Tag Archive | Breastfeeding vs. Formula

A Tongue-Tie Survival Story

Survival?  Well, I don’t know.  But it does sound catchy, and we did make it through with not a single drop of formula.

When the hospital’s pediatrician checked Tova he told Yitzchak, “Just so that you don’t sue me, she has tongue tie.  It shouldn’t cause a problem for nursing and in 90% of cases it doesn’t.”

When Yitzchak brought Tova back to me (note: in Hadassah Ein Karem they don’t separate you for a minute; in Soroka it took two and a half hours before she was brought back to me, during which time Yitzchak was with her for all except five minutes) he told me what the doctor had said.  Angry as I was at how the birth had gone, the birthing-factory treatment (they have 20 delivery rooms and no competing hospitals) and how I was being treated like an idiot (thanks, Soroka), I rolled my eyes, thought, “Oh, great; a nursing mother’s nightmare,” and asked why they hadn’t clipped it.  Yitzchak told me it shouldn’t be a problem, and I hoped that he was right, while reminding myself that he was the sane one at the moment (and I was the exhausted, hormonal one).

After a few days, we brought Tova to the pediatrician because we were concerned about her jaundice.  The jaundice, thank G-d, turned out to be fine, but the pediatrician asked to weigh her (fine by me, since I hadn’t taken her to the well-baby clinic to check her weight yet) and discovered that her weight was not fine; I think she had gained 50g.  We were to come back in three days.

Three days later she had gained only another 30g.

Three days after that, we came back again.  This time, she was already over a week and a half old and hadn’t yet regained her birth weight – and at the rate she was going, we weren’t sure when she would.

At two weeks, she still hadn’t.  I don’t remember when it was, but there was a week in there that Tova gained only 70g – slightly less than half of what she should have gained.

I remember that during this time my mother called and asked how we were doing.  I said we were fine and thank G-d everything was going pretty good.  And as I said it, I thought of how ironic it was.  Shlomo had bronchiolitis (or bronchitis, not sure which) and was on antibiotics.  Tova wasn’t gaining weight and the pediatrician, Dr. R.,  had sent us for a pee test and told me to pump, see how much I got, and then feed her the bottle to see how much she took, and had given us a referral for the ER just in case she did XYZ (don’t remember what).  I was sore, overwhelmed, and dealing with excruciating pain every time I nursed.  Yitzchak and I were barely sleeping, despite being blessed with a baby who, if left to her own devices, will give us a decent night’s sleep.  And with all this, I told my mother I was fine.

Then we did a nursing test.  I brought Tova in, she was weighed, Dr. R. put me in a private room to nurse, and then 40 minutes into the nursing session Tova was weighed again.  To our credit, she had gained 85g.  Not all would stay, obviously, but it meant that she had eaten quite a bit.  Don’t tell the pediatrician, but a good portion of it was squirted into her mouth, since she wasn’t nursing well.  Not that it mattered, of course: the point was to see how much she was getting, and it didn’t really matter which of us was doing the work, as long as it did the job.  To my dismay, the previous day’s “cheating” backfired: I had sent her to be weighed just after a meal, so that the scale would show more.  It wasn’t enough, obviously, and when she was weighed, hungry, the next day it looked like she had “lost” weight.  I didn’t tell Dr. R. why she had “lost” weight; it was enough that to see that she obviously could get enough and officially rule out milk supply as the issue (it wasn’t the issue and I knew that, but we had to prove it).

Several times along the way we were suggested formula – starting in the hospital.  Because even a single bottle of the stuff can do permanent damage to a baby’s gut, Yitzchak and I have started calling formula “medicine”.  It is lifesaving when medically necessary and potentially damaging in any other case. What parent gives their kid medicine when it’s not medically necessary?  And what parent will expose their kid to something even potentially damaging, if there is another option?  Thankfully, our pediatrician was as reluctant as we were to add formula and gave us other options.

The “other options” weren’t fun, though.  The next step was to see if she would gain weight if enough food was forced down.  So, Dr. R. told us to nurse every two hours, maximum every three at night, and come back in two days.  If she hadn’t gained at least 50g – well, let’s not think about that.

We did it.  And thank G-d, she gained 70g in those two days.  In other words, problem found, and it was a simple, easy-to-fix problem.  Tova wasn’t eating enough, and therefore wasn’t gaining enough.  Thank G-d, a million times over, that that was the problem.

