Bad advice: Parenting Magazine on nursing and failure to thrive

Apparently, I could make this a monthly feature. To be fair, this is Parenting: Early Years magazine, not last month’s Parents (but really, I find the two relatively indistinguishable).

In any case, when my May 2009 Parenting arrived, I was actually interested in reading one of the articles mentioned on the cover: “6 Baby Health Scares That Are Really No Biggie.” Intriguing, I thought. The article adequately treats dislocated hips, abnormal heartbeats, crossed eyes, swollen genitals, pigeon toes, and bowed legs, explaining how many of these things correct themselves, and referring parents to pediatricians for final diagnoses. Fine so far. . . but wait! The sixth “baby health scare” is “not gaining weight” (p. 78), and, you guessed it, the magazine manages to blame breastfeeding mothers.

This section of the article begins innocuously enough:

Although babies typically double their birth weight by 4 months and triple it by 1 year, some experience “failure to thrive.” Despite the horrifying (not to mention guilt-inducing) label, this diagnosis isn’t nearly as ominous as it sounds.

Fear-Calming Facts–A swerve off the normal growth curve can happen for a variety of temporary, treatable reasons, says Andrea McCoy, M.D., chielf medical officer at Jeanes Hospital, in Philadelphia.

It’s great that Rosemary Black, author of this article (officially titled “Low-Stress Baby Checkups: 6 Scary-Sounding Problems You Don’t Have to Worry About”), acknowledges that the “diagnosis” of “failure to thrive” sounds as though it blames parents, and it’s great that–in theory–a mainstream parenting magazine is tackling the issue of babies who lose more birthweight, or take longer to gain it back, than their pediatricians feel comfortable with. 

I expected the rest of the response to reference the new WHO growth charts, based exclusively on breastfed babies, which actually show that breastfed babies in general tend to follow a different growth curve than previous growth charts (based on formula-fed babies with early introduction of solids) have shown. You can see the charts for yourself at the link above, or read a WHO statement explaining their introduction here; looking at this one (boys 0-6 months) just as an example, you’ll notice, in fact, that the boys do not tend to “double their birth weight by 4 months” as Black claims.

The article continues, however, by listing three possible reasons for “failure to thrive”; I’m listing them here in reverse order from that given in the article:

3) Genetics: Black notes that some babies just are genetically “programmed” to be slimmer than others. Her recommendation is vague, merely to “check with your pediatrician about any growth concerns.”

2) Gastroesophageal reflex: Black notes that most cases of GER are outgrown by six months, but in the meantime, she suggests “frequent burping, holding a baby upright for 20 minues after she eats, and offering her small, frequent meals” as a fix.

1) Here I have to quote, in its entirety, the first (and presumably most important/most common) reason the article gives for “failure to thrive”:

A skimpy diet: A baby who’s exclusively breastfed may not be getting her fill at each meal, but if she’s the laid-back type and doesn’t fuss about it, you won’t know. Most likely, Mom’s milk production is at an ebb for some reason (undereating herself? overexercising? stressed out?); a lactation consultant can help. Meanwhile, check with your doctor about supplementing with formula.

Sigh. First of all, calling exclusive breastfeeding “a skimpy diet” is wrong on many levels; next, Black manages to implicitly blame the baby here (she’s so “laid back,” you see); then, Black directly blames the mother for not taking proper care of herself; ultimately, the solution is, of course, to supplement with formula. There is nothing in this response to make women feel good about exclusively breastfeeding, to acknowledge the different growth of breastfed babies, to reassure women that the vast majority of women can produce enough milk to feed their babies, or to support women who want to continue exclusively breastfeeding.

This article upsets me, to put it mildly.

–Christina