Breast is best except when it is not!

With the last essay I referenced the breast feeding Nazis, I thought this topic important enough to follow up that theme this week.

In the book Bad Mother there is a chapter on the author’s experience breast feeding her fourth child. This child was born with a missed minor cleft palate that inhibited the ability to breast feed. As a result, the baby essentially starved for eight days. Ayeletat Waldman had teams of lactation consultants who strongly advised her to just stay with it. Between her own guilt, stubbornness and scores of bad advice from assorted professionals, the baby almost died.

Upon hearing this I have to comment, as we went through the same experience she described. By the fourth day of our daughter’s life I was convinced she would die and my wife would kill me. Like the baby in Bad Mother my daughter was unable to latch on and get breast milk. More than four lactation consultants and multiple nurses kept up the mantra “breast is best she will get it, just persevere.” It was obvious that the baby was getting weaker and eventually she was unable to stay awake long enough to keep trying. Just as bad, my wife hadn’t slept for four straight days, as the baby had to continually breast feed and my wife had to use a pump to keep her breasts from drying up. Chances are, had we ignored the recommendations and started the bottle right away, things would have gone better. Our daughter was born slightly premature and was just too small and weak. When my wife’s fatigue and fear eventually outpaced her guilt and sense of failure, we found a much more practical pediatrician who said, “of course use the bottle!”

The change in my daughter was immediate. The super nutrient formula we switched to saved her life and our marriage. My wife was finally able to get some sleep, my daughter was finally able to get some calories, and I finally was able to stop hearing that we need marital counseling because I wasn’t bonding with the baby whom I was convinced would die.

Breast is Best almost killed our child. We and everyone else ignored the obvious despite our gut feelings because this mantra is so blindly reinforced by those who believe in it. It is like a religion where one’s faith demands sacrifice. In fact, the denial of common sense by reason of religious guilt may indeed lead to death.

Dr. Brilliant Cliché

The Granny Doctor would like to take this opportunity to rant against fundamentalists. If a button is ever pressed to destroy the world, she doesn’t know what particular philosophy or religious beliefs that button pusher will embrace, but she can bet they will be a Fundamentalist.

Fundamentalism is, by definition: a movement or point of view characterized by rigid adherence to fundamental or basic principles.

The people who advised both your wife and Ayeletat Waldman to continue to breast feed although it was obvious it wasn’t working were fundamentalists. They clung to beliefs in the face of contradicting facts and instead of solving a problem caused it to exacerbate to the point of near death. Had the facts not been examined and acted upon by both parents the children may indeed have died.

It was Sakyamuni who said “No dharma is definitive”. That does not mean there are no means by which we can determine what is right in any given circumstance. It means that in any given circumstance, there is a unique configuration of facts and elements that have to be dealt with, and one cannot expect to effectively deal with every circumstance in the exact same way.

A great example of the truth of this is in putting out kitchen fires. If your dish towel catches on fire, throwing water on it will put it out. But if your frying pan develops a grease fire, water will only spread it. A better choice is to smother it with salt.

A fundamentalist who believes water puts out fires would disagree. A fundamentalist would continue dousing a grease fire with water until it spread into his living room and his curtains caught on fire, at which point he may indeed be able to put the curtains out with water and prove his fundamentalist point.

A fundamentalist Right to Lifer will kill to underline his point.

What kind of idiotic sense does this make?

Don’t be a fundamentalist. Keep your eyes open and have some common sense. Word from the Granny Doctor.

B.C. – I agree with your points but my issue is with professional fundamentalism: those in charge and those whom we depend on to KNOW- doctors, teachers, elected officials, etc. They don’t come with a pin saying “I am a fundamentalist Right to Lifer” or “I’m a Breast to Death advocate.”
Yes we have our own personal responsibility toward common sense but when the supposed educated authority speaks, you not only are expected to follow directives but most often do in fact defer one’s own common sense. We are a nation of specialists. You can say each specialty is like a fundamental belief system. A specialist will look at the data solely from their own training. So yes, fundamentalism is wrong, but we live in a fundamental society. Who do you trust?

