Wednesday, September 18, 2013

The Cost of Not Breastfeeding: laboratory modified infant food products

Let’s face facts: human breasts were designed by the Creator for two purposes; one is to attract the male so the species continues and two, to feed the offspring of procreation.  Breastfeeding babies is normal.  There are scientific studies that show that what is eaten during pregnancy directly affects the physical and mental growth of a fetus.  Is it any wonder that what the baby eats also affects physical and mental growth?
Then what is all of the hub-bub about breastfeeding photos?  Why is something so normal and
natural looked at as the exception rather than what it is ~ normal?
There are situations when formula is necessary to feed an infant.  Such cases include but are not limited to some maternal breast reduction surgery or past history of maternal abuse.  With the surge in the number of breast milk banks, the need for adoptive parents to formula feed is on the decrease, yet still there.
But the bottom line here is that formula production is big business, not only to the production company but to hospitals as well. 
For example:
Medela announced on 9/17/13 a call to share best practices to raise awareness about premature births and effective efforts to support human milk consumption with the goal of improving infant health. One in nine babies in the United States is born prematurely--more than in most developed countries. Content of human milk can substantially improve outcomes for critically compromised and premature infants (preemies). Outstanding neonatal intensive care units (NICUs) across the country understand that a mother's breastmilk gives the baby one of the best health outcomes available.
Premature birth costs society more than $26 billion a year and takes a high toll on families. Premature babies, born before 37 completed weeks of pregnancy, are at risk of both moderate and severe health problems, as well as lifelong disabilities. Premature birth is the number one contributor to infant mortality. Human milk acts much like medicine to premature babies who are vulnerable to potentially fatal diseases such as necrotizing enterocolitis (NEC), an intestinal disease associated with a high mortality rate in the NICU, from merely being born too early.
Research shows that:
-- Length of stay was reduced from an average of 88 days to 73 days for babies fed more than 50ml/kg of breastmilk daily versus preterm formula.
-- Increasing average daily doses of human milk from less than 25 to less than or equal to 50 ml/kg/day for Very Low Birth Weight babies decreased NICU costs incurred by the hospital by $31,514 per infant.


Breastfeeding and breastmilk saves lives and saves money.  Saving money in this way is not something businesses want to do – they want to bring in more money.  Just ask why your local hospital is not Baby Friendly ~ some say it “costs too much” and some even turn down funding for BFHI because in the long run, it will cost them in less revenue.
Perhaps we should rename infant formula to "laboratory modified infant food product"?
You know like GMOs (genetically modified organism)?

Monday, September 16, 2013

So are Early (Elective) Inductions Still the Norm in Your Community?



If early (elective) inductions are still the norm in your community, they shouldn't be.  Three of the most influential groups in maternity care: the March of Dimes, AWHONN, and ACOG/AAFP have launched campaigns to not only educated expectant mothers/families but also care providers.


While an analysis of 230,000 medical records of US women giving birth from 2002 to 2008 in a consortium of 19 hospitals reported an induction rate of 44% among women planning vaginal birth (Optimal Care in Childbirth: The Case for a Physiologic Approach by Goer and Romano citing Zhang, et al. Contemporary cesarean delivery practice in the US.  American Journal of Obstetrics and Gynecology 2010; 203 (4): 326 e1-e10.)

This prompted ACOG (the American College of Obstetricians and Gynecologists) to join with 49 other
organizations through the ABIM Foundation to come up with a talking paper on why scheduling early delivery is not a good idea. Their Choose Wisely campaign hopes to reach those who still use non-medical reasons to induce early: family is in town for a short time, desire to pick a birthday, suspected large baby/macrosomia, etc.  This campaign dovetails with ACOG's Committee Opinion Number 561 April 2013 which states: Morbidity and mortality rates are greater among neonates and infants delivered during the early-term period compared with those delivered between 39 weeks and 40 weeks of gestation. Nevertheless, the rate of nonmedically indicated early-term deliveries continues to increase in the United States. Implementation of a policy to decrease the rate of nonmedically indicated deliveries before 39 weeks of gestation has been found to both decrease the number of these deliveries and improve neonatal outcomes; however, more research is necessary to further characterize pregnancies at risk for in utero morbidity or mortality. Also of concern is that at least one state Medicaid agency has stopped reimbursement for nonindicated deliveries before 39 weeks of gestation. Avoidance of nonindicated delivery before 39 weeks of gestation should not be accompanied by an increase in expectant management of patients with indications for delivery before 39 weeks of gestation. Management decisions, therefore, should balance the risks of pregnancy prolongation with the neonatal and infant risks associated with early-term delivery. However, ACOG Guidelines for Elective Labor Induction state that commonly used indications for labor induction that make the induction elective: include impending macrosomia, history of fast labors, family in town, and maternal exhaustion or discomforts.  These guidelines "while not intended to reflect or establish a standard of care", definitely includes Criteria for Initiating an Elective Induction, Implementation Suggestions as well as auditing suggestions.


