Delaying Umbilical Cord Clamping

Clamping and cutting of the umbilical cord should be delayed for three minutes after birth, particularly for pre-term infants, suggests a senior doctor, Dr. Andrew Weeks, in the British Medical Journal. 28/08/2007.
Early clamping and cutting of the umbilical cord is widely practiced as part of the management of labor, but recent studies suggest that it may be harmful to the baby. Dr Andrew Weeks, a senior lecturer in obstetrics at the University of Liverpool, looked at the evidence behind cord clamping. For the mother, trials show that early cord clamping has no ill effects, he writes. But what about the baby?

At birth, he says, the umbilical cord sends oxygen-rich blood to the lungs until breathing establishes. When a baby is born it must transfer from receiving oxygen from the placenta to receiving oxygen from its lungs. For this to happen, the baby’s lungs must first expand, and the burst of blood from the umbilical cord helps to get the newborn’s lungs to expand properly. So as long as the cord is unclamped, the average transfusion to the newborn is equivalent to 21 percent of the neonate’s final blood volume and three quarters of the transfusion occurs in the first minute after birth. For babies born at term, the main effect of this large autotransfusion is to increase their iron status.

This may be lifesaving in areas where anemia is endemic. In the developed world, however, there have been concerns that it could increase the risk of abnormally high levels of red blood cells and bile pigments in the bloodstream often leading to jaundice. But trials has shown this is not the case.

Umbilical cord blood is a baby’s life blood until its birth. It contains stem cells, red blood cells, and more recently scientists have discovered that umbilical cord blood contains cancer-fighting T-cells.
For pre-term babies the beneficial effects of delayed clamping is greater, he says. Delayed clamping is consistently associated with reductions in anemia, bleeding in the brain, and the need for transfusion.
He proposes that in normal births, delaying cord clamping for three minutes with the baby on the mother’s abdomen should not be too difficult. The situation is a little more complex for babies born by caesarean section or for those who need support soon after birth. Nevertheless, it is these babies who may benefit most from a delay in cord clamping. For them, a policy of ‘wait a minute’ would be pragmatic, he says.

The World Health Organization’s (WHO) policy supports delayed cord clamping, stating:

“The optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased, and the cord is flat and pulseless (approximately 3 minutes or more after birth).” 

They continue:
“Clamping the umbilical cord immediately (within the first 10 to 15 seconds after delivery) prevents the newborn from receiving adequate blood volume and consequently sufficient iron stores.
Immediate cord clamping has been shown to increase the incidence of iron deficiency and anemia during the first half of infancy, with lower birth weight. Waiting to clamp the umbilical cord allows a physiological transfer of placental blood to the infant which provides sufficient iron reserves for the first 6 to 8 months of life, preventing or delaying the development of iron deficiency …

For premature and low birth weight infants, immediate cord clamping can also increase the risk of intraventricular hemorrhage and late-onset sepsis.13 In addition, immediate cord clamping in these infants increases the need for blood transfusions for anemia and low blood pressure infants and infants born to iron-deficient mothers being at particular risk …

Numerous research studies and experts are also confirming that waiting to clamp the cord offers significant benefits. Among them:
• In the Journal of Cellular and Molecular Medicine, researchers say delayed cord clamping is “mankind’s first stem cell transfer and propose that it should be encouraged in normal births.”
• In a BMJ editorial, James Neilson, professor of obstetrics and gynecology, states that delayed clamping should be practiced.

Resources, Support:
“Early versus delayed umbilical cord clamping in preterm infants”. Rabe H, Reynolds GJ, Diaz-Rosello JL http://tinyurl.com/4w63wv8 (Cochrane Review)

ACOG Recommends Delayed Umbilical Cord Clamping for All Healthy Infants http://tinyurl.com/lopdtn8

Benefits of Daily Probiotics

goodbacteriaProbiotics are beneficial bacteria that help maintain the natural balance of organisms (microflora) in the intestines between harmful and beneficial bacteria and work to remove toxins from the body. The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt with live cultures, is the best known. Yeast is also a probiotic substance.

Probiotics promote healthy digestion by providing beneficial bacteria to recolonize and balance the GI tract, and hinder the growth of harmful, toxic bacteria, while also promoting a healthy immune system.

