Attitudes About Breastfeeding — A Tale Of Two Doctors

I wrote this during a quiet moment when W had hand-foot-mouth, after our first visit to the pediatrician but before she was hospitalized. In the craziness that followed, I didn’t get around to publishing it right away.

Do I have to stop nursing just because it's my birthday?

My poor W is sick. It started on Wednesday with vomiting, and then a high fever by afternoon. The next morning, she had some suspicious-looking sores on her lips and chin, so off to the doctor we went. Apparently, she has hand-foot-mouth disease, which I’d never even heard of. Having a toddler is a crash course in microbiology. Anyway, she has blistering sores all down her throat, which makes it painful for her to swallow. The pediatrician said that we were looking at about 5-7 days of high fever and difficulty eating and drinking, and that dehydration was the major concern. I mentioned that I was still breastfeeding, and her response was, “Oh, WONDERFUL! That will be so soothing to her. She’ll be able to nurse even if she can’t get anything else down.” The doctor was right; nursing is about all W has been able to do, so I’m very thankful we have that option available to us.

Yesterday, I had to leave my sick baby at home so I could go see my orthopedic surgeon for a pre-surgical consultation. Thanks to a skiing accident a few years ago, I have a torn labrum in my shoulder and a capacious capsule. The repair he’ll be doing sounds like a combination of woodworking and dressmaking; he needs to screw the labrum back on, and “take up” the extra capsular space with — as he described it – pin-tucking. Anyway, as we were discussing how the surgery would proceed, I asked if it was a problem that I was still breastfeeding. His response was “You’re STILL breastfeeding? {Insert appropriately horrified face here} At 13 months? WHY!?” It went downhill from there. He told me I needed to wean her because of the general anesthetic during the procedure and codeine afterward, but when I countered with the resources I’d found that stated otherwise, he said he didn’t really know, and to ask my pediatrician. He essentially told me that he didn’t want to talk about it anymore; he’d had enough of talking about breastfeeding. Alrighty then.

Part of me is annoyed by the orthopedic surgeon’s response; after all, nursing is not only still important to W, it’s probably the only thing keeping us out of the hospital for dehydration right now. I thank my lucky stars we’ve got this available to us. Part of me is hurt. I’ve been really lucky to have had no negative interactions as a result of my breastfeeding. This is the first time someone’s made me feel like a freak about it, and it stings. Part of me is scared. I really, REALLY want to do what’s best and safest for my baby. There’s enough information out there for me to know intellectually that it’s ok to keep breastfeeding despite my surgery…but emotionally, I still worry.

I was pretty frustrated yesterday, and kept thinking I felt so good about nursing after seeing the pediatrician; why did the orthopedic surgeon have to make me feel so awful? Last night, though, I rocked my hot-as-lava baby, pushing her damp hair off her forehead and listening to her rapid, shallow breathing. She opened her tired eyes and looked at me, opened and closed her little hand in our sign for nurse. With her first swallow of milk, she sighed. Her whole body relaxed. The peace of that moment swirled up around us both. I no longer feel the sting of the second doctor’s words; in fact, I know now that nursing is how I’ll help explain to W that everything’s ok after my surgery. It’s how I’ll comfort her even though Mama won’t be able to bathe her or carry her, and even though Mama will be sleeping away from her for the first time ever.

That I’m still nursing my baby is not me trying to make a “statement” of any kind, or fit into a particular parenting philosophy. I’m not a “lactivist.” It’s just something we do when she asks, which isn’t often anymore, unless she’s sick. In answer to the second doctor’s question — WHY!? — I now have a response. We’re still nursing because it’s a phase of development that she’s still in. It’s like babbling, or crawling, or thumb-sucking. It’s something she’ll do for a while, but won’t do forever. I won’t push to extend this phase, nor will I try to curtail it. For now, it is something she needs, and that’s enough.


Post-Script — As I review this post before publishing, I am amused at how worried I was about nursing W despite my surgery. The general anesthetic won’t affect her at all; if it’s still in my system, I’ll be asleep. If I’m awake (and able to nurse her), it won’t be in my system anymore. With regard to the codeine…well, as I write this, W is sleeping on my lap, narked out on Vicodin because her blisters from hand-foot-mouth disease have gotten so bad. Before the Vicodin, they tried codeine. She’s been on the drugs for three days so far, and I expect we have at least another day of them. So, am I worried about the bit of codeine she’ll get via my milk for a few days? No.


