Breast Pump Comparisons

Need to buy a breast pump? Compare brands and styles at Breast Pump Comparisons.

How Safe Are Epidurals?

The Guardian posted a recent article, "How safe are epidurals?":

There are, however, downsides. An epidural literally paralyses you and the effects of it can be, according to the National Childbirth Trust, "an increase in assisted vaginal birth rate". There is some evidence that "sleepiness arising from the opiate may delay successful breast feeding". Some mothers also complain of having headaches and/or debilitating drowsiness for days afterwards. The natural-birth lobby will tell you that 23% of women will experience complications. The pro lobby will tell you that an epidural is one of the safest anaesthetics around.

I have to say I felt pretty cock-a-hoop straight after my epidural but, some hours later, my head felt as though someone large and heavy had been sitting on it. The next three times I gave birth, I had them all drug-free and at home. Did they hurt? Hell yes, but I felt so much better afterwards.

Ultrasound Estimates of Baby Weight Unreliable

From BirthEcology.org:

Here's an important research study that shows what we all know to be true, that ultrasound in late pregnancy is not a reliable source of weight estimation.

http://www.nzma.org.nz/journal/119-1241/2146/

Conclusion: The accuracy of ultrasound estimations of fetal weight performed at Wellington Hospital within 7 days of delivery in term singleton pregnancies was at least similar and sometimes better than that reported in other studies. For one in four women, however, the fetal weight estimation was more than 10% different from the actual birth weight of their infant. Ultrasound measurements had a tendency to overestimate the weight of small infants while underestimating the weight of both large infants and the infants of diabetic mothers. As the reliability of ultrasound estimation of fetal weight to detect larger babies was poor, the use of such an objective measurement in the management of suspected macrosomia in term singleton pregnancies should be avoided.

Permalink.

Hospitals May Overfeed Newborns

It seems that as breastfeeding continues to make its comback, we continually have to redefine "normal"; since for years "normal" was based on what was normal in babies fed artificial milk - everything from how fast babies grow, to how often they eat, how long they sleep, how often they poop, and even how much weight they loose after being born:

Physiologically appropriate infant weight loss is less for babies fed formula in the hospital than for those who are breastfed, suggesting that hospitals feed too much, researchers here said.

Formula feeding in the first few days of life may lead to later overweight and obesity by way of metabolic imprinting, Patricia J. Martens, Ph.D., and Linda Romphf, of the University of Manitoba, reported online in the Journal of Human Lactation.

Link

Gibbon learns parenting, breastfeeding from humans

Look, learn works for Sue the gibbon:

Since the birth of Intan, a baby siamang gibbon, staff at the Christchurch wildlife centre are taking a unique approach to teaching new mother Sue how to care for her gibbon.

The use of video technology, cue cards, and even real life demonstrations of how to breastfeed are being used to teach Sue correct parenting.

Breast-feeding patrons visiting the reserve have also been enlisted to help give Sue the right idea.

She was fascinated by it, said Monique Van Der Linden, head of Willowbank's zoo section.

Monkeys were able to "learn from people", she said.

The Potty Training Answer Book

I've posted a review of The Potty Training Answer Book by Karen Deerwester over on The Book Blawg.

Waterbirth on "Private Practice"

I've just learned that Wednesday's episode of Private Practice (ABC @ 8 PM CST; watch the trailer here) will include a water birth in a La Bassine tub. The La Bassine is the tub that my youngest son was born in, and which I currently rent out. Let's hope it is a positive/accurate portrayal of birth! But as they say, there is no such thing as bad publicity.

You can see a photo of me in the tub here. And for more information about the La Bassine, visit Yourwaterbirth.com , the US distributor. For general information on waterbirth, Waterbirth International is a great resource.

Birth & Pregnancy Briefs

US among worst in world for infant death:

The United States ranks near the bottom for infant survival rates among modernized nations. A Save the Children report last year placed the United States ahead of only Latvia, and tied with Hungary, Malta, Poland and Slovakia.

The same report noted the United States had more neonatologists and newborn intensive care beds per person than Australia, Canada and the United Kingdom — but still had a higher rate of infant mortality than any of those nations.

And Memphis fights its infant mortality rate, nearly twice that of the national average.

