Thursday, January 27, 2011

Book Review: What Your Pediatrician Doesn't Know Can Hurt Your Child A More Natural Approach to Parenting by Susan Markel MD

What Your Pediatrician Doesn\'t Know Can Hurt Your Child: A More Natural Approach to Parenting
Well anyone that knows me will tell you I am not a big fan of most of the parenting/baby books out there.  Bonfire material mostly...I have been known to say, "That's why I haven't written my book would be one page long stating, "Don't read any books!"

Anywho,  low and behold I was sent a copy of the above book.  Title - right up my alley, of course.  The following was the gist of the cover letter accompanying it:  

It’s a really interesting book that encourages mothers to take a more natural approach, and to trust their instincts when it comes to raising emotionally and physically healthy children. As a pediatrician who has devoted her career to the support and promotion of breastfeeding, along with more accurate evidence-based information for parents, I’m quite gratified to see my book finally published and on bookshelves. It is the culmination of my efforts to create mindful and compassionate parenting, beginning with the best and most important start: breast milk and nothing but.  Further, throughout, the book I discuss ways for readers to respect the environment, to avoid raising a generation of super-consumers and to bring peace of mind into our lives without harming either our vulnerable children, or our surroundings. If you have ever been frustrated, or simply not satisfied, with traditional medical advice that is being given to new parents, or if you are eager for accurate information, you will likely find my book quite enlightening.  The first chapter, FROM BIRTH ONWARD, explains the real story behind standard (and often unnecessary) newborn medical procedures such as treatment of bilirubin, eye prophylaxis, hepatitis B vaccine and others.

Here is Dr Merkel's back round - I was impressed:
Board-Certified Pediatrician who has a private consultative practice special­izing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, I became a fellow of the American Academy of Pediatrics in1981, and an International Board Certified Lactation Con­sultant (IBCLC) in 1997. For many years I was a medical liaison for La Leche League and a member of the research advisory counsel at Attachment Parenting International. You can read more about her philosophy, which is expanded upon in the book, at her website:

I have to say, "Love this book with the exception of Chapter 6 - The Good Enough Mother - which I recommend you just skip right over or since I have spurred your curiosity read it but please, don't practice it.

I received your book today and am about half way through.  So far, I absolutely love it except for chapter 6, not quite sold on the "Transitional object" in theory or practice. I think the introduction of such at 6 month is too early if at all. Don't you think as a culture we are too attached to objects instead of people? I feel if you wait for the child's readiness for independance they will do so without the need for an attachment object. If babies/children are neglected or left then yes I assume they would need something but otherwise it's a poor substitute for a person and scary when a child can go nowhere without the object. I just don't buy the theory even though I realize why it would "work"  but your basically pawning off your baby to an object.  If an older child chooses to drag a favorite toy around I don't think it should be discouraged but to reinforce the idea to a 6mo doesn't sit right with me That object will never do what a real person can.
Anyway just me feedback so far I will keep reading.

p.s. - Dr Merkel did respond to say that she will take it into consideration if the book goes into reprint.

Conclusion:  I am going to be very honest and blunt here.  I live in what I consider a poisoned environment every day (professionally), please do not take offense I don't mean you!  So, it is not always easy and sometimes very lonely, swimming against the current. Many of us have discussed socialogica/psychological reasons why people have to stick to their ways of thinking, but suffice it to say that it makes them feel safe that way, to have their team rules to play by and root for. This is addressed somewhat in the book, I have to give Dr Merkel credit for "sticking out her neck" although in general the tone of the book is very positive , but in being positive she brings out the fallacies of those poisoning ways of thinking.
(ie the AAP)

I think that most of you will really like the book and that it will help you to take a stand against the nay-sayers. Would it help to have them read the book? Probably not. It might make it worse as they would have to take a stand against the ideas in the book which make them feel uncomfortable. 

Hey, it is what it is....  Personally I felt somewhat vindicated since much of the book is information and ideas that I have been trying to circulate and share for years.  Frankly,  if it weren't for the wonderful books by Bill Sears MD, I would have surely jumped off a cliff by now!

Wednesday, January 26, 2011

This Month is Maria's Car Seat Challenge!

 Yes, that's right.  During the entire month of March,  I challenge you to LEAVE THE CAR SEAT IN THE CAR and CARRY YOUR BABY!  Of course you may use a sling, wrap or structured carrier.  Now, I don't want to hear, "What if he is sleeping?" Yes, even if he is sleeping!  Listen, 85% of the time I look into those seats the babies are awake;)  News flash - car seats are for cars!  When my kids were little (in the horse & buggy days-Lol)  we never took the car seat out of the car and nothing bad happened :)  I promise you, that if you left the car seat in the car and carried you baby to and from wherever your going, they would actually be accustomed to it and guess what ? ... Be a better and more flexible sleeper! 
I am not kidding when I say that the only advantage I'm ever told when I protest the bucket's ubiquity is that you can carry a sleeping baby in from the car. But, in my real-world observations, I've seen mostly awake babies carried around and set on the floor or the church pew or a table -- all those missed opportunities to attach, instead of detach, with your baby. Although, really, it would be fine to hold a sleeping child as well.

