We are a one-car family; my husband and I share an economical, sensible vehicle that is no larger than what we absolutely need. During the weekday, the car is with my husband at work, leaving Han Solo (my new internet pet-name for my boy because yes, we are geeks) and I sans personal transportation. You may be thinking how noble we are to make such a sacrifice for the environment, to reduce our entire family's carbon footprint to that of just one person. If you spotted me and my boy waiting at the bus stop, his stroller laden down with groceries in reusable shopping bags, you might nod approvingly as you sped by in your air-conditioned SUV, thinking, now there's a true environmentalist.
I wonder if you would think the same thing about the Mexican lady sitting on the bench next to me, who is also toting children and groceries. The thing is, she's probably there for the exact same reason I am--her family cannot afford for her to have a car. Like me, she's probably grateful to have any transportation option at all, and considers a walk (it's a half mile from my front door to the bus stop and I'm guessing that's about average) followed by a five to fifteen minute wait in the sun and humidity while traffic whizzes by just feet away, to be a reasonable price to pay to be able to leave the house and go somewhere. Yet my hypothetical SUV driving environmentalist would probably not notice her at all, relegating her to the background, just another expected part of an everyday commute.
I say this not to point out what a racist a-hole the SUV driver is (though I am starting to dislike this pretend person), but to illustrate how unusual it is for a white woman my age to take her young child on the crosstown bus. Sometimes I catch people looking at us with a quizzical expression, as if wondering what the hell happened to put us in such a position.
For the most part, my bus-riding experiences have been positive. People smile at my son, help me lift my stroller if it's obvious I'm having trouble juggling all the crap I'm carrying, and switch seats just to give Han a better view. But there are also some unsavory characters on the bus, young guys who swear loudly and holler at the young ladies on their way to the community college, folks who are clearly a little deranged, and rundown types who smell like they just crawled out of a bottle of Night Train. Some of the bus drivers are surly cranks who gaze at my son with undisguised hostility, seeing us as yet another in a string of time-consuming hassles putting everyone behind schedule. It's a mixed bag, is what I'm saying, and I never know what to expect.
There are two ways of looking at this. One, it is terrible that I have to subject my son to potentially frightening strangers just to get to the grocery store. It sucks that buses are not only designed without regard to mothers transporting young children, but they seem to actively inhibit them. It blows that it may be up to a year before we get our finances to the point where a second car is even possible. It bugs me that buses are exclusively the domain of poor people, and that the SUV environmentalist will never truly understand the situation that I and the unnoticed Mexican lady share.
All of these things are true, but I still prefer to look at this from a second perspective: every bus ride is an adventure. This sounds stupid at first (at least it did to me) until you remember that "adventure" is not synonymous with "fun." Think about the great adventures of movies and literature--they were each a series of tests, designed to educate and toughen the characters. The heroes of these stories learned from, and were often made better by, the trials and tribulations they overcame while trying to reach their goals.
Now, our goal is just to get to the grocery store and back, and we are rarely tested by anything we can't easily handle. But there's a sense whenever we walk away from the house, of setting off, of knowing where we're going but not everything that will happen between here and there. I want my boy to know that we can handle whatever comes, that we are no better or worse than the people around us, and that fear is normal but you can't let it stop you from going where you need to go.
Friday, March 25, 2011
Monday, February 28, 2011
Circumcision: Let's Talk About Dicks
These days, parents of baby boys are faced with a tough decision: whether or not to have their sons circumcised. Just a generation ago, it was a no-brainer--circumcision was widely known to result in a cleaner, more attractive, and socially acceptable penis. Boys with foreskins were the exception, the freaks in the locker-room covering their crotches in shame while the "normal" boys pointed and laughed.
But the world is moving on, and as the years pass and my peers flood the earth with their children, the practice is becoming less common. In fact, only 56% of baby boys born in the US were circumcised in 2008, down from more than 80% in the 1960's. And thanks to the growing intactivism movement, that number is likely to continue decreasing. Parents are becoming more aware of their choices, as well as the potential risks and benefits to accepting or declining the procedure. We've realized that whether or not to circumcise really and truly is entirely up to us. Unfortunately, this means that we get to take the blame if, someday, our boys decide that we made the wrong choice. With all the shouting surrounding this issue, it can be hard to decipher hyperbole from fact. Here's my attempt to cut through the bullshit and help you make a choice both you and your child can be comfortable with.
What does the AAP (American Academy of Pediatrics) have to say about circumcision?
AAP policies reflect the current medical consensus among pediatric practitioners based on the most recent evidence. In the case of circumcision, however, they're not much help. While the AAP acknowledges that "existing scientific evidence demonstrates potential medical benefits," their official policy statement concludes that "...these data are not sufficient to recommend routine neonatal circumcision." In other words, the decision is left to parents and their pediatricians. However, the AAP plans to update this policy in light of new evidence about potential health benefits of the procedure. Whether or not this will affect their recommendations remains to be seen.
Why do people have their boys circumcised?
According to this article on PubMed, circumcision reduces the incidence of urinary tract infections (which are especially dangerous in infants), lowers the risk of many types of STD (including HIV and HPV), has a protective effect against penile cancer, eliminates the medical need to have the procedure performed as an adult (well, duh), and improves "sexual function and creativity". One study found that circumcised men enjoy "...a more elaborate sexual lifestyle," and their female partners report being "...more pleased with the aesthetics of the circumcised penis." (I'm not sure if that last part counts as a health reason, but hey, I didn't write the article.)
However, the health issue is kind of a red herring, because most parents make this decision for cultural reasons, such as religion or family tradition. One study found that circumcision status of the father, as well as the parents' education level and ages, are the most important factors in the decision. In this same study, mothers-to-be were given an informative brochure put together by the AAP which outlined the health benefits and potential complications. Not one woman changed her mind after reading the brochure.
What is the history of circumcision?
The oldest documented evidence of circumcision comes from ancient Egypt. Many historians believe that the Jews acquired this practice during their period of enslavement to the Egyptians, though competing evidence suggests that it has been a custom in Semitic tribes going back much further than that. The tradition also has roots in Islamic culture, tracing back to the tribal practice of circumcising both boys and girls. It is still a common cultural tradition among orthodox Jews and devout Muslims.
Circumcision didn't catch on in the United States until the late nineteenth century. Doctors who advocated for the procedure recommended it to curb masturbation, or in the words of John Harvey Kellogg, as a "PREVENTION OF SECRET VICE" (apparently cranks have always had a love affair with caps lock). Kellogg, who helped popularize the practice in the US, believed that masturbation was an act of evil and that the inability (or refusal) to abstain from it constituted a disease. In addition to performing circumcisions (without anesthetic, so the pain would have a "salutary effect upon the mind,") he encouraged parents to force their children to work long and hard during the day so they would be too exhausted to "defile" themselves at night. For younger children, he suggested tying their hands, or, more effectively, "bandaging the parts" to prevent access. Fortunately, his more extreme ideas did not catch on (such as applying pure carbolic acid to the clitoris if a woman proved unable to "exercise entire self control"), but other doctors of the era took his anti-foreskin fervor and ran with it. To this day, many Americans still consider circumcised penises to be cleaner and more civilized than their intact counterparts.
How is circumcision performed?
I always imagined it to be rather neat and precise: the doctor pulls the foreskin up from the penis between his fingers, the way a barber prepares to trim a lock of hair, then pulls out a specialized penis guillotine that resembles a cigar-cutter, and snip snap snip, the penis is circumcised. The nurses dab off the tiny amount of blood with a soft cloth, and the smiling baby boy is delivered safely to his mother's arms.
But it's not like that at all. The Wikipedia page on circumcision goes into graphic, gory, detail on how it really happens (warning: pictures!). There is a clamp involved, used in conjunction with a "restraining device". The inner lining of the foreskin is "bluntly separated" from the glans so that the clamp can be forced into place. Sometimes this requires a dorsal slit, and sometimes the frenulum band near the urethra needs to be "broken or crushed" so the foreskin can be cut. The clamp stays in place until the penis has healed, at which point it should fall off on its own (the clamp, not the penis).
