The truth about sleeping with baby

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Source: The Guardian.com, Sarah Boseley
Date: Friday 16 October 2009Time and time again, mothers are warned of the dangers of sleeping with their infants. But has the science been badly misinterpreted?

Is it safe? ‘Surveys suggest that a quarter of parents routinely share a bed with their baby’.

It seems like the most natural thing in the world to bring your baby into bed with you and give this tiny scrap of humanity all the closeness, comfort and reassurance you can. Mothers who do it know it quietens a fretful baby, and allows them to breastfeed without having to stumble out of bed into the shocking chill of the early hours in a half-dazed, sleep-deprived state of resentment.

Authoritative bodies go against well designed research

But we must not do it, say authoritative bodies including the Department of Health and a leading charity. We must go against our instincts because we are risking our baby’s lives. Bedsharing is a risk for cot death.

The Foundation for the Study of Infant Deaths (FSID) and the department say categorically that the safest place for a baby is in a cot in the parents’ bedroom. Babies must sleep alone. Breastfeeding mothers should wake up, get up in the cold grey dawn, pick them up, settle in a comfortable armchair, feed them and then put them back in the cot and hope they won’t wail piteously for long.

This message was strongly repeated by the foundation on the publication of a study this week by the British Medical Journal which FSID itself funded. “Latest findings by researchers from Bristol University . . . confirm that ‘the safest place for a baby to sleep is in its own cot’. This four-year study . . . found that in half of all unexpected deaths of children in the south-west of England, babies had died sleeping with a parent or carer,” said FSID’s press release.

What is worrying, the release went on, is that 25% of mothers in a survey “were not persuaded that bedsharing can increase the risk of cot death”.

But anyone who read the full paper, by a very experienced and well-respected team from Bristol and Warwick Universities, would be hard pushed to believe it either.

Do not sleep/ risk falling asleep on the sofa

Yes – the study found that 54% of cot deaths occurred while the baby was co-sleeping with a parent. But although the risk was strong if they had crashed out on the sofa, it was only significant among those in a bed if the parent had drunk more than two units of alcohol or had been taking drugs.

This is a serious, heavyweight piece of research by a team with impeccable credentials who have been working in this field for 20 years. They looked at all sudden unexplained infant deaths (Sids – often referred to as cot deaths) in the south-west of England between the start of 2003 and the end of 2006. After campaigns in the 90s on the dangers of putting babies to sleep on their fronts, the number of cot deaths has dropped dramatically – by half. But there were still enough deaths (79) in this study to make their conclusions valid.

Peter Fleming, professor of infant health and developmental physiology in Bristol, one of the study authors, was appalled by the misinterpretation, as he sees it, of the paper in the media this week. “I really felt quite uncomfortable about it,” he told the Guardian yesterday.

“My view is that the positive message of this study is that it says don’t drink or take drugs and don’t smoke, particularly for breastfeeding mothers. We did not find any increased risk from bedsharing. It is a very different message from the one the media picked up.”

You can say that half the deaths occurred while babies slept with their parents. You could also say that half the deaths occurred while babies were alone in their cots, he says, but: “I don’t see anybody saying, ‘Don’t put your baby in a cot.'”

Fleming has a particular reason for worry. The study showed that sleeping with the baby on a sofa really is a risk. Yet seven of the parents whose baby died say they had gone to the sofa to feed, aware that bedsharing is said to be dangerous, and had fallen asleep.

Do not feed your baby on the sofa in the middle of the night/ when you’re very tired

“Any advice to discourage bedsharing may carry with it the danger of tired parents feeding their baby on a sofa, which carries a much greater risk than co-sleeping in the parents’ bed,” says the paper. “Anecdotally, two of the families of Sids infants who had co-slept on a sofa informed us that they had been advised against bringing the baby into bed but had not realised the risks from falling asleep on the sofa.”

But despite Fleming’s concern, the FSID was sticking to the line agreed with the Department of Health yesterday: “The safest place for an infant to sleep is in a cot beside the parents’ bed.” It pointed out that the same sentence appears in Fleming’s paper, but did not mention what follows next: “Based on evidence from research into Sids it is questionable whether advice to avoid bedsharing is generalisable and whether such a simplistic approach would do no harm. Parents of young infants need to feed them during the night, sometimes several times, and if we demonise the parents’ bed we may be in danger of the sofa being chosen. A better approach may be to warn parents of the specific circumstances that put infants at risk.”

Joyce Epstein, director of FSID, says this is too complicated. “If you can get people’s attention for more than three seconds you would like to give the whole story every time, but at what point do you lose everybody?” she says. From their perspective, the simple direct message – put your baby to sleep in a cot near the bed, not in the bed, is the key.

The new study, she says, is just one study (although in a Lancet 2006 paper the Bristol team also found a link to drink and drugs). George Haycock, professor emeritus of paediatrics at St George’s hospital in London, who is FSID’s scientific advisor, points to nine previous studies that have looked at co-sleeping and cot death and concluded that sharing a bed is risky.

“You can’t say there is no risk,” says Haycock, even if it is small for non-smokers. And he is tacitly critical of the “breastfeeding lobby” for defending bedsharing, when there is no concrete proof that it increases the numbers of women who breastfeed.

Ground breaking research

But Fleming says this study breaks new ground. Nobody in the past has gathered reliable information about drug-taking. “The advantage of this study is that because we did a death-scene evaluation, three to four hours after the baby died, we were able to look at all sorts of factors which in the past we couldn’t look at.” When the researchers talked to the parents, offering sympathy without blame and the possibility of explanations for their tragic loss, the parents told them everything, including what they had drunk and what drugs they took the night before. “People are very willing to share that information with you at that time,” he says. “You get the real picture.”

Co-sleeping around the world

The paper adds that the findings may explain some of the quirky cultural associations between co-sleeping and Sids. Among black African populations in the United States and Maori and Aboriginal people, where babies commonly sleep with their parents, cot deaths are high, yet in other bedsharing communities, such as Japan, Hong Kong and among the Bangladeshi and other Asian peoples of the UK, deaths are low. The difference is in their smoking, drinking and drug habits.

