Lucy Ruddle IBCLC is exasperated because I have repeatedly used her as an example of the heartlessness many lactation consultants show to women who can’t or don’t wish to breastfeed.
I doubt she is going to be relieved that today I will use her as an example of the utter cluelessness of lactation consultants when it comes to the scientific literature. Not only do they fail to read it, but when they read it, they don’t understand it.
Yesterday Lucy gleefully wrote:
She read the wrong paper; misunderstood what she read; and the paper confirmed my claim.
So, that study being shared by certain places who like to scaremonger… the “1 in 71 breastfed newborns are readmitted” one… I got hold of it, mainly because I was interested in the limitations, which SOB and FIB have a habit of ignoring.
The first thing which I found interesting was there was a significant difference in readmission rates if the baby was delivered by C section vs Vaginal delivery. Csec babies had a readmission for weight loss rate of 6%, vs 0.4% of vaginal birth babies.
Right away we learn several things.
1. Lucy — like many lactation consultants — is not in the habit or reading the scientific literature. She knows what she knows and imagines that she can’t learn any more. She only read this paper so she could play “gotcha.”
2. Lucy had no idea which paper I referenced, she couldn’t be bothered to check the many times I had provided the citation.
The paper has this quote:
…[E]xclusive breastfeeding at discharge from the hospital is likely the single greatest risk factor for hospital readmission in newborns.29,30 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).
She just guessed and chose the WRONG paper.
3. Lucy — like many lactation consultants — cannot understand the science she reads. She confused weight loss rates with readmission rates.
She read literally ignored the results section of the abstract that said this:
Exclusively breastfed newborns had higher readmission rates than those exclusively formula fed for both vaginal (4.3% compared to 2.1%) (p<0.001) and Cesarean deliveries (2.1% compared to 1.5%) (p=0.025).
It couldn’t possibly be clearer!
Instead Ruddle seized on these sentences deep in the paper:
For newborns delivered vaginally, WEIGHT LOSS >10% at discharge was rare (0.4%)… For newborns delivered by Cesarean, WEIGHT LOSS >10% at discharge occurred for 6% of newborns …
That’s an interesting finding, but those are NOT readmission rates.
4. Lucy didn’t stop to think. She assumed that she had caught me as well as the Fed Is Best Foundation in a glaring error. It apparently never occurred to her that since we have far more education and experience with scientific evidence, she ought to carefully check her own findings that disagreed so dramatically.
5. Lucy spun nonsensical theories based on her nonsensical conclusion:
So, why are C section babies more likely to be readmitted for weight loss? I’m wondering if its linked to delayed onset of copious milk production. Milk “coming in” can be delayed by 24hrs following a C section, and this may cause excessive weight loss with, or without signs of baby struggling or even being bothered by this…
But C-section babies are LESS likely to be readmitted, so her entire theory is a figment of her imagination. Why are they less likely to be readmitted? Because they stay in the hospital 24-48 hours longer while their mothers are recovering; dehydration and jaundice is more likely to be picked up and treated BEFORE discharge.
6. In the ultimate irony, the paper that Lucy read and misunderstood has a HIGHER readmission rate than 1 in 71. According to the data in the paper, the readmission rate for exclusively breastfed babies in as high as 1 in 54.
To summarize: Ruddle read the wrong paper; misunderstood what she read; never questioned why her “findings” differed so dramatically from others; spun a nonsensical theory to account for her misinterpretation; and the paper actually CONFIRMED my point by showing that even MORE than 1 in 71 exclusively babies are readmitted.
The bottom line? Don’t listen to lactation consultants if you want to know what the scientific literature shows.
Only one question remains: Will she apologize and issue a correction when she finds out how foolish she has been?
