How to have a bottle-refusing baby (and a life)

Before I had my baby 16 months ago, I was quite clear on one thing: if I breastfed her (and I wasn't yet sure which way I would swing), she was going to take a bottle. Oh yes, she would. I had no desire to join the dreaded ranks of the Mothers Whose Babies Will Not Take A Bottle. I'd read all the stories, you see--about how a bottle-refusing baby irrevocably ruined your entire life, chaining you to your infant night and day and ensuring that you never had a evening-out or date night ever again. I was horrified by such stories, but not terribly sympathetic. Really, these sad excuses for mothers had only themselves to blame for not introducing a bottle properly at the right time. Or maybe they did introduce a bottle in time, but then failed to follow up on it. Tut tut. Apart from anything else, how utterly irresponsible, I sniffed--what if they suddenly had to be hospitalized and the poor husband had no means of getting milk into the baby? I, by contrast, was going to do things properly.

And so I carefully introduced bottles--beautiful, carefully selected glass bottles--at five weeks, as per The Sleep Lady. Baby Seal took them like a dream and I congratulated myself on my superior mothering skills. I now had the ideal breastfeeding-yet-bottle-accepting baby who would allow me to leave her, when desired, with Dad or Grandma--though, if pressed, I would have been forced to admit that keeping my baby primed and ready for such occasions was actually a heck of a lot of work.

You see, the Sleep Lady stipulated a rule of "one bottle a day" to make sure that baby did not lose her bottle-latching skills. This meant that in addition to breastfeeding and babycare, I had to find time to sterilize the pump (carefully gripping each piece with tongs while pouring boiling water though it), set the pump up, mechanically wheeze the milk out drop by drop, store it, sterilize the bottle parts with more boiling water, screw the bottle together, fill it with milk and warm it. Then there was the business of trying to find a time-slot for fitting the bottle-feeding into the daily routine. As Baby Seal's bedtime became earlier, my husband was no longer home in time to give her an evening bottle, so I began to give it myself.

Perhaps that's where the trouble began. At any rate, at three months old, Baby Seal began to refuse her carefully prepared bottles. In horror, I posted on Facebook "She's stopped taking the bottle!!! HELP." Everyone weighed in with suggestions (from giving the bottle out of doors, to rolling the teat in icing sugar) all of which I duly followed--to no avail. My pliant little bottle-accepter was gone, and she never took one again... well, not until she was nine months old and bottles were no longer necessary anyway. Bit of a climbdown for me, as you can imagine.

And... it was okay. We managed--just about--without bottles. Not always very conveniently or efficiently, it's true (I moaned about the problems of my little bottle-refuser here). And yet, somehow, we got through it and came out the other side.

Needs
As it turns out, bottles are not absolutely indispensable for getting milk into a baby without a breast. Over the millennia, a variety of things from spoons to droppers to cups have been used for the purpose. So why the ubiquity of bottles? Well, the big advantage of bottles over other feeding methods is that they are a way of getting a lot of milk into a baby with relative speed and without wastage. If you are looking to get large quantities of milk into a baby sans breast, then a bottle is what you need. If speed/efficiency/quantity are less important--because you are, say, a stay-at-home/work-at-home mother or on mat leave and you only need to leave your baby for the odd evening out, the hairdresser's, doctor's appointments and so on, a bottle may not be essential and could even be more trouble than it's worth.
When it became clear that bottles were simply not going to work, I girded my loins and went to internet to learn about alternative feeding methods. Over the next few months our family ended up doing a mixture of dropperfeeding, cupfeeding and spoonfeeding (milk and cereal); no method was perfect, each method had its own advantages. On preparing to leave the house without the baby, I would basically defrost a container of breastmilk, sterilize a spoon, dropper, and cup, and say to Dad/Grandma, "Erm, your guess is as good as mine. Try lots of stuff and see what works." Here's my rundown.

• Dropperfeeding

This method suggested itself from the dropper I'd used to give Baby Seal her Infacol. I know, I know--feeding milk in a dropper sounds like it is going to really, really, really slow. In fact, for this particular purpose, droppers should really be named "squirters" because you put the milk in one squirt at a time, not literally drop by drop. Slowish, but not nearly as bad as it sounds, and less messy than some other methods.

To give Baby Seal a dropper feed, we would put her in her bouncy chair facing us. It's a funny thing, but when breastfed babies are being fed milk from anything other than a breast--a dropper, spoon, cup or bottle--they tend to prefer the whole experience to be as different from nursing as possible; different posture, different part of the room, and often from someone who's not the mother. It's as if anything that reminds them of breastfeeding makes them furious--"Look, I know this isn't real breastfeeding... do you take me for a fool??" Anyway, we started off with a few drops at a time, then increased to half a dropperfull, then a full dropperfull. I found a video here, but honestly, there is no special technique to dropperfeeding--it's just insert and squirt. Any medicine dropper will do.

• Cupfeeding

Baby Seal came to cupfeeding rather late--at four months, she grabbed the rice cooker measuring cup and put it to her mouth with a cheeky grin... and I had an "Aha!" moment. The best way to learn how to cupfeed is to see it in action--thank you, Youtube.
Shot glasses are the most popular cupfeeding option, but I used either the aforementioned rice cooker cup (which had a little "give" in it), or a tiny Japanese teacup. The trick with cupfeeding (and this flummoxed me for ages until I worked it out) is to get the baby's tongue inside the cup. You're not actually pouring the milk into her mouth, because if you do this, she will splutter and gag; you need the baby to use her tongue to sip or lap the milk from the cup.
I found cupfeeding faster than dropperfeeding, but at the expense of more wasted milk. When this is breastmilk you've spent forever carefully expressing and storing, that's hard (could this be the true origin of the old saying about crying over spilt milk?). After five months old when Baby Seal was having solids anyway, I made sure there was some ready-made formula knocking about in the house, which made it a bit psychologically easier to experiment with different ways of giving milk.

• Spoonfeeding

Spoonfeeding breastmilk struck me as being the slowest and messiest method of the three mentioned thus far--Baby Seal always seemed to have a lot coming out of her mouth, perhaps due to the tongue-thrust reflex--yet my mother-in-law and mother seemed to prefer it to other methods. I guess it comes down to familiarity--grandmas are usually accustomed to spoonfeeding babies. Which leads me to....

