how to live on the outside.

      • AnnaPDE

        But that’s sooo horrible for those poor C section mums! You have yo escape the scary hospital with its terrible nurses and evil doctors as soon as possible. Every minute you stay longer impacts your “good mum” score.

  • Emilie Bishop

    Did I read that right? Did they actually say that hospital readmissions of starving newborns is an acceptable trade-off to achieve higher breastfeeding rates? Have these assholes ever had THEIR newborn readmitted? Have they felt like abject failures as parents for not feeding their baby “the best” or for not recognizing the signs of starvation or of my own inability to produce milk (even though both were deliberately withheld by the hospital)? In what universe is any of this acceptable for ANY reason?

    • KeeperOfTheBooks

      And the sheer logistical factor of readmission…ugh!
      One friend had a newborn readmitted due to jaundice the day they were discharged. (Long story involving idiot lactivist nurse.) Mom spent her recovery from birth lying on a folding cot next to the kid’s biliblanket, while stressing about how her disabled mom was going to continue caring for the two older kids because husband/daddy had zero paternity leave and had to be back at work.
      An ideal recovery, I don’t think.

      • Emilie Bishop

        Your poor friend! Those cots aren’t a good place to recover from anything. I remember hearing the nurses on the peds floor whisper about how tired I looked (I’d given birth about 78 hours prior), oh poor mom, yet they made me start triple-feeding and made me clean all the pump parts and bottles while caring for him. One nurse, who was pregnant with her second baby, took him to the nurse’s station twice so we could rest, but I was so stressed I couldn’t sleep. If they actually cared about babies and moms, they would come up with better solutions.

    • CSN0116

      I can’t even. I would have never had the balls to author that statement in a scientific paper, ever.

    • aurora

      Disgusting.

  • Sheven

    The focus on “exclusive” breastfeeding is so bizarre in light of health claims and makes perfect sense in light of the need by some for status and/or to punish women.

    Women who breastfeed their infant 80 percent of the time, 90 percent of the time, all the time except in the first weeks when they supplemented with a bottle every couple of days until they got the hang of things, are all “breastfeeding.” So now it’s not just breastfeeding, it’s exclusive, never-let-a-bottle-touch-your-baby’s-lips breastfeeding. Does that make your baby healthier? In light of this study, clearly not, but it makes those who do manage it (without hurting their kids) feel a little better, so . . . keep encouraging it.

  • Roadstergal

    I’ll echo my FB comment – yes, the ’70s heyday of formula in the US was the pendulum too far in one direction, but at least in that direction, healthy term babies weren’t _starved_.

    • The Vitaphone Queen

      Hooray for the ’70s! Hee hee hee! (I was born in the ’90s, so obviously didn’t live through the ’70s, LOL. Also, I know we’re more technologically advanced here in the ’10s. Just being silly.)

      • Roadstergal

        Formula, birth control, and awful couches.

        • BeatriceC

          And me. The 70’s produced me, so it’s the best decade. 🙂

          • The Vitaphone Queen

            Oh my. Read this, y’all:
            http://www.mommyish.com/10-things-not-to-say-to-a-formula-feeding-mom/
            Look at the response to #3 (“You have such big BOOBS! You should have TONS of milk!”).

            I know I already posted this on the “claiming Volvos are optimal for babies” post, but I’m just being my dorky Autistic self and squeeing over this reference.

            NO SPOILERS, PLEASE! I’ve only watched the FIRST SEASON!!!

          • The Vitaphone Queen

            BONUS FUN: All my Point Placer pals, thumbs up this comment! (I’m watching the eighth episode of season 2 now.)

    • Caylynn, RD, MPH

      As someone who was adopted, I either wouldn’t be here, or would have had a dramatically different life, if it wasn’t for formula. Yay formula!

      • Eater of Worlds

        I had friends who adopted a baby. They were hell bent on breastfeeding. Both were women, and both had to take breastfeeding supplements and domperidone in order to feed one baby and they still needed formula. They were incredibly stressed about giving the baby breastmilk. Baby was about 75% breastfed but at what cost to themselves? Baby ended up with massive allergies and had to go to prescription formula as he grew anyway (he might have had eosinophillic esophagitis, it’s been a long time) and was always sick, they had to keep themselves on extremely restricted diets that I thought would give them malnutrition if they kept it up for longer than 8 months. Restricted as in “today and the next few days we eat only potatoes because they cause no reactions and the last food we tried resulted in reactions.” I sometimes think of how much plain enjoyment of their baby that they missed out on because of breastfeeding instead of going to straight formula.

        • Daleth

          Both were women, and both had to take breastfeeding supplements and domperidone

          DOMPERIDONE CAN KILL YOU. It can trigger cardiac arrythmias resulting in sudden death. For fuck’s sake, people, that’s why IT IS ILLEGAL IN THE US. See link below.

          Pop quiz: Which does a baby need more: (a) breast milk or (b) a mother WHO IS NOT DEAD?

