Today’s post is a bit of a departure for me, since it has absolutely nothing to do with infant feeding, or infancy, for that matter. And this is a good thing, because to be perfectly honest  it gets rather dull writing about babies. Babies are kind of boring. Preschoolers are much more interesting. Also more whiny, but that’s fodder for another post.

The reason I’m writing about preschool today is that I’ve joined an incredible group of research and science-driven parenting bloggers. It’s nice to feel I’m part of a group, rather than my usual position as the parenting world’s social media pariah – and I also appreciate that by joining this group, who will be doing a monthly blog carnival with rotating topics, I will be forced out of my comfort zone and inspired to write about a variety of parenting-related issues.

This month’s topic is Preschool. This is a subject which I don’t think much about; ironic, as my children are both in preschool. You’d think I would have at least done some thinking about what type of educational environment would be best for them, but when the time came to decide on a school, I didn’t feel I had much choice. There were very few schools in my area which were not church-based; being Jewish (totally secular, but still self-identifying) I wasn’t sure how I felt about my children learning about God in a way that didn’t feel kosher to me. Thus, we chose the one Jewish (secular, but self-identifying) preschool within a 30-minute radius and called it a day.

We were lucky, because that school turned out to have a warm, outdoor-focused, play-based curriculum. In other words, there really is no curriculum. The kids run around outside. screaming like banshees, riding trikes around the play yard sans helmets (oy), planting lemon trees, and creating Thomas the Train out of old boxes and paint. When holidays arise, they usually approach them by crafting some sort of makeshift art project (i.e., the “Star Wars”-themed Passover seat cushion my 4-year-old proudly brought home last month). It’s a haphazard, seemingly directionless environment, and I adore it (so much so that I’m willing to drive 20 miles to and from school every day, in LA traffic, with gas prices being what they are).

However, a few months ago, I started getting a wee bit nervous when I entered my son’s preschool classroom and discovered him doing a “Letter Book” with one of the teachers. That day’s letter was “C”; I was hoping they’d have him think of all the words that started with “C”, or talk about the different sounds “C” can make.

Instead, the teacher had him glue a “C” she cut out from construction paper onto the book. That was the extent of the project.

Now, my son, like many 4-year-olds,  can write the entire alphabet, and is starting to sound out words on the page when we’re reading together. He recently created a pair of paper “shoes” for his sister using nothing but tape, construction paper, and our (regular, non-”kiddie”) scissors, so there was no reason he couldn’t have at least cut the darn “C” out himself. So this project seemed a bit…well, for lack of a better word, pointless.

I started panicking a little. What were other preschools doing? (I didn’t know, but I knew you had to sign up for them before you even conceived.) Had I picked a school for my son out of laziness? (Yes.) I knew play-based curriculums were all the rage, but this wasn’t the sort of free-form artwork I’d envisioned. And maybe I’d picked the wrong environment for my intellectual, perfectionist child – my daughter was thriving at the same school, loving the social interaction and singing and craziness of it all. My son, though – he flourished with structure. He loved instruction and learning. Maybe this was the wrong school for him?

But through the panic, the uber-rational devil on my shoulder kept whispering “does it really matter? It’s preschool.”

Of course, I started looking into the research (a few years too late, but whatever) and found myself even more confused. The overall benefits of preschool have been all over the news lately, as Obama has announced a new plan to bring universal preschool to our nation’s 4-year-olds in “low and modest-income families”. The opposition has argued that this will be a waste of money and resources; a spokeswoman from the Heritage Foundation countered that “the administration should be working to trim duplicative and ineffective programs, and leaving the provision of early childhood education and care to private providers and, most importantly, parents.”

Taking away the politics for a minute, let’s consider the research being used to back up Obama’s assertions that funding universal preschool will make an impact on society, and what this research means for parents. The National Institute for Early Education and Research (NIEER) put out a position paper trying to explain the research, and it does seem clear that there is a small but significant benefit in early education, in both cognitive and social development, that lasted well into the school years – this effect was seen in a number of studies and meta-anaylses, across different populations and socio-economic groups.

Still, one must ask: How much of this advantage had to do with the children merely being surrounded by their peers? Was it the educational component of the curriculum, or simply having an adult who paid attention to them and attended to their needs? What were these kids’ home lives like? If it was more an effect conferred by social interaction, are parents doing kids a disservice by homeschooling preschoolers? (This would be relevant to the Heritage Foundation’s argument, because it might mean that a parent can give all the attention, education and creative play s/he can muster and it wouldn’t be as beneficial as sending a kid to a multi-age daycare).

