Ten questions I’d like to ask Kathleen Kendall-Tackett, PhD, IBCLC

Number ten wooden material on table with copy space

Breastfeeding professional Kathleen Kendall-Tackett PhD, IBCLC wrote an editorial for the latest issue of Clinical Lactation entitled Concerns About the 10 Steps.

She’s attempting to respond to growing criticism of breastfeeding promotion initiatives by the Fed Is Best Foundation. The second paragraph sounds quite reasonable.

While I frequently do not agree with Fed Is Best’s recommendations or approach, I feel that it’s important to hear what they are saying. Mothers do fall through the cracks, and tragically some mothers and babies have been harmed. In response to these stories, we have two options. We can ignore them and keep doing what we are doing. Or we can view this as an opportunity to continue to improve our models of care.

Unfortunately it was preceded by the first paragraph, which makes accusations about the Foundation.

Will breastfeeding professionals answer these questions if mothers ask them?

For the past several weeks, I’ve been working on a talk about what we can learn from Fed Is Best. I spent days going through their Website and reading the stories they have posted—a pretty tough assignment. Some of the breastfeeding information on their site is completely wrong — or wrong enough. And the mothers’ stories are heartbreaking. This organization has been a vocal and divisive presence on social media, and they have garnered international attention to their cause.

It’s difficult to be more vague and unsubstantiated than “wrong – or wrong enough.”

I know better than to believe that Kendall-Tackett would agree to engage publicly with me, but I’ve decided to imagine what I would ask her if she agreed. I would not press her to detail her concerns, but rather I’d pose a series of yes or no questions to clarify her position. Since the Fed Is Best Foundation bases its recommendations on the scientific evidence, I’d question her about that.

1. Is the claim that exclusive breastfeeding is now the leading risk factor for newborn readmission wrong? Yes or no?

2. Does the scientific evidence show that the risk of a breastfed baby being readmitted to the hospital is 1 in 71? Yes or no?

3. Has there been a recent surge in cases of hypernatremic neonatal dehydration sometimes correctable, but sometimes leading to seizures, permanent brain injury or death? Yes or no?

4. Are approximately 90% of cases of kernicterus (severe jaundice) the result of insufficient breastmilk intake? Yes or no?

5. In the wake mandated of hours of skin to skin and mandated rooming in has there been a rise in the incidence of newborns smothering in and falling from maternal hospital beds? Yes or no?

6. Breastfeeding professionals promised that an increase in breastfeeding rates would lead to decreased incidence of conditions like allergy and childhood obesity. Isn’t it true that while rates of breastfeeding initiation have shot up from 22% in 1972 to over 80% in 2015, incidence of those conditions has continued to rise? Yes or no?

7. Breastfeeding professionals predicted that breastfeeding would reduce infant hospitalizations. That didn’t happen, did it? Yes or no?

8. Breastfeeding professionals insisted that increasing breastfeeding would save infant lives. With the exception of a decreased incidence of necrotizing enterocolitis in premature babies, that has not happen either, has it? Yes or no?

9. Isn’t it true that infant stomach capacity is not 5-7 cc as claimed by lactation professionals with reference to a paper published in 1921, but actually much higher, 20 cc or more as demonstrated by more recent scientific evidence? Yes or no?

10. Isn’t it the case that nearly all the benefits for breastfeeding claimed by lactation professionals have been debunked by newer, more comprehensive research that corrects for confounding variables like maternal education and socioeconomic status? Yes or no?

These are not hard questions to answer. Hopefully breastfeeding professionals like Kathleen Kendall-Tackett will answer them — perhaps if mothers ask her.

  • Ayr

    I have to admit, I am really looking forward to telling the lactation consultants at the hospital to take a hike in 11 days when I have my baby girl. I will be on blood thinners that can cross into the breast milk and will be formula feeding my daughter just like I did my son. I’m sick of sticking myself with a needle everyday and am switching to a pill. I’m kind of excited and so is my husband, we had a horrible experience with a lactation consultant in the hospital with our son.

