Breastfeeding Initiative

I work for Oneida County Department of Health.  I LOVE my job and the people I work with.  One of things we are big on is education and public awareness.  This year we are working on increasing the awareness of breastfeeding and its benefits.  Being a doula I needed to tell them that successful breastfeeding starts with the birth. When I can across this blog entry I was like - YES, that's it.

It's the birth silly.      You are probably saying - what?  But it is true.

Mothers in our culture haven’t given birth since the early part of the 20^thcentury.  And no mammal who has birth taken from her goes on to nurse easily, or even to mother easily.  It’s not the breastfeeding that’s the problem. It’s the birth!  

did that peak your interest - then go to the above link and find out more of why, with out a support and successful birth breastfeeding becomes more difficult.

It's my baby

For starters how DO mom's know - that's my baby.  We are mammals after all and how do they distinguish between their's or someone else baby.  Smell.  Yes, as the mammals with the biggest brain we also can reason that we saw this baby born and he looks just like dad so he must be mine.  But research has shown that not only does scent let us know our baby but it can also arouse certain pleasurable feelings with in us.

How many times have you heard a mom say -  "I could just eat you up" or "I just can't get enough of that baby smell".  We hold them close to our faces, we caress them with our lips, and we inhale that wonder aroma that only a baby can have.

A baby’s scent works the same as drugs and food on a mother’s brain 
                  (from  A World in our Backyard by Laura Sesana)

“The olfactory—thus non-verbal and non-visual—chemical signals for communication between mother and child are intense,” explained Frasnelli, in a university publication. “What we have shown for the first time is that the odor of newborns, which is part of these signals, activates the neurological reward circuit in mothers. These circuits may especially be activated when you eat while being very hungry, but also in a craving addict receiving his drug. It is in fact the sating of desire.” 

Read more: http://communities.washingtontimes.com/neighborhood/world-our-backyard/2013/sep/30/babys-scent-works-same-drugs-and-food-mothers-brai/#ixzz2hYmn3zhO
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That is why after birth mothers long to hold their infant and being deprived of that (for what ever reason) creates a void within us.  And this is also why women are so easily attracted to young infants.  It is amazing where I work how the women come out of their offices when a baby is around.  We would love to hold every one of them and i usually get the privilege when mom's are tending to their other children.  In fact I always make sure to say thank you for letting me hold their baby. (I work in a public health clinic so baby's are a common presence.  We love it)

AND - That is why it is so important for mom and baby to be united skin to skin immediately after birth and even foregoing that first "bath" the nurses can wait to give.  Mom and baby need to bond,  to experience, to unite as one during those first hours after birth.  We call it "owning your baby".  During that first hour you will smell, touch, stroke, listen to your baby, she will start to suckle at your breast and will be quite aware of her surrounding.  This  is a time when nurses will want to do all their required things - ask that they be done while baby is still laying on your tummy or chest.  If you are not able to do this --- then have dad do skin to skin, it is that important.  

Psoas, pain, pregnancy

When I first heard this word at work I thought how weird, like couldn't they think of a better word for this important major muscle group?  But no matter how you say it - "So As" it is a very integral part of being pregnant.  Twice this week I have been asked "what is this pain I am having". Aha, I said,  it is your psoas muscle.  Huh???  and then I go on to explain just what is happening and why it is hurting and why it needs to STOP hurting.

For me to understand something I need to research it.
This is what wikipedia says about my psoas - oh and by the way there is a major and a minor psoas and 50 percent of humans do not have both.

The psoas major /ˈsoʊ.əz/ is a long fusiform muscle located on the side of the lumbar region of the vertebral column and brim of thelesser pelvis. It joins the iliacus muscle to form the iliopsoas. In less than 50 percent of human subjects,^[1] the psoas major is accompanied by the psoas minor.

Not a very good explanation is it.  But the muscle runs from your lumbar vertebrae, over the brim of the pelvis and to your leg. And where is baby you say - right in the middle of the red muscle group.

Rachel at New Beginnings Doula Training,  has an excellent blog entry about your psoas with good links on stretching, alignment and the role of the psoas in pregnancy. 

Katy Says - a web page dedicated to alignment has a very informative entry about psoas in pregnancy and the pelvis during labor.  As you read through her entry you will see why it is so important to have a balanced pelvic area during pregnancy labor and birth. 

Kelly from Spinning babies - a real go to site that has just been revamped.  Has a tremendous amount of information on getting baby in the best possible position for birth including breech kiddos, posterior presenters and babies that just want to hang out above your pelvis for a while. 

These are just a few good places to start at. Even if you aren't experiencing pain or discomfort doing the exercises and suggestions will on enhance your pregnancy and birthing experience. 

Now that you know the why behind your Psoas and pregnancy,

 lets get down to a routine that you can live with. 

We live in a sedate society.  Lets face it, we sit - at breakfast, in the car on our way to work, at our desk at work, a table at lunch, back in the car to go home, sit to eat dinner and then the big SIT - in front of the computer or television. Now, don't get me wrong -- sitting is bad - how else are you going to get to work but we have a tendency to recline while doing this and that is the problem.  So, what can you do to counter this persistent problem.  

1. walk more

2. watch how we sit when we do sit

3. try sitting back wards on a chair - you know that unlady like straddle facing the chair back

4. sitting on a correct height birth ball. 

5. stretching

6. READ - 3 principles to support your pregnancy

                  7-Week Exercise Guide to a Better Birth

7. Research - and my final answer - for just about everything - google.  google Psoas in Pregnancy,  read and use common sense when deciding what is best for your body. 

It's all in the planning

Without a vision, the people perish, and I believe that vision needs to be written down and revised as needed.  I'm talking about that birthing plan that so many pregnant parents (yes dad too) hear about.  When I came across this article written by a pediatrician I just had to link to it.

