Remember the biblical story of David and Bathsheba?

David, while walking on the roof of his palace, saw a very beautiful woman bathing. He ordered enquiries and found out that she was Bathsheba, wife of Uriah. He desired her …

[T]he king gave the order to his general, Joab, that Uriah should be placed on the front lines of the battle, where Uriah would be more likely to die. David had Uriah himself carry the message that led to his death. After Uriah had been killed, David married Bathsheba.

Not surprisingly, God was very angry with David.

Imagine if David, to absolve himself of responsibility, had responded: “But Goliath!”

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Wailing “But formula companies!” does not absolve lactation professionals for their execrable treatment of women who don’t breastfeed.[/pullquote]

That’s not what happened in the Bible; David recognized that he had become Goliath.

But it is what happens whenever you try to call lactation professionals to account over their execrable behavior toward women who can’t or don’t want to breastfeed. When you point it out, they routinely respond: “But formula companies!”

Lactation professionals fail to understand two things King David understood immediately.

Just because you were the underdog in one situation does not mean that you aren’t the powerful person in another. Just because you were once the underdog, does not leave you free to abuse the power you do have.

When David faced the giant Goliath, he was the underdog. But over time he acquired greater power, eventually becoming king. He now had power over others.

Similarly, when lactation professionals first faced off against formula companies, they were relatively powerless. But over time they have acquired greater power, eventually becoming arbiters of all things breastfeeding within and outside hospitals. They now have power over others: vulnerable new mothers struggling to care for their babies.

Like King David abusing his power to get what he wanted, lactation professionals are abusing their power to get what they want: a world where all women MUST breastfeed or face social opprobrium.

David had enough power to arrange for Bathsheba’s husband to die. Lactation professionals have only enough power to kill women’s spirit and they have taken to the task with relish.

They abhor the Fed Is Best Foundation and its founders. They abhor medical professionals like me who disagree with them. They even abhor fathers who dare to love formula feeding.

Journalist Nathaniel Popper had a beautiful piece the NYTimes this past weekend, What Baby Formula Does for Fathers:

Now when my son cried in the night, or out in public, I instinctively started toward him. Before this, my wife had been the first responder because we assumed that he probably needed to be fed. Now, I was just as capable of feeding him as she was. This meant that I not only fed him, but learned about all the times when he wasn’t actually hungry but needed a burp or a clean diaper, or something else that we couldn’t figure out, but that was part of the essential mystery of parenting. I came to understand his rhythms and needs.

Lactivist “mean girls” (professional and lay) have responded with unmitigated fury! And they’ve created a new version of underdogma: “But the patriarchy!”

Prof. Amy Brown:

Wants wife’s bodily function to fail so he gets to do what he wants. Can you imagine a woman writing this about a male body part. Oh I hope it fails so I can use what I really want to…

Elizabeth Grattan:

He used the same straw man tropes about nursing or not that so many are striving to strip from these discussions in this sexist garbage op ed. It’s such a grotesque narrative. And it panders. Just awful.

Lucy Martinez Sullivan:

There are also a handful [of] people who think this Op-Ed was written by an algorithm programmed by a formula company.

Prof. Cecilia Tomori:

It’s 2019 and yet we have a piece in the NYTimes that promotes formula as way to achieve gender equity in parenting. Because you can’t possibly bond with babies if you are not breastfeeding them. The astounding privilege and ethnocentrism in this piece is mindblowing.

Have these women lost their minds? How dare any father offer love and support to a wife who struggled with breastfeeding! How dare he enjoy bottle feeding!

But if you are looking for a true WTF experience, you must read Doula Maddie’s febrile ravings!

You may remember doula Maddie MacMahon from her musings on the subject of vaginal exams during childbirth:

Midwives shld be debating the pros and cons of routine VEs and exploring the evidence, or lack of, for regularly fossicking around in a normal labour. I’m just a woman telling you that you need a damn good reason to finger me. Just telling me I’m Xcm is not a good enough reason.

So I wasn’t exactly expecting moderation when I read her piece, but damn, the woman is self-absorbed and self-aggrandizing.

She analogized breastfeeding support to the story of Cinderella:

How does she view herself? She the Fairy Godmother!

Bear with me – I’m not on a massive ego trip here.

Are you sure about that?

Fairy Godmother can, when required, conjure up powerful magic – she can sometimes tempt non-latching babies to suckle or take a mother from agony to comfort with some small, subtle adjustments to the posture of the mother and the position of the baby. Her wand is often wielded with a light touch – it might not, if you are watching her, look like she is doing much. Her magic is rarely loud and glamorous or even instant. Rather, it works delicately and leaves the mother feeling like she has found her own answers. Fairy Godmothers are often called Breastfeeding Counsellors, Breastfeeding Supporters, LLL Leaders or International Board Certified Lactation Consultants…

What about those who support women in whatever feeding method THEY feel is best for their babies. They’re the Wicked Stepmother. (Maddie has all the subtlety of a sledgehammer!)

Wicked Stepmothers might be working for formula companies’ care lines or appear as a media-savvy ‘guru’ or ‘expert’; a nanny with her own TV show or parenting book. She might be a blogger or active on social media …

And the baby’s father? He’s the Prince of Patriarchy (I kid you not)!

I hope Cinders really did love him and that he empowers her in an equal partnership. I hope he doesn’t think he can just strut in and fix Cinders. But I suspect he is the actually symbolic of the Patriarchy, consistently ignoring and cutting services for women so that under-trained coachmen, stepmothers and ugly sisters are created and given free rein to continue sabotaging breastfeeding. The Prince rules – he gets to decide what commercial influences and social injustices can negatively impact your breastfeeding journey.

Is this woman for real? Sadly she represents and is embraced by other lactation professionals. They envision themselves as small compared to the power of the formula industry and the patriarchy. They imagine themselves as David against Goliath.

They fail to see what David recognized. They’ve become Goliath.

David acknowledged that his treatment of Uriah and Bathsheba could not be defended by falling back on his previous good deeds. Lactation professionals need to acknowledge that their vicious treatment of women who can’t or don’t breastfeed cannot be defended by falling back on their previous good deeds.

Lactation professionals, you are not the good guys here. Like David, you are trying to eliminate anyone who gets in the way of your desires, while ignoring the desires of the people whom you manipulate. And no amount of wailing “But formula companies!” or “But the patriarchy!” can justify that.

Fed is minimal.

Is there anything more emotionally abusive than this “rebuttal” to the Fed Is Best campaign?

