While researching this on the internet, I’ve stumbled upon some fascinating information which flies in the face of conventional wisdom.  Conventional wisdom suggests that kegel exercises are the answer to this sort of pelvic floor weakening problem, and in fact they’re what I have been doing primarily, and have been teaching my patients how to do for years now.  Kegels, kegels, kegels!  However, after reading this amazing post over on MamaSweat where Kara Thom of MamaSweat interviews Katy Bowman of Aligned and Well, I am beginning to change my mind.  Katy is a biomechanical scientist who has done a lot of research into the mechanics of the pelvic floor, and in her radical departure from conventional wisdom, she suggests that squats are the answer rather than kegels.  Naturally, rocking the boat like this has brought with it a bit of a back lash, including this hilarious video aimed at Katy from the “Kegel Queen” (an RN who also believes highly in the merits of kegels); even a year after the initial interview, the debate is still alive and well.

So in addition to kegels, I’ve decided to add some squats to the mix, and I’m even squatting and peeing in the shower each morning (apologize for the potential TMI right there, loyal readers!).  There are also some pretty cool exercise systems out there which can be purchased, as well as physical therapists who specialize in nothing but the pelvic floor, so I’ll keep all of you posted on pelvic progress 6 months from now.  But I’m also a firm believer in sexercises, too!

But now, suddenly, sometime in the last week, I have found myself walking down the street with the baby attached to me, and feeling like this is normal.  Like this is part of who I am.  That being a mother is one of the ways that I identify myself, just as I think of myself as a midwife, a woman, a wife, a sister, a daughter, a friend.  And there are definitely some moments (fleeting! and few and far between) when this feels normal.  Days when I am taking it all in stride.  But the transition, here, is that I have spent 34 years on this earth without a son, and only two brief months on this earth with a son.  It makes sense that the idea of me as a mother still feels so foreign.

And I was never sure about the mothering part, anyway.  When we were talking about getting pregnant, it was never the pregnancy or the birth that I worried about (not much, at any rate)…it was always the mothering part, the being responsible for a new human being part, the raising a tiny baby into a useful and functioning member of society part.  So much responsibility on your shoulders, and so many opportunities to mess it up, big time!  (One has only to look at articles like this, in the Atlantic last month, to see how easy it is to mess it up, even when trying so very hard to get everything right!)

There are moments when I think that this is all it’s ever going to be: the exhaustion, the monotony (feed, burp, diaper, soothe to sleep, rinse and repeat), the constant cluelessness, the slow dawning on you that life will never, never be the same.  This is all I’ve known of parenting so far, so it’s hard to imagine what it will be like 2 months from now, let alone 2 years from now.  I know, logically, that he will grow and develop, and that gradually it will become more fun and more rewarding.  But for now, this is all you can see.  And you think it will never end.  And to honestly talk about some of the aspects of being a new mother that often get glossed over, there is a sense of mourning involved in all of this: a mourning for your old self, for your old life, for being able to go out whenever you want and stay out as long as you want, for dinners with friends and late night movies and living your life for yourself and your own pleasure, more or less.

But my beautiful son has also just begun to smile as well, in the last few weeks.  It’s one of the sunniest, most freely-given smiles I have ever seen, and he lights up over the simplest things: someone talking softly to him, a long-awaited burp which suddenly makes him much more comfortable, the late-afternoon light dancing through the leaves of a tree.  I know this will sound cheesy, but it is profoundly true: seeing his smile, realizing that he’s not just a small, unresponsive bundle of endless demands but instead a small human being, suddenly makes the sacrifice, the sleeplessness, the mourning, the loss of freedom, the strangeness of motherhood all worth it.  I am hopelessly in love with my son.  Hopelessly?  That sounds too dire.  Hopefully seems more like it.

