Monday, January 31, 2011

Taking Care of TCBN Business

If you live in or around Tarrant County (Fort Worth area), today is the deadline to get your birth story submitted for a book that the Tarrant County Birth Network is putting together.  All the submission information can be found here.  We want to hear from YOU!  All types of births will be selected for the book.

Our next TCBN meeting will be held next Thursday, February 10.  Same place and time.  Visit the website for more details if you have never joined us.  If you'd like to be included in our email list, please contact tarrantcounty@birthnetwork.org.

The topic for next week's meeting is "Is Your Care Provider Mother-Friendly?"  We will be reviewing the 10 Steps to the Mother-Friendly Childbirth Initiative as set forth by the Coalition for Improving Maternity Services (CIMS).  We will be hearing from two of the UNT Certified Nurse Midwives, Lindsay Kragle and Summer Latta, as well as Kim Watkins, Certified Professional Midwife.  All are members of the Birth Network.

Come hear what Mother-Friendly maternity care really means for the women and families of the Fort Worth area.  If you've looked through the TCBN Resource Guide, you've noticed that, with the exception of the UNT Midwives, all the midwives practice outside of a hospital setting, either in a birth center or home.  No other hospital group qualifies to be members of the Birth Network.  Why is that?  Come learn more about the care providers that truly provide Mother-Friendly care.  You have so many amazing care providers to choose from in and around Tarrant County.

Our door prize is amazing at this next meeting.  Alexa Gumm has been working on this, and I don't want to say too much, but ERGObaby has donated one of their baby carriers, worth $130.  Bring your pregnant friends and enjoy this evening with some amazing midwives.   Oh yeah, and everyone else is pretty amazing too!

Now get off here and get your birth story submitted!

Monday, January 24, 2011

Part 1: A Mother's Story -- Exclusive Pumping

One of my readers, Anne, sent me an email this week with a story about how she has exclusively pumped breast milk for her son who was born with Down Syndrome.  I thought it would be great to share her story here.   This is part of her email:

I always wanted a natural birth but it wasn’t meant to be - I had a ruptured uterus early on in a previous pregnancy, so c-sections seem to be necessary for me.  And I’m okay with that, at least I can still carry a child.  I also didn’t get to breastfeed with my son for more than, oh, maybe a month – once per day if even that.  If I was lucky.  He was a preemie, and tube fed at first and is a special needs child. He has Down Syndrome and has the most unique amazing story to tell . . . but that’s a whole other seizures/nutrition story! LOL  Anyway . .  boy have I learned a lot!  How to stand up to the NICU nurses . . . and that women can pump long term if breastfeeding doesn’t work out (no thanks to the NICU nurses there - UGH!!!).  Even the pediatrician didn’t think I could make it pumping for more than a couple months.

I hope you'll enjoy her helpful hints here and there are mothers out there that will find her story encouraging.   Thanks, Anne, for allowing me to share your story.

"This is for all you Mama’s out there who find yourselves in the difficult position of wanting to breastfeed, but for whatever reason are unable to do so.  Doctors and nurses are too quick to offer formula to the baby who won’t (or can’t) latch.  I am here to tell you, there is another viable option!  It’s called exclusively pumping, or EP’ing for short. 

Doctors and nurses might tell you that you can try, but they will most likely tell you that you WON’T be successful at it, especially not long term.  They will tell you that your body will not respond to a pump, that a baby is much more efficient than a pump, and, well, why bother when you can go straight to formula?  Trust me, ladies, you don’t have to.  You CAN exclusively pump.  Long term, if you want to!  I’ve been doing it for 2 years for my son . . . yes TWO!

Let me give you a little background on our situation: my son, Kaiden, was born 6.5 weeks premature by emergency c-section due to an overly large placenta intent on evicting him (the c-section was necessary from a previous injury) and needed to be tube fed for the first few weeks.  The nurses never even gave me a choice, within hours of his birth, they walked in and said, which formula do you want to use, Enfamil or Similac?  Indignant, I told them I wanted him to have my breastmilk.  They said, well, we CAN wait for your milk, but we’d prefer to give him some food now, so choose one.  I admit, I caved and let them give him formula until I had colostrum to give him, which came in 10 hours after his birth.

