30 January 2010
28 January 2010
In my post, I said:
Many hospitals have been advising all laboring women to not eat or drink during labor in case they need emergency surgery with general anesthesia. But isn't that kind of like advising everyone to skip breakfast in case they get hit by a bus?
Are the chances of having an emergency C-section really comparable to getting hit by a bus? I've definitely heard of more C-sections than I have bus accidents in the past...My reply:
Sure, Molly - the chances of having a labor culminate in a cesarean are, possibly, higher than having a random accident (edited to add: I'm guessing here - a less lazy/busy person might add some statistics - chime in if ya got 'em!). However, I think it's VERY important to differentiate between unplanned cesareans and true emergency cesareans. Many woman will call their unplanned cesareans "emergency" when in fact they were actually unplanned and while there was perhaps not an easy-breezy pace, there was likely time for regional anesthesia. I have, luckily, been a part of only one true emergency cesarean in about 400 births.
As I said, the chances of needing energy for labor is 100%...and not having sufficient energy can actually lead to unnecessary cesareans if the laboring woman is unable to carry on or her labor stalls and augmentation of that labor leads to fetal distress. Avoidable cesareans (major abdominal surgeries) pose risks to moms and babies. So the extremely small risk posed by eating in labor is, in my opinion, worth it.
Coincidentally, an OB from a respected hospital in Boston recently quoted in the NY Times used a very similar example and line of reasoning to my bus idea, so I'm comfortable with my statement. I'll post this in a blog entry & try to find the NY Times article too. Thanks for your important question.
And that NY Times article can be found here if you would like to read the whole thing - there is a good discussion of what all the fuss is about, concern-wise - it is serious, and it's very, very rare. The quote I mentioned:
“My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study.
26 January 2010
Urgent Call for Human Milk Donations for Haiti Infants
Donor milk provides unique protection for fragile preterm infants, mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank.
(PORTLAND, Ore.) - The Human Milk Banking Association of North America (HMBANA), United States Breastfeeding Committee (USBC), International Lactation Consultant Association/United States Lactation Consultant Association (ILCA/USLCA), and La Leche League International (LLLI) are jointly issuing an urgent call for human milk donations for premature infants in Haiti, as well as sick and premature infants in the United States.
This week the first shipment of human milk from mothers in the United States will be shipped to the U.S. Navy Ship “Comfort” stationed outside Haiti. “Comfort” is currently set up with a neonatal intensive care unit and medical personnel to provide urgent care to victims of the earthquake.
An International Board Certified Lactation Consultant stationed at the U.S. Navy base in Bethesda, MD is assisting with providing breast pump equipment and supplies to the “Comfort.” Dr. Erika Beard-Irvine, pediatric neonatologist, is on board the “Comfort” to coordinate distribution of the milk to infants in need. HMBANA, USBC, ILCA/USLCA, and LLL are responding to requests to provide milk for both premature infants and at-risk mothers who have recently delivered babies on board the U.S.N.S. Comfort, but an urgent need exists for additional donations.
At the current time, the infrastructure to deliver human milk on land to Haiti infants has not yet been established. As soon as that infrastructure is in place, additional donations will be provided to older infants.
Mothers who are willing to donate human milk should contact their regional Mothers’ Milk Bank of HMBANA. A list of regional milk banks is available at the HMBANA website at www.hmbana.org.
Currently milk banks are already low on donor milk. New milk donations will be used for both Haiti victims as well as to replenish donor supplies to continue to serve sick and premature infants in the U.S. Donor milk provides unique protection for fragile preterm infants.
Financial donations are also strongly encouraged to allow HMBANA, a nonprofit organization, to continue serving infants in need.
UNICEF, the World Health Organization, the Emergency Nutrition Network, and medical professionals all recommend that breastfeeding and human milk be used for infants in disasters or emergencies. Human milk is life-saving due to its disease prevention properties. It is safe, clean, and does not depend on water which is often unavailable or contaminated in an emergency.
Relief workers, health care providers, and other volunteers are urged to provide support for breastfeeding mothers to enable them to continue breastfeeding, and to assist pregnant and postpartum women in initiating and sustaining breastfeeding.
For more information, contact HMBANA at 408-998-4550 or hmbana.org. Additional information can be provided from the United States Breastfeeding Committee at 202-367-1132 (usbreastfeeding.org), ILCA/USLCA at 1-800-452-2478 (www.ilca.org or www.uslca.org), or La Leche League at 847-519-7730 (llli.org).
25 January 2010
23 January 2010
I just came from a wonderful yoga mini-retreat - just two and a half hours, but very thought provoking (and hard work!), part of a bigger weekend workshop. And all I had to do was go a few blocks from my house and join in. It was an Anusara workshop organized by South Mountain Yoga & facilitated by Ross Rayburn. And it's happening again tomorrow afternoon - there is still some room if you're local & interested! (Maybe you can score a new Ganesh tshirt too)
The thought behind the day was the trinity (he used a fancier word, which I've already forgotten)...he used, in part, the backdrop of Sachindananda, which is part of the Anusara invocation (above).
Sachidananda is a combination of three words:
Sat = existence, truth, real.
Chit = consciousness
Ananda = bliss.
