On Giants' Shoulders

Sunday, May 24, 2009

Product, Process, or Relationship

For the past year and a half I've had my head back into a subject which (while never gone from my memory) had not been at the forefront for many years. I've been studying human lactation in preparation for taking the International Board of Lactation Consultant Examiners test this summer. Becoming a lactation consultant was, I thought for a long time, a dream whose time had come and reluctantly passed. It turned out that the time simply hadn't yet been right to do it. Some people assumed that it was my daughter's pregnancy that sent me scurrying down this path, but, in fact, I started the process before she ever even got engaged. It had to do with picking up something that I was good at, that I really loved (i.e. working with nursing mothers) and beginning to do it again.

It's been an interesting time. I've done a ton of reading, some simply in order to get reactivated as a La Leche League Leader, some towards getting my CLC accreditation last fall, some in preparation for the IBLCE exam, and some simply because I frankly find the topic fascinating. I can quickly bore those who don't find it interesting (a fact which my son and husband will readily attest to) with various arcane facts I've learned. I attended a lactation counselor's class last fall which was interesting, informative, etc. I've been attending, and now leading La Leche League meetings for the first time in 20 years. That is an interesting experience in itself.

What all of this has done, in addition to preparing me for the exam, is raise questions in my mind about breastfeeding in our current culture. When I first encountered a breastfeeding mother when I was in junior high school it was certainly a novel experience. I'd not only never seen a baby breastfeed before, but I didn't know that anyone outside of the jungle even did it anymore. However, my reaction was positive and pretty much instantaneous. I was doing a Girl Scout badge in child care about the same time. One of the things I'd had to do for the badge was demonstrate feeding and bathing a baby using a life sized doll. The feeding part required taking the plastic lid of the bottle and using it to carefully push the nipple through the hole in the screw cap without ever touching the nipple with my fingers. It was the one part of the demonstration that I thoroughly blew. My reaction was, "Well it really doesn't matter to me, because I'm going to breastfeed my babies." Now that may be an example of how to turn failure into success or simply an excuse for being a butter fingers, but, in fact, I never changed my mind. I chose breastfeeding based on what I saw with that one encounter with a mom in my neighborhood. I liked what I saw of the relationship between her and this tiny person (who was in fact her 9th baby).

Through my teens and early twenties I did encounter the rare breastfeeding mom, but most of my friends' babies were on bottles. I was fortunate that the wife of the pastor who married my husband and me was a breastfeeding mom. Her one piece of pre-wedding advice was, "When you have a baby get in touch with La Leche League." I'd never even heard of the organization, but I filed that piece of wisdom away in my brain. Fortunately, the local La Leche League leader happened to be a member of the church my husband and I attended after we got married, so getting in touch with La Leche League didn't involve calling up some strange person. It's a good thing, because Glenna did stop by after the baby was born, and I did need her help. I didn't actually start going to La Leche League meetings until after the baby was born (a mistake in retrospect), but once I did, I became fascinated not so much by the process of breastfeeding as by the relationships.

I became a La Leche League Leader when my son was about a year and a half old. What I knew at that point was a lot about how to help mothers with typical difficulties, how to support mothers in their breastfeeding experience, how convenient breastfeeding was, and what a wonderful relationship breastfeeding produced not only with your baby, but with your husband and with these other breastfeeding moms. To this day there is nothing more relaxing to me than sitting in a room with a bunch of moms who are nursing their babies (even when my own "baby" is 27 and about to become a mother herself). It is such a different environment from other social settings, it often feels like someone turned off the clock, although we do have to sort of keep an eye on it so that we end somewhat nearly on time.

What I knew less well at that point was about human milk as product. I certainly read "The Specificity of Human Milk," and I read the increasing studies that were coming out at that point postulating the importance of human milk in Type 1 diabetes prevention, the prevention of severe allergies, and even SIDS prevention. However, much of what is now known about the importance of human milk had yet to be discovered. We did know that it was vital for third world women to nurse their babies, but thought that was largely due to water contamination and lack of money for formula. We didn't know the extent to which breastfeeding could make a difference in infant morbidity and mortality even in the first world. We weren't focused on product, we were focused on the mother baby dyad and supporting that relationship.

