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Thread: Church, drinking cultures, and the exclusion of teetotalers
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Twilight
Puddleglum's sister
# 2832
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Posted
quote:
Originally posted by mdijon:
quote:
Originally posted by lilBuddha:
Two, why risk a child's health because one cannot live without a pint or a shot for a few months?
I don't think there's any data supporting alcohol as a general remedy to support breastfeeding, but the problem with the very precautionary idea that you don't do anything which might have a theoretical risk is that before you know where you are pregnant/breastfeeding women are being told to avoid peanuts, soft cheese, shellfish, steak, chicken, chocolate mousse, tea, coffee, gluten...
There's good reason to think that more than light drinking is bad for babies, but going for abstinence as a public health message seems too restrictive. And the "if you tell them a little is OK they'll go too far" feels too paternalistic to me.
I really don't see anything too restrictive in warning pregnant and nursing mothers about any of the things listed. At least if warned they have the informed option. My mother never drank and I didn't drink at all while pregnant and nursing, I don't remember feeling deprived.
With such small families these days most women will only be restricting their choices for a year or two out of an eighty year life span. Not such a big hardship.
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cliffdweller
Shipmate
# 13338
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Posted
I'm with Twilight on this, but will acknowledge the research is sketchy both ways, simply because there are ethical problems with doing a double-blind study of pregnant or nursing moms. We simply don't know how much alcohol is safe, and at what point in a pregnancy.
In addition to which it's really out of most of our fields of expertise. I'm happy to stick with the tried-and-true "this is something you might discuss with your OB/pediatrician..." But I would stick with my response to the original post that triggered the tangent: not all women who have given birth would agree that a bit of Guinness is a good thing. So again, discuss it with your health-care provider.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by Twilight:
At least if warned they have the informed option.
But it isn't an informed option, and there probably isn't the bandwidth to actually inform people about these issues. Take soft cheese. The information should really be;
quote:
Listeria is a very rare infection. About 100 to 200 cases are identified every year among the 65 million people living in the UK. Just under half of those are in pregnant women or their newborn children.
When listeria occurs in pregnancy, it can lead to a mild fever, or to meningitis or severe infection in the newborn baby.
Listeria is found in salads, soft cheese, meat and various other foods. There is no actual proof that people getting listeria have acquired it from any particular food, and the DNA tests of listeria found in food versus listeria causing disease in pregnancy does not clearly link these two populations.
To avoid listeria we could suggest you avoid salad, although actually it is probably very low in listeria counts, processed meat, although it is probably OK if well cooked, and soft cheese.
That's a lot of information to discuss over one very small risk. I'm not sure how proportionate it is to do that, and presumably then say "By the way don't smoke. That's a public health disaster in the UK leading to thousands of premature or small birth-weight children every year."
Putting soft-cheese and salad in a list of foods to avoid really isn't being given an informed option, it's an uninformed instruction.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Leorning Cniht
Shipmate
# 17564
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Posted
quote:
Originally posted by cliffdweller:
We simply don't know how much alcohol is safe, and at what point in a pregnancy.
This is true. But we can say with some confidence that if there is an effect of the kind of low-level alcohol consumption that Moo and I have mentioned, then the effect is small. I agree with you that we cannot say with any confidence that the effect is zero. We can't even say anything about the sign of such an effect, although it's hard to come up with a mechanism for a small amount of alcohol to be beneficial for a developing foetus, unless you're going with the less stressed mother thing.
Posts: 5026 | From: USA | Registered: Feb 2013
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Gamaliel
Shipmate
# 812
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Posted
I'm sure it does vary from mother to mother.
My wife abstained from alcohol when pregnant but would drink a glass of Mann's, a rather weak stout similar to Guinness to aid lactation when breastfeeding.
It wasn't done to relieve stress or get a buzz but because she heard it helps lactating women to 'let down.'
Mann's is an 'old ladies' drink and not the sort of thing one would quaff. I only ever use it in beef stews.
I'm sure other women drink stout during lactation and don't find it helpful. My wife did. I'm sure not all women would.
