The first thing that got me thinking was a couple days ago, when my daughter, who is 7, was playing at the next-door neighbor boy’s house.  His grandparents were there watching him (which is common – we know the grandparents pretty well), and I told my daughter to be home at 4:30.  I just so happened to go outside at about 4:28 to take out some garbage, when I saw Lane walking toward our house with the boy’s grandma.  I went and met them and chatted for a moment with the grandmother, who told me she felt odd about letting my daughter walk home alone so she decided to escort her.  ”You never know these days!” she told me.  Well, no, ‘these days’ there’s no more crime against children than there ever has been, historically.  It was daylight, our houses are about 100 feet apart.  It really, really, REALLY does not require an in-person escort to see my daughter home.  I think it was thoughtful and sweet that she did it, but at the same time I feel such actions also convey a sense of mistrust to kids that they aren’t capable of these easy things.   Her main motivation seemed to stem from the fear that some ill-intended creepy person might happen by and snatch her from under our noses.  Well.  The teaching of “Stranger Danger” is, by and large, a disservice to kids, and I refuse to indoctrinate my kids that way.  Sure, I tell them if they’re lost who would be the best people to trust (in a store, for example, someone who works at the store, or another mom with kids).  And, I have talked to them about behaviors an adult might engage in that should raise a red flag in their head (asking them to keep a secret, asking them for help to find a puppy, stuff like that).  But I simply will not make them fear for their own safety every minute they are out of my sight for my own (false) sense of security.

Next, a quick conversation I had with my daughter’s bus company today.  Again, she’s 7 – in second grade.  The bus driver had told me once, a ways back, that it was “policy” that parents have to meet the bus.  Well, OK… but really?  Obviously it wasn’t set-in-stone policy because he never needed the 5th grader-at-the-same-stop’s mom to be present.  Is there a cut-off?  He refused to give me a clear answer.  Well, I have a baby at home, and the weather’s getting cooler.  I like getting my daughter off the bus, but with the baby it isn’t always practical or prudent or even possible for me to get to the bus stop (which is not far, it is across the not-very-busy street and one house down from us) every single day right at 3:18 p.m.  I plan to inform him of this, that occasionally I may not be there and it is OK for Lane to walk home by herself, that she knows how to get into the house.  (We have a door with an electronic keypad; she doesn’t even need to remember a key.  Which,  if you are considering getting one, do it.  Tomorrow!  It’s an incredibly awesome convenience.)  However, I didn’t want him coming back at me with “but it’s against policy” bullcrap.  So I called the transportation department to find out what the real policy was.  Officially, I was told, only kindergartners have to be met by an adult to be let off the bus.  However, I was firmly scolded, “there’s policy and then there’s common sense.”  Yeah, well, common sense tells me that empowering my daughter to take care of herself on occasion in a low-risk situation is nothing but beneficial to her self-sufficiency and independence.

Then there was an internet posting I came across just now that lambasted the lack of risk to which we expose our children.  They need to play outside (agree), engage in unstructured activity (agree) be allowed some independence (agree), and car seats aren’t necessary after a couple years, seat belts are just fine.  Um, no, big fat disagree.  I’m totally for letting kids be exposed to risk.  They will get bee stings and scraped elbows and even a broken bone or two, and that’s fine.  They might get scared from time to time, and that’s OK too.  Everyone gets scared.  But moving out of a car seat too soon, or switching from rear- to front-facing, that’s not an acceptable risk to me.  Simply because there’s no real derived benefit.  It might be a little more convenient, or maybe you can save a little money, but is there anything long-term that comes of it?  In my opinion, absolutely not.  My kids won’t gain any emotional benefit from not sitting in a car seat.  My baby won’t increase her self-worth by forward-facing any sooner.

But, wait, just a little framing & backstory before I get into this…

Backstory part 1:

My mom’s parents got divorced and both remarried other people when she was in high school.  Her father married who I had mostly always thought was a nice enough lady, and since they’d been married *my* whole life, I just always thought of her as another grandmother.  She was affectionate with me and really gave me little reason to think of her as anything but “grandma”.

However, she and my mother had had a very contemptuous relationship for a long time, which my mom told me about once when I was in my teens, after sort of realizing I didn’t think that my ‘grandma’ could do much wrong.  They didn’t get along for a long time, like REALLY didn’t get along, to the point where my mother felt that her father’s home was not a welcome place for her.  Long story short, they eventually made amends (must have been before my mom got married at 25, because they had their wedding reception at my grandpa’s house), and as far as I knew got along pretty well from then on.

