Allison Dixley’s feeling threatened; maybe she isn’t an alpha parent after all

alpha

Oooh, someone’s feeling threatened.

That would be Allison Dixley, the self-proclaimed “Alpha Parent.”

Those who denounce breastfeeding science are merely the exhaust fumes of the internet. They are an unfortunate and unavoidable result of our information age. Whilst emotionally satisfying for the denouncer, their pseudoskepticism has reckless consequences for the rest of society. Denouncers hold moral and political responsibility for selfishly promulgating misinformation to advance their own interests while knowingly damaging the work of organisations whose main focus is improving all our health. We need to reframe breastfeeding, not as some sort of ideology to be defended; but rather as a universal act of allegiance to our children and to ourselves.

Sorry, Allison, but no matter how much you wish to rub our faces in your “superiority,” you are out of luck. The science simply doesn’t support your self-serving claims.

You’re hardly the first to moralize breastfeeding by brandishing “the science.” Indeed, Charlotte Faircloth refuted your piece before you even wrote it in her paper ‘What Science Says is Best’: Parenting Practices, Scientific Authority and Maternal Identity.

She’s got you pegged:

Faircloth explains the meaning of “the science” to lactivists and the paradoxical invocation of scientific evidence by women who are just as likely to ignore science when they feel like it.

Simply put, lactivists don’t read scientific papers, don’t know what they show and don’t care anyway. “The science” is simply a convenient cudgel which lactivists use to metaphorically hammer away at women who do not follow their example:

The scientific benefits of breastfeeding and attachment parenting serve as a (seemingly) morally neutral cannon about which mothers can defend their mothering choices and ‘spread the word’ about appropriate parenting. I noticed that for some particular women, sharing ‘information’ with other mothers … was a source of great enjoyment – as Felicity in the quote above puts it, she is ‘super empowered’ with the knowledge that she has. Amelia, cited above, also said that she felt ‘like a genius on a planet of idiots.’ Any criticisms she has of other women are de-personalised, because science ‘has no emotional content…’

“A mother describes how she responds to those who criticise her decision to breastfeed her son until his seventh birthday, by saying: ‘I mean, do you want to see studies? Because I can show you studies!’ There are laughs and cheers from the rest of the group.”

But lactivists like Allison, who have basically no idea what the actual scientific evidence shows, use “the science” in another way:

Arguably, ‘science’ here is not about understanding, but belief. The use of ‘evidence’ has reached the level of the quasi-religious; not in the sense that the beliefs are other-worldly (quite the opposite) but that they are held to be beyond the possibility of doubt and revered as truth.

In other words, belief is described as “science” in order to trade on the reputation of science. As Faircloth notes:

In many ways, however, it is ironic that my informants refer to science, since many attachment parenting advocates are openly sceptical about scientific knowledge… What is interesting then, is the selective use (and mis-use) of scientific evidence to support certain (moral) discourses about parenting.

Appeals to “the science” are a rhetorical strategy, and a rather cynical one at that. The very same people who ignore the scientific evidence on the dangers of homebirth, who openly spurn the World Health Organization recommendations on vaccination, and who dismiss the scientific evidence on circumcision by insisting it is only relevant in the developing world choose to misinterpret and misuse the scientific evidence on the limited benefits of breastfeeding.

In Faircloth’s words “sharing ‘information’ with other mothers … was a source of great enjoyment.” That’s because lactivists are not “sharing,” they are browbeating other women as a method of enhancing their own self esteem. As Faircloth notes:

When ‘science’ says something is healthiest for infants, it has the effect, for [lactivists], of shutting down debate; that is, it dictates what parents should do.

Critically, for lactivists, it allows them to “moralize” the choice of infant feeding. In the minds of lactivists, “the science” turns breastfeeding from a choice to an obligation, the classic is-ought confusion.

… [U]nder the assumption that science contains ‘no emotional content’, a wealth of agencies with an interest in parenting – from policy makers and ‘experts’ to groups of parents themselves – now have a language by which to make what might better be termed moral judgements about appropriate childcare practices. [But] ‘Science’ is not a straightforward rationale in the regulation of behaviour, rather, it is one that requires rigorous sociological questioning and debate in delimiting the parameters of this ‘is’ and the ‘ought’.

Allison responds with anger whenever anyone points out that the benefits of breastfeeding, while real are small, because her own self conception and her ability to feel superior to other women (“alpha parent” just in case you don’t immediately understand that this is about boosting Allison’s fragile self-esteem) rests on presenting “the science” as firm, strong, unequivocal and dispositive. In the case of breastfeeding, it is none of the above.

Allison is a typical Sanctimommy, ignorant, immature, self-absorbed … and wrong when it comes to the benefits of breastfeeding.

Sorry, Allison. You’ll just have to find another way to boost your fragile self-esteem. Have you considered therapy?

Don’t know where to start? Just mention to a therapist that you refer to yourself as the “alpha parent.” He or she can probably take it from there.

 

Contains excerpts from a piece that first appeared in March 2011.

  • Tippa

    I just found that Alpha Parent blog today! I got about halfway through the first article I saw and thought ‘I bet Dr. Amy has some things to say about this. I better go check her blog.’ And lo and behold, I was not disappointed!

    As a side note, the article I read was called ‘Why the way you feed your baby IS my business,’ and it was every bit as sanctimonious and obnoxious as the title would lead you to believe (not to mention wrong). Some of the stuff on her list has already been discussed here, but I would just love to see it picked apart piece by piece.

  • Catherine

    My goodness thank you so much for this article. I’m tired of being ranted at by lactivists when they can’t back up their claims, apart from some very vague WHO stats

  • Ethereal01

    I feel sorry for your kids as you seem to seem to be a very angry person. By your tone, I guess you didn’t breast feed your children and want to trivialise mothering through breastfeeding as unimportant.

    • S

      Incorrect. Thanks for playing.

    • Box of Salt

      Ethereal01, did you read anything in this post that you think is factually incorrect? If so, could you tell what that is?

      Or are you just reacting in anger because the opening line above applies to you, too?

    • Jocelyn

      Breastfeeding is fine. Formula feeding is fine. That’s the point that she’s trying to make.

    • Bombshellrisa

      “Mothering through breast feeding”-so an adoptive mother can’t possibly “mother enough” if she didn’t breastfeed?

    • LibrarianSarah

      I feel sorry for your kids if you thinking mothering is as simple as open mouth insert boob.

      • ethereal01

        Mothering is meeting your child’s developmental needs at age appropriate stages. We are mammals and our babies have a need to suckle at the breast. Bottles and soothers are breast substitutes.

        Adoptive mothers can lactate, but it is hard work to establish a milk supply.

        What is factually incorrect is to state “that the benefits of breastfeeding, while real are small” Look at what has happened with the formula milk in NZ this week.

        http://online.wsj.com/article/SB10001424127887323681904578646952552857298.html

        We as the human race should be looking to encourage mothers to breastfeed through peer support and adequate maternity leave.

        • KarenJJ

          With you on the maternity leave but humans are also very good at using technology. Bottles and soothers are not just “breast substitutes” but an alternative to dying from malnutrition and/or an alternative to being fed pre-chewed rice or whichever supplementary food desperate mothers have fed their babies over the millenia in order to keep them alive.

          • Ethereal01

            Yes, I was born 2 months early, 30 years ago. My mother FF me. From what I see now, it is possible to bf a premature baby, but you have to have knowledge and support to do so. My mother didn’t have any of that and was told I had to be formula fed. Mothers are exhausted after giving birth, but they should have proper information to make a choice. Doctors may not know the answers themselves or they could be influenced by outside pressures to encourage a mother to decide a certain way.

        • Amy Tuteur, MD

          We are mammals and computers are unnatural technology. Therefore, I could hope that you could communicate the way that we are designed to do so, with words and gestures. Computers are communication substitutes, so you shouldn’t be using them.

          Or are you just another breastfeeding hypocrite, invoking nature when it suits you and ignoring it otherwise?

        • PJ

          Not a single child has actually got sick from botulism in formula in NZ. Your logic fails, anyway. Children can (and do) contract HIV and other diseases from breastmilk.

  • Sue

    ”We need to reframe breastfeeding, not as some sort of ideology to be defended; but rather as a universal act of allegiance to our children and to ourselves.”

    So, ”universal act of allegiance to our children and to ourselves.” is science, not ideology? That’s hilarious! These people don;t see irony even when they are drowning in it.

  • thank articles so much

  • I also think so. But really, it is a rather complex issue. Gru.

  • I don’t have a creative name

    These nutjobs would be much better off just offering help to women who want to bf and are having problems, and leave women who literally can’t, or just don’t want to, the hell ALONE. But then again that wouldn’t serve their purpose of desperately trying to prove to someone, anyone, that their behavior makes them superior to any mother who chooses otherwise.

  • Meerkat

    I know, I know! Why don’t these lactivists create a non-profit organization that will help women with breastfeeding. They could come to women’s homes and provide lactation support, free of charge. Wouldn’t that be lovely? Maybe not- or maybe they can raise money, so certified lactation consultants can do that. Or lobby the government for longer paid maternity leave. But that’s not fun! That way they’ll have no one to spew their venom on.
    You are right, Dr. Amy, it isn’t about breastfeeding at all.

    • yentavegan

      La Leche League is a non-profit organisation. Many La Leche League Leaders do provide at home lactation support for free. LLL Leaders do not charge for phone help, home visits or group meetings.
      I am not sure if you were being sarcastic, or if you did not know about LLL.

      • Meerkat

        I was being sarcastic. La leche league, ha! I called la leche league after I came home from the hospital. Actually, their hotline. Interestingly enough, I had to leave a hysterical message, because no one answering the phone. I guess the line wasn’t so hot…They called me back 8 hours later. They were about as helpful as my cat. No, less helpful, because my cat was very soothing. They gave me a list of lactation consultants in my area. The average price of a house visit was $200.00. There were support groups at the Y, also not free. I refused to pay that money on principle. My subsequent experience with a couple of lactation consultants proved that they are absolutely useless. I didn’t waste a dime on them. I am hoping that some lactation consultants do know what they are talking about, but I haven’t met any. I am really annoyed that my baby friendly hospital gave me an impression that there would be some support after I went home. I received zero support. It would have been easier if my hospital gave me formula and sent me home without lectures. That way I would know that I was on my own and be mentally prepared.

        • yentavegan

          yes, the phone hot lines are no longer a useful, reliable method of getting help quickly. And not to make excuses but most LLLLeaders do group meetings and give out their personal phone numbers to women who make contact at the meetings. all LLL leaders are volunteers so they are not on call 24/7 Also many LLL leaders are mindful when a mother needs more than just mother-to-mother support.
          I agree with you concerning the freebie sample of formula. I found it very reassuring to have those pre-made bottles at the ready should the shit hit the fan. I do not agree with the policy of denying free samples.

          • Meerkat

            The problem with group meetings is that a woman newly released from the hospital might have real difficulties getting to them. I had a C- section, terrible foot swelling and was in pain. I was in no condition to go anywhere. I also don’t think it’s advisable to cart a newborn to public places. By the time I could get to the meeting, I didn’t need it…
            I didn’t realize La Leche League was non- profit, because they made no effort to let me know that they offered anything else than paid options.
            All in all, I wouldn’t recommend them anyone.

        • KatrenJJ

          The hotline doesn’t sound too ‘hot’. 8 hours is a long time to wait for a desperate parent and a newborn baby that’s having feeding difficulty.

