Lactivists lying to women “for their own good”

Right Wrong Ethical Unethical Road Street Signs 3d Illustration

Dr. Gabrielle Colleran, why are you lying to women about breastfeeding?

According to attendees at a recent meeting of La Leche League Ireland, you claimed — falsely — that women who give birth but don’t breastfeed have a 4X increased risk of heart attack. The truth is that the scientific literature shows NO consistent relationship between breastfeeding and maternal cardiovascular disease.

You apparently claimed — in a remarkably vile and vicious falsehood — that both SIDS and childhood leukemia are twice as common in exclusively formula fed children, adding piously that this is very difficult information for parents.

It’s also a lie.

D5D961E5-4D71-46E4-B164-0A467A98B61F

According to a recent comprehensive review of the breastfeeding literature, 3,500 mothers would need to breastfeed 3,500 babies to prevent one SIDS death. Moreover, pacifiers are MORE protective against SIDS than breastfeeding!

Dr. Colleran, apologize and set the record straight. That’s the ethical thing to do!

The same review cautions that the association between breastfeeding and childhood leukemia is NOT firmly established and even if it were, 12,500 women would have to breastfeed 12,500 babies for more than 6 months to prevent one CASE.

I might have thought that the conference attendee was exaggerating or misunderstood the utterly false claims, but then I saw with my own eyes on the LLL Ireland Facebook page a snippet of video from your talk in which you claim, brazenly and falsely, that giving babies formula often leads to allergies. I shared the LLL Ireland post on my Facebook page and — surprise! — LLL Ireland deleted it.

Dr. Colleran, multiple people have asked you on Twitter to provide scientific references for your claims. As far as I can determine, you blocked each and every one of them. You blocked me even before I asked you.

I can’t imagine clearer sign that you KNOW your claims were lies than the fact that you block anyone who asks for proof and that LLL Ireland deleted the video evidence.

Dr. Colleran, we in medicine have a long and sordid history of lying to patients “for their own good.” As recently as the 1960’s doctors told cancer patients with a straight face and a clear conscience that they did not have cancer. Had those doctors been asked, they almost certainly would have justified their behavior by pointing out that patients given a cancer diagnosis often lost hope; it would be better for them to believe they had a less serious illness while the doctors treated them with chemotherapy without their consent.

This is paternalism.

Dr. Colleran, I know you are a pediatric radiologist, but I can tell you that we in obstetrics have a disturbing history of lying to patients “for the good of the baby.” While the current distrust of obstetricians by some patients has been assiduously fanned by midwives, doulas and natural childbirth experts, it could never have taken hold if obstetricians hadn’t already abused the trust of some patients. Natural childbirth advocates contemptuously refer to such behavior as “playing the dead baby card.” Even though it happens much less often than natural childbirth advocates believe, it does happen.

This is yet another, even less justified, form of paternalism.

Women have been in the forefront of holding doctors to account for paternalism. Some of the most well known legal cases that created informed consent law were brought by women. Furthermore, the natural childbirth movement itself was critical in changing paternalistic hospital practices around childbirth, empowering women as consumers of healthcare to whom hospitals and doctors now market medical services.

I doubt that they fought so aggressively against doctors lying to them “for their own good” so that lactation professionals could take up where other doctors left off — lying to women about the “risks” of not breastfeeding and the “risks” of infant formula.

Dr. Colleran, I suspect that you think you can hide from me and I will give up and go away. You don’t know me very well.

You owe new mothers clarification of and references for your outrageous claims. And if you can’t find references for your claims — because you know they don’t exist — you owe an apology to the attendees of the conference for misleading them. They believed you because you are a doctor. If you lied to them, they will take those lies and repeat them to patients “for their own good.” Both mothers and babies will be harmed.

You also owe an apology to new mothers, many of whom struggle with breastfeeding precisely because people like you apply tremendous pressure with fabricated claims of “benefits” of breastfeeding and “risks” of formula. No doubt you believe you are doing it “for their own good” or “for the good of the baby.”

But just as that doesn’t absolve doctors of the past for lying to patients, it most certainly doesn’t absolve you.

Dr. Colleran, apologize and set the record straight. That’s the ethical thing to do!

  • GeorgiaPeach23

    Everything I was taught about breast feeding was a lie – including that my baby was more efficient than my pump, and therefore if I was pumping enough then when he was fed whenever hungry until full, that would be plenty. That lie has caused my son to become underweight, not dangerously so, but enough for me to want to slam the brakes on EBF and start formula supplements immediately.

    His pediatrician is acting like going from 54pct at birth to 27pct at 1 month to 8pct at 2 months is something we can address just by pumping a little hind milk. I feel like I’m being gas lighted by the last medical professional in my sons life that I thought I could trust.

  • demodocus

    My ob was visibly irritated when I told him that neither husband, friend, nor I could even remember if the woman delivering BoyBard was a CNM or a doctor, much less if she’d introduced herself. (He said she must’ve been a resident since my type of case would only be seen to by docs. All’s I knew was that Dr. E’s partner and his resident were off to the side, and the 3rd partner was seeing to other patients.)

    I wonder why Dr. K wanted to stay on my case through all 18 hours. I already knew Dr. P, since I’d seen her once when Dr. E was on vacation, and I’d never met Dr. K. or his resident before. I also let 2 different male nursing students following their mentors about in. One was there in the shadows for the delivery.

    • MaineJen

      I remember being delivered by a resident for my 1st, but the main doctor was right there. There were a bunch of people in the room whom I barely registered, some of them must have been students. There wasn’t much to do, in any case; once I get to the pushing stage, all you really need is a catchers mitt. 🙂

  • guest

    ‘sigh’

    OK…I hate these kinds of “correlation = causation” claims that are being made.

