Pregnancy Leave Laws

An Attorney friend of mine wrote this great article about Pregnancy Leave at Work. 
He educates employers and Business Owners, on employment law. 

I though this article was very relevant to everything Mommies, so Why Not! If you have a business and would like his advice, information is:

Natural Recipe For Killing Cockroaches "Roach Balls"

Natural Recipe For Killing Cockroaches "Roach Balls"

As you may agree, natural health is an all encompassing lifestyle for some of us. I try to keep pesticides away from my home as much as possible. My Husband found this very effective recipe on line and it got rid of roaches for us in a FEW days! 

I can't guarantee it will work the same for you, but I believe it will help tremendously. 

Other reasons roaches persist are, food or other left overs of many things which are  edible items to them including: Skin dander, hair, cardboard, paper, etc. 

Because of this, I recommend a thorough deep cleaning, a strict cleaning routine, as in a thorough periodic cleaning every week, including behind and under furniture, moping floor fully- not just wet wiping floors. Washing carpets with natural soaps on a cyclic schedule, as in every few months or at least twice a year. As well as routine de-kludge (getting rid of old things, getting rid of unneeded items, bags, cardboard, paper, things in storage boxes, etc.) Anything which attracts the attention of many a pest. 

This also helps you clear your mind as well and open up your space- for lack of a better word- to other new things coming into your life. I've always found it very therapeutic. I do it every six month or so, if the house has been particularly busy or has had extra use so to speak, as in guests or extra activity, I do it every 3 months. 

I hope this helps to rid you of some nasty little critters. 

Much Love,

Claudia 

RECIPE: 

White Flour
Boric Acid
Confectioners (Powdered) Sugar 

• Mix 50/50 flour and boric acid. Sprinkle in some confectioners sugar (about 1/4 of the amount of flour used). Make a dough by adding in water, don’t make it runny.
• Roll the dough into small marble sized balls and place them in corners, dark cupboards, behind heavy appliances, along floor boards and around the garbage.

Within a month the critters should be gone.

If the infestation is particularly bad:

• Double the effort by making a mix of 50/50 boric acid and brown sugar then pour the mixture in a thick line around the entire room and entrance ways. The roaches will get the stuff on their bodies and carry it back to the nest. Once there is no trace of the pest left (usually within the month), vacuum up the powder.

Keep away from children and pets. If you have little ones running around, keep the balls behind furniture and heavy appliances and inside cupboards.

More tips:

• You can also use Borax as a substitute for the boric acid, but the boric acid is more effective.
• Replace old, hardened balls with fresh ones as needed.

Pregnancy Time Lapse Video

Something sweet and beautiful for the weekend. :) 

IV Fluids In Labor, Leading To The Appearance Of Exaggerated Weight Loss In New Borns?

This is a great and thorough article explaining weight loss, it's meanings to Doctors and Nurses inside the hospital and great valuable data regarding IV Fluids. It is something which makes sense. I've been looking at it for a while. And I agree, that unless a mother is truly experiencing dehydration IV Fluids should not be administered, instead the mother should be allowed to drink. However most hospitals won't allow the mother to drink. Once you're checked in- at least in the United States. Advise Mothers to get proper guidance and a skilled coach that knows facts and handlings and can detect indications in the body, so they must not just be a "Coach" or "Doula" but understand the body's physiology and detect the bodies' indications and advise them to stay out of the hospital with that Doula or Coach as long as possible, if they haven't been classified as "High Risk". If Classified as "High Risk" you need to work with someone as trained as me or a Midwife and you may have to go in the hospital sooner, but your rights will be more protected the more training your coach has. ;) THIS will allow you to DRINK and EAT as you need to, in order to keep your basic body needs in! Which helps tremendously when you're trying to accomplish natural birth as your pain threshold diminishes by about 50% when those our out! Ahh. So much introduction for this article! ;) But you understand now why hospital procedures turn into a chain reaction of intervention, they don't let you eat or drink, thus you're out body basics aren't being met, and then you get dehydrated, thus to re-hydrate you they give you IV Fluids, etc. You get the point. ;) 

Best Wishes!
Claudia Perez Silva- Certified Master Doula & Advanced Midwifes Asst. & Student Midwife

----------------------------------------------------------------------------------------

The significance of weight loss in the first few days after birth.

