5 lies my lactation consultant told me

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Another day, another “study” of breastfeeding based on ignorance and ideology.

When I first saw the article from Manchester University, Research reveals why obese mothers less likely to breastfeed, I thought it would be about insulin resistance. After all, insulin resistance, a common complication of obesity, has been found to affect production of breastmilk.

These 5 lies interlock to create the impenetrable wall of denial faced by new mothers who have breastfeeding complications.

[P]revious research had shown that for mothers with markers of sub-optimal glucose metabolism, such as being overweight, being at an advanced maternal age, or having a large birth-weight baby, it takes longer for their milk to come in, suggesting a role for insulin in the mammary gland…

“This new study shows a dramatic switching on of the insulin receptor and its downstream signals during the breast’s transition to a biofactory that manufactures massive amounts of proteins, fats and carbohydrates for nourishing the newborn baby,” says Dr. Nommsen-Rivers.

“Considering that 20 percent of women between 20 and 44 are prediabetic, it’s conceivable that up to 20 percent of new mothers in the United States are at risk for low milk supply due to insulin dysregulation.”

But shockingly the paper didn’t mention insulin resistance at all. Instead it advanced the all purpose lactivist lie that the only limitation to breastfeeding is lack of maternal support.

Factors holding obese women back from breastfeeding included: lack of breastfeed planning, low belief in breastmilk’s nutritional adequacy and sufficiency, poor body image and lack of social knowledge.

That’s like looking at someone with glasses and blaming lack of support — instead of nearsightedness — for difficulty seeing. In an additional irony, the paper appears on the website Obesity Reviews beneath a paper exploring the role of insulin resistance and obesity in prostate cancer. Apparently no one insists that prostate cancer is due to a lack of support.

This is just the latest example of the sad fact that lactivism is based on a system of lies. Babies are suffering and dying as a result and their mothers are suffering, too.

Each individual lie is harmful of course, as any lie about healthcare will inevitably be, but the true danger comes from the system of lies and the clever way they interlock to prevent women and babies from receiving appropriate medical care.

What are these lies?

1. Breastfeeding is perfect? No, that’s a lie.

This is the foundational lie of breastfeeding advocacy — the belief that breastfeeding is perfect — and the lie from which all the other lies spring. Breastfeeding is a biological function just like any biological function; that means it will inevitably have a failure rate. And like most aspects of reproduction (human or animal), its failure rate is HIGH. Up to 20% of couples will suffer from infertility. Up to 20% of established pregnancies will end in miscarriage. It is hardly surprising then that up to 15% of first time mothers will be unable to produce enough breastmilk to fully nourish an infant especially in the first few days after birth.

2. All but the rare woman will make enough breastmilk? No, that’s a lie.

Insufficient breastmilk isn’t rare; it’s common and the consequences are widespread. Breastfeeding doubles the rate of newborn hospital readmission leading to literally tens of thousands of hospital readmissions per year for dehydration and jaundice. The leading cause of kernicterus (jaundice induced brain damage) is breastfeeding, accounting for 90% of cases.

The cost of hospital readmissions is massive, literally hundreds of millions of dollars each year. And that doesn’t even count the downstream costs of caring for children who suffer injuries and learning disabilities as a result of breastfeeding induced dehydration, hypoglycemia and hyperbilirubinemia.

3. The benefits of breastfeeding are massive? No, that’s a lie.

The benefits of breastfeeding in industrialized countries are trivial. Most of the myriad benefits claimed are based on studies that are weak, conficting and riddled with confounding variables. When breastfeeding studies are controlled for maternal income and education (both independently associated with improved health of offspring), nearly all of the purported benefits disappear. To the extent that breastfeeding has greater benefits in the developing world it’s because the unclean WATER used to make the formula is harmful NOT the formula itself.

4. Formula supplementation or pacifiers interfere with breastfeeding? No, that’s a lie.

The Baby Friendly Hospital Initiative, designed to promote breastfeeding, specifically discourages both formula supplementation and pacifiers as harmful to the breastfeeding relationship. But research shows that early judicious formula supplementation increases breastfeeding rates and pacifiers save lives by preventing SIDS (sudden infant death syndrome).

Moreover, many women successfully combo feed using both breastmilk and formula for months or years.

5. All breastfeeding problems can be solved with more support? No, that’s a lie and a particularly self-serving one.

A new paper about publicly funded lactivism, State power and breastfeeding promotion: A critique, makes the point eloquently.

The problem – whether it be postnatal depression, multiple births, or severely cracked nipples – can almost always be surmounted with appropriate counselling, management and determination. This is the case even when the problem is one of insufficient milk and the infant itself is not thriving as well as their peers. Hausman, for example, writes that ‘no one disputes that cases of true (or primary) insufficient milk syndrome exist – breastfeeding advocates simply tend to question the idea that there are large numbers of women who physically cannot make enough milk’…

Perseverance, counselling and management, and not choice, context and individual circumstances, seem to be an all too common response from many public and/or publicly funded health professionals and institutions to those struggling.

In other words, whatever the problem, more lactation consultants making more money by providing more government (or privately) funded support is  always the solution.

These 5 lies interlock to create the nearly impenetrable wall of denial that greets most new mothers when they experience entirely predictable difficulties and complications with breastfeeding. That’s how you end up with the travesty of a paper blaming obese women’s difficulty breastfeeding on “lack of support” when the cause is almost certainly biological at least in part if not entirely.

  • Cat

    OT, but I’ve been wondering for a while how strong the evidence is for recommending that babies should share a room with their parent(s) for at least the first six months of life? I get the impression that putting a younger baby in a separate room is far more taboo than bedsharing (anyone admitting on a parenting forum to moving a four month-old into its own bedroom is likely to be shouted down for playing Russian Roulette with their sweet baby’s life, whereas bedsharing, although controversial, is routinely recommended as the solution to all sleep and/or feeding woes, including by one of my health visitors) yet both are contrary to official guidance, at least from the NHS. Also, I can think of several mechanisms by which a baby sleeping in an adult bed might come to harm, but I can’t think of any obvious reason why a baby in a safe sleep space in its own bedroom (assuming that it has parents who are able to hear and responsive to its cries) should be at much greater risk than if it were on the other side of a wall in the parents’ room? Can anyone explain the reasoning and the science behind this, please?

    (I don’t have any personal stake in the answer – my two year-old still sleeps in my room because I can’t afford to heat a second bedroom at the moment – but I’m genuinely curious).

    • The Bofa on the Sofa

      I can understand an argument that having the baby sleep in the same room might be helpful, because there could be things that you don’t hear on a baby monitor, but other than that, it all sounds like complete nonsense.

      No, bedsharing is not safer than not bedsharing, which is why it is contrary to official guidance.

      Yes, I understand there are babies that will sleep better that way, so that is why a lot of people do it, but that doesn’t make it appropriate for everyone else. And even if you are doing that, you need to be working to train your child to sleep on their own. They have to move to their own bed at some point. And getting them to do so does not harm them. It’s good for them to grow up.

      • Cat

        Yup, I can definitely understand the argument that it will make your life unnecessarily difficult, if you’re a heavy sleeper who’s likely to sleep through the first minutes of fussiness and only wake up when the baby is actually screaming. But that’s the only angle I can think of – I can’t see why it would actually be dangerous in most people’s circumstances.

        “It’s good for them to grow up.”