By now, the nurses knew I wanted Kaiden to have my breastmilk and their only words of advice were that I needed to pump every 3 hours for 15 minutes around the clock.  That’s it, nothing more, no words of encouragement or more advice, no tips or tricks, nobody even took the time to show me how to use a breastpump.  They did bring in one of the hospital’s Medela Symphony pumps that I could use. It wasn’t too hard to figure out, but I hated that pump; trying to sit up and hold the horns in place while staying near a plug-in was hard on my post surgery body.  I had previously purchased a used Medela Pump In Style and gave that a try instead.  Unfortunately for me, I hadn’t gotten the suction tested when I bought it and as it turns out, that pump was a little too used (weak motor) and I threw it away after the first try.  My supportive husband, seeing me in so much discomfort, took me down to the lactation department and encouraged me to buy whatever pump I desired.  I chose the Medela Freestyle, a nice little portable unit.  It wasn’t cheap, but that pump has become like an extra body part over the last 2 years and was well worth the money spent.

If EP’ing looks like it might be the way to give your baby your breastmilk, let me give you some tips:

·         Invest in a good quality double electric pump. 

·         If you choose to buy a used pump, get the suction tested before you commit to buy!

·         Keep spare pump parts on hand.  The membranes/valve assemblies DO wear out and should be changed every 3 months to keep the suction at its best.

·         For working Mama’s, most workplaces are required to provide a private place for you to pump.  Check your state laws and with your employer.

·         You DO need to pump every 3 hours around the clock, for 15 – 20 minutes per session for the first 6 – 8 weeks.  No skipping sessions.  This establishes your supply just as breastfeeding does. 

·         Follow your baby’s feeding routine: Feed baby, pump, get some sleep.  Repeat. 

·         Do NOT skip nighttime pumping sessions until your baby sleeps thru the night.

·         Same as breastfeeding, be aware that what you eat affects your baby and you may need an elimination diet depending on your baby’s dietary needs.

·         Learn the proper way to hand express milk from your breasts, and do so after every pumping session to fully empty your breasts as possible.  In an emergency situation (like forgetting  your pump AND stored milk at home and your baby is hungry!) you can hand express what your baby needs.

·         Always keep a spare bottle/nipple in the diaper bag.  If you aren’t afraid to breastfeed in public, be warned, there are times you may need to pump and/or hand express in public.

·         You CAN exclusively pump long term.  It just takes a time commitment.

·         Keep up on your calories and fluid intake!  This is not the time to worry about your weight or figure.  Your body needs the extra calories and fluids to produce milk.

·         You may become obsessed with the amount of breastmilk you produce . . . nursing Mama’s don’t get to see the amount their baby eats, but you do.  Try not to get over-obsessed with it.

·         As your baby grows, your supply will naturally diminish.  It is typical to lose a little supply around the 6 – 9 month period, then again in the 9 – 12 month period.  As your baby begins to eat solids, they will eventually need less breastmilk so although it can be saddening, it really is okay to see your supply decrease.

·         If you are still pumping when your post-partum menstrual cycle returns, know that it may decrease your supply for a few days to a couple weeks.  Your milk supply may also follow your menstrual cycle – highest production around ovulation, lowest around your period.

·         Stress can diminish your supply, especially emotional stress.  While it’s near impossible to avoid such situations, you can be aware in advance that you will need to take extra care of yourself during these times by practicing relaxation techniques and not skipping meals.  Especially not skipping meals.

·         There are herbal supplements you can try if your milk supply isn’t what you’d like.  Mother’s Milk tea, fenugreek, blessed thistle, and fennel are just to name a few. 

·         There are internet forums just for EP’ing Mama’s, I recommend joining one for encouragement and support.


