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Monday, September 19, 2011

Gardasil and the systematic destruction of Michele Bachmann

As the election season draws closer, there is a lot of media attention on Minnesota Republican Michele Bachmann - namely a systematic destruction of her career a la Sarah Palin - because of Bachmann's views on the controversial HPV vaccine, Gardasil.

Many were not happy when Texas governor Rick Perry voted to push through legislation that would make it mandatory for the vaccine to be administered to Texas school kids. Some, including Bachmann, criticized him for being 'sold out' by the vaccine's manufacturer for the tidy sum of $5,000. Perhaps, but I'm not so sure. I think he was just drinking the Kool-Aid prepared for him by Merck - the same crap doctors, nurses, and just about everyone else feeds to us when it comes to making informed decisions for our kids.

The other day I decided to flip on the TV and watch a little Fox News, only to see a group discussing Bachmann and her 'radical' views on Gardasil on Greg Gutfeld's segment. One contributor said she couldn't understand what the big deal was and called the vaccine a "wonder drug for women," and made a reference to schools requiring vaccines anyway - so what's the big deal about this one?

During a news break just a few hours before, the news anchor made Bachmann sound like a complete moron for daring to question "science." Everyone is trying to make her look as pathetic and idiotic as they did Sarah Palin, nitpicking and ridiculing at every turn.

She's the candidate everyone loves to hate - and no one wants to admit that they agree with. Dr. Manny Alverez, a Fox News contributor, stated his piece on their website that he has to 'side with Governor Perry' on this one, but doesn't agree that it should be mandated by the government. He also goes on to say that it isn't 100 percent effective at preventing or treating all strains, and thinks Perry made the wrong move by endorsing it. Well then, it doesn't sound like you are siding with Perry at all, does it? Did I read that correctly?

He latches on to her claim that a parent told her it caused her child's mental retardation after she received the vaccine. True or not, he isn't making any mention whatsoever of the potential side effects of this or any other vaccine, a completely legitimate argument not to vaccinate. Bachmann never said she personally made the claim, only related the story of someone else that did - and Merck immediately, unsurprisingly, went on the defensive.

Basically what I have noticed is that they are completely ignoring the issues surrounding Gardasil - whether they're political, philosophical, medical or spiritual - and ganging up on her to destroy her credibility and her reputation. No one mentions anything about side effects or potential complications, or that it ideally should be administered to children as young as nine years old.

Apparently Perry's legislation did include an opt out* for parents, but that also seems to be publicized little. Some argue that bureaucratic red tape could make it difficult or virtually impossible to refuse, combined with pressure from districts to go ahead with it. The word 'mandate' implies that parents don't have a choice when really they do, but I bet Merck and others involved want you to think you don't - sort of the "if you can't beat 'em, you might as well join 'em" approach.

What everyone except Bachmann seems to be missing is the idea that yes, this threatens personal liberty - that of the child in question and that child's parents. The state, to some extent, does intervene in our lives, in the sense that we would be arrested if we were doing our children bodily harm. Unfortunately to some, not vaccinating your child constitutes as 'bodily harm.' Where do you draw the line?

As a result, the State of California is giving children as young as 12 years old the power of informed consent to be given Gardasil, without their parents' knowledge. Groups that support the legislation include the ACLU, ACOG, and Planned Parenthood, and opposition is considered "largely faith-based." (I find it laughable that the ACLU, of all organizations, is basically saying only the rights of certain people - in this case, not the parents - count.)  I find this probably the most alarming, least-talked about aspect.

As parents, we know how hard it often is to refuse vaccinations at the doctors' office that we might philosophically disagree with, and are frequently pressured by pediatricians, healthcare workers, school nurses, friends and family to vaccinate for everything, without question. How then, do you expect a 12-year-old to adequately make that decision? And why are they essentially ignoring the rights of the parents? What happens if a well-informed child tries to refuse? And if children are fed scare tactics to get the shot, but know their parents don't approve, isn't this essentially a situation of the school district (and the state) pitting the child against her parents?