What sorts of responses to breastfeeding have you had from healthcare professionals?




Cesarean Sections in the U.S. — The Trouble with Assembling Evidence from Data (Guest Blog at Scientific American)

I’ve been invited to guest blog at Scientific American today. The article, which is about the c-section rate in the U.S., was an interesting one for me to write. I initially approached it from the perspective that there were too many c-sections in the U.S., and I wanted to dig around and see whether there was good support for the litigious nature of American society being a causative factor. In the process of my digging, however, I found evidence that changed my thinking. Here’s an excerpt:

While it’s tempting to look at the data and make the assumption that over-medicalization is responsible for the high rate of induction and c-section in the U.S. — and to further extrapolate that the high rate of c-section is responsible for increased maternal mortality — there are several problems with this interpretation. First, it goes without saying that c-sections, while not medically necessary in the majority of deliveries, are lifesaving for both mother and infant when medically required. Per WHO data, those undeveloped nations with the very lowest c-section rates have staggeringly high maternal mortality, with more than 1 in 100 labors resulting in the mother’s death. By comparison, maternal mortality in much of Europe and North America is in the range of 0.001 – 0.03% [3]. This somewhat deromanticizes the image of a native tribeswoman squatting in her hut, giving birth “as nature intended.” It’s easy to forget that if we desire completely natural childbirth, we have to accept the natural maternal and neonatal mortality that accompanies it.

Read more at Scientific American’s guest blog.



The Hospital — Pictures, and Lessons Learned

W was diagnosed with hand-foot-mouth disease on Thursday. We were warned that with painful sores in her mouth and down her throat (plus nausea and diarrhea), the biggest complication to watch for would be dehydration. It was hard for her to swallow. She didn’t want to eat at all, and struggled to drink water and juice, but she did nurse a lot more than usual. By Saturday morning, she wasn’t even nursing anymore. She would sign “drink,” but then push the cup away when offered. She’d sign “nurse,” but wouldn’t latch. By Saturday afternoon, we were in the ER.

I took W to an ER at a children’s hospital. It’s not our closest option, but it’s worth the extra drive. They did things that regular ERs wouldn’t, like numb her arm with pneumatic lidocaine before putting in her IV. This was a really big deal, because as dehydrated as she was, it took a few tries, a few different sites, and a lot of digging to find a vein. They gave her some Vicodin between IV attempts and let her chill for a little bit. The second attempt went much more smoothly, probably at least in part because she was trippin’.

Watching cartoons and waiting for meds to kick in.

Keens are the best shoes ever. She barfed all over me in the ER. The staff was nice enough to get me some scrubs. I rinsed my shoes off in the sink, and they were good as new!

IV in place, we were brought an assortment of soft foods and beverages and told that if she could take anything on her own (or nurse), we could go home. While she was willing to sleepily finger paint with pudding, she didn’t want to eat anything. She finally agreed to take one little taste of some applesauce, but only if she could lick it off an empty syringe (sans needle) that she’d stolen from a nurse. Apparently this wasn’t good enough…we got admitted to the hospital.

Saturday night and most of Sunday, they kept her on an IV for fluids and on Vicodin for pain. She slept…

…and slept…

There was a brief period after her Sunday afternoon pain meds during which she was feeling perkier, so she tore up a magazine for a while.

And that was pretty tiring.

Late Sunday afternoon, she was feeling a lot better. She drank some water, which bought us our ticket home.

Feeling pretty good after a dose of pain meds. She's had so much IV fluid, her eyes are puffy!

First thing she did when we got home was get herself all dolled up with not one, but TWO bows (she took them to her daddy and he installed them for her), and cuddle with BuBuBo, her teddy (who, yes, has antennae. And wings. And who, if Mama had been thinking straight, would have come to the hospital with us).

First thing Mama wanted when we got home was a shower. First thing W wanted? BOWS. Sometimes, a girl just needs to feel pretty.

She’s still pretty sick, but she’s definitely on the mend. She won’t eat or drink anything, but she’ll nurse as long as we keep her pain and fever under control, so hopefully we’re only in for a few more days of this.


Things I Learned About Toddlers In The ER/Hospital

1) Even if your toddler is limp as a dishrag at home, bring entertainment (an iPod or something similar works great) for the ER. New environments are stimulating, and the only thing harder to deal with than a sick, cranky toddler is a sick, cranky, BORED toddler.

2) It’s definitely worth the drive to a children’s hospital, if that option is available.

