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. 

Subversive marketing tactics: Nestle "milk nurses"

In light of the recent flak Mayor Michael Bloomberg has been getting for his breastfeeding campaign in NYC hospitals, it's important to go back in history a little and explore the origins of that "little bag of freebies" - which might not be as harmless as we think.

For more than a century, Nestle has become a household name - associated with everything sweet and good. But what you may or may not know is that when it comes to marketing their infant formula, they often left a very bitter taste in the mouths of many mothers and infants worldwide.

"Milk nurses" in South Africa. "Some firms
used "milk nurses" as part of their promotions.
Dressed in nurse uniforms, "Milk nurses" were
assigned to maternity wards by their companies
 and paid commissions to get new mothers
to feed their babies formula. Mothers who did
so soon discovered that lactation could not be
achieved and the commitment to
bottle-feeding was irreversible." -
Business: Its Legal, Ethical, and
Global Environment, by Marianne M. Jennings

Nestle made its presence known in South Africa more than half a century ago with "milk nurses," women who were either actually nurses or those dressed to look like ones - who represented the company. Poor women with little, if any, access to clean, running water were then persuaded to try their products, and soon the baby would be accustomed to getting a bottle of formula instead of mom's breast. In time, the breast milk would dry up - but so would the cash flow necessary to buy more formula to feed the baby.

Problems ranged from mothers reconstituting formula with contaminated water, which often led to diarrhea and even death, or watering it down to make the product last longer - which led to malnutrition. One blogger notes:

A fellow nutrition student of mine was formerly head of the Nestle milk nurses in Kenya. She told me that she and her staff not only were qualified, they were among the most senior nurses in the country and wore uniforms indicating this. She said that regular government nurses then had to “obey” the Nestle milk nurses!

Meaning, there is a systematic method of coercion: whether real or portrayed as such, these "milk nurses" were an established presence on behalf of the company, and by showing a special uniform as a display of power and authority, seems to suggest that anyone who questioned them was "in trouble."

Nowadays we think of those typical goodie bags as no big deal, and with heavy government subsidization of formula, it's not that difficult to obtain more when you run out. However, the problem of reconstituting weakly to make it last longer, doesn't seem to be isolated to foreign countries with indigenous tribal people: the same thing happens here in the US. Whether it's simply greed or ignorance, I don't know, but hearing comments like this one make me want to scream - is it still a mother's choice not to breastfeed, even if it's a completely ill-informed one?

People here in America do this too. I've seen a woman water hers down and sell the remaining WIC cans on craigslist.

Although there are WIC programs that do encourage breastfeeding among low-income mothers, it's obvious that the memo might not be as widely-circulated as it should be.

Some ask, "How is Nestle responsible for people who water down their baby's formula?" By marketing heavily to a nation who cannot sustain using their product. The level of abject poverty in many African nations is something even our poorest cannot comprehend, and seemingly few understand the role that these powerful milk "nurses" played in convincing a woman that her own milk was inferior.

One blogger says she was told by a high school teacher about this situation in South Africa, and promptly thought those women must be "stupid" for believing these nurses. Then when she grew up and nursed her own babies, she said, she ran across this image and it opened her eyes:

Photo credit: UNICEF. Source:
http://www.jemjabella.co.uk/2010/jemjabella-is-a-nestle-free-zone/

The babies in this photo are actually twins. At the mother's permission, she posed for this photograph, taken by a UNICEF worker, after learning that even some breast milk could have helped her daughter to thrive like her brother. Healthcare workers convinced this mother, however, that there was no way she could provide enough milk for both babies, so she faced a difficult decision. Her daughter apparently died the day after this photo was taken. Now that's guilt.

Some ask, "Why didn't workers do this? Why didn't workers tell her that?" Because they have a product to sell. Much like drug reps, hospitals and doctors are often given copious amounts of the stuff for those who truly cannot nurse or don't wish to, in exchange for other goods, I've read. When you have healthcare professionals spewing out this kinds of misinformation, vulnerable mothers are more likely to believe it.

Many have chosen to boycott Nestle as a result; still others ask, "How does this affect me?" The same thing happens here all the time: studies have shown that poorer families are more prone to water down infant formula to make it last, even while getting government subsidies. What if, when those women were in the hospital, they were actually encouraged to breastfeed? With generations of dysfunctional attitudes and perpetuating myths about breastfeeding, how can you expect them to?

More reading:
Poor parents found to water down baby formula: study
Cash-strapped parents warned after Florida infant nearly dies from watered-down formula
China finds cancer-causing toxin in baby formula
Nestle dupes moms, kills babies in Indonesia - DailyMomtra