Monthly Archives: October 2011
Mythbusting: Ferber Hasn’t Recanted Controlled Crying
Background: I actually used a spin on Ferber’s method when our kid was waking up every 90 minutes all night and we were going to die if we didn’t get some sleep. I read his book and adjusted it to what I was comfortable with (max 10 minutes of crying, and soothing her after each interval however I wanted, just so long as it didn’t actually put her to sleep in my arms; also I didn’t completely night wean – just cut it down to 1-2 times a night). I don’t think deliberately letting a baby cry, even when they’re older, is an ideal option, nor the first approach you should try if possible. But I also don’t think any kind of sleep training is automatically the fruuwits of the deveel like so many crunchies do.
And some terminology: Ferber endorses “controlled crying,” letting a baby cry for increasing intervals before comforting them, to help children sleep. This is one of many approaches to “sleep training,” or trying to get babies to sleep for longer periods without parental help. Any sleep training method that allows the baby to cry may be called “cry it out” or “CIO,” especially by sleep training opponents.
So anyway, I bought Ferber’s book in 2008, and he had a foreword stating that he’d reconsidered his stance on co-sleeping. In his original book he was 100% against it. In the new book he says he looked at new research and changed his mind, so he altered the book to include information on co-sleeping. While there may be some minor changes such as noting that controlled crying might not work for some children, the rest of the book is still about sleep training and how to do controlled crying.
The newest edition of The Womanly Art of Breastfeeding (La Leche League’s main publication) was published in 2010. It has a chapter on sleep, and on page 240, the authors argue against any kind of sleep training, claiming,
At least one well-known proponent of sleep training, Dr. Richard Ferber, has publicly altered his position on “crying it out” at night in light of more recent research.
No quote or citation is provided.
At a recent breastfeeding conference, several people brought up in a session that “even Ferber has changed his mind about CIO!” I asked if they meant the co-sleeping thing, and they said no, it was about not being in favor of sleep training anymore, and when I asked for a citation, I was told to Google it and it’s easy to find. That’s kind of true – lots of result headlines like “Ferber changes mind!” but when you read them, it’s only in reference to the co-sleeping issue, and it’s all referencing the new edition of his book, the entire purpose of which is to endorse and facilitate sleep training.
I don’t really mind if someone challenges one of my parenting choices, especially if they bring up new evidence that shows what I did was a bad choice (like putting my first baby in a separate room and using a sleep positioner!). But it totally irks me when people use false information to browbeat people into agreement. Folks who quote this Ferber meme only investigate far enough to support their own preconceptions, and ignore the actual evidence. It makes them look desperate and weak. It’s particularly questionable when such rumors are repeated in a prominent book which quotes a lot of research and includes citations. Were the authors merely negligent, or is this a purposeful attempt to mislead? Either way it’s a shame, because the book contains a lot of useful information that is actually true.
At its core, skepticism is about holding all conclusions provisionally, and being open to changing your beliefs if there is sufficient evidence refuting them. It’s easy to believe claims that dovetail with your personal inclinations. That’s why it’s even more important to investigate these claims before passing them along as gospel. Anyone can seek out confirming factoids, and even cherry-pick scientific research to support preconceived notions. The real test is looking at the strongest evidence against your pet theory, and taking it seriously. If your stance survives that, it’s robust and reliable. Then it’s time to pass it along to others. If you have to use obfuscation, avoidance, and misdirection to prop up your position, it’s time to reconsider it!
Natural Childbirth – No Medals Required
Sometimes when you talk about planning for a natural, drug-free labor, people will protest and tell you, “You don’t get a medal for having natural childbirth, you know.” The underlying message is that going drug-free is some social power play, motivated by a need to feel superior.
