We cosleep with our baby, but she keeps waking up every hour or two to breastfeed. I put her to sleep at 7 p.m., and she wakes up two hours later. I join her at around 10 p.m. and then she keeps waking up and nursing. Should I move her away from our family bed to help my baby sleep better?
A: I am delighted that your baby sleeps with you. If she woke up in another bed or another room, she would have had to go through anxiety and crying every time she needed to breastfeed or to feel reassured that you still exist. She would have given up half the times, and she would have learned a painful lesson, “When I need care, I have to cry loudly.” This is the early training for tantrums and anger.
When babies are carried on our bodies and sleep with us, they hardly have to make a sound to get the care they need. As they grow older, they will keep asking for what they want in gentle ways.
Waking at night is nature’s clever design. Babies grow in their sleep and can become easily hungry. Sensing the presence of the mother’s body reminds them to wake up and nurse. In addition, since their breathing is still immature, nature makes sure that they wake up often enough to avoid very deep sleep and apnea. Nature makes no mistakes.
Your expectation that she should wake up less frequently causes you undue stress. The good news is, she is thriving and you are meeting her needs wonderfully. Without your misled expectation, you can respond to the way she is with joy. I recall waiting impatiently for the sweet moments of my babies waking up at night so I can kiss, smell, breastfeed, and feel the baby. These times are heavenly, but resisting and worry steal our joy away. The more you follow your baby’s needs, the easier it becomes. Of course, make sure to eat well yourself, avoid stimulating foods, and provide a dark, quiet bedroom for your family.
The baby is always right. The baby never asks for something wrong. The basic needs she signals for are what she absolutely needs. Your job is not to alter your baby but to respond to the way she is. You only doubt yourself when under the influence of other people. Listen to your little baby and to your own heart. She is needing to sleep with you and to wake to breastfeed as often as she does. There are ways for you to get enough sleep without going against your baby’s needs.
Couple Time and Bedtime
Many couples with a first or even a second baby are still “hoping” to resume life the way it was. They want to put the baby to sleep and have time for themselves. However, more often than not, sleep proves itself far from a good babysitter. Bedtime becomes a struggle because of an unspoken goal of getting rid of the baby or child. The baby senses this intent and may become resistant to sleep or simply not wanting to be excluded. Because it seems to work for some when the baby is still young, we are fooled to believe it would keep working.
In reality, your baby needs your uninterrupted presence when sleeping. The baby has no idea of future and no sense of existing without her body being touched. She can therefore experience terror when alone. This is the reason that nature gave babies a built-in reaction of crying when away from our bodies. Nature never meant for babies to sleep away from their mothers. And, mothers naturally want to hold their babies. There is no reason to train mothers and babies out of their healthy attachment.
When you put your baby to sleep at 7 p.m., she is not cosleeping for a good part of her night. She is alone. Waking up to find herself without you is scary for her. She can develop into a light sleeper who wakes up frequently to guard that you are close by. Your daughter’s emotional well being, confidence, intelligence, and health depend on taking for granted that mom is always present. This may require a lot more than you thought you were ready to give, but at the end, it is the easier way and it results in a well-behaved, content child. Be gentle with yourself by avoiding guilt, and instead, learn and grow daily by listening to your baby and exploring inside of you the thoughts that drag you away from enjoying her fully.
In natural societies, parents never put their babies or children to bed. A baby sleeps when she sleeps. She is in arms at all times and regulates her own sleep. In this way, the baby learns self-awareness and self-regulation without becoming dependent on adult control. Let your baby fall asleep on the breast anywhere you are, at her own time, so she can become self-aware and develop healthy sleep.
Full-Time Cosleeping
I often say that I was a lazy mother. I wanted to do everything the easiest way. Amazingly, I found that this was also the kindest way to babies and children. I always went to sleep with my children in the same bed and the same time. They had no stress about bedtime and are terrific sleepers. I never put them to bed. Every night was a slumber party, and we always had enough sleep and sometimes I even read in bed in the morning while the children were still asleep.
We must move on and depart from old expectations. Sex and couple time don’t have to be always in the evening and in the bedroom. Trying to impose couple time in the evening, when the baby needs you the most, is a struggle against nature. Find new times and settings for your relationship and realize that being together as a family is romantic, too. It is not about sex but about love and sharing the child you are nurturing together.
Your baby needs to be in body contact with you at all times, including the first hours of her night’s sleep.
Use these principles in your own creative ways. Respond to the flow, nurture your daughter’s natural ability to recognize her own tiredness even if she fights it — it is her self-discovery — and provide constant, stress-free physical closeness. Your baby wake-ups are wonderful and healthy; without struggling against it, you can cherish each moment of cuddling with your nursing little angel.
Dad’s job is to take over the job of the lactation consultant when the family goes home from the hospital. The father is who will be available to answer questions at 3 a.m.
Many mothers struggle with confidence when breastfeeding: They doubt the baby’s desire to breastfeed, they doubt their family’s support for breastfeeding, and most of all, they doubt themselves and their ability to breastfeed. A new mother struggles with confidence almost every day, and her shaky confidence is easily destroyed by a doubting father. When you say something foolish like, “I don’t know, Honey, maybe we need to give him a bottle,” you have just damaged your family’s chances at breastfeeding success.
