Anyone who has read my blog or Facebook page for any length of time knows that I rarely censor comments. I am happy to argue with anyone, no matter how outrageous their claims, because there’s always a possibility I can convince readers, if not the commentor herself.

Like anyone trained in science, I argue using the principles of basic logic and scientific evidence. But it’s difficult, if not impossible, to argue with laypeople who might understand neither.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]No one has to prove elephants can’t fly in order to claim they can’t fly.[/perfectpullquote]

It’s not difficult to prove them wrong. That’s easy. To anyone with a modicum of understanding of logic, they’ve made fools of themselves. But it’s difficult to get them to understand that they are wrong, or that they have not been able to support their own claims. What follows, therefore, is a very basic primer on the null hypothesis, the cornerstone of scientific reasoning.

Let’s start with the definition of a hypothesis:

a supposition or proposed explanation made on the basis of limited evidence as a starting point for further investigation.

Most people understand that a hypothesis is a provisional claim and it remains provisional until it can be tested and shown to be true.

It can be a description: Pigs are mammals.

It can be a prediction: Tadpoles become frogs.

It can be a claim of relationship: Light is necessary for plants to grow.

You can generate a hypothesis about nearly anything.

But what many laypeople don’t understand is that science ALWAYS starts with the null hypothesis.

What’s the null hypothesis?

The null hypothesis is that there is NO connection between the elements of any hypothesis.

For the hypotheses above, the null hypotheses are:

Pigs are not mammals.

Tadpoles and frogs are unrelated.

Light has nothing to do with the growth of plants.

The null hypothesis is NOT the negative of the hypothesis. This is where laypeople often get confused. It null hypothesis is ALWAYS the claim that there is no connection.

If you want to claim that pigs are mammals, you must prove they are mammals because the null hypothesis is that there is no connection between pigs and mammals. In other words the BURDEN OF PROOF is on the person who asserts the connection.

Laypeople usually understand this to a certain extent, but because they don’t understand the null hypothesis, they don’t understand who must offer proof.

If you claim pigs are mammals YOU must prove the assertion that pigs are mammals. If I claim pigs are not mammals, I DON’T have to prove it because I am merely stating the null hypothesis that there is no connection and the null hypothesis is ALWAYS true until someone proves it isn’t.

To better understand how this works, it is helpful to use an absurd example.

Suppose I say that elephants can fly. I assert that if you push an elephant off a cliff, it will flap its massive ears and settle safety to the ground.

If you insist that elephants can’t fly, do you have to prove that they can’t? Do you have to push an elephant off a cliff and watch it fall to its death below before you can claim that an elephant can’t fly?

No, because the null hypothesis is ALWAYS that there is NO CONNECTION between elephants and flight.

Here’s a real world example:

Yesterday I noted on my Facebook page that there is no evidence that immediate skin-to-skin contact is necessary for mother-infant bonding. I therefore claimed that skin-to-skin contact is not necessary for bonding.

The lactivists promptly swooped in.

Janet KS vehemently disagreed with me. I wrote:

Please supply scientific evidence that skin-to-skin has had any impact on child mental health at the population level.

She offered what she thought was a clever riposte:

Please supply scientific evidence that skin-to-skin has NOT had any impact on child mental health at the population level.

But all she did was demonstrate that she doesn’t understand how science works. The null hypothesis, the starting point for any claim, is ALWAYS that there is no connection, in this case, no connection between skin-to-skin and child mental health. It does not require proof; it is accepted as true.

The burden of proof is on those who want to assert that skin-to-skin improves child mental health. No one has to prove it doesn’t because the null hypothesis is not the negative of the hypothesis. It is the assumption that there is no connection.

The same thing applies to most of the major claims of contemporary lactivism. If lactivists want to claim that breastfeeding in industrialized countries saves lives, they have to show that it does.

It goes both ways.

If I want to claim that aggressive breastfeeding promotion leads to serious, life threatening neonatal complications, I have to prove that it does. Lactivists don’t have to prove that it doesn’t.

The bottom line is this: science ALWAYS starts with the assumption that there is no connection. If you want to claim otherwise, YOU have to prove otherwise.

For lack of a vaccine life as we know it has ground to a halt.

For lack of a vaccine Americans are being sickened in the hundreds of thousands, perhaps millions.

