Do I Really Need to Do(ula) This? Part 2

Do I Really Need to Do(ula) This? Part 2

As promised, we are back with Part 2 of our doula blog. We pick up from where we left off a few weeks ago when the leaves were not quite as crunchy…

In Part 1, I featured the work of the Labor Support Doula, and what she can offer during pregnancy and birth. Before anyone calls me out for being sexist, let’s acknowledge that there are currently a few men who are trained doulas around the world (and, fun fact for any Gleeks out there: Matthew Morrison’s father was a midwife!) However, since women tend to be the overwhelming majority working in these areas, I will, going forward, refer to doulas as women.

Naturally Choosing and Determining Baby's Sex

To try to conceive a specific sex, there is a costly, invasive and controversial way of preimplantation genetic testing when doing in-vitro fertilization (IVF) or boy/girl sperm sorting with intrauterine insemination (IUI) - although not as full proof.

There is no research or science to back the effectiveness of other natural methods. The theory behind a few of them is that girl producing sperm move slower than boy producing sperm, but last longer. So, if you want a girl, try to have sex 2-3 days before ovulation, as they will still be in the fallopian tubes when egg is released. If you are trying for a boy, timing sex as close as possible to ovulation theoretically is more likely to work, as the boy carrying sperm swim faster to the egg but don’t last as long.

Another theory is based on biochemical cyclic changes in a woman’s body favoring girl or boy carrying sperm, leading to the opposite conclusion above. Having sex 2-3 days before ovulation is more likely to be. girl, 4-6 days before ovulation is more likely to be a boy, but this is confusing as male sperm are unlikely to survive that long.

There are people that swear by either of the two methods, claiming it worked for them consistently, but others got opposite results and again it’s not backed by the research. Same with sexual position - missionary for a girl baby, doggy style deeper penetration for a boy baby to help the faster swimming male sperm real their goal before the girl sperm. There is no harm in trying any of these natural methods, just no guarantees it will work.

When it comes to determining baby’s sex in pregnancy, contrary to popular thinking, sonograms can make mistakes and are not 100% accurate, possible north of 100% when done mid pregnancy, depending on the skill of the sonographer to identify the genitals of boys and girls, as is also effected by baby’s and the umbilical cord’s position. The noninvasive DNA blood test is way more accurate 98-99%, as it detects fetal blood cell chromosomes in maternal blood.

Then there is the magical surprise, not knowing as was done through history until the actual birth, when mama and her partner are encouraged to discover it for themselves. You do not need to go with the modern flow of knowing if you are carrying a boy of girl before birth and “gender“ or sex reveal parties.

I get a kick out of the old wive’s tales about detecting sex in pregnancy - some still currently practiced, like rate of fetal heart, how mama is carrying, what she senses within, and cravings. Some do swear by them, but they are myths, not reliable according to the science, research and literature.

There was actually a study based on mama’s intuition that showed it was correct about half of the time, the same accuracy as flipping a coin.

I knew an obstetrician who said he had some fun with this and made an “educated” guess, was able to detect boy or girl to mamas in his practice, but write the opposite sex in the chart. He was always “right” because either what he told mama was correct, or the opposite was in the chart, she must have been mistaken or heard him incorrectly. They always had a laugh. No reason not to have fun with this.

For more on fertility awareness to boost your chances of getting pregnant naturally, best preconception lifestyle practices read my Natural Birth Secrets book 2nd edition. It is doctor and midwife recommended guide for all stages of birth, from natural family planning and preconception, to pregnancy, birth, and postpartum. Whether birthing at home, hospital or in a birthing center - even if this is not your first baby - experience the unique approach on how to have a deeply positive, empowered, and joyful journey. Included are effective holistic and natural remedies for common issues.

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The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.

INITIAL POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE - PART TWO

POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE TO THE FIRST FEW WEEKS - PART TWO

Do see last month’s blog for Postpartum Care at Home: Your Comprehensive Guide to the First Few Weeks - Part One.

Dealing With Postpartum Exhaustion

Welcome to motherhood!  Caring for a newborn and recovering from childbirth is no small task.  Fatigue can easily lead to exhaustion, infection, irritability and depression if you do not listen to your body’s signals for increased rest during this time. 

The best way to minimize fatigue is to spend the first two to four weeks after birth (longer after cesarean) caring only for yourself and your baby, while someone else (like your partner, a close relative or friend) tends to the other needs of the household. No need to feel guilty for doing nothing other than resting, taking care of you and your baby during this time. This is your sole job right now, with nothing else on your plate. 

Many of the suggestions for fatigue in pregnancy still apply, but other suggestions specific for postpartum to prevent exhaustion include:

  • Eat well, at least three whole food varied healthy meals and snacks, without skipping meals

  • Drink at least 8-10 glasses (64 ounces) of water daily

  • Take recommended supplements, to ensure you are getting all the nourishment not you need for yourself and your baby while you breastfeed and recover, that is not supplied by diet alone. 

