4/28/09

CALL TO ACTION ON BREASTFEEDING

The U.S. Department of Health & Human Services' wants YOUR feedback about how to tackle problems related to breastfeeding, they want your ideas for a new plan of action. Go to the link at the bottom of the article to submit your opinions.

Breastfeeding is unquestionably healthier for mothers and babies compared to feeding with infant formula. The scientific literature is clear. Numerous reviews of the medical literature have confirmed these benefits. But life in America often creates barriers to breastfeeding and makes it hard for women to breastfeed. It is time for our society to get serious about giving families the support they need to be successful with breastfeeding. For this reason, the U.S. Department of Health & Human Services (HHS) would like to open up a national dialogue on how to make breastfeeding easier in this country.

The U.S. Department of Health & Human Services' (HHS) Office on Women's Health, Office of the Surgeon General, and Centers for Disease Control and Prevention want your input on a new HHS Call to Action on Breastfeeding.

Nearly 10 years ago, the HHS Blueprint for Action on Breastfeeding was released. This was the first comprehensive breastfeeding policy and action plan for the nation and was the result of broad collaboration and public input. Today, more mothers are starting and continuing to breastfeed, but our society has changed dramatically since 2000, and many problems related to breastfeeding persist. These factors point to a need for a new national plan of action. Public input is key to developing this plan.

We are seeking comments from individuals and organizations about breastfeeding in the United States . We welcome your suggestions about policies, activities, or other initiatives to protect, promote, and support breastfeeding that need to be considered for inclusion in our national action plan for the next decade. We are especially interested in new ideas that will increase equity in breastfeeding rates among all racial, ethnic, and socioeconomic groups. Ideas should build on programs and policies that are recognized to be effective or evidence-based. In addition, we welcome suggestions to adopt, expand, implement, research, or improve existing strategies.

Visit this link to submit your comments (deadline is May 31, 2009):
http://www.blsmeetings.net/owh_call_to_action_on_breastfeeding/index.cfm

On the right side of the page are 12 topic areas for you to submit your comments. Individuals and organizations may comment on any or all of the 12 areas. In addition, you may wish to read and comment on comments from others in any of the topic areas. We very much appreciate your participation in this important work. All recommendations will be considered by the Steering Committee of Federal representatives from the HHS Office on Women's Health, the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the Health Resources and Services Administration, the Indian Health Service, the Eunice Kennedy Shriver National Institute for Child Health and Human Development, and the Office of the Surgeon General.

United States Breastfeeding Committee
2025 M Street, NW, Suite 800
Washington , DC 20036
Phone: (202) 367-1132
Fax: (202) 367-2132
E-mail: office@usbreastfeeding.org
Web: http://www.usbreastfeeding.org/

The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of 41 nationally influential professional, educational, and governmental organizations. Representing over half a million concerned professionals and the families they serve, the USBC and its member organizations share a common mission to improve the Nation's health by working collaboratively to protect, promote, and support breastfeeding.

4/27/09

Of service

I was called as a back up doula to step in for a local doula last Saturday. It was marvelous to be called upon to serve this family.

Mom was lovely, handling most contractions like a peaceful song, toning low and letting her body tell her when to move. Mom's bag of water stayed intact for a long portion of labor - creating lots of extra pressure. She loved the double hip squeeze and any fears I had that I was "doing it wrong" were dismissed when mom said mid contraction "ohhhh-i love that."

:)

Mom loved to be talked to gently through contractions, "That's it, take some deep cleansing breaths, thats right, breathe the baby down." she would sail through the contraction.

I had only planned to be away as a back up doula for a few hours but ended up staying at the hospital almost 6 hours just entranced in Mom's labor. The Mom's main doula was present and I had to leave to nurse Jude because I didn't bring my pump.

I left before the baby was born, before Mom could claim her reward for her body's hard work, but I left feeling incredible.

The reward of a doula's work is immediate. Just the look in a moms eyes when she swears she can't go on, and you suggest a new position, work on breathing or remind her of her body's strength, and she reaches within herself to take labor....one contraction at a time.

4/23/09

Being upright IS better!

