Look in Saturday's Ledger-Enquirer for my story about ear infections, including how to help prevent them and how to manage them once they hit.
Here are some additional links on the subject:
Clinical Practice Guideline for Diagnosis and Mangament of Acute Otitis Media, published in the May 2004 issue of Pediatrics (Scroll down to recommendation 3A to get the full details on when the American Academy of Pediatrics and American Academy of Family Physicians suggest that observation without antibiotics may be appropriate for an early-stage ear infection)
Trends in Management of Acute Otitis Media Since the Release of the 2004 American Academy of Pediatrics/American Academy of Family Physicians Clinical Practice Guidelines August 2007
Get more Otitis Media facts here.
And a final item of interest. This excerpt from the 2004 Clinical Practice Guideline gives some risk factors for acute otitis media:
A number of factors associated with early or recurrent AOM are not amenable to change including genetic predisposition, premature birth, male gender, Native American/Inuit ethnicity, family history of recurrent otitis media, presence of siblings in the household, and low socioeconomic status.
During infancy and early childhood, reducing the incidence of respiratory tract infections by altering child care center attendance patterns can reduce the incidence of recurrent AOM significantly. The implementation of breastfeeding for at least the first 6 months also seems to be helpful against the development of early episodes of AOM. Avoiding supine bottle feeding ("bottle propping"), reducing or eliminating pacifier use in the second 6 months of life, and eliminating exposure to passive tobacco smoke have been postulated to reduce the incidence of AOM in infancy; however, the utility of these interventions is unclear.
Source: Clinical Practice Guideline for Diagnosis and Mangament of Acute Otitis Media, published in the May 2004 issue of Pediatrics
If you have other advice for coping with ear infections, please share.
Showing posts with label health and safety. Show all posts
Showing posts with label health and safety. Show all posts
Friday, February 15, 2008
Saturday, January 26, 2008
Fats and fertility
Rob and I decided a while back to retire from the baby-making business. We’re content with our cozy family of four. But for all of you out there who are still interested in getting pregnant – or who have friends who are struggling on that point, here is an article worth reading. Granted I’m a month and a half late sharing it and some of you probably already read it, but I didn’t get to it until this week.
It was the December 6 Newsweek cover story, which reviewed a bunch of the key findings presented in The Fertility Diet, a Harvard Medical Book that offers strategies for increasing your fertility odds simply by eating healthfully -- based on data from 18,000 women who took part in a long-term research project called the Nurse’s Health Study (which examined how diet and other factors affected a broad range of chronic conditions including heart disease and cancer). So there’s implications for how to stay healthy for those of us not personally vested in fertility probabilities anymore.
And for the thousands of women who consider fertility treatment every year, it would be nice to know that just some basic dietary manipulations might solve the problem naturally. Of course it’s not a panacea. The recommendations are aimed at preventing and reversing ovulatory infertility, which they say accounts for one quarter or more of all cases of infertility. And I’m sure there are plenty of causes of ovulatory infertility that are beyond the realm of a dietary fix.
One interesting finding though: “The more low-fat dairy products in a woman's diet, the more likely she was to have had trouble getting pregnant. The more full-fat dairy products in a woman's diet, the less likely she was to have had problems getting pregnant.” The authors don’t recommend consuming pints of ice cream at a time. They say “aim for one to two servings of dairy products a day, both of them full fat.” And they advise switching back to lowfat once you’re no longer pregnant. But I wonder about the broader implications for how whole fats consumed in moderation might be generally healthier for our bodies than they are generally given credit for.
(We’re still drinking whole milk and eating butter in moderation in our house after my interview with Sally Fallon of the Weston A. Price Foundation. I don't know if we’ve chosen the right path, but we’re at least enjoying the flavors. If you're interested in the whole saturated-fat-as-good-or-evil debate, this is another very interesting and fairly comprehensive article on the subject -- entitled "What if bad fat isn't so bad?" -- at msnbc.com.)
Highlights of the strategies outlined in "The Fertility Diet," according to the Web site for the book, include:
*Avoiding trans-fats, the artery-clogging fats found in many commercial products and fast foods
*Eating more vegetable protein, like beans and nuts, and less animal protein
*Drinking a glass of whole milk or having a small dish of ice cream or full-fat yogurt every day; temporarily trading in skim milk and low or no-fat dairy products for their full-fat versions
*Getting into the "fertility zones" for weight and physical activity.
It was the December 6 Newsweek cover story, which reviewed a bunch of the key findings presented in The Fertility Diet, a Harvard Medical Book that offers strategies for increasing your fertility odds simply by eating healthfully -- based on data from 18,000 women who took part in a long-term research project called the Nurse’s Health Study (which examined how diet and other factors affected a broad range of chronic conditions including heart disease and cancer). So there’s implications for how to stay healthy for those of us not personally vested in fertility probabilities anymore.
And for the thousands of women who consider fertility treatment every year, it would be nice to know that just some basic dietary manipulations might solve the problem naturally. Of course it’s not a panacea. The recommendations are aimed at preventing and reversing ovulatory infertility, which they say accounts for one quarter or more of all cases of infertility. And I’m sure there are plenty of causes of ovulatory infertility that are beyond the realm of a dietary fix.
One interesting finding though: “The more low-fat dairy products in a woman's diet, the more likely she was to have had trouble getting pregnant. The more full-fat dairy products in a woman's diet, the less likely she was to have had problems getting pregnant.” The authors don’t recommend consuming pints of ice cream at a time. They say “aim for one to two servings of dairy products a day, both of them full fat.” And they advise switching back to lowfat once you’re no longer pregnant. But I wonder about the broader implications for how whole fats consumed in moderation might be generally healthier for our bodies than they are generally given credit for.
(We’re still drinking whole milk and eating butter in moderation in our house after my interview with Sally Fallon of the Weston A. Price Foundation. I don't know if we’ve chosen the right path, but we’re at least enjoying the flavors. If you're interested in the whole saturated-fat-as-good-or-evil debate, this is another very interesting and fairly comprehensive article on the subject -- entitled "What if bad fat isn't so bad?" -- at msnbc.com.)
Highlights of the strategies outlined in "The Fertility Diet," according to the Web site for the book, include:
*Avoiding trans-fats, the artery-clogging fats found in many commercial products and fast foods
*Eating more vegetable protein, like beans and nuts, and less animal protein
*Drinking a glass of whole milk or having a small dish of ice cream or full-fat yogurt every day; temporarily trading in skim milk and low or no-fat dairy products for their full-fat versions
*Getting into the "fertility zones" for weight and physical activity.
Wednesday, January 9, 2008
Medicating children
Frontline aired an eye-opening segment last night called “The Medicated Child,” which looks at the increasing numbers of children who are being diagnosed with serious psychiatric disorders and the medications that are being prescribed to them despite the fact that they’ve undergone little or no testing in children (since running clinical trials on children is a risky and ethically problematic affair). You can watch the program online or just read about it here. http://www.pbs.org/wgbh/pages/frontline/medicatedchild/ Rob and I exchanged skeptical looks as we watched toddlers diagnosed with bipolar disorder and wondered to ourselves whether a good 70 percent of toddlers aren’t naturally bipolar. Tantrums and elation seem like pretty normal mood swings to us these days. It’s the controversy around childhood diagnoses of bipolar disorder (which have shot up 4,000 percent in the past 10 years, according to Frontline) that is the most heated issue in this exposé. I’m no psychiatrist, and I’m sure that many of these medications are of great benefit to the kids who take them, but as a parent, it probably makes sense to stay tuned to reports like these and make all decisions about how to cope with childhood mental illness critically.
Friday, January 4, 2008
Here come the teeth
Owen’s bottom middle two teeth are showing their faint whites just beneath the gums and we’ve been hearing about it the past few nights as he wakes up crying about an hour after bedtime. The tears persist, minus some relief from ice-sucking, until we cave and give him infant Tylenol. Will was relatively unbothered by the process, but unless we’re misdiagnosing some simple unwillingness to sleep, Owen needs relief if we hope to get any sleep. I’m thinking of trying some Hyland’s Teething tablets but I’m always hesitant to try any products (even when they’re homeopathic and “natural”) out on a baby.
So, tell me your favorite teething remedy – especially for nighttime (just gumming on teethers and fingers and ice cubes seems to suffice during the daylight hours).
So, tell me your favorite teething remedy – especially for nighttime (just gumming on teethers and fingers and ice cubes seems to suffice during the daylight hours).
Thursday, December 13, 2007
Rethinking childbirth
This evening’s screening of “The Business of Being Born” (at 6:30 at the Columbus Public Library) should be worth the trip.
I’m stuck at home alone with the boys tonight so I won’t be there. But I’m eager to see the documentary, with Ricki Lake as executive producer – not because it contains some footage from Lake’s home birth, but because it’s garnering attention as an exposé of the state of maternity care in the U.S. (ABC News Australia called it “The Inconvenient Truth” of Childbirth, according to the film’s Web site, where you can also watch a preview of the film .)
As a preview to tonight’s screening, I interviewed LaGrange doula Kristin Pittman (via e-mail and phone) about her own experiences giving birth to four children and now supporting other women as a doula. Read the interview in today’s Ledger-Enquirer here.
Kristin offers a fascinating look at a range of childbirth experiences through one woman’s eyes. Although she had hoped to have all of her children naturally, her first two births wound up being medicated hospital births (and both led to hospitilizations of the babies within their first week of life), her third child was born naturally in a hospital with an obstetrician and a doula assisting, and her fourth child (now 21 months old) was born in an inflatable pool in her bathroom at home (with the assistance of a midwife).
There wasn’t space in the print edition to include the stories of her first three births, but they are well worth reading. Take a look -- and pass her story along to any mothers-to-be you know so they can think ahead about the sorts of choices they may be faced with in their owns labor and births.
Kristin's first birth story:
My desire from my very first pregnancy was to give birth naturally, with as little intervention as possible. I have always believed that women were perfectly designed to give birth, and our bodies will do just what they need to do if we trust in the process. There are, of course, times when medical intervention is necessary, but it’s my belief that it should not be used routinely, as any intervention into the normal process of labor and birth comes with risk, and can interfere with what the body is naturally doing.
In my first labor at the hospital not all of the staff was supportive of my desire for natural childbirth, and my confidence was quickly undermined. My first nurse’s response, when my husband informed her of my plans, was “Oh, first baby huh?....You’ll see…” I had a
very difficult and slow back labor, with a posterior baby. After many hours of laboring and terrible pain, I started giving in to interventions and pain meds. Every intervention seemed to come with another, and I ultimately delivered my baby girl with the assistance of forceps. She had a pretty rough transition and was not very alert and responsive and was taken immediately to the nursery to be worked on. Right before discharge we found that she was not only very jaundiced, but dehydrated as well. We ended up having to admit her to Children’s Hospital (in Akron, Ohio) the night after we brought her home due to her dehydration and jaundice, where she stayed for 3 nights. I felt confident that Cadence’s troubles were due to the many interventions, drugs and her difficult labor and birth. I also believe that if I had had the proper support, my labor with Cadence may have not been so difficult. If I had had someone who knew (which the nurses did) that my baby was posterior and suggested to me that there were things we could do to facilitate her getting into a better position (and things that we SHOULDN’T do ~ namely break my water ~ which would exacerbate the situation), things MAY have gone very differently. A doula would have been wonderful for me during that labor. At the time, though, I really didn’t know much about doulas.