  • If you are anemic or had excessive blood loss after birth, be sure to take herbal iron at least for the first 6-8 weeks postpartum, until you feel back to yourself and your labs including iron stores are normal. 

  • Try to plan so that for the next 2, ideally 4 weeks, someone other than you is doing errands, cleaning, preparing meals for you and your family, and tending to the older siblings.

  • Consider hired help (such as a mother’s helper or postpartum doula, a cleaning lady and even a personal chef or healthy meal delivery) if you do not feel you have enough support, or after your support leaves. This can be put on your online baby gift registry and is much more essential than stuffed animals, toys and an oversupply of newborn clothes Baby will soon grow out of.

  • Be honest and direct about communicating your needs. Don’t be afraid to delegate responsibilities to others.

  • Gratefully accept offers to help. Remember this is not just a much needed time to heal from the birth, but it is also a sacred time to get to know your baby and learn to breastfeed. As long as you are well supported, allow yourself to enjoy this special time and bask in the loving support of others.

  • Rest, sleep and lounge as much as possible during at least the first month postpartum. Nap when Baby naps and ask a friend or relative to take the older kids for even an hour or two each day so you can do this. When you have a choice between folding the laundry or doing the dishes and napping, choose napping. Do not give into the temptation to do any housework, errands, childcare or cooking, as these tasks can be delegated to others during this time while you are recuperating. This is not a time to be supermom. Allowing yourself this extra time to rest now, will help you stay well physically and emotionally for you and your family, and will help you feel back to yourself sooner.

  • Be strict with visitors. Don’t be shy about suggesting when it’s best for them to visit or excusing yourself if you feel tired. Ideally, put a sign on your front door saying something like,

“New moms and babies need lots of rest and help. We are resting now, please do not disturb. But, we would love a short quiet visit between {insert baby’s most awake hours}. If you would like to stay longer, please bring or cook a meal, play with our older children, or do some housework like the dishes or laundry.”

  • Ask your partner to tend to the baby at night after you breastfeed for burping, diaper changing, settling, or holding skin to skin. Once breastfeeding is well established, your partner can also give the baby a bottle of expressed breast milk for one of the night feedings.

  • Keep night feedings dark, quiet and boring so that baby will eventually learn to sleep longer periods of time during the night.

  • If you can’t fall asleep at night, try these suggestions for insomnia, and make sure to take 1-2 daily naps or rest periods when the baby sleeps. Remember to silence your phone. Better yet, keep it out of the bedroom.

  • Limit caffeine and avoid it after 4:00 P.M.

  • Limit time on computer and iphone, and avoid it after dark.

  • Get daily fresh air and sun exposure during the non-peak hours. 

  • Treat yourself to a nice deep tissue massage focused especially on areas of aching muscles, or ask your partner to do it. A soothing simple combination for massage oil includes 3½ ounces Almond oil, ½ ounce Arnica oil, 15-30 drops of your favorite uplifting essential oils like Rosemary, Evergreen (Pine), Peppermint, Spearmint, Rose, Geranium, Ylang Ylang, Orange, Lemon, Citrus blend, Lavender or Jasmine. Shake well before each use, and store in a cool dark place in a glass bottle (this Almond oil comes with an extra 4 ounce travel bottle). A few drops of Vitamin E oil can be added to preserve it.

  • After the first few weeks, an occasional weekend in a nice hotel with your partner and baby can be a really nice restorative rest and treat. And so worth the expense, as the hotel staff will clean your room and cook your meals!

  • Practice regular yoga and light stretching any time. There are many ways to do it with your baby, or you may benefit more from having some space to do it alone, leaving Baby with pumped breast milk and a trusted sitter. Gradually get back into exercise in the morning or early afternoon after the first several weeks, and increase as tolerated after your bleeding stops and you feel up to it. 

  • Do daily 10-20 minutes of conscious connected breathwork that provides you with natural energy and increases vitality. 

  • Heed to signs of not getting enough rest, which include:

    • Ongoing exhaustion

    • Feeling run down and achy

    • Excess or prolonged bleeding

    • Inflamed clogged milk ducts

    • Frequent infections and colds

    • Excess emotional irritability 

Report to your practitioner if you cannot sleep, are too exhausted to cope, or your fatigue worsens or does not ease up by six weeks after Baby is born.

Excessive Sweating, Peeing and Shaking

A normal increase in perspiration and trips to the bathroom are common as your body rids itself of additional fluids that developed during pregnancy, and IV fluids if given during labor. Intense shaking right after birth is also common due to the hormonal fluctuations, temperature and body changes after the huge work your body just did to give birth. This is a normal stress response to release the intense energy that was involved.

Suggestions are:

  • Ask your partner to hold you when shaking, but do encourage and embrace the shakes, without trying to stop your body from doing what it needs to do in order to reset.