• Cereals

If a baby is at least four months old and you've been spoonfeeding breastmilk anyway, adding a little baby cereal like baby rice or oatmeal can be a nice, not-overthinking-it start to solid foods. It stabilizes the breastmilk and makes it less messy to feed, while also giving your baby a little extra iron... and there has recently been a swing back towards emphasising supplementary iron for breastfed babies. Now... I know I mentioned this in another post, but the funny thing about a lot of lactivists is that they think spoonfeeding breastmilk is great--like a kind of superior alternative to the evil bottle--but that spoonfeeding solid foods is a Bad Thing (forcefeeding, doesn't allow your child to control their food intake, blah blah). So according to this logic, the moment you add a little powdered rice to a spoonfull of breastmilk, your baby suddenly becomes incapable of controlling their intake of what's on the spoon, and you are essentially just waterboarding them with the contents. No, I'm not buying that bit of logic either. We did the cereal thing, and offered a couple of teaspoons of water as well, to counterbalance the solids that had been added.

• Sippies

I had high hopes that Baby Seal might take to a sippy cup super-early; alas, she hated every sippy I tried on her for the longest time. She even hated the soft-spout type which are recommended for young babies. Still, it's worth giving them a try; I've heard of bottle-refusers taking a sippy as early as four months.

It doesn't last forever
So in the end, it was okay. I got out without the baby; somehow, with a bit of this and a bit of that, Baby Seal got enough milk inside her.
Now, I should stress, however, that I'm speaking from the privileged position of someone who was able to take six months' mat leave and then work from home while using in-house childcare. If a mother is going to work outside the home in the usual way, a bottle-refusing baby is far more of an issue, which is why (as discussed in a previous post) it drives me nuts when I see lactivists disingenuously advising planning-to-return-to-work mothers to wait for two or three months before introducing a bottle, or even not bother at all. With the best will in the word, babies are not going to get huge amounts of milk inside them with these methods, so if we are talking about a baby who is at a daycare nursery much of the day, suggesting to mothers that they don't bother with the bottle and instead just have their baby fed with an open cup or spoon is basically tantamount to telling mothers to encourage their babies to reverse cycle--a phenomenon which sometimes occurs with breastfed babies of working mothers, whereby the baby eats next-to-nothing all day and then makes up for it by clusterf*ck-feeding all night long. Which some mothers may be okay with, and others most definitely are not. That's even assuming you can get a daycare nursery to handle cupfeeding with a baby in the first place.

However, if you are, say, planning to leave your baby only for the odd evening out or whatever, having a bottle-refuser is a nuisance but not a disaster. Although I do generally rather hate the hoary platitude "This, too, shall pass," this is one of those instances where it does have the ring of truth. Most new mothers aren't doing much in the way of evenings-out for the first month or so after the birth anyway; and then at four to six months you start solids and the feeds start getting fewer and further apart; at seven or eight months baby may start taking a sippy cup, and so on, and the whole situation starts to look completely different. So in the great scheme of things, the time that having a bottle-refusing baby will inconvenience you is really, at most, only a few short months out of your entire life. And even during this period, honestly, you can go out without your baby when you want to--it's just a bit more fiddly and involves rather more spilt milk.

And there is a bright side to having a bottle refuser. At least you don't have to wean them off the wretched bottle if they never take to one in the first place (same with pacifiers). And to be honest, yes, going straight to an open cup probably is more hygienic, and better in terms of palate development and dental health.

In hindsight
Knowing what I do now... if I were to have another baby in similar circumstances, would I bother with the bottles this time? Well... I think would certainly introduce one like I did with Baby Seal--it's worth a try, at least. But I think that this time I wouldn't put myself through all that exhausting palaver of the daily bottle; it was just.so.much.work and I'm really not sure it was worth it. And if my hypothetical second child were to start refusing the bottle like Baby Seal, I 'm pretty sure that this time I wouldn't waste energy on fighting with her over the issue. I would just remind myself that the inconvenience of the bottle-refusing baby doesn't really last very long, and that in the meantime there is nothing more adorably precocious than the sight of a young baby drinking from a teeny little teacup.

Bullshitometer: Breastmilk has more calories than any solid food

Mmm....food!

One of those internet memes that is always cropping up on online forums is "Breastmilk contains more calories than any other food." Like all internet memes, it comes in various forms--"Breastmilk contains more calories than almost any other food," "Breastmilk contains more calories and nutrients than any other food," "Breastmilk contains more calories than any other food except avocado""Breastmilk contains as many calories as melted icecream" and so on. It's usually something you hear when some mother is debating whether to start her baby on solids (because her baby seems hungry on breastmilk alone) or whether to offer more solids to her older baby or toddler who is nursing almost exclusively and is gaining poorly. Sometimes, just to add to the general drama, there is a pediatrician involved in the background who is apparently telling the mother to stop/reduce nursing because this is "filling the baby up on breastmilk" and preventing them from wanting their solids.

This is the point where someone will inevitably advising the mother to sack the pediatrician, nursenursenurse, and not bother about introducing solids/offering increased amounts of solids--or even cut back on the things or stop them completely. Given the "breastmilk contains more calories than any other food" meme, it's easy to see why. If you actually believe that breastmilk contains more calories than any other food, then logically, why would you introduce/increase solids in response to hunger or poor weight gain? In fact, if you took the idea to its logical conclusion, you should actually decrease solids or better still, take them away altogether, because surely the only thing those rotten, puny solids are going to do is fill the kid up and reduce their appetite for your calorie-festa boobie milkshakes. Clearly you should introduce solids as late as possible, or better still, never.

Since my own impression of breastmilk's flavor--oh come on, like you've never tasted your own--is that it does not taste like melted icecream, I did some research into the calories counts of solid foods commonly offered to babies using USDA figures. Very easy to do. Here's what I found:

Food	Kcal per 100g
Acorn Winter Squash (without salt, mashed, cooked, boiled)	34
Cooked spinach	40
Orange	47
Apple	52
Boiled carrots	54
Pear	58
Yoghurt (whole milk)	61
Breastmilk	67
Cottage cheese	103
Baby cereal oatmeal cooked with milk	116
Baked or broiled haddock	128
Egg	154
Chicken breast	195
Brown bread	210
Lamb chop	314
Egg yolk	322
Baby rice cereal (NB: See below)	391

This is a pretty reasonable "range" of vegetables, cereals, fruits and animal foods, and in terms of calorie count, breastmilk comes slap in the middle of the list; not a low-calorie food by any means, but not "melted icecream" or "richer in calories than any solid food" either, not by a long shot.

There are two conclusions one can draw from this. Firstly, look at the things in the upper part of the table with fewer calories than breastmilk: pear, carrot, squash and so on. Notice anything about them? Most of the the things which are offered to very young babies are actually pretty low in calories. So no, giving your five-month-old a few teaspoons of pureed carrot is not going to miraculously make her sleep through the night, as many disappointed parents have found out the hard way (seriously, is there anyone for whom this trick has ever actually worked?). Plus, let's face it, actually getting 100g of breastmilk into a young baby is usually easier than trying to get 100g of banana into them... as opposed to all over the floor, highchair, bib, baby's hair etc. etc.