        This. I’m heartily sick of the mantra “They’re only little for such a short time” when it’s used as a justification for treating kids like babies until they’re in secondary school. But then I’m the big meanie who wouldn’t carry my daughter home from the shops today because I had three bags of heavy shopping and she wasn’t too tired to ask to go to the playground. Maybe I’ll be sorry when she’s left home that I didn’t carry her everywhere whilst she was still (sort of) little, but I suspect I’ll be more grateful to my past self for sparing my back!

        • Empress of the Iguana People

          My entlings sometimes try that, but I really can’t carry even my 21 mo for long anymore, much less the 4yo. “Little” is a relative term! They can still both crawl into my lap when they want to. 🙂

          • Cat

            “”Little” is a relative term!”

            It sure is! Mine has only just turned two but she’s about to go up into size 3-4 year clothes. The phrase “mummy, I want a carry!” chills me to my very bones (that, and “mummy, where are youuuuuuu?” when I’m trying to go to the loo in peace 🙂 ).

          • swbarnes2

            Soooo glad that mine has never broken the 9th percentile in weight, means she’ll be easy to carry for a while yet.

          • Cat

            Yup – there are some advantages to having a baby who sails above the 98th percentile, not least that, for a nervous first-time mum, it’s reassuring to have a newborn who doesn’t feel quite so breakable, but it’s hard to explain to a two-year old that, nope, mummy can’t swing you round again because you pretty much broke her last tine *grins*. Plus nobody appreciates the obviously amazing unprecedented super awesome preciousness of your two year-old because they just think that she’s a very naughty three year-old 🙂 :).

          • Empress of the Iguana People

            I enjoyed surprising people who’d ask if boybard was 3 before his 2nd birthday. He’s tall and verbose.

          • Christy

            It’s fun, isn’t it! :o) Roo is barely 2 but in size 3 clothes and his speech is very clear. I get a lot of surprised reactions when people ask his age. (also he’s a super-genius…but I may be a tad biased)

          • The Bofa on the Sofa

            I still take my 7 yo and throw him into the top bunk at night at bedtime. I’ve told him I was going to stop when he turned 7 (and I didn’t) and now I tell him that when I hit 50 (tomorrow) that’s the end of it.

            It probably won’t be.

          • You can’t go to the loo in peace. Learn to live with it. I suffered from constipation for years

          • sdsures

            My cats insist on watching me when I’m on the loo. I’ve decided to find it endearing.

          • Yes, they look as if they find it all very interesting, don’t they?

          • sdsures

            They see it as a perfect time for cuddling.

      • sdsures

        If the baby gets picked up every single time he squeals, all it will do is teach him that he can manipulate the hell out of his parents and get whatever he wants. No one likes a spoiled child.

    • Empress of the Iguana People

      in my ppd group, some of the moms are so very disturbed by crying or so very anxious about something happening when they aren’t there that keeping baby near them is the best way to deal for the present. not an issue for me, fortunately. we did keep our very young babies in our room, mostly to facilitate 3 am feedings. Also, I didn’t want to wake up Spawn1 when Spawn2 cried. Both slept through the night early, thankfully.

      • Cat

        That makes perfect sense to me. I suffered from massive anxiety when my daughter was tiny and found it reassuring to have her close by. Plus I imagine that a lot of first-time parents are worried that they’ll sleep through their baby’s cries.

      • StephanieA

        I had the opposite experience with ppd. My babies weren’t great sleepers, and their every little move and breath kept me awake. I would go to bed so anxious because I was worried that every rustle was them waking up again. I kept them in our room til 5 months or so, and slept so much better when they were in their own rooms.

        • Empress of the Iguana People

          There are advantages to hearing impairment, lol. Demodocus got up with them. Postpartum issues are so individual, aren’t they?

          • Indeed they are. My three never slept in the same room with us, and in those days, baby monitors were unknown in Israel. All survived. Even me.

            38 year old son is arriving today from NYC with a brand new iPad Pro for his Old Mother, so I guess I must have done something right!

            Happy and kosher Pesach, everyone! [And a Happy Easter to everyone else]

          • Empress of the Iguana People

            You too! Is Pesach what we call Passover?
            I’ve amused more than one Jewish friend by happily sharing their matza. It’s a lot better when you only have it once in a blue moon rather than every meal for a week.

          • Pesach is Hebrew for Passover. It is actually possible to manage not to eat matza for the week without a lot of difficulty. Substitute potatoes, or depending on one’s customs, rice or other pulses for carbohydrates.

            You might like to try matzabrei. Dampen a matza, and crush it into some beaten egg. Fry some chopped onions, and put the egg-matza mixture over it and cook like an omelette. Salt and pepper to taste. Makes a light supper with a green salad, or as a breakfast dish.

          • AnnaPDE

            My mum’s main source of nutrition was matza crumbled into choc milk for a good part of her early childhood. She was a fussy kid.

        • Kelly

          Me too, although it was not a result of PPD but of just not being able to sleep with all their noises. Our first slept in our room for the longest at two weeks. The others we put in their crib as soon as they got home. We either keep the doors open to both rooms and/or turn a monitor on. In fact, with the first one, we ended up sending her to the nursery for the night because my husband kept thinking she was dying from all the noises. Ten minutes of him freaking out and I called the nurses.

    • MelJoRo

      The Science of Mom has a decent dive into the SIDS recommendations by the AAP in the US on her blog. My take was that it was a lot of correlation with a biological explanation for why it works, thus enough data for their recommendation. I believe the number I have read (in Precious Little Sleep, which quotes the same commendations) is that roomsharing, but not bedsharing, can reduce the risk of SIDS by 50%. Since most cases of SIDS happen in the first 4-5 months, it is my goal to tough out roomsharing until then, which also corresponds to when sleep associations set in and sleep training is an option (also a taboo on many parenting forums!). In the US it is still quite common for folks to move baby to their own room after a few weeks, despite the recommendation. I also agree that bedsharing is getting increasingly common, which is something that I am terrified to do. My bassinet has the capability of attaching “sidecar” to our bed, which I suppose (with the appropriate bedding) could be a happy medium for some people.

      • Empress of the Iguana People

        Someone in my due date group posted a picture of her daughter having learned to roll and take up Mom’s side of the bed. It was pretty funny since Mom hadn’t gone to bed yet and the baby was fine.
        Our bassinet was the playpen with an insert. Good for Entlings.

      • Cat

        Thank you – that’s helpful. I’ll check that blog out! Correlation plus some kind of remotely plausible biological hypothesis would definitely be more than enough to sway my own choices (though, as previously mentioned, my kid is still room-sharing but not bedsharing with me at two plus for practical/financial reasons).