FSID’s raison d’etre is to eliminate sudden unexpected infant deaths and that is what they believe their advice on putting babies in cots, on their backs, “feet to foot”, on a firm mattress with no pillow, will help do. But other organisations think there may be real benefits to taking your baby into your bed. The National Childbirth Trust (NCT), the country’s leading parenting organisation (and champions of breastfeeding), openly defends bedsharing.

“The study shows that risks for babies whose parents did not smoke or consume alcohol or drugs but who did share their bed with their baby were not different from that for babies in a separate cot,” says its head of research Mary Newburn in a statement responding to the BMJ publication.

The reality of parenting

The NCT’s position is a response to the real world of its members. “Many parents share their bed with their baby when they are young and this can be done safely,” says Newburn. “It is clear from surveys that around half of parents sleep with their babies at some point in the first six months, and around a quarter do so routinely, so we need to help them to do this in the safest way possible.”

Rosie Dodds, NCT senior public policy officer, says they understand FSID’s position. “They are really worried about the number of babies dying and want everybody to be as safe as possible,” she says. “But there are likely to be advantages to babies sharing a bed with parents.” Although she acknowledges that there is no scientific evidence establishing that bedsharing increases breastfeeding, there is an association, and breastfeeding on its own has been shown to lower the risk of cot death.

Deborah Jackson, author of Three In A Bed, says she thinks we are, in the UK, “fixated on the bad aspects of sharing a bed with the baby”, which is strange because “the history of bedsharing or shared sleeping places with the baby is as old as humanity itself”.

Her research, together with her own experiences of bedsharing with her three children, have persuaded her it is profoundly beneficial for both mother and child. The mother is aware of her baby as she is sleeping and reacts to her. “[Once] I was asleep,” says Jackson. “[One of my children] was sleeping next to me. I suddenly sat up in the night and held her over the bed and she was sick,” she says. Somehow she had known the baby was about to be unwell.

But there are clear dangers if the mother has been drinking or taking drugs. “All the things that make it good can make it really dangerous if you are not incredibly sensible. That’s true of everything in parenting,” she says.

We all want the same thing

Cot death is devastating and everybody is on the same side – they want to see fewer tragic families who have lost their babies. But there is clearly not one single road that everybody can march down together. In the end, a single prohibitive message for parents may even be counter-productive. This may be one of those cases where the public should be given credit for their intelligence and allowed to make up their minds on the basis of rather fuller information.

Best Diaper Changing Technique for Newborns to Reduce Crying and Colic

Almost every parent changes their newborn with the double leg-lift technique, which looks convenient but might not be right for your baby. The roll technique, especially with newborns until they start crawling, may be a better option. Dr. John Edwards from Mama’s Chiropractic Clinic demonstrates the technique and explains why.Dr. Edwards is a member of the International Chiropractic Pediatrics Association.
ADDRESSING COMMENTS & QUESTIONS ABOUT COLIC: I usually see a few reasons why a baby has colic in my office. This video is intended to show parents of newborns a technique they can do to reduce one of those factors- repetitive stress to the spine where the nerves for the intestines come out.

Optimal Foetal Positioning (for an easier birth)

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Source: Optimal Foetal Postitioning
By Jean Sutton, New Zealand MidwifeThe Optimal Foetal Position is our term for the First Vertex; Vertex Left Occipito Anterior; Vertex L.O.A. The position most commonly chosen by near term babies when they are able. [In every day terms it means baby is head down with their spine at the front of the belly on the left side]

Optimal Foetal Positioning, or OFP for short, is the term coined by myself (Jean Sutton ) and Pauline Scott to describe ways a mother can assist her baby to assume the best position if he/she is to have the simplest, safest birth. Today we are told that human babies always need help to be born, but why?

Babies managed for countless years before midwives and doctors were involved.

They know what to do, but not how to tell us how to help them. Or have we stopped listening? Parents-to-be today are bombarded with advice from all sides. Ante-natal classes teach many ways of managing labour; mothers build up an expectation of the perfect birth, but few teach about the baby’s role.

This is what optimal foetal positioning is – encouraging the baby to move into the optimal position for labour and birth.

OFP was conceived to encourage birth practitioners to view the mother’s pregnancy and the baby’s birth from the baby’s perspective. We accept that the baby is in control of the growing part, so why shouldn’t he/she largely manage the birth process?

Traditional birth wisdom and old textbooks held the view that the baby’s position at the beginning of labour predicted the result.

They divided the possible positions into vertex (head down) breech (bottom first) and a few other highly unusual angles. The most common positions came first, and the rest followed. The first choice was head down, back between Mother’s left hip and umbilicus. Vertex L O A left occipito anterior or Optimal Foetal Position. Amazingly, 75% of babies chose this position. Around 10% chose to be on Mother’s right side–this is only possible for second and later babies. That meant that only a few were facing forward,or R O P right occipito posterior, and even fewer were breech.

When mothers stayed mobile during labour, and the baby was the right way round, labour tended to start on time and proceed smoothly to a tidy birth.

If baby is to get himself/herself into the best position, baby needs mother to spend most of her time with her abdomen ( tummy ) forward, and her knees lower than her seat. Then baby will, during the last few weeks of pregnancy, be most comfortable lying with his/her back to mother’s front. Mothers aren’t keen on this, as they end up with a bulgy abdomen, a saggy back, and a “duck waddle” walk!!
Still, if they want as simple a birth as possible that’s what is needed. Today, mothers want to stay as “tidy” looking as possible for the whole pregnancy. This only happens when baby is in a posterior position (facing forward) with his back straight, or is sitting as a “bottom down” baby.

Why has the change happened?

Sometime around the 1960′s, people’s lives began to change. The modern world and technology brought us comforts undreamed of, but we may have forgotten the amazing wisdom of our ancestors. Television has us sitting in comfortable armchairs instead of upright furniture. Motorcars became common. Fewer people walked or cycled to work. Modern employment needed people with more education, so girls were at school for much longer, and not looking after smaller siblings. Work changed, sitting at a desk became the norm, and as computer use spread,we spent even more time sitting. Household chores were made easier by wetmops and vacuum cleaners. No more hands and knees–no more tubs of washing!