The definition of minimal is:

barely adequate or the least possible

Could there be anything more cruel than telling a mother who couldn’t or didn’t want to breastfeed her child that SHE is barely adequate?

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It often seems that for lactation professionals, the cruelty is the point. They find fellowship in contempt for women who don’t breastfeed.[/pullquote]

The Fed Is Best Foundation was started to protect infants from dehydration, severe jaundice, brain damage and death, all of which have been rising alarmingly since the advent of the Baby Friendly Hospital Initiative.

While infant health remains the primary focus, the Foundation also provides support to all women regardless of how they feed their babies. As anyone who is part of their many groups can see, that support comforts women who are struggling with deep emotional pain, depression and self-hatred.

Is there anything more vile than when faced with that pain, lactation professionals responded NOT with compassion, but with cruelty?

Prof. Amy Brown, in her subtly titled piece Why Fed Will Never Be Best, writes:

…Fed is therefore not best, because best implies that there are other acceptable alternatives.

Secondly, at what other point in our lives do we believe that fed is best? With older children do we accept that any food at all is best? No. We campaign for children to receive optimal nutrition. As adults we know that diet can play a major role in our health and wellbeing so why would this be any different for those whose sole nutrition comes from their milk?

Cruella de Vil could not have said it better!

Amy Brown is hardly alone among lactation professionals in her viciousness. Dr. Jack Newman famously had this to say about formula feeding:

Dr. Jack Newman, author of The Ultimate Breastfeeding Book of Answers, contends that “no close holding of the bottle-fed baby can duplicate the nursing relationship.” We asked whether there are any studies that support his thesis. “Feeding a baby with a bottle is akin to making love with a condom,” replied Dr. Newman, who founded the Newman Breastfeeding Clinic and Institute in Toronto. “Ask the men. They’ll tell you direct contact is different.”

Kathy Dettwyler wrote TO a mother who had left a positive review of Courtney Jung’s book Lactivism on Amazon:

Your children may or may not be “inferior” to breastfed kids … But formula-fed children definitely WILL BE INFERIOR to how those same individuals would have turned out if they had been breastfed.

Not to be outdone, Kimberly Seals Allers counsels women to ignore pediatricians when they warn about the dangers of exclusive breastfeeding, now the single largest risk factor for newborn hospital readmission accounting for tens of thousands of readmission each year.

No one would accept a nutritionist trained at a’McDonalds Health Institute’ but every day mamas face pediatricians only trained in breastfeeding by infant formula industry. The ones who financially benefit from failure of breastfeeding. We deserve better!

What proof does she offer for this slander? None of course.

These statements, and others like them, constitute a clear pattern of emotional abuse. They involve many of the behaviors commonly associated with abuse:

Denying something you know is true. An abuser will deny that an argument or even an agreement took place. This is called gaslighting. It’s meant to make you question your own memory and sanity.

Using guilt…

Denying their abuse. When you complain about their attacks, abusers will deny it, seemingly bewildered at the very thought of it.

Accusing you of abuse. They say you’re the one who has anger and control issues and they’re the helpless victim.

Trivializing. When you want to talk about your hurt feelings, they accuse you of overreacting and making mountains out of molehills.

Saying you have no sense of humor… If you object [to vicious accusations], they’ll tell you to lighten up.

If you want to see the emotional abuse in real time, check out the Twitter feeds/Facebook pages of the lactation professionals mentioned above and those of their colleagues.

Over and over again, I have been astounded to see the obvious pain of new mothers met with a wall of derision, gaslighting, dismissal and contempt. Twitter in particular is the mean girls’ equivalent of the lunch room table. Lactation professionals won’t let anyone who is not a part of their clique sit near them; you can almost see the eye rolling and hear the cruel laughter. Lactation professionals often freeze suffering women out altogether by blocking them completely.

It often seems as if the unifying factor among lactation professionals — the concept around which they bond with each other — is not support for breastfeeding; it is contempt for women who don’t breastfeed. They appear to find fellowship in exacerbating and then celebrating the suffering of women whom they condemn as “minimal” mothers for not breastfeeding.

That’s why it’s so hard to stop their cruel behavior; it has become a social ritual for lactation professionals. Like all bullying, it isn’t just about tormenting someone else; it’s about impressing one’s peers by jointly tormenting others.

Fed is minimal? Only if the cruelty is the point.

You might think — I always have — that childbirth is about the birth of a healthy baby to a healthy mother. But according to many midwives, that isn’t enough. A mother’s birth experience is deemed critical and the experience is apparently ruined by technological interventions. Hence the dangerous campaigns for “normal birth,” defined as birth without any interventions, any machines or any surgery.

Indeed, midwives wax lyrical on the subject of the medicalization of childbirth, forcefully arguing that most babies would be fine without intervention of any kind, insisting that doctors have medicalized childbirth for their own benefit, and claiming that doctors cause emergencies so they can heroically step in and “save” their patients.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Lactation professionals have created breastfeeding “emergencies” from which they heroically “save” babies. But most of these emergencies have been caused by lactation professionals themselves.[/pullquote]

Clearly, medicalization is a very, very bad thing … until it comes to infant feeding. With infant feeding medicalization isn’t just awesome, it is absolutely necessary.

You might think — I always have — that infant feeding is about providing a developmentally and nutritionally appropriate food resulting in a healthy baby and a healthy mother. But according to lactation professionals, that isn’t enough. Trivial benefits and fabricated benefits are deemed critical to infants who are apparently ruined by formula. And any intervention, no matter how artificial, burdensome or technological — including surgery on babies — is not merely justified, but necessary. The mother’s breastfeeding experience? That’s irrelevant!

But I’m here to tell you that the medicalization of infant feeding is harming babies and mothers. We KNOW, though generations of experience involving millions of babies, that term infants will be healthy on formula. And I have come to believe that lactation professionals have medicalized infant feeding for their own benefit, creating feeding “emergencies” so that they can heroically step in and “save” patients breastfeeding.

Wait, don’t lactation professionals say that breastfeeding must be best because it is natural? Don’t they demonize formula because it is technological?

Yes, they say that, but their behavior belies their rhetoric.

First, breastfeeding is apparently a bodily function that is outside the natural realm of other bodily functions, all of which have failure rates. Most women won’t conceive the first month they try to become pregnant; up to 20% of established pregnancies end in miscarriage. Breastfeeding, too, has a natural failure rate: up to 15% of first time mothers will not be able to produce enough milk to fully nourish an infant, especially in the first few days after birth. Some babies are incapable of fully draining the breast. Furthermore, just as some pregnancies aren’t wanted and will be terminated, some women have no desire to breastfeed.