      • Busbus

        It’s funny that you bring up the “taboo subject” of not room-sharing with your newborn. I guess I really did end up ditching attachment parenting completely…! We had our third baby 10 weeks ago, and we did actually end up putting her to sleep in her own room at just a few weeks of age. When it comes to sleep associations, that worked a lot better for us than doing it later. If you ask me, the secret to babies who sleep well is to start waiting a few minutes before going in if they complain but should be tired/sleeping and to only go in if they haven’t fallen asleep or quieted down after about 5+ minutes. That’s just much easier to do if the baby is not in your room. And the earlier you start the more effective it seems to be – at least that was true for kids number 2 and 3 in our family. Our newest addition started sleeping for around 10 hours most nights at 7 or 8 weeks. I wouldn’t ever have thought that possible before! (I originally got the idea from the book “bringing up bebe,” where the author says most French babies sleep through the night at 2-3 months of age due to that method.) My oldest co-slept with us and nursed 4-8 times each night until she was almost 2 years old – so I certainly know the other side of that picture…
        Anyway, simply because she is such a good sleeper, it is easy to follow all the other SIDS recommendations with this little one, and I am sure she must be much safer than my first two children were. And it makes our parenting less “chaotic,” too, to have two adults who are relatively well-rested 🙂

        • MelJoRo

          The “biological explanation” for why roomsharing seems to work may be as simple as everyone sleeps more poorly, so baby spends less time in REM sleep (I am an engineer, so this not my strong suit in science, so bare with me). But this is the crux of it—baby may be ‘safer’ if people are sleep deprived and possibly miserable, which for many families means more unplanned cosleeping, possibly even in a couch or chair which we are told in the US is by far the most dangerous. Do what you need to for your family. As Mabelcruet so excelently explains, it is complicated. We are at 7 weeks and things are going pretty well. Baby wakes 2, occasionally 3, time to feed. I sleep the worst in the early AM hours because baby is louder and my body is battling its natural desire to be an early riser. My husband has been sleeping in the guest room on work days, which is less than ideal but makes it easier for me to ‘ignore’ the baby squawking that are not true cries or needs. It is working for us, but that could change at any point, and would likely be different if I was not lucky enough to be taking an extended maternity leave (which is still much shorter than what you lucky folks in Canada and the rest of the world get…)

    • mabelcruet

      In the UK, the term SIDS has fallen out of use (among paediatric pathologists and others) and we use the term SUDI (sudden unexpected death in infancy) and this can be SUDI-unascertained (no definite cause found at autopsy), or SUDI-ascertained (cause found, whether natural, unnatural or multifactorial). Its such a complex area with a lot of interplay between physical, situational and biological issues, but at the moment, the general consensus is the ‘triad theory’. The triad is pregnancy/infant health, biological development, and situational assessment. So we have babies who are physically perfectly healthy and die because of adverse environment (the ones who roll and get wedged between the side of the bed and the wall and that can cause asphyxiation), and other babies who are vulnerable because of being, for example, ex-premature babies with poor growth, poor placental function, chronic lung disease from ventilation etc who are found dead in their own cot.

      The triad theory is that there is a uniquely vulnerable time for all infants-think of it like a Venn diagram, those overlapping circles. One circle is baby-its physical, biological, and anatomical parameters. Another is the environment-room temperature, bedding, parental smoking etc, and the third is time. We know there is a peak age group for sudden infant death and that’s about 3 months of age. Where all three circles overlap is the danger spot-so if we have a baby with inherent vulnerabilities (like low birth weight, growth restriction in utero), at a vulnerable point in his development (the 3 month age), and who is placed in a vulnerable position (sleeping with parents, use of soft mattresses and pillows), that baby is going to be a far greater risk than either a older infant put into the same environment, or a baby who was perfectly healthy and who’s mother had perfectly heatlhy pregnancy.

      But all this means there are so many factors that have to be taken into the equation to look at safe sleeping for babies. In my field (as a pathologist who does the autopsies on babies who die unexpectedly) there is a definite danger in the final co-sleeping event. Bedsharing is common, and many families do it. The risks can be significantly reduced, for example, using appropriate bedding, no soft pillows, making sure the room temperature isn’t too warm (babies prefer a much cooler bedroom than adults-about 16-17 degrees Celsius) and most definitely no adult smoking in the home etc. What I, and many of my colleagues noted, and what the data shows is that the risk of death increases when the final co-sleeping event wasn’t planned.

      This is where the baby is usually in a cot or basket elsewhere, and for some reason the parent brought the baby into bed unplanned and spontaneously. Sometimes the parent had been drinking and picked the baby up for a cuddle and fell asleep, sometimes the baby wouldn’t settle in their own cot and the parent picked them up for soothing, and fell asleep, there are several different scenarios but its the spontaneous nature of it that is the feature.

      The difficulty we have is that you can’t spotlight a baby and say ‘that baby has a risk of death of X’, and if I do an autopsy, I can’t say ‘that baby died because of parental smoking’. I can say ‘there is an increased risk of sudden infant death in families who smoke’ but I can’t say with absolute conviction that the baby was killed by parental smoking (unless, god forbid, it was something horrible like the house burning down because of a cigarette left burning). The coroners don’t like this, they much prefer a black and white answer and we can’t usually give it to them.

      The other problem is that it is a very difficult area for parents to get to grips with-they are bombarded with information from all sides. From a public health point of view, it is far easier to say ‘Never, ever sleep with your baby until they are one year of age’. The real message is ‘the risk of sudden death whilst bedsharing is reduced if you do X, Y, and Z, but increased if you do A, B and C’. That becomes a complicated message to get across, so public health programmes generally go for the more simple option as that is more understandable. The unintended consequence of that is that parents who do make a value judgement and take a decision to co-sleep and make safety-conscious changes about the bedding and room temp etc get criticised for going against ‘official’ advice.

      In my practice, its got to the stage that on the whole, most of the babies I’ve examined in the last few years that died whilst co-sleeping had died the night their parents had been drinking alcohol or taking drugs.

      Coming up with definite stats is further complicated by differences between coding the cause of death. In the UK, all babies who die unexpectedly have an autopsy mandated by the coroner. All these babies are examined by a paediatric pathologist, or a paediatric pathologist and a forensic pathologist working together. In the 60s, 70s, and early 80s, these cases were generally examined by either a general adult pathologist, or a forensic pathologist. There are data indicating that the preferred formulation of the cause of death depends on which type of pathologist was involved-forensic pathologists tended to use rather vague terms like ‘interstitial pneumonitis’ rather than saying SIDS or SUDI, and that makes it difficult to compare across time, countries and populations.

      • The Bofa on the Sofa

        and most definitely no adult smoking in the home

        OK, you hint at this later on, but I have a question: I know there is a strong correlation between parental smoking and SIDS (or SUDI or whatever you want to call it). The question is, why? What’s the mechanism? Is it second-hand smoke causing lung issues? Or is there a co-variable in there somewhere?

        Does parental smoking cause SIDS? Or is it just an indicator of something else?

        • mabelcruet

          Start with the easy questions, why don’t you!!

          It’s likely to be due to the interplay between a number of different mechanisms both antenatally and postnatally. Overall, it seems to be dose related, so the risk goes up the more you smoke.

          Smoker’s babies are often slightly smaller with a degree of suboptimal growth and suboptimal utero-placental function. It’s a combination of nicotine and carbon monoxide related damage. If you took two babies of the same birth weight, one of whom had a mother who smoked during the pregnancy and the other one didn’t, the smoke exposed baby has a higher risk of death even though they are both small.

          There is also data showing that organ development in babies of smokers could be retarded or abnormal leading to some degree of suboptimal function, like in the infant brain you get some neuronal network disorganisation, sympathetic nervous system innervation problems and neurotransmission aberrations.

