There’s new advice for new parents

It’s been a busy week when it comes to telling new parents what they should and shouldn’t do.  The American Academy of Pediatrics (AAP) released several new policies, and the US Preventive Services Task Force (USPSTF) reviewed and updated their recommendations on breastfeeding support.  Even though Little Boy is well past infancy, I’m still very interested in the science of infant care (and we might decide to have another kid), so I’ve been paying attention.  Let’s take a look at each of the new policies.

Kids & screen time

The general message of the AAP’s new policy statement on media use by young children is familiar: choose age-appropriate media, talk to your kids about what they’re watching, and turn off the TV (and other devices) before bed.  But there are a few key updates worth pointing out:

  • They’ve lowered the age of “no digital media” from 2 years to 18 months: you are now allowed to introduce “high-quality programming” to your 18-month-old if you so choose.  I’m pleased with this recommendation, because it agrees with my observations of child development.  Little Boy was 17 or 18 months old when he started really caring about Sesame Street.  By age 2, he knew all the characters and could identify the letter C (is for Cookie) in other contexts.  The old ‘kids don’t get anything out of TV before age 2’ policy seemed frankly incorrect.
  • For children under 18 months, the “avoid digital media” recommendation now explicitly says video-chatting is OK.  It’s a little thing—I mean, we all kind of figured that Skyping with Grandma didn’t really count as “screen time”—but it shows that the AAP put some thought into the various uses of media in modern society.
  • I also appreciate that this statement is included: “…there are intermittent times (eg, medical procedures, airplane flights) when media is useful as a soothing strategy…”

Safe infant sleep

Again, most of the recommendations in the AAP’s new policy statement on infant sleep safety are things we’ve heard before.  Babies should sleep on their backs.  Avoid blankets and soft bedding.  Don’t smoke.  Offer a pacifier (nobody quite knows why, but pacifier use is associated with lower rates of SIDS).  In a few cases, though, the details have changed:

  • Room-sharing (baby sleeps in parents’ room but in his/her own crib or bassinet) is now explicitly encouraged for the first 6–12 months.  Popular media articles seem to be treating this as a shocking new development, but the old safe sleep policy already recommended room-sharing, just without a specific length of time.  The science around this is up for debate, though; it’s not clear if the references cited by the AAP really show strong support for room-sharing.  (Some thoughts from educated folk here and here.)
  • The AAP remains very strongly against bed-sharing; however, they now admit that parents get really fricking tired caring for new babies and sometimes falling asleep with your baby in bed is the least bad option.  While bed-sharing is most definitely not for me, I appreciate their concession to reality:

    However, the AAP acknowledges that parents frequently fall asleep while feeding the infant. Evidence suggests that it is less hazardous to fall asleep with the infant in the adult bed than on a sofa or armchair, should the parent fall asleep.

Supporting breastfeeding

The recommendation statement by the USPSTF, accompanied by an in-depth statistical analysis, addresses whether anything hospitals and medical professionals do actually increases breastfeeding rates, and if so, what interventions are most helpful.  They conclude, “with moderate certainty,” that breastfeeding support has a “moderate net benefit.”

That’s not terribly surprising, but there are some really, really interesting specifics in the report, highlighted in a Journal of the American Medical Association editorial:

  • There is no evidence that the Baby-Friendly Hospital Initiative (BFHI) does any good.  If you’re unfamiliar with the BFHI, the idea is that hospitals can be certified if they implement a set of ten “baby-friendly” (read: breastfeeding-friendly) steps.  Some of these steps are controversial; for instance, if a new mother wants to formula-feed, the BFHI requires that hospital staff “educate her about the possible consequences to the health of her infant.”  Anyway, the USPSTF report determined that “individual-level interventions” (seeing a lactation consultant, attending a breastfeeding support group, etc.) were useful, while “system-level interventions” (the BFHI and other hospital policies) were not.
  • There is no benefit (in terms of breastfeeding duration) to completely avoiding formula during the newborn period.  Moms who supplement with formula before their milk comes in are just as successful at breastfeeding!  This is a big deal, because current breastfeeding advice tends to take an “any formula ever will ruin your breastfeeding relationship” approach.
  • Pacifiers are also OK!  Pacifier use is not associated with breastfeeding problems.  In fact, because pacifier use is associated with lower SIDS risk, the JAMA editorial goes so far as to say that

    routine counseling to avoid pacifiers may very well be ethically problematic.

Interestingly, when the USPSTF posted a draft of their recommendations back in April, there was apparently some concern about their choice to talk about the “support” of breastfeeding instead of the “promotion” of breastfeeding.  Because people are weird about this.

How I came to hate attachment parenting

When Little Boy was an infant, I spent a lot of time online.  Trying to keep myself awake, mostly.  Somewhere amid the long dark nights, I found myself Googling “I hate attachment parenting.”  I needed affirmation for the black fire of anger that had arisen during pregnancy and spilled out everywhere during those newborn days.  I needed someone to tell me it was OK to parent in a way that really, truly worked for me and my baby.

This post is about where that black anger came from, and why I’ve had so much trouble letting it go.

