Extended Breastfeeding, Milk Production, and Feelings About Nursing

Yesterday (Thanksgiving), I nursed my daughter and batted around ideas for my weekly Phthursday Philosophy article. Of course, being that it was Thanksgiving, the most obvious choice was to do a “What I’m Thankful For” post. In the end, though, something else got into my head. As I looked into my nursing W’s face, it occurred to me that she was doing the thing for which she was most thankful. W’s less than a year old, so nursing is still a major source of her daily calories. It’s also meaningful to her in so many other ways; it’s comfort, and mama, and love…all rolled into one. I’m a big advocate of breastfeeding (for me, I mean; others make their own choices, and I’m a big advocate of picking what works best for you) and W and I are nowhere near weaning.

Having said that, though, I was reading La Leche League’s excellent book The Womanly Art of Breastfeeding the other day; specifically, I was perusing the section on nursing a toddler. The book mentioned that in many cases, older toddlers and preschoolers who are still nursing may not be getting any milk, or only minimal milk, and yet they still enjoy nursing. This was a revelation to me; I had assumed that once mama’s milk dried up, the nursling would wean. In fact, I assumed that in general it was the weaning of the nursling that caused milk to dry up.

I’m in an interesting place, intellectually and emotionally speaking, as a result of this revelation. Before I had W, I figured I’d wean at a year (whether she was ready or not). I had the “If she’s old enough to ask for it, she’s too old to have it” notion firmly embedded in my mind. The more I read about nursing, however, the more I changed my mind. I don’t necessarily think a baby living in an industrialized, developed nation needs to breastfeed longer than a year (the scientific evidence on this topic is simply quite lacking, as Alice at Science of Mom addresses), but I certainly think that continued nursing is emotionally comforting, if not emotionally and physically beneficial (though I hesitate to use the word “beneficial,” since again, there’s no good scientific evidence) to the older nursling.

Nursing — that is to say, breastfeeding — is one thing, though; simply suckling, or dry-nursing, is quite another. I have not dealt emotionally with how I feel about continuing to nurse W if and when my milk disappears. There are those who would tell me that nursing continues to be beneficial even if the milk is gone. My question, though, is how do they know? There’s no research to support “extended” nursing for nutritional OR emotional reasons in the developed world. In the undeveloped world — where studies on extended breastfeeding are more numerous and come down conclusively on the side of nursing well into toddlerhood, if not beyond — the studies deal with mother-child pairs in which the mother is still lactating. Scientifically, dry-nursing gets into uncharted waters. Milk isn’t the only “chemical” involved in nursing, so it’s reasonable to speculate that even dry-nursing could affect hormone levels, neurochemicals, and so forth in both mother and baby, conferring benefits. But this is pure speculation. Is there anything more to dry-nursing than simply baby using mama as a human pacifier?

My mind is buzzing. What do I do? It’s not a decision I feel I have to make based upon science; I’m fine with doing something scientifically unsupported if it makes both me and W happier. From an evolutionary perspective, it seems a cave-mama would knock a cave-baby away from the breast if mama’s milk had dried. Because I try to parent in a way that both feels integral and is true to my evolutionary roots, should I do the same? If W is still enjoying nursing a year or more from now, though, and if I find it a useful parenting tool for inducing naps, calming tantrums, or soothing skinned knees, will I really want to give it up? Emotionally, will it feel right — will it feel integral — to continue to nurse even if I’m barely lactating?

Have you struggled with when and how to end your nursing relationship? What influenced your decision?

 

References:

Wiessinger et al. The Womanly Art of Breastfeeding. 2010.

Cord Blood Banking — Is It Worth The Money?

