Tuesday, June 25, 2013

Primitive Bonding

In the late 1970s, after the end of the Vietnam War, over 35,000 Hmong tribesmen and women with their children entered the U.S. They had been interned in refugee camps in Thailand, some for the last 20 years, while trying to escape the War and the Pol Pot communist regime who, having discovered that the Hmong in the mountains of Laos had secretly been helping downed American pilots, first wiped out over 30,000 of them causing the remaining population to flee, most via the Mekong River. Many were shot while crossing, many drowned.

The Hmong had lived in the mountains, the Lao people in the lowlands and towns. The Hmong in general did not learn to speak Lao, use their money or intermarry during the 500 years of their sojourn in Laos. They had been transplanted there earlier by Hun Warriors in Upper Mongolia who took it into their heads one day to oust the darker, clannish Hmong from their territories. They call themselves Miao or Meo, the free people. There are three clans within their overall population: Blue Hmong, White Hmong and Green Hmong. There are only eighteen Hmong surnames, the clans often represented by only a few names, for example, Lor, Her, Vang, Yang, Kong, Xiong, Cha, Chue, Vue, Moua, and Thao.
Their language is one of 24 distinct Chinese languages also shared by the Dao peoples. There are no plurals and no past, present or future tense. Unlike English, they don’t have a different word, for example, for ‘woman’ when it becomes plural: ‘women.’ They will just say ‘two woman’ or ‘many woman,’ or ‘foot’ becomes ‘two foot.’ They weren’t warriors but preferred to peacefully herd their horses. They are also known for their exquisite Oriental embroidery, called Paj Ntaub (pronounced pan-DOW,) and silver jewelry. They lived communally in long houses in the jungles of Laos, raising their own meat and growing their food, harvesting the seeds for the next planting season, carrying their babies on their backs wherever they went.
In the late ‘70s I was working to put my husband through college before any children came along. I would go back to school ten years later for my midwifery license, after 5 children, but with David studying full time, I had time and energy back then – we were young – to find something else to do when I wasn’t working. One evening I came across an article in the local newspaper about a program that Macalester College was initiating matching refugee families with people in Minnesota who would be willing to visit once a week and teach them English. I asked my husband to listen to this while I read it to him.
“But you don’t have a degree in English!” was his response. He does -- have a degree in English.
“I can teach the alphabet and colors and food and stuff!” I retorted.
“You don’t have a curriculum.”
“I don’t need one!”
“Poor people.”
Thus began a decades-long love affair with some of our closest friends. I called the telephone number listed in the paper and left my name and phone number with the receptionist. The next day I had My Family!
I was terribly nervous and excited. I had gone out and bought crayons, pencils, ruled paper and a bag of tangerines as a gift. And I did my homework. I learned that the Hmong people are believed to have come from the Yangtze River basin area in southern China. Chinese scholars have recorded contact with the Miao as early as the 3rd century BCE, and wrote of them that they were a proud and independent people. The history of the Hmong people is difficult to trace; they have an oral tradition, but there are no written records except where other people have encountered them. Hmong history has been passed down through legends and ritual ceremonies from one generation to another. However, throughout the recorded history, the Hmong have remained identifiable as Hmong because they have maintained their own language, customs, and ways of life while adopting the ways of the country in which they live. In the 1960s and 1970s many Hmong were secretly recruited by the American CIA to fight against communism during the Vietnam War. After American armed forces pulled out of Vietnam, a communist regime took over in Laos, and ordered the prosecution and re-education of all those who had fought against its cause during the war. Whilst many Hmong are still left in Laos, Thailand, Vietnam, Myanmar, and China (which houses one of the biggest Hmong populations in the world, 5 million), since 1975 many Hmong have fled Laos in fear of persecution.They have come to be known as very resistant to assimilation, but their way of life is all they ever knew and they take great pride in it.
The University of Berkley in California, upon learning of the vast exodus of the Hmong from Southeast Asia to the U.S. proposed a brilliant plan by which rural communities throughout the United States would absorb Hmong families and thus enable them to continue their agricultural lives far from the urban centers in America. Sadly, our government vetoed this proposal and the Hmong were moved into cities throughout the continental U.S. Having been a fiercely tribal people with a central elder, they became paralyzed with the thought that they would have to live apart from his direction in their daily affairs. Within months of resettlement, the majority left their new homes in various states and settled in Minnesota where their elder, General Vang Pao lived, cramming sometimes 4 families into a one-bedroom apartment and pooling money, food and cars to care for one another. Thus I found the Hmong as I set out in 1977 to teach English.

The Yang family might have known about the program, but I couldn’t ask and they didn’t tell me. We sized each other up as I made myself at home and spread out my teaching materials. The alphabet would be enough for day one. I visited once a week, but by week 4 I realized we weren’t getting anywhere. Everything was being forgotten in the interim. Thanks to (then) President Regan, the number of social workers being laid off reached epidemic proportions that same year. No one was taking these families on the bus, or to a restaurant or to the health department for screening. I found a box of Ivory Baby laundry detergent with its big, happy white baby on the box next to the bathtub. They were using it to wash their children, including a newborn! The big joke one day was that they had ventured into a grocery store on their own, and spying a lovely large tin can with fried chicken pictured on the label had bought it and were very surprised upon opening it that it contained a white paste of some kind and not one piece of chicken! (It was Crisco shortening).

That night I announced to David that I had decided to move in with my Hmong family. The only way they were going to learn English – really learn it – was through emersion. It was a Saturday night and by now they understood that I would be there by suppertime every 7 days. Though they had never used a Western calendar, they had dinner ready and were waiting for me. I had learned a bit about cultural etiquette while living in Japan a few years earlier, so I made sure to tell them (effusively) how much I enjoyed the meal – though I have no idea what I ate that night -- and I always brought something as a gift, usually fruit or flowers. I knew of no other specifically Asian customs, but figured that perhaps I would be forgiven any bloopers in this situation. I figured if I watched a lot, and listened a lot, I would learn how things worked.

Sai Zor Yang was the dad whom I guessed to be around 35 or so; Po Yee Vang his wife. She did not adopt his last name at marriage, but the children did. There was Sai’s mother, Mee Thao, a happy old lady without teeth and electrified jet black hair who perpetually had a baby tied onto her back. Then there were 4 more sweet, very shy children. There were just too many people in this new country that looked very different from themselves for comfort, me for one with curly brown hair and slate blue eyes and then there were the neighbors, the “messy cans” as Sai referred to them. It was not meant to be derogatory. He simply could not pronounce ‘Mexican.’ Hmong has no sound like our X. The surname Xiong is pronounced Shong. Either way you say it, the Yangs were terrified of their neighbors, especially their loud drinking parties that often spilled out into the back and front yards every weekend. They would bar their doors and lock all of the windows in their sweltering apartment during the hottest part of the summer. Temperatures in Minnesota easily reach into the high 90s from June through August. Housing projects do not come with air conditioners.

That first night after I moved in, I couldn’t communicate what this crazy white lady was up to. I spread out the bedroll I had brought with me on the sofa in the living room and sliding under the top sheet, smiled, waved and said slowly, Good. Night. I closed my eyes. The children had literally dropped where they were when sleep overtook them and were gently transported to the main bedroom. Grandma had been nodding off during our English lesson after supper, but jerked to attention at my escapade. Sai and Po Yee looked at each other, completely befuddled. Grandma decided to take control of this unexpected situation. She ordered Sai and Po Yee into the bedroom where I soon heard an animated discussion going on. A few minutes later, Grandma marched back out into the living room where I was dozing off and grabbed one of my writs, hauling me up to a sitting position. 

