Attached at the Hip

The Baby and the Bathwater

This evening on Facebook, I came across a post that caught my attention.  It was a picture of a baby.  I have a thing for cute, sleeping babies, so I looked closer... And, to my horror, I discovered that the image was of a baby sleeping in a bed with - get this - a butcher knife. The title across the top of the image reads, "Your baby sleeping with you can be just as dangerous."  These shocking, ghastly images are put out by the City of Milkwaukee Health Department, part of a campaign from the Mayor's office to reduce the abominably high rates of infant mortality in their city.

It turns out that Milwaukee has had an unusual number of infant deaths that occurred while the child was bed-sharing.  Or so it would seem.  The City Health Department claims that 89 infants died in an "unsafe sleep environment" (which is not exclusive to bed-sharing) from 2006-2009.  (In the US in 2000, only 60 deaths are reported to have occurred in an adult bed, whether or not it was related to being in the bed.)  Even the Milwaukee Health Department acknowledges that there are multiple factors involved in these tragic deaths.  In fact, it doesn't appear that being in bed with a parent or caregiver is actually the most common factor!

Still, they have decided to vociferously work to undermine bed-sharing.  For the first time in my life, I was compelled to write to those in charge of making this abhorrent ad campaign.  Following is the letter I emailed to the Mayor of Milwaukee, Tom Barrett.  I encourage you to also write to the Mayor's office and the Department of Health and encourage them to withdraw these provocative, misleading ads.

Mayor Barrett,

I have recently been made aware of an upcoming publicity campaign directed by your office with the purported goal of reducing infant mortality.  The ghastly image of a child sleeping with a butcher's knife is certain to evoke emotion - but unfounded fear of bed-sharing with an infant will not, in fact, affect your city's infant mortality rates.

While you have had some notable deaths in your area related to bed-sharing, you have neglected to see the underlying and root cause of the problem.  It is not sharing the bed that is harmful; it is doing so when impaired (i.e., drunk) and, moreover, doing so when not breastfeeding.  

Dr. James McKenna of Notre Dame has done extensive research on mother-baby sleep patterns.  His summary of risk factors for infant death in bed-sharing are as follows:

"In sum, overwhelmingly, bedsharing deaths are associated with at least one independent risk factor associated with an infant dying. These include an infant being placed prone (on its stomach) and placed in an adult bed without supervision, or no breastfeeding, or other children in the bed, or infants being placed in an adult bed on top of a pillow, or who bedshare even though their mothers smoked during the pregnancy therein compromising potentially the infants ability to arouse (to terminate too little oxygen, or to terminate an apnea). 

Drug use and alcohol have historically been associated with poor outcomes for bedsharing babies so if drugs and/or alcohol are present, please don’t bedshare."

(Source:  http://cosleeping.nd.edu/frequently-asked-questions)

Bed-sharing with a sober, clean, non-smoking, breastfeeding mother in a suitable environment is not only safe but actually safer for the baby, as the mother is immediately available to any distress, illness, or need.  It is a normal, healthy human behavior that should not be discouraged by any government office.

(Sources:  http://www.askdrsears.com/topics/sleep-problems/sids-latest-research-how-sleeping-your-baby-safe

and http://cosleeping.nd.edu/ - video)

How much better would it be for your office to undertake education and support for your at-risk population to initiate and continue breastfeeding?  The benefits of breastfeeding are multifold and bed-sharing while breastfeeding is rarely harmful; indeed, the opposite.  Your bed-sharing concerns could be reduced or eliminated by educating mothers and supporting them in providing the most perfect, healthful feeding for their babies.  The rates of breastfeeding in African American mothers is significantly lower than other demographics.  The poorer and younger the mother, the less likely she is to breastfeed, as well.  Addressing these issues will have long-term benefits to your city and the generations to come.

(Source:  http://www.breastfeeding.com/all_about/all_about_more.html

and http://www.cdc.gov/nchs/data/databriefs/db05.htm)

Would it not also make sense to address the issues of drug and alcohol abuse, which present significant dangers to mothers, their children, and society?  There are, in fact, numerous factors that have led to the abysmal infant mortality rates in your city.  Addressing these issues is admirable and needed, but the attack on a normal, nutritive, safe practice is abhorrent.

