Archives for December 2009

Induced Lactation: Breastfeeding your Adopted Baby

The special closeness fostered by breastfeeding is indeed possible between a mother and her adopted infant. Whether you have been pregnant before or not does not affect your ability to produce milk (except for colostrum, which is only produced by postpartum women for a few days after birth). Even a woman who has had a hysterectomy may lactate.  Generally, all it takes is will, perseverance, and physical stimulation of the breasts.

During pregnancy, breasts are ordinarily prepared for lactation because of the influence of hormones including estrogen, progesterone, and prolactin. However, without pregnancy, you can start secreting prolactin simply through nipple stimulation. The basic principle in breastfeeding is supply-and-demand. That means that the more there is suckling on the breast (or stimulation with a breast pump), the more prolactin increases, the more oxytocin is released to signal the brain, and the more breast milk you will produce!

Mother & Baby Unit

image from Cheyenne Regional Medical Center

Nipple stimulation: You may be able to induce lactation by using a breast pump every 2-3 hours, either before the baby comes or after. Some also use a device such as the Medela Supplemental Nursing System or the Lact-Aid Nurser Training System. These both enable you to feed your baby while he is at your breast. This way, your baby gets enough milk while stimulating your body to produce your own milk. The key to all this is that the more stimulation your breasts receive, either by pump or baby, the more likely milk will be produced.

Hormone Therapy: Sometimes doctors prescribe supplemental estrogen or progesterone to mimic the effects of pregnancy. In some cases, other medications may be prescribed, such as Domperidone, although no drugs have been specifically approved to induce lactation, and potential side effects may be a concern. (Jay L. Hoecker, M.D., Mayo Clinic)  There’s even an approach called the Newman-Goldfarb Protocols, which uses birth control pills to simulate pregnancy in the body, followed by other deliberate steps to trigger lactation. Typically, hormone therapy is discontinued shortly before breast-feeding begins.

Herbs and Nutrition: There are several natural herbs that can help with milk production. According to Dr. Jack Newman, a pediatrician that specializes in breastfeeding issues, herbs can be taken without any harm to mother or baby when used as directed on his website. Increased food and water intake, proper rest, and avoiding sress can also help increase your milk supply, according to experienced mothers.

Breast Changes: Milk production typically begins between one to four weeks after initiating mechanical stimulation. At first, there may be only drops. During this time, you may notice changes in the color of the nipples and areolar tissue. Breasts may become tender and fuller. Some women report increased thirst and changes in their menstrual cycles or libidos.

If you want to induce lactation, you can get help and support from lactation consultants, such as at your local La Leche League. They’ll be able to provide information on the subject, connect you with other women who have induced lactation, and provide equipment (feeding tube devices, electric breast pumps) to help you get started.

Mothers who induce lactation vary widely in the amount of milk they are able to produce and in the amount of time required to produce milk. All agree that inducing lactation is a process that takes patience, commitment, diligence and education. A reasonable goal might be to try to provide some, or maybe most, of your new baby’s nutrition yourself, while fully enjoying the closeness and bonding that breastfeeding brings. This nurturing is by far more important than the actual volume of milk produced.

Sources:

AssociatedContent: How to Induce Lactation – the Well May Not Be Dry!

La Leche League: Can I Breastfeed My Adopted Baby?

Mayo Clinic: Induced lactation: Can I breast-feed my adopted baby?

Baby Zone: Induced Lactation

To Circumcise or Not to Circumcise

If you have a little boy on the way, you have probably thought about whether to have the foreskin on your son’s penis removed, or leave it intact. With both “pros” and “cons” to consider, some new parents may be confused about this decision. In the end, it’s a family’s personal choice. However, here are some things to consider.

Dr. George Steinhardt, a urologist at Helen DeVos Children’s Hospital in Grand Rapids, Michigan, says the biggest reasons American parents choose to circumcise their boys are still religious and cultural. “I think it’s done primarily for cultural reasons,” he explains.

travelling-newborn-baby-photographer.jpg

photo by Proud to Introduce

The Medical Perspective
Medical professionals today debate whether or not the procedure is medically necessary. Dr. Mark Reiss, a retired physician and executive vice president of the nonprofit organization, Doctors Opposing Circumcision, believes that there is no medical reason to circumcise.  “The penis is meant to be covered by the foreskin. The normal state is intact. The U.S. is the only country in the world that performs routine circumcisions.”

