On parenting through trauma, the intersection of fatphobia and doctor-prescribed diets, and finding ourselves in motherhood, with Debi Lewis, author of Kitchen Medicine.
This was such an interesting (and heart-wrenching) conversation - thank you. I couldn't help but think also of the "failure to progress" diagnosis that women in labor are given, which makes us feel like we're failing at parenting even BEFORE we have given birth, and which then justifies doctors making all sorts of medical decisions without truly getting informed consent first. Debi's comment that failure to thrive "is used as a justification for removing parental rights" feels really apt there, too.
Ugh this conversation brings up so much for me. After my third child was born everything was great until the second week check-in at the midwife office when we realized he hadn't gained any weight in the previous 2-3 days. The midwife whisked me into a chair and demanded I demonstrate how I breastfeed in front of her because, clearly, I must be doing it wrong. Again, this was my THIRD child. I complied and she immediately and aggresively corrected me and then implied that because I had two other kids at home I must be too distracted to be attending to this baby's needs. I left just devastated. They checked absolutely nothing else with my baby. That night he woke to feed and when I picked him up he was about a thousand degrees. Long story short he had a urinary tract infection, which is quite dangerous in newborns, and we spent the next week together in the hospital. Once he had antibiotics in him he started gaining weight like gangbusters and recovered well. Even still, when nurses came in to check on us (and they were all lovely people) they often remarked on how quickly and efficiently he nursed, often only for 5-10 minutes, with a whiff of judgement that, again, I wasn't doing it right. I would just smile and point to his weight gain chart.
Anyway, he's now 4 and just thinking about that one day in the midwife office and her blatant insinuation that I wasn't nourishing my child properly still has the power to make me feel awful, even though it wasn't true. Sorry for the long message, but I've never put it all down into words before. I wish that woman knew how damaging her words were to me.
Debi’s comment “The question should always be, if this is a problem, why do you think it’s a problem? And why do you think it’s happening?” is so basic and I could I never form these words when I was talking to my child’s doctor. I relate to her experience about feeling judged and fearful. I plan to keep this question handy - it’s excellent advice!
Our pediatrician (who I actually loved and had a good relationship with even when things got contentious, because I was able to be openly frustrated and very direct about it with her -- she left to work in NYC) wanted to diagnose my youngest with failure to thrive at 3mo and I just held my hand up and said, hell no. Turns out my daughter was allergic to the dairy protein in my breastmilk -- and of course, if you're having bloody diarrhea at that age, it's really damn hard to hold weight. I took her to the ER the first time this happened -- they missed the allergy, so I continued to eat dairy, obviously unknowingly, for about two more weeks before it happened again and I refused to leave the Children's Hospital until someone told me something definitive about why this was happening. They *did* catch the allergy there, and I gave up dairy (and anything with dairy ingredients, which is a LOT more food than you might think) for a year to continue nursing her, and the course of "failure" immediately reversed (though she was, and is, still just a small person). I brought this whole thing back to our ped to (somewhat aggressively, I must admit) show her how close she came to putting my baby (and me) in a category that was not only completely unhelpful but possibly outright damaging to us both. I was doing my best to feed my child (and about to go back to work, which meant back to my breast pump during the day), and to be told it wasn't good enough, to even use the word "failure" in conjunction with it? I was so angry, and I told her.
Always, thank you for this post, Virginia. I live in an area with (and have access to) world-class healthcare, I have a lot of privilege, I am pretty much fundamentally incapable of backing down in a fight, and if it was hard for me, I can only imagine the experience of others without these things.
This is fascinating. I think I've said this before, but as a teenager I babysat for a kid diagnosed with failure to thrive, and in my house we always said those words in air quotes because it was so obviously a diagnosis that did not describe this child, who was thriving but very thin. (She had been premature and her parents were small and we are Facebook friends and she has just been thin her whole life.) And now I think back, and to us it was so ridiculous on its face, but I wonder about her parents.
Also my best friend's 12-year-old is a very thin kid who had pneumonia last summer and lost a whole lot of weight, and my friend really struggled with doctors and nurses who looked at this thin kid refusing to eat (while she was in so much pain she really couldn't) and jumped to assuming an eating disorder. So there was a moment where my friend really had to fight for adequate care for her child's pain, saying no, this is a kid who has some food aversions because of really traumatic experiences with allergies, but she is dutiful about eating, she eats what we ask her to to be sure she gets a baseline amount of food. And they really didn't believe her, until her husband had the stroke of genius of finding a virgin pina colada, one of their daughter's favorite things, and she was able to get herself to sip that enough that they believed she was willing to consume calories, basically.
“this larger cultural failure, where we make feeding kids the main project and problem of mothers.” Whoa. This part of the conversation made me pause. And then text it to a friend. I keep unpacking the infinite load borne by mothers, and feeding is such a major part of it. Culturally, we often talk about the logistical components: grocery shopping and meal planning and cooking and serving and cleaning up that tends to fall to mothers. As if that weren’t enough, those of us trying to reject diet culture are also doing the researching and deconstructing and reimagining of what feeding kids even looks like--building a whole new foundational framework for ourselves and our families. It is exhausting, and in my experience, it rarely produces a feeling of “I am nailing it!” Part of me wants to release it all, but then our family culture around food would default to my husband’s beliefs, and he’s not as far away from diet culture as I am.