The goal of pumping so much is to build up an oversupply.  While this can be an issue for breastfeeding Mama’s, it can be your salvation.  You can freeze any extra milk to be used during growth spurts or low-supply days, and is a great way to be able to continue to give your baby your breastmilk for awhile after you have stopped pumping.

If you find you have too much milk, you may consider either reducing your pumps, or donating your extra milk to a needy baby.   Because of our special circumstances (which you can read more about in my blog if you wish) I ended up donating somewhere around 1200 oz of frozen milk. 

This is by no means all the tips & tricks you may learn, but it should give you a good start.  Never let anyone tell you that exclusively pumping is impossible!" If you'd like to read more about Anne's story, visit her blog, The Green Child Chronicles.

Two other friends will be sharing their stories over the next few weeks, too.  Alisa pumped for her son born with a severe cleft palate/lip, and Mellanie will be sharing her story of breastfeeding her daughter born with Kabuki Syndrome.  Both are touching and inspiring stories I hope you will enjoy.  I know these stories are near and dear to these mother's hearts and I appreciate their willingness to share them here. 

Monday, January 17, 2011

The Next Generation -- The Old Lady Post

Last week on the news there was a report about college-aged kids and their desire for praise and compliments being stronger than the desire for sex, drugs, or alcohol.   I thought that was so crazy that they craved positive attention so much that it was a driving force in their lives.  It got me thinking about what possibly led up to that.

I've had some interesting conversations lately with a friend about this and related subjects.  These are some of my thoughts, and I may show my age quite a bit in this post, but I think it's important to have this dialogue in our homes.  Do we want to raise our children to be adults that are driven by the outward praise of others to feel good about themselves? 

First, when I was a kid, I wasn't really involved in sports.  I did ski and I played clarinet.  I was a cheerleader in 5th grade.  I got good grades, at least until high school.  I do not ever remember an awards ceremony for anything.  I don't remember my sister getting trophies for sports.  We just participated in different things.  We either excelled or we sucked.  That pretty much determined what we went on to do later.  We learned how to fail and how to get over it and move on.

My kids have all played soccer and even when they didn't score a single goal all season, the kids on the team all got a trophy, especially when they were little.  I think this is the most ridiculous statement to our children -- "Thanks for participating, and just for doing so, we are giving you a trophy."  What does that say to the teams or children that truly excel, the ones that really earned the trophy? 

At the risk of sounding like an old person, I see so much laziness in many young people today.  My younger kids all have awards ceremonies at the end of the school year.  They are very long, as the parents listen to all the awards of all the kids.  Some of these awards are truly praiseworthy, and others, frankly, are unbelievably stupid.  It's the participation awards that get me.  Why are we praising these kids for having the opportunity to participate in an activity?

Right about now is a great time to mention that my children are so far from perfect, and half the time I have no idea what I'm doing as their parent.  But I look at so many young people and know that I don't want my children to take what they have for granted.  I don't want them to feel like their value or self esteem comes from what other people think of them.

So this leads me to the question, is it a good thing that we are praising them for every little thing they do?  Will they ever learn how to deal with criticism?  Will they learn how to fail and how to succeed -- both with grace?

This friend I was talking with this week was telling me about a guy that her husband had hired to help him with a project.  He was 22 and insisted that he couldn't work at certain times (his girlfriend didn't like it), along with a number of stipulations for his boss!  Can you imagine telling your boss all the things you require in order to work for him?  He obviously felt "equal" to his boss, even superior.

This leads me to a side discussion concerning informality in our American culture.  Children being treated as "little adults."   They are not adults.  And children calling adults by their first name, in my opinion, is wrong.  It does not encourage respect and has a very negative effect on the respect children have for adults, or the lack thereof.   I could never have imagined calling my friends' mothers by their first names as a child.   That would have been incredibly disrespectful.  Even this migration to adding "Miss" in front of a first name, it just shows that we are more lax than we used to be.  It puts children and adults on the same level.  I understand with close family friends, but I believe it should not extend outside of that.  Before we moved to Texas, the schools my children were attending in NM were beginning to start using the "Miss" in front of their names instead of the formal "Mrs." and their last name.  I am relieved that our school district is "old-fashioned" and the children are even encouraged to use "ma'am" and "sir." 

