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Wednesday, October 17, 2012

WTH?! Wednesdays: Pinkwashing Hall of Fame

Now that we're seeing pink ribbons literally adorning everything, I've become acutely aware of them when I'm out shopping and doing things. They're everywhere. They're multiplying, it seems, and can be found on the strangest of items.

This Pinterest board is worth sharing, as it highlights the absurdities and questionable practices surrounding the breast cancer awareness campaigns. One thing is quite clear: whether they donate to research or not, it's an industry - a marketing ploy that gets you to feel better about spending money. I wonder, what do cancer victims and survivors think of that? That someone is basically making money off of their disease? Has anyone ever asked them or are they just "bitching?"

This election cycle we're constantly hearing about the "war on women." I argue that there are many of them being waged, some silently, some not so much, and this is just one of them. Because it won't take long before someone criticizes your "poor attitude" in questioning the ethics of raising money for cancer awareness, or where the money really goes. If you dare question it, you're unfriended, blocked, criticized, told to "get a life" because you want to show what real awareness looks like: maybe a recovering mastectomy patient, not someone decked out in pink and white and prettied up for the cameras. It seems to be the one real truth no one wants to see.

One thing that really makes me shake my head are the campaigns to raise awareness that are from products that can actually raise your risk of cancer. Some of the companies responsible for donating millions (hey, good for them!) are also simultaneously marketing products that are putting their very user at risk for the disease. Go figure. Here's a short list:

Nestle has donated probably gagillions of money (Ok, I don't have a source for that LOL) towards breast cancer awareness and research, yet is only "phasing out" the cancer-causing plasticizer BPA from their water bottles. While I don't necessarily fault them for that, I do fault them for their long-standing heavy marketing of infant formula to mothers who are either in vulnerable populations or just being part and parcel of convincing otherwise capable women that breastmilk is inferior. You can slap the words "breast is best, but...." on your container a hundred times, but it doesn't help. Guilty of sending in official-looking "milk nurses" into poor African nations, Nestle effectively 'hooked' mothers on the stuff and had them believing their own milk was inferior. Not only would their breastmilk then dry up, but they'd be forced to buy more of the product they had no money to buy, and reconstitute it with contaminated water, leading to sickness and even death of the baby.

While only recently has the link been made to breastfeeding and cancer prevention, the health benefits to both mother and baby have been well-established. The presence they and their counterparts had (and continue to have) in influencing cultural trends and thus destroying any chance of a successful breastfeeding relationship could very well have lead to increasing cancer rates among women for decades.

Exposure to cleaning products is one plausible link to breast cancer, according to some studies. When you think about it, females are generally more likely to be in more direct contact with these products, and for longer periods of time (no offense to guys who clean). It's reasonable to suggest that products can also be leached into the bloodstream and can affect the offspring of their users as well. Have you ever looked on a bottle of cleaning solution? The ingredients are usually not listed - either because there wouldn't be enough room on the label, or they're too scary to think about.

Many of the products that contain known carcinogens are manufactured by companies that donate heavily to breast cancer awareness and research. One marketing ploy I find kind of annoying is how many of these products are geared towards women - even though yes, men do clean, and men do get breast cancer. A pink mop or Swiffer? Pink dishwashing gloves? Gee, thanks a lot.

The cleaning aisle at Walmart was awash (no pun intended) with a sea of pink ribbons, mops, dusters and other garbage. As far as I could tell, when I looked closely for the "We donate money to the cause" disclaimer, there was nothing on the label - or on Swiffer's website - that indicated any money went towards breast cancer anything of any kind. Not surprising.

The chemical industry also produces plasticizers that have known feminizing agents in them, that have been in use for decades. Plastic wraps, containers that are re-heated again and again and leach into your food, as well as agents in shampoos, makeup, personal care products, children's toys  and baby bottles are also points of controversy, and many of these byproducts would be found in the bloodstream of just about anyone - including unborn children.