Yet, other experts point that there are valid reasons to consider the procedure. Among them are the following:

Infections: Dr. Anthony Chin, a Los Angeles-based obstetrician, points out that circumcision does make it easier to keep the penis clean, and decreases the chances of infection.  “Let’s face it, boys aren’t the cleanest of genders,” he points out!  Today, however, we have antibiotics to treat infections, making them less dangerous than they were in the past. “Before antibiotics, people got really sick, but now in the post antibiotic era, circumcisions are not ‘medically’ necessary anymore.”

Kindney Problems: “We see a lot of babies with kidney problems,” notes Steinhardt. “For those boys, I would recommend that a circumcision be done. It protects against the possibility of an infection.”  In particular, when his patients are diagnosed with fetal hydronephrosis, or dilated kidneys (which is more common in boys than girls) he almost always believes that circumcision is necessary to alleviate the risk of infection and other complications.

Sexually Transmitted Disease: Steinhardt believes that circumcision may have other serious benefits. “There’s valid scientific evidence that HIV is more likely in a man with foreskin than in a man without foreskin.” Steinhardt also says that you rarely see cancer of the penis in a man who has been circumcised.  However, other experts say there is not evidence that circumcision prevents any STD’s or cancers.

Appearance
Chin notes that circumcisions are basically for cosmetic purposes now, saying that sometimes an uncircumcised child decides to have the procedure done later in life.  In the US, women seem to prefer a circumcized penis, and there are plenty of teenagers who get  circumcised for cosmetic reasons.

Ease
A 5-minute procedure as an infant is easier than the same procedure on an adolescent or adult.  Barbara Dehn, RN, MS, NP, a practicing nurse who teaches at Stanford University, says if you opt to circumcise, do it soon after birth. “The key with circumcision,” she says, “is that if you decide to do it, don’t wait too long. Even when they’re 3, that’s probably too late, since the experience will be too traumatic for them.”

Pain Control
Those who oppose circumcision often call it as a barbaric procedure that leaves infants in terrible pain.  The issue of pain and cruelty is often one of parents’ biggest concerns. Will he feel the incision? Will there be a long, difficult recovery? Will there be complications?

The claim that circumcision causes tremendous pain is simply not true, says Steinhardt. “In general, it’s a pretty harmless procedure. It’s well tolerated, it’s done with great care, and complications are rare and few and far between.”  Plus, with proper pain control, many babies just sleep right through the procedure. “You can have confidence that it can be done safely.” If you are concerned, have a conversation with whoever will be doing the procedure, whether the pediatrician, OB/GYN, or mohel, about what measures can be taken for pain control. A local anesthetic can be used to ensure a painless circumcision.

For more info:

TheCradle: Circumcision: What you need to know

Dr. Sears: Frequently Asked Questions about Circumcision

Setting up an Eco-Friendly Nursery

There are lots of great ways you can create a safe, healthy and non-toxic haven for your precious little baby. Most baby products are completely safe, but it’s worth being aware that some choices of furniture, carpeting and even bedding could expose their child to a variety of chemicals that they’re better off without!

Paint: Paint the nursery walls with environmentally friendly paint that doesn’t release poisonous volatile organic compounds (VOCs) into the air. Ingredients such as turpentine, formaldehyde, any animal products should also be avoided. Look for VOC-free paint made from all-natural ingredients such as mineral pigments, beeswax, plant oils, crushed limestone, soy resins and buttermilk.

Also, paint the nursery in far in advance and keep windows open to air out the fumes!

Flooring: Carpeting can trap mold, dust mites, and other allergens. Instead, choose wood flooring made from wood from sustainably managed forests such as bamboo or lyptus. Finish them with a nontoxic or natural sealant.

