Here
One Moment. Gone The Next
The Birth And Family Place
Barely A Life
Coming Into My Own
Being A "Wise Mother" From The Start
Jack
The Right Answer
Naturopathic Medicine: The Best In Natural Medicine
For Your Whole Family
Watch Your Language
Here
One Moment. Gone The Next©
A note from the editor
By Karen Squires
I walk for
exercise during the spring and fall months. The rest of the year I walk on the
treadmil, inside, to avoid the extreme heat of the summer and unbearable cold
of the winter. I've always enjoyed walking in the spring especially, as the
sunrise is so incredile in Utah. I've lived in Scotland, Canada, England, and
different states here in the USA, but none of them can compare to Utah as the
sun arrives each morning. I always think, as I'm taking my morning walk, that
I should get my camera out and start trying to catch some of that morning beauty
on film. I haven't for a few reason.
1) I can never remember to pick up film,
2) When I do remember to pick up film, I forget to take the camera with me,
3) I don't think it's possible to catch such wonder on film. Not possible for
me that is. Ansel Adams I'm not.
I've taken my teenager to meet the school bus every morning since it became cold and dark last fall. He would leave the house with wet hair and I was sure he'd catch something horrible or get stolen if I didn't drive him the two blocks to the bus and keep him in the car warm and safe. I'm not the only paranoid mother apparently, as other mothers are there right along with me, kids in their cars, safe and warm.
Usually when the bus leaves, with our children safely inside, it's still dark outside. But for the last week or two it's been getting lighter. This morning it was almost full daylight.
As I drove home I went over a small hill that left me, for a few seconds, higher than the roof tops of the houses in my area. I was taken by surprise at the site I saw this morning. Winter has been long and cold and I had forget about how beautiful spring mornings are here.
The sun was not yet up but I could see the promise from behind the mountains that it would soon arrive. There was a light orange-pink to the sky off to the south. The mountain are still covered with snow and the contrast between the white snow and the black of the mountain was startling. The sky was a deep gray-blue. The street was quiet, deserted, peaceful. What made this scene complete was the steam coming of the roof of each and every house. I'm not sure what caused it, some atmosphere thing, who can say, but it was incredible. It looked like something Ansel Adams might catch on film and win a big award for. Of course if I took a picture, I could probably get it in focus, thanks to my auto-focus camera, but could I capture the contrast of the snow against the mountains. Could I capture the steam just right. The sun promising a new day, a new start. Could I have captured the serenity, peacefulness. I doubt it.
I still plan on getting film for my camera and at least trying. Who can say, maybe I'll luck out and get one good shot a year. Or maybe I should forget it and just go for a walk and enjoy the view. Catching awe on film maybe like taking a picture of the kids. It can capture their likeness, but it can't capture their personality, who they are. You just have to be there, with them, enjoying the moment. They are as fleeting as the sunrise. Here one moment, and gone the next.
FREE ARTICLE: You are free to publish this article on websites and print publications. You can also email it to friends and/or associates. We just ask that you include this information with the article and let us know where you published it. This article first appeared in The Wise Mother magazine, published in Salt Lake City, Utah. http://www.motherchronicle.com email karensquires1@msn.com
by Suzanne Michaels
Shudder the thought of taking away consciousness just before giving birth to your child. That was commonplace just over a generation ago. Then take a look at how far we've come. Now consider how far we have to go to capture the very essence of what birth was meant to be; a normal and natural physiological process. Birth is not a medical crisis. But change in social attitudes does not happen in a heartbeat. It does not come about in one generation either. Necessary change is seen first in the heart and soul of visionaries. Mix this with the courage to bring change into being and you have the necessary ingredients for the advancement of mankind. Marcia Scoville MS CNM, a certified nurse-midwife, is such a visionary. With the undying support of Susan Rugg, RN, they are serious family advocates, sometimes fighting an uphill battle against the regimented habits of a medical belief system that turns the family celebration of birth into a medical procedure. The good news is that there is a miraculous manifestation of their visions in the Holladay area; The Birth and Family Place.
Marcia is an optimistic professional with valid commitments which strive to bring the home atmosphere back into birthing. Visiting the Birth and Family Place is rather like walking into a luxurious hotel with spaciousness and comforts to spare. Birthing rooms are dressed in comfortable decor and cozy interior decorating with beds large enough to accommodate the new family. "They're big enough to tuck mom, dad, and baby in together," Marcia said with a maternal smile. Around the corner is a large, private jetted tub. Disguised as mere comfort to the birthing mom, the tubs have an essential purpose. During the later stages of labor, the feelings of heavy contractions must compete with the sensations drawn by the jetted water over the body. It helps relieve labor and promotes the rise of the endorphins which labor initiates. Rather than shutting down the endorphins through medical intervention, the Birth and Family Place cheers them on in even more ways than atmosphere and soothing baths.