          This leads to a suggestion that in utero nicotine exposure causes brain stem anomalies that results in their hypoxic arousal mechanisms not working properly. Some autopsy data shows that infants of smokers have signs of established hypoxic-ischemic cellular injury in the brain and the heart which probably occurred in antenatal life, may have been caused by suboptimal placental function and may have been sub-clinical, but if the baby continues to be in a vulnerable environment exposed to post-natal passive smoking, this could affect autonomic nervous system function and lead to poor temperature control, and poor heart rate and respiration control. There’s a suggestion that these microdamaged areas could then affect the baby if they contract an infection-a minor viral illness that most babies shrug off could turn more serious if there is underlying damage.

          At birth, smoker’s babies have reduced lung volume, poor airways control, less lung compliance, more airways obstruction-their airways don’t react normally and this is mediated by nicotine in utero causing collagen and elastic fibre abnormalities in the airways. The effect of this is increased risk of infection, and also increases their vulnerability if they are in a risky environment (like co-sleeping, big duvet, pillows etc). This starts very early in fetal life-babies practice breathing in utero, breathing the amniotic fluid in and out and that helps the lungs grow and develop-fetuses who syndromes causing muscular abnormalities meaning that can’t breathe in utero frequently die at delivery because they simply don’t have enough lung tissue to survive. Nicotine affected babies are similarly affected (obviously to a much lesser extent).

          The risk of cot death whilst bed sharing is higher in smokers, and that could be due to microenvironmental changes. There is data showing that cotinine (a nicotine metabolite) is increased in babies who bedshare with a smoking mother compared to those who still have a smoking mother but who don’t bed share.

          There’s also a more nebulous issue which is far harder to quantify, but parents who smoke around their children and whilst pregnant tend to be rather more ‘chaotic’ in their parenting. We see features like babies missing appointments with the health visitor, or babies being a bit underweight, or having untreated bad nappy rash, or parents who tend to use alcohol and drugs more frequently, or tend to pay less attention to their infant’s health and ignore early signs of illness. Nicotine exposed babies have reduced immune function and poorer response to inflammatory conditions like infection so its a double whammy-they are more likely to get infection and more likely to get sicker with infection.

          We used to routinely measure cotinine levels in infants who died of SUDI (and I know of a few cases where the police attempted to charge the parents with child neglect if the cotinine levels were high but I don’t think any successful prosecutions were made). All in all, smoking whilst pregnant is really not good for the baby.

          • The Bofa on the Sofa

            Ok, but wait a minute. That’s a different statement. Is it babies whose mothers smoked during pregnancy that are at risk? But babies in the house with smokers? Those are two very different issues.

            What if only the dad is a smoker, and the mother is not? Is that still an elevated risk? My interpretation is that, yes, it is, but maybe I have been misunderstanding all these years.

            If dad is the smoker and mom is not, then all the developmental issues go out the window. Moreover, the risk is not mitigated if mom stops smoking after the baby is born (although that’s a really dumb situation – if she can quit smoking, she should have done that before).

            If you want to say that smoking during pregnancy is not good for the baby, I’m ok with that. But I’m wondering more about SIDS risk for being in a smoking house. From what you say, most of that seems to be co-variate. The closest you are coming to a mechanism would be reduced immune function and infection. But if the baby is dying with an infection, does that make it SIDS? It’s certainly not SUDI.

            Smoking parents are bad for babies, not doubt. I’m still trying to work out the mechanism, though.

          • mabelcruet

            Its difficult epidemiologically separating out the effects of antenatal smoking by the mother and the effects of the baby being exposed to cigarette smoking after birth. But there have been a few studies where the mother didn’t smoke and the baby was exposed to smoke after birth from the father. But even then, if the couple co-habit, there may still have been an effect on the baby through passive smoking whilst in utero.

            But, in general, if the mum doesn’t smoke and the dad/partner does, there is still an increased risk of SUDI, but not as high as if the mother smokes and this is most likely due to the developmental issues on the brain and lungs are not as pronounced (less antenatal damage).

            There’s some data from looking at multi-person households and having others smoking in the house but not the parents-again its a dose dependent thing with the risk of SUDI increasing slightly the more people smoke, even when its not the parents.

            The other problem is smoking during different periods in the pregnancy. There isn’t much data on whether smoking around the conception and the initial post-conception period has a greater impact than smoking later on in pregnancy. Many women who smoke may have smoked before they realised they were pregnant and stopped when the pregnancy was confirmed. I can’t find much data at all about whether their babies were at the same risk as non-smokers, or intermediate risk (higher than non-smokers, lower than smokers). And all the studies obviously rely on parental recollection about how many they smoked, so this could all be based on guesswork.

          • The Bofa on the Sofa

            In principle, you could look to SUDI in adopted infants, but at this point, it’s getting to be a pretty narrow option.

          • mabelcruet

            And another group there is minimal data on is mothers who don’t smoke at all before pregnancy, don’t smoke during pregnancy but take it up with the baby is born. But I think they would be unicorns!

          • The Bofa on the Sofa

            Now mothers who didn’t take up drinking until after the kids were born, I can understand…

      • Cat

        Thank you – that’s a very helpful explanation indeed. My concern with co-sleeping/ bedsharing is that I’ve come across a lot of people who believed that what they were doing was safe co-sleeping in accordance with official recommendations when their actual sleep space looked kind of dangerous (e.g. photos on Facebook with big hot heavy duvets, soft pillows etc). Even my health visitor suggested that I make a nest out of duvet and pillows and leave a five day-old baby in it to sleep whilst I slept. So I do agree that a more targeted message spelling out the factors that reduce and increase risk could be more helpful than a blanket “don’t do this”.

        • mabelcruet

          That’s not the most sensible idea. I’ve posted before about some of the co-sleeping scenarios that resulted in infant death and that came to me for examination.

          A baby who was laid to sleep in his parents bed-the parents had one pillow each and the baby was placed in the void between the two pillows and wasn’t covered by the parents duvet. Overnight, due to the relative movements of the parents bodies, the pillows shifted position and moved closer together overlapping over the baby.

          A baby who was laid to sleep alongside his mum, the bed was close to the wall but not quite touching. Overnight he ended up falling into the gap and ended up asphyxiating and unable to breathe because of the pressure on his chest.

          A baby who normally slept in a cot in the parents bedroom. In the morning the mum brought the baby into bed for a snuggle. She lay on her back and brought her knees up, creating a sort of sling for the baby to lie in on top of the duvet. She fell asleep and the baby ended up entangled in the duvet and suffocated.

          A baby who rolled out of bed and landed headfirst in a waste basket by the bed which was lined with a plastic bag.

          A baby who was put onto his dad’s chest while dad lay on the sofa. The dad clamped his hands over the baby’s chest to keep him in position and then fell asleep. The deadweight of dad’s arms and hands was enough to stop the baby breathing.

          Putting the baby into a nest of pillows would be reasonably safe in the first few weeks as the baby isn’t capable of independent movement. But as soon as they learn to roll, that’s when the risk increases, and its possible they may roll over into the pillow and not be able to get back out. You obviously have to decide for yourself, but I personally think those ‘alongside’ sleeping platforms are the safer option.

      • MelJoRo

        Thank you for your explanation. As a parent with an infant, the idea that my healthy baby could die unexptedly and without warning is genuinely terrifying. Before delivery I rationalized that it was rare, and we would follow the guidelines and be fine. Now it is something that sometimes takes my breath away. We are fortunate to be without many of the risks you list, and that makes me feel a bit better. Obviously I will continue to follow the recommendations to keep my baby safe, but extra knowledge in this case is nice.

