Private Midwifery in Sydney Rotating Header Image

Breastfeeding

Caesarean babies face more infections

Feb 4th, 2012
by Melissa Maimann.
No comments yet

Link

Some caesareans are genuinely necessary for the safety of mother or baby, so I wouldn’t like for this article to offend readers who may have had a caesarean that they feel was necessary for one reason or another. However, necessary or not, this article is reporting on the fact that babies who are born by caesarean tend to experience more infections than babies who were born vaginally. This adds to the other known risks of caesareans such as an increase in the rate of asthma, respiratory infections and diabetes.

BABIES born by caesarean are much more likely to be admitted to hospital with gastrointestinal disease or chest infections in their first year of life than those born naturally … The babies were 22 per cent to 26 per cent more likely to be hospitalised with gastrointestinal disease and about 12 per cent more likely to be admitted with bronchiolitis, a type of chest infection …

… children born by caesarean could miss out on picking up important gut bacteria that children born naturally get during the birth.

“We take all these yoghurts and things to get the right bacteria in our guts but the baby travelling through the birth canal is going to get the right sorts of bacteria,” …

… there could also be a link between caesareans and breastfeeding problems.

… women who gave birth by caesarean were 70 per cent more likely to be diagnosed with a complication affecting breastfeeding.

And the babies of the women with breastfeeding problems were then 30 per cent more likely to be hospitalised with gastrointestinal problems.

… Earlier Australian research had found the link between bronchiolitis and caesareans existed with only planned caesareans, suggesting labour itself could activate the mothers’ immune system …

Visit my website to learn more about my services.

Natural Twin Birth

Jan 26th, 2012
by Melissa Maimann.
No comments yet

I had a difficult delivery with my first baby, including posterior presentation, premature rupture of membranes, meconium staining, stalled labour, 18 hours of Syntocinon, a largely ineffectual epidural, a 4 hour second stage, and forceps delivery. My daughter had severe respiratory distress and was in the NICU for several days. It was a very tough introduction to parenthood and left me quite traumatised, especially the separation from my daughter. My husband and I decided that we would try for a homebirth if we had another baby, in the hope that a calmer environment would assist the birth process. When I fell pregnant again, we found a lovely homebirth midwife.

I started to show really early. At 8 weeks I was in maternity wear. I thought it was just because it was a second pregnancy, but a 9 week ultrasound showed TWO BABIES. We were completely shocked as there are no twins in my family. Twins of course meant that a homebirth was out of the question.

There followed many long months of argument with various obstetricians about our birth choices. We wanted as little intervention as possible. A standard twin delivery involves syntocinon (which I was very afraid of, after the previous experience), continuous monitoring (which I had hated with my first birth, as I felt chained to the bed) and an epidural prior to the second stage, in case positioning/version or a c-section is necessary to deliver the second twin. In my first birth, the epidural meant I had no pushing urge and seriously compromised my ability to deliver my daughter, hence the very prolonged second stage, so I did not want an epidural this time around, although I was prepared for Synto to be administered between the twins if labour did not re-establish. The hospital also wanted both twins delivered on the bed, which I did not agree with as I had found pushing in that position impossible the first time around. Our views were very challenging to the obstetricians and some were quite aggressive about it, although I must say the head OB was more reasonable and was prepared to admit that my refusal to consent to an epidural would be a “complete contraindication” to giving me one! Throughout this stage our midwife was a pillar of strength and information. She gave us the courage of our convictions and more than once came to the hospital to talk with the obstetricians on our behalf. Even so, the hospital was very unhappy with our birth preferences. It was a stressful time, helped somewhat by a Calmbirth ® course.

In the end all our arguments ended up being moot. At 33 weeks, I started to feel an ominous itching all over. Tests showed elevated bile salts and poor liver function results. I had obstetric cholestasis. Our midwife and the hospital agreed: the babies would need to be delivered by 37 weeks. And I knew that that early, an induction would almost certainly involve Syntocinon.

This was really difficult for me to accept. I was terribly afraid of the drug, and knew that Synto would mean continuous monitoring and therefore limit my movement, which I also feared. However, I knew that my fear would make the delivery more difficult and the pain worse. At this point the hospital dropped the bombshell that despite all their delivery rooms having deep birthing baths, I would not be allowed to use those or the shower if I had to have Synto, as they believe this risks pump damage to the Synto pump. Essentially this meant I was walking into a labour that was likely to be more painful, with less pain relief options. It was going to be down to Calmbirth ® alone, if I wanted to avoid drugs (and I did!).

I did a lot of Calmbirth ® practice from then on. But the Calmbirth ® visualisation exercises presupposed a normal delivery without intervention, and I found it very upsetting to listen to them. I hit on the idea of doing my own visualisations, of a medicalised induction process. After a few of these I was able to work through some of my fears.

On the day of the induction, we kissed our daughter goodbye at 5am and met our midwife at the hospital. Preliminary checks showed a Bishop score of 5, very promising for 36 weeks. The hospital midwife applied prostaglandin gel and sent us out to freedom. We had a lovely breakfast. I started to have sporadic contractions but nothing serious. We returned to the hospital 6 hours later. My cervix had ripened to 2cm, and the very cheerful OB was able to break the waters for twin 1 (our second daughter) at 3.45pm. No meconium staining! I dared to ask the OB how she was presenting. ANTERIOR, WOOHOO! I was very pleased with that.

Contractions came rather more strongly after that point, but were still sporadic. The felt very “knifey”, and our midwife explained this was from the prostaglandin gel. We held off on the Synto as long as possible, but at 6.25pm the drip was put up and contractions started in earnest. Continuous monitoring was in place, but via telemetry so I could have moved. Ironically, though, I didn’t feel the need to. I went deep into calm breathing and spent most of the labour sitting beside the bed on a fit ball, sometimes circling my hips but more often just breathing to ride the contractions with my husband stroking my back. Unlike my first labour, I had no real idea of when the next contraction was coming, and ended up doing my calm breathing (in for 4, out for 6) solidly for hours. I wasn’t afraid of the contractions. I could really feel them doing their work, and little twin 1 moving firm and fast down. I was determined to “get out of the way” of labour and with each contraction focused on opening up and not clenching against the pain. Our midwife was convinced things were going quickly and asked us when we thought we would be having the babies. I told her anything before midnight was a sucker bet! She said 11pm.

At 8.30pm, about 2 hours after I started having regular contractions, the pain was starting to get BIG. The OB did a cervix check – I was 5cm. I was very disheartened by this, but our midwife told me that the first 5cm was the hardest, and the very encouraging OB tried to convince me that it wasn’t all about centimetres and that my cervix felt promisingly thin and stretchy. In hindsight, even in my first labour I dilated from 5 to 10cm in under an hour, so I should have known what was coming – but I didn’t!

Throughout this time I was not making any noise. The hospital’s midwife didn’t seem to think I was in established labour, and threatened to up the Synto dose to make the contractions “strong and regular”, even though they were already sufficient to dilate my cervix 3cm in under 2 hours. I managed to insist “no. more. Synto!” She reserved judgement, but it might have been the adrenaline kick I needed, as by 9.15pm I was having enormous contractions every 2-3 minutes. I could feel them as a giant swelling band of pain stretching around my whole belly and stretching lower. At this point I started vocalising “ah, ah, ah” throughout contractions, to help me ride the pain and stop me clenching down. I remember saying “if this isn’t transition, I’m in trouble!” I didn’t believe it could be transition, though – not so early, not when my first birth had taken almost 3 days. Our midwife said she thought we would have babies by 10pm, and I didn’t believe her.

I needed to get off the fit ball and change position, and asked if I could get on all fours, although the idea of moving seemed impossible to imagine. The hospital midwife set up a crash mat and a nice beanbag for me to lean on. I leaned forward and within one contraction of moving had started making some amazing noises. Unlike my “ah ah ahs” they were completely involuntary. And then I could feel twin 1 crowning. I did not believe it had happened so quickly, and cried out “what’s happening?” Everyone still makes fun of me for this. She was born in only a couple of pushes at 9.25pm, and our midwife had to tell the hospital midwife to put her gloves on to catch her. Our beautiful daughter, with a lovely round head, pink skin and a great big yell! There is a photo of me still on all fours, with a blissed-out grin. I could not believe how easy and quick it had been. I got to hold her straight away, but contractions started up again quite quickly, and she went to her daddy for some skin to skin time.

At this point the obstetricians arrived – a registrar and resident. I wanted to stay on the floor, but the registrar managed to persuade me up on the bed to check twin 2′s position, as we knew he was breech. Contractions started up again within minutes and were really agonising now, as I had lost my Calmbirth focus and as the position (twin 2′s spine to mine) had that sort of posterior feeling to it. But within seconds I was again feeling the inexorable urge to push. The OB flicked twin 2′s feet out as he was in a squatting position, the midwife and OB flexed twin 2′s head by pushing on my stomach and with a few mighty pushes he was out too, at 9.39pm. Our son! He was handed to me but unlike J, had a bit of trouble breathing, and spent some time in the special care nursery. He was back to us almost before we knew it. I must say he had a very breech-looking head, which looked like a mighty frown, but he’s ever so handsome and cheerful now.

J weighed in at 2.98kg (I was really ticked off she could not stretch to the extra 20gm), and P weighed 3.06kg, excellent weights for 36 weekers, let alone twins!

After twin 2 was out, I lost all patience for the pain – rather a pity as the Synto kept getting ramped up to deliver the placentas and then to deal with my uterus which did not want to shrink back down. I ended up with a Synto drip all night. I tell people this birth was meant to help me deal with my fear of Synto once and for all.

Both babies had beautiful breastfeeds within an hour or two of birth, which sadly was not an omen of things to come for twin 1, but it was lovely.


Anyway, that was our birth. Twins born without any pain relief (not even hot water) or really any intervention other than the induction drugs, with 4 hours of contractions total and only about 2 of those active labour. It wasn’t the birth I had wanted but it was a wonderful experience and very healing after my first daughter’s birth. I am so proud of myself, and look back on the birth with amazed gratitude all the time.

Visit my website to learn more about my services.

Mothers who breastfeed for ‘at least six months have lower blood pressure’

Dec 29th, 2011
by Melissa Maimann.
No comments yet

Link

… women who gave their babies formula or breastfed for less than three months were almost a quarter more likely to develop blood pressure problems.