          I called the Australian equivalent once. I got through straight away (they do a roster of volunteers to cover 24/7), but the advice was ‘iffy’ and as I’d already been advised to supplement I didn’t appreciate the medical advice I received from someone that hadn’t even examined my baby. Apparently they’re not meant to do that. I should’ve complained but didn’t realise and just said ‘aha yes ok thankyou’ and hung up.

          I also hired a lactation consultant out of pocket. She couldn’t fix the breastfeeding but was somewhat reassuring at the time.

        • Bomb

          I went to a BF support group run by LLL when I was pregnant with my first, but stopped going shortly after birth when they had a chiropractor come in and hock her services and tell everyone about the dangers of vaccines.

          • yentavegan

            Thank you for bringing this breech of LLL’s mission to my attention. LLL policy is not to mix causes. We are a non-profit NGO. Better mothering through breastfeeding is our stated mission. To promote, protect and support breastfeeding.

          • Esther

            LLL (the org and its representatives ,I might add) have strayed from their “mission” so long ago, it’s not even funny. You only need to look at their various publications and approved list of books to know that.

          • yentavegan

            sigh..I have seen my beloved organisation radicalised.

          • Esther

            There’s a case to be made it was always that way, yentavegan: https://www.llli.org/lllihistory.html

            “1957 – LLL brings Dr. Grantly-Dick Read, childbirth expert, to speak to a packed house at the local high school.”

          • Amy Tuteur, MD

            The problem is that LLL has switch from promoting breastfeeding to promoting lactivists.

          • Esther

            And lactivists’ other pet causes, certainly.

        • Lisa Miller

          LLL–BOOOOOOOOOOOOOOOOOOOO

      • Zornorph

        La Leche League has been labeled a terrorist organization in 38 countries.

  • Tim

    We went through this – my poor wife felt like a massive failure because her supply was dwindling due to having to pump and fortify with formula and polycose in order to boost caloric count because of our daughters heart. It isn’t helping anyone when the pervasive “formula is evil” messaging makes even people who have to give up on breastfeeding because of serious health problems feel awful about themselves. Maybe having first world maternity leave in the US would help encourage breastfeeding more than guilt trips.

    • Clarissa Darling

      Heck, at this point, I’d even settle for developing world maternity leave. My in laws live in India and they’re appalled maternity leave is unpaid in the US.

  • Amy Tuteur, MD

    OT: I’ll be on Huffington Post Live at 8:30PM EDT to discuss the cost of obstetric care.

    http://live.huffingtonpost.com/r/segment/cost-of-birth-in-united-states/51d1c07778c90a67c900010a

    • yentavegan

      great. i will tune in to listen!

      • Karen in SC

        the other two guests are idiots, sorry to say.

    • amazonmom

      Listening now! I love how the non doctor is talking out of her butt about what is necessary or not.

      • Karen in SC

        and the moderator is not very effective

        • amazonmom

          The moderator obviously doesn’t want to hear that cutting costs in the USA isn’t as simple as making all women give birth in a birth center. I would rather pay the 20000 out of pocket (the cost for my prenatal care and hospital for c section) than be forced into the craptastic Puget Sound Birth Center where I can be told it doesn’t REALLY hurt that bad and of COURSE my breech baby will be just fine being born vaginally.

          • Bombshellrisa

            But you could give birth in the water, with candles and pretty antique lace curtains!!! You could also push for hours on end and end up with a fistula-but remember, they are experts in normal birth. A few of those midwives also teach at Bastyr, so they must be amazing/*snark

          • auntbea

            I’m sorry, but a fistula is not normal birth and if you are going to get a fistula, you shouldn’t use a birth center. THIS is why the stats look so bad — all these women with bad outcomes keep trying to take part.

          • Bombshellrisa

            Oh I forgot: the stats are great if you exclude anyone with a bad outcome!

          • Anj Fabian

            The birth center study covered a fairly TINY percentage of all US births. I’m guessing less than 1%.

            The demographic included in that study is probably a minority of all expectant mothers.

            So holding the birth center study up is like saying “Well, if you are low risk and if you are (probably) middle class, white and educated AND you have this option available – THEN you could save money.”.

            The rest of us? Sorry, darlings, it’s not for you. You pay the full price. Or have your insurance pay. Or have your state Medicaid pay.

          • Bombshellrisa

            Washington state assistance to pregnant women program does pay for places like Seattle Center for Birth and Puget Sound Birth Center and they also pay for home births. Some insurance plans will cover them as providers. But you are right, most people would have to pay out of pocket, on the “pay before birth” plan or in three installments. And for what? It’s not like there is adequate prenatal care being given in the first place.

          • I’m very annoyed at how easy it is to deny effective pain relief in the name of saving money.

          • Lisa Miller

            YOU AND ME BOTH!! You know my story Mrs. W. And I yours. I know the thought is nothing short of terrifying and anxiety inducing. Fuck me running.

    • yentavegan

      Holy crap…has every one been drinking the kool-aide!?

  • Anj Fabian

    OT
    Muhlhan may be going to court. The hospital appealed the verdict…and won

    “For the foregoing reasons, we hold that the circuit court abused its discretion in
    precluding evidence of the midwife standard
    of care, and evidence
    of Midwife Muhlhan’s
    breach of that standard of care during her treatment of Martinez. Additionally, for purposes
    of remand, we conclude that, under the circumstances, the circuit court abused its discretion
    in admitting evidence that Ms. Fielding was not offered general anesthesia. Accordingly, the
    judgment is reversed and the case is remanded for further proceedings.”

    I need a legal eagle to determine if this has set any precedent, but look forward to the retrial – if indeed the trial will go forward.

    Any lawyers wish to comment?

    • Amy Tuteur, MD
      • R T

        Oh yeah! Horrible case! Can’t believe all the interventions she used in a home setting! It’s disturbing the mother would allow the midwife to do all of that to her, but freaked out when a nurse tried to draw her blood. This is a sick example of the unhealthy relationship some homebirth midwives cultivate with their clients!

        • OBNurse

          We see these types of patients all of the time. Even if they aren’t attempting a home birth, they stroll into the L&D ward and tell us we can’t do this or that, that they want to deliver on all fours on the bathroom floor, refuse labs, saline locks, refuse supplementing babies when they have dangerously low blood sugars, even when they are too weak to breastfeed………….. They truly think that we want to hurt them. Or they bring their doula and their 4 page birth plan, refuse every intervention, and prolong their labour by hours. We once had a multip refuse ARM at 8 cm and sat there, at 8cm, for four hours, while the doula played her home made sound track in the back ground. The song was “O is for Open”. Finally one of my colleagues was able to get the husband in the hallway in private and convinced him to convince his wife to let us break her water. Baby was born a few minutes later. We have a little fun at work and make “birth plans” for our pregnant nurses, and while they are hilarious, they are usually loosely based on real events. And don’t get me started on the placenta eaters. I seriously think I should be contacting the health inspector to see whether these idiots who dry and encapsulate placentas for a living should even have a license to do so…..

    • Lisa from NY

      Not lawyer, but:

      http://www.mdcourts.gov/appellate/cosa/2013/1394s12.pdf

      Page 7:

      13 The Hospital’s witnesses testified that Ms. Fielding did not want a Caesarean section, that they had difficulty obtaining Ms. Fielding’s medical history, and that Ms. Fielding was removing necessary medical devices. Further, the Hospital’s witnesses testified that Ms. Fielding interfered with its ability to complete her blood work, because she told caregivers, “don’t touch me,” when they attempted to draw her blood. Moreover, once nurses began to draw Ms. Fielding’s blood, the Hospital claimed that Ms. Fielding refused to stay still, which prevented the nurse from obtaining a sufficient blood sample. The insufficient sample allegedly required a second test, which added to the delay. In short, the Hospital contended that Ms. Fielding was “very uncooperative, combative, resisting, and making management generally more difficult.”

      • Amy Tuteur, MD

        And then she turned around and sued!

      • Amazed

        This… insert the vilest expletive you know here, it won’t come close to what I think of this “mother”! I don’t care about the general mood of sympathizing with homebirth lottery loss mothers. I am often quite sympathetic to them but this… deserves no sympathy. So, it’s “me, me, me, don’t touch mighty me because mighty me has rights” and then it’s “reward mighty me for being an ass”!

      • attitude devant

        Oh this is a huge help. Now I see why this case went as it did.
        The narrative is very very enlightening.

        • Isramommy

          Rather OT but, from the case report I read:

          “Finally, Dr. Katz’s deposition testimony provided that fundal pressure is no longer used in labor and deliveries, and that applying fundal pressuring during the second stage of labor in these circumstances constituted a breach of the standard of care.”

          Just curious about that- why is fundal pressure no longer used? I ask because it was done by an OB during my son’s in-hospital birth after the attending nurse-midwife requested assistance due to heart rate decels. Of course, my baby was **actually** crowning when fundal pressure and an episiotomy were done, as opposed to this poor child in the Johns Hopkins case.

          After my son was born the OB told me fundal pressure was her first step- if it hadn’t worked she’d have then tried the vaccum or gone to c-section . From that comment I am guessing she uses the technique fairly often. I’m not in the US, and my OB was trained in Jordan, so things may just be done differently here, but I am wondering about why the difference in the standard of care?

      • Anj Fabian

        That puts a totally different spin on this case.

        Pardon me whilst I put my helmet on for a few solid headdesks.

        • rh1985

          I certainly don’t blame the jury like I originally did. They were not allowed to hear the whole story.

      • Karen in SC

        I’d like to see a timeline on the entire birth. It doesn’t make sense to me (a non-doctor) why the baby ended up with brain damage from oxygen deprivation if there was CTG continuously administered as soon as the mother arrived in the hospital.

        The baby’s parents seemed to be arguing that there shouldn’t have been a delay – that a c-section under general anesthesia could have happened right away with no need for the bloodwork. But the medical team apparently didn’t see a need for a crash section. It’s confusing and the legalese doesn’t help…

        • suchende

          “It doesn’t make sense to me (a non-doctor) why the baby ended up with brain damage from oxygen deprivation if there was CTG continuously administered as soon as the mother arrived in the hospital.”

          The court seems to imply that the oxygen deprivation happened at home, when the midwife administered too much pit, which lead to insufficient oxygen transfer.

      • Susan

        O….M…G….. that could win the prize for the most disturbing thing I have ever read here. I think it could drive almost any sane person out of OB. Go to work, do your job… some nut job comes in after her midwife did EVERYTHING wrong and then sue the hospital and the doctors and WIN?? So they get an appeal great but at what cost already to the careers of these people. Oh please….. And I think I was literally nauseated when I read the expert WHORES defending the midwife’s use of Pit at home… is there anything, ANYTHING they can’t find someone willing to say? God that makes me sick. Something’s got to change god knows what those doctors went through…. and… oh yeah.. they think a labor nurse can’t give an expert opinion that IM pit is unreasonable…. what a screwed up system we have Something just so different about knowing you can get sued by the homebirth trainwreck and seeing in black and white what they actually are going to do to you. I need medical care now after reading that…

    • An Actual Attorney

      It is precedent — all cases are precedent. But it is precedent regarding evidentiary standards, not anything specific to midwives or obs or birth. The case gets sent back to the trial judge. It is up to the plaintiffs (the parents) to push forward. They could walk away, but probably will not. The hospital and the parents could reach a settlement, but it doesn’t seem likely. OTOH, many cases settle at exactly this point.

      At least the facts of Muhlhan’s insanity are public.

