Making the Most of a Bad Breastfeeding Experience

Breast milk is the perfect food for a new baby.  The World Health Organization (WHO) recommends that all babies be exclusively until 6 months of age, and that breastfeeding should continue until at least 2 years of age.  Exclusive breastfeeding has been linked to a variety of health benefits for both mother and baby, including increased immunity, reduced risk of obesity, and lower risk of cancer and osteoporosis in mothers.  Most mothers, especially in the industrialized world, are aware of the benefits of breastfeeding, and according to the 2011 Breastfeeding Report Card put out by the Centers for Disease Control (CDC), nearly 75% of American babies receive SOME breast milk.  But by 3 months, 65% of babies are receiving some kind of supplement, and by 6 months that percentage jumps to 0ver 85%.  By 12 months, the minimum breastfed age recommended by the American Academy of Pediatrics (AAP), less than 25% of babies are receiving ANY breast milk.  So even though it seems most mothers know enough about the benefits of breastfeeding to initiate it, the majority of them encounter challenges at some point along the way that makes it difficult for them to continue nursing their child.

Common “Booby Traps”

So what should a mother do when she encounters such challenges?  The World Health Organization has explored the various options available to new mothers who are for any reason unable to continue breastfeeding:

Mother’s Breast Milk in a Bottle

There are many reasons why a mother may prefer to pump her breast milk and bottle feed.  Some mothers experience pain with breastfeeding, while others find it difficult to continue breastfeeding once they return to work.  Many families do a mixture of breast and bottle-feeding in order for another adult to care for their child.   This is the safest alternative to breastfeeding, since your baby still receives the natural health benefits of breast milk.  However, some mothers find that exclusive pumping is in some ways even more difficult than breastfeeding, especially since pumping is the less efficient way to empty the breast, and find it necessary to turn to other supplements. Since many mothers return to work between 6 and 12 weeks, this could explain why 65% of babies are at least supplemented with formula at 3 months, or why less than half are receiving ANY breast milk at 6 months.

Find the Right Breast Pump

Another Mother’s Breast Milk in a Bottle

If a mother is unable to produce milk to sustain her child (e.g., adoption), the next alternative is giving the baby another mother’s milk in a bottle. This is possible through either private mother-to-mother donations or through a milk bank.This provides your baby with the next best nutrition, but can be inconvenient (driving all over town to pick up donations) and is definitely more expensive than formula, but mothers who choose this method consider it worth it to provide their baby with the best nutrition.  Obviously, not everyone has the time and resources to feed their baby donated breast milk, in which case formula is their only remaining option.

Find a Milk Bank in Your Area

Infant Formula in a Bottle

After considering all other methods, if a woman still finds it difficult to feed her child, the third option is of course formula.  Formula is a nutritious substitute for infants not receiving breast milk, but should only be used when other more nutritious options have been explored.  It is more expensive than breastfeeding or pumping, but also more convenient and socially acceptable.  Formula has been linked to poorer health during infancy, including higher rates of illness, digestive problems, and allergies. Although most of these problems can be addressed through further medical care, some babies do experience life-threatening or even fatal reactions to infant formula.  It is essential that if you choose to give your baby formula that you follow the necessary precautions in order to ensure your baby’s optimal health.

Safe Formula Preparation

A forth option?

Another option not mentioned in the World Heath Organization’s list is the use of a Wet Nurse, or a lactating woman who breastfeeds other women’s children.  Wet nursing used to be common, even in our own culture, and was once even a respected profession, but as breastfeeding has fallen out of public favor, so has this vocation.  However, it is still possible to find women who believe so much in the power of breastfeeding that they are willing to nurse other women’s children.  It may even be possible to make an informal arrangement with a friend.

However you decide to feed your baby, make sure you are doing it safely and try to mimic breastfeeding as much as possible.  Breastfeeding is about more than just nutrition, it is a connection between mother and child.  Bottle-fed babies should be held lovingly by the caregiver, perhaps even skin-to-skin, and interacted with just as he would be while nursing.  In this way you can be sure that your are providing the best possible experience for your child, regardless of what he is being fed.

