Considering colic…

In my work as a doula and childbirth educator, I’m often asked in the weeks/months following the birth to support mum’s who have a baby with colic.  I always struggle with the term “colic”, as really it isn’t a diagnosis in and of itself, but a diagnosis of exclusion (in other words, we know baby isn’t happy but we’re not sure why, so we’ll call it colic).

Kind of like Irritable Bowel Syndrome…you go see your GP because you have painful abdominal cramps and bloating, they do some tests, ask some questions, can’t find any obvious problem so tell you your suffering from painful abdominal cramps and bloating (um, thanks!).

Some of the literature around early parenting recommends not calling it colic, but rather talks about parenting the “fussy” baby.  Again, I’m not entirely sure this is helpful language.  Why do we need the label?  When our babies are expressing some kind of need or discomfort, it’s our job as parents to work out what it is and try and help and support them.

Anyway, I’m not planning to go into a lot of detail about what colic and reflux (a symptom that sometimes accompanies colic) are in this post.  But the other day I attended a wonderful workshop with the amazing lactation consultant April Whincop (www.believeinbreastfeeding.com).  We spent some time discussing colic and reflux, and I found what she had to say incredibly helpful.  Below, I’ve laid out, in order, some steps you can try which will hopefully be helpful for you and, of course, for your baby!

Addressing Colic and Reflux

The first thing is to keep baby skin to skin, as much as possible.  Basically think about wearing your baby (in a wrap or sling) as much as possible during the day (again, ideally skin to skin), and keep baby close (co-sleep) at night.  [Please note that if you are planning to sleep share with your baby, and yes I do think this is a great idea, make sure you are following safe sleep sharing practices.]  It’s worth noting that in cultures where they basically don’t put their babies down for the first few months (referred to as the fourth trimester), colic doesn’t seem to exist.

Many people share with me that they find this difficult…the idea of being constantly with their babies!  Yes, it is sometimes difficult.  But for the previous 9 months that they were in the womb, your baby was with you constantly, and when they are newly born (i.e. the first few months) they are quite likely not ready to transition away from this.  This phase won’t last forever, and in any case is it not worth it if it eases the frantic crying and discomfort?  Of course, rope in some support if you can…fathers and other main carers can also wear baby skin to skin!

The second thing is to ensure you are actually feeding baby enough.  Very often, the baby doesn’t have colic…baby is hungry!  So make sure you are feeding lots!  There is a lot of misinformation about breastfeeding in the early weeks, and many of us new mums do not fully understanding baby’s needs in the early post natal period (yes, I include myself here…I had no idea how much feeding I would be doing in those first weeks when I had my first baby).  They need to feed more often than we think!  And this may well be more frequently than every 3 hours.  Again, this won’t last forever…the early weeks are all about establishing breastfeeding, and frequent feeds will help to ensure a good milk supply.

If you’ve tried really upping the baby wearing and skin to skin and your ensuring your baby is feeding frequently, but it hasn’t helped, the third thing is to start to pay attention to what your (mum’s) eating and digestion is like.  If you’re supporting your own digestion, you’re supporting your baby’s too.  The better you digest your food, the less irritants make their way into your breastmilk.  This includes eating well (i.e. nutritious foods…mind the sugar!!!) but also chewing well, eating slowly, not eating when anxious, that sort of thing.

The fourth step, if the above points don’t resolve the problem, is to start thinking about what you are eating that might be causing a reaction in your baby.  The top triggers are dairy and wheat, but citrus, sugar, fish, fruit and caffeine can be problematic as well.  Many mums say that brassicas (broccoli, cauliflower, etc) cause discomfort in their babies.  Really you need to eliminate foods for a good 3 to 4 weeks.  I will write a separate post soon about how to go about eliminating foods to see if they are causing a reaction, so stay tuned for that.

You can drink a tea made of fenugreek, dill, turmeric, cumin, nigella seeds.  The herbs will make their way into your milk.

It’s also important to check out the fatty acid content of your diet.  It’s important that you are eating a lot of fat, and the good fats!  Saturated fats are not a problem (contrary to popular belief), and you can take a spoonful or two of virgin coconut oil every day to up your fat intake.  You should also up your intake of the essential fatty acid Omega 3.  Omega 3s are found in oily fish, eggs (free range, organic) and dairy from grass fed animals.  You can also take a good quality Omega 3 fish oil  (make sure it’s a good quality one as omega 3 fats turn rancid very easily).

