Please reply directly to me or at least cc a copy to me at
[log in to unmask] I am usually set to nomail and will not
necessarily see all answers posted to the list.

I would like information about parenting customs in Egypt, preferably
from someone in or from Egypt.

I have been asked to testify in a child protection case, for a family I
do not know and only met the parents this week. The family emigrated
from Egypt last year, and have a preschool age child and a breastfeeding
infant, or at least he was breastfeeding until protective services
removed both children  from the home two months ago.  My role is not to
weigh in on the question of abuse, but to help the infant regain access
to his mother's breast, to cite the risks of formula feeding, etc., and
I also in my affidavit added the neurodevelopmental and neurobehavioral
risks simply of the separation itself, even if breastfeeding were not
involved.

The parents recently obtained private counsel, and after this long
separation, with only brief once a week visits, are requesting both more
appropriate visitation and a more speedy resolution of the case so that
breastfeeding can resume.

No one is alleging abuse against the infant, but it is considered normal
caution in our state (and probably all others) if there is a young
infant to remove the infant if the older child is at risk.

Byeond what I have been asked to do, I am simply perplexed by the
contradictions in this case. This is not a socially isolated family.
The older child had been breastfed, as proscribed in the Koran, for two
years. They have an estblished relationsip with a doctor in Egypt, but
attended a university clinic for care since arriving here. Their atty is
making contact with the Egyptian doctor, but I am seeking independent
information, for my own understanding of the cultural situation.

The situation is confusing to me, since I have this view that the
bonding afforded by breastfeeding acts as an immunization against abuse,
and also this view that it is difficult for breastfeeding to thrive,
i.e. for a mother to continue breastfeeding, in an abusive environment.
( See my note below describing a reference by Acheson*). I wonder if
that is perhaps more true in the US, where women have to "invent"
breastfeeding for themselves, so have more trouble establishing
breastfeeding in an environment of abuse. Could it be that it is less
true where the larger culture is so supportive of breastfeeding that  a
woman can establish that connection despite domestic violence or child
abuse by her spouse, for example?

I wonder if anyone can tell me about typical childhood discipline
culturally acceptable in Egypt-- is corporal punishment common? And if
so, what kind? Are instruments used, or the hand? At what age? ( 2, 3,
4, years old?) for what kind of infractions? Who does the punishment?
This family actually says that they do not use corporal punishment, and
the trauma was child accidents playing, etc., but the photographs would
appear to contradict this. It is very confusing.

What about child abuse in Egypt? Does it coexist with breastfeeding?
Does 2 years of breastfeeding seem to protect against abuse? Does
Egyptian culture define the line between discipline and abuse
differently than we do here? Is child abuse a well recognized problem,
or are their cultural barriers to identifying abuse? The Egyptian doctor
told the parents' atty that this child had "easy bruising" yet the lab
tests here did not confirm a disorder.

If there are any Egyptian physicians online, I would like to know if
such a previous diagnosis (with reference to a "vitamin D deficiency")
would suggest to you that the doctor was actually missing a case of
abuse or is there something else going on here?

Please advise.

thank you, Tina Smillie, MD
again, please reply directly to me or at least cc a copy to me at
[log in to unmask]
I am usually set to nomail and will not necessarily see all answers
posted to the list

* In one study in the US Northwest, where 95% of women, regardless of
financial status, began breastfeeding at birth, and, at 6 weeks
post-partum, 85% of them were still breastfeeding, it is informative to
look at the 15% of women who were not breastfeeding. The mothers who
were not breastfeeding at six weeks were 38 times more likely to have
been reported to be in an abusive family situation than were mothers who
were breastfeeding at six weeks. Indeed, of the 611 families where the
mother was still breastfeeding at six weeks, only one family (0.2%) had
any prior history of domestic violence reported, whereas, of the 113
women who never initiated breastfeeding or who had stopped breastfeeding
by six weeks, there were seven families (6.2%) where domestic violence
or child had been previously noted. (Acheson L, Arch Fam Med 4:650-52.
1995)

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