As a midwife, lactation consultant, and father of seven beautiful breastfed babies, I’m often asked to share my perspectives with new parents. First, let me say, I have found through personal and professional practice that almost everything is hard the first few days or weeks with a new baby — and breastfeeding is no different.
You will do yourself a favor if you prepare for the challenges by learning all you can before your progeny is born. I encourage you to talk to your health care provider, lactation consultant, and especially friends who have successfully breastfed for more than six months. Learning from successful and experienced breastfeeding friends is a good way to get honest, accurate information and avoid the myths that make breastfeeding so very challenging. I warn you to ignore the advice of couples who failed at breastfeeding, as their perspectives, while honest, may not always be accurate.
Before we can talk about your role in breastfeeding, we have to first answer the most fundamental question: Why would anyone want to breastfeed? In the old days, we used to talk about the benefits of breastfeeding and you will still hear some people mention it, but not me. Believe it or not, breastfeeding doesn’t make your baby bigger, stronger, faster, or smarter. Breastfeeding doesn’t make him super-human, it just makes him human. Continue reading #1 on the Breastfeeding Team –> Daddy→
One of my worst parenting days was when I was still sitting at my computer in pajamas and my husband walked through the front door. I thought that he had forgotten his laptop again and returned to get it so that he could go back to work and get started on his day. When he didn’t seem to want to leave again, I realized that it was suppertime and that I had succumbed to spending the whole day in the black hole of the internet and social media.
Where had the time gone? My kids had spent the day at home watching movies and eating sugar cereal for breakfast, snack, lunch, and snack. I realized then that I needed to manage my online time better and not have it manage me so that I was missing out on the life I wanted.
The internet and social media can be a huge distraction for women who work and parent at home. Here are some tips to manage your online life: Continue reading Managing Your Time Online→
In April 2005, Rani Jamieson gave birth to a healthy baby boy, Tariq. She was given Tylenol #3, a medication containing acetaminophen and codeine, for postpartum pain. She took two pills twice a day, less than the prescribed amount, and cut this dose in half two days later after experiencing fatigue and constipation. She was told it was safe to take this medication while breastfeeding, and did so.
When he was seven days old, Tariq became excessively sleepy and had trouble breastfeeding. His mom began pumping and froze her extra breastmilk while continuing to nurse. She brought Tariq in to see his pediatrician when he was 11 days old for poor feeding; the pediatrician noted he had regained his birth weight and nothing further was done. On his 13th day of life, Tariq became unresponsive. When the ambulance crew arrived, he was already dead. Six months later, an autopsy showed a deadly overdose of the codeine his mother had been taking.
Codeine is generally regarded as a safe medication for use by breastfeeding moms immediately postpartum. In 2001, the American Academy of Pediatrics issued a report stating that codeine had not been reported as causing signs or symptoms of problems in breastfed infants and that it had no effect on lactation. It was included in a list of medications “usually compatible with breastfeeding.” Actually, several reports of apnea in infants whose mothers were taking codeine had been previously reported, in 1993 and 1984, according to a study published in the January 2007 issue of Canadian Family Physician.
Even today, the Academy of Breastfeeding Medicine, a breastfeeding advocacy organization, reports that codeine is generally a suitable choice for postpartum pain. In their report on pain control in breastfeeding mothers, they advise limiting doses of pain medications to the minimum amount necessary and suggest that nonpharmacologic means of pain control such as hypnotherapy may be better. However, they ultimately conclude that codeine is generally safe because it has been widely used by millions of women worldwide.
How can a medication that has been safely used in millions also be dangerous enough to kill a newborn baby, even when used at lower doses than the standards recommended? Scientists have recently begun studying the role of genetic variations in drug reactions. They have found that individuals with certain forms of genes are more likely to metabolize drugs in ways that lead to higher side effects. For example, the chemotherapy drug cisplatin causes hearing loss in some of the people who receive it, particularly children. However, until recently, no one knew why this was. It’s now been shown that certain forms of genes are responsible for this side effect, as published in the September 2007 issue of American Journal of Human Genetics.
For codeine, the answer lies in a gene called CYP2D6. Those with a certain form of this gene metabolize codeine very rapidly. Codeine works as a pain medication after it is metabolized to morphine, which then acts on pain receptors in the body. Those who metabolize codeine very rapidly end up with very high levels of morphine in their bodies very quickly. In the case of Tariq, his mother had symptoms early on, suggesting that she was a “fast-metabolizer” of codeine. Tariq was found to have morphine levels of 90 ng/mL, much higher than the level usually seen in infants receiving intravenous morphine, about 12 ng/mL. Rani’s frozen breastmilk contained 87 ng/mL of morphine.
Why, before codeine was deemed safe for the infants of nursing mothers, weren’t morphine levels in breastmilk studied? They were. A study published in The Journal of Human Lactation in 1993 measured the levels of morphine in the blood and milk of seven mothers taking codeine and in the blood of their infants. The levels of morphine in the infant’s blood never exceeded 2.2 ng/mL, which is generally considered a safe level, and is much lower than the levels found in Tariq’s blood.
