Category Archives: Grr, argh

Their bodies, their choice

Last year, clicking through links from different blogs, I came across one called The Honest Courtesan, written under the nom de plume of Maggie McNeill.  I've been reading it ever since; it makes a pleasantly interesting change from all the heated debate over parenting-related issues that is my more usual fare.  Maggie is a former escort worker who blogs in favour of decriminalisation of prostitution.

I've never had a problem with the concept that prostitution should be legal; I've always found it far harder to see why it shouldn't be.  I have never seen a voluntary exchange of sex for money as being something that should be the law's business (except insofar as any profession should be assured of good working conditions), and I'd like the portion of my taxes that's spent on law and order to be spent on clearing up things that actually do harm other people rather than wasted on arrests of/sanctions against people who weren't doing anyone any harm in the first place.  So the idea of decriminalising prostitution (1) wasn't a new or startling one to me.

However, reading Maggie's blog, and some of the sites she links to, has been an education on the complexities of the subject.  And an eclectic one.  Maggie writes a lengthy post every day, nearly all of them on the topic of prostitution, and she approaches it from every angle imaginable.  Current events, legalities, ethics, philosophy, personal experience (never written to be racy or titillating, but do be warned that she does get pretty frank and open about some of the details), history, and even the odd bit of prostitution-related fiction (and, no, it's never pornographic fiction).  As you can imagine, I've learned a lot about the subject, and a lot about anti-prostitution arguments and some of their flaws.

So, a couple of years back, Maggie made a suggestion.  For reasons explained here, she suggested making Friday the Thirteenth a day for speaking out in favour of decriminalisation of prostitution. I wasn't reading her blog then, and so I didn't see this until her follow-up post on May 13th of last year; as it happens, this is the first Friday the Thirteenth since then, and thus the first opportunity I've had to use this day to speak out on the subject.

While most happy to oblige, I wasn't sure where to start on dealing with the complexities of this subject and the many myths around it. As it happens, however, the perfect cue came up a couple of weeks ago; the subject of prostitution somehow came up in the middle of a blog debate about something utterly different, and one commenter summed the different positions up rather nicely:

What a certain sector of feminist thought argues is that sex work can be *chosen* and is a legitimate and potentially empowering choice for women. Those that disagree will often retort that no one would choose prostitution if other options were reasonably available and though they may not be “forced” at gun point they are “forced” by lack of access to education, poor support for addictive illnesses, shredded social safety nets, etc.

And so, for this Friday the Thirteenth, I want to reply to the position described in her second sentence.

First of all, there is an important factual error to note here: the claim that no-one would choose prostitution if other reasonable options were available. In fact, many women do precisely this. Last year, in Wales, researchers surveyed women in the non-streetwalker forms of prostitution (brothel work and escort work) to find out about their reasons for entering the world's oldest profession, and were surprised to find that – far from being forced into it by desperate circumstances – the majority of the women they spoke to had willingly left good careers in other areas to go into sex work.  Similar findings were emerging from research done in the USA.

While many people will have a hard time believing those findings, the fact is that a career in the higher-end forms of prostitution has many benefits – it's very well paid, women can set their own hours, working conditions are often excellent (they may see their clients at luxury hotels, and at least one post on Maggie's blog is a review of the quality restaurants to which her clients took her before, or sometimes even instead of, getting down to the part of the evening more usually associated with the job), and there is no doubt that they're going to have a lot of satisfied clients. So, in fact, it isn't so surprising to find that there are women such as Maggie who genuinely enjoy their work in prostitution and who choose to stay in the job in spite of having other perfectly good options available to them. In fact, the biggest problems that many women face with the job are simply those thrown in their way by the restrictive laws around the profession that have been put into place in misguided attempts to help these women.

However, it is also, of course, quite true that many other prostitutes are only in the profession due to being forced into it by straitened circumstances – they don't like the idea of having sex with multiple strangers, but they need the money and either they have no other way of getting it or the other jobs available to them are worse. (2) And this fact is often used as an argument for trying to stamp out prostitution – that anti-prostitution laws are needed to help and protect those women forced into the profession.  What this argument ignores, however, is that if someone has picked Option X as being the best available to them out of a limited selection of disliked options, all that removing Option X does is to leave them with the options that they've already concluded are even worse.

If a woman has decided that prostitution is the least unattractive option available to her at this time in her life, making it illegal is not going to change whatever life circumstances have led her to that decision.  It may leave her with one of the choices that she has already decided to be more unsavoury to her (destitution, or working at a worse job); or it may leave her working as a prostitute anyway, with her lot made worse by the added burden of anti-prostitution laws.  Either way, it is not going to help her.  She does not need anti-prostitution laws set up in a misguided attempt to 'protect' her – she needs help and support coupled with an acknowledgement of the fact that, if she is an adult of sound mind, she is the person best placed to make decisions about her own life and that she should have the right to do so.

So, for the above reasons and many others: yes, I do agree that sex work can be freely chosen.  I do agree that it is a legitimate choice.  I do agree that it can be potentially empowering for women.  And, while I recognise that there are large numbers involved in the industry who do not find it empowering and would not want to be in that job if they had a better option, I also recognise that making it illegal is not the answer to that problem.  Today is my first Friday the Thirteenth of blogging for the rights of sex workers: I hope it won't be the last.

 

Footnotes

(1) There is, apparently, a technical issue of wording to be considered here: apparently legalisation is not the same as decriminalisation.  Legalisation requires prostitution to be subject to whatever laws and licencing procedures the government may deem relevant, and governments, apparently, have an appalling track record on that score; their attempts to set up legal frameworks to control and regulate prostitutes have invariably led to laws that have done far more harm than good.  Decriminalisation apparently means that you stop making it illegal without the requirement to throw in a bunch of totally unnecessary and problematic new laws.  I am not a lawyer and don't play one on TV, so I do hope I got that distinction right.  In any case, this is why decriminalisation is the term that Maggie uses and the one that I have used here, other than in the footnoted sentence describing my views prior to encountering her blog.

(2) I'm not, in this post, discussing the far more uncommon but far more tragic cases in which women are forced into prostitution in the more literal sense of being under threat of violence to themselves or their families if they don't comply, such as trafficked women.  I think that people from all sides of the prostitution debate can agree that trafficking is a hideous crime that needs to remain illegal, regardless of what happens with prostitution laws.  However, although making prostitution illegal is often advocated as a way of fighting sex trafficking, there is little evidence that it is of any help; meanwhile, anti-prostitution laws harm the women who are involved in the profession by choice.

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The Happiness Project and Lori Gottlieb

A few weeks back, Atlantic.com carried an article about parenting by therapist Lori Gottlieb by the intriguing title How To Land Your Kid In Therapy.  I may or may not ever get round to blogging about Gottlieb's views on parenting and how they match with mine (which they do, for the most part, though I don't know if I'd agree with all her points).  But I do, however, just need to point this out: she has totally misrepresented Gretchen Rubin

Rubin, as many people will know, is the author of The Happiness Project, in which she chronicles her year spent working on increasing the happiness level in her life; a month each of focusing on eleven different life areas or aspects of happiness (energy, marriage, children, fun, etc.), wrapped up by a final month of attempting to put into practice everything she'd learned in all eleven areas. She did this by means of working on several resolutions each month, many of them delightfully prosaic – the first month's resolutions included getting to bed on time and decluttering her apartment.

Although I'm always a bit baffled by the concept of needing to work on being happy and don't feel any need to start a Happiness Project myself (plenty of other potential projects, but not one on happiness – I'm happy already, thanks, so I'd rather spend my time and energy conquering some other mountain), I still loved the book.  It's not everyone's cup of tea, obviously; it is, essentially, the story of an exceptionally privileged woman painstakingly teaching herself how to stop whinging about relative inconsequentialities and enjoy her privilege, and I do get that this is not everyone's idea of an interesting read.  But I was fascinated by the concept of working on the different areas and resolutions, I loved reading about her successes, her backsliding, and her general experiences throughout the year, and I'll often get the book off the shelf to reread a few pages for inspiration and/or sheer fun of reading.

Here, however, is what Gottlieb has to say about it:

The American Dream and the pursuit of happiness have morphed from a quest for general contentment to the idea that you must be happy at all times and in every way. “I am happy,” writes Gretchen Rubin in The Happiness Project, a book that topped the New York Times best-seller list and that has spawned something of a national movement in happiness-seeking, “but I’m not as happy as I should be.” …Still, Rubin writes, she feels “dissatisfied, that something [is] missing.” So to counteract her “bouts of melancholy, insecurity, listlessness, and free-floating guilt,” she goes on a “happiness journey,” making lists and action items, buying three new magazines every Monday for a month, and obsessively organizing her closets.

Minor point: Rubin does, indeed, as I said above, organise her closets along with the rest of her apartment.  However, I'd hardly call it 'obsessive' – she spends one afternoon on the project early in the year, and then goes on to make something of a thing of offering the service to any friends of hers who are having difficulty doing the job but would like to, but there's nothing to indicate that she spends any time re-organising her own closet during the rest of the year.  A one-off afternoon project is hardly what I'd call 'obsessive' – hell, I've spent twice that time this year on my own closet (so of course I may be biased, but I really don't feel obsessive on the subject and, believe me, I know obsession).  This comment just left me feeling that Gottlieb was looking for a bit of an easy shot as a way to discredit Rubin.)

At one point during her journey, Rubin admits that she still struggles, despite the charts and resolutions and yearlong effort put into being happy. “In some ways,” she writes, “I’d made myself less happy.” Then she adds, citing one of her so-called Secrets of Adulthood, “Happiness doesn’t always make you feel happy.”

Modern social science backs her up on this. “Happiness as a byproduct of living your life is a great thing,” Barry Schwartz, a professor of social theory at Swarthmore College, told me. “But happiness as a goal is a recipe for disaster."

