Autism Awareness: Frontline and "Moms against science"

Earlier this week, PBS broadcast its Frontline piece on "The Vaccine Wars," touching on the MMR vaccine-autism debate and the Thimerosal-autism debate, both of which are still ongoing in some communities in spite of the fact that the supposed links have been debunked. I watched the show online (you can do so here), and was disappointed by the way that the show pitted anecdotal evidence from parents against research and advice from medical professionals. As Dr. Jay Gordon put it in an open letter to one of Frontline's co-producers, the program created "a pseudo-documentary with a preconceived set of conclusions: 'Irresponsible moms against science' was an easy takeaway from the show." I agree completely, and we're discussing the show -- and what it means for parents who avoid vaccinating or who are proponents of an alternative vaccine schedule -- at my new parenting column for the Boston Globe, In the Parenthood.

An assistant professor of pediatrics at UCLA Medical School who has reservations about vaccinations, Dr. Gordon's multi-hourlong interview with Frontline ended up on the cutting room floor, he says, as did an interview with Dr. Robert W. Sears, author of The Vaccine Book: Making the Right Decision for Your Child, who advocates an alternative vaccination schedule. Evidence in favor of vaccination was provided by researchers including Dr. Paul Offit, who has earned millions of dollars as the co-creator of the RotaTeq vaccine, is a paid spokesman for Merck, and has said that he thinks infants' immune systems could theoretically handle as many as 10,000 vaccinations at one time, or perhaps "closer to 100,000."

Autism Awareness: The seven -- yes, seven -- senses

Sensory Processing Disorder, or SPD, is not technically an autism spectrum disorder -- making it difficult to address on an IEP -- but many children with autism also have some symptoms of SPD, which is why I wrote about it under the "Autism Awareness" heading over at In the Parenthood this month.

One of the things we learn early on in school is that we all have five senses: taste, touch, smell, hearing, and sight. But as Hartley Steiner, author of This is Gabriel Making Sense of School,
points out on her blog, Hartley's Life with 3 Boys, there are actually seven. In addition to the five we learn about as kids (sight, sound, taste, touch, and smell) there are two more -- vestibular
and proprioceptive. And those are the ones that pose a particular problem for some kids who have SPD and are on the autism spectrum.

Finding comfort in being constructive

Freshly baked bread is one of my top, all-time favorite comfort foods. I've been craving it pretty much ever since I first got teeth. My mom used to bake bread for local restaurants when I was a kid, and I've yet to find a commercial bakery that can match her pumpernickle.

Years ago, I'd bookmarked a New York Times adaptation of the Sullivan Street Bakery's amazing no-knead bread. I don't know why it took me so long to try it -- maybe I was intimidated by the long rise time -- but I finally did a few months ago.

And you know what? I've been making it frequently ever since. (That's the latest loaf right there, in the picture.) As I wrote over at The 36-Hour Day a couple of weeks ago, this bread is a working mom's dream, because it practically makes itself.

Autism Awareness: Asperger's goes mainstream

Even if your child is neurotypical, chances are he or she knows someone -- a classmate, a neighbor, a relative -- on the spectrum. With this in mind, PBS's hit children's show Arthur introduced a new friend to the intelligent aardvark's class earlier this month: A sweet, brown-haired bunny named Carl, who has Asperger's Syndrome.

"Imagine you've crash-landed on an alien planet," explains The Brain, another one of Arthur's friends. "It looks like Earth, but there are lots of differences."

As a parent with a child on the spectrum (our oldest son has Asperger's), I have to say that The Brain's description really rings true to me. And I love the way the simple explaination is given -- without judgement, without fear, without question that some people are just different.

On tracking, budgeting, and making the most of your money

My series on family and finance continues over at Yahoo!'s Shine. This week, I shared some tips for keeping track of your household expenses, and looked at easy, moderate, and drastic ways to trim your household budget. Click over and take a look!

In the lunchbox: What's healthy or what's convenient?

I was watching British chef Jamie Oliver's Food Revolution the other night, and was struck by a scene in which he showed elementary school kids in Huntington, West Virginia -- recently named the unhealthiest place in America -- how chicken nuggets are made.

It was pretty revolting.