Most boys have pediatricians (or mohels) who follow AAP recommendations and use local anesthtic, either in the form of a topical cream or by a series of injections. But not all practitioners believe that babies feel pain (or perhaps, like Kellogg, they believe the babies deserve pain), so sometimes the procedure is performed with no pain relief at all.
Do the benefits make it worth doing anyway?
In sub-Saharan Africa, where most of the studies showing a positive benefit were conducted, it probably is worth doing. AIDS and other STD's are rampant, people have limited or no access to contraception, rape is commonly used as a tactic of warfare, and access to clean water and adequate medical care is scarce. In conditions like these, medical interventions that even slightly lower the risk of passing on infectious disease make perfect sense.
Here in the US, it makes less sense. The typical American man has the luxury of plenty of hot water and soap in the comfort of his own home. He can dry off with a clean towel and put on freshly-laundered underwear. He can waltz down to the CVS and pick up a box of condoms any time he likes. He is unlikely to force himself upon an unwilling woman.
However, health issues aside, some people do prefer the aesthetics of the circumcised penis, seeing it as cleaner and more streamilined. Plus, circumcised men don't get smegma (which is not a health risk but is still pretty gross.)
Conclusion
Though circumcision's popularity in the US is fading, it is unlikely that the intactivists will get their wish and put an end to the practice altogether. I personally feel that the procedure is unnecessary and opted out for my son, but I also don't buy the more extreme claims of men feeling violated by their parents and mourning the loss of their foreskins. I'd imagine the average guy doesn't give it much thought; his dick is as familiar to him as the contours of his own face and, as long as it works like it should, he should be happy.
But the world is moving on, and as the years pass and my peers flood the earth with their children, the practice is becoming less common. In fact, only 56% of baby boys born in the US were circumcised in 2008, down from more than 80% in the 1960's. And thanks to the growing intactivism movement, that number is likely to continue decreasing. Parents are becoming more aware of their choices, as well as the potential risks and benefits to accepting or declining the procedure. We've realized that whether or not to circumcise really and truly is entirely up to us. Unfortunately, this means that we get to take the blame if, someday, our boys decide that we made the wrong choice. With all the shouting surrounding this issue, it can be hard to decipher hyperbole from fact. Here's my attempt to cut through the bullshit and help you make a choice both you and your child can be comfortable with.
What does the AAP (American Academy of Pediatrics) have to say about circumcision?
AAP policies reflect the current medical consensus among pediatric practitioners based on the most recent evidence. In the case of circumcision, however, they're not much help. While the AAP acknowledges that "existing scientific evidence demonstrates potential medical benefits," their official policy statement concludes that "...these data are not sufficient to recommend routine neonatal circumcision." In other words, the decision is left to parents and their pediatricians. However, the AAP plans to update this policy in light of new evidence about potential health benefits of the procedure. Whether or not this will affect their recommendations remains to be seen.
Why do people have their boys circumcised?
According to this article on PubMed, circumcision reduces the incidence of urinary tract infections (which are especially dangerous in infants), lowers the risk of many types of STD (including HIV and HPV), has a protective effect against penile cancer, eliminates the medical need to have the procedure performed as an adult (well, duh), and improves "sexual function and creativity". One study found that circumcised men enjoy "...a more elaborate sexual lifestyle," and their female partners report being "...more pleased with the aesthetics of the circumcised penis." (I'm not sure if that last part counts as a health reason, but hey, I didn't write the article.)
However, the health issue is kind of a red herring, because most parents make this decision for cultural reasons, such as religion or family tradition. One study found that circumcision status of the father, as well as the parents' education level and ages, are the most important factors in the decision. In this same study, mothers-to-be were given an informative brochure put together by the AAP which outlined the health benefits and potential complications. Not one woman changed her mind after reading the brochure.
What is the history of circumcision?
The oldest documented evidence of circumcision comes from ancient Egypt. Many historians believe that the Jews acquired this practice during their period of enslavement to the Egyptians, though competing evidence suggests that it has been a custom in Semitic tribes going back much further than that. The tradition also has roots in Islamic culture, tracing back to the tribal practice of circumcising both boys and girls. It is still a common cultural tradition among orthodox Jews and devout Muslims.
Circumcision didn't catch on in the United States until the late nineteenth century. Doctors who advocated for the procedure recommended it to curb masturbation, or in the words of John Harvey Kellogg, as a "PREVENTION OF SECRET VICE" (apparently cranks have always had a love affair with caps lock). Kellogg, who helped popularize the practice in the US, believed that masturbation was an act of evil and that the inability (or refusal) to abstain from it constituted a disease. In addition to performing circumcisions (without anesthetic, so the pain would have a "salutary effect upon the mind,") he encouraged parents to force their children to work long and hard during the day so they would be too exhausted to "defile" themselves at night. For younger children, he suggested tying their hands, or, more effectively, "bandaging the parts" to prevent access. Fortunately, his more extreme ideas did not catch on (such as applying pure carbolic acid to the clitoris if a woman proved unable to "exercise entire self control"), but other doctors of the era took his anti-foreskin fervor and ran with it. To this day, many Americans still consider circumcised penises to be cleaner and more civilized than their intact counterparts.
How is circumcision performed?
I always imagined it to be rather neat and precise: the doctor pulls the foreskin up from the penis between his fingers, the way a barber prepares to trim a lock of hair, then pulls out a specialized penis guillotine that resembles a cigar-cutter, and snip snap snip, the penis is circumcised. The nurses dab off the tiny amount of blood with a soft cloth, and the smiling baby boy is delivered safely to his mother's arms.
But it's not like that at all. The Wikipedia page on circumcision goes into graphic, gory, detail on how it really happens (warning: pictures!). There is a clamp involved, used in conjunction with a "restraining device". The inner lining of the foreskin is "bluntly separated" from the glans so that the clamp can be forced into place. Sometimes this requires a dorsal slit, and sometimes the frenulum band near the urethra needs to be "broken or crushed" so the foreskin can be cut. The clamp stays in place until the penis has healed, at which point it should fall off on its own (the clamp, not the penis).
Most boys have pediatricians (or mohels) who follow AAP recommendations and use local anesthtic, either in the form of a topical cream or by a series of injections. But not all practitioners believe that babies feel pain (or perhaps, like Kellogg, they believe the babies deserve pain), so sometimes the procedure is performed with no pain relief at all.
Do the benefits make it worth doing anyway?
In sub-Saharan Africa, where most of the studies showing a positive benefit were conducted, it probably is worth doing. AIDS and other STD's are rampant, people have limited or no access to contraception, rape is commonly used as a tactic of warfare, and access to clean water and adequate medical care is scarce. In conditions like these, medical interventions that even slightly lower the risk of passing on infectious disease make perfect sense.
Here in the US, it makes less sense. The typical American man has the luxury of plenty of hot water and soap in the comfort of his own home. He can dry off with a clean towel and put on freshly-laundered underwear. He can waltz down to the CVS and pick up a box of condoms any time he likes. He is unlikely to force himself upon an unwilling woman.
However, health issues aside, some people do prefer the aesthetics of the circumcised penis, seeing it as cleaner and more streamilined. Plus, circumcised men don't get smegma (which is not a health risk but is still pretty gross.)
Conclusion
Though circumcision's popularity in the US is fading, it is unlikely that the intactivists will get their wish and put an end to the practice altogether. I personally feel that the procedure is unnecessary and opted out for my son, but I also don't buy the more extreme claims of men feeling violated by their parents and mourning the loss of their foreskins. I'd imagine the average guy doesn't give it much thought; his dick is as familiar to him as the contours of his own face and, as long as it works like it should, he should be happy.
Wednesday, February 9, 2011
Open Letter to Mayim Bialik: Why Can't We Be Friends?
