Tag Archives: breastfeeding

2. The Infant

Why Breast is Best, and What Needs to Change in Society to Better Support Mothers

2 Comments

By Christina Podolak

Breastfeeding

For most of our human existence on earth, mothers have fed their babies breast milk. Within the last 100 years, mothers had another option for feeding their babies: formula.

Mothers today are faced with the decision whether to formula feed or breastfeed their babies. Six years ago, I was one of those mothers. I was pregnant with my first child and went in for my first prenatal check-up. My doctor asked if I planned to bottle-feed or breastfeed my baby, and I didn’t hesitate to answer — breastfeed. The topic was never mentioned after that visit.

Why Breastfeed?

When asked a few years later why I wanted to breastfeed, I didn’t have a clear answer. I was aware of some of the health benefits to my infant, but formula processed from the milk of a cow or soybeans just didn’t seem natural or healthy. The cost savings was an obvious benefit, but I also had great breastfeeding role models in my family. My three older sisters as well as my mother had chosen to breastfeed through the first year of infancy. It wasn’t until I heard Dr. Jeanne Stolzer talk in Lincoln, Nebraska, in April 2009 that I fully understood the broad range of benefits available to my baby and me by choosing to breastfeed.

Stolzer is an associate professor and researcher of family studies at the University of Nebraska at Kearney. After hearing her talk about the overwhelming body of scientific evidence supporting breastfeeding, I couldn’t understand why if a mother was educated with this information, she would still choose formula without some sort of circumstance that would make breastfeeding medically impossible for either her or the baby. My concept of the importance of breastfeeding to the mother as well as the child was solidified. It made me feel even more passionate about sharing and education other mothers on the many benefits of breastfeeding.

Research is finding lifetime benefits for both the breastfeeding mother and baby. These benefits are a dose response-specific variable. This means that the outcome is different for each mother-child pair and is associated with the amount, intensity, and duration of the nursing experience. It can be compared to two persons, a regular drinker and a non-drinker: They can be given the same amounts of alcohol for the same length of time, but if one is used to drinking on a regular basis, he won’t be affected as much as the non-drinker. The specific breastfeeding benefits are affected by the amount of milk given, how long the nursing relationship is, and the intensity of nursing sessions. Research has found that the following health benefits to the mother included a reduced the risk for:

  • Type I and II diabetes
  • Anxiety
  • Mood disorders
  • Osteoporosis
  • Breast, ovarian, and uterine cancer
  • Depression rates
  • Cholesterol.

The baby benefits from an overall reduced risk of death from all causes. Research has also found many more lifetime benefit for the baby which includes a reduced risk for:

  • Upper and lower respiratory infections
  • Ear infections
  • Bacterial infections
  • Urinary infections
  • Asthma and allergies of all types
  • Diarrhea
  • Skin disorders
  • Type I and II diabetes
  • Celiac and bowel disease
  • Cancer, especially lymphoma and leukemia.

Stolzer shared the statistics of health care savings by breastfeeding alone: $3.2 billion dollars would be saved on health care if all Americans breastfed for six months.

Getting This News to Mothers

The challenge is providing the needed education to new mothers still on the fence about breast or bottle-feeding, as well as eliciting positive support from medical staff. I think back to own experience with my first pregnancy. I wasn’t offered any information from my OB/GYN at my prenatal visits. I agree with Stolzer in that our hospital protocol needs to be changed. All hospitals need to go to the Baby Friendly guidelines and not offer any formula samples or pacifiers.

There also needs to be better prenatal education for the mother and father. This would include a class on breastfeeding as commonplace as childbirth classes, for both parents, so each would know what to expect and how to handle any possible challenges.

A Need for Cultural Acceptance

Better role models for breastfeeding on the cover of magazines and on television shows would be “worth a thousand words” toward building public acceptance for a practice that is as natural to a baby as crawling. How many times has a mother been shown breastfeeding a baby? Not many. There is always a bottle in the baby’s mouth. Rather than baby bottles being the symbol of “babyhood,” an infant wrapped in the warm embrace of his mother would prevail.

Generations of Change

How do we get women to realize the numerous benefits of breastfeeding? I believe education and ongoing support through the first difficult weeks of breastfeeding would move our culture to a time where a majority of women instinctively answer, “Breastfeed my baby, of course.” In the hospital where I delivered my three children, I have found that the doctors dictate protocol, and it can be intimidating to challenge the “expert.” But consider how births have changed in one or two generations. I can’t imagine being unconscious for my deliveries. It takes just a few mothers to intelligently challenge the way doctors choose to educate their patients. Then we can get back to 100 years ago when the majority of mothers breastfed their happy, healthy babies.

Discuss this topic with other API members and parents. Get advice for your parenting challenges, and share your tips with others on the API Forum.