Birthing mothers can take comfort in knowing that "we provide a watchful, skilled eye," said Marcia. The nurse midwife is with the mother during the entire process of labor. They keep a keen eye on whatever is working to induce comfort for the mom and then they amplify it. "We don't just come in and catch the baby." she states. Professionals are available on the staff who can provide a massage, explore pressure points, and even provide hypnosis. Being with the mom during the entire course of labor gives the opportunity for the family to share in the experience.
The nurse-midwife becomes a valuable advocate who can key in to the unique needs and direction of comfort for the birthing mother. In the meantime the family, including the birthing mother, is free to wander. In a normal pregnancy and birth, out of bed management is more conducive to a satisfied and successful labor and delivery.
Studies support this logic. The Public Citizens' Health Research Group on nurse-midwifery care conducted a survey of 419 hospitals and 39 freestanding birth centers. Their final recommendation embraced the use of freestanding birthing centers to insurers, hospitals, and the public. The use of birthcenters initiates greater satisfaction at a lower cost with fewer invasive procedures and fewer cesarean sections. Marcia's sincerity and passion for her work strongly reiterates that "Birth is a celebration."
Though the Birth and Family Place maintains basic necessities such as a resuscitation station and a fetal monitor, the medical intervention is kept to a safe minimum for low risk delivery. Also, the Birthcenter follows careful criteria for determining low risk pregnancies. The center advocates a physician's support for higher risk pregnancies. If any concerns arise, and the mom is transported to a facility that can better suit her needs, the nurse-midwife stays right by her side and continues supporting her birth experience at the hospital.
Some midwives who work with home births carry no credentials and no license. This is an area that is vastly unregulated in the state. Families would do well to proceed with caution when making the home birth decision. Owned by Susan Rugg, RN, a nurse who worked with the midwives at a previous birthcenter managing their outcome data, was so impressed with the quality of care given that she started a business to open this birthcenter.
The Birth and Family Place is Utah's only open-staffed, state-licensed, freestanding birthcenter. It is a gentle and rational compromise for the family who is reluctant to venture full speed into home birth, yet feel weary about surrendering the birth of their child into the hands of a large corporation. The center is an alternative that provides a net of safety, while giving the family complete control over the birth of their child. "We're all about making the family work," said Marcia, "it's not about making the system work." The Birth and Family Center is licensed by the state and accredited by the National Association of Childbirth Centers.
The entire inspiration of The Birth and Family Place is a reflection of the wisdom of our ancestors; birth is not riding on a medical conveyor belt. It is the rejoicing of family and a time for the support of close friends. For a new mother, those friends may very well be waiting at the Birth and Family Place with competency, experience, compassion, and a deep, deep appreciation for the miracle of giving life.
If you are interested in teaching childbirth or lactation education classes at The Birth and Family Place, feel free to contact the center. For more information about The Birth and Family Place, visit http://www.birthandfamilyplace.com, phone: 278-3102. email:amity@birthandfamilyplace.com
Suzanne Michaels is the mother of four children and a Certified Lactation Educator. Currently she is the director and a teacher of Magic Merlin Preschool for bright and gifted children. She is the published author of Raising Children to be Gifted and Magic Merlin Preschool Curriculum. Suzanne is a freelance writer whose articles have appeared in local publications. She has been interviewed by local television news shows and radio programs. Currently she lives in East Sandy. To contact Suzanne Michaels, call (801) 942-0660
by Helen Whitehead
My mother sometimes tells me a story, a story from our family history, from the bad old days of the pre-war years. It's a story about keeping a baby alive-for the maternity money. Joanna doesn't have the patience to listen to the same story over and over again, but I love to hear it. There's a comfort in repetition, the comfort of a well-known nursery rhyme or fairy tale. But in passing on the family stories, there is also something to marvel at, something to think on, something to admire.
It's usually one of those quiet times, after a big Sunday dinner with all the family, while the dishwasher chugs in the kitchen and the women's jobs are done for an hour or two. My mother and I sit with our elbows on the cleared family dining table, which is still extended to seat all the visitors. The cream Irish linen tablecloth is marked by a wine spill, washed out, with a saucer underneath to raise it to dry. There might be a discarded napkin, a pyramid of spilled salt, smears of Yorkshire pudding and crumbs of the stuffing my mother makes from my grandmother's recipe - a meal in itself incorporating not just breadcrumbs and herbs but onion, mushrooms and a whole pound of sausagemeat.
