My archives might be a little outdated especially the older blogs. My links above are all new and current.

I have only positive things to say about Permission to Mother, an autobiographical account of a thoughtful mother and clinician who courageously writes from her heart, soul, brain, and personal experience; who is open to change in her views and opinions and is not guided by the safety of rules of any group or the status quo; she is guided by love and openness to the experiences life brings her and her family. Her process benefits her and those around her and those who read her words. And to add to that, the writing style and story telling ability here make it a very enjoyable read speckled with both the humor and seriousness of life. ~Laura Keegan RN FNP, author of Breastfeeding with Comfort and Joy

I enjoy reading your feedback and Reviews (81!) on amazon. Kindle Version Available!

Please Join me on Facebook at Punger Family Medicine.

Tuesday, October 30, 2007

Permission To Mother Table of Contents

Table of Contents (potential subjects that will be discussed in this blog)
FOREWORD by Bernadette Clark RN CD(DONA)
PREFACE
PART 1 – CHILDBIRTH AS I EXPERIENCED IT
Labor & Delivery in Medical School 5
Family Medicine with Obstetrics 15
Childbirth – It’s My Turn 23
My First Labor 25
Pregnant a Year Later 29
Birth with a Doula 31
Finding Breastfeeding Medicine 35
My Friend’s Surprise Homebirth 37
Healthier Images of Pregnancy 41
Bernadette’s 11th Blessing 43
Another Missed Homebirth 47
Getting Ready for My Own Homebirth 49
“It’s Toes!” 61
A Letter to My Third Son 67
The “Awesome and Powerful” Experience of Rumping 69
The Cost of a Doula 73
A Twin Homebirth 77
Permission to Birth 81
Doctor, Mother and Political Advocate 85

PART 2 – THE BREASTFEEDING YEARS
Breastfeeding Didn’t Come Natural 95
Nursing in Public 99
Nursing After Conception 101
Tandem Nursing, One Day at a Time 103
On Weight Gain 107
A Case for the Family Bed 109
More About Our Family Bed 111
Tub Time 113
Sling Musings 115
Switching to Cloth 119
A Word about Wipes 123
A Visit to the Pediatrician 125
Scott in the Middle 127
Surviving Anesthesia 131
My Spiritual Journey as Physician, Mother and IBCLC 133
To My Sons: How You Were Named 137
Unexpected Benefits of Breastfeeding 141
Comfortable With My Body Through Breastfeeding 143
Working and Breastfeeding 145
Kids at Work with Mom 149
Homeschooling: The First Year 153
Unschooling: The Second Year 157
Lifetime of Learning 163

PART 3 – BREASTFEEDING MEDICINE: MORE THAN PERMISSION
Baby Shower Gift 171
Just say NO to Formula Company Diaper Bags 173
Is it Worth Breastfeeding My Newborn All Night 175
How Dads (and Grandparents) Can Show Support 177
“I could not breastfeed because…” 179
Sarah’s Thyroid 181
Failure to Thrive 183
Not Enough Milk? 185
Nursing an Adopted Baby 187
Donating Human Milk 189
All in a Day’s Work 191
Breastfeeding and Birth Control 193
Freeing the Infant Tongue 195
Second Opinion on Jaundice 199
How Long Before Supplementing a Newborn? 201
First Latch at Six Weeks 203
Another NICU Graduate 207
A Positive PKU 211
Screening Tests: Not Worth Triple the Trouble 213
Nursing with Teeth? At Night? 217
Permission to Grieve 221

PART 4 – WHY I DO THE WORK I DO
Breastfeeding Help is Available 231
Baby Goals I Wanted to Meet 233
Strengthening My Inner Confidence 235
Worth the Drive 237
Putting Me at Ease 239
A Sensitive Two-Year Old 241
Comforting Him in Our “special little way.” 243
A Letter From Pennsylvania 245
APPENDICES
Appendix A: Resources 249
Appendix B: Herbal Labor Inductions – Are They Safe? 255
Appendix C: Pregnancy and Labor – No Picnic for Dad 257
Appendix E: Why the Dash? 261

Are you a newbie to blogs?

