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Posts tagged ‘vintage’

Fabulous Vintage Breastfeeding & Mother’s Day Art

HAPPY

MOTHER’S

DAY !

1859 "Abundance" engraved by T.Vernon

1850 "The Gypsy Mother" engraved by E.Portbury

1840 "The Gypsy Mother" engraved by Greatbach

In the world of childbirth, Mother’s Day is a very special day. I have enjoyed years of watching a women become a mother either for the first time or again and again on this very day. It is always wonderful to share that experience with them.  Fabulously Joyful!

But today, I get to be home, pampered by my hubby and just milling about… I came across some wonderful websites carrying fabulous vintage engravings and various clip art. I absolutely adore antique engravings! I have some framed and others saved for something I’ll get to one day…  😉

This first few photos above are images courtesy of antiqueprints.com depicting mother and children. There are two WONDERFUL Antique Breastfeeding Engravings! These are all steel engravings with hand color in the first two.

The remainder of art below is from a website called “The Graphics Fairy” and all of these photos  are to Karen’s credit over there. Beautiful!

Enjoy!

Victorian "The Mother" engraved by the Illman Brothers

1880's Antique Engraving Children with Cherries

Beautiful old painting of a Mother with Children

Old French post card

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“The American Propensity to Shun Human Milk is a Public Health Problem”

A Historical Perspective

Bulletin: Chicago School of Sanitary Instruction (June 3, 1911)

This is a part of my comment reply placed to an individual who had commented on The Feminist Breeder’s  post “When It Comes to Breastfeeding, We Can’t Handle the Truth”

“There were countless situations over the last 200 years which forced caregivers (whether the natural mother or another individual)to resort to artificial feeding of one kind or another. It is amazing what some of them came up with to try to feed those infants! Necessity was the mother of invention. And many were able to survive. It’s wonderful that they could. Many more, however, sadly died. Many many babies were sickly or died in those times.
You say: “The matter is that formula/breastmilk substitutes became so helpful that people continued for centuries to make it work.” I agree.
But my take on it is that the necessity of an available safe artificial alternative to breastfeeding for those mothers who could not breastfeed their babies took centuries to formulate…to make it nutritious enough and safe enough and to come up with a safe enough feeding container. It was just that.. an artificial substitute.
Gosh– I am NOT an expert on this aspect at all.
I just feel that the heart of this conversation is that artificial infant feeding has risks. Risks that mothers aren’t informed about because society has normalized artificial feeding. Breastfeeding is normal feeding.
No one should ever take away an individual’s choice..EVER…!!!!!
Mother’s simply need better information to make INFORMED choices.
I’m very sensitive and careful in my approach to moms… helping them with information they need to make the best choice for them. Then I will ALWAYS support that mother 100%.
Here’s an interesting historical perspective link for your review from the American Journal of Public Health | December 2003, Vol 93, No. 12
It covers history from about 1890 to early 1900’s.”

“Low Breastfeeding Rates and Public Health in the United States”

Here are some quotes and excerpts from this article published in the American Journal of Public Health (December 2003, Vol 93, No. 12 ) discussing Public Health THEN and NOW.

Quotes:

“Late-19th-century physicians . . . constantly
decried the ‘children with weak and diseased
constitutions belonging to that generally
wretched class called bottle-fed.’

“Today’s medical community recognizes what their
predecessors knew a century ago—that the
American propensity to shun human milk is
a public health problem and should
be exposed as such.”

Abstract: “The medical community has orchestrated breastfeeding campaigns in response to low breastfeeding rates twice in US history.
The first campaigns occurred in the early 20th century after reformers
linked diarrhea, which caused the majority of infant deaths, to the use of cows’ milk as an infant food.
Today, given studies showing that numerous diseases and conditions can be prevented or limited in severity by prolonged breastfeeding, a practice shunned by most American mothers, the medical community is again inaugurating efforts to endorse breastfeeding as a preventive health measure.
This article describes infant feeding practices and resulting public health campaigns in the early 20th and 21st centuries and finds lessons in the original campaigns for the promoters of breastfeeding today.”

I found this article to be very informative and very interesting.

WHAT HAVE WE LEARNED???


