Breastfeeding. Sunday May 16, 2010 2 pm to 6 pm

Content: why is breastfeeding good for the baby, why is breastfeeding good for the mother, how to get off to a good start and avoid problems down the line, how does milk production work, how to ensure you have enough milk, how can you tell whether baby is getting enough milk, feeding on cue versus feeding on schedule, sore nipples and other breastfeeding complication, lots of pictures and videos about how to get the baby on the breast correctly (to avoid damage to the nipples and ensure proper milk flow), when to express milk, how to express milk, how to safely store milk, using artificial nipples (bottles and pacifiers), herbs and foods to increase supply, breastfeeding and illness, breastfeeding and medications

Handouts: breastfeeding cheat sheet

Fees and organization

Private classes: HUF 10 000 per occasion

Group classes: HUF 5000 per couple for groups

Location: Életkör, II. Szilágyi Erzsébet fasor 43/b, 3rd floor #3 (Életkör buzzer – keep pressing continuously to be let in!)

Please RSVP so I know how many handouts to bring! And feel free to forward this email to anybody you think may be interested.

The following Bill of Rights was written with American women in mind, but most of it holds true for conditions in Hungary. In fact, in Hungary, medical establishments and doctors may be even more cavalier about obtaining informed consent from their patients. Nonetheless, you have the right to make informed decisions concerning procedures (most of which are actually not supported by medical literature – see emphasis in text below) about to be used on you and your child. Stick up for yourself! You have the right.
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THE PREGNANT PATIENT’S BILL OF RIGHTS

Many pregnant women are not fully aware of their right of informed consent or of the obstetricians’ legal obligation to obtain their patient’s informed consent prior to treatment. The American College of Obstetricians and Gynecologists (ACOG) first publicly acknowledged the physician’s legal obligation to obtain his or her pregnant patient’s informed consent in its 1974 publication, Standards for Obstetric-Gynecologic Services, (pg 66-67) which reads:

“It is important to note the distinction between ‘consent’ and ‘informed consent’. Many physicians, because they do not realize there is a difference, believe they are free from liability if the patient consents to treatment. This is not true. The physician may still be liable if the patient’s consent was not informed. In addition, the usual consent obtained by a hospital does not in any way release the physician from his legal duty of obtaining an informed consent from his patient.

“Most courts consider that the patient is ‘informed’ if the following information is given:

• The processes contemplated by the physician as treatment, including whether the treatment is new or unusual.
• The risks and hazards of the treatment.
• The chances for recovery after treatment.
• The necessity of the treatment.
• The feasibility of alternative methods of treatment.

“One point on which courts do agree is that explanations must be given in such a way that the patient understands them. A physician cannot claim as a defense that he explained the procedure to the patient when he knew the patient did not understand. The physician has a duty to act with due care under the circumstances; this means he must be sure the patient understands what she is told.

“It should be emphasized that the following reasons are not sufficient to justify failure to inform:

• That the patient may prefer not to be told the unpleasant possibilities regarding the treatment.
• That full disclosure might suggest infinite dangers to a patient with an active imagination, thereby causing her to refuse treatment.
• That the patient, on learning the risks involved, might rationally decline treatment. The right to decline is the specific fundamental right protected by the informed consent doctrine.”

American parents are becoming increasingly aware that well-intentioned health professionals do not always have scientific data to support common American obstetrical practices, and that many of these practices are carried out primarily because they are part of medical and hospital tradition.

The distingquished obstetrician Dr. Roberto Caldeyro-Barcia, while President of FIGO, the world congress of obstetricians-gynecologists, cautioned two decades ago:

“In the last forty years many artificial practices have been introduced which have changed childbirth from a physiological event to a very complicated medical procedure in which all kinds of drugs are used and procedures carried out, sometimes unnecessarily, and many of them potentially damaging for the baby and even for the mother”.

A growing body of research makes it alarmingly clear that every aspect of traditional American hospital care during labor and delivery must now be questioned as to its possible effect on the future well-being of both the obstetric patient and her unborn child.

There has been a three hundred percent increase in the rate of autistic children in the United States in just one decade. One in every 35 children born in the United States today will eventually be diagnosed as retarded; in 75% of these cases there is no familial or genetic predisposing factor. One in every 10 to 17 children has been found to have some form of brain dysfunction or learning disability requiring special treatment. Such statistics are not confined to the lower socioeconomic group but cut across all segments of American society.

