WHAT YOU’LL LEARN

• Why the Fed is Best Foundation was Formed
• How the Pendulum Swung to “Breast is Best”
• The Problem with Rigid View on the “Best” Method
• Myths About Formula Feeding vs. Exclusive Breastfeeding
• The Risks of Underfeeding (and Signs to Watch For)
• Why Hospitals and Organizations Need to Embrace “Fed is Best”

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Trigger warning: This blog post contains stories of medical emergencies involving infants and might be disturbing to some readers. Please use your discretion when reading. 

After seeing so many clients struggle with guilt and shame over not being able to breastfeed, sleep deprivation from being the only one up at night, and fear that any formula or supplement will derail their breastfeeding journey, I have witnessed how harmful the “breast is best” push can be. 

As moms, we are so conditioned to be self-sacrificers, put our own needs on the backburner, and strive for the “perfect mother myth” that it becomes hard to break away from pressure and make our own decisions. 

I have known for a long time that breastfeeding doesn’t always come easily, and that moms who can’t breastfeed or moms who choose not to breastfeed for any other reason should not have to experience shame or guilt. 

But what I never realized is that the extreme breast is best push isn’t just potentially harmful to moms—it also poses a real threat to babies who aren’t able to get the nutrition they need.

In a world where we are told that exclusively breastfeeding is the “best” decision, moms are not being taught about the signs that their babies need supplementation or that they are being underfed. And babies are potentially being put at risk because moms aren’t given this information. 

This week on The Momwell Podcast, I’m joined by emergency physician Dr. Christie del Castillo-Hegyi, co-founder of the Fed is Best foundation and expert on insufficient infant nutrition. We discuss the goals of the “fed is best” campaign, why rigid guidelines on breastfeeding are leaving moms and babies at risk, and how moms can spot signs that their infants are being underfed. 

Why the Fed is Best Foundation was Formed

Dr. Christie started Fed is Best after a traumatic personal journey involving her son. Like so many moms, she was conditioned to believe that exclusively breastfeeding her baby was the best path. 

She gave birth to a healthy 8 lb 11 oz baby boy. She was told her latch was perfect and sent home told to keep breastfeeding on demand. Everything seemed fine. 

Then came three days of crying, latching, and unlatching. Dr. Christie said she followed the recommendations of the books, experts, and the World Health Organization. She let her son suck for extended periods of time. When he cried, she put him back on her breast. 

When Dr. Christie took her son in for his three-day check-up, he had lost one pound and three ounces (this was 15% of his body weight, but Dr. Christie wasn’t told that percentage). She was sent home with two options—either breastfeed more or supplement with formula. She planned to start offering formula if her son became fussy. But he didn’t seem fussy, so she kept up exclusively breastfeeding. 

The next day at a weighted feeding with a lactation consultant, she found out that her baby wasn’t taking in anything during breastfeeding sessions—he’d essentially gone four days without eating. 

As an emergency physician, Dr. Christie knew her son was suffering. She gave him formula right away. He rested, but soon became unresponsive, and then had a seizure. He was diagnosed with a severe form of dehydration called hypernatremia. Today he suffers from multiple developmental disabilities.

Fed is best promotes safe, research-backed infant feeding. 

Dr. Christie thought that her situation must be rare. However, when she started researching, she discovered that dehydration is the most common reason why a newborn is readmitted to the hospital. This wasn’t that rare—and moms weren’t being warned or educated about it.

She formed the Fed is Best foundation to promote safe, research-backed infant feeding—and to counter harmful misinformation.

How the Pendulum Swung to “Breast is Best”

The idea of “Breast is Best” often brings up a lot of shame for moms who choose not to, or can’t exclusively breastfeed. But it didn’t come from a bad place originally. 

Dr. Christie said that the push for exclusive breastfeeding came from a distrust of formula companies. When formula was created, it was popular, offering a way for moms with low milk supply or other medical concerns to feed hungry babies. But the problem arose when companies started marketing the exclusive use of formula. 

Formula companies began using unethical marketing tactics, preying on parental fears and promoting the idea that crying and fussiness meant breast milk was insufficient. And because of the focus on formula, breastfeeding support waned. Moms weren’t trained on how to preserve their breast milk, and they struggled to keep up their supply. In places with poor water quality, some babies suffered contamination. 

World health leaders came together to address the issue, agreeing to ban the aggressive advertising of infant formula and to warn parents about the potential dangers of contaminated formula. 

What started as a movement to protect moms shifted to promoting one form of feeding exclusively. 

But Dr. Christie said that a bias arose within some organizations, pushing against any use of infant formula. What started as a movement to protect moms against predatory  marketing shifted to promoting one form of feeding exclusively. 

Combined with intensive mothering culture and a widespread “natural” movement, the pendulum swung too far in the other direction, leading to moms being deprived of valuable information and empowered choices to protect and feed their babies. 

The Problem with Rigid Views on the “Best” Feeding Method

When we promote any one feeding method as the “best,” it creates the same problem—moms are being pushed into one extreme without considering individual infant needs. 

Breastfeeding can be a great and positive way to feed your baby. But exclusively breastfeeding isn’t the right option for everyone. Each baby has their own needs. Some need more nutrients than their mom can physically supply. Others have latching issues. 

Formula can be a great choice for many families—and for some families, it’s the only viable option. 

But instead of being empowered in our choices and encouraged to make decisions that are right for our babies, we’re told that breastfeeding is the “best” way to feed a baby, leading moms to feel guilt or shame when they feed with formula. Moms shouldn’t be shamed for using the best option for their baby—or for themselves. 

Moms shouldn’t be shamed for using the best option for their baby—or for themselves. 