When Oliver's done demonstrations like this in England, the school kids are disgusted by the nuggest and reach for the grilled chicken legs instead. But when he tried the experiment in West Virginia the kids, who gagged and gasped while he showed the what went into the nuggets, clamored to eat the final, uber-processed product. Here's the clip, courtesy of YouTube:

My kids, like most kids, like chicken nuggets. I don't have time to make my own all the time, so the ones they get in their lunchbox are as "natural" as possible, but really, they're still fake food. And after watching this, I felt kind of bad about it. Which isn't Oliver's point at all; a once-in-a-while -- or even once-a-week -- chicken-nugget lunch isn't going to rocket kids into obesity. But coupled with studies that say working moms are raising unhealthy kids, it does ratchet up the guilt levels, no matter how healthy the rest of their lunches are.

Of course, it's possible to pack healthy lunches for your kids. What makes it less convenient is when those healthy lunches also have to be portable, disposable, not require reheating or refrigeration, and peanut and tree-nut free (and, in my case, gluten-free as well). Throw a picky eater into the equation and it's easy to see how schools started serving sugary, fatty, cheaply made, processed foods instead of wholesome, home-cooked fare.

Do you feel like you have to choose between healthy and convenient when it comes to packing your kids lunches? What kind of food is your child's school serving in the cafeteria?

In the spotlight at SafetyNetSource.com

I'm honored to be in the Caregiver Spotlight at SafetyNetSource.com today, where they're focusing on autism awareness and caregiving. Here's an excerpt:

What advice would you give to caregivers of children with autism?

Breathe. Remember that each child is different, and that it’s called a spectrum for a reason. What treatments, exercises, and coping methods work for one child may not work for yours, so find the tools that you need to help your own child, and don’t worry about whether you’re doing it “right” or not. If it works for you, and your child is doing well, it’s right.

I found it very helpful to try to see things through our boy’s eyes. Ellen Notbohm wrote a great essay a few years ago, called “10 Things Every Child with Autism Wishes You Knew”; I interviewed her last year as part of my month-long Autism Awareness series. (You can read the interview and her essay here.)

Who is one of your idols? Why?

This may sound silly, but when I was a child, “Mighty Mouse” was my idol. I loved the idea that the tiniest of creatures could be the one who saved the day.

I’m not sure I have an idol now, as much as I just have ideals.

Click here to read the rest of the interview.

Earth Day 2010: 10 ways to go green at home or at work

Earlier this week at The 36-Hour Day, I wrote about how my husband is far more crunch granola than I am. In fact, by comparison, I'm just a little bit cripsy.

A couple of years ago, we set out fruit trees and expanded our garden — or, rather, he did, given that I kill plants just by looking at them. My husband runs his Suburban on a combination of diesel and waste vegetable oil (no, it doesn’t smell like french fries) and fantasizes about having a wind turbine on our property. (Not going to happen, though. Two reasons: We don’t get that much wind, and we don’t particularly want to piss off our lovely neighbors.) And, this year, he’s rebuilding the old chicken coop out back, with an eye toward raising up his own flock of dinner. I’ve assured our lovely neighbors that we won’t have roosters (they crow all day, not just in the morning, you know), and I’ve vowed to name each chick after a different recipe. (”Heeeeeeere, Homemade Stock! Bok bok, Sweet-Potato Curry! Where’d you hide your eggs this time, General Tso?”) ... [More]

I am trying to be more green, however. According to the EPA, the environment inside your home is two to five times as polluted as the environment outside -- and we spend about 90 percent of our time indoors. Here are 10 tips, many of them courtesy of my friend Anca Novacovici, founder of Washington, D.C.-based Eco-Coach, for making your home or office more eco-friendly:

Proximity, location, and autism diagnoses: Is there a connection?

April is Autism Awareness month, and if you've been in Boston lately, you've probably seen the posters hanging in T and commuter rail stations -- photos and stories of children with autism, and a question: "What does autism look like?"

To answer the May Institute's question, a person with autism can look like anyone.

Late last year, the Department of Health and Human Services reported that autism was more widespread that previously believed, with about 1 in 100 children on the autism spectrum. The oft-cited link between the MMR vaccine and autism has been officially dismissed, and studies seem to show that now, more than ever, no one knows what really causes or triggers the disorders.

