Monday, 25 November 2013

How To Buy A Christmas Present That Will Really Be Appreciated

Today is the International Day for the Elimination of Violence Against Women. I've been following @countdeadwomen on twitter as they list all those who have been victims of domestic or misogynistic violence so far this year and, yeah, it is very depressing reading.

Here is something positive though. The charity Refuge help around 2800 women and children every day. On Christmas day they will have women in their shelters who arrived with only the clothes on their backs and their children in their arms. They won't be able to buy their kids any presents this year, but you can, in a few minutes, for a few quid.

To make it easy Refuge have set up a John Lewis gift list. Anyone who's been to as many middle class weddings as I have will be very familiar with those! It has a range of gifts for kids and for their Mums from as little as £6, you can just pick what you want to give.  Here's how:

Select Buy a Gift
Enter the gift list number: 564013
Browse the list, choose and purchase your gifts

I'm sitting here in my lovely warm house, contemplating Christmas food and still wondering what to buy for my kids this year. For Refuge I've bought a toy that was one of baby M's favourite birthday presents. She has boxes full of toys and whatever I get her for Christmas probably won't be as exciting as the paper it comes in. I'm ridiculously lucky. I can't pretend to be able to imagine what it's like to be a mother in a refuge at Christmas. But I do know the joy that that toy brings to a little child and that, even if nothing else I buy causes much excitement, this gift will be appreciated on Christmas morning.

With thanks to The S-B Blog for reminding me about this

Wednesday, 13 November 2013

That Story - Paying Women to Breastfeed, A scientific Perspective

I wasn't going to write about this as so very much has already been said about it in the media and on other blogs. But a couple of people have asked me what I think and I haven't seen much coverage of the science behind it all, so I'm going to bash out a quick post - forgive me if it's not a great read!

If you've missed it, (HOW???) A study is being launched to look at offering financial incentives to women to get them to breast feed.  The idea is that in some poor areas breastfeeding is taboo. No one does it, no one sees anyone else do it and it's thought of as a weird. So the study want to see if they can encourage women to breastfeed by offering them vouchers if they do.

Cue twitter storm and massive outrage in the media.

I agree with a lot of what has been said TBH. I find the hypothesis that poor people won't breastfeed because it's good for their baby, but can be bribed into it, deeply unpleasant. I think that breastfeeding is often incredibly, unimaginably difficult, and that the best way to increase it is to ensure there is adequate and consistent help available. I also worry that those on the trial who "fail" to breastfeed will then have the added guilt of not getting the vouchers for their family. But lots of people have written all that already. What I'm wondering about is the science behind it.

Firstly lets look at breastfeeding itself: There are definite benefits to it but they are often overstated. For example, it does reduce the mother's risk of breast cancer, but if you had two children you would have to feed them for far more than the recommended six months in order to get that benefit. Evidence for many of the benefits to the baby is often a bit weak too, a lot more research is needed to confirm it all. As breastfeeding is more common among more affluent and educated groups it's often hard to separate the effects of feeding from other social and economic influences. Ultimately, while not breastfeeding may be one cause of the shameful health gap between rich and poor in this country, there are bigger fish to fry. Stopping poor kids taking up smoking for example would have a much bigger effect.

Now the study. What I can't tell from the reports is how this will actually be conducted. There are issues about finding out if the women really are breast feeding and exactly how you define that. More importantly what controls will be in place? If they are enrolling women onto the scheme and then comparing breastfeeding rates to the norm for the area, how can we be sure that it is the vouchers making the difference? As I said above the biggest barrier to many women is the lack of good advice and support. If the women in the study are regularly seeing midwives or health visitors to prove that they are breast feeding then it's possible that they will be receiving more help and attention than most of their peers. If the voucher scheme were to be rolled out nationally we'd need to know if it was really the vouchers or that additional help, making the difference.

