Infections & Essential Oils

Yeast, Thrush & Candida

Candida infections of the nipples may occur at any time during the breastfeeding relationship. Candida albicans is the culprit for both yeast infections and thrush. It likes warm, moist, dark areas and normally lives on the human body, but when the skin breaks down, yeast can become a problem. Achieving the best latch possible is the best prevention for troublesome yeast. An asymmetrical latch is the goal, with more of the underside of the areola in the baby’s mouth than areola above the nipple. The nose does not usually touch the breast. Infection can sometimes occur following antibiotic use as the good bacteria has been wiped out, allowing Candida to overgrow.sucking thumb

Typical Symptoms

Nipple pain that begins after a period of pain-free nursing is often indicative of yeast. Burning nipple pain that continues throughout the feeding, sometimes continuing until after the feeding is over, is also a classic sign of yeast. Pain in the breast, often described as “shooting” or “burning,” even “glass in my breast” radiating through to the mother’s back and shoulder are also quite common. Pain may be worse at night, may only be in the breast and not on the nipple, and may improve with use of gentian violet.

Diagnosis

There is no good test for diagnosing a yeast infection on or in the breast. A positive culture is costly and does not prove your pain is due to Candida. A negative culture does not prove your pain is not because of Candida. The experienced clinician makes a diagnosis based on history of the problem and a thorough breastfeeding assessment.

Treatment of Yeast

Gentian violet (GV) is often the first step in treating yeast on the breast. It is messy and will stain clothing. Your baby’s lips will turn purple, but the color will disappear in a few days. Gentian violet is available at most pharmacies without prescription. Call around before making the trip. Two teaspoons is more than enough for an entire treatment. Paint the inside of your baby’s mouth to cover as much as possible and then nurse, so your nipples are also treated. Apply once a day for 4 to 7 days. If pain is gone after 4 days, stop the gentian violet. If there is improvement but not resolution, then continue treatment another 7 days. Stop after the seventh day either way. If there is no improvement at all in 4 days, stop the gentian violet and call your midwife.

Your midwife may prescribe a topical all-purpose-nipple-ointment for treating topical yeast as well, which can be taken in between the applications of gentian violet. Grapefruit seed extract (not grape seed extract), 250 mg three times a day, can be taken orally by mother or it can be applied on the breast. Simply apply the diluted liquid on the nipples, then apply the all purpose nipple ointment prescribed by your midwife after each feeding. (Mix five to ten drops in one ounce of water and apply to nipples and areola with a cotton ball. Let dry a few seconds and then apply the all purpose nipple ointment. Use until pain is gone.)

If none of these steps are successful your midwife may prescribe fluconazole (Diflucan), an antifungal the mother takes by mouth. Fluconazole does pass into your milk, as it should, helping rid any yeast baby may be harboring. It may be that your midwife needs to prescribe fluconazole for your baby as well to reach appropriate levels for therapeutic treatment. The safety profile of fluconazole in infants and children is excellent. For deep breast pain, ibuprofen 400 mg every four hours may be used until definitive treatment is working (maximum daily dose is 2400 mg/day).

Natural Remedies for Thrush

Use up to three capsules of acidophilus (Lactobacillus acidophilus) three times daily. Babies may be treated with acidophilus diluted in breastmilk swabbed in their mouths, or you can dip a finger in the powder and let the baby suck. The intent of acidophilus treatment is to rebalance your body, so don’t expect instant results. Sometimes lactobacilli need a bit of help getting hold in the intestines, and some practitioners recommend FOS (fructo-oligo-saccharides) to enhance colonization.

Apply ¼ cup white distilled vinegar in 1 cup water topically to the breast. If this is too strong, you can use a dilution as weak as 1 tablespoon in 1 cup water. Allow to air dry, and do not wash off before nursing unless baby protests. This should be done at least four times a day and continued for two weeks after all symptoms are gone. Taking baths with vinegar in the water will allow the treatment of more than one source at a time. Distilled vinegar is important as the distillation process destroys any active fungus spores. Yeast cannot survive in the pH environment that is created by the vinegar, which is why making a paste of baking soda in water and swabbing the baby’s mouth at least four times a day may also be beneficial. Practice caution with baking soda as it shouldn’t be swallowed.

A strong immune system booster that may be lacking in the mother’s and baby’s intestines if they have had antibiotics is nonyeast-based vitamin B complex. Zinc is another immune system booster. Take 45 mg per day. Vitamin C can be taken to the point of having loose stools and then reducing the dosage a bit. Since vitamin C is water soluble, it must be consumed throughout the day. Echinacea capsules or tincture can be taken simultaneously to boost the immune system.

Increasing dietary garlic may be helpful, but clinically effective doses are easier to get if you take triple-strength deodorized garlic tablets (three tablets, three times daily for two weeks or more). The liquid, cold-pressed, aged garlic is thought to be the most potent. Kyolic is the brand about which the most conclusive research has been published. Note: ginger and cinnamon reportedly have antifungal properties, but there is less research in this regard.

Apply olive oil topically to breasts after each feeding. Olive oil contains linoleic acids, which are antifungal and may cut off the yeast’s oxygen supply. Caprylic acid, when taken orally, has strong antifungal properties; take to three capsules three to four times per day for two weeks (or 1 gram at meals). Citrus seed oil is a strong, but natural, antifungal, antibacterial, and antiviral substance. It can be used topically but must be diluted. Try 10 drops in ¼ cup water swallowed at once, twice daily. Tea tree oil is thought to have antifungal properties; a few drops may be added to bathwater or diluted and applied to the breast. The bath method may also be used with vinegar, and has the added benefit of helping clear the sinuses.

