Hey, Fatso, we have some breastfeeding advice for you

Beautiful woman doing different expressions in different sets of clothes: be careful

Information for Porky Patients from Smug-Bigoted Maternity Hospital

Welcome to Smug-Bigoted Maternity Hospital! We know how frightening and disruptive hospital admission can be and we want to tell you we are are sorry that a big honking whale like you has been admitted. We’re not just sorry for you; we’re sorry for ourselves. Do you have any idea how hard it is to turn a fat cow like you in bed?

Hey, we’re not insulting you. We care about your health and obesity is unhealthy. Push yourself away from the table for a moment and listen up. Hungry Hippos like you often have trouble breastfeeding and have to resort to artificial baby milk. It’s your choice to be the size of a house so don’t think we’re going to provide you with powdered or ready to feed poison, a suboptimal choice for nutrition chosen only by shit mothers. Losers like you can bring your own.

Referring to formula as “artificial baby milk” is no more effective than addressing overweight women as “fatso” and just as harmful and unethical.

Is this an ethical or effective way to address patients? Is insulting women about their weight likely to result in weight loss? Does insulting them make women more likely to follow healthcare advice? No, no, and no! We would rightfully be appalled at hospitals and healthcare providers treating obese and overweight patients this way.

So why is it acceptable for formula feeding mothers to be bombarded with insults under the guise of providing healthcare?

The BBC reports Hospital’s ‘artificial feeding’ letter to mothers criticised:

A hospital trust has been criticised for describing mothers who use formula milk as “artificially” feeding babies.

Worcestershire Acute Hospitals NHS Trust made the comment in a letter that said it would no longer provide formula milk in its maternity units to mothers who had decided not to breastfeed.

One woman who said she had been unable to breastfeed said the letter’s wording made her “sick to the stomach”.

The trust said it would “consider carefully” feedback it had received.

Where did they get the idea that such language was acceptable in the first place? They got the idea from lactation consultant Diane Weissinger.

Risky Business: Breastfeeding Promotion Policy and the Problem of Risk Language a 2017 paper published in the Journal of Women, Politics & Policy explains:

In 1996 the Journal of Human Lactation published a guest editorial called “Watch Your Language!” by Diane Wiessinger, an International Board Certified Lactation Consultant … In her editorial Wiessinger argued that, rather than providing a convincing case for breastfeeding, the language most commonly used to describe breastfeeding instead serves to reinforce formula feeding as the normative method of feeding infants. Words like “[b]est possible, ideal, optimal, perfect,” she insisted, “are admirable goals, not minimum standards”. Few people feel driven to provide the best, to “be far above normal,” she pointed out, but most people “certainly don’t want to be below normal”… [B]y using words like “best” and “benefits of breastfeeding” rather than “normal” and “risks of formula feeding,” breastfeeding supporters are depriving “mothers of crucial decision-making information”…

[Her] argument has become so well known among lactation consultants, [breastfeeding advocates] often introduce her “Watch Your Language!” piece as “seminal” or “classic.” It is perhaps even more telling that
her name has been made into a verb that is widely understood in the breastfeeding support community: to “Wiessingerize” means to refer to breastfeeding as the norm against which other infant feeding methods fall short…

The decision by the Worcestershire Trust to derogate formula as artificial baby milk is typical of the strategy.

The effort to promote breastfeeding by demeaning formula feeding has only accelerated in the past two decades.

Even just a cursory Internet search shows that breastfeeding promotion materials framed in terms of “the risks of formula feeding” are currently being used by some state breastfeeding coalitions, two hospitals, two private corporations, the Departments of Public Health in California and New York, the City of New York, as well as The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs in at least five states… The United States Department of Health and Human Services’ Office on Women’s Health publishes a 50- page guide to breastfeeding that points out that “among formula-fed babies, ear infections and diarrhea are more common”. It goes on to state that “Formula-fed babies also have higher risks” of a variety of conditions …

The authors note:

Making it hurt: The strategy of risk
The irony, of course, is that individuals and organizations so determined to convince women to breastfeed because of evidence-based claims about its health effects are themselves choosing a breastfeeding promotion approach that is not based on actual evidence.

Insulting formula feeding mothers is no more effective than insulting obese women. Indeed, there is a large and growing body of evidence that Weissingerizing breastfeeding promotion efforts is harming mothers and thereby harming babies as well.

They interviewed hundreds of women and found:

[Women] can recognize when they are being manipulated and that they distrust breastfeeding promotion materials worded in ways they identify as manipulative. Listening shows that many of them think it is cruel or unfair to make infant formula sound so dangerous, especially when it is the only option available to some mothers. Listening indicates that some of them believe that the science is correct and that others have doubts based either on their own experience or on their assessments of the science itself. Listening shows us that some of these women may not believe the risk is large enough, or that there are other risks that are larger or that matter more to them.

They conclude:

All of this suggests that breastfeeding promoters need to do more than simply “watch their language,” lest they themselves risk alienating their audience. Rather, they may want to consider stopping talking altogether, even for just a moment, so that they can hear what women are saying.

In other words, referring to formula as “artificial baby milk” is no more effective than addressing overweight women as “fatso” and just as harmful and unethical.

