On Friday I started reading The Business of Baby, by Jennifer Margulis. The author’s name sounded familiar, but I couldn’t place her until I looked at her picture on the book jacket. It was then I remembered seeing her interviewed in Frontline’s piece on vaccines. She is not a fan. In the interest of full disclosure I was a little bummed. I did not agree with a lot of what she said on Frontline, and was a little leery of reading a whole book by her. That being said, it seemed well-researched, covering a lot of topics from prenatal care through baby’s first year, and had good initial reviews on Amazon. I dove in.
I finished the book last night and let’s just say it gave me a lot of things to think about. It is a book that I wish was around before I had children because some of what I read would have impacted decisions I made, questions I asked, questions I didn’t ask, and products I purchased.
The purpose of this post/review is to highlight some of the information I found most thought-provoking and give people a few things to consider who might not be interested in reading a book like this, but who do read this blog.
I didn’t read this book and take everything at face value. Much of what I found compelling echoed things I had read before. In that sense some of the information reassured me about decisions I made as a pregnant woman and as a mom. Some of the information made me wish I had trusted my gut.
Saturday morning I took Madeline to ballet. That hour that I sit and wait is when I get a lot of reading done. I came home and told Jay that when we have our hypothetical fourth baby we will not be finding out the gender because I’m not getting any ultrasounds (unless some problem arises that makes the benefit outweigh the risks). I had read before about ultrasound changing cell structure in mice, so the idea that there might be some risks to ultrasound, especially multiple ultrasounds like some women have, or long ultrasounds like many women have around the mid-point of pregnancy, was not surprising. Anecdotally, at my 20 week ultrasound with Madeline the technician had a really hard time getting a look at her head because she kept moving away. I remember thinking that it seemed like she was trying to get away. I wish that I had just stopped the ultrasound right there. But I didn’t. I didn’t really question the safety much at that point.
Before each of my next 20 week ultrasounds I told myself that if I felt anything like I had with Madeline I would discontinue the test. The boys never seemed to be trying to escape, but after Benjamin’s Jay even told me that he felt like it was really invasive. The way she pushed the wand into my belly to get the baby to move around and “show” her the right parts. I told him that I had my reservations about it, but what if they did see something? One of those rare cases where they detect some abnormality that can be fixed via surgery while the baby is still in utero? Or something that they will need to act on as soon as the baby is born? But much of the data shows that on average, outcomes are not better because of ultrasound. Yet according to the Listening to Mothers Survery released last week, 70% of mothers have three or more ultrasounds. If results aren’t better, and the data is pretty clear that they aren’t great at estimating fetal size, one of the major reasons many women have them (and why a lot of women are induced or sectioned for a suspected “big baby”), why subject the baby to the test? Do we know they are safe in the long term? It was once thought x-rays of pregnant women were a good idea.
We do know doctors make more money when they do ultrasounds.
This is one of the big ones that really gets me. The way the companies producing formula influence doctors, nurses and new mothers makes me sick. I’m not attacking anyone’s decision to feed their baby formula. I know that not everyone can breastfeed. I know firsthand that it can be difficult and you might supplement or not breastfeed for a full year. What I do want people to think about is why they are using formula and why they are using the formula they are. Know how breastfeeding works and do not allow nurses at the hospital to give your baby formula or anything else. 99% of the time your baby is okay. They will lose weight after birth. They will lose more if you had interventions causing the baby to retain fluid. Your milk will come in. Colustrum is all your baby needs at first. Don’t take samples. Having the product in your home will make it more likely that you use it.
Also, Don’t call Similac or Enfamil or Gerber for breastfeeding advice.
