Jennifer Fargár

LOL Post Partum Doula,  Licensed Director & Registered Teacher

www.MusicTogetherMetroAtlanta.com

Did you know that all children are musical?  Yes!  They can learn the music of their culture just the way they can learn the language of their culture.  How’s that?


You gave birth.  You’re holding your sweet newborn in your arms and talking to him.  Does he talk  back?  Of course not!  But do you stop talking to him?  Of course not!  Do you decide then that he won’t ever talk just because he didn’t talk back in that moment?  Of course not!  We know that babies are born wired to learn the language of their culture- and do so quite easily just by hearing the patter of their parents’ speech.  And before you know it they can say more words than you can count and probably a few you wish they wouldn’t say!   (Wonder where they learned those?!)  But did you know they are also wired to learn and enjoy the music of their culture in exactly the same way?

For many parents if a child appears to be “tone deaf” or to not ‘have rhythm’ by a certain age we decide that our child must not be very musical and that is that.  However if our child doesn’t walk or talk by a certain age, we take him to the doctor and say’ “What is up with that?!  Fix it!” (more…)

Lately we have had a flux of clients whose babies were subjected to bili lights- bil beds and separation from their moms and/or their moms staying an extra day in the hospital due to elevated bilirubin levels. It is really amazing that these babies levels are really what I thought were considered low. Weird that I left the hospital on day two with a baby at the level of 18 and was told to put the rocking chair by a window an open the blind and place her cradle by that same window for a bit of indirect sunlight. We did have to go in a few days later for an additional heel stick to make sure all was well. This is medical advice- so I am not going to tell you when the levels are considered high or not. Just relaying my personal experience.

But I did want to share with you a doctor’s opinion-  a well respected pediatrician who is nationally known: http://www.askdrsears.com/topics/breastfeeding/breastfeeding-special-situations/babies-jaundice He states:

Bilirubin levels average 2-3 milligrams higher in breastfed infants than in formula-fed infants (14.8 milligrams versus 12.4 milligrams). The difference is thought to be due to an as-yet unidentified factor in breastmilk that promotes increased intestinal absorption of bilirubin, so that it goes back into the bloodstream rather than moving on to the liver. Higher rates of jaundice in breastfed infants may also be related to lower milk intakes in the first days after birth, because of infrequent or inefficient feeding. It is normal for jaundice to last a bit longer in breastfeeding infants, sometimes until the third week after birth.

In most cases, it is not necessary to treat jaundice when bilirubin levels are less than 20 milligrams. (more…)

Crossing Bridges

I was asked to share my story about how I’m the poster child for changing my ideas about child rearing once my daughter was born.  Before Anne arrived I only knew traditional ideas about how to do things and I had some serious misconceptions about things I really knew nothing about.  Here are at least some of the things that changed, sometimes in the spur of the moment, and my thoughts on each topic.
Water Birth.  I knew from the beginning that I wanted to experience natural, unmedicated childbirth.  The thought started with the idea that if my mom and my mother-in-law could do it, then so could I.  It evolved into doing more research about the effects of inducement and epidural drugs on my own body and my baby, and that research solidified my resolve.  Water birth was introduced as an option for pain management in our childbirth classes with Labor of Love Doula and Childbirth Services and through my midwives at Intown Midwifery.  Never having really been a water person, I kept it on the table as an option, at least for labor, but I honestly didn’t see myself delivering in the water.  I’m just not a bath person and I don’t particularly enjoy swimming.  Kristian was weirded out about the idea all the way until delivery, I think.  But once we got to the hospital, I knew the second my midwife asked if I wanted to get in the tub that the answer was yes.  Once I got in that glorious warm water, there was no getting out, especially since I was already pushing.  The water helped immensely, if nothing else the weightlessness was amazing, and given the option, I will never birth a child again any other way. (more…)

I have been known to say that you do not need a birth plan per se. What I mean by that is that you should be able to trust your care provider, communicate with your support team- and understand that birth is not predictable- so your plan needs to be individual and flexible. I do not like the links that you choose multiple choice and get a nice and neat three page plan that looks like everyone else’s. It does not help you to be seen as an individual at all.

