I hate the AAP

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

[Anonymous]

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

yay starve your baby until they officially fall below the FTT line! But up until then, doctors should “discourage” formula. Seriously WTF. That makes me furious. Women’s bodies and labor are not free.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

Omg you are insane. Babies need to eat. Starving babies cannot be justified like this. You are a disgusting person.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

yay starve your baby until they officially fall below the FTT line! But up until then, doctors should “discourage” formula. Seriously WTF. That makes me furious. Women’s bodies and labor are not free.

Except the line isn’t FTT and no one says it is…

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.

Are you not the same person who just said how much she values women’s bodies and time? Because my body sure could have used the sleep and my time would have been much happier holding my baby than doing something wholly unnecessary because someone was “old school”. But I guess woman’s bodies only have value when that’s a convenient point for you?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Hats

The final change I wanted to discuss is a new prohibition on infant hats.

In prior iterations of its guidelines, the AAP has noted concerns with overheating as a risk of SIDS. I talked about that evidence in this post a month ago. The evidence on heat overall is a bit sparse, but in this iteration, the organization has taken it one step further to express concern about the heat generated by infant hats.

The data cited is from a single paper. This is a case-control study in Australia that looked at a large number of possible relationships between clothing and bedding and SIDS. The paper finds that in 8.3% of SIDS cases, a hat (“bonnet”) was worn, versus only 5.2% of control infants. This difference is statistically significant.

However: the paper runs a lot of tests, and this raises concerns about overinterpreting any one result. The authors find, for example, a much stronger statistical link between SIDS and wearing socks than between SIDS and wearing hats. They also find that wearing a nightgown is protective, but wearing “stretch and grow” leggings is associated with an elevated SIDS risk. It’s not clear what any of this means.

In fact, the authors do not make much of any of these results. They note: “Significant differences in the type of products used by case and control infants occurred, and may be related to the difference in season of interview between cases and controls.” Basically, they may have observed more SIDS infants in the winter, when hats (and socks) are more common.

Without belaboring the point, to take from this paper the conclusion that infants shouldn’t wear hats seems … a stretch. The data would more strongly support a “no socks” conclusion. Put differently: if the AAP is convinced by this one study that hats are dangerous, it should also be convinced that socks are dangerous, and nightgowns are protective. "

https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding

The AAP addresses this : " should be noted that because there are no randomized controlled trials related to SIDS and other sleep-related deaths, case-control studies are the best evidence available."...."Physicians and nonphysician clinicians are encouraged to have open and nonjudgmental conversations with families about their sleep practices. Individual medical conditions may warrant that a clinician recommend otherwise after weighing the relative risks and benefits."....

AND YET AGAIN SHE ONLY LINKS THE ONE PAPER NOT BOTH CITED IN THE REPORT. She picked the 2008 Bristol paper and not the NICU paper that found that hypothermia was not a risk for infants who didnt have hats. The paper further goes on to say "It is unclear whether the relationship to overheating is an independent factor or merely a reflection of the increased risk of SIDS and suffocation with blankets and other potentially asphyxiating objects in the sleeping environment. Head covering during sleep is of particular concern. In 1 systematic review, the pooled mean prevalence of head covering among SIDS victims was 24.6%, compared with 3.2% among control infants.274 Although head covering usually refers to bedding or bed clothes, 1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing. A study on the aerodynamics of rebreathing exhaled gases demonstrated that with higher temperature and humidity, the exhaled gas is denser and does not escape the vicinity of the nostrils.429 In this in vitro model, the result was increased rebreathing of CO2-rich gas, suggesting that both overheating and rebreathing are important components in the association between head covering and SIDS." Going back to the NICU study on hats, suffocation was a concern ".

Hats have multiple risks and have no discernable benefit. Thats the equation.

What about socks?

I cant access the full article. But as I stated above- socks were in the article she choose but she didnt talk about the NICU paper or other papers r/t hats and suffocation risk AND she emphasized in her article that the AAP recommendation was based on one article- not true.

Further, if there are papers on socks and suffocation risk then yes the AAP should be consistent. The hat is 3-fold risk- overheating, suffocation, and rebreathing risk. Socks may only be an overheating risk, which makes them less risk. That would also imply that footed pajamas should be avoided.

As your excerpt said, the studies looked at head covering, not hats. The concerns over overheating, rebreathing, and suffocation don't apply to hats in the same way as blankets/sheets that end up over heads.

The AAP should really be more concerned about their reputation. People aren't going to take their recommendations seriously if they explicitly recommend things without evidence indicating a risk.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.

