Book Talk: Sleep Choices

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Photo Credit: Lori Cole

Photo Credit: Lori Cole

I’m working on the sleep chapters of my book right now. I had originally planned one sleep chapter, but I’m realizing that it’s such a huge topic that it needs to be split into two chapters: one on the question of where baby should sleep and one on sleep strategies and sleep training.

I have been focusing on the question of bedsharing for the last several weeks. I have read the major studies associating bedsharing with SIDS and suffocation and studied the professional opinions of those recommending against bedsharing from a public health perspective. I have also read the studies coming from James McKenna, Helen Ball, and others that take a more holistic view of bedsharing. These authors talk about bedsharing as the cultural and physiological norm for human infants, particularly in the context of breastfeeding. They advocate for a more tempered view of bedsharing safety, one that recognizes that all bedsharing situations are not alike and that, though not proven, it is certainly possible that a safe bedsharing environment can exist.

I’m trying to understand both the science and the controversy of this topic. There are the data, and there are the people analyzing it and interpreting it. Reading these papers, I get the feeling that it is difficult to find someone conducting research in this field who isn’t at least a little invested in the outcome. I wonder if these guys ever sit in the same room together and talk it out, because it feels like they are coming from different planets. There’s the epidemiology planet, where numbers rule and nuance is scorned. (And don’t get me wrong – I’m a numbers girl – but I can see the limitations in them here.) Then there’s the anthropology planet, a beautiful land of skin-to-skin, breast milk, and perfect physiological attunement between mother and babe. In my opinion, neither world completely represents the reality facing new parents in today’s world.

I wonder, for example, if the members of the AAP committee, which recommends against bedsharing, have ever cared for a baby who had extreme difficulty sleeping alone. And I wonder if the anthropologists have ever cared for a baby who wanted her own space, perhaps needing a break from all that day-and-night sensory input. I have met both types of babies, and as parents, I think we have to recognize that their needs are not the same.

In the real world, lots of factors determine how different families handle sleep. Infant temperament is one of them. Safety is another. There are also cultural expectations, family dynamics, work schedules, parenting styles, and feeding methods to factor in. Where baby sleeps is a complex parenting decision, one that is exceedingly difficult to study in a quantitative manner.

As I’m writing this chapter, I’m trying to present the science in a balanced way. I also recognize that this parenting decision – and most of them for that matter – can never be reduced to science and statistics. Parenting is about people and their stories. I know that I need to understand those stories as well as the science to write a worthwhile book.

So, I’m hoping you can help me.

Help me understand WHY your babies slept where they did – in your bed or in a crib or some combination of the two. What factors were important in your decision? Did your baby sleep where you had planned, or did you have to adjust your expectations? What worked well about your arrangement, and what didn’t?

I may be interested in including some of your stories in my book, but I’ll send you a direct email if that’s the case. Thank you – as always – for sharing your stories!

 

A Question of References

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stack of booksI’m working away on my book, but my progress is maddeningly slow. I’m getting hung up on really important questions of scope and tone, and I’m hoping that as I resolve these, the writing will start to come easier.

Here’s an important question that I’m struggling with, and I’d like your advice. How do you like to see references in a non-fiction book?

The writing in my book is like that in my science-based blog posts. I am basing it on lots of references and papers, but I am trying to frame the scientific questions with real-life stories from my experience and that of other parents.

When I submitted my book proposal, the peer reviewers responded that they thought an evidence-based book backed by references would be a unique and helpful resource to new parents. And based on the responses from you, the readers of my blog, I think you value this as well. So providing references and making them accessible to the reader is important to me.

When my editor and I were going over the book contract, the topic of how to handle references came up. Initially, he thought that I should avoid in-text references – either noted by author or by number. That is, he didn’t expect sentences like this made-up one: “In one surprising study, researchers from the University of Amazing found that children were more accepting of new foods when they XXX.57” Instead, he recommended simply providing a list of references, by chapter, at the end of the book, without necessarily linking each reference to the text describing it. After some discussion, he said he was open to me using in-text citations, but I also agreed to give some thought to different options.