        I also want to say that when we took our infant CPR/Safety course from a major metropolitan children’s hospital, and they did give us the more complicated message. It was essentially “this is IDEAL, and what the AAP wants. We know this is probably not where most parenting happens, so NEVER cosleep if you have been drinking, here is a photo of a safer cosleeping situation, etc”. They also definitely hit on the increased risk of a parent was a smoker, or if the cosleeping happened on a couch or armchair. I am not sure how common this message is, or if it is better received in a setting where people signed up, and generally paid money to take this course. I am sure those messages would be much harder to administer in a public health campaign. For us, it was very helpful and helped us to have conversations about if I am tempted to have unplanned cosleeping, I need to wake my husband for a break. And if roomsharing is contributing to the fatigue that is making that happen, then we need to explore either planning to cosleep with a sidecare style bassinet, or moving baby to his own room.

  • Jessica Cupit

    Something I’ve wanted to ask on here for a while… I cannot find any of the studies that purportedly produced irrefutable evidence of Breastfeeding reducing the risk of Sudden Infant Death Syndrome, which in turn led to ‘Breastfeed baby’ or ‘Breastfeed if you can’ being added to the SIDS Australia ‘checklist’ back in 2010/11 (as I recall – it’s still there). Would anyone on here know where to find them/what the studies were (and is it really ‘irrefutable evidence’? Always struck me as an odd thing to claim given cause of SIDS unknown). Google isn’t getting me anywhere…

  • kilda

    and by lack of support, they mean “lack of sufficient browbeating.”

    • maidmarian555

      Because clearly what obese women need is to be shouted at more about how they’re just not good enough. I’m sure they absolutely are not subjected to that attitude anywhere else in their lives and will welcome additional measures to shame them as a result of this paper /sarc.

      • kilda

        I expect they think the obesity itself is a sign that the women weren’t properly shamed and browbeaten enough in the first place, otherwise they wouldn’t have the bad manners to be obese.

        • maidmarian555

          Absolutely. If you’re fat, it’s always entirely your own fault for eating too much without the simple self control to choose a salad instead; and nothing to do at all with the myriad of complex external and internal factors that may lead someone to have the temerity to possess a BMI of over 30.

          • Empress of the Iguana People

            like skinny people eat salad for every meal.

          • MaineJen

            Do you know there are people who eat ice cream every blessed day and are still skinny? I know, it blew my mind too. Like, if they want to lose a few pounds, they just cut out their DAILY ICE CREAM. I eat ice cream approximately once a month and I’m still overweight. Genetics, people. Genetics.

          • Empress of the Iguana People

            Well, daily ice creams went a long way to explaining my weight, but cutting them and all the other junk food did jack-shit for losing weight once it’s there.

          • Heidi

            Heh, I used to rarely have ice cream but now that I’m purposely losing weight, it’s nightly, except it was frozen yogurt and now it’s soy milk ice cream and I weigh the portion. I don’t know why, but including a small dessert every night has helped. I’ve tried cutting carbs, I’ve eaten all “organic,” eschewed all processed foods and that promise that my weight will regulate itself and I’ll have a healthy BMI if I just follow whatever diet has never worked. Ive tried “listening to my body.” My body wants to eat too much and why wouldn’t it?? Starvation is a more imminent threat than extra pounds, and heck, as far as my body’s concerned, I might need them to get through a famine. I can easily overeat on homemade food, organic or not. Overeating for me isn’t anything spectacular either. I’ve lost 50 lbs. and I’m beginning to lose a bit of steam. I’ve maintained the weight loss though but that’s been at 1800 calories with moderate exercise and so much effort. It’s not a lot of food. I’m pretty sure some salads have that many calories! Anyway that’s a lot of blabbering on my part, but my point being I don’t know why obesity and being overweight are being portrayed like they are. It’s not helpful to anyone. It certainly never helped me. I don’t know why some people can eat exactly the amount of food they need effortlessly (I assume a combination of genetics and environment) but I refuse to see myself as less than or blame myself anymore just because it doesn’t happen for me.

          • kilda

            I think people who judge overweight people are often those people – the ones who can eat plenty of food without gaining. They assume that since they eat cheeseburgers, ice cream, etc and don’t get fat, that anyone who IS fat must eat gargantuan quantities of food. They don’t get that some people can eat a reasonable amount of food and still get overweight.

            The hard scientific facts are that weight loss very hard to achieve and almost impossible to maintain. But we doctors keep telling people “just eat less and exercise” even though we KNOW it doesn’t work. I mean, all known strategies we have for weight loss, except bariatric surgery, have about a 95% failure rate in the long run. In any other arena of health, doctors don’t go around recommending treatments with 95% failure rates to our patients. But with weight loss, we do, and then we blame them when it fails.

          • Heidi

            Even bariatric surgery has a failure rate of 40% doesn’t it?

            I’ll be totally honest. I have avoided getting a GP because of the fear of what might be said to me. I didn’t even go back to my 6 week post-natal appointment because I hadn’t managed to lose any significant weight. I know what I weigh and I know my BMI and I can just as easily as the next person read about the correlations between higher BMIs and health issues. My husband’s insurance tries to make us go to checkups where you are berated for your weight, even if you are at a healthy BMI. Seriously, they scolded my husband for being at 24. Then condescendingly told him how to eat “healthy.” That is eat flax and chia seeds and olive oil… olive oil on everything! I refuse to do that to myself. I know I should know my other numbers but I’d rather not embarrass myself with the crying I know I’d do when I got fussed at. My work insurance simply took your lab work without all the, “omigod, you’re a fatty who is going to die unless you put down the cheeseburger and eat olive oil soaked chia seeds!” I actually participated then.

          • kilda

            yeah, I really hate that that happened to you. That kind of behavior is so crappy, and it just drives people away from getting health care, which if they’re so supposedly concerned about your health….

          • Christy

            I actually found a doctor who doesn’t bother me about my weight, to the point that sometimes I think “Hey, shouldn’t he be saying something about my weight?”. But my other parameters are good so I guess that’s why he doesn’t bother. Anyway, they exist. I hope you can find one.

          • Heidi

            Generally my OB/GYN group never said anything about it. I think my first appointment it was recommended I gain only 10-15 lbs. A lot of my issues are internalized, and not necessarily even happened to me. I don’t know that anyone would have said anything unkind to me when I hadn’t lost more than 5 or so pounds by 6 weeks but unfortunately I felt bad about it. I went to a quick care clinic for a chronic sinus infection just a couple of months ago because finally I figured since I was only one point in the obese category, probably nothing would be said (and my weight was a good bit under 200). Plus if I’m honest with myself I kinda blamed my sinus infection on my weight. But it didn’t budge after significant weight loss.

          • Banrion

            That’s so much better than my Dr who hands out treatments for non-weight related issues like prizes for losing weight. 2 Years ago I asked for a referral to a dermatologist for my rosacea and was offered a referral to a dietitician. This year when I went in I had lost enough weight to drop me from “obese” to “overweight” on the official chart and after asking me “how does it make you feel to change categories?” suddenly she would write the prescription I needed without sending me to a specialist.

          • mabelcruet

            Olive oil is disgusting stuff-its ok as a salad dressing but I hate it used for cooking or sauteeing, it just makes everything taste of olive oil. And the way chefs like Jamie Oliver drizzle it over virtually everything-why?