Dear Mayim,
I hope you'll forgive me for calling you by your first name, but I can't help but feel like I know you. You see, you and I grew up together. No, we didn't live in the same neighborhood or attend the same schools. This relationship is purely one-sided: to me, you will always be the girl who played Blossom. This isn't a bad thing--Blossom was by far the smartest, hippest, savviest, and most confident girl on TV in the early 90's. They just don't make girl's role models like that any more, to the detriment of Miley Cyrus fans everywhere. And it wasn't just your TV persona--judging from what I saw in interviews, you were pretty hip and savvy yourself. I admired your unwavering, uncompromising, you-ness. You didn't wait for others to hand you your self-esteem. You took it as your birthright, and nerdy, insecure girls like me were inspired and emboldened to do the same.
But we arrived at adulthood along very different paths. You went on to gain a Ph.D. in neuroscience while I delivered pizzas, taught preschool, and went into debt to finance my liberal arts degree from a state college. I'm not saying that my way was "better" or gave me some profound insight you are lacking. I don't begrudge you your good fortune or opportunities in the slightest. I'm just pointing out that our respective paths taught us each very different lessons and, as a result, we approach parenting from different perspectives. Yet I'd like to think our core values are still in alignment--we both care deeply about the earth and preserving its resources, we both want humane treatment for all animals, and we share the belief that children are our most tangible investment in the future of our planet and the survival of our species.
So why do we find ourselves on opposite sides of an impenetrable wall when it comes to parenting? Do our families' respective sleeping arrangements and meal habits really matter so much that they would strangle a potential friendship before it is formed? Does the fact that I had a C-section while you had your babies at home make us the Capulets and the freaking Montagues?
It hasn't always been like this. In a past interview you said, " ...everyone does things differently and that’s OK. It’s very important to us to raise nonjudgmental children who don’t go finger-wagging." You were also self aware enough to acknowledge that "...a lot of people hear that term [attachment parenting] and automatically get turned off or automatically assume that you think you're doing things better than them." Based on statements like these, I think we could get along despite our differences as parents.
But then I read the intro to your new blog on TODAYMoms. You start out by condemning labels and distancing yourself from the term attachment parent...but then you go on to state all the ways in which you are, indeed, a full-on attachment parent. You say you don't want to judge anybody, but you also say that "natural" childbirth should be the norm and that "almost all women should [emphasis mine] be able to...successfully breast-feed, barring rare genetic conditons." Mayim, when you say things like these, women who prefer to give birth in a hospital or who choose to bottle feed feel like you are attacking their parenting choices. Your attitude has changed from: "this is how I choose to raise my kids" to "this is the right way to raise all kids, everywhere."
I think I know how this happened. When you first started revealing your particular, somewhat peculiar, parenting choices, the sanctimommies piled on. I'm sure there were plenty of fingers wagging at you as thousands of moms felt it their duty to tell you every little thing that was wrong with every little detail of your parenting plan. No doubt you felt a bit defensive; after all, you made these decisions consciously, with your children's best interest in mind. What right did these people have to judge you? So you did what anyone in your position would likely have done--you looked for support from like-minded people. And, thanks to the internet, you found it in spades. Not only are your choices acceptable, your support group assured you, they are deeply, fundamentally, right. But by this logic, people who make different choices are simply, flat-out wrong. Such is the danger of the echo chamber, where extremism is born.
Mayim, I respect your right to make the choices you feel are right for your family. But if you refuse to extend the same courtesy to others, you run the risk of alienating readers like me, with whom you may have more in common than you realize. I have a feeling that if you and I met as total strangers, in a park with our children perhaps, we would strike up a lively and enjoyable conversation. Let's not let the sanctimommies of the world ruin our chance to get along, and to model for our kids a very important lesson: that just because we're different doesn't mean we can't be friends.
Sincerely,
Sane Mom
I hope you'll forgive me for calling you by your first name, but I can't help but feel like I know you. You see, you and I grew up together. No, we didn't live in the same neighborhood or attend the same schools. This relationship is purely one-sided: to me, you will always be the girl who played Blossom. This isn't a bad thing--Blossom was by far the smartest, hippest, savviest, and most confident girl on TV in the early 90's. They just don't make girl's role models like that any more, to the detriment of Miley Cyrus fans everywhere. And it wasn't just your TV persona--judging from what I saw in interviews, you were pretty hip and savvy yourself. I admired your unwavering, uncompromising, you-ness. You didn't wait for others to hand you your self-esteem. You took it as your birthright, and nerdy, insecure girls like me were inspired and emboldened to do the same.
But we arrived at adulthood along very different paths. You went on to gain a Ph.D. in neuroscience while I delivered pizzas, taught preschool, and went into debt to finance my liberal arts degree from a state college. I'm not saying that my way was "better" or gave me some profound insight you are lacking. I don't begrudge you your good fortune or opportunities in the slightest. I'm just pointing out that our respective paths taught us each very different lessons and, as a result, we approach parenting from different perspectives. Yet I'd like to think our core values are still in alignment--we both care deeply about the earth and preserving its resources, we both want humane treatment for all animals, and we share the belief that children are our most tangible investment in the future of our planet and the survival of our species.
So why do we find ourselves on opposite sides of an impenetrable wall when it comes to parenting? Do our families' respective sleeping arrangements and meal habits really matter so much that they would strangle a potential friendship before it is formed? Does the fact that I had a C-section while you had your babies at home make us the Capulets and the freaking Montagues?
It hasn't always been like this. In a past interview you said, " ...everyone does things differently and that’s OK. It’s very important to us to raise nonjudgmental children who don’t go finger-wagging." You were also self aware enough to acknowledge that "...a lot of people hear that term [attachment parenting] and automatically get turned off or automatically assume that you think you're doing things better than them." Based on statements like these, I think we could get along despite our differences as parents.
But then I read the intro to your new blog on TODAYMoms. You start out by condemning labels and distancing yourself from the term attachment parent...but then you go on to state all the ways in which you are, indeed, a full-on attachment parent. You say you don't want to judge anybody, but you also say that "natural" childbirth should be the norm and that "almost all women should [emphasis mine] be able to...successfully breast-feed, barring rare genetic conditons." Mayim, when you say things like these, women who prefer to give birth in a hospital or who choose to bottle feed feel like you are attacking their parenting choices. Your attitude has changed from: "this is how I choose to raise my kids" to "this is the right way to raise all kids, everywhere."
I think I know how this happened. When you first started revealing your particular, somewhat peculiar, parenting choices, the sanctimommies piled on. I'm sure there were plenty of fingers wagging at you as thousands of moms felt it their duty to tell you every little thing that was wrong with every little detail of your parenting plan. No doubt you felt a bit defensive; after all, you made these decisions consciously, with your children's best interest in mind. What right did these people have to judge you? So you did what anyone in your position would likely have done--you looked for support from like-minded people. And, thanks to the internet, you found it in spades. Not only are your choices acceptable, your support group assured you, they are deeply, fundamentally, right. But by this logic, people who make different choices are simply, flat-out wrong. Such is the danger of the echo chamber, where extremism is born.
Mayim, I respect your right to make the choices you feel are right for your family. But if you refuse to extend the same courtesy to others, you run the risk of alienating readers like me, with whom you may have more in common than you realize. I have a feeling that if you and I met as total strangers, in a park with our children perhaps, we would strike up a lively and enjoyable conversation. Let's not let the sanctimommies of the world ruin our chance to get along, and to model for our kids a very important lesson: that just because we're different doesn't mean we can't be friends.
Sincerely,
Sane Mom
Tuesday, February 1, 2011
Hot Saucing: Hurting Kids for Christ?
Sometimes I worry that I'm coming up short as a mom. Does my son eat enough healthy food? Are his toys stimulating and age-appropriate? Should I really let him wile away the afternoon watching Dino Dan, or should I bundle him up and drag him outside to play in the howling wind?
Then I see videos like this one, and I feel much better about myself.
This video is all over parenting websites, leading people to debate furiously in comment sections. The majority, thankfully, sees this as a clear-cut instance of child abuse (and the state of Alaska agrees) but an alarming number of commenters are rushing to this horrible lady's defense. Apparently, a large subset of the population still practices "hot saucing" as a disciplinary technique. But why? Who are the defenders of this practice, and are they, in fact, torturing children?
