Mom of Many Redheads

Ebay auction by a mom of 6 (incredibly funny!)

2007-08-22T16:48:00.000-07:00

This is from a real auction on ebay and it was so funny and true to life that I had to post it! You can see the auction here http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&item=130144061675

Her set of Pokemon cards were up to $103.50 with 6 hours left when I posted this! Way to go mama!

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I'm selling a bunch of Pokemon cards. Why? Because my kids sneaked them into my shopping cart while at the grocery store and I ended up buying them because I didn't notice they were there until we got home. How could I have possibly not noticed they were in my cart, you ask? Let me explain.

You haven't lived until you've gone grocery shopping with six kids in tow. I would rather swim, covered in bait, through the English Channel, be a contestant on Fear Factor when they're having pig brains for lunch, or do fourth grade math than to take my six kids to the grocery store. Because I absolutely detest grocery shopping, I tend to put it off as long as possible. There comes a time, however, when you're peering into your fridge and thinking, 'Hmmm, what can I make with ketchup, Italian dressing, and half an onion,' that you decide you cannot avoid going to the grocery store any longer. Before beginning this most treacherous mission, I gather all the kids together and give them "The Lecture".

"The Lecture" goes like this…

MOM: "We have to go to the grocery store."

KIDS: "Whine whine whine whine whine."

MOM: "Hey, I don't want to go either, but it's either that or we're eating cream of onion-ketchup soup and drinking Italian dressing for dinner tonight."

KIDS: "Whine whine whine whine whine."

MOM: "Now here are the rules: do not ask me for anything, do not poke the packages of meat in the butcher section, do not test the laws of physics and try to take out the bottom can in the pyramid shaped display, do not play baseball with oranges in the produce section, and most importantly, do not try to leave your brother at the store. Again."

OK, the kids have been briefed. Time to go.

Once at the store, we grab not one, but two shopping carts. I wear the baby in a sling and the two little children sit in the carts while I push one cart and my oldest son pushes the other one. My oldest daughter is not allowed to push a cart. Ever. Why? Because the last time I let her push the cart, she smashed into my ankles so many times, my feet had to be amputated by the end of our shopping trip. This is not a good thing. You try running after a toddler with no feet sometime.

At this point, a woman looks at our two carts and asks me, "Are they all yours?" I answer good naturedly, "Yep!

"Oh my, you have your hands full."

"Yes, I do, but it's fun!" I say smiling. I've heard all this before. In fact, I hear it every time I go anywhere with my brood.

We begin in the produce section where all these wonderfully, artistically arranged pyramids of fruit stand. There is something so irresistibly appealing about the apple on the bottom of the pile, that a child cannot help but try to touch it. Much like a bug to a zapper, the child is drawn to this piece of fruit. I turn around to the sounds of apples cascading down the display and onto the floor. Like Indiana Jones, there stands my son holding the all-consuming treasure that he just HAD to get and gazing at me with this dumbfounded look as if to say, "Did you see that??? Wow! I never thought that would happen!"

I give the offending child an exasperated sigh and say, "Didn't I tell you, before we left, that I didn't want you taking stuff from the bottom of the pile???"

"No. You said that you didn't want us to take a can from the bottom of the pile. You didn't say anything about apples."

With superhuman effort, I resist the urge to send my child to the moon and instead focus on the positive - my child actually listened to me and remembered what I said!!! I make a mental note to be a little more specific the next time I give the kids The Grocery Store Lecture.

A little old man looks at all of us and says, "Are all of those your kids?"

Thinking about the apple incident, I reply, "Nope. They just started following me. I've never seen them before in my life."

OK, now onto the bakery section where everything smells so good, I'm tempted to fill my cart with cookies and call it a day. Being on a perpetual diet, I try to hurry past the assortment of pies, cakes, breads, and pastries that have my children drooling. At this point the chorus of "Can we gets" begins.

"Can we get donuts?"

"No."

"Can we get cupcakes?"

"No."

"Can we get muffins?"

"No."

"Can we get pie?"

"No."

You'd think they'd catch on by this point, but no, they're just getting started.

In the bakery, they're giving away free samples of coffee cake and of course, my kids all take one. The toddler decides he doesn't like it and proceeds to spit it out in my hand. (That's what moms do. We put our hands in front of our children's mouths so they can spit stuff into them. We'd rather carry around a handful of chewed up coffee cake, than to have the child spit it out onto the floor. I'm not sure why this is, but ask any mom and she'll tell you the same.) Of course, there's no garbage can around, so I continue shopping one-handed while searching for someplace to dispose of the regurgitated mess in my hand.

In the meat department, a mother with one small baby asks me, "Wow! Are all six yours?"

I answer her, "Yes, but I'm thinking of selling a couple of them."

(Still searching for a garbage can at this point.)

Ok, after the meat department, my kids' attention spans are spent. They're done shopping at this point, but we aren't even halfway through the store. This is about the time they like to start having shopping cart races. And who may I thank for teaching them this fun pastime? My seventh "child", also known as my husband. While I'm picking out loaves of bread, the kids are running down the aisle behind the carts in an effort to get us kicked out of the store. I put to stop to that just as my son is about to crash head on into a giant cardboard cut-out of a Keebler elf stacked with packages of cookies.

Ah! Yes! I find a small trash can by the coffee machine in the cereal aisle and finally dump out the squishy contents of my hand. After standing in the cereal aisle for an hour and a half while the kids perused the various cereals, comparing the marshmallow and cheap, plastic toy content of each box, I broke down and let them each pick out a box. At any given time, we have twenty open boxes of cereal in my house.

As this is going on, my toddler is playing Houdini and maneuvering his little body out of the seat belt in an attempt to stand up in the cart. I'm amazed the kid made it to his second birthday without suffering a brain damaging head injury. In between trying to flip himself out of the cart, he sucks on the metal bars of the shopping cart. Mmmm, can you say "influenza"?

The shopping trip continues much like this. I break up fights between the kids now and then and stoop down to pick up items that the toddler has flung out of the cart. I desperately try to get everything on my list without adding too many other goodies to the carts.

Somehow I manage to complete my shopping in under four hours and head for the check-outs where my kids start in on a chorus of, "Can we have candy?" What evil minded person decided it would be a good idea to put a display of candy in the check-out lanes, right at a child's eye level? Obviously someone who has never been shopping with children.

As I unload the carts, I notice many extra items that my kids have sneaked in the carts unbeknownst to me. I remove a box of Twinkies, a package of cupcakes, a bag of candy, and a can of cat food (we don't even have a cat!). I somehow missed the box of Pokemon cards however and ended up purchasing them unbeknownst to me. As I pay for my purchases, the clerk looks at me, indicates my kids, and asks, "Are they all yours?"

Frustrated, exhausted from my trip, sick to my stomach from writing out a check for $289.53, dreading unloading all the groceries and putting them away and tired of hearing that question, I look at the clerk and answer her in my most sarcastic voice, "No. They're not mine. I just go around the neighborhood gathering up kids to take to the grocery store because it's so much more fun that way."

So, up for auction is an opened (they ripped open the box on the way home from the store) package of Pokemon cards. There are 44 cards total. They're in perfect condition, as I took them away from the kiddos as soon as we got home from the store. Many of them say "Energy". I tried carrying them around with me, but they didn't work. I definitely didn't have any more energy than usual. One of them is shiny. There are a few creature-like things on many of them. One is called Pupitar. Hee hee hee Pupitar! (Oh no! My kids' sense of humor is rubbing off on me!) Anyway, I don't there's anything special about any of these cards, but I'm very much not an authority on Pokemon cards. I just know that I'm not letting my kids keep these as a reward for their sneakiness.

Shipping is FREE on this item. Insurance is optional, but once I drop the package at the post office, it is no longer my responsibility. For example, if my son decides to pour a bottle of glue into the envelope, or my daughter spills a glass of juice on the package, that's my responsibility and I will fully refund your money. If, however, I take the envelope to the post office and a disgruntled mail carrier sets fire to it, a pack of wild dogs rip into it, or a mail sorting machine shreds it, it's out of my hands, so you may want to add insurance. I will leave feedback for you as soon as I've received your payment. I will be happy to combine shipping on multiple items won within three days. This comes from a smoke-free, pet-free, child-filled home. Please ask me any questions before placing your bid. Happy bidding! :)

Take Control of your Health!!!

2007-07-31T05:21:00.000-07:00

Getting to the bottom of cloth diaper debate

2007-07-13T06:36:00.000-07:00

Saving the earth, one question at a time
By ADRIA VASIL

Q I recently heard cloth diapers are just as bad as disposables. Is this true?

A Get your rattles out – the battle of the nappies is heating up again. You heard right, a four-year-long British study has just concluded that cloth diapers are as damaging to the environment as the plastic type. While the media is jumping on the story with glee, the whole thing is giving environmentalists a bad case of diaper rash – and with good reason.

Yes, the government-funded report did look at the life-cycle costs of three options: home-laundered cloth, commercially laundered cloth and disposables. And yes, the hefty 200-page paper weighed everything from the dirty oil extraction process involved in making plastic diapers and the water and pesticides used in growing cotton to the electricity needed to iron fold 'n' pin types.

In the end, the study concluded that all three are neck and neck. The electricity used to wash and dry cloth diapers is just as damaging to the environment as burying disposable diapers in landfills. The results actually landed the British government in hot water for spending $30 million on its Real Nappy promotional campaign. But is the study right?

Environmentalists don't think so. They're freaked because they say the report is hinged on some old-fashioned assumptions about cloth diapers that only looked at the habits of 200 washable diaper users (versus the 2,000 surveyed on disposable diapers). The UK's Women's Environment Network says warm water washes in A-rated (i.e., Energy Star) machines, for example, reduce climate-changing pollutants by 17 per cent (not to mention all the water savings).

The report also factors in a good chunk of tumble-drying when parents should be air-drying their nappies, not just to save a lot of power but also to make them last longer. If you're one of the 10 per cent the study says irons your cloth bum wraps, all I have to say is you gotta chill out. You're wasting hydro, and your babe doesn't need a smartly pressed bottom!

Investing in diapers made with unbleached, pesticide-free fibres like hemp, bamboo or organic cotton puts you even further ahead, especially if they are stitched locally and used on more than one kid.

Thanks to the outcry, the British government has supposedly promised to reassess the cloth diaper thing. Keep your eyes peeled for yet another report at some point in the future.

Need another reason to stick with cloth? A German study linked use of plastic diapers to male infertility. The plastic keeps their boy parts hotter than cloth, which ain't good for long-term sperm health.

Keeping cloth nappies green

• wash in cold or warm water

• skip the dryer and hang to dry

• pass on chemical detergents

• only flush poop-filled liners

• buy more diapers so you wash full loads

Perspective: The Invisible Woman

2007-07-10T14:55:00.001-07:00

Not sure of the author, but this is good!

It started to happen gradually. One day I was walking my son Jake to school. I was holding his hand and we were about to cross the street when the crossing guard said to him, "Who is that with you, young fella?"

"Nobody," he shrugged.

Nobody? The crossing guard and I laughed. My son is only 5, but as we crossed the street I thought, "Oh my goodness, nobody?"

I would walk into a room and no one would notice. I would say something to my family - like "Turn the TV down, please" - and nothing would happen. Nobody would get up, or even make a move for the remote. I would stand there for a minute, and then I would say again, a little louder, "Would someone turn the TV down?" Nothing.

Just the other night my husband and I were out at a party. We'd been there for about three hours and I was ready to leave. I noticed he was talking to a friend from work. So I walked over, and when there was a break in the conversation, I whispered, "I'm ready to go when you are." He just kept right on talking.

That's when I started to put all the pieces together. I don't think he can see me. I don't think anyone can see me. I'm invisible.

It all began to make sense, the blank stares, the lack of response, the way one of the kids will walk into the room while I'm on the phone and ask to be taken to the store. Inside I'm thinking, "Can't you see I'm on the phone?" Obviously not. No one can see if I'm on the phone, or cooking, or sweeping the floor, or even standing on my head in the corner, because no one can see me at all.

I'm invisible. Some days I am only a pair of hands, nothing more: Can you fix this? Can you tie this? Can you open this? Some days I'm not a pair of hands; I'm not even a human being. I'm a clock to ask, "What time is it?" I'm a satellite guide to answer, "What number is the Disney Channel?" I'm a car to order, "Right around 5:30, please."

I was certain that these were the hands that once held books and the eyes that studied history and the mind that graduated summa cum laude - but now they had disappeared into the peanut butter, never to be seen again.

She's going, she's going, she's gone!

One night, a group of us were having dinner, celebrating the return of a friend from England. Janice had just gotten back from a fabulous trip,
> and she was going on and on about the hotel she stayed in. I was sitting there, looking around at the others all put together so well. It was hard not to compare and feel sorry for myself as I looked down at my out-of-style dress; it was the only thing I could find that was clean. My unwashed hair was pulled up in a banana clip and I was afraid I could actually smell peanut butter in it. I was feeling pretty pathetic, when Janice turned to me with a beautifully wrapped package, and said, "I brought you this."

It was a book on the great cathedrals of Europe. I wasn't exactly sure why she'd given it to me until I read her inscription: "To Charlotte, with admiration for the greatness of what you are building when no one sees." In the days ahead I would read - no, devour - the book. And I would discover what would become for me, four life-changing truths, after which I could pattern my work: No one can say who built the great cathedrals - we have no record of their names.

These builders gave their whole lives for a work they would never see finished. They made great sacrifices and expected no credit. The passion of their building was fueled by their faith that the eyes of God saw everything. A legendary story in the book told of a rich man who came to visit the cathedral while it was being built, and he saw a workman carving a tiny bird on the inside of a beam. He was puzzled and asked the man, "Why are you spending so much time carving that bird into a beam that will be covered by the roof? No one will ever see it."

And the workman replied, "Because God sees."

I closed the book, feeling the missing piece fall into place.. It was almost as if I heard God whispering to me, "I see you, Charlotte. I see the sacrifices you make every day, even when no one around you does. No act of kindness you've done, no sequin you've sewn on, no cupcake you've baked, is too small for me to notice and smile over. You are building a great cathedral, but you can't see right now what it will become."

At times, my invisibility feels like an affliction. But it is not a disease that is erasing my life. It is the cure for the disease of my own self-centeredness. It is the antidote to my strong, stubborn pride. I keep the right perspective when I see myself as a great builder. As one of the people who show up at a job that they will never see finished, to work on something that their name will never be on. The writer of the book went so far as to say that no cathedrals could ever be built in our lifetime because there are so few people willing to sacrifice to that degree.

When I really think about it, I don't want my son to tell the friend he's bringing home from college for Thanksgiving, "My mom gets up at 4 in the morning and bakes homemade pies, and then she hand bastes a turkey for three hours and presses all the linens for the table." That would mean I'd built a shrine or a monument to myself. I just want him to want to come home. And then, if there is anything more to say to his friend, to add, "You're gonna love it there."

As mothers, we are building great cathedrals. We cannot be seen if we're doing it right. And one day, it is very possible that the world will marvel, not only at what we have built, but at the beauty that has been added to the world by the sacrifices of invisible women.

Fast Food Milkshakes Exposed

2007-07-10T14:49:00.000-07:00

Even though I live in America now, I still like to keep an eye on the British press to see what's going on in Britain. A little while ago, I came across an article in one of Britain's biggest newspapers, The Guardian. I found the article funny, but at the same time, shocking.

The headline of the article went like this: The 59 Ingredients in a Fast Food Strawberry Milkshake. Now, that's not a very good start. Is it? Fifty-nine ingredients. So, I looked a little further, and it turns out that in one fast food restaurant strawberry milkshake from a big fast food chain, there are two ingredients that are notably absent: Milk and Strawberries!! Does that put you off for life already? Well, let's see if I can put you off a bit further.

It turns out that the strawberry flavor they use to flavor their milkshakes is actually made from 40 different chemicals. Let me read you a couple of the names of these chemicals. This is just the strawberry flavor. Forty different chemicals.

* Amyl valerate
* Anethol
* Ethyl lactate
* Methylphenylglycidate (Oh, my word! That's a mouthful and a half!)
* Ionone
* Maltol
* Methyl benzoate

That's just to name but a few of those 40 ingredients that go into their strawberry flavoring.

Now, I don't know about you, but I've had strawberry milkshakes from fast food chains before, and some of them are very, very tasty. But after finding out that there's 59 ingredients, and that both milk and strawberries are absent from these milkshakes, I can definitely say I've been put off for life, and I hope you are as well.

So, is there a healthy alternative? Of course! And in a future video, I will be showing you how to make your own raw, very healthy, strawberry milkshake, start to finish, in only one minute. So, I hope you'll going to enjoy that recipe.

But in the meantime, now that you've got this information about fast food restaurants' strawberry milkshakes, (and I'm sure this goes for their other milkshakes as well) I hope you will want to avoid them like the plague. I know I sure will.

Judge lets off rapist of girl, 10

2007-07-08T13:58:00.000-07:00

June 25, 2007

A JUDGE spared a man who raped a girl of ten in a park — because she wore a “provocative” frilly bra and thong.

Window cleaner Keith Fenn, 25 — who could have got life in jail — will be free in just FOUR MONTHS after admitting twice having sex with the child.

Judge Julian Hall decided to be lenient because the girl “didn’t look 10”.

He caused fury earlier this year by freeing another paedophile, telling him to buy his six-year-old victim a new bicycle.

The judge referred to the 10-year-old as a “young woman”, and called her “very disturbed, very needy and sexually precocious”.

He told Oxford Crown Court: “She liked to dress provocatively. She was 10. She’d been in care since she was four.

“Did she look 10? Certainly not. She looked 16.”

Fenn, of Oxford, got two years’ jail but will soon be free because of time spent awaiting sentence. Accomplice Darren Wright, 34, of Henley-on-Thames walked free after getting just nine months.

Last night, campaigner Dr Michele Elliott of children’s charity Kidscape called the sentences “beyond pathetic”.

The NSPCC added: “There’s no excuse.”

VIDEO :: Jerusalem: A Closer Look

2007-07-08T13:51:00.000-07:00

Awesome VBAC video!

2007-07-08T13:47:00.000-07:00

Make an on-line slideshow at www.OneTrueMedia.com

Many Benefits of Birth at Home

2007-07-08T13:45:00.000-07:00

By REBECCA GARDINER

Monday, 02 July 2007

• Howick and Pakuranga Times

ONLY two per cent of Kiwi women do it, but one Bucklands Beach mother says she’d do it all again in a flash.

A little more than nine weeks ago, Rachel Springett gave birth to a healthy baby boy in the comfort of her own home.

While the vast majority of New Zealand women opt for hospital births, Ms Springett chose to have her third child at home.

The decision was an easy one for the former Howick Primary schoolteacher, who was already mum to two teenage daughters before the arrival of baby Tane.

“It’s really empowering,” she says. “You have more control to be able to be yourself and you’re more likely to trust your instincts. [Labour] has become so medicalised. It’s such a natural thing but women often don’t trust themselves.”

She describes the day as “perfect” and says she’d recommend homebirth to anyone.

“Having the familiar background made me relax so much more. It just made me feel ‘this is right’. I totally trusted the midwifes. They talked me through it the whole time. I never felt unsafe. The hospital’s just 15 minutes away so it was there as a backup.”

Ms Springett says giving birth at home was also an eye-opener for her partner Wayde and two daughters.

“Society has lost that passing down of mothering skills. My girls learnt so much,” she says.

“[My partner] thought it was a real plus — he wasn’t just hanging around going ‘oh my god’.”

Mother-of-three Lesley Hinson has been a New Zealand registered midwife since 1986 and is a strong advocate of planned homebirths.

Along with several other midwives, she recently led an information evening at Howick’s Crawford Medical Centre for those interested in homebirth.

In New Zealand, homebirths aren’t “the norm” and many women just “go with the flow”, says Ms Hinson.

“We’re all victims of the society we live in. We’re all conditioned to what we grew up with.

“Society gets the image that every baby needs to be born with all the emergency equipment around it. If we don’t promote [homebirth] they don’t think about it.”

She says homebirth is an option for a woman who’s had an uncomplicated pregnancy, has previously given birth and is in good health.

“Some people choose homebirths because they want that privacy. What most women like is that their husband doesn’t need to go anywhere. They’re more relaxed in their own place.”

Midwives are trained to deal with emergencies and don’t hesitate to refer their patients to hospital if there’s a problem during labour, adds Ms Hinson.

“We don’t hang around, but I can’t remember the last time I had to transfer a baby in.”

Although she’s an advocate of planned homebirth, Ms Hinson stresses the final decision of where to have their baby is up to the woman concerned.

“Homebirth is not the average person’s plan, depending on who you know and what you’ve been exposed to. If I meet people and they choose to go into hospital then that’s fine.

“Every woman’s different and every baby’s different. Our group is promoting planned homebirths. We give people information and they make their choices,” says Ms Hinson.

The next information evening on planned homebirths is in August.

For details, contact Joyce on 537-1808, or Clare 533-0233.

