Saving private me

I’ll preface this post by saying that I’m returning from a hiatus during which I produced another child. My children number two, but there might as well be 200. 
When you’re pregnant, so many people get to see your vulva that it almost becomes routine. Once you’ve had the baby, no amount of attempted discretion can prevent you occasionally flashing a nipple at a stranger while you’re breastfeeding. Your relationship with your body changes, and so does your definition of privacy. 
None of this prepares you for having a toddler. In the last week alone I have: showered in full view of 3 other humans, been asked by my preschooler “why my tummy looks like that” and received a round of applause for doing a poo. I could say the definition of privacy has changed for me but that it is still nebulous and ethereal, something about setting my own boundaries on a sanctuary etc etc but right now it’s passing urine, on a toilet, unmolested. 

We recently had to have the door of the downstairs toilet removed because of a washing machine debacle and our dear builder was very apologetic about the inconvenience this would cause us. My husband took an audible sharp intake of breath through his teeth at the prospect of having to traipse upstairs to do his private business. Not me. It didn’t occur to me until some moments later that the reason I was so unfazed was because it wouldn’t change a thing. Daytimes at home with my two kids necessitate a level of transparency to my most intimate goings on that would make a Big Brother contestant clutch his pearls. 

I’ll break here to say that despite nearly a decade of cohabitation my husband and I are very committed to our boundaries. The open door policy only applies to instances of solo parenting, which for me is the majority of the time. 
Really, it should have been during the course of my first pregnancy, when the checkout lady in the supermarket told me about her daughter’s cervix, that I should have surmised that something was up. That the routine rules of civilised discourse didn’t apply before, during or after the process of childbirth.

Don’t get me wrong. I’m no shrinking wallflower. I’m Greek. I’ve stood in line in front of elderly ladies in church. I’ve heard about their bunions, their husbands’ diabetic feet, their bowel movements. I’m a doctor, I actually encourage people to share with me their intimate bodily functions. But you have to draw the line somewhere, and strangers asking about the state of my nipples is where I draw mine.

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Saving private me

Breasts

Ah, breastfeeding. Few subjects are guaranteed to draw the ire of so many with the utterance of a single word. Most recently, Jamie Oliver managed to call upon himself the wrath of women across the land who felt he was not entitled to an opinion on what they should do with their breasts. I won’t deny, it’s a hugely complicated issue. 

It has not been long since some shocking data was published in the  Lancet confirming that the UK has the lowest rate of breastfeeding at 1 year in the world. 

Now, before I start picking things apart, I’m going to lay down some bedding of basic facts. There are a multitude of studies of varying quality that ascribe various benefits to breastfeeding. I’m not going to go into any of these individually because they muddy the waters terribly and because I’m sure most of you aren’t looking for a critical appraisal of all breastfeeding related papers. 

I could bombard you with guidelines, like the World Health Organisation advice that infants are breastfed (alongside a normal diet) for 2 years and beyond. Or the NHS advice that babies are exclusively breastfed for 6 months and that breastmilk forms the mainstay of their diet for the first year. But by the time we’ve got to that stage, the issue is already confused and people are angry and hurt.

Instead, I’m going to try and pare it back to the basics. 

1) As far as infant feeding is concerned (and I use the term infant feeding to describe the food ingested by infants and only that), breastmilk is superior to any alternatives. It contains a combination of nutrients and antibodies that are not reproducible in artificial feeding products. Some of these benefits (specific antibodies) are only produced by the suckling of the infant.

2) Can’t and won’t are different when it comes to breastfeeding, but does it matter? The proportion of women who can’t (and by that I mean that their bodies/breasts are physically incapable of feeding) breastfeed is actually very low. There are a limited amount of reasons for which a woman may not be able to breastfeed: drug therapy with incompatible medication (rare), previous breast surgery (may reduce milk production but unlikely to halt it completely), HIV infection, certain conditions of breast tissue growth (breast hypoplasia – rare). In the vast majority of cases, milk production is governed by a simple endocrine feedback mechanism that links suckling to production and it can/will be sufficient. 