How about rice cereal? Lest you are goggling at that last figure on the list, I should let you know that this appears to be the figure for dry baby rice; I can't seem to find a figure for rice cereal mixed with breastmilk, which is how it's usually served. Kellymom (which does things in ounces.... Americans, please get with the program and switch to metric like the rest of the planet!) gives 22kcal/ounce as the calorie count for breastmilk and 20kcal for a very watery-sounding "Baby rice cereal  (2 TBS dry cereal prepared in one oz water)," so I'm going to go right ahead and assume that 100g of regular-thickness breastmilk-mixed-with-rice-cereal probably contains somewhat more calories than 100g of breastmilk, though certainly not anywhere near as much as 391kcal. That said, The Sleep Lady is something of a goddess in my household, so when she says that of the countless parents she's worked with over the years who have dutifully given their babies rice cereal every night, she has never seen any cases where actual sleep improvements have resulted, I tend to believe her. Let's face it, there are a lot of reasons why young babies wake at night.

However. The second point one might take home from the chart is that it would appear to call into question the idea that introducing or increasing solids is unnecessary or harmful for on older baby/toddler who is eating very little food and is hungry or gaining poorly.

Three other points:

(1) Breastfeeding at the breast is quite hard work for the nursling, who has to suck hard for every mouthful, and the milk comes slowly. This of course is generally a good thing as it acts as a natural corrective to overfeeding, which is probably why excessive weight gain is less common with breastfed babies. On the other hand, if a mother has a hungry or failing-to-grow child and needs to "feed them up," I suspect that this feature of breastfeeding may become a hindrance, and easy-to-eat solid foods are probably more suited to her purpose.

(2) With breastmilk a mother limited to whatever her body can produce, and at times when it is available--i.e., she's probably going to have to feed throughout the night if she is to stand a chance of providing enough calories. With solids--assuming one is not living in the South Sudan famine belt or something--one can always just go to the fridge and get more.

Granted, some women no doubt can provide more than enough calories to sustain a baby up to a year or even beyond with little or no solid food, assuming they have a strong supply and are prepared to do plenty of night feedings. According to this USDA source, a 1-month-old baby boy requires about 472 calories a day, which means a mother of twin boys would need to produce 944 calories a day in breastmilk in order to exclusively breastfeed them. A single 12-month-old baby boy, on the other hand, requires just 844 calories a day (and bear in mind that breastmilk typically becomes more calorie-dense as your child grows older). Since there most certainly are mothers who manage to exclusively breastfeed twins to a month or well beyond, it would appear that some women, at least, are capable of producing more than enough calories to feed a child healthily to a year or so. There are other reasons why babies need solids by about six months or so (iron and zinc), but calorie-wise, a baby who takes to solids slowly is probably not a problem if they are gaining well and meeting milestones. But not everyone has a terrific supply. If a child is not growing well, they probably need more food.

(3) With the exception of infants in the Gerber puree stage, it's not like we human beings actually tend to sit down and eat Plain Boiled Carrot/Spinach With Nothing Else very often. You're more likely to eat, say, steamed veggies dressed with oil or butter, which boosts the calorie count quite a bit even for those low-cal foods at the top of the list. (And you'll notice that the super calorie-rich things like avocado and olive oil weren't even included on my chart.)

One thing which seem very hard to verify is whether overconsumption of breastmilk really can "fill a child up" and stop them eating enough solid foods. My own hunch would be that if you've a child who just plays with solids, restricting nursing for a bit might be worth a try, to see if it can kickstart a child's developing a bit more of an appetite for solids... some kids are just very reluctant to try anything new and may need an initial kick up the butt to get them going. If that doesn't work, an assessment for texture/aversion issues might be an idea. I very much doubt whether stopping nursing altogether is necessary; some pediatricians are genuinely biased against extended nursing and tend to see it automatically as being the cause of any problem that a child's parents complain of.

Bullshitometer verdict

Breastmilk appears to have plenty of calories--more than a few teaspoons of pear puree or whatever, anyway. That said, it's not true that it has more calories than any other food. If you have an mostly-breastfed older baby who's not growing too well, they probably need more solids. I think it's worth banging on about this a bit because while there is no real evidence that solids-introduction methods have any long-term effects on children, and the differences between breastmilk and formula are probably a lot smaller than many people believe, there is a ton of robust evidence suggesting that chronic shortages of calories (and iron) in the first couple of years can have long-term negative effects, especially on cognitive development.

It might seem like a no-brainer that a child not getting enough calories is bad for them, but it seems a few people really do need telling--and that people who have drunk deep of certain kinds of woo can start looking at their children through a kind of distorted lens. On Trolls With Wooden Spoons (an interesting forum created by former Mothering.com posters who had become disillusioned with the site), I remember an occasionally disturbing thread titled something along the lines of "What was the stupidest thing you ever did under the influence of Mothering.com?" (quoting from memory). One poster wrote something particularly sad. It was, roughly, "The stupidest thing I ever did because of MDC was exclusively breastfeeding my toddler, and telling myself again and again that he was a perfectly healthy toddler who just happened to be really tiny for his age." Yikes. As they say, "Rule No. 1: Feed the baby"!

Attachment parenting isn't about checklists (or is it?)

Happy_Hippie: People are so obsessed with the idea that attachment parenting is about a laundry list of parenting "rules"--that it's about babywearing or baby led weaning or natural birth or whatever. Well, it's not actually about those things at all. It's about following your heart and your child. It's about doing what works for you as a family.


AttachedAndLovingIt: Exactly! What gets me is that they're painting attachment parenting as something for martyr mommies. Well, guess what? I only do attachment parenting because it's actually easier for me--cosleeping and breastfeeding are totally the lazy way! My 18-month-old is still up four or five times a night--can you imagine if I had to go downstairs and sterilize and prepare bottles of formula for him each time?


K8lynne's_mommeee: And recovering from a natural birth is way easier than from a c-section!


GranolaGirl: I have hard time with these sorts of discussions, to be honest. I tried really hard to birth my son, but after 56 hours of back labor, things just weren't progressing and we had to have a cesarean section. And I wanted desperately to do babywearing but he hated the sling. I kind of feel like I was lied to by the books and websites that told me that there is only one correct way to parent...


AttachedAndLovingIt: But GranolaGirl, you CAN be a great attachment momma even if you did have a c-section! I had a c-section and I challenge anyone to say that I'm not an attachment parenting mother--I wore my daughter for hours on end when she was a baby and we did baby led weaning and we co-slept and nursed and used rear-facing carseats till she was almost three, in spite of the fact that I didn't have a natural birth. Attachment parenting is not about checklists, people!