Are you not the same person who just said how much she values women’s bodies and time? Because my body sure could have used the sleep and my time would have been much happier holding my baby than doing something wholly unnecessary because someone was “old school”. But I guess woman’s bodies only have value when that’s a convenient point for you?

I absolutely value women's bodies but really? You think that's k st as bad as a starving baby? You're insane.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.

Are you not the same person who just said how much she values women’s bodies and time? Because my body sure could have used the sleep and my time would have been much happier holding my baby than doing something wholly unnecessary because someone was “old school”. But I guess woman’s bodies only have value when that’s a convenient point for you?

I absolutely value women's bodies but really? You think that's k st as bad as a starving baby? You're insane.

Please provide a single documented instance in the United States, Canada or Europe of a baby of 12-16 hours old starving to death due to lack of formula. I’ll wait.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.

Are you not the same person who just said how much she values women’s bodies and time? Because my body sure could have used the sleep and my time would have been much happier holding my baby than doing something wholly unnecessary because someone was “old school”. But I guess woman’s bodies only have value when that’s a convenient point for you?

I absolutely value women's bodies but really? You think that's k st as bad as a starving baby? You're insane.

Please provide a single documented instance in the United States, Canada or Europe of a baby of 12-16 hours old starving to death due to lack of formula. I’ll wait.

I am not sure why you are setting this arbitrary timeline of 12-16 hours but there are absolutely documented cases of babies starving either to death or to the point of having brain damage in their first days of life because they were dined formula. All you have to do is read the link cited in the first post above which links to the documented cases. I'm sure you'll come up with another lie to justify this, and you can go to hell as far as I care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Hats

The final change I wanted to discuss is a new prohibition on infant hats.

In prior iterations of its guidelines, the AAP has noted concerns with overheating as a risk of SIDS. I talked about that evidence in this post a month ago. The evidence on heat overall is a bit sparse, but in this iteration, the organization has taken it one step further to express concern about the heat generated by infant hats.

The data cited is from a single paper. This is a case-control study in Australia that looked at a large number of possible relationships between clothing and bedding and SIDS. The paper finds that in 8.3% of SIDS cases, a hat (“bonnet”) was worn, versus only 5.2% of control infants. This difference is statistically significant.

However: the paper runs a lot of tests, and this raises concerns about overinterpreting any one result. The authors find, for example, a much stronger statistical link between SIDS and wearing socks than between SIDS and wearing hats. They also find that wearing a nightgown is protective, but wearing “stretch and grow” leggings is associated with an elevated SIDS risk. It’s not clear what any of this means.

In fact, the authors do not make much of any of these results. They note: “Significant differences in the type of products used by case and control infants occurred, and may be related to the difference in season of interview between cases and controls.” Basically, they may have observed more SIDS infants in the winter, when hats (and socks) are more common.

Without belaboring the point, to take from this paper the conclusion that infants shouldn’t wear hats seems … a stretch. The data would more strongly support a “no socks” conclusion. Put differently: if the AAP is convinced by this one study that hats are dangerous, it should also be convinced that socks are dangerous, and nightgowns are protective. "

https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding

The AAP addresses this : " should be noted that because there are no randomized controlled trials related to SIDS and other sleep-related deaths, case-control studies are the best evidence available."...."Physicians and nonphysician clinicians are encouraged to have open and nonjudgmental conversations with families about their sleep practices. Individual medical conditions may warrant that a clinician recommend otherwise after weighing the relative risks and benefits."....

AND YET AGAIN SHE ONLY LINKS THE ONE PAPER NOT BOTH CITED IN THE REPORT. She picked the 2008 Bristol paper and not the NICU paper that found that hypothermia was not a risk for infants who didnt have hats. The paper further goes on to say "It is unclear whether the relationship to overheating is an independent factor or merely a reflection of the increased risk of SIDS and suffocation with blankets and other potentially asphyxiating objects in the sleeping environment. Head covering during sleep is of particular concern. In 1 systematic review, the pooled mean prevalence of head covering among SIDS victims was 24.6%, compared with 3.2% among control infants.274 Although head covering usually refers to bedding or bed clothes, 1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing. A study on the aerodynamics of rebreathing exhaled gases demonstrated that with higher temperature and humidity, the exhaled gas is denser and does not escape the vicinity of the nostrils.429 In this in vitro model, the result was increased rebreathing of CO2-rich gas, suggesting that both overheating and rebreathing are important components in the association between head covering and SIDS." Going back to the NICU study on hats, suffocation was a concern ".

