What’s the most important tool of any science denialist? It’s the delete button, of course!
From anti-vaxxers to homebirth advocates, from creationists to climate deniers, advocates of pseudoscience sharply distinguish themselves from advocates of science by aggressively deleting any comments that question received wisdom and banning those who persist in inserting actual scientific evidence into a discussion. Deleting and banning is the quickest way to squander scientific credibility.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The hill they chose to die on? Breastfeeding.[/pullquote]
Therefore, I was surprised to see March for Science squander its hard earned credibility to promote an ideology ahead of scientific evidence. The hill they chose to die on? Breastfeeding.
We have had some come to us about this post promoting an organization (Sci Moms) with a history of denying the well-established science on infant nutrition and criticizing health promotion initiatives of the World Health Organization and other health orgs.
We don’t dispute the science of this particular post, so we’re going to leave it up, but we want to encourage everyone to treat the SciMoms with some healthy skepticism and remind everyone that there are more reliable resources out there on infant nutrition, such as the World Health Organization, the American Academy of Pediatrics, and the Academy of Breastfeeding Medicine…
Someone came to them?
Denying the well-established science?
Criticizing health promotion initiatives?
Orwell couldn’t have done a better job.
This isn’t a science; it’s the logical fallacy “argument from authority.” But the worst part is the deleting and banning of anyone who tried to reason with the folks at March for Science.
Let’s take a look at what the LATEST scientific evidence about breastfeeding shows.
The most recent, most comprehensive review of the entire breastfeeding literature is Greenville, N. C. “Is the” breast is best” mantra an oversimplification?.” THE JOURNAL OF FAMILY PRACTICE 67.6 (2018). Here’s what the authors found:
The evidence for infant breastfeeding status and its association with health outcomes faces significant limitations; the great majority of those limitations tend to overestimate the benefits of breastfeeding. Nearly all evidence is based on observational studies, in which causality cannot be determined and self-selection bias, recall bias, and residual confounding limit the value or strength of the findings.
Moreover, breastfeeding has risks as well as benefits:
…[E]xclusive breastfeeding at discharge from the hospital is likely the single greatest risk factor for hospital readmission in newborns. Term infants who are exclusively breastfed are more likely to be hospitalized compared to formula-fed or mixed-fed infants, due to hyperbilirubinemia, dehydration, hyper- natremia, and weight loss (number needed to harm (NNH)=71). For weight loss >10% of birth weight with or without hospitalization, the NNH for breastfed infants is 13.
That translates to tens of thousands of preventable hospital readmissions each year.
According to Sarin, Arjun, Andrew Thill, and Clay W. Yaklin. “Neonatal Hypernatremic Dehydration.” Pediatric annals 48.5 (2019): e197-e200:
Dehydration/excessive weight loss is defined as a loss of more than 10% of birth weight prior to the end of the first week of life, and is thought to occur in up to 15% of exclusively breast-fed infants.
And the consequences are devastating:
Serum sodium level greater than 160 mEq/L is a risk factor for morbidity and mortality. The most commonly cited complications include seizures, bradycardia, vascular thrombosis, disseminated intravascular coagulation, renal failure, intracranial hemorrhage, pontine myelinosis, cerebral edema, and death. Seizure is the most common complication and usually occurs during correction of the hypernatremia, as do the other common complications.
Aggressive, unreflective breastfeeding promotion (like the breastfeeding promotion by the March for Science) has been responsible, particularly the poorly named Baby Friendly Hospital Initiative:
Flaherman, Valerie, and Isabelle Von Kohorn. “Interventions intended to support breastfeeding: Updated assessment of benefits and harms.” Jama 316.16 (2016): 1685-1687.
The BFHI bans pacifiers in contradiction to the scientific evidence.
Counseling to avoid the use of pacifiers in the newborn period is an intervention commonly used to support breastfeeding. However, evidence has been building that infant use of a pacifier may be associated with a reduced risk of sudden infant death syndrome,7 the most common cause of postneonatal death in the United States. The evidence review showed that avoiding pacifiers was not associated with any breastfeeding outcomes assessed in the evidence review. A recent Cochrane systematic review reached the same conclusion. Thus, routine counseling to avoid pacifiers may very well be ethically problematic.
The BFHI bans formula supplementation in contradiction to the scientific evidence.
Counseling mothers to avoid giving infants any food or drink other than breast milk during the newborn period is step 6 of the BFHI and one of the primary care interventions most commonly used to support breastfeeding. Three randomized trials have specifically examined the effectiveness of counseling to avoid giving newborns any food or drink other than breast milk; none showed a beneficial effect of such counseling on breastfeeding duration.
Aggressive breastfeeding promotion HARMS babies:
Other harms were noted in the 2016 paper Unintended Consequences of Current Breastfeeding Initiatives:
Enforced prolonged skin to skin contact leads to deaths from Sudden Unexpected Postneonatal Collapse (SUPC).
Reports of SUPC include both severe apparent life-threatening events (recently referred to as brief resolved unexplained events) and sudden unexpected death in infancy occurring within the first postnatal week of life. A comprehensive review of this issue identified 400 case reports in the literature, mostly occurring during skin-to-skin care, with one-third of the events occurring in the first 2 hours after birth …
Infant injuries and deaths as a result of enforced 24 hours rooming in and closing well baby nurseries.
An overly rigid insistence on these steps in order to comply with Baby-Friendly Hospital Initiative criteria may inadvertently result in a potentially exhausted or sedated postpartum mother being persuaded to feed her infant while she is in bed overnight … This may result in prone positioning and co-sleeping on a soft warm surface in direct contradiction to the Safe Sleep Recommendations of the National Institutes of Health. In addition, co-sleeping also poses a risk for a newborn falling out of the mother’s bed in the hospital, which can have serious consequences.
So the benefits of breastfeeding have been massively exaggerated and the risks ignored. That’s precisely what feeding safety advocates have been saying for years. It is deeply unfortunate that the March for Science chose to elevate ideology over science, and ideological conformity over scientific debate.
They would do well to keep the following aphorism in mind.
Science:
If you don’t make mistakes, you’re doing it wrong.
If you don’t correct those mistakes, you’re doing it really wrong.
If you can’t accept that you’re mistaken, you’re not doing it at all.
I propose that we add the following line just for March for Science:
If you delete and ban those who question you and hide the evidence that you were mistaken, you have spectacularly destroyed your credibility.
