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BirthWorks Birth Prep!

This virtual experience is a fantastic way to prep for birth now from home!!
What a brilliant gift to give yourself or to give to new parents you know!

The BirthWorks Experience helps every woman find her own best way to birth. First-time parents (as well as parents having another child) will love our engaging, interactive format of evidence-based and emotional childbirth preparation which highlights:

…understanding ways to labor that can minimize interventions

…how human-values practice increases confidence and decreases fear in birth

…understanding Four Principles of Optimal Pelvic Positioning to shorten and ease labor and birth

energy, relaxation, affirmation, primal health and more!

What is unique about BirthWorks innovative and experiential approach? 

In two short virtual Zoom sessions, parents experience a balanced, non-judgemental approach to childbirth preparation including:

  • Experiential energy work to empower and transform
  • The most gentle, amazing relaxation exercise!
  • Chance to identify beliefs about birth
  • Creating powerful affirmations to overcome and release fears
  • Knowing how to position your pelvis for an easier birth
  • Birth anticipations and expectations
  • How hormones work to your advantage and “Adrenaline Language”
  • Non-pharmacological comfort measures and the HPA axis
  • Exercises to relax the pelvic floor before and during labor
  • Understanding Primal Health – the importance of mother/baby skin-to-skin contact on brain development
  • Mother-Daughter Relationships
  • Common Sense Nutrition

If this resonates with you, join our August Birth Prep or sign up for fall BirthWorks Birth Preps now offered monthly! Questions? Please reach info@birthworks.org

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Sleep? What Sleep?

“The one thing nobody told me about having a baby was about sleep and how exhausted I would be! I haven’t had a good night’s sleep in over six months!”

Many new parents are completely unprepared to cope with a baby who does not sleep well, who wakes up much more often than normal during the night and cries.  Some infants begin to sleep through the night almost immediately and others do not do so for many months.  Newborns lack a regular pattern for waking and sleeping. Their sleep-deprived parents quickly reach a peak of frustration and experience intense emotions as they struggle to meet the 24/7 demands of their child, at the same time trying to balance that with their own needs for sleep. Dazed parents groggily note this night after night, when the baby wakes time after time for feeding or comforting.  For a while parents have to adapt their own sleep cycle to the baby’s irregular sleep, taking catnaps and rising out of deep sleep to attend the baby’s needs.  The situation intensifies if the parents are arguing about how to handle the situation.

These parents have a dangerous amount of sleep debt. Parents of newborns are said to lose 2 hours of sleep per night until the baby is around 5 months old, which decreases to 1 lost hour per night during ages 5-24 months.  Sleep and nap times shift steadily from day to day, so that parents might find themselves up at midnight one night and at 3am the next. Over the first year of a baby’s life, parents each lose an estimated 350 hours of sleep at night.  Preparation for parenthood needs to include a consideration of strategies for parents to cope with their own loss of sleep as well as wakeful babies.

After a long labor that ended up in a cesarean, and then nights with little sleep, my postpartum days were a fog.  I had all the symptoms of sleep debt – lack of focus and clarity, impatience, worry and anxiety, low energy, and crying.   My husband was in medical school and not home to help much.  My mother insisted on doing everything for me, even taking care of the baby which I wanted to do. My daughter cried a lot and my pediatrician told me it was because I was vegetarian – she couldn’t have been more wrong.

Most people in America today are suffering from some sleep debt and go about their days feeling that the tiredness is normal.  Birthing parents are likely in sleep debt even before they give birth to their baby being up through the night to change positions and urinate due to pressure of the fetus on the bladder.  Couple this with a long labor followed by needing to be awake night after night to feed and soothe their baby.  And what if their baby is one who does not sleep through the night for many months?

Even before pregnancy, we as a nation are sleep deprived and go about our days feeling that tiredness is normal.  This is mostly due to the invention of a single and profound technological advance – the light bulb (1879). Now we could work late into the night, or read for pleasure into the wee hours of the morning. The light bulb mimics daylight and has the ability to shift our internal biological clocks.

When I was travelling around the world years ago with my husband, we often slept in places that had no electricity.  We found ourselves going to sleep just after sunset and rising at sun rise.  We became more familiar with the zodiac moving across the night sky.  We were more in tune with the earth’s rhythms and felt more energy.  There was no light bulb to keep us up. The light bulb has upset the natural order.

When new parents know what to anticipate and expect, and when they have the support they need, the postpartum period can even be enjoyable. I wish I had known more.

Did you know….