Take either 1 to 2 grams dried barberry bark or 1 ½ teaspoon of tincture (1:5), or 250 to 500 mg of powdered extract, three times a day. Although very bitter, golden seal is very affective at clearing yeast. Consume either 1 to 2 grams dried bark or 1 ½ teasponse of tincture (1:5), or 250 to 500 mg of powdered extract, three times a day. Caution: rapidly dying yeast can cause intestinal gas.

Pau d’arco is an antifungal tincture with a long history of use in developing countries. Take 20 to 30 drops four times a day. Warning: it tastes horrible. Maitake tea is an antifungal tea that also helps to rebalance the intestines; drink the strongly brewed tea throughout the day for two weeks (4 to 6 cups a day). Soak plantain seeds overnight in warm water and apply the resultant gel topically. Lecithin can be taken orally. Take two 250 mg gel capsules, three times per day, or the equivalent in lecithin granules sprinkled on foods. Deep massage of any plugged ducts with arnica oil as a lubricant supplements this treatment. Massage while baby nurses, taking advantage of gravity.

Household Decontamination

Boil all artificial nipples that the baby uses or simply throw them away. Change breast pads at each feeding. Go without a bra. Use soap and water, avoid antibacterial soaps. Temporarily use disposable diapers. Spray ¼ cup distilled vinegar to 1 cup water to moist body areas (pubic areas, armpits, under folds) four times a day. Get a new toothbrush for everyone in the family. Avoid cornstarch powders and deodorant. Eliminate damp laundry hampers, wet windowsills, and moist bathtubs with 10-percent bleach solution or white distilled vinegar in water. Clean floors, baseboards and walls the same. Wash laundry in the hottest water possible and then add a cup of distilled vinegar to the final rinse. Boil underwear, cloth diapers and sheets for five minutes. Boil toys baby chews on or put in the dishwasher if water is over 130 degrees, with vinegar in the rinse cycle. Use paper towels for hand drying and a fresh towel after each shower.

Baby Wearing

It wasn’t until my last few babies that I discovered the brilliance of the ring sling baby carrier and I honestly can’t imagine mothering another child without one close at hand, especially the ring sling made for me as a generous gift by Rixa Freeze.

How do you choose your baby carrier?

They come in a large variety of styles, fabrics, and colors and most mothers seem to own a few variety. You might choose one to keep in your car for outings, or another as a back-up in the event you have some sort of baby leak (or explosion). Some mothers choose them specifically to match their wardrobe, or a special occasion. Either way, your baby carrier can be both functional and attractive. The options are quite honestly, a bit overwhelming. Visit your local baby wearing group to learn and experiment with several different types of carriers, or try on-line forums for suggestions.

Choosing a sling is dependent on the age and size of your child.

Carriers are made for front wearing, hip wearing, or back. Most can be used from birth until they toddler away. We encourage mommas to connect with their local baby wearing group to discover the many options and trial the wide variety of carriers, or browse online forums for recommendations.

Wraps

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A simple strip of cloth makes an elegant and comfortable baby sling. A little learning is required to wrap and tie the cloth, but basic methods can be mastered in minutes. Wraparound slings can be short, for quick one-shoulder carries, or longer, to distribute the baby’s weight evenly over two shoulders and the caregiver’s torso and hips. Wraparound slings come in a variety of fabrics, but natural fabrics such as cotton, linen, hemp, wool, and silk are more breathable and have a more appropriate texture than synthetics. Some wrap-around slings are specially woven to have exceptional performance as baby carriers, offering strength, breathability, just the right amount of diagonal stretch, and the right texture for holding the baby securely. Wraps are an optimal and versatile carrier from birth.

The Red Raspberry Boutique carries a number of Moby Wraps.

Ring Slings

In its simplest and most elegant form, a ring sling is a shawl with a pair of rings attached to one end. The rings replace the knot or tuck-and-twist method of fastening used with traditional shawl carriers such as Mexican rebozos or Indonesian selendangs. Some ring slings have padding where the sling rests on the caregiver’s shoulder or along the edges of the sling, and some depart further from traditional shawl carriers by having the fabric at the end of the sling folded and stitched into a rope-like tail. Ring Slings are an ideal newborn carrier and are also fantastic for the up-and-down toddler phase.

Mei Tais

The modern take on a traditional Chinese baby carrier with a body panel, shoulder straps, and waist straps still carries the traditional name, “mei tai” (pronounced”may tie”). The new-generation mei tais typically have either wide, padded shoulder straps, or extra-wide, wrap-style, unpadded straps for the wearer’s comfort. They also offer a variety of features such as headrests or sleeping hoods for the baby, pockets for diapers or other essentials, and fabric choices that range from strictly utilitarian to truly luxurious. Mei tais can be used from birth and are ideal for sharing among caregivers.

Soft Structured Carriers

These carriers have a body panel, and shoulder and waist straps to redistribute weight and over an overall different look than the mei tai. Its soft structure is also unique from the framed carriers, allowing baby to lie securely against the wearer’s body. Unlike frame structures as well, these soft carriers are appropriate from birth through toddlerhood, but are most appreciated after four to five months.

Our clients are largely baby-wearers, but we do get questions occasionally about how to do this safely. True to any other event in one’s life, there are practices that are important to consider in effort to maintain a safe and satisfying experience. Most importantly, whatever carrier you choose, learn to use it properly and always be mindful of its weaknesses.

