Antivax conspiracy thinking has become a serious public health problem. Vaccine preventable diseases, along with the illness, injury and death that they cause, are making a comeback.

Antivaxxers like to portray themselves as possessors of secret knowledge about vaccines. In truth, they don’t have secret knowledge; they have deficient knowledge. In addition, conspiracy theories are less popular among those with higher levels of education. Yet efforts to fight antivax sentiment with accurate information have been notoriously ineffective. That’s because antivax, like most conspiracy theories, isn’t about the subject of the conspiracy; it’s about the psychology of conspiracy believers.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The typical antivaxxer is someone with limited higher education, low sense of control and low social standing.[/pullquote]

Antivaccine conspiracies meet certain specific needs of believers. Inaccurate information can be swept away by accurate information, but unmet psychological needs are, not surprisingly, impervious to accurate information. Hence those charged with keeping the public healthy have an urgent obligation to understand the psychological needs that drive antivax conspiracies.

A new paper in the journal Applied Cognitive Psychology by Jan-Willem van Prooijen attempts to describe those needs. The title is Why Education Predicts Decreased Belief in Conspiracy Theories. It is about conspiracy theories in general, not antivax conspiracies in particular, but antivax conspiracies are in many ways paradigmatic.

Van Prooijen writes:

One demographic predictor of belief in conspiracy theories is education level. Various studies revealed that high education levels predict a decreased likelihood that people believe in conspiracy theories. What is unclear, however, is why this relationship emerges. Education is associated with a range of cognitive, emotional, and social outcomes, and hence, there may be multiple underlying processes that explain this relationship. Establishing these underlying processes provides novel insights that may form the basis for future interventions designed to systematically decrease conspiracy beliefs among the population.

He identifies three underlying processes that lead to belief in conspiracy theories: “belief in simple solutions for complex problems, feelings of powerlessness, and subjective social class.”

1. Cognitive complexity:

Education is associated with cognitive complexity, defined here as people’s ability to detect nuances and subtle differences across judgment domains, along with a tendency to consciously reflect on these nuances. People with high cognitive complexity are better equipped to attain high education levels; moreover, education nurtures and develops such complexity.

As H. L. Mencken explained:

For every complex problem there is an answer that is clear, simple, and wrong.

Van Prooijen notes:

The seemingly articulate nature of some conspiracy theories notwithstanding, these findings are consistent with the assertion that conspiracy beliefs are grounded in a general tendency to embrace relatively simplistic ideas… [C]onspiracy beliefs are strongly associated with a belief in simple solutions for complex societal problems.

Though antivaxxers are not children, their thinking is very childlike: A happened, then B happened; therefore A must have caused B.

2. Control:

People are particularly receptive to conspiracy theories when they lack control, and hence feel powerless. Lacking a sense of control leads to mental sense-making in the form of illusory pattern perception, that is, connecting dots that is not necessarily connected in reality. These sense-making activities are central in belief in conspiracy theories, which are designed to increase understanding of a distressing situation… [P]eople are most likely to believe in conspiracy theories in response to distressing societal events that they cannot control …

In other words, belief in conspiracy theories gives a sense of control to people who otherwise view themselves as powerless. That sense of powerlessness is exacerbated by lack of education:

Throughout an educational trajectory, people learn how to independently solve problems, and they acquire the social skills that are necessary to influence their social environment. It has been noted that, as a consequence, education makes people feel more strongly in control of their life and their social world, thus decreasing feelings of powerlessness …

3. Social standing:

Education influences people’s social standing relative to others, both in objective as well as subjective terms. Education is intimately related with people’s objective social standing in terms of socio-economic status (SES): People with high education are more likely to occupy the relatively privileged positions in society in terms of desirable jobs and high income…

…[F]eelings of societal marginalization are relevant for people’s susceptibility to conspiracy theories. Research indicates that communitarian but marginalized groups within society tend to make sense of the realistic problems that their group faces through assumptions of conspiracy formation (Crocker et al., 1999). In a similar vein, subjective low social class may lead people to blame the psychological or realistic problems that they face (e.g., alienation from the societal elite, unemployment, and relative deprivation) to the existence of malevolent conspiracies.

With these factors we can define the typical antivax conspiracist as someone with limited higher education, low sense of control and low social standing. Those factors cannot be addressed by merely offering accurate information. How can we address them?

Van Prooijen has recommendations for improving children’s critical thinking skills:

… [B]y teaching children analytic thinking skills along with the insight that societal problems often have no simple solutions, by stimulating a sense of control, and by promoting a sense that one is a valued member of society, education is likely to install the mental tools that are needed to approach far-fetched conspiracy theories with a healthy dose of skepticism.

But what about adults? That’s much more difficult because antivax functions for antivaxxers to enhance their sense of control and social standing. That’s why they are constantly parachuting into science websites and Facebook pages and — without any sense of irony — announce that they are going to educate the other readers who are generally far more educated than they.

Since the primary function of antivax for antivaxxers is to bolster their ego, it seems to me that the most effective strategy would be directed against their egos.

It’s been done before, most notably in the cases tobacco smoking and of drinking and driving. Smoking was once seen as sophisticated; now it is viewed as dirty and unhealthy. Smoking used to enhance the egos of those who smoked; it no longer does. Drinking and driving used to be viewed as inevitable and worth boasting about. Spurred in large part by campaigns mounted by Mothers Against Drunk Driving (MADD) and similar organizations, drunk driving went from being viewed as benign to utterly socially unacceptable. Driving while drunk used to have a positive or no impact on ego. Now it is a source of guilt and social opprobrium.

We should embark on a similar “makeover” for anti vaccine advocacy. When refusing to vaccinate is widely viewed as selfish, irresponsible, and the hallmark of being UNeducated, anti-vax advocacy will lose its appeal.

It’s truly one of the great existential questions of the 21st Century. Which is greater: antivaxxers stupidity or their heartlessness?