Finally, I have concerns over the person running this study. Dr Claire Relton is a Homeopath. Something she makes quite clear on her university page. Now, I really REALLY don't want to start a homeopathy debate here. It's been done a million times and we are not going to suddenly reach a consensus in one blog post. But whatever side you are on we can probably agree that homeopathy isn't accepted by conventional, mainstream science and medicine. A major reason for this is that there are few if any well designed trials that show homeopathy has an effect beyond placebo. There are plenty of trials with more questionable methods though. A large proportion of Dr Relton's previous publications are in the field of homeopthy and alternative medicine. Which leaves me feeling a little uneasy. If Dr Relton has mostly produced the kind of publications that are generally seen as poorly designed by most mainstream scientists, how can we be sure that this study will be well run? Surely something this important and this likely to be controversial needs to be whiter than white and run by someone a proven tack record of high quality study design? It's also worth noting that this is all being funded by the government, via the MRC.

I've not had a lot of time for this post so I've not been able to find and read the protocol for the trial, it could actually be perfectly good and I don't think that any of the concerns here or raised by others are a reason not to do it. It is possible that it could be beneficial so it's worth a look. But when we do get published results and no doubt a million more media stories about them, I for one will be looking very, very closely at them before I make my mind up.

PS Sorry for the lack of references in this post, I just don't have time to dig them all up - if you're really bothered contact me or, you know, google it.

Tuesday, 12 November 2013

Exercise In Pregnancy Boosts Babies Brains. Well, Possibly

According to an article on the Guardian website on Sunday:

"Pregnant mothers who exercise boost babies' brains. 
Weekly exercise by mothers linked to better mental performance in later life".  

If you suspect I'm about to lay into this article, you'd be right. Somebody please sound the using dodgy science to attack women, again, klaxon.

The claim is based on a study led by Elise Labonte-LeMoyne at the University of Montreal. The first thing to note is that she was presenting her findings at a scientific meeting. You could in theory say almost anything at one of these meetings. The evidence presented does not have to first be subjecting to the scrutiny of peer review as happens with published scientific papers. I'd therefore always advise caution before taking anything unpublished too seriously.

But lets have a look at what the study actually did. They told ten pregnant women to exercise three times a week and six pregnant women not to exercise. Eight to 12 days after their babies were born, scientists tested for a specific form of activity in the sleeping infants brains. This apparently indicates how mature the brain was.

Ten women in the test group six in the control. These are TINY numbers. Far too small to give statistically meaningful results given the huge number of potential variables. As there is no published paper and I don't happen to have been at the meeting, I don't know  how or if these were controlled for. We don't know, for example, if all these babies were born at full term. With the numbers so low a single premature child in the control group could sway the results of the entire study. 

How sedentary were the control group?  I did little formal exercise in my second pregnancy but I was chasing after a very active three year old most days. I suspect that added up to far more than the hour a week of exercise for the test group in this study. Is it even ethical to insist that a group of pregnant women do no exercise? Quite apart from the practicalities of it, it seems to be common sense that a bit of exercise in pregnancy is a good idea.  Giving birth and then caring for a small baby is likely to be by far the most physically demanding thing that most women will ever do, it makes sense to do a bit of training if you can.

Does brain function at a few days old really equate to "mental performance" in later life? To me this seems like a pretty big leap. Ok so a kid has a slightly less mature brain at eight days old, it's surely not that unlikely that they could catch up a bit over the next 18 years?

I also wonder about the design of the study. Generally speaking randomised controlled trials like this one (the participants were randomly assigned to exercise or non exercise groups) are seen as the gold standard. However, for this to really work you would need a very large number of women who were all very similar (how healthy are they? How active before pregnancy? Were the babies breastfed? Did they have time in NICU? etc.etc.)  They also have to be willing to take part and I for one wouldn't sign up for something if it meant I had to be sedentary for months. 

It's not the study itself that I'm really annoyed with though. What I'm wondering is - Why on earth is this a story from a major national news outlet? Ok we might expect it from the Daily Mail, but the Guardian is usually a bit better about science reporting.

This is a scientist talking about a very small and preliminary study. It may be academically interesting to others in her field and it may form the basis of further, larger studies which would be worth reporting. But at the moment it tells the rest of us absolutely nothing. It really is a non story. Except that it is a story about women's bodies and what they choose to do with them and that, it seems, is always news.


