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Sleep? What Sleep?

“The one thing nobody told me about having a baby was about sleep and how exhausted I would be! I haven’t had a good night’s sleep in over six months!”

Many new parents are completely unprepared to cope with a baby who does not sleep well, who wakes up much more often than normal during the night and cries.  Some infants begin to sleep through the night almost immediately and others do not do so for many months.  Newborns lack a regular pattern for waking and sleeping. Their sleep-deprived parents quickly reach a peak of frustration and experience intense emotions as they struggle to meet the 24/7 demands of their child, at the same time trying to balance that with their own needs for sleep. Dazed parents groggily note this night after night, when the baby wakes time after time for feeding or comforting.  For a while parents have to adapt their own sleep cycle to the baby’s irregular sleep, taking catnaps and rising out of deep sleep to attend the baby’s needs.  The situation intensifies if the parents are arguing about how to handle the situation.

These parents have a dangerous amount of sleep debt. Parents of newborns are said to lose 2 hours of sleep per night until the baby is around 5 months old, which decreases to 1 lost hour per night during ages 5-24 months.  Sleep and nap times shift steadily from day to day, so that parents might find themselves up at midnight one night and at 3am the next. Over the first year of a baby’s life, parents each lose an estimated 350 hours of sleep at night.  Preparation for parenthood needs to include a consideration of strategies for parents to cope with their own loss of sleep as well as wakeful babies.

After a long labor that ended up in a cesarean, and then nights with little sleep, my postpartum days were a fog.  I had all the symptoms of sleep debt – lack of focus and clarity, impatience, worry and anxiety, low energy, and crying.   My husband was in medical school and not home to help much.  My mother insisted on doing everything for me, even taking care of the baby which I wanted to do. My daughter cried a lot and my pediatrician told me it was because I was vegetarian – she couldn’t have been more wrong.

Most people in America today are suffering from some sleep debt and go about their days feeling that the tiredness is normal.  Birthing parents are likely in sleep debt even before they give birth to their baby being up through the night to change positions and urinate due to pressure of the fetus on the bladder.  Couple this with a long labor followed by needing to be awake night after night to feed and soothe their baby.  And what if their baby is one who does not sleep through the night for many months?

Even before pregnancy, we as a nation are sleep deprived and go about our days feeling that tiredness is normal.  This is mostly due to the invention of a single and profound technological advance – the light bulb (1879). Now we could work late into the night, or read for pleasure into the wee hours of the morning. The light bulb mimics daylight and has the ability to shift our internal biological clocks.

When I was travelling around the world years ago with my husband, we often slept in places that had no electricity.  We found ourselves going to sleep just after sunset and rising at sun rise.  We became more familiar with the zodiac moving across the night sky.  We were more in tune with the earth’s rhythms and felt more energy.  There was no light bulb to keep us up. The light bulb has upset the natural order.

When new parents know what to anticipate and expect, and when they have the support they need, the postpartum period can even be enjoyable. I wish I had known more.

Did you know….

  • Our sleep begins well before we are born. The fetus spends most of his time asleep – about 16-20 hours a day.  Many women believe their baby is awake when kicking inside, but the baby is most likely asleep which explains why pregnant women can feel kicking at almost any hour.
  • We have biological clocks and circadian rhythms: The internal pacemaker or biological clock located deep in the brain in two pinhead-size clusters of nerve cells called the suprachiasmatic nuclei or SCN, controls a profound daily continuing oscillation approximating 24 hours. These cycles are called our circadian rhythms. They can be seen in almost every function in the body, from basic cell processes to activities of the whole body.
  • Circadian sleep cycles cross the placenta

The circadian sleep cycles begin before birth by passing across the placenta.  Even though the fetus isn’t exposed to light from outside the womb and can’t tell when it is night or day, the mother is communicating this information to her baby. Research on rats and mice at Harvard University showed that these signals from the mother actually stimulate the fetus to mirror its mother’s circadian cycles.  They found that the mothers’ fluctuating melatonin hormonal levels signal the biological clock in the fetal brain, preparing the babies for the rhythms of life outside the womb.

