Fact Vs. Fiction: Calling Out a Misleading FIB, Part 2

– From Twitter, August 2

• The person referenced here is Lawrence Gartner, MD. He is a member of BFUSA’s Board of Directors, not BFUSA’s “medical director.” The slides from Dr. Gartner’s lecture were posted without his permission, a gross violation of accepted professional protocol.
• The “very different story” conclusion is based on a single bullet point from a single slide taken out of context from the rest of Dr. Gartner’s lecture. Dr. Gartner’s primary message in the entire lecture was that physicians and nurses need to recognize and correct inadequate intake of calories in sick infants and those with excessively rising serum bilirubin levels that are approaching potentially toxic levels, whether formula feeding or breastfeeding.
• We have never disputed the fact that breastfed babies are at a higher risk for weight loss which contributes to the risk of jaundice. Individualized care requires health professionals to recognize conditions that merit further assessment and close follow-up with the mother and infant.

– From their “Official Response” originally posted on Facebook and subsequently posted on their website

• Baby-Friendly USA does not designate systems; we designate individual hospitals within systems. Most of the hospitals in the Northern California Kaiser system never participated in the BFHI, so the claim that these findings are representative of Baby-Friendly is not accurate.
• The referenced study was designed to test the clinical effects of recalibration of the bilirubin testing instrument, not to assess hyperbilirubinemia levels across a population.
• The results contrast hyperbilirubinemia levels “before” and “after” recalibration of the testing instrument. A reasonable assumption is that the “after” datapoint (12%) most closely reflects the “true” level for this population, as this figure was acquired via the improved methodology. The whole point of this study was to demonstrate that improved measurement results in bilirubin rates that are not as high as previously reported, yet Fed Is Best includes the “before” and “after range (12-20%) in its interpretation because this helps exaggerate the result to better support its message.

– From their “Official Response”

• Again, the 12-20% figure is a misrepresentation of the findings in this study (see above).
• This comment completely misses the point of BFUSA’s August 2nd statement. Our point was not that the 10-18% was misleadingly high (although it was), but rather that this was one of many examples where this organization manipulates scientific data to support a campaign of misinformation. Ironically, they attempt to distract from this inaccuracy by drawing attention to still another inaccuracy.
• If they “stand corrected,” why have they not yet removed the many references on their website to the erroneous 10-18% statistic?

– From an article on their website referenced in their “Official Response”

• This figure is “astonishing” because it is a weighted average of the “before” and “after” percentages calculated by Fed is Best, not by the authors. Again, they have failed to recognize that the higher rate was found before the improved bilirubin measurement methodology was implemented and have falsely manipulated the data to exaggerate their incorrect conclusion and misleading message.

– From their “Official Response”

• This claim references two articles. The first article states: “Almost 5% of vaginally delivered newborns and almost 10% of those delivered by cesarean had lost ≥10% of their birth weight by 48 hours. By 72 hours of age, >25% of newborns delivered by cesarean had lost ≥10% of their birth weight.” So the claim that “10% of vaginally-delivered newborns lost >10% of their body weight is blatantly untrue. That figure is correctly stated as 5%, which means 95% of exclusively breastfed infants lose <10% of their birthweight.
• The second article states that there were 7 formula-fed infants in the study with >10% weight loss. So, while it is true that formula-fed babies experienced a lower rate of weight loss, it is a complete fabrication to say that “none” in this study lost >10%.