New concerns are being raised by childbearing women because no one knows how drug induced changes in brain chemistry, oxygen depletion, head compression, traction and skull fracture by both forceps and vacuum extractor the fetus and newborn infant can tolerate before that child sustains permanent brain damage or dysfunction. The findings regarding the cancer-related drug diethylstilbestrol have alerted the public to the fact that neither the approval of a drug by the U.S. Food and Drug Administration nor the fact that a drug is prescribed by a physician serves as a guarantee that a drug or medication is safe for the mother or her unborn child. In fact, the American Academy of Pediatrics’ Committee on Drugs has stated that there is no drug, whether prescription or over-the-counter remedy, which has been proven safe for the unborn child.

The Pregnant Patient has the right to participate in decisions involving her well-being and that of her unborn child, unless there is a clearcut medical emergency that prevents her participation. In addition to the rights set forth in the American Hospital Association’s “Patient’s Bill of Rights,” the Pregnant Patient, because she represents TWO patients rather than one, should be recognized as having the additional rights listed below.

• The Pregnant Patient has the right, prior to the administration of any drug or procedure, to be informed by the health professional caring for her of any potential direct or indirect effects, risks or hazards to herself or her unborn or newborn infant which may result from the use of a drug or procedure prescribed for or administered to her during pregnancy, labor, birth or lactation.
• The Pregnant Patient has the right, prior to the proposed therapy, to be informed, not only of the benefits, risks and hazards of the proposed therapy but also of known alternative therapy, such as available childbirth education classes which could help to prepare the Pregnant Patient physically and mentally to cope with the discomfort or stress of pregnancy and birth. Such classes have been shown to reduce or eliminate the Pregnant Patient’s need for drugs and obstetric intervention and should be offered to her early in her pregnancy in order that she may make a reasoned decisions.
• The Pregnant Patient has the right, prior to the administration of any drug, to be informed by the health professional who is prescribing or administering the drug to her that any drug which she receives during pregnancy, labor and birth, no matter how or when the drug is taken or administered, may adversely affect her unborn baby, directly or indirectly, and that there is no drug or chemical which has been proven safe for the unborn child.
• The Pregnant Patient has the right if Cesarean birth is anticipated, to be informed prior to the administration of any drug, and preferably prior to her hospitalization, that minimizing her intake of nonessential pre-operative medicine will benefit her baby.
• The Pregnant Patient has the right, prior to the administration of a drug or procedure, to be informed of the areas of uncertainty if there is NO properly controlled follow-up research which has established the safety of the drug or procedure with regard to its on the fetus and the later physiological, mental and neurological development of the child. This caution applies to virtually all drugs and the vast majority of obstetric procedures.
• The Pregnant Patient has the right, prior to the administration of any drug, to be informed of the brand name and generic name of the drug in order that she may advise the health professional of any past adverse reaction to the drug.
• The Pregnant Patient has the right to determine for herself, without pressure from her attendant, whether she will or will not accept the risks inherent in the proposed treatment.
• The Pregnant Patient has the right to know the name and qualifications of the individual administering a drug or procedure to her during labor or birth.
• The Pregnant Patient has the right to be informed, prior to the administration of any procedure, whether that procedure is being administered to her because a) it is medically indicated, b) it is an elective procedure (for convenience, c) or for teaching purposes or research).
• The Pregnant Patient has the right to be accompanied during the stress of labor and birth by someone she cares for, and to whom she looks for emotional comfort and encouragement.
• The Pregnant Patient has the right after appropriate medical consultation to choose a position for labor and birth which is least stressful for her and her baby.
• The Obstetric Patient has the right to have her baby cared for at her bedside if her baby is normal, and to feed her baby according to her baby’s needs rather than according to the hospital regimen.
• The Obstetric Patient has the right to be informed in writing of the name of the person who actually delivered her baby and the professional qualifications of that person. This information should also be on the birth certificate.
• The Obstetric Patient has the right to be informed if there is any known or indicated aspect of her or her baby’s care or condition which may cause her or her baby later difficulty or problems.
• The Obstetric Patient has the right to have her and her baby’s hospital- medical records complete, accurate and legible and to have their records, including nursing notes, retained by the hospital until the child reaches at least the age of majority, or, alternatively, to have the records offered to her before they are destroyed.
• The Obstetric Patient, both during and after her hospital stay, has the right to have access to her complete hospital-medical records, including nursing notes, and to receive a copy upon payment of a reasonable fee and without incurring the expense of retaining an attorney.