Wordless Wednesday… 1950’s “Good Wife Guide” and more…

goodwif1A guide for a “Good Wife” and more…….  vintage 1950’s and 1960’s American culture Photos found on this amazing collection of photos. Great find!!! I really remember many of these things.. Born in 50’s, preteen to teen in 60’s to 70’s.

Fun Memories

Click here for all the photos!

http://www.billsretroworld.com/RETROLIFE.HTM

I recently found this first link wasn’t working now…so I found another copy of this guide here:

http://www.snopes.com/language/document/goodwife.asp

http://www.snopes.com/language/document/goodwife.asp

Little Old Men… & Nursing in Public

Welcome Readers…to my first Carnival of Breastfeeding post!
This month’s topic is “Nursing in Public”.
Links to all the Carnival Posts are listed @ the bottom. I’ll update this as more are posted.

Keep checking back and Enjoy!!

My first baby was born in sunny Florida during a particularly hot stretch in May 1979.  Although I was an OB nurse, I knew very little about breastfeeding other than what my older co-workers had taught me—which was not all that correct or very helpful information. Luckily, I had a great friend who was nursing her 3 month old at the time my son was born. She really showed me the ropes. It just so happened that she was the one who took me home from the hospital. We had to stop at the store for a few items so we went in to a “Publix” supermarket with both babies in our arms.  My newborn son began fussing to nurse soon after we hit the air conditioning.

I said.. “I’m going to have to go back out to the car and nurse him.”

My friend says “Oh..You’ll do no such thing.. You’ll die in that heat.. Just hook him up and keep shopping so we can get finished and out of here!”

Me- “Nurse him in here?”

Friend- “Well if he’s hungry.. yeah!.. (after looking at my face) Oh stop worrying about it..go over to a deserted aisle, get him hooked on and put your receiving blanket up near his face… nobody will know!”

Me- timidly…above the louder howls.. “Alright, be right back..”

I found the most private place I could. I started cursing that complicated “wonderful nursing bra” I just had to have. (Remember..this is 30 years ago… this bra is now an antique!) My skills handling newborns allowed me some grace as I attempted to multitask by stooping down, prop my loudly crying baby on my partial lap, use 2 hands to fiddle with the damn nursing bra, then get him back up near my finally free boob and latched on.

Ahhhh~ quiet, happy, drinking baby!

Still stooped down, I peered slowly behind me — expecting that a large crowd must have assembled. Somewhat surprisingly, everybody was just going about their business and I happily realized that noone was looking at me! I stood up, made sure I wasn’t showing anything, and walked off with my happily nursing baby to find my friend.

It’s amazing how many people want to see a quiet baby as opposed to a screaming infant!

A sweet little old man stopped me first and asked me how old my baby was….”3 days”, I replied. He peeked in for a closer look and he actually didn’t get it right away.. “I can’t really see his face.”.. I said “Well- he’s feeding right now.”.. He just said..”OOPS….sorry about that! Well he’s a cute one!” then walked off.

The next person who stopped me was again.. a sweet little old man. He was very smiley and jolly. He asked all about the baby but didn’t lean over to look like the other man. I quickly said he’s nursing now and then answered all the small talk.  He never seemed uncomfortable about it at all! That probably gave me a lot more confidence. We parted ways and I finally found my friend. She gave me an approving thumbs up, asked me to hold a basket with my other hand and said we were almost done.

Another little old man stopped us by the register to ask about both babies. We gave him all the small talk answers and let him know my son was nursing. This guy was a real sweetie, commenting on how lucky kids were that moms were starting to “nurse their young” again and ‘good for you.”  He never tried to look in at my son. He didn’t seem embarrassed by the process at all. He was the coolest guy!

I left the Publix Supermarket on my way home to begin my life as a mommy…. with a little public education bonus.  Encountering those sweet little old men while feeding my baby and receiving their positive type feedback was the gentle support I needed. I went on to feel empowered to nurse in public for all three of my babies…  Those little old men were just so supportive! ~ When my baby was hungry, he needed to feed and it really didn’t matter where I was at the time.  Thank goodness for my friend’s wisdom and support to go for it!