Happy_Hippie: The other thing that really bugs me is the way Time magazine kept talking about attachment parenting as The New Latest Thing To Do--like some sort of a 21st century fad. But the reality is, attachment parenting is just going back to basics--it's the way human beings have parenting since the beginning of time. Hello, co-sleeping and breastfeeding into toddlerhood--all this was considered completely normal and mainstream until very recently in human history!


I'm didn't blog about the Time magazine cover and I'm certainly not going to do so now, because frankly I think we're all a bit sick of this rather stale bit of news that was never particularly interesting in the first place. (My own reaction to hearing about that Time had put an extended nursing picture on its cover was rather like my reaction the first time I heard that scientists had succeeded in cloning animals for the first time: basically, "I'm a bit embarrassed to admit this when everyone else seems so terribly excited about this news, but to be honest I actually had this vague idea in the back of my head that they'd already done this years ago.")

People's reactions to the news were actually a lot more interesting than the news itself. There have been a lot of conversations about attachment parenting taking place on blogs, boards and Facebook pages in the wake of Timegate. Online conversations about attachment parenting are basically really, really weird. They go round and round and round in circles, and are full of contradictions that never really get properly discussed.

Take the whole little speech about "Attachment parenting isn't actually about babywearing or baby led weaning or natural birth--it's not a checklist of parenting rules, it's about relating to your child in a way which works for you" etc. etc., some version of which can be found hundreds of times over on any attachment parenting-oriented attachment parenting-/natural family living-related website or blog, Google group, discussion board or what-have-you.

Now: I would like to propose a little experiment (no, seriously; you can actually try this one out). Go to one of these online fora, and ask people one of the following questions: "How popular is attachment parenting where you live?" "Do other members of your family do attachment parenting?" or "Can you recommend any children's books which have images of attachment parenting in them?" Check the responses.

Now here's the thing: I can guarantee that pretty close to 100% of the responses will basically talk about breastfeeding and bed-sharing, homebirth and baby led weaning, rear-facing car-seats, midwives and slings. "This is a very attachment-parenting friendly area--you just step outside the door and babies in Ergos are at least as popular as babies in strollers." "I'm the only one in my family who does attachment parenting; my sister-in-law [BFWOBS: why is it always sisters-in-law?] formula-fed from day one and had an epidural at 2cm so she wouldn't 'feel any contractions' LOL" "Well, Mommy Had A Baby is pretty attachment-parenting-friendly--the mom gave birth at home and it definitely shows a baby that appears to be in the parent's bed asleep, although I was rather disappointed to see a picture of a baby being spoonfed at one point..." (I remember stumbling across a group of online mothers who were picking over every last detail of a Dora The Explorer episode--yes, really--in terms of whether the newborn mom was parenting her twins according to a laundry list of attachment parenting "rules," and thinking to myself, "I'll definitely be remembering this one next time I hear someone insist that 'attachment parenting isn't about checklists, you know.'")

To be honest, though, you probably don't have to go so far as to start a whole new thread in this manner. See the little imaginary discussion thread above. It's weird, really. Someone will do the whole speech about "attachment parenting isn't about checklists," and someone else--or sometimes the same person--will then go on to say things like "Attachment parenting is the historical norm for human societies, because look at all those ancient tribal people doing bed sharing and carrying their kids in slings" or "I attachment parent because breastfeeding and co-sleeping and babywearing so on are so much easier." And everyone then agrees with everything that everyone else has said, and nobody really points out that some of those statements directly contradict each other. Like, you kind of feel like saying, "Erm, hang on. I thought we'd all just agreed that attachment parenting actually isn't about breastfeeding and co-sleeping and babywearing, right? So... now you're saying it is basically about these things after all? Which do you mean?"

The other comment you might be tempted to make is along the lines of "Sooo.... you're saying that if your circumstances had dictated that formula feeding [for example] had proved to be more convenient than breastfeeding, then you would have done that instead?" Seriously, go to an attachment parenting/natural family living forum and try telling them that "I sleep train because I'm lazy, and sleeping eight hours in a row is easier than being woken up all long by a 12-month-old," or "I prefer cesarean section because it saves me the effort of laboring" or "I'm too lazy to do this babywearing thing. For me it's more convenient to put the baby in an exersaucer and use a pram." You won't get very positive responses (understatement of the century there). This is not an attempt to start a conversation about (for example) whether vaginal delivery or ceserean section is actually the easier way to give birth, because that's actually a very complicated question. Rather, the point is that with the "I am an attachment parent because it's soooo much easier" people, the "easier" solution is only embraced when it happens to be one of the items on the checklist. So yeah... checklists again.

(Actual example: I once came across a discussion on cloth diapering on a certain board I frequent, which was full of posters earnestly claiming that they did cloth diapering out of sheer laziness... Reasons given for this rather incredible claim were that (a) using disposables causes so many blow-outs that you end up doing more laundry than if you were using cloth, and (b) when you are using disposables you constantly run out of them and have to rush to the store to buy more. Now, firstly, disposables only cause lots of blow-outs if you are using the wrong size. And the second argument isn't really very logical, because if you really were trying to minimize effort, the rational thing to do would be to use mostly disposables and keep a few cloth diapers on hand for those times when you run out, not to use cloth the whole time. (Also, I am strangely touched to think that in 2012 there are people who apparently don't know of the existence of online ordering and bulk buying. Back when I used sposies exclusively, I never ran out) Don't misunderstand me--if you have decent laundry facilities and are prepared to mix 'n' match with sposies, cloth diapering is usually not an insurmountable amount of extra work, but honestly, it is extra work and it's just silly to claim otherwise. Well... on this particular discussion thread, an unrepentant disposable diaper-using mum turned up and pointed all this out--and almost instantly the whole tone of the discussion changed and suddenly everyone became very hostile towards the idea of doing diapering or anything else "the easy way." For an outsider, this is all highly amusing.)

 I think you get my point. Honestly, I think there really is a strong element of modern tribalism about attachment parenting and other parenting styles--that is to say, the practice of sorting other human beings into "Us" and "Them" based on differences of dialect/vocabulary, dress, appearance, taboos, food, body modification (or absence of same) and dining rules--whether people are prepared to admit this openly or not. Like... c'mon, let's get real, people. Nobody in the books or on the blogs or message boards actually says you can't be classified as an "attachment parenting" mother if you don't do [natural childbirth, babywearing, whatever]--that's a straw man argument. But these media do do a really good job of making it clear that some choices are definitely considered less equal than others, and of making mothers who are unable to succeed at these things feel permanently apologetic and "less-than" as a result... Like those c-section mothers who, every time the subject of their child's birth comes up, feel the need to go into this long, rambling apology about how much they wanted a vaginal delivery, and how hard they tried, and how much they hate having had a surgical birth, and... It's easy to dismiss these women as hooking for compliments or head-pats, but I think their anxieties are quite genuine. They really are insecure about the way they gave birth. It's all a bit sad, considering that for the most part we are talking about mothers who love their children heartily and whose children are surviving and thriving in their care.

