Tag: Baby Care

Optimal Recovery from Caesarean Birth

Posted by on in Birth Prep

After a Caesarean birth, you will be given a list of recovery tips from your medical care provider.  The following additional information contributes to optimal recovery following a surgical birth.

Taking care of a baby is a full-time job and deserves recognition as such.  Recovery from major abdominal surgery is also a full-time job.  Most new (or new again) parents will find a new normal around 6-8 weeks postpartum, but it takes considerably longer than that to fully recover from a Caesarean birth.

FOR BIRTH MOM:

REST, REST, REST!

This is essential for recovery. Although you have a newborn (perhaps other children too) at home, do the best you can to rest and recover. Get the support needed to do this, such as from a Postpartum Doula.

  • Sleep while the baby sleeps. I know – ugh – everyone says that and it’s not realistic. But…. really, really try!!! Let the house go for now! Enlist help if other responsibilities prevent you from napping.
  • Lift nothing heavier than your baby for 6 weeks! (A-hem – that means not lifting the baby in the bucket seat either.)  Avoid hard exercise for 6-8 weeks. Listen to your body. Any pain means stop and rest right away. This will be humbling. And frustrating. But it will pay off in a faster recovery overall.
  • Hire a cleaner if you don’t have good live-in support and if you’re in a position to do so. A weekly or bi-weekly cleaning works magic for your sanity.
  • If you wish to introduce your baby to others, then have an open house / meet-baby gathering to entertain all friends at once rather than spend hours daily with visitors. I recommend this happens closer to 6 weeks postpartum but that can be a long time for many families.
  • Learn to accept help. Just say thank-you! Ask for help from friends & family. They’d love to make food, babysit siblings, walk the dog, feed the pets, do laundry and other chores etc. Your turn to help another will come later.
  • Make a “guest rule”. Any visitors must bring or prepare food (and clean up their mess), and/or do a chore from a list you’ve made. Make it clear they will not be entertained! They are there to help. This gets you help and decreases visitors.

For internal healing:

Osteopathy, Visceral Manipulation Therapy, and CranioSacral Therapy help resolve trauma and restore fluidity to organs & tissues, which speeds healing, decreases pain and facilitates long-term recovery. When internal tissues are exposed to air, adhesions can form. During surgery, organs are shifted from their optimal placement. Wait 4-6 weeks before starting treatment.

If you’re into Homeopathy: Traumeel (drops or tabs) during the entire post-surgical recovery phase, or homeopathic Arnica 200CH first 3-5 days (3 granules once daily).

Emotional Recovery:

Emotions following a Caesarean birth vary. One person may feel completely satisfied with their birth and emotional recovery is not an issue. Conversely, another may feel loss, regret, blame or disappointment. There are infinite factors that lead to Caesarean birth.

Many people will say, “At least your baby is healthy”, but a woman’s birth journey is important too. Give yourself permission to feel sadness about your birth; it doesn’t mean you’d trade your baby’s health for your “ideal birth” nor that you don’t love and appreciate your baby. There’s room for being totally in love, feeling anger or sadness or happiness – all of it!

Some people will assume it’s totally devastating to have a caesarean. Perhaps you are happy with your birth, and that’s OK too.

Other well-meaning folks might say at least you didn’t have to “suffer” in labour or that you got to take the “easy way out”. Forgive their ignorance. Many people don’t realize how difficult a Caesarean birth and recovery can be, often much more so than a natural birth.

  • Rescue Remedy as needed for grief, shock, disappointment.
  • Be kind and forgiving to yourself and allow space for grieving if you need it.
  • Several local health professionals can help with emotional trauma. Some use Flower Remedies, homeopathy, Reiki, other energy work, and/or verbal counselling styles.

