Minor chaos of a grad school drop-out, parenting (and cooking for) two small boys, loving one bean-counting man, dealing with hemophilia, mammoth allergies and trying to find my own feet. They're here. Somewhere.
Saturday, September 22, 2007
Sophie Currier: following the story
Her appeal is to be heard at 9 am on Tuesday: see here for details.
Opinions about her continue to be mixed, except on her blog which has become a dumping ground for vicious comments. She closed the blog, making it accessible by invitation only. Meanwhile, here are some other perspectives:
DollyMix - Natalie blames Currier's situation on poor gadgetry, which is only slightly missing the point. Her conclusion, " You never stop being a mum but unless you have a kid that's asking for "Bitty" when he's in his twenties, you do stop breastfeeding and you do reduce your amount of feeds with the introduction of solids ...." is a bit impenetrable. Whazzat? And how does that relate to a 4 month old infant and nursing mother dyad?
Breastfeeding Symbol - MamaBear is patient, if frustrated. "It is discriminatory (and hypocritical, considering the institution which this test is for) to not allow pumping breaks. Full stop." Well, considering that I wrote a nearly parallel post here, I'm disinclined to argue. Our stats even matched. Too cute!
Economics for What Ales You: ignoring the breastfeeding issue, the blogger asks: would you want someone with dyslexia/ADHD as a doc? Um, thanks. I certainly wouldn't want you on the job...your analytical skills seem a touch unsteady.
Sexing the Cherry - Zahra is flat out furious: "The decision comes down to this: don't feed your child or don't become a doctor." She argues that women can have it all - after all, men can! I'm dubious (men have different post-partum biochemistry than we do), but I appreciate the vote of support.
CMCCurry - is scratching his head a bit. He asks, "Why not put off having a kid until you get your PhD?" Oh, where to start, where to start.
And Notes of an Anesthesioboist is sincere, thoughtful and has the most mature commentators I've seen yet. On this subject, that is.
I think the word I'm looking for here is sigh. Currier is too human, too imperfect to be a good spokesperson. Her ADHD and dyslexia make her the target for people who say that she is a whiner and always looking for accomodations. It's impossible to say if this is true or not. Women who've been there and survived are writing in saying that their experience was that they didn't need X minutes to pump, they didn't pump during the exam - and their experience is surely definitive. It's not. In this case, as in the LD, the neurochemistry, the history of mastitis - the devil (or should I say plugged duct?) is in the details.
And then there are the medical students, writing crass things about Currier needing to keep her legs crossed, or to use her 'funbags' [sic] for better purposes. Lovely.
What do I think? I think that if this was a purely medical decision and it was made by an educated medical professional, Currier would be given the time she needs to pump. But it's not being done that way. Instead, this is a legal matter in the hands of an under-educated legal system (where breastfeeding is concerned) whose legislature does not support nursing mothers. See Carolyn Mahoney (NY) for exceptions. And frustrations.
I think I wish Currier well. She's fighting a good fight, and I can only hope she's doing it for the right and legitimate reasons. I think she might be, which relieves me - because if she's not, then she's only proving some nasty-minded folks true, and we've now got a judge telling nursing mothers to stay home. Just what we needed.
If there's a revolution coming, bringing respect for the woman and mother, well, it's taking its sweet time getting here...
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coming up: nothing to do with milk ducts!
Instead, a review of the early days at kindergarten, and a new gluten-free (vegan, nut-free, etc, etc, etc) bread that actually came out of the machine at 4 inches high. Holy moly.
Thursday, September 20, 2007
Sophie Currier: didn't we just do this post?
Let the crunchiness roll on: a local judge decided that a nursing mother can wait until she's done nursing before taking the 9 hr medical boards. (Article is here, courtesy of the Boston Globe. Currier blogs about it here. )Sophie Currier asked for extra time in order to pump milk (she's nursing a 4 month old baby) during her test, and the judge said the following:
"The plaintiff may take the test and pass, notwithstanding what she considers to be unfavorable conditions," Brady wrote. "The plaintiff may delay the test, which is offered numerous times during the year, until she has finished her breast-feeding and the need to express milk."
This is impressive.
The judge is flat out missing the point here: "unfavorable conditions?" try instead, 'risk of infection' and 'painful engorgement.' The best part of this quote is, of course, "may delay the test...until she has finished her breast-feeding and the need to express milk." Hmm. Well, let's see: Currier has a residency waiting for her this fall, assuming she passes the boards. So I guess the judge is giving her, oh, a month? to finish nursing - unless, of course, he's saying that if she needs to nurse (and thus to express), she shouldn't be taking the boards OR the residency.
I smell an appeal. That judge came within a hair of effectively telling this woman to lose a major career opportunity, because she's a nursing mother. Oh, dearie me, I think I must now suppress an urge to cackle, evilly, because this cannot, should not end well for Judge Patrick Brady.
