A Look Back

I have not posted for some time, obviously.  I visited this blog tonight while searching for the title I had given to the article about "desiring the sincere milk of the word."  For the first time, I saw there were some comments.  Some indicated the information had been helpful, which warmed my heart.  I will consider returning to writing more article for this blog.  There is more and updated information on the topics of breastfeeding and on childbirth that I have incorporated into my childbirth prep and breastfeeding classes as an RN parent educator.  We'll see.  Thank you to those who took the time to leave a comment on some of the posts.

Compassion and Respect for Women Who Choose Abortion

This title might cause you to wonder if I am "pro-choice".  I am not.  I am very much "pro-life".  Simply put, killing another person, no matter how young or old, no matter where they "live", and no matter how big or how little or how much they can defend themselves, does not solve a woman's problem.  I believe it compounds it.  For me, the only gray area is when staying pregnant truly threatens the mother's life. In this case, arguments can be made both ways.  For all others, there are options which will not cost the innocent baby its life, and which, with necessary emotional, physical, and spiritual support, will help the mother through her crisis of an unwanted pregnancy and help minimize or prevent added emotional and physical complications for her afterward.

We live in a country where women can decide to carry their babies until time for birth or to end the pregnancy by ending the life of their child.  For some women, this is a very difficult decision to make. For others, this is not a tough decision, regardless of which way they choose.   Most young women in the United States have grown up in a society where "choice" has been and is the mantra.  Many do not even believe that God exists, much less that He is the giver of life.  It is not surprising that many of these women will immediately think "abortion" when an unwanted pregnancy is suspected or confirmed.

I have had the recent pleasure of learning more about how one crisis pregnancy center in Hampton Roads works.  Had I simply listened to the mainstream media's portrayal of "pro-life" centers, I could have had the picture of "Bible thumping", self-righteous people telling women that they were going to lose their own souls if they had an abortion, tying them to a chair, and forcing them to watch a video where babies are ripped apart and suctioned from the womb. In reality, this is  not the case regarding how women are treated in this faith based crisis pregnancy center in the Hampton Roads area of Virginia.  In fact, it is far from it.

The center, which is part of a larger network of crisis pregnancy centers, is staffed by people, mostly women, who LOVE the women who come in with an unwanted baby in their wombs.   They understand that women, as are men, are made in image of God, and should be treated with respect because of this. Their babies are, too, and the efforts to support the mother in crisis flow down to the baby, too.  Staff members and volunteers RESPECT the legal, medical right of the women to make an INFORMED decision. Yet, they do not push the woman to even watch a video on abortion if she prefers not to.  They do not judge any of the women who come in for services. The staff simply listens to the woman, assesses what her needs might be, and provides education and caring support as she makes her decision.  If the ultrasound indicates a possible abnormality, they will refer the woman to her physician or to the emergency room, which ever is most appropriate.  They never advise abortion. They will let her know that if she decides on abortion, that she, based on the research evidence, will likely experience some emotional repercussions of the decision.  They let her know that they offer her loving counseling to help her with this common aftermath.  Many women have benefited from this type of support.  For those who choose to have, and then to keep their babies, the center offers free clothing and diapers for a period of time to help the often financially strapped mother.  They do not get involved in the adoption process, but will refer the mother to appropriate resources.

Some women come in just to have the free pregnancy test and ultrasound the center offers all women to confirm and to date their pregnancy before scheduling an abortion elsewhere.  Others look for advice and counsel. The woman is provided with as much information as she wants, with respect and care, and without being judged.

What I took away from my experience there is that these centers offer a "safe" space for women to learn about all their options, without someone trying to sell them anything.  There is no fee for the services and support offered.  These centers are supported by the donations of individuals and businesses which have the same philosophy of life and of respect for women. This is in stark contrast for the "educational" services offered by abortion clinics, including Planned Parenthood, where information may be slanted in favor of abortion because of ideology, and where the clinic reaps financial benefits from governmental and private income for the cost of the procedure and, -- most shockingly -- in some cases, the sale of intact pre-born babies, or their body parts.

So, if you are reading this blog -- and a few of you do  -- if you know of someone who is experiencing a crisis pregnancy, tell her about the faith based crisis pregnancy center in your area, and encourage her to go.  Offer to go with her if she wants the support.  Let her know that you care for and respect her to the point that  that you want her to have all the facts so she can make an informed decision. Just knowing she has other options -- including adoption options -- and how they might work for her might save the life of her baby, and prevent her from experiencing emotional, and perhaps physical, lasting trauma.  Finally, if you are as impressed as I was, look for opportunities to support this important work, whether it is by volunteering, participating in the annual "Walk for Life", or by contributing financially.  The rewards for doing so are eternal.  It is quite possible that in Heaven, someone might come to you and thank you for your part in giving them life, or to thank you for  your part in helping her choose life for her baby, or to thank you for helping her recover from the trauma of abortion and to learn about the love of Jesus Christ for her and for her little one.

A Few, and Happy, Updates

Since my last post about the parallels between birth and death, some changes have occurred in how the medical approach to childbirth has been handled.  (The midwifery approach has been on target all along.)  The American Society of Anesthesiologists have come out with new recommendations on oral intake during labor.  They are now stating that it is OK for a low risk mother and baby for the mother to consume clear liquids during labor.  Also, the American Congress of Obstetricians and Gynecologists (ACOG) put out Committee Opinions stating that based on research (or lack thereof in some cases), that improves both safety and the physical and emotions experience of giving birth, and success when initiating breastfeeding.  

What is fairly obvious is that God's design for childbirth and breastfeeding work quite well.  Clearly all cases are not textbook perfect, for we are under the curse of the Fall.  But, many in the medical profession are beginning to see that trying to medically manage the beginning and course of labor for a low risk woman and her baby often introduces medical issues which, themselves, require treatment. We can be grateful that technology has advanced to the current level where many discovered or unexpected problems can be treated successfully, but trying to prevent possible problems with medical intervention does not seem to always be the best course of action.

Many, but not all, women in the US have options regarding how their birth is to be handled.  This includes medications and anesthetics used to control pain, induction for medical reasons, or, within established safety guidelines, for convenience, repeat C-sections when there is no medical indication for doing so, and more.  However, the pendulum is swinging in the direction of providing and protecting the woman's right to decides, bases on research evidence, how she wants her birth experience to be handled.  ACOG has even put out a committee opinion of how to work with patients who want to do something different that what the physician recommends.  I think the opinion shows respect for the woman's right to decide how and where she wants to give birth.

As a childbirth educator, as a nurse, and as the mother-in-law of two wonderful women who have had the blessing of many of the choices, I am grateful to see that birth, once again, is coming back under the dominion of women, who are the real experts at giving birth.

 

The Processes of Birth and Death -- a Comparison

In the year 2000, my mother was diagnosed with terminal lymphoma.  She was a strong believer.  After listening to the pros and cons of medical intervention -- which might extend her life by six months -- and of hospice care, she chose hospice.  This was my first experience with what hospice was about.