Bottle-Feeding the Breastfed Baby


Practical Parenting: Cord Blood Banking

Quite simply, cord blood banking is saving the blood found in the umbilical cord for future use.   Cord blood (and umbilical tissue) is rich in stem cells, which, despite their controversy, have very powerful help applications because of their regenerative abilities.   Cord blood is easier to match than bone marrow, meaning it can be given to a wider variety of people.  It is also considered “less invasive” than the typical bone marrow donation.

After birth, the cord is clamped and cut, severing the physical connection between mother and baby.  The blood that remains in the umbilical cord and the placenta, is normally discarded as medical waste, but if you choose to bank the cord blood, it will be extracted and transported to a cord blood bank.

At a PUBLIC cord blood bank, your baby’s blood will be identified by a number, tested for quality, and then cryopreserved (frozen).  Doctors search the bank for their patients and if your baby’s blood is a match, it will go toward helping that person.  Donating to a public bank is free.

At a PRIVATE blood bank, your baby’s blood will only be available to your family.  If you have another family member with a condition treatable with stem cells, you can set it aside for that purpose, but it will not be available for public use.  You pay for this exclusivity, usually around $1-2,000, and is not covered by insurance.  The Royal College of Obstetrics (RCOG) [1] , the American Academy of Pediatrics (AAP) [2], and American College of Obstetrics and Gynecology (ACOG) [3] all recommend against PRIVATE cord blood banking — unless you have a family history of a genetic disorder.

Stem cell research is changing the face of medicine, and umbilical cord blood is contributing to that transformation.  Conditions we thought untreatable are now being healed, saving the lives of many, including children with terminal illnesses.  Cord blood is easier to match from donor to recipient than bone marrow, meaning that your baby’s blood has a greater chance of healing someone.  By donating your baby’s cord blood, you could save the life of another person, including your own family.  Much like donating blood or organs, donating cord blood is giving the generous and admirable gift of life.

But this gift of life comes with a price.  The donation of cord blood requires immediate cord clamping, a practice I investigated in a previous post.  By donating this amazing substance to someone else, you are depriving your baby of receiving it himself.  And this is some powerful stuff.  Who’s life is more valuable, and who does the cord blood help more?  That is the difficult decision in front of you.  Rationally speaking, unless you have someone specific in mind to which to donate the blood, it is probably more beneficial for your baby to receive it, and benefit from it’s miraculous health-boosting powers himself.

“The likelihood of using cord blood in private banks has rested mostly on the odds that the donor child or a family member will require a stem cell transplant. In the United States, the lifetime probability (up to age 70) that an individual will undergo an autologous transplant of their own stem cells is 1 in 435, the lifetime probability to undergo an allogeneic transplant of stem cells from a donor (such as a sibling) is 1 in 400, and the overall odds of undergoing any stem cell transplant is 1 in 217.  These figures are based on actual transplant rates in 2001-2003.” [4]

If stem cells are so powerful that they can heal these diseases in others, just imagine what that could do for your own baby.  Stem cells could cure cancer — what if they could also PREVENT it?  To whom would you rather give this gift,  a stranger or your newborn baby?  Which do you decide?

Resources

Evidence-Based Medicine: Immediate Cord Clamping

National Marrow Donor Program — Cord Blood Donation

Wikipedia: Cord Blood Banking


Practical Parenting: Circumcision

There is a lot of false information going around about circumcision — that it’s important for proper hygiene, that it lowers the risk of contracting STDs, that the infant can’t feel it or that it carries no risk of injury or death.  Parents make this decision for their child based on this misinformation, but when things go wrong, their sons are the ones who get hurt.

Circumcision, for those unfamiliar with the term, is the removal of the foreskin, a piece of skin which covers the head of the penis.  The head, or glans of the penis has a similar function to the female clitoris, so the foreskin is similar to the clitoral hood in women — one of it’s functions is to protect the highly sensitive glans.  The foreskin itself also serves a sexual function — the highly sensitive nerves found in the foreskin can enhance sexual pleasure, not only for the man but for his partner as well.  Nearly a third of baby boys are circumcised shortly after birth, and in the Jewish culture it is considered an essential rite of passage.  Most American women have never seen a circumcised penis.