3) Bring a snack. No, not for the baby. For you. For when you realize it’s been, like, 12 hours since you’ve eaten.

4) Be involved, be proactive. You’re not the patient, but you are the patient’s voice. You’re not the doctor, but you know your child. Most of the care providers know what they’re doing and are totally on top of their game. Most, but not all. Ask questions and keep track of your child’s care. Know when she’s supposed to get meds, and don’t be afraid to ask for them. Be willing to ask for reevaluation or changes. Don’t assume that because you’re not a medical practitioner, you’re not part of the care team. In many ways, you’re actually the one in charge.


What tips do you have on caring for a sick toddler or having to do an ER/hospital visit?



Kids and Peer Pressure

W and a little friend

Last weekend, W succumbed to peer pressure for the first time (that I know of). See, she’s been walking pretty well for about a month now, but she’s had herself convinced that she has to hold my hand to do it, even though I can tell she’s not relying upon me for help. Last weekend, though, we went the birthday party of one of W’s little friends, and there were lots of toddlers there. She started off walking the way she always has — holding my hand — but I could see her watching the other little ones. Oh, I could almost hear her thinking, is that what we’re doing now? And she let go of my hand and started walking on her own.

This got me thinking about two different things. First, even though W is closest emotionally to her daddy and me, she clearly identifies with other toddlers. After all, it wasn’t watching US walk solo that led her to take the plunge. Used to be, she thought she was a part of me (or I was a part of her); somewhere along the line, that changed, and I’m not sure precisely when. She’s clearly her own little person now, and what amazes me is that she knows she’s a little person. Not a big person, not a dog, not a unique life form. A little human. How amazing is it that she’s figured that out, even though she’s never been explicitly told, “You are a small human, and these other toddlers are also small humans. You are like them.”

The other thing W’s experience made me think about is how commonly we associate the term peer pressure with something negative. You know, the whole all the cool kids are doing it phenomenon, where the “it” is something they shouldn’t be doing, like having sex, or smoking, or consuming entire tablespoons of cinnamon at once.*

*Yes, this is apparently the new(ish) thing. And while I would be somewhat remiss if I didn’t mention that there’s the (remote) potential that trying to swallow a whole tablespoon of cinnamon could cause choking, lung irritation, or suffocation, I will say that as stupid, peer pressure-related behavior goes, this sort of amuses me. And for added parental convenience, engaging in The Cinnamon Challenge is its own punishment.

Anyway, humans are social creatures, so it doesn’t really make sense to talk about peer pressure as though it’s limited to isolated incidences, or to adolescence. In fact, much of the behavior in which we engage on a daily basis and throughout life is determined by social pressure to act in particular ways. Even within the confines of the more traditional definition, peer pressure exerts a positive influence on kids and teens just as much as or more than it exerts a negative influence. Among the various findings that demonstrate the positive power of peer persuasion (hooray for alliteration): “popular” kids feel peer pressure to perform in school and engage with family (Clasen et al); peer monitors are effective at helping to maintain order in the classroom (Carden Smith et al); peer-led education improves attitudes about asthma and compliance with treatment protocols (Gibson et al); peer pressure pushes adolescents to conform with socially-acceptable behavior (Urberg et al).

A major task of W’s infancy was learning that she had a body (and how to control it). I see very clearly now that as she enters toddlerhood, she’s learning that she has a self, a personhood, an identity that goes beyond the corporeal. Watching her develop a personal image and start to identify peers is delightful from a maternal perspective. From a scientific perspective, too, it’s fascinating. It’s amazing to me that we (humans) are at once so caught up in our own identities and the desire to stand out as individuals, and yet are so shaped — literally from our first steps — by observing and imitating the behavior of others.


What aspects of social development do you find fascinating?



Carden Smith et al. Positive peer pressure: the effects of peer monitoring on children’s disruptive behavior. J Appl Behav Anal. 1984 Summer;17(2):213-27.

Clasen et al. The multidimensionality of peer pressure in adolescence. J Youth Adoles. 1985; 14(6):451-68.

Gibson et al. Peer-led asthma education for adolescents: impact evaluation. J Adolesc Health. 1998 Jan;22(1):66-72.

Urberg et al. Peer influence in adolescent cigarette smoking. Addict Behav. 1990;15(3):247-55.

Easy DIY “OK To Wake” Timer

Homemade sleep alarm -- nightlight plugged into a digital timer.

