Everyone knows that breastfeeding provides benefits to babies. That’s true even in first world countries where the threat of pathogen contamination of the water used to prepare formula is nearly nonexistent.
Those benefits are so small, however, that they are measured in individual IQ points, and fewer episodes of mild neonatal illness like colds and diarrhea.
Nonetheless,among ambitious privilege parents in first world societies, incredible social pressure is brought to bear to force exclusive breastfeeding in the first six months. This pressure has been stimulated in large part by the efforts of lactivists (breastfeeding activists) and the breastfeeding industry, comprised of lactation consultants, and hospital credentialing agencies like the oxymoronically named Baby-Friendly Hospital initiative.
As a result, many infants are starving. Stories of breastfeeding failure abound and countless women are tormenting themselves and their babies, taking herbs, supplements, pumping around the clock, and refusing to supplement with formula in an effort achieve and maintain exclusive breastfeeding.
Which raises the question:
What are the long term consequences in brain function and other areas for babies whose mothers do not produce adequate milk and who, therefore, starve for weeks at a time?
The answer to that question, to my knowledge, is unknown.
We know that dehydration as a result of inadequate breastmilk can cause serious health problems in neonates.
Hypernatremic dehydration in neonates is a potentially devastating condition. Recent reports have identified breast-feeding malnutrition as a key factor in its pathophysiology.
Breastfeeding-Associated Hypernatremia: Are We Missing the Diagnosis?:
The incidence of breastfeeding-associated hypernatremic dehydration among 3718 consecutive term and near-term hospitalized neonates was 1.9%, occurring for 70 infants…
Conclusion. Hypernatremic dehydration requiring hospitalization is common among breastfed neonates…
In this case report, we describe unrecognized fatal hypernatremic dehydration in two exclusively breast-fed neonates due solely to failure of maternal lactation. We further describe epidemiologic and etiologic features of such deaths …
Fortunately, severe complications like death, seizures and permanent disability are relatively uncommon in first world countries, because most mothers will ultimately offer formula supplementation or will seek medical care and a pediatrician will strongly recommend formula supplementation.
The overwhelming number of babies who are getting inadequate breast milk will ultimately survive to get formula supplementation, but they (and their mothers) suffer greatly in the meantime.
I wrote last week about the mother who ultimately resorted to using her friend as a wet nurse after her baby languished for nearly a month without adequate food.
She wrote:
… I tried to be cheerful, but when we were alone, I wept, lashed out at my husband, and spiralled into exhausted, muddy irrationality, panicked about failing the precious boy we had only just met. There was very little distinction between day and night. Time took on a strange new cast. I nursed and pumped and nursed and pumped and nursed some more. I remember my husband singing to our crying son while I soaked my breasts in bowls of warm, salty water. I remember cooling my breasts with cabbage leaves, drinking herbal tinctures, pumping and pumping and pumping. I remember hoping each new lactation consultant was going to be The One. I remember hoping the midwife would drop by, or at least return a call. The baby was wetting nappies, but he needed to nurse constantly, and never got a full belly on which he (and I) could rest for a few hours.
Today on Gawker, another mother writes:
… I’d existed practically shirtless from the moment the baby was born, nursing her every time she whimpered or stirred. I gave her the smallest amount of formula I could soothe her with at a given time, having read that every ounce of formula I gave would be an ounce my body wouldn’t make. I was taking all the herbs all of the other lactation consultants had prescribed, pumping every time I had a spare moment. I was doing everything anyone had ever suggested might help. I was desperate to feed her. I was more determined to figure this out than I had ever been about anything in my life…
But my baby was hungry all the time. And very thin.
What happens to infant brains as a result of short term starvation?
It’s shocking that, as far as I know, there is no research on this question. We devote reams of scientific journals and endless pages of parenting websites to debating the subtle value of the additional antibodies in breastmilk, or the possible existence of unknown long chain fatty acids that may promote brain development in the critical early weeks of the neonatal period, but we devote no effort to determining the effect of the tremendous metabolic insult of starvation — lack of calories, lack of fluid, increased serum sodium, etc. — that occurs in those same critical early weeks of the neonatal period in a significant portion of infants whose mothers are attempting to breastfeed them exclusively.
We know that a significant proportion of women (5% or more) cannot produce enough breastmilk to fully nourish an infant. We know that, as a result, a significant proportion of babies spend days, or even weeks, starving, losing weight, hungry (and screaming) for hours at time, unable to settle or sleep.
That cannot be good for the developing neonatal brain.
Does it impede neonatal brain development? Do these infants lose IQ points?
We have no idea.
So why are we pressuring women into exclusive breastfeeding when have no clue whether we are consigning a significant proportion of infants not merely to weeks of misery but possibly a lifetime of subtle (or not so subtle) cognitive effects?