  • Our sleep begins well before we are born. The fetus spends most of his time asleep – about 16-20 hours a day.  Many women believe their baby is awake when kicking inside, but the baby is most likely asleep which explains why pregnant women can feel kicking at almost any hour.
  • We have biological clocks and circadian rhythms: The internal pacemaker or biological clock located deep in the brain in two pinhead-size clusters of nerve cells called the suprachiasmatic nuclei or SCN, controls a profound daily continuing oscillation approximating 24 hours. These cycles are called our circadian rhythms. They can be seen in almost every function in the body, from basic cell processes to activities of the whole body.
  • Circadian sleep cycles cross the placenta

The circadian sleep cycles begin before birth by passing across the placenta.  Even though the fetus isn’t exposed to light from outside the womb and can’t tell when it is night or day, the mother is communicating this information to her baby. Research on rats and mice at Harvard University showed that these signals from the mother actually stimulate the fetus to mirror its mother’s circadian cycles.  They found that the mothers’ fluctuating melatonin hormonal levels signal the biological clock in the fetal brain, preparing the babies for the rhythms of life outside the womb.

  • The mother’s circadian rhythm seems to act as a gatekeeper, inhibiting birth during the day and promoting it at night. That is why women often go through “false labor” the night or two before actual labor begins. The mother’s circadian rhythm is opening the gate to a nighttime delivery, even before the baby’s biochemical push to be born is strong enough.
  • The fetus starts labor: The fetus signals the mother when its body is mature and ready to be born and actually starts the labor process. All mammals tend to give birth during the time they normally would be asleep, possibly to make sure the birth happens “at home” and safe from predators.
  • When does dreaming begin? Rapid Eye Movement (REM)

It was found that near term fetuses have about 60-80% of the sleep time in REM sleep, also known as “dream sleep.” Typical newborns spend about eight hours in REM sleep, about 50 percent of their daily sleep. As adults, we spend about 25% or about two hours a night in REM sleep. By old age we have only 15-20% REM sleep.

Immediately after birth, there are only two sleep stages, REM and non-REM sleep.  REM sleep is sometimes called active sleep in babies because the muscular paralysis that always accompanies such sleep is not fully developed. Non-REM sleep on the other hand is often called quiet sleep, because the baby is sleeping like a baby, perfectly still, quiet, and limp.

At birth, infants usually sleep 16-18 hours per day, distributed evenly over six to seven brief sleep periods.  They can pass directly from wakefulness to REM sleep and alternate between REM and non-Rem sleep every 60 minutes or so instead of the 90 minutes adults take to cycle from REM sleep.

Newborns can’t talk but very young children can and do talk about their dreams. Less       than two years old, a little girl was sleeping one morning and her father heard her say           “pick me, pick me.” He looked at her eyes and saw some typical rapid eye movements.        He woke her and she said ‘Oh Daddy, I was a flower.”

  • Newborn sleep states: We now know that a newborn gradually develops more sleep states and these are not random. Stages that have been identified are Deep Sleep (quiet sleep), Light Sleep (active sleep), Quiet Alert state, Active Alert State, Crying State, and Drowsy State. The best time to play with a baby is in the Quiet Alert state.
  • Baby’s biological clock matures gradually. A newborn’s biological clock matures gradually to keep track of the time of day. Therefore, imposing a regular pattern of sleeping and waking is bound to be met with distress for both the parents and baby. However, providing cues such as light in the morning and evening dim light along with regular feeding schedules, can help them along as their biological clocks are maturing. Because new infants have a strong homeostatic sleep drive, they build up sleep debt over a few hours and then pay it back right away with a nap. This continues throughout the 24 hour day until their biological clock is mature.
  • Sleep by the age of 12 months: By the end of the first year, the overall number of sleeping and waking hours has changed very little. The infant still sleeps 14 to 15 hours a day. Except for one to two daytime naps, the sleep periods have shifted to the night and the waking periods to the day.  By about 18 months of age, most toddlers are taking only one nap.  Children slowly sleep less and less until their daily sleep measures about 10 hours which holds steady until they reach puberty.
  • Dangers of sleep debt: Without warning, drowsiness can become sleep in an instant. You are only a few seconds from sleep when your eyelids begin feeling heavy. When the biological clock is not alerting the brain, the sleep debt pushes it toward sleep. The biological clock is at its lowest ebb in the middle of the night and people are more prone to distractions, lack of focus, poor memory, bad mood, and slow reaction times.  This is life threatening if for example you are driving a car.

What you can do…

  • Napping – the most important solution

Taking naps is an excellent and respectable strategy for sleep management.  Naps can make you smarter, faster, and safer than you would be without them.  They should be widely recognized as a powerful tool in battling fatigue and the person who chooses to nap should be regarded as heroic. The longer the nap, the greater the benefit and the benefits seem to be long-lasting. A 45 minute nap improves alertness for 6 hours after the nap. And for 10 hours after a 1-hour nap.  The rule of thumb for new mothers is:  “Sleep when your baby sleeps.”