For the scar:

  • After the stitches have dissolved and the wound is fully closed, healthy high-quality oil such as rosehip seed oil (Rosa masquetta) on the incision site as often as possible to nourish the skin and decrease scarring. Combine with an essential oil blend to decrease itching, scarring, incidence of thick scarring and to speed healing (eg Blaine Andrusek Scar-B-Gone). If you don’t have these, vitamin-E oil will do.
  • From 6 weeks on, Castor Oil packs over the incision to help with healing. Soak a cotton cloth in castor oil. Put cloth against skin, cover with plastic bag or saran wrap (to protect bedding or clothing), then apply hot water bottle. Leave on for 20-40 minutes daily or until you intuitively feel you’ve had enough. If the cloth is still clean it can be folded away in the plastic and reused. Once the cloth appears to have absorbed toxins use another one. This treatment can be done for as long as you wish – weeks or months.

To Counter the Antibiotics:

While antibiotics can prevent or treat infection, they also lead to an imbalance in normal flora by killing the good bacteria in our gut. Balance can be restored by ingesting unpasteurized, fermented foods (e.g. kombucha tea, kimchi, sauerkraut) or probiotics such as acidophilus powder or caps – high quality only.  That’s the ones found in the fridge at health stores or your holistic care providers office.

  • 1-3 caps or ¼ tsp daily for 3-4 weeks – read the label for instructions. This decreases Candida albicans overgrowth, which in turn protects the digestive system from pathogens and boosts immunity. It protects you from diarrhea, vaginal yeast infections, and painful nipples commonly associated with antibiotics, and will protect the baby from thrush (mouth sores/diaper rash).
  • If you or baby show signs of such side effects, then double the dose until 2 weeks after symptoms disappear, then go back to the regular dose. Make a little paste to apply to nipples or pinkie-finger at feeding time to dose your baby.

Nutrition:

  • Eat whole, healthy foods and lots of them.
  • Continue your high-quality prenatal vitamin for the duration of breastfeeding or 8 weeks, whichever is later.
  • High quality, easily assimilated iron supplement such as Floradix or placenta capsules. You’ll take less of this type of iron, absorb more overall, and avoid constipation associated with most iron supplements. Helps after blood-loss associated with surgery. (Average blood loss is up to 1L of blood after a Caesarean birth, compared with 300-500 ml with vaginal birth.)
  • Eat well and drink lots of water. Continue drinking your raspberry leaf and nettle tea, optimally 3 cups daily, for at least a month. See herb tea recipe, “Essential Herbs for Pregnancy & Nursing”
  • Ingest healthy absorbable protein; your body’s doing a lot of rebuilding now.

FOR BABY:

Caesarean birth is also traumatic for the baby. Osteopathy, cranio-sacral therapy and newborn chiropractic care by someone who specializes in newborn-care is essential.

To Counter Antibiotics Side-Effects: Acidophilus powder (see above). Continue for 3-4 weeks. This will decrease Candida overgrowth, which in turn protects the digestive system, boosts immunity, protect thrush (mouth sores), diarrhea, and diaper rash commonly associated with antibiotics. Make a paste from 1/8 tsp and rub on nipples just before nursing, twice daily. Or dip a wet pinkie-finger into the powder and let baby suck it off.

If you’re into homeopathy, there are remedies that are safe and effective for baby too, in case you notice thrush, trauma, or other long term effects.

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.

Male Infant Circumcision

Posted by on in Baby Care

The info in this article comes from evidence-based info. In fact, I did a course about male circumcision and the purpose of the foreskin a few years ago in 4 x 2 hour classes – yup – 8hrs!!  (Who knew there was even that much info out there about down there?)  There is no high-quality, evidence based research that shows the benefits outweigh the risks under normal circumstances. 

Current research supports leaving boys intact. While it is not yet illegal to circumcise male babies in Canada, the Canadian Paediatric Society has recommended against routine circumcision since 1996. As early as the mid-70s, they stated there was no medical benefit to this surgery. Not one provincial health insurance plan covers the cost due to the lack of health benefit. In fact, it is considered cosmetic surgery. Several Canadian hospitals do not offer non-therapeutic neonatal circumcision.  Parents who wish to have this surgery performed on their sons must search for a doctor to do it and then pay out of pocket. Most health regions will not share the name of doctors who offer routine circumcision of male babies.