            But regarding chia seeds, they are brilliant for adding loads of protein and fibre. I soak them in yoghurt over night and it makes for a very filling breakfast. They don’t taste of anything so I chuck them into all sorts of things.

          • Who?

            It has a low smoke point, which makes it not great for cooking. I prefer rice bran oil. And I agree there are many places where it has no business.

            Haven’t tried chia, maybe I should…

          • mabelcruet

            It’s good stuff, honestly. It’s very versatile-when you soak it it looks just like tapioca pudding. I use it to thicken soups and stews, and throw a handful in cereal, and even in baking-you don’t really notice its there. It makes me feel vaguely healthy, and really helps boost my fibre intake (I could live off cheese and cake, but my digestive tract would not be happy with that!)

          • Heidi

            We actually put a dash in our smoothies, a dash of chia seeds that is but have been for years. My husband still has a low HDL.

            I use canola oil. It’s cheap and has a good omega 3/6 ratio and doesn’t burn easily. I’ve lost weight by not drizzling oil on my food.

          • maidmarian555

            They do with addictions. Alcoholics Anonymous only manages (at generous estimates because of course they don’t actually properly track results at all) about an 8% success rate (in terms of getting people sober and keeping them sober for a significant period of time). Much easier to blame the addict than to look at the treatment and point out that a failure rate of over 90% is a terrible treatment (particularly if that treatment is super cheap). Whilst I am skeptical that being overweight is in the same category as being addicted to substances, it does seem to be thrown in the same bag as a morality issue, rather than a complex health issue. People (generally) seem quite happy to blame the suffering individual, and so there’s no real impetus to change the way we treat these problems. (My Dad was an alcoholic and it took a very persistent and supportive GP to get him the proper treatment and support to sober up- he’d been referred to AA repeatedly during the 40yrs he was drinking, and it never worked for him at all. Rather than try new things, they just kept sending him back there and telling him to try harder, which is where I see the similarity with treatments for obesity).

          • Empress of the Iguana People

            I think it’s partly related. Some of who are overweight have used food as self-medication, and a number of addicts started for similar reasons.

          • maidmarian555

            Yeah there are definite parallels. But I’d certainly stop short of making wild claims about over-eating being an addiction per se. And also, you can’t use abstinence as a treatment for obesity. We all *need* to eat to survive.

          • Busbus

            A little OT plugin for anyone dealing with alcohol issues or who has loved ones dealing with it: look into the Sinclair method. It is not AA, it is science based, it does not involve harsh methods (like that drug that makes you vomit, whatever it is called), and it actually works. Here’s good info: https://www.sinclairmethod.org/claudia-christian-ted-talk-sinclair-method/
            It uses a drug called Naltrexone, which blocks the opiate receptors involved in creating the dependency on alcohol. It does not require that you stop drinking. It’s important, though, that you follow the right protocol – many doctors in the U.S. don’t recommend the right method (if they know about the drug at all). One of my loved ones has used the method, and it has literally changed that person’s life. Seriously, go look into it. Okay, plug over 🙂

          • maidmarian555

            The drug is called antibuse. My Dad said when they first started prescribing it (I guess in the 60s or 70s) they’d have a nurse wheel a drinks trolley in so you could get to see the reaction your body would have to it. He also told a story where he got put on it and him and his friend headed off from rehab to the pub (obviously) and figured they’d have a shandy as it ‘wouldn’t be that bad’. So they ordered their shandy and drank it and within a few moments the pair of them projectile vomited over the bar and the barman. The fact that he had so many antibuse stories probably gives a good indication as to its efficacy (although, in fairness, he was on it for his final five years or so and it did work as an effective deterrent in the end).

          • Empress of the Iguana People

            It’s a moral failing, of course. /sarcasm.

          • Empress of the Iguana People

            The put the twinkies down comments are so obnoxious, too. I lost 40 pounds immediately post partum and was freaking -starving- for the next 3 months until I regained most of it. Mind, I’d only gained 10ish pounds during pregnancy.

          • Heidi

            Oh gawd, I think Twinkies are awful. I personally can’t stand any snack cakes. I don’t fry my food. I don’t hit up fast food joints. We don’t have junk food or full sugar sodas. I can’t speak for anyone but myself but nothing I regularly ate was even a food associated with obesity. Again, speaking only for myself, I did eat too much but it’s not this obvious binging scenario portrayed. By eating too much I mean the math failed me, not that I’m stupid, weak or out of control. I might have burnt 1800 calories but averaged 2100 daily. Ive seen plenty of binge eaters much less overweight than me. It does so much disservice to everyone to simplify a complex matter.

            I legitimately find myself hungry a lot too. I think that’s just how it goes when you are eating at a caloric defecit especially. Those who have not struggled with their weight don’t understand that to lose it, you have to defy what your body is telling you to do – eat! I know a lot of my struggles are PMS-related. I get lovely bouts of my sugar dropping so yeah not eating when your sugar is under 60 is one, not a good idea but also harder than one might imagine. I have no clue why of all the times I’ve attempted to lose weight, this time has been successful even. I hope I beat the odds and keep it off. I feel more comfortable for sure.

          • Empress of the Iguana People

            My pmdd gives me cravings. Between that and the keen desire to comfort eat getting increased, sigh.

          • kilda

            my dad was one of them. He snacked *constantly* his whole life, candy, ice cream, nuts, whatever was handy. Was the same skinny size until he died at 76.

            I on the other hand inherited mom’s metabolism. Damn it. I don’t even LIKE ice cream, but you wouldn’t know it to look at me.

          • Who?

            Some do. The really skinny people I know fit into one of two categories-eat to stay alive, therefore do so sparingly as they have other things to do that interest them more; or obsessively measure and assess every measly mouthful to ensure it is perfect for them.

  • Tbird

    Having my baby at a hospital with the “Baby Friendly Hospital Initiative” caused my baby to end up in the NICU. My baby was born at 7pm and was taken for four hours of observation for borderline low oxygen levels in the NICU. They wouldn’t give my baby formula until I “consented” which I couldn’t because I was in recovery after my c-section and doped up on morphine. Little did I know, my baby was not given a drop of formula until almost 9pm. When my baby was brought to me around midnight, my baby struggled to latch and no matter what I did, I couldn’t nurse her. The RN was useless at assisting me with nursing or expressing colostrum. Around 5am they took my baby to NICU for treatment of hypoglycemia for three days. Had the nurse just brought me some formula it would have been avoided.

    • Tbird

      I also ended up breastfeeding my kid just shy of 16 months no thanks to the BFHI.

      • Hannah

        I got mixed messages as to whether my medication was safe for it, so I didn’t. But from what I saw on antenatal ward, even if it was safe, I wouldn’t do it until my milk came in, and only after I was home. On the other hand, the hormones were horriffc when it came in, so it might not be worth it. Oh, and I had an oversupply, so so much for the “you have to bf constantly and exclusively for the first few days or you won’t be able to produce enough” bull we were fed in prenatal class.

        • Tbird

          I’m so sorry you went without medication!! That’s terrible. I had an oversupply until my baby was about 7 months. So much of what was taught in the prenatal class was dead wrong. They told me how delicate the breastfeeding was, how if I missed a feeding my milk would dry up. It’s so not true. They also didn’t mention c-sections at all. They just kind of glossed over it and made it seem like only “unhealthy women” had them. “Unhealthy” in their words were “gestational diabetes”, high blood pressure, too much weight gain. I had zero complications my whole pregnancy, only gained 18 pounds, no issues.

