ONE of Britain’s leading experts on children’s mental health has advised parents to reject years of convention and allow children to sleep in bed with them until the age of five.
Margot Sunderland, director of education at the Centre for Child Mental Health in London, says the practice, known as “co-sleeping”, makes children more likely to grow up as calm, healthy adults.
Sunderland, author of 20 books, outlines her advice in The Science of Parenting, to be published later this month.
She is so sure of the findings in the new book, based on 800 scientific studies, that she is calling for health visitors to be issued with fact sheets to educate parents about co-sleeping.
“These studies should be widely disseminated to parents,” said Sunderland. “I am sympathetic to parenting gurus — why should they know the science? Ninety per cent of it is so new they bloody well need to know it now. There is absolutely no study saying it is good to let your child cry.”
She argues that the practice common in Britain of training children to sleep alone from a few weeks old is harmful because any separation from parents increases the flow of stress hormones such as cortisol.
Her findings are based on advances in scientific understanding over the past 20 years of how children’s brains develop, and on studies using scans to analyse how they react in particular circumstances.
For example, a neurological study three years ago showed that a child separated from a parent experienced similar brain activity to one in physical pain.
Sunderland also believes current practice is based on social attitudes that should be abandoned. “There is a taboo in this country about children sleeping with their parents,” she said.
“What I have done in this book is present the science. Studies from around the world show that co-sleeping until the age of five is an investment for the child. They can have separation anxiety up to the age of five and beyond, which can affect them in later life. This is calmed by co-sleeping.”
Symptoms can also be physical. Sunderland quotes one study that found some 70% of women who had not been comforted when they cried as children developed digestive difficulties as adults.
Sunderland’s book puts her at odds with widely read parenting gurus such as Gina Ford, whose advice is followed by thousands.
Ford advocates establishing sleep routines for babies from a very early age in cots “away from the rest of the house” and teaching babies to sleep “without the assistance of adults”.
In her book The Complete Sleep Guide for Contented Babies and Toddlers she writes that parents need time by themselves: “Bed sharing . . . more often than not ends up with parents sleeping in separate rooms” and exhausted mothers, a situation that “puts enormous pressure on the family as a whole”.
Annette Mountford, chief executive of the parenting organisation Family Links, confirmed that the norm for children in Britain was to be encouraged to sleep in cots and beds, often in separate bedrooms, from an early age. “Parents need their space,” she said. “There are definite benefits from encouraging children into their own sleep routine in their own space.”
Sunderland says moving children to their own beds from a few weeks old, even if they cry in the night, has been shown to increase the flow of cortisol.
Studies of children under five have shown that for more than 90%, cortisol rises when they go to nursery. For 75%, it falls whenever they go home.
Professor Jaak Panksepp, a neuroscientist at Washington State University, who has written a foreword to the book, said Sunderland’s arguments were “a coherent story that is consistent with neuroscience. A wise society will take it to heart”.
Sunderland argues that putting children to sleep alone is a peculiarly western phenomenon that may increase the chance of cot death, also known as sudden infant death syndrome (Sids). This may be because the child misses the calming effect on breathing and heart function of lying next to its mother.
“In the UK, 500 children a year die of Sids,” Sunderland writes. “In China, where it [co-sleeping] is taken for granted, Sids is so rare it does not have a name.”
Thursday, November 12, 2009
Wednesday, November 11, 2009
Perception and Priorities
Washington, DC Metro Station on a cold January morning in 2007.
The man with a violin played six Bach pieces for about 45 minutes. During that time approximately 2 thousand people went through the station, most of them on their way to work. After 3 minutes a middle aged man noticed there was a musician playing. He slowed his pace and stopped for a few seconds and then hurried to meet his schedule.
4 minutes later: The violinist received his first dollar: a woman threw the money in the hat and, without stopping, continued to walk.
6 minutes: A young man leaned against the wall to listen to him, then looked at his watch and started to walk again.
10 minutes: A 3-year old boy stopped but his mother tugged him along hurriedly. The kid stopped to look at the violinist again, but the mother pushed hard and the child continued to walk, turning his head all the time. This action was repeated by several other children. Every parent, without exception, forced their children to move on quickly.
45 minutes: The musician played continuously. Only 6 people stopped and listened for a short while. About 20 gave money but continued to walk at their normal pace. The man collected a total of $32.
1 hour: He finished playing and silence took over. No one noticed. No one applauded, nor was there any recognition.
No one knew this, but the violinist was Joshua Bell, one of the greatest musicians in the world.. He played one of the most intricate pieces ever written, with a violin worth $3.5 million dollars. Two days before Joshua Bell sold out a theater in Boston where the seats averaged $100.
This is a true story. Joshua Bell playing incognito in the metro station was organized by the Washington Post as part of a social experiment about perception, taste and people's priorities. The questions raised: in a common place environment at an inappropriate hour, do we perceive beauty? Do we stop to appreciate it? Do we recognize talent in an unexpected context?
One possible conclusion reached from this experiment could be this: If we do not have a moment to stop and listen to one of the best musicians in the world, playing some of the finest music ever written, with one of the most beautiful instruments ever made.... How many other things are we missing?
The man with a violin played six Bach pieces for about 45 minutes. During that time approximately 2 thousand people went through the station, most of them on their way to work. After 3 minutes a middle aged man noticed there was a musician playing. He slowed his pace and stopped for a few seconds and then hurried to meet his schedule.
4 minutes later: The violinist received his first dollar: a woman threw the money in the hat and, without stopping, continued to walk.
6 minutes: A young man leaned against the wall to listen to him, then looked at his watch and started to walk again.
10 minutes: A 3-year old boy stopped but his mother tugged him along hurriedly. The kid stopped to look at the violinist again, but the mother pushed hard and the child continued to walk, turning his head all the time. This action was repeated by several other children. Every parent, without exception, forced their children to move on quickly.
45 minutes: The musician played continuously. Only 6 people stopped and listened for a short while. About 20 gave money but continued to walk at their normal pace. The man collected a total of $32.
1 hour: He finished playing and silence took over. No one noticed. No one applauded, nor was there any recognition.
No one knew this, but the violinist was Joshua Bell, one of the greatest musicians in the world.. He played one of the most intricate pieces ever written, with a violin worth $3.5 million dollars. Two days before Joshua Bell sold out a theater in Boston where the seats averaged $100.
This is a true story. Joshua Bell playing incognito in the metro station was organized by the Washington Post as part of a social experiment about perception, taste and people's priorities. The questions raised: in a common place environment at an inappropriate hour, do we perceive beauty? Do we stop to appreciate it? Do we recognize talent in an unexpected context?
One possible conclusion reached from this experiment could be this: If we do not have a moment to stop and listen to one of the best musicians in the world, playing some of the finest music ever written, with one of the most beautiful instruments ever made.... How many other things are we missing?
Saturday, October 31, 2009
4 COMMON REASONS FOR A CESAREAN BIRTH AND WHAT YOU CAN DO TO AVOID THEM
1. Failure to progress accounts for around 30 percent of cesarean deliveries. It means that labor doesn't progress according to the usual timetable. For various reasons the cervix does not open enough and/or the baby does not descend. Some cases of failure to progress cannot be avoided, such as a very short cord. Most cases, though, are due to inadequate support for the laboring woman and violation of the basic physiology of labor. Of all the reasons for a cesarean, "failure to progress" is the most under your control. No other system in your body "fails" 25 percent of the time; why should your "delivery" system? Emotional and physical support for the mother, walking during labor, upright pushing, along with the prudent use of medication and technology will help labor progress by increasing the efficiency of uterine contractions rather than interfering with them.