Only one little problem with this interpretation; although Gottlieb conveniently omitted to mention this little fact, Rubin's project actually worked very well indeed.  Far from being a disaster, it did exactly what she'd hoped – left her feeling far happier with her life by the end of the year. 

So why that comment about having made herself feel less happy?  One of Rubin's aims, throughout the year, was to work on behaviour that detracted from her happiness by leaving her feeling guilty about having done things she knew she shouldn't, such as gossiping or eating junk food; inevitably, this was often difficult for her in the short term, as she had to focus more on the behaviour of hers that she felt worst about, and the need for changing it.  In the long term, of course, it was worth it – she did manage to cut out a great deal of this behaviour, and this was one of the biggest factors in feeling a lot better about her life by the end of the year.

I don't know whether Gottlieb deliberately misrepresented the book; more likely, she just skimmed through it in search of a couple of lines that appeared to work well to back up her point when taken out of context, and didn't bother looking more closely.  But what she says about the book simply doesn't represent it fairly, and that annoyed me.  I may agree with a lot of what Gottlieb says about parenting, but, on this one, she strikes me as just plain out of line.

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Why brutally unpleasant lactivism is everyone’s business

I have just read Why the way you feed your baby is MY business, by The Alpha Parent, who describes her blog, with unusual but impressive honesty, as 'The snobby side of parenting'.  The post is very long and very unpleasant reading.  It consists of luridly emotive descriptions of every possible real or imagined consequence to others of formula feeding, including a long list of every proved or claimed risk to babies associated with it, some of them repeated several times as different synonyms (I'm not sure whether that's a deliberate attempt to ensure the list is padded out still further, or whether she's just sloppy with her cut-and-pasting).  I think the best way to summarise her reasons in one sentence would probably be 'Because I don't want to be saddled with the environmental damage, increased medical costs to me as a taxpayer, and other dire consequences to me/to others that will result from your decision to feed your child formula, bitch'.

I was going to start out by correcting/questioning some of her claims, but not only is life too short, I think it would actually be exacerbating one of the underlying issues here – that people who take this sort of line on formula feeding (or any other behaviour of which they disapprove) generally see the only issue with this sort of unpleasantly critical post as being whether or not what they say is Right.  ('Right', here, usually means 'can come up with some kind of argument, no matter how weak or flawed, in favour of these statements being correct.').  And one thing life's taught me about trying to persuade other people is that it's not actually enough to stop at considering whether or not what you say can be justified on purely factual grounds.  It's also crucial to think "Is this helpful?  Is it constructive?  Is it going to achieve the end I want?"

The end the Alpha Parent wants, it seems fair to assume, is for more women to breastfeed.  Is her post going to achieve that?  Because I have yet to hear of a case where a woman who would otherwise have chosen formula feeding has decided to breastfeed because someone lectured her on her duty to society, the taxpayer, the cause of feminism, or the environment.  Women want to breastfeed because it has health benefits for their children and because it's usually vastly more convenient.  Women don't breastfeed, despite these advantages, for a variety of reasons – lack of good information, lack of support, medical issues, genuine milk insufficiency, flashbacks to an abuse history.  How is the Alpha Parent's post going to help with any of those?

How are women going to react to this article?  I know how I reacted to it – anger, upset, a churning in my stomach at the hectoring, judgemental tone.  I read a bit more of her blog as well, and rapidly concluded I just didn't want to read any more of what she had to say, because the combination of dubious and distorted facts and the tone she uses is so unpleasant to have to deal with.  And I'm a woman who breastfed both of her children in the face of considerable problems; I can look back and say with absolute confidence that I did everything feasible in order to provide them with breastmilk.  The only guilt issue I feel the need to deal with about my breastfeeding history is guilt that I was so stubborn-headed about not giving my son formula supplements a darned sight sooner.  So, if I react to this article this way, how is someone else going to react to it?  A woman who formula-fed a previous baby, perhaps, and who might have been persuaded to try breastfeeding her next baby?  What about the woman who has no previous feeding experience but is still put off by the tone in this article?  How is this furthering the cause of breastfeeding? 

The facts in her post could have been presented in a warm, positive, encouraging way.  Instead, she presented them as an incredibly off-putting lecture.  If her goal is to persuade more women to breastfeed, I'm guessing she's failed to do so.  And I fear her post may even have backfired, by putting more women off seeking help from the pro-breastfeeding movement for fear of the reception they'll find there.

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Formula bans in hospitals

Ask women who formula-fed what led them to that decision, and you'll get a sheaf of answers.  Some tried to breastfeed but didn't get the support they needed; some couldn't get breastfeeding to work even with support; some never really thought about it, just opting for what all their friends and family had done; some had medical or practical issues that made breastfeeding a no-go; some hated the whole thought of breastfeeding from the start; some believed myths about breastfeeding; some researched the facts carefully before making their decision.  No doubt you can think of a few I've missed off that list.  But there's one reason I've never yet seen and really don't expect to see showing up significantly often, and that's "Because I knew the formula in the hospital would be free".

However, it seems an increasing number of policymakers in British maternity units do believe this to be a significant factor.  At the beginning of June, a news article reported that the Hull and East Yorkshire NHS Trust would, except in emergencies, no longer be providing formula milk to new mothers.  Women who plan to formula-feed have to bring supplies with them; women who plan to breastfeed but find things going badly and want to change their minds/give some supplementation while they get breastfeeding started, have to find a friend or family member that they can send to get one.  Several other hospitals have followed suit, assuring us that it is not a cost-cutting exercise but simply a way of encouraging breastfeeding.

It took me a while to articulate the reasons behind my automatic feeling of dislike of this policy.  My first thought was that this sounded like some sort of regression to a Third World country in which the hospital would expect the family to bring in a patient's food, rather than supplying it on site.  If we treated any inpatients apart from newborns this way there would be an uproar; why was it considered acceptable to single out formula-fed babies in this way?  Well, because it was all in the interests of encouraging breastfeeding, of course.  So I did give some careful Devil's Advocate-style thought to whether that was a good reason.  After all, it is fair to say that newborn babies are a unique case in that their mothers do normally produce their food supplies.  Besides, hospitals are meant to be promoting healthy behaviour – is it worth treating newborn babies as a special case if this encourages breastfeeding?

Then it hit me that I was actually focusing on completely the wrong question.  The most important question here was actually "How in the blue bleedin' heck is this supposed to be encouraging breastfeeding??"

I repeat: patients will make the choice to formula feed for a variety of reasons, but "Because I can get free formula while I'm still in hospital" just isn't one of them.  So, conversely, who is going to decide to breastfeed just because the hospital will otherwise make them pay for their own formula?  Women giving formula to their newborns while still in hospital fall, as far as I can see, into two categories: women who've decided to formula-feed from the start, and women who've decided to breastfeed but are struggling so much they turn to formula (either for good, or as a supplement to tide them over as they continue trying to get breastfeeding going).  How is the decision to ban hospital-supplied formula going to play any part in encouraging breastfeeding in either of those two groups? 

Women who've decided to formula-feed have, presumably, already weighed up the fact that one of various disadvantages of this choice is going to be the necessity of paying for 360+ days' worth of formula for their infant and have decided to go ahead anyway.  Is the news that they'll have to add an extra few days' worth of formula costs to that bill really going to be the tipping point that makes them decide, oh, well, better breastfeed, then?  If you think women might not have already thought about the costs of formula, discuss that with them beforehand in antenatal consultations and leave them to weigh it up and make up their own minds.  If they've decided the bill is worth it to them, is a marginal increase in the total really going to make a difference to their decision?

Women who've decided to breastfeed, by definition, want to breastfeed.  They're likely to be extremely happy to get support and help in the matter.  If they're struggling so much they want to give formula then either all the support and advice you can give them will solve the problems effectively enough that they'll no longer feel that way (in which case, the decision over whether or not to let them have some formula will be a moot point anyway), or it won't (in which case, denying them free formula is not going to alter their decision). 

So, either way, it's very hard to see just how the buy-your-own-formula rule is going to do anything whatsoever to encourage breastfeeding. Of course, what it might end up doing is putting the latter group of women through an extremely frustrating and distressing time.  Imagine struggling mightily with feeding, feeling absolutely at the end of your tether, hearing your baby screaming with hunger, desperately wanting to be able to give even a bit of formula to ease the burden on both of you to the point where you could bear to carry on.  Imagine, further, that it is the early hours of the morning, there is no-one that you can reasonably call up at that time to go get formula, your only chance of getting some is the midwife who is supposed to be your mainstay and support at this time… and she tells you that, no, dear, you can't have any formula because it's all for your own good and your baby's that you don't.  Anyone think that scenario couldn't possibly happen, on a maternity unit with that sort of anti-formula attitude?

I can also think of a couple of ways in which this policy could backfire.  Let's say a woman who hopes to breastfeed is planning to give birth at one of those units, she's aware that it might not all go smoothly, and she doesn't want to take the risk of ending up in the scenario outlined in the last paragraph.  What's the obvious, sensible thing to do in that case?  Take a carton of formula in just in case.  If she doesn't need that formula while she's still in hospital, is she going to throw it away?  Not likely – no point wasting it now she's got it, might as well put it in the cupboard just in case she needs it at a later date.  What is the usual position of breastfeeding advisors on having formula sitting in the cupboard just in case it's needed?  DON'T DO IT!  DON'T DO IT!!  On nights when breastfeeding is going badly, that formula will lure you with its siren song!  And, if you yield to temptation and give it, it will interfere with the delicate balance of supply and demand and start you on an irreversible downward spiral of needing to give more and more formula until your supply fails completely!  Don't have it in the house in the first place!! Just say no!

As you can possibly guess, I'm a wee bit sceptical over the whole 'just one bottle will inevitably cause the breastfeeding relationship to topple around your ears' theory – I suspect that, in fact, women who are going to be able to make breastfeeding work out are able to bounce back perfectly well from giving 'just one bottle', and, in cases when it doesn't work out, it's usually because of various other factors stacked against the woman rather than because of that One Bottle.  However, it's possible that it might be the breaking of the camel's back for a woman who is having difficulties; and, regardless of what substance there may or may not be to the advice, having formula in the house is quite definitely a no-no in the book of most breastfeeding supporters.  So, if buying some formula for emergencies is something that women are supposed to avoid, why set up a situation that positively encourages them to do so?

