What if formula harmed as many babies as breastfeeding does?

Risk

For years I’ve been pointing out that the promised benefits of breastfeeding have failed to materialize.

Although lactation professionals like Melissa Bartick, MD have continued to write papers modeling the purported savings of both lives and healthcare dollars, with the exception of extremely premature babies neither she nor anyone else can point to any lives or healthcare dollars that have actually been saved. Moreover, the countries with the lowest rates of breastfeeding like the UK have among the lowest rates of infant mortality in the world, while multiple countries with the highest breastfeeding rates in Africa have the highest rates of infant mortality in the world.

The promised benefits of increased breastfeeding have failed to materialize because the risks were never taken into account.

Why is there such a discrepancy between what breastfeeding professionals promise and what actually happens?

There’s a simple reason: exclusive breastfeeding also has risks.

Although those factors are never taken into account in Dr. Bartick’s modeling, they appear to negate the saving of lives and obliterate the saving of healthcare dollars that lactation professionals promise.

What if formula harmed as many babies as breastfeeding does? There would be a national outcry!

Consider the furor surrounding revelations that French formula manufacturer Lactalis sold products contaminated with salmonella over a period of a decade.

In the 2005 outbreak, 146 children fell ill. In last year’s outbreak, at least 38 cases in France and Spain were traced to Lactalis milk.

On Thursday, researchers from the Pasteur Institute in Paris said the salmonella bacteria had remained at the Craon factory until it was closed.

As a result, they said, a total of 25 babies had been affected between 2005 and 2016.

Parents were horrified, governments swung into action, and the formula company will ultimately pay hundreds of millions of Euros in fines and to damage claims … all because 209 babies became sick.

Now consider that literally TENS OF THOUSANDS of American newborns are readmitted to the hospital each year, costing HUNDREDS OF MILLIONS of healthcare dollars because breastfeeding doubles the risk of newborn hospital readmission.

Why? Because insufficient breastmilk is common (up to 15% of first time mothers in the days immediately after birth) and severe dehydration, jaundice, failure to thrive and death are the inevitable results of pressuring women to exclusively breastfeed regardless of whether the baby is getting enough.

It’s a scandal that dwarfs the Lactalis scandal yet no one seems in the least upset. Researchers merely ponder how they can reduce the harm while continuing to promote exclusive breastfeeding for its “benefits.”

Consider, too, that breastfeeding is now the leading cause of kernicterus (jaundice induced brain damage) responsible for 90% of the cases of this serious complication that often results in long term disability or even death.

It’s scandalous but researchers merely ponder how they can reduce the harm while continuing to promote exclusive breastfeeding for its “benefits.”

Consider that emphasis on skin to skin contact and 24 hour rooming in has led to a dramatic increase in sudden post neonatal infant collapse (SUPC). SUPC can result in severe brain damage and many affected infants die.

It’s scandalous but researchers merely ponder how they can reduce the harm while continuing to promote exclusive breastfeeding for its “benefits.”

Consider that the Joint Commission has just issue new guidelines to combat an epidemic of infant falls — and the resulting injuries and deaths — that also result from the promotion of extended skin to skin contact and 24 hour rooming in.

It’s scandalous but researchers merely ponder how they can reduce the harm while continuing to promote exclusive breastfeeding for its “benefits.”

So why hasn’t there been an outcry about the dangers of breastfeeding? The answer has more to due with psychology than scientific evidence.

Psychology leads people to imagine that the risks of technology are always greater than the risks of nature.

Professor David Ropeik discusses this in The Consequences of Fear. He notes:

… [M]any people fail to protect themselves adequately from the sun, in part because the sun is natural and because, for some of us, the benefit of a healthy glowing tan outweighs the risks of solar exposure. However, solar radiation is widely believed to be the leading cause of melanoma, which will kill an estimated 7,910 Americans this year.

Psychology is also responsible for out marked aversion to betrayal:

…[S]afety products rarely provide perfect protection and sometimes “betray” consumers by causing the very harm they are intended to prevent. Examples include vaccines that may cause disease and air bags that may explode with such force that they cause death…

The mere possibility of betrayal threatens the social order that enables us to trust the safety infrastructure of our society, causing intense visceral reactions and negative emotions toward the betrayer. Unfortunately, these strong negative emotions toward a potential betrayer may also lead people to take unwise risks…

So we react with outrage when we learn that a manufacturer sold contaminated formula and insist that breastfeeding, because it is natural, will never betray us.

There’s a final reason why we’ve acquiesced to the rising tide in injuries and deaths from exclusive breastfeeding promotion: lactation professionals have lied about them. They create endless lists of the “risks” of formula feeding and refuse to mention the risks of breastfeeding like insufficient breastmilk, SUPC and falls from bed.

Even worse, they demonize the people and organizations who try to alert mothers to the risks and prevent the injuries and deaths. The founders of the Fed Is Best Foundation have taken an incredible amount of abuse from lactation professionals who appear psychologically incapable of accepting the scientific evidence on breastfeeding harms.

