parenting | Motherworldly

03 Mar

Book Review: Beyond the Sling, by Mayim Bialik

Mayim Bialik is a neuroscientist, an actress, and with this book a real spokesperson for Attachment Parenting. If you imagine a spectrum with absolutely routine-focused, parent-led families at one end, and completely baby-led, bed-sharing, nappy-free families at the other end, then Bialik is telling a story set right at the tip of the baby-led end of that spectrum. The title “Beyond the sling” tells us just how far along it is.

As she tells us at the start, this is not a quick-fix parenting manual. Although she clearly is writing about what, in her view, is the best way to parent, she delivers most of this through anecdotes about her own family. I spoke to a new mother recently who liked that because it gave her a new perspective to think about, rather than telling her what to do.

Attachment Parenting considers parenting to be “the most natural and instinctual event on the planet.” (p11), fostering respectful and loving relationships between parent and child, and ensuring a securely attached, happy individual. Bialik argues that this process is innate and this outcome biologically inevitable, and devotes one chapter to explaining some very basic science behind attachment theory. This section was disappointingly thin on actual science.

Part Two of the book is entitled “What a baby needs,” and covers birth, breastfeeding, babywearing, bedsharing, and elimination communication, which she feels gave her a deep intuitive connection with her children. These chapters are mostly evidence-based, however they frame this style of parenting very much within the limitations of natural birth, exclusive breastfeeding, and easily cleanable floors, which I fear would make her exhortations inaccessible to many parents.

Part Three is about what babies don’t need, and while there is much to admire in keeping one’s home free of battery-operated toys, I absolutely cannot get behind her “informed decision” not to vaccinate her children, and feel that the resources offered to support this very brief section are rather one-sided.

The chapter on discipline gave me a lot to think about; I felt like I violently agreed or disagreed with every other paragraph. There is much clear and logical thinking about how to deal with behavioural matters, but many of the anecdotes about how she and her co-parent implement this thinking seem not to line up with the theory. I think that a child would understand “not for Miles” (p195) to mean exactly the same thing as “no,” but perhaps it depends on the parenting context. I feel like I must be missing some very subtle nuance here.

I would be unlikely to recommend this book to someone who hadn’t specifically asked for something on Attachment Parenting. I am uncomfortable with dogma at any end of the spectrum. Bialik states that “this is not a judgemental book,” nor is it one of those books that “make me feel that I am failing and inadequate,” (p13); and yet this is exactly how I felt reading it – and this is from the perspective of a straightforward birth, bedsharing, full term breastfeeding, and a pretty good grasp of brain development myself. When Bialik claims that she does not need to put her own needs on hold to parent in this extreme way, she also contradicts herself by repeatedly telling us how tired she is, but that it is the right thing to do. I think it would be okay to be honest about the amount of sacrifice needed to parent in this extreme way, and that there are parents who will choose it anyway, or moderate their approach to meet both their own needs, and those of their children.

Disclosure: I was sent a free review copy of Beyond The Sling by the publishers Pinter & Martin. You can currently buy it on their website for £6.99.

19 Oct

Book Review: The Food of Love, by Kate Evans

The Food of Love is a fun breastfeeding guide full of Kate Evan’s clever pictures and even fuller with words. I think it is aimed at mums-to-be and new mums, but I think it’s also widely enjoyed by people working with new parents.

There is a lot to like about this book. Most of the cartoons are funny (some of them are a bit judgey), and it is jammed with a huge amount of well-researched information. Evans positions herself firmly at the Attachment Parenting end of the spectrum, and is more than capable of backing up her position with evidence. Unfortunately she doesn’t, always, which relegates a lot of her bold statements to opinion. The book would be much stronger if it was better referenced.

In the early chapters, Evans covers the basics of how breastfeeding works, using cartoons to demonstrate very clearly the mechanics of breastfeeding as well as a lot of the interesting sciencey stuff about breastmilk. The section on hand expressing is excellent; the section on positioning is surprisingly prescriptive – I’m sure laid-back Kate didn’t always sit bolt upright to breastfeed.

Evans’ passion and enthusiasm for breastfeeding comes across on page after page of often rather stream-of-consciousness text, as though she has scribbled down everything she can think of about breastfeeding, and when she runs out of that she goes on to talk about parenting in general, sleep, postnatal depression, relationship stuff, and toddler discipline. It’s a really useful general parenting book in that respect and could probably reach a wider market if sold as such.

I enjoyed the lovely bit on the evolutionary context of attachment theory, again illustrated with amusing drawings. Occasionally she follows a fairly idealistic opinion section with a contrasting realistic cartoon, for example the starfish baby in the middle of the bed showing the reality of co-sleeping for many parents.