My mother has always told me stories of her childhood, and stories that were told to her. She tells me about her mother, Mary, and her grandmother, Eileen, and how Eileen saved a baby. Life was hard in the industrial towns of Yorkshire back then. Eileen's was a steel town on the East Coast. They lived in SeaView Terrace. Once they might have been able to glimpse the sea by peering out of the attic windows of the terraced houses, but not now. Now the steelworks had been built on the flats between the houses and the shore. A cloud of dark grey smoke hung permanently over the town and often there wasn't even a view of the sun.
Now there were jobs, but not for everyone. Eileen's husband had trouble with his health - or at least, that's how they explained his frequent periods out of work. They were poor but proud back then. My great-grandmother came from good solid yeoman stock. The women were strong and capable - the kind who carried an entire neighbourhood on broad shoulders. The town produced steel.
When my great-grandfather died, Eileen needed to apply to the authorities for help. She was told she wouldn't be given any money while she had in the house any decent pieces of furniture, such as the carved wooden sideboard that had been passed down the women in her family for generations. She didn't want to sell it, but to get the benefit, she had to. She got little enough for it. Years later her daughters found out that the piece had been a Chippendale.
But that's not the story I was going to tell. She was tough, my great-grandmother, so it was natural for the weeping mother of a premature baby to call her for help. And Eileen would have wiped her hands on the apron she never took off, told her eldest to "look sharp and mind the bairns", and gone to do what she could.
The baby, poor little mite, hadn't much chance of life. What was worse, it was born too early to qualify for the maternity grant. And the loss of that grant meant a lot to a family as poor as that one. There were still a few days to go before it would have existed long enough to qualify as a birth.
My great-grandmother didn't give up. She wrapped that baby up and stoked the fire and warmed some milk, and she fed it every two hours and she nursed that baby in a basket on the hearth of her kitchen for long enough that it survived past the qualifying date.
She wasn't sentimental either, my great-grandmother, Eileen. A born fighter, she never resisted the inevitable. Once past that all-important date, she stopped her efforts. She let the baby die. It had never had much chance of life. She kept the baby alive long enough to claim the maternity grant and that was a real achievement.
My mother told me this story, and others, of her grandmother. "She was a hard woman," was always my mother's final comment. But we both admired that "hard" woman. I wondered then, as I often wonder still, is there any of her steel, of her pragmatism, of her practical generosity in me?
Barely a Life is part of a longer hypertext fiction about motherhood and spirituality; some of it based on true experience (as Barely a Life is a fictionalized account of a real family story). It's called Visions and Dreams and it's at http://ds.dial.pipex.com/h.whitehead/Dissert/visions.htm
Copywrite Helen Whitehead
by Dawn Friedman
OK, I'll say it. Sometimes I miss going to work. It's not something I like to admit; I feel like a traitor to my cause. I spend a lot of energy trying to convince working mothers-of my-acquaintance that staying home with their children is a loving, positive, intelligent choice and so I hesitate to admit to any downside. But the truth is that staying home with your kids can be hard. Really hard. And sometimes --through those rose-colored glasses with which we tend to look at our past -- being at work starts to sound like a nice vacation. Dressed in sweats, contemplating my living room strewn with toys with a toddler hanging off my leg and wiping his nose on my pants, I think back to the job I held pre-mommyhood. I sigh as I remember how I used to trot off to my busy yet mostly predictable job in stylish clothing, a latte in hand. I picture myself sitting at a spacious, comfortably cluttered, un-childproofed desk making leisurely, uninterrupted phone calls. A lunch meeting at noon to participate in stimulating conversation and debate about company policies (how could I have ever found that boring!) and then an afternoon kept busy with appointments and undistracted computer time. All right, so I miss it occasionally but that doesn't mean that I ever regret my decision to be home.
I realize how lucky I am that I am even allowed to be disgruntled. My mother recalls that reading Erma Bombeck for the first time (back in the 60's) made her feel so relieved; she thought she was the only one that ever felt overwhelmed by full-time motherhood! And yet, I find myself becoming defensive when confronted with the assumption by outsiders that my life is made up of martyrdom and drudgery and so I have reacted in the past by denying the very real travails of the full-time parent.
Unfortunately, I think that by waxing on about the joys of at-home motherhood I've probably done more harm than good. I came to this realization when a friend of mine (after listening to one of my glorious speeches) said, "But it's easy for you; you're that kind of person. I'm not." But am I? Am I that kind of person? What does that mean? I thought back to other comments I've been handed by friends (and I bet these sound familiar to you):
"I would
get bored staying at home."