What about hip health?

Manufacturers of baby carriers are provided information by a medical advisory board to guide them in developing products that are safe for hip health. Parents and caregivers are encouraged to choose a carrier that allows for health hip positioning, specifically, hips should be allowed to spread apart with the thighs supported and the hips bent.Baby carriers and hip dysplasia

Consider the number of months babies have spent in the fetal position with their hips flexed. It takes many months for this ball and socket joint to relax, but poor positioning during the first few weeks can cause flexible little legs to become misaligned and ultimately result in hip dysplasia. The risk is certainly greater during the first few months of life, and because there is no real pain associated, this condition may go unnoticed until the little one attempts to walk.

The most unhealthy position for the hips during infancy is when the legs are held in extension with the hips and knees straight and the legs brought together, which is the opposite of the fetal position. The risk to the hips is greater when this unhealthy position is maintained for a long time. Healthy hip positioning avoids positions that may cause or continue to development of hip dysplasia or dislocation. The healthiest position for the hips is for the hips to fall or spread (naturally) apart to the side, with the thighs supported and the hips and knees bent. This position has been called the jockey position, straddle position, or the frog position. Free movement of the hips without forcing them together promotes natural hip development.

Further information about hip dysplasia can be read here at the International Hip Dysplasia Institute.

Great Importance

  • Be sure baby can breathe. Little ones can droop down into a position that compromises their airway, so while having your arms free is very convenient, don’t loose sight of the need to be observant of your baby’s positioning. Babies should not have their head and face covered. They need fresh air and you need to be able to see them.
  • Don’t jog in your baby carrier. Don’t jump on a trampoline. Don’t roller-skate. Don’t ride a horse, climb a ladder, or ride a bicycle with a baby in a carrier on your chest or back. Yes, it had to be said. Don’t ride a motorcycle or use your baby carrier while driving in the car, or even while riding as a passenger. Not only will all these scenarios cause damage to your baby’s neck, but an air bag in a vehicle can be deadly.
  • Identify the appropriate age and weight for the carrier you have chosen. Frame backpacks for example, are useful for hiking with older babies and toddlers, but aren’t so fabulous for little ones.

General Guidelines

  • Don’t use a carrier unless it is structurally sound. If your dog has chewed on it or a strap became tangled in the washing machine, use it for scrap material but don’t put your precious baby in it and expect it to remain secure.
  • Protect your little one from the elements. Consider a safe sun protection cream, sunglasses and a hat. In the winter, wear the carrier on the inside of your coat and wrap them within it.
  • Be aware that babies may reach for things you aren’t aware of which could be harmful to them, or expensive in a retail store.
  • Cooking and wearing your baby in a carrier is not so wise. They can easily be burned by splatters that were not expected.
  • When boating, baby should wear his or her own floatation device.

Please share with us your thoughts about baby-wearing, the pros and cons. Do you have a favorite carrier? Suggestions?

101 Things TO Say to an Over Due Momma!

You look so healthy! Do you have middle names picked out? Have you had any cravings? Where will your first trip with your baby be? I’d love to take your kids for a day after the baby is born.  Let’s go get a pedicure, on me!  Would you like me to bring you a meal?  Are you able to get a nap everyday?  Would you like me to weed your garden?  Do you have any last minute things you’d like me to help you take care of?  Have you read any good IOL:Postdatesbooks lately? How big do you think this baby is going to be?  Do you want to go have lunch, my treat? Here’s a great novel I thought you’d like to read. Where does your baby kick you the most?  Before you know it you’ll be holding your baby in your arms. Would you like a massage? I made you a CD of songs my baby really liked. Are there any family birthdays you’re hoping to avoid birthing your baby? I am available for childcare if you need me.  Do you have a breastfeeding book?  Here’s a couple of nursing nightgowns I thought you could use.  Can I fold laundry or vacuum for you?  Are you sure you’re eating enough chocolate?  I’m here to wash your dishes.  What’s your sweetest childhood memory?  Do you ever see a chiropractor?  Do you have a baby sling? I am here for you if you ever need to call and just talk. You are going to be a wonderful mother. I love your hairstyle.  You make pregnancy look easy! I made this casserole since I know it is your favorite. Have you been nesting? It should be called a “guess date,” don’t you think? What is the one thing you will miss most about pregnancy? Do you have a doula? Have you had a prenatal massage? A great website you might enjoy is www.spinningbabies.com. Would you like to go on a walk with me? I have a lot of back issues of this magazine, would you like them?  What do you like to do to pass the time? Besides being a mom, what are you most looking forward to after this baby is born? I bet you are looking forward to sleeping on your belly again, huh? What is your favorite pregnancy reference book? Have you thought about having a blessing-way? What is most interesting pregnancy dream you’ve had? Have you seen any good movies lately? I bought these flowers for you. I’ve heard that avocado is a good first baby food. How many brothers and sisters do you have? Have you been keeping a pregnancy journal? What was your favorite part of your baby shower? Do you have a favorite book that was read to you as a baby? How did you find out you were pregnant?  Did you have a lovey you liked to cuddle with when you were little? Do you have someone to come help you with house chores after the baby is born? Have you ever thought about having a water birth? Your sixth! Your kids must be so excited! Won’t it be neat to see if your baby has hair or not?  Do you have any pets to introduce this baby to? Does your hair always look so shiny when you’re pregnant? Is this your first baby? Have you been able to spend plenty of quality time with your husband? Does you baby get the hiccups? Do you have everything you need for the baby?  Will this be a first grandchild? What has been your favorite part of being pregnant? Do you know how much your husband weighed when he was born? Isn’t it fabulous that we have cell phones now to reach our husbands when labor starts? Are you going to have photos taken during your birth? Won’t your baby’s first [fill in the blank] be so sweet? I LOVE your shoes! Has your husband had any sympathy pregnancy symptoms? Do you have a favorite author? Here is a list of scriptures I read to help me prepare for labor. How many pillows do you use to get comfy at night? Do you need me to run any errands for you? Have you tried the body pillow?  Have you made a belly cast? Have you tried henna on your belly? Do you have your names picked out yet? Did you find out the gender or are you going to be surprised? Is this pregnancy different than your previous pregnancies? What is the one thing that excites you most about being a mom? Have you been able to enjoy some special time with your kids before the new baby comes? I love your maternity outfits.  Where did you get them? It’s true what they say about pregnant women having a glow! What do you like to do to help you relax? Have you been able to swim at all?  It can be very relaxing. I’ve organized a food chain for you so you don’t have to think about what to make for dinner after for a few weeks after the baby is born. You are doing such a great job of being patient! You look radiant! Are you going to use cloth or disposable diapers? Aren’t you thankful we don’t carry our babies as long as elephants?! What theme did you choose for the baby’s nursery? Who do you think your baby will look like? Have you been photographing your belly as it grows? What do most people guess the gender to be? Will this baby have any older cousins? Isn’t it great that babies are born right when they are ready?