Photo credit: USAToday, 10/5/2010
The alcohol industry has also been quick to jump on the bandwagon, but not without notice. Many are questioning that one, since studies have shown that alcohol consumption can be a risk factor in the disease. The image above angered some cancer survivors, and I can see why. Another article from CNN with the headline "Buy a bottle, save a breast" irked others who felt - and I agree - that we're focusing more on the breast than the person attached to it.

The sex industry seems to be the most recent player in the "awareness" game. Although I can't prove it anymore, this image was taken last year from the "Save the Boobies" breast cancer "awareness" fan page on Facebook, but when I went back to look for it, it had been taken down. This is their idea of a "breast exam."

The porn industry has graciously? donated a penny per view of their breast-related content towards breast cancer awareness, but I argue that really the only thing we're aware of is breasts. Not the illness itself, the risk factors or prevention techniques, not the reality of it at all, but simply breasts. It's another way to use controversial, if not completely offensive images, slogans and questionable marketing ploys to get people to support a feel-good cause. It goes much further to damage any real awareness, though, because we are so used to seeing images like this one in public - yet one very good way to lower your risk is to breastfeed, which no one wants to see you do. With the combination efforts of the infant formula industry and overt sexualization of the breast, an important preventative measure has now been nearly quashed.

Using cutesy slogans like "boobies," "tits," "hooters" and other sexualized euphemisms is equally offensive, in my opinion, because it not only sounds degrading and juvenile, but tends to make light of a very serious, often debilitating, disfiguring and deadly disease that can devastate entire families. I know we can't all be serious all the time, but I think because we often see too much of this kind of "advocacy" we don't take it seriously enough.

The food industry is equally guilty of just slapping a ribbon on things and calling it "good." I can't even begin to detail the chemicals and other crap we're ingesting every day, meal after meal for years, that likely contributes to breast cancer (if not a whole host of other cancers). Some additives actually have estrogen-like qualities and therefore could contribute directly to estrogen-fed cancers. Of course some foods have naturally-occuring estrogen-like properties (soy, for instance).

It's impossible to pinpoint so we use terms like "could" and "probably," because there are so many factors it might be impossible to tell for sure. But just in reading the list of ingredients, you know it can't be all that good, can it?

Ultimately there is so much we don't know, at least for now. I don't want to come off as a complete wacko conspiracy theorist, but even these obvious links should be enough to make you wonder where we get our information from, and make us question the motives of people and companies who want us to think we're helping for a good cause. Questions we should ask ourselves before we "think pink" include:
1. Does this product contribute to cancer in some way?
2. Does this product or slogan objectify the breast and women in general?
3. Is my money even going to the cause?
4. How much money is this group actually donating to research? To raising "true" awareness?
5. Does this campaign, slogan or product do more to hurt cancer victims and survivors than actually help them?

More reading:
Buying pink may not mean what you think - YouTube
Seven controversial pink products for breast cancer awareness

Wednesday, October 10, 2012

WTH?! Wednesday: Defining sexy and "scary beautiful" shoes

Two articles caught my eye yesterday: one featured Mila Kunis (sorry, the name sounds vaguely familiar but really I have no idea who she is) voted by Esquire readers (insert eye roll) as the "sexiest woman alive." The second featured a short video clip of a model attempting to walk in some of the most bizarre high heels - if you can call them that - that the world has ever seen. I can't help but notice  connected these stories are to each other.

Photo: Esquire Magazine
Mila may be pretty to some - but surely there is more to sexy than pretty. She might fit into one tiny definition of sexy, but I'm pretty sure there are a lot of homelier-looking women out there who are considered pretty sexy, too, especially by the people who matter most to them. That's far more important to me than a pool of readers "voting" on my physical appearance. The whole thing sounds like a big popularity contest - like, haven't we left high school behind already?

To each his (or her) own: I guess this just isn't my definition of sexy. I asked this question: what defines sexy? How can you determine if someone is when you don't even know them? Just based on what you saw in a movie or a video - a side of them that isn't even real? 