"I need the intellectual stimulation I get at work."
"I'm good at what I do; I don't want to give that up."
"I just don't have the patience to stay home."
Do I get bored staying at home? Occasionally. Do I crave the kind of stimulation I got at work? Sometimes. Was I good at what I do? Well, I don't like to brag but... Am I truly a patient person? Ummm, before or after my morning coffee? What I ought to have done was explain to my friend that at-home mothers come in all shapes, sizes, configurations and levels of patience and that at-home motherhood is more flexible a career then it might at first appear. When I hear about women who gave staying home "a shot" and found themselves going stir-crazy I wonder if they allowed themselves enough time for the necessary detoxification from the working world. Being at home is like living in molasses after years spent in the 9 to 5 regime. Tasks take longer, the hours moves more slowly and yet there are days when you can't even find the time to bathe. Oh yes, I know how frightening it can all be to someone used to living by her day-planner! But if given time, the newly at-home parent will find herself letting go of fabricated schedules, adjusting to -- and even relishing! -- her new routine. And she will likely discover (as I have) that although she will have less time and energy to spend on herself, she will ironically be allowed to know herself better once she is divested of the day-to-day expectations of the outside world.
Ultimately, being at home is a journey into self even as we make the daily personal sacrifices that caring for our children requires. We are stretched to our limits, forced to confront our secret flaws and given the opportunity to discover where our true happiness lies. What a privilege to reject our culture's pervasive belief that our value is measured by our paychecks and instead discover that we can measure our value ourselves!
My life is richer for having left the work-a-day world and not just because of the joy I find in my son. It is so much less artificial and so much more grounded. I realize that my occasional bouts of reminiscing are due more to the intensity of at-home motherhood than lack of challenges and rewards. When I think back fondly to my time spent on my career, I remind myself that I had just as many bad days as I do now (more, in fact) but that now my bad days can't be left behind at five or delegated to someone else. Confronting my problems when I would rather hide my head in the sand is hard but more gratifying in the long run. Each day when I see that my son is coming into his own just a little bit more, I'm proud to say that the same is true for me.
Instead of denying my difficulties, I'm going to free myself to talk about them and also to talk about their resolution. Perhaps when my friends see me struggling, surviving and flourishing they will allow themselves to discover that being at-home may be the best thing they can do not just for their families, but for themselves.
Written by Toni LaMalfa, Certified Nurse-Midwife
Did you know that planning for a pregnancy could make you a "wiser mother" from the start? Whether you are actively planning to conceive a child or just thinking about it, what you do now could make a difference in the health, comfort, and joy you will experience during the pregnancy. Making sure you are planning ahead could even affect the health of your baby. By reviewing the following preconception checklist, you can see how ready you are to take on one of the most important jobs of your life. Not only will this pay off when you are pregnant but for your entire life. By modifying some health behaviors now, you could be around longer to enjoy the fruits of your labor.
Lets start
with your health.
•See your midwife or doctor and get a complete physical, pap, and breast
exam.
•Find out if you are anemic (low blood count) so you can correct this now
•Talk about any chronic medical problems that may impact your pregnancy
•If you are taking any medications see if they need to be changed or discontinued
•Know if you are protected against Rubella, German Measles. If you don't
know, get a blood test. If you aren't protected consider getting immunized three
months prior to conception, if already pregnant you can avoid exposure
•Make sure you are taking a multivitamin with Folic acid, at least 400mg/day
to help reduce the occurrence of spine defects. You can request a prescription
prenatal and start taking it 3 months prior to conception if desired
•Consider if there are any work related hazards (chemicals, heavy lifting)
that could pose a risk to the developing fetus, make necessary changes
•Look at your over all body weight and height ratio. If overweight, develop
a plan to start losing. If underweight, start putting some on! Both conditions
can cause increased risks like gestational diabetes and premature birth
•Look at your stamina and fitness. If you aren't getting regular exercise
- think of what will work for you and get moving
•If you do regular exercise check and see if this will need modification
once pregnant
•Evaluate your eating habits: Keep a journal of every thing you eat for
a week
•Cut back on sweets and fats
•Drink at least 8 glasses of water, juices, and milk each day
•Cut back on caffeinated beverages if needed
•Compare your intake to the FDA guidelines for good health and modify your
diet to come as close as possible.
As a Certified Nurse-Midwife, I try to assist women in obtaining the awareness and tools to optimize their own health. With knowledge comes empowerment. With empowerment comes self-esteem and the ability to take control of your own life.