  • The mother’s circadian rhythm seems to act as a gatekeeper, inhibiting birth during the day and promoting it at night. That is why women often go through “false labor” the night or two before actual labor begins. The mother’s circadian rhythm is opening the gate to a nighttime delivery, even before the baby’s biochemical push to be born is strong enough.
  • The fetus starts labor: The fetus signals the mother when its body is mature and ready to be born and actually starts the labor process. All mammals tend to give birth during the time they normally would be asleep, possibly to make sure the birth happens “at home” and safe from predators.
  • When does dreaming begin? Rapid Eye Movement (REM)

It was found that near term fetuses have about 60-80% of the sleep time in REM sleep, also known as “dream sleep.” Typical newborns spend about eight hours in REM sleep, about 50 percent of their daily sleep. As adults, we spend about 25% or about two hours a night in REM sleep. By old age we have only 15-20% REM sleep.

Immediately after birth, there are only two sleep stages, REM and non-REM sleep.  REM sleep is sometimes called active sleep in babies because the muscular paralysis that always accompanies such sleep is not fully developed. Non-REM sleep on the other hand is often called quiet sleep, because the baby is sleeping like a baby, perfectly still, quiet, and limp.

At birth, infants usually sleep 16-18 hours per day, distributed evenly over six to seven brief sleep periods.  They can pass directly from wakefulness to REM sleep and alternate between REM and non-Rem sleep every 60 minutes or so instead of the 90 minutes adults take to cycle from REM sleep.

Newborns can’t talk but very young children can and do talk about their dreams. Less       than two years old, a little girl was sleeping one morning and her father heard her say           “pick me, pick me.” He looked at her eyes and saw some typical rapid eye movements.        He woke her and she said ‘Oh Daddy, I was a flower.”

  • Newborn sleep states: We now know that a newborn gradually develops more sleep states and these are not random. Stages that have been identified are Deep Sleep (quiet sleep), Light Sleep (active sleep), Quiet Alert state, Active Alert State, Crying State, and Drowsy State. The best time to play with a baby is in the Quiet Alert state.
  • Baby’s biological clock matures gradually. A newborn’s biological clock matures gradually to keep track of the time of day. Therefore, imposing a regular pattern of sleeping and waking is bound to be met with distress for both the parents and baby. However, providing cues such as light in the morning and evening dim light along with regular feeding schedules, can help them along as their biological clocks are maturing. Because new infants have a strong homeostatic sleep drive, they build up sleep debt over a few hours and then pay it back right away with a nap. This continues throughout the 24 hour day until their biological clock is mature.
  • Sleep by the age of 12 months: By the end of the first year, the overall number of sleeping and waking hours has changed very little. The infant still sleeps 14 to 15 hours a day. Except for one to two daytime naps, the sleep periods have shifted to the night and the waking periods to the day.  By about 18 months of age, most toddlers are taking only one nap.  Children slowly sleep less and less until their daily sleep measures about 10 hours which holds steady until they reach puberty.
  • Dangers of sleep debt: Without warning, drowsiness can become sleep in an instant. You are only a few seconds from sleep when your eyelids begin feeling heavy. When the biological clock is not alerting the brain, the sleep debt pushes it toward sleep. The biological clock is at its lowest ebb in the middle of the night and people are more prone to distractions, lack of focus, poor memory, bad mood, and slow reaction times.  This is life threatening if for example you are driving a car.

What you can do…

  • Napping – the most important solution

Taking naps is an excellent and respectable strategy for sleep management.  Naps can make you smarter, faster, and safer than you would be without them.  They should be widely recognized as a powerful tool in battling fatigue and the person who chooses to nap should be regarded as heroic. The longer the nap, the greater the benefit and the benefits seem to be long-lasting. A 45 minute nap improves alertness for 6 hours after the nap. And for 10 hours after a 1-hour nap.  The rule of thumb for new mothers is:  “Sleep when your baby sleeps.”