Last fall as I went through the CLC class I learned a tremendous amount about process. It meant unlearning a few things that I used to know and learning new things about latch, scheduling, skin to skin, self attachment, and ways of dealing with complex problems. It was a course well worth taking, yet at the end of the week I came away wondering if it weren't so process focused that the participants lost sight of the fact that what we were talking about was an important relationship. I wrote to the leader who was in charge of my LLL reactivation about the class and about my concerns that we were so overmedicalizing the process instead of focusing on the mother and the baby, and encouraging the mother to become the expert on her own baby. The class made me really wonder what I would want to do with the LC certification once I got it, because I couldn't really see myself being as clinical as some of what was being suggested. While the clinical information is important, mothers and babies are not simply pieces to a machine to be assembled correctly and the overly clinical approach can convey this impression.

Recently, I spoke with a someone whose daughter-in-law "failed" at breastfeeding, but succeeded at pumping. With her second baby she chose to not feed the baby at the breast at all, but to simply pump. This is an example of focus on product. We have convinced mothers that human milk is incredibly valuable, and it is. However, what they seem to be learning, is that they can be producers of human milk as well as producers in the workplace without having to take the time to establish that delicate dynamic between mother and nursling. In short the product has, in a bizarre way, replaced the relationship. It isn't that these are bad mothers, it's that a mother who never feeds her baby at the breast is not having the same relationship with that baby as the one who does. The mother who only pumps is actually missing out on something, and she doesn't even know it. Some mothers may pump in order to maintain the nursing relationship. They pump to provide bottles for a couple of feedings a day so that they can have the nursing relationship the rest of the time. That's a very different thing from simply seeing human milk as a product to be supplied. We live in a world that is dominated by production of product, how sad that one of the most fundamental relationships a person can have would be altered to become a matter of providing a product.

I read an article a few months back about mothers being turned into their own wet nurses. It talked about ads showing the corporate mom in her Prada shoes tripping gaily off to the office breast pump in hand. My daughter actually worked for someone who did just that. The baby was mothered most of the time by a nanny while the mother continued to work at a very high paid job. She clearly loved her child and wanted her to have the best in life, but her relationship with that child was to a large extent secondary to her career and the very affluent lifestyle she had carved out for herself. She was making an enormous effort to continue to provide breast milk for her child, but taking a year off for mothering wasn't something she was willing to consider.

In our efforts to encourage parents to be to consider the case for breastfeeding, or to encourage employers to consider the business case for breastfeeding it is easy to focus on product. I know that when I talked with my son-in-law about breastfeeding I focused on the evidenced based studies, the value of human milk, and the cost of formula. Those are great selling points to males. As we attempt to turn hospitals into baby friendly places instead of advertising arms of the pharmaceutical industry, it is tempting to focus on product. We can look at human milk direct from mom as simply the top of the hierarchy of feeding choices with number two being the mother's pumped milk, number three human donor milk, and the pharmaceutical industry's artificial baby milk coming in dead last. However, if all we focus on is the product we are missing a vital part of the picture.

Our society has been focused for a long time on what people produce. I once read a piece that talked about breastfeeding mothers not contributing to the gross national product in the way that formula feeding mothers do. Of course the flip side of that is that breastfeeding mothers also don't have the impact on the environment that formula feeding mothers do. There is none of the waste associated with formula containers, or formula manufacture. However, I wonder whether part of the reason that breastfeeding has been so devalued, even as we recognize the value of the milk, is that we have fallen into the trap of only valuing those activities we can put a price tag on.

We could create situations where mothers don't have to choose between product and relationship. We could create workplaces where infants are welcome, we could create systems where maternity leaves were long, we could create more jobs where mothers could actually work from home. Our world, our country, does not have to be baby unfriendly. It is possible for babies to be present at church, at funerals, at meetings, at work places if we choose to make that happen. It is also possible for us to continue to have raised eyebrows when a mother brings her baby into a meeting or discretely nurses her baby in church. If we don't value the relationship we will say things like: "why doesn't she get a sitter," or "why doesn't she use a bottle."

