This post goes along with my previous post, "How to avoid the ol' bait-and-switch with your OB/midwife/pediatrician." I'd like to go one step further, though.
I wish I had a dollar for every time I heard someone say something absolutely absurd that their doctor "believes" or "doesn't believe." I have a great idea. HOW ABOUT WE "BELIEVE" IN EVIDENCE-BASED MATERNITY CARE???? That would be a fantastic place to start and it would stop conversations like this from making my head explode:
Facebook acquaintance: "Would you all like to guess the date my baby will arrive? (My last baby was induced at 41 weeks.)"
Me: "Would you like resources and research regarding the pros & cons of induction, when it's medically indicated, etc.? I'd be happy to help."
Facebook acquaintance: "My doctor doesn't believe in letting mothers go past 41 weeks so I have my induction scheduled already in case I don't have my baby before then."
*facepalm* *facedesk* *facelaptop*
What do you mean, your OB "doesn't believe in letting mothers go past 41 weeks"? The same way he doesn't believe in Santa Claus? Because I can assure you, there are plenty of mothers who go past 41 weeks safely and healthily, including the majority of first-time mothers. The statistical average length of gestation for a first-time mom is 41 weeks 1 day. AVERAGE.
Can we please, just please, once, read the research instead of just "trusting our doctors"? Are our doctors informing mothers that induction doubles a first-time mother's risk of a cesarean? I cannot understand why some women will trust what their OB says even if it flies in the face of all the current research. Doctors are fallible, just like all other humans.
Trusting your doctor (or midwife) is great. I'd highly recommend that you do whatever it takes to find a care provider who you can trust. Just not with a god-like trust.
Oh, and this isn't even close to all I have to say about inductions (those which are preventable, i.e. "most of them"). I have to break down into manageable chunks.
Well Rounded Birth Prep
WellRoundedBirthPrep.com
Monday, August 30, 2010
Friday, August 27, 2010
Myth-conceptions: cord wrapped around baby's neck
Hello, readers. Thanks for your patience with my spotty attendance. It's back-to-school time in our household of 4 kids age 7 and under, and that means homeschooling first and second grades simultaneously while attempting to throw a few Pre-K activities for my busy 4 y.o. son and nursing my toddler daughter as she wants up on my lap, then down, then back up again, and repeat. I've also spent a lot of time trying to secure a regular venue for my Well Rounded Birth Prep classes.
I would like to start a blog series called Myth-conceptions, addressing common myths regarding pregnancy, birth, and breastfeeding. I have so many things I'd like to address in this series that I don't know where to start. It's actually a bit daunting.
I've heard and read hundreds of birth stories over the years, and it didn't take long to begin to see patterns. Research has established the cause-and-effect relationship between routine birth interventions and potentially preventable complications.
Since I have to start somewhere, why not this one: "The cord was wrapped around his neck--twice!!!--and if we hadn't been in the hospital, we both would have died!" True cord emergencies are extremely rare. In God's perfect design for the umbilical cord, the two arteries and one vein that make up the cord are covered with a rubbery substance called Wharton's jelly that helps protect the cord from kinks. The normal blood pressure through the arteries and vein in the cord help put positive pressure outward on the cord to help keep it from kinking as well. Even in the event of a true knot in the cord, Wharton's jelly usually prevents problems for the infant by keeping the cord from compressing. A knot in the cord isn't typically discovered until after the birth anyway, which means that nothing could have been done to have foreseen or prevented any true cord issues.
I once read a comment in response to a friend's informative post about homebirths, stating something to this effect, "I'm glad that worked for you, but my wife and son would have both died had she not been in the hospital. The cord was wrapped around his neck 3 times, and it even had a knot in it. Then there were heart decels while she was pushing and the doctor had to perform an episiotomy to get him out faster."
Let's take a look at this scenario piece by piece, shall we? First off and foremost, having the cord around the neck (in and of itself) at birth is not an emergency. In fact, it occurs in about 30% of all births. OBs and midwives will check around the neck to see whether the cord is wrapped around the neck after the head has been born. If the cord is wrapped around the neck, they will gently slide the cord over the neck without any problem. If the cord is wrapped multiple times, they will attempt to slide the first loop over the baby's head and sometimes this gives enough slack to the rest of the loop that the body is delivered with no complication at that point. If there isn't enough slack for that, a midwife will hold the baby's head near mother's leg and allow the body to be delivered in a maneuver resembling a somersault (pictured below), which doesn't put extra strain on the cord around the neck. (Most doctors will not do this, as they have not been trained to do so.) In a rare, true wrapped-tight-cord situation, the birth attendant will clamp the cord twice and cut in between, then help the mother to deliver the baby quickly as his/her oxygen supply (cord) as been severed.
As for the knot in the cord, in this particular birth story, nothing was done about it during that birth (nor could anything have been done about it) and there was no indication that the knot caused any problems. When and how did this dad think that knot got there, anyway? True knots can only occur early on in pregnancy when baby has enough room in the uterus to flip and spin freely to do a loop-the-loop and create the knot. This knot had been present for months.
As for the fetal distress during delivery, it's hard to say, since no details were given in this man's account of his wife's birth. However, it is well established that fetal distress can be an indicator that the baby is not tolerating mother's position well. The first thing a midwife will suggest if baby's heartrate is dipping, is to switch positions to see whether baby's heartbeat responds in a more favorable way. Sometimes it's something as simple as baby's cord getting slightly compressed due to the mother's positioning. Changing positions to help baby's heart rate would be difficult if the mother had an epidural, which has issues all its own that I will address in a moment.
