As is often the case on The Skeptical OB, a single post becomes a multi-day meditation on a topic. I started the week asking if natural childbirth and lactivism cause postpartum depression, progressed to discussing the lactivist War on Formula as a rather poorly disguised war on women, and then shared a new campaign to support mothers (#sogladtheytoldme) and my gratitude for the women in my life who supported me through motherhood.

And, as so often happens, a natural childbirth advocate or lactivist obligingly provides me with an outstanding example of what I have just been criticizing.

In this case, The Alpha Parent (Allison Dixley) has returned from a two month hiatus, just as hateful as ever, this time with bonus victim blaming.

Which raises the question: Why is The Alpha Parent happiest when kicking other women?

I understand why the lactivist industry grossly exaggerates the benefits of breastfeeding, and grossly inflates the purported “risks” of formula feeding. I understand why the lactivist industry attempts to shame and humiliate women who don’t breastfeed; they profit from monetizing that shame and guilt. But why would an individual woman spend so much time excoriating women who don’t breastfeed when the infant feeding decision is deeply personal and affects no one else? It’s the age old tactic of trying to feel better about yourself by tearing other people down.

The Alpha Parent wants you to know that she is better than you, hence her moniker and her blog. She likes to terrorize other women, finds shaming and humiliating other women to be deliciously satisfying, and merely uses breastfeeding as the rhetorical excuse to stomp on other women.

But The Alpha Parent has a problem. As campaigns like #sogladtheytoldme demonstrate, shaming other mothers is going out of style. The intended victims of the shaming are no longer passive. They point out the harms of idealized images of birth and breastfeeding; they support other women in their mothering journeys; and they take aim at the whole idea of attempting to induce guilt in other mothers.

What’s a woman who feels happiest when kicking other women to do?

Berate those women for their own guilt! How?

1. Women should be strong enough to take what ever Allison Dixley enjoys dishing out.

…“Stop being judgemental, I should not be made to feel guilty” is their mating call.

Yet contrary to what some mothers and stand-up comedians may claim, women are not fragile simpering wallflowers at the mercy of iron-tongued tormentors. They are not passive pawns pushed around by the force of others’ words. The image of the female as a boiling pot of feelings, a puppet to her emotions, easily triggered and unable to control herself is a misogynistic invention of a culture that’s still riding on patriarchal coattails. Sadly, many women continue to lap up this rhetoric, and when they become mothers, it becomes enshrined in their self-entitled, self-serving psyche…

2. It’s their own fault that they feel guilty, not Dixley’s fault for heaping abuse (complete with annoying GIFs) on them.

… By its very nature, guilt assumes a wrong doing that one has committed. So in order to feel guilt, two components must be present: 1. A wrongdoing. 2. Personal blame. Now let’s apply this to an obvious example: failure to breastfeed. If the mother believed that breast milk and formula were equivalent, #1 would be absent in her view. Thus, she wouldn’t feel guilty for not breastfeeding. If on the other hand, #1 is present but #2 is not, the result is merely shame not guilt.

3. They’re doing something wrong.

If you’re feeling guilty right now (heck, you’re a parent), look at your guilt with the idea that you are, or might be, responsible …

To that end, Dixley misinterprets a quote often attributed to Eleanor Roosevelt, “No one can make you feel inferior without your consent.”

The quote does NOT mean that if someone’s abuse makes you feel bad, it must be true. The quote stands for the proposition that you can and should fight against attempts to demean you.

When in 1939 African American contralto Marian Anderson, one of the most celebrated opera singers of her generation, was denied permission by the Daughters of the American Revolution (DAR) to use its Constitution Hall for a concert, Mrs. Roosevelt did not tell Ms. Anderson that if she felt bad that the DAR viewed African American women as inferior, it was because she believed herself to be inferior. She did not say, “no one can make you feel ashamed of your race unless you really are ashamed of it.”

What did Roosevelt do?

First, she resigned from the DAR to signal her disgust with their behavior.

Second, she arranged for Marian Anderson to give an open air concert at the Lincoln Memorial, attended by 75,000 people.

When the DAR figuratively kicked Marian Anderson to the curb, Eleanor Roosevelt KICKED BACK.

As Eleanor Roosevelt showed us, when you encounter someone attempting to shame and humiliate another human being, you don’t laugh it off as harmless; you don’t blame the victim for being upset by abusive treatment; you don’t tolerate that behavior but instead condemn it in word and deed.

Which is what I am trying to do.

I don’t have the power to arrange a public tribute to bottle feeding mothers at a national monument, but I do have the power to publicly reassure them that Allison Dixley speaks from hate, not from science. And I have the power to express my personal disgust that for Allison Dixley, it isn’t enough to stomp on women when they are down; she has to crown her efforts by blaming women for her heel prints on their foreheads.

Allison Dixley’s behavior is nothing more than self-serving viciousness.

On Monday and Tuesday I wrote about the ways in which people misuse science to tear down emotionally fragile new mothers.