What is hot saucing?
Hot saucing refers to placing a drop of hot sauce on a child's tongue as punishment, usually for offenses such as lying, talking back, and swearing. The idea is to have the child associate the pain with the misbehavior in order to deter the behavior in the future. This is more commonly practiced among Christians (though by no means do all of them do this), who believe that children need to learn respect and obedience for parents so they will learn to respect and obey God. They claim this will lead to a more "moral" society, one which is being threatened by permissive parenting and the disrespectful, entitled children it produces.
Who is encouraging people to do this?
Blair from The Facts of Life. No, seriously. Though she didn't invent the practice herself, former actress turned born-again Christian Lisa Whelchel heartily endorses hot saucing in her parenting book, Creative Correction. The book is published and endorsed by the hugely influential Focus on the Family, a evangelical organization that works to promote socially conservative social policy. While this book isn't exactly mainstream (it's ranked #55 in popularity among books focused on parental discipline), it does appeal to a significant portion of the population, and does influence the day-to-day discipline strategies of many, many parents.
It's just a drop of Tobasco. What's the worst that could happen?
For the record, the makers of Tobasco Sauce condemn the use of their product as a disciplinary tool. They are wise to distance themselves from hot saucers, whose children can suffer severe consequences such as burned esophagus, swollen tongue, and anaphalaxis. A third of the adult population has no tolerance for capsaicin and has a severe negative reaction to ingesting it. Children's palates are even more sensitive than that--for a capsaicin-intolerant child, a dab of hot sauce goes beyond mere pain, creating a sensation as agonizing as a lit cigarette being ground out on the tongue.
Is hot saucing always abusive?
In my opinion, yes. If we accept the notion that pain is a necessary part of punishment, then why not just squirt children in the face with pepper spray? What about tasers and shock collars? They work for subduing criminals and dogs, so why not kids? Should we bring back the hair shirt? If the ends (obedience) justify the means (pain), then where do we draw the line?
Hopefully, the controversy caused by this video will cause some hot saucing parents to renounce their ways, or at least consider alternative forms of discipline. Unfortunately, this pattern of abuse goes beyond mere hot sauce. As the above video shows, hot saucing is part of a larger disciplinary strategy, one by which the parent rules through fear and intimidation. Pain and humiliation are the desired outcomes of this form of discipline. Even if we outlaw hot saucing, abusive parents will still do it, or just find another form of torture to take its place.
How can we influence hot saucing parents to change their ways?
I don't know any parents who admit to doing it (and I kind of doubt any of them are readers of my blog), but I have a couple of arguments handy in case I find myself debating a hot saucer.
The first argument is one based on their own Christianity. I'm not a religious person myself, but I was raised as a member of the Seventh-Day Adventist church and I'm quite familiar with the Bible. I would ask the abusive parent why he or she chooses to model the behavior of the vengeful, cruel god of the Old Testament instead of after His representative here on earth, the benevolent and kind Jesus Christ. Did God intend for us to act just like Him, or was Jesus meant to provide an example of idealized human behavior? Personally, I think Jesus would have made a great dad, always ready to listen with an understanding heart, reacting to his children's misbehavior with love and gentle guidance. I have a hard time imagining the Prince of Peace shouting in a child's face, taking pleasure from inflicting misery onto one of God's most helpless and sensitive creations.
If that argument didn't get through, I would try a more practical approach. The world is an uncertain place and we're all getting older, fast. Chances are, the economy will not have significantly improved by the time our generation gets too old to work. We can't count on Social Security to still be in place, and most jobs nowadays offer no hope of pension or comfortable retirement. Who will take care of us when we are, ourselves, helpless and frail? Who will ensure that our deaths are tender and meaningful, that our memories endure after our bodies are long gone? How we treat our kids is an investment, not just in their future, but in ours as well. We have the right to expect them to be as respectful and loving as we once were. And something tells me that the poodle-haired lady from the video will die bitter and alone.
Then I see videos like this one, and I feel much better about myself.
This video is all over parenting websites, leading people to debate furiously in comment sections. The majority, thankfully, sees this as a clear-cut instance of child abuse (and the state of Alaska agrees) but an alarming number of commenters are rushing to this horrible lady's defense. Apparently, a large subset of the population still practices "hot saucing" as a disciplinary technique. But why? Who are the defenders of this practice, and are they, in fact, torturing children?
What is hot saucing?
Hot saucing refers to placing a drop of hot sauce on a child's tongue as punishment, usually for offenses such as lying, talking back, and swearing. The idea is to have the child associate the pain with the misbehavior in order to deter the behavior in the future. This is more commonly practiced among Christians (though by no means do all of them do this), who believe that children need to learn respect and obedience for parents so they will learn to respect and obey God. They claim this will lead to a more "moral" society, one which is being threatened by permissive parenting and the disrespectful, entitled children it produces.
Who is encouraging people to do this?
Blair from The Facts of Life. No, seriously. Though she didn't invent the practice herself, former actress turned born-again Christian Lisa Whelchel heartily endorses hot saucing in her parenting book, Creative Correction. The book is published and endorsed by the hugely influential Focus on the Family, a evangelical organization that works to promote socially conservative social policy. While this book isn't exactly mainstream (it's ranked #55 in popularity among books focused on parental discipline), it does appeal to a significant portion of the population, and does influence the day-to-day discipline strategies of many, many parents.
It's just a drop of Tobasco. What's the worst that could happen?
For the record, the makers of Tobasco Sauce condemn the use of their product as a disciplinary tool. They are wise to distance themselves from hot saucers, whose children can suffer severe consequences such as burned esophagus, swollen tongue, and anaphalaxis. A third of the adult population has no tolerance for capsaicin and has a severe negative reaction to ingesting it. Children's palates are even more sensitive than that--for a capsaicin-intolerant child, a dab of hot sauce goes beyond mere pain, creating a sensation as agonizing as a lit cigarette being ground out on the tongue.
Is hot saucing always abusive?
In my opinion, yes. If we accept the notion that pain is a necessary part of punishment, then why not just squirt children in the face with pepper spray? What about tasers and shock collars? They work for subduing criminals and dogs, so why not kids? Should we bring back the hair shirt? If the ends (obedience) justify the means (pain), then where do we draw the line?
Hopefully, the controversy caused by this video will cause some hot saucing parents to renounce their ways, or at least consider alternative forms of discipline. Unfortunately, this pattern of abuse goes beyond mere hot sauce. As the above video shows, hot saucing is part of a larger disciplinary strategy, one by which the parent rules through fear and intimidation. Pain and humiliation are the desired outcomes of this form of discipline. Even if we outlaw hot saucing, abusive parents will still do it, or just find another form of torture to take its place.
How can we influence hot saucing parents to change their ways?
I don't know any parents who admit to doing it (and I kind of doubt any of them are readers of my blog), but I have a couple of arguments handy in case I find myself debating a hot saucer.
The first argument is one based on their own Christianity. I'm not a religious person myself, but I was raised as a member of the Seventh-Day Adventist church and I'm quite familiar with the Bible. I would ask the abusive parent why he or she chooses to model the behavior of the vengeful, cruel god of the Old Testament instead of after His representative here on earth, the benevolent and kind Jesus Christ. Did God intend for us to act just like Him, or was Jesus meant to provide an example of idealized human behavior? Personally, I think Jesus would have made a great dad, always ready to listen with an understanding heart, reacting to his children's misbehavior with love and gentle guidance. I have a hard time imagining the Prince of Peace shouting in a child's face, taking pleasure from inflicting misery onto one of God's most helpless and sensitive creations.