Before I go any further, let me be very clear on one thing:  If you practice attachment parenting or any of its components because it is what works for your family, then this post is not about you.  All the core components of AP fall onto the spectrum of perfectly acceptable parenting behavior.  We did several of them ourselves: I breastfed Little Boy for 17 months; we frequently “wore” him around the house and neighborhood; we room-shared for the first few months.  Heck, most of those things are recommended by the American Academy of Pediatrics (AAP).

No, when I say I hate attachment parenting, I mean that I hate Attachment Parenting™, the worldview that believes that it is the only acceptable way to parent.  I hate the naturalistic fallacy that has infected the white, liberal, middle-class approach to parenting, and I hate the misinterpretations and misappropriations of science that are used to back it up.

It started when I was pregnant.  As those of you who’ve read Little Boy’s birth story know, I was interested in “natural” birth—that is, giving birth without pain medication—until Little Boy flipped breech in the third trimester and it became clear that a C-section was likely.  I am the kind of person who likes to learn as much as I can in advance, so I did a lot of reading about “natural” childbirth.  Only… it turns out that there aren’t a ton of resources for women like me, women who want to skip the epidural but stay in the hospital.  It was always sort of assumed that if I was going that route, then of course I didn’t trust doctors and of course I’d probably really want to give birth at home.

Here’s the thing: I’m a trained scientist.  I may not be a medical expert, but I have enough background to read medical papers, and my university affiliation gives me access to the full text of most major journals.  I can tell when people are spewing bullshit, and my bullshit meter was blaring like a siren.  It was so easy for me to check that all the woo about homebirth was wrong.  And all this scary stuff that people were telling me about hospitals?  It hasn’t been true since before I was born.

Unfortunately, while it was easy to dismiss the stuff that was obviously fringe, it was much harder to ignore that which had crept into the mainstream.  One of my friends, a smart, educated woman, was reading Ina May Gaskin and planning to deliver at a local birth center.  So that couldn’t be that weird, right?  The local hospital’s birth classes were taught by doulas and lactation consultants; the hospital itself boasted that babies were expected to room-in full-time after birth.  So that was good, right?

Except… My OB was a wonderful, caring woman, and the lactation consultant who visited our hospital room was a jerk.  Full-time rooming-in was terrifying and exhausting.  All of the naturalistic stuff I’d been hearing just didn’t jive with my experiences.

The second step came with the breastfeeding.  The funny thing is, breastfeeding went really well for us.  No problems with supply, no issues with weight gain, nothing to feel guilty about.  So why does the über-pro-breastfeeding culture make me so angry?

Well, there was the way the lactation consultants in my breastfeeding class spent the first 10 minutes telling us how inferior formula was.  We’re here at this class—we’ve already decided that we want to breastfeed!  Plus they seemed to be going way beyond what the science actually says, twisting and stretching the facts to suit a certain narrative about good motherhood.  Like I’ve said, I hate it when people get the science wrong.

Yet again, I found that there was no place for me in mothering culture, no place for a mother who wanted to breastfeed but didn’t want the answer to everything to be “more boob.”  It has always been extremely important to my husband that he be an active parent, and so it was very important to us that both parents be able to soothe Little Boy.  I didn’t want to nurse every five minutes.  I can’t nurse every five minutes and keep my sanity.  And you know what?  Little Boy didn’t need to nurse every five minutes.

It turns out, though, that when you search for the answer to breastfeeding questions, the answer is always “more boob, more often.”  Even when that doesn’t make sense.  Even when it’s clear that baby isn’t hungry.  The top-listed resources, Dr. Sears and KellyMom and La Leche League, they all assume that of course mom is going to be with baby constantly, probably co-sleeping, and dad’s just there to help out.

Attachment Parents like to tell you that their parenting beliefs are all about “following your instincts.”  They’re just doing what they feel they should do!  But here’s the thing: my instincts about parenting were always on the side of “he’s fine, give him a minute.”  I never had an “instinct” to run to the baby the second he started crying.  I love snuggling with him, but my “instinct” is always to put him down so that I can do things for myself once in a while.

I made the mistake, during pregnancy, of joining my “birth month group” on BabyCenter.com.  Oh hell no—do not do that.  BabyCenter purports to be a mainstream resource, but in its fora I saw women excoriated for letting their babies cry for THREE whole minutes.  Horrors!  Apparently my instinct—that is was OK to let Little Boy fidget a bit while I set up my environment to be comfortable for nursing—made me a terrible mother.

I’ve never felt the need to stare into Little Boy’s eyes constantly while I nurse, or to be down on the floor with him every second of his playtime.  Quite the opposite, in fact: I need time to myself in order to literally stay sane enough to function.

What do you do, when the culture is telling you your “instincts” are wrong?

I was already pretty viciously anti-attachment-parenting by the time we sleep trained Little Boy, but that was the last straw.  Our baby, at the age of three months, was not interested in being nursed to sleep, nor in being rocked gently off to dreamland.  We know.  We tried those things.  As long as something worked, we were willing to do it—but nothing worked.  Little Boy resisted sleep, and woke from his naps cranky and tired.

