©iStockphoto.com/kate_sept2004

If you are among those who think hunger is a condition that exists only in poor countries—remote parts of the world with limited resources—think again. Although the United States is one of the world’s wealthiest nations, one in four U.S. children goes to bed hungry one or more nights each year—a condition defined as food insecurity. Nearly 20 percent of children in seven U.S. states and the District of Columbia live in households without adequate food supplies. And with summer just around the corner and school lunch programs coming to an end, the situation is about to get worse.

Administered by the United States Department of Agriculture (USDA) the National School Lunch Program provides low-cost or free lunches to more than 30 million children a day nationwide—children from families with incomes at or below 130 to 185 percent of the poverty level. But what happens to those children when the school year ends?

In 2009, among families with children seeking services at emergency feeding sites, 62 percent participated in the National School Lunch Program and 53 percent participated in the School Breakfast Program, but only 14 percent participated in the Summer Food Service Program. Research shows that children who go hungry during the summer months are less likely to perform well once school begins. Hunger affects not only their ability to learn but their overall health and development. It increases the risk for slower growth and brain development, fatigue and concentration issues, psychosocial and behavioral issues, and much more.

The Summer Food Service Program—designed to fill that nutritional gap—provides over two million students with breakfasts, lunches, or snacks during the summer months. It currently serves just over six percent of students in need of summer meals. It’s a start. But what happens to the rest of the children in need of food?

Enter companies like Revolution Foods which serves 50,000 meals a day to participating schools during the school year and which plans to serve 7,000 families a day this summer at two feeding sites. “Our students are the neediest out there. Eighty percent are free-lunch students, precisely the students who are unable to access federally-subsidized lunches, breakfasts, and snacks during the summer,” says co-founder Kristin Richmond.

Unfortunately, there aren’t enough organizations and companies like Revolution Foods with the means to provide healthy meals for children year round. According to the USDA, low participation in the Summer Food Service Program is due mainly to a lack of feeding sites. The lack of sponsors (usually non-profit organizations) is due in part to organizations feeling the pinch of the recession. The end result is that many more children are at risk of going hungry this summer.

The right stuff
To compound the issue, it’s not just about getting enough to eat but about getting the right stuff to eat. According to Revolution Foods, U.S. children currently get 50 percent of their calories from added fats and sugars. It’s no wonder today’s generation are predicated to be the first to die at a younger age than their parents due to obesity-related health issues.

Revolution Foods, in partnership with Whole Foods and other natural food providers, serves students in participating schools only all-natural foods. Their meal plans offer affordable breakfasts, snacks, and lunches to kids who need it most—communities with the highest obesity rates and the lowest income levels. The results speak for themselves—participating schools report higher attention levels in the classroom, less disciplinary problems, and sustained weight loss among its students.

Now more than ever, parents need to introduce healthy meals at home and support healthy food plans in their schools. As a nation, we need to invest in federally-funded health education and food service plans to make the right foods more affordable and accessible—to all children—year round. Congress is scheduled to reauthorize child nutrition programs this September. Meanwhile, the senate is sitting on the Healthy Hunger-Free Kids Act 2010, which would offer an additional $4.5 billion to child-nutrition programs over the next 10 years and require new nutrition standards for all food served in schools. The time to act is now. Kids shouldn’t have to wait.

Click here to learn more about the Summer Food Service Program and how you—or an organization you know—can become a sponsor or feeding site for children this summer.

“I dreamed I was having milk,” Tommy said, his voice shaking a little. “And I’m so glad because I love having milk!”

“Having milk” was what my 3-year-old son called nursing, an activity we had ended three weeks ago. And he was still talking about it.

“Um, are you thirsty?” I asked. “Would you like some water?”

He said he would, so I stumbled out of bed while he climbed into it. It was still very early and we snuggled together for a while after he drank his water. He didn’t mention breastfeeding again that morning.

But he hasn’t stopped talking about it completely. Every once in awhile he’ll bring it up. He has started a new thing, too: lifting up my shirt just a little bit to passionately smash his face into my bare stomach. He calls it “hugging my belly.” I wonder if he misses the skin-to-skin contact of nursing. Or maybe he just really likes squishing his face into my post-baby belly. It probably feels like a giant pillow to him.

In any case, every wistful mention of “having milk”—whether he means it or is just playing around—feels like a punch in my gut. Every time, I wonder if weaning was the right choice, if he had been ready. If I had been ready.

To be honest, he technically weaned himself, although I had gently pushed him in that direction. He had only been nursing in the mornings, often when I was half-asleep, and I was fine with that. But my son was gigantic and gangly, several heads taller than any other child his age, and his idea of cuddling while nursing was becoming painful and annoying. Also, I could tell my milk supply had significantly decreased, to the point where I wondered if he got anything at all some days. I was ready to bring this journey to a close.

So we talked about it.

“You know,” I said, “My body is making less milk now. Soon it will stop making milk completely. But that’s OK, because you don’t really need it anymore, do you?”

“Nah,” he said, but it was hard to tell if he was listening.

“I think you’re going to stop nursing soon,” I said. “Are you OK with that?”

“Yeah,” he said.

My husband planned to take Tommy out of town for a few days, just the two of them. It would be the first time I’d ever slept away from my son. The reasons were numerous—they’d visit family; I’d finish a big writing project in peace—but the obvious idea was that weaning would actually happen.

We talked about that too.

“You’re not going to have milk when you’re in Savannah, you know,” I said. “And when you come back, I’m not going to be making any more milk. Are you OK with that?”

“Oh, yeah,” he said.

But then, two days before they left, he stopped nursing by himself in the morning. He asked me, “Have you stopped making milk?”.

I didn’t know what to say, but finally settled on, “Yes.” I felt half-deceiving, half-truthful. This was a kid who decided on his own that Santa didn’t exist, and when he asked us, we confirmed it. We had always been honest with him.

“Can I have some soy milk in a cup?” he asked. He didn’t sound upset at all.

And so they left. And I finished my writing project and enjoyed the wonders of a quiet house. While they were away, my husband said he mentioned “having milk” just once—he said “it made him a little sad” to stop, but he didn’t seem very affected as he said the words. In fact, he had a great visit with his Nana, who happily indulged my son’s desire to spend hours watching boats on River Street or the cogs and gears of taffy-pulling machines in the candy shops.

I thought he’d forget about breastfeeding completely, that he wouldn’t mention it to me after his return. Isn’t that what you read? The kid stops nursing and a day or so later, the memory of ever having done it all is wiped clean from their young, malleable minds. Life goes on. Breastfeeding becomes a sweet memory.

Not my kid. Every once in awhile, he’ll wake up in the morning, clamber into our bed (if he’s not there already) and say, dramatically, “Oh, I wish I could have milk.” (His pathos disappears upon an offer of water or almond milk, leading me to believe he’s simply thirsty and slightly manipulative.) Occasionally at bedtime, when it’s my turn to tuck him in, he’ll mention it again—despite the fact he stopped nursing at night ages ago.

