Lactivists forced to acknowledge the basic tenets of Fed Is Best

White flag

“Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

These were Winston Churchill’s words in November 1940 after a seemingly endless series of defeats fighting the Germans in WWII was succeeded by a victory. There were still four years of bloody fighting and countless deaths ahead, but the first glimmers of eventual triumph could finally be discerned.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]This is not the end of the tyranny of “breast is best.” It is not even the beginning of the end. But it is, perhaps, the end of the beginning.[/pullquote]

That’s how I feel about the fact that even the most ardent lactivists have been forced to acknowledge the fundamental tenets of the Fed Is Best Foundation. No matter that the lactivists themselves don’t realize that they are now on the defensive and actually think that they are still fighting against the idea that fed is best. The first glimmers of eventual triumph of sane breastfeeding policy are coming into view.

What are the central tenets of the Fed Is Best philosophy? In my view they are:

  • Breastfeeding is just one of two excellent ways to feed a baby.
  • It is more important for a baby to be fully fed with formula than underfed with breastmilk.
  • Inadequate breastmilk is common, not rare, especially in the first few days after birth.
  • Mothers should be taught the signs of infant starvation.
  • Healthcare providers to rule out potentially deadly complications of exclusive breastfeeding INSTEAD of offering only reassurance.

These tenets are in direct contrast to the false claims made by lactivists that formula is substandard, inadequate breastmilk is vanishingly rare, infant starvation never happens, and the only thing a new breastfeeding mother needs is reassurance to continue breastfeeding exclusively no matter what happens to her baby.

Meg Nagle, the Milk Meg, who almost certainly doesn’t recognize that she is now falling back, has begun to fall back. Consider the blog post Cluster feeding…when is it normal? When is it not?.

What is cluster feeding? It’s the habit that some babies have of nursing multiple times over a few hours in preparation for an extended period of sleep. How can we tell the difference between true cluster feeding and a desperately hungry infant feeding in clusters then falling asleep due to exhaustion despite still being hungry? Sometimes it’s not easy, but it is very important because an infant feeding in clusters is at great risk for dehydration, brain injury and even death.

Even the title of Nagle’s piece is a fallback position. It was not long ago that lactivists refused to acknowledge (and some still refuse to acknowledge) that there are many women who can’t produce enough breastmilk to adequately nourish an infant, especially in the first few days after birth. For an extreme lactivist like Nagle to even acknowledge that inadequate breastmilk production is a real possibility is a victory for the Fed Is Best campaign.

The truth of the matter is that in MOST cases (statistically speaking) a baby who is unsettled and looks for the boob immediately upon putting them down (even if they just breastfed), is actually just a baby who wants to be cuddled and breastfed, not a baby who is starving. On the flip side of that, a baby who is at the breast constantly on and off all day and night and rarely doing anything but crying whether you’re holding them or not, is not normal.

Nagle goes on to describe accurate signs of a baby who is underfed:

An unsettled baby who is crying even right after being fed and immediately looking for another breastfeed, after MOST feeds…

Not having periods of awake times and sleep times as expected…

A baby who is breastfeeding for up to an hour or more at EVERY or MOST feeds, 24/7…

Of course Nagle can’t help but offer a dig at the Fed Is Best Foundation:

There are people who will state that cluster feeding is not normal (false) … The truth … is about LOOKING AT THE WHOLE PICTURE when assessing the situation.

The issue here is semantics. The term “cluster feeding” is imprecise and open to deadly misinterpretation. The average person on hearing the term “cluster feeding” is likely to assume that it means a baby who is feeding repeatedly in a short period of time. As Nagle notes, the whole picture must be taken into account when assessing cluster feeding so a term that reflects that fact would be far better. Until lactivists figure out what that term might be it makes sense to warn mothers that cluster feeding may be a sign of starvation.

Kate Tietje of Modern Alternative Mama just wrote a piece that while ostensibly criticizing the Fed Is Best Movement actually capitulates to almost every single major tenet. It’s titled Why “Fed Is Best” is the wrong approach but it actually confirms that fed is best is the right approach.

First the whining:

… At its core, “fed is best” is simply the wrong message. The bottom line for them is, not starving a baby is the most important thing. Therefore, ‘fed’ is the ‘best.’


But fed isn’t “best.” Fed is a minimum requirement for having a child. No one, anywhere, is suggesting that a child not get fed if breastfeeding isn’t possible. What they’re suggesting — what I’m suggesting — is that yes, it does matter what you feed your child.

That’s a straw man. No one is suggesting that it doesn’t matter what you feed your baby. Fed Is Best does NOT mean that goat’s milk or homemade formula is acceptable, let alone chicken McNuggets and cola. Fed Is Best means that it is more important to prevent starvation with formula than to let a baby starve on breastmilk. That’s a mouthful; summarizing it as Fed Is Best puts the point across to everyone but the willfully obtuse.

What do I mean when I say that Tietje capitulates?

Consider this:

Biologically speaking, breast milk is the optimal food for all newborns. This does not mean it is always optimal for other reasons. Some mothers are unable to breastfeed. Some babies struggle to breastfeed or are unable. Some mothers can breastfeed, but do not produce enough. Some mothers are struggling with PPD or with a history of sexual abuse.

Or this:

Fed is Best is missing the difference between “cluster feeding” and “frequent, unsatisfied feeding.” These are different!

No fooling! If the difference is so subtle that otherwise intelligent people are confused it’s a sign that the term cluster feeding is inappropriate, not that there’s anything wrong with the folks at Fed Is Best.

Or this:

When women or babies are not healthy (if baby needs to be in the NICU for any reason; if mom had a c-section and isn’t recovering well, etc.) then these mothers are at risk for lower milk supply and should be watched more closely… And of course, if it is discovered that they are struggling to produce, baby should be offered supplements so that s/he receives adequate nutrition.

Of course!

These quotes reflect the truth of the central tenets of Fed Is Best that I listed above.

So if Tietje agrees with the central tenets, then she agrees with Fed Is Best, right? She doesn’t think so:

They are attempting to explain away why some women have difficulties by saying that it essentially doesn’t matter if women breastfeed or not, and that breastfeeding can even be ‘bad’ or ‘dangerous’ for some mothers and babies.

Well actually it doesn’t matter whether women breastfeed or not; it’s a personal choice with benefits and risks to each option. Tietje has already acknowledged that breastfeeding can be bad or dangerous for some mothers and babies so there’s no pointing in denying that now.

What’s really bothering Tietje?

This is going to have the effect of convincing women who can and want to breastfeed, not to because it seems “too hard” or because they are worried about starving their babies.

That makes no sense. The vast majority of women DO try breastfeeding. They stop because it doesn’t work for them or for their babies. On consideration, the risks (or drawbacks) of breastfeeding outweigh the benefits for them. Tietje may not like it, but that’s her problem, not our problem.

It may seems that extreme lactivists like Nagle and Tietje are only taking baby steps, but having written about this issue for more than a decade, I can assure you that even baby steps are a momentous occurrence.

Obviously this is not the end of the tyranny of “breast is best” or the end of the Baby Friendly Hospital Initiative. It is not even the beginning of the end. but it is, perhaps, the end of the beginning of the fight to establish once and for all that Fed Is Best.