Granny Doctor- A good question, especially when trust can mean the difference between life and death. A personal example similar to yours: when I was 26 years old I nearly died from acute Crohn’s Disease and the doctors who operated on me gave me terrible advice. If I had followed it, and the western medical treatments for my medical problem, I would have ended up on dialysis by the time I got to be a Granny. My own common sense prevailed and I spent the next 30-40 years figuring out how to handle the problem more intelligently. How did I know to do that? Much like you, I first faithfully followed their advice. When it seemed to be having an adverse effect, I researched and found some answers on my own. I sought the help of better informed professionals who practiced a different sort of medicine. Much like you did with your daughter.

Your expectation of being able to trust advice just because it comes from someone labeled an Authority is reasonable in an ideal world. But we don’t live in an ideal world. As you pointed out, we live in a fundamentalist society. I would go further and say we live in a fundamentalist World. This means we deal with a lot of intractable nuts- and they can come wearing lab coats and stethoscopes as easily as they can come waving guns. In answer to the question, “who do you trust?” I have to ask “what are you trusting them with?” If it’s something really important, one thing you can do is RESEARCH their background and credentials before buying their services. And no matter what, don’t forget that the voice of reason and common sense inside your head will always steer you in the right direction if you listen.

Trust isn’t just who you are dealing with… it’s who YOU are. If you are a person with common sense and reasonable intelligence, you can pretty much always pull yourself out of the pot before the cannibals cook you. There are no guarantees in life, but there is usually a chance to save your own butt if you are street smart. Don’t ever go to sleep while you have an important decision to make and leave it up to someone else. There’s a reason they have patient advocates in hospitals. Someone figured out it’s not always SAFE to be there. It should be. It isn’t.

Just don’t forget there are still people and systems you CAN trust. Treasure those with whom you can safely close your eyes and sleep. They make all the rest of it worthwhile.

About Dr. Brilliant Cliché

Dr. Brilliant Cliché and the Granny Dr. are a fictional web presence and advice blog. Together we offer a joint perspective that is deep but not academic, entertaining but not fluff, and educated yet street smart. By joining the internet community we hope to share thoughts and stimulate insightful conversation around pressing issues that affect us all. Looking forward to hearing your thoughts. (This is not a site for therapy nor does it intend to replace medical or other professional care. ) You can leave comments here or email The Dr. at and don’t forget to like us on facebook. Our facebook page is Dr. Brilliant Cliche
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3 Responses to Breast is best except when it is not!

  1. One reader commented:

    I sit on our task force for Breast-feeding, and am a huge advocate. To the point where I don’t even look so much at daily weights and more at hydration, wet diapers, “wellness”. BUT, sometimes it just doesn’t work – gotta be a realist. Whether it is psychologic, physiologic, combo of both, not trying hard enough- I don’t know. I wonder if these are babies that historically wouldve required another woman to feed or the child wouldve not survived. I think people need to be realists- be supportive, encourage pumping, get to lactation consultants

    And I have seen Lactation Consultants who are totally over the top as described above. “Nazis”, like it or not [I use “fascitsts” but thats me 🙂 ] is used to denote totalitarianism. And this type of approach will be good for some, and detrimental to others.


