Category Archives: General Health

Kid and Car Saftey: A Reminder About the Dangers of Kids Playing (or Sleeping) in Cars

According to an article from last year’s Momlogic Newsletter, 23 U.S. children died by mid-summer, 2010,  in hot cars.  Many of them were incidents in which the parent/care taker forgot the child was in the car upon arriving at their destination…and the kiddo remained in the car for hours (or minutes) thereafter and perished in the heat of what can basically become an oven on wheels.

As mentioned in the Momlogic article, approximately 36 American children die every year in hot cars.  And according to a study conducted by researchers at Stanford University School of Medicine, a car’s interior can heat up by 40 degrees within an hour–even if it’s a relatively cool day outside.  It all has to do with the size and shape of the car and whether or not the sun is out…plus the fact that the car’s windows act like a circumferential set of inward-facing magnifying glasses.

According to this article on the National Weather Service website, “Leaving the windows slightly open does not significantly decrease the heating rate. The effects can be more severe on children because their bodies warm at a faster rate than adults.”

***Follow any of the links above to learn more, especially additional hints about kids and car safety.

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Filed under family, From One Mother to Another, General Health, Kids, travelling with kids

Formula Marketed to Moms–For Moms. Really???

 

This article was recently posted on  Birthing Beautiful Ideas:

[Recently] on Twitter, @heartsandhandss alerted me to a Similac product that has me wavering between disheartened disbelief and cynical outrage:

SIMILAC MOM

That’s right.  Formula for moms.

Or as the Similac Canada site specifically states, it’s a “nutritional beverage” designed “for pregnant women and breastfeeding moms.”

Uh huh.  A formula for moms who may be planning to or who are already breastfeeding.

Not surprisingly, after glancing through the site’s information on Similac Mom, I’ve counted more than a few glaring problems with this (patently ridiculous) product.

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A badge declaring that Similac Mom is “available in the infant aisle” (or, it suggests, “ask your pharmacist.”)

Riddle me this: why would a product targeted to pregnant women and breastfeeding moms be available in the infant aisle?

It couldn’t possibly be that the proximity of Similac Mom to formula canisters would lead pregnant women to associate their own “nutritional beverage” with Similac’s baby formula!

It certainly couldn’t be that each and every time a pregnant or breastfeeding mother went to pick up her Similac Mom, the Similac brand would become further entrenched in her mind, potentially leading her to think “Similac! Formula!” every time she went for her daily “nutritional beverage.”

And goodness me, it couldn’t be that this “nutritional beverage” for “breastfeeding moms” would thereby insert a well-known infant formula brand into the breastfeeding section of a grocery or pharmacy aisle!

Canadian moms: if you’ve seen Similac Mom in your grocery or pharmacy, is it located near the formula containers or near the breastfeeding products?  Or is it somewhere else entirely?

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The product is described as “the first and only nutritional beverage for pregnant women and breastfeeding moms.”

Formula-feeding moms are, it seems, not an important demographic for this particular product.  And why might that be?

It is true that pregnant and lactating women have different nutritional needs than women who aren’t pregnant or lactating.

But I think there’s another reason why Similac Mom isn’t targeted to formula-feeding moms: They’re already purchasing formula!

Similac Mom ensures that all women can be consumers of Similac-brand formulas–even the ones who aren’t buying it for their babies!  (And hey–Similac Mom might just “help” breastfeeding moms to choose Similac infant formula too!)

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When combined with prenatal vitamins, Similac Mom could lead to potentially dangerous levels of Vitamin A.

Both pregnant and breastfeeding moms are encouraged to take prenatal vitamins in order to supplement their daily nutritional intake.  Typically, the daily dosage of these vitamins contains 5000 IU of Vitamin A.

But taking too much Vitamin A during pregnancy can lead to birth defects.

Similac Mom includes 1166 IU of Vitamin A.  When combined with a prenatal vitamin and food sources of Vitamin A–especially if one were to drink more than one serving of Similac Mom–this could lead to a potentially dangerous level of this vitamin.

(And this is why the site advises women to consult their doctors if they plan to drink more than one serving.  Yikes!)

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The site describes Similac Mom as something women can drink “rather than skipping a meal” and as a “meal replacement.”

I can make this short and sweet: Don’t. View. Similac. Mom. As. A. Meal. Replacement.

Please.  Don’t.

A supplemental snack?  Sure.  But a meal?  No.