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Let us with a gladsome mind
Praise the Lord for He is kind.
http://philthebard.blogspot.com
Posts: 15997 | From: Cheshire, UK | Registered: Jul 2001
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by cliffdweller:
We simply don't know how much alcohol is safe, and at what point in a pregnancy.
Likewise we don't know how much sugar is safe. Or fruit juice. Or how much caffeine is safe. The list goes on of substances that one could advise avoidance of.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Brenda Clough
Shipmate
# 18061
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Posted
Which is why we should leave it to the mother. She, guided by her physician, her own state of health, cultural indications (the variety of practices around the world is amazingly huge and babies by and large seem to do fine) and her love for her baby, gets to decide.
We, the bystanders, get to mutter and tut, and admire how fat the baby is, the dumpling! and is that a first tooth coming? The magazines and websites get to chase after whatever is the Parenting Scare of the Week (plastics! wasps! fish! laundry detergents!) until the end of time, because it is endless. The state gets to butt out.
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Science fiction and fantasy writer with a Patreon page
Posts: 6378 | From: Washington DC | Registered: Mar 2014
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lilBuddha
Shipmate
# 14333
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Posted
quote:
Originally posted by Brenda Clough:
Which is why we should leave it to the mother.
So, when the mother shoots heroin, beats her child, starves her child, leaves it unattended. etc.: the state get to "butt out"?
quote:
She, guided by her physician, her own state of health, cultural indications (the variety of practices around the world is amazingly huge and babies by and large seem to do fine)
Mothers and doctors are not magical creatures with instinctive knowledge. This is why we have general standards.
Also, there is a large range that people exist in between perfectly healthy and dead. I might be the strange one here, but I think we should aim more towards the healthy.
quote:
and her love for her baby,
We do a lot of fucked up things to our children, and it isn't always out of hate. FGM isn't typically done out of animosity.
Alcohol is a poison. In moderate amounts it does not seem to be excessively detrimental to adults. This does not automatically translate to children.
Why risk it?
quote:
Originally posted by mdijon:
quote:
Originally posted by cliffdweller:
We simply don't know how much alcohol is safe, and at what point in a pregnancy.
Likewise we don't know how much sugar is safe. Or fruit juice. Or how much caffeine is safe. The list goes on of substances that one could advise avoidance of.
That expectant mother's should be eating healthy, but mightn't, isn't a defence for doing something that is more likely to be harmful.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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Brenda Clough
Shipmate
# 18061
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Posted
The beating, starving etc. are already against the law. It is illegal for your cat, never mind your baby.
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Science fiction and fantasy writer with a Patreon page
Posts: 6378 | From: Washington DC | Registered: Mar 2014
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lilBuddha
Shipmate
# 14333
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Posted
quote:
Originally posted by Brenda Clough:
The beating, starving etc. are already against the law. It is illegal for your cat, never mind your baby.
That is my point. The state already "butts in" because we want it to do so. We already do not trust mum to do best.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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Leorning Cniht
Shipmate
# 17564
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Posted
quote:
Originally posted by lilBuddha:
Why risk it?
It's interesting, isn't it, that "why take the risk?" seems to be the typical approach that the state takes when issuing diktats to other people, but when it would involve the state committing some of its own resources, it becomes "nobody has proved that tighter standards would have measurable benefit".
It's also worth noting the huge cultural aspect to many of these diktats: when Mrs. C was pregnant with our eldest, she was advised by her doctor to keep a large jar of peanut butter by the bed, and eat a spoonful before getting up in the morning, in order to help with morning sickness. Her schoolfriend, who was pregnant in the UK at the same time, was advised by her doctor to strictly avoid all peanut products.
Obviously the difference here is culture - peanut butter is a staple foodstuff in America - the PBJ is possibly the archetypal child's sandwich - whereas although peanut butter exists in the UK, it's not nearly so ubiquitous. If I were making sandwiches for UK children, peanut butter wouldn't make my top five possible fillings. It might not even make the top ten.
[ 03. August 2017, 17:05: Message edited by: Leorning Cniht ]
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lilBuddha
Shipmate
# 14333
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Posted
quote:
Originally posted by Leorning Cniht:
It's interesting, isn't it, that "why take the risk?" seems to be the typical approach that the state takes when issuing diktats to other people, but when it would involve the state committing some of its own resources, it becomes "nobody has proved that tighter standards would have measurable benefit".