1. Pregnancy & Birth, 2. The Infant, The Editor's Desk

AP is Good for Mom, Too

Leave a comment

By Rita Brhel, managing editor and attachment parenting resource leader (API)

AP is Good for Your Emotional Regulation, TooExperts and parents agree – telling and retelling of a birth story is vital for a woman to overcome an emotionally traumatic birth. But there is certainly something to be said for the power of parenting in an attachment-promoting way in healing a mother’s feelings of disappointment, guilt, anger, and other strong and often confusing emotions that may surround her child’s entry into the world.

Women who are struggling with their emotions are not only grieving their lost dreams of what they had hoped for their labor and birth experience, but may also be battling with feelings of guilt and inadequacy as a mother. While we must take time to fully grieve our birth experiences, we must also find a way to move forward. It can be very fulfilling, and healing, to channel the strong emotions surrounding our child’s birth into caring for her in a loving, positive, attachment-promoting way. Just as a hobby or a phone call to a friend can give a release for our strong emotions in a healthy way, so can we heal through our parenting.

It must be noted, though, that by healing through our parenting, I do not mean that we transfer our strong emotions to our baby or that we attach onto our child in any other way than an appropriate parent-child relationship. What I’m referring to is using parenting as a healthy outlet for women to move forward. Harville Hendrix, PhD, and Helen LaKelly Hunt, PhD, explain this in their book, Giving the Love that Heals.

“In a conscious marriage, partners grow when they stretch to meet the needs of the other, and they heal when their needs are met by their partner,” they write. “The process is mutual. In marriage, it is appropriate for a partner to grow by meeting the needs of the other partner, but it is not appropriate for a parent to try to heal by having the child meet his needs. The process for parents and children is not mutual. The parent must heal his childhood wounds in an adult relationship and not in his relationship with his child.”

However, while healing through the parent-child relationship is not synonymous with the adult-adult relationship, Hendrix and LaKelly Hunt acknowledge that parenting can be a pathway to personal healing.

“The sense in which marriage can be healing is that partners restore their own wholeness when they stretch to meet each other’s needs, giving to the other what is often hardest to give,” they continue. “The sense in which parenting can be healing is that parents restore their own wholeness when they stretch to meet the needs of their children at precisely those stages at which their own development has been incomplete. Through marriage and parenting, partners and parents can recover parts of themselves that have been lost. Both marriage and parenting give people the chance to receive for themselves what they give to their partner or child. They get what they give. In this way, both marriage and parenting can be transformational, because the healing experiences these relationships can provide will change the very character of the people involved.”

Healing from birth trauma is, of course, not the same as healing from childhood wounds, but this excerpt is illustrative of the difference between a parent inappropriately leaning on her baby to provide emotional comfort and a parent appropriately using parenting her baby in an attachment-promoting way as an opportunity to heal through giving to another.

Virtually all Attachment Parenting (AP) practices can help a mother heal from her birth trauma by promoting a close, positive relationship between her and the baby, but there are a few that research has shown to be especially beneficial to the new mother – perhaps not in magically healing emotional trauma but in providing an atmosphere supportive of a mother’s own efforts in healing.

Breastfeeding

Breastfeeding is particularly powerful in jump-starting the mother-baby attachment bond. Attachment Parenting International (API) Co-founders Barbara Nicholson and Lysa Parker describe breastfeeding as the ideal model of attachment in their book, Attached at the Heart, for sale here. There are myriad benefits for the baby and mother, in regards to health and attachment, but what about helping mothers’ emotional well being?

Read API’s review of Attached at the Heart here.

“Breastfeeding triggers the release of the attachment-promoting hormone oxytocin into the mother’s body,” Nicholson and Parker explain. “Often called ‘the mothering hormone,’ oxytocin has a calming effect on both mother and baby. “

Futhermore, “research in depression is showing a correlation between lower levels of certain hormones in mothers who experience depression, so it appears that anything we can do to increase levels of these natural hormones may be a powerful aid in prevention,” Nicholson and Parker write.

Health psychologist and API Resource Advisory Council and API Editorial Review Board member Kathleen Kendall-Tackett echoed this research in her 2007 International Breastfeeding Journal article, “A New Paradigm for Depression in New Mothers: The Central Role of Inflammation and How Breastfeeding and Anti-inflammatory Treatments”: “…although women experience many stressors in the postpartum period, breastfeeding protects them by inducing calm, lessening maternal reactivity to stressors, and increasing nurturing behavior. …breastfeeding can protect mothers’ mental health and is worth preserving whenever possible.”

Responding with Sensitivity & Providing Consistent, Loving Care

Lack of sensitivity toward the baby is a hallmark effect of a mother who is dealing with emotional issues, but a mother who focuses on responding appropriately and quickly to her baby’s cries can improve her mood by reducing how much her baby cries. Nicholson and Parker explain that parents need to respond to their baby’s pre-cry cues; by waiting until the baby is crying, he will be much more difficult to console. Babies are not born with the ability to regulate their strong emotions – they rely on their caregivers to do this for them by responding quickly, appropriately, and consistently.

