Another way to kill a baby through breastfeeding promotion

Wrongful Death report and gavel in a court.

Breastfeeding promotion has a death toll and it’s likely to be substantial.

As breastfeeding promotion has become ever more aggressive, babies have been dying from dehydration, hypoglycemia, severe jaundice, failure to thrive and starvation.

As lactation professionals have embraced mandated skin-to-skin care and mandated rooming in of babies and mothers, babies have been dying from smothering in their mothers beds in the hospital and at home, and skull fractures as a result of falling out of those beds.

The problem of death from breastfeeding promotion has become so severe that the US government is taking action.

Now we can add a new cause of potential death: massive hemorrhage from tongue tie clipping.

We might not have heard about this baby’s near death experience if his father hadn’t been an Australian celebrity:

Struggling to hold back tears, the children’s entertainer explained how the most traumatic days in his and wife Tori’s lives unfolded late last week after a tongue-tie snip went horribly wrong.

“My son Mack was in for a routine procedure and it didn’t go very well,” he said through tears in the emotional clip that aired on Dancing With The Stars last night, explaining to fans why he chose to withdraw from the competition.

“It led to blood loss, it snowballed from there. The blood loss got worse. He was rushed to hospital, it got critical and CPR was administered to the little fella.”

A Facebook post offers more information:

After a failed tongue tie snip on Thursday afternoon my son was rushed by ambulance to Gosford hospital where he lay in resus and had over 30 people working on him. CPR, blood transfusions, ventilator, emergency surgery, NETS transfer, ICU and a hell of a lot of drugs my Mack has proved the specialists wrong and is slowly mending. Gosford emergency department, you saved my son’s life – you were incredible. I love my family, I love my sons, I love my friends, and thank you so much for your thoughts – we are going to be ok. xxx @jimmyrees

The family posted a picture on Instagram:

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What went wrong?

I speculate that the clipping was being performed by a lactation professional or midwife, not a physician.

Given the massive blood loss, it sounds like someone clipped a blood vessel on the underside of the tongue — or worse, mistook the blood vessels FOR a tongue-tie.

As this illustration shows, the blood vessels that supply the tongue run close to where the tongue meets the floor of the mouth, in exactly the area where tongue-ties are severed.

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Isn’t it possible that a physician lacerated a blood vessel? It’s far less likely since they are much more knowledgeable about the anatomy of the tongue and because a physician is likely to have the clamps necessary to close off the blood vessel until it could be repaired and the ability to repair it.

It’s also possibly, though less likely, that the massive blood loss was the result of an underlying clotting defect such as hemorrhagic disease of the newborn, the result of refusing Vitamin K prophylaxis at birth. It’s less likely because that would have led to a continuous ooze and it would have taken more time to result in the infant’s cardio-respiratory collapse.

As long as I am speculating, I am going to speculate about something else: I suspect that the baby didn’t have a tongue-tie at all or at least not one that required correction. The blood vessels were probably mistaken for a tongue-tie because someone was looking for an explanation for pain or difficulty breastfeeding, not because there was evidence of a tongue-tie. There has been a massive increase in tongue-tie surgery in the past decades and most of it has been unnecessary.

As a recent article in The Atlantic noted:

In recent years, surging numbers of infants have gotten minor surgeries for “tongue tie,” to help with breastfeeding or prevent potential health issues. But research suggests many of those procedures could be unnecessary.

So add yet another way to kill a baby through aggressive breastfeeding promotion.

How many babies are dying each year?

We don’t know because we don’t keep track. That must change.

The Fed Is Best Foundation formally submitted an addition to the pending Healthy People 2030 goals:

Reduce the proportion of infants who require treatment and/or extended or repeat hospital admission for insufficient feeding-related hyperbilirubinemia, hypernatremia, dehydration, excessive weight loss, hypoglycemia and failure-to-thrive.

The Committee promulgating the recommendations has already reduced the aggressive pressure to breastfeed by removing 7 of the 8 goals that appear in Healthy People 2020. Hospitals will no longer be required to reduce the proportion of infants who receive formula and no longer be encouraged to seek Baby Friendly Hospital Initiative certification.

How did we get to the point where the government must try to rein in breastfeeding promotion efforts to protect babies?

We got here because the lactation profession’s bizarre insistence that — unlike ALL other bodily processes — breastfeeding is supposedly perfect.

The egregious harm to babies — including the fact that exclusive breastfeeding on discharge has become the leading cause of neonatal hospital readmission — is not because lactation professionals have grossly exaggerated the benefits of breastfeeding although they have done so.