I took a breastfeeding class last week.  Yes, I actually took a class. And I’ll be attending it again this coming week as well.  This from a midwife, someone who has taught countless other women about breastfeeding, and who has helped countless women get a good latch with their brand new baby.  But there’s a big difference between helping a newborn (as in, minutes-old) baby latch for the very first time versus addressing the myriad difficulties and complications which come up over the course of time: the engorgement, the first growth spurt, and then what happens after the first growth spurt.  There’s much to be said for getting a baby onto the breast in the first hour of life, but as a midwife you’re not doing much lactation support at 3 weeks of life.  Maybe a bit more at the 6 week postpartum check-up, but in between birth and 6 weeks, a lot of breastfeeding happens, and a lot of challenges arise.

Case in point: for me, my challenge is oversupply.  I have a huge oversupply problem!  Who would have guessed that I would be such a milk goddess??  Whenever I thought about potential breastfeeding snafus, I always thought about undersupply.  It didn’t even really occur to me that oversupply could be a problem.  But it can indeed  be a problem.  A very challenging problem, in fact.  So, I will speak to this for a bit, since I now have first-hand experience with it (and maybe someone else wants to write a guest article about first-hand experience with an undersupply problem?).

This is what oversupply looks like: ever since my son’s growth spurt, my breasts have been painfully full.  When he tries to latch, he has a hard time getting his little mouth to even indent the breast, and then when he does, the milk flows down so quickly it completely overwhelms him, and he ends up pulling back and choking.  This has made his latch very painful for the past few weeks.  In an attempt to stem the overwhelming tide of milk, he’s been pursing his lips and using a much smaller latch than he was the first two weeks, which has led to him sucking little grooves into my nipple and turning the nipples black and blue.  I keep trying to get him to use a wider latch, but inevitably he closes his mouth to a smaller diameter again, and I can’t really blame him.  I would do the same, too, if the milk was flowing so quickly into my poor mouth.  During let-down, my let-down has been so forceful that I have actually sprayed him in the face with milk, like a shooting milk geyser!  Poor guy, how is he supposed to drink from a breast that is out to get him like this?  Every feeding has become a wet and sticky mess.  By the end of it, I’m covered in milk, he’s covered in milk (bring on the baby acne!) and my clothes are covered in milk.  Forget trying to nurse in public at this point, there is no way we can be discreet at this point.  Every feeding feels like a pitched battle against the exploding milk fountain of doom!

Then, there are the digestion issues.  Because the milk is flowing so fast, he ends up gulping a lot of air.  Despite frequent burp sessions, his little belly is full of air by the end of the feeding.  He’s also become a really fast drinker to try to cope with the let-down.  He may finish the breast in about 10 minutes, but it hasn’t satisfied his urge to suck yet, so he continues to try to suckle at the breast for another 20 minutes or so.  And because he’s drinking so quickly, and filling up so quickly, he’s not always getting to the hind-milk at the back of the breast, which comes at the very end of the feeding.  I just found out that hind-milk is crucial to improving his digestion.  If he’s getting enough hind-milk, he digests everything more slowly, and the poop is mustard yellow and much easier on his G.I. tract (less gas, less explosive poops, less fussing).  If he’s not getting enough hind-milk, everything digests much too quickly, with a lot more gas and fussing involved, and comes out green instead of yellow.

I went to a breastfeeding class last week, and this is the advice I was given: first, try more upright feeding positions, where he’s sitting up or across my chest but I am leaning back so that his head is over the breast, rather than under it.  This will make the milk have to work against gravity, which might help slow the flow down.  I was pumping a little bit before feeding him to try to soften the breast somewhat and make it easier for him to latch.  The lactation consultant advised to stop pumping immediately, because this was just encouraging more milk production!  Instead, I can manually express just a bit, if I have to, but if at all possible I should just let him eat directly from the breast, and supposedly that will help regulate our supply/ demand more quickly.  She advised I continue with the frequent burpings, and that if he finishes the breast quickly but still wants to suck, I can offer him a pacifier or clean finger to suck on instead, since continued sucking helps with his peristalsis and may also help him digest the milk more easily and spit-up less.  She suggested that I could also try block feedings if I wanted to in an effort to make sure he gets enough hind-milk (this is where I offer him the same breast for 2—or more—feedings in a row, so that I know for sure that the breast is completely drained and that he got the hind-milk before moving on to the other breast).  However, other advice is suggesting that maybe block feedings are not the best idea, since this increases the risk of mastitis and may eventually lead to undersupply (see the link below from Nurtured Child).