Let's not "throw the baby out with the bathwater," shall we?

Sincerely,

H. B.

I dare say that providing accurate, research-based information on creating a safe sleeping environment would be far better, in the long run, for all of the children of Milwaukee.

Why use a Midwife?

Whether or not you've ever had a baby (or supported a woman who has), you've likely heard of the term "midwife."  What IS a midwife, you may have wondered, and WHY would someone choose to use one in lieu of an obstetrician?

While the latter question is multi-fold, the former is mostly straightforward.  "Midwife" means, literally, "with woman."  A midwife is a skilled, trained birth attendant (almost always a woman but I have known of male midwives), who supports a woman through pregnancy and childbirth.  Midwives may be nurse-midwives who work primarily in hospital settings; nurse-midwives who work in birth center or home settings; or certified midwives who work in birth centers or at home.  There is some overlap, depending on states and particular midwives.

The common thread behind all midwives is the adherence to the Midwives Model of Care, which includes support for ALL aspects of a woman's well-being (not just the physical aspects of the pregnancy), and a trust in the natural course of birth and the natural design of the woman's body to birth.  Therefore, midwives use far fewer interventions than obstetricians, and most midwife-attended births are "natural" births - vaginal, drug-free, non-interfered-with.  

Many midwives have expertise in alternative treatments and may employ herbal, homeopathic, and common remedies for various issues in pregnancy, birth, and postpartum.  Their varied "bag of tricks" often makes them far more successful in dealing with these issues than an obstetrician, who is not trained in handling many of these variances of normal.  Midwives will also carry oxygen for mother and baby, pitocin for handling heavy bleeding after the birth, and tools for suturing.  In some states, they may also carry IVs or other equipment.

So, now you know what a midwife is.  But why do people choose them?  There are many reasons, to be sure, but one of the primary reasons is SAFETY.  Many studies have shown that, for a woman with a low-risk pregnancy, birthing at home with a skilled midwife is as safe - or SAFER - than a hospital birth.  

This is a short film that covers this question thoroughly, "Why Choose a Midwife?"  In the film, a variety of doctors, including obstetricians, speak on why midwifery and home birth are good and safe options for many women, and why it is beneficial to states to support access to midwifery.

5-Steps for Safety

My oldest son is almost 8, and up until a couple of weeks ago, has ridden in a 5-point harnessed safety seat his entire life.  He started using a booster in his grandma's car a few months ago, but it wasn't until our 2-year-old needed a bigger seat that the car-seat-shuffle required us to move G out of the harness and into a high-back booster.  At his age, I'm pretty comfortable with this, and I like that his booster has deep side-wings for added upper-body support and side-impact protection.  The trickiest transition, though, is the one yet to come - when is he ready for an adult belt, only?

The answer to that lies in 5 Steps (aka, The 5-Step Test), a simple, easy to learn test to evaluate a child's fit in every vehicle they ride in.  It's necessary to evaluate each time in each vehicle because, as counter to modern myths and state safety laws as it may be, age and weight have nothing to do with appropriate fit in an adult belt.  The 5 Step Test takes into account the size of the child, vehicle dimensions, and belt geometry, all of which are essential to make a good fit.

So, as I re-learn these 5-Steps and teach them to my son, I'd like to also share them with you.  I found an excellent blog post with not only the 5-Step Test but also pictures of several children in both belts and boosters.  The pictures are a great aid to help you evaluate fit, and demonstrate the difference between belt-only fit and fit with a booster seat.  Check out the CarSeatBlog to see the 5-Step Test and learn how to use it!

Remember, motor vehicle crashes are the number one killer of children in the United States.  Keeping children well-protected is the single biggest factor we can control in minimizing harm and saving lives.  For more statistics, see the CDC's Fact Sheet on Child Passenger Safety.

The Great Debate

Some time ago, a reader wrote and asked me to post about routine infant circumcision.  I was surprised to search the archives here and discover I hadn't posted anything about it in the past.  Today, I saw a post on the Peacful Parenting Facebook page that is so well done that it must be shared.  I know it's a very sensitive (ha!) topic, so first, let me share my own story.