Apparently this legislation is part of an already existing bill that enables children as young as 12 to seek treatment and testing for STD's without parental permission. (Click here) The thinking is that those kids who are too afraid to talk to their parents will get the treatment they need. Unfortunately, I think that is only feeding the problem.

The core issue at the heart of the state-forced Gardasil vaccine is that parents are not often adequately talking to their kids about sex. Period. Kids know little information about what constitutes sexual contact, and parents admit to not having appropriate conversations with their children about it. The state, in an effort to curb STD and pregnancy rates in teens, has no doubt decided to do the parents' jobs for them - figuring that if they don't, we will.

The problem is, many parents do educate their  children about the reality of sexual relationships and the dangers of STDs. In many circles this vaccine, and our overall sheeple mentality on vaccines in general, is that it will fully protect our children 100 percent of the time. Even though some suggest educated teens do wait longer to have sex, there is still the idea that "teens are teens" and will do this sort of thing, so why not provide a safety blanket of sorts. Others think that safety blanket is not enough, and it might fool teenagers into thinking they have a green light to engage in even riskier behavior.

In order for the vaccine to work, it's suggested that patients receive three doses, and some are speculating that often the girl doesn't get the remaining two vaccines. You're considered more at-risk for HPV if you've had multiple sex partners, or been with someone who has. Additionally, the younger a girl is when she starts having sex can also increase her risk. The irony in this is that culturally, we seem to condone teen sex or even embrace and tolerate it in an effort to remove the stigma. Combined with the fact that many parents do not adequately inform their teens about the potentially life-threatening repercussions of sexual relationships, this is like setting a trap for our children and then pushing them into it. Even so, is that really up to the state to decide?

In the meantime, legislators had to disclose that Merck personally paid them to push legislation through. And at $360 for a trio of doses, that's a lot of money the drug manufacturer stands to gain.

The Gardasil problem joins a number of other ones surrounding our medical community. What once started out as an altruistic approach for the common good, now the boundaries are blurred as more and more people want to take initiatives to force that "common good" on others. Forced or coerced vaccinations are just the tip of the iceberg; it's not unheard of for women to be forced into cesareans by court order, or for cancer patients who refuse treatment to be ordered to do so. A UK woman with severe hospital phobia and "learning difficulties" has been the subject of just such a debate, and was ordered into surgery to save her from potentially fatal cancer. What does it take to deem a patient unfit to make their own medical decisions? Probably not a whole lot.

Because Bachmann is essentially questioning the motives of the medical community and others' blind trust in it, I think it will be hard for her to wade through the mire of opponents. I'll also be waiting to see if Merck personally decides to take action to shut her up already regarding her claims on Gardasil, or if the media will essentially take care of that problem for them.

I'm seeing an interesting turn of events, though - perhaps what will amount to parents on both sides of the political and faith-based spectrum siding with Bachmann because she is such an outspoken opponent of this policy.

More reading:
Judge criticizes council for trying to force contraception on woman - The UK Telegraph
One More Girl - Truth About Gardasil documentary
Bachmann's Vaccine Theory pulls GOP to Jenny McCarthy Territory 

