Petition to Protect Newborns from Brain Injury Caused by Insufficient Breast Milk Intake

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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. 

I thought this was rare but it turns out that many of my friends and colleagues, including physicians, nurses and even lactation consultants have similar breastfeeding stories, many discovering their children starved at home, some requiring hospitalization. Many of these stories are posted by parents, nurses and pediatricians on the comments section of this page.

Every year, roughly 1 in 50 babies or 60,000 U.S. babies are rehospitalized for similar complications. In fact, 1-6% of breastfed babies all around the world get hospitalized for starvation-related complications mostly from insufficient breast milk production and intake, which can be prevented with increased monitoring and timely supplementation. It has also been found that as many as 10% of closely-monitored exclusively breastfed babies are hypoglycemic (<40 mg/dL) within the first 48 hours and that even transient hypoglycemia to this level can reduce 4th grade math and literacy test scores by 50%. Yet few breastfeeding mothers are told about this. 

On September 2015, the Hospital Pediatrics medical journal published a report of 11 exclusively breastfed babies who came to the Cincinnati Children's Hospital in a similar fashion. 5 out of 6 MRI's obtained showed widespread brain injury to a third to almost the entire brain, all caused by profound, sustained hypoglycemia due to the babies accidentally not getting enough milk. 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 or unresponsive like mine. 

Please petition the CDC, the AAP 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:  On this page is a link to a parent guide to help protect newborns from insufficient feeding.  Please watch the video presentation above to learn about newborn dehydration and what the scientific literature says about it. 

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

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