Friday, 29 April 2011

Judgemental

As I get older, some rather interesting and unexpected things are happening.  One rather pleasing development is that some of the crap I've got shoved at the back of my wardrobe is actually coming back into fashion, meaning less trips to Primarni are needed in these credit crunching times.  Even stranger and more shockingly, I find I am beginning to mellow.  Gradually the waves of time are washing over me, and like a piece of glass in the ocean, my sharp edges are slowly being soothed and smoothed and rounded.  Or, to put it another way, as I make cock up upon cock up upon cock up, I am becoming less judgemental of other people's cock ups.

Parenting can be a heady mix of both solidarity and judgement.  The vast majority of us are struggling along, fuelled by the most heart bursting levels of passion and love for our children, and desperate to offer them the best that we can.  There's often a great feeling of compatriotism amongst groups of mothers, as stories are shared, help is offered, and differences are accepted.  A warm acknowledgment that, as John Lennon put it so well, 'Whatever gets you through the night, is alright'.

But there are also some areas of hot debate.  BBC3 is currently running a parenting series, 'Bringing Up Britain', and I've already managed to catch 'Is Breast Best?' and some of the series 'Misbehaving Mums to Be', about pregnant women who smoke, eat too much, or not enough, and so on.  Inherent even in the titles of these two programmes is an element of judgement.  There are some parenting behaviours that we describe as 'best', and others that we describe as 'misbehaving'.  Discussing some of these shoulds and should-nots can be a tricky business, as they are emotive subjects, liable to push buttons and cause upset and offence.  There are those who argue, perhaps quite rightly, that we should 'live and let live', respect another's right to choose, and keep our peace.  But even if we are magnanimous and tolerant to a saintly level, there must be somewhere that we draw the line and judge a parenting choice to be just plain wrong?

Yesterday as I walked through the streets of my nearest town the woman in front of me clipped the young boy in her charge around the ear.  Somewhat ironically, she was punishing him for pushing his sister, and her blow was accompanied by an order 'not to hit people'.  I felt shocked, but to my shame, I did nothing, just shuffled off, not wanting to get involved.  Afterwards I wished I had, and I reflected on how strange it was that if a grown up man had hit a grown up woman in the street, there would have been an outcry, but that somehow it is still acceptable for a small child to be hit by a big adult. 

For me there is a distinction between a personal judgement of an individual's choices and a passion for changing the wider social construct that feeds, supports or even enforces them.  The actions of the woman in the street were part of a bigger picture, informed for her by her own background and tolerated by every person, myself included, who passed her by as she struck her child.  Many of the women interviewed on 'Breast is Best' chose to formula feed because they felt breasts were sexual, and / or they did not wish to risk exposing themselves in public.  A young girl pregnant with twins on 'Misbehaving Mums' was effectively starving herself because she did not wish her body to get big or fat.  Whether we choose breast or formula, Gina or Sears, stay at home or back to work, our choices are perhaps never truly individual, and change, if needed, is best sought and addressed at a social and cultural level.

Well I started this post rummaging around at the back of my wardrobe and I seem to have accidentally fallen into a strange land of morals and ethics, so I apologise if you were hoping to read about my laundry or the sticky patch on my kitchen floor.  Sometimes when I start composing a post for this blog I feel a pang of fear that something I say will upset or offend or be perceived as judgemental, and that perhaps I should just stick to the more lighthearted stuff.  But I do feel, quite passionately, that we should be able to discuss the tougher questions of parenting, without allowing ourselves to take things personally.  This is hard because we all like to feel we are making the best choices for our children.  But if we do not speak and debate freely, we will not be able to improve the world for them, now and in the future.


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Sunday, 17 April 2011

Health Visitors

Well, you might have noticed, but although this blog hasn't been going for very long, I've already given Health Visitors a couple of mentions.  I'm passionate about good evidence based care for women during a really important time in their life: pregnancy, birth, and new motherhood.  The Health Visitor plays a vital role in helping mothers to bond with their babies, and care for them night and day.  They can influence the decision to breastfeed and its success or failiure.  They are there for women who may be becoming depressed.  They offer advice on health, sleep, feeding, weaning, growth, and much much more.  And yet in my personal experience, I have been offered some poor advice by them, and I have heard similar stories from many other mothers. 