  • Mimc

    I’m thankful my hospital didn’t take this approach. They fed my baby formula until I was able to pump enough breastmilk (he was in the NICU so I couldn’t breastfeed him). They even insisted on us taking about a dozen bottles home with us even though my husband tried to leave it. I’m glad they did because baby boy did not latch and I got tired of pumping. I don’t know if checking out of the maternity department instead of the NICU would have changed that.

  • fiftyfifty1

    The ridiculous thing about the “artificial feeding” rhetoric is that at some point the child has to be given something other than breastmilk, no? So that means that the child will be “artificially fed” at some point. And since that’s the case, why not start now?
    It’s like the people who use the “outsourcing care to strangers” rhetoric to refer to daycare. I mean using this logic, isn’t sending your child to school the same thing? Letting them go to camp, spending an hour at Sunday school…all of it involves “outsourcing their care to strangers.” And since that’s the case, might as well start now.

    • Mimc

      There are some that don’t do school, camp, or sunday school for that very reason. I think I would lose my mind if I felt I couldn’t let someone else watch my kid for even an hour.

      • Children need exposure to other children in order to learn how to socialize . There probably is nothing worse than being isolated with a mother 24/7, especially if she’s neurotic.

        • Mimc

          I agree. It’s not healthy for moms or their kids.

      • The Bofa on the Sofa

        I’ve said it before, if kids only spend time with you, then the only thing they know are the things you have taught them.

        What good is that?

        I want my kids to know more than I do! I want them to learn things that I don’t know, and the way to do that is to interact with others. This is how they can improve, how they get to be better than me.

  • The Vitaphone Queen

    You forgot “You gorged yourself on the artificially flavored GMO-laden filet mignon at Chez Amy rather than the salad Niçoise at Wize Wimmen Resterent. Serves you right, Fatso.”
    (For those new here who don’t get the reference: http://www.skepticalob.com/2014/01/when-is-a-hospital-like-a-restaurant.html)

  • Guest

    I’ve had patients burst into tears when I reassure them that so long as their baby is sufficiently fed with something safe, I’m happy. It’s incredible how much of a difference it makes in the patient-physician relationship when you treat your patient like a person instead of a template onto which you paste population-based guidelines. I’m only a student (starting residency in July) so unfortunately I haven’t been able to follow any of these patients for longer than a rotation, but I have had several ask if I’ll be their family doctor after residency.

    The ability to change so much of the transition to parenting is part of why I decided on family med instead of OB/gyn. Here in Canada, as a family doc I can provide the full scope of prenatal, intrapartum, and postpartum plus neonatal care for normal risk patients. So I can go to bat for my patients if someone bullies the parent, because the baby is my patient too. I look forward to that advocacy part of the job. Never been afraid to ruffle feathers when necessary.

    • MaineJen

      That reminds me so much of a story my mother told us…my brother was ill as an infant and had several hospital admissions as little more than a newborn. Between all the stress of being postpartum, having a sick baby and a toddler (me!) as well, she found herself unable to breastfeed any more. The stress was just too much; the milk had dried up. She broke into tears at his bedside one day, and some kind doctor reassured her that my brother would be absolutely fine on formula, that she shouldn’t give it a second thought and should concentrate on taking care of herself and him.

      She really never forgot that doctor’s kindness. And my brother was indeed just fine, he grew into an enormously fat happy baby, and is now grown with a family of his own. This was the late 70s/early 80s and I’m not sure the pressure to breastfeed was quite what it is now! There was certainly no BFHI…

  • aurora

    OT but I need some advice. I am having a c section at a BFHI hospital and I am not sure if I want to breastfeed. I am of the mind of I will see how it goes, but I do not want to be grabbed or pushed to do so. I am also bringing my own formula. Is it better to say I am not breastfeeding so I can be left alone unless I ask for help?

    • StephanieA

      yes, unfortunately that’s probably the best thing to do. If you say you want to breastfeed, some nurses might then discourage formula when you ask for it, tell you all the ‘risks’ to formula, etc. Not all nurses are like this but you don’t know what you’re going to get. Although it does help that you’re bringing your own because that way you can’t be bullied about giving it and they can’t try to with hold it.

      • swbarnes2

        I think they will tell her the ‘risks’ of formula no matter what she says. I think BFHI rules mandate that lecture.

        • StephanieA

          It really depends. Moms who come in to L&D wanting to exclusively formula feed often are spared the lecture, because they have their minds made up. But like I said, it does depend on the nurse and LC’s you get. Our LC’s don’t bother the formula feeding moms at all, but I’m sure its different at other facilities.

    • seenthelight

      I actually would, yes, because your milk likely won’t even come in until after you’re home, but they’d be pushing you to only feed your newborn colostrum for the whole hospital stay. You could look up local lac consultants now to have a list ready to call if you try and have trouble after getting home.

    • Cartman36

      Hi! I am preparing to have a RCS at a BFHI in June. I plan on telling them that I am supplementing from the beginning (i.e. check in) and requesting formula to be brought to my room (I will also bring some) so I can top up after nursing.

      One of my favorite saying if someone is being pushy is “I am not going to debate you and I am not going to justify my decision to you. This is my decision, period.”

      Best wishes for you and baby!

      • aurora

        Thank you!

