Monday, August 13, 2012

3D Model of Your Fetus?

I just came across an interesting article which talks about a company that can print a 3D model of your fetus and womb using MRI imaging to create the model.  Is anyone else just a little creeped out by this?  I thought getting a 3D or 4D ultrasound was a bit much for myself but getting an actual model takes this to a whole other level.  In the video segment below, they can even make mini models for you to hang from your cellphone!  What do you even do with such a thing?  Do you show it off at family gatherings?

I think ultrasounds have been a wonderful advancement in modern technology.  It can help diagnose diseases before a baby is born and it can help practitioners monitor the health of a developing fetus.  I enjoyed seeing my twice weekly ultrasounds during my non-stress tests but they were to determine if my gestational diabetes was harming my baby.  However, is this taking things a little too far?  This is not a "medically necessary procedure."  What about the long term effects of MRI exposure on a developing fetus?  Has that even been studied?  Also, in the video, they mention CT scans.  Do they use CT scans as well to get the image?  What about the radiation exposure from CT scans?  How is that not harmful to both the mother and fetus?

Would you get a 3D model of your womb and fetus?  If so, what would you do with it?

Tuesday, August 7, 2012

Suggestions for calming a crying baby are welcome.

It seems these days, everyone has their own idea of how to calm a crying or fussy baby.  I have heard things like feeding my baby formula before bed will help him sleep longer or giving the baby some cereal in a bottle will help as well.  After researching those two suggestions, I have decided that those are things that I will not pursue.  I have to admit that for the most part, my little guy has been great.  However, like my older child, there comes a point every night where he becomes fussy.  This time has been commonly referred to as the "witching hour."  To get around this fussiness, I have been trying several methods.  Since I am breastfeeding, I start off by nursing.  I notice that beginning in the late evening to around 11PM, I feel like I am nursing constantly.  He seems to be cluster feeding at this hour and can't seem to get enough.  It has left me quite hungry and thirsty during this time.  It has also turned me into a night owl.  I have always been more of a morning person and this is not something I want to continue.

I have also been trying the methods from the book, The Happiest Baby on the Block, by Dr. Harvey Karp.  In this book, Dr. Karp uses the theory about the "fourth trimester."  He states that babies are born "before they are ready" and therefore, to calm a crying baby, you have to create a "womblike atmosphere."  He recommends the 5 S's to calm a baby.  The 5 S's are:
1. Swaddling
2. Side or Stomach Position
3. Shhhh (White Noise)
4. Swinging
5. Sucking
To accomplish the 5 S's, I have been doing a lot of babywearing with the Moby wrap and swaddling.  This method worked really well with my older son.  Unfortunately, since we're still establishing breastfeeding, we aren't using pacifiers yet.  This baby has a strong sucking need and I think until we introduce a pacifier, I will be his pacifier.  The following video demonstrates the 5 S's (notice the dad is wearing the Moby wrap).

Another method that I have been reading about is the Dunstan Baby Language.  With this method, it is believed that before the age of 3 months, babies will make 5 "sound reflexes."  These "sound reflexes" are a baby's way of communicating.  The 5 "sound reflexes" are as follows:
1. Neh - I'm hungry
2. Owh - I'm sleepy
3. Heh - I'm experiencing discomfort
4. Eairh - I have lower gas pain
5. Eh - I have (upper) gas
If you can identify the "sound reflex" you can determine what your baby needs.  The following are video clips of the 5 "sound reflexes."
As you can see, she was featured on Oprah Winfrey's Show.  A longer video of her segment can be found below:
I was intrigued by this and started paying attention to my baby's cries.  It turns out that I can recognize the "Neh" and "Eh" sounds.  The others, I'm not so sure.  I guess I'll have to try the DVD rather than rely on the YouTube videos.

Does anyone else have suggestions for calming a crying baby?  What has worked for you?

Monday, August 6, 2012

Cereal in the Bottle?

I starting hearing about parents putting cereal in their baby's bottle so they can sleep longer through the night.  I don't plan on giving the baby a bottle of anything for a few more weeks to make sure breastfeeding is firmly established.  However, since I am up every 2 hours to nurse, I decided to do a little research to determine if this has been proven to work.

