Mama Knows Breast: A review

Andi Silverman presents a breezy, conversation-with-girlfriends style in her new book Mama Knows Breast: A Beginner's Guide to Breastfeeding. Meant to be a basic handbook rather than an oracle (Silverman provides a list of those at the end of her book), Mama Knows Breast covers the essentials of breastfeeding a baby: pros and cons, "operating instructions," etiquette, and spousal involvement, among others.

It's important to read the book cover to cover, since Silverman either omits or glosses over some details in the opening chapters but covers them later on. Still, even as a handbook, I found it to be not quite informational enough, especially to a first-timer. For example:

• Silverman recommends healing sore nipples with breastmilk, but doesn't say why (the antibodies in the milk aid healing).
• While she advises that thrush can be cured with antifungals, she doesn't discuss the natural remedies (including probiotics) that many women feel are more conducive to healing (especially if mother and/or baby are taking antibiotics).
• A mention of the milk-supply-enhancing effects of dark beer doesn't take into account research that shows it is the prolactin level, not the actual supply, that increases with alcohol intake.
• Nursing pillows are never mentioned (they can help support a smaller-than-average infant, as well as an inexperienced mother; I depended on mine with my first, but hardly needed it with my second).
• Neither are growth spurts, which can be stressful for a mother who doesn't know why her baby suddenly refuses to be put down!

A discussion about the history of formula is good, but does not discuss social/class attitudes toward breast- and formula-feeding during this century - a critical omission, since many of our grandmothers felt that breastfeeding was something "only poor people" did. Even if our mothers disagree, the lack of support from either or both generations can persist, leading a mother to give up sooner than she might have liked.

Some details outright concerned me. "No one's handing out a martyr medal," Silverman tells the reader after she advises not to suffer in silence, but this is not what keeps many women from asking for help. Instead, help is either not there (if a new mother lacks supportive family and friends) or it's available, but conflicts (differences in opinion among care providers, such as the pediatrician and the obstetrician).

In my own experience, confused about how to handle my older son's dietary sensitivities and afraid that my care providers would advise a switch to formula, I ended up calling my local La Leche League leader. Many women are not so lucky, and Silverman doesn't account for this. (Neither does she account for soy allergies, which can affect many babies who are sensitive to milk protein, or spicy foods, which can trigger reflux in reflux-prone babies.)

Likewise, a frank mention of sexual arousal while breastfeeding is not given adequate attention. Specifically, given the anxiety in our culture about sex and children, Silverman could have devoted a few extra sentences to the reason why this happens: the hormone oxytocin, which flows in abundance during both sex and nursing. It happens that way to promote bonding between partners - yes, nursing is a partnership - which is crucial to a mother and the newborn she doesn't yet know.

The book does have its strengths. Relationships are given some weight in Mama Knows Breast, which was nice to see. A father's role gets a good discussion, as does co-sleeping, which receives a realistic balance as to safety vs. efficacy. Some of the relationship advice is a bit too glib - "Use erotica" may not be helpful to people who simply aren't turned on by it, and "Keep communicating" doesn't help a couple who have had hundreds of conversations interrupted - but by the same token, sometimes the simplest solutions just don't occur to sleep-deprived, lifestyle-shocked couples.

The "From the Mouths of Moms" segments, following a format in use by other childcare experts, are good (notwithstanding the mother who advocated breast pumping while driving - "If people can talk on their cell phones while driving, why can't I pump?" - actually, many states and cities now ban cell phone use while driving); it's always helpful to see how other moms have handled a trying situation.

Silverman also spends considerable time discussing relactation for adopted babies, as well as using milk from milk banks. Her section on nursing etiquette is wonderful in its detail, including comebacks for nosey critics. Likewise her kick in the pants about comparing oneself to celebrities who have personal trainers, chefs, and nannies that most of us can't afford.

Silverman's best advice is in her closing paragraphs. "Wean yourself of all your preconceived notions about breastfeeding.... In some ways, that's the beauty of this whole Mama thing. You get to make it up as you go along." All in all, Mama Knows Breast is a good start, but in spite of its encouraging tone, may not be all a newly nursing mother needs as she starts - or continues - a nursing relationship.

From fearlessness to paranoia

I'm a paranoid mother. I wrote about my paranoia recently on my Family.com blog. And there was that story I wrote for the Blog Short Story Project this year. Which was why the latest MotherTalk Blog Bonanza is so interesting: we're buzzing "The Dangerous Book for Boys."