  • Amazed

    Update on my friend with the high blood pressure and the asshole doctors: BP started getting dangerously high, so out the baby went. She can’t breathe on her own yet and is on antibiotics but this was expected, with a 31 weeker. They still can’t get BP down to normal levels. You know what I asked? “How are you? How is the baby? Do you want me to do something for you? Do you need company? You know I work late hours, so you can always call me without even bothering me? I won’t be calling since I might wake you up when you need rest but you know you can ALWAYS call me?” You know what I didn’t ask? “Did you have a CS? Are you doing everything you can to induce lactation?” Hell, I don’t even know what’s going on on the feeding front. They’re in the hands of people who know far better than I and really, who would ever think that she needs MY reminder that in her case, pumping would be a good thing IF there is any milk which I don’t know?

    It’s in Prof Dahlen’s best interest not to come anywhere near me now. I could happily throttle her!

    • Ozlsn

      Best wishes to your friend and her new baby. Hope the BP has stabilised.

      • Amazed

        Thank you. The BP is not quite stable yet but about an hour ago, the little one breathed on her very own for the very first time!

  • Steph858

    Instead of complaining about how offensive the Lactivists were by calling formula feeding ‘artificial’ (I have a feeling this will just encourage them to do it more – after all, if they’re getting us riled up they must be doing something right!) I suggest we reclaim the word ‘artificial’. Perhaps print leaflets/placards/whatever to hand out/wave around whenever someone tries to invoke the Naturalistic Fallacy. They could say something like this:

    Natural:
    – Hemlock
    – Rabies
    – Belladonna
    – Death Cap
    – Ebola
    – Tornadoes
    – Earthquakes
    – Malaria
    – Plague
    – Mycotoxin
    – Syphilis
    Etc

    Artificial:
    – Living to adulthood
    – Avoiding vaccine preventable diseases
    – Clean water
    – Sewage systems
    – Refridgerators
    – Clothes
    – Antibiotics
    – Houses
    – Travelling faster than a horse
    – Agriculture
    – Civilisation
    Etc

    And those are just off the top of my head.

    • Merrie

      Yeah, exactly. I was like, so what if it’s artificial. It is healthy food for a baby and is great to have available so that babies are able to eat! It’s better for baby than any of the “natural” alternatives to nursing like goat’s milk. Lots of foods that we eat are artificial or processed in some way.

    • Cartman36

      Good Point! We don’t use the term artificial immunity when talking about the benefits of vaccines but its no different.

      • MaineJen

        Actually, we’ve encountered antivaxxers who do indeed make the argument that immunity gained from vaccination is “artificial” and the “natural” immunity you get from being sick is far superior. No joke.

        • Cartman36

          true but medical professionals don’t and wouldn’t use it.

    • kilda

      add eyeglasses under artificial!

    • Heidi

      Well, don’t underestimate the stupidity of a select few. I think I read some people are ingesting terpentine because it’s “natural.” I mean, I don’t think extracting a concentrated substance from a plant is natural myself but I digress. These same people who worry about the well within safe limits of glyphosphate in their Quaker Oats are purposely ingesting a substance that is considered very harmful at 800 PPM. Oh yeah, and Belladonna was responsible for a few deaths in some “natural” teething homeopathic bullshit.

    • MaineJen

      Someone meme-ify this, please!

  • CSN0116

    Sigh – so this is where we’ve devolved to. When people don’t buy your flat-out lies about “benefits” and use their bodies as you prescribe, you just resort to insulting them. What’s next? Lighting them on fire?

    • kilda

      please don’t give them ideas.

    • Well, burning fat is good, right?

  • Heidi

    I’m also over the whole, “But breastfeeding will help women lose weight and prevent them from getting diabetes.” Hey, some of us that are overweight and were blessed with gestational diabetes find ourselves unable to breastfeed. Yeah, I get the correlation with breastfeeding and less likelihood of later developing type II diabetes, but that doesn’t mean breastfeeding prevents diabetes. I definitely know many women don’t find they lose weight either. I just find it overall infuriating.

    • kilda

      yes, the article leaves out the part where Smug-Bigoted Maternity Hospital tells the mom, “You really need to breastfeed anyway. It will help you lose some of that weight. Plus it will save your baby from growing up to be a fatty like you.”

      I actually have a private theory about weight and diabetes. Everyone assumes that being overweight causes type 2 diabetes, because most diabetics are overweight for some years before developing it. But what if it’s the opposite? What if diabetes causes the overweight? If diabetes is caused by some other, unknown factor, like say a virus that alters metabolic processes, and weight gain is just an early symptom, before the changes that we define as diabetes become apparent. That would change the whole paradigm of “fatties are to blame for giving themselves diabetes.” Maybe people who are overweight are not only not at fault for becoming diabetic, but aren’t even at fault for becoming overweight.

      • Roadstergal

        There is a lot of work ongoing about genetic susceptibility to T2D, and if those risk alleles also predispose one to weight gain.

        There are a lot of genetic factors involved in weight, for sure. And those are, in the scarcity in which we evolved, survival traits. We just aren’t evolved for our world. It’s not about being a morally better person, FFS.

        • Sarah

          This is one of the reasons I always roll my eyes when people claim breastfeeding is protective against obesity. Why on earth would we have evolved to protect against something that has been advantageous for most of human existence?

        • kilda

          I think about this because I am old enough to remember when everyone knew that ulcers were caused by stress and the idea that they could be due to a bacterial infection was outlandish. It’s pretty much guaranteed that some things we take as obvious medical truths today are totally wrong. We don’t know which things – but guaranteed there are some things future generations will laugh at and say “can you believe doctors used to think that?”