  • Take Rescue Remedy to support your normal stress response, if you feel you need it.

  • If you are cold, wear absorbent all-cotton clothing and warm socks, dress in layers and cover yourself with warm blankets.

  • For sweating and chills not related to infection:

    • Sleep on a large towel or terry cloth sheets.

    • Drink Ginger tea alternating with Cinnamon tea. It is best homemade, by adding a pinch of freshly ground ginger or a stick of Cinnamon to 1 cup boiling water and brewing covered for 15-20 minutes. Or a steep a stick of cinnamon in the water for a few minutes. Strain into a glass mason jar, add honey and or pure nut milk to taste.

    • For severe sweating, get an acupuncture treatment to balance your Qi and promote healing. 

Report to your practitioner persistent sweating that lasts several weeks, chills, muscle aches, and temperature over 100.4 after the first few days.

Dealing with Feeling Fat

This is one of the most common postpartum complaints. Women often struggle with body image issues postpartum, and feel fat. Typically, only about 12 pounds are lost with delivery, another 5 pounds are lost during the first week, and an additional few pounds are lost by the 6 week check-up. It can take several months for the fat stored around your hips and buttocks for breastfeeding and nourishing you during the pregnancy and postpartum, to be used up. So, it is good to remember that the calories used for breastfeeding will help you lose this extra pregnancy weight.  

The rest of the weight gained during pregnancy will have to be lost through a healthful diet and exercise program. Also, it takes at least 6 weeks for the uterus to return to a non-pregnant size, and it takes time and abdominal exercises to tone up the muscles and overlying skin that was stretched. It takes at least several months to return to your pre-pregnant size. 

Remember, breast milk production requires even greater caloric intake than pregnancy, as you are the primary provider of nourishment to your rapidly growing baby. So, this is definitely not an appropriate time to diet, as it deprives you and your baby of essential nutrients. If you gained excessive weight in pregnancy or were overweight before pregnancy, eating varied, whole food of high quality, and avoiding processed foods high in unhealthy fats, refined carbohydrates and sugars, and regular exercise when ready, is usually sufficient.

To summarize:

  • Drink 64 ounces filtered, spring or well water daily between meals, at least 20-30 minutes before or 2 hours after eating.

  • Eat a balanced, nourishing and varied diet high in:

    • Fresh organic fruit and vegetables

    • Organic tofu and tempeh

    • Beans 

    • Nuts, nut butters, and seeds

    • Organic pastured whole eggs

    • Organic free range, grass fed chicken and turkey, beef, lamb, and wild game

    • Wild Alaskan salmon and other fresh water fish from non polluted waters

    • Organic whole raw dairy-goat or sheep is best

    • Limited whole grains (sprouted is ideal)

    • Organic cold expeller pressed extra virgin olive oil, coconut oil, ghee or goat butter 

  • Avoid foods that are heavily processed and loaded with unhealthy refined vegetable oils and partially hydrogenated fat, sugars, refined flours and starches.

  • Begin regular exercise like brisk walking or dancing as soon as you are able and the bleeding stops. Aim for 30 minutes 4-5 times per week. Pilates is a great way to strengthen your muscles, and especially tone up your core. Yoga will tone your core as well, in addition to increasing total body flexibility and strength, and helping you calm and grounding feelings. Ideally, take a local class like mommy and me yoga or postpartum yoga and Pilates. There are also plenty of online classes until you can manage to get out to an actual class. Light walking, gentle yoga stretching, side lying leg lifts, pelvic floor muscle strengthening, and gentle abdominal toning exercises can be done after the first few weeks. Gradually increase time and intensity as you are able. Listen to your body, though. There is no need to rush or push yourself during this time of needed rest, healing and recovery.

  • Historically and in plenty of cultures around the world, a fuller figure is more glorified, respected and honored, and being too thin is not considered healthy or attractive. While obesity is unhealthy and it is important to have a healthy weight and body image, there are many variations in normal weight and body characteristics. Ditch the pervasive media pictures of thin models. They are not realistic, they wreck havoc with body image and often result in you feeling unnecessarily bad about yourself. If you need to, look at the #BodyPositive images of mothers on social media. Be mindful of unhealthy thoughts from modern, western cultural stereotypes that imply “thin is most beautiful” and “looking fat is ugly.” Try to replace them with more true affirmations of pride and gratitude for your body having just grown and birthed your baby. Maintain acceptance and love for your unique body type which is forever changing. Know that you are more than just a body, but a beautiful eternal soul with your own special gifts, attributes and purpose far bigger than that of your body. Even though you are a postpartum woman who has just birthed her baby, you are also physically radiant, lovely, magnificent and have a deeper sort of beauty and wisdom.