Now many more babies had little choice but to lie with their back against mothers. One can’t lie on one’s face in a hammock. The scene is set for problems. Overdue, long and painful labours, made worse because mothers were put to bed on their backs. The cascade of intervention became the norm.

The babies don’t like today’s way of birth.

When things go according to their expectations, they come out with the most beautiful triumphant look on their faces. Today, many come out looking confused, bewildered, or frightened. My hope is that if enough people understand the baby’s point of view, we will again see more of those lovely expressions.

Babies are my passion. They have only one birth, and it should be as safe and as pleasant as we can make it.

Optimal Foetal Positioning is not a new concept. The origins of it can be found in old midwifery text books or by talking with midwives who trained as apprentices with older, wiser and more experienced midwives. What has changed since the days of apprentice-trained midwives, is that our contemporary lifestyle has meant that mothers are at risk more than ever before. At the same time, childbirth wisdom from our past has almost disappeared. As midwives seek independence and recognition as the specialists of normal pregnancy and birth, ways to decrease the rate of medicalised labour are in everyone’s interest. The concept of OFP is very timely in our present climate of financial restraint and increasing reliance on technology.

Babies who commence their journey in the optimal position make the birth process an exciting adventure, rather than a harrowing experience for all involved.

Find out how to use your body to help baby into a good position for an easier and safer birth. We’ve had some feedback from those who have used the pillow during their labor and each of them have had fast and natural births.

[wpvp_embed type=”youtube” video_code=”66xH1M1sOw4″ width=”640″ height=”360″]

Common Sense and CoSleeping

Source: Tales of a Kitchen Witch, By Joni Rae
Date: 16th November 2012Cosleeping is not the devil. Is it dangerous? Yes. But so is sleeping in a crib. Do we still use them? Of course. The key is common sense. Something we sorely lack in this world.There are safety measures you have to take no matter where your baby sleeps. To put your baby in a crib you have rules. Common sense rules like no heavy blankets, pillows, toys, bumpers, gaps in the mattress, bars of a certain width, etc.

Cosleeping has safety rules too: do not drink or smoke before bed, sleep on a firm mattress or futon, no heavy blankets or pillows, don’t sleep with the baby if you have sleep apnea or if your bed is too small, put your mattress on the floor, etc.

It isn’t “cosleeping” that causes death, its the unthinking parent that goes to bed tipsy and rolls over onto the baby, or the parent that hasn’t bothered to take a good look at their fluffy bedding. Or the parent that doesn’t cosleep at all- their baby is in a crib thank you very much but one night they are so exhausted and at their wits end and bring baby into their bed, only to have tragedy strike because they aren’t used to baby being there.

So why all the attention? Money, I’m sure. The studies you see being thrown around in the news are skewed. No! Surely not. That never happens, right? These campaigns aren’t about the safety of our babies. These campaigns are about you buying cribs. According to the Ask Dr. Sears website:

“Who is behind this new national campaign to warn parents not to sleep with their babies? In addition to the USCPSC, the Juvenile Products Manufacturers Association (JPMA) is co-sponsoring this campaign. The JPMA? An association of crib manufacturers. This is a huge conflict of interest. Actually, this campaign is exactly in the interest of the JPMA.”

Wow. So the people telling us we have to buy cribs are the people that sell the cribs. I have four children and I’ve NEVER bought or used a crib. (Except for Cooper, who spends part of the night in his p&p but that is a different story.) I know lots of people that are the same. This isn’t about “raising awareness” or “getting us talking about it” or the health and safety of our children. It is about getting you to buy a crib.

Here are some real statistics according the The Baby Bond’s Fact sheet:

Number of U.S. births year 2000: 4,058,814

Total infant deaths year 2000: 28,411
Age birth to 1 year. (6.9 per thousand)

Number SIDS deaths year 2000: 2,523
Defined as death with unexplained cause, birth to 1 year.

Total suffocation deaths year 2000: 1,000

Number of crib-related “accidents”/yr: 50

Number of playpen-related deaths/yr: 16

Number deaths/yr attributed to overlying: 19 Most are only “suspected.”

Number of babies (0-2) dying in night fires/yr: 230 Many of which may have been retrievable if next to parent, not in another room of home. This is true for abductions and other night dangers as well.

Number of deaths/yr in adult beds reported as entrapment/suffocation between bed and wall, headboard, or other furniture, on waterbed, in headboard railings, or tangled in bedding: 18 With side-rail: 1 That’s 19 of the 60.

Number of deaths/yr reported as suffocation of unknown cause in adult bed: 13

These would be SIDS if in a crib. Remember, these do not necessarily involve cosleeping.

Number of deaths/yr in adult beds from prone sleeping: 5

Again, these are considered SIDS in cribs, and they are preventable in adult beds, as in cribs.

4/yr died not from falling out of adult bed, but from suffocating (pile of clothes, plastic bag) or other danger (such as drowning) after falling out.

13% of U.S. infants are routinely cosleeping with nearly 50% sharing bed for part
of the nights.
National Institute of Child Health and Human Development 2000 Survey.

“Why does our nation rank only 42nd in infant survival?* in the industrialized world (some non-reporting nations are thought to rank better than us as well)? Our difference from the best-ranking nations is a high predominance of formula feeding, isolated sleep, and medical intervention. The highest cosleeping/breastfeeding nations rank with half our overall infant death rate (and negligable SIDS rates). Remember we rank #1 in medical intervention.”

So is cosleeping dangerous? Yes, if done without care or thought. So think. Use the mind that the creator (whoever she/he is) gave you and think about what you are doing with your babies. Don’t blindly follow trends or advice from ads plastered on bus shelters. Do research and make informed decisions with a big dollop of common sense tailored to your own little family’s needs.