True, our kids are more protected now than ever before. But I tend to think that's in response to the more we know, and the more we have. Fifty years ago, sneakers were enough to play. Now we know the kind of shoes, their fit, and how they wear all affect a person's athletic prowess - no matter how young or old. Why else do pediatricians recommend a baby's first set of walking shoes come from Stride Rite, or orthotics for a teenager's shinsplints?

Maybe we do go a bit overboard. For instance, just this morning, Hamlet fell down on his way in to preschool. Tripped over a bit of sidewalk and sprawled in the doorway. "I want to go home!" he screamed. Now, another mother may have let him do just that. But I knew he wasn't hurt - simply embarrassed. And I knew he'd get over it as soon as someone distracted him. Sure enough, the preschool teacher pulled out the Play-Dough - and off he went.

Meanwhile, Boris was still in the car, which I remembered I'd left unlocked. Because 1) it takes but seconds to walk from car to preschool. And 2) I hadn't anticipated I'd need to take more time with Hamlet. And 3) it was pouring rain out. And 4) all the other parents leave their babies in their cars. And 5) the preschool is on a private road. In the trees. In a very rural area.

Never mind all that; my paranoia kicked in. All I wanted was to get out the door and make sure no one had grabbed him. Irrational as hell? Yes, absolutely. But things happen. No matter that they are "isolated"; they still happen. Unbalanced women desperately want children. Pedophiles lurk everywhere, even in my secluded little corner of the woods. These things have been true for generations, giving rise to better security systems on maternity wards and state sex offender registries.

What has not been true for generations, however, is the fact that families and friends are more spread out than ever before, denying people of critical support systems. A "maiden aunt" had plenty of nieces and nephews to care for, and everyone knew - and told their kids to avoid - the "strange man" down the street. These days, the Internet has replaced those support systems - not just for family members, but for pedophiles too. It's so much easier to decide to assault a child when 1) no one knows who you really are*; 2) the chat room you're on effectively depersonalizes that child and 3) you've got other pedophiles telling you that you're normal and okay!

While it's a sad fact that those bygone family support systems often covered up and glossed over in-family sexual and domestic violence, we do know so much more about those problems now that it is simply prudent to be vigilant. As for the rest of it? Well, I probably won't put knee pads on my boys every time they play outside. But I sure won't leave them alone, not until they are old enough to understand "stranger danger." A little paranoia, in my opinion, is worth it.

*This is why I am not in favor of laws that keep sex offenders out of towns altogether. Away from daycare centers and schools, certainly. But I'd much rather know who and where they are, than have them driven underground.

The fearless freelancing mother

Back in 2000, I hated my job at a university computer help desk so much that I was willing to do just about anything to get out. So I did: I started my own freelance writing business. My birthday present to myself was leaving the workplace. I figured if it didn't pan out, I could always go back to tech support - in a different company. But it did pan out. Within two months, I made my first sale. My first article appeared in October 2001, and the following year I got contracts that carried me through 2002. I felt I'd arrived. You could say I was, in a word, fearless.

That all changed in late 2002, when I found out I was pregnant with my first child. Even though I'd started to freelance with an eye toward staying home with children, reality scared me badly. I got an inkling of what it might be like when I totally lost my brain, when the hormones made me so scattered that I had to wonder if this was what it was like to work around a talkative, active little boy. (It is, only louder, though it is slightly easier to pick up the thread of what I was doing.)

Fortunately, I was working for editors who were also parents - or becoming parents. One was pregnant with her fifth child, due not long before me. The other's wife was due with their first, just a few weeks after me. They were sympathetic and supportive, and they waited for me during my protracted maternity leave.

Pregnant with #2, I found I wasn't quite so fearful. The placenta brain wasn't so bad this time around, and even though Hamlet had dropped his nap the year before, I was able to take on other work that didn't necessitate blocks of quiet time. Fearlessness came once I realized the most crucial aspect of working at home with children: to succeed, I had to find ways to be flexible. To be willing to change the type of work I was willing to do, to change my expectations about my time - and my kids'.

This year sees me blogging for a Disney subsidiary, continuing the work I did for an architectural PR firm, and a few other odds and ends to keep my irons in the public-safety fire. In other words, six years after I first quit my "real" job, I'm still a successful freelancer - and a successful mother, too. That knowledge keeps me fearless that whatever life throws my way, I'll be able to handle it and still survive.

* This post brought to you today by MotherTalk, which is promoting the release of Arianna Huffington's new book, "Becoming Fearless." Thanks to Miriam Peskowitz for inviting me to participate!