Then she pulled me – the surprised one now – into the communal bedroom and pointed to the far end of the row of tidy mattresses lined up next to each other against one end of the room. Sai and Po Yee were settling themselves at the other end with the baby next to his mother. Mee Thao pointed to a space they had made for me at the opposite side by the youngest toddler. So the order in bed was: new baby, Po Yee, Sai, 3 older children, Grandma, toddler and me. It was only years later when they could speak English and by the time I had become comfortable with Hmong that they could explain their predicament: according to their time-honored customs. The Hmong had an elaborate system of hospitality: You must welcome any traveler who came to you after dusk, even someone from a foreign clan, into the common sleeping area where the head of the household could protect them. The heavens forbid you left anyone out by the cooking fire where wild animals could harm them! That was absolutely out of the question, but the conundrum here was that this was a new country and they had never been faced with a situation like this one before. Did the old rules apply here as well? What if one of the ‘messy cans’ broke in and attacked her at night? Better err on the side of the caution and not incur the wrath of those bad sprites should we be overstepping our bounds here. So I had to sleep in my ‘spot’ in the correct order for the rest of my stay with the Yangs. After some weeks Jou Zhe, one of Sai’s brothers complained to me through one of his children who had a bit of English under his belt by then, “You always sleep with Sai and you never sleep with me!” Eventually I agreed to their code of hospitality and visited more homes than I could count.

I realized that this could turn into a full-time occupation. I didn’t want to give David the impression that he wasn’t my favorite bedfellow anymore, nor that I didn’t miss his nightly attentions, so I quickly enlisted all of my friends, coworkers and even a few acquaintances,  assigning each to one of Sai’s brothers’ or cousins’ families to host. This freed me to stay with the Yangs while my friends were getting to know and teach English to their new families. After doing this for 3 years we founded Abraham’s House, later called the Mustard Seed in an abandoned storefront in St. Paul out of which we distributed donated food and clothes, held English classes (we had real teachers volunteering by this time) and 24-hour liaison services. I haggled with the phone company when they sold designer phone sets to unwitting families for hundreds of dollars, threatened landlords who refused to fix broken furnaces in the middle of Minnesota winters, and began speaking at churches throughout the Twin Cities and on radio, exhorting my fellow Minnesotans to reach out to these truly beautiful people. I felt like we were gaining far more than we were giving by getting to know them. As my Hmong got better I was called to help at funeral homes, courts, and local hospitals, but that would be another book which you didn’t sign up for when you started reading this one.

Like Jean Leidloff (The Continuum Concept, 1971) whom I didn’t read until many years later, I was not seeing babies who resembled our American babies. These babies hardly fussed, never seemed to cry, were carried most of the day only being put down on straw mats on the floor when they were sleeping, but were otherwise scooped up at the first peep and tied onto whomever was the first adult on the scene. Babies were nursed on demand until the next newborn came along. Then that toddler became the charge of Grandma or an Aunt who would carry, feed, sleep with, entertain and care for him so that the little person would not feel left out for one minute by the tiny intruder. Children were constantly milling around the grownups wherever they were congregating. The men would gather before and after a meal, often sharing a bamboo hookah, babies or toddlers on their knees or in their laps, older children quietly playing and listening to the conversations while their moms and sisters cooked, cleaned and took care of the household.

During the first years I was with the Hmong, I never saw a baby crying uncontrollably, or left to cry behind a closed door. I never saw a tantrum when a parent said no. I didn’t see whiny or clingy children in stores demanding this or that dry cereal or toy. I also didn’t see parents entertaining their little charges, rather, they were simply brought along throughout the day wherever their parents or aunt or grandma needed to be engaged. Toddlers were looked after by the whole extended family. It did take a village to raise each child. Everyone, even the oldest grandpa’s lap wasn’t off limits to a grazing toddler. Grandpa just kept talking or telling a story to whomever was listening (or no one.) Spoken Hmong is a preliterate (unwritten) language, so there is a very rich oral tradition of story-telling. Stories are told and retold. Stories are sung over and over. Stories are even sewn into intricate, elaborate quilts and wall hangings.
You can find story quilts telling the story of a particular family’s exodus from Laos (right) or the layout of the clan’s farm and animal herds before the war. I also saw toddlers wielding knives and machetes. Adults didn’t admonish the children, or grab the tools away but quietly hovered nearby, letting this be an educational moment. Children hardly more than toddlers themselves would comfort a smaller child if he fell down. There were no toys as such in those early days, but children would share or patiently wait for a turn with an empty juice bottle ‘doll’ wrapped in a rag that another child was playing with.

This was continuum bonding. After 9 months in utero, being totally surrounded by everything he needs a baby’s care isn’t suddenly completed, like an assembly line product, popped out at birth. The complete circle of touch, smell, sounds, taste and comfort must be continued 24 hours a day. ‘In arms’ he will continue to be held, fed, jostled, rocked and hear and see everything around him that he will slowly learn from. That is stimulation enough. We don’t have to constantly entertain, provide educational toys, teach, hang mobiles, come up with unique experiences, run through flashcards, schedule play dates, put on classical music, or play CDs of foreign languages, ad infinite. Our babies will process as much as they are able at each appropriate stage without our perpetually thinking that they won’t learn or be smart if we do not personally fill each teaching moment by offering them multiple options. Our daily lives already provide the social and physical requirements for our brain development.

After the second year with the Yang family, and David was nearing the end of his studies, I became pregnant. I was elated as this had not come easily; months of grueling tests, charts, surgeries and buckets of tears finally paid off. One interesting aside here is that as soon as Po Yee noticed I was showing, she tried to let me know I must now come in the back door. The spirits wouldn’t like it if I came in the front door! One day when Sai drove up to our apartment to pick up a car-load of donated rice, he found me in our little patch of garden. He looked at me, then at the plump cucumbers. He knelt down and picking one up carefully examined it. According to him, they shouldn’t be growing. I asked ‘why not?’ He said, for one I am a woman and two, a pregnant one at that. I told him I have been growing cucumbers for years and they don’t seem to know there is a difference. He shook his head, incredulous. This was indeed a strange new land!

Finally it was November. After a quick birth, we left the hospital 6 hours later and were happily snuggled in bed by supper time with our very clever, very amazing baby boy. We started calling relatives and friends, Sai’s family among them.

Within an hour his family came over to check out what an American newborn looked like. Grandma was the first to speak. While pinching Avi’s nose and cackling she said the equivalent of “Look at the shnozz on this kid!” She gave it a few gentle pushes, hoping to reshape it, perhaps. Definitely too big for a baby! I could hear the kitchen cupboards opening and closing from my bed. I wasn’t sure what they were looking for. Sai came back into our bedroom and said, “Where are the grandmas?” I explained that David’s mother was elderly and sick, and mine had a career on the West Coast. He looked horrified. They all packed up and left then, only to return two and a half hours later, laden with bags of groceries, filled the refrigerator and put a beautiful bowl of fragrant chicken and rice soup on a tray for me. We were flabbergasted! Such generosity! Then, to top it off, they explained that they were giving Grandma to us! The old lady was smiling from ear to ear. Then she opened her mouth and pointed inside. “See” she said, glaring at me. “No teeth. Don’t even try to teach me English.” We agreed and we had our very own experienced postpartum doula for two weeks!

I was anxious to try some of the Hmong parenting styles I had come to respect on Avi. He nursed on demand, and slept with us, much to the chagrin of our relatives. We had decided before his birth not to even have a crib or bottles in the apartment. Po Yee gave her babies a quick bath each and every time they pooped. None had ever had a diaper rash. Neither did my babies. I knew we wanted to nurse longer than the then popular token 3 – 6 months, but were afraid of being constantly questioned by relatives if we were still doing that after 2 or 3 years. I got around this one by switching to my now-semi-fluent Hmong with Avi whenever we nursed. By the time he was one he was asking for ‘milk’ or ‘breast’ only in Hmong. Years later our 4th baby, Rachel when they were both 3 asked a little friend she was playing with  if she also still got “naw mee” when she wanted it. She told me later that night that “poor Emily doesn’t even know what naw mee is!”

