I have been arguing for years that the Baby Friendly Hospital Initiative (BFHI), designed to promote breastfeeding, ignores scientific evidence and leads to preventable deaths of babies.

A new paper in JAMA Pediatrics confirms what I have been saying.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]A practice designed to promote breastfeeding is injuring and killing babies.[/pullquote]

It’s entitled Unintended Consequences of Current Breastfeeding Initiatives. Breastfeeding is a good thing and should be vigorously supported, but:

Unfortunately, there is now emerging evidence that full compliance with the 10 steps of the initiative may inadvertently be promoting potentially hazardous practices and/or having counterproductive outcomes.

The authors note a variety of serious problems with the BFHI:

1. Enforced prolonged skin to skin contact leads to deaths from Sudden Unexpected Postneonatal Collapse (SUPC).

Reports of SUPC include both severe apparent life-threatening events (recently referred to as brief resolved unexplained events) and sudden unexpected death in infancy occurring within the first postnatal week of life. A comprehensive review of this issue identified 400 case reports in the literature, mostly occurring during skin-to-skin care, with one-third of the events occurring in the first 2 hours after birth …

And inevitably:

…[A] recent publication from the American Academy of Pediatrics observed that lawsuits have surfaced in US hospitals attributed to unexpected respiratory arrest in apparently healthy newborns during early skin-to-skin care …

In other words, a practice designed to promote breastfeeding is injuring and killing babies.

2. Infant injuries and deaths as a result of enforced 24 hours rooming in and closing well baby nurseries.

An overly rigid insistence on these steps in order to comply with Baby-Friendly Hospital Initiative criteria may inadvertently result in a potentially exhausted or sedated postpartum mother being persuaded to feed her infant while she is in bed overnight … This may result in prone positioning and co-sleeping on a soft warm surface in direct contradiction to the Safe Sleep Recommendations of the National Institutes of Health. In addition, co-sleeping also poses a risk for a newborn falling out of the mother’s bed in the hospital, which can have serious consequences.

3. The ban of formula supplementation is contraindicated by scientific evidence.

…[W]hen supplementation was given for a medical indication, there was no adverse effect on the duration of breastfeeding.

4. The ban on pacifier use is contraindicated by scientific evidence.

[The BFHI] requires that mothers be educated repeatedly that pacifiers may interfere with the development of optimal breastfeeding. Because there is strong evidence that pacifiers may have a protective effect against sudden infant death syndrome (SIDS), the American Academy of Pediatrics has suggested avoidance of pacifiers only until breastfeeding is established at approximately 3 to 4 weeks of age. Because a substantial number of SUPC events occur during the first week of life, this recommendation to proscribe the use of pacifiers is difficult to defend based on risk.

So the BFHI leads to preventable infant injuries and deaths and the ban on formula supplementation and pacifier use are contraindicated by scientific evidence and may lead to further injuries and deaths from dehydration. Yet, health organizations are promoting the deadly BFHI tenets.

Preventing the unintended serious outcomes from these practices has been made more challenging by the emphasis on breastfeeding exclusivity in the perinatal measures recently promulgated by The Joint Commission. Measure PC-05 requires documentation of the reasons for not exclusively breastfeeding, with no allowable exceptions for newborn conditions. In addition, the Centers for Disease Control and Prevention actively promotes the “10 Steps” and Baby-Friendly designation, and monitors “10 Steps” compliance in the United States. In Massachusetts, the recently enacted Massachusetts Health Quality Measure 3A requires increasing rates of breastfeeding exclusivity, with soon to be implemented financial implications.

Why have these deadly measure been promoted? It’s certainly not because they benefit babies (or mothers). They have been promoted because of extensive lobbying on the part of the breastfeeding industry and the lactivists who support it. The BFHI should more properly be called the Lactivist Friendly Hospital Initiative because that’s who benefits.

As the authors note:

If government and accreditation agencies wish to encourage and support breastfeeding, their focus should shift from monitoring Baby-Friendly practices and breastfeeding exclusivity to monitoring breastfeeding initiation rates coupled with evidence of lactation support both during and after the hospital stay. More attention should also be placed on ensuring compliance with established safe sleep programs, emphasizing the need to integrate safe sleep practices with breastfeeding. Hospitals should direct their efforts toward implementing practices that will promote breastfeeding safely, the common goal of both private and public groups with an interest in these issues.

If doctors, hospitals and public health officials truly care about the wellbeing of babies, they will end the BFHI.

It is perhaps the ultimate irony.

Advocates of attachment parenting many of whom reject vaccination because of fear of autism have failed to recognize that it is attachment parenting itself that causes autism.

Consider the ever growing body of evidence:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There has never been a randomized controlled trial of attachment parenting that shows it doesn’t cause autism![/pullquote]

1. Both autism and attachment parenting have increased dramatically in the past two decades. The origin of the attachment parenting is credited to Dr. William Sears, who first mentioned it in his book in 1988. Studies show that in the VERY SAME YEAR, the incidence of autism began to rise dramatically. (Environ. Sci. Technol., 2010, 44 (6), pp 2112–2118).

2. Regardless of who practices attachment parenting or how they define it, no one can deny that the practice of attachment parenting ALWAYS precedes the diagnosis. There are no known cases in which attachment parenting practices began after autism was diagnosed.

3. The purported mechanism is thought to be the sensory deprivation caused by baby wearing and extended breastfeeding. During the critical early months and years, when babies should be learning about the world and making millions of neuronal connections, babies exposed to AP are deprived of contact with the outside world (many are constantly carried in a position where they can see nothing but the surface of the mother’s clothing) and their exposure to other individuals such as fathers, grandparents and childcare workers is severely limited.

4. No one has EVER shown that attachment parenting does not cause autism.

5. Even those who strongly reject the notion that attachment parenting causes autism acknowledge that there are MANY children raised with attachment parenting who are subsequently diagnosed with autism.

6. Many of those who deny a link between attachment parenting and autism stand to lose money if attachment parenting is shown to be harmful. Authors, lactation consultants, and sling manufacturers, among others, have a strong economic motivation for discouraging investigation of this link.