I myself am often accused by lactivists of “hating” breastfeeding even though I happily and successfully breastfed four children; no doubt this piece will reinforce their views. But I don’t hate breastfeeding. I hate iatrogenic injuries and deaths that are the result of refusing to acknowledge that breastfeeding has risks as well as benefits.

Sure breastfeeding has benefits, but they can easily be dwarfed by unacknowledged risks. That’s why the predictions of lactation professionals like Melissa Bartick, MD haven’t come true and never will.

  • anh

    OT: just had to leave an online support group for children with my daughter’s condition as it was full of crazy antivaxxers. Yadda yadda yadda Gardasil kills yadda yadda you only get HPV if you have sex yadda yadda (why they’re deciding now their kids won’t have sex ever is beyond me).

    I do understand a healthy degree of mistrust. MFMs (from whom we get our kids’ diagnoses) tend to often be insanely ill informed and grossly pessimistic about our kids’ conditions. And I’ve found it really has served my daughter that I’ve done a crazy amount of reading (not research, I do not work in a lab or library). I just haven’t figured out a way to express “doctors may be ill informed on SB but they seriously have vaccines figured out!

  • Empress of the Iguana People

    Dr. Amy and her crazy talk. *shakes head in mock disbelief*
    /sarcasm

  • Who?

    Another example of breastfeeding attempts taken to extremes:

    http://www.abc.net.au/news/2018-04-05/naturopath-sentenced-to-seven-months-in-jail/9622276

    Apparently she’s suffered a lot. My words have run away.

  • Cat

    OT, but a family member is around 37 weeks pregnant and the baby is measuring pretty big according to her latest scan. I don’t know the exact estimate, but she’s been told she might be induced at 40 weeks. I’m glad her care providers seem to be on the ball. I’m a little puzzled though because my midwife repeatedly told me in late pregnancy that no doctor would ever induce based on the baby’s size (I wasn’t actually asking to be induced, just to be referred for a growth scan because we grow monster babies in my family and a stillborn sibling was over 11lb, and she was telling me there was no point because it wouldn’t make any difference to my care if the baby was large – no doctor these days would ever perform a c-section or induce before 40+12 just because the baby was predicted to be huge). Can anyone enlighten me as to what that’s all about? Inconsistencies in NHS care depending on postcode? Has there been a change of policy since 2015? Or did I have a militant midwife going off her own script?

    • Empress of the Iguana People

      I suspect it’s the midwife. My american pregnancy books in ’13 did mention that doctors do induce for size. Some of the looney sites warn that ultrasound measurements are often wrong and ignore a doc who’s recommending induction because baby’s probably not 12 pounds. Except when baby’s actually 13. /snort.

      • Cat

        Mysteriously, scales for weighing newborns are also unreliable, but always in the other direction. At least, that’s what lactivists tell mothers when they’re considering supplementing babies who’ve lost 15 per cent of their body weight. I remember a particular lactivist on Mumsnet or Netmums or Babycenter telling a new mother that scales are “notoriously inaccurate as a method of weighing babies” (compared to what, one wonders – holding the baby in one hand and a bag of flour in the other and guessing which is heavier?).

      • Heidi

        I know of one incident where the U/S was way off. My husband’s cousin’s baby was showing as being big so the OB induced her at 39 weeks. He was only 5 lbs. 13 oz. which is too small and induction would have still likely happened but for possible IUGR.

        • Empress of the Iguana People

          That’s -tiny-for a term baby

          • My first was 5 lbs 10 oz at 41 weeks. The ultrasound estimated her to be two pounds heavier than she was. She was 20 inches and skeletal at birth. Picked up plenty of weight rapidly, though, once I started bottle-feeding her.

          • Heidi

            My son has shot up. I joke my body kept him little so the birth wouldn’t be so bad. Birthing a 6 lb 5 ouncer was hard enough!

          • Empress of the Iguana People

            Goodness. That’s probably why they overestimated, all those long bones.

          • Heidi

            He’s still little. Now mine on the other hand was 19th percentile in height and weight at birth and was induced because the U/S estimated him at 5lb. 13 oz. (which was his weight exactly the day after birth) but is now 75th in height and 30th for weight. He was actually 6 lb 5 oz at birth which wasn’t an induction percentile but it was still pretty close.

          • Empress of the Iguana People

            Mine were born at 75th ish and are now about 85 (him) and 90 (her) So my judgement is a smidge skewed.

        • Tigger_the_Wing

          That’s the exact weight of my second – who was born a whole month early.

    • swbarnes2

      Here’s acog’s bulletin, only a month old:

      http://opqic.org/acog-practice-bulletin-173-fetal-macrosomia/

      Suspected fetal macrosomia is not an indication for induction of labor because induction does not improve maternal or fetal outcomes (Level B).

      However

      With an estimated fetal weight of greater than 4,500 g, a prolonged second stage of labor or arrest of descent in the second stage is an indication for cesarean delivery (Level B).

      Barring unusual circumstances, cesarean delivery should be performed for midpelvic arrest of the fetus with suspected macrosomia (Level B).

      • Cat

        Thank you!

