Friday, March 21, 2014

Newborn Reflexes



Newborn Reflexes

Newborns depend on their primitive reflexes for survival. Absence or extended duration of these reflexes could indicate a problem with the baby's central nervous system. Just after birth, the newborn will be assessed for the following reflexes:

Rooting Reflex - when a finger or nipple is placed into the baby's mouth, the baby begins to suck. Also, if you lightly stroke the cheek, the newborn will turn towards the stroking and open her mouth to accept the nipple. This reflex usually lasts for up to seven months.

Palmar and Plantar Grasp Reflexes - the baby will grasp an object placed in his hands or curl his toes around fingers placed near his toes. The palmar reflex usually lasts three to four months and the plantar can last up to a year.

Moro's Reflex - this startle reflex appears with a sudden loud noise or any intense stimulation. The arms and legs extend and the fingers fan outward, with the thumb and forefinger forming a C-shape. This reflex usually disappears within three to four months.


Doll's Eye Reflex - as with a doll's eyes, when a baby is lying on her back, if you turn her head from side to side, her eyes remain fixed. This reflex lasts up to two months of age.

Babinski's Reflex - the baby's toes will hyper extend when the bottom of his foot is stroked upward from the sole to the ball of his foot. This reflex disappears within a year.

Stepping Reflex - when the newborn is held upright with the feet on a flat surface, the baby will make stepping motions. This reflex diminishes by the forth month and does not return until the baby begins to stand and walk.

Bauer's Reflex - when pressure is applied to the soles of the feet of a newborn lying face-down, the baby will making crawling movements. This disappears by six weeks of age and returns when the baby is learning to crawl.


Tonic Neck Reflex - the baby appears like a "fencer" when lying flat on her back and facing to the side. Whichever direction her face is turned, that arm will extend and the other will be flexed. Babies may sleep in this position for a couple of years; however, an awake baby should not display this reflex beyond four months of age.

Traction Reflex - when a newborn is pulled up by the wrists to a sitting position, her head will first fall back, then lift upright and held before it falls forward onto the chest. This is a sign of maturity and muscle tone.

Arm Recoil - the baby's arms will flex rapidly after extending them.

Thursday, March 20, 2014

Tea During Pregnancy

Herbal Tea During Pregnancy

With all of the warnings about consuming caffeinated drinks during pregnancy, many moms-to-be are hesitant to drink their favorite tea. But is drinking tea during pregnancy safe? And if so, what types of tea are safe?

Drinking herbal teas during pregnancy is certainly a wise choice when compared with caffeinated beverages.   Caffeinated drinks may have a diuretic effect, reducing nutrient absorption and deplete the adrenal glands.  Herbal teas hydrate, provide nutrients and feed the body during pregnancy. Some are also packed with antioxidants and vitamin C which helps lower your anxiety and stress levels. Various types of herbal teas can also reduce morning sickness symptoms and even prepare the uterus for labor.

1. Ginger Tea 

Eases nausea aids the digestion process and relieves stomach issues . Add four or five slices of fresh ginger root to a cup of freshly boiled water and drink a maximum of three cups daily

2. Nettle Tea

Provides high levels of iron, magnesium and calcium and is described as a nutritive tea to sip while pregnant. Stick to one or two cups a day.

3. Raspberry Leaf Tea

A favorite of midwives, this tea prepares the uterus for labor and helps prevents post-partum hemorrhage. It's high in calcium and magnesium and is safe to drink from the second trimester onwards. 

4. Dandelion Leaf Tea

 Dandelion tea can be supportive in late pregnancy when fluid retention is an issue.  It is high in potassium and is a gentle but effective diuretic. Add dandelion leaf to another tea as it has a slightly bitter, grassy taste.

5. Peppermint Tea

Peppermint tea is great for relaxing your stomach muscles to help settle an upset stomach as well as the nausea and vomiting common in early pregnancy.

6. Rooibos Tea

Rooibos tea is highly recommended in pregnancy. It is caffeine free, contains calcium, magnesium and loads of antioxidants. It also has positive effects on digestion and can ease colic and reflux. Children can also drink Rooibos, and it is lovely with milk and a little honey.


Teas To Avoid During Pregnancy

Caffeine consumption during pregnancy (particularly over has 200mg) has been directly linked with reduced birth weights.  While this research is by no means exhaustive, it does illustrate the importance of keeping an eye on your caffeine consumption during pregnancy. For this reason, teas that are particularly high in caffeine should be restricted while you are pregnant.


