24 Feb

Book Review: How to grow a baby and push it out, by Clemmie Hooper

Clemmie Hooper is the new Mark Harris: the midwife all the talk shows want, popular on social media, and with a new, slightly different book about pregnancy and birth. Sorry Mark.

How to grow a baby and push it out‘ is a colourful, cheery book, with lots of pictures (mainly of Clemmie herself looking pregnant and glamorous). With a heavy emphasis on what to buy and how best to treat yourself (“Find a really, really lux hotel to stay in.” p101) and an assumption that you will “buy friends” by doing NCT classes, this really is the yummy mummy’s handbook.

I would have quite liked this book during my pregnancy ten years ago. In between the slightly vapid chapters about shopping, it covers a lot of topics, including how to massage your perineum, what to consider when choosing a place to give birth, and different options for coping with pain. With its bite-sized chapters and clear explanations, it is more accessible and less gloomy than the book I did have, ‘What to expect when you’re expecting.’

Reading it now, I would like to see more on consent and informed choice; Clemmie is in a good position to talk about building that kind of trusting relationship with Health Professionals, but at the end of the day she is working within a medical model, and that’s what comes across. The information given about breastfeeding is scant and inadequate, starting with a list of its benefits, omitting any discussion of how it works, conveying the message that it is always difficult and usually painful, and then admonishing readers not to pay attention to pressure about how long to do it for. This could have been done so much better.

I liked the positive tone of the book, although in places the chumminess gets annoying; and I liked the focus on active birth, and the signposting (other than in the breastfeeding section) for readers who would like to explore the many topics in greater depth. It’s a nice starting point for mums-to-be who like a guidebook, but doesn’t really replace good quality antenatal education, where there will be more for partners, and lots of opportunities to discuss what might happen and how you might feel, rather than just be passively told about it all.

22 Feb

Book Review: The Gentle Discipline Book, by Sarah Ockwell-Smith

The Gentle Discipline Book is a book for parents, based firmly in attachment theory and gentle parenting practices, just as you would expect from an author who has very much made this her specialism.

Ockwell-Smith defines discipline as a supportive teaching process, and devotes a chapter to critique of discipline in its more widely-understood sense, i.e. punishment and reward. She supports this approach very thoroughly with a good chapter on neuroscience, and logical explanations of the developmental reasons for various behavioural issues in young children.

The book then goes on to look at a range of problems, from sulking to swearing, with helpful strategies for dealing with them. This is a widely applicable, useful read for all parents, and for anyone involved in educating parents and parents-to-be about raising children with empathy and kindness.

I also found that Ockwell-Smith gives a helpful perspective on parenting, recommending the 70/30 rule: “trying to be the best parent you can be 70% of the time and not worrying too much about the other 30%” (p238) As the mother of an occasionally difficult (but generally delightful) ten year old, I found this very affirming.

In this book, Ockwell-Smith offers an updated and less US-centric take on Sears’ Discipline Book, and I would recommend it unreservedly.

[Disclaimer: I was provided with a free review copy of this book]

17 Feb

Fed Is Best misses the big picture

There is a growing movement of vociferous breastfeeding skeptics, more organised and insidious than the usual lone voices of disappointed, angry, grieving women whose breastfeeding experience was not what they had hoped for. I have ignored it for long enough, but they now seem to be everywhere I look, and their words are dangerous and damaging.

As is so often the case, this “backlash” arises from one sad incident that happened to one articulate and privileged woman whose baby failed to thrive in circumstances where, if I understand it correctly, no baby could have thrived. I will refrain on commenting on a situation about which I know very little, as any well-trained and mother-centred breastfeeding supporter should. But this movement has easily, inevitably snowballed, gathering followers from that huge group of women who have been failed by society at a most vulnerable time.

This is a group of parents who are so upset that breastfeeding did not work for them, that they would prefer it not to work for anybody. Rather than campaign for better support and a more breastfeeding-friendly society, they present breastfeeding as an unnecessary choice, that mothers would be better off without. As with much of the anti-breastfeeding literature, we see the people who offer breastfeeding support portrayed as cruel, evangelical bullies and the well-evidenced disadvantages of formula milk downplayed.

In the past decade, I have written this again and again: we do not need to divide mothers and babies into the false categories of Breastfeeding and Formula Feeding. The first rule of infant feeding is to feed the baby, but “fed” is only best if “not fed” is the only alternative. And with better knowledge about breastfeeding and a more supportive environment, not fed should not happen. A woman with the confidence to trust her own instincts does not restrict feeds just because she has been told her baby’s stomach capacity is small; a well-informed woman who wishes to breastfeed understands that frequent feeding is what builds up a milk supply, and the delightful contents of every nappy can reassure her that this is happening; an educated health professional can support her with this knowledge.

Those key elements, maternal instinct and good information, slip through the cracks. And why do they slip through the cracks? Because in western society we believe, in the face of the evidence, that breastfeeding does not work. And why do we believe that it does not work? Because the voices of anger and disappointment are louder than the voices of women who just got on with it because it was no big deal.

