Wednesday, November 21, 2012

Skipping sippy cups?

No, you are not imagining things; that sippy cup really is designed to look like a pasty-white plastic tit. Needless to say, the only sippy Baby Seal would drink from was the one I was embarrassed to carry around...
It's become popular recently for breastfeeding mothers to skip the bottle and going straight to a sippy cup. However, some mums take this a stage further and go straight to an open cup. By the way, "some people" actually includes me... sort of. Since Little Seal hated bottles and was very slow to learn to drink from a sippy, I ended up more or less going straight to a little regular cup--supported/steadied by me in the early days, obviously. It wasn't until later that I discovered that "skipping the sippy cup" was a Thing.

Why are some people anti-sippy? Well, one point sometimes made is that they aren't necessary. The alternative name "trainer cup" implies that they are an essential step to learning how to drink, but this is of course nonsense; babies learned to drink from cups just fine before sippies were invented, and getting water out of a sippy involves an entirely different set of skills compared to drinking from an open cup. The real raison d'etre of sippies that they are spillproof and therefore a convenience to parents. Here in Japan, most daycare nurseries apparently insist that toddlers over 12mo use open cups only--a fact which amazes some Westerners when they first see all these tiny tots independently drinking from these little cups (without spilling... no doubt due to that mysterious ability that daycare workers have to get children to do things that they would never ever do at home).

Some lactivist-y people are anti-sippy because of fears that babies who start to enjoy the autonomy of wandering around with a cup will be more likely to self-wean early from the breast. Skipping sippies is relatively popular among baby-led weaners, which is a bit surprising, really; sippies actually allow early self-feeding and autonomy earlier and it's a rare baby who can manage an open cup independently at 6mo. However, mainstream pediatricians and dentists also tend to recommend skipping/severely limiting sippies. Extensive use of these cups has been linked with speech problems, possibly because in order to get liquid out of them--especially ones with valves--you have to push your tongue into a peculiar position which isn't used in the formation of sounds. And the very spillproof-ness of these cups can be a bit of a menace. Parents are tempted to put juice in and let toddlers wander away from the table with them (no way would you do that with an open cup, unless you like having disgusting sticky all over your house); sucking on the cup keeps kiddo quiet, so you let them have it a bit longer; and then you find yourself giving them a sippy with juice to stop them wailing in the car seat, and so on, and before you know it, the kid is spending half the day with a chewed-up plastic stub in their mouth and juice/cow's milk pooling around their teeth. The other thing about sippies is that they are often a bit... gross. They get all chewed-up, they have all these little cracks and crevices for germs to breed, they get thrown around and dropped and picked up and put in the mouth again and discovered under the car seat covered in two weeks' worth of fluff and lint and dog hair... you get the picture.

The case for sippies
That said, when at 9mo Little Seal finally took to one of the sippy cups we offered (after I got frustrated one day and ripped the valve thing out... I felt vaguely guilty afterwards, as if I'd vandalized the cup, then an online search revealed that loads of parents do this), the dreaded sippy also turned out to be useful in its own way, and I can't quite imagine never using anything but an open cup with a toddler.

Why? Well, for one thing, kids don't seem to drink quite as much from open cups as they do from sippies. I've found it useful to "add in" a little drinking from the sippy at times when it just seemed like she needed more fluids. Also, I'm not sure how you are supposed to nightwean if you never do bottles or sippies; how do you give them a sip of water if they do wake up? Open cups of water in a dark bedroom when you're tired sound like a disaster waiting to happen. Finally, I'm told that car-using parents find a sippy of water useful when they are on the road.

Cups, cups, cups
Back when we were in the bottle-refusal trenches, I did briefly wonder whether the famous Doidy cup (a funny little open cup with tilted sides) might be the answer. I think I'm glad I didn't bother, since the impression I get from Mumsnet is that there are a lot of Doidies gathering dust in people's cupboards. The Doidy's tilted sides allegedly make it easier for babies to control the flow of liquid and thus drink independently; the reality seems to be that the vast majority of babies need some help with a Doidy until toddlerhood, much like with an ordinary open cup (as one Mumsnet poster put it "The myth of the Doidy cup: 4 month old baby sips delicately at the clever slanty cup of healthy beverage.  The actuality of the doidy cup: 15 month old baby tips contents of clever slanty cup all over own chest. Cries. Change clothing and repeat. Buy cup with spout.") Also, in my experience, babies spill from open cups mainly because a) they plonk cups down clumsily and b) they think it's fun to chuck water everywhere... not because they can't control the water flow. I think if you use any type of open cup with a baby, realistically you need to be prepared to help them out with it for quite a long time unless you like soggy children and drenched floors.

A lot of parents seem to be using straw cups these days due to concerns about sippies. If I could do things again, I think I would have given these a try with Little Seal. It's handy if a baby can drink from a straw early on. That said, the other issues of sippy cups--grunge/germs, temptation to let the kid sip juice or milk all day--still remain with straw cups, so I think there's still a case to be made for introducing an open cup in the first year as well. Also, I wonder how long it'll be before "they" (dentists, pediatricians, whatever) discover some sort of problem caused by sucking on a straw all day long...

My verdict
So, all in all, going straight to an open cup--for 90% of water consumption, anyway-- turned out to be quite a nice way of doing things. You do have to supervise more and have a little more tolerance for spills--but then, if you're only doing water in the cup, this isn't usually a real problem. And I love not having to drag grotty sippies around with me. Some restaurants only have thin glasses which a young child could bite through causing serious injuries (sturdy glasses are OK); in these cases I ask for a mug or a straw, or just feed water on a spoon. The other useful thing I worked out was to keep the cup out of reach, offer it at intervals and teach Little Seal to point to it when she wants to drink. If the cup is right there in front of a toddler, the temptation to dump the contents all over the floor (just to check that gravity is still working) can become irresistible.

The sippy in our house is only for water; cow's milk comes in an open cup. However, I suspect that using an open cup only for milk is probably only practical if you are doing extended nursing, with cow's milk as a sort of supplement; if I were only doing cow's milk/toddler formula, I think I'd use a sippy/straw cup--not sure a toddler would reliably drink enough milk from an open cup. I do think that the pediatrician's rule of "juice only in an open cup (with or without straw)" is a good rule to stick to, as it means that juice stays in its rightful place as something sipped occasionally at mealtimes, not an all-day pacifier. You see, as it happens I'm awful with the TV... you know, putting it on for a few minutes (cue mummy-guilt spasm) multiple times a day when I need to immobilize Little Seal or get essential stuff done, so I think I'm probably better off not having the temptation of juice or milk in sippies for keeping Little Seal quiet; I bet I wouldn't be self-disciplined enough to restrict usage.

To sum up; I think using open cups as the main drinking device for older babies and toddlers can work, but better to be a bit flexible and consider adding in a sippy or straw cup when it seems to make sense. Happy drinking!

Sunday, November 11, 2012

When mainstream babycare gurus go bad

I should have known better, really. A few weeks back I cobbled together a list of "No-BS Breastfeeding Resources" comprising various books, websites and blogs which I reckoned were "credible, science-based and reasonably representative of how most of us actually mother." On the list I included Robin Barker, author of the bestselling Australian book Baby Love. I had not, I should confess, read any books by Barker, but trusted that they were likely to be sound, since they had been recommended by more than one person I respected.

So I open up Facebook one day and lo and behold, there is an article by Barker, "Duration not initiation is the real breastfeeding battle," which deplores the fact that according to a recent Australian Institute of Health and Welfare (AIHW) report, only 15% of women in Australia are exclusively breastfeeding by the six-month mark.

Now, before we all get into a flap about Oh My God Nobody's Doing Any Breastfeeding... here's the thing. The AIHW defines "exclusive breastfeeding" as nothing by mouth except breastmilk and certain medical supplements: no water, no solids and not even a single bottle of formula. Given those criteria, I'm actually astonished that the figure at six months is as high as 15%. I don't think I know any mother who would meet those standards. Not me, for a start: Little Seal had a bottle of sugar water in hospital (soothing for her and reassuring for me, as I was panicking about dehydration) and started small amounts of solids from four-and-a-half months, based on my own carefully researched decision. Now, I kind of resent the implication that these actions of mine now turn me and my child into some kind of Official Public Health Problem; yet when we take "exclusive breastfeeding to six months" as a barometer for correct infant feeding practices, that is the inevitable implication. The ridiculous thing is that in Oz, the pendulum in recent years seems to have swung back towards encouraging small tastes of food from four months or so in an effort to reduce food allergies, a point made by several commenters on the Barker article. (By the way, if a mere nip of sugar water negates the "exclusive breastfeeding" label, does this mean that we also have to be terribly careful when washing our babies' faces, lest a few drops of water make it into their mouths? How many cubic milliliters of water represent the level that breaches the "exclusive breastfeeding" threshold? How about when your baby starts putting their hands in their mouth and there's dust and detritus and cat hair on them--wouldn't that disturb the virgin gut just as much as a tiny bit of rice cereal? We could go on like this all night, really.)

Okay, so that was a bit dodgy. But my jaw really dropped when I saw some of the ideas that Barker floats as possible proposals for increasing the breastfeeding duration of Australian women. Better maternity leave, funding for research into breastfeeding problems and funding for experienced staff to help women... no problem. But "Infant formula in the first six months by prescription only." What?

Now, the formula-by-prescription-only thing comes up regularly in infant feeding discussions, so I really should not have to spell out the reasons this would be a terrible idea, but things like "The government of Iran is not a role model" "Screaming baby, new mother with stitches where the sun don't shine, pharmacy halfway across town" and "Gee, we've run out of formula again. Giving a newborn some cow's milk from the carton isn't that bad... right?" are flashing through my head like visions from some bad dream. Not to mention that whole tedious business about women being able to, you know, control their own bodies and all that. Material written by Barker quite recently on breastfeeding that I have been able to find (this, for example, written in 2004) comes across as eminently sensible, as does Baby Love judging by the Amazon reviews; so seeing her suddenly come out with such an extreme idea does make me start to wonder if (as some parenting bloggers have suggested) we have indeed seen in recent years a hardening of the rhetoric on breastfeeding and a shift towards more extreme positions.

The alternative explanation, of course, is that Barker (who is well into her 70s) is out of touch or starting to lose it a bit. This last thought is one that also occurred to me a few months ago when I came across an utterly bizarre article called When Should You Stop Breastfeeding in the Daily Mirror by Miriam Stoppard--another popular mainstream childcare writer who is now in her 70s and who I had always vaguely assumed represented a fairly sane and sensible voice in the world of infant feeding politics.
"...For years, we’ve followed the World Health Organization guideline that where possible babies should be breast-fed for six months. Recently, the Institute of Child Health put forward the case for mixed feeding from four months. I’m with them. Many mothers wean their babies around four months anyway and in the Third World it’s often an economic necessity. ...The mother on the Time cover believes in letting her child decide when breast-feeding should stop. I’ve never heard anything so irresponsible. No young child should be asked to shoulder the burden of such a decision... My guide is the appearance of teeth. Nature arranges for them to erupt when a baby needs food that has to be chewed. That should be when breast-feeding is gently suspended."
I'm not going to go through a word-by-word commentary on this confused and confusing mess of an article. I would say that when you are actually a babycare writer by profession and this is supposed to be your "area," it shouldn't be too much to expect some basic fact-checking. The WHO actually recommends two years of breastfeeding and six months of exclusive breastfeeding. Throughout the article, Stoppard keeps muddling the two definitions of weaning--"introduction of solid foods" versus "cessation of breastfeeding." A baby who is just starting to have a few teaspoons of food per day is still going to be dependent on breastmilk for most nutrition for many more months; you don't suddenly go from "no solids" to "all solids and no breastmilk/formula." It also makes no sense to say that solid foods should accompany tooth eruption (my grandmother was born with a tooth; should she have had solids from birth?) and in any case, isn't it a bit odd to say that after saying that babies should have solids at four months? Most babies don't get teeth that early. Finally, Stoppard must have led a very sheltered life if allowing a child to self-wean is the most "irresponsible" thing she's ever heard of. I'm sure she does not have a shred of evidence to suggest that this is in any way psychologically damaging, as she claims.

It's a bit rough, really. We have people pressing us in on all sides, telling us that we must breastfeed, but that we're disgusting or irresponsible if we do it for too long. If these pearls of wisdom were coming from an extremist like Dr. Sears or Gina Ford (the British babycare world's Queen of Routine), that would be one thing; when they come from writers who you always vaguely supposed represented the voice of sanity in all things baby-centered, it's a bit of a shock. It certainly points up the difficulty of trying to find and share breastfeeding-related resources that are moderate, science-based and non-judgmental... well, non-judgmental about things that don't matter, anyway. I mean, if you fill your newborn's bottles with a homemade Weston Price concoction of pureed liver and raw egg yolks, I will judge you.

One thing does hearten me though. As we all know, in general, the Comments sections on internet news articles are where crazy people go to die. The Comments sections on these two articles, however, actually defy the odds by being more sensible than the articles themselves, with the majority of commentators pointing out the flaws in Barker and Stoppard's reasoning. Perhaps there's hope for the world of online parenting discussion after all.

In the meantime, the two lessons I'll be taking from this are: a) if you run a blog, don't recommend writers you haven't actually read (blush); and b) if you are a doyenne of the babycare advice world, get your facts correct and think before you write, for God's sake!