However, since she was such a weak nurser, and didn’t want to be nursing so often, each feeding took about an hour.  Every five minutes, we were waking her up.  At one point, I was pumping in the evening, refrigerating the bottle, and Yitzchak was feeding her one of the late-night feedings so that I could sleep a bit.  (After all, I was only three weeks postpartum.)  Other times, Yitzchak gave the bottle I’d pumped earlier, while I pumped a new one.

You know that there’s something wrong when it’s easier to pump than it is to nurse.

Thankfully, I had a hospital-grade pump from Yad Sarah and could easily get 80-90 ml in about 20 minutes (from one side).  Let’s hope that when I go back to work and have to pump, I still have an easy time pumping the amount that she needs.

For a week, I nursed every two hours during the day and every three at night.  Ten feedings a day.

We asked the pediatrician – maybe it’s the tongue tie?  We were told to go to the ENT; the place where he does it, and he himself, will not clip a tongue before the baby is 8-10 months old.

Then it was every two hours during the day and every four at night – for another week.  Nine feedings a day, she said.

Then we got permission to let her sleep – no more than five hours – at night, but we still had to do every two hours during the day. Eight feedings a day; don’t do any less.

Then I realized that the usual postpartum breastfeeding pains had gone away, but Tova was STILL hurting me every time she had nursed.  I managed to keep her from making my nipples bleed, but the dark lines on the tops hadn’t gone away, and my nipples would often continue to hurt for an hour after each feeding – which in those days, meant that the side I had nursed on hurt pretty much until the next feeding.

It suddenly occurred to me that maybe her gassiness, my sore nipples, her difficulty gaining weight, and the long nursings, all had a common cause: TONGUE TIE.  I went online, asked if I was on the right track, and asked for referrals.  I was given two names: Dr. C., a surgeon in Be’er Sheva, and Dr. K., a surgeon in Ashkelon.  Be’er Sheva is closer, so Be’er Sheva it was.  I asked for a referral and Yitzchak took her in.  Dr. C., and all of Soroka, will only clip the tongue when the baby is at least a year; we should wait and see if it interferes with her speech development.  Yeah, and what about the nursing?

[Then Tova got a cough and we borrowed a nebulizer from Yad Sarah, bought a mask and saline solution, and “masked” her three times a day for five days.  Dr. R. wanted to see her again just to make sure that she was able to breathe okay.  And we got another list of things to watch for and another just-in-case ER referral.  Thank G-d, these referrals were never necessary.]

Then Dr. R. told us to go the Tipat Chalav (well-baby clinic, where nurses check development and give vaccinations) and that she was officially dismissing us.  Thank G-d.

I made an appointment with the surgeon in Ashkelon.  He, I had heard, would clip the tongue in the clinic, on the spot.  He was on vacation for a few weeks, so I took an appointment the first day he was back.

We went back to the pediatrician to get another referral.  Dr. R. doesn’t like surgeons; she prefers ENTs.  So she went to ask the ENT herself, partially to make sure that it was really impossible and partially because maybe if she asked the answer would be different.  It wasn’t, and she gave us the referral.

In addition, for the past month or so, Tova’s poop had been forest green.  Dr. R. said it could be because she had a cough, but sent us for a stool culture.  Thank G-d, it came back negative and the doctor said we didn’t really need to do it after the color changed back, even if it wasn’t perfect.  But we did it anyways.

So, we went to Ashkelon.  And I took Tova on a bus, by myself, to Ashkelon.  We left at 1:30pm and came back at 7:45pm.  She was two and a half months old, and still taking an hour to nurse.  Both buses were late, so I arrived 40 minutes late.  Thankfully, Dr. K. still took us, and even forgave us after I explained what had happened.  He asked some questions, including one that surprised me – if milk spilled out the side of her mouth while she ate (it did).  Then he checked her tongue, expressing surprise at how far the frenulum was tied, “It’s tied practically to the end.”  (Dr. C. had said it was “borderline”.)

