Milk Matters UK, did Baby H ever have a tongue-tie?

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The principle is called Occam’s Razor.

It is sometimes paraphrased by a statement like “the simplest solution is most likely the right one” …

The Wikipedia article notes that possible explanations can become needlessly complex.

It might be coherent, for instance, to add the involvement of leprechauns to any explanation …

Those complex explanations are — revealingly — saving hypotheses.

These are special purpose hypotheses that are typically used to save a theory from being falsified by an observation.

For example, when you find your preschooler next to a vase that has fallen off a table, you will likely conclude that the preschooler knocked the vase over. The preschooler, however, may insist that bad men broke into the house, threw down the vase, and left; he was just trying to save the vase from the bad men. The principle of Occam’s Razor means that the simpler explanation (the preschooler knocked over the vase) is far more likely than the elaborate yarn he has spun.

The simplest explanation — insufficient breastmilk — explains everything every step of the way.

Similarly, the principle of Occam’s Razor suggests that the elaborate yarn Milk Matters UK has spun about starving Baby H is unlikely compared to the simple explanation that the baby starved because of insufficient breastmilk.

I wrote about Baby H last week. According to Milk Matters UK, the organization run by lactation consultant Charlotte Young (the Analytical Armadillo):

Meet H, a nearly 9 week old baby we met this weekend. H is just back at slightly above the weight at which they were born; we’ve plotted their birthweight and last weight into a growth chart, to give you a visual representation …

How did this horror happen?

[O]ne midwife noted some concerns and suggested a feeding group, where they were told to stop expressing and supplementing, relax and just “feed feed feed”. Seen weekly at jaundice clinic, reluctant to weigh but did after mum pressure, no concerns noted.

Baby H starved for 9 weeks because no one dared admit that he was getting insufficient breastmilk and therefore no dared give him the infant formula he desperately needed. Apparently the mother intermittently ignored the professionals and fed the baby formula from a bottle.

MMUK prefers a much more elaborate explanation, one that markets their lucrative service (at $280/hour) of tongue-tie surgery. They diagnosed Baby H with tongue-tie and treated it.

What does Occam’s Razor tell us?

The simplest explanation is that Baby H was suffering because his mother had insufficient breastmilk and no healthcare professional was willing to admit it. The more complex explanation, favored by MMUK, is that the baby had a tongue-tie that made it impossible for him to take in adequate nutrition by breast or bottle. That multiple medical professionals examined the baby and no one noticed this tongue-tie. That the mother failed to notice that the baby was not able to drink from a bottle.

According to MMUK, their treatment was “successful”!

They posted these “before and after” photos:

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But these photos don’t show that the baby had a tongue-tie or that the “treatment” fixed anything.

Why are there no pictures of the tongue-tie itself?

The simplest reason is that there was never any tongue-tie and pictures of the baby’s mouth before and after would make that clear. MMUK has offered no explanation as to why they failed to show the “tongue-tie” that multiple other medical professionals ostensibly missed.

Instead MMUK posted a looping 2 second gif of the baby breastfeeding.

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The baby is wearing an SNS (supplemental nursing system) designed to provide milk when the mother has insufficient breastmilk.

But why would a baby who supposedly had successful tongue-tie surgery need formula supplementation?

The simplest answer is that the problem all along was insufficient breastmilk.

That’s what I noted in a post on my Facebook page:

No evidence has ever been presented that this baby had a tongue-tie, needed expensive surgery, or benefited from it.

Indeed, it appears that the problem was — and still is — insufficient milk supply.

MMUK responded:

The milk is mum’s expressed milk, she can express oodles as this isn’t her first rodeo and actually has oversupply.

Really? If the mother has an oversupply of breastmilk, why is the baby being supplemented WHILE breastfeeding?

An MMUK partisan offered this bizarre explanation:

A baby who has been unable to feed because of severe restriction will not have the energy to nurse for as long as required in order to gain weight, hence why continued supplementation is recommended until back to full health.

If the baby does not have energy to nurse effectively (though the video shows the baby nursing vigorously), the answer is to supplement the baby through a bottle. It shouldn’t take long (hours not days) for the baby to be able to nurse effectively.

What does Occam’s Razor tell us about the cause of Baby H’s starvation?

The simplest explanation is insufficient breastmilk. It explains everything at every step of the way.

But that won’t sell MMUK’s services.

