What You Need to Prepare for Your Baby

While all of this is still pretty new to me, I figured I'd put together this list for friends who are expecting or who will be trying to have children soon:

My Amazon Listmania List: What You Need to Prepare for Your Baby

Breastfeeding Basics

Our little guy is exclusively breastfed so far, and I'm really pleased with how well it's going, how much I enjoy spending time feeding him (even though I wish he'd let me sleep a bit longer at night), and how easy it has been. So far, at least, we've had no problems - he learned to latch on properly his first day in the hospital, and he's been eating well ever since then - he regained his birth weight and more by the time of his 10-day checkup, and he already weighs more than 10 pounds!

I like knowing that I can provide for our baby like this and seeing how well he is growing from the nourishment I'm giving him. One other nice thing about breastfeeding is that the body burns calories making all that baby food! Though I haven't had time to exercise since Ari was born (unless you count a couple of ab exercises and a few walks to the park), and though I have a ways to go in this regard, I am slowly and steadily losing the baby weight!

I skimmed a few sections of my copy of The Nursing Mother's Companion (which I highly recommend as an excellent reference to have on hand) before Ari was born, but I didn't read much on breastfeeding ahead of time. For any other moms-to-be who are in the same boat, here is what I think you basically need to know:*

• Make sure your baby is latching on properly. Every nursing book and website gives the same general guidelines for a proper latch, including pictures of proper latches, so I won't repeat all that here, but if have time to read nothing else about breastfeeding ahead of time, just make sure you know what a proper latch looks like. If you can help the baby get this right, it's more likely that everything else will go well - you won't be sore, baby will get enough milk, etc. In short, if it hurts when baby is latched on or if he doesn't seem to be drinking and swallowing, you probably need to adjust the latch. Either help baby adjust his latch (for example, I sometimes need to gently push down on my baby's chin a bit to open his mouth a little more), or detach him from the breast and try again. 
• Don't always use the same nursing position, but put the baby in different nursing positions (football, cradle, side lying) as you nurse throughout the day. For me, at least, this helps make sure the baby evenly drains the milk and has helped keep me comfortable and prevent blocked ducts.
• If you think you may be getting a blocked duct, the next time baby nurses at that breast, aim his or her chin at the area that feels too full. So if the outside edge of the breast feels uncomfortably full, use the football hold the next time you nurse, for example.
• This isn't absolutely necessary, but I think it's helpful to encourage your baby to completely finish one side when he nurses. This will help keep you more comfortable, will ensure baby is eating enough, and will help prevent your baby from wanting to "snack" constantly. If the baby starts to fall asleep shortly after starting nursing, stroke his face, remove excess clothing to make sure he is not too warm, or put a cool cloth on his forehead to wake him up so that he will finish nursing.
  

*Obviously, if there are special considerations that might interfere with nursing - the baby is premature, a difficult delivery made it impossible to get started with breastfeeding right away, mom's nipple shape makes latching difficult, or baby is "tongue-tied" - you should know more than a few general guidelines. These are just the basics, and the tips I've found most helpful so far!

Welcome to the world, Ari!

Our son Ari was one of those rare babies born on his actual "due date" - he was born almost 3 weeks ago now and we are both doing very well. At birth he was 8 pounds, 14 ounces, and 21 inches long.

My Maternity Clothes Don't Even Fit Now

Or at least most of them don't - I've outgrown all but the roomiest few pieces I have. Even the gigantic maternity t-shirt I got for Christmas with the "Chicks Dig the Jewfro" design is now a bit tight! So if you see me and suspect that if I'm wearing the same outfit as I was a couple of days ago, your suspicions are hereby confirmed. (But I'm still washing all my clothing regularly, so don't be afraid to get too close!)

But the good news is, I don't care, because I'm not going to be so big for much longer - as of today, I'm about 1 cm dilated! Progress! This probably means we will have a baby soon!