The risks linked to caesarean births from a study published in the British Medical Journal:

They found that a woman having a caesarean delivery had twice the risk of illness and mortality (including death, hysterectomy, blood transfusion and admission to intensive care) as a woman having a vaginal delivery.

There was a five times higher risk of having to have antibiotic treatment after birth for women who had a caesarean delivery (elective or decided by clinicians) than those who had a vaginal delivery.

Risk of having to stay in a neonatal intensive care unit for newborn babies who were born head-first was doubled after a caesarean delivery compared to a vaginal birth.

The authors also found that the risk of neonatal death was also significantly increased (more than 70% higher) up to hospital discharge for babies who were born head first from both an elective and a clinician chosen caesarean delivery, compared to a vaginal delivery.

However, caesarean delivery had a large protective effect in preventing foetal deaths in cases of breech born babies and reduced overall risks in those cases.

Elective Caesareans put mums and babes at risk of death:

According to a new British study women who opt for non-emergency Caesareans double their risk of dying or developing severe complications following the procedure.

The study by researchers at the University of Oxford has also found that in some cases Caesareans increased the risk of death to newborn babies by as much as 70 per cent.

Common Drug For Stopping Preterm Labor May Be Harmful For Babies

Dozens of studies have been done, but none have had a large sample size or a definitive outcome on the effects of indomethacin. The new analysis of a collection of studies, or a metaanalysis, by University of Rochester Medical Center researchers pulls together enough data to conclude that there is an association between use of indomethacin and babies experiencing periventricular leukomalacia (white matter injury by decreasing blood flow in the brain, which may lead to cerebral palsy).

The analysis also showed an association between indomethacin and necrotizing entercolitis (a condition in which intestinal tissue dies, which can sometimes be successfully treated with antibiotics but can require surgery and even cause death), especially for those babies who were exposed to the drug within days of birth.

And, no surprise, Diet Affects Fertility.

Breastfeeding Briefs

New this week:

Breastfeeding reduces the risk of cardiovascular disease later in life:

Having been breastfed in infancy is associated with a lower average body mass index (BMI) and a higher average HDL (high-density lipoprotein or “good” cholesterol) level in adulthood, even after accounting for personal and maternal demographic and CVD risk factors that could influence the results,” said Nisha I. Parikh, M.D., M.P.H., author of the study and a cardiovascular fellow at the Beth Israel Deaconess Medical Center in Boston, Mass.

A lower BMI and high HDL both protect against CVD.

(link)

Breastfeeding & IQ are genetically linked - This study shows that breastfeeding increases I.Q. for most children. For around 10% of children, however, breastfeeding has no effect on I.Q. due to a lack of a particular gene variant:

This study looked at how long-chain polyunsaturated fatty acids (LC-PUFAS), which are present in human milk but not in cow's milk or most infant formulas, are metabolized. LC-PUFAS in breast milk, the authors said, is believed to enhance cognitive development because the fatty acids are required for efficient neurotransmission and are involved in neuronal growth and regeneration.

(link)

Cord Clamping

Soon after a baby is born, the umbilical cord is clamped, and then cut. Research continues to show what many have long believed, that delayed cord clamping is beneficial to the infant. However, current obstetrical practice is to clamp the cord right away. As long as the cord is pulsing, the baby is continuing to receive blood and oxygen from the placenta. For babies who are born healthy and crying, it may not make much of an apparent difference. But for babies who do not breathe right away, clamping the cord means that they must breathe - or else be deprived of oxygen. Delayed clamping eases the baby's transition into the world. In fact, cutting the cord at birth is not necessary at all - the cord will clamp itself off when it stops functioning.

For research into cord clamping, try these sites:

Gentlebirth Archives - Perhaps the most comprehensive list of resources on cord clamping available, but you will also get about 50 different opinions.

Cordclamp.com - Lots of good, technical info, but advocates the idea that premature cord clamping is responsible for autism, cerebral palsy, mental retardation, and the fact that more women than men get college degrees. Also contains the archives of the now-defunct, oft-linked-to cordclamping.com.

Cochrane Review information on Cord Clamping in Preterm Infants, Cord Clamping in Term Infants, and Topical Cord Care.

