Borchardt Consulting

Posts Tagged ‘Infants

Exhausted New Mom

Every new mother has a treasured photo like this one. Exhausted from childbirth, sometimes medicated we are given our precious new baby for “rooming in”.  We hold tightly to this little miracle that has just arrived and fall deeply asleep exhausted from our bodies hours of hard work. Unfortunately, it’s a dangerous, sometimes deadly trap.

Since the early 90’s, the world health organizations have been urging parents to practice Safe Sleep techniques with their babies.  Place baby on his or her back, alone in a safe crib.  Yet, in hospitals all over the United States, exhausted, sometimes medicated women are being left with their fragile newborns to care for them in a practice called “rooming in”.

Hospitals want to encourage breastfeeding and bonding between mom and baby.  New Moms want to see, touch and hold their precious babies allowing their brains to absorb that they really created these miracles.  It’s a connundrum.  But, hospitals must take a leadership role in modeling the behavior that we want new mothers to follow when they arrive home just a short 48 hours after birth.

Even proponents of bedsharing warn that babies should never sleep in a bed with a parent that is excessively tired or on medication.  Nor should the adult bed be filled with pillows and other soft bedding.  Hospital beds can be especially dangerous.  They were not designed for infants.  The beds are frequently set up so that mom is reclining rather than laying flat.  They put the side rails up to keep a medicated mother from falling out of bed, but the side rails are not designed for infant safety.  The baby has a hospital bassinet to sleep in but mothers rarely place the babies back into it before they doze off.

Hospital policy should require doctors, nurses, lactation consultants and all hospital healthcare staff to impress upon the new mother and any of her visitors that mom cannot be left alone with the baby in her arms unless she is fully awake and unmedicated.  The new mother cannot be expected to make safe decisions when she is in the haze of new motherhood hormones and after-birth exhaustion.

As a Safe Sleep Educator, I’ve been preaching this message for years.  It starts at the hospital!  Now, unfortunately, the worst has happened and a lawsuit has been filed against the hospital that allowed a post-C-Section mother on heavy pain medications to fall asleep with her baby only to wake up to find that the baby had died due to an accidental overlay.  I am not generally in favor of law suits but perhaps this will make hospitals sit up and take notice.  You cannot be a “Baby Friendly” hospital just by withholding free formula.  You must also look out for the health and safety  of the baby.  That includes taking steps to keep baby safe while mom gets  her well deserved recovery time.

Do you agree?

 

Breastfed infants are 80% less likely to die before age 1 year than those who never breastfed, even controlling for low birth weight.  Breastfeeding is the most effective way to insure your baby’s health and survival.   That’s a pretty impressive, yet globally, only 40% of babies under six months are exclusively breastfed.

Breastfeeding is also really good for Mom’s health.  Women who breastfeed for more than twelve months during their lifetime tend to have lower risk of high blood pressure, high cholesterol, heart disease, and diabetes. Breastfeeding has also been shown to reduce the risk of breast, ovarian, and endometrial cancer in a mother’s later life and may reduce the risk of osteoporosis. Perhaps best of all, breastfeeding women use the weight (fat stores) they accumulated during pregnancy to produce breast milk. Breastfeeding mom’s burn an additional 500 calories a day.  Wow!  A simple, relatively easy way to lose baby weight.

Baby benefits from breast milk too.  It is the food least likely to cause allergic reactions; it is inexpensive; it reduces the risk of SIDS; it is readily available at any hour of the day or night; babies accept the taste readily; and the antibodies in breast milk can help a baby resist infections.

Breast Milk is the Best Food for Baby

 

If both Mom and Baby benefit from breastfeeding, then what’s the problem?  While baby instinctively knows exactly what to do, for Mom breastfeeding has to be learned.  Many women need support and advice as they begin breastfeeding.  Some women experience nipple pain and fear that baby won’t get enough milk. Once past those initial challenges, more than half the mothers of infants will return to work.  While companies are supposed to provide a clean place (not the bathroom) for a working mom to pump, breastfeeding friendly companies are still relatively rare.

It is possible to work full-time and successfully breastfeed but it takes commitment and planning.  The best time to work through a breastfeeding plan is actually before the baby is born.  Find out what the company’s policy is for supporting breastfeeding moms.  Talk with other working moms and healthcare providers about the options for pumping.  There are lots of different types of breast pumps available both for rental and purchase. There is a breast pump that fits every mother’s needs.

