Four Boys? You've Got Your Hands Full!

When I'm out grocery shopping with my four boys (and having four boys requires a lot of grocery shopping!), I get a lot of looks. People mentally count my kids. People watch me go by with my train of ducklings. I sometimes feel like I'm leading an invasion whenever we all go somewhere. My kids are noticeable, with two redheads, a taller-than-average 7-year-old, the 5-year-old's big brown eyes, the 2-year-old's contagious grin. They are not quiet kids, and they are not shy kids.

I admit that I'm "that" mom sometimes. My middle two, for some reason, go nuts in stores. They run up and down the aisles shrieking like banshees. They grab each other, knock each other over, get in other shoppers' way. They touch every single price tag. I can't get the toddler to sit in the cart if he doesn't want to. I can't get the 5-year-old to walk sedately beside the cart no matter how many different ways I frame it.

On the bright side, they don't knock things off shelves or break things, so I've got that going for me.

Thankfully, I live in an area full of very friendly and forgiving people. I get indulgent smiles from grandmotherly ladies. I get wondering comments like, "Wow, four boys?! You've got your hands full!" I get commiseration. I'm grateful for all of it, because we parents of young children often feel that everyone is judging our parenting all the time, and it's nice to know that most of the time, the people watching understand that sometimes little boys just want to run around. (And who could blame them for not wanting to go grocery shopping?)

I hope that I remember those amused glances, those understanding comments, the occasional compliment when my kids are grown. I hope that one day I'm that lovely grandmotherly lady who sees a young mom come in with her brood and tells her she's doing a good job, tries to make her baby smile, and commiserates about the nonstop energy of little boys. I imagine that 30 years from now, I'll be the friendly woman in the grocery store who tells that young mom, "Oh, yes, I had four boys. They're all grown up and married now, and they treat me like a queen."

I want to remember this feeling of overwhelmed-ness, of frustration, of burnout, because one day I want to offer the comforting smile, the gentle joke, and the compliment to that young mom in the store with her four boys (or girls). I want to remember how much a kind word can lift a weary soul. I want to be the one to make the toddler's tears turn to smiles, to joke with the 5-year-old, to make silly faces at the baby, so that sagging mother can finish her shopping. I want to be the one who steps aside with my one loaf of bread and carton of eggs so the mom with the full cart and melting-down 2-year-old can just get finished and get home already.

So thank you to the understanding mothers of grown children who have smiled at me and said hello. Thank you to the kind store employees who are patient with me and my crazy kids. Thank you to the other mothers of small kids who join me in a resigned sigh as we cross paths from aisle to aisle. And thank you to the sweet grandfathers who joke with my little ones and tell me about their grandchildren. You brighten my day so that I, in turn, can one day brighten someone else's.

Please Don't Tell Me I'm a Supermom

When I tell people I've gone to the store, or out to eat, or made dinner, or gotten a few hours of work done, or some other apparently monumental task while being responsible for all four of my kids, I get exclamations of amazement. "You're a supermom!", they'll say. Or, "I only have two, and I can barely manage most nights!" Or, "I don't know how you do it!" I know these are meant as compliments and are honest reactions to something outside their own frame of reference. And I appreciate them as such.

But it makes me uncomfortable just the same. Because secretly, deep down, it releases all kinds of insecurities. All I can think of is all the things I've done wrong, the mistakes I've made, the things I wish I had managed to do. I berate myself for not paying enough attention to the kids, for letting them fend for themselves while I work in another room, or, conversely, for spending a few hours with them instead of working a few more hours to pad my paycheck. Or, for neglecting both work and kids to sit on the toilet and play Candy Crush in private. I should hold my baby more, hug my five-year-old more, draw with my toddler more, and read with my seven-year-old more. I should put the phone down during dinner and make them tell me about their day. I should try harder to get the toddler to take a regular nap. I should get the middle two dressed before noon. I should take them to the park more so they can run around on sunny days. I should replace their bike helmets and let them out front to ride. I should fold their laundry. I should wipe down the kitchen counters, sweep the floor of the toddler's food-leavings, and change the baby's diaper and give him a bath.

I see other people accomplishing things I haven't been able to, and I think I have no right to those compliments. I'm not "doing it all." I'm not a supermom. And when you tell me I am, you're belittling yourself. You're negating all of the amazing things you've managed to do, like have a dance party in the living room and do an art project with your preschooler, like cook healthy meals all week long, get your car washed, and clean your toilets. Like sign your second-grader up for soccer, acquire all the gear he needs, and attend all his games. Like save up for two years to take the family to Disneyland. Like start your own business and run it successfully, work full time outside the house and still get the laundry folded and the lawn mowed, and remember to pick up a birthday present for the party this weekend.

I'm just a mom. Some things, I know I do well. Some things, I know I could improve. And, looking at you, looking at how well dressed you are, how neat and clean your house is, how you make healthy meals all the time and get your housework done regularly and limit screen time to just the weekends, and have money left in the bank at the end of the month, some things make me feel very, very inadequate. Not because I think you're judging me, but because I'm judging myself.

Please don't tell me I'm a supermom. I don't feel all that super, and I don't have a cape. Sure, I made it to the grocery store, but I nearly lost the stroller, forgot to buy half the things we needed, and left the reusable bags at home. Yeah, I got the oldest to school on time, but the other three are still in pajamas and the toddler's diaper needs changing. Absolutely, I made dinner and put the dishes in the dishwasher, but I didn't make them clean up their toys, there are shoes everywhere, and the baby is crying in his swing while I rinse the last of the dishes.

