7 August, 2014, Melbourne, Australia
Edited half-hour speech given at the Victorian Association of Maternal & Child Health special general meeting, to an audience of mainly midwives and maternal-child nurses.
I often wonder just what you maternal and child health nurses think of the rest of us. At any given time the clients you see are dribbling wrecks who can’t string a sentence together, have either vomit or banana in their hair and are likely to burst into tears or hold the baby upside down and ask if it needs watering once a week.
I must say I have always thought the practice for measuring the length of babies and their weight was of limited value. Can you not, instead, rig up some sort of machine that will measure how much sleep a person can miss out on before they lose their tiny minds? How about a machine that calculates the likelihood of eternal damnation if you don’t give a small child a bath every day?
I also wonder what it’s like for you to always see people who are tired and worried and confused, and pretending they haven’t got their pajamas on underneath their overcoat. I imagine that being a maternal child health nurse is a bit like seeing the world as a crowd of desperate, confused, blank shufflers. It’s like being in a zombie movie but without the chance to have sex with Brad Pitt.
Although we forget you’re there until we want you, we need you to be good at what you do. You’re like the girl in the rhyme: when she was good she was very, very good and when she was bad she was horrid – or at least a bit of a worry. I remember a maternal health nurse who was so cold and impersonal she chilled the inside of my bones. I remember one who tried to tell me that diphtheria and tetanus were the same thing and that’s why they were in the same injection.
But mostly I remember midwives and health nurses and nurses in general, who, when I needed them, were awesome in their service and professionalism. Who combined their medical and scientific knowledge and their experience and efficiency under pressure with their compassion and their caring and made me long to hug them and wish upon them biscuits with their tea forever.
I’ve been working in the State Library of Victoria on a creative project, and I thought it might be fun to look at some of the history of Midwives and child nurses. You mob got a very bad name from the 1800s when Charles Dickens created a drunken, terrible midwife for his book, Martin Chuzzlewitt – a character called Mrs Gamp. Mrs Gamp was an undertaker’s laying-out assistant, I think, but also a “monthly nurse” for women who could afford it – in other words a mother and child live–in nurse for at least 10 days to a month after a birth.
As we know, midwives and maternal child health nurses are not usually drunks who do double shifts in funeral parlours. No, having watched the TV show ‘Offspring’ I imagine instead that most baby-related professionals spend their lives in a sort of pantomime fantasy world in which they are constantly having sex with hot men and/or women and going to the pub but never getting pissed.
It’s amazing what you find about childhood in the past when you start rummaging. I was just talking with a woman about her vaudeville act during World War 2, when she casually mentioned she got tired during the dancing because she’d had a “mild” case of polio as a child, which made breathing and exercise difficult for the rest of her life.
And when researching something else entirely, I noticed a teensy brief paragraph on a huge broadsheet page of one of the Melbourne newspapers about the “latest” measles outbreak – because it was so common it didn’t even rate a front-page snippet. Every 4 to 5 years in the late 1800s, a measles epidemic would sweep through Melbourne. In the first half of 1898 between 400 and 500 people died just in this city alone, most of them children and babies. And now maternal and child health nurses are often the ones left to explain how important immunisation is to people who’ve found all sorts of conflicting advice online.
I’ve felt strongly about this for a long time, and had just finished fact checking a little e-book I put together about immunisation for parents. Imagining what it was like in Melbourne as hundreds of babies and kids died each year has really made it more personal for me.
I knew that German measles used to be one of the major causes of babies being born deaf and blind. And whether women and babies even survived childbirth was often more of a lottery than anything else. But I didn’t know that so many deaths went unreported because German measles went by several different names and recordings on death certificates back then – black measles, rubella, rubiola and rotheln.
So I just wanted to say thank you, because you’re at the frontline of protecting babies and their sisters and brothers from these diseases, and having to deal with poor parents who are told all sorts of terrifying fibs or out-dated information by the anti-vaccination websites.
Incidentally there was another researcher at the State Library while I was there, the lovely Madonna Grehan who’s researching 19th century widwifery and medical practice among nurses of the time, from childbirth to teething and the terrible twos, and she’s looking at the tension between nurses and doctors.
In the middle of the 1700s the doctors, formerly barbers, had worked out there was more money in medicine that in giving people a short-back-and-sides and a jaunty goatee. Surgeons got hold of controlling the childbirth business and most women had to become “attendants”, only allowed in after the birth.
