Why does lactivist Prof. Amy Brown keep lying about breastfeeding physiology?

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One of the most distressing things about breastfeeding advocates is the cavalier way in which they dismiss the suffering of starving babies. It bears an uncomfortable resemblance to the way that drug companies cavalierly dismiss the suffering of patients when they learn of deadly side effects of medication. Both promote profits ahead of people.

For example, Vioxx is a non-narcotic medication that had dramatic benefits for a certain population of pain sufferers and, as a result, was a reliable money maker for Merck. But it also had serious side effects that Merck tried to hide in an effort to maintain market share. Merck lied and patients died.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The breastfeeding industry continues to lie and babies continue to suffer brain injuries and die.[/pullquote]

That’s how you can tell the difference between medical professionals and businesses. When real medical professionals learn about harm from their recommendations, they investigate and try to mitigate that harm. When businesses learn about harm from their recommendations, they issue denials that misrepresent or lie about the scientific evidence.

Breastfeeding is a biological process with small benefits for term babies, but because of exaggeration it has become a reliable money maker for the breastfeeding industry of lactation consultants, La Leche League and the Baby Friendly Hospital Initiative among others. But it also has serious side effects that the breastfeeding industry is trying to hide to maintain market share. The breastfeeding industry lies and babies die.

Consider the latest lie from lactivist Prof. Amy Brown, a psychologist by training who has no education in physiology:

#1 There is a misleading post circulating suggesting a newborn’s stomach is larger than medical textbooks say it is. It suggests that the volume at 40 weeks could be 33ml rather than approx 7ml. Based on this it incorrectly claims colostrum is not enough and top ups are needed.

#2 There are many things wrong with this. These figures are taken from 1 baby during an ultrasound. They measure an emptier stomach and then the stomach 15 mins later when the baby has swallowed amniotic fluid. Scientists do not make decisions based on 1 baby or 1 set of measures

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Brown’s lie is chilling on a variety of levels.

1. A real medical professional would start by reviewing the scientific literature on neonatal gastric capacity. A business person more concerned about profits than people would ignore the scientific literature as Brown has done.

Here’s what the scientific evidence shows:

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This chart comes from a literature review published in Acta Pediatrica in 2013. You can see that the average stomach size was found to be anywhere from double to nearly quintuple the size quoted by lactation consultants.

The lactivist claim is based on a study from 1920 by Scammon and Doyle that has clearly been discredited by seven studies done since then. The average size of the newborn stomach is NOT 5-7 cc but closer to 20 cc, rising dramatically over the first first days. And some babies need every one of those 20 cc per feeding and more.

2. A real medical professional would review the scientific literature for reports of breastfed babies being underfed (case reports). A business person more concerned about profits than people would ignore the scientific literature as Brown has done.

Even a cursory examination of the scientific literature reveals multiple case reports of babies suffering brain injuries and death from hypernatremic dehydration, hypoglycemia, hyperbilirubinemia, known manifestations of infant underfeeding. Brown either does not know or does not care.

3. A real medical professional would consult the scientific literature on the incidence of underfeeding among breastfed babies. A business person more concerned about profits than people would ignore the scientific literature as Brown has done.

Had Brown bothered to read the scientific literature, she would find quite a few papers on the risks of breastfeeding.

Health Care Utilization in the First Month After Birth and Its Relationship to Newborn Weight Loss and Method of Feeding by Flaherman et al. was published earlier this year. The results are startling.

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)…

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.

The study Efficacy of Subthreshold Newborn Phototherapy During the Birth Hospitalization in Preventing Readmission for Phototherapy was undertaken to determine whether prophylactive phototherapy could reduce the risk of hospital readmission for severe neonatal jaundice.

Phototherapy does work, but the authors serendipitously found a far simpler intervention that also dramatically reduces the risk of readmission: formula! Infants allowed unrestricted access to formula had a 76% reduction in risk of readmission.

So we have multiple scientific papers that show that newborn stomach capacity is far greater than what lactivists claim, multiple scientific case reports of babies harmed by underfeeding, and a variety of scientific papers that show that aggressive breastfeeding promotion accounts for tens of thousands of newborn hospital readmissions each year at a cost of hundreds of millions of dollars.

Who benefits by lying about that scientific evidence? It’s not babies since they are clearly harmed, sometimes even killed, by the insistence that newborn stomach size is so small that babies can’t possibly be underfed. It certainly isn’t mothers since they are clearly harmed by their babies screaming from hunger, readmitted to the hospital and sustaining brain injuries or even dying because they have been unwittingly underfed. The ONLY people who benefit from lying about newborn stomach size are those who make their money promoting breastfeeding … and that’s why they continue to lie.

The makers of Vioxx could have salvaged quite a bit had they been honest about the potentially deadly side effects of the drug. Alerting doctors and patients would have allowed them to consider the risk and the fact that the benefits might clearly outweigh the risk. But the drug company was afraid that the truth that Vioxx wasn’t perfect would lead to a tremendous fall off in market share so they lied. Eventually they were caught in those lies and they paid a massive financial price, but that didn’t bring back the patients who had already suffered and died.

Breastfeeding advocates could salvage quite a bit if they were honest about the potentially deadly risks of breastfeeding. Alerting providers and patients to the true newborn stomach size and counseling them to look for and treat underfeeding would allow them to consider the risks and the fact that for many women the benefits might outweigh the risk. But breastfeeding advocates are afraid that the truth that breastfeeding is not perfect would lead to a tremendous fall off in market share so they lie. They are already being caught in those lies, although I doubt they will pay any price for their lying. In the meantime babies and mothers continue to suffer and die … while breastfeeding advocates continue to profit.