Last night, while checking my Twitter feed, I made the happy discovery of a new movement designed specifically to do the opposite, to support mothers, especially emotionally fragile new mothers.

It’s #sogladtheytoldme and it was started by women whom I admire.

Here’s Stephanie Sprenger explaining the genesis of the movement:

… [W]hat if we didn’t do either of those things — fill mothers’ heads with unrealistic, sugar-coated imagery OR try to scare the bejeezus out of them with horror stories and unkind warnings? What if, instead, we just supported mothers? What if we gave them the room to speak honestly and openly about their experiences, including the ugly, hard-t0-hear stuff? What if we compassionately shared our own truths without a hidden, possibly malicious “warning” attached to it?…

I am teaming up with my partner Jessica Smock at The HerStories Project to issue a challenge to mothers this week. We want to hear from YOU now. Did anyone throw you a life preserver at some point—either during your pregnancy, postpartum period, or even later into motherhood? Did someone give you a piece of advice or an honest admission that you were profoundly grateful for?

I had my four children before the motherhood competition became as toxic as it is now. I was exceedingly fortunate to be surrounded by a group of women friends, as well as the greatest sister-in-law in the world, who supported each other through pregnancy, infancy, toddlerhood and beyond. Most are friends from college or professional school. I knew them in their pre-mommy incarnations as doctors, lawyers, teachers and executives. Most were at my wedding, and I was beyond thrilled that nearly all were there when my eldest son and his wife were married over a year ago. It seemed only fitting since there were times I didn’t think I would survive until his adulthood without the love and support of those friends.

I learned a lot from these women as we navigated motherhood together. It wasn’t so much what they told me, as what they showed me.

I’m so glad that they showed me that it makes no difference how a baby arrives, whether through vaginal birth, C-section or adoption. The love of a mother is fierce regardless of how the baby came to be part of the family.

I’m so glad they showed me that it makes no difference how an infant is fed. I was proud that I breastfed my children, but 25 years later I can see clearly they are indistinguishable from the children of my friends who bottle fed.

I’m so glad they showed me that there is no right way to raise a child. Different approaches work for different families and different approaches are needed for different children within the same family.

I’m so glad they showed me that it doesn’t matter whether a mother stays home full time with her children, pursues a full time career, a part time career or a career that is staggered over time to accommodate the needs of children.

I’m so glad they showed me that the most important thing a mother can do is love a child and make sure that child knows it. The rest, as they say, is just commentary.

Truth be told, what I learned from these women, influences what I write nearly as much as what I learned in medical school and working as an obstetrician.

I’m so glad they supported me in motherhood, and I hope that by what I write, I can support other mothers in the same way.

It’s the third rail of contemporary parenting.

In a society in which intensive mothering (attachment parenting) is the dominant paradigm, though people are willing to acknowledge that idealized representation of perfect motherhood can contribute to postpartum mood disorders, no one dares note that the natural childbirth industry and the lactivism industry are front and center in a campaign to shame and humiliate new mothers.

Case in point, a conference that is going to take place in early March sponsored by BACE, the Boston Association of Childbirth Educators & Nursing Mothers Council. Here’s a portion of the email announcement:

Keynote Speaker Lawrence Noble, MD, FABM, IBCLC is going to speak on What’s Really Wrong with One Bottle: Microbiota & Metabolic Syndrome.

Spoiler alert:

What’s really wrong with one bottle of infant formula? Absolutely NOTHING!! Zip, zero, nada! That’s what the scientific evidence tells us.

So if there’s nothing wrong with one bottle of infant formula, what’s Dr. Noble going to talk about?

Presumably he is going to give the same talk that he gave last May.

He telegraphed his approach with this opening editorial cartoon:

He plans to baffle the attendees with bullshit!

See, look at that scary complicated math! How impressive that an important man like Dr. Noble can understand that stuff! It’s too hard for lil ol’ lactation consultants and childbirth educators. They’ll just have to lap up what he says and regurgitate to “counsel” their clients.

But I don’t have to take Dr. Noble’s word as truth. I’ve reviewed all 83 slides in that talk and there is NOT EVEN ONE that shows any evidence that a single bottle of formula causes any impact at all, let alone a harmful impact.

Looking over the slides, filled with cherry picked studies, discredited studies, and other nonsense, I had a sense of deja vu. It took me awhile to recognize why and suddenly I realized what this reminded me of. It reminded me of the pitches by Big Pharma detail men and women; elaborate presentations packed with slides and statistics that ultimately prove nothing but are designed to convince doctors to prescribe the drugs they are selling.

Dr. Noble is not shilling for Big Pharma, but he is promoting an industry, the lactation industry.

The lactation industry arose as women commercialized what they had previously given to each other for free: advice on how to breastfeed. Now the very same hints and tips cost $100/hour or more. Their biggest competition in efforts to profit from breastfeeding is infant formula. That’s why they’ve embarked on a campaign to demonize formula, the truth be damned.