It is time to launch a comprehensive investigation of the harmful side effects of attachment parenting in general, and the relationship between attachment parenting and autism in particular. It’s hardly coincidental that the same people who make money from attachment parenting have NEVER bothered to study these harmful effects. They insist that attachment parenting is beneficial, but there is no way they can know for sure.

****

Those who have read this far have probably figured out that this is a satire. I’m satirizing the “thinking” of anti-vaccine parents on the purported relationship between vaccines and autism. The purpose of the satire is to demonstrate that what seems to anti-vaxxers to be irrefutable “reasoning” is nothing more than nonsense and logical fallacies.

The above list highlights the major rhetorical gambits of anti-vaxxers. Number 1 is the claim that because both vaccination and autism have risen in recent decades, vaccines must cause autism. That claim is foolish as can be seen when the same observation is made about attachment parenting and autism. Just because the incidence of two phenomena rise at the same time does not mean that one caused the other. And that doesn’t even take into account the fact that rates of vaccination have actually been FALLING while rates of autism have been rising.

Number 2 is the temporal connection. Early childhood vaccination precedes the observation of autistic symptoms, but a lot of things precede the observation of autistic symptoms. That’s because those symptoms typically do not appear until the early toddler years and anything that takes place during infancy (like attachment parenting practices) will precede the observation of symptoms.

Number 3 invokes a spurious mechanism of action. It is certainly plausible, but no evidence is presented that it actually occurs. Anti-vaxxers play the same tricks with claims about the deleterious effects of “toxins” in vaccines.

Number 4 is the “argument from ignorance.” The argument from ignorance dares the opponent to prove a negative and when a negative cannot be proven (since that is a logical impossibility in most cases), the conclusion is proclaimed that this “shows” that vaccines cause autism.

Number 5 is the “fallacy of the lonely fact.” Since some children have developed autism after their parents practiced attachment parenting, the conclusion is drawn that large numbers of children will develop autism after their parents practice attachment parenting.

Number 6 is the conspiracy theory that undergirds almost every attempt to defend anti-vax. But when the same “reasoning” is applied to attachment parenting, it is easy to see that the conspiracy theory does not have much explanatory power. There is ALWAYS someone who stands to benefit from any recommendation or practice. That does not mean that those who benefit are actively hiding information on harms and risks from everyone else.

The concluding paragraph is the seemingly innocuous call for “more research.” But we cannot and should not waste time “researching” connections that have no basis in science. If we did, we could spend a lot of time “researching” whether the moon is made of green cheese or whether clouds are made of marshmallows. The call for “more research” is just away to add gravitas to what are often ridiculous claims. We do not need to “research” every wacky idea that anti-vaxxers devise and our refusal to “research” those ideas without basis in science or logic is not a sign that someone is hiding something.

The key point is that what passes for “reasoning” among anti-vaxxers is not reasoning at all. It is nothing more than wild accusations, logical fallacies and conspiracy theories. There is no more reason to take seriously the idea that vaccines cause autism than there is to take seriously the idea that attachment parenting causes autism.

She writes on her Facebook page:

While I am proud of myself for birthing and catching my baby myself, thankful he was strong enough at that age to be saved, I don’t feel like I did anything super or amazing…

That’s good, Paala, because you didn’t do anything super or amazing. You did something immature and despicable. You risked your baby’s life by repeatedly defying the doctors who were working desperately to save him.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”Labor by myself with my baby, just us, and I’d birth him and catch him and then call for help.”[/pullquote]

Early in the second trimester, Palaa’s began suffering a serious and growing placental abruption. Thus began the effort to save Palaa’s son by keeping in the womb and long as possible. That must have been very difficult for Palaa since her identity is based on her childrearing choices:

I write about my journey through motherhood as co-sleeping, babywearing, full-term breastfeeding parent to four wonderful children. We spend our days unschooling, exploring nature and all that the … area has to offer. I’m also a birth, breastfeeding, and women’s rights advocate so I post about those as well.

Simply following medical advice in an effort to save her son’s life did not offer enough scope to burnish her crunchy mom cred, so she acted like a willful toddler repeatedly defying medical advice.

…One day in December when I was 14 weeks along. I had what seemed to be an all day Braxton Hicks contraction, quite painful if anything bumped my belly, that ended in a gush of blood as I walked up my stairs at the end of the day. Bright red blood out of no where was worrisome… [W]hen the bleeding repeated itself once more the following day, I reached out to my birthy friends and took a tincture a trusted ex-midwife friend of mine suggested, drank lots of tea, and then all was fine.

Her baby freebirth was at risk!

I wasn’t able to envision a sweet home freebirth like my last one… I still hoped for the best, even as I bled occasionally. It wasn’t serious enough to warrant a trip to the hospital until I had a larger gush than usual.

She sought treatment at the hospital at 22 weeks:

I didn’t like the florescent lights, strangers that hardly made eye contact, the chilly doctor wasn’t soothing at all, didn’t put her hand on my skin, on my belly once while I was there for a couple hours, just touched me with tools and sent me to get an ultrasound. I also came during dinner time and no one offered an obviously pregnant woman anything to eat or drink. Not even a snack like they had sitting around.

She was released home and at 23 weeks and 3 days she had another “huge gush of blood,” bleeding through pad, pants and sheets and on to the mattress.

Did she go to the hospital? Of course not:

While I was in the shower, I assessed myself and considered my situation. In addition to the painful, regular contractions and bleeding, felt my cervix opening up from when I checked a few hours earlier…

I started driving to the hospital with a NICU 25 minutes away and kept tracking contractions…

When she got there:

…I told her I was 23 and 4, contracting every 2-3 minutes, they were painful, I was dilating, I was bleeding heavily, I had a SCH, I could feel the baby kicking fine, and I was there to get some labor stopping drugs. She had me fill out paperwork, put some plastic name tags on my wrist, and sat me down in a triage room and I gushed more blood, waiting to see someone. I wasn’t treated with urgency or offered any water, juice, or anything.

Imagine that! She bled for hours at home before she could be bothered to go to the hospital, showed up at 3 AM and there was no doctor to attend to her.

Everyone was so mean. [Could it be because they were incredulous at her willingness to ignore the potential death of her child?]

