A Doctor's Advice for Family Life

A DOCTOR'S ADVICE FOR FAMILY LIFE

Robert L. Jackson, M.D.

The following article by Dr. Jackson is chapter sixteen in a book by Fr. Anthony Zimmerman, Human Life Education. Dr. Jackson is Professor Emeritus, Department of Child Health, University of Missouri, and Distinguished Professor of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas. At the request of Fr. Zimmerman in 1989, he wrote what follows as a kind of testament coming from the heart of a doctor, a pediatrician, a Catholic and a family man. It incorporates some materials published previously (see "A Pediatrician's Advice for Family Life," HLI Reprint 10.)

The family, society's most vital and basic human institution, is being affected adversely by profound and rapid changes resulting from the gradual adoption of unnatural ways of life.

After over fifty years of pediatric clinical experience and fifty years of marriage, it has been the author's observation that to establish enduring families in our more complex society, it is equally important both for boys and girls to complete their formal basic education and be self-sufficient before marriage. After marriage, both will have grave family responsibilities requiring sacrifices for each other. The boy should be a man in a position to support a family and with basic knowledge of reproductive physiology. The girl should be a mature woman with knowledge of her fertility and with sufficient education to support herself and her children should the need arise.

Soon after marriage, it is preferable for couples to prove their fertility and establish a family. Children normally bind and bring couples closer together and help them to mature faster. My extensive clinical experience indicates that sex without children does not get marriages off to a good start and is likely to lead to self-indulgence. Spacing children at about two year intervals is desirable and can be achieved by biological breastfeeding and knowledge of fertility awareness. After the couple has the number of children they can support and educate, a natural conception regulation method can and should be used effectively to control conception. These natural, safe, free and reliable methods require education, experience, and above all, motivation of both husband and wife. Natural family planning can be as effective as any unnatural method.

As a pediatrician, my concern has been to help parents accept, love, and enjoy their children by learning and understanding good health practices. It also has been my observation that more than anything else, children need unselfish parents. Unselfish meaning a full-time mother and a responsible and loving father, during infancy and the critical preschool years when physical growth as well as emotional and intellectual development are proceeding so rapidly.

As stated by Dr. Harold Voth (Senior Psychiatrist) of the Menninger Foundation:

"A baby must have a mother, a mother who is mature enough to attend to its needs and provide so-called object constancy for a minimum of three years. The very foundation of personality is influenced through the consequences of inadequate mothering during this period, particularly the effects of separation. The mothering function is one of the most important of all human events but, unfortunately, one of the least appreciated or regarded by modern society" (Medical Times, November 1980).

The first child in any family has inexperienced parents but if the child is wanted and accepted, the parents learn a great deal in a very short period of time. The second child arriving in about two years will not only extend the education of the parents but automatically provides the discipline especially needed by a first child. Three or more children spaced at about two year intervals are desirable for most healthy couples living in a stable environment. The cooperative help of mothers and fathers in families provides the ideal role models for normal sex identification during infancy and the preschool years.

Only in the past few years has increased medical knowledge of reproductive physiology made possible more complete understanding of natural conception regulation. Now more precise natural methods of controlling births are reliable, safe and inexpensive and also help protect the health of mothers and grandmothers to be. Natural family planning involves the couple in a whole new approach to conception regulation in which the normal and healthy processes of fertility are understood, accepted and lived with, instead of being disrupted by chemicals, pills, intrauterine devices or surgery all of which have the real potential of insidiously causing very serious health problems for women. And, because of the shared commitment of the couple to be responsible together for a fertility that is "ours" not "hers," greater mutual respect and trust flourishes. Parents who learn and practice natural conception regulation are preparing themselves to become the most effective teachers of human sexuality for their children and for all succeeding generations.

Few people realize that the large-scale change from natural childbirth and natural breastfeeding to unnatural methods of childbirth and infant feeding took place only during the past half century. The major factor which led to shortened child-spacing was gradual displacement of breastfeeding by bottle feeding. Bottle feeding results in early postpartum ovulation and abnormally shortened child-spacing of about one year and consequently, overwhelming physical, emotional and economic stresses on families. These family stresses induced couples to seek means for controlling the frequency of conceptions. Easy availability and convenience of barrier techniques which are advised by health professionals readily persuaded most couples to use unnatural methods of conception regulation.