Linoleum, made of all-natural materials (sawdust, linseed oils, pigments and a jute backing) is soft underfoot, and easy to clean. Consider cork, too. It’s a natural insulator of both heat and sound, and soft enough to cushion those inevitable tumbles.

Rugs: To cozy up the room, select nontoxic carpets and area rugs made from natural, untreated fibers such as wool, organic cotton, hemp and jute. Synthetic carpeting can harbor over 100 toxic and carcinogenic chemicals.

Tranquil Nursery Collection by CoCaLo via Babble

Furnishing: Look for furnishing with a water-based aluminum oxide with no volatile organic compounds (VOC) emissions. Avoid furniture made with plywood, particle board, and medium-density fiberboard (MDF) because they often contain formaldehyde in their glues. Used furniture that’s already a few years old is also a good choice, as it is likely to have released all the harmful chemical fumes by now. (Recycling furniture is also a more affordable options compared with buying new, solid wood furniture!)

Mattress: Pick a baby mattress made with wool casings or organic cotton filling. Regular mattresses that are treated with fire retardants, stain- and moisture-resistant formulas contain harmful and potentially cancer-causing chemicals. You can also find pillows stuffed with natural stuffing such as kapok, buckwheat hulls, untreated wool, organic cotton or synthetic-free latex.

If you do purchase a regular mattress, air it out for a couple of moths before use. you can also cover it with an organic mattress pad protector.

Bedding: Look for organic all-cotton bedding for the crib. Conventional cotton is one of the most heavily pesticide-sprayed crops, and the chemicals could irritate your baby’s sensitive skin. Permanent-press sheets are treated with formaldehyde, a known carcinogenic.

Window Treatments: Organic cotton curtains are a safe and pretty option. Mini blinds, made of PVC, have been shown to give off gas when heated by the sun.

Toys: Safe toys are especially important because most of your baby’s playthings will end up in her mouth! Choose toys made with wood or natural fibers, and decorated with nontoxic paints.  Steer clear of plastic toys made with PVC (polyvinyl chloride).  This material releases toxins into the environment throughout its lifecycle.

Cloth Diapers: Although they require more of a time investment than disposable diapers, cloth diapers pollute less. Because they are chemical-free they may also be less irritating on your baby’s skin.

Fresh Air: You may decide to invest in an air purifier to clear the room of chemicals, gases, and household allergens.  Open the windows daily to bring in fresh air and circulate out stale air.

Recycle: Ask friends and relatives for their old baby gear, shop at secondhand stores, and check out recycling/sharing websites (such as Zwaggle, where you can find used stuff and give away your own used gear — no money required!)

For more info, visit:

BabyZone: Eco Friendly Nursery Basics

eHow: How to Create an Eco-Friendly Baby Nursery

TheBump: Creating an Eco-Friendly Nursery

TheCradle: The Eco Friendly Nursery

The Dangers of Immediate Cord Clamping

In many hospitals, the umbilical cord is routinely cut and clamped just seconds after the baby is born. But could this carefree clamping be causing damage to your newborn baby? Research today is increasingly revealing that clamping the umbilical cord prematurely robs your baby of much-needed blood and oxygen.

In the womb, a baby’s lungs are filled with fluid, and it receives oxygen through the umbilical cord. When the infant is born, the placenta and cord continue to pulse, delivering a burst of blood volume to the infant’s system. This blood is needed to help the the lungs of the newborn to expand.  According to this startling article, Are Doctors Causing Infant Brain Damage by Clamping the Umbilical Cord Prematurely?


Without the burst of blood from the placenta, the infant suffers a drop in blood pressure as its lungs fail to open as they should, creating a chain reaction of effects that can include brain damage and lung damage. Immediate cord clamping can cause hypotension, hypovolemia and infant anemia, resulting in cognitive deficits. Some have even theorized that the rise in autism could be linked at least in part to early cord clamping.

Image of umbilical cord at birth

image from Mayo Clinic

Interestingly, the umbilical cord, if left intact, actually “clamps” itself in as little as five minutes. Wikipedia explains that shortly after birth, the reduction in temperature starts a physiological process which causes the Wharton’s jelly (that’s what the cord is made of) to swell and collapse the blood vessels within. This, in effect, creates a natural clamp, halting the flow of blood.