Another issue is the potential missed opportunity to talk to a woman who's reached the stage of feeling she needs to give some formula.  Of course, most women who are struggling with breastfeeding while still on the maternity unit are going to come and ask the staff for help anyway; but some might not, and some might get so little help from the first midwife they ask that they conclude it isn't worth asking anyone else (probably not a hugely uncommon scenario, sadly).  If a woman who wants formula has to go ask the midwife on duty for it, then that's a chance for that midwife to talk to her about whatever problems she's having and see if she can suggest anything.  And while "No, we aren't going to give you any formula" doesn't do a darned thing to sort out whatever problems have led the woman to ask for it, a sensitive, sympathetic, non-authoritarian exploration of what's going on may identify something that can be helped and may give the woman the strength she needs to keep going a bit longer.  If that woman is, instead, getting the formula out of her bag that she's brought in with her because she knows she'll have no joy asking for it and is worried she'll only get a lecture for her pains, then the midwife isn't going to hear about that problem and isn't going to have a chance to help.

So, there is a real chance this policy could do more harm than good to breastfeeding rates.  Probably not a lot more: I'm guessing there aren't that many women for whom a carton of formula lurking in the cupboard, or a missed chance for an opportunistic chat with a midwife whom they wouldn't otherwise have thought to approach, was the one factor that led to them ultimately formula-feeding when they would otherwise have successfully continued breastfeeding.  But I'm also guessing that that's still greater than the number of women who are unmoved by all the other practical, financial, and health drawbacks of using formula but decide that the need to pay for the amount of formula a newborn can drink in its first couple of days of life is the one factor that brings them round to breastfeeding.  So, yes, overall I'm estimating more harm than good.  (And, let's face it, if the best thing you can say about a policy is that it probably isn't going to do much more harm than good then that's a policy that shouldn't ever see the light of day.)

However, I also think that for the most part the practical effects of this are going to amount to nuisance value only; so, although that plus the occasional more serious impact is quite enough for me to oppose this policy, it doesn't quite account for the distaste I felt when I first heard about it.  I thought more about that one, and finally managed to pin it down and put it into words.  The problem is what it says about the attitude of the people who came up with it.

What we have here is a policy that is being sold as 'encouraging breastfeeding', when it clearly doesn't.  It is in no way an attempt to look at how the obstacles in the way of breastfeeding can be removed, or how women can be helped to surmount them.  Instead, it's an attempt to throw an extra obstacle in the way of formula feeding.  This is not the sort of policy that gets thought up by people who see their goal as working together with women to help them make informed choices and achieve what they want to achieve in infant feeding.  It's the sort of policy that gets thought up by people who see their goal as figuring out how to get women to do things the policymakers' way.  The former lot of people want to work with us; the latter want to work on us.  And, while it is not news to me that there are rather too many people with the latter goal in positions of power, it still isn't something I ever like to see examples of.

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How Not To Be A Successful Lactivist

This is another comment-turned-post from the debate over at Fearless Formula Feeder's blog, once again in reply to Alan.  This time, it's in reply to the second part of this comment.

A quick bit of background: One of the features on FFF's blog is a weekly slot where women who've used formula can post their stories – their reasons for doing so and the emotional struggles that so often went into the decision.  It's a great slot not only for allowing people to vent, but also for dispelling the myth that formula is just for women who are too lazy to breastfeed and those formula-feeding mothers could have breastfed if they'd just cared more/tried harder/done a more efficient job of being Supermum.  Unfortunately, it does have one big drawback – reading so many stories of breastfeeding-gone-wrong, all collected in one place, might potentially be offputting to mothers-to-be who are considering breastfeeding but wavering about the possibility.  When FFF mentioned this concern, Alan agreed with it, and stated:

This is precisely the reason I offered a
counter-anecdote about the experience my children's mothers had (no need
even of lactation consultants, never any thrush, mastitis, etc.). At
least one person complained that posting this anecdote was insensitive
to all the readers of the blog who have had trouble; but it was
precisely for those newer readers you mention,–who have yet to attempt
breastfeeding and might start to wonder if they could ever possibly
accomplish such a seemingly Herculean task–that I wanted to provide a
competing narrative, one which happens to be just as true and accurate
as the others.

And I think that's actually a good idea – if properly and sensitively done.
Unfortunately, this is how Alan actually did it. Alan, what I want to explain here is why the way you went about it didn't work, why it annoyed people, and why it is, in fact, practically a case study in how not to do it. 

The first thing you said in that comment, after the
basic information about number and ages of your children, is that
none of them ever had/is planned to have 'a drop' of formula.
Subtext (whether intentional or not): You disapprove of formula to
the extent that you think it worth avoiding even in the smallest
quantities, and speak approvingly of the fact that you have managed
to do so. Problem with this: It potentially alienates any woman
who's already used formula (with either their current baby or a
previous one). They may become concerned about the possibility of
you criticising them for their formula use, and this may put them off
speaking to you for any help or advice that they might have felt able to seek from you had you
handled the conversation differently. (And, unfortunately, this may extend to making them that bit less likely to seek advice from pro-breastfeeders in general, for fear of criticism.  I think the effect of that one line would be a small one, but, when that's within the context of a very anti-formula-feeding society, these effects can add up.)

Following a quick detour onto the topic
of your ex-wife's horrible labours (ooops! just lost anyone who wants
to steer clear of labour scare stories), you make the point you were
trying to make in the first place about how easily breastfeeding all went, and
then promptly move on to boasting about how long your two older
children breastfed for. Now, look at that for a moment through the
eyes of a mother-to-be who's wavering badly on the issue of whether
to breastfeed at all and who isn't too keen on the idea because she
thinks it's sort of icky. How do you think she's going to feel on
hearing about breastfeeding for two or three years? Yes, it might be
inspiring – or it might be daunting to the
point of putting her still further off the whole idea.  (And let's face it, the women who'd find that story inspiring are the ones who are pretty keen on the idea of breastfeeding anyway.  With a comment like that, you're likely to end up preaching to the choir and putting off the very women you actually most want to preach to.)

That gets
even worse when you write about the child who wouldn't take anything
*but* breastmilk for an entire year. The reason many women give for not wanting to breastfeed is that they want somebody else
to be able to feed the baby now and again.  For women who feel this way, you've just confirmed their
worst fears about breastfeeding.

Your comment then hits its nadir in the next paragraph, where, in a moment of truly staggering
tactlessness, you let us all know that you don't believe your
children's IQs would have been as high had they been formula fed, despite the fact that this was in response to a post in which a
woman had been talking about how guilty and distressed she felt about
having to feed her baby formula. 
Without, apparently, the least thought about how that might make the original poster, and the many other blog readers in the same situation as her, feel.  Does that answer your question about who you attacked?

[In
all fairness, as Alan has pointed out to me in comments, he has since
stated his regret for choosing that particular post to comment on
.]

Following that, there were three
more paragraphs of fairly random points related to general themes of
breastfeeding, formula feeding, and lactivism, by which time I think everybody was at a bit of a loss as to
where you were trying to go with this and
the point you'd originally been trying to make was pretty much lost
in the general rambling.

Alan, you asked why anecdotes of problem-free breastfeeding wouldn't be welcome on the blog.  Well, I don't think your anecdote of problem-free breastfeeding was actually the part of your comment that wasn't welcome.  I think that if you'd just sympathised with
the OP, made your point, and shut up (“I'm so sorry to hear things
went so badly for you. Sounds like you were really unlucky – that
sort of problem really is unusual. I know my wife and my ex-wife
both managed to breastfeed easily, and really enjoyed it. What you
went through must have been awful.”), nobody would have minded.  Instead, you had to not only make it into Random Ramblings Of A Lactivist, but do this so tactlessly that it was completely counterproductive to your cause.  And, if you want to be a successful breastfeeding advocate, you just can't get away with that kind of clumsiness.  You stated in another thread that it would all be worthwhile if your comment could convince even one person to breastfeed.  What you've failed to take into account with that argument is the very real risk that going about it so badly will put off rather more than one person in the process.

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Filed under Grr, argh, Milky milky

Breastfeeding, formula-feeding, demonising, and choice

In recent months I've been following the Fearless Formula Feeder blog, a blog that… actually, I was trying to think how to summarise what it's all about in a quick phrase or two, but in fact since the main point of this post is to (hopefully) clarify the blog's philosophy I'll skip the summary.  If you're interested, do check it out, and with an open mind.  Anyway, in the past few weeks a lactivist by the name of Alan has started some debates in the comment threads which have run into a number of posts, and things have been getting pretty heated, though with an overall civility which is impressive to anyone as used to internet debate as I am.  Inevitably a lot of different and overlapping points are getting debated, and, if I get the chance, there are a few I plan to jump in on myself.  But what I want to write about in this post is this particular comment of Alan's.

In response to this comment from Brooke, a reader defending the site, Alan wrote: 

@Brooke: Thank you for your post,
because it shows clearly that despite the disavowals of some here, at
lea
st one of you (and I'm thinking quite a few more than one) *is*
pushing an agenda of prom
oting formula feeding for people struggling
with breastfeeding (the same potential "converts" the
formula companies are after). So if there are people on the fence,
not sure what to do, and you are whispering sweet nothings in their
ears about how formula's been unfairly demonised, it's not so bad,
they ought to just try it, it may be the solution to all their
problems…well, I want to be there giving another perspective.