One thing they did was to give us a packet of information.  In that packet was an article on what happens as a person begins to die, until the moment of death.  This process can take several weeks, especially with death is due to dying.  By that, I mean that a seemingly healthy, but old, person, just starts to feel bad, slows down, looses his or her appetite, becomes weaker, goes to bed, and eventually dies.  The dying process is also seen in people with terminal illness, including Alzheimer's dementia.
I was so impressed with what I read, and then what I experienced with hospice care for my mother that I developed a presentation entitled "How to Support a Terminally Ill Christian Loved One" which I have used in women's ministry.

While I was reading the paper supplied by hospice for the first time, I was struck by similarities between labor and birth, and the "labor of dying" and death.  I could immediately see God's design in both.   I also could see that many of the interventions the health care system routinely implemented in both cases actually made each process more painful and more difficult.  Some interventions, thankfully, have been abandoned on a routine basis, but others have not.

Let's look at some of the parallels.

Food and Drink

During labor, women giving birth in most hospitals are not allowed to eat.  Some are allowed clear liquids, but are often discouraged from actually taking them ("You'll regret it later when you get sick and throw  up because you have this on your stomach!")   Instead, IV fluids are ordered.   These practices, on a routine basis, are not supported by the research.  Withholding food, and often, drink, is based on an outdated approach to the management of labor.  At one time, most women giving birth in the hospital were given medications which caused sedation and also decreased emotional control.  The benefit of these was that when the women woke up after their baby was born, they said "I slept through the whole thing!".  The truth was that many of these women cried out in pain and distress during labor.  Some had to be physically restrained in their beds.  If a Cesarean was needed, it was performed under general anesthesia.  In a few cases, the mother vomited during surgery (or during vaginal birth if "gas" was used).  In some of these mothers, stomach contents went into the lungs.  This is known as "aspiration".  In some of these cases, the mother developed aspiration pneumonia.  In some of these cases, the mother died.

In modern day obstetrics, most C-sections are done with epidural or with spinal anesthesia.  The mother is awake and thus the risk of aspiration approaches zero.  Only in rare circumstances is general anesthesia required.  In some of those, the C-section is planned, without the mother going into labor.  The typical "NPO after midnight" (no oral intake after midnight), can be implemented.  Still, in most of these scheduled C-sections, the mother remains awake for the surgery, and aspiration is of little concern.  

Statistically, a pregnant women if more likely to die in a car accident or from being struck by lightening than from aspiration syndrome.

In our lawsuit happy society, anesthesiologists still prefer to force women to fast during labor, no matter how long the labor, and no matter how uncomfortable and hungry it makes the mother.  Any honest anesthesiologist will tell you that fasting does NOT prevent aspiration in 100% of cases.  Any good anesthesiologist will tell you that they can manage anesthesia quite successfully in the patient who left a restaurant after a full meal and was involved in a car accident which resulted in injuries requiring immediate surgery.  However, by forced fasting, she experiences additional risks from the results of fasting, and from interventions used to address those problems which can arise.

Yet, for some reason, most women, except those giving birth at home, most birth centers, and a few hospitals, are required to fast during one of the most physiologically complicated and physically intense events of their lives.

IV fluids have no research to support their  routine use during labor.   First, it communicates to the woman that she is not a healthy woman giving birth, but a "patient" who is undergoing a medical procedure, which, hopefully, will go well.  Secondly, fluids over hydrate the mother and the baby.  This can lead to the unnecessary use of formula when a baby "looses to much weight", when in reality, the birth weight was skewed from the IV fluids received by the mother and passed to the baby.  Mothers can have trouble with breastfeeding because of breast and nipple edema which makes it difficult for the baby to latch correctly.  Also, if hormones which control labor are flowing through the mother's body, dilution of the blood stream by added fluid might cause labor to slow and contractions to be less effective.  Obviously, if a mom is dehydrated, or wants pain medications, or is considered high risk due to current complications, an IV is appropriate.


Fasting in labor not only makes most women uncomfortable, it can lead to problems with the birth process.  The contractions themselves may be more painful as the muscle known as the uterus is not getting the nutrition it needs to do its work properly.  Labor may last longer due to nutrient restriction.  Complications can accompany the use of Pitocin which is often administered to strengthen weak contractions.  Some women end up with a Cesarean.  And, in a few cases, some women die from complications of the surgery . . . including massive hemorrhage, infection, pulmonary embolus, and, once in a while, aspiration.

Women may have a decreased appetite during labor, but if labor is long, most women want to take in some nourishment. (My own mother told me that she wanted a steak just before it was time to push.  Since she gave birth at home, someone cooked one for her and she ate it!).   The energy supports the normal process.  There are fewer complications which require interventions which, too, carry risks.

A person who is dying will typically begin to loose his or her appetite.  This becomes more pronounced as the process continues.  At some point, they do not want to eat, or even drink.  Forcing foods and fluids can cause great G.I. discomfort in a digestive system which is shutting down.  This can make the dying process more painful and often longer than it would have been.  In such a terminal state, nutrition and fluid is not saving the person's life, but prolonging death in a way which is more uncomfortable for the patient.

I recently heard a relative state that another relative did not die from advanced Alzheimers, or heart failure, but from starvation after having received hospice care.  If food and drink was withheld from the patient, causing pain and distress, that would be starvation, but that is not the practice of hospice.  If the patient refused food and drink during those last days or weeks, then signs of starvation would likely show up on the autopsy, as it would if nutrition was intentionally withheld.  The difference is in WHY and HOW the starvation occurred.  When no appetite is present, then lack of nutrition does not cause the same discomfort that withholding food when appetite is present can cause.

A woman in labor will eat and drink as she desires.  This makes her labor more comfortable.  A dying person will eat and drink as he or she desires.  This make the dying process more comfortable.

Activity

Women in labor typically find that moving around and changing positions to those which bring comfort help them cope with pain.  These also help facilitate labor.  When movement is restricted, women experience more pain and longer labor.

Again, some of the reasons for restricting the mother's movement is not based on the research evidence.  For decades, women giving birth in the hospital were forced to remain in bed so they could be continuously hooked up to the electronic fetal heart monitor -- which, in  itself, was an unproven, experimental intervention.   Epidurals became common because most women could not tolerate the added discomfort bed restriction caused.  With both limited mobility and the use of epidurals (not to mention limited understanding of what those monitor tracings meant), it is no wonder the C-section rate skyrocketed from around 5% to close to 40%, and even higher in some hospitals.  More recently, it has been around 33% on average, but varies according to place of birth and whether the birth is high risk or not.  Thankfully, a better understanding of why those C-section rates escalated has occurred and new guidelines regarding monitoring the baby's heart rate, allowing the mother more time to reach active labor, and others, should result in a reduction of C-sections.