37-week checkup

And I was 50% effaced, no dilation. (The appointment was actually just 2 days shy of the 38-week mark.) I also now have very puffy hands and feet - the only real discomfort of my pregnancy since about a month of morning sickness during the first trimester. It's uncomfortable to write when my hands are at their worst, and I have no manual dexterity anymore because of it. I had a minor meltdown when I spilled a huge pile of nails onto the carpet the other day while hubby and I were doing some last-minute nursery decorating - how would I ever pick them all up?!! Luckily, my husband, with his deft, non-pregnant hands, stepped in and saved me!

A mom blogger I enjoy reading speculated that this kind of thing is perhaps evolution's way of making women not grieve the end of pregnancy and making them eager to labor. Whether this phenomenon is evolution's handiwork or not, late pregnancy definitely has this effect - I'm ready to meet this baby in some more meaningful way than through his funny little squirms and kicks to my belly, and I'm so ready not to be pregnant any more! Bring on the labor! My husband and I have just finished with birth classes, so I suppose we're as ready as we'll ever be. Let's get this started, kid!

"Listening to Mothers" Survey

First-time moms tend to spend a good deal of time agonizing over a birth plan. Or at least I did, since I had no idea, going into this, of all the birthing options, let alone what the possible advantages and disadvantages of each were. If you're going through this process now, you might be wondering how happy women ultimately were with the results - how was their recovery, short term and long term? How helpful did women rate doulas and various kinds of birth classes? Were they pleased with the kind of facility and support personnel they chose? Well, wonder no more - this national survey talks to mothers with various kinds of different birth experiences to see how they'd rate their experiences:

http://childbirthconnection.org/article.asp?ClickedLink=205&ck=10068&area=2

This survey is especially interesting in comparing the short term and long term satisfaction of women who had cesarean sections and vaginal births. Women also answer questions on how long it took them to lose the baby weight, how well breastfeeding went, when their sex lives got back to normal, and other likely topics of interest to new or soon-to-be moms.

Happy Mother's Day to my mom, my mother-in-law, and all my mom readers!

The Hazards of Attachment Parenting and the Like

This story about mothers who gave up custody of their children is interesting for what it says about the self-abnegating and self-destructive ideals of parenting and specifically, motherhood, many in our culture hold.

One mother featured is Rahna Reiko Rizzuto, a professor and author who gave up custody of her children when she divorced. She explains,

I had this idea that motherhood was this really all-encompassing thing. I was afraid of being swallowed up by that.

Talyaa Liera, another mom who took the same course of action, describes her experience as a mother before she divorced and moved thousands of miles away from her ex and her children:

At the time I was a heavily involved, attachment-parenting Waldorf mom. I did the whole family bed, breastfeeding-into-toddlerhood, baby-wearing thing. I was at home with them for 10 years before their father and I split up, and stayed at home after that, trying to create a writing career to support myself.

Why is it that these women, who obviously cared deeply for their children, felt that they had no option but to give them up? It certainly doesn't seem that either suffered from any initial lack of dedication to her children. Liera, for example, practiced attachment parenting, which strives to build "a special bond between parent and child". Dr. Sears, the founder of the attachment parenting approach, explains,

Attachment means that a mother and baby are in harmony with each other. Being in harmony with your baby is one of the most fulfilling feelings a mother can ever hope to have. Watch a mother and baby who are attached (in harmony) with each other. When the baby gives a cue, such as crying or facial expressions, signifying a need, the mother, because she is open to the baby's cues, responds... Because the baby gives the mother the feedback that her mothering is appreciated, the mother-baby pair enjoy each other more.

So far, so good - who wouldn't want to feel in harmony with her child, respond appropriately to her baby's cues, and enjoy her child more? Any parent would, of course, and the fact that Liera subscribed to such a parenting philosophy perhaps makes it even more surprising that she ultimately gave up custody of her own children. What went wrong?

What attachment parenting holds is necessary to have a harmonious relationship with one's child helps answer this question. For a taste of what attachment parenting specifically counsels, see here, here, and here. In these responses, Dr. Sears counsels against parents spending even a single night apart from their child until the child is at least two or three, and against rushing children out of their parents' bed - if the child is still not ready to leave, at age 4-1/2, and dad is sleeping on the sofa, well, that may be fine if it's what the child needs.