At 4:30am, an hour after arriving, the doctor on call finally arrived. She had a gruff beside manner, zero warmth. She shoved a couple of gloved fingers in me and confirmed what I’d been telling them, that I was dilated a couple centimeters. She said I was 80% effaced and she was going to start me on magnesium to stop labor. Oh and my baby was breech.

And then, horror of horrors, she had to put on a hospital gown.

By 6am, my husband got my message and I was given the first of two steroid shots, betamethasone, to mature my baby’s lungs in case he was born early and was started on magnesium sulfate intravenously with an IV drip to hopefully stop my labor. Thankfully, my labor slowed and then eventually stopped. The mag made me feel slow and hot…

Oh, and she got 5 units of blood!

By noon on Thursday, I was given 3 pints of blood. Apparently, I was only at 20% blood volume when I walked in. I was given 2 more pints in the next day to bring me back into the normal range… I had to fight to eat, telling them repeatedly that I was not going to have a CS at 23 weeks (my body, my baby, my choice), and I was pregnant and starving, that I needed to eat. Withholding food was unacceptable.

The next morning she woke up to a painful contraction. Did she tell anyone? No.

I went into steady labor again. I couldn’t sleep and I felt awful. I needed a shower. I wrapped up my IV and line ridden arm with a plastic bag and some tape that I found and rinsed off in the shower. I gently felt that I’d dilated another 2 cm and told my nurse so I could get started on mag again…I was given a second shot of betamethasone.

The mean people at the hospital tried to impress the seriousness of the situation on her but she didn’t get it.

The doctor on call scolded me for checking myself and told me to keep my hands out of my vagina. I’m pretty sure I gave them the “eff off” eyes because it was my body, I had made sure my hands were clean, and I knew I was more gentle with myself than they were.

Everyone continued being mean:

I continued being checked and prodded all day, all night. I had bruises on my arms for too many bad blood draw and IV attempts. I had to convince each new doctor and nurse that I didn’t want continuous fetal monitoring and I wasn’t going to have a c-section, that I could continue to eat. It was a constant fight to be listened to and left alone. It felt like it was all about control and slowly breaking me. I couldn’t believe this was standard care, that women were treated this way. Where was the respect?

I, I, me, me, my feelings, my need for control, me, me, MEEEE!!!

At this point, I asked the doctor of the day if I could eat outside because I was craving the outside world. He denied my request. I ignored the doctor’s orders on Sunday evening and went outside into the garden and ate my dinner outside before sunset with my husband.

Palaa’s baby is on the verge of viability, sure to be born early, and everyone is struggling to make sure he stays inside for as many extra hours or days possible.But Palaa found ignoring doctor’s orders to be delightfully transgressive.

So delightful that she continued defying the medical professionals:

By 8:30, I had enough. I took out my IV lines (nothing was being pumped into them at that point anyway) and my hospital bracelet. I wanted to take a shower with both arms free of junk. I figured they could put that crap back on me if it was an emergency but I needed to feel like myself again. (Did I mention they tracked and measured everything that came out of my body?)

Here’s the best part:

By 10pm, my body started going in to labor again. My husband was going to sleep and asked me if was okay. I said I just felt pushy, like I needed to poop. I blamed the start of a new round of contractions on the prune juice, them feeling like they needed to get me to poop and mess with my body. I went to the bathroom while he fell asleep on the fold out chair in the room. He was exhausted.

After a shower and sitting on the toilet a couple trying to poop, I realized I was in labor. I thought about my options as I sat in the bathroom. I’d been told my body only needed to open to 5 or 6 centimeters until my baby would come out because he was so small.

Palaa had to decide what to do.

Option 1. Call the nurses and either be prodded while birthing right there or be wheeled in for an emergency CS.

Option 2. Wake my husband and labor with him secretly but then I knew he’d lose his cool and call for help.

Option 3. Labor by myself with my baby, just us, and I’d birth him and catch him and then call for help.

Surprise! She went with the most transgressive choice!

Obviously, I went for option 3. It seemed like the safest thing for my baby and myself at the time. The studies I’d read didn’t report benefits for a c-section for babies of his age, that vaginal would have been safer, and I knew getting drugged up and controlled by strangers was going to make things dangerous for us. After a couple of painful contractions by the toilet, I laid out a couple of chux pads to catch the blood and crap I was sure was coming.

I kid you not!

My body slid Evar out, everything else, too, placenta and all in one contraction as I knelt down on the chux pads. I caught my baby boy and his bag of water broke as it hit my hands. I admired him and felt the relief of everything coming out. He looked perfect, though tiny, healthy, eyes closed but breathing, and I heard him cry.

Then she told her husband the baby had been born.

He jolted awake, ran out of the door to the nurses station at the corner to call for help. He said they were shocked and took a moment to move.

An ALS nurse came in a minute later and assessed Evar. He asked if we wanted to save him. We asked how he thought he was doing based on his professional opinion. He said he looked good and we said yes. (Babies born before 25 weeks are not saved unless the parents request it.) He milked the cord to give him more blood and then cut it. I was thankful it wasn’t too rushed but I wished he had carried the placenta up with the baby instead of cutting it…

She’s so proud of herself:

I had an unassisted freebirth, en caul just like my last baby, except in the hospital …

What about the baby?

He weighed 1 pound 6 oz, but survived. He spent four and a half months in the NICU and is doing well … no thanks to his mother who nearly killed him in her quest for bragging rights.

Kate Tietje, who writes under the nom de quack Modern Alternative Mama, professes herself shocked by the outcry to the execrable piece Five Reason Measles Is Better Than Autism, her “most controversial post of all time.”

Yesterday I wrote about the factual errors and neuro-bigotry in the piece (WTF, Kate Tietje?). Today I’d like to show how Kate’s response illustrates the 7 cardinal signs of an anti-vax quack.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”If you agree, join me. If you don’t…leave quietly.”[/pullquote]

1. Striking contempt for basic knowledge

Since Tietje believes herself qualified to opine on vaccine safety, you might imagine that she would have formal education in immunology, science and statistics. You would be wrong.

Kate, like most anti-vaxxers is a walking, talking illustration of the Dunning-Kruger effect. That’s the paradox that those who know the least actually believe they know the most. She is so lacking in basic knowledge that she is literally incapable of realizing just how ignorant she is about the topic.

