dehydrated babies

You'd be forgiven for thinking that the Fed Is Best motto is a well intentioned rally cry created by mothers who were sick of feeling shamed for using formula. Or perhaps you assumed it was a marketing ploy on behalf of the formula companies, a way to inflame the Mummy Wars that they created in the first place. 

But it actually began as a campaign to raise awareness of a condition wherein newborn babies dehydrate, which can cause lifelong complications and brain damage. 

Important right?

Problem is the way they are going about it.

Yesterday I shared an article from the Journal of Breastfeeding Medicine’s facebook page.

The comments section of the article has been decended upon by the women behind the #Fedisbest movement and foundation; because the article is about Neonatal Hypernatremia.

Dr. Christie del Castillo-Heygi one of the women behind fed is best started this campaign after first hand experience with Hypernatremia and secondary lactation failure.

Good for her.

Unfortunately, their hashtag quickly came to be the rallying cry for parents everywhere who felt pressured, shamed or guilty for not breastfeeding, or giving up breastfeeding.


If I were the creators, i’d be pretty pissed about that. It’s completely detracting from their core message and campaign - raising awareness for Neonatal Hypernatremia.


But it seems they aren’t really worried about the sidetracking of their message #alllivesmatter style.

I’ve read through a handful of comments threads like the one on the JBM article in the past 6 months, I also read plenty of comments threads on other facebook pages such as Essential Baby or Babble that use the fed is best motto to alleviate mother's guilt, or beg for an end to the #mummywars.


What i’ve noticed is that the FIB founders are nowhere to be seen when it comes to the latter comment threads, but will come out in droves on a thread that suggests that exclusive breastfeeding should be the goal for the majority of women.


That is what first made me question their sincerity.

They freely align themselves with Amy Tuteur of “The Sceptical OB” who is known to be adamantly well…..sceptical of natural birth and breastfeeding. They align themselves with Dr Bryan Symon who's talk I was in the audience for when he claimed that red-haired women cannot breastfeed. They regularly hijack threads on Dr Jack Newman’s page, The Milk Meg's page and a a handful of other pages that deal with breastfeeding promotion, and accuse them of purposely hoodwinking parents into risking their babies lives and brains, yet say nothing about all the formula pushing that happens in the name of their cause.


Their cause by the way is supposed to be about the prevention if Neonatal Hypernatremia, via routine supplementation in the first 3-5 days of life.

In the comments on the JBM article del Castillo-Heygi hypotheses “ Is it possible that the people who thought up of the story that exclusive breastfeeding was responsible for the propagation of our species were wrong and that non-exclusive breastfeeding, including wet nursing and pre-lacteal feeding was actually what allowed our species to survive?”

This is an important and valid question. And one that anthropologists and infant feeding researchers should be setting out to answer. I don’t know if anyone is. I do know that there are many cultures around the world where colostrum is viewed with suspicion, and mother’s don’t nurse until their milk comes in. What I don’t know is if all of these cultures use wet nurses or pre-lacteal feeding methods and if there are any who don’t: what the outcomes are for their babies when they don’t get any food for 3+ days.

My instinct says, it’s not a good idea for a newborn to go without food, but I don't know if that proves true in the cross-cultural research, it’s something that needs looking into.

So assuming that del Castillo-Heygi is correct in her assertion that there are no cultures that exclusively breastfeed from only the biological mother in the first week of life (ie. all used either wet nursing or pre-lacteal foods or both) and that we are therefore making a big mistake by trying to push for exclusive breastfeeding by the biological mother in the west, then yes, we should be supplementing all babies in days 1-5 of life.

My issue with the Fed Is Best campaign is that the only discussion on the table in terms of supplementation seems to be via formula use.

If all babies turn out to need supplementation, then so be it. But obviously there has to be ways of doing that that do not require formula.

Formula has only existed for a bit over 100 years. It’s only been decent and able to be made with proper sanitary precautions (both in the manufacturing and the at home stages) for about 40.

Clearly if all cultures supplement neonates, they have been doing it through other means. Now some of those means are by giving highly sugary and calorific liquid foods like honey and ghee. We’re obviously not going to push for all babies to be supplemented with honey, because botulism. We’re also not going to bring goats in and stick them over babies cribs for them to nurse from, because we have all these health and safety protocols theses days, and besides we know that babies don’t tolerate animal milks in their pure form particularly well. That’s why we invented formula.