Imagine the kind of life Talyaa Liera had, given these kinds of ideals - given the standards of parenting that she and her husband were trying to live up to. She and her husband had multiple children over several years, and over all that time that they had a "family bed", with breastfeeding into the toddlerhood of the youngest. They did this all perhaps without ever having even a single night to themselves or as a couple. It's surprising that their marriage didn't end sooner.

What is interesting - and very sad - about the story is that none of the women interviewed really question this self-abnegating ideal of motherhood, of which attachment parenting is just one manifestation. Instead they take the ideal for granted as the right one and explain why they gave up being custodial parents when they couldn't live up to it. As the stories in this article help indicate, this kind of ideal is incompatible with the woman's happiness, with either partner having any time for the marriage or for himself or herself, and with either parent (especially the mother) being able to enjoy parenthood; none of these things are good for anyone, which is why this is a seriously flawed way to approach parenting. If sustained, it also sets a bad example for one's children regarding their view of the importance of a person having his own values and pursuits outside of the family.

The current attachment parenting fad is just one manifestation of the wrong idea of what parenting is and should be that is unfortunately very widespread today. A good parent will give a child a sense that he is loved and supported, but she will do this in part by helping her child become a person - an individual in his own right, with his own interests and values - not by herself ceasing to be such a person.

Postscript: I should have mentioned that I think AP gets some of its specific recommendations right - especially its recommendations for newborn care - and that I think it is right to teach parents to try to understand and respond to children's individual needs. Nonetheless, I also think there are some fundamental problems with AP. For more on this, see the comments below.

36-week checkup

(actually, just shy of 37 weeks) And I'm about 30% effaced! There's no dilation yet, but since I'm a first-timer, that's not really expected until I go into labor. It's exciting to know that my body is gearing up to do this - and that I really won't be pregnant much longer!

The Honeymoon is Over?

As if my baby shower marked the point after which the ease and fun of pregnancy ended, I woke up the next few days after the shower with sore feet, a sore right wrist, and tingly fingers. My feet, fortunately, have since recovered (I think I had simply been standing too often throughout the weekend) - yay! But I still have the mild carpal tunnel symptoms that sometimes manifest once late pregnancy maxes out the mother's circulatory system. It's no fun, and it's slowing down my thank-you note writing, but compared to some pregnancy tales of woe and misery I've heard, it's no big deal either.

More on the awesome baby shower my girls threw for me in my next post!

More on Natural Childbirth

We went to our second (of six) birthing classes this week. The class is taught by a very experienced doula who is generally pro-natural-childbirth, and one of the things she explained to us this week is how the usual process of birth causes the baby to corkscrew through the mother's pelvis. Because the pelvis is widest from side to side at the top, and the baby's head is widest from front to back, the baby's head typically enters the pelvis facing sideways. However, by the bottom, the pelvis is widest from front to back, and so the baby generally turns to face backwards as it descends, finally turning to the side again as the shoulders present. (See page 179 of the Mayo Clinic Guide to a Healthy Pregnancy for a diagram and description of this characteristic movement.)

What effects this complex maneuver as the baby descends?

According to our instructor, tension and relaxation of the pelvic floor muscles is part of what causes the turning as the baby descends, pushed down by uterine contractions. This is one reason that she thinks it is often best to avoid an epidural, as these voluntary muscles stay uniformly relaxed throughout labor when anesthetized, which apparently makes the proper corkscrew descent more difficult.

This makes some sense on the face of it, but unfortunately, I have been unable to find any hard information to confirm or contradict this claim. While most texts on labor I have read describe this typical pattern of descent, none of them are clear on what causes it. (Most just describe how "the baby turns", though it obviously isn't choosing its path as it descends!) Space limitations must play some role in turning the baby, but I am curious as to whether anything about the actions of the involuntary muscles (the uterus) or the voluntary muscles (pelvic floor muscles) changes during different parts of labor to help this turning. If what our instructor has said is correct, this would be a good reason to avoid an epidural if possible. It would also help explain why the process of birth tends to slow or stall with an epidural. Readers: if any of you have more information on this claim, either in support of or against it, please post it to the comments!