2. Fact resistance

Kate isn’t merely evidence resistant; she is fact resistant. It doesn’t matter what the World Health Organization, Centers for Disease Control or anyone else tells her about the fact that the association between autism and the MMR (measles, mumps and rubella) vaccine has been thoroughly debunked by a plethora of studies, nor that the seminal study “proving” the association was fabricated by Andrew Wakefield in an effort to promote the profitability of own version of the vaccine that was in development at the time. [Correction: Edited to remove an erroneous claim that I made about measles death rates].

3. Embrace of blatant lying

In regard to the piece, Kate claims:

It was written because of all of the people who have said, “I’d rather my children have autism than die of the measles.” That’s an unfair and wrong comparison, that blow measles way out of proportion. Death rates from measles are quite low in developed countries.

Since the measles vaccine DOESN’T cause autism, no one is claiming that they’d rather have their children get autism than measles.

4. Privileging intuition over facts

Kate believes that vaccines cause autism because that’s what her intuition tells her, facts be damned.

5. Outsourcing blame

As the population has fallen prey more and more to autoimmune disorders, chronic illness, and disability, they’ve been told, “It’s just a new variation of normal! It’s genetic! There’s nothing you can do! Accept it and love it!”

There’s no denying this is happening. There’s no denying that rates of allergies, autism, autoimmune disorders, learning disabilities, obesity, and more are rising exponentially. But if the powers-that-be redefine all of these things as “normal,” then no one has to answer for it or do anything about it.

For every untoward occurrence, Tietje never thinks to ask, “What went wrong?” Instead she demands to know: “Who did this to us?”

The fault always lies with a conspiracy, in the case of vaccines a conspiracy so large as to encompasses nearly every scientist, doctor, and public health official in the entire world.

The truth is, that post hit people hard, in their core belief systems. These people believe the lies that the doctors and pharmaceutical companies have sold them. It isn’t their fault. Basically, they’ve been “gas-lighted.”

That’s not what gas-lighting means. According to Wikipedia:

Gaslighting … is a form of psychological abuse in which a victim is manipulated into doubting their own memory, perception, and sanity.

Gaslighting involves empirical facts, NOT feelings. Gaslighting means insisting that the lights are bright when they are actually dim. Giving greater weight to scientific evidence than the perceptions of the scientifically illiterate is not gaslighting; it’s SCIENCE.

6. Desperation for adulation and self esteem

For Tietje, like most anti-vaxxers, it has precious little to do with vaccines or with children.  She view the combination of self-education and defiance of authority as an empowering form of rugged individualism, marking out her own superiority from the pathetic “sheeple” who aren’t self-educated and who do follow authority.

I feel sorry for all of these people. These children deserve *better.* I want them, and all children, to be the best versions of themselves…

I know that there are possibilities to achieve health, to really HELP people, that exist outside of what the mainstream says is possible. They deny it angrily, they call it magical thinking. Yet I’ve seen it work…over and over.

7. Isolation is critical to self-regard

If you agree, join me. If you don’t…leave quietly.

Kate can’t be bothered to convince anyone who disagrees because she cannot tolerate anyone who does not praise her. She spent yesterday banning and deleting anyone who dared to present scientific evidence because she cannot abide proof that she isn’t knowledgeable, uniquely insightful and special.

Kate Tietje is merely ignorant and deluded; she’s hoping against hope that by wiping away real scientific evidence she can prevent her gullible followers from realizing it.

I learned a new word today: neuro-bigotry.

Neuro-bigotry is prejudice against people on the autism spectrum based on the idea that they are less worthy of moral regard than everyone else.

Who taught me the new term? None other than neuro-bigot Kate Tieje whose nom de quack is Modern Alternative Mama.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Suggesting that the risk of brain damage or death from measles is preferable to having a child on the spectrum is neuro-bigotry.[/pullquote]

Kate posted the mind boggling piece Five Reasons Measles is Better than Autism. There’s been such a firestorm of protest that Kate cannot ban and delete people fast enough from her Facebook page. But she is desperately trying to defend the post despite the fact that it is scientifically illiterate and startlingly prejudiced against those on the spectrum.

Here’s the Facebook version of the post:

**New Post** Enough with the fear-mongering, let’s be honest: measles is better than autism. We have five reasons why the disease is preferred over the vaccine…

The actual post is a festival of stupidity. Just about every scientific “fact” is at best cherry picking and at worst a bald faced lie. And that’s not even the worst part of the post.

The worst part is this:

When a child gets autism? There’s no easy bouncing back. A bowl of chicken soup ain’t gonna solve this problem (though soup can help to heal autism).

Autism results in long-term neurological damage with can affect a child for lifetime, though there are children who recover through the hard work of their warrior mamas! Indeed, many studies … have found that gut health has a profound impact on the behaviors of those on the autism spectrum, and interventions such as diet and probiotic supplementation may be helpful.

I have an adult child on the spectrum. He is not neurologically damaged. He’s a highly successful, productive member of society with a degree from an Ivy League college, a wife and a high paying job.

Wait! They’re not talking about people like my son?

And before you cry for acceptance of neurodiversity, keep in mind, I’m referring to children with severe, regressive cases of autism, not those that are high-functioning and more self-sufficient.

But the majority (up to 75%) of people on the spectrum DON’T have severe, regressive autism.

What about measles?

You know what’s not a big deal? Measles. Did you know that according to this CDC document (page 85), between 1950 and 1960, there was less than 1 death per 100,000 in the US, which is 0.00001%, or about 1 in 100,000.

But that’s about 1 death per 1,000 reported cases, not a trivial number. [Correction: Edited to make clear the difference between death rate per population and death rate per reported cases.]

According to Measles Elimination in the United States published the Journal of Infectious Diseases in 2004:

From 1956 to 1960, an average of 450 measles-related deaths were reported each year (∼1 death/ 1000 reported cases), compared with an average of 5300 measles-related deaths during 1912–1916 (26 deaths/ 1000 reported cases). Nevertheless, in the late 1950s, serious complications due to measles remained frequent and costly. As a result of measles virus infections, an average of 150,000 patients had respiratory complications and 4000 patients had encephalitis each year; the latter was associated with a high risk of neurological sequelae and death. These complications and others resulted in an estimated 48,000 persons with measles being hospitalized every year.

