Nursing in Pubic, Part 2

http://community.babycenter.com/post/a26558233/bf_in_public?cpg=1&csi=2305345030&pd=-3

How sad is it that people can see a disabled woman who clearly has her hands full taking care of her young children and doing basic tasks like shopping, and think that it is appropriate to subject her to ridicule or suggest that she should hide from public view?

Seriously, where is the basic human decency?

More fear-mongering about Canada's "socialized medicine"

http://community.babycenter.com/post/a26539077/canadian_judge_orders_breathing_tube_removed_from_baby?cpg=1&csi=2304845086&pd=-1

First, Fox gets basic facts wrong in its coverage of the story (like the role of the Office of the Public Guardian and Trustee), then posters with an agenda distort it further.

This is undoubtedly a tragic story.

The hospital may be motivated, in part, by a concern about spending medical resources in a situation of medical futility. However, by law they cannot do anything without consent. The court order gave a deadline for the parents to consent, but since the parents didn't consent, the hospital wasn't able to do anything.

I don't have the court decision in front of me, but we do have an independent judiciary. This wasn't a decision of a bureaucrat bean-counter.

If the parents don't give consent, the hospital may seek it from the Office of the Public Guardian and Trustee. No, they are not Public Defenders. They are a special government office mandated to provide specific services to people who are mentally incapable of making their own decisions - including health care decisions. In the case of a minor, the criteria for their health care decision would be simply the best interests of the child. They can't consider the cost issue.

Now, I don't pretend to know the least horrible way for a child to die. It all sounds hideous. I'm not sure, though, that it's better to subject this child to a tracheotomy just so he can be moved home, as opposed to simply removing the breathing tube. It may be - and perhaps the fact that the parents had previous experience with this gives them a reason to choose it now.

There are issues here about the extent of parental discretion in making medicals decisions, and the role of hospitals where they believe that further treatment is futile or even harmful. These issues should be discussed. Falsely labelling this as an issue about Evil Socialized Medicine, however, helps no one.

Roles of religions with people with mental illness

What duty, if any, do religions have, when reaching out to people who may have some sort of mental illness or instability, to try to ensure that the teachings are not taken out of context or misused?

Religious groups can be very supportive and tend to reach out to "lost sheep". Some of this work is really great. What happens, though, when the message ends up being twisted in unintended ways?

Should religious groups tell folks in no uncertain terms: "If you think you hear the Voice of G-d, go back on your meds NOW"?

If a religious group reaches out to prisoners, do they need to take extra steps to make sure that new converts aren't going to commit violence in the name of that religion?

Approach to genetic disorders

I just read through this thread:

http://community.babycenter.com/post/a26083179/trying_to_conceive_with_high_chance_of_disorder?cpg=2&csi=2287443638&pd=1

Surprisingly, none of the Jewish posters have weighed in. Too bad, because we could add another perspective.

Thanks to a relatively limited gene pool, certain nasty genetic diseases are more common among Jews. One of the earliest to be identified was Tay Sachs disease - a truly nasty disorder in which a child seems normal at birth, but goes downhill at around 6 months and dies before the age of 5. More info here: http://en.wikipedia.org/wiki/Tay%E2%80%93Sachs_disease. A carrier of the disease will be perfectly normal, but if 2 carriers have a child, there is a 25% that the child will have the disease.

One of the reasons that Tay Sachs is so well-known in the Jewish community, aside from its nastiness, is that there are widespread screening programs that started around 1971. By widespread, I mean that every Jewish teen is told to go for testing, and in very Orthodox circles, there is an organization that ensures that matchmakers don't set up 2 carriers.

I was raised hearing about this from the time that I was a kid, so I forget somethings that it's a novel idea for some. My parents actually got tested when I was newborn (I was born in 1971) - and they were told that they were carriers. It was a moment of terror for them because I was too young to show symptoms, and yet there was a 1 in 4 chance that I could have a fatal disease. With my sister, they had an amnio. My mom described it as stressful, since she hid the pregnancy until receiving the results, but less stressful that worrying about a baby having it.

I haven't seen much moral debate about this in the community. It's considered obvious that the only way to deal with the disease is by preventing it through screening. Obviously, there are no guarantees in life, and a child who doesn't have Tay Sachs could still have any number of other problems, but if you could prevent a child from suffering with a horrible disease - why wouldn't you? Thanks to the screening, cases of Tay Sachs have become exceeding rare in the Jewish community.

