Facebook has threatened the fantastic lactivist group Hey Facebook, breastfeeding is not obscene! with closure for ’sexually explicit’ pictures – yet nowhere in law could the pictures posted meet with the definitions for explicitness.
With a quarter of a million members making this one of the strongest and devoted Facebook campaigns, plus dozens of other pro-breastfeeding groups, it is absurd that such adolescent threats can pop up in an otherwise savvy corporation.
The irony is that Facebook could not even ask a breastfeeding woman to move from the sidewalk outside their building, such is the strength of legal protection for breastfeeding in California where both Facebook and Shinemama are based.
I’m tempted to take a trip to Palo Alto to sit out there myself and breastfeed. Time for a nurse-in?
Breastfeeding and natural birth are emotive subjects and sadly surrounded in controversy.
These two subjects trigger all kinds of feelings in women and for those who wanted to breastfeed or who wanted a ‘natural’ delivery but did not succeed, for whatever reason, those feelings are often tinged with deep sadness, regret and guilt which can contribute heavily to postnatal depression.
This poses a great dilemma for educators. We are charged with not building up ‘unreal expectations’
Why natural birth is ‘difficult’
In American hospitals, the chips are stacked against anyone wanting a delivery without interventions as labour without augmentation with pitocin (artificially increasing the intensity and regularity of contractions) is increasingly rare. The spiral of interventions is fast and furious. Pitocin often makes contractions unmanageable by the body’s own hormones, which makes epidural pain control essential, which restricts the body’s ability to push and the woman’s ability to move and remain upright.
Why breastfeeding is ‘difficult’
Similarly, breastfeeding is challenged by unfair tactics – caesareans make breastfeeding more difficult, criticism of bedsharing threatens one of the most natural ways for you and your baby to share closeness, triggering hormones which aid milk production and more subversively, marketing of formula milk (free samples on the labour ward for example) hints that it is condoned by medical professionals, that it is just as good as breast milk. Most critical of all is the lack of support. Few of us are lucky enough to have experienced family around us who can help out with breastfeeding. Not enough professional breastfeeding counsellors are available (although the NCT in the UK or La Leche League in the US are always great places to shout for help with breastfeeding if you need it!) and maternity wards are understaffed – they simply don’t have the time or resources to give every woman the support she needs to breastfeed. According to the USA’s CDC figures for 2003, 71% of women tried to breastfeed in hospital. By 6 months, only 36% of women are still breastfeeding at all and only 14% still breastfeeding exclusively. Figures for the UK Office for National Statistics 2005 are worse, showing only 35% of women exclusively breastfeeding at one week and only 3% at five months.
The World Health Organisation recommends breastfeeding until two years and exclusive breastfeeding up to six months.
It’s a gloomy picture isn’t it? And for educators teaching to a hospital curriculum, the challenge is nearly insurmountable. How can we tell women they can have the birth they want and feed in the way they want when the odds are so heavily against them? Aren’t we just setting them up for failure? Isn’t the guilt just compounded when we teach that bottlefeeding increases their baby’s risk of SIDS or leukemia.
Can you plan for birth?
One argument I come across is that birth is ‘random’ and that birth plans are frequently laughed at by hospital staff. “The one way to jinx your birth is to write a plan” they say. Well, while it is true that birth can be unpredictable, it’s not the same as saying that it is completely out of control. A percentage of births are easy – labour is relatively short and the baby comes without too much effort. Another percentage of births are very difficult. No matter what the mother or the staff do, the baby is badly positioned or ’stuck’ and needs intervention to be delivered. I would suggest that a large percentage of births fall somewhere in between – that a natural delivery is feasible, but if poorly managed, they may be written off as a ‘failure to progress’ and progress to caesarean or instrumental delivery. It is for this large group that active birth is so crucial. Staying upright, moving around, drinking raspberry leaf tea, using a doula, using a birth ball, swaying the pelvis, relaxation and visualisation may all swing the balance, stave off stress and help labour to take its natural course.
Breastfeeding is very similar. A small amount of women may never be able to breastfeed, another percentage will find it easy. Most will need some support and to overcome a few obstacles to really settle into it. Once again, the right support can really swing the balance, yet as we have seen that support is frequently lacking.
