Nestle - what would we do without them?

What would we do without those brilliant people at Nestle?

As though being the kind and generous global food and drinks giant which has done SO MUCH to introduce unenlightened women of the developing world to the elegant, civilised art of feeding their babies 

 - in a way which, while it may have a few easily waved-away side effects (poor baby growth due to mothers trying to skimp on the stuff, limited protection against infection, dodgy hygiene, use of hard-earned pennies that could go elsewhere) DOES have the great benefit of making MORE MONEY for Nestle -

WERE NOT ENOUGH,

those clever people in the lovely, clean Nestle labs have come up with a true miracle of science: 

THE WORLD'S FIRST COMPREHENSIVE INFANT AND TODDLER NUTRITION SYSTEM!!!!!

here's the link to this great advance for humankind:

http://www.nestle.com/Media/NewsAndFeatures/Pages/Nestle-launches-BabyNes-first-comprehensive-nutrition-system-for-babies-Switzerland.aspx

And here's a picture of it in action:

D'oh! Silly me.

I just pasted in a picture of a woman breastfeeding her baby by mistake.

I'm such a klutz with this blogging business.

I mean, who on earth but a daft old non-techy would absent-mindedly think THIS was what is meant by "the world’s first comprehensive nutrition system for infants and toddlers"

I've just looked again at the Nestle website and I must have missed the bit where it says that the world's first comprehensive nutrituion system for infants and toddlers is "based on Nestlé’s latest scientific achievements in baby nutrition and systems technology"?

Aren't I just an old fluff-head.

 What could POSSIBLY have made me think that human lactation is any match for the global food and drinks giant's "unmatched expertise in baby nutrition gained over 145 years since the invention of Farine Lactée by Henri Nestlé" ?

No, HERE'S a picture of the world's FIRST COMPREHENSIVE INFANT FEEDING SYSTEM:

As if you could confuse the two!

I mean look at all the advantages of the "BabyNes" (for so it is named).

It hasn't been trialled for over 70 million years.

It doesn't change the nutritional content of the milk with the needs of the baby throughout the day.

It requires sterilising, measuring, checking.

It is not free.

It is not disposable or ecofriendly and it needs a power source.

It is not so easily packaged that you don't even have to remember to take it with you when you go out.

In fact, it's hard to see how we have managed without it all these years.

It says on the BabyNes page that Nestle "supports breastfeeding for the first six months of a baby's life".

I wonder how they do that.

I'm sure they have a way. I just haven't noticed it yet. 

On the other hand...wouldn't it be wonderful, if Nestle had just stuck to making great chocolate bars?

New guidelines on NHS Caesareans published by NICE

The National Institute for Health and Clinical Excellence has started the process of updating its guidance on caesarean births with more emphasis on explaining to women what the risks and alternatives are.
The guidelines are up for consultation at present. They propose that women who have multiple C-sections should be informed that their risk of bladder damage etc is as high as if they have a vaginal delivery.
So...they aren't told now?
The guidelines also suggest that a woman who says she wants a CS because she is terrified of labour should be referred to an appropriate healthcare professional to talk over her fears.
So...there are doctors who simply say, "yes, absolutely" and book a woman in for major abdominal surgery without a thought for what mental torment might have brought her to this point?
Rather revealing.

Water birth and infection risk

A study which concludes that water birth does NOT increase infection risk in mothers or babies. They also found that water birth reduced the need for analgesic drugs and shortened first and second stage labour. Result! So please could more hospitals invest in wireless monitoring kits so as to reduce the number of women who get told "you can't use the pool because..blah blah blah-di-blah...."

Women who join my home birth group here in beautiful rural (not) Shepherds Bush get a 10% discount off a well-known brand of birthing pool. Just mentioning it.

Pre-eclampsia: has this study found a simple, low cost dietary answer to protecting women?

This is a really interesting study. Did you realise that pre-eclampsia might be linked to dietary factors?

The BMJ has published a study done in Mexico involving women at high risk of pre-eclampsia. The women given food bars with high supplements of L-arginine (an amino-acid) and anti-oxidant vitamins showed a quite dramatic decrease in pre-eclampsia.

Only thing is...Mexico's not a very rich country so with all due respect it may be that the women involved were not getting a good diet.  In countries where women normally have a good balanced diet with the requisite amounts of dairy products, poultry and plant protein sources then maybe these levels of L-arginine and anti-oxidants are reached in the general population.

All the same, it's all the more reason to lay off the fizzy drinks and pile on the yoghurt, milk, chicken breasts, wholemeal bread, nuts, lentils...all the usual suspects!

