tag:blogger.com,1999:blog-57410365410416725602024-03-09T21:45:47.395-05:00Dou-la-laIBCLC, former postpartum doula, birth advocate, LMT, writer of things, mama to Lily. Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.comBlogger245125tag:blogger.com,1999:blog-5741036541041672560.post-11277904174098117662015-04-17T21:13:00.004-04:002015-04-17T21:21:46.710-04:00A Nursing Mom Walks Into A Bar<br />
<div class="_209g _2vxa" data-block="true" data-offset-key="91tkl-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$91tkl" style="background-color: white; color: #141823; direction: ltr; font-family: 'helvetica neue', helvetica, arial, 'lucida grande', sans-serif; font-size: 13px; line-height: 18px; position: relative; white-space: pre-wrap;">
<span data-offset-key="91tkl-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$91tkl.0:$91tkl-0-0">"One a day helps the boobie milk stay!" They trademarked that specific phrase. They actually did. </span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyHm1hpivGFiFnmFowmCGKrgeru0tOudU_uSVNz1DFy46rw1LFdFh8fvHsXmW5h9zKsrIE7bnxqUKotU2iXVF_cC0Gbo3oTIySogpdY0KTtXXXBhIkljXB_dARH5ipy9oQEKOhPRV3xs8/s1600/Cookies+Claim+What.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyHm1hpivGFiFnmFowmCGKrgeru0tOudU_uSVNz1DFy46rw1LFdFh8fvHsXmW5h9zKsrIE7bnxqUKotU2iXVF_cC0Gbo3oTIySogpdY0KTtXXXBhIkljXB_dARH5ipy9oQEKOhPRV3xs8/s1600/Cookies+Claim+What.jpg" height="240" width="320" /></a></div>
<span data-offset-key="91tkl-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$91tkl.0:$91tkl-0-0"><span data-offset-key="bid0s-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$bid0s.0:$bid0s-0-0">Anyway, brought to my attention today: The (yes, really) <a href="http://getboobiebars.com/" target="_blank">Boobie Bar</a>, merely the latest in </span>processed, packaged lactation cookies, though it claims to be "the original lactation bar", which I guess refers to the fact that it's the first to be cut into a rectangle rather than a circle, since it's obviously far from the first. Look, I know nothing is new about manufacturing and marketing lactation cookies at this point, there are a couple of them out there now, but as far as I'm aware, this is the only one trumpeting the fact that it was co-created by an IBCLC. </span></div>
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<span data-offset-key="588fu-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$588fu.0:$588fu-0-0">A few starter questions: </span></div>
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<ol>
<li style="color: #141823; font-family: 'helvetica neue', helvetica, arial, 'lucida grande', sans-serif; font-size: 13px; line-height: 18px; white-space: pre-wrap;"> The aforementioned IBCLC is identified only as "Nurse Wendy" anywhere on the site that I can find. Why no last name so we can verify her credential?</li>
<li><span style="color: #141823; font-family: 'helvetica neue', helvetica, arial, 'lucida grande', sans-serif; font-size: 13px; line-height: 18px; white-space: pre-wrap;">This "independent study" they refer to on the Our Story page, highlighted in pink but not actually linked to anything - where is it? What does it say? What was the control? How large was the group? Are there any details you can tell us beyond the claim that they "can increase milk supply up 4.6oz per day! [sic]"?</span></li>
<li><span style="color: #141823; font-family: 'helvetica neue', helvetica, arial, 'lucida grande', sans-serif; font-size: 13px; line-height: 18px; white-space: pre-wrap;"> The "proprietary herb blend" that each bar contains: How much of each? All the information about each herb they list on your Ingredients page is great. I'm actually a big fan of lactogenic foods. I also know that much depends on the use of an actual therapeutic dose, which is why many of the tea blends that throw a little of every popular galactagogue into the mix are a serious gamble. Those blends might happen to have one or two of the right ingredients for a particular mom (galactagogues are NOT one size fits all, either, but that's another post), but in such a minuscule amount that they have minimal, if any, effect on mom's production. The Boobie Bar promotional materials make a big show out of the claim that you only need to take one per day to increase your supply (okay, to "make the boobie milk stay"). That's pretty impressive, so how much of each herb, exactly, goes into that one bar?</span></li>
<li><span style="color: #141823; font-family: 'helvetica neue', helvetica, arial, 'lucida grande', sans-serif; font-size: 13px; line-height: 18px; white-space: pre-wrap;"> Each bar has more sugar and carbs than a Krispy Kreme doughnut. Okay, that's not a question, I just thought it was worth pointing out. </span></li>
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It's genuinely nice that they refer to the importance of seeking an IBCLC in multiple places on their site. I will say that one positive thing for them. I just wish it didn't come as part of the promotion of a product that does nothing to actually target any individual woman's underlying cause for low supply. I wish even more that it, and others like it, didn't <a href="http://dou-la-la.blogspot.com/2013/12/battlestar-galactagogue-on-fenugreek.html" target="_blank">contribute to the undermining of mothers' confidence in their own bodies</a>, and to the overall perception that perfectly normal women need to purchase and consume products in order to have a healthy milk supply.</div>
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<div class="_209g _2vxa" data-block="true" data-offset-key="c61du-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$c61du" style="background-color: white; color: #141823; direction: ltr; font-family: 'helvetica neue', helvetica, arial, 'lucida grande', sans-serif; font-size: 13px; line-height: 18px; position: relative; white-space: pre-wrap;">
<span data-offset-key="c61du-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$c61du.0:$c61du-0-0">I've said it before and I'll say it again and again and again: physiological low supply doesn't just randomly happen to unlucky moms for no reason. There is always an underlying cause. </span></div>
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<span data-offset-key="9abq4-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$9abq4.0:$9abq4-0-0">Galactagogues CAN often be part of that solution - but only if they're A) tailored to that specific mom's underlying cause, and B) used in therapeutic doses. Boobie Bars and Milkmakers and the like? Hey, you might get lucky if you just so happen to need one of the herbs included in the melange, and need so little of it that it happens to work. And placebos can also be very effective. Is either possibility worth $16 per box (6 bars each)? </span><br />
<span data-offset-key="9abq4-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$9abq4.0:$9abq4-0-0"><br /></span>
<span data-offset-key="9abq4-0-0" data-reactid=".1hd.0.1.0.1.0.0.1.0.0.$9abq4.0:$9abq4-0-0">*A</span>s opposed to <i>perceived</i> low supply, a critical distinction and one that is imperative to rule out first (and which is coincidentally very likely to respond well to the placebo effect).</div>
Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com0tag:blogger.com,1999:blog-5741036541041672560.post-33438106506027774482015-02-26T02:55:00.002-05:002015-02-26T02:58:46.702-05:00The Unexpected Shower Guest<div class="separator" style="clear: both; text-align: center;">
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<a href="http://images.wikia.com/tardis/images/2/28/11-Doctor-Fez.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://images.wikia.com/tardis/images/2/28/11-Doctor-Fez.jpg" height="320" width="288" /></a></div>
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INT: SMITH-JONES RESIDENCE in Kensington. Afternoon. A baby shower is underway, with stylishly
dressed women sitting in a semicircle around DR. MARTHA SMITH-JONES, who is
clearly in her third trimester. A huge pile of pastel-festooned gifts is in
front of MARTHA, who is opening a large flat box. <o:p></o:p></div>
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MARTHA: </div>
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This is from Sarah, eh?<o:p></o:p></div>
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She takes out a yellow onesie, as all the women coo. She
turns it around to show off the back, which has a duck face on the bottom. The
women squeal. <o:p></o:p></div>
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SARAH:</div>
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I do wish you’d let us know whether it’s a boy or a
girl. It’s so hard to buy everything in gender neutral yellow, or purple, or
green, or white, or . . . Well, you know what I mean.<o:p></o:p></div>
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MARTHA:</div>
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It’s a mystery to us, too, on purpose. We’re totally
fine with being surprised, and besides, who knows how they might identify in
the futu-<o:p></o:p></div>
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She trails off, distracted by a telltale whooshing sound
outside their window. Only a few of the partygoers notice the sound, and seem
undisturbed by it.<o:p></o:p></div>
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MARTHA: </div>
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Excuse me. I
. . . think we might have a late
arrival. <o:p></o:p></div>
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She hoists herself up off her chair and walks with effort
towards the front door, clearly with equal parts apprehension and excitement.<o:p></o:p></div>
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TISH:</div>
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They’d better have RSVP’ed, yeah? <o:p></o:p></div>
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The women go back to chatting amongst themselves.<o:p></o:p></div>
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MARTHA takes a deep breath, opens the door and sees the back
side of the ELEVENTH DOCTOR, who is fussing with a gift bag. He wheels around. MARTHA
marvels at his transformed appearance and style, not sure what to make of it. <o:p></o:p></div>
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DOCTOR: </div>
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Well, look at you. Martha my dear. I heard the news
and just couldn’t pass up the chance to travel back 6,237 years and drop by for
some well-wishing.<o:p></o:p></div>
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MARTHA: </div>
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It really is you. <o:p></o:p></div>
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DOCTOR:</div>
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You look so . . . different!<o:p></o:p></div>
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MARTHA:</div>
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Likewise.<o:p></o:p></div>
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DOCTOR:</div>
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Hm? Oh, oh yes, right. My extreme makeover. (He
steps back with a flourish.) What do you think? <o:p></o:p></div>
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MARTHA:</div>
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. . . Quite
fetching. I . . . just wasn’t expecting.
I mean, I am. Expecting! That is. As you can surely – won’t you come in?<o:p></o:p></div>
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She steps back from the door and gestures him in. As he
enters the living room, all the heads turn to stare at him. He waves amiably if
awkwardly. <o:p></o:p></div>
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MARTHA:</div>
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Everyone, this is the Doc . . .tor John Smith, <o:p></o:p></div>
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DOCTOR:</div>
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Hello.<o:p></o:p></div>
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TISH (skeptically):</div>
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Dr. John Smith? So, he’s a . . .
relative of Mickey?<o:p></o:p></div>
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MARTHA:</div>
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No, no, just an old friend. Colleague.<o:p></o:p></div>
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SARAH:</div>
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Speaking of Mickey, this IS supposed to be ladies
only, Martha! You didn’t even want the father here, much less old flames. (She
giggles)<o:p></o:p></div>
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MARTHA (flustered): </div>
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Not a flame at all, just a friend. <o:p></o:p></div>
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DOCTOR:<br />
Very old. </div>
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TISH:</div>
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Suit yourself, it’s your shower. But I only have
enough sticky toffees for those who RSVP’ed.</div>
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<o:p></o:p></div>
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She exits to the kitchen, two other women following with
wine glasses in hand. <o:p></o:p></div>
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DOCTOR: </div>
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So, I brought you something. Made you something
actually. <o:p></o:p></div>
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MARTHA:</div>
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Really? You made something for me?<o:p></o:p></div>
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DOCTOR:</div>
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For you and little Stella. <o:p></o:p></div>
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He jovially pats her belly. The ladies gasp. Martha looks
stunned. <o:p></o:p></div>
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DOCTOR:</div>
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Ohhh. You – you hadn’t gotten there yet. Right. Well
she turns out to be just super, reall-<o:p></o:p></div>
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MARTHA gestures to stop and shushes him.<o:p></o:p></div>
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DOCTOR:</div>
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Sorry, right, got it. ANYWAY, here.<o:p></o:p></div>
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He holds the bag out in front of him. <o:p></o:p></div>
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MARTHA: </div>
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Can’t believe you did this. Thank you.<o:p></o:p></div>
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She smiles and sits down to open it. She pulls out a nipple-shaped
contraption with flashing lights, wires and electrodes extending from it. She and the party guests are all stumped.<o:p></o:p></div>
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MARTHA:</div>
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Um, wow! It’s, um. What exactly is it?<o:p></o:p></div>
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DOCTOR: </div>
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I call it the Tracking Incremental Totals Breastmilk
Infant Transfer.<o:p></o:p></div>
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MARTHA looks blank.<o:p></o:p></div>
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DOCTOR:</div>
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I know, a bit cumbersome, even for the brightest of
you humans. So you can just go by the acronym. <o:p></o:p></div>
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MARTHA (pauses to think):</div>
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. . . Oh no.<o:p></o:p></div>
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DOCTOR:</div>
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That's right. The TITBIT.</div>
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<span style="text-align: start;"><br /></span></div>
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He beams. MARTHA is now completely nonplussed.</div>
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PARTY GUEST: </div>
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So, what’s it for? What’s it actually do?<o:p></o:p></div>
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DOCTOR:</div>
<div class="MsoNormal" style="text-align: center;">
Here, allow me.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
The DOCTOR begins fiddling with the TITBIT, unwinding wires
and starting to set it up as he talks. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR:</div>
<div class="MsoNormal" style="text-align: center;">
You see, I knew you’d want to breastfeed, since you
surely know it’s the biological norm and the optimal start for your baby. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He places electrodes on various places on mom, looks around
and grabs a throw pillow to place in her arms as the “baby”, places electrodes
on it as well, then goes to place the nipple shield component on her
breast. There’s an awkward pause. He then hands it to Martha to place herself,
which she does, skeptically. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
But I read that early cessation of breastfeeding is
attributed largely to lack of maternal confidence in her supply, and not
knowing how much milk their baby is actually getting. So I thought, why not develop
technology that can demonstrate both! The TITBIT here measures flow of milk,
volume in the mammary gland, corresponding volume in the infant stomach, and
maternal hormonal levels as well. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He sets up a switch that goes *DING*<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Brings back memories, eh? Then, all that lovely data
connects to an app [he grabs MARTHA’S phone off the side table and hands it to
her] so Mum can follow the whole flow of the feeding, right on her mobile. Not
unlike the monitors they use to track contractions at the hospitals when you’re
in labor! All right there in a readout. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He steps back to admire his handiwork, very self-satisfied.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
There you have it. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
There is a long, uncomfortable pause as Martha and the
guests all look at each other. The Doctor rocks back on his heels. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
So, accolades now?<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA: </div>
<div class="MsoNormal" style="text-align: center;">
It’s . . . I
know you mean well, and I can tell you put a lot of – <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
PARTY GUEST:</div>
<div class="MsoNormal" style="text-align: center;">
Oh, I’ll say it. I know he’s your friend, so
I’ll say it. Dr. Smith, I appreciate that what you meant to do was encourage
Martha, but honestly, all that contraptions like this do is undermine a new
mum’s confidence. Doing things like weigh-ins at home before and after
feedings, just creates an obsession with numbers, and makes mom start doubting
everything. Mums need to trust themselves, and if something seems to be going
off the normal path, they need real support, not a mechanical measuring system
spitting out numbers she can’t make sense of.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
YET ANOTHER PARTY GUEST:</div>
<div class="MsoNormal" style="text-align: center;">
I thought the diaper was the breastfeeding
measuring system.*<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
ANOTHER PARTY GUEST:</div>
<div class="MsoNormal" style="text-align: center;">
Exactly. In most cases that’s the only
one you need! I’m a lactation consultant at Martha’s hospital, and while pre-
and post-feed weights can be useful information – and only if it’s done with a
VERY accurate scale, which is unlikely to be in a layperson’s home – but it’s
only one part of a very complex picture. Just giving mums the raw numbers
doesn’t give her any idea how to put them in context. And in most cases, she
doesn’t need to anyway. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
The guests all murmur their agreement. The DOCTOR is taken
aback by the conversation, occasionally looking like he’s about to interject,
but thinks better of it each time, and continues to listen to them. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
STILL ANOTHER PARTY GUEST:</div>
<div class="MsoNormal" style="text-align: center;">
And numbers aside, using a nipple
shield is already an intervention, isn’t it? And one that can interfere with
breastfeeding if it’s not actually indicated in their situation? Why would you
introduce one in a contraption like this, for no good reason?<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
YET ANOTHER PARTY GUEST: </div>
<div class="MsoNormal" style="text-align: center;">
What about the sensors supposedly
reading milk volume? It’s like he has no idea how human milk is synthesized –
which is constantly adapting and changing. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
SARAH:</div>
<div class="MsoNormal" style="text-align: center;">
This won’t be the last such invention
we see, I’m afraid. I actually attended
the MIT Hackathon in Boston last fall. Many of the brilliant engineers wanted
to "fitbit" breastfeeding, <a href="http://www.breastfeedback.com/about_vasa.html" target="_blank">exactly like this device.</a> I spent all
weekend telling them NO. And then explaining <a href="http://dou-la-la.blogspot.com/2012/10/calculated-risk-new-milkscreen.html" target="_blank">why this would actually hurt breastfeeding.</a>
They had a hard time understanding the concept, and I can imagine we will see
lots more devices like this in the coming years. Sigh. Let's hope the
innovative breast pump ideas I saw work better than <a href="http://www.simplystacie.net/2014/12/milksense/" target="_blank">these feedback devices</a>.**<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
YET ANOTHER PARTY GUEST (gesturing with her wine glass): </div>
<div class="MsoNormal" style="text-align: center;">
Quit trying to biohack breastfeeding, technology overlords!<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
The guests all raise their glasses.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Not overlord, actually, Timelo-</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
MARTHA shakes her head vigorously at him, and he zips it.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
1<sup>st</sup> PARTY GUEST: </div>
<div class="MsoNormal" style="text-align: center;">
If you really want to create
something that helps nursing mums, why not hook up with Human Milk for Human
Babies to create an app that will match milk donors with babies who are in
need?<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
STILL ANOTHER GUEST: </div>
<div class="MsoNormal" style="text-align: center;">
Yeah, or what about an app that
connects mum to her community and helps coordinate all the support she needs?