225 calories per serving does not a meal make for a pregnant or breastfeeding mom.  (And two Similac Moms is probably not an option for most women, especially if they are also taking a prenatal vitamin with the aforementioned dosage of Vitamin A.)

If you don’t have time to prepare quick meals or snacks as you need them, try and spend one or two mornings or evenings each week making turkey sandwiches on whole wheat bread, or apple slices and peanut butter, or cheese and crackers, or bran muffins, or anything that you can store in the fridge during the week and then grab “on the go” when you need them.

If you forget to eat meals (and I never understood this until I had kids), try and store baskets of healthy snacks all around the house and/or on your desk at work.

If friends and/or family members have offered you help, ask them to bring you meals.  They don’t even have to be hot meals!  A basket filled with healthy snacks (that you can combine into a makeshift “meal”) for pregnant or breastfeeding moms is a wonderful treat!

Just make sure that none of those “meals” is Similac Mom.

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As if this weren’t all bad enough, the second listed ingredient in Similac Mom is sugar.  And there’s no fiber in it to boot.

On behalf of pregnant and new mom’s bodies (and butts) everywhere, I say no thank you, Similac.

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Filed under breastfeeding, From One Mother to Another, General Health, Mommy and Motherhood, prenatal health

Marching Forth: Africa’s Committment to Improve Safety of Moms and Babes

It’s always wonderful to come across stories like this, that highlight successes in the pursuit of improved maternal and infant outcomes revolving around pregnancy, birth and the postpartum period.  Congratulations to Rwanda for making drastic changes and improvements, with the plan to meet the Millennium Development Goals of 2015 in regards to maternal and infant mortality.  For a highlight on improvements made toward maternal and fetal/infant/child health throughout many African countries, read this July 2010 article.

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Filed under breastfeeding, Childbirth Issues, family, From One Mother to Another, General Health, pregnancy, prenatal health

Keeping Childbirth Safe–No Matter Where it Takes Place

The world finally gets it (OK, some parts of the world). Childbirth does not have to be as dangerous as it is for many women and fetuses in developing countries.  For that matter, it does not have to be dangerous for the vast majority of women in developed countries, either, but that is a whole other ball of wax (in short, think: high rates of medical intervention in low-risk women have the propensity to create more problems that require fixing, than they necessarily do solve or prevent potential problems).

Here is yet another example of a relatively simple technology with a focus on reducing perinatal maternal mortality, as presented at the American College of Nurse Midwives‘ annual convention.  The device?  A strap-on belly with uterus, baby and blood contained within.  The goal?  To get as many birth attendants around the world–especially in areas like Afghanistan, the Central African Republic and rural India– trained with basic life-saving knowledge of how to catch a baby (or help to deliver a malpositioned fetus) and intervene when postpartum hemorrhage is occurring.  Truthfully, most of the life-threatening scenarios surrounding childbirth can be handled successfully, as long as the knowledge of how to handle those scenarios is there, and well practiced.

As described in this article, “Using both hands, the teacher wearing the device can move the baby through the birth canal, which is formed from a flexible plastic frame. Simulated blood flows out of the vagina, controlled by a thumb-operated roller valve. To simulate the contraction of the uterus after delivery, the teacher squeezes air from a large bladder into a smaller one while pulling the latter lower in the pelvis. She can tap on a piece of hard plastic inside the mannequin to create a heartbeat, varying the rate and loudness to simulate fetal distress. In all cases, the sense of reality is heightened because the equipment is connected to and manipulated by a human being.”

The “Mama Natalie” simulator can even replicate a retained placenta fragment–the primary cause of third stage and postpartum hemorrhage.  When would-be birth attendants know how to recognize this condition, they can also learn how to remedy it (by manually removing the left-over piece of placenta that is stuck to the internal uterine wall, thus allowing continued bleeding).  In extremely rural areas or home birth scenarios where high-tech intervention is miles away, the performance of this relatively simple procedure, and appropriate follow-up techniques and care, can be a matter of life and death.

Kudos to Laerdal Medical for creating this device, making it available to poor countries at cost ($100/each), and adding to the overall trudge toward the Millennium Development Goal 5 which “seeks to cut the 1990 maternal mortality ratio of 320 deaths per 100,000 births by 75 percent.”

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Filed under Childbirth Issues, cultures, From One Mother to Another, General Health, Mommy and Motherhood, natural childbirth, pregnancy, prenatal health

Confessions from a Medical World Drop-Out

When you make a major life choice, and do so with the hopes of not looking back, chances are, you’ll look back–a lot.

Once upon a time, I was young and enthusiastic, and thought I could change the world.

Wait–doesn’t everyone feel that way, at some point?

For me, that enthusiasm turned toward the world of medicine:  as an inherently compassionate, intelligent person, I thought I could bring some sweet, albeit well-informed, spirit into an industry that has, in many cases, lost its bedside manner altogether.

I was twenty-four years old when I enrolled in PA school, and didn’t know what I didn’t know.

Fast forward six years, and I found myself reeling from the ambush of experiences I wasn’t emotionally mature enough to handle.

In my short tenure working in the world of medicine, I experienced what I realize now were some very traumatic scenarios–scenes that a majority of human beings just couldn’t handle being witness to without some sort of long-lasting repercussions.

While working in the surgical world and less than a year after finishing PA school (mind you, I was now just twenty-six-years-old) I found myself in the operating room, harvesting veins out of people’s legs for cardiovascular surgeons to use in bypass surgeries.  Harvesting veins is tricky business with fragile specimens.  If you offer up a harvested vein with any nicks or holes in it, the implanted vein could leak, and the person could potentially bleed to death–in a matter of minutes.  That’s hefty responsibility for a new grad.

While working in orthopedics, I functioned under a womanizing, industry demigod who required me to satisfy the requests of his narcotic-seeking patients…despite my better judgment and the risk to my own license.  I handled the paper work for worker’s compensation patients–for those who didn’t want to go back to work and did everything they could to avoid it, and those that did want to go back to work, but were too injured to be able.  I witnessed accidents in the operating room that rendered people permanently injured–and a lack of honesty during those post-op visits about what actually transpired while the patient was asleep.

While moonlighting in the ER–working a few extra hours in hopes of paying off my student loans a bit faster–I saw women miscarrying the fetuses that would’ve been the babies they so desperately wanted.  I performed chest compressions on a seventeen-year-old kid who’d been shot by his best friend with the hand gun the two boys had snuck out of the friend’s dad’s gun safe (or bedside table drawer?)  I performed chest compressions on that kid–his lifeless chest heaving under my efforts with me winded so easily, five months pregnant with our first child at the time.  The bullet exit wound on his upper abdomen (bullets have a strange way of ricocheting around, once they’ve entered the body) was only finger breadths away from my compressing hands–so innocuous looking.  So Hollywood make-up like.

I was thirty-years-old.

I surgically assisted in not one, but three of the most graphic, horrendous surgeries known to (wo)man: hemipelvectomies:  a procedure in which a person’s entire leg, and half of their pelvis are surgically removed…a hopefully life-saving procedure (with a low percentage for success) for an aggressive form of metastatic cancer.  While in the OR, the joke usually went around–whomever was the least senior person in the room (by years of tenure, not by professional rank) had to be the one to carry the leg away from the table.  Guess who was usually the least senior one in the room?  Can you imagine the weight of an adult man or woman’s leg and half pelvis?

I was less than thirty-years-old during those surgeries.

At what point does a person become emotionally mature enough to handle these types of things and avoid being permanently scarred?  Would I have had a better shot at succeeding in the career I thought I wanted, had it not been for these early on experiences?  Do other twenty-something-year-olds who pursue a career in medicine experience the same types of things and not become permanently  scarred by them?  If so, what does that say about those people?

Every time I find myself talking with someone in the medical industry–a former colleague, a friend, an acquaintance, a health care provider for our family–I can put on my old hat again.  I can talk the talk, share in the lingo, operate intelligibly.  I go away from the conversation missing that part of my life a little–being apart of a club, a fraternity, a society in which not just anyone can belong.

And then I remember how I felt for all those years when I struggled to decide:  do I belong in the world of medicine?  Do I, really? Or is there another place for me…a place in which I can have an effect in the well-being of people who consume our medical industry, but from a drastically different vantage point?

I am now in the process of researching grad school options for myself–again. I have thoughts to communicate, things to do and changes to create.  I feel it in my bones.  But those thoughts, things and changes will enter the world through a different avenue this time.  For me, I am sure, a more successful avenue.

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Filed under Balancing career and motherhood, General Health, Uncategorized, Writing and Publishing

Breast Feeding, Breast Cancer, Pink Glove Dance

Lately, our almost-seven-year-old daughter has taken to nursing her baby doll at the dinner table.  “She’s hungry,” our daughter proclaims.  “I can feed her even while I’m eating!”

Oh, how many evening meals I spent doing the very same thing.  Good thing I’m ambidextrous when it comes to eating.

