Wednesday, April 4, 2012

True, woo or just plain EEWWWW....?

It's certainly been a good month for Alternative Mothering In The News. First we had Mayim Bialik (more on her in my next post) with her elimination communication and alternative medicine. Then we had Mad Men's January Jones eating her own placenta. And now we have Alicia Silverstone premasticating her 11-month-old baby's food and spitting it into his mouth. The media, of course, has had fun with this, producing headlines about "Gross Moms" among others. Here is Breastfeeding Without BS's official "True, woo, or just plain EEWWWW....?" rundown. The "gross" sections represent my subjective opinion; take it or leave it.

1. Elimination communication

Mayim Bialik's mothering style has raised a few eyebrows, but none more so than her use of elimination communication (infant pottying). Bialik's form of EC was pretty full-on, but some form of EC (getting baby used to the potty early etc.) is commoner than many people realize; in fact, the The Baby Whisperer Solves All Your Problems and Diaper Free Before Three, both very mainstream books, recommend incorporating the potty into the routine from 6-12 months onwards. Contrary to the rather sensational media coverage, no ECed infant in a developed country setting is actually diaper-free (including Bialik's); however, babies tend to be free from diapers part of the time, soil fewer, and get out of diapers for good at an earlier age.

Is it gross (in my opinion)?
No, I don't think EC is gross. Some messes are inevitable, but if you have wipe-clean flooring, clearing up the odd mess is no big deal. Looked at another way, diapers (sitting in your own waste products) are pretty unpleasant too, though a necessary evil in developed countries.

Beneficial?
Honestly, using diapers less and getting out of them earlier can only really be a good thing, in terms of health and environmental impact.

Harmful?
Pottying a newborn full-time day and night as Bialik did could possibly be hazardous to your sanity, but otherwise I know of no harm that comes from EC. I totally agree with ECers that the notion that sitting on a potty is an act somehow fraught with psychological danger is bullshit; I've been in some parts of the world where diapers are never used and babies are "held out" from the newborn stage, and people in these societies are not having Freudian catastrophes all over the place.

2. Afterbirth for afters

Placentophagy, the practice of consuming your own--or rather, your baby's--afterbirth, has been growing in popularity recently; in fact, a whole cottage industry has sprung up whereby "placenta encapsulators" will dry your afterbirth out and turn it into little pills for you to swallow, with the aim of warding off postpartum depression (PPD), stopping hemorrhaging or boosting milk supply. You can also do it at home, as demonstrated here. Or you can just puree it in a blender. Placentophagy is commonplace (though not universal) among mammals, but is extremely rare in human beings; it has only really been seen since the 1960s as one of the more extreme manifestations of the alternative/natural birth and parenting movement.

This kind of progressive shifting of the boundaries of "natural," as previously alternative practices become mainstream and people have to invent ever more outrageous things to do instead, is quite common in the whole "natural parenting" movement... although Dr. Amy's example in the link actually concerns lotus birth, an even more bizarre practice in which the baby is left attached to its own placenta until it rots off. The idea apparently is that this represents the ultimate non-violent birth, based on the idea that the placenta is part of the baby's body and experience; as such, it of course goes against the idea at the core of placentophagy, which is that the placenta is part of the mother's body. Mothering.com has a few countless unintentionally hilarious threads which feature worried mums-to-be trying to decide between the delights of placentaphagy and lotus birth. How to choose when both options are so tempting? Or could you possibly do both--eat part of the placenta and leave the rest attached? I was tempted to suggest that they could combine both practices by curing the placenta into jerky to be consumed later, but refrained from posting because it occurred to me that the other posters might actually think I was being serious. But enough of that.

Is it gross (in my opinion)?
In my personal opinion, yes, consuming a (smelly) human body organ that mostly contains your child's DNA, while not immoral, is kind of gross. As someone on Science Based Medicine points out here, "If a child was born with a useless extra digit and you had it removed, would you eat that?" Placentas, never the nicest things to begin with, are pretty rank by the end of a term pregnancy; indeed, that's a key reason why OBs start talking induction if you go well beyond your due date, because it's not very healthy for the baby to be stuck in there with an increasingly manky aging placenta. From Science Based Medicine: "At term, the placenta is at the end of its normal lifetime and is becoming senescent [i.e. aged]. The rate of senescence increases with stress, and in the case of a high stress pregnancy, such as one characterized by preeclampsia, the placenta could get filled up with stress proteins, like prions and amyloid."

Human beings in general seem to be pretty grossed out by placentas, hence the extreme cross-cultural rarity of placentophagy. And frankly, it looks like most practitioners of placentophagy have a "yuck" reaction as well, hence the need to turn the placenta into pill form before most of them can bring themselves to eat it. Just a comment from the sidelines here, but... given that the natural parent-y people claim to be so into the whole idea of  "TRUST YOUR GUT INSTINCTS! FOLLOW YOUR INTUITION!" ... isn't it a bit odd that these are the same people forcing themselves to choke down something which they and human beings down the ages have intuitively felt disgusted by--to the point where they can only eat it when it is presented in an unrecognizable form, like capsules or blenderized puree? (Anyway, I thought we were all agreed that purees were unnatural because Cavemama didn't have blenders. Shouldn't these mums be eating steamed chunks of placenta on a tray so that they can experience and enjoy its flavor and texture as they eat...? Okay, okay, I'm being facetious now).

