I was very fortunate in my OB-GYN training. I did my internship and residency at Boston’s Beth Israel Hospital, a Harvard hospital. I prize that training, but over the past 35 years I’ve discovered that some of things I was taught were wrong. Three of the principles of obstetrics and gynecology that were accepted as conventional wisdom when I was trained were actually untrue.
In the 1990’s we finally recognized we were wrong about episiotomies; they were not beneficial but actually harmful. In the 2000’s we finally recognized we were wrong about hormone replacement therapy (HRT); it was not beneficial but actually harmful. In both cases, it took years to change clinical practice but eventually the scientific evidence forced us to back away from defending the status quo.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””] How many babies have to be injured, starved or allowed to die before ACOG admits they’re wrong about breastfeeding.[/pullquote]
In 2018 we have copious data that we have been wrong about breastfeeding; sadly, just as in the case of episiotomies and HRT, ACOG (the American College of Obstetricians and Gynecologists) is resisting the acknowledgement that what we thought was an unalloyed good doesn’t have the benefits we’ve claimed and can actually be harmful in some cases.
In a recent newsletter, ACOG published a remarkably fact free attack on the Fed Is Best Foundation:
In May 2017, an organization called the “Fed is Best” (FIB) Foundation issued an open letter to obstetric care providers that outlines concerns about the safety of exclusive breastfeeding, and has caused some expectant mothers to question breastfeeding as the optimal feeding method for the health of the mother and baby. Although FIB describes itself as a non-profit volunteer organization and appears to cite peer-reviewed literature, many of the assertions that FIB makes misrepresent the findings of referenced studies…
ACOG believes that parents must have accurate, current, evidence-based information on which to base their infant feeding decisions, not on sensationalized headlines. FIB’s inflammatory anecdotes and misleading portrayal of evidence threatens to undermine and confuse mothers about well-established knowledge and breast-feeding protocols.
Inflammatory anecdotes, ACOG?
You mean the seizure and subsequent death of Jillian Johnson’s baby from dehydration only 12 hours after she was reassured by hospital personnel that her son was getting enough breastmilk and discharged home?
You mean the appalling before and after photos of Mandy Dukovan’s baby, emaciated on breastmilk but thriving on formula?
Fed Is Best misrepresents the findings of referenced studies?
Care to explain how the findings of these papers were misrepresented?
- The revised United States Preventive Services Task Force (USPSTF) guidelines
- Interventions Intended to Support Breastfeeding: Updated Assessment of Benefits and Harms
- Unintended Consequences of Current Breastfeeding Initiatives
- Health Care Utilization in the First Month after Birth and Its Relationship to Newborn Weight Loss and Method of Feeding
- The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature
- The Effect of Early Limited Formula on Breastfeeding, Readmission, and Intestinal Microbiota: A Randomized Clinical Trial
- Breastfeeding during infancy and neurocognitive function in adolescence: 16-year follow-up of the PROBIT cluster-randomized trial
Taken together, these papers demonstrate that insufficient breastmilk is common (up to 15% of first time mothers), formula supplementation makes successful breastfeeding more likely, pacifiers prevent SIDS, extended skin to skin contact lead to babies falling from their mothers’ hospital beds or suffocating while in them, and the latest results from the PROBIT studies show no impact on IQ at age 16. In addition, we know that the leading cause of jaundice induced brain damage (kernicterus) is breastfeeding.
In what way has Fed Is Best misrepresented the findings of these up to the minute papers? They haven’t misrepresented them at all.
ACOG, you seem certain that breastfeeding is the optimal feeding method for every infant. If it’s optimal why is there no correlation between breastfeeding rates and infant mortality rates? Why, given that the breastfeeding rate has tripled in the past 45 years, have the savings in lives and healthcare dollars predicted by breastfeeding advocates, failed to materialize?
And what’s up with the ugly insinuations? Fed Is Best describes itself as a non-profit volunteer organization? Do you have any evidence they are anything other than that? They appear to cite peer-reviewed literature? How can one “appear” to cite the scientific literature? This is nothing more than a thinly veiled attempt at the “shill gambit”, a claim beloved of quacks and charlatans, that medical providers with whom they disagree are hiding the fact that they are on an industry payroll. It’s wrong the peddlers of pseudoscience use it and it is wrong of you to insinuate it about Fed Is Best.
ACOG, it took you years to admit that you had been wrong about episiotomies for decades. It was hard to give up on something that had become embedded in clinical practice, especially because it seemed to make so much sense. ACOG, for years you promoted hormone replacement therapy despite the fact that the evidence in its favor was relatively weak and had not yet been confirmed by longterm studies. It seemed to make so much sense that you rushed to incorporate it into clinical practice. Now, ACOG, you are refusing to admit that you have been wrong about breastfeeding. It seemed to make so much sense that something natural would have great benefits and low failure rates so, in response to high pressure lobbying by the breastfeeding industry, you incorporated its promotion into clinical practice even though the data was weak, conflicting and riddled by confounders.
There’s no question in my mind, ACOG, that you will eventually be forced to acknowledge that you have been wrong about breastfeeding just like you were wrong about episiotomies and hormone replacement therapy. The only question is how many babies have to be injured, starved or allowed to die before you acknowledge your mistake.
