I read and loved The Hunger Games series of books. For those who haven’t read them or seen the movies, The Hunger Games describes a dystopian society forced each year to send some of their youngest members to the “games” that are a literally fight to the death. The leaders of the dystopian society view the games as a tool to bind society together through fear, desperation and spectacle.
I was reminded of that when I read the JAMA piece, The Hunger Games, written by pediatrician Rebecca E. MacDonell-Yilmaz, MD, MPH. Her pain is palpable:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Promoting exclusive breastfeeding and hoping that the odds of timely access to sufficient milk are in the baby’s favor is immoral.[/pullquote]
I cried the first time I fed formula to my infant son.
Many of my friends and colleagues did as well. One banished visiting family members—including her husband—from the hospital room, apologizing to her days-old little boy as she brought a bottle of premixed formula to his lips. Another had trouble latching her child but pumped doggedly for the year following his birth. When feeding him bottles of expressed milk in public, she found herself explaining to strangers—strangers who had neither asked nor even looked at her askance—that it was, in fact, breast milk, not formula. Heaven forbid they think she was giving her child anything less than the best.
She had assumed that she would never let a drop of formula pass his lips:
As a physician and as a member of a family that has largely breastfed its infants, I had no doubts that I would breastfeed any and all babies that I bore. During my residency in pediatrics, I viewed formula as an expensive and unnecessary crutch that hinted at a mother’s lack of dedication to her child. Mothers whose milk “hadn’t come in,” who struggled to achieve a latch, who began by giving small feedings of formula then tumbled face-first down the slippery slope into exclusive formula use were simply uninformed, disengaged, or even lazy.
But she realized that her son was becoming dehydrated since her milk had not yet come in:
We started with syringe feedings, unsure of how much to offer and how he would react. He slurped it voraciously, halting his crying to root in the air for more, drawing out my tears faster and faster as my guilt at giving formula titrated to guilt at having starved my son.
Formula supplementation is anathema to lactivists, both lay and professional; they insist that it interferes with breastfeeding. Yet the research shows the opposite: early judicious formula supplementation improves the chances for an extended breastfeeding relationship. Indeed, the author went on to breastfeed he son for more than a year.
Dr. MacDonell-Yilmaz, like many new mothers, had been forced to play the Breastfeeding Hunger Games for the benefits of “society.” Lactation professionals have decreed that relentless promotion of breastfeeding is the order of the day and it doesn’t matter how many babies and mothers are hurt in the process.
Those who stand by as babies suffer hunger, dehydration, starvation and occasionally death reassure themeselves that they are promoting public health though the health of individual babies may suffer in the process. The dystopian leaders in The Hunger Games also insisted that they were promoting the public good even as individuals suffered and died. But the promotion of the “public good” NEVER justifies letting individuals suffer when that suffering can easily be prevented.
The focus of hospitals on attaining Baby-Friendly status begins with laudable efforts to support mothers and babies as they learn this skill … But the moratorium on feeding babies formula “unless medically indicated” diverges into territory that I fear trades support and encouragement for guilt and shame…
Because lactation professionals have utterly lost sight of the fundamental truth of healthcare practice: a good outcome (healthy baby, healthy mother) is ALWAYS more important than the value of any biological process, no matter how much it is idealized and idolized. Fed is ALWAYS best! Starving a baby is NEVER justified. Promoting exclusive breastfeeding and hoping that the odds of timely access to sufficient milk are in the baby’s favor is immoral and inexcusable!
And it’s not just the wellbeing of the baby that counts. The mother counts, too.
Ultimately, maintaining the mental health of the mother such that she is able not only to feed but to bond with and nurture her infant should trump any debate over which combination of nutrients she provides.
There is no benefit of breastfeeding worth letting a baby starve, even temporarily. There is no benefit of breastfeeding worth letting a baby’s brain bathe in the neurotoxins of high salt (dehydration) or high bilirubin (jaundice). There is no benefit of breastfeeding worth depriving a baby’s brain of the fuel to continue working properly (hypoglycemia). There is no benefit to breastfeeding worth risking maternal self-loathing, let alone risking or exacerbating pospartum depression.
In other words, there is no benefit to society that justifies forcing babies and mothers into the Breastfeeding Hunger Games.
