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One about putting babies to sleep on their stomachs.

A Quiet Revolt Against the Rules on SIDS
By BRIAN BRAIKER

Danica Stanciu was commiserating with her friend Natasha who, like her, had recently given birth.

"She called me in the throes of sleeplessness, " Mrs. Stanciu recalled, "so I said, 'Do you want to know my deepest, darkest mothering secret? I put Elena to sleep on her stomach.' "

Natasha, Mrs. Stanciu said, gasped, "and I said, 'Maybe I shouldn't have told you about that.' "

In homes across the country, parents like Mrs. Stanciu are mounting a minor mutiny against the medical establishment. For more than a decade, doctors have advocated putting babies to bed on their backs as a precaution against sudden infant death syndrome, or SIDS.

Increasingly, however, some new parents are finding that the benefits of having babies sleep soundly - more likely when they sleep on their stomachs - outweigh the comparatively tiny risk of SIDS.

Every parent lives with the specter of the sudden, inexplicable death of a healthy baby during the infant's first year. In 1992, after reviewing British and Australian research on SIDS, the American Academy of Pediatrics recommended that parents put babies to bed exclusively on their backs in their first year.

In 1994, the National Institute of Child Health and Human Development followed that recommendation with a far-reaching federally financed Back to Sleep public education campaign.

At the time, 70 percent of infants in the United States were sleeping on their stomachs. By 2002, that figure had plummeted to 11.3 percent.

Over the same decade, deaths from SIDS fell by half, to 0.57 deaths per 1,000 live births in 2002, the most recent year for which figures are available, from 1.2 deaths per 1,000 live births in 1992, according to the National Center for Health Statistics.

Clearly, there is some connection between stomach-sleeping and SIDS, but doctors still do not know what it is.

"If we knew exactly what causes it, we wouldn't call it SIDS," said Dr. John Kattwinkel, the chairman of the pediatric academy's task force on the syndrome.

New research suggests that some SIDS babies are the victims of a toxic confluence of genetic makeup and environmental factors like sleep habits.

On Oct. 10, the pediatrics academy issued an advisory re-emphasizing the correlation between "nonprone" sleeping and a lower rate of SIDS.

The academy also advised parents to breast-feed, to avoid placing their infants on their sides to sleep, to use pacifiers and to refrain from "co-sleeping," that is, bringing a baby into bed with them.

Still, most pediatricians concede that when babies are placed on their stomachs, they tend to sleep better, they are less apt to startle and they often sleep through the night sooner.

And despite the warnings, a growing number of parents - exactly how many is impossible to quantify- are turning their backs on the Back to Sleep campaign. Postings on child-rearing Web sites also indicate a trend.

"The Web consensus is that it is O.K. to do," said Sarah Gilbert, a mother in Portland, Ore., and the editor of the popular Web log bloggingbaby.com.

Ms. Gilbert, said that she let her 5-month-old son, Truman, sleep on his stomach, just as she did her 3-year-old son, Everett. Truman, she said, has none of the other risk factors listed by the pediatrics academy: she breast-feeds him, she does not smoke, and he sleeps close to her in an uncluttered space.

"On the Web, people always broach it very gingerly," Ms. Gilbert said. "They say, 'Just this one time I let my child sleep on her tummy.' And when you say you do it, too, they say 'O.K., I've been doing it since the third month.' "

In some cases, said Erica Lyon, a newborn-care instructor and the director of Manhattan's RealBirth center, parents who post anonymously on Web sites are guilt-ridden and looking for permission to ignore the academy's recommendations.

At BabyCenter.com, a Web site intended to help parents improve their child-rearing skills, one reader posted a plea titled, "My baby hates sleeping on his back."

The posting drew responses from more than 400 other parents, a majority admitting to, or even advocating, stomach sleeping. The site draws about 3.5 million users a month.

Another discussion, in the child-rearing forum on craigslist.com, began with a nervous dad who admitted to letting his baby sleep on his stomach and continued with postings titled, "Mine did as well" and "Went through the same thing."

To be sure, not everyone is so sanguine about ignoring the experts' advice.

"Do you want your child to be uncomfortable or dead?" asked Vanessa Saft, the mother of a 2-year-old, Ramona, and an early childhood educator who is working on her master's in social work.

Ms. Saft said she was baffled by some of the permissive discussions she read on the e-mail list of the Park Slope Parents, where Brooklynites share their advice on vaccinations, sippy cups, schools, nannies and, also, sleeping.