I was talking on the phone about this to a friend recently, about weaning and guilt and wondering whether I did the right thing. She told me something very clear that I heard even over the din of my son hollering in the background: A lot of mothers who wean—whether it’s at 3 weeks, 3 months, 3 years—wonder and worry. They aren’t sure if they could have done more. They second-guess themselves. Instead, why not frame it like this: This is how it happened. This is how you weaned your son.

So, this is how I weaned my son. I breastfed him in the hospital right after his birth, marveling at his quiet alertness. I breastfed him in those early weeks, when I was so sleep-deprived that I was miserable and wondered what I had done to ruin my life so thoroughly. I breastfed him when I finally knew that no, it had not been a mistake, that I loved this small creature more than life. I breastfed him through teething and illness and first steps and first words. I breastfed him until we stopped breastfeeding.

And that’s how it happened.

©iStockphoto.com/Floortje

Natural. Pure. Wholesome. Good. Those are the words that come to mind when I see the “USDA organic” seal. At a time when we are all more mindful of the dangers of pesticides and chemicals in the foods we eat, it’s reassuring to see the small green-and-white emblem that means you don’t need to worry–this product is natural and good for you.

However, a recent ban of synthetic fats commonly found in some organic products raises serious questions about such thinking. A statement on the ban was recently issued by the United States Department of Agriculture (USDA), and will impact infant formula and other foods that contain the synthetic additives widely known as DHA and ARA. As reported by the Washington Post last year and last month, these synthetic oils were added to a list of non-organic ingredients allowed into organic products through a decision by a Bush administration official after discussion with a formula industry lobbyist and over the objections of several USDA employees who had determined such action a violation of federal standards. Deputy Secretary of Agriculture and organics expert Kathleen Merrigan acknowledges that the synthetic oils should not be allowed in organic foods. New guidelines will be developed by the USDA. The process will include a 60-day period for public comment, and could take a year or longer.

What does this mean for parents?
The changes that result from the USDA’s decision may be noticed first by parents who feed their children formula, since the synthetic oils currently are added to nearly all infant formulas. In fact, except for some prescription formulas, the Cornucopia Institute notes that “only one over-the-counter formula is available without synthetic DHA/ARA.” Every other formula on the market includes them. The USDA’s decision ensures that more infant formulas will be available without DHA and ARA.

While the USDA does not, in its statement, challenge the safety of the additives, others do. For years, the Cornucopia Institute and the National Alliance for Breastfeeding Advocacy (NABA) have questioned the appropriateness and safety of adding these substances to infant formula and other foods.

Its report, “Replacing Mother – Imitating Human Breast Milk in the Laboratory,” is an examination of the synthetic oils from production to inclusion in formula, a caution about reports of side effects experienced by infants who consume them, and a look at relevant federal policies.

Why include DHA/ARA in formula?
DHA and ARA are polyunsaturated fats naturally found in human milk. In recent years, these fatty acids have received heightened attention in both the laboratory and the media as a result of ongoing controversy about healthy levels of fish intake for pregnant and breastfeeding women. Authorities have agreed that the fatty acids are important for brain, neural, and eye development; as discussion turned to how much DHA and ARA pregnant and breastfeeding women should consume for their infants’ health, formula companies saw a marketing opportunity. If they included synthetic versions of these oils (manufactured under the names DHASCO and ARASCO) in infant formula, the companies could assuage parents’ concerns about their baby’s development while suggesting that formula is “as close as ever to breast milk.” As noted in a Martek investment promotion from 1996 (and quoted in the Cornucopia Institute’s report), “Even if [the DHA/ARA blend] has no benefit, we think it would be widely incorporated into formulas, as a marketing tool and to allow companies to promote their formula as ‘closest to human milk.’”

In fact, leading formula manufacturer Mead Johnson admits on its Enfamil website that numerous scientific studies have shown little or no benefit to infant development, lending support to the theory that inclusion of these oils is just a marketing gimmick—much like the inclusion of prebiotics.

Unfortunately, it seems to be an effective gimmick. The percentage of people who agreed that “infant formula and breastfeeding are equally good ways of feeding an infant” doubled from 12 percent to 24 percent between 2003 and 2004, when the formula companies began advertising their supplemented formulas.

What is the cause for concern?
There are several causes for concern about the synthetic DHA and ARA added to formula and other foods and beverages.

First, parents should be aware that even though their infant formula may be labeled “USDA organic,” the process by which these additives are made is about as far from natural as possible. Martek Biosciences Corporation, extracts the oils from fermented algae and fungus with the use of a synthetic solvent hexane, a neurotoxic chemical. It’s possible that hexane residues evaporate before the oils are consumed, but according to the Cornucopia Institute’s report, tests have shown that hexane residues do appear in some edible oils. We don’t know the effects of hexane on health, but organics experts feel that the process would cause the National Organics Standards Board to deny the inclusion of these synthetic fats on the list of allowable additives to organic foods. Fats produced in this way hardly sound like the sorts of things parents who are shopping organic want to feed their children.

Second, the Food and Drug Administration (FDA) has not affirmed the safety of the synthetic oils, noting that “[s]ome studies have reported unexpected deaths among infants who consumed formula supplemented with long-chain polyunsaturated fatty acids … attributed to SIDS, sepsis or necrotizing enterocolitis. Also, some studies have reported adverse events and other morbidities including diarrhea, flatulence, jaundice, and apnea in infants fed long-chain polyunsaturated fatty acids.”

Unlike the natural DHA and ARA in breast milk, many infants are unable to digest the synthetic oils. The FDA has received what NABA Executive Director Marsha Walker calls “scores of reports on the adverse effects of these ingredients,” in which infants experience gastrointestinal symptoms ranging in severity from vomiting and diarrhea that cleared up when the baby switched to a non-DHA/ARA formula to severe dehydration and seizures that required hospitalization. Still, infant formula manufacturers have resisted calls for the addition of “warning labels” to product packages. As a result, parents cannot make informed decisions about the risks of DHA/ARA formula relative to other feeding options, and they often don’t know that their children’s health problems can be solved by switching to a formula without these additives.

Recommendations
What can parents do?

• Be aware of the risks. If you are feeding your child a formula that contains DHA and ARA, keep an eye out for possible gastrointestinal problems such as vomiting or diarrhea. If the symptoms persist, talk with your baby’s doctor about switching to another formula, but know that there are few DHA/ARA-free formulas available.

• Report adverse effects. Be sure to tell your child’s pediatrician about any problems. Also, enter your experience into the FDA’s Adverse Events Reporting System.

• Share information with other parents. Across the board, parents whose children experience adverse effects of the formula say they had no idea that could be the cause. Until the FDA decides to require warning labels we can spread the word to other parents, so they can be aware too.