I honestly believe that it is a huge mistake to think that we are merely substituting the breast for the bottle (even if once upon a time a medically oriented community encouraged us to do the reverse) when we breastfeed our babies. Nursing your baby, while it certainly is about feeding, is not just about feeding. Nursing your baby is simply the easiest way of mothering your baby. It doesn't always feel like that in the first weeks. There is a learning curve for both mother and baby. Relationships are like that. There are intangibles here that no one but another mother who has breastfed her baby can understand. It's those intangibles that don't get measured in our "evidenced based" studies. In the long run, though, it's those intangibles that keep mothers going when the society around them is unsupportive, when there is little encouragement from friends and family.

This spring I went to a conference where one of the speakers spoke about the way that the profession of lactation consultancy had become too technically oriented. She, like me, was concerned that we were forgetting why most of us had nursed our babies in the first place. While we have convinced mothers of the value of human milk, the profession was falling into the same trap of having 1000 techniques all of which mothers "needed" to know in order to nurse their babies. The mothers were getting overwhelmed in the process. She suggested that we go back to the description in the earliest Womanly Art of Breastfeeding and rethink the approach. It isn't that those 1000 tricks don't have their place. It's great to know that there are techniques to help mothers who truly run into unusual problems. However, we shouldn't be looking for zebras every time we see a field of horses. Most mothers will do far better to simply focus on their baby, not on the techniques. Most lactation consultants and counselors will do far better to encourage mothers to look at their own baby.

It isn't the product (while the product is of inestimable value), it isn't about the process (although knowing something of the process may be helpful, your body does remarkable things without you knowing how it does it), it's about a relationship with a tiny new person. The job of a lactation consultant, lactation counselor, La Leche League volunteer is to gently encourage you as you get to know that tiny new person. We should be attempting to support mothers in this relationship, not get so caught up in how many ounces the baby has transferred, how many suck/ swallows they've had in a minute. Some babies will always feed quickly, other babies are gourmets who savor their meals. When we become too fixated on process we attempt to hurry the gourmets along in the name of efficiency. We start saying things like "feeds shouldn't take more than 20 minutes." Mothers start listening to "experts" who tell us things like: "you shouldn't need to do night feeds after 3 months." We need to encourage mothers to listen to their babies, to focus on the delicate dance that they are doing with this little person and not be pulled away from that dance too early.

So what will I do with the certification if I manage to pass the test? I'm still not completely sure. What I know is that I love being part of a community which supports moms in that delicate dance. I want to be someone who helps mothers be all that they can be. I've known just enough mothers in the past who needed just one phone call's worth of my time in order to go on to successfully nurse their babies. I've been thanked enough times for my support after toddlers have finally weaned, to know that it's a job that's well worth doing. I want to be part of a community which helps the larger community begin to understand he delicate dance and to value it as well. It may not contribute to the gross national product, but it just may change the face of our society if we begin to consider people more important than things and value the breastfeeding relationship as well the milk.

Sunday, May 17, 2009

Not A Native, Never Will Be

When you grow up in a place you have a sense of things that those who move in from somewhere else never have. Vermonters are notorious for being proud of being native and also for being somewhat skeptical about non-natives and their motivations. Consequently, I understand this native, non-native phenomenon pretty well. However, this entry is not really about Vermonters and "flatlanders". It's about cradle Catholics and converts.

I'm a convert, and I'm a convert who had a fairly winding road to get to the end of the journey. Unlike a lot of cradle Catholics I didn't grow up in one church building where my parents had also grown up. Let me explain a little about the journey and you'll understand better why sometimes some cradle Catholics are an enigma to me.

When I was a little girl my mother, my sister and I attended a tiny (the place would hold no more than 55 people) little church that was actually simply a room in a house. The room had a raised platform at one end with seats crammed in as tight as possible. It would never get past the fire inspector today because it was a genuine fire trap for anyone sitting in the inside seats. This was particularly true since many of the people were elderly and unable to move quickly.The building is now the rectory for the Episcopal church that was always located next door. So going back to the church I was dedicated in is really no longer possible.