David and I took turns tying Avi on with a colorful Hmong carrier whenever he was awake. He was very easy to care for, and happy just to see what we were doing all day. His first words were in Hmong. I was visiting Mee Thao who snatched him up as soon as we arrived and I found him in the kitchen later with her feeding him rice and soup. At one point she howled with laughter. I asked her what was going on. She said, “He talk Hmong!” I was not surprised, I told her; she talks to him all the time. I tried to explain that if I took one of their babies home and it seldom heard Hmong that it would speak English. She violently disagreed. Hmong babies are born knowing Hmong. Then I asked her what he had said. She said, “Naw maw!” (Eat more rice!) Then when he was done, he turned to her and said, “moe oo-wash-ee:” Go play (now).

I was honored to have spent so many years watching and learning from our Hmong friends. I think they really got this one right. I am just so sorry that the next generations feel the need to look and act truly American, complete with strollers, Nuks, formula and cribs - the whole shebang. They have lost more than a homeland. They have lost the wisdom of their elders. 

STAY TUNED... This and other stories will be appearing the book, Stone Age Babies in a Space Age World:§ Babies and Bonding in the 21st Century,© or "Call the Doula! a diary"© both pending by Stephanie Sorensen

§This phrase was first coined by Dr. James McKenna, used here with permission and gratitude for his work. A world-renowned expert on infant sleep – in particular the practice of bed sharing, he is studying SIDS and co-sleeping at his mother-infant sleep lab at Notre Dame University. He is the author of “Sleeping With Baby: A Parent’s Guide to Co-sleeping,” 2007, Platypus Media, Washington, D.C.

Monday, June 24, 2013

Every Doula’s Wish Come True!

Over three hours with Penny Simkin! It was so inspiring to hear Penny tell about her journey as a mother, grandmother, doula, author, birth counselor and childbirth educator. A special thanks to Liz Abbene and all the enlightened women at Enlightened Mama in St. Paul, Minnesota for hosting this amazing event. Penny Simkin, 75 years young, trained as a physical therapist that has specialized in childbirth education and labor support since 1968. She estimates she has prepared over 11,000 women, couples, and siblings for childbirth. She has assisted hundreds of women or couples through childbirth as a doula. She is the producer of several birth-related films and is the author of many books and articles on birth for both parents and professionals. Books include The Labor Progress Handbook (2011), with Ruth Ancheta, The Birth Partner (2008), and When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse of Childbearing Women (2004), with Phyllis Klaus.
Currently, she serves on several boards of consultants, the Editorial Board of the journal, Birth, and serves on the senior faculty at the Simkin Center Allied Birth Vocations at Bastyr University, which was named in her honor. Today her practice consists of childbirth education, birth counseling, and labor support, combined with a busy schedule of courses, conferences and workshops. Penny and her husband, Peter, have four grown children and eight grandchildren, ranging in age from 7 to 27 years, and a pug, Hugo.
We were also honored to hear about the upcoming work and research that Penny is hoping to do and some the ideas that are still solidifying about birth – both good and bad – in her mind. She is passionate about her work with PATTCh and finding ways to arrest and reverse the unacceptable trends and direction we are seeing in many births today. PATTCh began in 2008 when founders Penny Simkin, Phyllis Klaus, Annie Kennedy, Teri Shilling, Sharon Storton, and Kathy McGrath met at Penny’s house in Seattle. 
From their Website:
What is Traumatic Childbirth?
If a woman experiences or perceives that she and/or her baby were in danger of injury or death to during childbirth, her birth is defined as traumatic  –psychologically, physically, or both. Usually, she experiences extreme sense of helplessness, isolation, lack of care, fear, and anxiety (Beck, 2004a). Traumatic childbirth occurs in as many as 18% of all births. Approximately one-third of those women may develop Posttraumatic Stress Disorder (PTSD).
We envision a world where women, infants and families experience optimal physical and mental health in pregnancy, childbirth, and the postpartum period.
The PATTCh board members are a group of psychotherapists, childbirth educators, doulas, researchers, and academicians who are dedicated to bringing together like-minded individuals to educate childbearing women and families and maternity care professionals; develop effective prenatal, intrapartum and postpartum care practices to prevent or reduce traumatic birth and post-birth PTSD; and identify and promote effective treatments to enhance recovery.

Thus yesterday we were honored with an amazing encounter with one of our heroines. Penny continues to inspire thousands of childbirth educators, doulas, midwives, parents and providers and draws us all together to reach our collective goal: that of improving birth outcomes and support for each mother we care for. Thank you Penny Simkin!

Thursday, June 20, 2013

Bonding with Partners: (be that him or her)

At birth a baby is fully expecting to continue the level of attachment s/he had while in the womb. Actually, they are ready for the next stage, sometimes called ‘a womb with a view’, but still motherbaby. They are not prepared to be independent on any level. They are the most helpless of all mammals at birth. We are actually beginning to write 'motherbaby' as one. We could also call it ‘motherbabyfather’ or ‘motherbabymother.’ Stop and think about it: they have been one all these months, and that bonding continuum should be ongoing during the next weeks and months. Our babies are not born mature enough to be without us at all. They are totally helpless, far more vulnerable than any other baby mammal at birth.

Have you ever wondered why we as humans have such large brains but start out as such helpless creatures? This one is obvious: we are smarter than any other animal. Part of the reason is that, yes, we are the most intelligent species, but our babies are born unprepared for survival. Our brains grow so fast before we are born, and into the first year, however, that if they kept growing until the rest of the body caught up and was as mature as, say, a calf is at birth, their heads would be far too large for the birth canal that they must pass through. Since our brains are so advanced, they grow faster in the first year than the brains of any other species. If we waited another 4 - 5 months or until they could crawl to deliver, our babies’ heads would be too big to fit our frames. So Mother Nature had a toss-up: make mothers’ hips even bigger than what we have now (Horrors!) or have babies born sooner than they are in reality ready for.

So, this makes it clear that they are not as mature as other little mammals and do need us constantly, even more than the offspring of other species. Nature knows this. Babies know this. Do we? We don’t act like we know it. Nature knew also, by the way, that baby elephants would not survive if they couldn't walk and keep up with the rest of the herd shortly after birth, and would likewise be eaten if left behind, so elephant mamas are pregnant for 2 years or until baby Babar can walk! And we complain about our 9 months' gestation. (A MUST see: The Dramatic Struggle for Life - Bali, on YouTube)

It is actually an illusion to imagine that our man- or woman-made time machine should likewise affect our babies, but we in fact do believe this. The truth is our babies are as immature at birth as our fore-mother Lucy’s were 3.18 million years ago. Consider Lucy (who currently resides at the Ethiopian National Museum in Addis Ababa, Ethiopia), whose babies had to be carried, and in constant contact with her, 24 hours a day, day and night, for at least 2 years or until they could walk. He had constant skin-to-skin contact; was in
constant proximity for eye contact with his mother or whatever member of the clan his mother was interacting with throughout the day – at an adult’s eye level, incidentally, and not lower as in a crib or stroller where faces suddenly appear to loom above his and just as quickly disappear.  He nursed on demand.  He had no need to cry. A grunt or his reaching for a breast would be enough of a sign. His mother had enough time connected to him that she could already easily ‘read’ any signals coming from him. He listened to his mother interacting with others all day long. We do not know when she began speaking directly to him, though. Perhaps it began when he spoke first, having listened to adult speech and figured out how it worked.