But Ms. Saft said she refrained from chiming in with an unpopular viewpoint, even one in line with the medical mainstream, because, "I always get in trouble."

Linda Murray, the executive editor of BabyCenter.com, pointed to the findings of an unscientific poll conducted on the Web site.

The poll, which involved more than 24,000 users of the site, found that just about as many parents (42 percent) said they put their babies to sleep stomach down as on their backs (43 percent), even though half the respondents reported being "worried" about sudden infant death syndrome.

Why would a parent do anything other than minimize every known risk to their baby's health?

Ms. Murray suggests that the Back to Sleep campaign is a victim of its own success.

The SIDS rate has dropped so significantly over the past decade that parents today are less likely to know someone who has lost a child to the syndrome. "People have this false sense of security," she said.

It may not help that the experts themselves sometimes send garbled messages. A 2002 study in the journal Pediatrics, for example, found that preterm infants in intensive-care nurseries were frequently placed on their stomachs, and became accustomed to the position.

Lorrie Leigh, whose twins were born prematurely three months ago, resulting in the death of one, said she was surprised when neonatal nurses placed the surviving twin, Kalleigh, on her stomach.

Ms. Leigh, who teaches breast-feeding classes out of her home in Silver Spring, Md., already had three children under the age of 9, so she was well versed in the Back to Sleep literature.

"I thought for sure the doctors would follow the best guidelines," Ms. Leigh said. "But the nurses said babies sleep better this way."

Yet when Kalleigh was ready to go home, she added, the same nurses began placing her on her back. "They said, 'We have to tell you to do this.' "

Not only do many infants sleep better on their stomachs, they are much less likely to develop plagiocephaly, a deformation of the skull that leaves infants with flattened heads.

Dr. Jeffrey H. Wisoff, an associate professor of neurosurgery and pediatrics at New York University Medical Center, said that since the Back to Sleep campaign began, the head condition had "become an epidemic."

Dr. Wisoff, although he does not dispute the evidence linking supine sleeping to the lower SIDS rates, said that a decade ago he saw only a handful of plagiocephaly cases a year.

"Now we see up to a dozen kids with asymmetric heads a week," he said. "It drives parents nuts." The pediatrics academy, Dr. Wisoff said, should do a better job of telling parents to turn infants 180 degrees in their cribs occasionally and to place them on their stomachs while they are awake (a practice known as "tummy time").

But in the face of so much advice, many well-meaning parents simply balk. Doctors, they feel, issue proclamations without living in the real world.

"I'm very sympathetic to the mother who is so sleep-deprived that she puts the baby on its belly knowing that all the experts recommend not to," said Ms. Lyon, of the RealBirth center. "The role of the professional is to say 'these are the recommendations and this is why.' The role of the parent is to think critically and apply those recommendations in a way that makes their life manageable."

Perhaps surprisingly, Ms. Lyon finds no argument from Dr. Kattwinkel of the pediatrics academy.

"There is some justification to mothers who want to accept some of the risk factors and not others," he said. "You can follow all the risk factors and your baby may still die of SIDS. But as a national organization, we need to warn the public about it."

He added, "Any pediatrician who didn't would not be responsible."

On a fight with the Amish

Amish May Be Good Neighbors, but Not Their Horses
By ALEXEI BARRIONUEVO

LOYAL, Wis., Oct. 14 - For years, the residents of this small town surrounded by dairy farms have tried to get along with their Amish neighbors, who commute in horse-drawn buggies to banks and stores in town.

But horse droppings keep getting in the way. They often land at Inga Larsen's driveway, making an adventure out of walking to the mailbox for Ms. Larsen, who is 92 and uses a cane.

The Methodist church, on a busy corner, is particularly unlucky. When the buggies pull up to a stop sign there, horses often relieve themselves. JoAnn Oestreich, who lives next to the church, said she stopped opening her windows because the stench and flies were unbearable.

"With all the other things we have to do in life, you just get sick and tired of cleaning up the horse manure," Gladys Zuehlke, Ms. Larsen's daughter, said.

There is the health concern. "Maybe horse manure does not carry illness, but flies do," Ms. Zuehlke said.

Three years ago, people in this town of 1,300 thought that they had settled the dispute with a gentlemen's agreement in which the Amish promised to stay off certain well-traveled roads and to clean up regularly at a handful of hitching posts.