*The Association of American Physicians and Surgeons, Inc. issued this statement on Perry's approach to state-mandated Gardasil, as copied and pasted from the blog, "A Time for Choosing:"
“Opting-Out” of HPV Vaccine WILL NOT WORK for Many in Texas
Governor Perry is misleading legislators and families in Texas by claiming that they will be able to “opt-out” of having their 6th grade daughter vaccinated with the vaccine for the sexually transmitted virus HPV. For many families currently, the exemption isn’t worth the piece of paper it is printed on. Besides the simple fact that parents should not have to get permission from the state to make informed consent medical decisions for their own children, here are four reasons why “opting-out” of state mandated vaccines doesn’t work for many families in Texas:
“Opt-out” or Conscientious Exemption to Vaccination Process is a Bureaucratic Nightmare
To get the exemption form, parents must first submit a written form to State Health Department in Austin which forces the disclosure of the child’s full name, birthdate, and mailing address. The Health Department takes those written requests and creates yet another form on which they print the child’s same personal information that the parent had to send to health department, and the Health Department sometimes takes weeks to mail out these forms inevitably disrupting the child’s school attendance. The Health Department only sends the forms by U.S. mail, and once the parent receives the forms, they must be notarized within 90 days of submitting them and then repeatedly resubmitted every 2 years even though there is no expiration set in statute.
[1] Because the Health Department further eroded parental rights by publishing more rules getting rid of provisional enrollment for exemptions, (families used to have 30 days at the beginning of school to get their paperwork in), now schools participate in aggressive misleading education campaigns touting “no shots – no school” while not informing families of the exemption or the instructions how to obtain it.
Private Schools Deny Admission
The Texas attorney general issued an opinion in April of 2006, ga0420, that states that private schools do not have to accept the conscience exemption to vaccination in Texas Law[2], and many private schools do not. For example, the Dallas Diocese for Catholic Schools policy number 5024 states, “Schools will comply with immunization requirements established by the Texas Catholic Conference Education Department. Conscientious objections/waivers are not accepted in schools of the Diocese.” [3] Every new vaccine mandate causes more children with valid legal exemptions to be denied their private school education.
Doctors Refuse Medical Care
Even though you may be able to get a piece of paper from the state health department affirming your right to refuse state mandated vaccines for your child, just try and find a doctor who will honor it! According to a recent study published in the Archives of Pediatrics and Adolescent Medicine, 39% of pediatricians surveyed said they would throw kids out of practices who are not vaccinated. [4] PROVE has documented this rampant problem of doctors dismissing families utilizing a vaccine exemption in Texas to the legislature in previous sessions. Please review our report entitled “The Erosion of Public Trust & Informed Consent through Immunization Harassment, Discrimination and Coercion” prepared for the House Public Health Committee in 2005. [5]
Insurance Rates Rise and Accessibility Affected
Responsible parents who have secured health care coverage for their children will be forced to pay higher insurance rates whether they want the HPV vaccine or not. Even if you “opt-out” of the HPV vaccine mandate for Gardasil by Merck by securing a conscientious exemption waiver, there is no way for Texas parents to “opt-out” of the corresponding rise in their insurance premiums. § 1367.053. (a)
(2) of the Insurance Code REQUIRES that any vaccine required be law must be covered by insurance. [6] This first-dollar coverage requirement results in corresponding direct hiking of insurance premiums to meet costs, and for a vaccine as expensive as this one, an HPV vaccine mandate risks putting premiums for basic health care coverage out of reach financially for even more Texas families. Additionally, we have received complaints from families where insurance companies are harassing parents with letters and discriminating on coverage based on whether or not the child has had all their state mandated vaccines.

Friday, September 16, 2011

Is America being brainwashed by formula ads?

Yesterday someone on Facebook posted a lovely article about babies' development of facial expressions in the womb. Too bad I couldn't get past the hyperactive web banner at the top that screamed "70 PERCENT OF BABIES WILL HAVE FEEDING ISSUES IN THE FIRST YEAR" or something to that effect. Before I could click or do anything, it magically morphed into an ad for infant formula. It was, basically, a call to action that you should be running around with your arms in the air, screaming hysterically, "I must put my child on formula or she will die!"

I must have refreshed my screen several hundred times and that ad never came up again, something I found interesting. I did manage to get a screen shot of the second half, though:

Since I skipped infant formula altogether, perhaps I'm a big dummy - but doesn't soy formula often lead to more stomach upset - not to mention constipation - in babies? And for some infants, it's often an allergy trigger. Not only that, but some worry that the phytoestrogens (a group of chemicals found naturally in plants that can often act like estrogen) and isoflavones (organic compounds that often act as a phytoestrogen in mammals) can be harmful to developing babies. Although the jury is out on whether or not it's harmful, there has been little research done on it - which doesn't necessarily mean it's totally safe.

