Caesarean risk higher when labor induced

A new Australian-based study shows that first-time moms are more likely to "need" a Cesarian when induced:

In a study of more than 37,700 women, Mary-Ann Davey, an epidemiologist at La Trobe University's Mother and Child Health Research, looked at all uncomplicated first births in Victoria between 2000 and 2005. The mothers were aged 20-to-34 when they were between 37 and 41 weeks' pregnant.

Of those, 9.4 per cent had their labour induced — 6.1 per cent of public patients and 14.1 per cent of private patients.

"These women had no medical indication recorded for induction of labour," Ms Davey said. "Common reasons given were 'social' or 'post dates' (but less than 41 weeks' gestation)."

She also found that more women who were induced had epidurals then those who weren't induced. Although her findings are still preliminary, Ms Davey said there was "a substantial and significant increase in the number of caesareans" following an induced labour.

Pregnancy vs. Childbirth

Baby Keeper posts 8 Do's and Don't's for a Safe and Healthy Birth.

Eating Durring Labor

A new study finds:

Women permitted to eat low-fat, low-residual foods during labor were no more likely than women who received only water to have labor, delivery, or neonatal complications in a randomized study conducted in the United Kingdom.

Moreover, women who ate rated their overall labor experience as significantly better than that of women who were only allowed to drink water, according to a study presented in poster form at the annual meeting of the Society for Gynecologic Investigation.

(link)

Liver function and Hyperemesis

Amy's Humble Musings has a great post on the subject (make sure to read the comments).

The Nursing Room Locator

Thanks to My Baby & More, check out The Nursing Room Locator. As the author states:

I firmly believe that every mother has the right to nurse her child wherever she sees fit, be it a bench in the mall or at the coffee shop down the street. That said, sometimes you just want a quiet place to feed your baby.

So she's compiling a list.

Birthing With Midwives

Here's a new site that may be helpful to the consumer as well as to those in the birth biz:

Birthing With Midwives

Breastfeeding and HIV-Positive Moms

Exclusive breastfeeding halves HIV infection risk for baby:

After three months, the HIV infection rate among the exclusively breastfed group was 4.04 percent.

Among the mixed group, babies who received formula milk in addition to breast milk were twice as likely to acquire HIV infection. And those who had solid food -- typically porridge -- ran 11 times the risk of infection compared with the breastfeeding-only group.

In addition, the death rate at three months among the exclusively breastfed babies was 6.1 percent; among children given replacement feeds, it was 15.1 percent.

New Email Address

Please note that I've changed my email address to (in standard format) mommyblawger at gmail.com. Thanks!

Traveling with Breastmilk

Mothering Magazine has a nice piece on Traveling With Breastmilk, including some creative tips on packing it and technical advice on how long it stays good:

When our country goes to orange alert at the airports, mothers who travel without their babies are not allowed to take their pumped breastmilk in the cabin of the plane with them. Women have traditionally been encouraged to keep pumped breastmilk on ice, so they often took it in their purse or carry-on bag. Now, however, toting breastmilk in your carry-on bag without a baby has become officially forbidden and deemed "suspicious." Of course, if you had the baby with you, you wouldn't need to pump and carry precious breastmilk. What is a mother to do? Get clever.

New research in the journal Breastfeeding Medicine has come to the rescue. The researchers took frozen breastmilk and thawed it, refroze it, refrigerated it and left it out at room temperature. Essentially, they beat it up. What did they find? Breastmilk is fairly robust and does not grow bacteria easily nor lose vitamins A and C or free fatty acids (FFA) to any degree that would harm a full term baby. Breastmilk fresh from the breast or thawed in a clean container can be left at room temperature for less than 8 hours. This means on a day trip, you can safely pack expressed breastmilk in your checked bag and take it home just as it is.

Delayed Cord Clamping

Delayed Cord Clamping at Birth May Reduce Neonatal Anemia

No Benefit to Fetal Oxygen Monitoring

This is an old article, but one that I think is important, and didn't get much press at the time:

New Childbirth Technology Tanks: A study finds no benefit from monitoring fetal oxygen during labor. The rate of Cesarean deliveries is not reduced.

Breastfeeding Benefits

According to recent studies, being breastfeed may increase one's social mobility and protect mothers from heart attacks:

[Study leader Alison Steube of the Harvard Medical School] said: "Pregnancy is associated with a number of things that you normally wouldn't want to happen to your body, including storing more fat and having higher than normal levels of fatty acids circulating in the blood.

"By breastfeeding, mothers can convert those energy reserves into nutrition for their infants. Breastfeeding isn't just good for babies, it's good for mothers, too."

Breastfeeding Enhances Children's Vison

According to a study in the January 2007 issue of American Journal of Clinical Nutrition, children between the ages of 4 and 6 who were breastfed as infants performed better on one test of visual acuity than did those who were formula-fed:

During the first six months after birth, the formula-fed children were randomly assigned formula either with DHA or without DHA added.