• Contact policymakers. The USDA will have a 60-day public comment period before it issues its final guidelines about the inclusion of additives in organic infant formula. Let the USDA’s decision makers know what you think on this topic. In addition, leading DHA/ARA manufacturer Martek Biosciences has already indicated that it will petition the National Organic Standards Board to allow the fatty acids into organic food.

• Contact formula and food manufacturers. Tell them you purchase only products that do not include these synthetic fats. If your family members have suffered side effects from the ingestion, talk about that; if you object to the manufacturing process, explain that. Since companies want to manufacture products that will sell, they should listen to consumer feedback.

• Breastfeed! If you want to provide your baby with DHA and ARA, there is no safer way than from human milk.

©iStockphoto.com/raycan

Breastfeeding should be an equal opportunity experience for all women, but for many, breastfeeding is a missed opportunity. While many factors contribute to a woman’s decision to breastfeed—support at home and from health care providers, a woman’s work environment, the media and its perception of normal infant feeding, and misinformation about the effects of formula feeding—the decision to breastfeed isn’t always black and white. Or is it?

Research
A recent report by the Centers for Disease Control and Prevention (CDC), found that non-Hispanic black women in the U.S. were least likely to breastfeed compared to other racial groups.

Results
Using data from the National Immunization Survey—an on-going telephone survey conducted nationwide—among those surveyed, 75 percent initiated breastfeeding, 42 percent breastfed for six months, and 21 percent breastfed for one year. Hispanic women were most likely to initiate breastfeeding (80 percent); followed by non-Hispanic whites (73 percent); and non-Hispanic blacks (54 percent).

“What we saw across the U.S. were lower breastfeeding rates among non-Hispanic black women in all but two states [Minnesota and Rhode Island],” says Kelley Scanlon, epidemiologist at the CDC, who supervised the study. “In the last 20 years, differences in breastfeeding initiation rates between non-Hispanic black and white women have narrowed, however differences in breastfeeding duration have not. When you think of improving the duration women breastfeed, you think of support received in the hospital, when returning home, and to work—hospital practices, social support, and worksite support. We’re trying to understand more, so we can better address disparities in breastfeeding with our strategic plan.”

Data suggest that there may be experiences unique to non-Hispanic black women that contribute to their decision to bottle-feed:

• Lack of culturally relevant information and images of non-Hispanic black women breastfeeding.

• Perceptions that breastfeeding is inferior to formula feeding or conflicting messages about breastfeeding.

• Need for non-Hispanic black women to return to work sooner, where, until recently, support for breastfeeding was often insufficient.

• Lack of social or partner support.

In 2003-2004, in an effort to glean what women knew about breastfeeding and what their early experiences with breastfeeding were like, Erika Reed-Gross and her colleagues at Westat conducted focus groups with low- and middle-income African-American women in three southeast cities. Their findings support the theory that African-American women, though well informed about the benefits of breastfeeding, receive little information about how to breastfeed. The women surveyed reported a lack of support in the hospital, citing limited access to lactation counselors and ready access to free formula. Despite an expressed desire to breastfeed, they indicated that they were rarely counseled about breastfeeding after birth and that their babies were often supplemented with formula.

According to Reed-Gross, the issue of low breastfeeding rates among African-American women extends beyond racial lines. It’s a socioeconomic issue, a cultural issue, a childrearing issue. Reed-Gross’ findings identify two factors that may explain the low breastfeeding rates among African-American women: lack of comfort with the idea of feeding their child in public (some women stated that their communities, families, and churches were not supportive of breastfeeding in public); and lack of support for breastfeeding beyond 8-10 weeks citing concerns that their babies would be spoiled or too attached. Some women were taught that a child should learn self-reliance, especially when a mom returns to work or school. Says Reed-Gross, “For African-American groups, privacy concerns and values around childrearing merit more research and discussion.”

Recommendations
In December 2009, the CDC hosted a meeting where experts, including Reed-Gross, explored possible reasons for the racial disparities.

“We don’t have the answer,” says Scanlon. “We brought together these experts to try to understand why disparities in breastfeeding persist. What we do know is that we have strategies for promoting breastfeeding in all populations; we just don’t know if the practices are equally reaching all populations. We promote strategies for improved hospital practices, worksite support, peer support, education for new mothers, and media and social marketing. The question is, are there certain strategies we are missing?”

Whether or not a strategy is missing, one thing is for certain: non-Hispanic black women in the U.S. need more support for breastfeeding, starting in the hospital. Although lack of hospital support affects all women, Reed-Gross points out that there is research beyond this study and these focus groups to suggest that African-American women in particular receive little hospital support and may be the most harmed by this lack of support because for many African-American women, there is less support when they leave the hospital and return home to offset the negative experiences in the hospital.

“As a group, these women had negative experiences in the hospital and that had a deleterious effect on their experience breastfeeding at home,” says Reed-Gross of her focus group. “A lot of women had issues with breastfeeding and felt they had nowhere to turn. ‘Am I doing this right?’ ‘How frequently should I feed?’ ‘Who do I call for help?’”

Programs like The Baby-Friendly Hospital Initiative (BFHI)—a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF)—foster environments where breastfeeding is the norm, in all communities and all states, among all ethnic groups, across the nation. BFHI assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies. Though data collection regarding the impact of the BFHI on breastfeeding rates in the U.S. has just begun, some studies show positive results.

Researchers at Boston Medical Center have reported that during the implementation of the BFHI, breastfeeding rates among U.S.-born African-American mothers rose from 34 percent to 74 percent in 1999.

The BFHI is a start, but with the majority of hospitals not BFHI-compliant (there are currently 91 Baby-Friendly hospitals across the U.S. and only one in the southeast), there is a lot more work to do. As a nation, we need a heightened awareness not only of the benefits of breastfeeding but of the information and support all mothers need to initiate and continue breastfeeding for at least the first year of a baby’s life. Without adequate support, even the best of intentions are unlikely to be realized.

©iStockphoto.com/THEPALMER

Let’s Move! is the rallying cry of the new nationwide campaign to address childhood obesity. Launched in February 2010 and spearheaded by first lady Michelle Obama, this campaign aims to “eliminate the problem of childhood obesity in a single generation.” It’s an ambitious goal, considering that over just the last few decades, childhood obesity rates have more than tripled, increasing from 5 percent in 1980 to 17 percent in 2008. Currently, almost one in three children is overweight or obese.

Although its name emphasizes activity, Mrs. Obama notes that the campaign relies on a multi-faceted approach where attention to food may even exceed that given to activity. The campaign is centered around four core goals:

• Offer parents the tools and information they need to make healthy choices for their kids.
• Get healthier food into schools.
• Ensure that all families have access to healthy, affordable food in their communities.
• Increase opportunities for kids to be physically active, both in and out of school.

Accomplishing these goals will require a great deal of help from federal government agencies, state and local leaders, private companies, and the public sector. Help shouldn’t be hard to find; a wide variety of entities—ranging from the American Academy of Pediatrics (AAP) to the No Child Left Inside coalition to the National Parent Teacher Association (PTA) recognize the problem. One group has even called it “a threat to national security.”

