Ecological breastfeeding and the slippery slope

I've recently become more and more aware of a baffling (and for me, frustrating) trend among young Catholic families. As a physician practicing within the reach of Boulder County, I'm used to the "all-natural" crowd. I hesitate to lump all of this into one label, but you know the ones I mean--the babies with their amber teething necklaces, lack of vaccines, homeopathic remedies, breast-feeding until 2, co-sleeping until 8, and a firm mistrust of anything "scientific".

I'm used to it from certain people, but when I started to see more and more young Catholic parents falling into this camp, I couldn't understand why. Now, I realize that to most of the secular world, Natural Family Planning (NFP) and big families and home-schooling place Catholics squarely in the kook camp along with the other stuff. But in my mind, the Church and science have gotten along pretty well since Galileo, and there's definitely a place for both in living life to the full. So why the shift?

I'm obviously not a mom, so I can't say for sure, but I think it comes down to one practice: ecological breastfeeding (EBF). For those moms who are using NFP, a non-hormonal way to ensure birth-spacing is probably desirable. There seem to be two main options--wait until your periods return and resume NFP, or breastfeed to keep your prolactin levels high enough to prevent ovulation. For those who are breastfeeding anyways, return of normal periods can take several months, so many are opting for the latter. There is some science (I haven't read all of it, but most of seems to come from a single source--Sheila Kippley--one of the founders of Couple to Couple League) that supports the best way to ensure lactation amenorrhea (lack of periods from breastfeeding).

The basic premise is that if you follow the Seven Standards, your prolactin levels will be high enough to prevent ovulation for an average of 14 months. Most of the support for this method touts the "natural" and "God-intended" practices, as if failing to adhere to these standards is somehow second-rate. And I think it then leads followers to embrace all other things "natural", especially since many of the breast-feeding, co-sleeping moms fall into that Boulder camp that I mentioned earlier, and that's what's out there on the internet.

I am not against EBF by any means. I think that it can be a wonderful way of bonding with your child, spacing birth without hormones, and supporting good nutrition and health as recommended by the American Academy of Pediatrics. However, there are several conclusions from the EBF mentality that I absolutely disagree with, and I think this is where my frustration comes in--seeing well-meaning, intelligent, faithful people sliding down a path of ignorance and frankly, sometimes danger.

I think if you're going to consider EBF, please also consider the following:

1. EBF is NOT the only way to space birth without hormones or contraceptives.

Those who do EBF can expect a delay in their periods for 4-24 months. That's a big range. Not every woman, even following the Seven Standards, can expect her body to delay ovulation 100%. Studies suggest that those who exclusively breastfeed can rely on their bodies not to ovulate before the return of periods up to 93% of the time (in other words, once you start bleeding again, even if it's irregular, you need to start charting). However, if you continue to chart temperature and mucous like before, you can fairly accurately predict ovulation even without menstruation over 90% of the time as well. I can't find the original data I read on this, but I'm sure NFP providers would know more.

2. If you are unable to do EBF, it does NOT make you a bad mom. Similarly, doing EBF does NOT automatically make you a better mom.

EBF is HARD. Those Seven Standards make it literally impossible to have a job, have a babysitter, be away from your baby pretty much ever, have your husband do one nighttime feeding so you can get some sleep, or use a pacifier in a pinch. Not everyone can do that; not everyone is supposed to do that. If you need extra sleep for your health, if you need to return to work for financial stability, if you need to step away for your sanity, that does not make you a bad parent. It makes you an aware parent who realizes that the baby's health is determined by more than just whether they can nurse on demand.

3. Co-sleeping does not have to mean bed-sharing, and there are safe and not-safe ways to do this.

From everything I've read, the Seven Standards allow for room-sharing without bed-sharing--a bassinet, a crib, a mat on the floor, a side-sleeper--all allowed. Further more, there are safe ways to bed-share and not safe ways to bed-share. You still need to have a firm mattress close to the floor without extra pillows or bedding. Avoid any medications, including alcohol, that make you sleepy, and never co-sleep in a chair or on a couch. Please, please, please talk to your doctor about how to make bed-sharing safe if you want to do it.

4. Using a "natural" method of child-spacing does not make all "natural" things better, and avoiding the "scientific" way of child-spacing does not make all "scientific" things bad.

