Leave Mothering Decisions to Mothers

My 10-year-old is now one of the mellowest kids you could ever have the delight to interact with, but when he was an infant he was a fussy, colicky nightmare. He especially hated to get overheated—and he ran hot, so he would overheat all the time, especially when strapped to my wife in the baby-carrier. This was even the case in the Chicago winter, and so, to prevent screeching and encourage napping, my wife would often leave his hat off. This made him much more comfortable…but others were discommoded. Passersby would tell her earnestly that the baby needed a hat. People would even slow down and shout at her from passing cars.  Eventually she started telling folks who expressed concern about the hatlessness, "It's okay, I'm a doctor." She isn't a doctor, but it did get them to shut up.

The specifics of my wife's struggle against community headgear norms are somewhat idiosyncratic, but the general outline I think is probably familiar to many. The choices of pregnant women, and of the mothers of young children, are seen as being open for public debate and input, whether that input involves polite advice or open bullying. The advice/bullying is generally done in the name of science or health—put a hat on that baby or he'll get sick!  A couple of recent studies, though, undermine the case for some of the most common and enthusiastic rationales for telling young mothers what to do.

The first of these relates to drinking during pregnancy. It's well-established that binge-drinking or heavy drinking during pregnancy can cause serious developmental problems in children. However, there's a good deal of controversy around moderate drinking. Some doctors recommend complete abstinence—and so do many helpful friends and strangers when pregnant women dare to lift a glass in public.

A recent study by Janni Niclasen, a post-doctoral student at the University of Copenhagen, adds to the literature suggesting that abstinence does not necessarily ensure better health for the child. On the contrary, after looking at a large population study by the Danish Health and medicine authorities, Niclasen found that "the children of mothers who drank small quantities of alcohol [a little more than one glass of wine a week] during their pregnancies show significantly better emotional and behavioral outcomes at age seven compared to children of mothers who did not drink at all."

Niclasen attributes her findings to psychological and behavioral factors; mothers who drank during pregnancy tended to be better educated and healthier overall than those who didn't drink. Niclasen insists that "this is not an invitation to pregnant women to drink alcohol," and she's also been quoted as saying, “I really believe that even a glass of wine now and again is really damaging.” Certainly, as a researcher, her opinion matters—but at the moment, her contention that any alcohol has a major effect on child development appears to contradict the data she's found. At the very least, it seems like a pregnant woman could look at this study and make an educated, reasonable assessment that drinking a glass of wine on occasion isn't going to doom her child. And since the available data and recommendations are conflicting, if you see a pregnant woman taking a drink, no one is really in a position to tell her that she is immoral, or needs to stop.

If drinking is the issue du jour of pregnancy, once a child is born perhaps the biggest area of contention is whether or not to breast-feed. Another recent study adds some science to that debate as well. The paper in the journal Social Science and Medicine "compared siblings who were fed differently during infancy," and found that "breast-feeding might be no more beneficial than bottle-feeding for 10 of 11 long-term health and well-being outcomes in children age 4 to 14." The one case where there did appear to be a difference was in incidence of asthma, which was actually worse among breast-fed babies.

As Maggie Koerth-Baker argues at Boing Boing, the study doesn't necessarily show that women should stop breast-feeding or shouldn't try to breast-feed—among other things, formula is expensive, which is reason enough to make it easier for women in public spaces to breast-feed if that's what they want to do. But what the study does show, as Koerth-Baker says, is:

"For those of us living relatively wealthy lives in developed countries, whether or not we are breastfed is just one of many, many factors that affects our long-term health, behavior, and intelligence and there is at least some reason to suspect that breastfeeding may not be the most important of those factors."

Coincidentally, this is exactly what Niclasen's study of drinking shows. That is, it demonstrates that for those living relatively comfortable lives, there are many factors which affect child health, and drinking moderately during pregnancy is not necessarily the most important of those.

Koerth-Baker adds parenthetically at the end of her piece that "the lack of nuance about the science of breastfeeding in public discourse can really do a number on a new mother's psyche." That lack of nuance, it seems, extends well beyond breast-feeding, to include such topics as alcohol consumption and hat-wearing.  One thing we know for sure, though, is that stress isn't good for anyone. Given that, and in light of these studies, I suggest that if you see a parent bottle-feeding a baby, or out in the cold carrying that baby without a hat, the best thing you can do for the long-term health of all parties is to leave them alone.