What if she had great brains, a nice figure, and was ugly (which is a relative term)? What if she had acne, or gapped teeth? Is it possible for someone to be sexy then? I personally find Lauren Hutton and her gap tooth smile to be very sexy and appealing, and am glad she decided all those years ago not to get her teeth fixed. The industry often sees these actresses (Anna Paquin, Madonna and others) and wants them to change to conform, and so far, they haven't.

The next piece is a video clip featuring a model "walking" in a pair of bizarre high heels. They're thankfully not really meant for actual use, and when she walks in them, she more resembles a duck taking a dump than a pretty model on the runway. (I did notice in the video, by the way, that the model actually had some cellulite - woot!)

The shoes were created by a Dutch artist and a shoe designer to illustrate our "impossible standards of beauty." Amen to that. What is beautiful to one person might look absolutely stupid to someone else, and many fashion trends I see in magazines and on the racks often make me wonder, Who buys this stuff?!

The clip also reminds me of the age-old (and now thankfully defunct) practice of foot-binding, which Chinese women had done to them as young girls to conform their feet into a dainty, pointed position. The toes were literally broken and folded underneath the foot so as to fit into a shoe that is actually even too small for a child to wear. The pain was torturous, and yet, a sign of delicacy and femininity to the Chinese people for centuries. Although the practice has been discouraged and was banned outright by the Chinese government in 1911, it's clear that it still continued for several decades afterwards, despite the ban. In some villages, there are still a handful of elderly women tottering around in tiny shoes - and it was a gradual process before that standard of beauty was no longer considered beautiful.

Are there standards of beauty that we create for ourselves - or are they created for us? Can we ever live up to it? Why should we even want to?

The video is literally symbolic of the lengths women (and really, we shouldn't just blame the ladies here) will go to look beautiful, even if it causes them physical pain. I thought of Karen Carpenter and her very private battle with an eating disorder when I watched this video. I love watching her play drums - a girl drummer is awesome! - but it's very painful at the same time, because of the way she was slowly killing herself, and everyone around her realized it but her. It's hard to watch because you know how it all ended, how it ends for thousands of women every day. It may not always be a physical death, but when you're trying to live up to a standard of beauty that might not even exist in the real world, it can be an emotional and psychological battle we all, at times, struggle to conquer. We're not in the school yard anymore, but somehow the standards of who we are and the often shallow, outward expression of who we should be hasn't changed at all. For the young women watching, how many more Karen Carpenters (and now, Nicole Richies) will this false standard create?

More reading:
Airbrushed models are 'harming children and should have warning labels' - Daily Mail
Dove - Evolution of Beauty video
People Magazine, 1983 - an article featuring Karen Carpenter's brother Richard talking about her struggles with anorexia, the severity of which was poorly understood. How many celebrities can we think of today who meet this criteria, and look just as she did not long before her death?

Saturday, October 6, 2012

Tongue tie and the breastfed baby

Breastfeeding can be a wonderful thing. It can also be difficult, especially if things aren't going especially well. There can often be bumps in the road that make you want to totally give up and call it quits forever.

When it comes to those difficulties and feeding issues, perhaps one of the most under-explored problems is tongue tie. The difficulties a tongue-tied baby often has at the breast can be quite profound, and yet if you - or your doctor - don't fully understand what they are, it can either make or break the breastfeeding experience.

The tongue obviously has a major role to play in breastfeeding. Tongue tie, or anklyoglossia, is when the frenulum - the tissue that connects the tongue to the floor of the mouth - is tight, making it hard for the baby to feed properly. Some can be mild, some quite pronounced, and can affect different babies in different ways, or not at all. While some tongue-tied babies have no problems, for others it can be extremely difficult.