During the past half century, scientific studies also have documented the importance of: (1) nutritional status and physical fitness of women before and during pregnancy; (2) the desirability of natural labor and delivery for healthy women; (3) the immediate needs of the mother and her newborn baby for tactile contact after birth; (4) the emotional, nutritive, immunological and fertility regulation advantages of biological breastfeeding for about a year after birth and (5) the availability of reliable new natural methods of conception regulation to control the size of families.

As an experienced doctor, I urge a return to trustworthy traditional values and teachings that held families together, that is, a sense of personal responsibility and dignity including chastity before and fidelity after marriage. But, concurrently, we need to accept that it will be almost impossible for young and middle-aged adults to alter established patterns, to overcome social pressures and to accept readily natural methods of fertility regulation. We also need to appreciate fully that reliable natural methods of conception regulation only began to emerge in the late 1960's and into societies which for a generation or two had learned and accepted legally approved, unnatural and convenient methods of birth control on the advice of doctors and which were sanctioned or opened to doubt by many if not most religious teachers. However, I wish to emphasize that their is great potential for educating future generations. Consequently the most urgent need is to develop programs to help parents meet their grave responsibilities in this regard. Parents who continue to use unnatural methods of birth control are in a compromised position to instruct and guide their children to accept chastity.

Family life education is a process by which the family transmits values from one generation to succeeding generations. To explain family life education, I quote Ingrid Trobisch from her 1984 address to The International Federation for Family Life Promotion:

A. What is Family Life Education?

Helping men and women understand each other, giving help to parents in raising their children wisely, and making changes in our society through healthily contagious living.

B. When does Family Life Education begin?

The child will be greatly influenced by the way the parents themselves were raised. Is the child viewed as a nuisance, or only as an heir, or as a real, healthy individual to be loved and guided?

C. Pregnancy, Childbirth, and Breastfeeding.

The child in the womb is dependent on the health of the mother. The moment of birth should be the time of a woman's greatest dignity, when she is co-worker with God in bringing this new life into the visible world... Newborn babies need food, warmth, and security and all three are received best at the mother's breast, where the foundation for mutual confidence and companionship is begun.

D. The Place of the Father in Family Life Education.

The father is the first man that a daughter knows, and he to a great extend determines her attitude toward men later in life... The father is the role model for the son; the daughter needs a mother with whom she can identify.

E. The Role of Parents in Pre-School Education.

Here are laid the foundations for self-esteem and self-acceptance, essential for any love relationship. Children need to know that they are unique, created in the image of God...Answer all questions simply and naturally, but do not tell more than the child asks.

F. Role of Parents in the School Years of their Children.

Example speaks louder than words... The school child needs kindness (I'm on your side), encouragement (you can do it), and challenge (now, do it)... The family table conversation can be the greatest single influence in the life of the child.

G. Role of Parents During the Adolescent Years.

This is the time for teaching the child that is possible to live a fulfilled life in spite of many unfulfilled desires...Adolescents need help in understanding their own physical and emotional development with the goal of a marriage only with a mature partner.

H. Mature unselfish parents are needed to accomplish family life education goals.

A child is not a toy, but a very real person to be respected, loved, and educated. Our goal is reached when we see our children establishing stable families and doing a good job of parenting.

We live in a dynamic world and each generation faces new and different problems. In the more developed world as the general health and nutritional status of children has improved, the age of maturation has decreased. Over the past few generations, the age for girls to begin menstruating has gradually decreased from over 16 to 13 years of age. Boys also are developing sexually at earlier ages (13-16 years). We need to make a clear distinction between sex education and human sexuality. Human sexuality includes emotional and spiritual maturation in addition to understanding the facts of reproductive physiology. It is not surprising that teaching reproductive physiology and the use of contraceptives to adolescents has not been effective in controlling teen-age pregnancies and even repeated pregnancies among our youth.

Our children are growing up in a secular society which accepts and even condones sex-pleasure with minimal consciousness that the abuse of sex invariably leads to very serious and lasting problems. Sociological data indicate that secularism has become so pervasive and intimidating in Western Culture that natural health practices have seemed headed toward extinction. Many studies reveal why contraceptives are ineffective. These include: immaturity; high-impulse gratification drives; poor communication abilities; and lack of long-term committed relationships. These are the classical characteristics of adolescents. Knowing all about reproduction in no way prepares the teenager how to deal effectively with passion, arousal and self-discipline. During sexual maturation, which primarily occurs when children are in secondary schools, the greatest need is how to cope with their normal sexual drives. Although it is the parent's primary responsibility to teach their children human sexuality, at present, most of them are not prepared and do not have adequate community resources to help them. Most parents and grandparents of former generations taught, and firmly believed, in chastity before marriage, and fidelity after marriage. It was only two to three generations ago that chastity before marriage and fidelity after marriage were the accepted norms of most societies. However, only within the past few generations many national cultures rapidly have undergone profound changes so that by now (1988) unnatural methods of contraception as well as abortion are not only legal but are being advocated, especially by Planned Parenthood, to become the revised norms. In addition euthanasia insidiously is being considered as an acceptable means of ending human life.

