Mainstream Parenting Resources – Offline ones, that is

So I went and got me an Amazon widget to put on this blog with my favorite offline mainstream parenting books, only to find out that WordPress doesn’t support Amazon widgets! Oh well. I may consider a move to Blogger just to be able to use plug-ins, but I find the WordPress format so much more user-friendly, I think I’ll stay here for now.

In the meantime, here is my list of parenting-related books I recommend every mainstream parent, or one looking at AP from the outside in and seeking to understand the phenomenon (and want reassurance that she isn’t the only mom who finds it odd) read. None of the books are actually how-to parenting books; I think seeking guidance from real live people close to you is the best way to go. There is also reliable medical and parenting information galore online, at Dr. Hull’s website (listed in my blogroll to the right) , at the AAP’s website, and the CDC, to name just a few. But there’s nothing quite like curling up with a book on the sofa, just reading about motherhood and what makes moms tick.

The Paradox of Natural Mothering, by Chris Bobel. A semi-crunchy mom herself (she had a homebirth and selectively vaccinates), Bobel wrote her Ph.D dissertation on “natural” mothering and its philosophical underpinnings, and what attracts women to practice it. If you read only one book on this list, this should be it.

Parents Who Think Too Much: Why We Do It, How To Stop by Anne Cassidy. This book was referenced in an article I read about spoiled children (I think it was in the Boston Globe), and was the first book on the subject I read. Cassidy compares the overprotected, overstimulated, over-spoiled children of today with the children of yesteryear, discusses how the current situation came about, and how we can give our children an “old-fashioned childhood”… with a little benign neglect. A real eye-opener in the pre-Mommy Myth era (I also, naturally, recommend the latter book).

Bottlefeeding Without Guilt (or, in its repackaged form, When Breastfeeding is not an Option) is a bit of light reading that has earned its author, Peggy Robin, much scorn from APers. When Robin’s breastfeeding career was cut short due to a very bad bout of mastitis, she started to look at the assumptions surrounding breastfeeding advocacy with a critical eye. While her book is mainly anecdotal and doesn’t make any claims to scientific rigor, there is an interesting dissection of the “the world breastfeeding average is 4+ years” myth you see a lot online, and an early (mid-90s) recognition of the cluster of beliefs held by lactofanatics. Even if you don’t agree with anything written in this book, you’ll at least come away with an understanding of where the “militant breastfeeding cult” website got its name from.

Dr. Ferber’s much-maligned Solve your Child’s Sleep Problems is worth a read, if only to familiarize yourself with the concept of CIO as Ferber actually presents it. It has nothing whatsoever to do with how the APers portray him, of course. The part about helping babies to sleep through the night is only a minor part of the book, though, and the chapters about night terrors, bedwetting and other true sleep pathologies are clear, concise, and obviously professional.

As I said, a mere partial list, but enough to run up a nice bill at any bookstore for now. If any of you have suggestions for further reading on the subject or would like to discuss any book on the list at length, please leave a comment.

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10 Responses

  1. Peggy Robin?? I’m discouraged that a doctor would recommend Peggy Robin’s book. It’s been more than ten years since I read it, but my overwhelming impression was of a woman with an axe to grind. The book is filled with misinformation and nasty little anecdotes about breastfeeding supporters.

    Do you agree with her contention (she was quoting a doctor, if memory serves) that if breastfeeding is a 100, formula is a 99?

    The 4.2 years myth has long been debunked in the breastfeeding support community. I don’t doubt that it’s still floating around on the Mothering boards and the like, but are you seeing it elsewhere as well?

  2. Peggy Robin is definitely bitter about her experience with breastfeeding advocates and as such, she has an axe to grind. That doesn’t mean her information is incorrect. If you’d like to point out what parts of her book are “misinformation”, I’d be grateful, because I really didn’t find anything so shockingly wrong there. Some of it (much of it, actually) may not float my personal boat, but that doesn’t make the advice wrong. Incidentally, Robin does not contend that “breastmilk is 100 and formula is 99”; that’s a quote from a woman who is quoting what her pediatrician told her. The book,as you remember, is full of such quotes culled from women offline and online. As for me? No, I don’t think of formula as X% (insert any X) as good as breastmilk; I’m not even sure what the scientific basis for that opinion would be.