  • Megan

    Sort of OT: I was just listening to the Hidden Brain podcast today (link below if interested) about the scarcity trap and it reminded me so much of my breastfeeding experience. All I thought about was breast milk and feeding and pumping and increasing supply and power pumping and getting donor milk and on and on. I became so obsessed that my relationship with my newborn daughter and husband suffered. My mental health suffered. I didn’t sleep. I spent so much time crying. I listened to that podcast and they mentioned it in relation to poverty, loneliness, time, but all I could think was, “that was my breastfeeding experience.”

    https://www.npr.org/2018/04/02/598119170/the-scarcity-trap-why-we-keep-digging-when-were-stuck-in-a-hole

    • MaineJen

      I love Shankar. His voice is so soothing 🙂

      • Megan

        I agree. I need more of Shankar’s voice in my life. 🙂

  • CSN0116

    So, exclusive breastfeeding is associated with higher rates of starvation, death and profound permanent disability.

    And formula feeding is associated with higher rates of chronic morbidity like obesity, diabetes, allergies, and cancers (if I take their word for it).

    Sounds a bit like an epidemiological transition to me. A trending away from acute and sudden premature death and towards prolonged life even if coupled with chronic health conditions. Isn’t the epi transition a gooooood thing? Isn’t formula a scientific/technological invention to then be applauded by world health leaders?

    • swbarnes2

      So, exclusive breastfeeding is associated with higher rates of starvation, death and profound permanent disability.

      Yeah, but it’s more than just an association. Insufficient breastfeeding without supplementation causes all that. It’s pretty clear. Not feeding baby = bad things. Trying really hard to breastfed =/= feeding baby.

      Formula feeding almost certainly doesn’t cause all its supposed issues, It’s just correlated with the real causes, which are related to lower socioeconomic status.

      • CSN0116

        Yes. Very true. So, science milk wins 😉

  • CSN0116

    Somewhat unrelated but anyone notice that Lactivists are OBSESSED with highlighting the risk of cronobacter and formula feeding? They insist that every mother in every country make formula feeding as inconvenient as possible, mixing up powder formula with boiling water and allowing it to then cool …to kill the ever-present, lurking-around-every-corner – cronobacter.

    You’d think cronobacter is everywhere. Oh, and they cite WHO like it’s their job. AAP recommendations be damned. WHO or bust.

    • AnnaPDE

      So how many Cronobacter infections have there been in, say, Australia in the last years? I couldn’t find the number in a few minutes googling on a small phone, but given that every freak accident is discussed yo death in parenting articles yet our formula guidelines are still “add cooled boiled water”, it can’t be many.,

    • Allie

      Ha, meanwhile I certainly didn’t disinfect my boobs, or wash my hands every time after stumbling to the bathroom in the middle of the night and then nursing my daughter. In the early days, I went days on end without even showering. Meanwhile, my poor SIL was up in the night boiling water and sterilizing bottles, and they said she was taking the easy way out by not nursing!

      • Empress of the Iguana People

        I automatically wash after using the toilet, but not always thoroughly. Spawn1 did often have to deal with underwashed mom boobs.
        We’d just make sure we put more water in the kettle when we made tea than we needed, to fill Spawn2’s bottles with. And sterilized the bottles only every month or so.

    • Hannah

      Yeah I couldn’t believe it when everyone was freaking out about ‘you HAVE to sterilize the formula!!!’ so I did some research. Only ever found ONE mention of a baby who got sick from the formula powder. One. Out of the millions of babies who’ve drank it. The midwives kept going on about ‘oh but the bacteria from the house gets in it’ well in that case, he’s living in the house so exposed to it anyways, what difference does it make! I did for the first week or so because we were at home and I could make it and bung it in the fridge… but beyond that, didn’t bother. Never told the health visitor, of course. My mum’s also a daycare supervisor in the baby room in the States and I asked her… she couldn’t believe it, said the same thing as me, surely that’s the formula company’s job? So apparently a lot of folks Stateside aren’t even being told that part! Made me feel better about not bothering at least.

  • Emilie Bishop

    I have been trying to share my and my son’s story with patient-safety organizations in the hopes that the hospital, especially the LC who literally wrote in my chart that my breasts had physical markers for low supply but that she wouldn’t tell me, would be forced to re-evaluate how they treat moms and newborns. I am finding that frankly, my dears, no one gives a damn. Maybe the Joint Commission does, as they’ve been critical of BFHI practices. My state boards of health and nursing are too busy passing the buck to each other to do anything. The IBLCE ethics committee has been “reviewing” My complaint for almost nine months. The hospital itself has sent me letters full of lies and gaslighting, and Baby Friendly USA took my complaint and then said because I wasn’t willing to meet with my lying, gaslighting hospital, they didn’t see any reason to intervene. I was lied to, my son starved and was readmitted, my mental health was wrecked by triple feeding and the guilt of never producing enough milk, but the hospital is being given free reign to do it to other moms and babies as they see fit. It has truly been the most frustrating experience. And I agree–if formula somehow made him sick instead of saving his life, every one of these groups would be clambering to fight for us.