  • Zornorph

    I’m waiting to find out what is going to happen next month when I have my baby. No breastfeeding because I’m a dude, but if any pushy nurse starts to suggest I let my surrogate mother breastfeed him for a few days I’m going to shut them down hard and fast.

    • yentavegan

      ok, I’ll bite. Why would you shut down the option of early breastfeeding?

      • Zornorph

        Because I’m a single parent. I don’t want my son breastfeeding from the surrogate mother. I don’t want to raise any bonding issues there. Not really interested in pumping, either. We live in different cities.

        • yentavegan

          Yes. of course that makes sense. Your baby is your baby to love and feed and raise. You are the parent so you get to choose how and with what your infant is fed.
          I do not know how surrogacy works during the labor and delivery of the baby, but if you are already listed on official hospital documents as the parent your wishes should be respected.

          • Zornorph

            Laws vary from state to state, but in the state I’m in, my name (and only my name) goes on the BC as the father – no mother. So all the legal say is mine.

          • Karen in SC

            Congrats!

          • attitude devant

            Big congratulations!!!

        • Stacy Knuth

          I think it would be hard on the surrogate mother too to nurse a baby that she wouldn’t be raising.

        • R T

          Congratulations! I’ll probably have a surrogate for my next child! I had a very dangerous, scary pregnancy with my first so my husband and I think it would be best for a surrogate to carry our embryos next time. One of our friends volunteered to do it and one of the first things I asked her is if she would be willing to breast feed or pump colostrum for our baby. She said she would love to! I’m not concerned so much about long term breast feeding but I do want the baby to have colostrum! Colostrum is such an amazing food I’d hate for it to waste! I figure the time my baby spends in the surrogates womb is way more bonding than a couple days of breastfeeding. Every one had different ideas on what is right for their children!

        • Lizzie Dee

          Your baby, your choice. In my mind, there is a difference between breast feeding, and the benefits of breast milk, so if the surrogate was willing to pump, I’d be glad of it. Not a big deal, in the long term.

          I had a premmie, who got donated milk. Fine with me.

    • Lisa from NY

      Just curious: Do you have to pay extra for breastfeeding? Does she charge by the feeding or by the day?

      • Zornorph

        I would have to pay extra for that, but it’s not even the money. I want to be the one to feed my son.

  • Bomb

    Talk about the pot calling the kettle black, Alpha Parent.

  • R T

    The “science” circumcision supporters use is as exaggerated as the “science” lactivist cling too! I think the two have a lot in common actually! They both try to force parents into doing something which might not be best for their child for some tiny, perhaps not existent, future benefit.

    • I don’t have a creative name

      That’s actually a good point. I don’t give a crap whether anyone circs or not. We didn’t, for several reasons, and it annoys me when people judge that.

      • Sue

        I don’t have a strong view of circ, and have no sons to decide about, but I find the discourse fascinating to compare with various aspects of the childbirth discussion.

        Male foreskin removal is an ancient practice, particularly prevalent in semitic cultures, and linked with religious ritual. Probably more than any other procedure it has had EXTENSIVE safety trials – ie literally millions (if not billions) of people over thousands of years. It is a painful procedure (in the short term), chosen by the parents on behalf of the baby.

        Serious adverse outcomes are statistically vanishingly small. As, some would argue, are the benefits.

        Let’s now compare the situation with radical-NCB vs hospital birth with modern care. Also trialled over millions of people, but only decades. Hospital birth has a MAJOR outcomes benefit – both for morbidity and mortality, for both mother and baby. The mother endures the pain (or not) for the benefit of the infant. There are essentially no benefits for the infant of emerging away from hospital/medical care.

        This is what seems ironic to me: Male circumcision is essentially a religious/cultural practice with little influence on health outcomes, but where both risks and benefits are exaggerated by opposing poles in the debate. Essentially, Ideology dressed up as health policy.

        NCB is the reverse – health practice, with a huge influence on morbidity and mortality, presented by NCBers in an ideological framework.

        Just my musings…apologies if I have offended anyone in the circ debate.

        • Lilly de Lure

          I was wondering – does anyone have a link for any studies that compare the rates of the relevant health outcomes (phimosis/bladder infections/STD transmission rates etc) in first world countries between circumcised and uncircumcised populations? I’m asking as for me this is the most relevant piece of information I would need when making this decision: how do circed versus uncirced men/boys actually fare in the first world – and it appears to be nowhere to be found (or nowhere I can find it)? Full disclosure – at the moment I’d veer towards not circumcising any son I had to be on the safe side, but feel frustrated as I haven’t found any reliable studies on this point. If such studies were to show similar advantages in first world settings as seems to be the case in third world ones I would change my mind in a heartbeat (and campaign for routine circumcision to be made available on the NHS – at the moment it’s religious or specific medical conditions only:

          http://www.nhs.uk/Conditions/Circumcision/Pages/Introduction.aspx). Anyone able to help?

          In some ways I feel it is rather similar to the breastfeeding debate which is what is making me nervous about the current information I’ve been able to access – if I were to only read studies about third world outcomes for breastfed/formula fed babies I’d be convinced formula was actively dangerous which is simply false when you have access to clean water to make it up. Are we sure the studies on the benefits of circumcision in the third world may not suffer from the same problem in the reverse direction when translated to the first?

    • suchende

      It’s not my experience that circ defenders are trying to push anyone into circing, so this analogy doesn’t work in my view.

      • antigone23

        Yes, this is my experience too. The science is mainly used to justify parents having a right to decide, rather than saying everyone should circ. The anti-circ side doesn’t want parents to have a right to choose.

        • Rachel Mills

          Really, we want the choice reserved for the actual owner of the penis. That seems the most fair thing, no? Circ can be done at any time in his life and later on, he can have anesthesia and have it be his decision. I realize it is a choice you get to make. I would lobby for leave it alone since there is no good reason to do it, and the procedure is painful and leaves an open wound in the diaper area… Just if you leave him intact, remember to NOT ever retract to clean under it. It is fused like a fingernail and will stay that way probably for years. Leave it alone leave it alone leave it alone. It is that way for protection.

          • xyz

            I’m sorry but, I don’t make medical decisions for myself or my kids based on someone else’s understanding of fairness. I make medical decisions based on my understanding of the risks and benefits. I think a doctor is a better source of this information than someone who is morally opposed to the medical procedure in question. Case in point: all the information I received from my church regarding the horrible risks and non existent benefits of birth control.

          • Clarissa Darling

            This is me BTW, couldn’t log in to disqus on my phone.

        • Kerlyssa

          I am against parents having the right to make many decisions for their children, if said decisions are against the welfare of said child. Being a guardian does not mean being an owner- hell, even animal owners are limited in what they are allowed to do with animals in their possession. When the best argument for something is that the child belongs to the parent, and anyone else should just butt out…

          Put it this way. I can’t justify allowing dog owners to dock their dogs’ ears and tail, why would I extend that to docking a human penis because the ‘owners’ of that human find it aesthetically appealing? It’s all a matter of degree, circumcision is not on the same level as FGM, but neither is it on the same level as ear piercing. It is considered culturally normal, and so people are offended when someone tries to take away their right to do it, despite their own complacence with their not being allowed to have anything else surgically removed from their child. Good luck getting your physician to remove portions of the labia of your infant girl, or getting rid of the police should someone get wind of you having a non physician over to do it. Or, back to ears, having parts of the cartilage removed for a more pleasing shape.

          All things, mind, that there’s no law against the parents doing to themselves, should they so desire.

          • antigone23

            Well, thanks for proving my point. You don’t want us to have a choice, and that’s why you explain away all evidence that circumcision could have any positives. Parents who circumcise believe that they are doing what is in the best interest of their child, period. And no matter how loud the anti-circ extremists scream, the evidence points to circumcision having some very small benefits and very few risks, and the only people qualified to weigh this balance are the child’s parents in concert with their physician. I had my daughter’s adenoids removed also but no one gives me crap about that.

      • Clarissa Darling

        I’m having a little boy and I’m currently on the fence about
        circumcision. I’m leaning towards not doing it. I agree I haven’t run across anyone who believes strongly that I must circumcise
        him. However, I have run across people who believe strongly that I must not. Some of their claims –your son will be psychologically damaged! Your son will mourn the loss of his foreskin!–seem pretty dubious as well. If I don’t circumcise
        him it certainly won’t be because I believe any of that.
        Although if I do circ him and I turn out to be wrong and he does miss his foreskin I guess I’ll just buy him a pony (or the boy equivalent—I grew up with all girls so I don’t know…..) and hope he gets over it.

  • Maire

    What I find very interesting is during a time when Pro Choice is being vehemently argued, the rabid Lactivists IMO actually muddy the waters, if not outright hurting the cause of Pro Choice by providing information that is in no way accurate. If you wish to choose AP, BF, etc. because it satisfies your own emotional need, so be it. But don’t pretend that these practices are based on fact & then breathe fire when those facts are refuted. Lactivists prey on a Mothers fear pure & simple. And that’s not encouraging Pro Choice; it’s aggressive marketing of ignorance.

  • JMac

    Actually, I was practically an attachment parent against my will. I had a natural birth because the kid shot out of me like a cannon and there was no time for the epidural. I nursed because he refused bottles. He wanted to be held ALL THE TIME. And he would not stay asleep in his bloody crib no matter what, so I wound up taking him to bed with me for a few months because that was the only way I could get any sleep. And he’s not even circumcised.

    So SHOULDN’T HE BE FRIGGING PERFECT??!!

    • R T

      Is he not?

      • JMac

        Well, I think he’s completely perfect… sweet, incredibly smart, devastatingly handsome and athletic. But the screaming really sucked and the dyslexia is tough.

        • R T

          He sounds like a wonderful boy! I was just teasing you!

          • JMac

            🙂

    • stacey

      I got you beat, because I had a VBAC, in addition to all the other stuff. LOL
      Really, my DD is exactly like this. Refused bottles. Is in arms/ergo all the time (even at 16 mo). Sleeps with me in our “family” bed.

      I WISH that was a formula for awesome! My DS came out awesome and he was a CS, FF, crib sleeping, never wearing, daddy parented lil dude.

  • JMac

    I exclusively nursed my 9 year-old son until his first birthday. He screamed every night for 4 months with colic, and was diagnosed with dyslexia last year. The magic breast milk thing is bullshit!

    • R T

      My breastfed baby got RSV at four months so I feel ya!

    • Lilly de Lure

      Ditto: my sister was exclusively breast fed whereas I was regularly supplemented with formula. So what precisely is mother nature’s excuse for her being the one with the chronic ear infections throughout baby/toddlerhood?

  • Hmmm

    Those poor Japanese men. So much HIV because they’re mommies ignored the scientific evidence and didn’t circumcise them…oh wait….

    • Typo

      Sorry, meant “their” not “they’re”

      • Hmmm

        But seriously, I won’t circumcise my sons because I’m English. No one in my family is circumcised. As far as I know, English boys aren’t suffering from any more UTIs than anyone else. And honestly, I’ve never met a heterosexual, non IV drug user, non hemophiliac with HIV.

        • attitude devant

          Please tell me you’re joking? Because HIV has long since moved into the mainstream population in many countries.

          • If

            There’s no evidence that Circumcision prevents HIV in homosexual men, only heterosexual.

          • me

            There appears to be some evidence that circumcision increases male to female HIV infections:

            http://health.howstuffworks.com/diseases-conditions/infectious/circum-aids-female.htm

            Yeah, circ protects your sons; it puts my daughter at higher risk.

            How about we protect BOTH our sons and our daughters, and talk to our children early and often about CONDOMS!!!