The person who has begun the dying process slows down physically.  While there is merit in suggesting (like food and drink) some light activity, it is better to let the dying person take the lead.  Of course, a bed ridden person benefits from being turned every two hours to minimize pressure sores, but at some point, near the end of life, this can become very uncomfortable to many patients. 

A few years ago, my neighbor, a wonderful Southern gentleman in his early 90's, was dying from COPD.  He had just arrived home from yet another hospitalization because he chose to die at home. He was in the bedroom with his nurses aid, and his two daughters were waiting to come in.  As he sat in his favorite recliner, he told the aid that he just could not move right then.  She responded "You don't want your daughters to see you without your pajama top on, do you?".  As a gentleman, he forced himself to put on the pajama top, gasping for breath even though on oxygen, and collapsed back into the recliner -- and died.  Poor man! 

When my own mother was in a hospice facility, very close to death, I had noticed that it had been about 8 hours since she was turned.  I asked the nurses about this.  They said that they had been discussing turning her, but believed that, if they did so, it would lead to her immediate death.  They were right.  When they did finally turn her, she took her last breaths and died.  Thankfully, in this case, my mother was deep into the death coma, and did not suffer, like my neighbor did.

When a person is dying, especially when he or she is quite close to death, the desire for movement or no movement should be respected.  Is it really worth forcing movement which causes pain just because "this is what we are supposed to do (in healthier patients)" or because of social propriety?

Women in labor should be allowed to move and to assume the positions most comfortable for them.  People who are near the end of the dying process should be assessed to determine how much movement they can tolerate, and the indicators of how well they tolerate the movement and positioning (grimacing, crying out in pain, etc.) should be considered.

Focus, Zones and Euphoria

God's design for natural birth includes "pain medication" in the form of endorphins.  The hormone oxytocin facilitates normal contractions and also an increasing trance-like state in late first stage labor.  Both of these help the mother rest between contractions and helps her to better cope with the contractions.  As labor advances, the mother "withdraws" from everyday life to becomes birth focused.  All attention is on dealing with each contraction, and, near the end of the first stage, just before complete dilation, on resting between them.

Likewise, as the dying person nears the end of life, they leave everyday life and are engulfed in the "valley of the shadow of death".  

For the woman in labor, giving Pitocin, a synthetic form of oxytocin, disrupts the path toward the "natural pain relief" provided by her body.  While Pitocin causes contractions, they are often harder and have a different form from natural contractions.  We have already discussed the effects of forced fasting.

The epidural, too, interferes with the natural flow of these hormones.  Thankfully, most women in this country have access to epidurals if they want one.  My personal position is that all women have the right to make an informed decision on every intervention or restriction ordered or suggested in labor and birth.  Like all options available, the epidural has benefits and risks.  Women who have an epidural will miss out on the special mental and emotional status provided by endorphins and oxytocin.  They will miss out on an intense "high" experienced by most women who have had a totally natural childbirth.  As one of my clients loudly exclaimed after giving birth without pain medications last year, and holding her newborn daughter skin to skin at hear breast, "I am SO HAPPY!".  That was the hormones talking.

Forcing the basic things which sustain life can interfere with the floating, trance like, "far away" state the dying person enters into.   Giving oxygen, when the dying person is not experiencing air hunger, interferes with the euphoria which can occur when carbon dioxide builds up in the body.  Again, forcing fluids and food can disrupt the "fading away" and the "floating" and the more euphoric state which God has integrated into His design for the dying process.  Oxygen is a comfort measure to the person who is exhibiting signs of air hunger, but not for those who do not.

The process of labor itself, correctly understood and supported, provides for some natural pain relief and for positive emotional and mental states. The process of dying, correctly understood and supported, also provides for some natural pain relief and positive emotional and mental states.  In both cases, additional pain relief is, and should be, available for use as needed.

There are other parallels, but these are the most important, in my opinion.  Whether a woman is giving birth, or someone we know is dying, even though we live in a fallen, imperfect world which prevents both the natural process of birth and of death from being universally experienced, the basic principles are still in place.  If we trust these designs as a gift from a God who loves His creatures, even those in rebellion to Him,  we can experience His blessing whether giving birth, or leaving this world.

For more information on the evidence for the labor and birth procedures noted above, go to www.EvidenceBasedBirth.com.

"Mommy Wars" Commercial by Similac™

Well, since Similac™ (or other formula companies) can't attack breastfeeding and breast milk on their merits, it is trying another approach.  With this approach, the artificial baby milk manufacturer does not have to state that it's products have forty-ish components, and that human milk has a minimum of two hundred.  Similac™ does not have to state that formula feeding is associated with juvenile onset diabetes, asthma, and reduced cognitive abilities as compared to breast milk fed babies, among several other deficiencies.  They do not have to disclose that formula feeding increases the mothers' risks of a variety of cancers, heart disease, diabetes, and more.  They do not even have to disclose that most, if not all of their formulas contain GMOs.

What they have done is divert education regarding nutritional and developmental facts so women can make an informed feeding choice to something strictly emotional.   The first, and most memorable barb in the commercial is "Oh look!  The breastfeeding police have arrived."  They go on to parody other mommy "groups", except for perhaps those moms who choose to smoke legal or illegal marijuana or indulge in street drugs or excessive alcohol.  Formula feeders in this formula company sponsored commercial somehow escape being categorized negatively or ridiculously.  I doubt this is due to an oversight.  For decades, formula companies have proven to be expert at providing misleading -- even totally inaccurate -- information in their ads and printed "educational" literature.  From photographs of disinterested looking breastfeeding mothers to statements like "Let's be honest.  Breastfeeding is hard (hurts, etc.)", formula companies are world class manipulators of the emotions of expectant and new mothers. 

The theme of this commercial would be like a maker of a less healthful snack, say, a crunchy fried cheese flavored crisp taking on the sellers of healthful, organic, nutrient rich foods.  The point would be "proving" it is not about the snack one chooses to feed one's children, but that every option is equal, that it simply "fits" the parent's lifestyle and values, and in the end, we all want to save the baby in the runaway stroller. All this other stuff doesn't really matter -- especially the choice of what to feed the child.

I have made my position on infant feeding clear in previous posts. As a mother, grandmother, RN, certified lactation consultant, and childbirth educator, I have come to believe that every woman deserves objective information on the benefits and risks to her baby and to herself regarding infant feeding choices.  From there, she owns her decision.  When things don't work out as she desires, a Christian woman can trust God's sovereignty and His plan for her and her baby. For women who wanted to breastfeed, but an illness or circumstance prevented this from occurring, formula is the commonly selected option. (Some mothers elect to secure milk from one or more breastfeeding mothers -- an option with it's own benefits and risks). 