What’s more, Let’s Move! has a ready-made collaborator in the Partnership for a Healthier America, a foundation launched for the purpose of “support[ing] the First Lady’s cause [of fighting childhood obesity] by encouraging, tracking, and communicating commitments to healthier lifestyles from partner organizations.”

Let’s Move! in action
In February, President Obama signed a memorandum creating a Task Force on Childhood Obesity to include representatives from the Department of Interior (DOI), Department of Agriculture (USDA), Department of Health and Human Services (HHS), Department of Education, Office of the First Lady, and other agencies. The Task Force conducted a review of all programs and policies related to child nutrition and physical activity to “develop a national action plan that maximizes federal resources and sets concrete benchmarks towards the First Lady’s national goal.”

Plans are already in place for each of the four goals, as detailed on the White House and Let’s Move! websites:

• Offering parents the tools and information they need to make healthy choices for their kids involves empowering consumers, having parents receive guidance from pediatric health care providers, launching a major new public health campaign, revamping the current food pyramid site, using the USDA’s new database to create change, and maintaining the LetsMove.gov website.

• Getting healthier food into schools means reauthorizing the Child Nutrition Act with an $10 billion budget increase, doubling the number of schools participating in the Healthier U.S. School Challenge, encouraging school food suppliers, the School Nutrition Association (SNA), and other national school organizations to meet Challenge standards.

• Ensuring that all families have access to healthy, affordable food in their communities means eliminating so-called “food deserts” (areas without grocery stores or access to healthy foods in convenience markets) and increasing farmers’ markets.

• Increasing opportunities for kids to be physically active, both in and out of school involves updating the Presidents’ Physical Fitness Challenge and Active Lifestyle Awards, creating a Safe and Healthy Schools fund, and involving professional athletes from twelve leagues (e.g., NFL, WNBA) in the Let’s Move! public awareness campaign.

To think, this is just a start! Imagine what we’ll see when the campaign really gets moving.

Concerns about Let’s Move!
Although everyone supports good health, some have voiced concerns about the program.

Most notably, the campaign has been criticized for its emphasis on obesity. Some critics say the campaign essentially places a target on fat kids. As Deb Burgard, one of the founders of the “Health at Every Size (HAES)” model for treating weight and eating concerns, writes on her blog, these critics feel that “the initiative is framed as a way to eliminate the fat kids.” Writing candidly in Newsweek about her lifelong struggles with weight, food, and physical activity, Lesley Kinzel agrees that the emphasis of the campaign ought to be on healthy eating and regular exercise which, together, “work to make a body—any body—feel good, even if they don’t result in weight loss.”  Similarly, CNN reporter Claudia Garza revealed obesity-related bullying she suffered from her own parents, and experts agree such incidents are not uncommon. These concerns seem to be supported by a recent article in the NY Times in which Gretchen Reynolds notes that the connection between exercise and weight loss is a complicated one, particularly for women. Furthermore, Dr. Regina Benjamin, Surgeon General of the United States, chooses to emphasize a positive approach to the topic. Her first paper in her role as U.S. Surgeon General is entitled not “The Surgeon General’s Vision for an America with No Childhood Obesity,” but rather “The Surgeon General’s Vision for a Healthy and Fit Nation.” Referring to childhood obesity at a recent health conference, she noted that she focuses on the “positives” of “health and fitness” rather than the “negatives” of “illness and obesity.”

Finally, Megan McConville, urban planner and blogger on TheCityFix.com, notes that the campaign seems to lack urban planning and design considerations. Targeted active community design strategies can make big differences in children’s ability to walk or bike to school safely, community members’ ability to engage in urban farming, residents’ ability to access grocery stores selling healthy foods via public transportation, and children’s access to available open play space.

Tips for parents
As parents, we don’t need to wait for the Task Force to decide on a national plan before we take action in our own homes to ensure our own children’s health. Here’s what we can do today:

• Select healthy foods and beverages for our children. Avoid sugar-sweetened drinks in favor of water and milk. Read labels on food packages, paying attention to ingredients and serving sizes. Cook with fresh foods, rather than pre-packaged goods as often we can.

• Encourage physical activity. Limit passive time spent watching television or playing video games, and encourage kids to play outside. Unstructured play is great; school-age children may also enjoy after-school activities or community athletics.

• Keep an eye on what schools are serving. Mrs. Obama notes that between school lunch and breakfast programs, many U.S. schoolchildren are getting more than half of their daily calories at school. Pay attention to the school menus, and talk with other parents and school administrators to address anything that concerns you, such as high sugar or salt content, lack of fresh fruits or vegetables.

• Talk to your children’s health care providers. See how your child measures on child growth charts. (For breastfed children, refer to the World Health Organization’s child growth standards.) Discuss the body mass index; similar to athletic adults, children who are athletic and muscular may have deceptively higher BMIs.

• Eat well and play, too! Remember that parents are natural role models for their children. Favoring healthy foods and engaging in regular physical activity (whether taking nightly walks after dinner, kicking the soccer ball around with your child, or heading out to the gym) send an important message for lifelong wellness—and that’s something we all want our children to learn.

In Bangladesh, only 1 in 10 births occur in a clean environment and with the aid of a skilled healthcare provider. The result: a maternal mortality rate of 1 in 51.

In sub-Saharan Africa, where the maternal mortality rate is 1 in 22, less than one-third of women have contact with a healthcare worker during or after birth.

In Tanzania, a woman in labor walks five miles to a clinic because she has no money to pay for care at the hospital. Staffed by one nurse and one midwife, the clinic offers limited care and resources. Workers at the clinic tell the woman her only chance for survival is a hospital birth. Turlington Burns’ film crew intervenes and arranges to transport the woman to the hospital—a ride that typically costs $30, more than this woman’s family earns in an entire month. With proper care, she safely gives birth in the hospital to a healthy baby boy—a happy ending that is, far too often, a rarity in many parts of the world.

Every minute, a woman dies from complications related to pregnancy or childbirth—resulting in the death of more than half a million women each year (the vast majority in Asia and sub-Saharan Africa), making reproductive health issues the leading cause of death among women of childbearing age.

The United States ranks 41^st in maternal health and spends more money on healthcare than any other country in the world—as much as $86 billion annually on pregnancy and childbirth related hospital costs. Still, the risk of maternal death is greater in the U.S. than in 40 other countries, including virtually all industrialized nations. In the last 20 years, maternal mortality rates in the U.S. have doubled from 6.6 deaths per 100,000 births in 1987 to 13.3 deaths in 2006. Given that there are no federal requirements for reporting maternal deaths, this number may actually be higher.

Prevention
Experts estimate that 90 percent of maternal deaths are preventable. According to the world’s leading non-governmental organizations, most maternal deaths could be prevented if there were adequate equipment and supplies, transportation in rural areas, money to pay for proper care, and skilled health workers. Half of all women in the world give birth at home without a skilled attendant.