Most of us that have labored know that being upright, standing, walking or squatting helps bring the baby down. This article brings the science to why it can speed your labor and reduce epidural requests. Enjoy!

See the original article here: this NY Times article
Having a Baby: Activity May Decrease Length of Labor
By NICHOLAS BAKALAR
Published: April 20, 2009

Lying down during the first stage of labor may slow the process, a new review of studies has found, but if the expectant mother sits, stands or walks around she may safely bring matters to a quicker conclusion.

The analysis, published April 14 in The Cochrane Collaboration, combined data from 21 studies with a total of 3,706 women. The analysis, published April 14 in The Cochrane Collaboration, combined data from 21 studies with a total of 3,706 women.

Women who lay down — lying flat, in a semireclined position or on their sides — were no more likely than those who sat upright or stood to have unexpected needs like a Caesarean section. And there was no discernible difference between the groups in maternal satisfaction or the amount of fetal distress.

But over all, those who sat up, stood or walked spent an average of one hour less in the first stage of labor (strong, regular contractions with 3 to 10 centimeters’ dilation of the cervix) than those who did not, and they were slightly less likely to require epidural anesthesia.

Annemarie Lawrence, the lead author and a midwife at the Townsville Hospital in Queensland, Australia, suggested that gravity helps.

“The baby’s head pushing down on the cervix improves the regularity and intensity of contractions,” she said.

“Women should be allowed to move around freely. What this study shows is that lying down isn’t safer in the first stage of labor.”

4/21/09

Acupressure Hand Technique

I am adding combs to my birth bag! This is a great way for moms to get the benefits of accupressure during contractions!

These points lie along the creases of the hands where the fingers join the palm. These are said to help release endorphins (the body's natural painkillers) into the body.

Women can hold a small comb in the palm of their hand so that the teeth of the comb are touching these points. They can then grip the comb during contractions, applying pressure to the level that feels the most useful.

4/17/09

Breastfeeding Boosts the National Economy



Nursing by Numbers:
How Breastfeeding Boosts the National Economy By Olivia CampbellWeb Exclusive, April 2009

Forget about retail therapy, breastfeeding is an economic stimulator that's completely free. According to USDA research, infant formula-feeding exacts a toll on national pocketbooks.

"Breastfeeding and the provision of breastmilk exclusively for the first 6 months This research promises the United States improved health of both its citizens and its economy," the US Breastfeeding Committee said in response to the USDA report.


Most people understand how nursing benefits baby's health and parent's finances, yet few people realize the extent to which breastfeeding benefits the mother's health and how this all spells savings for the entire nation.

Research shows breastfeeding decreases the incidence and/or severity of the following illnesses in childhood (and in many cases also into adulthood):- Ear infections- Bacterial meningitis- Respiratory infections and viruses- Sudden infant death syndrome (SIDS) - Asthma - Allergies (nasal and skin)- Urinary tract infections- Gastrointestinal infections- Diarrhea- Lymphomas, leukemia and Hodgkin's disease - Autoimmune thyroid disease - Type 1 and type 2 diabetes - Ulcerative colitis and Crohn's disease - Necrotizing enterocolitis- Multiple sclerosis - Obesity- Bacteremia- Celiac disease- Botulism- Pneumonia- Lung disease- High blood pressure- Anxiety/stress- Bed-wetting- Nearsightedness- Increased intellectual, developmental, and cognitive aptitudeFor the nursing mother, breastfeeding can help protect against the following diseases:- Breast cancer - Ovarian cancer- Uterine cancer - Thyroid cancer- Type 2 diabetes - Osteoporosis - Lupus- Rheumatoid arthritis- Obesity

In 2001, the USDA concluded that if breastfeeding rates were increased to 75 percent at birth and 50 percent at six months, it would lead to a national government savings of a minimum of $3.6 billion. This amount was easily an underestimation since it represents savings in the treatment of only three of the dozens of illnesses proven to be decreased by breastfeeding: ear infections, gastroenteritis, and necrotizing enterocolitis.


