Parenting: the evidence

My son is nine weeks old now and I’m tired. I know that’s a given at this stage of life. But I have this persistent feeling that I should be getting more done. Life doesn’t stop when a baby’s born; there’s still a house to clean, bills to be paid, brains to stimulate (mine as well as his).

The thought of getting him onto a routine seemed really attractive. I borrowed a suitable book from the library and started the mental preparation for it. There were lots of useful ideas in it, but I had some misgivings, mainly about the frequency of breastfeeds suggested for his age. The author also admitted that the book was based on her anecdotal findings rather than medical recommendations.

So I decided to return to first principles and do some research. But it was initially difficult to find information on my specific question: How many feeds should a baby have in 24 hours? I found some interesting websites on evidence-based parenting and breastfeeding, and many interesting Cochrane reviews (current and planned).

I got side-tracked by a feminist critique of expectations placed on mothers and the World Health Organization’s breastfeeding guidelines (despite the WHO not being in our best books right now, I was interested in how firm they were about not introducing solids before 6 months; no big pharma behind that one, surely).

Still nothing concrete, although the WHO did recommend feeding “on demand”. But looking at the WHO site made me think more internationally. I wondered how women in other cultures feed their babies, and also how other mammals (especially our closest relatives, the chimpanzee) fed theirs.

Then I found an anthropology on Google Books, Hunter-gatherer childhoods, with a lot of interesting info. Apparently, mammals that carry their infants with them also feed them more or less continuously; evolutionarily, humans fall into this category. Hunter-gatherer women follow this model, essentially practising attachment parenting — they feed their infants constantly, carry them most or all the time, and sleep with them at night. Like other continuous-feeding mammals, their milk is more dilute than spaced feeders like rabbits, which leave their young in a nest or burrow and feed them at intervals.

Most women in developed countries feed more like rabbits than chimpanzees; for the most part, their babies seem to manage OK, but there’s no definite research into this. Certainly humans are very adaptive and the hunter-gatherer lifestyle can’t suit women who return to work, or who have limited support.

Still, I think it’s valuable to try and match our lifestyle to our design as closely as possible. I’d be interested in research into how different feeding patterns can affect health later in life, as well as general infant wellbeing (we always hear that colic doesn’t exist in developing countries, for example).

In the meantime, I’ve put the idea of a routine on the back burner. But it seemed like as soon as I relaxed about it, he started sleeping better anyway. They’re always one step ahead…

Organ donation: it’s for everyone

Yesterday, I had an article published at Galus Australis, which is a great website that features articles about Jewish life in Australia. I wrote about organ donation, as there are particular issues for Orthodox Jews when considering signing up as a potential donor.

For those less interested in the intricacies of Jewish jurisprudence, I’d like to present the Australian spin to the issue. This is a cheat of a post, because I’m going to pull some of the Galus Australis article into it, but I will add some further detail to assuage my guilt.

The good news for Australians is that we have a high rate of successful transplants. The bad news is that rates of organ donation in Australia are embarrassingly low for a developed country. According to the Organ and Tissue Authority’s website, around 1700 Australians are on a transplant list; last year, only half the organs needed were donated. (Fewer donors are needed than there are recipients, as one donor can save up to 10 lives, as well as providing non-essential [but life-changing] tissue, such as corneas to cure blindness.)

Fewer than one in five Australians have discussed their wishes regarding donation with their families. This is why donation rates are so low: people don’t know their loved one’s wishes and err on the side of refusal.

The Authority has a campaign running to encourage people to discuss their wishes regarding donation with their families. In many ways, this is more important than actually registering as a donor, as it’s the family, not the individual, that makes the ultimate decision. The message is pretty clear: register as an organ donor and talk about it with your family.

It can be uncomfortable to make plans about your body after death, and of course it’s highly unlikely that you will become an organ donor. But that’s precisely why it’s so important to have more potential organ donors willing and registered. It can also be helpful to consider registering for bone marrow donation and donating blood regularly; in the context of these living donations, the focus is taken off donation after death.

Together, these actions might save a life – or several – one day.

No right answer

“Good and ill have not changed since yesteryear,” says Aragorn in Lord of the Rings, but to me the goalposts must have shifted somewhere along the way. In my lifetime, mainstream opinions about euthanasia, and abortion (to name two important examples) have changed drastically.