The real difficulty for educators is that attitude makes a difference. Imagine a scale from one to ten, when 1 is “I don’t want to breastfeed”, 10 is “I definitely want to breastfeed” and 5 is “I want to give breastfeeding a try.” Those pregnant women who score themselves nearer to 10 are more likely to succeed in breastfeeding than those who score a 5. They are more likely to seek help, support and push on through difficulties. Similarly, a scale from 1 to 10 might exist for giving birth without an epidural. Those who are dead set against an epidural will be likely to try anything else first.
Of course, in both cases, nothing is guaranteed, no matter how determined you are. And it is possible that someone scoring a ‘1′ that they don’t want to breastfeed might have a change of heart and try anyway, or someone scoring a ‘1′ that they definitely want an epidural might realise in the delivery room that they are coping fine without. But scoring higher definitely boosts the chance of success.
Education is likely to raise those expectations. A woman who originally scored a ‘5′ that she might like to try breastfeeding (perhaps her family all formula-fed) could well shift her score up a few notches if she learned how it might benefit her baby. Similarly, a woman might become more determined to try birthing without an epidural if she learned more about the pro’s and con’s.
The difficulty here is that it sounds as if I’m arguing that success depends on determination. I do believe determination plays a part in both birth and breastfeeding, but as I have already pointed out, it is only part of the equation. Occasionally birth or breastfeeding have real physical reasons why they cannot work. Sometimes the support just isn’t there and sometimes women just don’t have access to the information they really need (their doctor perhaps tells them that an epidural is very safe and that they don’t need to suffer).
I would love to see the guilt taken out of these aspects of parenting. I would love to see women feel comfortable and happy with their choices. What stood out for me is that in the UK’s 2000 birth survey published by the Department of Health, ninety percent of women who gave up breastfeeding in the first six weeks wanted to continue. So who is to blame when it goes wrong? Clearly not these mothers.
The answer is complex. It comes down to a lack of support, from maternity wards to policymakers, from employers to public baby ‘unfriendly’ venues, from formula marketeers to family. There is a great need for education and for professional support. There is a massive demand for breastfeeding counsellors and consultants. I hear so many stories of women whose ‘milk never came in’ when they weren’t shown attachment techniques, skin-to-skin contact, frequent feeding, co-sleeping and so on. When they thought colustrum wasn’t enough. Similarly, where birth is concerned, there is a need for education, for evidence-based decision making in hospitals rather than unhelpful policies and procedures, for doulas and for the opportunity for women to really get active and work with their bodies rather than with hospital demands for restrictive monitoring, fasting or bedrest when not strictly needed.
What we need is to stop blaming ourselves. To have strength, determination and hope so that it can go right whenever it is possible, and when it occasionally doesn’t, we can be gentle on ourselves, and once we have mourned what was not to be, we can regroup and move forward.
The Facebook statuses rolled this week as people responded to one of those silly memes. The first wave went. ‘Post your bra colour, don’t tell the boys!’
The second wave went, ‘Post your bra colour, don’t tell the boys, it’s for BREAST CANCER AWARENESS.’
Hmm. Now, putting aside feminist rhetoric, I thought the first version was some lighthearted, childish fun.
The second wave I found more sinister and I’m going to try and articulate why.
Almost all of us know someone who has been affected by breast cancer and we all want to do our bit to help. However, we are all very well aware of breast cancer. This meme isn’t going to fund research and it isn’t educating women. I find it astounding that people will exploit this wish to ‘do good’ to get their friends to join in with a game. What does it say about our need to belong and to make others belong that we will use emotive subjects like this?
Now, I heard one theory that suggests people have a lot of sympathy for breast cancer because it is so random, there is nothing you can do to protect yourself from it (apart from try to live a healthy lifestyle).
Now this is partly true. Fit, healthy women get breast cancer. Men get breast cancer.
But there IS one other thing you can do to protect yourself AND your daughter from breast cancer.
Breastfeed.
Breastfeeding has some great health benefits for all women, but this is particularly important for premenopausal women who have a close family member (mother, sister) who has had breast cancer. Did you know that a recent study found breastfeeding for these women cuts their risk of getting premenopausal breast cancer by a staggering 59%? (Stuebe at University of North Carolina, published in the Archivesof Internal Medicine, Aug. 2009)
Additionally, it cuts your risk of heart disease, osteoporosis, cervical and ovarian cancer and high blood pressure.