"Choosing to give your baby formula results in an increased risk for ear infections, for diabetes, for leukemia and so on. We as a nation need to understand that it is not that breastfeeding lowers the rate of sudden infant death syndrome (SIDS), but that choosing to feed an infant formula increases his risk of sudden infant death syndrome," said Stacy Kucharczk, a certified lactation consultant and pediatric nurse.


The Centers for Disease Control and Prevention's 2008 breastfeeding report card found that since 2000, breastfeeding of newborns has increased from 64 to 74 percent, and from 29 to 43 percent at six months. However, at one year, only 21 percent of babies continue to be breastfed. The American Academy of Pediatrics (AAP) recommends breastfeeding for at least one year. The World Health Organization recommends breastfeeding for two years.

The AAP says each formula-fed infant costs the healthcare system between $331 and $475 more than a breastfed baby in its first year of life. The cost of treating respiratory viruses resulting from not breastfeeding is $225 million a year.


"Insurance companies should realize that covering a home visit by a board certified lactation consultant would result in significant healthcare savings down the road," said Kucharczk.
"Savings in the short-term for decreased pediatric health care visits for common acute illnesses, such as ear infections, gastrointestinal illnesses, and upper respiratory infections to name a few. Savings in the long-term from lower rates of chronic illnesses, such as diabetes, asthma, certain types of childhood cancers, and obesity—as well as lower rates of premenopausal breast cancer and ovarian cancers in the mother."

Health benefits for the nursing mother include a reduction in risk of many cancers and other serious diseases, during and after lactation. The key to achieving the maximum benefit to the baby, mother, and the economy appears to be extended breastfeeding, which is nursing for more than just six months or one year.


"We need to help mothers understand that extended breastfeeding does matter," Kucharczk said. "I often point out to mothers that the studies demonstrating the benefits of breastfeeding often show a dose-related effect, as in some breastmilk is good, but more is better."

Lactation duration and breast cancer risk are inversely related. The longer a woman breastfeeds the less likely she is to get pre- or postmenopausal breast cancer, even with a family history of the disease.

Re-examination of data from 47 international studies found that for every year a woman breastfeeds, she reduces her risk of breast cancer by an average of 4.3 percent. The risk is reduced a further 7 percent by simply having a baby.

For example, if you had three children and nursed them each for two years, your risk for breast cancer would be reduced by 46.8 percent. In fact, one study found that women who've nursed for six years or more reduced their risk of breast cancer by as much as a 63 percent.

The multi-study report estimated that breast cancer rates could be cut by more than half if women increased their lifetime breastfeeding duration. The National Cancer Institute reported the national expenditure on breast cancer treatment in 2004 was $8.1 billion, meaning extended nursing could save upwards of $4 billion a year.

For each year of breastfeeding, a woman decreases her chances of getting type 2 diabetes by 15 percent, reported a study in the Journal of the American Medical Association in 2005. So if we consider the woman from the aforementioned example, in her six years of breastfeeding she's earned a 90 percent reduction in her risk of developing diabetes.

The National Institute of Health estimates that between 10 and 11 million American women have type 2 diabetes. The estimated cost of their treatment and lost wages is roughly $78 billion a year. This expenditure could be cut drastically by increased extended nursing rates.

For the national Special Supplemental Nutrition Program for Women, Infants and Children (WIC), supporting a breastfeeding mother costs about 45 percent less than a formula-feeding mother. Every year, $578 million in federal funds buys formula for babies who could be breastfeeding.

A year of purchasing formula can cost a family between $700 and more than $3,000. Many women who go back to work soon after giving birth might think the expense of formula is worth the convenience. The extra medical issues of formula, for mother and child, make the cost more than monetary.

For employers, formula-feeding results in more health claims, more days off for sick children, and decreased productivity. It benefits employers in the long run to provide a time and place for mothers to pump breastmilk. A few minutes off the clock is more than made up for by the lifetime of health enjoyed by nursing babies and mommies.

The Oklahoma Breastfeeding Hotline now open

From Oklahoma State Department of Health

A new telephone support hotline is now open to answer questions about breastfeeding. The support line is a partnership of the Oklahoma State Department of Health (OSDH) Women, Infants and Children (WIC) Program, Title V Maternal and Child Health Service (MCH), and University of Oklahoma Health Sciences Center OB/GYN Department.