      • Heidi

        My mother is overweight now, and I believe even considered mildly obese. But when she was pregnant with my sister and I, she had a non-overweight BMI. I was born during her 36 week glucose intolerance test so we’ll never know if she had GD or not but I had a huge struggle with hypoglycemia at birth and had to be administered dextrose several times. Neither breastfeeding nor formula feeding was ample to stabilize my glucose. With my sister she was diagnosed with GD much earlier. In the end, she couldn’t produce enough with either of us. I couldn’t produce enough either. Neither of us have obvious breast issues, such as hypoplastic and/or tubular breasts. I figure there’s a good chance insulin issues are the true culprit. Although I weigh less now, I still figure there’s a really good chance I will be diagnosed with GD again with a 2nd pregnancy. And I have no big hopes my boobs will be milk machines either.

      • mabelcruet

        I’ve been obese most of my life, earlier in life I was definitely into the obese category (BMI 30+) and currently I’m at the upper end of the ‘overweight’ category (BMI around 28-29). I’m menopausal and my GP won’t start me on hormone replacement until I get my BMI below 25, which isn’t going to happen. However, because of that, I keep getting called in for well woman checks, blood pressure checks and more recently, the practice was doing an audit checking for pre-diabetes so I was invited to go and get fasting blood sugars and HBA1c checked. Every time I go I have to get my BP done at least 3 times because they don’t believe it-its absolutely normal, usually hovers around 110/70. They don’t believe it, so they do it again. And then they get a new cuff and a new reader, and repeat. And then they get the nurse practitioner to take it instead of the ordinary practice nurse. And I had the fasting sugar done twice because the first one ‘must have had a problem’.

        I’ll probably end up with hypertension or diabetes at some point, but there seems to be a resistance to accept an obviously fat woman could have quite normal blood/physical readings. I know that illness prevention and screening is important, but it actually gets a little insulting when they are so surprised that I have normal pressure and refuse to believe it.

        • Jen

          Is it at all possible to change healthcare providers? This treatment isn’t acceptable. It’s completely usual for patients in the BMI range you described to have normal blood sugar and blood pressure. Not all providers offices treat their overweight and obese patients this way. Fat doesn’t inherently mean metabolically unhealthy. I recommend a blog called dances with fat. She has a lot of practical advice on how to advocate for yourself when facing fatphobia in the medical setting. https://danceswithfat.wordpress.com/blog/

          • mabelcruet

            I think I got off on the wrong foot there when I registered there 15 years ago. I was a lot heavier then and when I had the registration medical the nurse couldn’t get the BP cuff to fit, she kept trying and pulling it tighter but the readings were all over the place. I suggested she would need to use a larger size cuff and she huffed and puffed a bit more and tried a couple more times, then went to get the duty doctor. The duty doctor promptly asked for the larger cuff and told the nurse that it was important not to use smaller cuffs on larger arms. So everytime I see that practice nurse she scowls at me like it was my fault.

            I’m moving house soon though now that I’m semi retired so I’ll be changing GP practice. The GPs are great, and most of the nurses, just that one stroppy one, but unfortunately I nearly always get assigned to her when I go.

        • BeatriceC

          I had it out with my doctor a while back. He diagnosed me as T2D on the basis of one, single minimally elevated fasting blood sugar. My A1C was fine. He ordered a second set of blood work and that one was completely fine; well within the bounds of normal. He never sent me for a glucose tolerance test or anything else. But I’m obese. So that means that single minimally elevated fasting blood sugar test meant I was diabetic even in the absence of literally any other test result that could lend credence to the diagnosis.

          In other words, I’m fat, so therefore I must be diabetic.

          • Heidi

            My mom had the bright idea to send me to a diet doctor when I was 17. It was bizarre because the doctor was no doubt in the “morbidly obese” range. I don’t say this in a ridiculing way, but it was a traumatic experience for me. It was, looking back, a huge bunch of sexism. How dare I be chubby! But men can be fat because I dunno, but it is fine. I, however, as an almost adult woman, needed to get my priorities straight and lose weight. He also told me I was prediabetic when my 2 hr. glucose tolerance came back at 118. I believed him because this was before you googled everything. I just got to sit there crying while he fear-mongered and belittled me. He then put me on, no joke, a 1000 calorie diet and some useless pills. I wouldn’t go on a 1000 calorie diet now at 33. If he wasn’t dead, I think I’d be standing up for 17 yr. old me. I blame him for disordered eating issues I had in college. I justified extremely low calorie dieting partly out of fear and mostly because a medical doctor endorsed it.

          • mabelcruet

            My mother first put me on a diet aged 8. At the time (1970s) there was very little childhood obesity, and we were very physically active-looking back at photos I was chubby, but not huge. I won prizes in high school for swimming, hockey and rounders so I wasn’t seriously obese. But being made to sit apart from my classmates and have 2 limmits (diet) biscuits for lunch instead of a normal meal really affected me and caused a lot of issues in future years.

            The only ‘diet’ that has worked for me is a keto type diet-I try and avoid all white food (bread, potato, pasta, rice, baked goods), eat loads of protein and fruit and veg. It’s not exactly a low carbs diet, but works for me.