In return, the town dropped a proposal to force the Amish to put manure-catching "diapers" on the bottoms of the buggies and to clean up all droppings or be fined. The Amish, offended by the tone of the debate, withdrew some of their savings from Loyal banks and boycotted city businesses for about a year.

Now the dispute has returned, and in a meeting on Thursday residents related their grievances for nearly two hours and debated a suggestion to limit the Amish to truck routes around the town. Residents said that the Amish had not been keeping the hitching posts clean and that the manure continued to cause trouble. Several business owners and the mayor expressed concern that irritating the Amish could cause a new boycott. The City Council plans to discuss the problem again on Tuesday.

Although some residents fret that the bickering is as embarrassing as, well, the manure itself, the debate displays fissures in the seemingly cordial relations between the Amish and "the English," what the Amish call non-Amish. The Amish are a Christian sect that favors plain dress and plain living, with little or no reliance on modern conveniences like electricity, cars or telephones. In Wisconsin, with the fourth-largest Amish population after Pennsylvania, Ohio and Indiana, their numbers are growing, exceeding 10,400 in 2002, said Ingolf Vogeler, a geography professor at the University of Wisconsin, Eau Claire, 50 miles west of Loyal.

Around Loyal, the Amish population has grown to 85 families, or more than 500 people, since the first two families arrived in 1989 from Ohio. The Amish have been loath to defend themselves. Two representatives declined to speak Thursday, watching silently.

Emanuel Miller, head of one of the two original families, said in an interview that safety concerns prevented the Amish from cleaning up more manure, though he acknowledged that they could do a better job at the hitching posts. He said it was dangerous to stop carriages every time the horses relieved themselves.

This month, cars chased down a horse that ran off with an empty buggy just after an Amish woman had untied it. Amish in nearby Augusta found that manure-catchers, which that city imposed about 10 years ago, spooked some young horses, Mr. Miller said. He added that that he would like to think the manure debate was an isolated problem.

"Over all, I would say we have come to a real good community here," he said Friday. "There are a few oddballs, but the vast majority are very nice people around here. I don't detect any prejudice as a whole."

Still, at breakfast at Grandma's Kitchen last week, a group of older women spoke about a host of concerns. They recounted that at a funeral three years ago at the Methodist church, the American Legion drill team halted before firing a salute so it could step away from a manure pile. The women also said motorists had a hard time seeing the buggies at night because the Amish had refused to put bright orange slow-moving-vehicle signs on their buggies, as some Amish in other places have.

Courts in Michigan, Minnesota and Wisconsin have upheld the right, based on freedom of religious expression, to use white reflective tape rather than the usual orange triangle, which some Amish consider a symbol of the non-Amish world.

Ms. Zuehlke, a nurse, said workers at her hospital could "never understand" young Amish children, who grow up speaking German. But she said her mother had, at least, used some of the manure to fertilize her backyard flower garden.

"The English community has a number of things they are upset about," said Harvey M. Jacobs, a professor in the urban and regional planning department at the University of Wisconsin, Madison, who has studied the Wisconsin Amish.

"The non-Amish community is feeling a sense of alienation, a confusion and anger," Professor Jacobs said, adding that its attitude was one of "these people live amongst us and yet don't live with us."

"The horse issue is a way that can express itself," he said.

Residents also fault the city for not cleaning the streets better.

[Mayor Randy Anderson said on Monday that the question boiled down to economics. City crews clean with a sweeper a few times a week, Mr. Anderson said."How many times do you send a city crew out there to clean up?" ]

Some business owners are clearly concerned about how the Amish will react if pushed. Tom Zettler, who owns the town's hardware store, said he relied on the Amish for a quarter of his business and watched Amish business drop to "almost nothing" in the 2002 debate.

"I don't believe this is just about horse manure," Mr. Zettler said. "The issue is these people are different than any of the people around here, and that's unfortunate."

If an ordinance restricts manure, Mr. Miller said, "we would avoid Loyal as much as we could."

As for health questions, Mr. Miller said: "This is so highly biodegradable. The good lord created the horse as a beast of burden, and he created it so it would not be so offensive an animal. The manure is much more unsightly than hazardous to health."

On crying


When I feel the urge to cry, I go with it. I don't care who's around. And I do it even though it makes me look terrible. My nose swells and lights up, my eyes shrink to mean little slits, my mascara runs. So be it. When I'm crying, as much as when I'm laughing, I feel completely alive. It works for me. As a writer, the test of my best work is whether it does more than simply stimulate thought -- it must also provoke emotion. As a mother, I've noticed that my tears can quell the intense rivalry between my two sons; they quickly join forces to comfort me.