Firstly, a few words about the issue of whether formula has been 'unfairly demonised' and is 'not so bad'.  You've indicated elsewhere in your comments that you feel this attitude has been proved wrong by the medical evidence showing breastfeeding to be better than formula feeding.  You know what?  Both those beliefs are correct.  There is indeed solid evidence that breastfeeding reduces the risk of a variety of short- and long-term illnesses and problems – but I've also seen plenty of lactivist scare stories and hype that claim benefits that aren't actually backed up by evidence and/or go way beyond what the impartial evidence supports in the way they present formula.  There is no contradiction in believing that Y is genuinely worse than X but that propaganda has exaggerated the differences between the two.

And now the main point I wanted to address: the accusation that some of the people on the site are 'pushing an agenda of promoting formula feeding'.  This was in direct response to a comment that clearly stated 'No one here is trying to make anyone formula feed, just question the
dogma that pervades certain parts of our society.'  Why was Brooke nevertheless accused of pushing an agenda of promoting formula feeding?  Because, it seems, she wants women to feel able to try formula if they feel that something is going wrong with breastfeeding.  This, as far as I can see, is what you classify as 'promoting formula feeding'.

Here (at the risk of sending this off on a massive detour into a completely unrelated and even more heated debate) is what that attitude reminds me of: the arguments about the pro-choice position on abortion rights that always crop up in the abortion debate. 

I am a pro-choicer: this means that I believe that all women should have the right and the opportunity to choose whether or not they want to continue their own pregnancies.  Back when I used to discuss such matters on debate boards, I would regularly see pro-lifers accuse pro-choicers of being 'pro-abortion' or imply/state that we were trying to push women into abortions.  And, over and over again, we would try to explain that, no, that is not what the pro-choice position is meant to be about.  It is meant to be about the belief that women should be allowed to make informed, unpressurised choices about whether or not to continue their own pregnancies.  I believe that abortion should be available for women who choose it, and that women shouldn't have barriers thrown in their way if they seek abortion.  Those potential barriers include exaggerated or incorrect information about potential risks of abortion, and a stigma of shame and guilt attached to it.  I want to get rid of those barriers, and I want a society where a woman who is unhappy with being pregnant can explore her options and can choose abortion if she genuinely feels this to be the right option for her.

And that is not at all the same thing as being 'pro-abortion' or promoting abortion.  What I'm promoting is informed choice.  My beliefs do not mean that I would ever tell a woman that she should consider abortion or try to push her towards that solution.  In fact, I would be flat-out against doing any such thing, because that would be just as anti-choice as trying to push a woman into continuing an unwanted pregnancy against her wishes.  Not only that, but I'm very much in favour of implementing the measures (better access to effective contraception, better social circumstances) that could reduce the overall need for abortion.  I would be delighted to see a drop in the number of women ending up in a position of wanting to have an abortion; I would not be delighted to see a drop in the number of women wanting an abortion and being able to get accurate information and unbiased support in helping them make the best decision for their own circumstances.  In being pro-choice, I am not promoting abortion.  I am promoting abortion rights.  Get the difference?

Hopefully you also get the analogy, but I'll spell it out to make it as clear as possible: Believing that women should get accurate and non-demonised information on formula, believing that women should have the option of being able to ask questions and consider formula as an option, believing that women with qualms about breastfeeding shouldn't be pressured into continuing if they genuinely feel that that is the wrong option for them… those beliefs are not the same as 'an agenda of promoting formula feeding'.  I believe that most or all of the people who follow this blog, including myself and, I am guessing, Brooke as well, do not believe in 'promoting formula feeding' and are in fact all in favour of women breastfeeding, just as I as a pro-choice advocate am all in favour of women continuing their pregnancies.  Now, anyone from the site who feels I'm incorrect in thus speaking for them is more than welcome to speak up now and set me straight.  But, the way I see it, we don't try to put pressure on women to try formula; we try to stop everybody else putting pressure on women to use any particular feeding method (whether that be formula or breast).  We don't try to talk women out of breastfeeding.  We just want to be sure that they feel freely able to stop it themselves if they want to do so.

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Filed under Deep Thought, Grr, argh, Milky milky, Sacred hamburger

Why I don’t believe that sleep training is incompatible with children’s rights

Mothers for Women's Lib regularly host a Carnival of Feminist Parenting.  Every month (recently reduced to every two months) they post links to a selection of posts about various diverse topics on the general themes of feminism, sexism, and other forms of discrimination, and about how parenting is affected by these issues (both by discrimination and by the need to fight against it).

A few months ago, one of the featured posts was an anti-sleep training polemic.  Just Let Her Cry started out with a fictional first-person tale of an ill and depressed woman shut in her room by her husband every evening when it suited him regardless of whether she was hungry, in pain, or just not tired.  The author then drew her analogy between this and controlled crying or other forms of cry-it-out (CIO) sleep training, which she referred to as 'neglect with a different name'.  She claimed, inaccurately but ominously, that scientists everywhere knew the short and long-term consequences of CIO to be 'vast', and was scathing in her condemnation of parents who've tried sleep training: 'They aren't setting out to harm a
child, but that doesn't change the fact that they are.  Argue with me
all you want.  Say "I let my baby cry it out, and he/she is fine".  I
don't believe you.  I believe you broke your child like an animal.  I
believe they gave up.  They didn't magically learn to "self-soothe",
they just figured out that you suck at being a parent at night time.'  This wasn't a discussion of feminist parenting; this was a no-holds-barred shot in the Mommy Wars.

I enquired as to the appropriateness of this post as a carnival submission.  One of the site's authors replied 'We are advocates of children’s rights as well as women’s rights and
believe the two are very much intertwined.'  So be it; their Carnival, their choice as to what they consider appropriate, and I wouldn't even want to go down the road of telling people what views they can or can't express.  But I disagree with the implication that a belief in children's rights automatically means a belief that controlled crying is always wrong, and I think it would be a shame if that particular post was the only view a site supposedly for anyone interested in feminism and parenting had on the matter.  So this is my explanation of why I do not agree with that poster's analogy, and why I do not agree that a belief in children's rights is incompatible with a belief that sleep training may be a perfectly reasonable option for a parent to consider.

First off, some background explanation of what sleep training actually is, what it's not, and what purpose it serves:

A little-known fact that's important for understanding sleep training is that all babies wake up multiple times each night.  I'm not talking just about the sleep pattern of very young babies or about occasional bad nights in older babies (although it's important to recognise those as facts of parenting life as well); I'm talking about what happens in every baby, every night, including all the ones whose parents think of them as sleeping through the night.  The parents of those babies aren't lying; the key is not that those babies don't wake up, but that they get back to sleep again right away when they do wake up.  If, on the other hand, the only way a baby can get to sleep is by being rocked or nursed or what-have-you by someone else, then the someone else is going to have to wake up several times every night to do this; and that's where it becomes a problem.

One way of dealing with this is simply to have the baby in bed with you, thereby meaning that you can cuddle or nurse them or whatever without waking up.  As long as the parents are also happy with this and have taken proper safety precautions, this can be a perfectly good solution.  However, there are various reasons why this is not a universal solution for every situation, and so the other option is to teach the baby to go back to sleep alone.  (Older babies, that is; babies in their early months still need to feed every few hours and so trying to get them to sleep through an entire night can actually put them at dangerous risk of dehydration.  For this, among other reasons, sleep training methods are not recommended for babies in the early months.)  Sleep training is the term used for the various methods used to do this. 

Sleep training is not meant for use in situations where the problem is actually that the baby still needs night feedings, or isn't well, or has had a nightmare, or some other need for help or comfort.  (I'm not trying to claim, here, that nobody has ever ignored a baby in such situations and mistakenly referred to that as sleep training; I'm pointing out that
this is not why sleep training methods were designed or how they are
appropriately used.  From what the author said in this post and others
on her blog, it is absolutely clear that she was not merely warning against
misuse of sleep training – in which case I'd have agreed with her – but
was lumping all sleep training in under that description and condemning
it wholesale.)  Sleep training is for teaching the baby to be able to get back to sleep in situations where nothing's actually wrong.

The method usually recommended a few decades back was simply to leave the baby crying for however long it took to fall asleep alone, cold turkey style, but this method was pretty distressing for everyone (including the neighbours), and hence a variety of modifications were introduced.  The first of these was the advice to come in at regular intervals to comfort the baby briefly before going out again, extending the length of the intervals as time went on; this is the infamous controlled crying method, also referred to as Ferberisation after its inventor, Richard Ferber.  He advocated a fairly rigid schedule for going back in and very limited
time in the room/interaction with the baby.  Most of the other suggested methods are just variations on this initial method with different advice about intervals for which the baby is left and/or the amount of time spent comforting the baby.  There are a couple of others which don't involve leaving the baby alone at all; Ferber had an alternative which I think of as Ferber-lite, in which the parent stays in the same room but moves further and further away from the baby's cot, and Tracy Hogg of Baby Whisperer fame had a version to which I personally am very partial called PU/PD, standing for Pick Up/Put Down and referring to doing precisely that with the crying baby until it gives up and falls asleep.  (By the way, if you go looking for that last then a) the full description is in this book, not this one which is a near-complete waste of time, and b) be prepared to grit your teeth, because she was one of the most annoyingly patronising baby experts on the market.  But I still think the method's a good one.) 

The plethora of methods can seem fairly bewildering, but makes a lot more sense when you think of them all as just being different ways of getting from point A (baby needs cuddling or rocking or whatever to get back to sleep) to
point B (baby gets back to sleep without any sort of requirement for
parental help).  The trick, as with an awful lot else in parenthood, is in finding a method that's not unduly harsh yet is firm enough to get the message across.  I don't think there's any such thing as a 'best' method because it will depend on the baby and the situation and what-all else; in any case, most methods will work perfectly well for most babies at the end of the day.  But the point of all of them is not to neglect babies who are hungry or wet or frightened, but to teach babies how to get themselves back to sleep after normal night wakings where there aren't any other problems.  Penelope Leach nicely summed up the principle behind sleep training when she said that the idea was to show the baby that you were
always available but after bedtime you were very boring. 
As the delightful Libby Purves comments, it is possible to get very
boring indeed by three in the morning.