The Oklahoma Breastfeeding Hotline, 1-877-271-MILK (6455) is available to nursing mothers, their families, partners, prospective parents, and health professionals seeking breastfeeding support and information.

“We are pleased to be able to provide this service as part of the health initiatives to make Oklahomans strong and healthy. Breastfeeding provides a good start in life for mother and child.

It helps improve the baby’s immune system to fight off numerous diseases as well as reducing obesity and diabetes for both mother and child,” said Becky Mannel, Lactation Manager at OU Medical Center.

“We hope this hotline will help more mothers overcome some of the barriers they face to continue to breastfeed,” said Interim Commissioner of Health Rocky McElvany, MS. “This hotline is part of a long-range plan to help improve the health of Oklahoma’s babies.”

The Oklahoma Breastfeeding Hotline is open 7 days a week, 24 hours a day amd staffed by International Board Certified Lactat ion Consul tants ( IBCLCs) provided by the OU Medicine Lactation Team.

Callers may leave a message for a return call that day. Those with urgent questions may page the IBCLC on call. The hotline cannot provide a medical diagnosis. All medical questions should
be directed to a health care provider.

The Oklahoma Breastfeeding Hotline provides accurate, up-to-date information for common breastfeeding issues and questions about:
Not making enough milk
Baby refusing to nurse
Breast or nipple pain
Medications and breastfeeding
Working and breastfeeding
Breast pumps
Breastfeeding in public
Weaning

Referral information is provided including outpatient lactation services available in Oklahoma, La Leche League breastfeeding support groups, and breast pump rental locations in Oklahoma.

For more information about the hotline contact: Becky Mannel, Lactation Center Manager at Rebecca-mannel@ouhsc.edu.

Childbirth Affirmations

Buddha said "We are what we think. All that we are arises with our thoughts. With our thoughts we make the world."

This is very true and I think when we are pregnant we really need to train our brain to focus on the positive affirmations when we are pregnant.

Affirmations used before and during labor and birth can help build a woman’s confidence tremendously. Positive statements allow a woman to focus on what feels right for her, what is possible, and it kicks in the Law of Attraction in a huge way.

I see women who have so much self doubt arise because of ALL those discouraging words tossed around when it comes to birth experiences, personal opinions and sometimes even the well intentioned but misinformed suggestions of our caregivers, family, friends, and the media.

Here is a beautiful video with some lovely affirmations that you can focus on. I encourage you to create some affirmations of your own that you and your partner can refer to prenatally and during labor.

4/16/09

My Services

As a DONA trained doula working towards certification I will be accepting clients as my schedule allows. I offer low rates, a sliding fee schedule, bartering opportunities and pro bono services for those that qualify. Payment plans are also available.

My Birth Doula packages include:

  • 2 prenatal home visits:
    -On our 1st visit I will help you create a birth plan and we will discuss your options to achieve your optimum birth experience.
    -On our 2nd visit we will go over relaxation and labor management techniques. I like to do this in your home so we can practice the relaxation for the early labor stage which you will likely experience at home before you go to the birth center/hospital.
  • Unlimited support availability by phone and email.
  • Individualized handouts.
  • On-call labor support availability beginning two days prior to your estimated due date.
  • Back-up Doula in the event that I am unavailable.
  • Continuous labor support throughout your labor and early postpartum.
  • Birth notes written for you to keep.
  • Help to establish early breastfeeding and bonding.
  • Two postpartum visits.
  • Additional breastfeeding support, resourcing, and advocacy.


You deserve a great birth experience!

I am there to help keep you on course with relaxation & pain coping techniques, to help you stay in rhythm with your body during contractions, to serve as an advocate helping to educate you about your birth choices; I serve as a coach to fathers and partners during labor to help them provide optimum support to you.I humbly serve to help you achieve your birth goals, whatever they may be – epidural or no epidural, hospital or home birth. It’s YOUR birth plan, not mine.

Email or call me if you have any questions or would like to meet for free to discuss your options.


You deserve the victory of a fulfilling birth!

4/15/09

Time is money


I saw this car driving on a local interstate and I had to take a picture. It cracks me up.