The convoluted dance between service, cost and private interest.
quote:
It's also worth noting the huge cultural aspect to many of these diktats: when Mrs. C was pregnant with our eldest, she was advised by her doctor to keep a large jar of peanut butter by the bed, and eat a spoonful before getting up in the morning, in order to help with morning sickness. Her schoolfriend, who was pregnant in the UK at the same time, was advised by her doctor to strictly avoid all peanut products.
Peanuts are an interesting question. They are often used in treating malnutrition because they are a very effective source of nutrients and calories. However, they are also a potent allergen.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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mdijon
Shipmate
# 8520
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Posted
The other interesting thing about peanuts is that there is now some evidence that the precautionary approach of cutting them out was wrong.
Peanuts during pregnancy seems to reduce the risk of allergy in the infant.
It isn't really home and dry, but there is very good data that introducing peanuts in early childhood does reduce the risk of peanut allergy in later life.
Alcohol is a poison in excess, but so are salt and sugar. I don't think the state has any business giving precautionary advice that isn't backed by data, and it looks really odd when it picks on women and alcohol as the time to get especially precautionary.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by lilBuddha:
The state already "butts in" because we want it to do so. We already do not trust mum to do best.
We do trust mum to do best, and we don't interfere until we have strong evidence to the contrary. There has to be a line so that the state isn't dictating to or advising mums (or fathers for that matter) based on whim, but on evidence and fact and levels of harm.
The state has a role in forcible rescuing an abused child and in nagging mothers and fathers not to expose their children to second hand cigarette smoke. But not in advising whatever unevidenced prohibition comes to mind.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Twilight
Puddleglum's sister
# 2832
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Posted
quote:
Originally posted by mdijon:
I don't think the state has any business giving precautionary advice that isn't backed by data, and it looks really odd when it picks on women and alcohol as the time to get especially precautionary.
Doesn't seem odd to me at all. What you see as "picking on women," I see as a special interest in the health and protection of children. That's a prime value in almost all species. Most mothers, in particular, would rather be "picked on," than see their child ill.
How many English mothers, after being prescribed thalidomide by their doctors, would have liked to have been informed of the early negative data about it that was coming from Australia at the time.
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mdijon
Shipmate
# 8520
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Posted
I don't see the logic that says because the state failed to insist on proper scrutiny of a drug company introducing a new drug for use in pregnancy, that therefore the state should now precautionarily advise against another substance.
Failing to act on data in the past shouldn't lead to acting on no data now.
[ 03. August 2017, 19:31: Message edited by: mdijon ]
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mdijon nojidm uoɿıqɯ ɯqıɿou
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Posts: 12277 | From: UK | Registered: Sep 2004
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by Leorning Cniht:
quote:
Originally posted by cliffdweller:
We simply don't know how much alcohol is safe, and at what point in a pregnancy.
This is true. But we can say with some confidence that if there is an effect of the kind of low-level alcohol consumption that Moo and I have mentioned, then the effect is small.
I think that is probably an overstatement. I don't think we can say that with any degree of confidence. We can say that large amounts of alcohol during pregnancy can be quite detrimental-- but parsing out the implications is very, very tough to do.
And again, it's beyond my area of expertise and that of most (tho probably not all) on a board such as this. The best advice IMHO is to address dietary concerns during pregnancy with your OB and while nursing with your pediatrician.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by mdijon:
I don't see the logic that says because the state failed to insist on proper scrutiny of a drug company introducing a new drug for use in pregnancy, that therefore the state should now precautionarily advise against another substance.
Failing to act on data in the past shouldn't lead to acting on no data now.
But again, it's not "no data" there IS data, it's simply preliminary or incomplete data. There is real, verifiable data that excessive alcohol use during pregnancy causes real, measurable harm. It is reasonable to suppose that risk exists on a continuum from "no alcohol = no harm" to "excessive alcohol = considerable harm." What we don't know is the individual points along that continuum.
quote:
Originally posted by mdijon:
Alcohol is a poison in excess, but so are salt and sugar. I don't think the state has any business giving precautionary advice that isn't backed by data, and it looks really odd when it picks on women and alcohol as the time to get especially precautionary.