Backstory Part 2:  My mom died when I was 22.  She was 47.  My grandpa and grandma (really my step-grandma) both outlived her, really a tragic sort of situation.

My grandparents lived in the Adirondacks, and it was always nice to visit them.  My aunt, their daughter (so, my mom’s half-sister) also lived up there with her family and I have always adored my aunt… she’s only seven years older than me so our relationship was always more sisterly than aunt/niece, even if we were never super duper close because I grew up in the Buffalo area and she was up there.  As I got older, the Adirondacks felt like more and more of a home (especially after my mom died), to the point where my husband and I chose to get married up there, and a year or so after getting married, semi-seriously considered moving up there.

My grandfather died of cancer in 2004.  About, oh, a year before he died, (and before he knew he was sick), he and my grandma decided they wanted to give a hunk of money to each of their kids.  Since my mom had passed away, they gave me and my brother her share.  (This wasn’t life-changing money, but it was enough to ‘pay off a car loan we had’ kind of money.)  My grandpa let me know ahead of time, and I was effusively grateful before he’d sent the check.  At about the same time, he’d sent me a check for $10 to cover an internet football pool a friend of mine ran that my grandma was involved in every year (she was a pretty cool lady, there were some very solid reasons I liked her!).  I was working full-time, well, really, more than full time, and I’d just found out I was pregnant but wasn’t telling anyone yet (thus my brain was pretty unreliable), and the $10 check had wallowed in my wallet for a while.  Well, my grandpa calls and says, “Hey, did you get that check I sent?” and all I can think of is this $10 check that’s been getting cobwebby in my wallet.  ”Oh yeah,” I said, nonchalantly, “I have it.  I just haven’t been to the bank.  I’ll cash it soon, sorry.”  He seemed…. odd… about my response, but dropped it.  Then, going through about two weeks of mail that had piled up the next day, I found a slip for something certified mail that had arrived sometime in that time frame, which I didn’t actually think anything of because we’d gotten a couple weird pieces of what were basically junk mail via certified mail over the last few months.  Went to the post office a couple days later, and discovered it was the check – the generous, much more than $10 check – from my grandparents.  Oh.

OOHHHHHHHHH.

Needless to say, I was mortified and called my grandparents and apologized profusely and vehemently expressed my gratitude for the gift.  Then after I deposited the check and paid off the earlier-mentioned car loan a few days later, I wrote them a thank-you letter, telling them about how we’d paid off that loan with their gift.

Backstory Part 3:

About a year later I had a baby (the first pregnancy ended as a miscarriage and I got pregnant again pretty quickly afterwards), and a week after the birth, my grandfather died of cancer.  There wasn’t a wake or funeral per se, but they had a memorial service for my grandfather about a month after he died.  It was 7 hours away from where we lived on an uneventful drive, but our daughter did NOT handle car rides well.  Lots of screaming and crying and not a lot of sleeping, and at that point she was still nursing every hour for 15 minutes.  Flying wasn’t an alternative because the service was in the middle of the Adirondacks, where commercial flights are few and far between and wicked expensive.  With much regret I explained to my grandmother that we just weren’t going to be able to make it.  She tried to sound understanding but in retrospect I think she was pretty offended.

A couple months later, once car trips with the baby weren’t a total nightmare, we did make it up to visit for a few days.  And overall, it was a really nice visit.  But on the day before we left, at a moment when my grandmother had me alone, she decided to tell me how offended my grandfather was at how ungrateful I was for the gift they’d given me.  Not only had he been taken aback at my behavior, but surely my mother raised me better than that.  She would have been mortified to know how poorly I’d behaved.  ”OK,” she concluded, “I just had to get that off my chest.  Let’s not let it bother us anymore.”

WHAT?!?