Measles was a very big deal indeed.

The blog post postulates that the autism is so debilitating that risking the very real chance of hospitalization, neurological damage and death from measles is better.

Many parents of autistic children posted on Facebook profoundly disagreeing with Tietje; she has deleted most of their comments and banned them.

She tries to defend herself.

Enough. It’s ok for us not to believe the same things. The article we shared earlier was written on our sister site Modern *Alternative* Health. We have an alternative point of view, and for good reason: today’s conventional food and medicine is not working for our kids.

Today’s generation of kids are actually predicted to have a shorter life expectancy than their parents. Something is wrong here, and calling names and insulting people because they believe differently than you isn’t helping our kids.

There is new information emerging, and refusing to believe doesn’t change it.

Please, let’s conduct ourselves in a dignified manner. And remember the rules: my page, my opinion. If you don’t like it, that’s ok, you are free to move on. Calling names, using foul language, and behaving like children will get you banned.

And:

Please understand we are NOT saying that autism is the worst thing ever, or that people with autism are somehow worthless. Not at all. That’s not what this is about.

This is about putting things back into perspective. We’d rather have a child with a mild, short-term illness than a chronic disability.

The truth is, measles is a mild, self-limiting illness for most. Autism is a life-long issue, and regressive autism can be especially difficult for families, coming with behavioral, neurological, and physical symptoms. Simple illnesses are always better than chronic issues.

Of course that misses critical points:

Vaccines DON’T cause autism
Most people on the spectrum DON’T have severe regressive autism
Neurological injury or death from measles is WORSE than being on the spectrum

The most fundamental point is this:

Mothers don’t get to choose between measles and autism. They can choose to protect their children from measles but they CAN’T prevent autism, no matter how much they wish they could. Autism is almost certainly genetic. That means it’s no one’s fault so leaving your child exposed to death from measles in an effort to prevent autism is deadly nonsense.

And suggesting that the risk of brain damage or death from measles is preferable to having a child on the spectrum is neuro-bigotry.

Why are those who battle pseudoscience called skeptics?

It’s not because they are skeptical in the colloquial sense. Rather, the term refers to the philosophy of skepticism. It’s an approach to knowledge that requires that claims be well supported by evidence.

According to Wikipedia:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Skeptics won’t believe without evidence; denialists won’t believe evidence.[/pullquote]

In philosophy, skepticism refers more specifically to any one of several propositions. These include propositions about:

(a) an inquiry,
(b) a method of obtaining knowledge through systematic doubt and continual testing,
(c) the arbitrariness, relativity, or subjectivity of moral values,
(d) the limitations of knowledge,
(e) a method of intellectual caution and suspended judgment.

Are people who are skeptical of scientific consensus on issues like vaccines and evolution entitled to be called skeptics? No, they’re denialists as Andrew Dart explains in an chapter from Building your Skeptical Toolkit:

… [T]here are a lot of people who like to call themselves skeptics but who it can be strongly argued are anything but. There’s HIV/AIDS skeptics, global warming skeptics, moon landing skeptics, evolution skeptics, holocaust skeptics, 9/11 skeptics and vaccination skeptics, to name but a few. But while there may be some people who would use these labels who could legitimately be described as skeptics the vast majority of them are not practicing skepticism at all, but rather skepticism’s evil twin, denialism.

What’s the difference between skeptics and denialists?

Denialism … is driven by ideology rather than evidence. Now denialists may claim they care about the evidence and will happily display any that supports their point of view, but in most cases they reject far more evidence than they accept. Furthermore, denialists will cling to evidence no matter how many times they have been shown that it is flawed, incorrect or that it does not support their conclusions; the same old arguments just come up again and again. Denialism also tends to focus on trying to generate a controversy surrounding the subject at hand, often in the public rather than scientific arena, and does so more often than not by denying that a scientific consensus on the matter even exists.

It’s easy to see how anti-vaccine parents and creationists are denialists. Though it isn’t as obvious, natural childbirth and homebirth advocates are denialists, too. They deny the scientific consensus of modern obstetrics. And natural childbirth and homebirth advocates share key attitudes with anti-vaxxers, creationists and other denialists.

1. Denialists love of conspiracy theories.

As Dart explains:

So the vast majority of the scientific community and an overwhelming mountain of evidence is aligned against you, what are you going to do? Well you could always claim that there is a conspiracy to supress the truth and that the scientists working in the field are engaged in a complex cover up for some bizarre and often undefined reason…

Anti-vaxxers are blunt about their favorite conspiracy: Big Pharma is in cahoots with Big Medicine to make money from useless and/or harmful vaccines.

Natural childbirth and homebirth advocates do include some blunt conspiracy theories like the idea that C-sections occur because obstetricians want to get to their golf games, but professional natural childbirth and homebirth advocates are more subtle. They assert an acculturation conspiracy, whereby doctors are “socialized” to participate in the conspiracy to foist harmful/scientifically unsubstantiated practices on women.

Most scientists are viewed as simply towing the party line and it is assumed that none of them ever comes to their own conclusions based upon the evidence; they just believe what they are told to believe. As for the peer review process, well that is just a tool of the conspiracy to make sure that only those papers that agree with the conspirator’s message get published.

Conspiracy theories, whether blunt or subtle are nothing more than evasions.

These conspiracy theories never attempt to actually address the evidence; rather they seek to dismiss it entirely as a fabrication of unseen forces. Furthermore no explanation as to how a conspiracy so vast that it encompasses every scientist in a given field, as well as every student studying to become a scientist in that field, can maintain itself without someone blowing the whistle is ever given, and reasons why the conspiracies exist in the first place are equally rare and incoherent.

2. Denialists love fake experts.

Fake experts are defined as people who claim to be experts in a given field but whose opinions differ greatly from the consensus of scientists working in that field and from established knowledge…

Only in the world of anti-vax and alternative health can actresses and other public figures without medical training be considered experts.

3. Denialists love cherry-picking.

Cherry picking is the act of selecting papers and evidence that seem to support your point of view, whilst at the same time ignoring the far greater body of evidence that goes against
your position.

Anti-vaxxers, like most advocates of alternative health, make cherry-picking even easier than usual since they don’t even bother to read the articles they cite.

4. Denialists love impossible expectations

Hence the insistence by anti-vaxxers that we don’t know if vaccines are effective if we don’t have a randomized controlled trial of vaccines vs. placebo, an experiment that would be unethical.

5. Denialists love logical fallacies.

I’ve written extensively about the logical fallacies favored by natural childbirth and homebirth advocates including the argument from ignorance, and the fallacy of the lonely fact.

Dart’s conclusion is one that anyone who cares about scientific integrity should keep in mind:

It is not the topic that makes someone a skeptic or a denier, it is how they handle evidence that contradicts their pre-existing beliefs. Do they resort to claiming there is a conspiracy to suppress the truth in order to explain why the evidence is against them? Are the people presenting the argument actually experts in the topic at hand? Do they cherry pick the data and only present those findings that agree with them? And do they constantly move the goalposts and make use of logical fallacies in defense of their claims? If you keep a look out for these five things then you should have a good idea whether you are dealing with a genuine skeptic or a closed minded denier.

How can lay people tell the difference between skeptics and denialists? The best way is to master the scientific literature of the topic under discussion. Then you will understand what the preponderance of the scientific evidence shows and you will recognize cherry picking. You can also read up about logical fallacies since those are often employed in defense of pseudoscience.

But there’s an easier way. As Dart notes, denialists can’t handle evidence that contradicts their pre-existing beliefs. That’s why denialist websites, message board and Facebook pages delete scientific evidence that does not support their claims and ban anyone who posts such evidence. They create echo chambers where they will never be forced to address dissent. They resort to elaborate and nonsensical conspiracy theories to promote claims that have been repeatedly disproven. If you find yourself on such a website, message board or Facebook page, you can be sure they are peddling pseudoscience.

Simply put:

Skeptics won’t believe without evidence; denialists won’t believe evidence.

I’ve seen the speculation that Donald Trump is purposely trying to lose the presidential election.

The thinking seems to be that no one would purposely be so contemptuous of the truth, so offensive and so outrageous if they wanted to win. Surely Trump can see that he has reached the ceiling of his support and he has to broaden his message to sway those who are undecided.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]For Donald Trump, as for anti-vaxxers, facts take a back seat to ego.[/pullquote]

But Trump wants to win. How do I know? His quixotic approach to the election seems remarkably familiar to me. I’ve been battling such tactics for years; they are the same tactics as the anti-vaxxers and for the same reasons. In both cases the fundamental issue is adulation and self-esteem.

Consider:

1. Both have a striking contempt for basic knowledge

You might imagine that Trump would find it needful to educate himself about American history, American government, the Constitution, foreign relations and a myriad of other important topics to make it clear that he is qualified to become president. You would be wrong.

Similarly, you might imagine that anti-vaxxers would find it needful to educate themselves about immunology, virology and statistics to make it clear that they are qualified to opine about vaccines. You would also be wrong.

Why? Because both Trump and anti-vaxxers are walking, talking illustrations of the Dunning-Kruger effect. That’s the paradox that those who know the least actually believe they know the most. They are so lacking in basic knowledge that they are incapable of realizing that they are lacking in basic knowledge.

2. Both are fact resistant

Both Trump and anti-vaxxers aren’t merely evidence resistant; they are fact resistant. However, a good portion of what appears to be blatant lying by Trump or anti-vaxxers is more properly described as “bullshitting.” To lie, one must be aware of the truth; bullshitting, in contrast, is a form of arrogant ignorance. Trump and anti-vaxxers often have no knowledge of a particular issue. Rather than acknowledge that (or correct it), they issue streams of blather meant to dazzle equally ignorant listeners.

3. Both embrace blatant lying when is suits them

They do lie, or course, in addition to bullshitting. Trump is a pathological liar. He proclaims what he wishes were true, even when he knows it isn’t (e.g. the invocation of a non-existent aide with a brand new Twitter account) to blame for Melania’s plagiarism of Michelle Obama’s speech. Anti-vaxxers, particularly professional anti-vaxxers, lie when convenient (e.g. pretending polio was disappearing long before the advent of the polio vaccine).

4. Both give primacy to feelings (gut, intuition) over facts

Though neither Trump nor anti-vaxxers are cognizant of the fact, they are the ultimate post-modernists, believing that reality is radically subjective. For them, reality is what they feel, and has nothing to do with an objective evaluation. It literally does not matter to them what the facts are; they believe that “listening to their gut (or intuition if you prefer) provides better “facts” than any expert or textbook.

5. Both outsource blame

Both Trump and anti-vaxxers are always sure that it is somebody else’s fault. If it’s bad, it’s not their responsibility. It’s always the responsibility of the elites or the despised (sometimes both). For every untoward occurrence (whether that is stagnation of blue collar wages or a child’s autism), neither Trump nor anti-vaxxers ever ask, “What went wrong?” Instead they faithfully resort to a different formulation: “Who did this to us?”

6. Both are desperate for adulation and self-esteem

Trump entered the presidential race for the same reason he does anything; as a narcissist he has a hunger for adulation that can never be assuaged. It is enough for him that he can bask in the glow of carefully vetted crowds of supporters. That is far more immediate and real to him than the majority of people who view him with contempt.

Anti-vax advocacy has precious little to do with vaccines or with children. The combination of self-education and defiance of authority is viewed by anti-vax parents as an empowering form of rugged individualism, marking out their own superiority from the pathetic “sheeple” who aren’t self-educated and who do follow authority. Anti-vaxxers congregate on websites and in Facebook groups that validate this distorted view of themselves.

7. Their isolation is the key to their self-regard

Trump is obsessed with his supporters because they temporarily fill the maw of his narcissistic hunger. He can’t bother to convince anyone who disagrees because he cannot tolerate anyone who does not praise him. Anti-vaxxers carefully curate their online spaces, banning and deleting anyone who dares to present science that does not support them because they can’t tolerate the idea that they aren’t knowledgeable, uniquely insightful and special; they’re simply ignorant and deluded.

Anti-vaxxers want to convince everyone that they are correct but since they cannot abide anything or anyone that does not satisfy their desperate need for self-regard, they make little headway with the majority of people who disagree with them because they can’t tolerate engaging with them.

Similarly, Donald Trump wants to be president. But since he cannot suffer anything or anyone who does not satisfy his desperate need for adulation, he can’t make any headway with the majority of people who disagree with him. At this point, he isn’t even trying; he just doubles down on the prevarication, bigotry and outrageousness that so delights his core supporters.

Donald Trump is not trying to lose this election. He would like to be president, but that desire is utterly dwarfed by his desperate need to be praised.

For hundreds of years medical practitioners were obsessed with “evil humors.”

What are evil humors?

Humoral theory, also known as humorism or the theory of the four humours, was a model for the workings of the human body. It was systemised in Ancient Greece, although its origins may go back further still. The theory was central to the teachings of Hippocrates and Galen and it became the dominant theory in Europe for many centuries. It remained a major influence on medical practice and teaching until well into the 1800s.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Detoxing is the new bloodletting.[/pullquote]

Evil humors were believed to be invisible. They constantly threatened people, and those people had no way of fending off the threat. Indeed, they were often completely unaware of the threat that was actively harming them. Practioners hypothesized that illness was the physical manifestation of evil humors that were out of balance.

Therefore:

The treatments for disease within humoral theory were concerned with restoring balance. These could be relatively benign and focused on changes in dietary habits, exercise and herbal medicines. But other treatments could involve more aggressive attempts to re-establish balance. As well as having the body purged with laxatives and emetics, or the skin blistered with hot iron, individuals already weakened by disease might be subjected to bloodletting because practitioners mistakenly believed that their bodies contained an excess of blood.

The theory of evil humors was thoroughly discredited centuries ago, but health quacks like Vani Hari, The Food Babe, continued to use them as the basis of their health advice. Vani doesn’t call them “evil humors” thought she calls them “toxins,” but the resemblance is unmistakable. They are invisible, constantly threatening people and supposedly, most people are unaware of the threat.

Since toxins are evil humors, Vani offers the modern day equivalent of treatments designed to restore balance. Chief among them are “de-toxifying” foods, drinks, enemas and cleanses.

Apparently someone pointed out to Vani that the body has two organ systems designed specifically to handle toxins, the liver and the kidneys. There is no need to anyone to use de-toxifying treatments because blood flowing through the liver and kidneys ARE de-toxifying treatments.

When the evil humors theory of disease was discredited, it’s purveyors were recognized as laughingstocks and were forced out of business. If the toxins theory of disease is discredited, Vani will be recognized as the laughingstock that she is and forced out of business.

She’s not taking it lying down.

Hence Vani’s latest post Does Your Body Cleanse Itself? Is Detoxing Really A Myth?

The scientific answers are yes and yes. Your body cleanses itself and detoxing is a myth.

But not according to Vani:

But what if I didn’t do anything to change my diet? What if I just believed the “experts” who said your body “detoxes naturally” – and there’s nothing you can do to make it detox any faster or better. What if I just listened to their advice and trusted that my body was going to be able to continue to detox itself just fine from all the soda, fast food and candy I was eating filled with a slew of controversial synthetic additives, pesticides and plasticizer chemicals from the packaging material – not to mention the daily exposure of suspect chemicals in water, air and the environment I was being exposed to … ?

Toxins are invisible … just like evil humors!

One thing is clear, we might not be able to see toxins, but they are there!

They’re everywhere … just like evil humors!

Many of them come from pesticide-sprayed food, farmed fish, and food packaging materials. Besides the food we eat, everyday items like shampoo, household cleaners, plastic bottles, clothing, furniture, water, and even the air we breathe are all possible sources of toxin exposure. It has been estimated that the average person could be harboring about 500 synthetic chemicals in their bodies, and one study found that unborn babies had over 200 toxins in their umbilical cord blood – this amount of toxins is no joke!

Your body can’t handle them … just like evil humors!

The problem is that your body can’t easily eliminate many of these toxins or break them down. They get stored in places like fat tissue and eventually make their way through your bloodstream and invade your brain, lungs, heart, eyes, stomach, liver, and sexual organs.

But don’t worry. You can treat them with special foods, laxatives and cleanses … just like evil humors!

For people who didn’t understand physiology, biochemistry and pathology, evil humors as a cause of illness made a lot of sense. They thought that people got sick because they couldn’t properly handle their humors. For people like Vani who don’t understand physiology, biochemistry and pathology, toxins as a cause of illness makes a lot of sense. She thinks people get sick because they can’t handle toxins.

Medical practitioners who worked prior to the advent of modern medicine were ignorant, but they were doing the best they could with the information they had available. Vani Hari is ignorant, but she has no excuse. The truth about human physiology is available to anyone who chooses to learn it.

Detoxing is the new bloodletting. Only a fool would think it prevents or treats illness.

 

California anti-vax parents are having a tough week. Senate Bill 277 went into effect on July 1, barring unvaccinated children from public schools unless they have a medical exemption. Personal belief exemptions will no longer be allowed.

According to The Sacramento Bee, Scores of students without vaccine proof sent home on first day of school:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Surely, if liberty is good for thee, it is equally good for me.[/pullquote]

In the Folsom Cordova Unified School District, 145 students out of about 3,200 starting kindergarten and seventh grade were sent home Tuesday on the first day of school for lack of immunization records …

A new state law that took effect July 1 eliminated personal- and religious-belief exemptions for families that opted to avoid vaccinations for their children. Under the new law, students entering the two checkpoint years of kindergarten and seventh grade are now required to show proof of vaccination…

Anti-vaxxers are appalled. It’s an issue of freedom! According to the Foundation for Economic Freedom, Mandatory Vaccinations Are Incompatible with Liberty.

Mandatory vaccinations involve a supreme violation of liberty, where agents of the state inject substances into someone’s body against his or her will. On the other side of the ledger, even in principle, mandatory vaccinations do not offer much benefit in enhanced public welfare, relative to a free society. When we throw in the realistic worries of government incompetence and malfeasance, the case against mandatory vaccinations is overwhelming.

And according to No on SB277, which opposed passage of the bill:

SB 277 eliminates a parent’s right to exempt their children from one, some, or all vaccines, a risk-laden medical procedure including death. In 2016, California parents will be forced to give their children more than 40 doses of 10 federally recommended vaccines. This open-ended vaccine mandate allows the State of California to add any additional vaccines they deem necessary at anytime. The only exemption available is a medical exemption that doctors deny to 99.99 percent of children under federal guidelines.

During their campaign opposing passage of the bill, they articulated a fundamental principle:

Where there is a risk of injury or death, no matter how small the perceived risk may be, there must be a choice.

I, too, am big believer in liberty. So anti-vaxxers, help me out. There’s something I don’t understand.

If you believe that you should be able to avoid vaccinating your children because you consider vaccines dangerous, shouldn’t everyone else in California be able avoid your unvaccinated children because they consider them dangerous?

Children who haven’t been vaccinated pose a risk because they can carry and spread vaccine preventable diseases.

How big a risk? That doesn’t matter, right? If it doesn’t matter how small the perceived risk of vaccines must be in order for you to refuse then, it shouldn’t matter how small the risk your unvaccinated children pose to their classmates, right. You insist there must be a choice.

The beauty of SB277 is that it allows you to exercise your right to protect your children from vaccines no matter how small the perceived risk may be and it allows the rest of us to exercise our right to ban your children from schools no matter how small the perceived risk may be.

Wait, what? You disagree??

Families that do not comply with the one-size-fits-all vaccine mandate, will lose their State Constitutional right for a free and appropriate education in public and private K-12 schools. The use of licensed daycare facilities, in-home daycare, public or private preschools and even after school care programs are also included in SB 277.

Duh! That’s the whole point of SB277. Since education is compulsory, without SB277 parents are forced to expose their children to the health threat of your unvaccinated children.

Any attempt by anti-vaxxers to force our children to be exposed to unvaccinated children is a violation of our liberty, right?

And surely, if liberty is good for thee, it is equally good for me.

Vitamin K refusal is in the news again.

According to WBUR:

The baby was born full-term and healthy, but now, just a few weeks later, lay limp and unresponsive, barely breathing…

“The baby was diagnosed with bleeding in the brain,” said Dr. Ivana Culic, a neonatologist …

… The parents of the baby had refused the standard shot of Vitamin K that would almost certainly have prevented that bleed.

Tragedies like these raise a thorny ethical issue: how do we protect children whose parents suffer from healthcare delusions?

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]You can’t take your baby home without a car seat; you shouldn’t be allowed to take your baby home without a vitamin K shot.[/pullquote]

Why is Vitamin K important?

Infants are vulnerable to a condition known as hemorrhagic disease of the newborn. The cause is deficiency of Vitamin K, an important component of the cascade of reactions needed for proper blood clotting.

As explained in this Medscape article:

Classic vitamin K deficiency bleeding usually occurs after 24 hours and as late as the first week of life. Classic vitamin K deficiency bleeding is observed in infants who have not received prophylactic vitamin K at birth.

The incidence of classic vitamin K deficiency bleeding ranges from 0.25-1.7 cases per 100 births…

Infants who have classic vitamin K deficiency bleeding are often ill, have delayed feeding, or both. Bleeding commonly occurs in the umbilicus, GI tract (ie, melena), skin, nose, surgical sites (ie, circumcision), and, uncommonly, in the brain.

There are approximately 4 million infants born in the US each year. In the absence of prophylactic Vitamin K shots routinely given to newborns, we would expect anywhere from 10,000 – 65,000+ cases per year. Routine vitamin K shots are literally life saving.

Sadly, some US parents embrace the fashionable delusion that vitamin K injections are harmful. It is their babies who suffer major GI and brain bleeds and the permanent injuries and deaths that go along with them.

Consider Baby Olive. Olive had been normal at birth and for the first few days afterward. Then her mother noted that she was lethargic. She immediately took Olive to the emergency room.

The next thing I knew I was sitting in a room with Eric and our Bishop from church, and seeing the doctor wheel in a computer with pictures on the screen… Just by looking, you could tell it wasn’t good. Where the left side of her brain was supposed to be, there was a huge (16 mm, to be exact) mass of blood, pushing her entire brain off center.

Dr. M. explain that a clot had developed which was placing immense pressure on Olive’s brain. Not only that, but there was bleeding on the back of the right side of her brain as well. The water pockets that are within the brain were completely destroyed, and the tissue on the left side of the brain looked mostly damaged. He said that the lack of Vitamin K in Olive’s system resulted in her body’s inability to clot. Anything as small as putting her down in her bed could have caused this bleed. Since she couldn’t clot, the bleeding didn’t stop. There had been one other case of this that the doctor had seen – I asked what had happened then, and was told that the baby hadn’t lived.

Olive was treated with vitamin K to restore the ability of her blood to clot and underwent brain surgery to evacuate the blood in her head; she made an excellent recovery. The entire disaster could have been avoided had Olive simply received vitamin K at birth.

As a general matter, we give parents wide latitude in determining the care and best interests of their children; we should! The freedom to raise your children as you wish is a critical freedom. But I would argue that we also have ethical obligations to babies like Olive whose parents embrace fashionable healthcare delusions.

Parents are free to risk their own lives by informed refusal of recommended medical care, but they don’t have the right to risk their children’s lives. Parents who refuse to seek medical treatment for deadly conditions like diabetes are (appropriately) charged with medical neglect. It doesn’t matter whether the parental delusion is that diabetes can be cured by prayer, or alternative health, or simply watchful waiting. Parents are both ethically and legally obligated to make sure the child receives medical treatment.

How about prophylactic care?

We have no problem mandating car seats when babies travel in automobiles regardless of whether parents think that car seats are helpful or harmful. You can’t take your baby home from the hospital in a car unless you have an approved car seat.

Similarly, we should mandate prophylactic vitamin K shots regardless of what parents believe about them. The facts are clear. Hemorrhagic disease of the newborn is a real threat to babies’ health and vitamin K prevents it; the benefits of vitamin K outstrip any possible risks. You shouldn’t be allowed to take your baby home from the hospital unless that baby has received a prophylactic vitamin K shot.

Parents are free to hold whatever healthcare delusions they choose, but they ought not to be free to risk their babies’ lives in service of their delusions.