Week 4: Consequences of Stress on Children's Development- Environmental Pollution

From before I was born until I was 17, my parents smoked cigarettes. They smoked inside of our house and our car, and anywhere else we went. The vast majority of adults who came to our house smoked. In addition, when we went to visit family members or stay at their houses for vacations, those adults smoked, too. I was surrounded by smoke. As a very young child, I was constantly sick and by six years old I was diagnosed with asthma. I struggled to breathe, but no one seemed to make the connection to the pollutants that I was inhaling every moment of every day. I continued to get worse and was diagnosed with Chronic Bronchitis, a subset of Chronic Obstructive Pulmonary Disease, something that is typical for heavy smokers to develop later in life. I've never smoked- not even once- but my exposure to second-hand smoke has greatly diminished my lung capacity as well as my quality of life. My breathing improved after my parents quit smoking and as an adult I avoid as many situations as possible that might trigger a breathing emergency. I have also made it my mission to protect my children from my experience. This has unfortunately resulted in them not knowing portions of my family as well as I would like, though, as I refuse to take them into a home filled with smoke. 

In 2008, my husband studied abroad in Cairo, Egypt. While he was enamored with the culture and history that he encountered, he was not quite expecting the level of pollution that surrounded the city. On a clear day, the mosque of Ibn Tulun looks like this:

On a day where pollution is very high and the air is hazy- my husband says most days are like this- the mosqu of Ibn Tolun looks like this: 

Imagine breathing those particles of "silica, sulfate and carbonate" into your lungs each day of your life (Khaled, 2013 para. 6). Pollution levels are many times higher in Cairo than any recognized safe or acceptable level. As a result, up to 25,000 people die each year and for those who survive, essential organs and body/cognitive functions are affected. In order to protect children, efforts are being made to reduce the impacts of pollution, such as planting tall trees to act as filters. A new program is also helping industrial plants to reduce their lead emissions; high lead emissions lead to stunted brain growth among other developmental delays (Cairo Air, 2014). 

References

Cairo Air Said 'Seriously' Polluted. (n.d.). Al Bawaba. Retrieved March 29, 2014, from http://www.albawaba.com/news/cairo-air-said-seriously-polluted

Khaled, R. (2013, April 21). Air pollution indoors and outdoors high, threaten health and environment. Egypt Independent. Retrieved March 27, 2014, from http://www.egyptindependent.com/news/air-pollution-indoors-and-outdoors-high-threaten-health-and-environment

Week 2: Child Development and Public Health- Breastfeeding

Since having my first child, I have become very passionate regarding the topic of breastfeeding. I struggled with low supply and a child who was unable to latch but because I knew of breastmilk's many long-lasting health benefits, I pumped what I could until he was twelve months old, while also supplementing with formula. In preparation for my second child's birth, I researched galactogogues to help increase what was likely to again be a minimal milk supply due to multiple endocrine disorders, met with lactation consultants, made sure that I had several electric and hospital-grade pumps available to increase my pumping output, and most helpful of all, I surrounded myself with people who knew how much I wanted to succeed in breastfeeding past one year and were willing to support me in that goal. My daughter was able to latch, and while my supply was still low, I was able to personally provide her with about half of what she needed each day. My wonderful support system stepped in and provided donor milk for the rest, stocking my freezer so that she received breastmilk until she was 18 months old. While I would have loved to breastfeed for even longer, I am happy to have at least given my daughter a bounty of immunities and nutrients while bonding and sharing those exquisite moments with her.

During my time as a nursing mother, and ever since, I have acted as a breastfeeding advocate and support network for friends, co-workers, clients, and even strangers. Sometimes this means offering empathy, giving guidance or information regarding laws on public feeding, pumping breaks, et cetera, or pointing families to support groups and resources specifically for breastfeeding mothers. It also means not pressuring, guilting, or shaming mothers into breastfeeding.