So, if the neglected-wife analogy in this post was rewritten to reflect the way in which sleep training is actually supposed to be used, how would it look?  Something like this:

There was a time, not so long ago in my life, when I had some major problems with getting to sleep.  The only way I could get to sleep was to have somebody hug me and rock my body back and forth in their arms, which would relax me enough to drop off.  As well as needing this at bedtime, I was waking up several times a night and needing the same thing each time.  Everything else in my life was going fine – I was happy, healthy, and had no other problems.  I just couldn't get to sleep by myself, that was all.

Fortunately, this wasn't a problem for me, as my husband was there to help.  Whenever I woke up during the night, I just woke him as well to rock me back to sleep (or, if he hadn't gone to bed yet and was trying to do something else, I'd just interrupt whatever he was doing and call him up to the bedroom to rock me).  That, as far as I was concerned, was the problem sorted out.  Oh, sometimes the disturbed sleep made me grumpy and grouchy during the daytime, but my husband could handle that.  And I didn't see a problem with calling on him at any hour of the night that I wanted to, every night.  After all, he loved me and was very attentive to my needs by daytime; I didn't see any problem with expecting the same intensity of service during the night-time hours.

It seemed not everyone saw it the same way.  At one point I heard my mother-in-law talking to my husband about the situation.  "You have to put your foot down.  You can't go on like this.  You haven't had a decent night's sleep for months!  You're going to make yourself ill with exhaustion – and for what?  She doesn't really need anything.  She should learn to get back to sleep by herself."  I didn't understand what she was talking about, and, even though my husband was looking haggard and was also becoming a lot more snappy during the daytime, I didn't see what that had to do with anything I was doing.  Even though I love my husband more than anything in the world, I didn't really see him as a person with his own needs.  I'd never seen any reason why I shouldn't expect him just to give me everything I want when I want it, or how this could have any sort of impact on him.  This wasn't my fault – I certainly wasn't intentionally being selfish.  It's just that, at that stage of my life, I wasn't yet mature enough to be able to think that way.  I wanted my husband's help to get back to sleep every time I woke up, so I called out expecting to get it.

But things changed.  My husband told me it was time for me to learn how to get back to sleep on my own.  I wasn't happy about this in the slightest, and burst into tears when he walked out leaving me alone to get back to sleep, but he stood firm.  He didn't leave me alone for long at a time – every so often he would come back to comfort me, check I was all right, and speak reassuringly to me – but he absolutely refused to stay in the room for long enough to help me to get back to sleep in the way I was now used to.  I was bewildered, upset, and furious at being left awake and alone, and at first I would lie awake for long periods of time, crying with frustration and upset that my husband had stopped doing things the way I wanted. 

Fortunately, it didn't last long – I found that, eventually, sheer tiredness was enough to overcome my difficulty in falling asleep, and, the more often I fell asleep without my husband there, the easier it got.  Within less than a week of this starting, I found I had reached the stage of being able to get back to sleep easily when I woke up without needing to call out for help.  If ever anything was genuinely wrong, my husband was quick to help out; but on most nights I could now get by without him.  He was as attentive as ever during the day – in fact, if anything, he seemed more attentive and less snappy than when I was waking him up multiple times at night – and it wasn't long before the new night-time pattern had taken over as the norm in our house. 

Does that still sound like an appalling story of a cruelly neglectful husband?

Also, do bear in mind that a baby may cry at bedtime simply out of annoyance that it is bedtime.  Babies are as capable of adults of wanting to stay up and have fun rather than putting everything on hold for the night to get some sleep, and rather less capable than adults of recognising the possible ramifications of this.  Have you ever had a friend wanting you to stay up and boogie the night away with her when you had to work the next day and knew that you – and, for that matter, she – would end up regretting it if you did?  If you said no, was that a shockingly neglectful act on your part that was likely to traumatise your friend so deeply that she would never be able to trust you as a friend again and would possibly suffer lifelong psychological damage into the bargain?

Babies cry when they need something.  But they also cry when they want something, and it is a really big mistake to assume that if a baby is crying for something this must mean that they need it to the point of risking psychological damage if denied it.  (One obvious reason why this is a really big mistake is because it would rapidly lead to you giving your baby sharp knives and live electrical circuits to play with.  Babies are totally capable of crying for things that they very much need not to be allowed to have, thankyouverymuch.)  I don't believe that setting limits on the extent to which you can meet a person's wants violates that person's rights in any way, regardless of their age.

One other point worthy of mention here, which is technically not sleep training but is very frequently mistaken for it, is that some babies actually need to cry for a few uninterrupted minutes as part of their wind-down into sleep, and attempts to soothe and settle them can backfire and keep them awake.  My daughter was like this; I've heard of other babies who are.  If your baby is one of these and you're locked into a rigid dogma of never leaving a crying baby alone, you're in for some problems, because all your efforts are actually going to be keeping your baby awake rather than settling them and what they really need is for you to back off and leave them alone while they go through the wind-down process.  In which situation, leaving your baby alone to cry is meeting his or her needs.

I wish I didn't even have to make the next point, because it seems so obvious to me, but… absolutely none of this is meant to try to persuade any parent that they should use CIO.  Believe it or not, I'm all in favour of avoiding CIO methods wherever feasible; not because I think CIO violates children's rights or damages their psyches, but because it's simple common sense that if you have a choice between equally effective ways of solving a problem it's good to go for the one that doesn't cause upset to anyone.  And I'm all in favour of minimising the amount of crying involved where crying does have to be involved, for the same reason.  I believe that parents should set limits gently, sympathetically, with full regard for age-appropriate behaviour, and with careful consideration of what limits really need to be set in that particular household and what limits don't actually matter.  I don't, however, think it a good idea to confuse any of that with the notion that we can get by without ever setting limits or
ever causing at least some upset to others by doing so.

So, if you've found an alternative method of dealing with the sleep situation in your household that seems to be working out all round, more power to you and go for it.  If you've found that that doesn't work and that, for whatever reason, your baby does have to be left alone for a bit as part of the process of getting them to sleep, then do that.  Either way, don't assume that whatever it is you're doing would work for every other family as well, and don't resort to scaremongering, guilt-tripping, or poorly-informed parent bashing to try to get others to fall into line.  I'm not trying to replace the anti-CIO polemic with a pro-CIO polemic;
I'm trying to replace it with an anti-Mommy Wars polemic.

Instead of the Mommy Wars, I'd like to see a widespread willingness to trust parents.  To trust that parents, if given information about different options (which is not code for 'scare stories about the options we don't like), are actually pretty good at making decent choices for their children.  To trust that even if a parenting choice isn't what you would choose/what would work for your child, it doesn't automatically follow that that parent did something terribly wrong and harmful to their child.  To trust that parents know their own children and that if a parent has done something that happens to go against your particular dogma but they genuinely believe their child is doing fine then it might just be that it's your dogma and not the parent's knowledge of their child that's wrong.  A feminist parenting site strikes me as a very good place to eschew the Mommy Wars and promote that kind of trust.

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Filed under Don't let the bedbugs bite, Grr, argh, Sacred hamburger

The Bartick Study and Breastfeeding Disclaimer Syndrome

I had a blast from the past the other day.  I logged into Typepad to find a new comment (an actual, genuine comment, I mean, not a spam comment, which I get all the time), on my post from back in 2006 debunking the Stats.org anti-breastfeeding article.  (Do please check that post out if you’ve time and haven’t yet read it, by the way – it’s one I’m proud of.)  The reason this was a blast from the past is not just because I haven’t read that post in a while, but because the commentator is one who not only commented on here several times in the past but also inspired a couple of my previous posts before dropping off the blogging scene a few years ago, to be sorely missed by many of us.  At least I’m assuming it’s the same one – she has a different blog, but the personal details, expressed views, and thoughtful and intelligent writing style all match the Jamie I remember (female, by the way, and no connection to my son of the same name).

So, not only does Jamie seem to be back (yay!) but she also had a request for a post from me, which I am also pleased about because I love getting post requests.  Jamie would like to know my response to the Bartick study.

The Bartick study, for those who haven’t heard, is the one that apparently worked out that $13 billion could be saved in healthcare costs in the USA if enough babies were breastfed.  My reaction to that was pretty much “Wow, that sounds good (um, must get round to reading it some time).”  Since even someone as wordy as I am can’t get much of a blog post out of that, I’ve decided instead to write about my reaction to other people’s reactions to the study. Jamie linked to an article from ABC News discussing the study, and it raised several points that I think are worthy of comment.

Firstly, Goldin seemed to be damning breastfeeding with faint praise when she described the research as showing ‘some suggestions’ that breastfeeding had benefits.  The evidence is, in fact, considerably stronger than Goldin is making it sound.  I wrote quite a bit more about this, but this point was only really meant to be an aside and I ended up writing so much about it I felt it was distracting attention from what I meant to be the focus of this post, so I snipped all of that and saved it for a potential future post, if anyone’s interested.  Meanwhile, see this old post of Annie’s at PhD in Parenting for a good layperson’s summary of the best paper on the topic.  (The paper she describes, by the way, is the one that was used as the source for the figures used in the study that’s causing all the current upset; so Bartick et al were in fact using fairly sound figures as to the rates of benefits from breastfeeding, despite what’s been elsewhere alleged.)

Secondly, the article criticised the Bartick study on the grounds of not taking into account the costs to society of providing the support that would be needed to get breastfeeding rates up and subtracting that from the $13 billion.  True enough, but it seems to me to be missing the point.  I think the point of the study was not meant to be “Whoopee!  We just found a way to make $13 billion out of thin air without lifting a finger!” but “We can afford to invest a hell of a lot of money in providing support for breastfeeding mothers and making the necessary changes in maternity leave laws, and still come out ahead of the game financially.”  Surely the real lesson of the study’s findings is that investing money in breastfeeding support is a win-win situation?