2. Repeat cesarean, means you had one previously. This is the most common reason for a surgical birth, and it is under your influence as well.
3. Fetal distress is the third most common situation leading to a cesarean delivery. Fetal heart patterns on the electronic fetal monitor may suggest that a baby's well-being is in jeopardy unless he or she is delivered quickly. A fetal heart rate that is higher or lower than average is a sign that the baby may not be getting enough oxygen or is not recovering well from the decreased heart rate that is normal during contractions. While some of the reasons babies receive insufficient oxygen are beyond your control, choices you make in labor help determine your baby's well-being.
4. Cephalopelvic disproportion (CPD), another reason for surgical births occurs when the baby is too big to pass through the pelvic outlet. Laboring and delivering in a more upright position, namely squatting, can enlarge the pelvic outlet, often allowing even a small mommy to deliver a big baby.
7 WAYS TO BOOST A NATURAL DELIVERY
1. Inform yourself. There are support groups for mothers who need help grieving about their previous cesarean and are adamant about doing everything within their power to avoid another one. Attend these meetings and talk to other mothers who have delivered vaginally after a previous cesarean. Besides providing you with practical suggestions during your pregnancy and labor that will increase your chances of delivering vaginally, the information you obtain from this group can empower you to have an easier and more efficient labor.
2. Eat right. Overeating may cause you to gain too much weight and raise your blood sugar to an unhealthy level. Both of these factors increase your chances of having a baby too large for vaginal delivery.
3. Exercise regularly. In-shape women have faster labors and lower weight gains than couch potatoes.
4. Employ a professional labor assistant. Studies show that mothers who use a professional labor assistant (“doula”) are much less likely to have a surgical birth.
5. Be upright. Back lying is the position for surgical birth; the more time you spend on your back, the more likely you are to have one.
6. Get moving. Avoid spending most of your time lying in bed wired to monitors – like a surgical patient. When you get moving, your labor will, too.
7. Trust your body. Believe that your delivery system will work. Believe that your pelvis is designed to birth your baby. A fear that you cannot go through with the delivery can be a self-fulfilling prophecy, since fear frightens the uterus into not working efficiently. Surround yourself with positive advisors. Even if your family tree or circle of friends is full of cesarean deliveries, know that you can beat these statistics.
For more information about pregnancy, childbirth and lactation go to: www.ReneeTheMidwife.com
2. Repeat cesarean, means you had one previously. This is the most common reason for a surgical birth, and it is under your influence as well.
3. Fetal distress is the third most common situation leading to a cesarean delivery. Fetal heart patterns on the electronic fetal monitor may suggest that a baby's well-being is in jeopardy unless he or she is delivered quickly. A fetal heart rate that is higher or lower than average is a sign that the baby may not be getting enough oxygen or is not recovering well from the decreased heart rate that is normal during contractions. While some of the reasons babies receive insufficient oxygen are beyond your control, choices you make in labor help determine your baby's well-being.
4. Cephalopelvic disproportion (CPD), another reason for surgical births occurs when the baby is too big to pass through the pelvic outlet. Laboring and delivering in a more upright position, namely squatting, can enlarge the pelvic outlet, often allowing even a small mommy to deliver a big baby.
7 WAYS TO BOOST A NATURAL DELIVERY
1. Inform yourself. There are support groups for mothers who need help grieving about their previous cesarean and are adamant about doing everything within their power to avoid another one. Attend these meetings and talk to other mothers who have delivered vaginally after a previous cesarean. Besides providing you with practical suggestions during your pregnancy and labor that will increase your chances of delivering vaginally, the information you obtain from this group can empower you to have an easier and more efficient labor.
2. Eat right. Overeating may cause you to gain too much weight and raise your blood sugar to an unhealthy level. Both of these factors increase your chances of having a baby too large for vaginal delivery.
3. Exercise regularly. In-shape women have faster labors and lower weight gains than couch potatoes.
4. Employ a professional labor assistant. Studies show that mothers who use a professional labor assistant (“doula”) are much less likely to have a surgical birth.
5. Be upright. Back lying is the position for surgical birth; the more time you spend on your back, the more likely you are to have one.
6. Get moving. Avoid spending most of your time lying in bed wired to monitors – like a surgical patient. When you get moving, your labor will, too.
7. Trust your body. Believe that your delivery system will work. Believe that your pelvis is designed to birth your baby. A fear that you cannot go through with the delivery can be a self-fulfilling prophecy, since fear frightens the uterus into not working efficiently. Surround yourself with positive advisors. Even if your family tree or circle of friends is full of cesarean deliveries, know that you can beat these statistics.
For more information about pregnancy, childbirth and lactation go to: www.ReneeTheMidwife.com
Friday, October 30, 2009
Having a Baby? Ten Questions to Ask.
Have you decided how to have your baby? The choice is yours! First, you should learn as much as you can about all your choices. There are many different ways of caring for a mother and her baby during labor and birth.
Birthing care that is better and healthier for mothers and babies is called “mother-friendly.” Some birth places or settings are more mother-friendly than others. A group of experts in birthing care came up with this list of 10 things to look for and ask about. Medical research supports all of these things.
When you are deciding where to have your baby, you'll probably be choosing from different places such as:
• birth center,
• hospital, or
• home birth service.
Here’s what you should expect, and ask for, in your birth experience. Be sure to find out how the people you talk with handle these 10 issues about caring for you and your baby. You may want to ask the questions below to help you learn more.
1. Ask, “Who can be with me during labor and birth?” Mother-friendly birth centers, hospitals, and home birth services will let a birthing mother decide whom she wants to have with her during the birth. This includes fathers, partners, children, other family members, or friends.
They will also let a birthing mother have with her a person who has special training in helping women cope with labor and birth. This person is called a doula or labor support person. She never leaves the birthing mother alone. She encourages her, comforts her, and helps her understand what’s happening to her.
They will have midwives as part of their staff so that a birthing mother can have a midwife with her if she wants to.
2. Ask, “What happens during a normal labor and birth in your setting?” If they give mother-friendly care, they will tell you how they handle every part of the birthing process. For example, how often do they give the mother a drug to speed up the birth? Or do they let labor and birth usually happen on its own timing?
They will also tell you how often they do certain procedures. For example, they will have a record of the percentage of C-sections (Cesarean births) they do every year. If the number is too high, you’ll want to consider having your baby in another place or with another doctor or midwife.
Here are some numbers we recommend you ask about.
• They should not use pitocin (a drug) to start or speed up labor for more than 1 in 10 women (10%).
• They should not do an episiotomy (ee-pee-zee-AH-tummy) on more than 1 in 5 women (20%). They should be trying to bring that number down.
• They should not do C-sections on more than 1 in 10 women (10%) if it’s a community hospital. The rate should be 15% or less in hospitals which care for many high-risk mothers and babies.