Do you feel like your coming into a conversation half way in the middle? No big deal? I am new too. I never thought much about the potential of a blog until a few days ago. For me, its spontaneous, quick and very easy way to post message and updates about the topics I care about. Many of my posts originate from a question someone asked me. I figure instead of answering it for one person, why not make it available for others who are interested.

At the bottom of the blog page there is a way to subscribe and get my posts in your e-mail or you can mark this site in your favorites and check back often.

In the comments section there is an opportunity to be notified of new comments by e-mail. Anyone can comment, but to keep spam coming through, I will moderate the posts before publishing. So far the comments have been contributory and worth browsing through. Please let me know you've been here and what you think!

In the side bar will be a list of previous postings. Its pretty user friendly. I hope you will enjoy!

Sunday, October 28, 2007

My unschooled child is student of the month at TBEI

Scott, my unschooled 9 year old (and with long hair) is student of the month in his religious school class at Temple Beth El Israel! Today he came home from class with a certificate with this honor. His teacher said he is most improved. Scott likes raising his hand and answering questions she and the Rabbi ask the whole class.

Why is this a big deal?

Unschooling does not mean we ignore education. I have never felt like our values and lifestyle fit well into public or private school, or prefabbed homeschool curriculum. We learn spontaneously from books and day-to-day events.

It goes to show that that children who don't do well merging into schools and curriculum in earlier years can "catch up" and do well in the group activities that we eventually feel is right for them. He is the only homeschooled student in his Sunday class. Scott also had a promotion exam in karate last week. And he likes me to read to him books in the Dragon Slayers Academy series and the Biography series, "Who was..." and asking lots of questions as we read.






Saturday, October 27, 2007

LOVE expressed by 2 four year olds

This memory has always been a favorite conversation with my oldest son:

As my son turned four years old, I was concerned that he was accumulating too many material gifts. I wanted him to enjoy what he was given, but I also wanted to teach him what was most important. After turning the lights out one evening, I asked him, “William, do you know what the most important gift of all is?”

Without a hesitation he stunned me, “Love," he said. I was very proud of him as we cuddled. He thought about my question a little more and then said, “Mom, breastfeeding is love,” and he nursed to sleep.

I was reminded of it this morning. My youngest son who is four expressed his love through a knock-knock joke.

David: Knock-knock
Mom: Who's there?
David: David
Mom: David who?
David: David who loves you!

Friday, October 26, 2007

Yes, you can link to me!

Having a blog is fun. After so many months of editing and proofreading, it feels so good to exchange some enthusiasm. I appreciate the link from campgirdwood. More have asked how to link to the book. There will be a link to purchase on amazon.com, bn.com, outskirtspress.com and hopefully a lot more places once the book is officially published.

In the meantime you can link to this blog: http://permissiontomother.blogspot.com/

Or to my web page dedicated to the book: http://twofloridadocs.com/permissiontobf.php

When you do post a link to my book. Please leave a comment about where you posted it. Then the rest of the readers can come visit your site. And thank you so much!

Why you need a bassinet!

I usually counsel my families with new babies to sleep with the baby. I let them know that I am probably the only baby doctor in the area that will insist on co-sleeping. I warn them that many people will tell them, "Don't sleep with the baby!"

Some families are glad to hear my re-assurance. Other parents will express the concern of rolling over the baby as the reason why they put the baby in the bassinet. Usually, I then go make a suggestion to roll a blanket or towel like a log and put it one on each side of baby giving baby some space.

Recently, one "comedian" Dad came up with a unique solution to avoid rolling over his newborn, "I'll go sleep in the bassinet!"

I love this arrangement. Dad can go sleep by himself and discover how lonely it is in the bassinet away from his partner and new baby.

Thursday, October 25, 2007

Breastfeed with Confidence

I was overnight visiting a relative we haven't seen in a while. It was late and David was tired and wanted to nurse to sleep. I felt like staying in the common area rather than take him in to bed because I still felt like chatting with our host. David plays with the opposite nipple and bra hooks when he nurses. I admit, sometimes it's annoying to be rubbed and I try to guide his hand away or distract his hand.