You see the ads everywhere — in magazines for expectant mothers, in printed pamphlets at the obstetrician’s office — and they evoke the wonder of life and perfection of a new baby. They’re carefully designed to rev up the protective instinct of any woman with a reproductive inclination and a pulse. The private cord blood banks cast a wide net, appealing to the “conventional” parenting set with glossy photos of a cherubic toddler contemplating her belly button in magazines like Parents, while “hippies” get reeled in by the touchy-feely Dr. Sears, who touts the benefits of cord blood banking in more “alternative” publications (I really hate these labeling words). In the end, though, does cord cord blood banking do any more than separate a set of new parents from a big chunk of money? What are the potential benefits of cord blood banking?

Private banks make cord blood banking sound crucial by telling parents that cord blood contains stem cells. Very few people really know what stem cells are, but most people know (from popular media sources) that they’re important and potentially lifesaving. Unfortunately, this particular combination — knowing that something has medical potential without really understanding what the heck it is — is a dangerous one, and one that opens the door to predatory marketing. Knowledge is power, however, so here we go. A stem cell is a semi-undetermined body cell. Clear as mud, right? Ok, let’s try again. A stem cell has the potential to develop into multiple types of body cells. Here’s how this works. When a sperm and an egg join to make a fertilized egg, that egg cell is totipotent, which means that as it divides to make new cells, it can make all the cell types in a baby and in the extraembryonic tissues (the placenta and whatnot). As the fertilized egg starts to divide and form a cell ball, a variety of determination events occur. These help to determine which cells will become which tissue types. Once a cell becomes determined, it loses the potential to become other tissue types. For instance, a cell that has been determined to be part of the ectoderm (a layer of cells in a very early embryo) can become skin or brain or nerve, but can’t become, say, part of the pancreas. Loss of potency (the ability to become other types of cells) doesn’t involve loss of DNA (genetic material); all body cells have the same complete set of DNA. However, determined cells lose their ability to express (which basically means use) DNA that isn’t related to their function. In any case, the process of determination is progressive. After becoming part of the ectoderm (to stick with that example), a cell will go on to become even further determined (perhaps it becomes a brain cell, and can now no longer become skin), and will eventually become differentiated, which means it starts to behave the way it has been determined to be. A fully developed fetus is made up mostly of fully differentiated cells, plus a few stem cells scattered here and there throughout the body (such as hematopoietic stem cells — HSCs — which are found in the bone marrow and which give rise to blood cells throughout life). The reason stem cells are important medically is that they’re currently used to treat a number of conditions. For instance, the bone marrow transplants that can help to treat leukemia are stem cell-based treatments, because bone marrow contains HSCs. The reason stem cells are exciting medically is that researchers ANTICIPATE that they may one day be able to use them to treat a large number of diseases and conditions. Injuries to the spinal cord, Parkinson’s disease, and many types of cancer are on the docket as potential diseases that stem cells might someday contribute to treating. Notice all those qualifying words, like “might”? Because very little of this has actually happened yet. Currently, the list of diseases treated with stem cells is very short, and includes certain blood diseases, a few (mostly blood) cancers, and a few genetic disorders. There’s a complete list at the International Cord Blood Society’s website.

Cord blood contains HSCs, so it’s a source of stem cells. Currently, these cells can be used to do basically what bone marrow-derived HSCs can do, without the need to harvest bone marrow. There are some other stem cells in cord blood as well, and scientists might one day be able to do amazing and lifesaving things with them, but not yet. And that’s the first important point when it comes to deciding whether you should bank your child’s cord blood: the currently usable stem cells in the blood are basically the same as the stem cells in bone marrow. Which means that you’re not really losing anything if you get rid of them; all you’re losing is an easy source, because once the cord blood is gone, getting to those HSCs requires going into the bone marrow. But the private cord blood bank ads lead you to believe that cord blood cells are somehow unique, and this is simply not true (or at least, the currently usable cord blood cells aren’t unique). There are some advantages to using cord blood as a source of HSCs over bone marrow; these include that bone marrow harvesting is a surgical procedure, marrow donation requires more perfect matching of human leukocyte antigens (HLA, which is similar to blood type), and marrow donation increases the risk of transferring a viral infection, explains the National Cord Blood Program. In the end, though, the point remains that cord blood can’t do anything (currently) that marrow can’t.