No one's life is perfect. I think as moms we only see our own shortcomings while we admire the accomplishments of all moms around us. I'm wondering how she can remember to put jackets on both of her kids and manage to keep them from running around screaming in the store, while she's wondering how I can load four kids into the car in half the time it takes her to put her two in. I'm wondering how she finds the time to make dinners from scratch every night and keep the living room free of clutter, while she's wondering how I can work part time from home with three kids in the house.

I'll tell you what, if you buy the capes, I'll wash them. But don't blame me if I forget to put them in the dryer.

Parents' Responsibilities to Others Versus Others' Responsibility to Parents

I was musing about this while I "supervise" my house being packed up, and I thought it might make a good quick little blog post.

I took the kids out for breakfast this morning to Coco's, a family restaurant similar to Denny's or IHOP in terms of ambiance and food. It was quite empty, given that it was after 9:00 on a weekday morning, except for a few older couples enjoying some coffee and a mature woman with a calendar and iPhone doing...something. The hostess showed us to a section and told us to sit anywhere and that she would be right back with a high chair for the toddler.

My two older kids immediately sat down in the first booth, on a bench back-to-back with the lone woman tapping away on her iPhone. I monitored G while we waited for the hostess to bring a high chair for him, keeping him from either running off or climbing into another booth. iPhone lady shot me a look and I realized that N was kicking the bench, which had to be annoying to her. I told N to stop kicking, figuring that would be that. N did stop kicking, and then woman said, "Actually, could you sit somewhere else? Or should I move?" not in the politest of tones. I hesitated, then asked my kids to move to a booth farther back (two tables away), which they did, cheerfully (and noisily). I felt like the woman's eyes were drilling into my back. I didn't glance back to see if they actually were. I then spent the first half of breakfast diligently trying to keep my kids to "indoor voices." They were behaving very well, and if there had been any other families there at that moment, I would have been happy to let my kids keep on how they were, but I felt like I didn't dare disturb iPhone lady. It really put me on edge, and I found myself fighting tears for no good reason. I'm very stressed right now, preparing to move 500 miles north and waiting for my house to get packed up and taking care of my kids by myself. And being pregnant.

I calmed down as my coffee arrived, and the kids set to their food very nicely, and I turned around to see that iPhone lady was gone. The rest of breakfast was very pleasant and relaxed, and we left happy.

The incident made me think about the balance of "give me a break here; I'm alone with three kids" to "I'm sorry my kids are annoying you; I'll do my best to keep them quiet."

As parents, we have a job to do: We have to prepare our kids to function in society. That means teaching them manners, how to act in different arenas (home versus store versus restaurant, for example), and to be sensitive to how their actions affect others (i.e., empathy). As a result, we parents spend a lot of time trying to be tuned in to how are kids are acting and to how others around us are reacting to us. It can be exhausting. I find myself watching the faces of those around me, trying to judge whether they are charmed or irritated by my kids. I find in large part that people don't mind when my kids are just being kids, as long as they're not being destructive or unreasonably loud or exuberant. If I see an amused or nostalgic smile on the face of a grandmotherly woman, I don't try to rein my kids in as much as if I see the pursed lips and pointed looks of someone less open to "kids being kids." I try not to be too entitled. Just because I have kids and am stressed and sometimes they're hard to control doesn't mean my kids have the right to run rampant around a quiet restaurant and disturb other diners (which they weren't doing, but just for arguments' sake). I don't think I deserve special treatment because I decided to have kids, like I'm somehow unique among the women of the world.

As members of society, though, isn't it right for us to be aware that parents with kids sometimes need a little leeway? I know that for people who don't have kids, or haven't been around kids in a long time, or aren't usually around kids at all, it can be hard to understand or be forgiving of even normal kid behavior, and every noise or accidental shout of excitement can be irritating. But if you're in a family restaurant, one that regularly serves, and even caters to, parents and children, it shouldn't be overly surprising if a family comes in for a meal. And if that family is a mom alone with three young boys, it shouldn't come as too much of a shock if those boys are a little excited or hyper, and the mom looks a little exhausted. Where does that balance point fall? How much is it my responsibility to keep my kids from annoying you (yes, kicking the bench was not okay, and I stopped him as soon as I saw it), and how much is it your responsibility to realize that I also have a right to sit there and eat (my kids weren't doing anything unreasonable or unpleasant), and just because you had until then been in a quiet restaurant working quietly on whatever-it-was you were doing, doesn't mean you could expect it to remain quiet. It's a restaurant, not a library.

Frankly, if I had gotten there first (instead of having to corral the toddler), I probably would have chosen a table farther from her anyway, as, just like anywhere else, if there's room to sit farther away from people, I generally choose to do so (movie theaters, restrooms, the DMV). It wasn't that I minded moving to a farther table, it was more the sour look and the obvious annoyance at the audacity I had to bring my family to a family diner for a family breakfast. And that's all it was. There was no confrontation, no complaint, and no further incident with her. I didn't otherwise feel unwelcome, and a couple that came in after us did watch my kids with the welcome amused smile and eye twinkle that I usually associate with older people. I didn't worry that we had disturbed their meal at all.

So what balance do we need to strike? It's obviously different depending on where you are and what the demographic there is like. Behavioral expectations vary with venue for adults as much as for kids. I sometimes struggle with my need to please everyone. I don't want to annoy people or disturb their meals or interrupt their work or reading. At the same time, kids are kids and I can't always control every noise or every action. I can tell them when they're being inappropriate and work with them on it so that next time they'll know better. That's my job, and I take it seriously. I want to raise responsible, empathetic, and pleasant human beings. But can I enlist the rest of society to help me with that a little bit, and maybe give me a little bit of empathy and patience themselves when they see I'm doing the best I can?

