Newborn Male Circumcision

What is circumcision?

Male circumcision is the surgical removal of some or all of the skin covering the tip of the penis, called the foreskin or the prepuce. In the United States, this surgery is often performed within the first few days of an infant’s life, when it is considered the most “simple.” It can also be performed later in life, should a man choose, though the procedure is considered “more complex.”

Infant male circumcision is one of many decisions parents are asked to make during their pregnancy or shortly after their boy is born. Socio-culturally speaking, this issue is very controversial and carries a lot of cultural, religious, and ethical charge. We believe that informed decision-making is paramount and want to empower our families to make an educated decision about infant male circumcision. While we cannot cover all of the information about male circumcision here, we hope to offer a broad look of this issue, as a launching point for gathering more information.

How prevalent is circumcision?

Globally, it was estimated in 2006 that approximately 30% of the world’s men were circumcised. The practice is nearly universal in some parts of the world (in most of these countries the practice is done almost exclusively for religious or cultural reasons), while in other areas the numbers are quite low.

In the United States, most estimates show that between 70-90% of males are circumcised, with the numbers peaking in the 1960s and falling by 5 to 10% since then. The practice has seen a greater decline in other developed nations including Canada, England, other parts of Europe, and Australia. The rates also vary by race, region, and class in the United States today.

The Controversy

There are a variety of views about circumcision. Generally speaking, those in favor of circumcision point to medical evidence that circumcision offers some health benefits to men. These advocates state that the benefits of the procedure greatly outweigh the potential risks. Some believe that circumcision should be performed for religious or cultural reasons (this is the more common reason, globally speaking).

Critics of the procedure believe it is entirely unnecessary, traumatic, and painful to a child.

Some people talk about the importance of choice—that parents should be able to make a choice about whether or not to circumcise their child. Others argue that the choice should be with the child because it is their body—in this view, circumcision is not considered ethical to perform on someone who is not able to make that choice.

Parents are often weighing all of these views and conflicting information in the context of cultural and familial norms. That is, many of the men in our country (and within our families) are circumcised, so there may be an additional pressure (stated or unstated) to conform to this norm.

It can be helpful to become aware of the reasons you may feel compelled toward or against the procedure as you explore this issue for yourself or your family.

The purported pros of male circumcision

In the US, the practice began in the late 1800s, prior to the germ theory of disease, when circumcision was thought to be “morally hygienic” (reducing sexual excitation) and even curative of such things as paralysis, masturbation, epilepsy, and insomnia. Those views have changed, but the health benefits of circumcision are still widely touted by the dominant medical community in our country.

For a long time, the American Academy of Pediatrics had remained neutral on the practice of circumcision. Then in 2012, it changed its policy (on which many insurance and social health care decisions are made). This new statement on circumcision stated that medical evidence shows that the health benefits of circumcision significantly outweigh the potential risks. They stopped short of actually recommending the practice, however, and instead said that families should have access to the procedure if they so desire.

The health benefits of male circumcision, as described by the AAP report include but are not limited to the following:

• Reduced lifetime risk of urinary tract infections
• Lowered risk of some cancers of the penis and prostate
• Lowered risk of some, but not all, sexually transmitted diseases

They claim that the benefits outweigh the risks by 100 to 1 and that 50% of all those uncircumcised will experience some negative health effects as a result. They also claim that circumcision does not appear to have any negative effects on sexual sensitivity or function later in life.

The purported cons of male circumcision

There are many reasons given against male circumcision. The group Intact America, one of several organizations in the United States that are against circumcision, offers the following 10 arguments against circumcising, which you can read more about on theirs and other websites. 

1. There is no medical reason for “routine” circumcision of baby boys and it is not recommended by any major organization in the nation.
2. The foreskin is not a birth defect; it is a normal, sensitive, functional part of the body.
3. Federal and state laws protect girls of all ages from forced genital surgery and they should protect boys as well.
4. Circumcision exposes a child to unnecessary pain and medical risks
5. Removing part of a baby’s penis is painful, risky, and harmful.
6. Times and attitudes have changed and it is becoming more acceptable not to circumcise.
7. Most medically advanced nations do not circumcise baby boys
8. Caring for and cleaning the foreskin is easy and being intact doesn’t present hygienic concerns.
9. Circumcision does not prevent HIV or other diseases
10. Children should be protected from permanent bodily alteration inflicted on them without their consent in the name of culture, religion, profit, or parental preference.

Risks of circumcision

Significant complications are believed to occur in approximately one in 500 procedures.  One source states that over 100 infant males die each year as a result of circumcision complications, although this number is hotly contested by some members of the medical community and does not seem to be supported by medical data (although reports of circumcision deaths are not actually reported to the CDC, making it difficult to gather data at all).

Possible complications of circumcision can include:

• Local Bruising
• Bleeding
• Scarring (always occurs)
• Adhesions
• Puncture and skin bridges
• Amputation
• Difficulty breastfeeding
• Difficulty with urination
• Long term aggravated response to pain
• Infection
• Subsequent corrective surgery
• Permanent disability or death

Many also argue that because the foreskin is so sexually sensitive, that circumcision reduces sexual pleasure and function.

This list doesn’t include the potentially negative psychological impact of this procedure on the newborn child, which is more difficult to account for.

Bottom Line

As mentioned we encourage our families to research and talk to their pediatric care providers about circumcision. We hope this article serves as a “launching off” point for one’s own exploration of this issue and we hope that each family makes an informed decision based on their own preferences and values, as well as a clear understanding of the available information on circumcision.

Resources

http://www.mayoclinicproceedings.org/article/S0025-6196%2814%2900036-6/fulltext#tbl4fne

http://www.mayoclinic.org/tests-procedures/circumcision/basics/why-its-done/prc-20013585

http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-1990

http://www.nytimes.com/2012/08/27/science/benefits-of-circumcision-outweigh-risks-pediatric-group-says.html?_r=0

http://www.who.int/hiv/pub/malecircumcision/infopack_en_2.pdf

http://www.jurology.com/article/S0022-5347(12)05623-6/abstract

http://www.intactamerica.org

http://www.circumcision.org/

http://www.cirp.org

www.cirp.org

Eight Reasons to Wear Your Baby

Baby wearing is the experience of carrying your child in a sling or other carrier on your chest (and/or, as they get older, on your back). Baby carriers come in different materials and configurations, each with their benefits. Keeping a child close to you in a carrier is a natural practice utilized by people across time and cultures. There is something instinctual and natural about keeping babies close to our bodies in infancy. Baby wearing has many practical benefits but, more importantly, it offers a number of significant benefits for baby and caregiver. Here are eight benefits of carrying your baby in a carrier in his or her early days, months and even years.

1. Baby wearing supports bonding.

When we wear baby close to us, we learn his cues and communications so intimately. This not only allows us to get to know our child, it helps us more effectively meet his or her needs, which will support bonding, ease the transition into parenthood, and so much more. Face to face orientation between baby and caregiver offers a powerful catalyst for bonding. Baby wearing can be great not only for mom and baby pairs, but also for dad (or other parent) and baby pairs, and babies and other caregivers, such as relatives. It gives others an opportunity to be close to and bond with baby.

2. Baby wearing is good for baby’s physiological systems.

According to Dr. Sears, babywearing provides an external regulation system that balances the irregular and disorganized tendencies of a baby adjusting to life outside the womb, where all systems were once in harmony and regulated for them. If you think about it, the baby in utero is lulled to sleep by the rhythmic movements of his mother as she walks or moves about during the day. The gentle pulsing sound of her heartbeat and her breath are familiar and constant rhythms throughout womb life and likely offer tremendous comfort and stability.

Bringing baby close to us in a carrier or just being held, reintroduces those powerful organizing environmental cues back into baby’s life—baby places her ear to mama’s chest and hears mama breathing, baby is lulled to sleep by papa’s heart beat as he carries about his morning routine, baby is soothed by the familiar rhythms of walking as mom and dad go for a neighborhood stroll. All of these regular rhythms not only comfort but also have an organizing effect on an infant’s naturally rhythmic physiological processes, such as sleeping and waking; breathing; eating, digestion and elimination; temperature; heart rate; and more.

3. Carried and worn babies are happier and cry less.

Likely connected to the phenomenon above, babies who are carried and held often are less fussy, cry less, and seem more content than those who are put into devices (such as cribs, car seats, and bouncers) most of the time. According to one study in which routine baby wearing (3 or more hours of carrying per day) was compared to a control given no instructions on wearing baby, the babies held more often throughout the day cried over 40% less. Wearing or carrying baby close helps make them secure and content. Furthermore, colic and reflux can be reduced by the upright position of being held, which can make babies more comfortable (and thus happier).

4. Carried and worn babies learn more.

When babies are not exerting their energy on crying and fussing, they are able to devote more energy into taking in and learning from their environments. Research shows that babies who are carried show enhanced visual and auditory alertness and spend more time in the quiet alert state in which they are best able to interact with their environment. Carried babies also have the opportunity to see more and experience more varied environmental stimulus at an adult’s chest level than they would if they were on the ground or in a device. Carried babies are intimately involved in their caregiver’s world and learn what human life is all about from a young age.

5. Carried and worn babies develop social skills

Along those same lines, being at an adult’s chest level, babies get an opportunity to pay close attention to the subtle non verbal language used by their caregivers and by others in their shared environment. They begin to learn how social interaction works, what cues are used for different feelings and needs, and the whole dance of human social life. Carried babies also get more opportunity to observe and learn verbal language as well. Research has found that carried babies experience enhanced speech development. Many report that carried babies seem to be more tuned into and attentive toward the world around them.

6. Baby wearing is convenient.

Babies can nap in a sling or just be with you during their waking hours, happily carried about in a soft carrier. With your hands free, you can still attend to and be close to your baby while taking care of your life responsibilities and doing things you enjoy. You don’t have to be distracted by a baby monitor or constantly stop to soothe or check in with baby. Many mamas exercise with baby in a carrier, socialize with friends or family, get household chores done, and so much more with a baby in a carrier.

7. Carrying baby in a carrier (versus car seat) is better for parent or caregiver’s body 

Sure there may be some times when baby falls asleep right before you get somewhere and leaving baby in the car seat means more rest for them while you go about your business. However, making a habit of leaving baby in the car seat can deprive you and your baby of the benefits of close physical proximity. More than this, carrying around a car seat is not easy on a caregiver’s body. Having that much weight outside your center of gravity is hard on the body and can cause or exacerbate physical pains and stresses. This is not ideal for the healing postpartum body. Holding baby close, in a carrier for example, is easier because there is no extra weight of the car seat and baby is much closer to your center of gravity, making it easier on the body to carry this additional weight.