In the link referenced above, a mom named Janet nervously poses a question to Dr. Ianelli, and says that:
"I am very upset because I have 3 boys who have had to take soy as infants on the advice of my pediatrician and a daughter 2 mos old currently who is having feeding problems while breastfeeding presumably secondary to dairy in my diet and is on soy presently."
Janet, what you need to do is this: save your hard-earned money and change your diet, honey! We want the best for our children. So why aren't more people willing to sacrifice milk and cheese while nursing their babies? Because it's just easier to put them on formula?

I went through this with my second child, who regularly spit up, vomited copiously and screamed halfway through bedtime because, as I found out, she was so miserable. I was determined to find the source, and so, as the Enfamil ad above suggests, I asked my doctor. Turns out, she didn't know squat about what to do and suggested this: "You could put her on hypoallergenic formula for three days and see what happens."

Thankfully I had already done some research on Kelly Mom and realized this would do little, if any, good - for a number of reasons. Namely because if I don't change my diet, then what difference will it make when I started nursing her again? Little did I know, the majority of infant formulas out there are made from cow's milk protein, the very stuff in my breastmilk that was making her so miserable.

Was I broken? Was my child somehow "allergic" to my breastmilk?

Nope. She was sensitive to the stuff in it, and that meant I had two choices: drastically change my diet or put her on formula. I knew one of those definitely wasn't gonna happen, so I took the Mama Bear approach: I totally cut dairy and all its forms (not just lactose) out of my diet, and voila! In ten days (not three), she was a new baby and we were happy. No butter for nine months, but hey, it was worth it and by then it had become more of a minor inconvenience than anything else.

For those babies who routinely are fussy, etc. I bet they too are sensitive to cow's milk proteins, like many babies would be up until around a year - cows milk is often hard for little ones to digest, and if you fed it to them straight before they're ready they'd often up end up projectile vomiting/pooping clear across the room. Is putting them on formula the best answer? Apparently Enfamil thinks so. (And chances are your pediatrician probably would too.)

How many nursing mothers with protein-sensitive babies are told "You have to put your  child on formula!" just because the baby is fussy? How many are encouraged to make dietary changes, or even know that they can, and furthermore - that it might help, or totally solve the problem?

When I googled "side effects of soy formula" I found an article through the website, and scrolled down to read a conveniently-tucked away ad from Enfamil again - this time suggesting you try Nutramigen, a "hypoallergenic formula for babies' milk protein allergies." Dietary changes for mother might be a pain in the ass, but a few months' worth of Nutramigen - at around $30 per can - sounds even more painful on my wallet. No thanks.

I find the sway of advertising particularly amusing, if not frustrating, when it comes to infant formula. Many of them have names like "Good Start," "Nurture," "Premium" (as if the non-premium stuff is made from glass shards) and "Advance." Funny, but if I didn't know any better, I'd think they were talking about breastmilk!

What they don't say, at least
not very loudly: "DHA 
supplemented infants 
exhibited better visual acuity
than that of non-supplemented 
infants (equivalent to one line 
on the eye chart), and similar 
to that of breast-fed infants.
Most advertising seems like a clever ploy to get mom to feel better about her decision to use formula. No one should guilt her into doing or not doing anything, but at the same time one should realize the infant formula's role in cementing the idea in our collective minds that "breast is best, but..." (and that's a big but) or that somehow, you are incapable in some way. While that may be true for some, it certainly isn't for all!

The sad truth is that even after a well-meaning visit from your doctor, you might not come away with all the answers. If you happen to land one who knows a thing or two about nursing, great! But not all of them do, and many get loads of freebies from these same companies who are actively undermining your breastfeeding relationship in an effort to get you to buy their product. Plain and simple. In a normal business setting, this would generally be called a "conflict of interest."

That conflict can taint the ideas of health care professionals who either advise you on breastfeeding problems or take care of your newborn. It's not completely unheard of for mothers to practically insist, to the point of near-violence, that they breastfeed their NICU babies, and will often find the nurse has "just fed the baby" a bottle of formula after they rush in to nurse their own child. Mothers are often told inappropriate things to convince them that breastfeeding is not a viable option and handed a bag of samples "just in case." Perhaps this is borne out of ignorance about breastfeeding; and perhaps it's based on the cultural institution that breasts are for pleasure, not infant feeding. And maybe, just maybe, they're brainwashed by the formula companies who tout their product like the Liquid Gold it is not. (The sad part of it is, infant formula manufacturers have been heavily marketing their product for decades, which can probably why breastfeeding rates have often taken a nosedive in our culture.)