For lack of a vaccine Americans are dying in the thousands, soon to be tens of thousands, ultimately hundreds of thousands and hopefully not millions.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Look what we’ve suffered for lack of ONE vaccine.[/perfectpullquote]

For lack of a vaccine the American economy is in free fall.

For lack of a vaccine the stock market has shed nearly a third of its value.

For lack of a vaccine we are entering another Great Recession and possibly a Great Depression.

For lack of a vaccine millions have already lost their jobs and millions more, possibly tens of millions more will do so.

For lack of a vaccine we have had to cancel every high school graduation, every college graduation and thousands of weddings.

For lack of a vaccine we must stay in our homes, leaving only to get more food. We must keep our distance from even those we love the most.

For lack of a vaccine we take our lives in our hands every time we do leave our homes no matter how desperate the need.

For lack of a vaccine hospitals are being overwhelmed with seriously ill and mortally ill patients.

For lack of a vaccine we may exceed our ability to care for them and people will die because there are not enough ICU beds and ventilators to save them.

For lack of a vaccine we are setting up hospitals in stadiums and fields.

For lack of a vaccine our friends and loved ones are dying alone, separated from spouses, children and parents — the ones who could bring them precious comfort.

For lack of a vaccine we are running out of space in morgues.

For lack of a vaccine our family and friends cannot attend the funerals.

Think we don’t need vaccinations? Think they are a plot by Big Pharma? Think natural immunity is enough?

Look what we’ve suffered for lack of ONE vaccine. Now you have a glimpse of what life could be like before there were any.

Within a year or two there will be a vaccine for COVID-19. Millions of people will rush to get it. Like the flu, they may need a new vaccine each year and millions will readily comply.

And within a generation or two anti-vaxxers will be back to their inane conspiracy theories, as if the world was not convulsed in 2020 for lack of a vaccine.

Dr. Melissa Bartick has probably done more than any other individual to grossly exaggerate the benefits of breastfeeding. That’s why her latest piece, promoting breastfeeding in the age of COVID-19, is remarkable: the spurious claims are gone.

Enumerating the benefits of breastfeeding, Bartick offers this:

breastfeeding reduces the risk of ear infections and diarrhea

What happened to the claims of lives and health dollars saved and severe illness prevented, claims that Bartick has routinely made for the past decade? Either the editors of the Harvard Medical School newsletter removed her typical extravagant claims for lack of evidence, or she has finally admitted to herself that they never existed.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Bartick finally admits the benefits of breastfeeding are limited to a few less colds and episodes of diarrheal illness.[/perfectpullquote]

Who is Melissa Bartick, MD? She’s an internist at a small Harvard affiliated hospital who has a personal interest in breastfeeding. In the past 10 years she has produced a series of scientific papers about the purported benefits of breastfeeding — reduced mortality, severe morbidity and healthcare expenditures — based on mathematical models that were never validated.

I first wrote about her, and deconstructed her nonsensical claims, exactly ten years ago. That’s when her first paper, The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis, was published.

Bartick “estimated” that the US could save 900 infant lives and $13 billion if 90% of US women breastfed. These numbers are grossly misleading since not even a single US term infant death has ever been attributed to not breastfeeding and since the purported savings are primarily the “lost wages” of the 900 dead infants.

Bartick has published more papers since then, all using the same faulty modeling. How do we know it’s faulty? Because it makes predictions that can be tested with historical data. Over the past 45+ years, US breastfeeding rates have quadrupled, yet there is no evidence that any term babies’ lives have been saved, any severe illness prevented or any healthcare dollars saved.

Bartick herself admitted as much to me in print almost four years ago. In the comment section of a piece on the Academy of Breastfeeding Medicine blog, I asked Dr. Bartick directly:

Where is the evidence that term babies lives has been saved? Where is the evidence that the diseases you insist are decreased by breastfeeding are actually decreasing as a result of breastfeeding? Where are the billions of healthcare dollars you claimed would be saved as the breastfeeding rates rose?

Her response:

…To my knowledge, no one has actually dug it up yet.

In other words, no one — even Bartick herself — can find any evidence to support her claims. Therefore she stopped making those claims, or the editors of the newsletter refused to allow claims unsubstantiated by scientific evidence.

That hasn’t stopped Bartick from making unsubstantiated assumptions in the current piece, an attempt to justify promoting breastfeeding despite lacking basic knowledge about the deadly COVID-19 virus.