8. Baby wearing is economical.

Baby carriers can run from $10-20 (used—or free!) up to about $100 or so. This is typically far less than the cost of strollers, baby bouncers, and other devices meant to hold baby. Baby carriers often last a long time and can be used from a the newborn stage into toddlerhood.

These are just some of the many great reasons to keep baby close in infancy. If you choose to use a baby carrier, do some research into the different kinds, ask others for recommendations, and try them out to see what works best for you (many parents have different preferences in style. Make sure to follow safety recommendations as well to keep baby safe while in a carrier. Enjoy these precious times with baby.

Infant Massage: How To

As we mentioned last week in a post on the benefits of infant massage, this special activity with baby can be a great bonding tool with myriad benefits to both babies and their caregivers.

While no special training is required to offer healthy touch to a baby, here is some additional information on how to give infant massage.

When to massage

For young babies, it can be ideal to offer a massage when your baby is in a quiet yet alert state. You may want to avoid the time just after a feeding or when baby is sleepy.

Setting the scene

Lay a soft towel or blanket on the bed or floor where you will offer the massage. You may also wish to sit on the floor (or bed) with the soles of your feet together and knees apart, forming a diamond shape with your legs. Drape the blanket over your feet and between your knees. Undress baby down to the diaper and place him or her on the blanket, head toward your feet, facing you.

You can use massage oil in a non-breakable container. Almond oil or coconut oil work well for many babies, but you may wish to test the oil on a small spot on baby’s skin and wait a day to ensure they aren’t irritated by the oil.

Beginning

Start with a gentle stroke from baby’s head to toes. If baby stiffens up, cries, or becomes irritable, switch to another area of the body or end the massage for time being. If s/he responds well, start gently massaging his/her body. Here are some techniques for each body area.  Note: their is not one particular “right” order of body areas to massage.  You may choose to work from trunk to extremities, or the opposite, or massage in any order that feels right.

Tummy

1. Hold your hands palms toward you, fingers pointing in (wrists bent), so the edge of your pinky can move across your baby’s belly. Starting at the base of the rib cage, stroke down with one hand, then the other, continuing one after the other.
2. Massage her belly with your fingertips in a circular, clockwise motion.
3. Do the “I Love U” stroke: Trace the letter I down your baby’s left side. Then trace an inverted L, moving across the belly along the base of her ribs from your left to right and then down. Trace an inverted U, stroking from low on the baby’s right side (your left), up and around the navel, and down the left side (your right).
4. Walk your fingers around baby’s navel, clockwise.
5. Hold baby’s knees and feet together and gently press knees up toward the belly. Rotate baby’s hips around a couple times to the right. (Great for expelling gas. 

Note: Avoid massaging tummy if the umbilical cord site hasn’t completely healed.

Head and Face 

1. Cradle your baby’s head with both hands, gently massage the scalp with your fingertips, as if you’re shampooing. (Avoid the fontanel, the soft spot on top of baby’s head.)
2. Massage her ears between your thumb and index finger.
3. Trace a heart shape on baby’s face, bringing your hands together at his/her chin.
4. Place your thumbs between your baby’s eyebrows, and stroke outward.
5. Stroke from the bridge of the nose out over the cheeks.
6. Using your fingertips, massage the jaw hinge in small circles.

Chest

1. Place both hands on baby’s chest and stroke outward from sternum to shoulders.
2. Beginning at the sternum, trace a heart shape bringing both hands up to the shoulders, then down and back together.
3. In a crisscross pattern, stroke diagonally from one side of your baby’s hip, up and over the opposite shoulder, and back down to her hip.

Arms

1. Hold her wrist with one hand and hold your other hand in a C-shape around baby’s upper arm; make long strokes from her shoulder down to her wrist
2. With each hand grasping her arm, one right above the other, stroke down from shoulder to wrist with both hands rotating in opposite directions, as if you were gently wringing out a towel.
3. Massage baby’s palms, moving thumb over thumb from heel of the hand to the fingers.
4. Stroke down from the wrist to fingertips on the back or front of the hand. Gently squeeze and pull each finger.
5. Roll her arm between both your hands.

Legs

1. Hold the ankle with one hand and hold your other hand in a C-shape, thumb down, around your baby’s upper thigh. Stroke from thigh down to foot, skipping over the knee joint.
2. With your hands grasping the leg at the thigh, one right above the other, stroke down from hip to foot with both hands rotating in opposite directions, as if you were wringing out a towel.
3. On the sole of her foot, use a thumb-over-thumb motion to massage from heel to toes.
4. Use your whole hand to stroke the bottom of the foot from heel to toes.
5. Stroke the top of the foot. Gently squeeze and pull each toe.
6. Roll each leg between your hands, as if you’re rolling dough.

Back

Place baby on tummy horizontally in front of you, or lay baby across your outstretched legs. Keep baby’s hands in front of him/her, not at the sides.

1. With both of your hands on baby’s back, move each hand back and forth (keeping them going in opposite directions) from the base of the neck to her buttocks.
2. Hold your baby’s bottom with one hand and use the other to make long strokes from the neck down to the bottom.
3. Using your fingertips, massage in small circles down one side of baby’s spine and up the other. Avoid pressing on the spine directly.
4. Massage the shoulders with small circular motions.
5. Massage the bottom with big circular motions.
6. Holding your fingers like a rake, stroke down her back.

Other infant massage tips:

• Make strokes gentle but firm, and not ticklish.
• Build massage into your baby’s daily schedule.
• Follow baby’s signals about when to stop. A massage can last anywhere from a few minutes to as much as 30 minutes, depending on baby’s moods.
• Enjoy this precious time with your beloved little one.

Five reasons to massage your baby!

Infant massage offers many benefits to babies and their caregivers. For many parents, touch is a natural part of caring for their children but some may not feel like they know how to give infant massage. While you can certainly take a class on infant massage, watch a youtube video or a read book about baby massage, you don’t have to be an expert to offer this wonderful healing touch to your child. If you follow your instincts and have a little fun, you can massage your baby without any additional knowledge. (Next week, we will post a “how to” for those wanting some more information on giving infant massage)

Here are five great reasons to massage your baby

1. Infant massage facilitates bonding and healthy attachment

Infant massage promotes and develops positive interactions between caregivers and babies, helping them to better learn each others’ feelings and needs and understand one another’s communication. Massage and regular touch can help infants to feel more secure and attached to their caregivers. Massage facilitates the release of “love” hormones such as oxytocin and prolactin in both caregiver and baby, helping each to feel connected to one another in a strong, positive and healthy way. Infant massage is a great way for fathers to build their nurturing skills.

2. Infant massage can help with colic and digestive complaints

Massage can help tone the digestive tract and stimulate the release of insulin and related chemicals, which help with food absorption. According to research, infant massage can increase the assimilation of nutrients at the cell level, helping babies’ digestive systems function better, including easier elimination and less gas.

3. Infant massage calms babies, helping them to cry less and sleep better

Massage stimulates the body’s production and release of natural painkillers that may ease emotional distress. Touch balances our autonomic nervous systems. Massage can help to relieve tension in a baby’s body caused by all the sensory stimulation and processing he/she experiences in daily life.

4. Infant massage can increase baby’s brain and muscular development

Research shows that frequent healthy touch increases a baby’s neurological and muscular development. Infant massage can also have a profound effect on a child’s emotional development.

As one professor and researcher of developmental psychology put it,

“Early understanding of self and early understanding of other is developed through interaction. It teaches babies basic lessons that they have some agency in the world, so that allows them to explore the world and feel like they can affect their environment as opposed to just being helpless to whatever happens to them. We’re basically a social species, and we learn those things through interacting with others.”

5. Infant massage reduces levels of stress in the caregiver

Mothers and fathers (and other caregivers) who offer infant massage to their children and other forms of nurturing touch on a regular basis report lower levels of depression. They also seem to be more sensitive to their babies cues, are thus better able to meet their child’s needs, and experience greater overall satisfaction in their relationship with baby. Infant massage boosts positive caregiving and maternal feelings in adults.

Stay tuned for next week’s details on offering infant massage.

Flower essences

Flower essences are an amazing and lesser-known healing resource that can be quite amazing for expectant and new mamas, and, really, anyone.  We offer a line of flower essences by Santosha Birth and Wellness that are specifically for conception, pregnancy, birth and motherhood.  We also have a new acupuncturist that is trained in the use of flower essences.  With all the buzz about flower essences, we wanted to share a bit more about what flower essences are and why they are so wonderful for the childbearing cycle.  

What are flower essences?

Flower essences are type of botanical medicine that works on the energetic level (like acupuncture does) to positively affect the emotions, energy, and deeper soul levels. Flower essences are especially suited to helping people overcome obstacles, heal the past, reduce negative thoughts, actions and perspectives, cope with changes and challenges, and achieve greater joy and peace. Put simply, flower essences are energy medicine—they safely and effectively address root causes of emotional and physical issues to bring healing and growth on all levels (physical, emotional, mental and soul).

Odorless and virtually tasteless, a flower essence is an infusion of flowers stabilized in water and a small amount of brandy to preserve. 

What is the history of flower essences?

Flower essence therapy has been used by indigenous people for centuries and have been thoroughly studied and developed in the West for over a century. Dr. Bach, a British physician and homeopathic doctor, was the first to develop a robust system of flower essence therapy in the early 1900s. His system included 38 flower essences and his blend, Rescue Remedy^® is the most famous of all flower essences. Dr. Bach’s early death left room for further development and refinement of this system and additional flower essences have been added to this healing system.

Master herbalists such a German healer Julia Graves (creator of the Lily Circle) and Flower Essence Service, among others, have continued Dr. Bach’s legacy, producing high quality flower essences that yield profound results. The Lily Circle (used in Santosha’s blends) is exceptionally well suited for female archetypal issues and those surrounding birth and motherhood, but are equally powerful and healing for all people.  

Why flower essences?

There are so many reasons why flower essences are an incredible healing tool, especially in the childbearing cycle.  