Here's another one: It's OK for your baby's face to feel the cool air or have the sun light shine upon it or even a rain drop or two to touch it.  How do these babies experience anything when the whole outside world is a zipper flap away?  

On a daily basis I see parents struggling to carry these infant car seats, and straining their bodies. I think to myself, "Why would someone choose to carry 20 lbs or more when they can carry 8 or 10?  Using your infant car seat as a carrier can be a killer on your wrists, elbow, lower back, and neck if you tote it by the handle or if you string it on your forearm like a handbag. “The greater the horizontal distance from the weight you’re carrying to your torso, the more stress on your joints, discs, ligaments, and muscles,” says Mary Ellen Modica, a physical therapist at Schwab STEPS Rehabilitation Clinics in Chicago, IL. “It’s equivalent to walking around with three or four full paint cans in one hand--something most people wouldn’t do, but they’ll carry a car seat that way.”

Come on, common sense tells us that neck, shoulder, rib cage, pelvis, knee and ankle problems can arise or aggravate old injuries from lifting a heavy load on only one side of your body repetitively. Similar strains occur when struggling to get the infant car seats in and out of cars.  It's not the breastfeeding positions or the holding of the baby.

 Trust me, being an ER nurse over the last 35 years, I know how important car seats are for infant safety but , for the car, not everything else!  New parents often look at me in shock when I pose the idea that they can actually carry their own baby instead of the bucket!  Like they never knew the option even existed!  Yes, the option does exist.  
 Now more about your precious cargo! Babies are very susceptible in early days of molding to their environment and a lack of movement results in decreased brain stimulation causing several long term effects.  Basic neurology states that the motor movement of the body drives the Sensory system which in turn develops the cerebral cortex(smart part of your brain). With the weight of a newborn's head on such a weak neck, lack of proper head support is very stressful on the nervous, skeletal and circulatory system. I have also observed new babies who have been left in these seats for too long with their heads becoming flat on one side, dropped over to one side or forwards.  Many parents comment, "He hates the car seat!"  Well, wouldn't you if you spent that much time in one?  Or If all you saw was a piece of fabric in front of your face instead of  the trees or clouds?  Honestly, what do we think we are protecting them from?  

Yes, a newborn's cranium or head is sensitive to flattening when left for too long in one position. This is not just an aesthetic point, the brain is resting within this cavity and the cranial bone movement determines how well cerebral spinal fluid circulates and bathes the brain and cord. A flattened occiput (back of the head) has been linked to SID's, nervous system, respiratory, digestive, cardiac and behavioural problems. I work with babies with colic, sleep issues, ear aches, breast-feeding problems and more and they always have cranial and upper cervical problems.    

Timothy R. Littlefield, MS is affiliated with an Arizona clinic that treats plagiocephaly (flattening of the skull).  In an article in the Journal of Prosthetics and Orthotics, he notes that 28.6 % of infants who attended the clinic spent 1.5-4 hrs daily in car seats or  swings and nearly 15 % were in them for more than 4 hrs a day.  Another 5.7 % were allowed to sleep in their car seats at night and for naps.
Littlefield observes that cranial distortion resulting from overuse of car seats and swings is more severe and complex than in children who develop plagiocephaly from back-lying on a mattress.

If that's not convincing enough read this story: Study: Infants Sleeping in Car Seats Could Be At Risk. It points out that the head flexion in car seats that are outside the car can restrict breathing in young infants. I believe that this is the study referenced in the article. A Google Scholar search turned up numerous other articles dealing with head injuries due to falls and overturning of the plastic carriers, plagiocephaly from spending too long in the seats, and many recommendations that these infant seats be limited to their proper use inside of cars only. Apparently, bringing them in not only exposes children to the dangers of falling out of them, but it also places them at more awkwardly upright angles that can threaten their airways.   

So listen to "the voice of reason" (maria)  and keep your babies moving, pick them up and carry them to and from the car and lay them flat in a bassinet or cradled in a sling. Or simply carry your baby in your arms, and your baby and you will both benefit. 

Infants transported that way use their head, neck, and shoulder muscles to stabilize themselves and establish stronger trunk stability. Those muscles develop sooner in babies who aren’t carried around in a car seat.  And then NO NEED for TUMMY TIME- that your baby dislikes.

With all of the physical, chemical and emotional stress that is on parents and babies these days, it is nice to know that we don't all have to "buy into" or subscribe to the incorrect use of these products. 
Conclusion: Products that are introduced to our western culture may be very convenient or look good but what is the long term cost to us and our environment?   Car seats are very good at doing what they are supposed to do: protecting children in the event of an accident .  But there is no evidence to suggest that staying in a car seat after the ride is over offers a child any benefit .