Circumcision rates vary by province but the national average is around 10-15%, with the great majority of those being done for religious practises.  Several European countries have banned the procedure. In most of the world, including Canada, female circumcision, called Female Genital Mutilation (FGM), is illegal. The movement to offer male babies the same protection is gathering momentum. The Canadian Children’s Rights Council’s position is that “circumcision of male or female children is genital mutilation of children”. The growing trend is to let each boy decide for himself when he’s old enough.  It can’t be undone but it can always be done later if desire or circumstances present a compelling reason. 

Genital surgery is painful. (Would any of you readers like to have surgery in this sensitive area with just a local freezing? Yikes!! No thanks.) A great benefit to waiting is that adequate anesthetic (general or spinal) can be used. THERE IS NO SUCH THING AS A “GENTLE CIRCUMCISION”! That’s just the name of a business that profits from doing non-medical circumcisions.

The foreskin has a purpose. In addition to a whole lot of nerves that send pleasure signals to the brain, there are cells and membranes in the foreskin that secrete antibiotic substances. The 2 main medical benefits cited for doing circumcision have both been discounted – it doesn’t prevent AIDS (condoms do thought) nor does it prevent infection (other than a part that isn’t there can’t become infected). Do we cut off our children’s ears off to avoid ear infections?  In the unusual circumstance of infection, it’s like any other body-part: treat it. Certainly there are medical reasons to do a circumcision but those are uncommon and should be evaluated on an individual basis. (Kind of like tonsillectomies, which used to be common-place but are no longer routine, and also hurt like mad!)

Many people who circumcise their baby boys claim it’s important for their son to “look like dad”. Well many of those dads are now intact, so that argument is diminishing. Not to mention, there are many, many ways infants and toddlers don’t look like their parents.

Caring for Your Intact Boy:

It’s important that intact boys are treated properly – no one except the owner of the foreskin should ever retract their foreskins! Never retract the foreskin and don’t let anyone else do so either. Most medical care providers know this, but be watchful anyway at your child’s check-ups. 

Summary of today’s research about cleaning an intact boy…  Until recently medical people advised parents to forcibly retract the foreskin.  This lead to inflammation, pain, infection, and complications.  Current recommendations are to ‘clean only what is seen’ and to never ever retract the foreskin.  Medical articles still advise soap and water but there are many holistic practitioners advising to avoid soap until teen years.  Soap is irritating.  A nice middle ground could be to use a very gentle soap such as castile (Dr. Bronners) or unscented baby soap if that’s one’s preference, and rinse very well without forcible retracting.  (People are using less soap in general (less often, only if needed) for infants and young children due to skin irritation.  Obviously lots of hand-washing is an exception to the less-soap trend.) 

If You’ve Been Circumcised:

Perhaps you’re totally happy with your body and that’s cool. I sometimes worry for grown men who learn the facts and then start to research the physiological functions of the foreskin.  Some get upset or angry at their parents (there are law-suits galore in the USA – yup, men suing parents) so I remind them we all do the best we can with the info we have at any given time.  Others mourn the loss of a part of their body.  There are some men undergoing medical procedures and little tricks to try to grow some back.    

For many men, getting informed helps them break the cycle set up a couple of centuries ago for the sole purpose of decreasing or preventing male masturbation.  Learning the physiological role of foreskin is quite helpful.   

Further Study:

Canadian Paediatric Society

National Organization of Circumcision Information Resource Centers

Circumcision Resource Centre

Canadian Children’s Rights Council

Function & Care of the Foreskin

Some Facts to Consider:

Angie The Doula – Postpartum Warning Signs for Mother and Baby

Posted by on in Baby Care, Birth Prep, Interventions, Labour, Postpartum, Pregnancy, Recovery, Safety

CALL 811/DOCTOR/MIDWIFE WITH ANY WARNING SIGNS.  CALL 911 FOR EMERGENCY HELP!

If you call 911, have someone clear a path for EMT (halls, stairs etc), turn on outside light, put pets away, unlock door, clear driveway.)