  • Faith and Surrender: Surrender to the process of parenting, and even in your most tired moments, remember that amazing thing you have done to conceive, grow, and birth a baby.  Have faith that it will get easier as he/she sleeps through the night.
  • Drink a glass of water and feel the peace that it brings.
  • See birth as a miracle: Yes, your life has changed, but soon you will hardly remember the time before birth. Babies and young children make us smile. Their joy is immeasurable.
  • Breathe deeply and slowly: Take long deep slow breaths in and out when you feel you have reached your limits.  Practice awareness by closing your eyes, breathing in love and breathing out your worries.

 

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When Will my Baby Sleep Through the Night?

By: Katie Sanzi, Certified Pediatric Sleep Consultant and owner of Sleepyhead Consulting

This is a difficult question to answer without getting into some specific details, which is unfortunate, because when parents ask me this, I know they’re looking for a quick, concise, time-based answer.

“Three nights from now,” or “Six months old,” are the kind of responses they’re hoping for, and the kind I wish I could give them, but there are a lot of factors to consider, and some things to understand before you can narrow down the timeline.

The first thing I feel parents need to understand is this…

Your baby will never sleep through the night.

That’s right! They won’t sleep through the night when they’re toddlers, or when they’re teenagers, or when they’re grown-ups, because nobody ever does.

We human beings sleep in cycles, which vary from light sleep to deep sleep and back again. Occasionally, when we get into the light sleep stage of a cycle, we hear a noise, or we’re in the middle of a crazy dream, or the dog jumps on the bed, or we just shift a little, and that little thing, whatever it may be, is just enough to wake us up.

As adults, we have experienced this thousands of times, so we just shake it off and go back to sleep. Most of the time, the wake-up is so brief that we don’t even remember it the next day.

But for babies who are used to being rocked, sung, bounced or nursed to sleep, waking up in the night requires external help to get back into a peaceful slumber.

So that’s the reason why baby’s never going to sleep through the night, but then, that’s not what parents are really asking.

What they want to know is, “When will my baby be able to get back to sleep on their own?”

That’s a much easier question to answer. Quite simply, this will happen when they learn how.

When you teach your little one to go to sleep on their own, they’ll be able to employ that skill multiple times a night, every night, for the rest of their lives.

Now, there’s more to it than just leaving your baby alone in their crib and letting them figure it out for themselves. Don’t get me wrong, that approach has worked for a lot of people, but it’s not one that everybody is comfortable using, and it’s not the most gentle or effective way of teaching your baby great sleep skills.

The traditional Cry-It-Out approach is a lot like leaving your child in front of a piano with some sheet music and saying, “Figure it out.” Eventually, they just might, and you might just have the Elton John of sleeping on your hands. But assuming your child isn’t gifted in the sleep department, (and I’m just assuming they’re not, since you’re reading this) they could probably benefit with some lessons.

And as with any skill that a child needs to learn, practice is essential, so let them give it a shot. There’s probably going to be a bit of crying, but that doesn’t mean you can’t go in and encourage, comfort and reassure them.

What you shouldn’t do, however, is sit down at the piano and play it for them. Obviously, that doesn’t teach them anything. So whatever it is that you’ve traditionally done to get your child to go to sleep in the evening, or in the middle of the night, whether it’s giving them a pacifier, rocking them back to sleep, nursing them, whatever, these “sleep props” are the equivalent of playing the piano for your child to teach them how.

They may be frustrated, they may get upset, but they’ll learn with a little time and practice.

So although I can’t give an exact date or age when your baby will go through the night without crying and demanding help to get back to sleep, I can tell you without hesitation that it will be much, much sooner if you stop doing it for them.