Meals, errands, a load of laundry, I would have loved that in those early
postpartum days.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
YET ANOTHER PARTY GUEST: </div>
<div class="MsoNormal" style="text-align: center;">
Or if you really must invent a
wearable device that measures something, make it measure the amount of time the
mother and baby spend skin to skin. That alone is so powerful and so
overlooked, since there’s no way to make money off it. Well, YET, I suppose. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
SARAH: </div>
<div class="MsoNormal" style="text-align: center;">
Another area that could use some help
is <a href="http://dou-la-la.blogspot.com/2011/01/lact-aid-demo-in-which-i-take-one-for.html" target="_blank">making at-breast supplementers a little more user-friendly</a>, so that in the
cases where supplementation is truly needed – again, hopefully with
professional guidance - mums have an easier time with doing so at the breast.
But it needs to be minimally invasive. Not like this nightmare. [She gestures
at MARTHA, then looks at the DOCTOR.] No offense.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: None taken, none taken, but I . . .<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
TISH enters with a tray of sticky toffee cupcakes and her
two friends.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
TISH:</div>
<div class="MsoNormal" style="text-align: center;">
Here we are, everyone. [To the DOCTOR] I think there
are some Jaffa cakes in the pantry, if you’d like. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
MARTHA starts taking off the device and placing it back in
the bag. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA: </div>
<div class="MsoNormal" style="text-align: center;">
Come on, I’ll get them for you.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
She rises from the chair and walks to the kitchen, the
DOCTOR following.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Is that all true, what they’ve said? What do you
think?<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA (rummaging around in a cupboard):</div>
<div class="MsoNormal" style="text-align: center;">
Doctor, you know I
adore you, more that I even should. Even with the bowtie. I appreciate you
wanting to do this for me so much. You mean so well. But they really are right. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: Well, I just . . . I wondered about, you know.
You’re not particularly, um.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
MARTHA turns around with a packet of Jaffa Cakes. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA:</div>
<div class="MsoNormal" style="text-align: center;">
I’m not particularly what?<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR (looking around, avoiding her gaze):</div>
<div class="MsoNormal" style="text-align: center;">
Not, well, I
mean relatively. Compared with, I mean . . .<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He notices a portrait of a Rubenesque woman on the wall and
gestures to it. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
With, say . . . and you, not that there’s anything
wrong. You’re, you’re quite comely, but, I mean, rather petite and . . . <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He gestures quickly and bashfully at her chest.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA:</div>
<div class="MsoNormal" style="text-align: center;">
Oh Doctor. That? (She laughs, looking at her bosom.)
Breast size has next to nothing to do with supply. Women with cup sizes even
smaller than mine can produce more than enough milk quite well. It's supply and demand, as long as
babies have plenty of access and everything else is proceeding normally. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Really? I mean, that’s wonderful of course. But
really?<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA: </div>
<div class="MsoNormal" style="text-align: center;">
Really. (She hands him the packet of Jaffa Cakes.)
Think of them as being bigger on the inside. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Marvelous. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA:</div>
<div class="MsoNormal" style="text-align: center;">
All that unbelievable intelligence, all those
hundreds of years in that spectacular head of yours, and yet you somehow missed
that little, uh, tidbit of information. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Well, it doesn’t happen often, but when it does, I
am happy to stand corrected. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He bows, takes a bite of cake and then looks suddenly
crestfallen.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR (through a full mouth): </div>
<div class="MsoNormal" style="text-align: center;">
But now I have no gift for
you and Stel- er, the mystery fetus.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA: </div>
<div class="MsoNormal" style="text-align: center;">
Oh, it’s quite alright, just coming here at all was
such a nice ges – <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: WAIT! I’ve got it.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He turns and runs back through the living room, past the
cupcake eating guests who watch him fly by.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Beg pardon, won't be a moment . . .<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
TISH: </div>
<div class="MsoNormal" style="text-align: center;">
Awfully rude.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
He departs. We hear whooshing. Martha walks to the front door and waits. We
hear whooshing again. The DOCTOR races back up, slightly winded and hands her
another bag.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
There we have it. Go on. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
MARTHA cautiously opens the bag and takes out a tiny fez. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA:</div>
<div class="MsoNormal" style="text-align: center;">
I . . .<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Cool, isn’t it? Now available in size Cute as well. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA:</div>
<div class="MsoNormal" style="text-align: center;">
It’s absolutely both. Thank you. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
She reaches out and squeezes his shoulder. He pauses and
then hugs her in return. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Well, universe calls, as always. Best of luck. Dr.
Smith-Jones. And abundant breastfeeding.
<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
MARTHA: </div>
<div class="MsoNormal" style="text-align: center;">
And best of luck to you, Doctor. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
DOCTOR: </div>
<div class="MsoNormal" style="text-align: center;">
Oh, and if you ever need someone who speaks Baby to
translate . . .<o:p></o:p></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<br />
<div class="MsoNormal">
He waves, hops back into the TARDIS and is gone. She walks
back into the party, smiling. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="text-align: center;">
____________</div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
* Quote by Pauline Gnesin, on Anne's personal Facebook page</div>
<div class="MsoNormal">
** Quote by Lori Bond Atkins, on :LACTNET Facebook group discussion (links in quote are my own addition)</div>
</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com3tag:blogger.com,1999:blog-5741036541041672560.post-55758057325369563162014-12-23T03:42:00.001-05:002014-12-24T03:24:45.714-05:00Elementary, Mrs. Watson<div class="separator" style="clear: both; text-align: center;">
<a href="http://i.huffpost.com/gen/1393359/thumbs/o-PINT-GLASS-BEER-facebook.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://i.huffpost.com/gen/1393359/thumbs/o-PINT-GLASS-BEER-facebook.jpg" height="160" width="320" /></a></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">INT: WINCHESTER
PUB, Early evening. SHERLOCK HOLMES and
JOHN WATSON are settling into a booth with two full pints. INSPECTOR LESTRADE
walks over to the booth, pulling on his overcoat.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">LESTRADE<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Bang-up job again, you two. As per par for the course. I'll head down
and book the scumbag. I never did get what he was doing with all those bendy
straws, though.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<br />
(keeping his eyes on his mobile as he types in rapid-fire)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Of course you didn't. Your mastery of rote procedure and protocol in no
way prepares you for the kind of incisive insight I bring to the table. I would
have thought by now that was more than clear.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">LESTRADE rolls
his eyes.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Check the blog later, he surely means to say. Join us for a round? Mary's on her way to
meet us. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">LESTRADE<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Take a raincheck if you don't mind.
Cheers. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN raises his
glass. SHERLOCK raises one hand in a
wave, without lifting his eyes from the phone. As LESTRADE exits, he passes
MARY WATSON as she enters the pub.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">LESTRADE<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Evening Mary. Dynamic duo's in the back corner there.<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Oh, thanks Greg. But, you're not
staying then?<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">LESTRADE<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Nah. Got some rote procedures to master at the station. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">He smiles wryly
and continues on his way. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Oh. Well, oh. (Calling after him) Bye
then!<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">She walks back
towards their booth and waves as she approaches.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Mrs. Mary Watson. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN smiles
warmly. MARY kisses JOHN </span><span style="font-family: 'Courier Final Draft'; font-size: 12pt;">on the head as she takes off her coat and slides in
next to him.</span></div>
<div class="MsoNormal">
<span style="font-family: 'Courier Final Draft'; font-size: 12pt;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<br />
(eye still glued to his phone)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">How is the wee bairn, Mary?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Oh fine, fine, good. Asleep! Nursed down just before I jumped in the
cab, Mrs. Hudson’s got it all under control, as always. So, I got your texts!
Sounds like another case wrapped and sorted? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Indeed. Do join us in a celebratory gesture. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Don’t mind if I do! <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">She gestures to a
waitperson, who approaches with a notepad and an expectant look.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Pint of stout, thanks!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<br />
(after a momentary pause)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">What? Wait. ‘Scuse me? Waiter? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">The waiter
returns, brow furrowed.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<br />
(clearing throat)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">I’m sorry, my wife, terribly sleep deprived, new baby, you know how it
is, I’m sure. Anyway, I’m sure she meant to say she’d like a club soda. Or
maybe some tea. Would you like some tea, love?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> I’m quite sure I’ll take the stout,
thank you.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">But Mary, you’re, um (trying to keep his voice down, clearing his throat
again uncomfortably), you’re . . . (whisper) breastfeeding.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> And?<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK looks up
from his phone and observes. The waiter attempts to hide his growing
impatience. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">But, you can’t, I mean you shouldn’t, I mean, isn’t it, I mean . . . <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<br />
(returning her gaze to the waiter)<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Pint. Of. Stout, please. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">The waiter nods
and walks away.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Okay, clearly I’ve, uh, missed something
here.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK and MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Clearly.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> But, you’re breastfeeding!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Yes, as you said. I am. I’ve done almost nothing BUT breastfeed for
weeks on end, actually. Love it though I do, I’m ready for a wee drink.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">I just – I didn’t think that was allowed, is all. You were so careful
not to have even a drop while you were pregnant. You and the midwives told me
all about that. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Yeah, I was. And behold, I’m no longer
pregnant.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Surely you’ve observed this rudimentary fact.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">I do have a grasp on that bit of obvious, yes, thank you. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Well, so it’s completely different
now.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">It is? You don’t care that the alcohol going to get into your milk,
then? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">But that’s just it. Now that the baby is born, it’s completely fine to
have a drink or two. All the experts say so. It’s not really going to even
reach the baby, much less cause any bother.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> She’s correct.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">The waiter
returns with her drink. MARY takes it and raises her glass.<o:p></o:p></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Cheers!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK raises
his glass in kind and clinks it to hers. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Cheers to you and the bairn. And his well-meaning but underinformed dad.
<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">They each take a
hearty swallow. JOHN watches in exasperated befuddlement.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">So you support this, too, then, mate?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Why wouldn’t I? It’s perfectly logical.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Go on. Enlighten me, then.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Very well. The <a href="http://www.medsmilk.com/">Thomas Hale guide</a>,
considered to be the authoritative source on lactational pharmacology - meaning medications and other substances
in human milk - states that “mothers who ingest alcohol in moderate amounts can
generally return to breastfeeding as soon as they feel neurologically normal.”
In other words, as soon as it’s out of mother’s bloodstream, it’s also out of
her milk. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">And that’s pretty much exactly the amount of time a baby will go between
nursing sessions, about two hours or so.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Mmm. There you have it. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Okay. Okay, well, wouldn’t it be better for mums to, what’s it called,
pump and dump? Just to really get it out of her system, be on the safe side?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Certainly not, don’t be ridiculous.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Why is that ridiculous?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Tell me, Dr. Watson, when YOU have to sober up, do you need to drain a
liter or two of blood, to get it out of your system?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> Don’t be absurd. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Equally as absurd for a lactating mother. Pumping does nothing to speed the
metabolism of alcohol. The only reason a mother should ever pump related to
drinking is if she plans to be away from her infant for an extended period of
time, but the point of that is to maintain her supply in lieu of any missed
feedings, not to somehow detoxify her milk. All that is needed is the passage
of time.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Right, I read that on </span><a href="http://kellymom.com/bf/can-i-breastfeed/lifestyle/alcohol/"><span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Kellymom</span></a><span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">. Great resource, by the way, all the information
there is based on evidence. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> My favorite.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">You. Have a favorite breastfeeding website.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">NO, my favorite type of information. Research and evidence. Further, Dr.
Jack Newman, an MD who specializes in lactation, </span><a href="https://www.facebook.com/DrJackNewman/posts/237837423033978"><span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">shared the results</span></a><span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"> of a breastfeeding mother
who once analyzed her own milk and <a href="http://biologybrain-simonsays.blogspot.com/2008/12/alcohol-content-of-breast-milk.html" target="_blank">cited the findings on her blog</a>. See for
yourself.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK pulls up
a website on his mobile browser and hands it to JOHN.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">“The alcohol content in breast milk immediately after drinking is
equivalent to a 0.0274 proof beverage. That's like mixing 1 oz of 80 proof
vodka (one shot) with 2919 oz of mixer . By the way, 2919 oz is over 70 liters.