Monday, 11 November 2013

Let's End The Packet Racket

There are a lot of uncertainties in medical science (see my recent post here for just one example), a lot of areas where we just don't have enough research to know if something is harmful. But smoking isn't one of those areas. To be blunt, cigarettes are expensive, addictive and they kill. I hope my daughters will never take up smoking and I think most parents feel the same, even those who smoke themselves. Yet every year in the UK 207,000 children start smoking. Yes, 207 THOUSAND.

Thankfully my children won't be exposed to tobacco adverts on TV and at sports events, they won't see people smoking on trains or in cafes like I did as a child. But there are still a few ways that cigarette companies can entice new users and the major one is packaging.

The current use of design and branding has been shown to be attractive to children*, even very young ones. Cancer research UK are campaigning to to get all cigarettes sold in plain, standardised packaging. This recently became law in Australia and early studies suggest it's having an effect. But it's a global problem, as shown in this new film released today by Cancer Research UK:

The new packets would, basically, be boring. They would be a standard size, shape and colour with no branding or logos. There would simply be the health warnings, the duty stamp and the brand name in a basic font.

Sadly the government isn't pushing this idea forwards as they had initially said they would. So Cancer Research UK are trying to keep the pressure up on them to do something about this. If, like me you don't want your kids to think that cigarettes look "cute, classy and feminine"** then have a look at their website here, share this blog post and tweet: end the #packetracket .

Companies go to a lot of effort to make their packaging look attractive. Let's make this simple: if the packs are boring, there is one less reason for kids to reach for that first smoke.

* Full version of this report here
**From: Adolescent perceptions of cigarette appearance. European Journal of Public Health. Ford et al: (to be published this Autumn).

Disclaimer- I am an employee of Cancer Research UK, however I have nothing to do with this campaign and have received no money or any other incentive to write this post. I saw a request for bloggers to get involved  and decided it was something I wanted to help with because I don't want my or anyone else's children taking up smoking.

Friday, 8 November 2013

Canada Water Culture Space

It's all been a little bit serious on the blog of late - so here is something more fun. A lot more fun actually.

I have a soft spot for Canada Water. It's where F and I first shared a flat. A studio so tiny that I had to put most of my belongings into storage (including, accidentally, some fairly crucial clothing - oops). A lot has changed in the area since then. I knew there was a big shiny new library but I hadn't realised that it contained it's own little theatre, until I was invited to come and take a look.

Canada Water Culture Space is a 150 seat venue, but for kids shows it can also become small and informal. When E and I arrived to see "Yumm!" there were just two rows of seats for grown ups (which was plenty) and the kids were all encouraged to sit/ wriggle about on mats next to the performance area. The show itself was a sort of contemporary dance piece about food and flavours. I was a little worried that it would be overly preachy on healthy eating but they got the balance about right. We went in to find one of the dancers holding a cabbage aloft, while another hid under a giant chair with a small pink cupcake. The kids were encouraged to smell and touch the food and joined in with great delight when a super long string of "spaghetti" was produced and used to entangle the entire stage.

As a venue for children's theatre it worked very well and not just because of the mats and pasta set up. Firstly it was very easy for us to get there. The library is right over Canada Water station which is on the Jubilee line and the London Overground. It also has lifts to all levels so buggies are no problem. If like us you (somehow!) accidentally  arrive early, then there is the library to explore. E initially insisted that we read books in the little wooden sailing boat but I persuaded her that the sofas looked more comfortable. My only complaint about the children's area was the TV showing Cbeebies. The sound was off but I kept catching E's eyes drifting up to it when I was reading to her. The library also has toilets, including some in rooms big enough to take a parent, a buggy and several kids all at the same time (handy). Next to the theatre entrance there is a cafe which looked nice but we didn't actually try it out - despite E's many requests!

All in all a really nice and very easy afternoon out with a four year old.

You can find the programme of future events at the Canada Water Culture Space here, there are quite a few kids things and some for the grown ups too.