          • Lisa from NY

            “But there’s a major caveat here: The researchers believe that the circumcised men may have had sex with their partner before their wound was fully healed. It takes about a month for a circumcision wound to heal, and while the couples were warned not to have intercourse until a doctor declared it safe — and were counseled to always use condoms — it appears that some of the couples didn’t follow at least the condom recommendation. So the researchers are wondering if thos­e couples didn’t end up following “wait until it heals” recommendation, either. It’s natural that having intercourse before the wound were fully healed would increase the risk of transmission. HIV is carried in blood, not just semen, and an unhealed wound on the tip of the penis is very likely to tear during sex.

            It’s worth noting that another, smaller study is reporting different results. Researchers are examining the medical records of 300 couples in Uganda to find out how circumcision affects AIDS transmission between partners. So far, with another year to go before the research is done, this study reports that a woman is 30 percent less likely to contract HIV from an infected man if that man is circumcised.”

          • me

            I read it, but it’s conflicting. And how applicable is it to infant circ? There would need to be a study comparing HIV rates of men who were circ’d as infants vs intact men (including the impact on women) to really have any bearing on whether infant circ is protective. I;’m not saying that it’s impossible for circ to have a protective effect, but it seems there is a lot of info missing, and that explains why the AAP does not recommend circ – they don’t have enough evidence to recommend it. whether they ever will or not is purely speculative.

          • If

            But we still don’t know how they are transmitting it. There is good evidence that a lot of HIV cases in Africa are from sharing intravenous needles for hydration within families and other poor hygiene practices.

          • attitude devant

            Hello???? I’m not even talking about Africa here! If you think being straight and not using drugs protects you, you are dead wrong.

          • Ugh

            Ok, whatever you say.

          • auntbea

            A study? Yes. Good evidence. No.

            HIV in Africa is spread mostly through heterosexual encounters, largely cross-generational transactional sex (although the proportion of HIV among gay men is increasing because homosexuality is so stigmatized health workers in some areas won’t test or treat men suspected to be gay.) We know this because when we introduce interventions that stop cross-generational sex, new HIV infections rates plummet.

        • suchende

          I also plan on raising only heterosexual children.

          • Lisa from NY

            But your children may unknowingly partner up with a bi-sexual person.

          • suchende

            I was being facetious. The fact that everyone I have personally known with HIV has been homosexual (which is true) is a bad argument against circ. I am a bit of a circ fence-sitter, but of all the unconvincing arguments…

          • theNormalDistribution

            Haha, I lolled for real when I read that one.

        • Lisa from NY

          How would you know if someone has HIV other than by a blood test?

        • fiftyfifty1

          “I’ve never met a heterosexual, non IV drug user, non hemophiliac with HIV.”
          You need to get out more.

          • Squillo

            Indeed. I’m not a fan of RIC, but the idea that HIV prevention is irrelevant in the “heterosexual, non IV drug user, non-hemophiliac” population is ridiculous.

        • realityycheque

          “And honestly, I’ve never met a heterosexual, non IV drug user, non hemophiliac with HIV.”

          To be fair, there is still a great deal of stigma out there against people with HIV/AIDS or STDs, so a lot of sufferers are likely to keep their positive status a secret.

          • KarenJJ

            Very true. We had a distant family member pass away from AIDS about 20 years ago. Pretty much everyone thinks it was cancer. Not sure why we got brought into the big family secret on that one, but it was an eye opener to the stigma of the disease. She was a middle-aged woman with a full time career and a young son – no hemophilia. As far as we’re away she wasn’t an IV drug user. It is believed she caught it from a partner.

    • R T

      You’re a little outdated! Japan is one of if not the only industrialized nations where HIV rates are still increasing!

      • Lisa from NY

        It’s because more teenage girls in Japan are having sex. The societal pressure to abstain is stronger there.

        • R T

          It’s also because of lack of condom use by the Japanese sex workers! Cause Japanes mean can’t have HIV dotcha know *eyeroll*

      • Name

        “Japan is one of if not the only industrialized nations where HIV rates are still increasing!”
        Which is interesting, considering that *most of* the industrialized world (eg. pretty much all Europe) does not do circumcisions.

  • theadequatemother

    I wish that the lactivists would have to get some education in social policy, human behavior and motivation as a pre-requisite for getting an internet connection. Shame and blame don’t work to get people to lose weight, drink less, quit smoking, engage in safe sex, drive the speed limit or refrain from stealing office supplies. It’s not going to work to increase successful BF relationships either.

    Support will work but shame has a way of negating support.

    What shame and blame does is drive the behavior being shamed “underground” so that they activity becomes hidden. In doing so, the potential for the shamed activity to be more damaging than otherwise increases. Imagine formula feeders that have not been given the support and education required to do this safely (underdilution, overdilution etc). These adverse effects are “unmeasured” by the lactivists and public health offices using shame as a tactic.

    • Amy Tuteur, MD

      That presumes that lactivism is about breastfeeding. I would argue that it has nothing to do with breastfeeding; it’s about forcing other women to mirror lactivists’ choices back to them in order to boost their fragile self esteem.

      That’s why the fact that breastfeeding promotion efforts have been spectacular failures is irrelevant to them and does not make them reassess their methods. Their goal is to shame women who do not copy them. By that measure, lactivism has been a spectacular success.

      • theadequatemother

        For TAP, sure. But how do you explain the shame based BF “education” that is being pushed by the BFHI, the Calgary Public Health Office, and the public health nurses that do home visits for post partum moms? It can’t be about egos for all these people.

        The use of shame is deeply entrenched in BF “promotion” above and beyond insecure sanctimommies.

        • Amy Tuteur, MD

          I’m sad to say that I think the BFHI is all about the egos of the women who promote it. It is a massive failure in promoting breastfeeding, but a spectacular success in promoting shaming.

          At this point, I think it is safe to say that BFHI is just Sanctimommyism writ large.

          • theadequatemother

            Is shame based “obesity education” all about allowing skinny people with fragile egos to feel superior and sanctimonious?

            Shame as a motivational tactic runs deep in all kinds of programs that are meant to change human behavior. The lactivists aren’t the only ones that, if they were serious about promoting their cause, need a reboot into a more effective way of engaging in health promotion.

          • OttawaAlison

            If shame worked to eliminate obesity no one would be obese…

          • Amy Tuteur, MD
          • LovleAnjel

            I think there is quite a bit of that in obesity education measures. One of the most common obesity-related memes, for decades, has been lack of self-control of the obese (ie the skinny have a lot of self-control). That’s pretty damn sanctimonious.

          • theadequatemother

            This is exactly my point – a lot of public health promotion resorts to shame based tactics. For some reason, in this culture we think that shame and blame “works” to change behavior. Available evidence is largely to the contrary. Shame doesn’t work. The use of shame to try to change behavior runs *deeper* than an explanation that those that shame have fragile egos that they are trying to buttress.

          • Clarissa Darling

            I guess I have a more cynical view of human nature. I think people do know on a certain level that shame isn’t a great motivator. And if they don’t know they are burying their head in the sand because, if it works, where are all the results? In order for shame to exist there has to be someone in a superior position to do
            the shaming. I can believe that people who are in that position are highly motivated to stay there and would continue with the blame and shame status quo solely because it benefits them.

        • suchende

          “It can’t be about egos for all these people.”

          I am not so sure. I think political pressure from women who do have this mindset is a big part of it, paired with lots of the fieldworkers having it themselves.

  • EllenL

    I wonder what happens today, especially in a “baby-friendly
    initiative” hospital, if you announce you aren’t going to breastfeed. Do they
    cooperate with your plans or harass you? Do they provide milk and bottles, or do you have to bring it with you? What if you arrive without it (due to emergency, early birth, poverty or whatever)? Just how does this play out?

    I found this article on the Guardian’s website (“Mothers outraged after NHS
    Trust withdraws free formula milk for newborn babies”):

    http://www.dailymail.co.uk/health/article-1393082/Bottle-feeding-New-mothers-outraged-NHS-Trust-withdraws-free-formula-milk-babies.html#ixzz2YYfQf7Cg

    What I found interesting (as a formula-feeding mother):

    “Liz Mason, infant feeding coordinator at the trust, said
    mothers who do use formula will receive advice and support to prevent them
    overfeeding.

    She said babies who are bottle-fed formula milk gain
    weight too rapidly in their first year of life – putting them at risk of
    obesity and potentially developing childhood diabetes.”

    Hm, breastfed babies get as much milk as they want, as
    often as they want, but bottle fed babies shouldn’t? I wonder how that works. I can’t imagine withholding milk from a crying baby.

    • Awesomemom

      My kids were not idiots they knew exactly how much formula they needed and were easily able to self regulate. It helps if you are a relaxed parent and don’t feel like you need to force them to drink every drop of a bottle. Yeah I dumped a lot of formula down the drain when they didn’t finish a bottle but they also did not over eat.

      • Amy M

        Yes, we found this as well. Once we got a handle on about how much they were likely to eat, we’d make up bottles with that amount, plus “stock” bottles, to pour from in the fridge. Then we could just grab the pre-made bottle, or just pour the desired amount, or add more or whatever. We kept track of how much they ate for way longer than necessary, but it did help predict how much they were likely to eat and possibly helped waste a little less formula (I hope, desperately trying to justify keeping that chart for as long as I did.) Also, I have twins and was feeding two at once, and we didn’t want to be constantly making up and washing bottles, hence our system of making up lots of formula at once.

        • KarenJJ

          I could have probably done with some help with this. Those first months were such a fog and the children’s nurses here recommend a feed, play, sleep routine for infants. But mine didn’t seem to feed much when waking and then seemed to fall asleep better after a bottle. So we ended up with a feed, play, feed, sleep routine. But then one was a notorious cat napper so it felt like I was constantly feeding her. Finally figured out that the routine wasn’t working for my little cat-napper and I dropped the routine. She got a bit porky from all this – and she was very slow to get moving too – but it all dropped off by 12 months and she started zooming around.

          • Mac Sherbert

            Yep…feed play feed sleep with both of mine. I don’t sleep well on an empty stomach, so why would a baby? The fuller the tummy when they’re put down the longer they sleep.

      • EllenL

        Exactly. We are supposed to trust birth and trust breastfeeding, but we can’t trust our babies to know how much formula they need?

        It’s almost like formula is some evil drug they might get hooked on. How absurd.

        My kids were average weight as babies, slender as children, and as adults, they are not a bit overweight.

        I think a lot of this is in the eating patterns we establish as parents, preparing healthy foods and modeling healthy eating.

        • realityycheque

          “It’s almost like formula is some evil drug they might get hooked on. How absurd.”

          I have actually heard someone compare formula to heroin. HEROIN. I was so done with the internet that day.

          They drew this comparison because formula is “loaded with sugar” and they assume that 10g of ‘sugars’ means 10g if sucrose. It’s such a colossal fail I don’t even know where to begin.

      • Mac Sherbert

        With my first I never dumped one drop of formula. It didn’t matter how much formula you put in a bottle him would drink until it was gone. Of course, when he over ate it all came back out/up. He was a Barracuda baby.

        He now eats like a bird and we have to make sure he is putting on weight!

        • suchende

          And likewise some BF babies overeat and then spit up. It’s almost like every baby is different! But how can you write a parenting book about responding to your own baby’s unique needs? Better to shove one approach down everyone’s throat.

          • Mac Sherbert

            Oh, he over ate breastfeeding too. It’s one of the reason’s he got a bottle. I was exhausted…literally drained. I never understood engorgement until my 2nd child. (I realize that in some circles this makes me a selfish mom. I think it just makes me a sane mom!)