So, W is understanding more and more language these days, and I can explain increasingly complex ideas to her. I’ve been thinking of getting one of those alarm clocks that let kids know when it’s ok to get up (without having to tell time), because she tends to want to wake at around 5:30 in the morning…and I don’t. My hope is that if I get her an alarm clock of sorts, she’ll cuddle with me quietly for about half an hour between the time she wakes up and the time I feel it’s reasonable to get out of bed. I know that even with her improving language skills, communicating this is probably a long shot at this point…but it’s worth a try. Even if it doesn’t work now, it’ll work someday.

There are lots of options for kids’ sleep clocks out there; some change color at a specific time, others glow, and some show pictures of a sleeping or playing cartoon creature. The clocks are expensive, though; they tend to run in the neighborhood of $40. In scouring the interwebs for a good deal, I ran across this site, which (in addition to doing a comprehensive review of sleep clocks for kids) suggested saving a bunch of cash by making your own sleep alarm. I can’t believe I didn’t think of that myself. Major DUH moment. A homemade sleep clock is a simple thing to put together. You can get little light timers like this one for about $5 bucks; digital ones are a bit more. Plug a nightlight into the timer, and you’re all set; when the light goes on (or off — you could do it either way) it’s ok to get up!

I think we’ll give it a shot!


How do you let your munchkin know when it’s ok to get up?



When Is The Best Time To Introduce Solids?

The decision to start solids is both an exciting one (your baby is growing up!) and a difficult one for many parents. The latter is because there’s so much conflicting information floating around (“Starting solids sooner will make your baby sleep better!” “Starting solids too soon will give your baby allergies!”). The purpose of this post is to summarize the research that addresses when to start solids in a baby that is breast- and/or formula-fed.

If you’re confused by all the seemingly conflicting information out there regarding when to start solids, you’re in good company; the American Academy of Pediatrics (AAP) is split on this issue. The AAP’s Breastfeeding Initiatives state that it’s best to wait until an infant is 6 months of age, while the AAP’s nutrition division suggests that it’s fine to introduce solids around 4 months of age. There is no research to suggest that there’s any benefit associated with introducing solids before 4 months of age, and there is quite a bit of research suggesting that such early introduction of solids is associated with increased risk of allergies and eczema (see, for instance, Greer et al, Tarini et al, Zutavern et al). Waiting until 6 months of age to introduce solids decreases the risk of atopic diseases (allergies, eczema, and asthma). Researchers are split on introduction of the most allergenic foods (including eggs, shellfish, and nuts). Some studies (including Filipiak et al) suggest that there’s no benefit associated with waiting beyond the sixth month to introduce these foods (in non-chokable form), while other studies (such as Fiocchi et al) suggest waiting to introduce dairy, egg, nuts, and seafood. Given the split nature of research findings on delayed introduction of highly allergenic foods, it may be worth delaying such foods in families with a history of atopic disease. Highly allergenic foods aside, the preponderance of evidence suggests that the best time to introduce first solid foods falls somewhere between 4 and 6 months of age. The question, then, is whether to shoot for closer to the beginning of that window, or closer to the end.

There are several arguments often made for adding solids to the diet earlier, rather than later. None of these, however, are supported by science. Perhaps the most common assertion is that adding solids will improve infant sleep. Several studies have examined this issue, and have found no sleep improvement with added solids (see, for instance, Macknin et al, Oberlander et al.) The Oberlander study looked at newborns, comparing sleep after a randomly assigned meal of water, carbohydrate, or formula. Water-fed infants slept less than formula-fed infants, while carbohydrate-fed infants (contrary to the common maxim) didn’t sleep as well as formula-fed infants. The Macknin study examined the effects of adding infant cereal to the nighttime bottle (a common practice thought by some to promote sleep) of 5-week-old and 4-month-old infants. The sleep durations of the infants given cereal were compared to the sleep durations of same-age infants given formula with no cereal; the researchers found no increased quantity or quality of sleep with cereal. There is no research support for beginning solids as a means of improving sleep.