    If everybody was perfectly healthy and our bodies worked the way we wanted them to all the time, then there would be no need for interventions like formula. But hey, surprise surprise – they don’t. Let’s say that the mothers who formula feed having more heart attacks correlation was true and proven.

    Well, women who have underlying health conditions or other serious stressors are more likely to be unable to breastfeed (and therefore need the intervention of formula) AND may more likely to die from a heart attack. But in what universe does that make it the fault of formula? This is not a rational jump to make – it is more like superstition, like the fear of the number 13 that Dr. Tuteur brought up previously.

    And what a horrible way for LLL to shame people with ill health.

    • demodocus

      My body works perfectly in this particular regard. I just f’ing _loathe_ breastfeeding. Its all I can do to not push my kids away if they accidentally put a hand on my breast when hugging me. And they’re both little.

      • guest

        I am working off the theory that personal preference has little impact on disease/breastfeeding correlation, but the ability or inability to breastfeed does. And focusing on formula as a medical intervention.

        I am sorry for stating that “there would be no need for (formula) if our bodies worked the way we wanted them to”. This is certainly not true for everyone and there are many, many other reasons that parents choose formula feed. It was thoughtless of me and should have been corrected.

        • Good of you to have realized that, and graciousof you to admit it. There simply is NO “one size fits all”.

        • demodocus

          It’s okay. Everyone says stuff thoughtlessly often enough

      • I’m with you, in that breastfeeding #1 and combofeeding #3 was utterly exhausting; I felt as if my bone marrow was being sucked out with the milk, and actually began to resent the children for doing this to me. Nevertheless, since it was The Right Thing To Do, I persisted until it was obvious that I just wasn’t making hardly any milk. With great relief I weaned both to formula, and saved my sanity.

  • Sarah

    This is just an extreme example of shit that happens all the time really. It starts with not telling patients the difference between correlation and causation and this is the outcome.

  • Twilight

    I’m Irish and breastfeeding isn’t popular over here.

    Why on earth would a radiologist care so much about breastfeeding?

    Also in the Republic of Ireland, we are run by State HSE – Health Service Executive. We have nothing to do with the UK’s NHS. The Irish Gov. withdrew funding for advertising breastfeeding as it wasn’t working and doesn’t make any difference in a western country.

    Some nurses have been pushy with it but nowhere near as bad and aggressive on the whole as other countries.

    We have one of the lowest rates of breastfeeding in the developed world yet not one of the highest rates of mothers with heart attacks or babies with SIDS or childhood leukemia!!!!!

    There are a few mad rabid lactivists who are considered just odd and most parents just ignore them. Sadly some do write newspapers articles which are even printed in the broadsheets. I often write in challenging their “statistics”.

  • mabelcruet

    She needs to be careful about the information she’s putting out there. The General Medical Council (UK) and the Irish Medical Council (in Ireland), the organisations that govern doctors here, both have very specific codes of conduct with regard to social media, clearly laid out in their professional ethics publications. The Irish one states:

    “Patients and professional colleagues may rely on information you provide online. You must take all reasonable steps to make sure that any information or advice you give is accurate and valid.

    Information about your practice or the services you offer should be factual and
    verifiable. You should not make unsustainable claims for the effectiveness of treatments or exploit patients’ vulnerability or lack of medical knowledge”

    It sounds like she’s making unsupportable or unevidenced claims to an audience that isn’t equipped to examine the evidence properly.

    Plus, that nonsense statement about having only 1 hour of training about breast-feeding in 17 years of undergrad and post grad training? She’s a radiologist-why on earth would a person specialising in radiology, then sub-specialising in paediatric radiology be expected or need to have loads of training in breast feeding? She’s not responsible for people breast feeding professionally. If it was a consultant obstetrician or neonatologist claiming they’d only had one hour on breast-feeding then that would be a worry, but not for a radiologist. That’s like me saying I’ve never been trained to do a hip replacement.

    • Amy Tuteur, MD

      I wasn’t aware of the code of conduct! That makes it worse.

      • mabelcruet

        I don’t know if she’s registered with the Irish Medical Council or the General Medical Council (but she will have to be registered with one of them in order to practise). The GMC-the one that governs my behaviour as a UK doctor, states:

        “The standards expected of doctors do not change because they are communicating through social media rather than face to face or through other traditional media”

        Those standards include best practice, ensuring you provide accurate and supportable information and that you are acting in your area of expertise.

        The IMC guidance is here:
        https://www.medicalcouncil.ie/News-and-Publications/Reports/Guide-to-Professional-Conduct-Ethics-8th-Edition.html

        Technically, providing misleading or inaccurate information could be considered a breach of the public trust and unprofessional.

        She could argue that she wasn’t deliberately misleading anyone, that the literature isn’t that clear cut and she was trying to debate the issue, and that this conference was aimed at studying the issue and she wasn’t providing dogmatic facts, merely debate and wider issues.

        She could argue that she’s not an expert in breast feeding so she wasn’t intending to manage patient care in any way, so any comments she makes couldn’t be considered as her providing medical advice. The problem with that is though, that the comments were made in the public arena and she made it very clear she is medically qualified. Being medically qualified means that she is expected to be held to high professional standards. So even though its not her official area of expertise, the fact that she’s making these comments publicly means that she, and any comments she makes, have to be held to the same standard of professionalism as her recognised area of expertise in radiology.

        If she’d presented it as ‘I’m a breast feeding mother and this is my advice based on my personal experience’, then fine, that’s fair enough. But she’s saying ‘I’m a doctor and the facts are…’, so she’s got to evidence those ‘facts’ or withdraw them.

  • aurora

    Thank you Dr. Amy for holding her accountable!!