Baby Dies From Toxic Breast Milk

2007-07-08T13:42:00.000-07:00

Codeine prescribed for postnatal pain can produce deadly concentrations of morphine in breast milk.

A lawsuit over the death of Toronto newborn Tariq Jamieson, who died as a result of opiate toxicity in his mother's breast milk, has renewed the debate over prescribing such drugs as Tylenol 3 to breastfeeding mothers.

Tariq's mother Rani was prescribed Tylenol 3 for lingering episiotomy pain. Although Tariq was initially healthy, he developed increasing lethargy after the seven-day mark, and after 11 days he was brought to a pediatrician due to concerns about his skin color and poor feeding. Two days later, Tariq died.

Tariq was found to have high blood levels of acetaminophen, and a blood concentration of morphine six times higher than would normally be considered safe in a neonate. Tylenol 3 contains both acetaminophen and codeine, which is metabolized to morphine in the body. However, not everyone metabolizes codeine at the same rate. Rani Jamieson was an ultra-rapid metabolizer of codeine to morphine, which means that the opiate built up in her breastmilk very fast.

While ultra-rapid metabolization of codeine occurs in about 1 percent of Caucasians, it occurs in as much as 30 percent of some African and Asian populations.

National Review of Medicine June 15, 2007

Dr. Mercola's Comment:

Mothers must use extreme caution when taking any drugs while breastfeeding, because those drugs could be transferred to your baby.

Prescription drugs like Tylenol 3 are not the only danger. The excessive acetaminophen you can get from regular Tylenol, even without the codeine, can be extremely dangerous. Because some 5 billion over-the-counter medications are sold in the United States annually, many believe they're safe.

But you, or your baby, could suffer from serious side effects and possibly die unintentionally if you don't take them with the proper care.

Even environmental chemicals like rocket fuel are sadly now being found in breast milk. But nonetheless, breastfeeding is without a doubt the healthiest way to feed your baby. Breastfed infants have added protection against:

Heart disease
Immune system cancers such as lymphoma
Bowel diseases such as Crohn's disease
Juvenile rheumatoid arthritis
Asthma and allergies

So although this child died from breastfeeding, that in no way discounts its value as breastfeeding is not only incredibly good for your baby, it's good for moms, too!

Another Tragic and Unnecessary Death

Flame Retardant in Furniture Causes Concern

Victory Over Crib Death

The Sunscreen Myth: How Sunscreen Products Actually Promote Cancer

2007-07-08T13:40:00.000-07:00

The hard-hitting NewsTarget piece linked below explains in detail how the idea that sunscreen prevents cancer is nothing more than a myth promoted by industries seeking to make a profit off of human suffering.

In fact, sunscreen actually promotes cancer by blocking your body's absorption of ultraviolet radiation, and therefore blocking the production of vitamin D in your skin.

Studies have shown that vitamin D can prevent as many as 77 of all cancers. In addition, most sunscreen lotions also contain cancer-causing chemicals.

A portion of the profits from the sale of these lotions is then donated to organizations such as the American Cancer Society, which in turn runs public service ads encouraging the use of sunscreens.

Proper nutrition is a better way to prevent sunburn then sunscreen lotion. Berries and microalgae such as spirulina, astaxanthin, and blue-green algae can make the body naturally resistant to sunburn, as well as similar radiation damage to the eyes and optic nerve.

NewsTarget.com June 15, 2007

Dr. Mercola's Comment:

How many people know that not getting enough sun KILLS 50,000 people from cancer deaths every year in the US alone?

The myth that the sun is detrimental to your health, and that sunscreen is a necessity to guard against cancer is one of the most pervasive hoaxes in our society today.

As this article points out, this myth can be traced back to the two industries that benefit the most: the cancer industry and the sunscreen manufacturers. These two giant profit-makers tag-team efforts which keep the unsuspecting public in a trance.

Not only do sunscreens promote cancer by blocking your vitamin D production, they are also likely carcinogens all by themselves. A study in the April 2004 Journal of Chromatography found that there is significant penetration of all sunscreen agents they studied into the skin.

So when you use most sunscreens, your body is absorbing synthetic chemicals, and with experts' recommendations to apply generous amounts of the product every few hours, you will likely be absorbing a fair amount. Some of these chemicals are quite dangerous. Octyl methoxycinnamate (OMC), which is present in 90 percent of sunscreen brands, was found to kill mouse cells even at low doses.

Sunburn should always be avoided, but there are many all-natural ways to protect yourself from sunburn that you can use instead of resorting to the toxic infusions of commercial sunscreens.

Boosting your skin's "internal sunscreen" from within with effective antoxidants from whole fresh vegetables and fruits like goji berries (not the juice), raspberries, blackberries, blueberries, are far healthier options. Additionally, slathering on some aloe vera gel can also be helpful.

If you're still hooked on the idea of a cream, there are safer natural sunscreen products that contain no petrochemicals, such as Aubrey's Active and Green Tea sunblocks. Just remember, although these products are non-toxic, they still prevent you from metabolizing vitamin D, so use them with caution.

I recommend testing your vitamin D levels to make sure you're not deficient before resorting to sunscreen of any kind.

For more information about the vital importance of vitamin D from sunlight, please review my article Reduce Your Risk of Cancer With Sunlight Exposure, if you haven't already seen it. You might also want to keep an eye out for my forthcoming book, Dark Deception, which is due to be published in 2008. It will take an in-depth look at all of the various issues relating to sunscreen, cancer, vitamin D, and sunlight.

Slathering on Sunscreen Does Not Prevent Cancer

How to Reduce Your Risk of Cancer By 50 Percent

New Sunscreens Can Cause Brain Damage

Three Girls Died, Others Hospitalized, After HPV Vaccine

2007-07-08T13:37:00.000-07:00

Amid controversy over state legislatures in the U.S. requiring young girls to take Gardasil, Merck's new vaccine for human papillomavirus (HPV), severe side effects are being reported.

1,637 adverse reactions have been reported by Judicial Watch, a public interest watchdog, including three girls who died shortly after receiving the immunization. Judicial Watch obtained the reports from the U.S. Food and Drug Administration using the Freedom of Information Act.

In Australia, 25 girls who had just received their first injection of the vaccine experienced headache, nausea, and dizziness. In some cases, the problems were so severe that they were hospitalized. Shares of the vaccine's Australian developer, CSL, fell after the incident was reported in the news.

British Medical Journal June 9, 2007;334:1182-1183

Dr. Mercola's Comment:

Should young girls be required to take Gardasil by the government when possible side effects include hospitalization and death? There have also been reports from the National Vaccine Information Center about fainting and dizziness reported by dozens of patients as side effects of Gardasil, and there are even some concerns that Gardasil may cause infertility.

These are steep risks for a vaccine that only sometimes protects against HPV, which is virtually 100 percent avoidable without an expensive and potentially fatal vaccine.

Please realize that Merck has manipulated the medical and political system to FORCE children to get this dangerous vaccine for their own bottom line profit. The potential promised reduction of cervical cancer is the bait they use.

Remember Merck, the manufacturer of this vaccine, is the same company that made Vioxx that killed over 60,000 people.

It is also important to understand that this year, some 11,000 women will be diagnosed with cervical cancer, which can be caused by HPV, and about 3,700 will die from it. In comparison, 16 times more American women will be diagnosed with breast cancer (178,480), and 11 times more will die from it (40,460).

As Merck's own literature says, it is important to realize that Gardasil does not protect women against some "non-vaccine" HPV types. So, even if girls accept the risks and get vaccinated, they can still get HPV.

Finally, although more than 6 million women contract HPV each year, a woman's immune system is often strong enough to clear up the infection on its own. About 90 percent of HPV infections simply clear up within two years.

Remember, it is NOT the infection that is the issue as much as it is the person's immune system. You can be exposed to these bacteria and viruses and if you are living a healthy lifestyle your body's immune system will typically know how to address the infection.

Merck's HPV Lobbying May be Coming to Your State

Will the HPV Vaccine Soon be Mandatory for Schoolgirls?

Do Women Really Understand HPV?

Indian Teen Performs C-Sec for the Record Books

2007-07-08T13:29:00.000-07:00

June 23, 2007
DesiGirl

The Hippocratic Oath, according to Wikipedia, "...is an oath traditionally taken by physicians pertaining to the ethical practice of medicine." As even us non-medical professionals know, thanks to a decade of ER and such, upholding the Oath is of vital importance to a physician. Though segments of the original Greek words have been modified to suit the modern times, the essence of it remains the same:

To do no harm to those who come in search of a cure.

I guess this is where the good doctors K Murugesan and his wife, M Gandhimathay slipped. In their eagerness to be the proud parents of a Guinness Book of Records certified 'World's Youngest Surgeon', they veered off their Oath-sworn path and well into the path of controversy.

By allowing their 15-year-old son, Dileepan Raj, to perform a c-section on one of their patients, they have caused moral and ethical outrage within the medical community and across the general populace. As doctors, their duty is towards the welfare of their patient - in this case, a pregnant mother and her unborn infant. How can they put that aside and entertain thoughts of world records and such at this stage?

Not stopping at operating on that poor woman, 27-year-old Neela, the doctors parents decided to go further and let the whole world and its wife know what a pistol they have for a son. They filmed the operation (oh the ignominy of it!) and premiered it at the Indian Medical Association's meeting on May 6. When the assembled brethren didn't gasp in wonder but in dismay at this, Dr Murugesan quipped, and I quote, “If a 10-year-old can drive a car and a 15-year-old can become a doctor in the US, what is wrong if my son, though not qualified, performs a surgery?”

Let's see if we can tell the good doctor what is wrong. Googling for the Hippocratic Oath netted me the gems the doctors have forgotten:

1. To keep the good of the patient as the highest priority - Strike one - having an unskilled boy perform a complex operation such as a caesarean-section, thereby risking not one but two lives is a big no no. I cannot imagine anyone feeling better at the thought of having the proud parents hovering over their son's hands and guiding them.

2. Never to do deliberate harm to anyone for anyone else's interest - it wasn't in anyone else's interest but their own, so that they could see their son's name in the Guinness Book of World Records. That they didn't cause GBH to the mother or the baby is a blessing. So, strike two!

3. To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them - The mother of them all, 'for the good of my patients', has been wiped off the memory banks of the culprits. Strike three!

Three strikes, doc - you're out!

The IMA's less than enthusiastic response and the resulting fallout possibly triggered a late reaction in his brain and Doc Murugesan backpedalled furiously to keep self and wife from disbarment and further negative publicity. He has denied that the offspring actually took the scalpel in his own bare hands and cut open a woman's belly. Apparently, the boy just watched, while his dad did the deed.

Maybe. But what about his claim to the Kumudam Reporter that his boy has been performing such operations from the time he was 12?

With the IMA urging disbarment and the local Health Minister promising 'tough action' if the whole incident could be proven, the future seems a bit sticky for the doctors. But no one can get their hands on a copy of the offending video - maybe the doctors came to their senses and burned the evidence. I, for one, hope that someone locks these offending individuals up and throws away the key. What sort of a doctor, what sort of a person does such a thing?

Growing ear hair to get your name on the record books is one thing; wilfully endangering a person's lives is a different kettle of fish. I say, punish these idiots and make an example out of them. Maybe that will deter other idiots from trying to create such vile records, like the nut who tried to make waves by performing 50 hernia operations in 24 hours.

Another benefit of breastfeeding...

2007-07-08T13:23:00.000-07:00

BARCELONA, Spain, Jun 15, 2007 (UPI via COMTEX) -- Breastfeeding for 13 months or more can reduce the mother's risk of developing rheumatoid arthritis, Swedish researchers reported Friday.
Comparable use of oral contraceptives or hormone replacement therapy showed no significant effect on the risk of developing rheumatoid arthritis, said Dr. Mitra Keshavarz, of Malmo Hospital University, Sweden.
The findings add to the "growing body of evidence in favor of breastfeeding and its positive health implications -- this time demonstrating its protective benefits for the mother," Keshavarz said.
The study compared information from the Swedish National Hospital Discharge and the National Cause of Death Register from 1991 to 1996.
The findings were presented at the Annual European Congress of rheumatology in Barcelona.

Palestinian State No Longer Practical or Relevant

2007-07-08T13:21:00.000-07:00

by Ezra HaLevi
Israelnationalnews.com

“We have to replace the conception of a two-state solution it is not relevant anymore,” former Chief of Staff Lt.-Gen. (res.) Moshe Yaalon told Army Radio Thursday morning. “This is not pessimism, but realism. It is not practical to keep assuming it is the answer.”

“We are trying to find answers for the situation in Gaza without diagnosing the problem,” the previous IDF chief said. “What we are witnessing in Gaza is the establishment of a Jihadist Islamic society.”

Yaalon says that any talk of negotiations and withdrawing to the 1967 borders pushes peace farther away. “These are movements that are not interested in territorial issues between us and the Palestinians, but in other issues altogether. This was proven with the Disengagement and now is our opportunity to look and learn. It was a victory in their eyes for the global Jihad and gave strength to Hizbullah, Hamas and all the other Islamist groups.”

“Maybe we should therefore strengthen the moderates?” Army Radio’s Yael Dann asked Yaalon.

“I am not saying to sit and do nothing…but in the face of the wave of Jihad, any discussions of agreements are not relevant. Any talk like this distances us further from peace rather than bringing us closer…It is a kind of blindness to continue to pursue these policies.”

“How do you explain our ‘blindness’ during Oslo and now during the era of ‘Hamastan,’” Dann asked.

“We are always looking for a solution - we want peace now and it blinds us. We blame ourselves, changing the government and the prime minister.”

Asked if he would be joining Binyamin Netanyahu on the eve of elections, Yaalon said: “Right now I am not entering politics.”

What's Really in a McDonald's Chicken McNugget?

2007-07-08T13:18:00.001-07:00

Chicken McNuggets include several synthetic ingredients, such as tertiary butylhydroquinone (TBHQ), a petroleum-derived chemical sprayed onto the "food" or inside the box to preserve freshness.

Deep-fried foods in general are also dangerous in many ways, which is why French fries remain one of the worst foods anyone could eat.

Also, about one-third of the ingredients necessary to make the average McNugget (13 out of a lengthy list of 38) include some derivatives of corn, which may explain one reason why industrial agriculture produces so much of it -- in addition to the lucrative subsidies.

The Omnivore's Dilemma

Dr. Mercola's Comment:

I can honestly say I have never tasted a Chicken McNugget, but I am sure that is not true for most people. If you fall into that group then I would encourage you to review The Omnivore's Dilemma, a brilliant book by New York Times author Michael Pollan, who has also written about all the health problems associated with cattle raised conventionally.

You can use the information he has researched to lovingly share with your children the next time they beg you to take them to the nearest McDonald's. (Most likely one is close to your home as there are over 30,000 McDonald's restaurants worldwide.)

Pollan found that not only do the french fries contain acrylamide but the nuggets also contain TBHQ, which in high doses has caused precursors to stomach tumors and DNA damage in lab animals. A number of studies have also shown that TBHQ can be carcinogenic with prolonged exposure.

Other McNuggets ingredients include sodium acid pyrophosphate, sodium aluminum phosphate, monocalcium phosphate, calcium lactate, hydrogenated vegetable oils (that is to say, trans fats), and dimethylpolysiloxane.

Sounds like exactly what you want in your food, doesn't it?

I know it is not the easiest thing in the world but it is VITAL to understand that you are not going to achieve optimal health unless you make a conscious commitment to eat healthy unprocessed food made by someone in your kitchen.

Yes, this is not always convenient, but it is important to think long term. Wouldn't you much prefer to invest a few minutes to do some cooking and enjoy the increased energy, vitality and freedom from acute illnesses like coughs, colds and flus?

Believe me, once you start eating healthy you will be shocked at how good you feel in the short term. And the great thing is that 10 to 20 years from now when your friends and relatives are dropping like flies because they chose "convenience" foods you will not be following their quick path to the grave.

Wise up, stop the McDonald's and start Taking Control of Your Health today.

Imported toothpastes from China

2007-07-08T13:11:00.000-07:00

Imported toothpastes from China contain highly toxic levels of a sweet-tasting chemical called di-ethylene glycol (DEG) that's commonly used in antifreezes, brake fluids, and as a commercial solvent.

WHY should this be so alarming (aside from the obvious). It's because DEG has been pinpointed as the major cause of an astounding number of deaths and poisonings in the last century. Here's a summary of just a few of the most egregious examples:

* 1937: 107 Americans perished after taking sulfanilamide (anti-bacterial agents) dissolved in diethylene glycol. This tragedy was the driving force behind 1938s Federal Food, Drug, and Cosmetic Act of Congress.

* 1990: 339 Bangladeshi children suffered kidney failure, again at the hands of an analgesic syrup laced with DEG. Most of them died as a result.

* 1996: 85 children died in Haiti from a glycerin-based analgesic syrup contaminated with DEG - the suspect glycerin was supplied by a company that obtained it from a manufacturer in China. Similar deaths have been reported in South Africa, India, Nigeria, Argentina, and Panama.

* 2006: 46 deaths from renal failure, paralysis and other causes are linked to DEG by Panama's Ministry of Health and the CDC. The source of the contamination was a Chinese company that sold DEG wrongly labeled as pharmaceutical grade glycerin - which the Panamanian government had used as a main ingredient in over a quarter-million bottles of cold medicine.

Of course, the Chinese government isn't copping to any culpability in these documented mass slaughters. Nor are they admitting to guilt in this latest toothpaste/DEG scandal.

In fact, quite the opposite - just days ago (June 4, 2007), their Foreign Ministry issued a press release stating that their own state-run studies indicate that as much as 15.6% DEG is perfectly safe in toothpastes.

Thankfully, FDA guidelines for Americans' safe ingestion stipulate that NO DEG be allowed in any consumable product. I know I'm a huge critic of theirs more often than not - but I have to think that even in spite of their flaws (including allowing Chinese toothpastes to be sold in the U.S.), they're looking out for us better than China's government is looking out for those poor people.

A recent Reuters Health online article maintains that in the People's Republic of China, as many as 10,000 children are rendered deaf each year.

From the improper or excessive use of prescription antibiotics.

Few people realize (especially here in the U.S.), that antibiotic drugs can have negative side effects - sometimes permanent ones, and especially when overused. Among these can be varying degrees of hearing loss, up to and including total deafness.

And according to the Reuters piece, Chinese doctors routinely over-prescribe the newest and most powerful versions of antibiotic drugs for everything from a hangnail on up - largely because of kickbacks they get from "middlemen" for drug makers!

Here's how big the problem is: A Chinese newspaper that broke the story cites their official state sources for the article as claiming that 25% of antibiotic prescriptions in the People's Republic were baseless.

And in a country as populous as China, that equates to a lot of needless harm.

McDonald's Tries to Convince Moms That its Food is Nutritious

2007-07-08T13:08:00.000-07:00

In an effort to convince consumers that its food is nutritious, McDonald's is letting a group of six mothers, aged 35 to 42, go behind-the-scenes at McDonald's restaurants, processing plants, orchards and test kitchens.

The mothers will share their experiences with the world via online journals.

McDonald's says that it will have no control over what the women write. The women are not being paid, but McDonald's is paying for their travel and they have been given laptop computers that they will be allowed to keep.

McDonald's is calling the program Mom's Quality Correspondents. The six mothers were picked from a group of 4,000 applicants.

Currently, only 48 percent of women believe that McDonald's food quality is "excellent" or "very good", according to a survey of 14,000 women.

USAToday.com June 12, 2007

Dr. Mercola's Comment:

McDonald's, of course, is banking on the fact that these moms, hand-picked from a pool of thousands of applicants, will help give them a more family-friendly, "mom-approved" reputation amid growing claims that fast-food giants are contributing to obesity and a host of other diet-related health problems across the country.

Frankly, it's shocking to me that even 48 percent of women associate McDonald's with "quality food."

Only this year did McDonald's finally start to remove trans-fat from some of their French fries (and many of their fries still contain it), and their menu is full of non-nutritional "fake foods." Just check out the movie SuperSize Me if you want to know how this food affects your body.

I am fond of telling patients that one French fry is worse for your health than one cigarette, so you may want to consider this snippet before you order your next 'Biggie' order. One of the best things that you can do for yourself and your family is to stay away from fast food restaurants, and carve out some time to prepare healthy food.

If you want to get or stay healthy, someone is just simply going to have to spend some serious time in the kitchen. The time you save by eating at fast food restaurants is not worth the future health complications it could cause.

Please avoid exchanging convenience for your health. Your health is far too precious to lose for a few moments of free time. If you think that you truly don't have the time to do this, take a look at my past article:

Six Easy Ways to Get Better Nutrition Even if You Don't Have the Time.

It will be interesting to see what the moms report. Keep in mind that their journals are being posted on a McDonald's-run Web site, and that there is a strong likelihood that they will be seeing precisely what McDonald's wants them to see. As this Slashfood post points out, this really is a pretty transparent ploy by McDonald's -- there is no doubt that the response will be rave reviews about the quality of McDonald's products, even though any teenager actually working at McDonald's could tell you otherwise.