With all of the time that I have spent reading about and researching breastfeeding, I am surprised that I just now found the article "Breastfeeding in the Land of Genghis Khan" by Ruth Kamnitzer. This amazing piece details the author's experience, as a breastfeeding mother, of moving to Mongolia from Canada where the social climate and expectations related to breastfeeding are very different. In Mongolia, breastfeeding in public isn't just common; it's expected and accepted as completely natural. Kamnitzer (2011), in my absolute favorite part of the article, illustrates this perfectly with the following vignette:

When I walked through the market cradling my feeding son in my arms, vendors would make a space for me at their stalls and tell him to drink up. Instead of looking away, people would lean right in and kiss Calum on the cheek. If he popped off in response to the attention and left my streaming breast completely exposed, not a beat was missed. No one stared, no one looked away—they just laughed and wiped the milk off their noses. (para. 8)

There is no pressure to wean children from the breast at 6 months or 12 months, as is often the case in North America; Mongolian children often breastfeed until their third birthday or beyond. The article mentions that it's not even uncommon for adults to drink leftover breastmilk; there is no attached taboo or stigma. Clearly, they "get it" in Mongolia! One of my current personal/professional goals is to help others "get it" by having my workplace certified as breastfeeding friendly for both the public and employees. More information on what that means can be found here: http://www.c-uphd.org/documents/maternal/Breastfeeding-Friendly-Business-Rating-System.pdf  If we normalize breastfeeding, mothers, children, families, employers, and communities will all benefit.


References

Kamnitzer, R. (February, 2011). Breastfeeding in the land of Genghis Khan. In Culture Parent. Retrieved March 14, 2014, from http://www.incultureparent.com/2011/02/breastfeeding-land-genghis-khan/

Week 1: Childbirth in My Life and Across the World

My son's birth and my daughter's birth were very different. With my son, I was a first time mom who had a birth plan and some ideas about how I wanted his birth to proceed, but I was also afraid to make decisions that might harm him. I wanted a low-intervention birth but my doctor pressured me into an induction on my due date by saying "if you go over forty weeks, he's more likely to die". I knew that my body was not ready, but the doctor's scare tactics left me feeling like induction was the only responsible choice I could make. I endured three days of chemical induced laboring, three hours of pushing, and an episiotomy before finally being asked to choose between having my son removed via c-section or vacuum suction. I chose suctioning, and he finally arrived, 8lbs 10 oz, 20.5 inches. 

With my daughter, I  alternated between a low-intervention doctor and a set of midwives for my prenatal appointments, and all were present for her birth. There was no pressure to induce or deliver early, and I very happily and comfortably delivered my daughter at 41 weeks 5 days after just under 30 minutes of pushing. She was 9 lbs 15 oz, 21.5 inches. 

I chose this example because there was a dramatic difference between the two births, and having the appropriate provider and environment really makes an amazing impact. Childbirth standards and practices vary not only from provider to provider, but also from one country to the next. For example, I read an illuminating article about the world's best and worst places to give birth (Sweden and Niger). In Sweden, mothers have access to affordable prenatal and postpartum care as well as high quality delivery rooms and well educated doctors and surgeons. Hospitals are clean and offer alternative pain treatments to laboring mothers. Very few mothers or babies die in Sweden as a result of labor or delivery. In contrast, in Niger, mothers have a one-in-seven chance of dying during labor/delivery and one-in-six children will not survive to the age of five. Mothers labor in silence and if they are assisted by a medical professional, it is usually in a dirty facility with outdated or unsafe equipment. Prenatal, postpartum, and labor/delivery services, if available, are unaffordable for most mothers (Moorhead, 2006).

Birth, and the circumstances surrounding birth, including prenatal care and labor and delivery, absolutely affect child development on multiple levels. If mothers do not receive adequate care, nutrition, and services, their infants will be negatively affected- developmentally, physically, and cognitively. Proper care for mothers, then, is essential for the healthy development of their babies. 

Reference

Moorhead, J. (2006, October 3). Different planets. The Guardian. Retrieved March 10, 2014, from http://www.theguardian.com/lifeandstyle/2006/oct/03/healthandwellbeing.health