August 29, 2007
Volume 9, Issue 18
Midwifery Today E-News
“Breastfeeding”
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You'll learn about herbs, homeopathics and other natural remedies…

…when you attend Lisa Goldstein's full-day Herbal and Homeopathics Workshop at our conference this September in Oslo, Norway. Plant identification slides, an extensive reference book and a wide variety of demos will give you an in-depth look at the various ways you can use natural remedies to help women during pregnancy, birth and postpartum. Go here for info and a complete program.

We must receive your registration in-office by August 31, 2007. Walk-in registrants are welcome, but you should check with Midwifery Today to learn the availability of classes.


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Attend this full-day class with Gail Hart and Ina May Gaskin and discover how good pre-natal care can help prevent labor complications. Other topics covered include protocols and techniques to help the mother move through first stage, prolonged ruptures of membranes, failure to progress, abnormal labor patterns and non-medical intervention. Part of our Philadelphia conference, March 2008. Go here for more information.

In This Week’s Issue:


Quote of the Week

"Formula feeding is the longest lasting uncontrolled experiment lacking informed consent in the history of medicine."

Frank Oski, MD
retired editor, Journal of Pediatrics


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The Art of Midwifery

When labor begins the mother is in charge, as she should be. All her attendants are there to help her and look after her as best we can. Her every wish is our command. When baby is born, we are all quiet while the parents welcome their child, and a flood of love fills the birth room.

— John Stevenson, excerpted from "Lessons from a Homebirth Practice," The Birthkit Issue 39


ALL BIRTH PRACTITIONERS: The techniques you've perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to mtensubmit@midwiferytoday.com.


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International Breastfeeding Remedies

A 40-day period of rest and nutritious foods is standard for Mexican mothers (de Paula, Lagana and Gonzales-Ramirez 1996). In the Latino tradition, mothers use foods and teas to ease the discomforts of childbirth, to promote milk production and to ease infant colic. Light foods rich in nutrients such as caldo de pollo (chicken soup) and tortillas are provided to the newly delivered mother. Foods that are believed to dry up her milk are avoided. These include parsley, which, like sage, has been observed to reduce milk supply; indigenous vegetables such as tomatoes, squash and bell pepper (but not lettuce); and also sour foods such as lemon.(Agnew 1997)

Foods such as alfalfa and fenugrecco (fenugreek) are eaten to help a mother build her milk supply. Malt drinks, dark beer and a drink made from boiled corn and milk are used to increase breast milk production.(City of Toronto, Department of Public Health, 1992: key informant interviews) However, alcohol can deter the development of a good milk supply if used frequently. (Mennella 2005) Teas such as manzanilla (chamomile), yerba buena (spearmint), oregano and elderberry are used to assist infant colic.

Many postpartum remedies traditional to the Americas are used in other parts of the world as well. Native American galactagogues such as varieties of lettuce, thistle and dandelion are used around the world to promote milk flow and production. Plants of the urtica family (stinging nettle) are used to increase milk production by women (and cattle) in southern Europe, across Asia, in the South Pacific, and in northern and southern Africa.

From the Latino tradition, mothers across the Mediterranean region take malt to boost their milk supply, and chicken soup is a postpartum tonic in China. Fenugreek, a member of the leguminosae family, is taken to increase breast milk from the mid-East to Asia. This family contains a multitude of lactation-supporting plants and foods such as lentils (Africa, India), peanuts (unripe, cooked into stew or soup in Africa and Asia), various astragalus plants (Eurasia), and goats rue (Galega officinalis L.) (middle, southern and eastern Europe).

Like mothers in Mexico, mothers around the world also avoid specific foods and herbs in the early postpartum period. These foods are frequently considered to be "cold" according to humoral concepts of traditional systems of medicine. Mexican vegetables such as tomatoes, squash and bell pepper are prime examples of "cold" foods.

Although not free of bias and superstition, food avoidance traditions are doubtless based on observations of sensitive mothers and babies: if a few mothers or babies have a bad reaction to a certain food, then all mothers are advised avoidance, at least the first few weeks postpartum. In most cultures, food avoidances are not meant to be strictly followed. Rather, they provide guidelines for those mothers and babies who develop problems with foods the mother eats.

— Cheryl R. Scott and Hilary Jacobson, excerpted from "A Selection of Nutritional and Herbal Remedies for Breastfeeding Concerns from Around the World," Midwifery Today Issue 75


Midwifery Today Issue 75


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Research to Remember

The duration of breastfeeding is inversely related to pediatric overweight. In Harder, et al., the greater the duration of breastfeeding, the lower the odds of overweight. For each month of breastfeeding up to age 9 months, the odds of overweight decreased by 4%. This decline resulted in more than a 30% decrease in the odds of overweight for a child breastfed for nine months when the comparison was with a child never breastfed.