The Slashfood post goes on to wish that McDonald's would just admit what they really are and stop trying to fool everyone into believing that, against all logic and evidence, it's a healthy place to eat. I couldn't agree more.

DIY delivery

2007-05-16T06:31:00.000-07:00

ADRIANA BARTON

From Tuesday's Globe and Mail

May 15, 2007 at 8:41 AM EDT

BURNABY, B.C. — When Nicole Becker felt the pangs of late labour in January, she lit candles in the bathroom of her two-bedroom flat in Burnaby, B.C., and filled the tub. Only her husband and the couple's four-year-old son looked on as baby George slid into the water. "It was my dream birth," Ms. Becker says.

Ms. Becker planned throughout her pregnancy to give birth without a midwife, doctor or other birth attendant. After using a doula for her first child's home birth, Ms. Becker decided that the job of a good midwife is to "let the process happen," she says. So with George she decided to go solo.

Choosing to deliver without skilled help remains a controversial and uncommon choice. But now, spurred by the Internet, unassisted childbirth is reaching a broader range of women than ever before.

On sites such as Birthjunkie.com, Mothering.com and Trustbirth.com, women trade tips on such topics as how to measure the uterus to calculate the due date and how to figure out if the baby is breech. One of the most popular sites, Unassistedchildbirth.com, now has 30,000 to 40,000 visitors each month.

Many women join one of nearly 100 Yahoo groups that list unassisted childbirth in their subject lines, including UCbirthnews, an online newsletter with over 1,110 members. They also browse online for books, videos and do-it-yourself resources such as Unhindered Childbirth - The Online Childbirth Class (at Unhinderedliving.com) as well as inflatable birthing pools.

"People who wouldn't have considered this years ago are considering it now," says Laura Shanley of Boulder, Colo., who wrote the influential book Unassisted Childbirth in 1994 and runs the website Unassistedchildbirth.com.

Until recently, "I was hearing more from hippie types, people more on the fringe," says Ms. Shanley, who gave birth to five children without medical attention - including one breech presentation. "I do think it's getting more into the mainstream."

But most doctors and registered midwives strongly oppose the practice. Skilled attendants play a crucial role in identifying problems such as hemorrhages and fetal distress before they become emergencies, they say.

In a few cases, child welfare authorities in Canada and the United States have investigated parents who planned unassisted births.

Although there are no large or recent studies on the outcomes of planned unassisted childbirth, the evidence stacked against the practice is "overwhelming," according to Vyta Senikas, associate executive vice-president for the Society of Obstetricians and Gynecologists of Canada.

Dr. Senikas questions the rationale for choosing unassisted childbirth. "By all means, choose the home," she says, "but have a skilled attendant there."

Childbirth is a natural process, she adds, "but you can die and you can end up having problems."

Advocates of unassisted birth say that any medical interference, no matter how well-meaning, can disrupt the instinctive and hormonal processes of labour, triggering a stress response that halts the birth's progress. They believe that widespread use of interventions that slow labour can contribute to higher rates of C-section.

Adherents base their beliefs on the writings of authors such as French obstetrician Michel Odent, who wrote Birth Reborn in 1984. Although he does not specifically advocate unassisted childbirth, Dr. Odent says that in his practice, women who weren't observed in their labour had faster and easier births.

There is no way of knowing for sure how many Canadians are choosing to give birth unattended, since neither the federal nor provincial governments collect statistics on planned unassisted childbirth. But the rate is probably much lower than home births attended by registered midwives, which accounted for just 1.5 per cent of all deliveries in British Columbia and Ontario in 2005 and 2006.

Jodie Boychuk of Dunnville, Ont., says she chose an unassisted birth for her second child because of the difficult recovery following the cesarean delivery of her first daughter. In September, 2005, her second daughter was born at home into the hands of her husband, Richard. The labour was smooth and the 8½-pound baby was healthy, Ms. Boychuk says.

But the practice remains controversial enough to impel some midwives and authorities to intervene. When Ms. Boychuk declined the services of a registered midwife during her second pregnancy, the midwife - who questioned the safety of even an attended home birth after a cesarean - promptly called the Children's Aid Society.

A two-week investigation ensued, but it was dropped because unassisted childbirth is not illegal.

Even the staunchest advocates of the practice acknowledge that it's not for everyone.

Sarah Buckley, an Australian physician trained in obstetrics and author of the book Gentle Birth, Gentle Mothering, says a woman must be healthy and educated about birth to deliver unassisted.

As well, she says, the woman should be relaxed enough to avoid triggering the fight-or-flight response that can delay the birth, and should have a backup plan such as transferring to a hospital.

Registered midwives agree that too much medical intervention can impede labour - but they "cannot support the concept of unassisted, unattended births" due to the risks, says Elana Johnson, president of the board of directors of the Association of Ontario Midwives.

For Ms. Becker of Burnaby, the birth of her baby in January is still fresh in her mind. It was a joyful occasion to share with her husband and her son Max, she explains, and most of all, "it was just us."

How to Green Your Baby

2007-05-15T06:31:00.000-07:00

by Team Treehugger, Worldwide on 05.14.07
TH Exclusives (how to green your life)

What’s the Big Deal?

A new baby entering your life can create an enormous number of unexpected changes. Along with the little one comes a whole new category of things to purchase—not only the obvious large items like furniture and diapers, but also all the unforeseen extras that seem to accumulate. While having a baby is consumer heaven, the key is to not be gulled into an unnecessary buying frenzy. In truth, a baby has very minimal needs. On the flip side, there is more to a sustainable life with your baby than cloth diapers, organic baby food, and fair-trade clothing…read on for more.

Top 10 Tips

1. Diapers (aka Nappies)

Studies are divided on the subject of environmental impact of disposables vs. cloth. But knowing that your baby will use approx 6,000 diapers before toilet training, and that disposable diapers take 200-500 years to decompose, this is certainly a key issue to ponder. Washing cloth diapers takes water, energy, and chemicals (not to mention time), but you might want to consider the benefits of a laundering service. One study has found that home-washing cloth diapers has only 53% of the ecological footprint of disposables, and if you use a diaper laundering service that impact is halved again.

Cloth: Reusable diapers aren’t what they used to be and the days of diaper pins are all but bygone. Go for fitted cloth diapers with Velcro or snap closures for convenience, made from an eco-friendly material such as hemp, bamboo, or organic cotton. Use an organic wool cover that is both warm and breathable, minimizing diaper rash and cold bottoms at night. Use either removable or flushable liners and when washing either use a laundering service or wash at home at lower temperatures. With a new baby around you’ll probably notice a lot more laundry piling up, so make sure you’ve optimized your setup with an efficient machine and non-toxic detergent. If you can line-dry, that is ideal, but don’t bother ironing.

Biodegradable diapers: Made with plant-based plastics (also known as bioplastics), these diapers non-petroleum based and are compostable. While these have been found not to break down under landfill conditions, there are other options to compost them such as using a composting toilet, an earthworm system, or a highly active and properly conditioned composting area. Hybrid diapers, like gDiapers, have removable inserts that can safely biodegrade when flushed.

2. Breast or bottle

This one’s a no-brainer: breastfeeding is best. It's free, has health benefits for mother and baby, has no environmental impact, and is a precious bonding experience. However, in our commerce-driven society there are products for everything, and breastfeeding is no exception. For breast pads, ditch disposables and try re-usable organic cotton or wool felt pads. While there are many great, organic nipple creams available, some locally produced olive oil or organic lanolin does a great job.

If bottle feeding becomes a necessity, pumping your own is the first choice. Beyond that, using a fair-trade organic infant formula is preferable. If this is neither affordable nor accessible, then the next best thing is to ensure the brand of formula you buy is from a company not profiteering from marketing their product to developing countries. These companies disregard or try to get around the marketing code set by The World Health Assembly.

3. Solid foods

At about six months, babies starts to eat real food. Rice cereal and mushy veggies turn to combinations of fish, meat, eggs, legumes, and vegetables—yep, a regular person’s diet. Buying jars of food is sure convenient, but as an adult you don't live out of jars, so why should your baby? For those occasional situations, purchase organic or fresh frozen baby foods. Otherwise, make your own. Cook up veggies, casseroles, or tofu and lentils, whatever is your thing, and freeze it in tiny containers or ice cube trays ready to take out and defrost when needed. (Be sure you discuss any concerns over dietary requirements with your health professional)

4. Clothing

All those designer baby clothes are cute and oh so hard to resist in their fruity colors. But be careful. Not only does a baby grow out of clothes amazingly fast, they are constantly sending bodily fluids flying onto those precious outfits. The baby couture might be better replaced with convenient one-piece suits in practical white terry cloth. Choosing organic hemp or cotton, bamboo or wool fabrics made without toxic chemicals are best against a baby's sensitive skin and last longer with the constant washing. Second-hand clothing is the cheapest and most sustainable option. Get hand-me-downs from friends and family or look in thrift shops, Craigslist, or Freecycle.

5. Body care and bath time

It’s very easy to get sucked into the constant advertising of baby powders, creams, and lotions. But the best baby lotion is plain old olive oil—cheap, natural, and un-perfumed. As for other products, keep it as natural, organic, and fragrance-free as possible. For more on this, take a look at How to Green Women’s Personal Care.

6. Laundry and washing

It’s quite possible that our war on germs is actually making things worse. Studies have shown that children brought up in over-cleaned houses are more likely to develop allergies, asthma, or eczema. The best thing you can do for sensitive baby skin is not to cover it with synthetic chemicals. Wash nappies with pure soap and warm water. Make your own non-toxic cleansers with simple ingredients such as baking soda and vinegar. For more, see How to Green Your Cleaning.

7. Toys

Get back to basics and try old fashioned wooden toys and organic cotton or homemade teddies. Because babies put most things in their mouths, go as natural as possible, then when baby is a little older, get hold of second-hand toys. Also aim for toys that helps build a child’s bond with nature and the natural world. The sad truth is that the average American kindergartener can identify several hundred logos only a few leaves from plants and trees.

8. Furniture and accessories

Babies don't need much—a secure place to sleep, a car seat, a high chair, and a way to be trundled around. Go for second-hand furniture, everything except cot mattresses (some research suggests a link between second-hand cot mattresses and sudden infant death syndrome) and car seats, (which can have invisible accident damage). If you buy new furniture, purchase high quality, durable pieces made of sustainable, low-toxicity materials. Think about some alternatives to the regular old wooden baby bed; try using an organic cotton baby hammock or a cot that extends into a bed and lasts 6-7 years. The most ethical option for stroller (pram) is recycled. For more on furniture, see our guide.

9. Household environment

It goes without saying that alcohol consumption and cigarette smoking while pregnant are bad for a baby. But it is also very important to avoid exposure to the synthetic chemicals contained in everyday products such as paints, carpet, furniture, bedding, and pesticides. When decorating the nursery, use natural and low-VOC paints and don't lay new carpet before the baby is born. Suspicious new items should at least be left outside to off-gas for a few days before bringing inside.

10. Wipes and liners

Diaper wipes and liners commonly include propylene glycol (a binder also found in antifreeze), parabens (a family of compounds commonly used as preservatives) and perfume, which can be made from up to 600 different chemicals. Try using good natural organic cotton wool and water and avoid disposable changing mats and perfumed diaper bags.

So You Wanna Do More?

1. To have babies at all?

With the world population estimated to pass the nine billion mark by mid-century, the sheer number of people on the planet is one of our biggest risks. While the biggest population booms are happening in the less wealthy developing countries, North Americans and Western Europeans have a per-person environmental footprint that is far above world average. It’s a big decision and a touchy subject, but the number of children you have, if any at all, is an enormous factor in your impact on the Earth. Adopting kids is also a profound contribution to a sustainable world.

2. Try attachment parenting

Sleeping with and wearing your baby, while not for everyone, is said to promote a strong bond leading to a sensitive, emotionally aware child.

3. Avoid using diapers altogether

Elimination communication is a technique of timing, signals, cues, and intuition to help baby/infant express his or her poo-related needs. This is best begun before six months of age, and while it is most commonly used in third-world countries where parents are in constant contact with their children, it has been used in the West with some success.

4. Shower with your baby

Save water and enjoy precious bonding time by holding your baby while in the shower.

5. Get crafty

Make your own diapers, breast pads, toys, and baby clothes. There are plenty of Web sites offering free patterns and advice on DIY baby goods (see below for more). Also, don’t forget about your local craft shop or group for advice and materials.

6. Avoid unnecessary gadgets

Monitors, motorized rockers, musical mobiles and the like are tempting, and can be useful or educational, but keeping the baby-related consumerism in check is a wise move. Ask yourself if you really need them? If so, try for secondhand items first.

7. Swapping

So many baby things only get used for a few months, it seems mad to buy them new, (e.g. strollers, beds, playpens, highchairs, etc). Buy secondhand, beg, borrow , or swap with friends and family to find what you need. Also remember community fairs, garage sales, and online swap sites.

By The Numbers

1. The average baby uses approx 6,000 diapers before potty training.

2. Petroleum-based disposable diapers take between 200 and 500 years to decompose.

3. Disposables used per day: Australia uses 2.2 million, Japan 6.7 million, the UK 9 million, and the USA 49 million.

4. A home-washed cloth diaper has only 53% of the ecological footprint of disposables, and a nappy laundry service has a mere 37% of that footprint.

5. Americans spend an estimated $1.4 billion on complicated births due to smoking while pregnant.

6. Disposable diapers contain chemicals that were banned in the 1980s in women's tampons, but continue to be used today to improve absorbency in children's diapers.

Treehugger Resources

Diapers are one of the biggest issues when thinking about having an eco-friendly baby. Check out our explorations on diaper alternatives like The Nature Nappy, The Cradle to Cradle-certified gDiaper, Wam Bamboo Nappies, and Eenee eco-diapers.

Here, readers offer comments on finding a stroller without the toxins.

Lovely eco friendly furniture options include Stokke Tripp Trapp chair, and the eco crib from Mothercare.

For baby food, check out Liz Hurley's line of organic natural foods and organic baby food from Ulula.

Find more on eco friendly baby creams, lotions, and powders from sources like Sage Baby, Avalon Organics, Erbaviva, and Munchskins.

And if you were intrigued about the no-diaper solution, read our story on potty whispering and this earlier story on diaper-free babies.

For clothes and cloths, go organic and get back to basics. Check out hemp towels from Transylvania and organic baby gear from Nui Organics.

If you want to buy just one perfect soft organic teddy, check out our top five organic soft toys.

Baby furniture from Nurseryworks is handmade and highly morphable.

E Magazine takes a hard look at raising a healthy child in a toxic world.

More Resources

Vegetarian Baby is a site for parents of vegetarian and vegan children under three, with topics on pregnancy, nutrition, and products.

The Guardian has a charming article entitled “How to stop your baby wreaking eco havoc.”

Organic Baby is a New Zealand site offering guides on safe, natural parenting.

Kids Health provides doctor-approved health information about children from before birth through adolescence.

Baby Center is an Australian site with information on shopping for your eco baby.

Information on formula marketing around the world can be found from the International Baby Food Action Network.

Baby Milk Action and The Australian Breastfeeding Association have more in depth information on feeding your baby.

The Real Diaper Association has hard facts on the impacts of disposable diapers and the benefits of cloth.

Colorado department of public health and the environment has facts about smoking while pregnant.

Alabama Mothers Deserve Midwives

2007-05-15T06:20:00.000-07:00

North Carolina mothers say Amen!!!

Going it alone

2007-05-14T11:25:00.000-07:00

Why would anyone choose to give birth without a doctor, midwife or even her partner in attendance? Viv Groskop reports on the growing trend for freebirth

Wednesday May 9, 2007
The Guardian

To me, giving birth is as personal as having sex," says Sarah, 24, from Essex. "You don't want someone else sitting there watching you." Sarah chose to "freebirth" her first child, now two, at home. Freebirthing involves giving birth alone, without a midwife and often even a partner or friend in attendance - Sarah delivered while her husband was in the next room. "I didn't have any experience of pain," she says, "there was just this really strong sensation that muscles were working. Then the baby's head appeared."

To prepare for the three-hour labour, Sarah had read everything she could on the subject, and says she "would have known instinctively if anything was wrong. As his head started to come out, I thought, I know the cord is around his neck." She flipped the cord over his head and, "He just flew out." As he was born, she says, she was laughing with joy.

Although rare in the UK, there is a growing online community of freebirthers or "UC-ers" (unassisted childbirthers) in the US who are celebrating "the primacy of autonomous birth". Laura Shanley, 49, from Boulder, Colorado, author of Unassisted Childbirth (Greenwood Press, £14.95) and veteran of five unassisted births, believes that "women are the true experts of birth. Birth is sexual and spiritual, magical and miraculous", she says, "but not when it's managed, controlled and manipulated by the medical establishment." Her website motto? "If you want the job done right, do it yourself."

"People think it's pretty crazy," admits Laura Field, 31, from Atlanta, Georgia, whose second child, Grace, nine months, was born at home, unassisted, after four hours. "Some people think you must be superwoman. Others think it's reckless. You get every reaction from awe to horror. I just feel like it was the most normal thing. It felt somehow life-changing and extremely ordinary at the same time." She is a member of a local group of 15 women who have had unassisted births. "There are a few extremists who are really anti-medicine but they are in the minority," she says, "To me it wasn't 'unassisted or else'. If you have good back-up plans - you know the warning signs to watch for and you are really in touch with what is going on - it is safe. I had back-up midwives and knew which hospital I would go to if necessary."

Mary Siever, 36, from Alberta, Canada, has free-birthed three children at home. "I think hospitals and doctors have their place, I just don't think they have their place in birth," she says. "I've noticed a lot more people are getting interested in it now. People are trusting themselves more or maybe they are trusting the doctors in hospitals less. I wanted personal control and responsibility. For others, it may be that they had a horrible experience in hospital and don't want that again."

Bornfree, the biggest internet forum for freebirthers, has more than 1,000 members worldwide, mostly in the US, Canada, Australia and New Zealand. In the past 10 years Laura Shanley has heard from "a couple of dozen" British mothers who want to go it alone and Sarah knows of two others who chose to give birth without assistance.

Although it is never going to be a majority movement, the issue of the over-medicalisation of birth is pushing freebirth on to the mainstream agenda in the US. A slogan war has broken out, with natural birth websites selling T-shirts which read "Pizza boys deliver. Women birth", while the American College of Obstetricians and Gynaecologists gave out bumper stickers at a meeting last year, bearing the opposite message: "Home delivery is for pizza."

Home birth per se is not illegal in North America, but in 13 states there are legal issues for midwives attending home births. Denied the chance of an attended home birth, some women would simply rather do it on their own than go into hospital. "Women who feel they are being shoehorned into hospitals, and who don't like what happens to them when they get there, see freebirth as a viable option," says Tina Cassidy, author of Birth: A History (Chatto & Windus, £12.99), who is based in Boston. "It's a fringe thing but it's a signifier of something bigger: women now feel they have no control in the birth process."

What is telling, says Cassidy, is that there is virtually no historical precedent for this movement: "Since the beginning of time women have turned to other women for help in childbirth. There are one or two very small tribes where giving birth alone is a means of status - but even within those cultures people rush to the woman's side afterwards to make sure she and the baby are OK." That women are considering going it alone is a wake-up call for the medical profession in the US, she says, where one in three births now ends in a caesarean section. "I'm not an advocate for or against freebirth. But you can understand why people would go underground. They think, I'm just having a baby. What is the big deal?"

Because freebirth is such a fringe movement there have been no studies on it. However, a report in the magazine New Scientist recently quoted a survey undertaken in a religious community in the state of Indiana, where there were more than 300 unattended births in the 1980s. The neonatal death rate was calculated as 19 per 1,000 live births, compared with seven per 1,000 for the rest of Indiana.

There is some concern that the number of freebirthers in Britian may rise, because so many women feel their choices over how they give birth are limited, says Beverley Beech, chairwoman of the Association for Improvement in Maternity Services. While the health secretary, Patricia Hewitt, has promised that every woman will be able to choose an attended home birth by 2009, the service is currently a postcode lottery. Plus, the government is planning to introduce new - and prohibitively expensive - insurance requirements for independent midwives who currently provide private backup to women who have found it difficult to arrange an attended home birth on the NHS. "If this law comes in, either [independent] midwives will practise illegally or we will have a lot more women who will choose to give birth alone," says Beech. "We have been having discussions about providing a support group for these women so we can provide somebody to be with them."

Freebirth fans contend that it can be better to be alone anyway. On one blog a woman writes of "the thrill of the catch" - what it feels like to seize your baby emerging from your body. Self-delivery is not necessarily something women should strive for, she adds, but something they should know they are capable of. There is much online discussion about "lotus birth" - when the umbilical cord is not cut but left to disintegrate naturally, usually within three days of birth.

One pioneer of the freebirth movement is Dr Sarah Buckley, a respected Australian GP who lectures on home birth and is described by the French natural birth guru, Michel Odent, as "driving the history of childbirth towards a radical and inspiring new direction". Buckley had her fourth child unassisted at home near Brisbane and writes: "It was a great gift for me, with my medical training, to liberate myself ... from expert thinking."

