Fetal heart rate & ST segment changes predict neonatal acidemia

Fetal heart rate and ST segment changes predict neonatal acidemia ..." Red alerts in the last hour of the tracing predicted acidemia with 100% sensitivity and 94% specificity. The alerts had a positive predictive value of 47% and a negative predictive value of 100%."

Breastfeeding may support earlier hospital discharge for moderately preterm infants ..." Breastfed infants also had lower PMA at discharge (mean 2.7 days lower) than those not breastfed, partly explained by lower morbidity in the breastfed infants and the researchers recommend that supporting the establishment of successful breast feeding in preterm infants should therefore be given high priority in neonatal care."

'Viagra' for women? Would you try this?

Doctors testing a new antidepressant found it was useless as a mood brightener -- but was unexpectedly effective at boosting the female libido.
Read more here.
Would you try it?

Tour of the Breastfeeding Unit

Check this out: A Tour of the Breastfeeding Unit

Out Today: March of Dimes Premature Birth Report Card

"Today is the release of the second annual Premature Birth Report Card, and I wanted you to hear the news from me: America receives a "D." As a country, we are failing to give our babies the healthy start they deserve.

Your state has received its own report card. I'm afraid you'll agree we have a long way to go. In fact, before the end of this year, more than half a million babies will be born too soon, some very sick."

Florida got an F.

Completely off topic, cool site to check out:
A Print a Day

"Mamatini... created to help women breastfeed better, easier, longer..."

"Mamatini is the first-ever, ready-drink, doctor-designed, 100% organic herbal infusion created to help women breastfeed better, easier and for longer. Mamatini contains herbs used for centuries (fenugreek, fennel, chamomile and ginger) to address the difficulties that many women experience when breastfeeding."

Fenugreek is commonly used to amp supply, and my own personal, anecdotal experience has found that fennel can help colic/gas.

I wonder how it tastes? I wonder how the dose of fenugreek compares to the recommended dose typically taken to help low milk supply. Is it enough fenugreek to alternate this drink with fenugreek tea (or capsules) for mothers who are already using it?

I just wouldn't want moms to think they need this (or anything special) in order to breastfeed in the normal course of things. It's also kind of expensive, at about $3.30 per 16 oz. bottle.

Has anyone heard of this, tried it, or know anyone who has? I would love to hear any feedback!

Download Ina May Gaskin's Presentation "Combining Modern Obstetrics..." and more

On Friday, October 30th, Ina May Gaskin presented a closed clinical conference to the medical staff of Sarasota Memorial Hospital. Her presentation was entitled "Combining the Best of Modern Obstetrics with Respect for Nature and Traditional Midwifery Approaches."
View a PDF of the accompanying power point presentation, in both English and Spanish, here.

Pain Control Recommended for Newborns = .5 free contact hours (for CME, too) - during heal sticks, breast-feeding or formula feeding resulted in greater improvement of pain relief indicators than the other methods of pain relief (oral glucose, pacifier, holding by mother), although any method is better than no method.

Antipsychotic Use Linked to Rapid Weight Gain, Adverse Metabolic Changes in Kids (Abilify, Seroquel, Risperdol, Zyprexa) = .5 free contact hours

Diet Rich in Processed Food Linked to Increased Risk for Depression = .5 free contact hours - found protective effect with whole foods, increased risk with processed foods

NICU Program Succeeds in Promoting Breast Milk for Premature Newborns

NICU Program Succeeds in Promoting Breast Milk for Premature Newborns

Induction Of Labour Versus Expectant Monitoring For Gestational Hypertension or Mild Pre-Eclampsia After 36 Weeks' Gestation

Induction Of Labour Versus Expectant Monitoring For Gestational Hypertension or Mild Pre-Eclampsia After 36 Weeks' Gestation - "Changes Clinical Practice: Pregnant women with mild hypertension at 37 weeks' gestation should be offered induction of labour (IOL). This recommendation is not restricted to women with pre-eclampsia, but is also valid for women with non-proteinuric hypertension."

I am seriously thinking about joining the National Bone Marrow Donor Registry. I am an organ donor and I think that's important. I have also thought about the marrow registry before and never acted on it but I've been reading the FAQ's and the risks seem pretty small for the potential benefits if you match someone (about 1 in 200 potential donors end up actually donating). If you do it, they only take 5% or less of your marrow, which your body replaces in 4-6 weeks.
Check out the Frequently Asked Questions and Myths & Facts about it.