          • Empress of the Iguana People

            Despite being obese, I gained the weight of my baby and the placenta both times. No diabetes, gestational or otherwise. I had oversupply once it came in. 4 1/2 days with my ff’d baby and 5 with my bf’d baby.

          • Tbird

            Yeah I don’t buy it! My cousin’s wife is over 300 lbs and she breastfed for almost three years.

        • Merrie

          Oh man, the whole “Your supply will be damaged if you don’t feed enough in early days”. Complete bunk and I had an oversupply once it did come in. In my case, with my firstborn, the real issue was that she was jaundiced and needed to eat more to clear the jaundice but didn’t want to eat because she was sleepy due to the jaundice, more so than the average newborn. Which was not communicated to us very well. In hindsight we should probably have stuffed some formula into her during one of her rare wakeups. Thankfully, she suffered no adverse effects and is now a healthy and extremely smart 6 year old.

          • Tbird

            You’re absolutely right!! Same thing happened to my baby. She was very sleepy and jaundiced and their negligence put her in the NICU.

    • MaineJen

      It blows me away that women are expected to breastfeed their babies with no help after emergency c section. Or any c section, for that matter. Especially first time moms. When I had my son it was an uncomplicated VB, and it still took what seemed like forever to get the hang of breastfeeding. I just could not get him to latch for the longest time in the delivery room, and afterward he would eat sometimes, and then he would scream and not be able to latch at other times. I was a mess of postpartum hormones. How do they expect someone to deal with all that when they are immediately post op??

      • Tbird

        Right?! I feel like half the battle with giving birth and post partum is a good delivery team. It seems to be the luck of the draw.

        Especially since I labored for 26 hours and pushed for nearly 3 hours and ended up with a c-section. I felt horribly embarrassed and ashamed for having a c-section. Especially with the fact that my mom, mother-in-law and husband just saw me prone and pushing for that long only to have a c-section. My mom still makes comments about me “not pushing hard enough” to this day.

        But after all that it was shift change so my nurse was gone, got a different one in my post partum room anyway, and it was night so no lactation consultants were available…though they turned out to be no help anyway. Oh and my first post partum night alone the night after my kid was born the fire alarm went off for three hours and then the lactating consultant screamed at me at 6 am because I hadn’t pumped every two hours overnight.

        • MaineJen

          Good god. That sounds horrific. Not ‘pushing hard enough?’ Either that baby is going to fit, or it isn’t. How hard you push seems to have little to do with that. Women who are unconscious can still give birth; they are hardly actively pushing.

          • Tbird

            That’s what I’ve read. She was a completely average sized baby, 7 and a half pounds. She was persistent posterior. I knew it when I went into labor because I had nothing but back pain for 12 hoursbwith no break in between so I got an epidural. And then the doctor rupture my membranes around 5cm because it had been about 16 hours at that point. I think that caused baby to drop into a bad position and stay there. I begged my nurses for suggestions to cope with pain or positions because it felt so wrong but they basically only came in to check my dilation and left.

          • PeggySue

            Good gravy, with every addition the story gets worse!

          • Tbird

            Seriously! It was a shit show! And nothing like any of the birthing classes suggested it would be, that’s for sure!

      • Gæst

        I wasn’t allowed to go to the bathroom by myself the first day after my c-section. But had they not been in the NICU, I would have been expected to care for infant twins. Yeah, sure.

    • PeggySue

      I’m so sorry this happened to you and your baby.

  • anh

    So, fat women are stupid? Is that the takeaway they’re aiming at?

    • Megan

      That was the first thing I thought when I read about it. It doesn’t make sense. The usual argument is that all women who don’t breastfeed do so because they don’t have “enough support.” If they’re claiming that it’s the same reason for obese women, then why is there a difference in breastfeeding rates? I feel like they’re being insulting and contradicting themselves at the same time.
      Incidentally, I am one of those insulin resistant moms, needed metformin to even maintain a pregnancy. Made only 8-9 ounces of milk a day with both of my first two kids and now pregnant with my third and I still get asked “but you’re going to try, right?” Does it even matter if I “try” when my kids WILL NEED formula anyway? Why are we still pushing this??

      • StephanieA

        Ugh yes. I’m pregnant with my third also. Both of my boys were formula fed (I did combo feed the second for less than a month). People are still asking me if I’m going to try to breastfeed this time. God, no. I have two healthy boys and I’m very vocal that I hate breastfeeding- why in the world would I even want to try this time?

        • Megan

          I saw the OB doing my RCS yesterday and she asked about it and I said “Well, it doesn’t really matter to me how, so long as they get fed.” You should’ve seen the disappointment in her eyes. I really do love her, but I wanted to yell right then and there, “Do you not remember how both of my children were readmitted for jaundice because of “trying” to breastfeed? I just want my kids healthy and home with us!” God, the whole thing makes me angry. I am a teaching family doc, and I know I am seen as “anti-breastfeeding,” which I’m not at all. I just don’t worship breastmilk or see it as some kind of miracle. I look back on my previous attempts to breastfeed and it just makes me sad.
          I actually still have not decided whether to “try” this time or not, but it has nothing to do with baby at all. It’s that every time I wean, I get horrible mood symptoms and the more cold turkey I wean, the worse it is. I have no idea what would happen if I just didn’t breastfeed at all and that scares me. I at least know it’s better if I wean very gradually. I only breastfed for a week last time, stopped cold turkey and the depression that ensued was absolutely terrifying. I am so scared to have that happen again. And yet, I’m asked more about breastfeeding that that at my visits! Ugh…

          • PeggySue

            Sounds just awful and that OB needs some Education.

          • StephanieA

            I feel the same way about my OB- she’s wonderful about epidurals, maternal request sections and inductions, but has major breastfeeding bias. It’s the only thing I can fault her for, and since she provides good care otherwise I can look past it. I’m sorry you have such a terrible reaction to weaning- would some type of medication help with the process? I hope your OB is at least open to that discussion. And thank you for being a provider that isn’t infatuated with breastfeeding, we need more of you!

          • Teddy

            Is it possible that OBs are not able to tell patients that formula is ok? Sometimes I wonder if hospital administrators force doctors to only push breastfeeding. Our pediatrician was all about breastfeeding for my first, and even when I said I hated breastfeeding she still recommended it (with what I imagined was a quiet desperation yearning to tell the truth). When I had to supplement with my second, she was a big fan of formula. So I always wondered if she was silenced, just didn’t want to ask her because I didn’t want her to get canned.
            Can someone who works in field enlighten me please?

          • Megan

            I’m actually still on meds from the last time. I felt so much better I didn’t really want to stop and it is category B for pregnancy. I’m still just afaid that it might not be enough. I’m wondering what would happen if I didn’t try to breastfeed at all. I’m assuming my milk would still come in (since that is more about the quick drop in progesterone from delivery of the placenta) but then would it cause the same symptoms as previous times when I don’t then empty my breasts? I just don’t know. The whole decision has me tied in knots. I am really scared of having the same thing happen. Last time I was like a totally different person and it really scared me. I’ve told my doctor (my family doc who also does my prenatal care) and at least this time we’ll be watching for it instead of me just hoping it will get better, but I can’t help but be anxious about the unknown.