We must end the relentless promotion of exclusive breastfeeding. Our motto should be: her baby, her body, her breasts, her choice.
We must end the Baby Friendly Hospital Initiative immediately. It moralistic, unscientific and harmful.
And we must acknowledge the incontrovertible truth: Fed Is Best!
Thank you so much for sharing my article! I still am passionately in favor of breastfeeding if it is possible – it has led to beautiful bonding with both of my babies – but ultimately I could not agree more with your final line: Fed is Best!!
Rebecca MacDonell-Yilmaz, MD, MPH
http://www.thegrowthc.com
You’re piece is fantastic!
Well, gee, how does a parent discern that the infant had a satisfying breastfeeding session? How about prior to the nursing session the mother’s breasts are heavy with milk and yearning to be relieved of the pressure and that during the feed her breasts become noticeably softer and more comfortable. Also the infant gets that milk drunk sheen as their eyes glaze over and they roll off to sleep with milk dripping out of their mouth. The baby’s diaper is soiled several times a day with a frothy mix of yellow seedy poo..sometimes green sometimes bright neon orange. Feedings take no more than 20 minutes per side and in between feeds the infant sleeps peacefully. Looking at the infant you see skin well filled out and no shrunken soft spot on skull. Crying incessantly, nursing without frothy poos, nursing without periods of restful sleep, no feeling of full of milk breasts, no dribbling of milk from infant’s mouth are not cues to power through. They are red flags to warn of underfeeding, low milk production, low milk transfer. And the correct answer to those signs are to feed the baby. Formula is a correct infant feeding choice.
I’m not going to have children, but if I were, I’d probably feed formula, for the simple reason that it’s more reliable. You don’t have to worry about your milk coming in and accidentally starving your baby. Hell, if it’s fortified, it’s arguably better than breastmilk. Why take the risk of your precious child’s life/brain?
I’m grateful to this knowledge being out there now; when my brother and his wife start having children, depending on where they settle (they are currently in Vietnam), I hope to be able to offer information like this on it.
It’s entirely possible to breastfeed with no risk of accidental starvation, you just have to pay attention and supplement if necessary. Regular weighing of the baby is a good way to monitor, so is behavior (persistent crying during or after feeding.)
The problem is, we’re choosing NOT to monitor, or to monitor very little, and we’re choosing to ignore clear trouble signs until emergencies develop.
Exactly. My 2 were breastfed only until I went back to work, and I never worried about starving them. My son ate for 45 minutes at a time, and luckily I produced enough…no problems gaining weight there.
They were both regularly weighed, though, and I was glad for the reassurance. My daughter ate like a bird (5 minutes at a time), and wasn’t gaining as fast as her ped liked, so I was told to increase the frequency of her feedings, which I happily did. I mean, isn’t it better to *know*?
I don’t understand this trend for “less” information. Don’t monitor during pregnancy…don’t do ultrasounds…don’t test blood sugar…don’t worry about high blood pressure…don’t weigh the baby. To me, more information is always more reassuring.
I think sometimes more information is unnecessary and leads to paranoia and/or unnecessarily acting on an outlying value, but it doesn’t follow from that that no information is better. Most people with high blood pressure probably would not benefit from checking it 10 times a day and calling their doctor if it fluctuates by 5 points. But that doesn’t mean some of them might not benefit from checking once or twice a day, or every few days.
The woo-happy trend for less information, though, is a direct result of the idea that medical science treats things *wrong*. GD doesn’t really need to be addressed, you can avoid preeclampsia with diet, the answer to all breastfeeding woes is just to breastfeed, so why bother getting information that will just lead to your health care providers wanting to give you unnecessary treatments?
Not necessarily more reliable — both of my kids gained a full pound over their birthweight by their TWO week appointment. They looked like the Hulk by three months. For some of us, the milk comes easy and is apparently made of ice cream. But of course, and with good reason, one sees more of the troubling cases online! No one should hesitate to supplement, assuming clean water. Formula’s great.
OT – anybody else seen this: https://ro.pinterest.com/yourdoulabag/induction-stinks/ ? I cannot believe it, what is wrong with an induction? What’s so wrong with delivering a baby at 39-40 weeks?
ugh. As several of us can attest, waiting as long as 39 weeks can be hazardous to our health!