            I wish people would understand that babies are not little machines. They are not the same! They are like adults. They have different personalities and needs.

        • amazonmom

          My daughter was mostly formula fed at 2 months. She would stop sucking when she was done. Nothing could have made her eat more, if you did try and make her eat more it would all run down her face because she wouldn’t swallow it. She has always had adequate growth, but never excessive according to the ped.

          My friend who has never used formula had a baby that would guzzle down both breasts, vomit it all up, then repeat about every 2 hours. His weight gain was so bad the docs were at a loss about what to do, he ended up on 5 medications. She still doesn’t understand what she did wrong, she did everything the lactivist way. I tell her SHE didn’t do anything wrong. He was going to have feeding issues and she didn’t fail him in anyway.

      • Jessica

        Before I had my son my MIL made a comment that she loved feeding babies and knew how to get every last drop from a bottle down a baby. She also shared stories that my husband was drinking 16 oz. of formula per feeding after just a few months. She also had to pack numerous burp rags because he would spit up so much he would soak through everything. I don’t think she understood the concept of paced, relaxed feedings. She was shocked at the fact that my son never really drank more than 4oz of breastmilk at a feeding. (And not for lack of trying – when he was done, he would push the bottle away pretty forcefully.)

    • OttawaAlison

      My daughter would reject a bottle if she wasn’t hungry and not finish a bottle once she felt she was done. At almost 7 she’s a very sensible eater (more than me anyway ;-)).

    • theadequatemother

      I think they might be extrapolating from data in adults that show that liquid calories aren’t registered by the satiety system as well as solid calories…but babies are not adults. All they know are liquid calories and they seem (in my experience of one) to be pretty good at following their biologial satiety cues…at least until we start socializing that out of them and teaching them to overeat.

      • OttawaAlison

        I may be wrong on this, but I was always taught that milk acts more like a solid when digested than a liquid.

        • theadequatemother

          When I drink milk and then jog the combination of sloshing and stomach acid turns it into cottage cheese? 🙂

          • OttawaAlison

            Yup, actually cheese was initially discovered when people in the middle east put milk for their babies in animal’s stomachs when they traveled and the enzymes solidified it..

          • suchende

            Interesting. But also ew.

          • auntbea

            These are disembodied, dead animal stomachs, right? They didn’t just feed the milk to the animals and then cut them open?

        • LovleAnjel

          And thus the Milk Challenge – drinking a gallon of milk in less than an hour. Almost no one can do it without a reversal of fortune.

    • MichelleJo

      They make these claims from growth charts of breast feeding babies compared to those of bottle feeding babies. The average weight of the breast fed baby is lower. So instead of worrying that there might be a good proportion of breast fed babies who are underfed, they just say that bottle fed ones are over fed. Much easier way to justify the results.

    • amazonmom

      I work in the first baby friendly hospital in the USA. We provide formula and bottles if a mom is formula feeding. The outdated parent manual that is still handed out to all parents that deliver here says to bring your own but only parents that insist on a particular style or brand actually do so.

    • OBNurse

      I am both and L&D nurse and an LC. While we do attempt to adhere to the BF initiative, we still supply formula with a smile. I don’t know of many nurses who give a rat’s a** about whether you BF or not. In fact, it’s far easier on me to take care of a bottle feeding mom and baby. But if you want the help, fine. The other morning, a mom demanded formula because she’d been up all night with the baby. I brought her the formula, and I offered to cup feed the baby to avoid nipple confusion, or just hand her the bottle and go with it. I told her that she might have a different perspective after a few hours of sleep and I didn’t want to sabotage her efforts to get her baby on the breast. Actually the baby was latching well, but mom’s milk supply wasn’t up there yet. She let me cup feed that baby. I’m willing to bet that she ended up bottle feeding anyway, but I wanted to at least help keep her options open until she made a decision after getting some sleep. My first priority is to feed the baby. Number two is support the mother and help her get some sleep. Number 3 is to help her to breastfeed if that is what she wants. I think it helps to be supportive in a non judgemental way, and that can be tricky. Just by cup feeding, she may have felt as though I was pressuring her to breastfeed when she did not. But maybe she DOES want to breastfeed and just needs a little help and a little time and gentle support and encouragement. I can’t win, really. I just wish women would be honest with themselves and their caregivers, without feeling as though they have to justify themselves. We will probably never achieve baby friendly status, but no one but our manager really cares. It doesn’t mean anything. Putting the formula under lock and key would make our jobs infinitely harder.

      I don’t work as an LC, it’s just some extra letters I have after BSCN, because at one point, when my kids were small, I thought maybe I could find a cushy day job to get out of the crushing shift work/day care dilemma. It didn’t pan out, we have one LC at our hospital and one in the community (funded by alberta health, their services are free, but they don’t do home visits). The hospital LC is having surgery and will be off for several months, and they have no plans of replacing her in her absence. I think it’s because they know I’d take the job and then they’d have to replace me as an L&D nurse and I am “irreplaceable”. 😉

  • Box of Salt

    I took a look at Alpha Parent’s blog post linked above. I think I’d like to rename her “Irony Parent.” She commits as many logical fallacies as she denounces.

    For example, she tells us the defenders of formula feeding engage in conspiracy theory – immediately after drawing analogy to Tobacco companies (implying formula actually causes SIDS).

    How does anyone take her writing seriously?

    • Box of Salt

      I am also wondering what she’s trying to suggest with all the pictures juxtaposing bottles (presumbly of formula) with computers, with or without a mom and baby. One can’t feed a baby and use a computer at the same time? But isn’t she a blogger, published on a computer?

      • Amy M

        My favorite is the one that explains why it is her business what other people feed their children. It goes into this spectacular story about plastic formula containers and landfills—it is a work of art. I am sure her carbon footprint is super minimal, and has no car, grows all of her own food, makes all of her own clothing by hand and will be soon blogging via carrier pigeon since using a computer uses a lot of energy and all. If she is so worried about the state of the earth for her special snowflake, I don’t understand why she isn’t promoting formula use, in order to kill off the competition with that poison, leaving a depopulated and therefore, pristine United States utopian paradise, for her tribe of self righteous, breastfeeding, genetically superior in every way earthy-birthy goddesses.

  • Rachel Mills

    Ugh. Had to bring up circumcision, didn’t you?

    Question: If the evidence in favor of circumcision is so strong, why are ~80% of the world’s males intact and not experiencing the various problems it is supposed to prevent?

    Follow up question: If circumcision reduces risk of HIV by 60% as those studies in Africa purported to show, where is the correlation between circumcising countries/populations and rates of HIV?

    The more I look at circumcision, the more convinced I’ve become that you have this issue bass-ackwards. Circumcision is the woo here, brought back into popularity by none other than notorious quack Kellogg who thought it would prevent masturbation, and scoliosis, and epilepsy, and whatever else was scary. The trend is that it is continually fronted as a savior from whatever disease is scary in whatever era. It is a cure in search of a disease, and in reality, a bronze age blood ritual that we should have shunned ages ago. But we’re coming around. Even the AAP can’t say much in favor of it except that their members should be paid for performing them. They are, when you get down to it, a trade organization, and on circ they act the part.

    Sigh.

    • suchende

      “Question: If the evidence in favor of circumcision is so strong, why are ~80% of the world’s males intact and not experiencing the various problems it is supposed to prevent?”

      I bet if you sit and think a minute, you will see why this isn’t very meaningful. Same with your follow up question. I am not saying your wrong in your conclusion, but hot damn your reasoning is shit.

      • Rachel Mills

        Really? Obviously I’m a bit slow. How about you lay it out for me?

        • Birth goes well about the same percentage of time – that doesn’t mean that providing intervention before a problem becomes a disaster is ‘unneccessary’.

          • me

            But you’re not talking about an IV or CEFM or induction/augmentation of labor or pain meds. You’re talking about a surgical procedure that permanently alters a man’s genitals. If we must compare it to childbirth interventions, it’s much more comparable to episiotomy. Which is NOT done routinely anymore. Doctors are advised to only perform them when needed, NOT to do them prophylactically. Why? Because they can cause complications, because they are thought to take longer to heal, cause more pain, and cause more long term problems than natural tearing. So you wait until a problem surfaces to perform one so you can avoid cutting hundreds of women unnecessarily. Why not wait until a man presents with an actual problem before considering circ as a solution? That would spare hundreds, if not thousands, of babies from undergoing this procedure, and the risks associated with it.

          • Amy Tuteur, MD

            Frankly, I think a better comparison is vaccination, which permanently alters a baby’s immune system (that’s the point of it).

            It amazes me that the same people who feel justified in exposing their children to crippling and life threatening diseases because they “educated” themselves on vaccination and because “parents have a right to make medical decisions for children” flip out when parents make the decision to have their sons circumcized, which, as far as we know, reduces the chance of death and serious disability instead of increasing it.

          • me

            Thanks for changing the subject, lol, but I won’t debate your straw man. I fully vax my kids based on the CDC schedule. And yet I’m still opposed to RIC. That being said, vaccinations don’t alter your body in a visible way and certainly don’t effect sexual function, both episiotomy and circ can have an impact on sexual function, and obviously circ alters a man’s appearance.

            Plus vaccination is something that should not be delayed – many of the illnesses they prevent are more dangerous to children than to adults (tho not all, obviously). So waiting until a child is 18 to vax is counterproductive; most of the benefit is seen during childhood when the immune system is underdeveloped and the individual is at greatest risk of death/permanent injury from the diseases vax prevent. With circ, the only “benefit” you might see in childhood has to with UTIs (which are very rare in males to begin with, intact or not, and are easily treated with abx). Most of the other potential benefits wouldn’t be seen until adulthood anyway (STI reduction, tho this one is debatable; cancer prevention, keeping in mind penile cancer is less common than breast cancer in males, oh and let’s not forget epilepsy and masturbatory insanity, lol).

          • Amy Tuteur, MD

            I’m opposed to RIC, too. I’m just not opposed to circumcision at parental request.

          • me

            Okay! Thanks for clarifying. It seemed to me that you were promoting circ, not just refusing to condemn (like the AAP does). I don’t have an issue with it, assuming the parents are informed that it is totally unnecessary and it carries risks to their child. Kind of like choosing a VBAC or a TOL for twins. Yes, parents should have the right to choose it, but they need to know that it carries potential dangers and little discernible “benefit”. If they still want to do it, well, so far it’s not illegal, more power to ’em.

          • Guest

            I also believe that parents should be allowed to choose whether or not their sons are circumcised. My family does not circumcise (and my dad is a hematologist/oncologist with an MD/PHD and knows how to make medical decisions for his children LOL). My husbands family does. To me it’s a largely cultural decision, and generally medically neutral….. Sort of like natural vs epidural HOSPITAL birth, or breast vs formula feeding. For personal preference I choose to not have medication during labor, and choose to breastfeed and not circ my boys. I think those decisions are all perfectly reasonable. However, if I chose not to vax my kids, I’d be an IDIOT!

          • Kerlyssa

            You really dragged vaccines into this? If circ had even a tenth the shown efficacy of _any_ of the scheduled vaccines, this wouldn’t be up for debate. Comparisons like that throw actual health initiatives into confusion, just to piss on the health counterculture. Widespread circ predates these studies, is not driven by these studies, and is yet to be justified by these studies.

          • Guest

            I don’t think the two compare at all. Children in countries with low vaccine rates have much higher rates of childhood mortality. Is the any evidence that say German boys have high rates of UTIs or any other “intact penis diseases”.