Without any evidence of any kind, Bartick warns:

There have been widespread reports of shortages of retail supplies of infant formula due to hoarding. Given the risk that novel coronavirus infections can spread through formula factories and delivery warehouses, potentially shutting them down, there is a risk of supply chain interruption.

To my knowledge, not a single baby has missed a single bottle of formula so far and formula manufacturers insist that there is no shortage of any kind. No matter. Scaremongering is Dr. Bartick’s tool of choice and if she can’t scaremonger about babies missing out on the “benefits” of breastfeeding, she’s reduced to scaremongering about the supply of formula.

Bartick can’t help herself from making another nonsensical claim:

Breastfeeding is the safest, most reliable method of infant feeding in an emergency.

Breastfeeding is actually the LEAST reliable method of infant feeding in an emergency because it depends entirely on the health and availability of the mother. If the mother is sick or dies, or even if her supply merely drops, the baby starves.

Why do breastfeeding researchers like Bartick exaggerate and mislead over and over again, moving to new exaggerations and falsehoods when caught in old ones? They have become confused about their legal and ethical obligations. They proudly boast about supporting breastfeeding as if any process could or should be supported above the wellbeing of patients themselves.

The truth is that no one knows whether breastfeeding is safe when a mother gets infected with coronavirus. We don’t know if the virus can be transmitted in breastmilk; we don’t know if the risk of infecting the baby outweighs any benefits of breastfeeding; we don’t know if breastfeeding provides any protection from COVID-19.

Those healthcare providers who admit they don’t know put the health and wellbeing of babies above all else; they won’t make recommendations without evidence to back them up. Anyone who makes claims about purported “benefits” of breastfeeding during a novel pandemic, in contrast, is more concerned with promoting breastfeeding than promoting infant health. That’s wrong.

Lack of data is one of the things that is hampering us most in providing effective guidance and care during the COVID-19 pandemic. Perhaps nowhere is that more obvious than in the care of pregnant women who are ill with coronavirus at the time of delivery.

Fortunately, medical journals are rushing data online as fast as becomes available. Today JAMA Pediatrics published the latest data on newborn early onset COVID-19, Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China.

Here are the highlights:

– Babies can be infected with COVID-19 at the time of birth but it is unclear whether the virus was transmitted in utero or during delivery.

– The transmission rate is relatively high at 9%.

– The babies experienced only mild illness.

The authors described the 3 cases:

Patient 1 was born at 40 weeks’ gestation. The delivery was by cesarean delivery because of meconium-stained amniotic fluid and confirmed maternal COVID-19 pneumonia. On day 2 of life, the infant experienced lethargy and fever, with unremarkable physical examination results, and was moved to the neonatal intensive care unit. A chest radiographic image showed pneumonia … Nasopharyngeal and anal swabs were positive for SARS-CoV-2 on days 2 and 4 of life and negative on day 6.

Patient 2 was born at 40 weeks’ and 4 days’ gestation by cesarean delivery because of confirmed maternal COVID-19 pneumonia. He presented with lethargy, vomiting, and fever… A chest radiographic image showed pneumonia. Nasopharyngeal and anal swabs were positive for SARS-CoV-2 on days 2 and 4 of life and negative on day 6.

Patient 3 was born at 31 weeks’ and 2 days’ gestation by cesarean delivery because of fetal distress and confirmed maternal COVID-19 pneumonia. Resuscitation was required. The infant’s Apgar scores were 3, 4, and 5 at 1, 5, and 10 minutes after birth. Neonatal respiratory distress syndrome and pneumonia confirmed by chest radiographic image on admission resolved on day 14 of life after treatment … Nasopharyngeal and anal swabs were positive for SARS-CoV-2 on days 2 and 4 of life and negative on day 7.

In all cases, strict infection control procedures were in place during delivery. So how did the babies become infected? They got the virus from their mothers either in utero or during delivery itself:

Because strict infection control and prevention procedures were implemented during the delivery, it is likely that the sources of SARS-CoV-2 in the neonates’ upper respiratory tracts or anuses were maternal in origin. Although 2 recent studies1,2 have shown that there were no clinical findings or investigations suggestive of COVID-19 in neonates born to affected mothers, and all samples, including amniotic fluid, cord blood, and breast milk, were negative for SARS-CoV-2, the vertical maternal-fetal transmission cannot be ruled out in the current cohort.

The authors recommend rigorous screening and infection control measures:

… [I]t is crucial to screen pregnant women and implement strict infection control measures, quarantine of infected mothers, and close monitoring of neonates at risk of COVID-19.