    When breastfeeding doesn’t work, the first step is to examine BOTH the mother and the baby, which would have picked up the cleft palate. Often the mom sees her OB and the baby does not get examined.

    yet another:

    I will add my breastfeeding experience, as I have a four and a half month old daughter. I was gung-ho on breastfeeding. It was very difficult, I barely slept, and I had to use a nipple shield. When my daughter was 6 weeks old, I developed mastitis, which is not uncommon. Despite treatment with 3 different antibiotics, I developed a HUGE abscess (the size of a softball). I continued breastfeeding through all of this. I was in the emergency room 3 times. It was drained twice before I was admitted to the hospital for IV antibiotics and I had to have surgery to drain the abscess. I developed bacteremia which then caused endocarditis and I was placed on IV antibiotics for 6 weeks with a PICC line. I was inpatient in the hospital for a week – I have never had any health problems in my life before this. Needless to say, I abandoned breastfeeding during the hospital stay. And I felt so unbelievably guilty about it, and still do. But my daughter is doing GREAT – her terrible colic diminished after I stopped breastfeeding. I think that there is SO MUCH pressure in our society to have women breastfeed and to make them feel guilty if they do not. I have to tell myself constantly that feeding the baby formula is OK – women have been doing this for YEARS (I was formula fed and turned out just fine) without difficulties. I think that women have to be allowed to make this decision on their own without pressure. Yes, breast is best, but it is not always possible.

    and lastly:

    Just one more example that level of education doesn’t even come close to being predictive of common sense or “good medicine ” !!!! A dead baby at the breast is better than a bottle fed infant———– I just love it !!!

  2. another comment:

    Sorry – Shakyamuni didn’t say “no Dharma is defiinitive” You might have that confused with Zen Buddhism…
    And I take exception with calling anyone supporting breastfeeding a Nazi.
    Nazis exterminated millions of Jews, Gypsies, Homosexuals, political folk and other religious.
    I don’t think breastfeeding proponents have done anything this heinous.
    Yes feed the baby matters…
    And yes breastmilk is the gold standard for infant feeding… and in some mother-infant dyads the breastfeeding needs a lot of support and rarely supplementation. And some mothers choose formula feeding….
    Perhaps this posting is just an April Fools joke….

    Dr Brilliant replies:

    Thank you all for your comments. The purpose of the blog IS to generate discussion. I thought this particular topic was important especially when I read that someone else had the same negative experience we did regarding breast feeding. The larger picture is also important Common sense vs. Authoritarianism.

  3. Another Dr. commented:

    First of all, I strongly encourage breastfeeding in my practice, and breastfed all three of my own. One of the most horrible things I’ve ever had to do was watch my friend starve her preemie twins for their first six or more months of life. An intelligent woman with a phobia of becoming obese like her mother, she adamantly believes that babies should be breast fed exclusively for the first six months, only she doesn’t make enough milk even for a singleton, (as evidenced by the infancy photographs of her first, much older son, showing a skeletal infant), perhaps because she strictly limits her own caloric intake. Even when they were allowed solids at about 7 months old, it was in limited amounts and only of non-calorically dense foods. The horror, the horror. The babies were on her literally 24 hours/day, never sated, wasting away. So, so thin. The woman had a lactation nurse coming in regularly, who NEVER told her to supplement them, never pointed out to the mother how wasted the infants were. As far as I know, the pediatrician never read her the riot act (although for all I know it was read, and ignored). I finally gave up going to help her, since I realized that all I was doing was trying to console a starving infant who was not being allowed access to sufficient calories, despite being on the breast 24/7. The mother was actually hoarding her pumped milk, not allowing the infants to drink it, lest they not nurse aggressively. They are now toddlers, and are very, very small for their age.

    I have identical twins in my practice who were born at 4 and 6 lbs respectively, because one twin’s cord had an imperfect insertion to the placenta. They were both formula fed ad lib from birth, so the only possible time of nutritional deprivation was prenatally. The larger twin is still, at nearly 4 yrs old, two pounds heavier and a couple of inches taller than the smaller twin. Point is, you cannot make up for prenatal, or probably neonatal starvation by allowing access to calories later on! Infant growth is definitely stunted by inadequate caloric intake, and the growth deficit is permanent! Mothers must be told the signs of inadequate lactation, and be told that they have to supplement if there is inadequate weight gain, whether or not it interferes with the sacred breastfeeding!

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