But not according to lactation professionals. To hear them tell it, breastfeeding is perfectly designed for every mother and every baby and failures rates are exceeding low. Moreover, all good mothers want to breastfeed; only inferior, lazy women who are dupes of the formula industry and lack lactation support would ever consider formula.

Second, the process of infant feeding itself has been medicalized. For most of human history, infant feeding involved giving infants food so they could grow. In our contemporary culture — with its twin emphases on intensive mothering and reducing risks — breastfeeding has recently acquired all sorts of medical benefits ranging from the trivial (8% fewer colds and 8% fewer episodes of diarrheal illness across the entire population of infants in their first year), to major “benefits” (supposedly increased IQ, decreased risk of allergic disease, improved long term health), all of which disappear when socio-economic status is taken into account. Therefore, ever more arcane, highly technological benefits are dreamed up like a “better” microbiome or “better” epigenetics for which there is only speculation and no actual evidence at all.

Third, any and all technology, no matter how invasive, is embraced if it results in more women breastfeeding for longer.

Don’t produce enough breastmilk to fully nourish your baby? Pump after every feeding with an electric pump whose plastic parts are strapped to your body! Take drugs like domperidone!

Baby having trouble extracting milk from the breast? Tape a plastic Supplemental Nutrition System (SNS) to your nipple in order to feed the milk that you pumped! Or perform surgery on the baby’s tongue!

And above all, pay money to a lactation professional who will press all sorts of unnatural interventions on you so you can “naturally” breastfeed.

I’m reminded of the paper by anthropologist Margaret MacDonald in the Lancet entitled The cultural evolution of natural birth:

Natural birth has long held iconic status within midwifery and alternative birth movements around the world that have sought to challenge the dominance of biomedicine and the medicalisation of childbirth…

But there’s is nothing natural about waterbirth, listening the fetal heart with a Pinard stethoscope or recommending chiropractic. Yet midwives do it anyway. Why?

[If an intervention] can bring back the clinical normalcy of the labour pattern and keep it WITHIN THE MIDWIFERY SCOPE OF PRACTICE, it is generally regarded as a good thing by midwives and clients alike … (my emphasis)

The same thing is true about lactation professionals. ANYTHING is acceptable as long as it can keep the women breastfeeding and within lactation consultants’ scope of practice. Lactation professionals have created breastfeeding “emergencies” from which they heroically “save” babies. But most of these emergencies have been caused by lactation professionals themselves with their relentless pressure to breastfeed. They could easily be solved, or avoided altogether, by feeding babies formula.

In truth, the scientific evidence tells us that breastfeeding is a lifestyle choice, NOT a health choice. We know that because breastfeeding rates have no impact on infant mortality and major causes of infant morbidity. We know that because nearly two entire generations of Americans were raised on formula and every possible parameter of infant health improved during that time.

But in their relentless effort to claw market share from formula companies, lactation professionals have medicalized infant feeding by claiming a perfection of breastfeeding that doesn’t exist, medical benefits for breastfeeding that don’t exist, and by creating medical emergencies that they caused.

That’s why we should stop medicalizing infant feeding and return it to its unhindered state. Above all, we must end intrusive breastfeeding promotion in hospitals. It is harming infants’ physical health (exclusive breastfeeding is now the leading cause of newborn hospital readmission) and mothers’ mental health.

Let MOTHERS decide what’s best for babies, their families and themselves, NOT lactation professionals.

Janis, one of the characters in Mean Girls, says:

There are two kinds of evil people in this world. Those who do evil stuff and those who see evil stuff being done and don’t try to stop it.

There’s actually a third kind: those who see good stuff being done and harrass those who do it.

That’s what came to mind when I saw this mea culpa written by a midwifery student, desperately trying to survive in a profession dominated by lactivist bullies.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Lactivists subject one of their own to a re-education campaign.[/pullquote]

According to 19 year old Sophie, she had posted her support for the #FedIsBest campaign on her Instagram account:

Originally, I had understood that ‘Fed is Best’ was a concept about babies receiving correct nutrition and perhaps if you didn’t support the campaign, then you were implying you didn’t care about the feeding of babies.

That IS the concept of the Fed Is Best campaign. It rests on the premise that being fully fed with formula is much better, healthier, and safer for babies and mothers than starving on breastmilk. If you don’t support it, you care more about the promotion of breastfeeding than the promotion of infant and maternal health.

Poor Sophie didn’t realize that on Wednesday all the followers of the mean girls wear pink and she dared to wear a different color.

The mean girls subjected her to a re-education campaign and she is apologizing as frantically as she can:

Following my original post, some of my followers contacted me directly with links to articles and information which gave other viewpoints on #FedisBest. I am so grateful that these messages were sent to me with respect and kindness. I was not belittled, or sent hateful comments, even though I’m sure I offended many of my followers. A positive of this situation has shown me how social media can be used in a kind way – I have learnt so much, and if I hadn’t posted about the campaign, I would probably still be in my naïve bubble of confusion and misconceptions. I am the first to admit that as I am so new to midwifery, there are huge gaps in my knowledge and skills. I have so far to go, but we all must start somewhere. This is what my blog is about – sharing honestly about each step in my journey, whether it’s forwards or backwards.

Who was responsible for her re-education? Prof. Amy Brown, the Regina George of lactivism.

The article that really helped me learn was written by Professor Amy Brown; ‘Why Fed Will Never Be Best: The FIB Letting Our New Mothers Down’…

Amy’s article also made me realise that at no other point in our lives do we accept fed as best, rather than an absolute minimum.

See? Fed is minimal! That’s what all the mean girls say and Sophie desperately wants to be part of the in crowd, not on the outside getting bullied by the mean girls. And if there is one thing that the mean girls are absolutely, positively sure of is that anyone outside their group deserves to be bullied.

Rosalind Wiseman, author of the book Queen Bees and Wannabees on which Mean Girls is loosely based had this to say on the topic of mean girls:

The hazing experience and then the subsequent participation in the group forces its members to maintain the status quo and traditions at all costs. It demands mindlessness and unquestioned loyalty, resulting in boring people who have little ability to think for themselves or have an opposing viewpoint from those who have the most social power.

Sadly, that seems to be true for lactation professionals. They demand mindless, unquestioned loyalty and bullying of anyone who disagrees.