… mothers who breastfed for at least six months were less likely to develop hypertension over a 14 year period than those who bottle fed.

… While the findings do not prove breastfeeding was behind healthier blood pressure, researchers said it added to evidence that the practice was good for mothers as well as babies.

… Current Department of Health guidelines urge all mothers to breastfeed their children exclusively for the first six months of life …

… it was not a matter of making women try harder at breastfeeding but rather to make it easier for them.

Studies have previously shown women who breastfeed have lower risks of diabetes, high cholesterol and heart disease later in life …

Visit my website to learn more about my services.

Australian breastfeeding patterns

Dec 27th, 2011
by Melissa Maimann.
No comments yet

Link

Almost all Australian infants commence breastfeeding but most do not continue as long as recommended …

Australian dietary guidelines recommend babies are fed only breastmilk to around six months, but the survey shows that only 15% are meeting this recommendation.

… although 96% of babies were initially introduced to breastmilk, 61% were exclusively breastfed for less than one month and this progressively decreased to 15% at around six months of age.

About 21% of infants were predominantly breastfed to around 6 months of age, meaning that breastmilk was their main source of nourishment, though they may also have been given other drinks such as water or fruit juices.

Infants of mothers aged 35 years and over were more likely to breastfeed for longer periods. Breastfeeding was also more likely for infants whose mother/carer had a tertiary education or higher income.

…‘The guidelines also recommend babies be introduced to solid foods at around 6 months, however, our survey found that around a third of babies were introduced to these foods a little earlier than recommended, indicating there is some more work to be done in this area,’ …

The survey results will help monitor aspects of the National Breastfeeding Strategy 2010-2015, which aims to improve breastfeeding practices in Australia …

Visit my website to learn more about my services.

Baby’s smothering death must spark change

Jul 14th, 2011
by Melissa Maimann.
No comments yet

Visit my website to explore home birth, hospital birth and Medicare-funded private midwifery care.

Link

This article completely misses the point. Babies co-sleeping isn’t a problem – it is helpful for many problems like a baby who is cold, sick, low blood sugar levels, premature, or just wanting love and affection from its parents. The problem – as mentioned in this article – is nurses providing care that they are not qualified to provide, and the poor staffing levels on our maternity wards that see midwives allocated up to 15 mothers and babies per 8 hour shift. Eliminate nurses who are not qualified to provide midwifery care (anymore than a physiotherapist or dentist is) and boost the midwife staffing levels and there might be some changes.

Nurses to do a risk assessment before allowing mothers to breastfeed lying down, says coroner.

Nurses must ensure new mums are alert enough before letting them breastfeed in bed, an inquest into the smothering death of a baby has found. New mums must also be educated about the dangers of accidentally suffocating their newborns …

Zelia Blomfield gave birth to a healthy baby girl … on February 28, 2008 …

Blomfield was breastfeeding Bela for only the second time, about two hours after her birth, when she awoke to find the baby dead. A nurse had placed Blomfield, who felt sleepy but was responsive, in bed on her side, with a pillow behind Bela.

Bela’s post-mortem examination found she died due to asphyxia …

This could have been a result of part of the bed or bedding blocking her airway.

… all Queensland Health birthing services have a specific policy on bed sharing, and be made aware of three deaths in similar circumstances.

The existing policy should be updated to make nurses do a risk assessment before allowing mothers to breastfeed lying down …

This would include noting how lucid she is, giving her information about the dangers of lying down and a buzzer to contact staff if she gets tired, and determining how much supervision she needs …

… The inquest looked into staffing and workload at the hospital … the supervision was not adequate …

Midwives say not enough staff for best practice

Jun 30th, 2011
by Melissa Maimann.
No comments yet

Visit my website to explore home birth, hospital birth and Medicare-funded private midwifery care.

Link

… To Queensland now where a coronial inquiry is calling into question the practices of the state’s maternity hospitals and midwives.

It investigated the third smothering death of a newborn baby in a Queensland hospital in six years and the latest coronial inquest is recommending a review of midwife supervision of patients.

But the Australian College of Midwives argues more supervision is not possible without more staff.

… The peak professional body for midwives says the evidence is clear.

… If a woman is going to be breastfeeding a baby in a bed then a midwife needs to stay with her, someone needs to be there. Once the breastfeed is completed, the baby needs to be put back into the cot. That is best evidence that supports safe sleeping.

ANNIE GUEST: And is that a practical measure in Australian hospitals? Do midwives do that, do they have time?

HANNAH DAHLEN: And this is now the reality, and this is the really important question that we need to deal with – no. Midwives often don’t have time, midwives are often rushed, in fact many hospitals now don’t have midwives.

… Back in 2008 after a long labour going one and a half nights, first time mother Zelia Blomfield gave birth to a baby girl at about two o’clock in the morning.

She had been tired and nauseas and a nurse helped position her to breastfeed in bed.

But about three hours after the birth, Bela Heidrich was found cold and blue beside her mother … staff believed she hadn’t been seen for anywhere between 10 to 40 minutes.

The coroner wants Queensland Health to review patient supervision levels with a view to framing them within a consistent approach, but the College of Midwives gives this warning:

… It’s very difficult to get down to prescribing times. If the Government is wanting to prescribe times then the Government needs to get its act together and provide midwives …

Study connects SIDS risk with infant formula

Apr 19th, 2011
by Melissa Maimann.
No comments yet

Visit my website to explore home birth, hospital birth and Medicare-funded private midwifery care.

Link

An opioid-like element of cow’s milk that is commonly found in infant formulas may be linked to sudden infant death syndrome …

Polish researchers … reported that 12 formula-fed infants who had experienced ”near-miss SIDS” episodes where they temporarily stopped breathing had triple the number of peptides … compared to 20 healthy formula-fed babies who had not experienced breathing difficulties.

The 12 children who had experienced life-threatening breathing problems also had low levels of an enzyme … known to deactivate or modify BCM-7.

… BCM-7, a product of cow’s milk, is known to have opioid-like effects, meaning any penetration of an infant’s immature central nervous system could inhibit the child’s respiratory system.

The researchers concluded that the two factors in the 12 vulnerable infants suggested a link between BCM-7 and apnoea (temporary suspension of breathing).

Australian doctors warned that the study was not sophisticated or big enough to draw conclusions and said parents did not need to act on the study.

… more research was required, but the research suggested that more of the peptide was getting into the brainstems of the ”near-miss” babies because they had less of the DPPIV enzyme to break it down.

Dr Seton said the study reinforced the fact that breastfed infants were known to have about half the risk of SIDS compared to formula-fed babies.

… exposure to cigarette smoke [posed] the greatest risk factor now that most parents knew babies should sleep on their backs …

‘Kangaroo care’ enhances mother-baby bond

Apr 3rd, 2011
by Melissa Maimann.
No comments yet

MEDICARE NOW AVAILABLE FOR MIDWIFERY CARE THROUGH THIS SERVICE!
Want to know more about home birth, hospital birth or Medicare-funded private midwifery care? Visit my website.

Link

… “kangaroo mother care” … The idea was that a mother’s body temperature could take the place of the incubator – just like a mother kangaroo nurtures her baby in her pouch – while enhancing mother-to-baby bonding.

Holding the baby skin to skin in an upright or near-upright position around the clock also would encourage successful breast-feeding and allow early discharge of stable babies regardless of weight or gestational age.

Magee began promoting the practise in 1997 in the neonatal intensive care unit. It expanded in the last few years … Dads can do kangaroo care, too.

… kangaroo care of low-birthweight infants reduced severe illness, infection and breast-feeding problems; improved mother-baby bonding and perhaps even saved lives …

… “The surprising benefits of kangaroo care for the infant include warmth, stability of heartbeat and breathing, increased time spent in the deep-sleep and quiet-alert states, decreased crying, increased weight gain, and increased breast-feeding. These benefits are apparent even when kangaroo care occurs for only a few minutes each day,” the academy says on its website.

… Casper credited kangaroo care with a baby’s “better weight gain; better sleep time – sleep helps brain development; they grow better; it helps with mother’s anxiety and postpartum depression”, she said, adding: “It evens out their breathing, (helps) skin maturation; and declining rates of infection.”

She said studies have shown kangaroo care will decrease the length of their hospital stay, so it’s a potential cost-saving measure.

… breast-feeding is more likely to be exclusive and of longer duration; even bottle-fed babies stabilise more quickly in terms of body temperature, heart rate and breathing.

… “It can be used months later and have an impact on mother, baby, dad,” she said. “Continuing skin to skin through the first year there is a benefit: babies have better self-esteem, a sense of trust.”

To find out more about the services I offer, please visit my website.

Bottle-feeding ruining tots’ teeth – says Children’s Hospital’s dental expert

Feb 7th, 2011
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or Medicare-funded private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

AUSTRALIA’S leading children’s hospital has urged parents to stop bottle-feeding their babies because of rising rates of severe tooth decay in infants as young as 12 months.

… prolonged feeding with bottles of breast milk and infant formula are linked to the problem, especially at night, when children suck on bottles in their cots for extended periods.

… naturally-occurring lactose was present in both breast milk and formula. When combined with plaque in a baby’s mouth, it could erode the enamel of primary teeth.

“Ideally, children should go straight from breast to cup, avoiding bottles altogether,” …

… the hospital had been removing teeth, under general anaesthetic, from babies as young as 12 months due to bottle-feeding infants at bedtime.

Paediatric dentists had noticed a pattern of decay on the back of the upper front teeth, indicating the cause was drink from a bottle that had been held between the child’s tongue and teeth for prolonged periods.

… The waiting time for dental surgeries under general anaesthetic is between nine and 12 months.

… primary teeth were important because they helped children chew food properly, develop proper speech and guide permanent teeth into the right place.

Even when teeth had not formed, it was important to establish good habits and not let a child become accustomed to sucking on a bottle at night …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breast Feeding Benefits Boys’ Brains

Jan 10th, 2011
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or Medicare-funded private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

Breast feeding for at least six months has been associated with enhanced immunity and other benefits for children — but a prospective study from Australia suggests breast feeding may also yield academic benefits later in a child’s life, at least for boys.