Plus, I love the drama.

Two recent articles exploring women's supposed emotionality in the workplace made me think about my own tendency to tear up. In the New York Times, Martha Stewart and other female honchos say that women who want to succeed in business must not weep, period. It's a remnant of advice from the era when women felt they had to imitate the dress and behavior of men in order to succeed. And a number of women executives in the article attest to the fact that, regardless of a female's biological predisposition to cry, stoicism is essential to her credibility as a leader.

A cover story in Newsweek on "Women's Leadership" takes a polar tack. There, successful women from politics, science, media and business expound on the unique emotive capacities that women bring to their management style. Unlike the women in the Times story, the women in Newsweek share a sensitivity to work-life balance issues, to building a sense of community at the office, and a keen, unapologetic recognition of the obstacles to advancement women continue to face.

It seems that when it comes to assessing whether women's emotions are a hindrance or, simply, a difference, we are still as divided as Janus.

I discovered early on that crying was controversial. "People will think you're weak," my older sister said, when I came home from a schoolyard fight in tears. "People will think you're unstable," I was told as a summer associate in a big city law firm, when I went crying to a female lawyer after a senior partner obliterated one of my memos. "People will think you're unhappy," my mother warned when I cried at my son's brilliant performance as Charlie Brown in the kindergarten play.

Often I've been cautioned that emotions make people uncomfortable. As a black woman, I am also aware that my crying jags might fulfill a stereotype: that all black women are prone to fly off the handle, to be illogical, perhaps uncontrollable. I remember, after the O.J. Simpson verdict, how the exultation of many blacks was seen by some as a collective intellectual failure to understand the legal issues of the case. Emotions can be used against you, rendering you either too human, or less than human. And yet, yielding to the tornado of feeling that whirls inside me at times is irresistibly cathartic, and ultimately empowering. Public tears feel liberating, an act of defiance against those who would subdue me with decorum and logic.

My father was the first person to tell me it was OK to cry. Perhaps it was this early support from a male authority figure that has given me the license and the confidence to remain emotional. I was about 7 when he caught me sobbing at the end of the film "Heidi," at the denouement, when Heidi's friend Clara tosses her crutches away and ambles across the Swiss mountaintop. My father took me on his lap and said, "Princess, never be ashamed to cry."

Of course, I was a girl. I never saw him cry, and I don't know that he ever said as much to my brother, but I doubt it. It's too bad because they both would have benefited if they'd had the freedom to let the tears flow.

I have become a crying booster. When I see my sons, or other boys, crying, I want to say, "That's right! Just do it! You da man!" If men and women became more comfortable with expressions of emotion, we could humanize the workplace, lead more fulfilling personal lives and welcome authentic compassion into political life.

The response to Katrina had me over the moon because it illustrates my point: Emotions, particularly when expressed by men, are powerful. Mayor Ray Nagin's expletives; Kanye West saying "George Bush doesn't care about black people" on national television; NBA basketball star Stephon Marbury weeping uncontrollably at a press conference; the breakdown of Jefferson County Parish president Aaron Broussard, as he described the calls for help from a friend's mother who drowned in her nursing home. These incidents placed heartbreak on the political agenda. Homeland Security Secretary Michael Chertoff's cool appraisal, "It's an emotional time," seemed a paternalistic understatement intended to dismiss these protests as uncontrolled ravings. But on display in the days after Katrina were unvarnished tears and genuine empathy, which eventually compelled action.

Tears teach. What stirs us to public emotion reveals our needs, reflects our values. It also asks others to evaluate what, if anything, they are doing to provoke our tears, to take responsibility for our feelings by trying to make things better. This is why emotions are politically incorrect; they impose on us burdensome questions: What have I done? What can I do? The images of men breaking down and speaking out after Katrina exemplified true compassion, not the propagandistic kind that is safely contained and manipulated with photo ops and false camaraderie. It was raw, it was real and it won the hearts and minds of the nation. Let's hope we haven't seen the last of it.

Date: 2005-10-19 12:08 am (UTC)
From: [identity profile] literalgirl.livejournal.com
Interesting. Sounds like the same people who won't take the unquantifiable risk of having a kid vaccinated are the SAME types who will gleefully take the risk of their kid dying in its sleep. Seems quite confusing to me... Isn't a small-but-possible risk, still a risk?