Her second birth story:
In my labor with my second baby, I was again coping very well at home and actually coping well at the hospital…until my OB arrived. He had been called in (at around 2 in the morning) for another patient, next door to me, who had been slowly laboring all night and suddenly went from 2 cm to complete and baby flew out! Needless to say, he missed the birth. Since he was there, he came into my room to check on me. I had not even been officially admitted yet, because I was still in the “monitoring” stage, seeing if I was progressing, before deciding if they would keep me there or send me home. He decided to check my dilation and as he was checking, he asked the nurse to hand him a “hook.” I knew immediately what he meant ~ the amnihook, to break my water. I said “No!” The nurse started telling him that I hadn’t even been admitted, and that my birth plan said I did not want my water broken, etc. He asked for the hook again, she hesitated, I screamed “NO!” ~ and he proceeded to yell at the nurse, tell her “I’M the doctor!” and go into a tirade about how he “HAD” to break my water because of some scenario (both my husband and I believe he said something about the cord). So as I’m saying no, my nurse reluctantly hands over the hook, doctor breaks my water, and there is meconium. What does the doctor say? “See? That’s why I had to break your water.” (Never mind that he couldn’t have known about the meconium before breaking my water…it was just a convenient excuse after the fact. We will always believe that he was (a) fired up after missing a patient’s birth, and (b) ready to just get my labor moving along and done since he was called there in the middle of the night.) He had scared me to death -- made me think something terrible was wrong and that my baby was going to die. So here I was, traumatized, crying, and a very basic part of my birth plan had been violated. This baby was also posterior, but up until this point the back pain hadn’t been near as bad as it was with baby #1. When my water was broken, however, the pain intensified dramatically.
A few minutes after this incident, my OB came back in the room, sat down next to me, held my hand, and told me something along the lines of “I just want what’s best for you.” And then he said: “Don’t question me in front of the nurses.” I was so traumatized at that point that I was speechless. I once again asked for an epidural because I was so overtaken by the sudden intensity of the pain once my water had been broken, I couldn’t get focused again.
Once again, my posterior baby remained posterior…and maybe if his water had stayed intact, and I had been able to use position changes (if I’d had support from someone to assist me in what to do), he would have been able to turn and have an easier labor and birth. Micah was delivered with the assistance of vacuum, and he aspirated his meconium. It’s possible that he would have aspirated anyway, but I will always wonder if his water being broken before it was time contributed to it. It’s also possible that his difficult birth and his position coming down the birth canal could have contributed to him swallowing and aspirating the meconium. Micah was transferred just hours after his birth to the NICU at Rainbow Babies and Children’s Hospital (in Cleveland, Ohio) due to the meconium aspiration. He required some oxygen that night and observation for the next few days.
Her third birth story (with a doula, this time):
By the time I conceived my third child, I knew I wanted a doula for my next birth. I needed someone who would provide that continuous emotional and physical support, with her trust in the process of normal birth, along with knowledge and experience in natural childbirth. I was more dedicated than ever, after having two newborn babies hospitalized, to doing what was best for my babies (and myself) and doing everything in my power to minimize risk. And I knew I needed someone by my side who could “hold the space” and assist me in following my body’s cues and allowing it and my baby to do the work they were meant to do. As much as I love my husband, and as wonderful as he is during labor and birth (and all other aspects of parenting), it’s a difficult role for a husband to “doula” his wife. Husbands are emotionally invested; it’s difficult for them to see their wives in pain. It’s difficult for them not to worry. They are distracted by the enormity of this huge life event. A doula is there ONLY for the mother. She does not have the distractions of monitoring and medical tasks or an emotional stake in the event. She can remain focused and objective at all times. There is great power in women helping women through childbirth.
So I hired a doula. She made all the difference. She came to my home as soon as I was ready for her to come during my labor. The moment she arrived and placed her hands on my back, I felt a sense of real calm come over me. We labored at home for several more hours, until I decided that I was ready to make the transition to the hospital. Once I got into my room in the hospital, I was able to get in the labor tub and relax for a bit. While in there, I felt lots of pressure and knew my baby was coming down. I did get out of the tub and up onto the bed in a kneeling position to give birth. Hannah came flying out! (Anterior!) She was born less than an hour after I got into my room.
I believe that the difference in Hannah’s labor and birth were due to more knowledge and more support for my plans and wishes. I was free to move the way I wanted and do what felt right, with no tension around me or pressure to have this intervention or that…no timeline. Hannah was able to maneuver into just the right positions for her journey through the birth canal and her birth. Her water remained intact until she started coming out (when I was in the tub). This made a difference in her position and in my level of pain.
After Hannah was born, we had no health issues with her. She had no drugs in her system, and she had a very gentle birth.
Here Kristin discusses some of the positive aspects of home birth AFTER the delivery of her fourth child, Ethan (now 21 months old). See the print edition link above for details of the labor itself):
I was allowed to hold my baby immediately (my husband put him right on my chest) and stare at him and touch him, as my husband exclaimed that it was a boy! There was no one to take him out of my arms and rush him into an isolette under bright lights to “examine” him while I sat empty-handed, longing to hold this life that I had carried inside me for 9 months.
My children were able to see their new baby brother immediately (I had meant for them to see the birth, but at least a couple of them had fallen asleep by the time he was born ~ 11:15 p.m. ~ but we did wake them up right away to come see him), in their own home…They all got to hold him and have pictures taken and then they got to go to sleep in their own beds, with Mommy and Daddy and new baby brother just down the hall.
I was able to climb into my OWN bed with my baby and initiate breastfeeding immediately. I was allowed to wait for my placenta to come in its own time as well, with no tugging on the cord (and no early clamping of the cord). I got to clean up in my own shower and again climb into my own bed, with fresh sheets placed on it by my midwife and her assistant, while Daddy did his own bonding.
My midwife’s assistant made me a sandwich to eat shortly after the birth, while my husband and I relaxed in bed with our newborn. We were given plenty of time alone with our baby. When we had said goodbye to our midwife and her assistant, we settled into our own bed and had a peaceful night of rest, between feedings of course, with no interruptions from strangers. The next few days were so comfortable, being in our own home, our own bed, with our whole family together, and close friends and family visiting here and there.
Another question that didn’t make the print edition:
Do you have a sense, in the work you’ve begun to do as a doula, that more women are beginning to seek out natural childbirth or home birth experiences?
I do believe more women are seeking natural childbirth. At a time when we are seeing our nation’s c-section rate rise each year (preliminary data for 2006 shows a rate of 31.1%, up from 30.3% in 2005), I think more women are looking for ways to not only stay out of the operating room, but to simply bring their babies into the world as safely as possible.
And here Pittman shares her wishes for all women (a nice note to end on):
What I wish for all women is factual information, informed consent, informed refusal, respect for the laboring woman’s wishes, no agendas, no coersion. No more putting mothers and babies at risk in the name of hospital policy dictated by malpractice insurance carriers, as a result of our litigious society. Women deserve options and the freedom to give birth the way nature intended and freedom to listen to their bodies and do what their bodies are telling them to do.
Learn more about the movie and watch a preview here.
Learn more about BirthNetwork – in Columbus or in your area here.
Other resources:
Childbirth and Postpartum Professional Association
DONA International, a doula association
Childbirth International
Association of Labor Assistants & Childbirth Educators
BirthWorks International
For more information about Kristin Pittman’s doula services go here.
Leave a comment and share lessons learned from your own labor/birth.
I’m stuck at home alone with the boys tonight so I won’t be there. But I’m eager to see the documentary, with Ricki Lake as executive producer – not because it contains some footage from Lake’s home birth, but because it’s garnering attention as an exposé of the state of maternity care in the U.S. (ABC News Australia called it “The Inconvenient Truth” of Childbirth, according to the film’s Web site, where you can also watch a preview of the film .)
As a preview to tonight’s screening, I interviewed LaGrange doula Kristin Pittman (via e-mail and phone) about her own experiences giving birth to four children and now supporting other women as a doula. Read the interview in today’s Ledger-Enquirer here.
Kristin offers a fascinating look at a range of childbirth experiences through one woman’s eyes. Although she had hoped to have all of her children naturally, her first two births wound up being medicated hospital births (and both led to hospitilizations of the babies within their first week of life), her third child was born naturally in a hospital with an obstetrician and a doula assisting, and her fourth child (now 21 months old) was born in an inflatable pool in her bathroom at home (with the assistance of a midwife).
There wasn’t space in the print edition to include the stories of her first three births, but they are well worth reading. Take a look -- and pass her story along to any mothers-to-be you know so they can think ahead about the sorts of choices they may be faced with in their owns labor and births.
Kristin's first birth story:
My desire from my very first pregnancy was to give birth naturally, with as little intervention as possible. I have always believed that women were perfectly designed to give birth, and our bodies will do just what they need to do if we trust in the process. There are, of course, times when medical intervention is necessary, but it’s my belief that it should not be used routinely, as any intervention into the normal process of labor and birth comes with risk, and can interfere with what the body is naturally doing.
In my first labor at the hospital not all of the staff was supportive of my desire for natural childbirth, and my confidence was quickly undermined. My first nurse’s response, when my husband informed her of my plans, was “Oh, first baby huh?....You’ll see…” I had a
very difficult and slow back labor, with a posterior baby. After many hours of laboring and terrible pain, I started giving in to interventions and pain meds. Every intervention seemed to come with another, and I ultimately delivered my baby girl with the assistance of forceps. She had a pretty rough transition and was not very alert and responsive and was taken immediately to the nursery to be worked on. Right before discharge we found that she was not only very jaundiced, but dehydrated as well. We ended up having to admit her to Children’s Hospital (in Akron, Ohio) the night after we brought her home due to her dehydration and jaundice, where she stayed for 3 nights. I felt confident that Cadence’s troubles were due to the many interventions, drugs and her difficult labor and birth. I also believe that if I had had the proper support, my labor with Cadence may have not been so difficult. If I had had someone who knew (which the nurses did) that my baby was posterior and suggested to me that there were things we could do to facilitate her getting into a better position (and things that we SHOULDN’T do ~ namely break my water ~ which would exacerbate the situation), things MAY have gone very differently. A doula would have been wonderful for me during that labor. At the time, though, I really didn’t know much about doulas.
Her second birth story:
In my labor with my second baby, I was again coping very well at home and actually coping well at the hospital…until my OB arrived. He had been called in (at around 2 in the morning) for another patient, next door to me, who had been slowly laboring all night and suddenly went from 2 cm to complete and baby flew out! Needless to say, he missed the birth. Since he was there, he came into my room to check on me. I had not even been officially admitted yet, because I was still in the “monitoring” stage, seeing if I was progressing, before deciding if they would keep me there or send me home. He decided to check my dilation and as he was checking, he asked the nurse to hand him a “hook.” I knew immediately what he meant ~ the amnihook, to break my water. I said “No!” The nurse started telling him that I hadn’t even been admitted, and that my birth plan said I did not want my water broken, etc. He asked for the hook again, she hesitated, I screamed “NO!” ~ and he proceeded to yell at the nurse, tell her “I’M the doctor!” and go into a tirade about how he “HAD” to break my water because of some scenario (both my husband and I believe he said something about the cord). So as I’m saying no, my nurse reluctantly hands over the hook, doctor breaks my water, and there is meconium. What does the doctor say? “See? That’s why I had to break your water.” (Never mind that he couldn’t have known about the meconium before breaking my water…it was just a convenient excuse after the fact. We will always believe that he was (a) fired up after missing a patient’s birth, and (b) ready to just get my labor moving along and done since he was called there in the middle of the night.) He had scared me to death -- made me think something terrible was wrong and that my baby was going to die. So here I was, traumatized, crying, and a very basic part of my birth plan had been violated. This baby was also posterior, but up until this point the back pain hadn’t been near as bad as it was with baby #1. When my water was broken, however, the pain intensified dramatically.