And it’s hard to protect yourself. As Wiseman notes:

Sometimes bullies are your friends and very rarely do bullying prevention tips acknowledge this fact or what to do about it.

And poor Sophie is exquisitely anxious that her “friends” within the midwifery and lactation professions consider her one of the group.

She can’t prostrate herself enough!

Although I feel embarrassed about publicly sharing my misunderstandings and may have led to others unintentionally being misinformed too, I’ve learnt lots in a positive way, thanks to social media and my followers. I plan to do more reading of articles and research about infant feeding. I will also investigate what the organisation where I work does to support infant feeding and I’ve got Amy Brown’s ‘The Positive Breastfeeding Book’ on my must-read list!

Hopefully Regina George Amy Brown has been pacified.

But Sophie, if you read this, I want you to consider something else:

You should NEVER apologize for being compassionate! You should NEVER apologize for refusing to take part in bullying! You should NEVER apologize for thinking for yourself and reaching your own conclusions!

Only mean girls would expect that from you.

As someone who endured my share of hazing during medical training, I know how very, very hard it is to maintain compassion for patients within a system that encourages treating them shabbily. I don’t expect you to resist the pressure now; you have no choice but to go along to get along.

But be assured that your first impulse — to be kind and respectful toward women and babies suffering from pressure to breastfeed — was correct. Don’t let the mean girls bully the compassion out of you.

Anti-vaxxers preen to themselves and each other that they are educated, empowered protectors of their children’s well being. They’re not; they are social parasites.

I’ve written before about the fact that privilege is the sine qua non of the contemporary anti-vax movement. Vaccine preventable diseases have to become rare before it is possible to imagine that the “risks” of vaccines outweigh the risks of diseases themselves.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Social parasites take their share of  the benefits of society while refusing to shoulder their share of the burdens.[/pullquote]

Furthermore, anti-vax is unethical. It only becomes a realistic option in societies where most parents behave morally and follow the admonition to get their children vaccinated. Most people, understanding the importance herd immunity, vaccinate their children. In contrast anti-vaxxers assume that they will be protected from diseases like measles because everyone else is vaccinating, and — privileged as they are — they imagine they are entitled to keep their own children unvaccinated.

In other words, they are social parasites.

Social parasitism is a phenomenon that occurs among social insects.

Social parasitism is a condition where a parasitizing ant species depends upon the labour provided by a host ant species within the context of a mixed-species colony.

They are the freeloaders of the insect world:

…Social parasite species evolve from seemingly typical, social species but have evolved mechanisms which shortcut the usual social formalities like building your own nest and raising your own brood. In this sense, they are receiving all of the benefits of social organisation while giving little in the form of social costs…

Among humans:

Social parasitism is a pejorative that is leveled against a group or class which is considered to be detrimental to society. The term comes from the ancient Greek παράσιτος (parásitos), “one who lives at another’s expense, person who eats at the table of another,” used to label the social offender.

Anti-vaxxers are most certainly detrimental to society as demonstrated by the recent resurgence of vaccine preventable diseases that had become extremely rare. Anti-vaxxers and their children survive and thrive at the expense of others mothers’ children. How? Children who are younger, more fragile and less immune competent (due to chemotherapy or immunologic disease) are both more likely to be susceptible to vaccine preventable diseases and less likely to recover from them.

Imagine an ancient agrarian community facing famine restricting each individual to only two meals a day in order to extend the food supply as long as possible before the next harvest. Now imagine that a few individuals take enough food from the community supply in order to provide their own children with three meals a day. Not only will the food for the whole community run out earlier, but when the whole town is starving, it is the weakest among them who will succumb long before those who took more than their share. Those who took extra (and their children) will survive at the expense of the rest of the community. That makes them social parasites.

Immunity to disease, like a communal food supply, is a benefit that is only possible within a community. The ancient agrarian community pooled their food to maximize the survival of everyone, even the young and the weak who could never have fought for a fair share on their own. As long as you are dependent on the benefits of that society (that’s what you are doing if you eat from the communal supply), you must contribute to preserving that supply by taking only what everyone else is taking. Otherwise you are a social parasite.

Contemporary society “pools” immunity in order to maximize the survival of everyone, even the young and the weak. As long as you are dependent on the benefits of that society (and you are if your children face minimal risk because other children are vaccinated), you must contribute to preserving that supply by having your own children vaccinated. Otherwise you are a social parasite.

Notice that it doesn’t matter whether or not vaccination has risks (there is a real, but tiny risk of brain damage or death) or what those risks are (autism, autoimmune diseases, vaccine “injuries” or whatever non-existent risks you choose to imagine). Arcane discussions about the scientific literature are irrelevant. Regardless of the risks, everyone must share them, just as in the case of the dwindling food supply. Insisting that you don’t have to vaccinate your children because you are afraid vaccines raise the risk autism is like insisting that you can take more than your share from the communal food supply because two meals a day instead of three raises the risks of malnutrition. It doesn’t matter even if it’s true.

Once you choose to share the communal benefits of society, you are morally obligated to share the burdens as well. Otherwise, you are a social parasite and the community will have a right — indeed an obligation — to punish you for putting the entire community, particularly the young and the weak, at risk.

Many years ago I received an urgent gynecology question at 11 PM. I was the OB-GYN Chief Resident on call that night so any outside calls came to me.

The middle aged woman on the phone told me she was desperate for help. She needed to know if her son’s girlfriend had come to the hospital to have an abortion. I repeatedly explained to her that I didn’t know, wouldn’t find out and was constrained by patient confidentiality from telling her in any case. I thought we were having a conversation about abortion and patient privacy. But then she said something that changed everything:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Laysplainers don’t merely overestimate their own knowledge; they can’t tell the difference between real knowledge and impossible knowledge.[/pullquote]

Please, you must let me know if she had an abortion at your hospital, because I hear the baby calling to me from a jar: Grandma, Grandma, come get me!

I realized then that we were having a conversation about mental illness.

I didn’t understand what was going on until the moment the woman offered impossible knowledge. Impossible knowledge is what people believe they know but couldn’t possibly be true because it is literally impossible (as in this case) or because it doesn’t exist.

Many people with mental illness believe they are in possession of impossible knowledge. The woman I spoke with believed with every fiber of her being that her putative aborted grandchild was telling her to come get him. But you don’t have to have to be mentally ill to claim you have impossible knowledge. Laysplainers offer it all the time to “prove” whatever it is they believe.

