CHEAT SHEET FOR PARTNERS
This is a brief list of ways to make a big difference for the woman who is breast feeding. Do one, some, or all, everything matters.
1. When the breast comes out, you run to get a big glass of something for her to drink. (Trust me, the minute the baby latches on, her throat will go dry).
2. Find (or buy) a low foot stool for her. (Rubbermaid makes a good one and Ikea has a cheap, functional one). Putting her feet on a stool brings baby up to the breast so she doesn’t have to hunch forward.
3. Watch her shoulders, if they are hunched forward, she’s not relaxed. Find some soft pillows to bring baby up higher or support her arms. She’ll forget about this so you keep on top of it.
4. Tell her what you authentically appreciate about her feeding the baby. E.g. Thank you for all you do to make our baby healthy. You look so beautiful when you’re feeding the baby., etc etc.
5. Put a snack beside her, she needs extra calories to produce milk. A plate of sliced apples, toast with almond butter, cheese and crackers, etc.
6. While she’s feeding, scan the environment she’s looking at. When she’s sitting, you’re moving. Empty the trash, clear the clutter, mop the dust bunnies, water the plants.
7. Give her a shoulder massage.
The partner being an active participant in the breast feeding support can strengthen the family. Please add your ideas in the comments section.
Gloria Lemay, Vancouver BC Canada
1. Start with giving the birthing woman antibiotics in high doses so that the baby develops candida (thrush) and colic. Then mix in a lot of stitches, either to repair the perineum or the lower belly/uterus.
2. Separate the mother and newborn. Make the mother walk a long distance (with her stitched body) to be able to see/feed her newborn.
3. Teach her that the best (and only) way to feed her baby is to sit upright in a chair
4. Discourage sleeping together as a family. Don’t let her know that lying down to nurse will enable her (and her partner) to get much more sleep.
5. Tell her that the baby is not getting enough milk and don’t give her the tools to increase her supply.
6. Scare her into thinking that her instincts about caring for her baby are not to be trusted and that she should listen to professionals for all things to do with her baby’s health.
Journal of the American Medical Association
JAMA Original Investigation | June 01, 2015
Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants FREE ONLINE FIRST
Stephen D. DeMeo, DO1; Sudha R. Raman, PhD2; Christoph P. Hornik, MD, MPH1,2; Catherine C. Wilson, DNP, NNP-BC, FNP-BC3; Reese Clark, MD4; P. Brian Smith, MD, MPH, MHS1,2
[+] Author Affiliations
JAMA Pediatr. Published online June 01, 2015. doi:10.1001/jamapediatrics.2015.0418
Importance Immunization of extremely low-birth-weight (ELBW) infants in the neonatal intensive care unit (NICU) is associated with adverse events, including fever and apnea or bradycardia, in the immediate postimmunization period. These adverse events present a diagnostic dilemma for physicians, leading to the potential for immunization delay and sepsis evaluations.
Objective To compare the incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death among immunized ELBW infants in the 3 days before and after immunization.
Design, Setting, and Participants In this multicenter retrospective cohort study, we studied 13 926 ELBW infants born at 28 weeks’ gestation or less who were discharged from January 1, 2007, through December 31, 2012, from 348 NICUs managed by the Pediatrix Medical Group.
Exposures At least one immunization between the ages of 53 and 110 days.
Main Outcomes and Measures Incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death.
Results Most of the 13 926 infants (91.2%) received 3 or more immunizations. The incidence of sepsis evaluations increased from 5.4 per 1000 patient-days in the preimmunization period to 19.3 per 1000 patient-days in the postimmunization period (adjusted rate ratio [ARR], 3.7; 95% CI, 3.2-4.4). The need for increased respiratory support increased from 6.6 per 1000 patient-days in the preimmunization period to 14.0 per 1000 patient-days in the postimmunization period (ARR, 2.1; 95% CI, 1.9-2.5), and intubation increased from 2.0 per 1000 patient-days to 3.6 per 1000 patient-days (ARR, 1.7; 95% CI, 1.3-2.2). The postimmunization incidence of adverse events was similar across immunization types, including combination vaccines when compared with single-dose vaccines. Infants who were born at 23 to 24 weeks’ gestation had a higher risk of sepsis evaluation and intubation after immunization. A prior history of sepsis was associated with higher risk of sepsis evaluation after immunization.