          “Domperidone is not currently a legally marketed human drug and it is not approved for sale in the U.S…. FDA took this action because of the concern about the potential serious health risks associated with the use of domperidone by lactating women to enhance breast milk production. The serious risks associated with domperidone include cardiac arrhythmias, cardiac arrest, and sudden death.
          https://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/ApprovalApplications/InvestigationalNewDrugINDApplication/ucm368736.htm

          • Eater of Worlds

            This was somewhere around 2000, so it was quite some time ago.

          • Vittles

            It’s not FDA approved, but domperidone is prescribed and dispensed in the US all the time. Compounding pharmacies around here get the drug from Canada.

          • Daleth

            It was almost certainly domperidone. I still see women recommending it on lactivist and crunchy-mama websites.

          • Eater of Worlds

            For a second when you posted that I thought it was unable to be procured at all and thought I was misremembering.

          • Sarah

            The answer is a, breastmilk, and I claim my free placenta art.

          • Daleth

            Sadly the mom died before she was able to complete her placenta art. So that won’t be available, but hopefully her surviving family and friends will be consoled by the knowledge that the baby got two weeks of exclusive breastfeeding.

          • Sarah

            And no hatting.

          • The Vitaphone Queen

            NO HATTING, CHATTING, OR PATTING!!!!111!!1!1!1!1!1!1!1!

          • Young CC Prof

            Another set of lactivist victims that don’t get talked about much: People with certain severe digestive disorders. Domperidone is an effective medicine for conditions like gastroparesis, there’s nothing else quite like it, and it should be available for folks who really need it and have been screened for cardiac risk factors.

            Instead, the FDA refused to approve it because it was being misused as a galactagogue, an indication for which the benefits cannot possibly outweigh even a small risk of sudden death.

          • KeeperOfTheBooks

            Reglan’s another one–it’s used for gastroparesis, but can have the side effect of boosting milk supply, so some moms will have it prescribed.
            Mind you, it also has some very nasty potential side effects, ones that make me question my otherwise very sensible OB for being willing to prescribe it for me the first time around. Severe depression, for one thing (thank goodness I didn’t take it, my PPD was hellacious as it was), and permanent paralysis of some muscles, for another–if you’re lucky (?!), “just” facial ones, and if not, you could be walking with a cane for anywhere from weeks to the rest of your life.
            He did, at least, phrase it as “take it if you’re comfortable with it,” and after a lot of discussion with DH about the potential risks, I did.
            (If anyone doubts how crazy moms can be driven by lactivist ideology, I at one point quite seriously told DH that on a risk/benefits tradeoff, DD not getting breastmilk would be worse than her growing up without a mom, or with a mom who couldn’t run after her, so I should probably take it.)

    • StephanieA

      Why was it too far? I’m asking out of curiosity, because my grandmother raised my dad and his siblings in the 60s and 70s. She loved bottle feeding, it allowed her to work and have a life that didn’t revolve around nursing. Were women shamed for breastfeeding?

      • They were. Breastfeeding was seen as backwards and primitive, almost. If you wanted to give your baby the best, you bottle-fed with scientifically created food. That’s also not a healthy attitude and women who breastfed were shamed heavily for doing it.

        It’s a class thing in a lot of ways. Formula is expensive, so only poor women breastfed. But then everyone started using formula as prices went down (especially relative to other inflation), so now breastfeeding is the “in” thing to do. You have to have time to do it, and a good workplace, and maternity leave, and so forth. Only wealthier/middle class women have even a prayer of being able to take the time to breastfeed, so the pendulum has swung the other direction.

        • StephanieA

          Thank you for the explanation.

      • MaineJen

        My siblings and I were born in the late 70s/early 80s, and we all at least started out breastfeeding. But my parents were working class and my mom stayed home with us, for the most part, so I guess we fit right into the demographic of the time 🙂

  • Sarah

    We never seem to see articles in the mainstream media or breathless extrapolations from lactivists about how much this costs the NHS. Funny that.

  • StephanieA

    Sometimes when our peds unit is full we will take a newborn readmission (L&D unit). Recently we had a baby who had 15% weight loss and a bili of 25. Mom’s breast were engorged but baby wasn’t latching. We got an order to supplement, and our charge nurse wondered why they didn’t just supplement at home? I said because it is so indoctrinated in new parents that formula is poison that they feel they need ‘permission’ before giving it. I’ve also seen such relief in mom’s eyes when I suggest supplementing; it’s like they’re too afraid to ask, and hearing it from medical staff is what they needed.

    • Caylynn, RD, MPH

      For some of them, even when given “permission” they resist supplementing. I work in primary care, and sometimes both the primary care provider (MD or NP) are telling the mom to supplement, I’m telling the mom to supplement (as RD), and still they are reluctant. They have been brainwashed into believing that formula is bad and breastmilk will solve everything.