What does this mean, exactly? The phrase "Time is money" seems almost like it belongs in a sales floor pep talk to car salesmen. The phrase definitely shouldn't belong in the Maternity ward. But here we, and the business of birthing babies is all about sales.

Here are some of the more common sales pitches we hear...

"Why wait? Have your baby now! The earlier the better, waiting to full term is just a suggestion these days!" (In normal circumstances babies come out when they are fully matured and ready)

"Big baby means early induction, don't want shoulder dystocia!" (Even though prenatal fetal measurements are almost always inaccurate and research shows that a "big baby" doesn't mean shoulder dystocia is going to occur. Research actually shows that interventions such as a induction can make you more prone for shoulder dystocia and 50% more likely to have a Cesarean)

"You want a VBAC? That's too risky, you should just schedule your c-section now, hun." (It's fear mongering. The risk to most moms for in uterine rupture during a VBAC is RARE. It's like we are telling women that their bodies don't work and they can't deliver the baby without medical interventions)

Some care providers are throwing around Inductions & Cesareans offering them up like shiny new cars. Moms get drawn into to the idea of holding that baby sooner, scheduling births so that they can schedule family flights accordingly, etc. all for the sake of convenience. And, care providers are selling the benefits, but what about ALL the risks to mom & baby?
Where is informed consent?

Home births 'as safe as hospital'

http://news.bbc.co.uk/1/hi/health/7998417.stm

The largest study yet on the safety of home births suggests that, in most cases, the risk to babies is no higher than if they are born in a hospital.

Research from the Netherlands - which has a high rate of home births - found no difference in death rates of either mothers or babies in 530,000 births.

However, only women who were deemed to be at low risk of complications were included in the Dutch study.

UK obstetricians welcomed the study but said it may not apply universally.

Home births have long been debated amid concerns about their safety.

But the number of mothers giving birth at home has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research - published in the BJOG - was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option.

But a comparison of "low-risk" women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

"We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife," said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

"These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth."

Hospital transfer

Low-risk women in the study were those who had no known complications - such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose - including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

 The NHS is simply not set up to meet the potential demand for home births 
Louise Silverton 
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background - the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

 Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital 
RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was "a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

"However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

"There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies."

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births "in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: "Women need to be counselled on the unexpected emergencies - such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage - which can arise during labour and can only be managed in a maternity hospital.

"Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home."

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: "All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies."


4/6/09

The new "natural" Caesarean

Below is a article from UK Times online. I think it is wonderful that doctors finally see the differences in the mother to baby bonding experience in a Cesarean, a leading midwife and author, Jenny Smith points out several ways to have a "natural" C-section if you must have one for medical reasons. She suggests:
  • Ask if the surgical team will play music and if your partner can take photographs.
  • Ask for an epidural dose that won't make your arms “heavy”.
  • Ask for the screen to be dropped so that you can see your baby being delivered.
  • You can ask to call the sex of your baby yourself.
  • Ask the midwife to pass your baby directly to you so that you can enjoy skin-to- skin bonding immediately.
  • Ask that the father may perform the second “cutting of the cord” while the baby is in your arms.

I would also add that I think its important to not wash the baby and to massage the white vernix covering into the skin. The purpose of the vernix in the womb was to protect the skin like a moisturizer. It can be massaged in just like lotion. It is not dirty and does not need to be removed. In the hospital, you can choose not to have the vernix removed, but you need to request this ahead of time. Also, the vernix contains familiar smells of the amniotic fluid which can be very soothing for a newborn baby.

With more babies being born by Cesarean section, a new movement is campaigning to make the event a more "natural" experience.

See full article at: http://www.timesonline.co.uk/tol/life_and_style/health/article6028478.ece


4/1/09

Birthrite

We've all been waiting for you.
For you.

Your arrival has been marked,
has been recorded on earth, in the universe,
in the galaxies,
in all of space,
in all of time.

You come with a birthright,
written in love and sung through all Creation in words which promise that no matter where you're at,
you're home that no matter who you're with,
you're welcome that no matter who you are,
you're loved.
Welcome.

-Rita Ramsey

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