The Fed Is Best Foundation has accomplished so much in such a short time that professional lactivists, who ignored just about everyone and everything that did not support their preferred narrative, have been forced to take it into account.
The most prominent example to date has been Dr. Alison Stuebe of the Academy of Breastfeeding Medicine. Dr. Stuebe has publicly acknowledged that for years she promoted a lactivist lie:
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There is no benefit of breastmilk that is worth allowing your new baby’s brain to bathe in a neurotoxin.[/pullquote]
Six years ago, I wrote a blog reflecting on Diane Wiessinger’s seminal essay, “Watch your language.” “There are no benefits of breastfeeding,” I wrote. “There are risks of formula feeding.”
Likely spurred by the incredible success of the Fed Is Best movement and the seemingly never ending maternal accounts of starving, injured and even dead babies, Dr. Stuebe did what few have the strength and character to do; she admitted she was wrong:
… a substantial proportion of infants born in the US require supplementation. Delayed onset of lactogenesis is common, affecting 44% of first-time mothers in one study, and 1/3 of these infants lost >10% of their birth weight. This suggests that 15% of infants — about 1 in 7 breastfed babies — will have an indication for supplementation.
That’s the essence of good medical practice. When you become aware of new data, new research or new innovations, you change your advice accordingly.
Sadly, Dr. Jack Newman has done the exact opposite. When faced with evidence that his advice is leading to iatrogenic injuries to babies, he’s doubling down. As it has become increasingly clear that relentless pressure to breastfeed is leading to serious, potentially life threatening weight loss, he casually (and without any scientific evidence) dismissed the accuracy and value of newborn weights.
That was bad enough, but now he’s using sophistry to minimize the deadly impact of both neonatal jaundice (hyperbilirubinemia) and low blood sugar (hypoglycemia).
What’s sophistry?
[It’s] the use of reasoning or arguments that sound correct but are actually false.
Why does Dr. Newman engage in sophistry? It appears that he thinks the process of breastfeeding is more important than the outcome of a heathy baby. But no process is more important than whether a baby lives or dies. No process is more important than preventable brain injuries and death.
Consider Dr. Newman’s inexcusable approach to hyperbilirubinemia that appears on the website for his International Breastfeeding Centre.
It is usual and normal for babies to become jaundiced in the days after birth. But the bilirubin that causes the yellow colour of the baby’s skin is protective (it’s an antioxidant) and too often we treat higher than average bilirubin levels in a sort of panic state. Hardly ever does anyone routinely take time to watch babies drinking at the breast right after birth and before they become jaundiced. Once the jaundice becomes a worry for the staff on the ward, the solution always becomes phototherapy which misses the real issue …
Bilirubin is protective? That’s sophistry. Bilirubin in “high normal” amounts is an anti-oxidant but no one has demonstrated that it has any protective effect in neonates. Above high normal rates, bilirubin is a NEUROTOXIN.
As the paper Bilirubin-induced neurologic dysfunction explains:
Bilirubin is a beneficial antioxidant at low levels, but a neurotoxin at higher levels, where it can impair the normal developmental maturation of the neonatal brain. This “silent toxin” can have a deleterious impact that is further exacerbated by co-morbidities such as inflammation/sepsis, oxidative stress, prematurity, and even sociocultural environmental factors. Failure to recognize or identify infants at high risk for developing extreme hyperbilirubinemia can lead to severe neurologic sequelae, which include athetoid cerebral palsy (CP) or kernicterus to a range of subtle cellular damage or clinical dysfunction …
A high normal levels of bilirubin in the first week of life is common, so common that it is known as “physiologic jaundice.” No pediatrician or neonatologist worries about physiologic jaundice. In contrast, high levels of bilirubin can lead to cerebral palsy or brain damage (kernicterus, literally “yellow brain”). Dr. Newman casually dismisses the bilirubin in hyperbilirubenemia as an “innocent bystander.”
The problem is not the bilirubin, the problem is inadequate feeding. The bilirubin is an “innocent bystander”, blamed for brain damage when it is the dehydration, acidosis and other metabolic abnormalities that are the problem in severe cases of poor breastfeeding. Phototherapy may bring down the bilirubin, but it doesn’t fix the problem, which is that the baby is not breastfeeding well. Fix the breastfeeding before the situation deteriorates and phototherapy and supplementation would not be necessary most of the time.
That’s deadly sophistry. The problem in hyperbilirubinemia is not that the baby isn’t breastfeeding well; that’s the CAUSE of the hyperbilirubinemia. Indeed, the baby may be breastfeeding just fine; as Dr. Stuebe noted, delayed onsent of lactation is common. The problem is that the baby is not getting enough milk and that can easily be fixed by supplementing with formula.
There is simply no benefit of breastmilk that is worth allowing your new baby’s brain to bathe in a neurotoxin. Dr. Newman’s effort to minimize a deadly problem is simply inexcusable. It’s almost as if he thinks breastfeeding is more important than infant health and wellbeing.
He takes the same absurd approach to neonatal hypoglycemia (low blood sugar).
Hypoglycemia (low blood sugar) is one of the commonest reasons for formula supplementation in the first few days after birth. But most babies are tested for low blood sugar for no good reason, and most babies get formula by bottle also unnecessarily.
No good reason? That’s not what the scientific evidence shows.
Neonatal hypoglycemia, defined as a plasma glucose level of less than 30 mg/dL (1.65 mmol/L) in the first 24 hours of life and less than 45 mg/dL (2.5 mmol/L) thereafter, is the most common metabolic problem in newborns. Major long-term sequelae include neurologic damage resulting in mental retardation, recurrent seizure activity, developmental delay, and personality disorders…
Hypoglycemia should be treated as soon as possible to prevent complications of neurologic damage.
But not according to Dr. Newman:
There is a lot of hysteroglycemia [sic] out there and the “treatment” of it is causing many babies to be unnecessarily supplemented with formula often with bottles.
It’s almost as if he thinks it’s more important to avoid supplementation with formula than to avoid neonatal brain damage. But no process is more important than whether a baby lives or dies. No process is more important than preventable brain injuries.
Dr. Newman appears to be engaged in a battle to promote breastfeeding when he really should be promoting infant health and well being. Dr. Newman and other professional lactivists have been losing ground in their efforts to protect breastfeeding above infant health.
Their original position was that breastfeeding (unlike all other physiological functions) is always perfect and all women will produce enough milk before the baby begins to suffer.
The first fallback position was that, yes, some woman might have delayed lactation or insufficient lactation in the early days, but babies are “designed” to withstand that.
The next fallback position was that, yes, some babies lose an excessive amount of weight, but weights aren’t accurate or meaningful and anyway, so long as the baby doesn’t develop complications of weight loss and dehydration (like hyperbilirubinemia and hypoglycemia) it doesn’t matter.
Now Dr. Newman appears to be falling back to the preposterous and deadly position that hyperbilirubinemia and hypoglycemia aren’t problems (bilirubin is an anti-oxidant!) and we shouldn’t become hysterical (hysteroglycemia!) about it.
What’s next Dr. Newman, better dead than formula fed?
Dr. Newman has lost sight of the ethical imperative of all physicians, to place patient welfare first. The physician’s job is never to promote a process above the best possible outcome. Sadly, Dr. Newman seems to have forgotten that … or perhaps he never knew.