Probiotics may seem new to the food and supplement industry, but they have been with us from our first breath. During a vaginal birth while the newborn passes through the birth canal, a newborn picks up bacteria from his/her mother. These good bacteria are not transmitted when a Cesarean section is performed and have been shown to be the reason why some infants born by Cesarean section have allergies, less than optimal immune systems, and lower levels of gut microflora.

What are probiotics used for?
Some people use probiotics to prevent diarrhea, gas, and cramping caused by antibiotics. Antibiotics kill “good” (beneficial) bacteria along with the bacteria that cause illness. A decrease in beneficial bacteria may lead to digestive problems. Taking probiotics may help replace the lost beneficial bacteria. This can help prevent diarrhea.

A decrease in beneficial bacteria may also lead to other infections, such as vaginal yeast and urinary tract infections, and symptoms such as diarrhea from intestinal illnesses.

Probiotics may also be used to:

• Help with other causes of diarrhea.

• Help prevent infections in the digestive tract.

• Help control immune response (inflammation), as in inflammatory bowel disease (IBD).

Poor food choices, emotional stress, lack of sleep, antibiotic overuse, other drugs, and environmental influences can all shift the balance in favor of the bad bacteria.

When using probiotics, the idea is not to kill off all of the bad bacteria. Our body does have a need for the bad ones and the good ones. The problem is when the balance is shifted to have more bad than good. An imbalance has been associated with diarrhea, urinary tract infections, muscle pain, and fatigue.

Maintaining the correct balance between the “good” bacteria and the “bad” bacteria is necessary for optimal health.

When the digestive tract is healthy, it filters out and eliminates things that can damage it, such as harmful bacteria, toxins, chemicals, and other waste products. On the flip side, it takes in the things that our body needs (nutrients from food and water) and absorbs and helps deliver them to the cells where they are needed.

The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn’t function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn’s disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, Helicobacter pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it’s never too late.

Probiotics convert the fiber in food into healthy fatty acids that nourish the cells that line the intestines. They also help the intestines make short-chain fatty acids, which contribute to the overall health of the body.

Benefits of Probiotics in Pregnancy
Many women suffer from digestive issues, such as heartburn, diarrhea, constipation and intestinal cramps, during pregnancy. Probiotics help relieve constipation and other intestinal issues by improving gastrointestinal function. The healthy bacteria can also improve the immune system of both the mother and baby during pregnancy. Probiotics can help you fight off or avoid colds and other illnesses, which is essential during pregnancy due to a suppressed immune system. Taking probiotics during pregnancy may also help prevent allergies and eczema in both mothers and infants.

A study performed by the Norwegian University of Science and Technology discovered a lasting impact on babies whose mothers took probiotics during pregnancy. According to this study, babies and toddlers up to 2 years old were 40 percent less likely to suffer from eczema compared to babies whose mothers did not drink probiotics. Additionally, babies who did experience eczema had less severe cases. This study, which was published in the “British Journal of Dermatology,” highlights the effectiveness in preventing eczema in children and did not indicate any adverse risks to the mother or baby.

References
Parenting; Ask Dr Sears: Probiotics During Pregnancy?; William Sears;
http://alturl.com/354h8
Pregnancy Today; Probiotics and Pregnancy; Teri Brown
Colorado State University Extension; Food Safety During Pregnancy; J. Dean & P. Kendall; December 2006
San Mateo Medical Center; Acidophilus and Other Probiotics; 2011

ZIKA VIRUS and PREGNANCY

mosquitoZika Virus: Answers for Pregnant Women

What is Zika virus?

Zika is a virus that’s been around for actually dozens of years; it generally causes a mild viral syndrome and is prevalent in the Tropics—South America, the Caribbean islands, and Pacific islands.

Zika virus is a mosquito-borne illness.  Most people who are infected with Zika virus have no symptoms. If they have symptoms, they are usually very mild such as fever, rash, red eyes, muscle pain or joint pain. People usually do not get sick enough to be hospitalized and they very rarely die.

Is there a link between the Zika virus and birth defects? Infection during pregnancy can be harmful to the fetus or the newborn. Zika virus has been associated with microcephaly, a birth defect in which the size of a baby’s head and brain is smaller than expected. This birth defect is associated with developmental delays including trouble speaking, problems with movement and balance, hearing loss, and vision problems.