We now know that bonding is reciprocal. Even into the 21st century, however, we can read some authors who are still considering bonding a mother-led phenomenon, whereas it is actually reciprocal. When a baby searches his mother’s face, he is seeking her gaze in return. If her gaze is not there more times than it is, she has also given him a clear message: this is not how we humans interact, though she gives him no alternative solution. When he reaches out to touch her, he expects his hand will be held or carressed. When he first coos, a rewarding sound from his mother will encourage more early speech. If parents are engaged elsewhere either mentally or literally, while interacting with a cell phone or texting, for example, and those overtures from your baby are ignored, that, too, is a message: he isn’t being answered. Perhaps his voice may not be the best way to communicate after all. He’ll have another try at it first: cry louder, perhaps, to get the needed response. Or do something, anything, to get your attention. Sounds familiar? But back to Lucy. Bonding was the way to survival. Had she put her babies down, they would have been mauled or eaten. And we would not be here today.

Kangaroo care is a method of holding a baby that involves skin-to-skin contact. The baby, who is naked except for a diaper and a piece of cloth covering his or her back (either a receiving blanket or the parent's clothing), is placed in an upright position against a parent's bare chest. This snuggling of the infant inside the pouch of their parent's shirt, much like a kangaroo's pouch, led to the creation of the term "kangaroo care."

Kangaroo care came about as a response to the high death rate in preterm babies seen in Bogota, Columbia, in the late 1970s. There, the death rate for premature infants was 70 percent. The babies were dying of infections, respiratory problems, and simply due to lack of attention. Researchers found that babies who were held close to their mothers' bodies for large portions of the day, not only survived, but thrived. By using a carrier, your hands are free and you can get on with the business of living while your baby comes along for the ride: the place and activities he is expecting at this point in his continuum.

All of a baby’s bonding cues need to be met during the critical ‘in arms’ stage, or the time before they choose to wander farther and farther away from us as they gain confidence and the ability to first roll, then creep, crawl and finally walk. If they have been made to feel completely secure up until that point, they will have the self-assurance to begin exploring the world beyond the motherbaby bubble at the right time. By separating our babies from us over and over during the first days, weeks and months of life, they hardly feel secure or sure enough of their safety to ever want to let go. In the Western World we have decided to trust so-called experts in child care and development far too long. I always ask myself first when reading a new book on the subject: 1. did this person earn a doctorate degree through this study? and 2. how many children does s/he have? If the first question is answered with a ‘yes’ and the second with ‘none’ I am probably not going to read it at all or I will not put much stock in it, if I do.

The bonding cues that babies have been hard-wired with since Time Immemorial seal or solder their connections to their survival source: Parent. They imprint her odor immediately at birth. The first sense to kick in is smell. The early milk or colostrum actually smells like amniotic fluid and thus attracts the baby instantly to the breast for food = Survival. Without it, the little mammal knows it doesn’t stand a chance. Our human babies are born with the same sense of smell that baby sheep, and other herd animals are born with. Have you ever wondered how a little lamb finds its mother in a crowd? What if he gets lost on the way to a new pasture? He doesn’t just start nursing at the first engorged teat he sees. He smells each large animal he passes until he finds his own. As he grows and as he is sure his mother now knows his voice, he will call for her, knowing if she hears him, she too will be helping to reunite with him.

Our babies are born with a very good communication system, too, however, we often ignore it. When a human baby first grunts or fusses and then cries, he expects his language to be heard, interpreted as a need, and answered. If this doesn’t happen, he tries again, cranking up the volume. If his mother has been told that it is good for his lungs to cry or that he has to learn to go to sleep in his own room or sleep through the night, and she tries to ‘train’ him then he is led to believe she is simply gone. 
And he will grieve. If his communication system fails him over and over and over in the coming months, he will give up depending on it, clinging tighter when she does appear to avoid another terrifying experience of being left alone with a communication system that doesn’t work, even though it is all he has to work with and she is the only person in the entire universe that he is trying to communicate with. He will not ‘learn’ to self soothe himself or come to trust that she will appear at the proper times. He is not that smart yet. He might be given and bond with a blankie or a soft teddy bear which he will not let out of his sight – a sorry substitute for a mother. 

Touch, I believe is the most important of all bonding behaviors. Smell, taste, sound, and eye-to-eye contact follow. Now there are a few authors that we should learn from. One of them is my favorite midwife in the U.K., Carolyn Flint, (below) former president of the Royal College of Midwives who recently said, “Women can give birth perfectly well on their own without interference.” Britain's most famous midwife says ALL babies should be born at home (and most geniuses were...) Her new book, Do Birth, is a guide to giving birth for mothers.

Britain's most famous midwife, who has delivered babies for celebrities including Thandie Newton, Davina McCall and Stella Tennant, says birth in Britain has become industrialized and should be stripped back to a simpler and more natural experience. Caroline Flint, 71, from Vauxhall in London has said she believes all babies should be given the opportunity to enter the world at home during a 'normal' and non-medical birth.

Caroline Flint believes all babies should have the opportunity to be born at home, and her new book, Do Birth, is a guide to giving birth for new mothers, not people within the profession. She added: “I think if women could start off with a midwife in their home, whether they are high-risk or low-risk, and then if she needs to go into hospital, she can go with them; Much less intimidating. A brutal entry into the world, where the baby is pulled out of his mother's body, accompanied by loud voices and bright lights, and then rubbed with a rough towel, teaches this oh-so-sensitive baby that the world is a tough place where he may not always be welcome.” Flint also says the theory that children born at home will not flourish academically (compared to those born in hospitals) is nonsense.

'Think of every genius you have ever heard of and the likelihood is that they will have been born at home - Mozart, Beethoven, Einstein, Elgar.'

She says, “My life experience is that things very, very, very, very, very, very, very rarely go wrong', Flint also explains that some women have such an enjoyable experience giving birth that they can even reach orgasm - and the best place for this to happen is in the home. She says: “After the birth you will snuggle in bed with your beloved partner and gaze at your baby, telling each other how very clever you are...fragrant, joyful and transcendent.” She adds: “I can't imagine becoming sexually aroused in a brightly lit hospital. Can you?”

In her childbirth education series Ms. Flint teaches about bonding and falling in love with your baby.
(see: YouTube link: https://www.youtube.com/watch?v=jGTEg25bX9Q Carolyn suggests that you go home after your baby is born if you aren’t there already, take off all of your clothes –because the skin contact triggers your oxytocin output, the ‘love hormone’ -- and your baby’s clothes (nappies or diapers allowed) and go to bed with your baby mammal. Staying there for 14 days will ensure continuum bonding, establish the right milk supply, and give you time to recover properly. We are the only mammals who dress our babies at birth, and ask “where will my baby sleep?” and “what should I feed my baby?”

In his book entitled Touching: the Human Significance of the Skin Ashley Montagu has found enough to say about touch and skin-to-skin contact as crucial to our species to fill all of 494 pages (not to mention all the other books he has authored!) Written in 1971 I believe it is even more needed today in the 21st Century than we realize. We have more children with more problems than ever before in history, yet we claim more medical and scientific advances than ever. Why has no one questioned this troubling sequence of our so-called progress? Do we take our evolution for granted and assume we are constantly improving through osmosis in spite of the devastating statistics on the state of children and mothers throughout the world while they continue to escalate? We have the capacity to research and promote change, but how and why have we taken so many steps backwards in our understanding of our most primal needs?

By meeting those needs at the proper time and in the proper sequence, I believe we would avoid some of the most troubling consequences that we see and that we are apparently mystified by today.

