30 November 2011

snippet of motherhood: makes my heart melt

Bananas with brown spots...no one around here wants to eat them that way. They usually go into the freezer for smoothies or future baking. Today, however, I decided to seize a rare moment of quiet and see if my middle kid wanted to learn how to make banana bread.

I'm sure they would figure this kind of stuff out if they need to, but I want to know that they will be men who have a few cooking techniques under their belts and can properly fold fitted sheets and any of the other stuff I feel compelled to show them...

As we were cooking, he said something that made me so glad,

"Mom - did you ever notice that food cooked at home tastes so much better than any other food you can buy?"

This from my non-eater. I love that kid, and I'm glad he gets the value of home cooked food...at least food containing chocolate.

23 November 2011

Pure, Utter Joy!

This ecstatic photo of a home water birth in Australia, taken by midwife photographer Jane McCrae, is in the running to win National Geographic's Photo 2011 contest, showing the world how utterly joyous birth can be...something to be thankful for, indeed!

The photographer's commentary,

Only a mother can understand the joy of locking eyes with her newborn babe the moment they take their first breath.

After the powerful journey of labor, Natalia embraces her babe for the very first time. Sheer exhilaration, joy and love describes the moment of bringing forth her child. The gentle hand of her midwife, trusting in the innate wisdom of birth

Location: Homebirth. Tumbi Umbi, NSW, Australia

18 November 2011

Can you spare 3 minutes? Cord clamping: new information confirms what many of us "knew" already

Most families I serve ask for "delayed" cord clamping, assuming the baby is well and not in need of immediate care away from the mom. But what constitutes "delayed"? It's always been a mushy concept and for some providers, delayed is 10 seconds while another might wait 10 minutes. A study abstracted on Medscape (see below) finds that 3 minutes is enough to allow the baby to take back what rightfully belongs to it and decrease chances of anemia and other health implications:

Delayed Cord Clamping Raises Iron Stores at 4 Months

Ricki Lewis, PhD

November 15, 2011 — Allowing placental blood to flow into the neonate for 3 minutes, rather than cutting the umbilical cord within the first 10 seconds, as is common, increases blood volume sufficiently to elevate ferritin at 4 months, finds a study published online November 16 in theBritish Medical Journal.

Adequate iron stores are essential for brain neuron myelination, dendritic growth, neurotransmission, and energy metabolism in neurons and glia. Because iron demands are high in the young, iron-deficiency anemia and subclinical iron deficiency are associated with long-lasting cognitive and behavioral problems. Past studies that support a delay in cord cutting were conducted in developing or middle-income populations that have a high prevalence of iron deficiency anemia (ie, in Guatemala, India, Mexico, and Zambia), but did not follow up children past the neonatal period. Iron deficiency is less prevalent, yet still fairly common, in other nations.

Ola Andersson, MD, a neonatologist at the Hospital of Halland in Sweden, and colleagues enrolled 400 full-term infants born after low-risk pregnancies between April 2008 and September 2009, and randomized the time of cord cutting to either 10 seconds or 3 minutes. When a birth was imminent, the midwife would open an envelope assigning either cord-cut time. Midwives held the neonates 20 cm below the level of the mothers' vulvas for 30 seconds and then placed the infants on the mothers' abdomens to facilitate blood transfer.

The researchers assessed infant blood sampled on the second day for CBC (hemoglobin, packed cell volume, mean cell volume, mean cell hemoglobin concentration, reticulocyte count, and reticulocyte hemoglobin), iron status (serum iron, transferrin, serum ferritin, transferrin saturation, and soluble transferrin receptors), C reactive protein, and bilirubin and repeated all but the bilirubin test on 4-month samples.

Because past rationale for cutting the cord immediately after birth was increased risk for adverse events resulting from excess blood, the researchers also assessed the late-cord-cut infants for respiratory symptoms, polycythemia, and need for phototherapy to treat neonatal jaundice. Blood was drained from the placenta and volume measured, which explained the higher average weight of the babies with later-cut cords.

At 4 months, the infants in both groups had similar hemoglobin concentration, but the infants whose cords were cut later had 45% (95% confidence interval, 23% - 71%) higher mean ferritin concentration (117 μg/L vs 81 μg/L; P < .001) and lower prevalence of iron deficiency (1 [0.6%] vs 10 [5.7%] infants; P = .01). The delayed group also had lower prevalence of neonatal anemia (2 [1.2%] vs 10 [6.3%] infants; P= .02). The groups did not differ in respiratory symptoms, polycythemia, or hyperbilirubinemia.

Every 20 babies having delayed clamping could prevent 1 case of iron deficiency, the researchers estimate. They conclude that delayed clamping "should be considered as standard care for full term deliveries after uncomplicated pregnancies."

Patrick van Rheenen, MD, a consultant pediatrician at the University of Groningen in the Netherlands, agrees in an accompanying editorial that "enough evidence exists to encourage a routine change in practice."

The study was supported by grants from the Regional Scientific Council of Halland; the HASNA Foundation, Halmstad; HRH Crown Princess Lovisa’s Foundation for Child Care, Stockholm; and the Framework of Positive Scientific Culture, Hospital of Halland, Halmstad The authors and the editorialist, Dr. van Rheenen, have disclosed no relevant financial relationships.

BMJ. Published online November 16, 2011. Full text

Unclear how this would impact cord blood banking for those who wish to do that, I contacted one of the major providers of this service, CBR. According to their phone representative, banking requires 100 million total nucleated cells - not a specific volume of blood. Every collection is tested to make sure there are enough cells for banking. It was the opinion of the representative with whom I spoke that allowing the cord to pulse for 3 minutes would still leave sufficient blood to allow for banking. Happily/surprisingly,CBR will call and give people the option to continue with the service in the event that not enough cells are present to meet their threshold for storage or exercise the option of a full refund. They said that it's very rare, as most samples are in the billions. They were aware of the study and it had been passed around there for their education. It is their hope that someday even small samples will be able to be "grown" into large amounts of stem cells.