If the hospital or your doctor gives you formula samples do not take that as an endorsement of the brand. They got it free from the formula company so that they would give it to their patients who will see it as an endorsement and then buy it themselves. Even though they can get the same thing in a generic version for MUCH cheaper. Companies making formula donate millions of dollars to the American Academy of Pediatrics each year. Next time you are in a maternity ward or a pediatrician’s office keep an eye out for products with the brand name of formula on it – pens, notepads, tape measure for measuring baby’s head circumference, handouts about various infant care issues, posters on the wall, etc. When I had my first two babies in a military hospital in Washington I did not see one bottle or container of formula. I’m sure they had it because sometimes it is necessary, but I never saw it. With my last baby there were shelves of it in the room where they bathed the babies. Right next to the bassinet under the warmer. You couldn’t miss it. My doctor’s office had goodie bags with samples and who knows what else right behind the receptionist’s desk. There were brochures in the waiting room. These things do not support breastfeeding and undermine women’s attempts to feed their baby the most natural way possible.
Also, the United States was the only country to vote against a document written by the World Heath Organization that would protect moms from unethical advertising by formula companies. The International Code of Marketing of Breast Milk Substitutes instructed that, “Health workers should not give samples of infant formula to pregnant women, mothers of infants and young children, or members of their families.”
When Houston was just over a year old I switched to cloth diapers. I heard that kids in cloth diapers get less diaper rashes and Houston was prone to some bad ones. I also heard that cloth diapered babies potty train earlier because they feel wet after they pee. I had always pictured cloth diapers from when I was a baby, secured with pins and needing to be folded and all sorts of things I didn’t feel motivated to get into. Not the case with cloth diapers these days.
We all know that disposable diapers are expensive, contain all kinds of ingredients, and produce enormous amounts of trash. I won’t go into all that. What I did find interesting was the information on potty training. Back before disposable diapers were the norm 90% of children were potty trained by around 18 months. Now the average age is between 36-39 months. Cloth diapers don’t hold as much urine and babies/toddlers still have the sensation of being wet. And that’s not comfortable. Good disposable diapers can be left on for hours and hold a lot of liquid. Now we have kids still wearing diapers at three and four years old and this is normal. But is it necessary? Many kids are interested in the potty before then, but we don’t really take on the task of potty training because they seem so young. Interestingly some research indicates that earlier potty training actually leads to less bed wetting and day wetting than waiting until the child is older. Who benefits from four year olds in diapers? The diaper manufacturers who make size 5-6 diapers. We even have pull-ups to “help” with potty training, but all they really are are more diapers. Pampers had a pediatrician on its payroll for years who advocated for a child led approach that put off potty training.
This is another place where product placement is huge. Diaper manufacturers give their products to hospitals for free to be given to new parents. They know that if you get a package of Pampers Swaddlers at the hospital, you are more likely to continue using them when you get home. What if they gave you a couple of cloth diapers and showed you how easy it can be? There is a hospital in Colorado that uses exclusively cloth. They don’t want to endorse disposable diapers generally or a brand of diaper specifically. They also think that cloth on a newborn is a better option than a diaper made out of so many synthetic ingredients.
Are cloth diapers for everyone? I would argue they can be, but in reality that’s probably not the case. I would rather a busy working mom have more time with her kids than spend it washing diapers. I use disposable sometimes when we go out and I use them at night. This is all just stuff to think about more critically.
Obviously a lot of the information in the book shows correlations. A correlation between use of ultrasound and autism. A correlation between use of disposable diapers and late potty training. No one made it through the first five minutes of a high school statistics class without learning that correlation does not equal causation. Say it with me: correlation does not equal causation. However, what correlation does do is give us things to consider. Just because it doesn’t prove causation doesn’t mean that there is not relationship. Being pregnant is an amazing and exciting experience. So is having a child. We owe it to ourselves and to our kids to do our homework. Stop buying What to Expect When You’re Expecting (it’s a waste of money – all of the information is free on their website) and buy a book that will really educate you about the process of giving birth. Spend as much time making decisions about whether to breastfeed and what kinds of diapers to use and whether to circumcise as you spend decorating the nursery and creating your gift registry.
P.S. It’s no secret how I feel about childbirth and stuff. Everyone should make their own decisions. Educated decisions. If you can point me to the book that talks about how birth with lots of interventions is better, or how breastfeeding isn’t as good as we think, or how disposable diapers are good for the environment, I will read it.