Montagu begins the preface to the 3rd addition by saying that, “We in the Western World are beginning to discover our neglected senses. This growing awareness represents something of an overdue insurgency against the painful deprivation of sensory experience we have suffered in our technologized world. The ability of Western man [and woman – ed.] to relate to her/his fellow human beings has lagged far behind his ability to relate to consumer goods and the unnecessary necessities which hold him in thrall – possessed by his possessions. He can reach out to other planets, but too often he cannot reach out to his fellowman. His personal frontiers seldom, if at all permit the passage of a deeply felt communication across them. The human
dimension is constricted and constrained. Through what other media, indeed, than our senses can we enter into that healthy tissue of human contacts, the universe of human existence. We seem to be unaware that it is our senses that frame the body of our reality. To shut off any one of the senses is to reduce the dimensions of our reality, and to the extent that that occurs we lose touch with it; we become imprisoned in a world of impersonal words, sans touch, sans taste, sans flavor. The one-dimensionality of the world becomes a substitute for the richness of the multidimensionality of the senses, and our world grows crass, flat, and arid in consequence.”

Having thus established that touch is most likely the first and foremost sense to require attention at birth in order for bonding to follow in its intended order, how is that accomplished? Well, let’s look at what happens at the moment of birth: The midwife or doctor, or father or partner or the mother herself instinctually reaches for her baby and immediately attempts to bring the child to her arms and then her chest. The only time this does not happen is when the baby does not appear to be breathing and the birth team assesses that s/he
needs assistance to do so. In most hospitals, the baby is immediately brought to a warmer which has been preheated and is high enough for access by the nurse or pediatrician. They will suction the baby’s mouth and then nostrils while at the same time reciting the protocols for resuscitation in their minds: heart rate, color, muscle tone, respiration, cyanosis (areas still blue), and will act accordingly, either initiating further interventions to help the baby get started or if she has sufficiently recovered will be returned to the mother where she and baby left off: being held on her mother’s chest. At this point I usually make sure that the mother is ready for this and 99% of the time she is, but occasionally a mother needs a few moments to also recover especially after a particularly traumatic or very long birth and then I suggest that her partner remove her/his shirt and holding the baby skin-to-skin cover her with a warm blanket. Again, in a perfect scenario, a mother or partner usually begins talking to the baby next. This is the mother’s cue to the baby to reassure her that she is in the right place and that the birth is over and she is safe. If this has indeed happened and the baby feels instinctually that all is right with his little world, he is free to go on to the next stage in the continuum. He will begin to smell his mother or other parent’s unique odor. I personally think this will work to its optimum intended effect if artificial fragrances are avoided at birth. Powder, deodorant, perfume, cologne, and hairspray may confuse the little nose trying to imprint his new environment. Clothes washed and dried in artificially perfumed soap and fragrant dryer sheets should be removed.

Your baby’s next task is to take in his mother’s voice which he is already familiar with. Babies hear a muffled version of everything that has been going on for the past 9 months. It is interesting that we have devised a special tone for this early communication with our babies. It is the higher pitched sounds or ‘baby talk’ that we notice that our babies respond to better than monotone or lower sounding speech. Called Motherese, most cultures employ this type of verbal bonding, first by a parent speaking to the baby often right at birth and then in response to sounds he makes, either in answer to your prompting or later on his own initiative.

Your baby will then be ready for the next step: imprinting important tastes that will continue to assure her that bonding and survival are happening right on Nature’s schedule. I believe that Nature makes no mistakes. Everything is programmed into that tiny brain to work according to a specific plan. The same workings are present in the mother, though we have succeeded in overriding most of those through our misguided intellects. Again, we have listened to the so-called ‘experts’ and not our instincts when it comes to raising children and meeting their inherent needs.

Our baby will now move on to the work of surviving. He will begin to lick his mother’s skin in order to imprint this next needed connection within the continuum. At the same time he will smell that enticing colostrum which is a miracle substance in its own rite. High in antibodies and sticky and thick enough to thoroughly coat his gut on the way down, it will protect him from any rogue germs that might be present in his new environment. It will act as a laxative and help dispel whatever meconium is in his intestines, hastening the work his liver and kidneys have begun to purge themselves of the waste products that have accumulated there during his internment in the womb until now. His stomach is no bigger than a marble on his first day of life, so filling it with anything other than a few teaspoons of colostrum every hour or so will tip the very delicate balance that is in place there. In our lactation course which prepares us to become certified consultants we learned that by introducing sugar water or baby formula at this stage and especially more that those few teaspoons, but trying to force-feed a whopping 4 ounce bottle of anything can cause micro-hemorrhages in the newborn’s gastro-intestinal tract. No wonder doctors were pushing iron drops for all newborns during the 70s and 80s and even into the 1990s because their iron levels were dropping. What they did not realize though, until much later, was that they were the cause of the anemia by giving babies far too much too soon of the wrong stuff for their systems. Let’s leave this to Mother Nature, please. Your baby can also practice his sucking skills on the small droplets of colostrum without being deluged by buckets of milk choking him while he is trying to get the hang of it.

My Quaker friends once told me that they have a saying: Breastfeeding is perfect because it is always warm, it is always ready, and it is up high where the cats can’t get it!

By day three his stomach is the size of a walnut, about 1 ½ ounces; still not very big. Your baby was saturated in water for nine whole months. Babies do not need to eat yet. Unless your baby has high sugar levels due to hypoglycemia he can still work on getting the colostrum and more mature milk as your breasts begin to produce it. By giving your baby a pacifier or bottle at this point you will very likely run into what we call ‘nipple confusion’. As much as your partner would wish to have a turn feeding their baby, I would strongly caution against it for now. I don’t think pumping your milk at all is a good idea at this point either.
The milk supply is triggered by the baby himself creating a demand if all of his sucking is done at your breast and not on a Nuk or bottle filled at a breast pump machine. He will demand the right amount of milk according to his needs, continually adjusting that as he grows. Four weeks is the recommended time frame to be giving only the breast in the beginning while you are both learning how to breastfeed and bringing the supply up to what will be needed.
Adopted babies can also be breastfed. If you have ever been pregnant, even if that pregnancy ended in a miscarriage or loss, you may be able to induce lactation or ‘re-lactate’. This is when the breasts are stimulated enough to trigger the release of oxytocin in the brain and begin to once again produce milk. If the pregnancy ended, for example, 6 months ago, it may be that 6 more months will be needed to bring your milk supply up to full tilt once more. Some people have used an oxytocin nasal spray while using a breast pump to help signal the let-down reflex with some success. Even without a former pregnancy, any woman can let a baby suck to pacify himself. This was first observed by Dr. Margaret Mead in the 1950s in New Guinea. Native grandmothers would re-lactate when their own daughters had just given birth and they would let their newborn grandchildren nurse at their breasts while giving their daughters needed rest.
See: Extraordinary Breastfeeding https://www.youtube.com/watch?v=1YHO9lzDt9w

Another scenario is that a woman has had breast reduction surgery and that at the time the areolae and nipples were removed during the operation and then re-attached. You will not be able to establish a milk supply in this case, because the milk ducts were severed but you can still nurse your baby. If you have never lactated or been pregnant, you can still nurse and properly bond with your baby, whether you adopt or have chosen another arrangement. I would suggest that babies always nurse from their birth mother for at least the first 6 months. Two years would be ideal, though. (In the U.K. Parliament recently enacted a bill that strongly encourages all mothers to breastfeed for 2 years and has paved the way for employers and policy makers to follow suit with appropriate accommodations in the workplace and in public.) Should your partner want that experience too, don’t make the 2nd maternal parent’s primary task to nurse the baby with his birth mother being assigned the part of carrying him to term. He needs plenty of breast milk first and foremost for optimum growth. But there are ways a never-pregnant mother or partner, adoptive mother or a woman who has experienced radical breast reduction surgery can nurse.