I’ve been looking up some other resources about oversupply on the web.  This is what I’ve found so far, which has been very helpful:

Kellymom.com – great resource for all things Breastfeeding.  I just added it as a permanent link under the Breastfeeding section.

Nurtured Child: Managing Oversupply (written by a LLL leader), which discusses frequent switching of sides rather than block-feeding as a way of dealing with it.

At the moment, we’re skipping the block feedings, I’m doing manual expression when needed, and just letting the little guy eat directly from the breast when he’s hungry.  And hoping that the supply/ demand issues will sort themselves out soon.  But no, it’s not easy.  Even with too much milk, there are still challenges.  I will keep you all posted!

Dear Parents, I am your brand new, wonderful baby. I have very simple needs, but I cannot communicate them to you, therefore, I am a mystery.  I also am changing very rapidly, and every day will be different.  I promise you–DIFFERENT.  Make no assumptions, there are no patterns, just when you think you know who I am and what I like, I will CHANGE.  Oh, and let me tell you about my first growth spurt. It will happen sometime when I am 2-3 weeks old, and it will come out of nowhere, like a bolt of lightning.  Up until my growth spurt, I may have been a good nurser.  You may have been banking on me sleeping at least 2 hour stretches at a time. You may have thought you had figured out what kind of bouncing or rocking or swaying or singing I enjoyed.  You may have been gaining some confidence with your new parenting skills. HAH! I am here to tell you that my growth spurt will throw all of this out the window. It won’t just throw it out the window, it will toss it up, spit on it, tear it to shreds, set fire to the shreds, and then throw the ashes out the window all done while laughing maniacally.  During my growth spurt, I will DEMAND food every hour, on the hour, and when you offer me your breasts, I will flail at them and spit them out because they will be EMPTY and so inadequate for my growing needs.  I will not just be fussier than usual, I will be INCONSOLABLE.  I will introduce you to several of my more distressing cries which I have been saving for just this occasion: the high-pitched wail, the piercing shriek, the crying-so-hard-I-choke-and-stop-breathing-for-awhile, the so-red-in-the-face-you’ll-think-you-need-to-call-911—these and other specialty cries I prepared for you.  I will not let you sleep. AT ALL. EVER.  You might have thought other parents were just joking when they said they literally got NO sleep, but really, TRULY, you WILL NOT SLEEP.  You will spend 24 hours trying to comfort me.  You will pull your hair out. You will wonder where you can return me to.  You will question the decision you made to have a baby.  You will question whey you ever wanted to have sex, ever, in your life, instead of joining a convent at the tender age of 13.  You will be forced to watch an all-night Hugh Grant movie marathon in bleary sleep-deprivation while I gnaw and masticate your nipples to a pulp in my unending demand for milk, of which you are so unable to provide for me.  And then, finally, when I pass out from exhaustion after wailing for 8 hours, I will only sleep for 2 hours before beginning the cycle all over again.  THIS IS MY GROWTH SPURT!  BE AFRAID! BE VERY AFRAID!

In other words, the next time I tell other women about the growth spurt, I will try a little bit harder to prepare them for it. Not that anything can really prepare a new parent for it, but I will, indeed, make a bigger deal about it.  And, for the record, we did survive.  It wasn’t quite 24 hours, more like 36, but now, on the other side of it, I can vouch for the fact that your milk supply does catch up, remarkably quickly, and normal nursing does resume again, about a day later.  But honestly, new parents, be on the lookout for the growth spurt—it is truly no joke!!!