The egregious harm to babies, including deaths, is because lactation professionals have refused to acknowledge the limitations and risks of breastfeeding:

They’ve refused to acknowledge that the incidence of insufficient breastmilk is HIGH, not low … and babies have died.
They’ve refused to acknowledge that formula supplementation is OFTEN needed, not rarely needed … and babies have died.
They’ve lied about the size of the newborn stomach in order to pretend that babies need less fluid than they do … and babies have died.
They’ve lied about the need for skin-to-skin contact … and babies have died.
They’ve lied about the need for babies to room in with mothers … and babies have died.
They’ve lied the incidence of tongue-tie and the need for tongue-tie clipping … and babies may die.

The problem has become so severe that the US government is taking action. Individual mothers need to be aware of the deadly risks of breastfeeding promotion, too, so they can protect their babies from lactation professionals.

  • Ayr

    When my son was born, the first lactation consultant I had suggested that he was tongue tied and that was why he would could not latch. He had no problems latching, I had flat nipples and to top it off I didn’t produce anything. She really wanted to get his tongue clipped that day, we refused and said we would talk to his pediatrician first and until then he could bottle feed, which really set her off. We eventually told her to leave the room, and complained about her methods, I was given another lactation consultant, one who was more understanding and said there was no sign of a tongue tie (which his pediatrician agreed with). She encouraged the bottle feeding and worked with me to try pumping, it was to no avail, but at least she was kinder.

  • KQ Not Signed In

    I still stress out about having my son’s tongue tie clipped at birth.

    I hadn’t heard anything about that and the pediatrician suggested it. She said it wouldn’t hurt him and it would help him nurse and be able to talk. It was the morning after he was born; he had latched just fine I think but I was post C-section and it’s all a blur. I didn’t watch – my mom did – and he barely cried and seemed okay.

    Now he’s older and he’s been diagnosed with a large band of tissue tying his upper lip and keeping his teeth gapped – the orthodontist said he’ll need that surgically removed before he has braces and that it was likely he did have a substantial tie.

    So yeah, probably was a medically indicated, recommended, and properly executed tongue tie clip, performed in a hospital by an excellent pediatrician. …But I live in Woo Central (Eugene, OR) and it’s a trendy and controversially over-performed procedure. And my whole stay at that (baby friendly) hospital was a nightmare of pressure/shaming because I did not want to go all natural and refusal to help and sleep deprivation, so it’s very hard not to feel duped.

    Mom guilt sucks.

    • Merrie

      You did what you thought was best and he didn’t suffer appreciably for it. You obviously are trying to make the best decisions possible for your child with the best possible information available to you, and that is all anyone can ask. Nobody is perfect! You are good enough just the way you are.

  • rational thinker

    That natural friend of mine that I sometimes post about once said this to me: “I know how to diagnose a tongue tie” when we were talking about her newborn son. I did not say anything but I was thinking- No, you really dont and you are part of the problem.

  • mabelcruet

    Slightly OT:

    https://midwifethinking.com/2019/04/09/no-womans-land-a-student-midwifes-call-guest-post/

    I know it’s an individual account of her initial training experiences, but it sounds like she is being taught from the very beginning of her training that natural=good, medicalised, technology and intervention =bad. There’s little insight into why intervention is needed, and little recognition that intervention may be asked for by the mother herself, her choice. The overarching theme is the biased and stereotyped ‘if only women were supported properly, they would never need any intervention’. I have a feeling that this student will probably end up one of those midwives who deal with epidurals by ‘too early to call the anaesthetist…oops, too late now, sorry’. How about taking a neutral stance on intervention and not demonizing it for a change?

    • Ozlsn

      This sounds a lot like someone who went into the training with very set ideas and who is going to cling to those ideas come hell or high water.

      I really wish midwifery remained a specialisation rather than a stand alone degree – going through rotations in other specialities might give a wider view of what “natural” entails.

      • mabelcruet

        This is one of my worries. Midwives who started out as nurses would have far better insight into maternal morbidity. They would have seen patients with essential hypertension, corrected heart disease, transplant patients etc. They would be more aware of how maternal health impacts on pregnancy. Midwives who have only ever done midwifery-most of their experience is with women who are generally healthy, and because they have never seen or treated someone with a significant co-morbidity, I think there is a risk they might downplay it-they’ve not seen it, they’ve not treated it, so because it’s not in their syllabus it’s not important.

        • Ozlsn

          I agree. I also would prefer that all midwives do at least a 6, preferably longer, rotation in a highest level hospital so they actually see all the complicated cases with the comorbidities – but also so they see how even the “normal” cases can develop into high risk pregnancies. One of the (many) things that shocked me in the coroner’s report into the death of Caroline Lovell was that the junior midwife had only attended 28 births. She was essentially clueless – OK she had a senior midwife present (who also proved to be useless) but my feeling was that she should have attended a hell of a lot more births in a controlled setting first before she even contemplated taking on home birth clients.