Any baby who has been consistently breastfed will attempt to latch even if it is on a different breast than they originally started on. It may have a different shaped nipple and he may need several attempts to get it, but it usually will work unless the newer breasts have inverted nipples. A breast shield might help make nursing possible or even correct the nipple. You can also roll the nipple manually, encouraging it to stay erect long enough for the baby to latch onto. A baby who has been only bottle fed, as is the case when coming from an orphanage or foster home will not know how to latch properly and may go on strike when offered the breast. Sometimes by feeding a bottle-fed baby a bottle first and then switching to the breast while they are dozing off and very relaxed might work. Milk flows out of most bottles much faster and with less effort on the baby’s part than breast milk so keep in mind that your baby may expect and demand the easier of the two should you try to offer a bottle and then try to go back to breastfeeding. A plastic nipple shield will feel more like a bottle to a bottle-fed-first baby. You can also find bottle nipples with smaller holes, usually designed for preemies, which will flow more slowly and help a bottle fed baby transition to the breast more easily. See: http://www.babycenter.com/404_how-do-i-know-which-bottle-nipple-is-best-for-my-baby_1334551.bc

While I was in midwifery school in the 1980s in Texas (see at this blog the March story, “What a midwife should not do: A lesson in destroying bonding”) I caught a baby one afternoon whose mother had decided to give him up for adoption, a very difficult decision to make. I was doing my internship in preparation for the state boards that year at a freestanding birthing clinic on the Mexican border. A beautiful 8 pound baby, I knew that the mother wanted to see him, but chose not to hold him. Her own mother was there to support her, so after the birth, I took him to my bunk in the dorm where we students stayed during our time there. I wanted him to know he was loved and would soon have a family but they were not coming until the next day after his mother had gone home. We had no nurses on duty and really had no other facilities like a nursery much less an isolette or crib. We had sterile water and a bottle or two on hand, but I had never used them for any of my 5 babies, so the idea popped into my head that I could let him nurse on me until his new family came. I got permission to keep him with me and, sure enough, he latched on and stayed there most of that night. I doubt if I had much milk, though I had only weaned my last baby a month earlier. I cried when I lay down with him, his perfect little brown body against mine in that narrow bunk bed. I could only hope they wanted him and would love him, too. When they came the next morning with their social worker, I brought him to his new parents and explained how we had let him nurse and that was an option, should his new mom want to explore the possibility. I gave her the following information, should she choose to. It seemed to thoroughly confuse her, though I think adopting your first baby might alone be mind-boggling enough for the first day.

In the early 1970s an adoptive mother, Jimmie Lynne Avery, of Athens, Tennessee together with her husband came up with a revolutionary way for adoptive mothers to breastfeed. It is a tube feeding system created to supplement baby at the breast while nursing. It consists of a bag or container to hold supplemental formula (or breast milk if you are lucky enough to have a source for it. Contact your local La Leche League first for sources.) A tube reaches from the bag to the nipple at the breast and baby suckles the breast and tube together. This assures adequate nutrition and helps maintain or re-establish breastfeeding. It lets the baby stimulate the breasts more effectively and as milk increases, the supplemental milk is decreased. It trains baby to stimulate the sucking reflexes for improved coordination and skill. It also avoids overtiring and frustrating a baby while you are working at building up a milk supply. See http://www.lact-aid.com/ 
Again, I would stress using exclusive breastfeeding from one source only during the first crucial 4 weeks at least. I have been called in to consult on problems when babies have gone on strike and refused to latch when mothers have left Vaseline or lanolin cream on their sore nipples. You should wash off any lotions before nursing. They can taste funny and put a baby off. When bathing, too, be sure to completely rinse off any soap or shampoo. Newborns latch best when you express the first drop of milk and let him smell and taste what is coming. A baby has to wrap his tongue around a pacifier differently from a bottle nipple (no matter how ‘like mother’ they promise it is) and then again differently from a breast shield or a breast. Some people settle a frantic, hungry baby by putting a little finger into his mouth and letting him calm down before nursing, but then once again, his tongue has to re-think how to create suction in order to suck from the finger without losing it. No wonder we see so much nipple confusion. Even when using a nipple shield to give cracked or sore nipples a chance to heal, they work best if you express a little colostrum or milk into the inside of the nipple and drip or rub on a little on the outside where your baby will be sucking from before placing it on your breast.

Sleeping with your baby is also how Nature intended bonding to happen. Contrary to all the dire warnings, we now know that babies and parents both get far more sleep if they are in the same room if not in the same bed.
See: http://cosleeping.nd.edu/safe-co-sleeping-guidelines/ and www.cnn.com/HEALTH/9703/21/nfm/family.bed/

Noted physician and author Dr. Benjamin Spock, years ago popularized the notion that stern bedtime routines are essential in raising children to be independent and well-behaved. Many pediatricians still urge parents to follow that advice. Many parents insist on their own space and privacy. And there's a strong case to be made that both children and parents sleep better when the kids have their own beds. Some parents have an open-door policy, where children are allowed into the parents' bed if they ask. But a growing number of parents feel strongly that the best way to nurture children is a return to old-fashioned bed sharing. It is also interesting that it is only in Western cultures that we ask: where will my baby sleep and what should I feed my baby? The rest of the world doesn’t seem to have a problem with this.

Consider the Lilyerd family: Faye, Jerry, 6-year-old Aaron and 2-year-old Sara sleep together every night. "I find that after a really rough day, it's a relief to be able to go to bed," Faye Lilyerd said. "It's a relief to be able to go to bed. We can all lay down, read some stories and either relax and just enjoy each other in that peaceful time." Jerry Lilyerd agrees. "Why, for such a short period of time, should you make somebody that's small and young sleep by himself?" "I just love that big bed," the 6-year-old says. But there are obvious pitfalls to the arrangement. What about sex, for instance? "That's never really been an issue," Jerry Lilyerd says. "If we want to be private or whatever we come downstairs." "Anyone who doubts whether you can have more children when you have a family bed, go talk to those people who figured it out," Tine Thevenin says. "You'll figure it out." But figuring out when to wean the children from the practice isn't always a simple matter. "That's always a worry," says Dr. William Sears. "Will they ever leave our bed? Yes, they do leave your bed" he promises. See: http://www.cnn.com/HEALTH/9703/21/nfm/family.bed/ and http://www.parenting.com/article/the-family-bed

Another good time to bond is when you bathe your baby. I would have my husband David get into the tub first and then hand him one baby at a time (we had a toddler and then twins. See “Twin Birth on the Farm” at this blog.)  If he wasn’t home I would get in the tub with them. I could scrub one at a time without breaking my back and we would all have fun at the same time.

Of course, wearing your baby(ies) is tantamount to bonding. There must be as many varieties of baby carriers as there are countries in the world. Most free your hands so that you can continue doing whatever you need to without feeling like you have to entertain your little person constantly. Actually they don’t expect to be given stimulating activities throughout the day. Rather the opposite is true. They are only simple observers at this stage in the beginning, just taking in how life and relationships work. They use their eyes, ears, taste, touch and smell to process all that is going on around them. They could hardly take in much more if it was up to them and we often think we need to further engage them but we don’t. They would become over-stimulated and we see them trying to push away or cry away what is simply too much, and then we don’t read those cues very well. Too many options offered at this age are overwhelming. "What do you want to eat? Cookie or banana? Which book do you want to read? Which song? Which toy? What new activity? What should Mommy do? What do you want?" This is clearly shown in the beautiful movie, “Everybody Loves … Babies” by director Thomas Balm├Ęs. I show this DVD in my childbirth education classes to bring attention to these bonding and non-bonding behaviors in particular. I find it quite interesting that the babies from the two so-called Third World countries in the film appear happier and better adjusted little people as they grow up in spite of far less toys and parent-sponsored activities compared to the babies in the U.S. and Japan. I will be exploring baby wearing more in the chapter, “Wear Your Baby!” in my upcoming book.

Again, I can only stress that we already have in place a natural continuum that is everything our babies need, if only we would open our hearts and not more books (unless of course those books show us how to open our hearts.) And once again I can remind new parents that they cannot multi-task during the critical first months of parenting. We need to pay attention to the cues that your  baby(ies) are using and learn to recognize and respond to them. The progression of those cues will only lead us to raise children who feel secure and loved without undue stress, especially on the part of his parents.