They are safe: Because flower essences work on the energetic rather than biochemical level, they don’t pose the same risks that some pharmaceuticals, herbal tinctures, and essential oils may pose. This makes flower essences particularly attractive for treating issues that may arise in the childbearing cycle, when other treatments may not be advised. Flower essences are completely safe for use in pregnant women, birthing women, nursing women, newborns, infants, and children (and even pets and plants, evidence shows!). There are NO known contraindications.

They are gentle: Flower essences are gentle, they don’t work by force, nor do they overwhelm the body or mind. Flower essences are subtle, yet powerful and profound in the positive change they produce.

They address root causes of physical ailments and emotional/spiritual conditions. Flower essences often get to the source of one’s physical or other ailments. By addressing underlying emotional/mental/energetic/spiritual factors contributing to dis-ease or challenges, flower essences heal the deeper levels of one’s being and when they are healed, the body follows. What better time than pregnancy to clear out what doesn’t serve us and make room for greater wellbeing in parenthood? The healthier and happy we are going into parenting, the better we can be for ourselves and our children!

How do you use a flower essence?

Flower essences are commonly taken by mouth, with 4 drops taken orally 4 times a day. This is a general guideline—a person in an acute situation (e.g. labor) may take an essence as frequently as every 10 minutes as needed. Taking an essence frequently is the path to desired change. Because there is a small amount of brandy in the essence, some pregnant women or sensitive individuals may prefer not to take the essence directly under the tongue. You can add an essence to beverage—covered water is best (but tea or juice can also be used). For those that wish to avoid ingestion entirely, flower essences can be sprayed or applied on to the skin, clothing, bedding or air. One can also take a flower essence bath.

How long should one use a flower essence?

Many flower essence practitioners note a definite cycle period in taking a flower essence, typically two to four weeks though this can be longer or shorter for some and depending on the reason for use.

Can flower essences be used together with other healing modalities?

Flower essences can be used alone or in conjunction with other therapies to enhance a healing process. They have been used with great success by flower essence practitioners, naturopathic doctors, massage therapists, psychologists, medical doctors, veterinarians, and other health care practitioners.

How do I learn more?  

If you want to learn more about flower essences, you can speak with us at an upcoming appointment or contact Santosha Birth and Wellness directly at http://www.santoshamama.com.  

4 of the most important pregnancy foods you never hear about

Here at Health Foundations, we emphasize the importance of a healthy diet before and during pregnancy because we’ve seen again and again how much of a difference good nutrition makes in the health of mom and baby, including a reduced risk of c-sections, easier labors, quicker postpartum healing, and so much more.  And the benefits aren’t just relegated to the childbearing year.  Babies who receive good nutrition in the womb are at a lower risk for many serious diseases in their child and adulthoods, including high blood pressure, diabetes, obesity, breast cancer, autism, and ADHD.  Science is finding the crucial role nutrition plays in epigenetics, or the factors, such as chemical reactions, that influence gene expression.  Cutting edge studies are finding the importance of the gut microbiome in overall health for both babies and adults.  

So in that spirit, here are five foods that you might not find on the list of best pregnancy foods but are actually some of the best foods you can eat when expecting (and when planning to conceive).  

1.  Traditional Fats:  

We went through a phase in our collective history during which everyone feared fats.  And we still haven’t quite recovered.  But many kinds of natural fats are not only good for you, they are essential to your wellbeing.  Across cultures, you will find fats emphasized in fertility and pregnancy diets.  Good fats include ghee, butter, dairy fat (full fat dairy products), avocados, and coconut oil.  Used in moderation, these healthy fats can do a world of good for you and baby.  They can support maternal skin health, optimizing your body’s response to the stretches and effects of gravity that pregnancy impose.  Healthy fats in pregnancy also lower the risk of childhood allergies for baby, research shows.  Additional studies show that health fat consumption in pregnancy can lower the risk of baby later developing autism.  

2.  Organ meats:

Okay, we are not a culture that commonly enjoyed organ meats.  In fact the words alone may turn people off.  But meats like liver are super foods when it comes to baby making (we’re talking pregnancy here, folks).  Organic, grassfed and/or free range organ meats are some of the most nutrient dense foods absolutely loaded with a wide array of vitamins, minerals, proteins and fat.  They are particularly rich in the nutrients that help keep our brains healthy and grow healthy well-functioning baby brains– i.e.  the essential fatty acids EPA (eicosapentaenoic acid), DHA (docasahexaenoic acid), and AA (arachidonic acid). Liver is one of the best sources of folate, which is SO crucial in pregnancy (and supplemental folic acid pales in comparison to food-sourced folate in terms of health).  Liver and other organ meats are also tremendous sources of:

• high-quality protein
• fat soluble vitamins A, D, E and K
• vitamin A, which is rapidly depleted during periods of stress
• All the B vitamins in abundance, particularly vitamin B12
• A highly usable form of iron, so important in pregnancy
• Trace elements such as copper, zinc and chromium
• CoQ10, a nutrient that is especially important for cardio-vascular function
• Purines, nitrogen-containing compounds that serve as precursors for DNA and RNA

One of the easiest and tastiest ways to eat liver is through liver pates.  Here is a tasty recipe for Chicken Liver Pate.  Here is one for a delicious Beef Liver with fig, bacon, and caramelized onion.  While not as ideal as consuming as food, desiccated liver in capsule form is also available.  

3.  Bone Broth

Beloved by the burgeoning paleo health movement, bone broth has numerous benefits for both mamas and babies (and the rest of us!)  Bone broth has shown to offer the following benefits:

• builds, rebuilds and repairs our connective tissue, including joints, tendons and ligaments
• improves hair, skin and nails
• strengthens bones
• heals and promotes a healthy digestive system 
• supports optimal nerve health
• great for the immune system
• good source of protein
• supports brain health
• boosts fertility
• and much more

Because broth supports the nervous system, endocrine system and brain function, consuming it while pregnant helps the developing fetus build healthy organs.

Bone broth is cheap and easy to make yourself.  You can use the bones from a whole chicken you have cooked or can get soup bones from the coop. It is best to use high quality bones to make bone broth– those from healthy (grassfed or free range), organic sources.  This is not a difficult thing to do in Minnesota!  There are many great recipes out there for bone broth.  Here is one simple way to make and enjoy bone broth throughout the week.

4.   Fermented foods

Fermented foods are some of the best sources of probiotics one can get from food (which is a superior source of all nutrients, compared to supplements, in virtually all cases).   Fermented foods are great for maintaining a healthy digestive system in pregnancy, which many of us know can go awry when we are expecting.  Eating these probiotic-rich foods is also great for gut health and the immune system and can positively impact your child’s gut health and overall wellbeing.  Fermented foods also increase your body’s ability to absorb the maximum level of nutrients from the foods you eat.  You can make your own fermented foods or there are some great (and quite tasty!) options available at co-ops, Whole Foods, and other health markets.  Examples of fermented foods include:

• Sauerkraut
• Kimchi
• Kefir
• Plain yogurt
• Kombucha

Here’s to you and your family’s health, mamas!

Breast Feeding after Breast Reduction (BFAR)– One mama’s journey through the first 6 months

BFAR – My Journey through 6 Months

Photo credit: Render Photography

When I became pregnant with my son, George, I knew I wanted to breastfeed him.  There were a lot of reasons that this was important to me: nursing him would be better for his health, for my health, and it just felt like it was the natural thing to do.  Every time I learned another thing about breastfeeding, I was amazed.  

 

I read so many horror stories on the internet, from bleeding nipples, to low milk supply, to oversupply.  In fact, my mom hadn’t been able to nurse me due to recurring mastitis, and she never even tried with my brother.  I knew that nursing could be really hard – it could be impossible.  And that was from women who had never had breast surgery.  

 

When I was 17, I had a breast reduction.  It was not a tough decision to make.  I was told that there was a chance I wouldn’t be able to breastfeed, but I was 17 and not thinking that far down the line.  I had the surgery the summer I graduated from high school, and I felt so much more confident.  Although I had the scars to remind me, it became a distant memory.

 

Fourteen years later as I prepared to give birth, I started researching as much about breastfeeding after breast reduction as possible.  I read Diana West’s book, Defining Your Own Success: Breastfeeding after Breast Reduction Surgery.  In it were many stories about women who had varied amount of success with breastfeeding.  I felt like the book prepared me to fail, to be mentally OK with the idea that exclusive breastfeeding was not the only option.  

 

I called my plastic surgeon to ask his office which type of surgery I’d had (inferior pedicle).  That method was known to have the best success rate for nursing because it leaves the nipple intact.  I was relieved.

 

I read and read and googled everything I could on the internet.  I think I found one success story on a blog but for the most part success stories were few and far between, especially for first time moms.

 

Perhaps the best thing I did was read Ina May’s Guide to Childbirth.  Her book helped shape my whole birth plan.  Instead of giving birth in a hospital, I chose to have my baby in a freestanding birth center.  Although her book did not directly discuss breastfeeding after a breast reduction, it did offer many suggestions applicable to all women attempting to breastfeed – skin to skin contact immediately after the birth of the baby, rooming in with the baby, initiating breastfeeding as soon as possible after the birth, limiting the use of drugs and other modern interventions so that baby is wide eyed and awake after birth, no pacifiers, bottles, supplementing, etc.  I felt that having a natural birth, without any medical intervention (no pitocin, no pain medications, etc) would set me up for the best breastfeeding journey.  Additionally, the birth center released its patients just 5 hours after the birth of the baby.  I’d recover in my own bed, with my husband and mom caring for me, instead of nurses I didn’t know, which was one of my biggest fears about a hospital setting.

 

I’m not sure if I would have been as successful breastfeeding had my birth story been different, but I am so thankful that I had an uncomplicated labor and delivery, and I was home in my own bed the night that George was born, snuggling with my sweet baby.  

 

My milk came in within 48 hours of having George.  George was born 2 weeks late at 9 lbs, 6.5 oz.  I think he got down to about 8 lbs 12 oz, and was back to 9 lbs 1 oz by day 6.  He nursed like a champ!  He was hungry ALL the time and those first couple of weeks my nipples were SO sore, but no one, myself included, ever asked if he was getting enough milk.  There was never a doubt in my mind.

 

I wanted to wait we had really settled into a routine to write about my experience.  It was so wonderful, I didn’t want to jinx it.  

 

I exclusively nursed George until he was just 5 days shy of 6 months old.  We then started introducing solid foods via baby led weaning.