We have the obligatory dip into alternative medicine (which if it worked would be called medicine), which is a shame when she’s so clear and comprehensive on brain chemistry and other sciencey stuff. The recommendation of homeopathic belladonna as a treatment for mastitis is a highway to a breast abscess.

The chapter offering solutions to common breastfeeding problems includes some excellent flowcharts (pp131-132), however the solutions offered are a bit garbled in places and there is no signposting to reputable breastfeeding support organisations such as NCT or ABM, nor any discussion of breastfeeding support groups (which surely would lend themselves well as subjects for caricature).

In summary, I loved parts of this book but not all of it. I probably would give it to a new parent, but not universally; I think some people might be more receptive to it than others. I’d love to see it repackaged as a general parenting book as it’s so good on attachment parenting. And I can strongly recommend Kate’s blog!

10 Jun

Baby Boxes or Tickboxes?

This lovely article was all over twitter on Tuesday Why Finnish Babies Sleep In Boxes:

For 75 years, Finland’s expectant mothers have been given a box by the state. It’s like a starter kit of clothes, sheets and toys that can even be used as a bed. And some say it helped Finland achieve one of the world’s lowest infant mortality rates.

The box contains baby clothes, breastpads, nappies and other essentials for the first few weeks, and comes with a mattress that fits in the bottom so it can be used as a crib. A graphic in the article shows the dramatic drop in the infant mortality rate since the box was introduced in 1938, attributed to, amongst other things, the decreased rate of unsafe bedsharing* and increased rate of breastfeeding that the box has helped bring about. 99% of Finnish mothers initiate breastfeeding, compared with 81% in the UK. While these are quantifiable factors that are known to have positive health outcomes, the underlying message to parents that they and their offspring are valued and important must surely also have some impact on early parenting.

Compare this with the pitiful situation here in the UK. Our equivalent state-sponsored freebies come from an organisation called Bounty, which promises free samples in return for your personal details, and then inundates you with adverts and misinformation in the form of a chatty little booklet called Emma’s Diary. New parents receive a small sample of nappy cream, one nappy, and a sachet of detergent (or something similar). The government pays Bounty £90,000 per year to distribute the freely-available Child Benefit Form in amongst all the adverts. Bounty reps collect new parents’ personal data and sell it on to other advertisers.**

What message does this send, in contrast to the Finnish government’s warm welcome to new babies? That mothers and babies are only worth their economic value. That they should be encouraged to buy the nappies and creams and household products that appear to have government, and by reason of being brought to you at your hospital bedside, NHS-approval. That love for your newborn baby can be measured by your willingness to buy a photograph from a stranger. That parents must hurry back to work in order to keep the economy afloat, and can do so thanks to lowering the standards of nursery care but probably not the cost.

The social impact of the Finnish baby box undoubtedly goes beyond impressive breastfeeding rates to make parents feel cared for:

This felt to me like evidence that someone cared, someone wanted our baby to have a good start in life.

Both giveaways are aimed at improving outcomes by bringing families into contact with health services. It would be interesting to compare the social return on investment in Bounty Packs, taking account of their negative messages about birth and breastfeeding, with the investment in a few articles of baby clothing and a nice blanket.

*That is, sharing a bed in unsafe conditions; not bedsharing per se.
**The petition against Bounty reps on maternity wards is here.

Further Reading
Come for the box, stay for the life saving services
Alice Roberts: Why are Bounty reps allowed on maternity wards?
Profits from pregnancy: how trusted organisations sell out women to commercial interests
http://margaretmccartney.com

30 May

Book Review: Baby Management for Men, by Henk Hanssen

Author Henk Hanssen claims that fatherhood is his favourite subject, and a real sense of fun comes across in this warm and accessible little baby manual.

In this book, the father is the consummate manager. The family is your enterprise, the mother your producer, the baby your product. [p10]

Heavy on the business-speak and technical jargon, it might not appeal across the board, but beneath the veneer of gentle silliness, the book is packed with practical information. It addresses how the new father’s life will change, how to approach his employer with requests for paternity leave and flexible working hours, and directs the him to think about the kind of father he wants to be. It then goes on to describe in detail the baby’s appearance, likely behaviour, and maintenance required in the first year or so.

You might pick up a book with the title “Baby Management” expecting a rigid, parents-in-charge approach; in fact I would place this well towards the attachment parenting end of the spectrum. Hanssen encourages dads to be hands-on, and quotes evidence to show the benefits of an involved, engaged father, for the whole family.