Antivaxxers latest attempt at “reasoning” involves viciously attacking a mother whose baby died of suffocation, claiming that it must have been a vaccine injury instead.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Anti-vaxxers demonstrate their derangement.[/pullquote]

As this article on Romper explains:

On the morning of July 3, Jordan DeRosier posted on Facebook that her infant son, Sloan Valor DeRosier, had unexpectedly died. She wrote a touching message …

One day later, DeRosier shared her son’s cause of death on Facebook. Not because she wanted to, but because she wanted her followers and those who commented on her post to know the correct circumstances that led to Sloan’s death. And vaccines were not to blame.

DeRosier bravely explained:

He was last laid down to bed with this blanket made by his great-great grandmother, and one other blanket, a grey one he had been attached to since birth. They took the grey one he had been found with his head in. He had pulled it through the crib rails somehow and gotten himself stuck in it. You never think it will happen to you. You never think it will be your baby. Please do not put your babies to bed with a blanket. Please. He was 7 months old, I thought because he was crawling, standing on his own, and climbing, that he would be fine with a blanket. This is the face of immense, unfathomable grief, the face of longing, of heartbreak, of self inflicted GUILT. I will NEVER stop feeling responsible. I will relive this for the rest of my life knowing EXACTLY what I could have done differently. Please learn from my world shattering mistake.

That’s why we counsel parents about safe sleep practices, including:

• Always put babies on their back to sleep for naps and at night…
• Keep babies near, but in their own crib …
• Don’t let baby sleep or nap in the same bed with anyone else … Another person, no matter how small, could roll over and smother the baby.
• Use firm mattress and a tight-fitting sheet in your baby’s crib…
• Don’t put toys, blankets, pillows, or bumper pads in the crib. These things could make it hard for your baby to breathe.

It couldn’t be clearer; blankets pose a suffocation hazard to babies. The mother put the baby to sleep with a blanket; the baby was found suffocated with his head trapped in the blanket. It’s tragically straightforward.

But not according to antivaxxers:

The grieving mother wrote:

To those who keep commenting and messaging trying to blame vaccines for our sons [sic] death- stop… I will not allow anyone to try and place blame where it does not belong.”

How did antivaxxers “reason” their way to blaming vaccines? In theIf fervid, conspiracy obsessed minds, the “logic” is obvious. A vaccinated baby died; the death must therefore have been caused by vaccines. Never mind that there was no temporal association with vaccination; never mind that the baby was trapped in the blanket; never mind that the baby died of suffocation, not fever or encephalopathy.

It’s yet another example of the breathtaking stupidity of antivaxxers, but it is also an example of their mind boggling heartlessness. How vicious do you have to be to write to a grieving mother in the wake of her baby’s death in order to promote your favorite conspiracy theory? Who does that? Only people who are desperate for validation of their stupidity.

No doubt the antivaxxers thought they were sharing their knowledge. In reality they were merely demonstrating their derangement.

Natural parenting advocates in general, and anti-vaxxers in particular, are certain about one thing: if it’s natural it must be nearly perfect.

Breastmilk is “best” because it is naturally made by the human breast.

[perfectpullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There is one human organ that does not receive the same respect as all the others: the human brain.[/perfectpullquote]

Childbirth pain is good for women because it occurs naturally in labor.

Childbirth itself is inherently safe because women were naturally “designed” to give birth.

Natural immunity is all we need to protect ourselves from disease (despite the fact that reliance on natural immunity leads to countless preventable deaths) simply because it is natural.

If natural is better — and it is always “better” — then the product of the human breast, the workings of the human uterus, and the disease fighting attributes of the human immune system must be superior.

Curiously, there is one human organ that does not receive the same respect as all the others; instead of being lauded, its products are derogated. It’s the human brain.

Despite the fact that the human brain is entirely natural, it’s workings are routinely disparaged as unnatural. This disparagement is particularly ironic when you consider that the human brain is the ultimate human organ.

The brain, more than any other organ, has allowed human beings to survive and thrive in a world where its closest hominid relatives became extinct long ago. Tool making hominids vanquished and/or outlasted all other hominid species. The human brain has allowed us to do something that no other large animal species has ever done: survive and thrive in nearly every earth environment.

Curiously, we do appear to appreciate the workings of the brains of other animals. We marvel that chimps construct tools to dig bugs out of rotting logs; we thrill to video of dolphins that have learned to work together, rounding up fish and herding them toward shore to eventually beach them, making it impossible for the fish to escape and easier for the dolphins to eat them; and we ponder the complex underwater communication of whales. All these are products of the animals’ brains and we don’t accuse those animals of behaving unnaturally when they use their brains to solve problems instead of relying on instinct and other organs.

So why have we created a false dichotomy when it comes to the human body and brain? Why do we venerate breastmilk as the natural product of the human breast, but denigrate infant formula despite the fact that it is the natural product of the human brain? Why do we extoll women who passively accept the pain of labor because it is a natural result of the working of the human uterus, but deride women who use epidurals — a natural product of the human brain — as selfish wimps? Above all, why do the antivaxxers among us extoll the limited virtues of natural immunity, the natural product of the human immune system, and deny the unlimited virtues of vaccines, the product of the natural human brain?

The truth is that vaccines, the fruit of years of scientific inquiry conducted entirely by human brains, are perhaps the paradigmatic example of natural humans doing what they do best — recognizing a problem and then using tools to solve it.

Help me understand, antivaxxers: why you practically worship every organ in the human body for what it was “designed” to do, routinely insisting that the products of each organ system are virtually perfect, yet disparage the natural products of the human brain doing what it was designed to do? When you consider that the human brain is our most distinguishing natural feature, how could one of its most spectacular products, vaccines, be anything other than natural and therefore great?

Most of the evidence for the purported benefits of breastfeeding for term infants is weak, conflicting and riddled with confounders … not to mention distorted by white hat bias. Time and again, rigorous studies have failed to confirm the breathless pronouncements of lactivists. Now a new study shows that far from preventing childhood obesity, breastfeeding seems to increase it.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Yet another claim of lactivists is demonstrated to be false.[/pullquote]

The title of the study published JAMA Pediatrics is a mouthful: Effects of Promoting Long-term, Exclusive Breastfeeding on Adolescent Adiposity, Blood Pressure, and Growth Trajectories A Secondary Analysis of a Randomized Clinical Trial.