Toni LaMalfa,
A.R.N.P., C.N.M.
Mt. Olympus Obstetrics & Gynecology 685-7188
By Julie Shipman
Sometimes
I complain.
about how you scream,
about how you never seem
to sleep.
But those are just words.
When
you cry at night,
My heart aches.
I want to make it better.
I go into your room.
I pick you up and wrap you in your blanky,
You know, the blue one with the silky edges.
I
hold you tight in my arms.
You sigh. I sing you a lullaby.
You smile.
I rock you back to sleep.
You close your eyes.
Your
little hand is wrapped around my finger.
The house is silent,
Just the sound of creaking,
as the chair rocks on
the wooden floor.
I see a full moon out the window.
The sky is clear.
I
sit in that chair longer than necessary.
I could go back to bed.
But, I wonder.
Does life get any better than this?
I will savor this feeling a few moments longer.
Then I will put you back in your crib and crawl under my covers.
When
I go to work tomorrow,
I will probably complain,
About how you cried.
About how you were up
last night.
But those are only words.
by Sharon deLaubenfels
"If you could have dinner with anyone in the world, alive or dead, who would it be?" My husband and I were on our nightly walk with our cocker spaniel, Spike. It is a leisurely walk, partly because we talk about our day, or the neighbor's scraggly lilac bush, or about another neighbor's brick wall lining his front walk and how it is all wrong for the space. But it is also an unhurried walk because Spike makes, on average, 10 stops in 10 minutes of the walk, either to sniff a bush or to "make his mark" on it.
Somehow this evening, I managed to successfully slip in my "dinner guest" question--a real coup--since my husband generally dislikes those kinds of games, but this time he didn't dismiss the question. I had my smug reply ready for when he returned the question: "Anton Chekhov; I don't think it could get much better than that," I was going to say. I expected his answer to be "Albert Einstein," or "Bob Dylan," or "William Shakespeare," someone totally cerebral, a groundbreaker, a genius. I wasn't ready for his answer. But when it came, I was envious; why didn't I think of an answer like that? It seemed so obvious, so right. And I never felt closer to him.
She had passed away 16 years ago; and how much he missed her. Without hesitating, he said, "My mother."
Sharon deLaubenfels email: sdelaube@creighton.edu
Naturopathic
Medicine:
The Best in Natural Medicine for Your Whole Family
by Leslie Peterson, N.D.
It seems as if every person you talk to: your neighbor, friend, teacher is raving about some type of natural remedy that turned their health around. And they boldly proclaim, "You've just got to try it!" So maybe you try this, that or the other remedy and nothing happens for you. Now what? Natural medicine seems to make a lot of sense, but who really knows the bottom line about what works best? I'd like to introduce an old friend in the natural medicine world: Naturopathy, and the doctors who practice it, Naturopathic Physicians, or N.D.'s.
For over 100 years, Naturopathic Physicians have served the natural medicine needs of North American's. At the turn of the last century, naturopathy was a popular form of healing with medical schools in nearly every state and thousands of physicians treating scores of people. With the introduction, and hence exceeding popularity of pharmaceutical medicines, naturopathy fell out of favor and nearly became extinct. As time went on, it became clear that conventional (drug-based and surgical) medicine had definite limitations and clearly wasn't for everybody. So people began once again to seek out alternatives.
Today, there are four naturopathic medical schools educating hundreds of future physicians who can practice legally in many states. The education is rigorous and very in-depth. The first two years of the four-year training are very similar to conventional medical school: lots of medical science classes and exams. The last two years involve hundreds of hours of clinical training in public natural health clinics as well as education about naturopathic healing modalities. To become licensed in one of the twelve states offering licensure, an N.D. must pass a three and a half day series of clinical examinations.
Naturopathic Medicine is often described as being like an umbrella over other natural medicine methods. N.D.'s are trained in the use of herbal medicine, nutrition - both dietary and clinical, homeopathy, hydrotherapy, and physical medicine. Some N.D.'s may further their training and include minor surgery, acupuncture or natural childbirth. The majority of N.D.'s practice as family-practice, or general practitioners and are able to treat most any health condition. Very few choose to specialize, although some may only practice homeopathy, or physical medicine for example.
In Utah, four-year educated N.D.'s can become licensed and practice as primary-care providers. They can diagnose and treat illness by ordering any type of laboratory test, and can prescribe certain medications such as antibiotics and hormones if needed. Naturopath's in Utah are also able to perform minor surgery, practice natural childbirth, and administer intravenous nutrients if they are trained to do so. Some insurance companies, like Blue Cross Blue Shield and DMBA, in Utah cover naturopathic medical services. Check with a Naturopathic Physician to find out which plans they are covered under.