But the War on Formula has other casualties besides formula sales. The War on Formula is a war on women.

In its impact on women’s health, mental health, economic health, and ability to reach their fullest potential, infant formula is akin to the birth control pill.

Just as the Pill allowed women to control their own bodies, effectively separating the decision to have sex from the potentially unwanted children that could result, infant formula has allowed women to control their own bodies, effectively separating the decision to have and nurture children from the potentially unwanted need to stay with them 24/7/365 and therefore forgo income and career. It also has allowed women who cannot trust their own bodies to produce enough breastmilk to nourish their children just as effectively as if they were breastfeeding. Sure, breastfeeding has benefits, but in an industrialized society with clean water, those benefits are trivial.

The lactation industry wants to go beyond a war on women’s income and women’s careers to a war on women themselves, by promoting humiliation and guilt among new mothers. That’s the primary message of Dr. Noble’s talk. There is no harm from one bottle of infant formula. In fact, the scientific evidence strongly indicates that there is no harm from exclusive use of formula. But how deliciously humiliating and guilt producing to emotionally fragile new mothers to pretend that one bottle of formula is harmful! How delightful to pretend that new mothers should be bullied into breastfeeding for the good of their babies (when the people who are really benefiting are the lactation consultants and their industry)!

Imagine if we tried to address smoking related illness by humiliating anyone who ever had ONE cigarette. Imagine if we tried to address obesity by shaming anyone who ever ate even ONCE at McDonald’s. That’s absurd, right? But that’s the equivalent of what the lactation industry is doing.

Make no mistake, I support breastfeeding; I’ve breastfed 4 children and I enjoyed it. But I also used formula, too and that improved the quality of my life and my children’s lives.

The War on Formula is not justified by scientific evidence, merely by the profits of the lactation industry. If that were all there was to it, the lactation industry would be no different than any other industry such as Big Pharma.

But the War on Formula is a war on women. Talks like Dr. Noble’s are just battle orders on how to shame, humiliate and bully women into breastfeeding regardless of whether it is the right choice for them or the right choice for their families.

I’ve got a great idea for a new medical drama: Homeopathy 911!

It takes place in a quackademic medical center and follows the lives and loves of alternative medical practitioners.

Can’t you just imagine the scenes in the ER?

“Nurse, get me the reiki practitioner STAT!!”

Or how about the crises in the ICU where young practitioners struggle to mix homeopathic preparations in massive amounts of water to create super-dilute medications for super sick people? It’s the perfect backdrop for illicit sex.

And what about tension in the operating room as chiropractors struggle to manipulate the beautiful innocent bystander hemorrhaging to death after being struck by gang warfare bullets? Is it any wonder that the married nurse falls for the hunky chiropractor once she sees what he can do with his hands?

And then it occurred to me:

There are no alternative Emergency Rooms.

There are no Quacktensive Care Units (QCUs).

And the only surgery performed by purveyors of pseudoscience is the wallet biopsy. If it comes up green, they proceed with treatment.

There are none of these things because alternative practitioners don’t take care of sick people; they don’t even know how to take care of sick people. They only care for the worried well, carefully separating them from their money by shilling herbs, supplements, books and DVDs that no one needs because they are utterly, spectacularly ineffective!

Alternative medicine isn’t medicine; it’s trickery. It’s the placebo effect writ large.

Even practitioners of alternative medicine recognize that it doesn’t actually work. That’s why there are no alternative hospitals, no alternative free clinics, and no medical missions to treat Ebola with homeopathy, or reiki or chiropractic. Its own practitioners recognize that alternative medicine only “works” in first world societies where well off people have discretionary income, not in underdeveloped countries where poor people can’t pay. And it only “works” to enrich alternative providers, not to diagnose, prevent or treat actual diseases.

So I guess Homeopathy 911! is a non-starter.

Hold on! I have another idea.

How about a reality show about women, influenced by midwives, doulas and childbirth educators to view birth as a piece of performance art, choosing to giving birth unattended in the wild.

Wait, what? Lifetime has already thought of that and Born In The Wild, will debut soon?

Hmmm. Maybe Homeopathy 911! isn’t such a bad idea after all.

It’s serious problem, but sadly Avital Norman Nathman dares not speak its name.

Norman Nathman wrote an entire piece on the detrimental impact of “idealized representations of ‘perfect’ motherhood” on the development of postpartum mood disorders without naming or acknowledging the most important culprits: the natural childbirth and lactivism industries.

In a piece entitled What impact does the ‘Good Mother Myth’ have on postpartum mood disorders?, Norman Nathman writes:

… For the most part, many of us are able to push through these idealized representations of “perfect” motherhood, but for others the inundation of these types of images can have a more drastic and damaging effect.