Here are some of the more common reasons parents give for circumcision:

Reason #1: Circumcision is important for hygiene.

This is essentially saying that the vagina would be easier to keep clean if it weren’t for those pesky labia.  That may be true, depending on your definition of clean, I guess.  Lots of things would be “easier to keep clean” if we simply removed a part of our body — ears, bellybuttons, nostrils, between our toes — but instead of removing it, we simply learn how to clean around it.  What a concept.

Reason #2: If he is intact, he will be teased.

This may be very true.  He might also be teased if he has red hair, or freckles, braces, glasses, is fat, is learning disabled, is gifted, has a lisp, has a unique name, is gay, stutters….

Kids can be cruel.  Cutting off a perfectly healthy part of his body doesn’t make him any less tease-able, I’m afraid.

Reason #3: It’s better for his health.

Once upon a time, circumcision was claimed to reduce chances of a boy contracting HIV and other STDs, as well as reducing his chances of getting penile cancer.  These claims have recently been disproved.  The best thing a man can do to prevent HIV, STDs, and penile cancer is to practice safe, non-promiscuous sex — cut or uncut.

Reason #4: He can’t feel it anyway.

Please tell me you don’t believe this.  Can he feel when he gets a shot?  Can he feel you touch him? To think that he can feel everything else but not someone cutting off a piece of his body is just ludicrous.  If someone tells you this, please just laugh in their face.

Here are my thoughts on circumcision:

1. It’s cosmetic, therefore technically unnecessary.  

2. It carries some risk. 

Less than 1% of boys who undergo circumcision will either during or after the procedure.  I mean, that’s still about a 99% chance they won’t, so the risk isn’t HORRENDOUS, but if there’s no health benefit, and arguably no social benefit, is there any reason to take the risk?

And even if they don’t die, what if they botch it?  I once heard the story of a man who realized during puberty that he had a botched circumcision, when the skin of his penis wouldn’t stretch enough during an erection.  Ouch.  What would you rather your child endure — some teasing in the locker room, or learning to associate arousal with pain?  Oh, and one rejected skin graft later, this man is now without a penis entirely.  But hey, at least he didn’t get penile cancer, right?

Or in the 60s, when some doctors took a little bit too much off the top and cut off the penis entirely.  Luckily they convinced the baby’s parents to raise him as a girl, so nobody was any the wiser.  I’m sure that ended well.

My point is, if there was some actually benefit to it, 1% could be an acceptable risk.  But if it carries absolutely NO benefit, why chance it?

3.  Whose choice should it be?

What’s the rush, anyway?  Why do we circumcise as infants?  Couldn’t we just let them make the decision for themselves when they’re old enough to understand it?  Are we afraid they wouldn’t make the choice we want?  This isn’t like getting a little girl’s ears pierced — foreskins don’t grow back.  If he doesn’t like it, he’s pretty much stuck with it.

4. It’s becoming more popular.

If you are considering circumcision because you are afraid of locker room or lover’s lane (Eek! An uncut penis!”) drama, rest assured that circumcision rates are actually plummeting in the last decade.  Over two thirds of all boys born in the US in 2010 were uncircumcised.  So, there might be more intact penises gracing the locker rooms, and any lovers may be more accustomed to the sight as well.

I don’t care if you circumcise or not.  There’s not a HUGE risk, after all.  Just know that you can’t believe everything you read on the internet — an uncircumcised penis can be just as healthy as a circumcised one.  Rather than cut him, teach him how to care for himself, practice safe sex, and let him know that if he ever wants to change it, it’s his body and his choice.  Armed with that knowledge and power, he can have a very happy penis.  And isn’t that what we all want for our little boys?