At Labor of Love we do not host a birth planning workshop due to the reasons above. We sit down during our prenatal meetings with labor doula clients and discuss what is an ideal birth experience: how you plan to achieve that- what works for you when you are in discomfort- and we offer some ideas and options you may not have considered. We do not feel this needs to be put into a form to give the staff at the hospital necessarily but instead see it as a discussion to have with your care provider and have your support folks understand how strong you feel about each option. If you feel the need to make a birth plan- consider at most ten bulleted items that are the most important. (more…)

Many like the idea of “seeing” our baby growing in our bodies prior to the birth. The world of technology is all around us. Sometimes we do not find out til much later the risk factors on things that are considered very benign. When I was pregnant with my first child, 33 years ago, ultrasounds were only used to diagnose an existing concern. They were not used to determine when conception occurred- or a due date nor the gender prediction. Now often women have several ultrasounds done during their pregnancy although there are no medical reasons for doing so.

As with most anything, there are risks and benefits. You need to determine what the benefits are and if they outweigh the risks. The FDA in their recent statement said,

“Ultrasound imaging has been used for over 20 years and has an excellent safety record. It is non-ionizing radiation, so it does not have the same risks as x-rays or other types of ionizing radiation. (more…)

Did you know you could go to Dr Sear’s website and there is a link to information about vaccines- schedules that may be more baby friendly and also a link to a page of pediatricians who will respect alternative schedules? Click Vaccine_Friendly_Doctors to find a care provider in your area!

I had published this in my blog last year. But after a mom came to the Meet the Doula Tea this past week and shared that she had had a list of questions to ask her doctor when she was first pregnant, but once she asked them she did not know what the answers really meant. I have heard it said that question 2 about episiotomies is one of the most- if not the most- revealing question to ask. If they routinely find it “necessary” to cut a first time mom, they are more than likely very interventive. I had a client get this answered by one doctor as he only did it when “necessary.” When asked further when he found it necessary, he said, if it looks like she is going to tear. Ouch! She decided he was too interventive for her and she found a new care provider.

I think when the care provider determines you are “late” is also a revealing question. In the ACOG pamphlet it states,  “The day your baby is due is called the “estimated date of delivery,” or EDD. Although only about 1 in 20 women give birth on their exact due date, your EDD is useful for a number of reasons. It is used as a guide for checking your baby’s growth and your pregnancy’s progress. The EDD gives a rough idea of when your baby will be born. Most women go into labor within about 2 weeks before or after their due date. “ There are several things a physician can do to help determine the well being of a baby who is still in utero after 40 weeks. But if they say things like, “nothing good can come after 40 weeks.” and “your baby is only getting bigger and your placenta is only getting older.” both things I personally have heard care providers say, then perhaps they need to rethink their association with the ACOG stance. You have a due month for a reason- babies come sometime between that 38th and 42nd week because most often the due date is merely a guess!

So here is the repost! (more…)

Have you considered not cutting the cord of the baby to the placenta later? It is not common practice to wait… but this video may teach you something about what could be more gentle- what could be more helpful- what could be less traumatic… a great source of blood volume and oxygen… view this and consider doing something different.

We could be much kinder
the video

seems you tube took this one off due to breasts being at the beginning- no notes or anything to the producer- just kicked it off! I got this from the producer:

“My trailer and my entry to the Better Birth VA contest, “We Can Be Much Kinder” was removed by YouTube for inappropriate content — breasts in the short entry– and they took down both. It’s crazy as I have taken great care to make my work rather conservative and respectful for the mother and for “mainstream” viewers. There was no notice, no email, no way to find any info or communicate with YouTube. I have spent hours and hours to learn that I can not get them back.

I have created a new account and reposted the revised entry, trailer and few other pieces. I hope they stay up.