“I came across your website when I was google searching the words “Ina May” and hyperthyroidism. Reading a bit on your blog, I saw that you did a monstrous report on the condition. I have a ten month old baby girl (my first) and was recently diagnosed with hyperthyroidism (my TSH was .004) but have not yet been to an endocrinologist. My physician put me on atenolol, but I am still breastfeeding so I’m not taking it. Anyway, I was wondering what your report was about, and if you might have any suggestions that you could share. Many thanks in advance.”

Funny that you should ask about this, because we actually had our lecture on thyroid conditions during pregnancy today. My earlier report was on different thryoid conditions which are often seen during primary care of women (not necessarily during pregnancy), although today’s lecture focused only on pregnancy. My first suggestion would be to go to an endocrinologist as soon as possible. There are many different causes of hyperthyroidism, the most common cause being Grave’s Disease, which is an autoimmune disorder caused by thyroid stimulating antibodies. However, there are many other different causes of hyperthyroidism, running the gamut from pituitary tumors (very rare) to iodine-induced hyperthyroidism. This is why you’ll really need an endocrinologist to help figure all of this out; it’s complicated stuff, with many different etiologies.

Another thing to think about is when your symptoms first began. Was it before your pregnancy, during your pregnancy, or has it been only during the postpartum period? If only during the postpartum period, there might be another cause for the hyperthyroidism: postpartum thyroid dysfunction (also called lymphocytic thyroiditis or postpartum thyroiditis), which occurs in about 5-10% of all pregnancies. With this disorder, usually hyperthyroidism develops first, about 2-3 months postpartum, and will continue for up to 4 months postpartum, followed by a hypothyroid phase lasting 1-3 months. In 70-90% of all cases, this will usually resolve spontaneously without treatment, usually within 6 months. However, 10-30% of women with postpartum thyroiditis may have permanent hypothyroidism, so again, it would be a good idea to have an endocrinologist following this in order to determine the true cause of your hyperthyroidism, and whether it will resolve or not.

Treatments for hyperthyroidism usually include either PTU (Propylthiouricil) or Methimazole (Tapazole), both of which interfere with the synthesis of thyroid hormones by preventing iodine uptake. Both of these medications can be used during pregnancy AND are safe for breastfeeding. Atenolol (a beta blocker) was also listed in our lecture as one of the drugs used to help control the severe hypermetabolic symptoms of hyperthyroidism, such as tachycardia (fast pulse), tremors, palpitations and heat intolerance. Beta blockers are actually the treatment of choice for thyroiditis, and are safe to use during pregnancy. There is no contraindications to using beta blockers while breastfeeding. I just visited the website forum of Dr. Thomas Hale, one of the leading experts on pharmacology during breastfeeding, and looked up Atenolol. In this post, as you can see, one woman was concerned about the possibility of a baby having hypoglycemia after breastfeeding from a mother who was taking atenolol, but it seems that while atenolol might cause hypoglycemia in adults, he didn’t think it was present in breastmilk in suffiicient quantities to cause hypoglycemia in an infant:

I spoke with a Pediatric Cardiologist whom I greatly respect. He assured me that he’s used beta blockers and atenolol many times in pediatric patients and has yet to see hypoglycemia.It is true that in adult diabetics, it may induce hypoglycemia, but I’m reassured that his probably does not occur in infants, particularly from minor exposure via milk.He also told me that infants are apparently less sensitive to beta blockers and that even higher doses are sometimes required to be effective.So I’d look for something else causing hypoglycemia in your infants.

The thread on antihypertensives makes it very clear that beta blockers are fine during breastfeeding, so I think you would be okay taking atenolol and nursing at the same time. Medications in Mother’s Milk might be a really good resource for you.

Other treatment options for hyperthyroidism, if that is indeed what you have (as opposed to postpartum thyroiditis), include radioactive iodine treatment or surgery (partial thyroidectomy), but again, these are options best discussed with your endocriniologist.