A second important point is that because the cord blood stem cells are basically the same as the bone marrow stem cells, if your child has a blood-related or genetic disease (including the vast majority of the diseases for which cord blood cells are CURRENTLY used), it’s very, very, VERY unlike you’ll be able to treat it with their own banked blood. The odds that your child will someday be able to use their own banked blood are hard to calculate, because they depend heavily on the future of medical research, which can’t accurately be assessed. However, people who calculate these sorts of things have estimated the odds at anywhere between 1 in 1000 and 1 in 200,000 (Johnson). Note that those are the odds that your child will be able to use their own blood if they need it. The odds that they’ll even need the blood in the first place is a separate calculation. The bottom line is that your child probably won’t ever need their own cord blood, and even if they do, they probably won’t be able to use it.

Another selling point used by the private cord blood banks is that the stem cells in the blood could be of use to a sibling. This is potentially true; a type-matched sibling is the best bone marrow donor, so a type-matched sibling would also be the best source of HSCs from cord blood. However, there’s only a 25% chance that a child’s sibling will be an HLA match (Karanes et al). So if you banked child 1’s blood, it’s not a sure bet that child 2 would be able to use it, should he or she need it. Oh, and if child 1 were a match for child 2, and child 2 needed the stem cells, you could likely use child 1’s bone marrow as a source. Granted, this is much more invasive than using child 1’s cord blood, but it’s certainly possible.

This is not to say that cord blood is junk; in fact, it has valuable research and medical potential. First and foremost, it’s a source of HSCs for non-family members with diseases like leukemia. There are public banks to which you can donate your baby’s cord blood (when you do this, you give up the rights to the blood, but as we’ve already established, it’s not likely to be useful to you). The blood then becomes available to non-family, and increases the likelihood that someone will be able to find an appropriate donor and get the treatment they need. Donating your baby’s cord blood to a public bank is a lovely thing to do, but not all hospitals currently allow for it. You can learn about donating cord blood through the National Marrow Donor Program. Donated cord blood is also used in research, which helps to increase the likelihood of one day realizing cord blood’s full potential.

One thing to consider with regard to cord blood banking — both private and public/donated — is that it’s more likely to be bankable and usable if there’s plenty of it, but guaranteeing lots of cord blood requires clamping the umbilical cord early. This potentially decreases the amount of the new baby’s blood that actually makes it into the baby after delivery. Overzealous cord blood banking presents an increased risk of anemia to the newborn (Fox et al).

In the end, the American Academy of Pediatrics does not support the practice of private cord blood banking (AAP Statement). In fact, they’re quite against it, stating in essence that the private cord blood banks are taking advantage of families at an emotionally vulnerable time. The AAP further notes that some physicians may profit from advising patients to use private cord blood banks (the bank may pay them to encourage it). Finally, private banking is simply expensive. Typically, the collection fee for a private bank is on the order of $2000, and it costs about $150 a year to maintain the blood. Because the practice isn’t regulated, there’s no telling whether privately-banked blood is actually collected or stored in such a way as to make it usable IF (and that’s a big if) your family ever needs it.

 

Science Bottom Line:* There’s really no justification for banking your child’s cord blood for private use under most circumstances. The exception to this is if you either: a) have a child with one of the diseases for which HSC transplant is a treatment (and the second child is a good HLA match), or; b) have a family history of or genetic predisposition to one of those diseases. Again, remember that the odds of any given child being able to use his/her own cord blood are infinitesimally small, but child 2’s blood might be able to help child 1, or vice versa. There are free programs to allow banking of a child’s cord blood in the case of a diagnosed sibling with a cord blood-treatable condition, such as The Sibling Connection through the Children’s Hospital Oakland Research Institute.

