Wednesday, January 7, 2015

Be Ready to Birth!: things change

Be Ready to Birth!: things change: Every new year, I go back and review what I am passing on to my clients. This year I am concentrating on basic infant care because that seem...

things change

Every new year, I go back and review what I am passing on to my clients. This year I am concentrating on basic infant care because that seems to change so much from generation to generation.I have more and more grandparents joining my young folks to learn what's up with their skills as far as grandparenting is concerned.

So this is what I have produced for Baby Basics this year and I am happy to share:



Diapering is to keep the poops in. Diaper tightly and make sure that the elastic around the thigh is not tucked in. Diapering is used to provide a barrier between the baby’s butt and the poopy diaper. The goal is to prevent diaper rash; not cure it. So, grease ‘em up. Vaseline, Burt’s Bee’s, will work fine. So does Butt Paste, A&D, Desitin  and list goes on. In a pinch, use Crisco. No powder.

Girls have a lot of folds that need to be separated and wiped from front to back. Not to be alarmed, the first few days girls may have mucousy, blood-tinged dicsharge from their vaginas. Boys who are circumcised need a tube of Vaseline and some gauze squares ( you can get those at the hospital ). Put a blob of  jelly on that newly circed penis topped off with a gauze square so it won’t stick to the diaper. It heals in a few days. All diapers need to be tucked under the belly so the cord stays dry. Clean it with an alcohol wipe and keep it open to the air. It heals in about a week.

Babies need to be slept on their back to reduce the risk of SIDS. But that doesn’t mean flat. Try a 45 degree angle for more comfortable sleep and less reflux.

Babies need to burp a lot. More than you can believe. LOUDLY. If they don’t burp up their belly bubbles, they wake up screaming.

I like the ear and axillary thermometers. And light-suction bulbs. And gowns instead of onesies. A mosquito net and a receiving blanket over strollers in any weather. I like duckies that tell you when the temperature of the water is just right. And those little purses stuffed with essentials like safety clippers.

Let your kid get used to sleeping through anything. Run the vacuum, play the TV. Let the doorbells ring, Open the shades. Bark the dog. Dress them inside and out just like you would dress yourself and keep the temperature in your house comfortable for you and the baby will be comfortable too.

No pillows, blankies, stuffed animals, bumpers in the crib. Nothing but a sheet.

Even if you can’t get around to a bath ( not until the cord falls off, but sponge ) clean under the baby’s chin where he doesn’t have a neck. From ear to ear, twice. Lots of stuff gets caught under there.

Sick infants don’t exhibit adult sick symptoms. If you aren’t sure, if your baby doesn’t look right, if your baby isn’t acting like himself. Call the doctor. Report a temperature from where it was taken. Emergencies go to Children’s Healthcare of Atlanta.

This is your baby. You belong to it. You have to keep it. Learn how to slow down and watch and listen to it. They are gone before long. One day something may work and the next, not at all. Make mistakes. Make it up. Remember my absolute rule: You mst feed your baby.

And when that little stinker pushes you to your wits end, put the baby on the floor ( can’t fall off it ) and walk away from the scene. Remember to take a few deep breaths and

Wednesday, December 17, 2014

Be Ready to Birth!: Busy

Be Ready to Birth!: Busy: WE are all very busy this end- of -year and holiday time. Pretty poor excuse for not blogging more this year! Please allow me to remind you ...

Busy

WE are all very busy this end- of -year and holiday time. Pretty poor excuse for not blogging more this year! Please allow me to remind you that just about anything you want to learn or hear from me can be easily found in five years of archives at readybirth.com.

My best holiday present is usually a trip far away to off- the- beaten- path places learning about culture and history and how women live, work and birth and parent. I put that present on hold and plan for a few interesting trips later this year. I have a partner of over a year who likes December in Atlanta so in deference to him, I am staying close to home. It gives me pleasure to make him happy and there has been a bonus in it! Hanging around with my grandchildren as the season's frenzy mounts has been lots of fun even though I have purchased more gifts for everyone than I normally would!!

Another big surprise has been the radio interview I did 12/16/14 with follow up from the show today:
I just got a call from NYC from Scotty the producer of the show I spoke on yesterday morning. He wanted to give me my "stats". 926,000 people listened for the entire interview which means 91% of their listeners stayed with me the entire time I spoke. My rating was a whopping 5.2 as compared to their average of less than 2! Maybe I'll get to be Dr. Ruth before I retire! Everyone should be able to tune in to www.wrnw.1 in 24-48 hours to hear the recording.

So all in all it has been a good year for me and I hope that you all can say the same. With the volatile stock market and ISIL and planes mysteriously disappearing and North Korea threatening destruction for SONY and a lot of Christmas movie goers, the beat goes on and the world still spins; reminding us of what's really important and also of what we cannot begin to control.