It's also well established that the lithotomy position (a.k.a. "stranded beetle" position, lying flat on her back: the most common position for pushing in America) can cause fetal distress. Remember how expecting moms are cautioned never to lie on their backs for extended periods of time beyond the 5th month of gestation, since sleeping or lying on their backs (for more than a few minutes) can cause the weight of the uterus to compress the main artery providing blood flow to the lower half of the body (including baby)? What makes anyone think this would suddenly be a good idea during labor and delivery????
Epidurals are sometimes responsible for fetal distress. I wonder how many women are told this before they get an epidural: blood pressure drop is a common epidural side effect. They try to combat this by giving IV fluids or medications, but it doesn't always work, which sometimes causes fetal distress. Directed pushing (a.k.a. "purple pushing" = "hold your breath and push as hard as you can while we count to 10") is also associated with higher incidence of fetal distress.
Was the mother on Pitocin (synthetic oxytocin, a drug given to speed up labor)? Pitocin can also cause fetal distress. Insiders from our local hospitals have told me that the overwhelming majority of labors they have attended are induced or augmented with Pitocin.
So, were there other factors with this particular fetal distress? I don't know. I'm just pointing out some common situations so that readers can have an understanding that "fetal distress" doesn't often happen out of the blue, and it's even more rare that it would happen "without any apparent reason." (Yes, I'm aware that it *can* happen that way. I'd just like to reassure readers that those are the rare exception, not the rule.) And as for that poor woman's episiotomy, was it truly medically necessary? Perhaps. They are medically indicated approximately 5% of the time. Sometimes true fetal distress means that an episiotomy would save 5-10 minutes of pushing time; if changing pushing positions and giving mother oxygen to help fetal oxygenation doesn't help, then the episiotomy can help. Most of the time, however, episiotomies are entirely preventable and amount to nothing more than genital mutilation.
I think this episode of Myth-conceptions has melded into many posts at once. I'll try to delve into the other topics in greater detail in future posts.
To sum it up, this guy's argument was that his wife and child would have died had they given birth anywhere but in the hospital. I totally respect their right to give birth anywhere they want, and that's their personal decision, but nothing he said indicated any care provided by hospital staff that would not have been available at a birth center or a homebirth (namely, episiotomy, which is available at either a birth center or homebirth but rarely performed since most midwives understand the true indicators for an episiotomies and do not perform them routinely).
I'll close by sharing a birth story that a local doula shared with me. One baby whose birth she attended at an independent birth center had his umbilical cord wrapped all around his body *five times* in different ways: around the neck, around the chest, above and under the arms, etc. The baby was fine. When the cord is wrapped multiple times like that, it is usually long enough to compensate.
The bottom line is that true cord issues are rare and unpreventable. There's no need to fear them. A skilled birth attendant (whether OB or midwife) knows to look for a cord around the neck, and knows what to do if it occurs. There's no need to panic, people. It's only birth.
See also : Doula'ing my nephew's gorgeous home waterbirth! My nephew was born with his cord wrapped twice around his neck.
I would like to start a blog series called Myth-conceptions, addressing common myths regarding pregnancy, birth, and breastfeeding. I have so many things I'd like to address in this series that I don't know where to start. It's actually a bit daunting.
I've heard and read hundreds of birth stories over the years, and it didn't take long to begin to see patterns. Research has established the cause-and-effect relationship between routine birth interventions and potentially preventable complications.
Since I have to start somewhere, why not this one: "The cord was wrapped around his neck--twice!!!--and if we hadn't been in the hospital, we both would have died!" True cord emergencies are extremely rare. In God's perfect design for the umbilical cord, the two arteries and one vein that make up the cord are covered with a rubbery substance called Wharton's jelly that helps protect the cord from kinks. The normal blood pressure through the arteries and vein in the cord help put positive pressure outward on the cord to help keep it from kinking as well. Even in the event of a true knot in the cord, Wharton's jelly usually prevents problems for the infant by keeping the cord from compressing. A knot in the cord isn't typically discovered until after the birth anyway, which means that nothing could have been done to have foreseen or prevented any true cord issues.
I once read a comment in response to a friend's informative post about homebirths, stating something to this effect, "I'm glad that worked for you, but my wife and son would have both died had she not been in the hospital. The cord was wrapped around his neck 3 times, and it even had a knot in it. Then there were heart decels while she was pushing and the doctor had to perform an episiotomy to get him out faster."
Let's take a look at this scenario piece by piece, shall we? First off and foremost, having the cord around the neck (in and of itself) at birth is not an emergency. In fact, it occurs in about 30% of all births. OBs and midwives will check around the neck to see whether the cord is wrapped around the neck after the head has been born. If the cord is wrapped around the neck, they will gently slide the cord over the neck without any problem. If the cord is wrapped multiple times, they will attempt to slide the first loop over the baby's head and sometimes this gives enough slack to the rest of the loop that the body is delivered with no complication at that point. If there isn't enough slack for that, a midwife will hold the baby's head near mother's leg and allow the body to be delivered in a maneuver resembling a somersault (pictured below), which doesn't put extra strain on the cord around the neck. (Most doctors will not do this, as they have not been trained to do so.) In a rare, true wrapped-tight-cord situation, the birth attendant will clamp the cord twice and cut in between, then help the mother to deliver the baby quickly as his/her oxygen supply (cord) as been severed.
As for the knot in the cord, in this particular birth story, nothing was done about it during that birth (nor could anything have been done about it) and there was no indication that the knot caused any problems. When and how did this dad think that knot got there, anyway? True knots can only occur early on in pregnancy when baby has enough room in the uterus to flip and spin freely to do a loop-the-loop and create the knot. This knot had been present for months.