      • Mariana

        For me it took a visit to my own pediatrician (the one who took care of me!). He sat me down and said: “formula is a great invention. Before formula babies like yours, with moms that don’t make enough milk, would be dead at 4 months. So give her all the formula she wants, using whatever method you think is best (bottle, cup or sns).” She was already 2 months, and had been getting formula for a long time then, but I still felt like a failure everyday. It was only after he said that to me. A bunch of pediatricians had already told me that… but it took hearing from the one I trusted above any of them to get through the “Breast is best” brain fog.

  • jane

    I wonder if we’ll see a write up of this in the New York Time’s health section … or if they just like to report breathless summaries about the supposed benefits of breastfeeding!

  • jane

    it’s interesting that readmission rates are so much lower for c-sections (for both breastfed and formula fed.) I’m guessing that this is due to being in the hospital for a longer time, which allows feeding issues to be corrected?

    • BeatriceC

      I assume that the extra day or so allows for problems to become more apparent to more babies aren’t actually discharged, and then are no longer “healthy full term neonates”, as they have an extended birth hospitalization. I’m sure that’s not the only reason, but it almost certainly plays a role.

    • KeeperOfTheBooks

      When I had the first kid via C-section and intended to breastfeed her, I was in the hospital for four days. Most moms who have uncomplicated vaginal deliveries are out in two. It was only on day 3 that the official story went from “she hasn’t lost much weight, don’t worry about specifics, she’s nursing just fine and all that screaming is normal” to “if her weight doesn’t increase today, she can’t go home tomorrow.”

  • Empress of the Iguana People

    Its not like liberal use of formula in a baby’s first days will damage a long term breastfeeding plan in the least. My boy bard got liberal amounts of formula from day 3 for the next week or two. Then he breastfed for the next 10 months without formula.

    • Merrie

      A lot of people don’t know this.

      • Roadstergal

        All I ever hear is ‘nipple confusion.’ Strange that babies who ‘know when to be born’ get confused about nipples? I think they’re not confused at all – they just prefer the one they get milk out of!

        • Amazed

          … and they’ve had their choice already. They were allowed to choose their birthday (if they were born to crunchy enough mothers) some 3 weeks after term. Choice of feeding method? Sorry, dude, you’ve exhausted your supply of choice.

          • Young CC Prof

            Wait, does that mean babies who are induced or scheduled still get to pick?

          • Amazed

            They’ve got a better chance, unless they luck on crunchy mama and/or crazy providers.

            There is much to be said about choiced at young age. Yesterday, my dad taught Amazing Niece (in 10 days, she turns two!) how to answer the question, “Whose girl are you?” She says, “Grandpa’s!” Unless her dad is there. Then, she quickly becomes Daddy’s (the first time the Intruder heard the question, so we know for sure he did not teach her the answer!) Today, she heard me on the phone and immediately became Auntie’s.

            Yeah, I can see how terrible confusion is. Clearly, there is something wrong with her. An “attached” mom would be terrified that the kid wants whoever is available and not only her.

        • Caylynn, RD, MPH

          Yes! I know one couple (well educated – the father had a master’s degree and the mother had a bachelor’s) who used an NG tube to feed their baby expressed breastmilk because they were told that otherwise there would be nipple confusion! I mean really? An NG tube is better than a bottle (mom had milk, but baby was underweight)? Especially a bottle of expressed breastmilk if you actually think breast is best? I had to bite my tongue (they weren’t clients of mine, but rather acquaintances, so I wasn’t in a position to actually counsel them). It made me realize how far lactivism had gone, and was around the time I started reading this blog, after searching for evidence that nipple confusion was a real thing.

    • CSN0116

      At my formula feeding helpline this is all. we. do. OK, not really …but we do it every single day. It’s the #1 request we get, by far. We get requests for consultations from (mostly) moms with very new babies >2 weeks, who are losing way too much weight, crying incessantly and peds are encouraging supplementation. Despite all that, they still struggle to pull the trigger. We spend copious amounts of time disproving nipple confusion, reassuring, teaching supplementation strategies, and feeding plans that work to maintain their long-term feeding goals. I’d say 80% or more are EBF after two weeks or so, and go on for many months. Of those who aren’t, their body was never going to do it. Formula supplementation didn’t “break” anything, it was already compromised.

      They come around best if I, 1) give clear examples of past clients in similar scenarios who turned out alright, 2) listen to their concerns, 3) address the concerns succinctly and directly (no fluff), 4) reaffirm them on an emotional level, and 5) give hyper-clear directions for what to do and how to do it. This all takes time. Lots of it. I imagine a ped or other health care provider could never dedicate that much. And God knows they staff lactation consultants to manage BF problems, but nadda support and tips for those requiring formula.

      Early, liberal formula supplementation from birth to two weeks keeps babies breast feeding, goddammit! I wish I could plaster it on billboards. So many suffer needlessly. We catch women (and babies) at very, very low points. It’s ridiculous and uncalled for.