Women know the situation they have gone through and are going through and will likely be facing in their lives.  They will factor these things in when they make their infant feeding decisions.  Some will feel guilty, knowing that they are not providing the proper, optimal nutrition for their babies' growth, development, and immediate and future health.  Some will grieve if their choice does not work out.  Some will feel very satisfied with their choice.  Many will learn things as a result of their choice and may make a different choice the next time -- for either option.

But, if Similac™, and other formula companies -- whose primary aim is to sell product and make big bucks-- continues to focus on the emotional instead of the physical aspects of infant feeding options, they are doing a disservice to mothers and babies.  In their attempt to make ALL breast feeding women look like anti-formula feeding "police", they inaccurately portray MOST breast feeding women. More importantly, they are communicating that they do not respect the mothers' RIGHT to an INFORMED infant feeding decision.

Perhaps, in reality, they are engaging in a de-escalation of "infant milk wars" and not "mommy wars" for THEIR OWN benefit . . . and not for the benefit of the baby in the runaway stroller.

Skin to Skin Care is for Fathers and Babies, Too

On occasion I will hear of a woman or man saying that she or he does not want to hold his or her newborn baby skin to skin until the baby has been "cleaned up".  I also hear sometimes that a dad may laugh and joke at the concept of skin to skin with his newborn.  

I actually feel a little sad because I believe a special opportunity for the baby's health can be missed.


Is it better and more acceptable that a baby be taken from her mother and be held only when she is enveloped in a blanket or "onesie"?  Should a dad only hold his "baby in a blanket"?  Does it matter?

We are used to running water and all manner of sanitation promoting options.  But imagine, even hundreds of years ago, that many babies were born where there was not running water.  Yes, newborns are "gunky", but the are NOT dirty!  

Vernix, the cream cheese looking coating on a newborn has a couple of purposes:  the help make the baby slide through the birth canal easier, to provide a protection to the skin soaking in amniotic fluid for many months, and to provide protection against exposure to a blast of micro-organisms once baby leaves the womb.

The excess fluids and solids of birth can be wiped away while baby is resting on mom's abdomen, immediately after birth.  The World Health organization recommends NOT wiping the newborns hands as they state the scent of amniotic fluid helps them find the breast, which is also emitting a similar scent.

We are now learning more about the original design for protection of babies in their new environment, even before birth.

1.  Amniotic fluid probably contains "healthful" bacteria and also growth factor allow the villi in the intestinal tract to develop properly AND to set up an optimal, healthy microbiome.  This impacts the baby's immune system in both the short and long term.

2.  Babies should be "inoculated" with the flora (germs/bacteria/microbes) from their mothers and fathers -- ideally before being exposed to the flora form hospital equipment, linens, and personnel.

3.  Breastfeeding exclusively (no formula) is necessary to establish the optimal healthy gut microbiome in newborns.  Skin to skin with mom and dad helps to establish and perpetuate the family microbiome, including skin, respiratory, gut, and others.

4.  Skin to skin helps the baby better regulate his heart rate, respiratory rate, blood sugar, and emotional state.  A crying newborn uses a lot of energy and is at risk of disturbing its acid-base balance.  Low blood sugar increases the chance that a baby will be given artificial baby milk to correct that problem -- only to increase the chance of other problems.

Skin to skin with either mom or dad is good health care practice -- not silliness.  A man is no less a man when he holds his newborn close to his heart.  In fact, he is being a good FATHER.  It can even be argues he is being a good husband because by helping his baby maintain better stabilization of the infant's blood sugars and ability to eagerly breastfeed, he is minimizing the potential for his wife to experience trouble with breastfeeding.  Lactation success provides life long benefits for her as well as for the baby.

Some of my favorite moments as a doula when assisting with births if when "daddy" assumes this role of protector and involved father.  Below are two of my favorite photos of this experience.

The dad is this photo is a 6' 4" military man.  He is no sissy for caring for his one hour old baby in the best way possible.

This dad, who holds a doctorate in pharmacy, knows that skin to skin with his newborn when mom is resting will promote optimal health for both mom and baby via the direct contact and the secondary support of exclusive breastfeeding.

So, it is safe to say that REAL MEN, who are educated about the health benefits, HOLD THEIR NEWBORNS SKIN TO SKIN.  It's not only OK, it is advisable.

Forget the "Ewwwww" or even "girly" factors.  "Man up", in this special way and give your newborn the best.  Encourage his mother with skin to skin from birth and with breastfeeding before the baby goes to any one else.   When mom is ready, take the baby from mom and hold her a few moments to inoculate her with your flora before your baby is exposed to that from others.  Help your baby transition to extra uterine life with less stress on his or her body systems and decrease the chance of your baby receiving foreign proteins and other substances via artificial baby milk by incorporating best practices of care.

Change -- The Tenacity of Just One Woman

Tonight I met an amazing woman in my Comfort Measures class.  She is planning to deliver at a hospital different from the one where I teach. She and her husband have given me permission to share her story and I will do the best I can to express why I was touched by her.

She has older children, as well as school age, and is pregnant after giving birth a couple of years ago to a baby who did not make it to his birth day.  This woman had done a lot of research and insisted that her doctors allow her to deliver her baby vaginally . . . after three (3), yes, that's THREE previous C-sections.  Now, I personally an aware of and support what is typically referred to as VBACs (vaginal birth after Cesarean.  I was just surprised that this mom demanded . . . and got . . . her VBAC after three C-sections-- and at this particular hospital.  This woman had done a lot of research, took copies of that research to her care providers, and convinced them to support her efforts to avoid another C-section.

She delivered her baby . . . who was also in a frank breech position . . . vaginally, and without an episiotomy.  This amazingly strong woman -- even with the grief of the expected loss of her baby due to a birth defect incompatible with life (past a short period of time) --worked to have the birth experience she wanted . . . and was very empowered by it.  Not only that, she was likely the catalyst to encourage her physician to support other women who had 2 and 3 previous C-sections to deliver vaginally their healthy babies.  Her doctor has become known as THE physician to go to for VBAC births in this geographical area.

This amazingly strong woman said that the empowerment she felt two years ago to stand her ground in her desire was a gift from her baby.  In my opinion, it could be one of the purpose's of his brief life.  Because no one expected him to live, even if born alive, her health care professionals were more open to the VBAC.  The success of the birth with regard to the mother's health made a real impact on her care providers.  It made an impact on his mother too, as she described the vast difference she felt physically after having C-sections and then having a vaginal birth.  I could see it's effect on her as she told her story. Women remember each birth the rest of their lives, and even "re-feel" the emotions of each experience.  I could hear sadness,  determination, strength, intelligence, and bittersweet joy in her story.  Obviously, I was very moved.

This mother has now planned for the birth of this healthy little one.  She has hired a doula, taken a comfort measures class, takes good care of herself, and continues to do research.  Her husband is a quiet man, yet very supportive, and must be a man of great strength himself.