But surely an ethical and balanced approach to eliminating Neonatal Hypernatremia and even the less severe cases of mild dehydration, hypoglycemia and jaundice has to involve the use of human milk. The birth mother’s colostrum along with mature donor milk, or formula.

But the discussion that we are seeing, completely avoids any mention of wet nursing or donor milk.

Formula is mentioned time and time again, the term “supplementation” is used without any clarification (but in our culture the automatic assumption is that “supplement” is a synonym for “formula”).

Sure formula should be included in the discussion, but it is not the only option and shouldn’t be sold as such. (That goes for all aspects of supplementation be it in the first days of life, the NICU for breastfeeding difficulties or because you are returning to work or whatever).

The Fed is Best foundation campaigners argue that our (being breastfeeding supporters) “obsession” with exclusive breastfeeding is putting babies at needless risk.

Well surely giving all babies formula in the first 5 days is also putting all babies at needless risk - hello NEC and  allergies.

Even if you don’t believe in virgin gut and the microbiome and epigenetics, there are still risks associated with formula use especially in newborns.

An ethical and logically driven discussion would look at the potential risks and benefits of all methods and then work out what the best options are, train healthcare professionals appropriately, give parents the information they need to make an informed choice, and then let them decide on the path that they feel is best for them, based on the risks that they are prepared to deal with. In other words, true informed consent and options. The same things birth and breastfeeding campaigners are fighting for in everything from abortion to birth control to VBAC and more.


If we are really putting babies health first, and the science shows that that means they need more than just colostrum in the first days of life than what we should actually be fighting for is hospitals and birth centers with all of the following:

• Uninterrupted golden hours to best establish the chances of breastfeeding success.
• Hour by hour glucose testing and checks of every baby’s health and liquid intake by truly knowledgeable staff as well as a full oral-motor assessment and proper instruction on latching and expressing
• Nothing less than an IBCLC qualification for everyone giving feeding advice and those doing the hour by hour checks should also have extra training in identifying risks of dehydration and sodium/birllium buildup.
• If you discharge before your milk is fully in and your feeding is truly established then you get free home visits every day for the first week. Plus a direct phone number for your IBCLC who is on call, and a comprehensive checklist of warning signs to watch for.
• Human milk banks, wet-nursing services and formula all equally available as options for supplementation.
• Pumps available for all mothers to use, as well as all mothers being encouraged to express and store colostrum before birth so that it can be given via syringe immediately after birth in cases of hypoglycemia or as part of a supplementing process.
• Rooming in for all babies, including NICU’s with rooming in facilities.
• Way, way better antenatal infant feeding classes

Additionally as a society we need

• No medical professionals anywhere telling mothers that they should feed on a schedule or that they should ignore a baby’s cries.
• IBCLC services available for all women in all areas free of charge.
• Decent education on infant feeding for all healthcare professionals.
• A culture that focuses on trying to resolve the underlying issues instead of just covering them up with formula or medication (eg. reflux) use.
• Public health coverage for tongue and lip tie revisions (and significantly more people trained in assessing and releasing ties)

(Again, almost all of these things are things that “lactivists” have been fighting for anyway.)


Del Castillo-Heygi insists that more breastfeeding education is dangerous, makes no mention of human milk's place in the supplemention discussion and wants all babies supplemented at birth (assumably with formula since it’s the only thing mentioned) and aligns herself with anti-breastfeeding promotore; yet says that she is against the current breastfeeding support and education because it forces women to breastfeed, stigmatisies supplementation and takes away free and truly informed choice.

I’m confused.

So you’ll have to forgive me if I question weather much like Benny Bears the Fed Is Best Foundation’s supposedly well intentioned message isn’t actually that well intentioned after all.

Update:

Oh, what a surprise. When you Goggle Dr Jack Newman + Facebook, the second result is an article from Fed Is Best 

"Dr. Jack Newman believes that a mother rarely has to supplement her baby with alternative milk and that breastfeeding is almost always solved with "support." To the mothers whose children have experienced complications from lack of supplementation, who have found their children lethargic, failing-to-thrive, hypoglycemic, severely jaundiced, hypernatremic and/or brain injured, please leave a message on the Huffington Post article or on his Facebook page and inform him of the complications that kind of advice caused your babies."