    • rational thinker

      What did the previous lactation consultant do to you? If you don’t mind sharing, but its ok if you don’t want to say.

      • Ayr

        It’s ok, I had two at the hospital one was very sweet and kind the other was a pushy b****. She swept into the room with a very superior manner, took my son from my husband who was feeding him, threw the bottle away, clucking her tongue the whole time. She handed my son to me who was more than a little pissed that his feeding had been interrupted and proceeded to try and move my gown and bra aside. I stopped her and asked who she was and what did she think she was doing. She gave her name and said she was a lactation consultant with the hospital and showed us her badge. She again tried to move my clothing and told her hands off I can do it myself, I handed my screaming son to my husband and did what I needed to do, she tapped her foot impatiently the whole time. She told me how to hold him, blah, blah, blah, he latched, but nothing came out and it was so painful that I started crying. She basically told me to toughen up and get over it. After a few seconds my son disengaged because he wasn’t getting anything so I switched sides, again same thing. This went on for a few minutes before my husband said enough, he was just going to give him a bottle because he was hungry and she had interrupted his feeding long enough. She got all self righteous and started preaching to us about the evils of formula and how I should only BF and my son could handle being hungry until my supply came in, I just needed to try harder. She claimed my son had a tongue tie and that was why he wasn’t latching correctly, he had no trouble latching, and that she could take him to have the tie clipped that very day all we had to do was sign a form. We refused and said we would talk to his pediatrician at his first visit. She got all huffy and then turned to me saying I needed to start pumping every hour to get my supply to come in. She got everything out and again tried to get all handsy with me, again I told her no, just tell me what to do. Got the pump going, again nothing came out. She sighed a frustrated sigh and said I was really going to have to work at this if I wanted to be a good mother. She tried to get me to sign this thing stating that I wouldn’t give him formula, and of course I refused and we asked her to leave. The next day the other lady came in she was super sweet, she checked my son, no tongue tie, the problem was me, I have inverted nipples and it would take a lot of practice to get them to do what they needed to do. We told her about the other lady and she got so angry, apparently she had been warned about that kind of behavior before and this was her last chance. She had worked at a ‘Baby Friendly’ hospital before this and had been told that her La Leche League beliefs were not welcome and the hospital was firmly Fed Is Best. She encouraged pumping but only every two hours and said to feed my son whatever I needed to, just make sure he was fed. While she was very nice, the first lady put a bad taste in my mouth when it comes to lactation consultants.

        • rational thinker

          OMG that is just horrible I hope she was promptly fired. Sadly I think about 70% or more lactation consultants are like that. Thank goodness you got a proper one the next day. I find that the good ones are sadly a rare occurance nowadays. Thanks for sharing.

          • Ayr

            No problem, people need to be honest about their experiences like this, otherwise there will never be a chance for change. I hope she was too, I’ll never know. But really, lactation consultants of all people should understand that not everyone produces and they should be more compassionate. But alas the profession has attracted a lot of nut cases like that lady.

          • FormerPhysicist

            Um, and they need to not commit assault. That seems like the baseline. Both grabbing your son from your husband, and grabbing you are assault. No two ways about it.

          • Ayr

            I’m fairly certain she was fired, the second lady was head of the department and she was pretty pissed. So the lady getting fired is good enough for me. People like that never learn no matter what you do.

  • Amazed

    OK, who is this Mike person and why is he trying to take Brooke’s place as the resident fanatic at Dr Amy’s facebook? Please tell me that this is an online theft of identity and he doesn’t really have any access to new mothers in any professional capacity? Pretty please?