A few minutes after this incident, my OB came back in the room, sat down next to me, held my hand, and told me something along the lines of “I just want what’s best for you.” And then he said: “Don’t question me in front of the nurses.” I was so traumatized at that point that I was speechless. I once again asked for an epidural because I was so overtaken by the sudden intensity of the pain once my water had been broken, I couldn’t get focused again.
Once again, my posterior baby remained posterior…and maybe if his water had stayed intact, and I had been able to use position changes (if I’d had support from someone to assist me in what to do), he would have been able to turn and have an easier labor and birth. Micah was delivered with the assistance of vacuum, and he aspirated his meconium. It’s possible that he would have aspirated anyway, but I will always wonder if his water being broken before it was time contributed to it. It’s also possible that his difficult birth and his position coming down the birth canal could have contributed to him swallowing and aspirating the meconium. Micah was transferred just hours after his birth to the NICU at Rainbow Babies and Children’s Hospital (in Cleveland, Ohio) due to the meconium aspiration. He required some oxygen that night and observation for the next few days.
Her third birth story (with a doula, this time):
By the time I conceived my third child, I knew I wanted a doula for my next birth. I needed someone who would provide that continuous emotional and physical support, with her trust in the process of normal birth, along with knowledge and experience in natural childbirth. I was more dedicated than ever, after having two newborn babies hospitalized, to doing what was best for my babies (and myself) and doing everything in my power to minimize risk. And I knew I needed someone by my side who could “hold the space” and assist me in following my body’s cues and allowing it and my baby to do the work they were meant to do. As much as I love my husband, and as wonderful as he is during labor and birth (and all other aspects of parenting), it’s a difficult role for a husband to “doula” his wife. Husbands are emotionally invested; it’s difficult for them to see their wives in pain. It’s difficult for them not to worry. They are distracted by the enormity of this huge life event. A doula is there ONLY for the mother. She does not have the distractions of monitoring and medical tasks or an emotional stake in the event. She can remain focused and objective at all times. There is great power in women helping women through childbirth.
So I hired a doula. She made all the difference. She came to my home as soon as I was ready for her to come during my labor. The moment she arrived and placed her hands on my back, I felt a sense of real calm come over me. We labored at home for several more hours, until I decided that I was ready to make the transition to the hospital. Once I got into my room in the hospital, I was able to get in the labor tub and relax for a bit. While in there, I felt lots of pressure and knew my baby was coming down. I did get out of the tub and up onto the bed in a kneeling position to give birth. Hannah came flying out! (Anterior!) She was born less than an hour after I got into my room.
I believe that the difference in Hannah’s labor and birth were due to more knowledge and more support for my plans and wishes. I was free to move the way I wanted and do what felt right, with no tension around me or pressure to have this intervention or that…no timeline. Hannah was able to maneuver into just the right positions for her journey through the birth canal and her birth. Her water remained intact until she started coming out (when I was in the tub). This made a difference in her position and in my level of pain.
After Hannah was born, we had no health issues with her. She had no drugs in her system, and she had a very gentle birth.
Here Kristin discusses some of the positive aspects of home birth AFTER the delivery of her fourth child, Ethan (now 21 months old). See the print edition link above for details of the labor itself):
I was allowed to hold my baby immediately (my husband put him right on my chest) and stare at him and touch him, as my husband exclaimed that it was a boy! There was no one to take him out of my arms and rush him into an isolette under bright lights to “examine” him while I sat empty-handed, longing to hold this life that I had carried inside me for 9 months.
My children were able to see their new baby brother immediately (I had meant for them to see the birth, but at least a couple of them had fallen asleep by the time he was born ~ 11:15 p.m. ~ but we did wake them up right away to come see him), in their own home…They all got to hold him and have pictures taken and then they got to go to sleep in their own beds, with Mommy and Daddy and new baby brother just down the hall.
I was able to climb into my OWN bed with my baby and initiate breastfeeding immediately. I was allowed to wait for my placenta to come in its own time as well, with no tugging on the cord (and no early clamping of the cord). I got to clean up in my own shower and again climb into my own bed, with fresh sheets placed on it by my midwife and her assistant, while Daddy did his own bonding.
My midwife’s assistant made me a sandwich to eat shortly after the birth, while my husband and I relaxed in bed with our newborn. We were given plenty of time alone with our baby. When we had said goodbye to our midwife and her assistant, we settled into our own bed and had a peaceful night of rest, between feedings of course, with no interruptions from strangers. The next few days were so comfortable, being in our own home, our own bed, with our whole family together, and close friends and family visiting here and there.
Another question that didn’t make the print edition:
Do you have a sense, in the work you’ve begun to do as a doula, that more women are beginning to seek out natural childbirth or home birth experiences?
I do believe more women are seeking natural childbirth. At a time when we are seeing our nation’s c-section rate rise each year (preliminary data for 2006 shows a rate of 31.1%, up from 30.3% in 2005), I think more women are looking for ways to not only stay out of the operating room, but to simply bring their babies into the world as safely as possible.
And here Pittman shares her wishes for all women (a nice note to end on):
What I wish for all women is factual information, informed consent, informed refusal, respect for the laboring woman’s wishes, no agendas, no coersion. No more putting mothers and babies at risk in the name of hospital policy dictated by malpractice insurance carriers, as a result of our litigious society. Women deserve options and the freedom to give birth the way nature intended and freedom to listen to their bodies and do what their bodies are telling them to do.
Learn more about the movie and watch a preview here.
Learn more about BirthNetwork – in Columbus or in your area here.
Other resources:
Childbirth and Postpartum Professional Association
DONA International, a doula association
Childbirth International
Association of Labor Assistants & Childbirth Educators
BirthWorks International
For more information about Kristin Pittman’s doula services go here.
Leave a comment and share lessons learned from your own labor/birth.
Monday, December 10, 2007
More on toy safety – and cosmetics too
If, as Santa Claus, you believe in making gift lists and checking them twice, here is a little tool for the paranoid parent in you. It’s the HealthyToys.org web site, where I have decided NOT to sink hours investigating every single plastic toy in our house but instead to focus on the few baby toys that I watch Owen mouthing on all day long.
This is because every time Owen has something plastic in his mouth, which is quite frequently now, I can’t help but think about lead for a fleeting moment. And then I do nothing about it. Partly because he’s mostly got infant toys inherited from Will and I don’t even know how I’d look them up at this point. Partly because I know paint in old homes (we happen to live in one) is a much bigger danger in terms of lead poisoning -- and I still haven’t decided how paranoid to be about plastic toys. But if I’m seeing plastic in the mouth and thinking lead, obviously I’m still a bit worried.
Want to worry some more? Go to this site and check out just how many of the toothpaste, baby shampoo, and other cosmetic products that you buy for your kids contain potentially problematic chemicals, according to the Environmental Working Group’s Skin Deep Safety Base. (They list plenty of safer alternatives.)
This is because every time Owen has something plastic in his mouth, which is quite frequently now, I can’t help but think about lead for a fleeting moment. And then I do nothing about it. Partly because he’s mostly got infant toys inherited from Will and I don’t even know how I’d look them up at this point. Partly because I know paint in old homes (we happen to live in one) is a much bigger danger in terms of lead poisoning -- and I still haven’t decided how paranoid to be about plastic toys. But if I’m seeing plastic in the mouth and thinking lead, obviously I’m still a bit worried.
So with a few minutes work, you can buy yourself some peace of mind and check out products on your Christmas list. I’ve discovered that these stackable rings are free of toxins, for 
example. Down side is there’s so many products out there that there’s plenty that hasn’t been tested and inventoried on this site. To do a quick scan for potentially problematic toys in your house, skim through the toys listed by type and just note which toys received ratings other than low for overall toxicity (they’re highlighted yellow).
example. Down side is there’s so many products out there that there’s plenty that hasn’t been tested and inventoried on this site. To do a quick scan for potentially problematic toys in your house, skim through the toys listed by type and just note which toys received ratings other than low for overall toxicity (they’re highlighted yellow). Right now I’m wondering whether I really need to discard Owen’s Gerber NUK pacifier just because a similar looking NUK pacifier gets a medium toxicity rating on the site because of chlorine or polyvinyl chloride in the packaging it came in, which we long ago discarded. (PVC in packaging seems to be one of the most common toxicity issues listed on the site.)
Want to worry some more? Go to this site and check out just how many of the toothpaste, baby shampoo, and other cosmetic products that you buy for your kids contain potentially problematic chemicals, according to the Environmental Working Group’s Skin Deep Safety Base. (They list plenty of safer alternatives.)
Then say a little prayer or do a little yoga, and forget about it all.
Friday, November 30, 2007
the yuck bug
Last night, for the first time I removed the tired old covers from our sofa and gave them a Woolite washing. This was the highlight of an afternoon and evening in which Will got a little five-hour mystery bug featuring bad sore throat, two bouts of profuse vomiting (the first of which soaked the couch), and then… Recovery. He’s completely fine today, although we’re holed up in the house making sure that the thing really has left his body.
Low-light of the evening was of course looking into Will’s terrified eyes during the second-go-round of throw up (which I was able to catch in a 13X9 pan that has since undergone multiple vigorous washings). The last time Will vomited he was too little to know what hit him, too non-verbal to express his dismay (in fact I’m not even sure he was crying that much). This time post-expulsion he emitted a higher-pitched shriek than I’ve ever heard out of the little guy and then shouted “YUUUCCCK!!!” I think he might have repeated the refrain a couple times: shriek, YUCK, shriek, YUCK – and I was thinking yes, you have captured my feelings about stomach bugs precisely.
By the way, if you’ve got a Pedialyte-resistant drinker like Will, be sure you know about Pedialyte freezer pops. When he was about 15 months old, Will wound up dehydrated in the hospital after a severe case of rotavirus and his stubborn refusal to drink the liquid stuff (we were trying and largely failing to force it down his throat via syringe) was largely responsible for landing us in the hospital. It was there – too late – that I learned about the Pedialyte popsicles that Will loves so much he asks for them when well (we decline these requests of course).
Low-light of the evening was of course looking into Will’s terrified eyes during the second-go-round of throw up (which I was able to catch in a 13X9 pan that has since undergone multiple vigorous washings). The last time Will vomited he was too little to know what hit him, too non-verbal to express his dismay (in fact I’m not even sure he was crying that much). This time post-expulsion he emitted a higher-pitched shriek than I’ve ever heard out of the little guy and then shouted “YUUUCCCK!!!” I think he might have repeated the refrain a couple times: shriek, YUCK, shriek, YUCK – and I was thinking yes, you have captured my feelings about stomach bugs precisely.
By the way, if you’ve got a Pedialyte-resistant drinker like Will, be sure you know about Pedialyte freezer pops. When he was about 15 months old, Will wound up dehydrated in the hospital after a severe case of rotavirus and his stubborn refusal to drink the liquid stuff (we were trying and largely failing to force it down his throat via syringe) was largely responsible for landing us in the hospital. It was there – too late – that I learned about the Pedialyte popsicles that Will loves so much he asks for them when well (we decline these requests of course).
Tuesday, October 23, 2007
Guns in the house?
Will woke up yesterday all lovey-gushy.
Daddy, I love you so much. You’re my best friend. And Owen’s my best friend and Mommy’s my best friend. 'Cause I love Owen and Mommy and you so much.
We told Will how much we loved him too. But that was enough of the niceties for Will.
But Ally and Puff and all my other friends aren’t very nice. I’m going to shoot them down with a gun.
