My archives might be a little outdated especially the older blogs.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.

Saturday, April 30, 2011

And Even More Inspirational Reviews

From One Jewish Mama to Another, March 12, 2011

By Liz P-L -
This book is amazing--I wish I read it when I was pregnant so I could have avoided heartache and doubt BEFORE my little one was born. Dr. Punger's journey from doctor to mom and then to her amazing blended life is inspiring. As a Jewish mom that questions conventional wisdom regarding birth and the early years, I especially appreciated Dr. Punger's candidness about her experiences as a young mom and her spirituality. The letter to her boys (included in the book) about their Jewish names is beautiful. There are not many resources out there for Jewish moms that need "Permission to Mother" so this was an extra special message for me. There are not a lot of heroes in this world like Dr. Punger that have the courage to speak the truth of what it means to be a woman and mother from a thoughtful, emotional, physical, and spiritual perspective. I will refer back to this book as I raise my daughter when I need to remember that we indeed have the right to raise our children in ways that align with our core beliefs. I also appreciate her example of blending her career with motherhood and perhaps find that aspect of the book most inspiring.


She was 'lively', April 28, 2011

By Channah
The book was excellent! Once I opened it, I couldn't put it down. I was intrigued as to how this doctor had the nerve to use the services of a doula, at the hospital; and then, go on to have a footling breech birth at home. As I read each chapter, I was convinced that her experiences were for the many women who will read her book, and receive the answers they need. The most inspiring section of this book is, most certainly, the manner in which she prepared to deliver her last child. She so eloquently describes how she focused on the tetragrammaton, the sacred name of God, putting her trust in HIM; and He not only heard her; but, strengthened her to persevere such an obstacle of great proportions and triumph dramatically.

Indeed, she was `lively'. This is the word used in Exodus 1:19 to describe the Hebrew woman who delivered their children without the assistance of a midwife, in order to save them from Pharaoh. Let it be known, however, that I wouldn't of known this had Dr. Punger not interpreted this Scripture in her book, Permission to Mother. It is a MUST READ!

Friday, April 29, 2011

Two More PTM Reviews

For Older Moms, April 26, 2011
By Connie Allen Pridgen

I can say what a blessing to have met Dr Punger, by accident, as a dr. who believes in all the things I do and doesn't question me. My daughter is 19 and wish I raised her the way Dr Punger has raised and is raising her children and her teaching other moms how to raise theirs...naturally....Another book I would encourage her to write......is transition from mothering to peri-menopause and what happens next....as she is quite useful and knowledgeable in that area as well!!!! Read her book and her blogs, but become a patient, it truly is life changing ask me and my husband and we have only been her patients since Jan.!!

A "MUST-READ" book for all mothers, February 4, 2011
By Jenn Cohen --See Jenn's Blog, The Natural Mama

This book is a "MUST-READ" for all mothers! I have bought several copies for my pregnant friends. This book totally opened my eyes more to natural births, breastfeeding, attached parenting, etc! I enjoyed Dr. Punger's honest and knowledgable accounts of not only her own birthing experiences but also of today's "typical" birthing senerios. She encourages and empowers women to trust their bodies and their instincts as mothers and embrace nature! With so many other "parenting" books out there, this book truly sets it's self apart. I have personally read this book several times, gathering more from it each time. I had planned a homebirth with my son and at 20 months now, he still breastfeeds, co-sleeps and co-bathes with us. He is an extreemly healthy, bright and independent little boy and I thank Dr. Punger for her inspiration and "permission to mother".

Wednesday, April 27, 2011

More Reviews

A book every woman should read before having children, April 8, 2011

By Kristeen Oliveira
I really wish I read this book before my daughter was born! It's a raw eye opener on the subject of natural birth, breastfeeding, and bonding with your children. Dr.Punger helped me tremendeously with low milk supply issues with my infant. I owe it to her that I was able to continue breastfeeding my daughter into toddlerhood. I refer all my nursing mommie friends to her and recommend her book to any mother or mother-to-be. Help other customers find the most helpful reviews

This book is an inspiration!, March 23, 2011

By bobbi2782
I recently have received this book from my sister in law. She gave it to me when I became pregnant with my third baby. I always have had trouble breastfeeding and wasn't sure if I would breastfeed with my third, but after reading this book I am inspired to try again! I am also preparing for a natural birth this time around, even at home! Denise has inspired me and I know I can do it now! I can also add that because of her book and blog that I am eating much healthier than I did when I was pregnant with my first two. I would definitely recommend this book to any mother, whether you are pregnant with #1 or #5, or you are just a mom looking for a great book with great information!