The surgeons of course were right on top of things and kicked off by refusing to wash their hands between patients, and almost all of them initially opposed the idea of pain relief during childbirth because the Bible said that women had to pay for the sins of Eve by suffering. Which is a bit rich since some of these doctors were mad rooters who spent a lot of time wishing they’d discovered a cure for syphilis, for purely personal reasons. But it wasn’t until Queen Victoria insisted on chloroform for her granddaughters in childbirth, overruling the royal doctors across Europe, that the policy changed. Chloroform became fashionable, and of course brought its own problems.
Finally, just after 1900, the English and Australian governments had grudgingly accepted that women might have some sort of interest or expertise in the baby birthing department, and be allowed to be involved in the business of birth, what a simply radical idea, next the damned strumpets would be wanting the vote.
And of course there have been the fads in how to “rear” babies, I always think the word “rear” in this context is so bizarre, it seems to belong more to a hobby, like breeding tadpoles or other small amphibious creatures.
It turns out that an argument been going on for centuries between “natural” parenting and “scientific” methods. Is it such a bizarre idea that we might be able to choose the best ideas from both and ignore the bonkers bits? Let’s have a compassionate, involved, supportive birth process with love and cuddles, but just leave those antibiotics and an anaesthetist in the corner just in case, thank you.
One thing I do recommend to maternal child health nurses if they really want to get as drunk as Sarah Gamp is to play a very ill-advised game called Bonkers Baby Advice Bingo. You have to have a drink every time certain things happen. Now, as I go through this list I want you to know that when I yell “Drink!!” it is purely for comedy purposes. You are not to drink from a flask of banana-flavoured schnapps every time I say it.
Okay, here’s how it works.
Yell ‘Bingo!’ and have a drink every time the official guidelines say babies must not eat solid food until they are six months old or their head will explode.
Yell Bingo and have a drink every time the official recommendation changes to suggest instead that babies must start on solid foods aged three months or they will become allergic to eggs, nuts, cars, and people with purple hats on.
Yell ‘Bingo!’ and drink every time somebody uses the term ‘Baby Whisperer’. As well as yelling bingo you may also shriek wildly.
Yell ‘Bingo!’ and drink every time a parent suggests their child is “gifted” has a special talent by the time they are four months old. Listen, I don’t like to boast, but I really can’t help telling you that my daughter was a very gifted dribbler. Oh, she could dribble at will, upside down or right side up. She was on the Hundred and fortieth percentile for dribbling. We went through bibs like nobody’s business. Anyway, you hear the word “gifted” before 6 months old, Bingo – Drink!
Yell ‘Bingo!’ and drink every time a story in the newspaper based on about 11 people in Finland is a “study that proves” child care is so dangerous it causes murderous neglect of children.
Yell ‘Bingo!’ and drink every time a survey of 5.5 people in Botswana is a“study that proves” childcare should be compulsory for all children or they will never learn to socialise.
Yell Bingo every time you realise that a set of rules for bringing up babies was written by a man decades ago who never even saw his own children except every third Sunday for a small consultation and wouldn’t know a nappy from a nap. From John Locke in the 17th century to Dr Spock to some of the latest people to give advice about babies and little kids. Especially the ones who not only left all the hard work to their wives but made them type up their bloody books. Drink!
In the 1920s a John Broadus Watson wrote a bestseller explaining that babies were machines that needed programming and their mothers were too indulgent. Technically, Mr Watson was not a doctor, nor a principal caregiver, but what is known as a total tool. Dr Spock told everyone that being a mother was natural and instinctual, which was of approximately zero help to mothers who had no experience and were worried about whether they were doing the right thing. In fact, yell ‘Bingo!’ every time somebody says mothers should know what to do naturally, because of lady-instinct magic. Drink!
When people say to me that mothers and fathers should just look to the animal world, and shouldn’t need advice because animals know how to raise their children without help, awww, those people, I want to just ruffle up their hair and push them in a pond. Full of crocodiles. Who apparently we are supposed to look at as mothering role models.
Far be it for me to point out that female lions, for example, when not being fiercely protective, have been known to EAT their own cubs, which I do not recommend. Squid will leave their children even before they are hatched, leaving their babies to come into the world saying “Where is everybody? I suppose I had better just get on with it!” and swim away none the wiser about anything, even the tide times.
I don’t know about you, but I’m fairly loathe to take advice on how to care for children from anybody with more than 7 tentacles. Nobody expects a pilot to fly a plane the first time without instruction. No politician’s staff is complete without a brace of “advisors”. Frank Sinatra may have sung “I did it my way” but he did it with a musical score, lyrics written by somebody else and a dirty great trained orchestra with a conductor.
Right, back to the game. ‘Yell Bingo!’ every time somebody tells you that she was advised to use “natural” contraception ie the rhythm method, or breastfeeding, and then within microseconds she was immediately up the duff again. Drink!!