These teas include:
  • Black
  • Green
  • Oolong
  • LiChee
  • Hong mao
  • Earl grey
  • Darjeeling
Other common teas and herbs to avoid during pregnancy include (but not limited to):
  • St John’s Wort
  • Don Quai
  • Ginseng
  • Yarrow
  • Penny Royal
  • Ephedra
  • Licorice Root
Always speak to your midwife or herbalist if you have any concerns about which teas are safe to drink during pregnancy.


Suggestions and advice are not intended to replace advice from a qualified professional.


Monday, March 3, 2014

Poetry on Motherhood: With Child



With Child

 by Genevieve Taggard



Now I am slow and placid, fond of sun,
Like a sleek beast, or a worn one:
No slim and languid girl – not glad
With the windy trip I once had,
But velvet-footed, musing of my own,
Torpid, mellow, stupid as a stone.

You cleft me with your beauty's pulse, and now
Your pulse has taken body. Care not how
The old grace goes, how heavy I am grown,
Big with this loneliness, how you alone
Ponder our love. Touch my feet and feel
How earth tingles, teeming at my heel!
Earth's urge, not mine, – my little death, not hers;
And the pure beauty yearns and stirs.

It does not heed our ecstacies, it turns
With secrets of its own, its own concerns,
Toward a windy world of its own, toward stark
And solitary places. In the dark
Defiant even now; it tugs and moans
To be untangled from these mother's bones. 

- See more at: http://www.poets.org/viewmedia.php/prmMID/23800#sthash.Uj2hNeYD.dpuf

Sunday, February 23, 2014

Skin to Skin Contact: The Right Start


Being skin to skin with your baby after birth has many benefits on your health and baby's health including:

  • Baby is warmer. Your skin is a radiant warmer and will help regulate your baby's body temperature. Simply lay baby on your skin, abdomen or chest, dry the baby off while there and put warm blankets over you and baby.

  • Baby breathes more normally. Babies who are skin to skin with mom after birth breathe more easily and more rhythmically.

  • Baby cries less. The comfort of being with mom leads to babies who cry less after the initial cries at birth.

  • More breast milk. When babies are skin to skin after birth, they are more likely to nurse and nurse sooner and longer. This can lead to a better breast milk supply.

  • Baby can her your heart beat. After nine long months of hearing your heart beat, your baby feels comforted by hearing the heart beat he or she has grown with.

  • Baby is more likely to have a normal heart rate. All of these add up to a baby who is more stable.

Skin to skin with baby is good for all types of births, assuming your baby is stable.   Often even after a cesarean birth mom can hold baby skin to skin ; or dad can perform this important role if mom is not available.  There are a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket), immediately after birth, as well as throughout the fourth trimester. 

We know that this is true not only for the baby born at term and in good health, but even for the premature baby. Skin to skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their needs for oxygen, and keeps them more stable in other ways as well.

From the point of view of breastfeeding, babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without help and are more likely to latch on well, especially if the mother did not receive medication during the labor or birth. 

There is no reason that the vast majority of babies cannot be skin to skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence.

The baby should be dried off and placed on the mother. Nobody should be pushing the baby to do anything; nobody should be trying to help the baby latch on during this time. The mother and baby should be left to enjoy each other’s company. (The mother and baby should not be left alone, however, especially if the mother has received medication, and it is important that not only the mother’s partner, but also a nurse, midwife, doula or physician stay with them—occasionally, some babies do need medical help and someone qualified should be there “just in case”). If the optional eyedrops and the injection of vitamin K are being administered, they can wait a couple of hours.

Studies have shown that even premature babies, as small as 1200 g (2 lb 10 oz) are more stable metabolically (including the level of their blood sugars) and breathe better if they are skin to skin immediately after birth. The need for an intravenous infusion, oxygen therapy or a nasogastric tube, for example, or all the preceding, does not preclude skin to skin contact. Skin to skin contact is quite compatible with other measures taken to keep the baby healthy. Of course, if the baby is quite sick, the baby’s health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin to skin with the mother immediately after birth. Indeed, in the premature baby, as in the full term baby, skin to skin contact may decrease rapid breathing into the normal range.

Tuesday, February 4, 2014

Planned Birth Support by Harmony at Home


Caring for your newborn after a cesarean presents many different challenges. Feel secure, prepared and nurtured with the support of Harmony at Home. Whether a planned or unplanned C-Section, we will determine your individual needs and goals for successful healing. We'll provide the comprehensive support you and your baby need to safely make the transition from pregnancy to family.