Two new studies by researchers at Columbia University offer new ideas about what causes autism, at least in California, where autism cases handled by the state's department of developmental services increased 636 percent from 1987 to 2003, according to Science Daily. One study points to a cluster near West Hollywood, where children were four times more likely to have autism than babies born in other parts of the state. The other asks whether proximity to a child with autism increases the chances of other children being diagnoses with the disorders.

In the first study, published recently in the Health & Place journal, researchers analyzed data from 11,683 autism cases out of the 4.1 million babies born in California from 1993 to 2001. They identified a 20-kilometer by 50-kilometer "cluster" or area where the autism rate seemed highest, and also noted 38 other "secondary clusters" with high rates. All of the secondary clusters were located in the greater Los Angeles region.

"The identification of robust spatial clusters indicates that autism does not arise from a global treatment and indicates that important drivers of increased autism prevalence are located at the local level," the researchers wrote. While their study did not attempt to pinpoint a single cause for autism, it does suggest that localized environmental toxins could play a part, as well as certain social influences, including "increased awareness of autism, decreased stigma associated with the disorder, or increased number of local advocacy groups," according to Soumya Mazumdar, a postdoctoral research scholar at Columbia’s Institute for Social and Economic Research and Policy who authored the study.

The other study, also by researchers from the Institute for Social and Economic Research and Policy at Columbia University but published in The American Journal of Sociology, shows that children who live near a child who has been diagnosed with autism are more likely to receive an autism diagnosis themselves. How could proximity play a part?

"From shared toxicants, through the diffusion of a virus, as a by-product of neighborhood selection, or through the diffusion of information about autism through social networks," the researchers wrote, adding that "meeting children with autism and having discussions with parents of children with autism could lead parents (of children not diagnosed with autism) to observe behavioral symptoms consistent with autism, to learn how to effectively identify and reach a physician, and to learn how to access and subsequently navigate services and service agencies."

The Columbia University team studied data from more than 300,000 children born in California between 1997 and 2003, and found that children who live within 250 meters of a child with autism have a 42 percent higher chance of being diagnosed with an autism spectrum disorder with the next 12 months. Children who live 250 to 500 meters away have a 22 percent higher chance of being diagnosed, and the greater the distance the less the likelihood of a diagnosis. The "social effect" was more prevalent in cases of mild (or "high functioning") autism diagnoses.

One of our children is on the spectrum (he has Asperger's Syndrome), and I absolutely agree that exposure to a child with autism builds awareness -- perhaps even overawareness -- of the signs of spectrum disorders in other children. It's easy to see how increased awareness could lead to an increase in diagnoses; a generation ago, a child with mild (or "high-functioning" autism would simply have been labeled "difficult" or "quirky," but now we have a better idea of what to look for (and how to help). Also: The autism spectrum itself has grown to include several things, including the all-encompassing PDD-NOS (Pervasive Developmental Disorder Not Otherwise Specified) that would have been dismissed just a decade or so ago.

In the Parenthood: A new blog at Boston.com

My new blog at Boston.com is live! Please join me at In the Parenthood for discussions about parenting news, tips, tricks, and trends, and be sure to update your feed readers and bookmarks.

Here's what we're looking at right now:

At Singlemommyhood.com, Dr. Leah describes a situation that might make many single parents nod and cringe at the same time. A single dad, who has been the primary caregiver of his kids for the past five years, fields a request from his broke ex-wife: "Will you please let me stay on your couch for Mothers Day?"

You can weigh in here.

Have a parenting topic that you'd like me to tackle? Please feel free to drop me a line at WriteEditRepeat (at) gmail (dot) com. You can also catch the latest by following me on twitter: @WriteEditRepeat.

Evaluating daycare centers and preschools: What to ask

Once you've figured out what kind of childcare might work best for your family, the challenge is figuring out which provider is the right one for your child. There are some differences between formal daycare centers, in-home daycare providers, and hiring a nanny or babysitter.