It’s also important to lower your intake of Omega 6 fats, which most of us have way in excess of what is needed by the body.  So avoid vegetable and seed oils (olive oil is fine, but omit vegetable, sunflower, safflower, rapeseed/canola, etc).

Finally, you also need to be getting a good amount of protein in your diet.  Ideally your having protein at every meal.

Tips for Reflux

If baby is sicking up quite a lot, here are some things to try:

  • Keep baby’s head above it’s bottom whilst feeding (have baby at a 45 degree angle rather than horizontal)
  • Keep baby upright 30 to 40 mins after a feed
  • Handle baby gently (no jiggling) after a feed
  • Lie baby on left side
  • Lie baby prone (ideally on mum’s chest)
  • Only use car seat in the car (this should be the case whether there is a reflux issue or not…car seats are only for cars…they are not great for baby’s back!)
  • Roll baby onto left side when changing nappy
  • Offer small, frequent feed
  • If the above don’t resolve the issue, progress to elimination of foods which may be problematic (as described above).

A little trick you can try on an uncomfortable baby, which one of the doulas present on the workshop shared with us:  There are acupressure points either side of the navel that you can press.  So put your fingers either side of the navel and press gently.  If it feels hard, then gently massage these points.  If it feels soft, then just hold using gentle pressure.

I hope this information is helpful to you and your baby, and feel free to leave comments and share your experiences!

Posted in Uncategorized | Leave a comment

Boost your Iron!

A friend of mine has asked me to make her and her pregnant friend a batch of iron tonic, and I thought it might be a good idea to put up a post about this for those of you who may either regularly or occasionally struggle with your iron levels.

First I must say that I cannot claim to be the inventor of this genius concoction…the recipe comes from my friend Max the herbalist (here’s a link to his site), and you can buy the iron tonic herbs that are listed in the recipe from his shop.

This tonic is excellent for a few reasons.  First, the taste, although strong, is actually rather nice.  Second, and most important, the iron in the tonic is very easily absorbed by the body.   Indeed, it seems to be much better absorbed than the iron tablets (ferrous sulfate or ferrous gluconate) that are often prescribed by the GP.  These tablets also have constipation as one of the main side effects, and this is a third advantage of taking the tonic…it most definitely does not wreak such havoc on the bowel!  Nor does it cause upset stomach, nausea, heartburn…some of the other common side effects of the tablets.  (Ferrous gluconate is given to people who really struggle with the side effects from ferrous sulfate, but it contains a lower concentration of iron).

As I mentioned above, I’m making this batch for a pregnant friend…the tonic is perfectly safe for pregnant women, and is particularly good to have on hand for the post partum.  It is common for women to have low iron after the birth, and I highly recommend this tonic at that time…you really don’t want to be struggling with fatigue whilst trying to look after a new baby!

A post about iron wouldn’t be complete without also indicating some of the foods that include iron, and you will probably want to ensure these are included in your diet if you’re low on iron:

  • liver (yep, it might not be the tastiest thing in the world but it’s full of nutrients and iron is one of them!)
  • dark green, leafy vegetables
  • some dried fruits (prunes, raisins, apricots, figs…but eat these in moderation because of the sugar content)
  • eggs

Note that some whole grains contain iron, but they also contain phytates which make the iron difficult to absorb.  Similarly, spinach contains loads of iron but the iron is not easily absorbed due to the presence of oxalates.  Sorry Popeye!

I also recommend investing in a good quality black cast iron pan.  Not only are they amazing to cook with, being highly durable, easy to clean and non-stick, but apparently some of the iron is leached into the food (particularly if you cook things like tomato sauce in it) and thus boosts the iron in the diet.

Finally, here is the recipe for the tonic:  I’d love to know how you get on, either making it or taking it!

Ingredients:

1 kg unsulphured apricots
1 kg molasses
3 L red wine
5ml/L tincture of ginger, gentian, rhubarb root, yellow dock, damiana and nettle tops (you need 5ml of each herb per litre of tonic, or 30ml of a mix of all of them)

This recipe makes about 4L of tonic…so a rather big batch!  You may want to halve the recipe.