I became a lactation professional while nursing my last baby. It was then, only after I really became more aware of issues surrounding nursing in public that I actually took any kind of public action to empower other moms.  I’ve done lots of different little things as the years have gone by. I want to mention one fun way that I thought I could help gently re-educate some of the “new” sweet little old men of this day and age.  Our local paper has a lot of little retired guys commenting back and forth on various local articles. I’m guessing their age and status by all the things they say. I took this opportunity to possibly educate some of these forum readers about breastfeeding rights in public.  Every once in a while, on the forum, I put out a little snippet on nursing in public… and sit back and watch what they have to say in reply! It’s quite fun!

Here’s an example I wrote on a long forum discussion a couple years ago on a breastfeeding article:

On another note, regarding a reader reaction in the forum, a skimpy bikini or the bathing-suit issue of a favorite sports magazine show more skin in a provocative, sexy way than any mom breast-feeding. Even the movie stars in their gowns with plunging necklines are showing almost the entire breast! Somehow, that is OK. It is sad that the public opinion of a baby breast-feeding (the most natural way for him to eat) is something that should be done in private … yet young girls are encouraged by media to bare more and more skin. Of course being discreet while feeding is important, but I can assure you, most girls in a tiny bikini are thinking more about “tacky exhibitionist behavior” than a mother breast-feeding her baby. August 1-7 is always World Breast Feeding Week. The theme this year is “Welcome Baby Softly,” focusing on the importance of the first hour or two after birth. Learn more about it. I would love to see the paper do an article on that.

This one provoked a few responses in both directions and sometimes there were a few people who actually thought out loud that …gosh maybe I was right… never thought about it that way…etc..

Here’s an example I wrote on a recent article about the appropriate % amount for tipping :

I have never left an establishment without tipping– however, I also tip according to service up to 20%. If there are unkind reactions to small children in a FAMILY establishment, they will be getting a bare minimal tip for sure!! I do my best to keep my children behaved with table manners AND respect other patrons… but fact remains, they are children! I cannot possibly be prepared for every behavior or an accidental spill. In addition, my breastfeeding baby may be hungry.. By PA law, I have the right to nurse my baby in a public place wherever he and I are allowed to be. I am discreet.. I am protected by law… I don’t need an unkind comment from servers. They do not get a 15-20% tip if nasty, unkind or disrespectful comments have been made about my children or my breastfeeding baby!

This provoked a foray of comments ranging from ‘good for you’ to ‘you should be in the back booth…controlling kids etc..’  Sometimes the opportunities to educate others come at unexpected times but produce amazing results!

On a few occasions, other readers were supporting my comments and

helping to educate those sweet little old guys with me!

😉

Carnival of Breastfeeding Post Links (Check back for updates)

Cesarean Delivery of the Second Twin… Why? 

029I was talking to one of my on-line Twitter friends @onefinebreeder about twin delivery. I was telling her about how things used to be.. how vertex-nonvertex twin gestation’s were always delivered vaginally ….. and she commented on how it was sad that some of the old OB skills have been totally lost to surgery… So Very True!

I got to thinking about the first combination Twin delivery I had witnessed back in the very early 80’s. This was actually one of our own (hospital employee) nurses .  She was a multip…. around 37-38 weeks and healthy…no complications during pregnancy. Twin A delivered spontaneously, vaginally with a generous episiotomy as they often performed at that time… The baby , a girl, was about 6 pounds, vigorous and had no problems. We were all marveling at the first baby, checked fetal hearts on the second twin and started waiting for him to get in position.  Still before consistent ultrasound, we were not worried. However, we had a newer doctor who was attending this birth. He began to get concerned after 5- 10 min when contractions slowed and he was worried that if this baby was breech, he would have difficulty with the “after-coming” head. Up to this point, all I had learned was this can be a real concern if the smaller feet or buttocks present through a cervix which is not fully dilated. Much research was done later on but at the time, I did not know about it. He began to ask us to call the OR for a C/S. This was unheard of in my limited experience at the time…. my 70’s world. I thought.. how can they do a C/S now when one baby was already born??? I tried to be an advocate… (my early days… )”We have Piper forceps…”  I said meekly… “Have you tried to grab a large part and help bring the baby down… ?” This was my limited knowledge… all I knew to suggest. I kept wishing one of the other doctors was on duty that day.. or maybe we could call them???

In front of the mother, he said to me “I’m not going to have a bad outcome here!” By now it was 20 minutes or so. There was no cord prolapse, no drop in fetal hearts, no evidence of immediate trouble… the baby was seeming to work itself into breech position…. To the mother he said “Your baby is in serious danger and the best thing to save him is to take you for a Cesarean now!” “I’ll sew your episiotomy together while we are in the OR.”

I was in shock. She signed, scared to death of course. So we prepped her for the OR. She went up for a C/S of her second twin and repair of her generous episiotomy. Her second baby was delivered frank breech…  a beautiful boy about the same size and was also vigorous and healthy. I remember I felt as though she was almost assaulted. I remember feeling that this was a true rare event if it every happened before. There was no immediate access to information like today.

Luckily mom and babies did fairly well in the postpartum period even though healing from both the episiotomy and the C/S was difficult for her.

"How can I get out if I'm not head 1st ??"

" Psst-- How can I get out if I'm not head 1st ??"

I wanted to see how much research I could find on this topic. I had gone to the green journal (OB & GYN) website but then it locked me out. (You can only look at abstracts anyway unless you want to purchase the article. You are on your own for that.) I had some luck with the abstracts at PubMed so I have put a few here.

I decided to take a look across time…….

This first one is from 1981. . Quoted abstract from the PubMed site:

Cesarean Section for Delivery of the Second Twin

Evrard,JohnR.; Gold, Edwin M.
Obstetrics & Gynecology. 57(5):581-583, May 1981.

Four cases of combined vaginal-abdominal delivery of twins are presented, and an additional 5 cases from the recent literature are discussed. Malposition, malpresentation, and contracted cervix were the main indications for cesarean section for the birth of twin B. In the 9 cases presented, there were 2 perinatal deaths.

Interesting that this research was done during the same time frame as my experience above. I’d like to know more about those poor outcomes 😦

The next interesting article I found was researched over a 10 yr period, somewhat close to here in a larger facility, published 1997. THIS study examines the delivery of the second twin by utilizing external version vs breech extraction . 😉 The results are showing in favor of breech delivery vs version (those meeting exclusionary criteria ).. Versions were associated with higher a incidence of Cesarean and fetal distress. Neonatal outcomes no different and are stated below:

Method of delivery of the nonvertex second twin: a community hospital experience.

 Smith SJ, Zebrowitz J, Latta RA.   J Matern Fetal Med. 1997 May-Jun;6(3):146-50

Abington Memorial Hospital, Pennsylvania, USA.

The purpose of this study is to examine the incidence of cesarean section and fetal distress complicating the delivery of the second twin in vertex-nonvertex twin gestations in which the second twin underwent either breech extraction or external version. The intrapartum courses of 510 twin gestations delivered at a community hospital over a 10-year period were retrospectively analyzed. All vertex-nonvertex twin gestations were identified in which the second twin underwent attempted breech extraction or external version. Exclusion criteria included birthweight < or = 1,500 g, fetal anomaly, intrauterine demise, and monoamniotic twins. Of the 76 twin sets that met inclusion criteria, 33 underwent external version and 43 underwent primary breech extraction. The two groups had similar demographic characteristics. External version compared to breech extraction was associated with a significantly greater incidence of cesarean section (8/33 vs. 1/43, P = .008) and fetal distress (8/33 vs. 1/43, P = .008). There was no difference between groups in neonatal outcome for the second twin as measured by length of stay, 5-minute Apgar < 7, intensive care unit admissions, hyaline membrane disease, intraventricular hemorrhage, and traumatic birth injury. In conclusion, the increased incidence of cesarean section and fetal distress in patients undergoing attempted external version suggests that breech extraction may be the preferable route of delivery for the nonvertex second twin weighing more than 1,500 g

The next study was published a little later in 2001 and covered a 20 year span of time… during the 80’s and 90’s at a larger center in Nova Scotia, Canada. They noted an increase in their combination vaginal/cesarean twin births and documented some statistical data, looked at reasons for an operative second twin birth. I wish to read this study further some day to see if there is mention pertaining to mother/baby outcomes other than statistics outlined (even though that wasn’t their objective) in this abstract:

Combined Vaginal-Cesarean Delivery of Twin Pregnancies

Obstetrics & Gynecology . 98(6):1032-1037, December 2001.

Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.

OBJECTIVE: To estimate the incidence and factors associated with combined vaginal-cesarean delivery in twin pregnancies. METHODS: We studied all twin births weighing 500 g or more during a 20-year period (1980-1999) at a tertiary care center. Major anomalies, monoamniotic and conjoined twins, and antepartum fetal deaths were excluded.

RESULTS: During this 20-year period, 105,987 women delivered, of whom 1565 (1.5%) had twins. Of these, 1151 twin sets fulfilled the study criteria. The mode of delivery was vaginal in 653 (56.8%), cesarean in 448 (38.9%), and vaginal-cesarean in 50 (4.3%). During the 20 years there was a statistically significant increase in combined vaginal-cesarean and elective cesarean deliveries, with a decrease in vaginal deliveries. Parity, gestational age, and birth weight discordance (>25%) were not associated with combined delivery. Compared with vaginal delivery, the nonvertex second twin was associated with a twofold higher risk of cesarean delivery (relative risk [RR] 2.3; 95% confidence interval [CI] 1.3, 3.8; P =.002); and an interdelivery interval of over 60 minutes with an eightfold higher risk (RR 8.2; CI 4.6,14.6; P <.001). Vaginal-cesarean delivery had a 22-fold higher use of general anesthesia compared with vaginal delivery (RR 21.8; CI 5.4, 88.5; P <.001). CONCLUSION: There has been a significant increase in combined vaginal-cesarean and elective cesarean deliveries among twin gestations, with a decrease in vaginal births. Vaginal-cesarean delivery is associated with nonvertex second twin and a prolonged interdelivery interval.

Now we come to 2008!  There is a study here from Texas. This study looked a twins born by C/S after labor and twins who had cesarean birth of the second twin. they campared outcomes to see if the twin of a combined delivery had more problems. The most important pieces of information I gather from this abstract of results…. (again, having NOT read the entire study):

“Combined twin delivery may be associated with endometritis and neonatal sepsis when compared with a twin delivery where both are delivered by cesarean in twin pregnancies experiencing labor. More serious neonatal sequelae, including hypoxic ischemic encephalopathy and death, were not affected by the route of delivery of the second twin.”  Hmmm 

Cesarean Delivery for the Second Twin

Alexander, James M.; Leveno, Kenneth J.; ….et al:for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network (MFMU)   Obstetrics & Gynecology . 112(4):748-752, October 2008.

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75235-9032, USA. james.alexander@utsouthwestern.edu

OBJECTIVE: To examine maternal and infant outcomes after a vaginal delivery of twin A and a cesarean delivery of twin B, and to identify whether the second twin experienced increased short-term morbidity as part of a combined route of delivery. METHODS: Between January 1, 1999, and December 31, 2000, a prospective cohort study of all cesarean deliveries was conducted at 13 university centers. This secondary analysis was limited to women with twin gestations who experienced labor and underwent cesarean delivery. We compared outcomes of the second twin in women who had vaginal delivery of the first twin and a cesarean delivery of the second twin to those who had cesarean delivery of both twins. RESULTS: One thousand twenty-eight twin pregnancies experienced labor and underwent cesarean delivery; 179 (17%) had a combined vaginal/cesarean delivery. Gestational age at delivery was 34.6 weeks in both groups (P=.97). The rupture of membranes to delivery interval was longer in the combined group (3.2 compared with 2.3 hours, P<.001). Endometritis and culture-proven sepsis in the second twin were more common in the combined group, respectively (n=24, odds ratio 1.6, 95% confidence interval, 1.0-2.7; n=15, odds ratio 1.8, 95% confidence interval, 1.0-3.4). These differences were not significant after logistic regression analysis. There were no statistically significant differences in an arterial cord pH of less than 7.0, Apgar score less than or equal to 3 at 5 minutes, seizures, grade III or IV intraventricular hemorrhage, hypoxic ischemic encephalopathy, or neonatal death. CONCLUSION: Combined twin delivery may be associated with endometritis and neonatal sepsis when compared with a twin delivery where both are delivered by cesarean in twin pregnancies experiencing labor. More serious neonatal sequelae, including hypoxic ischemic encephalopathy and death, were not affected by the route of delivery of the second twin.

