Valerie Gommon Midwife’s Blog

Archive for the ‘www.guardian.co.uk’ Category

In a paper published yesterday in the British Medical Journal researchers from the University of London Institute of Child Health (UCL) claim that relying purely on breastfeeding for the first six months might not be best for babies. Interestingly, the study “acknowledges that three or four of the authors have performed consultancy work and/or received research funding from companies manufacturing infant formula” which brings into question the validity of the research; a further criticism is that research needs to be population specific.

Today, many prominent organisations have spoken against this paper, however it is confusing for members of the public and undermines the work that midwives and others do to promote breastfeeding.

The current advice in the United Kingdom based on World Health Organisation guidelines, says that babies should be exclusively breastfed for 6 months however the UCL team say that weaning could happen as early as four months as it is claimed that the later weaning might increase food allergies and lead to nutrient deficiencies.  This statement is heralded as a “retrograde step” by the Royal College of Midwives professional policy adviser Janet Fyle and others.   Indeed a Department of Health spokeswoman said: “Breast milk provides all the nutrients a baby needs up to six months of age and we recommend exclusive breastfeeding for this time. Mothers who wish to introduce solids before six months should always talk to health professionals first.

In summary the current best advice is to exclusively breastfeed for six months and then to continue breastfeeding with food supplements for at least a year.

Further discussion can be found at:
www.guardian.co.uk/lifeandstyle/2011/jan/14/breastfeeding-comment-joanna-moorhead

There is an excellent article in The Guardian discussing the pros and cons of going overdue http://www.guardian.co.uk/lifeandstyle/2010/oct/01/pregnant-for-10-months

Although many women are very “fed up” by the end of pregnancy it is worth thinking about the risks and benefits of accepting a hospital induction.  It is also worth noting that different doctors and different hospitals set wide ranging dates for induction so there is clearly room for discussion with your midwife or doctor about if and when you should be induced.

Remember no one can force you to be induced!

The most important thing to remember is that you should monitor your baby’s movements – although the movements will change towards the end of the pregnancy as the baby runs out of room s/he should still move in his/her usual pattern.  Another important thing to monitor is that your bump continues to grow and is not getting smaller.  If you are at all concerned speak to your midwife or local maternity unit.

Understandably, one of the “hot topics” of the moment is should pregnant women accept the Swine Flu vaccine.

On discussions with women I have met with many women who are concerned about the vaccine and unsure whether to be vaccinated

Pregnant women are not known to be more susceptible to catching swine flu but if they do the risk of complications is higher because their immune system is naturally suppressed and the Department of Health is recommending and prioritising the vaccine for pregnant women.  It is important to remember that for the vast majority of people (including pregnant women) that, although unpleasant, influenza is self-limiting and the vast majority of people will make a quick recovery.  Should a pregnant women develop flu the recommended treatment is early instigation of antiviral therapy.

www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/@sta/@perf/documents/digitalasset/dh_107768.pdf

Recent Department of Health advice is available at: www.dh.gov.uk/en/Publichealth/Flu/Swineflu/DH_107340

Obviously if you are unwell do follow the Government’s advice http://www.direct.gov.uk/en/Swineflu/DG_177831 or contact your doctor or midwife for advice.

However a recent Guardian article quoted a survey, published by the website mumsnet.com, confirmed the uncertainty felt as almost half – 48% – of pregnant women who responded said they probably or definitely would not have the jab if it is available. Only 6% said they definitely would and 22% said they probably would.

http://www.guardian.co.uk/world/2009/sep/02/swine-flu-vaccine-pregnant-women

Another recent article www.examiner.com/x-4079-SF-Sexual-Health-Examiner~y2009m10d23-California-suspends-ban-on-thimerosal-containing-H1N1-vaccine-for-pregnant-women  also raises concerns about the immunisation programme.

I am unsure which vaccine is being given to pregnant women in the UK – this may be something for you to research further.

Good luck with your decision making.

When a mum is breastfeeding she is giving her baby the very best – breastmilk is full of antibodies and is therefore hugely protective.

The Department of Health has issued advice on what to do when breastfeeding if you have contracted the flu.  If a mum is receiving antiviral treatment or prophylaxis, they are advised to continue to breastfeed as frequent as possible and continue to have as much skin to skin contact as possible with the baby.  Ensuring hands are washed as frequent as possible as well as limiting the sharing of toys.

For more information on breastfeeding and swine flu go to www.dh.gov.uk/en/Healthcare/Children/Maternity/Maternalandinfantnutrition/DH_099965

An interesting article in The Guardian today discussing the increased risks for women over 35 when planning pregnancies. www.guardian.co.uk/society/2009/jun/15/older-mothers-health-risks

The Royal College of Obstetricians and Gynaecologists (RCOG) suggest that women should become mothers by the age of 35 or risk infertility, miscarriage and health problems.  It is suggested that the optimum time to have a baby is between 20 and 35 years of age.

Both the RCOG and the Royal College of Midwives (RCM) however do support a women’s right to have children as later, but recognise that many women are simply unaware of the increased risks for older mothers and that that using fertility treatment is not a guarantee of success.

Excellent information on preconception issues can be found at:

https://midwifevalerie.wordpress.com/2008/12/05/planning-a-baby/www.haveababy.com
www.womantomother.co.uk
www.foresight-preconception.org.uk
www.zitawest.com

www.eatwell.gov.uk/agesandstages/pregnancy/whenyrpregnant/

Freebirthing or unassisted birth has been discussed in the media over the past year or so; freebirthing is when a woman or couple decide to give birth with no medical input.

Last year there was a Channel 5 documentary called Extraordinary People: Outlaw Births http://freebirthing.org/ which gave a fascinating insight into three women’s experiences and reasons for taking this unusual route.  For some women they just feel “in tune” and “in control” of their lives and bodies and feel no need to seek a professional who may interfere with the process and their wishes, for others like Janet Fraser www.joyousbirth.info it is a reaction against what she calls “birth rape” (birth interventions done against the woman’s wishes) at a previous birth;  for others it may be unintentional and that the baby just comes faster than expected www.guardian.co.uk/society/2009/apr/30/father-delivers-baby-youtube-clips

Obviously as a midwife I would not suggest that women give birth without medical aid; however I do understand that for some women birth is a private, intimate affair and I certainly understand that women who have been subjected to any violence whether that be sexual abuse, “birth rape” or any other emotional challenges may find intimate examinations extremely difficult.

I have encountered women who are unable to labour in my presence, and who wish absolutely minimal intervention.  I have also heard of women wishing to give birth alone but who have allowed a midwife to sit in the next room just in case help is required.  I believe this to be far preferable to giving birth alone and would be willing to support a client in this way www.3shiresmidwife.co.uk.  Women should remember that it is an assault for any medical professional to do anything to them against their wishes; this includes measuring blood pressure, the administration of any drug or intimate examinations.

I have recently learnt that Janet Fraser gave birth to her last baby without assistance and that sadly this baby did not make it.  It is unclear whether her baby had died in utero and whether medical help would have saved her baby, but it does highlight the dangers of unassisted birth.

Further information and support can be obtained from:

www.sheilakitzinger.com/birthcrisis.htm
www.unassistedchildbirth.com


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