Sleep training (we used the Ferber method) was a miracle.  It took only a few nights and surprisingly little crying.  Little Boy, it seems, wanted the space to be left alone to sleep, without rocking or singing or nipples in his face.  He was happier, we were happier, and I have never had any doubt that we did the right thing.

Sleeping training, though—from an attachment parenting perspective, that is the worst thing we could do.  Some commenters have implied that we should have waited until six months.  One woman online told me that I was lazy and clearly didn’t know how to soothe my baby!  (I do know how to soothe my baby.  It involves giving him peace and quiet.)  I have seen mothers adopt severe martyr complexes about what they endured to avoid “crying it out,” even more than the martyr complexes they take on about breastfeeding.

My baby needed to learned to sleep on his own.  Anyone who thinks otherwise can fuck off.

Much later, I checked out Dr. Sears’ The Baby Book, that bible of attachment parenting, from the library and read it, wondering if perhaps my impression of him had been wrong.  Nope.  The Baby Book is every bit what I thought it was, filled with dire warning about the “bad start” of an un-“natural” birth and a general snide message of “don’t you want to know that you did the best for your baby?”  The “best,” of course, being Dr. Sears’ tenants of attachment parenting.

I’ve noticed that Attachment Parents like to present an aura of being rebels, of going against the mainstream.  It’s one of the things that seems to appeal to them.  But are you kidding me?  I’m sure there are places where it’s some of this stuff is still unusual, but on the whole?  In the media?  Give it up, you guys, you already won!  The AAP is staunchly pro-breastfeeding.  Babywearing has been common for a quarter-century.  Bed-sharing remains controversial, but the AAP itself recommends room-sharing.  The classic baby-care guide What to Expect the First Year won’t even answer the question of how to put a three-month-old on a regular schedule.  Among the white, liberal, educated middle-class, the attachment parenting approach is already the norm.

In fact, that’s why it’s so hard to reject: because there are bits and pieces of it that are smart and good and true, or at least reasonable under some circumstances.  If it didn’t pretend to be based on science, I would laugh it off just as I laugh at the anti-vaccine crowd.  But it pretends to be The Right Answer, and it drives the guilt that underlies my approach to motherhood.

So there it is: the anger.  Little Boy is one year old, going on two; you’d think I could let all this go by this point.  But I still remember the deep black darkness of his early days, and I remember how much the feeling that I was doing something wrong contributed to that pain.  I felt alone and judged and hopeless, and the attachment parenting ethos is one reason why.

And now, if you’ll excuse me, I’m off to be a DEtached parent.

We need to banish the phrase “That’s what you signed up for when you became a parent”

If you’re spent any time on the “mommy internet” (forums, blogs, etc.), you’re bound to have come across the self-righteous mother.  You know, the one who made all the “best” choices in pregnancy and birth and parenting and can’t imagine that—gasp!—other people’s lives might be different.  One of Ms. Self-Righteous’s favorite things to say is this: “Well, that’s just what you signed up for when you became a parent.”

Kid wakes up every 45 minutes all night long?  “That’s what you signed up for when you became a parent.”

Bleeding nipples from trying to breastfeed?  “That’s what you signed up for when you became a parent.”

Feeling stuck at home and missing adult interaction?  “That’s what you signed up for when you became a parent.”

It’s bratty, it’s common, and it needs to be banished forever.

For one, it rests on an utterly ridiculous assumption: that the person in question “signed up” to be a parent.  Some people do.  I did: the pregnancy that brought me Little Boy was very carefully planned and sought after.  But half of all pregnancies in the U.S. are unplanned, so chances are good, when you’re speaking to a strange woman on the internet, that she didn’t actually “sign up” to be a parent.  For some people, it just happens.

Second, do you know what this attitude reminds me of?  Hazing.  “You can’t complain about having to run around campus naked in sub-zero temperatures,” says the bro.  “It’s what you signed up for when you pledged this fraternity.”  We don’t allow that kind of excuse when it comes to college students, why should we allow it with new parents?

Third, while all parenting necessitates sacrifice, there is essentially no one specific hardship that is required by 100% of all parents.  Some women (me!) breastfeed with minimal pain.  Some babies actually do go to sleep easily, and some very lucky parents can afford a night nurse or postpartum doula to help when they don’t.  Heaps and heaps of parents balance parenthood and working, or parenthood and community service.  There’s no checklist of things you could “sign up for” to be a parent, even if you wanted to.

Fourth, it’s just plain mean.  Becoming a parent is a huge adjustment, and people need safe spaces to talk about that.  Even if someone is venting about something that seems completely shallow to you (“I can’t go out to the bar as often anymore!”), don’t be a brat.  They’re going through a major life transition and they need empathy, not self-righteousness.  If you can’t muster up any empathy, STFU.

Fifth and finally, this phrase and its variants tell us something very important about the speaker:  When you say this, what you’re really saying is that you’re insecure about your own parenting choices.  You’re angry and bitter about other people taking the “easy way out.”  That’s why one of my husband’s relatives was so insistent that formula-feeding mothers were “selfish”—she couldn’t handle the thought that it would’ve been OK if she’d switched to formula and skipped the hardships she’d faced while breastfeeding.  (For another example along the same lines, see this comment.)  It’s again very much like hazing: “I did it, so you must too, or else you’re not worthy.”