As I wrote last week, a laysplainer is a layperson (typically an anti-vaxxer or alternative health advocate) who “explains” disease, prevention or treatment to a medical professional in a condescending, overconfident, oversimplified and inaccurate way. And they don’t restrict themselves to false claims. They freely (and irritatingly) offer impossible knowledge.

In 2015, Dr. David Dunning, of the Dunning Kruger effect, published a paper on impossible knowledge.

At times, people even claim knowledge they cannot possibly have, because the object of their knowledge does not exist, a phenomenon known as overclaiming. For example, in the late 1970s, nearly a third of American respondents expressed an opinion about the “1975 Public Affairs Act” when asked about it directly, even though the act was a complete fiction. Approximately a fifth of consumers report having used products that are actually nonexistent …

Impossible knowledge looms large in the anti-vaccine movement. Many rabid anti-vaxxers assert confidently that there is a secret world-wide conspiracy of nearly all doctors, immunologists and public health officials to promote vaccines that don’t work and actually cause injuries to innocent children. That’s impossible knowledge because there is no such conspiracy and it couldn’t possibly be secret if you learned about it from a YouTube video.

The shill gambit, beloved of anti-vaxxers and lactivists, is often a form of impossible knowledge. Accusing me of being a shill for big Pharma or Big Formula is definitely impossible knowledge since I don’t get paid by any pharmaceutical or formula company. It is also impossible knowledge since you can’t possibly know it unless you have examined my finances and/or the finances of drug and formula companies.

Claiming that I “hate” breastfeeding is another variation of impossible knowledge since I breastfed my four children and both I and they enjoyed it and thrived.

So why do people claim knowledge they couldn’t possible have because it didn’t happen or it isn’t true?

According to Dunning and colleagues:

A sizable body of work on how people evaluate their own knowledge suggests that they rely not only on a direct examination of their mental contents but also on a feeling of knowing. Notably, a feeling of knowing is often only weakly predictive of actual knowledge and appears to be informed, at least in part, by top-down inferences about what should be or probably is known. We theorized that such inferences are drawn from people’s preconceived notions about their expertise, inducing a feeling of knowing that then prompts overclaiming.

In other words, anti-vaxxers and other alt-health aficianados don’t merely overestimate their own knowledge as the Dunning Kruger effect predicts (those with the least knowledge tend to think they know the most). They aren’t capable of telling the difference between real knowledge and a “feeling” of knowing.

The authors note:

It is easy to imagine how a tendency to overclaim, especially in self-perceived experts, could have adverse consequences. Self-perceived experts may give bad counsel when they should give none. For instance, an individual considering a financial decision may consult a friend who expresses confidence in her financial knowledge. That friend may provide inappropriate advice because she fails to recognize her insufficient familiarity with the question. Further, a tendency to overclaim may discourage individuals from educating themselves in precisely those areas in which they consider themselves knowledgeable and that may be important to them. In other words, over-claiming may hinder people from truly achieving a valuable level of genuine knowledge.

Similarly, self-perceived vaccine experts (anti-vaxxers) give bad counsel when they should give none. The typical anti-vaxxer provides inappropriate advice because she fails to recognize her insufficient knowledge. Moreover, because she “feels” like she knows all she needs to know, she doesn’t seek education in immunology, science and statistics. Offering impossible knowledge marks her not as knowledgeable, but as ignorant and gullible.

So, laysplainers, spare me your impossible knowledge!

Don’t tell me what doctors do or don’t learn in medical school; I went to medical school and you didn’t.

Don’t tell me how many “unhindered” vaginal births obstetricians have seen; I’m an obstetrician and you’re not.

Don’t tell me vaccines cause autism; I’ve read the vaccine literature and you haven’t.

Don’t tell me the Fed Is Best Foundation is shilling for formula companies; their financial forms make it clear that they aren’t.

When you assert impossible knowledge you are like the woman who told me she heard her aborted grandchild calling her. You indicate that you have lost touch with both knowledge and reality.

What if we’ve been approaching the anti-vaccine phenomenon the wrong way?

We’ve been operating under the assumption that anti-vax is fundamentally a misunderstanding, reflecting lack of knowledge of immunology and statistics. But what if it is actually a culturally mediated phobia like triskaidekaphobia, fear of the number 13?

That would explain why fear of vaccines has continued to metastasize even though in the entire 200+ years of the movement, anti-vaxxers have never been right even once. It would explain why attempts to educate anti-vaxxers have been utter failures. It would explain why anti-vaxxers huddle together on social media; only another sufferer of the irrational fear can understand it. And it would explain why anti-vaxxers keep moving the goal posts — It’s mercury! It’s aluminum! It’s autism! It’s vaccine “injuries”! — to justify their irrational fear.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]What does fear of vaccines have in common with fear of the number 13? Both are culturally mediated phobias.[/pullquote]

What is a phobia?

According to Wikipedia:

A phobia is a type of anxiety disorder, defined by a persistent and excessive fear of an object or situation… The affected person goes to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the feared object or situation cannot be avoided, the affected person experiences significant distress…

Phobias can be divided into generalized fears like agoraphobia (fear of leaving home), social phobias (fear of being judged by others) and specific phobias involving fear of specific objects and situations, like fear of heights (acrophobia) and fear of enclosed spaces (claustrophobia).

A specific phobia can reflect a previous bad experience. For example, getting bitten by a dog can lead to a paralyzing phobia of dogs, not merely a rational fear of aggressive dogs.

Specific phobias can be the result of watching others have a bad experience, such seeing another person bitten by a dog.

Phobias can also be taught, and therefore be culturally mediated. That’s how people become afflicted with fear of specific numbers like triskaidekaphobia, fear of the number 13.

Although it may seem trivial, triskaidekaphobia is an issue that affects western societies economically. Because of the superstition, some people delay doing business on the 13th of any month, while statistically there are more people who do not go to work on the 13th day of any month …

Friday is also considered to be an unlucky day in western culture…

The term for the fear of Friday the 13th is paraskevidekatriaphobia.

It is estimated that the United States loses about $900,000,000 in productivity every year because of Friday the 13th as some people are so superstitious about it that they wouldn’t even get out of bed.