Then he took out a sterile kit with scissors, a long q-tip, and asked me to hold her chin.  Using the q-tip to hold the tongue up, he showed me what he was about to cut, took the scissors, reassured me that the crying was okay and I shouldn’t worry, and clipped.  It took about two minutes.  There was a bit of blood, but after another two minutes it had all but stopped bleeding.  Tova, the sensitive baby that she is, cried hysterically for long after the bleeding stopped.  Dr. K. said that she would calm down when I started nursing – and she did.  I took her to a corner of the waiting room and nursed.

She latched easily.  She sucked fast.  It took 40 minutes, but not 40 minutes like the previous 40 minute nursings had.  Previously, when I stopped after 40 minutes, I felt like she hadn’t finished but didn’t have the energy to argue.  This time, I was pretty sure she’d eaten enough.  And – what had been sore still hurt.  But as any nursing mother knows, previous sore spots and new sore spots feel different.  There were no new sore spots.  And she didn’t leak milk.

I went to the wheelchair bathroom (that’s what you do with a stroller; this one happened to have a change table, too) and changed her diaper, which had leaked.  It had been full before the doctor clipped her tongue, but for obvious reasons, I nursed before changing her.  Since Yitzchak had forgotten to pack me wipes, and I had decided not to ask because obviously he hadn’t forgotten, I had to clean Tova in the sink.

We went home; Tova pooped on the first bus; I nursed her on the second bus, stopped just before I had to get off, and finished nursing her fifteen minutes later when we arrived home.

When we got home, a few things happened:

1. YItzchak changed her diaper – and her poop, which had been green when I changed her diaper in Ashkelon, had suddenly turned mustard yellow again.

2. She went back to nursing for an hour.  Luckily, this was temporary.  Now she nurses for twenty or thirty minutes; more than that happens, but not often.  She can eat every two and a half or three hours.  I am starting to trust Tova to tell me when she’s hungry. But I still want to weigh her again, just to make sure I’m not making a mistake by trusting her.  She still spills milk sometimes, but after she finishes nursing, not while she’s still attached.

3. Nursing didn’t hurt anymore.  After two and a half months of torture – it didn’t hurt anymore!  I’m still in shock, a few weeks later.

I have a life again.  When I was nursing an hour out of every two, this is how my day looked:

Nurse.

Pee and drink OR eat OR shower

Nurse

Sort laundry

Nurse

Poop and eat a bit

Nurse

Shower and get dressed

Nurse

Put in a load of laundry

Nurse

Get the point?

In three words: It Was Awful.

But we did it.  Without a single drop of formula to ruin our baby’s gut.  If I hadn’t read up on the subject of formula, nursing difficulties, and tongue tie, I wouldn’t have made it.

If Yitzchak hadn’t been so helpful and supportive, I wouldn’t have made it.

And next time they tell me in the hospital that my baby has tongue tie, or I see that my baby has tongue tie, I will wait a week to see if the weight gain is normal.  And if it’s not, or the baby isn’t latching well, I will make an appointment with Dr. K. in Ashkelon and take the baby to get its tongue clipped at three weeks instead of at two and a half months.

I tell this story for a few reasons:

1. It is therapeutic for me to write it.  Very therapeutic.  This post has taken me about two hours to write, and I feel so, so, so much better now.

2. If this post helps anyone else, I will have done a lot.

3. I believe that it is important. Important to write about nursing difficulties, important to know that they can be overcome, and important to be educated.

I do not tell this story because I want everyone to know that I, Chana of Little Duckies, gave birth to a tongue-tied baby and am a radical anti-formula mother who insisted that her baby will have no medicine that is not medically necessary.

I would rather be able to choose who I tell my story to and who I do not tell my story to; this choice vanishes the moment I write the story on the internet.

But it is important, it can be done, and if any of you are in Maccabi in the south of Israel, use the “contact me” page and I will try to help you out.  After all, it was another mother online who helped me.

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Extremism Sometimes Pays Off

Yes, it does.  Because if you’re extreme about something, you usually know enough to argue your case when necessary.  And you usually are loath enough to agree to any alternative, that you stick to your decision and persevere.

[Sometimes it’s not a good thing to be an extremist.   But sometimes it is.]

Here’s a case in which Yitzchak and I were – are – both extremely glad that I am as extremist as I am.  (And my apologies for not posting for an entire month.  For most of the month, I was slightly out of it.)