Claims of medication safety are usually made after drugs have been tested in uniform populations at standard dosages, not in diverse populations that represent our society. In the case of CYP2D6 gene variations, the fast-metabolizer form occurs in up to 29 of every 100 people, depending on ethnicity, as published in the Canadian Family Physician study. It’s easy to see how measuring the levels of morphine in the milk of seven mothers of an ethnicity with a 1% rate of genes causing fast metabolism of morphine would be unlikely to include a mother with this variation. Had the study been done in mothers of Ethiopian descent, who have the highest chance of having this form of the gene, the researchers likely would have seen very high levels of morphine in the milk of at least one of the mothers.
Given these facts, it is likely that millions of infants worldwide go through their first days of life sedated and drowsy, while their mothers are reassured that the medication they are taking is harmless. Many new moms, unfamiliar with an infant’s behavior, may not recognize that their babies’ behavior is unusual. If they do worry and seek medical care, many doctors would fail to recognize the symptoms as a drug effect. One can only surmise the effects of this early drug exposure on brain development.
Genetic mutations such as this also account for other side effects of medications. For example, the CYP2D6 gene is also important in how the body handles another pain medication, tramadol. Those with the gene variation causing rapid metabolism are much more likely to experience nausea than those who do not. Half of rapid metabolizers develop nausea, compared to only 9% of those who are able to metabolize tramadol completely, according to a study published in the February 2008 issue of Journal of Clinical Psychopharmacology. Similarly, individuals with this form of the gene who take codeine have a 91% chance of becoming excessively sleepy with the medication, compared to 50% of those without it. Those who metabolize codeine very rapidly have 50% higher levels of morphine in their systems.
This new understanding of the role genes play in the way our bodies process drugs illustrates the reasons why pharmaceuticals that seem safe can still be very dangerous. Since this report was published, some strategies that have been recommended are using medications such as ibuprofen instead of codeine in breastfeeding mothers, using codeine for a shorter time after the baby is born, or even performing genetic studies in all mothers to determine if it is safe for them to use codeine while breastfeeding. These strategies are flawed. Simply reducing or changing the pain medication used is not likely to be effective in controlling a mother’s pain. Carrying out mass genetic screening would be extremely costly and time-consuming.
Not only are these strategies impractical, they fail to address the real issue. Pharmaceuticals are dangerous. Reports indicate that adverse drug events occur in 67 of every 1,000 hospitalized patients and are fatal in 3.2 of every 1,000 patients, according to a study published in the April 1998 issue of Journal of the American Medical Association. Worse, 95 of every 1,000 hospitalized children experiences an adverse drug event. Of every 1,000 children admitted to the hospital, 20.9 are admitted because of drug reactions. Almost half of these are life-threatening reactions. It’s estimated that 14.6 of every 1,000 children who are not hospitalized will experience an adverse drug reaction, as published in the July 2001 issue of British Journal of Clinical Pharmacology. According to the United States Food and Drug Administration, if these rates are accurate, adverse drug reactions are the fourth-leading cause of death in the United States. Even when drugs are thought to be safe for many years, using them can still have devastating consequences.
The best strategy, one that isn’t commonly proposed, is simply avoiding medications in the first place. Medications are widely overused. In the case of postpartum pain, choosing a natural childbirth, with alternate methods of pain control if needed, provides the safest environment for the baby. This option avoids the risks of codeine in particular and also lets women avoid all of the drug effects that are not yet understood and can’t be predicted. If a mother does feel that taking a medication is important for her health or that of her child, she should diligently watch for any side effects. Mothers are wise to listen to their bodies and to not hesitate to seek alternate treatments if concerning symptoms occur while taking a drug.
Some mothers who chose to avoid drugs while pregnant and breastfeeding do so because they are aware of studies showing the harms this can cause to their infants. Most, however, likely are led to this choice by their innate wisdom. The choice to have a natural childbirth is often criticized as unnecessary because of claims that drugs such as codeine are safe. The new understanding of genetic variations provides evidence that the instincts of mothers who choose to avoid these situations should be trusted.
Mothers who are in a situation where they are offered pharmaceutical treatments should carefully weigh the potential, unknown risks of taking these medications. Because the effects a drug will have on one individual cannot be predicted by what has happened in others, one cannot be too cautious in making this decision. As with many parenting decisions, the choice to use pharmaceuticals cannot be taken lightly. It is prudent for all individuals, but especially nursing mothers and growing children, to avoid these potentially toxic chemicals whenever possible.
By Sonya Fehér, contributing editor for the API Speaks blog, leader for API of South Austin, Texas, USA, and blogger at www.mamatrue.com
Before my son was born, a friend gave me the book, Babyproofing Your Marriage. The book was based on very traditional gender roles and a husband who expected his wife to have dinner on the table when he got home and justify why the house wasn’t clean when all she had to do was hang out with a baby all day. The advice they were giving wasn’t for us.
Even so, it turned out our marriage did need some babyproofing. Decisions we made about parenting turned into unanticipated challenges to our intimacy and partnership. Continue reading The Marriage Challenge→
As each new talent emerges, toddlers get busy and forget to do lots of things: watch in front of them when moving, pick up toys before stepping on them, and eat. They fight the fork, the spoon, and even self-feeding in an effort to get back to their most important work: play.
Some toddlers make up by nursing even more at night. Sometimes this continues to work for both mother and toddler. Sometimes, however, Mother chooses to night wean.
In this case, night weaning led to day weaning, and soon, my toddler was completely off the breast long before I ever considered the idea.