Two hours after drinking one (strong) drink the alcohol has disappeared from
the sample. Completely harmless to the nursing infant.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">0.0274 proof. I heard there’s more alcohol present in fruit juice. Not
that we’re giving the baby fruit juice yet, but the point remains.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Not to say that mothers should be getting falling down drunk and then
caring for their children, of course, but at that point it is a safe parenting
issue more than anything else. A drink or two, spaced out over several hours, seems
to be just fine. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">But if you’re still feeling concerned, the best timing for a drink is
right after a feeding -or even during the feeding - so there’s plenty of time
for metabolism to do its thing. And I’ve just come from doing exactly that!<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<br />
(giving the phone back to SHERLOCK and throwing his hands up in defeat)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Alright. I get it. Bottoms up, Mrs. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY smiles and
squeezes his arm affectionately.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<br />
(to SHERLOCK)<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Just how the hell do YOU know anything about sodding lactation in the
first place, anyway?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Well I do take an interest in all things relating to our species. And
the means by which we feed our young is a defining characteristic of all
mammals, after all.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">It’s where the term “mammal” comes from in the first place.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Quite right. The very nomenclature of our biological classification.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK clinks
his glass to Mary’s again and takes another drink.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Also I rather like babies.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">He takes another
swig of his drink.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">SHERLOCK<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Don’t tell anyone.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">Your secret is safe with us. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div align="center" class="MsoNormal" style="text-align: center;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">JOHN<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">For now.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: 1in;">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">MARY gets her own
mobile phone out and begins showing off photos of the newest addition to the
Watson family.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: center;">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">FADE TO BLACK.</span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: "Courier Final Draft"; font-size: 12.0pt; mso-bidi-font-family: Arial;">*****</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: 'Courier Final Draft'; font-size: 16px; text-align: center;">Elementary, Mrs Watson</span></div>
<span style="font-family: 'Courier Final Draft'; font-size: 16px; text-align: center;">by Anne Tegtmeier</span><br />
<span style="font-family: 'Courier Final Draft'; font-size: 16px; text-align: center;">December 2014 </span><span style="font-family: 'Courier Final Draft';">Picture via Huffington Post</span><br />
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Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com3tag:blogger.com,1999:blog-5741036541041672560.post-81776294732988433572013-12-11T17:58:00.002-05:002013-12-12T01:19:11.047-05:00Battlestar Galactagogue: On Fenugreek and Other Products for Perfect Production<u>Pop Quiz:</u> Assuming physiological normalcy for both mother and infant, a healthy milk supply depends on:<br />
<blockquote class="tr_bq">
<blockquote class="tr_bq">
a) Making sure mom goes through a batch of lactation cookies at least once a week.</blockquote>
<blockquote class="tr_bq">
b) Getting the best tincture from a health food store.</blockquote>
<blockquote class="tr_bq">
c) Drinking 4 cups of breastfeeding tea blends every day.</blockquote>
<blockquote class="tr_bq">
d) Obtaining a prescription for Domperidone.</blockquote>
<blockquote class="tr_bq">
e) None of the fracking above.</blockquote>
</blockquote>
Following on my recent theme of <a href="http://dou-la-la.blogspot.com/2013/11/help-me-to-help-you-promise-and.html" target="_blank">nursing support in the age of social media</a>, breastfeeding support products are more easily available than ever before. How is this going for us? Have we, with all our good intentions in making galactagogue products more widely available, contributed to the (apparently growing) perception that mothers can't have a normal milk supply without teas, tinctures, cookies, and pills?<br />
<br />
First off, what is a galactagogue?<br />
<br />
<b>Defined: Ga·lac·ta·gogue: gəˈlaktəˌgäg/ noun. 1.a food or drug that promotes or increases the flow of a mother's milk. </b> Common and popular herbal options include blessed thistle, fennel, and the most famous reindeer of all: Fenugreek. Drop into any mom's forum, and you'll see that every thread discussing supply will inevitably include recommendations for various galactagogues, in drug (i.e. Reglan or Domperidone), food (oatmeal for all), and herbal forms, fenugreek being by far the most well-known.<br />
<br />
A brief stroll down the aisle at New Seasons, a local Whole Foods-like company in the Portland area, revealed these options:<br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgx5cOO58nG-RAAGNDTf_veVxMhYBn4A6I0vmbyLXezK8m5bLyqYMkfwwCR22BNv9aCjR3AMeMChibKyQmr39Ozig-gFdSRSnzXCwNeI6fk5lBVvyTolOcFoiBh9YmRoJK3nSgYjHvqHEM/s1600/Galactagogues.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="187" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgx5cOO58nG-RAAGNDTf_veVxMhYBn4A6I0vmbyLXezK8m5bLyqYMkfwwCR22BNv9aCjR3AMeMChibKyQmr39Ozig-gFdSRSnzXCwNeI6fk5lBVvyTolOcFoiBh9YmRoJK3nSgYjHvqHEM/s400/Galactagogues.jpg" width="400" /></a></div>
<br />
<br />
So, here I go with another post in which I preface with a disclaimer and close with a hedging qualification. Let me be clear: There is nothing <i>at all </i>wrong with galactagogue use when needed! I cannot stress this enough. Part of the very reason we have such a diverse array of options for galactagogues in the first place is because women in vastly different cultures in a variety of ecosystems all over the world have sought them out and passed them down through generations.<br />
<br />
The world is very different now - so many undeniable improvements, and yet the matter of marketing as a major force in our collective psyches is a critical one. Let's think about this: how does formula marketing actually function? The most effective formula marketing depends on insidiously undermining women's confidence (I discussed this <a href="http://dou-la-la.blogspot.com/2010/09/horror-how-backhanded-breastfeeding.html" target="_blank">here</a> and then illustrated it <a href="http://dou-la-la.blogspot.com/2010/09/breast-is-best-sponsored-by-simfamil.html" target="_blank">here, a la Mad Men</a>). Is the promotion of galactagogues as something lots and lots of women are likely to need really <i>that </i>different, purely psychologically speaking?<br />
<br />
It IS different in some crucial ways because it's not artificial infant milk, of course, and ever moreso because it's not as though well-intentioned companies like Motherlove are engaging in underhanded tactics like slipping samples into gift bags of hospitals. And they possess nowhere near the financial oomph that massive corporations like Abbott wield. My point is not their intention, but the effects on us as a community of mothers. What <i>overall effect </i>does the promotion of galactagogues (whether from professionals, peers, or by the company itself) have on attitudes toward breastfeeding? We collectively need to ask ourselves if this is helpful.<br />
<br />
Boiling it down, is it helpful for us to have so many mothers believing that A) they cannot produce a <i>normal</i> supply without purchasing and consuming a product or products, even really high-quality ones? Again, taking a peek into any peer support forum is guaranteed to provide multiple examples of galactagogue recommendations flowing as freely as an uninhibited milk ejection reflex. And possibly even more damaging, is it B) helpful for mothers with <i>genuine</i> low supply to be taking them (haphazardly in many instances, i.e. all-fenugreek-all-the-time) without addressing or even identifying the underlying issues?<br />
<br />
And as one learns more about herbal galactagogues in particular, you can't help but notice that most herbs function by supporting the health of the mother, working with whatever underlying condition may have caused or contributed to her low supply in the first place (many of the most effective galactagogues work primarily on the digestive system, for example, the very core of maternal health). Low supply doesn't just happen randomly to moms who are unlucky; there is always a reason. But just as with the matter of breastfeeding advice in general, the most critical point is to tailor the plan to each dyad, and to use <i>when NEEDED</i>.<br />
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Again I find myself on the horns of a dilemma. I am truly glad and grateful that a variety of galactagogues are so readily available when mothers need them, and often in such good quality and variety. And yet. I want to discuss all of the above, with pros, peers, moms, and companies too, but I also want to convey this bottom line:<br />
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<b>Moms, you do not have to take galactagogues <i>Just Because.</i> Not as a preventative measure, not even "just in case."</b><br />
<br />
So say we all.*<br />
<br />
P.S. Yes, I am hereby claiming the Battlestar Galactagogue name as my very own, especially if I decide to create my own herbal blends as part of my future practice. I CONTAIN MULTITUDES.<br />
<br />
P.P.S. Aside from galactagogues, there are many other 'helpful' products being marketed to breastfeeding mothers which have a very much related effect, as corporations recognize this category of mothers as a largely untapped group and try to figure out how to profit off of them. (This sounds terribly cynical, I realize.) Take the recent <a href="http://dou-la-la.blogspot.com/2012/10/calculated-risk-new-milkscreen.html" target="_blank">Milkscreen products</a> as merely one example. Since I like to drop in on Babies R Us et al once in a while to keep in touch with the latest products that are widely available - and thus the marketing moms are being exposed to - I may address these other products in a follow-up post.<br />
<br />
<span style="font-size: x-small;">*Not actually speaking for all. Just geeking.</span>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com3tag:blogger.com,1999:blog-5741036541041672560.post-8261062916647440332013-11-11T15:26:00.003-05:002013-12-11T18:11:25.986-05:00Help Me To Help You: The Promise and Pitfalls of Peer Support in Social Media<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://doublethink.us.com/paala/wp-content/uploads/2013/01/Macierzy%C5%84stwo-1905-%E2%80%93-Stanis%C5%82aw-Wyspia%C5%84ski-breastfeeding-painting.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="204" src="http://doublethink.us.com/paala/wp-content/uploads/2013/01/Macierzy%C5%84stwo-1905-%E2%80%93-Stanis%C5%82aw-Wyspia%C5%84ski-breastfeeding-painting.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><i>Macierzyństwo, 1905 by Stanisław Wyspiański</i></td></tr>
</tbody></table>
<br />
This is quite the time to be a new breastfeeding mom. Support for breastfeeding has never been more abundantly available, especially when it comes to social media forms of it. There are multitudes of message boards, there are blog followings with regular, lively discussions, there are lactation support websites with many different specialties - and then there's the juggernaut (you see what I did there) that is Facebook, of course. Breastfeeding discussions come up regularly on fan pages for various bloggers and organizations, but the liveliest action by far is in the groups, whether open, closed, or secret. I have no idea if anyone has ever tried to get a ballpark idea of how many Facebook breastfeeding-related groups there are, but there have to be hundreds if not thousands.<br />
<br />
So this is great, right? It's what we've always strived for, yes? Nursing moms helping one another, spreading positive promotion of breastfeeding, cheering each other on by the dozens, this is living the dream. In many, many ways, absolutely yes! But in some other ways, well . . . it gets complicated.<br />
<br />
I'm part of quite a number of different groups and boards, some of them breastfeeding specific, others more about parenting in general. I witness and sometimes participate in breastfeeding-related threads on a daily basis, and have been doing so for years. You know that saying "The more you know, the more you realize you don't know?" The deeper I've gotten into my lactation science program at school, the quieter I've gotten on those threads. Note my long period of radio silence on this very blog; it's definitely related. Partly due to being absurdly overcommitted, fer sher, but part of it is also due to a growing realization of my own limits.<br />
<br />
In the boards and the groups and the pages, within any given breastfeeding thread, there's an ever-variable mixture of totally great advice, utterly terrible advice, and advice that could maybe, possibly, perhaps be good - IF we had a hell of a lot more information about the mother and baby at hand. All this comes with a liberal serving of emotional support- never something to be discounted; at times it is what the mother needs more than anything. And ALL OF IT IS MEANT TO HELP. But when it comes to even the seemingly-simplest of nursing issues, how can moms possibly sort this all out? Sometimes they'll get lucky and go with advice that happens to be sound, and all is smoothly resolved. But sometimes, not.<br />
<br />
Let me see if I can illustrate this with an example.<b> </b>In my Advanced Case Studies class a few terms ago, one of our texts was the excellent book <a href="http://www.amazon.com/Case-Studies-Breastfeeding-Problem-Solving-Strategies/dp/0763726001" target="_blank">"Case Studies in Breastfeeding: Problem-Solving Skills and Strategies" by Karin Cadwell and Cynthia Turner-Maffei.</a> In it was an table that sums the social media support dilemma up perfectly.<br />
<b><br /></b>As part of learning the Eight-Level Lactation Consulting Process, a chart was laid out with six different dyads, labeled A through F. Eight columns listed the various steps: 1) History, 2) Assessment, 3) Symptoms, 4) Problem Formulation, and so on. The interesting part: Column three was identical in every case. <i>"Mother describes hard breast with shiny skin; breast larger than normal and warm to the touch; breast pain."</i><br />
<br />
Every single mother presented with the exact same symptoms. And EVERY SINGLE ONE OF THEM had a totally different underlying cause, with a different strategy devised to address their issue.<br />
<br />
But in (totally well-intended!) online situations, many sympathetic moms will read the presenting symptom and only know their own individual, unique experience of that symptom. That experience might be relevant to the mother at hand - and it also very well might not. And sometimes moms simply want to share their own stories in return, which is also a very valid need - but conflating that with offering advice is treading into very tricky territory.<b> </b>This was an insight shared with me by <a href="http://holisticibclc.blogspot.com/" target="_blank">Jennifer Tow</a>, and I think about it frequently when following such conversations. It can be so hard for both storyteller and advice-seeker to know whether the shared story has any practical relevance to the situation at hand.<br />
<br />
Case in point: Fenugreek might very well have helped your supply, but it is absolutely not appropriate for every woman, nor is it a panacea for supply issues in general, which can range from simply turning around some poor management in the early postpartum period to very complex physiological conditions.<br />
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<br /></div>
Lactation pros are sometimes present on such threads - and it is worthwhile to note that they are often the ones offering the LEAST advice of all. This may be partly for financial reasons, partly for liability concerns, but primarily because they know full well just how individual each case really is. Without a maternal health history, information about the birth itself, a feeding assessment, an oral evaluation, and any number of other relevant pieces, the full situation is incomplete - and that's not even getting into the options for how to actually address the issue (once it is actually identified) with a comprehensive care plan. The variables are endless and the details always, always matter.<br />
<br />
I think lactation professionals have been reluctant to bring this matter up because seriously, the good intentions of everyone ARE so deeply felt and appreciated, and who wants to be the Scoldsy McBuzzkill who rains on the peer support parade? Honestly, where would we even BE without peer support? The progress we as a society have made in reclaiming breastfeeding has everything to do with it, and we owe an immense debt of gratitude to the founders of La Leche League, the most famous breastfeeding peer support group of all time. LLL began as peer support, continues as such, and is AWESOME for it . . . but there's a fourth L in that organization that makes all the difference in the world. Every meeting is facilitated by a<i> Leader.</i> Some meetings need more active guidance, in others the mothers need very little input, but that guidance is<i> </i>there for a reason.<br />
<br />
For the most part, I write this post not because I have solutions to propose, and certainly not because I think lactation consultants should be the only persons allowed to speak about breastfeeding (because how paternalistic would that be?), but because I want to open this up for discussion. Let's talk about this. IBCLCs, moms, other perinatal professionals, breastfeeding peer counselors. I truly believe that unless the formula companies have become so devious that they're willing to plant undercover undermining minions on message boards ( . . . actually, <a href="http://dou-la-la.blogspot.com/2010/09/horror-how-backhanded-breastfeeding.html" target="_blank">let's not rule that out altogether</a>), every mother posting in groups and boards is doing so mainly because they genuinely want to help. This is not an easy topic to discuss, but I think it's time.<br />
<br />
How can we best help each other to help each other?<br />
<br />
<br />
<br />Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com6tag:blogger.com,1999:blog-5741036541041672560.post-31092508126801329922013-02-07T16:49:00.000-05:002013-02-07T16:58:40.219-05:00 First Blood, Then MilkA reading from this week's Breastfeeding Politics & Policy class stopped me in my tracks, for obvious reasons.<br />
<blockquote class="tr_bq">
<i>"I think she looks like you," [the lactation consultant] says with a wink.</i> <i><br /></i><br />
<i>"I'm adopted," I say blankly. It's a telling response. I'm so accustomed to discounting the physical resemblance people claim they see between me and my own mother that I forget Faith and I are related. Even though I have the episiotomy stitches to prove it. Which, right now, are hurting me a lot.<br /></i><br />
<i>Lisa studies me for a while.<br /></i><br />
<i>"So am I," she replies slowly. Then she shows me a picture of her own (breastfed) daughter, now eight years old. Bright eyes, mile-wide grin, she looks like a miniature version of her mother.<br /></i><br />
<i>And that's when I know it is no accident that Lisa has devoted her career to helping mothers forge abiding, biological bonds with their babies. Nor is it any accident that I desire this relationship so deeply. Your body out of mine. From my body into yours. First blood, then milk. These are the living threads that weave mother and child together. As much as I love my adoptive mom, this bond is a connection we never had. And as for the unknown woman who gave birth to me, we were lost to each other before I was even as old as Faith is now. And for about the twelfth time today, I begin to cry.</i></blockquote>
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<a href="http://www.amazon.com/Having-Faith-Sandra-Steingraber/dp/0425189996" target="_blank">-- Having Faith: An Ecologist's Journey to Motherhood"<br /> by S Steingraber</a>. Excerpt from the chapter titled "Mamma"</div>
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Another rumination of mine on adoption:</div>
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<a href="http://dou-la-la.blogspot.com/2011/01/when-dna-isnt-just-dna.html" target="_blank">When DNA Isn't Just DNA</a></div>
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Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com0tag:blogger.com,1999:blog-5741036541041672560.post-44991139916109896822012-10-02T15:14:00.000-04:002012-10-11T11:05:20.536-04:00Calculated Risk: New Milkscreen Calculator Product for Breastfeeding Mothers<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.milkscreen.com/sites/default/files/finder-uploads/images/MSC-box-3Q-2012-200px.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://www.milkscreen.com/sites/default/files/finder-uploads/images/MSC-box-3Q-2012-200px.jpg" width="179" /></a></div>
<br />
There's a new product hitting the aisles. <a href="http://www.milkscreen.com/calculator" target="_blank">Milkscreen Calculator</a>
claims to evaluate a lactating woman's supply and tell her whether her
production is adequate. Is it designed to reassure nursing mothers, or
to prey on their insecurities? Who designed this? And how exactly does
it work?<br />
<br />
Brought to you by Upspring Baby, the same
company that created the alcohol test strips for breastmilk, Milkscreen
Calculator is introduced on their webpage like so:<br />
<br />
<div style="text-align: center;">
<blockquote class="tr_bq">
<span style="font-size: x-small;"><b><i>DO YOU MAKE ENOUGH BREASTMILK FOR YOUR BABY?<br />GET MILKSCREEN CALCULATOR</i></b></span></blockquote>
</div>
<blockquote class="tr_bq">
<span style="font-size: x-small;"><i>Many moms wonder: How much breastmilk do I make, and is it enough for my baby?</i></span><br />
<span style="font-size: x-small;"><i>
</i></span><br />
<span style="font-size: x-small;"><i>Take the new Milkscreen Calculator test and learn:</i></span><br />
<ul>
<li>
<span style="font-size: x-small;"><i>How much breastmilk you are making</i></span></li>
<li>
<span style="font-size: x-small;"><i>If you need to increase breastmilk production</i></span></li>
<li>
<span style="font-size: x-small;"><i>Baby's weight gain and weight percentiles</i></span></li>
<li>
<span style="font-size: x-small;"><i>How to naturally increase breastmilk production </i></span></li>
<li>
<span style="font-size: x-small;"><i>How to overcome common breastfeeding problems</i></span></li>
</ul>
</blockquote>
It's no secret that anxiety and insecurity about
milk supply are leading causes of premature weaning. Milkscreen
Calculator states that "50% of moms stop breastfeeding because they are
concerned they are not making enough for their baby." In a <a href="http://www.youtube.com/watch?feature=player_embedded&v=3nuj3xBpjwU" target="_blank">video interview, Dr. Susan Landers</a>, a fellow of the <a href="https://www.facebook.com/pages/Academy-of-Breastfeeding-Medicine" target="_blank">Academy of Breastfeeding Medicine</a>
who helped develop the Calculator, she explains that the product was
indeed intended primarily to reassure mothers who have unfounded fears
about their supply.<br />
<br />
How does this work? From what I can
tell on the site, the product you purchase is basically just a
container into which you measure your pumping output. After registering
on their site and filling out a questionnaire which collects more data
on you and your baby, you are given a pumping schedule. In the example
cited in the FAQ video, you are to nurse your baby at a set time, then
pump three different times at hourly intervals. You will then enter your
data online and receive an analysis of your supply, such as <a href="http://www.milkscreen.com/calculator/sample-report" target="_blank">this example:</a><br />
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<a href="http://www.milkscreen.com/sites/default/files/finder-uploads/images/sample-report.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://www.milkscreen.com/sites/default/files/finder-uploads/images/sample-report.jpg" width="243" /></a></div>
<br />
<br />
I
should fully admit right up front that I have a hard time being
objective about this. As someone who works with nursing mothers in my
clinical training to become an IBCLC (supervised by preceptors at all
times), it breaks my heart to think that a mother who was producing well
but did not respond well to pumping (or had a faulty pump, or poorly
fitted flanges, or any number of other variables) could potentially be
told that her supply was inadequate by this product. There are mothers
who have successfully breastfed their babies exclusively, with perfectly
healthy weight gain, who report <i>never</i> being able to elicit more
than a few drops from a pump. Perhaps it was an equipment issue, perhaps
hand expression might have worked for her, who knows? What would
Milkscreen Calculator tell a mother like this?<br />
<br />
Conversely,
if it's used on a newborn (they state not to use it prior to 8 days
old, but day 9 is still very, very early), honestly, mom might still be
producing well due to that postpartum hormonal abundance . . . and baby might actually
have some issues that prevent them from actively transferring well. So
baby feeds passively on mom's surplus letdown for a while, and a few
weeks later, her supply actually <i>does </i>start to dwindle because
the demand end of the supply & demand equation was never strong
enough. But hey, the Milkscreen told her everything was just fine.<br />
<br />
In
a few places on the site, the company mentions that moms that were
found to have low supply according to their calculations may want to
consult with a pediatrician or a lactation consultant (after trying some
of their automated suggestions for increasing supply). Which, in my
mind, begs the question, wouldn't a better effort be to increase access
to IBCLCs in the first place? By the time a mother in this position
seeks professional help - if in fact she does or can - she may be facing
an uphill battle to bring her supply back on top of addressing the root
cause of the baby's poor transfer. <br />
<br />
To give the
company the benefit of the doubt, I do believe the intention was to
create a product that would reassure most mothers that their supply is
normal and healthy - after all, for most women, it is, as long as poor management
doesn't interfere with the natural process. Does it succeed in this
goal? Or is it more likely to just exploit their fears? A little from
column A, a little from column B? <br />
<br />
What do YOU think?
