published on Sunday, December 27, 2009 8:33 PM MST

By RACHEL HERGETT Chronicle Staff Writer

Cindy Maxwell answered her door last week with her 14-month-old son Titus tight against her front, sleeping snugly in a colorful Sakura Bloom ring sling.
Titus snored away with his mom rubbing his back, oblivious to the world around him.

This, Maxwell said, is one of many reasons she is a steadfast supporter of the concept of babywearing, which is exactly what the term says: wearing or carrying a child in a sling or other carrier.

“You don’t have to do anything to comfort them, or entertain them, or appease them, because they’re already comforted,” she said.

Maxwell, 26, carried son Corban, 4, in a Bjorn front carrier and a framed backpack, but was not entirely comfortable and only carried him on occasion. Then, when she had daughter Jaelle, 2, a friend lent her a stretchy wrap, and she was hooked.

Maxwell started the BabyWearers of Bozeman in June 2008, a group that meets monthly to help each other with certain types of carriers and discuss their shared interest in the practice. She also does private consultations for parents interested in learning how to use different types of carriers effectively.

BabyWearers of Bozeman also has a lending library with around 60 different carriers for mothers (or fathers) to test.

“They can try out not only the type, but different brands within that type,” Maxwell said.

That way, parents are able to find which type of carrier — everything from slings to stretchy and woven wraps — works best for them and feels the most comfortable.

Aside from more abstract benefits, wearing a baby is practical for people’s busy daily lives.

“The number one thing that I tell parents is that they have hands free,” Maxwell said.

Parents are then able to go about their daily lives — doing laundry, cooking, playing with (or, as Maxwell said “chasing around”) older children — without having to constantly shift a baby in their arms or on their hip with no external support.

Dr. William Sears and Martha Sears, a registered nurse, who run www.askdrsears.com, tout babywearing in their pediatric practice.

According to the site, social development is actually expedited because parents have more communication with their child. And the children learn about the environment around them, too.

“Sling babies spend more time in the state of quiet alertness,” the site states. “This is the behavioral state in which an infant is most content and best able to interact with his environment.”

Other sites, including a couple Maxwell moderates and accessible through links on Maxwell’s blog, have a multitude of information on babywearing practices and benefits.

While some parents worry about attachment to parents, wearing a child for a while each day is shown to make them more independent.

“Babies who are worn are more independent at an earlier age,” said Maxwell, who wears Titus five or six hours a day. “They are free to be independent because they don’t want their mother’s comfort. They already have it.”

The only problem Maxwell can see with babywearing is the stigma sometimes associated with it. In the United States, the idea is most closely connected with down-to-earth mothers, or “hippy” culture.

“They don’t see it as being hip or mainstream,” she said.

But for Maxwell, and many mothers around the world, being in constant contact with their children has nothing to do with class or stigma.

“It’s all about just bonding with your baby,” Maxwell said.

And in about 30 more weeks, she’ll have a fourth child to bond with.

“I have one more baby to carry, then that’s probably it,” Maxwell said.

BabyWearers of Bozeman meets at the Bozeman Birth Center at 10 a.m. on the second Wednesday of every month. From more information, visit the blog at http://bwbozeman.com/ or e-mail info@bwbozeman.com.

Rachel Hergett may be reached at rhergett@dailychronicle.com or 582-2603.

The ingredient called pancreatic secretory trypsin inhibitor (PSTI), is found at its highest levels in colostrum – the milk produced in the first few days after birth.

Researchers found that PSTI stimulated cells to form a natural protective ‘plaster’ over damaged intestinal cells.

The molecule also helps prevent further damage by stopping cells in the intestine from self-destructing.

Experts at Queen Mary, University of London, found that PSTI could reduce damage by 75 per cent.

Professor Ray Playford, who led the study, said: “This study is important because it shows that a component of breast milk protects and repairs the babies delicate intestines in readiness for the onslaught of all the food and drink that are to come.”

Prof Playford, of Barts and the London School of Medicine and Dentistry, part of Queen Mary, added: “It reinforces the benefits of breast feeding, especially in the first few days after birth.”

The lining of a newborn baby’s gut is particularly vulnerable to damage as it has never been exposed to food or drink.