Our Story
When Ryan was 15 months old, we decided to move. (May I just point out, this is total chaos and I never recommend it!) We packed up everything we owned and drove four hours north. This move from the familiar into the unknown turned my toddler’s world upside-down. He didn’t know where he was, where any of his toys were, where his dogs were, and most importantly, he didn’t understand why Mommy had been less than 100% attentive in the weeks leading up to the move. Since he was mobile, self-feeding, and easily entertained, my attention had been focused on working and packing.
So, slowly but surely, one feeding would slip through the cracks, then another and another.
At the same time, we gave up night nursing. As a family, we decided that Ryan’s continued and constant night nursing wasn’t working. As he became a busy toddler, he became what I like to call a “full-body” nurser. What I mean by this is that he no longer just nursed with his mouth, he rubbed my belly with his hand, kicked with his feet, and screamed every time I even considered taking him off the breast so I could roll over and sleep myself. When he was an infant, night nursing was a joy. But as he grew more adept with his body, it became a challenge.
One thing led to another, and the next thing I knew, my toddler had not asked to nurse and I had not offered in several days. He did take a few weeks to wean completely; it was a gradual and gentle weaning.
But I found myself missing the time we spent together. My baby was gone, and a cranky toddler had replaced him. And though I love the new skills and fun this age provides, I missed my little boy.
I felt rejected — that I was less than the mother I used to be. How can I possibly be an attached parent if I didn’t breastfeed past the 16th month? And the guilt — oh, the guilt! I’ve selectively vaccinated my son — is he now set to get polio since he’s weaned? Do I have to skip ahead and vaccinate like crazy to catch up now that he won’t be getting breastmilk anymore? These are just a few of the questions bouncing around in my mind.
Nursing had always been my go-to fix for anything Ryan needed. Fell down and bumped your knee? Nurse. Bored and cranky because we’ve had to wait too long for an appointment? Nurse. Tired and distracted and just need some time to get centered? Nurse.
With weaning, like all transitions, I had to learn how to interact and care for this new person in my life. This independent, yet fragile, little boy still needed my love and support, and I had to figure out some other way to be there for him without offering the breast.
Easing the Transition
Here are a few tips that have worked for us:
Make up for the missed breastfeeding time by having extra cuddle time — Sleep with your toddler even after the nursing is gone.
Have special before-bed and wake-up time — that involves singing, cuddling, and the same undivided attention you would have given had you been nursing.
Consider bottle nursing — If you are comfortable with it, cow’s milk or water in a bottle can be tempting enough for some toddlers to allow lap time, even if it is only once a day.
Pick a special song or two just for boo-boos — When Ryan gets hurt, I pull him onto my lap and sing very softly and close to his ear the same song every time. He seems to get a sense of comfort from this. He knows that he has been upset or hurt before, and by the end of the song everything seems a little bit easier to handle.
Acknowledge and mourn the passing of one stage, but celebrate and rejoice in this new one — It is okay to feel sad and miss that small bundle who depended on you for everything. It is also normal to feel happy and relieved that you are no longer the only one who can provide this comfort for your child. Allow yourself some time to just stop and feel.
I know that Ryan still loves me, needs me, and can’t imagine a day without me. And I know that like all things in life, this too shall pass. Sometimes, though, I wish some things — like breastfeeding — wouldn’t pass so quickly!
By Joe Diomede, author of Cycles of a Traveler and owner of Cloughjordan Cycle Co-op in Tipperary, Ireland, CloughjordanCycleCoop.com
Editor’s Note: Attachment Parenting is an approach to childrearing that is defined by Attachment Parenting International’s Eight Principles of Parenting. Alternative parenting styles, such as that practiced by the author, and which include natural parenting and instinctual parenting choices, may include Attachment Parenting but do not define Attachment Parenting. API takes no position on homebirth, vaccinations, elimination communication, non-consumerism, and other choices made by this particular family. For more information on Attachment Parenting, visit www.attachmentparenting.org.
When my wife, Angie, and I became parents, a whole new world was opened up to us. We had read books and talked to friends as everyone does, but in the same way that you cannot learn what a good Indian curry really tastes like until you experience it for yourself, being a parent and all that that entails was still only conceptual until the day our son arrived.
On that day our world changed — and not just because we now were three. Just five weeks after Louis was born, we moved to a tiny village in the Loire Valley of France and, in doing so, found ourselves in the situation of being cut off from friends, family, and such networks in a way that rarely happens to new parents in today’s world. It was during this time that we came to deeply connect with a part of ourselves that is buried within all of us and continually trying — sometimes even screaming — to be heard: our instincts.
As parents, we are generally not allowed the space to be able to connect with our inner feelings. There is constant bombardment from all sides telling us what a baby and mother need to be happy, well adjusted, and healthy. While many of these sources may be well-meaning, none of them are without an agenda: Governments, in conjunction with the powerful medical/pharmaceutical industry, want us to raise our children a certain way within their system of medicating and vaccinating our children to excess; baby food and formula manufacturers discourage breastfeeding so we spend on all the accessories to complicate a totally natural process. As new parents we are so vulnerable. We instinctively want to do everything right for our child, but with powerful influences like these, many of us are left shell-shocked and blind to what feels instinctively right. If somehow we could pull away from all of the people trying to sell us and tell us, we would be able to reconnect with ourselves and realize that we are the experts, and that is exactly how nature intended it to be.