Yell ‘Bingo’ and drink every time some poor mum has been told by a relative she should ignore a baby crying every single time.
Yell ‘Bingo’ and drink every time a poor Mum has been told by her friend from Byron Bay called Cloudsong she should never put the baby down or give it to anyone else and should take her time to play the recorder around a campfire while eating a placenta and cheese sandwich.
Sometimes I think becoming a mother is a bit like being given a lucky dip show-bag – you get a baby, some paw-paw ointment, a packet of wet wipes … and the judgement and unsolicited opinions of the world.
So yell ‘Bingo’ every time people complain that a mother is too old, and ‘drink!’ every time she’s said to be too young. Drink when someone condemns a woman for having no children, obviously caused only by modern selfishness, and bingo to condemning that other frightful greedy woman for having IVF and bingo for the tut-tutting at an out-of-control woman with more than 4 kids.
No wonder Charles Dickens' maternal and baby nurse Sarah Gamp was drunk all the time, if she played this game of Bonkers Baby Advice Bingo.
Don’t forget to yell ‘Bingo!’ every time somebody comes into your office and cuts up their credit card because of the money they’ve spent on baby massage classes, baby yoga, Baby Einstein flashcards, meditation-for-tots podcasts, and instructional videos on how to teach Italian to a 36-week-old fetus and writing a creative journal at the same time as downloading 10 apps with a baby heartbeat monitor and contractions counter and which set off an alarm if your four-month-old baby does not reach developmental milestones by 3 pm every Friday.
Bingo every time somebody explain why ‘Toddlers and Tiaras’ is an inspirational documentary or proof that we are all better mothers than they are.
Big Fat Bingo every time somebody shows you a gossip magazine with a story on the front about “Losing the Baby Weight”. If you see a client with one of these magazines, roll the magazine up and strike her with it on the nose, until she agrees not to read such utter poop any more. Cheers!
Yell ‘Bingo!’ any time somebody passes on advice from elderly relatives that could include but is not restricted to “… put honey on the dummy, you don’t need a car seat because a cushion will do, a good shot of espresso in the morning is good for a preschooler, teething doesn’t exist, get them to chew on a biscuit soaked in honey, put honey in their milk before bed, when they have a bath add some honey to the water, put a poultice of honey on a bruise, make a cot out of honey”. DRINK!
Bingo every time somebody says “the old ways were best”. I took the liberty of looking up some of the best practice advice that used to be given in the old days. The Handbook for Wives and Mothers of the Working Classes, at the State Library of Victoria. On microfiche you can read this advice, given by the Christian Women’s Association and imported to Australia straight from Glasgow in 1873.
The best time to wean a baby is at 9 months, when you can start introducing food, or otherwise when four or five teeth have appeared. At a year old the child can have a potato and gravy for dinner (lunch). Or pudding.
Introduce meat, such as mutton, at eighteen months old, with bread or potato. And salt. Alternate puddings with animal food. Puddings are made from flour, water, suet and salt and BOILED FOR A LONG TIME. Dry or buttered bread with milk is a good meal. You can feed them broccoli, cauliflower, French beans and asparagus and turnips as long as these are BOILED thoroughly.
“Sugar is frequently withheld from children on the grounds that it is unwholesome and spoils the teeth: both of these impressions are incorrect. Salt should never be restrained.”
“Do not allow children to eat hot buttered toast. Cakes produce fever and sickness.”
“The hour of breakfast should be 8 o’clock, half an hour to an hour after rising. Dinner should be ready by twelve, an afternoon meal between four and five o’clock and a light supper at seven.”
“Children should not be allowed anything between meals; it is a bad habit and very injurious to the health …If the intervals must be protracted, a little bread and butter and treacle, and a draught of water may be given till the child is 5 or 6 and after that a piece of bread will be sufficient to prevent exhaustion, which is all that is required.” (This is tremendous advice. Just feed them only enough to stop them from actual fainting.)
“Drinks should be room temperature. Too hot and they will enfeeble the stomach, too cold and the system will receive a terrible shock. The Christian women recommend against wine, spirits and beer for toddlers.”
It is worth noting at this point that common sense of the day dictated that babies be given gin to sleep and cocaine for toothache and be wrapped in wet bandages if they developed neurological symptoms. When I was born in 1962 my mother was instructed to wash me every day in an alcohol-based antibacterial lotion.
“There should be an hour between a child eating any food, and drinking any fluids.”
“Children should not wear hats as it can cause affectations of the head … Children should wear flannel underclothes as an impetus to languid circulation. Dressing girls in corsets will cause them to develop an unsightly red nose.”
