Moms kicked out for breastfeeding - again

At least two reports have surfaced this week - one in the US, and one in Canada - that breastfeeding mothers were harassed and asked to leave when they were seen nursing their babies in a public space.

Brittany Warfield was nursing her baby, with a jacket covering the infant, at a Houston-area Hollister store when a manager accosted her and asked her to leave. According to Warfield, she was sitting in chairs near the front of the store, with her baby covered, when the manager approached her and made a scene, to the point where others were stopping to look at what was going on.

As usual, the comments spark controversy. Basically, if you aren't runway-model perfect and drop dead gorgeous, they assume you're a "cow" and don't want to see you nursing your baby, because, after all, breasts are primarily sexual tools and serve no other function whatsoever.

The mom appropriately noted, however, the scantily-clad mannequins posed in the windows as she was getting yelled at for having the indecency to nurse her baby.

Interestingly, the same chain received a complaint back in 2010 because a manager kicked a shopper out for nursing in the fitting room. Which sort of blows that whole "You need to do it in private!" argument right out of the water. I can understand if there were dozens of people waiting in line to try on clothes, but really - I kind of doubt this was the case.

Another mom in Nova Scotia, Canada, was shopping in a mall on Christmas Eve when she asked an employee at Claire's for a chair so she could sit down, at the back of the store, and nurse her baby. Even though she reported that her baby was covered by her husband's coat, the manager of Claire's kicked her out of the store. Of course, the comments were inane as usual, including one person who harps endlessly on the fact that the woman had the audacity to ask for a chair. I'm guessing that if this were anyone else (like an elderly or disabled person), that would be okay, right? This one kills me. It's her fault because she wanted to shop on Christmas Eve, with a baby! Oh, the NERVE of some people! 

Funny how when you're harping on chairs in aisles and public safety, not once do you consider the potential unsafe conditions of feeding a baby in a dirty bathroom. It's like we've suspended all disbelief for a moment!

It seems people really don't like to be confronted on their views that they consider the breast's primary function to be a sexual one. They will often come up with a million other reasons why it's wrong, unclean, inappropriate, etc. often finishing up with, "But breastfeeding is a basic human right!" (As long as you're doing it in a way I deem appropriate) It underscores how comfortable (or tolerant) our culture is of breasts that are performing their sexual function in a public place, but not when they're being used to feed a baby. Asking themselves, "Why do I feel this way?" would cause them to examine their own ideas about it and might possibly make them look like a fool. I mean, really, if our breasts are innately designed to produce milk, then ... what's the problem? It would force them to admit that they don't understand the mechanics of it (like why it "spilling" on the clothes is not really a credible threat) or why our culture is so against it (and why you see so few women doing it in a public space). Many dissenters' arguments just don't hold up to logic.

Once upon a time in America, you were considered weird if you
didn't breastfeed. These women apparently don't give a crap that the
person next to them has just "whipped it out" and is feeding her child. 

Hyperemesis gravidarum: not your garden variety morning sickness

So the tabloids have finally broken the real news that yes, Will and Kate, everyone's favorite Royals, are really, truly, pregnant. This time it's for real! And wouldn't you know it, Kate is making headlines for yet another reason: because of her recent hospitalization with hyperemesis gravidarum.

HG is probably one of the most poorly
understood conditions of pregnancy,
and its sufferers sometimes find
themselves marginalized, ignored,
and made fun of or told to
"just suck it up." If you wouldn't
say this to a recovering cancer
patient, then don't say it to a
pregnant woman - who likely is
experiencing daily debilitating
and excessive vomiting and nausea,
weight loss and severe dehydration.
For more information, visit the
Hyperemesis Education Research
website at helpher.org.

Many pregnant women have suffered through it and can relate. Many of us, like myself, have not, and find just regular old run-of-the-mill morning sickness utterly a royal pain, if you'll excuse the pun. When I wanted a second child, two things worried me: the recovery (as I planned at the time to have another cesarean), and the morning sickness. I don't know what it is, but even while not pregnant, I cannot stand being nauseated. I crocheted a lot while pregnant and now, can't even think of crocheting because the thought of doing so makes me queasy. So Kate is probably pretty miserable right about now.

HG, as it's called, can be a nightmare for sufferers. Many women I've talked to or know suffered for months, sometimes the entire duration of the pregnancy. One friend was finally, to her great relief, hooked up to a Zofran pump (like an insulin pump) that helped her manage through the feelings of constant nausea, complete loss of appetite and many, many trips to the toilet. If you've ever suffered through a day or two of stomach bug, you know how easy it can be to get dehydrated. Now think how that would feel day after day, for months. 

When it gets bad enough, a hospitalization for IV fluids can sometimes be in order. In order to differentiate between it and just normal morning sickness, severity is a consideration: if your nausea and vomiting are especially bad, to the point of being able to keep nothing in your stomach, then you're probably the lucky winner. The author of this Washington Post article humorously noted (although probably not funny at the time, I'm sure):

"I have often told people that I knew my condition was bad when a helicopter flew over my home and instead of listening to its rumble to make sure it passed safely overhead, I thought to myself, 'Well, at least if it crashes into my apartment I won't have any more morning sickness.' Death would have been an improvement...I mostly slept, and carried a trash can wherever I went. All my husband wanted was an omelet, but the thought of eggs made me want to kill him."  