Agree with the general principle, but I think the science is much more nuanced and not nearly as conclusive as you seem confident in suggesting. At this point the govt (at least in US) issues warnings but no prohibitions about alcohol use during pregnancy and nursing. That seems appropriate given the level of data available to us at this point in time.
[ 03. August 2017, 20:25: Message edited by: cliffdweller ]
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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Curiosity killed ...
Ship's Mug
# 11770
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Posted
I have worked with a number of teenagers who, although they have not been diagnosed as having foetal alcohol syndrome (I have worked with young people with that diagnosis too), were the children of drug and/or alcohol using mothers. These teenagers had a pattern of behaviour, including lack of ability to focus and ADHD that becomes recognisable when you've seen it enough. These youngsters also had an arrested emotional development.
Having seen this is enough to make me think twice about drinking should I be pregnant.
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Mugs - Keep the Ship afloat
Posts: 13794 | From: outiside the outer ring road | Registered: Aug 2006
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chris stiles
Shipmate
# 12641
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Posted
quote:
Originally posted by Curiosity killed ...:
These teenagers had a pattern of behaviour, including lack of ability to focus and ADHD that becomes recognisable when you've seen it enough. These youngsters also had an arrested emotional development.
Having seen this is enough to make me think twice about drinking should I be pregnant.
Well, if they have also been brought up by drug addicted parents; diet and upbringing while infants is also going to play very heavily into this.
Posts: 4035 | From: Berkshire | Registered: May 2007
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by lilBuddha
Alcohol is a poison. In moderate amounts it does not seem to be excessively detrimental to adults. This does not automatically translate to children.
Why risk it?
Because without very small amounts of alcohol, some women can not manage to breastfeed.
Moo
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Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by chris stiles:
quote:
Originally posted by Curiosity killed ...:
These teenagers had a pattern of behaviour, including lack of ability to focus and ADHD that becomes recognisable when you've seen it enough. These youngsters also had an arrested emotional development.
Having seen this is enough to make me think twice about drinking should I be pregnant.
Well, if they have also been brought up by drug addicted parents; diet and upbringing while infants is also going to play very heavily into this.
Well, but the studies that have been done find these same symptoms among children removed from the home and adopted by non drug-addicted parents. I don't think you can dismiss the substantial evidence of fetal alcohol syndrome as a Real Thing. The problem again is we haven't mapped out what the impact of each point along the continuum from complete abstinence to heavy drinking might be. Which argues for a fairly light touch (again, warning vs prohibiting) but it also argues against the sort of confident overstatements that have been made here.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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Moo
Ship's tough old bird
# 107
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Posted
Fetal alcohol syndrome is a recognizable physical condition. As I mentioned upthread, I have seen a baby with FAS. Before I saw her, I had read a description of the physical symptoms of FAS; she had them.
Her face was unusually short and wide; her eyes were unusually far apart; and she lacked a philtrum She was born this way; her post-birth environment had nothing to do with it.
Moo
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by cliffdweller:
But again, it's not "no data" there IS data, it's simply preliminary or incomplete data. There is real, verifiable data that excessive alcohol use during pregnancy causes real, measurable harm.
Just like sugar then. But we don't advise pregnant women to avoid all sugar, just to avoid excessive sugar.
I don't think data on excessive alcohol use can be described as preliminary data on moderate alcohol use. In fact there are plenty of data examining moderate alcohol use and outcome, more of them in pregnancy rather than breastfeeding per se, and it is inconclusive. There are some studies that appear to show harm, and some that appear to show no effect. If anything it would be more correct to say that the incomplete data on alcohol is conflicting, rather than real measurable harm.
quote:
Originally posted by cliffdweller:
but I think the science is much more nuanced and not nearly as conclusive as you seem confident in suggesting.
I'm not suggesting the science is conclusive, rather the opposite. It seems to me the burden of evidence and confidence is more on the side of the one wanting to act.
Having said that, we started talking about breastfeeding. The slight evidence of harm of moderate alcohol consumption among mothers seems mostly limited to the first 3 months of pregnancy to me. I personally would want to be more cautious during that period, see less reason for caution later on, and absolutely no evidence that moderate alcohol use during breastfeeding is harmful at all.