If that argument didn't get through, I would try a more practical approach. The world is an uncertain place and we're all getting older, fast. Chances are, the economy will not have significantly improved by the time our generation gets too old to work. We can't count on Social Security to still be in place, and most jobs nowadays offer no hope of pension or comfortable retirement. Who will take care of us when we are, ourselves, helpless and frail? Who will ensure that our deaths are tender and meaningful, that our memories endure after our bodies are long gone? How we treat our kids is an investment, not just in their future, but in ours as well. We have the right to expect them to be as respectful and loving as we once were. And something tells me that the poodle-haired lady from the video will die bitter and alone.
Tuesday, January 25, 2011
Prescriptive Parenting, Part 2: What's the Deal With Babywise?
A while back I noticed something puzzling a friend had posted on Facebook. It was a screenshot of an iPhone sleep-training app. The idea is that app helps the weary, stressed-out parent keep track of how many minutes have actually passed (usually less than they think, I'd imagine) since the last time they were in the nursery attempting to lull a fussy child to sleep. The app itself wasn't puzzling, but the comments under the picture confused me. I don't remember them verbatim, but essentially people were scandalized that Apple would allow its users to purchase an app that facilitates child abuse.
Child abuse? Holy shit! I've never had to use sleep training myself, but I think it's a potentially useful tool for parents who are too overwhelmed by their children's crying to make sensible sleep decisions. Calling it child abuse seemed a little extreme. I commented: I don't get it. What's so bad about this? My friend commented back with links denouncing a series of parenting materials called Becoming Babywise. Apparently, a large part of this strict, Christian fundamentalist approach to parenting is devoted to structuring a child's sleep schedule, which is what got my friend so worked up. The man behind the Babywise series, an evangelical minister named Gary Ezzo, believes that babies should be sleeping through the night by eight weeks. This is among many unrealistic beliefs being promoted by a man whose only child-care expertise comes from raising his own children. But just how bad could Babywise be, and was it possible that my friend (who practices attachment parenting, breastfeeds exclusively, and considers circumcision to be genital mutilation) was just overreacting?
Trying to find unbiased sources of information on this topic was surprisingly difficult. AP advocates like Katie Allison Granju describe Babywise as a sinister right-wing Christian agenda with potentially serious consequences in terms of children's mental and physical health. But Babywise parents and members of Ezzo's GFI ministry emphasize just how normal and common-sense the approach is, especially when compared to those who take attachment parenting to extremes. Now, I admit I haven't read these books myself (nor have I read Dr.Sears's attachment parenting book), but I've tried to figure out his basic approach to parenting by finding the answers to the following qustions.
What is the Babywise stance on sleeping, and can it be considered abusive?
Like attachment parenting, Babywise is focused on the way things ought to be. In Gary Ezzo's view, children should be sleeping through the night from a very young age. Parents should expect this and plan the infant's schedule accordingly. If a child wakes up crying, the parent should let him go at it for a while before checking on him. Ideally, the baby falls back asleep on his own. This is where sleep-training apps can come in handy. Time becomes extremely relative in the wee hours of the morning, and to an exhausted, aggravated parent a minute of crying can seem like an hour.
What this method doesn't take into account are the variability of a baby's cries. Sometimes fussing and whimpering can smooth out on its own as the baby shifts position or drifts back into sleep. But if he is uncomfortable or has a wet diaper, ignoring the problem only lets him get even wider awake as he waits for help. This can be stressful for him as he wonders why you are not responding to his cries. Plus, newborns get hungry every few hours, regardless of the time of day. Trying to ignore his hunger cries can be agonizing for mom and dad (and I doubt there is a mom alive who could sleep through such a sound), but can also be distressing to the baby, who is completely overwhelmed by the intense biological need to nurse.
So, while sleep-training itself is not abusive, using it in lieu of common sense can be. If you and your baby are both utterly miserable, then what you're trying is not working. Some parents who have refused to back down from Ezzo's expectations have ended up with children that are malnourished, dehydrated, and failing to thrive. Some babies really do sleep through the night starting at eight weeks or even younger. But to expect that of all babies is wildly unrealistic and potentially harmful.
What advice does Babywise offer about feeding?
Babywise emphasizes Parent Directed Feeding (PDF), which is just what it sounds like. Unlike attachment parenting, in which the baby's hunger cues determine when he is fed, the Babywise parent decides when, how often, and how much a baby should eat. Even breastfeeding (which the program encourages mothers to do) is to be done on a strict, carefully timed schedule. The idea is that you can "train" your child to only eat at appropriate meal times, even if it means they get very hungry between meals.
As children get older, the meals get even more controlled, to the point where kids as young as eight months are expected to have impeccable high-chair manners. They are to be discouraged from playing with their food, making a mess, throwing food on the floor, or rubbing it in their hair. This discouragement is often physical, in the form of squeezing a child's hand or swatting him. Based on the way my own toddler eats, I'd imagine it is an uphill battle for parents to get their children to behave the way they "ought" to at meal times.
So, Babywise condones parents hitting their children as a form of discipline?
Yes, but only in "appropriate" ways. While information in the more secularly-oriented Babywise series doesn't go into much detail on how to spank, the more openly fundamentalist Growing Kids God's Way (which Ezzo also wrote and published, previously to Babywise) has more specific instructions. Starting when the child is 14 months old, the parent should use "a somewhat flexible instrument (that) stings without inflicting bone or muscle damage…if there is no pain, then the instrument is probably too light or too flexible." Pain is the natural outcome of bad behavior and the parent must induce pain to ensure that the child understands this life lesson.
This belief is contrary to virtually any advice given by experts in the field of child care or child psychology. Physical punishment like spanking more often than not leads to angry, troubled children. The short term, fear-based improvement in behavior can lead to more serious behavioral problems down the road.
Is everyone who follows Ezzo's advice abusing their children?
Not at all. As with attachment parenting, most people who read these books do not follow Ezzo's advice to the letter. Many people (myself included) feel that the parent should be in charge of the child's schedule concerning eating and sleeping, at least after the baby has grown out of the feeding-around-the-clock stage. And a lot of parents, especially when harried and worn-out, have let loose with the occasional swat or firm grab of a misbehaving child. This is by no means effective behavioral management, but it is a far cry from actual child abuse.
However, those who are already inclined to hurt children may see Ezzo's books as justification for their violent tendencies. Instead of feeling guilty for losing their tempers, they feel vindicated and, in some cases, holy. There is also the problem of the insecure parent who trusts Ezzo's advice over their own experiences. I imagine a young Christian first-time mother trying to ignore a wailing child, crying because she believes something must be wrong with either her child or her. This is a tragic yet plausible outcome of committing fully to Babywise.
I realize this isn't the most topical post--after all, Babywise was denounced in 1997 in a "letter of concern" to the AAP signed by approximately 100 health-care providers. Since then, it has fallen out of mainstream popularity. But I think the damage from Babywise is still being felt by parents who attempt to structure their child's eating or sleeping habits, especially when other parents are so quick to label something as abusive.
Child abuse? Holy shit! I've never had to use sleep training myself, but I think it's a potentially useful tool for parents who are too overwhelmed by their children's crying to make sensible sleep decisions. Calling it child abuse seemed a little extreme. I commented: I don't get it. What's so bad about this? My friend commented back with links denouncing a series of parenting materials called Becoming Babywise. Apparently, a large part of this strict, Christian fundamentalist approach to parenting is devoted to structuring a child's sleep schedule, which is what got my friend so worked up. The man behind the Babywise series, an evangelical minister named Gary Ezzo, believes that babies should be sleeping through the night by eight weeks. This is among many unrealistic beliefs being promoted by a man whose only child-care expertise comes from raising his own children. But just how bad could Babywise be, and was it possible that my friend (who practices attachment parenting, breastfeeds exclusively, and considers circumcision to be genital mutilation) was just overreacting?
Trying to find unbiased sources of information on this topic was surprisingly difficult. AP advocates like Katie Allison Granju describe Babywise as a sinister right-wing Christian agenda with potentially serious consequences in terms of children's mental and physical health. But Babywise parents and members of Ezzo's GFI ministry emphasize just how normal and common-sense the approach is, especially when compared to those who take attachment parenting to extremes. Now, I admit I haven't read these books myself (nor have I read Dr.Sears's attachment parenting book), but I've tried to figure out his basic approach to parenting by finding the answers to the following qustions.