15 November 2011

well that's a new one...

Last night, as my much-delayed plane landed, I checked messages and there were several...a client's labor had started a bit early, but she did not need the waiting backup yet and knew I was en route. Then another, just before my plane landed: her water broke and they were on their way to the hospital...eek! Although I'd been mad that my flight was rerouted to NYC instead of NJ, it ended up being great - I went straight from the airport to the hospital in the city. No birth bag and wearing cowboy boots, but it didn't matter. I did have my iPad and was able to supply the music they had left in their rush to get to the hospital, as well as waters and such.
Just goes to show, it's not about the stuff or the toys - just being present with an open heart is often what's best. (minus the boots, maybe)

Welcome baby Guiliana!

Born on your Grandma's birthday very early this morning - you are so beautiful and delicate. Your momma knew just what she needed to do and your daddy was right there with her for every minutes of your labor and birth...
welcome to the world!!

10 November 2011

Welcome Abbey!

Beautiful girl - born with the full moon, within an hour of your girl cousin...a hawk told me you were coming. What wonderful instincts you have, just like your momma! Welcome to this world, little girl.

08 November 2011

an open letter to leaders from The MotherHood Blog

Dear 2012 Presidential Candidates,

We are your future constituents and we are parents.

We are American mothers and fathers and grandparents and guardians. Our families might be the most diverse in the world. Blended and combined in endless permutations, we represent every major religion, political ideology and ethnic culture that exists. We are made from equal parts biology and choice. Our children come to us in every way possible—including fertility miracles, adoption, and remarriage.

Our very modern families embody the freedom that defines America. We embody America. We are rich in diversity, but we are united in our family values. We come together today, with one voice, to express our grave disappointment in the national political discourse.

The 2012 countdown has barely begun and we are already bombarded with the warmed-over, hypocritical rhetoric of 2008. We are living in a time where 15.1% of Americans now live in poverty, the unemployment rate stands at 16%, and we are spending close to $170 billion annually between the wars in Iraq and Afghanistan.

Given the current state of affairs we would expect every candidate to focus on the issues that truly matter: job creation, debt-relief, taxes, education, poverty, and ending the war(s). Instead, it is already clear to us that the conversation has been hijacked, with the goal of further polarizing our nation into a politically motivated and falsely created class-war.

We will not stand for another campaign year in which politicians presume to know what our family values are as they relate to the nation.

To be clear, here are our family values:

• Affordable health care, including family planning, for all Americans. We will not tolerate any candidate using the shield of “Choice” to blind us from the issues that really matter. When funding is stripped from organizations like Planned Parenthood, access to sliding-scale health care (including yearly pap smears & mammograms), comprehensive sex education, and family planning is blocked from the poorest of the population.

• Access to education, and the ability to actually use it. We want quality, affordable, federally-funded full-day, pre-K programs made available in every State, in order to provide an even starting point for all children enrolled in public schools— regardless of the wealth of the district or town they live in.

• A reinstatement of regulations for banks issuing mortgages and full prosecution for those who engaged in fraud. We want full accountability —investigation, indictment and prosecution— of those individuals and financial institutions who engaged in fraudulent lending practices and who helped create the massive foreclosures that left many families homeless or struggling to keep their homes.

• A return of strict environmental regulations protecting water, air, food, and land that were removed in the last two decades. We want our children to grow up in a world not weighed down by the strains of pollution and global warming. Between BPA in our products, sky-rocketing rates of asthma in kids, questionable hormones in our over-processed food, and more, we need leaders who will put our needs and safety over the desires and profits of large corporations.

Family planning, healthcare, education, economic solvency and environmental safety: these are our national family values.

Candidates who demonstrate the ability to understand the gravity of these issues, and their impact on our families, and who can provide actual, viable solutions to these problems will garner our support and our votes.

We believe in our democratic system, and we'll continue to use our voices and our votes to see that it reaches its fullest potential.


Your future constituents,

The Mothers & Fathers of America

To whom it may concern,

Dear leaders and aspiring leaders of the free world,

I bet many of you were called to politics out of a desire to serve and make the world a better place. Well, it looks like you have lost your way.

In addition to being a wife and mother, I work to serve birthing women and families. In that role, I see every day people within healthcare who have also lost their way. Not unlike physicians and others in healthcare, you have taken an oath to serve those who have entrusted themselves to you. I know as well as anyone the demands of service can take a toll personally. We are all human, with our own needs and our own families and aspirations. But when you find that your own interests are causing you to sell out the best interests of those you serve, it's time to move on. Otherwise, it's time to have integrity and do what you said you would do. It's simple really.

We gave you your power, please don't forget that.

BLOG-IN! SPEAK OUT! Parents Send a Letter To Washington

* Today, across the web, bloggers will be simultaneously posting this letter as a new form of democratic protest called the Blog-In. I am just one of many. Click here to see a full list of the writers participating. (Our hashtag on Twitter is #BlogIn2011.)

07 November 2011

a loving universe

I sometimes read my horoscope. There - I said it. I find it a bit embarrassing that I turn to horoscopes like a crystal ball when I'm stressed about something, but I do.
Anyway...here's part of what it said...not what I was worried about, but so very nice...about the nicest thing I could imagine reading:

If you have children, you will see them protected and cared for by a loving universe. You need not worry about your children!

"protected and cared for by a loving universe" - isn't that just the best?