Oops! Breastfeeding nearly doubles the risk of newborn hospital readmission

Newborn child baby having a treatment for jaundice under ultraviolet light in incubator.

For lactivists, breastfeeding occupies roughly the same place as Earth occupied for medieval Catholics in the geocentric theory.

The idea that Earth was the center of the universe was accepted an incontrovertible proof of the importance of man in God’s plan. Never mind that as scientific instruments improved it became increasingly clear that Earth and the other planets revolved around the sun. The medieval Catholic Church clung to the geocentric theory and persecuted those who opposed it because if the Bible were wrong on that point, the faithful might waver in their belief. The laity were instructed to ignore scientific evidence in favor of doctrine.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Aggressive breastfeeding promotion could lead to 60,000 excess newborn hospital admissions at a cost of nearly a quarter of a billion dollars each year.[/pullquote]

Similarly, breastfeeding is the center of the mothering universe for lactivists, accepted as incontrovertible proof of the importance of “natural” mothering to Nature’s plan. Never mind that study after study has failed to demonstrate the purported lifesaving benefits of breastfeeding and a growing body of scientific literature is making it clear that aggressive promotion of exclusive breastfeeding has substantial and deadly risks. Lactivists — and the organizations they have captured like the World Health Organization and the Centers for Disease Control — have clung to the belief that breastfeeding has major, lifesaving benefits despite all evidence to the contrary. The faithful are routinely instructed to ignore scientific evidence in favor of doctrine.

The latest addition to the scientific literature is Health Care Utilization in the First Month After Birth and Its Relationship to Newborn Weight Loss and Method of Feeding by Flaherman et al. The results are startling.

Exclusively breastfed newborns had higher readmission rates than those exclusively formula fed for both vaginal (4.3% compared to 2.1%) (p<0.001) and Cesarean deliveries (2.1% compared to 1.5%) (p=0.025). Those exclusively breastfed also had more neonatal outpatient visits compared to those exclusively formula fed for both vaginal (means of 3.0 and 2.3, p<0.001) and Cesarean deliveries (means of 2.8 and 2.2, p<0.001)

Aggressive breastfeeding promotion is making babies sick, so sick that they need to be readmitted to the hospital.

We had data on inpatient feeding for 105,003 (96.6%) vaginally delivered newborns and 34,082 (97.0%) delivered by Cesarean. Among vaginally delivered newborns, readmission after discharge from the birth hospitalization occurred for 4.3% of those exclusively breastfed during their birth hospitalization and 2.1% of those exclusively formula fed during their birth hospitalization (p<0.001)… For Cesarean births, readmission occurred for 2.4% of those exclusively breastfed during the birth hospitalization and 1.5% of those exclusively formula fed during the birth hospitalization (p=0.025)…

This was not an anomalous finding. Breastfed infants had more outpatient visits as well.

Those exclusively breastfed during the birth hospitalization also had significantly more outpatient visits in the first 30 days after birth compared to those exclusively formula fed during the birth hospitalization for both vaginal (means of 3.0 and 2.3, p<0.001) and Cesarean deliveries (means of 2.8 and 2.2, p<0.001)…

In addition to the pain and suffering of the newborns and anguish of the parents, a tremendous amount of money was spent.

…[S]ince the cost of a neonatal readmission has been estimated at $4548.27 a potential savings of $7.8 million might be realized for a cohort similar to ours if the readmission rate of exclusively breastfed newborns approximated that of newborns exclusively formula fed.

To put that in perspective, with 4 million births each year and more than 75% hospital breastfeeding rates, that means we should expect 60,000 excess newborn hospital admissions at a cost of more than $240,000,000 each and every year — nearly a quarter of a billion dollars. And that doesn’t even count the downstream impact of brain injuries, a consequence that was beyond the purview of this study.

These are impressive results of significant harm, made even more disturbing by two important facts.

1. The excess hospitalizations represent iatrogenic insults and injuries.
2. The excess hospitalizations could have been easily avoided by liberal formula supplementation.

We caused this harm and we could easily prevent it.  All it would take is a bottle of formula. That’s what the data shows, but that’s not what the authors suggest.

… Such short-term adverse consequences of exclusive breastfeeding may be viewed as representing an acceptable tradeoff given the magnitude of its reported benefits.

What reported benefits? Where is the evidence that breastfeeding reduces hospitalizations, saves lives or saves money? There is no evidence; countries with the highest breastfeeding rates have the highest mortality rates and vice versa. No one can show that changes in breastfeeding rates have any impact on mortality rates. The belief that breastfeeding has lifesaving benefits — benefits that would represent an acceptable tradeoff for 60,000 additional newborn hospital readmissions and nearly a quarter of a billion dollars in healthcare spending — is an article of faith, just like the geocentric universe.

And just like the geocentric universe was promoted by religious leaders who felt they needed it to preserve religious “market share,” the purported benefits of exclusive breastfeeding are promoted by lactivists who also feel they need it to preserve market share.

Lactivists could and should learn the lesson that religious leaders learned: no amount of lying or wishful thinking about the geocentric universe changed the fact that the sun is at the center of the solar system. And no amount of lying by lactivists about the “benefits” of breastfeeding changes the fact that the benefits are trivial, the risks of aggressively promoting breastfeeding are substantial and — unacceptably — babies and mothers are entirely preventable casualties of putting belief before science.