Disclaimer - Photos were provided by Canada Water Culture Space. I was given free tickets for E and myself to this show

Thursday, 7 November 2013

WDDTY - Depression, Drugs and Autism: Blame Mum

The latest edition of "health" magazine "What Doctors Don't Tell You" claims that if a mother takes antidepressants during pregnancy, she triples the chances of her baby developing autism. Except that's not quite what the study it references actually said....

Firstly - I have to thank the lovely writer of Nurture My Baby who posted about the WDDTY piece on twitter and brought my attention to it. She is also working on a blog post about it and I'll update this post and link to it when she gets that up. She also makes lovely crochet things, I have no idea how to do that!

For those of you lucky enough not to know what WDDTY is, it's a magazine, widely available in supermarkets etc. which claims to reveal the truths that doctors are hiding from us. That cancer can be cured with massive doses of vitamin C, that vaccinations give kids autism, and that all manor of "natural" remedies can cure pretty much everything. That sort of stuff. Of course they throw in lots of helpful adverts for these remedies to help us all out as well. So that's nice of them.

This month they carry a small piece based on a study published in the BMJ.  Here's a few quotes from that piece:

"Women who take certain prescription drugs while pregnant are increasing the chances of Autism in their child"

"Antidepressants ... have been associated with the learning and behavioural problem" *

"Women who suffer from depression during pregnancy should seek out non-drug therapies, say researchers from the university of Bristol"

The message from WDDTY is carefully worded but here's how I reckon it would sound to a pregnant woman with depression, a women who already feels that she is utterly useless and inadequate:

If you take those pills from your doctor, you will damage your baby. You selfish cow.

This though, isn't at all what the paper actually says. It doesn't show a tripling of the chances of autism. It's a bit less than double and it's doubling a very small chance to make another very small chance. The researchers found no increase in the types of autism that include intellectual impairment (to my mind that doesn't fit with the claims about learning problems). In fact you can't actually tell from this study if it is the drugs that cause the few extra cases or autism or if it is the depression itself.

Depression is a horrible, horrible disease, but it comes and goes. We know from the study that autism is more likely in children whose mothers have been diagnosed with depression, but only if they were on antidepressants during pregnancy. What we don't know is who was actually suffering symptoms of depression during pregnancy. Perhaps those who weren't on medication were well at the time and those taking the drugs were suffering from current and severe depression? Perhaps this depression is what caused the autism and the use of medication merely indicates the severity of the mothers condition?

This isn't me nit picking the data to suit my needs, the authors of the paper say the same thing, repeatedly:

Importantly, it is not possible to conclude whether the association between antidepressant use and autism spectrum disorder reflects severe depression during pregnancy or is a direct effect of the drug

There are a lot of things we just can't tell from this study and the authors make this quite clear. They don't call for an immediate end to antidepressant use in pregnancy, they call for more research, more information and a cautious approach in the mean time. That's science. If the drugs are causing autism then they would still only account for 0.6% of cases and the rates of autism have rocketed in recent years. We still don't know if this is due to increased awareness and willingness (perhaps over willingness) of doctors to diagnose the condition. It could well be that there is something causing a genuine increase, although it's clear from this that if that thing exists it's not just antidepressants in pregnancy.

Of course the small effect shown in this paper could be down to the drugs, so it's not unreasonable to suggest caution when prescribing antidepressants in pregnancy. The paper's authors suggest that psychological therapies may be a better alternative, but they also acknowledge that, sadly, it just wouldn't be possible for most women to access these quickly enough. Over all, even if the drugs were definitely responsible,  the risks of coming off medication may be far greater than of taking it. What doctors would tell you (hopefully) is that you need to weigh up these risks together, and for your own personal circumstances.

 But of course this isn't what WDDTY is all about. They don't seem to see anything wrong in telling unwell, vulnerable women that if they are not actively out there, ignoring their doctor, hunting for alternatives themselves and throwing away the only thing that may be helping them, then they are permanently harming their precious unborn child. I mean, it's not like these women are already feeling a bit bad or anything is it? Depressed people could probably do with a bit more guilt - right?