Besides, what kid wants a birthday -on- Christmas? You only get presents once a year. I was annoyed as a kid to have a birthday 2 weeks after. At least my family remembered my birthday separately from Christmas
I have a brother whose birthday is christmas day…we always made a point of celebrating his birthday separately, earlier in the month. 🙂
I’m 8th December- which is early enough in the month for it to be seen as separate, which means I always got lots of presents. My brother had to wait until March for his!
Ah, yes my first was due on the 21st and I was so worried I’d a Christmas baby. I talked my OB into planning an induction at 39 weeks, but was assured that she had worked the Christmas before last and no babies! It turned out not to matter as my water broke at 38 weeks. We still do birthday separate from Christmas, but it’s hard to plan B’day parties in December!
January 3 is interesting too, lol
One of DD’s friends has an Xmas birthday.
So her parents throw her party as close to 25th June as they can, as a “half-birthday”.
She gets the full cake , candles, kids-screaming-at-an-indoor-play-area experience, and doesn’t get all her presents in December.
It’s a rather lovely idea.
Mine is December 24th. I can confirm how much this blows.
My brother’s birthday is December 23. Mine is December 29. Our parents were really good about giving us Christmas AND birthday presents. My brother got (in general), stuff for his birthday and things for Christmas. I got (in general) stuff for Christmas and clothes for my birthday (after Christmas sales!). We also got to pick an activity (movie, bowling, science museum, etc) and a restaurant for supper and the choices were honored. It worked out well for us.
My SO’s little sister was born the day before his own birthday. So since she was born, their parents made them share birthday parties and such. And since the sister’s birthday was first, it was always on her date, not his. And he had to let her play with his BD gifts because it was her birthday also.
And on his actual birthday, all he got was the leftover cake of his sister’s BD party.
He’s still terribly annoyed over all of it. (His parents are very loving, but they are a little weird. My SO is full of weird/funny childhood trauma as a result)
WOW this is WAY DUMBER than I thought it would be. The Batman “let her walk around” meme is completely inane. Stalled labor is something we *know* to be dangerous, are they familiar with “history before 1950”?? Jesus.
Yes, that one struck me to … I mean … what the hell.. It’s as if they hate preventative medicine and then invent reasons to avoid it – like forcing a woman to labor 24hs. I live in an eastern european excommunist country – and my OB actually acknowledged – during a conversation where I was explaining how I want a MRCS in order to protect my pelvic floor – that in western Europe women have it worse in terms of damage to their bodies because they are left to labour hours on end with little intervention. In my country doctors are very criticised for (from mothers recounts) being to quick to c section.
I think part of the induction hate is myths about natural labor. If you found induced or augmented labor to be horribly painful, then the problem must be the induction, not that labor is actually horribly painful for most mothers. If you “caved” and got an epidural, it was because your labor wasn’t natural, and if you’d only waited, surely it would have been all-natural.
There are a few other things going on, too, but this is part of it.
Is my baby still hungry? DON’T trust the hands!
https://uploads.disquscdn.com/images/8e09914052cc1f2750e034c55aac1161faa5fb6ec03f5d918a57ceaa3ad71a8b.jpg
Exactly. A starving baby may show it by crying endlessly…or by sleeping seemingly peacefully.
My daughter with DS had low muscle tone, and she was extremely hard to wake for a feed. If I’d just looked at her hands, she likely would never have eaten at all!
My baby was frantic at first, then he started to calm down. I thought it meant he was feeding well, in fact, it just meant he he had no energy left to cry.
Meanwhile, I have a picture of him from a few days after he recovered from the jaundice and passed birth weight. He’s sleeping, happy as a clam, tight fist tucked under his chin.
Just saw a La Leche post about telling if you child is hungry by looking at their fists and seeing if they are relaxes. What? Why don’t you give the baby a bottle or weigh them before and after to make sure they are getting enough. This is getting out of hand. My second child slept all the time the first week because she was not getting enough food. The limp test and the fist test would not have worked for her. Giving her a one ounce bottle to after nursing gave me a much better idea. Now they are just making up things so that women will continue to accidentally starve their children.
