To the Mother of the Newborn Who Starved to Death Despite Breastfeeding

I’m so terribly sorry for your loss.

You tried to give your baby the best.

You were told that everything was fine.

You never in a million years thought of this outcome.

You trusted the team of medical professionals for help.

The medical professionals failed you. We failed you.

The shocking story of an American baby who accidentally starved to death at 17 days old despite breastfeeding is tragic to read. Landon Johnson’s mother, Jillian Johnson, recently shared her story on a blog in the hopes that other mothers will learn from her experience. Baby Landon would have been 5 years old now.

This story is not an isolated case. And I’m sure there have been similar cases here in Israel. The saddest part is – this all could have been prevented. Jillian Johnson was diagnosed with PCOS (polycystic ovarian syndrome) and because of the hormone imbalances which are associated with this syndrome it makes it harder for women with this medical condition to produce milk.Her low milk production was obviously unknown to her before she gave birth (wherein lies the problem). One lactation consultant at the hospital was apt enough to connect the dots after she saw the mom struggling to produce milk and suggested for her to take herbs once she was released from the hospital.

This recommendation did not save Landon’s life and within 12 hours after being released from the hospital he went into cardiac arrest caused by dehydration. There are many lessons we can take from this specific incident and I will highlight a few.

A study done by Dr. Marianne Neifert from the University of Colorado showed that nearly 15% of the 319 women studied produced insufficient human milk to exclusively breastfeed their babies. What this study indicates is that obviously all women should have an individual evaluation by a certified breastfeeding specialist because every woman needs an individualised plan. This plan should already be drawn out for her ideally starting from her 34th week of pregnancy in order to determine in advance if she will have a problem producing and ejecting enough milk. If a woman has the full knowledge of her own condition, she can plan with the breastfeeding specialist on how to correct the problem or know to supplement her milk before her baby arrives.

So for example, when you plan a vacation, do you check out the location where you are staying to see if it’s a good place to travel to? Do you consider all of the variables that might hinder your trip and plan everything out before you book your flight? For most of you, the answer will probably be, yes of course. So why don’t we educate first time parents, or parents in general, to consider their particular situation before they bring a child into the world? It’s an overwhelming experience and mothers and fathers need to learn what to expect in their specific cases because let’s face it, the parenting books are great, but they can’t possibly prepare you in every scenario. And breastfeeding does not come in a cinch for everyone, especially not when there are medical complications that you weren’t aware of beforehand.

Most new mothers are discharged from the hospital within 48 hours of delivery of their babies and their milk usually does not start to have full production until the 4th day of life. By that time, the mother is on her own with no one to accurately measure her milk production and make sure the baby is consuming enough milk. Who should she turn to for help once she’s at home? Tipat Halav? I’ve heard from numerous mothers how turned off they were after coming out of a Tipat Halav center, because they don’t receive specific instructions if their baby is underweight.  We can’t turn our backs on these mothers. They have to know that there is help out there.

Over the past few years, new methods of measuring accurately how much milk is produced by the mother can be determined by a home visit from a Certified Breastfeeding Specialist. If the mother can produce 70-120ml of milk in one feeding (approximately 15 minutes of pumping both breasts simultaneously), she is producing enough milk for her baby. The Breastfeeding Specialist uses a multi-user hospital grade breast milk pump to extract the milk and collect it to determine if the mother is able to nurse exclusively or will need to supplement. Sometimes the supplement can be extra production of the mother’s own milk or in some cases donated human milk or commercial infant formula.

The specialist also uses a special baby scale that measures every 2 grams of difference in weight. This scale accurately measures how much milk was consumed by the infant in one feeding (15 minutes of feeding on each breast). The baby is weighed before the feeding and after the feeding to show actual intake. If the infant is consuming approximately 70-120ml in one feeding, generally the baby does not require supplementation.

So why would a baby not take in enough milk at a feeding? Premature delivery, many neurological defects affecting sucking and swallowing ability, tongue tie, cleft palate, poor latch, lethargy, etc. are just a few conditions which will interfere with full potential to breastfeed. The baby needs its own evaluation on the 4th day of life by a Certified Breastfeeding Specialist. It takes two to make the process go smoothly: mother and baby.

Usually when the mother is in doubt, she will contact her pediatrician or family doctor immediately. The pediatrician or family doctor will provide general care but does not perform these types of evaluations. All of the information should be conveyed to the pediatrician or family doctor to coordinate the best care. Unfortunately, many new mothers are not receiving this top quality care once they are home with the new baby. They don’t know to ask for this type of care. Breastfeeding is not “guess work” when a qualified breastfeeding specialist can prove to the mother that she is capable and will be successful in nourishing her baby.

Think how more confident and powerful a mother feels when she’s armed with this knowledge and information. The more we continue to talk about breastfeeding, the more educated mothers and families are. And that can save lives. Baby Landon’s situation might have ended differently if Jillian had been given all the facts.

About the Author
Malka Ben-Ravi has been a Registered Dietitian and Lactation Counselor in the United States for over 25 years. She made Aliyah with her family in 2015 and began working as a Certified Breastfeeding Specialist to help new mothers enjoy breastfeeding their babies. Her goal is to establish a human milk bank in Israel to help save the lives of premature babies.
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