While it is fun to wow people with what a badass I am for having had natural childbirth, the thought of one-upping other moms was the farthest thing from my mind when I was deciding where and how to give birth. I did a lot of research and asked a lot of pointed questions (one midwife took me aside at a tour and asked if I was a nurse). I decided on natural childbirth outside a hospital, not for a medal, but for:
- Faster labor
- Lower risk of episiotomy
- Lower risk of instrument-assisted delivery
- Lower risk of breastfeeding problems
- No possibility of life-threatening epidural side-effects such as seizure, drop in blood pressure, or difficulty breathing
- Radically reduced risk of Cesarean Section
- Lower risk of infection
- No routine IV
- No chance of being denied food and water during labor
- Perhaps most importantly, the assurance that I would be treated with respect and care, and not as a hysterical idiot whose desires and even consent to treatment are irrelevant
My births were not exactly fun or easy. I didn’t have any powerful spiritual experiences, and I don’t feel the pain was necessarily a rite of passage. But I felt safe. I felt my babies and I had the best chance for health and wellbeing, and I trusted that if an intervention was suggested, it would be truly necessary and prudent, not just procedure or an aid to the convenience of the medical staff. I felt very secure that my care was both philosophically respectful of me as a person, and based on the best available evidence.
Who needs a medal when you’ve got that?
(Picture credit: Moms Deserve Medals, which produces medals for all mothers, regardless of birth circumstancs.)
Scene from an Acupunturist’s Office
Patient: So, I’ve never done this before. Can you tell me how this goes?
Acupuncturist: Well, first I clear an hour for your appointment. We spend a lot of time sitting and discussing your problems, your life, and what you’re looking for in treatment. I try not to talk too much, but just to listen to you.
Then I have you get comfortable and completely relaxed in our treatment room. It is decorated in a serene theme, and has scented candles and soft, tranquil music. You lie down on our padded table and close your eyes.
In my practice, I focus on respecting you as a complete person. I don’t treat you like a broken machine with one part that needs fixing; rather, I concentrate on supporting your total wellness, including mental and emotional health.
I provide caring, supportive human touch in a professional context that is all about you and what feels good for your body.
Oh, and I also stick needles in you.
Patient: Maybe we could just skip that last part?
Would you, could you, in a pill?
After giving birth, truly dedicated earth mothers don’t just delay cord clamping or ceremonially bury their placenta under a tree.
They eat it.
Why would they do this? It’s not completely out of left field. Many mammals, including herbivores, eat their placentas. We don’t really know why yet. Some people have taken this fact, together with the information that the placenta contains iron, estrogen, and progesterone, and concluded that eating your placenta will restore nutrients and hormones lost during labor, and help prevent such problems as anemia, low milk supply, and post-partum depression. Most people seem to go for having the placenta dried and made into pills (“encapsulation”), to cut down on the ick factor. Advocates of the practice are passionate and certain, employing a lot of bare assertion and very little actual evidence.
Check out some of the breathless claims from this placenta-preparation service:
The placenta has great restorative properties to assist you with your postpartum recovery. It contains many vital nutrients including iron, protein, vitamin B6, and the hormones it excreted during pregnancy. Just as it supported and nourished your baby, the placenta, when carefully prepared, nourishes the postpartum mother. It supports lactation and assists in the involution of the uterus to it’s non-pregnant size. It facilitates an easier postpartum recovery by increasing maternal energy and easing transitions.
Placental Services also gives this citation:
“181 out of 210 women who were given dried placenta to increase milk supply had positive results and saw an increase in their milk supply.
Placenta as a Lactagogon; Gynaecologia 138: 617-627, 1954”
Now, first let me say, if you would like to consume your baby’s placenta on the off chance it will do you good, I suppose you should go for it. I don’t see much harm. If it does nothing, you might lose some money to a professional encapsulator. (Of course safe handling is important, just like with raw beef or chicken or whatever.) But really, whatever floats your boat.
I’ll also grant that it’s possible that placentophagy could have some benefits. It’s not completely ridiculous, the way homeopathy is. It’s at least feasible that recouping iron and hormones could be beneficial.
But here’s my problem – this is at best a hypothesis. It’s testable, but hasn’t really been tested (as far as I can tell, that study didn’t use a control group, and the sample is small to boot). It’s a pretty big leap from “animals do this” and “it contains hormones” to “ingesting dried placenta prevents depression and low milk supply.” There’s also no particular reason to think that, say, iron from your placenta would be more beneficial than a Walgreens iron supplement.