What's really rather sad is this: a judge, who is presumably an educated, thoughtful person, has proven just how little is known and understood about breastfeeding. (The folks over at the TSA should be feeling a little self-congratulatory just about now. They get it - Brady doesn't.) The comentators over at Currier's blog show just where lack of understanding turns into defensiveness and just plain ugliness. Currier's description of her situation is angry, a bit overdone, but should not dent the validity of the matter at hand. And yet - women unite? Not over this issue.
But wait! It gets sadder:
"The national board thinks that breastfeeding is a fine thing to do but it also thinks that having a standardized examination for licensure is also really important," said board spokesperson Ken Cotton.
Okay, so let's walk through this slowly. The question was as to whether Currian's situation warranted extra time. The judge, who does not understand either the ramifications of not pumping regularly or does not understand the nature of breastfeeding in regards to the length of the nursing relationship - or both, says there's no reason to accomodate her. The board administering the test says that she doesn't fall under the ADA as a nursing mother, so standards are standards.
But, this is a board testing Currian's right to be a doctor. And as a doctor, she would dispense advice such as, oh, lemme see, this:
" The AAP identifies breastfeeding as the ideal method of feeding and nurturing infants and recognizes breastfeeding as primary in achieving optimal infant and child health, growth, and development. ... It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired."
And specifically on this subject (courtesy of the AP), "Dr. Ruth Lawrence, who chairs the American Academy of Pediatrics' breast-feeding section, called the medical examining board's position too rigid."
Or, what about those irresponsible folks at the World Health Organization, who say things like:
" A recent review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond."
Hmm. The exam is designed to test the medical competency of folk such as...these? Or these? Heaven help me if I ever get one of them as a doc - with the possible exception of the level-headed Baby Bop. Oh, dearie me. The women are defensive and the men are bitter, and none of these fine figures of would-be doctors are willing to stop being self-absorbed long enough to actually listen to the patient. Good grief.
Time to pack it in, ladies. The law, the test-givers - and the test-takers - have spoken. Who needs doctors, anyway? Especially the lactating ones.
Monday, September 17, 2007
Boobies, bogeymen and babies: the unabashedly crunchy post
Yes, I have a strong opinion about childbirth, and especially about c-sections and VBACs. I think there are too many of the first and too little of the second, and I'm a suspicious soul generally when it comes to medical consumerism. I know a few doctors, some professionally and some personally (the wife of one of my bleaders, for one), whom I'd trust absolutely if they performed a section. But the vast majority of ob/gyns? The statistics do not speak well of the profession as a group, I'm afraid. And I'm not so sure they speak well of the consumers, either.
So. I read this post at doulicia, and immediately sent a happy, excited email to the Grandmere, a person of wisdom and concern in regards to these matters. Wonders of natural childbirth in New Jersey? Rates of c-sections far below the national average? And in, I repeat, New Jersey??? The state has never struck me as a particular bastion of medical heretics. The Grandmere was as puzzled as I, as doulicia herself, and made some enquiries.
Here is a response from a trustworthy source working in the area (trustworthy by my standards, so caveat bleader). Please note that when she talks about her clinic patients, she's talking about those at her workplace, which is not Muhlenberg:
Muhlenberg is a small hospital with NO NICU or pediatric department. Babies are taken care of by pediatric hospitalists, as there are no attendings. Clientele is poor, black or Hispanic. I'm sure all high risk patients are shipped out to St. Peter's in New Brunswick. Any middle class family in this catchment area probably delivers at JFK in nearby Edison or goes to Somerset or Overlook.
More likely they have fewer C-sections because they do not have 24-hour anesthesia coverage and are not so worried about poor women and illegal immigrants suing for poor outcome. The high national C-section rate, I believe, is the result of MD fears of lawsuits if the baby is born with a hangnail, much less CP or infection or...
Our middle class/upper-middle class/wealthy mothers WANT C-sections. Labor is yucky and it HURTS! They surely want to breastfeed, but also expect to sleep through the night. (We do LOTS of education before and after birth on the importance of exclusive breastfeeding, for mom and baby, but...)
Our best breastfeeding moms are the clinic patients, almost all Hispanic. (Our black patients are usually middle class). They keep them in their beds with them, and breastfeed, breastfeed, breastfeed.
It makes me inexpressibly sad that WHO recommended standards for medical care are available to 1. the over-educated and crunchy (like me), who advocate furiously and can afford a doula and - this bit is crucial - are self-absorbed enough to trust ourselves over the wisdom of the medical standard, and
2. the lower class, who have no choices. This is frankly wrong.
This analyst offers a lot to consider, and I'm afraid I agree with most of it. I think too many people have sections because of poor labor support, I think they have poor labor support because they don't realize that they probably need more than a hospital (and a husband/partner) can give. And as a culture, we're afraid of pain. We don't like it, we refuse to accept it, and we turn those who can tolerate some into martyrs and heroes.
Should we accept pain when there is a choice? Well, I suspect it depends on the baggage for that choice. Should we accept that this hospital produces such amazing stats under these circumstances? Again, consider the baggage. American medicine just hasn't hit its stride where laboring mothers are concerned, and apparently the pendulum still swings too far one way or another, spending much too little time in the middle.