When the question arises of how best to treat your family's medical concerns, a licensed Naturopathic Physician can help you. N.D.'s are truly "integrative" practitioners and have a strong sense of which type of medicine is best, be it alternative or conventional. They won't hesitate to recommend what is best for the patient.
To find an N.D. near you, check the yellow pages.
The American Association of Naturopathic Physicians has a great website at: http://www.naturopathic.org.
Uli Knorr,
N.D. & Leslie Peterson, N.D.
Licensed Naturopathic Physicians
2188 S. Highland Dr., Ste 207, Salt Lake City, UT 84106
474-3684
By Diane Wiessinger, MS, IBCLC
The lactation consultant says, "You have the best chance to provide your baby with the best possible start in life, through the special bond of breastfeeding. The wonderful advantages to you and your baby will last a lifetime." And then the mother bottlefeeds. Why?
In part because that sales pitch could just as easily have come from a commercial baby milk pamphlet. When our phrasing and that of the baby milk industry are interchangeable, one of us is going about it wrong...and it probably isn't the multinationals. Here is some of the language that I think subverts our good intentions every time we use it.
Best possible, ideal, optimal, perfect. Are you the best possible parent? Is your home life ideal? Do you provide optimal meals? Of course not. Those are admirable goals, not minimum standards. Let's rephrase. Is your parenting inadequate? Is your home life subnormal? Do you provide deficient meals? Now it hurts. You may not expect to be far above normal, but you certainly don't want to be below normal.
When we (and the artificial milk manufacturers) say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, "So what?" Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy--and thus safety and adequacy--of artificial feeding. The truth is, breastfeeding is nothing more than normal. Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.
Advantages. When we talk about the advantages of breastfeeding--the "lower rates" of cancer, the "reduced risk" of allergies, the "enhanced" bonding, the "stronger" immune system--we reinforce bottlefeeding yet again as the accepted, acceptable norm.
Health comparisons use a biological, not cultural, norm, whether the deviation is harmful or helpful. Smokers have higher rates of illness; increasing prenatal folic acid may reduce fetal defects. Because breastfeeding is the biological norm, breastfed babies are not "healthier;" artificially-fed babies are ill more often and more seriously. Breastfed babies do not "smell better;" artificial feeding results in an abnormal and unpleasant odor that reflects problems in an infant's gut. We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.
We must not let inverted phrasing by the media and by our peers go unchallenged. When we fail to describe the hazards of artificial feeding, we deprive mothers of crucial decision-making information. The mother having difficulty with breastfeeding may not seek help just to achieve a "special bonus;" but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial milk just "to get him used to a bottle" if she knows that the contents of that bottle cause harm.
Nowhere is the comfortable illusion of bottlefed normalcy more carefully preserved than in discussions of cognitive development. When I ask groups of health professionals if they are familiar with the study on parental smoking and IQ (1), someone always tells me that the children of smoking mothers had "lower IQs." When I ask about the study of premature infants fed either human milk or artificial milk (2), someone always knows that the breastmilk-fed babies were "smarter." I have never seen either study presented any other way by the media--or even by the authors themselves. Even health professionals are shocked when I rephrase the results using breastfeeding as the norm: the artificially-fed children, like children of smokers, had lower IQs.
Inverting reality becomes even more misleading when we use percentages, because the numbers change depending on what we choose as our standard. If B is 3/4 of A, then a is 4/3 of B. Choose A as the standard, and B is 25% less. Choose B as the standard, and A is 33 1/3% more. Thus, if an item costing 100 units is put on sale for "25% less,"the price becomes 75. When the sale is over, and the item is marked back up, it must be marked up 33 1/3% to get the price up to 100. Those same figures appear in a recent study (3), which found a "25% decrease" in breast cancer rates among women who were breastfed as infants. Restated using breastfed health as the norm, there was a 33-1/3% increase in breast cancer rates among women who were artificially fed. Imagine the different impact those two statements would have on the public.
Special. "Breastfeeding is a special relationship." "Set up a special nursing corner." In or family, special meals take extra time. Special occasions mean extra work. Special is nice, but it is complicated, it is not an ongoing part of life, and it is not something we want to do very often. For most women, nursing must fit easily into a busy life--and, of course, it does. "Special" is weaning advice, not breastfeeding advice.