A C-section is a major operation in which a doctor cuts through the mother’s stomach into her womb and removes the baby through the opening. Mothers who have had a C-section can often have future babies normally. Look for a birth place in which 6 out of 10 women (60%) or more of the mothers who have had C-sections go on to have their other babies through the birth canal.
3. Ask, “How do you allow for differences in culture and beliefs?” Mother-friendly birth centers, hospitals, and home birth services are sensitive to the mother’s culture. They know that mothers and families have differing beliefs, values, and customs.
For example, you may have a custom that only women may be with you during labor and birth. Or perhaps your beliefs include a religious ritual to be done after birth. There are many other examples that may be very important to you. If the place and the people are mother-friendly, they will support you in doing what you want to do. Before labor starts tell your doctor or midwife special things you want.
4. Ask, “Can I walk and move around during labor? What position do you suggest for birth?” In mother-friendly settings, you can walk around and move about as you choose during labor. You can choose the positions that are most comfortable and work best for you during labor and birth. (There may be a medical reason for you to be in a certain position.) Mother-friendly settings almost never put a woman flat on her back with her legs up in stirrups for the birth.
5. Ask, “How do you make sure everything goes smoothly when my nurse, doctor, midwife, or agency need to work with each other? Can my doctor or midwife come with me if I have to be moved to another place during labor? Can you help me find people or agencies in my community who can help me before and after the baby is born?”
Mother-friendly places and people will have a specific plan for keeping in touch with the other people who are caring for you. They will talk to others who give you birth care. They will help you find people or agencies in your community to help you. For example, they may put you in touch with someone who can help you with breastfeeding.
6. Ask, “What things do you normally do to a woman in labor?” Experts say some methods of care during labor and birth are better and healthier for mothers and babies. Medical research shows us which methods of care are better and healthier. Mother-friendly settings only use methods that have been proven to be best by scientific evidence.
Sometimes birth centers, hospitals, and home birth services use methods that are not proven to be best for the mother or the baby. For example, research has shown it’s usually not helpful to break the bag of waters.
Here is a list of things we recommend you ask about. They do not help and may hurt healthy mothers and babies. They are not proven to be best for the mother or baby and are not mother-friendly.
• They should not keep track of the baby’s heart rate all the time with a machine (called an electronic fetal monitor). Instead it is best to have your nurse or midwife listen to the baby's heart from time to time.
• They should not break your bag of waters early in labor.
• They should not use an IV (a needle put into your vein to give you fluids).
• They should not tell you that you can't eat or drink during labor.
• They should not shave you.
• They should not give you an enema.
A birth center, hospital, or home birth service that does these things for most of the mothers is not mother-friendly. Remember, these should not be used without a special medical reason.
7. Ask, “How do you help mothers stay as comfortable as they can be? Besides drugs, how do you help mothers relieve the pain of labor?” The people who care for you should know how to help you cope with labor. They should know about ways of dealing with your pain that don’t use drugs. They should suggest such things as changing your position, relaxing in a warm bath, having a massage and using music. These are called comfort measures.
Comfort measures help you handle your labor more easily and help you feel more in control. The people who care for you will not try to persuade you to use a drug for pain unless you need it to take care of a special medical problem. All drugs affect the baby.
8. Ask, “What if my baby is born early or has special problems?” Mother-friendly places and people will encourage mothers and families to touch, hold, breastfeed, and care for their babies as much as they can. They will encourage this even if your baby is born early or has a medical problem at birth. (However, there may be a special medical reason you shouldn't hold and care for your baby.)
9. Ask, “Do you circumcise baby boys?” Medical research does not show a need to circumcise baby boys. It is painful and risky. Mother-friendly birth places discourage circumcision unless it is for religious reasons.
10. Ask, “How do you help mothers who want to breastfeed?” The World Health Organization made this list of ways birth services support breastfeeding.
• They tell all pregnant mothers why and how to breastfeed.
• They help you start breastfeeding within 1 hour after your baby is born.
• They show you how to breastfeed. And they show you how to keep your milk coming in even if you have to be away from your baby for work or other reasons.
• Newborns should have only breast milk. (However, there may be a medical reason they cannot have it right away.)
• They encourage you and the baby to stay together all day and all night. This is called “rooming-in.”
• They encourage you to feed your baby whenever he or she wants to nurse, rather than at certain times.
• They should not give pacifiers (“dummies” or “soothers”) to breastfed babies.
• They encourage you to join a group of mothers who breastfeed. They tell you how to contact a group near you.
• They have a written policy on breastfeeding. All the employees know about and use the ideas in the policy.
• They teach employees the skills they need to carry out these steps.
For more information on childbirth education and breastfeeding please go to:
www.ReneeTheMidwife.com
©2000 by the Coalition for Improving Maternity Services
Birthing care that is better and healthier for mothers and babies is called “mother-friendly.” Some birth places or settings are more mother-friendly than others. A group of experts in birthing care came up with this list of 10 things to look for and ask about. Medical research supports all of these things.
When you are deciding where to have your baby, you'll probably be choosing from different places such as:
• birth center,
• hospital, or
• home birth service.
Here’s what you should expect, and ask for, in your birth experience. Be sure to find out how the people you talk with handle these 10 issues about caring for you and your baby. You may want to ask the questions below to help you learn more.
1. Ask, “Who can be with me during labor and birth?” Mother-friendly birth centers, hospitals, and home birth services will let a birthing mother decide whom she wants to have with her during the birth. This includes fathers, partners, children, other family members, or friends.
They will also let a birthing mother have with her a person who has special training in helping women cope with labor and birth. This person is called a doula or labor support person. She never leaves the birthing mother alone. She encourages her, comforts her, and helps her understand what’s happening to her.
They will have midwives as part of their staff so that a birthing mother can have a midwife with her if she wants to.
2. Ask, “What happens during a normal labor and birth in your setting?” If they give mother-friendly care, they will tell you how they handle every part of the birthing process. For example, how often do they give the mother a drug to speed up the birth? Or do they let labor and birth usually happen on its own timing?
They will also tell you how often they do certain procedures. For example, they will have a record of the percentage of C-sections (Cesarean births) they do every year. If the number is too high, you’ll want to consider having your baby in another place or with another doctor or midwife.
Here are some numbers we recommend you ask about.
• They should not use pitocin (a drug) to start or speed up labor for more than 1 in 10 women (10%).
• They should not do an episiotomy (ee-pee-zee-AH-tummy) on more than 1 in 5 women (20%). They should be trying to bring that number down.
• They should not do C-sections on more than 1 in 10 women (10%) if it’s a community hospital. The rate should be 15% or less in hospitals which care for many high-risk mothers and babies.
A C-section is a major operation in which a doctor cuts through the mother’s stomach into her womb and removes the baby through the opening. Mothers who have had a C-section can often have future babies normally. Look for a birth place in which 6 out of 10 women (60%) or more of the mothers who have had C-sections go on to have their other babies through the birth canal.
3. Ask, “How do you allow for differences in culture and beliefs?” Mother-friendly birth centers, hospitals, and home birth services are sensitive to the mother’s culture. They know that mothers and families have differing beliefs, values, and customs.