This analysis found:

A randomized intervention that increased the duration and exclusivity of breastfeeding was not associated with lowered adolescent obesity risk or BP. On the contrary, the prevalence of overweight/obesity was higher in the intervention arm…

It is a secondary analysis of data derived from the PROBIT studies, long considered some of the gold standard studies in breastfeeding research.

The Promotion of Breastfeeding Intervention Trial (PROBIT) was designed to overcome limitations inherent in observational studies of the long-term effects of breastfeeding on child outcomes including adiposity and blood pressure. We cluster-randomized 17 046 children from 31 clinics, born between 1996 and 1997, to either a control arm or breastfeeding promotion intervention (based on the World Health Organization and United Nations Children’s Fund Baby-Friendly Hospital Initiative).

The initial data from the studies found that the only solid evidence of benefit from breastfeeding was limited to a slightly reduced incidence colds, and a slightly reduced incidence of episodes of diarrheal illness across the entire population of term infants in the first year. But lead researcher Dr. Michael Kramer believed that the data suggested that breastfeeding might have a beneficial effect on IQ and obesity.

Subsequent data from his studies and others has caused him to change his mind about breastfeeding and obesity. The data is consistent with Kramer’s previous observations:

We previously reported no evidence of a protective effect of the breastfeeding intervention on adiposity or BP at 6.5 and 11.5 years.

So one of the original proponents of the claim that breastfeeding prevents obesity found out years ago that it does not and is now emphatic in denying a connection:

An intervention that achieved substantially greater duration and exclusivity of breastfeeding in Belarus did not prevent over-weight or obesity or lower BP levels at age 16 years, despite differences in growth rates between the trial arms at various ages. On the contrary, overweight and obesity were more prevalent in the breastfeeding promotion intervention arm. While there are many reasons for promoting breastfeeding duration and exclusivity, our trial does not indicate that breastfeeding prevents obesity or lowers BP in childhood or adolescence.

Dr. Kramer does nevertheless engage in a bit of white hat bias. Had his data shown a decrease in risk of obesity in the group that was breastfed longer he almost certainly would have claimed that breastfeeding prevents obesity. But in keeping with the white hat bias of all breastfeeding researchers (that breastfeeding must be better than not breastfeeding) he does not follow where the data leads him: the possibility that breastfeeding causes obesity. I point this out not because I believe that the evidence shows that breastfeeding causes obesity (although it might), but because it highlights the profound bias in favor of breastfeeding within the scientific community.

Kramer himself has long been far more sober about the purported benefits of breastfeeding than many other lactivists.

In a 2016 interview on Canadian radio, Kramer was emphatic that breastfeeding does NOT prevent obesity, does NOT prevent allergies, and does NOT prevent asthma. When asked why lactivist organizations continue to insist on benefits that have been shown not to exist, he explained that these organizations rely upon preliminary data and simply refuse to accept anything that contradicts it. He was quite blunt that about the fact that lactivist organizations won’t accept scientific evidence that doesn’t comport with what they believe and he worries that their insistence of exaggerating benefits will undermine women’s trust in healthcare providers.

In the interview Kramer was refreshingly honest in acknowledging that public health officials underestimate the difficulties of breastfeeding. When asked whether the public health community can present the actual scientific evidence instead of the selected evidence that it prefers to present, he ruefully explained that “no one likes shades of gray,” preferring black and white pronouncements instead.

Breastmilk is food not magic.

Sadly breastmilk has been turned from food into manipulation. Lactivists and their organizations, especially the Baby Friendly Hospital Initiative, have made the harassment, inconveniencing and embarrassment of women a cornerstone of their efforts to promote breastfeeding. As Kramer himself acknowledges, most of their claims are empirically false and their efforts are beginning to backfire.

Michael Kramer, the person whose research led to the claim that breastfeeding reduces the risk of obesity, has officially withdrawn that claim. Does anyone want to bet against me when I predict that lactivist organizations will ignore the latest evidence and refuse to remove the claim from their websites and educational materials?

Lactivist organizations are certain that breast is best even when the evidence not only doesn’t support their claims but actually contradicts them. Regrettably, they are so sure of their own righteousness that they have become entirely unmoored from scientific evidence. Mothers and babies are placed at serious risk, under significant pressure, and with deadly consequences as a result.

There once was a time when all babies were breastfed … and they died in droves

You might think that people would reflect on this before promoting breastfeeding as a lifesaving panacea. Sadly, you would be wrong.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s an appalling presumption that only Western, well off, mostly white women know how to do breastfeeding right.[/pullquote]

The latest example, Breastfeeding Could Save 800,000 Children a Year, appears under Nicholas Kristof’s byline but was written by Aneri Pattani, “a freshly minted graduate of Northeastern University, is the winner of Nicholas Kristof’s annual win-a-trip contest.” She visited Nigeria.

She certainly means well:

While traveling around Liberia, I discovered a super-medicine. In a world full of intractable health problems, it’s a low-cost, practical and easily administered substance that saves children’s lives like almost nothing else.

… I’m talking about breastfeeding.

Breastfeeding is a foundation for good nutrition. It reduces child mortality by providing protection against illnesses like diarrhea and pneumonia, which kill 1.4 million children each year. In fact, by implementing proper breastfeeding practices alone, we could save the lives of 800,000 children a year in the developing world, according to estimates from the medical journal The Lancet.

Yet nearly all those children die in countries that have HIGH breastfeeding rates. Virtually none of them occur in places with clean water and easy access to infant formula.

Consider the United Kingdom where lactivists endlessly bemoan the low breastfeeding rate:

Only one in every 200 children here – just 0.5 per cent – is breastfed until the age of 12 months, placing us bottom of a global league table published in The Lancet medical …

The latest infant mortality rate in the UK — 3.6/1000 — is the lowest ever recorded.

Compare that to Liberia where over 98% of babies are breastfed for some portion of time. The infant mortality rate — 54/1000 — is 1400% higher than in the UK.