I don’t doubt for a second that my grandfather probably said something to that effect in the days between his call about the check, and me realizing the extent of the misunderstanding and apologizing profusely for it.  I knew he probably had a few days of thinking I was horrid.  But was she unaware of my apology, or did she forget about it?  I was truly so shocked at her scolding of me that I barely defended myself.  Instead I was left to wonder – did my grandpa somehow not really understand the root of the misunderstanding?  Did they never receive my thank-you note?  (I specifically asked that, and my grandma had no recollection of it.)  Did my grandfather die thinking I was some awful person, or had she been so angry in her grief after he died that she just ruminated on every wrong she felt was committed against him, remembering vividly the harsh words but forgetting the amends?  Regardless, that moment she felt she had to be ‘honest’ with me has permanently and unalterably made me question how my grandfather, and maybe even how my mother felt about me.  99% of me knows she was just way off-base, and grief had made her behave out-of-line.  But in a more meta way, I was just really pissed she would say something that accomplishes nothing but to help her soothe the pain she was feeling by trying to right the wrongs she felt had been committed against my grandfather.

I later came to learn she’d similarly laid into my brother when he was up there for different, but similarly somewhat petty reasons that had happened years earlier… which means she verbally disciplined him on behalf of my dead grandfather for stuff he did when he was a teenager.  A teenager whose mother had died when he was 15.  As cross as I was about the gall she had with what she said to me, I was doubly angry that she could do the same to him.  My brother had also missed the memorial, but through no fault of his own.  My grandma had told my dad, who for whatever reason couldn’t make it, and he never told my brother about it.  I was sleep-deprived with a new baby and never thought to tell him, I only happened to mention it a few days later to ask why he and Dad didn’t go… and that was the first time he’d heard about it.  He was really, really upset that he missed it.  He adored our grandpa.  Of course grandma also got really mad at him for it, and probably mad at me also that I didn’t make sure he knew.  I’m sure a lot of that fueled her need to ‘get things off her chest.’

Had she told off anyone else?  I never heard about it, if she did.  But it made me wonder if we were targeted because we weren’t really “hers”… and had she always felt that way, disconnected from us because we weren’t her biological grandchildren?  I remembered what my mom had told me about how poorly my grandmother had treated her when she and my grandpa first got married.  It made me question everything I thought I knew about my relationship with her.

I think we only visited twice after that.  Both visits were fine… but her brutal ‘honesty’ that one visit had me constantly on edge that she might decide she needed to tell me something else that would further chip away at truths I took for granted.  So the visits stopped, and we rarely spoke on the phone.

I can own that I was probably being petty, and perhaps I should have leveled with her about how what she said made me feel.  Maybe our relationship could have been salvaged.

I’m sad she died, for sure, but I know she’s been pretty sick for awhile so I’d sort of already mourned her over the last couple months.  If there’s anything though, her death has made me realize how angry I still am with her.  I hate that I feel this way.  I’m just not quite sure what to do with it.

http://www.cdc.gov/breastfeeding/pdf/2011BreastfeedingReportCard.pdf

Chances are, not well.  Most states aren’t doing a great job at this.

It’s a puzzle as to why, since so many states are having trouble financing Medicaid and WIC programs, and many also have state-sponsored child and/or family health insurance programs.

Breastfeeding is so important to reduce costs for families and for our state governments!  Of course formula provides adequate nutrition, and many babies do just fine on it.  But it’s certainly not ideal, and it definitely costs more money.

So why is breastfeeding important?  Well, here are a number of articles you may peruse for more information (all from very reputable sources):

Why Breastfeeding is Important (US Office of Health & Human Services)

The Economics of Breastfeeding: A Cost/Benefit Analysis (Ph.D. in Parenting blog)

Affordable Health Care beings with Breastfeeding (USLCA)

More Breastfeeding could save U.S. billions (Reuters, citing a study in Pediatrics)

How can we get there?  The answers begin in the articles linked above.  But the big answers, in my opinion, are:

• Incentivize hospitals to become “Baby-Friendly“
• Get more certified Lactation Consultants into practice, both privately and employed by hospitals/pediatric medical practices/WIC organizations
• Require medical pediatric training programs (for pediatricians, obstetricians, midwives, and OB/pediatric nurses) to include a minimum amount of course hours on infant nutrition and breastfeeding
• Restrict marketing by formula companies and force them to be more WHO-compliant, and make WIC organizations only do business with companies in WHO compliance for the marketing of breast-milk substitutes

Life with three has been fun. Things are going well, and Catie is a complete joy. She turns 7 months old tomorrow! She has been sitting for a couple months, and is now doing that hands-and-knees rocking back and forth that forewarns us to babyproof our house, again.