One of the women who commented on The Washington Post article said that her daughter had it - and was hospitalized for the better part of her first pregnancy. Unlike Kate, however, the traditional remedies (and we're talking the big guns here that you get only at the hospital) did not work. To top it off, she became pregnant again, only to have it worse than the first time, which resulted in TPN (total parenteral nutrition, a form of IV that basically gives you all of your nutritional needs in IV form. *insert completely horrified face here*.) That would basically make you never want to have any other children, ever again. (As a side note: I used to make that stuff for patients when I worked in a pharmacy, and it basically meant you were pretty sick.)

I was glad to see that it made news, though, because of one thing: this horrible, not-your-average-pregnancy symptom is often delegitimized by people who think it's just regular old puking and feeling yucky. They often say terrible things like, "Suck it up!" or "You're just doing it for attention!" Sadly, I've even heard things like that from labor and delivery nurses, one of whom basically said, "You were the one who wanted to have a baby, so deal with it." She didn't seem to believe that it could be debilitating. I asked on my fan page if anyone had dealt with it and if they could share their comments:

"It was debilitating. I had little to no support. I was told to eat crackers, sip ginger ale, and it would just stop. I vomited around the clock for close to 7 months. When it did ease and I could eat, I had lost a lot of weight and began to develop very severe pre-eclampsia...The comments which hurt the most were when I was told I was doing this 'for attention' and that morning sickness is "all in your head." I could have died, my son could have died. I *wanted* to have a baby. I *wanted* to enjoy being pregnant. Why in the HELL would I then bring such suffering upon us both for 'attention?' It caused a lot of heartache and created a rift in my family relations for a long time afterwards." - Rebekah

"I was unable to hold down water, let alone food. Even with meds I'd have to crawl into an E.R. once a week for IV meds and fluids....The worst is when the doctors don't want to believe you...not sure I could ever put myself through being pregnant again. Which sucks because I long for another child." - Noel

"Meds didn't work. I spent my whole day either throwing up or trying not to. I lost my job - had to be hospitalized for dehydration. I lost my baby as a result of being so sick...The comment that hurt the most especially at the end where I was still but knew the baby was gone was when everyone would say the baby would be worth it." - Robynn 

"I threw up daily around the clock for 88 weeks out of my three pregnancies...it was worse with each child. The puking and never-ceasing nausea is hard, but the time you lose being completely debilitated is the hardest part. Your children don't understand. Your mother-in-law doesn't understand or people think you are exaggerating. When people ask "How are you feeling?" you learn to simply say, "Hanging in there." Reading or looking at a computer screen might exacerbate it. Grocery shopping becomes a challenge - beat the clock before you hurl. Your ribs ache from dry heaving. You eat and eat because you are worried your baby isn't getting enough. Your partner stops being empathetic. It becomes "normal." You clean your own puke off the wall behind the toilet. There is no one to take care of you. You will have days where you will cry clinging to the toilet as you dry heave bile and over and over again say "I'm so glad my baby is healthy!" to keep your affirmations as positive as possible." - Green Births

"Green Births is totally spot on. Eventually no one around you cares or will even help. Honestly it's so emotionally, physically, mentally crippling. I feel so awful for my daughter who has no idea why mommy can't do fun things with her very often, the strain and stress it has put on all my relationships, I just feel miserable and helpless." - Aimee

"I was losing a pound a day. I had to leave university because I was constantly running out of class to throw up...most of my day was spent with my head in the toilet or laying on the sofa." - Catherine

"Favorite moments were pulling over to puke in front of a bunch of teens in town. Puking in my work car park and simultaneously weeing. Puking on my steering wheel because I couldn't get out in time. HG destroyed my life for 9 months." - Sian

What's really sad, is that for some women, hospitalizations are really the tip of the iceberg. For some, the meds do not work, and it's speculated that as many as 6,000 abortions a year are performed on women who are at their wit's end dealing with HG and just can't take it anymore. Honestly, if you are experiencing misery day in and day out for months on end and then someone comes along and tells you "just deal with it," wouldn't you be reaching the end of your rope, too?

Those who think it's "all made up" might need a little education as to what it actually is: that big-sounding Latin word might trip them up. Maybe they need to be shown? Who knows. If you were a cancer patient going through the rigors of chemo, would they dismiss you as creating drama and trying to attract attention to yourself and just "suck it up?" I highly doubt it.

My best to Kate - I hope she responds well to treatments and gets better soon.

More reading:
Our lady of hyperemesis gravid arum - The Washington Post

WTH Wednesdays: "What not to buy my kids for Christmas"

I love the holidays. And yet, on some level, when it comes to gift-giving, I dread it.

Tonight my daughter was determined to save her half-eaten Girl Scout cookie as a treat for her first-grade teacher. I tried to explain to her that perhaps that wasn't the best gift; perhaps we could find something more appropriate to give instead. I then launched into a discussion with my son about "remember that car wash kit you picked out for her one year? That was probably the best gift ever, because it was something she could really use." I tried to explain to him that sometimes, we buy gifts for people that they can neither use nor want, just to "fill a void" that says, "Hey, I got you a gift. Isn't that nice of me?" (I'm not sure he got it, but whatever.)