Look, sometimes you have to own your own decisions and accept that you did things the hard way.  We, for example, played a crazy game of alternating shifts to keep Little Boy out of daycare until he was eight months old.  In retrospect, that was unnecessary (except possibly for the money side of things).  We could’ve put him in daycare several months earlier and maybe been happier, without any sacrifice at all to his well-being.

You know what we don’t do?  We don’t go around trying to justify our decision by telling everyone that babies need to stay home with their parents for the first eight months.  We’re OK with the decision that we made, even if we might do it differently in retrospect.  Because here’s the thing: when it comes to parenting, if you really made the best choices for your family, then other people’s choices don’t matter.*  So take responsibility for your decisions and don’t be a smug jerk to compensate.

*Except for vaccination.  You’re putting my kid at risk if you don’t vaccinate yours.  Vaccines are awesome.  Make sure your children get them all.

What other parenting-related phrases should be banned forever?

Bye-bye, breast pump

Going back to school/work after Christmas is always hard, but there was one definite positive this week: I’m not pumping milk anymore!  We dropped the last middle-of-the-day nursing session over the holidays, when the excitement of travel and new toys made it relatively easy to coax Little Boy into changing his routine.  He’s still nursing, but only once a day, when he first wakes up in the morning.

It’s so nice to be done.  I didn’t particularly dislike pumping—it wasn’t terribly difficult for me, and my office on campus turned out to be nearly ideal as a lactation space.  But it was always a thing to do, a thing that I had to remember to do, a thing that took time to set up and put away.  It meant hauling another hefty bag to school every. single. day. and washing a bunch of tiny fiddly pieces every. single. day.  It came with a bunch of extra little tasks, like remembering to grab the milk from the mini-fridge at the end of the day, that made my mental load just a little bit larger.  Being done means that mental weight has lifted, along with the physical weight of that big ol’ bag.  It feels good.

Ouch ouch ouch ouch ouch and useless advice

Having my first experience with a clogged milk duct this week.  Ow.  The achy soreness seems to have subsided, but the spot where the blockage was still stings like a &^%!*&#^% at times.

Of course, I did a Google search for tips on how to treat it.  One of the first hits was this page from La Leche League, which helpfully begins its advice with,

Your best move is to take your baby to bed and stay there for as long as possible.

.

.

.

BWAHAHAHAHAHAHAHA!  (That’s the sound of maniacal laughter, in case you can’t tell.)

Leaving aside any commitments that I myself might have that might preclude me from hanging out in bed all day, Little Boy would not stand for this.  He would lie still next to me in bed for exactly 30 seconds before gleefully wiggling away to play.  Maybe, if it were nap time, I could convince him to doze off nursing for a bit.

To be fair, there’s nothing strictly wrong with this advice.  It probably will help, if you can do it.  It’s just so… unrealistic.

Don’t be like this obnoxious breastfeeding advocate

On Friday, I came across science journalist Tara Haelle’s latest piece in Forbes, titled “How Toxic Is Your Breastmilk?”  The headline is pure clickbait, but the article itself is a well-written discussion of a recent medical study.  Breastfeeding mothers need not worry: the “toxin” in question has no known major effects on humans, and the study was conducted on a small, isolated population and may not be widely applicable.

Besides the well-researched reporting, what I really liked about this piece was its overall attitude toward breastfeeding, namely, that it’s good and has known healthy benefits, but it won’t make your child into Superman or Wonder Woman.  The article starts with this:

Contrary to popular belief in some circles, breastmilk is not the pure and magical serum of the Earth goddess which ensures an eternal life of prosperity and good health to all who partake. That’s unicorn milk — it doesn’t exist.

And ends by affirming:

The real take-away, it would seem, is that there is no perfect, “right” way to feed a baby. […] But breastfed and formula-fed children all across the world are all leading happy, productive lives. So carry on. Feed your baby.

Absolutely.  Ab-so-fricking-lutely.  I want to write this on a sign and shout it from the rooftops.

I’ve written before about how the media and zealous breastfeeding advocates tend to over-exaggerate the benefits of breast milk.  It was so nice to see a balanced, positive take on this frequently guilt-inducing issue that I shared the article, first on Twitter (where I am pseudonymous), and then on Facebook (where I am not).

“Don’t panic, your breast milk is probably fine,” my Facebook post began, followed by a brief note about the way the advantages of breastfeeding tend to be over-hyped.  The first few comments I received were normal conversational stuff.  Some friends and I commiserated about how the study referenced in the article was woefully limited, yet the article itself described it well.

Then stuff got weird.

Specifically, a trio of my husband’s relatives started commenting, led by a woman I’ll call J.  All three of them work in health care.  J is the mother of a toddler, whom she breastfed throughout his infancy.  Like many women, she struggled with latch and other issues early on.

J et al. COULD NOT DEAL with the idea that breast milk might be anything less than 100% perfect baby food for 100% of children.  Over the course of a number of comments, they took it upon themselves to inform me that:

Breast milk contains hundreds of compounds that we don’t know how to synthesize and so aren’t in formula.