Another argument used to support introducing solids at closer to 4 months than 6 months of age is that the older infants are (according to their caregivers) no longer satisfied by breast milk or formula alone. Because 4- to 6-month-olds have very limited communication ability, this is largely based upon speculation. For instance, some caregivers interpret a 4-month-old’s sudden interest in the food on an adult’s plate (or silverware) as an interest in eating. Given the opportunity, many 4-month-olds will grab food off an adult’s plate and place it in their own mouth, interpreted by some caregivers to mean the baby wants to (and/or is ready to) eat solids. However (and I recognize this is not a scientific statement), 4-month-olds also put rocks, garbage, and anything else they can find into their mouths. Around 4 months of age, an infant’s attention begins to turn to the outside world. The infant also increasingly possesses the ability to control his hands, allowing him to grasp objects of interest and bring them to his mouth for exploration. Infants don’t differentiate “food” from “non-food” with regard to what they taste; they simply use oral investigation as one of their means of gaining information about the world. It is a misattribution of intent to suggest that a 4-month-old who grabs food off his mother’s plate wants to eat solids. More scientifically, there is no evidence to suggest that an infant younger than 6 months of age needs anything more than breast milk (with supplemental vitamin D if indicated, see this article for more information) or formula. Further, there is ample scientific evidence showing that infants thrive on nothing but breast milk for the first 6 months (see, for instance, Carruth et al, Dewey, Nielsen et al). There is also evidence showing that introducing solids after 4, but before 6 months of age doesn’t positively affect growth (Cohen et al), because infants fed solids consume less milk or formula. Even infants given as many nursings (this study was conducted on breastfed infants) as they’d been given prior to introduction of solids consumed less milk per nursing when given supplemental solids. This demonstrates that a 4-month-old can’t be made to increase his caloric intake by giving him solids, as he’ll take less milk in response. Of particular concern is the case of the breastfed infant; there is no substance as nutritionally complete or suited to the digestive tract of the young infant as breast milk. Thus, since the breastfed infant responds to solids by decreasing milk consumption, supplementing with solids prior to 6 months of age actually decreases the quality of the breastfed infant’s diet. Given that formula is designed to mirror the nutritional qualities of breast milk as much as possible, we can reasonably extrapolate that it is the best second choice for feeding a non-breastfed infant (or supplementing an infant whose mother is not exclusively breastfeeding) until 6 months of age, and that introduction of complementary solids displaces a higher-quality source of nutrition.

If waiting until 6 months to introduce solids is good, then, is waiting longer than 6 months even better? Apparently not. There’s research that suggests rather strongly that delaying the introduction of solids beyond the 6-month point does not further decrease the risk of allergies (see, for instance, Filipiak et al, Greer et al, Zutavern et al), and may even increase the risk (Nwaru et al). Further, breast milk and formula are no longer sufficient to support increasing nutrient needs beyond 6 months of age (Dewey). As an isolated (but not unique) example, breast milk is quite low in iron (there is a great article about this at Science of Mom), and complementary foods can be used to increase iron in the diet (there’s another great article from Science of Mom here). The most nutritionally-complete diet for a 6-month-old (or older) infant should consist of mainly breast milk (or formula), with carefully-selected complementary solid foods.


Science Bottom Line:* There is ample research to support waiting until after 4 months of age to begin complementary solids, and there is a modest amount of research to support waiting until 6 months of age, particularly in the case of a breastfed infant. There is no evidence of any nutritional or behavioral benefit conferred by solids between 4 and 6 months of age. Research does not support (and, in fact, opposes) waiting beyond 6 months of age to introduce complementary solids.


When did you/will you introduce solids, and why?



Carruth et al. Addition of supplementary foods and infant growth (2 to 24 months). J Am Coll Nutr. 2000 Jun;19(3):405-12.

Cohen et al. Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: a randomised intervention study in Honduras. Lancet. 1994 Jul 30;344(8918):288-93.

Dewey, K. Nutrition, Growth, and Complementary Feeding of The Brestfed InfantPediatr Clin North Am. 2001 Feb;48(1):87-104.

Filipiak et al. Solid food introduction in relation to eczema: results from a four-year prospective birth cohort study. J Pediatr. 2007 Oct;151(4):352-8. Epub 2007 Aug 23.

Fiocchi et al. Food allergy and the introduction of solid foods to infants: a consensus document. Ann Allergy Asthma Immunol. 2006 Jul;97(1):10-20; quiz 21, 77.

Greer et al. Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Pediatrics. 2008 Jan;121(1):183-91.

Macknin et al. Infant sleep and bedtime cereal. Am J Dis Child. 1989 Sep;143(9):1066-8.

Nielsen et al. Adequacy of Milk Intake During Exclusive Breastfeeding: A Longitudinal Study. Pediatrics. 2011 Oct;128(4):e907-14. Epub 2011 Sep 19.