Thirdly, the commenters’ views seemed to carry a strong hint of what I once dubbed Science Myth 2 – the idea that it’s well out of order for a researcher to (gasp! the nerve of them!) come up with findings you don’t like.  Maybe I’m misinterpreting what was said there, because I’m only too aware of the risks of reading too much into quotes that may have been taken out of context, but Goldin’s and Beard’s comments did seem to be coming across as anger, not with any actual example of an interpretation of the study that they’d heard and disagreed with, but with the study itself.  (McKenna’s attitude came across as rather more sensible.)  If the ABC article misrepresented Goldin and Beard in that regard, my apologies.  A much stronger example of this attitude came from Lenore Skenazy’s ‘Quit Picking On Moms Who Don’t Breastfeed’.  Uh, Lenore?  Examining a legitimate research question is not the same as ‘picking on’ anyone, and – stop me if I’m wrong about this – I’m pretty sure no-one’s used “Irresponsible Parents Continue To Formula Feed” as a headline either, outside your imagination.

(You know – now that I think about it, this whole phenomenon of taking research you don’t like as a personal attack does seem to be something I cannot remember ever coming across before joining the mommyblogging world.  I used to spend a lot of time on an abortion rights debate group, and the members of that group would merrily ignore or misrepresent any research that didn’t suit whatever their particular views happened to be, and occasionally a researcher who’d found something that other people didn’t like would be accused of bias.  But I simply can’t remember anyone on the group, or in other debates I’ve come across, displaying that same sense of being personally affronted by research they didn’t like.  Am I wrong?)

The fourth point is the main one I wanted to write about, and is in fact something I’ve hoped for some time I’d eventually be able to get round to writing a post about; a phenomenon I’ve come to think of as ‘Breastfeeding Disclaimer Syndrome’.

Breastfeeding Disclaimer Syndrome (I’m not wedded to the name, by the way – if you have a better idea, I’m quite open to suggestions) is my term for the way in which people seem to feel the need to follow up any positive statement about breastfeeding with immediate disclaimers about the importance of recognising that of course many women can’t do it and they should not be made to feel guilty.  Sometimes this reaction comes from others; a surprising amount of the time, it comes from the person who made the initial positive statement, as though we can’t say anything about the benefits of breastfeeding without immediately qualifying it with the disclaimers about it not being univerally possible.

What interests me about this is that I don’t remember ever seeing this happen with any other public health issue.  I don’t, for example, see reports of studies on the benefits of exercise being responded to with hasty defensiveness about the importance of remembering that some people are quadriplegic and can’t exercise and some people have such long working hours it’s just impossible for them to find time to exercise and some people just find it really really difficult and painful and that amount of stress can’t be good for anyone either so we shouldn’t blame people who find a sedentary lifestyle works better for them and it’s important not to make anyone feel guilty about it.  People can accept both that exercise can be good for you and that there are various reasons why someone may not actually follow that advice, without the conflict between those two facts ever being any sort of particularly big deal.  So why the difference?

I can think of several reasons.  One, of course, is the whole “But think of the chiiiiiiiiildreeeeeeen!” factor that makes any debate about parenting decisions so particularly heated – nothing hits people’s hot buttons quite as hard as any suggestion that you may have been doing less than the best for your children.  One is the all-or-nothing attitude of breastfeeding activists, which I really do think often shoots them in the foot; the overwhelming emphasis on six-months-of-exclusive-breastfeeding that so often obscures recognition of all the benefits you can get from any amount of breastfeeding from any length of time.  If you feel guilty about your lack of exercise, you can appease the guilt with relatively simple measures like walking to the shops instead of taking the car; if public health announcements about the importance of exercise were all focusing on the importance of going to the gym for a complete workout every day for six months, I suspect we’d get a lot more of the same sort of overt defensiveness about exercising as we do about breastfeeding.

A third, major, reason is that breastfeeding is unique among healthy lifestyle measures in another way; it’s a one-shot deal.  With any other healthy lifestyle measure you care to think of – exercising more, drinking less, eating better, stopping smoking – we can appease our guilt over not doing as well as we know we should by picturing the hypothetical but will-definitely-happen-someday future in which we clean up our act and do things a lot better.  This may not get us very far in terms of here-and-now improvement, but it does at least ease any guilt we feel to the point where we don’t feel the need to get freaked-out defensive over it.  But, in the case of breastfeeding – with the little-known and time-limited exception of relactation – we don’t get do-overs.  Any child we didn’t breastfeed when we had the chance is going to stay non-breastfed. And it is very, very difficult to accept the idea of having done things in a way that you not only wish you hadn’t, but that you will never have the chance to go back and do right.  Of course, that’s something every human living has to deal with at multiple points in their life for all kinds of reasons, but add in the think-of-the-chiiiiiiiiildreeeeeeen emotiveness factor and the guilt can become overpowering.  And I think that’s why we get so much emphasis on the need to remember all the reasons why women may end up not breastfeeding despite really wanting to.  It’s our way of wanting to ease that pain by (rightly) giving women credit for their good intentions and best efforts.

The trouble with that particular temporary ease-off of the painful emotions involved in not managing to breastfeed is that it doesn’t look at how the whole thing could be made better for women struggling with the same problems in the future.  Sure, it’s important to recognise that many women can’t breastfeed.  You know what’s even more important?  Recognising that a much larger number of women could breastfeed if they had proper support and help when they needed it and a more breastfeeding-friendly culture.  Instead of putting all that energy into disclaimers, why not put it into clamouring for the importance of making the changes that would help more women breastfeed?

The article linked to in that last sentence, by the way, is a piece by none other than Melissa Bartick, the lead author of the much-maligned study in question.  While she does have the occasional unfortunate tendency to meander off the point into unrelated thoughts of her own fantasy birthing experience (look, by all means get your partner to cut the cord if that’s what you both want and by all means don’t do that if it isn’t what you want, but, either way, it’s not going to make a blind bit of difference to your chances of breastfeeding successfully, so let’s leave that decision in the realm of personal preference where it belongs and get back to the topic under question, please), she also raises a heck of a lot of good points.

So.  Work with me here, guys.  I’m throwing out these ideas as to why people react as defensively as they do to any kind of breastfeeding promotion, but I’d love further thoughts on where to go with this in terms of getting away from that attitude and, instead, seeing research like this as something we can use as a positive force for change.  Any thoughts?

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Filed under Deep Thought, Grr, argh, Milky milky

Tongue tied and twisted

The topic for the February Carnival of Breastfeeding is "Write a post that tells how you overcame a breastfeeding challenge".  This post will be published on Monday, February 22nd, the day of the Carnival.  As is the custom with the Carnivals, each carnival participant will put a list of links to all the other carnival posts at the bottom of their own post.  This means a certain amount of updating throughout the day, so, if you are reading this post on the 22nd, please do check back later to see whether any new links to new carnival submissions have appeared at the bottom.  Here is my own story.


"Oh, look," the midwife examining my day-old son told me, "he's got a tongue tie."

I leaned in to look into his mouth where she was pointing.  I'd barely heard of tongue tie, certainly never in the context of breastfeeding.  I don't even remember my reaction, other than that I was impressed by her thoroughness; a tongue tie certainly wasn't something I'd have noticed or picked up on any of the many babies I'd done baby checks on during my career. 

"But it shouldn't be a problem with breastfeeding," she assured me.  "Look, he can – just about – get his tongue to cover his lower gum.  So that'll be all right."

Oh.  Good.  I was glad to hear there wouldn't be any problems.  The pain I'd been getting on trying to nurse him was obviously just down to our mutual inexperience – I'd keep pestering people for help with the latch and we'd sort it out eventually.  It never occurred to me to question her; after all, she seemed to know exactly what she was talking about, and her explanation made sense.

It therefore took another two or three days of me reading all the advice I could find about how to get a baby well latched on and repeatedly asking different people for help (fortunately, the reading I had done before giving birth had at least left me aware that nursing a baby wasn't supposed to be this painful, and so, even when the nurses I first asked about it brushed aside my concerns with blithe assurances that the latch looked fine, I knew there had to be some problem that needed identifying and dealing with, and kept right on asking) before my usual midwife noticed the tongue tie and put together the two and two that I should have added already.  The other midwife had been wrong, and my son's overlong frenulum was indeed causing my problems.

The problems that tongue tie causes with breastfeeding, you see, aren't just due to the baby's lower gum not being properly covered by the tongue.  They're caused by the tongue being unable to work as efficiently in sucking – which means that not only does the baby have a lot of trouble getting enough milk (of which more later), the nipple isn't pulled as far back into the baby's mouth, and keeps getting caught on the gums.  This produces a sensation approximately akin to having your nipples pried off with a chisel.

I was very relieved to have an answer – by that time, I was starting to wonder whether perhaps I might just be the first mother in recorded history whose baby just wasn't able to get the hang of latching on no matter how hard we both tried.  Unfortunately, for practical purposes, it seemed that having found the answer wasn't going to make much difference. 

Although the cure for tongue tie is as simple as the problem – one quick snip through the extra bit of frenulum to free up the tongue to move properly – there does need to be someone available who has the know-how and the willingness to do it.  In Clacton-on-Sea, the area I lived in at that time, there wasn't.  Because, the midwife explained (and it was clear that she was as infuriated by this as I was), the local paediatric team didn't consider early frenulotomy to be a procedure worth funding.  Never mind that it could make the difference between breastfeeding and not breastfeeding successfully – that wasn't something the paediatric department saw as a priority.  She would certainly refer me, but she could tell me from sad experience that what would happen would be that I'd get an appointment for several weeks' time and they'd tell me to put my baby on the bottle instead.  If I wanted to get it snipped, I was going to have to take Jamie to Mervyn Griffith's team in Southampton.

I'd just had a baby, my world was in a spin, and I could barely get my head around the idea of getting to the end of the road, let alone Southampton.  I chickened out, and went for the option of local referral.  Maybe I could somehow persuade them to help.