The movement's unofficial leading light, Laura Shanley, explains: "I look at birth as a sexual creative act and you have to be free to birth in your own time and your own way. Even if you are with a midwife, she has to follow certain rules and your body can't do what it needs to do within its own time."

During her five pregnancies, Shanley shunned all monitoring, including scans. The first indication she had that her second child, Willie, was in the breech position was when she was giving birth at home alone and reached down to feel his feet coming out first. Her fourth child, Nicholas, was born prematurely unassisted at home and died almost instantly from a congenital heart condition. Shanley later sought reassurance that the outcome would have been the same in hospital (she was told that medical intervention would have made no difference).

The controversial NHS doctor who writes an award-winning blog under the pseudonym "Dr Crippen" has proposed that at some future point women will be sued by their (damaged) offspring for having had a home birth (let alone an unattended one). Freebirth advocates argue that a woman's choice of how she gives birth is a human rights issue. They say that most births proceed normally and going to hospital only increases the chances of intervention and complications. Even during a home birth, a midwife can intervene in a way the mother doesn't agree with. Is this a selfish attitude? Not necessarily, says Cassidy: "I don't buy that 'selfish' thing. I've heard horrible stories of women haemorrhaging to death in hospital and babies' faces being cut with scalpels during C-sections.

"Women have been giving birth since the beginning of time and birth is very rarely complicated. So is it selfish to stay at home? Or is it selfish to go to hospital?"

My story: 'I shed the placenta and had a bath with my son'

I always planned to have children but I could never imagine giving birth in a hospital, or with any kind of official in attendance. The only way I had ever been able to picture myself giving birth was alone, or with an old crone in silent attendance. At night in the woods by a stream was my preference, but my own front room and bath was, when my time came, the best available option.

As the day approached and pressure from the NHS to "plug-in" mounted, my partner became increasingly fearful and I increasingly resolute. Talk of stillbirth - designed to drive me to hospital - only heightened my distrust of those who saw fit to try and worry me at such a vulnerable time. I had, by this time, had my fill of the local midwives, all but one of whom had treated me with a complete lack of empathy, and the idea of inviting a random team of two of these frankly cold women into my small home seemed laughable.

The evening before I went into labour I had my spirits boosted by the book Spiritual Midwifery, not because I felt in any way connected to the free-loving, be-necklaced and hairy-partnered women pictured within, but because the pages and pages of homebirth statistics in the back made for optimistic reading. I read the book in the bath before going to bed and went to sleep thoroughly optimistic, When I got up in the night I found a trace of blood, which convinced me my labour had begun. I got up and while I was running a bath, I spread all the lovely white sheets the midwives had provided over the floor in the front room. My contractions were minutes apart within the hour and as the pain quickly intensified I woke my partner, who went straight back to bed on the basis that it would be a "busy day tomorrow". I was soon oscillating between agony and ecstasy, with only time to stagger the five yards between bath and white sheets, at which time I started to panic that I didn't know where my much-read-about cervix was.

I woke my partner, who went out looking for a newly qualified midwife who happened to be staying with a neighbour, and he returned with a drunk woman who reeked of cigarettes, which put me right off my contractions. I sent her away after agreeing with the general consensus that I was unlikely to give birth until the following day. As soon as she left I felt the baby's head emerging, and after much screaming but less than four hours of labour I gave birth to a very skinny boy on some very bloody sheets. I painfully shed the placenta and had a bath with my son before going back to bed. He is now four, and fine, and very wonderful, by the way.

In my second pregnancy I avoided all contact with the NHS and had no antenatal care whatsoever. After 10 hours of extremely painful labour at home, alone throughout, I gave up and called an ambulance. Less than an hour later, on my back in hospital, I gave birth, vaginally, to premature twins. In terms of the amount of medical intervention I had to have, it was the opposite of my hopes and dreams, but I had never imagined having twins - and what a lovely surprise that was. Besides, dialling 999 was always my back-up plan, being only 10 minutes from the nearest hospital. The twins are now big and bonny.
Name withheld

Jeannie Babb Taylor: May 2052

2007-05-14T11:24:00.000-07:00

05/09/07
Jeannie Babb Taylor

“You’re fortunate to be living in this era,” says Nonna, brown eyes twinkling above the dimples in her wrinkled cheeks.

Rachel sips at the red raspberry leaf tea, the cup clinking against the saucer as she sets it down to respond. Her grandmother is already talking again.

“When I gave birth to your mother,” she goes on, “I was not allowed to eat or drink.”

Rachel’s eyebrows shoot up. “The whole time?”

“That’s right. Back in those days, all babies were born in hospitals — even healthy babies. Laboring mothers weren’t allowed a single sip of water.

“I was so thirsty my tongue was swollen and sticking to the roof of my mouth. After many hours, I was given ice chips, but even that was taken away when I was caught swallowing some of the ice to stave off the gnawing hunger.”

“That’s horrible,” Todd interjects, dropping down to perch on the Victorian loveseat beside his wife. “Having a baby is like . . . running a marathon. What athlete would attempt such a feat dehydrated on an empty stomach?”

Nonna chuckles at his analogy. “You’re right, of course. But you see, laboring women were not treated like athletes. We were treated like sick patients, like there was something wrong with us. According to the doctors, our ‘condition’ was best treated with narcotics, opioids, and surgical intervention.

“By 2005, the c-section rate went through the roof, with nearly one out of three mothers sliced open for delivery. From the doctors’ point of view, laboring women were all potential targets for expensive surgery. That’s why they starved us.”

Rachel scowls, rubbing puffy hands over the swollen full-moon belly.

“But labor can go on for hours — or even days,” she notes.

“Especially when you’re lying down with feet in stirrups, pushing uphill,” the old woman acknowledges.

“That’s absurd,” Todd murmurs. “Why not let gravity work?”

Rachel shakes her head. “That position was designed to benefit doctors, not women.”

“You’re right,” Nonna answers. “It placed us at a great psychological disadvantage, too. It allowed medical staff to treat us as objects, paying attention only to the ‘business end,’ as if we had no face, no heart, and no mind.”

“I’m so glad no caregiver would think of using stirrups today,” Rachel sighs, rubbing her belly again. “It’s a wonder women were able to push at all.”

“The doctors had ways of speeding up labor artificially,” Nonna answers. “But the drugs sometimes caused uterine rupture, killing the baby or causing permanent brain damage.

"One drug, Cytotec, was not even FDA-approved for obstetrical use. Eventually they had to stop using it.”

Rachel smiles, her face transformed. “So they went back to the natural ways?” she guesses.

“Not at first,” her grandmother answers. “At first they skipped the contraction drugs and resorted to the knife much sooner.”

Rachel looks down, distracted for a moment by the contracting of her own womb.

“I’ll go heat the rice bag,” Todd offers, trotting to Nonna’s kitchen with the handmade cloth pouch. Nonna watches him round the corner, thinking how glad she is for Rachel.

At last Rachel’s attention comes back to her grandmother’s wizened face. “Why did the women allow it?” she asks.

Nonna sighs, holding out empty hands. “We just didn’t know better. Our own mothers were knocked out for birth. We thought we were making progress just by being awake. Some women realized things should be different, but it was a constant fight.

“I chose a hospital that was supposed to be supportive of natural birth. They still pulled the ice chip stunt. Before I registered, they said they allowed ‘rooming in’ so I would not be separated from my baby girl.

“But right after birth, they whisked her away! I begged for her, but they kept her ‘under observation’ for four hours. They also gave her sugar water against my wishes, and pushed to inject her with vaccines just hours after birth.”

“That’s horrid,” Rachel clucks. “Why didn’t women just stay away from hospitals? Have their babies at home?”

“Well, in Georgia it was illegal.”

Rachel laughs. “How can birthing a child break a law?”

“Oh, it was not homebirth that was prohibited, so long as we did it alone! It was homebirth midwives they outlawed.”

“So women could birth at home — but only without help?”

Nonna nods. “Things were different back in 2007 when your mother was born,” she says. “For one thing, eight out of 10 lawmakers were men. There had never even been a woman President. Women only earned 70 cents on the dollar.

“We didn’t have the kind of power you gals have!”

She beams at her granddaughter, so young and confident. “My next child — your Uncle Tim — was born at home with an ‘illegal’ midwife.”

“Wow,” Rachel whispers, throwing a glance at Todd as he tucks the warm rice bag into the small of her back, “There was a black market for midwifery?”

“Certainly. There were always women who refused to be mistreated, and there were always midwives willing to skirt the law to give excellent care. The legal risks were high for those midwives. Once in a while, a baby dies during birth. It happens sometimes, no matter where women give birth.

“In a hospital, these deaths were considered a statistical eventuality. In the early 2000s, no one was charged for hospital deaths, even when the damage was clearly caused by uterine-rupturing drugs or overuse of painkillers.

“It was extremely rare for a baby to die in a homebirth setting — but when it did happen the midwives were charged with manslaughter. In other cases, overdue women were jailed for refusing to have a c-section.

“It was actually against the law to disobey a doctor’s orders! Eventually it was the women who turned the tide.”

“Through lawsuits?” Todd guesses.

“That was part of it.” Nonna nods thoughtfully. “The studies showed clearly that it was doctors’ drugs and fasting that caused most of the ‘danger signals’ (like blood pressure drops and changes in babies’ heart rates) that led to the c-sections. But that went unreported for 20 years!

“It was not until women stood up for themselves that things changed. Women reporters talked about the studies on the six-o’clock news. Women journalists wrote about the prohibition of home midwifery and the barriers to natural childbirth. Women doctors watched the signs instead of the clock. Businesswomen opened natural birthing centers. Women were elected to office and they legalized home-birth midwifery in Georgia, and later nationwide.

“Most of all, laboring women refused to let their needs be sacrificed to hospital protocols and doctors’ schedules. We had to insist on change!”

Nonna sets down her teacup. “We insisted on dignity. We did not let doctors push us into inductions or surgeries just to accommodate their schedules. Women who still used hospitals refused the wheelchair and the gown that were presented at check-in.

“Women refused to be starved, or to have their veins punctured with unnecessary IVs. Mothers refused to let doctors break their waters or insert electronic monitors in the baby’s scalp.

“When we pushed our babies into the world with our own fierce power, then we refused to let them out of our sight.”

Nonna smiles. “Eventually even the medical community came to recognize that birth is an act of motherhood, not an act of medical science. Today a laboring woman is not regarded as a body on a table, as if she and the baby needed some doctor to ‘deliver’ them from each other. Today women are honored as life-bringers.”

Jeannie Babb Taylor is a local business leader and author. She also teaches Sunday school, educates her children at home, and engages in Georgia politics. To contact Jeannie, E-mail jeannie@babb.com.

Midwives and doctors get along just fine

2007-05-14T11:20:00.000-07:00

As a certified nurse-midwife, I am grateful for the attention given to midwifery by your article regarding midwives and upcoming legislation (Midwives fighting for legitimacy..., April 29). I beg to differ -- legitimacy cannot be legislated. Legitimacy grows with a reputation built on education, accountability and safe practice.

The article suggested an adversarial relationship between midwives and doctors. As certified nurse-midwives we work closely with supportive OB/GYN doctors, and the women we care for benefit from collaborative practice.

Our goal is safe and satisfying care. Most of us attend births in hospitals or birth centers, although some CNM's do homebirths.

Certified nurse-midwives are more than "...licensed nurses with additional training in midwifery." We enter our midwifery education programs with a bachelor's degree in nursing, and enter midwifery practice after extensive clinical experience and a master's degree. Our programs provide us with the pharmacology background to safely provide medications and write prescriptions.

Certified nurse-midwives are mid-level healthcare providers. We function independently at the same level as nurse practitioners and physician assistants. We care for women across their entire lifespan -- not just during pregnancy, but also for gynecological and menopausal care. CNM's are able to bill health insurance companies for the cost of care in the same way as doctors or other health professionals. Homebirth midwives are unable to bill insurance companies.

It's important that women understand the difference between certified nurse-midwives (CNM) and homebirth midwives (LM, CPM) regardless of the initials involved.

Erma Evans

Oakland

jeevans5@adelphia.net

Mom of 16 takes life ‘one day at a time’

2007-05-14T11:18:00.000-07:00

Submitted by Shawn Hogendorf on May 10, 2007 - 2:52pm.
Filed under: Entertainment

By Shawn Hogendorf

Staff Writer

Bea Melville of Prior Lake grew up with 15 siblings, so she was used to having a big family.

As a child, she joked that she was going to beat her mother and have more than 15 children.

“It didn’t turn out to be a joke,” she said, laughing.

In 1949, Melville gave birth to her first child. Twenty years later, she had her 16th.

Today, Melville is a proud mother of 16 children, 27 grandchildren and nine great-grandchildren.

Having 16 children didn’t shock Melville the way it would somebody else, since she came from a large family.

Bea married her husband Bernard in 1948. They had 12 children before they moved from Bloomington to Prior Lake in 1963.

Bernard worked for Honeywell as an electrical maintenance worker for 35 years.

Bea waited tables and cooked at Prior Place for five years, where she babysat women’s children while they bowled. She cooked at Freddy’s on the Lake, now Captain Jack’s, for five years and T.J. Hooligan’s for 15 years before retiring.

When the Melvilles first moved to Prior Lake, Bea worked three nights a week while Bernard babysat the children.

Being a mother of 16 came naturally. “I never minded having a lot of work to do,” she said.

In addition to working in restaurants three nights a week, Melville did all of the cooking for her children. Bernard was a big help with everything, she said, but he didn’t like keeping house. So, Melville always delegated jobs for her children around the house.

Melville cooked a lot of casseroles, soups and chili. The dinner table would overflow into the family room most of the time, she said. She made one meal, and if her children didn’t like what she cooked, they had to learn how to eat it.

“When I would give them something to eat and they didn’t like it, I would say, ‘I wouldn’t give you something I wouldn’t eat myself,’” Melville said. I would tell them, ‘I had 16 kids and I still have 16 kids, so, I wasn’t trying to kill you.’”

Melville has 10 daughters and six sons. All of her daughter’s names begin with the letter “P.” All of her son’s names begin with the letter “L.”

After the Melvilles moved to Prior Lake, neighbors and friends would say they named their children after the town, she said. “But we had 12 of them before we moved here, so we didn’t name them after Prior Lake,” Melville said.

Coming up with first names was never difficult. Finding middle names that didn’t begin with the same letter was the tricky part.

Melville can still keep all of her children’s birth dates straight, but she doesn’t know all of her grandchildren’s birthdays.

The only month Melville doesn’t celebrate a child’s birthday is March.

‘A lot of love’

Melville said her favorite part of being a mother was giving birth.

She loved watching her children grow up, but her favorite ages for children were before they became teenagers, she said.

“I loved being a mother to the little kids,” Melville said. “Once they became teenagers, they became trouble.”

Melville said she kept her children in line by watching every child, every day and getting to know who they were hanging out with.

“I was one with all my kids,” she said. “There was a lot of love to go around.”

In addition to her 16 children, there were at least three neighborhood children who always called her Mom, as well as a family dog, a horse, a donkey and a calf.

“It is amazing to see all the grandchildren and great grandchildren,” Melville said. “I never know when there is going to be another one. When my grandkids started having kids, I started to feel old.”

The novelty of birth never wears off, Melville said.

“It’s new every time a baby is born,” she said. “After my kids would have two children, they would say, ‘Mom, how did you ever do this?’”

One of Melville’s neighbors asked her the same question. Melville’s response was, “The same way you do it.”

“It’s something that comes on one by one,” Melville said. “They don’t all come at the same time, so you take it one day at a time.”

For most of Melville’s motherhood, she had four children in diapers. In addition to cooking for the other children, she made her own baby formulas, food and cleaned the cloth diapers.

Melville’s family has their own double-sided, nine-page directory to keep birthdays and anniversaries straight. Melville has been to hundreds of weddings, baptisms and confirmations.

For Mother’s Day, Melville’s children usually send her flowers or candy or pop in for the annual Mother’s Day open house.

She will spend Sunday sitting at her house waiting for phone calls from her children, who are spread out across the country, and visiting with those who stop by.

Melville had her first child on a Thursday. The following Sunday was Mother’s Day.

“That first Mother’s Day, they brought my daughter wrapped in a blanket and handed her to me,” Melville said. “She had a little corsage made of apple blossoms on her that read, ‘To Mom, from Peg.’”

Melville said she always wanted twin girls but never had them.

“I never got my twin girls, but my daughter Paula had twin girls,” she said.

Melville has another grandchild on the way, as well as her 10th great-grandchild.

One of her grandchildren, Amber McFadden, is currently serving in Iraq, Melville said with a proud look on her face as she held the American flag in her hands.

“She sent this flag to me that was flown in Iraq for nine minutes and 11 seconds,” Melville said.

Shawn Hogendorf can be reached at (952) 345-6374 or shogendorf@swpub.com.

Aims: Government must provide more resources

2007-05-14T11:11:00.000-07:00

11 May 2007

Aims: Government must provide more resources
The government must put more resources into funding for midwifery if it was truly to offer free choice for how a woman gives birth, according to the Association for Improvements in the Maternity Services (Aims).

Chairperson of Aims Beverley Beech said that while maternity services continued to be underfunded and overworked there was no real possibility of being able to offer every mother-to-be the option of having her baby at home.

"Until this government puts some resources in, it's going to continue to be difficult. There is a very serious shortage of midwives. And it means that women, in the meantime, are getting very substandard care as a result of this shortage," Ms Beech stressed.

She also said that any expectant mums who wanted a homebirth should be determined to make her wishes known to her health practitioners and to remain persistent if she was advised to have her baby elsewhere.

""[Home births] are an option for every woman. And it's the woman who makes the decision," she said.

Expectant Moms Eagerly Look Toward to Due Dates

2007-05-14T10:58:00.000-07:00

By Bailey Clark
Contributor

It is that time of year again. The time of year when on one singular day, we gather together to celebrate and pay homage to the most important women in our lives: our mothers.

For many parents, Mother's Day is a time to reflect on the children they've raised, the memories they've shared, and the joys they've experienced. Yet, for a rare group of young women, this Mother's Day means something entirely different as they await the birth of their new babies.

For these mothers, this occasion is one of anticipation, fear and excitement as they anxiously prepare for the arrival of the newest member of the family.

This holiday not only marks a moment of reverence for the women who have healed, helped and held us throughout our lives, but a time to recognize those who will soon be stepping into the role of mother once again. For three area women, this day is not only in celebration of their current role as parent, but also for everything that lies ahead.
Kristin Thomas

Due Date: Late August

"Expecting just one baby has been so exciting," says 31-year-old Kristin Thomas.

This is a rare statement from an expectant mother who intends to welcome her child into the world using natural homebirth methods. A rare statement, that is, until her 2-year-old twins come charging into view.

"Feeling the baby move this time around has been amazing," she said. "I didn't think it would be that big of a deal to me, but because it's just one, I can feel the baby move a lot more."

Thomas is a stay-at-home mom to fraternal twins, Isaac and Grace, and wife to her arborist husband, Matt Thomas. The family is ecstatic about the soon-to-be arrival of a little boy, whom they have decided to name Daniel.

Although homebirth may seem frightening to many expectant mothers, to Thomas it is a breeze compared to laboring at home with the twins.

"Sometimes I worry about finding enough one-to-one time with each individual child," Thomas admits, adding that "making sure there is enough time" is surely her largest fear.

However, Thomas's first singular pregnancy is not without its own joys.

"We were amazed at how much this baby is moving," she says, "I can see my belly hop around already."

Fruit and ice cream top the list of pregnancy cravings, and as Thomas approaches this latest Mother's Day, she has one goal in mind for her attributes as a parent: "patience."

"Love is the most important thing," the she adds. And if there is any value she hopes her future baby could understand, Thomas can sum it up in one sentence: "To grow up knowing the importance of a personal relationship with God."
Christy Miller

Due Date: Aug. 15

"Surprised and excited," was how Christy Miller, 26, said she felt when recently finding out she and her husband, Ben, were expecting their first child together. As a mother to a young son, Jordan, 8, Miller feels a completely new set of emotions with this pregnancy because she is expecting a baby girl.

"It's exciting how active she is," Miller said. "Jordan was a very calm baby, but with her I can sit on the couch and physically see her moving!"

As a busy insurance career sales agent with American General Insurance, Miller barely can find time between her hectic schedule to put her feet up. "I have to take naps in the evening, or I won't be worth anything later in the day!"

Then again, these days her biggest dilemma seems to be deciding upon a name for the baby girl.

"I keep telling Ben we have to pick one already," she explains, "but we just can't decide."

Names aside, Christy's biggest challenge with the impending birth of her child is certainly one of balance. "Trying to balance when I go back to work when I have a new baby," is the largest concern to date.

She is quick to add though, "With this pregnancy, I'm happy as long as the baby's healthy."

With the celebration of Mother's Day and her happy pregnancy, Miller has two wishes she hopes to give her child: "love and commitment."