I feel that this is an important issue and one which should be discussed.  Health Visitors surely all mean very well and would want nothing but excellence for new mothers and babies.  I would imagine it is a question, as always, of funding for training and development.  Perhaps if we gather together enough stories from mothers whose care has been lacking, we might be able to make a case for this.

Here are a few of my personal experiences with Health Visitors:
  • When my baby was a couple of weeks old, the HV told me that I was holding her 'too much' and that I needed to start 'putting her down', or I would create a 'bad habit'.
  • She told me that under no circumstances should I sleep with my baby in my bed, and that if I did there was a real risk of death by over-laying.  This is not evidence based advice.
    • When I told her in the clinic that one of my breasts felt uncomfortable, she took me off to an empty room and told me to show it to her.  She did not ask me to undress behind a screen or follow any of the procedures I believe are standard for such examinations.  I am not a particularly prudish person, but I do remember feeling a bit 'pushed around' by her approach.
    • The Nursery Nurse told me that babies were just like dogs, and that you just had to train them to do what you wanted.  She said that if I responded to my baby every time she cried at night I would create a bad habit.
    • When my daughter was just over six months old, I asked the HV for advice about sleep, as my daughter was waking very frequently to nurse.  She told me to 'Pack her full of as much solids as possible, then she'll sleep, and if she keeps waking up after that, just give her water.'  When I replied that I didn't think you were supposed to rush solids, and that I had read that that breast milk should remain primary in the diet for the first year of life, she replied, and I quote, "Nonsense.  Milk is just a drink now."

    I had a different HV for my second baby, who has seemed to be slightly less draconian, or maybe I was just slightly more draconian, and thus discouraged her from giving advice.  However, in our few brief meetings, I have still had some concerns:

    • She had not heard of or read the book, 'The No Cry Sleep Solution'.  This book about gentle night time parenting has sold millions of copies and been translated into 18 languages.  I would expect someone who is paid to give advice about babies and sleep to have at least heard of it, and preferably read it.
    • I overheard her advice to the breastfeeding mother of a 4 week old baby who was not getting much sleep.  She suggested that the mother did not pick the baby up every time it cried, but to pat it while it lay in the cot instead.  She also suggested the the mother try using a dummy, with no caveats, despite UNICEF advice that 'all breastfeeding mothers should be discouraged from using teats and dummies during the establishment of breastfeeding.'  Both of these pieces of advice risk jeopardising attachment, milk supply and the breastfeeding relationship in such a small baby.
    • When my own baby had some weight gain issues around four or five months, on two separate occasions she and the Nursery Nurse both told me, 'Don't worry, it's not long til she starts solids'.  I felt that this statement betrayed a lack of confidence in breast milk and undermined my hard work as a breastfeeding mother. 

    Health Visitors are in a position of great power.  It is said that the hand that rocks the cradle rules the world, and often the Health Visitor is giving advice to the cradle rocker about everything from the size of the crib to the frequency of the jiggles.  New mothers are often shocked, exhausted, perhaps traumatised by a difficult birth, and looking for advice and guidance in a world that has lost much of its community wisdom.  Health Visitors are often the only people that first time mums can turn to for help, and if they are being paid to give advice to such vulnerable people, they should be well read and up to date with the latest thinking and research.  Advice should be evidence based and not founded in their own personal views or parenting approach. 

    If you have a story to tell about Health Visitors, good or bad, please post it as a comment below, or email it to me via my blog.

    We are the cradle rockers, so if a change needs to be made, let's make it.


    Thursday, 14 April 2011

    A Bedtime Story

    Once upon a time, in a very far away land indeed, there was a blisteringly naive but well meaning girl who thought that babies slept through the night after the first few tricky weeks and that then you could get a sitter and go out dancing, whenever you pleased and without a second thought, just like you did in the good old days.

    Four years ago, that girl was me.  As previously discussed, I thought all babies behaved just like the ones on Eastenders, and trotted gaily off into the dark forest of parenting, confidently swinging my basket of breadcrumbs.  Like every other woman, I was totally unprepared for what lay ahead.  And I absolutely had no idea that my nights, my sleeping hours, that sacred time that I took completely for granted as one of life's essentials, would take perhaps the biggest hit of all.