​Harmony at Home offers hourly and overnight C-Section Support. Services may include:​

  • PreNatal Visit and Planning Session
  • Immediate Postpartum Support, Hospital to Home
  • Overnight Care
  • Incision Care
  • Breastfeeding and BabyWearing for the C-Section mom
  • Basic Newborn Care
  • Meal Preparation, Grocery and Menu Planning
  • Light House Cleaning and Errands
  • Infant Massage Instruction
  • Pet Care
  • Dad Support
  • Care to 6 weeks Postpartum



Here's how our program works~

*Free consult, if you would like we will meet with you for coffee (or tea!) so we can get to know each other in person.

*One Home Visit at 38 weeks to "fluff your nest!" We plan and prepare for you to have a smooth transition home, with everything you need all in place. 

*Post Natal support the day of the planned birth. We will be there to facilitate the natural bonding process from lots of skin-to-skin to back-to-basics breast feeding support so you are set up to succeed from the very beginning.

*24 hour Hospital visit for continued breastfeeding support and troubleshooting.

*First Postpartum visit the day you travel home. With your pillows just right, and fresh food and water on your night stand, it's straight to bed with your sweet new baby. We will leave you feeling confident in your ability to rest, recover and nourish your newborn now that you're home.

*Photography & Birth Announcements, Belly Casting and Infant Massage Instruction are all available upon request.

*Daily to overnight Newborn Nurse & Doula services are tailored to meet the needs of the family and change over the course of the Postpartum period. Our goal is to gracefully step aside as your new family settle in.


References available upon request.
Newborn Nurse, PP Doula Insured.
Contact us now! Space is limited.

Breastfeeding Basics for New Families


During the first few days after your baby is born, breastfeeding can be daunting and confusing. Many new parents are haunted by questions of whether their baby is getting enough milk and "are we doing it right?" Successful breastfeeding relationships are establish in an atmosphere of trust, support and knowledgeable guidance.  Harmony at Home is here to help if you have any questions or problems.

Here are some of our basic guidelines to keep in mind for the first few weeks.

Whether or not baby is getting enough milk is one of the most common concerns of new moms. Since we don't have measurement markers on our breasts, we can't initially "see" that our babies are really getting the milk they need. You can tell baby is getting enough milk, however, by keeping track of dirty diapers, weight gain, and appearance.

Diapers

Counting your baby's diapers can be a helpful indicator as to whether or not he is getting enough of your milk.
baby's agemother's milkwet diapers/24 hrsdirty diapers/24 hrs
1-2 dayscolostrum (provides immunities and helps with jaundice)1-2greenish-black tarry meconium
2-6 daysmilk "comes in"; bluish color5-6 wet disposable diapers
(6-8 wet cloth diapers)
At least 3 greenish transitional stools
6+ daysmilk supply adjusts to suit your baby's needsSame as 2-6 daysAt least 3-5 very loose stools; bright yellow color that are about 2.5 cm
6 weeksmilk supply establishedSame as 2-6 daysSome babies switch to less frequent but large bowel movements


Signs of poor feedings

  • Feeling pain during feedings
  • Sleepy baby
  • Inconsistent, flutter (weak) sucking
  • Difficulty latching-on and staying on
  • Clicking or popping sounds in your baby’s mouth
  • Prolonged nursing (more than 20-25 minutes on each side)
  • Infrequent nursing (baby does not wake to feed at least every 3 hours)
  • Frequent nursing (more than 12 per day)
  • Baby is not satisfied at the end of the feeding
  • Engorgement
  • Inadequate wet diapers and stools
  • Rapid or excessive weight loss (more than 7-10%) during the first few days
  • Has not regained birth weight by 2 weeks
  • Slow weight gain thereafter (less than 1/2 – 3/4 oz per day)


Signs of good feedings

  • Feeling a deep, strong pulling sensation without sharp pain
  • Consistent sucking with only brief pauses
  • Hearing swallowing (after the milk comes in)
  • Latch-on is easy
  • 15-20 minutes of vigorous sucking per breast (20-30 minutes for one breast feedings)
  • Breasts are softer after the feeding
  • Seeing milk in your baby’s mouth
  • Feeling a let-down reflex or seeing a change in the baby’s feeding rhythm
  • Adequate wet diapers and stools
  • Minimal weight loss during first few days
  • Regain birth weight by 2 weeks and gains ¾ to 1 oz thereafter


Breastfeed Often

A baby needs to breastfeed frequently. Your milk is digested quickly and easily, sometimes in as little as 60 minutes, and small amounts are perfect for baby's tiny stomach. These frequent feedings also help to establish your milk supply. In simple terms, the more milk that is removed from your breasts, the more milk your body will produce. Frequent feedings are good for both of you!  Keep in mind that some babies "cluster nurse," which means that they nurse very often for a few hours and then sleep for several hours. The number of feedings in a 24-hour period is more important than the spacing of feedings.  A sleepy baby may need to be wakened every two to three hours to feed, particularly if he has jaundice. Talk with your health care provider if baby is lethargic and difficult to wake for feedings.