A baby in a coma has limp hands.
The best lies have a little bit of truth to them.
And a logic lesson (mostly for the benefit of any lurkers who’ve never taken a formal logic class):
Say the statement if a, then b is true (conditional statement), can you say that if b, then a (the converse of the original statement) is true?
No. The converse of a conditional statement is not always true. Think of it this way:
a: I live in San Diego
b: I live in California.
The statement If I live in San Diego, then I live in California is true, but the converse, “If I live in California, then I live in San Diego”, is clearly not true.
This particular meme by the LLL is attempting to make a conditional statement true both ways, when they are clearly not. There are a special class of conditional statements called bi-conditional, but those are few and far between.
Their statements are:
a: a baby is happy and content (which means that he’s not hungry)
b: a baby has relaxed hands.
So the original conditional statement is “If a baby is happy and content then the baby will have relaxed hands.
They’re trying to say that the converse, “If a baby has relaxed hands, then the baby is happy and content” is also true.
This isn’t a bi-conditional statement. There are other reasons a baby could have relaxed hands, so the original statement is a conditional and not a bi-conditional.
It’s interesting to see them keep moving the goalposts. If you can’t say that babies don’t suffer from lack of food, or aren’t damaged by lack of food, then come up with a set of conditions that mean that no baby is “truly” hungry.
My baby who died five hours after birth had closed eyes and clenched fists for the majority of time he was alive. He was using all his energy to stay alive and try to breathe (it was his lungs that were compromised without amniotic fluid. 5 hours was an amazingly long time for a baby with Potter’s Syndrome like symptoms to survive without interventions). He likely was hungry but breathing was more important (and we weren’t going to force anything on him, we just wanted to make him as comfortable as possible with us for the time we had him with us). So once they relaxed, we knew he was near done with life.
Oh wow, I am so terribly sorry for your loss. But thank you for pointing out how dangerous this advice from LLL is.
Thank you! And everyone else too. It’s been a few years now, so it isn’t a raw pain anymore.
I’m so sorry for your loss. Thank you for sharing your experience to help others.
OMG. I’m so sorry…Potter’s Syndrome is so devastating. I can’t imagine.
my deepest condolences
I’m so sorry.
I’m so sorry you lost your sweet boy.
I’m sorry for your loss, but I’m also glad you told us about his life. He mattered. You are right 5 hours is incredibly long!
” When feeding him bottles of expressed milk in public, she found herself explaining to strangers—strangers who had neither asked nor even looked at her askance—that it was, in fact, breast milk, not formula. ”
Oh, boy did this one hit home. Even as recently as a few years ago, when I told the story of feeding YK in the store and having the stranger come up to berate me, I always made an effort to say that it was breastmilk in the bottle, not formula. It was posting here when I finally realized I didn’t have to make excuses for what I fed him, even though I’ve never once thought that formula feeding moms were somehow inferior. I just wanted to protect myself from backlash. Y’all helped me stop that, by the way. Anyway, that was almost 15 years ago. The lacitvisim has gotten a lot worse since then. I can’t even imagine the pressure new moms feel now.
I lurk at a board for relatives of Narcissists and one of the most valuable things I learned there was when someone insists on crossing reasonable boundaries you have not obligation to and in fact should not JADE. JADE stands for Justify Argue Defend Explain. Strangers who want to harangue you about the superiority of breastfeeding do not deserve your time or energy.
Some excellent tactics for defusing this kind of person include: “Wow, I’m surprised you feel comfortable saying that out loud in public!” Deadpanning “ok.” or simply walking away.
I think I know what board you’re talking about. I’ve been either a regular or a lurker on two boards that use the term JADE. I’m actually pretty good at it. During the actual situation I employed the strategy of responding with an icy glare and complete silence. It’s just that afterwards, in talking about it, I’ve felt the need to automatically explain. It took the regular contributors here to point it out. I didn’t even realize what I was doing. I’ve stopped that now.
I should have been more clear that it was a general “you.” Your response was perfect!
Did the board you’re talking about have a Toaster incident not too long ago?
I wouldn’t know. I haven’t logged into either forum in a year. I got super busy running my PPD group and stopped going to pretty much all the forums I used to visit. One had the initials EH and the other has the initials OOF.