    There's absolutely no point writing a blog post about the horrors of sleep deprivation, as this is old news to haggard-faced mothers everywhere.  But the story I do want to tell, is about how I survived it, and am still surviving it - by sleeping with my baby in my bed.

    Despite my lack of preparation for parenting, I did start out with some knowledge of child development and the psychological theory of attachment, an intuitive and deep despisal of Gina Ford, and a resolution never ever to 'sleep train' by leaving my baby to cry.  I knew I wanted to sleep with my baby near, or perhaps even in, my bed.

    However, I found my judgement being seriously called into question by my Health Visitor, who for the purposes of this fairytale we shall imagine with a rather distinctive pointy black hat.  She told me that it was incredibly dangerous to sleep with my baby in the bed, and even had a word to describe what their cause of death would be: "overlaying"

    She got to me, I believed her, and as a consequence I spent several months of my life beyond exhaustion, from nights sat bolt upright and wide awake breastfeeding, and failed attempts to put my sleeping baby back down in her cot.  Looking back on it, I have no idea why I thought that I might accidentally roll over in my sleep and crush my baby.  After all, I had successfully managed to maintain enough sleeping spatial awareness not to fall out of bed for the past thirty years or so.  Why would I suddenly and randomly roll in the opposite direction and squash flat my own little child?

    Slowly, slowly, my fears subsided, and my tiredness grew, along with my realisation that things were not likely to improve on the sleep front any time soon.  We began to experiment with bringing our baby in closer, and set up camp on a mattress on the floor.  I found that breastfeeding lying down meant that I did not have to fully wake up every time my daughter did, and as a consequence I felt significantly less shocking the next day.  And the older my daughter got, the more I began to enjoy really snuggling up to her, and the more I could tell that she loved sleeping that way too.

    Once she was one we graduated to two rooms - hers with a double mattress on the floor, and one for the grown ups with a 'proper' bed.  I would start the night with my partner and then go in and sleep on the floor with her from when she first woke up, usually in the small hours.  This worked well for everyone, and just over a year later I was to go into labour on that floor mattress!

    After our second daughter was born, things got even more crazy.  Our eldest girl suddenly felt isolated with everyone else in a different room, and I could no longer go in with her for part of the night.  So we made an even bigger floor nest, with two doubles pushed together, and I spent a rather hot and sweaty summer sandwiched between a newborn and a two year old, whilst my partner stretched out luxuriously on the other mattress.  Since then we have played musical beds and explored all kinds of combinations.  Currently I sleep with the youngest in a double bed, and the eldest shares a bunk bed with her dad in another room. To some people, this may all sound just too crazy. To others, I hope it helps to normalise the lunacy of their own night time household.

    Co-sleeping hasn't solved all our parenting problems or made our life perfect.  At times I have doubted our decisions and wished for a baby that slept seven til seven in a prettily decorated nursery.  But for the most part, it has enabled us all to get a better nights sleep, and hopefully our children to feel as close and as nurtured by night as they do by day.  Apart from temporarily falling under the spell of the Health Visitor, my only real regret is that we didn't take all the money we spent on useless new baby tat and buy a really enormous bed.

    Like all bedtime stories, this one is about more than the sum of its parts.  It's not just about co-sleeping.  It's about having belief in your own wisdom no matter how lost you may feel in a disenchanted wood of personal anxieties, misguided advice, and cultural and familial 'shoulds'.  If you find yourself at a parenting crossroads, for example, shall I take my baby into my bed? shall I stop breastfeeding? shall I send my reluctant child to pre-school?, it's worth asking yourself, who or what is guiding my decision making?  Am I anxious to behave as my parents did, placate my health visitor, mimic my friends or follow a parenting 'expert'?  Or can I make my decision freely, regardless of what outsiders to my family think or feel?  I'm mostly talking to myself here, as it's taken me thirty six long years to become this disobedient, and I'm still working on it.

    Whichever version of normality you decide to conform to, and however your family sleeps, I wish you sweet dreams, a way out of the woods, and a happy ever after.

    For detailed information and advice about co-sleeping from the Mother-Baby Behavioural Sleep Laboratory at the University of Notre Dame, click here.