        • Both you and Megan should take heart from the fact that #3 is almost always easier — in spite of having two others tearing the house apart full time. Why? Because you are now much more relaxed, EXPERIENCED mothers. You don’t need the books, or advice (you know what works for you and to hell with everyone else) or listen to the woo.

          All of you, and by that I mean the babies, too — because maternal anxiety is picked up by infants — will be FINE. Calm mother, calm baby, more often than not.

          • Empress of the Iguana People

            calm father’s important too, and my kids’ is a loony. (We tease like that; it makes him feel better, perversely) His anxiety is through the roof

          • StephanieA

            I had that exact experience with my second baby. I was a million times more calm and so was he. My poor first baby! I am nervous about the sheer workload of having 3, and getting everyone ready to go somewhere seems daunting.

          • The first years with three small ones ARE physically very tiring, even with a helpful partner [and not all are]. What’s different is that you know which things are REALLY important, and which less so. So for a couple of weeks you eat McDonalds and take-away, and let the house cleaning go except when the floors get so dirty you crunch when you walk [btw, a cleaning woman, rather than someone who wants to play with the baby like Grandma, is a major help and worth the money]

            I don’t know the ages of the other two, but if they are in school/daycare, use the time you’re alone with the baby as time to grab naps when he does, and to hell with it if it is in the middle of the day. Disconnect the phone.

            I also discovered that, while we had major adjustment problems with the arrival of #2 [#1 is a major Jewish Princess], #3 seemed to hardly bother them; they were older, and they had each other — in fact, both children helped a lot.

            Bottom line is: you’ll cope better than you expect to. If, like me, you’re not a natural organizer, you’ll have to make more lists to get everything in order, but it does all work out!

          • Empress of the Iguana People

            Being 10 years apart can help in it’s own way. Mom got a break from potty sharing and she could reliably send me to run after my little brother

  • Sarah

    There’s a big correlation between obesity and social class in the UK, which closely mirrors the correlation between social class and breastfeeding. White working class women have the lowest rates of breastfeeding and are more likely to obese than average. Thus I’m unsurprised to see that obese women are less likely to breastfeed in the UK.

    • StephanieA

      I’m pretty sure this is the case in the US as well. Of course the upper middle class woman who can afford healthy foods, has time to cook them, and has time and support to exercise after having a baby is more likely to breastfeed.

    • seenthelight

      Yep, same in US. Just imagine, not long ago it was 180* different.

  • Empress of the Iguana People

    The hardest one to talk about in my circle is the supposed benefits of bf’ing. It’s so ubiquitious that people don’t question it.

    • CSN0116

      See, and that’s the most obvious one to me that requires no proof to show that the benefits AREN’T real.

      There is zero measure, objective or subjective, by which I can come close to deciphering who was breast fed and who wasn’t. At any age. In any scenario. In my own corner of the world I know breast fed kids who are sick all the time and formula fed ones who are not. I know that the stomach bug wipes them all out in one swoop regardless of feeding mode (that shit is crazy contagious).

      I’ve never had a medical questionnaire ask how I was fed as an infant (to predict my disease risk). And my grandparents (each alive in their 90’s) and parents were all formula fed and doing just fine.

      I never, ever, ever, ever bought the benefits argument. Ever.

      • Empress of the Iguana People

        Its just so pervasive that even otherwise very science oriented people were babbling about colostrum.

      • StephanieA

        I did, but only on the surface. I never gave it much in depth thought. Once I did, I realized how unimportant it truly is. I’ve mentioned that I work at a BFHI, and I’m the only RN on my unit that doesn’t breastfeed for at least a few months. I might smile to myself just a little when many of my colleagues who are super vocal about breastfeeding for 1-2 years also have kids who are constantly sick. Like, all the time, and these aren’t kids in daycare either. My boys got a mild flu this winter and that’s it. The 4 year old has only been on antibiotics once, and the 2 year old never has.

      • Sue

        I had always assumed that “breast is best” was based on real and significant evidence, as it is repeated everywhere in health care.

        It was only reading references here that showed me how small and temporary the benefits are in wealthy countries. Yay for Dr Amy!

  • Emilie Bishop

    I know of no other medical profession that actively lies to patients like this. It’s disgusting. And I’ve said it before and will say it with my dying breath–WHO CARES IF THESE ISSUES ARE RARE OR COMMON? IF IT IMPACTS YOU OR YOUR BABY, IT IS IMPORTANT AND NEEDS TO BE FIXED!!!

    • mabelcruet

      Absolutely-when you look at comments made on here by people like Jan Hocking and Anna Perch, its blatantly obvious that they push their own agenda and see lying to patients (either as an act of omission or commission) as entirely normal. The end (all babies must be breast fed) justifies the means by which they achieve it(duck and dive, misinform, lie, gaslight, ignore, invent data). It’s paternalism on steroids-they have no qualms about it. They are far more patronising and paternalistic than any doctor I’ve ever worked with-they simply don’t believe in working in partnership with women.

      • Emilie Bishop

        Yes–Jen Hocking once told me that if she told every women every risk factor, many of them wouldn’t try breastfeeding. I’m like no, they could weigh their options with an honest scale and the ones most likely to not make enough milk might save their newborns a trip to the ER. In what universe is that a BAD thing??? Only the lactivist universe…

      • kilda

        **they simply don’t believe in working in partnership with women.

        So true, and so hilariously ironic!

        • mabelcruet

          And this thing is, doctors can be struck off for not giving appropriate information to enable a person to make a decision. There’s been case after case gone through litigation where a patient suffered harm after a procedure and where the court decided that had the patient received more information they may have chosen a different route. So why the hell are these women (seems to be mostly women, sorry to say) getting away with giving mothers advice about breast feeding that subsequently leads to their babies being re-admitted, or to the mum suffering significant mental distress? Has anyone actually tried holding them to account legally? Litigating against them for causing their baby’s brain damage by not providing information, or for out and out lying?

          There have been a few posters on here over the years who have said that incorrect information was written in their birth notes-has anyone gone via a formal complaint route about that?

          As a doctor, litigation is a scary thought, but actually it does help define what is appropriate when it comes to proper valid consent. I know its the last thing a new mother would want to contemplate, but if your baby ended up in hospital brain damaged because you trusted one of these morons, wouldn’t suing them encourage the others to improve their practice and communication skills, and finally learn what consent and partnership actually mean?

          • Empress of the Iguana People

            Jays, my kid’s male ped was more helpful in explaining how to bf than any lc i say -and- encouraged supplementation until my nipples stopped bleeding so badly I was crying. Not the way babies are supposed to get iron. ugh.

    • Merrie

      The main advantage I can see to that rare vs. common discussion is that if X and Y conditions have similar signs but one is much more common than the other, and someone has those signs, it’s more likely to be the common one. I mean, that’s legit. Though it still doesn’t excuse not considering a more rare condition to be present. And even 1% prevalence is still common. A clinician may see a few each week! 200 people in the entire US, that’s rare.

      • Emilie Bishop

        I agree. I just see lactivists insisting that low supply is rare as a way of saying, “So stop being a hypochondriac and nurse your baby.” And I honestly believed my son and I were freaks for all the trouble we had, so the LCs at my hospital accomplished that goal. In reality, it shouldn’t matter why he wasn’t getting enough to eat–he should have just been fed. It’s a situation where a detailed clinical analysis is secondary to preventing an emergency. But as you say, even if we were part of 1% of the population, that’s enough for documentation to see what’s going on! They have no excuse!