 

What do you think about cord blood banking?

 

References:

American Academy of Pediatrics Section on Hematology/Oncology. Cord blood banking for potential future transplantation. Pediatrics. 2007 Jan;119(1):165-70.

Fox et al. Umbilical cord blood collection: do patients really understand? J Perinat Med. 2007;35(4):314-21.

Johnson, F. Placental blood transplantation and autologous banking–caveat emptor. J Pediatr Hematol Oncol. 1997 May-Jun;19(3):183-6.

Karanes et al. Unrelated donor stem cell transplantation: the role of the National Marrow Donor Program. Oncology (Williston Park). 2003 Aug;17(8):1036-8, 1043-4, 1164-7.

NIH Stem Cells and Diseases. Accessed 22 Nov 2011.

Unusual Developmental Milestones — Gestation Day

Last Sunday, my little girl hit a major milestone. As of November 13, she has been outside my body for longer than she was inside it. We know this for certain, because my numbers-obsessed husband calculated (down to the hour) how long she spent inside me. The man loves numbers. Especially prime numbers. When I went into labor the morning of February 17 (a prime number), he was ecstatic. By 9 pm, we were JUST heading to the hospital, and he was growing concerned. By midnight, he was despondent, since it looked as though the baby would be born on the 18th (a non-prime number, for those of you who don’t keep track of that sort of thing). As the 18th wore on, he became hopeful again (19 is a prime number), but his hopes were dashed when I approached full dilation at 4 pm. I believe the words, “Can you hold it in?” actually crossed his lips. I won’t repeat the words that, 36 hours into labor, crossed mine in response.

Photo courtesy of Scott Lefler, http://www.scottlefler.com, (c) 2010

Anyway, this gestation-length milestone strikes me as somehow more meaningful than her upcoming first birthday. After all, her birthday will mean nothing more than that she’s been hanging out on planet Earth for 150 million miles worth of flight through space; that she’s traveled once around the Sun. That’s a pretty arbitrary thing to celebrate, if you think about it. What doesn’t feel arbitrary — what actually feels bittersweet and poignant — are the increasing signs that she’s growing up, and growing independent. These are the milestones that have really hit me hard, and they’re not ones for which Hallmark produces a greeting:

-The moment they clamped her umbilical cord. Granted, I was pretty distracted at the time, but in retrospect, I mist up when I think of this.

-The moment her belly button stump fell off. I was happy to see the little sucker go (from a pragmatic standpoint, because it was starting to smell) but it was the last physical remnant of the cord that had connected us for so long. Since the stump is long gone, I now fixate on her belly button, and give it lots of kisses.

-The moment she took her first bite of food. Prior to that moment (which occurred back in August), she’d been nourished entirely by my body, and by the milk it made, meaning that every cell in her little body was made up of molecules that had passed to her through me. She was still entirely made from me until she took a bite of food, and while I was excited to see her enjoy the new sensation, I have to admit I was also sad.

So add to all of the above her “Gestation Day” — if that’s what you want to call it — that passed us by on the 13th of this month. She’s now officially more a citizen of the planet than a citizen of my body, and I’m excited for her to get to know this beautiful world, but I am also sad that out here, she’ll have to learn about things like pain, and loss, and wickedness. Inside mama, there was warmth, and always-togetherness, and comfort. Then again, out here there are trees, and sunshine. There are mountains to climb up (and ski down!). There are streams to splash in and sunsets to behold. There are spring leaves to smell, and rain to dance in. Inside mama, she floated contentedly, never for want of anything. Out here, yes, sometimes she will weep with despair and explode with rage, and for that I am sorrowful. But out here, she will also quiver with excitement, flush from joy, bask in love. Out here, there is wonder, there is discovery, there is quite simply so much life to live.

Happy Gestation Day, my darling W, and may you always delight in exploring the world outside mama that is now, most certainly, your home.

 

What generally unsung milestones have you celebrated?