The American Academy of Pediatrics does NOT recommend giving cereal in the bottle until a baby's digestive tract is ready to process solid foods at around 4-6 months of age.  At that time, they should get the cereal from a spoon and not from a bottle.

Prematurely adding cereal to the bottle can cause the baby to aspirate (inhale into their lungs) the cereal and it can also activate any allergies a baby may have.  I have also written a blog post about breastfeeding and foods to avoid which touches on the American Academy of Pediatrics position of no solids before the age of 4 months.  If you're breastfeeding, it should be done exclusively (without solids or formula) for at least 3 months to protect against wheezing early in life.  If you are using formula, then there is evidence that extensively hydrolyzed formula without cereal is best for the prevention of atopic disease (allergic disease).   Adding cereal to the bottle may cause a baby to "overfeed."  "Putting cereal in the bottle is considered by some to be a form of force-feeding that can cause babies to “overdose” on calories."

I don't believe with a lot of things Dr. Sears has to say but he does break it down in an easy to understand manner why you should not feed your baby solids before 4 months.  Aside from the issues mentioned above, he gives an excellent description of the tongue-thrust reflex.  "In the first four months the tongue thrust reflex protects the infant against choking. When any unusual substance is placed on the tongue, it automatically protrudes outward rather than back. Between four and six months this reflex gradually diminishes, giving the glob of cereal a fighting chance of making it from the tongue to the tummy."  My mom fed me solids when I was 2 months old.  She took pictures and at the time said that is what the doctor told her.  You can clearly see that my tongue-thrust reflex was in action at that age.

This is another great post from a pediatrician who advises against cereal in the bottle because of the issues with overfeeding that this may cause.  "A major study looking for the causes of obesity found that short-circuiting young children’s self-regulation of how much they eat is a major cause of later obesity."   "Cereal in the bottle does just that.  Babies that are fed this way may appear to be unaffected – but those few weeks of added convenience may result in a lifetime of struggles with weight. This common practice may have contributed to our being the most obese generation in history.  And it doesn’t even work. Scientists at the Cleveland Clinic studied the effect of cereal on sleep and found that adding the cereal did nothing at all to speed up the age of sleeping through the night. That first uninterrupted 6-hour stretch of sleep came no earlier in those who took cereal early."

After reading more about the issue, I think putting cereal in the bottle is one thing I will not be doing to my baby in the hopes of making him sleep longer during the night.

Sunday, August 5, 2012

One Week Later... An Update...

Well, we "survived" our first week of being a family of four.  This first week was not as dramatic as his entrance into the world, but I say "survive" because as any new parent will tell you, the first week after delivery can be quite an adventure.  We (including the dog) are all adjusting to the new baby.

The baby is doing well.  He was 7 pounds 1.6 ounces at birth and reached his lowest weight the following day at 6 pounds 9.6 ounces.  At his follow-up appointment on Wednesday, he was back up to 6 pounds 12.7 ounces.  He is nursing every 2 hours round the clock.  It is tiring but worth it seeing him grow.  This is quite the contrast to his older brother that had latch problems.  I am liberally using the lanolin but the pain and sores that accompanied nursing the first time did not happen this time around.  I just weaned my older baby in March and I think that I never stopped lactating.  My milk came in right away and the baby has been eating like a champ.

The baby also did not get any jaundice which may have been a possible concern since I did delay the clamping of the umbilical cord.   Part of it may also be due to my milk coming in so quickly.  It is nice knowing that my decision to delay the clamping did not result in any negative effects for the baby.  He had his first non-meconium bowel movement at the doctor's office on Wednesday and his umbilical stump fell off on Saturday.

Recovery for myself has been a little easier this time around.  I didn't have to push for 2.5 hours like the last time so I haven't had any swelling.  I only took 600mg of ibuprofen for pain relief and that was 14 hours after delivery!  I also managed to escape the entire hospital stay without an IV.  The biggest thing for myself has been trying to get enough rest and making sure I eat and drink enough.  Since I'm up every 2 hours to nurse, I have become somewhat of a night owl.  I try to sleep when baby sleeps which means I am sleeping a lot during the day.  I am also hungry all the time.  I made my first batch of lactation cookies yesterday and after the gestational diabetes, being able to eat cookies again is a welcome treat.  My blood sugar and blood pressure have both returned to normal after I had the baby.