 

I think that there are a couple of things that really helped us to have a successful nursing relationship.  One: a birth team and husband who knew a lot about breastfeeding and who were 100% supportive.  Two: a ton of education while pregnant.  The birth center offered a one on one consultation with a lactation consultant during one of the last visits; one of the Bradley Method classes was dedicated to breastfeeding; in addition, I had the chance to do lots of research on sites like kellymom.com, which I bookmarked for questions that arose after George was born.

 

Nursing my son might be the coolest thing I’ve ever done.  It’s definitely the most beautiful thing my body has ever done, in addition to growing this tiny, perfect human.  I hope and pray that every woman who wants to breastfeed has the opportunity to do so, and that my story can help offer some hope to women who have chosen breast reduction surgery.

 

UPDATE:

George is now 9 months old are we are still enjoying nursing – maybe more than ever!  It calms him if he’s upset, it helps him sleep if he’s tired, and it’s so easy now that he can more actively participate.  I’m planning to let George self-wean, and I definitely don’t see that happening anytime soon.

Extended Breastfeeding

Source: kellymom.com

While there is much important information out there about nursing in the early days, weeks, and months of your child’s life, we hear less about the nursing relationship after a child’s first birthday and beyond.  Nursing beyond the first year of life is often referred to as extended breastfeeding here in the US, though other cultures don’t consider breastfeeding to be “extended” until after a child’s third birthday, as longer nursing relationships are more common.

Rates of Extended Breastfeeding

According to the CDC’s 2011 Breastfeeding Report Card, approximately three-quarters of mama-baby pairs initiate a breastfeeding relationship after birth.  At six months, about half of all mama-baby pairs are breastfeeding and at baby’s first birthday, about one quarter of all mama-baby pairs still enjoys a breastfeeding relationship. In Minnesota, about 23% are nursing by the child’s first birthday.

In many nations, the rates of breastfeeding at one year are much higher; for example, India, Iran, and the majority of countries in Africa have breastfeeding rates at one year at or above 90%.

Extended breastfeeding in the US

A 1994 study in the journal Birth looked at the characteristics of women and their children when breastfeeding continued beyond a year.  This study found that:

• Longer duration of breastfeeding was associated with greater maternal age and education and longer rates of exclusive breastfeeding
• Nearly 70% of women who continued to nurse beyond 1 year had returned to work before the child’s first birthday.
• About half of the women reported nursing on demand.
• At 12 to 15 months, 54% of children were sleeping separate from their mothers (in cribs) and 37% were co-sleeping
• The most frequently cited reason for continuing the breastfeeding relationship was the perception that it was a special way to nurture and bond with baby.

Another study of 179 women who nursed beyond one year found that the average age of weaning among this group was 2.5 to 3 years of age, with a span ranging from one month to 7 years.  Most of the women in this group described weaning as gradual and child-led.  Some also cited a subsequent pregnancy as the reason for weaning.

Support for extended breastfeeding

Most major health organizations both in the US and internationally recommend extended breastfeeding, citing significant health benefits to both mother and child.

• The World Health Organization recommends breastfeeding for at least 2 years.

• The American Academy of Pediatrics recommends that “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child… Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother… There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.”(AAP 2012, AAP 2005)

• The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and “should ideally continue beyond infancy,” though not the cultural norm in the United States. They cite that the natural weaning age for humans is between two and seven years. They also recognize that continued breastfeeding offers a child immune protection, better social adjustment, and a sustainable food source in times of emergency and offers the mother a reduced risk of breast cancer and other illnesses. They also note that, “If the child is younger than two years of age, the child is at increased risk of illness if weaned.” (AAFP 2008)

• The Academy of Breastfeeding Medicine affirms breastfeeding beyond infancy as the biological norm, with average age of weaning between six months to five years.  The president of The Academy says idea that breastfeeding beyond infancy is harmful to mother or infant has absolutely no medical or scientific basis.   He notes the more salient issue is the damage caused by modern practices of premature weaning.”  The Academy further notes that increased breastfeeding duration is associated with reduced maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, obesity, and heart attack.” (ABM 2012)

Benefits of extended breastfeeding for children

Evidence shows that breastfeeding continues to be a valuable source of nutrition and disease protection for as long as breastfeeding continues.  A 2005 study noted that human milk expressed beyond the first year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods.  A 2001 study noted that, “Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”

Some argue that breast milk doesn’t provide the same benefits after the first year.  However, some of the immune factors in breast milk increase in concentration during the second year and also during the weaning process. In several studies, breastfeeding toddlers between the ages of one and three have been found to have fewer illnesses, illnesses of shorter duration, and lower mortality rates.  The World Health Organization notes the importance of breastfeeding in the treatment and prevention of childhood illness, and states that “a modest increase in breastfeeding rates could prevent up to 10% of all deaths of children under five.

The benefits of extended breastfeeding continue beyond the body.  Research shows the longer a child nurses, the greater their cognitive development (as measured by IQ scores and grades in school later on).  Other studies show that children breastfed longer are more socially developed and have lower rates of mental health problems throughout childhood and adolescence.

Benefits of extended breastfeeding for mothers

Studies show the following benefits of extended breastfeeding for mothers:

• Delayed return of fertility
• Easier ability to lose weight if desired
• Lowered risk of:
  • breast cancer
  • ovarian cancer
  • uterine cancer
  • endometrial cancer
  • osteoporosis
  • rheumatoid arthritis
  • cardiovascular disease
  • Type 2 diabetes mellitus in mothers who do not have a history of gestational diabetes

Beyond the measurable

Elizabeth Baldwin, attorney and author of “Extended Breastfeeding and the Law” notes the following:

“Breastfeeding is a warm and loving way to meet the needs of toddlers and young children. It not only perks them up and energizes them; it also soothes the frustrations, bumps and bruises, and daily stresses of early childhood. In addition, nursing past infancy helps little ones make a gradual transition to childhood[…] Meeting a child’s dependency needs is the key to helping that child achieve independence. And children outgrow these needs according to their own unique timetable.”

 

 

Sources:

http://www.cdc.gov/breastfeeding/pdf/2013breastfeedingreportcard.pdf

http://kellymom.com/ages/older-infant/ebf-benefits/

http://kellymom.com/fun/trivia/bf-numbers/

Hormonal Changes in Fatherhood

While many of us are well aware of hormonal changes and their effects in pregnancy and new motherhood; we don’t often hear of the physiological effects a man’s body undergoes as he becomes a father.  But doesn’t he just “supply his genetic material” and mom does the rest?  No, fatherhood actually changes a man’s physiology too.  And these changes indicate the biological importance of active fathering. 

Research shows that a man’s testosterone levels are significantly affected by fatherhood; and—even more striking—by the quality of his interactions with his child.

A large study showed that men’s testosterone levels decrease with fatherhood.  For the 600 men in the study, testosterone was measured at the age of 21 when the men were single, and again nearly five years later.  Those who had become fathers in the 4.5 years between check ups had higher baseline testosterone (T) levels compared to those not partnered with children by the second check up. However, the testosterone levels of partnered fathers declined significantly more (2 times more) than the non-fathers, suggesting fatherhood lowers testosterone levels (this even when natural age-related testosterone declines are accounted for).

What’s even more fascinating is that the men who spent three or more hours with their children each day—playing, feeding, bathing, diaper changing, reading or dressing them—had even lower levels of testosterone compared to fathers less involved in care.

Now, many men believe that more testosterone is better, so before getting bummed about these findings, let’s talk about the benefits in this hormonal change of fatherhood.

Lower testosterone levels increase the likelihood that men will remain committed to their family and be involved in a care taking role with children.  This study shows that women are not the only ones biologically adapted to caring for offspring.  It indicates that men are biologically adapted toward an active care taking role within the family system.

“A dad with lower testosterone is maybe a little more sensitive to cues from his child, and maybe he’s a little less sensitive to cues from a woman he meets at a restaurant,” said Peter Gray, a University of Nevada anthropologist who has conducted research on fatherhood and testosterone.

Lower testosterone levels exhibited in fathers are significant but subtle in the big scheme of things.  Researchers note that these fatherhood hormone “drops” are not enough to affect libido, sperm counts, muscle mass, voice range, body hair distribution/amounts, or all those other characteristics of the human man.

Lower testosterone may also provide some protection against disease.  Studies show that higher lifetime testosterone levels increase the risk of prostate cancer, suggesting that fathers in committed fathering roles might have lower long-term exposure to testosterone and thus a lowered risk of prostate cancer.

This study shows that human males have adapted to have similar hormonal systems to other animal in which the males care for young, such as some birds and primates.

Sources:

Longitudinal evidence that fatherhood decreases testosterone in human males

In Study, Fatherhood Leads to Drop in Testosterone (New York Times)

Collective Wisdom: Preparing for Baby

Today’s Collective Wisdom post asks our mamas-to-be:

In what ways have you prepared for your baby’s arrival so far?

I’ve read books on childbirth and newborns.  I’ve taken childbirth classes. (Michaela)

Driving around with an empty carseat.  Getting the nursery ready.  Splurging on a cute diaper bag. (Lindsay D.)

Washed clothes, bought diapers, picked out some cute things for her.  Read Ina May’s Guide to Childbirth.  (Hanni Go)

Hypnobirthing classes, prenatal yoga, found the perfect doula, change from hospital to Health Foundations. (Angie Murphy)

Decorated the nursery, hired a doula, found day care, taken childbirth education class, and infant CPR class. (Cassie)

Reading lots of books, forums on babycenter.com, reading birthwithoutfearblog.com, attending Parent Topic Nights at the Childbirth Collective, hiring a doula.  (Leah)

I have been practicing yoga, reading lots of books—not just about pregnancy and labor but lots about the postpartum and babies, getting his room ready, and meditating.  Oh and we hired a birth doula and are considering a postpartum doula.  (anonymous)

How have you (or how did you) prepare for baby’s arrival during your pregnancy?

Introducing Solid Foods

Baby’s ideal first food

The American Academy of Pediatrics recommends six months of exclusive breastfeeding (no formula or solid foods). Breast milk contains antibodies that support immune function as well as optimal nutrient ratios that change as the child grows. Until approximately 6 months of age, a baby’s digestive tract is not able to adequately digest most foods. Early introduction of foods may result in food allergies or sensitivities.