Conclusions and Relevance All ELBW infants in the NICU had an increased incidence of sepsis evaluations and increased respiratory support and intubation after routine immunization. Our findings provide no evidence to suggest that physicians should not use combination vaccines in ELBW infants. Further studies are needed to determine whether timing or spacing of immunization administrations confers risk for
the developing adverse events and whether a prior history of sepsis confers risk for an altered immune response in ELBW infants. http://archpedi.jamanetwork.com/article.aspx?articleid=2300376&utm_source=silverchair+information+systems&utm_medium=email&utm_
Source: this blogpost http://www.jeffereyjaxen.com/
Question from a mother:
Obviously our little guy is not getting circumcised (unless he decides he wants to when he’s older and can make that decision independently) but I was wondering how to go about cleaning him, moreso when he is a bit bigger, but like I have heard you are not supposed to pull the foreskin back, but surely at some point that will need to happen to clean in there right? I don’t want to hurt/harm him, but i want to make sure that area doesn’t get full of bacteria. What is your advice on this?
Answer from Gloria:
Oh, so glad you asked, Karin. Right now, and until he is about 4 years old, his foreskin is actually attached to the glans just as the fingernails are attached to the nail beds. You only clean what is seen. Never retract the foreskin or you could damage that natural attachment and don’t let any medical professionals do it either.
When he’s about 4, he’ll reach into his pants and find that “toy” and then he will start playing with it. (They continue that till about age 80). That is the only way that the foreskin should come back—the boy doing it himself. Most boys/men simply retract their own foreskin in the shower and rinse with plain water and replace the foreskin. That is all the cleaning that is needed. It’s very easy.
This is a link to the brochure that I give out to mother’s of boys as a pdf. http://www.nocirc.org/publish/4pam.pdf Congratulations on your new little son. Love, Gloria
Additional comment, June 12,2015 Bodies are designed for pleasure. Only a big meanie would deprive anyone of having fun with their own body. Part of my education on boys having fun with their toy came from my brothers. When we were little, my mom would plunk all 5 of us kids (we were 18 months apart in age) in the bathtub. My brothers would do very impressive tricks with their toys,– popping out the shiny purple surprise from inside the foreskin. There was no need for my mom to clean anything, All that bathtub play took care of things. Gloria
You’ll have to view this little two minute video of a mother deer giving birth to twins on FB by going to the date link below. Here’s a photo as a sneak peek. Gloria
Be sure to click on the highlighted DATE, not Debbie’s name.
Midwifery Care for the VBAC Woman
by Gloria Lemay
© 2001 Midwifery Today, Inc. All rights reserved.
[This article first appeared in Midwifery Today Issue 57, Spring 2001.]
Someone asked me recently what things are done differently with vaginal births after cesarean (VBAC) as opposed to a first baby. Midwives usually reply to this question with a reassuring, “Oh, we treat you normally,” but there are differences in the two situations that can be distinguished in midwifery practice.
The full history of the events leading to the cesarean is very important. With a VBAC client, ask her to get her operative record, nurse’s notes, anesthetist’s report, pediatric report—get all the records and go over them thoroughly. Often the couple did not get full or accurate information about what was going on. Sometimes there’s a little “clue” as to what went wrong that could help to prevent a cesarean from recurring. Sometimes there is a big chunk of information that didn’t get communicated. I saw one set of records where the only indication for the cesarean was the note from the obstetrician that “this woman is a natural childbirth fanatic.” Another set of cesarean records had no indicator whatsoever of why the woman received abdominal surgery when she had given birth at l9 years old. When she told her parents that the midwife was perplexed and could see no reason for the surgery, her father admitted to her that he had stayed in the visitor’s lounge all day and had been verbally threatening to the doctor: “If anything happens to my daughter, I’ll sue you!” This helped the daughter to understand what had happened to her and also helped her to be firm with her father that he was to be nowhere near her VBAC birth.
With VBAC births it is important for the midwife to work with the dad prenatally. A VBAC father is in a horrible position because, despite the fact that his wife had an operation and a long recovery, he still got a live wife and baby at the end of it all. VBAC dads are often “fantasy bonded” to the medical system and terrified of childbirth in general.
The good thing is that they listen very carefully and really know when the care is better and more thorough and when the practitioner is authentically on their team. I find that if the midwife talks to them very honestly, they can trust and be fully supportive when the birth time arrives.
If the woman has dilated past five centimeters in the first birth, I plan for it to be fairly fast—like any second baby. If the woman has not gone into the birth process or not dilated past five the first time, that’s all right, she’ll still give birth vaginally, but we have extra midwives on call to bring fresh energy if the others get discouraged or tired. We plan for it to be like going to two births in a row. The point that the woman reached in her first birth is often a psychological hurdle for her. If she dilated to six centimeters the first time, the news that she is seven or eight will be a relief and a breakthrough. One of our clients, a minister’s wife, said over and over again in her pregnancy: “I just want to feel what pushing is. If I only get to push, I’ll be happy. I just want to know what other women mean when they say they had to push.” She’d had a Bandl’s ring in the first birth process and the cesarean was done at five centimeters. We were praying that the complication wouldn’t repeat. She dilated smoothly and began to push. With each push she would exclaim “Thank you Jesus, thank you Jesus!” What a wonder it was to watch her push out the baby, a girl whom she named Faith.
All humans have a certain propensity to self-sabotage, and the VBAC woman must be on guard against her own defeating patterns. The midwife must be bold in pointing out ways that the woman is repeating dumb moves—there’s no place for us being “nice” if it will mean another cesarean. An example of this: If the woman had a cesarean with five support people, she will be cautioned to keep her VBAC private.
Privacy and quiet are a must, and we will be very forceful about setting up logistics before the birth so that the woman can birth in peace. In short, the VBAC is high priority because this woman’s whole obstetrical future rides on its success.
We show the couple lots of videos of beautiful VBAC births because one video is worth a thousand words. If you don’t have your own, purchase a copy of my dvd “Birth with Gloria Lemay” which shows a beautiful VBAC waterbirth. Art therapy is helpful in creating the environment before the birth day. I place a big sheet of drawing paper in front of the father and mother with lots of colored pencils and instruct them to, “Draw your birth cave” or, “Color your birth.” When they are finished, I write the date on the two drawings and put them away in my files. After the birth, we take them out and are amazed at the details that were drawn weeks before and later manifested in the actual birth.
I schedule longer appointments with VBAC women because they seem to need to obsess. I don’t have solutions to many of their fears but it seems to help to just be able to talk to someone who cares and understands. I usually also ask them to, “Tell me how you know that this time you’re going to have a vaginal birth?” The answers always amaze me. One woman said, “Because this time I’m not depending on my doctor or my midwives—me and my husband are going to have this baby.” I suggested that she give up depending on her husband, too. She looked terrified at that idea but I could see that she understood; she looked me in the eye and said, “Right!” That was the moment I knew she would do it. She’s had three water homebirth VBACs since then, and after each birth her first words were, “I did it.”
VBAC women are so grateful for the opportunity to birth normally that they are often shy to ask for the extra things that make a birth beautiful, such as a Blessingway ceremony or a waterbirth. The midwife must remember to offer and encourage the mother to think “really beautiful birth” rather than “bare minimum birth.” I find it helpful to ask, “This is the only second baby you will ever have—what would make it really special?”
The Day of the Birth
In my practice, no one gets induced in any way or gets pain medication. This policy is very important for all women but especially for VBAC women. If there is a small chance of uterine rupture, we must have everything on our side to prevent it (the rate of VBAC uterine rupture without induction is 0.4 percent or less than one in 200*). It is beyond my comprehension how anyone could give a VBAC woman misoprostol (Cytotec), oxytocin or castor oil or strip the membranes or use any other form of induction when that would triple her chance of having a uterine rupture.
I believe that VBAC women have longer, gentler births because Nature is compensating for the scar. There is no hurrying. I would be terrified to induce a VBAC woman but feel safe to attend her at home if her body is pacing itself naturally. We keep it in the back of our heads that the signs of rupture are stabbing pain, unusual bleeding, decels of the baby’s heart, or a peculiar shape of the abdomen but we don’t look for problems if they don’t exist.
We are especially careful with the birth of the placenta in a VBAC because there is a slightly increased chance that the placenta might be adhered to the scar, and we do not want to have a uterine prolapse caused by pulling.
After the birth, VBAC women need to be told that they can walk upright. They can’t believe that they can straighten at the waist right after giving birth. Then, they can’t believe it when we ask them to do sit-ups and leg raises on day one. Usually by day three when we go to visit, their husbands say, “Oh, she’s gone to the gym.” With VBAC women, the complaints are very few in the postpartum period because they are comparing to post-surgery pain and any minor scrapes and bruises seem like nothing.
In the years following the birth, these women and men send us more clients than anyone else, and if we’re in legal trouble, they’ll be at all the rallies, raise money, stamp the envelopes, write letters to legislators, and be our true friends for life. A VBAC is an amazing experience for the birth attendants as well as the family. Very Beautiful And Courageous (VBAC).