Stealth-Adjusting a Car Seat: Right or Wrong?

I have a rule for myself, when it comes to the things I feel I know something about. That rule is: I don't give advice unless I'm asked. If someone asks me for help with breastfeeding, I'll jump in with both feet and tell them everything I know. If they don't ask for help or advice, I keep my mouth shut. If someone asks for help with their car seats, I'll throw at them everything I know. If they don't ask, I won't say anything, even if I can see how poorly their kids are buckled. I tend to assume my friends are intelligent, know when to ask for help, and want what's best for their kids. I also tend to assume that most people don't want me butting in and telling them they're doing something wrong unless they ask my opinion. Sometimes I can't hold myself back even with this internal rule, but most of the time I refrain from saying anything in the interests of maintaining cordial relations.

A few weeks ago, I started to watch a friend buckle his young baby into her car seat. I turned away quickly, having a hunch that he would not buckle her well. I said to my husband, "I think I'd better not watch, because it will just make me angry." I couldn't help sneaking a peak after he finished, and, well, I was right. There were just so many things done improperly that I couldn't bear to look. There was something like a Snuzzler behind her. While I hear good things about Snuzzlers from parents who have used them, I was fairly certain that a car seat tech would tell you not to use one. A quick Google search later on confirmed for me that Child Safety Passenger Technicians say that no aftermarket products should be used with your car seat, including Snuzzlers, Bundle-mes, etc., that go between the baby and the seat, because they may interfere with the harness or the padding of the seat itself. Reserving my judgment about that, the baby was also wrapped in a receiving blanket, which he did not remove before buckling her. This meant that the crotch strap was not snugly between her legs because the blanket interfered with the straps. Finally, and most troubling, the straps were quite loose and the chest clip was in the middle of her belly. For a moment when no one was tending her - she was asleep in the seat - I stealthily approached the seat, fixed the chest clip, and tightened the straps as much as I dared. I didn't want to wake her or draw attention to myself.

I mentioned to my husband and a friend that I had done this. There were a few arguments made for and against what I'd done. (No one argued that she shouldn't be buckled properly or that she had been buckled just fine before I changed it.) One point made was that if I didn't say something to the parents about it, then they wouldn't know for the future. On the other hand, they may not, in their sleep deprived, agitated state, want someone to criticize them (as they would see it), so saying something to them might mean straining our friendship, which I value. I said that at least for this one trip, she would be buckled correctly. And maybe since I'd tightened the straps, they wouldn't loosen them again, and they'd be properly tight the next time they put her in the seat (unlikely, but you never know). Finally, my friend suggested that we could bring up the issue of how to buckle a car seat in a general way around them in the future so that they could hear the instructions without feeling like they were targeted, which would be the best way. I muttered, have jokingly, "Doesn't she [the mother] read my blog?", which I don't think she does. (If she did, would I be wrong to post this story here? Would she know it was about her? Probably. That's a whole other topic!) I do feel that many people think they are doing it right until they are shown how it should look. It's not that they are intentionally buckling their seats wrong. It's just that they don't realize that they're not doing it right.

Now, there are plenty of people who say, "If someone would just show me, I'd be happy knowing that my child was safe." There are also plenty of people who don't want anyone to interfere with their parenting choices, which include whether they want to learn to correctly buckle a car seat. Hey, to each his own. I'm sure I put my kids into plenty of situations that would make other parents want to inform me about how unsafe it is.

Still, car accidents are a leading cause of injury and death for children. Children correctly restrained in cars are at significantly reduced risk of injury and death in a car accident. Sure, my kid might get hurt falling out of a tree at the park, but he's more likely to be injured or killed in a car accident driving to or from the park. Should he not learn to climb safely because of the risk of falling? He can't "learn" to ride in a car safely. He doesn't have control over that. He's either safe in the car, or he isn't. Drowning is the leading cause of death for children one to four years of age. Should I not let my kid in the pool because of this? No. I should teach him to swim and make sure that when he is around water, he is supervised, and that the pool has a fence so he can't accidentally wander in. Again, this is a risk that can be reduced through teaching him to swim. I can't teach him to not get in a car accident, especially since he's not even the one driving. The only way to reduce his risk of injury in the car is to make sure he is in a proper restraint and buckled correctly. The only way. And, of course, for me to drive safely. And, yes, there's an element of luck and trust in G-d, too. I don't deny that.

So, was I wrong to adjust my friend's baby's car seat? I wouldn't say I was morally wrong. They probably didn't even notice, and, if they did, they probably wouldn't know who had done it. And, it doesn't mean they'll do it correctly next time. But when you see something wrong that you can fix, the urge to fix it is sometimes so strong that you can't let it go.

On the other hand, another friend who was there that day asked me to look at her sons' car seats and make sure all was well. And since I was asked, I gave her my opinion, made an adjustment, and pointed out a problem. I also answered questions she had about weight and height for her older son in his Graco Nautilus (Google Affiliate Ad*), and about her rear-facing 16-month-old's feet being against the back of the seat. I told her, "Legs bend; necks break." Kids like crossing their legs in the car or propping them up on the seat rather than having them dangle. Rear-facing is more comfortable. Plus, that recline! It's like an easy chair.

And, for your further edification:

SB in his car seat carrier, about 5 months old, buckled correctly. No aftermarket products behind or around him, (except the toys on the handle, which should be removed when the car seat is in a moving vehicle, which it's not in this picture). The head support and shoulder strap covers came with the car seat, so they are perfectly fine to use.