This mom's blog post highlights exactly what I'm talking about, and why I dread the gift-giving season:  friends and family, well-meaning and good-intentioned, buying your kids scads of cheap junk that breaks, falls apart, makes more noise than a jet engine...you get the idea. Why, oh why, do they do that?

We usually travel and spend Christmas Day with my mom, who never seems to disappoint when it comes to the sheer volume of gifts she gives. I don't know how else to tactfully suggest quality over quantity; I've tried to explain that the kids don't really need a lot, really anything, and not to buy so much. She's getting better, but only after one particularly rough year where there were eleven presents under the tree for him from her alone. As she kept handing them over, my husband and I glanced at each other uneasily as the greed kept mounting. When oldest son was finally done opening gifts, he glanced around and said, rather frustratedly, "Is that it?!" 

Unfortunately, a lot of toys end up missing pieces and
parts not long after they're opened, which only
leads to copious amounts of tears and frustration.
Photo: Joel Messner/stock.xchng.hu

I must admit, we kind of both went ballistic on him. In a loving way, of course. I think my mom's eyes were really opened, though. Too bad she didn't see how the remote control truck broke within five minutes of arriving home to play with it; how the other cheap stuff eventually ended up in the trash because it just fell apart.

Unfortunately, so do some of the nicer toys you can still get. The well-chosen Etch-a-Sketch the kids got from my dad, the world's best gift-giver, fell apart too - because as they say, they just don't make them like they used to.

But just because stores like the Dollar Tree gives you lots of purchasing power, doesn't mean you should totally capitalize on it and go nuts.

A lot of toys, like the especially annoying Dora guitar, went to the basement after less than one year, to be hidden away and hopefully never heard from again. Unfortunately, I didn't burn it in time and the kids found it. I hate to sound like an ingrate, but even after politely joking that "you only buy all the loud toys so you can send them to my house," I was serious. Really. So sometimes, I pack up those loud toys and they go back to grandma's house. So the kids have something to play with while they're there, you know.

I know that "it's the thought that counts," but what if there's no thought put into it? The gifts don't have to be many in number, and they don't have to cost a small fortune or take a chunk out of your retirement savings. It's estimated that families spend an average of $700 a year on Christmas gifts, and I often wonder, why? What are you buying? If it's for children, you know that every year you have to up the ante more and more to make up for it.

I love my kids, but am not buying them an iPod. Or an iPad. Or an i-anything, really. In fact, I'll make a secret confession: when my kids get gift cards as a birthday present, they usually whip them out and throw them around, even when I remind them that they're just as good as money. That usually doesn't mean anything to them, so I secretly gather them up and put them in my wallet. And I spend them. Oh yes, I do. Sometimes on groceries - things that we can all use, and sometimes on Christmas gifts that I know they'll like or use (and yes, even some of my selections are hit or miss). My kids do not "need" money; they have everything they need already, and besides, just having people give you money is not teaching you how it's earned or its value. They can't even keep track of the money the Tooth Fairy lovingly puts by their bedside, and quarters are just shiny and sparkling and making tinkly sounds, quickly forgotten. In fact, I just gave them $4 for pizza money today that they got from grandma for Halloween or some such "holiday." Money well-spent.

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

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?

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.
Photo: http://newborns.stanford.edu/PhotoGallery/Ankyloglossia1.html,
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.
Photo: www.tempestbeauty.com

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

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.

Tori Spelling and cesarean complications: why we need to hear about it

It seems like everyone wants to hear about celebrity baby gossip. And with Tori Spelling's recent birth complications in the news, it's something we should be hearing about.

At the very least, Tori Spelling's
post-cesarean complications could
be an important vehicle for raising
awareness about risks of c-section and
the importance of adequate
informed consent. 

As Spelling underwent emergency surgery for complications after her fourth cesarean, the media was slightly abuzz about why it's such a concern, as they should be. I was elated that finally, finally someone was beginning to question the high c-section rate and how repeat cesareans can pose dangers for women. Not that I would ever wish those repercussions on anyone, but to have it happen to a high-profile celebrity, someone who's face we recognize, whose births are highly publicized - is perhaps instrumental in getting our attention when it comes to a very important topic that few people seem to really understand.

I don't know about Tori and her marriage, don't watch her show, or know what her motivations are, but it sounds like she wants a large family. She is in the minority, as more women are stopping after two children and therefore are not often exposed to the risks of what that number of c-sections can do to the body. Whether it's one, two or four or more, it always carries risks - but obviously with four surgeries under your belt you're going to be exposed to more risk than someone who's only had two. It's unclear, though, whether women really 'get' why this is important to understand - because many of them spend much time digging Spelling for 'not using birth control' (even though someone commented that yes, she was using it, and yes, it did fail). Some speculate that she did initially consider a VBAC, but decided against it when her first and second births were also close together (which can bring additional risk).

Instead of bashing her for having lots of kids, not 'getting fixed,' etc. etc. it should make us question why she wasn't encouraged to have a VBAC after her first birth, especially if she wanted more children. Although close births do pose a unique set of complications when considering VBAC, this is probably one case where why her first cesarean occurred is important to know: did she have a medical condition? Was she 'too posh to push' or did she simply want to schedule the birth? Who knows. Preventing the first scar is key, but sometimes it's not that easy, especially if you aren't sure how many kids you want. It's hard to gear up for a future birth when you're barely finished with the first one, but knowing before you get that uterine scar just how it could impact future births is very important.