Actually when I think of it, this might be just another study which concludes, "good food is good for you".

From the BMJ website (links below)

(1) New study suggests dietary supplement can protect against pre-eclampsia
(Research: Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial)
http://www.bmj.com/cgi/doi/10.1136/bmj.d2901
(Editorial: Can a dietary supplement prevent pre-eclampsia?)
http://www.bmj.com/cgi/doi/10.1136/bmj.d2777
A dietary supplement containing an amino acid and antioxidant vitamins, given to pregnant women at high risk of pre-eclampsia, can reduce the occurrence of the disease, finds a study published on bmj.com today.
Pre-eclampsia is a serious condition where abnormally high blood pressure and other disturbances develop during pregnancy. It affects about 5% of all first-time pregnancies and is dangerous for both mother and child.
Pre-eclampsia is thought to be linked to a deficiency in L-arginine, an amino acid that helps to maintain a healthy blood flow during pregnancy. Some experts also think that antioxidant vitamins can help protect against the condition.
So a team of researchers in Mexico and the United States set out to test the theory that a combination of L-arginine and antioxidants would prevent the development of pre-eclampsia in high risk women.
The study took place at a hospital in Mexico City. Pregnant women at high risk of pre-eclampsia were randomly divided into three groups: 228 received daily food bars containing both L-arginine and antioxidant vitamins, 222 received bars containing only vitamins, and 222 received placebo bars (containing no L-arginine or vitamins).
The supplements began when women were around 20 weeks pregnant and continued until delivery. Blood pressure and L-arginine levels were measured every three to four weeks at the hospital clinic.
The proportion of women developing pre-eclampsia was 30.2% in the placebo group, 22.5% in the vitamin only group, and 12.7% in the L-arginine plus vitamin group.
This means that women in the L-arginine plus vitamin group were significantly less likely to develop pre-eclampsia compared with the placebo group. However, vitamins alone did not significantly reduce the occurrence of pre-eclampsia.
The team also found that L-arginine plus vitamins significantly reduced the risk of premature birth compared with placebo.
"This relatively simple and low cost intervention may have value in reducing the risk of pre-eclampsia and associated preterm birth," conclude the authors. However, they say that further study is needed to determine whether these results can be repeated and to identify whether they are due to L-arginine alone or the combination of L-arginine and antioxidant vitamins.
This trial reports an important finding but crucial questions remain, say two UK experts in an accompanying editorial. For instance, how do L-arginine and vitamins work together, what are the potential harmful effects, and what are the effects in other settings and populations?
They suggest that, before more trials are started, a rigorous systematic review is needed "of the numerous inconsistent strands of evidence relating to L-arginine and its possible effects on pre-eclampsia."
Contacts:
Research: Professor Felipe Vadillo-Ortega, Department of Experimental Medicine, School of Medicine, Universidad Nacional, Autonoma de Mexico, Ciudad Universitaria, Mexico
Email: felipe.vadillo@gmail.com
Editorial: Liam Smeeth, Professor of clinical epidemiology, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Email: liam.smeeth@lshtm.ac.uk

The NHS trial of HypnoBirthing: BBC reports (sort of)

Some of my HypnoBirthing colleagues are a bit disappointed with this report from the BBC...the same old "you are getting very sleepy" cliches are trotted out, the linking is clumsy...but hey, chaps, we have come a long way. You can watch the report here:

 http://www.bbc.co.uk/news/health-13451452

Now setting the bias of reporting aside, the main thing is there IS a trial which suggests that someone somewhere has twigged the idea that if more women were properly prepared for childbirth it would increase normal birth and decrease reliance on costly interventions.

So maybe the day may come when people like me do not have to patiently explain over and over again that no, natural childbirth does not mean self-flagellation; no, hypnosis is not a stage trick; no, a doula is not a sort of shaman...

Home birth group

I've just put the dates for all future CHISWICK AND HAMMERSMITH HOME BIRTH GROUP dates in my diary right up to the end of 2012.

I've also put them on the HOME BIRTH GROUP page on my website  not to mention Facebook and I've tweeted the link with my @dailybabystuff Twitter username.

I run the Home Birth group as a casual drop-in meeting.

Typically we discuss subjects such as:

• How to arrange a home birth
• Your rights in choosing your place of birth
• Reasons why you might be advised against a home birth by medical caregivers
• How to get your home ready (not as much trouble as you might think!)
• Safety of home birth and common objections from family and friends
• Sharing experiences about home birth (The Good, the Bad and the Funny!)
• When you have to transfer to hospital

We welcome home birth mums and dads and of course midwives, doulas, grandparents - anyone who wants to find out if a home birth is the right decision for the particular birth they are involved in.