I've seen a bit more moral debate on the question of "what do you do with the information"? The ultra-Orthodox organization Dor Yeshorim doesn't tell those who are tested what their carrier status is, only whether they are genetically compatible with a potential mate. They have concerns that people would avoid testing due to stigma. That's truly unfortunate, because being a carrier in no way affects your life unless you happen to fall in love with another carrier. It just means that you need to tell your kids to get tested themselves.

One option that exists today that my parents didn't have is pre-implantation diagnosis. Yes, it is more expensive and involves more than having an amnio, but it also avoids the possibilities of a second trimester abortion.

Update:

Righteous Rasha has a post on Dor Yeshorim, the ultra-Orthodox anonymous testing organization. I agree that anonymous testing is far from ideal, but suppose that an imperfect option that at least prevents genetic diseases is worthwhile if the stigma would otherwise allow tragedies to occur.

Education and equality

I just saw this report about a mother jailed for 10 days because she gave a wrong address in order to send her children to a better school:

http://news.yahoo.com/video/us-15749625/mom-jailed-for-sending-kids-to-better-school-23973624

Why are they going after this woman?

I understand in the narrow view of things, she made a false statement.

In the broader view, though - don't we WANT to be encouraging people to strive to get a better education for themselves and their children?

How is it possible to give children of all backgrounds a fair start in life without quality schools?

Why not simply eliminate the whole idea of residency requirements for schools? In my city, local taxes no longer fund public schools, but the residency requirements still remain - unless there is a vacancy, no one outside of the school area can apply. What would happen to all schools if that changed? Would it force residents of wealthier areas to care about gang violence in bad schools? Would it force all schools to improve by introducing competition? Would it promote more diversity, and allow for more upward mobility among students from bad areas?

Nursing in Public

I remember getting into these debates 11 years ago. Apparently, not everyone has gotten with the program:

http://community.babycenter.com/post/a25782783/would_you_really_judge_me_for_nursing_in_public?cpg=1&csi=2273745661&pd=-10

While it's great to see all the positive responses, some of the others have me shaking my head. So folks - here is why the right to nurse in public is a personal AND political issue:

I have never, even seen any mom who was deliberately exposing as much as she could while nursing as some sort of provocative display to every male in the vicinity.

If you see someone nursing in public, you can likely assume the following:

1. She's a mother (since wet-nurses aren't really in fashion these days).
2. She has a hungry child.
3. She is not starving that child.
4. She is feeding that child in the best way possible according to medical recommendations.
5. Since she has a baby, she is likely to be busy and tired. Really, really tired.
6. Depending on just how new the baby is, she may need to breastfeed every couple of hours, around the clock. If the baby is having a growth spurt or is sick, it could be even more often.
7. If she didn't feed the baby right away, you'd be hearing a baby screaming instead of seeing him or her eating.
8. She may have tried pumping, which can be really time-consuming, involves extra expense, and can be a logistical nightmare when you have to figure out just how long it is going to take to defrost and how long unfrozen milk can sit before it's no longer safe. She may also have babies that simply refuse to take a bottle.
9. She may find that never leaving in the house is not a practical option for living. She may need to go shopping, go to appointments and have other errands. She may also feel that never leaving the house is a good way to go batty and get post-partum depression.
10. She may have a baby, like mine, whose first sign of hunger is to scream non-stop.
11. She may have discovered that at the moment that the baby decides to scream, a magic private room doesn't suddenly appear.
12. If she lives in Canada, her car is either boiling hot, freezing cold, or in the rain/snow. It is also on the other side of the mall, or parked in a far away lot or street if she lives downtown, or she doesn't have a car.
13. She has not had a full night's sleep in a long time. Instead, she's been feeding the baby, changing a zillion diapers, bathing the baby, dealing with baby puke and leaking diapers and leaking breasts, doing laundry, and all the other things that mothers need to do.
14. She has dealt with breasts that literally seemed to blow up overnight, that become rock-hard and painful if she goes too long without nursing, that can spontaneously spring a leak, and that may have had bleeding nipples generating more pain than the birth itself.

In short, the last thing that this woman needs is anyone suggesting for a moment that she shouldn't be doing exactly what she is doing, or putting more demands on her and her baby.

A favorite line seems to be a demand to "show some consideration". I agree. Please show some consideration for that mom, who is busy and tired and above all doing her best to meet her baby's needs. You would also be showing some consideration for the baby too, who is hungry and who is far less likely to be fed in the optimal way if the mother finds that she is no longer comfortable nursing in public.

Bottom line: your issues are not her problem.