As for teaching your little one to play piano, you’re on your own with that one.

 

Sleepyhead Consulting, LLC
570-436-3390
PO Box 36, Lattimer Mines, PA 18234

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Ten Tips for a Healthy Postpartum

by Brittany Sharpe McCollum, CCE(BWI), CD(DONA)

In an ideal world. the fleeting days of new parenthood are spent cocooned in a warm family bed
with meals being prepared and all the family’s basic needs being met. However, the reality is
that enjoying the early moments of new parenthood can be a challenge. In a society where
family and friends are often working or living far away, being a new parent can feel isolating and
overwhelming. Some simple tips for reclaiming the traditional postpartum period as a time for
bonding and nourishment may help to ease the transition into the new family dynamic and
encourage a healthier place for both the mind and the body in this phase of the childbearing
year.

Prepare for the postpartum while still pregnant. Anticipate your needs by talking with friends
and family members about what helped them most in their postpartum. Prepare foods that can
be frozen for quick meals and ask a close friend to organize a meal train and/or postpartum help
from those close to you.

Be assertive. Let your partner, family, and friends know clearly what your needs are and how
they can meet them. Request the help before it reaches a point where feelings of frustration
have taken over.

Make a daily list for family and friends. People love to stop by to see the new baby and often
want to lend a hand while they are visiting. Having a list of chores posted on the door that
friends and family can easily see – throw in some laundry, empty the dishwasher, pick up some
veggies at the farmers market – makes it easy to accept the help that people offer.

Make a list for yourself. As you think of tasks that you need to complete such as answering
emails or returning phone calls, write them down. Set a goal of completing one of these tasks
per day. Checking them off will offer satisfaction while the list will keep your thoughts organized
and manageable.

Let go of expectations. Recognizing that the main goal of the postpartum period is to heal the
body and bond with the baby helps a new parent let go of the constant to-do list that is often in
the back of the mind. Give yourself permission throughout the day to just rest and nestle in with
your baby.

Eat real food and stay hydrated. Nourishing food is the backbone of a healthy postpartum.
Encourage friends and family to bring over favorite dishes. Write down a few foods that you can
make and eat with one hand (smoothies are great for packing in lots of nutrients all in one
place). Eat the colors of the rainbow and focus on foods that can either be grown, hunted, or
fished (as in, stay away from foods with ingredients you can’t pronounce and unidentifiable
contents). Make sure you are taking in about half your body weight in ounces of fluid per day to
keep your body from retaining excess water (yes, you read that right!) and to help balance
electrolytes and hormones.

Set aside 20 minutes per day for yourself. Take time each day where the baby is well cared
for by someone else (a partner, a friend, a trusted neighbor) and grab a shower or bath, a quick
nap, or do some gentle stretching.

Take time with a partner or close friend. Spend time doing things that connect you to the
person you were before your little one arrived. Watch a movie, cook a meal together, play a
board game.

Sleep when your baby sleeps. It’s a cliche but a true one for sure. Babies sleep for roughly
16 hours per day but the sleep is inconsistent and often while eating. Allow yourself to rest with
your baby for at least a half hour every day and take a longer nap at least three times per week.
Even just a short time with your eyes closed and your body relaxed can leave you feeling
rejuvenated and energized.

Move your body. Get outside with your baby for a walk around the block. Dance in the house
with your baby in a wrap or a carrier. Breathe deeply and stretch your muscles.

Take care of the physical, emotional, and spiritual aspects of yourself and let others care for you
too. Your body and your baby will thank you.



Jequier E. and Constant F. “Water as an essential nutrient: the physiological basis of hydration.”!
Eur J Clin Nutr. 2010 Feb;64(2):115-23. doi: 10.1038/ejcn.2009.111. Epub 2009 Sep 2. 18 Feb
2018.