Lotus Birth from Answers.com

Lotus Birth from Wikipedia.

Umbilical Cord from Wikipedia.

And for the last word on the issue, a recent study published in the JAMA - Late vs Early Clamping of the Umbilical Cord in Full-term Neonates: Systematic Review and Meta-analysis of Controlled Trials (March 21, 2007):

Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn, extending into infancy. Although there was an increase in polycythemia among infants in whom cord clamping was delayed, this condition appeared to be benign.

Breastfeeding Briefs

I'm hoping to make this a weekly feature. In the news:

Research confirms what breastfeeding and childbirth professionals have been saying for years, Breastfeeding Does Not Create Sagging Breasts:

However, there are some factors that increase the chance of sagging breasts. A higher BMI and larger bra size before pregnancy increased the chance that the breast would sag. Also, smoking history, the number of pregnancies, and age also affected the risk factors of getting sagging breasts.

Factors that did not affect whether or not the women had sagging breasts were the number of children that were breastfed and the amount of time spent breastfeeding each child. Also, the amount of weight gained during pregnancy apparently had no affect on long term breast shape.

Breast milk helps lungs but not if mom has asthma - "Breast-feeding seems to protect children from asthma later in life, but only when the mother does not have the respiratory disorder herself."

News of the weird - Breastfeeding smell linked to higher sex drive.

The USDA announced this week a new MyPyramid for Pregnant and Nursing Moms. The website feature allows you to put in some information about you and your baby or pregnancy, and get recommendations on what you should be eating. Unfortunately, the website does not allow you to input dates for babies older than one year of age, nor does it account for women who are tandem nursing, or who are pregnant while nursing. Furthermore, it does so in a rather rude way, by stating that the date you have entered is "invalid". A better approach would be to refer mothers of older babies to the regular MyPyramid feature. If this irritates you as much as it does me, feel free to let the USDA know.

Here is the UNICEF Policy on Infant feeding and HIV:

UNICEF and other UN agencies recommend exclusive breastfeeding for HIV-infected women for the first six months of life unless replacement feeding is acceptable, feasible, affordable, sustainable and safe before that time. Such conditions are rare in much of the developing world. However, if they do exist, it is recommended that HIV-infected women avoid breastfeeding. [emphasis added]

The risk of a baby contracting HIV through breastfeeding from an infected, untreated mother is between 5-20%. However, the death rate of formula-fed babies in the developing world is approximately 33%. While formula feeding merely doubles the risk of death, compared with breastfeeding, for babies born in the US, babies in developing countries are ten times more likely to die within the first year. Given these numbers, a baby is better off getting milk from an HIV-infected mother unless the five UNICEF criteria can be met.

UNICEF also recommends exclusive breastfeeding of a baby already known to be HIV+.

National Blog Posting Month

Angela at Breastfeeding 123 has issued a challenge to Breastfeeding and Mothering bloggers to participate with her in National Blog Posting Month (NaBloPoMo). The idea is that you commit to write one blog post per day, for the entire month of November. Why do this? Cause, uh, you started a blog to make yourself write more often?

Anyhow, I'm in! If you haven't noticed, I am currently posting maybe every week or two. It's not that there's a lack of important things going which need to be blogged about, either. On the contrary; sometimes I feel overwhelmed by bad news and the amount of cruddy stuff still going on in the world.

I'm qualifying my participation by saying that since I have three blogs, I only plan to post to one of the three each day. Wish me luck!

Laudering your cloth diapers

Pinstripes and Polkadots has this great chart for evaluating laundry detergents. Based on their recommendation, we switched to Purex Free & Clear and have had no leaking or absorbency problems whatsoever.

Why Early Cord Clamping?

Andru Ziwasimon of to the teeth posted this insightful discussion about a year ago, on early cord clamping, which I am just now getting around to mentioning.

Water Birth a "valuable alternative" to traditional delivery

The maternal and neonatal infection rate and laboratory parameters showed no significant difference among the groups. There was no maternal infection related to water birth. There were five water born neonates and three neonates after normal vaginal delivery preceded by immersion with conjunctivitis. Significant differences were observed in obstetrical outcome parameters: less use of analgesia, shorter duration of first and second stage of labor, smaller episiotomy rate in water birth. In contrast no differences were seen in all observed fetal outcome parameters: APGAR score, arterial and venous pH, admission rate to neonatal intensive care unit. CONCLUSIONS: Water birth is a valuable alternative to traditional delivery. The maternal and fetal infection rate was comparable to traditional deliveries.