What is the Babywise stance on sleeping, and can it be considered abusive?
Like attachment parenting, Babywise is focused on the way things ought to be. In Gary Ezzo's view, children should be sleeping through the night from a very young age. Parents should expect this and plan the infant's schedule accordingly. If a child wakes up crying, the parent should let him go at it for a while before checking on him. Ideally, the baby falls back asleep on his own. This is where sleep-training apps can come in handy. Time becomes extremely relative in the wee hours of the morning, and to an exhausted, aggravated parent a minute of crying can seem like an hour.
What this method doesn't take into account are the variability of a baby's cries. Sometimes fussing and whimpering can smooth out on its own as the baby shifts position or drifts back into sleep. But if he is uncomfortable or has a wet diaper, ignoring the problem only lets him get even wider awake as he waits for help. This can be stressful for him as he wonders why you are not responding to his cries. Plus, newborns get hungry every few hours, regardless of the time of day. Trying to ignore his hunger cries can be agonizing for mom and dad (and I doubt there is a mom alive who could sleep through such a sound), but can also be distressing to the baby, who is completely overwhelmed by the intense biological need to nurse.
So, while sleep-training itself is not abusive, using it in lieu of common sense can be. If you and your baby are both utterly miserable, then what you're trying is not working. Some parents who have refused to back down from Ezzo's expectations have ended up with children that are malnourished, dehydrated, and failing to thrive. Some babies really do sleep through the night starting at eight weeks or even younger. But to expect that of all babies is wildly unrealistic and potentially harmful.
What advice does Babywise offer about feeding?
Babywise emphasizes Parent Directed Feeding (PDF), which is just what it sounds like. Unlike attachment parenting, in which the baby's hunger cues determine when he is fed, the Babywise parent decides when, how often, and how much a baby should eat. Even breastfeeding (which the program encourages mothers to do) is to be done on a strict, carefully timed schedule. The idea is that you can "train" your child to only eat at appropriate meal times, even if it means they get very hungry between meals.
As children get older, the meals get even more controlled, to the point where kids as young as eight months are expected to have impeccable high-chair manners. They are to be discouraged from playing with their food, making a mess, throwing food on the floor, or rubbing it in their hair. This discouragement is often physical, in the form of squeezing a child's hand or swatting him. Based on the way my own toddler eats, I'd imagine it is an uphill battle for parents to get their children to behave the way they "ought" to at meal times.
So, Babywise condones parents hitting their children as a form of discipline?
Yes, but only in "appropriate" ways. While information in the more secularly-oriented Babywise series doesn't go into much detail on how to spank, the more openly fundamentalist Growing Kids God's Way (which Ezzo also wrote and published, previously to Babywise) has more specific instructions. Starting when the child is 14 months old, the parent should use "a somewhat flexible instrument (that) stings without inflicting bone or muscle damage…if there is no pain, then the instrument is probably too light or too flexible." Pain is the natural outcome of bad behavior and the parent must induce pain to ensure that the child understands this life lesson.
This belief is contrary to virtually any advice given by experts in the field of child care or child psychology. Physical punishment like spanking more often than not leads to angry, troubled children. The short term, fear-based improvement in behavior can lead to more serious behavioral problems down the road.
Is everyone who follows Ezzo's advice abusing their children?
Not at all. As with attachment parenting, most people who read these books do not follow Ezzo's advice to the letter. Many people (myself included) feel that the parent should be in charge of the child's schedule concerning eating and sleeping, at least after the baby has grown out of the feeding-around-the-clock stage. And a lot of parents, especially when harried and worn-out, have let loose with the occasional swat or firm grab of a misbehaving child. This is by no means effective behavioral management, but it is a far cry from actual child abuse.
However, those who are already inclined to hurt children may see Ezzo's books as justification for their violent tendencies. Instead of feeling guilty for losing their tempers, they feel vindicated and, in some cases, holy. There is also the problem of the insecure parent who trusts Ezzo's advice over their own experiences. I imagine a young Christian first-time mother trying to ignore a wailing child, crying because she believes something must be wrong with either her child or her. This is a tragic yet plausible outcome of committing fully to Babywise.
I realize this isn't the most topical post--after all, Babywise was denounced in 1997 in a "letter of concern" to the AAP signed by approximately 100 health-care providers. Since then, it has fallen out of mainstream popularity. But I think the damage from Babywise is still being felt by parents who attempt to structure their child's eating or sleeping habits, especially when other parents are so quick to label something as abusive.
Monday, January 3, 2011
Safe and Effective Cough and Cold Treatment for Children Under Four
Watching your young child suffer through a cold or flu virus is a particularly insidious form of torture. The snot, the ragged breathing, the pervasive crankiness. To add to the misery, the primary caregiver and snot wiper (in our family's case, me) often catches the same bug. The caregiver, however, has the option of taking drugs to alleviate the symptoms. A couple teaspoons of Tussin and I'm good to go, or at least able to breathe again. Not so for my little guy. The warning labels on children's cough and cold medicine have changed since my days in child care, strongly advising us not to administer doses to kids under four.
If you're anything like me, you wonder why. What happened in the past few years to change these products from helpful symptom relief to little-kid poison? Don't these things help children to sleep, breathe, and just plain feel better? What prompted the American Association of Pediatrics to change their guidelines and what can we do to help our little sickie-poos feel better?
Which cough and cold medicines are affected by the new guidelines?
Antihistamines, decongestants, antitussives (cough suppressants), and expectorants. These active ingredients are found in a wide variety of products marketed for relief of cough and cold.
Pain relievers/fever reducers such as acetaminophen (Tylenol) and ibuprofen (Advil) are still okay for use in infants and small children, provided doses are measured properly.
Why did the AAP make these changes?
According to an FDA advisory panel, these products are ineffective and potentially hazardous when given to small children. There is not enough evidence of efficacy to justify the risk of adverse reaction or overdose.
Ineffective? But doesn't it make kids feel better, or at least help them sleep?
Intuitively, this seems to make sense. The caregiver doses the miserable, crying, phlegmy child with medicine and, usually within the hour, the child becomes drowsy and seems to breathe more easily. The medicine must have worked, right?
Not necessarily. The caregiver has fallen prey to the post hoc ergo propter hoc fallacy--in other words, he or she has confused correlation with causation. I admit I've fallen for this one myself; it's easy to attribute the seeming regression of symptoms to the administration of a drug. However, viral illness is not a fixed, static state. Symptoms fluctuate, with peaks of misery followed by valleys of relative improvement. Chances are, the kid would have calmed down and fallen asleep regardless, with or without the medicine.
In fact, one study comparing dipenhydramine (Benadryl) and dextromethorphan (cough suppressant) to a placebo found that cough and cold medicines are not effective in providing nocturnal symptom relief for children, nor do they improve quality of sleep for their parents. In other words, the family of a sick kid will be awake and miserable whether the kid is medicated or not. But there is a silver lining to this bummer of a study--all families in the study reported significant improvement on the second night, regardless of whether the children were given placebos or drugs.
Are cough and cold medicines really dangerous?
Not if administered properly; most adverse reactions are due to dosing errors and accidental ingestion. If parents are diligent about measuring doses (and can tell a mL from a tsp), and always keep medicines out of reach, that shouldn't be a problem. Unfortunately, a recent study shows that parents are quite likely to incorrectly measure a dose (especially with the little plastic measuring cups--oral syringes are far more accurate), usually giving more than the recommended amount. In fact, emergency rooms visits for "adverse events" (i.e. overdoses) decreased substantially after the withdrawal of infants' cough and cold formulas from the market.
What about alternative remedies? Are they safe and effective?