Breastfeeding is best; artificial milk is second best. Not according to the World Health Organization. Its hierarchy is: 1) breastfeeding; 2) the mother's own milk expressed and given to her child some other way; 3) the milk of another human mother; and 4) artificial milk feeds (4). We need to keep this clear in our own minds and make it clear to others. "The next best thing to mother herself" comes from a breast, not from a can. The free sample perched so enticingly on the shelf at the doctor's office is only the fourth best solution to breastfeeding problems.
There is a need for standard formula in some situations. Only because we do not have human milk banks. The person who needs additional blood does not turn to a fourth-rate substitute; there are blood banks that provide human blood for human beings. He does not need to have a special illness to qualify. All he needs is a personal shortage of blood. Yet only those infants who cannot tolerate fourth best are privileged enough to receive third best. I wonder what will happen when a relatively inexpensive commercial blood is designed that carries a substantially higher health risk than donor blood. Who will be considered unimportant enough to receive it? When we find ourselves using artificial milk with a client, let's remind her and her health care providers that banked human milk ought to be available. Milk banks are more likely to become part of our culture if they first become part of our language.
We do not want to make bottlefeeding mothers feel guilty. Guilt is a concept that many women embrace automatically, even when they know that circumstances are truly beyond their control. (My mother has been known to apologize for the weather.)
Women's (nearly) automatic assumption of guilt is evident in their responses to this scenario: Suppose you have taken a class in aerodynamics. You have also seen pilots fly planes. Now, imagine that you are the passenger in a two-seat plane. The pilot has a heart attack, and it is up to you to fly the plane. You crash. Do you feel guilty?
The males I asked responded, "No. Knowing about aerodynamics doesn't mean you can fly an airplane." "No, because I would have done my best." "No. I might feel really bad about the plane and pilot, but I wouldn't feel guilty." "No. Planes are complicated to fly, even if you've seen someone do it." What did the females say? "I wouldn't feel guilty about the plane, but I might about the pilot because there was a slight chance that I could have managed to land that plane." "Yes, because I'm very hard on myself about my mistakes. Feeling bad and feeling guilty are all mixed up for me." "Yes, I mean, of course. I know I shouldn't, but I probably would." "Did I kill someone else? If I didn't kill anyone else, then I don't feel guilty." Note the phrases "my mistakes," "I know I shouldn't," and "Did I kill anyone?" for an event over which these women would have had no control!
The mother who opts not to breastfeed, or who does not do so as long as she planned, is doing the best she can with the resources at hand. She may have had the standard "breast is best" spiel (the course in aerodynamics) and she may have seen a few mothers nursing at the mall (like watching the pilot on the plane's overhead screen). That is clearly not enough information or training. But she may still feel guilty. She's female.
Most of us have seen well-informed mothers struggle unsuccessfully to establish breastfeeding, and turn to bottlefeeding with a sense of acceptance because they know they did their best. And we have seen less well-informed mothers later rage against a system that did not give them the resources they later discovered they needed. Help a mother who says she feels guilty to analyze her feelings, and you may uncover a very different emotion. Someone long ago handed these mothers the word "guilt." It is the wrong word.
Try this on: You have been crippled in a serious accident. Your physicians and physical therapists explain that learning to walk again would involve months of extremely painful and difficult work with no guarantee of success. They help you adjust to life in a wheelchair, and support you through the difficulties that result. Twenty years later, when your legs have withered beyond all hope, you meet someone whose accident matched your own. "It was difficult," she says. "It was three months of sheer hell. But I've been walking every since." Would you feel guilty?
Women to whom I posed this scenario told me they would feel angry, betrayed, cheated. They would wish they could do it over with better information. They would feel regret for opportunities lost. Some of the women said they would feel guilty for not having sought out more opinions, for not having persevered in the absence of information and support. But gender-engendered guilt aside, we do not feel guilty about having been deprived of a pleasure. The mother who does not breastfeed impairs her own health, increases the difficulty and expense of infant and child rearing, and dismisses one of life's most delightful relationships. She has lost something basic to her own well-being. What image of the satisfactions of breastfeeding do we convey when we use the word "guilt"?
Let's rephrase, using the words women themselves gave me: "We don't want to make bottlefeeding mothers feel angry. We don't want to make them feel betrayed. We don't want to make them feel cheated." Peel back the layered implications of "we don't want to make them feel guilty," and you will find a system trying to cover its own tracks. It is not trying to protect her. It is trying to protect itself. Let's level with mothers, support them when breastfeeding doesn't work, and help them move beyond this inaccurate and ineffective word.