 

 

Glowing Green Milk

Mammograms aren’t fun for a variety of reasons. Perhaps the most obvious is that they involve smashing the breasts between two plates so that they resemble — as much as is possible for semi-spherical body parts — pancakes. I have a mammogram coming up shortly, and to be honest, I’m less concerned about the former, and am more bothered by the fact that I’m old enough to be on my second mammogram. Apparently, however, doctors don’t like it when mammograms converge with lactation in space-time. For instance, the health provider who prescribed my upcoming mammogram told me, “You may want to pump and dump afterward, because of the radiation.” When I actually called to schedule the procedure, I was told that they would be doing an ultrasound instead, because I was lactating and they didn’t want to “expose my milk to the radiation.”

Now, I teach chemistry, so I’m well aware of how common are fears and misconceptions about radiation. I have to admit, however, that I didn’t think doctors’ offices would share (or propagate) those fears and misconceptions. In any case, I thought it would be worth addressing why mammograms (and MRIs, and x-rays) won’t make your milk glow green (as cool as that would be), and why you don’t need to pump and dump if you have to have one of these procedures. (Incidentally, Kellymom has lots of information on what is and what is not safe during lactation.)

We tend to think of anything called “radiation” as being bad, and generally associate exposure to radiation with things like cancer, Chernobyl, and Spiderman. Thankfully, most radiation can’t produce cancer, and unfortunately, no radiation has the ability to produce Spiderman. “Radiation” is really just a term for radiant energy, which is even more technically referred to as electromagnetic radiation, or EMR. EMR encompasses many different types of phenomena that we don’t necessarily think of as related to one another. These include — but are not limited to — x-rays, visible light, and radio waves. Without getting too deep into the physics, all EMR has a frequency, and the frequency of the EMR determines the type of radiation. It’s possible to draw a limited analogy to sound here; the pitch of a sound is a function of its frequency, so frequency determines the “type” of sound. The analogy between sound and EMR doesn’t take us far, however, and the important point here is that high-frequency EMR has high energy.

From Wikipedia, Philip Ronan

The reason all this matters is that some EMR can interact with molecules, and the way EMR interacts with a molecule depends upon the type of EMR. Think of a molecule as being made up of particles (called atoms) connected by springs (bonds). The springs (bonds) naturally bend and stretch, and very high energy EMR can “overstretch” the springs and make them break, like this:

From Hendrickson, K. "Chemistry In The World" 2010.

 

Break the bonds, and you destroy the function of the molecule. If the molecule that gets broken is, say, DNA — your genetic material — then bad things happen, including disease, cancer, aging, and so forth. The only types of EMR with enough energy to break bonds in molecules are UV light, x-rays, and gamma rays (collectively called “ionizing radiation”). These are the only types of EMR that, consequently, can cause cancer and so forth (note that despite their bad reputation in some circles, microwaves have completely insufficient energy to cause cancer). Ok, so x-rays can cause cancer, as can mammograms (which rely upon x-rays). MRIs can’t, since they don’t use ionizing radiation, and rely instead upon the behavior of atoms in a magnetic field.

If x-rays fall into the category of ionizing radiation, why shouldn’t we worry about the milk that gets shot full of x-rays? The answer to this is simply that very, VERY few phenomena can actually make things radioactive. X-rays, and even gamma rays (which come from nuclear reactions and can cause a variety of cancers, radiation poisoning, and so forth) can’t make the things exposed to them radioactive. If you were exposed to nuclear fallout (like from the Chernobyl disaster), you could temporarily “become radioactive,” but only because nuclear fallout includes bombardment with subatomic particles called neutrons (among other things). If you have certain types of radioactive material introduced into your body, you can emit radiation due to the presence of the radioactive material. However, it is impossible for you (or your fluids) to become radioactive as a result of x-ray exposure. The only thing the x-rays could theoretically do to your milk would be to break down some of the proteins and other molecules (though they’re unlikely to, because the dose is so small), and furthermore, this wouldn’t affect the quality — or the safety — of the milk.