I'm basically just pointing out the inconsistency of the argument here, not arguing that we should follow our instincts where placenta-eating or anything else is concerned. If there were good scientific evidence that placentophagy did have benefits, presumably we should consider doing it even if we do instinctively find it repulsive. But is there any such evidence? Which brings me to...

Beneficial?
There is no proper scientific evidence suggesting that placentophagy benefits PPD, hemorrhaging, milk supply or anything else. None whatsoever. The evidence stacked up in favor of placentophagy seems to consist of one endlessly linked page on a website called Placenta Benefits... basically, a bunch of poor quality bibliography salad which Science Based Medicine shreds as quickly as a blender turning your afterbirth into an interesting-smelling breakfast drink. There is anecdata aplenty from mothers who insist that they were saved from PPD by daily placenta capsules, but then, back in the days of heroic medicine, there was also plenty of anecdata attesting to the efficacy of bloodletting, leeches and toxic purges. I've gone through all this before.

Harmful?
I have come across no evidence suggesting that placentophagy is actually harmful in any way. I do think that there is harm in the whole notion of pursuing non-evidence-based treatments based on internet hearsay, because once that is accepted as a principle it opens the door for more dangerous forms of woo like anti-vaccination. There is also the problem which inevitably accompanies all non-evidence-based medicine: namely, that it may distract the patient from pursuing evidence-based treatment. Post-partum hemmorrhage kills; what's more, so does post-partum depression. 

3. Eating like a bird

Since Silverstone's video (originally posted on her blog) went viral, reactions have been predictable: a collective "ugh!" followed by a few vague claims that by doing this, Silverstone was making it impossible for her child to learn how to chew. These last comments, by the way, came not just from a couple of mainstream pediatritians but also from a few sniffy baby led weaners... although my personal feeling is that some of them were basically sulking about the fact that they had just been out-crunched (see above bit on progressive shifting of the boundaries of the natural). Feeding your baby pieces of steamed sweet potato chunks on a highchair tray, you might have thought you were pretty Hip And With It compared with all those other mothers doing Gerber Graduates and rice cereal... but really, how can you possibly compete with someone who sits on the floor and offers her offspring chewed-up food mouth to mouth like a momma bird, while he crawls over to her and attacks her mouth, no less? I suppose the question is... what comes next? How do you out-do that? Raw-food-only diets for babies? Tearing off chunks of bloody meat from the living animal and feeding it to the baby with blood running down your chin? Something involving hemp? I dread to think.

Is it gross (in my opinion)?
My first reaction to the video was that yes, it looked icky. But (at the risk of going all post-modernist-cultural-relativist for a moment), I suppose my feelings are tempered by the fact that premastication is common in many traditional cultures, and that it seems a bit unfair to go all "Ewww!!" about a practice which, in food-poor environments, may be a necessary way of making sure that infants at least get some iron-rich foods inside them (see this paper here which suggests that the abandonment of premastication in some communities put infants at risk of nutritional deficiencies).

Beneficial?
In cultures where blenders are available, I know of no benefits to prechewing, although around the 'net there were a few people trying out the "it contains saliva and is therefore beneficial for digestion" idea out for size. I suppose prechewing could be convenient.

Harmful?
Yes. Now, in spite of the doomsayers, I don't think Silverstone has anything to worry about where her child's chewing skills are concerned; as I blogged about here, premastication is common in traditional cultures, and children there learn how to chew just fine. I'm pretty sure that's not how her child is eating all of his food, in any case; it's a rare 11-month-old who isn't trying to grab pieces of food off your plate to self-feed. However, prechewing may be a dodgy idea for other reasons.

There is good evidence that prechewing is associated with dental caries (see here for just one example). Apparently, the bacteria which cause caries are not ones we are born with; they colonize the mouth at some point after birth. All children will get it eventually, simply because babies and toddlers are grabby and eventually they are going to get a spoon or cup of yours in their mouth no matter how hard you try to stop them--but the later they are exposed to the bacteria the better, and pre-chewing definitely seems to speed up the process. I have a confession to make (hangs head): on two separate occasions I broke up a bit of meat on my front teeth and fed it to Baby Seal... oh, admit it, BFWOBS, you prechewed food for her, dammit. And it was gross, and it turns out that it was a bad idea. When I heard about the dental caries thing, I was sorry I prechewed and I wished I had never done it. :( Perhaps the take-home lesson here is that even when a practice is justifiable in "traditional culture" settings,  it may not be justified in an industrialized culture (i.e., we have blenders) because the benefits disappear while the risks remain. I think this is true of quite a number of "traditional culture" childrearing practices.

I'll be returning to Mayim Bialik in my next post. In the meantime, while pottying baby in some form or another looks innocuous, I'll be putting placentophagy and prechewing firmly into the "Don't Try This At Home" category.

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