As Moo says the foetal alcohol syndrome is very real and very well described. It occurs with heavy alcohol consumption in the first three months of pregnancy. Linking that to advice to breastfeeding mothers is too broad a brush.
[ 03. August 2017, 21:44: Message edited by: mdijon ]
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mdijon nojidm uoɿıqɯ ɯqıɿou
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Posts: 12277 | From: UK | Registered: Sep 2004
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Enoch
Shipmate
# 14322
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Posted
I thought peanuts were very dangerous for small children. Is that no longer the case?
And I'm fairly sure that although alcohol is not recommended for pregnant women, FAS is caused by having a seriously alcoholic mother, and that a baby is unlikely to get it just because his or her mother had a few drinks before she realised she was expecting.
[ 03. August 2017, 21:59: Message edited by: Enoch ]
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Brexit wrexit - Sir Graham Watson
Posts: 7610 | From: Bristol UK(was European Green Capital 2015, now Ljubljana) | Registered: Nov 2008
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Curiosity killed ...
Ship's Mug
# 11770
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Posted
These teenagers were being brought up by their fathers in the absence of their mothers, or by grandmothers, or in care. Some had stepmothers.
I am suggesting that foetal alcohol damage is not as simple as high levels of alcohol use leading to foetal alcohol syndrome (FAS) and moderate levels are fine, but that there is more of a continuum. That effects are observable from alcohol abuse while pregnant at lower than causing FAS. But that continuum is not quantified.
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Mugs - Keep the Ship afloat
Posts: 13794 | From: outiside the outer ring road | Registered: Aug 2006
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Nicolemr
Shipmate
# 28
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Posted
Peanuts are very dangerous for small children because of the danger of choking on them. That is still a hazard. Peanut butter is a different issue.
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On pilgrimage in the endless realms of Cyberia, currently traveling by ship. Now with live journal!
Posts: 11803 | From: New York City "The City Carries On" | Registered: May 2001
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by Curiosity killed ...:
That effects are observable from alcohol abuse while pregnant at lower than causing FAS. But that continuum is not quantified.
Well there's quite a lot of data for and against that idea, a fair amount of it against. Even with large cohorts it doesn't seem easy to define.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by Nicolemr:
Peanuts are very dangerous for small children because of the danger of choking on them. That is still a hazard. Peanut butter is a different issue.
Thanks, yes the allergy trial I mentioned was done with peanut-crisps, with smooth peanut butter for the children who didn't get on with the crisps.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Ricardus
Shipmate
# 8757
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Posted
quote:
Originally posted by mdijon:
absolutely no evidence that moderate alcohol use during breastfeeding is harmful at all.
Fwiw (not much), my wife was advised that although alcohol does indeed pass into the milk, the dilution is at the level of a shot of vodka poured into a swimming pool.
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Then the dog ran before, and coming as if he had brought the news, shewed his joy by his fawning and wagging his tail. -- Tobit 11:9 (Douai-Rheims)
Posts: 7247 | From: Liverpool, UK | Registered: Nov 2004
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mdijon
Shipmate
# 8520
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Posted
Downing vodka shots in the swimming pool sounds like the right way to facilitate breastfeeding to me.
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mdijon nojidm uoɿıqɯ ɯqıɿou
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Posts: 12277 | From: UK | Registered: Sep 2004
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chris stiles
Shipmate
# 12641
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Posted
quote:
Originally posted by cliffdweller:
Well, but the studies that have been done find these same symptoms among children removed from the home and adopted by non drug-addicted parents. I don't think you can dismiss the substantial evidence of fetal alcohol syndrome as a Real Thing.
I'm not dismissing it as a Real Thing, I'm pretty sure it is. I was just contesting the idea that it was necessarily the only thing to blame in the particular scenario described given the particular set of circumstances that were laid out.
Posts: 4035 | From: Berkshire | Registered: May 2007
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lilBuddha
Shipmate
# 14333
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Posted
quote:
Originally posted by Moo:
quote:
Originally posted by lilBuddha
Alcohol is a poison. In moderate amounts it does not seem to be excessively detrimental to adults. This does not automatically translate to children.