I’m including a few resources here in case you want to look any of this stuff up yourself. These were some of the references from my presentation. Hope this helps!

Smeltzer, S., Bare, B. (2000) Metaboloic and Endocrine Function; Assessment and Management of Patient with Endocrine Disorders. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing, Lippincott, Williams and Wilkins: New York.

Reid, J., & Wheeler, S. (2005) Hyperthyroidism: Diagnosis and Treatment. American Family Physician, 72(4): 623-630.

American Association of Clinical Endocrinologists. (2002). Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism and Hypothyroidism. Endocrine Practice, 8(6):458-469.

Via Gothamist, New York City mayor Mike Bloomber has recently pledged $2 million dollars to city-run hospitals for the promotion of breastfeeding, with the goal of getting more women to breastfeed for six months or longer.

“We don’t yet have any hospitals in New York City that meet national ‘baby-friendly’ standards,” Bloomberg’s health commissioner, Dr. Thomas Frieden, said at a parenting conference last week.”That means getting formula out of the nursery. It means putting the baby on the breast immediately after birth. It means that every person who interacts with that mother and child is supportive and encouraging of breast-feeding.”

Well, three cheers for that! I can tell you, a boost like this is sorely needed, particularly in public hospitals, since research has shown that the rate of breastfeeding increases with income, education and age, and public hospitals most often take care of the women who have the least. I hope a fair portion of this money is spent not only advertising and promotion among the general public, but on education for hospital staff. Women need so much help and support in order to be able to breastfeed, especially during those early crucial days in the hospital, when both mother and baby are still learning how; the attitude and encouragement of the hospital staff, from the doctors and pediatricians on down to the PCAs and nurses’ assistants, is absolutely crucial.

For a long time, breastfeeding education and attention has been given short shrift, but thank goodness things are starting to change—from much-publicized public nurse-ins in places like Toys R’ Us to the Massachusets ban of hospital distribution of diaper bags loaded with formula coupons and advertising. The hospital where I am currently doing my clinicals (a public new york city hospital) has recently created a new policy where formula is never placed in a baby’s bassinet when the baby is brought out to the mother, even if the mother is breast and bottle feeding. If the mother wants formula, she has to specifically ask for it. Small steps like that, but the hopefully the overall impact is much greater.

Mothering magazine recently ran a competition to create an internationally recognizable symbol for breastfeeding. The winning symbol, created by graphic designer Matt Daigle, can be seen at the top of this post. This symbol has been made part of the public domain, so it can be downloaded and displayed anywhere, by anyone. The intention is not to segregate breastfeeding mothers, or to designate specific places for breastfeeding, but to simply indicate that breastfeeding is welcome and acceptable on the premises. Hopefully we’ll start to see this symbol cropping up all over the place, in restuarants and malls and airports and libraries, movie theaters and convention centers, maybe even on subways and buses….starting with our public hospitals (I’m going to print out a couple of these and bring them to clinicals tomorrow).

A few months ago, during the summer, when I was working in postpartum one night, I was taking care of a woman who’s partner seemed to be completely checked-out of their relationship. He refused to respond to the woman’s repeated attempts at engaging him and getting him to help participate in baby care, or even pay attention to her and the baby in the first place. Often as a nurse I get the privilege of teaching both parents so much about their amazing newborn, and about breastfeeding and baby care, and often the fathers are just as eager to learn and help as the mothers. Not so in this case. And it was almost pathetic, the way she kept calling his name over and over, trying to get him to look, to pay attention, to help, to see, while instead he watched TV, and then eventually rolled over, turned his back on his wife and baby, and went to sleep. I was rather shocked by it, and went out of my way to help the mother take care of her newborn that night, while the husband slept on. I think I was hoping he’d see my efforts and realize that a) his wife needed help and b) he was doing absolutely nothing, and then begin to help, out of embarassment if nothing else. This didn’t work, obviously. The husband didn’t stir throughout the night, didn’t help his wife with the 3rd degree laceration walk to the bathroom, didn’t get up to check on the baby when it was screaming through the night (and in fact, how in the world do you SLEEP with a screaming baby in the same room??). The mother was very needy, wanting to breastfeed, lacking confidence in herself and her abilities, and desperate for praise and attention. I spent a lot of time in that room, and she stayed up for most of the night, while her husband slept. I could imagine how exhausted she’d be in the morning, and was worried about how little help and support she’d receive from him, and it turned out that I wasn’t the only one who was concerned! The nurse who’d taken care of the couple the night before confirmed that the husband’s behaviour had been just as unsupportive during her shift as well, and that there was definitely something “not quite right” about the way they related to one another (or failed to relate). Couple this with the fact that this woman had a history of depression, and it was almost like we were staring at a major case of postpartum depression just waiting to happen.