Food introduction: An important foundation

Around six to nine months, breastfed and formula-fed infants will begin to develop their gastrointestinal track in a way that makes them ready to start some solid foods.

Food introduction is one of the most important times in your child’s health; it becomes the building blocks and foundation of health for the rest of your child’s life. The gastrointestinal tract is an extension of the immune system. Introducing foods in a way that will not cause allergic reactions will help build a stronger and more solid foundation than if your child is always fighting off immune reactions.

When should solid food introduction begin?

Most babies will become interested in food between six to nine months. Since breast milk is all your baby needs in terms of nutrients, there needn’t be any rush to start your baby on solids. Let your baby lead. If she is always grabbing for your food, then allow her to explore it. But if she isn’t interested, don’t force her to try it. If your child hasn’t started trying solids by nine months, start offering it to him and see how he responds.

Signs Baby is Ready for Solid Foods

• Is at least 6 months old
• Able to sit unsupported
• Can push away food
• Can turn head from side to side
• Shows interest in what you are eating

This transition to solids can be a source of stress for many parents. Take your time and be patient with your child. Know that she is getting all the nutrients she needs from your breast milk or formula. Up until the first year, the benefit to babies of trying solids is being exposed to new textures and learning hand mouth coordination; prior to a year most babies gastrointestinal tracts are not mature enough to be absorbing many nutrients from solids, so if your child isn’t eating a lot of solids, it is not compromising his nutrient intake as long as he is still drinking breast milk or formula.

How to introduce new foods

New foods should be introduced one at a time.  Wait 3 to 5 days after introducing each new food to see if your baby reacts to the food.  If your baby has any signs of reaction (see below), remove the food from baby’s diet for 2 to 3 months and then try again.  If your child has a life-threatening reaction to food, such as trouble breathing, call 911.

Your baby will show you when he has had enough to eat.  Stop feeding him when he spits food out, closes his mouth or turns his head away.  There is no reason to force a baby to eat a certain amount.  Let him control how much he eats, even if it is only a bite or two!

Many babies at first will only eat a bite or two once a day and sometimes not every day.  It depends on the baby and their development.

Enjoy this new time in your baby’s life as he explores new textures and tastes. Be playful with your child and let meal times be a fun game or a time to be social and sing songs about foods. Use it as a time to learn colors or numbers, instead of always focusing on getting your child to eat. If they don’t like something, introduce it again in a few months.

Try to make it easier on yourself by modeling good nutrition to your child and giving them some of your meal, instead of always having to make something completely different for them. Enjoying our meals improves digestion and overall quality of life, so do what you need to for yourself to de-stress mealtime and enjoy.

Symptoms that may indicate a food reaction

So many early health problems in children are related to food introduction. It is pertinent that you observe your child for signs of a reaction.  If these early warning signs are not headed, more serious reactions may result as the immune system becomes more and more compromised.

• Rash or red marks around the mouth or anus
• Hyperactivity or lethargy
• “Allergic shiners” (dark circles under eyes)
• Skin reactions/rashes
• Infections/cold/flu
• Diarrhea or mucus in stool
• Constipation
• Runny/stuffy nose or sneezing
• Redness of face/cheeks
• Ear infection
• Other unusual symptom for your child

Food introduction suggested schedule

Use the following schedule as a general guide for introducing foods to healthy, full-term babies. If your child has chronic illness, special needs, or has signs of allergies or sensitivities such as asthma, chronic respiratory infections, or chronic ear infections, a modified schedule may be necessary.

Even though it is a common practice in our culture to give babies powered rice cereal, this is not an evidenced based practice and is not recommended by nutritionists. Start with vegetables and fruits. When it is time to introduce grains, use whole grains whenever possible, instead of processed grains.

6-8 Months (Hypoallergenic, purred, mashed foods with emphasis on foods high in iron)

• Banana
• Avocado
• Kiwi
• Pears
• Apples/apple sauce
• Blackberries
• Peaches
• Grapes
• Cherries
• Apricots
• Blueberries
• Nectarines

• Beets
• Cauliflower
• Squash
• Yam
• Sweet potatoes

• Blackstrap molasses (high in iron)
• Dulce or other seaweed flakes (high in iron)

9-10 Months (Mashed with more texture, and small, soft chunks)

• All vegetables and fruits EXCEPT: tomatoes, citrus (pineapple, oranges, lemons, limes), strawberries, corn and eggplant

• Oatmeal
• Rice
• Potato
• Beans (EXCEPT soy)
• Millet

11-12 Months (small, soft chunks)

• All vegetables and fruits EXCEPT: strawberries, tomatoes, eggplant
• Can add oranges, pineapple

• All grains
• Corn
• Lentils
• Wheat

• Poultry
• Meat-pureed or well-cooked small pieces

• Tahini

12-24 Months

• All vegetables and fruits EXCEPT: strawberries
• Can add Tomato, Eggplant

• Nuts & nut butters (EXCEPT NO PEANUTS OR PEANUT BUTTER)

• Yogurt
• Milk
• Cheese

• Soy products
• Chocolate

2-3 years

• Strawberries
• Eggs

3+ Years

• Peanuts/Peanut butter
• Fish

 

Benefits of probiotics in pregnancy, postpartum and for baby

Probiotics (which roughly translates to “for life”) are beneficial forms of bacteria/microbiota that can assist the human body in preventing and treating many types of illness and disease—from cancer to diarrhea.  We have these beneficial bacteria in our body naturally, but supplementation can greatly support the body in health and healing.

While nearly everyone can benefit from consuming probiotics, using probiotics is especially important and advantageous during pregnancy and once baby is born.  Read on to learn all about the amazing benefits of probiotics for mom and baby.

What are probiotics?

Probiotics are the beneficial bacteria living in your body that help protect against illness.  We can take supplements of these beneficial bacterial or obtain them from some food sources.  There are hundreds of different strains of probiotic, which are all important to overall health.  Certain strains are particularly good for pregnant women and others best for new mamas and babies.

While we typically think of probiotics as being good for digestive health, they do more to promote health in the body.  Probiotics are found lining the mucous membranes of your digestive, urinary, and vaginal tracts.  This last one is particularly important in pregnancy, because we want to foster healthy vaginal tissues before and during delivery (more about why below).

Additionally, probiotics are key to a healthy immune system.  These beneficial bacteria make up approximately 70% of your immune system, making them an important part of your daily defense mechanisms.  Ensuring a healthy balance of good bacteria in the body can foster overall wellness.

 Probiotics in pregnancy

Regular use of probiotics in pregnancy can offer women many benefits.  These benefits include lower risk of:

• illness (colds and flu)
• constipation
• gestational diabetes
• preeclampsia
• urinary tract infections
• yeast infections
• premature labor

Use of probiotics in pregnancy has also been found to keep levels of Group B Streptococcus (Group B Strep) low.  Group B Strep is a common bacterium of the vaginal lining, but if levels of these bacteria get too high at the end of pregnancy it can pose some risks to baby.  When this issue presents itself, it is often managed during labor/delivery with antibiotics.  However, steps in pregnancy, including probiotic use, can reduce the risk of this condition.

Healthy vaginal flora is crucial to baby’s health.  Babies are born with a sterile gastrointestinal system and exposure to mom’s vaginal flora is their first exposure to the bacteria their systems will be colonized by.  Healthy vaginal flora helps give baby’s immune system a good start.  Babies also continue to receive beneficial bacteria through breastfeeding, being held skin to skin, and via saliva exchange (think pacifier “cleanings,” shared spoons, and the like) in the first year.

Postnatal Probiotics Benefits 

Recent studies have found that consuming probiotic supplements beginning in the first trimester of pregnancy and continuing their use through at least the first six months of exclusive breastfeeding can help women lose weight after the birth of their baby.  Supplements with Lactobacillus and Bifidobacterium were linked to less central obesity (defined as a body mass index (BMI) of 30 or more or a waist circumference over 80 centimeters).

Probiotic use can be especially important if you need to take antibiotics for any reason in the postpartum period (really any time you take antibiotics, you can benefit from use of probiotics).

When mamas consume probiotics, the health benefits also find their way into breast milk and are passed on to baby. Breast milk is actually the source of our first immune-building “good” bacteria.  Since baby’s gut bacteria continues to culture throughout the nursing time, it is great for mama to continue taking probiotics in the postpartum and as long as she breastfeeds.

Probiotics for baby 

In addition to receiving probiotics via breast milk, probiotics can also be given to baby directly.  Supplementation to baby can take a few forms: you can add a bit of probiotic to a bottle of milk, you can take a little probiotic on your finger to give to baby orally, or you may even put a little on your nipple and baby will ingest it during a feed.

Probiotics have numerous potential benefits for babies including the prevention and treatment of:

• allergies
• asthma
• eczema
• food sensitivities, especially in infants with a family history of allergy
• colic, one study found decreased crying times by up to 75% (look for product containing Lactobacillus reuteri)
• diarrhea
• ear infection
• illness (colds and flu)

Research shows that good probiotic exposure in infancy can actually help optimize baby’s weight later in life.  Early probiotic exposure may modify the growth pattern of the child by restraining excessive weight gain during the first years of life.

Probiotics: Sources and Guidelines

Different blends of different strains of probiotic may be optimal depending on whether you are pregnant or taking them in the postpartum (or giving to baby).  We have a few excellent supplements at the clinic and we can talk to you further about what to look for in a probiotic.

Generally speaking, recommendations tend toward 1 to 10 billion Colony Forming Units for infants, and 10 to 20 billion CFU for older children and adults. To achieve and maintain a therapeutic effect, probiotics must be used consistently to ensure a sufficient and consistent population levels over time.  It can be difficult to say exactly what dose is ideal, as products vary.  Different probiotics have been shown to be effective at different levels.  Products containing a higher number of live probiotics may not be better than one with fewer.  It’s best to go with a reputable high-quality brand, ideally one that has been vetted by your health care professionals (such as us!).

There have been no reports of adverse reactions to supplementation of probiotics in moms or babies.

Food sources of probiotics

While supplementation is great, there are also many foods rich in probiotics.  Fermented foods are particularly rich in probiotics.

Food sources of probiotics include:

• Yogurt
• Kefir
• Sauerkraut
• Spirulina (with other great benefits in pregnancy and in general)
• Miso soup
• Pickles
• Tempeh
• Kimchi
• Kombucha tea

If you have questions about probiotics, be sure to discuss them with your midwife at your next appointment, give us a call, or stop in.  We’d be happy to talk with you further about what to look for in a probiotic or connect you with a great supplement we carry.