SB front-facing in his Graco Nautilus, about two years old. Straps tightened properly, chest clip at armpit level. Again, the shoulder strap padding came with the car seat and so are fine to use.

Things that are permissible:

• Putting a blanket over the child after he is buckled. A blanket will fall away in an accident and not interfere with the functioning of the car seat.
• Putting rolled up receiving blankets around the child's head or body for support after the child is buckled securely. Again, blankets will fall away from the child in an accident, allowing the car seat to do its job.
• Using any accessories that come in the box with the car seat, such as additional padding, head support, and shoulder strap padding. Check the car seat's manual for age or weight limits on using the additional padding. For example, my Chicco KeyFit30 has newborn support padding that can only be used until the baby is 11 pounds, after which it should be removed.
• Using any accessories sold separately by the car seat manufacturer that they specifically state are acceptable for use with your exact car seat. This means it has been tested using that accessory. For example, Diono sells an angle adjuster that can go under the car seat to change the recline angle of the car seat. When used properly, according to Diono's instructions, with a Diono seat, this would be a permissible accessory.
• Using an aftermarket accessory that your car seat's manufacturer specifically states is acceptable to use with your car seat. For example, some manufacturers state that putting a thin towel between the car seat and the vehicle's seat is permissible to protect your upholstery. Please check with your car seat's manufacturer to find out if this is acceptable to do with your car seat. 

If you have other questions, please consult with a CPST (Child Passenger Safety Technician). CPST's are trained in proper car seat installation and use and must keep up to date on new research and new seats, as well as being aware of vehicle compatibility issues. You can often have a consultation for free through your fire or police department, a local hospital, or a baby supply store. Check SafeKids.org to find a inspection station near you.

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*I have not been ask to mention nor have I been previously compensated for mentioning any of the brands in this post. However, if you click through a Google Affiliate Ad link and purchase that product, I may receive minor compensation. You can help support this blog and keep the posts coming supporting the advertisers on this page.

About Those Formula Freebies and Mayor Bloomberg...

By now, just about every breastfeeding blog I read has made some kind of commentary or another on New York City Mayor Bloomberg's new program for breastfeeding promotion in NYC hospitals. Part of the Latch-On NYC initiative, this voluntary program requires that participating hospitals lock up formula, not routinely give out formula samples and formula-branded paraphernalia to new parents, prohibit the display of formula promotional materials in the hospital, and conform to the New York State hospital regulation that exclusively breastfed babies not be given formula supplementation unless medically indicated. The program is expected to raise breastfeeding rates in participating hospitals because research shows that women who are given formula samples by their doctors or in the hospital are 3.5 times more likely to be supplementing with formula by two weeks of age. If formula is kept under wraps, and new mothers receive education about breastfeeding before their babies are given any formula, the thinking goes, breastfeeding rates will rise and the overall health of the population will improve. Hand-in-hand with this is news of an AAP resolution that pediatricians should not routinely hand out free formula samples to patients, for the same reasons.

I have been reading every blog post I've been linked to, taking in almost every comment on all the major breastfeeding and parenting blogs I frequent, and I still don't quite know how I feel about this initiative. It sounds like they're basically trying to get NYC hospitals to conform to the Baby Friendly Hospital Initiative standards without going through the BFHI certification process. I gave birth to GI in a Baby-Friendly hospital, and I felt that the breastfeeding support there was excellent. Of course, I went in intending to breastfeed. If I had gone in less certain, uneducated, or sure I wanted to use formula, I'm not sure how I would have felt. I didn't need or want to ask for formula, so I don't know what kind of "lecture" or "education" I would have gotten had I made the request. I didn't have any problem nursing or producing milk, so I don't know how I would have been treated had I genuinely felt my baby was starving and needed formula supplementation. Because I've been lucky enough to be able to nurse with relatively few problems, and because I'm extremely pro-breastfeeding, well educated about breastfeeding (I literally wrote a book on it), and because I wasn't going to let anything or anyone stand in my way of breastfeeding, I didn't need to think about "the other side."

I often wonder whether I would have been able to breastfeed NJ had I given birth to him in a hospital like the one where I had SB and GI. Rather than jumping straight to formula when there was the slightest hint of a problem, if they had been more supportive of breastfeeding and, more importantly, had been more supportive specifically of me in my situation, would I have left the hospital breastfeeding instead of with an extra case of formula? It's very hard to say. My husband and I were discussing this last night (in the context of the above-mentioned controversy). His perspective and memories of those early days are different from mine, but we both remember that the lactation consultants who visited me were quite unhelpful. While it may have been true that many women who experience postpartum hemorrhage have difficulty with their milk supply, and while it may have been true that pumping often would help bring in my milk, what I really needed was to spend lots of time skin-to-skin with NJ, nurse him on demand, and be forced to care for him. Yes, I was weak. Yes, I had lost a lot of blood. Yes, I was in pain. But NJ was healthy and strong, had a great latch, and, with a little help, I probably could have initiated breastfeeding while in the hospital and breastfed him several times a day during that four-day stay rather than allowing the nursery nurses, my husband, my mom, and my visitors to feed him for me. It's probable that he would have needed a few bottles (or to be fed via syringe, perhaps?) on the first day when I was fairly down-and-out from blood loss, but on the second day? The third? Through the night? I do remember some good practices, such as telling me to save whatever I did pump and that they could give him that in a bottle instead of formula. They did provide me with a pump and show me how to use it. They did have lactation consultants come every day. But I constantly feel, looking back, that the advice the LCs gave me was, while not necessarily wrong, unhelpful or misleading. If you straight out tell a woman she won't have enough milk, why should she even bother to try? And if you don't tell her or her husband that formula is not, in fact, equal to breastmilk, then why shouldn't she just go straight to formula to begin with?