Our family moved just as I was beginning high school and so went to a different church. This congregation was meeting in an unused Baptist church, which had actual pews and a lot more room and people. It was, however, a different denomination than the one we'd previously attended. The doctrine was close, but not identical, so that meant some shifts for my mother, particularly. For example, swimming on Sunday was no longer banned since the pastor took the youth group swimming on nice Sunday afternoons in the summer. Halfway through high school the congregation managed to build its own church building. That was the church I was married in. It's not a church anymore either. Now it holds school offices and the congregation has built another building a few miles away. It holds more people, but it looks more like an auditorium than a church. So no going back there either.

After my husband and I got married, although there were a couple of forays to other churches we pretty much settled in the Congregational Church he grew up in. Our kids were baptized there, although interestingly, not in the same parts of the building. Our son was baptized in the basement (where the congregation met during the winter to save heating expenses) and our daughter (a spring baby) was baptized in the main part of the church building. I actually spent more years in that church (about 20) than any other church until then. That building is still there, I even occasionally end up in a pew there for funerals. We've even thrown showers in the church basement because it's a convenient location to rent.You might think I wax nostalgic when I do, but I don't really. Every time I walk in the thing I experience most is absence. The Blessed Sacrament isn't there. The place feels, well, empty.

I love the parish church we attend. I personally think it's one of the prettiest churches in the state. After 13 years there I know a few people and it's as much home as I can imagine a huge church like that being. There are nearly 2000 people on the parish registry I think and it's technically the parish of a lot of lapsed Catholics not on the registry. So it doesn't exactly feel like a family, unlike most of the other churches I attended through the years . My relationship with the Church is not so much a relationship with the particular people as with the institution as a whole. I joined the Church because I embraced the doctrine, not because I felt so welcomed by the congregation. In point of fact, in general, I don't feel welcomed by the congregation. I feel like one of those "flatlanders" who moved into a very tight native Vermont community. People may smile and say hello to you, but you sort of know that on a very essential level you are a stranger in the midst.

This really came home to me a couple of weeks ago at a book group I was attending for the first time. It wasn't that anyone was unkind or anything, it was nothing like that at all. I wasn't even the only stranger in the midst. It was a story someone told about being part of a group that staged a sit in to protest the closing of a parish in Massachusetts. It was realizing the degree to which that person's Catholic faith was wrapped up in a particular building and a particular community. This was the building she was married in, that her husband was baptized in, that her kids were baptized in. This was a community that she had been part of, even though she now lived somewhere else. This for her was her Catholic home, and its continuation as a parish was incredibly important to her Catholic faith. Doctrine was much less central from her point of view, and from the point of view of at least one of the other participants in the group, than this sense of place and community. I came away realizing the gulf that exists between me and at least some cradle Catholics on that particular issue.

It's also the gulf that in part keeps one person in my life from swimming the Tiber. It's not so much the doctrinal issues, it's the loss of the place they grew up and the community among whom they grew up. They are willing to make all kinds of doctrinal compromises in order to "stay native." I grew up living more like an Army brat who never really got to stay connected to one place all that long. Other than living in Vermont my whole life there was nothing that stayed the same. We changed houses, we changed towns (multiple times), we changed schools, we changed churches. I once counted the number of separate places I lived from the time I was 13 until I was 25 and the results were in the double digits. Somehow the lesson I learned was that we have here on earth no permanent dwelling. I've lived in the same house now for 23 years and in the same neighborhood (almost the same plot of land) for nearly 34. I do understand the value of continuity. My kids can actually come back to the family home (even the home of their grandparents), I can't do that. My grandparents' homes have burned down, the homes I grew up in are owned by other people and radically changed.

Now, the fact is there are both two kinds of natives, and two kinds of newcomers. There are those people who move to Vermont because they've heard about the values, the beautiful countryside, the slower pace, and they want to embrace all of it. There are other people who move here because it's a pretty place, or they married someone who lives here, or they just happened to find a job here (although that's becoming rarer), but they don't really want the traditional Vermont lifestyle. They complain about the lack of malls, the lack of delis, the open spaces seem too open, and they're upset if cows, horses, sheep, or pigs escape and get on their lawns. They really want Vermont to be like where they came from, with perhaps a little less crime and cleaner air.