Whether she is busy or not, Miller believes in one thing as the key to being a good mother. "Optimism," she says. "Children get enough negative opinions in their lives, and I feel it's our job as parents to make them feel that they can do anything."
Danielle Miller

Due Date: Sept. 7

If you wanted to know how Danielle Miller, 28, is spending this Mother's Day, chances are you will find her cleaning the house.

"I'm fanatical about organizing with this pregnancy," she says, "I'm driving my husband crazy." As stay-at-home mother to daughter, Ivy, 20 months, and wife to painting contractor, Adam, many differences stand out between the arrival of this baby and that of her last.

"I have been sick this entire pregnancy," Danielle admits, "whereas it only lasted a few months with Ivy." In addition, Danielle plans to give birth at home, instead of the hospital setting that welcomed her previously.

Danielle and her husband are choosing not to learn their new child's gender until birth, and the same goes for their choice of names.

"We don't have any names picked out," she says, "when we see the baby, that's when we'll decide."

Despite the excitement of her pregnancy, Danielle still has her own fears as the due date approaches. "I am concerned about the state of the world," she explains, "and bringing an infant into it."

Yet, if she has her way, Danielle is determined to do her best to protect through the job of motherhood.

"I want to home-school my children, raise them with good Christian values, and teach them to have good relationships with people," Daniellesays, with "trust" topping the list of most important value to her as a parent.

This holiday, Danielle had threewishes for her children, as she anticipates the arrival of baby,

"I want them to be my very best friend, to trust me, and to tell me everything," she said.

Teachers joined in birth, death

2007-05-11T11:24:00.000-07:00

Two new mothers taught together, died days apart.

By Marie McCullough
Inquirer Staff Writer

In March, the staff, students and parents of Avon Elementary School threw a surprise baby shower for teachers Valerie Scythes and Melissa Farah.

Mere weeks later, both young women were dead.

They died, 15 days apart, after delivering by cesarean section at Underwood Memorial Hospital in Woodbury, Gloucester County. They left behind healthy infants - Isabella Rose Scythes and Grace Melissa Farah.

A combination of the unthinkable and the incredible, the deaths have turned two first-time fathers into widowers, shaken the tiny school and its close-knit borough of Barrington, and left myriad questions about what went wrong.

"It's just unbelievable," said Barrington Mayor John Rink, whose son Nolan was in Scythes' class last year.

Scythes, 35, died March 28. The cause is unclear, and final autopsy results are pending, said John Baldante, a Philadelphia lawyer representing the family.

Farah, 28, died April 12 of "shock, due to bleeding and anemia," according to her death certificate. The family's attorney, Todd Miller of Allentown, said he was awaiting an autopsy report.

Underwood Hospital spokesman Richard Bellamente said the women were "treated and transferred" to Hahnemann University Hospital and Cooper University Hospital - although he did not know which woman went where.

According to people who knew the women, Scythes was airlifted to Hahnemann University Hospital, while Farah was rushed to Cooper University Medical Center in Camden.

The New Jersey Department of Health and Senior Services, which investigates deadly medical errors, has not received reports or complaints regarding the care of the two women, department spokesman Nathan Rudy said.

Death during or around the time of childbirth, a common occurrence a century ago, is now extraordinarily rare in this country. In 2000, 396 women in this country died of obstetric complications of pregnancy or treatment of those complications - including incorrect treatment, federal statistics show. That's fewer than eight women per 100,000 births.

"It's like winning the lottery - a bad one," said Louis Weinstein, chair of obstetrics at Jefferson University Hospital.

The most common causes of such deaths are blood clots, a blood-pressure disorder called eclampsia, and a coagulation disorder triggered by, among other things, hemorrhage, said Robert Debbs, a high-risk obstetrician at Pennsylvania Hospital who also practices at Underwood and is familiar with the cases.

In Debbs' opinion, "the Underwood cases were both catastrophic complications that could have occurred anywhere in the country and were unpreventable," he wrote in an e-mail.

By all accounts, the poignancy of death so closely linked to birth has been compounded by the coincidence that Scythes and Farah were friends and colleagues in a small suburb. They were known to just about everyone with children in the two elementary schools that serve the 1.2-square-mile Camden County borough of 7,000.

Although Scythes came to the district four years before Farah, both were alumnae of Rowan University and loved working with special-education students.

Avon principal Anthony Arcodia, a 25-year veteran of the district, said he interviewed both and recommended they be hired. "They had a level of passion and enthusiasm. The last day I saw them, they still had it."

Scythes was known for giving her pupils individual, handmade Christmas ornaments. Both women were known for their love of all things Disney.

Daniel Farah, 29, a computer-information specialist who met his wife-to-be at Collingswood High School, recalled: "I proposed to her in front of the castle in Disney World after dinner at Cinderella's Castle. They had cleared everyone from in front of the castle for the fireworks show, and we were the only ones there."

The couple married in July 2005 and built a house in nearby Oaklyn.

"We started trying to have a baby on our first anniversary," he said. "I was a planner. She was a planner."

James Scythes, a college history professor who lived with his wife in Woodbury, declined to be interviewed. Baldante said his client wanted time to deal with the emotional trauma and questions surrounding his wife's death.

Underwood Hospital has about 1,100 deliveries a year, hospital billing records show. It is one of two hospitals with maternity units in Gloucester County.

Underwood has "never" had a maternal death, Bellamente said. He declined to discuss the cases, citing privacy rules. "Hospital policy and practice is to refrain from disclosing protected health information."

An Inquirer analysis of Underwood billing records shows that between 2001 and 2005, seven obstetric patients were transferred to other medical facilities.

In the Barrington school district, news of Scythes' death was shared by a letter sent home to parents. At the Avon school, which serves children in kindergarten through fifth grade, Melissa Farah was beyond grief-stricken.

"She said: 'Oh my God. Is this going to happen to me?,' " recalled parent-teacher association president Beth Cavallaro. "We tried to reassure her and said: 'No, no. It was just a freak thing.' "

On the Sunday night after Farah's death, the district's automated recording service called each Avon parent to alert them that an unspecified "tragedy" had occurred and that counselors would be available at the school to talk to the children.

Proposals for memorials to the teachers - and funds for their babies - are coming from all quarters, Arcodia said.

Already, the parent-teacher association has ordered plaques that will be unveiled at back-to-school night in September, Cavallaro said. The organization also plans to install a tree, a bench, and specially inscribed bricks in the new playground, to be built in August with $52,000 raised from Barrington parents and businesses.

Still, for most of those who knew the women, the double tragedy remains incomprehensible.

"Even if it was an act of God," said Daniel Farah, "the odds of two new mothers dying, then that those two people did the same thing for a living, that they worked together, that they went to one another's baby showers - the odds are astronomical."

For photos, obituaries and tributes to Valerie Scythes and Melissa Farah, go to http://go.philly.com/health

To Contribute

Funds have been set up for both of the babies.

For Melissa Farah's daughter:

Checks should be made to "Grace Melissa Farah UGMA Fund"

Pinnacle Food Group Inc.

6 Executive Campus

Suite 100

Cherry Hill, N.J. 08002

For Valerie Scythes' daughter:

Checks should be made to "Isabella Rose Scythes Trust Fund"

409 Mantua Ave.

Woodbury, N.J. 08096

Staff writers Josh Goldstein and John Sullivan contributed to this report.

Reach Sullivan at johnsullivan@phillynews.com or 215-854-2473.

Hail Caesarean: Such births rising in East Asia

2007-05-09T06:29:00.000-07:00

This is scary! - AmyMc

BANGKOK: When the time came, the doctor stood over Suthasinee Santikanavin's bulging belly and said: "It's almost 9:19. We are going to pull the baby out."

The birth of Suthasinee's daughter was written in the stars, at least according to a Thai astrologer who helped pick the precise day, hour and minute that the infant should be extracted from her mother's womb by Caesarean section.

Suthasinee's husband, Mahakanasnan, an intelligence officer for the Thai Navy, stood anxiously beside the operating table and made sure the auspicious timing was respected. He programmed the alarms in both of his cellphones, one in each pocket, to vibrate silently at 9:19 a.m.

"The alarms went off," Mahakanasnan said, a tone of satisfaction in his voice. "And I heard the baby crying."

That baby's birth at a private hospital here on March 22 was part of a wider trend of what medical researchers are calling an epidemic of Caesareans across East Asia.

Once considered a procedure reserved for emergencies or high-risk pregnancies, Caesareans are now commonly planned for a variety of non-medical reasons, including fear of labor pain, convenience for the doctor and the patient, and astrology.

In a region that lives by time-is-money production schedules at footwear and computer chip factories, the elective Caesarean brings clockwork and clinical tidiness to one of humankind's most stubbornly unpredictable processes.

Meanwhile, medical advances that have made the procedure safer and more routine have also, paradoxically, helped reinforce age-old superstitions. Couples in Chinese-influenced cultures have long tried to time births for auspicious years. Now, many can refine their choice to the day and minute.

The World Health Organization estimates that under normal circumstances a country should not have a rate of Caesareans higher than 10 to 15 percent. That widely quoted benchmark was established two decades ago and was loosely based on the experiences of developed countries with the lowest infant and maternal mortality rates.

But while Caesareans have become increasingly commonplace in almost all countries outside Africa - they make up around 30 percent of all births in the United States, a quarter of births in Germany but less than 2 percent in Mali, Niger and Nigeria - rates have skyrocketed over the past 15 years in East Asia as the region has prospered.

In Bangkok's private hospitals, which typically cater to wealthier patients, Caesareans now make up about 65 percent of births, up from 40 percent in 1990, hospital administrators said. In Hong Kong, where the notion of scheduling a birth dovetails with the city's palpable ethos of efficiency, 59 percent of all babies born in private hospitals came into the world under the knife in 2005, compared with 31 percent two decades ago, according to the Department of Health.

Cesareans involve slicing through layers of skin and fat and stretching apart abdominal muscles to reach in and pull out the baby. They take about an hour to perform and are safer than ever; in the West, the rate of maternal or infant mortality from the procedure is well below one percent for both mother and child.

Yet the growing use of elective Caesareans is controversial. Because it entails major surgery, there is always the potential for complications, even as the technology improves.

Still, the procedure's popularity is growing and is having a sociological impact. Increasingly, birthdays occur by appointment.

Whether astrologers or doctors decide, there is often haggling over the appropriate day and time.

Bumrungrad Hospital in Bangkok, a large private facility that caters to wealthy Thais and foreigners, bars parents from scheduling Caesareans during the inconvenient hours of 9 p.m. to 7 a.m. The hospital delivers about 180 babies a month, 65 percent by Caesarean.

At St. Paul's hospital in Hong Kong, where the Caesarean rate is about 70 percent, couples are charged extra if they select a time of birth between midnight and 7:30 a.m.

Noppadol Saropala, an obstetrician at Bumrungrad, says about one third to half of all his Thai patients who choose Caesareans want to set their own date and time. But there are limits: A patient must be close to the average gestation period of 40 weeks.

"I will not do a Caesarean if they're less than 38 weeks," Noppadol said.

If labor drags into a Friday evening, doctors may be tempted to speed things along, said Monir Islam, director of the WHO's Making Pregnancy Safer program. "They will go for a Caesarean section so that they don't have to be called over the weekend," Islam said.

Caesarean rates have been known to spike on the eve of major holidays. One recent example was April 12, the day before the start of Thailand's Songkran festival, a time of family gatherings, which this year amounted to five days off. At Phayathai 3, a private hospital in Bangkok, the number of Caesareans rose to eight, compared with the usual rate of three or four a day, said Supakorn Phawanna, a hospital spokesman. Supakorn said patients chose Caesareans because they wanted to "have relatives and friends visit their baby during the long holiday."

Doctors and hospitals alike have a financial incentive to perform Caesareans, especially at private hospitals. At Phayathai 3, a "Caesarean package" - four days and three nights in a private hospital room - costs 41,900 baht, or about $1,200. That is 40 percent more expensive than the typical vaginal birth.

Elective Caesareans are not covered by Thailand's universal health care system, reinforcing the notion that this is a procedure for the rich. In Thailand's government-run hospitals, which serve the country's have-nots, only 20 percent of births are Caesarean.

One of the women who chose April 12 to give birth was influenced less by the holiday schedule than astrology.

Apinya Jirupansawat, a 34-year-old employee of a stock brokerage, was told by a Chinese astrologer that she had three choices: April 12, 18 or 24.

After cross-checking with Thai and Western astrology books, Apinya settled on the first day. As she explained, according to Chinese astrology, a child born then "would support his parents and be easy to raise."

Some days of the week are luckier than others, said Pinyo Pongcharoen, the astrologer who helped time Suthasinee's daughter's birth.

This year, according to Thai beliefs, Sunday and Monday are generally auspicious, he said, while Saturday and Wednesday are not.

Doctors sometimes have trouble timing Caesarean operations so that the baby is extracted at the astrologically correct hour, Pinyo said, but ideally the birth should take place within 10 or 20 minutes of the time he selects as most compatible with stellar and planetary alignments.

"Sometimes we give them many dates," Pinyo said in the classroom at a Buddhist temple where he lectures fellow astrologers. "It's up to the doctors and the parents to choose which one is most convenient."

Pinyo's colleague, Sompong Winworanat, says the lucky time should be planned for the baby's first cry.

"It's not the time when the woman's stomach is cut," Sompong said. "It's when the baby first screams: Waaaaaa!"

While there is little public debate about soaring Caesarean rates in East Asia, there are early signs of a backlash.

Concerned by a national Caesarean rate of 40.5 percent in 2001, doctors in South Korea managed to bring it down by three percentage points by 2005, according to Joo Hyun Nam, the chairman of the Korean Society of Obstetrics and Gynecology.

In Japan, the overall Caesarean rate has risen sharply, but was well below its neighbors at 21.4 percent in 2005, up from 11.2 percent in 1990. The rate in Taiwan is 35.4 percent, according to a study published last year in the medical journal Birth.

If some see the burgeoning resort to Caesareans in Asia as a problem, it is overshadowed by more pressing issues related to the application of medical technology to engineer a culturally desirable outcome in childbirth, such as the growing use of ultrasound and abortion to determine a child's sex, said one international health official who asked not to be named because she is not authorized to speak for her institution.

When compared to such practices, she said, "I don't see such a big, big tragedy in terms of all babies being born on a Saturday."

Pornnapa Wongakanit contributed from Bangkok.

Placental problems in mums who have had a previous caesarean section

2007-05-09T05:35:00.000-07:00

New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology shows a link between the development of placenta praevia and placental abruption during the subsequent pregnancies of women who previously had a caesarean section.

Placental praevia is defined as the implantation of the placenta over or near the internal opening of the cervix. Placenta abruption is the premature separation of the placenta from the uterus. Both result in bleeding during the pregnancy, which could spell danger for mother and baby.

This study was undertaken to examine the risk of placenta praevia and placental abruption in singleton, second pregnancies after a caesarean delivery in the first pregnancy.

Data provided by the US National Centre for Health Statistics, Centres for Disease Control and Prevention was examined by a team of Canadian researchers. A total of 5, 146 742 pregnancies were analysed over 1995 – 2000. This is the largest population-based study of its kind to date.

Researchers found that women who previously delivered by caesarean section had a 47% increased risk of developing placenta praevia and a 40% increased risk of placental abruption in the following pregnancy.

The authors believe that caesarean sections cause scarring inside the womb which may affect placental attachment in future pregnancies. The ligation of the uterine vessels during caesarean sections could also da mage the lining of the womb, resulting in the low implantation of the placenta in the next pregnancy.

Dr Qiuying Yang of the Ottawa Health Research Institute and University of Ottawa said, “Our paper, which is the largest study to date, shows an important association between caesarean sections and the subsequent pregnancy complications of placenta praevia and placental abruption.”

“More than 1% of pregnancies with a prior Caesarean section had one of these events which had a 50% increase compared to women without previous Caesarean section. This has important implications on the management of these pregnancies. It also introduces new and important evidence in the debate on the risks of caesarean sections ‘on demand’.”

Professor Philip Steer, BJOG editor-in-chief, said “The caesarean section rate in the UK is one of the highest in the world. This isn’t because, in some cases, women are ‘too posh to push’, but rather, complications occur during the pregnancy or birth which make normal delivery impossible.”

“Women need to be informed of the possible risks that can happen throughout the pregnancy and it is important to have their scheduled ultrasound scans to detect if the baby is developing safely. Should a woman encounter unusual bleeding during her pregnancy, it is best if she sees the doctor immediately.”

(Last updated on Wednesday, May 9, 2007, and first posted on Tuesday, May 8, 2007)

A few more minutes of maternal attachment may reduce anemia in children

2007-05-09T05:30:00.000-07:00

In the past, the newborns' umbilical cord was not clamped right after birth, thus allowing the blood flow to stop naturally. This practice, known as "late clamping", was replaced by "early clamping", that is, cutting the cord immediately after the infant is expelled. However, this new practice lacks studies corroborating its benefits. In fact, recent studies on the importance of when clamping should be done have shown contradictory results.

A doctoral thesis carried out at the Department of Obstetrics and Gynecology at the University of Granada (Universidad de Granada [http://www.ugr.es]) by Catalina de Paco Matallana shows that the clamping of the umbilical cord of newborns from full-term pregnancies (that is, infants born after a nine-month pregnancy) two minutes after the infant is expelled from the womb makes no difference to hematocrit or hemoglobin levels of the umbilical cord vein compared to clamping the cord within 20 seconds. Thus, the study shows that early clamping (which is widely performed) is not justified.

Analysis of 151 umbilical cords

The doctoral thesis Repercusiones clínicas y fisicoquímicas del tiempo de ligadura del cordón umbilical en recién nacidos a término (Clinical and Physiochemical Repercussions of Clamping Time of the Umbilical Cord of Newborns from Full-Term Pregnancies) analyzed a total of 151 umbilical cords of newborns from full-term pregnancies. In 79 cases, the umbilical cord was cut within 20 seconds, and in 72 cases it was clamped two minutes after the infant was expelled.

The study found that the partial pressure of oxygen in the umbilical artery of the newborn babies who had late clamping had risen, while there was a lesser need of oxygenotherapy after birth. There were no differences in the removal time of the placenta and the mother's bleeding after birth - one of the reasons why early clamping of the umbilical cord started to be practiced.

De Paco Matallana also analyzed the melatonin concentration (one of the strongest and most currently studied antioxidants), finding differences between the melatonin concentration (aMT) in the umbilical vein and the umbilical artery, the latter being where the concentration is significantly higher. "This suggests that the fetus not only receives melatonin from the mother via the umbilical vein because it crosses the placental barrier, but also that it is produced in stressful situations such as during labor," says de Paco Matallana. Thus, high melatonin concentrations in the umbilical cord, together with the arterial and vein differences according to type of birth, suggest that the pineal gland is used by the fetus and that it can respond during birth.

Preventing anemia in children

As for the concentration of the triacylglycerols (TAG) analyzed in the umbilical vein of both groups, this study found statistically significant differences, as there is a higher concentration of TAG in the group of early clamping. The same is applied to the umbilical artery, where there are also statistically significant differences, with higher a concentration of TAG in the group of early clamping. However, there are no studies corroborating these findings, so more research is needed, although many other studies recommend late clamping "especially because of the beneficial effect on the prevention of anemia in children," says de Paco Matallana.

The author points out that the results of her thesis "show that there are no differences in the hemogram or the general biochemical profile in the umbilical vein in the cases of early and late clamping". Moreover, there were no differences in the viscosity or the melatonin in the umbilical artery and vein, which have traditionally been variables related to early clamping. From a clinical point of view, there were no differences in either group with umbilical clamping at birth.

"This study has not found any scientific evidence to suggest that the practice of early clamping is advisable or to justify the abandonment of late clamping in newborns from full-term pregnancies," says de Paco Matallana. "There are convincing findings for and against the two different types of clamping analyzed in this study, which shows not only the complexity of the problem, but also that research in this field may not be controlled enough or designed correctly."

(Last updated on Wednesday, May 9, 2007, and first posted on Wednesday, May 9, 2007)

Modern Milk

2007-05-08T17:03:00.000-07:00

The milk we drink today may not be nature’s perfect food,” says Ganmaa Davaasambuu, a Mongolian physician who is a fellow this year at the Radcliffe Institute for Advanced Study. Even as the scientific community has become interested in the effects of the bioactive substances found in pesticides, says Ganmaa, not much attention has been paid to the naturally occurring estrogens found in food, which are both far more abundant and more biologically available than environmental estrogens. In fact, she is concerned that the high levels of hormones found in commercially produced milk may be harmful to human health. Estrogens and other growth factors have been implicated in the development of hormone-dependent cancers: those affecting the prostate, testes, ovaries, breasts, and uterus.

Skeptics note that humans have been drinking milk without apparent harm for millennia, she says. But modern milk is different. Her concern stems not from the use of bovine growth hormone (she excluded BGH-fed cows from her studies), but from the fact that milk-producing cows in commercial dairies, through use of artificial insemination and high-quality winter feed, are kept pregnant and lactating 300 days a year. “Cows are like humans,” she explains. “When they get pregnant, the estrogen levels in their blood, milk, and urine increase. [Human pregnancy tests detect similar increases.] This made me wonder—since the cows are pregnant all the time, the hormone levels in their milk should be really high.”