Hats have multiple risks and have no discernable benefit. Thats the equation.

What about socks?

I cant access the full article. But as I stated above- socks were in the article she choose but she didnt talk about the NICU paper or other papers r/t hats and suffocation risk AND she emphasized in her article that the AAP recommendation was based on one article- not true.

Further, if there are papers on socks and suffocation risk then yes the AAP should be consistent. The hat is 3-fold risk- overheating, suffocation, and rebreathing risk. Socks may only be an overheating risk, which makes them less risk. That would also imply that footed pajamas should be avoided.

As your excerpt said, the studies looked at head covering, not hats. The concerns over overheating, rebreathing, and suffocation don't apply to hats in the same way as blankets/sheets that end up over heads.

The AAP should really be more concerned about their reputation. People aren't going to take their recommendations seriously if they explicitly recommend things without evidence indicating a risk.

"1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing." If you cant ascertain that a hat can cause the same issues as a blanket I dont think we are going to be able to find common ground.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Anti-breastfeeding poster" here (I'm not against breastfeeding, I EBFed for 6 months and kept it up until 14 months). Here's a quote from the NYTimes about the new guidelines. The AAP has messed up before (we know this because they have previously retracted guidance that severely harmed some children) and they have messed up again. It is not uncommon for subject matter experts to know a lot about their subject but very little about how to interpret data, and there is no doubt in my mind that this is a BIG issue at the AAP.

"The new guidelines suggest that in the first week after birth, “pediatricians should discourage the use of nonmedically indicated supplementation with commercial infant formula.” The 2012 A.A.P. statement was more subtle, advising that pediatricians encourage “support of practices that avoid nonmedically indicated supplementation with commercial infant formula.”

The difference may seem like a minor point — supporting breastfeeding practices versus discouraging formula use — but it matters. “Nonmedically indicated” is subjective, and the updated admonition concerns me. There are reports, such as this one from The Atlantic and this one from CNN, about mothers who’ve been pressured by lactation consultants, nurses or pediatricians to reject formula in the early days of their children’s lives, and as a result their babies lost a dangerous amount of weight and, in rare circumstances, became gravely ill."

These New Breastfeeding Guidelines Ignore the Reality of Many American Moms https://nyti.ms/3am1C5s

That is untrue. There are highly publicized guidelines for what percentage of dropped birthweight indicates supplementation with formula in the days and weeks after birth.

Yet there are babies who have been denied formula despite needing it. Is it really necessary to double down against formula, as these guidelines clearly do, despite the outright lies from previous posters on this thread?

There are also babies who have been denied breast milk, and had the nursing relationship undermined, despite it being a viable option, because those same nurses and pediatricians don’t tell them their baby is within normal range for breastfed. Practitioners not following the best practices doesn’t mean those best practices don’t exist.

baby starver!

Oh gosh you again? My baby is fine. She never had formula. She got syringe-fed my hand expressed milk because a nurse berated me to tears about how small she was and how fast she was losing weight. The next morning the pediatrician said she was completely fine, wholly within normal, and corrected the nurse. So I spent the night after I delivered a baby hand expressing the worlds most pathetic drops of colostrum because someone didn’t follow or “believe in” the published guidelines. That is a problem with a person not with the guidelines. It would have been equally problematic if she had needed formula and not been offered it.

Given how much some families have struggled this year to find formula for their babies, undermining women who *want* to breastfeed and *can* breastfeed is even more disrespectful of womens time, unless you feel like driving 3-5 hours to secure formula is somehow compensated?

You are off your rocker if you believe it is just as bad for you to have to hand express colostrum as it is to deny a starving baby formula. This is the problem with you sickos.

Are you not the same person who just said how much she values women’s bodies and time? Because my body sure could have used the sleep and my time would have been much happier holding my baby than doing something wholly unnecessary because someone was “old school”. But I guess woman’s bodies only have value when that’s a convenient point for you?

I absolutely value women's bodies but really? You think that's k st as bad as a starving baby? You're insane.

Please provide a single documented instance in the United States, Canada or Europe of a baby of 12-16 hours old starving to death due to lack of formula. I’ll wait.

I am not sure why you are setting this arbitrary timeline of 12-16 hours but there are absolutely documented cases of babies starving either to death or to the point of having brain damage in their first days of life because they were dined formula. All you have to do is read the link cited in the first post above which links to the documented cases. I'm sure you'll come up with another lie to justify this, and you can go to hell as far as I care.

Because my baby was 12 hours old when the nurse told me I “had” to supplement “immediately”. She was 18 hours old when the pediatrician told the nurse she was out of line. At 16 hours I passed out so I can’t take responsibility for what happened after that.