Unfortunately this study can’t tell us whether strict separation of newborns from infected mothers is necessary because every baby in the study was separated.

The bottom line is that newborns can and do get infected when mothers are ill at the time of birth. That raises the possibility that temporary separation of mother and baby could prevent serious illness. We need more data before we can know for sure.

Your money or your life!

Many Republican politicians believe that is the choice we face. They are arguing to end social distancing restrictions in order to bolster the faltering economy.

I understand the sentiment. All along I have been more worried about the economic impact of COVID-19 than the medical impact. Yes, I fear the disease, too. Even mild to moderate cases sound horrible and it’s not something I wish to endure. But it won’t be a victory if we survive the virus only to starve in a Great Depression.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Ending restrictions won’t allow us to forfeit our lives instead of our money; it would force us to forfeit both![/perfectpullquote]

Yet a premature end to social distancing restrictions, far from providing a boost to the economy, will be the worst of all possible worlds. We will pay with our money AND our lives.

We’ve all heard about flattening the curve. That refers to the massive increase in the numbers of coronavirus cases that have been occurring and will continue to occur over the coming months.

It’s illustrated like this (from The New York Times):

The same number of cases occur under the blue curve as under the red curve, just over a longer period of time. Let’s imagine that both curves represent a million cases of illness each. Why does that matter if both curves mean the same number of people get sick overall?

The longer time period is crucial because it means that our healthcare system won’t be overwhelmed. Therefore, although the number of cases of COVID-19 is the same in both scenarios, the number of deaths will be much smaller over the longer time period since we will be able to adequately care for everyone who becomes ill.

But there’s another curve which we need to bend and that has received less attention, but is just as critical. We aren’t fated to have a million cases (or more!); we could reduce the number to half a million, a quarter of a million or less. It’s possible to reduce the number of cases overall by limiting the ability of the virus to spread. That’s what happened in China. They didn’t merely slow the spread of coronavirus, they stopped it.

How? Their program of social distancing was far more rigorous than ours. The government monitored every individual and forcibly isolated those who showed signs of the disease. They segregated them from the rest of society until they recovered and could no longer transmit the virus. They literally ended the epidemic.

This graph provides the best illustration of the choice we currently face. It is taken from the Financial Times and I have highlighted the trajectory of coronavirus cases in the US.

The graph uses a logarithmic scale to show the number of cases of COVID-19 over time in each individual country. The advantage of a logarithmic scale is that it illustrates exponential increase as a straight line; the steeper the line, the faster cases are increasing.

If you follow the trajectory of China, you can see that initially the number of cases of coronavirus were doubling every other day. In other words, the disease was spreading very rapidly. But then China began its aggressive quarantine of whole cities. Shortly thereafter, the curve begins to bend. Cases were doubling every 3 days instead of every 2 days. As Chinese policies became even more restrictive, the increase in new cases dropped even more dramatically, first to doubling every week and then longer, then no new cases at all.

Now look at the trajectory of US cases. We are still in the phase where cases are doubling every other day. And we can see an ominous development. The US trajectory has crossed the Chinese trajectory. In other words, although China began to bend the trajectory of disease increase at day 17 of their epidemic, we have failed to do the same. Despite the efforts we have undertaken thus far, as onerous as they have been, we have not yet changed the rate of spread of the virus.

In fact, the US now has the dubious distinction of being the country with the worst rate of increase in disease cases, worse than Italy — which is foundering — and worse than China. A democratic country cannot institute the draconian measures put in place in China, but Italy has finally begun to bend their curve by basically locking down the entire country.

The restrictions we have faced in the US to date — burdensome as they are and economically destructive as they are — have not yet allowed us to exert control over the spread of the disease. And until we do exert control, it will get much, much worse. The pandemic will hit us harder than any other country.

What does that mean for prospects of getting back to normal in the next few weeks? It means that it is literally impossible. Sure, we can reduce restrictions so workers can go back to work, but those workers will fall ill in massive numbers, basically shutting down the economy due to illness instead of keeping it shut down due to government restrictions. We will face the worst of all possible worlds: an economic collapse coupled with massive rates of illness and death.

Contrary to what many Republican politicians would have you believe, ending restrictions won’t not allow us to choose forfeiting our lives instead of our money. Ending restrictions would force us to forfeit our money AND our lives.

That’s not a choice; it’s a death sentence.