AWHONN, the Association of Womens Health, Obstetrics and
Neonatal Nurses, have posted 40 reasons to go the full 40 weeks and divided the reasons into 3 categories: Finish healthy and well, Manage your risks, and Enjoy this time.  With a separate website devoted to the campaign, Health Mom & Baby, plus an iPhone/iPad app AWHONN is working hard to educate moms-to-be and reduce elective induction.  AWHONN has an Assessment and Care of the Late Preterm Infant Implementation Toolkit available for $499.  They also have Assessment & Care of the Late Preterm Infant Guideline 2010 for $53.95, and Hyperbilirubinemia in the Term and Near-Term Infant, 2nd Edition for $34.95.




March of Dimes in conjunction with the WHO have the Born Too Soon Campaign and have identified the fact that 49 countries do maternity care better than the US for infant mortality. Free to all is the Born Too Soon Global Action Report.  This 125 page report, written in conjunction with the WHO, is
designed to focus on prevention and care.  The report defined preterm birth as classified into two broad subtypes: (1) spontaneous preterm birth (spontaneous onsiet of labor or following prelabor premature rupture of membranes (pPROM) and (2) provider-initiated preterm birth (defined as induction of labor or elective cesarean before 37 completed weeks of gestation for maternal or fetal indications (both "urgent" or "discretionary"), or other non medical reasons. 

A wonderful free Toolkit, "Elimination of Non-medically Indicated (elective) Deliveries Before 39 weeks Gestational Age", developed with Federal Title V block grant funding from the California Department of Public Health; California Maternal Quality Care Collaborative and the March of Dimes.  The information in this Toolkit includes complications of non-medically indicated deliveries between 37-39 weeks as an increase in NICU admissions, transient tachypnea of the newborn, respiratory distress syndrome, ventilator support, suspected or proven sepsis, and newborn feeding problems and other transition issues.  In one very telling slide titled "What Motivates Some Obstetricians to Perform Elective Inductions", these reasons are listed: the physician convenience, physician guaranteed attendance at the birth, avoid potential scheduling conflicts, reduce being woken during the night, and "the NICU can handle it".

Other free information is available at www.prematurityprevention.org.  Registration is required but is also free and opens up to journal articles, and power points with many free downloads!

The bottom line: iatrogenic early preterm babies = NICU stays and complications = $$$ for hospitals, convenience for physicians.  Education for ALL is vital to stopping this unnecessary epidemic.

Sunday, September 15, 2013

Listening to Mothers

Health care providers/professionals need to listen to mothers.  I was shown this video several days ago and wanted to share it with you.  It really hits home.


Monday, September 09, 2013

When your childbirth class attendees go to the hospital of their choice, a tour can be overwhelming!  Here are some tips from Lamaze International about Getting the Most Out of Your Hospital Tour!


 

Thursday, September 05, 2013

Fundamentals of Relaxation - Part 8 Guided Imagery

In the 8th installment of the Fundamentals of Relaxation, guided imagery is featured.  Be cautious of using guided imagery in your classes or with clients, as some religions prohibit the use of guided imagery; as one empties the mind for the guided imagery, it allows evil or the devil to go into the mind.  Always ask if there are any religious or cultural beliefs about guided imagery before beginning!



Guided imagery has a solid role in relaxation.  It plays a key role in meditation and reduction of the stress that leads to anxiety.  With the amount of misinformation regarding labor and birth and the distorted view of birth in the media, is it any wonder that more and more childbirth educators are incorporating guided imagery into their curricula to not only relax expectant parents but also displace fears?

Guided imagery makes use of a peaceful setting. Calm lighting, aromatherapy, and music can enhance
the guided imagery experience.  Together, all of these complementary alternative methods (CAMs) help create a feeling of calm, relaxation and distraction which in turn slows the pulse, lowers blood pressure and reduces the secretion of stress hormones.

Whether the childbirth educator uses a script written by someone else, a script written by them or create the guide as they go along, word selection is important to obtain the proper response.  There is no benefit in “taking” someone to the beach if they are fearful of water!  Finding out stress triggers before the guided imagery session is recommended.  Choosing words that can be articulated well may be a reason for writing one’s own script.  Also, being able to set the script to certain piece of music may also be a reason.  However, not everyone feels confident in writing scripts or feels that another’s voice may be more soothing.

Guided imagery scripting begins and ends in the same place – a generically familiar place for everyone: a beach, the forest, mountains, near a lake, etc. Taking time to describe all aspects of the senses (what is seen, smelled, heard, tasted and felt) is important.  Below are two brief sample scripts about walking in a forest.  Which one is more appealing to you?

She walked through the forest at night, heading toward the stream that ran between the trees.  She heard miscellaneous woodland creatures settling in for the night.

Or

She carefully stepped on the green mossy path, the evening dew dulling the sound of her footsteps
and adding a moisture to the otherwise piney-earthy scent.  A faint breeze with the temperature of a baby’s breath, danced across her skin.  With the full moon’s light peeking through the branches of the mature pines, she quickly made her way to the babbling brook, the sound of which was enhanced by the many rocks and branches that built mini-dams here and there.  In the distance, she heard the night song of an owl, a chorus of crickets and a lowly bullfrog adding some bass to the evening lullaby.


Imagine the second script with the scent of pine and gentle music with nature sounds?  How relaxing!

To learn more about Guided Imagery in Childbirth Education Classes, click here 

Here is a collection of 10 guided imagery scripts: click here.

I found several You Tube relaxation/guided imagery presentations.  The first has slides, the second has a video: