Food for Thought
Mr. Jack Petch
Chairperson of the Board of Directors
St Michael's Hospital
30 Bond Street
Toronto, ON M2B 1W8
Dear Mr. Petch,
The Infant Feeding Action Coalition (INFACT) Canada wishes to bring to your attention
a matter concerning research and conflict of interest relating to a press release
issued on April 3, 2001 from St. Michael's Hospital. The press release entitled:
Researchers find peanut allergens can pass into breastmilk, reported in a study
conducted at St. Michael's by Dr. Peter Vadas published in the Journal of the
American Medical Association. [See E-News Issue 3:15]
Of major concern is the fact that the press release did not declare the competing
interests of the financial sponsors of this research. On reading the original
study, published in JAMA, one notes that a funder of the study is Nestle Canada.
Nestle is the world's biggest manufacturer and distributor of infant formulas
and a major violator of the World Health Organization International Code of Marketing
of Breastmilk Substitutes both in Canada and internationally. The World Health
Organization and UNICEF estimate that one and a half million babies die every
year because they were not breastfed.
Although the research, which tested the milk of 23 lactating women who consumed
a half cup of peanuts after a fast, found that only 11 showed peanut protein spillage
into the breastmilk and that the peanut proteins cleared from the breastmilk after
only a few hours, the implication of the press release was that breastfeeding
can sensitize children to peanut allergies. There is no evidence in Dr.Vadas'
research to support such an association, yet this is how it was suggested to the
media. In fact there is much research to show that breastfed infants and children
suffer less from allergies, asthma and atopic eczema because of the vast array
of complex and interrelating immunological substances found in breastmilk.
Additionally there was no mention in the press release that infant formulas
are manufactured with peanut ingredients and therefore might be a cause of rising
peanut allergies in the general population. Yet this research found its way to
the front pages of both national newspapers.
In future, in the interest of optimal health for infants, children and their
mothers, we request that St Michael's institutes research policies in the area
of infant and young child nutrition that require funding sources to be independent
of competing interests as obligated by the World Health Organization's International
Code and subsequent resolutions of the World Health Assembly. I look forward to
your response on this important matter.
- Elisabeth Sterken, nutritionist
National Director INFACT Canada/IBFAN North America
[Editor's note: Thanks to E-News reader Lisa Caron for submitting the above
letter. E-News readers are always encouraged to bring to light information such
as the above, especially if the information in question has been published in
an E-News issue.]
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Question of the Week
Q: I am going to give birth for the second time in
just a few weeks. I've suffered from hemorrhoids since my first baby's birth when
I used that eye-popping Valsalva pushing. I won't do that again! I want to keep
the hemorrhoids from being such a distraction during my labor. Any good ideas,
treatments, positions? Would laboring in water help? I love the squatting position
but it doesn't work well during pregnancy when the hemorrhoids are swollen. I'd
appreciate any advice.
- Anon.
Send your responses to:
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DONA (Doulas of North America) 7th International Conference
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Milwaukee, Wisconsin, Four Points Sheraton. Early-Bird Registration by June
9th. Also offered;DoulaTraining, Doula Teacher Training, and Pre-Conference Seminar-Bereavement
and the Doula. Speakers include Phillip Hall, Katherine Shister Harrod, Barbara
Harper, John Kennell, Marshall Klaus, Phyllis Klaus, Jack Newman, Penny Simkin,
Leona Van deVusse. Friday night on the town.
Register on our website www.dona.org
Question of the Week Responses
Q: One of my women is suffering from acute glomerulonephritis.
She is dumping large amounts of protein; as yet, hypertension hasn't developed.
I wanted to help her prevent it and suggested taking calcium, magnesium, and potassium
supplements, but then thinking it over, I decided that it was bad advice because
of the kidney damage. Does anyone have advice?
- Jordana
A: I have assisted a mother with kidney disease through two homebirths.
After the first I insisted she have an evaluation by a kidney specialist. The
specialist was amazed that she did not have severe toxemia due to kidney problems.
The two best things we did were to have her drink plenty of fluids and also take
Renatrophin PMG from Standard Process Labs. We kept her protein intake high even
though protein is hard on the kidneys.
- Judy
A: What does her diet look like? If she is a vegan or mostly vegan she
may not be getting enough protein! Make sure she is getting 80-100 g per day.
You can contact Tom Brewer, MD via Kalico.net and he may be able to help you.
It is worth a shot and I have his personal number if you need it. His life's work
has centered around women who are pregnant and have toxemia. If she is early toxemic
or borderline, this diet may turn her around in as little as 2 weeks but she MUST
eat the recommended 80-100 g protein/day. It sounds simple, but it is the truth.
My clients who ate less than 80 g per day all ended up with borderline toxemia
and/or horrible birth outcomes (medicated, forceps, vacuum, c-secs).
- Jill McDanal
Birthmama@att.net
Question of the Quarter for Midwifery Today Magazine
Theme for Issue No. 59: Prenatal
Question(s) of the Quarter: What are the essential elements of good prenatal
care? How does prenatal care create better birth? As a midwife/doula, what do
you hope to accomplish in the prenatal period with a pregnant woman?
Please submit your response by June 30, 2001 to editorial@midwiferytoday.com
In Celebration of Doulas
I have attended two births--one resulted in a c-section and the other in a vaginal
birth. In retrospect it seems I am both at the beginning of a long journey with
birth work and am also immersed and knowledgeable. Being with a laboring woman
resonates within me. To comfort and laugh and sit by the side of a woman is so
ancient.
My mind is not on the essential oil or the rolling pin, although I would reach
for whatever tool "felt" right. As grounded as I am, while at a birth
I don't think in the ways I usually do. I'm on standby, and my intuition is humming
and swimming on that wave.
Being a doula is being fully a woman and becoming a woman in the presence of another
who is in a primal place. Mythically she goes to the other side of the veil, glimpsing
its wonders and its unimaginable dimensions and bringing back life--renewed, fierce,
resolute, confident and triumphant. As a doula I get to witness and celebrate
this passage each time. My legs are firmly in this world with my hand in hers
as she ventures into the other, and sometimes I guide her on her return with her
treasure to this one. What an honor.
- Heather Morrison
Every woman is entitled to a safe and memorable birth experience. I also believe
that young women with low incomes who are potentially at higher risk in pregnancy
need the support of women in their community. Because my children are little and
I can't be on call for numerous clients, I find great comfort volunteering as
a doula for women in the Healthy Moms Healthy Babies program in Canmore, Alberta.
There's no doubt that the extra care these women receive reduces the risk of postpartum
depression. One of my main goals as a doula is to ensure that women are treated
with integrity and respect while they give birth in the hospital setting. I see the work of doulas as an excellent way to alleviate stress for mothers to be.
- Julia Lynx
Canmore, AB, Canada
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Switchboard
International Connections
~*~*~*~*
I am coordinating a doula service at the International College of Spiritual
Midwifery in Melbourne, Australia. Our philosophy is to provide a continuum of
care prior to labour, during labour and postnatally. Our support is emotional,
physical and informational; we do not provide clinical care. Our qualities are
compassion, patience and an ability to be totally present with the woman giving
birth. I would love to hear from other doulas in Australia.
- Sunderai Felich
Reply to: ssmfelic@web.solutions.net.au
We are two student midwives in our final year at Bournemouth University in England.
As part of our training we would like to experience midwifery in a culture different
to our own. The trip will be self-funded and for a period of about two weeks in
August or September 2001. We would be grateful for suggestions of where we could
go.
- Melanie and Lisa
I am moving to Turkey soon and have no clue on what to do about a midwife. I
will be five months pregnant when I get there and I will be on an Air Force Base.
I do not want to do a hospital birth again. Does anybody know a midwife or any
information I could get about one who practices in Turkey or one who would like
to go to Turkey?
- Brianna Ybarra
Reply to: jlybarra@earthlink.net
INTERNATIONAL MIDWIVES, please direct your questions, comments, and needs to
"International Connections." We're here to help you!
To make more "International Connections" join
IAM (International Alliance of Midwives)! All birth enthusiasts are encouraged
to join. IAM is an online directory.