… those who were predominantly breast fed for six months or longer had significantly higher scores on standardized tests of reading, math, and spelling at age 10 compared with kids breast fed for shorter periods …

However, the effects on those test scores appeared to be much stronger for boys than for girls …

… “Our study adds to growing evidence that breast feeding for at least six months has beneficial effects on optimal child development,” …

… The relationship may be explained by the fact that nutrients in breast milk — especially long-chain polyunsaturated fatty acids — are essential for optimum brain growth, including cell membranes and neurons.

When looking at other factors, the researchers found that lower maternal education and family income were significantly associated with decreased child academic achievement.

Conversely, reading and looking at books with the child between ages 3 and 5 were associated with improved mean scores for reading and writing, particularly for girls.

This gender difference also held true for the big picture. When analyzing the cohort by gender, predominant breast feeding at six months was significantly associated with increased mathematics, reading, writing, and spelling scores for boys — but there was no effect on educational attainment for girls in any subject …

Another possibility is that breast feeding has a positive effect on the mother-child relationship, facilitating bonding, interaction, and, indirectly, cognitive growth. Studies have shown that male infants are more reliant than females on maternal attention, so the positive effects of this bond may be stronger in males …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Your body, your choice

Nov 17th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

The transforming experience of childbirth is increasingly blotted by medical interventions. Are women making informed decisions?

LIKE most first-time mothers, Faye Wong … was incredibly excited when she got pregnant. She read baby books and magazines voraciously, signed up for ante-natal class … to prepare for baby’s arrival.

When she was 38 weeks pregnant, her obstetrician said the baby’s head had engaged and his size was quite big. The doctor suggested inducing her labour.

In the labour room, her “nightmare” began. The pain from the drug-induced contractions was a rude jolt to her system. Then she was jabbed and prodded with painkillers, IV tubes and the works.

“I was shocked, confused, and in absolute terror,” recalls Wong, 35. Finally, the induction failed and she had to be wheeled in for emergency caesarean. Thankfully, she delivered a healthy baby boy weighing 3.9kg. When she got home, she struggled with breastfeeding and suffered a severe bout of post-natal blues.

“I felt ‘cheated’ … ” Wong admits. Her son is now seven. “I was a newbie to the birthing process and was meek as a lamb led to the slaughter,” she adds. “If I’d known then what I know now, I probably would have been better prepared, stood my ground and not undergone early inducement.”
Though doctors play a role in giving women the necessary information about labour options, women and their partners need to take their share of responsibility too in making informed choices and decisions.

Wong’s experience isn’t unique.

“We see a fair amount of women who are unhappy about the outcome of their deliveries,” says Jennifer Hor of Jenlia Maternal Services. The UK-trained midwife has been running ante-natal classes and post-natal home visits for 17 years. “Some felt they had a C-section even though they didn’t want it. Or, some felt they didn’t get enough information from their doctors.”

So, are women less assertive when it comes to childbirth? Are they getting or finding the information necessary to make informed choices and decisions? And have we forgotten that childbirth, an age-old practice, is meant to be natural?

Birth trends

… the medicalisation of childbirth means what used to be a straightforward, natural process is now treated as a high-tech medical procedure.

Caesarean rates are on the rise in both developed and developing countries …

… “Women say they want to take ownership of their bodies, yet we have healthy, low-risk women who said they had a C-section for their first births because they listened to their doctors,” says Farouk, who also sub-specialises in reproductive medicine. And because of the risks from the first surgery, these women are requesting for repeat C-sections. “Ironically, women are pushing the trends that way.

“We are also seeing the use of more technology to manage pregnant mothers, for example using CTG (cardiotocography) … and ultrasound scans,” says Farouk. “It’s not all bad, but if you monitor too much, you might pick up something and wonder if you don’t take action, there might be consequences, hence the interventions.”

… Doctors come with their beliefs and agendas, based on experiences. Some underplay certain risks and amplify others. For instance, placental calcification … is not a major issue for some obstetricians if the woman is near term and foetal growth is normal. But for a different doctor, a few specks on the ultrasound scan is reason enough for labour induction.

“There can be grey areas in medical investigations. I tend to be more conservative with placental calcification and continue to monitor foetal health and growth parameters,” …

Also, fear of litigation is scaring obstetricians into defensive and often interventionist practices.

“An obstetrician is more likely to be subjected to litigation because a caesarean section was not performed or was perceived to have been performed too late …”

Medical interventions

Clearly, it’s not always true that C-sections or epidural blocks are being foisted on reluctant women. The fact is, some women don’t question their doctors, or they themselves are asking for interventions.

Labour induction, elective caesarean, epidural jabs, and routine episiotomy are some of the common medical interventions during childbirth.

Induction of labour … is usually done when the mother’s or baby’s health is at risk …

“For such cases, studies have shown that caesarean section rate has been unchanged or lower among the induced group as compared with expectant management of pregnancy … ”

“But induction of labour at 37 to 41 weeks on non-medical grounds is linked with an increased risk of caesarean section for … a woman who has never given birth and an increased risk of instrumental delivery,” …

No doubt, medical interventions can be a lifesaver for mothers and babies …

However, once the natural process of labour and birth has been disturbed, if there is no actual emergency, there is risk that the side effects of the treatment will trigger more intervention necessary to fix the problem. This sequence of events is called the “cascade of interventions”.

“Pitocin (Syntocinon), a synthetic form of the hormone oxytocin used to induce or speed up labour, often results in a rapid increase in the intensity and strength of the woman’s contractions. As a result, she may opt to use pain medications such as pethidine … or epidural anaesthetic. Babies sometimes don’t react favourably to the sudden increase in the intensity of the contractions, which may result in irregularities of the heartbeat. Thus in turn may necessitate delivery by caesarean,” …

“Many women who use epidural do not experience the urges to bear down which help them to birth their babies. Often, in this situation, the doctor will use forceps or vacuum to deliver the baby, which means he needs to do an episiotomy … Many women experience long-term perineal pain following episiotomy.”

A failed induction (when labour doesn’t started after the first cycle of treatment) can either require a rescheduled induction or emergency C-section.

“Women should received accurate information about the risks, benefits, and alternatives of induced labour and understand the possible side effects and interventions, ” …

The big ‘C’

Most women also come with the preconceived idea that C-sections are safer than vaginal delivery …

… “In fact, C-section, which is classed as a major surgical procedure, carries with it the risk of complications and shouldn’t be viewed as an alternative option to normal birth.”

… “Babies delivered by elective caesarean section at 37 to 39 weeks’ of pregnancy are at two to four times more likely to suffer from respiratory morbidity compared with babies delivered by vaginal delivery,” … WHO global maternal survey also finds that women who choose elective caesarean with no medical indication are at increased risk of maternal death and serious complications.

… Studies have linked depression and distress after birth, which affect up to one in five women, to forceps and caesarean births …

Disturbed birth

“You must be mad to give birth without an epidural!” A common reaction these days if you speak with women who have undergone labour. But as the WHO states, “epidural analgesia is one of the most striking examples of the medicalisation of normal birth, transforming a physiological event into a medical procedure.”

… in her book,Gentle birth, gentle mothering, internationally acclaimed birth expert Dr Sarah J. Buckley explains how epidurals or painkilling drugs and synthetic hormones (used during induction) interfere with some of the major hormones of labour and birth. The five major hormones: oxytocin (hormones of love); beta-endorphin (pleasure and transcendence); the catecholamines or CAs, epinephrine and norepinephrine (excitement); and prolactin (tender mothering) form a “cocktail of hormones that nature prescribes to aid birthing mothers of all mammalian species”.

During an undisturbed labour, these hormones rise in crescendo and peak around the time of birth or soon after for mother and baby, and subside over the following hours and days. “An optimal hormonal orchestration provides ease, pleasure, and safety during this time for mother and baby.” Interference with this process, by injecting drugs or synthetic hormones, will “disrupt the hormonal orchestration, making birth more difficult and painful, and potentially less safe”.

For example, epidurals lower the mother’s production of oxytocin or stop its normal rise during labour. Oxytocin causes a woman’s uterus to contract in labour. It peaks at birth and catalyses for the final powerful contractions of labour, and helps mother and baby to fall in love at first meeting.

Under stressful conditions, our body releases epinephrine and norepinephrine (CAs). Towards the end of an undisturbed labour, the mother experiences an adrenaline rush – the natural surge in these hormones gives her the energy to push her baby out, makes her excited and fully alert at first meeting with her baby.

But when a woman feels fearful or unsafe, her labour is inhibited by high CA levels. Epidurals reduce the release of the CAs, which may be helpful if the high levels are restricting her labour. However, a reduction in the final CA surge may make it difficult for the woman to push her baby out, thus increasing the risk of instrumental delivery (forceps and vacuum).

Epidural’s side effects include nausea, slowing of labour and drop in blood pressure, slowing of contractions, and headache.

35-year-old Laila Aziz of Kuala Lumpur was wheelchair-bound for four months after an epidural jab injured her nerves when she delivered her third child.

“I wish my O&G and the anaesthetist had explained in details the pros and cons of using an epidural,” says Laila, who suffered severe post-natal blues after childbirth. “I would at least reconsider whether to use the option at that time.”

… Childbirth educator and lactation consultant Christine Choong has been advocating natural childbirth for the past two decades.

“My main passion is how birthing practices affect breastfeeding. What happens when you’re in labour can have a long-term effect on your breastfeeding,” …

Research has shown that when you put a baby on his mother’s chest (skin-to-skin contact) immediately after he was born, the baby will crawl instinctively towards her breast.

“Quite often the baby won’t do that if you had used drugs during labour … because he will be drowsy the first two to three days,” … “If women use epidural, very often their babies are delivered by suction or forceps which can cause discomfort on baby’s head (a shock to the system) and baby initially will not be happy feeding on one side or the other.”

Whether a labour induction is done on medical grounds or not, the baby is – by definition – relatively immature and likely to have impaired ability to effectively coordinate sucking, swallowing, and breathing at breast …

“In a C-section delivery, very rarely the mother is given the baby straight away,” Christine adds. “Early stimulation or suckling is important to establish breastfeeding. Also a higher percentage of caesarean babies end up with respiratory problems, which results in separation of mom and baby.”

But we need to look at the whole picture – the impact on baby, feeding, and mother-baby relationship.

“It isn’t just feeding but also nurturing,” says Christine, a mother of three.