Why a Pro-Modern-Medicine Non-Hippie Might Consider a "Natural" Birth

My husband and I recently visited the only certified birthing center in our area, and barring any emergent complications in what has so far been a low-risk easy pregnancy, I am definitely considering giving birth there. The other main contender is Saddleback, a local hospital with a low c-section rate in comparison to other hospitals in my area. In any case, given that everything is going well, I am hoping to be able to give birth naturally - no c-section and no pain control meds. (We'll see how it goes, though - obviously, I'm new to this childbirth thing!)

You may ask, why would anyone even consider attempting this? Some women do because they are anti-technology or anti-medicine, and others simply think that all things "natural" are just better; I fall into neither of these categories. I am no fan of pain (though I have endured it as part of various athletic endeavors) and I also do not think that giving birth naturally should be held up as sort of test of one's womanhood or rite of passage as a mom or anything like that. For all these reasons, I wouldn't at all have expected to want a natural birth before I started researching pregnancy and birth options. So what other reasons are there for wanting a natural birth?

In short, while I think that such a birth may be somewhat more painful in the short run, it is less likely to cause actual damage - less damage to my body and less risk to the baby.

Let's consider c-sections versus vaginal birth fist. While c-sections are much easier to recover from than they used to be, they are still major abdominal surgery, and the recovery typically takes longer than with vaginal births. Women are advised not to lift anything over a few pounds for a couple of months after their c-section surgery. That means no lifting your baby. Also, no lifting the car seat, doing any laundry, etc. (You are even advised not to take the stairs for several weeks, though from talking to women who have had c-sections, I think many simply have to take the stairs slowly and ignore this restriction - what else can you do if you don't live in a 1st floor apartment, or if your home has stairs?) I recently spoke to one woman about why she opted for a vaginal birth with her second child after having to have a c-section the first time around, and she said that being disabled for so long after the birth was something she had really wanted to avoid. Given the quicker and easier recovery with her second child, she was glad that she hadn't needed a c-section again.

But even if you grant that trying to avoid a c-section may be a good idea, why would a woman try to minimize pain meds in the case of vaginal birth? The epidural is the most commonly used means of pain relief in childbirth in the States, and it is very effective in controlling or eliminating pain for most women who get one. So what's not to love? In short, the other possible consequences of an epidural: more short-term pain control may lead to more stress on the baby as well as more damage to the woman's body and thus, a longer and difficult/painful recovery for her. Given that this form of pain control may lead to more damage to parts I am frankly very fond of, this is a real concern to me, and any short-term pain seems to pale in comparison, especially if I find other non-pharmaceutical methods of pain control effective (more on that in a future post).

So what are some possible side-effects or consequences of epidurals? First, especially if they are given early in labor, epidurals tend to slow labor for various reasons, not the least of which is the woman's inability to move around - walking around during the first stage of labor helps keep things moving along and prevent stalled labor. Given that most hospitals want a woman to deliver within 24 hours or so of being admitted (even if neither baby nor mom are showing signs of distress), this slowing of labor increases the likelihood of the woman having a c-section, which is no fun for the reasons described above.

Second, epidurals also make it either very difficult or impossible to labor or push in certain positions, such as on all fours, squatting, standing, etc. Why does this matter? First, these positions are often very effective in getting the baby into a proper birthing position (rear-facing, head down), which leads to more effective and possibly less painful and less physically traumatic labor and pushing. Second, even if the baby is positioned just right at the start of labor, since gravity helps the laboring woman in these positions more than when she is lying flat or reclining, this is another reason such positions can help bring about more effective labor. Some experienced midwives say that in their experience, these positions, by opening the pelvis more, actually reduce the risk of vaginal and perineal trauma. (See Ina May Gaskin's Guide to Natural Childbirth for more information on this point of view. Yes, she's a crunchy-granola hippie, and that may not inspire confidence in her expertise. However, the fact that she is also a very experienced midwife, with amazing healthy baby/mom stats that would make most obstetricians jealous, does earn her views on such matters respect and serious consideration, in my estimate. She has a great deal of experience, has written interesting pieces on the body-mind connection in childbirth and how psychological stress can impede the normal physical progress of birth, and has done thoughtful and intelligent analysis based on her experience and on medical literature.) In any case, the use of such positions is definitely associated with fewer episiotomies.