I was in the hospital, trying to sleep, with a baby who wouldn’t stop crying every time she was put on her back.  From the leg movements, the reason was quite obvious: gas.  But what can you do when the only place to put the baby is a bassinet, you have no gas medicine, everything is closed, and even if it wasn’t you aren’t allowed to leave the ward?  Answer: Nothing.  You’re stuck holding the baby.

I was so exhausted (and this was nearly entirely the hospital’s fault) that I felt like I was about to drop her.  I’m not a person who cries easily, but I was crying then.  I just needed another pair of hands, and Yitzchak’s (even if he had been allowed to stay overnight, which he wasn’t, strange as it may be) weren’t available; he had to be close to home to pick Shlomo up from the neighbor’s in the morning.  And more than that, he needed to rest, because he had slept even less than me and had to take Shlomo to gan in the morning.

I refrained from calling Yitzchak, even though he had told me to call if I needed support, and just sent text after text, knowing that he would see them only in the morning.  One of the sentences I kept saying over and over [to myself, and to Yitzchak, before he went to sleep,] was, “Dang it/sheesh, I just need another pair of hands that I can trust won’t give her formula.  And I don’t know that I can trust the nurses.”

At about 3am, a nurse came in and we had the following conversation:

Nurse: Hi, is everything okay?

Me: Everything’s okay. (Except that she’s crying and I don’t know what to do, I can’t hold her for fear of dropping her or falling asleep over her; I need to sleep and there’s no one to hold her, and every time I put her down, she cries because she’s gassy.)

Nurse: She’s been crying a lot tonight.

Me: Yeah, she’s gassy. (Wow, thanks for stating the obvious.  Are you offering to hold her so that I can sleep?  Can I even trust you?)

Nurse: Maybe she’s hungry?

Me: No, she just ate.

Nurse: But she’s only nursing.

Me: Yes, but she’s not hungry, she just ate.

Nurse: She’s nursing, so she’s hungry.  Maybe you should give her a supplement?

Me: No, she’s not hungry.  (I knew I couldn’t trust you!  Thanks for telling me that I made the right choice in choosing not to ask for help.*)

Nurse: You sure you don’t want to give her a supplement?

Me: Yes, I’m sure.  She’s gassy, she’s not hungry. (And formula isn’t a solution to anything; it’s just bad.  Plus, she only needs 5cc at the moment, and she got it.)

The nurse left.  And I cried and texted Yitzchak, who, when he read the text at 5:30 in the morning, was furious at the nurse.

Yitzchak took Shlomo to gan, and then came with the carseat and a pair of hands to relieve me.  He was going to bring gas medicine (Simicol) but after speaking with Mom decided not to (because it isn’t really for babies under a week old.)

But seriously, if I wasn’t so dead-set that formula is a medicine to be used only when medically necessary (baby doesn’t have a mother, baby is lactose intolerant, mother doesn’t have milk or for some reason her milk is contaminated), and is permanently damaging in every other case, then I probably would have given in.

And then there was the nurse that told me that babies don’t get gassy before the fourth day – to which the response was a prompt [huge] burp.

Well-meaning, yes.  But definitely not that helpful.

And if I didn’t know better, I KNOW that I would have given in.  I know, because the only thing holding me back was the knowledge of the potential dangers that even a single bottle of formula can pose.

Extreme?  Maybe.

But it worked.

And continued working despite the issues that cropped up afterwards.

Because ignorance is not always bliss, and sometimes what you don’t know can hurt you, or your kid.

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*I believe, as I always have, that rooming-in is the best option, and I still believe it.  I also think – or rather, know – that if the delivery room staff, and protocols, had been different, I would not have been nearly so exhausted.  In other words, despite the difficulty presented here, I do not believe that it is good for the baby to be in a nursery, separated from its mother, just after being born; in fact, I believe the exact opposite.

A Bone to Pick: More on Nursing vs. Formula

I am planning to spend a day taking pictures, and then to spend a while posting pictures and commentary on life in Israel.  But before I do that, I want need to rant, get this out of me, and move on.

I have a [huge] bone to pick.  It has been bugging me since Shlomo was a couple of months old, over a year ago.  If you are super-sensitive and do not agree with my standpoint on nursing vs. formula feeding (read this to see if you do), stop right here, and do not read the rest of this post.  You’ve been warned; don’t say I insulted you.