    • mabelcruet

      He’s a very real person, he was a senior lecturer at University College London in health sciences, and now in Leeds. He started out in zoology, then psychology and now breast feeding. He has a fairly extensive CV and publication history.

      http://ucl.academia.edu/MikeWoolridge
      http://ucl.academia.edu/MikeWoolridge/CurriculumVitae

      • mabelcruet

        That’s assuming that the person posting is the person he’s claiming to be, of course.

        • demodocus

          don’t know which is more irritating an idea

        • Amazed

          Yeah. I was hoping that he wasn’t. I was too scared to look him up, just in case it was.

  • MainlyMom

    OT, but one of the Duggars had a baby at home, and she looks blue to me. Is it just me? https://www.yahoo.com/news/jessa-duggar-seewald-welcomes-baby-211532980.html

    • mabelcruet

      It’s not just you. That baby is very definitely purple. Maybe it’s the lighting, or the skin colour is being affected by the grey-blue head wrap thing, but if I saw a baby this colour I think I might be a bit concerned.

      Plus, ‘Spurgeon’? As a boys name? If they wanted to name the baby after a preacher, what about John, Wesley, William, Joel, Martin? Nice, graceful non-clunky names.

      • EmbraceYourInnerCrone

        Why the hell do these idiots have a TV show?? Lets show the world that one gets money and fame for squeezing ones kids into strict gender roles and having as many kids as possible. But then most reality TV shows make me want to throw things at the TV.

        • mabelcruet

          Me too. They are so obviously scripted-if I wanted to watch a fictional show, I’d watch decently written fiction acted out by actors, not a bunch of woodentops who are parroting a script written by an adolescent melodrama queen with a psychobabbling commentary running.

        • Russell Jones

          The Duggars still have a teevee show even after it came to light that the eldest spawn was fond of molesting his little sisters?

          Damn.

          Our appetite for swill is truly boundless.

          • MaineJen

            Come off it. They’re still making new episodes??

        • mabelcruet

          I suppose monetizing their quiverfull mentality is one way of paying for the hordes of offspring. If you’re offered millions of dollars in exchange for dropping sprogs, I can see some people might think that’s a good trade-off.

          Not me-I’d prefer my perineum and continence to remain intact.

        • Ayr

          I have always thought the exact same thing, I never watched it, but there are people in my church that love the show. I used to hear about what a wonderful Godly example they were, my only thought was, ‘How in the world is a family where the women are forced into outdated misogynistic gender roles a Godly example?’ She just goes along with whatever he wants and calls it being submissive… If I ever voiced this opinion ohhh the back lash! I have a modern view of gender roles, but not everyone in the church has made it into the 21st century.

      • Ayr

        Or at least use his first name Charles. Spurgeon just sounds pretentious, but then again we are talking about the Duggars…

    • rational thinker

      maybe a little but I have bad eyes and it could be just the lighting, did look a little puffy to me though especially around the eyes.

  • Emilie Bishop

    WTF does “wrong enough” even mean? I’m guessing it’s “right, but not what I want to hear,” but seriously. If it were her baby starving and her mental health wrecked, she’d have a better perspective.

  • Anna

    Lactivist pretending she gives a fuck about women : “We have to listen to women”
    Also lactivist pretending to give a fuck about women : insinuates true problems are rare and not the fault of aggressive breastfeeding promotion so fed is best and all the women talking about their experiences are wrong.

  • fiftyfifty1

    I predict her answers would be a series of “Yes, but” excuses.
    1. Yes it’s the leading cause of readmission, but it wouldn’t be if only mothers breastfed correctly.
    2. Yes it’s 1 out of 71, but it would be nonexistent if women received more support.”
    3. Yes, but talking about it is fear mongering.
    etc.

    • Anj Fabian

      The answer to everything breastfeeding is “more support!”.

      • Cristina B

        And “more breastfeeding!”

        • alongpursuit

          Haha yep! Just breastfeed harder!

        • rational thinker

          and “we must ban all formula advertisements and……..keep breastfeeding!”