Watch Baby, Not the Clock
Watch your baby for signs of hunger, not the clock. Follow baby's feeding cues and do not try to schedule feedings or limit feedings. Early hunger cues include:

Baby opening his mouth and moving his head side to side (known as the rooting reflex).
Baby making sucking motions with his mouth.
Baby begins to chew or suck on his hands or fingers.

Don't wait for your baby to cry to let you know he is hunger. Crying is a very late hunger cue.


Increasing Your Supply

Mothers throughout the ages have been able to produce plenty of milk for their babies. In certain situations because of a health problem or other complication, a mother may have a reason to be concerned and may need to carefully monitor her baby's weight gain in order to be sure he is getting enough milk. If baby is not gaining well or he is losing weight after the first few days, contact baby's health care provider. Slow weight gain may indicate a serious health problem. If you're concerned about your milk supply, get help. Being in touch with a Postpartum Doula, La Leche League Leader, or Lactation Consultant can often provide the information, support, and encouragement that mothers need to be reassured that they are providing plenty of milk for their babies. 

Steps that will help your baby get as much of your milk as possible include:

Nurse often for as long as your baby will nurse. The more milk that is removed from the breast, the more milk the breast will make to replace it. Frequent breastfeeding helps to establish a plentiful milk supply. A sleepy baby may need to be awakened and encouraged to nurse more frequently. A baby who nurses for excessively long periods may not be nursing efficiently.

Offer both breasts at each feeding. This will ensure that your baby gets all the milk available and that both breasts are stimulated frequently. Allow your baby to indicate he is finished on the first breast, then offer the other breast.

Check baby's positioning and latch. Breastfeeding should not hurt. Hold baby close with his whole body facing you so he does not have to turn his head. When he opens his mouth wide, his head should be slightly tilted back with his nose at the level of your nipple. As he approaches the breast with his head slightly tilted back, this will bring him to the breast chin first. This will help you better aim his lower jaw so that he covers more of your breast with his lower jaw than with his upper mouth. As you bring baby onto the breast, aim your nipple toward the roof of his mouth. If you feel comfortable and baby is nursing actively, the latch is good.

Try breast compression to keep your baby interested in breastfeeding. Squeeze the breast firmly with your thumb on one side and fingers on the other to increase milk flow. Keep squeezing until baby is no longer actively sucking, then release. Rotate fingers around the breast and squeeze again. Then switch to the other breast, using both breasts twice at each feeding. Squeeze firmly but be careful not to cause injury to your breast tissue.

Feed your baby only your milk. If your baby has been receiving formula supplements, do not cut these out abruptly. As you improve your breastfeeding techniques with the help of a lactation professional, and as your milk supply increases, you will be able to gradually reduce the amount of supplement. Monitor baby's weight gain and stay in touch with your baby's health care provider during this transition.

All your baby's sucking should be at the breast. If some supplement is necessary, it can be given by spoon, cup, or with a nursing supplementer. Be aware that a pacifier can create more problems than it solves. If you decide to give your baby a pacifier, wait until he is nursing effectively and gaining well.

Use skin-to-skin contact. It may encourage your baby to nurse more often. Skin-to-skin means that baby will be nestled upright between your breasts, clad only in his diaper directly against your skin. Your warmth, smell, and heartbeat will also soothe baby, which in turn aids in his development.

Try to relax. Paying attention to your need for rest, relaxation, and proper diet will help your milk supply and improve your general sense of well-being.

Talk to your health care provider about diet, medicinal herbs or prescription medications to increase your milk supply.



If you have concerns...

Some mothers think their babies are not getting enough milk when they are actually getting plenty of milk. Some "false alarms" that worry mothers include:

Your breasts feel different. If your breasts suddenly feel softer or your breasts no longer leak between feedings, it does not mean that you are producing less milk; it simply means that your supply has adjusted to your baby's needs.

Baby seems fussy. Many babies have a fussy time every day that is not related to hunger. Some babies need lots of stimulation and activity; others need soothing. You will learn how to respond to your baby as you find the ways that comfort him. If your fussy baby settles down when you offer him the breast, go ahead and breastfeed. But don't take this as a sign that he is not getting enough to eat.

