No doubt it is very difficult to learn that the organization that you lead, Baby Friendly USA — the organization that pays you — is completely ineffective at its central task. But that doesn’t make it acceptable to respond with fake news.
Fact vs. FIB: The Impact of Baby-Friendly on Breastfeeding Initiation Rates Is a masterful attempt to fool its lactivists and lactation professionals.
Breastfeeding rates were rising for decades before the advent of the BFHI.
The most recent example of data distortion is a novel but incomplete presentation of data in a study published last month in The Journal of Pediatrics, which Fed Is Best (FIB) has now leveraged into sensationalized social media posts and this erroneous and deceptive headline on its website: “US Study Shows Baby-Friendly Hospital Initiative (BFHI) Does Not Work.”
What did the study show?
Researchers could not find ANY ASSOCIATION (let alone causation) between the BFHI program and breastfeeding initiation rates and breastfeeding continuation rates.
To counter the copious data in the original study, BF USA presents this simple graph:
It appears to imply two things:
1. It appears to imply that the BFHI came BEFORE the rise in breastfeeding rates.
2. It appears to imply a dose-response: more BFHI facilities lead to higher breastfeeding rates.
But, like most fake news, it misrepresents the data — in this case by looking only at a select time period.
What happens when we take a broader view?
This happens:
The graph is from Surgeon General’s Call to Action to Support Breastfeeding 2011; I added the red markings to illustrate the point:
The BFHI came AFTER the rise in breastfeeding rates.
Since that’s the case, simply graphing breastfeeding initiation rates against the number of BFHI hospitals CAN’T tell us whether the BFHI is successful; breastfeeding rates were rising already.
So the authors looked for a dose-response. Did more BFHI hospitals in a state lead to higher breastfeeding rates in that state?
This is what they found.
You can see that increasing the proportion of BFHI facilities in a state has no impact on breastfeeding initiation rates. States with no BFHI facilities have the same breastfeeding initiation rates as those with nearly 100% BFHI facilities. The BF USA graph is fake news because it deliberately misrepresents the relationship between BFHI and breastfeeding initiation rates.
More remarkable still is that BF USA did not even try to dispute the central point of the study: that BFHI has no impact on continuation of breastfeeding.
Why is this so important?
Breastfeeding initiation rates were rising dramatically before the BFHI; women had received the message that breastfeeding has some benefits and they wanted to give their babies those benefits. However, the majority of women give up breastfeeding in a relatively short time. The study shows that BFHI has no impact on out of hospital breastfeeding rates. BF USA does not deny it.
The real problem, though, is that the BFHI is harming babies and mothers.
The authors of the study note:
…concerns about associated neonatal sentinel events including sudden unexpected postnatal collapse (SUPC), newborn falls, and newborn dehydration and jaundice, which are recognized by the American Academy of Pediatrics, the WHO, The Joint Commission, and the CDC.
Indeed, breastfeeding has become the LEADING risk factor for newborn re-hospitalization, leading to tens of thousands of re-hospitalizations a year at a cost of hundreds of millions of dollars.
BF USA has never denied this, and isn’t denying it now.
I suspect that lactivists and lactation professionals will gobble up BF USA’s misleading claims, but the rest of us don’t have to fall for fake news.