So, what did I do about it? I mentioned my concerns to woman’s attending doctor the next morning, and was flatly dismissed as being ridiculous and out of line. The doctor told me he knew the husband well, and had seen him at many prenatal visits, and was sure that not only was the husband supportive, but that the woman would be fine. When I suggested that we call social work, he told me absolutely not. When I mentioned her history of depression, he again stated that he was sure she would be fine, and that obviously what I had seen and observed was not what was really going on. He defended the husband again, said that maybe he was just tired and worn out from supporting his wife through labor, and that was that. No consults were made. No referrals were given. I felt absolutely helpless, but the way consults work in my hospital, only a doctor can order them, not a nurse, and what could I do? And frankly, I’m not so sure this woman needed a social work consult anyway—she didn’t need WIC or public assistance or anything like that, she just needed support!

I turned my patient over to the day nurse at the shift change, telling her about what I and the other nurse had observed, and then I went home, feeling shamed and belittled by the doctor, and feeling hurt and angry and pissed off and frightened, and alternately wanting to scream at the doctor, but also somewhat wishing I hadn’t opened my mouth, so thoroughly had I been shot down.

And where is that woman now? How is she doing? Who’s checking up on her? Has her partner become any more supportive, or is she feeling like she’s all alone in the world, with a new baby, absolutely no help at all, and ready to climb the walls? Did we let her down? Did I fail her by not taking a firmer stance with Dr. Belittle?

We had a very moving lecture on Postpartum Depression a few weeks ago, and of course this incident with Dr. Belittle and the scary unsupportive husband immediately came to mind. I wish I had had this lecture before above said incident, instead of 3 months after the fact. It was really driven home to me just how poor our country is at recognizing this disorder, let alone offering the appropriate resources and treamtent to the women who so desperately need support during such a terrible, vulnerable time. And as a nurse who occassionaly works on a postpartum unit, I’m amazed that I, personally, in the role of the nurse (i.e. someone who is supposedly trained to recognize signs of this, and to intervene with the appropriate support and treatment when necessary)…I had NO idea where to send a woman like this. No idea how to get in touch with support groups or hotlines. No resources to give this woman. No idea of who to call. No idea what referrals needed to be made (and as a nurse, my ability to refer is limited, since nurses can’t make referrals, but as a midwife, it’s a whole different story). Neither did the other nurse. We both felt something should be done, but we didn’t know what to do. Hello?? Shouldn’t the hospital have provided us with info and resources for this very situation? Where are nurses supposed to get this information from if it’s not part of their training? Why aren’t these resources more readily available? While the idea of routinely screening women for PPD as part of a nurse’s training/ job (let alone a doctor’s!) is given lip service, in practice, it isn’t really that routine. Isn’t that more than just a little scary??