There is no money in breastfeeding that works, unless you count the savings made in better overall health outcomes (and families who don’t have to shell out for formula): if anyone was really counting that, the governments of the western world would be investing in breastfeeding support and promoting a society that is truly supportive of breastfeeding mothers. Instead we have one where vitamins are marketed to them in case their milk isn’t good enough. One where lanolin cream is advertised for when their nipples hurt, as if this were inevitable. One where babies are expected not to inconvenience their mothers by requiring to be fed and to be held. One where qualified doctors can flatly deny science and continue to speak with the authority granted by their white coat.

It is a scientific fallacy to believe that cows milk, modified in a factory and dried into a powder, is better for human babies simply because it is sometimes more readily available. And it is a fallacy of privilege to believe that it is always readily available. It is not uncommon even in the UK for parents using formula not to follow the guidelines when making it up: too much powder (to make the baby grow), too little powder (to make the pack last longer), or water that is not hot enough to kill the bacteria (because it’s inconvenient, or they just don’t know, or they haven’t got a kettle). An 800 g tub of a popular formula costs £12.99 and would last roughly ten days for a newborn and five days at six months, if you feed according to the instructions on the side of the pack. Babies need breastmilk or a suitable formula until they are a year old. Breastfeeding support is free at the point of access. So tell me which of these is the choice of the privileged family?

Perhaps it is only the affluent and educated who can afford the privilege of lashing out at the passionate but inadequately funded network of people who could have helped them, and of missing the big picture of what is wrong in a world that let them down so badly.

08 Feb

Book review: Pride & Joy, A Guide for Lesbian, Gay, Bisexual and Trans Parents – by Sarah & Rachel Hagger-Holt

2017-02-07-18-30-37 This is the most perfectly-titled book I have ever come across, a fact which became increasingly evident as I read it – in one sitting – and found it to be so warm and upbeat, a book that is truly full of pride and joy.

Pride And Joy would be useful and interesting for LGBT parents; those considering becoming parents or even wondering if they ever can become parents; children of LGBT parents and other extended family members, and anyone working in a support role including health professionals, antenatal teachers and others. It is packed with anecdotes and quotes from that same wide-ranging group, so that it gives the reader a rich narrative, coherently exploring the broad experiences in the LGBT world. Each chapter ends with some points to consider, with signposting to useful resources, making it practical as well as very readable.

One thing that came across to me was that LGBT families have more common factors than differences with non-LGBT families. The authors treat extended and complex family situations as largely positive, acknowledging that blended families are now the norm for many people in western society, whatever the sexual orientation or gender identity of the parents. Many issues relating to pregnancy, birth, new parenthood, and growing up are not unique to LGBT families, however the fact that much of the support offered in these situations comes from the straight community reminds us of the importance of being open and inclusive when supporting parents. This book is well positioned to increase knowledge and understanding, and I hope it will be very widely read.

[Disclaimer: I was sent a free copy by the publisher. You can buy your own copy from their website, and use the code SPROGCAST at the checkout for a 10% discount]

07 Feb

Book Review: The State of Medicine, by Margaret McCartney

This book is difficult to read. It’s brilliantly written, coherently argued, and McCartney’s passion for the NHS screams through every paragraph, and for all that it is a joy to read; but it is difficult to read about the increasingly overt privatisation of the NHS, and the destruction of its most fundamental principles.

In 21st Century Britain, politicians express love for and pride in the NHS, while systematically setting it up to fail, by implementing policies for the sake of headlines, and apparently deliberately misreading research to support hopeless initiatives which are not trialled, and not terminated when they prove not to work. Modern social and cultural expectations enable the government to push forward their agenda, by creating an environment where popularity and choice trump evidence and effectiveness. The vocational nature of health work allows us to expect health professionals to give endlessly, while being abused in the press, badly paid, and put under intolerable pressure.

McCartney unravels so many threads of this Kafka-esque situation, bringing in clear evidence and pointing out where it is missing; and including the voices of real people working in and experiencing the NHS: doctors, patients, researchers, policy makers. She is so passionate and articulate, part of the very core of the NHS, and one of those who will fight to the last breath to maintain an evidence-based health service, free at the point of access, for everyone in the UK.

[DISCLAIMER: I was sent a free copy of this book by the publishers. You can buy your own on their website, with a 10% discount if you use the code SPROGCAST at the checkout.]

04 Feb

Welcome to The Motherland

New guidance from the British Medical Association recommends a change of language, from “expectant mother” to “pregnant person,” in order to recognise trans parents who may not identify as women. I confess that this is very confusing for me, and my confusion arises from how, then, we should define motherhood. There is also a conflict between my inclination to accept whatever terms people want to use for themselves, but also to value motherhood in a way that does not easily allow me to erase the “womanness” of it.