Case in point: product reviews for ProSobee on Enfamil's website.
"When my son was born, he was in NICU for 16 days and he wasn't able to breastfeed..."
 "I have always used Enfamil for my children. Being a Registered Nurse I know how important it is to give your baby a quality formula." 
I have to wonder about that last review, since infant formulas all have to be pretty much standard fare as it is. In fact, previous lawsuits filed against Enfamil have found them guilty of making false claims about store-brand formulas and misrepresenting their product through false advertising.

We already know that US hospitals get a pretty crappy grade when it comes to promoting breastfeeding in new moms. Is it any wonder?! (This link is actually from 2008, and the same articles were surfacing this year - which means not much has changed!) According to the article, the highest score a hospital received was 98 - the lowest was 12. 12?!
 "About a quarter of hospitals reported giving formula or some other supplement to more than half of their healthy, full-term newborns. The practice was common even when mothers were able and willing to breast-feed, Dee said.
Of hospitals who gave supplements, 30 percent gave sugar water and 15 percent gave water.
Experts say there are no good nutritional reasons to use those, but it is commonly done to quiet crying babies separated from their mother."
To me, this means one of several things: they are separating mothers and babies for all those "essential" newborn tests for no reason, which results in hungry babies that need to be placated some way. Therefore, they feed him useless sugar water or infant formula, and by the time he gets to you, he no longer wants to nurse because he's been fed. Even if you express an interest in nursing, they'll often give your baby a bottle anyway - without asking you first. Add nipple confusion, and voila! You're no longer a nursing mom.

Way back in 1981, the World Health Organization developed the International Code of Marketing Breast-Milk Substitutes, which outlined strict advertising guidelines for formula manufacturers. In some countries, like the United Kingdom - which has the lowest breastfeeding rates in Europe - infant formula ads are illegal, although this doesn't include the "toddler formulas" that have come out since the Code was adopted. Not surprisingly, the US does not follow the code. The Baby Friendly Hospital Initiative, begun by WHO in 1991, was a similar program to promote breastfeeding in hospitals. While breastfeeding rates in these specially-designated hospitals was nearing 80 percent, fewer than 100 hospitals nationwide (around five percent) had this designation as of 2008. Roughly half of all infant formula purchased in the US is subsidized by the government through programs like WIC. Consequentially, breastfeeding rates among WIC participants is lower than other groups.

Some of the interesting formula ads I've come across lately...

I love that little 'tilde' ~17 symbol, which basically means,
"We don't really fully understand the wonderful
properties of breastmilk yet, so we're just gonna guess."
These interesting web searches yielded interesting results, according to the PhD in Parenting blog. While the header says "breastfeeding support," you are guided to Enfamil's website and encouraged to try their product. How sweet of you.

The blog also noted how another popular website was offering breastfeeding tips, all while readers were being bombarded with formula ads:

This bag is really cute, but how much do you want to bet the
one they give nursing moms is really boring and ugly? 
Scare tactics and fear-mongering 101:
Only a parent who really cares about
their baby's immune system gives them
This vintage ad for the Enfamil Nursette is interesting - not only do they paint a picture of the idiot dad who can't screw the nipple on the bottle correctly, but they go on at length about how great their product is. When you're encouraged to 'ask your doctor if it's really as good as we say it is,' you're told, "It is." End of conversation, so take our word for it and don't even bother questioning it, 'kay?

During the 60s and 70s, when this ad probably ran, around 75 percent of babies were formula-fed.

This 2006 magazine cover incensed some readers, one of whom proclaimed "breasts are breasts - they're sexual" and shredded the magazine after feeling the need to shield her son from it.  