What's missing in all of this, to me, is that education prenatally is vitally important. The decision to breastfeed can't necessarily be made in the postpartum haze. The desire to stick with it is lowest when in the throes of newborn nursing, and the temptation to use that free formula is highest at the most critical period in the breastfeeding relationship. I know this. I've lived it. You need to walk into that hospital determined to breastfeed. You need a supportive hospital staff, from the OB or midwife to the delivery nurse to the postpartum nurses. You need lactation consultants on hand 24/7 (not just during business hours!). You need good, solid breastfeeding information. And you need to know that you are going to be respected for whatever choices you make.

The loudest complaints against this program seem to be from two basic viewpoints. One is the women who never wanted to breastfeed and don't liked feeling "shamed" or "guilted" by the hospital for their choice. The other is the women who desperately wanted to breastfeed but, for whatever reason, needed to supplement with formula in the early days and struggled long and hard with the decision. Both feel that formula samples are helpful, especially those that only needed a can or two of supplements before being able to go on to exclusively breastfeed. Both feel that being lectured or educated by hospital staff before someone will go get them a bottle for their starving babies is shaming and unfair.

The thing is, I agree with them, too. If my baby is starving because I can't produce enough colostrum or milk to satisfy him (please note that this is rare), then I need to be able to give him something else. If the hospital staff balk at giving me a bottle of formula to feed him, and I have to sign a form or justify my request every time my baby gets hungry, it's going to make me feel even worse and more inadequate. Support doesn't mean just patting a woman on the back and telling her she's doing a good job breastfeeding. Support means sitting down with a woman and figuring out what she wants, what her goals are, and then helping her get there. A good IBCLC knows this, and a good IBCLC will know when formula supplementation is necessary and how best to introduce, use, and wean off of those supplements, if possible. Having a nurse who's had a little bit of lactation training come in and tell you once again that formula isn't as good as breastmilk, and maybe you should have another go at feeding from the breast before you give a bottle, is only going to make a frustrated mother more flustered and upset. We need a balance.

I'm in favor of locking up the formula, but I'm also in favor of giving it to any mother who asks for it. I'm in favor of banning the gift bags and the formula-branded handouts, but I'm also in favor of giving unbranded formula to mothers who need it (in the hospital). I'm in favor of good breastfeeding support and information, but I'm also in favor of education in the proper preparation and use of formula, if a mother chooses to use it. I'm in favor of pediatricians having formula samples on hand to help out mothers who need it, but I'm also in favor of pediatric offices having lactation consultants on staff to help mothers who are struggling. Balance.

We need a more comprehensive solution. While restricting access to free formula will increase breastfeeding rates among those who are on the fence (that's been proven), it will not help those women who truly need it or who adamantly refuse to breastfeed. We need information and education throughout women's lives, and especially during pregnancy, to help them learn about breastfeeding before there's a squalling baby in their arms. We need postpartum support, especially for those women who are going back to work. We need support for pumping in the workplace. We need better, longer maternity leave. We need a cultural shift.

If there is one thing I know, unquestionably, it's that the more babies who are breastfed, the better. Banning formula freebies in hospitals and pediatric offices is a step in the right direction, but it's not the only step.

Kids Need to See Women Breastfeeding

The other day, we were at a community barbecue at the Rabbi's house. I wandered into the living room of the house, where several of my friends were sitting around and chatting. One friend said she was sorry, but she thinks she made a faux pas. I couldn't imagine what she could have done. She explained that NJ had come in while one of the other mothers was preparing a bottle of formula for her daughter. (Not that she needs an excuse for this, but her daughter is 2.5, autistic, and has feeding issues, so she takes a bottle of formula to supplement her food intake.) He said something along the lines of, "I didn't have that when I was a baby!", to which my friend replied that he had. He argued, and she wasn't going to push the issue, so she just said, "Okay."

I shrugged and said, "No big deal. He doesn't know that he was formula fed." It's not that it's a big secret or anything. It just hasn't come up as a topic of conversation. He watches me nurse GI, and I think he has a vague awareness of my having nursed SB, and he's seen several of my friends nurse their babies, and he has always just assumed that (a) that's how you feed a baby, and (b) that's how he was fed. I call him my little five-year-old lactation consultant because he's very interested in breastfeeding and knows that it's the best choice for a baby. I haven't made a big deal of it, just exposed him to it by feeding his brothers. It has imprinted as "normal" on his brain, and I hope he carries that image with him into fatherhood so that he can be an awesomely supportive husband when his wife (G-d willing) has a baby (G-d willing).

I told my friend not to worry about it and that, if he asked me, I would talk to him about it. Apparently the whole episode didn't make much of an impression on him, because he hasn't mentioned it. It does make me wonder if I should sit him down and have "a talk" about it with him, but I mostly feel that it just isn't that important. At some point, it will come up in conversation, or he'll ask, and I'll explain that when he was born, Mommy wasn't as well-informed as she is now, and she was also very sick, and it was very hard for her to nurse him, so he got bottles of formula instead because he had to eat something. I'll tell him that we don't need to judge other mothers for how they feed their babies. (I wouldn't want to deal with the embarrassment of having him say something rude to a mother giving her baby a bottle! And he's the type who would say something, too, if it occurred to him.). I'll just say that some mothers decide to feed their babies formula from a bottle instead of nursing them for whatever reason, and that's their choice to make.