Yes, I was very impressed by this woman.  Her efforts have educated her care providers.  They have made birth better for others.  I hope . . . no, not hope .  . . I trust she will have a very special birth experience this time.  Her last one was special, too -- even though it was heart breaking.   This one will be "the one" that all women should be blessed to have.  In reality, it will be the one which women were designed to have.  I'm glad, because of her determination and work, she will likely experience natural childbirth -- as it was designed to be -- with it's pain and it's joys, and this time, with a baby she will be able to keep and love in more than in her heart and in her memories.

God bless you, dear lady and husband.  I am honored to have met you both.   Thank you for making birth more positive and safer for others by your desire to understand it and your determination to experience it.  Your little one is in Heaven now, whole and happy, in the presence of the One who made that child and gave him a special purpose . . . one which could, in fact, save the lives of other babies and mothers.  May God give you and your husband much amazing joy and minimal bitter sweetness with this new baby's birth.

The Power of "No".

I recently was involved with putting together a conference entitled "Birth Really Matters:  Optimizing Maternal and Neonatal Outcomes".  We had a couple of physicians, half dozen midwives, several RNs, several doulas, several lactation consultants, and a few childbirth educators attend.  A certified nurse midwife from VCU Centering Pregnancy was a speaker.  She showed a video (link to be displayed at the end of this post) on the rights of childbearing women.

As a childbirth educator, I am often asked "Will they let me . .  .?".  To this I usually respond, "What you want to say it 'My plan is to  . .  .',  or, 'I will be doing . . . '.  Avoid asking if something is OK.  A nurse or physician could be having a bad day, and you can get a "no" when that should not be the case." 

At the conference, a midwife in the audience talked to us about the power of "no".  If a nurse says, "I need to take your baby to weigh and bathe it", you can say "No.  I want to hold my baby and let her breastfeed for a while longer.  I do not plan to for my baby to have a bath today."  If a physician says "You have to have IV fluids", you can say "No.  I will be taking in fluids orally.  I do not want to be connected to IV fluids".

So, what if you have signed all kinds of consent to treat forms?  "No" trumps these.  No matter what you have consented to allow to be done, or to do, at any time you can invoke the power of "No".  At this point, without a court order, no one can force you to do anything.

My advice?  Use your power wisely.  If necessary, ask questions, and use your BRAIN (benefits, risks, alternatives, intuition, and "no" or "not now" if applicable).  Christian women have a great resource:  prayer.  Ask for wisdom in making your decision (James 1:5).

Do not be intimidated.  It is your body.  It is  your birth experience.  To the care provider, it is just another day at the office.  You will remember this experience -- and deal with any effects -- for the rest of your life.  And, most importantly, it is YOUR baby.

http://www.youtube.com/watch?v=K105F9o3HtU

http://childbirthconnection.org/article.asp?ck=10084&ClickedLink=0&area=27

So What Do Doulas Do? Watch This Video!

This will be a short post.  There is a 50 minute video on how doulas support women in labor.  Benefits include less need for pain meds and reduced chance of having a C-section.  

Click on this link to watch the trailer, to rent or to purchase the video.  The trailer is free, and prices are reasonable for either option.

http://muvi.es/w3219/283382

Disclosure:  The organization which put out this video has a system where the person who provides a link will receive a small fee for sharing if the movie is rented or purchased.  I have not idea what that fee is, but it is probably very minimal. My goal is to inform women of the fantastic benefits of having a doula.

Noise Making: Friend of the Woman Giving Birth

One of the Power Point slides in my class shows three names:  Grantly Dick-Read, Fernand Lamaze, and Robert Bradley.  By each name are a few sentences describing the philosophy of their approach to birth.  Somewhere in each of those descriptions are the words "relaxation", "breathing", and "painless".  I explain that these physicians were known for developing a way of approaching childbirth in the previous century, with Dick-Read's work in the 1930's, Lamaze's work in the 1950's and 60's, and Robert Bradley's in the 60s and 70s. I then ask the class to see if they find common themes, or simply anything common among the physicians as they read the blurbs.  

Most of the time, members will identify the three words noted above.  And, in most cases, they notice that the physicians were all men.  "This is why they think birth can be painless if you can only relax enough.  They have NOT given birth", is my response, which typically brings about some laughter.  I also point out that they deserved some kudos for trying to make birth easier for women, and in some ways, they did.

However, these men were probably very uncomfortable with women making noise in labor!  Why?  In the context of the culture from which these physicians came, men did not want to hear women crying.  They typically wanted to "rescue" women in distress. It naturally followed that they would look for a way to keep the women they cared for in childbirth from making noise because crying, moaning, etc. meant the problem of pain and her response to it was not fixed.

The patterned breathing and the relaxation techniques were supposed to help a woman CONTROL her response to pain, but it also lessened or eliminated any noise she might make during contractions.  This is not a natural thing for women to do.  Therefore, "natural childbirth" practiced this way, is not really natural.  Even women who manage to "hee" and "hoo" their way through most of labor often make the hard "aaehhhh" sounds of work when pushing. Finally, women who are feeling their contractions seem to emit an almost primal scream as the baby is exiting her body.

Tears, too, are a natural part of many natural birth experiences.  Years ago, a young woman, around 18 years old came to my childbirth class.  Her mother was her "coach".  They wrote back that during labor, K., young woman, sat on the toilet to use the bathroom.  She found it comfortable and stayed there.  Her mother brought a pillow and placed it on the floor in front of her daughter.  She knelt down, and her daughter leaned against her during contractions.  At one point, K. began crying quietly, releasing tears.  The nurse came in, saw the tears, and said "Oh no!  Don't cry!".  K. told the nurse "I -- i-- it's  al --- right. (Sniff.)  I'm O -- oK" and continued coping the way she was.  K. ended up delivering without any pain meds and was thrilled she reached her personal goal of a natural childbirth. 

A friend something to me.   She told me how she tripped on her friend's deck, and hit her elbow.  She said, "All I could do what hold my elbow, rock back and forth, and moan.".  My response was "Somewhat like a woman in active labor".

I am convinced that women in labor naturally make noise (along with rhythmic movements) as a method of coping with pain -- and SHOULD be allowed, even encouraged, to do so.  I am not talking about screaming with fists clenched and back arched.  I am talking about tension releasing noises like moaning, or staccato sounds like "oh, oh, oh, oh, oh" vocalized in a tension releasing way.  A good cry during advanced labor helps to release tension, also.  Crying is part of the Master's design for tension release.

I also think that many nurses and physicians in today's hospital setting are uncomfortable with noise women make as a way of coping with contractions.  Nurses are trained to ask about and document their patient's level of pain based on the "faces" pain scale where "1" is a happy face and "10" shows an agonized countenance.  Then, they are trained to "fix" the patient's problem by medication until she can give a lower number when asked to rate her pain once again.  Our normal reaction is to want to help the woman "not to suffer", so drugs, or breathing techniques are offered, sometimes with intense pressure to comply. 