My few criticisms of the book would include a raised eyebrow that the feeding section starts with expressing before actually addressing the subject of breastfeeding. Granted that’s because the focus is on how a dad can be involved with this, but I would rather see the emphasis on supporting the mother to establish breastfeeding first; there are lots of ways dads can help with this. Hanssen erroneously states that breastmilk can be kept in the fridge for up to 72 hours; most reliable sources state 5-7 days. Other than that, the section dealing with feeding is almost entirely accurate. Sadly when it comes to introducing solids, the advice given is rather old-fashioned purees-only approach.

The section on growth and development is particularly fascinating, and the book is well-referenced. I wouldn’t hesitate to recommend it to fathers-to-be.

*****
To order Baby Management for Men with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

29 Apr

Book Review: Talking with children about things that matter, by Sheila and Celia Kitzinger

Talking with children about things that matter by Sheila and Celia Kitzinger, is a wide-ranging discussion about the big issues that bother contemporary parents. Although it was written in 2000, and therefore lacks that important chapter on social media and the internet, the contents of this book are highly applicable to the modern family.

The Kitzingers have surveyed parents and reviewed the literature to look into some really big topics, examining the way parents attempt to instil their own values in their children. The book therefore caused this reader to reflect on her own values and upbringing, and feel both optimistic and pessimistic about my son’s childhood.

Pessimistic because this world seems so much bigger and scarier than the one I grew up in, and the task of fitting my boy with tools and strategies seems insurmountable. In a week when teenagers have bombed marathon runners and a world famous children’s entertainer has been arrested for sexually abusing a child, how do I protect him, and how do I send him out there fit to do good, not harm?

Optimistic because many of the issues I find sticky, such as prejudice, sexuality and the environment, seem more openly and easily tackled by his generation. He takes for granted that men can love other men, that skin colour is no more important than hair colour, and that everyone recycles. That doesn’t mean my work here is done, but we’re off to a good start.

This is not a how-to book, but it opens up new perspectives as well as reviewing some traditional points of view such as the value put on an “obedient” child. It’s sometimes helpful to remember that a child who questions authority as a matter of course is perhaps in a safer place than one who always does as he is told. Especially when you want him to put the lego away and put his shoes on for school.

I would have liked the book to go further on the topic of sexuality, and to have explored the implications of an atheist upbringing in more detail. I closed the book with some deep thoughts and intentions about how I can include my son in discussion, not shelter him from the news, and somehow help him to understand how privileged he is. I don’t have the answers to any of this, but I have a few more clues.

25 Feb

What I’m Really Thinking

I’ve always assumed The Guardian’s What I’m Really Thinking column is meant to be a caricature, not something to be offended by. I know that last week’s anonymous piece by ‘The Child-Free Friend’ is not meant to represent the views of all childless people, and I admit that ten years ago I could have written it myself. I can quite smugly tell you that now I’m no longer childless, I finally have some empathy with parents, but that’s not to say that I speak fluently the language of child, that I find all babies beautiful, or that I ever want to change a nappy [unpaid!] again. I’m sure I’m not the only parent in the world who doesn’t really notice other people’s children until they make an annoying noise. That’s why I’m a doula, not a childminder; doulas care for mothers.

The writer is of the opinion that since parenthood is self-inflicted, parents deserve exactly zero amount of sympathy, even from a friend who claims to “care about you and your life,” when they express sadness at missing pre-parenthood freedoms. How can she possibly complain about the relentless demands of parenting, when this is what she signed up for? I’m sure you don’t have to offer to babysit for a night, to try to imagine that however much you love your child, there are always going to be times when you long guiltily for a night out that doesn’t take months of planning, an uninterrupted lie-in, or even just five minutes when nobody is asking anything of you. These are the things parents aren’t allowed to say, and because we aren’t allowed to say it, it comes as a shock to many new parents, to find that the child has no off-switch, our leisure time can no longer be filled by going to the gym or watching a Lord of the Rings triple bill, and the money drain never stops. So she didn’t sign up for it, exactly. A huge amount of doula work and breastfeeding support is about helping when reality doesn’t meet expectations.

As for your friend thinking that your life choices are less sincere, enduring or fulfilling, I had to laugh at how a paragraph about feeling judged could be so judgemental. This is why I knew that the writer didn’t stand for all childless people, because choosing to be childless is just one of many lifestyle choices, and most of us tend to think that the things we choose are better than the things other people choose. And most lifestyles are not simple binary choices.