Here’s the new link to the entry and the trailer will show up soon.
(more…)

There are several things that will happen once the baby is born when you are at a hospital- several of these things are not done routinely at a home birth. A great resource for looking at evidence based medicine is here
www.update-software.com/publications/cochrane/

I will offer some things for you to consider in making the choice that is right for you and your baby.

Cord Cutting

Separation From Mom

Suctioning of the Nose and Throat

Vitamin K Injection

Erythromycin Ointment in the Eyes

Bath

Visits to the Nursery

Cord Cutting– Some will decide to delay the cutting of the cord…others will not be concerned about cutting it right away. But you get to decide unless the baby is born with problems and needs immediate attention. There are concerns that if you clamp and cut the cord too soon you are actually robbing the new baby of the blood that can be beneficial to him or her. You may want to consider looking at these sites: www.cordclamp.com
www.gentlebirth.org/archives/lateClamping.html
www.sciencedaily.com/releases/2007/08/070816193328.htm

You may also want to consider cord blood banking- but some will say you are saving cord blood for a unknown need while robbing the new baby- but the cord blood banking I recommend is one that has services through four different banks- www.alphacord.com

Separation From Mom
– Many times it is difficult to keep the baby and mom together. Routine procedures are customarily done in the baby warmer. Why? Because that is easier for the nurses doing the procedures. But often times when we ask if many of those procedures can either be delayed or done by the mom on the bed, they can be done there. There are concerns that what is best for mom and baby are not being considered the utmost of importance. But we find that if the baby is put directly on the mom Skin to Skin immediately after the birth, the baby bathes the breasts in amniotic fluid- a substance that the baby has been drinking for nine months- so it makes the breasts a familiar taste. The mom is hot from pushing so it is easier to keep the baby really warm if the baby is placed directly on the mom. The baby and mom immediately begin their bonding process.

Suctioning of the Nose and Throat
– This has become routine. It may be necessary if the baby has had a bowel movement in utero and has therefore a risk of meconium. But we find that if the baby is squeezed out- especially over an intact perineum- the natural hymlic maneuver is done. Often times a baby can clear their own fluid- especially if the baby did not get any medication via the mom during the labor. Perhaps we should consider this instead of a routine procedure it should be done as a as needed procedure instead.

Vitamin K Injection-
This is done for blood clotting enhancement. This is needed if you are planning on circumcising your son. (That is a different subject- one you may read about in other articles in this blog.) but it is rare for a baby to actually have blood clotting problems- hemorrhagic disease. You may want to read about the occurrence of this here http://emedicine.medscape.com/article/974489-overview . Again it is routine- but you can decline it. There are no known problems with giving it except the injection itself. Research it and make a decision for yourself.

Erythromycin Ointment in the Eyes– This is routinely done although it is specifically for the treatment of genital chlamydial infections in pregnancy that the baby may be exposed to during the labor and birth. So if you know you do not have chlamydia why is this given?

Bath– An infant does not hold its temperature very well in the first eight hours. But often times a bath can help clear the baby of fluid since it cries a lot during the bath. But consider how a newborn may feel taken from his or her mom and then being put in a warmer to cry and get cold. But they will warm the baby up under the warmer- hmmm- could you just wait til the baby is a bit older- say nine hours old and then bathe the baby yourself. Perhaps this can become a new family tradition. After all- how dirty are most babies when they are born? The baby is wiped off a great deal at birth and the vernix that is on the skin will help keep the skin in great condition.

Visits to the Nursery – Often procedures that are done in the room of many hospitals are being done in the nursery more now. It is a staffing issue. It takes less employees if they can do it while the baby is in the nursery. But when the baby is out of your sight and arms, some procedures can be done that you did not desire. There has been a recent situation where a woman’s baby was given to another mom and she breastfed the baby before anyone realized she had the wrong baby. Yes situations like this are rare to be sure, but if the baby never leaves the mom and or dad, this never would have happened. If the baby has to go, send the partner with the baby. Often times the infants that are accompanied are returned quicker to the mom. But I have had moms never have their babies leave them- and so it can be done.

