Knitting for Save the Children

Yesterday morning I came across a plug for knitting newborn caps for Save the Children at www.designmom.com. The instructions are provided here. It really couldn't have been easier!

I am a VERY novice knitter, and by the looks of my "craft box" in the closet (which contains no fewer than 3 half-knitted baby blankets), not very persistent. So if you are anything like me, this project, which gives a finished result in less than 3 hours, is just the thing for you!

I couldn't even remember how to cast on, so I went to You Tube and found more than I needed in terms of guidance (casting on). And then I was on my way!

This is what the cap looks like about a third of the way through. The pattern that is provided in the Save the Children pamphlet couldn't be easier - just a series of knit and pearl stitches, plus a few "knit two together" rows at the end.  And two hours later: VOILA!

I can't think of a better project for moms on bed rest. I think I might make one cap for every week I'm on bed rest and send them off to Save the Children with a $10 donation for each one (see website - this nominal amount provides valuable postnatal instruction to one family that can make a big difference).

So get out those yarn scraps and start knitting for a good cause!

The Grinch that Stole Pregnancy

One thing that has struck me again and again in the two years since my son was conceived is how much commercialism surrounds babies and new parenthood. Mind you, I am the first to admit that I flip through the pages of Pottery Barn Kids, dreamy with thoughts of the perfect coordinating nursery in calming shades of porcelain blue and cream, before tossing it in the recycling bin.

But it's not just the prices that stop me (although my Scottish roots definitely give me pause). Or the thought of offering up a perfectly adorable crib bumper to the crib death alter. It's the fact that I'm distracting myself from the realities of parenthood - the good and the bad - by adding layers of perfection and sheen to a reality that is far from predictable. Doesn't this just set us up for disappointment and disillusionment? And leave us unprepared to deal with the challenges to come?

Maybe, maybe not. There is something very important about the excitement and anticipation of pregnancy, particularly a first pregnancy. It can focus us on the journey ahead. It can encourage us to adopt more healthy habits, for the sake of the new life growing inside. It can connect us with the greater community of parents who have been through this miracle many times before.

But the culture of overblown baby showers, of promoting the idea that every last inch of a baby's nursery need be in place before the baby arrives, that certain products and items are indispensable to new parents, runs contrary to the reality that we learn by trial and error. That not everything plays out according to plan.

This is not to say that sometimes, it would be easier to just accept the advice you are given. When we were expecting our first child, we tried very hard not to crowd our small apartment with what we considered to be unnecessary, commercial items such as baby bouncers, baby swings, video monitors and the like. We took a certain pride in resisting the advice of wise parents who had gone before. And so we still laugh heartily about the desperate late afternoon run to Children's Orchard that ensued on our son's first week home from the hospital when we realized that a baby swing was exactly what we needed to avert yet another evening of restless crying!

But it is lighthearted moments like these, and the more weighty ones left unsaid - the unexpected bumps and valleys - that teach us the most about ourselves and our cherished little ones. As we anticipate the birth of our second child, we have already been thrown a curve ball with the threat of a very premature birth and a prescription for bed rest. And I would submit that no catalogue could have prepared me for that!

Simple pleasures

I'm short on words today because I spent the morning writing a review on brain tumors that is draining every last ounce of literary spontaneity out of me. So here's a pictoral list of things I'd rather be doing and times and things worth treasuring, as modeled by my son. The list is purposefully short in hopes that others will add their own!

Apple picking in New England

Hand-knit sweaters

Birthday cupcakes



Sleeping in on vacation

Learning to walk on the beach

No rest for the wicked

Tonight, after my husband

rushed back to daycare in the early afternoon to examine a rash on our son's face (which later disappeared),
spent two hours with ten toddlers for our weekly parent shift,
stopped at the library on the way home and checked out every item on my wishlist,
fixed dinner for the three of us,
put the baby to bed and cleared the dishes,

he lay down on the couch in my arms
and within 30 seconds was fast asleep.

Dear, sweet man.

First poem of the week retired

I chose the first poem of the week, Langston Hughes' Jazzonia, simply because my son has a classmate at daycare named Langston, and I realized when I met Langston, the toddler, that I didn't really know much about Langston, the poet. That was two months ago. And now, thanks to bed rest, I have the time to revisit the question and learn a bit more about this great African American poet.

The poem is also of sufficiently short length to allow for memorization, which is one of the intended uses of poem of the week. (For me, that is. Others are under no such obligation!)