Is it reflux? Is it colic?

I've been finding out some fascinating stuff about reflux and colic and I'd like to share it with you.

Every other baby I meet these days seems to have something called reflux but an awful lot of these babies seem to have what in my day we just called colic. It's really confusing - are they the same thing?

So here's what I've found so far.

Gastric Oesophageal Reflux (GOR) is the normal phenomenon of stomach contents washing back past the oesophageal sphincter into the oesophagus. 70% of all healthy, happy, thriving babies do it several times a day. The peak period is 3-7 months and normally babies have stopped by 12-15 months old.

Gastric Oesophageal Reflux DISEASE (GORD) is when the reflux causes the baby pain and/or not to thrive because it is affecting digestion, feeding and causing damage to the oesophagus

My take on this: GOR is when the spitting up is mainly a problem for your laundry basket. GORD is when it is distressing the baby persistently and causing poor health.

“Silent reflux” – no outward signs (i.e. no regurgitation) but baby is unhappy because stomach contents are washing up a short way into the oesophagus àoesophagitis.

NB: JUST BECAUSE IT LOOKS LIKE REFLUX DOESN’T MEAN REFLUX IS CAUSING THE PROBLEM – THERE MAY BE UNDERLYING REASONS! Such as excessive gassiness, constipation, a food intolerance (especially to cow’s milk/soy milk), INFECTION, sensitivity to tobacco smoke, “colic” (baby is too little “switch off” crying) – MUM SHOULD ALWAYS CONSULT DOCTOR IF IN DOUBT (see “red flag” list)

An easy way of remembering the various solutions for GOR and GORD is:

·         Gravity – anything that helps the food go down and the air go up

·         O (= a boob!) – improve the breastfeeding technique or pattern

·         Reassurance/relaxing – anything to soothe baby (and mum)

·         Diet,  Doctors and other health professionals – medical and alternative therapy solutions

Gravity:

Baby as upright as possible during feed – eg in a wrap sling

Keep upright after feed 30 to 40 mins – a sling/carrier can help a lot

Baby upright as when over your shoulder rather than slumped in a chair (American Journal of Paediatrics, Orenstein and Whitington, October 1983)

Frequent burping BEFORE, during and after feed

Avoid car seat immediately after feed

Avoid nappies or clothing tight round tummy

Baby at 30 degrees – not flat –  in cot or on babygym

When changing nappy, put a cushion under baby’s head

Sleepcurve and special wedges

O   = a boob (Better breastfeeding)

Check the latch – getting air in?

One breast at a time, allow baby to continue until stops.  Sucking à continuous muscle movement through digestive tract àkeeps it all going down; baby emptying breast ensures baby ends with calorie-rich hind milk which stays in stomach longer; at end of feed flow is slow àless coming in at top while muscle movement still keeping things moving down.

In some cases with overactive letdown even two feeds in a row on one breast. Consider whether using a breast pump in between feeds is really helping.

Feed baby when not over-hungry so not gulping in air.

Feed baby more often to encourage smaller, more manageable feeds and more downward action.

Reassuring, relaxing and soothing

A pacifier helps baby carry on the helpful sucking action

Atmosphere calm and cosy –You are not a failure if you can’t “stop the baby crying”, you are a hero for giving baby the kind of environment that helps baby to calm self eventually

Mum relaxed with a glass of wine? (recommended by  Dr Jack Newman!)

Lying down;

Massaging Baby tummy and back, upright

Movement that is rhythmical and swaying - rocking, buggy, swing-seat, your lap, your arms

Support from others: Take turns, Find another mum with a colicky/reflux baby

Diet, Doctors (and other health professionals)

Write down everything mum eats for 3 days and log fussy episodes – is there a pattern?

Try cutting out one suspect eg dairy products for 3 days

All these foods and substances have been implicated in GOR and GORD:

cow’s milk protein, chocolate, spices, citrus, cauliflower, onions, broccoli, mustard, aspirin, decongestants, peanuts, wheat, tomatoes, cucumber, soy, apples, bananas...

 A probe or endoscopy can check for acidity and/or damage to the oesophagus.

·         Antacids  - infant Gaviscon

·         Acid blockers eg Pepcid

·         Motility improvers (muscle tone) eg Domperidone

Also many parents find relief after treatment by a cranial osteopath, herbalist.