I gather from these studies that a combined delivery route leads to more problems.. however…there are probably more problems than breech presentation alone to lead the provider to make that choice. I believe that many newer providers of obstetrics in a hospital setting are more apt to do a scheduled C/S for any vertex-nonvertex twins they encounter. That is what is done in my facility today. The same for all breech presentation singleton gestation.

Where is that old-fashioned nurse when you need her?? How ’bout the old fashoined doc??? 😉

I am very interested in anyone’s story or experience either in healthcare or your personal birth. Please let me know if you know anything about this!

Thanks for reading!

Wordless Wednesday…..

When Blood and Birth were considered CLEAN

When Blood and Birth were considered CLEAN

Thought I’d try this Wordless Wednesday style post. I give you a question….

Do any of you remember when Blood and Birth were considered CLEAN?

No gloves needed or used unless you would be STERILE or handling contaminated items??

Anyone??

 

No gloves

No gloves

Scary 1975 Breastfeeding Policy

 This story is about

VINTAGE Breastfeeding information

NOT Current Information

 

1979 Father wearing gown and mask to attend feeding

1979 Father wearing gown and mask to attend feeding

 

I have attempted to give an overview of our Maternity Ward as it was when I started to work there. I mentioned how “Once delivered, the baby went to the nursery and became the immediate property of the nurses, only to be seen from a window and allowed to be with the mother at token intervals. The poor little baby was often keep without food/ only water for the first 12 hrs. (Breastfeeding was something only the hippies did.)”

The thought process, as I was instucted even in nursing school, was that most newborns needed to rest after birth, and didn’t require food for 4 to 24 hours. They felt that postponing food would allow time for the mucous to be cleared from the throat and the baby would be allowed ample rest after the exertion of birth and all that handling by doctors and nurses as they provided the necessary care.  My nursing school textbook (Marlow, Pediatric Nursing, 4th ed. 1973) even goes so far as to say that this lag time would allow the mother sufficient rest before giving her infant the breast because….. this first offering is…… difficult. ( Oh… You’d better rest up, dear…)

Another thought process that unfortunately is still around today was that the nurse should not encourage the mother to breastfeed over bottle feed…. least she arouse or cause any maternal guilt feelings. My old textbooks all did list some basic benefits of breastfeeding and proclaimed this as the ideal food. Ie: easier to digest, natural diet for the newborn, convenience, availability AND the provision of identified and unidentified substances which may be protective.  The nurse should provide the information to the mother but not encourage her. They felt prepared formulas (Evaporated or whole milk formulas with added carbohydrates) OR the newer commercially prepared formulas were an “equal” substitute. We did have a full formula preparation room in the nursery with a refridgerator, range, sterilizing equipment etc. When I started, the Similac and Enfamil reps had already just hooked up the hospital with the marvelous free individual bottles of their products which were piled high on top of the former work area for formula prep. I don’t know when they actually stopped making it themselves.

Our 1975 Hospital Policy & Procedure  *

  • We start with NPO (nothing by mouth) for 12 hours.  Then feed one feeding of sterile water to confirm the infants ability to swallow.
  • If the baby has excessive mucus secretions, he should be fed 5% glucose water (G/W)  every 4 hours for the next 12 hrs before his first breast feeding.
  • The father may be present for feedings provided he is properly gowned, wearing hat and mask and has scrubbed hands.
  • For the first breast feeding,  teach the mother to cleanse her nipples with the cotton ball (soaked in a Benzalkonium chloride solotion) and teach proper latch-on techniques where-by the mother should cradle the baby near her breast, stroke his cheek so he turns and assist him to “grip” the nipple when he opens his mouth. Place the baby at both breasts for no longer than 2-3 min each side to avoid sore nipples. Feed the baby 5% G/W if he is still hungry when removed from the nipple.
  • Feedings should be every 4  hours, the mother should cleanse her nipples as above before each feeding.
  • If the baby should cry within 3 hrs of his last feed, he may be offered more 5% G/W.
  • The time spent at breasts should gradually increase to 3-5 min each feed for the first 2 days then continue to increase up to 10 min each side by the 4th day. When her milk begins to flow and the baby will actually be receiving milk.
  • Instruct the mother to pay close attention to which side she began and ended each feeding so she can alternate which side to begin the next feed.
  • Babies will usually require 6 feedings a day for the first several weeks.
  • Once lactation is established, she should be instructed to limit a feeding to 20 – 30 minutes total per feeding. The baby gets 90% of his milk in the first 5 minutes, any additional time is for his enjoyment. Some babies may “cling” to the breast after feeding and may need to be removed. Teach the mother to use her finger gently in the babies mouth to break the suction and remove him.
  • Babies may be taken to the mother for a breast feeding “on-demand” if so written on the chart by the physician