I'd like to try an experiment: let's pick a hospital with good medical backup - a good NICU, round the clock anasthesia, enough ORs, sensible doctors, etc. Offer a neutral prep class to mothers, one that talks about healthy and good pain, and tells you how to work with it, as well as giving you the options. (I remember my hospital tour with #2 - the nurse described the typical patient as flat on her back, plus epidural and catheter. If that's what you present as normal, then you get the stats to match it.) Then, equip each laboring mum with a doula - a good one, a sensible, noncrystal-waving one, and get the medical trappings of birth to a bare minimum. Check the laboring woman at the start and late in the game, unless she's presenting with complications. Reduce the pressure on her, increase the support, and see what happens.
I bet that we'd get many fewer sections, and many happy mums - and fewer happy lawyers holding hefty paychecks.
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Let's take the granola all the way to the cereal bowl, shall we? To cap off this post, here's this:
In response to my link about nursing in public, Mother in Israel pointed me to her own blog, and this http://mominisrael.blogspot.com/2007/09/nursing-in-negev-or-nursing-in-toilet.html post. It makes me tired and grumpy - what's the problem with a woman nursing among women? During my mother's shiva time, I nursed the Toddles in front of all sorts of people, but I watched the Grandmere's cues carefully. Sensitivity and respect - it was a strategy that worked just fine.
You grouchy types should just hush up - you're drowning out all of the quiet live and let live types, you are overriding all of the quiet, sympathetic smiles, the nostalgic glances. Your irritation and strident criticism is just too loud for a nursing mum, already anxious about tzniut [modesty] and kavod ha'makom [respect for the place] to hear the community's support when she nurses her child at services.
Yes, some communities have a nursing room - and some even locate it just off the women's section of the communal prayer room. (I have private, irritated thoughts for communities who relegate me to hot little rooms a floor or two away from the davening [prayer].) And others don't want to see a nursing mum, let alone her baby. But others, like my shul, debate whether it's okay to ask a woman to toss a shawl over her shoulder while nursing her baby in the women's section during davening. And they'll assign another, sympathetic nursing mum like me to do it.
The problem with the folks who hiss at small children who wriggle, or at mothers who nurse (even in the nursing room, as M.i.I's post shows), is that they resonate more loudly in the psyche than the folks who don't hiss. And for someone new to the community, the hissers can cut off newbie's chance to actually learn about the community, to see whether the shul is a hot small room (A), an adjacent (B) or a stay home (C) nursing community.
So I put it to you: two days of Rosh Hashana, with the extended service of the High Holy Days. Followed immediately by shabbat, and the shabbat davening. That's a whole lot of shul. And, if you are a nursing mum, it's a whole lot of staying home (if you have community C), or feeling anxious (A) or mostly accepted (B). Or frankly included.
Hmm. High Holy Days, when we examine our conduct towards others - even more so than our conduct towards the Big Guy Upstairs. Hmm. Yup, now would definitely be the right time to hiss at a poor mum, juggling her baby and her siddur [prayerbook]. Oh, yes - tactically sound, folks. Tactically sound.
As a considered, mature response, I have decided that the hissers among us should be dubbed 'boobies,' for boobies they are and boobies they object to. Silly boobies. Sit down and focus on your prayers, and not on a mother attending to her child.
Tuesday, July 31, 2007
time keepers and villages
Maybe it would make waking up fun. For him, anyway.
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For all of you lactating mums out there, past or present, biological or otherwise, here's to you:
Thursday, March 29, 2007
darkness and scary death (not mine)
Mama (absorbed): Mm, hm.
child: And I didn't make darkness or scary death.
Mama: Mm, hm - wha?
You've got my attention, kid.
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Attention-getting has been happening all over the place. For example, consider these gems:
* The Eldest has been accepted to the local pluralist school. This is an immense source of delight to me, and I went dancing around the house, post-phone call from the Director of Pluralist Admissions.
We'd love to offer [the Eldest] a spot in our incoming kindergarten class.
Oh!
I cannot tell you how sad we were not to be able to offer him a spot initially, he's such a taking child, [my brain tunes out here, waiting for the conversational pause in which I can screech YES YES YESSSS]...think he will thrive in our environment.
YESWEDLOVETOACCEPTTHANKYOU.
Oh - ah - well, I'll drop the packet in the mail to you tomorrow
happy Mama war dance
Yippee! Yippee! You are going to be pluralized!
The Eldest looks up from his book, an expression of mild alarm lurking around his ears - afraid to come out, probably. Finally, cautiously, he says, yay?
*The Toddles has been throwing food. Make no mistake, the kid loves to eat, and is even happily acquiring a bit of pudge. Pudginess in my offspring being hitherto unknown, I am happily pointing it out to strangers who are foolish enough to admire the child. Yup! He's adorable. And do you see the little double chin? See? There? And he's got a little extra on the thighs too - it's just fabulous. Seeing me reach for the Toddles pants, the stranger starts quietly edging away, remembering something else urgent that needs to be done in, oh, Stoughton.