There are also natives who resent the fact that Vermont hasn't gotten more with the times. They think we should have more malls, more entertainment, more interstates, more high tech gadgets. In short, they'd like the whole state to look like Chittenden county, only more so. The grass for them is always greener on the other side of the state line, but it's home so they stay. There are also natives that think change has come too fast, and without a whole lot of thought about what's been sacrificed to the great god Progress, and who wonder whether we wouldn't be far better off if we re-embraced the traditional values. They even wonder if the rest of the country wouldn't be better off to embrace them as well. As our congressman pointed out, Vermont didn't get the banking crisis that some parts of the country got, in large part because they hadn't embraced the same practices as some parts of the country.

I'm sure you see where I'm going. There are cradle Catholics who are Catholic, not just because that's how and where they grew up, but because they've truly embraced the faith. Some of them think change came too fast, and without sufficient reflection and are thankful for a Pope who has recognized that.There are also cradle Catholics who look longingly at their Protestant friends. As one of them told me while I was still Protestant, she could never become Protestant, but she wished she had been born one, she wished the Catholic Church was like that. They are the Catholics who think the Church hasn't gone far enough. They are the Catholics who stay because it's home, even if they don't really like home all that much. They are the Catholics who find converts downright perplexing, or at least my kind of convert.

There are also converts who became Catholic because they married a Catholic, or because the liturgy was attractive, the commitment to philosophy appealing, or the church buildings far more aesthetically pleasing than the other options around. They may have thought that it was a good place to be an agent of change. It certainly had a better educational system than the UCC . Additionally, unlike the mainline Protestant churches, there were actually families here rather than a bunch of old people. However, honestly, other than the ones who married Catholics, I don't understand why they chose to become Catholic. I find those kinds of converts perplexing and they don't understand me either. Why join a Church when you don't really believe what it teaches? Why join a Church just in order to change it? If you don't believe in hierarchy why didn't you become Congregationalist? If you do, well why not become...Episcopalian? Newark is to crime ridden and crowded, well what about the New Jersey countryside where you're still close to the malls. I'm sure you see the parallel.

I will never really be a native. I will never be able to quite be like the cradle Catholic who totally embraces the faith. So much of what is like breathing to him is still relatively new to me. I still have to think about syntax too much. It's like speaking fluent French, but with an English accent. You can be understood, but it''s a rare person who speaks a second language fluently enough to be mistaken for a native. In some ways, even those culture Catholics who don't particularly like the Church are going to look and feel Catholic in a way I never will. Perhaps my grandchildren will feel that way, they, after all will be cradle Catholics, but I suspect it may take more than one generation for the family to actually feel native.

I wish that those cradle Catholics who haven't yet fully embraced their faith would. They'd have so much going for them that I don't. Holy cards, baptismal gowns, the Infant of Prague, how to greet a bishop, what to give for ordination presents, all of those things are part of their native tongue. I will probably always need a bilingual dictionary of some sort. Just as the neighbors across the street from us will never be "real Vermonters" I will never be a cradle Catholic. To the end of my life, I will always be a convert. Thankfully the Church has room for all of us. The doors are open wide and the more faithful kind of Catholic is thrilled to see us arrive. They may not always understand our enthusiasm, and they may be amazed that we seem to have read Catholic authors they've never heard of, but they are often inspired by us (or so they tell me). What I continue to pray for those culture Catholics is that they will one day embrace all the graces that came with their baptisms. I have the same prayer for people who joined the Church without fully embracing who She is and what She teaches. After all I've seen it happen to those kinds of converts before, I've seen it happen to those kinds of natives before. It's called grace.

Vinegar Update

Well, it really does seem to be doing the trick. We have had the occasional setback when someone put something into the dishwasher that caused the spray arm to get blocked or when it got overloaded, but, even then it's been the occasional glass with something on it, not every glass in the load. It does help if you make sure that neither side of the sink is closed (so no thawing meat in cold water while the dishwasher is running. In general though, although it still needs a degree of pampering, my dishwasher is finally doing its job.