Nearly nine years ago, I was well into the second day of snuggling with my hours-old youngest son. For his birth, I had chosen the hospital in which I was employed. I hadn't done that for either of my older two sons because of insurance reasons and because I wasn't exactly sure that I wanted to blur the line between my personal and professional self for such an intimate event. But, his birth was beautiful and I was thoroughly enjoying my sweet little snuggly son. At about midnight, the (unfortunate, unlucky, brave) nurse who was taking care of me and Ethan came in to check on us. She looked scared. She stepped (sneaked? tip toed?) maybe two feet into the room and said, "How is the breastfeeding going?" It had been great and I said as much. Her next words tumbled out in a rush. "Good, because he's down 10% from his birth weight." And whoosh, she was out the door. I do not know what I would have done in her place. I would not have wanted to tell me that news either. As I absorbed her words, I did what any other board-certified pediatrician who had earned her IBCLC would do; I burst into tears. The rational part of my brain, such as it was, would eventually win when the sun came up. Those were a long few hours.

If I asked you to lose 10% of your weight in 48 hours, how would you do it? Not eating might get you there, but probably not in that short of a time span. How about terrible dehydration from food poisoning with really awful vomiting and diarrhea? Maybe 48 hours of continual exercise? Or exercising while pooping and puking? Right. The suggestions are absurd. Ten percent is a lot of weight to lose in a few days. But newborn infants often do lose 10% of their weight in the first few days after they are born. What factors are contributing to that weight loss?

First, we should understand that 10% or 7% (or whatever the worry threshold is where you are) is just a number. I have mentioned that I get very frustrated when I hear numbers given out of context, especially when we act on numbers just because they are numbers. When we look for signs of health and well-being in a newborn, we gather all sorts of pieces of information that collectively give us a picture of that baby. That context helps us interpret numbers. Newborn weight loss needs a context to be meaningful. The concept that numbers need to contribute something to the care of the infant in a meaningful way is the theme behind my three B's: bilirubin, birth weight and blood sugar. 

The American Academy of Pediatrics recommends that healthy, term infants who have a weight loss of 7% from birth, should have their feeding assessed and that providers should "consider more frequent follow-up." Hopefully, we are looking at the feeding of any newborn, frequent follow up is standard of care where you are and the AAP's suggestion is reinforcing best practices and not breaking new ground. If not, you have an opportunity to change the world.

That 7% value seems to be a standard trigger for increased attention to a baby's feeding. And unfortunately, 10% weight loss seems to be the trigger for supplementation. But excessive weight loss, typically defined as weight loss greater than or equal to 10% of birth weight, is actually pretty common. Losing 10% of birth weight is common? Yes, and 7% is likely a normal, average weight loss.

In a study by Chantry et al, the authors found that 19% of exclusively breastfed infants experienced excessive weight loss in the first 3 days of life, but by day 7 most babies had regained that weight. They also determined, in what we will see is a common theme, that intrapartum IV fluids were an independent risk factor for excessive weight loss. An independent risk factor is one that can cause the outcome regardless of other factors, so, in this study, intrapartum IV fluid could cause newborn weight loss all by itself.

From the study: Distribution of weight changes from birth to day 7 of life according to formula supplementation category on day 3 (on left) and day 7 (on right).

By day 3, 19% of exclusively breastfed babies lost 10% or more of their birth weight.

Another study, by Noel-Weiss et al, also found that intrapartum fluids are a risk factor for excessive weight loss. "Timing and amounts of maternal IV fluids appear correlated to neonatal output and newborn weight loss. Neonates appear to experience diuresis and correct their fluid status in the first 24 hours. " The authors suggest a (pretty cool) conceptual framework:

Conceptual framework includes potential confounding variables and effect modifiers. Noel-Weiss et al. International Breastfeeding Journal 2011 6:9 doi:10.1186/1746-4358-6-9

In a study done in rural Zaire, the average weight loss after delivery was 7%. Another study done in Italy found that weight loss of 10% was common in the first few days of life, especially after C-sections.So, lots of exclusively breastfed kids lose weight and at least one reason to explain that weight loss is that they are peeing off IV fluids. This just makes sense. And makes a whole lot more sense than they are exercising or suffering from food poisoning. I might be making a case here for not worrying about weight loss in the neonatal period at all. But we can not be that cavalier.