“When babies are nurtured and their needs are met, in the long term, they will become people who are secure, confident, and know how to form relationships with people.”

Take control

What do you do if your care provider says you or your baby is at risk and an intervention is necessary?

“Using evidence-based information, your doctor should explain the reason for any suggested interventions. He should also explain the benefits and risks of such procedures,” advises Choong. If you’re not sure or not too convinced by your doctor’s explanation, get a second opinion.”

“Empowerment with the correct knowledge and information is useful so women can ask the correct questions,” Chow adds. “And their fear of childbirth should be addressed by getting support and learning about the labour process and pain relief options.”

Ultimately, a woman’s satisfaction with her birth experience is related more to her involvement in decision-making than to the outcome, as Buckley emphasises. Though doctors play a role in giving women the necessary information, women and their partners need to take their share of responsibility too in making informed choices and decisions.

When Wong had her second child, she was more mentally and emotionally prepared.

“Although I ended up having another C-section (due to hypertension), I didn’t feel disappointed and helpless,” Wong says. “I felt as if I was a real mom this time around.”

As Buckley sums it up best, “birth is the beginning of life; the beginning of mothering and of fathering. We all deserve a good beginning.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Baby formula ‘should be prescribed’

Oct 7th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

… a Melbourne doctor of midwifery has inflamed the emotional debate by calling for infant formula to be made available only by prescription.

Dr Jennifer James wants infant formula banned from supermarket shelves.

She says the move is not designed to make mothers feel guilty, but rather to help them by ensuring that they see health professionals when problems arise.

The World Health Organisation’s message that breastfeeding is better for newborns has been made loud and clear.

But breastfeeding is not always easy or possible.

… Dr James says the majority of women want to breastfeed but she says many give up very early when they encounter problems like pain, lack of milk or when their baby fails to properly attach.

She says her plan to make formula available only by prescription will help mothers by forcing them to see a health professional when difficulties arise.

Seeing a health professional will not solve the issue. For example, the woman would most likely consult her GP in the first instance and most GPs do no have good knowledge of breastfeeding and support of breastfeeding. I can imagine scripts for formula being handed out willy nilly, simply because the GP does not have the knoeledge and skill to handle breastfeeding issues. Next is the issue of access: who should the woman turn to if she has issues overnight when there are no GPs open? The best person to consult would be a midwife or a lactation consultant, however without prescribing rights, formula could not be prescribed.

“It’s about looking at ways of ensuring that women get the support and the education they need when they need it,” she said.

Education is best done before the baby arrives. Most hospitals have breastfeeding classes for pregnant women; women can learn from other breastfeeding mothers via the Australian Breastfeeding Association and there are many books and articles on breastfeeding.

“Having to get some sort of prescription … then the woman is sitting with a health professional who can go through her breastfeeding problems and set up a plan of action to help her achieve her goal of successfully breastfeeding her baby.”

Ms James says it is important that women do their best to ensure they breastfeed their children.

“Artificial formulas have to meet food safety standards, but they are at best basic nutrition. They don’t provide anywhere near what a mother’s own breast milk can provide,” she said.

“So they’re a substandard product. We know that children that aren’t breastfed exclusively for at least six months run, have higher incidences of chronic disease in the long term.”

… While Dr James says her idea is designed to help women, the proposal has been fiercely attacked.

The editor of Practical Parenting Magazine, Mara Lee, says the proposal is outrageous and deplorable.

“What this move will do is further promote the notion that formula is poison and is not safe for infants and mothers shouldn’t have access to it,” she said.

I wouldn’t go quite this far: it’s no different to having other specialised foods available on prescription.

“What that does to mothers who are already struggling with guilt, with fatigue, with mastitis, with babies who simply aren’t being sustained by breastfeeding is it’s making them feel that they have no choice and locking them into a cycle of despair.

“That to me is pretty deplorable. I already see enough mums who are really struggling to make feeding work and I don’t think we should be trying to make it harder.”

The Australian Medical Association has also attacked Dr James’s idea.

It says there are a significant number of mothers who simply cannot breastfeed and limiting their access to formula could increase their sense of failure and be psychologically damaging.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Up to a third of Aussies against public breastfeeding

May 19th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

Up to a third of Australians still believe mothers should not breastfeed babies in public, while a third think a baby should stop breastfeeding within six months.

Despite 65 per cent of people saying breastfed babies had a better chance of surviving beyond a year old … only 29 per cent “strongly agree” that women should be encouraged do so in public.

… young adults … were the least supportive of public breastfeeding.

… “Part of the issue why young mothers wean their babies too early is societal pressure …”

… The World Health Organisation recommends breastfeeding exclusively for a baby’s first six months, continuing for up to two years …

… breastfed babies have lower risks of cot death and a decreased likelihood of developing diabetes or becoming obese.

“While nearly 90 per cent of Australian women initiate breastfeeding, one per cent of Australian children are breastfed for the minimum duration recommended by the WHO,” Dr James says.

“Australia needs a paradigm shift, and it has to start in our schools with education that normalises breastfeeding …”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Another reason to birth at home? Mothers brought the wrong baby to breastfeed.

May 9th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

Babies are being handed to the wrong mothers who are unknowingly breastfeeding another woman’s child, with a string of dangerous hospital blunders in New South Wales exposing both mums and newborns to disease.

In one shocking case uncovered in an investigation … a newborn baby had to have its stomach pumped after being given month-old breastmilk from a woman who was not the child’s mother.

At least 26 cases where babies have been wrongly identified have occurred in NSW public maternity wards in the past three years. Staff shortages and the failure by some midwives to check identification tags have been blamed for the errors.

After a year-long investigation, documents released under Freedom of Information reveal the extent of the bungles.

One of the most serious cases was at Blacktown Hospital … with a baby given unnecessary medication because of incorrect identification tags.

In another incident, a 10-hour-old baby girl was given to the wrong mother to be breastfed at Westmead Hospital … because staff did not check the identification tags properly.

At least half of the errors … occurred in the Sydney South West Area Health Service …

It is the same health service which tried to hide its mistakes by refusing to release the documents until ordered by the Ombudsman.

Documents released by the hospitals reveal mothers have been left distraught after being told,or discovering themselves, the child they were breastfeeding was not theirs.

… NSW Health’s breast-milk safe management policy advises staff to double-check ID tags on the baby’s ankles and wrists against the mother. Expressed milk should be cross checked with the mother and ideally stored in a fridge in her room …

These problems can be avoided by birthing at home. If a woman births in hospital, it is important to avoid separation from the baby, even if she is tired. Midwives typically care for 8-15 women on afternoon and night shifts and this can obviously impact patient care. It does not excuse the issue, but with a huge shortage of midwives, keeping your new baby with you can help minimise your chances of being handed someone else’s baby, or having your baby handed to another mother.

Melissa Maimann, Essential Birth Consulting 0400 418 448

FAQs

Apr 15th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

home birth: how messy is it

Homebirth generally isn’t messy. Many women labour and birth in a birth pool and any bodily fluids are easily contained. Towels and plastic sheeting come in handy and midwives are very good at leaving the house as it was found. Plastic bags collect any garbage, the placenta is collected in a bowl or container, and sheets and towels can be washed.

midwives home birth still legal

Yes, it’s still legal and it will remain legal after July 2010.

how many hours a day do you spend breastfeeding

Breastfeeding can take a long time! Some women spend about 50% to 2/3 their time feeding, especially if it’s a newborn baby. Newborns can healthily feed every couple of hours for an hour at a time. This feeding pattern is helpful to encouraging the mother’s milk supple, allowing bonding to occur, help the baby’s palate and jaw muscles to form well and assist the baby’s digestion.

i would like a private midwife but im giving birth at a public hospital

Women may take private midwives with them to pubic hospitals. Women may book into hospital, have all their pregnancy care with their private midwife, birth in hospital with their midwife and hospital staff, and then return home to continue care with their private midwife.

in home birth, what happens if emergency c-section is needed?

In homebirth, midwives are always on the look out for any signs of things not going well in the pregnancy or labour. This allows for women to be seen by doctors or transferred to hospital before true emergencies occur. Most “emergency” caesareans are not in fact emergencies in that they are life and death situations. They most commonly occur because a labour is not progressing and the baby will not come out any other way. However, in the event that a caesarean is needed, the midwife and woman simply transfer to hospital and are offered the best obstetric and midwifery care possible in the circumstances. planning a homebirth does not commit the woman to birthing at home if circumstances make it that hospital would be safer.

what’s the difference between a midwife and obstetrician

Obstetricians are doctors who have completed a degree in medicine and a degree in surgery. They then complete several years of internship and residency before going back to specialise in obstetrics. An obstetrician is a highly trained and educated doctor who specialises in the care of pregnant and birthing women, mostly dealing with complications. Obstetrics is a surgical specialty.

Midwives are qualified to care for women throughout pregnancy, birth and postnatal. They care for healthy women who are experiencing normal pregnancies. If a woman’s condition warrants consultation with an obstetrician, this can be arranged without fuss. Midwifery care generally affords women lengthier consultations, more personalised care and a greater satisfaction with the birth experience. Women who
are attended by midwives are more likely to experience a normal birth, to breastfeed and to receive fewer interventions in their pregnancy and labour such as induction, epidural and episiotomy.

water birth private hospital

Good luck! Private hospitals (in Sydney at least) do not allow for water births. If anyone knows of a private hospital that allows waterbirths, please let me know! Nabmour allows waterbirths but it is not in Sydney.

how to avoid hospital birth

Well, if you don’t go to hospital, you can avoid a hospital birth. I guess the question is – how can you prepare well for a homebirth so that you minimise your chances of needing to go to hospital? I think an excellent approach is to book with a midwife and explain that you would really like her to help you to birth at home.

how to choose a midwife

See here.

limitations of using a private obstetrician for maternity care pregnancy

1. You’re more likely to have intervention in your pregnancy and labour
2. Your obstetrician is likely to work with other obstetricians, sharing on-call over the weekend. So it’s possible that your obstetrician will not be available to you when you’re in labour.
3. You will be attended by hospital midwives in labour and postnatally who you may not have met.

Melissa Maimann, Essential Birth Consulting 0400 418 448

NHMRC: Pregnant women need an iodine supplement

Mar 7th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

The National Health and Medical Research Council (NHMRC) today released a new recommendation that all women who are pregnant, breast-feeding or considering pregnancy take an iodine supplement of 150 micrograms each day.