The Offer
A couple of months before the birth, a friend of Angie’s offered us her empty house in the Loire Valley of France — an opportunity we didn’t pass up: house sit and redecorate for her, both of us be there for our child’s first months of life, grow our own veggies, and have a totally different beginning as a family. It wasn’t going to cost much and we had some money saved, so there was not much to lose. We felt it was a perfect move.
It soon transpired, though, others felt very differently: “Your baby will be a newborn. What about a doctor, a phone, a car, your family and friends – your support network?” I can honestly say we didn’t listen to a word. Yes, it’s true our decision to move was made before the little guy arrived. We had not held that small baby and felt his warm fragile body. We had not known what protective instincts would come over us when our child was out of the womb. All we could do was be strong and go with what felt right.
The Birth
Louis arrived after a 14-hour drug-free labor. The first part of the day was spent walking on the beach connecting with nature and each other. Angie was determined that if she could keep in touch and go with the feelings that were happening to her rather than panic and try to get away from them, then everything would be fine. She also had me to remind her and keep her grounded when things became a bit too much. With labor now behind her, Angie constantly tells people of her belief that a normal labor is about 75% mental and 25% physical and that all the negative programming we hear, often in the guise of education, before giving birth can only disempower and weaken the inbuilt ability that women have to give birth naturally.
A Life-Changing Move
So when Louis was five weeks old, the move was made down to France. Angie’s college-level French came into its own, and with our neighbor’s help and a few borrowed tools, we had some beautiful, weed-free, brown earth ready to be planted.
Louis seemed quite content to lie near us on a shaded blanket and watch the birds and insects fly by as we worked in the garden. We were enjoying every minute of our lives. We had all day and night to spend with our son, no pressures, and the best thing we actually had was time to really get in touch with ourselves. We were able to make so many decisions without any interference. It’s true that we were miles from any social support systems, such as friends and family, and there were certainly times when we might have liked a word of reassurance or a home-cooked meal from a friend or relative, but Angie and I discovered depths of strength we never dreamed existed and the three of us developed a bond beyond anything we had ever known before.
When Louis was eight weeks old, we put a second-hand car seat, which Angie bulked up with comfortable padding, into a bicycle trailer. Now Louis and Angie could accompany me on my four-mile round-trip cycle ride to the nearest town with a market. Louis loved his first ride so much that we started exploring the wider area as a cycling family and became somewhat local celebrities. People were attracted by the novelty of the whole thing and became instantly smiling and friendly when they saw us. It just added to our status already as the quirky foreigners with the cotton diapers hanging on the washing line. I guess this was the reason we didn’t get any strange looks from the olive and cheese stall holder the first time we asked him to weigh Louis on his scale. It was almost expected.
Our veggie patch prospered, Louis was healthy and seemed happy, and our nights were basically calm with him in our bed. Each decision — like co-sleeping and long-term breastfeeding — was less a choice and more an obvious path.
We stayed in that tiny village for ten months. Louis was such a healthy boy that we never needed to call on the services of the local doctor, who also happened to be our next-door neighbor.
Finding Other Attached Families
In March, we were heading back to New York for a year. It was a great opportunity for Louis to be introduced to his large Italian American family and for us to come to New York for the first time as parents.
It was when we got to New York that we went to our first La Leche League meeting and met other attached parents. The instinctive way of bringing up a baby that Angie and I had followed actually had a name, a legion of followers, and libraries of books attesting to its virtues! We were relaxed with ourselves as parents and now had some like-minded friends. We were also introduced to baby sign language, which benefited all of us. Our choices spoke for themselves, and some of my family were actually enjoying the world we were opening up for them as well. Louis’ fruit-eating capacity and his love of ethnic foods gained him two nicknames: “Mr. Spicy” and “The Goat.”
I had to defend our decision not to vaccinate Louis to my well-meaning cousin who is a doctor in New York. Funny enough, two years previously, Angie and I had to defend our decision to have a homebirth to the same cousin. But demonstrating by example, hearing and seeing us standing strong and confident in our position, and seeing the living proof in Louis, I believe we have possibly opened up otherwise closed subjects to his medically-orientated mind.
Back Home with a New Lifestyle
After leaving New York, we headed back to France — this time to our own house in rural Brittany. Growing gardens was becoming a major part of our life. We were getting hooked on living away from it all, and our instincts were taking us down a path towards a simple lifestyle of non-consumerism: Our bike riding had never diminished as much as grown, as we tried as much as possible not to get into the car we had purchased for the further afield shopping trips. We enjoyed living in our small house in the countryside, growing our own food and being “creatively poor” as we liked to call it.
When Angie became pregnant ,we came across a book called Diaper Free. It interested us, and we thought we would give it a go. Raising Francesca diaper free proved to be a challenge, but at the same time was an incredible opening to a world that forced us to rethink some other pre-conceived ideas that, until then, we had never thought to question. It also made us realize just how much small people, even at six weeks old, are capable of, and how truly sentient a human child is.
Since we had fallen off the mainstream path in many ways, my family in America and Angie’s in England were not surprised about our new foray into alternative parenting. It was an incredible journey and humbled us in our realization that, like an onion, we have many layers to yet peel back.
Parenting by Instinct
The attachment style of parenting has always had its benefits in watching our children be a part of their own process of growth and maturation. They have taught us more about ourselves in their short time with us than any self-help course could ever do. We encourage them to safely explore their instincts and to try to work problems out for themselves.