I Googled lactation and mammography, because I wanted to know what it was (assuming most medical professionals know there’s no risk of radioactive milk from a mammogram) that would cause a health practitioner to put off a mammogram on a lactating woman (which, according to Google, happens quite often). It turns out that practitioners worry about the “goo-factor.” Breast milk is a bodily fluid, and apparently the staff of imaging clinics is concerned that it will, well, squirt on things. Not that it does, generally speaking…but regardless, this appears to be a major motivating factor with regard to lactating women and the medical profession’s desire to keep them, and their squirting milk, away from those hard-to-clean mammography machines.

 

Science Bottom Line:* There is no danger to your milk if you have to have a mammogram or x-ray while you’re lactating. There is, as always, some danger to you personally any time you’re exposed to ionizing radiation, which is why it’s always important to weigh the risks against the benefits when you need to have imaging done. You don’t need to pump and dump unless you’re engorged.

 

What medical procedures have you wondered (or worried) about during lactation?

 


Are Megadoses of Vitamins Healthy and Safe?

Photo by Ragesos

Megavitamin therapy is the use of very large doses of vitamins to prevent or treat illness or some symptom thereof. While not the first major proponent of megavitamin therapy, Linus Pauling is perhaps the best known; he advocated using huge doses of vitamin C (many grams per day) to treat and prevent disease. As a chemist, I have enormous respect for Pauling. His publication record is impressive, and his work in quantum chemistry helped lay the foundation of that field. Oh, and he was part of the team that helped discover the structure of DNA, which was kind of the Holy Grail of chemistry. As much as I hold him in esteem as a chemist, however, I have to wonder what business he thought he had dabbling in nutrition and medicine; he had training in neither of those fields. In any case, there was and is no evidence to support any of Pauling’s theories regarding megadoses of vitamin C. Neither is there evidence to support use of other vitamins in megadoses. The popularity of megavitamins is a “more is better” fallacy. Here’s the science bottom line: we need vitamins in small amounts. They serve a variety of critical roles in the body, and we experience illness, disease, and loss of function in the case of deficiency. More of a vitamin than the body needs, however, does it no good. Depending upon the vitamin, it’s either excreted or builds up and becomes toxic. Let’s stick with vitamin C as an example. Among its functions, vitamin C helps maintain the immune system; you’ll become more susceptible to disease (among other symptoms) if you’re vitamin C deficient. However, taking more vitamin C than recommended (the USDA currently recommends 90 mg/day for adult men, and 75 mg/day for non-pregnant, non-lactating adult women) doesn’t “supercharge” the immune system or help it function any better than it otherwise would. Think about it like this: if you’re trying to wash your hair in the shower, you need shampoo. If you use none, your hair doesn’t get clean. If you use a teeny, tiny amount, your hair gets a little cleaner. Use more, and your hair gets cleaner…up to a point. Once you’re using sufficient shampoo (usually anywhere from a dime-size to a quarter-size dollop, depending upon how much hair you have and how dirty it was), using more won’t get your hair any cleaner. It won’t do anything at all…except go down the shower drain. The same is true of vitamin C. Consume none, and you have problems. Consume some (but less than you need), and you have less severe symptoms of deficiency. Get what you need, and you achieve normal function (where it relates to vitamin C). If you take more vitamin C than your body needs to maintain function, however, the excess is excreted and goes down the toilet (or the shower drain, I suppose, depending upon your habits). Some vitamins aren’t as forgiving. For instance, vitamin A is quite toxic in megadoses. In any case, while there’s all sorts of scientific evidence to support getting your recommended daily dose of each vitamin, there’s just no evidence for — and in many cases, there’s evidence against — using megavitamins.

 

What’s your vitamin strategy?