My own journey with circumcision started 8.5 years ago, when I was pregnant with my first child.  There were many decisions to be made while pregnant: where to birth, what kind of diapers to use, whether or not to buy a crib, which dresser to get, whether to get an infant seat or a convertible seat, and, if it's a boy, whether or not to circumcise.  Most of those issues are not, in the long run, a big deal (even though I am now rather passionate about most of them!), but circumcision seemed like a much bigger one.  It was not something I had much exposure to or information on, so I began to dig up what there was.

My first thought was that we, as Christians, were supposed to circumcise, because, well, that's what all the Christians do - right?  It's clearly stated in the Old Testament as a command to the people of Israel, and by all appearances was prevalent in the Church.  But that seemed counter to the new covenant and New Testament statements such as in Galatians 5:6, "For in Christ Jesus neither circumcision nor uncircumcision has any value. The only thing that counts is faith expressing itself through love."  The New Testament is clear that we are saved by grace, not by any acts, including that of circumcision.  So why, then, did it seem like the norm in the church and the US as a whole?

Further research unveiled the origins of circumcision in the US, which was not for purposes of righteousness, but for an attempt to prevent masturbation in boys.  Whether that was for puritanical reasons or because they thought it created disease is unclear, but while the majority of the world was not practicing infant circumcision, it was introduced in the US for very suspect reasons.  (The US remains one of the only countries in the world to practice routine infant circumcision without religious reasons [it is a religious rite in both the Jewish and Muslim faiths].)

In fact, I discovered, there was no evidence of any real health benefit to circumcision.  The best I could find is that, maybe, intact males might experience more UTIs (which are far more common in girls than boys, to begin with).  But, still, we struggled with a decision.  It was the most trying of all, and it wasn't until we'd prayed long and hard that we finally felt a real peace with our decision to leave our child (if he was a boy) intact.  When he was finally born, I remember clearly the feeling that I couldn't possibly take my son home (he was born in a hospital) differently than how he was born, so perfect and beautiful.

Much later, after our second son was born (and also left intact), I came across this article on Biblical Circumcision.  I was awed by how much the conclusions they came to mirrored my own convictions following the research and prayer.  They had far more information than I did, but it all confirmed our decision once again.  I highly recommend that Christian parents read the article for an excellent lesson in the history of circumcision from a biblical perspective.

So, back to today.  The Peaceful Parenting blog posted an excellent, concise, and thorough article on cirucmcision that EVERY family should read.  The video at the end, while a bit long at 20 minutes, is also excellent.  Between the two, they answer all of the common questions about circumcision, including, what it is, why it's done, how it's done, what the short- and long-term effects are, and more.  I am a passionate believer in informed parenting, and hope that more and more parents will have access to this type of information in their decision making.  It certainly would have made our own struggle through decision much easier.

And, nearly 8 years later, I can testify that we have had absolutely NO regrets in our decision to leave our three sons intact.  With a combined 15 years of experience, we've had no UTIs, no complications, and have to do, well, nothing special.  It's so easy to clean and to teach them to clean, and they are very happy and comfortable with their natural bodies.  I am so grateful that there was at least some information out there when we were looking, and, moreover, that we were able to listen to the gentle nudges and assurances that this was the right thing to do.

.....

I know that many people have had to make these decisions without the benefit of resources like I found or am sharing.  And, I know many people who have learned more and regretted their decisions to circumcise.  I know there will be those who feel justified in their decisions, and that's fine.  Most of all, I do not want to condemn those who have made the decision to circumcise when they never had the resources to make an informed choice.  My goal is to share information to help everyone make the best decisions they can, from now into the future.  I trust we all make the best efforts we can to be the best parents we can be, today.

Picky on Plastics

As we begin this new year and new decade, many of us start thinking about ways we can improve our lives - our health, our dreams, our relationships.  While most of us don't think about "plastics" when we go through our resolutions for the new year, perhaps we should.

While it's impossible to totally avoid plastics in our lives today, there are certain types of plastic that we know contain harmful chemicals (such as bisphenol-A [BPA] and phthalates) which are best avoided.  The good news is there are many alternatives to these plastics, and they're becoming easier to find all the time.