An example of tongue tie in an infant.
Janelle Aby, MD
Sometimes it can be difficult to tell if your baby has tongue-tie; sometimes it's quite obvious. There are signs to look for, according to the La Leche League, that might be important identifiers in determining whether or not this is really the problem:
The tongue tip should be able to extend to lick the lips, lift the front half of the tongue to the roof of the mouth, and sweep along the gums. If a tongue-tied baby tries to extend the tongue, it may not be able to extend past the lower lip, or the tongue tip might be forced downward over the lower lip. If the tongue is particularly tight, the back of the tongue will lift while the front remains tied down to the floor of the mouth, which is sometimes called “tongue humping.” If the baby attempts to lift a tied tongue, it often leaves a dent in the tip of the tongue, reminiscent of the top of a heart. The sides of the tongue will lift more than the center if the baby is tongue-tied. When the tongue tip attempts to reach either side of the mouth, the baby will twist the tongue and will not be able to bring the tongue tip to the back of the gums. A severe tongue-tie will prevent the baby from getting the tongue tip over the lower gum ridge.
Both the connective tissue under the tongue and connecting the top lip to the gums can be tight as well, such as here:
Maxillary labial frenum.
Problems that tongue tie can create include a bad latch, which can cause nipple pain and soreness in the mother. Without proper latch and the full ability to suck, the baby may spend more time on the breast to get enough milk to satisfy him. He also may have weight gain issues, gassiness and fussiness. Mother's milk supply often goes down, leaving both mom and baby frustrated, and mom is left thinking something is wrong with her milk.

Unfortunately, doctors are often not entirely educated on the subject of tongue tie and what to do about it. My friend Amy, a mom of four, said that although her oldest two both had it, because they were gaining weight the doctor wasn't concerned. "My doctor said that their tongue tie was not a problem, even though it was causing problems, just not weight gain issues," she said. When her third son was born, she sought a second opinion when the initial physician found nothing wrong. "Within a few days" of getting the frenulum clipped, she said, "he was such a different baby, with nursing and just his disposition in general."

This is the problem: even if mom does suspect something is wrong, the doctor may not always act on your suspicions. I actually read a question from someone whose doctor told her tongue tie was over-diagnosed, which I find hard to believe. Based on the differences between each type of tie and the individual anatomy of the mother's breast, experiences may vary: some may give up nursing early because of painful, cracked nipples and low milk supply, and some may have no problems at all, which some speculate might cause doctors to not recognize it properly.

Third-time mom Christina is in the throes of trying to get her baby accurately diagnosed. She explains that her baby doesn't seem to be able to get a "deep latch," milk will dribble out of her mouth while nursing, and she makes "clicking sounds" when she eats. She also projectile vomits regularly and gags whenever a bottle or pacifier are used. The ENT specialist that saw her daughter pronounced her "fine," but Christina knows that isn't true. Upon getting a second opinion from a pediatric dentist, the dentist confirmed that no, she wasn't "crazy," and that she's 'heard her story hundreds of times' from other mothers, whose intuition "is rarely wrong."

Christina emailed photos to the dentist, who wrote back and said that her baby has the most severe form of tongue tie there is, upper and lower, and said that "signs and symptoms indicate that she requires tongue-tie and lip-tie frenectomies." (Does this sound like a baby that's "fine" to you?)

Although every baby occasionally spits up and has fussiness or gas, it seems like this leaves a wide door for the formula industry to step in. There are all kinds of formulas marketed for babies with "colic," gas and spitting up, and many think that tongue ties are going undiagnosed because of this. "This makes me seriously wonder how many breastfeeding relationships are destroyed by doctors telling women that everything is fine when it isn't," Christina says. That something is wrong with you and your milk, so why don't you just switch to formula instead?

Before the widespread use of infant formula, the birth attendant usually clipped a tight frenulum immediately after birth. Since the cultural shift to using formula, however, it's largely fallen out of practice.