For example, you may have a custom that only women may be with you during labor and birth. Or perhaps your beliefs include a religious ritual to be done after birth. There are many other examples that may be very important to you. If the place and the people are mother-friendly, they will support you in doing what you want to do. Before labor starts tell your doctor or midwife special things you want.
4. Ask, “Can I walk and move around during labor? What position do you suggest for birth?” In mother-friendly settings, you can walk around and move about as you choose during labor. You can choose the positions that are most comfortable and work best for you during labor and birth. (There may be a medical reason for you to be in a certain position.) Mother-friendly settings almost never put a woman flat on her back with her legs up in stirrups for the birth.
5. Ask, “How do you make sure everything goes smoothly when my nurse, doctor, midwife, or agency need to work with each other? Can my doctor or midwife come with me if I have to be moved to another place during labor? Can you help me find people or agencies in my community who can help me before and after the baby is born?”
Mother-friendly places and people will have a specific plan for keeping in touch with the other people who are caring for you. They will talk to others who give you birth care. They will help you find people or agencies in your community to help you. For example, they may put you in touch with someone who can help you with breastfeeding.
6. Ask, “What things do you normally do to a woman in labor?” Experts say some methods of care during labor and birth are better and healthier for mothers and babies. Medical research shows us which methods of care are better and healthier. Mother-friendly settings only use methods that have been proven to be best by scientific evidence.
Sometimes birth centers, hospitals, and home birth services use methods that are not proven to be best for the mother or the baby. For example, research has shown it’s usually not helpful to break the bag of waters.
Here is a list of things we recommend you ask about. They do not help and may hurt healthy mothers and babies. They are not proven to be best for the mother or baby and are not mother-friendly.
• They should not keep track of the baby’s heart rate all the time with a machine (called an electronic fetal monitor). Instead it is best to have your nurse or midwife listen to the baby's heart from time to time.
• They should not break your bag of waters early in labor.
• They should not use an IV (a needle put into your vein to give you fluids).
• They should not tell you that you can't eat or drink during labor.
• They should not shave you.
• They should not give you an enema.
A birth center, hospital, or home birth service that does these things for most of the mothers is not mother-friendly. Remember, these should not be used without a special medical reason.
7. Ask, “How do you help mothers stay as comfortable as they can be? Besides drugs, how do you help mothers relieve the pain of labor?” The people who care for you should know how to help you cope with labor. They should know about ways of dealing with your pain that don’t use drugs. They should suggest such things as changing your position, relaxing in a warm bath, having a massage and using music. These are called comfort measures.
Comfort measures help you handle your labor more easily and help you feel more in control. The people who care for you will not try to persuade you to use a drug for pain unless you need it to take care of a special medical problem. All drugs affect the baby.
8. Ask, “What if my baby is born early or has special problems?” Mother-friendly places and people will encourage mothers and families to touch, hold, breastfeed, and care for their babies as much as they can. They will encourage this even if your baby is born early or has a medical problem at birth. (However, there may be a special medical reason you shouldn't hold and care for your baby.)
9. Ask, “Do you circumcise baby boys?” Medical research does not show a need to circumcise baby boys. It is painful and risky. Mother-friendly birth places discourage circumcision unless it is for religious reasons.
10. Ask, “How do you help mothers who want to breastfeed?” The World Health Organization made this list of ways birth services support breastfeeding.
• They tell all pregnant mothers why and how to breastfeed.
• They help you start breastfeeding within 1 hour after your baby is born.
• They show you how to breastfeed. And they show you how to keep your milk coming in even if you have to be away from your baby for work or other reasons.
• Newborns should have only breast milk. (However, there may be a medical reason they cannot have it right away.)
• They encourage you and the baby to stay together all day and all night. This is called “rooming-in.”
• They encourage you to feed your baby whenever he or she wants to nurse, rather than at certain times.
• They should not give pacifiers (“dummies” or “soothers”) to breastfed babies.
• They encourage you to join a group of mothers who breastfeed. They tell you how to contact a group near you.
• They have a written policy on breastfeeding. All the employees know about and use the ideas in the policy.
• They teach employees the skills they need to carry out these steps.
For more information on childbirth education and breastfeeding please go to:
www.ReneeTheMidwife.com
©2000 by the Coalition for Improving Maternity Services
Thursday, October 29, 2009
Rituals and Uses of the Placenta after Birth
The placenta serves to nourish our babies before they are born, as well as forming a barrier to filter out substances that can be harmful to the unborn child. For the medical establishment, the placenta's job is done once birth has begun, and the organ that provided life for the child in the womb is to be discarded. However, for many cultures and some modern women, there are rituals surrounding the placenta that are observed; such as, consumption of all or part of the placenta, ceremonial burial of the organ, naming of the placenta, hanging it in a tree for consumption by scavengers, or making a print of the placenta as a reminder of its function.
Eating the Placenta
There is some anecdotal evidence that consumption of the placenta - cooked, dried, or as part of a broth, can help prevent or mitigate post partum depression. A number of cultures, including natives in Papua New Guinea and women in Vietnam and China prepare and consume the placenta, as do some animals, lending credence to this theory. Chemicals in the placenta may have the ability to repair some of the hormonal imbalances that occur due to childbirth, but they are probably not a complete remedy for all the effects that are referred to as PPD.
Burying the Placenta
Placenta burial is common among even more cultures. In a number of places, such as Kenya, Malaysia, and Nigeria, the placenta is considered the baby's twin, or thought to have its own spirit, and is buried with the appropriate rites. In Mexico, Nepal, and New Zealand, the placenta is honored as the companion or friend of the baby, and is placed in the earth reverently, but is not thought to have a spirit of its own. Specific burial rites vary by culture, and in some, the placenta will be placed high up, such as in a tree, instead of being buried in the ground.
In modern Western culture, placenta burial is usually highly personal. Some families choose to plant the placenta at the base of a tree or bush, for instance. Some mothers choose to get a special plant for each placenta they bury. Generally, if any time needs to elapse between the birth and the burial of the placenta, it is frozen until the time comes. Since the placenta is very nourishing, it will help the plant above it grow as it decomposes, returning to the earth. It may also be placed in its own container and buried with a marker.
Other Uses of the Placenta
Some people choose not to keep the placenta itself, or to engage in other rituals in addition to the burial or consumption of it. Making prints of the placenta, using either the blood that covers it or ink and paint, are not uncommon. Art done with a related substance – the amniotic membrane – has also been made. These are ways to have a keepsake of the pregnancy that reminds us of our connection with the earth. The placenta can be disposed of, buried, or consumed (provided no paint or ink was used) afterward, as the mother chooses.
Eating the Placenta
There is some anecdotal evidence that consumption of the placenta - cooked, dried, or as part of a broth, can help prevent or mitigate post partum depression. A number of cultures, including natives in Papua New Guinea and women in Vietnam and China prepare and consume the placenta, as do some animals, lending credence to this theory. Chemicals in the placenta may have the ability to repair some of the hormonal imbalances that occur due to childbirth, but they are probably not a complete remedy for all the effects that are referred to as PPD.
Burying the Placenta
Placenta burial is common among even more cultures. In a number of places, such as Kenya, Malaysia, and Nigeria, the placenta is considered the baby's twin, or thought to have its own spirit, and is buried with the appropriate rites. In Mexico, Nepal, and New Zealand, the placenta is honored as the companion or friend of the baby, and is placed in the earth reverently, but is not thought to have a spirit of its own. Specific burial rites vary by culture, and in some, the placenta will be placed high up, such as in a tree, instead of being buried in the ground.