 

(*This is a combination of information I have from a scanty old policy,
what I remember
and interviewing some older former colleages about what we all actually did.)

If we were unable to get a baby to latch on, we had one tool available to us at the time. We had a hard rubber nipple on a glass base shield that we placed over the breast/nipple and we used the same timing of feeds.  We would only help a mother pump her breasts if she was engorged. The only tool we had to assist her with this was a bicycle horn hand pump. 

There were some pediatricians who were starting to be flexible and improve the approach to breastfeeding in a more natural sense, encouraging initiation earlier and more frequent feeds “on-demand”. There were more professionals opposed to that train of thought and continued their same practices.  When the women started coming in and requesting a better approach to feeding…. they were sabotaged by the nurses who then fed their infants “white water” while in the nursery so these babies would sleep until the next designated feeding time. 

This was 34-35 years ago and I still work with nurses today who have some of these thought processes behind what they do. Many of the older physicians, if taught anything in Med school, were taught similar management protocols. It is such a difficult retraining, re-educating process that some of us face. 

Just last week.. a brand new RN/BSN asked me how the newborn was supposed to survive on colostrum alone?

She was blank faced dead serious. 
I started my answer with…”You are not the first nurse to ask me that very same question and it’s a good question. Here’s why etc……..”
I hope I answered her well enough so she can someday teach the next one and the next…..
We really need much better Lactation Education 
for our Doctors and Nurses.
They should not be so uneducated or ill-equiped 
to properly care for and advise the mother’s in their care!

Medical Science vs Natural Childbirth 

I sat here to write the story of our first planned VBAC and realized as I scanned my other posts that I had to tell just a little more history to help explain the attitudes of the times.

During the mid 70’s early 80’s… our country was changing in many ways. In the medical world, Obstetrical medicine was becoming more specialized with the development of many subspecialties including  “Perinatology” and “Neonatology”.  Perinatology by definition is the study of the unborn fetus and recently born infant during the first several weeks of life. It was the changing concern of obstetricians from a sole focus on the mother’s health to one which is balanced between the mother’s health and the unborn or newborn. ACOG started to offer a specialty certification exam for perinatology  in 1974, and in 1977, the Society of Perinatal Obstetricians (now called the Society for Maternal-Fetal Medicine) was formed.  The term used to describe a Perinatologist today is a Maternal-Fetal Medicine Specialist.  This specialty is the management of high-risk pregnancies and the assessment and treatment of the fetus. Neonatology (established 1975 by the AAP) is the study of a highly specialized care of the newly born infant especially the ill or premature newborn infant usually hospital based in NICU’s.

Young women were becoming more and more interested in a natural approach to childbirth. People all over the country were driving maternity services to offer the availability of birth options for these moms. The ICEA [International Childbirth Education Association] came to our town in the late 70’s and a local chapter was born. “Freedom of choice based on knowledge of alternatives” in childbirth was a motto on their pamphlet information. There were some individuals in the community going for the new certification of childbirth educators. They were educating some new mom’s about birth options…… that we, the staff hadn’t learned about let alone developed as an option for our patients. Many on the staff scorned this movement. It seemed to me that these changes were all happening at the same time. We were learning about advances in observing and monitoring the well-being of both the laboring mother and her unborn fetus, preventing complications etc…. arising from the research studies done from the emerging sub-specialties. We had one fetal monitor and purchased another. As soon as the specialists found that continuous fetal monitoring was advantageous to picking up potential problems in advance, to possibly avoid or prepare for complications, there was a natural childbirth revolt against the constant recumbent positioning that EFM (electronic fetal monitoring) seemed to require. There were more examples as with IV fluids or access and other routine procedures. The nurses didn’t understand. They were just trying to do what science and our doctors were telling them…[though not always willingly as some were afraid of the newer technology.] To them, this group pushing a natural childbirth movement was the same population that had just wanted to be given drugs, put to sleep and “wake me when it’s over” crowd.  