If you're going the nanny/babysitter route and aren't sure what to ask during the interview, here are 15 questions to ask. Commercial childcare centers and in-home daycare set-ups have different rules, licencing requirements, and issues to consider, though. Regardless of which type of formal childcare provider you choose, ask the owner or director the following:

1. How the caregivers are trained?
2. Do they receive or pursue ongoing education?
3. What is the staff turnover like?
4. How do they handle behavioral issues and discipline?
5. How do they deal with crying infants?
6. Can you observe the classroom or center before you make your decision?
7. What kind of food/snacks do they provide, and can they give you a menu?
8. Can they accommodate your child's specific dietary needs, if any?
9. Will they provide a criminal background check for staff? (In some jurisdictions, this is required by law; in others, it's optional. You always have the right to request one.)
10. What are the rates and fees?
11. How do you make payments? (Weekly? Monthly? Credit card? Direct withdrawal?)
12. Is coverage available on National holidays?
13. What is their policy on caring for sick children? (Are they sent home if they spike a fever of 100 or more, or is it 101? Are they willing to administer medication if given permission to do so?) 
14. Are children required to nap? Do they have a procedure in place for older kids or children who won't sleep? (Are they allowed to play with quiet toys, for example, or do they turn on a movie?)

For in-home daycares:

1. Is there an open-door policy and can parents drop in unannounced?
2. How long has she been providing care?
3. Is she monitored in any way? If there are inspections, how often and who performs them?
4. How many other children are in her care, and what are their ages?
5. What's the maximum number of children in her care at any one time?
6. Is she at capacity already?
7. What does a typical day look like?
8. Who else will be in house during business hours?
9. Any smokers in the house? If so, are there restrictions on where they smoke?
10. Does she have First Aid and CPR training? When was she last re-certified?
11. Does she provide a contract?
12. Will she provide references from current and past clients?
13. Can you visually inspect sleeping areas, changing areas, and play areas?
14. How will she transport the kids if they leave the premises?
15. Are there pets on the premises?
16. Do the kids watch television while in her care? 

For daycare centers and preschools:

1. What are the staff-to-child ratios?
2. What is the rate of staff turnover?
3. Are the staff members certified in early childhood education?
4. Do the staff members have First Aid and CPR training? How often do they re-train?
5. Do the kids go off the premises at all? How often?
6. Do they mix the age-groups?
7. Is there a formal curriculum?
8. Is there a contract?
9. Can you visually inspect sleeping areas, changing areas, and play areas?
10. Are they fully accredited, or are any requirements in the process of being met?

On money and marriage: The case for separate accounts

Over at Shine, I'm making the case for not mixing your money when you get married:

You've probably heard the horror stories: A new widow doesn't know how to manage her money because her deceased husband always handled all of the bills. A couple divorces and one spouse has poor credit because he never built up enough of a record on his own name. Both spouses pool their money, but then one makes a huge withdrawal.

For many people, marriage means that as two lives merge so must the checking accounts. "When you get married, you become one," advises financial guru David Ramsey. "Money is a key area that helps bring unity. When you handle your money together, you are agreeing on your hopes, dreams and goals."

But many financial experts agree that there some situations where it makes sense for spouses not to co-mingle their money. ... [More]

I interviewed Candace Bahr, co-founder of the Women's Institute for Financial Education (WIFE.org) and the Bahr Investment Group, for the Yahoo piece, and she pointed out several situations where it may be better for spouses to have separate finances. "Keeping some money separate doesn't mean you're keeping it secret," Bahr points out, and I absolutely agree.

Since mine is one of those situations where it makes more sense to keep things separate, I also took a look at the topic from a more personal point of view over at The 36-Hour Day:

My husband and I have never merged our money. It doesn’t make sense for our blended family to also have blended finances, so in order to keep our assets and financial obligations and liabilities separate, we keep our financial accounts separate as well. ... Some financial experts have found that keeping separate accounts is becoming more common: people are marrying (or remarrying) later in life, they point out, and more women are outearning their husbands. And with credit scores having become so important, it makes sense for each spouse to build and maintain a credit record in his or her own name. ... [More]

I just got an interesting comment at The 36-Hour Day, calling me a liberal for maintaining financial independence while married, which fascinates me -- has personal finance always been a political statement, or is that a recent development?

What money management system works for your family?

Tax tips for next year, and how to cope with an audit

My new series on family and finances has made its debut over at Yahoo!'s Shine, and the first installment is just in time for tax day: How to get organized for next year, and how to cope with an audit.

Here's an excerpt:

Ah, spring. It's when an adult's fancies turn to thoughts of... paying her taxes.

And, possibly, panic over the idea of being audited.