I'm glad that my sons are growing up exposed to women nursing. I think the image of a baby drinking from a bottle is so ingrained in our society that many girls (and boys) grow up thinking that's the only way to feed a baby. I know that when I had NJ, I didn't even really know what breastfeeding should "look like," or how it worked. I didn't know much about bottles, either, granted, but I think if I had grown up with more exposure to breastfeeding women, the idea of breastfeeding might have come more naturally to me. I didn't wrestle with the decision to breastfeed - I had intended to, before the circumstances of NJ's birth led me down a different path - but I didn't educate myself, and that was the mistake.

I think growing up knowing that babies are fed from the breast will serve more than one purpose. First, it will make breastfeeding normal, and that means that when they have their own babies, these children will think first of breastfeeding rather than bottles. Second, they will know how breastfeeding looks. How to hold the baby will come more naturally, because they'll have seen it live. They'll know how it should sound, and what the baby needs to be doing. They might even have talked to someone about how it feels or what problems she might have had. Certainly, they or their wives will need help and support from friends and relatives and medical providers and society as a whole in order to start and maintain a successful breastfeeding relationship, but they'll be motivated to breastfeed and motivated to seek out such support, knowing that their breasts were designed to feed their babies.

Growing up seeing breastfeeding as a regular and normal thing will also decrease the "breastfeeding in public" debate. If breastfeeding is just another thing you see every day, then it is no longer sensational or controversial, so there will be no need for debate. Feeding a baby is feeding a baby. It's not sexual or indecent or offensive. And if a baby suckling from a breast is as ordinary a sight as a child eating french fries, women will feel more confident in starting and continuing to breastfeed because it won't seem weird or unusual or "out there" or uncomfortable.

So, to my little five-year-old lactation consultant, my son who is so concerned for the welfare of babies, thank you for already being so supportive of breastfeeding. Thank you for showing that a child can process the idea of breastfeeding as normal, take it in stride, and establish a vision of baby feeding that will encourage him to champion breastfeeding for his own babies one day. Kids are not offended or put off by breastfeeding. It's kids who will become the next generation of breastfeeding supporters because they have been exposed to it as children and don't find it exceptional at all. And that's what we want.

And, if my son asks me how he was fed as a baby, he will also get to learn that sometimes we do need to use formula, and we don't think less of a mother just because she isn't breastfeeding. Maybe the next generation of "Mommy wars" won't include a breastmilk-versus-formula category at all.

Your Birth, Your Choice

The birth of a child is a dramatic, life-changing event. I'm not just talking about the impact a new baby has on your life, but how the birth itself affects you. I think often a new mother's feelings about the birth itself are overlooked or minimized. A woman may be reluctant to admit that she was in any way emotionally harmed by the method in which her child came into the world or by the circumstances surrounding the birth. It's as if  coming out and saying that she is dissatisfied, angry, depressed, regretful, or unhappy about any aspect of her baby's birth is tantamount to saying she is not happy to be a mother, or not happy to have a new baby.

This isn't fair, and it isn't true. It does women a great disservice to tell them that their feelings don't matter. If such feelings must be buried, ignored, or hidden then they can't be dealt with. Not only that, but these feelings must be aired so that they can be separated from the feelings about the child. You can absolutely unconditionally love your child but not love the way he was born. You can be over-the-moon happy about motherhood but still be angry about not having the birth you expected or wanted.

Pregnancy and birth change a woman. There are, of course, the obvious physical changes. There are the crazy hormones. And there are actual changes in the brain that prepare a woman to care for, love, nurture, and protect her offspring. Pregnancy and birth change your body and your soul. Those changes may carry emotional consequences, some positive, but some also negative. It's no secret that some women are very uncomfortable in their postpartum bodies, that we spend years after giving birth hoping to return to our "prepregnancy size." For many of us, that simply never happens. Our post-pregnancy bodies have stretched and expanded in ways that cannot be undone through any amount of diet and exercise. This is especially true if there was any surgical involvement in the birth!

While postpartum diets, our "prepregnancy" wardrobe, our flabby tummies and floppy breasts, our widened hips and bigger feet are common topics of discussion among new mothers, the emotions we have attached to giving birth are less often brought to light. The result of this lack is that we are hesitant to bring up issues like "birth options," "alternatives," "unnecessary interventions," and so forth, especially after the fact. We feel we are stuck with what we get, unable to discuss our reactions to the unexpected c-section or the emergency induction we didn't want, because, "at least you have a healthy baby!"

Not everyone is affected by birth in the same way, of course. For some women, birth is a major spiritual event, connecting her back through the generations to all the women who came before, empowering her, grounded in thousands (millions?) of years of evolution and nature, filling her with all the magic of womanhood. For others, birth is simply the vehicle by which the baby goes from inside to outside, without any particular emphasis on spirituality or life-giving. Some don't know how they will feel until they've done it. Others have built up a great deal of expectation about what giving birth will be like.

All of these women have a right to be heard, and all of these women have valid feelings. There is no "right" way to feel about birth.

I have a friend who has two kids. Her older child was born via emergency c-section after a long, hard labor. When she was ready to give birth to her second, she decided on a scheduled repeat c-section. Describing this, she says there's no better way to give birth. You show up, get on the table, and an hour later, you have a baby! No labor, no pushing, no work. She usually punctuates her description by rubbing her hands together like brushing off dirt, as if to say, "All done! Quick and clean."

