BabiesHealthMental Health

When Lactivism Kills

Recently, there have been so many sad, infuriating, and heartbreaking stories in the media that it’s hard to keep up. Surprisingly, the ones that are hitting me the hardest are not about politics. As a pregnant person, who is literally about to give birth to my third child, the stories that are making me shake and cry are about lactivism, breastfeeding advocacy, and how this movement is literally killing babies and breast/chestfeeding parents.

  • Moms like Florence Leung, who died from suicide, after the pressure to breastfeed her son contributed to severe postpartum depression. Her husband is begging new moms to get help and to ignore the Baby Friendly Hospital Initiative and the pressure to breastfeed at all costs that he blames for his wife’s death.
  • Babies like Landon, who experienced cardiac arrest from dehydration just 12 hours after being discharged from a “baby-friendly” hospital and who died after two weeks on life support.
  • Babies like Tyler, whose young mother was convicted of negligent homicide after he died from starvation when she was unable to produce enough breast milk.
  • The 15 newborns who suffered from Sudden Unexpected Postnatal Collapse (SUPC), a condition where healthy infants with no underlying conditions unexpectedly stop breathing, while their mothers were holding them skin-to-skin at “baby-friendly” hospitals, as the initiative recommends.
  • The 15 babies who died and 3 babies who nearly died as a result of falls and suffocation, while bedsharing with their likely exhausted moms in hospital maternity wards, after their moms were forced to room in with their newborns.
  • The unnamed baby in this study who died from brain edema due to hypernatremic dehydration from exclusive breastfeeding.
  • One study showed that 1.9% of 3,718 term and near term babies were admitted to Children’s Hospital of Pittsburgh in a 5-year period with postnatal hypernatremia related to insufficient breast milk intake. It’s important to remember that these are just admissions. There’s no way to know how many babies don’t get enough breast milk in their first days of life and BFHI does not track or report its complications or readmission rates. To put this in perspective, in 2009, the 28 day overall re-admission rate for newborns was 1.1%. The American Hospital Association estimates that 50% of re-admissions are preventable. Another study, which examined breastfed and mix-fed newborns, found that 9.3% of exclusively breastfed babies developed hypernatremia, compared to 2.7% of mix-fed babies.
  • The estimated 1,600 newborn who suffer from accidental falls in hospital post-natal units in the United States each year.
  • The thousands of babies who have narrowly avoided death or who may have life-long health problems due to insufficient milk intake and related health consequences (including my own daughter).

In so many of these stories and in my own experience, parents followed medical advice and hospital policies designed to encourage breastfeeding and didn’t realize that their babies were starving or at risk of harm. Inadvertently and ironically, their babies were harmed by so called “baby-friendly” policies.

Nearly 20% of babies in the U.S. are born in “baby-friendly” hospitals, and many hospitals are eagerly adopting this model, which requires that hospitals follow 10 steps to promote successful breastfeeding, and this should cause all of us concern. The hospital where I will deliver my son is one of them, as is the other hospital in our city. I have no other options. The International Board of Lactation Consultant Examiners, is no better, requiring that their certified lactation consultants uphold “breast is best” by “acting as an advocate for breastfeeding as the child-feeding norm.” What does that even mean? If breastfeeding becomes the standard that all of us are expected to achieve, what happens when achieving that standard is impossible, harmful, or even deadly?

Why do I care so much?

While everyone from health professionals, the media, and policymakers to parents, friends, and strangers in the formula aisle repeat the phrase, “breast is best,” without considering the complex realities of lactation, breast/chestfeeding challenges, modern parenthood, and postpartum psychology, babies and their parents are literally dying. Literally.

Recently, when discussing yet another case of accidental starvation on a Facebook post, someone asked me how many babies have actually died from this. As if there is an acceptable rate of neonatal death. As if “breast is best” is more important than babies.

Does it matter?

Do we really need to promote breastfeeding at all costs, when babies thrive on breast milk, formula, and combinations of both, with nipples, bottles, tubes, supplemental nursing systems, or all of the above, and the differences between breast-fed and formula-fed term babies are nearly nonexistent?

My 5-day-old daughter after she had lost almost 20% of her bodyweight

If a single life can be saved by changing our message around infant feeding from “breast is best” to “fed is best,” then it is worth it. We need to stop the almost religious devotion to the “breast is best” message and ill-advised hospital policies from preventing moms and dads from feeding their babies safely and creating situations where parents are so desperate to breastfeed that they would rather take their own lives than feed their babies formula.

I also speak out, because it happened to me.

I recently shared my story of accidentally starving my newborn daughter and the resulting depression that followed in a post on The pressure to breastfeed made me want to die. Specifically, the pressure to breastfeed exclusively, despite the fact that I, like hundreds of thousands of other parents, can’t produce enough milk to feed my babies, and that research shows early supplementation with formula is not only not harmful to babies, it can actually promote longer term breastfeeding.

I wrote about the lengths I went to to breastfeed, a routine which nearly killed me.