The most important thing to consider is what is right for you and your baby. It does not matter if it is routine- is it what you want? After all- this is your baby! So do your research- figure out what works for you and then ask for them to honor your desires.

Today in the local AJC newspaper this was an article I was sent…

“Circumcision victim gets $2.3 million

By Ty Tagami

The Atlanta Journal-Constitution

Tuesday, March 31, 2009

A Fulton County jury has awarded $1.8 million in damages to a boy injured in a botched circumcision.

The state court jury gave another $500,000 to the boy’s mother in the decision rendered Friday.

The case involves a child, identified only as D.P. Jr., who was born at South Fulton Medical Center in 2004. In a suit filed two years later, his mother contended that the doctor who circumcised him removed too much tissue and that his pediatrician failed to respond when a nurse complained of excessive bleeding. The boy’s penis was severed.

The jury found that both the pediatrician, Dr. Cheryl Kendall, and the physician who performed the circumcision, Dr. Haiba Sonyika, were negligent. South Fulton Medical Center was absolved of liability.

The pediatrician’s lawyer, Roger Harris, said he disagreed that the jury’s decision indicated that Kendall was negligent because she didn’t go to the hospital. “We believe there was error committed during the course of the trial,” he said.

Sonyika’s lawyer could not be reached for comment.

David J. Llewellyn of Atlanta, one of the mother’s lawyers, said the money awarded by the jury is to cover the cost of medical treatments and psychiatric counseling for the boy and his family. The jury did not award punitive damages. The Atlanta Journal-Constitution is not naming the mother to avoid identifying the child.

“This case does point out one of the dangers of circumcision that every parent must seriously consider when having the procedure done,” Llewellyn said.

In 1985, the penises of two infants were nearly destroyed during circumcisions with an electric cauterizing needle at Northside Hospital. Lawsuits filed against both doctors by the parents of the infants resulted in out-of-court settlements.

Circumcision, which involves removal of the foreskin, is performed routinely without incident. It is generally done for cultural reasons, but there is some evidence that it may help reduce the spread of sexually transmitted diseases.

and the subsequent article:

“$2.3M awarded in suit over botched circumcision

By TY TAGAMI

The Atlanta Journal-Constitution

Monday, March 30, 2009

A Fulton County jury has awarded $1.8 million in damages to a boy whose penis was severed in a botched circumcision.

The state court jury gave another $500,000 to the boy’s mother in the decision rendered Friday.
Related links

The case involves a child, identified only as D.P. Jr., who was born at South Fulton Medical Center in 2004. In a suit filed two years later, his mother contended that the doctor who circumcised him removed too much tissue and that his pediatrician failed to respond when a nurse complained of excessive bleeding.

The tip of the penis was placed in a biohazard bag and might have been reattached if a urologist had attended to the boy within eight hours, one of the mother’s lawyers, David J. Llewellyn of Atlanta, said.

The jury found that both the pediatrician, Dr. Cheryl Kendall, and the physician who performed the circumcision, Dr. Haiba Sonyika, were negligent. South Fulton Medical Center was absolved of liability.

The pediatrician’s lawyer, Roger Harris, said he disagreed that the jury’s decision indicated that Dr. Kendall was negligent because she didn’t go to the hospital. He hinted at an appeal. “We believe there was error committed during the course of the trial,” he said.

Dr. Sonyika’s lawyer could not be reached for comment.

Llewellyn said the money awarded by the jury is to cover the cost of medical treatments and psychiatric counseling for the boy and his family. The jury did not award punitive damages. The Atlanta Journal-Constitution is not naming the mother to avoid identifying the child.

“This case does point out one of the dangers of circumcision that every parent must seriously consider when having the procedure done,” Llewellyn said. He contended that parents are not told of the risks of the procedure.”

Something to be thinking about…is the risk worth the danger of this happening?

I have gotten a link that may be helpful to you as well. This website may be of interest http://circumcisiondecisionmaker.com/