Thursday, April 07, 2016

The Perfect Parenting Storm?

I’ve often called the autism-vaccine debacle The Perfect Storm of Parenting. Not solely for dramatic effect but because it's true. Just look at this remarkable, combustible brew of ingredients:
  • Botched media coverage with ongoing misinformation to this day,
  • Botched (and fraudulent, now retracted) research, 
  • Botched public health response, 
  • The rise of new media, questionable experts and the blogosphere,
  •  An epic showdown (falsely) pitting autism, a serious, rising neurocognitive disorder (this is the century of the brain!) against a host of serious childhood diseases.
Plus substantial long-term consequences. 

Lowered vaccination rates and heightened vaccine hesitancy treated us to a number of measles outbreaks and an even greater aversion to Disneyland and large groups of children accompanied by sweaty adults wielding jumbo turkey legs. We spent years and millions of research dollars on the debunked theory. Parents suffered plenty of distrust, worry, stress, inconvenience, and frustration (no, there is no data on this last, sadly). Still, the thoroughly debunked theory lives on, in fact, flourishes in some communities but thankfully, not on screen at the Tribeca Film Festival this year. (Good grief, Mr. DeNiro, I thought you were smarter!). One more thing, the controversy has inspired its own research paradigm. Yes researchers are using beliefs about the link between autism and vaccines to study judgments about public health information and experts. 

This is what I believed. Had believed. I truly thought I’d lived through The Perfect Storm and that nothing cold ever come even remotely close to it in this generation of parenting if not this lifetime. Now I’m not so sure there won’t be another perfect storm.  In time the autism-vaccine crisis could be just a perfect storm. True, a raging monster, but far from the only memorable one. I do still think it will go down in the history books. Our kids (and grandkids) will study it. Laugh at it. Take great joy in the stupidity of their parents.

No one particular event has changed my perspective. I’ve always fretted about misinformation and botched research. I’ve not had a personal crisis or any stunning revelations. Maybe it is the function of time and perspective and more misinformation or flawed advice. In the past several years alone there have been a number of opportunities to see the cracks and flaws in in the latest, greatest recommendations and interventions, ones with the potential to do damage for years, for a lifetime potentially.

Take the peanut allergy recommendations. 

Over 15 years I’ve witnessed drastic changes in food allergy recommendations. From no official recommendations during my first pregnancy, to discussion of banning peanuts and other allergens in pregnancy, breastfeeding and early childhood or “early avoidance” (second pregnancy), to an official early avoidance policy (third pregnancy), to a little loosening of early avoidance policy (a few years later) to correlational research suggesting early avoidance might backfire to last year’s first official trial showing early avoidance promotes more peanut allergies (or if you prefer: early exposure prevents them). It’s only a matter of time before the AAP catches up with the research and advocates early exposure at least when it comes to peanuts (fingers crossed).

Here stringent recommendations - broad extreme recommendations from peanuts to other food allergens from pregnancy, breastfeeding, to the first seven years of life for families with a history of allergies - were put in place without much evidence, in fact without any direct evidence. Not only did these steps not reduce peanut allergies, unfortunately if the latest studies are correct, this policy has caused peanut allergies. So not only did the old recs not work, they caused harm, potentially fatal harm. For families encumbered with food allergies, early avoidance was a perfect storm. For some, The Perfect Storm. 

It might be a slow accumulation of perfect storms for we parents. I dunno. 

Many of you know I wonder about other recommendations, especially the extreme breastfeeding guidelines and the recent “no alcohol is safe” one. Certainly they carry psychological risks for women and mothers being subjected to anxiety, frustration and other hardships associated with complying with perhaps overly harsh guidelines. But there is one other potential consequence of these stringent recommendations. Namely, the risk that people stop believing the purported risks. 

As a psychologist, I often think about the  possibility some parents will tune out or not give much thought to future expert recommendations. This psychological phenomenon has been studied for decades. Some researchers have shown that a single false alarm, even if it is a near miss so to speak, has the potential to negatively impact perception and judgment of future events. Especially for events that carry high emotion. Uh huh. In some ways the first Perfect Storm has set us up to ignore or discount the second one. Which is okay, I suppose, if it is a false alarm. But if it isn’t, if the threat is real, then those who have become jaded might miss it. Or not believe it is real. 


So I wonder what other issue could implode into the parenting media causing such long-term controversy, anxiety and lasting fall out? Ideas welcome.

2 comments:

Kate Amorella Proff said...

Great post! I too wonder how many times the parenting media can cry wolf. The breastfeeding guidelines really get under my skin. A friend recently asked if I knew of a good recipe for homemade formula. She was having trouble with supply and wanted something "as close as possible to breastmilk." She feared commercial formula as it has been demonized as poison. Until she asked, I had no idea that homemade formula is now a thing. It frightens me to think that mothers are willing to cobble together ingredients bought online and in health stores as opposed to grabbing a tin of highly regulated commercial formula. I can only hope that articles like yours will reach more mothers and we can educate ourselves of all sides of a story.

Polly Palumbo, Ph.D. said...

Hi Kate, why thank you. Now you've given me one more reason to keep writing about the absurdity in the breastfeeding era. I can't say I'm surprised but I'd not heard about homemade formula, at least not in 40+ years. What did she use? Were you courageous (or patient) enough to ask?