  • mabelcruet

    I vaguely remember a reader’s comment on here a while back about she was being pressured into getting her baby’s tongue clipped. IIRC, she said the lactation consultant had claimed that the tongue tie was fascia, and all fascia in the body was connected, so if she didn’t release the tongue tie then her baby would have trouble walking, which is an absolute towering pile of shit and physiologically and anatomically wholly inaccurate and untrue. Since when did frightening parents into making decisions count as informed consent? Outright lying to a patient is not ethically acceptable, regardless of their ‘reasoning’ that the end justifies the means.

    • Cartman36

      It is because, IMO, unless a lactation consultant has another credential (like a nurse) they aren’t medical professionals. They don’t understand that informed consent does not just mean the parents signed a piece of paper.

  • rosewater1

    Poor little man. And poor mom and dad. They sound-at least from the limited information given-like they have sense and realize how close they came to losing him. Hopefully this is enough of a wake up call for them to keep them out of the woo.

  • AnnaPDE

    “I speculate that the clipping was being performed by a lactation professional or midwife, not a physician.”

    This was in Australia, and pretty much all of the tongue tie providers around here are dentists or GPs, plus a small minority of pediatric surgeons. For a midwife or LC, this would be serious trouble for outside-of-scope practice.

    • Who?

      Let’s hope many questions are being asked about how this happened.

  • Amazed

    Poor little guy. Get better fast!

  • Gene

    Could this have been hemorrhagic disease of the newborn? Or hemophilia?

    • The Bofa on the Sofa

      Did the baby get a vitamin K shot?

      • Gene

        No idea. Though refusal of Vit K has become yet another trendy thing in natcheral circle.

  • The Bofa on the Sofa

    Aren’t babies born to be breastfed? I thought that it was the whole, “If babies couldn’t breastfeed, the human race wouldn’t have survived.” At least, that is the excuse for browbeating women into breastfeeding and denying their complaints about it not working.

    But babies….tongue tie! Tongue tie!!!!! Need intervention!

    • NoLongerCrunching

      Their thinking is that it’s a midline defect caused by artifishul folic acid supplementation. Everything is technology’s fault (eyeroll).

      • AirPlant

        So I just found out yesterday that people exist who are opposed to folic acid supplementation during pregnancy. I am still reeling from how bananas that is.

        I personally chose to take two or three prenatal vitamins per day during the crucial weeks. I am not an idiot and I know I just peed out the excess but I wanted so badly to do something and literally packing my body with more folic acid than it could use was something that made me feel like I wasn’t doing nothing. The idea that some women are just like LOL ARTIFICIAL NOPE just blows my mind.

      • MaineJen

        Seriously????

        • NoLongerCrunching

          Yes. I’m an IBCLC, so I hear some crazy shit.

        • NoLongerCrunching

          These are the same people who believe in making PLACENTA SMOOTHIES lol

      • Amazed

        WHAT?

      • Heidi

        So something that has been proven to reduce spina bifida somehow makes a tongue thingy not as flexible? Sure. Okay, not sure how that’d work but I don’t know everything. Well, I’ll take a less flexible tongue over a baby that is severely disabled or dead!

    • Cartman36

      If only the Neanderthals had lactation consultants, they would still be here.

      • Mel

        I snorted a Diet Pepsi through my nose. Thank you! I needed that.

        • Cartman36

          I wish I could totally claim this as my own snark. I made a comment on a previous post asking Dr. Amy if she had considered writing about all the other homo erectus species that did not survive despite EBF and another commentator said something along the lines of what I said above so I decided to shamelessly steal it. 🙂

    • rational thinker

      All this push for exclusive breastfeeding at any cost is just normalizing child abuse at this point.

  • MaineJen

    I’m going to go ahead and take a wild guess that the people who will recommend tongue tie clipping, for nearly every breastfeeding problem imaginable, are the same people who will SCREAM child abuse if an infant is c*rc*mcised.

    * = don’t want the raptors to descend

    • rational thinker

      I would say you are correct with that guess.

    • AnnaPDE

      Spot on.

      But point out that tongue tie needs real post-op pain relief, just like the procedure that must not be named, and see how quickly that gets you banned from those groups.

      Also here in Australia there’s a surprising overlap between doctors who do TT clips and those who do c*rc. (Being a <5% of boys procedure these days, there's not a big market.) Most of these doctors make a point of emphasising how much effort the put into pain relief. So it's ironic that they're seen as the "oh no don't go there" providers in the facebook groups, whereas the random dentist who buys a laser, shoots that around indiscriminately in kids' mouths and recommends homeopathy and breastfeeding for analgesia counts as the gentle recommended choice.

      • Who?

        The woo in dentistry in this country needs some thorough investigation.