I’ve received quite a few private messages asking whether homebirth is a better option than hospital birth in the age of coronavirus.

Let me start by acknowledging that I don’t know. No one knows; our lack of testing means that we don’t know how prevalent the virus is in the population or how likely a person is to catch it from another person. We also don’t know if coronavirus poses special risks to pregnant women and newborns although for safety’s sake, we must assume it might.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Homebirth midwives are providers, too. They are at much higher risk than average of having and transmitting the virus.[/perfectpullquote]

Since I don’t know, I can only list the pros and cons as I see them.

COVID-19 INFECTION RISK

Pro: There is no question that hospitals themselves are very high risk areas for COVID-19 transmission. They are filled with people who are severely ill and doctors and nurses who have been exposed to the virus repeatedly. That said, it is important to remember that hospitals are always full of sick people, so strenuous efforts are made to isolate labor and delivery as well as the postpartum floors from the rest of the hospital. The safest place within any hospital is almost always labor and delivery and the postpartum floors.

Con: midwives are healthcare providers, too. Unless they have stopped seeing all their other patients, they are at much higher risk than average of having and transmitting the virus. Moreover, they are unlikely to have access to the personal protective equipment that would reduce their risk. Keep in mind that a pregnant woman could have the virus already and SHE could pose a significant risk to her baby.

Con: If you need to transfer emergently during labor or after birth, you will be exposed to EMTS and emergency room personnel, the people who have the greatest risk of having been exposed to the virus and potentially exposing you and your baby to it.

INTERVENTIONS

Pro: Homebirth dramatically reduces your risk of unnecessary intervention.

Con: Homebirth dramatically increases the risk of death for baby and mother due to lack of necessary interventions.

COMPLICATIONS

Pro: There are no pros. Homebirths do not reduce the risk of complications; they increase the risks that complications will lead to brain injury for the baby or even death for the baby or mother.

Con: There is no access to an operating room for emergency C-section, no access to blood transfusions for hemorrhage and no access to the people who can perform advanced resuscitation and intubation of a baby who is born not breathing.

Con: Complications can often be prevented with early recognition and intervention. Homebirth midwives boast that they are experts in normal birth; they leave unsaid the fact that they are NOT experts in childbirth complications and often don’t recognize when they are developing.

Con: In the US (but not Canada, the Netherlands, the UK etc.) there is a second class of “midwife” known as certified professional midwife. They are not real midwives, merely lay people whose “education” is typically only a correspondence course. They lack the education and training of ALL other midwives in the industrialized world and they fail to meet the international standards of midwifery. They are barely better, and in some cases worse, than no midwife at all. They have NO training in managing serious childbirth and newborn complications. That’s why their death rate in much higher than midwives in other countries.

ACCOUNTABILITY

Pro: There are no pros.

Con: Homebirth midwives in the US, particularly CPMs, lack both malpractice insurance and accountability. If something goes horribly wrong, there is no one to sue and no way to hold them responsible for their errors.

THE BOTTOM LINE

There is one undeniable pro to homebirth in the age of COVID-19. It almost certainly lowers your risk of exposure to the virus compared to hospital birth but ONLY if you don’t need to transfer to the hospital. Your risk is not low, however, since your midwife is at high risk of carrying the virus.

There are a lot of cons but none greater than the fact that in the US, homebirth dramatically increases the risk of neonatal brain injury and death.

On balance, it seems to me that the risks of homebirth outweigh the risks of hospital birth, but other women may reach different conclusions and make different choices and that is their right.

Lactation professionals lie and babies die!

Now they’re lying about coronavirus and babies, providing reassurance that may not merely be false; it may be deadly.

NO ONE KNOWS whether it is safe for an infected mother to breastfeed her baby!

Why do lactation professionals lie? Because they’ve forgotten about their ethical responsibilities. They are so obsessed with protecting breastfeeding they have forgotten they’re supposed to be protecting BABIES.

The result: while breastfeeding rates at hospital discharge have risen dramatically, the purported benefits have never been seen and the risks of brain injury and death have risen dramatically.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Lactation professionals are lying if they claim breastfeeding with coronavirus is safe. No one knows![/perfectpullquote]

Lactation professionals have lied for decades:

– Breastfeeding saves lives? There is zero evidence that breastfeeding saves lives in industrialized countries; there are only mathematical models that have never been validated.

– Breastfeeding prevents serious illness? No, breastfeeding reduces the risk of colds and episodes of diarrheal illness, but every other claim has been debunked or is based on weak evidence that isn’t corrected for confounding variables.