While earning her doctorate in environmental health in Japan, Ganmaa began investigating the prevalence and effects of these naturally occurring hormones. In her native Mongolia, traditional patterns of milking—the same as those used in Westernized countries until the 1920s—are still followed: pasture-fed cows are milked only through the first three months of a new pregnancy. Their raw milk had only one-tenth the progesterone that she and her colleagues found in commercially produced milk in Japan.

Mongolian physician Ganmaa Davaasambuu has linked increased tumor formation and growth in laboratory animals with chemically induced cancer to high levels of hormones in commercial milk. Seasonal milking practices among Mongolian nomads ensure that cows produce milk only during the first three months of a new pregnancy, when hormone levels are low. Because modern dairies, on the other hand, milk cows well into their next pregnancy, commercial milk often contains much higher levels of biologically active hormones.

In a 2002 study of cancer and diet in 42 countries, Ganmaa and colleagues found that countries with the highest consumption of dairy products suffered the highest rates of prostatic and testicular cancer. (A similar study Ganmaa did in 2005 showed much the same results for breast, ovarian, and uterine cancers.) In 2003, the group focused on the relationship between rising rates of these cancers and increased dairy consumption in Japan. Prior to World War II, the Japanese consumed very little milk, and rates of these cancers were low. But in the 1950s, a school-lunch program that included milk was instituted nationwide. Since that time, the intake of milk has increased twentyfold, and the incidence of prostrate cancer has increased twenty-five-fold.

Still, such epidemiological evidence is circumstantial. But in a 2004 study that used rats in which mammary cancer had been induced, she and her colleagues found that rats fed low-fat milk (1 percent) were more likely to develop tumors, and in greater numbers and of larger size, than rats fed water or artificial milk. In a 2006 study, also in rats, she proved that the hormones in milk are biologically active in animals. Both adult and immature milk-fed rats showed increased uterine weight—the gold standard for measuring the estrogen activity of food and other substances.

During her time at Harvard, which began with a year as a research fellow at the School of Public Health under Stare professor of epidemiology and nutrition Walter Willett, she and her colleagues have conducted two pilot studies. The first compared American milk (whole, whole organic, skim, and “shelf-stable” ultra-high temperature milk) to milk from Mongolia. Levels of hormones and growth factors were low in both American skim milk (hormones are carried in the milk fat) and Mongolian milk. In a subsequent study, Mongolian third-graders were fed U.S. commercial milk for a month. The good news was that a number of the children who had been vitamin D-deficient when the study began saw those deficiencies corrected. “Milk is a complex food that contains many good things, such as vitamin B, vitamin D, and calcium,” Ganmaa notes. But the Mongolian schoolchildren’s growth- hormone levels shot up 40 percent; and the children grew, on average, one centimeter during the month—a statistically significant increase, according to Ganmaa. “But we don’t know if it will be sustained in the long term, whether it will affect their sexual maturation or their age at puberty,” she says. “One month is too short.” She and her Harvard colleagues are now seeking funding for a two-year study.

Based on what she has found so far, Ganmaa believes that cows in late pregnancy should not be milked—or, at least, that such milk should be labeled to indicate that it comes from a pregnant cow. In the meantime, it is reassuring to know that skim milk from the United States has low levels of hormones, just like the traditional stuff from Mongolia.

~Jonathan Shaw

Ganmaa Davaasambuu e-mail address: gdavaasa@hsph.harvard.edu

Lag Ba'omer bonfires 'ecological disaster'

2007-05-08T13:49:00.000-07:00

Reform rabbi slams ritual lighting of bonfires during holiday that causes massive air pollution each year, calls on haredi rabbis to issue clear instructions on matter

Kobi Nahshoni

Published:

05.07.07, 03:12 / Israel Jewish Scene

"This is an ecological disaster, it's virtually rabbi-sanctioned vandalism," Reform Rabbi Levi Weinman Kalman said Sunday, referring to the Lag Ba'omer bonfires that were lit across Israel Saturday night and caused massive air pollution throughout the country.

Weinman-Kalman, head of the Kol Haneshama congregation in Jerusalem, is a staunch opponent of the ritual Lag Ba'omer celebration, and claims that the "Bal tashchit" prohibition, which bans destroying anything that is of value to man, is a prominent mitzvah that applies in this case.

The rabbi, along with environmental organizations, does not expect Israelis to refrain from lighting the traditional bonfire on the holiday, but recommends to light less bonfires.

"Nowadays there is competition between yeshivas and families on who has the biggest bonfire. The rabbis should issue a clear instruction to those who celebrate that it is quality – not quantity – that matters," he stated.

Regardless of Lag Ba'omer, the rabbi believes that the concern for the environment can lead to rare cooperation between rabbis, including haredi ones, and the green organizations. For instance, he suggests to declare one Shabbat a month as a "car-free day".

"A car-free day and such cooperation certainly seem far-fetched, but creative thinking can lead to cooperation between sectors who usually don't meet," he stated.

Rabbi Aviner: Green organizations exaggerate

In response to Rabbi Weinman-Kalman's suggestion, Rabbi Shlomo Aviner, the rabbi of the Beit El settlement and head of the Ateret Kohanim yeshiva told Ynet that rabbis were aware of damages to the environment.

"Not everything we do gets media attention, and therefore I warn again of 'Bal tashchit' and of damages that may be caused to people and the environment," he said.

However, Rabbi Aviner said that as a former scientist, he knew that green organizations usually exaggerate the importance of ecological issues.

"It's true that we only have one planet Earth, and that without it there would be no Eretz Israel, Torah and mitzvot, but the damage caused

to it is minor… The money and resources that go into preserving the environment should be invested in more important things," he said.

Rabbi Aviner said that he believes that in the war for the environment, the consideration of gain versus loss should be kept in mind. "Disposable diapers are also bad for the environment, but no one thinks of returning to cloth diapers, because there are other needs as well," he explained.

According to the rabbi, although bonfires have no religious justification, if they meet the need for stress relief, entrainment or even pyromania, then they are legitimate.

The Home School option

2007-05-08T13:08:00.000-07:00

August 20, 2001: 10:38 a.m. ET

Why a growing number of parents are educating their children at home
By Kamala Nair

NEW YORK (CNNfn) - Deanna Busch runs a tight ship. Classes start at 6:30 a.m. – those who are not in their seat by then receive detention. Like other teachers, Busch does not allow gum chewing. She requires homework to be finished on time and tests to be taken in silence. The only difference is: Her students call her "mom."

Like most military families, the Busch's lifestyle takes them all over the world. When her husband was posted in Korea, Deanna Bush had a chance to preview schools for her six young children. Unsatisfied with the quality of education offered by the Department of Defense, she decided to take her children's education into her own hands.

She began researching the home schooling concept, reading books such as "The Big Book of Home Learning," by Mary Pride, which recommends curriculum and lesson manuals. She attended home school conventions, which are held annually in every state, where she visited exhibits displaying a variety of useful books and curriculum. Within a year, she added "teacher" to her list of qualifications, and turned their home into a classroom.

A growing contingent
According to the ERIC Clearinghouse on Educational Management, the Busch family is not alone. The home schooling population has grown from 10,000-to-15,000 children in the late 1960s to well over 1 million today.

The most common tools parents use when beginning to home educate their children are annual conventions, the Web, and correspondence programs, which test children and design curriculum for their specific needs. About 20 percent of home schoolers belong to these programs, which also keep records of academic history and issue diplomas upon graduation.

While currently only about one-third of parents educate their children at home beyond the elementary level, Chris Klicka, senior council at the Home School Legal Defense Association (HSLDA), estimated that roughly 80 percent of new home schooling parents plan to educate their children through high school. In such cases, parents themselves issue their children transcripts and diplomas.

Research conducted by the HSLDA indicates that since home education families are not dependent on public, tax-funded resources, they save United States taxpayers more than $7.5 million a year. However, parents who school children at home pay the same amount in property taxes as everyone else. Parents pay about $450 annually to teach one child at home, about $6,000 to send a child to public school, and anywhere from $1,000 to more than $6,000 to send a child to private school.

Busch said her costs have increased as her children grow older, reaching around $800 per year for her 7^th and 8^th graders, because she sends their assignments to certified teachers through a correspondence course, who provide grades and transcripts.

Busch emphasized that fusing the roles of parent and teacher can be a big sacrifice for parents. Because they are generally one-income households, money is often an important factor, especially for military families who don't earn a large income.

"But the sacrifice and hard work pay off," asserted Busch, who will be sending her oldest son on a $1,000 scholarship to begin high school at a prestigious parochial school in Washington, D.C.

Home schooling, which once was outlawed in most states, is now legal throughout the United States, and its popularity has grown steadily over the past several decades.

While the Department of Education does not impose any federal restrictions on home education, each state has its own policies regarding the issue. South Carolina, for example, requires a parent to enroll with the local school district or with an accountability association. The parent must have at least a GED or a high school diploma, must teach for 180 days out of the year, and keep records and samples of their children's work.

Other states, such as Arizona or Kansas, simply require parents who home educate to register with the state, but do not monitor the children's progress as closely.

According to ERIC, while home schooling families come from all major ethnic and income groups, the typical family tends to be large, religious (Christian), conservative, and white. They are also generally middle-class, better educated, and more likely to be part of a two-parent family.

About 10 percent of these families belong to the military as well, since many parents feel that forcing their children to migrate from one school to the next is harmful to their development.

"My oldest son has been to the same grade school even though we have moved so often. Our house and our friends change continuously, but his education has stayed constant," said Busch.

Brian Ray, president of the National Home Education Research Institute (NHERI), said the most commonly stated reasons that parents give for home schooling their kids include: teaching them specific philosophical and religious values; controlling their social interactions; developing close family bonds; and promoting high-level academics.

At the same time, he said, many parents feel that schools today are breeding grounds for morally corrupt behavior and attitudes. "Parents do not want their kids to be exposed to all the violence in schools these days," said Gloria Ferber, of the Grace Home School Association, based in South Carolina.

Academic and social implications
In fact, advocates argue that educating children at home not only protects them from moral corruption, but that it also leads to increased maturity and a higher level of academic achievement. Through a nationwide study conducted by NHERI, Ray discovered home educated students to be scoring, on average, at or above the 80^th percentile in all areas on standardized achievement tests. That is well above the national average, which is in the 50^th percentile. According to ERIC, college admission statistics are also a measure of success. Home school graduates have reported admission to more than 1,000 different colleges and universities, at last check.

While there is no conclusive research suggesting that additional time with peers is preferable to more time with individuals of varying ages, parents who choose to educate their children at home say that the increased exposure to people of all ages they receive through community activities and involvement with support groups, increases their self-confidence and maturity.

"Kids should not be learning what's right and wrong from other kids – they should be learning from adults," said Busch.

Although home schoolers are an ever-growing contingent, the practice still remains controversial. Organizations such as the national Parent-Teacher Association and the National Association of Elementary School Principals oppose this mode of education, and the National Education Association has called for more rigorous regulation of home schooling.

Conversely, groups such as the American Civil Liberties Union believe that parents have a constitutional right to teach their own children. The majority of Americans, while they don't necessarily promote the institution, believe in a parent's right to take charge of their children's education, and many state legislatures have amended their laws to provide greater flexibility for home schooling.

Klicka, of the HSLDA, acknowledged the limitations that home education poses to children, in terms of access to labs and athletics. However, he firmly believes the individual attention and disciplined learning environment it provides outweighs the cons.

"Home schooling parents feel their children need to be educated based on the values this country was founded upon," he explained. "A lot of people are concerned that their kids will become an academic or social statistic. They want their kids to be literate and to be able to have the necessary skills to succeed."

Canada the 15th best country to be a mother

2007-05-08T08:50:00.001-07:00

Updated Tue. May. 8 2007 10:20 AM ET

CTV.ca News Staff

Save The Children has released its eighth annual State of the World's Mothers report, ranking 140 countries on the wellbeing of their mothers and children. And Canada ranks 15th, well behind first-place Sweden.

The United States finished 26th, and at the bottom of the list were Niger, Sierra Leone and Yemen.

Save The Children President and CEO David Morley says his organization used a number of criteria to create their rankings, including: early childhood education; the support given to moms who want to stay home with their children; and health services for young children.

"We take all of those and that helps build the net around mothers and young children to support the survival and the strong development of children under the age of five," Morley told Canada AM Monday.

Morley adds he's not surprised that Sweden is at the top of the list.

"Sweden has very strong social systems," he says. "They have long maternity leaves so mothers can stay at home for a long time with their young children.

"And also, they've got excellent early childhood education. So those are the two real mainstays in wealthy countries to make it possible for children to have that strong development -- so that mothers can really be mothers."

Morley adds that while Canada is well ahead of many countries by providing up to 50 weeks of maternity and parental benefits to new mothers, it still lags behind many countries in Europe.

"In Scandinavia, in Europe, they have much better maternity benefits than we do," he says.

"There are times when it's possible to stay at home for two years to be able to look after your children," he says.

And then there's the early childhood education, which lays the strong foundations for children as they grow up, experts say.

"Here in Canada ... maternity benefits are better than they were 15 years ago, but it's not up to the standards of Europe," Morley says.

Morley adds, though, that the difference between mothers in Canada and mothers in Europe are small compared to the vast difference between mothers here and in the countries at the bottom of his organization's list.

The worst place to be a mother is in sub-Saharan Africa, Morley says. There, many mothers have no access to medical care when they give birth, they have inadequate health care, vaccinations and nutrition for their children, and they have poor or no access to education.

"Those are all things that lead to the terrible situation for so many mothers and children," Morley says.

The infant mortality rate in many of these countries is also still disturbingly high. A mother in Angola, Burkina Faso, Chad, and Zambia, for example, can expect to lose one child before they become adults, and a mother in Niger can expect to lost two.

The leading causes of death among children under five are newborn disorders, pneumonia and diarrhea - all preventable or treatable with low-cost basic interventions.

"In fact, this year, ten million children under the age of five are going to die from preventable causes. And that's just outrageous.

"And that's part of why we raise this report, not only to look at what can be done better in the wealthy countries but to show what's happening to so many children and mothers around the world."

Spit test spots deadly pre-eclampsia

2007-05-08T08:48:00.001-07:00

LONDON, May 8 A home test which uses spit allows mothers-to-be to check for themselves whether they are at risk for pre-eclampsia, says a British study.

The test is expected to be more reliable than the traditional blood pressure and urine tests conducted in doctors' offices and hospitals, according to the study published in Chemistry & Industry.

Pre-eclampsia, which can cause infant mortality, also causes maternal mortality, killing one woman globally every six seconds, according to the United Kingdom's Action on Pre-Eclampsia. Earlier detection and intervention could save lives, but standard blood pressure and urine tests are unreliable, and there is a lot of room for "user error" , according to Michael Rich, head of Action on Pre-eclampsia. The test works by monitoring levels of urate, a salt of uric acid, increased levels of which are thought to be due to impaired kidney excretion in pre-eclampsia.

Copyright 2007 by UPI

Pa. moms push to make breastfeeding in public a protected act

2007-05-08T08:46:00.000-07:00

By Kim Lyons
TRIBUNE-REVIEW
Tuesday, May 8, 2007

Cheryl Bradshaw is ready -- for the snide comments, the disapproving looks, the general sense of discomfort. Even though Bradshaw, mother of three, hasn't had to defend her decision to breastfeed her kids in public, there's no law in Allegheny County that protects her and other breastfeeding moms.

"I think we have some great lactation consultants and a really active La Leche League, but Pittsburgh has a lot of old-school thinking when it comes to breastfeeding," said Bradshaw, 38.

At a rally in Harrisburg yesterday, breastfeeding mothers said Pennsylvania's unsupportive atmosphere limits their nursing. A bill sponsored by Sen. Connie Williams, a Montgomery County Democrat, would protect breastfeeding in public and ban companies from firing women who breastfeed or use a breast pump at work. It also would extend tax credits to companies with policies encouraging breastfeeding.

"I have been fortunate to have young working mothers working for me. They're terrific," Williams said. "They come back to work while they're still nursing their babies."

In the meantime, the Allegheny County Health Department is looking for this year's most breastfeeding-friendly places in Allegheny county for its 12th annual Breastfeeding Friendly Place Awards.

"The place where I'm most self-conscious, and people seem to have the biggest hangup is in restaurants," said Charissa Howe, 28, of Observatory Hill, who's nursing her 11-month-old daughter. "People seem to think it's unsanitary or something, and they'll whisper or stare at you."

Howe said breastfeeding in places like museums and parks posed the least problems.

Stephanie Strazisar works at Bayer, last year's workplace winner. She said she knew returning to work after the birth of her daughter wouldn't mean she'd have to stop nursing, since Bayer has six lactation rooms at its Robinson campus. The lactation rooms are quiet, private rooms with comfortable seating outlets for breast pumps.

Diana Kamyk, Bayer's manager of work life diversity, said part of the reason a lactation room was such a natural fit for Bayer is the similarity of its corporate culture to the progressive social practices of its home country of Germany.

"There have been times where it's been a little awkward, having to excuse myself from meetings," said Strazisar, 33, of Venetia. "But everyone is really supportive. It's been a win-win; I'm happy at work, and I'm just as productive a worker."

The American Academy of Pediatrics recommends babies be breastfed for at least the first year, but the early return to work presents problems -- mothers can't bring their babies to work for eight-plus hours.

Simply getting mothers to ask for a place at work to pump breast milk is a major accomplishment, said Dr. Brian Donnelly of Pediatric Alliance in McCandless.

"They need to ask for support and time and a clean, safe place to express milk," said Donnelly, who is on the Allegheny County Health Department's Breastfeeding Promotion Steering Committee. The milk can be refrigerated or frozen to feed the baby later.

The numbers show that most mothers give breastfeeding a try. According to a 2005 Centers for Disease Control survey, more than 70 percent of new moms breastfed at birth, and 39 percent still were nursing six months later. By 12 months, that number was down to 20 percent.

The survey found Pennsylvania's numbers were pretty close to the rest of the country: about 69 percent of new moms breastfed at birth. After six months, only 37.5 percent of Pennsylvania mothers still were nursing; and only 20 percent were nursing 12 months later.

At first, Shayne Blacksburg, 33, mother of 11-month-old Ari, said she felt self-conscious about nursing in public. But she's moved past that.

"I'm at the point now where I think, 'If you need to look, go ahead. You're not going to see much,'" Blacksburg said.

Material from the Associated Press was used in this report.

Kim Lyons can be reached at klyons@tribweb.com or (412) 320-7922.

'Guardian angel' WA's best

2007-05-08T08:43:00.000-07:00

Victoria Laurie

May 07, 2007 06:13am

A MIDWIFE who delivered two dying babies for a Perth mother has been named top of her field in WA after being nominated by the bereaved parents.

Theresa Clifford attended the births of all three of Lisa Wilkinson's sons, and was present yesterday at the sixth birthday party of surviving son Shae, whose brothers Kaia and Finn died soon after birth from severe congenital hydrocephalus, a condition that causes babies to be born with an enlarged head and little or no brain matter.

Ms Clifford said it was heartbreaking when Kaia was delivered at home in 1999 and died suddenly twelve hours later.

"Lisa woke up at two in the morning and he was dead," she said. "He hadn't looked hydrocephalic at all."

Two years later, Shae arrived safely in an uneventful homebirth, but when Lisa's third child, Finn, was conceived last year, a late scan at 32 weeks showed Finn was also severely affected.

Ms Clifford supported Ms Wilkinson's decision to carry Finn full term. While not expected to survive the birth, he lived for eight days.

"It was amazing that Finn did live that long - it was his gift to Lisa and (father) Chris. We were all there when he died," she said.

Ms Wilkinson said the midwife's support had been crucial to her recovery.

"Theresa was like a guardian angel, sharing the most amazing moments of our lives and the most devastating ones," she said.

The Australian College of Midwives, which co-sponsors the annual Johnson and Johnson Midwife of the Year Award, said good midwifery care helped women through post-natal loss.

But college president Pat Brodie warned of a crisis in midwife numbers, saying an estimated shortfall of 1800 trained midwives across Australia in 2002 had worsened.

"We have queues of people wanting to join the midwifery profession who can't get a place in a program for want of funding for clinical placements," she said.

The Australian

Maternity wards use cloth nappies

2007-05-08T08:41:00.001-07:00

New mothers in Tayside are being offered the opportunity to "go green" with the introduction of cloth nappies in maternity wards.

Mothers who give birth at units in Angus, Perth and Dundee will be able to try the reusable nappies instead of disposables during their hospital stay.

Audrey McIntyre-Miller, antenatal health coordinator in Perth, said the nappies were modern and easy to use.

The move has been welcomed by a number of organisations.

Kay Forsyth, acting head of midwifery for Tayside, said: "We are providing women with a choice by having real nappies available for use in the maternity wards and letting mums try them before they take their babies home.