We don’t need a research study to show us how stressful it can be to listen to our child’s unrelieved cries, but I did want to share one study’s conclusion included in Attached at the Heart. According to a 1995 Pediatrics article, “Developmental Outcome as a Function of the Goodness of Fit Between the Infant’s Cry Characteristics and the Mother’s Perceptions of Her Infant’s Cry,” mothers who responded consistently and appropriately had higher self esteem than did mothers who were inconsistent in the responses to their baby’s cries.

In addition, “mothers who feel low, depressed, anxious, exhausted or angry, who have relationship problems with their partner, or who feel strongly rejected by their baby’s crying are more likely to have a baby who cries excessively,” according to Dr. Gillian Rice in his Netdoctor.co.uk article, “Why Do Babies Cry?” “This isn’t to say that the mother’s feelings caused her baby to become a frequent crier, but they may be a factor in perpetuating the baby’s crying.”

Nurturing Touch

Especially for mothers who are unable to breastfeed, nurturing touch stimulates the mother’s body to also release oxytocin.

“The good  news for a mother or caregiver who is not breastfeeding is that she can still receive oxytocin benefits from holding the baby skin-to-skin, and also by giving and receiving nurturing touch through massage and gentle caress,” explain Nicholson and Parker.

Louis Cozolino suggests through his book, The Healthy Aging Brain, that new mothers add nurturing touch as part of their regular infant care techniques, not just for the baby’s benefit but for their own mental health.

“Studies have found that teaching depressed mothers to massage their infants increased the amount of touching and bonding time between them, and decreased levels of stress hormones in both infants and mothers,” he writes. “The infants showed increased alertness, emotionality, and sociability, and they were easier to soothe. Touching their children not only activated smiles and positive expressions on the part of the infants, but also made the mothers feel happier and more effective.”

Cosleeping

I am amazed of how healing it can be at all stages of parenting to sleep in proximity of my children. For the new mother, cosleeping reduces stress and improves sleep by having the reassurance that the baby is nearby and safe as well as the convenience of caring for the baby in the same room rather than in another part of the house.

A study detailed in Sharon Heller’s book, The Vital Touch, describes how “mothers slept slightly better and slightly longer when their babies stayed with them.” Heller goes on to explain how a mother’s instinct is to protect her baby and separation and crying is contrary to this instinct – arousing a mother’s natural impulse to correct the situation.

“From a purely practical standpoint, parents report that they get more sleep with fewer interruptions when the cosleep,” write Nicholson and Parker. “They don’t need to get up to attend to baby’s needs, which keeps parents from having to wake up fully during feedings.”

Cosleeping enhances early mother-baby bonding, because nighttime parenting allows the mother to continue responding with sensitivity around the clock through breastfeeding, nurturing touch, and consistent and loving care.

“Babies feel warm, secure, and protected; therefore, they fret and cry less,” they continue. “Mothers worry less about their infants at night when they can reach out and touch the baby.”

Balance

Striving for balance between our personal and family lives is a must when seeking ways to decrease stress on new mothers and improve mood. Though it may not seem so, AP practices are in many ways just as helpful to maintaining balance in the mother’s life as they are in being compassionate and nurturing to the baby. AP practices aren’t solely for the child’s comfort – mothers receive hormonal benefits through breastfeeding and nurturing touch, more sleep through cosleeping, and reduced stress from crying through responding with sensitivity and providing consistent, loving care.

Still, especially for the first-time mother or for mothers who are going through a difficult postpartum recovery, balance can be an elusive goal. The key is to rely on others for their help in taking care of you. Postpartum Support International names social support as one of the most effective factors in prevention and treatment of postpartum depression. This social support may come in the form of your spouse, mother, friend, local API leader and API Support Group, or even through the virtual connection through the API Forums.

Nicholson and Parker describe the crucial importance of balance in a new mother’s life in Attached at the Heart, warning that “without support and other resources, we are taking a big risk for our children and ourselves. Margot Sunderland addresses the critical issue of stress and balance from a brain chemistry perspective in her power book, The Science of Parenting. She describes the positive effects of the hormone oxytocin and its role in helping calm all human beings. We are designed to help provide emotional regulation for children and each other. When a parent is alone most of the time without other caring adults to talk to, stress hormones rise, feelings get out of balance, and irritability and anger lash out.”

Sunderland’s advice: Mothers need to seek out nurturing touch from their partners, which triggers the release of oxytocin, which then gives a warm, calm feeling. And a sense of balance.

If you’re partner isn’t available or if you’re a single parent, talking to empathic friends can provide a much-needed outlet for stress. Other activities that can give you that oxytocin release include: meditation, acupuncture, massage, physical affection, yoga, warm bath, spending time in the sun or bright artificial lighting.

Discuss this topic with other API members and parents. Get advice for your parenting challenges, and share your tips with others on the API Forum.