Nwaru et al. Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years. Pediatrics. 2010 Jan;125(1):50-9. Epub 2009 Dec 7.

Oberlander et al. Short-term effects of feed composition on sleeping and crying in newborns. Pediatrics. 1992 Nov;90(5):733-40.

Tarini et al. Systematic Review of the Relationship Between Early Introduction of Solid Foods to Infants and the Development of Allergic Disease. Arch Pediatr Adolesc Med. 2006 May;160(5):502-7.

The Questionable “Science” of An Optimized Environment

Last week, I wrote about my experience letting W do her own thing outdoors. In short, she had a great time — and was obviously both physically and mentally stimulated — picking up rocks and licking them. I talked about having to remind myself that she doesn’t need fancy classes or an “optimized learning environment” in order to develop into a physically, mentally, and emotionally capable person. Still, I am cutting myself a BIG break for frequently forgetting that she doesn’t need all sorts of stimulation, because we parents are constantly told otherwise. Just today, I ran across a project from the Methodist University of Piracicaba in Brazil, called the Affordances in the Home Environment for Motor Development – Infant Scale (AHEMD-IS). The stated purpose of the study is “to provide researchers, educators, and parents with a reliable instrument to assess the quality and quantity of motor development opportunities in the home during early childhood.”

I’m all about science, but this…is ridiculous. The assessment questionnaire is available on the AHEMD website; there are several versions available for different age groups. I took a look at the 18-42 month questionnaire (validated, with results reported by Rodrigues et al).

The questionnaire asks about the home environment (Is there more than one type of flooring? Are there stairs?), about how the child spends time during the day (How much time being carried? How much time in a playpen?), and about toys in the house (How many toys that simulate adult activity? How many rolling toys? How many water toys?…) This last part goes on for 8 pages.

If this scale were meant to assess a daycare or preschool environment, I’d be all for it. After all, daycare and the like are parent proxies, which try to reproduce a home-like environment (and some could use help). That the scale is meant to assess the home, however, disturbs me. We’re forgetting our evolutionary roots when we consider a home full of all sorts of toys (rocking toys! musical toys! dolls!) to be superior — necessary, even — to development. After all, through the vast majority of evolutionary history, human babies have developed into functional adults through a combination of crawling around on the ground (cave floor?), which would lose our cave-ancestors points on the assessment (In your home’s inside space, is there any furniture or equipment for your child to pull up to a standing position and/or walk?) and/or being carried, which would also lose points (In a typical day, how much time does your child spend in a carrying device?).

As much as I’m bothered by some of the questions on the survey, I’m more disturbed by the questions the survey DIDN’T ask:

  • On a typical day, does your child have an opportunity to spend time outdoors (weather permitting)?
  • On a regular basis, do you involve your child in your daily household chores and/or in your outside-the-house errands?
  • Do you talk to your child about what you’re doing, and about what he/she is doing?
  • How many open-ended toys and/or objects that can be used for imaginative play (empty boxes, plastic containers) does your house contain?
  • Do you make allowances for the fact that children develop at different paces, or do you frequently compare your child to other children?

Research like this distresses me, because it supports the notion that development is fostered by things rather than by interaction, and it restricts the definition of a toy to something that has been manufactured for play. What about sticks and rocks? What about running around outdoors? What about helping Mama choose between beets and broccoli at the store, or learning that the greens growing in the garden have little carrots attached to them? This sort of research suggests that an “optimized indoor playspace” is infinitely superior to following a parent around, playing with empty toilet paper rolls, and spending time outside.

This kind of research validates the notion that we need to force development. That it somehow doesn’t come naturally. That a human baby needs to be taught (and bought things) to be human. It validates the notion that we need to start pushing at an early age and providing all the right toys (and heaven help us if we don’t have more than one flooring surface in the house!) so that our pint-sized Einsteins will get into the right preschool…so that they’ll get into the right kindergarten…the right college…the right job…

This kind of research supports the notion that our kids need to hurry up and develop, already! And the extent to which this notion pervades society distresses me. It runs completely counter to being in the moment and enjoying life as it happens. It sets us up to race through each stage to get to the next one…and if life is a race, the finish line is…death.


What do you think about the idea of assessing your child’s home environment?



Rodrigues et al. Development and construct validation of an inventory for assessing the home environment for motor development. Res Q Exerc Sport. 2005 Jun;76(2):140-8.

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