Postpartum Depression and Anxiety

Intense emotions, mild depression, anxiety and mood swings are common in the first few weeks after having a baby, as are postpartum struggles. This is especially true if you are overtired and exhausted, without help or support from others, and/or have other stresses, personal issues or other problems. You may find that you are at times down, irritable, easily upset, extremely sensitive, cry without apparent reason, overwhelmed, tense, anxious, and unable to concentrate or remember things.  

Natural remedies to lessen the emotional ups and downs, and help you cope include many that are mentioned in my posts for managing stress and emotions in pregnancy

Suggestions specific for postpartum include:

  • Minimize fatigue with the tips from the exhaustion section above. A - adequate sleep is crucial.

  • Eat a healthy well-balanced diet as described above, but many feel best completely off gluten, dairy, soy and all forms of cane sugar. Consider eating an organic Paleo diet, an ancestral whole or real food way of eating high in pastured organic animal protein and healthy fat, plenty of fruits, veggies, nuts and seeds, with free use of herbs, spices and healthier sugars like raw honey. Try it for a month. You will be amazed how much better you feel physically and emotionally.

  • For general health and physical and emotional well-being, make sure to take the supplements here that include a whole food multivitamin, omega threes, probiotics, Vitamin D, plus those specific for symptoms of anxiety and depression:

    • Calcium, 250-500mg 2-3 times daily

    • Magnesium, 200-400mg 2-3 times daily

    • Vitamin B complex, 20-50 mg once daily with methylated folate and 

    • Vitamin B12 sublingual (under the tongue) in the form of methyl, hydroxo or adenosyl cobalamin), 1000-5000 mcg daily to 2-3 times weekly depending on symptom severity and blood levels

    • Curumin (Tumeric), 500 1-3 times daily to reduce inflammation linked to depression, anxiety and other mental health challenges

    • Evening Primrose oil, 500-1300 mg daily

    • Continue your iron supplement if prescribed during pregnancy until you stop bleeding

  • Take your encapsulated placenta pills as directed (see supplement section).

  • Spend extra time breastfeeding and cuddling with your baby, skin to skin.

  • Share your feelings with a close friend, relative, transformational life coach or integrative health professional. An occasional good cry does wonders, as does a good hug, and a good laugh. 

  • Write and feel free to share your birth story. Include the details, the lessons you learned about yourself and others, your strengths you have discovered, how you and your partner have grown, and qualities you found that exceeded your expectations.

  • Commiserate with other mothers by taking a postpartum yoga or exercise class, or joining a mothering, breastfeeding or parenting class or support group.

  • Every day, remember to protect your emotional well-being by doing things that cheer you up and avoiding things that upset you.

  • Each morning, shower, brush your hair, put on your usual make-up, and get dressed, even if it is just changing PJs or sweat pants and shirt. After the first two weeks, get dressed in clothes. 

  • As soon as you are able and the bleeding stops, begin a regular exercise program such as brisk walking, hiking, low-impact aerobics, more active yoga, dancing or swimming for 30 minutes 4-5 times per week.

  • Get out of the house and get some fresh air at least once daily, even for just a little walk in the park, a trip to the farmer’s market, or enjoying a cup of tea with a friend.

  • Plan some leisure time away from the baby at least twice a week in the early weeks and more frequently later postpartum, even if just an hour each day.

  • Avoid drugs, alcohol and caffeine. 

  • Before attempting medication, try the recommended lifestyle changes, natural remedies and herbs for stress and emotions first, as they are non- toxic, effective and address the root causes, unless symptoms are too severe.  If you are already on medication, the natural modalities and suggestions here can be used in adjunct, and can ultimately support you when you one day taper down to lower doses and choose to stop taking them.

  • For persistent symptoms, make sure to have your provider check a comprehensive thyroid panel with thyroid antibodies, your vitamin D and B 12 levels, fasting glucose and hemoglobin A1C and address issues accordingly. Do what you can to prevent postpartum depression and anxiety and minimize underlying possible causes.

  • In Chinese medicine and many other ancient traditions, the dried placenta powder is recommended postpartum for its powerful healing properties, especially helpful for balancing emotions, prevent or lessen postpartum depression if there is a risk or history. Many doulas and birth professionals encapsulate placentas. If you encapsulated your placenta, take as directed by the provider who encapsulated it. 

Report to a healthcare professional if your symptoms of depression or anxiety worsen or last more than the first few weeks, if they interfere with your ability to carry out your daily tasks, if you notice significant changes in your eating and sleeping habits, if you feel desperate, hopeless, afraid, unable to cope, or have thoughts of harming yourself or your baby. 

Siblings

Postpartum is always a time of adjustment for siblings. It’s healthy and normal, and they each handle it differently. The youngest tends to have the hardest time, but not always. Some temporarily regress a bit. Some show upset towards mom, dad, or the new baby. Others become more needy and try to get negative attention and act out, if they can not get enough attention in a positive way. 