I’m actually really uncomfortable writing about science without in-text citations. I’m used to science writing where you provide a reference for just about every single statement you make. That’s how I learned to write for scientific papers, and on the blog, I’ve continued with this style without much thought. In this style, I’m saying, “Don’t take my word for it – this is coming from these scientists who researched the question.” I’m not writing this book from a place of authority but rather from one of curiosity. I’m not claiming to be an expert with all the answers but rather a person who has questions and is willing to dig for the answers. And as a reader, I like being able to flip to the reference list at the end of the chapter or the back of the book and see the authors, title, year, and journal where a particular study was published.

I think that the argument against in-text references is that they are distracting from the narrative. I do think that references providing names and dates can be distracting, but I personally think that superscript numbers can do the trick without taking away from the story. Even so, I understand the point that the story needs to stand on its own even if the reader never checks references. Perhaps not providing in-text references would force me to be more selective about the references I choose and to build the story of a particular study more fully. And it might make the book feel more accessible to a reader not accustomed to this style.

I also admit that my resistance to writing without in-text references comes in part from my hesitancy to step outside my comfort zone. It could be that references are a sort of crutch to me, and that my writing would improve without them if I was willing to work on this.

Going through the books on my shelf right now (those that relate to parenting and science but are written for a lay audience), I see a few different ways of handling this question.

1. A “Notes” section – without in-text markers – followed by a bibliography with full citations. Examples of this format:

NurtureShock, by Po Bronson and Ashley Merryman, is a really excellent book that makes science come alive within an easy narrative. I really admire this book, so I paid close attention to this format. There are no in-text references or footnotes. Important studies are described in detail, and sometimes the journal and year of publication are given within the text. A Notes section at the end of the book provides references backing assertions within the chapter. These are not marked within the chapter, but if you were reading along and wondering what evidence stood behind a particular statement, you might find a paragraph in the Notes describing and listing several studies by author and date. You could then proceed to the “Selected Sources and References” at the back of the book listing full citations by chapter. Finding the papers behind a given statement in the chapter thus requires a two-step process – checking first the notes and then the reference list. But the text of this book flows so easily that you want to keep reading, not check references. I think that’s a good thing.

The Panic Virus by Seth Mnookin, another book that I admire for its sound science and gripping narrative. The notes and bibliography of this book are nearly 100 pages long. Notes are not marked in the text but are listed by page number in the Notes section.

How Eskimos Keep Their Babies Warm by Mei-Ling Hopgood – (I reviewed this book here.) Notes are listed by page number, and it also includes a bibliography.

2. A “Notes” section – with superscript numbers as in-text markers – followed by a bibliography with full citations. Examples of this format:

Bottled Up by Suzanne Barston – Gosh, I’ve been meaning to write about this book, but I’m afraid I need to reread it first since now its been too long. Great book, though.

Bringing Up Bebe by Pamela Druckerman – There’s more science in this book than meets the eye.

Your Baby’s Best Shot by Stacy Mintzer Herlihy and E. Allison Hagood

3. Just one reference list at the end of the book, with in-text markers for sources.

The Science of Parenting, by Margot Sunderland. I also paid close attention to this book since my book may be competing in a similar market, and there are things that I both like and dislike about this book. Sunderland doesn’t tell us much about the studies she cites but instead uses them to back narrative text providing advice to parents. In this case, I really appreciate the in-text citations, because sometimes I’ve tracked down her references and found that she’s stretched the interpretation of a study and made a few conceptual leaps to link it to her statement. I think this illustrates one danger of in-text citations. It gives the look of authority, but perhaps it also allows the author to take more liberties with her interpretation, because she doesn’t actually have to tell you much about the studies backing her statement. If you’re wondering, you can go look it up, but many readers won’t have the time or resources to do this.

The Fourth Trimester by Susan Brink: I just received a review copy of this book and haven’t yet read it. In-text citations are given as superscript numbers, and all references (including interviews and correspondence) are given in one “Notes” section.