Why risk it?
Because without very small amounts of alcohol, some women can not manage to breastfeed.
Moo
If you read the link I supplied above, it is the barley not the alcohol. Indeed, according to one of the links I posted, the alcohol has an opposite effect.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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Moo
Ship's tough old bird
# 107
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Posted
quote:
Originally posted by lilBuddha:
If you read the link I supplied above, it is the barley not the alcohol. Indeed, according to one of the links I posted, the alcohol has an opposite effect.
Leorning Cniht reports that his wife got the same effect from a small glass of wine.
Moo
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See you later, alligator.
Posts: 20365 | From: Alleghany Mountains of Virginia | Registered: May 2001
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lilBuddha
Shipmate
# 14333
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Posted
quote:
Originally posted by Moo:
quote:
Originally posted by lilBuddha:
If you read the link I supplied above, it is the barley not the alcohol. Indeed, according to one of the links I posted, the alcohol has an opposite effect.
Leorning Cniht reports that his wife got the same effect from a small glass of wine.
Moo
That statement, in itself, means nothing. Some people report beneficial effects from all sorts of things that are a placebo at best.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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mdijon
Shipmate
# 8520
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Posted
To be even-handed I don't think that link quotes much scientific data either.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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lilBuddha
Shipmate
# 14333
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Posted
I'll have to go back through the pages I found, but right now this is too wearying.
This reminds me of the crazy rationales that popped up during a Ship exchange on smoking. Anything to justify.
Sugar is not healthy in large amounts, but it is not a poison. Neither is salt. Neither is fat. Anything can be dangerous in too large an amount, even water.
They are not the equivalent of alcohol.
Perhaps I'll revisit the searching I've done. At this moment, I grow too tired.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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mdijon
Shipmate
# 8520
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Posted
Here is stuff on alcohol and mortality in adults showing the "J-shaped" effect with moderate alcohol intake appearing to be beneficial; study one and two.
I would say at that point it makes no sense to describe alcohol as a poison.
Here is a paper on alcohol use in pregnancy suggesting that the overall evidence is not supportive of a risk of low-moderate drinking on pregnancy outcomes, but acknowledging weaknesses in the evidence.
And here is a review on evidence on alcohol in breastfeeding concluding things like;
"Alcohol intake inhibits the milk ejection reflex, causing a temporary decrease in milk yield.... even in a theoretical case of binge drinking, the children would not be subjected to clinically relevant amounts of alcohol.... "
and
"Minute behavioural changes in infants exposed to alcohol-containing milk have been reported, but the literature is contradictory. Any long-term consequences for the children of alcohol-abusing mothers are yet unknown, but occasional drinking while breastfeeding has not been convincingly shown to adversely affect nursing infants. In conclusion, special recommendations aimed at lactating women are not warranted. Instead, lactating women should simply follow standard recommendations on alcohol consumption."
I could repeat the exercise for smoking, but I promise you we wouldn't get the same output. The fact that people might use similar arguments for smoking doesn't mean that the arguments are faulty. Simply that they are misplaced for smoking and better placed for alcohol.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Ricardus
Shipmate
# 8757
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Posted
The other reason for being cautious about giving advice on drinking while nursing is that parents already get far too much advice already.
Much of it is contradictory and falls on a spectrum of:
1.) Stuff that is supported by actual evidence, e.g. babies should sleep on their backs
2.) "Some studies have suggested"
3.) Plausible "it stands to reason" ideas developed by someone with a supply of envelopes to write on the back of.
4.) "My family has always done it this way"
5.) Utterly made-up bullshit
My guess is that a lot of parents aren't good at putting advice into categories, but are capable of recognising contradictory advice, and therefore conclude that experts don't know what they're talking about.
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Then the dog ran before, and coming as if he had brought the news, shewed his joy by his fawning and wagging his tail. -- Tobit 11:9 (Douai-Rheims)
Posts: 7247 | From: Liverpool, UK | Registered: Nov 2004
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by Ricardus:
...and therefore conclude that experts don't know what they're talking about.