Practical Parenting: The Family Bed

I don’t remember the first time I realized that the practice of the family bed existed, but I certainly remember my attitude toward it.  It was the same I’ve heard time and time again — that it was dangerous, that co-sleeping fosters dependence — if you bring the child into the bed, they’ll never leave, that overall, it was just…weird.  Oh, and you’ll never have sex again.  I heard that one a lot.

I knew that I would want my baby in my room, and I knew that was better for her than across the hall.  I’d read about all the benefits, like a reduced risk of SIDS, less time getting up and down in the night, etc.  I even went to all the trouble of getting a heirloom bassinet, which had been handcrafted by my late grandfather.  My biggest fear in late pregnancy was that I wouldn’t get the bassinet mattress on time, and would have no place for her to sleep.  I was that dedicated to her sleeping in a cradle.  But she most certainly wasn’t sleeping in our bed.  It was too dangerous.

Then, she was born — and she didn’t want to sleep in the cradle, and even next to my bed felt too far away that first night.  I felt so…empty…without her close.  And I just loved her so much, it was unbearable, and I wanted her in my arms.  So into bed with us she came.  And she’s still there today, five months later.

At first, I did it with a conflicted heart.  I had been told about the dangers of bed-sharing — she seemed so tiny, and us so big, wouldn’t we roll over on her? — I was even told that if anyone found out about it, I might get her taken away.  My mother, who stayed with us the first week after Sweet Pea was born, kind of shook her head at it, but otherwise seemed to write it of as a sweet new mother thing (but she still asked the midwife about it to make sure it was safe).  At first, I told most people, even my pediatrician, that she slept in the bed with me.  It felt so natural to have her there, I kind of thought everyone would accept it as an instinctual maternal thing.  And at first, they did — but as she got older, I started to feel a lot of pressure to get her into her own bed.

So I started to hide it.  When we traveled, I took along the Rock N Play sleeper to make it look like she was sleeping in her own bed.  When people started to ask about where she slept (which happened a lot for some reason), I started to say, “we have a little cradle in our room.”  (Notice that I didn’t specifically say she slept in it.)  Every few weeks, I would commit to myself that I was going to get her in her own bed, that it was truly better for her that way.  I didn’t want her to become too dependent on it to sleep.  But in reality, bed-sharing was just so much easierEspecially when I learned how to nurse laying down.


It wasn’t until recently that I finally admitted to myself that I’d like to continue to bed-share.  Even at five months, I still feel like having her close, and she sleeps best snuggled up to me.  And I sleep better, too.  And as it turns out, there’s even evidence to suggest she’ll be even more independent because of it.

If you want your baby to sleep in a crib, I won’t tell you not to.  I think the best arrangement is what works for everyone — father, mother, and baby.  Everyone’s wishes should be considered.

But I also think that there’s a lot of negative feedback about bed-sharing out there, and the truth is, it’s a very natural thing to fall into.  I didn’t think I would bed-share, but, like so many other things, my feelings changed when I actually had my baby.  I felt so connected to her, like she was still part of me.  I couldn’t (and still can’t) imagine putting her to sleep in another room.  I was really surprised by that, and you might be too.  And if you do find yourself desiring to pull your baby into bed, I would encourage you to try it (but do it safely).  You might be surprised at how much you actually enjoy it.  And you’re definitely not alone.

And if you’re worried about your sex life, remember — bed-sharers have subsequent children, too.


Practical Parenting: Spanking

Were you spanked as a kid? 

Most people our age or older can recall being spanked as a child.  You bet your buns that I was.

My mother tells (fond?) stories of picking her own switch off a bush, as well as a particular “paddling” where she whipped out the wooden spoon on my brother because he started laughing at her, and “he couldn’t feel it through his diaper” (my emphasis).

I don’t remember exactly what kinds of behaviors deserved spanking, but I’ll say it was generally disrespect — lying, “backtalk”, etc.  I got spanked a lot.  To contrast, I seem to remember my older brother getting spanked much less frequently.  That speaks loads about our different personalities. 

I remember getting my last spanking sometime around 12 or 13.  I don’t remember what it was for, but I do remember thinking, “I’m way too old for this.”