Writing a GOOD birth plan. by Dr. Berchelmann

with out a plan - this little guys mama would have been confined to her bed because her water broke before she arrived at the hospital. But she knew before hand that she wanted to be up and walking through out her labor and even though the nurses said no, he doctor said yes because he knew her plan as well.  By the way - she walked around until she said --- have     to     push.  

When helping parents write a birth plan I tell them a few things:

1.  a plan will help you know your options.

 2.  a plan will help you achieve your choices

3.  a plan will help your care giver help you accomplish those desires. 

But a plan needs to be well thought out and not just something you found on the web. 

 While that can help you get started, your plan needs to be unique to you.  

Dr. Berchelmann makes some very valid points in her article, 

points that should be considered by anyone writing a birth plan.  

Oh and don't forget to add your doula as part of your support team.  

Considering Pertussis

If you are in your last trimester, your doctor might be mentioning that you need to get a tetanus booster shot.  Because I also work in public health, I get many questions about the why, the need,  the safety of this vaccine. Tetanus, Diphtheria and Pertussis has been around since I was a child when it was called DPT.  It did a pretty good job of protecting me from getting the whooping cough.  As I grew older, that vaccine became a shot I got for stepping on nails or needing to get it to participate in boy scouts.  Over the years, there have been pertussis outbreaks through the Oneida County area.  The recommendations have change because of that and now any child going into 6th grade is required to get a Tdap vaccine.

from  London School of EconomicsPrinter: Mospoligraf Publisher: Gosmedizdat Place of Production: Moscow Date: 1930


Two sepia illustrations, the first showing a breast-feeding mother with a cloth
wrapped around her nose and mouth; the second showing a mother pushing
another woman away from the baby on her lap.

But now the researchers are realizing just how "bad" this pertussis situation has become.  Not just in our county and state but around the nation.  It is now being recommended that parents to be get protected from pertussis.  CDC has released the following regarding Tdap in pregnant women.

On February 22, ACIP published its October 2012 recommendation stating that pregnant women should receive Tdap vaccine during each pregnancy, irrespective of the patient’s prior history of receiving Tdap. Receiving a Tdap vaccine during pregnancy allows for maternal pertussis antibodies to be transferred to the newborn and likely provides protection to the baby against pertussis early in life, before the baby is able to receive diphtheria, tetanus and acellular pertussis(DtaP) vaccines. Tdap will also protect the mother, making her less likely to transmit pertussis to her infant after birth. Optimal timing for Tdap administration is between 27 and 36 weeks gestation although Tdap may be given at any time during pregnancy. Pregnant women not previously vaccinated with Tdap and who did not receive Tdap during the pregnancy should receive Tdap immediately postpartum.

To read the recommendation,

Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and

Acellular Pertussis Vaccine (Tdap) in Pregnant Women

Advisory Committee on Immunization Practices (ACIP),2012

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm

This image depicts a female infant who presented to a clinic
suffering from what was diagnosed as pertussis.
provided by CDC. 

Pertussis is a highly communicable, vaccine-preventable disease due to

 Bordetella pertussis, a gram-negative coccobacillus, 

lasting for many weeks and typically afflicts children with severe

coughing, whooping, and posttussive vomiting. 

 So - to sum it up. 

If you are pregnant - consider getting a Tdap vaccine between 27 and 36 weeks gestation.  This way the baby gets the benefit of receiving protection early in their life.  Plus, it is good to make sure that the people who will be around the baby on a regular basis - father, older siblings, grandparents get this vaccine to keep them from getting whooping cough. 

The sneaky thing about pertussis is that when an adult gets this, they shrug it off as a bad cough or bronchitis.  Their symptoms aren't that strong.  BUT, now they have passed it on to an infant that has NO protection from whooping cough and 50% of all infants who contract pertussis will be hospitalized. 

 

Office for Emerency Management.
1943-45

And this is how it is spread.  Of course, we can't see our coughs this way -- thank goodness,
but how many times have you been sitting next to someone who turns their head to
sneeze or cough and misses his shoulder and you get the full blast of - yup -  his germs.
  Or coughs into his hands and then --- horrors, reaches out to shake yours and introduce himself.  

Having babies makes me think

One of the things I appreciate about my clients is what I learn from them by being their doula.  When I am asked to be someones doula, I always research such things as posterior babies, transverse babies, placenta abnormalities and the list can go on and on.  Every birth is so different from any of the others I have witnessed, from the 30 hour plus to the 3 hour, vbacs and cesarean,  each is one of a kind.

So today, I was asked by a fellow doula if I would help her teach a couple that because of hospital restrictions is only allow so many people in the birthing room.  After some thought I said, sure why not.  So now I am doing my research as to the best way to present to someone how they can be a doula for the women who will be having her baby.  The more I thought about it, the more I realized - what an honor.  To be able to have the support of your husband and the support of the couple who would be adopting their baby. What greater joy could there be.  So now I am excited because I get to teach a soon to be mom how to be a doula for her baby's mother.  Is that cool or what.

Birth Surveys

Today I was asked to look over a birth survey.  I thought,  that's a bit odd.  But then I gave it some more thought and realized that - it's not so odd at all.  if hospital don't know what they are doing either positive or negative, how will they know how to make improvements in their care.   Except for say plastic surgery, going to the hospital to have a baby is the one time your aren't sick or in need of special care to make you better. So, why do doctors, nurses, hospital administrators make you seem "sick".

You get wheeled in, you get removed of your clothes,  given a  hospital gown, you are hooked up, and on and on.  Sounds like a patient to me and not a mom to be.

So, I am looking over this survey and tweaking it here and there and praying that when parents fill this out and send it to the hospital administrators as well as the maternity wards a difference will be made.