In order to really help a woman prepare for her labor, she needs to be encouraged to surrender to it.  Learning to relax or "let go" at will is also important.  She needs to be told it is OK to cry (real tears) and to make tension releasing noise.

It is especially hard for the woman's husband or other support person, unless that person is a doula or someone who understands natural birth, to listen to his loved one "suffering".   But, it really is not suffering when the woman is not crying out for help.  It is coping, and needs to be supported and not discouraged.

This does not mean that you should not learn breathing techniques.  You might find them, particularly Bradley's show abdominal breathing, to be helpful, especially in the earlier phases of labor.  But don't feel like you have to stay with them when your body is "telling"  you to make noise.

If you are planning to have a natural childbirth, you might need to write something in your birth plan along the lines of  "I plan to use vocalization as part of my coping techniques.  Please encourage tension releasing noises instead of returning to more artificial breathing techniques if I am finding vocalization to be helpful."

I have a feeling that Dr. Lamaze, especially, would abandon his "hee-hee-hoo"s for some "ohhhhhhhhhhhhhhhhh"s moans if he actually labored and gave birth.

"I am SO Happy!"

I heard these words repeated over and over during the first thirty minutes following the delivery of her baby girl via natural childbirth.  Well, almost natural.  Here is the rest of the story, with the permission of the mother.

The face of a mother high on oxytocin following a pain med free, or "natural" childbirth.

She was induced at 40 weeks and 3 days due to "oligohydramios" (decreased fluid found upon testing) and "several dips" in the baby's heart rate.  I am not going to do into these finding or what may have caused them.  Some experts say that this is common with late "post date" pregnancies, and when mother has been confined to bed, on her back during the testing.  The situation was this:  I received a call at 2:45 a.m., with this mother in tears.  I assured her that God was in control and that I was on my way to serve as her doula.

I arrived around 4 a.m.  "A." was upset because the midwife on call at the military hospital had challenged A about her "too detailed" birth birth plan  (it was only one page in length) and told A. that she needed to give up some control.  Then the midwife tossed the birth plan at the nurse as she left the room.

I set up the room with flameless candles, essentials oils on cotton balls for aroma therapy, and Scriptures A. had selected from those I had printed out.  Actually, she and her husband decided where they wanted each verse posted, and he placed them around the room and bathroom. 

I then went to introduce myself to the nurses, who were very kind. One apologized about the midwife right away.  I asked who would be on duty at 7 a.m. and they assured me that it would be an OB who was easier to work with.  They were right, as we came to learn.  Before leaving the nurses' station, I explained that this was a very strong and capable woman, and having a natural childbirth was very important to her.  She would let us know if she wanted meds, but as stated on her birth plan, did not want anyone suggesting pain meds or discussing them before she inquired.  This turned out to be the only request which was ignored a few times.

A. was started on Pitocin (synthetic oxytocin) to jump start her labor.  She had done a lot of reading and told the nurse she did not want any increases for at least an hour.  The nurse agreed to check with the doctor.  Dr. Lee came in to visit, birth plan in hand, and the first thing she said, "I think we can do everything you want to do as long as the labor allows", and discussed most items.  This allowed A. to clarify one.  Everyone was now on the same page.

We finally got A. to lie down around 6:15 a.m. to try to sleep a little.  After a while, her nurse came in to give her oxygen since her baby's heart rate kept dropping a little.  A. told her she was not surprised because she had asthma and it had been hard breathing while trying to sleep.  After a bit more napping, A. got out of bed after the nurse removed the oxygen, and we walked around the unit several times.  The hospital had a wireless electronic fetal heart monitoring, which made it possible to do so with mom on Pitocin.  ALL hospitals need this for their patients.  The literature is clear regarding the benefits of walking and upright positions for labor.

A. was still 1 centimeter dilated after this and her OB suggested inserting a Foley catheter into her cervix to stretch it a bit.  She told A it would fall out when the cervix reached 3 to 4 centimeters.  A. was unsure, so, as her doula, I asked the OB to list for A the benefits and risks of the procedure.  A. considered the information and decided to try the Foley.  We walked some more, the nurse increased the Pitocin, and A. began having stronger contractions.  She went to use the bathroom and found sitting on the toilet comfortable.  I brought in a pillow, some flameless flickering candles, and some lavender essential oil on a cotton ball.  A. rested her head on the pillow behind her, and stayed on in this position for about an hour.  30 minutes into this "toilet time" she placed her legs over my thighs to elevate her feet, which had started swelling a little from the fluids and the Pit.

She managed her contractions by intentional relaxation, deep breathing, and "blowing out the pain", sometimes with moaning.  I would gently support her finger tips with mine to assess her relaxation and to let her know when she was beginning to tense up so  she could consciously relax.

A. had been at 1 centimeter for some time and I was a bit worried the induction would not work and that A. would end up with a C-section.  I texted my husband, her pastor, to ask him to pray that A. would dilate more quickly.  At the end of the hour, A. was checked and the balloon was still not ready to come out.  We went over to the bed and soon she felt it slip a bit.  The OB came in and gave it a tug and it came out.  A. was declared to be "3". 

We did some 'stomp, stomp, squats" around that time, and periodically during labor.  A. got into the bed, and leaned over a peanut ball (a large exercise ball shaped like a peanut), on her hands and knees and rested. I used two weighted soft exercise balls as counter pressure for her back, as she directed from the choices.  The room was dim, lighted by flameless candles and the scented with lavender and jasmine essential oils.  The nurse loved coming into the room because of the scent and atmosphere.  I put a little peppermint oil on A's back and inner thighs to help with pain.  After an hour, with contractions increasing in intensity, the nurse checked her and declared A. was "6". 

As I  had promised A., we got her into the shower for the expected, most intense phase of stage one of labor  -- transition.  At this point her nurse came in to check on her and told A., that she had been conservative with her last exam -- A. was really a 7.  This news encouraged all of us.  However, from A.'s first contraction in the shower, it was clear she WAS in transition because of her emotional response to it and her sleepiness between the rapidly occurring contractions.  

With A. sitting on the shower bench (well, leaning back a little against a pillow, with her legs stretched out with feet on a nursing stool) I sprayed warm water over her chest and tummy while her husband encouraged her with loving words. 

Let me digress a bit here.  At some point with each one of the above comfort measures and positions A. had used in her labor, her nurse would come in to teach.  In early labor, A. listened to the dangers of sucking on lollipops (increased saliva and stomach contents in case a C-section was needed).  I asked the nurse -- for A.'s benefit of hearing the answer -- how often they used general anesthesia for C-sections (VERY rare).  Since spinals and epidurals practically eliminate the risk of aspiration syndrome (vomiting stomach contents into the lungs) A. ignored the "caution" and sucked on her lollipop.  The research does not support having a woman fast during labor.  In fact, doing so can interfere with normal labor and a woman's ability to complete it without additional intervention.  