          • Heidi

            Yeah, I was put on diets constantly. I was treated like if lost weight, the world would hand everything to me, but being modestly overweight, I’d perish of loneliness or something. I don’t know what would have happened if I reached the magic number, but I have survived just fine with some extra pounds. I discovered the issues were more to do with how I felt about myself. I wish I’d known that then and not put myself through all the self-loathing, starvation, subsequent binging, etc.

          • BeatriceC

            My mother’s family is very skinny. All of my biological siblings (and the ones that are biologically related on that side but adopted by my parents) took after my mother’s side. My mother is 5’5″ and weighed 89 pounds on her wedding day, to give you an idea of their basic size. My father’s side of the family is all your basic linebacker build. Of course I took after my father’s side of the family. I look back on pictures from when I was a kid and I was not fat by any stretch of the imagination, but I was always told I was fat because I was larger than my siblings. I frequently had food restricted because of it, and if I complained I was hungry my father would look at me and say “oh, yeah, you look it” in a sarcastic, mean tone. I was also starved at the alter of breastfeeding when I was a newborn, losing 25% of my birth weight and taking nearly two months to gain it back, then gaining super slowly until my mother put me on formula when she got pregnant with my sister and her milk dried up when I was 7 months old. Then I started growing by leaps and bounds. Between those two things, I think we can completely explain my complex and unhealthy relationship with food, which leads to my current weight problems. I honestly need to see a psychiatrist about it, because my self help attempts have led nowhere.

          • Heidi

            Oh yes, I have been treated like that too by my parents. My parents denied any snacking. School lunches were at like 11AM, dinner was at 7. Of course I was hungry! Then of course I ate big dinners. I can’t imagine ever treating my child like that. I feed him as he wants to eat and he’s slim. If he is chubby as he grows up, I refuse to make an issue of it. I know from experience it doesn’t help but harms.

            My dad would forget to feed me as a toddler too. He would get caught up with work and not think to feed me. I think I started being chubby around that time. I don’t leave the house without a snack or two for my son.

          • BeatriceC

            I talked to my kids about balancing out food intake with activity. Any amount of food is acceptable as long as you’re active enough to need that much fuel. Undereating is unhealthy, but you can’t overeat if you’re burning the calories. My kids seem to have a much better relationship with food than I do.

          • Empliau

            I’m not medically obese, although as my sixtieth birthday nears I verge on the matronly. I was brought up to clean my plate – we were force-fed if we didn’t (vomiting didn’t get you out of it) and to this day I pretty much compulsively finish my meal. My teenager can eat when hungry, stop when full, and can do without when not hungry. It’s like living with Captain America – where did she get this superpower and can I have some?

          • MaineJen

            Same here. My kids get to eat whenever they’re hungry. I refuse to make an issue out of it.

          • FormerPhysicist

            OMG. All I can say, is that following and occassionally posting, I think you’re someone I’d love to get to know, and look just fine.

          • BeatriceC

            Thanks. One of these days I’ll get rid of all my baggage. It’s a slow process, but I’m getting there day by day. 🙂

          • mabelcruet

            I was treated as though being fat reflected badly on my mother, that I was embarrassing her. She was always very slim but put weight on in her 50s and found it hard to lose (I’m afraid I had no sympathy for her, having been told all my life ‘Just eat less, it’s easy, stop being so greedy and you’ll lose weight.’)

          • Heidi

            My mom used to tell me she wasn’t overweight in her teens or 20s. As if there’s no excuse to be overweight at that age but in your 30s it’s understandable. My mother is in the same boat in her 50s now. I want to tell her to shut up about her weight. I don’t care and it’s not my job to put her on a diet.

          • 1000 calories?! That’s insane.

          • Heidi

            That’s because I was still not an adult. His adult patients were on a 900 calorie diet. Every time I’ve gained a significant amount of weight, it’s been after dieting in such a manner. I doubt any of his patients had lasting success.

          • Ugh. Disgusting. I can’t imagine what that did to your metabolism.

          • mabelcruet

            Has that diagnosis been amended, corrected or removed? Won’t that affect your health insurance costs of you have a spurious diagnosis made?

          • BeatriceC

            It has not, but I only just discovered that, as I was assured it would be removed until appropriate diagnostic testing was done. But it’s come up again, so I’m arguing again. Honestly, they just need to send me to a GTT and be done with it.

        • kilda

          That is annoying. It also means they probably fail to catch diabetes and hypertension in a small number of “normal weight” patients because they don’t think about it. If I remember correctly, about 1/3 of obese people never get diabetes. And my BMI is barely above the healthy range, but my blood pressure without meds runs around 190s/100s (yikes). I also have sleep apnea, inherited from my skinny-as-a-rail father. Meanwhile my wife has a BMI in the 50s, and her blood pressure is perfectly normal, on no meds, and she has neither diabetes or sleep apnea.

          • MaineJen

            My paternal grandfather and ALL of his siblings were diabetic, once they reached age 40 or so. They were also all tall and skinny. Almost like…there’s a genetic component to susceptibility to IDDM2…and your diet can only do so much…

          • kilda

            almost as if medical conditions aren’t punishments for moral failings….

          • StephanieJR

            Louder for the people in the back!