Even more staggeringly, if you breastfeed your daughter (even if only for a short term) you cut her risk of developing breast cancer by 25%. (“Exposure to breast milk in infancy and the risk of breast cancer” Freudenheim, J. 1994)
Additionally, if you breastfeed your baby for ONE month, you cut their risk of childhood leukemia by 21%. Keep on for six months, you cut that risk by 30%. (Robison, L. at University of Minnesota, 1999)
Breastfed babies also have lower lifetime risk of obesity, diabetes, asthma, SIDS, ear infection, respiratory infection, bacterial meningitis, rheumatoid arthritis, Crohn’s etc. etc. They also have fewer admissions to hospital.
Sadly, bottle v. breast is often seen as a lifestyle choice, and even more sadly, those who want to breastfeed are very frequently not given the support they need. Lactation counsellors are few and far between and hospitals don’t have the time or energy to help new mothers breastfeed. Formula manufacturers market in unethical ways and to new vulnerable mothers, implying their product is the same as breast milk (which as we can see, it isn’t.) And new mothers aren’t always protected in their choice to breastfeed. California has laws protecting breastfeeding mothers in public places, sadly not all of the US follows suit.
Most women WANT to breastfeed. Nine out of ten mothers gives up breastfeeding before they hoped to. Most just weren’t given the support they needed to combat simple problems like thrush, a poor latch or blocked ducts (all of which can seem like agony but can be overcome with support.) Many were fed myths or unnecessarily worried by health professionals tutting over such vague things as ‘poor weight gain’ or ‘milk not coming in’ (diagnosed far more frequently than actual occurrence.) Some have had their breastfeeding relationship interrupted by custody or immigration or incarceration or hospitalisation. Some have been sabotaged by nipple confusion caused by unnecessary pacifiers or bottles.
I don’t blame mothers for not breastfeeding. It is tough at first. It needs support, from our family, from society, from experienced breastfeeders, from the government, from the policymakers of society.
Most of us don’t have that support.
Breastfeeding is a matter of public health. It should be an absolute priority for public health officials, the government and health care professionals of all stripes.
So, it’s not just about ‘awareness’ – there is something we can actually DO about breast cancer and about the health of our babies in general. We can educate on the importance of breastfeeding. We can show people where to get the help they need to be successful breastfeeding (La Leche League or the National Childbirth Trust (in the UK) are both good starting points.)
We can and should urge policy-makers to understand how important this is. If you could reduce childhood leukemia by 25%, wouldn’t you?
I took a note from Empowered Birth and changed my facebook status from ‘zebra striped’ to this:
Breastfeeding reduces your chance of getting breast cancer (and the longer you breastfeed, the lower your risk). AND it also helps your daughter reduce HER chances of getting breast cancer. So post THIS instead of your bra colour today.
I spent a fabulous couple of hours on Saturday with the ladies from Insight Pink, a unique group for women who feel they are transitioning from the period of their twenties and early thirties.
Read what they have to say about me here. (I was very touched by your kind words, ladies. Thank you.)
It was fascinating to learn from them and their experiences, and how we all deal with this process of ‘growing up’ differently. There seems some expectation that by your mid-thirties you’ve figured it all out and are settled, but some of us seem to bounce off in completely new directions!
As Baz Luhrman said:
“The most interesting people I know didn’t know at 22 what they wanted to do with their lives, some of the most interesting 40 year olds I know still don’t.”
There are no ‘rules’ now. Career, relationships, family, housing, travel, leisure, finance are all part of what we probably have to figure out at some time or another as women, yet there is no clear order to do them in or proportions to arrange them in. There is pressure from family, friends, finance and of course our biological clock and sometimes it seems very hard to do the ‘right’ thing because it always seems like something is being neglected.
Fitting babies into this mix can be very daunting and understandably so. Babies come with a whole other set of pressures and responsibilities.
I’m perhaps a little simplistic. I believe that babies always manage to ‘fit in’ somehow. I also think there is far too much pressure to be a perfect parent, to read all the parenting manuals, to establish routines and discipline early on and to always have your baby looking ‘perfect.’ It becomes about ‘active parenting’ which can quite honestly be stifling and stressful for all concerned.
I think you can do an amazing amount of ‘parenting’ by instinct, without actually worrying about ‘parenting’. Your baby’s needs in the beginning are very simple – lots of love, sleep, milk and interaction. Co-sleep and breastfeed and all you need to buy are nappies/diapers and a few clothes. And a sling is invaluable for going out and about. (My experience of complex ‘travel systems’ is that they’re very expensive and the baby outgrows them quickly. My son was already too big for the pram part of one I looked at in a shop when he was three months old! You really can get by with a sling until the baby is old enough for a simple stroller.)
This type of parenting is called attachment parenting. Demand feeding is a key part of this, so you keep your baby with you in the early weeks so that he (or she) can feed when he needs to. I actually found demand feeding very liberating. There’s no watching the clock, screaming babies or worrying, you just settle for a feed as soon as your baby shows signs of wanting one. You also don’t run into the problem of not being able to go out because it’s naptime – you just take baby with you and let him sleep in the sling.
A big secret of attachment parenting is that keeping your baby close to you releases the hormones which keep your milk supply plentiful and having each other close by and smelling one another is reassuring and good for the mental and physical health of both you and your baby. (There’s a reason nature made babies’ heads smell so yummy!)
Anyway, do take a look at Insight Pink’s blog. They’re a fascinating, smart, articulate group of ladies and true Shinemamas-to-be!
And if you would like me to come and spread a little SHINE by talking to your group or organisation, drop me an email!
A couple of weeks ago, I had the opportunity to drink coffee with two ladies who run a small women’s group for women in their twenties and thirties. I am now preparing as they kindly invited me to address the rest of their group tomorrow on the subject of pregnancy and birth. None of the group currently have children and many are now trying to conceive or thinking about it.
One subject that cropped up during our chat was fear. The fear of childbirth (tokophobia), fear of pregnancy and even the fear of trying for a baby.
When you think about it, these fears are justified. Pregnancy and birth is a life changing and somewhat unpredictable process. Infertility is deeply upsetting. Miscarriage is surprisingly common. Many of us live far from our mother or sisters and are the first of our social group to have children. Our first real experience of pregnancy and babies comes with our own. Yet there is a counter-argument that it is all completely normal and that women have been giving birth since the human race began.
But pregnancy isn’t all that normal in our society. Most women in the UK and the US will only do it once or twice in their lifetime, compared to some countries where women have an average of 6 or even 7 babies. (Niger has a birth rate of 7.19 and Afghanistan has 7.07 compared to the US at 2.10 and the UK at 1.66). My ‘hometown’ of Guernsey ranks only a little above China’s birth rate at 1.40.
Neither is the process of childbirth seen as normal, instead the American norm requires intrusive tests throughout pregnancy and a highly medicalised labour and birth which is ‘managed’ in order to proceed along a tightly defined curve and frequently results in major surgery.
Of course we all want the best outcome possible during pregnancy and childbirth, but our quest for perfection leads down some very odd routes and the climate of fear begins at preconception. “What if I can’t get pregnant?” My rather flippant answer of course is, “You’ll never know if you don’t try!” but this is where it all starts.
The ‘rules’ are laid down at the start and most of them are sensible and easy to follow – taking folic acid for example prevents a number of birth defects. Avoiding unpasteurised cheese reduces the likelihood of contracting listeria, stopping smoking improves outcomes immensely. But it doesn’t stop there. Many of the ‘rules’ are not evidence based. In fact, many of the ‘better safe than sorry’ rules (such as avoiding all alcohol during pregnancy or avoiding eggs altogether) arise from absolutely no evidence – just a misguided extrapolation that ‘excess alcohol is bad, therefore ALL alcohol is bad’ or ‘raw eggs are bad therefore better to avoid even possibly undercooking an egg.’
I have seen some immense anxiety because a woman had a couple of drinks before realising she was pregnant. The drinks were unlikely to do any harm at all, yet the fear kicked in. Fear and anxiety certainly have a negative effect – on blood pressure, heart rate and mood, all of which can also effect the baby. Yet the media feed on this fear, day after day feeding out non-stories based on misinterpretations of data and on theories rather than studies. Similarly, the medical profession fuel this climate of fear, abetted by lawyers and insurance companies. Pregnancy as an illness is a lucrative concept.
Another source of fear is the weighty sense of responsibility that goes with having a child. There is a perfect balance of physical fitness, ideal weight, financial stability, a suitable home, a secure relationship and career security that many of us long to attain before trying for a baby. Achieving these factors together is very difficult for most of us. When you throw in the time limits of peak fertility ages, it starts to look impossible. Then you have the woeful stories which await any woman who dares to get pregnant in her forties.
Of course we want the best for our baby, but sometimes you just have to go with ‘good enough’ – many women feel healthier and fitter naturally during pregnancy – the body does wonderful things to prepare itself for birth. And money and housing can be stretched.
Tokophobia, the fear of childbirth is the biggest fear of all for some women. It is considered a valid reason for an elective caesarean section and it is a fairly reasonable fear – after all, childbirth hurts. The situation is not helped by the portrayal of birth on television or by often exaggerated horror stories of birth. However ’secondary’ tokophobia is increasingly common. This is a fear which occurs in second or third pregnancies (or even later) and is rooted in previous birth trauma.
Birth trauma rates are rising dramatically and contribute to postnatal depression and other mood disorders. Birth trauma also significantly affects breastfeeding and bonding and has similar symptoms to post-traumatic stress disorder. While the term a ‘negative’ birth experience is somewhat vague, the causes may be very specific to a woman experiencing it. A sense of aloneness during labour, a sense of not being listened to, an arrogant or dismissive medical professional. Many women report that birth trauma arises from a sense of violation – a procedure or intervention that was conducted without their consent. For example, several women I have spoken to have found the amniotomy – breaking the amniotic sac with a ‘crochet hook’ like instrument to encourage labour to have been particularly traumatising, both visually and physically, although this is a common hospital intervention, albeit with limited medical evidence supporting its usage.
It is amazing to me that mortality rates are relatively low, yet birth fear is rising. Yet it is totally understandable. A normal hospital birth carries a high risk of birth trauma. Home births, birth centre births and doula attended births are all showed to greatly increase the mother’s feeling of satisfaction with the birth experience and reduce rates of postnatal depression.
The only way to ease the fear is to normalise birth. To show that it can be a safe, family centred event. To stop marginalising natural childbirth as a hippy or bohemian concept. To educate women that birth is a normal life event.
And most importantly that when left to its own devices, the body can do wonderful things. All the pitocin and medication are poor substitutes for the body’s natural hormones which are inhibited by fear and an artificial environment. When we labour in safety, our own endorphins are released freely and are a natural painkiller, helping us through the process.
What is clear is that in any stage from preconception right through to parenting a teenager, fear, anxiety and guilt are destructive, psychologically and physically. Take up yoga, take a hot bath, have a beer. But do try to relax.
The BBC today are reporting that Michael Odent is arguing against the presence of dads in the delivery room.
It is only in recent history that fathers have been allowed to be present at a hospital birth. It is also commonly thought that they are a reassuring presence and that women want them to be there.
Odent however, argues that they inhibit the flow of oxytocin, the hormone which encourages and supports labour.
Perhaps though, it is not simply a male presence which inhibits oxytocin, it is anxiety.
The problem with a dad in the delivery room is that unless he happens to be a midwife, obstetrician or similar, he is likely to be unfamiliar with the process of birth. He will also be anxious about his partner. She’s in pain, for heaven’s sake! Someone help her! He will maybe hang on the word of medical staff and stare at beeping monitors, rather than being the emotional support his partner needs. He may well be asking if things are normal and worry at the first sign of trouble (like a nervous passenger on a plane).
And there’s the other problem. Labour is messy and it can be a little undignified. His partner may not be altogether comfortable with her sexual partner seeing her in this way. Because let’s face it, there’s grunting and mooing, there may well be pooing and there’s goo galore. Being inhibited or worried about appearance isn’t good for the labour process.
Now, all that said, we’re talking about life partners, and we’re talking about the father of the baby. Doesn’t he deserve to see this miraculous event and welcome his new baby? And don’t you want him there to hold your hand?
The Bradley ‘husband coached’ method is as it sounds. For followers of Bradley, the dad’s role is very important, although with the best will in the world, he may surrender his position once into hospital territory and medical staff ‘take over.’
One solution here is a doula, a lay-woman trained and familiar with the process of childbirth. A doula need not replace the dad unless the couple specifically want this. In normal cases, she complements their partnership.
A doula serves many purposes. She is there primarily to provide comfort and support to the mother, through coping techniques which might include massage, breathing, aromatherapy, positioning and visualisation. She also is clearheaded and not emotionally attached so that she can help a woman to get the birth she wants, helping her to communicate her needs and wants. She can also support the dad.