Yeah, I know, that was the third slide in breastfeeding class.

Breast milk transfers mom’s antibodies to baby, so baby is less likely to get sick.

Uh-huh, that was mentioned in the article, and, you know, everywhere else.

Breast milk has evolved to be the perfect nutrition for babies. 

OK, but you realize this article was about man-made contaminants, right?

The article and specifically my “Don’t panic, your breast milk is probably fine” comment are “scaremongering.”

I see where you’re coming from on the article title, but are we working off of different definitions of “don’t panic”?

Breastfeeding reduces postpartum depression because it promotes “connection and bonding.”

Wait, are you trying to imply that mothers who bottle-feed have trouble bonding with their babies?  The research is also more complicated than that: if you try to breastfeed but fail, your risk for postpartum depression is much higher than if you formula-feed from birth.

The man-made chemicals in formula and the potentially-contaminated water it’s mixed with are way more risky.

I’m not sure the best response to “don’t freak out about chemicals” is “freak out way more about these OTHER chemicals.”  Also, everyone involved in this conversation lives in developed countries with safe water supplies…

Also, opened cans of formula can be contaminated with bacteria.

Uh, guys, you’re turning this into a hate-on-formula party and I’m not OK with that.

And parents mess up formula mixing all the time.

I’m starting to really not be OK with this conversation.

They are offended by the last paragraph of the article.

Uh, you mean the paragraph that says formula-fed children are leading happy and productive lives and feeding your baby is the most important thing? Um…

This article and/or study might’ve been funded by formula companies.

(Actually, they wouldn’t come right out and accuse the study of this, but just kept trying to passive-aggressively imply it.)

Mothers who “can but won’t” breastfeed are “selfish.”

Oh.  No.  You.  Didn’t.  You did NOT just say that.

Did I mention that J not only works in health care, she cares for newborn babies in the hospital?  That’s right, she’s looking after infants while judging the snot out of how their mothers choose to feed them.

Needless to say, the rest of the conversation did not go well.  I did learn what had set J off so intensely, though.  In the course of an increasingly angry back-and-forth, she brought up her own struggles with breastfeeding, telling me that she found it “very insulting” to be told that she “could have saved all that trouble and just formula fed him and he would be just as well off.”

Way to insult everyone who’s ever given their baby formula, J.  Good on you for persevering, but you do not get to make yourself a martyr and decide that everyone who makes different choices is “selfish.”  Because you know what?  Formula-fed babies ARE perfectly fine.  Sibling studies show that pretty clearly.

So yeah, it’s been an emotionally exhausting weekend.

Lessons from a year of breastfeeding

Little Boy’s first birthday is coming up, which means that my husband and I have survived 12 whole months of parenthood (!) and that we’re about to be the parents of a toddler (!!).  It also means that I (with significant help from my husband) have achieved my goal of breastfeeding for the 12-month minimum recommended by the American Academy of Pediatrics.  Here are a few of things that I’ve learned from those 12 months:

Breastfeeding can be easy

This isn’t to say that it will be easy, but it can be.  Every breastfeeding reference that I’ve encountered, whether in baby care books or online, emphasizes how difficult it can be in the beginning.  There are pages dedicated to resolving clogged ducts, soothing cracked nipples, boosting a low milk supply, and fixing a painful latch.  These resources are really, really important—it’s critical that new moms know that these issues can be resolved—but they do tend to give the impression that the first few weeks of breastfeeding are awful.  It’s enough to make you think twice about whether this is something you really want to do.

What I’m saying is: don’t be scared.  Sometimes your baby gets the latch figured out right away, you produce plenty of milk, and things generally go well.  That’s what happened for me.  There was a short period when Little Boy was about two weeks old when I had to be extra careful about how he latched on, but otherwise there was no pain, no cracks, no gritting of teeth.

An important corollary here is that the difficulty level of breastfeeding is mostly out of your control.  I’m not an über-mom who figured out the secret to easy nursing—I was just lucky.  My mom tells me that nursing went smoothly for her, too, so maybe there’s a genetic component.

…but it is a big commitment. 

A big commitment on top of the already huge commitment of being a parent.  All parents face the sleep deprivation of the early weeks, but for nursing moms, there is no reprieve.  You have to wake up for every feeding; even if your spouse gives a bottle, you still have to pump.

With a one-year-old, sleep deprivation is no longer an issue, but my life still revolves around Little Boy’s four-hour meal plan.  If I go anywhere without Little Boy for longer than that, I have to bring my breast pump.  It’s constraining in other subtle ways, too.  For instance, I can’t go for a run until after Little Boy’s first nursing session of the day, because the engorgement is too uncomfortable.  So when I go running in the summer, it’s in the hot hot heat.

Some parts are wonderful.

Some women like to gush about how perfect and natural and amazing breastfeeding is; I’m not one of those women.  The oxytocin rush tends to make me sleepy and light-headed, not blissfully happy.  Still, when Little Boy snuggles into my lap for his breakfast, it’s pretty darn nice.

Some parts suck.

One word: teeth.

We’ve mostly moved past the biting stage, thankfully.

You don’t have to sterilize your breast pump parts every day.

