In a letter to doctors and parents, an emergency physician and mom of a special need child, Christie del Castillo-Hegyi details her sour experience with proof in which she warned that, exclusively breastfeeding babies with insufficient milk could cause brain damage and a number of developmental problems.
“Dear Colleague and Parent:
My name is Christie del Castillo-Hegyi and I am an emergency physician, former NIH scientist, with a background in newborn brain injury research at Brown University, and mother to a 6-year-old child who is neurologically disabled. I am writing you because my child fell victim to newborn jaundice, hypoglycemia and severe dehydration due to insufficient milk intake from delayed milk production in the first days of life. As an expectant mom, I read all the guidelines on breastfeeding my first-born child.
Unfortunately, following the guidelines and our pediatrician’s advice resulted in my child going 4 days with absolutely no milk intake requiring ICU care. He was subsequently diagnosed with multiple neuro-developmental disabilities. Being a physician and scientist, I sought out peer-reviewed journals to explain why this happened. I found that there is ample evidence showing the links between neonatal jaundice, dehydration, hypoglycemia and developmental disabilities. I wish to explain to you how I believe this could apply to my son and the many children whose care you are entrusted with.
My son was born 8 pounds and 11 ounces after a healthy pregnancy and normal uneventful vaginal delivery. He was placed directly on my chest and was nursed immediately. He was nursed on demand for 20-30 minutes every 3 hours. Each day of our stay in the hospital, he was seen by the pediatrician as well as the lactation consultant who noted that he had a perfect latch.
He produced the expected number of wet and dirty diapers. He was noted to be jaundiced by the second day of life and had a transcutaneous bilirubin of 8.9. We were discharged at 48 hours at 5% weight loss with next-day follow-up. We were told by the lactation consultant before discharge that he would be hungry and we were instructed to just keep putting him on the breast. Upon getting home, he became fussy and I nursed him longer and longer into the night. He cried even after nursing and latched back on immediately. He did not sleep.
By the next morning, he stopped crying and was quiet. We saw our pediatrician at around 68 hours of life (end of day 3). Despite producing the expected number of wet and dirty diapers, he had lost 1 pound 5 ounces, about 15% of his birth weight. At the time, we were not aware of and were not told the percentage lost, and having been up all night long trying to feed a hungry baby, we were too exhausted to figure out that this was an incredible amount of weight loss. He was jaundiced but no bilirubin was checked.
Our pediatrician told us that we had the option of either feeding formula or waiting for my milk to come in at day 4 or 5 of life. Wanting badly to succeed in breastfeeding him, we went another day unsuccessfully breastfeeding and went to a lactation consultant the next day who weighed his feeding and discovered that he was getting absolutely no milk. When I pumped and manually expressed, I realized I produced nothing.
I imagined the four days of torture he experienced and how 2 days of near-continuous breastfeeding encouraged by breastfeeding manuals was a sign of this. We fed him formula after that visit and he finally fell asleep. Three hours later, we found him unresponsive. We forced milk into his mouth, which made him more alert, but then he seized. We rushed him to the emergency room. He had a barely normal glucose (50 mg/dL), a severe form of dehydration called hypernatremia (157 mEq/L) and severe jaundice (bilirubin 24 mg/dL). We were reassured that he would be fine, but having done newborn brain injury research, knowing how little time it takes for brain cells to die due to hypoglycemia and severe dehydration, I did not believe it, although I hoped it.
At 3 years and 8 months, our son was diagnosed with autism spectrum disorder with severe language impairment. He has also been diagnosed with ADHD, sensory processing disorder, low IQ, fine and gross motor delays and a seizure disorder associated with injury to the language area of the brain. Since my child’s diagnosis, I have been researching the scientific literature on breastfeeding insufficiency, newborn starvation, brain injury and developmental disabilities for two years. In addition, I have collected the breastfeeding stories of over 30,000 women through social media.
In the September, 2015 issue of Hospital Pediatrics, an article was published describing 11 exclusively breastfed newborn babies who developed profound hypoglycemia between the second and fifth day of life from insufficient breast milk intake. The child described in the body of the article was a healthy full-term baby who presented just like my son. He was seen on the third day of life at his pediatrician’s office. Despite that, he was found on the fourth day of life lethargic and unable to feed. He had lost 10% of his birth weight and had a low glucose of 20 mg/dL (normal > 47 mg/dL).
This child was given IV glucose after which he developed a seizure. They obtained a brain MRI which showed extensive areas of injury to almost the entire brain. In addition to this child, 10 other healthy term newborns were identified to have developed hypoglycemia from insufficient breastfeeding as well. They were found lethargic, seizing, hypothermic and/or not breathing. 5 out of the 6 MRIs obtained in these babies showed widespread injury to a third to almost the entire brain in varying patterns. They subsequently developed long-term neurological disabilities including seizure disorders, motor weakness, visual impairment and feeding difficulties requiring speech therapy.
The answer to the epidemic of developmental disabilities we are seeing may be found in this vulnerable period. The risk factors for neurological disabilities in children all have to do with brain injury caused by excessive jaundice, loss of oxygen, circulation and glucose delivery to the brain.
These include pre-eclampsia, intrauterine growth retardation and prematurity, which are caused by poor function of the placenta and decreased circulation to the baby. Hypoglycemia, umbilical cord prolapse, nuchal cord (cord wrapped around the neck), fetal distress, low Apgar scores, respiratory distress and other labor complications, events that all cause perinatal brain injury also cause long-term neurological disabilities.
Although there are many causes of newborn brain injury that we have no control over, we have control over whether or not a child is fed enough for all their neurons to survive. I believe we may be inducing hypoglycemic brain injury to many newborns by asking mothers who may not be producing sufficient milk for their newborn’s physiologic need to exclusively breastfeed. We are potentially putting ourselves at odds with the protective natural instinct to respond to a baby’s cry by telling mothers that their colostrum is enough (which for many it may not be) and by making them fear failure by giving their child supplementation when they need it.”