As for the fetal distress during delivery, it's hard to say, since no details were given in this man's account of his wife's birth. However, it is well established that fetal distress can be an indicator that the baby is not tolerating mother's position well. The first thing a midwife will suggest if baby's heartrate is dipping, is to switch positions to see whether baby's heartbeat responds in a more favorable way. Sometimes it's something as simple as baby's cord getting slightly compressed due to the mother's positioning. Changing positions to help baby's heart rate would be difficult if the mother had an epidural, which has issues all its own that I will address in a moment.
It's also well established that the lithotomy position (a.k.a. "stranded beetle" position, lying flat on her back: the most common position for pushing in America) can cause fetal distress. Remember how expecting moms are cautioned never to lie on their backs for extended periods of time beyond the 5th month of gestation, since sleeping or lying on their backs (for more than a few minutes) can cause the weight of the uterus to compress the main artery providing blood flow to the lower half of the body (including baby)? What makes anyone think this would suddenly be a good idea during labor and delivery????
Epidurals are sometimes responsible for fetal distress. I wonder how many women are told this before they get an epidural: blood pressure drop is a common epidural side effect. They try to combat this by giving IV fluids or medications, but it doesn't always work, which sometimes causes fetal distress. Directed pushing (a.k.a. "purple pushing" = "hold your breath and push as hard as you can while we count to 10") is also associated with higher incidence of fetal distress.
Was the mother on Pitocin (synthetic oxytocin, a drug given to speed up labor)? Pitocin can also cause fetal distress. Insiders from our local hospitals have told me that the overwhelming majority of labors they have attended are induced or augmented with Pitocin.
So, were there other factors with this particular fetal distress? I don't know. I'm just pointing out some common situations so that readers can have an understanding that "fetal distress" doesn't often happen out of the blue, and it's even more rare that it would happen "without any apparent reason." (Yes, I'm aware that it *can* happen that way. I'd just like to reassure readers that those are the rare exception, not the rule.) And as for that poor woman's episiotomy, was it truly medically necessary? Perhaps. They are medically indicated approximately 5% of the time. Sometimes true fetal distress means that an episiotomy would save 5-10 minutes of pushing time; if changing pushing positions and giving mother oxygen to help fetal oxygenation doesn't help, then the episiotomy can help. Most of the time, however, episiotomies are entirely preventable and amount to nothing more than genital mutilation.
I think this episode of Myth-conceptions has melded into many posts at once. I'll try to delve into the other topics in greater detail in future posts.
To sum it up, this guy's argument was that his wife and child would have died had they given birth anywhere but in the hospital. I totally respect their right to give birth anywhere they want, and that's their personal decision, but nothing he said indicated any care provided by hospital staff that would not have been available at a birth center or a homebirth (namely, episiotomy, which is available at either a birth center or homebirth but rarely performed since most midwives understand the true indicators for an episiotomies and do not perform them routinely).
I'll close by sharing a birth story that a local doula shared with me. One baby whose birth she attended at an independent birth center had his umbilical cord wrapped all around his body *five times* in different ways: around the neck, around the chest, above and under the arms, etc. The baby was fine. When the cord is wrapped multiple times like that, it is usually long enough to compensate.
The bottom line is that true cord issues are rare and unpreventable. There's no need to fear them. A skilled birth attendant (whether OB or midwife) knows to look for a cord around the neck, and knows what to do if it occurs. There's no need to panic, people. It's only birth.
See also : Doula'ing my nephew's gorgeous home waterbirth! My nephew was born with his cord wrapped twice around his neck.
Wednesday, August 25, 2010
Wordless Wednesday: Ripe with son
2006. About 25 minutes before I delivered my 8 lb 2 oz son into the birth pool in my foyer. 3rd child, 2nd homebirth.
Thursday, August 19, 2010
Who "delivered" your baby?
Am I the only one who is annoyed when people talk about OBs (or less commonly, midwives) "delivering" babies? I mean, don't get me wrong, I realize that OBs and midwives have important jobs in being guardians of safety and will sometimes necessarily intervene with tools, techniques, or even surgery for the betterment of mom and/or baby. I'm not denying that or minimizing that. Here's the thing: the birth belongs to the mother. Besides that, the mother (usually) did all the work in getting the baby out. The bulk of the time, nurses or OBs will periodically check in on a laboring mother, but it's not uncommon for an OB to show up literally in time to put on gloves, catch the baby, and sometimes stitch the mother back up if a tear (or worse: episiotomy) has occurred. The OB and nurses were not there for continuous labor support (most of the time).
Who really delivered that baby? And what definition of "deliver" are we using? I pulled out my trusty Webster's Dictionary, 10th edition, and it had 6 definitions of "deliver," each with several sub-entries.
deliver
1: to set free < and lead us not into temptation, but ~ us from evil -- Mt 6:13 (AV) >
2 a: to take and hand over to or leave for another: convey <~a package>
b: hand over, surrender <~ed the prisoners to the sheriff>
3 a (1): to assist in giving birth
(2): to aid in the birth of
b: to give birth to
c: to cause (oneself) to produce as if by giving birth < has ~ed himself of half an autobiography --H. C. Schonberg>
4: speak, sing, utter <~ed their lines with style>
5: to send (something aimed or guided) to an intended target or destination < ability to ~ nuclear warheads >
6 a: to bring (as votes) to the support of a candidate or cause
b: to come through with: produce < can ~ the goods >
I remember reading in a book (Readers: help me? Where did I read this? A Henci Goer book?) an interview with an OB who openly admitted that the only time when he felt that he actually DELIVERED babies was when he performed cesareans. That was worrisome to me. It smacks of ego. Are there power situations at play if highly trained surgeons want to feel as though they are *doing* something "productive" at a birth (whether or not the interventions were medically necessary)?