Our instincts brought us together as a couple, then helped lead us to where we are now as individuals, parents, and a family. This is not to say that we are perfect — far from it: Angie is fond of saying that parenting is the hardest, most wonderful, frustrating, fulfilling, amazing thing that can ever happen to you, and the biggest catalyst for personal growth in the world! I whole-heartedly agree.
Instincts have been around a long time. They have helped us survive and evolve as a species, so we are pretty comfortable trusting that they will help us to tread the path of parenting in the challenging years ahead. When in doubt, we always turn to books that have inspired us in the past or new ones that find their way to us. We also look forward to reading other sources such as good magazines, websites, or words of encouragement and advice from friends and others on similar paths. These resources are invaluable as guides, but remember, the inner voice should always have the last word.
Recommended Reading
These are books that Angie and I have found, and continue to find, helpful in our parenting journey:
How to Raise a Healthy Child in Spite of Your Doctor by Dr. Mendelsohn
Vaccination: The Medical Assault on the Immune System by Dr. Veira Schreibner
The Vaccination Bible by Lynne McTaggart
Spiritual Midwifery by Ina Mae Gaskin
Three in a Bed by Deborah Jackson
How to Talk so Kids Will Listen, and Listen so Kids Will Talk by Faber and Mazlisch
The Continuum Concept by Jean Liedoff
Superimmunity for Kids by Dr. Leo Galland
Yoga and Birth by Janet Balaskus
Immaculate Deception II: Myth, Magic and Birth by Suzanne Arms
By Rita Brhel,managing editor and attachment parenting resource leader (API)
Marian Tompson, founder of AnotherLook and co-founder of LLLI
When we think of the Attachment Parenting International Principle of Feeding with Love and Respect, what first pops into our minds is a woman enjoying a close breastfeeding or bottle-nursing relationship with her baby or perhaps a family sitting around the dinner table engaged in a lively conversation about the day’s happenings. What many of us don’t picture are the myriad challenges many parents must encounter in order to do what seems to be such a basic part of child-rearing: feed their child.
Unless we’re experiencing a challenge at the time, we don’t think of the working mother pumping her breast milk, the parents feeding breakfast to their son via a stomach tube, or even the parents struggling with emotions toward their picky preschooler. And we certainly don’t think what it must be like for the HIV-positive mother who wants to breastfeed but is opposed by the medical community. But there remains debate about breastfeeding by HIV-positive mothers and whether the mother, particularly in developing countries where there are additional serious risks to not breastfeeding, should breastfeed or formula-feed her newborn.
Even for breastfeeding advocates, breastfeeding by HIV-positive mothers is a gray area. We want all mothers to feel welcomed to nurse their babies, but no one wants to pass HIV to their child through this naturally loving act. When going against what seems natural to us, we have to look at the research — and many of us probably do not fully understand what the studies have found.
It is because of this gap in knowledge and application of that knowledge that Marian Tompson founded AnotherLook as a 501(c)3 nonprofit organization in 2001, separate and unaffiliated with the La Leche League (LLL) International she co-founded more than 50 years ago. The opening statement on the homepage of AnotherLook’s website, AnotherLook.org, says it all: “The issue of HIV and human milk has been clouded by possibly questionable science, lack of precision concerning the definition of breastfeeding, and premature public policy statements.”
Editor’s Note: Attachment Parenting International finds the mission of AnotherLook to be incredibly important to the HIV-positive community. However, API wants to make it clear that this contents of this article do not constitute medical advice and that all HIV-positive women should consult their health practitioners regarding breastfeeding and their child’s risk of transmission. API cannot be held liable for any personal decisions made by readers based on the contents of this article.
I first heard about the monumental hurdles HIV-positive women face in breastfeeding while attending a LLL conference in Nebraska last summer. The speaker was Tompson, and her topic that morning was the nonprofit organization called AnotherLook (at Breastfeeding and HIV/AIDS), which helps to educate both parents and professionals as to the issue of breastfeeding by HIV-positive mothers.
About AnotherLook Based in Evanston, Illinois, AnotherLook is dedicated to further its mission to gather information, raise critical questions, and stimulate needed research about breastfeeding in the context of HIV/AIDS. AnotherLook questions feeding strategies based solely on the possibility of virus transmission instead of on maximizing the probabilities for good mother-infant health. The organization calls for clear, published scientific evidence as to the type and manner of feeding that will minimize infant morbidity and mortality and seeks out scientific proof that infectious HIV virus is present in breast milk and is transmitted from mother to baby through breastfeeding.
AnotherLook provides presentations, position papers, and recommendations, which can be found at its website.
Tompson spoke about the variety of information related to HIV/AIDS and breastfeeding, such as that the medical community in industrialized countries like the United States advises HIV-positive women not to breastfeed their babies. The guidance is out of fear of transmitting the virus to their child. One story told was of a woman in only the last couple years whose baby was removed from her care until she promised not to breastfeed, because the authorities called the choice to breastfeed over using formula as dangerous mothering.
It is for this reason that AnotherLook exists — to give HIV-positive mothers and health professionals factual information on what we know and don’t know about breastfeeding when a mother is HIV positive, to ask critical questions, and to stimulate needed research. Knowing the importance breastfeeding has in establishing a strong mother-child attachment relationship, you can understand what this organization means to those women with HIV/AIDS for whom AnotherLook provides a voice in exclusively breastfeeding concerns.