Using real nappies instead of disposables dramatically reduces the amount of waste produced by a household

Melanie Nicoll, Perth and Kinross Real Nappy Network

"We advise women to bring nappies into the maternity unit for their baby and, of course, if they want to use disposables they can but this change will allow them to try an alternative."

Phyllis Winter, team leader at Montrose community midwives unit, said that a number of women had already expressed an interest in the nappies.

She added: "I think women are surprised at how different real nappies are from the old terry squares and how easy they are to use.

"They are a much better fit and they look lovely. I think they'll be quite popular here."

Perth and Kinross Real Nappy Network said the introduction of the scheme would send a positive message to parents.

"Using real nappies instead of disposables dramatically reduces the amount of waste produced by a household as well as offering parents the potential to save hundreds of pounds," said Melanie Nicoll, the organisation's project officer.

Mothers who want to continue using the nappies afer leaving hospital will be provided with ongoing support and advice through the Dundee Real Nappy Project and Perth and Kinross Real Nappy Nework.

Get your blog noticed with Technorati faves exchange

2007-05-04T08:53:00.000-07:00

Instructions for Blog Popularity shares the Ultimate Technorati Favorites Exchange, an ongoing experiment began by Dosh Dosh.

In a nutshell, here is how to do it:

1. Add me to your Technorati Favorites. Just click this button here or the one in my Social Bookmarking box:

2. Create your own post, in your own words about this favorites exchange, copying the table below if you wish, making sure to add your information to the table. See Dosh Dosh's blog for more ideas of what you might write. Then return to this blog.

3. Leave a comment on this post so I can add you to my faves and to the table below. In your comment, make it easy for me and give me that anchor text and link to your Technorati Favorites blog post with your Technorati button so that I can just copy and paste you into the table below. Also tell me your Technorati username so I can find you. I will then add you as one of my favorites. My Technorati username is AmyMc. It will appear in the list of those who have made you their Favorite at your Technorati account.
************************************************************************
To facilitate easier Fave-making, I have made a chart with the current list of participants with
buttons that allow you to add each one to your favorites of Technorati without having to visit
each individual page. After adding each to your favorites, then visit each site individually and
add your comment with a link to your Technorati Favorites blog post and your Technorati username.
All are welcome to copy this table and use it for your own sites, as long as you keep the
attribution in the footer of the table. Just drop us a line if you would like to be added to the
table of if your linking info in the table is incorrect.

1. GarryConn.com - Garry Conn
2. MrGaryLee.com - Gary Lee
3. AskaX World - Andika Kusuma
4. T Jantunen.com - T Jantunen
5. CalvinWarr.com - Calvin Warr
6. Vinod Live! - Vinod Ponmanadiyil
7. Bil2me dot com - William Toomey
8. Zath - Simon Barker
9. VersaCreations - Vivienne Quek
10. Azazil.net - Gary V. Vaughan
11. Blogging for Money - Michael A. Setyaputra
12. Money Consciousness - Nenad
13. Brown Thoughts - Brown Baron
14. Quasi Fictional - Diogenes
15. Foreign Perspectives - Arnold
16. Home Based Business - Brian Pratt
17. The Million Dollar Experiment Down Under - Rob St George
18. Sexy in Red - Norlina
19. JameoTips - ValkrieAngel
20. I Thought Therefore I Blog - Bet Shop Boys
21. Make Money Online: Quick n’ Easy Way - EJ Cooksey
22. MLM Forums online marketing blog - Jens P. Berget
23. Ramblings of an Undisturbed Mind - Beth
24. QMusings - Mrs Q
25. NiaTrading Signals - Alex 3071
26. BlogOp - Chris Lodge
27. Technospot.net - Ashish Mohta
28. ContentPays.info - Yogesh
29. Shadow Scope - Richard
30. TechJunction - Netbizopp
31. Genius Type - Brian Lee
32. FrugalMomma - Lisa Knight
33. Life Spices - Indra
34. Living Your Dreams - Lee Tuck Sing
35. My Online Collections - star500k
36. How to Earn Money Blogging - Daryl Lau
37. Pentimento - Webduck
38. Article Discovery Politics - David Greene
39. Rugjeff’s Blog about Blogging - Rugjeff
40. Lack of Money is the Root of All Evil - Kakashihatake
41. Digital Phocus - Brendan Monaghan
42. Digital Information Technology - Atul Dogra
43. Inklings: The Copywriter’s Blog - Walter Burek
44. Gauravonomics - Gaurav
45. Internet Serious Business - The Troll
46. Romance Tracker - Phil Van Treuren
47. Genus_Loci - John
48. KylesCove.com - Kyle Eslick
49. Msdanielle.com - Danielle
50. Bubba Stuff - Sandee Leong
51. Syaf the Geek - Syafrizal Abu Mansor
52. Manila Mom - Maia Jose
53. Can’t Coach That - Coach McGee
54. UrgentClick - Andy
55. Dannydang.com - Danny Dang
56. Blog About Money Online - Alex Bamo
57. The Pond - Karen
58. Untwisted Vortex - RT Cunningham
60. The Rojak Blog - Ap0gEE
61. eJabs.com - Matthew Jabs
62. Life Rocks! 2.0 - Nirmal T V
63. Life in the Fast Lane - Deborah
64. Dummies Guide to Google Blogger Beta - Vin
65. Army Mum: New Jersey - Charlotte
66. Home Office Women - Doris
67. Wampago - Chris
68. EmpowerWomenNow.com - Ponn M. Sabra
69. Bigfoot Sightings - Linda Martin
70. Online Business News - Tammy Ames
71. Tricia’s Musings - Tricia
72. Blog Fyais - iszo
73. ShanKri-La - Karthik Ramadoss
74. The anitokid chronikos - Anitokid
75. Random Expressions - Deepak Jeswal
76. Keeping Fit is A Daily Battle - Nash Trout
77. Magical Rose Garden - Magical Rose Garden
78. Revvi::blog - Revvi Sudirnoputra
79. Skeet’s Stuff - Skeet
80. Tech Lock Rahul - Rahul
81. Anja Merret - Anja Merret
82. Rishiraj - Rishi
83. ::Under the Rainbow:: - [s][e][x][y][i][n][r][e][d]
84. //Engtech - Engtech
85. Mom Gadget - Gayla McCord
86. Planet Apex - Planet Apex
87. Captain Picard’s Journal - Jean Luc Picard
88. Table4Five - Elizabeth
89. Computer Mobile Corner - Santa
91. Sizlopedia - Sizlopedia
92. Mother’s Home - Stine
93. Dox - Rahul
94. iReview - iReview
95. My Life - Clsyee
96. My Journey to One Million Dollars - Laura
97. Ordinary Folk - Mike
98. AndyBeard.eu - Andy Beard
99. TechnoDiary - Sahil Gupta
100. SEO Blog at Pixnet - SEO Blog at Pixnet
101. SMO Blog - Mark Blair
102. My Life My Story -My Passion - Yong Kai Loon
103. My Affiliate Journey - Vlad
104. Real Amber - Real Amber
105. Me and My Net - Anoop Kumar Singh
106. Klamath Design - Linda
107. Homemaker Diary - MQ
108. The Blog Columnist - The Blog Columnist
109. Six Degrees of Inspiration - Nicholas Kister
110. Internet Marketing - Schee
111. Vacilamos! - Ari
112. Mr & Mrs Imran - Mr and Mrs Imran
113. Mina’s Musings - Mina
114. Panda Cube - Aki Jinn
115. Lifecruiser - Lifecruiser
116. SMS Today - SMS Today
117. Creative Design - David Airey
118. Jon Lee dot see eh - Jon Lee
119. Nukilan Jejari Azhad - Shaz Azhad
120. (exceptional) work.com - Jon
121. Arts & Stuff - Susan Borges
122. Sapphire Knight - Sapphire Knight
133. Shakeroo’s Gold - Shakeroo
134. The Making of an Internet Entrepreneur - Maria
135. Domestic Divapalooza - Angela Llewellyn Stevens
136. Business Sanity - Susan Martin
137. The Thinking Blog - Ilker Yoldas
138. TechChee.com - ketyung
139. TechLivez.com - Tech Livez
140. Ms Latina Renee Enterprise - Latina Renee
141. Design Adaptations - Charity Ondriezek
142. Online Diary - Venu
143. Square Cookies - Square Cookies
144. Sleeping Princess - Jocelyn
145. Shankar’s Tech Blog 2.0 - Shankar
146. Diet Recipe for Everyday - Cherry
147. Technacular - Vikas Sah
148. Kabatology - Kabatology
149. Filipino Entrepreneur - Manolito
150. Intensive Care for the Nurtured Soul - Hueina Su
151. The Reviewer - The Reviewer
152. IndiaPR Blog - hobbithob
153. Show me the Money - Gerri
154. Blue Sky Brothers - Greg Meares
155. Reality Wired - James
156. A Blogspate - Juliet Pain
157. Mom Of Many Redheads - Amy Mc
158. JesterTunes - Jester
Table designed by the makers of Doodlebuckets.com and AskMama! Web Directory

Infant feeding and analgesia in labour: the evidence is accumulating

2007-05-04T05:32:00.000-07:00

Abstract

The interesting and important paper by Torvaldsen and colleagues provides further circumstantial evidence of a positive association between intrapartum analgesia and feeding infant formula. Not all research supports this association. Before 'failure to breastfeed' can be adjudged an adverse effect of intrapartum analgesia, the research evidence needs to be considered in detail. Examination of the existing evidence against the Bradford-Hill criteria indicates that the evidence is not yet conclusive. However, the difficulties of obtaining funding and undertaking large trials to explore putative adverse drug reactions in pregnant women may mean that we shall never have conclusive evidence of harm. Therefore, reports of large cohort studies with regression models, as in the paper published today, assume a greater importance than in other areas of investigation. Meanwhile, women and their clinicians may feel that sufficient evidence has accumulated to justify offering extra support to establish breastfeeding if women have received high doses of analgesics in labour.

Introduction

Torvaldsen and colleagues have published an interesting paper [1] on an extremely important topic: the impact of intrapartum analgesia on infant feeding. If intrapartum analgesics do interfere with breastfeeding, this might, arguably, be the adverse drug reaction with the greatest public health consequences. To explore this issue, Torvaldsen and colleagues revisited a 1997 cohort to examine the factors affecting duration of breastfeeding up to 24 weeks. These authors are among the first to employ a Cox proportional hazards regression model in this field. This illuminating analysis suggests that both intrapartum pethidine and epidurals can increase the likelihood of breastfeeding cessation: 210/292 (72%) women who had no pharmacological analgesia were breastfeeding at 24 weeks compared to 139/261 (53%) who received pethidine and 206/396 (52%) who received epidurals containing bupivacaine and fentanyl (hazard ratios [HR]: 1.95, 95% CI [confidence interval]: 1.45, 2.63 and 2.07, 95% CI: 1.57, 2.72).

Discussion

Women feed their babies infant formula for a variety of reasons: physical limitations; medical advice; psychosocial factors; cultural norms and expectations. Recently, the possibility that infant feeding is also constrained by pharmacological influences has attracted the attention of researchers. Several studies, including this [1], have suggested that 'failure to breastfeed' is linked to administration of intrapartum analgesics.

When deciding whether to accept, administer or advocate intrapartum analgesia, women, their clinicians, and those who compose clinical guidelines, need to consider whether 'failure to breastfeed' is a foreseeable and preventable adverse effect of opioids or epidurals. Is the association between analgesia and feeding infant formula strong enough to meet the criteria for an adverse drug reaction?

If failure to breastfeed is considered an appreciably harmful or unpleasant reaction, related to the use of intrapartum analgesics, and administration predicts hazard, and warrants prevention, specific treatment, alteration of the dosage regimen, or withdrawal of the product, then this is an adverse drug reaction [2,3]. It is possible that some women, and even some clinicians, will not consider 'failure to breastfeed' an appreciably harmful event, warranting prevention, and here the public health message needs to be communicated. Identification of adverse drug reactions is a socially contingent process. It is possible that infant formula feeding is such a common occurrence that it does not attract the attention of clinicians: in practice, a woman's failure to breastfeed may be more likely to be attributed to cultural norms and expectations than opioid-induced impairment of the suckling reflex. The concern of researchers is to examine the evidence for a causal, rather than a co-incidental, relationship by addressing four pertinent questions [4].

1) Is the strength, consistency, specificity and temporality of association between feeding infant formula and intrapartum analgesia sufficiently robust to attribute cause and effect?

Most of the evidence comes from cohort and observation studies. Not all these studies, particularly the small ones, indicate any association [5-8]. These cohorts included 56, 171, 181 and 114 parturients, respectively. No-one has suggested that intrapartum medication is the only determinant of infant feeding, and small cohorts may be unable to allow for the many confounding variables. Other cohort studies, ranging in size from 99 to 411 parturients, have supported the link between epidural analgesia and feeding infant formula [9-13]. With one of the largest cohorts in the area (n = 1178), Torvaldsen and colleagues are making an important contribution to this field [1]. However, even the largest well conducted cohort studies will never provide evidence as robust as that obtained by experimental methods, most particularly, well conducted double-blind randomised placebo-controlled trials.

Intrapartum analgesia is inevitably linked to method of delivery, as this study indicates, and feeding infant formula may be associated with Caesarean birth [14]. There are very few papers reporting the relationship between infant feeding and induction of labour [15], but women whose labour is induced often require more analgesia [16]. Disentangling the contributions of these interacting variables is not always possible. In this study, data were analysed excluding women undergoing Caesarean section, and findings were essentially unchanged. However, variables cannot always be removed from an analysis in this way, which may leave study findings vulnerable to confounding. Even the best statistical modelling cannot entirely compensate for the associations that are unavoidable in clinical practice: only large randomised trials can do this.

2) Is there any experimental evidence?

There would be considerable difficulties in allocating women to a placebo arm of a randomised controlled trial, where they would receive no real analgesia during labour. The existing randomised controlled trials in this area are too small and vulnerable to cross-over to fully test the hypothesis that intrapartum analgesia affects infant feeding. Interpretation of the largest trial is confused by the high proportion of women crossing over between the two arms of the trial: 314/499 (62.9%) women from the no-epidural arm required epidurals and 117/493 (23.7%) randomised to receive epidurals did not request them [17]. Per protocol analysis of the subset of 484 women with spontaneous labour and vaginal birth linked epidural analgesia containing fentanyl plus bupivacaine with shorter duration of breastfeeding (HR: 1.44, 95% CI: 1.04, 1.99; p = 0.029). A smaller trial randomised 177 women who had previously breastfed and were requesting epidurals to: bupivacaine only, 1–150 mcg fentanyl or >150 mcg fentanyl [18]. Cross-over between trial arms was 15/177 (8.5%), and reporting of infant feeding at six weeks was complete for 157/177 (89%) women. The findings support an association between administration of epidural fentanyl and feeding infant formula: babies were exclusively formula-fed by 1/51 women who received 0–100 mcg fentanyl, 3/54 women who received 20–350 mcg fentanyl, 10/52 who received 75–350 mcg fentanyl (p = 0.002).

3) Is there a dose-response relationship?

A dose-dependent relationship between medication administered and feeding or behaviour has been reported [13,18,19]. However, several researchers, including Torvaldsen and colleagues, were unable to obtain information on doses administered, thus limiting the options for data analysis.

4) Is the association biologically plausible and coherent?

All opioids administered to the mother pass into the neonate via both the placenta and the colostrum, but transfer is more rapid and complete for the more lipophilic compounds, such as diamorphine, fentanyl and fentanyl derivatives. The impact on neonatal behaviour is observable and dose-related [19]. The evidence from this paper would suggest that opioids affect infant feeding, regardless of route of administration. This is discussed more fully elsewhere [13].

Labour without recourse to pain relief, whether pharmacological or non-pharmacological, is not an option. If it is considered that, on balance, the evidence supports a causal association, extra support will need to be offered to the most vulnerable women, to ensure that their infants are not disadvantaged by this hidden, but far-reaching, adverse drug reaction. The experience of Henderson and colleagues indicates that undertaking a trial in this area is likely to present many practical difficulties [17], beyond the control of even the most expert researchers. Meanwhile, the absence of data from large successful trials increases the importance of cohort studies, such as that published today [1].

Conclusion

Clinicians basing their practice on the best available evidence, and women considering their analgesic choices, may feel that, despite the paucity of randomised controlled trials in this area, strategies for mitigating the impact of intrapartum medications on the next generation should be considered. Most particularly, women receiving high doses of opioids might be offered extra support to establish and maintain breastfeeding, coupled with information to help them gain an understanding of some of the reasons underlying any difficulties they are encountering.

Competing interests

The author(s) declare that they have no competing interests.

References

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2.		Edwards IR, Aronson JK: Adverse drug reactions: definitions, diagnosis, and management. Lancet 2000, 356:1255-9. [PubMed Abstract] [Publisher Full Text]
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3.		International Conference on Harmonisation (ICH): ICH Harmonised Tripartite Guideline For Good Clinical Practice. Institute of Clinical Research, Marlow, Bucks; 1996.
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4.		Bradford-Hill A: The environment and disease: association or causation. Proc R Soc Med 1965, 58:295-300. [PubMed Abstract]
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5.		Radzyminski S: The effect of ultra low dose epidural analgesia on newborn breastfeeding behavious. J Obstet Gynecol Neonatal Nurs 2003, 32:322-31. [PubMed Abstract] [Publisher Full Text]
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6.		Halpern SH, Levine T, Wilson DB, MacDonell J, Katsiris SE, Leighton BL: Effect of labor analgesia on breastfeeding success. Birth 1999, 26:83-8. [PubMed Abstract] [Publisher Full Text]
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7.		Rosen A, Lawrence R: The effect of epidural anesthesia on infant feeding. The Journal of the University of Rochester Medical Center 1994, 6:3-7.
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8.		Chang ZM, Heaman MT: Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding. J Hum Lact 2005, 21:305-14. [PubMed Abstract] [Publisher Full Text]
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11.		Baumgarder DJ, Muehl P, Fischer M, Pribbenow B: Effect of labor epidural anesthesia on breast-feeding of healthy full-term newborns delivered vaginally. J Am Board Fam Pract 2003, 16:7-13. [PubMed Abstract] [Publisher Full Text]
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17.		Henderson JJ, Dickinson JE, Evans SF, McDonald SJ, Paech MJ: Impact of intrapartum epidural analgesia on breast-feeding duration. Aust N Z J Obstet Gynaecol 2003, 43:372-7. [PubMed Abstract] [Publisher Full Text]
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18.		Beilin Y, Bodian C, Weiser J, Hossain S, Arnold I, Feierman DE, Martin G, Holzman I: Effect of labor analgesia with and without fentanyl on infant breast-feeding: a prospective, randomized double-blind study. Anesthesiology 2005, 103:1211-7. [PubMed Abstract] [Publisher Full Text]
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A family practice breastfeeding education pilot program: an observational, descriptive study

2007-05-04T05:27:00.000-07:00

Abstract

Background

The United States Preventive Services Task Force found that effective interventions for extending breastfeeding duration are generally begun during the prenatal period, provide ongoing support for patients and combine information with face-to-face guidance. A 2001 literature review had similar findings but also found that employing a lactation consultant in the clinical setting may increase breastfeeding duration rates. Thus, a program was developed at a family practice office that employed a lactation consultant and followed the American Academy of Pediatrics' "Ten Steps to Support Parents' Choice to Breastfeed Their Baby."

Methods

The program distributed handouts at each prenatal and well-child visit (up to one year). Using questionnaires, a small audit project evaluated the program's impact on breastfeeding goals, duration, in-hospital exclusivity and maternal perception of success. Mothers completed goal surveys at baseline and post-intervention, usually while waiting for prenatal clinic visits. Duration was assessed by surveys completed during well-infant visits, postal mailings or telephone interviews at breastfeeding cessation, 6 months and 1 year. The outcomes measured were increases in goals, maternal perception of success, duration and in-hospital exclusivity.

Results

Participants included 33 women: 48% had a bachelor's or master's degree, 61% were non-Hispanic white, and 67% reported incomes of US$75,000 or higher. At baseline 5/31 planned to exclusively breastfeed for 4–6 months and 5/33 planned to breastfeed for 6–12 months. Post-intervention there was a 200% increase (15/31) in the exclusively breastfeeding 4–6 month group and a 160% increase (13/33) in the 6–12 month duration group. Actual in-hospital exclusivity rates were 61%, 6-month duration rates were 73%, and 12-month rates were 33%. Over 75% of mothers reported feeling successful.

Conclusion

This small pilot educational program may have significant impacts on breastfeeding goals. Setting and meeting goals may increase duration and in-hospital exclusivity rates as well as enhance maternal self-perception and empowerment due to succeeding at their breastfeeding goals and/or experiencing a fulfilling breastfeeding relationship.

