Friday, October 29, 2010

Kangaroo Daddy Care

This is a great group on Facebook dedicated to a great topic- Kangaroo Daddy Care.

Kangaroo care refers to having your baby next to your bare skin immediately after birth and while very young. Many great studies have been done showing how kangaroo care improves the health and well being of babies and especially pre-term infants.

Kangaroo care is especially important in starting a great breastfeeding relationship and the bonding process with your child. Mostly- the news is about Mother Kangaroo Care, but now this group shows many examples of Daddy KC. This can be really important for the Dad to bond with the baby, or critical if for some reason, the mother is unable to offer this care right after birth. (This is a great alternative if a mom has a C-section and the hospital does not allow skin-to-skin contact right after birth. The Dad can follow the baby to the nursery and offer the skin-to-skin contact!)

Click here to see the group on Facebook and read more about the topic!

Friday, October 22, 2010

Nutrition Tips from Let's Move!

I seriously love the Let's Move campaign. They offer such great tips and have so many great resources on their website and blog. 

Here is a great article from the Let's Move Blog about starting your day (and your kids day) off right!

"Nutrition Tip: Start the Day Right With a Nutritious Breakfast

Posted by Shirley Blakely, Ph.D., R.D., FDA Senior Nutrition Policy Advisor on October 21, 2010
Like most working moms, I used to start the school year vowing to begin each day with a sane, unrushed, healthy breakfast. But within a few weeks, those plans would give way to the reality of lost socks, misplaced homework, enforced tooth-brushing—and breakfast on the fly.
The truth is, a quick breakfast can be healthy if you look at it as the first piece of that day’s nutrition puzzle. Hot and cold breakfast cereals are fast and easy. Pair a bowl of oatmeal or cereal with low fat milk and banana slices or blueberries, and you’ve gotten the day off to a pretty good start.
Preparing a healthy meal really starts at the grocery store, where you should check the nutrients in each item before filling up your shopping cart. Zero-in on two things:
  • the Nutrition Facts label—which tells you the calories and percentage of recommended nutrients per serving for one day
  • the ingredients list on the label of prepared foods—which lists each ingredient used to make the product, with the predominant ingredient first, the next most prominent second, and so on in descending order
Pay close attention to the ingredients list. If the cereal your kids like has some type of grain listed first, that’s a good sign. But if fructose, high fructose corn syrup, or sucrose—in other words, sugar—is listed first, you’d best leave that item on the store shelf because added sugars are taking the place of more nutritious ingredients.
But sugar isn’t always bad. Some foods—such as fruits—contain naturally occurring sugars. Bananas or juicy oranges straight from the tree or your grocer’s produce aisle are naturally sweet. But if you see sugar listed as an ingredient in canned, frozen, or packaged fruits, you’ll know it was added in the same way it’s added to cereals or other prepared foods.
Make a healthy breakfast part of your children’s morning routine. Studies show that students who eat breakfast perform better in school.
Ed. Note:   This blog is part of a series of nutrition tips from FDA nutrition expert Shirley Blakely, Ph.D., R.D."


Saturday, October 16, 2010

French School Lunch Program

I just came across this video from CBS Sunday Morning. It is a wonderful story about the lunch program in French public schools.

Not only do they provide healthy foods, but take great care in food safety and work very hard to offer different food choices. Each meal served has several courses too! They also provide the parents with a 2 month lunch menu that specifies what will be served, including dinner suggestions for parents. (I would LOVE this!!)

Absolutely amazing.

It is only a 6 minute video- so take the time to watch. Hopefully- we can inspire similar changes here in America!

Wednesday, October 13, 2010

Healthy Lunch Ideas

Let's Move is celebrating the National School Lunch week by posting a healthy lunch recipe on their blog everyday this week!

Check in each day and see what great ideas they come up with!

From the Let's Move Blog:

"Celebrating National School Lunch Week with Healthy Recipes
Posted by Erin Edgerton on October 13, 2010 
This week is the 65 anniversary of the National School Lunch Program, which has more than 31 million participating children and is aimed at preventing hunger and promoting education by providing students access to safe, balanced and affordable meals at school. 
To celebrate National School Lunch Week, we’re teaming up with to feature some delicious and healthy lunch recipes.  Each day this week, you’ll find a new recipe on the blog – and we encourage you to share your favorite lunch recipes on the Let’s Move! Facebook page."


"The Let’s Move! campaign, started by First Lady Michelle Obama, has an ambitious national goal of solving the challenge of childhood obesity within a generation so that children born today will reach adulthood at a healthy weight. Let’s Move! will combat the epidemic of childhood obesity through a comprehensive approach that will engage every sector impacting the health of children and will provide schools, families and communities simple tools to help kids be more active, eat better, and get healthy."