It is the obstetric patient and her baby, not the health professional, who must sustain any trauma or injury resulting from the use of a drug or obstetric procedure. The observation of the rights listed above will not only permit the obstetric patient to participate in the decisions involving her and her baby’s health care, but will help to protect the health professional and the hospital against litigation arising from resentment or misunderstanding on the part of the mother.

Prepared by Doris Haire ©2000

American Foundation for Maternal and Child Health

Source

Pre-conception

Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health

Fertility awareness is a scientifically proven, but little known method of birth control. It can also help you in optimizing your chances of conceiving. The book comes with thorough and practical explanations of your cycle, and how to tell when you’re most fertile.

Pregnancy

What to Expect When You’re Expecting

Some people call this book alarmist, but I say if you’re not looking at it as a list of mandatory pregnancy problems that you must check off one by one before you have your baby, than it can be a really valuable resource to provide reassuring answers to all your pregnancy related questions. If you’ve ever wondered “is it normal that…” then this book is for you.

The Complete Book of Pregnancy and Childbirth

Sheila Kitzinger provides an in-depth look at mother and baby’s emotional and physical development during pregnancy, and a candid view of what happens in birthing rooms at hospitals, how to have a woman-centered, positive birth experience, and how the birth partner can help.

Labor

Ina May’s Guide to Childbirth

Ina May is an amazing midwife in the United States. She and others like her established The Farm birthing center, where intervention and C-section rates are so low that hospitals go there to learn how they are doing it! In this book, Ina May begins with dozens of birth stories from women who have given birth on The Farm. The second half of the book is a clear, and unique, discussion of how birth works, and how women can prepare for a natural, satisfying birth experience. She also discusses the scientific evidence – or lack thereof – behind many obstetrical procedures.

Natural Childbirth the Bradley Way

This book has given me so many “yes, yes, YES!” moments as I was reading it, both as a mother and as a childbirth educator, that I can only recommend it. It gives really concrete, tangible, practical tips for having a natural, intervention-free birth, and clearly explains the risks associated with routine hospital interventions. Most importantly, it provides very concrete instructions for both the mother and her partner for what to do before and during labor for a good birth experience.

Baby care

Your Baby and Child: From Birth to Age Five

Penelope Leach provides clear, sensitive descriptions of baby’s physical, emotional, social development and also offers unbiased discussion of parenting choices. Best of all, she also includes very practical tips for how to, for example, calm newborns, make bathtime enjoyable, how to decide where baby should sleep, how to handle sibling rivalry, and much, much more. The book includes gorgeous color photographs that are very instructive (like the picture of the difference between colostrum, foremilk and hindmilk).

Breastfeeding

The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solving Guide to Breastfeeding from the Foremost Expert in North America

Dr. Jack Newman is one of today’s foremost lactation experts. His book provides practical information on how to overcome any and all breastfeeding difficulties you might run into.

Nausea is one of the most common symptoms of pregnancy, which happily fades of its own accord somewhere around the beginning of the second trimester (around week 12) for most women. It is often called morning sickness, which is a complete misnomer, as it can occur at any time of day.

Some consider this nausea to be a protective factor, discouraging the mother from ingesting anything potentially dangerous to the developing fetus.

There are some things that are known to make nausea worse. For many women, being hungry (low blood sugar) paradoxically triggers nausea, so try carrying around some bland food items to chew on, like crackers or rice puffs. If you find that nausea is worst in the morning (which is after a long period of fasting when your blood sugar levels are lowest), be prepared with a few crackers or some sweetened tea on your nightstand to raise your blood sugar first thing after waking up. Try to eat more frequent, but smaller meals throughout the day to keep your blood sugar levels even. Also make sure you get enough protein, and that your meals are balanced between carbohydrate and protein content.

Pregnant women are generally more sensitive to smells and tastes, which also means that strong smells and tastes are now more likely to make you gag. Avoiding trigger smells/tastes and keeping up good oral hygiene (brushing your teeth) could help you with this problem. Also consider mints or chewing gum to drown out unpleasant smells and tastes.