Method:

  1. Cover the apricots with water and simmer about 6 hours.
  2. Add molasses and simmer a further 2 hours.
  3. Cool and liquidise.
  4. Add the red wine and stir 5 to 10 minutes until pourable.  Add the tinctures.
  5. Bottle up in 500ml airtight bottles and keep refrigerated once open.

Dosage:  5-10ml 3 times per day.  30ml of tonic provides about 2mg absorbable iron.

 

Posted in Uncategorized | Leave a comment

Freedom for Birth

Hi all,
I know it’s been a long while since I’ve posted anything, but I’m really excited to be letting you know about an upcoming film screening that I’ll be hosting, along with the Bristol Doula Network, in Bristol.
We’ll be showing Freedom for Birth on Thursday 20th September, from 7.30 pm til 9.30 pm.
The screening will take place at Halo, 141 Gloucester Rd, Bristol.
The duration of the film is an hour, and will be followed by an hour long discussion of the film.  There is a suggested donation of £3 to cover the costs of hosting the film.
Please arrive 20 minutes early to buy drinks and get settled.  It would be helpful if you could email me on ly.malnick@gmail.com if you’re planning to attend, so we can get an idea of numbers.
“FREEDOM FOR BIRTH” is a new documentary that reframes childbirth as the most pressing global Human Rights issue today is launching with hundreds of premieres all over the world on the same day, Thursday 20th September 2012.
Freedom For Birth is a 60 minute campaigning documentary featuring a Who’s Who of leading birth experts and international Human Rights lawyers all calling for radical change to the world’s maternity systems.

Hermine Hayes-Klein, US lawyer and organiser of the recent Human Rights in Childbirth Conference at the Hague, the Netherlands says, “the way that childbirth is being managed in many countries around the world is deeply problematic. Millions of pregnant women are pushed into hospitals, pushed onto their back and cut open. They are subject to unnecessary pharmaceutical and surgical interventions that their care providers openly admit to imposing on them for reasons of finance and convenience. Women around the world are waking up to the fact that childbirth doesn’t have to be like this and it shouldn’t. Disrespect and abuse are not the necessary price of safety”.

Made by British filmmakers Toni Harman and Alex Wakeford, Freedom For Birth film tells the story of an Hungarian midwife Agnes Gereb who has been jailed for supporting women giving birth at home. One of the home birth mothers  supported by Ms Gereb decided to take a stand.

When pregnant with her second child, Anna Ternovsky took her country to the European Court of Human Rights and won a landmark case that has major implications for childbirth around the world.

Toni Harman, one of the filmmakers says, “the Ternovsky vs Hungary ruling at the European Court of Human Rights in 2010 means that now in Europe, every birthing woman has the legal right to decide where and how she gives birth. And across the world, it means that if a woman feels like her Human Rights are being violated because her birth choices are not being fully supported, she could use the power of the law to protect those rights. With the release of “Freedom For Birth”, we hope millions of women become aware of their legal rights and so our film has the potential to spark a revolution in maternity care across the world. In fact, we are calling this the Mothers’ Revolution.”

Cathy Warwick, Chief Executive of the Royal College of Midwives (RCM), says: “A safe childbirth should be a fundamental human right for women. Sadly, for many, many millions of women and their babies across the world this is not the case. The world is desperately short of the people who can help to ensure and deliver this human right; midwives. There is a real need for leaders of nations to invest in midwifery care in their countries. I hope that the making of this film which the RCM is supporting with a screening will go a long way to help make skilled maternity care a reality for those women who currently do not have access to it.”

Lesley Page, President of the Royal College of Midwives adds, “Too many women across the world are dying or suffering terribly because of a lack of skilled maternity care. This is unacceptable and I call on all Governments across the world to give women the right and access to safe care in pregnancy and childbirth.”

Ms. Hayes-Klein concludes, “Freedom For Birth” holds the answer to changing the system. Birth will change when women realise they have a right to meaningful support for childbirth and claim that right. Birth will change when women stand up against the abuses that are currently suffered in such high numbers and say, No More.”