My fumbling response: You wouldn’t want to do that, because they wouldn’t be around anymore. Guns can kill people.
Rob: Where did you hear about guns Will?
I just hold it in my hand and I shoot them down.
Rob: Do you pretend that you have guns with your friends at school.
Yeah. And I just shoot them down...
I know guns will be a part of Will’s play and I’m not going to hover and censor him (although I’m not planning any plastic machine gun purchases for Christmas). But I do need to start talking with him now about the dangers of real guns.
This article on Parents.com suggests that as parents we should probably be asking our friends if they keep guns in their house, and if so what safety measures have been taken to ensure children have no access to them, before we send our explorative children over to play. It cites a recent Pediatrics report that nearly 1.7 million American children live in homes with unlocked loaded firearms and a study by San Francisco General Hospital and the Harvard School of Public Health that found that: “In 39 percent of families where parents said their 5- to 14-year-olds didn't know where guns were stored, the kids actually did know the location. In 22 percent of homes where the parents said their children had never handled a gun, the kids told researchers that they had.”
I’ve very rarely left Will at a friend’s house – usually I still accompany him for play dates – but once he starts going solo more these are questions I’m probably going to start asking, awkward as it might feel at first. I can see how little Will understands about life and death and irreversible dangers, and guns are one place where there’s no room for exploration.
Daddy, I love you so much. You’re my best friend. And Owen’s my best friend and Mommy’s my best friend. 'Cause I love Owen and Mommy and you so much.
We told Will how much we loved him too. But that was enough of the niceties for Will.
But Ally and Puff and all my other friends aren’t very nice. I’m going to shoot them down with a gun.
My fumbling response: You wouldn’t want to do that, because they wouldn’t be around anymore. Guns can kill people.
Rob: Where did you hear about guns Will?
I just hold it in my hand and I shoot them down.
Rob: Do you pretend that you have guns with your friends at school.
Yeah. And I just shoot them down...
I know guns will be a part of Will’s play and I’m not going to hover and censor him (although I’m not planning any plastic machine gun purchases for Christmas). But I do need to start talking with him now about the dangers of real guns.
This article on Parents.com suggests that as parents we should probably be asking our friends if they keep guns in their house, and if so what safety measures have been taken to ensure children have no access to them, before we send our explorative children over to play. It cites a recent Pediatrics report that nearly 1.7 million American children live in homes with unlocked loaded firearms and a study by San Francisco General Hospital and the Harvard School of Public Health that found that: “In 39 percent of families where parents said their 5- to 14-year-olds didn't know where guns were stored, the kids actually did know the location. In 22 percent of homes where the parents said their children had never handled a gun, the kids told researchers that they had.”
I’ve very rarely left Will at a friend’s house – usually I still accompany him for play dates – but once he starts going solo more these are questions I’m probably going to start asking, awkward as it might feel at first. I can see how little Will understands about life and death and irreversible dangers, and guns are one place where there’s no room for exploration.
Friday, October 19, 2007
Boys -- they take their toll
Here’s how our day with the boys began: 6:35 a.m. A far-off noise wakes Rob off. Soon we discover it’s Will crying from the kitchen. He got up and rather than coming to wake us up, decided to be self-sufficient and strap himself into the booster chair where he eats his oatmeal. (We still haven’t graduated him from the thing because he’s a bit short and he prefers the seat to perching on phone books or encyclopedias.) But then he was trapped – stuck in his chair with no parents and no oatmeal. So he had to cry and cry until we were roused from our sleepiness. Might have been a few minutes, might have been twenty. Either way, self-imprisoned red-eyed Will was a rather pathetic sight.
And this is how our day ended: After an hour of quiet time but no nap, Will suffered through a series of meltdowns from 5:30 pm. to 6:30, at which point we tried to corral him toward bed but had to deal with more meltdowns on the way. (I never realized how much I loved Will’s nap until he stopped taking it.) Finally at 7:30 we had both Owen and Will down so I snuck off for an hour to visit a friend who’s been ill. On my way home, I answered the cell phone to hear both boys crying in the background. Overtired Will was having trouble sleeping and had been up three times since I’d been gone and Owen was crying inconsolably.
Sure having kids is a joyous life-giving experience, but days like these make you wonder if it’s also life-draining. Here’s some evidence from Finland suggesting that having boys, in particular, takes a toll – almost a year off your life compared to having girls, in fact.
(Evolutionary biologist Virpi Lummaa argues that birth weight (male babies are usually larger) and testosterone (which can compromise mother’s immune system) are the main reasons for the difference. Plenty of moms out there might suspect the general rambunctiousness and recklessness of boys – and the stress they cause their moms -- as factors as well.
And yeah, I’m feeling drained tonight, but I’d gladly exchange the last withering year or two of my life for my two little bundles of testosterone.
And this is how our day ended: After an hour of quiet time but no nap, Will suffered through a series of meltdowns from 5:30 pm. to 6:30, at which point we tried to corral him toward bed but had to deal with more meltdowns on the way. (I never realized how much I loved Will’s nap until he stopped taking it.) Finally at 7:30 we had both Owen and Will down so I snuck off for an hour to visit a friend who’s been ill. On my way home, I answered the cell phone to hear both boys crying in the background. Overtired Will was having trouble sleeping and had been up three times since I’d been gone and Owen was crying inconsolably.
Sure having kids is a joyous life-giving experience, but days like these make you wonder if it’s also life-draining. Here’s some evidence from Finland suggesting that having boys, in particular, takes a toll – almost a year off your life compared to having girls, in fact.
(Evolutionary biologist Virpi Lummaa argues that birth weight (male babies are usually larger) and testosterone (which can compromise mother’s immune system) are the main reasons for the difference. Plenty of moms out there might suspect the general rambunctiousness and recklessness of boys – and the stress they cause their moms -- as factors as well.
And yeah, I’m feeling drained tonight, but I’d gladly exchange the last withering year or two of my life for my two little bundles of testosterone.
Wednesday, October 17, 2007
Vaccine safety: Take two
After a few days of obsessive research following last week’s initial post about whether to get a flu shot for Will, I wrote this column on the subject of vaccine safety in today’s Ledger-Enquirer. I sought out the advice of my pediatrician, my midwife, an RN/lactation consultant, and a Washington-Based journalist who’s been writing about vaccine safety for several years. Some of their reaction is in the column – but you’ll find more that didn’t make it into the print edition at the bottom of this post.
Print-edition correction: For those of you coming here after reading the print-edition of the column, there was an editing mix-up that led to a major error in that column. Some of Dr. Mansfield's comments were attributed to Stephanie Cave, who I never talked to at all. The online edition of the column is correct -- click on the link above and jump to page two to read what Dr. Mansfield said in full.
The honest truth is, I’m a mess when it comes to this one little decision: One day I lean toward the flu shot, the next day I lean against it. It’s sort of a battle between something in my gut (that says we put plenty of unnatural substances into our bodies already without adding an optional flu shot every year) and something more cerebral (that says the science says it’s safe and your doctor’s recommending it, so get over it and give your kid the shot). For now Rob and I are still stalling on the issue.
If you’re hoping to make an informed decision you might want to do some reading of your own. Here are some of the web sites and articles I visited over the course of preparing this column. (If you wade into the first couple web sites be sure to also visit some of the articles on the second and third list to balance things out.):
On the vaccines can be risky side of the debate:
National Vaccine Information Center (a national, non-profit organization dedicated to preventing vaccine injuries and deaths through public education and defending the right to informed consent to vaccination)
Vaccination Risk Awareness Network (a Canadian-based, not-for-profit educational society, founded by parents whose children have suffered vaccine reactions and injuries)
The Autism Research Institute, a non-profit organization primarily devoted to conducting research, and to disseminating the results of research, on the triggers of autism and on methods of diagnosing and treating autism.
“Vaccinations: Parents’ Informed Choice” at the Weston A. Price Foundation Web site
On the vaccines are safe and the risks are overblown side:
“Sticking Up for Thimerosal: Read the Studies – It’s safe.” By Arthur Allen on Slate.com
“How to Think About Vaccination - My Perspective” by Arthur Allen, journalist and author of
“Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver.”
Other scientific reports and informational Web sites:
Centers for Disease Control and Prevention’s vaccine safety web page
Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health.
Table of thimerosal content in some US-licensed vaccines
“Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United kingdom does not support a causal association.” Pediatrics 2004; 114 (3)
“Mercury in Vaccines Is at Safe Levels, Study Suggests” University of Rochester Medical Center
“Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.” Pediatrics 2003; 112(5) …..tics
“MMR and Autism: Suspect or Superstition?” Pediatric Bulletin
“A two-phased population epidemiological study of the safety of thimerosal-containing vaccines: a follow-up analysis.” Medical Science Monitor
“Influenza-Associated Deaths Reported Among Children Aged <18> From Morbidity & Mortality Weekly Report
And then some reactions from health care professionals I contacted:
Melissa Terry Flynn, certified nurse-midwife:
I had never had a flu shot until I came here to Columbus and our practice pretty much requires everybody to take one. I have never had a problem taking it. I did have the flu once about 20 years ago and just remember feeling like I was dying and being thankful that I didn't have anybody to take care of. As a mother of young children I would probably get one unless you intend to stay holed up for the next six months. You don't have the option of going to bed for a week. There is also a FluMist for kids over age 2 that doesn't seem to have the preservatives that the shot has that you might find better for Will. Read about it online and see if your pediatrician will order it. It is a live virus vaccine but early studies look better than the shot in young children.
Our pediatrician, Richard Mansfield (additional reaction is in the column):
On FluMist: We do not have Flumist in our office this year due to inadequate demand. People balked at the extra cost. In addition, you have to be perfectly healthy. New data this year suggests that it lasts longer than the shot. The shot, if given early in the season may not be effective in February. Flumist is also a live virus and as such can give a flu like illness.
On Vaccines and autism: I have great empathy for parents dealing with special needs children. Every day can be a struggle. Many times we do not know what caused the disability. What I see written by blog writers and nonimmunizers is that they base their decisions on emotions or anecdotal reports. This is perhaps the way medicine was practiced centuries ago before we conducted double blinded randomized controlled trials. We as parents and physicians do our duty when we make decisions for our children based on sound science. Keep in mind that the cause of autism is unknown. The leading theory is a genetic defect. There is NO association with vaccines and autism.
Jennifer Fletcher, Registered Nurse and International Board Certified Lactation Consultant:
I think that for children over the age of two, a flu shot is probably a pretty good idea. Please know, however, that the thimerosal issue is very real and must be considered on an individual basis.I personally know of one case in which a child had seizures and eventually died at the age of sixteen months, after receiving her MMR. This child does not live in the Columbus area but was the niece of one of my breastfeeding clients. My client has decided to postpone ALL vaccinations for her child until she reaches the age of two and then vaccinate very slowly---none of those four to six injections at a time!Personally, I think that the effects of thimerosal, as with all heavy-metal containing substances, are dose-related. It might be that routine vaccinations PLUS flu shot might be too much, whereas one or the other might be fine.This is a very complex issue, and there is no one "one size fits all" answer. Who really knows what vulnerabilities our children might demonstrate? But for a child who is in close contact with others outside their families (day care, church nurseries, play groups, etc.) a flu shot may well be warranted for those over the age of two.