1. Pregnancy & Birth

What Goes into a Family-Centered Cesarean Birth Plan

8 Comments

By Connie Banack, CCCE, CPD, CLD, reprinted with permission from International Cesarean Awareness Network, © ICAN-online.org

C-section birth plan basicsFamily-centered birth is used to describe a birth that is more family oriented, allowing the new family to experience their birth more fully. Many believe that this cannot apply to a surgical procedure. This is not true. Even with a Cesarean surgery, you can have a family-centered birth if you know your options and choose to apply them. Some of the options will be the same as for a vaginal birth. You may have to work harder to have a family-centered birth in the event of surgery, but planning ahead — even if you don’t foresee a Cesarean — can go a long way. Make a birth plan! They won’t know what is important to you unless you let them know, and a birth plan is actually a legal contract as it is providing your wishes in a document provided to your birth team.

Very few women would choose a Cesarean for their birth experience. However, it is important that every pregnant woman is aware of the procedures that surround a Cesarean section. This will give those who do birth by this process more choices and hopefully less fear.

A Word about Doulas

The continuous support of a doula has been found in numerous scientific trials to positively affect obstetric outcomes and the women’s satisfaction with their birth experiences. Many women and couples choose to have a doula because they want and need this extra assistance. During labor, an intense bond develops between the doula and the couple, and if a Cesarean becomes necessary, it is very distressing for the woman to have to choose only one person to be with her. Mothers will hire doulas even during a scheduled Cesarean birth to provide the consistent professional support a doula provides.

A 2001 article by Penny Simkin, “Doulas at Cesarean Birth,” details the benefits of a doula during a Cesarean, which include:

  • Doulas are familiar with Cesareans and do not find them upsetting.
  • The doula’s familiar presence can calm and reassure the mother who is likely to be very frightened and worried.
  • The doula can reassure the partner, who is also likely to be worried and frightened.
  • The doula can explain what is happening.
  • Once the baby is born, the partner usually goes to see the baby, leaving the mother’s side. The doula remains with the mother, tells her what the baby is doing, and helps the mother feel less alone.
  • The doula goes to recovery with the mother. If the partner has gone to the nursery with the baby, the mother still has a support person with her.
  • The doula does not get in the way or behave inappropriately.

Check with your doctor to see if your doula is allowed into the operating room and recovery to support you.

Birth Plan Preparation

In preparing a birth plan, each point needs to be discussed with your caregiver, even if he may not be at your birth. He will be able to tell you if what you would like is an option with him or at the hospital you have chosen. Start early and discuss a few points each prenatal visit rather than trying to cover every point in one or two visits. This will help you in providing more time for questions about each point and reduce confusion for both you and your caregiver.

Communication is vital in learning about philosophy, options, and rapport. A good way to communicate with your caregiver in putting together a birth plan that will be read and followed is through the “Who’s the Boss?” Method:

  1. Acknowledge provider’s expertise
  2. Add personal information
  3. Listen and consider
  4. Summarize
  5. Respond in appreciative and authoritative mode.

Example:

  • You: One of my friends was telling me about avoiding post-operative pain medications just after her baby was born, which made her fall asleep, and I wanted to get your professional opinion on the subject.
  • Doctor: Routinely, a pain medication is given to you after the baby is born to help you relax during the long suturing process, which can take up to an hour. It can make you sleepy or even relax you enough to put you to sleep. You can then wake up refreshed when you meet your new baby.
  • You: Is it possible to ask not to have this given?
  • Doctor: Absolutely.
  • You: OK. Thank you for discussing that with me. Now I understand, and I’ll think about what you said before I decide.

When writing your plan, start by introducing yourself through a prologue. This provides a familiar base on which to build a rapport with your nurses and attending caregiver. This is followed by your wishes, which have been discussed with your doctor prior to your birth. Point form is the most efficient way to list these, as you don’t want your birth team to become mired in your plan looking for a lost point. Wording is crucial in a birth plan. It can make all the difference between a supportive or hostile atmosphere during your birth. Yet it is also a legal document.

“The language ‘I do not consent’ may sound harsh but, in fact, is the only statement that has clear legal power so I encourage you to use it for things that you feel strongly about,” emphasizes Gretchen Humphries, editor of BirthTruth.org. “If someone does something to you after you state that you do not consent to it, legally they have committed assault and battery on you. Hospitals are well aware of this, but they assume you are not.”

Make your birth plan short, preferably one page long. Include only those points most important to you. Providing two plans, one for birth and one for your new baby, is an excellent way to ensure that both you and your baby are cared for as you wish. The birth plan stays with you, and the newborn plan goes with your baby if he not able to stay with you. Have several copies with you and give it to everyone involved in your Cesarean. And finally, after you have finished discussing the points with your caregiver, consider having him sign it. This helps ensure that it will be read and followed during your birth.