Taxes are due April 15. If you're still staring at a pile of 1040s and W-2s, time to get cracking. If you've already filed them, pat yourself on the back, and then start getting ready for next year. Yes, really. Yes, now. Whether you do your taxes yourself or hire a professional, you can make filing your 2010 returns infinitely easier by doing a few simple things....[More]

If you do happen to get a love letter from the IRS in the mail, you'll want to make sure you do these seven things (and click through to Yahoo! for more details):

1. Don't panic, but don't ignore the letter, either. Read IRS Publication 1, which explains your rights under the Taxpayers' Bill of Rights, and do your research -- there are plenty of free IRS publications available at irs.gov.

2. Your best defense isn't a good offense -- it's justification. Have detailed records handy (and keep in mind that you are allowed to reconstruct those records if you've lost track of them).

3. If possible, avoid meeting at your home. Even better: Have your tax preparer represent you -- or hire one if you did your own taxes that year -- and hold the meeting at his or her office.

4. Bring only the documents that the IRS has requested. There is no need to explain items that they haven't asked you about.

5. Don't get emotional. The IRS certainly won't be. This isn't about you, this is about your money.

6. Don't sign anything if you can help it. Keep an eye out for Form 872; it extends the amount of time in which the IRS can assess additional tax on your return.

7. Don't fight the figures. Fight the tax issues -- what counts as a deduction, for instance -- instead.

Keeping kids in their beds at night

My youngest child -- age 3 -- has never been big on sleep. He's better now than he was as a baby, when he'd refuse to nap and would struggle to stay awake even when he was falling-down tired. Bedtime itself is better now, but every so often he likes to creep around the house at night. He usually heads to our bedroom around 6 in the morning, carrying an armload of stuffed animals, and slides under the covers to cuddle before facing the day for real.

I'm fine with that. But sometimes, he detours through the rest of the house first. "Hi, Mama!" he chirped when he traipsed into the kitchen at midnight recently, happy to see me on my laptop at the table. "I was jus' tip-toein' awound!" Another night he woke me at 2 a.m. to report that his older sisters were all asleep -- our 16-year-old later said she thought she was dreaming when she saw his little face at the side of her bed in the dark -- and that the dog was on the couch downstairs. Last night, he had to go to the bathroom at 11 p.m., was looking for his older brother at 1 a.m., and ran into my room at 5:30 a.m. to see if my clock read "7" yet.

A friend of mine is having problems with her toddler daughter sleeping through the night; her child hollars for Mama loud and clear around 4 a.m., waking the entire household. "Any ideas for a fix?" she asks. I turned to the great Boston.com/Moms community and my readers over at Child Caring for their suggestions.

It's a common problem: A 2004 study by the National Sleep Foundation found that 69 percent of children younger than 10 have problems staying asleep several times a week. Modern Mom suggests that parents try to create a consistent bedtime routine, use a patterned sound (like a white noise machine or a small fan) to block out noises that might keep your child awake, make sure his bedroom is a comfortable temperature, and consider implementing a rewards system.

I think it's also important to try to figure out why your child is calling you at 4 a.m. or exploring the house in the middle of the night. Is she scared? Is he bored? Does your toddler still take a long nap during the day and simply isn't sleepy anymore by 4 or 5 a.m.? Does the sound of the TV seem more interesting than the silence in her room?

All five of our kids wandered for a while when they were little, each for different reasons. One child needed to make sure her room was monster-free; a spritz of flowery perfume on her pillow and another into her closet made her feel safe (she reasoned that scary things are afraid of pleasant things, so a monster wouldn't like the pretty smell of the perfume). Another kept getting up for bathroom breaks; eliminating that last glass of water did the trick. Another slept better while wearing one of Daddy's gigantic T-shirts. And permission to turn on a small light and read helped keep middle-of-the-night boredom at bay. (Youngest boy may get a digital clock soon, so he can stop coming in to check mine.)

When I was a nanny, I used to wear several bangles specifically so I could leave them on the kids' bedside tables after I tucked them in; if the bangles were gone when the kids woke up, they knew I'd been in to check on them, and they didn't feel a need to get up to look for me at night.

What do you do when your child keeps getting up in the middle of the night?