STAY TUNED... This and other stories will be appearing the book, Stone Age Babies in a Space Age World:§ Babies and Bonding in the 21st Century,© pending by Stephanie Sorensen

§This phrase was first coined by Dr. James McKenna, used here with permission and gratitude for his work. 
A world-renowned expert on infant sleep – in particular the practice of bed sharing, he is studying SIDS and co-sleeping at his mother-infant sleep lab at Notre Dame University. He is the author of “Sleeping With Baby: A Parent’s Guide to Co-sleeping,” 2007, Platypus Media, Washington, D.C.

“We have bigger houses, but smaller families; More conveniences, but less time; We have more degrees, but less sense; More knowledge, but less judgement; More experts, but more problems; More medicines, but less healthiness; We’ve been all the way to the moon and back, but we have trouble crossing the street to meet the new neighbor. We built more computers to hold more information, to produce more copies than ever, but have less communication. We have become long on quantity, but short on quality. These are the times of fast food, but slow digestion; Tall men but short character; Steep profits but shallow relationships. It is a time when there is much in the window, but nothing in the room.”

 ~ XIV Dalai Lama

Thursday, June 13, 2013

A Day in the Life of a Doula: Baby Parties!

Every culture has their customs. Some are dictated by religion, some by superstition, or just plain wanting to have a good excuse for a party. In many cultures that have come out of primarily Third World Countries, the infant mortality rate is high – higher than ours, so you have more babies than you planned for, often as many as you can manage to make, because statistically, a certain percentage will not survive. A new report by Save the Children finds that India leads the world in the highest number of babies dying within the first 24 hours of their birth, more than 300,000 a year. The international non-governmental organization sounded the alarm this week with its annual State of the World’s Mothers report, which says India accounts for 29 percent of all global first-day deaths. The three major causes of newborn mortality are pre-term birth, severe infections, and complications during childbirth. Save the Children said these three conditions alone account for 80 percent of all newborn deaths worldwide. (And I cannot help but wonder if reports of killing unwanted baby girls is not being added officially to these numbers.)

As of this writing the best countries to have a baby in (and ensure its survival) is Finland, Sweden and Norway. The worst are the Democratic Republic of the Congo, Somalia and Sierra Leone (Save the Children’s Mother’s Index.) Tibet isn’t far behind with not only its high infant mortality rate but rates highest or number one on the charts for maternal deaths. Many studies have been done in Lassa, Tibet at the
hospital there on high blood pressure, anemia and altitude considerations as the possible cause, but according the Tibetan diaspora in Minneapolis, which is the 2nd largest next to New York in the U.S. when asked, they universally site the cause as the calculated Chinese genocide on the Tibetan population: A family brings a woman into the hospital because of complications during labor and the all-Chinese staff does little or nothing – intentionally. (Does anyone want to fund a watch-dog trip to Lassa? Let me know!)

A recent CBS report reveals that the United States has the highest first-day infant death rate out of all the industrialized countries in the world. About 11,300 newborns die within 24 hours of their birth in the U.S. each year, 50 percent more first-day deaths than all other industrialized countries combined, the report's authors stated. The 14th annual State of the World's Mothers report, put together by the non-profit organization Save the Children, ranked 168 countries according to where the best places to be a mother would be. Criteria included child mortality, maternal mortality, the economic status of women, and educational achievement and political representation of women. Worldwide, the report found that 800 women die each day during pregnancy or childbirth, and 8,000 newborns die during the first month of life. Newborn deaths make up 43 percent of all deaths for children under five. Sixty percent of infant deaths occur during the first month of life.

So I was not surprised when my friends from Laos explained that they will not celebrate the birth of their new baby until she reaches her 1st month birthday. We are not supposed to mention that she is cute, or adorable or strong, much less her name which the parents have not said out loud even once yet, lest the bad spirits hear of these things and come to spirit her away or make her sick, which is basically the same thing in
their history. The Ethiopian family that I recently was doula for asked me to attend their new daughter’s Orthodox baptism when she reaches 40 days of age. Boys’ baptisms take place on day 30. They could not tell me where that comes from, but I can only guess that in their experience in the past girls babies were stronger than boy babies, so they chose to move up the date for boys to somehow absorb a little extra grace so they might have a better chance at survival. In many cultures the baby won’t receive gifts until the proscribed ‘wait-and-see-if-he-lives’ period is over.

Adam Katz-Stone writes in an article in The Jewish Federations of North America newsletter:In Jewish tradition, baby showers were taboo. Neither Halakha or Jewish law forbids gifts for an unborn child, but custom effectively prohibits them. Such gifts once were thought to draw the attention of dark spirits, marking the child for disaster. To this day, many Orthodox Jews will not so much as utter the name of a baby until that baby is born, for fear of inviting the evil eye. In liberal Jewish circles, however, attitudes are more relaxed.
"I don't think there is anything wrong with giving gifts," said Rabbi James S. Glazier of the Reform Temple Sinai in South Burlington, Vermont. In his view the traditional reluctance to hold a shower "is based more on superstition than anything else. It's all Ashkenazik medieval superstition. I don't denigrate it, but on the other hand I don't put a lot of stock on it either."

While the rabbi and his wife had baby showers for both their children, they deferred to tradition in so far as they did not decorate the nurseries until after the babies were born. Like many modern rationalists, Rabbi Glazier said he respects the psychological imperative behind the custom of not holding a shower – a custom that arose in a time when infant mortality was high.

"I can see where you don't want to have a whole room waiting, in case something terrible should happen," he said. "Today people have concluded that since infant mortality in childbirth is so infrequent, they think every child will be healthy. I don't agree with that. In our case we didn't want to be faced with a complete room before the baby came home healthy."

At the Conservative Temple Beth Shalom in Mesa, Arizona, meanwhile, Rabbi Bonnie Koppell said her mom warned her against buying "so much as a receiving blanket" before her first child was born. The rabbi went shopping anyway, but she agrees that full-scale pre-natal nursery design may not be appropriate.
"My sense is that preparing a whole suite of furniture and decorating the room might be a bit much," she said. "However, a few receiving blankets, onesies, and diapers--G-d forbid, if the infant does not come home, these few things won't make terribly much difference in the face of such overwhelming grief." Yet there are many in the observant community who will not buy so much as a sock. Some say that the tradition of shunning the baby shower is not just ancient superstition: it serves a deeper communal need.” It's not just about the couple having the baby, they say. It's about all the other couples that can't. Rabbi Jay Yaacov Schwartz and his late wife wrestled with infertility for years before adopting. When they did begin the adoption process, "we didn't even tell people when we had an adoptive opportunity, because we were afraid of ayin hara -- of bad energy," said the rabbi, a spiritual leader at the Orthodox synagogue Young Israel of Oceanside in New York. Rabbi Schwartz was not literally afraid of demons. He feared waking the cosmic wheels of action and reaction that he believes return to us just what we give out. In this case, he knew that his happiness might cause pain for some childless couple, and their unhappiness would someday come back to bite him.

I have also been to Hmong baby parties for my friends from Laos. One time I was told to come to a certain address by 8 a.m. It was a good thing I didn’t have any other obligations that day. We didn’t eat until 7p.m. or later. Really. The pig was still running around in the basement when I arrived. He would be ritually sacrificed sometime during the day to drive away all bad spirits from the baby and his family. A shaman sat on a sawhorse upstairs and played his bamboo raj nplaim or tsaaj nplaim flute and communicated with the Other World, asking the bad spirits what they would require in order to vacate the premises.
More often than not, they would request a pig feast and the family would butcher the animal that just happened to be in the basement that day. A host of relatives (meaning up to 200 minimum) would be invited and the preparations would begin. The men would prepare the meat and bring it to the kitchen where all the aunts and grandmothers would be squatting at large round cutting boards that looked like small tree stumps, each wielding a huge machete or knife and would proceed expertly hacking and chopping it. Periodically during the day, a large dishpan would be brought around with the ‘appetizers’: whole scrubbed cucumbers or hard boiled eggs or apples and oranges. Thick, sweet syrupy hot instant coffee would be passed around, too. This would suffice to stave off starvation until we could feast later that night.