When a Florida doctor's child was born with tongue-tie, she had her son evaluated by an ENT who agreed to do the procedure. I'm guessing it's because she was a fellow doctor, not because he thought she was just a mom with good instinct. A lactation consultant, she pointed out, noted how lucky she was to find a doctor who would take her concerns seriously. When her child was born, she asked the postpartum nurse about the telltale heart-shaped tongue, and the nurse replied, "That's a tight frenulum. But no one does anything about them anymore." If no one does anything, the mother may go weeks, even months, struggling to breastfeed, even giving up because it seems unsuccessful. Because infant formula use has become so engrained in our medical culture it seems to be the first suggestion for solving any problem, even when there are other solutions.

Amy's doctor made an interesting observation: that more second- and third-time mothers come in for this problem, because first-time mothers often don't realize what it is and may stop nursing altogether because of milk supply issues, etc. "Perhaps they just give up nursing or trudge through even though they are having a horrible time," she thinks. "I didn't ask for help because I wouldn't even have known what to ask about." With no other children to compare it to, it can be confusing and frustrating to figure out what's going on. Then you might get an uninformed doctor who mistakenly says nothing is wrong.

If you suspect your baby has tongue-tie, especially when it's not glaringly obvious, here's a partial list of possibilities that might help:

• In mom, persistent very sore, damaged or blistered nipples (because of a bad latch)
• excessive weight loss in baby
• slow or no weight gain in baby
• cannot maintain a seal at the breast or bottle, often has gaps at corners of mouth that milk may spill out from
• baby only swallows infrequently
• very frequent feeds; I've also read that babies who spend a long time on the breast before being satisfied (if they are at all) is also a sign
• excessive gas, colic, green stools
• unable to protrude tongue (depending on the degree of the tie)
• clicking sound when feeding, may pop on or off
• low milk supply in mother
• gagging

For the article and entire list, click here.

It's important to trust your gut - if something doesn't seem right, check with your doctor. Realize that doctors aren't perfect, and do not be afraid to seek a second (or even a third!) opinion. It's not unheard of - and quite sad, really - for parents to travel miles, across states, even, to find someone who will listen to their concerns and do the procedure. But once it's done, it can often make all the difference in the world.

More reading:
Tongue Tie: From Confusion to Clarity
Tongue-tied breastfeeding 
Information on Tongue-Tied Babies: Breastfeeding Basics
Tempest Beauty: Maxillary Labial Frenum and Tongue Tie
Booby Traps: Docs who won't snip tongue-tie, thousands of breastfeeding moms and babies suffer - Best for Babes Foundation

Wednesday, October 3, 2012

WTH?! Wednesdays: Gardasil vaccine is "safe," at least according to Merck

Introducing a new feature: WTH?! Wednesdays, a time to reflect on the week's most absurd, weird, or amazing stories and photos.

Photo: Jan Christian/Wikipedia Commons
So this week's first post concerns a ridiculous article from the Wall Street Journal declaring that a study finds Gardasil "safe." I didn't even realize at first that it was from the WSJ, and since we subscribe, we have an online account. If only I could find the password, because there is no way I can resist commenting on that one...

However, the study is ... get this ... funded by freaking Merck! If that doesn't make you scratch your head, nothing will. And of the dozen or so people who commented on the article, none of them picked up on this and questioned the ethics surrounding it. I would have thought WSJ readers would have been a lot smarter than that.

Now check out this link to a study that basically says what I'm thinking: that there is less of a chance of an unfavorable outcome if the producer of said product is funding the study. Duh. Do you really think they're going to get unbiased results with Merck footing the bill? Do you really think we'd hear anything about it if they didn't?

From the BMJ study:
"Research funded by drug companies was less likely to be published than research funded by other sources. Studies sponsored by pharmaceutical companies were more likely to have outcomes favouring the sponsor than were studies with other sponsors. 
Conclusion: Systematic bias favours products which are made by the company funding the research. Explanations include the selection of an inappropriate comparator to the product being investigated and publication bias."  
It isn't exactly rocket science.