Academy of Breastfeeding Medicine publishes embarrassingly weak rebuttal to my plea to save well baby nurseries


The Academy of Breastfeeding Medicine (ABM) has just published a rebuttal to my recent piece in TIME, Closing Newborn Nurseries Isn’t Good for Babies or Moms in which I address one of the central tenets of the Baby Friendly Hospital Initiative (BFHI), rooming-in, which is ostensibly about increasing breastfeeding rates, a task that it doesn’t accomplish.

This is one of the main points of my piece:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Are we going to trot out ugly medical paternalism to insist that women can’t be trusted to know what’s good for them and their babies?[/pullquote]

Keep in mind that no one is preventing rooming in. If women want to keep their own babies in their rooms 24/7, they are welcome to do so. But that’s not enough; they insist that all women keep their babies in their rooms with them, whether they want to or not.

Apparently the folks at ABM don’t think that mothers can be trusted to make the choice they want them to make. Their response, Rebuttal to Dr. Amy Tuteur regarding Time editorial by Dr. Renee Boynton-Jarrett and Dr. Lori Feldman-Winter is embarrassingly weak, muddled and afflicted by remarkably foolish errors.

1. False dichotomy.

The ABM piece starts with the same false choice that preoccupies many apologists for the BFHI:

Thirty years ago, every newborn infant born in a US hospital was separated from their parents at the time of birth. Rooming-in was not an available option. We know now that that this standard practice was not optimal for the mother or the infant.

But the opposite of forbidding rooming-in is not MANDATING rooming in; it is ALLOWING rooming-in.

2. Red herring. A red herring is something that misleads or detracts from the issue at hand. The ABM red herring is pathetic in the extreme:

The image used by Time Magazine depicts an “unsafe” practice: several newborns swaddled in basinets on their sides sleeping. This sleep position carries more the double the risk of SIDS compared to infants sleeping on their backs.

The picture? Seriously, ladies, the picture? The picture (which I did not choose) is meant to illustrate the piece, not to accurately reflect contemporary well baby nurseries. You must be really desperate to be reduced to criticizing the picture instead of making a reasoned argument.

3. A whopper:

Rooming-in does not mean mothers cannot rest. In fact, studies show that mother’s sleep quality improves when her newborn is nearby, and sleep quantity does not diminish.

Studies show? Which ones? Oops, the authors could not manage to cite any of the studies! But worse than the fact that the authors don’t bother to provide citations is the fact that claims like these illustrate the most maddening aspect of the breastfeeding industry: they don’t listen to mothers. Women are complaining bitterly that they can’t rest when they are responsible for infant care 24/7 and they need to rest to heal from the ordeal of birth and any lacerations, stitches or surgery. But the breastfeeding industry couldn’t care less what mothers want; they are only interested in what THEY want.

4. Casual callousness:

It is unfortunate that the author believes Baby-Friendly is “deeply wounding” for those who choose to formula feed.

No, what’s unfortunate is that the authors don’t believe the MOTHERS who say that the BFHI is deeply wounding. I breastfed my four children. I did not directly experience the shaming and guilt of the BFHI but I don’t doubt the many, many women who have written to me and commented on my blog telling me that they have experienced the BFHI as shaming. But, as noted above, the breastfeeding industry couldn’t care less how mothers feel; to my knowledge, no breastfeeding researcher has ever asked them.

5. Speculation presented as scientific fact:

The benefits of breastfeeding and risks of formula feeding are anything but trivial. The establishment of the infant’s immune system and properly functioning microbiome are reliant on an exclusively breastfed diet with profound and lifelong results.

The only words in that sentence that are true are “and” and “the.” The rest is wishful thinking on the part of the breastfeeding industry, which routinely substitutes opinion for scientific evidence.

6. A lie:

There is no “breastfeeding industry.”

Really? Then why does a major market research firm publish a 56 page market analysis of the breastfeeding supplies industry? And that doesn’t even count the millions spent on lactation consultants, breastfeeding classes and promoting and implementing the BFHI. It’s an industry that’s so lucrative that market research analysts charge $2500 for the report, reasoning the members of the industry will be willing to pay that much to find out how to sell more goods and services.

7. Heartless indifference to the deaths of babies who die as a result of mandatory rooming in.

Mothers should be expected to use call bells when sleepy or having trouble transferring the newborn to the bassinet.

If you accidentally fall asleep with the baby in your bed and the baby dies, it’s your fault you didn’t call the nurse before accidentally falling asleep. That attitude is reprehensible.

8. Refusal to address the actual issue: lack of respect for women’s autonomy.

The issue is CHOICE. Are we going to treat women as if they are smart enough and capable enough to decide when they want their babies in the room and when they want to rest? Or are we going to trot out ugly medical paternalism to insist that women can’t be trusted to know what’s good for them and their babies?

The authors of this rebuttal are really grasping at straws if they have to resort to false dichotomy, a red herring, a whopper, a lie, speculation, casual callousness in response to women’s feelings, heartless indifference to preventable infant deaths, and lack of respect for women’s autonomy.

The issue is simple; the issue is choice. The breastfeeding industry does not trust women to make the decisions they want them to make so they prefer to restrict their choice.

I’m thrilled that the authors couldn’t manage anything more impressive than this. And if they thought they didn’t like my TIME piece, they are going to have an absolute fit when they see my book, PUSH BACK: Guilt in the Age of Natural Parenting – 384 pages, 256 footnotes – an extended argument on the ways in which the natural childbirth, breastfeeding and attachment parenting industries promote guilt in order to monetize it.

I just can’t wait for the ABM review!