Background

The World Health Organization recognizes the importance of promoting and supporting breastfeeding as the optimal feeding method used exclusively for at least 6 months and continued along with complementary feeding for no less than two years of life [1]. Given that current overall United States (U.S.) breastfeeding rates fall short of these recommendations [2-5], implementation of programs that promote breastfeeding are indicated. Additionally, for breastfeeding programs to be optimally effective, they should be combined with:

1. "Baby-Friendly" hospital practices [1,6]

2. Primary care settings which follow the AAP Task Force on Breastfeeding's "Ten Steps to Support Parents' Choice to Breastfeed Their Baby" (AAP's 10 Steps) [7]

3. A variety of other outpatient interventions [8,9].

While there are a number of ways to implement breastfeeding promotion within a family practice, this family practice in the U.S. developed a small pilot program consisting of a variety of interventions. The practice's program aimed to increase breastfeeding goals and document the participant's breastfeeding rates. There is compelling evidence that breastfeeding goals affect duration; however, research is needed to identify whether education can increase maternal goals [10]. The authors aimed for participants to meet or exceed local breastfeeding rates and the Healthy People 2010 goals [3,4]. This paper reports on the program.

Breastfeeding rates collected by the state of California varied within the county of Orange. In-hospital 2002 initiation rates ranged from 71.8% in African-Americans to 86.5% in Caucasians as well as multiple race or other [11]. In-hospital exclusive rates ranged from 15.1% in Hispanics to 52.5% in Caucasians [11]. In-hospital rates reported for the participants' birthing hospital averaged 90% for initiation of breastfeeding and 41% for exclusive breastfeeding in 2001 [12]. The highest in-hospital initiation rate for the same hospital and year was 93% for Asian/Pacific Islanders. The highest recorded exclusivity rate for this hospital (in 2000) was 46% in non-Hispanic whites [12]. Specific rates for duration of breastfeeding for 3, 6 and 12 months are not available for Orange County or the birthing hospital.

Methods

The pilot program was implemented and audited within a family practice setting consisting of nine physicians and three nurse practitioners. Three of the physicians practiced low-risk obstetrics, and one of the nurse practitioners was a board certified lactation consultant. The practice followed the AAP's 10 Steps [7]. The surrounding community was urban and multicultural with a substantial high socio-economic class population (Orange County, California).

For this pilot program, a total of 42 mothers were recruited in a 6-month time frame (beginning late September 2000), but 9 dropped out due to pregnancy-related reasons such as spontaneous miscarriage. None requested to be removed from the study, nor were any excluded from participating. The authors are not aware of any prospective candidate declining to participate, although medical assistants usually initially approached potential participants as they checked them in for their appointment. The project was reviewed and approved by the Orange County Breastfeeding Coalition and the medical directors of the practice. As the project was an audit of an educational pilot program and regarded as a quality assurance program, it was not submitted to an Institutional Review Board.

Mothers were usually recruited at the first prenatal visit but were accepted up to the second or third visit and prior to 16 weeks of pregnancy. Any mother attending this practice as an obstetrical patient was a candidate. Once recruited, consent forms were obtained and mothers were asked to state their breastfeeding duration and exclusivity goals. At the same time, mothers were also given the first breastfeeding educational handout and instructed to read this and subsequent handouts while waiting for their provider. The handouts were distributed at each prenatal visit and at each well baby checkup during the first year, unless breastfeeding ceased earlier. Generally well-baby visits occurred at 1 week, 2 weeks, 2 months, 4 months, 6 months and 12 months. When necessary, missed packets were either distributed at the next appointment or, occasionally, mailed (Figure 1).

The mother's physician was instructed to emphasize certain key points during each visit so that if the mother had any questions, she could ask her physician at that time. Just prior to or within the first week of birth (post-intervention) her goals were reassessed. Percent change from baseline was used to measure increases in breastfeeding goals. All unsure or indefinite answers were eliminated from analysis. Actual exclusive and overall duration breastfeeding rates were collected via questionnaires that also asked the mother if she was able to meet her goals. Exclusive breastfeeding was initially defined as "feeding your baby only your milk."

Once breastfeeding ceased or the infant turned a year of age, maternal perception of success was evaluated. Breastfeeding duration was assessed via chart review after every well-baby visit or earlier if it was learned that breastfeeding had ceased. Questionnaires were mailed or phone calls were made to collect data as needed (i.e. data was missing, mother had moved or transferred to another health care provider). Socioeconomic, work status and birthing practices, and in-hospital supplementation data were collected 6–19 months postpartum, generally via telephone interviews. The program's flow sheets, checklists and handouts can be accessed on-line at the following website: "The Breastfeeding Friendly Clinic: Breastfeeding Advice, Assistance and Advocacy" [13].

Results

Sixty-one percent (20/33) of participants were Caucasian, 48% (16/33) had a bachelor's degree or higher, and 67% (22/33) reported an income level of US$75,000 or higher.

Originally, 9 mothers were unsure about their exclusive breastfeeding goals and one did not plan to exclusively breastfeed at all. Only 5 had goals that were less than 4 months; 16 had goals that were 4 months or more. One mother did not answer the question and one stated, "Until milk runs out."

Post-intervention, 100% (33/33) of mothers planned to exclusively breastfeed for at least some period of time. The largest increases in goals were seen in the 4–6 month group for exclusivity and in the 6–12 month group for overall duration (Table 1). There were still three mothers (9%) who were unsure of their overall duration of breastfeeding goals, but they all had definitive exclusive breastfeeding goals.

The program's actual duration of breastfeeding results were: initiation 100%, 3 months 88%, 6 months 73% and 12 months 33%. The in-hospital exclusivity rate was 61%.

When barriers to meeting goals were evaluated, mothers reported more barriers to reaching exclusivity goals than duration goals, 67% (22/33) vs. 58% (19/33). Low milk supply was reported as a barrier by 30% (10/33). Nipple soreness was reported by 79% (26/33), and rates for in-hospital supplementation for latching and hunger problems were 32% (10/31). Despite the barriers, most mothers were likely to perceive themselves as successful, and 21% (7/33) exceeded their duration goals. More specifically, 76% (25/32) perceived meeting their exclusivity goals, and 78% (25/32) perceived meeting overall duration goals. However, in actuality, 55% (18/33) of mothers met their stated exclusive breastfeeding goals, and 67% (22/33) met their declared overall duration of breastfeeding goals.

Discussion

Some mothers remarked that they changed their goals after their babies were born because of breastfeeding difficulties like breast refusal and sucking dysfunction. Reevaluating and changing one's goals may be a positive coping mechanism employed when a mother experiences barriers that are too challenging for her to overcome.

Low milk supply was identified as the most significant barrier (and likely the most challenging) to meeting breastfeeding goals. However, all of the basics for protecting the milk supply were presented in the program, including the essentials of an adequate latch. In hindsight, latching may be an eye-hand coordination skill that may need to be discussed, demonstrated, and then practiced, particularly when mothers and babies are separated, medicated and not given an uninterrupted opportunity to self-attach at birth [2,14]. In addition, while it was recommended that mothers watch a videotape and attend a breastfeeding class at which latch was taught and demonstrated, compliance was not assessed. Nevertheless, the aforementioned rate of nipple soreness and in-hospital supplementation for latching/hunger problems supports the theory that this skill was not learned satisfactorily. Perhaps an intensive workshop to focus on latching should be offered to first-time breastfeeding mothers. Certainly, it is crucial that every postpartum nurse become trained in the basics of latching and breastfeeding management for the first few days of life [2,8]. Lastly, despite employing several lactation specialists, the birthing hospital is not Baby-Friendly.

The study had planned to measure exclusive breastfeeding rates over the first 6 months, but after the baseline evaluation, it became clear that the concept of 6 months of exclusive breastfeeding followed by complementary breastfeeding was not clear to some mothers. Thus, exclusive breastfeeding was more specifically defined on the post-intervention survey as "giving only human milk – no [infant] formula or solids like rice cereal." However, meeting this definition for a 6 month period was obtainable for only a very few mothers. This was due to in part to hospital supplementation rates and the barriers experienced by mothers (e.g. low milk supply). Furthermore, measuring exclusivity using a survey methodology that asked mothers what they practiced over the first six months of their infant's life versus using a 24-hour or monthly recall also affected rates.

This program was successful despite using handouts and counseling during routine visits; approaches found ineffective by the United States Preventive Services Task Force (USPSTF). One explanation for its success may be that, in addition to handouts, the program also incorporated the AAP's 10 Steps and a variety of other outpatient interventions. Notably, the outpatient interventions utilized have been found effective by the USPSTF and/or consistent with a 2001 literature review's findings regarding beneficial approaches [8,9]. Examples of these approaches include: face-to face guidance, employing a lactation consultant, and prenatal followed by postnatal instruction (i.e. a long-term and rigorous intervention). Moreover, one unique feature of this program was asking mothers to set goals. This may have been, in and of itself, an important component of the program, motivating mothers and leading to higher rates of breastfeeding [10].

Rates reported in this small pilot, exceeded the Healthy People 2010 overall duration of breastfeeding goals [4]. Additionally, initiation and in-hospital exclusive rates exceeded the surrounding community's [11,12]. They were not only higher than rates recorded in Orange County, California, but also specifically at the hospital where these mothers gave birth. Thirdly, the overall duration breastfeeding rates exceeded the highest rates found by the DHHS at 3, 6 and 12 months [5]. In 2003 the average U.S. rate at 3 months was 50.2% [5]. The highest 6- and 12-months rates found in any socioeconomic group or U.S. location were 58.1% in King County, Washington, at 6 months and 31.0% for Hawaii at 12 months.

The following are limitations of the program: there was a lack of a control group, maternal goals may have changed over time, independently of the program, and sometimes research participants may improve their performance simply because they are being studied.

Conclusion

This was an audit of a small pilot educational program with a mostly privileged population; caution should be used before applying the findings. Yet comprehensive breastfeeding educational programs, such as the one outlined in this report, may have significant impacts on breastfeeding goals. Setting and meeting goals may increase duration and in-hospital exclusivity rates as well as enhance maternal self-perception and empowerment due to succeeding at their breastfeeding goals and/or experiencing a fulfilling breastfeeding relationship.

Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

CMB developed the program and wrote several of the handouts. She developed the questionnaires and collected the information. It was also her responsibility to analyze, organize and report the data. KML reviewed the handouts for accuracy, educated patients and recruited them. She collected questionnaires and consent forms. She also reviewed the manuscript and questionnaires for content, clarity and editorial considerations. CS recruited and educated patients and reviewed the manuscript for content, clarity and editorial considerations. She collected questionnaires and consent forms. All authors reviewed the final draft and approved it for publication.

Acknowledgements

We would like to acknowledge the Orange County Children's and Family Commission for providing the funds for this program in conjunction with the Orange County Breastfeeding Coalition. Also, we would like to acknowledge Newport Family Medicine and its providers, especially Dr. Sheryl Long, for providing us with a setting and supporting us in completing this pilot program. Vivian Derr NP CLE and Diana Lamb RD IBCLC are to be thanked for helping by reviewing handout content for accuracy. Last, but not least, thank you to all the wonderful moms who participated and my own mom, Elnor Betzold MEd, who edited the manuscript.

References

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2.		American Academy of Pediatrics Section on Breastfeeding: Policy statement: breastfeeding and the use of human milk. Pediatrics 2005, 115:496-506. [PubMed Abstract] [Publisher Full Text]
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3.		U.S. Department of Health and Human Services, Office on Women's Health: HHS Blueprint for Action on Breastfeeding. Washington DC; 2000:8-9.
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4.		U.S. Department of Health and Human Services: Healthy People 2010. [http://www.healthypeople.gov/Document/HTML/Volume2/16MICH.htm#Toc494699668]
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5.		Department of Health and Human Services (DHHS) Centers for Disease Control: Breastfeeding: data and statistics: breastfeeding practices – results from the 2003 National Immunization Survey. [http://www.cdc.gov/breastfeeding/data/NIS_data/data_2003.htm]
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6.		UNICEF: The Baby-Friendly Hospital Initiative. [http://www.unicef.org/programme/breastfeeding/baby.htm]
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7.		American Academy of Pediatrics Task Force on Breastfeeding: Ten steps to support parents' choice to breastfeed their baby. [http://www.aap.org/breastfeeding/tenSteps.pdf]
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8.		National Library of Medicine: United States Preventive Services Task Force: behavioral interventions to promote breastfeeding: recommendations and rationale. [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat3.chapter.26669]
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9.		Couto de Oliveira MI, Camacho LA, Tedstone AE: Extending breastfeeding duration through primary care: a systematic review of prenatal and postnatal interventions. J Hum Lact 2001, 17:326-343. [PubMed Abstract] [Publisher Full Text]
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10.		Donath SM, Amir LH: The relationship between prenatal infant feeding intention and initiation and duration of breastfeeding: a cohort study. Acta Paediatr 2003, 92:352-356. [PubMed Abstract] [Publisher Full Text]
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11.		Maternal and Child Health Branch California Department of Health Services: *California in-hospital breastfeeding initiation as reported on the Newborn Screening Test Form by maternal county* of residence 2002.** [http://www.mch.dhs.ca.gov/programs/bfp/in_hospital_breastfeeding_initiation.htm]
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12.		Maternal and Child Health Branch California Department of Health Services: *California in-hospital breastfeeding as indicated on the Newborn Screening Test Form Statewide, County and Hospital* of occurrence by race/ethnicity 2000–2001.** [http://www.mch.dhs.ca.gov/documents/BFP/2000-2001%20hospital%20breastfeeding%20tables%20for%20web%20Madera-Yolo.pdf]
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13.		The breastfeeding friendly clinic: breastfeeding advice, advocacy and assistance [http://www.theBFclinic.com]
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Policy on infant formula industry funding, support or sponsorship of articles submitted for publication

2007-05-04T05:25:00.000-07:00

Abstract

Despite current scientific evidence that artificial feeding is a harmful practice, unquestioned acceptance of breastfeeding as the normal or "default" method of infant feeding remains elusive in the industrialised world. Throughout the developing world the profound consequences of the aggressive marketing strategies of the infant formula industry since the end of the Second World War is well known. A key objective of the International Breastfeeding Journal is to promote breastfeeding through addressing issues that encourage breastfeeding initiation, duration and effective management. Informing this aim is the recognition of artificial feeding as a harmful practice that places infant health at risk. From this perspective it would be unethical for this journal to accept for publication any manuscript that has received funding, sponsorship or any other means of support from infant formula manufacturers. This stance is consistent with the journal's aim of supporting, protecting and promoting breastfeeding. It will also contribute to the promotion of a breastfeeding culture.

Editorial

Despite current scientific evidence that artificial feeding is a harmful practice [1], unquestioned acceptance of breastfeeding as the normal or "default" method of infant feeding [2] remains elusive throughout the industrialised world. The dominance of an infant formula feeding culture is evident through popular beliefs such as "artificial milk feeds [are]...at least as good for the baby (if not actually better) as breast feeding", and ambivalent views associated with "give it a go" attitudes [3]. This lack of a breastfeeding culture in most industrialised nations is the legacy of decades of commercial marketing of infant formula, often endorsed by medical practices [4].

Throughout the developing world the profound consequences of the aggressive marketing strategies of the infant formula industry particularly since the end of the Second World War is well known. Public awareness of the tragic outcome of the use of infant formula in the developing world led to a consumer boycott of Nestlé products during the late 1970s and early 1980s. Around this time the first of a series of international strategies designed to reduce infant mortality rates through regulating the promotion of artificial baby milk was implemented. In 1981, the World Health Organization (WHO) announced the International Code of Marketing of Breast-milk Substitutes [5]. The aim of the International Code was "to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution" [5] (p.8). While a significant move, universal implementation of the International Code has been hampered by the difficulty of enforcing compliance among members of the infant formula industry and within non-signatory nations.

Following the launch of the International Code, the World Health Assembly has issued a succession of policy statements designed to increase global breastfeeding rates. Of particular significance was the 1989 joint WHO/UNICEF statement on the Protection, Promotion and Support of Breastfeeding: the Ten Steps to Successful Breastfeeding [6]. This statement aimed "to encourage hospitals and healthcare facilities to adopt practices that fully protect, promote and support breastfeeding". The internationally applicable Baby Friendly Hospital Initiative is currently the central aspect of a global strategy designed to foster the initiation of breastfeeding at the time of birth [7].

Despite several decades of initiatives by organisations such as WHO, UNICEF and other non-government bodies, for example, World Alliance for Breastfeeding Action, progress in fostering a breastfeeding culture among the industrialised nations has been slow. Hampered by the ideology of consumer choice that promotes a woman's right to decide the method of infant feeding that best suits her lifestyle and worldview, the goal of unquestioned acceptance of breastfeeding as the norm remains elusive. Not only does a consumer culture disregard the right of every infant to be breastfed, but it also fosters accusations that promotion of breastfeeding leads to guilt among those unwilling or unable to successfully establish and maintain lactation. Overlooked by such claims is the hegemonic influence of the infant formula industry, promoted and sustained over decades of marketing of artificial baby milk. As Wiessinger points out, the industry's influence has permeated even the language employed by health professionals to encourage women to breastfeed [8]. For example, promotion of the "advantages" of breastfeeding mimics the commercial sales pitch adopted by the formula industry and so endorses the notion of consumer choice. Wiessinger argues that because breastfeeding is the biological norm, breastfed babies should not be perceived as "healthier", nor do they "smell better" than formula-fed infants and so on [8] (p1). Breastfed babies are simply "normal"!

The profound consequences of the harmful impact of formula marketing practices have generated ethical debate over any form of support received from the artificial baby milk industry. In the late 1990s, Lucas argued that "provided . . . researchers declare their funding sources, they should not be censored for industrial collaborative research into child health" [9] (p. 337) because "formula companies provide a critical contribution to infant health care, health education, and high quality research" [9] (p.338). Others strongly disagreed [10-12]. Rundall pointed out that sponsorship is "a payment by a business firm . . . for the purposes of promoting its name, products or services. It is a commercial deal, not a philanthropic gift" [10] (p338). She argued that companies use sponsorship as a marketing strategy to create the image that they are responsible corporate citizens and to link their name to prestigious organisations and doctors [10]. Others mentioned the "inevitability of bias towards formula feeding in those who take money from the industry" [11] p 260.

"Sponsorship bias" in pharmaceutical research has been confirmed; a meta-analysis found industry sponsorship was associated with an odds of 3.6 (95% Confidence Interval [CI] 2.63, 4.91) of a pro-industry conclusion [13]. A recent systematic review of nutrition-related scientific articles focusing on soft drinks, juices and cow milk, examined the relationship between funding source and conclusion [14]. Again, industry funding was found to favour the sponsor's products. The odds of an article reporting a conclusion favourable to the nutrition industry versus an unfavourable conclusion was 7.61 (95% CI 1.27, 45.73) comparing articles with all industry funding to no industry funding [14]. Among the possible ways to reduce bias in nutrition articles, the authors suggested voluntary refusal by scientists to accept industrial support and the implementation of more stringent policies by journals over the publication of industry-sponsored research [14].

The call to eliminate commercial bias from scientific publications on infant nutrition is consistent with the spirit of the International Code of Marketing of Breast Milk Substitutes. In Britain, for example, direct to the public advertising of formula for infants aged under six months is prohibited in compliance with the International Code. Despite this law, formula advertising remains permitted in health professional journals provided information is restricted to "a scientific and factual nature" [15]. In light of the findings of sponsor bias in nutrition articles, the argument that there is a need to disseminate infant feeding information to all parents in the interests of infant well-being becomes highly questionable. Recently, Magda Sachs, one of the members of the International Breastfeeding Journal's Editorial Board, challenged the situation arguing, "Milk company advertising has no place in reputable journals", particularly in Britain where it represents attempts by the industry 'to circumvent the [country's] ban on direct advertising to mothers" [15] (p. 714). She also expressed concern that infant formula advertising may "entice [health] professionals to abandon their independence as practitioners" [15] (p. 714). Sachs made the comments in response to the pro-advertising stance of British Journal of Midwifery managing director and publisher, Mark Allen. Among other things, Allen advocates the parents' right of choice, and concern that exclusion of infant formula advertising would discriminate against parents who do not breastfeed [16]. Informing Allen's stance is the view that "we are professional publishers, not moral guardians" [16] (p. 715).

The Sachs/Allen debate draws attention to the challenges that need to be overcome if breastfeeding is to be accepted as the unquestioned "default" method of infant feeding. Central to this challenge are the ethics of the industry's funding, sponsorship and support of infant feeding research. Not only does such patronage jeopardise the independence of researchers and health professionals alike but more importantly it promotes and sustains a formula feeding culture.

A key objective of the International Breastfeeding Journal is to promote breastfeeding through addressing issues that encourage breastfeeding initiation, duration and effective management. Informing this aim is the recognition of artificial feeding as a harmful practice that places infant health at risk. From this perspective it would be unethical for this journal to accept for publication any manuscript that has received funding, sponsorship or any other means of support from infant formula manufacturers. This stance is consistent with the journal's aim of supporting, protecting and promoting breastfeeding. It will also contribute to the promotion of a breastfeeding culture.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

AB wrote the first draft of the paper. LHA conceived the idea for the editorial and contributed to the writing.

References

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