In modern Western culture, placenta burial is usually highly personal. Some families choose to plant the placenta at the base of a tree or bush, for instance. Some mothers choose to get a special plant for each placenta they bury. Generally, if any time needs to elapse between the birth and the burial of the placenta, it is frozen until the time comes. Since the placenta is very nourishing, it will help the plant above it grow as it decomposes, returning to the earth. It may also be placed in its own container and buried with a marker.
Other Uses of the Placenta
Some people choose not to keep the placenta itself, or to engage in other rituals in addition to the burial or consumption of it. Making prints of the placenta, using either the blood that covers it or ink and paint, are not uncommon. Art done with a related substance – the amniotic membrane – has also been made. These are ways to have a keepsake of the pregnancy that reminds us of our connection with the earth. The placenta can be disposed of, buried, or consumed (provided no paint or ink was used) afterward, as the mother chooses.
Wednesday, October 28, 2009
Good News for Breastfeeding Moms: Treating and Preventing Thrush
By Chris Hafner-Eaton
A common cause of breastfeeding failure, and one that often goes undiagnosed, is yeast overgrowth, also known as thrush or candidiasis. Leading to intense nipple soreness and breast pain, thrush can be caused by several factors. However, with proper management, thrush need not undermine breastfeeding.
To identify underlying causes of pain, consider your history of pregnancy, labor, delivery, and nursing. Mothers who received antibiotic therapy for B-strep prophylaxis may experience thrush. Other possible causes include:
• any procedure that has required antibiotics such as C-section or tubal ligation after delivery;
• the use of corticosteroids such as terbutaline to delay labor or asthma medications, or prednisone for allergic reactions;
• any other immune suppression (such as being HIV positive); long-term use of histamine-blockers; or a condition of diabetes.
Yeast infections may also be triggered by damp, rainy weather or exposure to other funguses and molds, including household and garden molds. There is an indication that dietary yeast may also be a trigger, a potential problem for women who frequently bake yeast breads. Yeasts love dark, moist, warm places, thrive in sweet environments, and multiply very rapidly. These factors account for why diabetics as well as pregnant and lactating women are all prime candidates for yeast overgrowth. The added factor of immunosuppression of the body’s natural balancing agents (such as broad-spectrum antibiotics or corticosteroids taken within the past few months, or even years if repeatedly used) may allow yeast to proliferate unchecked.
Mothers describe the classic symptoms of breast yeast in various ways: severe pain without nipple trauma; sharp, shooting pains radiating from nipples that may extend to the chest wall or back; nipples that may be red, flaky, itchy, shiny, or burning (these are all relative signs, so consider what is normal for you); small, white, hard blisters on the nipple (this may also be due to a blocked duct); and sometimes white fuzzy patches in the folds of the nipple. When nursing mothers describe an ice pick or glass sensation inside their breast, or pain that persists beyond latch on, yeast overgrowth in the milk ducts may be the cause. In the instance of thrush, babies may pull off the breast, refuse to latch on, or make clicking sounds. Other less clear clues for the mother range from cravings of sugars and breads to extreme fatigue.
At low levels, however, thrush may not have visible signs. Nursing may have been going well, and all of a sudden it hurts or the baby pulls off the breast (sometimes making that clicking or popping sound). In most cases, if latch on has been assessed and/or corrected, the offending agent is Candida albicans, but there are several other somewhat rare strains of Candida, and not all produce the fluffy patches of cotton that typically indicate a yeast infection. Fungal overgrowth, such as aspergillus and others are less likely causes of nipple and breast pain, but practitioners should be aware of them.
It is possible, in some cases, to have either yeast/fungal mastitis or bacterial mastitis coupled with yeast. Symptoms of bacterial mastitis (fever over 102º F, flu-like symptoms, red streaks on the breast, hot spots on the breast, etc.) require immediate medical attention, followed by lots of rest (including nursing lying down, if possible). Yeast, combined with bacteria is likely to require a course of antibiotics and other medication.
Treating Thrush
Over-the-counter and self-help approaches to yeast management can be quite effective, particularly if they are part of a comprehensive, holistic approach, and if the problem hasn’t become chronic. Along with the common recommendations of changing breast pads at each feeding, going braless (this can be a major help), and topical treatments, dealing with the underlying health status of mother and baby-and sometimes the entire family--is essential. Regardless of the type of treatment-prescription, naturopathic, homeopathic, or other--mothers need to address certain issues such as hygiene, diet, and even laundry. In a nursing relationship, it is imperative that both mother and the baby be treated, even if only one is symptomatic; many times father and siblings require lower-level treatment as well. In cosleeping arrangements, all members who sleep in close contact with each other should be treated. Yeast infections can be challenging because treatment must be continued for two weeks after symptoms subside.
Personal hygiene matters in yeast control. While antibacterial soaps are promoted for new parents, they may contribute to yeast overgrowth by killing “good” bacteria. Still, it is important to wash your hands with warm water and soap after diaper changes and using the bathroom. In addition, short-term switching to paper towels as a drying method (single use only) can help stop the spread. Temporary use of disposable diapers may help, too. Family members should use a spray bottle of vinegar solution (1/4 cup white distilled vinegar to 1 cup of water) to spray any areas on their bodies that stay or get moist (pubic areas, armpits, under breasts and under any folds of skin). This routine should be followed at least twice a day by those who are not symptomatic and four times a day by those who display symptoms, and continued for two weeks beyond the time that anyone shows symptoms. Bath towels should not be shared, and ideally should only be used once. If laundering after each use seems extreme, then they must be allowed to thoroughly dry after every use. Additionally, items such as toothbrushes and makeup can also harbor yeast spores. Every family member should get a new toothbrush once the anti-yeast regimen is begun, and then again when all symptoms disappear. No cornstarch powders or deodorants should be used, as they are a food source for yeast.
Extra housework is relished neither by new mothers nor anyone else, but it is necessary, to clear up chronic cases of thrush. Sources of mold-wet windowsills, damp laundry hampers, and moist bathtubs (especially the kind with jets) need to be cleaned with either a 10-percent bleach solution or white distilled vinegar in water. Floors, baseboards, and walls may all be cleaned by the same method. Laundry should be sanitized by washing in the hottest possible water and then adding a cup of white distilled vinegar to the final rinse. Because it would take a gallon of bleach in a standard washer to kill yeast spores (which would shred your clothing), boiling clothing and other items of close contact (such as underwear and sheets) for five minutes is suggested. Microwaving on the high setting for five minutes will also kill yeast spores; freezing, however, will not. Cloth diapers, whether from a service or your own, should also be sanitized in the same way, as should toys and any items babies gum or chew on. The latter may be put in the dishwasher if your water is hot enough (over 130º F) and you add vinegar to the rinse.
Yeasts are extremely persistent in the right environment, but there are a number of medical and naturopathic treatments available for mothers experiencing thrush. If you choose to use a prescribed pharmaceutical whose effects are unknown (check with the your local La Leche League Leader), remember that you may be able to pump and discard your milk instead of permanently weaning. However, most pharmaceuticals associated with yeast treatment do not require weaning.