You might be interested in our own article: “Some Shocking Facts About Cot Death (Sudden Infant Death Syndrome, SIDS)

Sleep comfortably next to your baby with the Mumanu Pillow

Mumanu_Postnatal_Pillow_cosleeping

Why I no longer believe babies should cry themselves to sleep

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Source: Globe and Mail by GABOR MATÉ
Date: Feb. 04 2006’Some of our friends see us as weak parents because we haven’t Ferberized our children,” says my niece Rachel Maté, a 33-year-old Vancouver lawyer and mother of two. ” ‘You’re letting your baby control your lives,’ they argue. But it would break my heart to let my baby cry without comforting her.”Named after Dr. Richard Ferber, the pediatric sleep expert quoted in a previous 2006 article on parents who share their beds with their children, Ferberization is the process of “training” an infant to sleep by ignoring her crying. As a family physician, I used to advocate the Ferber technique and, as a parent, practised it myself. Since then, I have come to believe that the method is harmful to infant development and to a child’s long-term emotional health.

Ferberization seems simple: “After about one week, your infant will learn that crying earns nothing more than a brief check from you, and isn’t worth the effort. She’ll learn to fall asleep on her own, without your help,” reads Dr. Ferber’s advice. The question is, what else does a baby learn when treated this way and what is the impact of such learning?

People cannot consciously recall what they “learned” in the first year of life, because the brain structures that store narrative memory are not yet developed. But neuropsychological research has established that human beings have a far more powerful memory system imprinted in their nervous systems called intrinsic memory. Intrinsic memory encodes the emotional aspects of early experience, mostly in the prefrontal lobe of the brain. These emotional memories may last a lifetime. Without any recall of the events that originally encoded them, they serve as a template for how we perceive the world and how we react to later occurrences.

Is the world a friendly and nurturing place, or an indifferent or even hostile one? Can we trust other human beings to recognize, understand and honour our needs, or do we have to shut down emotionally to protect ourselves from feeling vulnerable? These are fundamental questions that we resolve largely with our implicit memory system rather than with our conscious minds. As psychologist and leading memory researcher Daniel Schacter has written, intrinsic memory is active “when people are influenced by past experience without any awareness that they are remembering.”

The implicit message an infant receives from having her cries ignored is that the world — as represented by her caregivers — is indifferent to her feelings. That is not at all what loving parents intend.

Unfortunately, it’s not parental intentions that a baby integrates into her world view, but how parents respond to her. This is why, if I could relive my life, I would do much of my parenting differently.

When the infant falls asleep after a period of wailing and frustrated cries for help, it is not that she has learned the “skill” of falling asleep. What has happened is that her brain, to escape the overwhelming pain of abandonment, shuts down. It’s an automatic neurological mechanism. In effect, the baby gives up. The short-term goal of the exhausted parents has been achieved, but at the price of harming the child’s long-term emotional vulnerability. Encoded in her cortex is an implicit sense of a non-caring universe.

The concepts behind Ferberization precede the publication of Dr. Ferber’s 1985 bestseller Solve Your Child’s Sleep Problem. Forty years earlier, Benjamin Spock proposed the very same approach in his seminal book Baby and Child Care. The cure for what Dr. Spock called “chronic resistance to sleep in infancy” is straightforward. The way to ensure that the infant doesn’t “get away with such tyranny,” he wrote, was to “say good night affectionately but firmly, walk out of the room, and don’t go back.”

Dr. Spock was a great pioneer of humane and loving child rearing and much of his advice refuted the harsh Victorian practices prevalent in his days. On this sleep issue, however, he ignored his own admonition that parents should trust their own instincts and gut feelings and not defer to the opinion of experts.

Monica Moster, an 80-year-old grandmother of seven, recalls what it felt like for her to follow such advice with her own children. “It was torture for me to do it,” she says. “It went against all my motherly emotions.”

Rachel Maté reports that even some of her friends who believe in Ferberization have a hard time of it. “I know women who have to stand in the shower with their hands over their ears so they can’t hear their baby crying. It’s traumatic not just to baby, but also to parent.”

In our stressed society, time is at a premium. Beholden to our worldly schedules, we try to adapt our children to our needs, rather than serving theirs. More “primitive” aboriginal peoples in Africa and North and South America kept their infants with them at all times. They had not yet learned to suppress their parenting instincts.

The baby who cries for the parent is not engaging in “tyranny,” she is expressing her deepest need — emotional and physical contact with the parent. The deceptive convenience of Ferberization is one more way in which our society fails the needs of the developing child.

Vancouver physician Gabor Maté is the co-author of Hold On To Your Kids: Why Parents Need to Matter More Than Peers.

New Thinking on Risky Pregnancies

Bed rest may not be the answer for risky pregnancies
Source: The Wall Street Journal. Your health.
July 15th, 2013Studies show bed rest doesn’t alleviate complications, and could cause other problemsDoctors increasingly are recommending pregnant women limit their activities if they are at risk for complications, rather than resorting to the traditional approach of resting in bed.

Remaining in bed for extended periods has long been prescribed for women who are at risk for preterm delivery labor or have high blood pressure, bleeding or other complications. But studies have failed to turn up evidence that bed rest improves these conditions. And some research has shown that being confined to bed can cause health risks of its own, including blood clots and a temporary loss of bone-mineral content.

Bed rest is “not healthy, it’s not helpful and it’s potentially detrimental,” said Michael Katz, chief of obstetrics at California Pacific Medical Center in San Francisco. “It’s something I’m staying away from more and more.”

So why do many doctors continue to recommend bed rest? As many as 20% of women in the U.S. are placed on bed rest in the latter half of pregnancy, according to some estimates. Experts say some practitioners fear liability if a complication arises and the doctor didn’t take action. And some mothers want to feel they are minimizing risks to their unborn babies.

Dr. Adam Wolfberg says bed rest can help some women overcome fears.

“I think that bed rest is something women can do that makes them feel better in the incredibly powerless situation they find themselves in when facing a loss or preterm delivery,” said Adam Wolfberg, a specialist at Boston Maternal-Fetal Medicine. Dr. Wolfberg said he agrees there isn’t evidence that bed rest is beneficial, but he believes it can make a woman feel better and that it is unlikely to hurt.

Some doctors say they will only recommend full bed rest in extreme circumstances, such as advanced cervical dilation to the point when other measures haven’t helped, or the premature rupture of a membrane.