And why are people so eager to make that huge leap? Because it’s “natural.” You won’t see this wide-eyed credulity when it comes to vaccines, for damn sure. People who avoid ingesting acetaminophen or corn syrup jump at the chance to chow down on placenta, because that’s what sheep do. It just doesn’t make sense to me. And I’m worried about the general mentality because it leads to distrust of science-based medicine and encourages faith in altmed woo – something that occurs in nature and seems like an alternative to Big Pharma products catches on fast, but any inquiry into whether it’s true is ignored.
What is Crunchy?
jekandsuch asks a valid question – what the heck am I talking about when I say “crunchy?” I think the term comes from the texture of granola, the stereotypical food of hippie types. When I use it, I’m referring to people who might describe themselves as “crunchy” or “granola,” or who may say they embrace “natural family living.” There’s no official checklist, but here are some practices common in the crunchy parenting world:
- Natural childbirth and/or home birth
- No infant circumcision
- Breastfeeding according to WHO recommendations and using baby-led weaning
- Baby-led solids
- Cloth diapering
- Reusable menstrual products
- Fertility Awareness Method for birth control and conception
- Co-sleeping (bed sharing)
- Baby wearing (slings etc.)
- Buying organic and local foods
- Vegetarianism/Veganism
- Rejection of “Western medicine” in favor of homeopathy, herbs, naturopathy, chiropractic, etc.
- Not vaccinating or using an alternative vaccination schedule
- Homeschooling
- Gentle Discipline
I consider myself “semi-crunchy.” Some of my crunchy choices were evidence-driven, some are matters of personal preference. Some were the result of believing misinformation or getting psyched up about a great philosophy, before finding that applying it in the real world didn’t work for me. But yes, I gave birth naturally in a free-standing birth center, I’m against infant circumcision, I breastfed exclusively to 6 months and for several years thereafter, cloth diapered, used FAM, wore my babies, and vaccinated my second child on a modified schedule for a while. I’m currently exploring various discipline and parenting styles, some of which are very “Gentle Discipline” style and some of which are not terribly favored in those circles.
As you can see, many crunchies include both personal-preference or evidence-based practices as well as woo-driven and “alt-med” choices. It’s frustrating to be a skeptic in these circles, because people tend to assume if you’ve breastfed a 4 year old, you’re on board with homeopathy and chiropractic. And that frustration is a big driving force behind this blog!
Natural skin care – full of irritants!
The crunchy set tends to eschew mainstream beauty products, often because they have scary-sounding chemicals in them. And sometimes the chemicals are genuinely of concern. I remember when scientists first found that phthalates might act as hormone disruptors in the human body. Even though this was an extrapolation based on animal exposure and high levels, I decided to avoid scented products as much as possible while I was pregnant and nursing, because they could include phthalates without having them listed in the ingredients. Maybe it was an abundance of caution, but it didn’t cost me much to simply buy unscented hand lotion and refrain from wearing perfume for a while.
There can also be ethical concerns, from animal cruelty to how manufacturing affects the environment, that motivate people to choose natural products over the basic drugstore and department store brands.
But sometimes people choose natural products over mainstream ones for totally bogus reasons, and often the natural product will have more dangerous ingredients likely to cause a reaction.
Perhaps the biggest offender is peppermint oil. It’s extremely popular in lip products, presumably because we like the breath-freshening potential. It also pops up in many products meant for oily, acne-prone skin, along with its cohorts eucalyptus, menthol, and camphor. I can only assume it’s used because it has such a strong psychological connection with freshness. In reality, peppermint and similar oils are very irritating to skin, and irritation is a big contributor to acne!
Check out this Beautypedia review of Aubrey Organics Natural Herbal Facial Cleanser for Oily Skin:
Claims: Keep your complexion fresh and clean and give your face a lift with this hardworking cleanser ideal for oily or blemish-prone skin.
Review: Natural Herbal Facial Cleanser, for Oily Skin is painful to even write about! This very irritating cleanser exposes skin to soap, witch hazel, alcohol, eucalyptus, camphor, and menthol, among other problematic ingredients. Ouch!
Lemon and other citrus oils are another popular, yet counterproductive addition to many natural products. They smell wonderful, sure. And this is another ingredient that has connotations of freshness and being squeaky clean. But citrus oils are phototoxic and can cause a sunburn-like reaction when they are exposed to light.