Natural Remedies for Thrush
The following is a brief overview of how to utilize natural remedies in the case of breast yeast.
• Use up to three capsules of acidophilus (Lactobacillus acidophilus) three times daily. Babies may be treated with acidophilus diluted in breastmilk swabbed in their mouths, or you can dip a finger in the powder and let the baby suck. The intent of acidophilus treatment is to rebalance your body, so don’t expect instant results. Sometimes lactobacilli need a bit of help getting hold in the intestines, and some practitioners recommend FOS (fructo-oligo-saccharides) to enhance colonization.
• Apply ¼ cup white distilled vinegar in 1 cup water topically to the breast. If this is too strong, you can use a dilution as weak as 1 tablespoon in 1 cup water. Allow to air dry, and do not wash it off before nursing unless baby protests. This must be done at least four times a day and continued for two weeks after all symptoms are gone. Taking baths with vinegar in the water will allow the treatment of more than one source at a time. White distilled vinegar must be used because the distillation process destroys any active fungus spores. Arguments about the logic of using vinegar (which is fermented) abound, but yeast cannot survive in the pH environment that is created by fermentation and the temperature needed to distill the vinegar. If they catch the overgrowth early, many mothers have found that vinegar treatment works quite well when used with oral acidophilus taken three times a day to rebalance the intestines.
• Apply olive oil topically to breasts after each feeding. Olive oil contains linoleic acids, which are antifungal and may cut off the yeast’s oxygen supply.
• Make a paste of baking soda in water and swab the baby’s mouth after each feeding (if baby always falls asleep, then do it whenever possible, but at least four times a day). This also alters the pH of the environment (more toward the alkali side, in this instance), making it inhospitable to yeasts. Practice caution with baking soda because if swallowed in quantity it can dangerously disrupt the electrolyte balance.
• Apply potassium sorbate topically-1 tablespoon dissolved in 1 quart of warm water.
• A strong immune system booster that may be lacking in the mother’s and baby’s intestines if they have had antibiotics is nonyeast-based vitamin B complex.
• Another immune system booster is zinc; take 45 mg per day.
• Take vitamin C up to the point where loose stools occur, then reduce the dosage a bit. Since vitamin C is water soluble, it must be consumed throughout the day. Echinacea capsules or tincture can be taken simultaneously to boost the immune system.
• Although increasing dietary garlic may be useful, clinically effective doses are easier to get if you take triple-strength deodorized garlic tablets (three tablets, three times daily for two weeks or more). The liquid, cold-pressed, aged garlic is thought to be most potent. Kyolic is the brand about which the most conclusive research has been published. Note: ginger and cinnamon reportedly also have antifungal properties, but their use is infrequently reported and primarily unstudied.
• Caprylic acid, when taken orally, has strong antifungal properties; take two to three capsules three to four times per day for two weeks (or 1 gram at meals).
• Citrus seed oil is a strong, but natural, antifungal, antibacterial, and antiviral substance. It may be used topically, but must be diluted before use on the breast or on any mucous membrane. Try 10 drops in ¼ cup of water swallowed at once, twice daily.
• The Australian antiseptic tea tree oil is thought to have antifungal properties; a few drops may be added to bathwater or diluted and applied to the breast. The bath method may also be used with vinegar, and has the added benefit of helping clear the sinuses.
• Take either 1 to 2 grams dried barberry (Berberis vulgaris) bark or 1 ½ teaspoons (4 to 6 ml) of tincture (1:5), or 250 to 500 mg of powdered extract, three times a day.
• Although very bitter, golden seal (Hydrastis candadensis) is very effective at clearing yeast from the body. Consume either 1 to 2 grams dried bark or 1 ½ teaspoons (4 to 6 ml) of tincture (1:5), or 250 to 500 mg of powdered extract, three times a day. Caution: The rapid yeast die-off can cause intestinal gas.
• Pau d’arco (Tabebuia impetiginosa) is an antifungal tincture with a long history of use in developing countries; take 20 to 30 drops four times a day (warning: it tastes horrible).
• Maitake tea is an antifungal tea that also helps to rebalance the intestines; drink the strongly brewed tea throughout the day for two weeks (4 to 6 cups a day).
• Soak plantain seeds (Plantango major) overnight in warm water and apply the resultant gel topically.
• One of the oldest antifungal antiseptics available (preceding topical iodine) is gentian violet, which is very effective although extremely messy, staining everything it touches. Gentian violet should only be used for a maximum of two to three days (two treatments per day) by coating the nipple, areola, and surrounding breast tissue (plus the underside of the breast) with the liquid on a cotton ball. The long-term toxicity of this treatment is still being debated, but short-term treatment appears to cause no ill effects. Nursing babies will get a purple mouth, which will disappear in a few days. You might want to wear clothing that is dark or can be thrown away or bleached.
• Lecithin can be taken orally. Take two 250 mg gel capsules, three times per day, or the equivalent in lecithin granules sprinkled on foods. Deep massage of any plugged ducts with arnica oil as a lubricant supplements this treatment. Massage while the baby nurses, taking advantage of gravity.
• The over-the-counter anti-inflammatory ibuprofen might be appropriate for both pain relief and reducing ductile inflammation.
• Some practitioners have prescribed over-the-counter vaginal yeast creams with miconozole or clotrimazole be applied to the breast. While these may be effective and the active ingredients are compatible with nursing, there may be other ingredients not appropriate for babies to consume; therefore, this approach is not recommended unless extreme caution is used. As always, watch your baby carefully.
Pharmaceutical Remedies for Thrush
The first line of defense that is usually prescribed for yeast is Nystatin (cream or suspension), an exceptionally safe pharmaceutical that acts by disrupting the necessary enzymes yeasts need to reproduce, but doesn’t cross cell membranes. However, the drug may cause side effects such as nausea, gas, and fatigue as the yeast dies off. Nystatin must be scrupulously applied after every nursing, since yeast multiplies rapidly. Some researchers question the effectiveness of Nystatin suspension because it is mixed in a sucrose base (in which yeast thrives); instead, they recommend using Nystatin powder mixed in water or other liquids (breastmilk for babies).
If Nystatin is not effective initially, or the yeast becomes chronic or invades the ducts of the breast, other methods are available. Mycelex troches are often prescribed for the nursing pair. These tablets are crushed, mixed with breastmilk, and applied to the thrush. Older babies may like chewing on the troches. The active ingredient in these is miconazole, which is also the ingredient in many over-the-counter vaginal yeast medications. If applied to the breast, the drug will be taken into the baby’s mouth, as would any topical substance that is not washed off. (See above.)
As a third line of defense in the topical war against yeast, some practitioners may resort to Nizoral 2 percent cream for the breast and diaper areas (ketoconazole is the active ingredient). Nizoral is also available for internal use, although the effects of it have not been studied on infants. Nizoral tablets are a potent chemical whose side effects should be weighed against its possible benefits.
Lastly, a new and now commonly prescribed vaginal yeast medication, Diflucan (fluconazole), is being used to treat breast yeast. One dosage is utilized in vaginal yeast cases, but experience has demonstrated that in the case of breast yeast many more doses are required to fully clear the growth. Diflucan has few side effects, is taken once per day, and is quite effective if given for a long enough period (usually two to four weeks) while the baby’s mouth is simultaneously treated with another anti-yeast treatment. Sporonax is another drug that is available, but not very much is known about how it affects the nursing relationship, so you might want to think about asking for an alternative.
