Cord Blood Banking

Hat tip to Giving Birth Naturally for posting ACOG Revises Opinion on Cord Blood Banking:

It is refreshing to see that ACOG can make some improvements in judgment, albeit small ones. While they still won't take a stance for or against it, their revised opinion on the scam that is private cord blood banking is a small nudge in the right direction.

I especially like the statement, "ACOG also advises physicians who recruit patients for for-profit cord blood banking to disclose their financial interests or other potential conflicts of interest to pregnant women and their families."

Read the text of the news release here.

My major concern with cord blood banking is the necessity of cutting the umbilical cord earlier than might be optimal in order to preserve the cord blood, thereby depriving the newborn of the blood. A representative from a cord blood-banking company may be speaking to our homebirth group this year; it will be interesting to see what they have say on these issues.

Oxytocin

Hathor's been doing some neat comics lately on Oxytocin - the "Love Hormone". She just came back from the Trust Birth Conference which I really wish I could have gone to. She heard Michel Odent speak, and he really rocked her world, as he did mine when I heard him speak a couple years ago at a local conference. Hathor came across this article, over a year old and just a rat study, but still important:

The massive surge in the maternal hormone oxytocin that occurs during delivery might help protect newborns against brain damage, a new study in rats suggests.

Researchers say the findings should encourage scientists to investigate whether elective caesarean sections, which lack this oxytocin surge, disrupt normal brain development.

Also, I found Hug the Monkey, a whole blog devoted to the subject of Oxytocin; and an article entitled 5 Ways Pitocin is Different than Oxytocin which, in honor of list month, I will include here:

1. Pitocin is released differently. Oxytocin is released into your body in a pulsing action. It comes intermittently to allow your body a break. Pitocin is given in an IV in a continuous manner. This can cause contractions to be longer and stronger than your baby or placenta can handle, depriving your baby of oxygen.
2. Pitocin prevents your body from offering endorphins. When you are in labor naturally, your body responds to the contractions and oxytocin with the release of endorphins, a morphine like substance that helps prevent and counteract pain. When you receive Pitocin, your body does not know to release the endorphins, despite the fact that you are in pain.
3. Pitocin isn't as effective at dilating the cervix. When the baby releases oxytocin it works really well on the uterine muscle, causing the cervix to dilate. Pitocin works much more slowly and with less effect, meaning it takes more Pitocin to work.
   
4. Pitocin lacks a peak at birth. In natural labor, the body provides a spike in oxytocin at the birth, stimulating the fetal ejection reflex, allowing for a faster and easier birth. Pitocin is regulated by a pump and not able to offer this boost at the end.
   
5. Pitocin can interfere with bonding. When the body releases oxytocin, also known as the love hormone, it promotes bonding with the baby after birth. Pitocin interferes with the internal release of oxytocin, which can disturb the bonding process.
   

I knew, like, three of those already. And for some really hair-raising stories, try Knitted in the Womb's Rant on Pitocin (with comments).

Acupuncture may increase pregnancy chances

Acupuncture involves placing very thin needles at specific points on the body to try to control pain and reduce stress. In fertility treatment, it is thought to increase blood flow to the uterus, relax the cervix and inhibit “fight or flight” stress hormones that can make it tougher for an embryo to implant, Manheimer said.

The analysis pools results from seven studies on 1,366 women in the United States, Germany, Australia and Denmark who are having in vitro fertilization, or IVF. It involves mixing sperm and eggs in a lab dish to create embryos that are placed in the womb.

Women were randomly assigned to receive IVF alone, IVF with acupuncture within a day of embryo transfer, or IVF plus sham acupuncture, in which needles were placed too shallowly or in spots not thought to matter.

Individually, only three of the studies found acupuncture beneficial, three found a trend toward benefit and one found no benefit. When results of these smaller studies were pooled, researchers found that the odds of conceiving went up about 65 percent for women given acupuncture.

Link: Acupuncture may hike odds of pregnancy

Six Practices for a Healthy Birth

If you haven't seen a copy of Lamaze International's new quarterly publication, Pregnancy, Birth & Beyond, I highly suggest you try to get a copy. I was mightily impressed by the inaugural issue.

Lamaze has identified six care practices that promote, support and protect normal birth. These are:

1. Labor should begin on its own.
2. Laboring women should be free to move throughout labor.
3. Laboring women should have continuous support from others throughout labor.
4. There should be no routine interventions during labor and birth.
5. Women should not give birth on their backs.
6. Mothers and babies should not be separated after birth and should have unlimited opportunity for breastfeeding.

Detailed information about each of these Care Practices are available here.

Top 10 Most Important Foods to Buy Organic

The Green Guide publishes the Top 10 Most Important Foods to Buy Organic, based on information from the Environmental Working Group. Here's a summary:

1. Baby Foods
2. Rice
3. Strawberries
4. Grains
5. Milk
6. Corn
7. Bananas
8. Green Beans
9. Apples, apple juice
10. Peaches

And the runners-up are: nectarines, grapes & raisins, and kiwi fruit.

Elsewhere I have read that buying organic meat and dairy, rather than fruits and vegetables, gets you the most "bang" for your grocery "buck".

NaBloPoMo - Redux

See my NaBloPoMo- related announcement on The Mommy Blawg.

I spoke too soon (re: Perth)

From Breastfeeding123, this post (quoting The Breastfeeding Answer Book):

Ultrasound examination of the lactating breast during breastfeeding by Peter Hartmann’s research team in Perth, Australia has provided new information about what occurs within the breast during let-down.

Maybe I just like the way the word sounds. Perth.
Perth.
Perth.

Breast milk contains stem cells

What's the deal with Perth? First H.Pylori, then Heath Ledger, now this:

Breast milk contains stem cells.

Made for Birthing

Take a look at these neat hospital gowns made for birthing. Not only do they allow coverage for modesty while still providing access for medical procedures and breastfeeding, they also help support baby's immune system:

The risk of germs is one of the biggest risks in hospital birth. Hospitals and medical caregivers supposedly provide a "sterile field" but you and your baby are still exposed to a multitude of germs that your body has not built immunity to. Roll your gown around on your bed, couch, and hold the dog and cat before you bring it to the hospital. You'll be bringing YOUR "sterile field" from home for your baby to be born into and to be touched by first and covered by. Not harsh, potentially risky hospital towels and sheets.

Top 10 Childbirth Myths

The Journey Of An Apprentice Midwife posts a very excellent Top 10 Childbirth Myths, with references.

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.