The NIEER report does attempt to address some of these quandaries.  For example, there has been substantial research on whether preschool has more of a positive effect on disadvantaged children:

Generally, studies in the United States and abroad (where universal programs have a longer history) find that preschool education has larger benefits for disadvantaged children, but that high-quality programs still have substantive benefits for other children (Barnett, 2008; Burger, 2010).

They discuss a twin study which “finds positive impacts from attending preschool at age 4 across most of the socio-economic spectrum with effects declining gradually as socio-economic status increases” and another study from 1983 (almost as old as I am) that found “positive effects on achievement continued into the school years with very large effects for boys, in particular, found in the second and third grade (Larsen & Robinson, 1989.” even in higher socio-economic groups. But I still wonder – higher income is not synonymous with healthy home life. I’m not sure any of these studies really address whether the kids involved had parents around who were giving them the type of interaction, attention and play that they needed; that would again matter for those who choose to homeschool, or who didn’t qualify for public programs and yet didn’t have access to good preschools. Could parents make up for any shortcomings in their children’s early education?

The NIEER report also makes the point that the type of program matters. They cite the HighScope Preschool Curriculum Study, which randomly assigned 68 kids to one of three types of preschools:

 Both the HighScope and Nursery School approaches emphasized child-initiated activities in which young children pursued their own interests with staff support. The Direct Instruction approach, in contrast, focused on academics and required young children to respond to rapid-fire questions posed by teachers. (Source: http://www.highscope.org/Content.asp?ContentId=241)

They followed these kids through adulthood, and found significant differences in outcome. There wasn’t much difference in terms of IQ between the groups, but in terms of social development, the “direct instruction” kids fared the worst . And these results were… well, odd. For instance, the HighScope kids were more likely to be living with their spouses. (Crap- I should’ve asked about Fearless Husband’s preschool curriculum before we made it legal.) The Direct Instruction group were more likely to be involved in delinquent activity by the age of 15.

So what the heck does this all mean?

Obviously, my concerns, sitting here in my suburban Starbucks and obsessing over the quality of my childrens’ preschool curriculum have little to do with the concerns of the Obama administration or those criticizing the push for higher-quality public preschool. But I think all of us could use a dose of reality – these studies do not seem to show a definitive answer to what is going to help kids the most, in terms of both academic and social success. What does seem clear is that kids are helped to a small, but significant, degree when they are given some higher-quality early education. Child-led curriculums seem to fare better than having kids sit in chairs and firing questions at them (surprise) and having social interaction is a positive thing. Do with it as you will.

As for me? I’m sticking to my down-home preschool. The kids are nice, the teachers are warm, and my kids seem to like it.  I can work on the alphabet at home; what my son really needs is to learn to be free, to get dirty, take risks on the slide, and run around playing Power Rangers with other boys. He will enter elementary school thinking that school is a fun place where you can spend half the day wandering outside finding “treasures” of broken barrettes and rogue shoelaces in the sandbox. He might be in for a cruel awakening, but I’ll deal with that when the time comes.

Check out the other posts from the Carnival of Evidence-Based Parenting Bloggers (all much more coherent than mine, I’m sure):

Picking a Preschool (Momma, PhD)

Universal Prekindergarten: Evidence from the Field (Six Forty Nine)

Welcome to Fearless Formula Feeder Fridays, a weekly guest post feature that strives to build a supportive community of parents united through our common experiences, open minds, and frustration with the breast-vs-bottle bullying and bullcrap.

Please note, these stories are for the most part unedited, and do not necessarily represent the FFF’s opinions. They also are not political statements – this is an arena for people to share their thoughts and feelings, and I hope we can all give them the space to do so.

I’ve been working with Teri Noto, developing literature about the Family Friendly Hospital Initiative, and this FFF Friday post from Ashley (who blogs at Being a Conscious Parent) is a fantastic kick in the butt to get it all sorted, and soon. Like, yesterday.

I believe that regardless of how you choose to conceive, birth, or feed your baby, you should be given respect and quality care in labor, delivery, and beyond. Sometimes medical necessity gets in the way, and (after two complicated pregnancies and slightly scary births) I of all people commiserate with the doctors and nurses trying to ensure the safety of all involved. But in Ashley’s case – and, I fear, so many other women’s experiences – the minute a baby is born, she ceases to matter unless there’s a maternal medical emergency. As long as the mom is healthy, she is quickly dismissed as little more than an incubator that has finished the job, and later, as a source of food. I don’t blame the care providers, as they are attempting to meet the requirements of the hospitals that employ them, and there is a lot of pressure nowadays to fulfill quotas and follow protocols than ever before. 