The controversy underlying bed rest was highlighted in May with the publication in the journal Obstetrics & Gynecology of a study and editorials that cast doubt on or criticized the practice. The study found that restrictions on activity by women who had a short cervix—which increases the risk of preterm birth—didn’t result in fewer preterm births than those who had no restrictions. The study, supported by the National Institute of Child Health and Human Development, part of the National Institutes of Health, analyzed data from a previous trial of about 650 women. About 252 of the women said they had been placed on activity restriction or bed rest.

The American Congress of Obstetricians and Gynecologists issued a bulletin to members last year on preterm labor, which affects about 12% of births and is defined as birth before 37 weeks. “Although bed rest and hydration have been recommended to women with symptoms of preterm labor to prevent preterm delivery, these measures have not been shown to be effective for the prevention of preterm birth and should not be routinely recommended,” read the bulletin.

Other studies have found detrimental effects to bed rest. A 2010 study in the American Journal of Obstetrics & Gynecology that reviewed previous research said that women placed on bed rest had a 19-fold increased chance of getting deep-vein thrombosis, or a blood clot in a deep vein, usually in the lower part of the body, said Anne Lyerly, associate director of the Center for Bioethics at the University of North Carolina, Chapel Hill.

Dr. Lyerly, who co-wrote one of the editorials in the May issue of Obstetrics & Gynecology, called the practice of prescribing bed rest unethical. In her editorial, she cited a 2011 review of previous research that said bed rest can also result in bone demineralization and muscle atrophy, and cause psychological effects, such as depression and increased stress levels. The review, published in the journal Expert Review of Obstetrics & Gynecology, cited earlier studies including one that found pregnant women on bed rest had a bone loss of 4.6% compared with 1.5% for those who weren’t.

Some doctors say they are increasingly recommending at-risk patients limit their activity rather than go on bed rest. They may tell patients to rest more or avoid strenuous exercise or long walks. “The modern woman is going to say, ‘Can I go to yoga? Can I go to the gym? Can I still work 60 hours a week?,'” said Adam Romoff, associate chairman of obstetrics and gynecology at Lenox Hill Hospital in Manhattan. “We still should be careful about whether these patients should be going to the gym or taking long walks. I think we should negotiate 20, 30 or 40% off the top as far as physical activity goes.”

Taking a Load Off

 

Nearly 1 in 5 women are put on bed rest at some point during pregnancy to safeguard against complications, some experts estimate. Bed-rest regimens can vary, depending on the degree of pregnancy risk.

  • On modified bed rest, a woman might need to limit her activities for a period of time. It might be OK to move around the house, and even continue working. But heavy tasks, such as housework and lifting children, should be avoided.
  • Strict bed rest might require remaining in a sitting or reclining position most of the time. Getting out of bed might be permitted only to shower or use the bathroom.
  • With total bed rest, typically recommended for the riskiest pregnancies, women might need to lie on their side at all times, even when eating. Personal hygiene is often limited to sponge baths and a bedpan. Some women require hospitalization.

Source Mayo Clinic

Connie Fong, a patient of Dr. Katz at California Pacific Medical Center, was put on strict bed rest in the hospital during her first pregnancy in 2011 after losing a baby the previous year. For 10 weeks, she was restricted to a bed and was wheeled outside on a gurney to get fresh air for one hour a day.

“It became a physical and mental challenge,” recalled the 35-year-old resident of Menlo Park, Calif.

Still, she felt the bed rest was warranted given that she was showing signs of preterm labor. In the end, Ms. Fong didn’t deliver the child early, and her son is now 23 months old.

Ms. Fong currently is expecting her second child in a couple of months. She is on modified bed rest, working from home three days a week to avoid the commute to her job in San Francisco. She can’t lift anything more than 10 pounds and tries to lie horizontal as much as possible. Still, she says the restrictions are far easier, both psychologically and physically, than her last pregnancy.

Never let babies sleep in seats out of car – research suggests dangers

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Never let babies sleep in seats out of car – researchers suggest dangers in baby car seat sleeping. I think most parents leave a sleeping baby in the car seat for fear of waking them. It’s important to never leave a baby unattended in a car seat…Source: New Zealand Herald, By Martin Johnston
Date: 16th July, 2013Babies should never be allowed to sleep in car safety seats when the seat is not in a car, researchers say after a new study showing a link to decreased oxygen levels.

Dr Christine McIntosh and her colleagues have also warned that babies’ time in car safety seats should be kept to a minimum, after the latest findings in their long-running research.

The researchers, from Auckland University and the Cot Death Association, have previously shown a reduction in mild breathing problems in babies whose car safety seat was fitted with a simple foam insert with a slot for the back of the head.

Babies’ heads are larger, relative to the body, than adults’ heads, and protrude behind the line of the back.

The commercially available insert helps to keep the baby’s body forward. It also allows the head to remain upright even when the infant is asleep, rather than slumping forward, which can obstruct breathing when the chin is on the chest and pushed back.

A larger study, published today in the prestigious United States journal Pediatrics, confirms that using the insert does reduce breathing risks for babies who were on average 8 days old, but it does not eliminate the seats’ risks.

Comparing sleep studies in two groups each of 39 babies, the researchers found those whose car safety seats had the inserts had fewer instances of stopping breathing because of a blocked airway, and had less severe reductions in oxygen saturation levels than the non-insert group.

But there was no difference between the two groups in the number of moderate reductions in oxygen saturation levels per hour.

“Even reducing severity of the fall in oxygen levels is important and is a good indicator that the insert did help make babies safer,” Dr McIntosh said.

“This study also highlights the importance of not using car seats as a place of sleep for infants. Sudden unexpected deaths in infants can occasionally occur in car seats [and] capsules.”

In their journal paper, the researchers note car safety seats are essential for infants’ safe transport in cars but they express concern at the reported high rates of infants spending more than 30 minutes a day in a car seat, “often for sleep out of the car as well as for transport”.

“There is now compelling evidence that hypoxia [oxygen deficiency] is associated with behavioural problems and adverse effects on development and school performance.