The researchers found that breast fed children were significantly more likely to have better stereo-acuity than formula-fed children. Among the formula-fed children, addition of DHA into the formula did not make any difference in stereo-acuity measurements.

Although DHA has been proposed to be the benefiting agent in breast milk, the fact that fortification of formula with DHA did not make any difference in stereo-acuity suggests that the added DHA may not work or there is something else in milk that enhances the vision.

(link)

Acupuncture for Childbirth

Here's something you don't see every day:

Doctors Experiment With Acupuncture During Labor

Doulas in the news

About once a week, some hometown newpaper interviews local doulas and does a (usually) nice story about them. This one out of Ft. Wayne, Indiana had this interesting tidbit:

While Indiana does not require doulas to be certified, the Starks say it is something they will look for in any doula they might hire for a subsequent birth. Fort Wayne area doulas charge $350-$500, depending on the extent of their role. In New York, the going rate is about $1,800, said Saalfrank, whose sister is also a doula and childbirth educator.

Wow, $1800 is the going rate for a midwife in many places.

The Next Breast Thing

Wet-nursing seems to be making a comeback.

As the article mentions, the World Health Organization "recommends a baby should be breastfed by its mother in the first instance, or drink her expressed milk. If that is not possible, the next preference is for human milk from a donor and formula should be a last resort."

Andrew at One Year

It has been quite a while since I've written an Andrew update. The little pea-pie punkin' guy turned one this week. And to celebrate the occasion, he is walking! Over the last couple weeks, he had been taking a few tentative steps. Just between pieces of furniture and such. But the day before his birthday, he was walking with a "walker" toy and it got hung up on a rug. So he just continued on without it, half-way across the living room. He still crawls most of the time, but he loves practicing his new skill.

Other amazing things that Andrew is doing ...

Yesterday I was emptying the dish washer and putting the silverware away. Andrew grabbed a spoon and, instead of sticking it in his mouth like he usually does, he stuck it in the silverware drawer. Later I was sitting in a chair next to the dryer (a trick I discovered while I was pregnant) folding laundry and stacking it on the open dryer door. Andrew cruised over to the nearby shelf where we keep clean kitchen towels, grabbed one, and placed it on the dryer door. He did this about three times.

Andrew is using about three signs - the signs for "more" (which he does by pointing his index finger to his palm, just like his brothers did) and "all done" (well, mostly just waving his hands around) and pat-pat when he wants milk. He doesn't say much, although he clearly says "Da Da". He can clap his hands and wave "bye bye". He will follow me around from room to room (as the mother of three, I don't stay put for long) and is quite social. When I put on my sling, he gets very excited. This is not new; he's done this for several months. But he's not clingy at all and rarely asks to be held when we are at home. He is a busy boy and has things to do. He doesn't like strangers, though.

He weighs just over 21lbs. which is a bit below the old adage of "triple their birth weight by one year" but on track compared with his brothers' growth curves.

I am actually writing his birth story this week. And I promise photos coming soon.

Triple Surprise

Dusty and Lynette Johnson of Tuttle, North Dakota, were planning a homebirth, but they got a little more than they were expecting:

The Johnsons thought they would be bringing a third child into the family, and so did everyone else. When she had Christopher, he weighed more than nine pounds at birth; Abigail was 10 pounds when she was born. Lynette Johnson expected to have another large baby, and her midwife said her measurements were on target for that, she said.

When she gave birth, however, her midwife quickly prepared for a multiple birth after Marissa was born and she realized Lynette was not done giving birth.

The girl babies were fine, but the boy had some trouble breathing and spent a couple weeks in the hospital. Friends and neighbors threw a fundraiser to help defray medical and living expenses.

Mag Sulfate for Preterm Labor

An editorial published in this month's OBG Management argues that obstetricians should stop using Magnesium Sulfate to treat preterm labor:

Data from trials never clearly demonstrated that magnesium has a clinically significant tocolytic effect compared with “control” treatments. In a Cochrane review of magnesium tocolysis, neither improvement in the risk of delivery before 48 hours nor reduction in risk of birth before 34 or 37 weeks was observed, compared with control treatments. More recent data also suggest that magnesium may increase the risk of adverse neonatal outcomes, including death, especially at the upper end of the magnesium dose range.

In the absence of demonstrated clinical efficacy and a concern over potentially negative neonatal effects, obstetricians should consider strictly limiting their use of magnesium for tocolysis.

Link: Is the end of an era here for magnesium sulfate tocolysis?

Epidurals aren't for wimps

Epidurals aren't for wimps – labour can be different for every mother:

In everyday life, we respond in instinctive ways to pain. If you drop something on your foot, you automatically rub yourself because rubbing causes your body to make endorphins which are natural pain-killing substances. If you have a bad stomach ache, you would probably lie down and curl up in a ball with a heatpad because warmth and being in a particular position are very comforting. It would seem that pain tells us how to help ourselves recover from injury. In labour, there is no injury taking place, but the pain teaches the woman how to give birth. She is led by it to try a variety of positions to increase her comfort and by moving around and using different positions, she is also helping her baby's head to press down firmly all around the cervix so that it opens up evenly. Later in labour, her changes of position cause the baby to be shifted one way and then the other, helping him to find the easiest way down through the pelvis.