Food throwing, however, drives me stark raving batty. I start off with absolutely no perspective (but kids fling food. They just do.) or patience with behavior of the I'm bored/that's yucky/ *fling* variety, leaving my response to range between grrr and a shriek. There is, of course, a perfectly rational explanation for this: when I bust my butt making food for these children, it's especially infuriating to see them disdain both my efforts and the results.
No, strike that, the glory of my children is that they expect food to show up, just like they expect clean clothes and clean tushies/scrotums. Given this, my efforts mean absolutely diddly to them. So it's the food itself they are disdaining, not me.
Nonetheless, it drives me bananas.
To illustrate, here are some pics of tonight's dinner, a make it yourself affair in which I supplied minestrone and condiments (cubed tofu, cumin carrots, cucumber - essentially, the dregs of the pre-Passover fridge).
On the left, you have my bowl of soup. On the right, you have the Toddles, masterfully reworking his soup into a mushy mass, in preperation for flinging it at his brother. Lovely.
The Eldest hands a piece of pasta to the Toddles, having thoughtfully cut it up into cute rings.
Gang-gu [thank you], says the Toddles, shoveling it in.
The Eldest smiles sweetly at his sibling and tells him, you're welcome.
I swear they do it to throw me off-balance.
Umm, fine.
My opinion is that breast exams are like pregnancy: they are uncomfortable and poke and prod you in sensitive spots, painfully, and ramp up until you are practically begging for a needle biopsy/labor and delivery, just to get it all over and done.
I was invited to wear a glamorous, gaping garment over my skirt, and to sit, holding it closed in a room full of anxious (and some weeping) women, also trying to close the damned things. The collective levels of stress and distress in the room were astronomic.
From this room, one was taken to a procedure room, poked, prodded and squashed flat, then returned to the waiting room of terrorized subjects. Then, if you are particularly lucky (I was), you get called back for more photos (why? what did they see? I thought the films of my other, non-lumpy breast were a nice touch - especially with the dramatically circled bits) and more squishing.
Then you wait. And wait some more. All of this, mind you, without benefit of caffeine or alternate hot beverage, in respect for the women who are past the point where they get prodding and squishing, and are moving on to the incising and stitching.
Finally, you may get to meet the radiologist. Or, if you are a favorite with the staff, you may get to be prodded and ultrasounded and generally covered in warm jelly - and then, in that moment of especial glory, you get to meet the radiologist.
So, what did they tell you? The Man, having wheeled around, entertained and fed the Toddles during what was supposed to be a quick appointment, could be forgiven for asking what seems a rather reasonable question. After all, surely I had been told something.
In fact, by the time I met the radiologist, jelly and all, I was so limp an emotional rag as to not register more than this: I have asymmetrical breasts with varying types of tissue, no doubt compounded by continuing to breastfeed the Toddles (d'you plan to stop soon? pleaded a desperate tech), all of which made it hard to tell what was going on. I think - in fact, I'm fairly certain - that the bottom line is that I'm fine. But I'm asking for the radiologist's report, just in case.
I explained this to the Man, who shrugged. Have you ever noticed lumpiness in my breasts? He shook his head. No complaints here, he told me. Well, then. We'll just chalk it up to being (and you so knew I was going to do this)...imperfect.
Sunday, March 25, 2007
lump, bump, bump
I don't know where to begin.
First, I found a new blog: http://labornurse.blogspot.com/ No, wait, that's me writing about something else. Okay, focusfocusfocusfocus. Maybe I'll go take a shower.
focus, ya silly woman
Right. Jumping in, then: a month and a half ago, I had my annual physical. My doctor found a lump in my breast, and told me to come back in a couple of weeks, so that she could check it. As a nursing mum, I shrugged this off. I have full milk ducts, I have empty ones, I have all sorts of wee solid bits in my breast, inflating and deflating.
Except, of course, that on Friday this lumpy bit was still inflated, solid and in the same spot. If it were a plugged duct it would hurt, if it were an infected duct, it would really hurt...best case scenario, it's a cyst. Worst case scenario, it's cancer.
There, I said it.
My brain is running like a diarrhitic child. I'm googling in search of wisdom, and coming up with this:
there are approximately three million women in the US with breast cancer, one million of them are undiagnosed (getbcfacts.com).
From birth to age 39, one woman in 231 will get breast cancer. Hm.
The risk of breast cancer increases if a woman has a first-degree relative (mother, sister, or daughter) who had breast or ovarian cancer. (not me) But also, 80% of women who get breast cancer have no known family history of the disease. (argh)
Risk may also be higher in women who have taken oral contraceptives or hormone replacement therapy (HRT). (me - being on the pill is a good way to control bleeding in symptomatic carriers of the hemophilia gene) Except that breastcancer.org says: Many research studies show no association between birth control pills and an increased risk of breast cancer. However, one study that combined the results of many different studies did show an association between birth control pills and a very small increase in risk. The study also showed that this slight increase in risk decreased over time. (ah. scratches head.)
