Fed* is Best

Here is the problem with the “Fed is Best” campaign. Well, there are several problems actually.
Let’s talk about the people that share this catch phrase. These people are usually self-proclaimed scientists or consider themselves to be superior in that they follow the science of things. These people are also Facebook pages that are supposed to be about science. They usually promote the science about vaccines, GMOs, and other areas that are full of pseudoscience.

So why is it they are unable to acknowledge the scientific consensus about infant feeding? All sense of the scientific method flies out the window and it is all about feelings. They claim they don’t want to “shame” parents that feed formula. But they have no problem shaming parents that don’t vaccinate. They have no problem shaming parents that shop exclusively at Whole Foods.

I find that these science pages are also up on social justice and privilege. They are quick to call out “all lives matter” on their bullshit that minimizes Black Lives Matter. But they don’t see the hypocrisy of the “Fed is Best” campaign in that it is analogous to the “All lives Matter” counter-campaign. Just like BLM existed to assert their power and claim their right to a society that has always held power over them. So did the “Breast is Best” campaign begin to promote the importance of infant feeding choice in a society where artificial baby milk was the default choice.

The “Fed is Best” slogan is not harmless, and while it may make a parent feel better for a moment, you are harming many more infants in the process when you continually attempt to minimize the importance of infant feeding choice. The science is clear that breast milk is the optimal form of nutrition for human babies. Every health organization in the world, with or without clean water, agrees that infants should be fed breast milk. You don’t have to minimize one thing in order to not shame a person that chooses another.

Can we talk about other ways that the social media science community isn’t evidence-based when it comes to infant feeding? I’ve seen several times where the topic of donor milk has been discussed negatively despite the evidence to support it. If “Fed is Best” then they would show support for a parent’s decision to safely feed donor milk, but they don’t. So Fed isn’t best in this scenario. I’ve seen the science community outraged when homemade formulas are fed, when raw goat and cow milks are fed, and when they see infants with soda in their bottle. Obviously, fed is best, right? Or no, not here.
“A fed baby is better than a dead baby”
Well, not when that fed baby is going to die from kidney injury or diarrhea because they were fed unsafe milks.
Please Don’t Feed Your Baby Homemade Formula
CDC – Raw Milk

The fed is best campaign is a dangerous political slogan that does nothing to help parents or infants in the long run. This is simply a way for people that can’t separate emotion from scientific discussions to appear to have the upper hand while they accuse us of shaming people that feed formula or being lactivists.

What if I told you that you can support a parent in their feeding choice without minimizing the other choice? Weird huh.

“The expert consultation recommends exclusive breastfeeding for six months, with introduction of complementary foods and continued breastfeeding thereafter. This recommendation applies to populations. The expert consultation recognizes that some mothers will be unable to, or choose not to, follow this recommendation; they should be supported to optimize their infants’ nutrition.”

Just like there is a scientific consensus about vaccines, global warming, and GMOs, so is there a scientific consensus that breast milk is the optimal feeding choice.
According to the World Health Organization, infants should be fed according to this order; mother’s own milk, another mother’s milk, commercial infant formula, homemade formulas, boiled animal milks.
Global strategy for infant and young child feeding The optimal duration of exclusive breastfeeding
Infant and young child nutrition Global strategy on infant and young child feeding

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That Darn “Low Milk Supply 101” Article… and How it Minimizes Mothers

I have been seeing an article circulating called “Low Milk Supply 101.” I understand it is trying to be helpful, and it IS factually correct. But the way it is written minimizes mothers. How so? Did you know in the United States about 1 in 8 mothers have a delay of milk production?
– Milk increases in volume between the 3-5th day after birth.
– A baby can only carry himself on low volumes for about 3 days before they require supplementation of more than an ounce per feed.
– 1 in 20 mothers in America have primary lactation failure, meaning they will not be able to fully breastfeed their baby – at all.
– In the United States about 79% of babies begin life breastfeeding. By 6 months, only 49% are exclusively breastfed. (Data from 2014 CDC).