We need to ensure that voices like Ashley’s are heard, so that the powers that be can truly comprehend the human side to postpartum care. The system is failing breastfeeding mothers, and it is clearly failing formula feeding mothers as well. Maybe it’s time for a new perspective?

Happy Friday, fearless ones,

The FFF

*** 

Ashley’s Story: Punished Because I Formula Fed

I have read so many stories about hospitals that push women to formula feed their babies and how nurses/hospitals need to be more supportive of women and breastfeeding.  My personal experience is a little different from that with the birth of my second child.

While pregnant with my daughter I was diagnosed with anxiety and depression, or Post-Postpartum Depression as a result of my son being born just over a year prior.  I was in my third trimester and felt that it was best for my family and me if I went on medication.  Knowing that I was not going to stop the medication once my daughter was born, I decided that I was going to formula feed from the beginning.  I truly didn’t enjoy it with my son and I didn’t want to pass the anti-depression medication I was taking onto my baby through breast milk.

After 14+ days of a non-stop headache migraine, I was admitted to the hospital at 35 weeks and 3 days for an emergency caesarian-section.  I was diagnosed with preeclampsia and delivered my healthy daughter only a few hours after getting to the hospital.

The nurse on duty asked me if I was planning on breastfeeding before I went into surgery.  When I responded “no”, she proceeded to tell me that breastfeeding was what is best for a premature baby and that they need all the immunities they can get.  I informed her that I was on medication that was not good for her, which is something that she should have seen in my chart.  This was the first time throughout my hospital stay when the nurse on duty said something that implied that I was less of a mother because I was not breast feeding.

After my daughter was born, I returned to the labor and delivery room, where my daughter was with me.  Because her blood sugar was low they asked if I was breastfeeding.  When I informed them I wasn’t, my daughter’s nurse proceeded to open the bottle of formula and feed my daughter.  Both my husband and I were in the room to feed her and when I asked why we couldn’t feed her, she said that she had to do it because they wanted to get her blood sugar up. What would she have done if I was planning on breast feeding?

As this was going on, I was getting pumped with magnesium in response to the preeclampsia.  Per hospital policy, I could not have my baby in my room with me and be on magnesium, unless I had another adult stay with me.  One of my best friends was going to stay with me through the night, so that I would be able to have my daughter in the room with me.  The next thing I knew my daughter’s nurse was telling me that she had to stay the night in the nursery.  I was trying to get answers as to why, but she kept saying that it was because of me being on magnesium.  The nurse then said that the pediatrician needed to see my daughter in the nursery and she would bring her back up right after the pediatrician looked her over.  The last thing I said to her nurse was that I wanted to feed her, and to please bring her up if she needed to eat.

The next thing I knew it was several hours later and I was in a different room, and my baby was nowhere to be found.  I later found out that my friend had tried to get them to bring my daughter back, but because she was not a family member she could not do anything.  I had no number to call and had no idea where my baby was.  I was able to get in touch with my nurse and get the information I needed, only to be pushed aside because it was a shift change.

At that point I was furious!  I could not believe that the entire night went by and they did not bring my daughter up for me to feed her or to be with her at all.  When my daughter’s nurse finally came back with my daughter, I asked her why she was not brought up for feedings and the nurse told me that I was not breastfeeding and she needed extra watching because she was borderline premature.  I was livid! I asked the nurse what she would have done if I had been breast-feeding and she informed that they would have brought my daughter up to me.   The hospital punished me by not doing what I asked because I was not breastfeeding.  The nurse had made the decision that it was not important for me to feed my child because I wasn’t breastfeeding without even consulting me.

I cringe every time I hear about a story where a nurse pushes formula on a new mother, or a breastfeeding mother making it very well known that they are breastfeeding and not to ask about formula or give their baby a pacifier.  I did not get to feed my daughter her first few feedings, and I will NEVER get that back.

It does not matter what the reason was that I chose to formula feed my baby.  It was my choice to do that, just as much as it was my choice to have her in the room with me.  It is not for the hospital or nurses to decide what is important to the parent.  Whatever is important to you, make it known!