I realize that although these advances in science and the movement of young people seeking natural childbirth options seemed to happen so close to the same time in my world, it probably didn’t happen this way for all of the country. Here, I really think it probably greatly contributed to the attitudes of nurses and doctors I worked with at the time. Those professionals who just couldn’t relinquish control. They were learning more about the science of birth, of monitoring and couldn’t quite allow or see how the “natural” component could fit in. Those individuals often were guilty of the abuse of professional power, the use of misinformation and the blindness and arrogance to maintain control of the birth process… taking it away from the mother.  Those professionals who should have known better.  They did not know of the rights of childbearing Women, or of general patient rights for that matter. Unfortunately– there are some who still have these control issues.

That’s another story….

Stand and Deliver? There’s No Stopping Her

I recently read a post from another blog about the study cited in The Cochrane Library discussing patient mobility & upright positions in early labor. The summary talks of the authors’ conclusions that there’s evidence supporting walking and or upright positions in early labor which can reduce the total length of labor without being associated with any increase in medical interventions or untoward affects on mom or baby.

Thus I was immediately taken back to 1977, long before any such studies. This woman certainly didn’t read them! She wasn’t my patient…. my patient was in the bed next to her.  (No single labor rooms back in 1977.)

When she arrived on the unit, she was already entering active labor. Her contractions where about 2-4 mins apart lasting a good 60 seconds and she was WILDLY out of control. This was her first baby, and at 4 to 5 cm dilated, she was thrashing all over the bed refusing any measures of support, IV or pain medicine offered to her by her nurse. She was probably offered “Twilight Sleep” consisting of Scopolamine and some narcotic–which we used a lot and many mom’s had hallucination or delirious type side effects.

It is important to note here that this woman was 5 ft 11.5 in tall and probably weighed a good 225lbs.  I remember this because she seemed huge and I thought she was at least 6 feet tall and looked at her chart. Her nurse was only 4 ft 11.5. The doctor on duty that evening was of Asian decent, very petite and about 5 ft, 1 or 2 in.

Back to the poor mom in labor. I couldn’t help much because I was assisting my own patient and a few labor checks that were hanging around. No other labor coach or father of the baby around in those days… It wasn’t long before this run-away train of labor progressed to point where mom was fully dilated and had the urge to push. Many women of this body stature have quick, sometimes fierce labors…..I have no study, just my observation.
Here’s what happened:
Mom: “I have to get up out this bed
Nurse: “We have to start pushing now, I need you to take some deep breaths and when that next contraction starts, you can push with it.”
Mom: “Mmmh Hymmm I have to get up out this bed!!! Do you hear me???
Nurse: “I hear you, we can’t let you get up right now, the baby will be coming soon… Let’s try to focus on pushing”
Mom: “I AM TELLING YOU….. I HAVE TO GET UP OUT THIS BED!!!! YOU NEED TO HELP ME!
Nurse: “I am trying to help you”
Mom: “I’m gettin up
Nurse: “Please try to relax”…blah blah blah

There was no stopping her. This woman stood up, ON THE BED, placed her hands on the ceiling, spread her legs and began to push—loudly !
There wasn’t anything to do except accommodate her. The nurse grabbed the “precip-tray” we use for emergency deliveries and called the doctor in. They put the large metal side rail down and these two tiny birth attendants were actually the perfect size to get in under her large frame and assist the delivery of the baby. It was an awesome sight!
I wonder if she ever reads about the research now and thinks back at how she was ahead of her time..she knew what her body needed to give birth.

Once a Cesarean—ALWAYS a Cesarean

Thought process, attitudes and practice surrounding Cesarean Section Births of the mid 1970's from my memory.

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