Doctor Seuss for Nursing Mothers

Would you nurse her in the park?

Would you nurse him in the dark?

Would you nurse him with a Bobby?breastfeeding logo infotext

And when you boobs are feeling floppy?


I would nurse him in the park,

I would nurse her in the dark.

I’d nurse with or without a Bobby.

Floppy boobs will never stop me.

 

Can you nurse with your best dress on?

Can you nurse from dusk till dawn?

Though she may pinch me, bite me, pull,

I will nurse her ‘till she’s full!

 

Can you nurse and make some soup?

Can you nurse and feed the group?

It makes her healthy strong and smart,

Mommy’s milk is the best start!

 

Would you nurse him at the game?

Would you nurse her in the rain?

In front of those who dare complain?

I would nurse him at the game.

I would nurse her in the rain.

 

As for those who protest lactation,

I have a perfect explanation.

Mommy’s milk is tailor made

It’s the perfect food, you need no aid.

 

Some may scoff and some may wriggle,

Avert their eyes or even giggle.

To those who can be cruel and rude,

Remind them breast’s the perfect food!

 

I would never scoff or giggle,

Roll my eyes or even wiggle!

I would not be so crass or crude,

I KNOW that this milk’s the perfect food!

 

We make the amount we need

The perfect temp for every feed.

There’s nothing compared to milk from breast-

The perfect food, above the rest.

 

Those sweet nursing smiles are oh so sweet,

Mommy’s milk is such a treat.

Human milk just can’t be beat.

 

I will nurse, in any case,

On the street or in your face.

I will not let my baby cry,

I’ll meet her needs, I’ll always try.

It’s not about what’s good for you,

It’s best for babies, through and through.

 

I will nurse her in my home,

I will nurse her when I roam.

Leave me be lads and ma’am.

I will nurse her, Mom I am!

Postpartum Depression

Postpartum depression

has been described as a thief that robs a mother of precious time with the baby she has anticipated throughout her pregnancy. As many as one in ten mothers experience this devastating mood disorder during the first twelve months following childbirth. Postpartum depression or PPD impacts not only mom, but her husband, her newborn, her older children and her extended family.

Women are often too intimidated to share feelings of depression. We are expected to be joyful, so shame and fear prevent depressed mothers from seeking help early.  Although PPD can occur at anytime during the first twelve months following childbirth, most women are affected during the first three months. Often symptoms last six months or longer. The greatest determinant in how long depression lasts is how long mothers wait in seeking adequate treatment.

Crying WomanPPD research and awareness has focused a great deal on the mother; however, researchers are recognizing that fathers too, are victims of postpartum depression.  Nine percent are affected at six weeks postpartum, and five percent at six mRaonths.

We don’t yet know what causes PPD, although suspect it is a combination of many circumstances. The hormone fluctuations following birth are truly overwhelming to scientists, as most women can clearly identify. Stress is also a contributing factor. Lack of sleep and breastfeeding difficulties also play a significant role in PPD.

Distinguishing Postpartum Depression from the Baby Blues – The baby blues are experienced by 80 to 85% of postpartum women. Symptoms are short lived and mild, ceasing in one to two weeks. Women are still able to function day to day, although may cry occasionally. Irritability, anger, insomnia, exhaustion, tension, anxiety, and restlessness are common to the baby blues.

Postpartum depression is the same as the baby blues, but worse. The symptoms do interfere with the ability to complete daily tasks and lasts six weeks or more. These women need to seek professional help and get into a support group. Panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder and psychosis can also occur in postpartum women.

postpartum depressionCoping with the Baby Blues – Expectations of new mothers are often far from realistic. Moms that find the greatest joy in the early postpartum months often have a sink full of dirty dishes and days of laundry piling up! Ask for help.

Go outside. Every single day spend at least a few minutes outside with your baby. The fresh air is absolutely vital to both your health. If “baby blues” do not improve after a couple of weeks or you begin to feel worse, contact your midwife.