The manual that comes with your breast pump will say that you have to boil or steam the flanges, valves, etc. every single day that you use them.  For weeks, I dutifully washed my pump parts with soap and water, then popped them in a Medela microwave bag to steam clean.  Ugh.  So much work.

But you don’t have to sterilize baby bottles every day, so why should breast pumps be any different?  (And it’s not like I sterilize my nipples…)  Eventually, I decided to just do the steam-cleaning thing on the weekends.  These days, I mostly forget to do it at all.  Fortunately, the Food and Drug Administration assures me that this is completely OK.

On a related note: you can store pump parts in the refrigerator between pumping sessions!  I would go even more crazy if I had to wash my pump parts thrice a day at school, especially since my building lacks running water.  Breast milk stays good for several days in the fridge; the drops of milk on your flanges are no different.  I store everything in a quart-size Ziploc bag between pumping sessions, then wash it all at home that night.

You can breastfeed on a schedule.

Not right away, of course.  Newborn babies need to be fed on demand, both for their sake and to establish a good milk supply.  However, once breastfeeding is well-established and your baby is steadily gaining weight, it’s OK to introduce a routine.

I think a lot of people hear the words “baby schedule” and think that it means strictly applying time constraints without regard to their child’s desires.  “Sorry kid, I know you’re hungry, but your next meal’s not until 10 a.m. and it’s only 9:45 now.”  Yeah, don’t be a jerk.  (Also, surely that approach is bad for formula-fed babies as well…?)  But there’s a middle ground, one in which you guide your baby into a schedule that works for everybody.

For us, that meant waking Little Boy up at a consistent time every day and offering food every three hours during the day (and then as needed at night).  Between 4 and 5 months old, he started taking more consistent naps, and his mealtimes likewise became more consistent.  Today, his eating habits are very predictable, within ±30 minutes depending on naps and hunger.  Only once in recent memory has he asked* to nurse between regular meals, and that was when I was recovering from food poisoning and knew I was dehydrated and low on milk.

*How does Little Boy ask for milk, you ask?  He pulls down my shirt and demands, “Ma ma ma ma ma.”

It’s easier to nurse in front of strangers than in front of friends.

Obviously, this depends a lot on your personality.  Me, I’m not too worried if someone at a gas station catches a glimpse of something while we’re on a road trip—they can get over it.  But when friends (or worse, family) are around, I get nervous about whipping out the boob.  I worry about their comfort level with my usually-covered body parts.  The only exception is my mom, because she’s awesome.
 

Where do we go from here?  I’m getting awfully darn tired of pumping, so once we hit that 12-month mark, I’ll start weaning Little Boy off his mid-day feedings.  We’ll stick with breakfast and bedtime as long as it works, assuming my milk supply holds up.

Tell me about your baby-feeding experiences (breast or otherwise) in the comments!

Scenes from a journey

It’s mid-afternoon, but the airport is nearly empty.  There is no one behind me to wait impatiently while I unload shoes, laptop, liquids into the security bins.

“Do you have a laptop?”

It takes me a moment to realize that she’s talking to me, but then, who else would she be talking to?

“Yes, I do.”

“You need to take it out of your bag and put it in a bin.”

I respond by lifting my silver laptop out of its bin on the table, wordlessly demonstrating that I am aware of this regulation.  It seems an oddly accusatory instruction, given that I am still in the process of taking things out of my bag.

My belongings slide slowly through the X-rays.  The agent running the machine stops the belt, leans in, and lifts with one finger the strap of my Medela Pump-In-Style Advanced.

“What is this?” she asks.

“Breast pump,” I answer, a touch too loudly, overcompensating for my nervousness by a fraction of a tone.

She says nothing, but replaces the squat black cube in its bin and restarts the conveyor.  I half-expect another agent to materialize and swab the thing for explosives.  None do, but with the rush of adrenaline, I forget to pick up my pocket lip balm and spend the next thirty minutes trying to reassure myself that I didn’t forget anything else.

The airport remains eerily uncrowded.  I scan for a family or single-stall bathroom—there are none.  I scout out the ladies’ room—are there any outlets in the stalls?  How is this supposed to work, exactly?  I opt to stand at the far end of the counter, pumping apparatus modestly hidden under a nursing cover.

The pump is loud in the quiet room.

The janitor enters, a pleasant-looking woman.  She waves away my attempts to shift position and systemically wipes down the sinks, changes the trash, flushes the toilets.  It is only as she is leaving that I realize that she had blocked the bathroom entrance when she arrived.  I am grateful for this small kindness.

I buy myself a novel in the airport shop.  I cannot remember the last time I did this.  Usually I stare interestedly at the books on display, telling myself that they’ll be much cheaper on Amazon—except I never get around to purchasing them on Amazon.  And usually, I’ve brought a book from home.  But my book at home right now is a hardback copy of the eighth Outlander novel and my backpack has no space for that monstrosity, so I treat myself to a paperback of Gone Girl.

Three separate strangers on two separate flights comment to me that Gone Girl is a great book and I’m going to love it.

They keep announcing that the flight is completely full (“there is no remaining space in the overhead compartments”), but the seat next to me is still unoccupied.  Finally, a woman staggers down the aisle, led by a flight attendant, whose directions indicate that the woman had somehow lost herself on the way to seat 12B.

