The secret to marital bliss is not to have kids. That’s the pop psych story for the day, which I found on MSNBC.

I’d add to that–if you want to stay happily married, don’t do shift work. It sort of cuts into your time together. Then again, working shifts may mean so little time together, that when you accidentally bump into eachother, it’s like honeymoon bliss all over again.

Of course, you can’t take the MSNBC article too seriously. It’s talking about the results of an 8 year study, involving 218 couples. Not exactly a huge sampling of people. What I think would make more sense would be to really do a large survey, and find out actual divorce rates and such.

Hope the Easter bunny brought you lots of chocolate, and more chocolate, and more chocolate. No worries, chocolate is the new health food.

A nursing student was expelled for posting evil things on MySpace.  My first reaction was that the school was being really anal and trying to relive the myth of nursing students being angels-of-mercy-in-training. You know, they don’t do bad things like MySpace or post about subjects that might indicate a lack of celibacy.

But it seems that this nursing student is missing several screws. She posted about her patients on MySpace, apparently under her real name, and named her school. She can blog all she wants, but she is violating patient privacy even without specifically naming the patient. It can be easy to trace it back to who she is referring to. And I have to say, if she is being this dumb now, what is she going to do once she becomes a nurse? Blog about her employer, give the name of the hospital and discuss the patients she takes care of (let’s hear all about Mr. G’s incontinence).

This has nothingto do with freedom of speech but with patient privacy issues. If she blogged, for instance, about her patients but didn’t name the school she goes to and disguised the incidents and didn’t mention where they took place, then that would be one thing. Or if she blogged under a pseudonym, as a lot of nurses do. But this is different, sorry to say.

This is just an addendum to my posting the other day about the perils of the breast pump. Well, I should say the tie in to the NY Times article about the breast pump. But I found one of the comments rather provacative, and really, it says it all.  The breast feeding wars–like what is that about?  How truly inane are we becoming?

A lot of ideological wars going on around birthing and motherhood give me as much a feeling of freedom as being told to wear a burka. Exclusive breast-feeding for a year or more is one of them. The women who insist that we cannot be good mothers if we do not follow this edict are as repressive as the men who said women should not be in a boardroom or in combat positions.

I couldn’t have said it better. There is so much more to raising a happy, healthy, well-adjusted child who will hopefully become a productive and law abiding member of society than the amount of time you breastfeed, if you breastfeed exclusively for one year, or if you breastfeed at all.

Nurses should definitely try to guide new moms in their decision making, but it is not the nurse’s place to attempt to force an opinion, or try to make a new mom feel guilty or like she’s failing her baby if she doesn’t breast feed (yes, I’ve seen some of those). There’s more to it than just a breast and a baby.

As in breast feeding. Disclaimer–I really have no feelings about breast feeding either way–you want to breast feed, fine. You don’t, fine. There’s a lot more involved to raising a child over the next 18 years than on the mode of early feeding.

So why am I bringing up breast feeding, unless its to begin another never ending Mommy war. Well, Judith Warner wrote what I consider a rather amusing article in the NY Times called Ban the Breat Pump. Yeah, I know. The article would make the better-starve-than-eat-forumla fanatics go wild, but I thought of it as a sort of joke. She made some interesting points, but I can’t really believe that she is serious about banning breast pumps.

However, an interesting point was made in one of the 487 comments (yes, people do get impassioned over breast feeding). She pointed out that there is nothing special about breast feeding because it is “normative.”

What a revelation. And that’s all it is. It is the normal way of feeding a baby. Just a cat nurses its kittens, a horse nurses its foal, so a human mommy nurses her baby. And it’s a no-brainer that formula just isn’t going to be the same because its synthetic–however, babies that are formula fed grow up to be just as healthy as breast fed children. There are a lot more factors involved in overall child health and wellbeing, than weather the baby was breast fed or not.

But let’s go back to normative. Yes, that’s all it is, a normal way to feed a baby. Breast feeding is not going to make your child brilliant, not bestow super health upon him, not prevent allergies, and not prevent health problems in later life.  Breast milk provides some advantages over formula, but some of the studies that have been done and the mis-interpretation about breast feeding has made it almost into a cult.

First, the study that said breast feeding made children smarter. Please, did someone find that breast fed children has a few points higher on an IQ test? And did they factor in the child’s environment into that? I find the data shakey at best, but the bottom line is that every breast fed child is not going to suddenly develop the brain of Albert Einstein. Consider this–until fairly recently, like the early 20th century, almost all children in the U.S. were breast fed or fed by a lactating nanny. In much of the developing world, children are still primarily breast fed. The boob was the main source of nutrition for infants since the human race began.

So were we all brilliant? Were there no mediocre people in the golden age of breast feeding?

Of ocurse not. Proper nutrition is essential for a growing infant and child, but breast feeding alone is not going to guarantee entrance to Harvard. Or a Fulbright scholarship.