Since A. had reminded her nurse (who really was an excellent nurse) that she did not want to hear about the epidural, her nurse talked with her husband about it other pain meds.  She cautioned him that if A. did not take something soon, it would be too late.  She did just outside the bathroom door, and within A's. earshot.  A.'s husband re-stated A.'s desire NOT to be offered medication.  Once the nurse could see that A. was as determined as she was, and that what we were doing was working to keep labor progressing (thanks again, honey for praying for A.!), and that A. was coping -- albeit loudly at times-- the nurse did not mention the "E" word, or systemic meds, again.

During the hour we spent in the shower, A. experienced all the normal signs of transition:  nausea, drowsiness between contractions, slurred, slow speech, shaking, and near the end of transition "I want this to STOP!  I don't want to do this anymore!".   A. went from praying "Thank you, Lord for helping me.  Help me finish this labor!" to fussing about the pain, and back again.  Acceptance of a woman's powerful and volatile emotions in transition is crucial for her to let go and do this incredibly demanding work. 

Again, the nurse wanted A. go get into the bed to be checked and A. quickly and without reservation told her "You must be out of your mind!.  I am not moving".  I smiled and said, "I don't think she's ready to leave the shower yet".  So, I redirected the water while the nurse checked to see if A's water had broken.  It had.  There was no need to check for a cord prolapse.  Baby's heart rate was thumping along just fine. Thankfully, the waterproof transducers on A's belly, along with the wireless monitor allowed her to enjoy the shower during her labor on Pitocin.  ALL hospitals should have this equipment! 

A. had been complaining of feeling like she had to push for well over an hour, even before getting into the shower, but she was able to "blow" through them.  I knew she was not yet ready, even though she voiced her frustration a little of not being allowed to push.

A few minutes after the nurse checked for SROM (spontaneous rupture of the membranes", A. said she felt like she was about to pass out.  Her husband helped her onto her hands and knees (to prevent her falling and hitting her head) while I ran for the honey and a straw in my doula bag.  I shoved the straw into the honey, pulled it out, and told A. to suck all the honey out of the straw -- NO ARGUMENT.  She did so.  In seconds, she revived, and on the next contraction "cow bellowed," "I HAVE TO PUSH!"  Once again, I told her to blow (air out of her mouth) through the urge, but this time she told me, "YOU DON"T UNDERSTAND!  It won't let me!"  Those are the words I was waiting to hear.  A. "blew out the candle" anyway, between little fusses.  Strong woman!  

Once the contraction was over, I turned off the shower, had her husband help me get her up, toweled her off, threw a blanket over her, and headed for the bed.  The nurse came, checked A., and declared A. had dilated to "10" and she could being pushing.

A. had stated on her birth plan that she wanted to push on her hands and knees.  Her OB was comfortable with this.  A. rested her upper body over the same peanut ball she had used earlier to rest,  and grabbed the mattress at the head of the bed.  She managed to keep pulling it away from the frame, loosing her leverage.  Her husband secured her arms with his hands as she pushed.   What beautiful teamwork.  No class taught him that.

By the way, her husband was amazing!  They had attended my childbirth class and comfort measures classes, plus one held by her hospital.  Earlier in her pregnancy, they read a book I had loaned them, and continued reading many other other books and articles, so he was well aware of what to expect . . . to a point.  I had taken a few moments earlier in labor to remind him that he would see his wife in a lot of pain, but that God had also provided pain relief and naps between the contractions (via God-designed "morphine" known as endorphin).  I gave him a list of things to say to encourage his wife, with "I love you" and "You are amazing" at the top of the list.  He provided her with the "emotional medication" that often works as well as pharmaceutical meds in helping labor progress and helping women cope with the contractions.  Now, he was helping his wife do what she needed to do in order to push effectively.

A. started her pushing, as most women do, a little uncoordinated while trying to figure out what her body was doing.  The nurse, per her training, was wanting A. to hold her breath for a count of ten before pushing again.  This can be necessary when a woman does not feel her urges to push, as happens with most epidurals.  However, studies had shown that when the mother is allowed to follow her urges, she will hold her breath, if she does hold it, for about 6 to 7 seconds when she pushes.  The benefit to this natural pushing is that the baby's heart rate does not dip as low, and recovers more quickly than with directed pushing.  Also, when a woman is told to push out of rhythm of the urges, they experience more pain while the work is less effective.  Holding to someone else's count to "10" easily gets the woman out of HER OWN rhythm of pushing with her body's urges.

I told the nurse "Let's watch A. for about 15 minutes and see how she does before we direct her".  The nurse sweetly agreed (which spoke well of her because almost everything she had been suggesting throughout the labor was declined).  Soon, A. was pushing in harmony with her body, taking deep breaths to oxygenate her baby between urges to bear down, and when she was resting between pushes.

Dr. Lee was lying on her side across the bed, watching the baby's descent and figuring out the maneuvers for a delivery 180 degrees opposite from a typical birth.  She had done hands and knees births before, but not recently.  A's nurse, Janine, was on her knees on the floor beside the bed to hold the monitor on A's upside down belly to record the baby's heart rate.  What dedication!  This was clearly not a typical birth scene for that military hospital.  Yet, the OB and the nurse were smiling at each other at one point and agreed "this is cool!".   ALL hospitals need medical and nursing staff like the ones on duty for this birth! (I still scratch my head at the midwife's attitude, though.  It's so untypical for a midwife.)

In less than one hour, little Isabelle was born.  Well, not really little.  A. had delivered a 9 pound 14 ounce, 22 inches long baby without vacuum extraction, forceps, or C-section, so "little" is not the right word.  As A. requested, no episiotomy was done.

By the way, the baby's heart rate was wonderful throughout all of the labor, even with the Pitocin, with the exception of when A. was lying straight  in the bed.  There IS something to getting mom off her back when checking fetal heart tones!  Perhaps the induction wasn't really necessary, perhaps it was.  But, this was how God wanted this labor to occur, and He used it to bless A.

Back to the birth sequence.  The OB directed us how to help A. turn over on her back to receive her baby while maneuvering among the IV/Pitocin lines. Earlier during the pushing stage, she had asked how we were going to figure this out.  I suggested she call the shots since she had to best view of everything.  I was impressed by her attitude of teamwork vs. the "I am in charge of everything" personality exhibited by some OBs. Her approach to A.'s care had a major impact on how her labor was allowed to progress, and on all the positive results A. and her husband enjoyed.  All hospitals need physicians like this!

The photo above shows the triumph A. felt. once Isabelle was in her mother's arms.  After greeting her baby, her first words to all of us in the room were "I AM SO HAPPY!", followed by "Thank you, Lord!" not as an exclamation but as a prayer.  