Pros and cons, advantages and disadvantages. Breastfeeding is a straight-forward health issue, not one of two equivalent choices. "One disadvantage of not smoking is that you are more likely to find secondhand smoke annoying. One advantage of smoking is that it can contribute to weight loss." The real issue is differential morbidity and mortality. The rest--whether we are talking about tobacco or commercial baby milks--is just smoke.
One maternity center uses a "balanced" approach on an "infant feeding preference card" (5) that lists odorless stools and a return of the uterus to its normal size on the five lines of breastfeeding advantages. (Does this mean the bottlefeeding mother's uterus never returns to normal?) Leaking breasts and an inability to see how much the baby is getting are included on the four lines of disadvantages. A formula-feeding advantage is that some mothers find it "less inhibiting and embarrassing." The maternity facility reported good acceptance by the pediatric medical staff and no marked change in the rates of breastfeeding or bottlefeeding. That is not surprising. The information is not substantially different from the "balanced" lists that the artificial milk salesmen have peddled for years. It is probably an even better sales pitch because it now carries very clear hospital endorsement. "Fully informed," the mother now feels confident making a life-long health decision based on relative diaper smells and the amount of skin that shows during feedings.
Why do the commercial baby milk companies offer pro and con lists that acknowledge some of their product's shortcomings? Because any "balanced" approach that is presented in a heavily biased culture automatically supports the bias. If A and B are nearly equivalent, and if more than 90% of mothers ultimately choose B, as mothers in the United States do (according to an unpublished 1992 Mothers' Survey by Ross Laboratories that indicated fewer than 10% of U.S. mothers nursing at a year), it makes sense to follow the majority. If there were an important difference, surely the health profession would make a point of staying out of the decision-making process. It is the parents' choice to make. True. But deliberately stepping out of the process implies that the "balanced" list was accurate. In a recent issue of Parenting magazine, a pediatrician comments, "When I first visit a new mother in the hospital, I ask, 'Are you breastfeeding or bottlefeeding?' If she says she is going to bottlefeed, I nod and move on to my next questions. Supporting new parents means supporting them in whatever choices they make; you don't march in postpartum and tell someone she's making a terrible mistake, depriving herself and her child." (6)
Yet if a woman announced to her doctor, midway through a routine physical examination, that she took up smoking a few days earlier, the physician would make sure she understood the hazards, reasoning that now was the easiest time for her to change her mind. It is hypocritical and irresponsible to take a clear position on smoking and "let parents decide" about breastfeeding without first making sure of their information base. Life choices are always the individual's to make. That does not mean his or her information sources should be mute, nor that the parents who opt for bottlefeeding should be denied information that might prompt a different decision with a subsequent child.
Breastfeeding. Most other mammals never even see their own milk, and I doubt that any other mammalian mother deliberately "feeds" her young by basing her nursing intervals on what she infers the baby's hunger level to be. Nursing quiets her young and no doubt feels good. We are the only mammal that consciously uses nursing to transfer calories...and we're the only mammal that has chronic trouble making that transfer.
Women may say they "breastfed" for three months, but they usually say they "nursed" for three years. Easy, long-term breastfeeding involves forgetting about the "breast" and the "feeding" (and the duration, and the interval, and the transmission of the right nutrients in the right amounts, and the difference between nutritive and non-nutritive suckling needs, all of which form the focus of artificial milk pamphlets) and focusing instead on the relationship. Let's all tell mothers that we hope they won't "breastfeed"--that the real joys and satisfactions of the experience begin when they stop "breastfeeding" and start mothering at the breast.
All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances. A vital first step toward achieving those goals is within immediate reach of every one of us. All we have to do is...watch our language.
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Reprinted from the Journal of Human Lactation, Vol. 12, No. 1, 1996
References: 1. Olds D. L., Henderson, C. R. Tatelbaum, R.: Intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics 1994; 93:221-27.2. Lucas, A., Morley, R., Cole, T.J., Lister, G., Leeson-Payne, C.: Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339 (8788): 261-64. 3. Fruedenheim, J.L., Graham, S., Laughlin, R., Vena, J.E., Bandera, E., et al: Exposure to breastmilk in infancy and the risk of breast cancer. Epidemiology 1994, 5:324-30. 4. UNICEF, WHO, UNESCO: Facts for Life: A Communication Challenge. New York: UNICEF 1989; p. 20. 5. Bowles, B.B., Leache, J., Starr, S., Foster, M.: Infant feeding preferences card. J Hum Lact 1993; 9: 256-58. 6. Klass, P.: Decent exposure. Parenting (May) 1994; 98-104. to kayhh's Breastfeeding page