Of course the meaning behind this is much more profound:  Ellie witnessed her two younger brothers being breastfed as infants and, I assume, there’s some sort of cellular memory of her own breastfeeding days from her infancy.  She has clearly embedded these experiences into her concept of “normalcy” and is now acting this out with her dolls.  The hope, of course, is that she will grow up to be a breastfeeding mama if, and when, her life takes her down the road of motherhood.

Anyway, you’d have to oblivious as a doorstop in this day and age if you haven’t come to understand the various benefits of breastfeeding for the child:   decreased ear infections; decreased risk of developing: diabetes, asthma, eczema, allergies, obesity…the list goes on and on.  (As a side note, two of our three breast-fed kids have asthma and eczema, respectively.  The breastfeeding protection isn’t necessarily fool proof–likely because there’s a heck of a lot of STUFF in our environment that predisposes kids to things like allergies and asthma.)

Two of the latest findings regarding benefits of breastfeeding for the woman are protection against breast cancer and heart disease–metabolic syndrome, to be exact.  Check out this article on EmpowHer.com.  It does a great job reviewing a study started in 1985 that included 1,400 women and revealed a HUGE drop in heart disease-related illness in the moms who breast fed for greater than nine months.  (The American Academy of Pediatrics recommends breastfeeding a child for a minimum of one year.  The World Health Organizations recommends at least two years.)

Some estimates suggest that nearly 1 in five Americans have metabolic syndrome–or the precursors to it– and, at last count (per the National Cancer Institute) there were 192,370 new cases of breast cancer diagnosed this year…accompanied by over 40,000 deaths by the same disease.  Knowing these statistics, wouldn’t you make any choice you possibly could to lower your risk of these entities?

Thankfully, there are LOTS of folks out there researching, raising money and awareness for things like breast cancer and heart disease-related illnesses.  One such group, in Portland, Oregon, did their part by creating the following video.  Enjoy.

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Filed under breastfeeding, family, From One Mother to Another, General Health

Breast Pumps, Nipple Shields, Hooter Hiders…Oh, My!

As a childbirth educator, I frequently receive letters, pamphlets, postcards and, yes, the occasional free sample of products targeted toward the expectant and new mother.  One particularly popular category of said products includes those revolving around breastfeeding.

As breastfeeding (thankfully) continues to re-gain momentum in our culture, so do the products which are developed for and marketed to breastfeeding mothers.

But what about these products?  Which ones are necessary?  Which ones are helpful?  A luxury?  Superfluous?  Unnecessary?  Ultimately unhelpful to the breastfeeding process?

As is with life in general, the answers to the above questions represent a slippery slope–the grade of that slope largely dependent upon the dynamics going on between each mother-baby duo.

Here is a non-exhaustive list of the types of breastfeeding-related products out there:

clothing:
-nursing bras, shirts, tank tops, gowns, pajamas, etc.
over-clothing accouterments meant to cover up the nursing mom and baby:
– Hooter Hiders, Baby Bond drapes, screens, slings, wraps, cloths, blankets, etc.
sore nipple treatment products:
– ointments, creams, gel pads, nipple shields and shells
leaking breasts:
– breast pads, nipple shells/covers
breastfeeding aids:
– nipple shields, nipple shells, tube feeding systems, syringes, cups,
breast pumps:
-one- and two-flanged, manual, automatic, hospital grade, hands-free pumps…

With all this equipment out there, how does a woman choose which of these items is important to have on hand upon baby’s arrival, and which products represent little more than a marketing ploy aimed at capturing the dollars of vulnerable, new parents?  Which items ultimately have an influence on how we collectively view breastfeeding in our culture, which ones truly support the breastfeeding process, and which ones complicate it?

As documented and/or suggested in several recent studies (one being Kathleen Buckley’s A Double-Edged Sword:  Lactation Consultants’ Perceptions of the Impact of Breast Pumps on the Practice of Breastfeeding, as appeared in the Spring 2009 issue of The Journal of Perinatal Education a large percentage of American women view breast pumps as a necessary item on the to-get list prior to baby’s arrival.  The implicated assumption being: in order to achieve breastfeeding success, one must employ the use of a mechanical pump at some point, rather than encouraging the baby to perform the sole job of drawing milk from the breast on his or her own.

Of course, complicating this issue is the higher and higher percentage of women returning to work within a month or two of their baby’s births.  Whether by choice or by lack of adequate maternity leave, more women are trying to keep up with the practice of breastfeeding they so desire, all the while tending to their uncompromising duties at work (“work,” in this case, meaning financially reimbursed duties outside the home).