I think in general people are so uncomfortable with diagnosing and treating and accepting psychiatric illness that we’d rather look the other way and pretend it doesn’t exist, rather than confront it. And I think a lot of this also stems from the fact that so often as providers, we really don’t know where to send women so that they can get the help they need, aside from the truly drastic measures like psych consults and social work consults (a route which Dr. Belittle clearly didn’t want to take). Maybe the new postpartum depression bill that’s recently been proposed in Congress will help with recognition and treatment of PPD, because any help at all in this depeartment is sorely needed!

Anyway, to make a long story short, the lecture was fabulous. The presenter was an RN who had personally experienced PPD herself, and was incredibly passionate about the subject. She had references and resources coming out the wazzoo, and I’m now very pleased to be able to pass all of this information on to you, my loyal readers, as well as to know that next time I see something like this (as a nurse or midwife), I will know exactly where to send the at-risk woman. And I’ve started incorporating signs and symptoms of the Baby Blues and PPD into the teaching and educating I do when I’m working on postpartum. And, I’m kinda hoping I get another opportunity to bring an at-risk patient to the attention of Dr. Belittle, because not only will I now be prepared to tell him exactly where to go if he starts to belittle me again, but I also feel like have the tools I need to actually educate him. He wasn’t the one staying up all night with that woman. He should put more faith in a nurse’s judgement, because after all, we spend a hell of a lot more time with the patient than he does. Doctors of the world: ignore nurses and their insights at your own peril, because they see things you’ll never see during your 15 minute antepartum visit or your 10 minute rounding!

Every time I’m forced to stand up for myself, I get a little bit better at it: a little calmer, a little more grace under fire, and a little more articulate.

Postpartum resources:

1-800-PPD-MOMS

1-800-944-4PPD (4773)

Postpartum Support International

National Association of Mothers’ Centers

The Postpartum Resource Center of New York

Crosstown bus: We board a M79 at midday, taking a seat opposite the driver. At the next stop, the bus starts to fill up and we get down to business.

The baby wriggles around, exposing a few inches of skin – and all around me, riders develop the kind of glazed-eye look usually reserved for panhandlers and the mentally ill.

Finally, one passenger pipes up, “Can you do that someplace else?” But she’s not talking to me – she’s barking at a man talking loudly on his cell phone.

When we get to the end of the line, the driver tells me I’m his first breast-feeder passenger. He’s not sure what the Transit Authority’s policy on nursing is, but he has his own. “I don’t see no objections to it,” he says.

Overall, it seems that most New Yorkers are pretty cool when it comes to public breastfeeding, although Connor’s nursing prompted an admonishment from a Babys ‘R Us worker, which the corporate spokeswoman was quick to point out went against store policy. Guess they learned a thing or two from their partner company, Toys ‘R Us, but it sounds like their workers could still use a bit more training.

Anyway, enough about me. Here’s an article (The Formula Follies) by Jennifer Graham from last friday’s Wall Street Journal Opinion page, nicely summing up the debate which surrounds the Dept. of Health and Human Services controversial breastfeeding ad campaign.

The Massachusetts Breastfeeding Coalition announced plans for a nationwide “Ban the Bags” campaign at the International Lactation Consultant Association meeting in Philadelphia last week. Dr. Melissa Bartick, the coalition’s chairwoman, has promised that formula marketing in hospitals won’t last. She adds: “We’d never tolerate the thought of hospitals giving out coupons for Big Macs on the cardiac unit.” So baby formula is not yet the new cigarette. But it’s already the new Big Mac.

In other news, at some point I’m going to have to write a (several?) long post(s) about the Birthing From Within mentor workshop I attended at the end of June, and which was, to say the least, a complete and total mindfuck, in the absolute BEST possible way. Longheld beliefs which I have been gradually forming for years were unceremoniously dumped on their heads. Paradigms were shifted. Walls were torn down. The end result has been a student who’s still somewhat reeling from the overall effect, but beginning to incorporate this brand new way of looking at birth into her world view. Lots of cool stuff to say on that subject, but it’ll take some time to write a post like that, and I just haven’t had much time lately (and things are still stewing and simmering and sinking in). But I’ll get to it, I promise.