“Furthermore, car seat use has been associated with apparent life-threatening events and with at least some otherwise unexplained sudden deaths in term infants.

“We believe that caregivers should be strongly advised that car seats should not be used for infant sleep outside the car.”

Even when the insert is used, the researchers say, young infants should never be left unattended in car safety seats. “Car seat use should be restricted to the minimum time required for essential travel.”

 

Do you have any tips on keeping baby asleep while you transfer them from the car seat to a cot?

 

I was pregnant for 10 months

The idea that pregnancy becomes dangerous after 42 weeks, making induction essential, is out of date.
Source: The Guardian, by Viv Groskop
Friday 1 October 2010

Viv Groskop with Jack, born 20 days late: ‘I knew what I was doing and was happy with my decision.’ Photograph: Felix Clay for the Guardian
Jack, my third child, arrived last month, 20 days late. My first two babies were 15 days late. But a day shy of week 43? That is virtually record-breaking – and, some would say, slightly mad. For the last week I barely left the house. I knew what I was doing and was happy with my decision. But I didn’t want to hear what anyone else had to say about it. (Especially if it was: “Have you tried eating curry?” Yes. About 57 times.)In the US there are women like me who call themselves the Ten Month Mamas. The Mamas used to have an online resource – sadly now defunct – which featured the stories of dozens of women who had gone past 42 weeks, some of them as far as 48 weeks. (Many of the most extreme examples were Mormon – some with more than half a dozen children.)Historically, tales of weirdly overdue babies are not unprecedented. The actor Jackie Chan claims his mother carried him for 12 months before he was born by caesarean section, weighing 12lb. There is also a story of a woman in a prisoner of war camp who allegedly waited until the camp was liberated to give birth – at 12 months’ gestation.

But maybe these claims are not so odd when you remember that the average pregnancy is actually nearer 10 months than nine. So if you give birth at 43 weeks, you are heading towards 11 months anyway.

I held out as long as I could, but in the end Jack was induced. I wish it could have been otherwise. The day before he was born, the hospital consultant had made it clear that she didn’t agree with me remaining pregnant for a day longer. Despite the fact that there were no signs that there was anything wrong, there was a risk of stillbirth, she said. “How does that apply to this pregnancy in particular?” I asked, as all my tests were clear. “You’re very overdue,” came the answer. I could have waited another day or two maybe. But I wasn’t happy acting against the hospital’s wishes.

The induced labour was not a terrible experience – Jack was born with no complications in 50 minutes – but it was not ideal. I had wanted him to come out when he wanted to. Not when a doctor ordered him to. It turned out that he was large, but not abnormally so (8lb 12oz; his sister was larger at 9lb). And he had no signs of being post-dates: no wrinkly skin, and the amniotic fluid was clear. I wasn’t sure he was really that late at all.

So why is 40 weeks seen as the norm when only 5% of babies arrive on their due date – and when it is 41 weeks in France? Could we be inducing babies who don’t need to be induced – exposing both them and their mothers to unnecessary risk?

The US midwifery guru Ina May Gaskin thinks so. She believes that every baby will come in its own time, and she is currently campaigning for 43 weeks – rather than 42 – as the definition of “late”. The dates in themselves, says Gaskin, do not indicate the need for induction. There are clear signs if there is something wrong and the baby needs to come out: reduced foetal movement, for example, a deceleration in growth, or reduced amniotic fluid – all of which could be picked up by the mother or a midwife.

In recent years the ultrasound dating scan at 12 weeks has been seen as the best measure of due date in the UK. Statistics suggest it is marginally more accurate than the traditional LMP (last monthly period) date. The latter method, known as Naegele’s rule, dates back to 1838. It is based on the idea that human gestation lasts 10 lunar cycles (nine months plus seven days) and assumes that every woman has a monthly cycle of 28 days where she ovulates on the 14th day.

The trouble is that very few women fit the “average” – hence the huge variation in the dates when babies are born. Seventy per cent arrive after their due date. And yet it has become a fixed point by which we measure everything in pregnancy. Meanwhile, induction rates in England are rising – albeit very gradually – up from 18.3% of babies in 1990 to 20.2% last year.

Hannah Latham, 36, a writer from Bristol, was 18 days overdue when she gave birth to Noah, now six weeks old. “I do wish they could give you a ‘due window’ of three weeks instead of a due date,” she says. “It becomes very stressful. You have all these people hassling you, saying, ‘Isn’t he here yet?’ Because, of course, you tell everybody your due date. Which in future I wouldn’t do.” Latham consented to an induction in the end because an ultrasound scan showed that the amniotic fluid was starting to run low.

“Until then there was no good reason to induce. But they pressure you from when you are a week overdue. They say to you, ‘Are you aware that you are putting your baby at risk?’ I said, according to what statistics? They said, ‘We don’t know.'”

This is the problem with overdue babies: there is very little evidence because so few women allow their pregnancies to go past 42 weeks. As US midwife Gail Hart points out, the most-cited statistic about post-dates babies (that their risk of stillbirth “doubles after 42 weeks”) comes from a 1958 study – a time when mortality rates were 10 times what they are now. Also, as Hart argues, induction is hardly risk-free: it carries higher rates of caesarean section, uterine rupture, foetal distress and maternal haemorrhage.

These risks were what put me off induction. Home birth was also a factor, as it is for many: if you agree to induction, it has to happen in hospital. This usually means you end up being monitored, wired up to a machine to measure the baby’s heart rate, and you will have to deliver flat on your back. Having given birth twice, I know that I cope best if I am free to rampage around the room. Because my midwife knew me very well (by coincidence she had delivered my second baby at home), she helped me to stand and move around, while still being monitored. I was lucky – this is not standard practice.

Fear of intervention is the main reason women resist induction. The British website www.homebirth.org.uk features women who have given birth past 41 weeks, the latest at 43 weeks plus six days, and many of the mothers talk of being “reluctant to interfere with nature”.

Joanne King’s second baby was born at 43 weeks plus three days. She writes: “I explained [to the consultant] that I thought the risk of being induced versus carrying on with the pregnancy – when the baby and I were well – was not one worth taking. She agreed with me.”