But here’s a seemingly little known secret:  in most cases, whether returning to work or not, long-term breastfeeding success usually depends on less accouterments than more.  And early introduction of tools like breast pumps (before, say, three weeks postpartum) and nipple shields?  They actually decrease a woman’s likelihood of achieving long term breast feeding.  (By long term, I mean, say, longer than a few months.)

Breast pumps, specifically, have some potential drawbacks:
Unless a woman has an extraordinarily abundant milk letdown reflex, it is difficult to express a whole heck of a lot of milk via a breast pump.  Believe me.  I know.  I struggled for months at trying to get a breast pump to work for me, just to build up that little reserve of breast milk in the freezer for the occasional date night out or, way back when, a shift at work that kept me away from the baby beyond nursing time.

And because breastfeeding is a supply and demand system, the more you rely on the pump to generate milk for your baby, the less milk is being drawn from the breast.  Less milk “demand” equals less milk production.  Within a relatively short period of time (the body responds to a change in the supply-demand system within 24-48 hours) the woman begins to notice a decline in her milk supply.  Add to that, the visual image of how much milk is showing up in the bottle after any one pumping session (again, much less milk will come out into the bottle via the pump than would otherwise end up in the baby’s tummy via baby-to-breast feeding) and the woman starts to doubt her ability to feed her child.

Can breast pumps save the nursing trajectory for some moms and babies?  Sure.  There are a variety of scenarios in which breast pumps can undoubtedly be useful and helpful.  But that degree of assistance only goes as far as the knowledge of how to keep a woman’s milk supply up while also relying on the breast pump (basically, by adding in some extra stimulation of the breasts–a couple extra nursing sessions with the baby, or extra pumping sessions beyond the frequency of the baby’s normal nursing pattern).

And how about other items like nipple shields, an increasingly popular tool distributed by more and more lactation consultants?

nipple_shield

Are these tools the magic bullet they are so often made out to be?  Or is this a case of mistaken identity or, worse yet, blind acceptance of half truths fed to us by medical supply company salespeople working on commission?   In many cases, are products like nipple shields a divergence away from addressing, and treating, whatever the true problem is in a challenged breastfeeding situation?  Here is an excellent article that addresses these questions.

Whether it be in the realm of pregnancy, labor and delivery or breastfeeding, I see us as a general population more and more often taking the band-aid approach versus addressing issues, problems and concerns head-on and dealing with them proactively, succinctly and efficiently.  Going back to the nipple shield example:  if a baby and mother are having difficulty with breastfeeding due to a poor latch (the most common cause of breastfeeding woes) it’s easy to hand over a nipple shield which, when used carelessly, encourages the baby to latch on to the teat of the shield only and draw milk via isolated suction rather than suction plus significant jaw and tongue motion.  (watch this video clip and this for the proper manner in which a baby ought to latch on to the breast)

While nipple shields can temporarily help women with the most severe cases of inverted nipples:

invertednipple

or flat nipples:

flatnipple

there is not a strong indication for the frequent or regular use of nipple shields in most other situations.  The risks, however, are plentiful, as described in the article referenced above.

Of less severity, are some of the other products mentioned:  special nursing clothes, drapes, etc. meant to hide mom and baby as much as possible from public view while breastfeeding.  Here, I realize, I’m opening up an enormous can of worms but…what the heck, the can is already open, right?

How many folks, when preparing to purchase one of the dozen different nursing cover-ups, stops to think about why they feel compelled to add one of these things to their collection of baby stuff?  If it’s purely a matter of mother’s modesty than, have at it.  But if it’s a concern over what other people think about the act of a woman feeding her child, well…couldn’t one argue that the mass production and marketing of breastfeeding cover-ups onl furthers our culture’s still often distorted and prudishness views regarding breastfeeding?

So, if you’ve made it to the end of this post, you’re likely looking for a conclusion (or a couple Ibuprofen, or a stiff drink, or…an enormous sock to cram in my proverbial mouth).  My conclusion would be this:  think carefully about the products you buy in regards to feeding your child.  Think even more carefully about the products you recommend to an expectant, new and/or nursing mother.  Consider who will ultimately win at the end of that purchase:  The mother?  The baby?  The company who has happily sold another well-marketed product?

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Filed under Balancing career and motherhood, breastfeeding, Childbirth Issues, family, From One Mother to Another, General Health, Kids, Living, Mommy and Motherhood, pregnancy