Friday, October 8, 2010

Fruit and Veggie Blog!

A friend of mine has shared a blog she found dedicated to fruit and veggie recipes!

Add it to your daily reading list and enjoy trying some new recipes with your family.

Land of Fruit and Veggies

Saturday, October 2, 2010

Skin to Skin Contact After C Section

My biggest fear when delivering my son was if I had a C section- that the doctors would take him away from me and I would not be able to breastfeed immediately. I, of course, did not have a problem with needing a C section if something were to go wrong or if it meant having a healthy baby. I am someone who trusts my doctors opinions and do not have any problems with necessary medical interventions.

I do not understand however, the need to rush off babies to a nursery if they are completely healthy. So I have been VERY interested in new information on immediate skin-to-skin contact between mother and baby after a C Section. It is still not commonplace- but some hospitals and doctors are allowing the practice and it is something I will be discussing with my doctors before I deliver my next child.

Here is a great article I found on the topic:

From the blog: Stork Stories...Birth and Breastfeeding

Beautiful Skin to Skin after birth (iStock Photos)
Submitted for the Healthy Birth Blog Carnival #6: MotherBaby Edition

Skin to Skin immediately after birth is an extremely important part of the continuum of the nurturing of pregnancy, the process of birth and the transition of nurturing from inside mom to outside mom. This is the natural habitat where baby should transition and begin his own regulations of breathing, heart rate, temperature etc… This is recognized by the AAP in their changes to the Neonatal Resuscitation Algorithm back in 2000. The recommendation was to keep baby with mom and provide all initial evaluations and steps with baby on moms chest for all healthy babies!  We all know that babies have an inborn innate ability to self attach and nurse right after birth. These recommendations are not just for vaginal births. Kathy Petersen has a beautiful description of the importance of STS after a Cesarean birth on her Woman to Woman Childbirth Education blog in her 5/30/10 post Skin-to-Skin in the O.R. after a C-section.

As soon as I heard about the last edition of Science and Sensibility’s Healthy Birth Blog Carnival with a theme about “keeping moms and babies together after birth”, I wanted to write about my tiny little efforts, struggles and some successes in providing moms and babies with an environment that supports and protects their need to stay together. My recent role in the protection of such an environment and subsequent privilege of watching a baby self attach in the OR 15 min after a C/S birth has re-energized my efforts to get more mother’s and nurses to speak up and make this a standard for healthy babies!

Then….. I saw a link on Laura Keegan’s Facebook fan page for her book Breastfeeding with Comfort and Joy to an awesome video and a beautiful photo posted by the author of Cesarean Parents Blog about her birth. I had heard of Laura’s search for images of STS after C/S and asking for mother’s experiences. Amy Romano from Science and Sensibility alerted Laura of the photo: Kathy blogged about STS after C/S and I was working on this post! Such uncanny timing! I am just in awe of this marvelous networking community! Head over to Laura’s facebook link and share your experience for her info gathering. Here is the fabulous video they are all talking about “Breast is Best” from Norway:

Why is it so hard for the doctors and nurses to get on board? Most of them understand the word “bonding”.  But what many don’t realize is that it took a long time for the actual concept to take hold, to allow “time” for bonding to occur.  It sounds silly but many times if the baby and mother are still together after 2 hours…the nurses call that “extended bonding”.  I have been doing this for over 35 years now and the changes from the 70′s to now are fascinating and frustrating at the same time. To understand the process of change, we have to sometimes remember where we’ve been. I wrote about Medical Science vs Natural Childbirth a year ago because I feel history IS important to help us move forward. Often it is about control… but many times nurses and doctors are simply task oriented/ focused and not patient centered. They want to complete all their procedures and charting and move on to the next task. I understand this, there is always a lot to do and document. I work there too! The environment provided to us, the health-care workers, is one in which regulations are abundant and staffing is not always optimal. Flexibility is needed. I know there is a way. This culture just has to change. And it happens in small little doses.

SO–> Skin to Skin immediately after a C/S? I have been told by coworkers, doctors and anesthesia:
“It’s impossible, “
“It can’t be done”
“There’s not enough room”
“This patient (the mom) is in the middle of major surgery!”
“The baby needs to be under the warmer, it’s too cold in the OR.”