Please don’t imagine that my point of reference for motherhood is limited to floating around in a cloud of organic breastfeeding loveliness. In fact, I think that might be the core of the dilemma: this question of whether to use the word “mother” is just terribly reductionist, as though motherhood can be only one thing.

Motherhood emerges in so many different forms, perhaps uniquely for every single person who has – but there’s the problem – has what? Given birth? Some mothers adopt. Parented? Are women who miscarry or suffer stillbirth not mothers? The literature is at pains to emphasise that they are. Does that mean that women whose pregnancies end in abortion are also mothers? Some of them might feel that way; it was certainly the start of the journey into motherhood for me.

Clearly there is not one single event that turns a person into a mother. Motherhood is more like a place you go to, where you experience new things, which you may have expected or not, and which you may enjoy or not, and which change you, but do not turn you into a specific and new type of person. As with travelling, those experiences will affect you to some extent, but will be assimilated into your existing self.

A close friend tells me that she always knew she wanted to be a mother, by which she means give birth to and raise children, yet a decade in she still feels that this isn’t the real her, these boys aren’t really hers (this existential angst must necessarily co-exist with doing the laundry and preparing packed lunches). On the other hand, I never particularly yearned for motherhood (and I overheard my own mother, when I was six months pregnant, remarking “Karen was never very maternal.”) And yet I simply could not be the person I am now, and do the most fulfilling work I have ever done, without it.

It seems acceptable for other people to identify me as a mother, but I would prefer them to understand that I am not solely – or even mostly – that, while still being that to my very core. Yet having argued that neither being pregnant, nor being a parent, are intrinsic to motherhood, I think we could explore the possibility of having a term that isn’t gendered, to represent having travelled to this place, should it be necessary to reveal that element of one’s identity.

What of fathers, who now are expected to take on more of the nurturing role traditionally associated with motherhood? Up to 50 weeks of parental leave can now be shared in the UK, so dads can take on the majority of the parenting from very early in a child’s life (and technically a man can “father” a child without even knowing about it, so how can fatherhood then be part of his identity?). Perhaps the word “mother” is only differentiated by being the one who is expected to do the majority of the housework, whether he or she works outside the home or not.

[Cross-posted from Huffington Post]

02 Feb

Do our children want to be on social media?

I cannot help wondering how the post-millennial generation will incorporate social media into their parenting. Millennials are the most transparent, the most connected to social media, parenting in a world where not putting photographs of your children on Facebook, nor offering up a commentary on your broken nights and organic craft-filled days, seems downright antisocial.

But what is the downside of this transparency? And do other generations avoid this must-share tendency? You may not see quite as many baby photographs posted by proud grandparents, and let’s not assume that’s down to technical matters: my partner’s 92 year old grandmother is as IT-literate as I am, and my mother constantly invites me to join her in a game of Candy Crush. My father Richard Hilditch, on the other hand, has been a social worker for 45 years, and says,

“However much you may want to share the adorable cuteness of your offspring, grandchildren or friends’ children, however rightly proud you may be, don’t do it!”

In school IT lessons, children are taught important principles of security, including not to divulge personal information such as their birthday, their address, their school, or the names of their friends or pets. Meanwhile their parents may be posting photographs of beaming pigtailed children in badged school sweatshirts, standing outside their own numbered front doors. Scroll down a bit to find their friends name-checked at a party, and throw in the family dog, and you have everything you ever need to hack their future email and banking passwords, never mind anything more sinister. Today a photo in my feed shows happy new parents at the register office, clutching both baby and a fully visible birth certificate. According to the NSPCC over 90% of sexually abused children were abused by someone they knew. Dad says: “So an ill-meaning adult “friend” could sound pretty convincing… If there is someone amongst your friends, or friends of friends, who is intent on stalking or harming a child, how much more gift-wrapped could you make the opportunity?”

Facebook offers some layers of privacy, but when you post a status or a photograph, you grant them the license to use and display it. There is no guarantee that those layers of privacy will always remain. Even the more apparently private messenger services may not be as private as you think. Even Whatsapp, popularly thought of as a more transient and less indelible service, shares data with Facebook.

Nor do our children get any editorial rights over the comprehensive archive we are creating of their eating and sleeping habits, their first words and favourite games, their embarrassing mistakes, tantrums in shops, and a whole collection of peculiar – cute – annoying whims. Have you ever googled someone you just met? Think what future partners, clients, and employers will be able to discover about this reluctantly transparent generation. Last year an Austrian teenager sued her parents to force them to remove posts about her, citing their violation of her privacy. Under French privacy laws, parents could be imprisoned for publicising details of their children’s private lives.

Social media can offer sanity-saving connectedness and support, particularly during the isolated early days of parenthood, but I implore parents to consider carefully what information they make public. It’s true we live in a world of constant scrutiny, but there is no need to make it easy for those who might use this information maliciously. And by definition, you do not know who those people are.

[Cross posted from the Huffington Post]