3) It takes two to tango. Breastfeeding support powerhouse La Leche League use the term “the breastfeeding dyad”, which I find to be a useful and apt description. This means that there are two people participating in the breastfeeding relationship and that their rights should be respected and their “voices” heard. 

4)A mother’s decision not to breastfeed is hers to make. As mothers we are asked to make so many decisions about our parenting (increasingly so and increasingly publicly). This decision does not define us completely, just like the others don’t either.

5) Breastfeeding can be hard. And I don’t mean in a “ugh I’m watching TV and I’m hungry but I can’t be bothered to go to the fridge” way. It is a skill that has to be learned in the middle of a war zone of sleep deprivation, hormones and loneliness. No one’s breasts are available but your own. It can hurt. It can bleed. It can be hell (yes, it can be wonderful too). Babies are born into all sorts of circumstances, to all sorts of mothers. The love they receive is not defined by a single act. Breastfeeding and breastmilk may be the best thing for a baby in a world where babies existed in limbo, with no other factors or extenuating circumstances. But the moment the baby is born we can’t suddenly focus all our attention on its cute little scrunched- raisin face and forget all about the woman whose world this baby now is. Is this the best thing for the dyad? 

I hear the word ‘guilt’ thrown around like a sharpened dagger of accusation. Women made to feel guilty by the pressure to breastfeed. Women made to feel guilty about breastfeeding too often, too ‘ostentatiously’ (thanks Nigel Farage) in public, or for too long. 

Seriously?

 In which other sphere of parenting, apart from those reportable to social services, do we employ guilt? Here we have a situation where women who have scars borne of the same battles are going to war with eachother, backing up their arguments with the full force of the pain and frustration that the challenge of motherhood has given them.
I’ve been wading through this topic for long enough to take a step to the side and disclose a few further facts. I’m a doctor. I’m a mother to a 2-year-old, who I still breastfeed (increasingly infrequently, but weaning is a post for another day!). I have responsibilities in both of those roles, but they are hugely different.
As a mother, I am responsible for my child and for myself, and for ensuring that we are both happy and healthy. If I’m asked by another mum, I’ll happily give advice. 
As a doctor, I am responsible for providing patients with all the evidence-based information I have available, for knowing the limitations of my knowledge and when to seek help or advice to enhance it (this one’s actually in the GMC guidelines for good practice!) and for allowing them to then make their own decision based on that information. I can’t deny that it is my responsibility as a doctor to inform patients that breastfeeding is the gold standard and that breastmilk is irreplicable. Once I have done that, my duty is to support them in achieving this, but not against their wishes. I can address issues as they arise. I can seek support from other, specialist professionals. But if a mother makes a decision after being in full possession of the facts, undermining that decision insults her intelligence and competence as a parent.
To bring this opus to a close, I don’t have an answer.
It is hugely disappointing that the breastfeeding rates in this country are so low. I inhabit the real world (most of the time) and I understand that breastfeeding isn’t possible or appropriate for some women. It can’t be that the facts aren’t out there, because whilst some feel unsupported, others feel pummelled by information about how breastfeeding is superior to formula feeding. So I can only assume that whatever support we’re giving isn’t the right support and as a result we have women feeling bullied, marginalised, humiliated and despondent, whether they choose to breastfeed or not. We are branded ‘failures’ if we don’t, ‘breastapo’, ‘boob nazis’, ‘weirdos’ or ‘sickos’ if we do. So wrong have we got it that instead of focusing our energy on improving, we are raging against eachother in a vicious cycle that leaves the most important people, you and your baby, on the sidelines.

Breasts

Toddler defence tactics

It’s been quite a while since I’ve written and there’s no excuse, apart from having dropped into the black hole that is parenting a toddler. Recently I read that evidence had been found corroborating much of what had been surmised about black holes. I could have saved them the effort and money. Black holes are where time and sanity goes when you’re rearing a toddler wild child. They also contain every single children’s sock that has abandoned its pair, leaving it aching for its return. Which is to say all of them. 

