Monday, March 29, 2010

Lifestyle: Shaken babies: Alternatives to anger

Inconsolable crying is the most frequently reported reason by caregivers for losing control with a child, Green said.

And it only takes a few seconds for the damage to occur.

“Because of a baby’s relatively heavy head and weak neck muscles, shaking makes their fragile brains bounce back and forth inside the skull and causes bruising, swelling and bleeding,” she explained.

Symptoms can vary from mild to severe and include loss of consciousness, lethargy, extreme irritability, decreased alertness, pale or bluish skin, vomiting, convulsions and no breathing.

Hope Galantino, clinical educator for labor and delivery at Washington County Hospital, said shaking an infant usually comes about out of frustration at not being able to soothe a fussy baby.

“When a baby starts to cry, many parents think their child is crying for a reason,” Galantino said. “But many infants cry for no reason.”

This is identified as PURPLE crying by the National Center on Shaken Baby Syndrome.

The term PURPLE, Galantino said, is an acronym intended to help caregivers recognize when this type of crying is occurring. (See box at left.)

Green said inconsolable crying is most common in babies up to five months.

As the parent becomes frustrated in trying to soothe the baby, she said, he or she reaches a breaking point and that breaking point triggers violence.

“We want parents to know that it’s normal for babies to cry,” she said. “But when the pressure gets to you, find someone else to give you a break. If there is no support system, it’s important to know that it’s OK to put the baby safely in the crib and take a few minutes to collect yourself.”

Galantino said there is no socioeconomic, age, racial or cultural group more likely than another to shake their babies.

Parents who are unable to stop their children’s crying have one thing in common: feeling inadequate.

Giving parents the tools

In an effort to educate parents, Galantino said members of three local chapters of the Exchange Club worked together about one year ago to secure more than 1,000 DVDs called “Did You Know Your Baby Would Cry Like This.” The videos were obtained from the National Center on Shaken Baby Syndrome and given to the Washington County Hospital’s Family Birthing Center to pass on to new parents.

The hospital purchased an additional 1,100 copies of the DVD so they would be able to give a copy to every new parent over the next year, Galantino said. 

Green said the video emphasizes steps parents can take to comfort their crying babies. The most important step, she said, is easy to remember: Never shake or hurt a baby.

It’s also important, she said, to always check with your doctor to see if there is something wrong that is causing the crying.

Parents are encouraged to watch the video before leaving the hospital, Green said. The staff is then available to answer any questions parents or caregivers might have before they take their babies home. They also are urged to show the DVD to anyone who will help take care of the baby. 

“Hopefully, the DVD will make a difference,” Galantino said. “We can talk to people about not shaking their baby. We teach it. But there is no impact like watching the DVD. It’s a more effective way of reaching parents.”

Green said staff members have taken the DVD out into the community to further raise awareness about abusive head trauma. She also noted that pediatricians are aware of the DVD and have the ability to go online to purchase it.

“It’s our hope that these DVDs will save innocent lives,” she said.

Ways to comfort a baby:

• Meet the baby’s basic needs. Check to see if he is sleepy, hungry, needs burping, needs changing or is too hot or cold.

• Rock, walk, sing or dance with the baby.

• Give the baby a warm bath.

• Take the baby for a walk in a stroller or for a ride in the car.

• Hold the baby close to you with skin-to-skin contact. Breathe slowly and calmly. The baby may feel your calmness and become quiet.

• Lower any surrounding noise and lights.

These ideas won’t work every time, but they may be able to reduce crying by about 50 percent. Remember: You should always check with your doctor to see if there is something wrong that is causing prolonged crying.

— Provided by the National Center on Shaken Baby Syndrome

For more information on PURPLE crying, visit the National Center for Shaken Baby Syndrome Web site at www.dontshake.org.

PURPLE:

P: peak of crying

U: unexpected

R: resists soothing

P: pain-like face

L: long-lasting

E: evening, which is when this type of crying more commonly occurs.

— National Center on Shaken Baby Syndrome

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Monday, March 22, 2010

Review

My midwifery review yesterday was much more affirming than my previous one. I welcome the awesome future I get to create one step at a time.

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Sunday, March 14, 2010

Too Many Women Dying in U.S. While Having Babies: http://ow.ly/1iMfH (via @Joyce_Johnson)



Too Many Women Dying in U.S. While Having Babies










Daniel Allan / Photodisc / Getty Images

Amnesty International may be best known to American audiences for
bringing to light horror stories abroad such as the disappearance of
political activists in Argentina or the abysmal conditions inside South
African prisons under apartheid. But in a new report on pregnancy and
childbirth care in the U.S., Amnesty details the maternal-health care crisis
in this country as part of a systemic violation of women's rights.

The report, titled "Deadly Delivery," notes that the likelihood of a
woman's dying in childbirth in the U.S. is five times as great as in Greece,
four times as great as in Germany and three times as great as in Spain.
Every day in the U.S., more than two women die of pregnancy-related causes,
with the maternal mortality ratio doubling from 6.6 deaths per 100,000
births in 1987 to 13.3 deaths per 100,000 births in 2006. (And as shocking
as these figures are, Amnesty notes that the actual number of maternal
deaths in the U.S. may be a lot higher, since there are no federal
requirements to report these outcomes and since data collection at the state
and local levels needs to be improved.) "In the U.S., we spend more than any
country on health care, yet American women are at greater risk of dying from
pregnancy-related causes than in 40 other countries," says Nan Strauss, the
report's co-author, who spent two years investigating the issue of maternal
mortality worldwide. "We thought that was scandalous." 