She put the referral through, and I was sent a date for when my son was five weeks old and left to struggle on alone in the meantime.  (The midwife and I agreed that she might as well discharge me – she'd done everything she could, and we both agreed there wouldn't be a lot of point in her dropping round regularly just for me to tell her that breastfeeding still wasn't going well.)  I didn't try to fight for an earlier appointment date – I'd worked in the NHS for years by that time, and accepted the inevitability of long waits for everything in the same way that I accepted the inevitability of rain.  I wondered helplessly what I'd say to the doctor when I did get there, how to convince someone who didn't think breastfeeding was important, but in the end I didn't even try.  Nursing was becoming a lot less painful, and I figured Jamie must be getting the hang of the latch despite his tongue tie.  If paediatricians didn't care about cutting tongue tie even when it was causing huge problems for a breastfeeding mother, what hope would I have of persuading them if I had to admit that it wasn't causing too many problems any more?  I gave up.  I wrote to the hospital and told them I was cancelling the appointment as things were going better.

And, from the point of view of the pain, they were – it had now settled.  I didn't connect any of the other things that were going on with the tongue tie.  My son went on nursing non-stop.  I hardly left the house for days on end, every shower I took was a mad race to get finished before he could scream too much for food, and my own meals were eaten in instalments in between feeding him.  I accepted all this as a difficult but necessary part of successful
breastfeeding – after all, I'd had it drummed into me often enough by
pro-breastfeeding sites that it was normal for newborns to want
to nurse all the time and that I shouldn't try to limit his feeding at
all for fear of causing irreparable damage to my milk supply and
forever ruining my chances of achieving the Holy Grail of exclusive
breastfeeding until six months.  The amounts of weight he was putting on sounded disappointingly tiny compared to the amount of effort that was going into achieving them, but the health visitor I saw for his weigh-ins assured me that his weight gain was fine and that it was normal for a breastfed baby to gain less than formula-fed babies.  Since I already knew that last fact to be true, and since she spoke with such airy certainty, and since my perusal of breastfeeding sites had unfortunately never included paying too much attention to the actual numbers given as amounts that breastfed babies should be gaining, I accepted her reassurances unquestioningly.  Nursing was easier, I was being assured Jamie was gaining weight properly, I'd been told in the first place that his tongue tie was minor – obviously the tongue tie problem had resolved and the current problems were just normal early nursing hiccups that I had to grin and bear until they improved.  Which of course they would – didn't all the breastfeeding sites say so?

At his five-week check the health visitor assured me again that I was doing fine and told me that I didn't need to come back for another three weeks.  She didn't bother to plot his sequential weights on the graph provided in Jamie's health care record for that purpose, and neither did I until just before his eight-week check, so neither of us realised at the time that he'd actually dropped from the 75th to the 25th centile in those five weeks.  In the next three weeks, he stopped gaining weight altogether.  When he was weighed again at eight weeks, he was below the 9th centile.  Even the health visitor seemed to be running a little short on breezy assurances at that point.

According to my diary, I did ask the health visitor at this point whether this could be the tongue tie, but she didn't think so.  Instead, I was sent home with the standard advice to go to bed and nurse him as much as possible.  Thinking about it now, I realise that the point of this old standby is to deal with the sort of situation where the mother's been so busy rushing around doing other things that she's been unintentionally limiting the baby's feeds, and that it was completely inappropriate for a mother who already was nursing as much as possible, but at the time I took it seriously and tried my utmost to figure out how I could curtail my very limited day-to-day activities even further.  Since I had, by that point, finally reached the stage of starting to leave the house for regular walks and had even dared to consider venturing into the nearby town for a change of scene that I was only just beginning to realise how desperately I needed, this advice plunged me into despair – it seemed the only way I had a hope of salvaging the breastfeeding was to submit myself to terminal cabin fever.  And would that even work?  I was doing everything I was supposed to do – nursing all the time, not limiting his feeding at all, feeding on cue – and I still didn't seem to be making enough milk.  I felt gutted.

After a couple more days of trying to make myself into a virtual invalid, feeling scared to carry the baby from one room to the next in case this would
be too much exertion and limit my milk supply still further, and constantly dwelling on what on earth could be going wrong and what I could possibly do about it, I was becoming more and more suspicious that – whatever anybody else said about it being minor – the tongue tie might be the problem here.  After all, couldn't tongue ties cause poor sucking and lack of weight gain?  Then again, I seemed to be getting conflicting advice from people I knew, or even from articles I found on PubMed, as to what to do about it.  And, of course, getting it cut was going to be no small matter in practical terms, because of the need to find someone and drive there with a baby who couldn't always make the fifteen-minute drive to the local supermarket without screaming for a breastfeed.  I agonised over the best course of action.

My husband told me that I should make a decision one way or the other, stick to it, and stop driving myself crazy over it.  While I suspected a subtext of 'Stop driving me crazy over it', I could see that, either way, it was sensible advice.  Then I found the Hazelbaker Assessment Tool on line – a checklist designed to evaluate the severity of tongue tie.  The one I found wasn't in the easiest format in the world to use, but I scored Jamie's tongue tie as best I could and was very surprised to find out that, despite what people had been saying all along about the tongue tie being minor, it scored as 'significant' on both the appearance and function subscales.  Objective numbers were the backup I needed.  I was going to have the tongue tie snipped.

The next step was to figure out how and where to get it done.  There was one piece of good news here – I was at least not going to have to take Jamie all the way to Southampton (I was desperate enough to do so by that time, but it was a relief not to have to).  One of the women on the breastfeeding group I posted to on-line had found a list of other providers in the UK who could do it.  It looked as though I could arrange something in London, which would be substantially less difficult although still dauntingly so.  I started phoning around.  Meanwhile, I dug out the pump I'd ordered for going back to work and started trying to pump at the end of each of Jamie's feeds, getting Barry to feed the collected milk to him in the evening.  The difference was immediate – he became noticeably more settled and started sleeping for longer stretches at night.  And, finally, I struck lucky on the tongue tie snippage front.  One of the infant feeding advisors phoned me back with news of Peter Weller, a surgeon she knew of in Basildon Hospital, Essex – about an hour's drive from where we were at the time – who cut tongue ties.  He wasn't (at the time) on the list I'd been given, but she'd met him once at a conference, they'd chatted briefly about the subject, and he'd been surprised to hear that anyone was raising problems with cutting a tongue tie, since he himself was quite happy to do it.

I rang Mr Weller's secretary, and she told me that normally she would have been happy to book me in, but Mr Weller was just about to have surgery himself, and, after that coming Friday's clinic, he would be on sick leave for eight weeks.  Damn.  Oh, well, back to trying to arrange somewhere in London, and I supposed I was no worse off than I had been and at least better off than when I'd thought I'd have to go to Southampton.  Then I thought, what the hell, why not give it a try, and rang his secretary back to ask whether by any chance he could squeeze me in at the end of that Friday morning's clinic, since it would only take a few minutes to do.  A bit surprised, she said she'd see what she could do, checked with him, and rang me back to confirm that if I could get a referral letter from my GP in that time he'd be happy to see me.  I got the referral letter at Jamie's eight-week check the day before, and we were all set to go.

After nine weeks of trouble from the tongue tie, the snipping of it was so simple I didn't know it had happened until it was over.  Mr Weller got me to sit knee-to-knee with him with Jamie held between the two of us, his body on my lap and his head on Mr Weller's lap, and fiddled around briefly in his mouth with one hand to find the right place, holding the scissors ready in his other hand.  I was still bracing myself for the moment of snippage when Jamie's indignant wail told me it had already happened.  I hastily swung him up and around onto my breast, babbling heartfelt and probably incoherent thanks to Mr Weller and handing him the chocolates we'd brought along to thank him.  Oh, yes, and remembering to ask him whether he would be OK with the idea of being added to the list as an official frenulotomy provider.  (He was.  As you may have noticed, he's on the list now – that was due to me contacting the BabyFriendly initiative and adding him.)  We gathered up all our stuff and headed out to the waiting room for me to go on nursing Jamie, which I already knew was the recommended thing to do immediately after a tongue tie, to ease the baby's pain and help it to heal quickly.  Jamie went through a few minutes of "Something painful just happened!  Waaaah!! Oh – wait – nice breastmilk.  Yumyumyumyumyum.  Oh – wait – something painful just happened!  Waaaah!!  Oh – wait – nice breastmilk…" before the 'nice breastmilk' part of it took over conclusively and he settled down to sucking.  I let him have a long feed, and we headed back home again.

But it wasn't, alas, the end of the story.  I'd left it too long.  We'd wasted the crucial early weeks when I should have been building up my milk supply and Jamie should have been getting the hang of how to suck.  A week later, the weight check with the health visitor showed that Jamie had only gained two ounces since his last weighing, bringing him down to the second centile.  (The health visitor still kept assuring me he was fine and that breastfed babies just gained at a slower rate than formula-fed babies, that was all.  I tried to talk to her about it at a later stage, but she never did show any sign of accepting that there was any problem, that any of this could be anything to do with the tongue tie, or that there might have been anything wrong about her dismissing his lack of weight gain in the way she had.)

Barry suggested giving him formula supplements until his weight came up.  Primed by lactivist websites, I freaked out – formula?!  Didn't he realise we were meant to avoid supplementation at all costs?  Didn't he realise the critical importance of keeping babies exclusively breastfed for six months?  In the face of my immovability, Barry compromised – we'd have a two-week trial of supplementing Jamie with as much extra as I could manage to pump, and, if that didn't work, we'd revisit the question of formula. 