Why such a massive difference? As is distressingly typical in the neo-liberal accounting of health, Pattani blames mothers:

Myths and traditional customs often contradict best practices for breastfeeding… [M]any are also given water or solid food when they are young.

Yei Vahn, a 39-year-old mother of 12, told me she’d been giving her youngest son, Arthur, water since he was 4-months-old. “I noticed he would cry a lot when it was very hot outside, so I gave him water from the well,” she said. It’s a habit she developed while raising her 11 older children, and one that she passed on to her daughters as well.

The problem is, it is a dangerous practice. Giving a baby water, especially when it’s not boiled, can introduce harmful pathogens into the child’s system, leading to illness or death. That’s the most obvious problem, but not the only one.

It seems never to have occurred to Pattani that the traditional customs she decries might reflect very real problems with the adequacy of breastfeeding. Pattani is in good company. Though exclusive breastfeeding beginning within an hour of birth is aggressively promoted in industrialized countries, there’s no evidence that indigenous or ancient peoples followed what are now deemed to be “best practices.”

Pre-lacteal feeding (giving substances in addition to or instead of colostrum) is practiced worldwide. Indeed:

Colostrum avoidance has been reported across the globe, in varied places such as India, Nepal, Bangladesh, Indonesia, West Java, the Philippines, Vietnam, Thailand, Bolivia, Guatemala, Guinea-Bissau, Nigeria and Tanzania. Using the term ‘delayed breast-feeding’, Morse et al. found that fifty of 120 cultures described in the Human Research Area Files ‘withheld’ colostrum.

Obviously we cannot know the original reasoning behind the practice, but odds are high that it reflects the fact that 5-15% of women (or more) have insufficient or delayed production of breastmilk. Without supplements, those babies would have died of dehydration. With pre-lacteal feeds, babies lived who would otherwise have died. Over time, that observation was transmuted into a belief that colostrum was harmful and supplements were lifesaving.

The same reasoning may apply to supplementing breastfeeding with water or other substances. The mother quoted above (who has 12 children) explained that she supplemented with water because her baby cried for it when it was particularly hot. In other words, he appeared to her to be dehydrated and she couldn’t produce enough milk to prevent dehydration.

But Pattani, like most of those who promote breastfeeding as lifesaving, ignores reality in favor of blame:

The challenge for breastfeeding in very poor countries is not so much the use of infant formula, which is more of a problem in nations just a bit better off. In the poorest countries, very few have the money to buy formula.

Rather the problem is that breastfeeding isn’t done quite right. Moms delay breastfeeding after birth. They offer the baby sugar water or tea, cassava or fruit, well before six months — or they stick to exclusive breast milk too long.

A mother who has breastfed 12 children, comes from a culture where 98% of babies are breastfed, and has never been influenced by formula manufacturing isn’t doing breastfeeding quite right? Apparently only Western, well off, (mostly white) women know how to do breastfeeding “right.” The presumption is appalling.

No one seems to see what is right in front of their faces: it isn’t mothers who are deficient, it is breastfeeding. It is simply assumed that Liberian mothers who supplement are ignorant when the reality is more likely to be that breastfeeding is not the perfect process that lactivists pretend. Breastfeeding, like conception and pregnancy, is very imperfect. Infertility is far from rare and 20% of established pregnancies end in miscarriage. The rate of inadequate breastmilk supply may not be as high, but it’s high enough to cause significant rates of infant death. Supplementation is not an ignorant custom practiced by backward women, but a reasonable response to a very common problem.

Babies die because the water and other substances used for supplementation are contaminated (as they inevitably are in nature). Supplementation is a bad solution to a serious problem — insufficient breastmilk. Pattani, in company with most lactivists, simply assumes that all Liberian women could breastfeed exclusively, but choose not to do so. She further assumes that if women didn’t supplement (with contaminated water), their babies would be healthier. It is equally possible that their babies would be dead due to dehydration or starvation.

That’s why the Lancet’s claim that 800,000 lives could be saved each year if all women breastfed exclusively is both heartless and witless, not to mention unproven. The Lancet arrived at that figure by extrapolating from small studies. There is simply NO EVIDENCE that breastfeeding rates have any impact on infant mortality rates. And why would they? Breastfeeding didn’t prevent an astronomical infant death rate prior to the advent of sanitation, vaccinations and antibiotics. There’s no reason to think it would prevent astronomical death rates now.

The Lancet’s claim that breastfeeding could save 800,000 lives per year is wrong on so many levels. It is not supported by population data; it is not supported by historical evidence; and it is not supported by the fact that most babies die from causes that cannot be prevented or cured by breastmilk. But what bothers me most about the Lancet claim is its implicit medical colonialism: look at the poor women of color breastfeeding “wrong.” Watch their Western, wealthy (and mostly white) sisters “teach” them how to do breastfeeding right.

It is a terrible tragedy that Liberian babies are dying in such high numbers. But the truth is that they are dying for lack of access to formula made with clean water, lack of access to vaccines, lack of access to antibiotics, not from lack of access to breastfeeding. If we want to save those young lives we should send water purification facilities and clean water, vaccines and antibiotics, not lactivists pontificating about perfection of a process, breastfeeding, that is imperfect to a deadly extent.

Kimberly Sears Allers is shocked, shocked, that fear is being used in discussions of infant feeding.

Her piece on Lactation Matters, the blog of the International Lactation Consultant Association, is part of the new #FactsNotFear lactivist campaign created to combat the message of the Fed Is Best Foundation that breastfeeding has risks as well as benefits.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Lactivists are bewailing the very tactic that they pioneered, exploited and spent millions of dollars promoting.[/pullquote]

Sears writes:

But there is one place where fear should not exist. There is one area, where, as women and
mothers, that we should insist that fear not enter—that is in the precious act of feeding our babies…

That’s why a recent spate of fear-based marketing, particularly from the Fed Is Best Foundation, stoking fears that exclusive breastfeeding kills babies is both erroneous and irresponsible. But it is also the type of insidious marketing that preys on a mother’s existing insecurities that should make all women concerned…

Excuse me while I catch my breath from laughing so hard. Using fear to pressure women into breastfeeding is a deliberate tactic beloved of lactivists. Indeed, lactivists are now bewailing the very tactic that they pioneered, exploited and spent millions of dollars promoting.