The period of time immediately after having a baby — especially if he or she is your first — can be an incredibly fragile one… It can be even more challenging when faced with images of “ideal” motherhood everywhere you turn…

She speaks with an expert:

Dr. Jessica Zucker, a clinical psychologist specializing in women’s reproductive and maternal mental health explains the impact that these idealized notions of motherhood can have on the mental health of new mothers. “Cultural ideals surrounding motherhood serve to stimulate shame and secrecy when it comes to postpartum challenges,” Dr. Zucker told me. “As a result of media’s portrayal of idyllic early motherhood, women who don’t fit perfectly into this ubiquitous image often report feeling like “failures” and take their troubles underground.”

The media’s portrayal of idyllic early motherhood? While the media may play a part, the primary culprits in promoting “cultural ideas surrounding motherhood” are the natural childbirth and lactivism industries.

What are these cultural ideals surrounding motherhood that stimulate shame and secrecy?

These claims include:

• Women who have pharmacologic pain relief in labor have “given in” and put their own needs above the “risk of exposing their babies to drugs.”
• Women who have C-sections have “failed” at birth.
• Women who follow their obstetrician’s advice and have inductions are personally responsible for the “cascade of interventions” that led to their ultimate failure.
• Women who have pain relief can’t bond to their babies.
• Women who have C-sections have ruined their baby’s gut microbiome AND changed the baby’s DNA in harmful ways.
• Women who don’t have enough breastmilk are either failures or liars, since “every woman has enough breastmilk.”
• Women who give a baby even one drop of formula have permanently destroyed the baby’s microbiome as well as sabotaged the chance for a successful breastfeeding relationship.

I could go on and on, but I think you get the idea.

Leave aside for the moment that none of these claims is supported by scientific evidence and most of them are lies. As Norman Nathman points out, such idealized representations (even if they are lies) have the power to harm fragile new mothers. Who would be so cruel as to promote these accusations to a new mother? Not anyone who cared about women’s mental health, right?

Yet new mothers are bombarded by these accusations, either directly or as insinuations, before, during and after giving birth.

Why? Because there are entire industries that PROFIT by monetizing the shame and guilt thus created.

Follow the money!

The natural childbirth industry, encompassing midwives, doulas, childbirth educators, and lobbying organizations such as The Childbirth Connection, Lamaze International and the International Cesarean Awareness Network (ICAN), not to mention purveyors of books and DVDs promoting natural childbirth, PROFITS by insisting that these purely arbitrary, and thoroughly idealized representations of birth are “better” for babies.

They PROFIT by demonizing epidurals.

They PROFIT by convincing women that a C-section is both a personal failure of the mother and a health risk for the baby.

The lactivist industry PROFITS by convincing women that breastfeeding problems are their own fault.

They PROFIT by convincing women that every breastfeeding difficulty can be solved by a $100/hour lactation consultant.

They PROFIT by hijacking government public health policy to promote breastfeeding (which, in industrialized societies, has real but trivial benefits) and then using those same policies to harrass and humiliate women who can’t or (heaven forbid) don’t want to use their breasts in the way that lactivists think they should.

Norman Nathman writes about potential solutions to this problem of maternal anguish:

One way to help combat this range of detrimental representation is to provide safe spaces for mothers to talk without judgment…

Another solution is to provide a much more varied and diverse picture of what motherhood truly is about… Dr. Zucker agrees, suggesting that, “Maternal images that include the full spectrum of lived experiences would better serve women and their burgeoning families.”

Great! Who’s going to tell the natural childbirth and lactivist industries that they ought to provide a much more varied and diverse picture of what GOOD motherhood is truly about?

Sadly, it won’t be those who bemoan the effect of “The Good Mother Myth” on postpartum depression, but dare not mention the names of the industries who gain the most from the myth: the natural childbirth and lactivism industries.

I have an idea.

Let’s hold celebrities accountable for the medical advice that they give.

Much of it is just plain silly, like Gwyneth Paltrow’s recommendation to steam your vagina.

You sit on what is essentially a mini-throne, and a combination of infrared and mugwort steam cleanses your uterus, et al. It is an energetic release—not just a steam douche—that balances female hormone levels. If you’re in LA, you have to do it.

But some of it is deadly, like Jenny McCarthy’s claims about vaccination, Ricki Lake’s claims about homebirth, or Suzanne Sommers’ claims about cancer therapies.

Why haven’t these celebrities been sued for the injuries and deaths that result? The answer is in the fine print.

At the very bottom of the website of Jenny McCarthy’s organization, Generation Rescue, in teeny, tiny print, it says:

None of the information presented here should be considered medical advice or a “cure” for autism. The information presented represents strategies for dealing with autism that have been reported as successful by professionals and/or families with autism. While we believe this information to be accurate we are not in a position to independently verify it and cannot guarantee that it will work in any particular case…

The first page of Ricki Lake’s book, My Best Birth has this disclaimer:

This book is not intended as a substitute for the medical advice of physicians…

Hidden in the Terms and Conditions Page of Suzanne Sommers website is this:

Information contained in SuzanneSomers.com is not a substitute for professional medical advice, health care services or a medical exam. Nothing accessed is or should be interpreted as a general or specific recommendation for a specific treatment plan, product, exercise regimen or course of action.