Different HPV Vaccine Might Stop Vulvar Cancer in its Tracks

New HPV Vaccine Might Stop Vulvar Cancer in its Tracks
Working differently than Gardasil, Cervarix, it targets inside of virus, study shows

Moxibustion doesn't turn breech babies

Chinese medicine tactic doesn't turn breech babies:
"The study, reported in the journal Obstetrics & Gynecology, tested a tactic known as moxibustion, which uses heat to stimulate a particular acupuncture point in an effort to turn a breech fetus to the head-down position before birth.
Researchers found that the method appeared no more effective than Mother Nature among the 212 women they studied."

More:

Obesity Not a Risk Factor for Epidural Failure in Cesarean Delivery - .25 CME for physicians

Chlorhexidine Vaginal and Infant Wipes May Not Prevent Neonatal Sepsis - also .25 CME for physicians. This interests me because we do something sort of related: chlorhexidine abdominal wipes for all of our patients in the hopes of reducing our postpartum infection rates for women who end up with cesareans. We nurses aren't totally convinced but our infection control people are.

Immobilization May Improve Pregnancy Rate After Intrauterine Insemination
... guess that makes sense...

Prenatal SSRIs Linked to Problems in Newborns

Folic Acid Blockers Boost Birth Defect Risk

Breast-Feeding Women -Less Weight Retention CE/CME

Breast-Feeding Women May Have Less Postpartum Weight Retention --- I think most people already know this, but I am posting it because you can get .25 free & easy CE's/ CME's for it.

Also, check out: Migraine With Aura Doubles Stroke Risk - Many of us probably already know this, too. But, in that vein I though this was interesting Surgery Relieves Migraine Headaches - I had no idea they did this! I have migraines with aura but fortunately they are unusual, with usually only 2 or 3 per year. I don't think that is frequent enough to consider surgery (although they are horrible when I have them). But I'm glad to hear that it's an option for some people who suffer from migraines.

Trying Forceps Before C-Section May Not Raise Risks

Trying Forceps Before C-Section May Not Raise Risks

One Embryo as Good as Two in Second IVF Attempt

Life is busy here... this week started out with dirtbike racing way up in north FL, school (and report card conferences, which were wonderful! I am so lucky I have such great and smart kids!), piano lessons, and work, and now getting ready for our annual Halloween party (trying to!). The blog header photo is from last year's "Day of the Dead" theme. This year it's Sci-Fi!

Work is good, I'm working L&D and as an IBCLC (lactation consultant) right now. Birth number-wise we are actually down a little in numbers from the last couple of years. This is usually a very busy time of year for us and it's just kind of intermittent still right now. All that said, I'm sure I just jinxed myself for work tomorrow!!!

Here's a crazy ugly picture from the last race - the red helmet is my middle boy - they were all 100% fine (my son got back on his bike, finished the race, and got 6th place!):


Here's the same boy playing Claire de Lune:

Vaginal Hysterectomy Found to Be Ideal for...

Vaginal Hysterectomy Found to Be Ideal for Benign Issues

Drugs in labor & breastfeeding; Exclusive Breastfeeding= better sleep

Association between drugs used in labour and lower breastfeeding rates

It is often supposed that breastfeeding rates may be adversely affected by drugs taken in labour. A large retrospective study was carried out in Wales to investigate associations between drugs routinely administered in labour and breastfeeding outcomes at 48 hours, in healthy women and infants. At 48 hours, 43.3 per cent of women were not breastfeeding. Statistical analysis confirmed previously reported associations of lower breastfeeding rates with epidural analgesia, intramuscular opioid analgesia and ergometrine. The authors conclude that prospective studies on drugs used in labour are needed to investigate the potential associations between intrapartum medications and lower breastfeeding rates.
Read more details here.


Further evidence of the positive impact of breastfeeding on the incidence of pre-menopausal breast cancer and epithelial ovarian cancer (Two studies)

Several studies have found associations between breastfeeding and reduced risk of pre-menopausal breast cancer. However the results are inconsistent, and data from large prospective cohort studies are lacking. Such a large study was carried out in the USA using data from 60,075 parous women participating in a prospective cohort study. Women who had ever breastfed were less likely to suffer premenopausal breast cancer compared with women who had never breastfed and this association was modified by family history of breast cancer.

An Australia-wide population-based case-control study of epithelial ovarian cancer between 2001 and 2005 (1,092 cases and 1,288 controls) looked at parous women and their responses to a reproductive/lifestyle questionnaire. The researchers found a strong association between total duration of breastfeeding (all episodes) and reduced ovarian cancer occurrence, with protection increasing per month of breastfeeding.

Read more details here.