Am I overreacting in my concern? (It would hardly
be the first time. True fact.) If this product is a helpful and accurate
one, and
my reasoning is faulty, I would love to be reassured by an explanation.
Building confidence in new mothers is a very, very good thing; I am far
from convinced that a preprogrammed Calculator is the right tool for
that job.<br />
<br />
<div style="text-align: center;">
***** </div>
<br />
<i><b>UPDATE 10/5/12:</b></i><br />
<br />
Yesterday, I received an email from the CEO of Upspring Baby. I share it here with her permission,<br />
<blockquote class="tr_bq">
<br />
<div class="MsoNormal">
<i>Dear Dou-la-la, </i></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<i>I am the CEO of UpSpring Baby and saw your recent
post about our new product, Milkscreen Calculator. I thought you raised
some very reasonable questions, and many of the same ones that were
raised when we launched the product at the annual
ILCA conference in July. </i></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<i>We recognize that this is a complex product that is
intended to address a common concern of new moms: that their milk
production may not be sufficient to support their baby’s needs.
Milkscreen Calculator’s mission is to help moms overcome
this common worry, either by reassuring her that her production is
normal (in most cases), or by helping her overcome a high or low supply
by directing her to an LC. We know many moms quit breastfeeding, or
begin formula supplementation, because they
think they are not making enough breast milk. The<b> main purpose of this product is to educate mom and help her gain the confidence she needs to continue breastfeeding.</b> And for women with low or high production, we hope the test will give
them the extra encouragement they need to seek professional help so they can increase or decrease their production.</i></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<i>If you are interested in discussing the product
further, I would appreciate the opportunity to speak with you directly.
While we have tried to anticipate most of the basic issues, I’m sure
there are more things we can learn from experts
in the field. Prior to launching the product, we sought input from
LC’s and pediatricians who have specific expertise in breastfeeding
medicine in order to be as thorough as possible.
</i></div>
<div class="MsoNormal">
<i> </i></div>
<div class="MsoNormal">
<i>Thank you,</i></div>
<div class="MsoNormal">
<br /></div>
<i>
Caroline</i></blockquote>
<br />
What do you think? Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com21tag:blogger.com,1999:blog-5741036541041672560.post-34945933793202219772012-08-02T14:50:00.001-04:002012-08-08T03:21:35.472-04:00Our Babies, Our Guts, Or: What Napoleon Dynamite Can Teach Us About Breastfeeding<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-yhjSB-X_Y6Q/T1oOzYISrYI/AAAAAAAAASI/TSqMw1Fk14s/s320/24.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-yhjSB-X_Y6Q/T1oOzYISrYI/AAAAAAAAASI/TSqMw1Fk14s/s320/24.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Mmm, Gut Flora</td></tr>
</tbody></table>
Is it normal for a breastfed baby to go for days without pooing? How about weeks? It comes up fairly regularly (puns always intended around here) in online breastfeeding-related support groups, and the conventional wisdom/majority opinion is inevitably that infrequent stooling in exclusively breastfed infants is fairly common and thus, it is normal. But what do we mean by "normal"? If by normal (in this context) we really mean <i>common</i>, then yes, that's true. But does that, therefore, equal <i>healthy</i>?<br />
<br />
Usual pattern of discourse:<br />
<blockquote class="tr_bq">
One parent: "My baby usually went for 4 or 5 days without pooing. Then she'd have a huge blowout/poo all day on the fifth day." <br />
<br />
Another parent: "Breastmilk is such a perfect substance that the baby's body just absorbs it all! Breastfed babies don't need to poo regularly." <br />
<br />
Third parent: "Yes! Breastmilk is used so efficiently that there isn't any waste. Mine used to poo explosively once a week. It was just her 'natural rhythm', I guess."<br />
<br />
Me: "But . . . if a baby not pooing is a sign that the body is 'absorbing it all', then what does it mean when a baby actually poos? That they are <i>not</i> using it so efficiently<i> </i>and<i> aren't</i> getting the nutrients? And if they are then having blowouts later - doesn't that mean they were <i>not</i> 'using it so efficiently that there is no waste' after all? (And on to information about infrequent stooling sometimes being a symptom of food sensitivities, suggesting a look into gut healing if it;s feasible for the mom, etc, blather, rinse, repeat.)"</blockquote>
You get the idea. I'm always conflicted about this topic and its usual pattern because the women arguing in favor of infrequent infant stooling ARE breastfeeding advocates and are trying to encourage and reassure other mothers. I can't NOT support that right? The intention is so good. <br />
<br />
<i>I posit that something being common does not, in itself, mean that it is therefore healthy. </i><br />
<br />
This frequent conversation was on my mind when I shared <a href="http://www.thehealthyhomeeconomist.com/relieving-baby-constipation-naturally/" target="_blank">this link from The Healthy Home Economist</a> on Facebook yesterday and enjoyed the brief discussion that followed. From her post on relieving baby constipation:<br />
<blockquote class="tr_bq">
<i>"As little as ten to fifteen years ago, it was almost unheard of for a
breastfed baby to be constipated. In fact, the baby books at that time
almost universally stated that breastfed babies don’t get constipated. Nowadays, however, this situation is becoming more commonplace and
the continuing decline in the quality of the diet of nursing mothers is a
likely reason. </i></blockquote>
<blockquote class="tr_bq">
<i>While it is an unpopular position within the breastfeeding community,
the diet of the mother clearly impacts the quality of her breastmilk
(fats, vitamins and minerals in breastmilk vary considerably based on
the mother’s diet although protein and immunoglobulins do not) and studies such as the Chinese Breastmilk Study confirm this.</i><br />
<div class="text_exposed_show">
<i><br />
"Suggesting that a lactating mother can eat whatever she wants and
still produce quality breastmilk is also irresponsible and defies all
common sense and historical study of healthy traditional cultures which
put great emphasis on the quality of the diet of nursing mothers."</i></div>
</blockquote>
<br />
<span class="commentBody" data-jsid="text">I appreciate that she's
willing to state an unpopular opinion on two matters: That even a
breastfed baby needs to stool regularly (the body "using it so
efficiently" does not mean t<span class="text_exposed_show">hat there is
zero waste and that it just dissolves magically; that's simply not how human digestion
functions, whether said human is an infant or an adult), and that maternal diet DOES in fact have an impact on breastmilk
composition. Yes, breastmilk absolutely IS still preferable to formula,
even with a suboptimal diet, but that does not mean a nutritionally inadequate
diet and a healthful diet (and what "healthful" means definitely and obviously varies from individual woman to individual woman)
are therefore equivalent.</span></span><br />
<br />
<span class="commentBody" data-jsid="text"> I think we as breastfeeding professionals and advocates are frequently afraid to
address maternal diet because we don't want to create additional
pressure on mothers, and I completely get that. I don't want moms to feel that they
have to eat "perfectly", and opinions also do var<span class="text_exposed_show">y
on what optimal nutrition even is, I know. (Believe me, I know. Vegetarian? Vegan? </span></span><span class="commentBody" data-jsid="text"><span class="text_exposed_show">Paleo? </span></span><span class="commentBody" data-jsid="text"><span class="text_exposed_show">Raw? Low Carb? Macrobiotic? Kosher? Gluten-free? SAD? GAPS? FODMAPS? Aiiiieeeeee!) </span></span><br />
<br />
<span class="commentBody" data-jsid="text"><span class="text_exposed_show">However, I do feel sometimes
that we're assuming that women's commitment to breastfeeding is so
fragile and tenuous that giving information that includes suggesting
improvement to their nutrition</span></span><span class="commentBody" data-jsid="text"><span class="text_exposed_show">, </span></span><span class="commentBody" data-jsid="text"><span class="text_exposed_show">within whatever their means are (more on that in a sec) will cause
them to throw up their hands and give up. I want to give moms more
credit than that.</span> Yet I have also heard (as in
read-on-forums) moms deciding to formula feed because they can't afford
a perfect organic diet for themselves, so what's the point? Clearly we need to do a much better
job of getting accurate info out there re: this.</span><span class="commentBody" data-jsid="text"><span class="text_exposed_show"> </span></span><span class="commentBody" data-jsid="text"><span class="text_exposed_show"> </span></span><br />
<br />
<span class="commentBody" data-jsid="text">To wit, while this very conversation was taking place, a comment was posted on an
article about <a href="http://dailymomtra.com/2012/07/30/mayor-bloomberg-is-taking-away-bottles-say-what-heres-what-its-really-about/" target="_blank">the Bloomberg initiative</a>: "[Breastfeeding is] only
healthier IF the mother eats properly and chooses to not take in
UNHEALTHY substances. . ." </span><br />
<br />
<span class="commentBody" data-jsid="text">To which my classmate Catherine replied: "</span><span class="commentBody" data-jsid="text">Right. Because all those
cows whose milk is being used to make Similac are on an organic diet
(and eating "properly" - so no grains) and are never given unhealthy
substances." Those cows are not farmed on a different, uncontaminated planet, either. </span><br />
<br />
<span class="commentBody" data-jsid="text"><a href="http://thestir.cafemom.com/blogger/64/" target="_blank">Christie Haskell</a> then summed it up neatly:</span><span class="commentBody" data-jsid="text"> "We want people to know that
eating healthy does make things better for baby, but we don't want to
fuel the idea that if you don't eat healthy, you might as well formula
feed either." This is the dilemma.</span><br />
<br />
<span class="commentBody" data-jsid="text">My wise friend Arwyn, famed for her excellent blog <a href="http://www.raisingmyboychick.com/" target="_blank">Raising My Boychick</a>, offered some important perspective with some difficult but extremely relevant thoughts, thoughts that we should keep in mind whether approaching this from either an advocacy role or a professional one:</span><br />
<blockquote class="tr_bq">
<br />
<span class="commentBody" data-jsid="text"><span class="text_exposed_show">[T]he
majority of toxins in milk come from our own stored backlog, which were
laid down when WE were fetuses and infants and children. They come from
car fumes and factory fumes and "fire retardants" and water pollution,
from a thousand things we cannot control and which big money is invested
in preventing us from regulating. Does diet make a difference? Yeah, of
course it does. But I think any conversation about diet that takes
place outside of a dominant cultural conversation about how our waters
and lands and air and food are polluted is the wrong approach.</span></span></blockquote>
<span class="commentBody" data-jsid="text">
Arwyn makes very important points - I always appreciate her asking the tough questions. I think it's important to
have address ALL of these things. Socioeconomic issues, environmental
contaminants, AND also maternal nutrition. And as an IBCLC-to-be, the
subject I know most about is the latter, so therefore, it's what I'm
most qualified to speak about - that doesn't mean I don't recognize the
other things as significant factors. I don't have expertise in social justice or environmental science, but I do in human lactation
It's the area in which I have the best chance of making any significant
impact as a professional, therefore it is the main focus of my voice on this matter. She is absolutely right that I still need to remember to consider the big cultural picture - and check my privilege - on a regular basis in all of these conversations.<br /> <br /> It is absolutely true that our own health has
already been dramatically affected by our grandmothers, quite literally - I
say all the more reason to do what we can for our grandchildren in
addition to our nurslings. I think we can strive to increase access and
be sensitive and empathetic about resource inequity - and also not
perpetuate myths in our roles as professionals or advocates about
breastfed babies only needing to poo once a month-ish.</span><br />
<br />
No conversation about this would be complete without a link to
Jennifer Tow, who is one of the most experienced and brilliant IBCLCs
on the planet, and her poetic musings on <a href="http://holisticibclc.blogspot.com/2011/06/gut-microbes-and-poop.html" target="_blank">"The Gut, Microbes and Poop": </a><br />
<br />
<blockquote class="tr_bq">
<div class="MsoNormal">
<i><span style="font-size: small;">Someday, I am
going to write “Confessions of an IBCLC Heretic”, because for almost 20
years, I have been saying that it is absolutely not normal for
babies of any age to have fewer than several significant bowel movements
per day. Not per week! Per day. The more I learn about the gut and the
gut-brain axis, the more I have to learn. But, I am confident that human
milk is not “all used up” and that babies are not “efficient enough
that there is no waste”. </span></i></div>
<div class="MsoNormal">
<i><span style="font-size: small;"><br /></span></i></div>
<i><span style="font-size: small;">Such
comments do not even bear up under the scrutiny of common sense. If all
those babies who stop pooping at 4-6 weeks are using up all the milk,
what are the babies who are pooping 6-8 times per day doing? Making it?</span></i></blockquote>
<br />
<span class="commentBody" data-jsid="text">And finally, even Napoleon Dynamite knows that maternal diet impacts milk composition. <br /> </span><br />
<iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/I7D9MLW80s0" width="560"></iframe>
<span class="commentBody" data-jsid="text"> </span><br />
<blockquote class="tr_bq">
<br />
<i><span style="color: black;">Napoleon Dynamite</span><span style="color: black;">:
[</span></i><i class="fine" style="color: black;">drinks glass of milk</i><i><span style="color: black;">] The defect in that one is bleach.
</span></i><br />
<i><span style="color: black;">FFA Judge No. 1</span>
<span style="color: black;">:
That's right.
</span></i><br />
<i><span style="color: black;">Napoleon Dynamite</span>
<span style="color: black;">:
Yessssssssss.
</span></i><br />
<i><span style="color: black;">Napoleon Dynamite</span>
<span style="color: black;">:
[</span></i><i class="fine" style="color: black;">drinks second glass of milk</i><i><span style="color: black;">] This tastes like the cow got into an onion patch.
</span></i><br />
<i><span style="color: black;">FFA Judge No. 2</span>
<span style="color: black;">:
Correct.
</span></i><br />
<i><span style="color: black;">Napoleon Dynamite</span>
:
Yessssssssss.
</i><span class="commentBody" data-jsid="text"><br /></span></blockquote>
<span style="font-size: x-small;">[Side note: Lily has taken lately to saying "Yesssssss," whenever
she's mildly excited about something, and sounds exactly like Napoleon here.]</span>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com11tag:blogger.com,1999:blog-5741036541041672560.post-69556234307116815962012-07-16T00:41:00.001-04:002012-07-16T00:43:06.208-04:00Difficulty Conceiving/Difficulty Breastfeeding: POLL<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.uoit.ca/assets/Section%7Especific/Faculty_Staff/Campus%7Eservices/Campus%7EHealth%7ECentre/images/form-pencil.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="211" src="http://www.uoit.ca/assets/Section%7Especific/Faculty_Staff/Campus%7Eservices/Campus%7EHealth%7ECentre/images/form-pencil.jpg" width="320" /></a></div>
<br />
The last time we updated our intake forms at my school's breastfeeding clinic, we made sure to add a checkbox with <i>"Difficulty conceiving?"</i> to the maternal health history section. Reasons for fertility issues are myriad, but can definitely give us some clues as to possible underlying hormonal issues that can affect supply (more on that in an upcoming post, I hope). <br />
<br />
Yet in my (limited) experience so far, few mothers who sought fertility treatment received any indication from any of their prenatal care providers that they might in fact experience some challenges in the breastfeeding department. Before we get into the whys and wherefores, I thought it might be a good idea to get a sense of how common this lack of information is, however informal the poll.<br />
<br />
So, would you pass this along to anyone you know who has experienced fertility treatments and might be willing to share this info? And of course, answer it yourself if it applies to you? I'd be most grateful.<br />
<br />
<br />
<br />
<div style="text-align: center;">
<script language="javascript" src="http://www.blogpoll.com/poll/view_Poll.php?type=java&poll_id=211390">
</script><noscript>&amp;amp;amp;amp;amp;amp;lt;a href="http://www.blogpoll.com"&amp;amp;amp;amp;amp;amp;gt;Free Blog Poll&amp;amp;amp;amp;amp;amp;lt;/a&amp;amp;amp;amp;amp;amp;gt;</noscript>
</div>
<br />
This is just the opening of a potential ongoing conversation. There are many complex layers to this, and much to discuss.<br />
<br />
<i>[And hello there, o patient readers! I do indeed still exist, though between coursework for school and various other exciting outside projects (including promising memoir stuffs), I sometimes barely have time to parent, let alone wax lactosophical around here, much as I love to do so. I'm hoping that will start to change soon. Cheers!] </i>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com1tag:blogger.com,1999:blog-5741036541041672560.post-32957970773679038992012-01-31T00:10:00.002-05:002012-01-31T00:10:29.590-05:00Getting Off the Medela Teat<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://photos-f.ak.fbcdn.net/hphotos-ak-snc4/33391_407195209579_41543029579_4572360_7297274_a.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="195" src="http://photos-f.ak.fbcdn.net/hphotos-ak-snc4/33391_407195209579_41543029579_4572360_7297274_a.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><i>(I am SO not really.)</i></td></tr>
</tbody></table>
<br />By way of introductory comments, I first need to hail the revival of Just West of Crunchy, which was rendered out of commission by a terrible crash. Welcome back! Secondly, I'm going to point you in the direction of a Very Important Post: <a href="http://www.justwestofcrunchy.com/2011/01/19/the-problems-with-medela/" target="_blank">The Problems With Medela.</a><br />
<i><br /></i><br />
<i>What's that you say? Problems? With Medela? But - they make breastfeeding products! They promote breastfeeding, right? And I love my slick Pump In Style. How can you have problems with them? </i><br />
<br />
Trust me, I understand. I was right there with ya. Here's the thing. I have <a href="http://dou-la-la.blogspot.com/2010/02/ready-set-suck-on-medelas-who.html" target="_blank">my own post addressing my concerns about Medela</a>, as some of you might remember, but JWOC's post is incredibly detailed and thorough (heck, I included a link in my own piece) and does a bang-up job of explaining why everything with Medela is not as rosy as it might seem. <br />
<br />
The issues fall into two major categories: Medela's very-much-intentional violation of the WHO International Code Marketing Breastmilk Substitutes (henceforth known as "The Code"), and Medela's very-much-intentional production of open-system, mold-vulnerable, single-user-only, landfill-destined pumps. I'd excerpt from JWOC's and my posts, but I'd end up excising them almost in their entirety, so please, go ahead and click through and check them out.<br />
<br />
Why this is timely for me now: Here I am, in Boob School, knowing all of this . . . and turning around to distribute Medela nipple shields, and Medela hydrogel packs, and Medela Supplemental Nursing Systems, and Medela breast shells; and then there's Medela microwave steam cleaning kits, and Medela storage bags, and Medela sanitizing wipes, and on, and on, and on. I do it with an internal wince - but I do it. And this is definitely representative of many (I would venture to say most) lactation consulting environments. I would expect this in hospitals, as they rent out the Medela-manufactured hospital grade pumps (the only kind that are approved and safe to be used by more than one mother), but they're present to the point of ubiquity even in environments like Birthingway's clinic.<br />
<br />
So I have to wonder: Is there any way to change this? Is Medela so pervasive that even among those who know about the Code violations and the worries about their pumps, ethical concerns have to be shelved because their products are so indispensable? We know about some other excellent pumps, of course. Other companies produce 'accessories' that are on par with Medela's as well - I've written to some of them to ask for samples for our clinic. Yet I feel like a stronger statement could be made by our profession as a group, if we acted collectively.<br />
<br />
I'd love to hear from others working in lactation consulting environments. Are there any out there that are Medela-free? I genuinely do not know. Are they in private practice? Or might there be any Medela-free hospitals? What about hospitals that qualify as Baby-Friendly? What is their position on accepting and promoting Medela products? The Baby Friendly Initiative was started by the WHO (in conjunction with UNICEF); it would be odd to me if a Baby Friendly hospital were to distribute products made by a Code-violating company - but again, I don't know one way or the other.<br />
<br />
Can we start talking about this?<br />
<br />
One last thing: Another excellent <a href="http://www.phdinparenting.com/2010/01/25/information-advertising-spam-medela-crosses-the-line/" target="_blank">post on Medela</a> was written by PhD in Parenting. It's linked to in my own original Medela post, but it's worth mentioning again here, not just because it's great but because many of you (especially if all this is new information) might be wondering what the big deal is. <i>Okay, so they're not perfectly perfect, but why spend time attacking Medela when the formula companies are the real culprits?</i> I think she summarizes the objections to criticizing Medela so well here:<br />
<br />
<blockquote class="tr_bq">
<i>I don’t want to be overly critical of Medela. I think the company does a
great job promoting and facilitating breastfeeding. Most of the
information on its website is wonderful. Most of its products are of the
highest quality. I have been nothing but happy with my Medela products.