Well, I suppose it might be possible to come up with a more thoughtful definition of attachment parenting that is based on being a truly connected and conscientous parent who does what works for their family etc. etc. rather than being based on checklists (although, if you were to do this, you would have to formally detach yourself from Sears, Granju and pretty much the whole AP canon); the trouble is, if you define any parenting style along these terms, it all ends up becoming so vague as to be completely meaningless. I mean, really, how many parents don't consider themselves to be connected and conscientious parents who do things that work for their families? Not too many.

So, if we recoil at the idea of parenting by checklist, wouldn't it make more sense to just do away with the whole idea of defining yourself by a label in the first place? After all,  at the end of the day the parent-child relationship is merely a human relationship, no more and no less--like being a spouse, a sister, a next-door neighbor or an employee. And most of us would think it kind of odd to actually describe ourselves as a [insert adjective] wife or [insert adjective] daughter-in-law or whatever. (I wonder what a self-defining "attachment wife" would be like? "Sorry, girls, can't have a drink after work, I'm an attachment wife. Have you read Jane Smith's book on Attachment Wiving?" For some reason, I'm envisaging a  kind of crunchified Stepford-Wife type with the secret soul of a bunny boiler, who you know is one day going to snap and drown her husband in the bath. But I digress)

And that's enough of that. I'm got that off my chest. And after four posts in a row that go on (and on) about parenting styles/attachment parenting, I think it's time to step away from the fly-blown horse carcass. Tomorrow I am having a day off from work, and I shall be off to Yoyogi Park with Baby Seal to roll around on the grass with her, laughing and having fun, because that's what you do with people with whom you have a loving human relationship.

And my next post will be on the role of solid food before the age of 12 months. Are they just for entertainment? To what extent do they fill an essential nutritional role? Can you nourish a child effectively for the first year on exclusive (or almost exclusive) breastfeeding? (So far, the answer seems to be "It Depends.") Stay tuned.

Why I don't hate Dr. Sears

As anyone involved in parenting politics knows very well, Dr. William Sears is what might be called the grand-daddy of the attachment parenting movement--the guy who came up with the term, set out the central ideas and has a (vast) library of attachment parenting books, all to be found at a bookstore near you. As such, he is a divisive figure. Some people love Dr. Sears. Some really, really hate him. Some of them even write articles on why they hate him, like this rather wonderful piece by Cynthia Eller in Brain, Child magazine, which lays out the familiar charges against Sears and the attachment/natural parenting movement in general: sexism/misogyny, bad science, exhaustion, guilt trips, "noble savage" bullshit and all the rest.

Looking at Eller's article give me food for thought. Do I hate Dr. Sears? I mean really... actually hate him? Hate is a strong word. Would I wish him off the face of the earth? Honestly, it's a good--and complicated--question. Would I prefer to live in a world in which Dr. Sears and others like him had never existed?  For that matter, just what sort of parenting world would we be living in if ol' Bill Sears (and his ilk) hadn't Shown Us The Light with his parenting books and patented ring slings?

Anyone perusing the contents of the posts of my blog would probably guess (correctly) that I am largely sympathetic with the contents of Eller's article. Let's see, there's an article which I say some rather snarky things about baby led weaning, there are a couple of posts on nightweaning (of a baby under 12 months), Why I Like Nursing Covers, a thing where I say that I think that eating your placenta is kind of gross, a post about why I'm continuing to breastfeed my child after 12mo (but in which I also emphasize that I think the arguments made in favor of extended nursing are overblown, and manage to get in a few digs at KellyMom)... you get the picture.

Here's the thing though: If I write a blog post about Why I Like Nursing Covers (or something), it's not particularly because I'm trying to get other people to use them as well... some people use the things, some don't, I honestly don't care either way. It's just that there are already approx. 3,987 breastfeeding-related blogs talking about why you shouldn't use nursing covers (or, at least, being pretty sniffy about them). There aren't too many in which someone says things like "Actually, I like nursing covers! I use one all the time!" And the whole reason I started the damn blog was because I felt like the world of breastfeeding blogs and forums was excessively skewed towards certain viewpoints/mothering styles and that there needed to be a bit more diversity in there (well, that plus I wanted an excuse to practice my HTML skills, but that's a side issue). Also, it's about finding your niche: it's funner to write a blog that is actually saying something a bit different to what the other bloggers are saying.

Now, the funny thing is that if you asked the people who know me in real life about what "kind" of mother I was (especially people from back in the UK), they would probably make some vague comment about the fact that Emilie is a bit "alternative"... because she is still nursing her toddler and she uses washable diapers and all that kind of thing. Because the thing is, in spite of all the bad science and silliness and self-conscious hipster bullshit, there are so many things that originated from attachment parenting/natural family living which have enriched my life and my child's, and made mothering a much more joyful experience. Here are a few.

• Hospitals
  Some of us want to give birth naturally, some of us prefer a nice c-section with lots of lovely drugs (raises hand). But one thing we can all agree on is that lots of really, really positive changes came out of the natural childbirth "movement" which gathered steam from the 1960s or therabouts. Not just concerning the obstetric excesses of the earlier 20th century (routine forceps and episiotomies), but also the compulsory exclusion of fathers from labor wards, rigid four-hour feeding schedules and mandatory rooming-out of newborns. Some Japanese hospitals, by the way, have been slower to catch up with these trends; watching a friend of mine have her own breastfeeding experience nearly shipwrecked by her idiotic hospital a few months back made me realize afresh just how much I had taken for granted many of the things that lactivists talk about, and how thoroughly sensible and humane many (most?) of these ideas actually are.
  
• Nice stuff, like slings
  I love slings. And so does Baby Seal. Babywearing fap is annoying--Baby Bjorns are evil, facing your baby forward will melt their brain, people who don't babywear love their children less than I do, all babies love slings and if your baby doesn't it's because you're Doin It Rong, etc., etc. Slings themselves are not annoying; they are fantastic and that's a fact. They are cute, they are fun, they are practical, they are cuddly. And if it weren't for Dr. Sears (who sorta started it all with his patented Ring Sling) and the rest of the AP/NFL thing, we probably wouldn't have these things to enjoy, and that thought makes me sad. Okay, strictly speaking I suppose it might be possible to wear a baby in a sling even if Dr. Sears and the AP/NFL movement had never existed, since it's not like these parties actually invented slings or anything. But you know what--they have sure done a hell of a lot to popularize them, make them available at ordinary baby stores, create enough of a market that there is a sling type to suit most parents and most babies, and make them common enough that you can wear one without being stared at as you walk down the street--well, unless you live in the middle of Bumf*ck Nowhere-ville, The Mid-West, possibly.
  