It seems that, in America, the term "deliver the baby" is used with definitions 1: and 2: above, when I'd like to see the term used more the way it is in definition 3:. Even within definition 3:, I'm not sure I can agree with "aiding" or "assisting" with a birth as being the same as "delivering." I was a doula at my sister-in-law's birth last month. I think that she would say that I "assisted" and supported her birth even though I performed no medical services and did not catch the baby. Could I take credit for "delivering" her baby? Absolutely not! The mother *delivered* her baby.
We had an accidental unattended home waterbirth with our 4th baby. Let me clarify: we were planning a home waterbirth (our third), but we were planning on the midwives getting there in time. My husband caught the baby. It irks me when people ask incredulously, "So your husband delivered your baby???" Well, no. He caught her. It wasn't hard. I did all the work!
What do you think, readers? Does this have to do with the difference between being an active participant vs. a passive participant in our births? Who "delivered" your baby? Who SHOULD claim credit for "delivering" babies? What about cesarean births vs. vaginal births? Should there be a difference in who claims credit for the delivery? Are you bothered by others taking ownership of or credit for your work, or is it just an insignificant matter of semantics? What does "deliver" mean to you? "To give birth," "to catch the baby," "to set free," or "to take and hand over to or leave for another"?
Who really delivered that baby? And what definition of "deliver" are we using? I pulled out my trusty Webster's Dictionary, 10th edition, and it had 6 definitions of "deliver," each with several sub-entries.
deliver
1: to set free < and lead us not into temptation, but ~ us from evil -- Mt 6:13 (AV) >
2 a: to take and hand over to or leave for another: convey <~a package>
b: hand over, surrender <~ed the prisoners to the sheriff>
3 a (1): to assist in giving birth
(2): to aid in the birth of
b: to give birth to
c: to cause (oneself) to produce as if by giving birth < has ~ed himself of half an autobiography --H. C. Schonberg>
4: speak, sing, utter <~ed their lines with style>
5: to send (something aimed or guided) to an intended target or destination < ability to ~ nuclear warheads >
6 a: to bring (as votes) to the support of a candidate or cause
b: to come through with: produce < can ~ the goods >
I remember reading in a book (Readers: help me? Where did I read this? A Henci Goer book?) an interview with an OB who openly admitted that the only time when he felt that he actually DELIVERED babies was when he performed cesareans. That was worrisome to me. It smacks of ego. Are there power situations at play if highly trained surgeons want to feel as though they are *doing* something "productive" at a birth (whether or not the interventions were medically necessary)?
It seems that, in America, the term "deliver the baby" is used with definitions 1: and 2: above, when I'd like to see the term used more the way it is in definition 3:. Even within definition 3:, I'm not sure I can agree with "aiding" or "assisting" with a birth as being the same as "delivering." I was a doula at my sister-in-law's birth last month. I think that she would say that I "assisted" and supported her birth even though I performed no medical services and did not catch the baby. Could I take credit for "delivering" her baby? Absolutely not! The mother *delivered* her baby.
We had an accidental unattended home waterbirth with our 4th baby. Let me clarify: we were planning a home waterbirth (our third), but we were planning on the midwives getting there in time. My husband caught the baby. It irks me when people ask incredulously, "So your husband delivered your baby???" Well, no. He caught her. It wasn't hard. I did all the work!
What do you think, readers? Does this have to do with the difference between being an active participant vs. a passive participant in our births? Who "delivered" your baby? Who SHOULD claim credit for "delivering" babies? What about cesarean births vs. vaginal births? Should there be a difference in who claims credit for the delivery? Are you bothered by others taking ownership of or credit for your work, or is it just an insignificant matter of semantics? What does "deliver" mean to you? "To give birth," "to catch the baby," "to set free," or "to take and hand over to or leave for another"?
Wednesday, August 18, 2010
Boba baby carrier giveaway at Familylicious Reviews
Quick! Head over to Familylicious Reviews and enter to win a gorgeous Boba soft structured baby carrier!
Boba baby carriers are MADE IN THE USA and are 100% organic cotton. They offer a higher, more supportive back than some other carriers. They also have optional (removable) foot straps (think saddle stirrups) to support your toddlers' feet and legs as they grow.
I love wearing Baby K, but she is now 21 months old and weighs enough that I really need a supportive carrier to wear her for any amount of time. I'd love to win this Boba for Baby K and also to allow my clients to try-before-they-buy in my Well Rounded Birth Prep Babywearing Workshops.
Familylicious Review's Boba giveaway is accepting entries until September 5, 2010. My favorite is the Tweet fabric.
Which fabric Boba would you choose?
Boba baby carriers are MADE IN THE USA and are 100% organic cotton. They offer a higher, more supportive back than some other carriers. They also have optional (removable) foot straps (think saddle stirrups) to support your toddlers' feet and legs as they grow.
I love wearing Baby K, but she is now 21 months old and weighs enough that I really need a supportive carrier to wear her for any amount of time. I'd love to win this Boba for Baby K and also to allow my clients to try-before-they-buy in my Well Rounded Birth Prep Babywearing Workshops.
Familylicious Review's Boba giveaway is accepting entries until September 5, 2010. My favorite is the Tweet fabric.
Which fabric Boba would you choose?
Tuesday, August 17, 2010
Babywearing FAQ
I get this type of email a lot: "I need some advice on babywearing and types of carriers. I know you're an expert so any advice or references would be appreciated!!" I have so much to say about babywearing that I will have to break it down into chunks of several blogs.
One great site for comparing different styles, brands, and functions of slings/carriers is The Baby Wearer.
Babywearing Safety Facebook fan page is an excellent resource for positioning tips and other necessary safety tips. They have lots of links on safe positioning with various carriers.
There's more to baby positioning than this, but if I could tell you 2 quick laws for newborn positioning, they would be:
1. Baby's head should ALWAYS be close enough to kiss. This ensures that he is close enough for you to observe his breathing and that his airways are unobstructed.