While many people swear by Airborne, Oscillococcinum, and Zicam, there is no credible evidence that these products work as advertised. Not only are they ineffective for symptom relief beyond the placebo effect, but they can also have serious side effects. Airborne containsVitamin A, which is toxic in high amounts. The makers of Zicam were sued and settled out of court after their product caused more than 130 people to lose their sense of smell. And a homeopathic remedy like Ocsillococcinum poisoned children after manufacturing errors led to an excess of an active ingredient (usually active ingredients are diluted until not a trace molecule remains, as in all "true" homeopathic remedies). Considering the typically high price of these products, there seems to be very little benefit to justify the risks.
What can I do to help my poor baby feel better?
Medically speaking, not much. Cool-mist humidifiers can help ease congestion. If you're brave (and your child will let you), you can use a bulb aspirator to suck snot from the nostrils (be sure you're using it correctly so you don't puff air up there). You can also use saline drops to soothe and loosen the sinuses, and children's Vapo-Rub to help the child breathe (though this is not recommended for children under 2 because of the toxicity of camphor if ingested and the possibility of skin irritation).
Mostly, you just need to be patient. Kids get 6-10 colds a year on average, which tend to last up to two weeks at a time. That's a lot of snotty nights and grouchy days. But if you keep your child hydrated, well-fed, and comfortable, he or she will get better in a reasonable amount of time. Short of keeping children in a plastic bubble, there is no reliable way to prevent or cure occasional viral outbreaks. We just have to get through them the best we can. Children under four should be doing that without the aid of medication.
It's tempting to head to the drug store to buy something, anything, that will help our sick kids. It makes us feel in control, like we're being proactive and doing something to make what's wrong right again. But beyond that fleeting feeling of being a "good" parent, very little is gained from the purchase and administration of over the counter cough and cold remedies.
If you're anything like me, you wonder why. What happened in the past few years to change these products from helpful symptom relief to little-kid poison? Don't these things help children to sleep, breathe, and just plain feel better? What prompted the American Association of Pediatrics to change their guidelines and what can we do to help our little sickie-poos feel better?
Which cough and cold medicines are affected by the new guidelines?
Antihistamines, decongestants, antitussives (cough suppressants), and expectorants. These active ingredients are found in a wide variety of products marketed for relief of cough and cold.
Pain relievers/fever reducers such as acetaminophen (Tylenol) and ibuprofen (Advil) are still okay for use in infants and small children, provided doses are measured properly.
Why did the AAP make these changes?
According to an FDA advisory panel, these products are ineffective and potentially hazardous when given to small children. There is not enough evidence of efficacy to justify the risk of adverse reaction or overdose.
Ineffective? But doesn't it make kids feel better, or at least help them sleep?
Intuitively, this seems to make sense. The caregiver doses the miserable, crying, phlegmy child with medicine and, usually within the hour, the child becomes drowsy and seems to breathe more easily. The medicine must have worked, right?
Not necessarily. The caregiver has fallen prey to the post hoc ergo propter hoc fallacy--in other words, he or she has confused correlation with causation. I admit I've fallen for this one myself; it's easy to attribute the seeming regression of symptoms to the administration of a drug. However, viral illness is not a fixed, static state. Symptoms fluctuate, with peaks of misery followed by valleys of relative improvement. Chances are, the kid would have calmed down and fallen asleep regardless, with or without the medicine.
In fact, one study comparing dipenhydramine (Benadryl) and dextromethorphan (cough suppressant) to a placebo found that cough and cold medicines are not effective in providing nocturnal symptom relief for children, nor do they improve quality of sleep for their parents. In other words, the family of a sick kid will be awake and miserable whether the kid is medicated or not. But there is a silver lining to this bummer of a study--all families in the study reported significant improvement on the second night, regardless of whether the children were given placebos or drugs.
Are cough and cold medicines really dangerous?
Not if administered properly; most adverse reactions are due to dosing errors and accidental ingestion. If parents are diligent about measuring doses (and can tell a mL from a tsp), and always keep medicines out of reach, that shouldn't be a problem. Unfortunately, a recent study shows that parents are quite likely to incorrectly measure a dose (especially with the little plastic measuring cups--oral syringes are far more accurate), usually giving more than the recommended amount. In fact, emergency rooms visits for "adverse events" (i.e. overdoses) decreased substantially after the withdrawal of infants' cough and cold formulas from the market.
What about alternative remedies? Are they safe and effective?
While many people swear by Airborne, Oscillococcinum, and Zicam, there is no credible evidence that these products work as advertised. Not only are they ineffective for symptom relief beyond the placebo effect, but they can also have serious side effects. Airborne containsVitamin A, which is toxic in high amounts. The makers of Zicam were sued and settled out of court after their product caused more than 130 people to lose their sense of smell. And a homeopathic remedy like Ocsillococcinum poisoned children after manufacturing errors led to an excess of an active ingredient (usually active ingredients are diluted until not a trace molecule remains, as in all "true" homeopathic remedies). Considering the typically high price of these products, there seems to be very little benefit to justify the risks.
What can I do to help my poor baby feel better?
Medically speaking, not much. Cool-mist humidifiers can help ease congestion. If you're brave (and your child will let you), you can use a bulb aspirator to suck snot from the nostrils (be sure you're using it correctly so you don't puff air up there). You can also use saline drops to soothe and loosen the sinuses, and children's Vapo-Rub to help the child breathe (though this is not recommended for children under 2 because of the toxicity of camphor if ingested and the possibility of skin irritation).
Mostly, you just need to be patient. Kids get 6-10 colds a year on average, which tend to last up to two weeks at a time. That's a lot of snotty nights and grouchy days. But if you keep your child hydrated, well-fed, and comfortable, he or she will get better in a reasonable amount of time. Short of keeping children in a plastic bubble, there is no reliable way to prevent or cure occasional viral outbreaks. We just have to get through them the best we can. Children under four should be doing that without the aid of medication.
It's tempting to head to the drug store to buy something, anything, that will help our sick kids. It makes us feel in control, like we're being proactive and doing something to make what's wrong right again. But beyond that fleeting feeling of being a "good" parent, very little is gained from the purchase and administration of over the counter cough and cold remedies.
Thursday, December 2, 2010
Prescriptive Parenting, Part 1*: Does Attachment Parenting Victimize Women?
Feminist author Erica Jong recently wrote an article in the Wall Street Journal in which she heavily criticizes Attachment Parenting (the child-rearing philosophy pioneered by William and Martha Sears), accusing it of encouraging female victimization. She calls it a "perfect tool for the political right", promoting an unhealthy obsession with motherhood and convincing women that they're happier barefoot and pregnant at home than they would be pursuing their own careers in the workplace. Our feminist foremothers, she claims, would be appalled. Now, anyone who has read Jong's Fear of Flying or attended one of her lectures (I have done both) knows she has a penchant for the dramatic, and this article is no exception. But strident tone aside, Jong does raise some valid concerns about one of the most prominent fads in modern parenthood.
But not if you ask Attachment Parenting (AP) advocates Katie Allison Granju and Jillian St. Charles, who wrote a scathing rebuttal in the New York Times, in which they call Jong's article a "broad and unfocused screed," and a "lengthy, preachy, and ultimately pointless laundry list of crimes she believes parents are committing". They react as many AP followers react to criticism of their beliefs: by taking personal offense at what they perceive to be a direct attack. They reflexively circle the wagons and launch verbal arrows at their enemies, pointing out (irrelevantly) that Jong is 68 years old, from a generation of "second-wave" feminists who denies "the reality that many women ... are fulfilled by parenting their kids." They claim (apparently on behalf of all women) that "our most valued, fulfilling role is the one we take on as mothers to our children."
The word fulfilling pops up a lot in AP literature, usually to describe a woman's "natural" feelings towards motherhood. According to Dr.Sears's own website: "Being in harmony with your baby is one of the most fulfilling feelings a mother can ever hope to have." He also claims that "the mother feels right when she is together with her baby and not right when separated." That's how a mother knows she is securely "attached" to her child.