– Breastfeeding saves healthcare dollars? No, breastfeeding has become the leading cause of newborn re-hospitalization at a cost of hundreds of millions of dollars each year.

Most egregiously, lactation professionals lie about the risks of breastfeeding and that’s why babies have died:

– Insufficient breastmilk is rare? No, it’s common, especially in the early days after birth, affecting up to a third of first time mothers.

– Severe newborn dehydration is rare? No, the rate for babies of first time mothers is 223 per 100,000 births. That sounds small until you consider that it’s DOUBLE the rate of sudden unexpected infant death (SUID).

– Jaundice is nothing to worry about? Over 90% of cases of kernicterus (severe jaundice causing brain injury) occurs in exclusively breastfed infants.

– Newborn stomach size is only 5 ml? No, it’s 4X higher.

– Formula ruins the breastfeeding relationship? No, early judicious formula supplementation prevents complications and INCREASES the odds of extended breastfeeding.

Now lactation professionals are lying about breastfeeding and coronavirus and their arrogance may kill babies yet again.

NO ONE KNOWS whether it is safe for a woman to breastfeed if she is infected with coronavirus.

Let me say it again: NO ONE KNOWS!

NO ONE KNOWS whether coronavirus can be transmitted through breastmilk. While the existing evidence is reassuring it is also paltry. There are too few cases to draw any conclusions.

NO ONE KNOWS the risk of a nursing mother transferring coronavirus to her infant through respiratory droplets. It’s almost certainly quite high.

NO ONE KNOWS the risk to the baby of coronavirus itself. The Chinese experience was that the disease was mostly confined to older people, but the European and American experience has shown that coronavirus can and does sicken young people.

NO ONE KNOWS whether women who are infected will have antibodies to coronavirus in their breastmilk. It’s certainly possible, since the antibodies that are most likely to pass in breastmilk, IgA, can include antibodies to respiratory illnesses. But the bulk of antibodies produced by mothers in most diseases (IgG and IgM) don’t pass to infants through breastmilk.

What should we advise women about coronavirus and breastfeeding? No one knows and any lactation professional who tells you differently is not being honest.

When no one knows, the ethical obligation of medical professionals is to lay out the risks and benefits HONESTLY. Providing false reassurance is UNETHICAL.

When no one knows, medical professionals are forced to create protocols to prevent worse case scenarios (baby getting profoundly ill from coronavirus) because the opposite, letting babies get hurt, is UNETHICAL.

When no one knows, MOTHERS should be allowed to choose once they have been honestly informed of the risks and benefits.

It is possible that breastfeeding is the very best thing that an infected mother could do for her baby, but it is also possible that it is the very worst. NO ONE KNOWS!

And until we do know, breastfeeding professionals who offer false reassurance are lying and babies may die as a result.

We live in the age of coronavirus and it’s time to ask a critical, but uncomfortable question: should breastfeeding mothers switch their babies to exclusive formula feeding?

It should be up to individual mothers, but here are some important factors to keep in mind.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Should breastfeeding mothers switch their babies to exclusive formula feeding?[/perfectpullquote]

1. Without a diversity of sources, babies are excruciatingly vulnerable when breastmilk dries up.

Those who formula feed can get formula at their supermarket, their pharmacy, from stores like Walmart and Target, from Amazon and even from the manufacturer directly. Breastfeeding infants are restricted to the manufacturer only and if she gets sick and or hospitalized, they can starve!

2. Coronavirus is transmitted by respiratory droplets.

Therefore, women who become ill with coronavirus spew the virus over their breastfeeding infants, putting them at risk for illness.

3. Is there a breastmilk shortage? Probably not yet, but it’s a real possibility as more women become infected!

Should breastfeeding mothers worry? Of course! I hope I’ve done my part to make you scared out of your mind!!

*****

If you read this far, you’re probably wondering what is going on.

It’s simple: I’m copying lactivists who are trying to incite panic around formula.

There are always people who view a massive tragedy as an opportunity for personal gain. Consider the Tennessee brothers who hoarded hand sanitizer so they could gouge consumers on Amazon. They were off to a highly profitable start when Amazon noticed and shut them down. Facing state investigation, they decided to donate their stock.

Amazingly, lactivists (like the homebirth midwives I wrote about last week) view the pandemic as a marketing opportunity.