  • Faith and Surrender: Surrender to the process of parenting, and even in your most tired moments, remember that amazing thing you have done to conceive, grow, and birth a baby.  Have faith that it will get easier as he/she sleeps through the night.
  • Drink a glass of water and feel the peace that it brings.
  • See birth as a miracle: Yes, your life has changed, but soon you will hardly remember the time before birth. Babies and young children make us smile. Their joy is immeasurable.
  • Breathe deeply and slowly: Take long deep slow breaths in and out when you feel you have reached your limits.  Practice awareness by closing your eyes, breathing in love and breathing out your worries.

 

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Newborn Vitamin K – Yes, They Do Need It

By Michelle Chevernet, CCE (BWI)

An Uptick in Refusal

Not too long ago, somebody in a Facebook group I’m in posted a beautiful home birth picture (yay!), with a caption stating something along the lines of “Born at home, in water, lifted him out myself, no eye ointment, no vaccines, no Vitamin K!  Proud natural warrior mama!”  I experienced a moment of alarm.  This may surprise you, being as I had out-of hospital births for all three of my children and am of course very supportive of this “warrior mama’s” water birth.  The part of that post that got me was the “no Vitamin K” battle cry.  I have experienced an uptick in clients asking about Vitamin K refusal.  What is that about?

Throwing the Baby Out with the Bathwater

I believe that we have a couple of things happening here.  One, some parents are so excited to give their child a gentle, “natural” birth, that they choose to refuse anything that comes from modern medicine.  Two, care providers have perhaps done themselves a disservice by grouping eye ointment administration, Hepatitis B vaccination, and Vitamin K administration together in their “newborn procedures” discussions.  The thing is, the science on eye ointment isn’t that great, Hepatitis B isn’t generally an immediate threat to a newborn . . . but Vitamin K administration DOES have very solid research supporting it, and it IS an immediate and severe (if rare) threat to a newborn.

As BirthWorks educators, I believe that we need to be clear when an issue is truly a matter of “preference” and when there is an actual scientific safety concern.  Sometimes I feel that I don’t want to “alienate” parents by taking a research-based position that they may not like to hear, but I do think it is our responsibility.  While I always encourage clients to consider their own wishes in the face of non-evidence-supported birth procedures, the science is clear here.  So, I’ve started giving a more in-depth and explicit treatment of Vitamin K administration, and decided to highlight this concern in the BirthWorks context.  That said, my job is to present the information and facilitate discussion, and not to judge.  If a parent still chooses to decline Vitamin K administration, I would continue to support them.

The following information is based on Rebecca Dekker’s Evidence Based Birth signature article on Vitamin K, and on the Center for Disease Control and the American Academy of Pediatrics’ recommendations.  Please see the hyperlinked sources for greater detail and actual research citations.  This discussion is meant to raise awareness and introduce the topics to parents.

Are Babies “Deficient” in Vitamin K?

In a word, yes.  Humans can’t make Vitamin K, or store it very well.  We get it in our diets, but there’s not very much of it in breast milk.  It does not cross the placenta very well, so even mothers who consume a lot of Vitamin K will have a baby born “deficient,” because all babies are born deficient.  This is not “unnatural”, babies have many immature systems at birth.  However, it is risky to them, just as their immature immune system puts them at risk for illness.  “Natural” does not necessarily equate with “safe”.

What is the Danger?

Babies with Vitamin K deficiency (all of them, unless they get a shot of it within 6 hours after birth) are at risk for bleeding in the intestines, brain and other locations.  Bleeding can be severe, and babies can sustain lifelong injuries or even die.  There are three types of Vitamin K Deficiency Bleeding (VKDB)

  • Early, within the first 24 hours of life. Usually occurs in skin, brain and abdomen.
  • Classical, within days 2-7 of life, most often days 2-3 because that’s when levels have dropped to their lowest but baby isn’t eating enough to replace it. Often occurs in gastrointestinal system, umbilical cord site, skin, nose, and circumcision site.
  • Late, usually during weeks 3-8 of life. Least common but statistically the most serious as far as fatality and severe injuries are concerned.  Often occurs in brain, skin and gastrointestinal tract.  Babies can experience a late bleed up to 6 months after birth.

Does a Baby Have to Experience Trauma to Trigger Bleeding?

I saw a blog post stating that Vitamin K was administered “in case the baby is in a car accident on the way home.”  WRONG!  First of all, even a gentle birth can cause minor bruising in a baby, and if their blood can’t clot, then “minor” can become “major”.  Secondly, case studies of VKDB often find no known cause.  It can be related to the cord stump or circumcision, but more often than not, they just start bleeding and can’t stop.