According to the United Nations Population Fund, family planning is also a key component. Annually there are over 200 million pregnancies worldwide—and nearly one-third are unintended, resulting in 50 million induced abortions, 20 million unsafe abortions, and close to 70,000 maternal deaths. An estimated one in three lives could be saved if women had access to birth control measures. In countries such as China, Cuba, Egypt, Jamaica, Malaysia, Sri Lanka, Thailand, and Tunisia, significant declines in maternal mortality have been achieved through a combination of simple yet critical interventions that include access to: family planning, skilled birth attendants, and backup emergency obstetric care.

Access to health insurance is another strategy for reducing maternal mortality. In the U.S., one in five women of reproductive age is uninsured. Without affordable health insurance, access to care is limited and maternal mortality rates remain unacceptably high. In an effort to highlight the urgent steps needed to reduce maternal mortality in this country, Amnesty International offers 10 key recommendations in their report, “Deadly Delivery: The Maternal Health Care Crisis in the USA.” Among the recommendations:

• The U.S. government must ensure that all women have equal access to timely and quality maternal healthcare services—including family planning services—and that no one is denied access to healthcare services by policies or practices that have the purpose of discriminating on grounds such as gender, race, ethnicity, age, indigenous status, immigration status, or ability to pay.

• Federal, state, and local governments should ensure that an adequate number of health service facilities and health professionals—including nurses, midwives, and physicians—are available in all areas. Particular emphasis should be given to medically underserved areas.

• The Department of Health and Human Services should, in collaboration with affected communities and the medical community, develop and implement comprehensive, standardized, evidence-based guidelines and protocols for maternal healthcare services.

• Washington, D.C., and each of the 29 states that do not currently have a maternal mortality review committee should establish one. Committees should receive ongoing funding to collect, analyze, and review data on all pregnancy-related deaths and address disparities.

Solutions
The Millennium Development Goals–5 (MGD–5) set a target of reducing maternal mortality by 75 percent by 2015. Unfortunately, MGD–5 has made little progress to date. The objectives of No Woman No Cry is to increase awareness of maternal mortality, encourage women to become active participants in their fundamental human right to give birth safely, and urge lawmakers to fund these efforts. No Woman No Cry will be screened for an audience of leaders and representatives from 20 countries at the G8 in Canada—the premier forum for international economic development—in hopes of encouraging a dialogue on preventable maternal deaths.

The film ends by reminding viewers that during its 60-minute running time, 60 women died from pregnancy or birth-related complications. If you are among those who, like Turlington Burns, believe that maternal health is a human right, let your voice be heard.

Choose toys wisely: Avoid phthalates found in soft plastics (like teethers and rubber ducks). ©iStockphoto.com/cujo19

Mom’s job is to protect baby. Feed him, clothe him, keep him warm and dry. Buy the safest toys and the healthiest foods. I thought I was doing plenty by choosing organic food and BPA-free bottles. As it turns out, that wasn’t enough. By digging deeper into the countless products that surround all of us, including our children—common household products, even—it is evident the list of harmful chemicals is exponential. Thankfully, this month, one U.S. senator introduced legislation to reform our nation’s outdated policies on the control of toxic substances and create a more comprehensive policy that truly protects our health and our environment.

How chemicals affect us
In the past 30 years, environmental health studies led researchers to conclude that chemicals in our homes are contributing to the rise of chronic diseases and are intimately connected with childhood cancers, asthma, infertility, birth defects, and learning disabilities. According to the U.S. Center for Disease Control and Prevention (CDC), 133 million Americans are now living with such diseases and conditions, which account for 70 percent of deaths and 75 percent of U.S. healthcare costs.

Safer Chemicals, Healthy Families—a national diverse coalition of more than 200 organizations and 11 million individuals including the American Nurses Association, The Autism Society, Greenpeace, and Seventh Generation—cites chronic disease is on the rise and linked to chemical exposure:

• Leukemia, brain cancer, and other childhood cancers have increased by 20% since 1975
• Asthma rates have doubled between 1980 and 1995
• Since 1982, the incidence of difficulty conceiving and staying pregnant has nearly doubled in women between the ages of 18 and 25

This isn’t to say that chemical exposure is entirely responsible for the increase, but the coalition argues that it is a contributing factor. And as if our health and safety weren’t enough, according to the coalition, by reducing the nation’s exposure to toxic chemicals, the U.S. will also lower its cost on healthcare significantly. They estimate even a 0.1% reduction in exposure would translate into a savings of $5 billion each year.

How chemicals affect our world
Passed in 1976, the Toxic Substances Control Act (TSCA) regulates the amount and kind of chemicals used in Americans’ everyday lives. Under the current policy, the Environmental Protection Agency (EPA) can only intervene after evidence mounts to demonstrate a chemical is dangerous. Therefore, in the last 34 years, the EPA required testing on only 200 of the over 80,000 chemicals produced and used in the U.S. To date, just five (5!) chemicals have been restricted. Additionally, more than 60,000 chemicals that were on the marketplace prior to the TSCA being signed into law were approved without testing requirements. As the law stands now, chemical manufacturers are not required to demonstrate product safety before entering the marketplace; instead, the government has to prove actual harm before controlling, replacing, or denying a dangerous chemical.

“America’s system for regulating industrial chemicals is broken,” says U.S. Senator Frank R. Lautenberg (D-NJ) in his official press release. “Parents are afraid because hundreds of untested chemicals are found in their children’s bodies. EPA does not have the tools to act on dangerous chemicals and the chemical industry has asked for stronger laws so that their customers are assured their products are safe. My ‘Safe Chemicals Act’ will breathe new life into a long-dead statute by empowering EPA to get tough on toxic chemicals.”

The Safe Chemical Act of 2010 aims to finally flip the backward way the U.S. government protects its citizens from harmful chemicals. This legislation will finally overhaul the outdated and irresponsible regulations.