According to Dr. Mercola, the time between between birth and natural clamping, allows blood to flow from the placenta through the baby’s lungs. The natural process protects the baby’s brain by providing a continuous oxygen supply until the lungs are functioning well. While most full-term babies have enough blood to establish lung function and prevent brain damage, the early clamping can still leave them weak, pale, and gasping for air. For premature babies, the process can be even more devastating.

Immediate cord clamping could possibly be linked to:

  • Brain hemorrhage
  • Respiratory distress
  • Autism
  • Cerebral Palsy
  • Anemia
  • Brain injury
  • Learning disorders
  • Behavioral disorders

On the flip side, G. M. Morley asserts that “the child which is delivered without the use of a cord clamp receives a full placental transfusion with enough iron to prevent anemia for the firs year of life… this is only a reflection of how much of the infant’s blood volume was left clamped in its placenta. ” (Read more here.)

Today there is no consensus about the optimal time to clamp the umbilical cord after birth. But I think it’s interesting to note the observations of Erasmus Darwin (Charles Darwin’s grandfather) from 200 years ago:

“Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases.

As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child.”

Moving forward, this 1963 Time article suggests that there are sound reasons for a slowdown in cutting the umbilical cord. It is based on a study by a group of pediatricians from the University of California:

The California pediatricians base their theory on a study of 129 infants. Among 41 whose umbilical cords were clamped before they took their second breath, 21 showed moderate to severe respiratory distress. In another group of 52 infants whose umbilicals had been clamped some time after the second breath, only six suffered the same symptoms. The condition of the infants who retained their umbilical cords longest was by far the best.

Given the overwhelming research about the potential harms of early cord clamping, both the World Health Organization and the International Federation of Gynecology and Obstetrics (FIGO) have dropped the practice from their guidelines. (Mercola) But it is still widely done in the United States and other developed countries, which I find hard to understand.

Syphilis, Pregnancy, and False Positive Labs

Syphilis is a venereal disease which is fairly easy to cure, but if left untreated can cause serious health problems for both you and your child. For this reason, screening for Treponema pallidum, the bacterium that causes syphilis, is routine during pregnancy. It is recommended to do this at the first prenatal visit, because if treated early (before 4 months) it is curable and will usually not have infected the fetus yet.

Syphilis develops in three stages. The first state, primary syphilis, is characterized by an open sore called a chancre, which usually appears on the genitals, either internally or externally. If untreated, the disease can progress to secondary syphilis and tertiary syphilis. Other symptoms include fever, sore throat, a rash, hair loss and swollen glands. In its final stage, syphilis can cause dementia, blindness and damage to the nervous system.

How Would I Catch Syphilis?

The bacterium that causes syphilis can be acquired through sexual intercourse (the most common method), kissing, passage from mother to fetus through the placenta, blood transfusion or accidental contact with an infected lesion. (Your Total Health)

Syphilis During Pregnancy

Syphilis is extremely dangerous for a fetus, who can contract the disease through the placenta that nourishes it. It can cause miscarriage and result in a stillborn birth. It can be also transmitted to your baby through vaginal birth and possibly through a cesarean section.  Congenital syphilis can have some very severe symptoms, although they may not appear right away.

False Positive Lab Tests

If you do test positive for syphilis, don’t panic! NO TEST IS 100 PERCENT ACCURATE. According to Lab Tests Online, screening tests for syphilis are not highly specific, and a false positive result is quite common. The VDRL has a high sensitivity but low specificity, and is used as a screening test. Today, treponemal FTA-ABS or MHA-TP tests,with high specificity and sensitivity, are used to confirm the results.

How is Syphilis Treated?

Syphilis is treated with penicillin (PenVK), which is considered safe in pregnancy. t is not common for a fetus to be infected before the fourth month, so testing and treatment should be done as soon as possible. If you have a history of penicillin allergy, you should undergo skin testing. If skin tests are positive, you will be ” desensitized” and then treated with penicillin.