Different numbers are the source of phobias in different cultures. These include:

Tetraphobia, fear of the number 4. In China, Taiwan, Singapore, Japan, Korea and Vietnam, as well as in some other East Asian and South East Asian countries, it is not uncommon for buildings (including offices, apartments, hotels) to omit floors with numbers that include the digit 4 … This originates from Classical Chinese, in which the pronunciation of the word for “four” is very similar to that of the word for “death,” and remains so in the other countries’

17 is an unlucky number in Italy, perhaps because in Roman numerals 17 is written XVII, which can be rearranged to “VIXI”, which in Latin means “I have lived” but can be a euphemism for “I am dead.” In Italy, some planes have no row 17 and some hotels have no room 17…

Obviously there is nothing inherently dangerous or harmful about these numbers, or any numbers, yet many people are very afraid of them and some people are so afraid that it affects their life in significant ways.

What would it mean if vaccine hesitancy were not a rational fear, but rather a phobia, vaxophobia? It would mean that we must change our entire approach to people who refuse vaccines.

First, we would stop spending so much time educating people about the real risks of vaccine preventable diseases and focus instead on the irrational fear of vaccines itself. When treating a person who suffers from claustrophobia, we don’t spend much time explaining why the chances of being trapped for long periods inside an elevator is low. A phobia is not a rational fear, so it’s not amenable to rational explanations. Instead we try to trace the origins of the fear and help people to desensitize themselves by controlled exposure to the fear.

As this Mayo Clinic website explains:

The best treatment for specific phobias is a form of psychotherapy called exposure therapy. Sometimes your doctor may also recommend other therapies or medication. Understanding the cause of a phobia is actually less important than focusing on how to treat the avoidance behavior that has developed over time.

Second, we would spend more time and effort in understanding how this specific, culturally mediated phobia is transmitted from affected to unaffected individuals. It is an urgent question. While triskaidekaphobia may be harmful to the American economy, vaxophobia is very harmful to the health and wellbeing of babies and children. It puts them at risk of illness, serious injury and even death. And that doesn’t even count the economic impact of wages and productivity lost to vaccine preventable diseases.

Third, we would recognize that anti-vax physicians, naturopaths, chiropractors, etc. are not empowering their patients, they are reinforcing their enslavement to the phobia. The “service” an anti-vax doctor like Bob Sears provides by writing vaccine medical exemptions is no different than the “service” of providing a medical exemption for working on Friday the 13th. Both are abuses of the medical system.

Finally, we would stop arguing with and pandering to vaxophobes. We don’t excuse people from working on the 13th of every month simply because they are phobic about the number 13. Similarly, we should not allow philosophical exemptions for vaccination. There’s no philosophy involved here, just an irrational fear, and pandering won’t fix it; it will only make it worse.

It’s always the mother’s fault.

There is a long and storied history of mother blame extending back millennia. Women who couldn’t conceive were labeled “barren” even though infertility is caused by male factors 20% of the time. Women who had only daughters and no sons were blamed for the sex of their children, even though it is sperm that determine gender, not ova. For hundreds of years of recent history, women were told that their dreams could affect the outcome of pregnancy; dream of something frightening and the baby might be deformed. Within the past century, “refrigerator mothers” were blamed for autism even though there was never any evidence to support such a link.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]We must “discover” ever more arcane “benefits” so we can continue to shame, blame and humiliate women who can’t or don’t breastfeed.[/pullquote]

The latest recruit to the deeply satisfying pastime of mother blame is the microbiome. For the past few years it has been used to chastise women who can’t or don’t breastfeed. Recently, it has offered an a new opportunity to chastise women who pump breastmilk because — duh! — women who give up career and livelihood to breastfeed supposedly represent the apogee of contemporary motherhood.

On the face of it, there’s no reason why breastfeeding, which in industrialized countries has only trivial benefits, has become a public health cause celebre.

There are so many, many issues that have a much greater impact on child health that are being ignored, while breastfeeding advocacy benefits from millions of dollars of public and private funds, extensive public health campaigns, and redesign of hospital policies. We have public health campaigns against smoking because that costs millions of lives; we have public health campaigns to promote vaccination because vaccines save millions of lives; we have public health campaigns to promote breastfeeding … which has never been shown to save even a single term baby.

If you want to see how trivial the impact of breastfeeding is on public health you need only look at the impact of breastfeeding on infant mortality in the US during the 20th Century when breastfeeding rates fluctuated dramatically from a high of over 75% to a low of 25% and back up to 75%. Breastfeeding rates had ZERO impact on infant mortality.

While breastfeeding advocates breathlessly promote studies that show trivial benefits within tiny groups of carefully selected individuals, we’ve already done the largest public health experiment possible and it shows that breastfeeding is NOT a public health issue since it has no impact on public health.

Why then do we continue to justify a multimillion dollar effort to promote breastfeeding rates in the absence of public health benefits?

Frist, breastfeeding advocacy is a huge business. While individual professional breastfeeding advocates don’t make large sums of money, 100% of the income of lactation consultant derives from breastfeeding promotion, and 100% of the income of lactivist organizations like the Orwellian-named Baby Friendly Hospital Initiative comes from the more than $11,000 they charge each hospital for the privilege of being designated lactivist baby friendly.

Second, breastfeeding promotion, which has its modern incarnation in La Leche League as an effort to keep women in the home and out of the workforce, is a response to the profound social disclocation of women’s emancipation. The political right has retreated into religious fundamentalism and the political left has retreated into mindless worship of “nature.” Simply put, aggressive promotion of breastfeeding is deeply retrograde and anti-feminist.

So we must “discover” ever more arcane “benefits” so we can continue to shame, blame and humiliate women who can’t or don’t breastfeed or — don’t breastfeed the “right” way by staying home with their infants 24/7/365.

It’s part of the effort to maintain a traditionally misogynistic “blame the mother” culture.

As Phyllis Rippeyoung explained in her paper, Governing Motherhood: Who Pays and Who Profits? published by the Canadian Centre for Policy Alternatives:

This individualizing of responsibility for child welfare has also been seen among breastfeeding proponents, as most explicitly illustrated in an editorial by Dr. Ruth Lawrence, a founder of the Academy of Breastfeeding Medicine. In her essay, “The Elimination of Poverty One Child at a Time,” she argues that breastfeeding is the panacea for health and cognitive inequalities between poor and non-poor children. She ends the piece by writing that breastfeeding may be the only gift that poor mothers have to offer their children.

… I have been unable to find any research assessing whether breastfeeding … will actually reduce either poverty or the consequences of growing up poor, one child at a time or otherwise. In research I have recently completed, I assessed the relative impact of breastfeeding versus the family educational environment on reducing gaps in child verbal IQ between the poor, the near poor, and the non-poor … This research indicates that individual solutions to low test scores will not solve the problems of inequalities in school readiness.