Among its provisions, the Safe Chemicals Act issues these protective requirements:

• Provides the EPA with authority to determine the safety of any chemical entering the marketplace
• Requires chemical manufacturers to prove the safety of their chemicals and to make health and safety information publicly available
• Ensures chemicals meet a safety standard—one that would protect pregnant women and children alike
• Takes immediate action on restricting the most dangerous chemicals—such as formaldehyde, vinyl chloride, and flame retardants
• Establishes programs to foster the development of safe chemical alternatives

Protect your family today
The U.S. government will start making a shift toward control over our toxic chemicals, and groups like Safer Chemicals, Healthy Families will continue to raise awareness on the issue at the national level. Every parent can raise awareness in their own homes. Healthy Child Healthy World offers these five steps for reducing your children’s exposure to toxic chemicals and keeping your kids safe:

1. Manage pests safely. Use only non-toxic, pesticide-free products indoors and out. Prevent pests through good sanitation and food storage. Remove shoes and wash hands after playing outside to prevent 70 percent of the dirt and chemicals that can be tracked indoors.
2. Use non-toxic products. Buy gentle, natural soaps and body care products, avoiding those that contain with toxic synthetic preservatives (parabens), petroleum-based ingredients, and other proven harmful chemicals. Furnish your home with products made of natural, organic, and reclaimed materials, without VOC, water-based adhesives, formaldehyde, or polyurethane.
3. Clean up indoor air. Make sure your furnishings are made of natural products, from fabric and carpeting to material glues to paint and wallpaper. Use non-toxic techniques to scent your home, forgoing chemical fragrances for orange or lemon slices boiled in water on the stove.
4. Eat organic. Organic food is grown without potentially harmful, long-lasting synthetic chemicals and reduces the pesticides in our bodies. If you can only be organic sometimes, avoid foods with the highest pesticide residues (or make sure to buy these foods organic): apples, cherries, imported grapes, nectarines, peaches, pears, red raspberries, strawberries, bell peppers, carrots, celery, green beans, hot peppers, potatoes, and spinach.
5. Reduce use of plastics. Petroleum-based plastics can leach harmful chemicals into foods and drinks. Choose smart plastics that contain polyethylene and polypropylene, and avoid putting anything plastic in the microwave or the dishwasher, which can cause them to break down and release toxins.

Join the Million Baby Crawl (over 25,000 crawlers to date!) to show your support of toxic chemical policy reform.

The business license application was nearly complete. The only thing missing was the company name. The clerk was growing impatient, so I quickly chose Daddy, Mommy and Me , mainly because it described my target audience—moms, dads, babies. Amy’s Baby Company was chosen in desperation after I was forced to abandon Daddy, Mommy and Me. Legally I knew it was mine. Financially I couldn’t afford to defend it. Lesson learned—register any future name. At the time, I thought Amy’s Babies was an obvious choice; until I was asked on more than one occasion if we sold babies. However, I think all will agree, we saved the best for last. baby gooroo truly says it all—who we are; what we do; why we do it. We’re gurus—individuals with expertise in all things baby, especially breastfeeding. We give parents knowledge and skill so that they too can become a baby gooroo. We do it because babies are worth it.

Even though our name has changed, we have stayed true to our mission of giving parents the knowledge, skill, and confidence they need to keep their babies healthy and safe. Statistics show that U.S. breastfeeding rates have increased steadily since 1972. The Centers for Disease Control and Prevention (CDC) reported that 74% of children born in 2006 were breastfed shortly after birth, but only 13% were breastfed exclusively for six months. In an effort to help parents realize that breastfeeding is the healthiest way to feed a baby, baby gooroo is taking a fresh approach—provide a safe space for new moms and dads to come with questions and leave with the knowledge they need to make confident parenting decisions for themselves and their children.

In an effort to expand our online presence, baby gooroo has hired a new Editor in Chief for babygooroo.com, Allison Micarelli-Sokoloff. Allison brings a wealth of knowledge and experience to the position, having served as managing editor/consultant for a wide variety of print and web-based publications including cookiemag.com, parents.com, and The Knot.

Under Allison’s capable leadership, babygooroo.com is poised to become a leading online resource where parents and health professionals can access timely, accurate, and balanced information on breastfeeding and child nutrition—a site that is not only respected and trusted, but interactive and engaging—a site that truly meets the needs of today’s parents. And thanks to social media networks such as Twitter, Facebook, and Tumblr, accessing our information has never been easier.

In the coming months baby gooroo will introduce a variety of new products. We will be releasing new editions of each of our books (BREASTFEEDING, A Parent’s Guide is currently on the press!). And we will also be launching a line of baby products including burp cloths, bibs, hats, towels, and washcloths featuring our signature animal designs and factoids about their nutritional growth and development. You can find these items and more in our online store.

We’re incredibly excited about the future of baby gooroo and we hope you will consider becoming a gooroo, too.  STAY TUNED as baby gooroo prepares to take some giant steps!

Tip: Choose toys with parts larger than one-and-three-quarters inches in size, about the diameter of a toilet paper roll. ©iStockphoto.com/jaroon

Two-and-a-half-year-old Sam wants to do everything his older siblings do. He wants to play with the toys they play with. He wants to eat the foods they eat. He wants to handle the coins they do. As a parent, I know that is not always the best (or safest) decision. After all, choking caused by food, coins or toys is a common form of injury and death among children. It is the fourth most common cause of accidental death in children and, for those under one year, it is the most common cause. Approximately every five days, a child in the U.S. chokes to death while eating, and more than 10,000 emergency visits are due to choking on food by children 14 and younger. The risk of choking is highest among young children, with nearly 75% of choking episodes occurring in children under the age of three.

In a new policy statement, Prevention of Choking Among Children, the American Academy of Pediatrics (AAP) highlights the risks and provides recommendations for parents, health care providers, and regulatory agencies.

Parents
To a large extent, children’s environments are created by their parents and other caregivers. It should come as no surprise that the AAP emphasizes the responsibility of parents to recognize and reduce risks.

•    Parents should be especially wary of hot dogs, which, according to a widespread study, accounted for nearly one in five food-related choking fatalities among children under 10 years of age. Generally, it is good practice to cut food into small pieces for children.

•    Parents should choose developmentally appropriate foods. For example, young children lack the necessary grinding motion for hard, smooth foods (such as raw vegetables) until about age four. (For more specifics, check out Dr. Sears’ list of risky foods.)

•    Parents should always supervise their children when they are eating and encourage them to chew completely before swallowing.

•    Parents should never allow their children to run and play while eating.

•    Parents should avoid latex balloons, which have been associated with more than a quarter of choking deaths among children younger than 14 years old. Uninflated balloons and pieces of broken balloons can conform to the child’s airway and form an airtight seal.

•    Parents should check for small parts when selecting toys for their children. Choose toys with parts larger than one-and-three-quarters inches in size, about the diameter of a toilet paper roll.

•    Parents should keep their home clean, since young children explore their environments by putting even non-food items in their mouths. Coins, paper clips, and other small objects may cause choking.

•    Because accidents and emergencies do happen, parents and other caregivers should take an infant/child CPR class that includes instructions about what to do if their child is choking.

Health care providers
Too many parents never think about choking prevention. Many do not understand the full scope of their children’s physical development (e.g., the anatomical development, gagging reflex, chewing and swallowing abilities) and how it relates to choking. Health care providers, coming into contact with infants/children and their parents on a regular basis, are in the perfect position to educate parents on this important topic. The AAP urges health care providers to include discussions of choking prevention in health care visits.

•    Infant and child health care providers (including pediatricians, dentists, nurses and others) should provide choking prevention guidance to parents regularly, addressing foods, toys and the home environment.

•    Health care providers should discuss which foods children are able to handle at different ages and developmental stages.