Tuesday, April 26, 2011

Recent Permission to Mother Reviews

By 
I highly enjoyed reading this book and found it to be a real eye opener. In the five years that I have been mothering, I have come to distrust many doctors. The doctors I have been to do not seem to understand the importance and need for attachment parenting. Epidurals, C-sections, vaccinations, over use of antibiotics, etc. seem to be much more accepted in mainstream America than natural birth, homebirth, extended breastfeeding, babywearing, co-sleeping, tandem nursing, and homeschooling. To find a real MD that not only encourages these naturalistic practices, but came around to adopting all of them personally is beyond refreshing. I loved the brevity of each chapter and found myself finishing the book quickly because I wanted to just read one more chapter and that kept happening over and over. I think the book's overall appeal comes from the fact that Denise Punger is so open and vulnerable, she didn't hide anything about her experiences or opinions. I felt like i really knew this woman after reading the book. I too came to adopt many of these attachment parenting practices on my own, after searching out what I felt was right for me, my children, and family. In a world where there is so much advice and information from doctors encouraging us to detach from our children as young as possible, it is beneficial for women to know that there are other ways to parent. Hopefully more mothers will seek the permission they need to mother by reading this informative book!


By 
This review is perspective from a woman who breaks the stereo type of attached parenting/child led weaning/cloth diapering/all things considered "alternative". To have this book in my personal library has given me much pride as a woman and mother and I plan on
passing it along to my daughters in the hopes that it resonates with them and hopefullly it will empower them as much if not more than it did me. Another word that comes to my heart to describe this book is validating. To have a woman who has had the exposure to the world of all things medical come forward to share her journey on mothering the way she chose is and will be so validating for many women and men who question themselves over criticism from those they respect and trust (esp the opinions in the medical field). Everyone who loves to read knows that some books are so special they crawl in your heart and live their forever well this is one of those books for me. If you need a fresh perspective on parenting and or you need some validation this is def the book for you.

Monday, April 25, 2011

Moving Away From Vaccines

Patients often come to me because they have concerns about vaccines. They want to move away from vaccines. They want some freedom and flexibility. I am selected out by a unique group of parents that understand good nutrition more than most, understand the deleterious affects of preservatives, dyes, HFCS and other toxins in food, have high breastfeeding rates (and bf for the biologic norm), actively involved in their children's education,  and are around decreased amounts of second-hand smoke. It may be hard to compare my group of patients to other local pediatrician's practice vaccine outcomes or Pediatrician's in other areas. Many families choose not to immunize in my office, but from those that do this is the most they get in my office.

From 0-2 months
Nothing. I will not give a vaccine before 2 months.

From 2-6 months
Most families will wait till ~6 months to get Hib and/or Pediarix, but I can start now.

From 6-12 months
Pediarix x 3 doses (Can be done at 6, 8, 10 months or 6, 9, 12 months)

Hib x 2 doses. Hib was back ordered for several years. Much of my "vaccinated" practice  never got Hib because it wasn't available. (Can be done with Pediarix or opposite months. Most of my "vaccinated" kids get it with Pediarix.

I can provide Pediarix (Heb B, DTaP, polio) and Hib without each other. I can also provide Heb B, DTap, and Polio seperately).

That's it. Up to 5 shots.

From 12 months - 24 months

Pediatricians give Chicken Pox and MMR at 1st birthday. Most of my families who do eventually give these two wait until school entry or more developmental maturity. There is a 4th doese of DTaP due this year. A 3rd Hib can be given this year.

That would be 3 (maybe 4) more shots, if you get these.

Kindergarten Entry
I provide boosters for K. 4 boosters are "required." Polio, MMR, Chicken Pox, DTaP. I do not give these at one visit. I will do 2 and 2, 1 month apart. For Kindergarten entry I get referrals from the school, so I get more requests for these than I do the primary series from families that started with me with new babies.

A No-Hassle Medical Exemption is available from me whether you started shots or not.

Friday, April 22, 2011

Author reflections...

Tonight I am reflecting on the 4 years PTM has been out and what's new since. I am impressed with the diversity of mothers who have benefited from my work. The variety of reviews should be helpful to you as you could quickly determine if my book would be helpful to you or goes against any deep convictions you have. True, I want to preserve breastfeeding. You could call this a collection of articles on topics of concern to mothers and how they all relate to breastfeeding. I have been pleasantly surprised that even women, who have babies that didn't breastfeed, still find inspiration in my words. I am encouraged that the birth stories I share have given women courage to speak up for and reflect on their birth experience in an empowering way.


The basic needs of new mothers are the same. My personal autobiography of my childbearing years won't change. The way we get information since publication has advanced. Social networking is big. Yahoogroups was how I stay connected prior to printing, but I am quite impressed with the birth and breastfeeding community on blogspot and facebook. I would have loved a blog journal of my last pregnancy. I am most impressed with a facebook group matching up moms in need of milk with moms who have milk, Human Milk 4 Human Babies. There is a lot to be said for human milk donation especially since it's not heat treated. Despite facebook's adversity towards breastfeeding photos, the on-line extended breastfeeding community has reached a new level. Mom's are more openly willing to share their photos. I've been candid, but not to the level you can find on facebook now-a-days. Once, I thought Bernadette and I were like the only ones pouring out birth and breastfeeding updates via yahoogroups and our print magazine, Mother to Mother. It's a pleasure to get on my feed and have you sharing news stories quickly and instantaneously.

Since publishing, there have been birth documentaries to come out; Business of Being Born and Orgasmic Birth. See them both.