It is hardly a coincidence that the women who are targets for shaming by breastfeeding advocates are more likely to be poor, non-white and under-educated. It’s so much easier and cheaper (not to mention politically gratifying) to chastise these mothers for not breastfeeding than to address the terrible environments in which many are forced to raise their children.

The ugly truth is that money spent on breastfeeding advocacy benefits only the advocates — the very people who write and promote research that continually “discovers” new “benefits” — not mothers or children.

We should stop spending money on public health campaigns to promote breastfeeding and divert that wasted money to initiatives that we know will help ALL mothers and ALL children, not just those who breastfeed or are breastfed.

But is so much more satisfying to shame mothers for not breastfeeding — and blame them for everything!

Imagine a study that compared the mouth microbiome of men and women and found that up to 1/3 of the common mouth bacteria differed between men and women. Plausible, right, since male and female hormones are different and might exert some impact on the bacteria that live inside mouths?

Now imagine that the researchers concluded that women are inferior to men because their mouth microbiome differs.

[perfectpullquote align=”right” cite=”” link=”” color=”” class=”” size=””]This is not science; it’s misogyny. And that sucks![/perfectpullquote]

Outrageous, right?

How do the researchers know which microbiome is better? Why do they take men as a the standard? Why do they assume that any differences between women and men are “proof” that women are inferior? Where is the evidence that the mouth microbiome has anything to tell us about the relative value of men and women?

It’s outrageous because the researchers obviously started with the assumption that men are the standard against which women ought to be judged. Furthermore, they engaged in motivated reasoning; to the extent that any differences between men and women exist, they are assumed (without any scientific evidence) to support the pre-determined conclusion that men are “better” than women.

If you understand why the above imaginary study would be junk science, you now understand why the new study, Composition and Variation of the Human Milk Microbiota Are Influenced by Maternal and Early-Life Factors, comparing breastmilk to pumped breastmilk is also junk science.

It starts with the unwarranted assumption that breastmilk taken from women who breastfeed exclusively is some sort of standard. It assumes that any differences detected in the microbiome of women who pumped are “proof” that pumped breastmilk is inferior. And it demonstrates that the conclusion to which the authors were committed a priori was that fresh breastmilk is better than pumped.

According to the MedicalXpress:

A large-scale analysis in humans reveals that indirect breastfeeding using pumped milk is associated with the depletion of oral bacteria and a higher abundance of potential pathogens compared with direct breastfeeding at the breast…

Specifically, indirect breastfeeding (defined as at least one serving of pumped milk in the preceding two weeks) was associated with a higher abundance of potential opportunistic pathogens, such as Stenotrophomonas and Pseudomonadaceae.”Increased exposure to potential pathogens in breastmilk could pose a risk of respiratory infection in the infant, potentially explaining why infants fed pumped milk are at increased risk for pediatric asthma compared to those fed exclusively at the breast,” says first author Shirin Moossavi of the University of Manitoba. To determine if this is the case, there will need to be additional research into how changes in the milk microbiota affect colonization of the infant gut microbiome, which influences health.

There is so much wrong with these claims that it’s difficult to know where to start:

Potential pathogens?

Could pose a risk?

“Indirect” breastfeeding, implying it’s not real breastfeeding?

Let’s look at the actual scientific findings.

What did the authors set out to explore?

Two main pathways have been proposed to explain the origin of milk microbiota: entero-mammary translocation of the maternal gut microbiota and retrograde inoculation by the infant’s oral microbiota. The fact that colostrum collected even before the first infant feeding already contains a microbial community supports the entero-mammary pathway, while the similarity of infant oral microbiota to breastmilk microbiota supports the retrograde pathway. It is plausible that both pathways are contributing to the bacterial content of human milk.

What did they find?

To identify potential inherent patterns in the milk microbiota, hierarchical clustering was performed on the core microbiota…

Milk Microbiota Diversity Is Associated with Mode of Breastfeeding, Method of Milk Expression, and Other Maternal Factors

Overall, milk samples had a mean ± SD richness (observed ASVs) of 147 ± 44 and diversity (inverse Simpson index) of 15.8 ± 8.7. We explored the association of α diversity with multiple maternal and infant factors. In multivariable linear regression adjusting for infant sex, mode of feeding, mode of delivery, and parity (number of older siblings), indirect breastfeeding was independently associated with lower milk bacterial richness (adjusted Math Eq–18.9, 95% CI, −27.9, −9.9, p < 0.001) and diversity (adjusted Math Eq−2.08, 95% CI, −3.91, −0.25, p < 0.05; Table 1). In a subset with data on milk expression method, pump versus manual expression was associated with significantly lower bacterial richness (Math Eq = −39.6, 95% CI, −60.5, −18.7, p < 0.001)…

In addition:

Milk Microbiota Composition Is Associated with Breastfeeding Practices, Multiparity, and Other Maternal Factors in a Sex-Specific Manner

Indeed:

We observed intriguing differences in milk microbiota α diversity and overall community structure according to infant sex. There was a trend in direct association of infant sex with milk microbiota in our SEM analysis, and we also found sex-dependent associations of breastfeeding mode, exclusivity, and lactation stage (higher R2 in males), as well as parity, mode of delivery, and maternal BMI (significant in females only) with milk microbiota in RDA…

Overall:

Notably, however, the many factors we evaluated collectively explained less than a third of the total variation observed in milk microbiota composition, indicating that other unmeasured factors are contributing to the large inter-individual variation in milk microbiota profiles.

The study has some serious limitations:

The main limitation of our study is that milk samples were pooled from multiple feeds and were not collected aseptically.

In summary:

1. The authors found wide variation in the microbiome of pooled samples of of breastmilk that were not collected aseptically.
2. More than two thirds of the variation was unexplained.
3. Less than one third of the variation could be attributed either to the gender of the infant or a history of pumping breastmilk.
4. There is no evidence that any of these differences are clinically relevant.

So why did the authors blare their “conclusion” that pumping changes the milk microbiome? It certainly wasn’t because the findings have ANY implication for mothers or babies.

This paper, like nearly every aspect of professional lactivism from the inception of La Leche League in the 1950’s, isn’t about what is good for babies. It is about controlling women’s behavior through guilt. That’s why I have a handy rule of thumb for breastfeeding “science”:

Any paper that concludes or implies that giving up career and livelihood to stay home and breastfeed is “better” is deserving of special scrutiny.