•    Health care providers should address parents’ questions about toy selection and remind parents to be cautious about small toy parts, particularly those their young child may access because of an older sibling (e.g., advanced Lego blocks, Barbie doll shoes).

Regulatory agencies
The AAP details specific recommendations for the federal agencies charged with regulating toys and foods, namely the Consumer Product Safety Commission (CPSC), the Food and Drug Administration (FDA) and the Department of Agriculture (USDA). These recommendations aim to reduce children’s exposure to risky products. Several emphasize assessment and surveillance, since choking-related incidents have been poorly recorded. Many choking events, while dangerous, are transient and do not result in health care visits. Even when they do result in an emergency room visit, the specific cause may not be logged; for almost 10% of the choking incidents found in the national injury surveillance system, the cause is unknown. As a result, our understanding of the scope of the problem has been limited.

•    The FDA should establish a process for assessing and addressing food-related choking risks, including enhanced surveillance and public education, including warning labels on foods that pose a high risk.

•    The FDA’s authority should extend to choking risks of all foods, including meat (currently under USDA jurisdiction).

•    The CPSC’s national injury surveillance system (NEISS) should collect more information about food-related choking.

•    The CPSC should increase efforts to identify toys that pose choking risks and ensure they have appropriate warning labels.

•    The CPSC should work with manufacturers to improve recalls of products that pose choking hazards.

•    The CPSC should increase efforts to prevent the resale of recalled items via online auction sites, such as eBay.

Keep kids safe
Regulatory changes may be a long time coming; it’s hard to imagine the all-American hot dog being reintroduced in a new shape. Even if such changes do pass, toys and foods that pose risks to our children may still make their way into our stores. It is a relief to know that there are many steps that parents and caregivers can take to reduce children’s risk of choking. Many are common sense, and all take relatively little effort. Parents can check age-recommendation labels when shopping and be aware of small pieces when selecting toys. Recognizing that food can pose at least as great a choking risk as toys, parents can start by educating themselves on the risks, preparing and cutting up foods as needed, and keeping a watchful eye during dinnertime and playtime alike.

To encourage the support of the AAP’s recommendations for additional surveillance and assessment of risky products, parents can contact state and federal legislators or regulatory agencies—CPSC, FDA, and USDA—directly. Go for it!

©iStockphoto.com/ArtisticCaptures

Both you and your baby are going to sleep terribly, possibly for months, so you might as well get used to the idea.

But don’t freak out—this is totally normal. All you have to do is make sure everyone lives through this tumultuous time. Pretend there’s a zombie war going on outside and your priority is basic survival. Do whatever it takes to stay alive. Believe that this too shall pass.

For those of you in the midst of intense sleep deprivation, you would probably like to take your computer and throw it at my head right now. No one wants to be told “this too shall pass.” You want immediate solutions that will make your baby sleep so you can feel like a person again. Trust me, I know; I’ve been there.

And it’s not enough that you’re tired; you’re likely terrified that even minute bedtime choices will ruin your kid for life. Over 30,000 people responded to a Babycenter.com poll about toddlers sleeping in their parents’ bed, and it turns out that 44 percent answered that their children “almost always” co-sleep. When asked how they felt about it, 26 percent said “I love it,” but 43 percent called it “not ideal.”

Are adults who like to co-sleep doing something wrong? Some sleep experts say yes. There are plenty of sleep advice books out there, but they all offer different advice when it comes to getting your child to sleep.

So what do the authors of the leading sleep advice books have to say, from stern Ferber to groovy Pantley and a few others in between?

Richard Ferber, Solve Your Child’s Sleep Problems (Fireside, 1986, 2006)
If you’ve heard someone talk about “Cry It Out” (or CIO, or “Ferberizing”), that person is talking about the technique developed by Richard Ferber, director of the Center for Pediatric Sleep Disorders at Children’s Hospital Boston. With CIO, you basically let your child scream his or her head off for specified, timed increments (which grow gradually longer over a few days’ time) until he or she finally figures out you aren’t coming and gives up (or passes out). I’ve always associated this approach with distraught parents who dread bedtime and their screaming children they feel forced to ignore. Once upon a time as a nanny, I was instructed to use this method at naptime for the children under my care, and let me tell you, it was no picnic (although it sometimes—not always—worked).

I was prepared to read “Solve Your Child’s Sleep Problems” with a derisive eye, already knowing that my parenting style didn’t jive with Ferber’s method. However, I discovered his technique, especially as explained in an updated edition of the book, isn’t quite as rigid as I had thought.

“Simply leaving a child in a crib to cry for long periods alone until he falls sleep, no matter how long it takes, is not an approach I approve of,” Ferber writes in the 2006 preface. “On the contrary, many of the approaches I recommend are designed specifically to avoid unnecessary crying.”

He calls his technique “progressive waiting” that encourages frequent (but somewhat detached, I thought) comforting throughout the process.

More helpful in the book is his section on helping your child learn new sleep associations–different ways to find comfort and go back to sleep after nighttime wakings. After all, it’s normal for both children and adults to wake during the night. Ferber suggests using a “transitional object” (like a favorite blanket) for comfort.

He also says that having a regular daytime schedule will help set a reasonable nighttime schedule, and that you must choose your child’s bedtime and keep it consistent.

What about co-sleeping? Well, the 1985 edition is clearly against the notion. “We know for a fact that people sleep better alone in bed,” he writes. (Is he suggesting that parents sleep in separate twin beds, like Rob and Laura Petrie on “The Dick Van Dyke Show”?)

“Sleeping in your bed can make your child feel confused and anxious rather than relaxed and reassured…If you allow him to crawl in between you and your spouse, in a sense separating the two of you, he may feel too powerful and become worried,” he writes. I confess I laughed out loud at that part, as I suspect many parents who have co-slept would. I wonder what an actual psychologist might say about that (maybe I should ask my father, a retired psychology professor who had no worries when I routinely slept with my parents as a child).

Ferber also insinuates that co-sleeping parents might have a screw loose. “If you find that you actually prefer to have your child in your bed, you should examine your own feelings carefully,” he writes, suggesting that such a desire hints at underlying selfishness or other issues that may require “professional counseling.”

Yet again, the 2006 edition has some changes to it, suggesting a more laid-back Ferber. Co-sleeping children, he writes, “are not prevented from learning to separate, or from developing their own sense of individuality, simply because they sleep with their parents. Whatever you want to do, whatever you feel comfortable doing, is the right thing to do, as long as it works.”

Elizabeth Pantley, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night (McGraw-Hill, 2002)
The No-Cry Sleep Solution for Toddlers and Preschoolers (McGraw-Hill, 2005)
Pantley is like the anti-Ferber. Your first clue is title: “No-Cry” and “Gentle.”Another clue is that she calls CIO “mutual agony,” noting that babies are totally dependent and cry to remind you they have biological needs that need attention.

