I was thinking about parenting the other day and then (oddly) starting thinking about the idea of  Theseus’ Ship (in all fairness, not completely random as it was the philosophical basis for my comprehensive exam paper).  For those of you unaware of the story of Theseus and his Ship, let me provide you with a little synopsis:

Theseus, the mythical founder and king of Athens, returned to Athens on a ship after slaying a minotaur in Crete (and rescuing a girl). Upon arriving home, the ship was kept in the Athenian harbor as a memorial for his quest.  However, the ship would not last on its own – wood rots and pieces needed to be replaced.  As pieces fell apart, they were replaced with “new and stronger timber” (Plutarch, Life of Theseus).  However, after many years of this cycle, it was unclear if any of the original pieces of the ship were left; presumably, they had all been replaced.  The philosophical question for the ages then became, is it the same ship?

You may ask, what does a Greek hero and his ship have to do with parenting?  Literally, nothing.  But the philosophical question raised by Theseus’ Ship is highly relevant to the topic of parenting today.  Consider for a moment that a particular parenting practice is Theseus’ Ship.  Every aspect of parenting can be broken down into individual components and studied to try and determine what part of it makes it work (or not work).  It’s what science tries to do on a daily basis.  But the question here, and one I hope to tackle, is: are we’re doing ourselves a disservice by breaking it down as such?  Can certain practices only be truly understood as a whole?  And if we change the constituent parts, are we really getting the same results?

It seems to me that the predominant views on parenting today are built upon the assumption that you can replace any part of a parenting practice with something ‘new’ and ‘updated’ and end up with the same or better results than we’ve been doing as humans for ages.  Part of the issue is that I don’t believe we’re finding new practices that truly replace old ones like wood on a ship.  But the other issue is that I think parenting and various parenting practices are much more holistic than people recognize.  Because of this, it is nearly impossible to break down a parenting practice, replace a part with something else, and expect the whole to behave in the same manner.  It’s like removing certain roots from a plant, replacing them with mechanical roots, and expecting the plant to thrive – it just won’t happen.

One of the biggest areas in which this is apparent is breastfeeding.  For years, doctors and scientists have tried to unlock what makes breastfeeding so special.  First they focused on the actual milk and tried to outdo evolution by creating formula. They believed that could provide better nutrition for babies than mothers could and end up with the same or even better outcomes for babe.  But as we all know, they learned that that is hardly the case.  Breastmilk has antibodies to fight infections[1], lowers the risk of later obesity[2], and it has certain proteins that help brain development, with studies showing greater cognitive function and academic success for breastfed babies[3][4], things formula simply cannot provide.  And because of these discoveries, we’ve generally agreed as a society that breast is best. So what do scientists and doctors do?  They try to fix another part of breastfeeding by developing means to pump.   The new focus on the mode of delivery highlights the belief that it is the breastmilk that is important and that the role of mom in delivering this milk is moot.  Anyone can give baby a bottle of breastmilk; mom has been relegated to the role of a cow.  Because of this relegation, mom can go back to work where she’s really needed to help turn the wheels of capitalism.  (Of course, I should note that I am a HUGE fan of pumping to help other women provide their children with breastmilk – it’s better than formula and such a wonderful way for women to help each other, my problem is the politicians or ‘experts’ deciding that the act of breastfeeding is irrelevant.)  The failure to think of breastfeeding as a holistic act has meant we’ve yet again overlooked some ratherimportant things, such as

a)      The bonding that occurs between mother and baby during breastfeeding doesn’t happen as easily when baby is eating from a bottle for a plethora of reasons including hormonal, lack of touch, mutual gaze, etc.[5].  Bottle moms have to work harder for the same amount of bonding.

b)      Expressed breastmilk is still not as good as breastmilk from the breast because of the way the breast expresses milk – it starts with watery milk to quench thirst and then moves to the creamier milk to satisfy hunger whereas expressed milk tends to be blended together (unless pumped separately) meaning baby may fill up without full quenching his thirst thus requiring the addition of water to the diet.  (Although you can pump to separate them – see La Leche League on how to do this.)

c)       Milk from the breast is sterile whereas once is it placed into a bag or bottle, the chance of bacteria entering it increases which increases the risk of infection or illness.

d)      When a mother breastfeeds, the baby’s saliva enters the mother’s breast via the nipple which tells the mom what antibodies baby needs at the moment, allowing mom to produce whatever it is her baby needs to stay healthy[6].  This doesn’t happen with expressed breastmilk because the initial information doesn’t get passed on to mom (although baby will get moms antibodies, just not necessarily the ones needed most at any given time).

When doctors and scientists finally come to terms with this, they may accept that breastfeeding is a gestalt act, or they’ll find yet another component to try and replace.  But breaking it down and trying to look at individual aspects will always fail to yield the same outcome as focusing on the act as a whole.  It doesn’t mean we don’t stop pumping, because, again, it is a wonderful way for babies whose mothers’ cannot breastfeed to get breastmilk, but we have to accept the limitations.  And in accepting the limitations, realize that some of our policies that are based on the assumption that these replacements are just as good as the original act (like short maternity leaves) do not benefit parent or child.  Replacing individual parts will never equal the original because these individual parts work in a network to create the overall benefits of breastfeeding.

We can make similar arguments for baby wearing and co-sleeping.  Science gave us strollers when the thought was it was only about getting baby from point A to point B.  However, women have worn their babies for myriad reasons that have nothing to do with simply getting baby around.  Baby wearing helps babies stay calm and thus fuss less[7][8] and it also helps to promote bonding between mother and child[9].  And many wraps also allow moms to breastfeed on the go – a massive advantage when you need to get things done.  Similarly, co-sleeping is not just about sleep.  Babies didn’t sleep with their parents simply because there was nowhere else to go and no fancy crib to sleep in, babies slept with their mothers because it helped keep them alive, provided close contact, increased levels of oxytocin thereby reducing stress[7], and allowed babies to become more independent and confident as they got older (see Co-Sleeping: Fostering Independence).