Here’s a quick look back on her progress from tiny baby to bigger baby!

Here she is, brand new!

A couple weeks old

2 months old

About 3 months old, with her sister

5 months old

Just a couple weeks ago!

Photo of a photo, but here's the whole crew a month ago!

It was quite an interesting saga, the lead-up to the birth. Because I have (albeit mild and easily diet-controlled) gestational diabetes, my midwives were itchy to get the baby out, and started talking an induction if I didn’t go on my own by my due date, as I have previously chronicled. I did my research and was OK with postponing any induction until Thursday, if needed. Well, Monday I had an appointment and midwife Sue was generally OK with the few days’ postponement, but we both agreed it would be reassuring to have a biophysical profile done (an ultrasound where they specifically check baby’s well-being, blood flow from placenta, amount of amniotic fluid, stuff like that). So I had that done on Monday as well, and while the baby was looking very healthy and everything else looked good, I was apparently low on amniotic fluid… which mostly means it makes it easier for the baby to accidentally wedge up against the cord in utero and cut off its own oxygen supply. Combined with the gestational diabetes, it was a good reason to not wait until Thursday, but given the baby’s otherwise very healthy status, Sue let me wait until Tuesday morning which also gave me an opportunity to drink lots of fluids and try to get the amniotic fluid up a little. I was told to report to the hospital at 6:30 a.m.

Well, long story short… some strong contractions woke me up at 4:30 a.m., and we left for the hospital at 6:15 a.m. I was, quite fortuitously, seemingly in labor, all on my own. Called the midwife from the car, told her we would be just a little late (there had been a little snowfall and the roads were a little slick) but that I was pretty sure I was in active labor.

Got to the hospital, got checked in and changed into hospital garb, my very awesome OB nurse checked, and I was already at 6 cm. That was about 7:30 a.m.

Continued to progress, got the all-clear to push around 8:40, which was good because I really really wanted to push. I think I was still only in transition because the contractions never let up. I JUST HAD TO GET THE BABY OUT. NOW. Her head emerged almost immediately, they got me to pause for just a second because she had the cord loosely wrapped around her neck, so they slipped it off, and I went about the very quick business of pushing out her shoulders. The midwife had me reach down and grab the baby and finish delivering, and lift the baby onto my own chest. So awesome!! She also asked me to do the identifying… “Lisa — what do you have?” she asked. My first delirious thought was “It’s a baby, duh!” but then I realized she was talking about looking for gender!! I took a very hard look, because even delirious I knew I didn’t want to make a misidentification, certainly my husband would never let me live that down. And once I was incredibly certain there was no penis to be found, declared “She’s a girl!”

She cuddled skin to skin with me on my chest until her cord stopped pulsing, then the midwife clamped it off and Frank did the honors of cutting it. I delivered the placenta and was just exhausted. I knew I’d torn a little (how could I not have, I delivered her way too fast…) and while my labor wasn’t very long, it was very intense. The OB nurse took the baby while I started to get stitched up and did all the weighing and measuring and other requisite birth things, and I took her back about 20 minutes later. She latched on at that point and nursed pretty well. I also decided, in an odd fit of whimsy, that we were going to keep the placenta and buy a new tree and plant it under the tree in the spring. Never even hearing of anyone doing this before, let alone with the complete absence of any discussion between us, my dear husband took these new plans in stride.

And our baby is, in a word, awesome. She’s a great nurser, she sleeps pretty well, she has amazing periods of quiet alertness where she just does her best to look around and see as much as she can (before her eyes cross from the strain, but then she just blinks a couple times and tries again). She is crazy strong, too… even the pediatrician at the hospital commented on it. If she’s laying on your chest, semi-upright, she can lift her head and chest up and do a little push-up. It took her about a day to pick up that little trick, mostly because it helps her look around better.

Since I avoid using real names for my kids on this blog I shall only give you her nickname, and that is Catie. She is perfect and I am in love. Her birth was a great experience and I am so happy and proud that I got to have another drug-free birth… but I am also quite pleased that I never have to do that again, since we have no intention of having any more kids.