After the birth of her first son, Liam, Tori said this:

"I had a c-section...One of the biggest misconceptions is that celebrities have C-sections because it's easier. If I had a choice, I would not have. The recovery is much worse." 

To me, it almost sounds like her doctor was a "once a cesarean, always a cesarean" type of person. And while I'm sure there is some strong-arming going on when it comes to pleasing a celebrity client, these women are no different than we are: if a doctor tells you a VBAC is "unsafe, dangerous, and your uterus will shatter" then you are just as prone to believe it's true as any of us might be.

I'll never forget it: that's what Anna Nicole Smith reported that her doctor told her before the birth of her daughter, born by scheduled cesarean. That her "uterus would shatter," as if it's made of glass, as if one tiny contraction could forcibly blow the entire thing up like a bomb. I was so sad for her, because she naively believed him, much like any of us probably would have.

Some articles surrounding Spelling's complications ask an important question: are doctors doing enough to inform patients about the risks of cesareans? I was happy to see that headline, because I argue wholeheartedly that they're not. If you were scheduled for brain or open heart surgery, would a doctor simply tell you, "Everything will be fine, trust me! It's totally safe!" and walk away without so much as an explanation of the procedure? Highly doubtful.

I know my own physician, whom I saw for two of my three pregnancies, definitely did not. I still remember clearly our conversation prior to the birth of my first baby, who was breech: to his credit, he didn't schedule the cesarean until the week of my due date, but never went over any risks - if he did, I probably would have left the office that day in a panic instead of nervous excitement about the arrival of my child. Thankfully I did go into labor days before the surgery, which meant my baby (and most importantly, my body) experienced labor on its own, which is critical for future births. Yet I had no idea just how important that was at the time, because I was naive and very uninformed. No thanks to him.

When I became pregnant with my second child, my doctor gave me a 'choice' of what I wanted to do: the cesarean route, which I was already familiar with and had survived (isn't that a benchmark of just how casual our approach is to it?) or a VBAC, then proceeded to tell me that it could be dangerous and he'd had two women rupture on him. I decided the word 'rupture' sounded very unpleasant and I wasn't even going to consider it for a moment. Duh. What an idiot I was!

As my pregnancy progressed, I decided maybe having a VBAC wasn't such a bad idea. My primary motivation for choosing one was a) my baby wasn't breech and b) I wanted to avoid a potentially horrific recovery like I had with the first. I was terrified to tell him my intentions, because I had just three weeks until my due date. I stammered my way through our office visit, my husband at my side, while he proceeded to again tell me just how dangerous VBACs were and "I have one patient who's on her fifth cesarean!" I will never forget those words. That's when I asked him, "Well, what about this? That? Or this?" He had to concede that yes, those were definite risks to multiple cesareans. But reluctantly.

I know I'm not the only one. I've read so many accounts from near-panicked women that are on the eve of their inductions: "What should I expect? What do they do? Is this really necessary?" Something is clearly wrong with this picture. Either we trust our doctors too much, feel completely incapable of asking them questions, or they are completely inept at adequately informing their patients of risks and benefits to procedures. It shouldn't be a "don't ask, don't tell" policy; even if the patient says she has no questions, you should probably go ahead and tell her anyway. If she doesn't even know what to ask, then she's probably not even thinking about what could happen, what should happen, or what doesn't even need to happen.

I asked people on Facebook if they were induced or had cesareans, did their doctor cover the risks of the procedure? Of those that answered, all of them said "no."

It doesn't help that many doctors will discourage you from 'reading too much.' The internet be damned, because that means you're a religious follower of Ricki Lake and she only wants women to give birth in bathtubs. *eyeroll* Here, here's a copy of What to Expect When You're Expecting, now please - I don't have time to go over all the risks with you because there are none and it's perfectly safe so have a nice day. Does that sound like informed consent to you? Me neither.

So it's not a wonder Tori Spelling has had her fourth cesarean, and I don't think she should be blamed for it, either. Not because she's "old," or "a breeder," or any of those things. Stop blaming the person who just trusted her doctor, as you often blindly tell her she should. Start blaming the people who knowingly put vulnerable, often inadequately informed people at risk. Stop enabling the very system that allows this to happen.

The return of Ruby, the "Anti-Barbie"

My three-year-old saw this picture and asked,
"Is that a real Barbie? Is that a real doll? She is
cutting her hair." LOL No traumatizing here...

Remember Ruby?

A few years ago I posted a picture of Ruby, The "Anti-Barbie" and compared her with the current bizarre Mattel brainchild, Bratz dolls. A little backstory: a dad and his daughter were at the mall somewhere, caught a glimpse of The Body Shop's Ruby ad, and he basically flipped out and said his daughter was "traumatized." (I'm curious how many Victoria's Secret mannequins they had passed during that shopping trip.) Mattel then stepped in and took over.

After filing a cease and desist order to The Body Shop, the ad got pulled.

What I didn't realize was that this ad campaign originally debuted over a decade ago in 1998, before Twitter and Facebook, and as one writer put it, "If something went viral, it usually required a trip to the doctor's office." Now with the virtual explosion of social media, Ruby made somewhat of a comeback.