More often than not, such papers are not science, but exercises in motivated reasoning.

Most people are unaware that La Leche League, the first and still the most influential lactivist organization was founded specifically to convince women to stay home with young children.

In the book La Leche League: At the Crossroads of Medicine, Feminism, and Religion, Jule DeJager Ward explains:

[A] central characteristic of La Leche League’s ideology is that it was born of Catholic moral discourse on family life … The League has very strong convictions about the needs of families. These convictions are the normative heart of its narrative… The League’s presentations and literature carry a strong suggestion that breast feeding is obligatory. Their message is simple: Nature intended mothers to nurse their babies; therefore, mothers ought to nurse…

In 2019 you can no longer tell women that it is “better” for babies to have a stay at home mother. It’s easy to recognize the misogyny in that claim. Therefore, lactivist tactics have switched to convincing women that breastfeeding is better for babies. They’ve spent the past 30+ years promoting an expanding list of health benefits … that have nearly all been debunked.

So the search is on for ever more arcane “benefits” and investigations of the breastmilk microbiome are part of that effort. Our understanding of microbiomes is primitive. We have literally no idea what a “normal” microbiome looks like. We have literally no idea whether variations among individuals are clinically relevant or merely incidental. That hasn’t stopped breastfeeding researchers from drawing junk science “conclusions.” And those conclusions always rest on the assumption that a mother breastfeeding directly and exclusively is the standard against which any variations should be assumed inferior.

That reflects the patriarchal belief a woman’s place is in the home and nowhere else. It also reflects the patriarchal belief that women should be judged by the function of their reproductive organs, not their intellect, talents or character. That’s not science; it’s misogyny. And that sucks!

It’s been nearly 20 years since I was diagnosed with a benign brain tumor, a meningioma. At the time the Gamma Knife (stereotactic radiosurgery, which is radiation not surgery) was relatively new, but as my brain tumor was deep inside my brain it offered an opportunity to avoid potentially destructive brain surgery.

Nonetheless, I sought a second opinion from a prominent neurosurgeon who aggressively recommended surgery, although he warned me that I would almost certainly lose my hearing on that side of my head as well as sensation in my face.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The women and babies for whom I advocate are entitled to expect Dr. Jack Newman to answer the question I posed.[/pullquote]

So I asked him how brain surgery compared with the Gamma Knife for successful outcomes. He told me surgery had an 85% success rate and the Gamma Knife had a 95% success rate.

Then I asked him about the risk of complications. He answered that I would definitely have complications from the surgery (hearing loss, etc.) but that the complication rate for the Gamma Knife was extremely low.

So then I asked whether if I was one of the rare failures of Gamma Knife treatment, would that compromise a surgeon’s ability to remove the tumor. He assured me that it would make no difference.

Finally I asked if the Gamma Knife had a higher success rate, a lower complication rate, and did not prevent using surgery in the case of failure, why hadn’t he recommended the Gamma Knife. He didn’t miss a beat, acknowledging that he didn’t recommend it, because he didn’t have one.

I was reminded of that episode when I was recently deleted and banned from Dr. Jack Newman’s Facebook page for daring to ask a question that he didn’t want to answer:

[C]an you please show us any impact that changing breastfeeding rates have had on term infant mortality or any metrics of major term infant morbidity.

He’s hardly the only lactation professional to delete, ban or block me on social media. Although the phrase “what doctors don’t want you to know” is overused among the alternative health community, the tactic of hiding health information is alive and well in the lactation community.

Dr. Newman is afraid of me because, like the neurosurgeon who didn’t recommend the Gamma Knife because he couldn’t profit from it, he can’t answer a simple question because he won’t profit from the answer. And so it is very, very important to make sure not merely to ignore me, but to prevent others from even hearing my question. Who knows what might happen to the income of lactation professionals if women learn the truth that breastfeeding DOESN’T have the benefits they claim and has risks that they would prefer to ignore?

That’s why you must never, ever listen to Dr. Amy.

As a public service, I’ve gathered some of the most common reasons why you shouldn’t listen to me, complete with the English to English translations.

“Don’t listen to Dr. Amy because she’s biased.”

English to English translation:

Dr. Amy is biased toward presenting complete information. She won’t exclude the mass of data that we feel compelled to conceal.

“Don’t listen to Dr. Amy because she cherry picks the data.”

English to English translation:

Dr. Amy does not merely quote the data, but she breaks it down so you can understand it too. That means that instead of merely accepting what we tell you about breastfeeding, you will be armed with the actual statistics that show that the benefits of breastfeeding term infants in industrialized countries are so trivial that they cannot be detected in large populations.

“Don’t listen to Dr. Amy because she’s crazy.”

Only a crazy person would take the time to present the data, show you where you can find it yourself, and explain how even you can understand and analyze it. That’s dangerous. Listen to us and you won’t have to use your own intelligence and reach your own conclusions. Just accept what we tell you.

“Don’t listen to Dr. Amy because she hates breastfeeding.”

English to English translation:

Ignore the fact that she breastfed her own four children happily and with little difficulty. Don’t listen to Dr. Amy because she hates the fact that the only metrics that breastfeeding has managed to change in large populations is the increased rate of complications, brain injuries and deaths of newborns. Exclusive breastfeeding on discharge is now the leading risk factor for newborn hospital readmission. Those who “love” breastfeeding are willing to lie about; since Dr. Amy is not willing to lie, she must “hate” it.

The women and babies for whom I advocate are entitled to expect Jack Newman to answer the question that I posed. To that end, I have petitioned him on Change.org. Please sign the petition if you, too, would like to see Dr. Newman answer the question!

In the meantime, keep in mind what’s really going on when someone tells you “Don’t listen to Dr. Amy,” or deletes my questions and bans me for asking. What they’re really telling you is don’t read, don’t learn, don’t think. If you do, you are bound to conclude that they are telling you is false, and they can’t have that, can they?

Ask yourself: Are you brave?

Are you brave enough to read what I say, review the papers that I cite, analyze the data for yourself, and reach your own conclusions?

I’m not afraid of that, but apparently lactation professionals are. That should tell you all you need to know about the purported benefits of breastfeeding.

Just as it was wrong when the neurosurgeon recommended surgery to me because he couldn’t profit from the safer radiation treatment, it’s wrong when lactation professionals claim that breast is best — and delete, ban and block anyone who can demonstrate otherwise — simply because they can’t profit from formula feeding.