"The Folly of 'Fully'"

Practising Midwife May 2009

Sara Wickham's article breaks into the accepted idea of 10 centimetres exactly as the universal "fully dilated" measurement.

I have always thought 10 centimetres was a suspiciously round number. I mean, did someone at the Academie Francaise des Sciences, where the metric system now called the ISU system first saw the light of day, think hard and say, "I know, let's measure a woman's fully dilated cervix, and adopt a standard measurement exactly ten times that, and call it a metre!" I don't think so.

Indeed history tells us that the metre was originally defined as one ten-millionth of the distance from the North Pole to the Equator along the meridian which runs near Dunkirk and Barcelona. Even though you could presumably fit exactly one million fully dilated cervixes along that line, I doubt this was a test uppermost in the Academie's minds.

Wickham proposes that a normal range for "fully" or as one of my doula friends says, "fully delighted" would be more natural and more in line with the acceptance of RANGES of normality for all other measurements in childbirth.

Great birth story

Another fantastic birth story from a HypnoBirthing client today.
Her waters broke early one evening, she went briefly to hospital for a check, and within 24 hours she was having 20 second surges every five minutes (she rang me around 7pm to tell me). This intensified through the night, she managed the night with a TENS and HypnoBirthing breathing. When she got to the birth centre at 5am she was 7 centimetres dilated.
The first water leakage must have been hindwaters as as she stepped into her birthing room her forewaters went with a gush. She got straight into a birth pool and after quite a long second stage birthed her little girl. The long second stage was mainly due to the baby's having her hand up by her face.
She had no pain relief besides the TENs at first then the pool - otherwise she depended entirely on the self-relaxation and breathing techniques I had taught her in her HypnoBirthing sessions. Partner stuck her special birth pictures up around the room when they got to hospital. She listened to her HypnoBirthing affirmations throughout the second stage pushing.
In her own words she felt calm and relaxed throughout her labour!

Home Birth Safety - major study

Major study in the Netherlands shows home birth as safe as hospital for low risk mothers, reported 15 April 2009:
http://news.bbc.co.uk/2/hi/health/7998417.stm

Very stupid and annoying columnist called Melanie Reid in The Times the next day:


http://www.timesonline.co.uk/tol/comment/columnists/melanie_reid/article6101189.ece

Well, Melanie Reid, how would you like to be told you, or women like you, are "spoilt and complacent" because you insist on tying up scarce NHS resources with your expensive, consultant-delivered epidural anaesthesia and the cascade of interventions, requiring more and more medical staff to be involved in the delivery of your baby, which it often brings in its wake?
You wouldn't like it one bit. And of course no birth professional would be so purblind, mean-spirited and stupid as to describe a woman as "selfish" because she insists on the kind of high-maintenance birth environment Melanie Reid clearly thinks is essential for all women. Yet she thinks it is fine to throw this abuse at other women who want to make different choices.
How sick I am of women journalists who think that because they had a baby once, they know all there is to know about EVERYONE ELSE's labour and birth!

Euphemisms and birthing language

The language around birth is very important. With HypnoBirthing it is all-important since hypnotherapy is an entirely language-based therapy.
in this month's "Practising Midwife", the distinguished midwife Sara Wickham discusses euphemisms such as "pop" - "often preceded by the word just"..."an attempt to soften any number of clinical procedures which are routine but which individual women might not consent to if it was made explicitly clear that she had a choice"
and points out, perhaps subversively, that language which softens ie makes less frightening a procedure might not be bad. "I avoid using medical terms that I perceive as fear-filled (haemorrhage, risk factor) and choose words which I feel to be less hormonally and emotionally upsetting to women (bleeding, challenge).
She prefers calling sanitary towels bunnies - "removes the connotation of dirtiness"
She mentions Ina May Gaskin's rushes for contractions, but sadly not the HypnoBirthing surge...
She might have added that linguistically many of these "less threatening" words are of Anglo-Saxon origin instead of Latin/Greek origin.
Wickham S Euphemisms: good, bad or ugly? (2) The Practising Midwife Vol 12 Number 4 April 2009 page 35
Also refers to Nicky Leap (1992). The power of words, Nursing Times 88:60-61

Pre-labour cervix weeping

Back in October 2006 - have I really been a doula all this time? I noted with interest in this blog a midwife discussing the phenomenon of the cervix "weeping" a few days (5-7) before going into labour.
Well whaddyaknow, my current birth client seems to have had that exact experience last night, at 38 weeks exactly. It was so noticeable, with a distinct "gush" of clear fluid, that she thought it might be her waters breaking and we were on the QV all night.