Postpartum Depression and the Breastfeeding Mother – The breastfeeding relationship can only be enhanced by treatment of postpartum depression.

Believe Midwifery Services has several books in its lending library specific to postpartum depression, including the highly recommended Natural Health after Birth, by Aviva Jill Romm.

Treatment

When symptoms are mild to moderate, alternative therapies such as Interpersonal Therapy, cognitive therapy, exercise and/or supplementation with omega-3 fatty acids can prove beneficial. Omega-3 supplementation in particular has recently demonstrated exciting results. The vast majority of American women are deficient in omega-3s. This is especially true for pregnant and lactating women because of the demands placed on the mother’s supply of omega-3s for baby’s needs. Altering diet plans to gain necessary nutrients is the preferred method of addressing deficiencies; however, the unfortunate truth is that fish have become toxic due to mercury contamination. Pregnant women are unlikely to consume enough seafood safely to achieve the antidepressant effect. Fortunately, supplements in fortified foods are tested for contaminants and are safe for pregnant and breastfeeding women.

Contaminant-Free Sources of EPA/DHA

200-400mg of DHA is the minimum recommended dose to prevent depression

1,000-2,000mg EPA for treatment of depression (usually in combination with medications and/or DHA)

Figs, sprouts, royal jelly, bee pollen, Ginseng, Hops, and Sarsaparilla help the body process and balance hormones. Breastfeeding is probably the best cure for depression, as the process helps moderate hormone swings.

An infusion of lemon balm leaves, mellowed with milk and honey, every day for a week or two can reduce melancholy, hysteria and depression. Drink a cup or two each day.

 

Beck, C.T. (1999). Postpartum depression: stopping the thief that steals motherhood. AWHONN Lifelines, 3(4), 41-44.
Lin, P.Y. & Su, K.P. (2007). A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry, 68(7), 1066-1061.

Tips for Talking to a Pediatric Provider about Vaccinations

The topic of immunizations can be emotional – and confusing – for parents and healthcare providers caring for children. Many parents have heard horror stories about the dangers of vaccinations; many providers have been rigorously educated about the frightening consequences unvaccinated children suffer. Mutual understanding is therefore essential.

ImmunizationWhile many providers would prefer to vaccinate all children, many are increasingly sensitive to parent’s concerns about childhood vaccinations. Many agree that it is better to provide some childhood vaccines than none at all. The most unfortunate circumstance would be pushing parents into a position in which they turn their backs on medical care altogether.

In response to growing concern by parents regarding childhood vaccinations, the American Academy of Pediatrics (AAP), whose guidelines are followed by pediatric and family physicians as well as pediatric nurse practitioners, has encouraged providers to engage in a respectful conversation with parents concerned about immunizations rather than disregard their worries. Providers are encouraged to listen carefully and respectfully to parent’s concerns, recognizing that parents may not use the same decision criteria as the provider and may weigh evidence differently than does the provider.

The AAP advises pediatric providers to help parents make the best possible decisions based on the child’s unique circumstances, working with the parents to create a vaccine schedule and choice of vaccines with which they can feel comfortable. While the AAP recommends the full, conventional vaccine schedule, according to the AAP guidelines, children should not be penalized by loss of medical care based on their parent’s decisions.

Here are 10 tips for easing the immunization conversation with your child’s healthcare provider: 

  1. Interview pediatric providers (pediatric nurse practitioners, family practice doctors, chiropractors, naturopaths, and pediatricians) BEFORE you have your baby to find a like-minded provider for your child. If you already have a provider but cannot come to a respectful agreement about vaccinations, it may be better to find another provider. Good quality communication is vital.
  2. Start with the mindset that such provider chose the pediatric profession because s/he loved children and genuinely has their best interest at heart. Even expressing this appreciation as you approach questions and concerns about vaccines might help the practitioner feel less threatened as you ask more challenging questions.
  3. Request an appointment with the practitioner simply to discuss vaccinations prior to when the recommended schedule would begin. This provides plenty of opportunity to explore options and share convictions, without having to rush through an already busy well-child visit.
  4. Share with the practitioner that you desire a partnership with him, appreciating this will optimize your child’s care.
  5. Respectfully and calmly, rather than emotionally, share your convictions whether that might be using an alternative schedule, delaying the start of vaccinations, or omitting some or all.
  6. Ask the provider how familiar they are with alternative schedules, and what alternative schedules they recommend and support.
  7. If have you specific questions about one or two of the recommended vaccines, or several, whether in regard to ingredients, schedule, recalls or negative associations, explain this clearly. Share that you would like to give most of the vaccines, if this is true, and be clear about which you would like to omit.
  8. Many physicians will provide a written waiver for declining various vaccines. Read this closely and be sure it doesn’t place you at risk of being found negligent by a third party, such as Child Protective Services. Protecting the provider from liability should not come at the cost of putting yourself at risk as the parent.
  9. Ask your child’s provider for information on what signs and symptoms to look out for in the event your child is exposed to a communicable disease.
  10. Welcome an on-going conversation about vaccines, but respectfully ask that you not be pressured about your decisions at each visit.

 

The current CDC recommendations for scheduling childhood vaccines can be found here.

Fit for Two: Postpartum Exercise

Exercise is really a non-negotiable. You must do it if you want to remain healthy and feel great. This is no different following the birth of your baby. Exercise will help give your muscles tone and strength, and rebuild your energy. Start the very first day after birth but go slowly and let your body guide your progress. If you have an increase in postpartum bleeding, you are probably going too fast.

birth ball fitness

Do these exercises every day, three to five times each day. After some time, you may increase this to ten times, three times a day.