2. Never allow baby to be in the chin-to-chest position, which can cause positional asphyxiation. You should be able to tuck (at least) two adult fingers between baby's chin and chest when baby is properly positioned.
Here's a quick video on safe positioning for newborn. It's shown with a ring sling but applies to all carriers for newborns.
The proper physiological position for a newborn is vertical between his mother's breasts. This helps them assimilate neurologically and benefits breastfeeding. Researchers have noted that cradle or other positions for newborns can confuse them and even potentially cause breastfeeding problems. Here's an excellent article outlining the physiology of proper babywearing positioning regardless of brand of carrier:
Babywearing: Safe Positioning
Love that link.
As for my personal preferences, I own 8 slings of various styles/brands, depending on the function & my outfit.
For newborn, I recommend a soft, stretchy wrap such as Moby Wrap, Sleepy Wrap, or Cuddly Wrap.
I don't know whether or where I have photos of me wearing our littlest one in our stretchy wrap when she was an infant, but here's one of my midwives, Jennifer Stewart, wearing Baby K in my stretchy wrap when K was 3 months old. (She's more than a midwife; she's my friend!)
One alternative to the stretchy wrap is a hybrid that's similar in function but fitted (not adjustable, must buy your tight fitted size) so it doesn't require wrapping: the Baby K'Tan. Personally, I do prefer the adjustability and versatility of a traditional wrap sling, but I realize that some parents are intimidated by wrapping one. That's when a Baby K'Tan is handy.
Stretchy wraps' websites say they are safe until 3 y.o. or so, which is true, but they are really not comfortable beyond 20 lb or so (in my humble opinion). The soft, T-shirt type of material stretches w/ the weight & doesn't provide as much support as a soft structured carrier (like an Ergo) does at that point.
For newborn stage through 4-6 months, I *love* a stretchy wrap. It has a teeny tiny learning curve, but worth it. I could teach you how to wrap it in 2 min or less. Easy to wrap & tie before you even leave the house & leave tied & throw your coat on over it & slide baby inside once you arrive at your destination. You don't have to untie/retie to get baby in & out.
Stretchy wraps also should never be used for back carry, despite what their websites say. This 56 second clip shows why.
Woven wraps, on the other hand, ARE safe for back carry (or front carry, for that matter). Here's a 58 second clip showing why woven wraps are secure with baby on back in the same scenario as above.
Some examples of a woven wrap are the GypsyMama Wrapsody and Ellaroo's wrap.
Here's my sister-in-law safely wearing her toddler on her back (Tibetan tie) in a woven wrap while pregnant with her littlest one.
On a side note, are you aware that baby car seats are now warned only to use *in* cars, not as carriers out and about? They put babies at risk of low oxygenation & shouldn't be used as stroller systems and the like.
Infant safety in car seats and carriers
Here's one on other reasons to leave the car seat in the car:
Car Seats Are For Cars (Mothering Magazine)
My favorite sling/carrier overall is the Ergo, hands-down for comfort for long term (many hours straight babywearing) from newborn thru toddler years. It distributes baby's weight comfortably across both shoulders, around the hips via a padded waist belt, and across the back. It's safe for newborn when used w/ the extra infant insert or you can use receiving blankets to make a pocket of sorts so he/she doesn't slide down. It can be used without the infant insert around 15 lb or so. It's super easy to nurse from, while walking around, hands-free, without anyone seeing. It's so ergonomic (thus the name). It's safe thru 45 lb. Browse my Facebook photos and you will see Baby K in my chocolate brown Ergo in 90% of the photos. It's for front carry, back carry, or hip carry. If it tells you anything, it's the carrier that the Duggar family uses for their babies.
Here is a pic of me w/ Baby K in my Ergo (she's 15 months old here) and Trebor with her son in a Tre'Slings ring sling (and our friend Connie--hi, Connie!) at Chuck E. Cheese, chasing our older kids hands-free.
Other brands that offer a soft structured carrier similar in style to an Ergo are BabyHawk's Oh Snap!, Beco's Gemini (but NOT their Butterfly carrier, which has an internal harness and makes breastfeeding difficult while wearing baby in the carrier), and Boba Baby Carrier.
For a dressy sling (church, weddings, Christmas parties, graduations, baby showers, funerals, etc.), multi-purpose everyday sling, and for my water sling (pool, the beach, water park, hot summer days), I recommend ring slings from one of my best friends, Trebor Sutler. She's a SAHM who homeschools her 4 kids and makes these slings on the side. You can see pics of me wearing Baby K in her slings on her fan page under Fan Photos. Trebor's slings are top quality. The rings are safe for baby to teethe on, in addition to the superior sling craftsmanship. You can see comparison pricing from Sakura Bloom ring slings; a sling that Trebor charges $50-60 for would cost double that at Sakura Bloom. Trebor will ship your sling order anywhere.
Tre'Slings Facebook Fan Page
Ring slings are easy-on, easy-off, which makes them great for popping baby in and out when running errands. It folds very small, so it's easy to keep in your diaper bag for when baby *might* do OK sitting in the grocery cart, but will probably want out and want held in 10 minutes. It's very easy to nurse discreetly from a ring sling. Ring slings are adjustable, which makes them useful for more than one wearer of different builds/sizes. There is very little learning curve with a ring sling. They are quick and easy to use.
Here I am wearing Baby K in my cotton Tre'Sling:
My mesh water sling by Tre'Slings, pictured below, has been a lifesaver. Baby K *lived* in my water sling for our entire beach vacation last summer (when she was 9 months old). We also use it every time we take our kids to our local pool because our pools forbid anything inflatable, including swim wings and baby boats. This means that unless you have a Tre'Sling water sling, you have to either stay on the sidelines with your baby or hold a squirming, wet baby in your arms while in the water while trying to tend to your older kids. With my Tre'Slings water sling, I can actually manage to take our 4 kids ages 7 and under to the pool by myself!
