Thursday 24 January 2013

Ignoring the ‘experts’ and sticking with the hard to follow guidance as a mom

Posted by Liane Azevedo

Being a Mom has changed my research interests. Now, every time I see something related to physical activity, diet or even sleeping behaviour in early childhood it grabs my attention.

However, I must confess that it is not always easy to follow the public health recommendations that are set for moms on how we should raise our children. More important, I think, is to fight against the pressure that you receive from family, friends and sometimes complete strangers to follow their guidance.

For me this started with breastfeeding. Being born in Brazil where breastfeeding is the rule rather than exception, I have never considered any other option. However, I must say this hasn’t been an easy process. I faced several challenges including mastitis, bleeding, and the fact that my son woke every hour during the night to breastfeed. As soon as I mentioned these problems to other people the first advice I received was, “Give him a bottle.” But I don't want to give him a bottle. Then you’re told that your milk must be weak, which is why he is waking up every hour and so on... (Note: my son was born on the 50th percentile and after 4 months he was on the 90th just with breastfeeding). 

Pieter de Hooch: Mother nursing her child, c1674 
People appear to want to impart their ‘expertise’ on every phase of his development. They say: “Why did you let your child feed himself? Now he is a fussy eater and look at the mess he does! Look at my son he is 2 and I still feed him and he is not a fussy eater”. Then when it comes to sleep they suggest the use of techniques such as ’control crying’, in which you let your child cry until he/she settles down. Being a very soft mom (I know I will pay for this later in his teenage years), I can’t cope with this idea. Luckily, I found some scientific evidence to support my decision (you can always find what you want to, when you search for it). According to this paper “Leaving an infant unattended and in distress, advocated by many clinicians, is not the only efficacious method by which sleep consolidation can be achieved and may not be either necessary, ethical or biologically sound.” It basically says that crying is the way a child communicates with its parents and by ignoring it, you will be blocking this communication. So, that will do as justification for me.

This all reminds me of a presentation I saw recently at the North East Physical Activity Forum, with the intriguing title: “Why we should shut up about the long-term benefits of physical activity”. Although the presenter didn’t give any scientific evidence to her comments, the main message was that long-term benefits of physical activity cannot persuade people to start physical activity. So, we should advocate the short-term benefits such as “have more energy”, “sleep better”, “meet people”, and “reduce anxieties, worries and depression”. I don’t necessarily agree with her comments, probably because I work in this field and the long-term benefits strike me more than the short ones. But this might be worth investigating. However, if I decided to look for the short term-benefits on how to raise my child, I would probably be doing everything against the recommendations. Don’t breastfeed, let him cry himself to sleep, and leave him in front of the TV so you can have your own time. I’ve learnt that sometimes you need to stick with hard to follow guidance to see the benefits which, might take a while to show but, are much more important than the immediate comfort that you would probably get from not following them.

3 comments:

  1. I think your post illustrates very clearly the way in which 'evidence' does not necessarily translate into 'advice'. Particularly when cute-but-wailing babies are involved, professionals can allow lay beliefs and emotions to take over from evidence-based knowledge and clinical judgment - and I don't think that's sufficiently acknowledged. In the UK, I suspect that some of those 'experts' who advocate bottle feeding and leaving babies to cry are parents who themselves struggled with breastfeeding and sleepless nights and who are giving the advice they wish could have been given to them. What does Brazil do right to make breastfeeding the norm rather than an exception?

    (Quick declaration of interest: mine are 3 and 18 months, and I'm still breastfeeding them both, and have barely had a proper night's sleep since 2009. And yes, they feed themselves too, and the kitchen floor hates me for it too..)

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    1. Hi Heather,
      I totally agree with all your comments and I am amazed to know that you still breastfeed 2 children and one is 18 months old. Well done! I didn't manage to go that long. Answering your question. I think it is part of the culture in Brazil, your Mom, your grandmother, everyone that you know breastfeed at least for the first 3 months. I remember also watching some advertises on TV about breastfeeding and TV celebrities commenting about breastfeeding their child. And as TV plays a huge part in people’s opinion in Brazil, I think that helps. Just another interesting fact I read recently that the number of TVs in Brazilian slums are almost double of the number of fridges.

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  2. Janet Shucksmith31 January 2013 at 17:11

    I love the way that even the evidence for something like the benefits of breastfeeding is so heavily contested. It ought to be relatively simple to prove or disprove in terms of impact on child and maternal health outcomes, but apparently not. The French discourse around breastfeeding is entirely different (see http://www.guardian.co.uk/commentisfree/2011/apr/01/france-breast-breastfed-baby-death for a good laugh), and these cultural differences and the impact they have on use of evidence and the hijacking of the discourse are exactly why we need more sociologists in Fuse!!

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