  • alongpursuit

    I’ve been thinking a lot about informed consent and the promotion of exclusive breastfeeding. Despite having 12 hours of prenatal classes with a public health nurse, regular checkups with my PCP, and reading the Healthy Baby handbook published by my government and the handouts at the hospital touting the many benefits of EBF, I do not believe I was informed enough (read: at all) about the risks of breastfeeding in order to properly consent. If I had known then what I know now, we would not have suffered so much trying to exclusively breastfeed when I had such a dismal supply (max. 2 oz/day) that would not increase despite herculean efforts. I am angry as hell to have been duped into believing that breast is best for all mothers and babies.

    • Anna

      Its the same thing as vaginal birth “natural” birth. They don’t want to tell women the truth because then they might choose the option we don’t like. But we’ll bang on and on about informed consent like we know what it means!

      • Daleth

        After fighting my medical team for months to schedule a c-section (I was expecting mono-di twins, and they kept pressuring me to attempt a vaginal birth, even though mono-di twins are so-high risk you have to labor in the OR), I finally got one of them to admit that many of his colleagues “pushed maybe a little too hard for vaginal birth” and that maybe it wasn’t fair that they insisted on informed consent for c-section (i.e. warned me of every possible risk) but not for vaginal birth.

        I did end up getting my c-section in the end. But it was a fight. And this is in the US by the way.

        • rational thinker

          Wow twins should be an automatic section. That was very unethical to do to you for many reasons. Vaginal birth is not worth risking a life over or permanent damage to your vagina. My first baby was too big for vaginal birth and thinking back on it I think they knew it too. I had a vaginal birth with fourth degree tears. It was 17 years ago and I still have problems from it.

        • FormerPhysicist

          Yes, this.

      • rational thinker

        When trying to sell the whole natural childbirth spiel to pregnant women I love how they tell women not to listen to anyone about how painful it is and how much the epidural helps.

        Their philosophy is that if you just relax, meditate or try to get off on your own child by orgasmic birthing that it does not need to hurt.

    • Cartman36

      I think this is ultimately what will turn the tide because the hospitals are responsible for ensuring a patient understand the risks and benefits even when something is “natural” . Eventually, the lawsuit payouts from babies harmed by the extensive focus on EBF will force hospitals to give more balanced information and hopefully through the BFHI out on its a$$.

      • EmbraceYourInnerCrone

        I wish more patients and their families were aware of the procedure for making a complaint. And about the fact that they are allowed to complain about the BFHI and also the tendency of many US hospitals now to push breastfeeding/exclusive breastfeeding.

      • FormerPhysicist

        Actually, it’s my experience that the legalese only ever covers the risks of the procedure, and NEVER the risk of not doing anything. Doctors will talk about the risks of non-treatment, but it’s generally presumed obvious.

        Prophylactic double mastectomy – I certainly talked to me doctor a bunch about all the options (watchful waiting …) but any forms I signed only asked if I understood the risks of the procedure. C-section for failure to progress – any forms I signed only asked if I understood the risks of the procedure. Repeat pre-labor c-section – any forms I signed only asked if I understood the risks of the procedure. The hospital presumed my doctor had talked to me about the risks of doing nothing, but no one ever asked, let alone asked me to sign a form saying all possibilities and their associated risks had been discussed.

  • demodocus

    Perhaps i’m feeling divisive, but FiB and FFF are a lot more welcoming to me than the BiB group. Hell, FFF was more comfortable to read while I was BF’ing my first. That’s just my anecdote, of course, but my experiences are just as valid as hers.

    • AnnaPDE

      Weird, right? I’m in the FiB peer support FB group, and there is a ton of practical support and very qualified advice for every mum who asks, whether she wants to BF, FF, combine the two or do something else.
      The main difference to the BF groups I’ve seen is that the baby being fed and happy, and the mother getting rest and staying healthy, are not sacrificed over the BF goal but seen as the baseline prerequisites for success.