4. No in-text citations and one reference list available. This style seems to be adopted mostly by experts in their fields, who likely feel comfortable giving advice without backing it with research. (This isn’t me!)

Child of Mine by Ellyn Satter – This is my favorite guide to feeding children, and it is evidence-based to boot. She also has many appendices on important topics (like “Nutritional Principles for Baby Formula” and “Children and Food Acceptance: The Research”), written in more technical language and really geared for the parent who wants to know more about the research behind her recommendations.

Beyond Baby Talk by Kenn Apel and July Masterson – (I reviewed this book here.)

Brain Rules for Baby by John Medina – no printed references in the book, but a note on a single page at the back of the book refers the reader to a website that provides “extensive, notated references.”

Do Chocolate Lovers Have Sweeter Babies? By Jena Pincott – (I reviewed this book here.) One section at end has “Sources” listed by chapter.

Maybe you can help me figure out how to handle references. Can you check some of your favorite science books to see how they do it? What style do you prefer? Do you even check references when you’re reading a book like this?

Mama, Talk Busy Day?

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Cee was sick about a month ago – sick in a flu-sort of way with fever, cough, stuffy nose, and general misery. We threw our regular sleep routines out the window. There was a lot of back rubbing and singing to help her to sleep and more of the same when she woke burning with fever during the night, needing some reassurance from Mama or Daddy and another dose of ibuprofen.

Once she was better, Cee had a bit of a hard time transitioning back to our regular routine of books, song, and goodnight. She said, “Mama, lie down?” wanting me to stay with her until she fell asleep. I couldn’t get into that habit.  I had humored her a few times, and I knew how it went. I would lay down next to her until her breathing slowed and she was still, but I’d still be afraid to budge for another 20 minutes to be sure she was in a deep sleep. By that time, I would either fall asleep myself or at the very least have lost all motivation to do anything productive for the rest of the night. Plus, I hate the sneaking out thing. It makes me feel like I’m not being honest with her. Cee knows how to go to sleep on her own.

mama and ceeInstead, I stayed with her for a few extra minutes. I held her hand and talked quietly about her day, full of friends at daycare, walks outside, time with mommy and daddy, meals, bath, books, and all the regular mundane things we do together. It was a busy day, I told her, and tomorrow would be another busy day. Time to rest, little girl. Night night. I kissed first one hand and then the other and then her forehead, now thankfully cool now since the fever was gone. It was a good bedtime. She fell asleep, and I got to work.

The next night, as I was kissing her goodnight, she said, “Mama, lie down?”

“No,” I said, “I’m not going to lie down with you. I need to go work upstairs.” (She actually accepts this response. It seems to make sense to her.)

She had another idea.

“Mama, talk busy day?”

And so began our new bedtime tradition. It’s Cee’s favorite part of bedtime now, and mine too. She asks for it with anticipation every night. When Husband is home at bedtime, he shares in it as well. We snuggle together in a Cee sandwich and recall the day.

I love going back through the day with Cee. She often tells us little details about her morning at daycare, and Husband and I remind her of special moments that we shared together – all the funny, sad, joyful, painful, delicious, creative, and scary ones. In this quiet space, little bits of the day come to light that might otherwise be lost in the rush of getting from here to there. After we say goodnight and leave the room, I often listen over the monitor as Cee runs through her own busy day monologue, telling her baby dolls all about it, until her voice fades to quiet.

These days, I feel like I can never get enough done. But snuggling with Cee at the end of the day and talking “busy day” puts things in perspective. It is like pulling special stones and shells from our pockets at the end of a day on the beach. We lay them out so we can see each one. We polish the bright spots and examine the dark crevices we hadn’t noticed when we first picked them up. Remember? This is the one that was almost washed away by a wave; I grabbed it just in time. Remember this one? It was the bridge to our sand castle. The castle is gone, but let’s keep this shell, OK? And this one? I noticed it because it looks like a heart. It will remind me of you.