Margaret R., John L. Cox, Stella Neema, Paul Asten, Nine Glangeaud-Freudenthal, Barbara
Figueiredo, Laura L. Gorman, Sue Hacking, Emma Hirst, Martin H. Kammerer, Claudia M. Klier,
Gertrude Seneviratne, Mary Smith, Anne-Laure Sutter-Dallay, Vania Valoriani, Birgitta Wickberg,
Keiko Yoshida. “Postnatal depression across countries and cultures: a qualitative study.”
The British Journal of Psychiatry Jan 2004, 184 (46) s10-s16; DOI: 10.1192/bjp.184.46.s10. 18
Feb 2018.

Popkin, Barry M., Kristen E. D’Anci, and Irwin H. Rosenberg. “Water, Hydration, and Health.”
Nutr Rev. 2010 Aug; 68(8): 439-458: doi: 10.1111/j.175304887.2010.00304.x

Kitzinger, Sheila. Rediscovering Birth. UK: Little, Brown and Company, 2000. Print.

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Women Face the Risk of Pelvic Organ Prolapse after Childbirth

Elizabeth Carrollton writes about defective medical devices and dangerous drugs for Drugwatch.com.

One of the main reasons pelvic organ prolapse (POP) occurs is due to childbirth. The stress of birth can, in some cases, shift the organs in the pelvis from their normal positions. The most common organs affected during childbirth are the bladder and the uterus itself. When this occurs, the symptoms can be mild or severe, depending on the type and extent of the prolapse.

The most common symptom is a feeling of fullness or pressure in the lower abdomen. Frequent urination and incontinence are common with a prolapsed bladder. As the prolapse worsens, the feeling of pressure can change to pain, and the condition can be very uncomfortable and debilitating.

There are several treatments for pelvic organ prolapse, and recently, the use of an implant called transvaginal mesh has become very common. During this procedure, a light mesh material is inserted through the vagina to help secure the prolapsed organs. While in theory this seems like a great solution for pelvic organ prolapse, in reality there have been numerous complications associated with this procedure. Photobucket

These complications have been reported with increasing frequency to the Food and Drug Administration (FDA). Between the years of 2008 and 2010, more than 2,800 complaints about the transvaginal mesh procedure were logged. The FDA has made these complaints public in order to help patients realize the risk they are facing if they elect to go ahead with this procedure.

The most common side effect following transvaginal mesh surgery is the erosion of the mesh into other organs. This erosion can cause bleeding and other side effects. Another common complication is the actual wearing through of the vaginal walls, as the mesh presses against them. This is a very serious complication that can result in internal bleeding and serious infections. Because of such severe complications, mesh users have started to file a transvaginal mesh lawsuit against the mesh manufacturers. Photobucket

Other side effects noted by the FDA include pain and neuromuscular problems following the procedure. Unfortunately, many doctors are not aware of the complications that their patients are facing with this procedure. It appears that few are properly trained in the insertion of the transvaginal mesh, and this in part explains the high rate of complications associated with the procedure.

The FDA is continuing to monitor the problems associated with transvaginal mesh surgery. The agency has ordered dozens of mesh manufacturers to conduct safety studies on their products.

If your doctor has recommended transvaginal mesh, it is vital to understand the potential risks you may face. While all surgical procedures carry risks, the number of complaints associated with mesh are cause for real concern.

Ask your doctor if there are alternatives to this procedure. For minor cases, simple muscle exercises can be used to help shift the prolapsed organs back into place and strengthen the vaginal walls. Serious cases can be fixed with a surgical procedure that does not include the insertion of the mesh.

If you feel that you are not receiving enough treatment options, don’t be afraid to ask for a second opinion from another surgeon or specialist. You deserve to know the true complications associated with transvaginal mesh, and you deserve to have a surgeon who has been properly trained in the procedure before going ahead with surgery.

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Breastfeeding; Not So Pure And Simple

This is a wonderful article written by one our our BirthWorks Educators and Trainers, Joan-e Rapine. This article was also published in our newsletter, vol. 7 issue 3.