          • mabelcruet

            My family tend to breed large and tall, kind of 1/6 above normal scale. My gran was 6 foot 2, my grandad 6 foot 5. My nieces and nephews vary between 5 foot 11 and 6 foot 4. The women all survive until late 80s at least, so we make old bones. We are a solid hybrid of Irish and Yorkshire!

          • MaineJen

            Bah. According to 23andme, I’m 56% British Isles and 27% Scandinavian. Did I get any of that lovely Scandinavian height? HELL NO. I inherited allllll the ‘short’ genes from the Welsh ancestors. I didn’t even get the blonde hair…even the Swedish relatives are dark haired. I’m built like a really short pioneer woman.

          • mythsayer

            I’m HALF Scandinavian, the rest scotch Irish and some German. I’m 5’4. So there you go lol.

      • Madtowngirl

        Your private theory is in alignment with emerging hypotheses from recent research.

        I, too, have been overweight for most of my life. I have been on more crash diets than I can count, and I was pretty active in my youth. I overate on occasion, but I generally ate reasonably. Yet stayed overweight. It wasn’t until I had my third miscarriage that I received a PCOS diagnosis, and lost a bunch of weight when put on medication.

        People with PCOS are at a higher risk for developing Type 2 diabetes. The condition makes it easy to gain weight and difficult to lose. It is also underdiagnosed and doctors are still learning about the condition.

        Coincidentally, I was in play about diabetes a few years ago. The playwright addressed that one of the reasons people are so quick to jump to the conclusion that “you must have brought this on yourself” mentality is because we love to believe people get what they deserve. You have diabetes? It’s because you were an unhealthy pig!! It’s especially terrible because it’s very possible that you get heavy *because* of diabetes, not the other way around.

        Edited because fat fingers.

      • mythsayer

        100% this is true for many people (I don’t want to say all). I was overweight my whole life and couldn’t lose it. When I had weight loss surgery, they found out I was insulin resistant (prediabetic). Insulin resistance makes you retain sugars, and therefore gain weight. It’s a vicious cycle. You can’t get out of it without losing weight. I DID lose weight after surgery, and guess what? My metabolism re-regulated and I’m no longer insulin resistant. I also don’t gain weight like I used to. I’ve kept off 100 pounds for 14 years.

        My daughter is 7 and weighs as much as a small adult. Guess what she has?

        Yup. Insulin resistance.

        • Heidi

          I’ve noticed after losing 50, I don’t gain weight as easily and my hunger isn’t like it used to be. But being able to lose the 50 to get that stability was quite a feat. I don’t think I’d been able to do it without all the privilege I have. I was able to walk a lot during the day and didn’t have to worry about a food budget.

      • Megan

        I had acanthosis nitro and (a hallmark of insulin resistance) and horsutism from pubert onward, despite being very thin so I find it really hard to believe that’s not genetic. I have been battling my genes ever since. I’m not thin anymore and I work very hard at diet/exercise but even at my lowest adult weight I needed metformin to maintain my pregnancies and guess what? I have IGT and can’t breastfeed much either! My mother compounded issues by projecting her weight issues on me including putting me on my first diet at age 9 despite being normal weight to start with and telling me at the fitting for my wedding gown that perhaps I could exercise to get rid of my flabby arms. I now have two daughters of my own and I flat out cold turkey stopped bad mouthing my body as soon as my oldest was born. It was the best motivation to be kinder to myself. I may pass on my crappy genes but I refuse to make them feel bad about their bodies. We just try to be active and healthy as a family and we’ll deal with whatever medical issues arise as they come.

        • Megan

          *Acanthosis nigricans, sorry autocorrect

        • Empress of the Iguana People

          I’m trying to get my spouse to stop badmouthing himself. Out loud anyway. Its the depression and anxiety talking, but it’s not good for the munchkins to hear.

          • Mishimoo

            Same here! It’s hard though, because he just genuinely doesn’t believe any compliments he receives.

    • Merrie

      Does breastfeeding lower the diabetes risk or is it moms who are at greater risk of diabetes are also at greater risk of not being able to breastfeed for some of the same metabolic reasons? I know that PCOS is linked to increased likelihood of infertility, diabetes, and difficulty breastfeeding.

      I wonder how many of these studies feature moms who physically could breastfeed and chose not to and compare them to those who quit because they weren’t able to make milk, vs those who were able to make milk but the baby didn’t latch/was allergic to it/other factor, vs whatever else.

      • Heidi

        I would place my bets that women who later become diabetic already had insulin issues and weren’t able to breastfeed and that breastfeeding does not prevent diabetes.

  • StephanieJR

    OT PSA: As your resident Crazy Bunny Lady, and keen purveyor of Rabbit Facts, I feel that I must say that, although we’re all (mostly) responsible adults, there is still a lot of misinformation out there, and so I ask: please don’t buy your kids a rabbit for Easter.

    I know, I know, pretty damn obvious, right? But every year thousands of people buy their children a bunny, and every year, most of them end up being dumped, abandoned, or shut up in a tiny hutch and forgotten. The lucky go to rescues. I don’t know the exact statistics, but most don’t make it past a year, dying from improper care and neglect.

    A tiny baby bunny, so soft and fluffy and sweet, how could you not love them? Well, give it a couple of months, and that sweet baby is now a pissy, bratty, destructive, hormonal teenager, that growls, lunges, scratches and bites anyone that tries to pick them up. Which they hate; they’re prey, and think your child is going to hurt them. Which they can easily do just on accident, as rabbits are stupidly fragile, and can hurt themselves struggling.