Although your heart doubles with each new baby, meeting the needs of the older children and balancing that with your own healing and newborn care can be challenging. Having a strong network of family, friends, mothers with similar aged children, or hired help is essential in the early weeks. This support system can help with the siblings’ care, give you time to heal, rest, and focus on the baby and mastering breastfeeding. Extra support is especially important if the sibling is a toddler or young child, as they usually need the most tending to. 

Take a deep breath and let compassion run through you, and imagine how you would feel if your partner just brought home a new girlfriend everyone's all excited about and loving towards, and encouraged you to love her too. Reassure them they are loved, give them a lot of approval, and include them in age appropriate ways if they are interested in helping to encourage them to feel involved and important. Try to spend some quality time with each of them alone regularly, so your attention can be focused on them completely without interruption, ideally after Bbaby has been fed and can be held by someone else. 

It is important to avoid expressing criticism or anger towards them when they are seeming to be acting out or trying to help, and do not suppress the expression of their feelings. A great book written in easy to read comic strip form, with great suggestions on helping older children adjust healthfully is Siblings Without Rivalry by Adele Faber and Elaine Mazlish.

If you haven’t already done so, get the wonderful book written by herbalist, midwife, and doctor Aviva Romm, Natural Health after Birth, for a more complete holistic and heartfelt guide to postpartum healing and wellness.

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As always, if you need more personalized support and guidance, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.

My Natural Birth Secrets book 2nd edition is a great adjunct to the online Guide for postpartum and holistic modalities to common issues and discomforts.



For general postpartum healing:

Routine Newborn Procedures

Many mamas who want a natural birth may not be as familiar with the the number of choices they need to make regarding interventions to baby postpartum. These are routine in many hospitals, with more freedom of decision making out of hospital at a freestanding birthing center or home with a midwife. Healthy babies are suctioned, all exams and procedures are done in the nursery, not by bedside, they are bathed, given Vitamin K injection and antibiotics in their eyes, and Hepatitis vaccine, and babies with a penis are told they need medical circumcision. Other procedures are pulse oximetry to screen for critical congenital heart disease not picked up on the mid pregnancy anatomy scan if baby had one, audiology screening, and the newborn screening blood test.

Healthy vigorous babies born vaginally can clear their own lungs and don't need suctioning - even with bulb syringe. That's not a gentle welcoming for them, but invasive and traumatic. Suctioning can be harmful to baby’s transition from womb to world, and isn't evidence based care. It's more effective and less harmful to do percussion and postural drainage or use ambu bag if needed. Most of the lung filled fluid is cleared with the big squeeze through the birth canal. The rest is absorbed into the body, and for ~ first 24 hours, baby spits it up, coughs or sneezes it out.

All routine baby exams and decided upon procedures can be done in room with parents. It’s an important part of bonding, nursing and sensitivity to baby’s nervous system. Baby needs to be skin to skin for warmth and comfort after birth, close to mama for nursing. There’s no medical reason for healthy newborn nurseries, with babies separated from parents in bright rooms in isolettes filled with strangers. Nurseries serve hospitals, not babies. If mama needs a rest, it can be done with baby in room cared for by another support person.

Babies born in hospitals are still be given unnecessary baths with chemically laden soaps and kept dry with toxic talc and artificially fragranced baby powder. The birth juice and meconium can be wiped with your own natural products by you or your partner, but there is no rush to wash off the skin disrupting the flora of good bacteria that protects baby’s health, and remove the vernix (the white waxy, cheesy protective material that covers baby’s skin) so most of it can absorb into baby’s skin and allow baby to receive its protective benefits. It is not only a skin moisturizer and softener, it’s also an antioxidant and skin cleanser with anti-infective properties. It regulates baby’s skin pH needed for health, helps control baby’s temperature and insulate the baby, so crucial after birth from womb to world. It might help babies latch, as the scent of vernix may trigger neural connections in babies’ brains needed for breastfeeding, and bonding with that delicious new baby smell. It also smells of mama, which can provide comfort to baby and enhance bonding after birth. The The World Health Organization (WHO) recommends waiting at least six hours — and if you can go a full 24 hours, even better to give the first bath. Since it doesn’t fully absorb until day 5-6, I’m not sure why the first bath can’t wait until then. Leave it on and even rub it in like body butter. Don’t let anyone wash it off.

Hepatitis B vaccine is given to prevent baby from blood born infection spread by contact with blood and body fluids like unsafe sex, IV drug use, accidental professional needle stick, and high risk communal settings. If baby has not had these sources of exposure, it can be delayed until prior to entering school, if you choose infant and childhood vaccinations. Refer to my blog on immunization for more info.

Vitamin K injection and Antibiotic eye ointment are given routinely to all babies born in US hospitals without considering individual situations. In some states you can refuse, in others it’s the law and they can report you to Child Protective Services - but these organizations have bigger problems to deal with and often the case is dropped after some unnecessary stress and aggravation. We don’t have these laws in most homebirth settings.