Ah, different boards. Probably same stories though.
My favourite comeback is “how nice” (said with a sweet smile). No one can argue with that : )
E.g. “You shouldn’t be feeding your precious LO formula!”
Reply: “How nice : )”
I hear it’s common in the South to say something like ‘Bless your heart’, or ‘Oh, honey’
Oh, honey mind your own business. I think your mama is missing you.
“Oh sweetie. No.” is the northern version 🙂
“You shouldn’t be feeding your precious LO formula!” would trigger several responses from me. Anything from “Oh, it’s NOT formula. It’s Bailey’s Irish Cream. LO just LOVES it and will take a LONG nap afterwards!” to “it’s almond milk, coconut oil and turmeric” to perhaps pointing out that THEIR child is eating things it found in it’s nose or a simple shrug and walk away.
Buttinskis deserve a withering retort, sometimes.
I prefer fuck off weirdo, but fortunately or unfortunately was never in a position where I had to use that.
My beloved grandmother’ comeback is my favourite
“I was raised not to take advice from strangers, and I’m afraid we haven’t been introduced”.
You then either sweep off or pointedly ignore them.
It works beautifully.
I was binge-watching the newest adaptation of The Handmaid’s Tale. At one point, Offred describes the handmaids as “Wombs on two legs.” It pretty much describes the way these NCB/BF-at-all-costs/AP types view and treat women. Honestly, the fact that expressed milk isn’t considered to be good enough tells me that the whole movement has Jack the F Shit to do with what babies actually consume and everything to do with reinforcing the patriarchy. Well, nolite te bastardes carborundorum.
P.S. Does it help that Katniss Everdeen inspired me to take up archery? It’s pretty fun!
Loving THT (although it’s horrifying, but that’s why it’s good) not sure how far you got, but it’s interesting to me that the commander’s and their wives keep the handmaid’s after the baby is born so that the baby can nurse, but only for a short time…then they give formula. It’s just an interesting dynamic.
Side note: The system doesn’t seem very sensible for the future? The handmaid’s go to a new post when they have a baby, so surely this will lead to a new generation with a very limited gene pool? If all/most children are essentially half-siblings :/
Sorry, that was me! Disqus was being weird and wouldn’t log me in!
All caught up with it. Can’t wait for the new episode tomorrow. It looks like there will be some sort of showdown between Offred and Serena Joy.
The Handmaid system would seem to limit the gene pool, wouldn’t it? I suppose the thought was that if they didn’mt make it through the short term, there wouldn’t be a long term tomworry about. Maybe they will start marrying the girls off to commanders in other cities? The Handmaids can’t all be located in Cambridge, Massachusetts.
Yeh, it seems that it’s more than just MA that is in Gilead, but not all the states (war in Florida?)
I used to work at Gilead, which makes this conversation even more interesting…
assuming that handmaids have on average 10 children, which seems high if this is in a world where fertility is such a pervasive problem and the ‘mating’ setup is… dodgy… that’s hardly enough to cause inbreeding concerns. if it was like 5 men getting swapped around one city, then yes, but women don’t produce large enough numbers of offspring for this to be an issue- unless you keep mating the offspring to each other, generation after generation, which doesn’t really happen unless you have a society/community that is specifically enforcing that, or a very small and isolated community. a community not keeping accurate records on heredity and allowing half siblings to mate accidentally is nbg, genetically speaking, when they only share heredity w maybe 20 randos at most (10 for dad, 10 for mom)
I think the implication is that a lot of the men are also infertile, so you get a few women able to have babies with a few men. I guess if they ‘trade’ handmaids city to city and between countries you might be ok. Also, not sure how the ‘future’ generations will be chosen, which of the children will be governor’s/wives and which will be handmaids
Just to make it even more complicated its clear in the book that the majority of babies are not fathered by the husbands at all but by a (very) few doctors/servants who are both fertile and willing to risk execution, narrowing the gene pool even further.
And then also skewing any records that are kept, because the true parentage is not recorded. I guess there’s a huge amount of cognitive dissonance, and ‘magical thinking’. Interestingly, there was a discussion on another page of why, if the babies are so precious, there is so little ‘medical care’ for the pregnant women and during birth, it seems to be that they view success as a gift from God and failure as God’s Will.