Our lives are filled to the brim with little moments, so many that it is hard to do much besides move from one moment to the next. But if I worry that there is too much left to do at the end of my busy day, Cee’s little hand in mine reminds me of this: Of all the busy things we do, what could be more important for caring for the ones we love?

The Courage to Try

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I am tackling my book project, and I’m struggling. Like all of you, I’m juggling a few things right now. I’m parenting a toddler, teaching a few college courses, maintaining a home, nurturing a marriage, blogging (OK, barely), and trying to take care of myself. And writing a book. Some of those things seem to rise to the top of my priority list every day, and others always seem to be lingering at the bottom, which invariably means that they either don’t get done or they don’t get done well. Working on my book is one of the things that keep ending up at that bottom, not seeming to be as important as my other responsibilities. I know that if I’m going to write this book and write it well, that has to change.

It isn’t just about finding time and keeping a lot of balls in the air, though. It is also about fear. It is the fear that I can’t write the book I want to write. I don’t even really care if anybody reads it. What I care about most is that it is good and that at the end of this process I am proud of it. And I’m afraid of all the hard work that I know is between here and there. It isn’t just punching a clock and meeting deadlines. It is about the labor of thinking and synthesizing and storytelling. I know that it requires my full attention and energy for at least some portion of every day. The scale of the project scares me.

Husband tells me: “You only get one chance to write your first book.” I’m so afraid that it won’t be any good that I sit and stare at the screen or go and fold a load of laundry instead, neither of which will bring me closer to a book.

In light of all of this fear, I was inspired the other day by an interview with Ben Affleck on NPR’s Fresh Air. Terri Gross asked Affleck about his experience with directing his first movie, Gone Baby Gone, and this is what he had to say: Continue reading →

Guest Post: A Parent’s Experience with Childhood Apraxia of Speech

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     Lucky us, we have another guest post today! This comes at a good time for me, because Cee was sick and home from childcare for most of last week, which was coincidentally the first week of teaching this term for me. It’s incredible how much 4 days of a sick kid can set you back. I’m still catching up on my teaching responsibilities and book project schedule, so I’m happy to have a few stellar writers standing in for me on the blog this week.
     David Ozab is a local writer and father. We met last year at the only bakery in town that has both flaky croissants and a sandbox. A few months ago, I posted a review of a book about language development, Beyond Baby Talk. This caught David’s attention, because he has had a personal experience with his daughter’s language delay caused by Childhood Apraxia of Speech, a condition affecting somewhere between 1 and 10 kids per 1000. He is writing a book about it, and he shares some of his experience here for us.
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A Parent’s Experience with Childhood Apraxia of Speech

By David Ozab

“Don’t worry, she’ll catch up.”

I heard that sentence from so many parents around Anna’s second birthday. We were worried about her speech; she was talking all the time but we could barely understand her while kids her age and younger spoke clearly. “Don’t worry she’ll catch up,” people would say. I said the same thing to myself. I figured it would just happen. Her speech was like an out-of-focus photograph. Sooner or later, I thought, it would snap into focus.

My wife Julia wasn’t buying it. She thought something was wrong, and she was right.

We might have realized there was a problem sooner if she hadn’t talked at all, but she babbled constantly since she was a baby. She interacted with everyone around her, so we knew she wasn’t autistic. She understood everything we said, so we knew her language comprehension was fine. She even sight-read a handful of words. Granted, they were animal names and she didn’t say the names, she made the sounds. But she knew what the words were.

We would write on her Magnadoodle:

D-O-G

“Woof.”OLYMPUS DIGITAL CAMERA

C-A-T

“Meow.”

P-I-G

“oink.”

C-O-W

“Moo.”

F-R-O-G

“Ribbit.”

So we knew she was smart, but she wasn’t talking and she wasn’t catching up.