Q & A: VBAC
Two Types of Pelvises
by Gloria Lemay
Q: From a midwife: A great many Asian women are very small and small-footed, yet I hear that many of them birth vaginally. Would you comment on pelvic size?
A: When I get a VBAC client and she is endlessly self-psychoanalyzing and beating herself up for having a c-section, I usually say, “Look you made two big mistakes! First you were born in the wrong country, and second you were born in the wrong century—if you’d been born and raised l00 years ago in France, for instance, you would have given birth vaginally.” When I teach my workshops, I tell the students there are two types of pelvises in allopathic medicine: l) contracted, and 2) adequate. In midwifery, there are two types of pelvises as well: l) roomy, ample, and 2) you could get a pony through there!
Gloria Lemay is a Private Birth Attendant in Vancouver, British Columbia, Canada and a frequent contributor to Midwifery Today and The Birthkit.
This graphic was posted on Facebook by Chase’s Guardians on April 6, 2015
This news story of a baby boy screaming in an operation for three hours and being discharged without a penis really brings home the point, KEEP OUR BOYS INTACT.
MEMPHIS, Tenn. (FOX13) –
Nov. 7, 2013
It doesn’t happen often, but when a doctor botches a child’s circumcision, it’s heart-breaking.
Maggie Rhodes is dealing with that heartbreak right now, after a catastrophic mistake on the operating table.
Removal of the foreskin from a child’s penis is rooted in concerns about health, hygiene and religion. But some question the necessity of the procedure.
Rhodes is sorry she ever took her young son to get circumcised.
“After I went home and I discovered that my son’s penis was not there, I immediately froze, like, oh my God,” Rhodes recalls.
The mother said she couldn’t believe what happened when she took her three-month-old son Ashton to Christ Community Health Center on Broad Avenue for a circumcision in August. She says doctors told her the procedure would take about 20 minutes.
But after a couple hours, Ashton was still in surgery.
“It took them about three hours to do the circumcision and so my baby screamed the whole three hours, like the whole process,” Rhodes said. “Then even when she gave him back to us, he was still screaming.”
Rhodes said the doctor performing the surgery obviously botched the procedure. But when it was over, she says they simply returned her screaming son to her, never telling her about the devastating mistake that had happened in the operating room.
“I should have been notified that something went wrong in this room with your baby,” she said. “I wasn’t notified. They gave me back my baby like nothing was wrong. They said, ‘here go your son.’ Yeah, something went wrong in that room.”
It’s something Rhodes said she didn’t find out about until she went home with a still screaming son, and a diaper filled with blood.
She said her curious sister finally discovered Ashton’s mutilated penis.
“When my sister pulled the cloth back, it was covered in blood and it was no penis there,” Rhodes said.
All that was left was a partial penis and his tiny testicles. Rhodes said Ashton urinates through a hole in his penis. She says she can’t imagine what she’ll say to her son, when he’s old enough to understand what happened to him.
“Like, ‘Momma like, how could this happen to me? How could this happen to me?,'” she said. “How could you explain that to your child that you don’t have a penis that they have to reconstruct one or you probably have might not never be able to have kids? That don’t sit well with me at all.”
Rhodes has hired an attorney and is pursuing a medical malpractice suit against Christ Community Health Centers.
As for little Ashton, a reconstructive surgery planned for October has been rescheduled for early next year.
FOX13 News contacted Christ Community Health Centers for a comment. We’re told the CEO is aware of our request, but so far has not returned our repeated calls.
Nurses discuss vaccine dangers online
I saw this discussion online on March 9, 2015. I’ll post the link at the bottom but don’t recommend that you click on it because the site is a bit “iffy” re viruses/spam potential (it’s an investment site). I like to see what nurses are saying amongst themselves because, in my experience, they are often silent anti-vaccine experts. They see what reactions are coming into the Emergency, they work with families with vaccine-injured children, and they whisper amongst themselves about the growing number of shots. Gloria Lemay
concerned nurse Lindum • 5 months ago
Healthcare providers are being coerced into accepting the vaccine. At some hospitals, if you don’t accept it, you have to wear a mask for the entire flu season. Difficult to do as a Healthcare provider…limits your vision as the masks fit poorly. Makes patients feel uncomfortable as they can’t read your facial expressions. Also, some nursing schools are making it mandatory to have the vaccine or you can’t be in the program . The current flu vaccines only have a 55% efficacy rate with only 50% population getting the actual vaccination.
Would you take your car to a mechanic who fixed it only 55% of the time?
Also there is a huge disparity in what people have to pay for the vaccine. Medicaid recipients get it for free. Certain income levels $13 at DHEC. People who work and have insurance pay $20-30 if it’s not covered by their insurance.