The preferred MMUK explanation is a tongue-tie that multiple medical professionals failed to diagnose and for which there is no documentation. The baby was “cured” but still has problems nursing despite the “cure.” The baby is being supplemented at the breast even though the mother has oversupply.

Which sounds more likely?

  • Cee

    You cannot make a diagnosis without being presented with all of the symptoms.

    Is it possible you are no longer practising nor registered and therefore have no place to make your assumptions based only on the symptoms you know of?

    You fed your four children with no problems, you state you only did this because you found it so easy. Do you know how you would have dealt with problems had they of arisen? I presume no.

    You sound bitter and twisted about something, something which drives you to use pictures of babies without permission, and make your accusations. It would be more interesting to read about your drive (and where the bitterness comes from) than to hear you spouting on about a subject (Baby H) you know limited information about.

    Maybe the toddler knocked the vase off the table, but it doesn’t make it impossible for a man to have come in, knock it off and get spooked. The simplest explanation is not the only explanation.

    • swbarnes2

      She’s “bitter” about the fact that this baby went 9 weeks before returning to birth weight, and for most of that time, the LCs did nothing, but urge the mom not to have the baby weighed!

      If the baby is using an SNS, that suggests that either the baby is still not good at getting milk out of the breast, or that there’s not enough milk in the breast for baby, or both. Either situation should have been detected and dealt with way way before week 9.

    • fiftyfifty1

      I can’t speak for Dr. Tuteur, but what makes ME bitter is babies being starved for ideology. It is sick and it needs to stop.

    • Mel

      I have one kid who went through a whole host of feeding issues.

      I also have a well-calibrated bullshit meter.

      Bullshit One: No one in the SLP field would show a photo of the lower lip of a newborn as a sign of decreased tone since tone is assessed through manual manipulation. Doubly so since the kid is gaining weight at the same time which changes the overall contours of the face.

      Bullshit Two: That an SNS is an optimal way to feed an infant is weak from long-term starvation. That level of weakness from lack of calories is best treated with a temporary feeding tube system like an NG tube. NG tubes are placed for 2 weeks at a time, can be flushed with tap water and allow the open-ended feeding syringe to be washed separately. NGs are also optimal for helping a baby learn how to orally feed since the baby has to suck on the nipple to get milk. An SNS system creates a confusing set of sensations where the baby gets milk when it sucks – but also gets milk without sucking from the SNS system.

      • AnnaPDE

        Depending on the tubing size and how high you put the container relative to baby’s mouth, the SNS can need some suction too to dispense milk. (Source: Used it.)
        However, I agree that an SNS is not a good choice for feeding a baby who is weak from starvation and needs to regain strength.
        If it has any real good use, it’s to temporarily support breastfeeding while milk supply still has to build up: This would be the typical scenario after a tongue tie revision, when the milk supply has already tanked, but baby could use the tongue exercise involved in breastfeeding.
        In practice, it’s super tedious to set up for use and clean afterwards, and therefore only suitable for a few feeds per day tops. For everyone’s sake, the bulk of the baby’s intake calories should be delivered in a more efficient way.

        • rational thinker

          “However, I agree that an SNS is not a good choice for feeding a baby who is weak from starvation and needs to regain strength.” –
          I agree. In the case of this baby and other babies who may be in the same situation I would call use of an SNS sadistic.

        • Mel

          That makes sense; I’ve always heard of SNS as a method to increase breast stimulation while feeding a baby.

          I can also see how a SNS placed below a baby’s mouth could require suction. My son had a period where he had nasty reflux and could only eat 1 oz dispensed over 20 minutes each hour. I pretty much hooked his gavage syringe to a chair so that the base of the syringe was a cm higher than his stomach. (Thankfully, his doctor added a second reflux med; the nurse still remembers my call after 24 hours of round-the-clock feeding where I calmly informed her that we needed a med change or a g-tube surgery scheduled or I was going to lose my mind.)

          Honestly, the SNS looks like a pain to clean. The NG tube and gavage feeding tube (e.g. a 20mL syringe) could be disconnected and cleaned pretty easily. Spawn’s stomach acid kept the internal opening pretty clean and I could get residual milk out of the tube by pushing less than 5mL of tap water through the tube. The tube needed to be replaced every 14 days – but my kid pulled it out at least every 7 days. When he pulled it out, I’d push 10mL of Diet Sprite down the tube, then drop it in a small bowl of Diet Sprite because the combination of the carbonation and the acid did a great job of cleaning any residual proteins and fats on or in the tube. Once I had re-taped his face, I’d rinse the tube and reinsert it. The syringe itself was as easy to clean as a cup – no corners, no attached tubes.