Giving contraceptives to teenagers is tantamount to encouraging them to indulge in premarital sex. Rather, sex education at home, school and church should be premised on self-control and chastity. All adolescents find the struggle for self-mastery especially difficult. Giving contraceptives to adolescents is also telling them they cannot and need not control their sexual desires. Studies also indicate that, as might be expected, increased exposure of teenagers to contraceptives and education in their use also has led to, in addition to more pregnancies and abortions, more promiscuity (now known as being sexually active), to an increase in venereal diseases, including the fatal disease of AIDS, and to involuntary sterility which robs young women of their greatest creative power the gift of motherhood. Parents urgently need high quality educational resources to teach their children human sexuality.

In modern societies, couples from more educated and affluent families have tended to marry later, use unnatural methods of birth control to avoid conceptions, and to have only one or two children. In recent years, more mothers have become aware of the desirability of breastfeeding and now nurse their infants, although only for a few months. However, many, if not most, couples in more affluent families have lacked the determination to make the financial and social sacrifices required to have a mother available full-time to nurse their babies for about a year and to provide the daily care and education of their rapidly developing preschool-age children. It often is difficult for many fathers to provide full financial support of the family unless both parents are capable of and willing to distinguish between necessities and luxuries and to live on a more limited income by making major modifications of lifestyles. In addition to a full-time mother, infants and preschool children also need a loving father, not only to support and help the mother but also to be one who demonstrates by his actions that he loves their mother.

As previously stated, few people realize that the large-scale changes from biological breastfeeding to bottle feeding took place rapidly and only within the present century. The major factor which led to unnatural child spacing was the gradual displacement of breastfeeding by bottle feeding. With bottle feeding came early postpartum ovulation. This resulted in abnormally shortened child spacing of about one year and to overwhelming physical and economic stresses on families. These stresses induced couples to seek means for controlling the frequency of conceptions. The unreliability of and the self-discipline required by the older so-called "calendar rhythm method" and the easy availability and convenience of artificial barrier techniques which were advised by health professionals readily persuaded most couples to use artificial methods of conception regulation.

After fifty years of marriage and more than fifty years of practicing pediatrics and teaching child health to both under and post-graduate medical and other health professionals, I conclude this chapter by simplifying and summarizing my advice for enriching and stabilizing family life for our youth and for future generations.

It is very desirable for girls and boys to complete their formal basic education before marriage. The boy should be a man in a position to support a family and with basic knowledge of reproductive physiology. The girl should be a mature woman with knowledge of her fertility and with education sufficient to support herself with children should the need arise.

Soon after marriage, it is preferable for most couples to prove their fertility. For the first nine months of intra-uterine life an infant needs a mature well nourished mother. Labor and birth need to become again a natural and acceptable life experience for both parents.

It is preferable to space children about two years apart by biological breastfeeding and fertility awareness.

Each couple ultimately has to make the grave decision as to how many children they can care for and educate. (I recommend three or more children for healthy couples living in a stable environment. Many mothers have told me they cannot understand why their third child is so "good" and such a joy. The simple answer is that this child and future children have loving and experienced parents).

(For clarity in the following statement, I will refer to the baby as she). Love your baby by feeding her when she is hungry, changing her when she is soiled, and protecting her from all dangers. Enjoy your baby, play with her, talk to her and don't be reluctant to cuddle and handle her. You don't spoil a baby with tender loving care. Learn to know your baby �what she likes and dislikes. Each new baby is unique from any other baby who was ever born or ever will be born.

Breastfeed your baby. Biological breastfeeding consists of (a) feeding only human milk for about six months; (b) suckling on demand day and night (after about 6 to 8 weeks, most full-term breastfed infants sleep from the late evening feeding until an early morning feeding, i.e. for about 5 to 6 hours); (c) using no pacifiers; (d) gradual introduction of only small amounts of selected foods at about six months; (e) continuation of nursing as the primary source of food for about one year.