She seems to recognize the guy across the aisle from me, a man who could only be described as a “bro.”  Then she turns to me.

“Would you move to the middle seat?”

That’s it.  No “would you mind moving?”, no “I would really appreciate being able to sit next to my friend,” not even a “I met this guy in the airport bar and want to keep flirting.”  Just “would you move.”

I stutter, but can’t think of a way to say no without becoming the jerk in the interaction.  I’m also getting a strong feeling that she would just talk over me, if I were to remain seated in her way.  So I move.

She sprints to the bathroom the minute we’re in the air, heedless of the flight attendant’s chastisement and the “please remain in your seats” announcement that follows.  Later, she cheerfully declines to get out of the way for me, forcing me to awkwardly climb over her knees to exit the row.

She and the bro exchange phone numbers—and names.  They spend the ninety-minute flight flirting in the most blatantly obvious of ways.  They trade headphones to listen to each other’s music.  Sometimes they don’t bother with the headphones, choosing instead to share their music with the whole plane.

I try to drown out their conversation with my own headphones, with limited success.  They have jobs: she’s a mechanic, he’s a civil engineer.  She might have a kid.  They both buy alcoholic beverages from the flight attendant and toast something across the aisle.

It’s not that the instructions from Google Maps are wrong, it’s just that they appear to be filled with a number of extraneous side roads.  In the dark, I don’t care that going from road A to road B via roads C, D, and E shaves off half a mile when roads A and B do in fact connect directly.

Somewhere around road Q, I give up on the map completely and opt for the “I think this is the right direction” approach.  For several minutes, I drive alone in the dark countryside.

Fortunately, I’m right, and a few minutes later I pop out on a major throughway.

My mother has stayed up to let me in, as I knew she would.  I tell her that she’s free to sleep now, that I can take care of food and dishes and bedding myself, but she doesn’t.  We sit at the kitchen counter and I eat and she talks, and I wish I could take some of the sadness away from her.  She misses him—her father, my grandfather.

I miss him too.

Lies the baby books told me

Before Little Boy was born, I read: three books on pregnancy, one book about birth, one book about baby sleep, two books on general baby care (à la What to Expect the First Year), and countless online resources about all of it.  This was perhaps a little excessive.  The biggest thing I learned from this reading spree was that you can know every available detail on how to take care of a baby and still have absolutely no idea what to actually do with your baby.

Some of the information in the baby care books was helpful, some of it was clearly inapplicable to my kid, and some of it was just bizarre (do some hospitals really give you dry gauze pads instead of baby wipes?).  And then there were these:

 

“A breastfed baby’s poop smells sweet [or at least not bad].”  If by “sweet,” you mean “like a dozen rotten eggs,” then yes, I guess the poop of a breastfed baby does smell sweet.  (See also: “Breastfed babies don’t need to be burped as much.”)

 

“Your baby will naturally fall into his own schedule.”  Everything I read promised that after the first month or two, if you just kept track of your baby’s feeding and sleeping preferences for a week, his personal schedule would become clear.

Uh-huh.

To coax Little Boy onto a schedule, we had to:

  • Wake him up at the same time every morning.
  • Wake him from naps to make sure he ate enough during the day.
  • Deliberately aim to begin the bedtime routine around the same time every night.
  • Wait until he was nearly 5 months old and consistently able to nap longer than 45 minutes at a time.

 

“Newborns spend some of their time in a ‘quiet alert’ state.”  Is this the “I’m bored but I’m too little to be entertained by anything you do and I’m not tired so I’m just going to fuss until I get hungry again” state?  No?

 

“You don’t need to change your baby’s diaper at every nighttime feeding.”  I suppose this is theoretically true if your kid doesn’t consider every middle-of-the-night meal the perfect opportunity to poop.

 

“One pumping session with a double electric breast pump takes 10-15 minutes.”  Yeah, I wish.  Thank goodness I can work while I pump.

 

I can’t wait to see what gems the toddler care books have in store for us.  “Potty training is easy,” perhaps?

In praise of Dr. Ferber

Ferber seems to take a lot of flak on the internet these days.  I’m referring, of course, to Dr. Richard Ferber, author of Solve Your Child’s Sleep Problems and founder of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital.  His method of sleep training has become so well-known that it has its own verb: “Ferberizing.”  But spend any time on mommy forums and you’re bound to encounter science-y sounding proclamations about how terrible the so-called “cry it out” methods are for your baby.  Abandonment!  Brain damage!  Instant breastfeeding failure!

Those people are nuts.

I think when a lot of folks hear the words “sleep training,” they think of situations like the one described in this New York Times article, in which a doctor recommends leaving your 8-week-old alone for 12 hours, no matter how much he or she cries.  Don’t do that.  Don’t even think about doing that.  Seriously, that is a terrible, terrible idea.

That’s not what the Ferber method is about.