Conclusion? frightened rabbit brain skittering around inside my skull, with a small voice providing counterpoint by muttering, 'Dynasty. This is another freakin' episode of Dynasty, enacted by a cast of the Imperfects.'
Translation? There is so much medical drama in our life, the one kid is allergic to this, the other anaphylaxes to that, the first is getting physical therapy for a painful, immobilizing bleed, clotting this, oozing that, blah blah blah scarlet fever. Somehow, this feels like more of the same. Must be more of the same. (mental image: me, shrugging this off. C'mon, shoulders. One, two, three, shrug. Ah, the hell with it.)
So, part of me is having a hard time taking this seriously. It's shrugging this off (shrug shrug shrug), having read the script and knowing that yes, there is a next episode coming, same time, same channel. The other part is rabbitting away, muttering about the ultrasound scheduled for later this week, remembering my friend Malka, remembering Elka. Frankly, between these two bits of me, I'm fed up. I think I shall stage a revolt and create Part Number Three.
That part can be the bit that figures out Pesach (Passover). And possibly has a shower.
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Note: today is a two-fer-the-price-of-one blogging day. Here is the first post of the morn, this one with frogs in it.
Monday, November 06, 2006
serenades and other adventures
It's back. The Toddles is humming to himself at the breast, singing himself to sleep as he nurses. It's so gentle, so relaxing, that even post-biting, nursing has regained its role as a bubble of peace. And I am just a touch tickled that I'm being serenaded, even if accidentally!
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gDiaper: day two
had our first poop today, as well as our first leakage. The leakage was last night, possibly from an imperfectly fitted diaper, more likely from an overflow courtesy of the nightime marathon nursing champ. Next time, we'll have the extra flushable insert, as the gDiapers folks recommend.
Poop a la flush was easy, although I forgot to tear the insert on both sides, as the gDiaper folks recommend. With a lot of pee, the insert is heavy, and one tear allows the absorbent core to just fall out. Easy. With poop, it's a bit trickier.
Two things, however, remain to be resolved: first, the gDiaper folks are right - I did need more than the two little pants in the start-up kit. (If they know that, then why are there only two in the start-up?) Second, what to do with the diaper wipes from the poopy diaper? Seems to me that I still need my diaper pail, which is a real disappointment.
Tomorrow: considering buying another pair of little pants and a set of liners. Will we really commit to this experiment?
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NAET: session one
Today was the energy balancing, meridian first session of NAET. I have a thin book to read to understand it further, but from the Eldest's perspective, this was easy. After all, there were 'no needles,' he said.
During the procedure, he focussed furiously, cooperating to an extent that actually caused a backlash (I have a theory that the kid has only so much cooperation in him at one time, and if you use it up, you need to brace yourself until the next batch kicks in). We had to maintain skin contact while the practitioner did 'strength testing,' then she did some energy management on me (lots of swirling of hands), and finally simulated stresses on the spine, having me do some stressed breathing (holding a breath, blowing it out, panting). All with the Eldest (or the toddles) in skin to skin contact with me.
Intriguing, and certainly harmless. The boys were perfectly happy with the experience, and I'm content to continue. Oddly, I walked away far more energized than I would normally be at 5pm, when I typically crash a bit. Was it residue from the NAET, or was it relief at finally trying something new? Either way, I was as effective a parent as I normally am...when I am buzzing from a giant cup of coffee, loaded with sugar.
Hm.
Monday, October 30, 2006
dancing on the edge
Yup, the kid bites. Not fiercely, not angrily, but meditatively, at the end of a nursing/snuggle, or sleepily, holding on to his Comfort Thing, or even playfully, knowing that when he does this the mama yelps and glares most amusingly.
But then the mama takes away the Comfort Thing, which is not amusing.
So, for the past week, the toddles and I have been practicing dismounts. He is learning that biting means a sharp, unhappy ending to our snuggle, and is increasingly annoyed by the finger near his mouth, held ready to slide protectively between his jaws. He knows what that finger means, and he's latching on, sucking briefly, then carefully sliding off the breast, warily eyeing the Finger of Doom.
Temporarily, then, a sense of tension and urgency has entered our nursing times, flickering through us, each of us wary of the other, but trying to relax back into our old ease. This, too, will pass. But it reminds me of the early days of nursing, this thrumming tension.
Nursing a child in the first month is work. It's teaching the child how to suckle, it's relearning the process yourself. Eventually, you look up to realize that it's comfort, it's relaxing, even nurturing. But first, there's work.
And need. The newborn's need for the breast is unlike that of a four or five month old. Secure in the knowledge that the Comfort Thing(s) is in there, the older baby will pat or pull at mama's shirt, while the newborn is all fierce need. Watching my boys' lunge for the breast used to remind me of my college fencing teacher. You commit to the moment, she said, you let everything else fall away and see only the target, the motion...and you go.
Breastfeeding the boys has never been wholly simple for me. My list of motivations is long. I nurse the Toddles now, aware that his limited diet is worryingly unbalanced, and that my milk is both protecting his system and balancing his nutritional intake. I nursed the Eldest, aware of the sanctuary I was providing, and cheered on by our nurses, who could find a tiny vein with ease while he nursed - and the nursing would nearly eliminate the pain of the needle. He got a lot of infusions of his clotting proteins while nursing and napping at the breast, and sometimes didn't even wake up.