Since I first saw that ad two years ago, and I really haven't thought much about Ruby since, until I started making Barbie clothes for my daughter's dolls. As I studied patterns and then the mass-manufactured clothes, I remembered that ad and the freak out episode Mattel had surrounding it.

It seems that Mattel's energy is misdirected in their efforts to get the Body Shop to cease and desist: she looks, really, nothing like the "real" Barbie, and is merely a representation of a doll, any doll, not just Barbie. There are copycat Barbies everywhere, so why not go after those people, too?

Strangely enough, it didn't appear as though Mattel were going after the manufacturer of the doll, just the people who are showing us the image. So in other words, they can't stop someone from actually making a doll like this, but they can just try their hardest to keep us from seeing it.

Ironically, in the late 1950s, Barbie's creator had been to Germany and saw a similar doll, called Bild Lili, taking it back to the US to her husband, the co-founder of Mattel. The irony of Barbie's debut smacks of theft, in some ways. Later, Mattel acquired the rights to the German company, and Barbie's European cousin was no longer produced.

If Ruby were to really be created as a doll for the public market, it seems like she would threaten Barbie's livelihood about as much as Barbie moved in on Bild Lili's territory back in 1959.

There are countless styles of fashion dolls out there, many re-tooled and redesigned by adult collectors whose vast collections of Barbie-like dolls, clothing, shoes and furniture would make any kid envious. They are often produced in Japan, and can be made to look like celebrities, rugged men, glamourous women with excessively large breasts - just about anything you can think of - except overweight. And we know that even with two body redesigns (which may have been prompted by the Ruby ad, along with cries of protest by concerned parents), Barbie and her gorgeous body is still not really what the average American woman looks like, a size 14 - which is more like what Ruby looks like (as the ad truthfully suggests).

Because we all know that nurses everywhere
wear satin scrubs and sky-high heels. It was
either this or the astronaut costume.

As far as wardrobe choices, it seems like Barbie is devolving somewhat. Decades ago when she first came out, there were beautifully-styled dresses, jackets with linings and real tags, tennis outfits, all kinds of clothing - all of which looked very realistic. While it's true that changing times and hemlines are probably what Barbie's wardrobe reflects upon most, it's still not that true-to-life. The career dolls are still around, and I recently bought an astronaut suit (with matching helmet and boots!) for my daughter's birthday. But I made a pact with myself when I started buying those dolls for her - I'd rather see them naked all the time than with the barely-there clothing she often comes with. I contest that while ball gowns are very pretty and glamourous (I think girls prefer the long, flowing ones over the often tight-fitting, super short ones Mattel seems to be churning out), Barbie needs a good dose of reality in her wardrobe. Most of us do not wear negligee-type dresses out in public, or silk scrubs and platform shoes to our nursing jobs. If you want Barbie to have a realistic wardrobe that looks like a pint-sized version of your own, you have to make it yourself.

So Mattel was upset by the image of Ruby, yet condones the sexed-up, almost prostitute-ish look of Bratz dolls in their skimpy, barely-there clothing, platform shoes and heavy makeup. Barbie's own wardrobe generally consists of unrealistic, often revealing clothing, a complete departure from the original designs that were miniature versions of clothing real people would wear. Much like today, when the doll was first introduced, parents protested her unrealistic chest size. Despite the protests of parents now about the appearance of the Bratz doll, they still continue to be top sellers.

A rash of rashes (Don't fear the fever, Part 2)

With all the fun and exciting things that happened to our family this summer, we also had two crummy illnesses thrown into the mix, just to keep us on our toes (or should I say, knees?).

My husband and I had planned a getaway trip to Boston at the end of June, but my daughter had other plans: she got pretty sick about a week or so before our trip. I blogged about the experience, and mainly how we were deciding not to overdo it on the Tylenol/Motrin thing and just let her body do its thing to fight whatever she had. And of course, people wanted to know how things turned out.

After a visit to the peds, he diagnosed her with Coxsackie Virus, based on her rash features: sort of random, slightly raised red bumps. She had it on her hands, and it definitely looked like HFM (hand-foot-mouth). She also had it in a cluster on her torso, but nothing on her feet or in her mouth. I thought perhaps some Tylenol to keep her comfortable and we'd just ride it out, thankful that she didn't have the telltale mouth sores that many kids get.

Well, I was wrong. We ended up in pediatric urgent care, where they observed that her rash features had changed - she had something called erythema multiforme. They decided they couldn't tell conclusively if it was a viral agent or something called Kawasaki Disease, a vasculitis (which causes swelling of the blood vessels) that seems to affect primarily Japanese and American children. While it's pretty rare, it can pose serious complications if left untreated, including catastrophic heart damage that can lead to sudden death episodes. (Think John Travolta's son) W.T.F. I freaked. I held onto the notion that perhaps this was a particular strain of Coxsackie Virus, which can cause erythema multiforme.

In the end, they decided to treat her as if she had Kawasaki's, because they felt that the benefit outweighed the risks. She had a mixed bag of symptoms, some of which met Kawasaki's criteria. They waited at least a day and a half to treat her simply because the medication is insanely expensive and they weren't 100 percent sure - they even called in a delightfully old gentleman in infectious diseases who, I later suspected with horror, was a retired physician they called in to consult. Heck - the guy even carried a doctor's bag.