The Kegel Exercise helps build up the muscles of the pelvic floor and vagina. Tighten the muscles in your vagina and pelvis – the same ones used to stop and start the flow of urine. Hold this while you count to ten. Relax. Do these five times every two hours at first. After the first day, you may try this five times every hour and keep increasing each day.

Deep Breathing Exercises can help tone your abdominal muscles. Lie down on your back with your knees bent. Rest one hand on your stomach. Slowly and deeply breathe in through your nose so that your hand rises up. Breathe out slowly through your mouth. Feel your hand go down.

Prone Positioning helps relieve back strain. It also helps your uterus return to its normal position. Lie on your belly and place a pillow under your hips. Relax.

Pelvic Tilts strengthens your abdominal and back muscles. Lie down on your back with your knees bent. Tighten your stomach and buttock muscles. You should feel the small of your back push against the floor.

After three or four days, you can increase the level of exercise. Do each of these four or five times in a row, twice each day.

Three or four days after your baby is born you will need to check your abdominal muscles. These muscles, called the abdominal diastasis, separate during pregnancy so your abdomen can expand with the growth of the baby. Lie down on your back with your knees bent. Press your fingers from one hand firmly into the area around your belly button (navel). Slowly raise your head up as you breathe out. This will make your muscles pull toward the middle of your abdomen. If you can fit three or more fingers between these muscles, you will need to work on their tone before doing more exercises.

Modified Curl-Ups will help you strengthen these muscles. Lie down on your back with your knees bent. Cross your hands over your abdomen to help pull your abdominal muscles toward the middle. Slowly raise your head while taking a deep breath. Breathe out slowly and gently lower your head. It may take ten days to two weeks to correct diastasis. Until then, do not do exercises which rotate your waist or bend your body to one side.

Leg Slides help strengthen abdominal and leg muscles as well. Lie on your back with your knees bent. Slowly straighten your legs. When your back starts to arch, bend your knees, one at a time, to starting position.

Advance your exercises when you can no longer fit more than two fingers in the diactasis separation. Do each of these exercises four or five times a day. Slowly work until you can do three sets of ten, twice each day.

Straight Curl-Ups – Lie on your back with your knees bent. Slowly breathe out while reaching your hands toward your knees or placing them under your hips. Lift your head first. Then let your upper body follow. Do this exercise slowly. DO NOT JERK.

Diagonal Curl-Ups – Lie on your back with your knees bent. Reach your arms across to your opposite knee. Hold your chin against your chest as you bring your upper body forward. Hold this position for a few seconds. Slowly uncurl your body and relax. Do this same exercise, and reach toward the other knee.

Short walks outside or at the mall are a great form of exercise for you as well. Walks can also help improve your mood and be a special time to share with your baby.

fitness gal

Do not do any exercises that cause pain. If you have any questions, be sure to ask your midwife.

Natural Cold & Flu Remedies

flu and coldNatural remedies are our primary and almost exclusive recommendation for seasonal ailments. We encourage our clients to educate themselves and prepare ahead so they are equipped when and if they face these exceptionally inconvenient circumstances.

Although the common cold or influenza can be extremely debilitating during pregnancy, it should not be a threat to you or your baby. If you have a prolonged fever or particularly high fever however, you should consult your nurse-midwife or medical practitioner.

Recommendations for Management

Rest alone, at the start of a viral or bacterial infection can help shorten its duration. 

Mouth breathing at night can dry out your respiratory system and if you have an illness, this is particularly irritating. A vaporizer or humidifier can improve symptoms, although avoid the “cool misters” as they are not only less effective, but can breed bacteria.

Some foods are best avoided during a cold, as they can actually create more mucous during a respiratory illness. The biggest offender, cow dairy. Milk, cheese, yogurt and ice cream can make mucous thicker and more abundant, coating the back of the throat creating a breeding ground for bacteria and viruses. Other foods that can contribute are wheat products and for some people, particularly children, citrus juices. Stay away from smoke.

Extra water is important for thinning secretions and eliminating bacteria. Aim for half your weight in ounces of water or a cup of fluid every two hours, even more if you’re feverish. Avoid alcohol, carbonation and caffeine. Warm fluids can encourage white blood cell activity, enhancing healing. A Lemon-Ginger Echinacea drink can be found in most health food stores, or a glass of water with honey and lemon can be soothing.

Saline nose sprays are made of salt water, similar to your body’s own fluid, and can help moisten your nasal passages, clearing mucous and bacteria. If you can pry the top off the bottle, adding 5 drops of Grapefruit Seed Extract can greatly enhance its anti-bacterial effect. Don’t share nasal sprays and throw them away after an illness. Resist over-the-counter medicated nasal sprays as they are addicting in as little as three days.

Echinacea is an herbal supplement that is believed to boost the immune system to help fight infections. Tincture form seems to work better than capsules. When sick use 2-3 droppers full in about 1 ounce of water or juice, taken 3-4 times each day. If you are using it as a preventative, use 1-2 droppers full once a day, for one week a month during the winter. Evidence suggests echinacea as a safe pregnancy option.

Some studies support zinc as an antiviral. This mineral apparently helps prevent the formation of certain proteins the cold virus requires to reproduce. It doesn’t appear to prevent colds but can shorten the duration of a cold and reduce the severity when taken within 24 hours of the onset of symptoms.

Dilute grapefruit seed extract into the saline nose spray, 5 drops in 1.5 ounce bottle, or gargle with 10 drops diluted in about 1/2 cup of water. Grapefruit Seed can also be taken orally (10 drops to 1 cup of water or juice) 2 to 4 times each day. There is also a pill form which you’d take as directed on the bottle – less if just feeling like you’re getting sick, more if you’re already sick.

Vitamin C can both reduce symptoms, shorten the duration of a cold, and one study suggests it can even prevent colds. The suggested dose is 250mg every 2 to 4 hours if you are sick, with the maximum daily intake of Vitamin C for adults is 2,000 milligrams. If you have loose stools, take less frequently.

Grandma was a smart woman. Chicken soup may help cold symptoms in more than one way. Inhaling the steam can ease nasal congestion. Sipping spoonfuls of fluid can help avoid dehydration. And some advocates say the soup may soothe inflammation. Researchers have also found chicken soup to have anti-inflammatory properties.

tea kettle w flowerDrinking hot tea offers some of the same benefits as chicken soup. Inhaling the steam relieves congestion, while swallowing the fluid soothes the throat and keeps you hydrated. Black and green teas have the added bonus of being loaded with disease-fighting antioxidants, which help fight colds. Try lemon balm, chamomile, or elderflower and, in moderation, ginger or dried yarrow. However, avoid yarrow during the first trimester.

Garlic has long been touted for legendary germ-fighting abilities. Some take garlic capsules, others swallow garlic cloves whole, and still others favor garlic lemonade. Simply boil water for lemonade and then seep four or five cloves for twenty minutes within the water. Remove cloves and mix in freshly squeezed lemon juice and honey. Take with vitamin C for an additional boost.

If you are experiencing sinus pressure, there are a few tricks that can offer relief.

Craft a bean bag, or make a simple version with rice in a tube sock. Leave enough room to tie a knot at the ankle. Heat in the microwave and place over your sinus area while you rest. The Red Raspberry Boutique offers a nice bean bag with flax seed, rice, rosemary, camomile, lemon grass, and lavender flowers.

An ounce of dry rosemary or 3 drops of rosemary essential oil in a pot of boiling water can help open sinuses. Stir and cover 5 minutes, then take off the heat and sit over the steam, breathing it in. You can put a towel over your head to hold the steam in, but be careful not to get burned.

Pressure points can provide relief for sinus pressure as well. Massage the inner corners of your eyebrows, the middle of your eyebrows and the cheekbones beside the opening of your nose. Press and massage for one minute for relief.

The Neti Pot, an invention from India, helps wash out mucous that you cannot blow out. Simply add warm water and pour through your nose, up one nostril and out the other. Using it every day lessons colds as it washes away viruses and bacteria before they have a chance to set-up residence in there.

A few tricks for chest congestion include Mullein leaf tea or tincture, massaging pressure points on your chest where your ribs attach to the breastbone, and kelp 1-2 every few hours with a glass of water.

Sore throats can be relieved with elderberry syrups or lozenges, slippery elm lozenges or sprays which can help numb, and a salt water gargle (one teaspoon of salt per cut, gargle, letting the water get as far back into the throat as possible).  The Red Raspberry Boutique offers slippery elm Throat Coat tea, as well.

If your ears feel congested, blocked or ache a little, use Olive or Lavender oil Ear Drops (diluted in olive oil). Do not use if eardrum is perforated or you have ear tubes.

Allergies are yet another reason many suffer the above symptoms. Natural remedies and some of the food eliminations mentioned below can greatly relieve symptoms.

Pantothenic Acid (PA) which is a B Vitamin and Vitamin C with bioflavinoids has been suggested to assist those with allergies. Take 25-30mg of PA and 250mg of Vitamin C with bioflavinoids, three times a day, for the first three to five days, then as you notice improvement in symptoms, decrease to two times a day for three to five days, then try once a day. If a seasonal allergy sufferer, take these vitamins once or twice a week on the “off” season and when the “on” season approaches, symptoms should be controlled with either once a day dosing or even every other day.

Avoid diary foods, wheat and maybe even citrus. Try an elimination diet by taking out all of these foods for at least a month, and then add them back, one at a time. The fewer processed foods you eat, the healthier your body, the less you should experience allergy symptoms.

Important Reminder

Let your fever work. It is your body’s natural remedy for actively fighting colds and the flu by making your body inhospitable for germs. Endure a moderate fever for a couple of days to get better faster. Stay well hydrated. Call your provider if your fever is more than 101 if pregnant, and 104 if it doesn’t come down quickly with treatment while non-pregnant. In newborns 3 months or younger call their provider for any fever greater than 100.4. Children with a fever less than 102 usually don’t require treatment unless they’re uncomfortable.

Hirkani’s Daughters- a Book Review

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The title of this wonderful collection of memoirs comes from an Indian folktale, in which a mother’s love for her child is so strong that she escapes a walled city at night and climbs down a cliff in order to feed her child.  Though modern mothers may not often encounter these same sorts of geographic barriers to breastfeeding, cultural and societal cliffs do interfere for so many mothers wishing to give their milk to their children.

The book divides mothers’ personal stories by continent, but the memories shared are universal.  Mothers all over the world long to provide the nutritional and emotional benefit of breastfeeding while still contributing financially to their family.   Jennifer Hicks points out in her introduction that women have always worked and cared for their children, and that many women continue to work in both paid and unpaid jobs while nurturing children  all over the world.  This book compiles compelling memoirs of those who work outside the home and express breastmilk in all sorts of jobs all over the globe.  Mothers share their stories in their own words.  Particularly compelling were those of a Mexican housemaid who was encouraged to breastfeed by her employer (after having switched to formula) and the story of the mother of four who breastfed her last child after chemo and mastectomy.  With only her heart on her left side, she still nursed her baby with her remaining breast!