          But yeah, if the kid has been starving, you want a way to feed that wastes no energy on sucking – and that’s what NG, OG, G and all the other tube feeding methods are for.

    • I think you are simply in denial of reality. The reality is that breastfeeding is not simple nor always even possible. When it works, fine. When it doesn’t, go to Plan B — formula. The baby’s well being is paramount, not the nursing mother’s.

      • fiftyfifty1

        I would say that the baby’s well being AND the mother’s well being are paramount. What is not is the cult of exclusive breastfeeding.

    • rational thinker

      “Is it possible you are no longer practising nor registered and therefore have no place to make your assumptions based only on the symptoms you know of?” – Dr. Tuteur is retired. When you retire that does not mean that your skills and memory disappear. She is still skilled and keeps up with all the current medical studies. It is very obvious what was going on with this baby from the info they gave and the lies they told about this baby, and you dont have to be a doctor, retired or practicing to see that this baby was underfed because of lactivism and breast is best ideology.

      “You fed your four children with no problems, you state you only did this because you found it so easy. Do you know how you would have dealt with problems had they of arisen? I presume no” – Dr. Tuteur has stated many times that she breastfed her four children because she was lucky enough to have no problems and she enjoyed doing it. She has also stated she would have given formula if she did have problems cause the most important thing is not how a baby is fed it is that the baby IS FED.

      “You sound bitter and twisted about something, something which drives you to use pictures of babies without permission, and make your accusations. It would be more interesting to read about your drive (and where the bitterness comes from) than to hear you spouting on about a subject (Baby H) you know limited information about.”– Ok first the picture was shared in the public domain by Milk Matters UK and has therefore been made public, and second she blurred/blacked out the babys face to protect identity. I think if you were a regular here you would notice that most of us commenters here are also bitter. Actually we are not bitter we are outright PISSED OFF!!! Do you want to know why? We hear a story like this baby’s all the time. We are mad about babies starving or dying or have brain damage caused by breast is best nonsense. This story is not unique it happens all the time because of assholes that deeply believe “better dead than formula fed” or that “formula is poison” and should be avoided at all costs. Or “one drop of formula will ruin the baby for life”, or “everyone can breastfeed” and “low supply is a myth”. The leading cause of hospital readmission for a newborn is from jaundice/starvation/dehydration. When a baby is starving their body will begin to cannibalize itself, that means brain damage IS likely.
      So yeah at this blog we are a bit bitter and thats why.

      You have also unknowingly demonstrated something for us. When someone cannot back up their arguments with proper data and facts they immediately use insults. Which shows you have no idea what the hell you are talking about.

    • Russell Jones

      Oofa. I lost about 85 IQ points reading that post, a serious matter for those of us who don’t have a great deal of points to spare. Coherence is your friend, or could be if you gave it half a chance.

  • Bee

    I agree. I had a child with a tongue tie that was undiagnosed for the first four weeks of life. It couldn’t latch on at all (would just slip straight off). My supply was not good due to the child being unable to draw enough milk out. I would pump after feeding but it wasn’t enough. As soon as the tongue was cut the child could latch and with weighed feeds was immediately taking double the milk from the breast! We still had supply issues and would supplement after feeding. I find it incredibly unlikely that someone would have an oversupply with a child not emptying the breast for 9 weeks!! An explanation I can think of is that she was pumping after a feed. If you were pumping after a feed and getting a lot of milk and the baby wasn’t taking it (from a bottle or sns) and your baby looked like h wouldn’t you be at the doctor straight away saying something is clearly wrong? It seems far more likely to me that she was largely just feeding at the breast and had no idea how much the baby was getting but had been advised insufficient milk was rare and baby would be getting enough if she just breast fed harder. The poor mother and baby. I hope he is getting enough now with adequate supplementation. Feed the poor baby!

    • Any woman with “oversupply” but with a baby who could not empty the breast would no longer have “oversupply” by 9 weeks. She might well have had no milk at all by that time, certainly a noticeable dimunition due to lack of stimulation [which sets off the complex hormonal cascade resulting in milk production — remember the simplest way to end lactation is to not nurse].

      I not only hope the baby is getting sufficient nutrition but that the starvation hasn’t affected the brain negatively. Studies increasingly show that neonatal starvation has major effects on brain development.