Archive for November, 2011

Nursing through pregnancy, and super gentle weaning

My son is three years and three months old. He’s still nursing, nominally, even though my milk is, as far as I can tell, entirely gone. If there’s colostrum there already, he doesn’t seem to notice it. Basically, he’ll ask to nurse every 1-3 days these days–this has actually been the pattern for the past 4-5 weeks, so he’s been pretty stable now for awhile–and latch on, but with a confused look on his face. He sort of stays still on the breast for a few seconds, then comes off and tries again to get back on, and then almost seems as though he can’t quite remember what to do. He gives a few sucks, and maybe stays there latched on for another 5-10 seconds because he unlatches and seems satisfied and finished. It’s a super gentle step toward weaning, I guess–I’ve even stopped wearing nursing shirts every single day because he is almost certain not to ask to nurse unless I’m putting him to bed or comforting him on my lap at home after a head bump or tantrum, etc. It’s funny–I don’t know if he’ll keep this up for another four weeks (i.e., until my new baby arrives and milk comes back) or if he’ll wean entirely before then, or what. It’s like one of those universe clocks, sort of–such a slow, slow process, with almost imperceptible steps. Whatever happens, I’m really glad he’s in control of it.


29 November 2011 at 2:33 pm Leave a comment

High-protein snacks for pregnancy and beyond

I guess I’m nesting (at 38 weeks along).

I’ve stashed ziploc baggies of raw almonds around the house, near my bed and favorite nursing chair, and I I just made 6 dozen high-protein pancakes and stuck them in the freezer for the next couple weeks, and beyond. These pancakes are packed with cooked quinoa, instead of flour, and have about twice as many eggs as a typical panckae recipe. I just ate some for lunch, topped with Greek-style (thick) plain yogurt. My toddler thought yogurt on pancakes was a crazy idea, so he just ate the plain pancakes.

I made sure we have a supply of peanut butter, and, even easier to eat during labor or afterward, what my toddler calls “a pean’ butter squeeze in my mouth snack”–also known as Barney’s Almond Butter in individual packets.

Next I’m going to go hard boil a dozen eggs to snack on.

What’s your favorite high-protein snack for pregnancy, labor, or after baby arrives?


22 November 2011 at 1:09 pm Leave a comment

Book review: Cynthia Gabriel’s _Natural Hospital Birth_

Cynthia Gabriel, Natural Hospital Birth: The Best of Both Worlds (Harvard Common Press, 2011).

“Everything goes in cycles in medicine and in health care, just as in life. Cynthia Gabriel’s new book comes at a fortuitous ‘sweet spot’ when obstetric birth practices in the United States are again changing [and]. . . liberalizing” (vi). So writes Timothy Johnson, an Ob-Gyn, in the forward to this volume by medical anthropologist and birth doula Gabriel. Johnson may be a bit overly optimistic, in my personal view, but the perspective is a useful one. Gabriel cites her doula experience as key in helping her articulate her position in this book: “Doulas notice different things about birth than medical care providers do. When I read a book about natural birth authored by a physician, I realized that certain aspects of the hospital experience are invisible to her. . . she has never observed a woman fighting for a natural birth with an unsupportive caregiver,” etc., she notes (xiii).

Gabriel’s book hits a lot of the same cheerleading high-notes as Ricki Lake’s does (“So you want a natural birth. And, by choice or by circumstance, you will give birth in a hospital. You can do it!”) (3). Throughout, though, she emphasizes the enormous responsibility—for education and for advocacy—the women must take for themselves in such a position.

The bulk of the book is fairly blandly written in terms of style, and covers such topics as hiring a doula, deciding on a care provider, choosing who to accompany you to the birth, selecting better birthing positions, and avoiding fear and tension before and during labor. There’s much that’s useful here, though not much that’s new. In fact, a lot of it feels to me in some ways like a less-crunchy version of Penny Simkin’s classic The Birth Partner. Sadly, I’m not sure this book—considerably denser in appearance than What to Expect When You’re Expecting—will reach the full extent of its target audience, but it is certainly a positive addition to the birthing literature out there.