Disclaimer:  I am not speaking, in this post, about the mothers forty years ago, thirty, or even twenty-five.  I am speaking about the mothers that I meet on the street, who are my peers, and are supposed to know (but evidently don’t) what I am about to write. 

I am also not referring, in any way, shape, or form, to mothers, or babies, whose doctors have informed them that they have specific medical needs that impede breastfeeding.  If you cannot breastfeed for a medical reason, either yours or your baby’s, that is what formula is for, and I support you completely.  Please do not read this post; it is not meant for you.

Now, back to the beginning:  I have a [huge] bone to pick with mothers who choose to formula feed.  It began when I started getting comments on why I was not feeding my baby formula.  I got even more annoyed when these same people started deriding me for continuing to nurse.  And I got extremely annoyed (even though, to my credit, I always kept my cool) when they started telling me that they knew more than I did, because they were pregnant again, or had already had two, when our [first] babies had just turned one.

I’m sorry; having two babies in one year (plus or minus) is nothing to be proud of.  No, it’s not.  Just forget it.  If it happens, it happens, but it is far from ideal, by any standard (including religious standards).  (Yes, nursing really does can work as birth control – more on that later.)

benefits of breastfeeding, composition of breastmilk, breastmilk, breastfeeding, nursing, formula, bottlefeeding, breastfeeding vs. formula, advantages of breast milk, disadvantages of formula, breast is best, breastmilk is better than formula, formula is not good for your baby, formula is not good enough, why formula is good, why breastmilk is good, healthy babies

from Green Grub Wellness

If I am right, and I know I am, do NOT put me down for it.  It annoys me (but does not, in any way, deter my determination to nurse).  It makes me want to ban formula from being sold in supermarkets and make it prescription-only, with each OB/GYN, psychiatrist, and pediatrician allotted a certain number of prescriptions per month, and no overlaps (i.e., you cannot receive a prescription from more than one doctor, and you are allotted a certain number per year).  If you choose not to nurse, the least you can do is not flaunt it; flaunting the fact that you chose, of your own free will, to do something harmful to your child is disgusting and absolutely repulsive.  That’s first off.

Second of all, do not tell me that I am wasting my time and energy nursing and pumping, because you know so many babies who were formula fed and were fine.  You just end up sounding like an ignoramus (to put it nicely) who is talking about things that she obviously has never researched.  If you knew what you were talking about, you’d know that breast milk is the best, with only a few extreme medical exceptions (such as the mother being addicted to drugs, on certain medications, or a baby who is extremely lactose intolerant), and that there is a direct correlation between formula and all sorts of health problems.

And third, do not tell me that your baby is just as well off as mine is, even though he’s being formula fed.  Go get a life, and get an education.

Sure, we all know some breastfed babies who were sick a lot, and some formula-fed babies who are hardly ever sick.  Well, first of all, anecdotes do not make evidence.  Second, imagine what would have happened if the breastfed baby, who seems to always get sick, had been formula fed.  He would’ve been a lot worse off than he is now, and a lot sicker.  You can’t know, when your baby is born, whether he will have food sensitivities and frequent ear infections, or not.  And because you can’t know, you have to give your baby the best stuff you can – i.e., breast milk – so that he can grow up as healthy as possible.

benefits of breastfeeding, composition of breastmilk, breastmilk, breastfeeding, nursing, formula, bottlefeeding, breastfeeding vs. formula, advantages of breast milk, disadvantages of formula, breast is best, breastmilk is better than formula, formula is not good for your baby, formula is not good enough, why formula is good, why breastmilk is good, healthy babies

from Ten Steps

If it turns out that your baby has sensitive skin and allergies, be glad you’re breastfeeding, because he’d be worse off without it.  And if it turns out that your baby is pretty healthy, then think how much healthier he’d be, in the long run, if he had been breastfed.  Did you know that Crohn’s, which shows up in young adulthood, affects nearly double the number of young people who were formula-fed as those who were breastfed?  There are many other illnesses that are the same way.  Obviously, this doesn’t mean that breastfed babies won’t get sick later on, or that formula-fed babies will.  It just means that these are the facts, and you can weigh the risks of formula for yourself.

If you choose to formula-feed your baby, you are taking a serious gamble with his or her future health.  Don’t tell me that formula is good for your baby, or that I should stop nursing.