    And then there’s the poo. Oh god, the poo. Three hundred little shits a day. And the pee! Male rabbits (bucks) can spray it a few feet up the wall. And on your kid. Who they then try and hump. Along with anything else they can get to. They need to be neutered; even if your female (doe) is behaving, her health is important, as four years later, she’ll most likely get ovarian or uterine cancer and die. I’ve heard of some rabbits living to sixteen. Sixteen! There’s rabbits bought today that won’t make it past six weeks.

    Say goodbye to all your cables, your baseboards, your lovely wooden furniture; rabbits need space, a lot of it, far more than any cheap, store bought cage or hutch can typically provide, and they need to chew. How uncomfortable must it be, to have forever growing teeth, and nothing to wear them down. Which is why a diet of mostly good quality hay, with a small portion of appropriate pellets and safe greens, is so important. Half the stuff sold will kill your rabbit, as again their digestive system is highly sensitive. Expensive vet bills, and a heartbroken child, are not worth it.

    I’m not even getting into the trouble of getting two, finding out that they’re a buck and a doe, and the resulting baby bunny explosion.

    I love rabbits. They are wonderful, entertaining, engaging, mischievous little darlings to the people they suit. But a rabbit is not a suitable pet for a young child. If after all this, you and your family still want, and feel like you can provide a good home for, bunnies, wait a couple of months, and go to your local rescue. There you’ll find many a mixed sex pair, already neutered, litter trained and bonded, all the hard work done, as there is always a large influx not long after Easter, as so many are dumped or surrendered. Some may wait years to be adopted.

    This has been a rather long Rabbit Care PSA. This year, make your Easter Bunny chocolate.

    (Steps off soapbox)

    • BeatriceC

      One of the vet techs at my vet’s office runs a rabbit rescue from one of the back rooms at the hospital. Her busy season starts about a week after Easter. Last year rescued and placed over 300 rabbits, and this is just one person working with the blessing of an avian and exotic vet out of his office space. Can you imagine how many more are out there that don’t get lucky enough to find their way to a rescue?

      • StephanieJR

        Three hundred for one person is amazing! I’m grateful for anyone that works that hard for so many rabbits.

        The good pet stores don’t sell rabbits over Easter, and we are doing our best to spread awareness and correct information. I try my best not to be all lecturing and that, hopefully just passionate.

        I don’t know all the numbers. I’ve heard that 90% bought at Easter die within a year, though it’s been a while, and I’m not sure which country, so it may be inaccurate, but I do know that there is about 65,000 to 70,000 currently in UK rescues. The UK has the RWAF (Rabbit Association And Welfare Fund), and I recommend the House Rabbit Society for the USA.

        • BeatriceC

          She does have the advantage of running her rescue out of one of the most well respected avian and exotic animal hospitals in the US, so that helps her ability to reach people and place rabbits.

    • Roadstergal

      A-woman. You know what’s adorable and soft and squishy and kids can abuse and neglect it as much as they want? A stuffed toy rabbit! Kids love them! I have one! It lives on the back of my race bike!

      • StephanieJR

        I may or may not have amassed a large collection of my own stuffed buns (and a smaller collection of ornaments).

        Amy is my adorable, soft, fuzzy, squishy bunny; she is also my naughty, attention demanding, greedy, occasional litter habit abandoning bunny. She does like kids, though, so long as they’re not being too loud/active. She gave the five year old son of a family friend some kisses once, which was very sweet

      • Empress of the Iguana People

        Chocolate and stuffed were the only ones to ever grace our baskets.

  • Sarah

    There are quite a few hospitals who claim they don’t provide formula for newborn babies, but I’d be highly surprised to see any of them not cave if a mother hadn’t brought formula and declined to breastfeed. The reality is that they will have formula there because sometimes it’s medically indicated. There are also going to be women who turn up not knowing they’re pregnant, or in unanticipated labour and who’ve not brought their bag with them, and there are going to be some of them who for whatever reason do not breastfeed. It will happen. So the question is basically whether clinicians are going to blatantly refuse or not. With the professional bodies lurking in the background.

    I know we hear of stories of professionals allowing babies to be starved on their watch, but it’s a bit different when they can somewhat delude themselves there’s another nutrition source.

    • EmbraceYourInnerCrone

      So if one chooses not to breastfeed the hospital can require the parents to provide the infant with food, something they don’t do to ANY other type of patient. If one of their patients(the mother) chooses NOT to use a part of her body the way the hospital thinks she should, they reserve the right to penalize her for it….awesome

      • sdsures

        *splutters incoherently*

      • Emilie Bishop

        My hospital had this policy. It’s why my son starved, because I didn’t know we would need formula so I didn’t bring it.

        • Kelly

          This kind of crap makes me so angry. I would have never believed it if it were not for this blog. Both of the hospitals I delivered in were fine either way and I have done both without issue. Both times I nursed too, they provided me with formula when it was needed. My first was jaundice so they told me to nurse first and then top off. The second was a hungry little thing and when she wouldn’t stop nursing every hour, they took her to the nursery and asked if they could feed her a bottle. The third I formula fed and they gave me instruction on how much to feed her. They ended up taking her to the nursery overnight so I could get eight hours of uninterrupted sleep. This is how it should be. No matter the different circumstances I got help. I got lactation consultants when I needed as well.

