I was sitting in my Applied Nonparametric Statistical Methods lecture and in the middle of a discussion about the Small Sample Wilcoxon Signed Rank Rest for Paired Differences, it occurred to me that all the things I decided to blog about on this blog are intertwined. And maybe I should explore that a bit more.

That happened at nearly the same point the professor mentioned the Greek term Psi, used to define the +/- sign of the indicator variables, which led to this dude dancing in my head for the rest of the lecture.

Autism, breastfeeding, attachment parenting, nutrition, health education, technology, health equity - all intertwined. The tag line used for Black Breastfeeding Week has been on my mind quite a bit, because the idea to "Life Every Baby" is part and parcel of what drives me to be a breastfeeding advocate and ties together the disparate other interests that have permanent orbits in the galaxy of my mindscape.

Although there are some (many?) that might disagree, I believe that access to health is a fundamental human right. Physical health, psychological health, emotional health. This is not just an individual thing - the health of the entire interdependent system of humanity (or even the system comprised of the entire planet) depends on the support of this access. If every human is a cell in the giant organism of humanity, when one cell dies, the body can compensate. When an entire sector of cells fails, you get necrosis, sepsis - the entire body will become sick and feel the effects.

To operate under the assumption that we are all separate and that those issues and traumas that affect one part of humanity have no rebound effect (or direct effect!) on the rest of us is simplistic, born out of the avoidance that is often the unavoidable consequence of living with cognitive dissonance.

So autism is part of my lived experience, but I associate this with every difference in ability or capacity. Your number of spoons, your particular neurological/sensory thresholds,  your physical capacity to do what you have to do to earn a living and navigate through this complex social and structural system - that is a consideration for the autistic individual, or anyone who is not within the narrowly defined range of what is socially conceptualized as "normal/typical".

 What's breastfeeding got to do with it?

 There is a massive body of evidence that shows the health outcomes for both mothers and babies with exclusive breastfeeding. The optimal duration of exclusive breastfeeding is 6 months. As my toddler says, "every baby deserves bobos." Bobos are his invented term for lactating breasts and has become part of the family lingo.

The association with health outcomes is what makes breastfeeding a public health concern, even more than it is a lifestyle choice. I strongly feel that if we have the scaffolding in place that helps families achieve the optimal duration of exclusive breastfeeding (and beyond!), we would see an echoing of benefit not just in physiological and chronic health outcomes, but in psychological and emotional outcomes. As we often say in mother to mother support - breastfeeding is so much more than nutrition. And yes, it is totally possible to love and mother your child without this behavior, but the neuroendocrine system is simply not responding in the same way and no amount of tweaks to artificial baby milk can mimic the complex dance that happens in the physiological interaction between mother and child in the breastfeeding relationship. This is not to induce guilt. This paragraph is a reflection of my own deep convictions.

Breastfeeding is also involved in an inevitable feedback loop with attachment parenting (AP). I believe that AP is also a public health imperative. Front-loading the effort - taking on the psychological burdens that you as the adult have the capacity to cope with to a much higher degree than an as-yet-neurologically undeveloped infant is part of that. Accepting that sleeping through the night is not really a realistic expectation, that babies cannot be spoiled, that neurological development requires human touch in frequent intervals and for long duration...all of this is part of creating a foundation from which resilience can spring.

We cannot shelter or prepare our children for all the "slings and arrows of outrageous fortune," but we can give them the foundation of resilience that allows them to bounce back and know that no matter what happens, everything will eventually be OK. We can help to build that foundation from which they have the ownership of their ability to process trauma.

Nutrition, health education - food is everywhere. Whether we have access to it, or know what to do with it, or waste it, or use it as a drug. Knowledge is power. You can have all the resources in the world at your fingertips, but if you don't know how to effectively harness those resources, you have the practical equivalence of nothing. Nutrition education must happen at both the structural, policy level at at the grassroots among the people who are doing the eating. Policy makers at the mercy of nutrition education from lobbyists are not able to effectively levy their political power to make changes that can positively effect the electorate.

Finally, health equity. Racism. The structures within which we all live and operate have effects on each individual in different ways, and acknowledging these differences is not racist - it is real. In fact, being "colorblind" is profoundly disrespectful. Can't you see that you erase all those who have come before me when you ignore my cultural context and the history of my ancestors?

 Dr. Camara Jones used the metaphor of a garden to tell the story of how structural racism is married to health outcomes, both in the sense of the effect of our shared history and in the immediacy of the landscape today.

Applying the holistic approach to public health is not a new concept. It's been applied in previous models.

All that during the 2 hour lecture AND I managed to take notes and get a working knowledge of the Wilcoxon Signed Rank Test. Multitasking is definitely a mastery that came to me through motherhood.


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