Basics of a Family-Centered Cesarean Birth Plan

  1. Prologue — Most nurses and doctors appreciate a prologue to a birth plan. A prologue introduces you to your birth team and can give insight into the choices you have made in the plan itself. For instance, parents who have had a former general anesthesia Cesarean experience could include this in the birth plan as an explanation as to why they are choosing an epidural for this birth.

Example:
We understand that there are times when a Cesarean delivery is in the best interests of the mother and infant. We also understand that Cesarean delivery, as a surgical procedure, is common and even routine in most maternity centers. However, we would ask that the staff respect that this individual surgery is a unique and never-to-be-repeated event in the life of our family. For us, it is neither common nor routine, but rather is an event that will have effects lasting a lifetime. We have already experienced the Cesarean delivery of our sons and, because of that, have certain requests and requirements to be taken into account.

  • Pre-operative Preparation — If an elective Cesarean is necessary, then you should request that you be able to begin labor naturally before the Cesarean is done. That is, you do not want a date and time preset; you wish for your baby to decide the day on which it is ready to be born to avoid any problems with prematurity and for both of you to reap the benefits of your hormones. It is also important for your benefit in both recovery and in establishing your breast milk. Labor signals your body to start producing breast milk about two to three days after your baby is born and this is thwarted when baby is removed surgically without labor, often prolonging the production of milk by several days. If a scheduled Cesarean must be performed, then you should request preoperative blood work and tests to be done on an outpatient basis, and hospital admission on the day of the birth not the night before. There are several preparation procedures that are done before you enter the operating room such as establishing an I.V. and giving a bolus of I.V. fluid, placing the epidural catheter and ensuring adequate anesthesia, inserting a urinary catheter, checking of vitals (blood pressure, heart rate, temperature), and checking fetal heart tones. There is no reason why you cannot have your partner and others there to comfort and support you during any of them. One procedure specifically, inserting the urinary catheter, can be quite uncomfortable and many mothers recommend delaying the insertion until after the epidural or intrathecal is in place.

Example:
I do not consent to placement of a urinary catheter until after regional anesthesia is in place, unless it has been discussed with me in advance.

  • Anesthesia — Women have three options for anesthetic during a Cesarean section: general anesthesia (mom is unconscious), epidural anesthesia, and intrathecal anesthesia (with both of the latter, mom is awake for the delivery). Please research each option, both for availability and benefits and risks of each to find which is right for you. What many women do not realize if they are awake is that medications are often given before, during, or just after the baby is born to relax the mother, but the postoperative medication especially often puts the mother to sleep. You will need to decide if you want this or not and include it in your birth plan if you want to avoid further pain medications during or after the surgery.

Example:
I do not consent to any pre-, peri-, or postoperative medication without prior verbal consent from myself, or my spouse if I am incapacitated. I wish to discuss the complete anesthesia protocol with the anesthesiologist prior to any medication administration. I desire postoperative analgesia to be administered via epidural before any use of systemic analgesics, sedatives, or tranquilizers. I have used this protocol in the past and was pleased with the results.

  • During Surgery — It is the anesthesiologist who makes the decisions in the operating room. It is important that he reviews a copy of your birth plan and discusses it with you prior to your birth. Ensure you include in your birth plan who you would like to attend during and after your birth in the operating room. Some anesthesiologists allow only one person with you in the operating room; others allow two or more. Find out what your options are and prepare accordingly. If only one is allowed, one alternative may be having your partner be with you until the baby checks are completed and then have your doula or another support person come in when your partner leaves with baby, assuming baby is moving to the nursery. Routinely, your hands are strapped down to prevent tangling of the various cords to the medical equipment that is monitoring you and to prevent your arms from falling off the narrow boards they are placed on. You can ask to not have your hands strapped down, so as to better receive your baby when he is brought to you. Would you, and your partner, like to view the actual birth? Then make sure your obstetrician realizes this. Explain you would like the option of viewing the birth, either by lowering the screen or by positioning a mirror. Maybe your previous Cesarean is still a bit unreal, as you never have actually seen a baby leave your body — they tend to just appear from behind the green screen and be held up for a quick look before they disappear to be wrapped up and tested. Make sure that the operating room staff realizes that you would appreciate a verbal description of the birth as it occurs. You may have previously felt left out of your past Cesarean as your body and labor might have been discussed as though you weren’t there. Would you love to meet your new baby in his unclothed, naked newborn state — a wet, slippery baby? Request that the baby be placed on your chest with a warm blanket over you both. It would do a lot to make this surgical delivery a bit more natural for mother, father, and baby. And it may even resolve a few inner conflicts that are faced after the birth. In addition, ask that no screen be placed in the way as you will be able to see the baby as he emerges from your body immediately and even be placed on your chest for the baby checks and to cut the cord. Other options include taking pictures or videotaping the birth, having or even choosing background music to be played during the surgery, and your partner cutting the cord. What about that placenta? Most women who birth vaginally get to see it. If you would like to, too, make sure operating room staff knows you want to view the placenta. Make sure they realize the importance of this, and let them know not to just discard a part of you that you have carried for nine months as insignificant. You may like to take the placenta home, to plant under a tree, or even to eat (it reduces the incidence of postpartum depression), so please tell them to be sure to make suitable arrangements with you to see that this happens. If an emergency Cesarean is necessary, under general anesthetic, then you can have your baby given to your partner as soon as possible after birth and held by him (hopefully next to his naked chest – skin-to-skin contact) until you are awake and can be told of the baby’s sex and well-being by your partner. As with any surgery, there are risks and sometimes those risks can have drastic consequences. Some obstetricians remove the uterus to solve a problem like hemorrhage. Is this a concern for you? Many times, a hysterectomy can be avoided using other treatments. Have you considered the option of tubal ligation during the surgery? Many women have been asked on the operating table this question and have answered hastily only to regret it later. Make the decision before your surgery. Also, with any surgery, administration of blood products may be an option when there is excessive bleeding. Many have fears or religious considerations surrounding the dispensation of blood and blood products. Options may include banking your own blood or refusing blood products and building your own supply back to normal in the days following your birth. Finally, there are two methods to closing the uterus. Highly recommended is the double suturing method (suturing of both the inner wall and outer layer of the uterus) to further ensure scar integrity for subsequent pregnancies and labors. Closure of the skin layer can be done either with staples or with sutures. If either of these is preferable, note it on your birth plan as well.