A baby that is born with syphilis will also be given penicillin injections to fight the bacteria.

If your tests keep coming up positive, even without any physical signs of syphilis, your doctor may recommend treating you with penicillin, just to be on the safe side.

feature image

7 Need-to-Know Reasons to Breastfeed your Baby

I’m a huge advocate of breastfeeding, and this isn’t the first time I’ve written about the benefits that come along with it.  I think it’s so important that I have nursed both my children until age 2, and plan to breastfeed the next one for that same amount, too, if possible.

I know that breastfeeding causes many problems for new mothers, including painful, bleeding nipples, infections, and babies who don’t seem to be getting enough milk. Breastfeeding also requires quite a time commitment, especially for working mothers who need to pump or take time off to feed their baby. It’s not always simple, for many reasons that are personal to each individual woman. I  had a hard time in the beginning, and have had many friends and family members who were so frustrated they’ve given up breastfeeding altogether.  But I also think that the benefits of breastfeeding are NOT widely known, so if you’re on the fence about breastfeeding, here’s another list of reasons to remind you why nursing your baby is one of the greatest things you can be doing for him/her!

breastfeeding

image from HerDaily: Breastfeeding increases IQ

1. Breastfeeding Builds Your Baby’s Immune System

Newborns do not have a mature immune system to protect them from illness. Antibodies, or immune molecules, in a mother’s breast milk are transferred to the baby, giving them immunities to illnesses that the mother is immune to.  Beyond that, if your newborn is exposed to a germ, she will transfer it back to the mother while nursing. The mother’s body will then make antibodies to that particular germ and transfer them back to the baby at the next feeding.

Studies have also shown that babies who are breastfed exclusively have better functioning immune systems in the long-term as well.

Formula-fed babies have higher rates of:

  • Middle ear infections
  • Pneumonia
  • Gastroenteritis (stomach flu)
  • Urinary tract infections
  • Necrotizing enterocolitis, a digestive tract disorder that is a leading killer of premature infants

Breastfed infants have added protection against:

  • Heart disease
  • Immune system cancers such as lymphoma
  • Bowel diseases such as Crohn’s disease
  • Juvenile rheumatoid arthritis
  • Asthma and allergies
  • Respiratory infections
  • Eczema
  • Type 1 and type 2 diabetes

2. Breastfeeding Improves Baby’s Brain Function

Breast milk is not only good for the newborn’s immune system, it is also good for the brain. Breastfed infants tend to have higher intelligence than formula-fed infants. This may be due to certain compounds found in breast milk, including omega-3 fatty acids.

For instance, one study found that the verbal IQ of 7- and 8-year-old children who had been breastfed was about 10 points higher than those who were not. Another 18-year study of over 1,000 children found that those who were breastfed had higher intelligence and greater academic achievement than children who were formula-fed as babies.

It is interesting to note that babies who are breastfed naturally spend more time in what is known as the “quiet alert” state, which is not only soothing for parents but also it is the state most conducive to the newborn’s learning.

3. Breastfeeding Reduces Obesity

Breast milk contains a protein that could reduce the risk of obesity later in life. In fact, the longer a child is breastfed, the lower their risk of obesity, according to a study by U.S. researchers. The protein affects the body’s processing of fat.

4. Breastfeeding Helps Babies Emotionally

Babies have an intense need to be held and one of the most comforting things for a newborn is the physical act of nursing. Leaving a baby alone with a bottle is not emotionally satisfying to the child and does not make them feel safe or secure.

Breastfeeding also promotes bonding between mother and baby in a way that bottle-feeding cannot. Most women naturally feel a strong desire to hold their baby and there are physical and emotional reasons for this. Breastfeeding ensures that mother and baby have some intimate time together and actually stimulates the mother’s release of the oxytocin hormone, which is known to promote maternal behavior.

5. Reduces Mom’s Risk of Cancer and Other Health Conditions

Breastfeeding is a mutually beneficial experience in that it helps both mother and child. Women who breastfeed have a reduced risk of breast and ovarian cancers and osteoporosis later in life.