          • Emilie Bishop

            You’re totally right–that’s how it should be. Moms should be treated like patients who have gone through either major surgery or an exhausting ordeal (or both) and need sleep to recover. They should be given support to care for their baby in the healthiest way possible, regardless of ideology. But the BFHI has thrown all that out the window.

        • Xena

          I had never heard of this before and it’s horrifying. When I gave birth I didn’t breast feed and gave the baby up for adoption right away before I even left the hospital. If a hospital really wouldn’t give formula would they really have been ok with letting that baby starve until it left the hospital with whoever took it?

          What if the mother literally can’t breast feed or dies in childbirth?

          • Emilie Bishop

            I have a friend who delivered at my hospital who also made an adoption plan. Her daughter’s adoptive parents were chosen ahead of time and they stayed in the hospital with the baby. I would assume the baby was given formula by the hospital, but now that I think about it, I’m not positive of that. But I was told over and over in prenatal classes that we would either breastfeed or need to bring our own bottles and formula, which we would be responsible for preparing and cleaning. Truly awful policy.

    • BeatriceC

      I don’t think you can make that assumption. There’s a blog written by a same sex couple (two women) that describes what happened when their newborn was readmitted for jaundice in the middle of the night and the “baby friendly” hospital would not feed the child even though the gestational parent couldn’t have breastfed even if she wanted to. There were no nearby stores open so this baby, admitted for jaundice, for which one of the primary treatments is to make sure baby is well fed so the bilirubin can pass in the stool, was quite literally starved all night until one of the parents could get to the store and buy formula the next morning, and even then, they were given grief about using it. I’m hunting for the link now, but it’s a horrifying story.

      • Sarah

        I’d be interested to read it. Was it in the UK? I had been thinking this was probably aimed at getting women to bring their own formula with them and reduce costs to the hospital that way. Of course a woman might also feel there are advantages to bringing her own supply anyway even if the hospital provide it.

        • BeatriceC

          It was in the UK. But even if that was the reasoning, they literally starved a fucking jaundiced newborn all night. I can’t even begin to count the ways that’s wrong.

          • Sarah

            Gosh that’s appalling. That said, the hospital did actually supply some formula overnight and in the morning despite their stated policy, not enough but some, and these are parents who did also provide some themselves. I’m envisaging what the hospital would do if confronted with a situation where the parents simply don’t. I don’t think they’ll have the ova to just not do it.

            You won’t get any argument from me about how wrong any of this is, of course: this is not a defence of the hospital’s actions.

          • BeatriceC

            As soon as crazy mama, PhD came up with the actual link I did admit to getting some of the details wrong. 🙂 It’s been a long while since I read the post. But the overall point remains. They were willing to underfeed a sick newborn even when nothing else was available. This is bad enough under normal circumstances, but when one of the treatments for the particular issue that child had is “feed the baby”, it’s even more so.

          • Sarah

            Oh sorry I missed that bit. But yes, of course it’s inexcusable. I don’t think ‘we didn’t starve the sick baby we just bullied the shit out of the new mother’ is a particularly rousing defence.

            There seems to be a bit of a trend towards this in the NHS at the moment though, having public policies that conflict with legal and regulatory duties. I think this is the feeding equivalent of the Oxfordshire no MRCS thing. It would never stand if legally challenged, nor would the regulatory bodies allow it. And they know in reality they’ll still be providing some formula and doing some MRCS. The aim is just to put some people off. You’ll get it if you make enough of a fuss and make it enough of their problem. But meanwhile if you’re not, and this goes to some of the points about intersectionality on the thread about treatment of black women in the US, you’ll be given worse treatment.

            This is what I reckon, anyway.

      • crazy mama, PhD
        • BeatriceC

          That’s the one. I got some details wrong, but the overall point is the same.

          • crazy mama, PhD

            Yeah, re-reading it was making me rage-y.

        • Merrie

          That’s really bad. The hospital needs to feed their patient.

    • Roadstergal

      We hear so many stories, though, of the midwives trying to keep a kid technically just over the ‘starving’ threshold (even to the point of re-classifying acceptable % weight loss) and send it home, only to have it readmitted shortly afterwards due to dehydration/starvation…

      • Sarah

        We do. These are babies with an alternative feeding source though. I think there’s a distinction in blatantness, if you like. It’s easier to delude oneself that a child being breastfed isn’t starving than a child who is being given literally nothing.

    • Empress of the Iguana People

      Or women turning up for something else and need to get induced -tonight-. I feel better now

      Ahem.

    • Emilie Bishop

      I’m sure in an emergency like that, they would feed the baby formula. However, my hospital said in prenatal class that we would either have to breastfeed or bring our own formula and bottles. Even when I had injured nipples, a baby who was latching worse instead of better, and a baby who lost 4% of his weight in less than 24 hours, the most I got was a nipple shield and one round with the pump for “stimulation.” As a first-time mom, you don’t know what you don’t know–and they know that.

      • Sarah

        Yes, quite. As I said in another comment, I think what they’re doing here is trying to reduce the amount of formula they have to give whilst knowing secretly that they will never get away with not providing any if a parent doesn’t give either formula or breastfeed.