 

Reference:

USDA Dietary Guidelines. Accessed 11 Nov 2011.

 

Mom-Dating

I didn’t have mom-friends before I had a baby. My female friends are, like me, women who’ve put off having babies to finish college. And then graduate school. And then get a career established. I was the first to decide it was time to leap into motherhood (and by “decide,” I mean my husband and I shared a six-pack of local microbrew on a beach in Kauai, and…surprise! Decision made.) Fast-forward nine months to me with a baby in my arms and no sisters or friends with babies in sight. Thus I entered the world of mom-dating. Dating is a good word for it, because just as in real dating, you spend a lot of time shyly staring at a potential mom-friend from across the room, before approaching her and awkwardly trying to start a conversation. However, instead of all the typical dating conversation-starters (“So…what do you think about Transformers II / Dan Brown’s new book / the Keystone XL pipeline?”) you typically ask things like “So…did you…um…deliver vaginally?” Which is a pretty creepy thing to ask a complete stranger, if you really think about it, but is somehow completely socially acceptable if you’re both holding babies. Good thing, too, because when you have a baby, you haven’t seen the latest movies, read books that didn’t have the words “baby,” “sleep,” or “nurse” in their titles, or heard anything about current events in months (with the possible exception of a vague reference to the 99%).

So, yeah. Mom-dating. I was at a playgroup the other day — a new group of women, none of whom I’d previously met — and was trolling for potential mom-friends. I’d done the mom-dating equivalent of getting all dolled up in sexy makeup and strappy sandals by sniffing my way through the shirts on the floor of my closet until I found the cleanest-smelling one, and raking my “it’s been two days since I had a chance to shower” hair into the semblance of a ponytail. I was ready to meet some moms! Playgroups are generally pretty noisy affairs, with women attempting to keep their toddlers from committing too many social indiscretions, while simultaneously trying desperately to interact with someone who isn’t likely to spit up or poop on them. This was a pretty tame playgroup, however, because it was made up almost entirely of women with babies too young to sit up, much less move around and play. W was the oldest baby there, and since she really had no one to play with, she amused herself by crawling around and pulling other babies’ pacifiers out of their mouths. Which, looking back on things, probably set me up for trouble with this group.

After a while, W decided she wanted to nurse (at almost 9 months of age! I could hear the muttering). An out-of-place-looking mom who’d been eyeing me curiously from across the room for some time came over and sat shyly next to me. “Did you homebirth?” she asked. I told her I didn’t, but had given it some thought. Emboldened by my reply, she told me she’d birthed at home. I asked about her experience, and we swapped birth stories. She also breastfed and co-slept, and like me, she worried about things like when to night-wean. Mom-dating bliss! I was just starting to ponder how to ask whether she wanted to see me again when she asked THE QUESTION. The one that always gets me into trouble. “Do you vaccinate?”

My mind raced. I already liked this woman, and had been starting to envision a lovely, mom-friend future together. We’d take our babies to the zoo and nurse them on the benches, silently daring anyone to tell us they were too old. We’d swap tips on the best farmers’ markets, which second-hand clothing stores were having sales, and the most effective detergent for cloth diapers. I lamely tried to dodge the question with a non-sequitur: “I don’t much like my pediatrician,” I said, hoping to change the subject.

“Because he tries to make you vaccinate?” she asked knowingly, in a conspiratorial tone.

“No, W is fully vaccinated,” I sighed. “It was my choice.” She was clearly disappointed, but to her credit, she gave me another shot.

“Oh, on a delayed schedule, right?”

“No,” I admitted, “I follow the CDC schedule.”

“Oh,” she said. “But, um, you seem so…WHY?” I could have just shrugged and smiled. Acted clueless. But I felt myself being drawn inexorably into the discussion, like a moth to the flames, so I explained my reasoning. I wasn’t trying to change her mind about vaccinating. I just wanted her to like me. To know that I had reasons for making the decisions I did, just as I was sure she had reasons for making the decisions she did. But it was too late. “That’s just weird,” she said, “and you’re endangering your baby.” She walked away.