The antibiotic eye ointment is to prevent sexually transmitted infections gonorrhea and chlamydia that could cause blindness in newborns after exposure in birth. It is given within the first hour of life during the most alert time of baby after birth, interfering with vision at such a sacred crucial time when initial bonding and breastfeeding take place. It is irritating to baby and disrupts the delicate balance of flora in their eyes which can lead to other infections. Needing to give antibiotics is not relevant to babies born to mutually monogamous parents who do not have these infections. Taking into consideration that one may not know for sure there is another secret partner, these infections can be tested for in a pregnant mama at term, and if negative, the antibiotics can be refused in good faith. If you do test positive for one of these sexually transmitted infections, you and partner can be treated and retested to see if cured, but it may be wise to consider the antibiotics for baby’s eyes, since exposure can happen again. Then you can delay the medication until after you and baby look into each other’s eyes, have some time for bonding and breastfeeding.

To give vitamin K to the newborn within the first hour of birth is to prevent a rare but serious blood clotting disorder called vitamin K deficiency bleeding (VKDB). There is an early onset VKDB that happens within the first 24 hours, classical expression in 2-7 days, and late onset that usually occurs in 3-8 weeks of life. Our bodies need vitamin K to help the blood to clot when needed. Giving it to babies at the recommended dose via injection is currently evidenced based care, but still not a simple matter.

The American Academy of Pediatrics opines strongly in favor of it. The current evidence does support the injection, saying there is little risk other than rare potential allergic reaction, and that the benefits far outweigh the potential risks. The injection is mega dosed, with 20,000 times the amount new baby has at birth, 5000 times the recommended daily allowance. It is injected into the muscle, which is a more rapid route than oral. In its synthetic form, it is considered a class C drug which means its safety is unknown in pregnancy, risk cannot be ruled out, there are no satisfactory studies in pregnant women, but animal studies demonstrated a risk to the fetus or potential benefits of the drug may outweigh the risks. The package insert itself warns that it can cause sometimes fatal allergic reactions when injected into a muscle or vein, and is ideally take by mouth or injected under the skin. The synthetic medication contains concerning chemical preservatives. It is available, but not accessible in most hospitals without the preservatives, but the preservative free vitamin K still does have some chemicals to increase absorption. It is also concerning to ponder the impact of overdosing on a fat soluble vitamin that stays in the system, as opposed to water soluble vitamins in which excess is excreted out in the urine.

In formula fed babies, the risk of VKDB is negligible as the formula contains synthetic vitamin K. For babies who breastfeed, an alternative is the oral form of vitamin K, in which some protocols have not been as effective as the injection in preventing VKDB - although some of the increased risk was related to parents not administrating of all the doses. Vitamin K using the Danish protocol is just as effective at preventing VKDB, though not accepted by modern medicine and hospital practice in the USA. Several European countries have a licensed oral vitamin K available with varied protocols, for those who wish to decline the injection, which is most effective according to the research to prevent vitamin K deficiency bleeding in babies. Except the Danish protocol. The Danish protocol is preferred as it seems to be just as effective as the injection according to the studies. It is vitamin K1 - phytonadione: 2 mg orally at birth, the 1 mg once weekly for 6 months as long as breastfeeding is greater than 50% of the baby’s diet. As it is a supplement in the USA, it is not regulated, FDA approved or certified like the injection made from pharmaceutical companies, for preventing VKDB in new babies. That does not mean it is not effective or unsafe. Still many who decline the injection prefer it as a viable alternative. Finding it in the states can be a challenge, but some homebirth supply companies and midwives carry it. If doing this protocol, best to do with a feeding as vitamin K is fat soluble, to increase absorption.

Little research is available on the alternatives, such as breastfeeding mamas eating more vitamin K or supplementing (like with 5 mg daily) to boost levels in breastmilk and prevent the rare vitamin K deficiency in newborns.

But as with all other routine interventions in the entire healthy normal physiological process of having a baby, the more we study, the more we find their lack of benefit and increased risk, and that mother nature or the Divine intelligence that created it all did not get it wrong. Maybe there is a reason we do not know yet why newborns are born with low vitamin K that does not reach optimal levels until the eighth day of life, from the gut flora. Is it a deficiency if they are all born that way? I defer to Dr. Sara Wickham who has analyzed the research for over 20 years and even wrote a book on this subject alone. “Several thousand babies need to be given vitamin K in order to prevent each case of vitamin K deficiency bleeding (VKDB), a disorder formally known as hemorrhagic disease of the newborn. Unfortunately there is little research interest (as is so often the case) in questions such as 1- how we might be able to pick out the babies who are truly at risk rather than giving the universal prophylaxis and 2- whether and why it might benefit babies to have a relatively low level of vitamin K compared to adults.”