~*~*~*~*
In response to the Switchboard comment on a prolonged labor that was induced
with castor oil at 42+ weeks [Issue 3:21]: I have seen a lot of labors that were
artificially induced via so-called natural agents result in the same kind of lack
of progress as well as regression during labor. In my 10 or so odd years in the
midwifery community I have been stumped by how we midwives are willing to use
means we call "natural" to artificially bring on a labor. Many times
I have seen the exact same scenario with contractions, progression, then nothing.
The body is not ready for labor. The feedback loop is not naturally present. We
see this happen with Pitocin all the time.
My husband is an obstetrician and when we reviewed ACOG (American College of
Obstetrics and Gynecology) standards for what is truly considered a post-term
pregnancy, we found 42 completed weeks (first day of the 43rd week) is considered
post-term. This is when the risk of continuing the pregnancy is markedly increased.
I feel that midwives' responsibility is to encourage women to allow their bodies
to go into labor on their own.
- Anya Wait
Madison, WI
In response to questions about using herbs to support healthy pregnancies and
labor [Issue 3:20 and 21]: I have a viewpoint I hope is helpful. I am a homeopath
and resting midwife. In homeopathy, a substance is "proven" by giving
minute doses to a healthy person to see what effects the substance has on the
person's physical, mental and emotional states. These symptoms become part of
a catalog (called a materia medica) that tells us about the actions of herbs,
minerals, animals in the human realm. Since homeopathy is based on the premise
that "likes cure likes," a remedy prepared from these substances is
given to a person who has the same symptoms that they provoke in a healthy person.
For example, we all know the effect of chopping an onion: our eyes water and burn
and our noses can run with a watery discharge; we may even sneeze. So if a person
has a cold in which these are the predominant symptoms, i.e., burning eyes with
a lot of watering and runny nose and sneezing, and this person takes Allium cepa
(onion) in homeopathic potency, the remedy will somehow push the body into healing
faster and alleviate or "cancel out" the symptoms.
When an herb is taken over and over, we can cause a homeopathic "proving"
if the person doesn't really need the herb. In other words, we provoke the symptoms
in a healthy person that the same herb will help cure in a person who has a weakness
that could benefit by the support of the herb's properties. So, if a woman with
a "weak" uterus, prone to reactivity and premature contractions, takes
raspberry leaf tea to strengthen and tone the uterus, this is very appropriate.
However, if a healthy woman with a strong uterus takes the tea over and over,
she could provoke the symptoms she is trying to avoid. Her body is telling her
she doesn't need the tea. So, in deciding whether to give (or take) a substance,
it is wise to listen to the body and give it what it needs instead of using a
blanket formula. All women don't benefit from raspberry leaf tea (or peppermint
or nutmeg, etc.) just because they are pregnant, and some benefit greatly.
- Patricia Kay, CPM, Olympia, WA
I am noticing a number of newborns having seizures and cardiac arrest before
they even get home from the hospital. While I suspect there is a correlation to
the high-tech birthing process, I don't know where to get the information to support
it. Can you help?
- Rochelle
More on suturing/not suturing [Issue 3:21]:
No rule is true forever for all places and in all conditions. Sometimes rarely
suturing gives horrible results too.
- Anon.
I believe a healthy blood flow through the area is essential for optimal healing
and sutures do interfere with healthy tissue development. However, most mothers
are unable to keep as still as is required for the healing of anything more serious
than a first-degree tear. Staying off the area is also not always possible as
it makes latching baby to the breast difficult. I have chosen to align the skin
and apply surgical super glue in a crisscross pattern to hold tissues in place
so they are allowed to heal quickly and blood flow is not affected. The glue may
be reapplied if necessary. This, along with pelvic floor exercise, is a fail-safe
method for treating tears less than fourth degree.
- Anon.