It’s just as hard for parents to hold on to their non-parent friends as the other way around. It’s hard to have a conversation when part of your brain is permanently allocated to childcare, especially when you’re aware that the person you’re chatting with doesn’t like your snot-encrusted marmalade-fingered darling, is bored by their latest achievements, and just doesn’t get how your priorities are different now. And we’re tired. All the time. Like when you’re jetlagged or you’ve been working hard to meet a deadline or you’ve run a marathon, and those are lifestyle choices too, and you would expect some understanding.

Motherhood is pretty complex, and many non-parents seem to perceive it only at a very superficial level. We’re all childless before we have kids, we’ve all stood in your shoes. Now why don’t you try and stand in mine?

04 Feb

Evidence is overrated!

As a confirmed skeptic, my title is deliberately provocative, but reflects the tail-chasing propensity I have to apply skepticism to skepticism. I absolutely have to be evidence-based in my work, and I’ve completed a BA module in understanding and using research, but I still worry that I’m as guilty as the next person of cherry-picking it to suit my own views.

When it comes to birth and parenting, the quality of evidence available is not great. Much of the subject matter is undefined or too complex to boil down to a testable hypothesis, and RCTs on babies are ethically difficult. On top of that, parents being such a super marketing demographic, there are an awful lot of vested interests.

Most people working in this area are emotionally invested in some way, and not all the organisations supporting parents have a rigorous reflective practice and supervision structure, allowing them to debrief to the extent that they don’t carry any value judgement at all into their work.

This muddies our use of evidence.
There is some research on how hard it is to adopt new learning, when prior knowledge is deeply embedded. Hence out of date practices and misinformation propagated through on the job learning. If new evidence is not a good fit with what we already ‘know’, it is difficult to re-align oneself. We see this with adherents to scientifically implausible theories for example within alternative therapies, where belief is very much stronger than evidence.

There is also research [pdf] suggesting that GPs often base their breastfeeding advice on their own experience or that of their partners. In fact this rule applies to most people: if it worked for you, you may well suggest it to someone else, especially since the urge to problem-solve may be overwhelming. One GP spoke to me at length about something that she called “yeast mastitis.” A yeast infection of the breast (thrush) and mastitis are two entirely separate conditions, with different (but sometimes related) causes and different treatments. This is fairly basic stuff.

Parents are certainly titled to evidence-based information, and there are some good sources such as NHS and NCT websites; but this should include information about the limitations of the evidence, and where professionals supporting parents are unsure, untrained, or inexperienced, they should be clear about their boundaries and limitations. More damage is done by the supportive making up of answers than by handing over a reputable helpline number.

Evidence can be used as a stick to beat parents with (perfect example: “breast is best”), and then on the other hand it really is overrated as a decision-making factor compared with pressing lifestyle issues and social influences. Science journalist Linda Geddes, a busy parent of two who knows the evidence behind exclusive breastfeeding to six months, still chooses formula milk for her four month old when it is more convenient to do so. She weighs the risk, according to the evidence, but also in the balance are the fact that her two children are “simultaneously clamouring for their dinner and I don’t have time to sit and breastfeed.”

This is not a value judgement, but an excellent illustration of the way evidence is balanced and sometimes negated by parents’ lifestyle and needs, when making decisions. For me, it’s the evidence about sending a six month old to daycare that makes uncomfortable reading.

Working with parents is about providing evidenced information and decision making tools and confidence in themselves as parents. Evidence does not make something right or wrong when it comes to parenting, and we absolutely cannot use it either to dictate or to judge what parents do.

10 Sep

Book Review: Toxic Childhood, by Sue Palmer

I picked this book up for £1 at Wokingham NCT’s Nearly New Sale, purely out of curiosity. I would say that I have entirely grown out of my organic/green parenting frenzy, partly through poverty and partly from being exposed to science debunking quite a lot of it.

Palmer does state in her preface that the book is largely her own opinion based on largely qualitative research and extensive interviews. This comes across very clearly throughout the text, and may alienate a lot of parents who choose not to follow her highly directive recommendations.

The main message of the book is that childhood ain’t what it used to be, and everyone would be much happier if our kids roamed free in the fields until teatime, then feasted on vegetables from the allotment and played wholesome games until they went to bed. Palmer develops her arguments well, supports them with a wealth of anecdote, and offers suggestions for detoxing childhood both at a family level and at a policy level. This is all very well-meant, but the parents who read this book are quite probably those who already give some thought to things like the effects of TV and junk food on their children. However I feel that the Brave Old World solution is not the right one for my family, and I worry when books dictate parenting styles without leaving room for individual circumstances and inclination. The TV, the internet, junk food and the dangerous streets are realities that our children have to learn to cope with, and it is hard to find a balance between protecting them, and preparing them. I did not feel that Toxic Childhood made many positive suggestions about embracing change.