Finally, don’t go into breastfeeding with the belief that it’s all sunshine and fun.  Breastfeeding is an evolving activity.  Mom and baby develop a rhythm over time.  Ultimately, breastfeeding is one of the most satisfying, enjoyable activities a mother will every do with her infant.

 

SIDS has been every new parents nightmare since biblical times.  No more.  Parents now have the tools to keep  their babies safe. The goal to keep baby safe begins when you’re pregnant.

  1. Moms get early prenatal care.  See your doctor often when pregnant.
  2. Create a healthy lifestyle while pregnant.
  3. Don’t smoke while pregnant or let anyone smoke around you and your baby.
  4. Don’t drink or use drugs while pregnant.
  5. Plan to breastfeed as long as possible.

Getting the nursery ready is simplier than ever.  Remember, less is more.  Decorate the baby’s room.  Not the baby’s crib.  All you need is a safe crib, a firm mattress (read hard) and a fitted sheet.  That’s it.  Your crib should be manufactured after June 28, 2011 to ensure that it meets all the latest safety guidelines.  This is a place that you will leave your baby unattended for hours so don’t cut corners here.  Don’t borrow an old crib or buy one at the second hand store.  If you plan to use a portable play yard as your baby’s crib, there are new safety standards that will go into effect December 2012.  Place the crib in your room for the first 6 months of baby’s life.

Unsafe Crib

Unsafe Crib

Bumpers, quilts, pillows and stuffed animals should never be in baby’s crib.  They are all too soft and fluffy for an infant. and they pose a suffocation hazard for your baby.  When your baby is old enough to be put in the toddler bed, you can start allowing soft items.  Recently, the Juvinille Products Safety Commission admitted that it could not show any proof that bumpers keep a baby safe from getting arms or legs stuck in the crib slats nor could they prove that bumpers keep baby safe from head injury.  Unfortunately, the Consumer Product Safety Commission and SIDS researchers can prove that bumpers have been directly responsible for the deaths of some infants.  They may be cute, but the are not worth the risk to your baby.

After baby is born, just a few more simple behaviors for parents:

  1. But baby on his or her back alone in the crib.
  2. Use a pacifier after breastfeeding is firmly established for sleep times.
  3. Do not cover baby’s head with hats or blankets.
  4. Put baby in a wearable sleep sack or feetie jammies rather than using blankets.
  5. Swaddle baby if needed, but only up to 6 weeks…and remember to dress baby lighter since you hold in body heat with the blanket.
  6. Get baby all recommended vacinnations.
  7. Never put baby on an adult surface like a couch or adult bed to sleep.

That’s it! You have all the tools needed to keep your baby safe from both SIDS and other sleep related deaths.  Oh, don’t forget that baby needs good tummy time when awake for proper development.  Enjoy your baby!

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Vulnerable Babies Sleep in Pepi-Pod

The 2011 Christchurch New Zealand earthquake created an immediate crisis for the regions vulnerable newborn babies.  There was no safe place for babies to sleep.  This was seen as a public health crisis and the Pepi-Pod was born.  (Pepi means Baby in Maori.) The pēpi-pod package was quickly assembled as an emergency response to the increased risks to babies, posed by disrupted living and sleeping conditions in families, and as support for their fearful parents.  A pepi-pod is a general purpose storage box that converts to a baby sized bed with the addition of an attractive cover, fitting mattress and bedding. It offers babies a safe space when they sleep in, or on, an adult bed, on a couch, in a makeshift setting, or away from home. These are situations with a higher risk of accidental suffocation for babies.

Face Up, Face Clear

Volunteers from all over the country started sewing the covers needed for creating these pods.  Each volunteer used whatever fabric they had available. A complete package of pod, mattress, cover, 2 base sheets, 2 wrap around ‘settling’ sheets, and a double layer merino blanket for each needy family.  Blankets needed to be provided because heat was uncertain in post-quake Christchurch.   Each family receiving a Pepi-Pod received  a thorough safety briefing reinforcing the need to sleep babies on their backs with their faces clear of blankets, smoke-free environment and in their pepi-pod for every sleep.