Since I'm on a roll... 

Men don't wear suits to work anymore (OK, my husband does, but many are not required to anymore).  My dad would never have allowed his employees to not wear suits to work.  He was bothered by the shift to business casual and felt it was a huge mistake.  I think he was right.  He was a CPA and so is my husband. 

People wear jeans to church, like they are going to a BBQ or to the movies.  Dressing up shows respect.  Respect for our ourselves, our work and for our Lord.  Why do we have to be so relaxed about everything in our lives?  It spills over into disrespect for the things that really matter.

I also worry about this next generation not being able to communicate.  The texting and Facebooking is the main way my 14-year-old son communicates with nearly everyone.  We have many conversations about it, but it's hard for him to put it down.  I worry about addiction to these devices.  It's rude and disrespectful to answer a phone call or text while talking to someone else, and yet, we all do it. 

We all have so many distractions demanding our attention all the time.  We become consumed with me, me, me.  Not just the next generation, but all of us.  Fortunately, the older we are, the more we remember how it used to be.  This generation doesn't know how it was.  It's up to us, the ones who believe that more formality in our culture was a good thing.  Respect.  Dignity.  Thinking outside ourselves. Who's with me? Or is this what turning 40 does to you?

Thursday, January 13, 2011

Tarrant County Birth Network Meeting Tonight -- Topic: Pre & Post-Natal Fitness

I know, I know, I should have put this up earlier.  Hopefully you've seen it elsewhere and are planning on coming.

Our topic tonight is Pre & Post-Natal Fitness.  Maggie Grayson, owner of Stroller Strides in Mansfield, Arlington, and Hurst, will be speaking.  If you've never heard her speak before, she is a delight.  So full of energy and passion for what she does.  She is also a homebirthing mama after a c-section with her first.  (She is currently pregnant with her 3rd.)

In addition, Michelle Huynh is a yoga teacher that will be sharing her wisdom with us on the subject.  In my world, she's quite famous.  I've had several students that take yoga from her and they all rave about her.  I'm looking forward to hearing from her tonight.

We are also starting to do door prizes and Alexa Gumm, Chapter Leader, is on this.  Girls, you can't believe the stuff she has gotten!  She's after some big things.  It's fun to see these products and support the vendors that support Mother-Friendly Childbirth by supporting the local organizations such as the Tarrant County Birth Network.  Michelle and Maggie have both generously contributed tonight, and Earth Mama Angel Baby has donated a beautiful postpartum gift as well.  

We are meeting on the campus of TWU at the Sid Richardson Building on the second floor by the elevator.   7:00 pm.  Refreshments are provided this evening by Simply Sweet Bakery.  As always, lap babies only.  Visit us online at www.tcbirthnetwork.org or on Facebook.  See you tonight!

Monday, January 10, 2011

Breastfeeding, Allergies, and Antibiotics

I was born in January 1971 -- yes, I'm turning 40 this month! -- which had the lowest breastfeeding initiation rate on record.  I can't really blame my mother for not breastfeeding.  It was the culture.  Women only breastfed if they were too poor to buy formula.  Women were told that formula was superior to breastmilk.  Much like today, women trusted their doctors and didn't question them.  As far as I know, my mom never even considered breastfeeding.  I did not receive even one drop of colostrum.

I love to read my baby book.  I was eating veal at 3 weeks of age.  Yes, veal.  I was loaded up on all kinds of baby food in that first year.

During the first 5 years of my life, I was in and out of the doctors offices regularly -- ear infections, croup, you name it.  I was hospitalized for croup and lived in a "bubble" for what-seemed-like-forever to a 5 year old.  I went through the allergy testing at the same age and started the joyous road to allergy shots for the next 7 years.  I'm not sure why they stopped doing them when I was 12, but it was perfect timing because I picked up smoking!  It was 1983 and everyone smoked -- everywhere!  Plus, I grew up in Santa Fe and it was artsy and cool.  I'm sure that was great for my lung development, since I already had oodles of problems.