Next, there is also a belief that breast feeding imparts a protective shield around the baby, and wards off germs of every caliber. I don’t know how many calls we used to get when I worked in the NICU, from parents of our former inmates, who “couldn’t understand” how their baby had managed to catch a cold.

“But I’m breast feeding,” Mom would wail into the phone. “How can my baby be sick?”

It might have something to do with taking a sxi week old baby into a crowded mall during Christmas season, where the germs are thicker than flies circling a garbage dump.  But many parents were truly shocked that a breast fed baby could get sick, or get jaundiced, or fail to be reading Tolstoy and doing intermediate algebra by age 18 months.

Antibodies are passed from mother to baby, which gives a little bit of protection to the infant. But that’s all it is. Certainly, if breast feeding provided an impenetratable shield against microbes, then infant mortality would be almost non-existant. Those tales of the high death rate of infants who succumbed in scourges such as pneumonia, meningitis, measles, diphtheria, influenza, scarlet fever, pertussis, rotovirus, etc, in the days before good hygiene, vaccines, antibiotics, and intravenous fluids would just be a myth.

The myths and legends go on. Not only will breast feeding protect your baby against microbes and make him a genius, but it will also protect him in later life–against all sorts of chronic diseases. Another story is that breast feeding will get a new mom back into shape in no time. Well yes, you do use up more calories if you are nursing, but those extra 100 pounds aren’t going to vanish into breast milk unless you start eating a healthy diet and getting exercise.

So the point of this story is that breast feeding is a normal method of feeding a human child. In many ways it is healthier, since you are giving your baby the food that he was meant to be eating. It is also easiest on the digestive tract. But that’s the extent of breast feeding. It is not a magic serum or elixir, a miraculous fluid that will determine the baby’s future. It’s milk. That’s it. And there are many many other factors that go into raising a child.

Killer McCarthy

Now I’ve seen everything. Here is a website called the “Jenny McCarthy Body Count” and it blames her for all children in the US who have come down with an illness that is preventable by vaccine, and all deaths due to vaccine preventable illnesses. Now I realize that vaccination has been a hot button issue for many people, especially with the controversy over the HPV vaccine, but come on. Get a life.

The website was put up anonymously (come on, you feel so strongly about it then show your face), and puts up reproduced data from the CDC on morbidity and mortality. Note, and this is important, that the CDC data is just a table. It gives absolutely no information about the patients or their circumstances. While it might be quite true that the reason for the illness or death is due to the fact that the parent is opposed to vaccines, and as far-fetched as it may be, perhaps this parent was mesmerized by Jenny McCarthy and decided to ‘mimick her idol (including posing for Playboy), there is a good chance that its not the reason for most cases.

However, there are multiple reasons for the lack of vaccine protection, which the owner of this shadowy website doesn’t seem to have considered:

1) the vaccine may have been ineffective–yes, it does happen. Vaccines fail to “take.”

2) the child may have been unable to receive proper vaccination due to allergies to vaccine components

3) the child may be immunocompromised and unable to receive some vaccines

4) child may be otherwise ill with any number of serious conditions, and unable to receive vaccines

5) child may have recently immigrated to the US, and may have already been infected upon arrival

6) child may be recent immigrant, and family doesn’t understand vaccine policy, know that they are available, or whatever. It’s not like there is a great primary care health system in place in this country, and many immigrants are isolated

7) family situation may not be very conducive to child’s welfare, and parent is neglectful. This type of situation has nothing to do with any opinion about vaccines or Jenny McCarthy. In fact, in some case, the kid is lucky if he gets something to eat, let alone vaccinated.

child may have had a severe reaction to a vaccine, and parent is fearful and distrustful that all vaccines may cause a reaction.

9) May have received vaccines but immunity has waned. This is particularly true for the pertussis vaccine, and it has now been firmly established that immunity from that vaccine may be gone by the early adulthood or even late teens.

These are reasons that some children go unvaccinated, or not fully vaccinated, and it has nothing to do with any particular ideology, or a particular person, including Jenny McCarthy. But the anonymous website master wrote:

In June 2007 Jenny McCarthy began promoting anti-vaccination rhetoric.  Because of her celebrity status she has appeared on several television shows and has published multiple books advising parents not to vaccinate their children.  This has led to a dramatic increase in the number of vaccine preventable illnesses as well as an increase in the number of vaccine preventable deaths.

Has Jenny McCarthy been responsible for a “dramatic increase” in in the number of vaccine preventable illnesses as well as an increase in the number of vaccine preventable deaths? If so, then why does this person’s list only go back 2 years, to June 2007? Can we have a look at the number of cases prior to 2007, so as to make an intelligent comparison?

Also, there is not a steady climb in the death rate from June 2007 until March 21, 2009 (those are the beginning and end dates as of today). There seems to be a cluster of cases from early Feb 2008 to early April 2008, and then the number drops down. Then it climbs a little for March 2009. So it is uneven.