Does a Vitamin K Shot Work?

Yes, it does!  Infants who receive Vitamin K at birth have almost no chance of getting VKDB.  A study in England in 2013 showed that out of 64 million births in 18 years, only 2 babies who received a Vitamin K injection developed VKDB.  Two.  Out of 64 million.  Comparatively, data from other European countries indicate that with no Vitamin K, VKDB occurs in 4.4-10.5 per 100,000 births.  In Asia, the rate is higher, 1/6000 births, probably due to both dietary and genetic factors.

Are There Side Effects?

No, not any more than with any other injection – pain (which you can mitigate by nursing through the shot) and redness/swelling at the injection site.  There have been NO reported cases of severe allergic reaction, severe injury or fatality from the modern fat-soluble injection form.  (The form given in the 1950’s and 1960’s was less safe.)  So, there are NO reported fatalities from getting the shot, but MANY reported severe injuries or fatalities from VKDB.

Are There Alternatives?

I will point you toward Evidence Based Birth for a more detailed discussion if you are interested, but 1) there is no FDA – approved oral version and 2) the three-dose oral version given sometimes in Europe is less effective.

This is a very brief overview, and I would invite you to read further from reputable scientific sources such as Evidence Based Birth, the Center for Disease Control, and HealthyChildren.org . . . and most importantly, talk to your care providers!  Natural is great, but in this case, science is definitely better.

 

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When Will my Baby Sleep Through the Night?

By: Katie Sanzi, Certified Pediatric Sleep Consultant and owner of Sleepyhead Consulting

This is a difficult question to answer without getting into some specific details, which is unfortunate, because when parents ask me this, I know they’re looking for a quick, concise, time-based answer.

“Three nights from now,” or “Six months old,” are the kind of responses they’re hoping for, and the kind I wish I could give them, but there are a lot of factors to consider, and some things to understand before you can narrow down the timeline.

The first thing I feel parents need to understand is this…

Your baby will never sleep through the night.

That’s right! They won’t sleep through the night when they’re toddlers, or when they’re teenagers, or when they’re grown-ups, because nobody ever does.

We human beings sleep in cycles, which vary from light sleep to deep sleep and back again. Occasionally, when we get into the light sleep stage of a cycle, we hear a noise, or we’re in the middle of a crazy dream, or the dog jumps on the bed, or we just shift a little, and that little thing, whatever it may be, is just enough to wake us up.

As adults, we have experienced this thousands of times, so we just shake it off and go back to sleep. Most of the time, the wake-up is so brief that we don’t even remember it the next day.

But for babies who are used to being rocked, sung, bounced or nursed to sleep, waking up in the night requires external help to get back into a peaceful slumber.

So that’s the reason why baby’s never going to sleep through the night, but then, that’s not what parents are really asking.

What they want to know is, “When will my baby be able to get back to sleep on their own?”

That’s a much easier question to answer. Quite simply, this will happen when they learn how.

When you teach your little one to go to sleep on their own, they’ll be able to employ that skill multiple times a night, every night, for the rest of their lives.

Now, there’s more to it than just leaving your baby alone in their crib and letting them figure it out for themselves. Don’t get me wrong, that approach has worked for a lot of people, but it’s not one that everybody is comfortable using, and it’s not the most gentle or effective way of teaching your baby great sleep skills.

The traditional Cry-It-Out approach is a lot like leaving your child in front of a piano with some sheet music and saying, “Figure it out.” Eventually, they just might, and you might just have the Elton John of sleeping on your hands. But assuming your child isn’t gifted in the sleep department, (and I’m just assuming they’re not, since you’re reading this) they could probably benefit with some lessons.

And as with any skill that a child needs to learn, practice is essential, so let them give it a shot. There’s probably going to be a bit of crying, but that doesn’t mean you can’t go in and encourage, comfort and reassure them.

What you shouldn’t do, however, is sit down at the piano and play it for them. Obviously, that doesn’t teach them anything. So whatever it is that you’ve traditionally done to get your child to go to sleep in the evening, or in the middle of the night, whether it’s giving them a pacifier, rocking them back to sleep, nursing them, whatever, these “sleep props” are the equivalent of playing the piano for your child to teach them how.

They may be frustrated, they may get upset, but they’ll learn with a little time and practice.

So although I can’t give an exact date or age when your baby will go through the night without crying and demanding help to get back to sleep, I can tell you without hesitation that it will be much, much sooner if you stop doing it for them.

As for teaching your little one to play piano, you’re on your own with that one.

 

Sleepyhead Consulting, LLC
570-436-3390
PO Box 36, Lattimer Mines, PA 18234