Home Birth as safe as hospital birth

http://news.bbc.co.uk/2/hi/health/7998417.stm

Strange that it is thought that breech birth and prolonged labour can only be dealt with in hospital.

Excellent birth story from a US HB mum

http://bebeprocawood.blogspot.com/2008/04/here-it-is-neils-birth-story.html

Home Birth: The Sunday Telegraph

Excellent and factual article about home birth in Sunday Telegraph and no scare-mongering.
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/03/09/nhomebirth109.xml

new breastfeeding helpline

A breastfeeding helpline to support new mothers has been officially launched by the Government. Public health minister Dawn Primarolo announced a £150,000 year package for the advice line to give women practical support and information. Studies have shown that babies who are breastfed are less likely to be obese in later life and gain protection against conditions like asthma, eczema and chest infections. Mothers benefit too, with studies showing a protective effect against ovarian and breast cancer. The Department of Health recommends exclusive breastfeeding up to six months, with continued breastfeeding alongside solid foods afterwards. A new report published by the Scientific Advisory Committee on Nutrition (SACN), suggests a need for more support for new mothers. It looks at the Infant Feeding Survey of 2005, which showed breast feeding rates went up from 69% in 2000 to 76% in 2005 across the UK. However, only half of women in England were still breastfeeding after six weeks. The Government cash will help support the new helpline, which will be run by two existing networks. The Breastfeeding Network and the Association of Breastfeeding Mothers, which receive around 28,000 combined calls each year on breastfeeding, will merge and run the advice line. The Government hopes the newly-created National Breastfeeding Helpline will be able to handle a far higher number of calls than either organisation on their won. The new helpline number is 0844 20 909 20. Copyright © 2008 The Press Association.

Great waterbirth

My client X asked me to be her doula for the second time, a year after I attended the waterbirth of her second child.
We had some doubts about whether this would be a straightforward labour...but as it turned out, it was totally straightforward.
X had some cervical issues that might well have given some doctors reason to refuse to support her choice of natural labour. But the hospital we were at respected her as an intelligent informed mum and agreed to support her wishes. In the event, the cervical issues made absolutely NO difference to a steady dilation speed and a strong labour which ended with a gorgeous waterbirth of a beautiful baby girl.

Nancy's HypnoBirthing home water birth

In 2006 I had the privilege of being the HypnoBirthing educator who led Nancy and her husband Tecwin through the HypnoBirthing programme. Their progress and Nancy's remarkable labour and the birth of Sid, their second son, was tracked by the series Home Grown Babies (first shown on Living TV).
Someone (don't know who yet) has put extracts from the episode on YouTube. It is an amazing story.

http://www.youtube.com/watch?v=Ks1-23fcERg&feature=PlayList&p=31717DCA62BBD447&index=0

http://www.youtube.com/watch?v=6HiljszP1FE&feature=PlayList&p=31717DCA62BBD447&index=1

(begins with a bit of an interview with me in it)

http://www.youtube.com/watch?v=M75c73A22vE&feature=PlayList&p=31717DCA62BBD447&index=2

This bit shows the birth.

Guardian letters page

Jennifer Hall says it all:

http://www.guardian.co.uk/letters/story/0,,2186472,00.html

That moment when you feel you can't go on...

With all my own labours there was a moment when I thought, What WAS I thinking? Why am I doing this? I want to stop! Now! I want to give up and start again tomorrow! Likewise virtually all my birth clients have had a "dark night of the soul" moment when they felt they could not possibly, possibly carry on. This is usually the moment a woman asks for an epidural. It nearly always means that birth is very near the end.
A typical example was my recent client J. who really did not want an epidural but suddenly announced during labour that she must have one, she could not possibly endure another contraction as powerful as the past 3-5. We were in a low tech labour room where epidurals were not administered so we had to walk down the corridor to the high tec unit. The intensity of the contractions indicated that she was in "transition" (as I hate calling the phase covering the end of the cervix's dilation and the beginning of the baby's descent) and the walk really seemed to help things along! As a result she was feeling the urge to bear down within minutes of reaching the second room, the midwife quietly cancelled the anaesthetist and the baby was born not long after.
It is always difficult to explain to a woman that this moment, the moment you feel you cannot go on, is the sign to her supporters that the end, the moment she holds her baby, is almost certainly very close.
After her baby was born, J. said to me, "I am SO glad I didn't have an epidural!"