Additional information about Freedom For Birth can be found on the website:  http://freedomforbirth.com

 

Posted in Uncategorized | Leave a comment

Baby-Led Weaning…in the news

Hi all,

Read an interesting article on BBC news recently clocking some early research into baby-led weaning (BLW).  The study indicated that spoon feeding babies may result in babies developing a sweeter tooth than non-spoonfed babies.  Results also indicated a higher incidence of obesity in spoonfed babies.  My own sense from reading through the article (haven’t read the full research on this…sorry!) is that the sample size was very limited and more research needs to be done on this, but interesting to see a bit more on BLW in the news.

For those of you who haven’t heard of BLW (you’re not alone…it was a complete revelation to me when I started feeding my child solids!), the basic premise is that you allow your little ones to feed themselves.  Pretty simple!  You start by offering them stick-shaped food that is soft enough for them to “chew” with their gums.  When babies are given pureed food, they learn to swallow first and then chew.  This is fine, until you move onto food with “lumps”, and then they have to learn how to deal with these lumps in order to swallow.  In the case of BLW, babies are learning how to chew first, and swallowing comes later.

Additionally, babies are in control of what they put in their mouths, and how much they eat, which I suppose is what the above-mentioned study is on about…babies tend to eat as much as they need to eat, and will stop when they’ve had enough.

I’ll write more on the BLW approach in a later post.  For now, just to flag up this news piece.  If you’re interested in finding out more in the meantime, check out the BLW website.  The book is great too!  Full of very useful information.

Ly x

Posted in Uncategorized | Leave a comment

Creating Menstrual Health

Dear all,

I attended an amazing workshop today run by Alexandra Pope on menstrual health.  As someone who has charted her cycle from the physical point of view (i.e. noting when I ovulate and when I bleed), this was a great insight into the potential emotional literacy to be gained with being aware of my cycle.  It’s about acknowledging that we are different at every stage of our cycle.  That there are vulnerable moments in each phase, but also powers to be harnessed.

Many of us are aware that pre-menstrually we might be emotionally expressive, cranky, edgy, etc.  What’s that about?  What’s really going on for us as women at this time?  And are we equally aware of the qualities or feelings that dominate our experience or way of being in the other phases of our cycle (the run up to ovulation, the time around ovulation, and indeed the time when we are bleeding)?

Alexandra argues (and I agree) that this is basic knowledge that should be a part of every woman’s education.  It’s about valuing who we are as women, it’s creative, it’s about our health, it’s about our innate wisdom as women.

As a childbirth educator and doula, I was particularly inspired by some of the connections I was drawing out around the phases of labour and birth, and indeed the whole of the pregnancy journey, but that’s stuff for later as I take the time to think about and process it.

I highly recommend any woman to attend a workshop with Alexandra.  Truly amazing and inspiring stuff!  I’m very much looking forward to beginning to chart my own cycle in a way that also encompasses the creative/emotional/spiritual elements and beginning to understand how that influences my life, and also that I may get in touch with this deeper and richer way of being in the world.

Ly x

Posted in Uncategorized | Leave a comment

We Can Be Much Kinder – A Bit About Cord Clamping

Hello all,

I’ve recently been having some discussions about the various advantages of leaving the umbilical cord intact until it finished pulsating.  It seems that there are still many women who are not aware that they have a choice in this matter (i.e. that with a physiological birth, the cord doesn’t need to be immediately clamped and cut…and indeed even with some interventive births this can apply!).

I just watched a lovely video clip on this blogsite (it’s the first video on the page, entitled We Can Be Much Kinder…it’s about 7 minutes long).  I really recommend you have a look…it has quite a long bit about the advantages of leaving the cord to finish pulsating.  Briefly, the benefits of what we call a “physiological third stage” (mum is not given an injection of Syntometrine to deliver the placenta – it seems many women are also unaware that they have a choice as to whether to have this injection or not – and cord is left to stop pulsating before being clamped and cut) include:

  • Baby benefits from receiving a supply of blood from the placenta (when babies come through the birth canal, a lot of blood is shunted back to the placenta as baby squeezes through…when baby is born, the pulsating cord and the position of baby on the mother’s chest enables the baby to replenish it’s blood supply)
  • This blood also contains clotting factors, which may help prevent Vitamin K deficiency bleeding (M. Cranford, Midwifery Today, Issue 98, Summer 2011)
  • Baby benefits from oxygen coming from the placenta, which gives baby a bit of time to learn to use it’s lungs
  • On a simple note, it offers mother and baby quiet, undisturbed bonding time after the birth, while baby remains connected to its mother via the umbilical cord and perhaps facilitating baby’s transition into the big wide world

Ly

Posted in Uncategorized | Leave a comment

One World Birth – Launch

Hi everyone,

The One World Birth project has now officially launched…check it out here!  I think they are a hugely passionate bunch doing a very interesting project, and there are some great clips to watch on the site.  Nothing more I can say really…have a browse round the site and enjoy!