The free enterprise system is what motivates businesses, however, those companies should be obligated to be responsible in manufacturing their product and for the the quality of the product. Lastly, no one should ever be bullied into purchasing or accepting a product. Many healthcare providers have been in that profession for years and may have sought other opportunities if they had known that one day they would have to accept the flu vaccine.
heaven5951 concerned nurse • 5 months ago
Amen! No one should be forced to take any medicine that they don’t want to take. We nurses would NEVER force a patient to take anything against their will, but for some reason it’s ok to force us to take it. I’ve been a nurse for over 30 years, and I’ve never had the flu, until 2 years ago, when my granddaughter’s school was giving out “free” flu vaccines.
A few of the kids (one in her class that I know of) got the flumist vaccine, and 2 weeks later, one third of the school was out with the flu. Lilly got it, her momma got it, and I got it. Do you know who did NOT get it? Her 1 year old baby brother who was by her side the whole time she was sick. He even stuck a snotty tissue of hers in his mouth. And he is completely unvaccinated.
end of quoted material
This is a question that comes up a lot in pregnancy. . .”What kind of iron supplements should I be taking? My practitioner says I’m anemic.” It turns out that a lot of practitioners mistakenly diagnose anemia based on old information and lack of understanding of the physiology of the pregnant woman.
This information from Dr. Michel Odent is very helpful:
Question for Dr. Michel Odent:
My hemoglobin is now 11.4 in week of gestation 19. A friend of mine has 7.8. Do I have to take ferrum? Is there a hemoglobin-limit?
Answer from M. Odent
It is probable that from now on your hemoglobin concentration will decrease. The placenta – which is ‘the advocate of the baby’ – will send you hormonal messages so that you dilute your blood in order to make it more fluid. Your blood volume will increase dramatically (up to 40% to 50%). Although you’ll still have the same amount of hemoglobin available, its concentration in your blood will be lower if the placenta is working well. The most authoritative published study on this issue involved more than 150 000 thousands births (Steer P, Alam MA, Wadsworth J, Welch A. Relation between maternal hemoglobin concentration and birth weight in different ethnic groups. BMJ 1995; 310: 389-91). According to this huge study a hemoglobin concentration between 8.5 and 9.5 during the second half of a pregnancy is associated with the best possible birth outcomes. Furthermore, when the hemoglobin concentration fails to fall below 10.5 there is an increased risk of low birth weight, premature birth and pre-eclampsia.
The regrettable consequence of misinterpreting this test is that, all over the world, millions of pregnant women are wrongly told that they are anemic and are given iron supplements. There is a tendency both to overlook the side effects of iron (constipation, diarrhea, heartburn, etc.) and to forget that iron inhibits the absorption of such an important growth factor as zinc. Furthermore, iron is a powerful oxidative substance that can exacerbate the production of free radicals. The disease pre-eclampsia is associated with an ‘oxidative stress’. Pregnant women need antioxidants (provided in particular by fruit and vegetable) rather than oxidative substances.
You should print the abstract of the study I mentioned (you’ll find it via PubMed, for example) in order to be in a position to discuss with practitioners who might tell you that you are anemic and that you need iron supplements. Don’t take iron supplements as long as your iron deficiency has not been proven by specific tests (ferritin in particular).
I cannot comment on the hemoglobin concentration of your friend, first because I don’t know if she is at the beginning or at the end of her pregnancy, and also because data regarding her lifestyle and data provided by a clinical exam should prevail upon the results of one laboratory test; this test should probably be repeated and completed, according to the context. (end of Dr. Odent’s comments)
Here is the link to the study he talks about:
This study is another piece of the puzzle that more women should know about:
University of Turin researchers have found that women who take iron
supplements during mid-pregnancy have a higher risk of gestational diabetes,
hypertension and metabolic syndrome. The study assessed iron
supplementation, along with other factors, for 1000 women-half with
gestational diabetes and half with normal glycemic levels-between 24 and 28
weeks gestation. Of the women studied, 212 were taking iron supplements,
mostly in the form of ferrous sulphate.
The researchers concluded, “Routine iron supplementation in pregnancy is a
matter of controversy and debate. The increasing reporting of harmful
effects for unnecessary iron supplementation should be carefully considered.
Further studies on larger cohorts are warranted to confirm these results,
but glucose values should at least be monitored in iron-supplemented
The full report can be accessed online at:
– American Journal of Obstetrics and Gynecology, 201(2): 158.e1-6, 2009