    As for the “nasty little anecdotes about breastfeeding supporters” – they largely consist of quotes these BF supporters themselves made, and identifies (correctly, I think), the large amount of baggage surrounding breastfeeding advocacy. The fact is, LLL and its sympathisers don’t merely support BF, as they claim; they push a very specific lifestyle. It’s too bad that instead of taking Robin’s book as an attempt to understand how some BF advocacy is perceived and aspire to do better at understanding these women’s needs, they reacted with denial and derision.

    The 4.2 years myth (or 4.5, as I’ve also seen it quoted) is alive and well, unfortunately, often mistakenly ascribed to ‘experts’ and/or the WHO. See here and here, for example. You can also try Googling the phrase “average age of weaning” and see many other examples.

  3. I’m not going to be able to mount a critique of a book I read once a decade ago. I don’t own it; I don’t know if it’s still in print (another reason to strike it from your list!). It doesn’t seem to be available directly from Amazon so I can’t even do the “look inside” thing. But I do remember her minimizing the impact of breastfeeding on morbidity, along the lines of “breastfed babies get sick too and formula-fed babies of my acquaintance are perfectly healthy so quit yammering about how great breastfeeding is for babies.”

    Absolutely, some breastfeeding advocates get the research wrong. I’ve heard people cite the ’92 Lucas study to suggest that their full-term babies will get an 8-point IQ boost from breastfeeding — obviously inappropriate. But it is also inappropriate to suggest that the studies with null findings represent the true state of affairs. (Or to cite Lucas like Joan Wolf did. Did you see her Aug-Sept-ish article? I can send you a link if you’re interested. It gives me hives but it might be up your alley.)

    I’ll be interested to see your follow-up posts on LLL. When you say they have an agenda, do you mean the agenda of encouraging mothers to stay with their babies and nurse them when you’d prefer to see more support for employed mothers? or do you mean that the organization is secretly pushing an anti-vaccination anti-circumcision pro-homebirth platform while pretending to be just about breastfeeding support?

    Are you familiar with the story behind the 4.2 years myth? It’s a citationless assertion in the otherwise heavily referenced section on weaning in an outdated edition of Ruth Lawrence’s book, and I think from there it took on a life of its own. (Moral of the story: skepticism is warranted re: startling citationless assertions, even those found in reputable sources.) It was still in the 1999 edition but…hold on– I just checked and it’s still in the 2005. Huh. I’m going to write the publisher as soon as I finish this comment. Anyway– I was going to mention that just this month on Lactnet a newbie asked about the 4.2 years statistic and it was promptly discredited all around. So it doesn’t really surprise me that you found it in a 2001 LLL publication, but I’d be shocked to see it in something recent from them.

    I had more to say but I’m going to fire off an email to Elsevier. Maybe the API webmaster too while I’m at it. 🙂

  4. The book isn’t hard to get, even if it’s not currently in print or available directly from Amazon. I think I got my copy secondhand as well. I do remember her being a bit down on the effects of breastfeeding on infectious morbidity, but I really need to reread that part before I comment. Though breastfeeding babies really do get sick too, you know. You oughta have seen my office these past few weeks

    If you mean this Joan Wolf article, funny you should mention it…I just read it last week! I was saving my commentary for a future blog post, but I don’t think she was saying that “the studies with null findings represent the true state of affairs”. She does say that many of the benefits to BF claimed in the ad campaign are not as well established, nor of sufficient magnitude in the American target population to justify a campaign designed to scare women into breastfeeding. I don’t know why that should give you hives, though. And she cites the Lucas study as one where the authors acknowledged there might be confounding factors (page 14 of the .pdf file) – which they did. How is that a bad cite?

    I hadn’t planned on writing a whole blog post about LLL (it’s a great idea though!), but their extra baggage is hardly a big secret. I was referring mainly to the dearth of support for working mothers (an understatement) and the child-led weaning, and their promotion of cosleeping, “gentle discipline” and AP as a whole. That’s fine, but LLL needs to be upfront about its not just being “about breastfeeding support”.