That one's scientifically proven, folks. If you are nursing a baby, nurse them during innoculations and all invasive procedures - it reduces the physical experience of pain for the baby, and makes the whole thing easier for everybody. Except, possibly, for stubborn nurses who insist on poking and prodding a child on the examining table. But in a question of child's pain vs. medical convenience, well. How else?
But how different is that from the mother who stops into day care on her lunch break, to nurse the child? Forget the nutritional element, the biochemical need, the philosophy. She's lactating her way to a stronger connection with her child, using her breasts to pave the way to a moment of bonding, in the midst of an institution that is temporarily offering to replace her. Can you do that with a bottle? Sure, but your body won't force you to.
No, nursing is never simple. It's as tangled as everything else: gentle, fierce, nurturing, and occasionally sharp. And loving, even when you begrudge the 3am feeding, the 5.15 am demand for a cuddle with extras. But what sticks in my mind is the lactation consultant at our children's hospital, who when faced with a terrified me and a tiny Eldest, dripping in looping, messy tubes, simply swept them all aside, making a small space.
For, well, us.
Thursday, October 12, 2006
rabbinic bra-gazing, part II
A reader of your blog might misunderstand the pumping issue on shabbas. (Shabbas = Jewish sabbath)
So here are a few comments FYI:
Generally speaking you can't use an electriic or hand held or even hand express on shabbas.
Electricity is one thing. The malacha ('malacha' means work, which is forbidden on the sabbath) is squeezing (apart from the electricity issue). It can only be done on shabbas if a mother's health is threatened ,especially soon after delivery when she is still considered to be in danger. Later she is not considered to be in Sakanah. (Sakanah = danger)
She can't choose to pump even with a shabbas clock just because of the inconvenience of leaving her guests at the shabbas table to nurse.
The issue of throwing out the milk is to avoid getting hanaah (pleasure) from a labor done on shabbas. I and some rabbis argue that the infant needs the milk so it should be given to him/her. However, I don't think that would hold if there is lots of other breast milk available or if this is a a healthy toddler, for example. So, the health of the baby has to be considered despite the local culture that make a medical equivalent of formula with breast milk. The science indicates that there are risks of formula, especially to the newborn.
It is important to distinguish between newborn or an at risk (allergic family history) baby from another in this discussion.
:)
Right, ho then. Okay, so in the instance being described by the aforementioned rabbinic person, the child is indeed an infant. However, how far from delivery does the mother need to be for her not to be in 'sakanah?' A woman can get mastitis from not pumping, should she pump, for months after delivery - according to my limited understanding. And, yes, while it's one thing to say that an infant's health requires breastmilk, it's another to say that you won't defrost the frozen pumped milk because you want to give them fresh. Or you won't give them formula because you have milk.
Unless, of course, as this commentator points out, your child has allergies, in which case your milk is miles and away safer than formula, thanks to the cushioning immunoglobulins in the breastmilk, easing the passage of potential allergens through the kid's system. (Without these, the immune system could be triggered, creating a response to the foreign proteins, and leaving you with a right PIA.) And unless your child is medically fragile - particularly immunologically speaking - in which case the antibodies in the breastmilk are supporting the immune system. And unless - oh, heavens me, I could go on, but the bottom line is that there are any number of exceptions, and I don't know nearly enough instances of rabbis respecting those exceptions and ruling in favor of protecting the nursing mother-baby relationship.
But I do hope that they are exist. Maybe rabbis are quietly, secretly, ruling to protect the mother, protect the child, and Rabbi Irksome is a lone cog, wailing in the wilderness? Somehow, I'm skeptical. I suspect my skepticism is because these rulings, if they are being made, are quiet. I've never met another young mother who knew that you could use an electric breastpump on shabbat, let alone another who knew that there are circumstances in which you can use the pumped milk for the baby.
Then again, I rarely meet other mothers who don't believe that breastfeeding is supposed to hurt. Or who manage to extract adequate help and support from the sea of well-meaning and improperly educated people available. But that is, perhaps, another story.
Either way, this fellow isn't talking halacha (Judaic law). As I said to Precision Blogger, he's talking marital counseling with the voice of rabbinic authority. Which, in its own way, is worse. You can argue legalistically with a legal ruling. You can't extract the authority from someone who is flapping his mouth...but not overtly exercising his position as a rabbinic figure.
Irritating but true. And there I leave it.
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P.S. and in case you guys think the docs have got it right and the rabbis have it wrong, check this out: the latest word on c-sections. Thanks to Doulicia for the write-up. Sigh. We have all so very much to learn, a thought that I find alternately comforting and infuriating.
Tuesday, October 10, 2006
get that rabbi out of my bra
Naturally, someone sent me a link to this beliefnet article
Sigh. Okay, with a leetle spin, you can see that he’s making a good point: nourish the marriage as well as the baby. Yes, that’s important. But he’s also offering a line to the jealous husband (more on that jealousy in a moment), to say that the marriage trumps the baby’s need to breastfeed.