My husband claims he got spanked maybe once or twice.

But today?  A few years ago when I was teaching preschool, I remember being surprised to see a mother of a toddler spank her child, and I’m pretty sure she was in the minority in that community.  But she did it in front of the teacher, as if it was perfectly acceptable.  It got me to thinking…is spanking perfectly acceptable?

Is spanking an effective form of discipline?

A lot of research is being done, not just on spanking, but on rewards and punishments in general, and is coming to some interesting conclusions — namely, rewards and punishments are not as effective in changing behavior as many people think. Oh, you might see a change on the outside, but the inside, the conscience — the thing that controls future behavior, remains unchanged, or even resentful and likely act to out.

The ineffectiveness of punishment is displayed frequently in the driving behaviors of adults.  Maybe you’re driving down the highway, when all of a sudden you spot a patrol car.  What do you do?  If you’re like most adults I know, you slow down.  You certainly don’t pass it.  But what if that patrol car wasn’t there?  Would you behave differently?  Again, if you’re like most adults I know, you probably would.  You might drive over the speed limit, or squeak under that red light, or pass on the highway without flinching.  The fact is, that while the police have succeeded in altering our behavior when they’re around, we behave as we please when they’re not around.

Children are the same way.  While punishment is effective in controlling your child’s behavior when you’re present, as soon as you take the “punisher” away, the child is likely to behave differently.  I saw it first-hand in the preschool — I could always tell the kids who were spanked at home, because they kind of went nuts once their parents left.  Alternatives to spanking were less effective on them, because they knew that we couldn’t and wouldn’t spank them.  To them, if they weren’t getting spanked, it wasn’t worth behaving.

So is it effective?  Kind of.  In the short term.  For the child reaching for a tempting item, a spanking will alter his trajectory.  This short-term effectiveness is what keeps parents spanking.  But long-term is a different story.  And isn’t a long-term change in behavior the ultimate goal of discipline?

Is spanking harmful?

I suppose it depends on your definition of “harmful.”  Many people my age and older have proudly given credit to spanking for the way they turned out.  Some people would claim that without spanking, children would be “soft” or disrespectful.  But corporal punishment has left the schools, and fewer and fewer parents will (openly) admit to disciplining their children in this manner.  So clearly, it’s fallen out of public favor.  It has also fallen out of favor among child development experts and psychologists. Study after study have found spanking to effect aggression in children, self-esteem, success in school, etc.

In fact, the majority of sources I found to extol the benefits of spanking were primarily religious, using the famous line “spare the rod, spoil the child.”  What I found most interesting about this study was that the negative effects of spanking seemed to be strongly influenced by the age of the children when they were spanked.  Children spanked after age 6 were more likely to have behavioral problems than kids spanked before 6.   And teens who were spanked had the worst problems. (Teens?? Do people really spank teens??)

Another uncommon view to consider is not only the effect spanking has on the child, but on the parent.  Our brains respond in surprising ways when we spank our child, and not in ways I think many parents would find to be beneficial.

Being spanked myself, I have difficulty accepting that spanking has a universally negative effect on a child.  I did well in school and generally stayed out of trouble.  I haven’t had a particularly close relationship with my parents, but I hesitate to blame spanking.  But I’m sure there are people who were spanked more frequently (or more harshly) than I, and perhaps they do blame spanking for the way they turned out.  And when spanking turns into abuse, it is definitely harmful — and sometimes that line is easy to cross when you’re angry with your child.

Conclusions:

Personally, I wouldn’t classify spanking as abuse.  Not by itself, anyway.  It definitely has the potential to be harmful, though, and at it’s best it’s mostly ineffective.  As a nanny and preschool teacher, I would’ve lost my job if I had relied on corporal punishment to correct behavior, and I quickly learned many peaceful strategies that were quite effective.  So if a discipline strategy is at best ineffective, and has the potential to be harmful at its worst, and there are more effective, arguably less harmful strategies available, wouldn’t it make sense to try something else?