Sources:

http://www.nutraingredients.com/Research/Probiotics-may-help-women-regain-their-figures-after-pregnancy

http://www.ncbi.nlm.nih.gov/pubmed/20231842

http://www.ncbi.nlm.nih.gov/pubmed/24164813

http://cdrf.org/home/checkoff-investments/usprobiotics/probiotics-basics/

http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11172991&ordinalpos=36&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Healthy Teeth from the Start

Did you know you can affect your baby’s oral health before you even conceive?!?  Did you know that when your baby is born, s/he will begin to make to make permanent teeth?  Did you know some babies are actually born with their “baby” teeth?

We were lucky to have Dr. Julie Haman of St. Paul Pediatric Dentistry give her time generously at our Mom’s Group this week, talking all about taking care of little ones’ teeth.  Here are just some tidbits of wisdom she shared with us.

Baby’s oral health starts before conception!  Studies show that mom and dad’s oral health can have a profound effect on baby’s oral health.  Maintaining good dental hygiene habits even before conception can lower the risk that baby will get cavities years later.  Studies have found that if a mama uses Xylitol regularly before conception, during pregnancy, and in the first 6 months postpartum, she can reduce baby’s risks of cavities.

Xylitol products, such as mints, can be found at health food stores.  You can also buy the powdered form and make your own recipes.  (Be careful not to over-consume as it can cause stomach upset.)

Dental decay can be passed from caregiver to baby through saliva.  Our saliva carries the bacteria that causes cavities.  Sharing spoons, giving kisses, “cleaning” that pacifier with our mouths and other common saliva-swapping care between caregiver and baby can introduce cavity-causing bacteria to baby.  The risks are higher if the caregiver has recently had an active infection/cavity.

Active oral hygiene begins with that first tooth.  Ideally, when you baby gets his or her first tooth is the best time to introduce regular brushing or other cleaning of the teeth.  Bath time can be a great time to give those tiny pearly whites a little scrub.  (You don’t need toothpaste if they are under a year and should avoid fluoride until then, as it can cause staining/whitening of the permanent teeth).  You don’t have to make it a big deal or stress out about it, but early, positive introduction of teeth cleaning can help now and down the line.  Dr. Haman also suggested just rubbing a wet washcloth along the teeth and gums in the bath or at night.

Breastfeeding sugars alone do not cause decay.  While dietary sugars and carbohydrates are a major cause of tooth decay, the sugars from breastfeeding do not pose a risk of tooth decay in babies who are exclusively breastfed.  Once other foods are introduced, however, the risk of diet contributing to tooth decay begins.

Frequent snacks and sugary drinks are a common cause of cavities.  Dr. Haman explained that having 3 or more snacks or sugary drinks (even fruit juice) per day can increase the risk of cavities—and it’s the frequency that matters here.

She also explained that not all snacks are created equal.

Tooth friendly snacks include those that are crunchy and hard—such as apples, grapes, and carrots.  Also, cheese can actually prevent cavities and so makes a great snack.  Foods that increase the risk of cavities include sticky foods like raisins, candy, and sticky fruit snacks.  Carb-heavy snacks like cheerios are also less tooth-friendly.  She advises if these latter snacks are offered to give them at the first part of snack and finish with a crunchy hard snack option and/or water.

The best ways to reduce childhood cavities, according to Dr. Haman, are:

• Brush with fluoridated toothpaste twice daily after the age of one in high risk kids and after age two in lower risk kids.  Kids need help brushing for at least the first decade of life.
• Limit juice, soda, and milk except at mealtime.
• Limit frequent snacks
• Don’t put a child to bed with a bottle or sippy cup
• Drink fluoridated water.  (Most water in the Twin Cities is fluoridated)
• Start dental check ups by your child’s first birthday (or six months after the first tooth shows up)
• Visit the dentist every six months and get fluoride treatments.

Dr. Haman’s office offers free first visits to all babies under 18 months.  During this visit you can learn much more about preventative oral care.

15 Cool Facts about Breastfeeding

We all know the saying “breast is best” but here are some of the colossal benefits, and a couple quirky facts, about breastfeeding.

1.  Human milk boosts a baby’s immune system big time—helping baby fight viral, bacterial, and parasitic infections, including:

• Respiratory tract infections
• Ear infections
• Bacterial meningitis
• Pneumonia
• Urinary tract infections
• Infant diarrhea
• Common colds and flus

2.  Breastfeeding can actually reduce baby’s risk of disease later in life, including:

• Type I and II diabetes
• Hodgkin’s disease
• Leukemia
• Obesity
• High blood pressure
• High cholesterol levels
• Crohn’s disease
• Ulcerative colitis
• Asthma
• Eczema

3.  Breastfeeding reduces mama’s risk of ovarian and breast cancer, heart disease, and osteoporosis.  The longer she breastfeeds, the higher the benefit.  In fact, a woman who breastfeeds for 8 years has nearly a 0% risk of breast cancer.

Get this—breastfeeding a baby girl actually reduces her lifetime risk of breast cancer by 25%.

4.  Breastfeeding saves a family approximately $2 to 4 thousand dollars annually (compared to cost of formula).

5.  Breastfeeding helps mama heal faster in the postpartum, helping her uterus return to pre-pregnancy size faster and lowering overall postpartum blood loss.

6.  Breastfeeding can help mama return to her pre-baby weight.  It takes 1000 calories a day on average to produce breast milk.  Women are advised to consume an extra 500 calories a day, and the body dips into reserves it built up in pregnancy to make the rest (it’s important to consume those extra calories or the body actually goes into “starvation mode” and holds onto the reserves).

7.  Producing breast milk consumes 25% of the body’s energy; the brain only uses 20% by comparison.

8.  On average, babies remove 67% of the milk mama has available—they eat until fullness, not until the breast is emptied.

9.  Almost 75% of all moms produce more milk in their right breast, whether they are right- or left- handed.

10.  Mama’s body is constantly making the perfect milk for baby.  Milk changes its nutritional profile as baby grows (milk made for a 3 month old is different than for a 9 month old).  Milk can even change day to day—for example, water content may increase during times of hot weather and baby-sickness to provide extra hydration.

11.  Human milk contains substances that promote sleep and calmness in babies (who doesn’t love that?)  Breastfeeding also calms mama and helps her bond to baby.

12.  Breastfed infants are at lower risk for sudden infant death syndrome (SIDS)

13.  Mama’s breasts can detect even a one degree fluctuation in baby’s body temperature and adjust accordingly to heat up or cool down baby as needed.  This is one reason skin-to-skin contact in the early days is so crucial.

14.  Breastfeeding reduces baby’s risk of cavities later on and may lower the chance they will need braces as kids.

15.  Breastfeeding mamas sleep on average 45 minutes more a night, compared to those who formula feed.

Happy Halloween from Health Foundations!

Happy Halloween from your friends at Health Foundations!

Today at Mom’s Group, we had lots of festive little ones..and tons of fun chatting and enjoying treats.  The pictures are just too cute not to share!

Mamas, join us at Mom’s Group each Thursday from 11-12.  All moms are welcome at this free gathering and you don’t need to sign up.  Coming up in November we will have:

• FREE Mom & Baby Yoga (11/7),
• mama and baby clothes/books/toy SWAP (11/14)
• Infant Massage (11/21)

Storing Human Breast Milk

While our breasts may know exactly how to create the perfect food for our babes, they don’t come with an instruction manual for how to store and keep this amazing liquid in the event that we wish or need to express milk for our babies.  Expressing milk for the times when we cannot be with our babies is a great way to ensure they receive the myriad benefits of breast milk (e.g. optimum nutrition and protection against diseases).

While there are varying recommendations on how to store breast milk, this information is the product of a careful review of the best evidence available and is an appropriate guideline for storing milk to be consumed by healthy, full-term babies.

Keep it Clean

Human milk is a fresh living substance, so it’s important to be contentious of hygiene when handling breast milk.  Before hand expressing or pumping milk, it’s important to make sure your hands are washed and clean and all equipment used to gather the milk are clean and sterile.  Breast pumps have instruction manuals and how-to videos are available on the internet to acquaint you with how to clean and care for your breast pump.

One of the many amazing things about breast milk is that is actually contains properties that help safely preserve it outside of the body.  Its anti-bacterial properties—live cells and antibodies—help it stay fresh longer by discouraging bacterial growth when stored in a container.  (The same cells discourage bacterial growth in your baby’s intestines.)

Best Containers

The best containers for human milk storage are made of glass or hard BPA-free plastic (food-grade polypropylene or polybutylene) with properly fitted tops or lids.  Such containers should be washed with hot soapy water, rinsed thoroughly, and allowed to air dry before being used.  Some containers can also be washed in the top rack of the dishwasher.

If you plan to freeze in such containers, leave at least an inch of space at the top of the bottle since milk (and other liquids) expand upon freezing.

Polyethylene bags (bottle liners) do not preserve the nutrients and immune properties of milk as well as glass or hard plastic.  Using plastic bags expressly made to store breast milk can mitigate these effects to some degree.

Some of the downsides to using bags include:

• Higher risk of contamination
• less durability
• risk of leakage
• some bags destroy nutrients in milk

If you use plastic milk storage bags, make sure you:

• squeeze the air out of the top before sealing
• leave at least an inch at the top for milk expansion when frozen
• stand the bags upright in another container
• store this container toward the back of the refrigerator or freezer where the temperature is most consistent

Whatever you use, make sure the container is well sealed.  You may want to place baking soda in the frig to eliminate odors from other foods.

How much milk to store

Regardless of what container you use, it can be a good idea to only store 1 to 4 ounces of milk in each container.  This is the amount you are likely to need to provide a single serving to your baby.  This avoids waste and makes thawing easier.

Label your milk

Be sure to label your milk with the date it was expressed.  If you know where it is going (i.e. frig, freezer) you may also want to put a “use by” date on it, according to the guidelines below.  If your baby will be drinking the milk in a day care setting, also label the milk with your baby’s name.  You should use the oldest milk in your supply first, provided that it is still good according to your observation and the guidelines below.