In addition, since the woman often can't feel when to push or cannot push as effectively, epidurals also tend to lead to more prolonged labor, and more interventions like forceps (more commonly used in the past) or vacuum (more commonly used today) deliveries - both of which tend to cause perineal trauma, or even necessitate episiotomies. (Ouch and ouch! Thankfully the latter are no longer as commonplace as they once were.) Spontaneous pushing, where the woman pushes as and when she feels the need to, seems to be the most effective sort of pushing in terms of protecting the woman's body, and this often simply isn't possible with an epidural, since the woman often does not feel the urge to push and must be coached to push by medical providers. (This varies depending on the woman and the sort of epidural given, however; I do know women who had epidurals and still pushed spontaneously and effectively, without any perineal trauma.)

Finally, and on a closely related point, many midwives argue that if a woman can feel what is happening, she is more likely to be able to control the pace of her pushing (during the second stage of labor) and to slow down to give her body time to stretch and adjust as the baby is crowning. This may be part of the reason that spontaneous pushing tends to give rise to less damage to the woman's body. Unfortunately, there are not really any medical studies specifically on this, but the general principle does make sense to me. If you can't feel what's going on with your body, it seems like it would be harder to protect yourself by controlling the pace as needed. And the low rates of vaginal and perineal trauma among the patients of experienced home or birthing center midwives (where anesthetic is generally not available) seems to offer some support for this claim.

As to stress on the baby, epidurals are often used in conjunction with drugs like cervical softeners and Pitocin to speed up labor - either the epidural is necessary because such means of inducing labor tend to make contractions more intense than naturally-generated contractions (and thus difficult to bear without an epidural) or the epidural necessitates the use of measures like Pitocin because of its tendency to slow labor. These other drugs can cause fetal stress to such a significant extent that a c-section becomes necessary to get the baby out quickly, which is a less-than-ideal situation for mom and baby.

However, from what I can tell from my research, careful and gradual use of such drugs, judiciously tailored to the response of mother and baby, seems to obviate these possible risks, at least, to a large extent. Why can these drugs bring about fetal stress? The greater intensity of medically-induced contractions as compared to naturally-induced contractions is one problem. In addition, higher doses of Pitocin may not allow the uterine muscle to fully relax and rest between contractions, which means the baby cannot recover as fully between contractions - the longer the contractions, the more time the baby spends getting less oxygen and the less time it has to recover in between. Obviously, this is not good for the baby, and such problems are why a c-section may become necessary to prevent fetal stress. There are a few ways to reduce the risk of such problems. Cervical softeners like Cervidil (instead of Cytotec) offer less risk of this kind of downward spiral of fetal distress. Similarly, lower doses of Pitocin reduce such risks, as does adjusting the dose of it only gradually and as needed, instead of increasing it quickly, and/or by a set protocol (a set amount over a set period of time, without regard to how the individual mother and baby are responding).

I have not seen definitive evidence that epidurals directly cause any other ill effects to the baby - other than the effects caused by the various meds to induce or accelerate labor often used in conjunction with epidurals. Some claim, from anecdotal evidence, that babies born to moms with epidurals are less alert and active, but I haven't seen medical evidence to support such claims. The use of narcotic medicines, if timed too close to delivery, can definitely have such an effect on the baby, however, and can even cause the baby to have a difficult time breathing. Some commonly-used narcotics, though, if used early in labor and at proper doses, seem to have no ill-effects on the baby and may also help the mom rest a little to maintain her strength for the work that lies ahead. I'll see how things go - if this seems like a good option early in labor, I'll definitely consider it. (But then again, it seems like I'd be most likely to want pharmaceutical pain relief later in labor, so narcotic pain medicines seem to be of only limited usefulness.)