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The IBCLC that wrote this article is from London. Their breastfeeding initiation rate is 87% and data shows that 40% of babies are still exclusively breastfed at 2 months. What else can we examine… 1 in 3 women will give birth by cesarean in America versus the 1 in 4 in London. Cesarean birth can have some negative implications for breastfeeding initiation. In America, we have an epidural rate greater than 90% versus London’s 40%. Epidurals have a negative impact on breastfeeding initiation. 60% of women report nipple pain in the first two weeks of breastfeeding. What does that mean? Possibly that the baby is not effectively nursing, meaning that the breast isn’t being stimulated appropriately in order to promote the best milk volumes. One more thing we can talk about here for differences between America and London. American women get ZERO paid maternity leave while London gets ONE YEAR of… PAID maternity leave. Even fathers get 2 weeks of paid leave.

There are 2 specific things I do not like about this article when America women are reading it; having “You do not have low milk supply” bolded is pounding it into that mother’s head that she doesn’t have low milk supply. What if she does? The statistics favor that a lot of women feel they do not have enough milk to satisfy their baby. In fact, that is one of the top reasons mother choose to stop breastfeeding. American birth culture does not support healthy breastfeeding. Period. Not every breastfeeding mother knows how to establish a healthy milk supply, or that the early weeks are vital for doing so. Birth and breastfeeding advocates are quick to cheer mothers on by saying things like “you don’t have low milk supply” and “trust your body” … and I’m not here to undermine the support. But please, for the sake of these babies that depend on their mothers breasts, do not give so much reassurance without knowing for a fact (taking history, monitoring output, pre-post feed weights) that this mother does not have low milk volume. I feel we are too caught up in trying to promote breastfeeding that we are afraid to tell mothers something actually is wrong. For fear of making her doubt her body and her ability to nourish her child. Breastfeeding isn’t always rainbows and butterflies. Low milk supply happens. More often than people care to admit.

On to the second thing about this article that I’m not fond of.
“Find people who know about breastfeeding. Someone who tells you just to use formula in this situation is not who you need. If that’s all they can offer you, they don’t know about breastfeeding and you need someone else. You need someone who understands how lactation works.” (I know she goes on to talk about using formula under the care of an LC)
Again, breastfeeding and the “exclusively breastfed” title, is not more important than a baby that is fed. Not only is this paragraph inflammatory it demonizes formula. If you are at home, late at night, with a baby that is screaming because they are hungry (it’s a different scream, mothers say they never forget this scream), your baby hasn’t been voiding properly, and your baby isn’t sleeping, for the love of God feed your baby. Do not wait until you are under the care of a lactation consultant just so you can get their blessing. Feed your child. You have donor milk? EXCELLENT. But this isn’t the case for most mothers in America. One reason formula is frowned upon is because it exposes your baby to massive amounts of bovine proteins and alters the baby’s microbiome. If you are able, get elemental or hypoallergenic formula in the need of supplementation. It tastes horrible. It’s expensive. But it doesn’t have those potentially harmful proteins in it.

Your baby cannot eat if they are starving. They will either not be able to calm themselves to organize their suck pattern, or they will be too calorie deprived to wake up and eat properly.

I’m not trying to disrespect this wonderful IBCLC, not at all. I’m just saying our audiences are extremely different and need to be taken in the context appropriate for our breastfeeding culture.

Is placing your baby in sunlight enough to treat jaundice?

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Is putting your baby by the window good enough to treat jaundice? Maybe if they only have slightly elevated levels of bilirubin. Let us examine the evidence behind this ever so famous suggestion. *this is not medical advice, ALWAYS consult with your baby’s pediatrician*

“Putting your baby in sunlight is not recommended as a way of treating jaundice. Exposing your baby to sunlight might help lower the bilirubin level, but this will only work if the baby is completely undressed. This cannot be done safely inside your home because your baby will get cold, and newborns should never be put in direct sunlight outside because they might get sunburned.” Neonatal Jaundice: to sun or not to sun?