    I had no idea that the 4.2 stat came from a book – I thought people just stated the approximate midpoint between the 2.5 and 7 years that Dettwyler claims is the natural range of breastfeeding in humans. Thanks for the info!

  5. In the murky literature on breastfeeding and cognition, the Lucas study has a couple of distinctive strengths. Participants received milk via NG tube, which helps in looking at the breastmilk vs. breastfeeding question. The authors ran a separate analysis excluding the babies who continued to receive breastmilk post-hospitalization, with very similar results (a difference of 7.5 vs. 8.3 IQ points, though I believe the 7.5 is unadjusted and the 8.3 is adjusted). They considered exclusivity and found a 9 point difference for exclusively breastmilk-fed babies.

    One of my favorite things about the study is that they also looked at the kids whose mothers planned to provide breastmilk and then couldn’t. Those children did not have significantly higher IQs than the formula-fed babies. The authors didn’t control for maternal IQ, but they did control for maternal education and social class, and their adjusted results were highly significant (p < .0001). The analysis of breastfeeding intent is important, I think: the findings strongly suggest it’s not just that mothers who think breastfeeding is good are also reading their kids Tolstoy in the crib. (“Now look, sweetie, Anna goes under the train. The end.” A board book crying out for a publisher …or maybe not.)

    And yet Wolf says about the study, “The authors acknowledge that unaccounted for behavioral differences could explain breast-feeding’s protective effect.” She’s referring to one sentence from the Lucas paper that acknowledges they cannot exclude the possibility that parental behavior or differences in genetic potential might explain their results — which is of course true, but far removed from the thrust of the article. What kind of parental behavior results in an IQ difference of more than half a standard deviation (adjusted!)? Tell me quick, so I can behave like that. I mean, that’s a bit like saying, “Scientists who have studied the Titanic’s hull acknowledge they cannot exclude the possibility that it was sunk by hostile aliens.”

    Wolf also mentions two meta-analyses, one by Drane and one by Jain, that point out the shortcomings of many of the papers in this area (and let me be clear that I am not glossing over those shortcomings). She quotes Jain, whose conclusions support her thesis, and passes over Drane, who said, “Most studies were likely to underestimate the strength of association between breast feeding and cognitive development.”

    Those two things jumped out at me on my first skim-through last fall. I just noticed that she cited Philip Landrigan in support of her statement that contaminants in human milk could have unquantified deleterious effects on babies — the same Philip Landrigan who told the NYT, “”We are making a very clear and unequivocal affirmation that those of us in the medical community are all absolutely convinced that breast milk is without question the very best form of nutrition for human infants.” Once again, her contention is not *at all* the point of the article she’s citing.

    I haven’t read the literature on breastfeeding and diabetes, or obesity, or respiratory infections, and so I can’t assess her claims there. But I am singularly unimpressed with her treatment of the literature I do know. She’s welcome to her opinion about the breastfeeding awareness campaign, of course. A couple of posts ago, though, you yourself said that it’s imperative to ask: “Are the results of the study quoted truthfully?” I agree. And that’s why Joan Wolf’s article gives me hives.

  6. I can actually think of a couple of reasons why the infants mothers who initially planned to provide breastmilk and couldn’t may show a cognitive difference. A, the commitment to stick it out with breastmilk may be stronger in better educated mothers (or mothers with higher IQs), with better follow-through, pumping, taking supplements etc.; B, the mothers with more traumatic births/earlier gestational ages may have been unable to provide breastmilk because of the stress and their babies may have been neurologically impaired from the start. But I’m just speculating here, since I can’t access the full-text article. But the point is Lucas did say this in the abstract, and I’m guessing that’s probably all that Wolf read as well (which I agree with you is sloppy). In any case, the study doesn’t have practical implications for the 96% of mothers who give birth at term and the IQ issue regarding term babies is, as you said, far more murky – which was the overriding point Wolf was trying to make, I think. I agree she used a lousy reference to do it with, as there are far better ones.