To summarize, I am leaning toward a natural birth because I think that birth, unlike just about any other situation that may cause a person to go to a hospital, requires work on the part of the "patient" (hence the English name "labor" for the state leading to birth). In fact, except in medically complicated births, it seems that most of the work is done by the woman, with the medical staff primarily/ideally standing by to help if complications should arise. Given this, I think it is important that my body is not prevented from being able to do the work it must do to give birth. This means I have to be able to pay attention to and control my body, which is difficult or impossible with the use of many pharmaceutical methods of pain control. Given how useful pain is in preventing damage in other situations, it is not surprising that it should be useful in the same way in childbirth as well.

For my next posts:
- possible natural means of controlling pain during birth (Why think they'd be effective?)
- why a birthing center may be worth considering (even for non-granola types)

Good news!

We got back blood work and ultrasound results this week, and they confirmed that baby and I are both doing fine. No gestational diabetes for me, so I think I've now officially dodged all of the most common third-trimester health woes for pregnant women. Also, we had the ultrasound today, and it confirmed 1) that the baby is head-down 2) that the baby is a boy and 3) that he's measuring only about a week bigger than expected. The typical margin of error for ultrasound measurements, from what the ultrasound technician said, is +/- 2 weeks, so that basically means he's measuring normal for his gestational age (for what that's worth, given the general accuracy of such measurements).

Unfortunately, the ultrasound tech only had access to a rather low-quality printer, so I don't have any awesome photos of the little guy to post. The low quality of the photos along with the fact that only parts of him can be seen on screen at one time now that he's so big means that the photos I got are almost indecipherable. The screen at the doctor's office showed him in much better detail, though, and it was cool to get a look at him again now that he's basically formed!

The Apocalypse is Nigh...Like, Really Nigh

Just saw this story about some doomsday Christian group predicting that the world will end on the baby's birthday-to-be, May 21.

In case anyone was wondering, as persuasive as their arguments for the upcoming Rapture are, I'm still planning to set up the nursery, figure out how to care for a newborn, etc. Also, the baby shower is still on. :-)

Pregnancy + Furniture Assembly Marathon = Bad Idea

Hubby and I spent much of last weekend putting together furniture - we're still getting set up in our new place. That meant I spent many hours of the weekend hunched over partially-assembled Ikea bookshelves resting on the floor.

Bad. Idea.

I have a pretty strong back - I like to lift weights and was doing stiff-legged deadlifts as well as core exercises like the plank until recently, when I haven't had much workout time. Nonetheless, by Monday morning, my back was painfully objecting to me having spent so much time hunched over while hauling around almost 30 extra pounds of belly. It was pretty excruciating and rather comically disabling. I've just now recovered enough such that I can twist slightly to look over my shoulder while merging into traffic without my back muscles twinging violently. The takeaway tip from all of this, which is perhaps obvious to most sane people: don't take up furniture assembly as a hobby come third trimester. (Or if you must, at least make sure you don't have crappy furniture assembly posture like I did.) I'll definitely keep this in mind when some of our nursery furniture arrives this week!

Who Knows How Big This Baby Is?

This week, hubby and I met with obstetrician #2, who thought I was measuring completely normal for this stage of the pregnancy - within a centimeter of normal. Obstetrician #1 had thought the baby seemed quite large - so large that she ordered an ultrasound to have a look at the baby - but this second doctor thought the baby was right on track and seemed normal-sized. This is weird, since both were measuring fundal height!

