The Meta-Report - 8.19.11

This week in Meta-Report: 

Kids Count;

Birthing from the Den;

Much Ado about Nursing  

Kids Count

The Annie E. Casey Foundation released their 2011 KIDS COUNT Data Book this week, which measures the well-being of our nation’s children through ten social, health and other variables – everything from infant birth weight and mortality, to the work status of parents, to school attendance.  In the report, states are ranked on a scale of 1-50 for overall child well-being, with New Hampshire and Minnesota coming out on top.   

 

The report reveals that, compared to previous years, more children are living in low-income families and in families where one or more parents are unemployed (likely a result of the ongoing recession). Beyond this, the Foundation summarizes the results as follows: 

• “Five areas have improved: the infant mortality rate, child death rate, teen death rate, teen birth rate, and the percent of teens not in school and not high school graduates.

• Three areas have worsened: the percent of babies born low-birthweight, the child poverty rate, and the percent of children living in single-parent families.”

What do this information mean for the overall well-being of our nation’s children?  There is no definitive answer to this question yet, but it seems there is certainly room for improvement. I'm personally a little surprised to see an increase in the percentage of babies born at a low birthweight, although I have to wonder if this doesn't have something to do with the skyrocketing rate of cesareans in our country - many of which are planned, resulting in babies being born earlier.

Birthing from the Den

I’ve been following with great interest the recent surge in mainstream media stories on home birth and the increase in American women planning to have their children at home.

With the study most widely cited by home birth critics being called into question  due to poor sampling practices and inconsistent methods - and the field of obstetrics moving further and further away from evidence-based standards of care (Not even 1/3 of clinicians meet the requirement for practicing with “good and consistent scientific evidence.” WHAT?!) - more women are weighing the benefits of home birth against the often impersonal and overmedicalized (and expensive!) care that comes with birth in a hospital setting. I’m including yours truly in that last statement – more on that at a later date, perhaps!

Granted, home birth is still not generally considered safe for women who have experienced complications in their pregnancies or for women who have had a cesarean with previous birth(s) – but even here the lines are blurred. With a proper emergency plan, and the right team of skilled birth workers, many women can and do have smooth, uneventful home births. Although home birth is definitely not for everyone, I’m encouraged by what this trend signifies – more women are taking control of their births in a positive way, arming themselves with evidence-based information, and feeling empowered to make the choices that are right for them and their families. That is never a bad thing!

Much Ado about Nursing

It seems that this month the interwebs have been abuzz with talk of breastfeeding – from World Breastfeeding Week; to renewed fire under the breast vs. formula debate; to a breastfeeding advocate’s field day as a teacher sues her employer for violating her right to express breastmilk at work.

While breastfeeding proponents continue to tout the many benefits of breastfeeding, others – whether due to personal experience or contrarian studies - are "latching on" to the argument that breast may not be best, after all.

Joan Wolf, author and Assistant Professor of Gender Studies at Texas A&M, might rightfully be credited with calling into question the commonly held belief that breastfeeding is medically superior to formula feeding. 

Formula feeding moms simultaneously breathed a sigh of relief, I think, at Wolf’s assertion that the scientific basis of the “breast is best” slogan – and our culture’s resulting end all, be all emphasis on exclusive breastfeeding at any cost - is largely exaggerated. As Wolf is well aware, these “are fighting words.”

Personally, I'm not convinced that Wolf has a case - but maybe that is just a sign of exactly how deeply and thoroughly I have internalized the "breast is best" concept. In any case, I have it on my “to do” list to look further into Dr. Wolf’s body of work (she is published on this subject multiple times over). It's important to note that, as a mom who combo-fed (both formula and breastfeeding), I can understand that this is not an all-or-nothing debate - but the reality is that this is often the direction that discourse on breastfeeding seems to take. Anything less than exclusive breastfeeding is somehow seen to be a reflection on a mother's willingness (or lack thereof) to do what's best for her child - if she does not go this route, whether by free will or last resort, she is thought to have failed. As a result of this dynamic, breastfeeding advocates and mothers who formula feed are pitted against one another – emotions run high and feelings of guilt, helplessness and frustration frequently result as both sides attempt to prove that their way is best. The cultural complexities surrounding breastfeeding and the pressures exerted on a mother to make the “right” choice (no matter the cost on her own health and sanity) are subtle but real. From a cultural context, it is often impossible to extricate a mother’s desire to breastfeed from society’s assertion that it is her maternal obligation to do so; or, conversely, to separate a mother’s desire to formula feed from the cultural “booby traps” that lead many women to prematurely conclude it is the only way they can sufficiently feed their baby. 

With all this serious talk about a subject that is simultaneously very personal, but also widely though of as an issue of national public health, it's helpful to gain some perspective. I leave you with a hilarious, albeit disturbingly on-point, excerpt from a book I just finished this week (incidentally, the first mostly non-parenting book I have read all the way through since Little Man was born), Tina Fey's Bossy Pants:

“Invented in the mid-19th century as a last-ditch option for orphans and underweight babies, packaged infant formula has since been perfected to be a complete and reliable source of stress and shame for mothers. Anyone who reads a pregnancy book knows that breast milk provides nutrition, immunities and invaluable bonding time. The breast is best.

When I was pregnant for the first time I asked my mother for advice. “Don’t even try it,” she said. This is a generational difference...As a member of Generation X, I was more informed, more empowered, and I knew that when it came to breast-feeding I had an obligation to my baby to pretend to try.

There are a lot of different opinions as to how long one should breastfeed. The World Health Organisation says six months. The American Association of Pediatrics says one year is ideal. Mothering magazine suggests you nurse the child until just before his wedding rehearsal. I say you must find what works for you. For my little angel and me the magic number was about 72 hours…We didn’t succeed, so that first night the nurses gave my little one some formula without asking. I tried to be appalled, but I was pretty tired…Shortly thereafter, we made the switch to an all-formula diet. If you’ve ever opened a can of infant formula mix, then you know it smells like someone soaked old vitamins in a bucket of wet leaves, then dried them in a hot car…Also, formula is like $40 a can…However, the baby was thriving. I was no longer feeling trapped, spending 30 out of every 90 minutes attached to a Williams-Sonoma Tit Juicer. But I still had an overwhelming feeling of disappointment. I had failed at something that was supposed to be natural.

I was defensive and grouchy whenever the topic came up. At a party with a friend who was successfully nursing her little boy, I watched her husband produce a bottle of pumped breast milk that was the size of a Big Gulp. It was more milk than I had produced in my whole seven weeks…As my friend’s husband fed the baby, he said offhandedly, “This stuff is liquid gold. You know it actually makes them smarter?” “Let’s set a date!” I screamed. “IQ test. Five years from today. My formula baby will crush your baby!” Thankfully, my mouth was so full of cake they could not understand me."