How is Zika virus transmitted? Women can be infected with the Zika virus directly by mosquito bite in an area where there is active Zika transmission or by sexual transmission from an infected male partner.

How can I prevent catching the Zika virus? The Centers for Disease Control and Prevention (CDC) has recommended that pregnant women, or women who may potentially become pregnant, avoid travel to countries that have been affected by the virus, including a large number of countries in South America, the Caribbean and the Pacific Islands. Check the CDC website http://www.cdc.gov/travel/page/zika-travel-information for a complete list of affected countries. Both pregnant women and their partners should avoid mosquito bites, particularly if traveling to a country that has been affected by Zika. If your sexual partner has recently visited an area with the Zika virus or is infected with the Zika virus, abstain from sex or use condoms throughout the pregnancy.

 If I am going to travel to an affected area, what should I do to prevent catching the virus? Travel to an affected area is not recommended for pregnant women. If travel is completely unavoidable, talk to your healthcare provider and take precautions to avoid mosquito bites. This should include use of EPA-registered insect repellents, wearing long-sleeved shirts, long pants, and hats to cover exposed skin, and maximizing time spent indoors in air-conditioned or screened rooms.

The recommendations for people contemplating pregnancy are a little bit different. If the woman has been exposed to Zika and gotten sick—meaning she has flu-like symptoms, runny nose, sore throat, low-grade fever, red or itchy eyes—it is possible that it is due to the Zika virus and, currently for people who have symptoms that have been exposed, they can be tested to see if that is true.

For a woman who has been exposed and been sick from Zika, it is recommended  waiting 8 weeks before tyring to conceive. There’s concern for men that the virus can remain in their bodies and be spread through sexual contact. And so for a man who has been sick from Zika, again, been exposed, been in an area and had a viral syndrome, the man can now be tested and, if he’s been sick or tested positive, the current recommendation is that he not have unprotected intercourse with a pregnant woman or try to conceive for 6 months.

If I catch the Zika virus before my pregnancy, is my baby at risk? We do not yet have recommendations about the safe period between infection and conception. However, once the virus is cleared from the blood, prior Zika infection is not thought to affect future pregnancies.

For more information about Zika virus, visit www.ChildrensNational.org/Zika

If you are concerned that you have been exposed to the Zika virus, please talk to your doctor. The Fetal Medicine Institute at Children’s National can work with your doctors directly.

http://childrensnational.org/departments/fetal-medicine-institute

Phone number:  202-476-7409

*SOURCES: Information provided by Children’s National Health System Centers for Disease Control and Prevention

*Excerpts from The Zika Virus and Getting Pregnant, Eric A. Widra, Medical Director,  Shady Grove Fertility

Peace of Mind; Living Free of Fear of Losing a Child

Your family is your life and protecting your children from harm’s way is a growing problem and now it is now possible with technology.  Your child’s safety and whereabouts can now be monitored via your smartphone.  Children can have the ability to alert you when they are under duress, in trouble or find themselves lost.

Children 2-10 years old, toddlers and even newborns traveling and under supervision of others can be monitored 24/7 in five minute intervals and located immediately and automatically via e-mail or text messaging.  You set the schedule – minutes or hours – and receive regular alerts with the exact location of your child.  An SOS button allows older children to summon for help which includes their location as well as automatic tracking alerts to entrusted individuals you choose to receive them.

This child tracking solution is dependent upon 2 technologies – GPS (Global Positioning System) and wireless communications or cell phone (GSM). Anywhere you can receive both a GPS signal and have cell phone reception, the solution will work.

The solution was developed by the father of a young daughter who became lost at an amusement park for several hours.  After finding her and being an IT technologist, decided to develop a solution for preventing this from happening again.   He funded Amber Alert GPS and engineered the Law Enforcement Alerting Portal (‘LEAP”) used by law enforcement in states to issue the actual Amber Alerts.  The LEAP system is the fastest and most efficient alerting technology in the nation, and allows States to share Amber Alerts cross-borders. To date, law enforcement in the States using the LEAP system have a 100% recovery rate of all children for whom an Amber Alert was issued.

Protect your children.

Presented by Angel J. Miller, MSN, CNM – published earlier in 2015…

                                     girl riding bike

This entry was posted on May 1, 2016, in Pregnancy.