What we didn’t know was that Anna had something we never expected; something we’d never heard of. Continue reading →

10 Tips for Transition to Child Care (From a mom who got it all wrong)

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I’m excited to host a guest post by blogger Jessica Smock, an educator, mom, and almost-finished PhD student. Jessica has only been blogging at School of Smock since the new year, and she’s already turned out a ton of thought-provoking and informative posts about education and parenting. Today, she writes about her son’s transition to child care. It’s a sort of confession, because as you’ll learn, it didn’t go so well. The upshot is that she turned her experience into a useful guide for parents approaching this transition. Enjoy her post, and please feel free to add your own experiences and advice in the comments below.

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10 Tips for Transition to Child Care (From a mom who got it all wrong)

By Jessica Smock

I thought I had done my all of my homework, as a diligent parent, researcher and educator.

As a new parent, it can be a tough, long process finding the right child care for your child. You have to think about what your needs are: a small, intimate, home-like environment or a fully-accredited, educationally focused child care center; location (at home, close to home or work); your budget; your schedule… Next, you have to do your research, using friends, family, or a local or national referral agency, to identify providers that meet your needs and have openings. And then you should visit facilities and talk with the providers, asking them questions about their curriculum, sick child policy, discipline philosophy, caregiver experience and training, feeding and nap schedules. Finally, you sometimes just have to use your parental instincts, going with your gut about whether a provider will match your family’s parenting style and your kid’s temperament.

I had done all this before my son started a fantastic preschool program.  So why was my son’s transition to day care a complete disaster?boydaycare photo

My son had started off when he was six months old with a few different babysitters that came to my home a few times a week while I wrote and worked on my dissertation. He did well with this and loved playing with his young, energetic babysitters, but it wasn’t meeting my needs. I couldn’t concentrate in our small house with the constant chaos and noise that surrounds a baby. So I started looking into child care centers in my new city. I thought I was more than capable of doing this. I was a teacher and curriculum coordinator for more than a decade, with a Master’s and nearly a doctorate in the education field. I had worked as a research fellow for a social research nonprofit in Cambridge, where my major responsibility was helping to write a research report of high-performing child care facilities in Massachusetts. I had interviewed dozens of providers across the state and country, as well as state education heads and early childhood researchers from Harvard and other local universities, and helped to create a framework for evaluating child care providers.

I didn’t think at all about what happened after I chose the program. Continue reading →

Recovery

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I wrote my last blog post before going in for a D&C last Friday. The procedure itself was simple and quick. I “fell asleep” with the warm hand of my OB holding mine and woke up from general anesthesia feeling an inevitable emptiness but some degree of peace. At home, I ate a piece of toast, crawled into my own bed and woke up four hours later. What greeted me were your comments and emails of sympathy, empathy, and heart. There were a lot of them, some from people I have known for decades and some from readers that I had never heard from before, but I read every single one before I got up to face the afternoon.

The resounding message was this: You are not alone.

I was nervous about writing about miscarriage, but once it was out there, I felt nothing but support. It made me wonder why we hesitate to share this kind of hurt. It is personal, and it does seem strange to tell the whole world that I’m grieving. But the world is full of hurt. What’s wonderful is that so many people are willing to share a bit of mine – even the smallest bit – and enough people doing that really does make me feel better. I didn’t anticipate that writing about miscarriage here would be so therapeutic. The writing itself is actually sort of painful, in a good way I guess, but sharing the experience has been healing. Continue reading →

Pregnancy Lost

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It has been a hard couple of weeks for me, even with all the warmth and joy of the holidays. On December 21, 10 weeks into pregnancy (as yet unannounced here), we watched as my OB scanned my uterus. We saw the dark gestational sac and a small clump of embryonic tissue. There was no heartbeat, and the embryo measured at about 5 weeks. It hadn’t developed beyond that. This pregnancy would not be ending with a baby.

I’m a very cautious person when it comes to celebrating pregnancy. I didn’t really relax into my pregnancy with Cee until I saw the normal fetus at our 20-week ultrasound. I have had several close friends suffer the loss of miscarriage (and go on to have beautiful, healthy babies, I will add). I know that among clinically recognizable pregnancies (not counting the 30-50% of conceptions that never implant), about 15-20% will not survive. Even as I shared our pregnancy news with our close family and friends, I reminded them of this fact.

