Update: See clarification below.
The head of Beterem, the Israeli organization for child safety, has issued a warning that will strike fear into any young mother who relies on public transportation: Breastfeeding while riding on a bus puts your baby in danger. And bottle-feeding will likely to be next (or will it?).
In a tragic incident, a Jerusalem baby suffered brain damage after choking while breastfeeding on a bus. The report seems odd but there has been no further information. (Update: The baby apparently suffocated.)
Haaretz interviewed the director of Beterem, Orli Silvinger, about parents who forget children in cars. At the end, they ask Silvinger about the bus incident.
Here is Haaretz’s English translation of the relevant question (this did not appear in my original post):
A baby of a month and a half is now in hospital in very serious condition after choking while his mother nursed him on a bus. Is it dangerous to nurse a baby when traveling?Absolutely. Parents must know that it is forbidden to nurse babies during traveling. The baby’s windpipe is only the size of the small finger on a hand. Very few things can pass through there with ease. Secondly, the cough reflex that exists in a child or adult does not exist in the same way in a baby. A baby that has drunk too large an amount of liquid cannot bring it up and he chokes. Also, the movement during traveling causes liquids to go into the windpipe. Just as we do not read while traveling, or get dressed while traveling, we must not nurse while traveling. It’s better to hear the baby cry with hunger for a short while than to nurse him while traveling. It’s in our hands.
I asked Dr. Lisa Amir, medical director of the Department of Emergency Medicine at the Schneider Children’s Medical Center of Israel, whether caution is warranted. She said, “In 20 years of practice I’ve never seen a healthy child suffering any neurologic injury or severe damage as a result of having choked on a liquid, whether it be breastmilk or formula.”
Which feeding practices do cause hospital admissions? Dr. Amir added: “However, I have seen a number of children who were severely injured or who died after having choked on hotdogs, deflated balloons, and sunflower seeds.”
I wonder whether Silvinger’s experience is different. How many babies have been hospitalized during the last year because they choked while breastfeeding, whether on the bus or at home? Some breastfed babies “choke” or splutter when the flow of milk is strong, but they always recover immediately.
Silvinger says it’s better to let a baby cry than to nurse him on the bus. I’m guessing she’s never taken a baby on a bus, or listened to one screaming for 45 minutes. But there are a few other issues besides crying.
- Would Silvinger would apply the rule to bottle-feeding? It would seem that the risk is similar. And what about solid foods? Breastfeeding is one thing, but who can imagine a bus ride without Bamba?
- I guess that during long trips, Silvinger would require the whole family to get off the bus for the baby’s feeding, then get on the next bus.
- A hungry or unhappy baby will do much more than cry. She will most likely start flailing around, requiring the parent or parents to make a superhuman effort to prevent the child from bumping her head or worse. And any other children won’t get the attention they need.
- Small babies can get dehydrated very quickly.
Families who rely on public transport have enough challenges already. Traveling with a nursing baby is hard, but easier than with a bottle-fed baby. Or worse, one who is not allowed to eat at all.
For the record the safety of babies riding unrestrained on a bus or car is not the issue, but whether feeding in a moving vehicle increases the risk of choking. I’ve written to Beterem and am curious to read their response.
Clarification: My daughter points out that the Hebrew word chenek, used both in the original news reports on the incident and in the interview, can mean both suffocation and choking. The baby probably suffocated while being nursed under a blanket, as Erika mentions below. But Silvinger assumed the baby choked on the milk, which is highly unlikely. So this may turn about to be a story about hyper-tzniut, or excess modesty. I also removed the title of Dr. as Silvinger is not listed as such on Beterem’s website.