My curious relative said, "C'mon, it's like he's groping you... that can't be the same sweet feelings you get when you look down at your nursing newborn!" This must be quite a site for someone who is hardly ever 'round kids. I am around breastfeeding babies and children daily and know this is typical normal healthy behavior. AND just so everyone knows-- it is a very good feeling to know David continues to get his comfort and nutritional needs met. I am confident in my abilities and choices after the many years I have fed my children at the breast, but many mothers aren't. A comment like this from a well-intended relative can be very intimidating. It is my hope that my perspective builds up a nursing mother's confidence to keep up the good work without doubt or shame.

Birth: "But I have no choice..."

How many women do I meet that tell me they have, "No Choice!" They think they have to be induced, or they need a cesarean. If you are 38 weeks and its the first time you are considering your birth plan, you probably gave up your choice long ago. If you are not pregnant yet or you just found out your pregnant, you need to read up about birth. You need to educate yourself on providers in your community and beyond. Don't pick a provider because you went there last time or because they are listed at the top of your insurance provider list and are the closest. If you have been to this provider before, ask yourself if you were really happy with the care?

It is well worth it to research the statistics for a given provider: how many births are the cesarean, how many are induced, how many hospital transfers, how many babies get admitted to the NICU. Consider the hospital, also. Your provider may be great, but the hospitals may have stringent protocols. Can your provider give morally and ethical high quality of care or are they subject to the political agenda of the hospital.

On the Treasure Coast right now we are lucky to have several hospitals and several independent midwifery practices. Don't limit your birth options to the name at the top of your insurance list in your geographic area.

If you are near term and come to terms with the fact that the birth your provider has planned for you is not what you want, there may be hope. There are women that transfer to other providers late in pregnancy. The earlier you begin your research and become active in your birth plans the better.

Introducing a new blog...

I've been thinking about creating a place where I can continue to share developments about my book, blog on life experiences related to the book, collect anecdotes about my mothering experience, etc... and get feedback from readers like you. And maybe get side tracked onto other topics on occasion.

I went to see Wife of a Rockstar today, a popular blogspot and that convinced me to start this blog... well actually I know the author of this blog in real life and talked to her today and I am intrigued by the things she writes about and I know her "unsocialized" kids that she brags about. They are all so polite and inspiring. How can you be unsocialized when there is nine kids in your family? Because you are homeschooled! Well that's what a lot of people think. I homeschool, too, so that makes my boys unsocialized. The reason I wanted to publish my own book is reach more moms in order to dispel myths like this.

If I have a published book, why do I need a blog? After having the pressure of publication deadlines and the tedious job of proofreading, I welcome the opportunity to be spontaneous.

If you come to this blog and find not much here besides the first two posts, please come back soon.

Just one more very important thing... Please don't ask me personal medical problems (including personal breastfeeding) on this blog. If you do, I will offer an office consult, so if you know that's what you really need, call the office. Thanks for understanding.

Wednesday, October 24, 2007

Introducing my new book coming soon....

Why Do You Need Permission to Mother?

The "Standard-of-Care" is a legal term, the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would manage a patient's care under the same or similar circumstances.

Sadly enough, the standard-of-care legally protects only the provider (the physician or hospital) and is not necessarily in the best emotional, physical, or spiritual interest of the consumer (the patient). Dr. Punger’s personal experience brought this to her attention. She has experienced a doula-attended hospital birth without intervention, working while tandem nursing, tandem nursing beyond the toddler years, and perhaps most dramatically, a footling breech birth at home.

Included are other women’s experience's that go beyond the status quo. All stories have one feature in common: Dr. Punger goes beyond the medical standard-of-care that too often imposes on a women’s right to mother to the fullest.

Through her warm, attachment feel stories about her own mothering journey and the inspiring women she is in close contact with, Dr. Punger gives you permission—to birth just the way you want to and to breastfeed for how long you (and your baby) want to.

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