A Call to Action
AnotherLook has issued a Call to Action to assure the best maternal-infant health outcomes in relation to infant feeding in the context of HIV/AIDS. This call is needed because current research, policy, and practice, often based on fear, are focused on the reduction of transmission while neglecting the impact on morbidity and mortality. This not only may be misleading but may inadvertently set back critical gains already achieved in public health as a result of the protection and promotion of breastfeeding.
AnotherLook acknowledges the possibility that HIV may be transmitted through breastfeeding and that there is an urgent need for feeding guidelines.
In light of the above, AnotherLook calls for immediate action to provide:
Clear, peer reviewed research, with careful ongoing follow-up, which will provide sound scientific evidence of optimal infant feeding practices that lead to the lowest morbidity and mortality.
Concise, consistent definitions of feeding methods, testing methods, HIV infection and AIDS.
Development of research based infant feeding policies which are feasible to implement in light of prevailing social, cultural and economic environments; which address breastfeeding (particularly exclusive breastfeeding) as a critical component of optimal infant health; and which fully consider the impact of spillover mortality/morbidity associated with infant formulas.
Epidemic management from a public health perspective, with the focus on primary prevention, careful, unbiased surveillance, and the achievement of overall population health with the lowest rates of morbidity and mortality.
Evidence-based practices which protect the rights of both mothers and infants including education, true informed consent, support of a mother’s choice, and avoidance of coercion.
Funding to support the above actions and those programs which improve maternal/child health in general such as prenatal and postnatal care, nutrition, basic sanitation, clean water, and education, as well as exclusive breastfeeding until clear scientific evidence supporting the abandonment of breastfeeding is available.
Continued commitment by local and global researchers, policy makers, health workers, and funding bodies to basic scientific, medical, public health, and fiduciary principles in responding to this critical issue.
In summary, AnotherLook calls for answers to critical questions not currently being addressed that will foster the development of policies and practices leading to the best possible outcomes for mothers and babies in relation to breastfeeding and HIV/AIDS.
With the background laid out, let’s turn to Tompson for more information on the past, present, and future of AnotherLook.
RITA: Hi Marian. I recall hearing you say at the LLL conference that, knowing the time and energy and sheer work that goes into building up a successful nonprofit organization as LLL International is, founding another organization was a task that you never thought you would do. What made you decide to pursue the organization of AnotherLook?
MARIAN: It has always been important to me (and La Leche League) that mothers get correct information. In 1997, when WHO [World Health Organization] changed its infant feeding recommendations when a mother was HIV-positive from one where the decision would be made on a case-by-case basis as to whether or not she should breastfeed to one where all HIV-positive women were encouraged to formula-feed if at all possible, I set out to find the studies that backed up this change.
I was looking for the evidence proving that babies who are breastfed by HIV-positive mothers are more likely or less likely to get sick and die than those fed formula mixed with possibly contaminated water, which is common in developing nations with HIV/AIDS epidemics such as parts of Africa.
RITA: What did you find?
MARIAN: We question infant feeding strategies based solely on the possibility of virus transmission instead of on maximizing the probabilities for good mother-infant health. We still don’t know if HIV virus in breastmilk is actually live (infectious), and if it is infectious, if there is enough to infect the baby. We have a team ready to research this and have been looking for a grant to cover the cost.
The challenge is that most people in this field think we already have the answers to these questions.
RITA: How has AnotherLook reached out to professionals and the HIV-positive community?
MARIAN: We have had an international focus since the beginning, calling attention to the difference in recommendations depending on where the HIV-positive mother resides.
We have a private chat list that includes researchers, health professionals, speakers on this topic, health workers working with mothers in Africa, and LLL leaders and others interested in this issue.
We were invited to do roundtable sessions at an American Public Health Association annual meeting, did a poster session at the International AIDS Conference in Toronto [Canada], and our abstract was included in the syllabus of last year’s International AIDS Conference in Mexico City [Mexico]. We have given presentations at LLL conferences, both in the United States and abroad.
We’ve had letters printed in major medical journals criticizing published research.
RITA: Do you have any success stories that stand out of how AnotherLook is able to educate mothers or professionals in a way that changed the course of establishing a breastfeeding relationship when HIV/AIDS is a factor?
MARIAN: We have helped to change recommendations on infant feeding in developing countries from one in which mothers were told to formula-feed if at all possible to one where now all mothers are encouraged to breastfeed exclusively for six months.
Our poster sessions have pointed out the lack of evidence in the citations used to back feeding recommendations. The research hasn’t been done that would give us the answers needed about breastfeeding when a mother is HIV-positive.
We have become a resource for women in the United States who have no support group, like drug users and gay people have if they are diagnosed with HIV virus.
We also educate professionals about the assumptions that have long been accepted as facts.
RITA: Where do you see AnotherLook heading in the future?
MARIAN: Continuing to provide information through presentations and our website, while responding to inquiries. Even school children have contacted us. Working to get the research still needing to be done accomplished. Raising funds to enable us to participate in discussions of this issue.
When a director from UNICEF, who initially questioned the need for AnotherLook, attended one of our presentations at an LLL International Conference, she said that AnotherLook should participate in all international discussions because we were including elements that others had overlooked.