From what I've read, this kind of mixed message about a baby-to-be's size isn't unusual. Strangely, predicting the size of a baby before it's born is something the modern medical establishment can't yet do very accurately. According to Marjorie Greenfield, the obstetrician who wrote The Working Woman's Pregnancy Book, the most accurate way to predict the baby's size is for the mother to predict the size by comparison to her previous pregnancies. If she hasn't had any previous pregnancies, though, this method is obviously out. The next most accurate way is for an experienced medical practitioner to examine the woman, and the least accurate way is by ultrasound measurements. But none of these methods are particularly accurate. So...who knows how big this baby is?

I do know that he's pretty active, though - he's kicking and punching and moving around all the time lately, which is exciting! (I wish there was some way to communicate to him that he could stand to do a little less kicking of the underside of my diaphragm, though, since that seems to be a favorite activity of his lately.) I'm going to start keeping a kick count chart soon, since it's good to have a baseline record of his activity.

End of the Second Trimester

Haven't updated in a while, as hubby and I recently made a cross-country move and we're just getting caught up from that. I'm now in the process of looking for a doctor or midwife here in my new town - I'm planning to meet with 3 or 4 before we decide - and of trying to make some kind of general plan for having this baby.

Met with obstetrician #1 today, and there's good news and bad news.
The good news: Baby's already in head-down position. The doc said he might move again, but he probably won't. I can't imagine there's room for all sorts of spinning or flipping maneuvers in there anymore.
The bad news: The baby (or rather, my uterus) is surprisingly big. Due to the fact that my first two trimesters of medical records are from Canada, where they put the month and day in random orders when they write out dates numerically, the doctor had to do a double-take to see if the first ultrasound was done on October 11 or November 10. When she realized it was the latter, and that I was a month less pregnant than she thought, she was very surprised by the fundal height measurement and she ordered up an ultrasound to check on fetal size. I've felt gigantic lately (and think I look much larger than a similarly pregnant friend), so I can't say that I'm surprised, but that's a bummer. I'm pretty sure about when the baby was conceived, so this definitely won't make birthing this kid any easier! The ultrasound is in two weeks, so I guess we'll find out then if it's a big baby and/or too much amniotic fluid or something like that. I'll also have a gestational diabetes test before then.

Maternity Pants That Stay Up!

As promised, I paid a visit to A Pea in the Pod while holiday shopping, and I am happy to report that Heidi Klum's line of maternity clothing is as practical as it is beautiful. I bought the black evening dress pictured in my last blog post, as well as a pair of denim leggings from her line. I have never worn skinny jeans before, but these are flattering and comfortable—the fabric is very stretchy. What's even better about the jeans is that unlike every single other pair of maternity jeans I own, they actually stay up! This is accomplished, I think, by three features: the stretchiness and fit of the leggings, the contour of the waistband, and the extra strip of carefully contoured elastic sewn onto the inside of the jeans. It's nice not to have to face the alternative of either hiking up my jeans every few minutes (even the "secret belly" pants require constant adjustments) or having a case of plumber's bum. These should be featured on History Channel's "Engineering Marvels" series, as far as I'm concerned! :-)

The only downside is that her clothing is a bit pricey, so you may want to check out the sale rack (where I found my leggings!), or see if you can find gently used pieces on eBay.

New Breastfeeding Study: Start Introducing Solid Foods Earlier

A new study on breastfeeding suggests that giving infants only breast milk during their first 6 months may not be best for their health:
http://news.yahoo.com/s/afp/20110114/ts_afp/healthchildrenresearchbritain

Ten years ago, based in part on studies done in developing countries, the World Health Organization recommended that babies be fed exclusively breast milk for the first 6 months. This practice was thought to give rise to fewer infections and growth problems. Apparently, however, what is best for baby's health depends to some extent on whether the baby is growing up in a developed country; when the baby lives somewhere with access to better quality food, it is better to start to introduce other foods sooner - doing so seems to make make anemia and the development of allergies less likely! Researchers in Sweden confirmed the link between allergies and late introduction of foods other than breast milk: they found that early onset celiac disease increased after a recommendation to delay introduction of gluten until age six months, "and it fell to previous levels after the recommendation reverted to four months". This makes sense in principle, too, given that the body seems to learn from what it is exposed to early in life what is foreign and what is not. (For this reason, children who grow up in a household with pets are less likely to have dander allergies, for example.)

