Pressuring mothers to exclusively breastfeed can put newborns at risk of starvation
Instead of saying "breast is best," perhaps we should start saying "fed is best"
The benefits of breastfeeding have been well-documented. While some mothers have no trouble breastfeeding their little ones, others are not as fortunate. They struggle with producing enough milk to nourish their baby. However, mums today are more pressured than ever to exclusively breastfeed their babies.
It is this kind of attitude that the Fed is Best Foundation is trying to fix. According to Fed is Best, insufficient feeding could lead to low blood sugar, jaundice, and dehydration, which could escalate to brain injury. (It’s important to note that Fed is Best is not anti-breastfeeding. The organization is against shaming and pressuring mothers to breastfeed, especially as many are unable to do so.)
‘The push to promote exclusive breastfeeding as best for all babies neglects making sure that a baby is fed above all else’
“The [breast is best] mantra is intended to be about how to best feed your infant, but it misses the point of infant feeding entirely,” Fed is Best cofounder Dr. Christie del Castillo-Hegyi tells Forbes. “The push to promote exclusive breastfeeding as best for all babies neglects one very important matter, which is making sure that a baby is fed above all else.”
Del Castillo-Hegyi is speaking from experience. On the Fed is Best website, she tells her story in an open letter to doctors and parents. Her son was born “after a healthy pregnancy and normal uneventful vaginal delivery,” then was placed on her chest and nursed immediately. Everything went swimmingly at first. He had a perfect latch, and he was nursed for 20-30 minutes every three hours like the breastfeeding manuals recommended. He was also seen by the paediatricians and a lactation consultant. But no one predicted what would happen next.
In her open letter, del Castillo-Hyegi recounts the harrowing experience she and family went through after bringing her son home:
Upon getting home, he became fussy and I nursed him longer and longer into the night. He cried even after nursing and latched back on immediately. He did not sleep. By the next morning, he stopped crying and was quiet. We saw our paediatrician at around 68 hours of life (end of day 3). Despite producing the expected number of wet and dirty diapers, he had lost 1 pound 5 ounces, about 15% of his birth weight.
‘We discovered that he was getting absolutely no milk’
Our paediatrician told us that we had the option of either feeding formula or waiting for my milk to come in at day 4 or 5 of life. Wanting badly to succeed in breastfeeding him, we went another day unsuccessfully breastfeeding and went to a lactation consultant the next day who weighed his feeding and discovered that he was getting absolutely no milk.
When I pumped and manually expressed, I realised I produced nothing. I imagined the four days of torture he experienced and how 2 days of near-continuous breastfeeding encouraged by breastfeeding manuals was a sign of this. We fed him formula after that visit and he finally fell asleep.
Three hours later, we found him unresponsive. We forced milk into his mouth, which made him more alert, but then he seized. We rushed him to the emergency room.
At the hospital, doctors found that del Castillo-Hegyi’s son had low glucose levels, severe dehydration, and severe jaundice. After he was treated, del Castillo-Hegyi was told that he would be fine. But knowing what she knew about how fast brain cells die from hypoglycemia and severe dehydration, she found that hard to believe.
Now six years old, her son is on the autism spectrum. Doctors have diagnosed him with “ADHD, sensory processing disorder, low IQ, fine and gross motor delays and a seizure disorder associated with injury to the language area of the brain.”
Del Castillo-Hegyi points out that her son’s case is not rare. She cites several studies in her letter to back that up. One study found that out of 280 mothers who intended to exclusively breastfeed their babies, 22% of the mothers experienced a delayed onset of lactation. “This means more than 1 in 5 newborns are at risk of starvation-related complications if exclusively breastfed from birth,” writes del Castillo-Hegyi.
‘1 in 5 newborns are at risk of starvation-related complications if exclusively breastfed’
Fed is Best proposes increasing monitoring and supplementing to prevent exclusively breastfed newborns from harm.
Some of the measures recommended by Fed Is Best:
1. Teaching mothers to pump their milk to make sure that they are producing enough.
2. Monitoring the weight of exclusively breastfed newborns twice a day until the child begins to gain weight
3. Pre- and post-breastfeeding weighing after lactogenesis II (the stage where copious milk production occurs, between 32 and 96 hours after giving birth)
4. Regular bilirubin and glucose checks
5. Educating mothers on how insufficient breast milk intake can lead to her child becoming dehydrated, jaundiced, and hypoglycemic.
6. Teaching mothers that supplementing breastfeeding with formula should not be a cause for shame.