Like Jong, I have a problem with this attitude. While I don't deny that my son is the center of my life, to say that I am fulfilled by staying at home and taking care of him (which implies that I don't need anything else to feel "complete") is a bit of a stretch. If other women are made utterly happy by the sometimes wonderful, sometimes infuriating task of motherhood, to the point where time spent alone feels wrong, well, good for them, I guess. But to extrapolate that that's the way all women ought to feel is what I take offense to.
Not to mention that this attitude undermines whatever women have accomplished (or hope to accomplish)outside of the home. What of their careers, hobbies, interests, and relationships outside the family? If these things cease to matter when one becomes a mother, did they ever matter to begin with? I also find it insulting as a woman who struggled with infertility--was I a lesser woman when I was trying to get pregnant than I am now for having succeeded?
Don't get me wrong, I think my kid is the most adorable, brilliant, amazing creature who ever lived. His laughter makes me happier than any other sound on earth and I'll go to ridiculous lengths to provoke it. I'm incredibly proud of every one of his accomplishments, no matter how trivial or mundane they may seem to an outsider. Before he was even born, I rearranged my whole life so I could be his primary caregiver, quitting a job as a nanny and finding work I can do seasonally and from home. I didn't do this out of obligation or to fulfill my biological destiny, but because I felt like my years of looking after other people's kids had made me a high-quality caregiver; it seemed unlikely that my husband and I would be able to afford to send my son to a preschool or day care that would provide a better learning environment than what I could provide at home. I can't give my son much by way of material things, but I can give him the lifelong advantage that comes from having a former preschool teacher for a parent.
But despite my devotion to his well-being, he is still a selfish, irrational, loud 18-month-old. I love to grab a few hours to myself, letting dad or a babysitter deal with the screaming, the runny nose, and the food throwing. During these outings, I don't miss Little H at all; in fact, I don't even think of him that often. I get to focus on the parts of my life that have nothing to do with him, like meeting with my writers circle or catching up with a friend over a drink or three. When I get home I am always delighted to see him, ready to slip back into my all-consuming "mommy" role. I consider these outings crucial to both my sanity and to my identity, but according to the principles of Attachment Parenting, this means I must be doing something wrong. After all, if we were securely attached, I would want him with me everywhere I go and I would trust no one, not even his own father, to be able to care for him as well as I can.
Let me make it clear that I am not bad-mouthing parents who use Attachment Parenting as a guideline in rearing their children. I try very hard not to judge other (non-abusive) people for their parenting choices. If moms want to wear their babies in slings, breastfeed exclusively and on the baby's schedule, and co-sleep in a family bed, that's within their rights as parents. And I realize that most women who care for their infants in this way are not slaves to dogma; many adapt the principles of AP to their own families and situations, focusing on the overall positive AP values of fostering empathy and trust. Rather, I take issue with the insistence that all mothers have an obligation to subvert their own needs and identities to fill their "natural" role of child-rearing. It has led to a nagging voice in the heads of all mothers who feel that they must be coming up short if they ever, even for just an hour, are not completely in thrall of their children.
Little H may be completely dependent on me now, but in time he'll grow to have his own interests and friends, entire parts of his life in which he'd prefer me not to intrude. If I have completely identified with my role as mother, who will I be when he grows up and leaves the nest? What will I have to offer my adult child if I spent his youth arresting my own development? I love being a mother, but there's so much more to me than just that. I refuse to feel guilty for acknowledging this.
*This is the first post in a three (or more) part series in which I try to provide a skeptical viewpoint to counterbalance "expert" advice. Next on the chopping block: Gary Ezzo's Babywise.
But not if you ask Attachment Parenting (AP) advocates Katie Allison Granju and Jillian St. Charles, who wrote a scathing rebuttal in the New York Times, in which they call Jong's article a "broad and unfocused screed," and a "lengthy, preachy, and ultimately pointless laundry list of crimes she believes parents are committing". They react as many AP followers react to criticism of their beliefs: by taking personal offense at what they perceive to be a direct attack. They reflexively circle the wagons and launch verbal arrows at their enemies, pointing out (irrelevantly) that Jong is 68 years old, from a generation of "second-wave" feminists who denies "the reality that many women ... are fulfilled by parenting their kids." They claim (apparently on behalf of all women) that "our most valued, fulfilling role is the one we take on as mothers to our children."
The word fulfilling pops up a lot in AP literature, usually to describe a woman's "natural" feelings towards motherhood. According to Dr.Sears's own website: "Being in harmony with your baby is one of the most fulfilling feelings a mother can ever hope to have." He also claims that "the mother feels right when she is together with her baby and not right when separated." That's how a mother knows she is securely "attached" to her child.
Like Jong, I have a problem with this attitude. While I don't deny that my son is the center of my life, to say that I am fulfilled by staying at home and taking care of him (which implies that I don't need anything else to feel "complete") is a bit of a stretch. If other women are made utterly happy by the sometimes wonderful, sometimes infuriating task of motherhood, to the point where time spent alone feels wrong, well, good for them, I guess. But to extrapolate that that's the way all women ought to feel is what I take offense to.
Not to mention that this attitude undermines whatever women have accomplished (or hope to accomplish)outside of the home. What of their careers, hobbies, interests, and relationships outside the family? If these things cease to matter when one becomes a mother, did they ever matter to begin with? I also find it insulting as a woman who struggled with infertility--was I a lesser woman when I was trying to get pregnant than I am now for having succeeded?
Don't get me wrong, I think my kid is the most adorable, brilliant, amazing creature who ever lived. His laughter makes me happier than any other sound on earth and I'll go to ridiculous lengths to provoke it. I'm incredibly proud of every one of his accomplishments, no matter how trivial or mundane they may seem to an outsider. Before he was even born, I rearranged my whole life so I could be his primary caregiver, quitting a job as a nanny and finding work I can do seasonally and from home. I didn't do this out of obligation or to fulfill my biological destiny, but because I felt like my years of looking after other people's kids had made me a high-quality caregiver; it seemed unlikely that my husband and I would be able to afford to send my son to a preschool or day care that would provide a better learning environment than what I could provide at home. I can't give my son much by way of material things, but I can give him the lifelong advantage that comes from having a former preschool teacher for a parent.
But despite my devotion to his well-being, he is still a selfish, irrational, loud 18-month-old. I love to grab a few hours to myself, letting dad or a babysitter deal with the screaming, the runny nose, and the food throwing. During these outings, I don't miss Little H at all; in fact, I don't even think of him that often. I get to focus on the parts of my life that have nothing to do with him, like meeting with my writers circle or catching up with a friend over a drink or three. When I get home I am always delighted to see him, ready to slip back into my all-consuming "mommy" role. I consider these outings crucial to both my sanity and to my identity, but according to the principles of Attachment Parenting, this means I must be doing something wrong. After all, if we were securely attached, I would want him with me everywhere I go and I would trust no one, not even his own father, to be able to care for him as well as I can.
Let me make it clear that I am not bad-mouthing parents who use Attachment Parenting as a guideline in rearing their children. I try very hard not to judge other (non-abusive) people for their parenting choices. If moms want to wear their babies in slings, breastfeed exclusively and on the baby's schedule, and co-sleep in a family bed, that's within their rights as parents. And I realize that most women who care for their infants in this way are not slaves to dogma; many adapt the principles of AP to their own families and situations, focusing on the overall positive AP values of fostering empathy and trust. Rather, I take issue with the insistence that all mothers have an obligation to subvert their own needs and identities to fill their "natural" role of child-rearing. It has led to a nagging voice in the heads of all mothers who feel that they must be coming up short if they ever, even for just an hour, are not completely in thrall of their children.
Little H may be completely dependent on me now, but in time he'll grow to have his own interests and friends, entire parts of his life in which he'd prefer me not to intrude. If I have completely identified with my role as mother, who will I be when he grows up and leaves the nest? What will I have to offer my adult child if I spent his youth arresting my own development? I love being a mother, but there's so much more to me than just that. I refuse to feel guilty for acknowledging this.
*This is the first post in a three (or more) part series in which I try to provide a skeptical viewpoint to counterbalance "expert" advice. Next on the chopping block: Gary Ezzo's Babywise.
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