Ly x

Posted in Uncategorized | Leave a comment

Long term health and our earliest days…

Very interesting programme on BBC 2 Horizon, called The Nine Months That Made You (http://www.bbc.co.uk/programmes/b013c8kd).  I really recommend watching it.  The basic idea is that by looking at how our time in the womb, which is connected to our birth weight, can be a predictor for diseases and our long-term health.  It’s quite a shift in thinking.  I will write again soon to comment on it…I’ve only just watched it and I’m still digesting/reflecting.

Ly

Posted in Uncategorized | Leave a comment

Why have a Birth Partner? In the news…

Very interesting bit on Woman’s Hour (22 June; it begins at about 24 minutes) discussing a scheme that offers birthing women in a hospital in Hackney the presence of a birth buddy, or doula, for their birth.  The scheme began as a way of trying to reduce the number of emergency Caesareans and infant mortality occurring in women of Black African, Asian or Caribbean backgrounds.  The programme was so successful, the service was extended to all birthing women.

Why is the programme so successful?  As discussed on the show, fear associated with going in to hospital leads to tension in the mother.  The presence of the doula helps to reduce tension, helping the mother to relax and go with her labour, leading to a better outcome.

From a physiological (i.e. hormones) point of view, the key hormone in labour is oxytocin.  No oxytocin, no labour.  However, the presence of adrenalin inhibits oxytocin, which is why it is so common to hear women say that their labour slowed down or even stopped when on arriving in hospital.  (Adrenalin is released when mother is fearful, anxious…even something as subtle as being in unfamiliar surroundings can result in adrenalin being released!) Women may feel fearful during in labour if they are left alone…this may happen if the midwife has other clients to attend to, and cannot be with the labouring mother  for the duration.  A doula, who remains with the mother (and partner) for the whole of the labour, birth and appropriate time after the birth, can help reduce the level of distress associated with a lack of support.  As stated in the programme, this results in a better outcome for both mother and baby.

Also, whereas a family member or partner might find it difficult to see mother in distress because of the pain of labour, doulas act as a “neutral” person, providing reassurance and reminding the couple that this is good pain, normal pain, and that it is bringing the baby closer to being born.

There is a clip from a birth that is aired at the beginning of the programme, which the midwife interviewed on the show commented on.  She said she couldn’t recognise who was the doula and who was the midwife, as they both seemed to be coaching the woman to push.  I also found this rather strange, as I would expect a doula to adopt a “quieter” role, encouraging the mother to work with her body and use her breath rather than coaching her to push.  Indeed, the midwife commented that women shouldn’t be coached to push, as it is distressing for the baby and also may result in tears.

The key point here, though, was that doulas need to understand their role…they are present to provide emotional support to the mother (and her partner) [and I would add they are also able to act as an advocate for the mother and for the baby], and not to fill a gap in care resulting from a shortage of midwives.

Do have a listen if you have the chance; it’s quite an interesting piece!

Posted in Uncategorized | Tagged , , , | Leave a comment

One World Birth

Hi all,

I sat in on a webinar (online seminar) to find out more about the One World Birth project.  This is a really interesting project and I would definitely encourage you to keep in touch with them through their website to find out when it all goes live.  They are a really fantastic and enthusiastic team full of passion for what they are doing.

Basically, their idea is to create an online documentary that continues to expand as the world of birth grows and changes.  They have been (and will be) filming around the world, trying to include as many voices as possible to add to the richness and diversity of what we know about, and how we “do” birth on a world wide basis.

There are two clips on the site that you can watch to get more information.  One is a trailer for the documentary, and the other is more information on how the whole thing works.

Check it out, I think it’s exciting stuff and a really creative idea!

Posted in Uncategorized | Leave a comment