For the next fortnight, I felt I was in a frantic race against time to get Jamie's weight up.  My life narrowed to pumping and feeding him.  A diary entry I somehow found time to type during that fortnight reads "Feed,
pump, stash milk in fridge, feed, wash pump parts, feed, repeat in
random order. I'm pumping eight or nine times a day, double-pumping
when Barry can take the baby, single-pumping when I'm holding the
baby, passing the baby and the pump back and forth in a peculiar
juggling act. Logging the times and quantities in my notebook,
logging the amount I freezer-stash at the end of the day and (if I
can work it out) how much has gone into Jamie. I made it out to the
library in Clacton this morning – it was the first time I'd been out
of the house since the baby clinic six days ago. I'd hardly even
noticed.

At first I also fretted about the dreaded Nipple Confusion that can afflict mixed-fed babies (they get confused about the different sucking techniques needed for breast and bottle, and end up preferring the bottle and refusing the breast – it's been the death knell to many a breastfeeding relationship), but on that point, at least, things were all right – in the time it took the Lact-Aid I'd ordered to arrive, Jamie had made it quite clear that, when I was around, he preferred breastfeeding.  He would only take a bottle from Barry.  When I tried, he turned his face determinedly to my chest – come on, Mummy, don't play silly games, I know you've got the proper stuff in there.  Knowing he preferred breastfeeding was a boost I badly needed, and one less thing, at least, for me to worry about (I was too superstitious ever to return the Lact-Aid – I ended up passing it on to the local La Leche League team).  But the constant struggle to make enough milk was a continued worry.  I went on pumping, and feeding, and counting ounces, and obsessing, and wondering dazedly at the devastation wrought on my experience of new motherhood by one little piece of skin.

It worked – sort of.  I pumped enough extra to get Jamie's weight increasing again at a normal rate.  I never did pump enough for him to catch up to where he should be.  We limped along as we were until I went back to work when he was four months old, at which point I continued doing my best to pump but he rapidly ended up on solids and formula supplements.  He went through a major catch-up spurt (his growth chart for the early months is almost a right-angle), and, by the time he was six months old, he was happily settled on a mixture of breastfeeding, milk I pumped at work, formula supplements, and purées.  I'd even reconciled myself to not having made the magic six-month mark for exclusive breastfeeding, after actually reading the WHO guidance on the subject and finding that, for all the fuss that had been made about it, there wasn't actually any evidence at that time that exclusive breastfeeding for six months had any benefits over exclusive breastfeeding for four months.  (The study showing a slight benefit for six months exclusive breastfeeding in terms of reduced risks of chest infections was still a year away at that point.) 

I never did reach the point of being able to relax fully about breastfeeding, but I kept breastfeeding, in the end, until Jamie was sixteen or seventeen months old.  I didn't achieve the goals I'd originally held, but they aren't goals that bother me at this point; I kept breastfeeding despite all the odds, which is what I cared most about.  Technically, this is a success story.

But I never felt that I 'overcame' that challenge.  It overcame me.  It has never felt like a success story in my mind – it's too tainted with the dark, bitter taste of shame and regret.  I regret so many things about the way I handled the situation.  I should, of course, have taken Jamie down to Southampton in the first place, but I was overwhelmed enough by new motherhood that I can forgive myself for not doing so.  But I regret not keeping a closer eye on his weight and picking up the problem much sooner.  I regret not having a word with the health visitor's superiors about her failure to highlight Jamie's lack of weight gain to me as a problem or to acknowledge, when I raised the subject with her afterwards, that there had been anything wrong about the way she'd acted.  I regret not writing the blistering letter I meant to write to the Primary Care Trust at the time about their failure to fund frenulotomies locally, doing what I could to change things for the next person.  And I regret – deeply – the way I acted towards Barry, treating his wishes on how to handle the problem as an obstacle to be ignored or bulldozed past rather than as the valid views of the person with whom I was supposed to be sharing the raising of this baby.  And I regret obsessing about it to the extent I did – not the
efforts I put in to keep Jamie breastfed, which I'm still glad of, but
the underlying belief that failure to meet my breastfeeding goals would
be a disaster past bearing.  That marred my experience of new
motherhood, meant I could never simply relax and enjoy it for more than
snatched moments between the fretting.  With all those regrets, the
knowledge that I succeeded in breastfeeding Jamie despite all the odds
feels like a Pyrrhic victory.

If you're having problems with breastfeeding, do consider tongue tie
as a possible cause.  If you're being told that your baby's tongue tie
doesn't look too bad but you're still having problems, do go on
considering tongue tie as a possible cause, because a tongue tie that
looks relatively minor can still cause significant problems with the
function of the tongue.  If your baby's tongue tie really doesn't seem
too bad, do keep a close eye on your baby's weight so that you can pick
up small problems before they become big problems.  If your baby's
tongue tie is causing breastfeeding problems, do what you can to get it
snipped.  If your baby's tongue tie has been snipped and you still seem
to be having breastfeeding problems, do consider whether it might not
have been snipped quite far enough – it's unusual, but not unknown.  And if you're having problems with all this and could do with some support from someone who's been there and done that, contact me.  I'll do what I can.

Links to carnival participants:

The Importance of a Babymoon – Angela talks about how her husband's help got her through the rocky early days of breastfeeding her third baby.

How I got my bottle-guzzling, breast-phobic baby to love
nursing
– Christine (The Milk Mama) writes about how she got her new baby back
to the breast after a week of bottle-feeding.

 Which obstacles have you overcome to breastfeed? – Tanya
polls her readers on the challenges they’ve experienced. 

Supplemental feeding techniques for a breastfed baby
Lauren had problems with her baby’s nipple confusion after an ill-advised
bottle in the early days.  Here, she
gives advice on avoiding this problem with other methods of
supplementation.

A Rough Start – The problems Whozat faced as a result of her
baby being born a month prematurely were compounded by a lack of good advice at
crucial moments.  Despite this, she was
determined enough to keep going through some very rough times.

Clueless! Mamanadroit, in contrast, had the support and
advice she needed during the early days, when she needed it.  It made all the difference.

Week 7 and Our Breastfeeding Experience – Jessica has also had a
lot of problems getting her very new premature baby to nurse, but finally everything
seems to be going well.

I’ll Be Brief: How To Overcome Breastfeeding Challenges
Melodie recommends LLL attendance and/or online breastfeeding forums for women
facing difficulties.

When nursing takes longer – It took Boheime almost six months to get a diagnosis for her baby's problem, and another five before they were finally nursing smoothly.  She kept going in the face of all the odds.

Nine Things Your Nipples Wish You Knew About Them – Some practical advice from Melinda!

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Filed under Grr, argh, Here Be Offspring, Milky milky

Hey, Guess Where Your Freedom To Swing Your Arm Ends? My reply to Peggy O’Mara

The other day I stumbled across this blogpost, which is basically a verbatim post of an article by Peggy O'Mara, editor of Mothering magazine (a woman with whose rhetoric I have been somewhat unimpressed since reading a well-known article of hers in which she interrupted her prolonged diatribe about what we should be doing about our babies' sleep to tell us not to listen to experts who didn't know our babies.  I'm willing to bet that, to this day, she hasn't spotted the contradiction there.)  I couldn't decide which I found more objectionable – her skewing of the facts and figures in the name of 'informing' parents, or her attitude towards freedom of choice – but, either way, I hadn't actually planned to blog about it, purely due to the so-many-blog-topics-so-little-time factor.  However, thanks to my darling husband giving me the much-treasured Mother's Day treat of an hour on my own while he takes the children to the garden centre, I actually had a chance to sit down and write comments on some of the blog posts I've been wanting to comment on; and the comment I wrote for that post got longer, and longer, until before I knew it I realised I had a whole blogpost on my hands and might as well go ahead and post it as such.  So, this is my reply to Peggy O'Mara's article 'The Assault On Freedom Of Conscience'.

………………….

I'm all in favour of people having
freedom of choice, up to a point. But the point in question is the
point at which their freedom of choice impacts significantly upon the
lives of others. And, despite Peggy O'Mara's ridiculous claim in
her penultimate sentence, parents are *not* the only ones who have to
live with the consequences of these particular choices. Their
children also have to live – or die – with them.

In the case of choices about vaccines,
other people are also affected. No, Peggy O'Mara, no-one is trying
to claim that the vaccines are 100% effective – just that they
greatly reduce a child's risk of catching a disease, if they come
into contact with it. As, indeed, your own figures show. (The vast
majority of children are vaccinated, so, if the total number of
measles cases is split around evenly between the vaccinated and
unvaccinated groups, the rate of measles must be *much* lower in the
vaccinated group.) But they don't provide 100% protection (as,
again, your own figures show), and some children will be unable to
have them for health reasons anyway. So, if you allow measles to
start circulating again by providing a pool of unvaccinated children
who can pass it around, then some other children *will* be affected.

I don't know an awful lot about the US
Constitution, so please stop me if I'm wrong – but I suspect that,
while protecting your right to hold and to voice a minority opinion,
it does not protect your right to act on that opinion willy-nilly if
doing so is going to be harmful to others. If, say, your minority
opinion happens to be that small children are perfectly safe being
held on an adult's lap in a moving care instead of being restrained
in a car seat, you can hold that belief all you like but you'll find
that acting on it will bring you both public censure and legal
sanction. Not because the big bad government are meanies trying to
interfere with your sacred freedom of choice, but because, as the old saying
has it, your freedom to choose where to swing your arm ends where
someone else's nose begins.

Of course, it's necessary to draw a
balance between parents' rights to make their own choices and their
children's rights to be free from harm, and I certainly wouldn't want
to see a world in which it was acceptable to force all parents to
bring their children up exactly in line with State diktat. But
freedom of choice does not exist in a vacuum – some choices *are*
potentially harmful to other people, and that's not an issue we can
simply sweep under the carpet. Choices carry responsibilities.
Choices carry potential consequences for people apart from the person making them. We do need to find the best balance we can between allowing parents to parent unhindered, and stepping in where their ways of so doing may have major adverse impacts upon their children.  But Peggy
O'Mara is simply ignoring the other half of that dilemma.  She is trying to present this issue as though the choices she
discusses were purely individual ones that don't affect anyone beyond
the person making them, and that is manifestly untrue.

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