Dear Neonatologists, Pediatricians, Neonatal Nurses, and the organizations that represent them:
Please help me help babies and mothers. The Baby Friendly Hospital Initiative is killing babies and you’ve got to stop it.
Nearly every day I get another email or Facebook message about a baby who has been injured seriously or even fatally by the Baby Friendly Hospital Initiative (BFHI). And it’s not just mothers who are writing to me. It is postpartum nurses, neonatologists, pediatricians and other physicians who can’t believe what they are witnessing and seek my assistance in publicizing it and putting an end to these preventable tragedies.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Babies are being harmed and even die, yet the physicians and nurses who care for them feel powerless to help them in the face of the BFHI.[/pullquote]
In the last few months I’ve heard about multiple infants sustaining skull fractures by falling from their mothers’ hospital beds, multiple infants who have suffered brain damage from dehydration and greater numbers of hospital re-admissions to treat dehydration before it leads to permanent injury, and countless cases of poor weight gain and failure to thrive.
Babies are being harmed and even die, yet the physicians and nurses who care for them feel powerless to help them in the face of lactation professionals who have seduced hospital officials with the promise of saving money by implementing the BFHI.
What is the Baby Friendly Hospital Initiative and how is it hurting babies?
The BFHI is a hospital credential that is given to institutions that can demonstrate that they follow the ten steps of the initiative (and have given a big slug of money to BFHI to pay for it). It’s meant to encourage breastfeeding though there is evidence that it doesn’t even work.
You can find the Ten Steps here. The most dangerous steps are these:
- Give infants no food or drink other than breast-milk, unless medically indicated.
- Practice rooming in – allow mothers and infants to remain together 24 hours a day.
- Give no pacifiers or artificial nipples to breastfeeding infants.
This despite the fact that:
We KNOW that 5-15% of mothers will not produce enough breastmilk to fully nourish an infant.
We KNOW that judicious formula supplementation in the days after birth INCREASES breastfeeding rates.
We KNOW that there is no evidence that rooming in has ANY impact on breastfeeding rates.
We KNOW that there is NO EVIDENCE that pacifiers or artificial nipples reduce breastfeeding rates.
And most importantly:
We KNOW that the benefits of breastfeeding term infants in industrialized countries are SMALL.
No one can point to even a single term infant whose life was saved by breastfeeding whereas we can now point to many infants lives that have been destroyed or ended by letting a special interest group control infant care. And that doesn’t even take into account the suffering of mothers forced to endure their babies’ screams of hunger and are deprived of desperately needed sleep by the closing of well baby nurseries and enforced 24 hour rooming in.
Lactation professionals and the breastfeeding industry mean well. They honestly believe, in the face of copious evidence to the contrary, that breastfeeding has nearly magical health benefits, and that virtually any risk is worth taking to enforce breastfeeding among new mothers. But they aren’t medical professionals.
Neonatologists, pediatricians and postpartum nurses are medical professionals, and as such, are charged above all with ensuring infant well being. Outcome (a healthy baby) is far more important to medical professionals than any specific process like breastfeeding.
Neonatologists, pediatricians and postpartum nurses should immediately institute three specific measures:
- Easy access to infant formula and a low threshold for supplementation in the first few days.
- Routine access to pacifiers to soothe babies who are comforted by them.
- Mandatory access to well baby nurseries where every mother can send her baby for large blocks of time so she can sleep.
I don’t doubt for a moment that the breastfeeding industry is sincere in its beliefs, but babies are being harmed by those beliefs. We are experiencing an upsurge in serious adverse outcomes like infant skull fractures, severe neonatal dehydration, and even smothering deaths of infants left to sleep in their mothers’ beds because of forced rooming in. We should be tracking those adverse outcomes and doing everything in our power to prevent them.
I know that it is difficult to buck the hospital administration when it finds intellectual cover for financial decisions like closing well baby nurseries by insisting that it will boost breastfeeding rates. But babies have no one to defend them besides neonatologists, pediatricians and postpartum nurses.
Please, please stand up for them.