Epidurals May Negatively Affect Breast-Feeding

Researchers found that 93 percent of the women in the study breast-fed their baby in the first week after birth. However, women who had an epidural were significantly more likely to have difficulty breast-feeding during the first few days after delivery and to breast-feed less often than other women.

At 24 weeks, 72 percent of women who did not have an epidural were breast-feeding, compared with 53 percent who received pethidine or epidurals containing bupivacaine and fentanyl (an opioid).

(link)

Pat O'Brien, a spokesman for the Royal College of Obstetricians and Gynaecologists, said it was possible that fentanyl had an effect on the baby.

But he added: "There are other factors which may explain this link, including that if a woman chooses not to have an epidural, she may also be more motivated to persevere with breastfeeding.

"Also, a lot of those women who had epidurals also went on to have Caesarean sections which - unless you have a lot of support - make it difficult to breastfeed because it's harder for women to pick their babies up."

(link)

Miscarriage Risks

A new study points to factors that increase (and some that do not increase) the risk of early miscarriage. In addition to the risks to very underweight women, the study says:

Although the reasons behind miscarriage are still vague, the researchers did establish some other common risk factors. The study found that single women were at an increased risk of miscarriage, as were women who had had a previous abortion (60% higher risk) and those who had had IVF (40% higher risk). Those who took more than a year to conceive were twice as likely to miscarry as women who had conceived within the first three months.

The researchers also revealed factors in maintaining a healthy pregnancy. Two-thirds of the women they studied who took vitamin supplements during early pregnancy reduced their risk of miscarriage by around 50%. The effect was most pronounced among those taking folic acid or iron and multivitamins containing these. Eating fresh fruit, vegetables and chocolate daily was also found to halve the odds of a miscarriage.

The study also showed that

Women who suffered from nausea and sickness in the first 12 weeks of their pregnancy were almost 70% less likely to miscarry, especially those with severe sickness.

Which is small comfort to those who are severely hyperemetic.

Interestingly, and somewhat reassuringly:

Supposed risk factors such as alcohol consumption, smoking and caffeine intake were unconfirmed in the study.

HT: Perfect Work who has these comments.

Safety of Homebirth

I'm going back through some old things...

Selkie and Expectant Waiting had some great pieces on the safety of homebirth.

ADA Advises No Fluoride For Babies

The American Dental Association has done a 180 and now warns that infants under one year of age should not be given fluoridated water, such as that mixed with concentrated or powdered baby formula, according to the Organic Consumers Association.

ADA page on Infants, Formula and Fluoride.

A different take on tandem nursing

A Canadian woman is breastfeeding conjoined twins:

Although Simms breastfed her two older kids, it’s a whole new beginning with her twins.

"What’s the most challenging part of breast feeding them?" Simms said. "Positioning!"

"It’s very complicated because when one is on the breast the other has to be tilted and has to be slanted downwards.

"You’re feeding one and the other will suck on its tongue and you have to give it a soother or something because it wants food.

"We’re trying to figure out how to feed both of them at the same time," Simms said, bursting out laughing.

Simply amazing.

Blogger Beta

I've switched over to the beta version of Blogger. The good news: tags are enabled. Bad news: it will take some time before I get everything tagged and the blog reformatted. Sorry if it's a mess in the meantime.

Breastfeeding Carnival

Five blogs - Mama Knows Breast, The Lactivist, Motherwear, Breastfeeding123, and Breastfeeding Mums are starting

a monthly blog carnival focused on the topic of breastfeeding. Each month we'll pick a particular topic, write up our own posts around that topic and help you find your way to each of the five postings. We'll be starting off by blogging about breastfeeding and the holidays, be it with family, traveling or maybe even great gifts for nursing moms.

Look for their first edition on Tuesday.

Circumcision appears to reduce STD risk

Circumcision appears to reduce STD risk

Apgar Results Not As Objective As Thought

Apgar results depend on who scores the test.

Nausea Symptoms Undertreated

The New York Times reports "[a]lthough there are now safe and effective ways to prevent and to treat predictable cases [of nausea and vomiting], like those involving pregnant women and cancer patients, many people who could benefit fail to receive adequate treatment, if any treatment at all."(Nausea? There’s No Need to Suffer in Silence). Even worse,

In a clinical guidance bulletin for obstetrician-gynecologists, the [American College of Obstetricians and Gynecologists] wrote that an investigator found that among women who called a help line for those with nausea and vomiting during pregnancy and who subsequently terminated pregnancy because of these afflictions, fewer than 50 percent were offered anti-emetic therapy.

“Of those offered treatment, 90 percent were offered regimens that were not likely to be effective,” the bulletin says.

Related link: Hyperemesis Education & Research Foundation