Lactivists have been completely upfront about their use of fear to pressure women into breastfeeding. It was first articulated by lactation consultant Diane Weissinger in a seminal paper, Watch Your Language!, in 1996. It’s a blueprint on using fear to pressure women to breastfeed.

Weissinger saw a problem.  For many women, the benefits of breastfeeding simply aren’t great enough to overcome the difficulties and inconvenience:

When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding …

She proposed that lactivists pressure women to breastfeed by promoting fear of the risks:

The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus”; but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial baby milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.

For example:

…[B]reastfed babies are not “healthier” artificially-fed babies are ill more often and more seriously. Breastfed babies do not “smell better”; artificial feeding results in an abnormal and unpleasant odor that reflects problems in the infant’s gut.

Lactivists fully embraced fear based tactics for 20 years, until it turned out that breastfeeding has risks that women should fear — risks of dehydration, jaundice, starvation and death. In fact, we can point to literally hundreds of term babies injured annually by aggressive breastfeeding promotion, while we can’t find even a single term infant whose health has been substantially improved or whose life was saved by breastfeeding.

That’s why the hypocrisy of Sears Allers is so mind boggling.

Let’s face it, women are sold fear and anxiety as a marketing tool every day. In fact, the strategy, officially known in business circles as FUD—fear, uncertainty and doubt—was designed by an IBM executive decades ago to persuade buyers to feel “safe” with IBM products rather than risk a crash, virus or server disruption.

Let’s face it, women are sold fear and anxiety as a marketing tool by lactation consultants and lactivist organizations every single day. Lactivist tactics are a paean to FUD — fear, uncertainty and doubt. Women are told to fear the “risks” of formula feeding, to replace their conviction that their babies are starving on breastmilk with uncertainty about their own worth as women, and to doubt their ability to be good mothers if they don’t breastfeed.

Even while decrying fear based tactics, Seals Allers can’t stop resorting to fear based tactics:

The truth is, our bodies were uniquely made to feed the infants we create. Decades of scientific research proves that formula is nutritionally inferior to breastmilk.

The truth is that that our bodies were uniquely made to get pregnant, but that doesn’t prevent a nearly 20% infertility rate among couples; we’re uniquely made to carry babies to term, but that doesn’t prevent a natural miscarriage rate of 20%; and while we are uniquely made to breastfeed, that doesn’t prevent a high rate of infant dehydration, jaundice, starvation and death.

Seals Allers doesn’t hesitate to resort to claims contradicted by scientific evidence:

It’s no secret that, especially in the Western world, women already fear they will have insufficient milk. For some, this fear can become a self-fulfilling prophecy because fear and anxiety can literally limit lactation by stifling the letdown reflex that stimulates the milk glands.

There is no scientific evidence that fear of insufficient milk causes insufficient milk. Indeed, research shows that when women believe they have insufficient milk it’s because they do. In fact, new research shows that there may be a biomarker for low supply.

High levels of sodium in breast milk are closely associated with lactation failure. One study showed that those who failed lactation had higher initial breast milk sodium concentrations, and the longer they stayed elevated, the lower the success rate.

Another paper, The Relation between Breast Milk Sodium to Potassium Ratio and Maternal Report of a Milk Supply Concern, published in April 2017 noted:

…[T]he observed prevalence of elevated Na:K was 2-fold greater in the mothers with milk supply concerns (42% vs 21%)… This result challenges the belief that milk supply concern in the context of exclusive breastfeeding is primarily maternal misperception. (my emphasis)

Sears Allers concludes her piece with a flourish of hypocrisy:

Ultimately, women deserve facts not fear. Women have a right to guilt-free, confidence-building information and support.

Women have the right to the truth and the truth is that breastfeeding has very real, deadly risks.

#FactsNotFear indeed!

Is there anything more emblematic of white privilege than medical colonialism?

Colonialism is the practice one country occupying another country or region and exploiting it for the benefit of the occupier. Medical colonialism is the practice of exploiting black bodies, knowledge and practices and co-opting them for the benefit of the well off white people.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”Invoking simple, contented black women who function based on instinct not intellect is racism, pure and simple.[/pullquote]

Classic examples of medical colonialism come, not surprisingly, from medicine. The Tuskegee experiments, when black men with syphilis were deliberately left untreated, are the most egregious example, but medicine has plenty more including the story of Henrietta Lacks and the use of her HeLa cells for research, and the work of gynecologist J. Marion Simms, who practiced on female slaves to perfect his techniques for repairing obstetric fistulas.

Lactivists have enthusiastically embraced medical colonialism and today’s piece on NPR is a paradigmatic example. Entitled Secrets Of Breast-Feeding From Global Moms In The Know, it romanticized the lives of “primitives” in order to justify the practices of the privileged.

It’s almost like in the U.S. we’ve lost the breast-feeding instinct. That Western society has somehow messed it up. [Evolutionary biologist Brooke] Scelza wanted to figure out why: What are we doing wrong?

So a few years ago, she traveled to a place with some of the best breast-feeders in the world.

In the desert of northern Namibia, there’s an ethnic group that lives largely isolated from modern cities. They’re called Himba, and they live in mud huts and survive off the land…

Moms still give birth in the home. And all moms breast-feed.

“I have yet to encounter a woman who could not breastfeed at all,” Scelza says. “There are women who have supply issues, who wind up supplementing with goat’s milk, which is not uncommon. But there’s basically no use of formula or bottles or anything like that.”

And Himba women make breast-feeding look easy, Scelza says. They even do it while they’re walking around.

See the simple, contented black women who function based on instinct not intellect!

What’s their secret to instinctual breastfeeding? It’s the same as their secret to in homebirth. They and their babies die in droves.

According to USAID, the infant mortality rate in Namibia is 32.8/1000 and maternal mortality is 265/100,000. In the US, The infant mortality rate is 5.82/1000 and the maternal mortality rate is 26.4/100,000.