If you would like to see my sources, click on all the links.  Some of them are more informal, but some are pretty impressive.  All of them together are a small part of the wealth of research supporting breastfeeding and showing how formula is harmful.

Want to know why I think it’s my business how other people feed their babies?  Click here.  It’s long, but it states all the reasons I would have given you, in addition to others that I didn’t even think of.

For your information:  I Googled “formula is better than breastfeeding,” just to see the other side of the argument, and came up empty-handed.

Here is an understated summary of how breastfeeding benefits babies:

benefits of breastfeeding, composition of breastmilk, breastmilk, breastfeeding, nursing, formula, bottlefeeding, breastfeeding vs. formula, advantages of breast milk, disadvantages of formula, breast is best, breastmilk is better than formula, formula is not good for your baby, formula is not good enough, why formula is good, why breastmilk is good, healthy babies

from The Alpha Parent

Breastmilk vs. Formula

Similac formula cans

Less than a week and I’m posting about controversial subjects already, huh?

Here in Israel, all formula cans bear a warning in both English and Hebrew that “breast is best“, formula should only be used as a last resort, and only with a pediatrician’s consent.  I assume, logically, that this is required – why else would someone undermine the very product they are selling?

Yitzchak has often described his mother as one of those people who can give 3-hour lectures on why formula is bad for your baby.  Knowing her, I believe it.  All she has said to me on the subject is that breastmilk from a bottle isn’t nearly as good as breastmilk during nursing.

This is true.  If you pump your milk and refrigerate it, it has a 24-hour (tops 48 hours, but the recommended is 24) life.  In this case, all the antibodies are present – but usually a 180 ml. bottle will only include foremilk or hindmilk, not both.  Try pumping into a 240 ml. bottle!  It’s kind of depressing, unless you have a really good electric pump that gets every last drop out.  Also, if you only have 10 minutes, you probably won’t get every last drop.

Frozen (and then thawed) milk loses 40% of its antibodies.  That’s still 60% more than formula, but, especially if your baby is less than six months old, it’s not good.  Why?  Because babies less than six months don’t have a good immune system, so a baby who isn’t getting antibodies from Mom, is completely exposed to anything and everything.  Actually, babies don’t have a fully developed immune system for a few years, but we’ll leave that aside for the moment.

Now that I’ve gone off on a tangent, let’s get back to the point.  It really bothers me when mothers decide that pumping takes too much time, or nursing is too hard.  That’s what lactation consultants are for.  That’s what LLL is for.  The most common “excuse” I hear is that a mother doesn’t have milk.  Um, that’s kind of odd.  Because in the olden days, if you didn’t have milk, and you didn’t have enough money to hire a wet nurse (and most people didn’t), your babies died.  So, that horrifically scary gene in which a mother doesn’t have milk probably wasn’t perpetuated enough for it to have such a large influence (think 20%) on today’s mothers.  So no, that’s not an excuse.  But if your baby isn’t latching right, you WILL have milk problems, because your body is not being told to produce milk.  Well, obviously. . .

What I’m trying to say is this: Nursing is important.  It is not something to be thrown out lightly, and it is something that should be required of anyone able to.  Obviously, I am not talking about preemies who can’t suck, mothers whose milk is contaminated by an illness or by medication, or even babies who for some reason or other can’t nurse or need formula supplements.  Those people, and I am going to say this loud and clear, SHOULD NOT be made to feel guilty because they are not breastfeeding.  In these cases, formula is best, and a mother who cannot nurse is not at fault.  I am not talking to, or about, these mothers in this post.  I am talking to and about situations in which neither mother nor baby has any medical contraindications for breastfeeding, and yet the mother chooses for some reason or other not to nurse, or to stop early.  That bugs me.  It really does.  When you have a child, you are taking it upon yourself to care for him or her in the best way possible.  And part of that means nursing him or her until at least one year, if not two.

Oh – and about the pumping?  I told my MIL that I had to finish the semester, so I didn’t have a choice and he needed to be able to take a bottle.  Then she gave him the bottle I had pumped, because, of course, Shlomo had decided to wake up just as I finished pumping.

I know, I know, I’m not allowed to say this.  Go ahead, start the debate. *hides under table for protection*

Thanks to the debate here for giving me the inspiration for this post.