And what tremendous advice they had about sleep. “Until they are two, children are required to sleep the whole of the night. And also several hours in the morning and again in the afternoon.”
Get onto that, would you?
Until the child is 4 or 5, “The full half of its existence should be allotted to sleep”.
“The best mattress for a baby should be stuffed with hair or chaff. With a pillow bolster and blankets. The bed should be midway between ceiling and floor for the best air.”
“In the morning immediately after rising, and whenever children leave a room the windows should be thrown open to let in as much air as possible, even if it is raining or snowing. If the weather is very unfavourable you can shut the windows at 3 pm.
“If you know of a health-giving and beautiful spot you should occasionally take your children thither.” Because obviously the only reason the working class of industrial England didn’t take their children on holiday to the south of France was they couldn’t be bothered. So that was 1863 for you.
How about Advice to Australian Mothers: A Guide to the Care and Management of Children by Mrs Everett Ellis in 1902, you ask. You’ll notice we have no idea what her name was, just her hubby’s.
“Pregnant women should sleep with their windows wide open. She should leave off her corsets entirely … after the sixth month. She should take an hour’s rest on a sofa out of doors each day.” Who doesn’t have a lounge suite under the Hills Hoist?
The fashionable child was dressed in ready made grey “health flannel” outfits, or dressed in woolen clothes from the Jaeger company brand, which were said to be miraculous and allow air to massage the skin.
Mrs Everett Ellis told us that nothing but pure wool should ever touch a baby’s skin. Babies should not be wound in bandages unless the fabric strips are at least five or six inches wide. All nappies should be BOILED. Everything had to be boiled for ages – meat, vegetables, baby clothes, I’m surprised you weren’t told to boil your husband. Here’s the shortest list of baby clothes Mrs Everrett judges you can get away with: 4 knitted vests, 3 knitted belts to prevent gastro. 4 knitted or flannel petticoats, 4 muslin petticoats 8 pinafores, 8 bibs, 3 pairs woolen booties, 6 pairs knitted or flannel drawers 3 dozen squares. 1 high-day pelisse (like a pinafore) and bonnet, 1 everyday pelisse and bonnet and 4 flannel nightgowns.
All the lists of baby equipment we see today - they don’t exist 100 years ago. The only items mentioned are bottles and ‘Perambulators’. Mrs Everett says to get a pram the baby can lie down in until they can sit up, then get the other children to wheel them around in a go-cart. “In all except windy, wet, or very hot weather“a child should after the first month be accustomed to sleeping in the day time, OUT OF DOORS.”
If medical help has not arrived for the birth, and the baby is on its way, Mrs Ellis advises you to take to your bed. Straw mattress is best. Have some Condy’s Fluid and Jeye’s Disinfectant on hand. Some bandages and a pound of cotton wool. Make yourself comfortable for the coming ordeal. Then there are two brief paragraphs on how to deliver the baby, tie off the cord and wait for the doctor. Right. That was easy.
If you were still alive, you could have a look at the rest of Mrs Everrett’s book which is devoted to telling you that you must breastfeed, and how in order for the milk to come in, you must be absolutely quiet. Presumably a loud noise will frighten your bosoms.
The mother should eat two meals a day of porridge with brown – not white – sugar, also warm cocoa. No alcohol for the mother, but Mother can have two glasses of milk a day, mutton, lamb, beef or poultry, fish, green vegetables and fresh ripe fruit. She should have brains, oysters and sweetbreads ie the thymus gland and pancreas. Get a wet nurse if you need to, and inspect the wet nurse’s own children – for signs of wear and tear, presumably.
Wean at nine months or when the baby has cut his first 12 teeth. Most Australian women cannot do more than 7 months. Do not wean in summer. To assist weaning, rub bitter aloes into the nipples.
Baby should be fed one parts BOILED cow milk to three parts barley water. Variations ensue until the baby is 11 months old and then it should be fed five meals a day, each exactly the same being 8 ounces milk. 2 ounces barley water. 1 dessertspoon of food.
After a year, introduce custard, beef tea, Bovril, mutton, chicken broth, boiled or poached eggs and bread crumbs.
Right. Developmental milestones from Mrs Ellis. By the second year, your baby can gnaw a crust, string a few words together and blow out a match (that sounds like a useful skill to teach a baby, playing with matches). In terms of sleep, Mrs Ellis points out that if your baby does not sleep well it is because the mother, while pregnant, led an “excited, artificial, restless life” or it could be due to her ancestry.