However, I do think that some of their current actions to promote their
bottles are inappropriate. It would not be difficult for Medela to
continue to promote breastfeeding and sell its bottles without promoting
them. However, it has chosen to ignore the WHO Code and push more
bottle imagery and bottle messaging on moms (<a href="http://www.phdinparenting.com/2009/09/14/are-we-asking-the-wrong-people-to-comply-with-the-international-code-of-marketing-of-breast-milk-substitutes/">more on why bottle imagery and messaging is hurtful here</a>).
The result is that Medela is directly pushing bottles on moms and also
doing so indirectly via the Medela Mavens and others who might pick up
on the message about how breastfeeding ties you down, <a href="http://celebrity-babies.com/2009/12/06/medela-breastmilk-bottles-freeing-nursing-mothers-everywhere/">so you really need a pump and bottles so you can get your hair done</a>.<strong> </strong></i><br />
<i><strong></strong></i></blockquote>
<blockquote class="tr_bq">
<i><strong>To be clear, on a sliding scale this is not even close to<a href="http://www.phdinparenting.com/2009/10/07/wordless-wednesday-is-there-a-breastfeeding-article-amongst-those-enfamil-ads/"> Enf</a><a href="http://www.phdinparenting.com/2009/05/04/sabotage/">amil</a> or <a href="http://www.phdinparenting.com/2009/09/29/an-open-letter-to-the-attendees-of-the-nestle-family-blogger-event/">Nestle</a> or <a href="http://www.phdinparenting.com/2010/01/12/lies-lies-and-more-lies-3-year-government-crackdown-cant-keep-formula-companies-from-misleading-consumers/">other formula companies</a>.</strong> Not even close. But I would argue, and others do argue, that <strong>any violation of the WHO Code weakens its potential impact</strong>. We cannot say “<em>it’s okay because you are Medela</em>,” but then slap Nestle on the hand for everything it does wrong.</i> <i><br /></i></blockquote>
<blockquote class="tr_bq">
<i><br /></i></blockquote>
<br />Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com14tag:blogger.com,1999:blog-5741036541041672560.post-28937227381744695372011-11-21T14:31:00.001-05:002011-11-21T15:12:44.983-05:00Alfie On A Shelf: An Alternative to Creepy Elf Surveillance<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM40G5dXoS0Q6Vyhr03xdtSOsNflua75M-PGhn-bHn_eRscU2QVkQkg3XRat0pmdcMj6_mcuU7-vZnwG0C1XJNZUDYd16e6c1aJx4X5WDdiIpef4YzHKEkyMjIpuWzL118g3q29x0s56k/s1600/319619_2684829765750_1406567728_2984731_3872370_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM40G5dXoS0Q6Vyhr03xdtSOsNflua75M-PGhn-bHn_eRscU2QVkQkg3XRat0pmdcMj6_mcuU7-vZnwG0C1XJNZUDYd16e6c1aJx4X5WDdiIpef4YzHKEkyMjIpuWzL118g3q29x0s56k/s320/319619_2684829765750_1406567728_2984731_3872370_n.jpg" width="208" /></a></div>
Y'all have probably seen <a href="http://www.usatoday.com/life/books/news/2010-12-23-elf21_CV_N.htm" target="_blank">Elf On A Shelf</a>, the combination of book and ornament/decoration/toy that's become a big holiday hit - a phenomenon, even. The idea is that he's Santa's tiny spy, who monitors the children in every household, comes to life when no one is watching, and reports back to the North Pole with nightly reports on who's been naughty and who's been nice. It takes the deeply ingrained cultural idea of Santa Claus as bestower of karma and brings it to a whole new Orwellian level (not to mention the Chucky doll creep factor). And it's hugely popular.<br />
<br />
Some parents are just fine with this, and might find it a useful tool*. It's totally not my style of being, though, and I know it squicks some other like-minded parents out, too. What to do? It's always fun to find new holiday traditions, and I see the appeal of introducing a new game every year - with the original Elf, you move him around each night and the kids try to find his new surveillance spot. I'm the type of person who likes things like leaving hoofprints and making <a href="http://www.apronstringsblog.com/desserts/reindeer-crap-easy-christmas-cookies-gluten-free/" target="_blank">Reindeer Crap cookies</a>, so I totally get the fun of finding novel ways to engage in holiday hijinks. So I devised an alternative.<br />
<br />
I hereby present <a href="http://www.alfiekohn.org/index.php" target="_blank">Alfie On A Shelf</a>, a friendly reminder to treat your child with <a href="http://www.amazon.com/Unconditional-Parenting-Moving-Rewards-Punishments/dp/0743487486" target="_blank">unconditional love</a> this holiday season, and try to avoid the temptation to depend on bribes as a means of controlling our kids' behavior, naughty and nice lists notwithstanding.<br />
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Anyone have an in with a manufacturer?<br />
<span style="font-size: x-small;"><br /></span><br />
<span style="font-size: x-small;"><i>*Disclaimer: I totally understand that every child is different, and some parents may find it useful to introduce rewards in some situations. Even parents who hold unconditional parenting as an ideal do find it necessary at times. And using the concept of Santa to introduce the idea of karma or other values is legitimate, even if I disagree. It should go without saying, but I know these things can be sensitive among parents, and it's always worth acknowledgement. </i></span><br />
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<span style="font-size: x-small;"><i>Thanks to Rebekah Folsom for the Photoshopping! </i></span><br />
<br />Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com9tag:blogger.com,1999:blog-5741036541041672560.post-80431492022250640282011-10-17T22:40:00.007-04:002011-10-17T23:17:48.473-04:00Beyond Reckless<div><span class="Apple-style-span" style="font-family: arial; ">I must express regrets that I'm too wrapped up in both studying for my Oregon massage therapy licensure exam <i>and</i> Boob School homework to address this properly in my own wordstuffs, but lucky for me, Barbara Herrera (<a href="http://navelgazingmidwife.squarespace.com/">Navelgazing Midwife</a>) took the words right out of my brain.</span><span class="Apple-style-span" ><span class="Apple-style-span" style="font-family: Arial; font-size: 13px; background-color: rgb(255, 255, 255); "><div class="ds-list" style="margin-left: 1cm; "><b><br /></b></div></span></span></div><div><span class="Apple-style-span" >I posted a link to <a href="http://www.10centimeters.com/this-is-batshittery/">this important post about the Lisa Barrett debacle by 10 Centimeters</a> on my Facebook page. In the thread that ensued, a sarcastic comment to the effect of <i>"I'm soooo glad you all know what's best and have decided to control every mother's birth"</i> was posted. And Barb's reply, well, warranted me lifting it almost in its entirety, in the interest of me shouting it from the rooftops.</span></div><div><span class="Apple-style-span" style="color: rgb(51, 51, 51); line-height: 14px; background-color: rgb(237, 239, 244); "><blockquote><span class="Apple-style-span" ><i>The reality is FOUR BABIES DIED in her care. That is not disputed by anyone. No verdict needs to be given by anyone. That is a FACT. FOUR. And TWO within a very short time. These are babies that DIED. Gone. Forever. That their mothers will never breastfeed, but will feel their breasts swell trying to sustain the babies that are gone. Buried. Or cremated.<br /><br />Midwives do not lose babies like this without being <b>beyond reckless.</b> Taking the cases she's taken... and bragged about... is vile beyond anything anyone supporting homebirth could imagine.<br /><br />Hollering about a women's rights in birth is one thing, but doesn't ANYONE have a responsibility to see that everyone comes out alive and healthy? Why HAVE a midwife if you want to do anything and everything? Midwives like Lisa make homebirth look like the stupidest thing a woman could ever want to do -and that simply is not so.<br /><br />Homebirth NEEDS parameters in order to be safe. Every woman is NOT a candidate for a homebirth. And until the hollering masses like you lose babies yourselves at the hands of these horrid midwives, you're likely to continue being the sheeple you profess to not be. Instead of sheeple towards the medical way, you're sheeple thinking you can "Trust Birth" no matter what.<br /><br />But, you'll be wrong. Just ask the moms of those babies that died because of Lisa Barrett.</i></span></blockquote></span><span class="Apple-style-span" >Testify, Barb. Amen.</span><span class="Apple-style-span" style="color: rgb(51, 51, 51); line-height: 14px; background-color: rgb(237, 239, 244); "><blockquote><span class="Apple-style-span" ><blockquote></blockquote></span></blockquote><blockquote><span class="Apple-style-span" ><i><blockquote></blockquote></i></span></blockquote></span></div>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com5tag:blogger.com,1999:blog-5741036541041672560.post-43824422326668473662011-10-05T01:37:00.007-04:002011-10-05T02:03:20.239-04:00Tangled: Disney gets a little crunchy.Did you ever notice that in the Disney version of Rapunzel (I have a 3 year old kid; seeing it was inevitable, and actually somewhat enjoyable despite my grmph-ing), Rapunzel's mom has a birth complication that is treated botanically, saving both her and the baby princess? It's true. With a special flower that imparts the essence of the sun. Skip ahead to about :50 in the opening:<br /><br /><br /><iframe width="420" height="315" src="http://www.youtube.com/embed/zaXmHTHiz1U" frameborder="0" allowfullscreen=""></iframe><br /><br />I wonder if she ate the royal placenta? Maybe that's in the DVD extras.Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com5tag:blogger.com,1999:blog-5741036541041672560.post-10004357623819738622011-08-23T22:29:00.005-04:002011-08-30T20:51:11.137-04:00The KIT Project: Help make this a reality.I've mentioned Jennifer before, <a href="http://dou-la-la.blogspot.com/2011/03/happy-ibclc-day-how-timely-is-that.html">the lactation consultant who worked miracles</a> with Lily and I. What makes her so wonderful is not <span style="font-style: italic;">just</span> that her knowledge of breastfeeding is absolutely encyclopedic and second to none (which it is), but that she also sees beyond the symptoms, looking deeply and tirelessly into the underlying source of whatever dysfunction the dyad is expressing at the breast. It is truly <a href="http://holisticibclc.blogspot.com/">holistic lactation support.
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<br />I do believe she represents the best future of lactation consultants, and should become even more of a <a href="https://www.facebook.com/pages/Holistic-Lactation-Breastfeeding/258537754159365">leading voice in the community</a> than she already is - and yet there is a whole other dimension to her life work, which includes educating parents on holistic health. Fortunately for us, she has developed a "Kit" which includes everything a parent needs to begin supporting their family's health naturally and, again, holistically.
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<br /><iframe src="http://www.indiegogo.com/project/widget/36761" scrolling="no" width="210px" frameborder="1" height="400px"></iframe>
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<br /><div style="text-align: left;">Check out <a href="http://holisticibclc.blogspot.com/2011/08/so-whats-in-kit.html">this great detailed post</a> about the incredibly valuable content, and see what some of the parents who have benefited have to say, such as:
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<br /></div><span class="agText"><span style="font-style: italic;">“…</span><u style="font-style: italic;">The kit has empowered me; I feel confident that I can care for my family’s health and well-being using this arsenal of knowledge</u><span style="font-style: italic;"> Jen has given me. Before I had the kit, when my children were sick I would feel helpless to ease their symptoms and help their bodies heal, but now I have tools at my fingertips to help them to feel better and recover quickly. I highly recommend this kit, and I highly recommend Jennifer.” -- Kate Cordick-Burns Heiser, CT, USA</span></span>
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<br /><span class="agText">In order to launch this product for greater availability, some up-front investment needs to happen - but as with so many worthy projects, if everyone who encounters this gives just a little, we can make this a reality. And this NEEDS to become a reality. (I badly want this kit myself!)</span>
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<br /><span class="agText">So please click the IndieGoGo link above, check it out, and consider contributing!</span> Make it so.
<br /></div></div>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com0tag:blogger.com,1999:blog-5741036541041672560.post-4411877225983795312011-08-16T14:37:00.013-04:002011-08-16T15:44:03.108-04:00A suspicious new endorsement by singer Jewel, and a note from Anne re: life.Working out at the gym the other day, I was rocking out with my iPod and reading a trashy magazine. Hey, some people can read Pynchon and listen to Mahler, I need brain candy and synthpop. (I also choreograph song parodies as I'm trudging away. If anyone ever needs a breastfeeding promo set to Madonna, I'm your woman. Call me Madoula.) <span style="font-style: italic;">Anyway,</span> I came across an Oscar Mayer ad, and though I'd normally flip right past it, something in the jumbled images caught my eye.
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<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfiIwaPfDgKzZwy88sxT1bAN2n3OLqJYSduFlPrDD2C1LJFSdLpvcXEfjpMdn_3dJf-X6efIBXJVgQ8uRx8D-5Iay19FK0XkdEMe2I6heGXppnT8h5rTSAiqm3N1PLDG_Vq1MswB3mtFg/s1600/293595_10150285777602580_805232579_7598563_2742089_n.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 300px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfiIwaPfDgKzZwy88sxT1bAN2n3OLqJYSduFlPrDD2C1LJFSdLpvcXEfjpMdn_3dJf-X6efIBXJVgQ8uRx8D-5Iay19FK0XkdEMe2I6heGXppnT8h5rTSAiqm3N1PLDG_Vq1MswB3mtFg/s400/293595_10150285777602580_805232579_7598563_2742089_n.jpg" alt="" id="BLOGGER_PHOTO_ID_5641535575894664194" border="0" /></a>
<br />Apparently Jewel is now shilling for Oscar Mayer. But leaving aside how icky I think this processed crap is in the first place, something else really, REALLY bothered me. Can you guess what it is before scrolling down to see a close-up?
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<br />Okay, here's the zoom-in, also turned upside down:
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<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgP5jQezufcbmHQ8nS-yQ-GSJ0e3tQ5-E2PzeG5746HyoYZj1uxARuothaX9lvNuImz_XZkIbZ5y67SDhrdK29msR1icYgrucAhRloRq_v6YxQ5n2yprH5f2-GQMAesTLLJJbixPqx46xo/s1600/300154_10150285777912580_805232579_7598564_3727972_n.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 300px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgP5jQezufcbmHQ8nS-yQ-GSJ0e3tQ5-E2PzeG5746HyoYZj1uxARuothaX9lvNuImz_XZkIbZ5y67SDhrdK29msR1icYgrucAhRloRq_v6YxQ5n2yprH5f2-GQMAesTLLJJbixPqx46xo/s400/300154_10150285777912580_805232579_7598564_3727972_n.jpg" alt="" id="BLOGGER_PHOTO_ID_5641536573856453570" border="0" /></a>That right there, in what we're apparently supposed to think is Stuff You Find In Jewel's Bag, is a copy of Babywise. No doubt about it. See?