          • Guest

            Are you actually comparing routine circumcision to intervening in a birth catastrophe? Really? If intact men were in that kind of danger, American men would have a HUGE increase in life expectancy compared to almost ALL other men in the developed world.

        • suchende

          Most people who are treated with preventative medicine would have been fine without it. That doesn’t mean we should suspend preventative medicine on those grounds alone.

      • Lisa from NY

        Europeans are more likely to use condoms.

        http://www.cbsnews.com/2100-500368_162-3710255.html

    • MaineJen

      I agree with you that circumcision is largely unnecessary, and that more and more people in the US are realizing that. (Isn’t the current circ rate running about 50%? As opposed to 90%+ just a generation ago?) My problem with ‘inactivists’ (and I apologize, I don’t mean that in a derogatory way) is much the same problem I have with lactivists: the shaming of those who choose a different way. While I think that inactivists have a much better cause to promote, I think that there is too much finger-wagging at those of us moms who chose a social norm for our kids, not thinking it was a big deal, and later found out that it actually is a minor surgery and totally unnecessary. When I share my changed views on circumcision, I’m often met with the equivalent of “That’s great that you *know better* now, but you should still be shamed for making the ‘wrong’ choice to begin with.” Really?? Condescend much?

      • Rachel Mills

        I agree. And its too bad that as an “intactivist” I have to travel in a lot of the same circles as the lactivists. They are two totally separate issues, as far as I am concerned. I fail to see what one has to do with the other frankly. But for whatever reason, I’m constantly bumping into lactivism and it annoys the crap out of me for all the reasons in the post.

      • Lisa from NY

        So you are saying you are definitely sure that none of your child’s partners will have HIV, and each partner will know the HIV status of each one of their partners, when many people with HIV don’t tell their partners because they fear discrimination.

        • me

          Didn’t a lot of the studies that showed a protective effect against HIV for cut males also who that their female partners were more likely to contract HIV? Wouldn’t it be better to get your sons to use a condom? That would protect your sons AND my daughters!

          • suchende

            “Wouldn’t it be better to get your sons to use a condom?”

            For sure. But kids have this annoying tendency to be reckless in the face of sound parental guidance. I didn’t speed as a teen driver because my parents failed to try to get me to drive prudently.

          • me

            But again, we’re back to being left wondering why American men are so much more likely to get HIV, despite being largely circumcised, as opposed to European men, who are largely intact. And there are several countries in Africa where the HIV transmission rates remain woefully high, despite high circ rates. I really don’t think there is a true benefit here. I think it’s about as effective at preventing HIV as it is at preventing masturbatory insanity.

          • suchende

            Fine but that’s a separate argument. It’s pretty obvious to me that encouraging condom use alone won’t lead to perfect compliance.

            As for high HIV rates being paired with high circ rates, that’s not really indicative of anything. There are so many confounding factors in the populations you’re trying to compare I think we can both agree it’s not a meaningful one.

          • me

            No it won’t lead to perfect compliance. But telling young men that are circ’d that simply being circ’d offers them “protection” seems like giving them a “pass” to not use real protection (condoms). Sorry, but a circ’d man who doesn’t use condoms is at greater risk of HIV (or any other STI) than an intact man who does use a condom.

          • Rachel Mills

            That’s my point exactly! There are so many other confounders and circumcision doesn’t seem to be able to overcome any of them.

            Plus like it or not, Africans are getting a completely wrong message about circ and HIV. Its leading to less condom use and a false sense of security and this will backfire in a major way, sadly.

            The truth is – Africans who correctly understand that you have to use a condom EVERY time with or without a foreskin do not see the point of circ. They are not the ones signing up for the surgery – the ones who misunderstand are.

          • auntbea

            Please to cite.

          • Lisa from NY

            http://www.cbsnews.com/8301-504763_162-57497265-10391704/declining-circumcision-rates-may-add-$4-billion-in-u.s-health-care-costs-researchers-say/

            “Specifically, the researchers calculated that if circumcision rates were to dip to 10 percent, there would be a 212 percent increase in cases of male urinary tract infections and a 12 percent increase in HIV infections in men, along with a 29 percent rise in HPV infections and a 20-percent rise in herpes infections.

            Women would also be at greater risk, the researchers said, with a reported 51 percent increases in the infection bacterial vaginosis, an 18-percent rise in high-risk HPV infections and a 12.9 percent rise in low-risk HPV.”

          • me

            Note that this study was done entirely with computer simulations. In Europe the circ rate is low, as is the HIV rate; America has one of the highest circ rates, and also has some of the highest HIV and highest HPV rates in the industrialized world. Also it is not clear if the authors included in the cost of male circ the cost of botched circumcisions or the cost of treating other circ related complications and the resulting lawsuits. And to get the increase in rates that the authors are speculating about, they went to data from Africa (not Europe, which of course would actually be applicable).

            http://archpedi.jamanetwork.com/article.aspx?articleid=1568558

            Sorry, the study article you are citing is referencing is a perfect example of ‘garbage in: garbage out’.

          • MaineJen

            Well, a kid who has unprotected sex is going to be at higher risk for HIV, whether he’s circ’d or not. Condom drawer! Don’t ask, don’t tell!

          • suchende

            I don’t think it’s lack of access that’s stopping first world kids from using condoms.

        • MaineJen

          I certainly hope none of their partners will have HIV. I also fully intend to have a “condom drawer” in my house, when my kids get to that age. I’d be foolish to rely on circ alone to prevent HIV transmission, wouldn’t I? Even if there is a tiny preventative benefit, which is debatable. (That study of African populations that everyone cites…wasn’t it the case that the circed males were also given STD prevention counseling, while the uncirced males were not counseled? That was my understanding)

          • Rachel Mills

            Also, they began the 11 month study BEFORE the circumcision group had their surgeries done. Therefore, they had 6-8 weeks of abstinence that was not corrected for. THAT ALONE could account for the small absolute difference in the two groups.

          • me

            And and and… they ended the studies sooner than planned. Had they allowed the studies to go the full amount of time, the circ’d group could well have “caught up” with the intact group. The authors got the numbers they wanted to see and ended the study. Completely unethical.

    • Have you ever been around a kid with a totally unneccessary UTI? What about one who needed to be circumcised as an older boy or adult? Unneccessary is only known retrospectively.

      • The Bofa on the Sofa

        By the same argument, all kids should have ear tubes inserted right after they are born. Imagine all the ear infections that could be prevented!

        • Is performing an ear tube procedure more risky as the kid ages? The risk profile of circumcision changes with age.

          • The Bofa on the Sofa

            But currently ear tubes aren’t inserted until a pattern of problems has been established. My older son could have had probably 6 ear infections prevented in his first two years if he had ear tubes inserted as an infant.

            Are you for infection prevention or not?

          • but does the risk of the procedure change with age? Infant circumcision is entirely different from circumcision performed later in life.

          • The Bofa on the Sofa

            So what? I’m talking about preventing infections in children.

            Moreover, it isn’t even a permanent alteration.

          • Amy Tuteur, MD

            I know you’re talking about preventing infections. That’s why I asked you if there is data that shows that prophylactic insertion of ear tubes prevents infection.

          • The Bofa on the Sofa

            Are you accusing pediatricians of not practicing science based medicine?

          • Amy Tuteur, MD

            No. I’m simply pointing out that you used a lousy example in an effort to make a particular point.

          • The Bofa on the Sofa

            But if the science says they don’t prevent infections, and pediatricians put them in to prevent infections, then that means that pediatricians aren’t practicing scientifically.

            So stand by your claim. Do you contend that there is no scientific evidence that ear tubes prevent ear infections?

            If so, then you are accusing pediatricians of not practicing science-based medicine.

          • Amy Tuteur, MD

            Nice try, but we’re not talking about whether ear tubes prevent infections in children who have a history of ear infections, just like we are not talking about wether circumcision in toddlers and children who have UTIs prevents future UTIs.

            Your example was about prophylactic insertion of ear tubes before any infection develops (as you were analogizing to circumcision before any UTIs develop). That’s why I asked you whether there is any data that prophylactic insertion of ear tubes at birth prevents ear infections. I presume that because you haven’t offered any such data, there isn’t any.

          • The Bofa on the Sofa

            Nice try, but we’re not talking about whether ear tubes prevent infections in children who have a history of ear infections,

            No, ear tubes do not prevent ear infections in children who never get them.

            But are you suggesting now that children who are prone to ear infections, and benefit from ear tubes, would not have benefited if they got the ear tubes before they got recurring infections?

            That the ear tubes are not effective until after sufficient number of infections have occurred?

          • Amy Tuteur, MD

            No I’m suggesting that ear tubes is a faulty comparison to circumcision, nothing more and nothing less.

          • The Bofa on the Sofa

            You are the one who brought up circumcision. I didn’t. I am talking about preventing ear infections. If preventing infections is such a great goal, then why not use prophylactic ear tubes?

            Your sole defense seems to be that ear tubes do not prevent ear infections, even in kids that are prone to them.

            BTW, my stats are off. The number of kids that get ear tubes is more on the order of 1 in 15 to 1 in 20. If those children all got tubes earlier, and if they only prevented 1 ear infection, that means that this approach would cut 5 ear infections for every 100 children.

          • me

            Does RIC prevent UTIs in children who never get them? That’s just silly. UTI’s in males are a lot less common than ear infection (whether the males in question are intact or not). RIC only reduces the risk by a small amount, and IIRC the study that showed the biggest reduction compared healthy, full term circ’d babies to intact babies in the NICU, so that small amount may not even be attributable to circ. If ear tubes prevent future ear infections in children prone to them (which, I assume they must, otherwise why do doctors suggest it?), then couldn’t they prevent even more ear infections if inserted at birth?

          • Amy Tuteur, MD

            What’s the data on the benefit of prophylactic insertion of ear tubes?

          • The Bofa on the Sofa

            Well, if currently 1 in 100 kids end up with ear infections, and they have all had 5 ear infections before getting tubes inserted, and if having tubes initially would have prevented 4 of them, then that is 4 ear infections in 100 children prevented. That’s more than the number of UTIs prevented, but of course, these numbers are made up.

            You can look up the real numbers.

      • Rachel Mills

        I’d like to see some numbers on how many boys in say, China or Japan or South America “need” a circumcision later in life. Don’t have that, but in Finland one study shows its about 1 in 17,000… so what are they doing differently as far as intact boys are concerned? One thing is they do not give the disastrous advice to retract boys forcibly to “clean under it” as pediatricians still do here. Imagine if you forcibly retracted your fingernails. Might that cause infections and problems? I bet it would. I stick to foreign or young pediatricians for just this reason. Old school American doctors can’t seem to unlearn this bad advice for some reason.

        • GuestB

          It just depends on your doctor. I go to a practice with a nice mix of “new” and “old school” doctors. My son is 4 and I have never had any of them tell me to retract the forskin to clean underneath it. I think your final statement is akin to the “OB’s have never seen a natural childbirth” and “they all want to get to their golf games” business. Just because you had a bad experience with one or two docs doesn’t mean that they’re all like that.

          • GuestB

            Sorry – that should be “foreskin” and not “forskin”.

        • I’d like to know how many ‘need’ one and can’t access it in those countries or due to the body part involved are choosing not to have problems addressed (totally their Perogative). Actual incidence of the procedure being performed later in life says little about the actual need for it.