I actually read Ferber’s book, in its entirety, and it is the very opposite of ignoring your child’s needs.  His (in)famous method occupies just one chapter out of eighteen.  Most of the book deals with a variety of other sleep issues: nightmares, sleepwalking, bedwetting, circadian rhythms, etc.  It was clear to me that Dr. Ferber cares deeply about children’s well-being.  For instance, his recommendation for an older child dealing with severe anxiety is to do “whatever is necessary to help your child feel safe” – the italics are his emphasis, not mine.

My Little Boy stopped nursing himself to sleep somewhere around the 2-month mark.  Bedtime became progressively more and more of a struggle, as he grew less and less interested in being rocked or sung or swung to sleep.  By 3 months, it was taking a solid 90 minutes to put him to sleep at night, and then we’d be on tenterhooks for another 45 minutes in case he woke up at the end of that first sleep cycle.  The stress and lack of personal time was making my husband and me very unhappy.  Something was also making Little Boy very unhappy: he started crying the moment we took him out of his bath and kept it up all through his bedtime story and song.

That’s when we decided to sleep train.  Ferber’s book told us to lay him down in his crib with a kiss and leave for 3 minutes.  Go back in for more kisses and shushes and reassuring words.  5 minutes.  More reassurance.  7 minutes – wait, he’s quiet.  He’s asleep!  The next morning, Little Boy went down for his first nap with zero crying, and he cried for less than 5 minutes that next night.  Night 3 was a bit rough with 20 minutes of angry baby, but he’s been good at falling asleep ever since.

Now 7 months old, Little Boy falls asleep on his own and greets us in the morning with giant smiles.  He will sometimes grump for a few minutes when we leave him at night, but more commonly he happily babbles for a bit before getting comfy.  He sleeps well in strange places as long as he has a quiet, safe space to rest, and he’s added two teeth with extremely minimal sleep disruption.

We are happy, because nighttime is much less stressful.  Even more importantly, Little Boy is happy.  He stopped screaming during his bedtime routine, perhaps because he is confident in his ability to fall asleep.  (Ever been tired but unable to convince your mind and body to sleep?  It sucks.  It would make me scream, too.)  Sleep training has meant a lot LESS crying for Little Boy.

There are other methods of sleep training, with varying degrees of parental presence and intervention.  I liked the Ferber method’s balance of giving my baby the chance to fall asleep on his own while still allowing me to make sure he was OK.  We still check on Little Boy if he fusses for more than 5 minutes; on the rare occasion that this happens nowadays, it’s almost always because he needs a clean diaper.

Of course, you don’t need to sleep train your baby.  If you’re happily co-sleeping or just have a kid who sleeps easily and well – awesome!  Don’t fix what isn’t broken.  But if it takes hours just to put your baby to sleep at night, or if he’s waking up every 45 minutes all night long – the rest of this post is for you.

I call it “Crazy Grad Mama’s guide to (mostly) guilt-free sleep training.

Wait until your baby is old enough.  Most sources will say to hold off on sleep training until 4 months; some say to wait ’til 6 months.  The real hard-and-fast rule is to wait for the end of the “fourth trimester,” that 3-4 month period in which your baby is still adjusting to life outside the womb, his nervous system still developing to a point where it can handle the big wide world.  You can gently try to make your newborn sleep longer, but you can’t force it.

Sleep training is not the same thing as night weaning.  (In fact, they’re separate chapters in Ferber’s book.)  “Sleep training” should be about falling asleep, not specifically about sleeping through the night.  If your baby needs to nurse every hour because that’s the only way he knows to fall back asleep at the end of a sleep cycle, then yes, sleep training will mean fewer night feedings.  But you should never let your baby go hungry (duh, right?).  In our case, Little Boy had dropped to 0-1 night meals of his own accord before we sleep trained.  Since we knew that when he woke out of hunger, it was around 4-5 a.m., we decided to treat any wakings before 2 a.m. as not-hungry times.  (As it turned out, this happened only once.  I don’t remember what was bothering him, but his dad comforted him a few times, and he went back to sleep.)

Have a plan.  Consistency is key to learning any new skill or habit.  The first couple of nights of sleep training will probably suck, so it’s important to be prepared.  It’s also important to implement a legit sleep training method and not a haphazard “I’m going to let my baby cry for a while and see what happens” approach.  Read a book (or books, if you’re me) or find a non-crazy internet site for reference.  Noob Mommy has a great explanation of Ferber, and BabyCenter’s Teaching Your Baby and Toddler To Sleep board is a good resource for sleep training options (this is only time I will ever recommend a BabyCenter forum, so take note).

Commit for a week.  Again, the first few nights will be the worst, but you should see noticeable improvement after that.  It’s also not uncommon to see some improvement, then have a random worse night (like our third night).  But if you stick to it, things should be better after a week.  If they’re not, stop and reevaluate; either you, the parents, have implemented something incorrectly, or your kid needs a different approach for sleep.  (If you have Ferber’s book, you can refer to the section titled “If Things Are Not Getting Better.”)

Remember the importance of sleep.  Some people dismiss sleep training as selfish, and it undoubtedly benefits parents.  But sleep is important for growing babies, too.  Memories consolidate during sleep; the mind and body refresh and renew themselves.  Solid sleep is as important a biological need as food and human interaction.

For those about to embark on a sleep training adventure, I wish you luck!