Can you imagine the American College of Obstetrician-Gynecologists insisting that they must support the practice of routine episiotomies — even though they harm women — because obstetricians like them? I can’t. That would be deeply unethical.
Can you imagine the The American Academy of Otolaryngology insisting that they must support the practice of routine tonsillectomies — even though the risks to children’s lives far outweigh any possible benefit — because Ear, Nose and Throat specialists profit from them? I can’t. That would be deeply unethical.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Supporting “safe” bedsharing is no different from supporting “safe” drunk driving.[/pullquote]
Can you imagine the Academy of Breastfeeding Medicine insisting they must support the practice of routine bed sharing — even though it kills babies — because lactation professionals like it?
Despite the fact that would be deeply unethical, you don’t have to imagine it. Incredibly, for lactation professionals, promoting breastfeeding is more important than whether babies live or die.
The ABM has made their ugly position clear in a recent commentary by Ann Kellams, MD.
She starts with a lie:
…[T]he recommendations for infant feeding and safe sleep can be confusing and may appear to be at odds with one another.
There is NOTHING confusing about the recommendations for safe infant sleep. Every pediatric and public health organization — valuing babies lives above whether or not they breastfeed — is very clear that bedsharing kills babies and should NOT be practiced.
In contrast, every major lactation organization — valuing breastfeeding over whether babies lives or die — supports the deadly practice of bedsharing.
They have lots of excuses:
We know that mothers who bedshare with their infant breastfeed for longer. We also know that where babies start off the night is not always where they end up in the morning. We know that breastfeeding is protective against Sudden Infant Death Syndrome (SIDS), but also that bedsharing may pose a risk for a sleep-related infant death, particularly in the setting of other risk factors such as prenatal smoking, formula feeding, maternal substance use, sedating medications, maternal obesity, prematurity, and the presence of soft bedding in the sleep environment. Some organizations recommend bedsharing as a means of supporting breastfeeding and cite data about the physiologic patterns and postures of mothers and babies when they bedshare…
So what? How does that justify hundreds of preventable infant deaths each year? It DOESN’T.
Dr. Kellams seems to think we face an ethical conundrum:
What then is a mother to do? And how as physicians should we counsel them?
There is no conundrum. The ethical position for doctors is to counsel mothers that bedsharing might kill their babies. The ethical position for mothers is to try to prevent bedsharing in order to avoid the deaths of their babies.
But Dr. Kellams and the Academy of Breastfeeding Medicine apparently believe that promoting breastfeeding is more important than preventing infant deaths. For them, a few hundred dead babies each year pales into insignificance compared to goosing exclusive breastfeeding rates higher. Why? Because breastfeeding is “healthier.” They seem neither to know nor care that dead babies can’t breastfeed.
No matter. Is a flourish of mind-blowing hypocrisy, Dr. Kellams suggest that we should “listen to mothers.”
That’s hilarious! The same people who insist that we should NOT listen to women who don’t wish to breastfeed and utterly ignore those women who report pain, exhaustion and insufficient breastmilk as reasons for choosing formula suddenly think we should “listen” to mothers who bedshare? The same people who insist that we should hammer new mothers with masses of information about the benefits of breastfeeding, force them into hospital settings in which they will be pressured to breastfeed and shame them for not breastfeeding expect us to believe they care at all about what mothers think?
But Dr. Kellams and the ABM are undeterred:
…Starting with listening can help the physician determine the level of risk given the particular situation and tailor the education and advice. Even the organizations that recommend no bedsharing recognize that mothers are at risk of falling asleep while feeding and that the safest place to fall asleep while feeding is an adult bed with a flat, firm mattress and no soft bedding, i.e. pillows, blankets, or comforters in the environment. The groups that advocate for bedsharing as a strategy for successful breastfeeding also caution about soft bedding, the gestational age of the infant, breastfeeding vs. formula feeding, the avoidance of smoking and sedating medications or substances, etc…
By that “reasoning,” we should listen to drunk drivers.
Can you imagine ANY physician advocating counseling those who habitually drive drunk to make sure their brakes are in working order and buckle their seatbelts because they are probably going to drive drunk anyway?
What would you think of any physician who insisted that the key to preventing drunk driving deaths was to support safe drunk driving? I imagine you would conclude that such physicians were behaving unethically.
And what would you think of such a physician if you learned that she earned a substantial proportion of her income from bar owners and purveyors of alcoholic beverages in exchange for promoting drunk driving? I don’t know about you, but I would conclude she had a massive conflict of interest and that her “advice” should be ignored as utterly self-serving.
Because that’s what is going on here. The Academy of Breastfeeding Medicine has a massive conflict of interest. They profit from promoting breastfeeding regardless of who gets hurt — or who dies! — in the process.
They should be ashamed of themselves.
But that would require valuing babies lives above breastfeeding. Unfortunately, they appear so blinded by their own interests that they consider a few hundred dead babies a year a small price to pay to promote breastfeeding.