• Breastfeeding revival; breastfeeding knowledge; oh, and nursing older babies can be nice too
  In the United States especially, breastfeeding really did fall out of favor in the middle of the 20th century, and a lot of knowledge was lost as a result. The natural parenting movement has played a huge role in creating textual and online resources that can help women to breastfeed. There are some less-than-stellar things about KellyMom (more on KellyMom in another post), but give Kelly her due: her advice about the establishment of breastfeeding in newborn babies--supply/demand, allow lots of time at the breast, check the latch, count diapers--has helped many women to breastfeed who otherwise would never have been able to share this interesting, special connection with their babies. Particularly interesting and special for me because Baby Seal will most likely be my only child (alas, alas), and I relish the closeness. And it makes me so sad to think that if it hadn't been for the example of other extended nursers online and in real life who have helped me see that nursing an older baby or toddler is not something "weird" or exclusively for women in developing countries, I would probably have weaned her by now and be feeling a terrible sense of loss... or perhaps, continuing to breastfeed and feeling dirty or guilty.
  
• Joyless approaches to solid foods
  "Age: Five  months/Week 2/Thursday/11:05:26--Defrost 1.4 cubes of puree (comprising weird combination such as most people would probably choose to eat only in times of wartime food rationing, like lychee with courgette) and mix with 2.7 teaspoons of rice cereal. Feed it to your baby. If baby doesn't want it, play endless games of aeroplane hanger until you finally manage to get it into their mouth. HTH!!" OK, I may have mocked some of the excesses of evangelical BLWers at times, but I think we also have to remember that BLW probably developed in part as a reaction against bossy, guilt-inducing babycare gurus who made it sound as though dire things would happen if you didn't manage to get your child consuming exactly the right types of food in exactly the right amounts at exactly the right time. No, I don't think purees, spoonfeeding or cereals do babies any harm; but God, what an incredibly depressing way to think about food... which, after all, is supposed to be one of life's great pleasures.
  

I could go on.

Every now and again, I have to consciously remind myself that I'm in a privileged position in many ways, because I live in Japan. It's easy for me to roll my eyes when I see some mother online having a little white whine about how everyone thinks she's weird for nursing or using cloth diapers or whatever, and she feels so alone and judged and misunderstood in her parenting choices, and... But then, you know, I'm lucky enough to live in a country where nobody is going to look at you funny for using an Ergo, and nursing into toddlerhood while not exactly "mainstream" is common enough that you are unlikely to get any flack for it, unless you are going about it in a very extreme way (nursing your four-year-old on the subway etc. etc.). Every now and again, however, when I am talking to my own parents back in the UK, there are these weird little moments ("So.... how much longer are you going to nurse...?" "But you're weaning her off now.... right?") which remind me that a lot of what I am doing really wouldn't be considered normal in most parts of the west. So, no, I don't actually hate Dr. Sears. For what it's worth, Eller admits towards the end of her article that she doesn't really hate Dr. Sears either. For all the annoying excesses of the natural parenting/birth movement, we are all better off for living in a world where it exists and has made its mark and provided us with cool stuff, new ideas and above all, choices. It's possible--I think--to enjoy the cool aspects for what they are, without buying into some of the rather dodgy ideas which have got mixed up with them.

Attachment parenting without judgment... a celebrity interview at BFWOBS!

Breastfeeding Without BS's first ever celebrity interview! This week, I shared a cup of coffee and a (vegan) chocolate biscuit with Hollywood actress and mom-of-two Laurel Reznikov, who has also acquired a PhD in neuroscience while somehow finding the time to write a book on attachment parenting. She's here to tell us about works for her as a mother. Welcome to the blog, Laurel!

Laurel: Thank you, Emilie. It's a pleasure to be here.

BFWOBS: So, this book of yours is all about attachment parenting--your favored parenting style. Tell me a bit about that.

Laurel: Well, I don't really regard attachment parenting as a parenting style, Emilie--it's about following the biological norm for human societies and primates... the way people have parented for 99% of our species' existance. There are a thousand "baby books" out there telling parents what to do. That isn't what my book is about, because what I believe is that fundamentally, attachment parenting is about following your instincts as a parent. Specifically, things which are popular with attachment parents include extended breastfeeding, babywearing, co-sleeping and elimination communication.

BFWOBS: Sounds good, Laurel. I'm really happy to think that more parents will learn about how using a sling, for example, can make their lives easier, and it's nice to see someone challenging widely myths about things like extended nursing and early potty training. Although, for me personally, co-sleeping is something I could never have done; I don't sleep well with people touching me, so I suspect me and my baby would have been waking each other up all night long...

Laurel: Well, Emilie.. some of us (mentioning no names!) have made the decision to give up a good night's sleep because they know--deep down inside--that this is what's best for their child. So you've not convinced me yet that you can't co-sleep!

BFWOBS: Okay, Laurel, I'll try harder in future. But attachment parenting, as we all know, is not just about the baby years; so called "positive discipline," as you call it, can be done with children of any age. Could you talk a little about that?

Laurel: Well, positive discipline is not about permissive parenting or letting children run the show--it's a philosophy that is based on seeing children as partners in the family relationship and helping them to understand why they should do certain things and not others--and of course, no physical violence.

BFWOBS: You know, that all sounds very sensible, Laurel.

Laurel: But positive discipline goes deeper than that, Emilie--it's about choosing to see children's behavior as being fundamentally good. Even when they scream and whine and create havoc in the supermarket, we choose to see that not as misbehavior, but as a way of expressing a true need--a need that the parent has failed to meet.

BFWOBS: Okay, I see.

Laurel: Of course, I would like to emphasize that this isn't about making parents feel guilty; it's about educating them to understand that when your child appears to misbehave, it's basically your fault.

BFWOBF: So, coming to specifics, what are the things about positive discipline that look different?

Laurel: Well, for a start, we avoid using the word "No" to our children.

BFWOBS: Wow, so you never say "No" at all?

Laurel: Well, almost never. We try to save the "Nos" for really important things, like when one of our kids is being offered a slice of non-vegan birthday cake at a party. Don't worry though, we always bring a wholewheat organic bran muffin to the party for him to have instead!

BFWOBS: (laughs) Oh, wait--I see you're being serious. Okay, well, so what are some other rules?