Ashley is a working mother of two, who resides in Maryland.  She also writes for her parenting blog at beingaconsciousparent.wordpress.com

I’ve been struggling to write some sort of new yearsyish post for the past few days, and this process has provoked a deep, chilling fear that my brain has literally turned to mush. Unfortunately, I can’t blame this on excessive alcohol consumption or recreational drug use (as that would be a far more scintillating excuse); no, it seems that this brain cell death is perhaps the result of inhaling too much dust while packing up 10 years of our pack-rat life, in preparation for our upcoming move, or maybe just from watching the entire first and second seasons of Homeland in the span of a few weeks. Regardless, I can’t seem to form a cohesive sentence, let alone write a worthy diatribe on the sad state of infant feeding in the developed world, with the requisite positive spin tacked onto the end (because a new years post without a parting call to action is practically illegal), and I’m starting to understand the term “writer’s block’ on a whole new level. And incidentally, I don’t think writer’s “block” is an accurate description for this condition. “Block” sounds rather innocuous. That’s like calling the iceberg that brought down the Titanic a little block of ice. I’d like to lobby for a change in terminology, but the “block” is so bad that I can’t even think of a trite substitution, let alone a witty or more applicable one.

Plus, part of my writer’s block is not really to do with being a writer. It’s the subject matter. I feel redundant. Everything that needs to be said has pretty much been said, between three years of blog posts and Bottled Up. I don’t like regurgitating the same information over and over, and I’m boring myself, so I must be boring you folks too.

The problem is, there isn’t really anything new to write about, because no one is doing anything new. We (and I mean “we” mostly in the royal sense, as well as alluding to some of my blogging peers, journalists, feminists, etc.) have basically been sitting around complaining about the status quo. Until “we” start creating change rather than waxing poetic about it, there will be nothing exciting or worthwhile to inspire us to write new content.

While my writer’s block might make me feel like a cheap pair of jeans (the kind with a little too much spandex in the blend, and a finish that is uncomfortably reminiscent of acid wash), the reasons for it are actually giving me a fresh perspective. I may not be able to write anything inspiring or emotional at the moment, but I can focus on the concrete and rational ways that I’d like to change the infant feeding landscape in the coming year. In that spirit, here are my top resolutions for how I – and hopefully some of you as well – can help make that happen:

1. Create a new dialogue pertaining to the Baby Friendly Initiative

As I outlined in a post this past fall, I am attempting to develop a new schema for U.S. hospitals that will utilize the best aspects of BFHI, while still respecting the needs and rights of women who choose not to breastfeed.  I hope that some of you will join me in this effort. I’d love to get some lactation professionals involved, since the goal is to improve upon BFHI, helping women achieve their breastfeeding and bottle feeding goals. In 2013, I would like to clarify what a “family friendly” hospital would look like.

2. Partner with maternal mental health organizations 

Due to the current pathos of the American Academy of Pediatrics, and the concern of the physicians I approached in my interview process for the book that speaking against the grain of breast-is-always-best would be career and reputation suicide, I doubt that many M.D.s will be able to work with us on improving hospital and post-partum care for new moms in the realm of infant feeding. But since breastfeeding problems and ‘failure’ is so prevalent in the postpartum depression community, as well as the pain of being told to prematurely (and often unnecessarily) wean due to lack of quality research on psychiatric medications and breastfeeding, I think those who advocate for maternal mental heath can be great partners in our cause, and vice versa. I feel like a moron that I haven’t thought about this before, but 2013 will be the year I approach the leaders and changemakers in the PPD and maternal mental health communities and figure out how to make some much needed improvement in how women are treated during pregnancy, birth, and beyond – in regards to lactation and beyond.

3. Stop being All About Me.

I started this blog as an actress-turned-writer; I would like to continue it, in 2013, as a writer-turned-advocate. Part of this will mean smacking my inner diva upside the head when she starts bitching about how no one read her damn book, or how this reporter didn’t interview her, or how she didn’t get named to some best blogger list when a certain mean-spirited individual on the “other” side manages to make the cut every damn year… ahem. SMACK. You get the picture. Ego is a waste of energy and doesn’t help me, you, or my inner diva get anywhere, so she can shut it. That’s a writer thing. Advocates don’t have inner divas, or at least in my idealistic fantasy they don’t. Freud would probably say idealistic fantasies are a product of the ego though… dammit.