A beautiful collection, which also highlights public policy surrounding breastfeeding!  Recommended for anyone who has lactivist leanings, interest in public health, or who just enjoys reading the stories of women and their nursing babies around the world.  The push for maternal leave and positive workplace policy surrounding breastfeeding and milk expression  must continue in the US.  There is more work to be done!

 

 

Considering the Cost

Paying for maternity care out-of-pocket is a concept outside the comfort zone of many Americans. More than half of all births in Indiana for example, are covered by Medicaid. Our money pursepractice has discontinued our participation within the Medicaid program, however, and have ceased filing insurance claims with third party payers. Homebirth is certainly not mainstream, so as couples explore their options, considering the cost of homebirth is high on the list of discussion points.

The number one reason couples choose to birth at home is because they believe it to be the safest option (Boucher, Bennett, McFarlin, & Freeze, 2009). Unfortunately we live in a society in which our healthcare infrastructure demands the movement of patients through clinic visits with the efficiently of an assembly line and providers thrive best by securing those procedures which will return the highest dollar. Maternal and child health, however, suffers under these terms. Midwifery is the answer, but its model is juxtapose against the medical model and therefore, struggles to get a foothold within the current infrastructure. If the childbearing family seeks care that is time-intensive, education-rich, and intervention-free, they will need to personally invest.

Consider the cost one pays when they purchase their teenage child their first dependable car, or pay for the insurance to cover their young driver a single year. These expenses are both likely greater than the expense of securing the care of a nurse-midwife for the entire child-bearing year. Our maternity fee is a mere fraction of what parents pay for a single term at a private college, and one-fourth of what the average young couple pays for their wedding in the United States, not including the honeymoon or engagement ring.

A wedding is a single day. A term of college is but a few short months. A car may last ten years if one is lucky. The care of your midwife will last an entire lifetime. We do not apologize for our fees or not accepting insurance and Medicaid. In fact, we believe are fees are far too low for the standards of our society. Our nurse-midwife earns less than bedside nurses, and none of our staff have medical insurance. However, we each live within our means and we appreciate the autonomy to practice our passion. As expenses increase through the years, so will our fees. We challenge you to find a better investment for mom and baby, than midwifery care for the childbearing year.

Food for Thought

Food for Thought

"It is much more important to know what sort of patient has a disease than what sort of disease a patient has." Sir William Osler

Food for Thought

Happiness is underrated and critically important to health. Seriously! Unfortunately, many people just have no idea how to be happy. Aviva Romm

Food for Thought

Physicians simply do not have time to be what patients want them to be: open-minded, knowledgeable teachers and caregivers who can hear and understand their needs. Snyderman and Weil

Food for Thought #1

They say that time changes things. But you actually have to change them yourselves. Andy Warhol

Food for Thought

To think is easy. To act is hard. But the hardest thing in the world is to act in accordance with your thinking. Johann Wolfgang von Goether

Food for Thought

"Birth isn’t about avoiding one set of realities in favor of another. It’s about embracing all facets of birth--contradictory, messy, or unpleasant as some might be--as vital to the whole." Rixa Freeze PhD

Food for Thought

Why I appreciate being a certified nurse-midwife, as opposed to choosing another route for midwifery: I feel learning the science is vital so the art of midwifery is safe and effective. Dr. Penny Lane, nurse-midwife

Food for Thought

When the debate is lost, slander becomes the tool of the loser. Socrates

Food for Thought

To accomplish great things, we must not only act but also dream; not only plan, but also believe. Anatole France

Food for Thought

"Science and uncertainty are inseparable companions. Beware of those who are very certain about things. There are no absolute truths in biological sciences - only hypotheses... 'We need to train medical students and residents more in the art of uncertainty and less in the spirit that everything can be known or that it even needs to be known.'" Grimes (1986)

Food for Thought

American physicians are rewarded for doing things to patients, not for keeping them well. Grimes, 1986

Food for Thought

The false idol of technology. "Having a widget screwed into one's scalp has become an American birthright." Grimes, 1986

Food for Thought

"Between 1985 and 1987, a hospital instituted a successful program to reduce its cesarean rate. The rate fell from 18% to 12%, losing the hospital $1 million in revenues - no small sum in those days." Goer & Romano, 2012, p 37

Food for Thought

"Obstetricians are much more likely to perform a cesarean when they wrongly believe the baby weighs 4000 g or more based on sonographic estimates than when the baby actually weighs this much but the obstetrician did not suspect it." Goer & Romaro, 2012, p 35

Food for Thought

"If you play God, you will be blamed for natural disasters." Marsden Wagner (2006)

Food for Thought

An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you know and what you don't. Anatole France

Food for Thought #3

"Birth is not only about making babies. Birth also is about making mothers - strong, competent, capable mothers, who trust themselves and know their inner strength."

Barbara Katz Rothman PhD (1996)

Food for Thought #4

Believe there is always, always, always a way.

When you have exhausted all possibilities, remember this: you haven't. THOMAS EDISON

Food for Thought #5

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." Arthur Schopenhauer

Food for Thought #2

Yet you brought me safely from my mother’s womb and led me to trust you at my mother’s breast.

Psalm 22:9