Lactation consultant insists — in a scientific journal — that high quality scientific evidence can be ignored!


I knew this day was coming, but I’m pleased that it has arrived sooner than I expected. Lactation professionals are backpedaling as fast as they can.

I’ve been writing for years that lactation professionals in general, and Baby Friendly USA in particular, have been ignoring scientific evidence in favor of personal biases. Babies and mothers are suffering (and in the case of babies, dying) as a result.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The scientific evidence shows: Fed Is Best![/pullquote]

Along comes Marsha Walker, IBCLC to confirm it.

Walker essentially proves the contention of the JAMA paper that she is commenting upon. That paper found that the World Health Organization reviewed the latest evidence on breastfeeding and then proceeded to IGNORE it.

Specifically, the WHO noted but ignored the scientific evidence that pacifiers reduce the incidence of SIDS, that pacifiers do NOT interfere with breastfeeding and that early judicious formula supplementation does NOT interfere with breastfeeding. In addition, the WHO recommended policies for which there is NO EVIDENCE, including mandatory rooming in of babies and mothers, skin-to-skin beyond the first hour after birth, and the use of donor milk instead of formula for term infants.

The authors conclude that in both cases, stakeholder bias was allowed to take precedence over the actual scientific evidence.

This is a powerful critique (and confirmation of much of what I’ve been writing for years) but Walker tries to justify ignoring the scientific evidence that she doesn’t like. We don’t need high quality evidence for breastfeeding policies because breastfeeding is natural!

The use of the GRADE method and systematic reviews in this synopsis may not necessarily represent the best framework for evaluating interventions for an essentially normal process. Breastfeeding is not a medical problem…

This is so disingenuous that I wonder if Walker actually believes it. I doubt that she would accept scientific evidence that contradicts what she believes about breastfeeding UNLESS it was evidence of the highest quality. So to argue that it can be ignored BECAUSE it is the highest quality is bizarre.

The response by Bass, one of the authors of the original paper, is devastating:

Her statement that the synopsis used the GRADE method is inaccurate because that evidence assessment method was actually used by the World Health Organization (WHO)2 and is widely used and respected because of its rigorous approach to evidence rating. Suggesting that a lower level of evidence was warranted because breastfeeding is not a medical problem reflects confusion concerning the purpose of the BFHI guideline: to analyze the best manner to support breastfeeding, not to judge the value of breastfeeding.


This resistance to evidence that challenges BFUSA compliance criteria can inadvertently result in unsafe outcomes including sudden unexpected postnatal collapse4 and newborn falls, which have been associated with BF designation…

But Walker is hardly the only lactation professional attempting to backpedal as fast as she can.

Prof. Amy Brown is arguably the fastest backpeddler of them all.

In her latest piece for HuffPo, Brown is shocked, shocked to discover that some women cannot produce enough breastmilk. This represents a complete about face from articles she has written in the past.

In May of 2016, in the cruelly title article Why Fed Will Never Be Best Brown claimed:

Physiologically speaking only around 2% of women should be unable to breastfeed …

[T]he reason why we are struggling so much with breastfeeding is for most not initially a physiological issue…

As recently as December 2018, Brown had the temerity to suggest that women who alert others to the risks of insufficient breastmilk should be ignored:

Try not to pay too much attention to breastfeeding horror stories. People like to share stories – it makes them feel better – without thinking about the consequences for you.

There’s no mention in that piece of what Brown just discovered: some of those horror stories are true.

But give Brown credit for smartly performing an about face. Now not only is insufficient breastmilk much more common that Brown previously acknowledged, it’s the fault of doctors!

Given the breadth and depth of medical knowledge, why do women still not have answers if they can’t breastfeed?

How lovely that after years of repeatedly being informed by women that they weren’t breastfeeding because they had inadequate milk supply, Prof. Brown has suddenly discovered that some women have inadequate milk supply. For years women have struggled with shame, guilt and self-hatred induced by lactation professionals like Brown who refused to listen and berated them instead. I wonder if she plans on apologizing for her years of gaslighting these suffering women and treating them cruelly. Somehow I doubt it.

What’s the take away message from all this lactivist backpedaling?

First, as I and the Fed Is Best founders have been writing for years, contemporary breastfeeding promotion efforts like the Baby Friendly Hospital Iniaitive IGNORE the scientific evidence.

Second, babies and mothers have been harmed by the lactivist insistence on placing their personal biases above the scientific evidence.

Third, lactation professionals aren’t going to back down without a fight.

Whether it’s Marsha Walker pathetically insisting that we can ignore high quality scientific evidence because breastfeeding is natural or Amy Brown brazenly insisting that the problem of insufficient breastmilk — a problem whose existence she denied until yesterday — is both real and the fault of doctors, lactation professionals will maintain breast is best for every baby and every mother. It doesn’t matter to them both scientific evidence and real world experience show that’s a lie. That’s why you should ignore lactation professionals who ignore scientific evidence.

The final take away message is the most important of all:

Fed Is Best!