I am at least consistent. No MMR (just in case), and no tummy-sleeping (just in case). :-)

Date: 2005-10-19 12:27 am (UTC)
From: [identity profile] literalgirl.livejournal.com
Well, IIRC, the skull thing will sort itself out *anyway*, as you sit and crawl and eventualy walk. Isn't that the same reason we aren't supposed to worry about the strange head-shapes that are a result of childbirth? Those conehead kids always normalize, and the bones don't completely solidify until age 3.

Bolt was a c-section, then a back-sleeper, and his head is perfect. :-)

Date: 2005-10-19 11:44 am (UTC)
From: [identity profile] brownkitty.livejournal.com
And here I just dealt with the possiblity of a flat spot by making sure my kids didn't get put down to sleep in the same position twice. I had one of those side-sleep pillows, and the kids slept just fine.

Date: 2005-10-19 01:41 pm (UTC)
From: [identity profile] literalgirl.livejournal.com
That is an adorable icon. :-)

Date: 2005-10-19 01:46 pm (UTC)
From: [identity profile] brownkitty.livejournal.com
Thank you. One of my friends found it for me, I wish I knew where.

Date: 2005-10-19 12:37 am (UTC)
From: [identity profile] moggymania.livejournal.com
"As a mother, I've noticed that my tears can quell the intense rivalry between my two sons; they quickly join forces to comfort me. Plus, I love the drama."

Blech. Well, we can see why she likes crying, it lets her manipulate people. I really hate it when people do things like that. Especially because what happens is that then, somebody that isn't willing to bawl on command gets stuck with the crying person's share of the unpleasantness AND with trying to comfort the person. Grrr.

Date: 2005-10-19 01:26 am (UTC)
From: [identity profile] ex-chaos-by-699.livejournal.com
Since when do women have a "biological disposition to cry"?

Date: 2005-10-19 11:45 am (UTC)
From: [identity profile] brownkitty.livejournal.com
We do. Just as much as men do.

Date: 2005-10-19 12:08 am (UTC)
From: [identity profile] literalgirl.livejournal.com
Interesting. Sounds like the same people who won't take the unquantifiable risk of having a kid vaccinated are the SAME types who will gleefully take the risk of their kid dying in its sleep. Seems quite confusing to me... Isn't a small-but-possible risk, still a risk?

I am at least consistent. No MMR (just in case), and no tummy-sleeping (just in case). :-)

Date: 2005-10-19 12:27 am (UTC)
From: [identity profile] literalgirl.livejournal.com
Well, IIRC, the skull thing will sort itself out *anyway*, as you sit and crawl and eventualy walk. Isn't that the same reason we aren't supposed to worry about the strange head-shapes that are a result of childbirth? Those conehead kids always normalize, and the bones don't completely solidify until age 3.

Bolt was a c-section, then a back-sleeper, and his head is perfect. :-)

Date: 2005-10-19 11:44 am (UTC)
From: [identity profile] brownkitty.livejournal.com
And here I just dealt with the possiblity of a flat spot by making sure my kids didn't get put down to sleep in the same position twice. I had one of those side-sleep pillows, and the kids slept just fine.

Date: 2005-10-19 01:41 pm (UTC)
From: [identity profile] literalgirl.livejournal.com
That is an adorable icon. :-)

Date: 2005-10-19 01:46 pm (UTC)
From: [identity profile] brownkitty.livejournal.com
Thank you. One of my friends found it for me, I wish I knew where.

Date: 2005-10-19 12:37 am (UTC)
From: [identity profile] moggymania.livejournal.com
"As a mother, I've noticed that my tears can quell the intense rivalry between my two sons; they quickly join forces to comfort me. Plus, I love the drama."

Blech. Well, we can see why she likes crying, it lets her manipulate people. I really hate it when people do things like that. Especially because what happens is that then, somebody that isn't willing to bawl on command gets stuck with the crying person's share of the unpleasantness AND with trying to comfort the person. Grrr.

Date: 2005-10-19 01:26 am (UTC)
From: [identity profile] ex-chaos-by-699.livejournal.com
Since when do women have a "biological disposition to cry"?

Date: 2005-10-19 11:45 am (UTC)
From: [identity profile] brownkitty.livejournal.com
We do. Just as much as men do.

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