Tips for keeping your baby safe in her sling

I bought a sling when my youngest, don't-want-to-be-put-down-ever-ever-ever baby was born. It was gorgeous, and I had sweet visions of him sweetly curled up in it, content, while I had my hands free to do what I needed to do around the house (like take care of my 2-year-old and her three older siblings).

But I could never get the hang of the thing. Was my baby just too little? Was the sling too big? It wasn't comfortable, I was worried that I wasn't using it properly and ... I just gave up. I wish I hadn't; baby carriers and slings have been used successfully for centuries -- the Maya Wrap wasn't named for some woman named Maya, after all -- and there are plenty of different types I could have tried.

Now, babywearing is suddenly chic, as per this Style story in the New York Times. And with the increase in use has come an increase in problems. Last month, the US Products and Safety Commission issued a warning about the use of slings for babies younger than 4 months of age; two weeks later, Infantino issued a massive recall of two types of their soft, unstructured baby carriers. I wrote about both earlier this month, as well as tips for safely wearing your baby, in my new column for The Boston Globe:

April 1, 2010
In the parenthood

Baby wearing’s hip, but is it safe?
Tips for using slings with care

By Lylah M. Alphonse

People have been carrying their infants in slings, pouches, and packs for centuries, and in the 1960s, it became common to see women and men in the US with their babies bound close to their bodies. Now, “baby wearing’’ has gone from hippie to hipster, with the Maclaren crowd eschewing expensive strollers for chic, hand-dyed silk slings. And with the increase in popularity has come an increase in concern about the dangers posed by soft, unstructured carriers.

Last week, Infantino recalled more than a million of its “SlingRider’’ and “Wendy Bellissimo’’ infant slings, offering free replacements less than two weeks after the US Consumer and Product Safety Commission issued a warning about using slings for infants younger than 4 months. While 14 deaths have been reported over the last 20 years, three occurred in 2009 and 12 have involved babies younger than 4 months. “Many of the babies who died in slings were either a low birth weight twin, were born prematurely or had breathing issues such as a cold,’’ the report pointed out.

The danger is in the way a very small baby can suffocate in a sling-type carrier. Preemies and babies younger than 4 months are most at risk, because they aren’t strong enough to turn their heads or push their faces away from the cloth. But those babies are also the ones that can most benefit from baby wearing, according to Melissa Radcliffe, owner of baby carrier and accessory company TogetherBe.

“All of the benefits of kangaroo care can be mimicked by being worn in a baby carrier,’’ says Radcliffe, a mother of three, referring to the technique of holding a newborn upright against the parent’s chest, skin-to-skin, with a blanket or the parent’s shirt covering both parent and child. Kangaroo care has been shown to help stabilize the baby’s heartbeat, regulate breathing, improve oxygen-saturation levels, improve breastfeeding and sleep patterns, and decrease crying, according to information from several experts, including those at Children’s Hospital Boston and Harvard Medical School.

The most popular types of baby carriers include pouch slings (“Like a Miss America sash,’’ Radcliffe says), ring slings (like the Maya wrap, which uses a set of rings to adjust and secure the material), Mei Tais (a square of fabric secured by four long ties, based on a traditional Asian design), wraps (several yards of stretchy cloth that can be tied in different ways), and structured soft carriers (like the Baby Bjorn). Most of them allow parents to carry their child on their chest or on their back, but the safest way to wear a baby is upright and facing you, in a tummy-to-tummy position, Radcliffe says.

How do you know if your baby is safe in his sling? Here are some guidelines:

1. Make sure he’s not curled up tightly in a chin-to-chest position, say the experts at Babywearing International (www.babywearinginternational.org). This compresses the baby’s airway, making it difficult for them to cry or breathe.

2. Make sure you can see the baby’s face. If you have to move the fabric away from your baby’s face, you need to adjust the baby or use a different type of carrier.

3. Keep your baby close enough to kiss. “If you bend your head down, you should be able to kiss the top of their head,’’ Radcliffe says.

4. Make sure your baby carrier mimics the “in arms’’ position. That is, when your baby is in the carrier, she should be in the same position that she would be if you were carrying her in your arms: fairly snug to your chest and somewhat close to your face, according to Babywearing International.

5. Choose a carrier that’s appropriate for your child’s age and weight. Some carriers are safe for toddlers up to 35 pounds, others are better for smaller babies.