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<br /><a href="http://ezzo.info/"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 309px; height: 309px;" src="http://ecx.images-amazon.com/images/I/41P1Z65RKHL._SS500_.jpg" alt="" border="0" /></a>
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<br />I'm sure people following my blog are familiar with the most notoriously awful book on parenting ever there was, but just in case, you'll find all you need to know <a href="http://ezzo.info/">here</a>.
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<br />So, was this an intentional endorsement? She just had her first baby a month ago (congratulations on your baby boy, sincerely), so it's possible that this was on purpose (not the Boudreaux's Buttpaste in there as well). Or was this purely a matter of <span style="font-style: italic;">"Hey, young photographer's assistant, run out and grab a bunch of mom stuff. I dunno, diaper cream, I guess, whatever. Jewel can't possibly care what it looks like she's promoting if she's doing an Oscar Mayer ad, anyway,"</span><span>?</span>
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<br />Anyone else bothered by this? I'm not, like, ready to torch her Texas ranch or anything, but some sort of explanation would be nice. If, in the end, only kindness matters, "Babywise" is philosophically about as far from that as you can get.
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<br />And now for something completely different:
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<br />It bums me out that I haven't had more time for blogging in recent months. I normally try to maintain SOME boundaries between the blog and my real life, which may seem odd given the intimacy of many of the experiences I've shared here. But I'm not a "mommy blogger" in the strictest sense, if there is strictness in such things - while I certainly have blurred the lines at times, my focus is not on chronicling my parenting experience; my shared experiences have all been mostly on-topic.
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<br />But, suffice it to say, low-income single parenthood is seriously kicking my ass. There are LOTS of good things in the works for Lily and I, lots to give us hope and the gumption to stick it out - but the day to day present is quite difficult most days. Alas, this means blogging here is something that falls by the wayside during more strenuous times, which, again, bums me out because it's something I find very satisfying. This is my internal soundtrack* many days:
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<br />Point being, I'm not going anywhere, and as ever, hope to be able to produce more frequently in coming weeks and months. Just forgive the sporadic-acity and check in on me once in a while.
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<br />*Moment of teh fun: I managed to get out for some grown-up fun last week, and entered a pub trivia contest that was ALL JOSS WHEDON! And our team, Big Damn Heroes, won by a landslide.
<br />Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com13tag:blogger.com,1999:blog-5741036541041672560.post-25516876830278071222011-06-07T02:19:00.007-04:002011-06-28T14:10:02.325-04:00Once More With Feeling: Contemplating BBAC<div style="text-align: center; font-weight: bold;">Welcome, Second Time Around Carnival of Breastfeeding readers!<br /></div><br /><div style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNkfiWW96iQyyqK6VJ0Vc6BdxA0yB4Xn0_aveuulX23DS9ZkuTqyNZEXjnJNkTido5FfGJsJc_O4IzMN4wTu5IWPbswrCMMhHuGNaJFqAMlV624EeQzWXREqXtyTLQ0ecHA0PS51gzAoY/s1600/Second+month+029.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 242px; height: 325px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNkfiWW96iQyyqK6VJ0Vc6BdxA0yB4Xn0_aveuulX23DS9ZkuTqyNZEXjnJNkTido5FfGJsJc_O4IzMN4wTu5IWPbswrCMMhHuGNaJFqAMlV624EeQzWXREqXtyTLQ0ecHA0PS51gzAoY/s400/Second+month+029.jpg" alt="" id="BLOGGER_PHOTO_ID_5615355843284407538" border="0" /></a><span style="font-size:78%;"><span style="font-style: italic;">Finger-feeding at about 6 weeks. Still at the beginning of a long, strange trip.</span><br /></span></div><br />Could I do it all over again? Would I?<br /><br />I do hope to have a second child someday. No, there are no current plans or even prospects, but I would love for Lily to have a sibling, I'd love to give birth again, and, honestly, I really would love to have the chance to have a normal, or at least a less abnormal, nursing experience.<br /><br />When I got to act as a wet nurse a few times for a friend's baby, it choked me up the first time she latched on and chowed down happily - this was something I never got to experience with a newborn or even a young infant. By the time Lily and I made it, she was a roly-poly, active, distractable 5 month old on the verge of crawling - a very different creature than the little borrowed bundle I was guest-nourishing. Don't get me wrong, I was thrilled beyond belief that Lily was breastfeeding at all. It was just . . . different.<br /><br />When we were in the midst of <a href="http://dou-la-la.blogspot.com/2009/08/our-nursing-saga.html">Lily's struggle</a>, I found myself succumbing to moments of desperate jealousy of other moms with newborns or young babies who were able to nurse. My fantasies of motherhood had involved a lot of babywearing, strolling about with the baby nursing and sleeping in my ring sling at the grocery store, in cafes, on long walks. I envisioned making my way through my reading list while I nursed with my feet up in my glider with an ottoman. Tethered to the pump, I looked at those other moms through heartbroken, envious eyes.<br /><br />Needless to say, I didn't get halcyon days of early motherhood. Please don't mistake this for bitterness - what I DID get was the learning experience of a lifetime, for which I have found my way to be grateful (the Anne of 2.5 years ago is telling me to piss off, but never mind that). It has led to what I feel is a true calling for me, a real vocation. It has given me insight and painful empathy for the mothers I will be serving, having experienced many of their woes firsthand. And it was a real triumph for both of us to be able to overcome everything that we did. I genuinely am not bitter.<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNkfiWW96iQyyqK6VJ0Vc6BdxA0yB4Xn0_aveuulX23DS9ZkuTqyNZEXjnJNkTido5FfGJsJc_O4IzMN4wTu5IWPbswrCMMhHuGNaJFqAMlV624EeQzWXREqXtyTLQ0ecHA0PS51gzAoY/s1600/Second+month+029.jpg"><br /></a><br /><br /><div style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiX5KnPzwRfuerkNE1znJPYWxdb1naL9r6wr98I4kmACpvKbjGxwOC1_0rGIJQ5zJr4imT3EOtgFJ0_h_c96VmNJkUXHQT5Qg0Z001Sd1X5qL-hes_73djwgvPgTnugeORXYXH6a21zaAo/s1600/serenity.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 377px; height: 301px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiX5KnPzwRfuerkNE1znJPYWxdb1naL9r6wr98I4kmACpvKbjGxwOC1_0rGIJQ5zJr4imT3EOtgFJ0_h_c96VmNJkUXHQT5Qg0Z001Sd1X5qL-hes_73djwgvPgTnugeORXYXH6a21zaAo/s400/serenity.jpg" alt="" id="BLOGGER_PHOTO_ID_5615357074220312402" border="0" /></a><span style="font-size:78%;"><span style="font-style: italic;">Serenity at last.</span></span><br /><span style="font-size:78%;"><span style="font-style: italic;"></span></span></div> <span style="font-size:78%;"><span style="font-style: italic;"><br /></span></span>But the question remains: could I do it again?<br /><br />I would pray to be blessed with normalcy, but there is NO guarantee. I know much more now, to put it lightly. I would be prepared for any and all of the factors that affected us last time - tongue tie being the biggest, but the other components as well. What's the likelihood of facing some, most, or even ALL of these again with a second baby? Impossible to predict. Another tongue tie is certainly a strong possibility, as heredity is involved, but if we got it addressed immediately, our chances would be much better. <span style="font-style: italic;">Wouldn't they? </span><br /><br />No guarantees. What if lightning strikes twice? Can I walk through the fire again? So many life factors come into play. Lily was a first baby. It would be so hard to repeat the process all over again with another child to care for, though as she gets older, she may be independent enough that having to take many of these measures could be more feasible than if she were still a young toddler. What would my financial situation be? What if I needed to return to work earlier than I did with Lily? How would that affect us? All of it daunting - yet not totally deterring.<br /><br />I would imagine that it's something like a mom preparing for a VBAC after an unwanted cesarean, or looking at another birth after any difficult birth experience, period. Although I was blessed with a really wonderful birth, some aspects of our nursing experience were on the traumatic side, though it was a slow-motion trauma that occurred over months and months. What do VBAC-seekers do? They prepare with information, they seek out good care providers and other support, they evaluate their prior experience and look at factors that affected the outcome, considering whether these are likely to recur. And they work on the emotional healing as well - many times the preparation for the the next birth is a part of the healing process in itself. I'll dub myself as a mom seeking BBAC, then, perhaps: Breastfeeding Baby After Challenges (or Craziness).<br /><br />So this time around, I'm armed with information, with resources, with experience, with support. I doubt I could be more prepared. Will this be enough? Only one way to find out.<br /><br />Let's take it from the top.<br /><br /><br /><div style="text-align: center;">*****<br /></div><br /><em><strong>Please stop by the other Breastfeeding Carnival participants' posts and leave some comment love:</strong></em><br /><ul><br /> <li><strong>Ambular Logic: <a href="http://ambularlogic.blogspot.com/2011/06/breastfeeding-second-time-around.html">Breastfeeding the Second Time Around</a></strong></li><br /> <li><strong>Blacktating: <a href="http://www.blacktating.com/2011/06/june-carnival-of-breastfeeding-second.html">Second Time's The Charm</a></strong></li><br /> <li><strong>Motherwear Breastfeeding Blog: <a href="http://breastfeeding.blog.motherwear.com/2011/06/-reasons-why-its-usually-easier-the-second-time-around.html">Seven reasons why breastfeeding is usually easier the second time around</a></strong></li><br /> <li><strong>Reporter2Mother: <a href="http://reporter2mother.blogspot.com/2011_06_01_archive.html">Lessons Learned</a></strong></li><br /> <li><strong>Good Enough Mum: <a href="http://goodenoughmummy.typepad.com/good_enough_mum/2011/06/carnival-of-breastfeeding-the-second-time-around.html">The Second Time Around</a></strong></li><br /> <li><strong>Three Girl Pile Up: <a href="http://threegirlpileup.wordpress.com/2011/06/13/totally-different-and-completely-the-same/">Totally Different and Completely the Same</a></strong></li><br /> <li><strong>Treasured Belle: <a href="http://treasuredbelle.blogspot.com/2011/06/tandem-nursing.html">Tandem Nursing</a></strong></li><br /> <li><strong>Christine's Contemplations:<a href="http://christinescontemplations.blogspot.com/2011/05/carnival-of-breastfeeding-nursing.html"> Nursing Styles Between Siblings</a></strong></li><br /> <li><strong>TouchstoneZ: <a href="http://touchstonez.com/2011/06/13/once-more-with-feeling/">Once More With Feeling</a></strong></li><br /></ul>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com19tag:blogger.com,1999:blog-5741036541041672560.post-2726090966936272892011-06-04T05:29:00.000-04:002011-06-04T06:36:51.521-04:00Something of The Night About Them: Guest Post<span style="font-style: italic;">In the spirit of sharing that's going around lately, today it's MY turn to share a truly lovely, evocative piece by Mars Lord of </span><a style="font-style: italic;" href="http://www.blogger.com/www.mammydoula.co.uk">Mammy Doula</a><span style="font-style: italic;">. A good read to reflect on for the weekend!</span><br /><br /><a href="http://4.bp.blogspot.com/-bzNO8PX0JiM/TelT51gB36I/AAAAAAAAASY/Ta8WQNhbRpo/s1600/P1060751.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 300px; height: 400px;" src="http://4.bp.blogspot.com/-bzNO8PX0JiM/TelT51gB36I/AAAAAAAAASY/Ta8WQNhbRpo/s400/P1060751.jpg" alt="" id="BLOGGER_PHOTO_ID_5614110663573102498" border="0" /></a><br />There's something of the night about them.<br /><br />What is it that happens to some midwives after 8pm? These normally smiley, friendly, font of knowledge midwives seem to take on something of the night. The smiles are gone. The time to sit has vanished (yes I know it's a rare occurrence in the life of a day time midwife, but please… don't interrupt the atmosphere building). There's a need to make and keep everyone quiet.<br /><br />It is hard to see the breastfeeding posters in the dark. The muted lights must have something to do with that. The breasts of the Mothers have mysteriously failed to function and time has become the enemy. There is much rushing about to be done. There is much keeping of order. It is as though the job spec has changed and the Mothers are to be ignored.<br /><br />Perhaps the bells that call the midwives only work from 8.30am to 8.00pm. The only sounds heard are the ones demanded babies be taken out of the Mothers' beds and placed dressed and wrapped in plastic containers on wheels.<br /><br />It now, in the dead of night that Mothers are most at risk. They are more prone to making decisions that they (possibly) regret the next day. That dark lady of the night comes wielding a bottle of 'elixir'. The magic substance that will make their babies sleep and restore quiet and calm to a night ward. Here is when a Mother might agree to testing for her baby. She's been strong in the day, because she knows that baby is fine and the doctor has told her it's borderline and there is no urgent need to act. But now, as the darkness surrounds her and she's groggy from sleep, someone talks to her to tell her how risky borderline is and so assents.<br /><br />She has never been so tired. The labour was long, the golden hour when it was her, baby and partner slowly getting to know each other is almost a distant memory. Since then she has been hussled into a shower, her baby handled by any number of people. Her attempts at sleep thwarted by a baby that needs feeding, gazing at, kissing, holding and loving. It is hard to sleep when the only baby crying appears to be hers. Jiggling isn't working. No one has read the manual to her. Are her breasts producing enough milk? There's no way, she thinks, of telling. She is fearful of waking the other babies and starting the cacophony of a postnatal ward.<br /><br />And as she finally succumbs to sleep in walks someone to check her blood pressure, check the baby, check the bins, call her to breakfast.<br /><br />Being informed is the key here. The Mothers that we support as partners, parents, birth partners, Doulas, need to know that they have someone that they can call in the middle of the night. They should be aware that it is a different culture in the postnatal ward at night than the delivery suite in the day or even early evening. I often hear people talking about their birth experiences and an incredibly high percentage talk about the awful postnatal care, particularly at night.<br /><br />To those wonderful angels of the night that come in with calming, soothing voices, and time to give to the new Mothers, despite the files falling from their arms. Thank you. You have been far more important than you know.<br /><br /><div style="text-align: right;"> -- MammyDoula<br /><br />Mars Lord<br />Mother of 5<br />Birth and Postnatal Doula<br /><a href="http://www.mammydoula.co.uk/" target="_blank">www.mammydoula.co.uk</a><br /><a href="http://www.doula-lly.blogspot.com/" target="_blank">www.doula-lly.blogspot.com</a><br /></div>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com2tag:blogger.com,1999:blog-5741036541041672560.post-11550824247933295472011-06-01T11:58:00.004-04:002011-06-01T16:36:05.113-04:00Guest Post on The Leaky Boob: Good Cop, Bad Cop<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://theleakyboob.com/wp-content/uploads/2011/05/police-tape-policeline-3849334-h-300x200.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 300px; height: 200px;" src="http://theleakyboob.com/wp-content/uploads/2011/05/police-tape-policeline-3849334-h-300x200.jpg" alt="" border="0" /></a><br />Hey, check out the post I wrote for <a href="https://www.facebook.com/TheLeakyBoob">The Leaky Boob:</a> <a com="" img="" gifhref="http://theleakyboob.com/2011/05/goodcopbadcop/">"Good Cop, Bad Cop - On The Breastfeeding Police". A snip:<br /><br /><em></em></a><blockquote><a com="" img="" gifhref="http://theleakyboob.com/2011/05/goodcopbadcop/"><em>YES, I do think that women who feel they ‘can’t’ produce enough milk have often been sabotaged (i.e. </em></a><a href="http://www.bestforbabes.org/category/blog/booby-traps"><em>booby-trapped</em></a><em>) in ways they are unaware of. And one of the things that most often thwarts them is misinformation.</em> <p><em>HOWEVER. Statements that imply that really, everyone can breastfeed and if they didn’t succeed, they just didn’t try hard enough, mind over matter? EVERY BIT as misinformed as the bad advice that might have led a mom to undermine her supply or her belief in her supply. I know it’s highly unorthodox for a breastfeeding advocate to call other breastfeeding advocates out when their intentions really were good, but I see so much poor advice online that it’s really starting to get to me.</em></p></blockquote><p><em></em></p><p>And later:<br /><em></em></p><p></p><blockquote style="font-style: italic;">This does NOT mean that there is not a place for peer support. There so absolutely is is – La Leche League turned the tide on breastfeeding half a century ago and its very foundation was peer support. But part of being a trustworthy resource is knowing when something is beyond your knowledge – even for professionals, certain things are beyond one’s scope of practice, and it is crucial to have the honesty and humility to know when to refer. </blockquote><p></p><p><a href="http://theleakyboob.com/2011/05/goodcopbadcop/">Please hop on over and take a look!</a><br /></p><a com="" img="" gifhref="http://theleakyboob.com/2011/05/goodcopbadcop/"><br /></a>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com3tag:blogger.com,1999:blog-5741036541041672560.post-8582788422086888832011-05-29T18:45:00.002-04:002011-05-29T18:48:03.627-04:00Weekend Movie: Formula for Disaster<iframe width="425" height="349" src="http://www.youtube.com/embed/SNYDPKQOVUE" frameborder="0" allowfullscreen></iframe><br /><br />Have you seen this short but potent documentary on formula marketing in the Phillipines? It's available on YouTube in its entirety in 5 short segments. A great illustration of the coercive power of marketing, and why the WHO Code is so incredibly important.Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com1tag:blogger.com,1999:blog-5741036541041672560.post-57456022117722362872011-05-24T02:12:00.001-04:002011-05-24T19:43:02.132-04:00The Parallel Paradox Part 4 - Placenta Previa ResolvedAnd finally, the resolution.<br /><br />We left off in <a href="http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-3-dealing-with.html">part three</a> (see parts <a href="http://dou-la-la.blogspot.com/2011/03/parallel-paradox-my-experience-with.html">one</a> and <a href="http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-2-diagnosis-of.html">two</a>) with my 20 week visit with the CNMs, my sense of optimism bruised but not broken, relieved to have the biweekly cervical checks come to an end, especially now that they had to be performed by Steely Dan here:<br /><br /><a href="http://www.sonotech.com.pk/files/uploaded/Transvaginal-Ultrasound%202.