… “Women wanting to conceive, or who are already pregnant or breast-feeding, need a minimum of 250 micrograms of iodine each day for the baby’s brain and nervous system development,” …

“Australians now get more iodine in their diets following the mandatory fortification of bread last October, though it is still appropriate for women to supplement their diet with an additional 150 micrograms of iodine every day,” he said.

… “The body does not store iodine, so amounts taken in excess of the body’s requirements will simply be excreted by the kidneys.”

People with a known iodine deficiency, or who are concerned they may not be getting enough iodine, should consult their healthcare professional.

Melissa Maimann, Essential Birth Consulting 0400 418 448

FAQs

Feb 23rd, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

informed consent and childbirth

Every woman who is competent to consent, has the right to refuse any or all professional care. Informed consent must be obtained prior to any procedure being performed.

how to minimise labour intervention in a hospital?

The best way to minimise intervention in a hospital is to be as well informed as you can possible be about all things related to pregnancy, labour, birth, breastfeeding and babies. Read widely, attend independent childbirth education classes and consider employing a private midwife to be with you throughout your labour. She can help you to decide if the proposed interventions are necessary in your situation, she can support you emotionally, mentally and physically and she can aso help to ensure that your birth plan is respected without a fuss.

Do any independent midwives in Sydney offer prenatal care for women who are planning to freebirth?

Yes! This service enables women to access antenatal care from a midwife without the midwife attending the birth. Postnatal care is available if needed.

Do you think there are advantages to continuous monitoring for low-risk women

In a word, no. Intermittent auscultation is the method of choice. Continuous monitoring will increase the chance of a caesarean with no benefit to the mother or baby.

How much is a private midwife

Prices range from $3000 – $6000. Melissa Maimann offers for her clients to pay by the hour, making the service one of the cheapest.

What is a good caesarean rate?

The World Health Organisation recommends that no more than 15% births need to be caesareans. The WHO argues that when caesarean rates exceed 15%, the risks to the mother and baby increase on the whole. You’ll be hard-pressed to find a hospital with a caesarean rate of less than 15%, but birth centres and private midwives have caresarean rates of less than 10-15%.

What is the best hospital in sydney for delivering babies?

It all depends what sort of birth experience you’re after! If you’re wanting a natural birth, home birth will be the best option. If you want a natural birth in a hospital setting, the best options would be birth centre or private midwifery care for a planned hospital birth. If you’re wanting to have intervention in your birth, a hospital birth would be best. If you choose an obstetrician, you’re far more likely to have a caesarean, episiotomy, epidural, forceps or vacuum. Choosing your care provider is the single most important decision you will make in birthing.

Is there a birth centre at westmead hospital?

No, there isn’t. If you’re after a natural birth, the best choice would be a home birth.

C section or natural delivery midwife?

Midwves cannot perform caesareans. If a caesarean was needed, the midwife would call a doctor in to perform it. Most caesareans that are performed are unnecessary and increase the risks to the mother and baby. A natural birth is the safest way to birth, and midwives are qualified specialists in natural birth.

giving birth after birth trauma

Private midwifery care will be really important so that you can have the same midwife all the way through pregnancy, birth and postnatally. It’s also important to debrief your last experience and come to a place where you feel safe to birth again.

high risk midwife sydney

Midwives are not qualified to care for high risk pregnancies. We refer these women onto obstetricians. In most cases, one or two consultations is all that is needed with the obstetrician and the midwife continues the care of the woman.

how many births proceed naturally

What a great question! It all depends what care provider you choose and where you have your baby. You see, if you choose a private midwife and birth at home, you have about a 95% chance of having a vaginal birth. If you birth in a private hospital, you have about a 33% chace of having an unassisted vaginal birth. In some hospitals, the caesarean rate is more than the vaginal birth rate! Sad but true.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Feedback on our maternity system

Jan 5th, 2010
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448.

Link

… 20% of … mothers … said they had witnessed occasions when a lack of resources put a mother at risk; 14 per cent said they had seen shortages put a baby at risk.

63% of … mothers … agreed that public maternity units resembled ”herding yards” when asked if it was an appropriate description.

Of … women who gave birth in the public system … more than a third said leaving hospital too soon was a problem, 47 per cent felt their postnatal care was inadequate, and 48 per cent experienced a lack of breastfeeding support.

Of [the] … women who gave birth in the private system … 17 per cent said they were discharged too early, 39 per cent felt their postnatal care was lacking, and 45 per cent said they did not receive adequate breastfeeding support.

Of the … mothers who gave birth in both the public and private systems, 43 per cent thought the private system was better; 30 per cent thought the public system was better.

… providing midwives with more independence to prescribe drugs would improve the system.

62% … said Australia’s 30 per cent caesarean rate was too high. A quarter thought it was mainly done for professional liability reasons and a fifth believed it was done at a mother’s request.

47% … said there was a shortage of midwives …

WHAT MOTHERS SAY
”There should be more continuity of care. Knowing your carer and trusting your carer removes the fear from childbirth and fear leads to more interventions.”

… ”There is a severe shortage of birth centre places available and in many areas it is not even an option.”

”There are so many time limits imposed on women which completely disregard the natural progression of labour in women’s bodies. Doctors are too quick to intervene, too impatient to wait and allow the body to do its job.”

… ”Women are not being given enough time to labour naturally.”

“I was not supported well enough to have a vaginal birth. I felt like they were more concerned with getting me in and out quickly so they could free up beds.”

… ”There are too many obstetricians performing unnecessary caesarean sections and other interventions due to fear of litigation.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breast-Feeding Can Help Mom’s Heart

Dec 3rd, 2009
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.

Link

Breast-feeding … can significantly lower a woman’s risk of metabolic syndrome …

… Breast-feeding for longer than nine months dropped the risk of metabolic syndrome by 86 percent in women with gestational diabetes. Women without gestational diabetes saw a 56 percent reduction in their risk of metabolic syndrome …

… The benefits of breast-feeding for infants … include lower risk of ear infections, stomach problems, respiratory illnesses, asthma, skin allergies, diabetes and SIDS. For women, breast-feeding appears to lower the risk of type 2 diabetes, breast cancer, ovarian cancer and postpartum depression …

Metabolic syndrome [includes] … abdominal obesity, high blood pressure, low levels of HDL (“good”) cholesterol, high levels of LDL (“bad”) cholesterol, high triglycerides, insulin resistance, elevated markers of inflammation and a tendency for blood to clot …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Nursing mothers to get more support in ‘breast is best’ push

Nov 25th, 2009
by Melissa Maimann.
No comments yet

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email me or call 0400 418 448.

Link

MOTHERS will be encouraged to feed their babies only breast milk for the first six months as part of an ambitious new national breastfeeding policy.

The goal would require a huge rise from present norms under which only 14 per cent of mothers fully breastfeed their babies to six months. Nearly half of mothers have abandoned reliance on breastfeeding only after three months.

Federal and state health ministers yesterday endorsed the strategy which calls for more community acceptance of breastfeeding in public, more support and training for mothers before and after delivery and increased access to parental leave.

… “considering over a quarter of Australians think that breastfeeding in public is unacceptable, we know there is a long way to go,” …

She welcomed the recommendation for more support for mothers to begin breastfeeding by placing newborn babies in skin-to-skin contact with mother immediately after birth. Too often babies were taken away for jabs and checks after delivery, at odds with newborn babies’ ”extraordinary capacity to find the breast, attach and feed”.

Support for workplaces to adapt to the needs of breastfeeding mothers was also essential …

The Health Minister, Nicola Roxon, said … ”… all of the evidence shows breastfeeding children for a longer period of time than is common in Australia has enormous health benefits both for the child and for the mother.”

The breastfeeding strategy for 2010-15 also aims to increase the numbers of mothers who continue breastfeeding their babies and supplementing with solids for 12 months and beyond …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breastfeeding reduces chance of postnatal depression

Sep 9th, 2009
by Melissa Maimann.
No comments yet

Questions or comments? Email me at Essential Birth Consulting or call 0400 418 448.

Link

According to recent research … mothers who bottle-feed rather than breastfeed are putting themselves at greater risk of postnatal depression … an absence of breastfeeding has been connected with the death of a child, and … the decision to bottle-feed mimics that loss … those who bottle-fed their babies scored much higher on a postnatal depression scale than those who breastfed.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Most New Moms Use Contraceptives, Just Not Effective Ones

Aug 13th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link

Only 60% of women who have just given birth use a highly effective contraceptive …

… Highly effective methods include sterilization, an intrauterine device, the pill, the patch, or a ring. Moderately effective methods included condoms, while those less effective included a diaphragm, cervical cap, sponge, rhythm, and withdrawal.

It interests me that the Billings Method (LAM) is considered to not be effective, when research around it shows it to be 97%+ effective. I note that the authors of this study refer to it as “rhythm” which in itself if not accurate. the rhythm method is diffferent to Billings / LAM since different rules apply to lactating women. If health professionals are not cognizant of this, then it is no wonder the method is not effective.

Melissa Maimann, Essential Birth Consulting 0400 418 448

If Breast Is Best, Why Are 70% of U.S. Hospitals Pushing Formula?

Jul 27th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link

The majority of U.S. hospitals are providing formula packets … to breastfeeding mothers while nearly one-fifth of hospitals give something other than breast milk as a first feeding to … babies … This practice contradicts the best medical evidence available …

Breast milk … provides … antibodies and essential nutrients … breastfeeding benefits [include] decreased risk of diabetes, obesity, juvenile leukemia, heart disease, asthma and ear infections. Breastfed children also have been found to have better jaw and eye development than those who are not breastfed.

… breastfeeding helps a uterus return to its normal size. It may help a new mother lose pregnancy weight, and studies show that it reduces the risk of breast and ovarian cancer … breastfeeding [increases] bonding between mother and baby.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Bottle-Feeding Moms Ignored

Jul 17th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link

The lack of information and support for mothers who bottle-feed could put the health of their infants at risk …

… Variations in bottle-feeding can have long-term health consequences for children …

… Some mothers who bottle-fed … experienced negative emotions such as guilt, worry about the impact on their baby, concern about health professionals’ opinions, uncertainty about how to proceed, a sense of failure and anger at feeling pressure to breast-feed.