James Mercer Langston Hughes had an exceptional and diverse extended family. His maternal grand-uncle was the first African American from Virginia to be elected to the U.S. Congress, in 1888. His maternal grandmother, Mary Patterson, was of African American, French, Native American and English descent and was one of the first women to attend Oberlin College in Ohio. It was Patterson who raised Hughes during his early childhood years after his parents divorced and his father moved to Cuba and later Mexico.

Hughes eventually settled in Harlem, where he became influential in the burgeoning black cultural movement known as the Harlem Renaissance, beginning in the early 1920's. Also a novelist and playwright, Hughes is best known for his Jazz poetry, which incorporated the syncopated rhythms and improvisation of music from contemporaries in Harlem like the great jazz musician, Duke Ellington. Jazzonia was published in 1926 as part of Hughes' first collection of poems, The Weary Blues. By the time of his death from complications of prostate cancer surgery in 1967, Hughes had published over 50 novels, plays, childrens stories and collections of poetry and short stories. In the following link, hear a recording of Hughes reading his well-known poem, I, too.

Home entertainment

For the past few years, as our local movie stores have slowly closed, one-by-one, I have resisted the seemingly ubiquitous Netflix subscription. But after eight days of bed rest, my resolve is fading. Yet there is still something holding me back. Am I just an old-fashioned stick-in-the-mud, or are there others like me out there who still cling to NPR and their local library cards?

Apparently, not many. Not surprisingly, TV's are heavily penetrant in U.S. households. According to the U.S. Census Bureau, in 2009 there were about 114.9 million households (and a total population of 307 million), and according to the Nielsen ratings, there were 114.9 million TV-viewing households in the same year (with an average of 2.2 TV's per home).

The more depressing statistics follow: the average American watches more than 4 hours of TV per day; TV's are turned on for an average of nearly 7 hours per day; and 66% of U.S. families admit to watching TV regularly during dinner. So much for conversation! Video use shows similar trends, with daily video rentals doubling the number of books checked out at public libraries across the country. As for NPR, well, the frequency of fund-raising drives makes me think that the number of Americans listening to radio (or at least the money going to fund radio programs) is diminishing rapidly as well.

In the interest of preserving my safety from atop such a high horse, I will forgo more statistics (including those pertaining to infants in children). Needless to say, there are many ways in which to spend one's leisure time, and I don't begrudge the temptation to "veg" from time to time. In fact I am being forced into it full time for the next few months. But I hope that by the end of my stint on bed rest, I can at least say that I've read as many books as watched videos, I've avoided the temptation to tune in to Oprah every day of the week, and I've followed my husband's good example of always reaching for the newspaper before the remote control.

The origins of empathy

Last night my 16-month-old walked up to the couch where I was lying and planted a series of unsolicited wet kisses right on my nose. When prompted for the same by my husband, he demurred. It was as though this little boy, whose vocabulary at the moment is comprised of the words cheese, go! and NO!, recognized my plight as clearly as one who had seen it many times before. How early do children recognize emotions like sadness or grief in themselves and others?

I first considered a related question about two months ago, when I read Roger Rosenblatt's memoir, Making Toast. Mr. Rosenblatt, a journalist, novelist and playwright, lost his daughter, a pediatrician and mother of three, to sudden cardiac death. He and his wife moved in with their son-in-law and grandchildren, ages 14 months through six years, for the next year, and his memoir is an account of this experience. (It is written in heartbreakingly concise, unsentimental prose, and I highly recommend it to anyone with a box of Kleenex to spare.)

The most poignant scene comes towards the end of the book, when the author's youngest grandchild, now almost two, wakes up crying one evening, asking, "When is Mommy coming home?"  The child, 14-months-old and preverbal at the time of his mother's death, clearly experienced her loss and held onto the memory until he could express himself in words. This was a revelation to me as I sat watching my own one-year-old putter around the house, not obviously aware of anything or anyone but himself and the recycling bin.

It turns out that emotional awareness and understanding can be observed and studied in children as young as one year and in primates like chimpanzees. By the age of 12 months, infants begin to comfort victims of distress, and by 14-18 months, children display spontaneous helping behaviors. The capacity for empathy and sympathetic concern is linked closely with the development of self awareness, termed mirror self-recognition (MSR), according to leading social scientists (Video of MSR). MSR has been demonstrated not only in humans and chimps but also dolphins, elephants and even magpies (for those cartoon fans out there, think Heckle and Jeckle!).