Iron, which can be found in high concentrations in most prenatal vitamin formulations, can also cause nausea. If you notice that your nausea peaks right after taking your prenatal vitamin (regardless of the time of day when you take it), consider switching to a formulation with less iron, or taking folic acid supplements in addition to consuming a varied diet instead of taking a prenatal vitamin supplement. Folic acid is the only supplement that has actually been shown to prevent fetal abnormalities.

Some anti-nausea remedies:

Mint. Peppermint especially is known to settle the stomach. Try drinking it in tea form, or take it as candy, or chewing gum, whatever works best.

Ginger. Fresh ginger is best, but in a pinch, ginger ale may work, too.

Water. Keeping hydrated is important anyway, but the feeling of a dry mouth may trigger nausea. Drink up!

Acupressure wristbands. Can’t hurt to try!

Vitamin B6. Available in Hungary without a prescription as MagneB6 (includes a magnesium supplement), vitamin B6 has been shown to reduce nausea in the first trimester. If you’re wary of adding artificial supplements to your diet, try increasing your vitamin B6 intake by eating more bananas or baked potatoes with the skin on, both excellent sources.

If you find that your nausea prevents you from getting adequate nutrition, or that you literally cannot keep food down, consult your doctor as soon as possible. There are anti-nausea medications on the market, though these are not widely prescribed in Hungary.

The subject of constipation, and whether or not it is normal in the first trimester came up at our last mommy-baby group, so here’s a little bit of information about this first-trimester nuisance.

The short answer is that yes, constipation is a very common symptom in the first trimester because pregnancy hormones make peristaltic movements more sluggish and make muscles loose, which slows down the passage of stools. The uterus, now the size of a grapefruit, also puts pressure on the bowel, inhibiting its normal activity.

What can you do?

1. Eat fiber-rich foods

Fiber is the key to keeping bowel movements regular. And nothing beats fresh, raw fruit and vegatbles for fiber content. Other fiber-rich choices include whole grains, and products made from them, legumes (pulses) like beans and peas, and dried fruit, especially plums. Adding a sprinkling of linseeds to yogurt or other foods also helps.

Foods to avoid include ones made with refined white flour.

Eating less but more often may also help to make you feel more comfortable.

2. Drink plenty of fluids

Fluid is required to keep stools soft and helping it keep moving along the digestive tract, so drinking more will definitely help. Some people swear by hot water flavored with freshly squeezed lemon juice, while others find 100% fruit juice (especially prune) very effective.

3. Don’t hold your bowel movements

Holding on to your bowel movements regularly may weaken the muscles and lead to constipation. Allow yourself time to go to the bathroom. It is said that one mugful of food or drink at breakfast is enough to trigger bowel activity, so if you’ve been in the habit of skipping breakfast, try eating or drinking something that’s about a mugful in volume, and allow yourself time to use the bathroom before you have to dash off to work.

4. Check your supplements and medications

Calcium and iron can cause constipation, see if any of the supplements or medications you are taking contains these elements, and discuss with your doctor the possibility of not taking them or using something else. Many prenatal vitamin formulations have high levels of iron. Try switching to a lower-iron formulation and see if it helps. (If you cannot find one here in Hungary, you can always switch to taking the most essential pregnancy vitamin, folic acid, separately.)

5. Exercise!

If you move, your bowels move. Keeping active encourages an active bowel, so try to find an exercise regime that you enjoy and that does not strain you overtly compared to your pre-pregnancy activity level. If you are not at high risk for miscarriage (i.e., have a history of miscarriages or some other health problem), there is no reason you cannot take up walking or swimming as a mode of exercise during pregnancy. If you were used to jogging or aerobics, you can continue as before. Only highly jarring sports or sports where the likelihood of falling is high are discouraged, such as skiing, horseback riding, bungee jumping…

(Then again, I never saw a pregnant woman who suddenly had a desire to take up bungee jumping in her first trimester…)

When: Every Wednesday from 10 am to 12 pm
Where: NEW LOCATION!! II. Szilágyi Erzsébet fasor 43/b, 3rd floor #3, Életkör buzzer. By public transportation: Városmajor utca stop on the 61 tram.

This is an informal support group for women to talk about their questions and experiences with pregnancy, particularly being pregnant and giving birth in Hungary, as well as questions about life with a small baby, breastfeeding, sleeping, etc. Older siblings are welcome too! There is no appointment necessary, just show up whenever it is convenient for you! This group is free of charge.

Please spread the word!