Am J Epidemiol 162: 397–403, 2005


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In the United States, of infants born in 2004, almost three-fourths of mothers (73.8%) initiated breastfeeding shortly after birth. This represents an increase since the year 2000. Twenty-one states achieved the national Healthy People 2010 objective of 75% of mothers initiating breastfeeding.

www.cdc.gov/Features/Breastfeeding/ Accessed 19 Aug 2007


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Conference to Solve Maternity Care Crisis

Gentle Birth World CongressJoin: obstetricians, midwives, nurses, childbirth educators, lactation experts, alternative health providers and others as we create solutions to the problems facing maternal/child health today. Over 40 international speakers who have taken on the system and changed their practice to include gentle birth principles.

Gentle Birth World Congress ~ Oregon Convention Center ~ Portland, Sept. 28–30, 2007
www.gentlebirthworld.com 866-789-6488, 24 hours


Web Site Update

The complete program for the March 2008 Midwifery Today conference in Philadelphia, Pennsylvania, is now online, including PDF format. Register early so you don't miss out on your favorite classes! Check it out here.


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Question of the Week

Q: A nulliparous client of mine who is now 36 weeks and has been planning a homebirth has just remembered that she was told after a miscarriage and D&C, and also at the first ultrasound of this pregnancy, that she has a bicornuate uterus (having two "horns," or heart-shaped). Other than that, the pregnancy has been uneventful. I told her to do another ultrasound and find out if there is also a septum and where the placenta is. The doctor told her that he can't see anything now because the pregnancy is too advanced, but the placenta is anterior. My question is: Should she see an ultrasound expert who can tell more?

I know that there is more of a chance of retained placenta and need for lysis and also more postpartum hemorrhage (PPH) with a bicornuate uterus. I had one patient in the past who even had a successful version at 38 weeks, but had to have a lysis after waiting one hour and the placenta was increta in the cornua and there was a big PPH during the lysis. Then she had another totally uneventful second birth where the ultrasound showed that the placenta was not near the cornua and there were no problems with separation.

Do you think this woman should be risked out of a homebirth if the birth is six minutes from the hospital?

— Ilana Shemesh


SEND YOUR RESPONSE to mtensubmit@midwiferytoday.com with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.


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Question of the Week Responses

Q: My pregnancy is going well; I am about 32 weeks right now. We are having another little girl. I think that's why I was so miserable during the first trimester. I threw up every other day. It was similar with my first daughter, although not so extreme. With my son, I did not even suspect that I was pregnant for the first three months.

I am now debating whether to have a repeat c-section or try natural. My first son was born naturally, and then my daughter was born by c-section three years later because she was breech.

This baby has already turned head down, but when it's going to be born, it will be only 15 months between the two deliveries. Any ideas?

— Anonymous

A: In my practice, in the UK, we would suggest you have a trial of labour. If your baby is head down and engaged at the time of labour, if you are fit and well and at term, if the baby's heartbeat is normal prior to and during labour and the size of the baby feels right for your dates, etc., and if you have good regular contractions, there is no reason for you not to deliver normally.

If anything changes during the delivery period, a CS can be performed. Talk to your midwife and she should advise you. Good luck and I hope you have a nice normal delivery.

— Sandra Lochhead


Responses to any Question of the Week may be sent to E-News at any time. Write to mtensubmit@midwiferytoday.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.


Think about It

To kick off Oregon's Breastfeeding Promotion Month, Dr. Susan Allan, Public Health Director for Oregon Department of Human Services, presented "Maternity Care Best Practices" awards to 15 area hospitals which have eliminated formula sample packs from the discharge bags customarily given to mothers as they head home with their new babies. Portland is the first city in the nation to have both public and private hospitals ban the formula sample packs since the launch of the national "Ban the Bag" campaign one year ago.

"The bags are not free," says Amelia Psmythe, Executive Director of the Nursing Mothers Counsel of Oregon, "we are all paying for them through the decrease in breastfeeding rates and associated increase in health problems. Mothers who want the free formula can request it from the formula companies, but hospitals should market health and nothing else."


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Feedback

Once again, E-News 9:16 has referred to female circumcision as "female genital mutilation." I have yet to see a word about "male genital mutilation." I support neither; I think both little girls and little boys are born perfect. But I do care for many African women who have been circumcised and many American women who circumcise their sons. It is hard for me not to be judgemental of these cultural practices. But I think labeling only the female version "mutilation" is both ethnocentric and sexist.

Cynthia B. Flynn, CNM, PhD
Associate Professor of Nursing, Seattle University
Nurse-Midwife, Valley Medical Center
President-elect, American Association of Birth Centers


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