“In their original description of phototherapy, Cremer et al demonstrated that exposure of newborns to sunlight would lower the serum bilirubin level. Although sunlight provides sufficient irradiance in the 425 – to 475nm band to provide phototherapy, the practical difficulties involved in safely exposing a naked newborn to the sun either inside or outside (and avoiding sunburn) preclude the use of sunlight as a reliable therapeutic tool, and it therefore is not recommended.” (Cremer RJ, Perryman PW, Richards DH. Influence of light on thehyperbilirubinemia of infants. Lancet. 1958;1(7030):1094–1097)

“The practice of placing jaundiced infants under sunlight to reduce discoloration is a cultural health belief in most communities and appears to be effective in many anecdotal reports. In fact, midwives, nurses, doctors and pediatricians were identified to be the main professional sources of this belief [1]. In an in vitro experiment, it was found that sunlight was 6.5 times more effective than phototherapy in the isomerization of bilirubin compared to a phototherapy unit [2]. However, there are no appropriate controlled trials comparing the efficacy of sunlight to no treatment or artificial light therapy in jaundice [3]. Delayed treatment of severe jaundice in an otherwise healthy baby can result in the development of kernicterus – a complication causing brain damage as result of bilirubin deposition in the central nervous system [4]. Hence, withholding phototherapy would be unethical in controlled trials. We should not recommend sunlight for routine treatment of jaundice as this would encourage parental misconception that home therapy is adequate and result in delayed healthcare seeking behaviour. Moreover, there are concerns of adverse effects of sunlight exposure causing skin tanning, sunburn and hyperthermia.” Neonatal Jaundice: To sun or not to sun?

Anything done in vitro (tests done outside of the body in regulated conditions) is going to be almost always different when trying to replicate the results in vivo (things that happen within the body).

“In the late 1950s, phototherapy emerged as another potential treatment of jaundice. In 1956 at Rochford General Hospital in Essex, England, Sister J. Ward noted that sunshine decreased neonatal jaundice. Meanwhile, hospital biochemists noted erroneously low bilirubin levels in samples sitting in sunlight before processing.” A Tale of Two Hospitals: The Evolution of Phototherapy Treatment for Neonatal Jaundice

Listed below are 2 valuable resources for informing yourself about the management of jaundice.
ABM Clinical Protocol #22: Guidelines for Management of Jaundice in the Breastfeeding Infant Equal to or Greater Than 35 Weeks’ Gestation
Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
Also be aware that there are several types of jaundice, all with their own style of treatments.

What should you do if your baby is jaundiced? Talk to your pediatrician and link up with an IBCLC. Some moms don’t like hearing that their baby needs to be supplemented, and that is totally normal. Supplementation doesn’t always mean formula, consider hand expression or pumping to provide your baby’s supplementation. Colostrum and breast milk clears excess bilirubin much more effectively and also doesn’t disrupt the very sensitive and immature microbiome in your baby’s stomach. Also ask your doctor about donor milk if you are not able to express enough milk to adequately supplement your baby.

Supplementation doesn’t equal “bottle” … there are many different ways of delivering supplement to your baby. You can tube feed at the breast, cup feed, finger feed, or use a dropper.
There are many ways to cope with a jaundice diagnosis. One of the best ways is arming yourself prenatally with information on how to deal with it so you know all of the options.

 

About

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My name is Miranda Gallegos, I am an Internationally Board Certified Lactation Consultant (IBCLC) located in San Antonio. I enjoy helping women along their breastfeeding journeys and advocating on behalf of those who cannot advocate for themselves.

I am also a nursing student working towards my BSN degree and I graduate in May of 2017. I have two children ages 2 and 3, and I have been married for almost 5 years! I served my country in the United States Army for 5 years and I worked as a laboratory technologist.

My goal with this blog is to provide breastfeeding information as well as discuss issues surrounding pregnancy, child birth, motherhood, and human rights, all of which are very near and dear to my heart.

I also own 2 facebook pages if you would like to check them out!

The Sisterhood of Breastfeeding Support

The Peaceful Intactivists

*Disclaimer – nothing on this site is meant to be taken as medical advice. Please always consult with your healthcare provider and an IBCLC in your area. Anything posted on this blog are my interpretations of data and my opinions. I will do my best to stick with evidence based information and cite my sources.*