breastfeeding · Doula observations · Postpartum

Adam Ruins Having A Baby?

I discovered the show “Adam Ruins Everything” a few months ago because of the episode where Adam “ruins” sex.  I have many friends that are passionate about reducing routine infant circumcision and that episode addressed circumcision.  The YouTube clip was shared like crazy.  I found it both witty and informative and started a hunt for his other episodes.

When the past season ended, the character Emily had just gotten married.  I commented excitedly to my husband, “I hope they do an episode where Adam ruins birth– where they talk about the unnecessary interventions pushed on women in the hospital.  Or maybe blows the lid off the questionable ethics of baby formula marketing.”

Well… Adam ruined “having a baby” (although he completely skipped over the birth except to have Emily mention at the very end of the episode that her perineum tore “like tissue paper”), and he exposed a lot about the fear tactics behind egg-freezing and “advanced maternal age”.  He completely skipped over the birth.  And then spent much of the rest of the show attempting to prove that formula and breast milk are basically the same thing.  Now, I feel like I need to interject here that I am absolutely not against the use of formula, that I am not here to shame families that choose to or need to use it.  But saying that there is no difference is a slap in the face to women who persist through mastitis and inverted nipples and poor latches and more in able to breastfeed their children.

So I looked at his sources.  Adam (or rather his publication team) lists sources they used for research on each show.  What I found surprised me.  Adam (mostly) used thorough, well-studied sources in this show, including ACOG and Postpartum Progress.  What really surprised me was that his breastfeeding “expert” wasn’t an expert about infants or infant feeding at all.  Not a pediatrician, nutritionist, or neonatal nurse.  She was simply an author and political scientist that had struggled on her own breastfeeding journey.  I first came across her book Lactivism a few years ago by way of a New York Times article.  I agree with many of her points, and at the end of the day, you most likely will not be able to tell which adults were breastfed and which weren’t.

But some of Adam’s other sources were laughably shaky.  Like using this article to argue that there were no other reasonable choices for mothers that didn’t make enough milk before formula was invented besides “bread soaked in water”.  Which is funny, because the very first line of this article says:

“The historical evolution of infant feeding includes wet nursing, the feeding bottle, and formula use. Before the invention of bottles and formula, wet nursing was the safest and most common alternative to the natural mother’s breastmilk.”

It goes on to say:

“Breastfeeding rates in the United States have decreased significantly in the 21st century, resulting in serious health issues that include atopy, diabetes mellitus, and childhood obesity.”

This is not to say that babies didn’t sometimes die due to lack of food.  It became popular to begin weaning the baby early, using foods that included diluted wine, pap, meat based broth, and occasionally the bread soaked in water referenced in this episode.

One line that Adam says during the course of the episode is something like “Formula isn’t poison– in fact it saves lives.”

True.  When prepared properly and given to babies that are not premature or sickly, formula can be a life-saver.  It truly is a nutritionally adequate alternative to breast milk.  But it can be deadly, and we do families everywhere a disservice by not being up front about that.  Powdered formula should never be given to newborn babies, and if it must be, it should be prepared very carefully.  With premature babies, especially, most neonatalogists and neonatal nurses know the risks of NEC (Necrotizing Enterocolitis) are higher when a neonate is formula fed.

According to this NIH article:

“Several randomized controlled trials have been done to study the effect of donor human milk versus formula on the incidence of NEC and mortality in preterm infants. Meta-analysis of five of those randomized controlled trials comparing donor milk versus formula feeds in preterm infants showed that preterm infants fed with formula had more than twice the incidence of NEC…compared to the preterm infants fed with human milk.”

Adam lost a fan with this show.  I wanted to go back and fact check some of his other sources after the blatant cherry-picked data shown in this episode.  I continued watching hoping that Adam would redeem himself, and he halfway did when he started the segment about postpartum depression.  I was thrilled that he mentioned that, yeah, men can get postpartum depression too.  But the rest of his information was seriously lacking, and some of it was flat out wrong.

First off, he never mentioned any of the other possible postpartum mood disorders, nor the fact that it’s possible to have antepartum mood disorders too.  He didn’t mention that rage is often a symptom, or that the research shows that when a woman who planned to breastfeed is unable to, her symptoms can worsen.  And then, there was the misinformation, which is quoted in his sources.

“Research shows that just a few short therapy sessions can dramatically reduce feelings of guilt and sadness.”

Here’s the source he used to “prove” that.  Here’s what the “few short therapy sessions” looked like:

“The six two-hour therapy sessions covered the relationship between thought, mood, behavior and physical feelings.”

Six.  Six sessions that were two hours long apiece!  That sounds nothing like the therapy experience I had, where sessions were roughly 45 minutes long.  But it’s true that talk therapy can help.  It’s even true that some women don’t require more than that.  But medication was never mentioned as a treatment option, which serves to further stigmatize those that need it.  Proper medication can save lives.  It would have taken two more seconds to mention that it’s a viable option to talk to her midwife or doctor about.

There is so much more I could say about this episode, but I’ll end by telling you what I was hoping to see with this episode:

I was hoping to see discussion on the very real birth monopoly happening in the United States, an exposé on why our maternal mortality rate is climbing, expounding on our primary and repeat cesarean rates, our intervention-happy “active management” culture, and maybe touching on the Caroline Malatesta or the Kimberly Turbin cases of extreme obstetric violence.

I wanted to see Adam expose the shady marketing tactics of formula companies* that persist despite ethical marketing guidelines, the way that they used “toddler formula” as a way to continue growing their market despite the WHO marketing code, and the fact that hospitals consistently undermine attempts at breastfeeding by forcing early supplementation by bottle.  I wanted a spotlight shined on the ever-growing niche of galactagogues and other breastfeeding supplements marketed for the lactating parent.

I wanted it to emphasize choices, and discuss how sometimes, despite the evidence that breastfeeding provides perfect nutrition at every stage and reduces the cancer risk of the nursing parent, it’s not a perfect option in every situation.  I wanted reassurance to parents that are unable or choose not to breastfeed that it is an acceptable alternative, and that their babies will most likely grow up healthy and strong, just like breastfed babies will most likely grow up healthy and strong.

I wanted this show to address what good lactation support looks like (despite what the Fed is Best Foundation might make you believe).  I wanted recognition that breastfeeding can be hard and it’s okay to change your mind about your goals.

I wanted the stigma surrounding postpartum mood disorders destroyed.  I wanted Adam to talk about how extremely rare PPD related child abuse occurs but how common maternal suicide is.  Because of the media, people often assume that the worst will happen to the kids and then ignore or vilify the mother when postpartum mood disorders are openly discussed, which needs to stop!

But no, we got instead cherry-picked data, an inconsistent expert, and a very skewed definition of “a few short sessions”.  We got “victory” for the formula companies because an “expert” has proclaimed breast milk and formula nutritionally identical on TV.  Adam ruined himself.

(And we maybe I’m just a little jaded that he hated on Mommy Blogs.)

*Admittedly, he did touch on the Nestle scandal briefly in his new behind the scenes segment.

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