Not sure what's good and what's bad in the world of plastics?  The Environmental Working Group has put together some simple tips to help you make wise choices in choosing and using plastics.  With details on the safest types as well as those to keep away from, it's a must-read for any family ready to make a positive change.  Also check out the EWG's Tips to Avoid BPA Exposure to find out where BPA hides in other common products.

Then, check out some of our favorite plastic alternatives:

• Klean Kanteen stainless steel colored water bottles
• Snack Sacks fabric food bags
• Bambu compostable plates, wooden bowls, and wooden utensils
• Frigoverre glass food storage containers
• Haba wooden baby teethers and toys

May you and your family enjoy a very healthy and happy New Year!

Not-So-Medical Advice

I have been a proponent of natural/alternative/complementary therapies for quite some time. In fact, over the last 5 years, we've gone from a household of mostly conventional medical treatments to mostly alternative treatments.  We use a combination of homeopathy, herbs, amino acids, vitamins, and other nutrients to treat ailments on a daily basis.

Still, it can be hard to remember the details of each remedy and which situations it is best suited for.  That's when I turn to my favorite resources for treatment recommendations.  I keep Smart Medicine for a Healthier Child on my bookshelf at the ready for treating the kids, as well as Smart Medicine for Healthier Living, the adult counterpart.  These two volumes are arranged in an easy-to-use format, with information on common (and some not-so-common) ailments, along with a variety of treatment options.  Having details on conventional medical treatments side-by-side with herbal, homeopathic, and nutritional therapies is very helpful in making informed decisions.

For times when I don't have my books at the ready, I've discovered the University of Maryland Medical Reference on alternative medicines to be a very thorough and handy tool.  You can find details on specific remedies (such as the echinacea and astragalus that I dosed my kids with today), as well as information on the types of treatments (a very readable history and background of homeopathy is included), and even data on nutrient depletions that may be caused by other drugs.  With an iPhone app available, too, the UMMS Medical Reference is an excellent go-to resource with a bounty of balanced information.

As you explore options for your own family, I hope these resources will be helpful to you, too.

The Effects of Fear

I recently posted a link on Facebook to an article I found about the disturbing effects of cesareans on women's fertility.  The issues discussed in the article include secondary infertility as a result of a primary cesarean, as well as the emotional and psychological scarring that leads many women to refuse to have more children.  These women simply can't face the possibility of having another cesarean, even if they know that a VBAC is also an option.

One of the most concerning things to me about an article like this is that the vast majority of women do not go into birth knowing the true risks of cesarean.  They are not told about the risks to future fertility (something like 13% had issues, as described in the article), to their future children, and to themselves.  Most women who have cesareans believe it is in the best interest of their child and themselves, but statistically we know that most cesareans are not necessary.

As they say near the end of the article, necessary cesareans account for approximately 5% (WHO says up to 10% is acceptable) of all births. In the US, it's 36% nationwide! We are, without question, at a point when we are causing more harm than good. It's statistics, and the evidence is abounding. Rather than saving lives, we're taking them. Rather than preventing harm, we're causing it. We're past the point of diminishing returns, and the blasé attitude in this country about cesareans is only making it worse.

It is true that many people escape cesareans "relatively unharmed." And there are, certainly, those 5-10% of cesareans that truly save lives. But 26-31% of women in America are undergoing major surgery; being introduced to the risk of infections (which can be major), damage to internal organs, and fertility issues; and having their babies health and breastfeeding relationships jeopardized for no reason. They are completely avoidable, mostly iatrogenic (caused by a hospital/doctor), superfluous cesareans that do more harm than good.

Fear is a huge enemy to birth. Unfortunately, our society and our medical professionals create an atmosphere of fear around every.single.birth. This fear that "something could go wrong" (and I am very familiar with what can, truly, go wrong in pregnancy and birth) makes women dependent on doctors and medical technology. Instead of relying on their bodies and the Omniscient Creator of their bodies and this awesome thing called birth, they rely on the god of Technology.