My gestational diabetes is still very well-controlled with diet, which is awesome and very fortunate. I had an ultrasound to estimate size a week ago and then the baby measured about 7 lb. 2 oz., which is much less than the 7 lb. 10 oz. Jake weighed in at birth, and the 8 lb. 4 oz. that Lane came in at. The ultrasound tech said that chances were good the baby would weigh less than 8 lbs. at my due date, which is welcome news. Of course those ultrasound estimates can be pretty far off, but given I received good news, and I know I don’t have a ginormous belly, I’m going to assume the estimate is at least somewhat reliable.

One thing that’s come up is my OB/midwives’ general policy of inducing labor for moms with gestational diabetes. I had an in-depth discussion with one of the midwives about it, and they as a practice are pretty adamant about inducing if I haven’t delivered by my due date, because, she said, there is an increased risk of stillbirth in diabetic pregnancies. The reason for this is that the placenta gets worn out a little faster because of the issues with diabetes, and can’t sometimes handle the stress of late pregnancy and labor. She told me all about her recent review of the available literature, blah blah blah. I told her I was very uncomfortable with a standard policy of induction being applied to me (as a well-managed gestational diabetic patient) without specific evidence that MY pregnancy and THIS baby was somehow at risk. But, I was still a week and a half before my due date for that conversation, and we agreed there was time for things to happen on their own before a decision needed to be made.

There are lots of reasons I want to avoid an induction. Labor induction leads to a greater incidence of c-section, which I would very much like to avoid because a vaginal delivery, I believe, is more healthy for both the mother and the baby. Labors that are induced can be much more painful and I desire a drug-free vaginal birth. I know I have handled my last two labors fairly well, but if the contractions were much more intense, I’m not sure I’d have the stamina. And, if my contractions are much more intense in an induced labor, I feel like that’s more stress that the baby and the placenta has to endure, and isn’t that part and parcel to the logic of why they want to induce in the first place? It seems somewhat like a flawed logic — your placenta might be deteriorating and might not handle the stress as well, so we are going to give you drugs that might create a more stressful situation than a spontaneous labor. That, to me, just doesn’t hold up well, especially in the absence of any evidence (like through an ultrasound or non-stress testing) that there’s any added risk in my specific medical case.

Well, I am a researcher. I decided to see if my desire to avoid an induction was grounded in science and could be backed by the opinions of people who have had peer-reviewed research published in major medical journals. Or, was I just being stubborn and fixated on an ideal that really wasn’t ideal given the gestational diabetes, even if it seemed my case was mild and well-managed?

My goodness, I LOVE THE INTERNET.

What I learned is that gestational diabetes is divided into two classes: A1 and A2. A1 is me: glucose intolerance that is well-managed through dietary control. A2 are the more unfortunate women who need greater medical intervention to control their glucose levels — insulin injections, other diabetic medications, etc. and even with these sometimes their glucose levels are not well-controlled. It is believed that many of the A2 cohort are previously undiagnosed or borderline type 2 diabetics. My suspicion was that evidence of an increased risk of infant mortality (ie. stillbirth) was much greater for the uncontrolled or harder-to-manage A2 diabetics and that that risk was much reduced for women with A1 gestational diabetes. What I found, in reviewing a couple different studies and one metastudy is that my theory holds some water. Risks of stillbirth for the A2 diabetics are much greater than for those women with A1 gestational diabetes. For the A1 diabetics, the risk does seem to be slightly higher when compared to non-diabetic pregnancies, but having my condition be well-managed with diet only makes me much more confident that it is not a medical imperative that I be induced on my due date if I have not spontaneously gone into labor.

(I certainly don’t mean this as evidence for anyone else… I’m just thinking out loud here. This is for my own state of mind only! If you are finding yourself in a similar predicament, please do your own research and talk to your own care provider. I am NOT giving medical advice!!)

With my other two babies, I delivered the first (my daughter) at 3 days past my due date, and my son at 3 days before my due date. Length of gestation is very consistent for most women, so I am confident in my body’s intention to go into active labor sometime between right now and three days past my due date. Knowing there is some research that illustrates a very, very small risk (statistically speaking) of stillbirth, which isn’t too different for me than other pregnant moms without the label of “gestational diabetes”, I think I can confidently put off a scheduled induction. I won’t refuse it entirely, but I will compromise. If I haven’t gone into labor by four days after my due date, I will agree to an induction. Chances are pretty good that it will never get that far anyway. And if I don’t go into labor on my own, then chances are also pretty good that it will take very, very little “induction” to get labor rolling for me and the baby.