The Benefits of Red Raspberry Tea

Red Raspberry leaf tea is one of the safest and commonly used tonic herbs for women wanting to get pregnant or for women who are already pregnant. Red Raspberry Leaf (Rubus idaeus) tones the uterus, improves contractions and decreases constipation. Most tonics need to be used regularly, for a tonic is to the cells much like exercise is to the muscles; it is not much help when done irregularly . But you will still  benefit even from occasional use of tonics during pregnancy, since they contain nourishing factors. The herb comes in forms of leaves to make teas or tonics as well as pill like capsules you can swallow. Most of the benefits given to regular use of Red Raspberry leaf tea throughout pregnancy can be traced to the strengthening power of fragrine, an alkaloid which gives tone to the muscles of the pelvic region, including the uterus itself; and to the nourishing power of the vitamins and minerals found in this plant. There is rich concentration of Vitamin C, the presence of Vitamin E and the easily assimilated calcium and iron. Raspberry leaves also contain vitamins A and B complex and many minerals, including phosphorus and potassium.

When to use: There are two basic points of view on the subject. There is agreement among many
clinicians that in the 3rd trimester frequent (2- 3 cups per day of tea or 1 – 2 cups per day of infusion) isred raspberry leaf tea
beneficial to the uterine and pelvic muscles.

The more radical point of view is that drinking one cup of tea per day in the 1st trimester and 2 cups in the 2nd trimester and switching to the infusion in the 3rd trimester ensures a strong uterus, is good for you nutritionally and prevents miscarriage. Some say it is advised to not use it in the first trimester, particularly if you have a history of miscarriage. If a mother is prone to miscarriages she may feel safer avoiding raspberry until the third trimester. This is an herb with centuries of safe use behind it, there is usually little cause for concern, but check with your healthcare provider before using.

According to Susun Weed, author of “Wise Woman, Herbal for the Childbearing Year,” the benefits
listed below for drinking a Raspberry leaf brew before and throughout pregnancy are as follows:

  • Increasing fertility in both men and women. Red Raspberry leaf is an excellent fertility herb when
    combined with Red Clover.
  •  Preventing miscarriage and hemorrhage. Raspberry leaf tones the uterus and helps prevent
    miscarriage and postpartum hemorrhage from a relaxed or atonic uterus.
  • Use raspberry leaf infusion to help facilitate placenta delivery. Chips of frozen raspberry leaf infusion
    sucked throughout labor help keep the uterus working strongly and smoothly.
  •  Easing of morning sickness. Many women attest to raspberry leaves’ gentle relief of nausea and
    stomach distress throughout pregnancy. Drink a cup or two of raspberry leaf tea or infusion each day.
    Sipping the infusion before getting up or sucking on ice cubes made from the infusion increases the
    strength of this remedy.
  •  Reducing pain during labor and after birth. By toning the muscles used during labor and birth,
    Raspberry leaf eliminates many of the reasons for a painful birth and prolonged recovery. It does not
    counter the pain of dilation of the cervix.
  • Red Raspberry Leaves do not start or encourage labor. It can help the contractions to be productive
    once true labor has begun because it strengthens the uterine and pelvic muscles but it is not an oxytonic
    herb (one that would induce labor). That being said, it’s important to talk with your midwife,
    obstetrician or herbalist before beginning drinking red raspberry leaf tea or taking a supplement. Some
    will recommend you wait until you are 36 weeks along before incorporating the tea into your health
    regime while others may encourage you to begin right away. Each situation and pregnancy is different
    so it’s best to get other’s opinions before beginning red raspberry leaf tea.

Tea recipe: To make a tea, pour 1 cup boiling water over 2 teaspoons of herb and steep for ten minutes. Strain. During the first two trimesters, drink 1 cup per day. During the final trimester, drink 2-3 cups per day.

Excerpts from Weed, Susun. “Wise Woman Herbal Childbearing Year.”http://www.motherandchildhealth.com/Prenatal/raspberry.html

Presented by Angel J. Miller, MSN, CNM

www.midwiferycareassociates.com

https://www.linkedin.com/in/angeljmiller

Baby Massage: Bonding Through Touch

Baby Massage has been practiced in many cultures around the world for thousands of years, helping mothers and fathers to better communicate with their children through the power of touch. In today’s busy modern family, working moms and dads can feel guilty for missing out on time with our precious little ones. Infant Massage, or “Baby Massage”, is a great way to bond with your baby and have fun while making a stronger connection.