Unfortunately, study after study and uncountable real life situations have proven that these technologies are NOT creating better outcomes. In fact, in the US, where we use a laundry list of technological interventions because of our inordinate fear of birth (such as ultrasound, pitocin, continuous fetal monitoring, epidural, vacuum, forceps, and cesarean), our neonatal and maternal morbidity and mortality rates are climbing. We are one of the worst countries in the world for mother/baby health.  And, yet, these Technologies are touted as saving lives and preventing problems. Do they? Sure, in some situations. But they're overused and are responsible for so many of these problems.

And it's all because of fear. 

Women need to be informed, and by being informed, empowered. I have studied birth extensively, and I am firmly convinced that it is, as one midwife said, "as safe as life gets." There are risks everywhere, and birth is no different, when it is allowed to progress as designed.

It is, ultimately, a God-designed and God-ordained process that has very specific goals for both mother and child. When allowed to follow these processes, it is an amazing, enlightening, empowering, and wholly transforming experience. For every interference, some of that is lost, and the risks are increased.

I do highly recommend Pushed: The Painful Truth About Childbirth and Modern Maternity Care, by Jennifer Block, as a very thorough look at our modern birth care system. I feel that every woman (and her spouse) should read it, specifically, the first few chapters. Those interested in cesarean, VBAC, and birth advocacy should read the entire book (and likely won't be able to put it down).

Happy Days

Someone on a homeschool forum just posed the question, "Remind me all the good things about homeschooling!"  We're at a really fun place right now, so I came up with a quick list and thought I should share it.  :)

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I love that my kids can beg me at 10pm to do school, and we can sit down and do some, just because we want to. 

I love that I do NOT have to be up at the crack of dawn to shuffle them out the door to another location, and then go get them again a few hours later (we are done with mother's day out, too, for that reason!).

I love that I can work with them to figure out what THEY need, and how best they learn, and find one of the many curricula or resources out there to help them.

I love getting big boxes of books at the start of the school year. 

I love that our school year can start and end whenever we feel like it.

I love that we're *always* learning, and that even my kids know school isn't just when we're sitting around reading or doing bookwork.

I love that they're excited about learning together (my 4.5yo is officially starting K now!).

I love exploring topics with them that they are interested in, and finding ways to increase their love of learning.

Of course, it has its downsides.  But I'm really happy that, right now, we've got lots of up-sides! 

(First) Adventures in Lobbying

Yesterday, my three boys and I were up before dawn to join a group from Texans for Midwifery at the Texas State Capitol in Austin.  There, we visited with lawmakers (or their aides/assistants), even taking the little ones into the offices for a rare chance to see democracy in action.  We capped off the day with plenty of play on the Capitol lawns, lunch, and a visit to a well-renowned coffee shop.

Texans for Midwifery organizes these visiting days every two years, and this year is especially important with midwifery legislation on the table.  House Bill 1107 proposes that Advanced Practice Nurses be allowed to write prescriptions under their own license.  Currently, Advanced Practice Nurses such as Certified Nurse Midwives must work with a physician to have prescriptions, even for routine items such as prenatal vitamins, written.  If approved, the new law would take an extra step and extra work (not to mention potential for error) out of the system, giving CNMs the ability to order needed items for their patients.

The Austin media covered the event.  The Statesman has a video filled with cute babies (too bad we had already gone out to play when they got there!), and KVUE did an interview with the woman the boys and I partnered with for our meetings.  Of course, the KVUE article makes it sound like midwives only provide care where there are no other options.  In reality, they're an excellent choice for all normal, healthy pregnancies, AND are a low-cost, oft-used option in low-income and rural areas.

My boys really enjoyed our day in Austin, and I was happy to have the opportunity to take them to such an important event.  I hope that the group of over 150 adults and 100 children made a positive impact on how our State government will support midwifery both in this session, and in the future.

This is Must-See TV

The new wave in diapering... A must-see for all parents and parents-to-be!

Hope you enjoy this bit of humour, too.  I dare say the treatment of cloth diapering ("messy and hard to clean") is unfair, but I'm willing to overlook that for the hilarity of this skit.  ;)

Curious what cloth diapering is really like?  Check out a few Diapering Myths from Pinstripes and Polkadots (they have lots of other great diapering information, too).  Because even if Chewable Pampers are easier, they sure aren't cuter!