Some mothers said they didn’t receive enough information on correct bottle-feeding techniques …

It was common for mothers to make mistakes in bottle-feeding preparation. Incorrect preparation can increase the risk of infection, promote excessive weight gain or leave babies undernourished.

It’s important to promote breast-feeding because it’s the healthiest option for both mother and baby … But … it’s “also necessary to ensure that the needs of bottle-feeding mothers are met … Inadequate information and support for mothers who decide to bottle-feed may put the health of their babies at risk.”

Melissa Maimann, Essential Birth Consulting 0400 418 448

Colostrum Functions Like Human Growth Hormone

Jul 16th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link

Colostrum … is the first food, in which all the immune and growth factors that insure health and vitality are transferred from the mother to the newborn. Research has shown that colostrum is the one supplement that can bring help to everyone that uses it, largely because of its ability to perform many of the functions of human growth hormone (HGH) in the body … colostrum can prevent the death of human neurons and effectively treat Alzheimer’s patients. … Colostrum knocks out intestinal inflammation.

… a proline-rich polypeptide isolated from colostrum, can effectively treat Alzheimer’s disease patients.

… Colostrum works in a unique manner to protect the body from pathology. Most pathogens enter the system through the mucous membranes of the intestinal tract. Bacteria, viruses, pollutants, contaminants and allergens must be combated there. … a high percentage of the antibodies and immunoglobulins present in colostrum are not absorbed but remain in the intestinal tract. Immune factors work there to support proper immune function and healthy intestinal flora …

… Colostrum is the essence of pure nutrition, containing immunoglobulins, growth factors, antibodies, vitamins, minerals, enzymes, amino acids, and other special substances designed to prime the body to face a lifetime of invasion by various microorganisms and environmental toxins bent on destruction.

Even more data to support breastfeeding!

Melissa Maimann, Essential Birth Consulting 0400 418 448

No more tears

Jul 1st, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link

Howard Chilton has probably cradled a small percentage of Sydney’s locally born population in his arms. The specialist in newborn babies has devoted his career to the pointy end of medicine, keeping alive infants the size of a matchbox and inventing medical devices to help his work.

But after three decades, two of which he was director of pediatrics at the Royal Hospital for Women, the respected doctor has turned his attention to their often-anxious parents, risking facing the ire of many women in the heated debate on mothercraft.

… “I desperately want parents to enjoy their babies,” he says. “Mostly I call myself a reassurologist.”

… “If you want to have an independent baby, love-bomb them,” he declares. Feed them, cuddle them, let them rule your world. For the first six months of their lives at least….

… new interests have replaced old ones. He wants to convince health authorities to fund human milk banks across Australia for infants who need breast milk. Despite the fact that such services are common in other developed countries, he seems remarkably patient with the slow progress here. “They will move at their own speed,” he says.

… Perhaps more engrossing is his passion for educating parents against trying to create order in their new life with a tiny baby. Still a visiting medical officer at the Royal and in private practice, he wants to ensure such ideas for infants aged younger than six months are banished for good.

Every Thursday morning he meets new parents at the Royal to deliver his message. His group talk started because he found he was being asked the same questions again and again. The most pressing being how to settle a crying, distressed baby.

“I enjoy one-on-ones but one on 30 is a more efficient way of helping parents, reassuring parents that they are capable of looking after their baby.”

His introduction to parenthood has blossomed into an hour-long guided tour that begins with evolution. Humans are born premature, with brains that are only 25 per cent formed. Because humans walk on two feet, the birth canal in women is too narrow to allow a large, more fully developed brain to fit through the pelvis.

Because babies are therefore not fully formed at birth, parents should replicate the baby’s experience in the womb by providing a secure, quiet and well-fed environment for the first months after birth. He tells mothers to ignore age-old rules of mothercraft, urging them not to bother burping their babies, to breastfeed them (if possible) as much the baby wants, to sleep with them (under correct conditions) and not to let them get distressed if avoidable.

Chilton has been known to urge his audience to throw out any copies of the likes of best-selling author Gina Ford …

“I think the [likes of] Gina Ford are attractive to a small section of the population, usually career women who want their babies to fit into a template … teachers and accountants, people who really like things to be timetabled,” he says.

In reality, only about 15 per cent of babies conform to sleeping and eating at the whim of the parent. The rest pay no heed to day and night and end up crying to be held or fed. “I know a lot of people who sob over Gina Ford because it just doesn’t work for them or their baby.”

Chilton also has a book, Baby On Board, in which he warns of the effects of repeatedly leaving babies less than six months old to cry: “Without therapy or a change in their life, these babies can grow up into people who panic and fly off the handle when things aren’t going well, who are prone to depression and anxiety, and may use alcohol and other drugs in an attempt to blunt the way they feel about themselves and their world. The seeds of such life are sown in the nursery.”

Chilton bases this claim on neurobiological research. Evidence collected … shows it is during the early months after birth that crucial connections are established in the brain between the limbic system, where emotions are experienced and the neocortex, the part of the brain that rationalises experience. Babies can feel emotions but not rationalise them. If they are left to feel fear or stress, their brain releases stress hormones such as cortisol and adrenalin. If it happens in a sustained way, perhaps by parents trying to make them sleep on demand, their brains anticipate further stress as a matter of course.

Chilton acknowledges that his views may make parents even more anxious about such an enormous responsibility. It might sound sweet to “love-bomb” your baby but could you bear the guilt if you don’t? And what if your child grows up to experience depression or anxiety? Even though you tried, could you have loved him that little bit more?

At the same time he admits that the brain is highly “plastic”. “Just because you have a problem in your first year doesn’t mean you will have a problem later,” he says, the reassurologist in him returning …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breast-Feeding Boosts Child’s School Performance

Jun 26th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link

Children who were breast-fed do better in high school and are more likely to go to college than their bottle-fed siblings, researchers report.

… “We compare sibling pairs — one of whom was breast-fed and one of whom was not, or siblings who were breast-fed for different durations — and find consistent evidence that breast-fed children have higher high school grade point averages and a higher probability of attending college,” …

… “If you’re breast-fed, your high school GPA goes up substantially, and the likelihood that you go on to college goes up,” Rees said.

For every month you are breast-fed, your high school GPA goes up about 1 percent and your probability of going to college goes up about 2 percent, Rees added.

… “An array of health benefits is convincingly associated with breast-feeding, including a reduced risk of both infections and obesity in the breast-fed child,” Katz said. “Less certain, but long suggested, is enhanced cognitive development in breast-fed children as well.” …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breastfeeding reduces your baby’s chances of going to hospital

Jun 20th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

BMJ 300: 11-16, 1990:

A comparison of 227 babies who were breastfed for their first 13 weeks or more with 267 who were formula-fed from birth found that the breastfed babies had fewer hospital admissions, significantly less gastrointestinal illness, and a smaller reduction in respiratory illness. This result was the same even when supplements were introduced before 13 weeks, and lasted beyond the time of breastfeeding. Breastfeeding for less than 13 weeks resulted in a rate of gastrointestinal illness similar to that found in bottle-fed infants.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Low milk supply? Maybe it’s something you ate.

Jun 15th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Article

Exposure to dioxins during pregnancy harms the cells in rapidly-changing breast tissue, which may explain why some women have trouble breastfeeding or don’t produce enough milk …

Researchers believe their findings, although only demonstrated in mice at this point, begin to address an area of health that impacts millions of women but has received little attention in the laboratory …

“Estimates are that three to six million mothers worldwide are either unable to initiate breastfeeding or are unable to produce enough milk to nourish their infants,” Lawrence said. “But the cause of this problem is unclear, though it has been suggested that environmental contaminants might play a role. We showed definitively that a known and abundant pollutant has an adverse effect on the way mammary glands develop during pregnancy.”

Dioxins are generated mostly by the incineration of municipal and medical waste, especially certain plastics. Most people are exposed through diet. Dioxins get into the food supply when air emissions settle on farm fields and where livestock graze. Fish also ingest dioxins and related pollutants from contaminated waters. When humans take in dioxin – most often through meat, dairy products, fish and shellfish – the toxin settles in fatty tissues; natural elimination takes place very slowly. The typical human exposure is a daily low dose, which has been linked to possible impairment of the immune system and developing organs.

… researchers showed that dioxin has a profound effect on breast tissue by causing mammary cells to stop their natural cycle of proliferation as early as six days into pregnancy, and lasting through mid-pregnancy. In tissue samples from mice, exposure to dioxin caused a 50-percent decrease in new epithelial cells. This is important, Lawrence said, because mammary glands have a high rate of cell proliferation, especially during early to mid-pregnancy when the most rapid development of the mammary gland occurs.

Researchers also found that dioxin altered the induction of milk-producing genes, which occurs around the ninth day of pregnancy, and reduced the number of ductal branches and mature lobules in the mammary tissue.

… when exposure occurs very early in pregnancy but not later, … sometimes the mammary glands can partially recover from the cellular injury. However … it is irrelevant for humans, who cannot really control their exposure to dioxins …

“Our goal is not to find a safe window of exposure for humans, but to better understand how dioxins affect our health,” she said. “The best thing people who are concerned about this can do is think about what you eat and where your food comes from. We’re not suggesting that we all become vegans — but we hope this study raises awareness about how our food sources can increase the burden of pollutants in the body. Unfortunately, we have very little control over this, except perhaps through the legislative process.” …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Impact of Cesareans on Breastfeeding

Jun 14th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Excerpted from “The Physical Impact of Cesareans,” Midwifery Today, Issue 88

One of the earliest family relationships we see strained by a cesarean is that of the mother and baby.

Jennifer Block says, “The most common reason why babies are not put to the breast within the first hour is the cesarean section; and cesarean babies are more likely to be given milk substitutes in the nursery while the mother is recovering.”

Mothers who have cesareans are less likely to breastfeed, for many reasons. Often mother and baby are separated, which means a delay in getting baby to breast. The mom is dealing with pain, fatigue, possibly stress, and even trauma. The incision itself causes the mom difficulty in finding a comfortable position in which to nurse. The baby may have respiratory issues.

… The State of the World’s Mothers report asserts that “Immediate breastfeeding is one of the most effective interventions for newborn survival.” I submit that, rather than an intervention, breastfeeding is the normal biological extension of pregnancy and childbirth. It also provides many advantages to mom and baby.