When I was 18 or 19, I had an MRI and the doctor found that my sinus passages were completely white (they were supposed to be completely black) on the reading.  He asked if I did cocaine but I didn't.  Fast forward 20 years and my MRIs and cat scans all say the same thing.

I have suffered all my life with seasonal asthma and especially sinus infections.  I usually have about 5 or 6 per year.  Last year, I had 10 infections from October to July when I finally had sinus surgery.  Personally, it was the best move I've made towards better health. 

Let's talk about antibiotics for a minute.  I remember this being a big deal in the news a few years back -- the Superbug scare and antibiotics not being able to treat certain people because they are immune to antibiotics because they have been on them so much in their lifetime.  This is me!  In fact, last spring my allergist told me he hopes I never get really sick because he doesn't know if I could be treated.  I was on the strongest antibiotics possible at the time and could not get rid of the infections. (I have strong feelings about putting women who test positive for Group B Strep on antibiotics in labor just in case and then treating babies with antibiotics after birth just in case.  If there is a problem, you will know it in other ways.  Stop all the antibiotics!  Only use them when they are truly needed.)

Since the surgery, there have been a couple of times where I could tell I was starting an infection, but my ENT has me on a medicated sinus rinse (fellow sinus sufferers, you should know about this!) and it fights the infection because it's putting the antibiotic directly on the infection instead of traveling through the entire body trying to find the infection.  I wonder how I would have done if I'd been on that before the surgery...

I should add that I grew up in a very sterile environment.  My mom was a total clean freak -- still is.  I had all my immunizations.  I was probably not exposed to a whole lot of dirt, well, except that I grew up in the desert!  There are many factors to consider.  I believe, if I had been breastfed, I would not have as many problems as I do.  I also believe that starting all the solid foods at just a couple of weeks old really did a number on me as well.  My brother and sister do not have the allergy and asthma issues that I do.  I hate it when people say, "I wasn't breastfed and I turned out fine."  Sure, I'm fine, I'm surviving, although miserable half the time.  I think my brother and sister, while not allergy sufferers, have their own set of issues, would probably agree.   There is a big difference between surviving and thriving.

I really like my allergist, but for over two years we have argued over whether breastfeeding helps prevent allergies.  He has twins and I'm pretty sure his wife did not breastfeed because of his blase attitude towards it.  He insists that allergies are based on genetics.  Maybe.  My dad had allergies -- nothing like mine though.   I have always thrown back at my doctor that all of my kids have been exclusively breastfed -- no formula ever and all started solids at a late age, one at 9 months and another was over one year.  Why, with my allergies being so severe, if it's genetic, do none of my kids suffer from allergies?

So, I guess ultimately, I'll never know. There are things we can control and things we can't.  Babies can't control what kind of milk they get, but mothers can control what they feed their babies.  I only addressed allergies in this post, but the physical effects of breastfeeding are incredibly far-reaching and extensive.  Maybe another post for another day.  Mothers can control how early they introduce solid foods.  Mothers can control giving their babies and children antibiotics.  Rushing down to the pediatrician for an antibiotic every time your child is sick should not be taken lightly.

I have no doubt there will be people who comment here that they were breastfed and they still suffer from allergies.  Of course.  Again with the variables - how early and how often you received solid foods, did your mom supplement with formula, etc.  Food for thought -- how much worse off would you be if you had not been breastfed at all? 

Mothers, breastfeed your babies.  It's good for you, good for your baby (who will grow into an adult), good for the budget, good for the environment, good for humanity.  It's a no-brainer in the year 2011.

Monday, January 3, 2011

Is This C-Section Rate For Real?