Example:
I do not consent to having my arms strapped down unless I am physically unable to control them. I am familiar with surgical fields and understand the necessity of maintaining a sterile surgical field.

  • Infant Care — How about breastfeeding your baby straight away, rather than hours later? Let them know that you would like to feed your baby while you are being sutured, if you feel up to it, and you would like your baby to stay with you throughout the surgery and even during the recovery. Your baby should remain with you at all times, no disappearing off to the nursery with your partner. This simple routine can seriously affect your bonding with your child. If your baby must go to the nursery, then do send your partner and encourage skin-to-skin contact. Your baby will be much less stressed when with someone he recognizes, as baby will respond to your partner’s voice. Let them know that your partner would be delighted to hold his child within your view throughout these procedures, if you feel unable to participate in the bonding. Newborns are also subjected to various interventions, too — routine health checks using the APGAR assessment, vitamin K injection, eye ointment application, PKU test, weight and height measurements, a bath, and possibly Hepatitis B or other vaccinations. It is highly recommended you research each of these and make an informed decision on allowing, delaying, or not allowing these procedures. You can also ask that the procedures that are done right after baby’s birth be done while in your presence rather than in the nursery. If you are planning to breastfeed your baby, you may want to include in your birth plan that you would like your baby to avoid artificial nipples or supplements including water, sugar water, or formula. If there is a glucose or nutritional concern, ask that it be discussed with you before an action is taken.

Example:
We do not consent to the PKU test until after my milk is in. We believe that this will reduce the likelihood of an inadequate sample, making it less likely a retest will be needed.

Discuss this topic with other API members and parents. Get advice for your parenting challenges, and share your tips with others on the API Forum.

2. The Infant

Breastfeeding Helps to Offset Early Disadvantages

Leave a comment

From the University of London

BreastfeedingBreastfeeding may be particularly important to the educational and emotional development of children from single-parent and low-income families, new research suggests.

Previous studies have reported that the high nutritional content of breast milk can increase a baby’s IQ. Other research has found that breastfed children are at an advantage because their mothers are, on average, better-off and more articulate.

However, a new study from the Institute of Education, London, which involved 1,136 mothers, strengthens the argument that breastfeeding is also associated with more positive parenting practices that can continue beyond infancy.

Breastfeeding Strengthens Mother-Baby Attachment

Researchers who analyzed the behavior of mothers reading a storybook to their one-year-old children found that, on average, those who breastfed made more effort to engage their infants in the book than mothers who bottle-fed. In general, mothers with more positive attitudes towards breastfeeding also appeared to have a warmer relationship with their babies.

The greatest differences in behavior were between two groups of single and low-income mothers — those who breastfed for six to 12 months, and those who bottle-fed. Poorer women who breastfed interacted with their babies during the book-reading exercise almost as well as more advantaged mothers did. However, low-income mothers who bottle-fed their babies tended to communicate with them much less well than other mothers, the researchers say.

Marital status had no effect on the quality of a mother’s interaction with her child, provided she had breastfed for six to 12 months. In fact, single mothers who had breastfed for this period made slightly more effort than other mothers to explain the storybook to their child.

A repeat experiment four years later found that mothers who had been on a low income when their child was one, but had breastfed for more than six months, had a higher quality of interaction with their five-year-old than other mothers. They also made more effort to engage their child in the book-reading exercise than mothers who had not breastfed. By contrast, breastfeeding appeared to have no lasting effect on the parenting behaviors of married and higher-income mothers.