Breastfeeding provides the baby with good immune system protection, gut protection, protection against obesity and short- and long-term disease protection. Breastfeeding also helps the mom. Her uterus returns to normal size more quickly after birth if she breastfeeds. She is less likely to experience postpartum depression. She is less likely to have brittle bones later in life.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breastfeeding: good for baby’s immunity

Jun 13th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Excerpted from “C-sections, Breastfeeding and Bugs for Your Baby: What the doctor probably won’t tell you,” Midwifery Today, Issue 79

Breastfeeding newborns, like the evolutionary process of vaginal birth, is about bacteria. The breast milk of a human mother, like other mammalian mothers, is species-specific, having been adapted over eons to deliver specific and sufficient nutrition to guarantee proper growth, health, and immunity development. Researchers have long known that breastfed babies possess an intestinal flora that is measurably different than formula-fed infants. Of specific interest is a group of bacteria known as bifidobacterium. … These are probiotics.

Studies have shown that at one month of age, both breastfed and formula-fed infants possess bifidobacterium, but population densities in bottle-fed infants is one-tenth that of breastfed infants. The presence of a healthy and robust population of bifidobacterium throughout the first year or two of life contributes significantly to the child’s resistance to infection and overall development of defense systems—not to mention the physical development of the intestinal system in general. Aside from the substances secreted by these specific bacteria that are known to inhibit the growth of pathogenic bacteria, they also work to make the intestinal environment of the infant more acidic, creating an additional barrier against invading pathogens. In short, breastfed babies are sick less, are less fussy, have fewer and shorter duration of bouts of diarrhea, and have more frequent—and softer—bowel movements.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breastfeeding Reduces Postpartum MS Relapses

Jun 11th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Article

Women with multiple sclerosis had a 60% reduction in postpartum relapses when they breastfed exclusively for at least two months after giving birth …

… Note that the study involved a small number of patients.
Exclusive breastfeeding also was associated with a significantly later return of menses, and lactation-associated amenorrhea had a significant association with fewer postpartum relapses …

“Our findings call into question the benefit of forgoing breastfeeding to start MS therapies and should be confirmed in a larger study,” Annette Langer-Gould, M.D., Ph.D., of Stanford University, and colleagues concluded.

Immunomodulatory drugs used to treat MS are not recommended for use during pregnancy or lactation, and the effect of the drugs on postpartum relapses has never been studied. As a result, patients have to choose between nursing and resuming treatment, neither of which has clear supporting evidence, the authors said.

Previous studies of breastfeeding and postpartum relapse found little or no benefit, but none examined exclusive breastfeeding.

… The authors reported that 20 of 29 MS patients (69%) breastfed compared with 27 of 28 (96%) women in the control group. Eleven of 20 MS patients cited resumption of MS therapy as the primary reason for forgoing breastfeeding or early initiation of formula feeding.

A total of 14 of the 29 MS patients breastfed exclusively for at least two months postpartum, and five (36%) had postpartum relapses of MS. In contrast, 13 of the 15 (87%) women who did not breastfeed exclusively had one or more postpartum relapses.

The difference translated into an adjusted hazard ratio for relapse of 7.1 for women who did not breastfeed exclusively (95% CI 2.1 to 24.3, P=0.002).

… Median time to return of menses was 5.9 months postpartum with exclusive breastfeeding versus 2.2 months (P=0.001), and lactational amenorrhea significantly reduced the risk of MS relapse (P=0.01).

“Our findings suggest that women with MS should be encouraged to breastfeed exclusively for at least the first two months postpartum in lieu of starting immunomodulatory treatment shortly after deliver,” the authors concluded.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Formula Milk may make babies fat

May 19th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Article

Mothers who fail to notice signs that their babies are full tend to overfeed them, resulting in excess weight gain when the infants are between 6 months and a year old …

The finding comes from a study … of 96 … mothers who formula-fed their babies. The mothers recorded information about their babies’ feedings, and researchers visited the mothers when the babies were 3, 6 and 12 months old to observe feedings and to weigh the babies.

The study looked at a number of possible variables linked to infant weight gain and found that the number of feedings a day at 6 months approached significance in predicting weight gain from 6 to 12 months. It also found that mothers who were less sensitive to signals that their babies were full had infants who gained more weight.

“More frequent feedings, particularly with formula, are an easy culprit on which to assign blame,” the researchers wrote. But a mother’s “unwillingness to slow the pace of feeding or terminate the feeding when the infant shows satiation cues may be overriding the infant’s ability to self-regulate its intake,” they said.

Do we need any more research on the risks of formula and the benefits of breast milk for babies? Formula is completely processed and artificial. Maybe formula vs breast milk its akin to McDonalds vs grilled fish and veges for a meal.

Melissa Maimann, Essential Birth Consulting 0400 418 448

The Benefits of Using a Midwife During Childbirth

May 11th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

In Australia, all babies are born with the help of a midwife. This is true whether you’re giving birth in hospital, birth centre, at home or in an operating theatre. The question is really – what are the benefits to having a midwife as your primary care provider?

So, what is a primary care provider?
A primary care provider is someone who is responsible for your pregnancy and birth care. It will either be a doctor or a midwife, and in some circumstances, it will be both. Women may choose birth centre, homebirth or hospital midwifery care to benefit from primary midwifery care.

Primary medical care is provided by private obstetricians or through doctor’s clinics in public hospitals.

What are the benefits of having a midwife as your primary care provider?
Midwives generally have a firm belief in pregnancy and birth as natural processes that women can do. In other words, they believe that a woman’s body is perfectly designed for pregnancy and birth. They look for what’s right in the pregnancy and birth, while always being mindful of risks. Midwives help to keep pregnancy and birth normal by focussing on nutrition, lifestyle, health and well being. We that with health in general, healthy people are less likely to get heart disease, diabetes and so on. Well, it’s the same in pregnancy and birth: healthy women and babies are less likely to get sick. So midwives focus on health and well being, while always being alert for situations that need more attention.

Midwives use a holistic, or biopsychosocial model of care. What this means is that you’re not just a pregnancy or a birth to a midwife. You’re a woman, mother, friend, wife, partner, employer / employee and so on. Your midwife will seek information about your life, your family, your interests and so on, as well as your health and medical history. She will take all of this information into account when making recommendations and giving advice.

Midwives are less likely to use disruptive technologies that may lead to further intervention and complications. They’re less likely to induce labour, perform an episiotomy, perform vaginal examinations, break your waters and so on. So your labour is allowed to progress naturally. When you work with your body, it will work with you. When you interfere with your bodily processes, your body will not work as well. This is especially the case in birth where there’s a strong reliance on hormones to initiate labour and keep it going.

Women are usually very satisfied with midwifery care. They feel supported, emotionally, from seeing a midwife. They feel they can trust their midwife and that their wishes are respected. Women feel more comfortable to write a birth plan and discuss their hopes and preferences for their pregnancy and labour when they see a midwife.

So, what does this mean for birth and babies?
Well, there are lots of positives! When you have a midwife as your primary care provider, you can expect:
- choice of birth place (hospital, birth centre, or home)
- a lower rate of caesarean
- a lower rate of episiotomy
- you’re less likely to be induced
- you’re less likely to need pain medication in labour
- you’re less likely to have your waters broken
- you will be listened to and respected
- your birth plan will be respected
- you will be able to build trust with the midwife who will help you in birth
- you will be less likely to have an assisted birth (eg forceps)
- you will have a lower chance of getting postnatal depression
- you will be less likely to have birth trauma
- you will be more likely to bond well with your baby
- your baby will be more likely to breastfeed successfully
- you will most likely view your labour as being very positive

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breastfeeding debate revived after death of British mother Katy Isden

May 6th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link to article

THE death of a British mum in despair at not being able to breastfeed properly should well shock the world but will not surprise some mothers … Sitting among the flowers and cards, clutching her first-born child, my sister Lia could do nothing but sob.

Left alone in her hospital room and attempting to breastfeed her new daughter for the first time on her own, she felt her anxiety skyrocket, the mother guilt take over.

A broken emergency buzzer didn’t help, nor post-birth hormones and lack of sleep.

But almost two hours after she’d begun trying to attach her baby’s small mouth to her painfully engorged breasts, my niece was screaming and so was her struggling mum.

… Her experiences with the births of her next two children were equally traumatic, marred by a recurrent sense of inadequacy and in the case of her third, mastitis so bad she was forced to temporarily relinquish care of her family to seek medical help.

News, then, of the death of 30-year-old British mother Katy Isden, who fell to her death from a New York apartment block after becoming depressed over her bid to breastfeed, should well shock the world but will not surprise mothers with tales like my sister’s.

… “The pressure to breastfeed, the anxiety to be this super person, is just no way to live.”

The coroner said that although Mrs Isden had been depressed when she died, it was not clear if she fell or jumped. He therefore recorded an open verdict.

… The research about the benefits of feeding babies “naturally” – delivering vital nutrients and a bond between mother and child – appears black and white.

But for many it’s anything but a natural experience; rather a grey area of conflicting advice and a trauma that can torture women.

… there is no doubt support is the key to relieving the pressure.

Extra funding for the Australian Breastfeeding Association’s national helpline resulted in a 30 per cent increase in those seeking help since March, with more than 28,328 calls taken between October and April.

… “So many of us have issues,” she said. “This is a matter of seeking assistance, not being left to feel like a failure.

“The solution is for the community to get behind mothers rather than patronising them with the ‘breast is best’ slogan. It’s what’s best for you and your baby that counts, not breastfeeding at any cost.”

The ABA’s 24-hour helpline is 1800 Mum(686) 2 Mum (686)

Support is most definitely the key to successful breastfeeding, which is, without a doubt, the safest way to feed a baby – safest for mother and safest for baby. But I do wonder if we set women up to fail. Our current obstetric system churns women out as mothers who have “failed” even before they hold their baby for the first time. They “failed to progress” in labour, they were a “failed induction”, they had an “incompetent cervix”, they “failed to dilate”, their pelvis was too small. However you phrase it, the message is clear: women’s bodies don’t work; their bodies are broken. Is it any wonder that with this mindset in action, they also fail at breastfeeding?