Maternal Warning Signs

  • Vaginal bleeding heavy enough to soak a super-pad front to back in 1/2hr-1hr. Note: if blood starts to pour continuously, lay down immediately and call 911;
  • Foul-smelling bleeding or discharge
  • Passing clots bigger than a toonie
  • Temperature greater than 38C (100.4F)
  • Feeling flu-like
  • Uterus is painful to the touch
  • Uterus feels soft and is at or above the navel, and doesn’t respond to gentle massage
  • Sore, red, hot, tender area on leg or calf
  • Painful, swollen, red breasts or red / hot / lumpy spots
  • Sudden and extreme pain on nipples with feeding (may be thrush)
  • Persistent dizziness (call 911 if accompanied by bleeding)
  • Fainting (call 911 if accompanied by bleeding)
  • Feeling depressed, very anxious, unhappy or are crying without reason and cannot sleep or eat

Baby Warning Signs

  • Blue or grey in the lips, face or chest. Call 911.
  • Temperature of greater than 37.4C (99.3F) or lower than 35C (96.6F) (note: consider environment – e.g. is baby wrapped in layers in a hot room?)
  • Laboured breathing
  • Extra-sleepy and has not fed in the past 6-8 hours
  • Has not urinated or passed meconium (feces) in the first 24 hours
  • Yellow skin in the first 24 hours
  • Red patches, pimples or bumps
  • Vomits after every feed
  • High pitched cry or extremely irritable, inconsolable
  • Lethargic
  • Red, hot area around cord-stump; swelling of stump; discharge of pus, blood or meconium
  • Red blood in urine (note – some girl-babies get a little ‘period’ due to hormones)
  • Bright red diaper rash
  • White spots in mouth that don’t rub off (thrush)

Angie The Doula – Normal Postpartum Care of Mother and Baby

Posted by on in Baby Care, Postpartum, Recovery

If you’re concerned, see Warning Signs for Postpartum.

In the first 24 hours after birth it is normal for birth mothers to:

  • Expect a fairly heavy flow for the first 24 hrs, like a heavy period in appearance and scent. Flow should gradually taper in the following few days, then continue lightly for approximately 4-6 weeks.
  • Pass small clots and gushes, especially after lying down for some time
  • Have a firm uterus that feels like a grapefruit below the navel
  • Experience night sweats
  • Urinate frequently
  • Feel exhausted and need rest

In the first 24 hours after birth it is normal for babies to:

  • Breathe irregularly, including pauses and some periods of rapid breathing
  • Spit up mucus
  • Have blue hands and feet with pink body, face and lips
  • Sleep for 4-6 continuous hours after birth then wake up every 2-3 hours to breastfeed
  • Pass stool (but may be within 48hours)
  • Urinate

Postpartum Care – Mother

  • In the first week, only responsibilities should be to eat, sleep and feed and cuddle baby
  • Sleep when the baby sleeps
  • Get assistance with getting up for the first day. Never get up while holding the baby (first 24hours), in case of fainting.
  • Do not lift anything heavier than the baby for 3 weeks after a gentle vaginal birth; 6 weeks after a Caesarean or traumatic birth.
  • Take temperature daily for the first 5 days; twice daily if membranes were ruptured more than 12 hours before birth or in case of traumatic birth.
    • Oral temperature: 15min after ingesting hot or cold, or being in hot water. Put tip under and against tongue to 1 side of frenulum, close mouth and wait for the beep (or 5min for glass thermometer; remember to shake well before use)
  • Light movement is fine during the first 6 weeks. Any increase in cramping, bleeding, or discharge going from brown to red means you’re doing too much!

Uterus recovery:

  • In the first 1-2 days, gently massage uterus (back and forth motion) several times daily to ensure it’s firm like a grapefruit
  • Urinate often
  • Breastfeed often
  • Nothing inside the vagina

Pain:

  • Take arnica to aid with tissue healing
  • After-pains are due to the uterine contractions and tend to be stronger with subsequent pregnancies and during breastfeeding. Lay or sit, apply pressure (e.g. pillow) and heat (hot water bottle), take extra calcium, and consider calling midwife for homeopathy.
  • It’s safe to take acetaminophen (Tylenol x-strength) every 6 hours (for pain) and ibuprophen (Advil) every 4 hours for swelling for the first few days after birth
  • Avoid aspirin, alcohol, herbal supplements with willow-bark as they promote bleeding

Perineum:

  • Keep area as clean and dry as possible
  • Use peri-bottle of warm water and 1 dropper of calendula tincture after using the toilet
  • Wear the lightest pad necessary and change it with every visit to the washroom.
  • Apply frozen calendula pads to perineum/hemorrhoids several times daily for 2-3 days
  • If any tears/suturing to perineum, soak in a clean bath each day with ½ cup of Epsom salts or sitz-bath herbs added. Keep knees together as much as possible, including while walking or on stairs.  Airtime helps speed recovery.
  • Begin light elevator-Keigels and pelvic floor exercises

Nutrition:

  • Drink plenty of water and nutritional drinks, including Pregnancy Tea Blend
  • Eat whole foods – 3 meals and 2-3 snacks daily (just like during pregnancy)
  • Continue prenatal vitamins, acidophilus, essential fatty acids for at least 6 weeks
  • Continue or begin to take iron supplements if they were prescribed

Normal Postpartum Care – Baby

  • Feed when the baby wants but a minimum of every 4 hours around the clock (see “breastfeeding” below). A breastfed baby shouldn’t be offered anything other than breast milk/ colostrum.
  • If baby’s definitely satiated and still wants to suck, it may save nipples to offer a clean pinkie; insert to first knuckle, pad up.
  • Keep the cord-stump dry (fold diaper below) and clean. No need to put anything on it, but calendula tincture is acceptable.
  • When changing diapers wipe from front to back, only once per cloth. Clean folds of skin but do not open genitals and never retract foreskin.
  • Clean baby’s hands, folds in neck, and face with a clean damp cloth daily
  • Bathing is recommended only once or twice weekly with gentle and “edible” soap
  • If fingernails are long then prevent scratching by cutting with newborn-clippers or gently chew them off
  • Keep the baby at a comfortable temperature. If concerned take baby’s temperature.  Put the end of the thermometer at deep centre of armpit, then the hold arm against side until thermometer beeps (or 5min for glass; remember to shake well before use).
  • For plugged tear duct gently but firmly press at the inner bridge of the nose with the pad of your finger beside the baby’s inner eye. Stroke up to remove blocked material, then downward 3 or 4 times to the nostril.  Repeat several times daily until it clears.
  • Sleep with the baby in your room. Baby should sleep on her/his back, on a firm surface away from puffy blankets and pillows.

Breastfeeding

  • Feed baby frequently, usually 10-12 times/24 hrs after first day or so. Baby may have long periods of sleep in the first 24 hrs so may feed less frequently. Feed the baby on cue, minimum every 4 hrs or so. Babies usually nurse for 15-20 minutes.
  • Baby’s mouth WIDE open before latching! If painful, retry the latch over and over until it’s correct.  This will prevent sore nipples. Don’t do even 1 feeding with improper latch.
  • Should feel a pull but not a pinch
  • Breast well supported in one hand, where an underwire goes, away from nipple
  • Baby position: skin to skin, belly to belly, nose to breast, pull in very close so that very little/none of areola is visible, with both baby lips open (not tucked in).
  • Nipple care: Expect nipples to be tender for a few days.  Express colostrums onto nipple /areola after each feed. Allow to air dry.  Do not use soap or chemicals on nipples.  In case of chaffed or dry skin, Lanolin or pure vitamin e-oil can be used (but try the colostrum first).  Change nursing positions
  • If breasts get engorged with milk (hard and full-feeling), apply refrigerated green cabbage leaves, and reapply new ones as they “cook”
  • Avoid the use of pacifiers or artificial nipples

PLEASE CALL IF YOU’RE TEMPTED TO USE FORMULA IN SPITE OF PLANNING TO BREASTFEED

Angie The Doula – Warning Signs During Pregnancy and Labour

Posted by on in Birth, Birth Prep, Interventions, Labour

Unusual sensations and some discomforts are part of normal pregnancies.  It is important, however, that any of the signs listed below be assessed right away.

CALL 811/DOCTOR/MIDWIFE WITH ANY WARNING SIGNS.  CALL 911 FOR EMERGENCY HELP!

If you call 911, have someone clear a path for EMT (halls, stairs etc), turn on outside light, put pets away, unlock door, clear driveway.)