4. Find strength in numbers

Like most writers, I tend to close myself off, and avoid collaboration. I’m an introvert, and it’s just the way I’m built. But there is tremendous power in community and partnership – something that my brilliant sisters over at Bottle Babies have always known, and I’ve learned a lot watching them grow. I hope in 2013 to work more closely with them, and find a way for FFF and Bottle Babies to join forces in a more productive and official way.

5. Nip(ple) Breastfeeding Problems in the Bud

Sorry, couldn’t resist the pun. In all seriousness though, I had a revelatory dinner with the brilliant Teri Noto a few months ago, and she brought up an idea so revolutionary (and yet so frustratingly obvious, were anyone to really stop and think about it for a second rather than just heaping a load of guilt and pressure on moms, but I digress) that I nearly choked on my lentil soup. Why not create a prenatal program where moms were given an (optional) lactation-specific breast exam, as well as a carefully designed questionnaire that would help OBs and/or specially trained nurses to suss out potential breastfeeding problems before a woman gave birth? Imagine if you were told prenatally that you had hypoplastic breasts, or that your lifelong struggle with PCOS might cause supply issues, or that your nipples were slightly inverted? Contrary to what some may believe, I think knowledge is power. If this information was given in a nonjudgmental, unbiased, professional way, a woman could make decisions ahead of time that would allow her to feed her baby appropriately for her given situation. If she wanted to avoid formula, this might allow her to look into donor milk in case of a supply problem. Or maybe she’d want to hire a private lactation consultant to visit her in the hospital, one who was already informed in great detail about her medical history. Or, perhaps a woman who was told that exclusive breastfeeding might be difficult for her would go into her birth with less pressure on herself to “succeed”, and would instead be able to enjoy whatever breastfeeding she was able to do. See? I told you Teri was brilliant. And I’m so thrilled to say she’s agreed to work with me on developing this idea, as well as many of the others I’m outlining here.

6. Design a bottle-feeding education program

WHO Code basically forbids lactation consultants and medical professionals from talking too much about formula prenatally. Therefore, it’s difficult within the BFHI paradigm to convince anyone that formula feeding and combo feeding should be discussed at length in prenatal classes, or especially in maternity wards (unless formula feeding has already been initiated, at which point they are instructed to give ample – and, I personally believe, overly anxiety-provoking – information on avoiding the risks of bottle feeding). This means that the majority of parents are going home with newborns with little or no solid instruction on safe preparation of bottles, formula choices, hunger cues in formula fed infants, etc. This has been my platform for awhile now, but in 2013, I aim to turn my whining into action and get a formal formula education program going which could be offered to hospitals on a volunteer basis, or perhaps used in a more informal Mommy-and-Me workshop setting.

7. Enlist the power of the people

This is where you come in, my lovelies. If you want to make things better for your little sisters, daughters, and even yourself when giving birth the future children, make 2013 the year you do something to create change in this arena. Start a local formula/combo-feeding support group, where moms (and dads) can come and not feel they have to hide their bottles under nursing covers. Write to your congresswoman/man or senator if you hear of legislation brewing on baby friendly or ban-the-bag initiatives, and make sure that they are aware that there is more to the story than overzealous formula promotion. You can do this even if you support such legislation – tell them you are glad that they are trying to help women breastfeed, but to not forget that there are women who don’t want to or can’t, and that ALL mothers need good support, education and respect. Help a friend who is going through her own breastfeeding struggles by supporting her, listening to her, and telling her it will be okay no matter what she ultimately decides. Comment on every article you see in the New York Times, the Huffington Post, etc., that misrepresents the breast/bottle divide, and tell your story. Tell your story. And again, tell your story. Make people realize that this debate has gone off the rails not just because of patriarchy, or overly-medicalized childbirth, or unscrupulous formula companies, but also because of other women - many of whom are in positions to turn this whole thing around – who refuse to listen to our stories; refuse to take them as fact and not opinion; who are too caught up in their own narratives to realize that someone else may be speaking from a whole other genre.

Join me in resolving to make 2013 the year that begins our revolution- one that I hope will make breastfeeding easier and more enjoyable for future generations of women, and which will simultaneously respect womens’ rights, bodies, realities, families, and individual needs.

And I mean, please join me, because without you I will just go back to watching Homeland and arguing with Fearless Husband over whether Mike or Brody should be on my “free pass” list. (I’m a sucker for redheads, but that whole suicide bomber thing kind of turns me off…)  Then this blog will turn into a bunch of blathering nonsense and it will all be your fault.

Now there’s a call to action for you. Happy New Year, FFFs.