Where to store milk and for how long

You can store milk at room temperature, in the refrigerator (does not need to be kept separate from other foods), in a freezer, or in a deep freezer.  It is best not to store milk in a frig or freezer door or near an ice dispenser, and is best kept toward the back of the frig or freezer where the temps are more consistent.  It is best to refrigerate or chill milk after its been expressed.  When possible, refrigerated milk is preferred over frozen milk because some of the anti-infective properties of milk are lost when it is frozen.  That said, frozen milk is still preferable to formula, as the former still has disease protective agents, other benefits and lacks some drawbacks associated with formula.

Where	Temperature	Time
Room temperature	66-79° F	Ideal: 4 hoursAcceptable: 6 hours Some sources say: 8 hours
Refrigerator	Under 39° F	Ideal: 3 days (72 hrs.)Acceptable: 8 days if collected in a very clean and careful way
Freezer	-0.4 to -4° F	Ideal: 6 monthsAcceptable: 12 month

Specific considerations:

• Freezer to frig: Previously frozen milk that has been thawed can keep in the frig for 24 hours.

• Refreezing thawed milk:  while some sources say that you can refreeze previously thawed milk within a few hours, this causes a further breakdown in the milk and a loss of antimicrobial activity.  It is not currently considered an ideal practice.

• Leftovers?  While there has not been conclusive research on this practice, some sources say that is it probably safe to refrigerate leftover milk for 1-2 hours and offer it again within that time.  (Say, if baby doesn’t finish the bottle in one sitting.)

• Keeping it cool: if you don’t have immediate access to a frig, it is best to store the milk in an insulated cooler with ice packs until you are able to refrigerate or freeze it (24 hours or less).

• Separation: Human milk naturally separates into a cream layer and a milk layer when stored; this is totally okay.  Just gently swirl before serving!

• Slow defrost: Human milk should be thawed and gradually reheated, since high temperatures destroy important properties in the milk.

• Frozen to drinkable: The ideal way to prepare frozen milk for consumption is to place it in the frig overnight (for a total of 24 hours maximum) or thaw under cool running water (you can gradually increase the temperature).  Milk should never be microwaved (it not only kills nutrients but it can cause hot spots milk that can burn baby).  Milk should also not be heated directly in a pan, though you can gently heat water in a pan and place the container of milk inside (no boiling water).

• Temperature:  Though breast milk is naturally body temperature, many babies are fine with room temperature or even slightly cooler milk.  For some babies, it is more important that the nipple not be cold.  (So you may want to store with a lid and add the room temperature nipple before serving.)

• Frig to drinkable: warm the milk under warm running water if desired.  Some babies will accept milk right from the frig.

• Soapy smell: some breast milk that has been stored smells soapy or may even taste soapy.  This is believed to be the result of excess lipase (an enzyme) activity in the milk, which begins to break down the milk fat after its been expressed (Lipase has many beneficial properties).  While this milk is safe to drink and some babies don’t mind it, some moms and babies are off-put by this change in taste and smell.  If milk becomes sour or rancid tasting/smelling it may no longer be safe.  If excess lipase activity is a problem, you can scald your milk after expressing to deactivate the enzyme.  After expressing, heat the milk directly in a pan so that it bubbles around the edges of the pan but does not boil.  Remove from heat, quickly cool, and store the milk (in the frig or freezer).

Free Essential Oils Classes this Fall!

We are thrilled to be offering two free essential oils classes this fall– one on October 28 and the second on November 11, both the same class and both from 7 to 8 pm at Health Foundations.

Details:

This informative class will help you learn the basics of how pure, therapeutic grade essential oils can be incorporated into your everyday life. We’ll share real-life testimonies about how these amazing natural products have helped heal, soothe and enrich the lives of those who use them and discuss ways they can be used to improve your physical well-being and the health of those you love.

Brochures will be available outlining the benefits of using essential oils during pregnancy, with infants and children, and to transform your medicine cabinet..

Presenters:

Stacy Tiegs

Stacy Tiegs is a self-made entrepreneur, a mother to three grown children, and a wife of twenty-five years to her wonderful husband Tom . For six years Stacy has created, owned, and operated  Something Savvy in Buffalo, Minnesota. After being introduced to essential oils several years ago, Stacy used them to help heal herself and her family.  She watched her youngest daughter relinquish herself of many medications because of daily oil use.  Now, Stacy cannot stock her store shelves fast enough. She hears testimonies daily of how quickly these oils work and has decided to make it her full time mission to let others know there are healthier alternatives to pharmaceuticals that can often have serious side effects.

Betsy Kelly

Betsy Kelly is a mother, reading specialist, self-proclaimed cloth diaper guru, and a firm believer in natural medicine. After having been raised in a chiropractic family, she has become a woman passionate about preventative health and medicinal healing rooted in all that is natural. The power of essential oils is something Betsy has always believed in and now she is sharing her knowledge and love of them with others. Betsy lives in Hopkins with the love of her life, Paul, her daughter Ruby (born at Health Foundations Birth Center) and her son, Clyde (born at home).

Interview: Welcome Baby Care’s Carey Lindeman

We had the pleasure of speaking with Carey Lindeman, founder of Welcome Baby Care to discuss postpartum care and her pioneering postpartum doula service in the Twin Cities.  Many people don’t know what a postpartum doula is or how they can help.  Hopefully, this interview will shed some light on this invaluable and unique type of postpartum support and what amazing doulas, like those at Welcome Baby Care, can offer.

What is a postpartum doula?

While a lot of people have heard what a birth doula is, not everyone has heard of or understands what a postpartum doula is.  Essentially, what a postpartum doula does is come into a family’s home after the birth. Our first priority is taking care of the mother and making sure that she is healing properly and bonding with her baby.  So our goal is to relieve her of the things that would normally be overwhelming her.  Whether that be laundry, changing the sheets, keeping the bathroom clean, cooking, maybe running errands.

So there is that piece and there is also the education piece where we educate on taking care of baby—you know, best practices, what’s normal, what’s not, as well as what is normal and what is not in her own recovery.  So a lot of the questions she may call the doctor about or wonder about, we are able to help with and so help her with the transition into a more confident parent and navigating all of the unknowns.

Having this support can speed up the process of becoming a more confident parent and bonding with your family, staying connected with your husband, all those things you are negotiating during this tremendous transition.

What does a typical doula visit look like? 

It could be two different things depending on whether it’s a day shift or an overnight shift.  A daytime shift is usually a minimum of 4 hours.  When the doula arrives at a family’s home she is going to assess what is going on—she may walk into a sink full of dishes,

piles of unfolded laundry, or mom may need some hands on help with the baby or with breastfeeding).  She is not going to ask, “what can I do” but instead will assess and do what needs to be done.  She may ask things like “Have you had anything to eat today?” to mom.  Usually what a doula will do is prepare snacks for the day for when mom is feeding, she’ll prepare food for later, she’ll clean up, and essentially her goal is to create a very stress-free environment.

And, you know many times a doula is walking into chaos, there may be multiples or other challenging situations.  A doula’s role is to put a “calm” on the situation.

She may be managing other people as well—maybe there are grandmas involved or aunts, cousins—she may have to say to them “This is where you can be most helpful right now.”

 What about if there are older children there, how does that look with a postpartum doula? 

With other children, what a doula will do is find a way to entertain and manage them while mom needs to be breastfeeding or napping or whatever she needs.  But she also finds ways to incorporate the family together.  So it isn’t just a separation of mom from partner and other children.  Sometimes, for example, the doula will make a snack and ask dad or an older child to take it to mom and sit with her.  We are always trying to foster family bonding.

Great, and what about that overnight postpartum doula service you mentioned?

Yes, going back to our overnight care, this looks a little different.  This is a separate service and definitely our most popular.  A typical overnight shift will begin at about 9 or 10 at night. Mom and partner are off to bed immediately and we take over from there.  We are with the baby.  Mom may choose to pump and have us feed the baby or maybe she wants to breastfeed.  In that case, we would console baby for as long as possible, then bring the baby into her, she can breastfeed, and then we will change the baby and put him or her back to bed.  So we are with the baby all night long while the parents sleep.  The doula will stay as long as the family wants them in the morning but a typical shift ends about 6 am or so.  A lot of times we leave when everyone is sleeping.  And mom can get up with baby whenever that is.

What does service typically look like for a new or growing family—how often do people need care, is it different for everybody? 

You know it is different for each family, depending on if there are multiples or not, if it is a first child, etc.  We do have packages offered on our website that give some examples.  And I would say that most people buy one of our packages.  Probably in the next few weeks people will be able to purchase these right from the website (as well as our classes).

What does the training look like for a postpartum doula? 

We have our own postpartum doula training and certification program.  We have an excellent trainer formerly from Fairview and she has developed a certification program.  We felt that a lot of postpartum doulas coming to us as DONA-trained doulas (birth doulas with a piece of postpartum education) had great training but that it didn’t go far enough.  We wanted more extensive training.  So we developed our own specific postpartum training program.

People can go through it and not necessarily work for us, though there is always the option to interview with us, while other people will work independently or just want to learn this information for their own benefit.  We give people a max of 6 months to go through the program and there are 4 components: reading, classroom training, shadowing a doula, and pro bono work for moms in the community that need help.  The details of the classroom training content can be found on our website.

How did Welcome Baby Care come to be? 

One of the unique things about our service is that we also do senior care—so we are kind of a full spectrum in-home care provider.   How Welcome Baby Care started was with this senior business.  When my stepdaughter was having her first baby—and I have raised four children myself—I was there as a grandmother I thought, “I’m really rusty—I don’t really have all the answers to help out.” So what occurred to me at that time was, just like seniors, new moms need support, everybody needs a doula.  And its just one of those things, you know it’s the same type of care, the difference is the type of caregiver.  But it is still that turbulent time in people’s lives where they don’t know what they are getting into.  It’s so new.

So that is when we decided to have these two ends of the care spectrum (we split these into two sister companies).  And that’s how it came about.  Then I discovered that a doula with her expertise, the sixth sense they have…those were the kind of people that I wanted to do this care.  They are just so loving and caring and have such a heart.

Can you tell me more about the doulas you work with? 

The doulas are hand picked and multi-talented.  They all have their own gifts; they are all different in so many ways.  They are all doulas but they all have special additional gifts that they can offer.  So when we are interviewing with families, what’s great is that we have this whole team to pick from, not just one person.  So we can really assess what the family needs and hand pick the doula or doulas that are going to be the best fit.