If this is the first time you've come across this magazine - this piece is only one small section of it. Most of the rest of the issue is devoted to cancer, and the little I could bear to look at isn't any better. Just think on that for a moment.

PS. I've linked to the paper but not to WDDTY as I don't want them to get the traffic, but if you see one in a shop have a look, then put it back, preferably in the wrong place and backwards.

* the piece also makes these claims about Epilim, an epilepsy drug which has numerous risks in pregnancy. What What Doctors Don't Tell You doesn't tell you is that these risks are well known and acknowledged. Official advice doesn't just caution the use of Epilim in pregnant women, that is pretty common, it goes further and states that doctors should ensure any woman of childbearing age who is on the drug must take serious precautions to avoid pregnancy.

Tuesday, 5 November 2013

Can you be a 'mummy-blogger', and still be a feminist?

Did I mention that I'm going to Blogfest? Yes? Well one of the sessions that caught my eye on the programme is titled : Can you be a 'mummy-blogger', and still be a feminist?

I hadn't given much thought to feminism until fairly recently. As a child of the 80s I remember hearing something about womens' struggle for equality, but it seemed like it had all already happened. Bras had been burnt, horses had been jumped under and the three most important people in the world (Margret Thatcher, the Queen and Madonna) were all women. Job done.

As young women my friends and I encountered all the usual stuff, the guys in nightclubs who were "just being friendly".There was an unspoken protocol for dealing with them: pull the "help" face, rearrange the dancing circle. Move closer together and dance with elbows out behind you to keep those unwanted bodies from your backs. It was annoying and sometimes rather intimidating, when they just wouldn't go away, but it never occurred to most of us to be outraged. It was just something we all expected and put up with (being almost 6 foot tall didn't help much either. Daring your short mate to try and pull the tall bird seems to be something of a national sport). 

At work It was sometimes difficult to command respect, because I was young and female. I would dress older than I was and be sure to use my height to its full effect. But this never really held me back. It was only when I became a mother that I began to realise how far we still are, from where I thought we already were in the 80's.

I was very lucky, my employer readily agreed that I could take a years maternity leave and then return part time. I assumed it would be like this for most of my friends. We were all educated and in professional jobs. But as more of them began to have babies, very different stories started to emerge.  The women who were squeezed out their jobs, even out of businesses they had set up. The single mums whose employers refused to let them go part time, in the full knowledge that they'd be forced to quit. The senior employees expected to make the tea and take the minutes for men who had half their experience.

Then there is the constant media judgement, the lazy stay at home Mums, drinking lattes and sponging off their husbands or the state. The heartless working mothers, callously dumping their sprogs in nursery so they can pursue their careers while expecting the taxpayer to chip in for the costs. 

Being a Mummy can certainly make you think about feminism - but can you be a feminist and a mummy blogger?

Mummy blogging is, unsurprisingly, mostly women writing about raising children. It often includes cooking, crafts, fashion and beauty. Basically, the little, everyday domestic worlds that some women have fought for decades to escape. You could argue that advertising a life of kids and cupcakes is totally letting down the sisterhood.

I disagree though. For me, now I've thought about it,  feminism is about equality of choice. Its about being able to take up crochet or car mechanics, whatever your gender. Its about the contents of your pants being irrelevant to weather you want to be the prime earner or the prime carer in your household or if you choose to share both those roles. We don't make women equal to men by stopping the girls doing anything girly. We are equal when we can choose to blog about baking, fashion or nuclear physics and we're judged on the quality of our writing, not the gender of the writer.

That's the world that I want for my daughters. One where they can stay home and bake with their kids or run a multimillion dollar industry. Where they don't have to dress up as someone else to be taken seriously and where they can go out with their friends and have a proper good dance.

It'll be interesting to see what the debate at Blogfest brings up, the speakers know a whole lot more about this than me and I'm aware that there is an enormous amount of feminist philosophy and politics that I am completely ignorant of. Perhaps I'll even completely change my mind - isn't that a woman's scientist's prerogative?


PS - What do you think? Is all this twittering on about babies and bunting setting back the female cause?