Formula can help provide peace of mind that babies are getting enough to eat. It can also take some of the invisible load off of moms, giving partners a way to step in, bond, and protect maternal sleep. 

Instead, moms are shouldering the night wakings alone, enduring sleep deprivation, pushing themselves to breastfeed even if they experience pain, discomfort, or mental health struggles, and blaming themselves if their journey involves formula.

Dr. Christie also pointed out that rigid “breast is best” thinking sometimes focuses exclusively on the positives of breastfeeding. Meanwhile, it may present “negatives” about formula without acknowledging benefits. This has led to potentially harmful myths that keep moms from making informed decisions. 

Myths About Formula Feeding vs. Exclusive Breastfeeding

The “breast is best” push has created a lot of myths and misinformation about infant feeding that leaves moms and babies at risk:

Breastfeeding is “Natural” so We Should Be Able to Do It

Breastfeeding doesn’t always come naturally. Some babies take to nursing without any problems. But there are many babies with latching issues. Some moms can’t breastfeed—and for others, it’s an uphill battle. It isn’t something we all fall into with ease. 

Low Milk Supply is Very Rare

There is a belief that almost all moms can exclusively breastfeed. But according to research, low milk supply isn’t actually all that rare. Dr. Christie said that 15% of women have lactation issues—making it a common struggle. 

Most Moms Around the World Exclusively Breastfeed

Dr. Christie said that the myth that most moms exclusively breastfeed worldwide is unsubstantiated. Studies show that just 44% of babies under 6 months worldwide are exclusively breastfed. Dr. Christie pointed out that moms worldwide seem to have a natural sense that “fed is best,” finding ways to supplement if their babies aren’t getting enough. 

Colostrum Alone is Enough to Feed All Newborns

Moms are taught that colostrum is always enough—but Dr. Christie said research doesn’t support this idea. Studies show many babies who are exclusively colostrum-fed show beginning signs of dehydration, including elevated ketone and sodium levels. She said that the research shows that colostrum alone is not enough for most babies. 

Breast Milk is Significantly Superior to Formula Feeding

We’re often told that breast milk is linked to countless long-term health benefits, from higher IQ to decreased risk of diabetes later down the line. But Dr. Christie pointed out that research on the benefits of breastfeeding is often skewed by factors like lactation potential, privilege, and socioeconomic status. 

She said when you look at evidence that accounts for these factors, there aren’t many significant differences between the outcomes for breastfed and formula-fed babies. 

Breast milk does offer some additional protection against respiratory infections within the first year of life, and it is linked to lower rates of eczema. But these differences aren’t enough to mean that it is inherently the best and right option for everyone. 

There are No Risks to Exclusively Breastfeeding

Living in the “breast is best” culture, we’re often taught the benefits of breastfeeding without ever hearing about the risks. In most cases, breast milk is an excellent, healthy, wonderful source of nutrition, unless a baby is allergic. But when we aggressively promote exclusive breastfeeding, we are often not taught about risks such as underfeeding. 

Healthcare professionals are far more likely to warn moms against overfeeding their babies than emphasize the risk of underfeeding—even though the risks of being underfed can be far more severe. 

It’s important to understand these myths and to remember that breastfeeding isn’t the inherently right or only way to feed our babies—and that we need to keep our eyes out for potential signs that they aren’t getting enough. 

The Risks of Underfeeding (and Signs to Watch For)

Moms aren’t being equipped with the information they need to keep their babies safe—especially when it comes to signs of underfeeding. Dr. Christie said that all moms, whether formula feeding, breastfeeding, or a combination, need to understand the risks and signs to look out for. 

Moms aren’t being equipped with the information they need to keep their babies safe

The risks of underfeeding a baby can be severe. Long-term risks include: 

• Attention and executive function disorders 
• Struggles to problem-solve 
• Difficulty with schoolwork 
• Impaired speech 
• Inability to walk
• Potential seizures
• Brain and vital organ injury

Fortunately, a baby will usually give signs that they need food. Early signs that a baby is hungry include: 

• Fussing or crying
• Putting their hand to their mouth
• Rooting
• Looking for breast 
• Latching to breast or nipple

Later signs that a baby could be food-depleted are less expressive. Dr. Christie pointed out that when babies lack the calories to cry, they become fatigued, sometimes only having enough energy to slightly fuss or try to latch. Their bodies try to preserve energy for vital brain function. 

It’s terrifying to think that our babies might become severely starved or dehydrated without us even knowing what’s happening. But Dr. Christie said that’s why medical providers should be educating all parents about underfeeding. 

Why Hospitals and Organizations Need to Embrace “Fed is Best”

Hospitals and organizations teach new parents about so many concerns, from car seats to Shaken Baby Syndrome to warnings against bed-sharing. But this potential risk of underfeeding isn’t being taught. 

Dr. Christie believes that when healthcare providers don’t do their part to make sure parents know about these risks, it’s a failure of their duty. She said that there is something unethical happening in hospitals that is leading to these outcomes, and it’s centered around pushing for exclusive breastfeeding at all costs. 

Dr. Christie said that there is a lobby pushing for this agenda—and babies are suffering because of it. Moms are being taught to fear overfeeding, to believe that breastfeeding has no risks, and to overlook the signs that their babies are suffering. 

That’s what Fed is Best is fighting against—instead working to make sure that parents learn everything they need to know about feeding their babies in a science-backed way, whether that’s through breastfeeding, pumping, formula, or any combination. 

When parents are given the information they need, they can make the best choices for their babies. 

Dr. Christie believes that when parents are given the information they need, they can make the best choices for their babies—and rest assured that their best is best. 

If you’re struggling with anxiety, fear, mental health, or grief over your feeding journey or traumatic medical situations, working with a mom therapist can help. Book a free 15 minute consult today.