Their secret is that instinctual birth and instinctual breastfeeding leads to an infant mortality rate 450% higher than in the US (where we have easy access to formula) and 900% higher than in the US (where we have easy access to obstetric interventions).

It is reprehensible that the NPR article doesn’t even mention infant mortality, let alone address it, but it is typical of medical colonialism to ignore the appalling rates of suffering of black babies and mothers. Instead, we are treated to cluelessly racist “happy, simple black people” version of life in nature.

One idea is that the mom and her newborn have long, uninterrupted contact right after birth. Since women are at home, there are no doctors and nurses whisking the infant away for weighing, fingerprinting or tests. This contact allows the newborn’s suckling instincts to kick in, researchers have hypothesized…

Or maybe it’s because when limited to exclusive breastfeeding, babies just die.

The second hypothesis is that Himba women learn how to breast-feed throughout their childhood. Because women see their moms, siblings and friends breast-feed while growing up.

“Breast-feeding in public isn’t stigmatized at all,” Scelza says.

So by the time they have their own babies, Himba women know what to do and it appears instinctual. Here in the U.S. we hardly ever see mothers breast-feeding. So women never really learn.

Or maybe it’s because when limited to exclusive breastfeeding, babies just die.

Well, turns out both hypotheses aren’t quite right.

“I’m telling you that’s exactly what I thought was going on until I started to talk to Himba women,” Scelza says.

A few years ago, Scelza interviewed 30 Himba women in depth about their experiences breast-feeding, especially in the first few days after birth. And guess what? Himba women are a lot like American women…

Two-thirds of the women said they had some problems at the beginning, such as pain, fear, troubles getting the baby to latch and concerns about the milk supply — just like American moms…

“Most women talked about having little knowledge about early infant care, such as how to hold babies or how to be sure they’re sleeping safely,” Scelza says.

So how do the Himba get over these problems? They have a secret weapon many American women don’t, Scelza says: Grandmothers.”

And yet when limited to exclusive breastfeeding, babies die in droves.

Prof. Scelza and NPR are practicing casual medical colonialism, exploiting black bodies, knowledge and practices and co-opting them for the benefit of well off white people. Scelza and NPR actually think the major issue here is how to increase breastfeeding rates in American women (a preoccupation of Western, well off, white women) and ignore the REAL issue here, how to decrease the infant death rate among the Harimba people. But what’s few dead black babies when you are trying to convince white women to breastfeed? Not even important enough to mention, apparently.

“I think that there’s enormous pressure to succeed with breast-feeding in the U.S. and that you feel like if you can’t do it that this is a huge failing as a mother,” Scelza says. But Himba women didn’t seem to think the problems related to breast-feeding were a big deal.

It’s hard to imagine how Scelza and NPR could be more racist if they tried.

People who venerate the natural imagine that this is nature.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The cute baby zebra is perfectly designed to be lunch for lions.[/pullquote]

It’s a cute little baby zebra, galloping with the herd. It’s perfectly designed to keep up with it’s mother. Born from her body, it was perfectly designed to stand within an hour of birth. It’s nourished by its mother’s milk, perfectly designed to meet its nutritional needs. But that’s a blinkered picture of nature, literally. Indeed, it was cropped from this image. Note the lion on the attack.

Because the sad truth about the cute baby zebra is it’s perfectly designed to be lunch for lions, and that’s what happened to it.

Advocates of natural parenting, natural eating and natural healing wax rhapsodic about the perfection of nature. But that’s because they imagine that the blinkered view they prefer is reality when it is nothing more than a comforting fantasy.

Focusing on the individual animal (or human) leads them to make statements like, “women are perfectly designed to give birth,” “breastmilk is the perfect food for babies” and “natural immunity is the best way to protect ourselves from diseases.” In contrast, if you zoom out to encompass the entirety of nature, it is obvious that nature doesn’t create perfection; it leads to the survival of only the fittest.

Zebras aren’t perfectly designed to survive until adulthood. By some estimates, as few as 27% of baby zebras survive their first year. Only the fittest — fastest, quickest to bolt, strongest — survive. What makes some baby zebras fitter than others? It’s genetics, their’s, their mothers’ and their herds’. Genetics makes some baby zebras faster than others. Genetics allows some zebra mothers to produce more milk than others. Genetics makes some herds collectively better adapted to their environment than others.

Remember the old joke: “How fast do you need to be to avoid getting eaten by a lion?” The answer: “Faster than the other guy!”

The same thing applies to baby zebras. The 27% of baby zebras who survive don’t do so because they are perfectly designed but merely because they are fitter —faster, quicker and stronger — than the 73% of baby zebras who didn’t make it.

Evolution isn’t merely acting on zebras, either. It is acting on all of nature including lions, for whom zebras are ideal prey. Evolution favors lions who are the fastest, quickest and strongest on the plain, and every increase in lion fitness comes at the expense of zebra survival.

If you look at the baby zebra in isolation, you might be fooled into thinking it is perfect. When you pull back to the wide angle view you can see that most baby zebras aren’t even “good enough” to survive, let alone perfect.

Similarly, women aren’t “perfectly designed” to give birth. In fact there’s a mismatch between what is perfect for the baby (to be born as late as possible with the largest brain size as possible) and what is perfect for women (to give birth as early as possible to the smallest size baby as possible). Evolution doesn’t ensure that all babies and all mothers will survive childbirth. A significant proportion will die and only the fittest survive childbirth. And just because they were fittest for childbirth doesn’t mean they are fittest for life outside the womb.

Modern obstetrics has changed that. Since surviving childbirth is entirely independent of surviving childhood, adulthood and old age, it only makes sense to employ childbirth interventions to save babies and mothers who would otherwise die. If you look at an uncomplicated vaginal birth in isolation, you — like natural childbirth advocates — might be fooled into thinking that childbirth is perfect. When you pull back to the wide angle view, the view that shows you the millions of children and mothers who routinely died in childbirth, you can see that childbirth is hardly an example of natural perfection.