She had fluid around her heart - a possible sign of Kawasaki's, or something viral, or simply from being sick. Red, strawberry tongue - also a sign of Kawasaki's, but not conclusive enough to diagnose, and could also be a sign of dehydration. Whatever it was, it was kicking her butt. They gave her a round of IV IG - intravenous immunoglobulin, purified blood plasma that is supposed to boost her immune system and apparently costs around $3,000 per dose. Thankfully she tolerated it well and was able to leave the hospital after 2 1/2 days.

I still don't want to "fear the fever," but when it's accompanied by a rash - especially one that you've never seen before - it's probably a cause for concern. In the mom's guide to rashes stuff I've seen, this one hasn't been listed, and even though Kawasaki's is rare, it does need to be treated swiftly. One definite cause for alarm with regards to fever is one that lasts more than four or five days, which was a concern to doctors - at one point I was out in the hallway with the attending and his medical students, and felt like I was stuck in a surreal episode of House M.D. I don't ever want to do that again.

Just for your memory files, this is what it typically looks like after the red spots change - target or bullet-like lesions that sort of fan out from the center. It kind of reminded me of a head of cauliflower.

Erythema multiforme. Photo: Wikipedia Commons.

Our last hurrah for the summer was a trip to my mom's in Ohio, where I unfortunately spent the week with a sore throat. It would subside some during the day, but at night it was almost unbearable, and Advil only made a slight difference. At one point as I tried to fall asleep, I thought I was choking on saliva and a moment of panic set in. But otherwise I could function - I didn't feel too terrible during the day, and if I did, chalked it up to crummy food and not enough sleep. I thought I had a cold, until I suddenly realized it was getting worse instead of better, and hadn't gone away in the usual time a sore throat from a cold does. Do I have strep throat?! I thought. I wasn't sure.

I think I've had strep throat once - I can't even remember if that's what it was - and wished I had thought more about seeing the doctor when we returned home. I had cold symptoms the following week after the sore throat went away, and didn't think any more of it. Until I developed quarter-sized red bumps on my lower legs, serious joint pain in my knees and ankles, and just generally still felt like crap. I thought maybe it was from shaving. After a few days I decided I couldn't take it anymore and headed to the doctor.

I had done some googling but wasn't sure what I was looking at was really what I was looking at. I ended up seeing the Pretend Doctor, and after that visit have decided never again. I like my regular doctor, but I'm not sure where he found this person: she said it looked like a vasculitis (similar to the rash my daughter had), and I silently freaked out. But she also blubbered on about a "chest X-ray, punch biopsy," and a bunch of other stuff that had me wondering. I absently said I would like a second opinion from the doctor (thank God he was there that day) and he cheerfully came in and examined me quickly. His diagnosis was pretty succinct and seemed to match up with what I had read, and Pretend Doctor got a tad defensive (and after Dr. Real Doctor left, said, "I know what I'm talking about," a little confidently), but who cares. No punch biopsy for me (which I read later is only required in cases where the cause cannot be determined, and mostly for localized outbreaks or something, whatever that means). I had to laugh when I came across the words "Any experienced doctor should be able to diagnose based on clinical symptoms. Rarely is a biopsy needed." Hahahaha (this is me laughing hysterically in my altered mental state)

The final word was that I had developed erythema nodosum, a rash that (most commonly, I read!) is caused by a recent strep infection. I felt like a detective. I now knew more about stupid erythematous rashes than most people would care to, and was sick of the word 'erythema.' I had punched in that stupid search criteria into my computer so many times I barely had to type the letters e r y before the term came up.

In case you've never heard of it, erythema nodosum is a bumpy rash that is most often confined to the lower legs and shins, and feels pretty much like you played rugby for six hours in high heels and then were kicked in the shins by the entire team. It also includes ankle swelling, joint pain and general malaise, and as a result I've been sucking down more Advil than I ever thought possible.

I know some are skeptical of the effectiveness of taking antibiotics for strep infections, but I'm wondering if this could have all been avoided if I had seen the doctor sooner. The pain at times is almost unbearable, and I have a pretty high tolerance for pain. Sometimes Motrin works well, sometimes not. I'd rather risk potentially disturbed gut flora from a course of prophylactic antibiotics (which I'm on anyway right now, just in case) than deal with this again. Cases of rheumatic fever are virtually non-existant in the US now as a result of antibiotics after strep throat, but some people report pockets recurring - which I'm wondering is either because parents aren't recognizing the sore throat or think it's unnecessary and don't want to contribute to antibiotic abuse. I can appreciate that, to some degree. But even if don't have strep complications, you can still have rheumatic fever, which can have serious, life-long (and sometimes life-threatening) complications.

Erythema nodosum. Photo: MedicalPictures.net

Rheumatic fever is pretty rare in adults and mostly strikes children (like it did my grandma as a kid, before penicillin was even discovered) but that doesn't stop me from worrying about it, of course. In the meantime, I have a date with the heating pad. This should hopefully resolve itself ... in about three to six weeks. *frown*

More reading:
Your child has a rash: do you know what to do? 

How do we normalize breastfeeding?