Yes there are documented cases of babies dying from dehydration because their medical providers failed them. In many cases because they are *not* following published guidelines. But bad practitioners are bad practitioners regardless of the side of this debate they fall on, and that doesn’t mean the guidelines themselves are subjective .

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"Hats

The final change I wanted to discuss is a new prohibition on infant hats.

In prior iterations of its guidelines, the AAP has noted concerns with overheating as a risk of SIDS. I talked about that evidence in this post a month ago. The evidence on heat overall is a bit sparse, but in this iteration, the organization has taken it one step further to express concern about the heat generated by infant hats.

The data cited is from a single paper. This is a case-control study in Australia that looked at a large number of possible relationships between clothing and bedding and SIDS. The paper finds that in 8.3% of SIDS cases, a hat (“bonnet”) was worn, versus only 5.2% of control infants. This difference is statistically significant.

However: the paper runs a lot of tests, and this raises concerns about overinterpreting any one result. The authors find, for example, a much stronger statistical link between SIDS and wearing socks than between SIDS and wearing hats. They also find that wearing a nightgown is protective, but wearing “stretch and grow” leggings is associated with an elevated SIDS risk. It’s not clear what any of this means.

In fact, the authors do not make much of any of these results. They note: “Significant differences in the type of products used by case and control infants occurred, and may be related to the difference in season of interview between cases and controls.” Basically, they may have observed more SIDS infants in the winter, when hats (and socks) are more common.

Without belaboring the point, to take from this paper the conclusion that infants shouldn’t wear hats seems … a stretch. The data would more strongly support a “no socks” conclusion. Put differently: if the AAP is convinced by this one study that hats are dangerous, it should also be convinced that socks are dangerous, and nightgowns are protective. "

https://emilyoster.substack.com/p/new-aap-guidelines-on-breastfeeding

The AAP addresses this : " should be noted that because there are no randomized controlled trials related to SIDS and other sleep-related deaths, case-control studies are the best evidence available."...."Physicians and nonphysician clinicians are encouraged to have open and nonjudgmental conversations with families about their sleep practices. Individual medical conditions may warrant that a clinician recommend otherwise after weighing the relative risks and benefits."....

AND YET AGAIN SHE ONLY LINKS THE ONE PAPER NOT BOTH CITED IN THE REPORT. She picked the 2008 Bristol paper and not the NICU paper that found that hypothermia was not a risk for infants who didnt have hats. The paper further goes on to say "It is unclear whether the relationship to overheating is an independent factor or merely a reflection of the increased risk of SIDS and suffocation with blankets and other potentially asphyxiating objects in the sleeping environment. Head covering during sleep is of particular concern. In 1 systematic review, the pooled mean prevalence of head covering among SIDS victims was 24.6%, compared with 3.2% among control infants.274 Although head covering usually refers to bedding or bed clothes, 1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing. A study on the aerodynamics of rebreathing exhaled gases demonstrated that with higher temperature and humidity, the exhaled gas is denser and does not escape the vicinity of the nostrils.429 In this in vitro model, the result was increased rebreathing of CO2-rich gas, suggesting that both overheating and rebreathing are important components in the association between head covering and SIDS." Going back to the NICU study on hats, suffocation was a concern ".

Hats have multiple risks and have no discernable benefit. Thats the equation.

What about socks?

I cant access the full article. But as I stated above- socks were in the article she choose but she didnt talk about the NICU paper or other papers r/t hats and suffocation risk AND she emphasized in her article that the AAP recommendation was based on one article- not true.

Further, if there are papers on socks and suffocation risk then yes the AAP should be consistent. The hat is 3-fold risk- overheating, suffocation, and rebreathing risk. Socks may only be an overheating risk, which makes them less risk. That would also imply that footed pajamas should be avoided.

As your excerpt said, the studies looked at head covering, not hats. The concerns over overheating, rebreathing, and suffocation don't apply to hats in the same way as blankets/sheets that end up over heads.

The AAP should really be more concerned about their reputation. People aren't going to take their recommendations seriously if they explicitly recommend things without evidence indicating a risk.

"1 study found significantly more SIDS cases in infants wearing hats compared with controls.321 It is not known whether the risk related to head covering is attributable to overheating, hypoxia, or rebreathing." If you cant ascertain that a hat can cause the same issues as a blanket I dont think we are going to be able to find common ground.

that’s the same study that states it can’t be sure the cause is hats or the winter (since more babies wear hats in the cold).