Newborn screening checks a baby for serious but rare and mostly treatable health conditions at birth. It includes blood, hearing and heart screening. The newborn screening blood test may screen for up to 50 diseases, including phenylketonuria (PKU), sickle cell disease, and hypothyroidism but know it is only a screen that leads to more testing to confirm or more likely rule out the rare diagnosis. It has a high false positive rate, as there are more than 50 false-positive results for every true-positive result identified through newborn screening in the United States. This means baby tests positive on the screen but do not actually have the disease. Screening is mandatory in and funded by nearly all states - despite the varied diseases for which each state screens; although most will reluctantly allow parental refusals on religious and other grounds, and such refusal does not usually engender civil or criminal penalty. The American Academy of Pediatrics opines strongly about the importance of the screening, but it does not control the different conditions screened for by each state. You or your partner can certainly hold and comfort baby during the blood test which hurts for a few moments.

The American Academy of Audiology supports early identification, assessment, and intervention for all types of hearing loss in infants and young children to minimize deleterious effects on speech, language, education, and social/psychological development. The screening should take place by an audiologist at 1 month of age and does not need to be done after birth. It is not an invasive screening and can be done in your room by your side, so if you gave birth at the hospital it can be more convenient doing it there. Or you can take baby to an audiologist by one months of age if you choose the hearing screen.

Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for critical congenital heart disease (CCHD) in newborns, if done within 24 hours after birth. Current evidence supports consistent accuracy for detection of CCHDs in newborns by pulse oximetry screening in addition to prenatal ultrasound and clinical examination. Overall, early diagnosis of CCHD with pulse oximetry is judged to be beneficial, identifying disease that may be treated and lifesaving, and potential harms associated with false-positive tests are not serious, but stressful, while missing CCHDs and other serious diseases detected by hypoxemia without pulse oximetry screening can lead to serious consequences. It is interesting that this is not the position of other institutions such as the United Kingdom National Screening Committee and the Royal College of Pediatrics and Child Health. Further research is required to understand and improve the effectiveness and efficiency of the screening and its algorithm. Some mamas do not want this philosophical standard medical approach of looking for diseases, prefer to address the issue if baby shows signs, and have Divine faith that whatever happens is meant to be.

Medical (non-religious) circumcision is the most controversial routine surgical procedure done mostly in the US on babies with a penis, prior to discharge. The vast majority of boys in world aren't circumcised. There's no evidence to justify this routine procedure on medical grounds & its risks are downplayed. The American Medical Association classifies it as a non-therapeutic procedure, as it has no proven benefits and risks outweigh them. The American Academy of Pediatrics has never, in its over 75 years of operation, recommended routine newborn circumcision. The foreskin is a normal, sensitive, functional part of the body, protecting the head of the penis from urine, feces, and irritation; it also has an important role in sexual pleasure, as it has specialized, erogenous nerve endings, gliding and lubricating functions. For a thorough analysis of the literature, science & research, potential risks & alleged benefits, cultural/religious roots & human rights bioethical issues see here.
THIS ISN’T ABOUT PAST, HOW WE WERE ADVISED MEDICALLY OR CULTURED TO DO. IT’S ABOUT DECISIONS MOVING FORWARD.

I like to promote informed choice, question routine status quo, and help those interested in studying the data and what factors create opinion and dogmatic policies, as well as encourage those who wish to ponder this topic with a more critical eye and make their own decisions about their baby’s health care.

Educate yourself & make an informed decision about what you want or don't want for YOUR baby, with my online Guide to Pregnancy, Birth and Postpartum. And in adjunct, my Natural Birth Secrets book 2nd edition, as in many cases, it is totally safe and appropriate to investigate natural alternatives.

Natural Newborn Care

Congratulations! Having a new baby in the house is such an exciting and wonderful blessing. But, it can also be overwhelming, especially if this is your first or if you’re trying new things with this baby. Below are some tips to help guide you through this special time.

Feeding

Breast is best for you and your baby, but it is a learning process.  Allow a few weeks for the both of you to become pros. Get help from your midwife or lactation consultant as soon as possible if you are having difficulty. Some excellent resources are pediatrician Dr. Jack Newman’s website and his international center, as well as kellymom.com. General suggestions to ease the process are:

  • Nurse baby on demand or every 1-½ to 3 hours while you are awake. If the baby has a 4-6 hour stretch in the middle of the night, let baby sleep.

  • If baby is too sleepy to nurse this often in the beginning, try to rouse by  unswaddling and undressing, a diaper change, a gentle back rub, or a cool washcloth on the baby’s forehead.

  • Nurse one side each feeding. Start the next session on the other breast.

  • Alternate feeding positions between side lying, cradle and football hold.

  • Burp baby as needed if appears gassy during and after feeding.