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 297px; height: 194px;" src="http://www.sonotech.com.pk/files/uploaded/Transvaginal-Ultrasound%202.jpg" alt="" border="0" /></a><br />I wouldn't be returning until week 28, for what I hoped was the final follow-up ultrasound, in which I would surely be given the green light for a vaginal birth, since the overwhelming odds were in my favor that, by the end of pregnancy, the placenta would have safely 'migrated' off the os by the minimum 2 centimeters necessary.<br /><br />So, for the nest two months, my goal was to try to regain a sense of normalcy, if cautiously so. I would follow the recommendations against any exercise beyond the gentlest of yoga and abstaining from any and all sexual activity, but would also practice visualization, including my invented nightly ritual of focusing on positive images of unobstructed birth, while gently massaging my belly with upward-moving strokes (again, not a technique or treatment of any kind, just a form of meditation and positive thinking). I choked down my Floradix dutifully and started to enjoy my visits with my CPMs again. I even brought food on several occasions, and stayed for well over an hour PAST my appointment time. Can you imagine doing such a thing with your own care provider, if you've worked with someone other than a CPM? I laugh even now to think of what any of the CNMs would have done if I'd walked in with a picnic basket, or suggested we order a pizza and get to know each other a bit.<br /><br />And overall, though I was still concerned, I generally worked on trying to relax about the whole thing, and focus on impending motherhood, which was, after all, the whole point.<br /><br />Yet for all my fixation on positivity, I was still struggling with guilt over possible contributing factors to the previa. It can happen to anyone, but there are also risk factors that drive up the odds, such as smoking (which I no longer did, but had for 15 years) and prior uterine surgery, including D&C (guilty as charged). And I also often wondered if I was really just blowing the whole thing out of proportion. Some women who have cesareans have a hard time with it in many ways, yet others are really pretty much fine, given the added recovery time. Was I being insensitive to these moms, wringing my hands over the possibility?<br /><br />[Also? I gained some weight. To say the least. Hey, I was forbidden my normal level of pretty vigorous exercise, plus I happened to be pregnant over the holidays. And I wasn't even allowed to have sex - of <span style="font-style: italic;">any</span> kind. What else was I going to do but eat? I'm not endorsing this behavior, mind you, but in all honesty, this was my emotional response. And yes, I got pretty massive. I hope to be much more healthful if I get a second chance at pregnancy, because it's definitely not a great idea to gain 65 pounds to yield a 7 pound baby - I'm just being honest. Don't follow my example on this if you can help it.]<br /><br />Fast-forward to 28 weeks. I show up to the CNM/OB practice after much-appreciated 2 month hiatus, this time with babydaddy in tow (prior to this, he had only attended the prenatals with our homebirth midwives, as we still lived in separate states and had to choose carefully). By this point I was feeling pretty confident that we'd be hearing good news, but I definitely needed to make sure I had support this time, just in case.<br /><br />The technician was the same one I had seen several times before, and she knew how important this was to me. It was evident in her face as she silently scrutinized the screen, my heart racing, her brow furrowing as she searched and searched for an angle that would show us some good news. But she finally pursed her lips together, sadly shook her head, and said she was sorry, but it looked like it really hadn't moved at all since the previous visit 2 months prior, where 'complete' had given way to 'partial', but was mostly a matter of semantics (dealing, as we were, with millimeters).<br /><br />I remember feeling like the air just went out of the room. "At all? Not even a little?" I said, fighting back tears and unable to make eye contact with Aaron, knowing if I did I would lose it completely. She offered to try looking with the good old transvaginal wand again (see above), and I agreed. But no, it was definitely still right there brushing up against the os. Too close to call safe for a vaginal exit. We could try again in another month, she said, and gave me a sympathetic look and rub on the shoulder.<br /><br />I went to get my pants back on while Aaron went to wait in the exam room, since we hadn't yet seen the midwife (it was scheduled so that we'd know the results of the ultrasound first, sensibly), aware that the whole office could likely hear me crying. Again, I was self-conscious about whether I was blowing this all out of proportion - after all, this place had hear plenty of tears before, and for reasons much more tragic than mine. The <span style="font-style: italic;">BABY</span> was doing just fine, no one questioned that. And that was and remains the most important thing. So I did my best to pull myself together as I stopped by the nurse's station to give my vitals.<br /><br />"Your blood pressure is a LIT-TLE high, my dear," the nurse singsonged as she removed my cuff. She meant no harm, I know, but really, come on. The likely reason for the high reading could not have been more apparent. "Well, I'm a little upset right now," I said. "Can we please get a second reading?" She agreed, and let me sit and breathe for a few minutes. The second reading was perfectly fine. I proceeded into the exam room.<br /><br />This time, we did not have Ms. Worst Case Scenario, but another CNM I'd met with once before. Besides a mild reprimand for the amount of weight I had gained, she was kind but down to earth, who made it clear that her own recommendations were different regarding home birth, but still managed to be supportive of my choices as long as I was low risk - which, at the moment, I was certainly not.<br /><br />She saw the freshly-updated chart and gave me a look of genuine sympathy. "I know this wasn't what you were hoping for." Still trying to keep it together, I managed to get the words out: "So, do I need to meet with one of the OBs here now? To schedule a cesarean?"<br /><br />"No, not at all. We really don't need to do that yet. It's getting later in your pregnancy, but there is still time. We'll definitely do at least one more ultrasound."<br /><br />"Really?" At the moment, I wasn't thinking clearly at all. I had really felt like the jig was up.<br /><br />"Anne, we WANT you to deliver vaginally if possible. Yes, we would prefer that you do so in the hospital, but whatever you choose to do, there's still a chance it could move." I felt a bit better, and we went through the rest of the brief checkup - everything with the baby looked fine, as per usual.<br /><br />The following week's visit with my home birth midwives was therapeutic, also as usual. But given the update, I thought it was important to discuss what would happen if the placenta still hadn't moved after my next ultrasound. They explained that, just as if a situation arose in labor that mandated transfer, they would shift into the roles of doulas for me. "We're not just going to abandon you!" This was so reassuring. For all my positive affirmation and work on 'manifesting' a normal vaginal birth at home, I really hadn't let go of the mindset that if I did need to have a cesarean, all would be lost. Nothing would be familiar, I would have NO support, and I might as well surrender every other aspect of my pregnancy and my baby's birth to the authorities. Not a terribly productive or helpful perspective.<br /><br />We started talking about a variety of ways to make the experience better; more gentle for baby, less traumatic for me. It the medication was making me shake so I couldn't hold the baby, they would help me maintain skin-to-skin contact. If the baby and I needed to be separated, they would stay with me so Daddy could go with baby. They would help me just as much as they would have if we were at home, just in a different role.<br /><br />So it was from here that I started to work towards making peace with the possibility. Not just "giving up" and resigning myself to a cesarean, as I was oddly ready to do with the CNM, but simply finding some acceptance and letting go of the desire to completely control Lily's birth. Instead of resisting the concept with all my might, it was time to step back, recognize that there was a chance that this might be, and make peace with the fact that if this were the case, I needed to be grateful that there was still a safe way for my baby to be born, even if it wasn't my ideal, and find ways to make the best of it.<br /><br />At this point, you might be wondering: Had I not chosen to do some parallel care in the first place, and got all my prenatal care with the home birth midwives, what would have happened? What would the CPM approach to a placenta previa be? How would it even be identified if there were no ultrasound involved? Well, many CPM clients (or women seeing home birth CNMs) opt for an anatomy scan at 20 weeks anyway, but if mom wants to avoid unnecessary sonograms in the first place, a skilled midwife can locate the placenta via auscultation - i.e. listening to the flow of blood through a fetoscope or with a Doppler. If neither of the above happens, there is typically a "warning bleed" at about 34 weeks, which would alert mom and care providers to a persistent previa and the decisions would proceed from there. (Any bleeding in the 3rd trimester, though usually painless, should be taken seriously and reported immediately.)<br /><br />Though my next ultrasound was originally scheduled for 32 weeks, we decided to change it to 34, wanting to give it as much time as possible. I had continued learning as much as I could about previas from various sources. One had explained that the uterus did the most upward growth in the very last trimester, and moreover, it continues in the last part of the last trimester. I also confirmed that the placement of my placenta, though low, was also anterior, which was also encouraging - though a posterior placenta will still move up with the uterus, there is more growth in the front, as the uterus obviously doesn't grow <span style="font-style: italic;">back</span> toward the spine but forward and up.<br /><br />I had mostly given up on finding any sort of "treatment" when one day, while poking around online, I found a reference to an <a href="http://www.holistickid.com/acupuncture-placenta-previa/">acupuncture technique</a> that addressed placenta previa. I couldn't believe I never encountered it before, but investigated a little more. It seemed fairly obscure and quite specialized, but why not see if I could find someone familiar with it. The first practitioner I called had no idea what I was talking about. The second had heard of the technique but never done it themselves, though they were willing to learn. I said I'd keep that in mind if I couldn't find another person.<br /><br />Third time was the charm! She knew what it was, how to do it, and had practiced it before. So for about a month and a half, I went in twice a week to have the needles placed, relaxing for half an hour, continuing my visualizations and affirmations. The time flew by, and before I knew it, it was the week of what I again hoped to be the final ultrasound - but this time, I felt much more relaxed about it. If it hadn't moved, we'd check again at 36 weeks, and then again, and if it had to be, then, que sera sera, and I'd have, as a friend and wise yet snarky mentor put it, "another fucking learning experience."<br /><br />A few days before I was to go in, I was surprised to the [local CNM/OB practice] pop up on my phone. Lo, it was Ms. Worst Case Scenario, the one who had made sure I knew that "either it's going to move or it's not, and no amount of thinking you do is going to change that." She was calling to recommend scheduling an amniocentesis. Why, I asked? Well, because just in case my ultrasound showed no movement of the placenta, we needed to test for lung maturity so we could go ahead and schedule my c-section.<br /><br />I was momentarily thrown, but then addressed her calmly. Wasn't there a risk, with amniocentesis, of triggering labor? She admitted that yes, there was. A small one, but still a real one. I then declined the test for the time being, (politely, I promise), told her about the acupuncture, and explained that I just wanted to see what the ultrasound said first, and then, if we needed to start taking those steps, I would take them. I wasn't trying to take unnecessary, reckless risks, I just needed to give my body every opportunity to correct this on its own. She actually quite responsive to this explanation, and said that she understood where I was coming from. In the end, I actually found this phone call rather empowering.<br /><br />The 34 week ultrasound showed almost 3 cm of clearance off the os. Everyone at the CNM/OB practice shared my happiness, and didn't seem to take it too personally when I told them I didn't plan on returning.<br /><br />You basically know the rest: not even 3 weeks later, I went into labor and gave birth to my daughter at home, 13 hours later. There were no complications, but my intrapartum bleeding WAS noted as "significant". Not something that was alarming, but something my midwives paid close attention to, making sure I exited the birth pool in order to assess it more clearly. They stayed for 4 hours after the birth, until they were absolutely sure everything was fine, left detailed instructions of what to track and watch for (maternal and neonatal) over the next 24-48 hours then returned the next day as well as the third.<br /><br />I never had any bleeding during my pregnancy - no warning bleed at all, not even a drop since the extremely faint spotting that occurred right around the time implantation would likely have been happening.<br /><br />So what's the moral of the story here? Would it have moved without the acupuncture? Possibly. It's not even a stretch to say probably. But not only did it help to finally be able to DO <span style="font-style: italic;">SOMETHING</span> actively, I do think there's a chance it did help, and a tiny bit of help is all that was needed to make a huge, huge difference. The conclusion is also NOT "refuse all interventions and tests". There are times when interventions and tests are absolutely essential - I'm not trying to demonize the CNMs. I know they were good people trying to do the right thing, and that they DID care about both of us. I do think, though, that like many things that seem on the surface to be the "best of both worlds", parallel care is not worth the stress and dissonance of trying to have it both ways, so to speak. A little more faith in my body and a more positive outlook would have done wonders.<br /><br />I also feel that diagnosing previas as early as mine was diagnosed does nothing but cause unnecessary stress. So many placentas are low-lying or even some grade of previa at the beginning, simply because there is so little surface area during the first part of pregnancy. I found in my reading that the placenta grows faster than the fetus for about the first 20 weeks of pregnancy, in fact, and only then does that ratio start to slowly reverse itself. That, combined with the upper segment of the uterus doing the last bit of growth at the very end, should provide some much-needed reassurance to moms who have been given the scarlet P in an early ultrasound.<br /><br />What if, however, you happen to be the rare person whose placenta really does remain in a place that blocks the cervix? This was something I had to come to terms with. I think there is some peace to be found in knowing that your cesarean was, unquestionably, a medically necessary one. There's no doubts about it being an "unnecesarean" at all, as there can sometimes be with CPD or FTP. So, though it's easy for me to say in hindsight and as someone who got to have a vaginal birth after all, I really feel there is much value in this perspective. (And hopefully, the experience can also be made as gentle and positive as possible; see below.)<br /><br />"Previa moms", DON'T PANIC. There is every chance that it will migrate. The odds are SO in your favor. Yes, watch for bleeding and take it seriously, and don't take up pole dancing as a hobby all of a sudden, but really, don't live in fear and let this overshadow your whole pregnancy. Enjoy your baby and have some faith in your belly. As my own mom was fond of pointing out - they're a lot more trouble on the outside than they are on the inside.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrcFTYb0EgKGO2E9DrhYqf1JsWAyaqBiPz74Go-X92u-MB9RAxcBFG-vw1zjUSAcIKWk4GCQnmgDSv72P2s5Z4kHyn1_4nafu2HqJrvAe4nO89SFQ5G7U5oeGJ0M3lAi5BBx_V5v7q7KQ/s1600/DSCN1343.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrcFTYb0EgKGO2E9DrhYqf1JsWAyaqBiPz74Go-X92u-MB9RAxcBFG-vw1zjUSAcIKWk4GCQnmgDSv72P2s5Z4kHyn1_4nafu2HqJrvAe4nO89SFQ5G7U5oeGJ0M3lAi5BBx_V5v7q7KQ/s400/DSCN1343.JPG" alt="" id="BLOGGER_PHOTO_ID_5610419060668230850" border="0" /></a><br /><br /><blockquote>Related links:<br /><br /><a href="http://dou-la-la.blogspot.com/2011/03/parallel-paradox-my-experience-with.html">Part One</a><br /><a href="http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-2-diagnosis-of.html">Part Two</a><br /><a href="http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-3-dealing-with.html">Part Three</a><br /><a href="http://dou-la-la.blogspot.com/2010/01/c-section-birth-plan-oxymoron-not-even.html">Cesarean birth plans</a><br /><a href="http://dou-la-la.blogspot.com/2010/02/mothering-mother-in-all-circumstances.html">Doulas and cesareans</a><br /><a href="http://dou-la-la.blogspot.com/2011/03/weekend-movie-natural-cesarean.html">Movie: The "natural" cesarean</a></blockquote>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com8tag:blogger.com,1999:blog-5741036541041672560.post-27595307975374538802011-04-28T17:28:00.002-04:002011-04-28T17:43:20.106-04:00Winner of the "Arms Wide Open" giveaway . . .. . . is Jennifer, commenter number 5! Jennifer, email me at annetegtmeier [at] gmail [dot] com with your snail mail address and we'll send it off to you posthaste. (If I don't hear from you within a week, we'll draw another number, to be fair.)<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.chicmommagazine.com/admin/sites/default/files/Arms%20Wide%20Open.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 300px; height: 300px;" src="http://www.chicmommagazine.com/admin/sites/default/files/Arms%20Wide%20Open.jpg" alt="" border="0" /></a><br /><br />It seems especially meaningful to share a midwife's memoir as we memorialize another.<br /><br />Thanks to all my readers for taking in our sharing of Briana over the past week. It's something that has affected us quite a bit, so I appreciate having an especially relevant place to share it. I'm hoping to get the grand finale to my previa story up next, but sometimes life and all it encompasses - including death - takes precedence.<br /><br /><iframe src="http://player.vimeo.com/video/22881925" width="400" frameborder="0" height="225"></iframe><p><a href="http://vimeo.com/22881925">Briana Blackwelder (at my son's birth)</a> from <a href="http://vimeo.com/davidperryfilms">David Perry</a> on <a href="http://vimeo.com/">Vimeo</a>.</p>Thank you for bearing witness.