This is the one that drives me the most crazy. Hemlock is natural. Marijuana is natural. Cocaine is natural. Are those safe? Of course not. Untreated water is natural, but led to extremely low life-expectancy before waste management was developed. Homeopathic remedies are not tested, are not necessarily harmless, and are mostly not effective. I accept that not all available medical interventions are necessary or even right, but there are proven things we can do to improve your child's health. Similarly, just because your doctor recommended artificial birth control after childbirth doesn't mean everything she recommends is against the Church teaching. Find a doctor you trust and make it a partnership. And for Pete's sake, throw away the teething necklaces.

5. The Church does not care whether you do EBF, or whether you espouse Attachment Parenting, whether you cloth diaper, or whether you home school.

The Church is here to guide us on matters of faith and morals, not on what kind of car you drive, whether you buy organic, or how to raise your children. There are obviously moral implications to many of the things we do, but it's not black and white. You also have to think about what your reality is, what your strengths and limitations are, and whether the benefits outweigh the downsides. Of note, the Church does support breastfeeding ("if possible") as the intended means of nutrition and bonding for a new baby, but doesn't care if you use a pacifier. She does, however, think it's okay, and even morally responsible to vaccinate.

 Again, I'm not saying EBF is bad. In fact, if you can make it work, more power to you. But it isn't the only way, and it doesn't necessarily condemn you to a life of following Jenny McCarthy and Dr. Oz.

TED talks for the win

I have taken to downloading TED Talks for the commute to Broomfield (or random jaunts to the grocery store; I'm not picky). I can't remember how it first started. I've been doing Lanky Guys and Catholic Stuff podcasts and decided that I should figure out this phenomenon.

The idea behind TED is to share ideas.

There are conferences all around the world dedicated to just sharing ideas.

Isn't that wonderful?

In today's world that is so bent on productivity and one-upmanship and success and money and comparing yourself to the fake version of someone else that they decide to broadcast to the world, there are whole conferences where people sit and listen to other people share ideas.

There may be nothing more that comes of a talk than an interesting conversation. And that is okay.

Blame it on my introvert nature, or my melancholic longing for something better, but I hate small talk. Hate. I would rather stand in the corner for an entire evening--awkward as that is--than spend time gossiping about co-workers or trying to out-do each other for craziest work story or just rehash some pop culture news item. I want to talk about REAL THINGS. Science and philosophy and history and human experience.

Apparently there are other people who share this desire. Or else why TED talks? The beauty of this, if you can find ones worth listening to (and ones presented by speakers with understandable accents), is that someone else has already done the reading, the studying, the learning--and you get to benefit. You get the bullet-point, sound-byte-sized revelations that are interesting. That are worth sharing.

For example--
The power of games to increase resilience
One really important reason why we need sleep
Apparently my standards aren't high enough

TED talks obviously aren't the only way to get us beyond small talk. I'm just excited that I can slowly expand my universe during my drive. And I'd like to encourage you to do the same. Let me know if you find good ones.

Learning medicine

Last night I attended an awards banquet at the School of Medicine for physicians who volunteer as preceptors, taking on a student one half day a week for their first two years of medical school and part of their third, teaching them about clinical medicine in the real world. When the program was founded 30 years ago, most teaching was done in a university hospital, where less than 1% of those who sought medical care would eventually be treated.

I remember my Wednesday afternoons with my preceptor in medical school, me always feeling nervous beforehand, but excited to get out of the classroom and actually see patients. I left every evening grateful for the learning, but wondering how in the world would I ever know enough to practice medicine?

I remember my own student's first day, me still wondering if I knew enough--this time to teach it to someone else. And I guess it's going okay, because she nominated me for Best Pediatric Preceptor, which if you knew some of the others who were nominated, you'd know was a huge honor.

But there's a lot more than just imparting medical knowledge, and that was the takeaway for me yesterday. The best preceptors also invest in the relationship, becoming a role model for communication, empathy, integrity, balance, and perseverance. We have the opportunity to remind these students why they went into medicine, when they spend most of their days memorizing the Krebs cycle. We can show them the incredible gift it is to take care of patients. And in doing so remind ourselves of that very thing.