Here's a beautiful photo of Kelly Moles wearing her beautiful baby girl in a Tre'Slings dressy sling at a formal ball. Don't you just love this pic?
Mei Tai carriers, also called Asian style carriers, are another very comfortable option. They are similar in feel and function to Ergo (front or back carry) but with ties instead of buckles. They can be used from newborn through toddler (30-35 lb). You can nurse from them, but a bit more effort: you must untie, reposition baby, then retie, as opposed to quick loosen-tighten strap with Ergo (then reverse the process when finished nursing, untying and retying).
BabyHawk makes top quality Mei Tai carriers from trendy fabrics.
Trebor (Tre'Slings) has made several gorgeous Mei Tais as well. They take longer to make than ring slings, so she doesn't advertise them, but may make them custom order. You can also find many beautiful Mei Tais on Etsy.
Here's my friend Lynette Berger's Facebook fan page for her WAHM business, Designs by Lynette (who made my dressy Mei Tai).
She makes gorgeous, quality Mei Tais. Mei Tais are supremely comfortable when made with a cotton woven fabric. I picked a fabric that was well suited to a ring sling (like the photo above of the red ring sling) but isn't well suited to a Mei Tai. It wasn't her fault; I picked it. That kind of dressy, silky fabric looks & feels great on a ring sling, but due to the Mei Tai straps, the silky fabric digs. Lynette is a great option for ordering a Mei Tai carrier, and has photos of several she has made. Her workmanship is the highest quality, and her fabrics are gorgeous. My pics are in her fan photos, too.
Here I am at a Christmas party wearing Baby K (at 13 months) in my dressy Mei Tai made by Lynette.
One popular carrier is the pouch sling (brands such as Hotsling and New Native Baby Carrier). While they *can* technically be used safely for newborns, I don't recommend them because most versions are not adjustable (unlike a ring sling which is similar in shape but infinitely adjustable for perfect fit) and thus are far more difficult to properly position your newborn. Especially for newborns, proper positioning to ensure an unobstructed airway is essential. Pouch slings can be useful for an older baby or toddler (4 months or older through 30 lb or so) in a hip carry position. They fold so compactly that they are about the size of a diaper, so they're great to take with you in the diaper bag when you're not sure whether your toddler will want up or down. Most versions are not adjustable for size, however, so keep that in mind if you want a carrier that more than one adult can use. Here's me carrying my son in hip carry in a New Native Baby Carrier pouch sling when he was 20 months old. Personally, I have used my pouch sling exclusively for about 1 year old through 3 years old for the hip carry position.
Please remember that bag style baby carriers were recalled and are always unsafe. Even if someone gives you one for free, please throw it away. They are the equivalent of sticking your baby in a duffel bag and hanging it over your shoulder. They put baby in danger of positional asphyxiation (chin-to-chest position restricting airway) as well as re-breathing carbon dioxide from the fabric obstructing baby's face. There is no way to safely wear a baby in these unsafe carriers. Here's an article showing what a bag style carrier is and why it's dangerous.
I also do not recommend "crotch-dangler" style baby carriers such as Baby Bjorn, Snugli, some Infantino carriers and other similar ones. These are not ergonomic for the parent or for the baby. For the baby, it can put undue pressure on the spine and just feel uncomfortable in general. For best spinal support, newborns' legs should be in the fetal position in slings, and older babies' legs should be in the "M" shape position with knees higher than bum (as described by this babywearing article).
As for mom or dad's back, "crotch-dangler" front carriers leave baby's legs hanging straight down. This pulls the child's weight away from the parent's body, causing unnatural strain on the parent's back and shoulders. Quality baby carriers position the baby/child in a similar position to one you would use when you carry him or her in your arms, and at the same height as you would carry him or her.
Allow me to demonstrate the difference.
When properly positioned, look how my daughter's weight is distributed evenly around my body, close to my center of gravity, with her legs wrapped around my waist (as they would be with any of the carriers I advocated above). Her legs are in the "M" shape (well, close to it--they would be in "M" shape if she were in an actual carrier as opposed to my arms).
Now compare that photo to the one below, which mimics the position of a front carry "crotch dangler" carrier. Look how her weight is pulled away from me, throwing off my center of balance as well as putting much strain on my back and shoulders.
Worse yet, the next photo mimics front-facing position with a "crotch-dangler" carrier such as a Baby Bjorn. If you thought the last photo looked uncomfortable, wait until you see this! I don't know how or why people carry their babies like this!
OK, that oughta get you started. ;-) Let me know when you've browsed all that and have more questions.
I was not paid in any way to give this review of baby carriers. The opinions stated are my own. There are many other brands of baby carriers that offer safe, quality carriers. I don't have the time or energy (or space) to list them all; this is a sampling. Baby K'Tan did provide a sample carrier for parents to try on in my Well Rounded Birth Prep babywearing classes. I paid full price for all my other carriers.
Do you have babywearing questions? Email me at wellroundedbirthprep (at) gmail (dot) com and I'll answer your question on my blog.
Edited to add:
"Strollers, baby carriers, and infant stress" is a fantastic article explaining why babywearing is what baby expects and needs biologically, physically, emotionally, and neurologically, while artificial baby carriers (strollers, car seats, swings, bouncy seats) should be used sparingly. Lots of photos, including baby's head molding as a result of spending too much time lying flat in a crib or in a car seat instead of being held.
One great site for comparing different styles, brands, and functions of slings/carriers is The Baby Wearer.
Babywearing Safety Facebook fan page is an excellent resource for positioning tips and other necessary safety tips. They have lots of links on safe positioning with various carriers.