The presence of the doula actually frees up the dad to concentrate on emotional support, loving his partner and serving her emotional needs. While he may help her with her breathing or offer massages or suggestions, he no longer has the sense of responsibility or the demand to remember everything from birth classes – the doula may in fact help him out with reminders, ‘Hey dad, maybe she just needs you to breathe with her.. like this’ and if they’re doing fine, she may just sit back, or do something simple for the couple, like a hand massage. Many dads feel deeply relieved by the decision to have a doula on the birth team.
Numerous studies have shown that a doula supported birth shortens labours considerably, reduces complications and caesarean rate and reduces the need for pain relief or epidural. They have also found that women are more satisfied with their birth experience and their babies breastfeed more easily and have less special care admissions and shorter hospital stays.
As an afterthought, oxytocin is a bonding hormone and a love hormone. It is my belief that birth can be family centered and a birth can do wonders for bonding a whole family, mother, father and siblings, with one another and with the baby. This is why I believe that dads have a role in the delivery room at home or in the hospital and that they should (if both partners want) be allowed to experience this amazing day. But they must be free to provide emotional, instinctive support and not be worried about what they ’should’ be doing. For my last birth, I found dad and doula were the perfect team!
To find out more information on doulas, try DONA (Doulas of North America) or Doula UK. Doulas are also available to help during pregnancy (planning a birth plan for example) and to help postpartum.
If you’re in San Diego and expecting, I also offer doula services. Drop me an email!
M is six. She is a happy little girl who adores ballet and fairies and wishes she could fly. She dances everywhere and likes to hold hands with the teacher. She loves maths, science and her reading age is well above her grade level. So much the better for reading about fairies. If she’s allowed, she likes to work for hours at a computer game, finding all the tricks, secrets and making sure she’s explored every nook and cranny that other people never even notice. She giggles a lot. A LOT. She is a natural clown and loves to make people laugh. She’s always, always angled unusually in photographs.
M’s teacher stopped M’s mother the other day. The same old story. It’s difficult to make her write. It takes a while to get her attention. She doesn’t like sitting straight on her chair. She talks over the teacher. She’s sometimes too loud. It took M a whole day to write one sentence. She was kept in at playtime.
M’s mother recognises this story. When M’s mother was a little girl, she was often removed from classrooms. She remembers spending much of her childhood standing in corridors, unsure why or what went wrong. She remembers that she was always the naughty one. That rumours circulated about her, that parents didn’t like their children being her friend, that teachers would call her names. She never quite knew what she did differently from the other children. It’s just how it was. When M’s mother was a little girl, her doctor said that she was ‘hyperactive.’
Twenty years later, M’s mother is talking to M’s teacher. M’s teacher says M should be ‘tested.’ That she probably has ADHD. That she probably needs ‘medication.’ That if she ‘needs’ medication and won’t take it, then M might have to leave her class and leave the school that she loves.
M’s mother is gutted. M eats well, mostly organic food with minimal additives. She exercises well and she has a happy home life. She also has an older sister who is studious and well liked.
M’s mother is pretty pissed off.
Figures are blurry for how many children are on Ritalin or similar stimulants. Estimates suggest anything up to 8 million children are currently prescribed ADHD medication. At least 90 percent of them are in the USA. Ritalin affects chemicals in a child’s brain linked to impulsivity and ‘hyperactivity.’ The ideal result at the correct dosage is a child who conforms to the needs class.
Only a few weeks ago, M’s mother noticed an advertisement in a magazine for a free trial of Adderall in a parenting magazine. A free trial, like it was chocolate. Or perfume.
Yet a quick look at the professional guidance for Adderall given to doctors is more disturbing. In fact, it carries the following warning:
AMPHETAMINES HAVE A HIGH POTENTIAL FOR ABUSE. ADMINISTRATION OF AMPHETAMINES FOR PROLONGED PERIODS OF TIME MAY LEAD TO DRUG DEPENDENCE AND MUST BE AVOIDED. PARTICULAR ATTENTION SHOULD BE PAID TO THE POSSIBILITY OF SUBJECTS OBTAINING AMPHETAMINES FOR NON-THERAPEUTIC USE OR DISTRIBUTION TO OTHERS, AND THE DRUGS SHOULD BE PRESCRIBED OR DISPENSED SPARINGLY.
MISUSE OF AMPHETAMINE MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS.