12 Jul

Book Review AND GIVEAWAY: Kiss Me! by Carlos Gonzalez

Subtitle: How to raise your children with love

Dr Carlos González sets out his stall very clearly in the first pages of his book:

This book assumes all children are essentially good, that their emotional needs are important, and that we as parents owe them love, respect and attention [p13]

He demonstrates this last point over and over again, by taking the statements of various childcare experts and graphically substituting the word ‘child’ with ‘wife’ or ‘colleague’ or ‘prisoner,’ revealing shocking double standards in our expectations and our treatment of children.

The book is roughly divided into two main chapters, the first of which presents children’s behaviour in terms of survival, adaptation, and genetic predisposition. González reframes disobedience as instinct, explaining for example a toddler’s preference to be carried rather than walk as a deep instinctive drive for safety and security.

The other half of the book is given over to demolishing various parenting theories including sleep training, therapeutic crying, and smacking. It is particularly gratifying to read his meticulous critique of Dr Christopher Green, that unpleasant advocate of smacking, whose basic assumption is that children are all ungrateful tyrants in need of taming.

González’ style is ranty in the extreme, and occasionally it is hard to tell if he is being sarcastic. This book gave me a lot to reflect on with regard to the way I talk to new parents and try to help them understand their babies’ behaviour. But however much I enjoyed this most arid humour, and however valid his premise and instructive his examples, I am wondering whether I would recommend Kiss Me! to new or expectant parents.

González writes with great empathy for children, but much less for parents; who, he explains, are inevitably confused by woolly and non-evidence based ‘advice’ from authoritative experts. His suggestion to combat this is that all parenting books should state on the cover what the author’s basic philosophy of human nature is.

Kiss Me! is an interesting book, and its most useful chapter focuses the mind on understanding, respecting, and empathising with children. Despite his strident tones, this is a very healthy approach to parenting.

***
I’ve got a copy of the book to give away to a commenter. I’ll draw names out of a hat on Thursday 19th July, and the book will be sent to you.

To order Kiss Me! with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

01 Dec

Book Review: How Not To F*** Them Up, by Oliver James

I read They F*** You Up: How to Survive Family Life about five years ago, enjoyed it very much, and widely recommended it. The follow-up, How Not To F*** Them Up, was sitting on my shelf for nearly a year, and eventually I picked it up and started to read.

Half way through the introduction, I started to skip bits; and then I began to flick through using the ‘Practical Top Tips’ Index; and then I just leafed through the rest. I will not be widely recommending this book.

James claims that ‘solid scientific research’ (p5) divides mothers into three types, and goes on to write unpleasant caricatures of each type. I know which type he would consider me to be, but that does not make me find his descriptions of the other two types any less offensive. We have the selfish, stressed-out Organiser, the martyred earth-mother Hugger, and the dithering, overstretched Fleximum.

James exhorts the reader not to skip to ‘her’ section but to read the whole book exactly as presented, in order to gain a full understanding of herself through reading about the others. This overbearing paternalistic tone persists throughout the book, and may be one of the reasons why I did precisely the opposite.

When James writes about under-threes, I find that he is spot on. His section on the needs of (and myths about) toddlers is clearly evidence-based, and he is relatively open about the harm caused by controlled crying, as well as the pointlessness of the naughty step at that age. However almost every statement he makes about mothers is a patronising generalisation. The case studies are written in a deeply judgmental tone, giving the impression that, whichever camp we are in, we mothers haven’t got a hope of getting it right.

Of course the first section I skipped to was the three pages on breastfeeding, in which James repeats a lot of over-technical information about positioning, attributing it to respected midwife Chloe Fisher. He dismisses Health Visitors as breastfeeding supporters, and then falls into the well-established pitfall of the untrained breastfeeding supporter himself, by basing his advice entirely on his own experience. He repeatedly states that colic is caused by not draining the breast properly. There is no research that conclusively establishes the cause of colic, and advice to ‘drain’ the breast can be very confusing.

This book lacks empathy with the subjects of the case studies and with mothers in general. The useful and accurate information about the needs of babies and toddlers can be found in They F*** You Up. As far as mothers are concerned, though, I would recommend that we all stop reading at page 5, where he states that ‘mothers rarely find anything as helpful as talking with each other;’ and go out and find a Bumps & Babies group or an NCT Early Days course instead.