RITA: Thank you for your time, Marian. Do you have any closing thoughts?
MARIAN: New online at www.anotherlook.org/updates is Rodney Richard’s letter questioning the wisdom of mandatory testing of newborns for HIV. Richards is a bio/organic chemist who worked many years for Amgen, the world’s largest biotechnology company, specifically in the area of HIV test development.
His letter is in light of legislation passed in Connecticut, Illinois, and New York that require mandatory testing for HIV in newborns. Many states, such as Arkansas, Michigan, New Jersey, Tennessee, and Texas, have laws requiring HIV testing of pregnant women as part of routine prenatal care and then testing of newborns if the HIV status of the mother is unknown. We will probably see this legislation being considered in other states.
Also in the works are:
A detailed paper on WHO’s changing recommendations on infant feeding when a mother is HIV-positive
A report from the session we put on at the LLL International 50th Anniversary Conference, “Breastfeeding and HIV: What Works, What Doesn’t, What Has to be Changed,” with Cathy Liles, BBA, CPA, MPH, IBCLC, a member of the LLL International Board of Directors, and Ted Greiner, PhD, coordinator for the World Alliance for Breastfeeding Action Research Task Force.
About Marian Tompson Marian was one of seven women who co-founded La Leche League as a way for women to seek out support and education in breastfeeding as the best way to feed infants. LLL’s beginnings came at a time in history, 1956, when women were advised to forgo breastfeeding as an infant-feeding option. At this time, the U.S. breastfeeding rates dropped to only 20%.
Marian had an instrumental role in the nonprofit organization of LLL, serving as president for 25 years. In 1958, she started the newsletter that eventually became the magazine we know today, New Beginnings, and in 1973, she began the annually held Breastfeeding Seminar for Physicians.
Today, besides her work with AnotherLook, Marian is involved in the LLL Founders’ Advisory Council and the International Advisory Council for the World Alliance for Breastfeeding Action, and is vice chair of the United States Breastfeeding Committee. She and her late husband Tom raised seven children. Marian also has 16 grandchildren and five great-grandchildren.
API’s Connection >> Reedy Hickey, IBCLC AnotherLook and API share a member of their respective Boards of Directors. Hickey not only provides leadership to both organizations but also advocates breastfeeding as a local La Leche League leader and Georgia’s LLL professional liaison. She is the mother of two grown children and 32 foster babies, and practiced AP with each.
By Rita Brhel, managing editor and attachment parenting resource leader (API)
Attachment Parenting International’s seventh of the Eight Principles of Parenting, Providing Consistent and Loving Care, explains how babies and young children have an intense need for the physical presence of a consistent, loving, responsive caregiver who is interested and involved in building strong bonds through daily care and playful, loving interactions. Ideally, yes, this caregiver would be a parent. But, especially in the tough economic climate our world has experienced the past couple years, many families are finding themselves in a situation where both parents must work outside the home.
While a dual-income family may require more creativity in making the time and finding the energy to fulfill API’s Principles, it is certainly very possible to foster a secure attachment.
How does this relate to the second of API’s Eight Principles, Feeding with Love and Respect? According to Kirsten Berggren, PhD, CLC, author of Working without Weaning: A Working Mother’s Guide to Breastfeeding, going back to work is the hardest obstacle an exclusively breastfeeding mother will encounter. A neurobiologist, Berggren shares her own experiences and those of others to create this handbook for mothers who want to continue breastfeeding once they return to work after maternity leave. It’s a tough balancing act — maintaining the breastfeeding relationship despite day-after-day separations — but, as Berggren reiterates in her book, one that is completely worth the effort. Continue reading Working without Weaning: An Interview with author Kirsten Berggren→
Connecting with our children for a more compassionate world.
Dad’s job is to take over the job of the lactation consultant when the family goes home from the hospital. The father is who will be available to answer questions at 3 a.m.
As a midwife, lactation consultant, and father of seven beautiful breastfed babies, I’m often asked to share my perspectives with new parents. First, let me say, I have found through personal and professional practice that almost everything is hard the first few days or weeks with a new baby — and breastfeeding is no different.
One of my worst parenting days was when I was still sitting at my computer in pajamas and my husband walked through the front door. I thought that he had forgotten his laptop again and returned to get it so that he could go back to work and get started on his day. When he didn’t seem to want to leave again, I realized that it was suppertime and that I had succumbed to spending the whole day in the black hole of the internet and social media.
In April 2005, Rani Jamieson gave birth to a healthy baby boy, Tariq. She was given Tylenol #3, a medication containing acetaminophen and codeine, for postpartum pain. She took two pills twice a day, less than the prescribed amount, and cut this dose in half two days later after experiencing fatigue and constipation. She was told it was safe to take this medication while breastfeeding, and did so.
By Sonya Fehér, contributing editor for the 
As each new talent emerges, toddlers get busy and forget to do lots of things: watch in front of them when moving, pick up toys before stepping on them, and eat. They fight the fork, the spoon, and even self-feeding in an effort to get back to their most important work: play.
AnotherLook and API share a member of their respective Boards of Directors. Hickey not only provides leadership to both organizations but also advocates breastfeeding as a local La Leche League leader and Georgia’s LLL professional liaison. She is the mother of two grown children and 32 foster babies, and practiced AP with each.