As interesting as this study is, almost equally interesting is the response to it: one breastfeeding advocate challenged the findings not on any kind of scientific grounds, but because it "plays into the hands of the baby food industry". Whether or not it does, what does this matter if exclusively breastfeeding longer really does contribute to nutrition deficiencies and the development of allergies in the child? (As my husband commented, this is akin to opposing the development of an AIDS vaccine because it would benefit the pharmaceutical industry.)

On this issue, as with many issues having to do with birth and with child care, too often the question is which answer is consistent with one's uncritically accepted broader ideals, not which answer is actually right (let alone whether one's broader ideals are). A person's views on birth, child care and parenting, are almost always tied to his or her most fundamental ideas - about what it is to be human, what parenting requires, what raising a baby to be a healthy well-adjusted person means and requires, gender roles, and even about the value of modern medicine and technology more generally. For this reason, it's harder to get people like the breastfeeding advocate quoted above (or the doctors who treat pregnancy as a medical problem) to really consider the facts in their full context and reevaluate their judgments accordingly. In this case, it would mean considering introducing solid foods before 6 months. One thing that remains uncontroversial, however, is the health benefit, in terms of boosting the baby's immune system, of breastfeeding for newborns; the results of this study do not speak against the established health benefits of breastfeeding, just in favor of also introducing foods other than breast milk a little earlier in the baby's life.

Should you worry about that New Year's Eve sip of bubbly?

Many women entirely abstain from alcohol during pregnancy and worry about the possible fetal effects of any alcohol they consumed before they knew they were pregnant. Their caution and concern may seem well-placed; studies that show that excess alcohol consumption during pregnancy can cause low birth weight, cognitive impairment, behavioral problems, or even full-blown fetal alcohol syndrome.  The effects of heavy drinking during pregnancy are uncontroversial and are very serious to the health of the developing fetus, not to mention that anyone with binge drinking tendencies or a bottle-of-Jack-per-week habit is obviously ill-suited to be a parent for other reasons. 

If heavy drinking causes serious effects, doesn't it make sense to assume that even light drinking has some detrimental effects?  In short, no.  Obviously, the fact that excessive ingestion of any substance can have serious consequences doesn't necessarily mean that there are any risks to occasional, moderate ingestion of the same substance.  For example, although cyanide is lethal in sufficient doses, no one swears off eating apples because their seeds contain trace amounts of cynaide - the amount found in the seeds is so insignificant that accidentally swallowing the seeds has absolutely no detrimental effect. 

Thus, it is perhaps not surprising that new medical research shows that light drinking during pregnancy - i.e. having 1 or 2 drinks per week - has no discernible affects on your developing baby.  Researchers followed the children of women with different drinking habits (those who abstained entirely during pregnancy, those who had 1-2 drinks per week and those who were heavier drinkers) until the children were 5 years old, and found that light drinking during pregnancy had absolutely no detrimental effect on children's cognitive abilities or behavioral tendencies.  (Light drinking by the mothers at first actually seemed to have beneficial cognitive and behavioral effects on their children, until researchers controlled for the income and education levels of the mothers.)

For a decent layperson's summary of the study, click here.  To read the abstract and access a link to the full text of the study, in all its technical detail, click here. (Note: the full text of the study can only be accessed through a university library or with some other kind of subscription to the Journal of Epidemiology and Community Health.)

In short, the problem with studies of the fetal effects of the consumption of just about anything during pregnancy is that they tend to focus on pregnant women who ingest a lot of the substance. This makes it difficult for pregnant women to know what commonly ingested foods and medicines may be entirely safe in moderation.  This kind of study, with its focus on moderate alcohol consumption, is thus a valuable find (even if it is, unfortunately, retrospective regarding pregnant women's alcohol consumption).  It finds no evidence that light alcohol consumption during pregnancy causes any harm to the developing fetus, so have a glass of wine on date night if you'd like, and don't sweat that New Year's Eve toast!