Laurel: Well, we don't reward or punish, or require children to share things if they don't want to. We don't say "Mine" or "Yours" either; we say "Mommy's" or "Johnny's" instead. We say things like "Listening is important so that we can communicate well and stay safe at the park" or "The prickly words you are using are for grownups" (if they swear)...

BFWOBS: I have to say I'd feel a bit forced and artificial, having to remember all these rules every time I interact with my child...

Laurel: Well, it's true that positive discipline is all about cerebral, conscious parenting, and it's pretty difficult for everyone to master--even me! It's been a slow, painful learning process. Whole books have been written on this subject. That's why I advise people to study a few of these books, and take a parenting class to improve their skills. By taking classes, studying your parenting books carefully, applying all the rules they describe and painstaking analyzing each word you say to your child based on complex psychological theories, you can learn how to follow your intuitive instincts and parent the way that comes naturally.

BFWOBS: So... it's essentially about just following our intuition?

Laurel: Exactly! You've basically summed up the true meaning of attachment parenting--it really is just about following your instincts! Well... unless of course your instincts tell you to punish your child when they misbehave or something like that, in which case you should obviously suppress your instincts as hard as you can.

BFWOBS: Thanks, Laurel, it's all much clearer now. Now, I understand that you and your husband don't use any kind of childcare other than each other--not even a babysitter?

Laurel: We have chosen to look after our children ourselves with no help from babysitters, daycare or even extended family--nothing remarkable, simply taking care of our own children exclusively within the  nuclear family, just as human societies have done for millennia. My husband is currently the primary parent while I do my acting.

Of course, I don't mean that leaving your children with babysitters or daycare is bad. It's just that being a full-time parent lets you experience all the true joys of parenting, like getting to hold them when they cry and see their joy when they build something awesome with LEGO--things which part-time parents who use babysitters or daycare never get to experience. Nothing can make watching a video of your child's first steps match the experience of watching it actually happen.

BFWOBS: It's sad but true, Laurel; Baby Seal spends a few hours a day with a local daycare nursery or my mother-in-law, and to be honest, I can't remember the last time I saw her playing with a toy. But couldn't your children just as easily build a LEGO wotsit or take their first steps when they are with your husband as they could if they were left with a babysitter?

Laurel: Sorry, Emilie? Didn't quite catch that.

BFWOBS: Ah, nothing. Go on.

Laurel: We're not better than other people (well, except that we obviously are, but...).  I'm certainly not telling other people how to balance work and family, because that's a very individual decision. I'm not in the business of telling people how to parent; I'm just quietly doing what works for my family--this is something I've emphasized again and again, at every book signing and media interview that I've done for my attachment parenting book so far. I didn't write this book because I wanted to make other people start parenting the way I do...

BFWOBS: ...I think there's no danger of that, Laurel...

Laurel: ... and in my book you'll see several examples of different families making things work for them, through ways and means that are extremely different and varied--apart from the fact that in all three cases, they make it work without making use of daycare, nannies, babysitters or extended family. No wonder I like them so much!

BFWOBS: So... you're not against families using daycare?

Laurel: Well, Emilie, the way I see it, it's not about different parenting styles being right or wrong. It's about different families placing priorities on differnt things and making different choices--which is absolutely great! And here's how it works: some families make choices that are about devoting our... sorry, their lives right now to being the best parents they can be. Other people make choices that prioritize materialism and stuff and expensive clothes and expensive cars and a house with a hefty mortgage and traveling a lot without their children, which is why they both work and use daycare or nannies. And I'm totally fine with that.

The fact that I am a Hollywood actress is neither here nor there--I have committed, heart and soul, to being there for them, and this is a decision I would follow through no matter how much or little money I made; a decision I would honor even if it meant that I had to live in a studio apartment, or stop shopping in specialty markets...

BFWOBS: You would actually consider living in a studio apartment..?? Stop it, Laurel, you're scaring me! Okay, so let's talk medical matters. I know you've talked about trying home remedies for minor problems, and how important it is to avoid unnecessary use of antibiotics, which I'm sure nobody could disagree with. How about vaccines, though? Are your children vaccinated?

Laurel: We are a non-vaccinating family, Emilie. However, I would like to make one thing quite clear; I am in no way anti-vaccine, and I make no claims regarding other individuals' decisions. My stance on vaccines is simply this: that parents need to educate themselves on this topic so that they can come to an informed choice that feels right for them.

BFWOBS: Thanks for clarifying, Laurel! And could you share your favorite go-to resources on the subject?

Laurel: Well, the Holistic Moms Network (HMN)--of which I am celebrity spokesmama, by the way--is a great place to start. I believe some of the members of its advisory board, like Dr. Sherri Tenpenny and Dr. Lauren Feder, may have had a thing or two to say about vaccines in the past.

But honestly, Emilie--this whole vaccine issue is about parents making the right decision for their families. Now, let me explain what I mean. For my family, the right decision is not to vaccinate. For many, many other families, the right decision is for the kids to get their shots on schedule--especially if these kids, let's say, sit next to my kids on the bus or share the drinking fountain with them at the park. And I really hope that this kind of healthy diversity of choices will continue, in line with individual families' lifestyles and comfort levels. Because Emilie, I really and truly mean it when I say that I wouldn't want to live in a community where everyone made the same decisions on vaccination as I have! (laughs)

BFWOBS: Oh, I'm sure you do mean that, Laurel. By the way, I would like to reassure anyone reading this that Laurel's point about the drinking fountain was of course purely hypothetical.

Laurel: That's right, Emilie. As I said, we don't require sharing in our family either.

BFWOBS: Of course, non-vaccination isn't the only unusual medical choice that you're a fan of; I understand that you and the Holistic Moms Network are also very keen on acupuncture, herbalism, infant chiro and homeopathy?

Laurel: Well, they work for us, Emilie. I think you have only to look at the results; I had a cold last winter, and once I took the Boiron capsules it couldn't have been more than three days before my symptoms started to subside.

BFWOBS: Fascinating. I wish all people with science PhDs were this open-minded--my own doctor has been terribly dismissive of my attempts to heal my various ailments with leeches and mercury salts, in spite of all I've told him about those infallible instincts of mine, and about how these things were used for hundreds of years. I'm just a bit curious, Laurel, but have any of your ex-colleagues at the University of California Los Angeles (UCLA) or your sponsor organization Texas Instruments had anything to say about your unusual medical ideas?

Laurel: (laughs) Well, to be honest, Emilie, what I've found is that in the world of 21st century mass media, really you can get away with saying pretty much what you like, as long as you always add on the friendly bit about how "It works for my family" or "It's a choice that feels right to me" or "Trust your instincts" or "Some people believe..."! The media nowadays is very enlightened in that respect, I find.

BFWOBS: That's really heartening to hear, Laurel. Now, any closing words about parenting in general?