My own journey with nutrition has involved and I can support the desire to eat vegan and vegetarian while pregnant and breastfeeding (and I totally understand the cravings may keep you from your ideal goals.) I took my nutrition journal to its own blog.

Weaning is a process. I was still producing milk at the time of publication and nursing the baby. I am no longer producing milk, but he is still lingering. Some babies wean all of a sudden in a day or a week or a month. After 14 ½ years of nursing, the last 1 ½ years have been the weaning years.

Many call me courageous to speak out. What gives me confidence is my experience with vulnerable moms. All my topics were carefully considered before including (and before posting to the blog). As an author, I was hoping the book would help me find the woman that needed me. PTM along with the help from blogs and facebook have definitely helped mothers in need find me. I continue to find that in a highly technical world most mothers appreciate having permission to mother.

Bernadette and I met when I was pregnant with my second son. Traditional educated with a full-time career and completely vulnerable myself, I was totally fascinated with the world of a homebirthing, breastfeeding, homeschooling, doula, mom of 10. She has had tremendous influence on my mothering journey and opening the doors to possibilities of raising my boys in ways that deviated from societal norms. Through the years the internet has helped us stay connected and to allow us to support each other with our common goals. As one of the busiest moms I know, Bernadette's communications are a treat to me.

I sincerely hope you will take the time to read Permission to Mother from cover to cover. Read it again. You may be surprised that you find a new theme speaks to you the second time reading. Good or bad, I love your feedback. I would love for you to find me on the web.

You can also find me at:

Rawontheriver.blogspot.com

Twofloridadocs.com

Twitter

Facebook: Denise Punger Coquelet, Permission to Mother, Coquelet & Punger

My amazon, Permission to Mother page

Wednesday, April 13, 2011

Vaccination Observation

I am approaching 10 years in private practice. I have been in a unique situation where I can support parents choices in regards to vaccination.

The concern about vaccination is not just limited to parents about the childhood schedules, my senior patients also voice concerns. I have been able to support my older patient's decisions to vaccinate or not.

At the end of seven years this is what I have observed in children.

I have not seen consequences of "not vaccination." For example, I have not observed significant illness or tetanus that could have been prevented by vaccination. I have very few hospital admissions amongst my my pediatric patients following my schedule for well-child care (which is often individualized). ( I have lots of one-time consults and naturally don't know what happens to them.)

I have not seen serious consequences of partial/delayed vaccination. For example,  I have not seen "fine-today, not fine tomorrow." No one gets vaccinated before 2 months. Most parents tend to delay vaccination in my practice at least 6 months. We are NOT vaccinating sick children, failure to thrive children, or preemies. When parents accept MMR vaccination, it is almost always significantly delayed until social developmental milestones are obtained (or the lack of development noted and plan made.).

The less serious side effects I have seen of an injection is pain on injection. Some babies and children tolerate a shot well. I've seen a  few rashes or knots at the site of injection.  Sometimes the injection technique has unfortunately not been the best. The side-effects in a partial/delayed schedule seem to be few (I don't recall many parents reporting fever.) or maybe they don't report it to me. A few have changed their minds and discontinued vaccination. I appreciate feedback from families if a negative experience has been noted.

I have not offered full immunization. Most families seeking me out, seek me for supporting their decision and are not interested in Hep A, rotavirus, pediatric influenza or pc. I can not comment or compare positive or negative incidences to routine pediatric practice because I don't follow the full schedule. I don't offer HPV to young girls. All physicians providing vaccination should be open to discussion with their patients.

I have not enrolled in state computer system to record shots. Records are kept in our office at this time.

Getting a medical exemption is not an issue. Starting vaccination and declining further shots in a series is not a problem.

In my elderly population, more or less I am not seeing "consequences" of not vaccination.

Keep in mind I tend to have a healthy population of patients. Breastfeeding rates are high. Families tend to be conscientious of nutrition. Also, families tend to be aware of exposure such as tobacco, false-food products, community exposure. Making good lifestyle choices influences  how we respond to infectious illness. In my practice, I observe that families are active in their pregnancy choices and birth plans which in turn has lasting beneficial affect on the baby's health.

Today's epidemics are diabetes, obesity, high cholesterol, hypertension, cancer, and  arthritis. These conditions are far better of manged with nutrition and lifestyle.


We are human and "bad" things happen. Still, I feel like I can support families decisions to evaluate what their family is most at risk for and support their decision. I can also intervene if a particular family has apparently made a poor choice for their circumstances. It is my responsibility to inform my practice if community circumstances change that may sway them to change their previous decision.

I am traditionally educated. I was trained that vaccinations are the best advancement ever in medicine. Never did I imagine that I could be so flexible. I came across the debate 12 years ago for the first time when my 12 year old was a baby. I was shocked that a debate even existed and felt resistant to it.

By observing many of the families in my practice, I have come to the conclusion that the children in my practice are overall thriving and healthy. I am practicing the BEST medicine to optimize health and will continue to provide this flexible kind of care supporting families. I feel it is important to get this message out. Many physicians are employed, controlled by large practices and hospitals, or other external or internal regulations and don't have the fortunate situation to observe what I do.

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