Researchers found small amounts of PSTI in all the samples of breast milk they tested but it was seven times more concentrated in colostrum samples. The ingredient was not found in formula milk.

PSTI is a molecule which is normally found in the pancreas where it protects the organ from being damaged by the digestive enzymes it produces.

http://www.telegraph.co.uk/health/healthnews/5688590/Breast-feeding-protects-babies-from-stomach-damage-study-finds.html

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Following a dramatic fall through the 20th century, the U.S. infant mortality rate — the proportion of babies who die before they reach their first birthday — has leveled off at just under seven deaths per 1,000 live births. That’s a much higher rate than in other parts of the developed world. Across the European Union, for example, fewer than five in 1,000 babies die before they turn one. And in some stand-out countries like Japan, Singapore, Sweden and Norway, the proportion of babies who die is less than half that in the United States. Marian MacDorman, a statistician at the U.S. National Center for Health Statistics (NCHS), helps explain.

Q: Why do U.S. babies die more often than babies in other wealthy countries?

A: The U.S. ranks rather poorly compared to most developed countries. NCHS publishes a book each year called Health, United States, which has international rankings, and in the latest [edition], which ranks data based on the 2004 data year, the U.S. ranked 29th in the world in infant mortality.

One of the main [factors] is whether the baby is delivered too small or too soon, which increases its chances of death. About two-thirds of all of our infant deaths occur among the 8.2% of babies that are born at low birth weight. Most developed countries have lower rates of preterm and low birth weight deliveries [than the U.S.] and that makes a difference in infant mortality rates.

I think the single most important thing we can do to lower the rate of infant mortality is to reduce the rate of preterm birth. But in fact the trend is going in the opposite direction — that rate [in the U.S.] is increasing. There are several causes of preterm birth. One is spontaneous preterm labor. But there’s another component, which is medical intervention — for example, doing a preterm caesarean section or induction of labor. That component has been increasing as well, and I think that’s worrisome.

There are a lot of doctors who say it’s O.K. to take a baby out a little bit early because they’re going to do well — and it’s true. It’s only seven per 1,000 that are dying. Most of them do well. But still I think it’s important to note that the infant mortality rate for late-preterm infants is three times what it is for [full-]term infants. This is not a difference that may be perceptible to the average obstetrician/gynecologist doing 300 deliveries a year. But when you’re a statistician like me and you’re grouping millions of births and thousands of infant deaths, you can see a difference there. Basically the longer that baby can stay in utero, the better it’s going to do.

There are also really large differences in infant mortality rates by race and ethnicity. For 2004, the overall [U.S.] infant mortality rate was 6.78; but for non-Hispanic black mothers it was 13.60. It was also fairly high for American Indian mothers: 8.45. For non-Hispanic whites, it was 5.66. For Hispanics it was 5.55. And the lowest was for Asian or Pacific Islander mothers, which was 4.67. So there’s a huge range there. The rate for non-Hispanic black mothers was 2.4 times the rate for Hispanic or non-Hispanic white mothers.

Non-Hispanic black women have much higher rates of preterm and low-birth-weight delivery. Why that is we’re not exactly sure. But if you look at any of a wide variety of risk factors related to infant mortality, you can find differences between blacks and whites and between different races and ethnic groups. For example, a higher percentage of births to non-Hispanic black and American Indian mothers occurred to mothers who did not receive adequate prenatal care, were unmarried or were teenagers, were having a fourth or higher order birth, or had not completed high school. Certainly, if you take into account these kind of factors, the racial disparity lessens, but it doesn’t completely go away. Part of this racial disparity remains really unexplained. I think that’s something that researchers have really been struggling with for decades, and there are no simple answers.

http://www.time.com/time/health/article/0,8599,1736042,00.html

http://www.nytimes.com/2009/04/22/health/research/22breast.html?ref=health

Home births ‘as safe as hospital’

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.
“ The NHS is simply not set up to meet the potential demand for home births ”
Louise Silverton Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.
“ Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital ”
RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”

Story from BBC NEWS:

http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7998417.stm

Published: 2009/04/15 08:08:24 GMT

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