So World Breastfeeding Week is over and now we're into "National Breastfeeding Month" in the United States. It would seem that we need literally a month to devote to this subject because when it comes to our attitudes on breastfeeding, the rest of the world thinks we're nuts and can't understand our problem.

How exactly do we normalize breastfeeding? And what does that mean?

Some are all about the doublespeak: "I totally support your right to breastfeed, as long as you do it in private or very discreetly." Which sounds an awful lot like "I think breastfeeding is the best thing for babies, but I just don't want to see you actually doing it."

This Victoria's Secret mannequin
leaves nothing to the imagination

Sometimes when I'm out and about I observe things that make me scratch my head like "Seriously?" It's not a wonder we have issues.

1. We need to respect the breast. I'm sorry, but one thing I can't stand is hearing (especially women, for some reason) referring to them as "tits." And when men start basically making cat calls like "I'm all for anything that involves seeing boobs in public," that doesn't really help, either. Sexual euphemisms for your breasts are not helping with the double-minded attitude that people have about breasts and what they should be used for, or that they even have more than one function.

The popular nursing cover "Hooter Hiders" further emphasizes my point: when we're talking about breastfeeding but referring to them as "hooters," I don't know about you but I automatically think of the restaurant chain. Completely pointless.

Not only does the giant apron draw more attention to you, but the name
"Hooter Hider" seems to sexualize the act of breastfeeding. I cannot
wrap my brain around the conflicting messages here. It's like
nourishing your baby, with a touch of vulgarity. Bleh. (And while
they say it's a "top must-have for breastfeeding mothers," I have never
seen anyone use one of these things.)

By sexualizing the breasts even when promoting breastfeeding, it's like shooting yourself in the foot. Case in point - these idiotic promo ads from the Ad Council. Are you serious? Is this really doing any good?

Once again, Americans prove how incredibly juvenile they are about using the breasts for something other than sex.

On the other hand, New Zealand takes a radical approach and actually shows (gasp!) someone breastfeeding. Wait - there's no tarp covering her and she's nursing - and you really can't even tell. How is this possible?

2. Sort of dovetailing off the above point, just say the word breast. I dare you to. Target has a clever tactic of calling it natural feeding in their stores. They can't even say "Breastfeeding" on the sign above the display, even though I'm sure 100 percent of the product packages featured in that section do. Maybe we could get over our sexualization of them if we just matter-of-factly, maturely, called them what they really are?

3. And dovetailing off of that, get rid of the ridiculous marketing. Again with the Target display, I was dumbfounded when I saw this there the other day:

Not only do they not call it "breastfeeding," they don't show anyone actually breastfeeding anywhere in the picture: there is an entire display of bottles with formula in them, and a canister of powdered formula in the foreground. What?!

This was even more disturbing. The mother and baby featured aren't nursing, either. This would have been a perfect opportunity for Target to actually feature a mother doing what the sign advertises, right?

Stranger still is the sign underneath - that immediately equates "natural feeding" with using a breast pump. Some women, obviously, will use them, but this seems to make you think you must buy one, you need one, so you don't have to actually be seen feeding your baby. Truly bizarre.

4. Just do it. I can't think of a better way to normalize it than actually feed your baby somewhere. Who knows - the more women we see nursing in public, the more it can possibly change attitudes and even encourage just one mom. As much as people complain about "exposing" little Johnny and Susie to it as kids, children do need to see that relationship to understand the basic function of the human body, whether mom likes it or not. I'd much rather explain to my child how their brother is fed than have to tell them why Susie's mother doesn't object when she wears next to nothing to school every day.

5. Be an advocate, whenever possible. This doesn't mean staging a "nurse in" or anything of that magnitude, but respectfully standing up for yourself and your rights as much as possible. I'm not saying defy police authority in the pathetic event that they might be called, but responding even keel and not getting angry probably helps a lot (no matter how much you want to smash the person's face in). Hand them a pamphlet with your state's breastfeeding laws. Tell them you're perfectly within your rights and carry on. It's sad that you even have to approach such a thing as infant feeding looking for a fight, but some people will confront you no matter how much you're covered simply because they know what you're doing under there. 

Advocacy shouldn't include, however, being a "nursing Nazi" (a term I despise) and even if you do think formula is poison, keep those sentiments to yourself. Getting up in a mom's face for not breastfeeding is not going to make her turn around and lactate, either.

One way I could put my money where my mouth is, for instance, is to write a nice letter to Target asking them why they're complete asshats about the way they "promote" breastfeeding. Perhaps some positive changes will take place as a result; or maybe they'll just send me coupons for free formula. *snark*

A history of breastfeeding in public

When you're deciding on whether to make the commitment to nursing, undoubtedly for some the idea of nursing in public is daunting. Even experienced mothers have told me they never fully "mastered" it, and we all have our own individual levels of comfort when it comes to doing it. Add an older kid to the mix, and suddenly it's like juggling a three-ring circus with one hand.

Lots of people think breastfeeding
is the best thing for baby. They
just don't want to ever catch you
doing it. Isn't there a tarp or tent
somewhere you can use to huddle
under?