The advantages of breastfeeding are:

1. Breastfeeding reinforces mothers' and babies' love for each other on a regular basis.

2. Prolactin, a hormone, is secreted promptly in response to nipple stimulation which calms the mother and also automatically suppresses ovulation.

3. Milk from a healthy mother meets all of the nutritional needs of a full-term newborn infant for about the first six months of life.

4. The composition of human milk changes daily (especially during the early critical first months after birth) to meet the rapidly changing needs of a young infant. It's like having a new formula made special for your baby every day.

5. Babies have very strong sucking desires, so nursing will satisfy not only her appetite but also her desire to suckle, and make her unlikely to be fussy; nursing also makes the mother more calm and motherly.

6. Human milk will protect your baby from many infections. The first milk (colostrum) and early transitional milk contains many anti-infective substances which decrease not only the incidence but also the severity of infections.

7. Breastfed babies have fewer allergies. Human milk protects against sensitization to cow's milk, cereal and other foods given to young infants who are bottle fed.

8. Breastfed babies smell better�as: (a) they are less likely to spit-up, and human milk doesn't smell rancid as does cow's milk; (b) the stools of breastfed infants are not putrid as are stools of bottle fed babies; and (c) diapers will not smell like ammonia and cause diaper rash.

9. Breastfed babies are much less likely to spit-up, vomit or have diarrhea and never are constipated.

10. Babies breastfed on demand usually are content and much less likely to have colic in the early months and less likely to have emotional problems related to eating and sleeping as they grow older.

11. Human milk is always ready and needs no refrigeration or preparation.

12. Nursing requires only that the mother eat a little more high quality food so it is much less expensive than buying expensive formulas, bottles, nipples, etc.

13. Breastfed infants have many less dental problems in later life; i.e. less dental caries and malocclusions are often requiring very expensive and uncomfortable dental care.

14. "Biological" breastfeeding suppresses ovulation and doctors now understand why this happens. Only "token" or partial breast feeding has been customary in many cultures and we know that this kind of nursing has very limited and unreliable contraceptive effects. If the mother's milk supplies the only food for her baby during the first 5 to 6 months and she continues to nurse at frequent intervals as the baby begins to be given only small feedings of selected high quality foods during the second half of the first year, she is very unlikely to begin menstruating and ovulating again until about 9 to 18 months depending on how often the baby suckles and how much milk the mother continues to produce.

As a finale, I synthesize some of my prescriptions for teaching our youth how to understand why it is preferable and more rewarding to live in harmony with nature. Adolescents especially need role models and factual information to help them understand why and how to cope with their normal sexual desires, how to live a fulfilled life in spite of unfulfilled desires, and that the abuse of sex can lead to very serious and never ending problems. After marriage, couples should prove their fertility, and then space their children about two years between births by biological breastfeeding and knowledge of fertility awareness.

Both parents need to understand that during pregnancy and for about a year when the baby is truly breastfed the wife does not ovulate so conceptions are controlled naturally. Consequently, during the early years of married life, sexual abstinence is limited primarily to times of illness or separation and for about six weeks between births. The period of involutionary changes after birth in a healthy woman is shortened considerably by natural birth and by biological breastfeeding. When the couple decides to widen the spacing or to stop having more children, natural conception regulation will still permit them to have new honeymoons every month and after only a few years they will begin to recognize the symptoms and signs of approaching menopause and before long the wife will become naturally sterile with intact female organs. Sexual abstinence is much less difficult for a mature unselfish couple with a secure family.

Natural Family Planning in all of its aspects offers the best hope of overcoming the sense of foreboding for the future resulting from the moral vacuum that is enveloping our civilization. A new peaceful era is attainable if the scientific discoveries and technological advances now available can be applied for constructive rather than for destructive purposes and we modify the distribution of world resources on the basis of social justice in order to permit the emergence of an ecological society.

In recent years, there is an increasing realization that we need to revise and extend maternal and child health programs to attain and maintain higher degrees of health. Observations and experience should teach physicians and other health workers that interfering with the natural processes in healthy persons invariably results sooner or later in varying degrees of detectable pathological changes. Our long-term objective should be to have stable families with healthy children. There will never be too many well-cared-for children in the world for in the children resides the real hope for a more peaceful future.

Further writings by Fr. Zimmerman may be found athttp://zimmerman.catholic.ac/  

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