Women aren’t “perfectly designed” to breastfeed. A substantial proportion of them aren’t capable of producing enough breastmilk, not because of “lack of support” but because of genetics. Babies aren’t perfectly designed to nurse at the breast, either. A significant proportion don’t have enough strength or muscle tone to extract what they need from the breast. In nature, they die. Today their mothers can pump breastmilk for them or give them formula. If you looked at a single baby who successfully nursed into toddlerhood you — like lactivists — might be fooled into thinking that breastfeeding is perfect. When you pull back to the wide angle view, the view that shows you the astronomically high infant mortality rate in nature, you can see that breastfeeding is hardly an example of natural perfection.

The same thing applies to vaccine preventable diseases. If you look at unvaccinated adults who survived childhood diseases unscathed you — like anti-vaxxers — might be fooled into thinking that natural immunity is all that we need. When you pull back to the wide angle view, the view of cemeteries filled with children and adults who routinely died from vaccine preventable diseases, it makes it crystal clear that natural immunity is far inferior to vaccine induced immunity.

Natural childbirth advocates, lactivists and anti-vaxxers have a profoundly blinkered view of nature. Imagining that natural childbirth, breastfeeding and natural immunity are perfect is no different from imagining that all baby zebras are designed to survive lion attacks … and just as foolish.

Australian midwife Lisa Barrett is standing astride a pile of tiny dead bodies and … laughing. Apparently dead babies are hilarious.

Barrett has presided over the death of at least six babies, the five I wrote about earlier this week and a sixth that remains unnamed. You might have thought that would have sobered her. You’d be wrong. She was recently arrested for manslaughter in the deaths of two babies under her care. You might have thought that would finally sober her. Wrong again.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Even among a group of women notorious for their callousness and narcissism, Lisa Barrett stands apart.[/pullquote]

As a condition of her bail, Barrett was required to take down her website Homebirth: A Midwife Mutiny. Instead she redirected it to the photo above. It’s a picture of comedians Laurel and Hardy. Barrett title the phot “silenced” and, in case that was too subtle for you, named the page “Lisa Be Quiet!”

Well she certainly showed us, didn’t she? The rest of us may be horrified and grieved by the preventable death of six babies, but Barrett thinks the dead babies are a joke. The only thing she’s worried about is her “right” to let babies die.

Barrett herself appears to be widely despised within the midwifery community, not because of the dead babies, but because of her personality. Nonetheless, she does have some defenders.

Consider this overwrought verbiage from American “traditional birth attendant” midwife Maryn Green in The Time Has Come For Women To Stand Up And Speak:

This blog post is in support and solidarity of Lisa Barrett; a mentor and friend who is being persecuted in Australia for supporting women in birth. Lisa is/was one of the most genuine, humble and brilliant women I have ever met. I want her to know, from across the world, that she is supported and loved. Midwifery is the worse for her not in it, and the price we will pay for her persecution is huge.

Who cares about dead babies? Certainly not Maryn. In a 1200 word piece Green doesn’t mention even one of the dead babies even once. Why would she? She cares only about herself and her sister midwives.

We see our sister midwives being hunted, being chased, searched, thrown in jail, their phones being tapped. It’s enough to scare most people from even considering midwifery as a hobby, much less a full time passion. We see “her,” Lisa Barrett, persecuted and we shrink back in fear.

How could homebirth midwives be so callous? All too many of them bear a striking resemblance to sociopaths.

WikiHow has an illustrated guide to spotting a sociopath. It’s a bit tongue in cheek, but the basic characteristics are all there.

1. Someone is dead or severely injured and the homebirth midwife has no remorse.

Look for a lack of shame. Most sociopaths can commit vile actions and not feel the least bit of remorse… If the person is a true sociopath, then he or she will feel no remorse about hurting others …

Most obstetricians, midwives and obstetric nurses are devastated by an obstetric death. There is tremendous grief, anxiety and soul searching. Could we have saved that baby or mother if we had done something different? Did we make a mistake? Providers may give up obstetrics in the wake of a death. If they feel they are responsible, some will go so far as to commit suicide.

Many homebirth midwives respond in the exact opposite way. They can give a long exposition about their legal woes without once mentioning the fact that a baby is dead, let alone mentioning the name of the baby or the circumstances of the death.

There is no soul-searching, no root-cause analysis. The death is dismissed with a callous, “Some babies are meant to die.” or “Babies die in the hospital, too.”

I’ve never seen a clearer expression of homebirth midwives’ bone chilling lack of concern for dead babies than this quote from Geradine Simkins, former President of the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, in From Calling to Courtroom; A Survival Guide for Midwives:

You know, babies die; it’s part of life. And only those entrenched in the bio-technical model think that that it doesn’t, or shouldn’t happen. I have traveled extensively in other countries, mostly developing nations, and people understand this reality elsewhere. I once arrived at the house of a midwife in another country the morning a baby had died in a homebirth. I found that the family had embraced the midwife and was so grateful to her—because the mother did not die. They were understandably sad about the baby, but families expect that a baby might die. A mother dying is considered beyond tragic. It’s a matter of perspective.

2. The homebirth midwife refuses to accept any blame and lashes out at any attempt to hold her responsible.

When a sociopath does something wrong, he or she is likely to accept none of the blame and to blame others instead.

Or worse, she is likely to cry “persecution,” setting up Facebook pages and fundraising campaigns to solicit support and money.

Want to get money from other homebirth advocates? Just let a baby die!

A homebirth midwife who is alleged to have presided over the death of a very premature baby after insisting that homebirth would be fine, interfered with an ambulance crew trying to rescue a hemorrhaging mother, lied on medical records, and MAY HAVE MULTIPLE DEAD BABIES BURIED ON HER PROPERTY, is the beneficiary of a fundraising campaign.

An unlicensed homebirth midwife who was arrested for presiding over a homebirth death AND prostitution received enough donations to “free” her that she could make bail, and then violated the terms.

There appears to be no death so appalling and no circumstance so egregious that homebirth advocates will not rally to support the midwife … not the parents.

3. Homebirth midwives do not learn from their mistakes.

Sociopaths do not learn from their mistakes and repeat the same ones again and again.

Homebirth midwives learn nothing from a disaster or death, refuse to accept any blame and lash out at any attempt to hold them responsible. Inevitably, some will go on to preside over additional deaths. The average obstetrician may lose 1 or 2 term babies in a 40 year career encompassing thousands of births. There are quite a few homebirth midwives who have lost 2 or 3 babies in less than a decade, encompassing 100 or 200 births, if that. Lisa Barrett has lost at least 6 babies from 2007-2012.

MANA, the Midwives Alliance of North America, which represents homebirth midwives has LITERALLY no safety standards, so there is no teaching about safety. There’s no reason to have safety standards when safety is not important.

4. Homebirth midwives have no compunction about lying to protect themselves.

Sociopaths are perfectly comfortable going through their lives telling a series of lies. In fact, true sociopaths are uncomfortable when they are telling the truth. If they are finally caught in a lie, then they will continue to lie and backpedal to cover up the lies.

Indeed From Calling to Courtroom includes advice on lying in specific situation.

In the future my motto is, “No witnesses”…  For those midwives who do carry Pitocin, I would advise them to never admit it to anyone who has the ability to testify (that is, anyone except your husband). If a midwife ever feels the need to inject Pitocin or administer any kind of drug, such as Methergine, she should refer to such substances as “minerals.”

5. Homebirth midwives are emotionally manipulative.

Sociopaths understand human weakness and exploit it maximally. Once determined, they can manipulate individuals to do just about anything. Sociopaths prey on weak people and often stay away from equally strong people; they look for people who are sad, insecure, or looking for a meaning in life because they know that these people are soft targets.

 

There are just the highlights of sociopathy, but even a quick perusal suggests that homebirth midwifery (and doctors who support homebirth midwifery) has more than its share of sociopaths. These are people who preside over deaths and serious injuries of babies and mothers, but express no remorse, refuse to accept any responsibility, consider efforts to hold them accountable to be “persecution,” lie repeatedly to protect themselves, emotionally manipulate clients and refuse to learn from their deadly mistakes.

But even among a group of women notorious for their callousness and narcissism, Lisa Barrett stands apart.

Finally!!

We’ve waited a long time for the image above. It’s photo of homebirth midwife Lisa Barrett in handcuffs, arrested in connection with the deaths of babies in her care.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]She faces a maximum sentence of life in prison.[/pullquote]

Controversial homebirth advocate Lisa Barrett has been granted bail after she was charged with two counts of manslaughter on Tuesday.

As part of her bail conditions, Ms Barrett cannot undertake or promote midwifery. She also cannot be present at any birth.

Deputy Chief Magistrates Andrew Cannon ordered Ms Barrett not to contact witnesses, and to take down her homebirth website, reported the Advertiser.

She was released on $10,000 bail with her husband Jeremy as guarantor.

Barrett has presided over at least 5 homebirth deaths from 2007-2012, been scathingly reprimanded by a Coroner and been the subject of an Australian Supreme Court case.

In the wake of the deaths it was thought that a criminal prosecution of Barrett would be unsuccessful, but then evidence of a cover up was found, involving alleged destruction of evidence and alleged perjured testimony directed by Barrett.

Barrett’s actions nearly defy belief.

Tate Spencer-Koch, Jahli Jean Hobbs, Sam, Tully Kavanaugh and Ian died because Lisa Barrett minimized the risks of homebirth when counseling their mothers, all of whom were at high risk for complications. Of these deaths, 1 was a shoulder dystocia, 2 were second twins, and 2 were breech babies. They died because Lisa Barrett could not handle the complications that were predicted. They died because their mothers did not have the Cesareans that would have saved the babies lives.

The practice of homebirth is notable for its recklessness, but even so Lisa Barrett was in a class by herself. During the Coroner’s inquest into the deaths of Tate and Jahli Jean, Barrett was caught live tweeting the proceedings and offering scathing comments about the prosecution’s case. If that weren’t contemptuous enough, Barrett also managed to find the time to attend Tully’s homebirth death. As a result, the Coroner’s inquest was expanded to include both Tully’s death and Sam’s death.

The report, released in 2012 was scathing in its assessment of Barrett’s conduct, including:

• idiosyncratic views as to risk.
• the seemingly unshakeable dogma that an adverse outcome in the homebirth setting would inevitably have occurred in a hospital setting in any event and that the professional services that are available within a hospital would not have altered the outcome.
• Ms Barrett’s tendency to contradict or deny established evidence-based opinion.
• Ms Barrett’s general position [on macrosomia] is at odds with the written material that Ms Barrett herself produced in evidence.
• Much of Ms Barrett’s evidence about the desirability or otherwise of a vaginal delivery of a breech birth in the home setting was premised on a number of questionable views that she steadfastly appears to hold.
• Ms Barrett went so far as to say that it would be impossible to tell whether a planned caesarean section would have resulted in the child being born alive. She goes so far as to suggest that the risks associated with caesarean section are higher than the risks of vaginal birth and that the risk associated with caesarean section and the morbidity and mortality of breech is the same in vaginal birth and caesarean section … This opinion is simply manifestly incorrect. It causes me to doubt the genuineness of other assertions made by Ms Barrett …

To my knowledge, during the years when these deaths were taking place, up to and including the time during which she was being investigate, Barrett never expressed remorse for these deaths. Indeed, she primarily felt sorry for herself, as she expressed on her blog Homebirth: A Midwife Mutiny:

They have raided my house so I no longer have a computer or a telephone, my husband can’t carry on his business as they took his computer and the children can’t do their school projects as they took their computer too… All for a political agenda, to scare and humilitate…

Nonetheless, in the wake of a $20,000 fine, Barrett appeared to have given up attending births and apparently believed that the babies’ deaths had been forgotten.

As she returned to her picturesque Adelaide Hills property of five years without comment last night, her distressed children told how the family had “thought it had all blown over” and had been shocked by the dawn raid.

Apparently it hadn’t “blown over.”

If convicted, Barrett faces a maximum sentence of life in prison. Considering at least 5 babies are dead at her hands, that doesn’t seem excessive.