Although a part of me was prepared for this outcome, there was really no way that I could prepare myself for how it would feel. I have a profound sense of losing something important. Tiny as it may have been, it was part of me and part of Husband, and it was growing inside of me, if only for a short time. The wonder of pregnancy has been replaced with the vision of that ultrasound: the gestational sac a gaping dark hole, what remains of the embryo little more than a smear. Empty, dead, inevitably transient.

This is the grief of pregnancy loss, something so many of us must face as we try to build our families. What it speaks to, more than anything, is the power of a parent’s love, even for an embryo whose heart never beats. For many parents, it is the struggle to conceive, and after that, it is the fragility of human life. And even as our healthy babies become children and our love grows beyond the bounds of what we thought was possible, we know we are vulnerable to loss. It is the reason that it felt unbearable to be a mother on the day of the Newtown school shooting. This is family. This miscarriage, it is a small loss, but it still sure hurts. Continue reading →

Does My Child Drink Too Much Milk?

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glass of milk copyA couple of nights ago, I had the pleasure of going out for drinks with a couple of other moms, sans kids. Predictably, we ended up talking about our kids, among other things. One of my friends mentioned that her 2-year-old daughter is a big fan of cow’s milk, drinking about 3 cups per day. This reminded me of a study I’d gotten wind of earlier in the week that recommended kids drink only 2 cups of milk per day. Should my friend cut back on her daughter’s beverage of choice? I needed to look at the study more closely.

The study in question (The Relationship Between Cow’s Milk and Stores of Vitamin D and Iron in Early Childhood (1) – paywall) was conducted by a Toronto research group led by Jonathon Maguire and published on Monday in the journal Pediatrics.

The headlines about this study have made it sound like we now have the final word on just the right amount of cow’s milk for kids. The Atlantic posted a story with the headline “Kids Should Drink Exactly Two Cups of Milk per Day,” and others published similar statements. I will argue that it’s just not this simple, and prescriptive nutrition messages like these just end up confusing parents.

What is neat about this study is that it looked at two important nutrients for young kids: vitamin D and iron. Deficiency of both of these nutrients is common and cause for concern. Continue reading →

Weaning My Toddler

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So, I have some more big news to catch you up on. I weaned Cee a few weeks ago, soon after her second birthday. I took a few notes along the way, but I never pulled it together to post on the blog about it. I thought I’d share some of those notes here and reflect back on our experience.

Cee may be weaned, but she still nurses her own baby all the time.

Cee may be weaned, but she still nurses her own baby all the time.

11/24/12

Tonight, I nursed my baby girl for the last time. She’s not so much of a baby anymore. She turned two last week. But I savored the feeling of her curled into my arms. I noticed how her long eyelashes cast a shadow across her cheeks and how soft her face looked, the tension of the day melted away.

I remembered nursing her in those early days, when her eyelids were still translucent, tiny blood vessels visible. I remembered how she would be frantic to nurse one second and peaceful the next, her little hand clasped in a fist, resting on the top of my breast.

Cee and I started talking about weaning a few weeks ago. We usually read books while we nurse, and lately I’d noticed that she was so enthralled with the books that she could hardly nurse. I’d turn a page, and she would break her latch to look closer at a picture, pointing something out to me. We were going through the motions because we always had, but nursing didn’t feel that important to either of us anymore. It felt like it was time to make this change.

We had been down to nursing just at naptime and bedtime since the summer. We dropped the naptime feeding first. All fall, Cee had gone down just fine without me and my milk at daycare and with Husband, and there were only a couple of days of brief protest over this change.

Down to just nursing at bedtime, Cee and I talked about how Mama didn’t have very much milk anymore. We talked about how babies (like our friends’ 3-month-old) need a lot of milk, but kids like Cee eat lots of good food and can drink their milk in a cup. We talked about how we love snuggling and nursing, too. I guess I wanted a chance for us both to appreciate our final days of nursing.

A couple of days ago, Cee watched me as I undressed for a shower. She pointed at my naked breasts and said, “Milk?” Continue reading →