While I have some concerns about placing these pods in the adult bed, this was a brilliant solution to an immediate public health crisis for infants.  Placing an infant in a pod such as these was certainly safer than placing them on a mattress with the entire family in post-earthquake New Zealand and best of all, to get one, the parents had to have one-on-one safe sleep training.

Bedsharing isn't always pretty

Bedsharing proponents generally fall into one of two camps. The first kind is the “attachment parenting” type of parent that strongly believes that it is in the best interest of the baby to share a sleep space with the parents from birth. These parents will sometimes have a “family bed” where everyone in the family shares the same sleep space. Bonding and the emotional well-being of the baby is often sited as a primary goal for this group.

The second and most common group is the parents that have a crib or bassinet for their baby and plan for precious child to sleep the night through in his or her crib.  Unfortunately, no one informed junior of that plan.  After a night of singing, walking, rocking their darling, wide-eyed, screaming baby – these exhausted, anxious parents bring baby into bed with them because they can’t keep their eyes open one more moment and they have to get to work the next morning.  So in complete desperation they bring baby into bed with them in the frantic hope that they will get just 5 minutes of good sleep before the alarm goes off. This type of bedsharing parent is often referred to as the “Chaotic bedsharer”.

There is a raging debate amongst parents and professionals.  Advocates of bedsharing believe that it is:

  • Natural
  • Historical (It’s been done since the beginning of time.)
  • Facilitates breastfeeding
  • Helps with Bonding
  • Assists baby with healthy emotional development
  • Increases both parental and infant sleep time

Opponents of bedsharing believe that it is dangerous for the infant less than one year of age because it can increase the risk of Sudden Infant Death Syndrome (SIDS), accidental suffocation by overlay or by entrapment.

Whatever your belief, I think that we can all agree that neither parent is “evil” because they choose to bedshare.  But, the photo tells a truer picture of a night spent with a baby.  So, regardless of your parenting style, be prepared for a foot in your nose and another foot in your kidneys!  I wish all you parents a pleasant – “Good Night.”

Many thanks to bellyitchblog.com for this great photo!

Do you ever read the comments at the end of an on-line newspaper article?  I do.  Apparently, lots of people comment on newspaper articles.  Sometimes, those comments just make me want to scream.  I recently read an article from NPR entitled “Co-Sleeping is Back in the News”.

The author, Barbara J. King was commenting upon the fact that a baby died while sleeping in bed with his breastfeeding mother.  The cause of death was listed as “a co-sleeping accident”. This article was a fairly unbiased commentary on co-sleeping.  While there is much about this article that I would choose to comment on, I’ll pass by that for now and go directly to the comments.

nothing is forever  wrote:

responsible parents never roll over their babies it is not optimism but truth if it is not true humans would have been extinct by now…..from time immemorial babies slept with their parents that gives the parents and the child a bond which we is very important. When a baby dies with mother rolling over the baby it is news because it is very uncommon………….

WHAT!  Where do you get your information?  After nearly 20 years of working with newly bereaved parents whose infants have died, it’s not all that uncommon.  Every single day my fax machine will turn on with at least one death report for an infant.  When a baby dies due to an overlay or accidental suffocation, some parents are too grief stricken and guilt-ridden to tell the world.  It is a horrible accident.

Leah  wrote:

I slept in the bed with all three of mine when they were babies and never rolled on any of them. The elephant in the room here is the *size* of the parent, I’d wager.

Wow!  That’s certainly judgmental.   Having your children survive might just make you incredibly lucky – not right. Why is it necessary to vilify parents who experienced a horrible tragedy?  In order to separate yourself (you’re right and they are wrong), it’s apparently necessary to make them fat, drug using, alcoholics.  Research has shown us that some of the reasons that you should NOT bedshare are using  drugs (even over-the counter drugs like cold medication), alcohol,  smoking and being overweight.   But the list is actually much, much longer.  No one wants to be
the bed room police. The Academy of Breastfeeding Medicine actually has protocols for breastfeeding mothers to co-sleep.  You can check them out here.

Brow Master wrote:

You don’t need a doctors opinion on this just listen to your own mother or grandmother.