In reply to the question about bathing/not bathing baby soon after birth:
It is my understanding that the smell and taste of amniotic fluid on the baby's
body and hands helps the baby find its own way from mother's belly to mother's
breast and to latch and begin nursing, if baby is placed there after a little
drying and covered with a warm blanket. I forget the authors of the study (but
Kennell and Klaus undoubtedly reference it) who showed that if you washed a baby's
hands before placing him/her on mom's belly he/she had more difficulty locating
and reaching the breast. I wouldn't be at all surprised if the reverse is also
true in some way: that the smell of the unwashed baby stimulates oxytocin and/or
prolactin production in the mother, assisting both in breastfeeding and bonding.
I think the general theme of not bathing the baby for a while has to do with
our more recent understanding that nature has an exquisitely designed program
for moms and babies to get to know each other and for babies to adjust to life
outside the womb. The less we interfere with this design the better for all concerned.
A year or so ago there was a lengthy discussion on a doula list about the first
bath, and many women who posted were enthusing with passion about the smell of their unwashed newborns' heads.
A final justification for not bathing a baby soon after birth is that in many
hospitals such procedures are performed by nursing staff rather than parents,
and the current thinking is that (both for health and bonding's sake) it is more
beneficial for the family if the parents do as much as possible or all of the
handling of the newborn in the first day or two to help baby adjust to the world
and attach to its parents, and because the more the baby is cared for by hospital
"professionals" the less confidence new parents have in their own skills.
- Claire Winstone, pre- and perinatal psychology educator
While I don't think there's any particular guideline prevailing in my area,
there may be good reasons to delay a first bath. My first baby, born at home,
who had mild asymmetric IUGR and very red skin (a marker for blood sugar problems,
I've since learned) really screamed through his first bath (12 hours after birth)
despite a very warm room. He experienced a blood sugar crash right after. His
blood sugar became very volatile and he wound up spending 10 days in an NICU.
When my second was born I delayed his bath a full 36 hours with the support of
our midwife, and while he also had "off" blood sugar levels in the first
48 hours, he did much better than my first. My midwife also recommended a deep-immersion
bath with him (baby and mom in the bath skin-to-skin, with the baby in up to his
neck).
- Nora
I am a 22-year-old aspiring midwife who after trying different jobs, considering
different careers, and going in and out of college sees very clearly that midwifery
is my calling. My concern is that I won't be taken seriously because I haven't
had any children and don't really think I will have any. I am happy with this
decision because it would let me be free to throw myself into being a midwife.
Do you think I would still be taken seriously as a midwife even though I have
not given birth?
- Andrea
Sacramento, CA
In reply to teen mom/adoption [Issue 3:21]:
I don't know if her book is available in the US but Mavis Kirkham (professor
of midwifery at the University of Sheffield, United Kingdom) has edited an excellent
book called The Midwife-Mother Relationship. She makes reference in her
own chapter "How Can We Relate" to personal experiences, one including
dealing with a young single mother who was giving her baby up for adoption. This
book is excellent and I would recommend it to anyone working with pregnant women.
It contains several chapters, written by different authors, that look at the various
relationship issues with pregnant/ birthing women, including midwives without
children, homebirth, three-way relationships with midwives working through interpreters
and being with woman who are economically without. Well worth a read!
- Anon.
I was adopted at 6 weeks old, and all I know of my mother is that she was a
teenager and could not keep me. If anyone is blessed to attend the birth of a
lady who knows she's going to immediately give her child to someone else to love
and raise, let her know how *truly* brave, strong, giving and loving she is. Support
her and remind her of the beautiful gift she is giving, and help her recognize
what gifts of strength she might receive.
- Gail
As a doula I've worked with women who wanted to let their babies be adopted.
Because she is having a hospital birth, I would contact social services at the
hospital; they will be able to refer her for counseling and give her reading material,
legal information, etc. You may also need to make sure the hospital staff understand
her wishes. I had one troubling case in which a client (untreated schizophrenic
really not capable of coping with a child) had decided to let her baby be adopted,
and a nurse--without looking at the chart--tried to browbeat her into keeping
the baby.
- Sharon DeJoy, doula
Connections
Looking for a Labor Doula in Atlanta GA, who is trying to get certified and would consider helping me for a minimal fee. This is my first child - DD: July 7, 2001.
Please contact Phyllis @ 770-457-9455 OR email pmaslia@intermedia.com
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