Breasfeeding – Not So Pure & Simple
Excerpts from a paper on Beyond the Breast-Bottle Controversy by Penny Van Esterik (Rutgers, 1989)
By Joan-e Rapine, CCE

The breast-bottle controversy goes far beyond boycotting a product or its manufacturer.
In her book Beyond the Breast-Bottle Controversy, Penny Van Esterik examines the
controversy from every possible angle and brings up many points to consider, such as the
environment in which many women live, medicalization of infant feeding, turning infant
feeding into a status symbol, and breastfeeding as a feminist issue. As to existing studies,
Van Esterik says: “What is significant is what does not get researched, what questions are
not asked” (16).
It is easy to question people’s choices when they have everything available to them and
all resources at their disposal. However, when people live in poverty with limited
resources, if any at all, questioning their decisions would be unfair and inappropriate.
Many people, especially in developing countries, have no choices available to them.
There are women who breastfeed because that’s the only choice they have, while others
‘choose’ not to because of physical and emotional constraints. I have seen families living
in the streets of Lima, Peru – a mother sitting on a dirty old tarp, selling lemons, while
her children take turns at her breast. Children as old as nine or ten were nursing,
probably the only ‘meal’ available to them that day. That mother may have had no choice
but to breastfeed when her babies were born; she most likely could not afford not to. On
the other hand, there are women who have to earn a living and cannot afford to stay with
their babies and breastfeed (I am referring to women, in developing and developed
countries, who will die of starvation if they do not earn a living). There are also women
who are so malnourished, due to poverty, that they are unable to produce milk. All of
these situations are not a matter of choice, but harsh realities of many women around the
world. Some women live in such inhumane conditions, that they lack the spirit it takes to
protect their infants and do what is best for them. As Van Esterik wrote: “The cold,
damp mountain air blows through the flimsy walls of the shack, chilling Rosa’s body and
soul and reducing her will to struggle for her infant sons ” (36).
Although technically countries are separately governed, they are part of the “world
system” (55-63), which Van Esterik describes as a “unified hierarchical system” (55). As
long as economy and politics continue to influence all parts of the world, breastfeeding
mothers will face many challenges in their decision-making. “Certainly, …women have
some choices as to how they participate in the world system, but they cannot choose not
to participate in it” (62).
One of the world system’s effects is that women living in poverty are not only influenced
by their poor living conditions, but by the aid they receive. When I lived in Guatemala I
helped distribute the monthly shipment of food aid, which provided the local ‘poor’
villagers with powdered milk and refined flour, sugar and rice. Not only are these foods
traditionally not used in Guatemala, they provide no nutritional value and may contribute
to weakened immunity and disease. Nursing mothers were the main target of this aid and
many accepted the food articles, believing them to be healthier than their own traditional
rice (unrefined) and beans. Ultimately, it was the nursing infants who suffered from their
mothers’ poor nutrition. Other women accepted the food, but did not use it themselves.
Instead, they sold it and used the money to purchase corn, beans, molasses, and
vegetables. It seemed that the more remote the village and the simpler the people lived,
the healthier the choices they made.
Another way the world system affects infant feeding in developing countries is by
allowing companies to advertise formula as the better choice. Most new mothers want
the best for their babies and are easily influenced by advertisements for ‘better’ ways to
care for their babies. Mothers are convinced that formula is superior to breastmilk and,
despite their poverty, they purchase the pricey infant food. Many mothers cannot afford
to buy the formula regularly and ‘stretch’ it to make it last longer by diluting it, which of
course deprives the infant of whatever nourishment formula actually has. In addition,
most families lack the means for proper use of formula, such as clean water, refrigeration
and ways to sanitize the bottles and nipples. I have helped treat many bottle-fed babies,
gravely ill with cholera and a variety of parasites whose mothers used unserilized water.
When those mothers were asked to their reasons for not breastfeeding, they usually
replied that they wanted to be like American mothers. Whether American mothers breast