Study Author: Breastfeeding Especially Important for Single and Low-Income Parents

The report’s principal author, Leslie Gutman, research director of the Institute’s Centre for Research on the Wider Benefits of Learning, says that the age five findings underscore the “protective” influence of breastfeeding for lone parent and low-income families.  Future studies should investigate the processes behind the findings, she suggests. Researchers should attempt to establish, for example, whether skin-to-skin contact forms stronger bonds between breastfed infants and their mothers which, in turn, lead to more positive parenting practices.

Report Indicates a Need for Change in Government Policy, Improvement in Education

Gutman also says that the findings provide support for government policies that encourage breastfeeding, particularly for more disadvantaged mothers. “Mothers in such challenging circumstances may face more obstacles to breastfeeding, especially for a longer period of time,” she points out. “They may lack role models and encouragement, or they may be under greater pressure to return to work when their child is still very young.”

If a mother works on a short-term casual basis, or is an agency worker, she may not qualify for maternity leave, and if she earns less than £90 per week, on average, she does not qualify for Statutory Maternity Pay. This may act as an incentive to stop breastfeeding and return to work as soon as possible, the study says.

“New mothers, particularly in deprived communities, may therefore require more than information leaflets,” the researchers comment. “Rather, interventions that offer early and ongoing support and encouragement to manage breastfeeding may be needed: this may come from financial support in order to enable a delay in return to work and/or workplace nurseries where mothers can visit and breastfeed their babies during the day. Meanwhile, campaigns such as ‘Be a star’, run by Blackpool Primary Care Trust (PCT) and North Lancashire Teaching PCT to provide role models for young mothers, may be a way of highlighting the issue.”

The Institute of Education research, which was funded by the Department for Children, Schools and Families, is based on a new analysis of previously unreported data that were originally collected as part of the Avon Longitudinal Study of Parents and Children in the mid-1990s.

Report Also Shows Social Mothers as Having Stronger Attachments with Their Babies

Gutman and her colleagues also found that mothers with extensive social networks interacted with their infants more positively, on average, than mothers with more limited social circles. “At a community level, the finding implies that the networking and social interactions that go on between parents in children’s centres, early-years settings, community groups and many other community venues,  such as libraries, and health and leisure centres, are of great value,” they say.

Efforts to improve maternal health could also help to build parenting capabilities as postnatal depression impairs communication between mother and child, the researchers add.

For More Information

“Nurturing Parenting Capability: The Early Years,” by Gutman, John Brown, and Rodie Akerman, can be downloaded at www.learningbenefits.net.

Striving for Balance: Personal & Family

Striving for Balance in Family Life

1 Comment

By Tamara Parnay

**Originally published in the Winter 2006-07 Balance issue of The Journal of API

BalanceMany attachment parents say that the API Principle, Striving for Personal and Family Balance, is the cornerstone of Attachment Parenting (AP). We tend to be less emotionally responsive when we are struggling to achieve balance in our families, and this lack of responsiveness may impact the quality of attachment between us and our children. We may need help when our family life is out of balance, but the wide range of parenting advice can be confusing, even overwhelming.

The topic of parenting contains a wide spectrum of theories, values, ideals, opinions, and experiences. So much mainstream parenting advice seems to contradict the very essence of AP that we may sometimes feel as though we are swimming upstream against a very strong current.

Parent-Centered Parenting

We are told that extended breastfeeding is unhealthy or abnormal; that co-sleeping is dangerous; that being emotionally responsive to our children’s physical and emotional needs spoils them and fosters their dependence on us; that we need to fill our lives with activities and things rather than with each other; and so on. Continue reading Striving for Balance in Family Life →

1. Pregnancy & Birth, 2. The Infant, Special Circumstances: Multiples, Adoption & Special Needs, The Editor's Desk

AP from a Preemie Mom’s Perspective

6 Comments

By Rita Brhel, managing editor and attachment parenting resource leader (API)

**Originally published in the Spring 2007 annual New Baby issue of The Journal of API

Rita doing Kangaroo Care with Rachel
Rita doing Kangaroo Care with Rachel

It was a big day for me, my husband, and my daughter. In mid-January, seven months after Rachel was born, when she had reached 18 1/2 pounds and 26 inches long, her pulmonologist told us she was ready to come off the cardio/respirations apnea monitor that had been a constant part of her life since she left the hospital five months earlier. I was nervous, but her doctor told me that it was OK – in all his many years of practice, he had never seen a healthier looking preemie than Rachel.

It was a great compliment. My daughter was born in June at 30 weeks gestation, due to a significant placental abruption, a serious pregnancy complication in which the placenta prematurely separates from the uterus. Weighing three and one-half pounds and measuring 16 inches long, Rachel was nearly three months early.