I met with two hospital lactation consultants, my midwife, and a private lactation consultant. I took herbal supplements, ate any food that was reputed to increase supply, got a prescription for an expensive drug that’s not FDA approved, pumped 12 times a day, and tried to spend each day focused on feeding her. I’d tell myself, You have one job, damn it, feed the baby. Most days, I barely slept or ate. I cried while I fed her, and hated every moment in between.

I have read and heard a lot of #alternativefacts in the past few days. Let’s go ahead and add “breast is best” to the list, because when lactivism is literally killing people, how can breast be best for those families?

For more information on safe and evidence-based infant feeding and support for new parents, please visit the Fed is Best Foundation.

You don’t have to do this alone.

Featured Image: New Westminster Police Department

Other Images: Steph, all rights reserved.


Steph is a mom, stepmom, freelance writer, and advocate. When she's not busy writing, chasing kids around, cleaning up messes, and trying to change the world, Steph enjoys snuggling, making pies, politics, reading paranormal fiction, yoga, and fitness. A fully recovered natural parent, Steph now trusts science, evidence, and common sense to lead the way. She has been actively involved in the reproductive and women's rights movements for more than 20 years and is a passionate pro-choice feminist. Her writing can be found on Grounded Parents, Romper, The Cut, and other print and online publications

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  1. This is a fabulous post thank you for making it.  I nearly died in childbirth.  Bled horribly, lost consciousness, had to have a hysterectomy to save my life.  I was in the ICU the first 24ish hours, and the first night I was back in maternity the nurses shamed me horribly about placing her in the nursery rather than keeping her with me.  I could not sit up.  I could not get up.  I could not hold her.  Were she to cry, or spit up and be choking, I would not be able to get to her.  Nevermind that I was in pain, on heavy medication, recovering from transfusion and two surgeries…. you’d have thought I could get sympathy or failing that, at least not be shamed.

  2. Thank you for this post. I found it chilling: my elder daughter lost 17% of her body weight in the first five days, but I think I never quite registered how close to death/serious health consequences she came until reading this post. It was a horrendous time, to sit in a lactation consultant’s office surrounded by signs about breast is best and babies are born to breastfeed and the implicit message that formula is poison, to be told that I was starving my child to death, and ordered to give her formula. Fortunately, it was caught early enough that she suffered no long-term health consequences, but I found that once advice changed to “this baby needs formula”, no one was really adept at how to help me cope emotionally with the conflict between the cultural message of breast is best, my desire to be the very best mother possible, and my inability to breastfeed exclusively. And while very fortunately she thrived physically (and is now a bright, active 10-year-old), I don’t think it was in either of our best interests for me to spend those early months so distraught. I braced for PPD with my second, but in fact, being prepared really helped: I knew and accepted that I was almost certain not to be able to breastfeed her exclusively, insisted that we watch her weight like a hawk in the early days (contrary to the “frequent weight checks make mothers too anxious” advice first time round), and as soon as she hit 10% loss (on day 3), confirming that once again I did not have enough milk, began supplementing with formula. I took herbs and medication to maximize production, but I skipped the ridiculous endless pumping that I’d gone through with my first–there was no way I could do that with a toddler. And it was all so much less traumatic for me psychologically and for her physically than it had been with my first daughter. As for your point about supplementation promoting longer-term breastfeeding: as it happens, despite insufficient glandular tissue and low milk supply, both my children nursed until they were about two.  Combining breastfeeding with formula actually worked really well for us.

  3. bunnybear @1  I’m really sorry that happened to you.  I don’t know how hospitals can justify treating new mothers the way some do, when any other person who has had similar procedures or physical traumas would be told NOT to do a lot of those things.  I wish more new parents would file complaints with their hospital patient advocate office.  I think the only way things will change is if enough people object but most people feel that there is something wrong with themselves instead of  seeing the Baby friendly policies as anything but. (How is it Baby Friendly to make new mothers feel their only value is as a milk producer? Or that the BEST thing in the world is breastmilk and not the love and attention of loving parents. Making mothers exhaust themselves is no good for anyone)

    1. Thank you for your kind words!  I am happy to tell you that I did make a complaint, before I was even discharged from the hospital.  I first wanted to make sure for safety reasons that that individual nurse would not be involved with my or my daughter’s care, but also to voice what happened to me to help others.  Your comment is right on!!

  4. This is a desperately sad catalogue, tragic in its effects on mothers and babies. But you need to distinguish between very bad maternity care and breastfeeding advocacy.

    No baby, breastfed or formula fed, should become ill from dehydration; no mother, breastfeeding or formula feeding, should feel pressurised or castigated.

    It’s not breastfeeding, or Baby Friendly, that’s to ‘blame’ in these cases, but lack of sensitive, individualised, skilled maternity care, that spots the poorly-thriving baby before early difficulties become major challenges (a three-day-old baby who’s lost 10 per cent off birthweight may not need formula supplements, but more access to effective breastfeeding, for example; a baby who loses 17 per cent off birth weight by five days has been allowed to fly way under the radar by healthcare professionals who should have spotted problems days before it became an emergency).

    Baby Friendly training in the UK – and 60 per cent of babies are born in BF units –  stresses this, and places much emphasis on early relationships between parents and baby, so all babies thrive.

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