Ten questions I’d like to ask Kathleen Kendall-Tackett, PhD, IBCLC

Number ten wooden material on table with copy space

Breastfeeding professional Kathleen Kendall-Tackett PhD, IBCLC wrote an editorial for the latest issue of Clinical Lactation entitled Concerns About the 10 Steps.

She’s attempting to respond to growing criticism of breastfeeding promotion initiatives by the Fed Is Best Foundation. The second paragraph sounds quite reasonable.

While I frequently do not agree with Fed Is Best’s recommendations or approach, I feel that it’s important to hear what they are saying. Mothers do fall through the cracks, and tragically some mothers and babies have been harmed. In response to these stories, we have two options. We can ignore them and keep doing what we are doing. Or we can view this as an opportunity to continue to improve our models of care.

Unfortunately it was preceded by the first paragraph, which makes accusations about the Foundation.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Will breastfeeding professionals answer these questions if mothers ask them?[/pullquote]

For the past several weeks, I’ve been working on a talk about what we can learn from Fed Is Best. I spent days going through their Website and reading the stories they have posted—a pretty tough assignment. Some of the breastfeeding information on their site is completely wrong — or wrong enough. And the mothers’ stories are heartbreaking. This organization has been a vocal and divisive presence on social media, and they have garnered international attention to their cause.

It’s difficult to be more vague and unsubstantiated than “wrong – or wrong enough.”

I know better than to believe that Kendall-Tackett would agree to engage publicly with me, but I’ve decided to imagine what I would ask her if she agreed. I would not press her to detail her concerns, but rather I’d pose a series of yes or no questions to clarify her position. Since the Fed Is Best Foundation bases its recommendations on the scientific evidence, I’d question her about that.

1. Is the claim that exclusive breastfeeding is now the leading risk factor for newborn readmission wrong? Yes or no?

2. Does the scientific evidence show that the risk of a breastfed baby being readmitted to the hospital is 1 in 71? Yes or no?

3. Has there been a recent surge in cases of hypernatremic neonatal dehydration sometimes correctable, but sometimes leading to seizures, permanent brain injury or death? Yes or no?

4. Are approximately 90% of cases of kernicterus (severe jaundice) the result of insufficient breastmilk intake? Yes or no?

5. In the wake mandated of hours of skin to skin and mandated rooming in has there been a rise in the incidence of newborns smothering in and falling from maternal hospital beds? Yes or no?

6. Breastfeeding professionals promised that an increase in breastfeeding rates would lead to decreased incidence of conditions like allergy and childhood obesity. Isn’t it true that while rates of breastfeeding initiation have shot up from 22% in 1972 to over 80% in 2015, incidence of those conditions has continued to rise? Yes or no?

7. Breastfeeding professionals predicted that breastfeeding would reduce infant hospitalizations. That didn’t happen, did it? Yes or no?

8. Breastfeeding professionals insisted that increasing breastfeeding would save infant lives. With the exception of a decreased incidence of necrotizing enterocolitis in premature babies, that has not happen either, has it? Yes or no?

9. Isn’t it true that infant stomach capacity is not 5-7 cc as claimed by lactation professionals with reference to a paper published in 1921, but actually much higher, 20 cc or more as demonstrated by more recent scientific evidence? Yes or no?

10. Isn’t it the case that nearly all the benefits for breastfeeding claimed by lactation professionals have been debunked by newer, more comprehensive research that corrects for confounding variables like maternal education and socioeconomic status? Yes or no?

These are not hard questions to answer. Hopefully breastfeeding professionals like Kathleen Kendall-Tackett will answer them — perhaps if mothers ask her.