Arthur Allen (author of "Vaccine"; additional reaction is in the column):
On thimerosal: The data are clear on thimerosal. It does not cause harm. But that's a very long story. Perhaps it's easiest to point the following out: the ethyl mercury contained in a single flu shot that an a child over 3 years of age would be getting has approximately one sixth the ethyl mercury that was in the three DTP vaccines that children got between 1942 and 1992 or so, when the HiB and hep B shots were added … The data clearly show that the numbers of autistic kids continued to go up after thimerosal was removed from all shots except flu. In other words, the levels of thimerosal were back far below what they were in 1960, say -- but the autism rates continued to be 1 in 150 or whatever. Look at the California DDS statistics if you want more precision. You know, organic mercury is present in tiny amounts in the air we breathe and many foods we eat. Fish, for example -- a can of tuna has a dozen or so mcg of methyl mercury (check that, it's approximate), and even a head of lettuce, as I recall (from the book Quicksilver, I forget the author, 1972 or thereabouts) has 2 or 3 mcg of methyl mercury in it. We know that in massive amounts, mercury can cause all kinds of problems. But the only real data we have for harm from mercury in small, "natural" amounts comes from studies of seafish eaters. In one study, in the Syechelles, moms who ate lots and lots of mercury containing fish had kids who were smarter than the kids of moms who ate none. In another, in the Faeroes islands, there was some evidence of slight neurodevelopmental delays -- slower reaction on tests, slight attention deficits -- in the kids of moms who binged on pilot whale meat. These were massive consumptions, over time, of HG, but that was what EPA used to set its threshold--to be on the safe side. Bottom line is, even if thimerosal, in sufficient dose, were a cause for concern, that dosage is no longer given to kids.
Also, I'm sure you're aware of the fact that multiple studies done since 1999 (and since Stephanie Cave's alarmist and in my opinion worthless book came out) have shown no harm from thimerosal.The costs of vaccines are always exaggerated by anti-vaccine activists like stephanie cave. It of course makes sense to weight the costs and benefits of anything you do. But word to the wise: don't trust people like Stephanie Cave to make that equation for you.
On giving multiple shots at one time: The question is, what's the basis for concern about the multiple shots? Is there anything real, other than a gut unease about "all those shots?" cumulatively, kids get exposed to fewer antigen particles in vaccines than they did in the 1970s, because the DPT vaccine has a more purified pertussis component than the old one did, and they no longer get smallpox vaccine. Kids are exposed to multiple germs every day. Vaccines are just visible, that's all. I understand the fears -- kids hate shots, parents hate to see their kids suffer, it's a hassle and bother, and whenever the specter of harm arises in a substance that doesn't seem necessary at the time, we naturally shy away from it. But on the basis of rationally trying to protect our kids, none of the vaccine critics' points really stick.
On the flu vaccine: The thing about flu vaccination is this: old people have been trained to get their flu shots, and that's fine. But the fact is, even though cumulatively flu vaccine helps protect the elderly from flu, on an individual basis an old person's immune system has often deteriorated in a way that doesn't allow them to provide a good immune response to the shot. So they don't get that much beneift from it. The best way to protect old people from flu, it turns out, is to vaccinate their grandchildren and children. Ironically, although flu is not often deadly in the young--so their direct benefit from it may not seem that high -- in protecting the young we also protect the old. This is the concept of herd immunity. It's real.On vaccine safety in general: It's also important, in my view, to understand that many anti-vaccinators have a vested interest in alternative medicine that sways their understanding of these issues. There have been vaccine disasters in the past. But vaccines are safer now than they ever have been – I say this as someone who did a careful study of them for a book that took me 7 years to complete -- and the diseases they prevent are real.
If you're in a polling mood, go to the bottom of the October 11 "Flu shot" post and let us know whether you'll be opting for a shot this year, or whether you're still deciding. Or just leave your comments here.
Print-edition correction: For those of you coming here after reading the print-edition of the column, there was an editing mix-up that led to a major error in that column. Some of Dr. Mansfield's comments were attributed to Stephanie Cave, who I never talked to at all. The online edition of the column is correct -- click on the link above and jump to page two to read what Dr. Mansfield said in full.
The honest truth is, I’m a mess when it comes to this one little decision: One day I lean toward the flu shot, the next day I lean against it. It’s sort of a battle between something in my gut (that says we put plenty of unnatural substances into our bodies already without adding an optional flu shot every year) and something more cerebral (that says the science says it’s safe and your doctor’s recommending it, so get over it and give your kid the shot). For now Rob and I are still stalling on the issue.
If you’re hoping to make an informed decision you might want to do some reading of your own. Here are some of the web sites and articles I visited over the course of preparing this column. (If you wade into the first couple web sites be sure to also visit some of the articles on the second and third list to balance things out.):
On the vaccines can be risky side of the debate:
National Vaccine Information Center (a national, non-profit organization dedicated to preventing vaccine injuries and deaths through public education and defending the right to informed consent to vaccination)
Vaccination Risk Awareness Network (a Canadian-based, not-for-profit educational society, founded by parents whose children have suffered vaccine reactions and injuries)
The Autism Research Institute, a non-profit organization primarily devoted to conducting research, and to disseminating the results of research, on the triggers of autism and on methods of diagnosing and treating autism.
“Vaccinations: Parents’ Informed Choice” at the Weston A. Price Foundation Web site
On the vaccines are safe and the risks are overblown side:
“Sticking Up for Thimerosal: Read the Studies – It’s safe.” By Arthur Allen on Slate.com
“How to Think About Vaccination - My Perspective” by Arthur Allen, journalist and author of
“Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver.”
Other scientific reports and informational Web sites:
Centers for Disease Control and Prevention’s vaccine safety web page
Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health.
Table of thimerosal content in some US-licensed vaccines
“Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United kingdom does not support a causal association.” Pediatrics 2004; 114 (3)
“Mercury in Vaccines Is at Safe Levels, Study Suggests” University of Rochester Medical Center
“Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.” Pediatrics 2003; 112(5) …..tics
“MMR and Autism: Suspect or Superstition?” Pediatric Bulletin
“A two-phased population epidemiological study of the safety of thimerosal-containing vaccines: a follow-up analysis.” Medical Science Monitor
“Influenza-Associated Deaths Reported Among Children Aged <18> From Morbidity & Mortality Weekly Report
And then some reactions from health care professionals I contacted:
Melissa Terry Flynn, certified nurse-midwife:
I had never had a flu shot until I came here to Columbus and our practice pretty much requires everybody to take one. I have never had a problem taking it. I did have the flu once about 20 years ago and just remember feeling like I was dying and being thankful that I didn't have anybody to take care of. As a mother of young children I would probably get one unless you intend to stay holed up for the next six months. You don't have the option of going to bed for a week. There is also a FluMist for kids over age 2 that doesn't seem to have the preservatives that the shot has that you might find better for Will. Read about it online and see if your pediatrician will order it. It is a live virus vaccine but early studies look better than the shot in young children.
Our pediatrician, Richard Mansfield (additional reaction is in the column):
On FluMist: We do not have Flumist in our office this year due to inadequate demand. People balked at the extra cost. In addition, you have to be perfectly healthy. New data this year suggests that it lasts longer than the shot. The shot, if given early in the season may not be effective in February. Flumist is also a live virus and as such can give a flu like illness.
On Vaccines and autism: I have great empathy for parents dealing with special needs children. Every day can be a struggle. Many times we do not know what caused the disability. What I see written by blog writers and nonimmunizers is that they base their decisions on emotions or anecdotal reports. This is perhaps the way medicine was practiced centuries ago before we conducted double blinded randomized controlled trials. We as parents and physicians do our duty when we make decisions for our children based on sound science. Keep in mind that the cause of autism is unknown. The leading theory is a genetic defect. There is NO association with vaccines and autism.
Jennifer Fletcher, Registered Nurse and International Board Certified Lactation Consultant:
I think that for children over the age of two, a flu shot is probably a pretty good idea. Please know, however, that the thimerosal issue is very real and must be considered on an individual basis.I personally know of one case in which a child had seizures and eventually died at the age of sixteen months, after receiving her MMR. This child does not live in the Columbus area but was the niece of one of my breastfeeding clients. My client has decided to postpone ALL vaccinations for her child until she reaches the age of two and then vaccinate very slowly---none of those four to six injections at a time!Personally, I think that the effects of thimerosal, as with all heavy-metal containing substances, are dose-related. It might be that routine vaccinations PLUS flu shot might be too much, whereas one or the other might be fine.This is a very complex issue, and there is no one "one size fits all" answer. Who really knows what vulnerabilities our children might demonstrate? But for a child who is in close contact with others outside their families (day care, church nurseries, play groups, etc.) a flu shot may well be warranted for those over the age of two.
Arthur Allen (author of "Vaccine"; additional reaction is in the column):
On thimerosal: The data are clear on thimerosal. It does not cause harm. But that's a very long story. Perhaps it's easiest to point the following out: the ethyl mercury contained in a single flu shot that an a child over 3 years of age would be getting has approximately one sixth the ethyl mercury that was in the three DTP vaccines that children got between 1942 and 1992 or so, when the HiB and hep B shots were added … The data clearly show that the numbers of autistic kids continued to go up after thimerosal was removed from all shots except flu. In other words, the levels of thimerosal were back far below what they were in 1960, say -- but the autism rates continued to be 1 in 150 or whatever. Look at the California DDS statistics if you want more precision. You know, organic mercury is present in tiny amounts in the air we breathe and many foods we eat. Fish, for example -- a can of tuna has a dozen or so mcg of methyl mercury (check that, it's approximate), and even a head of lettuce, as I recall (from the book Quicksilver, I forget the author, 1972 or thereabouts) has 2 or 3 mcg of methyl mercury in it. We know that in massive amounts, mercury can cause all kinds of problems. But the only real data we have for harm from mercury in small, "natural" amounts comes from studies of seafish eaters. In one study, in the Syechelles, moms who ate lots and lots of mercury containing fish had kids who were smarter than the kids of moms who ate none. In another, in the Faeroes islands, there was some evidence of slight neurodevelopmental delays -- slower reaction on tests, slight attention deficits -- in the kids of moms who binged on pilot whale meat. These were massive consumptions, over time, of HG, but that was what EPA used to set its threshold--to be on the safe side. Bottom line is, even if thimerosal, in sufficient dose, were a cause for concern, that dosage is no longer given to kids.
Also, I'm sure you're aware of the fact that multiple studies done since 1999 (and since Stephanie Cave's alarmist and in my opinion worthless book came out) have shown no harm from thimerosal.The costs of vaccines are always exaggerated by anti-vaccine activists like stephanie cave. It of course makes sense to weight the costs and benefits of anything you do. But word to the wise: don't trust people like Stephanie Cave to make that equation for you.
On giving multiple shots at one time: The question is, what's the basis for concern about the multiple shots? Is there anything real, other than a gut unease about "all those shots?" cumulatively, kids get exposed to fewer antigen particles in vaccines than they did in the 1970s, because the DPT vaccine has a more purified pertussis component than the old one did, and they no longer get smallpox vaccine. Kids are exposed to multiple germs every day. Vaccines are just visible, that's all. I understand the fears -- kids hate shots, parents hate to see their kids suffer, it's a hassle and bother, and whenever the specter of harm arises in a substance that doesn't seem necessary at the time, we naturally shy away from it. But on the basis of rationally trying to protect our kids, none of the vaccine critics' points really stick.
On the flu vaccine: The thing about flu vaccination is this: old people have been trained to get their flu shots, and that's fine. But the fact is, even though cumulatively flu vaccine helps protect the elderly from flu, on an individual basis an old person's immune system has often deteriorated in a way that doesn't allow them to provide a good immune response to the shot. So they don't get that much beneift from it. The best way to protect old people from flu, it turns out, is to vaccinate their grandchildren and children. Ironically, although flu is not often deadly in the young--so their direct benefit from it may not seem that high -- in protecting the young we also protect the old. This is the concept of herd immunity. It's real.On vaccine safety in general: It's also important, in my view, to understand that many anti-vaccinators have a vested interest in alternative medicine that sways their understanding of these issues. There have been vaccine disasters in the past. But vaccines are safer now than they ever have been – I say this as someone who did a careful study of them for a book that took me 7 years to complete -- and the diseases they prevent are real.