For recall information, visit the US Consumer Product Safety Commission at www.cpsc.gov. If you’re confused about your carrier, or worried that it might not be safe, contact a store for a baby wearing demonstration (Crunchy Granola Baby in Salem offers classes every third Saturday and walk-in instruction any time; call 978-741-0800) or find more information at www.babywearinginternational.org

© Copyright 2010 The New York Times Company

The story was picked up at BabyWearer (thank you for the kudos!)

What do your kids think you do at the office?

When my now-5-year-old was a baby, she thought the phone was called Mama. I worked during the day while she was home with my husband (he worked at night, and we'd trade in the evening), and he'd call me at work and ask her if she wanted to "talk to Mama." She was close to a year old before she'd consistently point to me and not the phone when someone asked here where Mama was. (I'm not sure what she thought my name was back then, but she knew exactly who I was, so this was amusing rather than heartbreaking).

Our kids have always known that I work. But last week I wondered... do the little ones understand what I actually do when I'm at the office?

Sort of.


"What do you think Mama does for work?" I ask my 3-year-old.

He thinks about it. "Make dinner?" he asks.

"Anything else?" I ask him.

He nods, and tries to sneak a sip of my coffee. It's cold, so I let him, and he smiles and smacks his lips as a little bit of it dribbles down his chin. "Um... you do laundry?"

Is it realistic to expect 90 percent of US women to breastfeed?

I'm over at Child Caring, where readers are reacting to this week's news about the benefits of breastfeeding. Here's an excerpt:

The importance of breastfeeding is underscored in the recent Health Care Reform law, which requires employers to provide "reasonable" unpaid breaks for breastfeeding mothers to pump. And a study published today in the journal Pediatrics make clear the benefits of breastfeeding: If 90 percent of new moms in the United States breastfed their babies exclusively for the first six months, researchers estimate that as many as 900 more infants would survive each year, and the country would save about $13 billion in health care costs annually.

Which is wonderful, but without paid maternity leave, consistent workplace accommodations, or a way to implement the new law, how are 90 percent of new moms supposed to pull that off? ... [More]

Dr. Larry Gray, a University of Chicago pediatrician, called the analysis compelling and told the Associated Press that he thinks it's reasonable to strive for 90 percent compliance. For some women, though, breastfeeding is a lot easier said than done. And as any mom who has lugged a breast pump with her to the office for any length of time knows, returning to work can make it even harder to continue to nurse. It requires much more than simply a committment from the mother; it requires understanding from coworkers, support from her company, and, in some states, reinforcement from the law -- all things that many women don't have at their disposal.

Just 24 states, along with Puerto Rico and Washington, D.C., have laws relating to breastfeeding in the workplace. (Massachusetts is not one of them.) In Allen v. totes/Isotoner Corp., Ohio's supreme court ruled that it was legal for Isotoner to fire LaNisa Allen, the mother of a nursing 5-month-old, taking unauthorized breaks to pump -- and for "choosing to breastfeed" (Leah at Working (on) Motherhood had a great take on the case at the time).

Gina Ciagne, a certified lactation counselor and director of Breastfeeding and Consumer Relations at Lansinoh Laboratories who blogs at By Moms For Moms, left her job at the World Bank in Washington, D.C. because she was so upset by the lack of support they had for nursing moms. "They supported breastfeeding around the world in their development projects, but not their employees in D.C.," she says.

Support for employees who are breastfeeding or pumping is as important as providing gym memberships, health awareness programs, and supporting other healthy lifestyle choices, she says. "If she thinks that her employer doesn't care... then what allegiance does [a new mom] have to her company?" Ciagne asks.

"Inclusion of the workplace accommodation language in the Health Care reform bill is huge, but it has to be implemented," she adds.

Here's what I think: If it's in the country's best interests to have new moms nurse their infants exclusively for at least six months -- and the billions of dollars in health care savings per year indicates that it may be -- then new moms should get at least six months of paid leave in which they can do so. According to an article in BusinessWeek, the end of a typically short (six to 12-week) maternity leave in the US often signals the end of nursing as well. (The United States and Australia are the only two industrialized countries in the world that don't make paid maternity leave mandatory -- click here to read my take on that stat.)

For many moms -- myself included -- dropping out of the workforce once you have a baby simply is not an option. So what do you think would help US women reach that six-month recommended goal?