The pediatric guidelines read,
“Pediatric Use: Long-term effects of amphetamines in children have not been well established. Amphetamines are not recommended for use in children under 3 years of age with Attention Deficit Hyperactivity Disorder described under INDICATIONS AND USAGE.”
Professional warnings on Ritalin are similarly disturbing.
A study at Columbia University found an increase in sudden death in children who were taking Ritalin. Paediatricians and psychiatrists keen to continue prescribing argued that this was only relevant in children with existing heart abnormalities In 2008, the American Heart Association recommended EKG tests be given to children starting Ritalin, yet this is still not in effect, thanks to those prescribers fighting the recommendation. Even more worryingly, in a recent study published in the American Journal of Psychiatry, the link to sudden death was confirmed once more and in this case, children with any suspicion of heart problems had been removed from the study. Indeed, children on stimulants with no known pre-existing heart issues are five times more likely to die suddenly than other children.
These amphetamine drugs are also known to raise blood pressure, increase heart rate and are known in long term use to retard growth in children. Not to mention the tics and psychosis. Oh, and any long standing prescription for Ritalin or similar may jeapordise a military career.
So. If a doctor says so, M must take one of these drugs to remain at the school.
And let’s be under no illusions, the ADHD industry is huge. The books, the drugs, the remedies. Leon Eisenberg, a professor of psychiatry and social medicine at Harvard Medical School, says that the sale of Ritalin and other stimulant drugs for children are “driven by the convenience of the doctor, the profitability of the drug company, and the notion that there is nothing more meaningful to life than biochemistry”.
M won’t be seeing a doctor. M’s mother wonders why exactly M had to write that sentence that took all day. Whether it was worth staying indoors all day, struggling over. More than anything, she wants M to be happy, to be a pleasant, sociable child. She knows that M is not causing any harm to herself or to anyone else. She just doesn’t conform easily to the classroom rules. Much of it is just about sitting still and concentrating. M doesn’t deserve the same ‘naughty’ label that plagued M’s mother throughout her school years.
And what exactly are the school doing by giving M star charts, pulling her privileges (if play and exercise time can be considered a privilege for a six year old)? They’re using extrinsic forces to force what should be an intrinsic process. In the short term, reward and punishment may make a child conform and obey. They don’t however encourage any love of learning. The child thinks, “I must write because I will get my star and be allowed to play.” Not, “I must write because I want to master this skill and be able to enjoy using it.” In the long term, is the child going to continue writing? No. They will forever be seeking the external motivator and never develop a natural love of learning. (So what if the sentence never gets written! Will the child be a failure in later life? Unlikely.)
Mothering.com describes the Albany Free School, a drug free school where classroom life is individualised. Perhaps in these days of tight budgets, this is a dream but the article quotes Alexander S Neill who argued that the school must fit the child, not the other way round. Classrooms are there to educate children as they are, not to mould the children into ‘educatable’ beings. Surely, if so many millions of children ‘need’ ADHD medication, schools are failing them. They are not providing the education these children need. They are are merely providing a ‘one size fits all’ education. They are buying into our Western tendency to see difference as disorder.
The clue is in the word. Disorder. M refuses to be orderly. To order herself as the school would like.
M’s mother is considering home educating. M would probably thrive if given more autonomy over her learning. Fortunately, this is an option, but it should be an option. Instead, M’s mother feels forced towards this option, as to her, giving M drugs that carry a risk of death and which will change M’s brain chemistry is simply not an option. Even M’s sister says, ‘I like M exactly as she is!’ and M’s family are all in agreement here.
M’s mother believes that M has a very meaningful life. And more to the point, she enjoys her very unusual angles; in photographs, in chairs and in life!
For further reading, Dr Peter Breggin, an experienced Harvard educated psychiatrist has several eye-opening studies here concerning Ritalin, Adderall and Concerta ADHD drugs.
Mothering.com takes the debate one stage further by asking if ADHD actually exists. Shinemama’s feeling? ‘ADHD children’ undoubtedly exist. But they don’t have a disorder. They just have those unusual angles…
To discuss this article, visit our community forum here.
I was excited and a little starstruck to meet Ricki Lake and director, Abby Epstein last week at a party to celebrate the release of their new book, Your Best Birth which was followed by a screening of their excellent documentary, The Business of Being Born.