Really? Seriously? Watch Me………

I have actually been working on this issue for the past few years…… Ever since I began staff education for World Breastfeeding Week 2007′s theme “Breastfeeding: The first hour — Welcome Baby Softly”. The focus from ILCA was: ‘Establishing a welcoming environment that keeps mothers and babies together.’ It was then that I gently tried to introduce the concepts for C-Sections as well as all vaginal births. I was getting a lot of positive response for vaginal births…not so for C/S.

Anesthesia is our biggest barrier. The chest area of the mother seems to belong to them somehow. The arms too.. I always politely ask the doctor for permission to have at least one arm released so she can touch her baby. (they are secured on armboards to her sides.) Really the OB’s didn’t mind what was happening outside of their draped domain. The Pediatrician is the next barrier because they want to finish a complete exam…. in the nursery…. before they returned to the office or whatever.  So I started with the Peds… hoping they would stop expecting the baby to be quickly removed from the OR. I started with just simple requests for prolonged “bonding”… because they all get that. “Look how well this baby is transitioning.. so alert and PINK! ” “I’ll write all the measurements in your exam note…. I’m fine… I know you’re busy….” I’d say.   Sometimes mom and baby got to stay together. Soon, for some of the doc’s, the expectation of baby leaving mom was gone. They got tired of waiting around and would leave. More moms and babies got to stay together…even if it was dad doing the holding. My co-workers were not always so understanding because of the work flow on the unit. It would work best when the birth happened any time other than first thing in the morning when it’s busy everywhere. Isn’t that sad? Sitting here writing this I’m thinking of ways to work on that….. another time…..

Anesthesiologists or Nurse Anesthetists are all different. There are some wonderful ones who are releasing both arms and pushing things out of the way for the baby and others who are constantly telling moms they are “under” anesthesia and can’t hold the baby, or they have given meds to mom right after baby is born so mom is now groggy. I talk to each of them respectfully and differently depending on their own approach. I have discussed my plans for STS if baby stable ahead of time. I have discussed how it is up to us to provide this protected environment for moms etc…  I have used the patient satisfaction discussion, the scientific evidence discussion, the patient centered care discussion, and the increased patient numbers due to higher satisfaction talk.  I have let them know that when a mother requests that–> we must do everything possible to help her experience this. 

Slowly, over the last few months, I was able to facilitate some babies really getting skin to skin in the OR for short periods before going to the nursery. There were a variety of factors for why it wasn’t very long each time but at least it was happening!! It’s not a standard of care yet and I’m the only one working on it but others are getting interested… Communication has been very important to create the environment and reduce barriers. We still have a long road ahead. But we did pave a path for this mom….

She came in with an unknown double footling breech presentation in active labor and the doctors wanted to do a C/S right away. She was really upset and had a beautiful birth plan that was already getting discarded. “STS until first breastfeed accomplished” was on her plan and I was determined to help her with that! Things were happening fast. The anesthesiologist wasn’t my best STS supporter.. “oh well” I thought, “I’ll do what I can to help.” The baby was crying and pink when born and without thinking about it, the doctor, nurses and myself had him on the baby unit drying him. Mom went panicky! “Give him to me, give him to me! He has to be ON me! You just took him OUT of me, now he HAS TO BE ON ME!”  She was literally trying to sit up. Anesthesia was drawing up meds for her (that was his answer).  I said “OK here he comes!”. So I didn’t ask anyone’s permission this time….. just held that naked baby in one hand, snapped open her gown with the other and helped him move in. I asked for a warm blanket and looked up to see the other nurse and doctor staring at me. I said “Seriously… she’s exactly right, he does belong ON her!” Anesthesia saw the immediate transformation of his frantic patient to one with calm maternal bliss, admiration and cooing. He was then helpful to let her other hand out. This little boy stayed with mom, breastfed before he was 15 min old and went to the PACU with mom. She was so incredibly happy. I never got to see her after that since it was near the end of my shift and I wasn’t on shift the next few days. I saw that she exclusively breastfed in the hospital and without complication went home on day 3. At least part of her birth experience went according to plan!

If she hadn’t have been so vocal about what she wanted, so adamant… she would not have experienced what she did. 
Want to see more? This stunning video of a baby skin to skin then breastfeeding at birth in the operating room via @MothersUtopia @Laura_Keegan. What were your experiences? Please don’t forget to head on over to Breastfeeding with Comfort and Joy on FB to comment on your experience or opinion about this important topic!! Calling for women to share their experiences with skin to skin here, to help give a voice to the real need to make skin to skin in the OR routine practice in all ORs."


So what do you think?? What are YOUR experiences? If you had a C section- did you ask for immediate Skin-to-Skin contact? Share your story here!!!