          • Rachel Mills

            That’s a fair question, but Finland is hardly a country without quality medical care. I’d like to know if it is the case that people request circumcisions and can’t get them, but it appears that it is a highly cultural practice and in countries where it is not the cultural norm problems we blame on foreskin and solve with amputation they simply treat with steroid creams, antibiotics and less drastic measures.

      • me

        “Have you ever been around a kid with a totally unneccessary UTI?”

        Are any UTI’s “necessary”? That aside, my oldest daughter had one when she was 2. A few days worth of antibiotics and she was fine…. What’s the big deal?

        “What about one who needed to be circumcised as an older boy or adult?”

        While this is somewhat more compelling to me, but there is still the matter of not knowing whether or not it will become necessary. How many babies will need to be circ’d against their consent (and possibly their will) before you prevent a single adult circ? And if, as you say, “unneccessary is only known retrospectively” why don’t we do profilactic mastectomies at puberty? Why do you have to be over 18 and have a family history of breast cancer before a doctor will perform that procedure? Why not have all our teeth pulled as soon as they come in and just get dentures? Why don’t doctors push to have babies get their appendixes out shortly after birth? Why don’t we take tonsils out very often anymore? Maybe because necessary is only known when it occurs….

        • Again the risk of the procedure is different when it becomes neccessary and that may not be the case for the other examples you provide.

          Circumcision is a parent’s perogative – the benefits of the procedure outweigh the risks. That doesn’t mean all parents should do it – it simply means that it’s a choice that can be made by a parent for their child. A parent might decide its worth it for a whole host of reasons, just as a parent might decide to forgo it for a whole host of equally valid reasons.

          It is important to note though that infant circumcision does have an entirely different risk profile than one carried out later in life.

          • me

            I do realize that it is a more complex procedure (for the doctor) and has a longer recovery time when done on an adult/older boy than when done on an infant. And that is important to note. However, I’m not sure I agree that the benefits outweigh the risks. While UTI’s aren’t fun (from what I understand, I’ve never had one), they aren’t exactly the end of the world either. And, again FWIU, UTI’s are easier to treat in males and are less likely to recur. And it’s not as tho circ prevents all UTIs; it just reduces the risk (and not by a whole lot… only about 10%, IIRC… bfing supposedly reduces the risk by 300%, to put it in perspective).

            We really need to look at numbers. First, mortality – what is the mortality rate of infant circ vs adult circ? Then morbidity – what are the stats on botched circs, post op infections, hemorrhages, and other surgery related complications in the two groups (adult vs infant)? I guess I have a hard time believing that a grown man is at higher risk of death, infection, or other major complications associated with surgery than a newborn. Generally, babies are at higher risk for all those things wrt surgical procedures. I’d love to see some studies comparing outcomes of RIC vs adult circ. And then I’d love to see some studies showing how likely an intact man is to even need an adult circ – how many babies would need to be cut to prevent one adult from being cut, and how many will die or be seriously injured to prevent one adult from undergoing this procedure. Only then can you determine if it is “worth it”.

          • theadequatemother

            “While UTI’s aren’t fun (from what I understand, I’ve never had one), they aren’t exactly the end of the world either.”

            UTIs in infants are a bit more serious that those that occur in adults. Maybe a ped can pop in here but UTIs in infants aren’t always as simple as 3-5 days of Abx and off you go the way they generally are in adults…babies often need renal US and other testing to rule out obstructive causes and congenital malformations, and can lose renal function. So you would have to factor in the cost of all that testing, followup and treatment as well.

          • me

            Fair enough. But then why not push bfing harder? It’s said to reduce UTI’s by some 300%, circ only reduces them by 10%, and that only helps half of babies, the half that have a lower UTI risk to begin with….

          • Amy Tuteur, MD

            Where’s the evidence that “pushing” breastfeeding incrases breastfeeding rates?

          • me

            I guess I don’t mean “push” in the way most lactavists do. I mean push for policies that make bfing easier – longer, paid maternity leaves, insurance coverage for pumps and pumping supplies, insurance coverage for IBCLCs. Things of that nature. That would help both male and female babies avoid UTIs… without permanently altering anybody’s genitals.

          • theadequatemother

            I’m not sure that BF could be pushed harder in my community…:)

            I wasn’t really trying to weigh in on the merits or harms of circumcision as a method of UTI prevention, just trying to point out that these sorts of cost-benefit-harm analyses are rarely as simple as they first look.

          • Rabbit

            When we thought my son might have a UTI, his pediatrician said if he did, she would need to do the ultrasound and other testing because UTIs are so rare in boys and there is a substantial risk that the UTI is occurring because of a congenital malformation.
            Because he is not circumcised, I asked about that risk factor. Her opinion was that UTIs are exceedingly rare in circumcised boys, and almost as exceedingly rare in uncircumcised boys, and she’d recommend further testing whether the boy was circumcised or not. Girls just get Abx with no further testing unless symptoms don’t clear. (All of this is assuming an infant or child who has previously had no issues with urine production or elimination.)

          • me

            Precisely. Any benefit that may exist is vanishingly small, wouldn’t effect the way the boy is treated/tested, and hardly seems worth the additional risks involved.

          • Sarah, PharmD

            What makes you think UTIs are easier to treat in males? They are not easier to treat in males, are often complicated and frequently require longer courses of antibiotics.

          • Lisa from NY

            Does anyone know how many partners their child will have in life, or how many partners each of those partners had, and if any will have HIV?

            This is the real question.

          • me

            How about give them condoms and an actual sex education (not just this abstinence-only crapola)? And you’re right, you don’t know how many partners your kids will have. They could become priests/nuns and be celibate their whole lives 😉

            At any rate, if circ was so great at preventing HIV, then why do so many more Americans have it than their intact brothers across the pond? If circ offered any real protection, shouldn’t American men be less likely than men in other first world nations to have HIV?

            Oh, yeah, condoms….

      • AmyP

        My nephew had to be circumcized at 5. Awful!

    • Lisa from NY

      The reason circumcision reduces HIV risk is that it cuts down on blood to blood contact during sex.

      When an uncircumcised male has sex, the foreskin gets rubbed and little tears happen, and hence you have blood to blood contact with the vaginal tears or bloody secretions of female (or male partner).

      This is a scientific fact.

      The problem today is most people don’t know they have HIV until they have already shared it…

      • Rachel Mills

        Actually, that is just a theory for one mechanism for how circ is supposed to reduce risk of HIV.

        The reality is that circ does not have any protective effect against HIV whatsoever and bad science does, in fact, exist. Those studies had all kinds of methodological problems and gaping holes but that doesn’t stop people from trying to come up with a mechanism, an explanation for how it could be true.

        • me

          Not to mention there is also a theory that says that since the male glans of a circ’d man is keratinized and has less natural lubrication than the glans of an intact man, that sex with a circ’d man causes more abrasions to the vaginal walls, increasing the likelihood of transmission, especially to the female partner.

          Circ is, indeed, a cure in search of a problem. Always has been, always will be.

          • Rachel Mills

            Ouch. Can you say dyspareunia?

            I always thought it can’t be normal to need this much lube, or lube at all really, during sex. Turns out, its not normal. Its basically unique to circumcising cultures.

            Hmmm…

          • Amy Tuteur, MD

            Really? Where’s the data for that claim?

          • Guestl

            I don’t have *that* much experience, but I did grow up in the US and moved to the at 20, so I have tried both the circumcised and uncircumcised option. I would have to agree that in my limited experience uncircumcised means better, um, gliding properties and less requirement for extra lubrication. Whether that is offset by a greater surface area over which tears can occur I cannot say though.

            I did wonder about the studies though. Are men who are willing to be circumcised as adults likely to be more gentle during the act, decreasing the risk of abrasions?

          • realityycheque

            Women can suffer vaginal dryness for a whole host of reasons… hormones and medication to name a couple. To state that the need for lube during sex isn’t “normal” and that it’s unique to circumcising cultures is plain rubbish.

  • Jen

    I think I just died and went to heaven. This is great!

  • Allie P

    I felt a good deal of guilt and went to an enormous amount of trouble and expense to breastfeed my child and I don’t want other mothers to suffer the way I did. THe problem is there is a mainstream mantra of “breast is best” and scientific studies to support that, but not nearly with the clarity or to the extent that lactivists make it out to be. There are just to many confounders in first world studies (like breastfed babies are more likely to be born to high-income parents who have good health insurance, diets, other resources to devote tot heir child) and in third world studies (like poor water supplies that make formula a more dicey prospect for infants).

    As Dr. T has repeatedly shown on this site, if you want to find A study showing (or purporting to show) anything, you can. I worked for a scientific journal once that published a paper on how to determine the difference between radio noise and actual alien communication attempts. But when you look at the literature as a whole, that’s when you start to see the whole picture. And most laypeople aren’t capable of that kind of analysis.

    I really wish breastfeeding advocates turned their attention to support for women who can and wish to breastfeed, rather than guilt tripping those who can’t or don’t want to.

    • KarenJJ

      I also wish they’d be a lot more honest about the numbers of those who can’t and be a lot more interested in why women aren’t continuing to breastfeed. So far the main reasons women aren’t breastfeeding when they return home from hospital is because they are hoodwinked by doctors and nurses into believing that their babies aren’t putting on weight, the formula marketting machine gets to them with their colourful sachets or they are just too damn lazy to be the sort of self-sacrificing mother that their baby really needs…

      That women are encountering real issues and that babies might actually be suffering by the all or nothing breastfeeding advice we get is not something anyone can ever question..

  • LynnetteHafkenIBCLC

    “Just mention to a therapist that you refer to yourself as the “alpha parent.” He or she can probably take it from there.”

    Gold.

  • Bodnoirbabe

    I still regularly read up on breast-feeding vs formula feeding even though I left breast feeding behind when Max was 5 weeks old. I guess I have residual guilt that I didn’t stick with it. But the more I read about it, the more that guilt is replaced with anger. I was made to feel like less of a mother because I just couldn’t get the breast-feeding thing down. People stated I was poisoning my baby, that he’d be more sickly, more stupid, etc etc, all because he wasn’t getting breast milk. The more I read the actual studies that breast nazi’s point to as evidence the more I realize how duped I was. There is a statistically insignificant difference between breast fed and formula fed babies in almost all those things breast nazi’s advocate.

    I will never EVER get over the amount of shame and guilt I was forced to endure about stopping the breast. While I have no qualms about someone wanting to breast-feed their own baby, I will be a very vocal supporter of those who do not. No one should have to feel the way I did and hundreds of thousands of other woman did and do feel about switching to formula. The entire things makes me so pissed.

    • Lizzie Dee

      The idea that women are made to feel shame and guilt around any of these issues is what makes me pissed as well.

      A degree of confusion and feelings of inadequacy are easily generated in the turmoil and life changes of early mothering, and as women we tend to be good at guilt for some reason. But that there is an army of activists out there, dominating the internet and piling it on really does enrage me.

      I sometimes feel a bit like a time traveller. I had my children in one time slot, detached from the intensity of these concerns to raise them, then dropped into THIS time slot when my daughter’s children came along – and could not believe what had happened in the interim. In my day, I was irritated with feminism for sidelining mothers in favour of more “important” women’s issues – but I come back to find that when they focused attention, things have got much worse! Things were looking good for women when I stopped paying attention – how did we end up with shame and guilt being used to control in this way? Even in those who are not on the lunatic fringes. IF there are problems with hospital births, and it is quite a big if, why isn’t empowerment being sought by using grown-up methods of addressing them. It seems to me that hospitals are in some ways anxious to meet demands, are changing – but not always in the most productive ways. While the loudest noises are coming from a minority, things are not necessarily improving in the way that will benefit women who do not want to centre their identity below the waist rather than above their necks.