On the other hand, I have a friend who has one child, born via emergency c-section after a long, hard labor. I still haven't heard her entire birth story, because the experience caused her so much emotional trauma that she has trouble talking about it. She is healing, and she is more open about both what happened the first time and what she'd like the next time around than she was even a few months ago. She most definitely does not want a scheduled repeat c-section!

Then there's me. I had no idea that five years later, I would still be so affected by my first son's birth that I would be writing a blog about it! I, too, had a c-section (although not classified as "emergency") after a long, hard labor. For many months, I assumed future children would be born by c-section as well, not because I wanted it to be that way but because I thought I had no choice. I thought my uterus had been permanently damaged and that labor would put undue stress on my imperfect organ and cause me and my baby harm. It was only when I began to learn about VBAC, and that I might actually be a viable candidate for a vaginal birth in the future, that I began to process my feelings about the c-section and understand why I so badly wanted a vaginal birth.

At first, it was simply that my recovery from the c-section was very hard, and I saw friends who had had vaginal births having much easier and faster recoveries. That seemed to be the way to go. (That's what convinced my husband!) Then I started to learn about the risks of c-section and the benefits to both mother and baby of a vaginal birth. My attitude was still very clinical, but I was starting to acknowledge that there was an emotional aspect to my desire as well. But it wasn't until my second son was born vaginally that I fully recognized the power of getting the birth you want. As that baby slid easily out of my birth canal and was put on my chest, an incredible flood of joy and relief surged through me. This was my birth. I had done it. I was in control.

In a c-section, you have to give up control of the process and place your and your baby's bodies in the hands of others. In a natural birth, you are in control. You do the work. For me, that was very important, because I was able to put my trust in my own body instead of others' hands. I was able to get over the idea that my body was somehow imperfect. I could deliver a healthy baby on my own. I didn't need surgery to get him out. I am a mother. I am meant to be one. The revelation of motherhood didn't come with the first birth. It came with the second. (That's not to say I wasn't a mother to my first child before his brother was born, or that I don't love him and nurture him and care for him and protect him! It's just that I didn't feel like a mother, truly like a mother, until my second was born.)

When the time came to have my third baby, I knew without a doubt that I wanted a VBAC, and I was fairly certain I wanted to have the baby without any interventions, if I could. That is, I wanted no Pitocin and no epidural. I wanted to be in total control. I wanted to be able to ask for what I needed and refuse what I didn't need. And it turned out that the circumstances of his birth allowed me to have total control. I had no complications, and he was a full-term, healthy baby. I went into labor spontaneously and was able to fully dilate and push the baby out with no medication, although an episiotomy was helpful at the end. (This is in contrast to my second son's birth, for which I required an induction two weeks early due to pregnancy-induced hypertension. The intensity of the contractions caused by the Pitocin made it impossible for me not to have an epidural, although I was able to have the baby vaginally.)

Interestingly, despite having all of the power in this third birth, I didn't feel as powerful a sense of accomplishment as I had when my second was born. Partly, I felt I wasn't as strong as I could have been, because though I did end up having him without an epidural or other pain relief, I had broken down and asked for it repeatedly. My husband tells me over and over again that I'm being silly, that I was amazing and strong, but I think maybe I expected to feel more empowered, and instead I felt weaker than I wanted to be. I'm not at all disappointed. In fact, I'm thrilled to have been able to give birth in this manner, and my baby is as much a joy as anyone would expect. But, I think it's important to speak of feelings like these, just as it's necessary to express the anger, frustration, disappointment, or trauma of a birth that didn't go as hoped.

I bring up my third birth experience in order to make my final point. Going into this third pregnancy, labor, and delivery, I felt that I finally was fully informed. I knew what my choices were. I knew the possible consequences of any given option. I knew that sometimes an induction or c-section is unavoidable or absolutely necessary. And I felt that I would be able to make peace with however this birth happened, whether I got the natural birth I was planning or if I (G-d forbid) ended up needing an emergency c-section for whatever reason. I knew how to avoid unnecessary interventions that might lead to what would otherwise have been an unnecessary c-section. I knew what I didn't want (which I think was more important than knowing what I wanted). I'm sure that if the birth hadn't gone as "planned" (although I use that term loosely), I would have had some emotional consequences, especially if it ended up being traumatic as well as undesirable. But at least I would have known that I'd made all the "right" choices, that I'd known going in what my choices were and how various scenarios might pan out.

Thus, in conjunction with giving women the space to discuss birth trauma, to express any "negative" feelings that might be associated with their given birth scenarios, it is also important to discuss birth options. It is important to go into birth knowing what possible outcomes there are, depending on what choices are made. It is vital to understand when something is necessary and when it isn't. That's not to discount those times when we simply don't know what the right thing to do is, and we simply have to make a choice based on incomplete information, of course. But going in knowing that A may cause B, or that C is a direct result of A can help guide our decisions throughout the birthing process, and going in armed with information can at least alleviate the pain of thinking you've done something wrong if events don't play out as expected.