The problem really starts much earlier, in pregnancy.  For most of human history, pregnant women and their unborn children were seen as a symbiotic unit, dependent upon and providing for each other.  However, when the medical field started taking over as ‘experts’ in pregnancy and birth over midwives, they starting viewing pregnancy as a medical condition instead of the natural state that it is.  And by viewing it as such, they started the idea that the baby is simply a parasite-type creature who inhabits mom[10].  Breaking pregnancy down into host and parasite is not only an incredibly disheartening way to view the absolute beauty that is pregnancy, but once again it ignores crucial facts about pregnancy that has led us astray.  For one, it has led to the view that pregnancy is somehow an abnormal state because a pregnant woman is seen as a regular woman with some ‘thing’ attached to it (like a tumor).  So we continue to compare pregnant women’s vital statistics, such as blood sugar absorption for the diagnosis of gestational diabetes, to those who are not pregnant despite the very normal state of pregnancy.  Gestational diabetes is a classic example because for years it was diagnosed based on a non-pregnant woman’s rates, there are few to no symptoms (and none life-threatening), and the vast majority of women’s rates return to normal after pregnancy[11].  Yet doctors do testing regularly, will suggest (force) many interventions (which can be more dangerous than the GD) if tested positive, and no one has bothered to ask if perhaps GD is actually a normal state in some pregnant women.  And if not, look at the entirety of the woman and her pregnancy to figure out how best to approach something that has, generally speaking, rather benign consequences (unlike diabetes which can have severe consequences).

To further this notion that a pregnant woman is just like a non-pregnant woman but with a baby inside (that trivial distinction), doctors also come up with guidelines about how much weight a woman should gain during pregnancy. A couple generations ago, women were told that they should only gain 10-15 lbs during their entire pregnancy[12], and while this might make sense if you think of mom and baby as separate and thus mom only needs to gain the weight of the actual baby, when you consider their joint needs, there is no way that is healthy.  In fact, those guidelines led to a greater number of premature and low birth weight babies, both risks for infant morbidity and mortality[13] which is why they were revoked in the 1970s.  The debate about pregnancy and weight gain continues because of the effects on delivery and infant outcomes, but it seems to be that the better approach would simply be to focus on making sure everyone is healthy and then letting baby and mom do their thing.  If that means a mom gains 40 lbs, if she’s eating healthy and being active, what’s the problem?  Focusing on weight ignores health and what mom eats is as important as how much she eats for how well baby develops.

Epidurals are another manifestation of this separation of mom and baby, though I’ve already written about it (see To Drug or Not to Drug? The Epidural Debate).  To briefly summarize, while epidurals can be very helpful in limited situations, they are vastly overused.  Pain in childbirth is there for a reason, and one reason seems to be to help baby get through the experience.  Mom feels pain and her body produces endorphins that are passed on to baby, who can’t produce them herself.  By blocking the pain, you block the production of endorphins, and baby, who has to go through worse than mom, does it with no pain relief.  I’m not so sure that’s the way we’re supposed to enter this world.

When it comes to pregnancy and parenting, our bodies are equipped to handle almost anything that we’re presented with and it’s time we started trusting our bodies again.  It’s also time many (but not all) scientists and doctors realized their limitations when it comes to these topics.  There’s nothing wrong with trying to study parenting and pregnancy – in fact, it’s laudable when the focus is on expanding knowledge and promoting education – but there is something wrong with deciding you can do better than hundreds of thousands of years of human history when you lack a basic understanding of how intricately intertwined each aspect of parenting and pregnancy are.  It is a battle the experts will never win.

[1] Duijts L, Jaddoe VWV, Hofman A, & Moll HA.  Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy.  Pediatrics 2010; 126: e18-e25.

[2] Armstrong J & Reilly JJ.  Breastfeeding and lowering the risk of childhood obesity. The Lancet 2002; 359: 2003-2004.

[3] Oddy WH, Li J, Whitehouse AJO, Zubrick SR, & Malacova E. Breastfeeding duration and academic achievement at 10 years. Pediatrics 2011; 127: e137-e145.

[4] Horta BL, Bahl R, Martines JC, & Victora CG. Evidence on the long-term effects of breastfeeding: Systematic reviews and meta-analyses.  World Health Organization 2007.

[5] Else-Quest NM, Hyde JS, Clark R. Breastfeeding, bonding, and the mother-infant relationship. Merrill-Palmer Quarterly, 49, 495-517.

[6] Vickers MC. Breast milk production: The anatomy of breastfeeding. Accessed from <http://www.breastfeed.com/how-to/basics/breast-milk-production> on April 27, 2011.

[7] Uvnas-Moberg K. The Oxytocin Factor: Tapping the Hormone of Calm, Love, and Healing (2003). Da Capo Press: Cambridge, MA.

[8] Hewlett BS, Lamb ME, Shannon D, Leyendecker B, & Scholmerich A. Culture and early infancy among central African foragers and farmers. Developmental Psychology 1998; 34: 653-661.

[9] Anisfeld E, Casper V, Nozyce M, & Cunningham N. Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment (1990). Child Development; 61:1617-27.

[10] http://ezinearticles.com/?The-Parasitic-Nature-of-Pregnancy&id=757602

[11] http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001898/

[12] http://health.howstuffworks.com/wellness/food-nutrition/facts/pregnancy-nutrition-guidelines1.htm

[13] Ibid.