And so, this evening I hope to talk my husband into setting up our own rouge test (see video) on our little one, and in doing so we will be joining the ranks of social psychologists around the globe in delightful amazement and exploration of the human mind in all its glory.

References

Rosenblatt, Roger. Making Toast: A Family Story. New York: Harper Collins, 2010.

Warneken F and Tomasello J. The roots of human altruism. Br J Psychol 2009;100:455-71.

Bed rest: friend or foe?

A prescription for bed rest (the "rest cure") was first made popular by the 19th century neurologist, Silas Weir Mitchell, who believed that isolation, confinement to bed, dieting and massage were beneficial for a variety of nervous diseases, particularly hysteria.  His most famous, or at least prolific, patient was the feminist sociologist Charlotte Perkins Gilman, who was inspired to write the short story The Yellow Wallpaper based on her own experience with the rest cure. From the looks of it, the story may not be the most glowing review of the rest cure: the narrator is apparently driven slowly insane.

(I have just discovered that one can order short stories online through the Harvard library system, to be scanned and delivered by email! Very exciting for a woman in my current shoes. So, more on this tale later.)

As a treatment for threatened preterm delivery in pregnant women, bed rest is widely prescribed but has remarkably little (read: no) scientific evidence backing it. The Cochrane Collaboration, an independent, not-for-profit organization whose mission is to compile systematic reviews of primary research in health and health policy, reviewed bed rest for the prevention of preterm birth in high-risk singleton pregnancies (i.e. not twins or multiples) in 2004. They found only one (!) randomized study on the subject ever published. In this 1994 study of about 1200 high-risk women being seen at 8 different Los Angeles County prenatal clinics, women receiving extra education and clinic visits had a significantly lower preterm birth rate compared with those who received standard care. However, the specific intervention of bed rest (prescribed to about 400 of the women) did not significantly lower preterm births. This result could reflect the fact that bed rest really doesn't work to prevent preterm birth, or it could be that this study wasn't designed well enough (for example, didn't enroll enough patients) to show a benefit when there actually was one. The only way to know would be to do another, better study.

The potential harms of prolonged bed rest have been studied as well, perhaps with more gusto than have the benefits. Those who are sedentary have an increased risk of blood clots in the legs that can move dangerously to the lungs, bone loss, muscle deconditioning, hip and back pain, and depression. If a large randomized study of bed rest versus unrestricted activity ever does take place in pregnant woman, it should include careful measurement of these outcomes, since they are an important counterbalance to the potential gains.

And so, my husband and I and many others like us are left to wonder whether the age-old prescription of bed rest applied to the modern day is friend or foe. For now, neither of us is prepared to discount the accumulated wisdom of centuries of experience if it stands even a small chance of staving off harm to our unborn child.  But perhaps we'll think differently when the Charlotte Gilman text arrives.

References:

"The Yellow Wallpaper." New England Magazine 5 (1892): 647-56; Boston: Small, Maynard & Co., 1899
Sosa C et al. Bed rest in singleton pregnancies for preventing preterm birth. Cochrane Database Syst Rev. 2004;1:CD003581.
Hobel C et al. The West Los Angeles Preterm Birth Prevention Project. I. Program impact on high-risk women. Am J Obstet Gynecol. 1994;170:54-62.

First-time blogger

On Thursday last week I received the unexpected recommendation from my OB to go home on bedrest. For the rest of my pregnancy. And I am only 23 weeks pregnant. Wow.

By way of background, I am an academic physician working full-time in a field and job I love, with an active 15-month old son at home and a fabulous husband, also an academic physician.  I haven't spent more than 2 days in a row in bed since....well, since I last had the flu, which was before vaccinations became the norm for healthcare workers.

The good news: That backlog of New Yorkers never looked so appealing. And didn't I always want to recite the complete works of William Shakespeare aloud from start to finish?

The bad news: Where to start? The guilt over leaving my co-workers to cover my practice, with no clear benefit for them. The guilt over needing my husband to take over nearly EVERYTHING about the day-to-day care of our child and household (although admittedly he was already doing more than his fair share). The list could go on and on, with guilt appearing in most entries.

My goals in creating this blog are many:

• To work through some of the guilt...
• To brainstorm ways to pass the time
• To create a resource for other poor souls in this situation
• To have some fun while doing it!

And so, with 17 weeks to term, here's to the adventure!