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://utahfriendsofmidwives.blogspot.com/2011/04/mourning.html"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 268px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_eLyKXHOmhsa5iiuWhB_ivQVsATGkWPF2CKfF7iDEszDifVWLsEetbR8NzXfIIgwMs6ATcRzMhOnEW37Y566bxHT7-JUcNCL5LUSIXArsj1ugWmqMJMpyiJ2sB26l6lW9ebmq9sIQ9N8r/s1600/briana.JPG" alt="" border="0" /></a>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com1tag:blogger.com,1999:blog-5741036541041672560.post-44834206247908291462011-04-27T18:36:00.003-04:002011-04-27T18:40:51.837-04:00Briana's Words, Briana's WisdomCreated by my sister Kate and her husband, Neil. This uses footage from her adoption documentary project (more of which, including the conversation all 4 of us featured subjects got to have together, will be included in the final project).<br /><br /><iframe src="http://player.vimeo.com/video/22934125?title=0&byline=0&portrait=0" width="400" height="225" frameborder="0"></iframe><p><a href="http://vimeo.com/22934125">Briana's Words, Briana's Wisdom</a> from <a href="http://vimeo.com/kateandneil">Kate and Neil</a> on <a href="http://vimeo.com">Vimeo</a>.</p><br /><br />If you watch, definitely make sure you catch the very ending.<br /><br />A <a href="http://www.midwifery.edu/briana.php">scholarship fund has been created in her honor</a> at the Midwives College of Utah. Please consider donating to her legacy.Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com1tag:blogger.com,1999:blog-5741036541041672560.post-19723216075018378322011-04-25T18:40:00.006-04:002011-04-25T19:13:33.932-04:00In memory of a young midwife<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://www.fernmidwifery.com/_Fern_Midwifery/home.html"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 303px; height: 235px;" src="http://www.fernmidwifery.com/_Fern_Midwifery/about_us_files/shapeimage_3.png" alt="" border="0" /></a><br />This is <a href="http://thehousethatlarsbuilt.blogspot.com/2011/04/briana-blackwelder-celebration-of-life.html">Briana Blackwelder</a>, a 28 year old midwife and good friend of my sister, who was killed in a car accident this weekend.<br /><br />I was lucky enough to get to meet her just a few months ago, en route to Portland, when we stopped in Provo and stayed the night with family. My sister is working on a documentary film project about adoption, which I mentioned in <a href="http://dou-la-la.blogspot.com/2011/01/when-dna-isnt-just-dna.html">this post</a> a ways back. Kate is in DC, but since I was stopping through, this meant that 4 out of 4 interview subjects would be in the same city for the blink of an eye, so she arranged for us to meet and Skyped herself into what was a wonderful conversation between us all - my mom, a birth mother; myself, a relinquished child; Kate's friend Ashley, a birthmother-to-be; and Briana, Ashley's midwife. This was all caught on film, and editing is underway.<br /><br />After the conversation, I got to chat with Briana for a bit longer, talking about my hopes of attending Birthingway and about some of her own experiences, and I truly looked forward to getting to know her more in the future. Hindsight often magnifies these fleeting things, especially when tragedy and grief are involved, but I don't think it is any exaggeration to say that this was a truly extraordinary person whose genuine vocation as a midwife emanated from her very being. In addition to the inexpressible loss her family is suffering, the world of midwifery has experienced a huge loss as well.<br /><br />I'm reposting the Vimeo video from my previous post about the film; it focuses on Ashley, but in the process, you get to see Briana in action for an all-too-brief moment, starting at about 4:30. An all-too-brief moment in an all-too-brief life.<br /><br /><iframe src="http://player.vimeo.com/video/17343150?title=0&byline=0&portrait=0" width="400" frameborder="0" height="225"></iframe><p><a href="http://vimeo.com/17343150">Women's Bodies, Women's Wisdom</a> from <a href="http://vimeo.com/user4155408">Neil Ransom</a> on <a href="http://vimeo.com/">Vimeo</a>.</p><br />When Kate's film is finished, we'll be able to see her interview footage, and I very much look forward to hearing everything she has to say. I'll share this with you as soon as it's available.<br /><br />Please take a moment to hold her in your thoughts or your prayers or in whatever way you honor the departed.<br /><a href="http://lagunaniguel.patch.com/articles/memorial-service-for-briana-blackwelder-in-utah-wednesday-memorial-in-laguna-niguel-soon#c"><br />Memorial services will be held on Wednesday in Salt Lake City</a>, if you're a local.Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com7tag:blogger.com,1999:blog-5741036541041672560.post-89305058898642194202011-04-21T15:37:00.004-04:002011-04-21T18:39:54.285-04:00Big Birthday Giveaway! "Arms Wide Open"<a href="http://ecx.images-amazon.com/images/I/41VCu1g7TZL._SL500_AA300_.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 300px; height: 300px;" src="http://ecx.images-amazon.com/images/I/41VCu1g7TZL._SL500_AA300_.jpg" alt="" border="0" /></a><br />At long last, my first giveaway! I've been looking forward to doing this for some time, but was awaiting a ripe opportunity. Hence, my birthday.<br /><br />I love a good midwife memoir, and just started this the other night, at long last: <a href="http://www.amazon.com/Arms-Wide-Open-Midwifes-Journey/dp/0807001384">"Arms Wide Open: A Midwife's Journey". </a> I'll be giving my thoughts on the book soon enough, but wanted to get the giveaway going first!<br /><br />SO! Standard blog giveaway rules. One point each for: Following me on Google Friend Connect (over thar in the sidebar), liking my page on <a href="https://www.facebook.com/pages/Dou-la-la/185423424817397?ref=ts">Facebook</a>, following me on <a href="http://twitter.com/#%21/Dou_la_la">Twitter</a>, or subscribing via RSS. Post a separate comment for each! I'll give it a full week, then choose a winner via Random.org. Winner gets a free copy of the book, of course!<br /><br />Enter away!Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com39tag:blogger.com,1999:blog-5741036541041672560.post-1589660809366271792011-04-18T06:56:00.000-04:002011-04-18T10:12:49.726-04:00The Parallel Paradox Part 3 - Dealing with Placenta Previa<a href="http://psychy.org/2007/11/04/how-unrealistic-are-positive-thinking-strategies/" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 479px; height: 151px;" src="http://psychy.org/wp-content/uploads/2007/11/positive-thinking.jpg" alt="" border="0" /></a><br />Continued from parts <a href="http://dou-la-la.blogspot.com/2011/03/parallel-paradox-my-experience-with.html">one</a> and <a href="http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-2-diagnosis-of.html">two</a>.<br /><br />After getting off the phone, and calming down, I drove directly to my local natural parenting store, where I'd been going for cloth diapers, slings, and a home birth support group. Surely their abundant bookshelves would offer up some helpful and reassuring information, somewhere in all the books I'd been devouring for their information on natural/home birth and holistic pregnancy.<br /><br />On the contrary. I looked in index after index after index. And each book in turn referred me to a page that mentioned the several universally-agreed-upon contraindications for a vaginal birth. I might as well be walking around with a pre-prolapsed cord. Some mentioned that placentas can migrate late in pregnancy, but offered no further information. All the crunchalicious books I had found so empowering were now shutting a door in my face, or so it felt.<br /><br />One of the employees that I had become friendly with came over to offer some help, and I told her what was up. "I guess I'm just feeling pretty powerless right now," I said, fighting tears but still self-conscious that maybe I was blowing the whole thing out of proportion. She reiterated what the perinatologist had said about the likelihood of migration, and though she didn't know anyone who'd dealt with this personally, she had known of some women on a message board who had. I decided to check in on the message boards when I got home.<br /><br />Before I logged on, though, I decided to browse through my own shelves and see if I found anything new. All of my own books produced the same result as the books at the store -<span style="font-style: italic;"> "Previa, placenta, 176, contraindication to vaginal delivery"; "Placental abnormalities, 242, previa"; </span><span style="font-style: italic;"> "Placenta previa, 52, reasons for cesarean"</span><span style="font-style: italic;">; "Previa, placenta, 67, abandon all hope" </span>- except for one. One very unexpected resource.<br /><br />When she got the news of her impending grandmahood, my birthmom ran right out and picked up what seemed to be THE book, the bible, even, for pregnant women, and was recommended as such by the bookstore employees: "<a href="http://dou-la-la.blogspot.com/2010/01/what-to-expect-when-hollywood-takes-on.html">What to Expect When You're Expecting"</a>. Now, as you'll gather from that snarky link of mine there, this is a book that, generally speaking, is not held in the highest regard by many naturally-minded people. Those on the spectrum of crunch tend to see it as very conventional, quite pro-intervention, and unnecessarily anxiety-provoking. Yet this book was the one place that went beyond listing placenta previa as a flashing red light, offered me some more information, and even managed to be reassuring.<br /><br />It explained that previas are present at only 1 in every 200 births, that "A low-lying placenta is fairly common but as pregnancy progresses, the placenta usually moves upward and away from the cervix." It went on to say that nothing<span style="font-style: italic;"> (nothing!)</span> needed to be done about it - no mention of pelvic rest or limiting activity. "You don't even have to give your low-lying placenta a second thought." I wondered if I should have the authors call [insert Connecticut OB/CNM collaborative practice name here].<br /><br />The book then mentioned a few risk factors for placenta previa, including smoking and previous uterine surgery. Though I had already quit, I did smoke for 15 years, and 'uterine surgery' does include D&C, which, as the perinatologist had so sensitively clarified in categorizing its non-spontaneous nature, was also true in my case. Enter guilt: because of mistakes and poor choices past, my baby was now at risk. Add that to my custom blend of fear and helplessness.<br /><br />Yet despite feeling this guilt, I felt a little better about my odds, and a little more armed with information. I had a longer talk with Nancy, my midwife, about things I might be able to do for myself under the circumstances. "The worst part is that there's <span style="font-style: italic;">nothing</span> that I can do about it!" I cried. "Oh, but there is," she said. No, she didn't know of any acupuncture or homeopathic treatments, as I had been wondering, but talked about visualization as a powerful tool, and explained how placentas tend to be attached to parts of the uterus with good, iron-rich blood supplies. I devised a regiment where I would take Floradix*, a natural and non-constipating liquid iron supplement, every day, and every night I would utilize my massage skills and use upward strokes on my belly to help me visualize my placenta migrating upwards. (This is not a medical treatment or even an official massage technique, simply a tactile aid to my own visualization and positive-thinking process.)<br /><br />As the week wore on, I talked with others who offered comfort and support, and also valued the use of visualization. One of my wise massage therapy co-workers and mentors was especially adept at 'manifestation', and helped me fine-tune what I was going for. One important point was to work on visualizing and verbalizing things in the positive - in her view, the Universe doesn't respond to our negations of things in our statements, but to the things themselves. I know, I know, can I vague that up a little more? For example: in a birth plan, rather than asking for <span style="font-style: italic;">"no episiotomy"</span>, you would ask for and envision <span style="font-style: italic;">"an intact perineum."</span> So, in my case, rather than asking for and focusing on <span style="font-style: italic;">"no placenta previa</span>", I worked on manifesting <span style="font-style: italic;">"a clear and open cervix"</span>.<br /><br />Does this all sound awfully "woo" to you? I know. It kind of is. I'm actually really not much of a woo person in general, but this was all I had. It helped me to think I was doing something for myself, being active in the process, and taking back some power in some small way, rather than sitting around feeling passive, powerless, and sorry for myself, victimized by a cruel combination of questionable past choices and lousy luck.<br /><br />All this was prior to my next cervical check with the CNM practice. I had one more to go before they would give me the no-cerclage-necessary all-clear, and the perinatologist had sent them his recommendation to do all subsequent internal exams via transvaginal ultrasound. So I returned to the CNMs about a week after the Level II ultrasound that diagnosed the previa, a week that had started out as an emotional Space Mountain, but during which I had gradually found my way to feeling more stable and optimistic, however hesitantly. Assuming my cervix was still closed, I was planning on discontinuing the parallel care, but was a little uncertain now that my placenta had thrown a wild card into the mix.<br /><br />I started with a trip to the ultrasound technician's room, where she confirmed the same placenta location, and also noted that my cervix was still long and closed - no sign of 'incompetency'. I then went into an exam room to wait for whoever the rotation assigned to me that day, feeling a little wary but fairly resolved, based on everything I had learned.<br /><br />The CNM that entered the room was the one I had come to think of as Ms. Worst Case Scenario, the youngest one in the practice and also, in my experience, the most conservative. It had been she who raised the alarm about my cervix to begin with, and had exerted a substantial amount of pressure regarding prenatal testing. Now, she looked over my revised chart with its fresh new scarlet P, and reviewed all the precautions I needed to take, including pelvic rest and no strenuous exercise. I agreed to all of the precautions, and then started to explain what I was doing on my end, with visualization and positive thinking.<br /><br />She cut me off with a shrug, saying, and I swear I quote this word for word, even after all this time, "Well, either it's going to move or it's not, and no amount of thinking you do is going to change that."<br /><br />Long pause.<br /><br />You know, you don't have to believe in what I was talking about. I had my own doubts. But my GOD, it was obvious that the whole placenta situation was really , really upsetting to me, and even more obvious that this was something that was helping me to feel better about it. Would it have<span style="font-style: italic;"> &@#$!ing killed her</span> to at least pretend to be - well, not supportive, because that was clearly beyond her, but to simply remain neutral? Sure, YOU might not think it would help, but there's also no way it would hurt, so what the hell was the problem? Even a noncommittal nod, a "Mmm-hmm . . ." and a change of subject would have been preferable to just dismissing me outright.<br /><br />I shouldn't have let it affect me, but I was already on shaky ground. I tried to remind myself that, AGAIN, this was just the world that she came from, and she wished me no ill will; on the contrary, she was giving me the care that she believed in, and was trying to do what was best according to her belief system. A placenta previa WAS something to take seriously (none of my posts are intended to suggest that it isn't.). And again, in contrast with other major pregnancy complications, fetal OR maternal, things certainly could have been worse. I knew better. Already, I knew better, yet her words took the wind right out of my fragile fledgling sails.<br /><br />Slowly, I was realizing how I had been swept along in a cascade of interventions, prenatally. <a href="http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2010/4/2/re-post-you-buy-the-hospital-ticket.html">Hospital tickets</a> aren't only issued for the grand finale-ride of labor.<br /><br />We went on to have a bit of an argument about whether or not it was okay for me to fly home for Christmas. I had mentioned my plans to visit family in Colorado, and she grimaced as though I was suggesting I take up jousting. Asking her to explain her concerns, as every book and website I visited stated that travel was fine at this point (it might be unpleasant when feeling nauseous in the 1st trimester, and that in the third, the concern was that IF one should happen to go into premature labor, one would be away from appropriate care - not that it <span style="font-style: italic;">caused</span> premature labor), that 2nd trimester was the safest time of all. Did my previa make some kind of difference?<br /><br />She said her concern was the possibility that an abrupt change in pressure, should there be an incident, could cause my water to break. I was learning to speak up, however hesitantly, and have fewer<span style="font-style: italic;"> l'esprit d'escalier</span> moments five minutes after leaving the office where I thought of all the things I wished I could have said in the moment, and I pointed out that this unlikely scenario could happen to ANY pregnant woman. So was she really suggesting that no pregnant woman should ever board a plane, period? She waffled a little, but essentially said yes. <span style="font-style: italic;">There was a risk, and if that risk came true, how would you live with yourself?</span><br /><br />This is pretty much where I realized that East was East, West was West, and never the 'twain shall meet. I was trying to reconcile two very, very different worlds, and had fallen into a strange kind of mostly self-created trap as a result. The fact that I had been needing to decompress after every CNM visit had already demonstrated that there was a fundamental dissonance in mindsets. However unintentionally, I had bought the hospital ticket. I went into the situation thinking that parallel care would be "the best of both worlds", but it became ever clearer that it was not nearly as simple as that. The kind of care given (and sought) in pregnancy IS, in part, a manifestation of various sets of beliefs. I don't think it's remotely as black & white - or as polarizing - as "Trust Birth" vs. "Fear Birth", but there IS a spectrum between those two poles, and these particular CNMs** and I were clearly many, many miles apart.<br /><br />I left that visit with a stamp of approval regarding my cervical competency, informed them that as a result of said competency, I was not planning to continue parallel care in general, but did need to return for a follow-up ultrasound at 28 weeks. The odds were totally with me. One more spin on the hospital ride, I hoped and prayed and visualized - to see if it had migrated.<br /><br />Here I break with what would make the most sense in serial narrative form, and post a spoiler:<br /><br />It hadn't.<br /><br /><br /><span style="font-size:78%;"><br /></span><span style="font-size:78%;">*Note: I'm a fan of Floradix, but word to the wise, plan to have something in hand to 'chase' it with </span><span style="font-style: italic;font-size:78%;">immediately</span><span style="font-size:85%;"><span style="font-size:78%;">. Great product, revolting taste. I always followed with orange juice.<br /><br />**It bears reiterating that I am not at all trying to slam CNMs in general - this is, again, just my own experience.</span><br /></span>Annehttp://www.blogger.com/profile/01019907275666753543noreply@blogger.com11