Warning Signs – Seek medical advise soon, at least same day. Do not sleep on any of these or wait for them to go away on their own.

  • Reduced fetal movement that doesn’t respond to stimulation (see below) *
  • Maternal fever and chills
  • Dizziness
  • Persistent and severe mid-back pain
  • Prolonged nausea and vomiting
  • Initial outbreak of lesions or blisters in the perineal area
  • Change from normal urination – suspected bladder infection
  • Vaginal discharge with itching, irritation or a foul smell
  • Signs of bladder infection such as burning or urgent, frequent urination
  • Persistent negative feelings, low moods and/or overwhelming anxiety.
  • Gush of vaginal fluid or suspect ruptured membranes, with nothing felt to be falling out
  • Pinkish, brownish, sparse or suspected vaginal bleeding
  • Signs of labour (regular uterine contractions, waters releasing) before 37 weeks
  • If there’s a colour (yellow, brown, green) or foul odour when waters release

Danger Signs – The symptoms below may indicate a life-threatening condition, and require immediate medical attention.  Get to a hospital right away.

  • Accident or injury such as car accident or a fall (seek medical attention if required)
  • Sudden severe swelling of hands and face
  • Severe continuing headache
  • Visual disturbances (e.g., blurring of vision, spots, flashes of light)
  • Persistent, severe, sudden abdominal or pelvic pain
  • Severe epigastric pain (upper abdomen) – may feel like heartburn but more severe and not relieved by the usual tricks
  • Sudden and severe vomiting
  • Red flowing vaginal bleeding (CALL 911)
  • Persistent thoughts of self-harm, suicidal urges (CALL 911)
  • Convulsions (CALL 911)
  • Gush of vaginal fluid / suspected ruptured membranes, with a cord felt at or outside vaginal opening (cord prolapse) – get on hands and knees with buttocks higher than head (CALL 911)
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* Normal Fetal Movement:  If you’ve been busy or are unsure about movement then relax and have a meal, a small glass of juice or some fruit.  Palpate your baby to induce movement.  Pay attention to the movements.  Babies sleep.  If your blood sugar is low then so is your baby’s.  You should feel at least 10 movements over any 2 hour block and at least 1 in the first hour.   If not then seek medical attention.

Golden Nuggets for Breastfeeding Early Days

Posted by on in Baby Care, Breastfeeding, Education

Some little-known gold nuggets for breastfeeding in the first days (you may wish to print this and stick it on the fridge or by your feeding-nest):

  • Breastfeeding may take practise but is designed to work
  • Watch for feeding cues* and offer breast.  Crying is considered a late sign of a stressed babe.
  • Offer one cue, then pause to let babe work it out.  E.g. nipple to baby’s lips, then pause for 5 seconds to allow babe to sort out latch.  If she needs another cue, then give on, pause, and repeat if needed.  Baby is learning too.
  • Babies rest/pause with eyes closed.  If babe stops sucking but stays on breast, let him rest and resume feeding.  He’s likely not actually sleeping, so don’t take him off.  (Sleep test – lift and drop arm.  Sleeping baby’s arm will fall; wake baby’s arm will respond.)
  • You should feel a tug or pull, but no pinching.  Avoid the temptation to feed through a bad latch, no matter how demanding baby is.  Not even once!!  Break the seal (insert pinkie into babe’s mouth) and start again.  Even if it takes 10 tries.
  • Don’t hold baby’s head while feeding.  It may be sore from birth.  Sore or not, the stimulation causes baby to pull back from breast.  Hold head by putting hand on bones at top of neck if necessary.
  • Don’t “pet”, rub, stroke babe while feeding.  Holding and feeding baby is an act of big love in and of itself.  (Imagine if you were trying to enjoy a fine meal, and someone was petting and rubbing you all over.  Ok that might be fun, but not conducive to eating.)
  • After 3-6 weeks the effort of breastfeeding becomes way less than the effort of formula.  Keep going – it gets easier and is worth the early efforts.

Best Start has an excellent 1 page chart for the first days –  feeding guidelines, newborn stomach size, diapers and other info.  Print this!

* Here’s a great graphic to help you identify visual feeding cues.