That's my worry as well. There's only so much bandwidth for absorbing health advice, and I don't want smoking to end up in the same list as alcohol, prawns, peanuts and soft cheese.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Twilight
Puddleglum's sister
# 2832
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Posted
quote:
Originally posted by Ricardus:
The other reason for being cautious about giving advice on drinking while nursing is that parents already get far too much advice already.
Much of it is contradictory and falls on a spectrum of:
1.) Stuff that is supported by actual evidence, e.g. babies should sleep on their backs
2.) "Some studies have suggested"
3.) Plausible "it stands to reason" ideas developed by someone with a supply of envelopes to write on the back of.
4.) "My family has always done it this way"
5.) Utterly made-up bullshit
My guess is that a lot of parents aren't good at putting advice into categories, but are capable of recognising contradictory advice, and therefore conclude that experts don't know what they're talking about.
6.) things your mother-in-law tells your husband, such as my MIL telling him, "The baby cries too much because her milk is bad."
My baby and I barely slept for the first six months. It would go like this; baby wakes up screaming, I change him, feed him until he goes to sleep in my arms, carefully lay him on his back in his crib, still asleep, then turn him over on his stomach because in 1968 all the doctors and official Baby Books said that if he slept on his back and spit up, he would strangle to death. So I would turn him on his stomach and he would wake-up and scream. Repeat process.
I've had a lot of experience listening to experts who didn't know what they were talking about.
Posts: 6817 | Registered: May 2002
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mdijon
Shipmate
# 8520
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Posted
That sleeping on the front advice is exactly the sort of reason why recommendations should be made only based on evidence. It is very damaging to public confidence (and here to Twilight-confidence) to be advised to do something that turns out to be harmful.
Likewise imagine how all the parents feel who assiduously prevented their toddlers getting their hands on peanut butter for fear of allergies, only to hear later that they were increasing the risk of a peanut allergy.
The recommendations to sleep babies on their front or avoid peanuts were made on a precautionary basis. The experts would have said "Just in case". "There are reasons to believe even though the evidence isn't clear." "Babies are precious, we shouldn't take any risks".
So now we don't believe in experts anymore. The irony is that many of us are still using the same language to justify advising avoidance of all alcohol. "Just in case."
It seems like this precautionary fallacy is a human failing, not just an expert one.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by mdijon:
That sleeping on the front advice is exactly the sort of reason why recommendations should be made only based on evidence. It is very damaging to public confidence (and here to Twilight-confidence) to be advised to do something that turns out to be harmful.
I too, was caught in the middle of the front- to- back sleeping switcheroo. But I think you are failing to appreciate (both here and re alcohol) the way research is done/reported. And the illustration from front/back sleeping to alcohol use is entirely relevant.
At the time experts were recommending front sleeping there was good reason to do so. We were concerned about SIDs and looking for explanations. Since babies are known to be prone to spitting up, it was a reasonable thesis that choking on their own vomit was causing SIDs. It wasn't just made up, there was sound scientific reasoning behind it and even a small bit of data to support it (babies who did, in fact, die from choking on their own vomit). And, when lives are involved, it would be irresponsible not to avail parents of the best thinking/advice/research available at the time.
But the experts didn't rest there either. They continued to study the problem of SIDs and the effect of "front sleeping" recommendations. They discovered they were wrong. They instituted a comprehensive, science-based "back to sleep" program.
That's the way science works-- both times. It was good science when they were advocating front sleeping and good science when they were advocating back sleeping. It was responsible science to give parents the best advice possible based on the available data at that particular point in time, even though research is always going forward and that may change things. Because babies won't wait until all the research is in and we've got the final word on every issue. If that undermines public confidence in expert opinion that's because we're doing a crap job of teaching people about the scientific method and how it works.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by cliffdweller:
But I think you are failing to appreciate (both here and re alcohol) the way research is done/reported.
I have to say that I do quite a lot of medical research for a living, so whatever the issue with my explanation is that isn't it.
quote:
Originally posted by cliffdweller:
At the time experts were recommending front sleeping there was good reason to do so. We were concerned about SIDs and looking for explanations. Since babies are known to be prone to spitting up, it was a reasonable thesis that choking on their own vomit was causing SIDs. It wasn't just made up, there was sound scientific reasoning behind it and even a small bit of data to support it (babies who did, in fact, die from choking on their own vomit).