If you're in a polling mood, go to the bottom of the October 11 "Flu shot" post and let us know whether you'll be opting for a shot this year, or whether you're still deciding. Or just leave your comments here.
Tuesday, October 16, 2007
Autism on video
Here’s a new Autism Web site worth looking at if you have young children: Austims Speaks features dozens of video clips of typical children and autistic children at a range of ages. The idea is to help parents identify signs of autism spectrum disorder very early because early diagnosis and treatment can help young children with autism live more normal lives. One pediatrician points out in this article that it’s important not to try to diagnose your child yourself or to get overly concerned if your child seems to be doing a behavior similar to one of the autistic red flags --- there’s a whole range of normal behavior for kids. But this site might help some parents get a jumpstart on the disorder. You can also look through the Science section of the Web site, which contains links to some of the latest research on autism -- and which, incidentally, doesn’t say much about thimerosal-autism connections. More about that coming Thursday in a follow-up column on vaccine safety.
Even if you don’t have concerns regarding autism, it’s an interesting site for getting quick glances of babies and toddlers as they progress through different stages of development.
Even if you don’t have concerns regarding autism, it’s an interesting site for getting quick glances of babies and toddlers as they progress through different stages of development.
Thursday, October 11, 2007
Flu shots -- what to do??
So it’s fall and flu shot time is upon us – that is, if we opt to recognize flu shot time at all. Last year we subjected Will to the flu shot clinic at our pediatrician’s office after wondering whether or not to do it. I’m a sucker for CDC recommendations and they recommend it for children ages 6 months to 5 years old because they are “at high risk for complications from the flu” (along with everyone over 6 months who shares a house with them). Today a friend called to see if I’d be giving Will a shot this year because she’s trying to decide whether to do the same with her daughter.
Another friend, who’s been madly researching vaccines and has put her son on a schedule where he gets the ones she’s decided are crucial one at a time so she can monitor his reactions, recommended this Stephanie Cave book to me: “What Your Doctor May Not Tell You About Children’s Vaccinations.” I checked it out from the library yesterday, and I get a headache just looking at it and thinking about trying to weigh the risks and benefits of each vaccine for Will and Owen. Each time, whether I opt for the shot or not, it feels like I’ll be gambling with their health. Which is why up to now, I’ve been throwing my hands in the air, and following the advice of our doctor’s office (I checked in with them today and was told the vaccine is definitely optional but they recommend it).
Of course, the more I read the more confused I become about what to do. Cave says in her book (which I should point out has a 2001 publication date so some information may be dated): “The CDC recommendation that healthy children should get a flu vaccine raises questions for many people. Mass immunizations of healthy children removes natural antibodies to the flu, which are provided when the flu is acquired naturally. Medical science is not yet certain whether it is better for healthy children, who rarely experience complications from flu, to get the flu and develop natural, permanent immunity to that specific flu strain, or for them to get vaccinated every year and suppress flu…”
She also says this about the mercury-containing preservative thimerosol that is used in some flu shots: “Until the thimerosal is removed from the flu vaccine, I have concerns about its safety. I believe the ethylmercury in the vaccine can cause neurological or immune system problems for anyone who gets the shot, especially the elderly and I think it is unsafe to give to pregnant women during any stage of pregnancy.”
So I found a chart at the Institute for Vaccine Safety Web site, which shows which types of flu vaccine still contain thimerosal. I called our pediatrician’s office and discovered we’d be getting the version of sanofi pasteur that is not preservative free (so it does contain thimerosal).
It does bother me that, according to this CDC Web page the flu shot is the only vaccine with thimerosal given to young children: “Today, with the exception of some Influenza (flu) vaccines, none of the vaccines used in the U.S. to protect preschool children against 12 infectious diseases contain thimerosal as a preservative,” it says.
But is thimerosal really cause for paranoia? Here’s a link to a study in the New England Journal of Medicine, which concluded “Our study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years.” The Institute for Vaccine Safety has links to more articles, many of which seem to find no link between vaccines and thimerosal and autism or other pervasive developmental disorders.
But then this article at the Autism Research Institute Web site challenges the CDC claim that “the available scientific evidence has not shown thimerosal-containing vaccines to be harmful” and cites a bunch of books and articles suggesting the opposite.
Go here for the full list of who should get the vaccine according to the CDC. (They recommend it for pregnant women and people over 50 too.)
So what’s a mom to do? I haven’t decided. I’ll be contacting my pediatrician to see if he has any thoughts. And in the meantime, I’m going to experiment with a little poll and find out who among you is planning to do the flu shot. Not that it’ll necessarily sway my decision, but I am interested in how many parents are going the flu shot route. If you've got any thoughts on the matter, leave a comment too.
I’m glad the vaccine’s not recommended for babies under six months – so at least there’s no decision-making required for Owen (who, by the way is exactly 3 months old today – time’s flying!).
Another friend, who’s been madly researching vaccines and has put her son on a schedule where he gets the ones she’s decided are crucial one at a time so she can monitor his reactions, recommended this Stephanie Cave book to me: “What Your Doctor May Not Tell You About Children’s Vaccinations.” I checked it out from the library yesterday, and I get a headache just looking at it and thinking about trying to weigh the risks and benefits of each vaccine for Will and Owen. Each time, whether I opt for the shot or not, it feels like I’ll be gambling with their health. Which is why up to now, I’ve been throwing my hands in the air, and following the advice of our doctor’s office (I checked in with them today and was told the vaccine is definitely optional but they recommend it).
Of course, the more I read the more confused I become about what to do. Cave says in her book (which I should point out has a 2001 publication date so some information may be dated): “The CDC recommendation that healthy children should get a flu vaccine raises questions for many people. Mass immunizations of healthy children removes natural antibodies to the flu, which are provided when the flu is acquired naturally. Medical science is not yet certain whether it is better for healthy children, who rarely experience complications from flu, to get the flu and develop natural, permanent immunity to that specific flu strain, or for them to get vaccinated every year and suppress flu…”
She also says this about the mercury-containing preservative thimerosol that is used in some flu shots: “Until the thimerosal is removed from the flu vaccine, I have concerns about its safety. I believe the ethylmercury in the vaccine can cause neurological or immune system problems for anyone who gets the shot, especially the elderly and I think it is unsafe to give to pregnant women during any stage of pregnancy.”
So I found a chart at the Institute for Vaccine Safety Web site, which shows which types of flu vaccine still contain thimerosal. I called our pediatrician’s office and discovered we’d be getting the version of sanofi pasteur that is not preservative free (so it does contain thimerosal).
It does bother me that, according to this CDC Web page the flu shot is the only vaccine with thimerosal given to young children: “Today, with the exception of some Influenza (flu) vaccines, none of the vaccines used in the U.S. to protect preschool children against 12 infectious diseases contain thimerosal as a preservative,” it says.
But is thimerosal really cause for paranoia? Here’s a link to a study in the New England Journal of Medicine, which concluded “Our study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years.” The Institute for Vaccine Safety has links to more articles, many of which seem to find no link between vaccines and thimerosal and autism or other pervasive developmental disorders.
But then this article at the Autism Research Institute Web site challenges the CDC claim that “the available scientific evidence has not shown thimerosal-containing vaccines to be harmful” and cites a bunch of books and articles suggesting the opposite.
Go here for the full list of who should get the vaccine according to the CDC. (They recommend it for pregnant women and people over 50 too.)
So what’s a mom to do? I haven’t decided. I’ll be contacting my pediatrician to see if he has any thoughts. And in the meantime, I’m going to experiment with a little poll and find out who among you is planning to do the flu shot. Not that it’ll necessarily sway my decision, but I am interested in how many parents are going the flu shot route. If you've got any thoughts on the matter, leave a comment too.
I’m glad the vaccine’s not recommended for babies under six months – so at least there’s no decision-making required for Owen (who, by the way is exactly 3 months old today – time’s flying!).
Tuesday, September 11, 2007
Vaccines and intellectual failures
Today we had dual well visits: 2 months for Owen, 3 years for Will. I could dwell on how it felt to hold down little Owen’s arms as he got two shots in one leg, two shots in the other while I looked into his big, horrified eyes that said so obviously, “How could you do this to me???” and as I wondered, as I always do, about the wisdom of vaccines even as I follow the flock in having them all administered to my kids because I’m scared not to.
But I won’t.
Instead we’ll focus on Will’s intellectual shortcomings. We had to fill out a questionnaire to measure his fine motor, verbal and general intellectual skills as a 3-year-old. He had to draw horizontal and vertical lines and circles, pull zippers up and down on command, jump forward 6 inches and repeat a short series of numbers back to me, among other tasks. He would have passed the thing with flying colors if it hadn’t been for a scribbled half-stick man that Will was supposed to be able to identify as somehow human even though it was missing some key body parts.
My scripted question was: “What is that?” Correct answers included “snowman,” “mommy,” “daddy” and the like. But Will said, with full confidence: “a duck.”
WRONG ANSWER… And especially troubling when we consider that just this morning Will announced that he still had baby ducks in his tummy, even though a few weeks ago he said they’d come out. Perhaps it’s just Will’s postpartum confusion, but I may hang on to this duck misidentification thing as ammunition for that fateful day two years from now when Rob and I are arguing about whether we should (a) send Will, with his borderline August 31 birthday, along with his mostly older peers to face kindergarten and the following 12 years of his life as the physical and emotional runt of his class or (b) hold Will back and doom him to an extra year of life with his boring parents as well as a potentially larger-than-normal dose of intellectual boredom at school. “Remember,” I will say to Rob, who is already pretty convinced that we should send young, short Will full-steam ahead, “always remember the duck.”
But I won’t.
Instead we’ll focus on Will’s intellectual shortcomings. We had to fill out a questionnaire to measure his fine motor, verbal and general intellectual skills as a 3-year-old. He had to draw horizontal and vertical lines and circles, pull zippers up and down on command, jump forward 6 inches and repeat a short series of numbers back to me, among other tasks. He would have passed the thing with flying colors if it hadn’t been for a scribbled half-stick man that Will was supposed to be able to identify as somehow human even though it was missing some key body parts.
My scripted question was: “What is that?” Correct answers included “snowman,” “mommy,” “daddy” and the like. But Will said, with full confidence: “a duck.”
WRONG ANSWER… And especially troubling when we consider that just this morning Will announced that he still had baby ducks in his tummy, even though a few weeks ago he said they’d come out. Perhaps it’s just Will’s postpartum confusion, but I may hang on to this duck misidentification thing as ammunition for that fateful day two years from now when Rob and I are arguing about whether we should (a) send Will, with his borderline August 31 birthday, along with his mostly older peers to face kindergarten and the following 12 years of his life as the physical and emotional runt of his class or (b) hold Will back and doom him to an extra year of life with his boring parents as well as a potentially larger-than-normal dose of intellectual boredom at school. “Remember,” I will say to Rob, who is already pretty convinced that we should send young, short Will full-steam ahead, “always remember the duck.”