It's those random acts of kindness, rescuing that one starfish on the beach that make the world a better place. We all need to focus on peace, goodwill, kindness and love to see us through 2015 and beyond.
Best greetings for clean air, clean water and most especially food for everyone on earth. Wishing everybody a great new year.

Wednesday, September 24, 2014

Be Ready to Birth!: Happy New Year 5775

Be Ready to Birth!: Happy New Year 5775: I try to remember to blog at important times on the calendar. I have posted this on Readybirth's Timeline on Facebook as well, so I apol...

Be Ready to Birth!: Reprint from the CDC

Be Ready to Birth!: Reprint from the CDC: Hello. I am Dr. Wanda Barfield, Director of CDC's Division of Reproductive Health. I'm pleased to speak with you as part of the C...

Reprint from the CDC

Hello. I am Dr. Wanda Barfield, Director of CDC's Division of Reproductive Health. I'm pleased to speak with you as part of the CDC Expert Commentary series on Medscape. Today let's consider what some say is the overuse of cesarean section (C-section) deliveries. In the United States, C-sections declined slightly in 2013 to 32.7%, a decline of only 0.2% since 2009.
Much public and professional attention is being given to deliveries known as "elective C-sections." In some circumstances, these are procedures performed with no medical indication. In other cases, C-sections are performed on a woman's request. We understand that some women request a C-section because it gives them a firm date for childbirth and a schedule for maternity leave.
As a nation, we are seeing a very modest reduction in C-sections. What is behind this decline? We believe that healthcare professionals are adopting the American College of Obstetricians and Gynecologists guidelines.[1] These guidelines discourage the use of elective C-sections prior to the 39th week of gestation. We also believe that consumer awareness campaigns are reaching families with messages promoting full-term deliveries. One example is the March of Dimes' Healthy Babies Are Worth the Wait campaign asking women to "wait until 39 weeks."
Let's be pragmatic. C-sections are surgical procedures that pose risks. There are cases when the risks associated with the procedure will outweigh other potential maternal and perinatal risks and consequences. In the end, we all want a healthy infant to be delivered into the waiting arms of a healthy mother and family.
I know you wonder why we are presenting this commentary. CDC is one of many organizations throughout the country working to improve maternal and infant health. Let me talk for a minute about what CDC is doing that is of interest to providers.
First, there are state-to-state variations in rates of non-medically indicated C-sections. Indeed, there are variations even within states when looking at rates in specific medical facilities. This shows that there is no systematic pattern of decision-making about C-sections. It may even suggest that the differences are based on the decisions of providers and provider groups.
Second, a 2007 article published in the American Journal of Obstetrics and Gynecology [2] further supports this observation. The investigators found that these variations within geographical locations were random. They attributed this to a lack of standardized decision-making and a lack of appropriate tools for making these decisions at the patient's bedside.
Third, our partners in public health and medicine reviewed information about outcomes in both maternal and infant health. After reviewing evidence and examples of best practices, CDC decided to launch an evidence-based program promoting perinatal improvement collaboratives. We believe that collaboration between clinical providers and public health officials is a means to improve decision-making for patient care. It's an excellent example of how clinical practice and public health interact to improve health outcomes.
Our project partners are bringing many things to our attention. For example, they saw that Utah's Intermountain Healthcare System – which represents about half of all hospital beds in the state -- used quality improvement processes that significantly reduced the rate of C-sections. Changes in institutional policies and practices can result in an example of a "best practice." We also know that research by CDC and others found that C-sections without a medical indication resulted in some infants needing care in the neonatal intensive care unit.
Today, please consider how you might bring about changes in your organization or in your own practice. We now offer webinars through our Division's Perinatal Quality Improvement project with the most recent data and suggestions for taking action. You can participate in live webinars during which leaders discuss examples of successful activities and programs. You are also able to view archived webinars, offering you an option that fits with your busy schedule. We believe that working with others in your area or state to reduce the overuse of C-sections will help all meet the needs of patients while providing high-quality care.
We understand public perceptions about so-called "financial incentives" to perform C-sections. Yet, we also know that C-sections, when medically indicated, are a time-honored means of saving lives. But when we can reduce risks, we must do so.
I'm a neonatologist. I work with many fine obstetrical and maternal-fetal medicine specialists who know the consequences of preterm birth. I want women to take home full-term and healthy babies to their families. Infants who do not have the benefit of vaginal delivery are at risk for retained fetal lung fluid and respiratory distress. We can change the number of women who face days and nights sleeping on a recliner in our nation's neonatal intensive care units. I urge you to consider how we, together, can make a difference.
Thank you for your attention to this important area where public health meets clinical practice.