Yet this one is considered perfectly acceptable:

More reading:
From the PhD in Parenting blog

Past posts:

Monday, September 5, 2011

Words of discouragement

I woke up this "labor day" and began thinking about my own labors - my Labor Day-ish baby will be five in two days. I picked up Tina Cassidy's "Birth" and read a passage about influential but misunderstood obstetrician Grantly Dick-Read and how he, along with Dr. Joseph deLee, both though fear could hinder and negatively transform the birth process.

I thought back to my pregnancies and how fear took hold, both in pregnancy and labor. A negative attitude or word of discouragement not only gave me doubt about my body, but doubt in my care provider. I never received a "You can do this!" or "Good decision, you'll be thankful!" at any time during my care, except perhaps when I naively decided to have a repeat cesarean (I later changed my mind). It was only after the fact, after the VBAC that went well, that I heard "Good for you!"

"I do not want to be doing this." That is what one midwife told me before my second birth. She spent more time talking about how much she liked my haircut than the philosophy of birth, and didn't hesitate to tell me that she felt my decision to VBAC would be exposing her to more risk. I was taken aback and thought, What if I can't do this? What if something happens?

"I do not know how to do this." These were the words of a resident who 'attended' me during my last labor, during which showed a footling breech baby and a cervix that was fully dilated. While I could understand his nervousness, later I thought I should have yelled at him, "Yeah, so maybe you should LEARN!" You always hear stories of laboring women yelling at their birth attendants - I wished, for once, that I could have been one of them in that situation. I pictured him sitting in a classroom, full of other clueless students, and wondered if the dying art of breech birth would just slowly, quietly go away and no one would be the wiser. What would he do, I later thought, when a woman comes in with precipitous labor of a breechling? In other words, what would he do if he got more 'crazy' women like me?

I think of the women who had traumatic, difficult births and how those transformed them, fearfully: the women who wanted more children, but decided not to because things were handled so miserably. I have waffled back and forth since the birth of my last child on whether or not to have another baby, at one point resigning myself and saying "I just do not have the mental energy to fight the good fight anymore." Then something would change: I'd see a mother out and about with her brood of kidlets, or hear an empowering story from someone who had an amazing birth with confident care providers that supported her in every way possible. Last night my husband and I scanned the list of names in our phone book for an endocrinologist and ended up finding an OB who advertised that she specialized in home birth. That gave me a ray of hope - but of course our insurance doesn't cover her services.

The journey is an uphill battle the whole way, as I feared it would be the moment I had an unintended repeat cesarean. The nurse told me, moments before I was wheeled back to the OR, "You can have this baby vaginally, you know." A glimmer of hope, but at what cost? I wasn't mentally or physically prepared for that eventuality, and I'm not sure she was, either: was she prepared to see me through this birth by herself, in the wake of physicians who - with more power than she had - were not? Was she silently hoping I would speak up and advocate for myself in ways that so many others had not? I'll never know. I'd like to go back and ask her, though, if only I could: How were you planning on helping me?

That uphill battle, I am realizing, has more than one hill: the biggest being, do I want to try this again? I knew I wanted to lose weight in an effort to start out better than before, but hadn't really done much about it until nearly 2 1/2 years after my last birth. I realized that, had I been more serious about it, I probably would have dropped the extra pounds and been pregnant by now, if that's what I really wanted. Then I think, Well, maybe not - I consider this time one of reflection not on just "Do I want another baby?" but "How can I gear up for this process? Am I ready to climb those hills?", of which there are several. The biggest fight of all is finding a supportive care provider who is willing to climb those hills with me. After hearing so much discouragement, I wasn't sure if that was even possible.

I know Drs. DeLee and Dick-Read said that a woman's fear in labor can negatively impact her birth. But I also know a care provider's fear, transferred to the patient, can too. I wonder if I wouldn't have more confidence, and less fear, if I were cared for by someone who "gets it" and doesn't allay her fears and insecurities to you. Instead of hearing "I do not want to be doing this" you hear, "I want to be doing this as long as you do, and I will be here for you."