    But not quoting something truthfully doesn’t mean “not quoting it the way I want it to be quoted”, it’s the deliberate misquoting of a study to suggest it supports your POV when it clearly doesn’t (as shown by the examples from the anti-vaccine activists). You can argue that Lucas was obligated to write reservations about her own work she may not personally feel, but you can’t argue she wrote them.

    The fact that Landrigan told the NYT that breast is best (not that I disagree) does not change the fact that he alerts the public in his articles to the potential dangers of chemical contaminants in breastmilk. Again, if the point is whether the results of the study are quoted truthfully by Wolf – they are.

  7. Mea culpa: I didn’t look at the bibliography before I wrote the paragraph about Landrigan. Landrigan and Garg wrote another 2002 article together, one I happen to have read multiple times. It would have been an utterly inappropriate citation and I jumped to conclusions when I saw “Landrigan et al. 2002.” Thanks for the link.

    Tell me this, though. Suppose an epidemiologist published a paper about, say, the Hib vaccine, and concluded that it had dramatically reduced the incidence of otitis media, mastoiditis, and meningitis with only occasional side effects of tenderness and swelling at the injection site. (Does Hib protect against mastoiditis? This isn’t my area.) Would it be appropriate to cite that hypothetical article and say only, “As this article makes clear, the harmful side effects of the Hib vaccine are well-documented.” I would say no — I would say that was ridiculous, in fact. But it seems to me that Wolf has done something parallel.

    In the literature on PCBs, for instance, it’s clear that the damage is done prenatally. Breastfeeding appears to have a protective effect for children with high levels of gestational exposure, though this hasn’t been found universally. So it seems dishonest to me to disregard what we *do* know — that in the populations studied to date, breastfeeding has a positive effect or no effect — in favor of unproven speculation that happens to support Wolf’s agenda.

  8. If someone cited such an article as a reference to the sentence “Side effects of the Hib vaccine include swelling and tenderness at the injection site”, however, it would be entirely appropriate, and I see this as closer to what Wolf has done when quoting the Lucas study.

    As for the PCBs issue, she states there may be potential effects we don’t know about that may not be taken into account. While this may very well only be telling one side of the story (though far less decisively than certain BF advocacy papers, which state still-unclear issues like the effect of breastmilk on IQ as proven fact), she is correctly stating a point which apparently is still a concern to some.

    Do you see the differnence between raising a concern others have, and stating , in absolute terms, only part of the research, such as here?

  9. Esther, I hope you could tell from my previous comments that I would find the linked headline objectionable. My training has taught me to report all the relevant findings — not just the findings that bolster my arguments. But I think you’re being a bit inconsistent here. The studies cited at that page say what they’re quoted as saying. If the headline said, “Studies Show Breastfed Kids Have Higher IQs,” would you still object? (I would, but it’s true for the studies they’re citing.)

    By your logic, there’s no requirement for them to point out that studies exist with null findings, just as Wolf doesn’t have to report the actual results from longitudinal studies of toxin-exposed children. In fact, if I’m reading you correctly, the people could say, “Der, Batty, & Deary found that breastfed children had a 4-point IQ advantage over formula-fed children” — with no need to mention that the effect vanished with covariate control. It’s absolutely true — that was their initial finding — but I think it would be reprehensible. I have lots to say about Der, Batty, & Deary, but I will always acknowledge the null finding because I think I have an ethical obligation to do so.

    When you say “certain BF advocacy papers,” are you talking about peer-reviewed publications?

  10. They’re an advocacy organization (OK, a lactofanatic org), so I expect some one-sidedness. I would at least expect them to qualify that “will have a higher IQ”, though – or do you think they’ll give me a written guarantee? 😉

    Quoting Der et al‘s uncontrolled stats is dishonest because it contradicts entirely what the study found. That’s not the same as quoting Lucas’ legitimate reservations about her work, or a paper which implies a controversy which, in your mind at least, doesn’t exist (honestly, the PCB argument against breastfeeding has always seemed lame to me, and if I were Wolf, I’d have skipped it altogether. But that’s just me) . I’d like to hear what you have to say about Der et al, though.

    Oh, and I meant “sites”, not “papers”. Not sure why I made that typo…

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