Another great thing about having a doula team—and all of our doulas are our employees, none of them are contract—is that we have ongoing monthly training. So we may have speakers come in, and there is always a discussion session.  If there is ever something with a family that they maybe have a question or concern about, it’s all confidential, but they also have this team to talk with and get support from.  So they are not trying to figure things out all on their own.  And what’s really important is this ongoing training component.

When they go into a home, we always want that continuity of care.  So when you hire our doulas, you are not going to get someone different every time.  You are going to get the doula or two that are the best fit for you (# of doulas per family depends on # of hours needed).

What other services does Welcome Baby Care offer?

Through in-home care, lactation support, and classes, we offer:

• Information for bonding techniques for new families (including adoption)
• Breastfeeding support and counseling
• Special care for preemies and multiples
• Expertise in postpartum depression
• Overnight care
• Household care
• Bedrest support
• In-Home infant CPR

As far as our classes go, we offer a gamut of breastfeeding classes.  We have Breastfeeding 101, which is “the basics”.  The 201 class is not just breastfeeding or bottle feeding but also weaning, starting solids, and those types of things.

We also have a Grandmothers class, which is really popular.  This is where the expectant mom and her mother and/or mother-in-law come to class together.  And they talk about the differences between when grandma had the babies versus now.  A lot of new things that are happening, such as back to sleep and feeding and equipment, and all those things that may be new that grandma may not know about.

Kind of breaking down the barrier of her knowing what is important, and what mom feels is important, because often grandmas play a large role in raising the new child.  So with the help of this class, they are not going into it with preconceived ideas, barriers, and walls and not really discussing it.  And it’s learning on both ends—both the new mom and the grandma.  It’s a combination of education and facilitating communication between the generations.

What if you are not sure during pregnancy whether you want or need a postpartum doula? 

I would suggest pursuing it.  We are here to answer all questions without any strings attached.  And maybe its not even postpartum services she may have questions about.  We also have a separate lactation service so maybe if she is feeling uncomfortable about breastfeeding and has questions, you know she can ask without being locked into in-home services.

I think that it’s worth attending one of our classes. We help provide a postpartum plan.  You know a lot of people make a birth plan, but not always a postpartum plan.  And we help you develop a plan, which covers things you should be aware of postpartum.

And again, consider calling and asking questions or even interviewing someone just in case, because again no strings attached ever.  People don’t always realize the importance of having that care.  You know, in other countries, people have their families and they have people helping them and we just don’t have that in this country.  The lesson is from second world nations that really know how important extended family care is.

What if you are sitting at home one week postpartum and you realize you need some help.  Is it too late to call a doula? 

It’s never too late.  We answer our phone 24/7.  I get calls during the night.  Calls come in when people are in the hospital or are feeling like they need to go back to the hospital.  You know, I got a call from a mom recently, I couldn’t even understand her.  She was so tired and so overwhelmed—it was four in the morning—and I was trying to get information and finally I just asked: “Do you need help right now?”  She asked if we could call her back in the morning at nine.  So we called her back and she was so overwhelmed.  But we were able to help her.

So anytime, we are available for new moms.  We want you to call us.

What advice might you have for pregnant mamas?

No expectations.  I mean, plan, but have an open plan for how the postpartum is going to look.  I think one of the most damaging things about our social world and the media is they put such high expectations on new moms and I think that is a mistake.  To buy into that and listen to too many people ahead of time and have all these expectations and lofty goals is a mistake.

You know, take things a day at a time and realize that, more than anything, you just want to have time for that baby, and give them everything they need.  But don’t have this idea of what its going to look like—like you’re going to lose weight, you’re going to look like this, you are going to have all the perfect equipment and clothes, and everything is going to look perfect and composed, and then buying into what all your friends are saying.

You know make sure you know who your support people are: get the support.  But don’t surround yourself with people who tell you how you need to be—just get that loving non-judgmental support.  And know, too, that we come in with NO judgments—mom can decide and parent the way she feels is right.  You know, we will guide and support but we will not judge.  That’s the biggest thing—you do not want judgment around you because it is just toxic.

What advice do you have for new mamas, who are maybe going through the postpartum period right now?

For them, I would say, the same information applies.  You need the support of other people.  Do not isolate.  Get the support.  Find those people that don’t have expectations for you.  Because you are the parent and you know your baby better than anybody and you need to be the one to make decisions.  You know, 10 or 20 years from now, it is going to be your decisions that matter, not anyone else’s.  So I think you need to really look at your own “mama guts” because you know.  And don’t think you don’t know because you DO know what is best.

And also, there are so many good resources out there, so take advantage of these great resources.

And plenty of rest and relaxation, and try not to put too many expectations on yourself.

You can contact Welcome Baby Care on their website or by calling 952-942-5676. 

 

Finding a Pediatric Care Provider

One of the many to-dos during pregnancy is to find a care provider for your baby. It’s a good idea to meet and interview a few practitioners sometime in the third trimester (most providers are willing to do this—you may want to consider how future care may be with someone not willing to meet with you).

The provider you choose is someone you’ll likely be seeing many times in the next year and for years to come.  You want to make sure you select someone whom you trust and feel comfortable with.

General Schedule for Well Child Visits in the First Two Years

For Health Foundations mamas, we recommend that a pediatric care provider see your baby in the first week or so of life.  After that, the American Academy of Pediatrics recommended schedule for well-child visits in the first two years are:

• by 1 month
• 2 months
• 4 months
• 6 months
• 9 months
• 1 year
• 15 months
• 18 months
• 2 years

Well-child visits are important times to check in about your baby’s health, growth and development.  They are also key communication and education opportunities.  During these visits you can learn about and discuss issues such as normal development, sleep, nutrition, parenting practices, safety, diseases, and more.  The provider will do a physical examination, recording your child’s head circumference, weight, and height, and checking the heart, lungs, stomach, hips, head, ears, mouth, skin, etc..

Before Meeting Providers: Questions to Consider

Prior to these meetings, you may want to think through what is important to you in a pediatric care provider—

•  Do you have strong opinions on issues like circumcision, parenting, antibiotic use and vaccine schedules? (If you are not sure, you may want to do a little research into these topics to familiarize yourself with your options.) Do you want someone who is knowledgeable about natural medicine or a proponent of alternative and complementary care?  You may want to find a provider that shares your beliefs or, at the very least, will respect your decisions in regards to these issues.
• What is important to you in your child’s care provider in terms of access and availability?  To answer this question, you may want to imagine the case when something urgent comes up after normal business hours, maybe on the weekend or at night—what do you want in a provider in this situation?  How easily can they be reached?  How quickly can you be seen?  What if you have a non-emergency question after-hours, how easily can you reach someone?
• How about bedside manner?  Do you want someone with time to sit and answer all of your questions?  Do you want someone who can get you in and out of the office quickly?  Do you want someone who educates you about issues or do you just want their streamlined recommendations?
• Do you want a family doctor that can see the whole family?  Or someone who just sees kids?  Do you want a larger practice or a smaller practice and why?  (There are certainly benefits and drawbacks to each).
• How far will you have to travel to see this provider?

20 Questions for Potential Providers

The following are some questions you may want to ask potential pediatric care providers. You may wish to highlight those that you care about and add to this list other questions you want to ask.

1. What is your background and experience?  How many years have you been practicing?  Why did you get into pediatric care?
2. What do you like about your job?  Do you have kids of your own?
3. When we schedule visits, will we always be seeing you or will we be seeing other providers?  If the latter, how many providers are on staff?
4. What is after-hour (evening, weekend, holiday) access like—for questions?  For urgent visits?
5.  How quickly can we be seen for urgent/non-urgent issues?  Do you have same-day appointments?
6.  How easy is it to get a hold of a doctor with questions?  Do you accept questions by email?  Do you have an on-call paging service?
7.  What is your philosophy on breastfeeding? Do you have a lactation consultant?
8.  What is your philosophy on immunizations?
9.  What is your practice (conservative, liberal) of antibiotic use for common infections?
10.  How long are most appointments (including well-appointments)?
11.  What percentage (roughly) of your appointments start on time?
12.  Do you have separate sick and well child waiting areas?
13.  What is the first visit with baby like?  Where will the first visit take place?  Do you offer home visits?
14.  What hospitals/urgent care facilities are you affiliated with?
15.  What are your specific areas of interest when it comes to baby care?
16.  Do you take my insurance?
17.  How do you feel/how knowledgeable are you about “alternative” medicine?
18.  What are your recommendations on parenting and baby’s sleep?
19.  How important is patient education to you and in what ways do you facilitate this?
20.  How important is preventative medicine to you and in what ways do you facilitate this?

After the Interviews

After a few interviews, consider how you felt in each provider’s office—

• Did you feel relaxed and comfortable in their office?
• Did you feel good asking them questions or did you feel discouraged?
• Did you feel heard and understood?
• Did you feel rushed?
• Did they answer your questions to your satisfaction?
• Did the provider show interest in you and your family?
• Do you feel competent in their knowledge and skills?
• Do you trust them?
• What does your gut tell you about this person?
• Are they the kind of person you want to call in an urgent situation?
• Do their philosophies of care match your needs and desires?
• What did you think about the office and the other staff?

Remember that you can always try out a provider and see how you feel about your initial visits.  It’s okay to change providers at any time.  You may want to do another round of interviews before you decide to make a switch.

Happy searching!

Breastfeeding class this month

Breastfeeding 101: “So that’s what they’re for!”

If you are pregnant or recently gave birth, consider signing up for this fantastic course filled with important information about breastfeeding your babe(s).  The class, put on by postpartum service provider Welcome Baby Care, will be held at Health Foundations on August 26 from 6 to 8:30pm. Please join us!

Details:

This breastfeeding class for new and expectant parents covers everything you need to know to get off to a great start with your breastfed baby. Taught by trained lactation counselors, and covering the first month after the birth. We provide evidence based information on:

– the benefits of breastfeeding
– milk production
– milk supply
– best latch techniques
– how to know baby is getting enough
– common stumbling blocks and how to overcome them
– pumping and storage
– and much much more!

Offering only the most up to date and evidence based information, you will leave this class fully informed and confident in your body’s ability to feed your baby!

Light snacks and refreshments will be provided.

For more information, please call us at (952) 942-5676 or visit us at http://welcomebabycare.com.

You can sign up at https://welcomebabycarebreastfeeding101.eventbrite.com/