But for other pregnant women the desire to see their baby safe and sound is too much to bear. They would rather just get induced. “Most women are very impatient,” says Mervi Jokinen of the Royal College of Midwives. “And it is a mental strain: you are getting bigger, you are not sleeping well, you want to see your baby. Most women are not negative about induction by the second week [overdue] and some ask to be induced well before that.”

The latest baby Jokinen delivered was 44 weeks gestation. “As a midwife you know if a baby is truly post-mature by the state of the skin. It’s drier and flakier. They look like someone who has been in the water too long.” But according to one American study [cited by Gail Hart in Midwifery Today], more than 90% of supposedly “late” babies born at 43 weeks in fact show no signs of post-maturity.

Gaskin argues that in the US there is a new medical complication, “iatrogenic” (“doctor-caused”) prematurity – “inductions where babies turn out to be premature and then spend a week or more in the neonatal intensive care unit”. She says in four decades of experience and thousands of pregnancies, she has seen only one woman who needed to be induced. “We’ve had experience with many Amish families in which 43-week pregnancies seem to be the norm.”

To most hospitals, Gaskin adds, a lack of symptoms – and the patient’s history – is irrelevant: “This habit of making absolute rules that are applied to cases that used to be open to individual treatment has contributed to the dumbing down of maternity care.”

This is true in the UK too. I couldn’t understand why my doctor was not interested in all the heart monitoring (every two days after 42 weeks) – and all perfect – or in the ultrasound scan. Nor was there any interest in my birth history (two late babies and fast births, which I thought made me a poor candidate for induction). All that mattered were the statistics – from 1958.

So would Jack eventually have come out himself safely? I’ll never know. As Jokinen puts it: “This is the thing. Some babies come out ‘late’ and they are perfectly OK. And you wonder what was wrong with the dates.”

Why do you sit me up?

Source: Moverse en Libertad
26 may, 2013 by adminfreeimage-2155693-highI never liked the idea of sitting up babies early in life. In the beginning my reasons were more related with musculoskeletal issues, specifically to avoid stress in bones and joints that are still developing and consequently not prepared to support weight. Today I still advocate against sitting up babies but my reasons have changed, and now I think more about emotional and cognitive development, sensory nutrition, and growing up as active human beings. Let me explain further.

fuente autobiografia.blogspot.com

Sitting up our babies early in life is not a new practice in our society. Back in the 1950s the paediatrician Emmi Pikler already described how unnatural this common practice was and how those babies who were exposed to that posture early in their life showed a completely different posture in comparison to those babies who were raised up following the freedom of movement concept. She found that those babies were more likely to be tense and look as they had “swallowed a broomstick”. This kind of muscle tension is an understandable reaction to an unbalanced situation where the trunk is expected to keep a vertical position even though it has not had much time exercising antigravity muscles in previous postures such as tummy time (when the baby is rolling by himself). Thus, adults impose a posture that the baby is not able to achieve on his own and, in consequence, interfere with the normal developmental sequence of that child.

A couple of years ago, I did a lecture in Chile about the “Freedom of movement and Emmi Pikler’s approach” to physiotherapists, early childhood teachers, and students. I asked: When do children sit up by themselves? There was a range of answers: some of them said between 4 and 5 months, others said 6 months and some said 8 months. The only clear thing about the answers was that it was not clear at all. To answer this question, we need to start by asking if we all have the same understanding of what it means to “sit up”.

I can sit!

We need to analyse what we mean by “sitting up”, because there are significant differences between keeping that posture and reaching that posture. Let’s examine this further. When a baby manages to keep sitting up when an adult puts him in that position, it is because he has experienced this posture several times and is able to sort out the imbalance and keep the position. Nevertheless, if that baby falls over, he is not able to regain the position on his own. On the other hand, when sitting up is a posture that babies build from their own motivation and sensorimotor resources derived from exploring with their bodies, it does not require practice or teaching and is part of a chain of milestones that are inherent in our genes as a species. In general, a baby sits up by his own after rolling, twisting, and crawling, and this usually happens around nine months.

DSC02478

Therefore, respecting the developmental process of our babies means that we support and encourage their self-motivated exploration and avoid listening to the comments of other adults who will not hesitate to judge this practice as delaying our child’s development. From my professional and personal experience, I truly believe that a child who is not made to sit up by an adult in his early days and is, to the contrary, able to explore the world at his own pace, is a baby who will develop active movement earlier. He will be able to roll and become aware that if he rolls two times he can get something he likes, so he will be ready to move around a long time earlier than starting to crawl or walk. At the same time, and as a direct consequence of not being put in a position he is not able to keep, we have a child who feels secure and content in his own body and builds the awareness of active embodiment in space. As a result he develops more and more complex relationships with his environment and becomes an active explorer of the world.

When a child is made to sit up by an adult early in life, his exploration abilities are restricted by the imbalance and he will probably need constant assistance during his play; someone who will give him the toys and also give them back when they fall from his hands. Moreover, he will probably complain more often, reacting to what happened in his environment. A baby who explores from his own motor abilities will not need this constant assistance as he is able to do things by his own or is flexible enough to change his mind if he is not able to reach something he wants. That is probably why Emmi Pikler called one of her books “Peaceful babies, contented mothers”.

ID-10033740

In addition, if a baby is made to sit up early, his legs become a static part of the posture rather than being active as in rolling or crawling, skipping some very important milestones in his life. This lack of activation contrasts with the active and flexible legs of a baby who moves around, and a brain which is receiving constant sensory information from muscles, joints, touch and vestibular system. As a result, the baby who is in movement will have a more complex map of his body in his brain.

fuente www.waldorftoday.com

We could go on with many more reasons about why we should avoid sitting up our babies early in life, but perhaps another important thing we should keep in mind is… What is the rush? If we think about how much time this baby will spend sitting in his life, it will probably, similar to our own experience – i.e., too much time. So again, what is the rush?…better to give them the opportunity to actively discover the environment that surrounds them. As adults, we do not need to teach them how to move, we just need to trust in their own abilities and observe them unfold their full potential.