In the first fortnight a baby should sleep 20 of 24 hours. In the second month the baby will be fully under the mother’s control. Baby is never to be rocked. All day sleeps must be taken out doors, with a mosquito net, so put the pram on the verandah or – love this – wheel it onto a piece of scrubland.
If a baby or toddler is sick, give them castor oil or Brand’s Essence of Chicken in brandy. Or just brandy. Or Carnrick’s Liquid Peptonoids. Mothers are instructed to avoid raising their baby on condensed milk as it means the baby will probably get rickets and scurvy (which was probably right).
About 10 years after this, in the early 1900s, came The Mother’s Advice Book by Dr Harry Roberts. He advised pregnant women to exercise for four to five hours a day in the open air – and yes, sleep with her window open, and not become agitated or this would prove to be the personality of the child to come. There is a most pervy description of what a wet nurse’s breasts should look like. “Under no circumstances should starchy food be given to a baby under 7 months old”.
If you cannot breastfeed you should feed the baby a mixture of two parts water to one part cows milk. Dr Roberts has a recipe for Humanised Milk requires cows milk, sugar, rennet and cream. There is the usual faff about giving pounded mutton, potato, gravy, egg and milk to a child at 18 months Dr Roberts explained that everyone knows children of one and a half to two years old should go to bed at half past six and those aged 3 to 5 at seven to 7.30. And up to the age of seven, a noon-day nap is recommended.
What has stayed the same is a general approval of breast milk where possible. Many other things have changed quite radically. People used to have 7 to 10 children and expect to lose one or more babies to birth or illness, and often, the mother herself in childbirth. We forget how lucky we are now, in lots of ways. In those times, it was par for the course every day to know of child deaths from diphtheria, blindness and deafness caused by German measles, maimed by polio, and kids hurt or killed by kitchen or hearth fires. So bingo and drink up, every time somebody says “ooh, it was better in the good old days!”.
I was interested to find that Dr Roberts’s was the only book I found from this era which even mentioned crying or has a single word on what to do about it. “It is natural and necessary for a baby to cry” he says, echoing the idea of the day that the lungs need to be strengthened. Presumably he was thrilled with himself to explain to us that a cry that stops when you feed a child is always the cry of hunger. “A child should not be picked up and nursed when it cries,” he wrote sternly. “It should be examined”, and if no reason for the crying is found, “it should not be indulged”.
He does say something useful about this: “Some babies scarcely cry at all, whilst others seem to their parents to be crying frommorning to night…some babies are more philosophic than others, and accept with complacence what drives others to frenzy”. Most of the rest of the book is utter bollocks, except he’s a big fan of stories told to children. And recommends putting a child in a corner rather than beating it. You’ll be pleased to know that night terrors can be fixed by a dose of ammonia at bedtime. That would certainly cure me from mentioning the night terrors. Sleeplessness could be cured by vigorously rubbing the feet while wearing “hairy flesh gloves”. And as I never ever want to hear the phrase “hairy flesh gloves again”, that is where I left Dr Roberts and his advice.
If you ever feel dispirited in your work, may I suggest you compare yourselves to these early pioneers of maternal and child health advice, who were an endearing mixture ofwell-meaning, earnest and dangerous as hell. I myself, whenever I feel like a bad mummy, like to compare myself with Courtney Love who once described calling an ambulance for her drug overdoses as a terrific learning experience for her daughter.
You already know this but you people are the front line between us and madness, between us and death, between us and estrangement from our babies. You can soothe our fears, and refer us to where we need to go. What you do may be crazy hours and ludicrous pay and looked down upon by only the ignorant and stupid (very small, I hope) sections of the medical people who are so far up themselves they can’t see or hear anything, and you may be as drunk as skunks most of the time according to Charles Dickens but by crikey I salute you.
What you do is so important and noble and a tricky mix of science and emotion and hopes and fears and evidence-based statistics and instincts that it’s a wonder you get up in the morning. Bless you drunken bonkers bingo folk, I don’t even want to think what it would be like without you. You provide solace and medical help and a bastion against mental health problems for mothers, and ensure the future of the whole country.
I urge you to keep up the good fight. And I say unto you, you can’t go wrong if you regularly get to yell ‘Bingo’, even to yourself, perhaps without the binge drinking might be best.
I’ll leave you with my fervent hope that whenever you are in doubt, you will advise people to simply boil the buggery out of anything that does move and feed it to anybody that doesn’t.
Kaz is the author and illustrator of many books including Up the Duff: The Real Guide to Pregnancy; Kidwrangling: Looking After Babies, Toddlers & Preschoolers, and Girl Stuff: Your Full-on Guide to the Teen Years, as well as the children’s picture books, The Terrible Underpants and Wanda-Linda Goes Berserk.