For more information on this topic go to: www.ReneeTheMidwife.com
A common cause of breastfeeding failure, and one that often goes undiagnosed, is yeast overgrowth, also known as thrush or candidiasis. Leading to intense nipple soreness and breast pain, thrush can be caused by several factors. However, with proper management, thrush need not undermine breastfeeding.
To identify underlying causes of pain, consider your history of pregnancy, labor, delivery, and nursing. Mothers who received antibiotic therapy for B-strep prophylaxis may experience thrush. Other possible causes include:
• any procedure that has required antibiotics such as C-section or tubal ligation after delivery;
• the use of corticosteroids such as terbutaline to delay labor or asthma medications, or prednisone for allergic reactions;
• any other immune suppression (such as being HIV positive); long-term use of histamine-blockers; or a condition of diabetes.
Yeast infections may also be triggered by damp, rainy weather or exposure to other funguses and molds, including household and garden molds. There is an indication that dietary yeast may also be a trigger, a potential problem for women who frequently bake yeast breads. Yeasts love dark, moist, warm places, thrive in sweet environments, and multiply very rapidly. These factors account for why diabetics as well as pregnant and lactating women are all prime candidates for yeast overgrowth. The added factor of immunosuppression of the body’s natural balancing agents (such as broad-spectrum antibiotics or corticosteroids taken within the past few months, or even years if repeatedly used) may allow yeast to proliferate unchecked.
Mothers describe the classic symptoms of breast yeast in various ways: severe pain without nipple trauma; sharp, shooting pains radiating from nipples that may extend to the chest wall or back; nipples that may be red, flaky, itchy, shiny, or burning (these are all relative signs, so consider what is normal for you); small, white, hard blisters on the nipple (this may also be due to a blocked duct); and sometimes white fuzzy patches in the folds of the nipple. When nursing mothers describe an ice pick or glass sensation inside their breast, or pain that persists beyond latch on, yeast overgrowth in the milk ducts may be the cause. In the instance of thrush, babies may pull off the breast, refuse to latch on, or make clicking sounds. Other less clear clues for the mother range from cravings of sugars and breads to extreme fatigue.
At low levels, however, thrush may not have visible signs. Nursing may have been going well, and all of a sudden it hurts or the baby pulls off the breast (sometimes making that clicking or popping sound). In most cases, if latch on has been assessed and/or corrected, the offending agent is Candida albicans, but there are several other somewhat rare strains of Candida, and not all produce the fluffy patches of cotton that typically indicate a yeast infection. Fungal overgrowth, such as aspergillus and others are less likely causes of nipple and breast pain, but practitioners should be aware of them.
It is possible, in some cases, to have either yeast/fungal mastitis or bacterial mastitis coupled with yeast. Symptoms of bacterial mastitis (fever over 102º F, flu-like symptoms, red streaks on the breast, hot spots on the breast, etc.) require immediate medical attention, followed by lots of rest (including nursing lying down, if possible). Yeast, combined with bacteria is likely to require a course of antibiotics and other medication.
Treating Thrush
Over-the-counter and self-help approaches to yeast management can be quite effective, particularly if they are part of a comprehensive, holistic approach, and if the problem hasn’t become chronic. Along with the common recommendations of changing breast pads at each feeding, going braless (this can be a major help), and topical treatments, dealing with the underlying health status of mother and baby-and sometimes the entire family--is essential. Regardless of the type of treatment-prescription, naturopathic, homeopathic, or other--mothers need to address certain issues such as hygiene, diet, and even laundry. In a nursing relationship, it is imperative that both mother and the baby be treated, even if only one is symptomatic; many times father and siblings require lower-level treatment as well. In cosleeping arrangements, all members who sleep in close contact with each other should be treated. Yeast infections can be challenging because treatment must be continued for two weeks after symptoms subside.
Personal hygiene matters in yeast control. While antibacterial soaps are promoted for new parents, they may contribute to yeast overgrowth by killing “good” bacteria. Still, it is important to wash your hands with warm water and soap after diaper changes and using the bathroom. In addition, short-term switching to paper towels as a drying method (single use only) can help stop the spread. Temporary use of disposable diapers may help, too. Family members should use a spray bottle of vinegar solution (1/4 cup white distilled vinegar to 1 cup of water) to spray any areas on their bodies that stay or get moist (pubic areas, armpits, under breasts and under any folds of skin). This routine should be followed at least twice a day by those who are not symptomatic and four times a day by those who display symptoms, and continued for two weeks beyond the time that anyone shows symptoms. Bath towels should not be shared, and ideally should only be used once. If laundering after each use seems extreme, then they must be allowed to thoroughly dry after every use. Additionally, items such as toothbrushes and makeup can also harbor yeast spores. Every family member should get a new toothbrush once the anti-yeast regimen is begun, and then again when all symptoms disappear. No cornstarch powders or deodorants should be used, as they are a food source for yeast.
Extra housework is relished neither by new mothers nor anyone else, but it is necessary, to clear up chronic cases of thrush. Sources of mold-wet windowsills, damp laundry hampers, and moist bathtubs (especially the kind with jets) need to be cleaned with either a 10-percent bleach solution or white distilled vinegar in water. Floors, baseboards, and walls may all be cleaned by the same method. Laundry should be sanitized by washing in the hottest possible water and then adding a cup of white distilled vinegar to the final rinse. Because it would take a gallon of bleach in a standard washer to kill yeast spores (which would shred your clothing), boiling clothing and other items of close contact (such as underwear and sheets) for five minutes is suggested. Microwaving on the high setting for five minutes will also kill yeast spores; freezing, however, will not. Cloth diapers, whether from a service or your own, should also be sanitized in the same way, as should toys and any items babies gum or chew on. The latter may be put in the dishwasher if your water is hot enough (over 130º F) and you add vinegar to the rinse.
Yeasts are extremely persistent in the right environment, but there are a number of medical and naturopathic treatments available for mothers experiencing thrush. If you choose to use a prescribed pharmaceutical whose effects are unknown (check with the your local La Leche League Leader), remember that you may be able to pump and discard your milk instead of permanently weaning. However, most pharmaceuticals associated with yeast treatment do not require weaning.
Natural Remedies for Thrush
The following is a brief overview of how to utilize natural remedies in the case of breast yeast.
• Use up to three capsules of acidophilus (Lactobacillus acidophilus) three times daily. Babies may be treated with acidophilus diluted in breastmilk swabbed in their mouths, or you can dip a finger in the powder and let the baby suck. The intent of acidophilus treatment is to rebalance your body, so don’t expect instant results. Sometimes lactobacilli need a bit of help getting hold in the intestines, and some practitioners recommend FOS (fructo-oligo-saccharides) to enhance colonization.