or bottle-feed is not the issue, but what the formula companies are telling mothers in
developing countries.
In addition to being advertised as a superior infant food, artificial infant foods have also
become a status symbol. Since formula can be costly, only wealthy women would be
able to afford it, so when a mother is seen bottle-feeding her infant, it may be easily
assumed that she is wealthy. She now has status. In addition, with the world becoming
more technological, technology equals advancement. When formula is described as
“scientifically designed” and “developed”, or as “new and modern” (178), women
wanting to be viewed as advanced would choose formula over ‘primitive’ breastfeeding.
New mothers are also very vulnerable and have many fears about their ability, or
inability, to breastfeed successfully. One of their greatest fears seems to be having an
insufficient amount of milk. Formula manufacturers take advantage of this fear and
provide a ‘solution’ in the way of supplementation with formula, which is likely to cause
milk production to decrease. Once the mother’s fear has manifested she becomes very
thankful for the supplementation, unaware that it may have been the cause of the problem
in the first place. This makes “infant formula manufacturers… both the cause and the
cure” (128) for the problem. Even well educated women in western societies fall prey to
this game. They fail to recognize formula as the problem, disguised as the solution.
As technology advanced, doctors became an authority on almost everything, including
childbirth, breastfeeding and childrearing. The medical profession has created a
dependency on medicine and doctors by labeling normal conditions as diseased ones and
then creating medications to correct them (112). Infant feeding, too, has fallen under the
jurisdiction of doctors and has ‘earned’ itself a set of rules and regulations. Mothers are
advised by their doctors on how long and how often they should breastfeed their babies.
Since breastfeeding offers no financial advantage for anyone but the breastfeeding
mother, it is not beneficial to promote it. Unfortunately, the physiological and
psychological benefits do not count when it comes to politics and economy.
I feel that medical doctors have no place in the world of mothers and infants (except for
when true medical assistance is needed). Doctors are trained in treatment of disease, and
pregnancy, childbirth and breastfeeding are normal processes that do not require
treatment. Mothers need guidance and support through patience and love- things most
doctors are not trained in. When a natural process is portrayed as abnormal or diseased, it
is difficult to see it as anything but that. Furthermore, the medical profession has become
partners with infant formula manufacturers (143). This partnership may not be officially
documented, however, they depend on and promote each other. I find it very disturbing
and have lost my trust in the medical profession.
The decision to breastfeed depends on so many factors – some of which are in the
mother’s control, but many are not. It seems that world economy and politics play the
biggest role, and while well intending individuals and organizations may focus their
attention on the mothers, perhaps global attention is needed. Van Esterik quotes Dr.
Vicente Navarro, Professor of Public Policy, Sociology and Policy Studies: “The greatest
potential for improving the health of our citizens is not primarily through changes in the
behaviors of individuals, but primarily though changes in the patterns of control,
structure, and behaviors of our economic and political system” (150-1). While
breastfeeding is individual and intimate, it is affected by worldwide factors. Our goal
should be “not to have every woman breastfeed her infant, but to create conditions in
individuals, households, communities, and nations so that every women could” (211). We
must begin to question global environment and its effect on what we eat and breathe. We
must also question world economy and the effect that greed has on our future.
When evaluating the breast-bottle controversy it’s easy to get lost in statistics and facts.
However, breastfeeding is a very personal choice and may not always be easily explained
in a scientific factual way. Women “may well find they have no words, models, or
metaphors for expressing this intimate power” (107). This may render the whole issue of
breastfeeding difficult to study on a scientific level because one must rely on truths that
may not be supported by facts. When examining breastfeeding it is important to keep in
mind that “there’s a world of difference between truth and facts. Facts can obscure the
truth” (Maya Angelou), and as Van Esterik has conveyed so well in her book, there are
many truths to breastfeeding.