I have also been religiously binding my belly hoping I can fit into my non-maternity clothes sooner rather than later. I did it the first time around and thought it yielded good results.  I started "binding" myself at the hospital.  I requested a support band that they typically give to mothers who have had a c-section.  I did not have a c-section so I was happy they gave me one after I asked for it.  I am also using the "belly bandit" that I bought with my first baby.

My older son is slowly coming around to the new baby.  At the hospital, he didn't want anything to do with me or the baby.  He even lost the toy that his new baby brother bought for him.  Thanks to my in-laws who replaced the toy, a crisis was averted.  In the last few days, he's become very helpful around the baby.  He's tried to tell the baby "it's OK" when he's crying in the car and even tonight tried to help give him a bath.  He's also tried to read him a book and show him pictures of family members.  He's a sweet kid and I hope this is a sign that he will be a good big brother.

The dog at first was really anxious about the new baby.  We have the baby's crib in our room since we think it would be cruel to have him share a room with his older brother at this age.  The dog has been sleeping in our room.  The first time she heard the baby crying in the crib, she freaked out and wouldn't stop barking.  We thought we might have to figure out alternate sleeping arrangements for the dog.  Luckily, she has also adjusted to this new addition and no longer barks or whines when she hears crying.

My husband has been wonderful.  He's doing the laundry and cleaning around the house.  He is off for another a week so the real test will be when he goes back to work.  In the meantime, he's been getting the toddler ready in the morning (making breakfast, changing his clothes, etc) and letting me sleep in which is nice since I'm up most of the night feeding or changing the baby.

We're slowly getting into a routine with our family.  Thank you to all who have passed on their well wishes.  I am very thankful to have a beautiful family and great friends.

Friday, August 3, 2012

Vitamin D Supplementation for Breastfed Infants

Breastmilk is touted as "nature's perfect food."  It should contain everything that a growing infant should need for at least the first six months of life.  Major organizations from the American Academy of Pediatrics to the World Health Organization recommend exclusive breastfeeding for the first six months of life.  Exclusive breastfeeding means feeding the infant only breastmilk and no other solids or liquids.  If breastmilk is "perfect," why then do we need to give breastfed infants vitamin D supplementation?

According to the Centers of Disease Control and Prevention (CDC), "Breast milk alone does not provide infants with an adequate intake of vitamin D. Most breastfed infants are able to synthesize additional vitamin D through routine sunlight exposure. However, published reports of cases of vitamin D deficiency rickets among breastfed infants in the United States caused researchers to take another look at whether all breastfed infants were getting adequate vitamin D."  "Vitamin D deficiency rickets among breastfed infants is rare, but it can occur if an infant does not receive additional vitamin D from a vitamin supplement or from adequate exposure to sunlight. A number of factors decrease the amount of vitamin D a person will synthesize from sunlight. These factors include:
- Living at high latitudes (closer to the polar regions), particularly during winter months
- Air quality conditions: high levels of air pollution
- Weather conditions: dense cloud covering
- The degree to which clothing covers the skin
- Use of sunscreen
- Skin pigmentation: darker skin types
- Furthermore, there exists a major public health effort to decrease the risk of skin cancer by encouraging people to limit their sunlight exposure"

The American Academy of Pediatrics (AAP), recommends "that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth."  The "guidelines for vitamin D intake for healthy infants, children, and adolescents are based on evidence from new clinical trials and the historical precedence of safely giving 400 IU of vitamin D per day in the pediatric and adolescent population. New evidence supports a potential role for vitamin D in maintaining innate immunity and preventing diseases such as diabetes and cancer. The new data may eventually refine what constitutes vitamin D sufficiency or deficiency."