The article linked above describes the extreme measures that parents of a Ashley, a girl with serious brain damage, have taken to change their daughter’s life. They have had her sterilised, so that she can’t become pregnant if raped; removed her breast buds, so that she won’t have the added discomfort of breasts; and given her growth hormones so that she will remain smaller and thus easier to transfer and care for.

They argue on their blog that they have done this to make her more comfortable and not for their own benefit; certainly they seem to be trying to provide her with the best environment possible. And of course, within reason, making things easier for oneself as a parent does make things better for the child.

In the Time article, the doctors looking after Ashley discuss their approach to this unusual case as doctors. Here’s a quote that I think goes to the heart of the matter:

“I felt we were doing the right thing for this little girl—but that didn’t keep me from feeling a bit of unease,” admits Diekema. “And that’s as it should be. Humility is important in a case like this.”

There’s no rule book for situations like this. And sometimes there just isn’t a right answer. All you can do is weigh it up and make what seems to be the best decision. I don’t know if Ashley’s doctors did the right thing or not. Even they don’t really know. In a sense, that’s what medical ethics is about.

Private universe

There’s been a fair bit in the news about autism recently.

I’ve always been fascinated by this disorder. The MMR vaccine scandal has been interesting to follow as an example of below-par science, and poor understanding by the public of the science. To me, this is just a symptom that science education and mainstream media science reporting needs some vast improvement.

But the main reason is probably that I know so many people on the spectrum. I grew up knowing a family in which all the boys had quite severe autism and have since met others with autism or Asperger syndrome. I always wondered: What sort of place could these boys have in a world where communication is vital? When you “have a different sort of internal thought” that in some cases leaves you completely dependent on your family or other carers for your entire life — what does it mean? What does it tell us about the human brain? Is it really a disorder, or just another state of being?

From that last article:

With autism diagnoses rising steadily, talk of an “epidemic” and a growing search for a cure, Roy feels threatened. “I feel stabbed when it comes to ‘curing’ or ‘treating’ autism,” he says. “It’s like society doesn’t need us.”

Many autistic people are starting to agree. They have had enough of being treated as a medical problem, arguing that autism is not a disease that needs to be cured but just a normal part of human diversity. This emerging “autistic rights” movement hopes to launch an international campaign akin to Gay Pride, encouraging autistic people everywhere to embrace their “neurodiversity”, and persuading wider society to accept them as they are…

Carina Schmidt’s son has autistic disorder and requires round-the-clock attention. His condition is so severe that he required a 10-month stay at the Kennedy Krieger Institute to break some of his self-harming habits. She is adamant about doing everything possible to help her son, who now lives in a group home in Rockville, Maryland. She also supports the development of prenatal tests for autism. “If my son could be cured today I would say ‘yes’,” she says. “My family has suffered like there is no tomorrow – that’s why we choose to have no more kids.” … Schmidt says that she will continue seeking help for her son. And she is sure he wants her to. “I can see my son wants to be normal,” she says.

There are no easy answers here. But I think the research being done now is fascinating and exciting. Even if people with autism don’t want a cure, this research goes to the heart of what makes us human: our complex, intricate, amazing brains.

Sleep deprivation = torture

Since becoming a mother I’ve become too aware of why sleep deprivation is a form of torture. Night after night of broken sleep really wears you down. The world seems fuzzy. Your brain feels fuzzy. Which is my general excuse for not updating this blog as often as I should.

I was also forewarned that I wouldn’t regain all the brain cells that I lost during pregnancy. My mind is definitely much improved, but not back to normal (hmmm, reminds me of the state of my body).

All scientists like a unified theory, so I was pleased to read the article (linked above) from New Scientist. Lack of sleep, it seems, causes memory loss. So once my daughter is sleeping through the night all should be well.

New Scientist likes to add a dissenting voice to the end of its news articles, such as:

However, Tarja Porkka-Heiskanen of the University of Helsinki in Finland says that may be going too far, as the 72 hours of sleep deprivation experienced by the rats is exceptionally long, equivalent to several days in humans. Sleep deprivation can damage memory, but only “in extreme cases”, she believes.

Of course, all that proves is that motherhood is an “extreme case”.