Full article at: http://ow.ly/1iMfH

Amnesty International report at: http://www.amnesty.org/en/library/info/AMR51/007/2010/en


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The WHO Child Growth Standards

Thursday, February 11, 2010

nzmidwife@gmail.com sent you a link to content of interest

nzmidwife@gmail.com sent you a link to the following content:

New Born screening 2
http://www.homebirth.net.au/2010/02/new-born-screening-2.html

The sender also included this note:

Watch Gattaca for the sci-fi version of the end result of testing. DNA from the metabolic screen has been used in NZ for court cases. I usually remember to tell parents they can request the test card back.

Posted via email from nzmidwife's posterous

Osteopathic care may ease late-pregnancy back pain | Reuters

Osteopathic care may ease late-pregnancy back pain

Wed Feb 10, 2010 3:17pm EST

NEW YORK (Reuters Health) - Gentle manipulation from an osteopathic doctor may relieve late-pregnancy back pain that frequently hinders bending, lifting, or walking, findings from a small study hint.

Health

Doctors in osteopathic medicine (DOs) are medical doctors additionally trained in gentle manipulative techniques to help restore function, range of motion, and lessen pain in bones and adjoining muscles supporting the neck, back, chest, shoulders, and hips.

Osteopathic manipulation may particularly benefit pregnant women seeking medication-free back pain relief, note Dr. John C. Licciardone and colleagues at University of Texas Health Science Center in Fort Worth.

The study, in the American Journal of Obstetrics and Gynecology, included 144 otherwise healthy pregnant women, about 24 years old on average, with moderate levels of back pain and related movement difficulties during late pregnancy.

The women were randomly assigned to one of three groups: usual obstetric care only, usual obstetric care plus weekly 30-minute osteopathic manipulation treatments from the 30th week of pregnancy through delivery, or usual obstetric care plus sham ultrasound skin stimulation sessions.

Over the course of the study, women in the osteopathic group reported improved back pain and related symptoms, Licciardone noted in an email to Reuters Health. The sham ultrasound group reported no pain improvement and those in the standard care group reported increased pain. However, none of these differences were statistically significant.

Late pregnancy back-related movement problems generally worsened until delivery, but did so to a lesser degree in the osteopathic manipulation group.

Overall, these results suggest osteopathic manipulation may compliment conventional obstetric care, Licciardone and colleagues conclude. They call for further, larger investigations to assess the benefits and costs of this form of combined care.

SOURCE: American Journal of Obstetrics and Gynecology, January 2010

Nice to know research is reiterating what we already know and suggest to pregnant women.

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Wednesday, February 10, 2010

Age of mother affects child's autism risk: study | Reuters

Age of mother affects child's autism risk: study

CHICAGO
Mon Feb 8, 2010 5:35pm EST

CHICAGO (Reuters) -

Being an older mother significantly increases the risk of having a child with autism, but being an older father only increases the risk when the mother is under the age of 30, U.S. researchers said on Monday.

Health  |  Lifestyle

They found that a 40-year-old woman's risk of having a child later diagnosed with autism was 50 percent greater than that of a woman between 25 and 29.

But being an older father -- 40 or older -- only contributes significantly to autism risk when the mother is under 30.

"The older the mother, the more the risk that the child will develop autism, regardless of whether the father is young or old," said Irva Hertz-Picciotto of the University of California Davis MIND Institute, who worked on the study published in the journal Autism Research.

The findings contradict a 2006 study of children born in Israel that suggested paternal age played a much larger role.

"There has been a debate over whether it is maternal or paternal risk. A lot of people were thinking it's not really mom's age," Hertz-Picciotto said in a telephone interview.

Researchers and policymakers are increasingly looking for causes to explain the growing numbers of children diagnosed with autism, which affects 1 percent of U.S. children.

There is no cure for autism, a spectrum of diseases ranging from severe and profound inability to communicate and mental retardation to relatively mild symptoms such as with Asperger's syndrome.

The current study, which incorporates data on 4.9 million births and 12,159 autism cases in California, helps to clarify the contribution of age from both parents.

"We have such a very large database we were really able to disentangle the mother's age very well," Hertz-Picciotto said. This can be a challenge because older mothers and fathers tend to have children together.

"We found it does vary for the father, but not for the mother," she said.

For example, among babies born to mothers under 25, children whose father was over 40 were twice as likely to develop autism as those whose father was between 25 and 29.

This could be because when both parents are older, the risk conferred by the father is outweighed by the risk from the mother, Hertz-Picciotto said.

OLDER PARENTS

She said the point of the study is not to blame parents, but to gain clues about what is going on in older parents that could increase a child's risk of developing autism.

Older parents, for example, are more likely to have infertility problems and have used fertility treatments; the mothers are more likely to have autoimmune conditions, including gestational diabetes; and both have accumulated more toxins over their lifetimes, so the sperm and egg are more likely to have some changes that could increase risk.

"We see these age findings as clues for where to look next," Hertz-Picciotto said.

Autism researchers are looking at a broad range of potential environmental factors, including household products, medical treatments, diet, food supplements and infections.

And the National Institute of Mental Health, one of the National Institutes of Health, is looking at potential genetic causes of autism and has plans to sequence the entire genomes of hundreds of children and their parents to gain a better understanding of the role genes play.

(Editing by Cynthia Osterman)

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