There's more to baby positioning than this, but if I could tell you 2 quick laws for newborn positioning, they would be:
1. Baby's head should ALWAYS be close enough to kiss. This ensures that he is close enough for you to observe his breathing and that his airways are unobstructed.
2. Never allow baby to be in the chin-to-chest position, which can cause positional asphyxiation. You should be able to tuck (at least) two adult fingers between baby's chin and chest when baby is properly positioned.
Here's a quick video on safe positioning for newborn. It's shown with a ring sling but applies to all carriers for newborns.
The proper physiological position for a newborn is vertical between his mother's breasts. This helps them assimilate neurologically and benefits breastfeeding. Researchers have noted that cradle or other positions for newborns can confuse them and even potentially cause breastfeeding problems. Here's an excellent article outlining the physiology of proper babywearing positioning regardless of brand of carrier:
Babywearing: Safe Positioning
Love that link.
As for my personal preferences, I own 8 slings of various styles/brands, depending on the function & my outfit.
For newborn, I recommend a soft, stretchy wrap such as Moby Wrap, Sleepy Wrap, or Cuddly Wrap.
I don't know whether or where I have photos of me wearing our littlest one in our stretchy wrap when she was an infant, but here's one of my midwives, Jennifer Stewart, wearing Baby K in my stretchy wrap when K was 3 months old. (She's more than a midwife; she's my friend!)
One alternative to the stretchy wrap is a hybrid that's similar in function but fitted (not adjustable, must buy your tight fitted size) so it doesn't require wrapping: the Baby K'Tan. Personally, I do prefer the adjustability and versatility of a traditional wrap sling, but I realize that some parents are intimidated by wrapping one. That's when a Baby K'Tan is handy.
Stretchy wraps' websites say they are safe until 3 y.o. or so, which is true, but they are really not comfortable beyond 20 lb or so (in my humble opinion). The soft, T-shirt type of material stretches w/ the weight & doesn't provide as much support as a soft structured carrier (like an Ergo) does at that point.
For newborn stage through 4-6 months, I *love* a stretchy wrap. It has a teeny tiny learning curve, but worth it. I could teach you how to wrap it in 2 min or less. Easy to wrap & tie before you even leave the house & leave tied & throw your coat on over it & slide baby inside once you arrive at your destination. You don't have to untie/retie to get baby in & out.
Stretchy wraps also should never be used for back carry, despite what their websites say. This 56 second clip shows why.
Woven wraps, on the other hand, ARE safe for back carry (or front carry, for that matter). Here's a 58 second clip showing why woven wraps are secure with baby on back in the same scenario as above.
Some examples of a woven wrap are the GypsyMama Wrapsody and Ellaroo's wrap.
Here's my sister-in-law safely wearing her toddler on her back (Tibetan tie) in a woven wrap while pregnant with her littlest one.
On a side note, are you aware that baby car seats are now warned only to use *in* cars, not as carriers out and about? They put babies at risk of low oxygenation & shouldn't be used as stroller systems and the like.
Infant safety in car seats and carriers
Here's one on other reasons to leave the car seat in the car:
Car Seats Are For Cars (Mothering Magazine)
My favorite sling/carrier overall is the Ergo, hands-down for comfort for long term (many hours straight babywearing) from newborn thru toddler years. It distributes baby's weight comfortably across both shoulders, around the hips via a padded waist belt, and across the back. It's safe for newborn when used w/ the extra infant insert or you can use receiving blankets to make a pocket of sorts so he/she doesn't slide down. It can be used without the infant insert around 15 lb or so. It's super easy to nurse from, while walking around, hands-free, without anyone seeing. It's so ergonomic (thus the name). It's safe thru 45 lb. Browse my Facebook photos and you will see Baby K in my chocolate brown Ergo in 90% of the photos. It's for front carry, back carry, or hip carry. If it tells you anything, it's the carrier that the Duggar family uses for their babies.
Here is a pic of me w/ Baby K in my Ergo (she's 15 months old here) and Trebor with her son in a Tre'Slings ring sling (and our friend Connie--hi, Connie!) at Chuck E. Cheese, chasing our older kids hands-free.
Other brands that offer a soft structured carrier similar in style to an Ergo are BabyHawk's Oh Snap!, Beco's Gemini (but NOT their Butterfly carrier, which has an internal harness and makes breastfeeding difficult while wearing baby in the carrier), and Boba Baby Carrier.
For a dressy sling (church, weddings, Christmas parties, graduations, baby showers, funerals, etc.), multi-purpose everyday sling, and for my water sling (pool, the beach, water park, hot summer days), I recommend ring slings from one of my best friends, Trebor Sutler. She's a SAHM who homeschools her 4 kids and makes these slings on the side. You can see pics of me wearing Baby K in her slings on her fan page under Fan Photos. Trebor's slings are top quality. The rings are safe for baby to teethe on, in addition to the superior sling craftsmanship. You can see comparison pricing from Sakura Bloom ring slings; a sling that Trebor charges $50-60 for would cost double that at Sakura Bloom. Trebor will ship your sling order anywhere.
Tre'Slings Facebook Fan Page
Ring slings are easy-on, easy-off, which makes them great for popping baby in and out when running errands. It folds very small, so it's easy to keep in your diaper bag for when baby *might* do OK sitting in the grocery cart, but will probably want out and want held in 10 minutes. It's very easy to nurse discreetly from a ring sling. Ring slings are adjustable, which makes them useful for more than one wearer of different builds/sizes. There is very little learning curve with a ring sling. They are quick and easy to use.