15 November 2011 at 7:06 pm 1 comment

Babies in carseats

I think a lot of parents have heard of positional asphyxia and the risk to newborns/young infants, but many don’t really connect what they’ve heard to the everyday basics of carseats–especially those so-called baby buckets. I’m on an online messageboard where parents (mainly moms, but some dads) post about questions or concerns about their children, and recently when someone complained that the mattress in her co-sleeper was somewhat hard, someone else recommended just putting the infant carseat into the co-sleeper and letting baby sleep in it there. I wasn’t able to post a response that didn’t sound snarky, honestly, so I didn’t write anything, but it’s been bothering me ever since.

The short story is that it’s not a good idea to let your baby sleep in a carseat overnight: For more reading, this article reports on one effort to educate parents about the dangers of leaving infants in carseats for extended periods of time, and this site provides some clear, comprehensive information.


9 November 2011 at 8:44 pm Leave a comment

Inspirational novels for pregnancy?

When I was pregnant with my first child, I read a lot. I read the standard books on pregnancy and birth, and then their counter-cultural counterparts, and then all the things referenced in all of those, and then anything tangentially referenced in those, etc.

I also read and reread some novels, though, and I think the Sigrid Undset Kristin Lavransdatter trilogy, which I’d read for the first time ten years before but reread in my last few weeks of pregnancy, was really inspirational to me. The heroine is a strong woman, strong in marriage and strong in pregnancy, and the books detail her (natural, given the time period–they are set in the Middle Ages, written in the 1920s) births and her breastfeeding and her co-sleeping, as well as her close relationship with her sons. Before having my son, I had no intention of co-sleeping, no plans for extended breastfeeding, and no idea how I would relate to a boy. I wouldn’t say I got all my ideas from those novels, but I do think the books had a big effect on me–and, importantly, a different kind of effect than when I read them straight out of grad school as a twenty-three-year-old new bride.

What should I read, or reread, this time around? Undset again, or someone else?


2 November 2011 at 10:25 am Leave a comment

A Dr. speaks: Spotlight on c-sections here in Massachusetts

This article came out in The Boston Globe Magazine just this week. Written by an OB, it’s a pretty amazing story of the Massachusetts c-section rate. Because the Globe online is now subscription-only, you might or might not be able to follow this link (or try to find the article yourself via another search; if so, it’s “The C-Section Boom,” by Adam Wolfberg). Still, I’ll leave you with these few paragraphs from near the end of the article.

[M]y patient’s cervix finally became fully dilated. With the next contraction, she pulled her legs back and pushed as hard as she could. But now the baby’s heart rate, which had concerned us throughout the labor, dipped again with each push. Research suggests that even the most worrisome heart rate pattern rarely predicts injury. Still, I had to make a decision.

In my gut, I believed that my patient’s baby would make it safely to delivery. But I couldn’t predict how long it would take: an hour, two? Forceps or a vacuum wasn’t an option – the baby’s head was still too high up within the pelvis. I’ll admit that it crossed my mind that when my shift ended in two hours, my colleague would be annoyed to take over responsibility for a patient pushing that long and with a less-than-perfect heart rate pattern.

I sat down in a chair beside my patient’s bed. “I’m not worried about your baby right this minute,” I told her. “However, you have a lot of pushing yet to do, and I’m concerned that your baby will not tolerate it. My recommendation is that we do a caesarean now. I think it’s the safest thing.”

Under bright lights, 20 minutes later, we delivered a little girl, who emerged screaming and pink. My patient and her husband were delighted and thanked me for guiding them to a safe delivery. I didn’t spend time second-guessing my decision: Everyone was healthy; the new family was content.

I sure hope there’s a healthy amount of irony around these words. The bold–emphasis added–above is mine, of course.


1 November 2011 at 2:19 pm Leave a comment

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November 2011