Baby suddenly wants to feed more often, or seems hungry again soon after being fed. Babies often go through "growth spurts" when they are two to three weeks old and again at six weeks and three months. At these times, breastfeed as often as possible as your supply catches up with baby's demand.

Baby decreases his nursing time, perhaps down to five minutes or so at each breast. As babies get older, they become very efficient at taking the milk so this is a positive sign that breastfeeding is going well, not something to worry about.

La Leche League Leaders are accredited volunteers who are available to help with breastfeeding questions in person, over the phone, or online. Locate an LLL Leader near you at www.llli.org.


Please be aware that the information provided is intended solely for general educational and informational purposes only. It is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician for any questions you may have regarding your or your infant’s medical condition. Never disregard professional medical advice or delay in seeking it because of something you have received in this information.

Wednesday, January 29, 2014

Breast Milk Storage 101 - Safe handling of human milk



Breast milk handling and storage can be confusing. Follow these practical guidelines for safe handling of your expressed milk.


What kind of container should I use to store expressed breast milk?

Before expressing or handling breast milk, wash your hands with soap and water. 

Store expressed milk in a clean, capped glass or hard plastic container (long term storage).

You can also use special plastic bags designed for milk collection and storage. Keep in mind that breast milk storage bags aren't recommended for long-term storage; certain components of breast milk might adhere to the soft plastic bags during long-term breast milk storage, which could deprive your baby of essential nutrients.

Don't store breast milk in disposable bottle liners or plastic bags designed for general household use.


What's the best way to store expressed breast milk?

Using waterproof labels and ink, label each container with the date you expressed the breast milk. If you're storing expressed milk at your baby's child care facility, add your baby's name to the label. 

Place the containers in the back of the refrigerator or freezer, where the temperature is the coolest. If you don't have access to a refrigerator or freezer, store the milk in a cooler or insulated bag until you can transfer the milk to the refrigerator or freezer.

To minimize waste, fill individual containers with the amount of milk your baby will need for one feeding. You might start with 2 to 4 ounces, and then adjust as needed as your baby grows. Also consider storing some smaller portions — 1 to 2 ounces — for unexpected situations or delays in regular feedings. 

Breast milk expands as it freezes, so don't fill containers to the brim.


Can I add freshly expressed breast milk to already stored milk?

You can add freshly expressed breast milk to refrigerated or frozen milk you expressed earlier in the same day. Be sure to thoroughly cool the freshly expressed breast milk in the refrigerator or a cooler with ice packs before adding it to previously chilled or frozen milk. 

Don't add warm breast milk to frozen breast milk because it will cause the frozen milk to partially thaw.

Keep milk expressed on different days in separate containers.



How long does expressed breast milk keep?

In general, we recommend following the "rule of four's" for breast milk storage.  4 hours, 4 days, 4 weeks, 4 months.

Room temperature. Freshly expressed breast milk can be kept at room temperature for up to 3-4 hours. If you won't use the milk that quickly or the room is especially warm, transfer the milk to an insulated cooler, refrigerator or freezer.

Insulated cooler. Freshly expressed breast milk can be stored in an insulated cooler with ice packs for up to one day. Then use the milk or transfer the containers to the refrigerator or freezer.

Refrigerator. Freshly expressed breast milk can be stored in the back of the refrigerator — not the door — for up to 4-7  days.

Freezer. Freshly expressed breast milk can be stored in a standard refrigerator freezer for up to 3-4 weeks and in a chest/deep freezer for up to 4-6 months. Place the milk in the back of the freezer — not the door.

Keep in mind that storage guidelines might differ for preterm, sick or hospitalized infants.


How do I thaw frozen breast milk?

Thaw the oldest milk first. 

Place the frozen container in the refrigerator the night before you intend to use it. 

You can also gently warm the milk by placing it under warm running water or in a bowl of warm water. 

Before offering the milk to your baby, gently swirl it to evenly distribute the creamy portion of the milk that rises to the top of the container during storage. Don't vigorously shake the container or stir the milk.

Never thaw frozen breast milk at room temperature, which enables bacteria to multiply in the milk. 

Don't heat a frozen bottle in the microwave or very quickly on the stove. Some parts of the milk might be too hot, and others too cold. Some research suggests that rapid heating can affect the milk's antibodies as well.

Use thawed breast milk within 24 hours. Discard any remaining milk. Don't refreeze thawed or partially thawed breast milk.


Does thawed breast milk smell or look different from fresh breast milk?

The color and consistency of your breast milk might vary, depending on your diet. Also, thawed breast milk might appear different than freshly expressed milk. It's still safe to feed to your baby. If your baby refuses the thawed milk, it might help to shorten the storage time.