As a physician and expectant first-time mother, I had no doubts that I would exclusively breastfeed my child. I prepared diligently by reading the breastfeeding guidelines and attending classes. My child was born after a normal and healthy pregnancy and delivery. We were discharged at 48 hours having met all the expectations of the breastfeeding guidelines. Upon going home, my child began to be more agitated, nursing nearly continuously, which the breastfeeding manuals all say is normal, instructing mothers to just keep nursing, discouraging any supplementation. After 2 days of near-continuous feeding, while producing the expected number of diapers, we found out from a lactation consultant that he was getting absolutely no milk from me and that he had gone without food for 4 days. Three hours after feeding him for the first time, we found him unresponsive and had to force-feed him formula to wake him up. Then he seized. We brought him to the hospital and found out that he developed hypoglycemia, severe jaundice and severe dehydration consistent with profound brain injury.

Every year, roughly 228,000 U.S. babies are rehospitalized for jaundice, the majority from insufficient feeding. Phototherapy admission costs the U.S. $3.2-4.5 billion dollars, the majority of admissions preventable with timely recognition of newborn hunger and supplementation. It has also been found that as many as 10% of closely-monitored exclusively breastfed babies have low blood sugar by 6 hours of life, a complication of insufficient feeding that can reduce the ability to pass 4th grade math and literacy tests by 50%. Yet few breastfeeding mothers are told about this. 

An article published in the medical journal Hospital Pediatrics showed that breastfed babies who were found lethargic, seizing and poorly feeding from low blood sugar showed that they had significant brain injury on MRI resulting in severe long-term disability.  Mothers are told that the milk they produce is always enough. They are told their babies are crying for reasons other than hunger. Mostly they are discouraged from supplementing their hungry babies. Therefore, for a mother whose milk does not arrive on time, she has no idea what is happening until she finds her baby lethargic. 

Please petition the CDC, the AAP, the US Health Secretary and the Surgeon General to issue a warning to parents about the dangers of underfeeding exclusively breastfed babies and the risk of brain injury from hypoglycemia, jaundice and dehydration. Urge for increased monitoring to protect breastfed babies from these tragic outcomes. To read the full campaign letter and my recommendations to improve patient safety, please go to the following site: fedisbest.org.  On this page is a link to a parent guide to help protect newborns from insufficient feeding.

-- Christie del Castillo-Hegyi, M. D.