I usually had one or more of my children with me when I did home visits, always at least one or two was still nursing (See: Twin Birth on The Farm with Ina May Gaskin at this blog under the April posts.) So I would wander around the house visiting with the other moms, or talking with the grandmothers. One of the favorite activities among the girls was taking turns brushing my hair. Unlike their straight black hair, mine is brown and kinky curly (a true ‘Jew-fro’.) So I sat on a couch and submitted to the ordeal while nursing a baby or two just to pass the time. Then I would wander into the kitchen and watch the cooking. It was fascinating watching Grandma Moua Lee hacking perfect little broccoli flowerets for one dish with a giant machete and Great Aunt Mee Thao slicing pigs ears into what looked like long rubber bands. Fresh pig liver was frying on the stove and ground meat was being mixed with hot peppers and cilantro in another giant pot (see: http://hmongcookbook.com/main/.) Cauldrons of rice were steaming on the stove while another auntie was pounding raw, sweet rice in a mortar for sticky rice cakes or Hmoob Jiang that would be wrapped in aluminum foil and steamed in an electric rice cooker. Cases of Mountain Dew and Coke were piling up as each new car pulled up to the building in the housing project. Teenagers were visiting out on the lawn smoking cigarettes while the oldest grandpas shared a hookah in the back yard.

Finally, the dirty dishes and cutting blocks would be cleared away, the floors all swept with little handmade brooms and babies collected from all the mats on the floor. We all gathered around the new baby and her parents as the shaman began the ceremony with prayers and good wishes for a long, prosperous life. He burned some gold paper called joss or jin (below) which represents money to placate the ancestral spirits.
He tied a cotton cord onto one of the baby’s tiny wrists as he spoke the last blessing and announced her name. Then all of the grandpas and uncles tied their white cords onto the baby’s wrists with a blessing, also repeating her now-public name. Little Pah (which means ‘a flower’) slept through most of the ritual. Another uncle continued to pass out more pre-cut white cord to all of the guests down to the children. After a while both of Pah’s arms were full of strings and I noticed that some relatives had started attaching them to her ankles too. Some of the guests also pressed large bills into the parents’ hands, more often than not 50s and 100 dollar bills. Perhaps the money would be saved for her dowry, but it was explained to me that this way her extended family was ensuring that she and her parents would never have to go hungry. The strings would be left on little Pah until they literally fell off, at which time she would be much stronger and not in need of the prayers that had been attached to her arms and legs with the strings.

Next, all of the men and boys in attendance sat at the many card tables that had been brought in or stood around those sitting at them and ate from the communal bowls stacked around the center. Little children were already smacking their lips on sticky rice cakes. Meanwhile, the women kept their eyes on the bowls of stews and soups, refilling them
as soon as they emptied. When the men finished and roamed back out to the hookahs, all of the cracked Melmac dishes were snatched up and washed in the kitchen and the tables set once again which us women and girls descended upon.

Hmong etiquette requires one to eat until you are ready to burst. Perhaps this grew out of years of wars and occupations where you never knew if this might be your last meal for a very long time. And hostesses make sure you are told at least three times, “noj kom txog rau thaum koj muaj tag nrho” (pronounced: naw-maw choe-PLAH!) or literally, “eat your stomach FULL!) When my husband came along with me to these parties he had no trouble complying. He loves Hmong food. The Hmong grandmas and grandpas would sit around him, watching in awe as he filled his bowl over and over with food, commenting that they thought Americans didn’t like their food; after all, none of the doctors or social workers they had invited to a meal since they first arrived in the U.S. had ever once come to their homes to eat with them.

At one party we were at a young Hmong dad had sat down next to David with two cold beers, handing my husband one of them. At the previous party this father had noticed and obviously admired David’s boots and had gone out shopping until he found an exact replica. As they sipped their beers in anticipation of the meal, 
Jou Zhe Yang pointed out his new boots to David while grinning from ear to ear. He could not speak English yet.

I went to a Vietnamese Coming Out Party last weekend. It was amazing! The mom is required by tradition to stay in her room for a month. This is a tradition in many cultures suggesting that she needs time to once again become ‘pure’, or recover, (or I like to think establish a good milk supply.) It gives the family a chance to ‘mother’ the mother, which we could do a whole lot more of in our society in the U.S. She gets to rest for a whole month and doesn’t have to shop, cook, do laundry, care for other children, or think about her partner’s needs. She is waited on hand and foot!

Tuyen’s* midwife hosted the party at her home, inviting family and friends of the new mom and also quite a few of her own family. Her interpreter from the birth attended with her husband too. This was a first for me, so I wasn’t expecting to being invited to help with the cooking when I arrived. Maya,* the midwife, with the help of a niece had already shopped for just about everything listed in their Asian cookbook and were half way through a recipe for Green Papaya Salad when I arrived. I have seen this in Hmong and Thai restaurants and love it, so I was glad to see it here, too. It is a very spicy salad made with julienne slices of peeled green papaya mixed with cabbage, tiny dehydrated shrimp, raw green beans, fish sauce, sugar, carrots, red Thai chilies and a host of other ingredients.

While we were tasting that and adjusting the spices, turmeric-coconut rice was simmering on the stove, ground shrimp Pops on sugar cane sticks were cooking on the barbeque, catfish in caramel sauce was bubbling on the stove in another pot, and Maya was finishing up the rice and peanut sauce for the Pops and
a sweet chili sauce for the fried egg rolls. Spring roll ingredients were arranged on the buffet: rice ‘skins’, warm water for dipping them into, rice vermicelli, fresh mint, basil and cilantro leaves, lettuce, shredded carrot and cucumber slices.

All this time, little Ngoc was being passed around as she slept, oblivious to the festivities. Tuyen had dressed her in a tiny plum colored satin dress with matching booties fit for a princess. Finally when all the cooking was done a couple of hours later, we all sang Happy Birthday for Ngoc and then dove into the meal. It was
exquisite! Tuyen had brought all of the ingredients for quail egg drop soup and had been making that on the stove while we were all finishing making the last of the other dishes. I have eaten some very interesting things during the past 30 years that I have worked with refugee and immigrant communities, but this was a new one. I hesitated, thinking back to my son's little pet quail who died of a heart attack one evening as Isaac was holding him and a huge truck backfired as it passed our house, scaring the little guy to death. Literally.

After the meal, at which Tuyen ate more than any of us had ever seen her eat before -- all 85 pounds of her -- we opened presents. Baby clothes have gone to a whole new level since I had my babies in the early 1980s. She received the cutest little dresses, sleepers and shoes. She was given checks with which to buy things she may need for herself and her baby. It was a wonderful party, and a real encouragement to her in her new country.

*all names, dates and identifying characteristics have been changed.

STAY TUNED... This and other stories will be appearing in one of the books, Call the Doula! a diary© or Stone Age Babies in a Space Age World:§ Babies and Bonding in the 21st Century,© pending by Stephanie Sorensen

§This phrase was first coined by Dr. James McKenna, used here with permission and gratitude for his work. 
A world-renowned expert on infant sleep – in particular the practice of bed sharing, he is studying SIDS and co-sleeping at his mother-infant sleep lab at Notre Dame University. He is the author of “Sleeping With Baby: A Parent’s Guide to Co-sleeping,” 2007, Platypus Media, Washington, D.C.