This was such an interesting (and heart-wrenching) conversation - thank you. I couldn't help but think also of the "failure to progress" diagnosis that women in labor are given, which makes us feel like we're failing at parenting even BEFORE we have given birth, and which then justifies doctors making all sorts of medical decisions without truly getting informed consent first. Debi's comment that failure to thrive "is used as a justification for removing parental rights" feels really apt there, too.
Oh my gosh YES, I hadn't made that connection. The medical system needs to stop labeling patients/bodies/people as failures, full stop.
Ugh this conversation brings up so much for me. After my third child was born everything was great until the second week check-in at the midwife office when we realized he hadn't gained any weight in the previous 2-3 days. The midwife whisked me into a chair and demanded I demonstrate how I breastfeed in front of her because, clearly, I must be doing it wrong. Again, this was my THIRD child. I complied and she immediately and aggresively corrected me and then implied that because I had two other kids at home I must be too distracted to be attending to this baby's needs. I left just devastated. They checked absolutely nothing else with my baby. That night he woke to feed and when I picked him up he was about a thousand degrees. Long story short he had a urinary tract infection, which is quite dangerous in newborns, and we spent the next week together in the hospital. Once he had antibiotics in him he started gaining weight like gangbusters and recovered well. Even still, when nurses came in to check on us (and they were all lovely people) they often remarked on how quickly and efficiently he nursed, often only for 5-10 minutes, with a whiff of judgement that, again, I wasn't doing it right. I would just smile and point to his weight gain chart.
Anyway, he's now 4 and just thinking about that one day in the midwife office and her blatant insinuation that I wasn't nourishing my child properly still has the power to make me feel awful, even though it wasn't true. Sorry for the long message, but I've never put it all down into words before. I wish that woman knew how damaging her words were to me.
The rush to blame and judge moms CAUSES SO MUCH HARM. So glad your kiddo was okay. So sorry this happened at all.
Debi’s comment “The question should always be, if this is a problem, why do you think it’s a problem? And why do you think it’s happening?” is so basic and I could I never form these words when I was talking to my child’s doctor. I relate to her experience about feeling judged and fearful. I plan to keep this question handy - it’s excellent advice!
It's SUCH a useful framing. (For any doctor questions about weight, in any direction, frankly.)
Our pediatrician (who I actually loved and had a good relationship with even when things got contentious, because I was able to be openly frustrated and very direct about it with her -- she left to work in NYC) wanted to diagnose my youngest with failure to thrive at 3mo and I just held my hand up and said, hell no. Turns out my daughter was allergic to the dairy protein in my breastmilk -- and of course, if you're having bloody diarrhea at that age, it's really damn hard to hold weight. I took her to the ER the first time this happened -- they missed the allergy, so I continued to eat dairy, obviously unknowingly, for about two more weeks before it happened again and I refused to leave the Children's Hospital until someone told me something definitive about why this was happening. They *did* catch the allergy there, and I gave up dairy (and anything with dairy ingredients, which is a LOT more food than you might think) for a year to continue nursing her, and the course of "failure" immediately reversed (though she was, and is, still just a small person). I brought this whole thing back to our ped to (somewhat aggressively, I must admit) show her how close she came to putting my baby (and me) in a category that was not only completely unhelpful but possibly outright damaging to us both. I was doing my best to feed my child (and about to go back to work, which meant back to my breast pump during the day), and to be told it wasn't good enough, to even use the word "failure" in conjunction with it? I was so angry, and I told her.
Always, thank you for this post, Virginia. I live in an area with (and have access to) world-class healthcare, I have a lot of privilege, I am pretty much fundamentally incapable of backing down in a fight, and if it was hard for me, I can only imagine the experience of others without these things.
I share your fury. These experiences are JUST BRUTAL.
This is fascinating. I think I've said this before, but as a teenager I babysat for a kid diagnosed with failure to thrive, and in my house we always said those words in air quotes because it was so obviously a diagnosis that did not describe this child, who was thriving but very thin. (She had been premature and her parents were small and we are Facebook friends and she has just been thin her whole life.) And now I think back, and to us it was so ridiculous on its face, but I wonder about her parents.
Also my best friend's 12-year-old is a very thin kid who had pneumonia last summer and lost a whole lot of weight, and my friend really struggled with doctors and nurses who looked at this thin kid refusing to eat (while she was in so much pain she really couldn't) and jumped to assuming an eating disorder. So there was a moment where my friend really had to fight for adequate care for her child's pain, saying no, this is a kid who has some food aversions because of really traumatic experiences with allergies, but she is dutiful about eating, she eats what we ask her to to be sure she gets a baseline amount of food. And they really didn't believe her, until her husband had the stroke of genius of finding a virgin pina colada, one of their daughter's favorite things, and she was able to get herself to sip that enough that they believed she was willing to consume calories, basically.
Oh god that pina colada story! Can so relate. Gah.
“this larger cultural failure, where we make feeding kids the main project and problem of mothers.” Whoa. This part of the conversation made me pause. And then text it to a friend. I keep unpacking the infinite load borne by mothers, and feeding is such a major part of it. Culturally, we often talk about the logistical components: grocery shopping and meal planning and cooking and serving and cleaning up that tends to fall to mothers. As if that weren’t enough, those of us trying to reject diet culture are also doing the researching and deconstructing and reimagining of what feeding kids even looks like--building a whole new foundational framework for ourselves and our families. It is exhausting, and in my experience, it rarely produces a feeling of “I am nailing it!” Part of me wants to release it all, but then our family culture around food would default to my husband’s beliefs, and he’s not as far away from diet culture as I am.
It SO rarely produces a feeling of "I'm nailing it." Yes, yes, yes.