Now, the poster contradicts him or herself:

Is Jenny McCarthy directly responsible for every vaccine preventable illness and every vaccine preventable death listed here?  No.  However, as the unofficial spokesperson for the United States anti-vaccination movement she may be indirectly responsible for at least some of these illnesses and deaths and even one vaccine preventable illness or vaccine preventable death is too many.

He/she admits that McCarthy isn’t directly responsible, and may only be indirectly responsible for some of them….but yet, still has assigned McCarthy the title of unofficial spokesperson for the anti-vaccination movement. Uh, I hate to be a party pooper, but having worked in maternal/child health since the 1980s, I can assure all of you, that questioning vaccine safety did not begin with McCarthy. There have been very vocal critics of vaccine policy for the past 2 decades, who were out there on center stage writing books, getting press coverage, putting together websites as the Internet became popular–way before McCarthy ever gave birth. So trying to pile the body count on her conscience is just silly. And as I said above, there are numerous reasons other than an anti-vaccine stance why kids may not be getting all their shots.

Finally, while it is sad that anyone should get sick or die if it could be prevented, the numbers are extremely low. In two years, there were 142 deaths, which is 71 a year. Considering the amount of children (and the ages aren’t given on the CDC report for most categories so some of these may be adults/teens whose immunity has worn off!), it is a tiny percentage of the population. Even the 720 who became ill and survived, over a 2 year period. Still exceedingly low.

I really don’t have time to go searching through data right now, but it would be nice if the poster would put up some numbers prior to 2007, so we can see if the numbers did increase. And even if it is true, there are many reasons for it, other than Jenny McCarthy. I think the poster is giving this woman more credit than is due–I have barely heard of her, I had no idea what she thinks about vaccines, and I tend to think that for the majority of people living in this country, her opinion is of no consequence.

Let the hurricane blow, and get rid of the last of the Bush doctrines and policies. Especially when it comes to reproductive/maternal-child health. Blow the Bushies to the Andromeda galaxy. The U.S. is finally getting its head out of the sand, and embracing science and public health, rather than some distorted pseudo religious doctrine that seems to think genocide against women and infants is a-ok. I know, I’ve said it before, but I’ll say it again–Mr. “Pro-life” alias ex-president Bush, the man who fought to preserve pre-life in the petri dish and claimed to oppose abortion was actually the cause (the policies that he invoked) of several million abortions during his 8 years in office.

Anyway, the dork is gone, and the U.S. is on a path to redeem itself.

PRESS RELEASE

U.S. Shows the World it is a New Day in its Support for Universal Access to Sexual and Reproductive Health and Reproductive Rights
Center for Health and Gender Equity Applauds Renewal of U.S. Global Leadership

(New York, NY)–Late yesterday, the U.S. government decisively broke from its recent past by reaffirming its “deep commitment” to “universal access to sexual and reproductive health and the protection and promotion of reproductive rights” at the 42nd Session of the Commission on Population and Development, at UN headquarters in New York.  Women’s health and human rights advocates joined with world leaders in praising the U.S. statement.

“This bold affirmation of comprehensive sexual and reproductive health services and reproductive rights is a breath of fresh air for women and girls worldwide,” said Serra Sippel, executive director of the Center for Health and Gender Equity.  “By rejecting the political games of the past eight years that used women’s health and rights as pawns, the Obama administration has clearly proclaimed a new day.”

Advocates were particularly pleased by the U.S. renewed commitment to life-saving, comprehensive approaches, including voluntary family planning “that provides full information and respects the client’s choices;” complete services during pregnancy and skilled care for birth; and linking HIV/AIDS activities with sexual and reproductive health, “given that 60-percent of people on PEPFAR-supported antiretroviral treatment are women, many of whom are in their reproductive years.”

The U.S. also called for a broad international effort “to provide comprehensive, accurate information and education on sexuality [and] sexual and reproductive health for women, men, girls, and boys as they age and their needs evolve.”  This is particularly striking as it breaks from the previous administration’s restrictions on full information, such as its preference for abstinence-only programming in PEPFAR and its imposition of the Mexico City Policy, which limited information flow between health providers and their clients.

“We congratulate the Obama administration for its sophisticated, global perspective on these issues.  With half a million women dying each year due to pregnancy and childbirth, and HIV growing rapidly among women and girls, we cannot afford to delay action,” Sippel urged.  “We now look to Congress and the members of the administration to make the U.S. commitment to effective, comprehensive, and rights-based approaches to sexual and reproductive health a reality for women and girls around the world.”

The full U.S. statement is available here: http://www.usunnewyork.usmission.gov/press_releases/20090331_064.html

For more information on the importance of comprehensive approaches to sexual and reproductive health and rights and U.S. policy see http://www.genderhealth.org/pubs/foreignassistancereform.pdf.