I was hopeful, for a while, that I might hit it off with one of the remaining moms. I chatted with a few of the women seated near me, who remarked on W’s “advanced” abilities (are they? I think she’s pretty normal. She crawls around and eats books, for the most part). They wanted to know which Baby Einstein videos I had her watch each day. Baby Einstein? I don’t even own a T.V. The women asked how I ever got anything done without a T.V. to set her in front of. I told them the truth: sometimes she plays by herself and I get a few minutes. Sometimes she doesn’t…and I don’t. Lately, I told them, she’s had an obsession with crawling around after a meal, picking up little pieces of food off the floor and eating them. This can go on for 15-20 minutes, and I encourage it, since it gives me a chance to write. The women stared at me. Clearly, they thought there was something wrong with a mother who didn’t let her baby watch T.V., and encouraged her eat dropped food. Off the floor! Like a DOG!! “That’s weird,” they said, “and it sounds dangerous.” I started to explain, but my heart wasn’t in it.

Within moments, they’d drawn up into a tighter circle — with me outside it — and were talking about the videos and talking toys they planned to buy their babies for Christmas. W and I packed up and left. What a waste of a mostly-clean shirt!

Later, my husband and I sat on the couch in our T.V.-less living room, enjoying each other’s company, while our vaccinated baby ate a few pages out of a chemistry textbook and some leftover dinner from off the floor. It was a perfect evening. I may not fit in with any of the mom cliques, but in my family, I fit just fine. And I don’t ever have to explain myself.

 

Had any good adventures in mom-dating?

 

 

Mama, Sometimes You Just Need To CHILL!

Agonizing. That’s the best word I can think of to describe my parental decision-making process the majority of the time. Sometimes it feels like I treat every single decision as though W’s entire future hangs in the balance on what I determine to do. Here’s a short and incomplete list of decisions that have kept me up at night:

-Should I circumcise? (Thankfully, W was born a girl, so I got a free pass on this one).

-Should W sleep with us? (We decided yes…but see below for the rest of the story).

-Cloth diapers can be tricky at night. What’s the best combination? (I solved this one).

-I want to donate milk to a milk bank, but will that affect my health? Will it affect W’s? (Turns out yes for me [have to eat more…darn…], no for her).

-Should we give a Hep B shot at birth, or wait a few weeks? (We waited).

Here’s a short and incomplete list of decisions that are STILL keeping me up at night:

-I haven’t slept more than 2 hours in a stretch in 8 months. Should W still sleep with us? Should we night-wean?

-W has wants now, not just needs. Sometimes her wants don’t coincide with my wants (or needs). When should I start setting limits? At what point IS it possible to spoil a child?

-I have a torn labrum in my shoulder that affects my quality of life. When should I get it repaired, and how will my surgery affect W?

-When we get to toddlerhood, are time-outs effective, gentle discipline, or do they teach a child that her anger isn’t acceptable and gets her ostracized?

I don’t think I’m on my own here; I see a lot of moms agonizing. They do it alone, in groups, in person, and on the Internet. Here’s what I think (and I need to remind myself of this…maybe daily): we’re all doing our best, me included. Children are really, really resilient. There are as many parenting styles as there are stars in the sky (I think…I’m not an astronomer), and for the most part, parenting decisions notwithstanding, children turn out just fine. Will I make bad parenting calls? YES; probably many of them. There, that’s sorted. Now I can stop worrying about it. Will I make good parenting calls? Yes; probably most of them. Does my constant worrying help matters? No. But it does show that I care about being a good mom, and that (more than any actual decision I make) is the best indication that my baby will turn out just fine.

Give yourself a big hug, ladies (give yourself a big hug, SquintMom!); you’re a great mom.

 

What do you worry about as a mom?

 

 

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