This is supposed to protect these celebrities from any responsibility for their recommendations, products and advice (because regardless of what they say, it IS advice).

Here’s my thought:

Anyone harmed as a result of taking the advice of these celebrities or harmed by using the products that these celebrities shill in their books and movies and on their websites should be able to sue the celebrities for malpractice. Why malpractice? Because if a celebrity is profiting from her recommendations (through products, books and movies), she is practicing medicine without a license. Of course if the celebrity is not profiting, merely sharing what she and her family do, she should not be liable in any way. There’s a big difference between saying, “Here’s what I do.” and saying “Buy this in order to …”

After all, other companies and their executives are responsible for harm devolving from the products they sell, whether that harm was predictable of not. We don’t allow car companies to put tiny labels on their cars claiming that since you chose to buy the car, you are responsible for any harm that occurs when using the car. Why should we allow celebrities to put tiny print on their websites, books and movies (which are offering detailed medical ADVICE), claiming that they are not responsible for the outcome because it isn’t really advice (wink, wink)?

This is not censorship, because these same celebrities are free to give the exact same advice; they’re simply held accountable for it.

And how could holding them accountable be a problem if they are sure that the advice/recommendations/products they are promoting are safe and effective? It wouldn’t, if they had the courage of their convictions, right? They’d simply be putting their considerable wealth where their mouth is, and they can afford it.

So I declare people should be allowed to sue celebrities for harmful medical recommendations … but this claim should not be construed as legal advice.

*This statement should not be construed as medical advice.

The biggest problem with natural parenting (besides the fact that it is not supported by science) is that natural parenting is deterministic. It views children as vessels for parental action and ambition, not as actual people with needs, desires and dreams that may differ from their parents.

At its heart, natural parenting, an affectation of Western, white, privileged parents, views a child as an object to be acted upon to create the desired result: an adult with specific middle to upper middle classes achievements: smart, talented, and ready to enter the economic competition of adulthood at a high level. “Average” children are a disappointment, and, according to the anti-vax crowd, autistic children are better off dead.

What’s striking about natural parenting is not merely that parents wish to raise children they can brag about, but that they think they have the recipe to do it.

That recipe includes:

• unmedicated vaginal birth
• extended, exclusive breastfeeding
• rejection of vaccination
• “pure” food (organic, no GMOs)
• keeping the child often literally attached to the mother and thereby constantly controlling all experiences
• the family bed, insuring no privacy for child or parent even at night

In other words, natural parenting is determininstic. What is determininism?

According to Wikipedia:

Determinism is the philosophical position that for every event, including human action, there exist conditions that could cause no other event.

There are many different kinds of determinism. In the setting of parenting, determinism stands for the proposition that it is parental actions that determine the characteristics of the person the child becomes.

Natural parenting is not about children. It is a recipe that parents can use to create an adult intellectually, socially and economically successful in an upper middle class Western, (and to a large extent, white) environment. Children are viewed as objects to be acted upon, shaped and molded. The actual child takes second place to the future adult that is purportedly being created.

This deterministic view of parenting has important implications for children, parents and social policy.

Consider breastfeeding. It is a paradigmatic case of natural parenting beliefs being turned in to public policy. When and why did the government think it should get involved in promoting breastfeeding, which in first world countries has only trivial benefits?

There’s not much question that the government has inserted itself into breastfeeding promotion at the behest of lactivists (breastfeeding activists), despite the fact that there couldn’t be a more intimate, fundamental personal choice than how women use their own breasts. Lactivists have their own motivations for making their personal infant feeding choice into an object of public policy. There is a lactivist industry whose financial health is directly tied to the amount of pressure to breastfeed brought to bear on new mothers. The task of supporting new mothers who choose to breastfeed has gone from a volunteer task (La Leche League) to a profession that charges $100 an hour or more to do the same thing. The economic growth of the lactivism industry is tied directly to official efforts to demonize formula feeding, locking up formula in hospitals, forcing women to sign breastfeeding “contracts,” and overall efforts to make bottle feeding an object of social scorn. Moreover, lactivists themselves benefit from the psychological boost that comes from being able to claim success at an infant feeding method that is ostensibly so important that the government feels compelled to promote it.

Obviously the lactivist industry did not lobby for lactivist policies by declaring they would benefit from it. They lobbied by implying that breastfeeding has the power to create better, smarter, healthier (and therefore less expensive) individuals. Fill the child with breastmilk and presto, an ideal adult will be produced! The truth is, no matter how desperately lactivists insist that breastfeeding prevents the chronic disease of adulthood in privileged societies, breastfeeding is just one way of feeding a child and has no impact on the adult that is produced.