In a few minutes, still on her post natural birth oxytocin high, A. said, with a huge smile, "I am AWESOME!  I did this without pain meds AND on Pitocin".  Was she bragging?  No.  She was enjoying the empowerment God gives as a special gift to many women whose labor occurs in this manner.  She was not better than other mothers, she was simply experiencing a special feeling the Lord provides many women who have accomplished this work. Oxytocin is a powerful hormone, which is released in increasing amounts during labor.

Pain medications diminish the normal release of oxytocin, so 85% of women in this country do not experience the intense feeling God planned for them to enjoy.  Remember, pain meds have not been around for all of history. While women, due to the curse resulting from the Fall of Man, experience pain in childbirth, our loving God also provides something comforting during labor and very uplifting immediately after the birth.  A. was blessed to enjoy this gift.

As Dr. Lee repaired a tear from the birth, A. allowed Isabelle to progress through the steps God designed babies to be able to do to finally self latch and nurse.  Again the nurse tried to assist, but I explained that, as a lactation consultant, I too want to "help".  However, studies showed that if we leave healthy, alert babies alone, they will progress through certain, consistent steps and latch better than if we we jump straight to attaching baby to breast.  Again she nodded and let Isabelle continue without help.  Sure enough, in about 30 minutes, Isabelle accomplished those steps to latch beautifully and suckle away.  I showed her dad how a good latch looked so he could help assess with later feeds.

After an hour, A. gave the baby to her husband, who took it to the warmer where she was wiped down an little more, weighed, and measured.  Dad got to put on her first diaper, and then held his daughter for some skin to skin time.

A father falls in love with a beautiful girl.

What did A. and her husband think about their decision to have a doula?  I received a Facebook message from A. several hours after I went home from the birth.  

" . . . I don't know if we could've done this without you.  Knowing and having someone there to guide us and empower us through our labor was the BEST decision we have ever made together (besides getting married, choosing to have Heavenly Father as our families foundation, and having babies of course :-)) Thank you so much for the amazing experience you were able to give us.  We love you!!!"   

In her opinion, having a doula was the 4th best decision they had made in their lives.  Since it followed what it followed in her list, you can get an idea of how much support women discover that a doula can provide to help them achieve their goals for birth and breastfeeding initiation. 

Even though A. had planned her way, God directed her steps (Prov. 16:9).  She found, that with God's help, she was capable of more than she imagined.  She found Him to be faithful, to comfort, to strengthen, and to bless in ways she had never before experienced.  Yes, she had support from her husband, her doctor, her nurse, her doula, and for early labor, three amazing women:  her mother, grandmother, and mother-in-law (all who had birthed without meds, including the mother-in-law who gave birth to a 13 pound baby, who happened to become A.'s husband!).  

However, and most importantly, she had her GOD, the one Who created her, Who loves her -- Who gave her second birth -- to carry her through this labor which threw her into the depths of pain, and for a few moments, despair, before elevating her to heights of a type of joy she had never experienced.

Her husband learned that he, with God's help, could provide the necessary emotional support and physical comfort measures to help his wife birth their first 
child.

As their doula, I was blessed, once again, to witness the partnership of a man and his wife during her labor, and the birth of a man and a woman into parents, holding the one they had come to love, but never had seen before that special day.

Thank you, A. and T. for this precious experience.  I, too, "am SO happy!"

Formula Marketing Hits a New Low -- as in "Lower in a Key Nutrient for Brain Growth"

While attending a perinatal conference recently, I picked up some formula company literature.  I had noted that FCs were marketing a "gentle" formula for babies who were having trouble tolerating formula (not surprising as babies were not designed to tolerate well anything other the human milk).  Mead Johnson had removed 70% of the lactose, Similac had removed 80%, and Gerber had removed 98%!

Why is this significant?  Well the primary carbohydrate in human milk is lactose.  Lactose is critical for brain development in babies. 

I asked one of the reps if there were any studies of the effect of removing this vital brain growing nutrient from this product.  She could not think of any, but will look and if she finds any, will send me copies.  I could genuinely thank her for doing this for me.

I asked if her (or any company) put a warning on the packaging about this.  If a mother was having a problem with a fussy baby, and was tempted to change to this lactose lacking formula, she might reconsider if she could read a caution on the packaging.

Of course, this was a rhetorical question.  Formula companies do not list risks of their product on their packaging.  They only tell consumers how close formula is to breast milk, or that it contains all the nutrients required for a healthy baby.  They even proclaim how  (algae derived -- NOT disclosed) DHA, probiotics, choline, and other additives support brain growth similar to breast milk.  They do NOT list how using their product increases baby's risk of asthma, diabetes, leukemia, lymphoma, GI diseases, etc.  They do not discuss how their product decreases the baby's IQ when compared to breastfed infants, or that the brain is actually less developed as seen on MRI studies. 

In addition to the "gentle" formula, the FCs now advertise a "supplemental formula" for breastfed babies.

When asked by the rep my opinion of their packaging, I told her that I felt it was deceptive.  I have no trouble with formula companies marketing their product. There was a place for it.  However, I did not like incomplete disclosure or misleading phrases they consistently use in their marketing.  I explained that many mothers would see this "supplemental" formula for breastfed babies as "something close to breast milk, unlike the other formulas".  In reality, it is very similar to the other formulas.  Only a few ingredients were slightly tweaked.

At this point, the rep told me that her company was the last to market both the "gentle" (dumb down?) formula AND the supplemental (for breastfed babies) formula because of their commitment to integrity in marketing (What?).  She stated they finally had to do something to prevent some of an increasingly limited market share going to those competitors.  Really?  THAT is the reason for a formula company adding something "new" and "improved" and "designed" for certain babies, even though, by doing so, they actually are removing a vital, brain growing, nutrient? 

Moms, if you chose to, or have to use formula, think twice about giving your baby a "gentle" formula deficient in lactose.  I may be wrong, but I would not be surprised if we see ten years down the road a population of "gently fed" kid struggling with school work because their brains were starved of an essential nutrient.   We might be seeing this now.  

Many babies have been given plant based formula for years because they were "allergic" to milk based formulas.  But, risking future brain capacity because baby is fussy?  Try to stick it out for a few weeks in order to support your baby's brain, as best as formula can, for life long benefits. 

If you are breastfeeding, and think that this new "supplemental" formula can make breastfeeding easier while giving your baby the same nutrition as your milk without harming your baby's immune system, think long and hard.  Don't be fooled by pretty packaging, carefully contrived words, and smart marketing on social media and elsewhere.  It's really the same old stuff.  Even their latest study on DHA, which they say "proves" babies had higher intelligent scores as children, compared formula fed babies to formula fed babies. 

If you are using formula, save your money.  The FDA requires a certain standard in artificial baby milk manufacturing.  "Supplemental", "DHA/AA", "Gentle" and other formula types are typically more expensive than standard formula with little to no proven benefits.  

Finally, ask yourself if decreasing the amount of crying over a few weeks of time is worth the risk of giving your baby a formula which lacks so much lactose.