Laurel: I think there are so many misunderstandings about attachment parenting, Emilie--that it's about doing things a certain way, about breastfeeding, about co-sleeping, about slings. But attachment parenting is not about checklists. It's about making choices that work for your family. Now, what works for my family and others like us are choices that are biologically natural, which are the best for our children and which are about being the best parents we can be, and which lead to stable, loving families who cherish the earth they live on. What works for other families may be choices which are about prioritizing stuff and materialism, which deny our true nature as primates, which take the easy way out and which leave children alone with their feelings and fail to meet their needs. And I'm so not judging that.

I'm not saying these are inferior choices. I'm just saying that they're not the right choices for me and other attachment parenting families... because, well, obviously we know better than to make choices like that. I'm not judging these other parents. I'm just explaining that their parenting sucks.

BFWOBS: Thanks for sharing that with us, Laurel. It's refreshing to talk about attachment parenting with someone who not only is completely non-judgmental, but actually takes the time to tell us that she isn't judging us, in spite of our substandard parenting! Thanks for coming along today.

Laurel: Any time, Emilie.

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.

Cow's milk and the Law of the Lowest Common Denominator

Happy first birthday Baby Seal! First birthday, first ever chocolate cake (with homemade ganache). I appreciated your cake-eating enthusiasm.

As we all know, birthdays are magic and the first birthday is the most magic of all, because at the moment the clock strikes midnight on the day baby turns 12 calendar months old, something strange happens. In the upside-down carnival of the first birthday, all sorts of things which were previously "bad" become "good" and vice versa. Things that were fine to do before suddenly become A Problem. And everything baby does must be interpreted in a different light. Twelve months is officially the age at which solid food stops being "for fun," and becomes an essential nutrition source. Up until that fated birthday, baby's needs were the same as baby's wants; now baby has lost her innocence and becomes capable of manipulation. Pacifiers, which were fine yesterday, are now a Bad Thing. Bottles too (time to drink from a cup). If you are like a lot of westerners, one year old is the age at which breastmilk suddenly loses all nutritional benefit (exactly how is never explained) and the act of breastfeeding becomes something unseemly and not far from Child As Sex Toy. If you are a certain type of lactivist, 12 months is the point at which you will grudgingly tolerate another woman weaning without actually making snarky remarks (possibly).

And then there's cow's milk. There is a lot of confusion on parenting boards about cow's milk, formula and breastmilk...the when and the how and the why (and that's even before you bring in bottles vs. cups and other factors). The American Association of Pediatrics states that "Whole cow's milk is considered an inappropriate option for infants, which FDA defines as babies not more than 12 months old. According to the AAP, cow's milk contains very little iron and the small amount present is poorly absorbed into the body. Starting an infant on cow's milk too early can result in iron-deficiency anemia, particularly if the baby is not given an iron supplement or foods with iron." Formula or breastmilk should be the only milk given to the baby. Meanwhile, this National Health Service (NHS) resource advises us that "Babies shouldn’t drink cow’s milk before 12 months," but adds that "you can add cow’s milk to food before 12 months" and also recommends "full fat, low sugar dairy products like cheese, yoghurt, fromage frais, or custard."

Given this, us ordinary mothers on the discussion boards could be forgiven for being a bit confused. "My health visitor said it was fine to give DS cottage cheese or yogurt. I'm confused; they say no cow's milk before 12 months... why are yogurt and cheese so different?" Someone else will then chime in to speculate that it might be because yogurt and cheese are "cultured" foods which alters the proteins and sugars contained therein. To which someone else will point out that they have been mixing small amounts of cow's milk with their baby's cereal for the last month--with the health visitor's blessing. Surely if cow's milk has these evil iron-destroying powers, they are not going to magically disappear just because you've added a bit of Ready Brek, no?

I think the key to resolving this is to understand that this is an example of a common phenomenon in the world of official childrearing advice: The Law of the Lowest Common Denominator. Basically, what are the AAP and NHS worried about? Well, not about the perfectly healthy children of mothers who are conscientious enough to be on a childrearing-related discussion board in the first place. They worry about the children of parents who are young, poor and a bit clueless. Who might be tempted one day, when looking into the refrigerator, to think "Hey, we've got milk here. In a carton, all ready to drink. I know, why don't we just fill Suzy's bottles up with this stuff instead of fiddling about with that expensive formula bollocks?" Bad idea. Cow's milk and goat's milk, unlike formula/breastmilk, are not a complete diet, and babies fed in this way are at real risk of dehydration, kidney damage and anemia. Even older babies risk iron deficiency if cow's milk starts making up a substantial proportion of their diet. On the other hand.... a bit of cow's milk, for an older baby? No problem. It's essentially no different to any other complementary food. Can you give an older baby apple as a complementary food? Sure. Should you start giving them cupfuls of pureed apple all day long instead of formula/breastmilk? Of course not.

Trouble is, official organizations know perfectly well that if they start wheezing out long-winded explanations about core foods versus complementary foods and iron and how it's okay to give this much milk but not more than this... unless you are giving other dairy products as well, in which case you should probably give less milk... and it depends on how quickly they take to solids, and.... well, people's eyes are going to start glazing over (especially the kind of parents who are most likely to ignore sensible pediatric advice in the first place). On the other hand, if you make a crude blanket rule of "No cow's milk as a drink before 12 months. A bit with cereal is fine, and a bit of yogurt and cheese is fine," then people are more likely to remember the advice and adhere to it.

The same rule governs a lot of other childrearing advice. I remember (pre-baby) pursing my lips disapprovingly when I heard my sister had acquired a baby walker--didn't she know all the official guidelines said they were Bad For Babies? But (as my father pointed out to me) the reason baby walkers have a bad press is because some idiots leave babies in them for hours or use them as a excuse for not supervising, resulting in serious accidents. Used for short periods under supervision like other toys, there is nothing terrible about them. I think a lot of arguing on message boards and within mothers' groups could probably be avoided if the Law of the Lowest Common Denominator was more widely understood.

Anyway, I have been breaking the official recommendations by leaving Baby Seal with a cup of cow's milk plus water and solids whenever I go out in the evening (about once a week) since the age of 10 months. I hate pumping and have the smallest freezer known to man; while I have nothing against formula, there was a recall on Japanese formula at the end of last year due to the radiation scare, and frankly it's put me off a bit. With her only eight weeks to go until her first birthday, it hardly seemed worth dragging British formula all the way home on the plane. Also, I have heard too many stories of babies who were kept away from cow's milk completely during the first year, and then refused it vehemently when their parents tried to introduce it later on. So cow's milk it is. Now all I need to do is to get her drinking it from an open cup without throwing it everywhere. We can but hope.