On the flip side, most natural living resources decry mineral oil as a toxic, synthetic derivative of petrochemical refining. Depending on the prevailing fad, they promote plant oils like jojoba, almond, olive, and avocado oils, or the most recent darling, coconut oil. Now these plant oils can be just fine and do very good things for the skin, but mineral oil has actually been shown to be one of the mildest, most effective moisturizing ingredients, and the least likely to cause skin irritation or allergic reaction.
People just can’t seem to get past the idea that it comes from petroleum. (And I suppose it’s arguable that there are ethical objections to using petroleum-based products, but I seriously doubt purchase of Revlon lipstick would drive global oil drilling if we weren’t fueling our cars with gasoline. Mineral oil is a useful byproduct of gas production.) Witness this rationalization from Green Living Q&A when someone brings up the above-referenced information from cosmeticscop:
There are many more health effects associated with mineral oil, but my reason for not using it personally is that it is a refined petrochemical, it may have unknown toxic contaminants, it is incompatible with my body and the environment, and there are natural alternatives. A nut oil, for example, is simply pressed from the nut. Though separated from the nut meat, it is still in the form in which it exists in nature.
Yes, surely there is less danger of bad reactions if we use nut oils. No one is allergic to nuts!
When people make decisions based only on such fuzzy ideas as what’s “natural” and what isn’t, it can lead to some really perverse results. Someone desperate to avoid mineral oil due to speculation that it might contain toxins may enthusiastically embrace a product that will cause chemical burns to their skin if they wear it outdoors. A shopper who wants to clear up her skin without exposing herself to the evils of sodium laureth sulfate (which is actually a mild cleanser, unlike the similarly-named sodium lauryl sulfate), may scrub with a minty-smelling natural cleanser that winds up irritating her skin, thus increasing oil production and blemishes.
The best thing you can do is investigate the ingredients in a product and determine if they are likely to cause you a problem. As you may have gathered from my linkage in this post, I’ve found Paula Begoun to be an excellent resource for uncovering the bunk that abounds both in mainstream and crunchy cosmetics. But even perusing Wikipedia to research ingredients of concern can be helpful. What isn’t helpful is relying on labels that say “Natural!”
Jesusween
There’s a movement by some Christians to take advantage of Halloween to evangelize, since people will come to your door, and it’s considered acceptable to go knock on strangers’ doors. They’re calling it Jesusween, Jesus Ween, Jesus Win, and/or World Evangelism Day. They don’t seem quite sure how to brand it.
The main idea is to hand out miniature New Testaments, tracts, and Christian books and music to trick-or-treaters who knock on your door. “The days of hiding are over and we choose to take a stand for Jesus,” they declare. Personally I think they’re implying a greater level of persecution than is realistic. On Ash Wednesday, I’m not driven into hiding – I just don’t participate in that ritual. But I grant that priests don’t come door to door offering to smear ashes on me, so I can see how Halloween involves a lot more peer pressure. Most other people in the neighborhood will be handing out candy. It’s awfully uncomfortable to be the stick-in-the-mud whose porch light is off.
But is Jesusween a better option? If Christians worry that not participating in Halloween will alienate their neighbors, this is exactly the wrong direction to go in. A dark house on Halloween was always a bit of a disappointment, but you tended to roll with it. Sometimes people are at parties or events, or simply out with their own kids. But that lady who handed out apples, and the dentist who offered toothbrushes? Everyone hated those houses. They were total buzzkills. At best, receiving a tract will elicit a similar reaction from kids. Plus the added possibility of seriously offending parents (like me) who object to adults trying to convert their kids without parental consent.
Personally, I’m fine with people opting out of Halloween because it conflicts with their beliefs. You don’t owe my kids candy. But hand them a tract instead of a Snickers, and you’re going to ruffle my feathers. And theirs!
When I mentioned to my 8 year old that some people might be giving out Bibles instead of candy, she immediately said, “If someone gives me a Bible, I’m going to throw it in the trash. Besides, I’m too young to be reading that!” Covering my giggle at the latter statement, I talked to her about being polite, even when someone gives us something we don’t like. She allowed that she would be nice and say thank you, and wait until she got home to throw the Bible in the garbage.
Evangelizing: you’re doing it wrong.
Skeptical Mothering 