A Traumatic Start

I had been planning a drug-free childbirth, but what I got was anything but easy, natural, and beautiful. It was traumatic for me, both emotionally and physically. I had been in the hospital for four days after hemorrhaging, and I was being treated with several anti-labor drugs, one of which (magnesium sulfate) left me so weak that I required oxygen. I was given an epidural in case I needed a C-section, and I had an episiotomy that became a fourth-degree tear and later acquired an infection. This was not the childbirth of my birth plan. Continue reading AP from a Preemie Mom’s Perspective →

1. Pregnancy & Birth, 2. The Infant, Special Circumstances: Multiples, Adoption & Special Needs

Traci’s Story: Developing an Appreciation for Bottle-feeding

Leave a comment

By Traci Singree, leader of API of Stark County, Ohio

**Originally published in the Spring 2007 annual New Baby issue of The Journal of API

Traci and baby
Traci and baby

Before my children, I was career driven, working in retail management, which meant no family time at holiday or summer get-togethers because I was always working! And I loved it! I met my husband right out of college. We were together for about five years before we got married. In 1995, we were wed. I continued my course of 12-hour days, sometimes 6-day work weeks, and I was having a blast working in the fast-paced field of fashion retail.

About five years later, my husband and I were starting to get that something’s missing feeling, having done all the things we wanted to do. We found ourselves sitting around the house looking at each other on weekends saying, “What do you want to do?” round and round until we decided that maybe that something missing was a baby!

It took us nearly a year to conceive our first-born. We discovered I was pregnant the day of my first fertility appointment. My only knowledge of pregnancy came from what I had heard from my mother or from fellow co-workers with children. I never really researched anything to do with birthing or babies until late in my pregnancy. Continue reading Traci’s Story: Developing an Appreciation for Bottle-feeding →

Secondary Attachments: Fathers, Grandparents & Other Loved Ones

Living Proof: An Older Father Grows Up

1 Comment

By Dennis Lockard

**Originally published in the Summer 2007 Secondary Attachments issue of The Journal of API

Jack and Dennis
Jack and Dennis

Several months before the birth of our son Jack, my wife Liz started talking about using a sling instead of a stroller, nursing until he was ready to stop (as long as it takes – even three to four years!), and having the baby sleep in our bed. She went on to list a few other parenting ideas, including giving away a perfectly good Pack ‘n Play that we had somehow acquired.

At first, I thought she had lost her mind, but I later learned that among other ideas that she referred to as “natural living,” she was relating the principles of Attachment Parenting (AP), a completely foreign concept to me.

So, not only was I going to be a first-time father at 46 (which was going to be hard enough), but I also had to think about many parenting practices that were counter-intuitive to me. Continue reading Living Proof: An Older Father Grows Up →

2. The Infant

AP in a Non-AP World

5 Comments

By Sophie Aitkin

**Originally published in the Summer 2008 AP in a Non-AP World issue of The Journal of API

Sophie and children
Sophie and children

My first baby, Howard, was born in the back seat of our family car on the way to the hospital. My husband continued driving, and I had precious minutes in the back of the car alone with my new baby. As the intense pain of childbirth ceased, I was flooded with an ecstatic love for this little, naked bundle, and the natural process of bonding began.

Naturally AP

From that moment, my instincts took over, and I found myself naturally following the principles of Attachment Parenting (AP), although I was not aware of the literature in this area until later. I slept with him against my body, breastfed him on cue night and day, wore him in a sling wherever we went, allowed him to sleep when it suited him, and tried to be highly attuned and responsive to his needs. I did not leave him with anyone else until he was comfortable to be left, which was when he was nearly two years old and he said emphatically, “Go ‘way, Mama!”

A Non-AP Society

However, I was somewhat surprised to discover that this parenting style, which felt so intuitively right to me, was out of sync with the way that much of society here in Australia expected me to parent. Continue reading AP in a Non-AP World →

1. Pregnancy & Birth

Planning for the Postpartum Period

8 Comments

By Molly Remer, MSW, CCE

**Originally published in the Spring 2008 New Baby issue of The Journal of API

Molly and son
Molly and son

When my first baby was born in 2003, I made a classic new mother error – I spent a lot of time preparing for the birth, but not much time truly preparing for life with a new baby.

I had regularly attended La Leche League meetings since halfway through my pregnancy and thought I was prepared for “nursing all the time” and having my life focus around my baby’s needs. However, the actual experience of postpartum slapped me in the face and brought me to my knees.

Hurrying to Rejoin the World

My son’s birth was a joyous, empowering, triumphant experience, but postpartum was one of the most challenging and painful times in my life. I had not given myself permission to rest, heal, and discover. Instead, I felt intense internal pressure to “perform.” I wondered where my old life had gone, and I no longer felt like a “real person.” A painful postpartum infection and a difficult healing process, with a tear in an unusual location, left me feeling like an invalid. I had imagined caring for my new baby with my normally high energy level, not feeling wounded, weak, and depleted. Continue reading Planning for the Postpartum Period →