I kid you not! At a moment when each of us should be doing our utmost to reassure others that we will get through this extraordinary hardship together, lactivists are aggressively promoting the notion that there is a formula shortage.

There is no shortage of formula. It is easily available online and in most grocery stores, supermarkets and other retailers. But lactivists are so aggressive in their attempts to scare mothers that formula companies have had to publicly respond to deny that there is, was or will be a shortage.

Why would lactivist create and propagate such a vicious falsehood?

Two reasons: punishment and projection.

Lactivists seem to have a deep, abiding, ugly need to harass formula feeders.

That’s what’s behind periodic calls to make formula prescription only.

Requiring a prescription for infant formula is a form of shaming. How dare a woman imagine that she is entitled to determine how her own breasts are used? She should be required to abase herself in order to feed her baby the way she thinks is best for her baby, herself and her family.

It’s cruel, but it is far outstripped in cruelty by the current attempts to incite fear of a formula shortage.

For example, this “public service announcement” on Facebook:

If you breastfeed like a real mom, you wouldn’t have to worry about the formula shortage.

Or this lactivist who claims she is hoarding formula to sell it:

And THIS ladies is why breastfeeding is a vital part of life as a mammal. IT’S FREE WAY HEALTHIER AND IF YOU WAS EDUCATED ON IT PROPERLY and NOT LAZY & SELFISH those very who actually CAN’T do it would be fine

Or this lactivist:

Actually during this time of formula shortage breastfeeding can save a babies lives. I’m actually going to relactate so I don’t have to worry about formula anymore

I doubt she stopped breastfeeding, but the truth is that relactation after complete weaning is usually very difficult, if not impossible, and almost never produces enough to fully nourish a baby.

Lactivists are cruelly trying to use the deadly pandemic to punish women who formula feed by frightening them about supply, but there’s something else going on:

Lactivists are projecting!

They are the ones who are worried about their babies’ supply because they might get sick and not be able to provide enough or — if they become critically ill — any breastmilk. They subconsciously fear that THEIR babies are the ones who might suffer and reassure themselves by inciting other women to worry.

The ugly truth is that lactivists promoting rumors of formula shortages are no different from the Tennessee brothers who thought they could make a buck by price gouging on hand sanitizer. In this time of international crisis, when everyone should be helping everyone else, lactivists care only about victimizing others!

I spend a lot of time writing to, for and about people who are profoundly cynical regarding medicine, science and pharmaceutical companies. Some are sure that doctors are useless, if not harmful. They feel free to ignore expert scientific advice (e.g. climate change) and they are absolutely certain that Big Pharma provides nothing that has value beyond making a profit.

Now all of us, including the cynical, are in the midst of a global crisis that will ONLY be treated and solved by healthcare, medications/medical devices and ultimately vaccines.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]What do you think of doctors, scientists and Big Pharma now?[/perfectpullquote]

I’d like to ask the cynical: what do you think of doctors, scientists and Big Pharma now?

What do you think of doctors now?

Still think they care only about themselves? Then why are they working flat out in hospitals, exposing themselves to a virus that could be just as deadly for them as it is for you?

Still think they’re arrogant? Then why are they the first to admit that they don’t know much about the novel coronavirus? Why are they telling anyone who will listen that they have no specific medications to treat it, not enough ventilators to care for the most severely affected patients and no vaccines to prevent it?

Still think they only provide services for profit? Then why are they caring for anyone who is ill, regardless of ability to pay?

What do you think of scientists now?

Still think it’s okay to ignore their warnings? Then why did the countries who responded immediately and aggressively manage to “flatten the curve” so their healthcare systems aren’t overwhelmed? Why is it that China, a country that ruthlessly instituted every public health recommendation, has managed to contain the epidemic when others cannot?

Still think their work is esoteric and impractical? Then how did they manage to sequence the COVID 19 genome in only a few weeks, the first step to understanding how to get this pandemic under control?

Still think we don’t need basic science research? Would it change your mind to know that scientists had been developing a vaccine for coronaviruses in preparation for future epidemics but had their Federal funding cut and had to give up? Imagine how many things would be different now if a vaccine existed or were far along in clinical trials. We would not be facing a mounting death toll, our economy would not be grinding to a halt, we would not be stuck in our homes because our only tool of prevention is social distancing.

What do you think of Big Pharma now?

Still think their products exist only for profit? If you get very sick are you planning to refuse the antiviral medications that might help you recover faster? If you have severe difficulty breathing will you refuse the ventilator that would keep you alive?