What irks me is that this wolf is wearing halachik (Judaic law) clothing. It is a common misconception among religious Jewish women that either, a. you cannot use an electric breastpump on the Sabbath/jewish holidays or b. if you do use one, you must ‘pump and dump,’ tossing out the milk that you produce, instead of feeding it to the baby. The reasoning behind a. is that using electricity is forbidden on the Sabbath, but b. it’s okay to use electricity because it’s a matter of the mother’s health to pump, as unemptied breasts become engorged breasts, and there is a risk of mastitis (shudder).
But what about c.? C. is the part where we say that the mother should not only pump on the Sabbath with the electric pump, but feed the milk to the baby, because the baby’s health and well-being depend on it, too. Some rabbis have ruled that, based on ‘pikuach nefesh,’ or the preservation of life, that c. is acceptable. More so, where pikuach nefesh is concerned, c. is actually necessary - it's (wait for it) the law. So ruling c. means making a big statement about the significance of breastmilk, and don’t kid yourself – religion’s stance here says a lot about the social positioning of the rabbi in question. The first guy to really give c. credibility was a major rabbinic figure – anyone lesser ruling c. ran the risk of being called a hippie radical. I know of one major rabbinic figure in NY who is considering the halachik witness protection plan because an infuriated lactation consultant lives (and worships) in his area. He has all but admitted to c., but won’t rule publicly – thus the ire.
Okay, so is the marriage more important than the preservation of life? I refer you now to the question of jealousy. And this delightful response to the rabbinic busybody by Armin Brott, an author whose book I happily bought for the partner when we were expecting the Eldest. The father’s adjustment to the baby is a tough one, make no mistake, especially when the mother is breastfeeding. He was sidelined during the wedding, during the pregnancy he was support staff and local punching bag, and now he’s what, the water boy? Yippee ki yi yay. So yes, this will make a man southernly limp – and give him a sense that he’s being badly done by.
If, of course, he’s unprepared to grow up and be a parent. Because, of course, as the mother has long since discovered pre-baby-arrival, babies are ruthless about extracting their due. Get kicked in the liver enough by your unborn child and you come to realize that it’s not all about you, you are just the chauffeur. For fathers, I suspect that the physical reality of having to dramatically shift priorities and foci comes later, and most harshly when the baby is out and all she wants to do is….sleep?
A brief pause here, while we review the significance of sleep. I refer you to this blatant exhibition of greed, with specific reference to item three. Sleep has trumped food in my house, and I've walked away from mouthwatering meals to...dream about them. Oh, ye gods and little diapers, what I wouldn't do for five consecutive hours. No, for four.
Given the immaturity and selfishness of this hypothetical male attitude (and I do respect a good bit of selfishness, don’t get me wrong, even grumping about said selfishness – it’s when you take it out on others that it irks me), I really, really regret this next part: because, of course, the rabbi is right. Marriages do need to be nourished, and when there’s a new baby is when they are most likely to be starved, as well as most likely to be fragile.
What’s that irritating Johnson and Johnson ad? Babies change everything? Okay, they do. Ruthlessly. Let’s summon the echo of my man here and talk numbers: 50% of marriages end in divorce. With kids, the stakes rise, you have less time to communicate, greater need of support – this is the great flaw in having children right off the bat after you pop a ring on each other, because your support systems aren’t fully developed, you haven’t got strong habits of nurturing and caring for each other, solid communication strategies – all of which is going to be hit by Tsunami Baby, so if it’s not strong, it’s toast. Strong just gives you good foundations on which to rebuilt, anyway.
With a baby with a major chronic medical issue, the numbers are worse: 70% of those marriages end in divorce, post-diagnosis. If the stakes go up with a baby, they are high beyond conception with a baby with medical needs. So, okay, here it is: if the marriage survives, it’s because of the foundations you laid before the baby was born, healthy or complex. Especially not because some whiner imposed his needs between the mother and child – not only is that not a great choice, medically speaking, it’s pure idiocy where the lifespan of the marriage is concerned. Trust me that as grudges go, He Made Me Stop Nursing So He Could Get Laid – it’s a doozy. I’d rather send him down the hall with a box of tissues and a magazine, but when you wrap that whine up in religious excuse, who can argue with you?
Apparently not Reb BusyBody's poor wife. Jeez.
Sex is dead in the American bedroom, they say, and oh no! We must resurrect it, apparently even at the cost of the relationship. Oh, no, wait – it was the relationship that we were trying to protect all along. Oh, no, wait – it was the American family. Phooey.
I can only speak for myself here, but post-baby sex? With the man who supported me, the man who stepped up to parent a fragile, complicated child? Who backed me to the hilt through a second pregnancy and VBAC? (I can feel the MIL cringing, so I’ll be a good girl here.) Oh, it’s good. It’s better than it’s ever been, and ooh yes I'll stay awake for that.