I've had to think really hard about those times I nursed in public, and honestly I can't remember a whole lot. I think I mostly hid out in fitting rooms (and even a few bathrooms, but usually not for the reason you'd think - usually because as soon as I sat down to nurse a baby, the sudden, overwhelming urge to use the bathroom often hit me). I preferred those places not so much because I didn't want people seeing me nurse my baby, although because I was a bit clumsy with things that might have been part of it; but more because when I nursed, I wanted to spread out, get comfortable, and just sit. That meant I could lean back, hang my leg over a chair and get comfy. Although yes, in some ways, I was not in the mood to be stared at, harassed - even potentially - and felt generally uncomfortable and paranoid.

To think - those feelings and anxieties, over something real or perceived - can actually keep a woman from wanting to nurse at all. I had one playgroup buddy who refused to nurse even in front of us other moms, women she'd known and worked with for nearly a decade. One day I saw her bottle-feeding and realized it wasn't so much to get her daughter "used to" the idea of getting a bottle; it was because she was embarrassed to be seen doing it in front of us. Other moms propped themselves up while at my house, and even though we weren't the closest of friends, they still found a way; and yet, as I sort of watched them, it made me feel slightly weird to be sitting there as they were feeding their babies. Why? I nursed my own children; I fully supported them and wanted them to feel as comfortable as possible while relaxing in my home. Why did I feel strange about it, then?

I think because even as a nursing mother, I had seen few moms like me - nursing their babies in the open, in private, anywhere, really. How sad. How pathetic. How trained we've become (some of us, anyway) because we don't want to invite criticism, controversy or because we are made to feel like we should give more of a crap than necessary about everyone else when really, it's our babies we should be focusing on.

When people say they "don't want to see you flash your boobs in public," I wonder if they have any idea, really, that women decades before us did just that to feed their babies, often in public. What else could you do - it's not like they had tank tops and two-piece sweatsuits at their disposal in 1946. Women typically wore dresses that buttoned up the top, and that was their idea of "nursing clothing." Some dresses were styled somewhat to accommodate, many images simply show a mother unbuttoning her dress or blouse and simply feeding her baby.

So when someone tells you they don't want to see a breastfeeding mother "showing her boobs," just tell them, "Really? Because that's the way they did it 60 years ago." You know, back when everyone was conservative and puritanical, right?

'The Cornstalk Madonna,' by Orin Crooker,
Hoopestown, Ill. c. 1916. One of my
favorites.

Yeah, nowadays barely-there bikinis, thongs and cleavage are all the rage. But I bet if you sat down and decided to feed your baby, you'd be asked to leave (as many mamas have been).

At the beach. In front of people. c. 1930s.
Photo credit: Joseph Schwartz/Corbis. 

But if you're ever at the pool and happen to run into Ice-T's girlfriend, just remember that this is okay, got it? 

Most onlookers drool in approval -
but if this were a nursing mother,
I'm sure there would be an
uprising and police would be
on the scene in minutes. 

This one has always made me laugh - the only one
who apparently gets a rise out of it is a young boy who
is maybe 8 years old. The rest are like, "eh, whatever."
Source: Jennifer James/mothering.com

Babies sometimes get hungry in all kinds of places - regardless of whether they've just been fed or not - like just when you're getting ready to leave to go someplace. It looks like, throughout the ages and no matter what mode of transportation was available, this has always been the case. LOL

Notice how none of the women looks uncomfortable, and the one to the nursing mother's left doesn't seem to be saying, "OH. MY. GOD. I cannot believe she has the nerve to whip that thing out in public while we're all sitting here!"

Caption: "A mother is traveling from Louisville, KY
to Memphis, TN on a Greyhound bus. Here, she is
waiting in the Chattanooga bus terminal and breast-
feeding in public in September 1943."
Source: Jennifer James, mothering.com

I've included the above image in a past blog post, but I never realized that another image is also included in the set:

This could either be a look of consternation that says,
"Did I miss the train?" or "What was that, Gertrude? I
couldn't hear you." Now it's "Ok, when is the angry
flashmob going to show up with the police to
escort me off the property for feeding my baby?!"

This one has always cracked me up, too. This couple
is more excited about saving their farm after the
Great Depression than wasting time worrying about
what everyone thinks about her baby eating. Even
the adviser they're talking to is casual and normal
with them, not all "Mrs. Jones, would you like a
receiving blanket to cover up with? Shall I ask
if there is a nice bathroom stall or dark closet for you
to nurse your baby in?"
Source: Jennifer James, mothering.com

(It was always my dread that my baby would be hungry while I waited at the pediatrician's office - not that I didn't want anyone seeing me, but that a) all those sick people would be breathing on me and b) that I'd have to run to the bathroom, which was across two waiting rooms on the other side of the office. Then, while I was in there, they'd inevitably call my name...)

Anyway, I remember not long ago having a discussion with NICU moms that nurses actually wanted to put up a freaking screen while some of the moms nursed. I've also heard some horribly sad stories about NICU nurses being completely unsupportive - to the point of literal sabotage - of moms who wanted to nurse their babies there. Unreal.

Caption: "Mothers nursing their babies
while waiting their turn to see the doctor,
a nun standing nearby. Location: Paris, France.
Photographer: David E. Scherman.
Time/Life Magazine, August 1, 1946

There are lots more - if you want to see them, visit my gallery on Facebook here or the Facebook fan page Historic Photos & Prints of Breastfeeding.