He suggested that in yoga we must first surrender, then reign it in and consider the boundaries before we can once again and more fully surrender. We spent time in each posture playing with the idea that you can't really fly or surrender or get to the bliss with out finding the tension and working with it, fine-tuning it, moving beyond it to a place you wouldn't have gotten to without first acknowledging it. So often we just go to the fullest expression of something, because we can, out of habit or because it's easier than really engaging...like in Uttanasana (standing forward bend) if we make touching the floor the main goal, and flop down there without making sure that our shoulders are engaged, pulling back even as we reach forward.
Like many things, this got me thinking about, what else?, birth. How many times have I told someone in labor to "just surrender" - JUST! Maybe I need to be mindful of the negotiation that must take place between the tension & surrender, allowing a woman to be contained by her body, feeling safe, before surrendering a little and then contained again, and then a deeper surrender. Like when a baby is being born and he turtles back and forth until ready to emerge under the pubic bone and out. Like when it's kinder to a mother's body if she can stay in the place of tension as she stretches, even as she wants to maybe blast out that baby, but allows herself to negotiate the passage, tempering the holding with releasing.
Balance requires choice and mindfulness, but then we get to melt more fully.
22 January 2010
21 January 2010
Well, finally a well-respected organization is calling BS on this (read the full article here) for low risk women:
NEW YORK (Reuters Health) - There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.
..."Women should be free to eat and drink in labor, or not, as they wish," the authors of the review wrote in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research....
...Standard hospital policy for many decades has been to allow only tiny sips of water or ice chips for pregnant women in labor if they were thirsty. Why? It was feared, and some studies in the 1940s showed, that if a woman needed to undergo general anesthesia for a cesarean delivery, she might inhale regurgitated liquids or food particles that could lead to pneumonia and other lung damage.
But anesthesia practices have changed and improved since the 1940s, with more use of regional anesthesia and safer general anesthesia...
...And recently, attitudes on food and drink during labor have begun to relax. Last September, the American College of Obstetricians and Gynecologists (ACOG) released a "Committee Opinion" advising doctors that women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. They fell short of saying food was okay, however, advising that women should avoid fluids with solid particles, such as soup...
...Singata and colleagues systematically reviewed five studies involving more than 3100 pregnant that looked at the evidence for restricting food and drink in women who were considered unlikely to need anesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.
The evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.
...Singata and colleagues acknowledge that many women may not feel like eating or drinking during labor. However, research has shown that some women find the food and drink restriction unpleasant. Poor nutritional balance may be also associated with longer and more painful labors. Drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications.
18 January 2010
I know it's kind of crazy, but I have not been able to bring myself to throw away the last bag of frozen breast milk...it's WAY expired (since I pumped it in 2005!) but has just been a happy little memento that I would notice every so often when I opened the freezer. Kind of weird, I know. Anyway, today I'm tossing it with a slightly heavy heart...I did, however, get to have a great discussion about breastfeeding with my youngest, since it's really his milk I'm getting rid of.
(Assuming your milk is a bit more current, here are guidelines for storage)
15 January 2010
"My birthday is Martin Luther King Jr's birthday and so I think I should celebrate his birthday, and mine, on the actual day"
So I said yes - sometimes it's nice not to say no.
14 January 2010
The scene: This morning on the way to school, Oasis' "Wonderwall" is playing on the iPod thingie in the car & I hit replay
My five year old says, "MOM - can you please change the music?! This song is SO irritating!"
Wow - everbody's a critic.
05 January 2010
Tonight my middle son, clearly a realist, requested that his oatmeal be prepared and waiting before I wake him so that he can eat right away and without being rushed...
note to self: get it together, lady!
01 January 2010
We just returned from our family ski trip. My oldest, 12, is a great skier and now snowboarder - he started at 4. My middle son, nearly 9 and not yet crossed over to the board side, is now flying over high ramps and sliding rails - he started at 3. My youngest, 5.5, made the biggest strides and graduated from the Magic Carpet up a baby hill to the rope tow to the lifts and even did some intermediate terrain - he started at 2 but took last year off. They all have a need for speed...I think they have that thrill-seeking gene.
I started as an adult in my late twenties. I didn't have the benefit of childhood fearlessness. I always skied very conservatively (read SLOWLY)! I thought I was in decent shape but until this year with the triathlon training and major slimming down, I was not. I used to sweat and huff and puff and felt sore and achy; I assumed this was just part of skiing and still loved it. But this year was amazing...I was truly a better skier and it all seemed effortless. I could ski more aggressively, mostly keep up with my oldest two kids, have much better form and I was never sore. My feet used to cramp from squeezing so much, out of stress and fear I think...no longer.
But the biggest revelation came on the last day, when I was once again waiting for my dad (whom we introduced to skiing the year after we started) and my husband to catch up.
I was waiting for them!
For all the years we have been skiing, they always waited for me, stopped for me, asked me if I wanted a rest. Amazing the difference a year makes. When my dad caught up, I thanked him for his patience all these years. It was a bit bittersweet, like a passing of the torch, but I'm cutting the guy some slack - he did have open-heart surgery eight months ago, so I may have to up my game next year if I want to beat him down the mountain.
So on this first day of a new year, a new decade, I will appreciate that today is truly the first day of the rest of my life. It feels good.
Happy new year!