There have been vignettes aplenty in the past months. Many of them frustrating but also hilarious and wonderful in equal measure. As my barely-contained wild child grows in physical strength, I am having to find new and inventive ways of circumventing his defence tactics. These are the strategies he uses to stymie me when I’ve asked him to do something and he feels he’d really rather do something else.

Below I provide a synopsis of his most successful tools:

The wet rag

This is your basic toddler refusal to be moved. All toddler defence begins with this age old tactic, doubtless modelled on scores of protesters across other noble revolutionary movements. Essentially, when someone tries to remove you from an area using physical means, you go completely limp. Behave as though you have been administered a potent and instant muscle relaxant. Like all the bones in your body have been removed. You will achieve a laws of physics- defying increase in your bodily weight. For your foes, it will be like trying to scoop up jelly with your bare hands.

The plank

This has nothing to do with motivational exercise programmes. Very much the opposite of the above method, this involves you making yourself completely rigid. This is best deployed if, my some miracle of nature, they manage to lift you out of the wet rag pose. It makes you very difficult to carry and usually necessitates you being hoisted underarm, like the latest flat pack from IKEA (probably pithily named ‘Hell’). This is not only exhausting for the carrier but also deeply huniliating. It normally draws tuts from onlookers and muttered words you may not have heard before from the lips of the carrier. 

The 12 limb flail

This is what might be, in some circles, called the ‘nuclear option’. Who knew one small human had so many limbs? Suddenly they’re appearing from every angle, making contact with every undefended surface of parental body. They key is to be completely unchoreographed and keep moving at all times. This one usually ends in the parent sitting down in defeat, sometimes weeping quietly, especially if it’s deployed in a public place.

There you have it. These methods have been used against me for a range of infractions ranging from daring to remove my son from an area of high vehicular traffic to cutting a sandwich into the wrong shape (the one he requested).

I think I need a lie down now.

Toddler defence tactics

About my son

I read an article today that got me thinking about the way I’m raising my son. 

I grew up in a country where casual sexism is alive and well. I was fortunate enough to be born into a liberal, financially comfortable family and as such, never had reason to believe that anything was out of my reach because I am female. I believe passionately in gender equality and am acutely aware that there are still places where women are stripped of their human rights and girls are born without a glimmer of hope to dream. I also know that within our ‘progressive West’ women have yet to achieve equality in the workplace and in their home lives. We cling to gender stereotypes like life vests, as if these outdated ideals will save us from a world we feel has gone hopelessly awry.

I know all this, and as a woman I recognise that the unprecedented freedoms I enjoy are as a result of the brave and tireless efforts of countless men and women, past and present, who do battle for my rights. 

And yet. This half-page article lit a wick of self doubt about some truths I felt were unassailable. Since reading it I’ve been made uncomfortable by the suspicion that I have fallen into a trap of lazy feminism that is borne of my favourable circumstances.

Allow me to explain. My son is white, middle class, male, the son of two doctors. By all accounts he should have no impediment to success in life. He should sail through to the profession of his choice. I’m ashamed to say that until this moment, it never occurred to me to worry about this. Then I read this article and thought about the sorts of choices he might make. If he was more interested in dance than in sports would he be called, in a heinous misappropriation of the word, gay? How many professions will he be subliminally steered away from or worse, not even be offered, because he is a boy? As a teenager, will he be branded dangerous, sex-obsessed, raucous? So often we deride the stereotypes of powerful, white, middle class males, but do we question why there is no urge for that group to diversify? 

I guess the patriarchy bites us all on the ass, eventually. 

We are increasingly frequently reminding young girls that their dreams, whatever they are, are theirs to define and completely attainable. I couldn’t agree more. But I hope this applies to my young son, too. 

I’m not naive to the extra legwork required to close the yawning gender gap that has (and continues to) undermined women for so long. But by focusing on the inequality of their successful adult counterparts, do we risk leaving young boys behind? Can we not offer them the same support to pursue their dreams, whatever those may be? 

Creating an environment where the choices of children are not at all encumbered by their gender is a key step to achieving true equality in the future. It’s important that we do this for girls, so that they learn that the shackles that bound their predecessors can be broken in a single leap. But we can’t, we mustn’t, forget the boys who risk behind drowned out by the history of the gender gap and need just as much encouragement to be their weird, unique, ambitious selves.

About my son

Forewarned is forearmed

You may think that having chosen the career I chose, I would thrive in an atmosphere of unpredictability. You would be wrong. I love the foreseeable future, planned outcomes and general order. I’ve never minded the volume of work when I’ve been on call, but I’ve often found the unpredictability of emergency admissions unsettling. Perhaps it is the use of treatment algorithms in medicine that attracted me. 

What better way to amplify my anxiety than to make my life subject to the whimsies of a tiny, capricious tyrant?

It’s a funny old thing, being put in charge of rearing a tiny human for whom you feel an abiding, aggressive love. On the one hand you want to please them always, to hear the unbridled cackle of their laughter. On the other hand, and this weighs on you heavily, you fear that without proper management you will guide them down a path of dysfunction, rendering them incapable of survival in an adult world. And so it begins, you try to apply reason and order to their world.

Allow me an example. Food is a recurring issue with parents, especially first-timers like me. Are they eating enough? Is what you’re offering good enough? Why are they refusing? And on and on. My toddler has just come out of a phase of obsession with apples. Obsession may be too mild a word. For the past few weeks he has eaten mostly apples, seldom seen without one in his hand, even sometimes wanting to hold one whilst he nurses to sleep. He developed his own hand sign for apple and, if he wasn’t grasping said fruit, would probably be signing for one. 

Suddenly, he stopped wanting apples. I’ve offered, but got a dismissive shake of the hand. This has got me thinking about the weird position I’m in, trying to fulfil his needs but not knowing what they are. Yes, you can subscribe to the school of “he gets what he’s given” and no, I wouldn’t keep offering him hundreds of things until I happen upon the right item. But it seems strange that we are frustrated (and I’m as guilty as anyone) by babies refusing to do as we want them to (sleep at a specific time, eat a specific food) when it would be considered inappropriate for us to do this to an adult. I’ve digressed somewhat but, for me, part of the stressful unpredictability of each day is not knowing if, or what, he’ll eat. I long for a time when I might say “shall we have chicken for dinner tonight?” And he replies “no thanks mummy, your chicken is terrible, I’d like beef instead”. Yes, I realise that conversations of this sort only occur in children’s books from the 1950s.

However, anything would beat the constant background fretting about “will he eat/reject/scream?” that follows me like a cartoon rain cloud all day, reaching fever pitch by dinner time as my inner voice screams “WHAT IS IT YOU WANT?”. In my more gracious moments, I feel sorry for him, helpless as he is, unable to communicate his desires to the person he looks to for all comfort. Then I remember my own mum’s sage words: “he probably doesn’t even know what he wants”.

The point of all this is that the profound lack of foresight and forewarning when you’re dealing with a toddler makes me very nervous. I try, borrowing a phrase from a lady who knows about adversity, to “let it go”, but I’m fundamentally not the sort of person who can stride confidently out of the front door with a toddler on my hip, armed with nothing but a bag of nappies and snacks and a sense of adventure. I wish I was.

Life has become about coping mechanisms and long, deep breaths. I’d love to write something about cherishing every moment like a precious jewel but that’s quite hard to do when you’re standing in the middle of Sainsbury’s with a toddler who’s thrown himself on the floor and has gone rigid, screaming about a personal insult you cannot perceive, when all you want to do is buy some fucking milk without an operatic performance. Stronger women (and men) than I would roll their eyes and shrug their shoulders and not translate this into a leaden knot that crouches in their stomach next time they have to venture out to the shops.

I don’t want you to think that I find all, or even most, of motherhood harrowing. There are plenty of moments of pure bliss, more than enough to compensate for the low points when I’ve had to pretend I didn’t mind him rejecting the 127th meal I cooked from scratch and ask for a breadstick. Sometimes I just watch him pottering around the living room and think about how unutterably amazing he is. Then I notice he’s trying (with some success) to push a biscuit into the playstation and it starts all over again. 

Forewarned is forearmed