Katharyne of Shinemama.com meeting Ricki Lake
The party was held at the gorgeous Babies in Bloom boutique in Vista, CA which specialises in cloth diapers (real nappies), slings and breastfeeding equipment and was attended by a crowd of San Diego birth specialists. It was a very special evening and I feel very lucky that I had the chance to meet Ricki and Abby and thank them for making such an important, eye-opening movie.
They showed that midwifery and home birth are real, plausible options for modern, intelligent women. For someone with Ricki’s status to throw herself into such a project and allow footage of her baby’s birth to be included is really incredible.
Their new website is called My Best Birth and I can’t wait to see how their community develops.
The Guardian goes one step further to argue that the ’science’ is being badly misinterpreted and used to demonise parents.
So what is the truth? Well, the BMJ study doesn’t tell us much we don’t already know. Their conclusion is as follows:
Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa.
The problem we have in finding the truth is that none of the big cosleeping studies have separated out those bedsharing safely with their babies (no drugs or alcohol for parents and a safe space for baby, free from pillows and excess covers) from those who have fallen asleep on a sofa, possibly in a drunken or overtired state.
Consistently, studies have found the vast majority of ‘cosleeping’ deaths have been sofa-sleepers, where the baby has been smothered or suffocated whilst sharing a sofa with a parent. These really aren’t true SIDS or cot death cases as there is a clear cause of death. Similarly, we know that smoking and alcohol consumption in parents are linked to incidents of SIDS.
There is no evidence that planned bedsharing is in any way harmful.
What we DO know however is that the original study which FSID quote repeatedly and which was aimed at finding a link to cosleeping and SIDS was funded in a large part by the JPMA – The Juvenile Product Manufacturers’ Association who described themselves:
JPMA is a national trade organization representing 95% of the prenatal to preschool industry. Today, JPMA represents 250 companies in the United States, Canada, and Mexico who manufacture, import and/or distribute infant products such as cribs, car seats, strollers, bedding, and a wide range of accessories and decorative items.
Hardly an uninterested party. Though none of these studies have actually proven any link to bedsharing and SIDS, the party line is still not to bedshare.
Fortunately, a few voices of reason have spoken up. The National Childbirth Trust (NCT) Chief Executive, Belinda Phipps has said, “The findings sound extremely significant. We are really pleased to see that evidence about the safety of co-sleeping is building, because we know it improves breastfeeding rates. We also know a lot of parents prefer to do it but feel guilty because they are unsure about the risks”. (The Telegraph, 2009)
Similarly, Dr Peter Blair from UNICEF has said, “This study shows that it is not co-sleeping that is unsafe, but the circumstances under which some parents co-sleep that create risks”.
So why is this so important to parents?
Well, we know that half of parents bedshare at least once in the first six months. A quarter of parents bedshare regularly. Many are made to feel guilty about it. This guilt is mired in the belief of FSID that it is better to tell parents never to cosleep at all rather than expect them to understand a few common sense precautions. Yet this sledgehammer approach is dangerous because bedsharing carries considerable, known benefits.
Bedsharing supports the breastfeeding relationship between mother and infant. Mothers who bedshare are more likely to feed on demand and continue feeding for longer. Proximity of the baby helps the mother produce prolactin which keeps milk supply high.
Bedsharing is comforting, normal and natural. Most other cultures outside the US and UK bedshare, many with very low incidences of SIDS. The practice was discouraged by the Victorians. Babies aren’t designed to be alone.
It’s easy! No getting out of bed to fetch and feed the baby.
It’s safe. Feeding then falling asleep on the sofa isn’t.
There is evidence bedsharing can help regulate the baby’s breathing, temperature and heart rate as well as reduce stress hormones.
It may mean a much better night’s sleep for mum and baby. A known factor in decreasing postnatal depression.
A secure baby with a close maternal attachment is likely to not suffer separation anxiety, so is more likely be a secure, independent, happy child.
Deborah Jackson’s book Three in a Bed was a groundbreaking book on the benefits of bedsharing. It’s a great read for parents wanting to know more on the subject. I am a strong believer in bedsharing and am sharing with #3. #1 and #2 moved on to their own bed cheerfully when they were ready.
There are just a few common sense guidelines:
Avoid drinking, drugs or cigarettes if you are bedsharing.
Make a safe space for the baby… no pillows or excess covers, no cracks they can get wedged in.
Don’t cosleep on the sofa
Is there anything nicer than seeing your baby’s face grinning back at you when you wake up?