Still think vaccines are ineffective? Then why doesn’t Big Pharma simply announce they have a coronavirus vaccine? Who would be able to tell the difference if vaccines don’t work anyway?

Still think Big Pharma shouldn’t have special legal protections to induce them to produce a vaccine that — because it will never be perfect — will end up spawning lawsuits that make the production unprofitable? An effective vaccine against COVID 19 could end the pandemic in days, not the weeks or months we are looking at now.

How fast do you want it developed? Do you want Big Pharma to spend years testing it and refusing to release it until they satisfy themselves that it won’t cause them to lose money from lawsuits? Or do you want them to bring it to market as soon as reasonably possible with the understanding that a small number of people may be harmed?

Still deeply cynical about doctors, scientists and Big Pharma? Who do you think will save you if not them?

There is no such thing as virginity. It is not a physiological concept. It is a social construct that reflects an obsession with female purity, virtue and honor. It is deeply misogynist.

There is no such thing as gut virginity, either. It is not a physiological concept but a social construct that reflects lactivists’ obsession with infant purity and maternal virtue and honor.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]It’s a tactic for controlling women’s behavior.[/perfectpullquote]

Lactivists have created and promoted the notion of gut virginity for the same reason that men created the notion of female virginity. It’s a tactic for controlling women’s behavior. The lactivist insistence on harm from formula supplementation — any amount, at any time, for any reason — was fabricated to keep women from using formula.

Consider sexual virginity:

There is nothing physiologically different in a man who has had his first sexual intercourse and one who has not. In women, there can be a minor physiological change, the tearing of the hymen, but many women do not experience that. Nevertheless, the hymen has come to represent the concept of virginity although there are many ways to have sex without changing it. There are even cosmetic surgeries that aim to recreate the semblance of a hymen to allow women to claim spurious virginity.

There is no such thing as virginity in the animal kingdom. Some members of a species are sexually mature and receptive; they have sex. Others are not; they don’t have sex. There is no self-imposed waiting period between becoming sexually mature and engaging in sex. There is no purity, virtue or honor being protected by abstinence.

Virginity isn’t physiological, it’s transactional. It is a way for men to characterize the products on offer in the marriage market. Women’s virginity is prized by men because it prevents cuckholding, reflects the masculine horror of raising another man’s child as his own, asserts ownership over women and allows fathers and prospective grooms to evaluate the “worth” of a woman.

How about gut “virginity”?

There’s nothing physiologically different in a baby who has had formula. There are no macroscopic or microscopic changes to any aspect of its body.

But wait! What about the microbiome?

The microbiome, the bacterial content of the infant gut, is a subject about which we know very little beyond the fact that it is exists. We have literally no idea what proportion of what organisms the infant microbiome is supposed to contain. We have literally no idea of the significance of individual variation: does it reflect a substantive difference or merely a diversity of normal like eye color or hair color. We have literally no idea whether any differences in the infant microbiome between breastfed and bottlefed infants has any impact on anything, let alone short term or long term health.

No matter. The infant gut microbiome in gut “virginity” has come to play the role of the hymen in sexual virginity. It is viewed as a marker of an infant’s “purity” and a mother’s honor and value. Both serve the same purpose; it’s a method of controlling women’s behavior. Hence it is referenced and mythologized in the same way as sexual virginity.

The young women who has sex just one is forever defiled and she has “lost” her virginity. The baby who gets “just one bottle” of formula is forever impure and has lost its gut virginity.

Both concepts are self-serving fictions.

A woman’s virtue is not in her vagina. It is in her intellect, character and talents. Whether or not she is a sexual virgin tells us nothing meaningful about her or her worth.

A mother’s virtue is not in her breasts. It is in her caring and emotional connection to her infant. Whether or not her baby is a formula virgin tells us nothing about her, her worth or her love for her child.

Yesterday I wrote about a new paper in which breastfeeding researchers were forced to acknowledge risks and complications they have denied for years.

Yet despite the litany of life threatening risks, despite the fact that judicious formula supplementation improves the odds of exclusive breastfeeding and despite the fact that a study of formula supplementation followed by exclusive breastfeeding showed no difference in the gut microbiome, the breastfeeding researchers still recoil from formula in horror.

That’s because the “virgin gut” isn’t really about breastfeeding and babies; it — like the concept of sexual virginity — is about controlling women.