"There are 2 forms of vitamin D: D2 (ergocalciferol, synthesized by plants) and D3 (cholecalciferol, synthesized by mammals). The main source of vitamin D for humans is vitamin D3 through its synthesis in the skin" when exposed to ultraviolet light.  "Historically, the main source of vitamin D has been via synthesis in the skin from cholesterol after exposure to UV-B light. Full-body exposure during summer months for 10 to 15 minutes in an adult with lighter pigmentation will generate between 10000 and 20000 IU of vitamin D3 within 24 hours; individuals with darker pigmentation require 5 to 10 times more exposure to generate similar amounts of vitamin D3."  Vitamin D3 which is derived from fish "has greater efficacy in raising" vitamin D levels.  It is the supplement of choice over vitamin D2.

"In a lactating mother supplemented with 400 IU/day of vitamin D, the vitamin D content of her milk ranges from <25 to 78 IU/L."  Even if a mother takes a vitamin D supplement and her infant drinks a liter of breastmilk a day, this is far less than the 400IU recommended daily for infants.   For a woman to produce the recommended amount of vitamin D in her breastmilk, she will have to consume 6400 IU/day of vitamin D supplements.  "Although vitamin D concentrations can be increased in milk of lactating women by using large vitamin D supplements, such high-dose supplementation studies in lactating women must be validated and demonstrated to be safe in larger, more representative populations of women across the United States. Recommendations to universally supplement breastfeeding mothers with high-dose vitamin D cannot be made at this time. Therefore, supplements given to the infant are necessary."

Vitamin D supplementation is recommended because "in adults, new evidence suggests that vitamin D plays a vital role in maintaining innate immunity and has been implicated in the prevention of certain disease states including infection, autoimmune diseases (multiple sclerosis, rheumatoid arthritis), some forms of cancer (breast, ovarian, colorectal, prostate), and type 2 diabetes mellitus.  Results from prospective observational studies also suggest that vitamin D supplements in infancy and early childhood may decrease the incidence of type 1 diabetes mellitus."

Despite the recommendations by the AAP, a study published in the journal Pediatrics, titled, "Adherence to Vitamin D Recommendations Among US Infants," found that "most US infants are not consuming adequate amounts of vitamin D according to the 2008 AAP recommendation. Pediatricians and health care providers should encourage parents of infants who are either breastfed or consuming <1 L/day of infant formula to give their infants an oral vitamin D supplement."  I don't find this particularly surprising since many message boards that I have been reading have threads full of mothers saying that their Pediatricians have told them that it "wasn't necessary."

I plan on supplementing my baby with vitamin D especially since I will not be exposing him to much sunlight during his first six months of life.  I remember that with my first baby, it was difficult in the beginning to get him to take his vitamin drop and I wasn't always that consistent with it.  After researching this topic, I am going to have to make sure that I am more diligent with the vitamins and also be more diligent with myself getting enough calcium and vitamin D.

Thursday, August 2, 2012

Happy World Breastfeeding Week!

Did you know that August 1-7, 2012 is World Breastfeeding Week?  "20 years ago, the World Alliance for Breastfeeding Action (WABA) launched its first World BreastfeedingWeek (WBW) campaign with the theme: "Baby-Friendly Hospital Initiative."  It is celebrated every year from August 1-7 in more than 170 countries to "encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding."

There are many celebrations around the world and country commemorating this week.  The La Leche League of the United States has information on their website regarding events in the United States. One of the big events scheduled this year is the "Big Latch On."  There are a number of sites around the country that will have women breastfeeding their babies at the same time (10:30AM) on either Friday, August 3 or Saturday, August 4, 2012.  You can check the following website to determine if there is a site near you participating in the "Big Latch On."

The Big Latch On is hoping to:
  • "Support for communities to identify and grow opportunities to provide ongoing breastfeeding support and promotion.
  • Raise awareness of breastfeeding support and knowledge available in communities.
  • Help communities positively support breastfeeding in public places.
  • Make breastfeeding a normal part of the day-to-day life at a local community level.
  • Increase support for women who breastfeed - women are supported by their partners, family and the breastfeeding knowledge that is embedded in their communities.
  • Communities have the resources to advocate for coordinated appropriate and accessible breastfeeding support services." 

As you all probably know, I am a big proponent of breastfeeding.  Unfortunately, this year, my baby is a little too young to go out in public.  I may not be able to be "officially" counted at an event but I am going to be latching my baby at 10:30 on Friday and Saturday in support of all of the mother's participating in the "Big Latch On."  Is anyone going to join me?