Source

Crib bumpers do more harm than good

According to a recent study published in the Journal of Pediatrics,

The research team found the reports revealed that 11 infants suffocated when their face rested against the bumper pad, 13 died after being wedged between the bumper pad and another object and three were strangled by a bumper tie.

An examination was conducted of 22 commercially available crib bumpers for potentially dangerous features such as excessive softness, a space between the bottom of the bumper pad and mattress, the width of the pads and the length of the ties that attach the bumpers to the crib slats.

All of the bumper pads were found to be hazardous because they left a space between the bottom of the bumper pad and mattress, an area in which an infant's head could become lodged.

The researchers say the bumper pads are not providing any benefit and do more harm than good and should not be placed in cribs or bassinets.

Link

1 Million Cribs Recalled

It's the largest crib recall in CPSC history, and now the one place parents are told they can safely leave their children without supervision is in question.

"Crib hardware failure is actually one of the most common causes of death in cribs," Nancy Cowles, a crib safety advocate, told CBS News correspondent Sandra Hughes.

In fact, according to Cowles' organization Kids In Danger, 30 children are killed and 1,200 are injured every year in crib accidents.

And while these cribs were made in China, in this case she says China isn't to blame:

"The problem is the design flaws that the U.S. manufacturers designed into the product," Cowles said.

Link to news article
Recall information

Keeping Your Placenta

Jodi Selander gives advice on Bringing Your Placenta Home from the Hospital:

Women who give birth at home have the luxury of being in complete control over the care and handling of their baby’s placenta. A woman who births in a hospital has to adhere to the guidelines and policies in place at their facility of choice. In some cases, there is no written policy, and mothers are then subjected to the whim of the staff on duty at the time they deliver. If you want to take your placenta home after its birth, you must have a plan before you walk through the doors in labor. Your chance of success will increase greatly.

New York Hospitals "Ban the Bags"; World Breastfeeding Week

Women's Health News reports that New York City public hospitals will "exclude free baby formula samples from gift bags to new mothers, will ban formula promotion materials from labor and delivery units and will encourage initiation of breastfeeding in the baby’s first hour as part of a campaign to increase exclusive breastfeeding and improve infant health."

Perhaps not coincidently, the theme for this year's World Breastfeeding Week (August 1-7, though local events may be held on other dates) is "Breastfeeding: The First Hour", emphasizing early initiation of breastfeeding. More information about WBW in the United States from WBW, La Leche League, and ProMoM.

Women given unwanted episiotomies

A CNN Health article, "5 operations you don't want to get -- and what to do instead", covers episiotomies:

It can sound so simple and efficient when an OB-GYN lays out all the reasons why she performs episiotomy before delivery. After all, it's logical that cutting or extending the vaginal opening along the perineum (between the vagina and anus) would reduce the risk of pelvic-tissue tears and ease childbirth. But studies show that severing muscles in and around the lower vaginal wall (it's more than just skin) causes as many or more problems than it prevents. Pain, irritation, muscle tears, and incontinence are all common aftereffects of episiotomy.

Last year the American College of Obstetricians and Gynecologists released new guidelines that said that episiotomy should no longer be performed routinely -- and the numbers have dropped. Many doctors now reserve episiotomy for cases when the baby is in distress. But the rates (about 25 percent in the United States) are still much too high, experts say, and some worry that it's because women aren't aware that they can decline the surgery.

"We asked women who'd delivered vaginally with episiotomy in 2005 whether they had a choice," says Eugene Declercq, Ph.D., main author of the leading national survey of childbirth in America, "Listening to Mothers II," and professor of maternal and child health at the Boston University School of Public Health. "We found that only 18 percent said they had a choice, while 73 percent said they didn't." In other words, about three of four women in childbirth were not asked about the surgery they would soon face in an urgent situation. "Women often were told, 'I can get the baby out quicker,'" Declercq says, as opposed to doctors actually asking them, 'Would you like an episiotomy?'"

Wow.

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