Here I am wearing Baby K in my cotton Tre'Sling:
My mesh water sling by Tre'Slings, pictured below, has been a lifesaver. Baby K *lived* in my water sling for our entire beach vacation last summer (when she was 9 months old). We also use it every time we take our kids to our local pool because our pools forbid anything inflatable, including swim wings and baby boats. This means that unless you have a Tre'Sling water sling, you have to either stay on the sidelines with your baby or hold a squirming, wet baby in your arms while in the water while trying to tend to your older kids. With my Tre'Slings water sling, I can actually manage to take our 4 kids ages 7 and under to the pool by myself!
Here's a beautiful photo of Kelly Moles wearing her beautiful baby girl in a Tre'Slings dressy sling at a formal ball. Don't you just love this pic?
Mei Tai carriers, also called Asian style carriers, are another very comfortable option. They are similar in feel and function to Ergo (front or back carry) but with ties instead of buckles. They can be used from newborn through toddler (30-35 lb). You can nurse from them, but a bit more effort: you must untie, reposition baby, then retie, as opposed to quick loosen-tighten strap with Ergo (then reverse the process when finished nursing, untying and retying).
BabyHawk makes top quality Mei Tai carriers from trendy fabrics.
Trebor (Tre'Slings) has made several gorgeous Mei Tais as well. They take longer to make than ring slings, so she doesn't advertise them, but may make them custom order. You can also find many beautiful Mei Tais on Etsy.
Here's my friend Lynette Berger's Facebook fan page for her WAHM business, Designs by Lynette (who made my dressy Mei Tai).
She makes gorgeous, quality Mei Tais. Mei Tais are supremely comfortable when made with a cotton woven fabric. I picked a fabric that was well suited to a ring sling (like the photo above of the red ring sling) but isn't well suited to a Mei Tai. It wasn't her fault; I picked it. That kind of dressy, silky fabric looks & feels great on a ring sling, but due to the Mei Tai straps, the silky fabric digs. Lynette is a great option for ordering a Mei Tai carrier, and has photos of several she has made. Her workmanship is the highest quality, and her fabrics are gorgeous. My pics are in her fan photos, too.
Here I am at a Christmas party wearing Baby K (at 13 months) in my dressy Mei Tai made by Lynette.
One popular carrier is the pouch sling (brands such as Hotsling and New Native Baby Carrier). While they *can* technically be used safely for newborns, I don't recommend them because most versions are not adjustable (unlike a ring sling which is similar in shape but infinitely adjustable for perfect fit) and thus are far more difficult to properly position your newborn. Especially for newborns, proper positioning to ensure an unobstructed airway is essential. Pouch slings can be useful for an older baby or toddler (4 months or older through 30 lb or so) in a hip carry position. They fold so compactly that they are about the size of a diaper, so they're great to take with you in the diaper bag when you're not sure whether your toddler will want up or down. Most versions are not adjustable for size, however, so keep that in mind if you want a carrier that more than one adult can use. Here's me carrying my son in hip carry in a New Native Baby Carrier pouch sling when he was 20 months old. Personally, I have used my pouch sling exclusively for about 1 year old through 3 years old for the hip carry position.
Please remember that bag style baby carriers were recalled and are always unsafe. Even if someone gives you one for free, please throw it away. They are the equivalent of sticking your baby in a duffel bag and hanging it over your shoulder. They put baby in danger of positional asphyxiation (chin-to-chest position restricting airway) as well as re-breathing carbon dioxide from the fabric obstructing baby's face. There is no way to safely wear a baby in these unsafe carriers. Here's an article showing what a bag style carrier is and why it's dangerous.
I also do not recommend "crotch-dangler" style baby carriers such as Baby Bjorn, Snugli, some Infantino carriers and other similar ones. These are not ergonomic for the parent or for the baby. For the baby, it can put undue pressure on the spine and just feel uncomfortable in general. For best spinal support, newborns' legs should be in the fetal position in slings, and older babies' legs should be in the "M" shape position with knees higher than bum (as described by this babywearing article).
As for mom or dad's back, "crotch-dangler" front carriers leave baby's legs hanging straight down. This pulls the child's weight away from the parent's body, causing unnatural strain on the parent's back and shoulders. Quality baby carriers position the baby/child in a similar position to one you would use when you carry him or her in your arms, and at the same height as you would carry him or her.
Allow me to demonstrate the difference.
When properly positioned, look how my daughter's weight is distributed evenly around my body, close to my center of gravity, with her legs wrapped around my waist (as they would be with any of the carriers I advocated above). Her legs are in the "M" shape (well, close to it--they would be in "M" shape if she were in an actual carrier as opposed to my arms).
Now compare that photo to the one below, which mimics the position of a front carry "crotch dangler" carrier. Look how her weight is pulled away from me, throwing off my center of balance as well as putting much strain on my back and shoulders.
Worse yet, the next photo mimics front-facing position with a "crotch-dangler" carrier such as a Baby Bjorn. If you thought the last photo looked uncomfortable, wait until you see this! I don't know how or why people carry their babies like this!
OK, that oughta get you started. ;-) Let me know when you've browsed all that and have more questions.
I was not paid in any way to give this review of baby carriers. The opinions stated are my own. There are many other brands of baby carriers that offer safe, quality carriers. I don't have the time or energy (or space) to list them all; this is a sampling. Baby K'Tan did provide a sample carrier for parents to try on in my Well Rounded Birth Prep babywearing classes. I paid full price for all my other carriers.
Do you have babywearing questions? Email me at wellroundedbirthprep (at) gmail (dot) com and I'll answer your question on my blog.
Edited to add:
"Strollers, baby carriers, and infant stress" is a fantastic article explaining why babywearing is what baby expects and needs biologically, physically, emotionally, and neurologically, while artificial baby carriers (strollers, car seats, swings, bouncy seats) should be used sparingly. Lots of photos, including baby's head molding as a result of spending too much time lying flat in a crib or in a car seat instead of being held.
Subscribe to:
Posts (Atom)