*Many thanks to David Moore from The School for FM Alexander Studies in Melbourne who generously edited my first translation.

Some Shocking Facts About Cot Death (Sudden Infant Death Syndrome, SIDS )

cot_death_SIDS_statistics
There has been a BBC story doing the rounds on Facebook about why Finland has such a low cot death rate (also known as Sudden Infant Death Syndrome, SIDS). It got me thinking about the global statistics of SIDS and how/if it’s different for each country. I was really shocked at what I found.Below are the statistics for SIDS from a 2004 WHO report. Unfortunately I’ve not been able to find any other up to date global statistics on SIDS. Interestingly (and annoyingly) the report ranked each country by the number of deaths per year. Obviously the USA, with such a huge population, ranked as the highest place for babies to die of SIDS (China and India were not included). But when I compared the number of deaths per country by the birth rate and how many babies are born there was a completely different picture.I was totally shocked to find that New Zealand ranked number one with the highest rate of recorded SIDS in the world! In fact babies are nearly twice as likely to die in New Zealand than they are in America! What is it that this peaceful, developed country is doing that makes it so much more dangerous for babies to sleep compared to El Salvador with all their drugs and gang related problems where they have the lowest recorded SIDS rate in the whole world?

I was also really surprised to see that in 2004 the UK was the safest place for babies to sleep in the western world at a 0.004% SIDS death rate. However, according to a BBC article, in 2010 254 babies died of SIDS. That’s 222 more babies dying than just six years previously. I wonder how correct all of these statistics are?

According to the WHO statistics more than 99.8% of babies all over the world will NOT die of cot death (SIDS). I always believed the rates were high and every baby was in danger. However, looking at the statistics below I really can’t figure out what is actually making the difference. How can there be such a big difference between all these countries?

Going back to the BBC article about Finland we can see that actually in 2004 babies were six times more likely to die there than in the UK. There is such a huge difference in the size of the population so when you look just at the numbers of deaths you can be very misled about the real picture. What is it that the UK is doing so much better than all the other westernised countries?

Looking at the statistics you will also notice that the poorer the country the safer babies sleep. Could this be to do with CoSleeping, breastfeeding, vaccinations, toxins in the water, the family unit, or maybe even genetics? But maybe all or none of these?

There is still a huge debate about what causes a baby to die in their sleep. It’s possible that for every baby that dies there is some one thing that has actually caused it no matter where in the world they are. We just don’t know yet. It does seem that the UK is doing something right, maybe something as simple as lying a baby on their back will stop the trigger from causing their death. Maybe it’s something else.

If you have more up to date statistics please will you let me know as I would like to do a more recent analysis.

Take a look at the summary table below and see just how much difference there is in a country’s ranking when considering their population… What surprises you most about this?

Table of Statistics: Rate of SIDS including population and birth rates 2004 (pdf)

Rank by Birth Rate
Nationmaster.com Rank by number of deaths
Countries
Amount of Cot Deaths (SIDS) 2004 Percentage of Cot Deaths
# 1 # 15 New Zealand: 62 0.114%
=2 = 32 Latvia: 17 0.074%
=2 = 42 Belize: 6 0.074%
# 4 # 8 Chile: 144 0.064%
# 5 # 1 United States: 2,523 0.063%
# 6 # 2 Germany: 429 0.062%
# 7 = 50 Barbados: 2 0.059%
# 8 = 23 Uruguay: 26 0.057%
# 9 # 49 Luxembourg: 3 0.056%
# 10 # 16 Paraguay: 56 0.053%
# 11 = 50 Malta: 2 0.049%
# 12 = 44 Qatar: 4 0.047%
=13 # 5 Argentina: 303 0.045%
=13 = 19 Austria: 32 0.045%
# 15 # 10 Australia: 103 0.042%
# 16 = 44 Bahrain: 4 0.041%
# 17 = 29 Norway: 20 0.040%
# 18 # 9 Canada: 121 0.036%
=19 # 3 Japan: 363 0.034%
=19 # 31 Denmark: 19 0.034%
=21 # 22 Sweden: 28 0.030%
=21 # 35 Kuwait: 14 0.030%
=21 = 36 Croatia: 13 0.030%
=21 # 39 Lithuania: 10 0.030%
=25 # 21 Nicaragua: 30 0.029%
=25 = 44 Estonia: 4 0.029%
# 27 = 53 Iceland: 1 0.026%
# 28 = 13 Ecuador: 65 0.025%
# 29 = 36 Finland: 13 0.024%
# 30 # 28 Hungary: 22 0.023%
=31 # 11 Korea, South: 87 0.021%
=31 = 53 Bahamas, The: 1 0.021%
=33 # 7 South Africa: 164 0.020%
=33 # 27 Israel: 24 0.020%
=35 # 12 Spain: 70 0.017%
=35 # 34 Czech Republic: 15 0.017%
# 36 = 29 Kyrgyzstan: 20 0.016%
# 37 = 25 Netherlands: 25 0.014%
# 38 # 6 Mexico: 261 0.013%
# 39 # 41 Slovakia: 7 0.012%
=40 # 4 Brazil: 318 0.011%
=40 # 18 Poland: 43 0.011%
# 42 = 32 Dominican Republic: 17 0.010%
=43 = 42 Costa Rica: 6 0.009%
=43 = 44 Puerto Rico: 4 0.009%
=45 # 40 Cuba: 8 0.007%
=45 = 44 Moldova: 4 0.007%
=47 # 17 Colombia: 45 0.006%
=47 = 53 Slovenia: 1 0.006%
=49 = 23 Venezuela: 26 0.005%
=49 = 25 Peru: 25 0.005%
=49 # 38 Romania: 11 0.005%
=52 = 13 Egypt: 65 0.004%
=52 = 19 United Kingdom: 32 0.004%
# 54 = 50 Panama: 2 0.003%
# 55 = 53 El Salvador: 1 0.001%

Mumanu_Postnatal_Pillow_cosleeping

The pillow that gives you the most comfortable night’s sleep. Ideal for CoSleeping, breastfeeding while side lying and anyone with lower back and hip pains. www.mumanu.com