Tuesday, August 14, 2007
Pacifier waffling: The suckifier makes its debut
In the midst of a long day juggling Will and Owen – which included stubborn Will acting out when it was time to leave a friend’s house, a few bouts of Owen and Will crying in unison, no overlapping naptime, and general Owen fussiness – I decided yesterday to finally break open the pacifier package that Rob bought before Owen was born. We’d decided we might try the tool after struggling so much with Will and after reading a few books that made me feel like very judicious use of the devices in just the first few months of life could be okay. I’d been putting it off until now, because I’ve generally been able to figure out what’s bothering Owen and find a way to calm him down. 
Yesterday, though, we were getting into a pattern of nursing too frequently (and spitting up and having gas because of it) and I knew it was because Owen just wanted some good sucking time. He frequently tries to gnaw on his knuckles but doesn’t have the control yet to find his thumb.
“He just needs to suck,” I told Will, who was following me and crying Owen around. “I think I’m going to try the pacifier.”
Will was immediately excited by the idea. He asked impatiently about when Owen could have his “suckifier” as I set some water boiling to disinfect two straight-from-the-package pacifiers.
I wasn’t sure what Owen would think. I’d waited until much later to try a pacifier with Will, at some moment when I was desperate, and he never took to the thing. This time, following a suggestion from Harvey Karp’s “Happiest Baby on the Block” (in which you employ a little reverse psychology: put the pacifier in the mouth, then gently tug it away, which makes the baby want it all the more) Owen took less than 30 seconds to get quite happy with his suckifier.
I almost hate looking at him with it – he looks so unnatural with a big plastic plug obstructing his mouth. And I was feeling a tad guilty again: Now I’m pacifying son #1 with 15 minutes of TV a day and son #2 with the suckifier. Except with this pacifier there was such peace. I let Owen suck himself to near sleepiness for five minutes, then gently removed it from his mouth and carried him to his bassinet, where I patted him some and he had a nice nap.
I’m swearing to myself, and making Rob join me in the vow, that we’re not going use the suckifier until nothing else works. I don’t want to plug up Owen’s only form of communication and I am beginning to know his cries and his needs. I’m also going to plan to pull the plug on the ol’ suckifier entirely, assuming we do stick with some occasional use of it, by the time Owen hits three or four months. I’d rather not be dealing with the thing all the way into toddlerhood and I’d rather Owen learned to get himself to sleep without it early on.
Today I found that my own well-washed fingers work about as well as the pacifier, so when it’s practical I think I’ll use them first. But I’m tempted by the idea of having a pacifier for some situations – if Owen starts screaming in the stroller on the way home from the park, for example. Still, maybe it’s not worth flirting with a device that could become addictive for both Owen and us. I think there are probably plenty of babies out there who need a pacifier more desperately than Owen, and it may be better to avoid the thing entirely in our case. Or maybe I need to lighten up and let the boy suck??
Some downsides I’ve found on long-term pacifier use: From this Dr. Sears Web site: One study reported in Pediatrics showed that babies who used pacifiers in their first six weeks tended to wean earlier (this one scares me – I’d like to nurse Owen for at least a year, but I also imagine that most pacifier babies get much more time with their “paci” than Owen will). A few studies have reported that babies using pacifiers get more ear infections, probably because sucking hard on a pacifier disturbs the pressure in the ears. This Mayo Clinic site says: “Babies who rely on a pacifier as a way to self-soothe have a higher risk of developing ear infections. Pacifier use is directly related to ear infection problems in babies, especially those between 6 and 12 months of age. However, there's no evidence that thumb sucking increases the risk of ear infection.” ) Karp says not worry about ear infections for babies under four months because young infants can’t suck hard enough to cause much pressure to build up. Really longterm pacifier use can become a dental problem too – if your 4-year-old’s still walking around with binky in mouth, he may develop an overbite.
Of course, for nursing moms it’s also important to avoid pacifiers until babies are well established in breastfeeding – preferably at least four or five weeks old – to avoid “nipple confusion.”
If you’re considering pacifier use, go to this University of Michigan Health System site for tips on when and when not to use it. They advise against using pacifiers to help your child fall asleep, for example. You’re likely to end up losing sleep in the long run as you go pacifier hunting throughout the night.
So we’ve been sucked just a little ways into suckifier land, but we’re not in deep yet. Owen has yet to put mouth to pacifier today. And I, always the wishy-washy mother, am still straddling the fence – to suckify a little only as "needed” or not to suckify at all?
Anyone with thoughts on the matter? You might just bring me some clarity.
Saturday, August 11, 2007
Police those toys
As a follow-up to my plastic toy rant on August 3, I wrote a column for today’s edition of the Ledger-Enquirer that includes more specific information about lead safety concerns in children’s toys. Go here to read the full column.
In it, Patty Davis, a spokesperson for the U.S. Consumer Products Safety Commission, recommends going here and signing up for recall announcements. Since the commission announces about 400 recalls a year, spare yourself an e-mail overload by choosing the categories that concern you (child and infant products is one option).
For information about lead paint in homes and getting your children’s blood lead levels tested go to this EPA site or this CPSC site.
Also, in a comment after that August 3 post about the Mattel toy recall, Kevin, who’s a much more conscientious consumer than me, recommends this Web site for finding made-in-the-USA products. If you’re shopping for kids, they sell mostly Holgate and Maple Landmark wooden toys.
An afterthought: After that August 3 plastic toy tirade, my mom started defending plastic to me. “Everything in moderation,” she says. And she’s probably right. In fact, as much as I favor Will’s little wooden farm
m
an, woman and cow, he tends to spend a lot more time with his other little plastic people and animals. They’re colorful and easy to maneuver and they inspire lots of creative play in him. So most of his toys are plastic, and most of them will be staying, although I still do intend to clean out some of the lesser-loved junk at some point. I'm also feeling inspired to buy a couple wooden toys for Will's birthday, and I’ll be on a more vigilant lookout for recalls from now on.
In it, Patty Davis, a spokesperson for the U.S. Consumer Products Safety Commission, recommends going here and signing up for recall announcements. Since the commission announces about 400 recalls a year, spare yourself an e-mail overload by choosing the categories that concern you (child and infant products is one option).
For information about lead paint in homes and getting your children’s blood lead levels tested go to this EPA site or this CPSC site.
Also, in a comment after that August 3 post about the Mattel toy recall, Kevin, who’s a much more conscientious consumer than me, recommends this Web site for finding made-in-the-USA products. If you’re shopping for kids, they sell mostly Holgate and Maple Landmark wooden toys.
An afterthought: After that August 3 plastic toy tirade, my mom started defending plastic to me. “Everything in moderation,” she says. And she’s probably right. In fact, as much as I favor Will’s little wooden farm
m
an, woman and cow, he tends to spend a lot more time with his other little plastic people and animals. They’re colorful and easy to maneuver and they inspire lots of creative play in him. So most of his toys are plastic, and most of them will be staying, although I still do intend to clean out some of the lesser-loved junk at some point. I'm also feeling inspired to buy a couple wooden toys for Will's birthday, and I’ll be on a more vigilant lookout for recalls from now on.
Friday, August 3, 2007
Recalling all toys
By now you’ve probably heard about Mattel’s recall of nearly 1 million Chinese-made toys – including plastic Big Bird, Elmo, Dora and Diego characters -- because their paint contains excessive amounts of lead. (Go to http://www.ledger-enquirer.com/262/story/99249.html for the full story and to http://www.service.mattel.com/us/ for a list of recalled toys.)
We don’t own any of the affected toys, but the news has almost inspired me to do my own mammoth recall of all the cheap plastic toys in our home. I don’t know how we’ve managed to accumulate so much junk: plastic party favors, plastic miniature animals and people, plastic cars and plastic trucks, plastic scooters, plastic Legos and plastic balls. My favorite toys are wooden, but they are sadly outnumbered by the ugly stuff in our house.
Here’s photo evidence from today: Will and a friend play with a large plastic scooter and
plastic push toy as they hover over a jungle of little plastic toys they emptied out of a bin and played with earlier. Our house is small and our living room doubles as play room. Until clean-up time arrives each night, we tend to live in this kind of chaos.
Last year, as I read “You are Your Child’s First Teacher,” by Rahima Baldwin Dancy, a book that lays out the philosophy of Rudolf Steiner, who founded the first Waldorf school, I found the idea of giving children only crude wooden toys – dolls whose faces left much to the imagination, rather than highly detailed anatomically correct Barbies for example – enticing. But Will’s play world was already littered with so much plastic that I never did anything about it. (We do have a loosely enforced ban in our house on all things battery-operated, flashing and otherwise extraordinarily obnoxious.)
Today though, as Will took the plastic orange head off one of his plastic golf clubs (from a set which cost something like $5 at Wal-Mart, I’m ashamed to admit), stuck it in his mouth and pretended it was a harmonica, I got a little nervous. I thought, that’s got to be a made-in-China toy, produced by some unknown manufacturer that may be a lot less likely to issue a well publicized toy recall than toy giant Mattel. Will handed the spit-covered orange “harmonica” to me so I could have a turn making music, and sure enough there were the three words: “Made in China.” With 80 percent of all toys made in China, that was no surprise.
Time to go outside and start carving wooden dolls and boats out of fallen tree limbs.
Still, while I like to dream romantically about a plastic-free house, if you come visit me anytime soon you’ll probably notice that I haven’t found the will power to toss 75 percent of Will’s toys (there’s probably that much plastic in our toy chest) to the curb. Just imagine the tears. Slowly and sneakily though, I may start withdrawing at least a few of them here and there.
We don’t own any of the affected toys, but the news has almost inspired me to do my own mammoth recall of all the cheap plastic toys in our home. I don’t know how we’ve managed to accumulate so much junk: plastic party favors, plastic miniature animals and people, plastic cars and plastic trucks, plastic scooters, plastic Legos and plastic balls. My favorite toys are wooden, but they are sadly outnumbered by the ugly stuff in our house.
Here’s photo evidence from today: Will and a friend play with a large plastic scooter and
plastic push toy as they hover over a jungle of little plastic toys they emptied out of a bin and played with earlier. Our house is small and our living room doubles as play room. Until clean-up time arrives each night, we tend to live in this kind of chaos.Last year, as I read “You are Your Child’s First Teacher,” by Rahima Baldwin Dancy, a book that lays out the philosophy of Rudolf Steiner, who founded the first Waldorf school, I found the idea of giving children only crude wooden toys – dolls whose faces left much to the imagination, rather than highly detailed anatomically correct Barbies for example – enticing. But Will’s play world was already littered with so much plastic that I never did anything about it. (We do have a loosely enforced ban in our house on all things battery-operated, flashing and otherwise extraordinarily obnoxious.)
Today though, as Will took the plastic orange head off one of his plastic golf clubs (from a set which cost something like $5 at Wal-Mart, I’m ashamed to admit), stuck it in his mouth and pretended it was a harmonica, I got a little nervous. I thought, that’s got to be a made-in-China toy, produced by some unknown manufacturer that may be a lot less likely to issue a well publicized toy recall than toy giant Mattel. Will handed the spit-covered orange “harmonica” to me so I could have a turn making music, and sure enough there were the three words: “Made in China.” With 80 percent of all toys made in China, that was no surprise.
Time to go outside and start carving wooden dolls and boats out of fallen tree limbs.
Still, while I like to dream romantically about a plastic-free house, if you come visit me anytime soon you’ll probably notice that I haven’t found the will power to toss 75 percent of Will’s toys (there’s probably that much plastic in our toy chest) to the curb. Just imagine the tears. Slowly and sneakily though, I may start withdrawing at least a few of them here and there.