• Apply ¼ cup white distilled vinegar in 1 cup water topically to the breast. If this is too strong, you can use a dilution as weak as 1 tablespoon in 1 cup water. Allow to air dry, and do not wash it off before nursing unless baby protests. This must be done at least four times a day and continued for two weeks after all symptoms are gone. Taking baths with vinegar in the water will allow the treatment of more than one source at a time. White distilled vinegar must be used because the distillation process destroys any active fungus spores. Arguments about the logic of using vinegar (which is fermented) abound, but yeast cannot survive in the pH environment that is created by fermentation and the temperature needed to distill the vinegar. If they catch the overgrowth early, many mothers have found that vinegar treatment works quite well when used with oral acidophilus taken three times a day to rebalance the intestines.
• Apply olive oil topically to breasts after each feeding. Olive oil contains linoleic acids, which are antifungal and may cut off the yeast’s oxygen supply.
• Make a paste of baking soda in water and swab the baby’s mouth after each feeding (if baby always falls asleep, then do it whenever possible, but at least four times a day). This also alters the pH of the environment (more toward the alkali side, in this instance), making it inhospitable to yeasts. Practice caution with baking soda because if swallowed in quantity it can dangerously disrupt the electrolyte balance.
• Apply potassium sorbate topically-1 tablespoon dissolved in 1 quart of warm water.
• A strong immune system booster that may be lacking in the mother’s and baby’s intestines if they have had antibiotics is nonyeast-based vitamin B complex.
• Another immune system booster is zinc; take 45 mg per day.
• Take vitamin C up to the point where loose stools occur, then reduce the dosage a bit. Since vitamin C is water soluble, it must be consumed throughout the day. Echinacea capsules or tincture can be taken simultaneously to boost the immune system.
• Although increasing dietary garlic may be useful, clinically effective doses are easier to get if you take triple-strength deodorized garlic tablets (three tablets, three times daily for two weeks or more). The liquid, cold-pressed, aged garlic is thought to be most potent. Kyolic is the brand about which the most conclusive research has been published. Note: ginger and cinnamon reportedly also have antifungal properties, but their use is infrequently reported and primarily unstudied.
• Caprylic acid, when taken orally, has strong antifungal properties; take two to three capsules three to four times per day for two weeks (or 1 gram at meals).
• Citrus seed oil is a strong, but natural, antifungal, antibacterial, and antiviral substance. It may be used topically, but must be diluted before use on the breast or on any mucous membrane. Try 10 drops in ¼ cup of water swallowed at once, twice daily.
• The Australian antiseptic tea tree oil is thought to have antifungal properties; a few drops may be added to bathwater or diluted and applied to the breast. The bath method may also be used with vinegar, and has the added benefit of helping clear the sinuses.
• Take either 1 to 2 grams dried barberry (Berberis vulgaris) bark or 1 ½ teaspoons (4 to 6 ml) of tincture (1:5), or 250 to 500 mg of powdered extract, three times a day.
• Although very bitter, golden seal (Hydrastis candadensis) is very effective at clearing yeast from the body. Consume either 1 to 2 grams dried bark or 1 ½ teaspoons (4 to 6 ml) of tincture (1:5), or 250 to 500 mg of powdered extract, three times a day. Caution: The rapid yeast die-off can cause intestinal gas.
• Pau d’arco (Tabebuia impetiginosa) is an antifungal tincture with a long history of use in developing countries; take 20 to 30 drops four times a day (warning: it tastes horrible).
• Maitake tea is an antifungal tea that also helps to rebalance the intestines; drink the strongly brewed tea throughout the day for two weeks (4 to 6 cups a day).
• Soak plantain seeds (Plantango major) overnight in warm water and apply the resultant gel topically.
• One of the oldest antifungal antiseptics available (preceding topical iodine) is gentian violet, which is very effective although extremely messy, staining everything it touches. Gentian violet should only be used for a maximum of two to three days (two treatments per day) by coating the nipple, areola, and surrounding breast tissue (plus the underside of the breast) with the liquid on a cotton ball. The long-term toxicity of this treatment is still being debated, but short-term treatment appears to cause no ill effects. Nursing babies will get a purple mouth, which will disappear in a few days. You might want to wear clothing that is dark or can be thrown away or bleached.
• Lecithin can be taken orally. Take two 250 mg gel capsules, three times per day, or the equivalent in lecithin granules sprinkled on foods. Deep massage of any plugged ducts with arnica oil as a lubricant supplements this treatment. Massage while the baby nurses, taking advantage of gravity.
• The over-the-counter anti-inflammatory ibuprofen might be appropriate for both pain relief and reducing ductile inflammation.
• Some practitioners have prescribed over-the-counter vaginal yeast creams with miconozole or clotrimazole be applied to the breast. While these may be effective and the active ingredients are compatible with nursing, there may be other ingredients not appropriate for babies to consume; therefore, this approach is not recommended unless extreme caution is used. As always, watch your baby carefully.
Pharmaceutical Remedies for Thrush
The first line of defense that is usually prescribed for yeast is Nystatin (cream or suspension), an exceptionally safe pharmaceutical that acts by disrupting the necessary enzymes yeasts need to reproduce, but doesn’t cross cell membranes. However, the drug may cause side effects such as nausea, gas, and fatigue as the yeast dies off. Nystatin must be scrupulously applied after every nursing, since yeast multiplies rapidly. Some researchers question the effectiveness of Nystatin suspension because it is mixed in a sucrose base (in which yeast thrives); instead, they recommend using Nystatin powder mixed in water or other liquids (breastmilk for babies).
If Nystatin is not effective initially, or the yeast becomes chronic or invades the ducts of the breast, other methods are available. Mycelex troches are often prescribed for the nursing pair. These tablets are crushed, mixed with breastmilk, and applied to the thrush. Older babies may like chewing on the troches. The active ingredient in these is miconazole, which is also the ingredient in many over-the-counter vaginal yeast medications. If applied to the breast, the drug will be taken into the baby’s mouth, as would any topical substance that is not washed off. (See above.)
As a third line of defense in the topical war against yeast, some practitioners may resort to Nizoral 2 percent cream for the breast and diaper areas (ketoconazole is the active ingredient). Nizoral is also available for internal use, although the effects of it have not been studied on infants. Nizoral tablets are a potent chemical whose side effects should be weighed against its possible benefits.
Lastly, a new and now commonly prescribed vaginal yeast medication, Diflucan (fluconazole), is being used to treat breast yeast. One dosage is utilized in vaginal yeast cases, but experience has demonstrated that in the case of breast yeast many more doses are required to fully clear the growth. Diflucan has few side effects, is taken once per day, and is quite effective if given for a long enough period (usually two to four weeks) while the baby’s mouth is simultaneously treated with another anti-yeast treatment. Sporonax is another drug that is available, but not very much is known about how it affects the nursing relationship, so you might want to think about asking for an alternative.
For more information on this topic go to: www.ReneeTheMidwife.com
Tuesday, October 27, 2009
A new study out of Canadia prompts provinces to rethink flu plan
A new study out of Canadia prompts provinces to rethink flu plan - noting seasonal flu vaccine may increase risk of H1N1. Report suggests people who get vaccinated are more likely to catch H1N1
http://www.theglobeandmail.com/news/technology/science/study-prompts-provinces-to-rethink-flu-plan/article1303330
www.ReneeTheMidwife.com
http://www.theglobeandmail.com/news/technology/science/study-prompts-provinces-to-rethink-flu-plan/article1303330
www.ReneeTheMidwife.com
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