  • Do not give baby glucose water or common formula, especially while you are trying to get the breastfeeding going. Breastmilk alone, including the ‘liquid gold’ initial breast milk colostrum, is adequate nutrition and hydration for at least the first six months when all is well. The water or formula fills up their tiny stomach so they nurse less, which makes you produce less milk, and the bottle’s teat confuses them and can impair their ability to suck on your nipple. If there are issues and you do need to supplement, pumped or donor breast milk from certified mild banks is the choice method of feeding. If you must give formula, go for the organic brands that most closely resemble breast milk. Use a dropper to the side of baby’s mouth, supplemental nursing system or slow flow nipples that are more similar to the breast.

  • Avoid smoking, alcohol and drugs while breastfeeding. Always consult your practitioner before taking any medications or herbal preparation.

  • Limit caffeinated beverages to no more than 1-2 cups per day.

  • To calm a screaming baby that is too upset to nurse, try:

    • Changing the diaper

    • Burping baby

    • Swaddling baby in a blanket

    • Giving baby a warm bath

    • Cradling or cuddling baby close to your chest

    • Rocking

    • Singing

    • Swinging

    • Talking softly to baby

    • Giving baby a gentle back massage

    • Taking baby for a walk or car ride

    • Holding baby in a position that allows application of slight pressure on his or her abdomen

    • If all else fails, give baby to your partner, take 30 minutes, and try again.

Sleeping

Babies sleep about 18 hours per day.  Place your baby on his or her back, or side to sleep, with baby’s back supported by a rolled receiving blanket.

Bowel Movements and Voiding

Babies have greenish-black, sticky stool for the first few days. This is called meconium.  Breastfed babies’ stool will then become golden-yellow, soft, and seedy-looking. Once your full milk comes in and replaces colostrum, your baby will have 1-4 stools and 6-8 wet diapers in a 24 hour period. Change the baby before each feeding to prevent diaper rash. For a reddened diaper area, use homeopathic calendula, zinc oxide or herbal diaper cream, A & D ointment,  Desitin cream plain or with zinc oxide. French green clay is excellent for diaper rashes. Use talcum free baby powder. Place baby on an absorbent pad and allow periods for baby to be diaper free, or read up on elimination communication - training baby to poop and pee on the potty! 

Cord Care

Keep the cord stump dry by folding the front of the baby’s diaper down. Squeeze a saturated cotton ball of alcohol or hydrogen peroxide to the cord stump three times per day to keep it clean. Open a capsule and apply powdered goldenseal herb or herbal combination cord powder around the base. The cord stump should fall off by itself within 8-12 days after the birth. 

General Care

Wash hands before handling the baby.

Bathe baby with mild natural soap and water, and wash the baby’s hair with a gentle tear-free natural shampoo several times per week (ideally every day – they love it).  

After the first 24 hours and the baby’s body temperature stabilizes, dress him according to the temperature as you would dress. 

Best to file than cut long nails with scissors, so baby does not scratch her/himself.   

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Take the baby for a daily outing, but keep the baby away from crowds and people with contagious illnesses.  

Wear your baby. Experiment with a few baby carriers and see which one you and baby like the best.

Add to your collection The Baby Book by William and Martha Sears, as it is a wonderful “must have” comprehensive reference and guidebook to the baby’s first two years of life and virtually every aspect of care.

If you had antibiotics or baby was born by cesarean, take extra precautions to restore baby’s microbiome (healthy balance of flora).

Safety

It is State law and safe practice that babies ride in car seats every time that they travel in a vehicle. 

Always make sure that the baby is not unattended on changing tables, beds or other high places.   

If the baby sleeps in bed with you, make sure baby is in a sleeping pod or baby lounger, and that the bed has a guard rail. Do not keep pillows, stuffed animals or extra blankets in the baby’s sleeping area.

Danger Signs

Contact your pediatrician immediately if:

  • The baby becomes listless, will not nurse, is inconsolable, has high pitched screaming, or behaves in an unusual way.

  • The baby does not urinate within the first 24 hours, or voids less than 6 diapers per day after your milk is in.

  • The baby has no bowel movement for 48 hours, or has more than 10 watery green, foul-smelling diarrhea diapers per day.

  • The cord starts to smell bad or has pus oozing from it and the area around it becomes red and swollen.

  • The baby’s temperature is below 97 degrees or above 99 degrees when taken under the baby’s arm.

  • The whites of the babies eyes become yellow or the skin color becomes a yellow or tan tinge.

  • The baby’s skin turns blue or white, especially the trunk or around the mouth.

  • Projectile vomiting.

For more tips on newborn care and breastfeeding, read my Natural Birth Secrets Book 2nd edition and take my online course. Need more personal guidance? Schedule a consultation with me.  Many of the reputable brands of remedies I recommend are available in my online holistic apothecary.

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For extra support in relieving common aches and pains, wear an abdominal binder. like Bellefit. They make postpartum support girdles that mamas really love. I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. 

I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

Have a Great Postpartum Recovery (with a little help from Bellefit)!