Lactivism, like all of natural parenting, is a one size fits all policy. The fundamental assumptions of lactivism is that ALL children will do “better” if breastfed, that ALL women make enough breastmilk to satisfy the needs of ALL infants, that EVERY child’s brain is “improved” by breastfeeding, and that ALL women should be more concerned with using their breasts to feed babies than their minds and talents to work outside the home and meet any of their own needs. Those assumptions are flat out false.

The more important issue, though, is what breastfeeding policy tells us about the way we conceptualize children. We don’t see them as people, unique individuals with unique needs. We see them as future adults, guaranteed to become the adults we desire if only the parents fill them with the correct inputs. But any parent who has more than one child knows that the parenting strategies that make one child happy may be utterly wrong for another child who has the same parents, in the same family, growing up with the same economic and socio-cultural conditions.

The implications of the determinism of natural parenting are enormous, ranging from anti-vaccine advocacy, where parents are more concerned about the purported creation of a socially and economically non-competitive autistic child than whether that same child lives or dies; to hysteria about parents letting their children out of their sight to walk home from the park unattended; to parenting choices that not so coincidentally place extraordinary stress and responsibility on mothers and force women to stay in the home.

The message that natural parenting sends, particularly to mothers, is, “It’s all up to you.” and if things don’t work out, “It’s all your fault.”

Parenting is NOT deterministic. Yes, parents can screw up children (it takes a tremendous amount of neglect and abuse to do so), but parents can’t create perfect adults no matter how desperately they wish they could. And good parents can, with the best effort and intentions, raise children who are average or below average, emotionally fragile, subject to the perils of addiction, or even criminals.

Fortunately, most children are resilient. If they were not, I would fear we are raising a generation that will struggle because we ignore who CHILDREN are, their needs, desires, dreams, talents and limitations, in favor the ADULTS that parents desire they become.

Yesterday, the PBS NewsHour felt compelled to inform its viewers that they should not let their children attend measles parties.

Measles parties are relatively new since, until recently, there were very few cases of measles. But now that measles is back (courtesy of anti-vax parents):

KQED Public Media told the story from Marin County of unvaccinated children being invited to a so-called measles party for intentional exposure.

The belief behind measles parties is that exposing them to the disease will protect them by allowing them to develop “natural” immunity. Of course it will also sicken them and possibly kill some before they develop that “natural” immunity. Yet what these anti-vax parents fail to realize is that the immunity is no more “natural” than the immunity developed in response to the measles vaccine.

Immunity requires that the body “see” the virus or bacterium and then develop antibodies to disable and ultimately kill it, so that the next time the child encounters the relevant virus or bacterium, it will have a head start in creating antibodies and therefore will not once again become ill with the disease.

What’s the difference between immunity developed to the disease and immunity developed to the vaccine?

Every virus or bacterium is covered with hundreds of molecules; antibodies can be created to any of those molecules. In the case of disease, the child is exposed to the entire potentially deadly organism. In the case of the vaccine, the child is exposed either to a weakened organism or a non-harmful piece of a harmful organism. That’s why a vaccine can create immunity without causing illness. The evidence that the child’s body has “seen” the virus or bacterium is usually localized inflammation (some redness and swelling at the site of injection) and possibly a fever as well. These are signs that the body is reacting to the presence of the vaccine IN THE EXACT SAME WAY that it would react to the presence of the virus or bacterium.

To use a military analogy, a vaccine is like breaking a code. Breaking the code allows one side to learn the plans of the other side and prepare to defend against them. Knowing, for example, when and where an attack will be launched as well as what weapons, air coverage and troop strength will be involved, helps the code breakers to arrange their forces in the way that will best counter the attack.

Refusing the vaccine is analogous to refusing to intercept and break the code. It’s waiting until the attack starts to figure out when and where it is taking place, and waiting for the battle to develop to determine the weapons, air coverage and troop strength arrayed against you.

Which tactic do you think gives an army the best chance of fighting off an attack? Knowing the enemy’s plans and creating a strategy to counteract them or waiting until the battle is joined to figure out what is going on and what you need to do to defend yourself?

A measles party is the equivalent of dumping your troops on to the battle field without advance intelligence. Sure, those that survive the battle will walk away with knowledge of when, where and how it took place, but lots of soldiers won’t survive to convey that knowledge.

Although measles parties are new, there is ample precendent in the anti-vax community. Chicken pox parties have been popular for years, and mothers have offered on Facebook and message boards to send lollipops licked by children with chickenpox (I’m not making this up!) to mothers whose children have no immunity.

So here’s my question:

Why are there no ebola parties?

Why aren’t mothers reaching out to African parents to get lollipops or articles of clothing from children infected with ebola in order to create “natural immunity” in their own children. After all, it is only a matter of time before an ebola epidemic occurs here.

The dearth of ebola parties harks back to the motivations of anti-vax parents. As I’ve written repeatedly, anti-vax is not about science, but about parental ego, defiance and empowerment.