Weight loss is important because some kids who lose weight need no intervention at all. Some weight loss is preventable. And some weight loss is real and scary. The key is knowing which babies are in trouble and then having access to somebody with the skill set to know which weight loss is significant and needs intervention.

One way to assess adequate transfer of breastmilk is to monitor stool output. Urine output is usually a good way to monitor fluid intake, but if our baby is going to be peeing off lots of fluid from birth interventions, urine output may be great. In fact, the urine output might be awesome. But, in the first few days after birth, the urine output maybe artificially good as the baby becomes less of a water balloon. So, what did not get messed up by delivery? Poop.

Colostrum is full of oligosaccharides: prebiotic, non-digestible sugars that play a crucial role in the development of the neonatal immune system. Since oligosaccharides are abundant in milk and are non-digestible, the more the baby gets, the more poop there is. The more milk the baby gets, the more stool output. We can use stool output as a good marker of the adequacy of breastfeeding. We would like to see the baby clear all the meconium by 4-5 days of life (maybe a day later for babies born via C-section).

Weight can also be influenced by which scale we use, under what conditions the baby is weighed (dressed, naked?), and whether they have just eaten, peed or pooped (every ounce counts!) before we put them on the scale. We can also look at the trend in weight loss over time. If a baby has lost 10% in 72 hours, what was the pattern of the weight loss? If the baby experienced a normal fluid diuresis, the weight loss pattern may have been 8% in the first 36 hours and only 2 % since.

Neonatal weight loss can therefore be interpreted in a context which looks, not just at the number, but at the baby, the stool output, the conditions of mom's labor, the conditions under which the baby was weighed and a good assessment of feeding. Understanding the many variables that can influence weight loss helps us decide which baby needs intervention and which babies do not. However, too often we are not putting weight loss into context. Kids are getting supplemented just because of a number. Just one bottle of formula can make a huge difference in how that baby's immune system develops. We should have a very good reason for supplementing. But do we? I would guess that some of that supplementation is done because of weight loss and a number out of context.

Check out the graph from the CDC, specifically the blue line. According to this graph, more than 20% of kids in the US are being supplemented with formula before 2 days. That makes no sense. Surely, our species can do better than having one in five newborns needing supplementation to survive the first 2 days of life.

Since we know that weight loss after birth is influenced by many factors, we could not only educate providers, but share that information with the mother. Empowering the mother and her support system with knowledge about what is normal and expected is crucial. And may even prevent her from crying and feeling like a failure at midnight.

Jenny Thomas, MD, MPH, IBCLC, FAAP, FABM (and Ethan)

www.drjen4kids.com

Mothers! Stay Hydrated In The Heat!

Ladies, in this HEAT, please remember to stay hydrated! If you're pregnant OR nursing remember that your baby gets everything you eat and drink, if your milk is coming in thicker or slower than before the heat started, you may be dehydrated, and thus, dehydrating your baby! :( So! :) Please make sure you drink not only water but also, Electrolytes, AND Minerals! Liquid Minerals in a nice liquid form for both adults and children can be found at Wholefoods. Or you can order them online. There are many signs of dehydration before the really obvious ones appear, headache, feelings of anxiety or even disorientation or lack of concentration, swollen tongue, or swollen throat, dry mucus membranes (so your nose, eyes, mouth/throat feel dry.), feeling hot- almost feverish but no fever present and constipation. Remember to keep your children hydrated, toddlers, babies, older children! ;) A fun way to hydrate quickly is cutting open a fresh, delicious coconut and popping a straw into it. Avoid sodas, coffee and alcohol, as all these are dehydrating elements. Hope this helps. ♥