Mneh. Words are cheap, navel-gazing words the cheapest of all. I think I’ll just go off and prove it, instead. Again. Heh.
Thursday, September 21, 2006
all sorts of shapes and sizes
We are driving in the car, listening to Joseph and the Amazing Technicolor Dreamcoat. This is a favorite in our house, and we even have a video tape of the production, with Donny Osmond as Joseph. The Eldest loves it, loves watching the story explode into light and color and music. Thus, the CD playing in my car.
Suddenly, This is the part where they start taking off his clothes, I am informed. Wha? I say, cleverly.
This is the part where they take off his clothes so that he can go to jail, the Eldest explains.
Not all of his clothes, I protestweakly, not really sure why I'm protesting at all. He has the wrapping skirt thing that he wears in jail.
Yes, all of his clothes, the Eldest informs me, sternly. And (giggles) he has nai-nais!
Nai-nai is our family code for breasts, a quasi-discreet choice for those of us who choose to nurse our children longer than society really wants to think about. Of course, how discreet the code can be, when combined with a toddler determinedly lifting one's shirt...well, that's a post for another day.
I consider Donny Osmond. Do you mean nipples, perhaps? I ask the Eldest.
Nope. He has nai-nais like you! They come out of his chest, and the Eldest makes curving, cupping motions to show me. To my delight, the Eldest seems to be wholly aware of the gender-bending he's describing. It occurs to me that he could, if he chose, characterize this as male, but that he's tickled by the idea of it being transgressively female. He loves the idea of rules being bent - and this is no different.
Yes, yes he does, I agree. But no milk...
The Eldest, giggling till, stops and looks at me, surprised and disappointed in the Joseph who can't make milk.
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Years ago, when I was a new mother, I spent a lot of time in toy stores, trying to buy the perfect toy, the toy that would make all things right, make all of us happy. It was a difficult time, when we were new to the Eldest's pair of diagnoses, and I was grasping at anything to tell me how to parent, show me how to bring happiness back to our lives, to keep it there.
I do not miss those days.
One day, I was in a store looking at a shape sorter. I must have this, I thought. How else will my baby learn to sort shapes? And then, deep in my cloud of mindless commercialism, I paused. This? This is the crucial and must-not-miss thing that will teach my kid this lesson? What the hell happened to me? And I walked away.
Four years later, I was standing in Babies R Us, trying to figure out what to do with some store credit. I bought diapers, wipes, a set of binkies (pacifiers) and finally, found myself staring at the same shape sorter. Unlike the rest of the toys, this had no batteries, didn't promise to increase the babes' IQ and oh, what the hell. Kismet?
To my delight, he had no interest in it for months. Instead the Eldest used it, lining up the shapes, sorting them by colors, by shapes, doing disappearing tricks so that three by three by three became two by two by two, then one... It's magic! he proclaimed. Eventually, the babes rescued the toy, and learned the joys of taking in and putting back. Each time, though, by yanking off the sorting top to get easy access.
I sat down with him. Together, we pushed circles through the holes in the lid, then squares and finally stars. Each time, he yanked off the cover to see the block, lying in the container. Insert, check, insert, check. Finally, I turned it over to him. He picked up a circle, pushed it in. Then he picked up a triangle, tried to fit it in, failed and considered the matter. He looked at the cover and yanked it off. See? Easier this way. I grinned and let him be.
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Here is the cake I made for the babes' birthday dinner. It was splendid, and I'll be making it again tonight, for Rosh Hashana.
Many-Bowled Cranberry Cake (Four, to be Precise)
serves 6-8
Cranberries:
2 oz soft butter/margarine
1/2 c. sugar
1 Tb grated/zested orange peel
10 oz cranberries, fresh or frozen. Chopped is nice.
2 Tb orange juice concentrate
2 Tb water
beat butter and sugar together, mix in orange peel. Spread mixture over the bottom of a greased cake pan (not springform - this will leak). Sprinkle cranberries on top. Mix juice and water, then pour over cranberries.
Cake:
1 c. gluten free baking flour blend (your choice)
1 tsp egg replacer
1/2 tsp baking powder
1/4 tsp xanthan gum
1/8 tsp salt
1 stick unsalted butter/margarine
1/2 c sugar
2 eggs, or 2 Tb ground flaxseed, plus 1/2 c water, boiled in microwave and let cool
1/2 tsp vanilla
Preheat oven to 350 degrees.
Mix flour blend, egg replacer, baking pwder, xanthan gum and salt. In a separate bowl, cream butter and sugar. Add eggs to butter-sugar mix, mix until smooth. Add vanilla, then slowly add dry ingredients (be prepared - the flour will puff up and make a bit of a mess unless you add it slowly).
Spread batter over cranberries.
Bake for 25 minutes, checking with a toothpick. (My cranberries were still slightly frozen when I popped the cake in, mine took about 40 minutes to bake.) Let cake sit for 5 minutes before turning it out onto a serving plate.
Recipe from Living Without, fall 2006 issue. This recipe is or is potentially: dairy-free, egg-free, gluten-free, nut-free, etc. And yet, somehow it is delicious!