There are no ebola parties (and there won’t be any for the foreseeable future) because anti-vax parents are not insulated from ebola by their privilege. Yes, they live in a wealthy, technologically advanced society and have easy access to hospitals and medications, but that isn’t always effective against ebola. Parents do not have the privilege of ostentatiously refusing vaccination against ebola because there is no vaccine as yet, And the “evil” hospitals and doctors may fail in treating it so they don’t have the privilege of turning to them to rescue their children from their own selfishness.

The element of defiance that is so important in the contemporary anti-vax movement is also missing since no authority figures have issued any recommendations about avoiding ebola. Where’s the thrill in having an ebola party when you haven’t defied anyone to do so. How much better, then, to have a measles party in order to thumb your nose at the CDC?

Finally, even for the anti-vax folks, there’s nothing empowering about ebola. It’s highly contagious and highly deadly. The chances of making an “empowering” statement of defiance on ebola are much lower than the chances of dying of ebola itself. Have a measles party, and odds are good that your child will survive the measles. Have an ebola party, and you’ll almost certainly be burying your children in the ground.

There are no ebola parties because the opportunity to broadcast your privege by refusing that privilege is non-existent; the opportunity to pat yourself on the back for defying authority is non-existent, too.

There’s no chance of bolstering parental self-esteem with an ebola party, so the anti-vax crowd will burnish their egos with measles and chickenpox parties, instead. And their children (and other people’s children!), who could have easily been protected by the vaccine without getting ill, will suffer and may die so that anti-vax parents can boast to each other that they understand vaccines better than all immunologists, pediatricians and epidemiologists the world over.

The anti-vax movement has been exposed for what it has always been, intellectually and ethically bankrupt.

And it has been exposed in the most spectacular fashion due to the Disneyland outbreak of measles simultaneously demonstrating that the empirical claims of anti-vax parents are nothing more than nonsense and that the practical effects of refusing to vaccinate your children involves putting other children at risk of serious disease and even death.

So should we expect a mea culpa, and admission acknowledging that anti-vax advocates have been wrong all along, duped by lack of basic knowledge about immunology, science and statistics and aided by gullibility in trusting folks like Jenny McCarthy and Jim Carrey?

Not in this lifetime!

Why not? Because as I have written before, anti-vax advocacy was never about science. It was always about EGO.

Admitting one’s mistakes is not an ego boost, so there won’t be any admissions of thoroughly misunderstanding (or never understanding) the science behind vaccination, and there won’t be any expressions of regret about harming other people’s children.

What there will be is retrenchment, and as the Facebook post below demonstrates, Mayim Bialik shows us how it’s done.

Bialik writes, apparently with a straight face:

i [sic] would like to dispel the rumors about my stance on vaccines. i am not anti-vaccine. my children are vaccinated. there has been so much hysteria and anger about this issue and i hope this clears things up as far as my part.

How could anyone have thought that Bialik was anti-vax?

After all, look what she told People Magazine in 2009:

We are a non-vaccinating family, but I make no claims about people’s individual decisions. We based ours on research and discussions with our pediatrician, and we’ve been happy with that decision, but obviously there’s a lot of controversy about it.

In 2012, she wrote a whole essay on why she didn’t want to talk about it:

Children today get about four times as many vaccines as the average 35-year-old did when we were kids. Besides visiting the CDC website … here are the books we used to research each vaccine and discuss each with several doctors before deciding what was right for our family.

She follows this with recommendations for anti-vax books by two celebrities beloved in the anti-vax community, Mothering Magazine contributor the late Dr. Lauren Feder (primary care medicine, pediatrics and homeopathy) and super-quack Dr. Bob Sears.

Does Bialik think we are idiots and don’t remember that she declared hers to be a “non-vaccinating family”?

I doubt Bialik is thinking of us at all. She’s attempting damage control for her own ego, not her public image.

Bialik, like most anti-vaxxers in February 2015, now knows that she was utterly, spectacularly wrong about vaccination. She faces two choices; she could admit that she was wrong and learn from her errors. That’s what typically happens when people learn that they were wrong about some aspect of science. Or she could preserve her sense of self esteem by pretending that she was never wrong because hers was never a “non-vaccinating family.”

See, her children are vaccinated! Against what and how closely have they adhered to the CDC vaccination schedule? I’m going to go out on a limb here and suggest that while Bialik’s children are selectively vaccinated according to a schedule that she, or someone she admires, made up in defiance of the CDC.

No matter what happens, Bialik needs to feel that she is both “empowered” by making a personal choice, and not one of those “sheeple” who accept that the expert opinion of experts has more value that her idiosyncratic personal beliefs.

Bialik will not be the only one. We are all vaccinating parents now!

I predict that anti-vax celebrities and celebrity quacks are embarking on an about-face so fast that their heads will spin. That’s how they will protect their egos. Then it is only a matter of time before they settle on some other form of quackery in defiance of authority to demonstrate that they have done their “research” and are “empowered” by refusing to follow the recommendations of experts.