Five years after my own traumatic birth experience, I looked into the bathroom mirror and examined my recent postpartum belly. Under the little "shelf" of belly fat left over from being sewn up from the c-section is my external scar. I noticed, that day, that the scar was quite faded. It was no longer an angry red or purple. It no longer stands out brightly against my pale skin. It's there, but it's become a part of the landscape of my body. It no longer angers me. And I realized that along with the fading of the external scar came the fading of the internal ones, the emotional scars that I'd been left with because I thought I had made a series of bad choices that had led me to end up in a place I didn't want to be. Over the years, I have played out those couple of days of labor and delivery, trying to figure out "what went wrong." I shouldn't have gone to the hospital so soon. I should have walked around more. I shouldn't have gotten the epidural so early. I shouldn't have let them give me Pitocin. I should have been mobile so I could have pushed in a different position. It's easy to go over and over all the "bad" choices I made. For a while, I thought I might write out the "timeline" of the birth and go through and pinpoint each moment where I was led farther down the path to a c-section. But now, as I learn even more about the birth process, I have come to feel that a c-section may ultimately have been necessary no matter what choices I made to begin with. You see, the anger and guilt I felt didn't come from the fact that I had a c-section. It came from the impression that it was my fault I'd had a c-section. That I'd made the wrong choice when presented with an option. I no longer feel that way. I know I didn't have all the information going in. I now know that I couldn't have made good decisions based on what I knew at the time. And beyond that, now that I understand better how a normal birth should progress, I can see that it's entirely possible that my son was simply stuck, that there was no way he would ever have come through the birth canal no matter what I did, or that if I had tried to get him out that way, he or I might have been injured in the process. If that is the case, which I am more and more willing to believe, then thank G-d for the c-section, because I got a healthy baby and a healthy mom out of that decision.

My friend who had the scheduled c-section was describing the difference between the major surgery of a c-section and the major surgery of having her thyroid out. You see, "You get the door prize!" after the c-section. You get to take home your baby. Having your thyroid out isn't nearly as rewarding.

In the end, then, only you know how you feel about birth in general, about your birth experience(s), and about what you want to get out of having a baby. It's not anyone else's job to tell you how you "should" feel, or what choices you "should" make. I do believe, very strongly, that you need to know your options, you need to know the possible outcomes, you need to understand the process before you can make an informed choice. Because when you've made an informed choice, at least you aren't left with the "what ifs." I think it's the "what ifs" that are the most difficult to heal from.

Enthusiasm Does Not Equal Judgment

I sometimes feel that I'm treading a fine line between expressing enthusiasm about my chosen interests and the risk of offending friends who may feel I'm not being sensitive enough to their choices. Let me say this straight out, right now: I do not think you are less of a mother if you do not breastfeed. I do not think you are a bad mother if you use formula. I do not think you are abusing or poisoning your child with formula. And, finally, I would never judge you for making a parenting decision different from mine (unless there was clear child abuse involved, of course).

I consider breastfeeding another parenting choice we all have to make, just like we have to decide where the baby is going to sleep, live, go to school. Just like we have to choose a car seat and meals and whether we'll ever set foot in McDonald's with our kids. Just like we have to choose whether to cosleep until four years old or nightwean and cry-it-out at six months of age. Just like we choose whether to mostly use a baby carrier or a stroller, or to go 50/50 with it. Just like we choose whether our kids watch TV, and how much, and what. Just like we have to decide how to discipline our kids.

I happen to be very enthusiastic about breastfeeding and car seats. You may have noticed. I've also recently gotten very interested in birth practices (c-section versus vaginal, use of medications, etc.). Everyone has their "things." These are mine.

What it boils down to is, I just want to help. I'll never impose. I'll never jump into a Facebook discussion and tell you that I think you're doing something wrong. (I might jump in to defend you if I think you're doing something right, though!) But I do want you to know that I'm here with a sympathetic ear and a reasonable amount of information if you do want my help, and I'm very happy to help if asked.

I admit, it makes me sad when I see a kid buckled incorrectly in a car seat, or in a car seat that is too mature for his size or age. I'm sad because I know that child's life is at risk, when making him safer would be so simple, if only the parents would ask someone who knows how to do it properly. I'm not judging the parents' choice not to do it "right." I'm not labeling them bad parents. I'm not calling the police. It's their decision whether to properly educate themselves in car seat usage, and it's their prerogative as the parent to balance the risks and benefits to their child in using their car seat how they see fit, either for convenience or safety or somewhere in between. I know how I use my car seats, but I also know that I do things that other parents probably think are terribly unsafe, even if I think the risk is negligible. A lot of risk perception also depends on your own experiences.

It also makes me sad when I see a mother preparing a bottle of formula for her baby, but not for the same reasons as above. It makes me sad for the mother, because if she's using formula, it's likely because of a medical, psychological, or physical condition in her that makes her unable or unwilling to breastfeed, a medical or physical condition in the baby that makes breastfeeding difficult or impossible, or a case of the mother not having the support or information that she needed to initiate or continue to breastfeed. (In my case, it was that last reason.) Granted, there are women who decide, even when given all the information, that they simply do not want to breastfeed and start formula immediately after birth. That, too, is entirely their choice to make.

All I can do is provide information and support, give more "hands-on" help when asked, and offer advice when solicited. I certainly would not walk up to someone feeding her baby formula and confront her about it. But if I were sitting somewhere nursing my baby and someone asked me about breastfeeding, I would certainly be thrilled to offer any information she wanted, or even demonstrate if she were curious.

That's not to say I don't observe and wonder. If I see a baby being bottle-fed in a picture on Facebook, I may think to myself, "I wonder what the story is there." I don't ask. If she wants to tell me, she will. She knows I'm here to help if she wants help. If she's interested.

In the end, I just want my friends to take as much joy and love out of motherhood as possible, however that can be accomplished.

So, to make a long story short, I'm here with advice and assistance if you want it. That's all.

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Also, don't forget about my book! This book is targeted toward pregnant women and mothers with babies under three months old who have decided to breastfeed and want quick answers and support. It makes a great new-mom gift, and it's an excellent addition to your parenting library!