    • LynnetteHafkenIBCLC

      Even if things are statistically significant, it doesn’t mean that it’s clinically significant. Which means that if a child gets one more episode of ear infection or diarrhea, it’s not going to affect his long term health.

      • The Bofa on the Sofa

        I say it again:

        ALL ELSE BEING EQUAL, breastfeeding is better. However, in life, all else is never equal.

        • Elle

          Exactly. Feeding decisions cannot be made in a vacuum.

    • Amy M

      Yeah, I never felt too guilty myself, but I get angry on behalf of women like you. It is just not worth getting that upset over and yet so many women spend so much time beating themselves up. Inability to breastfeed (or the jerks who shame women for it) can be a trigger for PPD (for women who wanted to BF and who are prone to PPD)…I had PPD, not having anything to do with infant feeding issues, but I know what that is like and I wouldn’t wish it on anyone for any reason. If it could be avoided in even just one woman because a new mother knows that formula is fine that would be excellent.

      More time spent cuddling the new baby, less time spent worrying about breastfeeding, that’s my motto.

      • MichelleJo

        Someone else’s motto – “Sleep at night and bond in the morning.”

    • amazonmom

      When I returned to work in the NICU at a baby friendly hospital it was horrible. My LC coworkers would literally follow me around the unit asking for my good reason why I quit breastfeeding. FOR WEEKS. I didn’t think it was any of their d*** business that I was on lithium, the only drug that made me functional after severe PPD. I needed to be back at work , I was out of money. Oh and I got crap for my c section too. The LC people assumed it was unnecessarian. That’s when I realized woo was truly dangerous. I started looking into the evidence for the whole NCB/lactivist movement and the emperor has no clothes. I started reading SOB because I thought to myself “wow, someone who thinks the same way I do!”

      • MaineJen

        That’s absolutely horrifying. Did you/ could you have reported them?

        • amazonmom

          I knew them well enough to say to them that I don’t wish to discuss my medical history at work. That ended up keeping them quiet. I also told them there was no way in hell I was risking my cord presentation breech baby so I could have a vaginal birth I didn’t care about in the first place. This time around (im 18 weeks preggo) they are being much more supportive I’m glad to say.

  • Kerlyssa

    Whoop, snuck that bit about circumcision in there. Concerning hobby horses, I’d say disease transmission and circumcision in the third world is about as relevant as contaminated water and formula feeding in the third world, yes? I continue to be puzzled over the continued dedication to a culturally driven cosmetic surgical procedure with, at most, negligible health benefits in the first world. I mean, it seems a rather similar issue to breastfeeding in that way, except the body involved is that of a baby rather than a grown woman.

    • The fact that it is a baby makes it an entirely different issue – parents are fully expected to make health and other decisions for their children. Women are grown adults who should be given the freedom to make their own decisions. Equating the removal of bodily autonomy from a woman with the removal of bodily autonomy of a child seems a bit of a stretch. Give parents the information they need to make a choice and assume the parent will do so in the best interests of the child.

      • me

        What other cosmetic procedure are parents allowed to consent for on behalf of their child with no medical indication? Why should they be allowed to alter their child’s genitals without medical indication? Even if there is a benefit, why can’t the boy grow up and then decide for himself if the supposed benefits truly exist and are great enough for him to voluntarily alter himself?

        • Lisa from NY

          Why is condom use more prevalent in Europe than in U.S.? Peer pressure.

          I hope your child never has peer pressure.

          • me

            ? Is this non sequitor day?

        • Rea

          In Finland for a long time, the health service would pay for cosmetic surgery on baby’s ears because they considered a certain type of ear to not be aesthetically pleasing. I don’t think it’s as common these days. But as a general rule of thumb, I decide not to remove or change bits of my child’s body unless it’s medically necessary. Everything else they can decide when they’re older. Then they can be mad at themselves if it’s a mistake instead of me 🙂

        • FormerPhysicist

          Parents are allowed to consent for many cosmetic procedures for their children. Starting with piercing* (ear or nose), and certainly including rhinoplasty and laser removal/fading of birth marks. Also including ‘reconstructive’ surgery for indeterminate genitals, though that is becoming less done, I believe.

          None of these are a good argument to choose circ, but it is well within the norm of what we allow parents to consent for.

          *And don’t give me the argument that piercings close. Mine haven’t in 25 years of not wearing earrings.

          • Kerlyssa

            It’d compare more closely to clipping off part of the ear than to piercing them, or removing the canines perhaps, and it’s on a more sensitive body part- if you pierced a baby’s genitals like some do their ears, you have a much greater chance of infection and complications. Totally different body parts.

            My objection is to the invention of medical rationales for a cultural practice. People don’t do that for earrings, because earlobe piercing is pretty fecking minor. It’s something adults are comfortable doing to and having done to themselves. Circumcision is a more involved, altering, painful, and permanent procedure, and the myths that go along with it are correspondingly stronger. Medical providers should have no part in the woo surrounding circumcision.

          • me

            Well, I didn’t have my daughters’ ears pierced – their ears, their choice. When they are old enough to take care of the fresh piercings, I’ll be glad to take them to a reputable place to have it done, heck I’ll even pay for it and take them out to lunch after. But it is up to them. I guess if I have a hard time putting a tiny hole in my child’s body without her consent, I seriously can’t see removing a perfectly healthy, fully functioning body part without consent. But I understand not everyone has the same moral compass. It’s not illegal (at least not yet), and while it may never become illegal, that doesn’t mean it isn’t wrong.

            As far as rhinoplasty, the child must be old enough that the nose has stopped growing (at least for cosmetic nose jobs, if there is a medical need, maybe it could be done sooner, IDK). FWIU most surgeons won’t do it prior to about age 16. At that point it isn’t the parents forcing it on the child without the child’s consent – the kid knows about it and is on board wit it (I really can’t see a surgeon performing a nose job on a kid who has openly refused one, even if the parents really want to have it done).

            Removal/fading of birth marks, same thing. That will typically be done at the child’s request, with parental consent if the child is a minor. No baby ever requests to be circ’d.

            Maybe you are confusing parental consent for something the child requested with parental consent before the child is able to have any input….

        • LibrarianSarah

          Braces, and the correction of certain birth defects are the first that come to mind.

          • me

            Braces and correction of birth defects are not purely cosmetic; those kinds of defects (including crooked teeth) can impact a child’s health and development. A normal functioning foreskin is not a problem that needs “correction”. In fact, being born without a foreskin is defined as a birth defect.

          • LibrarianSarah

            Braces are mostly cosmetic especially now a days when we put them on every kid with less then “perfect” teeth. It has just become the so standardized as of late that we no longer see it as the body modification that it is. My bottom teeth are “crowded” had a been born a decade or so later I would have been put in braces. However, my teeth are perfectly healthy, I rarely get cavities and they have made no impact on my health or development. The only reason to get braces is to have pretty “perfect” teeth. Anything less than “perfect” results in braces now a days, how is that not cosmetic?

            Not all birth defects are cleft lips. My cousin’s kid was born with a big red birth mark above her left eye. Her parents decided to have it removed because they were worried about her being teased and that was their decision to make. They could have easily said no and even if the kid wanted it removed and save up her lemonade stand and allowance to pay for it no doctor would touch her without her parents permission. This would go for any procedure that isn’t required to save a child’s life. Parents have control to a large extent of a child’s medical and bodily decisions until the children are 18.

            I live in a largely immigrant community and it is very common for mother to have their daughters (and sometimes sons) ears pierced when they are babies or toddlers. I don’t see anyone saying that these parents don’t have a right to do this even though it is just as cosmetic as circumcision. They have a right to their cultural practices even if I don’t understand it.

          • me

            But, again, with braces the child is old enough to have some sort of say in the matter. You don’t put braces on infants 😉 My teeth are like yours – pretty good, with just a little crowding on the bottom. Braces weren’t even a blip on my parents’ radar for me. My brother has teeth that are decidedly crooked-er (sorry, I know that’s not a word) than mine, and he could have used to get braces (he’s since had some problems, perhaps due to them being crooked), and my parents offered to get him braces, but he adamantly refused. Who’s going to hold down a 12+ year old kid and *force* them to get braces? Answer: No one. But you CAN (and often do) hold down a newborn baby and *force* him to get circumcised. Sorry, while it may be legal, it is immoral. Just as immoral as if you held someone down and forced braces upon them.

            My middle child has a cafe au lait spot on her shoulder. It’s small, it’s not dangerous. I won’t remove it/lighten it, unless and until she wants it done (if ever). If she does decide she wants it gone, sure I’ll support her in that and pay for it. But what if she likes it? The difference between my daughter’s birthmark and the daughter of your cousin’s is that it was a different type. IDK if your cousin’s child had a port wine stain (which, if left untreated, can get darker and bigger, and that close to the eye should probably be treated) or a haemangioma, which could disappear on it’s own (I had one on my stomach as a child – a “strawberry” mark, my parents called it, it disappeared by my teens) or, especially if it is close tot he eyes (as in your cousin’s child’s case) could potentially start to interfere with vision. It may not be that they had it removed to spare her “embarrassment” later, so much as it was medically indicated that it be removed, as it was close to her eye, or if the doc thought it would continue to grow/darken.

            I know many people have their baby girls’ ears pierced at birth. Personally, I don’t think it’s right (my husband wanted our oldest to have hers done at birth, I said no… I want her to beg for a couple months, then have the opportunity to take her out for the day, sort of a rite of passage… that’s how it was for me when I got mine pierced), but its nowhere near as big a deal as circumcision. A tiny pinhole in a body part that is of no real use anyway is different than removing a functional, healthy body part entirely. I’m sure you can see the difference.

    • Mamatotwo

      I wouldn’t call making someone’s chance of getting penile cancer nil, reducing risk of HIV, and reducing risk of HPV to be negligible health benefits.

  • ratiomom

    I`m amazed that Allison Dixley has the guts to put her real name under all that hatespeech. Everyone she ever meets only needs to do a simple google search to learn that she either has narcissistic personality disorder or is a huge asshole. It also means that people she meets IRL can call her out on her bullsh*t. I guess every FF and combo-feeding mother in her social circle gives her the cold shoulder. I`m curious to know what her husband does for a living and whether he is embarrassed by his wife`s online shenanigans

  • thepixiechick

    Try replacing “formula feeders” in the article with “homebirthers” for a surprisingly insightful discussion of the HB crowd’s use and abuse of science.

  • Mtx

    I am a week away from my due date with my first child. I will do my best to breastfeed her through her first year but if I run into problems and decide to use formula for whatever reason, no one has the right to tell me what to do or make me feel guilty about that decision. I have never understood the notion of shaming another woman’s personal parenting decisions or the holier-than-thou attitude some moms have towards other moms. Here is a hint: try looking at your own parenting skills/decisions first and see how you might improve yourself first before propping yourself up on an artificial throne that somehow exemplifies a standard we must all achieve in order to be a good mother. Or better yet, maybe share some things you did wrong or if you could do over would do differently. I would be much more apt to take advice from someone who appears to be genuinely helpful and a flawed human being like all of us than someone who just wants to be a know it all.

    • The Bofa on the Sofa

      Here is a hint: try looking at your own parenting skills/decisions first and see how you might improve yourself

      You don’t get it, Mtx. These folks already HAVE (at least in their minds) done that. They have done their “research” and are doing it the best way it can be done.

      Hence, they feel they are perfectly justified in being able to tell all of us idiots about how we are doing it wrong.