As I wrote last week:

When refusing to vaccinate your children is widely viewed as selfish, irresponsible, and the hallmark of being UNeducated, anti-vax advocacy will lose its appeal.

That moment has arrived. Let the backpedaling begin!

An alt-med shill’s work is never done.

She always has to be out there shilling her books and supplements to increase her income, as if she didn’t already make enough from practicing “functional” medicine.

One of Romm’s favorite tactics, in common with everyone who profits from the natural childbirth industry, is to demonize modern obstetrics. But this time she appears to have gone off the rails. She is so busy demonizing that she comes perilously close to demonizing women who die in childbirth.

Here’s what she posted on her Facebook page, attempting to boost sales for one of her books.

While the chance of dying in childbirth in the US is extremely low, the rate, according to the latest data from the CDC, continues to rise, not go down in recent years. This is attributed to increasing rates of chronic disease in pregnant women — and much of this is preventable by achieving a healthy weight prior to pregnancy, preventing gestational diabetes with a properly balanced diet that is not high glycemic and getting enough nutrients, especially vitamin D3. Some of this is also due to birthing practices in the hospital (not saying that home is without problems, but the maternal mortality rate is lower with planned home births to healthy moms with competent midwives).

So, Aviva, if only those lazy, fat pregnant women would stop stuffing their faces, they wouldn’t die in childbirth?

And since maternal mortality disproportionately affects Black women (who are 3 times more likely to die in pregnancy or childbirth than white women), they must be 3X more likely to be lazy, fat, and endlessly eating, right? It couldn’t possibly be racism or poverty?

That wasn’t what you meant to imply, Aviva, when you blamed women who die in childbirth for their own deaths, was it?

You only meant to mislead women about the role of nutrition in maternal death so you could make more money off your own books? That’s what it seems like to me.

Before we parse the absolute bullshit that you posted, let’s take a look at who dies in pregnancy and childbirth in the US. The data come from Pregnancy-Related Mortality in the United States, 2006–2010 published in the January 2015 issue of Obstetrics and Gynecology.

The highest rates of maternal mortality occur in women greater than age 40. Maternal deaths among African Americans dwarf those of other ethic groups.

Why do women die in pregnancy and childbirth?

You can see that whereas some causes of maternal death like hemorrhage and pre-eclampsia/eclampsia have diminished in importance, others have steadily increased including pre-existing cardiac disease and cardiomyopathy (pregnancy induced weakness of the heart muscle).

What do these have to do with nutrition?

Absolutely, positively NOTHING.

What do these have to do with vitamin D3?

Absolutely, positively NOTHING.

What has Aviva herself been doing to decrease maternal mortality?

Absolutely, positively NOTHING.

She practiced for years as a homebirth midwife, but now that she has real medical training, and could actually care for pregnant women properly, she refuses to take that responsibility.

Wait, let me amend that; she’s not doing nothing: she’s been exploiting the tragedy of maternal mortality to sell her books and promote her world view.

And lying.

Consider this gem:

[T]he maternal mortality rate is lower with planned home births to healthy moms with competent midwives

Not only is this a lie, but to my knowledge, there are no studies that are large enough and have enough statistical power to address that issue, since maternal mortality is measured per 100,000 women.

Ironically, I recently heard about yet another maternal death at homebirth that occurred in Arlington, Texas. A mother attempting a VBA2C delivered a lifeless baby and collapsed. The baby survived after being treated with cooling therapy for hypoxia (lack of oxygen), but the mother died despite heroic attempts by doctors to save her life. She left 4 children motherless. Add that to the 22 additional children left motherless when their mothers died at homebirth (She trusted birth … and it killed her. Now her children will pay the price.)

No doubt all these women were getting enough nutrients, but it didn’t make any difference.

The truth about maternal death is the US is this:

It’s not clear that it is rising, because better reporting has been responsible for at least part of the increase, but it isn’t falling. As the graph above demonstrates, the single biggest factor is the increased birth rate of women over 40. Those women are more likely to have chronic diseases, NOT because they didn’t eat right, but because chronic disease incidence increases with age. Moreover, although the number of pregnant women requiring intensive care is increasing, there are very few obstetric intensivists, very few obstetric intensive care units, and no rating system to facilitate transfer of critically ill mothers to hospitals that have the experts and equipment to treat them.

The bottom line is that the solution to maternal mortality is NOT better nutrition; it is NOT vitamin D3; it is NOT homebirth; and it is NOT buying Aviva Romm’s books. It is imperative that we increase our ability to identify critically ill pregnant women, transfer them to specialty obstetric units that have the personnel and equipment to manage their complex medical problems so we can apply MORE interventions to those complex medical problems, and identify best practices for managing complex medical conditions in pregnancy.

Stop blaming the victims, Aviva Romm; stop exploiting the tragedies of these women, particularly women of color, to shill your books; start doing something effective to address the problem, if indeed you care about it at all.