6. Moms Return to Pre-Pregnancy Weight Faster

Breastfeeding women lose weight faster than those who do not. This is because producing milk and breastfeeding requires about 500 calories per day. This is the equivalent of jogging about five miles! Breastfeeding also stimulates contractions in the uterus that help it to shrink back to its normal, pre-pregnancy size faster. It also helps to reduce lower body fat.

7. Save Time and Money

Of course, your primary reason for wanting to breastfeed is for your baby, but the more material advantages of breastfeeding are hard to ignore. If you breastfeed you don’t have to prepare bottles and formula–breast milk is always fresh and ready to go. This will save you a substantial amount of time at a period in your life when you will need it!

Breastfeeding also saves you the expense of buying formula, which typically costs at least $800 per year. The savings continue to accumulate as your child grows, as breastfed babies tend to have fewer doctor’s visits and lower overall medical expenses. One study even found that a group of formula-fed babies had over $68,000 in health care costs for six months, compared to only $4,000 for the breastfed group.

From: Seven Reasons to Breastfeed Your Child That You Need to Know

More info: Breastfeeding A-Z Index

Overcoming Pregnancy Stereotypes at Work

NY Times: “Pregnant women in the workforce are often stigmatized and stereotyped and can elicit unwanted paternalistic protection,” says Jack Tuckner, a partner in Tuckner, Sipser, Weinstock & Sipser, a law firm in Manhattan specializing in women’s workplace rights.

For example, he said, someone might think it’s best if the pregnant woman is not included in late night deadlines, social events involving “knocking back martinis” with the team, or long-term projects that may coincide with her due date.  A pregnant woman might also be excluded from e-mail lists, meetings or business trips. 

Eden B. King, an assistant professor of psychology at George Mason University, explains:  “They are seen as already being out of the game,” she said. “Some women report experiencing a form of benevolent sexism, where they are treated like a child who needs to be protected or people pat their stomach.”

So what can you do to get fair treatment?  Speak up, says Tuckner; according to federal and state laws, pregnant women are protected from being treated differently from others.  It’s advisable to put any formal complaint in writing, but keep it civilized and add a touch of humor if appropriate. An informal email is better than an angry letter, which may turn people against you (and elicit a couple snide comments about raging hormones).

But there is a benefit to being pregnant and returning after work as a new parent, says Jamie Ladge, an assistant professor at the Northeastern University College of Business Administration who has conducted studies on pregnancy in the workplace.  Becoming a mother (especially a first-timer) helps you connect to people at varying levels within the company who are also parents. “You make friends with more senior people, clients and those in other departments, easing into a conversation without making it all business,” she said. “Now you have this common ground and that can have very positive ramifications for your career.”

When should I tell people I’m pregnant?

Most women like to wait until they’re past the 12-week mark.  Most women are not showing until about that time, anyway. But if you are experiencing morning sickness, fatigue, or other pregnancy symptoms, you might want to explain to co-workers what is going on. Disclosing your pregnancy early also allows more time to communicate about it with colleagues, says Ms. King.

Keep a barf bag handy

Well, maybe not an actual barf bag. But if you experience nausea and vomiting, you should prepare a bag of emergency supplies, including things like ginger snaps, dry cereal, crackers, hard lemon candies and mouthwash, “and an extra blouse, in case it gets stained or sweaty.”

If you find that you need to use the bathroom frequently, try to combine trips to the bathroom with other places you need to visit, like the mailroom. When in meetings, sit near the door so you can make a quick escape if necessary.

When dealing with fatigue, inquire about having more flexible hours, so that you can come in later or work part-time at home. Some women try to plan time off at the eighth or ninth week, which is when symptoms tend to peak.

Staying part of the team during maternity leave

Make sure your boss and coworkers know how important your career is, that you plan on coming back, and that you are committed to the organization. You can show this even during maternity leave by calling in to see how projects are progressing and stopping by with the baby for a visit, said Jamie Ladge.

Read the entire article here: Expecting a Baby, but Not the Stereotypes

After Content Ad