To look at it from another perspective, breastfeeding can be effortless and enjoyable. If we look at what goes on in birth, before the breastfeeding experience, we see that a relaxed and healthy breastfeeding experience is correlated highly with a natural birth (no induction, no epidural, no caesarean etc). If you like, natural birth primes mother and baby for breastfeeding. Maybe we’re expecting too much of mothers and babies to breastfeed successfully after their induced, pethidined, epiduralised, and surgically-extracted birth. Babies are traumatised by their birth experience, as are mothers. The cocktail of natural hormones that lights the path for a successful breastfeeding experience is grossly absent. Not just absent, but the very hormones that are the anti-dote to the natural-high-hormones, are present in ever-abundant quantities.

Women report feeling a disconnect with their baby when they meet their baby for the first time after a labour and birth that has been marked with various interventions. They report not bonding. That they really had to work at the relationship with their baby. And some women even resent their baby. All of this is very uncommon after a natural birth without drugs, induction, epidural, forceps, episiotomy and of course caesarean.

The best way to achieve a natural birth is to choose a care provider who specialises in natural birth. Currently, we have 2 types of maternity care providers: midwives and obstetricians. Obstetricians are surgical specialists. That may come as a surprise for some! But it’s true: obstetrics is not a medical specialty. It’s a surgical specialty. Obstetricians, on the whole, do surgery. And most do it very well. Thankfully!! Midwives on the other hand, are natural birth specialists. We’re trained in recognising normal, keeping pregnancy and labour normal, and in getting help when things are no longer normal. If you see a midwife and have a natural birth, you’re highly unlikely to ever have the issues with breastfeeding that are described in this article. Not to mention, if you did have problems with breastfeeding, your private midwife would be following you up for 6 weeks after your baby is born, so you would have a midwife on the end of the phone, 24/7 who knows you well, who has known you the whole of your pregnancy. The continuity of care provided by a private midwife is known to reduce breastfeeding complications and postnatal depression, whether you birth at home or in hospital.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breast Is Best

May 3rd, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

April 23, 2009 (Pittsburgh, Pennsylvania) — Women who breast-fed for a year or more were less likely to develop hypertension, diabetes, hyperlipidemia, and cardiovascular disease when postmenopausal than women who were pregnant but never breast-fed …

“We were able to show that benefits were visible in anyone with six or more months’ lifetime duration of breast-feeding,” Schwarz told heartwire , with those who reported a lifetime history of more than 12 months’ lactation being 10% to 15% less likely to have hypertension, diabetes, hyperlipidemia, and CVD than those who never breast-fed.

… the findings … build on a growing body of literature that demonstrates lactation has beneficial cardiovascular effects, as well as reducing the risk of breast and ovarian cancer. “We’ve known for years that breast-feeding is important for babies’ health; we now know that it is important for mothers’ health as well,” she notes.

“… It is imperative that healthcare providers and our society support and educate women concerning the maternal benefits of prolonged breast-feeding as well as the well-documented benefits of breast-feeding for the child.”

The Risks of Not Breast-Feeding
The study examined 139,681 women enrolled in both observational and clinical-trial cohorts of WHI who had had at least one live birth. The dose-response relationship between the cumulative months women lactated and postmenopausal risk factors for CVD were examined; the average age of the women was 63 years. Lifetime duration of breast-feeding was based on patient recollection, and Schwarz admitted this could have been subject to recall bias, a point that Newton also makes in his editorial.

In fully adjusted models, those who reported a lifetime history of more than 12 months of lactation were less likely to have hypertension (odds ratio 0.88; p<0.001), diabetes (OR 0.80; p<0.001), hyperlipidemia (OR 0.81; p<0.001), and CVD (OR 0.91; p=0.008) than women who never breast-fed, but they were not less likely to be obese. In models adjusted for all of the above variables and body-mass index (BMI), similar relationships were seen.

And women who breast-fed for seven to 12 months were also significantly less likely to develop CVD (hazard ratio 0.72) than those who never breast-fed.

Schwarz said: "We saw significant trends; the longer someone had breast-fed, the better." In his editorial, Newton says that prior analyses from the Nurses' Health Study show that women who breast-fed for a lifetime total of two years or more significantly reduced a major predictor for CVD--insulin-resistant diabetes--by 14% to 15% and had a 23% lower risk of incident MI.

We can talk about the benefits of breast-feeding but perhaps it is better framed as the risks of not breast-feeding.

Schwarz stressed an important point to heartwire . "It's not that you are better off if you have a baby and breast-feed than someone who's never been pregnant, it's that you are better off than someone who becomes pregnant and does not breast-feed. A woman who becomes pregnant and does not breast-feed is actually putting herself at risk. So we can talk about the benefits of breast-feeding but perhaps it is better framed as the risks of not breast--feeding."

... "Women put themselves at risk by becoming pregnant and not fulfilling the cycle that nature has intended," Schwarz says. "In my mind, the cycle really ends with breast-feeding. During pregnancy, the body stores up a bunch of nutrients with the plan that it's going to release much of this in the form of breast milk, a very calorific food. If this doesn't happen, what we see is that the woman's body pays the price. Breast-feeding really helps bring you back to your baseline, and it helps women recover from the stress test that pregnancy entails."

... "the antistress, probonding effects of oxytocin and intense skin-to-skin contact found with prolonged breast-feeding certainly contribute to the protective effects," he notes.

Although Bairey Merz acknowledges the findings were adjusted for BMI, she says it is well known from many studies "that women who breast-feed lose the pregnancy weight gain better than those that do not--and this likely contributes to their lower CVD risk. What we do not know is whether breast-feeding preferentially impacts the visceral fat deposits, which would be of specific benefit and should be the focus of research."

"A more intense and focused study of maternal physiology during lactation may give us critical information to limit the scourge of CVD in women," Newton concludes.

Melissa Maimann, Essential Birth Consulting 0400 418 448

Breastfeeding reduces the risk of Heart Attacks Or Strokes

Apr 23rd, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Link to article

The longer women breastfeed, the lower their risk of heart attacks, strokes and cardiovascular disease … We have known for years that breastfeeding is important for babies’ health; we now know that it is important for mothers’ health as well …

According to the study, postmenopausal women who breastfed for at least one month had lower rates of diabetes, high blood pressure and high cholesterol, all known to cause heart disease. Women who had breastfed their babies for more than a year were 10 percent less likely to have had a heart attack, stroke, or developed heart disease than women who had never breastfed.

Dr. Schwarz and colleagues found that the benefits from breastfeeding were long-term – an average of 35 years had passed since women enrolled in the study had last breastfed an infant …

Melissa Maimann, Essential Birth Consulting 0400 418 448

Early pacifier use linked to shorter breastfeeding

Mar 18th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimannat Essential Birth Consulting

Link to article

Mothers who want to breastfeed their baby successfully may want to hold off on giving their infant a pacifier, new research from Denmark shows.

Nearly two-thirds of the women reported giving their baby a pacifier. Pacifier use was associated with a shorter duration of breastfeeding, independent of breastfeeding technique.

Use of the pacifier “should be avoided in the first weeks after birth by mothers who want to breastfeed,” the researchers conclude.

SOURCE: Birth, March 2009.

- Use of dummies has long been identified as something that works against successful breastfeeding. The World Health Organisation and UNICEF 10 Steps to Breastfeeding advise against dummy use for the reasons stated in the study above.

Melissa Maimann, Essential Birth Consulting.

Australia is not so baby friendly

Mar 17th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Ms Randa Saadeh, a Senior Scientist with the World Health Organization (WHO), is speaking at the Australian Breastfeeding Association’s national seminar series … [she] is stressing the need for hospitals, workplaces and the community to support mothers and babies to continue breastfeeding.

Current infant feeding practices in Australia are resulting in unnecessarily high hospitalisation rates. Early weaning increases, by five fold, the risk of respiratory disease, gastro, middle ear infections and obesity.

The Baby Friendly Health Initiative (BFHI) improves breastfeeding rates which result in fewer child health interventions, including costly hospital admissions. In Australia however, the number of BFHI accredited hospitals is just 20%. New Zealand boasts 90% of their hospitals with BFHI status as a result of strong government support.

Melissa Maimann, Essential Birth Consulting.

Breast-Feeding May Reduce Risk for SIDS by Half Throughout Infancy

Mar 17th, 2009
by Melissa Maimann.
No comments yet

For further information, contact Melissa Maimann at Essential Birth Consulting.

Breast-Feeding May Reduce Risk for SIDS by Half Throughout Infancy
Author: Laurie Barclay, MD
CME Author: Penny Murata, MD

Breast-feeding reduces the risk for sudden infant
death syndrome (SIDS) by approximately 50% … Exclusive breast-feeding at age 1 month was associated with half the risk for SIDS. Although partial breast-feeding at age 1 month was also
associated with lower risk for SIDS, this risk was not significant …

SIDS is a leading cause of death in infants … [the] SIDS risk was 2-fold higher in formula-fed vs breast-fed infants … However, breast-feeding is not universally included in SIDS prevention guidelines.

- Yet another benefit of breastfeeding!

Melissa Maimann, Essential Birth Consulting.

‘Silence’ on risks of baby formula

Mar 10th, 2009
by Melissa Maimann.
1 comment

For further information, contact Melissa at Essential Birth Consulting

Link to article

* Leo Shanahan, Canberra
* March 10, 2009

FORMULA feeding is not being described as a health risk to children because researchers are too scared to do so … despite weighty evidence that breast-fed children are less likely to suffer from type 1 diabetes, allergies, infections, die of infant death syndrome or develop certain cancers, researchers are not willing to name formula as a danger in the titles or summaries of studies.

… The Royal Australasian College of Physicians advice says breastfeeding is superior to formula with studies showing among other things that breast-fed babies have lower rates of diabetes and obesity, higher IQs and as well as lower breast cancer rate in breast-feeding mothers – but have found the causes remain inconclusive.

We’ve known that breast feeding is superior to formula feeding for many many years now. The only thing that surprises me is that it continues to be researched. Surely the research funds can be allocated to more under-researched issues? The target needs to be around mass eduction campaigns around breastfeeding and ensuring compliance of hospitals with the WHO Breastfeeding Guidelines. Next, money needs to be put towards supporting women to breastfeed – eg paid maternity leave for all women for 6-12 months.

Melissa Maimann, Essential Birth Consulting.