Wednesday, August 1, 2007
Co-sleeping safety: Take two
As a follow up to any paranoia I may have stirred up (mostly in myself probably) in regards to co-sleeping after Sunday’s post about the infant suffocation deaths in Detroit:
Jennifer Fletcher, a registered nurse and International Board Certified Lactation Consultant for One Baby Place at Doctors Hospital wrote this in an e-mail:
I am glad you are tackling this topic. Of course, we know there is unsafe co-sleeping, and there is 100% SAFE co-sleeping. You may already be familiar with the work of Dr. James McKenna, but if not, please, please get to know this fellow. He runs an infant sleep lab at Notre Dame University, and he is, in my opinion, the absolute final authority on safe co-sleeping. The fact that the tragic deaths you heard about on NPR occurred in the Detroit area raised a red flag for me. Perhaps entirely erroneously, I think of Detroit as a kind of gritty urban area---lots of poverty, lots of unsafe or sub-standard housing, lots of large families where toddlers and pre-schoolers perhaps share beds with infants. Again, this may be an entirely unfair stereotype, but I would want to know a great deal more about the circumstances of these deaths before I would be willing to alter my opinions about the benefits of co-sleeping.
Also Lindsay C., mother of 11-month-old Cannon, offers up her experiences co-sleeping plus some good websites with info on how to co-sleep safely including this one: http://www.cosleeping.org/. See her comment on the July 30 post.
For an in-depth review of research related to co-sleeping, SIDS and other fatal sleep-related accidents (with McKenna as co-author), go to http://www.naturalchild.org/james_mckenna/cosleeping.pdf. The review is boldly entitled: “Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding.” Here by “alone,” McKenna means in another room. He suggests that bottle-fed infants should not sleep in the same bed as their mothers (see his quote in this July 25 article that ran in the Ledger-Enquirer: http://www.ledger-enquirer.com/312/story/93048.html), that nursing infants are safe sleeping with mothers who take certain precautions, and that all babies are safer at least sleeping in the same room as their parents.
Among the findings cited and arguments made:
“After all, mother-infant co-sleeping represents the most biologically appropriate sleeping arrangement for humans and is both ancient and ubiquitous simply because breastfeeding is not possible, nor as easily managed, without it. The increased sensory contact and proximity between the mother and infant induces potentially beneficial behavioural and physiological changes in the infant.”
“Three major epidemiological studies have shown that when a committed caregiver, usually the mother, sleeps in the same room but not in the same bed with their infant the chance of the infant dying from sudden infant death syndrome (SIDS) is reduced by 50%.”
“… the overwhelming number of suspected accidental overlays or fatal accidents occur not within breast feeding-bedsharing communities but in urban poverty, where multiple independent SIDS risk ‘factors’ converge and bottle feeding rather than breast feeding predominates.”
And while we’re on the subject of SIDS, there’s been interesting news on that front in the past week too. Researchers in Seattle say that hearing tests given to 62 infants in Delaware show a unique pattern of partial hearing loss among those babies who later died of SIDS. If hearing loss can be established as a definite indicator of SIDS it could mean a major breakthrough in preventing the syndrome among infants at risk. Go to http://www.latimes.com/news/science/la-sci-sids28jul28,1,2214491.story?track=rss for the full story, which ran July 28 in the Los Angeles Times.
Jennifer Fletcher, a registered nurse and International Board Certified Lactation Consultant for One Baby Place at Doctors Hospital wrote this in an e-mail:
I am glad you are tackling this topic. Of course, we know there is unsafe co-sleeping, and there is 100% SAFE co-sleeping. You may already be familiar with the work of Dr. James McKenna, but if not, please, please get to know this fellow. He runs an infant sleep lab at Notre Dame University, and he is, in my opinion, the absolute final authority on safe co-sleeping. The fact that the tragic deaths you heard about on NPR occurred in the Detroit area raised a red flag for me. Perhaps entirely erroneously, I think of Detroit as a kind of gritty urban area---lots of poverty, lots of unsafe or sub-standard housing, lots of large families where toddlers and pre-schoolers perhaps share beds with infants. Again, this may be an entirely unfair stereotype, but I would want to know a great deal more about the circumstances of these deaths before I would be willing to alter my opinions about the benefits of co-sleeping.
Also Lindsay C., mother of 11-month-old Cannon, offers up her experiences co-sleeping plus some good websites with info on how to co-sleep safely including this one: http://www.cosleeping.org/. See her comment on the July 30 post.
For an in-depth review of research related to co-sleeping, SIDS and other fatal sleep-related accidents (with McKenna as co-author), go to http://www.naturalchild.org/james_mckenna/cosleeping.pdf. The review is boldly entitled: “Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding.” Here by “alone,” McKenna means in another room. He suggests that bottle-fed infants should not sleep in the same bed as their mothers (see his quote in this July 25 article that ran in the Ledger-Enquirer: http://www.ledger-enquirer.com/312/story/93048.html), that nursing infants are safe sleeping with mothers who take certain precautions, and that all babies are safer at least sleeping in the same room as their parents.
Among the findings cited and arguments made:
“After all, mother-infant co-sleeping represents the most biologically appropriate sleeping arrangement for humans and is both ancient and ubiquitous simply because breastfeeding is not possible, nor as easily managed, without it. The increased sensory contact and proximity between the mother and infant induces potentially beneficial behavioural and physiological changes in the infant.”
“Three major epidemiological studies have shown that when a committed caregiver, usually the mother, sleeps in the same room but not in the same bed with their infant the chance of the infant dying from sudden infant death syndrome (SIDS) is reduced by 50%.”
“… the overwhelming number of suspected accidental overlays or fatal accidents occur not within breast feeding-bedsharing communities but in urban poverty, where multiple independent SIDS risk ‘factors’ converge and bottle feeding rather than breast feeding predominates.”
And while we’re on the subject of SIDS, there’s been interesting news on that front in the past week too. Researchers in Seattle say that hearing tests given to 62 infants in Delaware show a unique pattern of partial hearing loss among those babies who later died of SIDS. If hearing loss can be established as a definite indicator of SIDS it could mean a major breakthrough in preventing the syndrome among infants at risk. Go to http://www.latimes.com/news/science/la-sci-sids28jul28,1,2214491.story?track=rss for the full story, which ran July 28 in the Los Angeles Times.
Monday, July 30, 2007
Co-sleeping: A nice bit of nighttime family harmony or a big safety hazard?
A few readings of various Dr. Sears’ books back when I had Will convinced me that if we did it responsibly, a family bed could be a healthy and safe way for us to survive the nights with our fussy baby and bond with him as well. After realizing, though, that helping Will learn to sleep through the night in his own room was incredibly difficult to do after a year in our bed and that sleeping together was no longer peaceful for all of 
us, we’d decided to limit Owen’s time in our bed to just a few months, at which time I’ve read that it’s still quite easy to shift to the crib, especially if I put him down for naps during the day in his bassinet during these first months.
We borrowed an Arm’s Reach Co-sleeper from a friend and we have a little baby nest bed (The First Years Close & Secure Sleeper) that sits on our bed, but somehow in the middle of the night it becomes difficult for Owen to go back to sleep once I move him back to the co-sleeper or the nest bed. So he had been right next to me in our bed, with the secure sleeper dividing him from Rob, who is a heavier sleeper and who is the one we’ve worried about in terms of the dangers of baby suffocation. Side by side, Owen and I seemed to sleep in more harmony (just as Will and I did in that first year) and I’m a light enough sleeper that I’ve always felt in tune with his presence and his needs. (Go to http://www.askdrsears.com/html/7/t071000.asp to read Dr. Sears’ arguments about how mothers act as breathing pacemakers for their babies, how mothers and baby’s develop “sleep harmony” side by side and how co-sleeping may reduce the risk of SIDS).
But a visit to our pediatrician, Dr. Mansfield, for Owen’s two-week well visit on Friday got me rethinking things again. He told me about a story he heard on NPR discussing the suffocation deaths of five infants (ages 27 days to 3 months) over the past week in Detroit due to various co-sleeping scenarios which weren’t laid out in detail (one incident occurred when the infant was co-sleeping with a sibling). You can hear the story, which aired July 26 and was entitled “Infant Smothering Deaths Spike in Detroit,” at http://www.npr.org/templates/story/story.php?storyId=12262817. Now for the past couple nights I’ve been forcing myself to put Owen back into the arms-reach co-sleeper after nursing, even though it may mean a slightly less peaceful night for all of us.
I know all the arguments by co-sleeping advocates that if you’re not overweight, not consuming alcohol, not smoking and especially if you’re the mother of the infant (and biologically tuned in to his every peep), then co-sleeping is safe and provides emotional benefits to baby and parents. But just the remote possibility of losing little Owen to some sort of bed-related accident frightens the heck out of me. So Friday and Saturday night I made myself put Owen back in the co-sleeper even though he couldn't settle into it easily and we lost some sleep as a result. But last night a few gentle pats was enough to reassure him and we slept more soundly and a bit longer than we have since his first sleepy week of his life. He may have just been exhausted, but hopefully I've arrived at a good compromise: with Owen safe but still nearly next to me and maybe less likely to develop a years-long co-sleeping addiction.
If you have any thoughts on co-sleeping and why you did or didn’t go down that road with your own children – or how you did it safely, please share.
us, we’d decided to limit Owen’s time in our bed to just a few months, at which time I’ve read that it’s still quite easy to shift to the crib, especially if I put him down for naps during the day in his bassinet during these first months.We borrowed an Arm’s Reach Co-sleeper from a friend and we have a little baby nest bed (The First Years Close & Secure Sleeper) that sits on our bed, but somehow in the middle of the night it becomes difficult for Owen to go back to sleep once I move him back to the co-sleeper or the nest bed. So he had been right next to me in our bed, with the secure sleeper dividing him from Rob, who is a heavier sleeper and who is the one we’ve worried about in terms of the dangers of baby suffocation. Side by side, Owen and I seemed to sleep in more harmony (just as Will and I did in that first year) and I’m a light enough sleeper that I’ve always felt in tune with his presence and his needs. (Go to http://www.askdrsears.com/html/7/t071000.asp to read Dr. Sears’ arguments about how mothers act as breathing pacemakers for their babies, how mothers and baby’s develop “sleep harmony” side by side and how co-sleeping may reduce the risk of SIDS).
But a visit to our pediatrician, Dr. Mansfield, for Owen’s two-week well visit on Friday got me rethinking things again. He told me about a story he heard on NPR discussing the suffocation deaths of five infants (ages 27 days to 3 months) over the past week in Detroit due to various co-sleeping scenarios which weren’t laid out in detail (one incident occurred when the infant was co-sleeping with a sibling). You can hear the story, which aired July 26 and was entitled “Infant Smothering Deaths Spike in Detroit,” at http://www.npr.org/templates/story/story.php?storyId=12262817. Now for the past couple nights I’ve been forcing myself to put Owen back into the arms-reach co-sleeper after nursing, even though it may mean a slightly less peaceful night for all of us.
I know all the arguments by co-sleeping advocates that if you’re not overweight, not consuming alcohol, not smoking and especially if you’re the mother of the infant (and biologically tuned in to his every peep), then co-sleeping is safe and provides emotional benefits to baby and parents. But just the remote possibility of losing little Owen to some sort of bed-related accident frightens the heck out of me. So Friday and Saturday night I made myself put Owen back in the co-sleeper even though he couldn't settle into it easily and we lost some sleep as a result. But last night a few gentle pats was enough to reassure him and we slept more soundly and a bit longer than we have since his first sleepy week of his life. He may have just been exhausted, but hopefully I've arrived at a good compromise: with Owen safe but still nearly next to me and maybe less likely to develop a years-long co-sleeping addiction.
If you have any thoughts on co-sleeping and why you did or didn’t go down that road with your own children – or how you did it safely, please share.
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