What is Baby Massage?

This easy-to-learn Massage technique is a gentle-pressure, rhythmic rubbing of your baby’s body and skin with your hands and fingers. You can use a moisturizer or lotion to help your hands glide over their skin and gently wiggle their ankles, elbows, wrists, and fingers. Developing a ritual will help your baby recognize the process. Be sure to make expressive eye contact throughout, engaging the child as much as possible. You can talk softly, hum, or sing a song.

What are the Benefits of Baby Massage?

The soothing rubbing of your hands stimulate the production of the feel-good hormone Oxytocin in the baby. Oxytocin is the hormone that gives you that warm, loving feeling. Mom produces it during breastfeeding, and Dad can produce it simply by holding the baby close. Parents relax, and baby is usually calm and receptive.

Some other benefits include:

• A better connection to your child spiritually and intellectually

• Relaxes your baby, putting them in a state of playful curiosity

• Better sleep patterns resulting in better moods

• Helps alleviate gas and stimulate bowel movementsbabymassage.jpg.

• Promotes sensory stimulation

Baby Massage is one of the most natural and pleasant methods of providing early nurturing, helping to strengthen the bond between you and your child. Parents report feeling more comfortable and confident in their ability to care for the baby. They learn to understand and respond to the baby’s cues, and learn techniques to comfort, calm, and soothe their babies. If you are looking for something special to do with your baby, consider adding Infant Massage to your routine.

For more information on infant massage or to host a workshop please visit www.DanaDurand.com

by Dana Durand, NCTMB, Licensed Massage Therapist

What is a Perinatal Mood Disorder?

Recently, the media has reported several stories relating to perinatal mood disorders (more commonly considered to be post-partum depression, but are not limited to depression). Guidelines around who should get screened and when have taken center stage. Despite this attention, many don’t realize what perinatal mood disorders are or whether or not they are at risk for one.

black-and-white-person-woman-girl-mediumQuite simply, a perinatal mood disorder is a mental health concern that occurs either during pregnancy or post-partum. This can include depression, anxiety, obsessive thoughts, paranoid thinking, and thoughts to harm yourself or your baby. While these concerns exist prior to pregnancy for individuals, they can be exacerbated during pregnancy and after for several environmental reasons: changes in hormones and lack of sleep are two prevalent factors. Of course, not everyone who has a baby experiences changes in mood, and certainly, some people seem to be more resilient during this transition.

Common symptoms of a perinatal mood disorder may include:
*Changes in sleep (not being able to sleep at all, even when the baby is or
oversleeping)
*Irritability
*Fears of something happening to the baby (being dropped, not
breathing, etc)
*Concerns (despite weight gain) that baby isn’t eating enough
*Uncontrollable crying
*Disinterest or lack of connection to the babypexels-photo-48566-medium
*A feeling of not being yourself

Nearly 1 in 8 women (and 1 in 10 men) experience a perinatal mood disorder. Treatment is simple and can range from therapy, medication, or both. However, without treatment, there can be long-term consequences that are dangerous for both mother and baby, as studies of depressed mothers have shown difficulties in their children as they age. There is a simple screening that you can opt to take to see if you might be experiencing a perinatal mood disorder and it can be found here. People who are are risk for developing a perinatal mood disorder include those that have experienced depression or anxiety during pregnancy; those that have a family member who had a perinatal mood disorder; those with a history (or family history) of depression or anxiety; those that have suffered a pregnancy loss; those that conceived through infertility; those with a baby that was in the NICU; teenage mothers; those that are having financial/housing/medical concerns; and those that do not have a social support system or a limited one. Certainly, this is not an exhaustive list, but is inclusive of many “red flags”.

 

If you are concerned about you or someone you know that might be having difficultly adjusting to life postpartum, you can contact your OB-GYN/Midwife/Primary Care Physician about a mental health referral. It is important that the clinician you meet with has experience and training in treating perinatal mood disorders as it is not something that most graduate programs cover.

By Julie Bindeman,  Psy-D

http://www.greaterwashingtontherapy.com/