Yeah, I hate to get all “here’s how to do this evil job more effectively,” but if you were all about maximizing healthy births, wouldn’t you want to abort nonviable fetuses ASAP to get the Handmaid “back into rotation”, as it were. Seriously, evil or stupid – pick one, Gilead!
If only they’d had you as a consultant, maybe they wouldn’t have been so short lived!
There is sort of tacit acknowledgement in there, I forget where, that there are logic fails going on there. Ie they’re wasting fertile handmaids on men that are, at a minimum, not known to be fertile. Most of them are older in the book which wouldn’t have helped either. Presumably not all of the handmaids managed to have sex with a convenient doctor, chauffeur etc, or at least not without being noticed. I think that’s in the essay at the end too but I can’t remember.
I wonder what they did about vaccines?
That’s the point. It’s not really about increasing the population, there are much easier ways to do that. You can offer financial rewards for families that produce babies, make daycare free, support adoption and surrogacy, offer fertility testing and at least some treatments free. Focus on male fertility, and encourage sperm donation, because one highly fertile man can produce hundreds of children.
Instead, they deliberately chose to do it in a way that strips women of any form of agency in the process, while not actually maximizing the number of offspring. The drop in birth rate wasn’t the reason for what they did, it was the excuse.
Exactly. It’s the same reasoning as the ‘pro-life’ crowd these days; you can see by their actions that their goal is not about actually reducing the number of abortions done.
Anyone remember the famous “Hobbling” scene, from Misery? Kathy Bates describes killing the workers in the diamond mines as being like “Junking a Mercedes because it has a broken spring.”
Which they say they did later in the Gilead period, in the essay at the end of the book written a couple of centuries later. They say in the mid-Gilead period they declare any marriage not contracted within the state church null. So that increases the pool too.
Definitely need to re-read the book!
I’d forgotten about that – must reread!
In the book there is another class of women who never seem to be mentioned in the films/TV series (I’ve only seen the Hulu one; don’t know if they feature in the Netflix adaptation): the econowives. They’re not talked about in the book in any great detail, but from what I gathered they’re the wives of working-class men who can’t afford to support servants and handmaids. The econowives have to “Do everything, if they can.” – they’re basically 1950s housewives. If Offred’s husband hadn’t been a divorcee, she would’ve become his econowife after the coup. Fertility is considered a rare gift in the book, but at least some of the econowives might have children. Unless the upper classes point blank refuse to intermarry with the working classes, the econowives’ children can be added to the ‘breeding stock’.
I remember them – from what I recall I think you are right – in theory they get to keep any children they have. Presumably it is possible for boys to work their way up into the elite through the ranks of the army/ eyes but its not made clear what the daughter of such a household could do to “get ahead” so I’m wondering if handmaiden might have been on the cards for fertile girls in their position.
Although, given the way that children are prized in the gilead of the book I would suspect that any econo-couple who successfully produced a child would instantly be charged with some transgression or other so the child could be stolen and adopted by the elite.
I thought the econocouples would’ve normally kept their children. If children are so prized that the elites would charge an econocouple with some transgression as an excuse to take their baby the minute it was born, then it wouldn’t make sense that they would sterilise the Jezebels; if the elites were that desperate for children then why not keep the Jezebels as fertile as nature made them and pass off any babies the Jezebels have as being the babies of transgressing econowives?
As for econodaughters: Aunt Lydia says, “In the future, no one will have to be an econowife.” In a tone which suggests econowives are pitied by the elites. But on the other hand, Offred notes elsewhere that econowives view handmaids with derision; they think handmaids are all promiscuous ladies of leisure. So I thought in the future the only women who would choose to become handmaids would be econowives stuck in marriages so bad that being a handmaid looked good by comparison.
Ok I just wanted to jump in here now that I’ve finished the finale… that dealt me *serious* emotional damage, ngl. I had my most rage-filled and most emotional moments of the whole season during that hour. Damn damn damn.
Ikr??? Evil, evil producers to finish off on such a cliffie and then make us wait 11 months!!!
Oh I hope it’s not that long to wait!