I’m sure that your mother would be happy to hear that you believe she is always right; however, changes in childrearing occur because research
continues to give us more information, new products are discovered and even our children change. I’d wager that your mother did not put her children in a car seat.  There was probably lead paint on the crib that she used.  I played on construction sites, drank out of garden hoses and ate white bread with butter and sugar for lunch, but I certainly wouldn’t want my grandchildren to do that.

Jerry wrote:

From an evolutionary perspective, survival requires co-sleeping. For most of human history, sleeping away from your parents would most likely result in your becoming food for predators.

I wonder if the any of the studies factor in the size of the mother. There are some women walking around here even I wouldn’t feel safe sleeping next to.

Excellent point – Evolution. Defined as  1. any process of formation or growth; development. 2. A product of such development. 3. Biology.
Change in the gene pool of a population from generation to generation by such processes as mutation, natural selection, and genetic drift. 4. A process of gradual, peaceful, progressive change or development, as in social or economic structure or institutions.

In short, evolution means change.  I can’t speak for everyone, but in my neighborhood, I don’t have to worry about lions eating my children.  We have heat in our home so I don’t have to keep them close for heat.  I sleep in an America style comfortable bed, not on a dirt floor.  Sometimes, we outgrow our evolutionary history.  Some call that progress.  As to the other point about a woman’s weight – that’s just mean.  Most women who have recently given birth to a baby are carrying a bit of extra weight.

Candida  wrote:

I am sorry for this mother though it may be that the baby would have still passed or passed sooner had it been in a crib. The majority of the worlds culture co-sleep.

Back to that.  I don’t live in a third-world country (most of the world’s population).  Also, please don’t ever say something like
that to a bereaved parent.  We all die eventually but you have no way of knowing that this baby would die under other circumstances.

jpett88 wrote:

“3 million years of human evolution have prepared you for it.”

My favorite product of millions years of human evolution is the frontal cortex of the brain, which allows [most] humans to think rationally. It’s why we buckle our seatbelts in cars. Why we avoid drinking antifreeze. And probably why we shouldn’t sleep in the same bed as our babies, given the evidence. Bed-sharing is probably on par with opting out of vaccinations. Low risk but
high stakes. It’s a parenting choice, of course.

There are no right answers. Just safer answers.

AMEN! Excellent answer!  There are no right answers.  Just safer answers.  As a parent, you get to decide for your family what works best for you.  Consider, are you putting the comfort of the parents ahead of the safety of the child?   Babies are dying – unnecessarily.  As the parent, you get to chose what is right for your baby and for your family.  Make an informed choice and don’t for a minute think that it only happens to “bad” people.  It happens in every racial, ethnic, economic group.  It happens to loving parents who desperately wanted a baby.  Luckily, it doesn’t happen to most of us.  But, most people do know someone who has had a baby die.  That family deserves your sympathy, empathy and support.  Not your judgment.

When you are a mother, you are never really alone in your thoughts. A mother always has to think twice, once for herself and once for her child.   Sophia Loren, from Women and Beauty

Dr. Rachel Moon, lead author of the new American Academy of Pediatrics guidelines and Pediatrician at Children’s National Medical Center in Washington DC discusses the latest information.  Click Safe Sleep Guidelines.

Follow these tips to create a safe sleep environment and help reduce the risk of SIDS for infants.

Reducing the Risk of SIDS poster

Positioning

  • Babies should always sleep on their backs.
  • Place baby on his/her back to sleep at night time and naptime.
  • Babies shouldn’t sleep on their side. They may roll to face down position.

Cribs

  • Every baby should sleep in his/her own crib.
  • Place baby on a firm mattress in a safety-approved crib.
  • Remove all fluffy and loose bedding from the sleep area. The only thing that should be in the crib is the baby.
  • Make sure baby’s head and face stay uncovered during sleep.
  • Use blanket sleepers instead of blankets during colder months.

Room sharing

  • Babies from birth to age 6 months should sleep in the same room with their parents.
  • Babies should not sleep on the same sleep surface with their parents.
  • Bring the baby into your bed for cuddling and feeding, but return the baby to his/her crib when you are ready to go back to sleep.

Other tips

  • Don’t let baby get too warm during sleep. A general rule is that babies need one more layer than you do.
  • Use pacifiers at naptime and bedtime during the first year, but not during the first month for breast-fed babies.
  • Breastfeeding is best!
  • Make sure your baby gets all the recommended vaccinations.
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