This week I went to the American Girl store in Dallas with my middle daughter (9) and a friend of hers.  We had a great time and went to lunch afterwards.  While we were waiting for a table, Abby's friend was telling about how she was born in the same hospital as a friend of hers, they have the same pediatrician, and born the same year.  I leaned over and told her that Abby was born at home in a big pool of water in our living room.  She was in total shock!  She said, "Did a doctor come to your house to get her out of your stomach?!"  (Abby seemed equally shocked by her reaction, which I must admit, made this mama proud.)

This is what girls growing up in America believe is normal -- babies being cut out of their mothers. 

I am certain that we are all aware that the rate of women having c-sections in the United States is about 1 in 3.  In North Texas, where I live, it's about 50%.  I have a friend that is a labor and delivery nurse at an area hospital and another that works postpartum at the same hospital.  They have both said there are days/nights that they do not tend to or witness a single woman that has a vaginal birth.  They are at a hospital that has a 60% c-section rate, but they have both told me they believe the rate is even higher.

I have another friend that works as a lactation consultant at another area hospital.  This is a portion of an email I received from her this weekend:

Out of 12 patients on the floor, 6 were c-sections.  Today's breakdown looked like this:
1 induction for "post dates" - mom was 40 weeks.  Ended in C/S
1 induction for "large for gestational age" at 39 weeks - baby weighed 7lb 9oz and ended up on antibiotics because mom ran a fever during labor.  Baby will spend an extra 2 nights in the hospital without mom for antibiotic therapy
1 induction at 39 weeks for "suspected ployhydramnios" - mom managed to deliver vaginally but baby is feeding poorly
1 induction for "post dates" at 40+6 - resulted in maternal fever, Failure to Progress, C/S and baby on antibiotics
1 "Term Induction" (whatever that means!) at 39+2
3 repeat C/S (1 at 36+ wk, 1 at 38wks and 1 at 39wks)
4 spontaneous labors, one of which ended in C/S for "Failure to descend"


Also this week, at the same hospital, a woman was told that she would have to have her birth plan approved by the legal department.   It was 11:30 p.m. and they would not be available to do so until the morning.  Her doula reminded her that she had options.  Yadda, yadda, yadda, she drove across town and birthed with the UNT Midwives in Ft. Worth -- no pain medication, cord wrapped around baby's neck 3 times, and water broken for almost 48 hours.   This couple would certainly have had a c-section had they stayed at their original birth place.   If that story doesn't inspire you to hire a doula, I don't know what will!

One of my couples had their baby at 37 weeks right before Christmas.  She had started bleeding pretty heavily, but it would stop when she laid down.  They suspected a placental abruption, but the midwife (yes, one of the UNT Midwives) and back-up OB couldn't see anything on the ultrasound.  She had lost quite a bit of blood, but they decided to wait it out.  Her contractions were sporadic -- short and not very strong -- and this went on for over 6 hours.  Baby was fine.  The midwife finally decided to break her water and things progressed from there.  She was catheterized so that she would not get up and start the bleeding again.   Her baby was born, posterior and wrapped in his cord, about 12 hours after the midwife broke her water.  No epidural.  As it turns out, she had had an abruption, but she had a large blood clot on the placenta that had stopped the bleeding.   Had it broken free, she would have had an emergency c-section.    I believe she would have had a c-section had she walked into the majority of the DFW hospitals bleeding like that.  Baby is nursing well and everyone is doing great.

So, yes, the c-section rate is crazy.  But we don't have to leave it to chance.  Do not ignore red flags.  If they are popping up at your hospital tour or monthly/weekly appointments, do not put a blindfold on and keep walking, hoping things will work out in your favor.  Tear it off and RUN!  There are care providers who will support you -- not just go along with you -- in your decision to have a normal vaginal birth.

Let's face it though, if I was an OB, I would be all over the c-section thing.  No waiting around, twice as much money, I'm the hero saving the day, and dang it, no one ever sues an OB for performing a c-section!

Saturday, January 1, 2011

Banned From Baby Showers is on Facebook!

I finally did it!  Banned From Baby Showers is on Facebook!  Go like me and let's continue this conversation over there.