I recently saw this article, Mom’s Message About Her Baby’s Death: “If I Had Given Him Just 1 Bottle, He’d Still Be Alive“, posted with the recommendation to share it with all new and expectant parents. That has got to be the absolutely worst advice ever. The article is of questionable veracity – there is something very fishy about it. The link is titled “baby dies from cluster breastfeeding” and claims that this couple, “Jillian and her husband thought that they were doing everything in their power to prepare themselves. ‘We took all of the classes. Bought and read all of the books. We were ready! Or so we thought'” and yet somehow their baby dies at 10 days old:
After getting home, Landon fell asleep while cluster feeding and became unresponsive with no pulse, and turned blue. After 15 days on life support, the newborn passed away. “The best advice I was given by one of his NICU doctors while he was on life support is ‘Sure breast is best, but follow with the bottle,'” she wrote. “This way you know your baby has eaten enough. If only I could go back in time.”
Dr. Christie del Castillo-Hegyi, an emergency physician with a background in newborn brain injury research at Brown University, explained how Landon died as a result of dehydration, which was followed by cardiac arrest caused by brain injury:
“Constant, unsatisfied nursing and inconsolable crying are two of the signs of newborn starvation that lead to brain-threatening complications. If a child is receiving a fraction of their caloric requirement through early exclusive breastfeeding, they can experience severe hunger and thirst, which is why they will cry inconsolably and breastfeed continuously when it is the only source of calories and fluid they are offered. If a mother’s colostrum does not meet the child’s caloric requirement, they will breastfeed for hours a day in an attempt to relieve their hunger. A child who is “cluster-feeding” may actually burn more calories breastfeeding than they receive in return, which can result in fasting conditions and accelerated weight loss.”
Five years later, his mom is still dealing with endless guilt and questions what her life be now if she had just known to give him a bottle.
So here’s my take as someone who spent years keeping up-to-date on pregnancy/birth/breastfeeding best evidence-based practices and sharing them with expectant and new moms:
a) If the parents had known to watch wet and dirty diapers, there is no way this baby could have died of dehydration. If there is enough coming out, then there is enough going in. If the parents were at all educated about newborns and breastfeeding, they would have known this. Unless there is some other rare or unusual medical issue going on with the baby that isn’t addressed in the article (if indeed anyone even bothered to figure it out). I’m not sure how this can be seen as anything other than tragic parental ignorance or some very strange underlying medical issue. Or there’s a lot more to the story than is being reported.
b) Sounds like this could be a problem of medical neglect/incompetence, because they should have made sure the baby was getting enough nourishment/liquids. Hospitals normally keep track of these things when mom and baby are there after delivery and are usually prompt in pushing bottles if they suspect baby’s not getting enough. Where were her release instructions telling her what to watch for (they typically include signs of dehydration) and how to tell if the baby was getting enough? Where was her follow-up visit with a pediatrician after baby was discharged from the hospital? Why wasn’t anyone weighing this baby to see if weight loss stopped at 10% and started to pick back up? Why wasn’t there a lactation consultant telling her to pump if it seemed she wasn’t producing enough or if the baby wasn’t getting enough?
c) The advice given by the NICU Doctor,”sure breast is best, but follow with the bottle,” is terrible advice for normal situations. For a normal mother/baby pair this advice may well spell the early and unnecessary end of breastfeeding. It is possible that this advice was appropriate to this particular mother, but her situation was clearly not normal. Sifting the normal situations from the abnormal ones is why people include medical professionals in the process of birth and breastfeeding at all. Otherwise, if all situations were normal, they would be entirely unnecessary. The quoted emergency doctor’s statements are also problematic to be sharing with expectant parents. What she says might have been true in this situation, but just isn’t good advice for most parents. Whether a baby is crying “too much” is really subjective. Some babies come out screaming and don’t stop for years (only a slight exaggeration) even though there is nothing physically wrong with them. This is why many midwives and doctors tell new moms to call/visit if they are worried, if they think something might be wrong. It doesn’t hurt to check, though most of the time nothing will be wrong. Also cluster feeding and newborns nursing “constantly” can also be completely normal. When a baby is born he has a stomach the size of a marble. It doesn’t take much to fill it up, and it needs to be filled pretty frequently. Breastfeeding for “hours a day” is normal for a newborn. Those are well-established facts.
This mother’s guilt, and the likely malpractice of her care providers, may make it attractive to blame breastfeeding for her baby’s death rather than looking at what the real reasons might be. Breastfeeding doesn’t kill babies; it sustains them. We’re mammals; how else would the human race have continued to exist for thousands of years before the invention of man-made substitutes?
Sharing inaccurate and fear-mongering articles with expectant mothers, especially first-time moms, will only freak them out and possibly cause them to make fear-based decisions, rather than evidence-based ones for their babies’ care and feeding. Spreading this around doesn’t do anyone any favors. Including these bereaved parents.