Exclusive breastfeeding associated with better sleep

A study in Norway was carried out to assess the prevalence of, and risk factors for, postpartum maternal sleep problems and its associations with depression. In addition, the study aimed to identify any other factors independently associated with either condition. A total of 4,191 mothers completed a questionnaire seven weeks postpartum. The prevalence of sleep problems was 57.7 per cent, and the prevalence of depression was 16.5 per cent. Mothers reported an average of 6.5 hours sleep. Factors associated with poor sleep quality were depression, previous sleep problems, being primiparous, not exclusively breastfeeding, or having a younger or male infant. Poor sleep was associated with depression independently of other risk factors.

Read more details here.

Proposed bill excuses nursing mothers from jury duty

Proposed bill excuses nursing mothers from jury duty ... do you think they should pass this bill?

AAP on breastfeeding mothers w/ H1N1

AAP Advice regarding breastfeeding for mothers with possible H1N1 infection

also, check out Arizona Mom Will Travel Over 300 mi. to Avoid C-Section

Self-Cesarean

Holy cow!! Check out this Self-Cesarean (quoted below) story at the Guerrilla Mama Medicine blog (originally here on BBC News). Aside from the infection issue, I'm surprised she didn't bleed to death or cut her bladder, etc... somehow I don't think she had a bladder blade out there; furthermore, how could she even. *see* what she was doing? It begs so many questions!

Last year at my hospital, incredibly, we had something in the same realm... I can't give details because it would be too telling... but we had a lady come in by EMS who had attempted a cosmetic surgery on herself at home!!! She had gotten pretty far through it, too, but was unable to complete it and someone 'caught' her hours later and had her brought to the hospital. HOLY, HOLY COW!!! Would have loved to see the pysch eval on that one. Can you believe that?

Both are incredible but at least the c-section lady had a baby to save as a motivational factor.

Anyway, here's the cesarean story:

"It is thought to be the first known case of a self-inflicted Caesarean in which both the mother and baby survived.

The unidentified 40-year-old, lived in a rural area of Mexico without electricity or running water, and eight hours from the nearest hospital.

The International Journal of Gynaecology and Obstetrics reported the case.

The woman performed the operation when she could not deliver the baby naturally, having lost a previous baby due to labour complications.

Hard liquor

Dr R Valle, of the Dr Manuel Velasco Suarez Hospital in San Pablo, Mexico, said: "She took three small glasses of hard liquor and, using a kitchen knife, sliced her abdomen in three attempts and delivered a male infant that breathed immediately and cried."

This case represents an unusual and extraordinary decision by a woman in labour Dr R Valle

Before losing consciousness, the woman told one of her children to call a local nurse for help.

After the nurse stitched the wound with a sewing needle and cotton thread, the mother and baby were transferred and treated by Dr Valle and his colleagues at the nearest hospital.

"This case represents an unusual and extraordinary decision by a woman in labour who, unable to deliver herself spontaneously, and with no medical help or resources, decided to perform a caesarean section upon herself," he said.

He added that a mother's instinct to save her child can move a woman to perform extraordinary acts but said it would not have been necessary if adequate medical care had been available.

Professor James Walker, professor of obstetrics and gynaecology at St James's University Hospital, Leeds, said he had heard of cases in the past where farmers had performed Caesareans on their wives after having previously carried out the operation on animals.

But he said it would not happen now. "In this country, there is virtually never a situation when an individual is totally isolated from medical care even in the most outlying areas." "

One Embryo at a Time: A Suggestion or a Law?

"Ever since in vitro fertilization became an option, there has been widespread concern about the multiple births that result from implantation of multiple embryos. Yet most doctors and patients are comfortable with implanting two or three embryos, despite the costs involved and the far higher risk of prematurity associated with twins. Should the United States move beyond recommended guidelines for fertility treatments to impose stricter regulations on I.V.F. procedures?

Should transfers be limited to one embryo at a time? " (From Bioethics Discussion Blog)

I have always found this topic interesting. What do you think?

Does anyone have full access to this article (in Pediatrics)?

Does anyone have full access to this article (in Pediatrics), who could save it and send it to me?

Closing the Quality Gap: Promoting Evidence-Based Breastfeeding Care in the Hospital

Also, I thought this Funny Birth Plan at The Midwives of Bethany Healthcare blog was, well, funny.

Overheard in a Beauty Salon

So many pregnant women do not get the seriousness of prematurity:

Overheard in a Beauty Salon -from OB/GYN Kenobi

and...

To Take or Not Take the H1N1 vaccine - from the ACNM's Midwife Connection blog.

..."If you’re still on the fence about vaccination, consider this: for the first time ever, a national coalition of eight organizations (including ACNM, March of Dimes, ACOG, and AWHONN) has come together to develop a clear statement about the seriousness of H1N1 flu and the importance of receiving the vaccination."

Here is a nice handout from ACNM that practitioners can use for pregnant women regarding Swine Flu (it looks as if the handout was made pre-vax).