That's very tangential data. It would have been just as possible to come to the opposite conclusion from similarly weak data - for instance that babies would be more likely to have their nose pushed into the bedding and stop breathing. And one could find blocked secretions in the noses that might be related to cot death.
But biology is that it isn't like process engineering on a machine. The complex systems of human beings respond counter-intuitively. Tightly controlling the high blood sugar levels that are associated with diabetes doesn't always improve outcome. An antibody response to a virus sometimes makes the disease worse instead of clearing it.
quote:
Originally posted by cliffdweller:
They continued to study the problem of SIDs and the effect of "front sleeping" recommendations. They discovered they were wrong. They instituted a comprehensive, science-based "back to sleep" program.
Ironically if everyone had followed advice it wouldn't have been possible to do the study. The benefits of back to sleep were only possible to determine by making empiric observations on what actually happened when parents did either thing. That could have been done at any time, it didn't need the prior recommendation to come out first.
So my message is that recommendations should generally be made based on actual observations, not based on theoretical considerations. And certainly these days policy makers are much more likely to insist on randomised trials or, where that isn't possible, observations of outcomes in the real world rather than biological reasoning.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Leorning Cniht
Shipmate
# 17564
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Posted
quote:
Originally posted by cliffdweller:
And, when lives are involved, it would be irresponsible not to avail parents of the best thinking/advice/research available at the time.
But there's a considerable difference between "I don't have much good data, but based on what I do know, this would be my advice" and "the evidence is clear - don't do this."
And "expert" advice almost never distinguishes between the two. Which is an issue, because those cultural issues tend to weigh in to the first category in a big way.
There's a third category, too. The new UK limits on weekly alcohol consumption are set at the level that will cause less than a 1% increased risk of cancer in an average person. This is a small number. If we were to take it seriously, we would be going through every activity that people do, and telling them how much of it increases their cancer risk by 1%. (We do, in some cases. That's why the advice for eating processed meats is "don't". In terms of cancer risk, moderate bacon consumption is worse than moderate beer consumption.)
Posts: 5026 | From: USA | Registered: Feb 2013
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Brenda Clough
Shipmate
# 18061
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Posted
The 'what is best practice at the time' is the killer. The best thing to do for your baby alters often. I remember putting my children to sleep on their tummies; the trend now is on the back. And the whole peanut allergy issue is fearful.
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Science fiction and fantasy writer with a Patreon page
Posts: 6378 | From: Washington DC | Registered: Mar 2014
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mdijon
Shipmate
# 8520
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Posted
But it isn't just a trend. That's the danger of giving "what is best practice at the time" advice. If we don't really know we shouldn't say anything until we do. There will still sometimes be flips, but the point is that if we wait until we are 95% certain before saying something we will change the advice less often than if we say stuff when the evidence is 50:50.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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Jane R
Shipmate
# 331
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Posted
When I had my daughter they'd just decided that babies shouldn't be weaned until they were six months old, if it was possible to keep them on milk-only until then. So the imperfectly updated leaflet I got gave the impression that you should start weaning your baby on fruit and vegetable purees, then progress to meat, eggs etc. at six months - but because you weren't supposed to start feeding them solids until they were six months old it sounded like you had a window of a single day to introduce your baby to a range of different foods, one at a time...
I don't know how typical I was, but I ignored the (then-current) advice and started giving her pureed fruit and vegetables (and baby rice) as soon as Madam decided that milk was Not Good Enough - around the age of four and a half months, IIRC. And they seem to have gone back to the 'fruit and veg after four months, meat/fish/eggs etc after 6' advice.
Posts: 3958 | From: Jorvik | Registered: May 2001
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Pyx_e
Quixotic Tilter
# 57
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Posted
I find it hard to express my disappointment at the direction this thread has taken. While it is important to keep abreast of current medical thinking is it not time to get this thread back on track before I call for the Nurse.
Pyx_e
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It is better to be Kind than right.
Posts: 9778 | From: The Dark Tower | Registered: May 2001
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mdijon
Shipmate
# 8520
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Posted
I think I know what you want. I think nurse does too.
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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