As someone who champions co-sleeping (as long as you follow safety precautions) and has practiced it herself, Pantley is a favorite among followers of attachment parenting. However, she does not advocate constant tending at the expense of your own sleep.

She talks about “sleep association,” in which babies associate (and feel they need) certain things with falling asleep. Pantley says she nursed one of her children to sleep for at least a year, and disagrees that it’s a negative sleep association (as the other sleep authors discussed here propose).

“It is probably the most positive, natural, pleasant sleep association a baby can have,” she writes in “The No-Cry Sleep Solution.” “The problem with this association is not the association itself, but our busy lives. If you had nothing whatsoever to do besides take care of your baby, this would be a very pleasant way to pass your days and nights until he naturally outgrew the need. After all, this is natural. You may not even see this as a problem, in which case it is not. It’s all a matter of your perception and your personal needs.”

She does acknowledge that “few parents have the luxury of putting everything else on hold until their baby gets older,” so she recommends gradual (not cold turkey) changes, namely ending a feeding session when the baby is drowsy but still awake.

In her The No-Cry Sleep Solution for Toddlers and Preschoolers, there’s an entire section called “The Nighttime Nursling.” In it Pantley sings breastfeeding’s praises, explains why a toddler might still want to nurse to sleep (and why parents may not want to give it up either), but suggests options like ending a nursing session gradually (following the blueprint laid out in her book the “Sleep Solution” ) and creating new routines. She even has advice on how to continue co-sleeping without breastfeeding.

“If your child is getting enough sleep, you are all sleeping well, and the people who live in your home are happy with the way things are working out, then nothing needs to be fixed, regardless of what anyone else has to say about your family’s sleeping solution,” she writes.

Kim West, The Sleep Lady’s Good Night, Sleep Tight (Vanguard Press, 2010)
In the interest of full disclosure: a photo of my son appears in this book and is used with permission.

Now that we’ve got Ferber and Pantly out of the way, this book is pretty middle-of-the-road, appealing to those who are wary of both CIO and co-sleeping. West, a licensed clinical social worker, seems more lenient with co-sleeping, but you can tell she’s not a huge fan (one of her chapters is called “Whose Bed Is It Anyway?”). If you invited West and Pantley over for a slumber party, Pantley would braid your hair and enthuse about co-sleeping bonding, while West would be at the foot of the bed saying, “Well, if it works for you, but…”

She’s coined a catchy phrase for her approach: The Sleep Lady Shuffle. It’s similar to CIO in that there are timed intervals of interaction, and the goal is to detach yourself from your baby as he cries—but you stay in the room for much of it. Over a series of nights, you move your position within the room closer to the door, using minimal touches to comfort the child, until you eventually find yourself outside the door.

She recommends against nighttime feeding entirely at a certain point. “One of my hardest tasks is convincing mothers that most healthy six- to eight-month-old babies on a normal growth curve don’t need to eat at night,” she writes.

Alison Scott-Wright, The Sensational Baby Sleep Plan (Transworld Publishers Ltd, 2010)
I recently read a very favorable Telegraph review for this book, so I thought I’d check it out. Scott-Wright, a former maternity nurse, sounds like a lovely woman who is well-liked by those who say they have found salvation through her help.

Alas, the actual sleep plan is nothing ground-breaking,and most of the book is devoted to infant feeding and consistently offers false information.

Scott-Wright makes a big deal about not vilifying women who are unable to or choose not to breastfeed, a sentiment with which I completely agree. But she goes to rather astonishing lengths—sometimes making statements that completely contradict research and what we have long known to be scientific truth—to make the point that formula feeding is actually preferable to breastfeeding.

“We all know, and are certainly told often enough, that ‘breast is best,’ but in my view it is better to adopt an approach that can be adapted to your lifestyle than to restrict yourself to a method that you may find difficult to maintain,” she writes. “I promote and support breastfeeding, but never to the detriment of mother or baby.”

Later, she lists seven benefits to exclusive breastfeeding (101 reasons can be found here), but 11 benefits to “Breastfeeding and expressing breast milk” and 13 to “Exclusive formula feeding.”

Some of the listed benefits to exclusive formula feeding are simply untrue, or are unsubstantiated opinions. We know that breastfeeding mothers do not have more dietary restrictions (she even includes a list of foods that “seem to cause problems,” including citrus fruit and curries). We know that breastfeeding mothers do not necessarily feel like “feeding machines.” We know that babies with reflux do not respond better to formula (good grief!) or that formula relieves a mother of “physical and emotional strain” (Um…ever hear of prolactin?). And it’s completely wrong (and dangerous, I feel) to suggest that formula-fed babies receive “more lasting satisfaction.”

Elsewhere, she suggests putting newborns on a breastfeeding schedule of 2-3 hours. She also includes recommendations on weaning, starting as early as 4 weeks of age. She devotes several pages to the common woes of breastfeeding problems, then writes, “It is a shame in today’s society that formula-feeding, when used in preference to breastfeeding, is almost frowned upon.” Research promoting breastfeeding over formula is “flawed,” she writes, right before several pages on how to choose bottles and nipples, making bottle-feeding sound absolutely fantastic—as if magical genies await your command to sterilize bottles and mix powder in the middle of the night. Dreamy!

Honestly, this book sets back breastfeeding promotion, I don’t know, let’s say a million years.

I really would like to say something positive about this book, but it takes three chapters to even get to what the “plan” is, and it appears to simply be a feeding schedule, which for newborns is every three hours during the day and every four hours during the night (with recommendations to supplement with formula by week two!), which again is counterproductive to establishing breastfeeding.

Near the end of the book, Scott-Wright addresses “sleep training,” which I assumed would be something along the lines of cry-it-out. But her sleep plan consists of creating a calm, quiet atmosphere, feeding the baby, putting him or her to bed and saying good night. If necessary, go back in to the room to reassure the baby, tell him good night again, and walk away. There are no timed intervals. If the baby cries, she simply advocates  doing the same thing over and over again until it works.

In other words, it’s the kind of common sense “sleep training” that doesn’t require a book to explain it.

So, whose advice should you follow?
When I mentioned on Facebook that I was working on this article, I immediately got comments from very tired parents, pleading for information that would help their babies and toddlers sleep better… and several almost apologizing for their babies who slept through the night, no Ferberizing required, by three months.

I wish I could give you the definitive advice that will help your baby sleep better, but that’s impossible. Some advice makes sense—like having a consistent and early bedtime routine—but when it comes to selecting cleverly named sleep plans, methods of inching your way out of your kid’s room, or your comfort level for hysterical screaming, only you can choose what works for your family.

You could pick and choose the bits and pieces you like the best— a little Ferber here, a little Pantley there. To paraphrase a friend, “use what works and leave the rest.”

Remember my initial analogy. There are zombies out there, and you have not yet succumbed—no, you will not succumb. You will survive! When the tanks come in to blow off the undead’s heads, you’ll still be there—cozily tucked up in your bed, fast asleep. Just keep telling yourself that.