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Sleeping Like a Mammal: Nighttime Realities for Childbirth Educators to Share With Parents

August 21st, 2014 by avatar

By, Linda J. Smith, MPH, IBCLC, LCCE, FACCE

In recent days, there has been much press and discussion about a new book written by pediatricians that professes to help parents “train” their new baby to sleep through the night. The scathing criticism of the book by both parents and professionals alike are consistent with what we know about the needs of a newborn baby and their sleep and feeding patterns. Today on Science & Sensibility, Linda Smith, MPH, IBCLC, LCCE, FACCE shares accurate, evidence based information that childbirth educators and other professionals can use to talk to new families about newborns and their sleep and feeding patterns. Linda is one of the authors of La Leche League International‘s newest book; Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family.

This book written by Smith along with co-authors Diane Wiessinger,  Teresa Pitman and Diana West provides families with information to help the entire family get more sleep and do so safely, while meeting the nutritional and developmental needs of newborns. Preparing families for life with a newborn is one of the challenges we face as educators. The information Linda provides here along with the resources included in this post can help you to be sure that your information is backed by research and appropriate for your new families. – Sharon Muza, Community Manager, Science & Sensibility

How do I address sleep with my childbirth class participants?

261653 ML Algebra1 2007New parents are instantly thrust into the reality of life with a baby. As Dr. Helen Ball writes, “Sleep (or the lack of it) looms large for parents-in-waiting—and it is pointless to pretend that your sleep will not be disrupted by your new bundle of joy. His body clock, which until recently was controlled by your own, is now free-running, and a day-night pattern does not start to emerge until he is around three months old. His stomach is tiny, and he will need frequent feeds all around the clock—he cannot wait eight hours through the night to be fed just because you need to sleep. If you don’t feed him, he will cry. If he’s cold, he will cry. If he hurts, he will cry. If he misses being in close contact with you, he will cry. He doesn’t know that you will come back once you leave his sight. If he feels abandoned, he will cry frantically—it’s his only method to attract attention and bring himself to safety. If he cries frantically, it will take a long time for him to calm down and you will have to help him.”

“The experience of sleep, and of being left alone for sleep, is very different for babies than it is for adults. The more quickly you can understand your baby’s needs—for comfort, food, reassurance, contact, love—the less disruptive nighttime baby care will become, and the less anxious you will feel. Some of the decisions you make early on about nighttime baby care will affect how you manage sleep disruption and cope with your new baby.” Dr. Helen Ball

What is normal sleep?

  • Pregnant women do not sleep in long unbroken stretches, i.e., “all night.” Neither do postpartum mothers – not for many months, regardless of how they feed their babies.1 Breastfeeding mothers get more sleep than formula-feeding mothers; breastfeeding mothers who bedshare get the most sleep of all new mothers.2,3
  • Before birth, babies sleep rather randomly, not necessarily closely synchronized to their mothers’ body clock. After birth, babies sleep in short (1 to 1½ hour) cycles and need to be fed approximately hourly because of their very small stomachs.4 They do not even begin to develop day-night sleep patterns for several months, regardless of how they are fed.5
  • Frequent feeding day and night is normal, essential for the baby, yet is often called ‘inconvenient’ for parents. Let’s face it – all babies are “inconvenient.” Most of us didn’t get pregnant just to make our lives less complicated. Babies need to be touched – a LOT, day and night, and skin-to-skin.6 Touch is nearly as important to babies’ overall development as food.7 Breastfeeding is an easy way to assure plenty of touch; so is safe bedsharing.8 Most breastfeeding mothers nurse their babies to sleep and sleep with their babies at least part of the night.9

LLLI | Safe Sleep 7 Infographic

Safety issues

  • SIDS (Sudden Infant Death Syndrome) and suffocation are two distinct and rare risks to infants in the early months. SIDS is a diagnosis of exclusion: there’s no obvious reason for a baby’s death. Risk factors for SIDS are well- documented, so avoiding these can help parents reduce the already-small risk: (1) smoking;10 baby sleeping prone;11 formula feeding;12 and baby sleeping unattended.13 (details below)
  • Suffocation is a more easily-preventable risk to babies than SIDS. The main risks for suffocation (entrapment) are putting the baby to sleep on a sofa with or without an adult,14 and/or a drunk/drugged adult sleeping with a baby on any surface.15 “Never bedshare” warnings don’t tell tired parents/mothers where they CAN safely feed their babies at night. A new infographic by La Leche League, “Safe Sleep Seven: Smart Steps to Safer Bedsharing,” lists seven steps that vastly reduce the major SIDS and smothering risks.
  • Prenatal smoking is very bad for babies and increases risk of SIDS at least five-fold. Smoking is a significant hazard to babies if the mother smokes during pregnancy, and smoking in the household (and everywhere) continues to be a risk to the baby after the baby is born. Smokers exhale carbon monoxide for many hours after each cigarette,16 and secondhand smoke is harmful to babies.17 Smoking is a well-known risk to adults, too.
  • Every health authority in the world recommends exclusive breastfeeding for the first six months starting in the first hours after giving birth, then continued breastfeeding while adding family foods till the child is at least two years old.18 Formula-fed babies are less arousable from sleep than breastfed babies;19 have more than double the risk of (SIDS);12 and have many other health problems.20 If families need help with breastfeeding, contact WomensHealth.gov or La Leche League International or the federal government Women, Infants and Children program (WIC).
  • Unattended babies (sleeping out of sight and sound of a competent adult) are at higher risk of SIDS and entrapment/smothering accidents. People are better monitors than electronic devices. Babies should always sleep face-up, in a safe container, and within sight and sound of a competent adult for all sleeps, naps and nights – unless they are safely tied on someone’s body or safely in someone’s arms or sleeping next to their sober, nonsmoking, breastfeeding mother on a safe surface. Baby should be lightly clothed (not overheated. One study reported swaddling as an independent risk factor for SIDS. 21).
  • Recommend that parents baby-proof the family bed, even if they think they won’t ever bedshare. Sleep happens, and exhaustion overrules common sense. No thick covers, no toys, no pets, firm clean flat mattress. Most breastfeeding mothers sleep with their babies at least part of the night, and breastfeeding mothers have the lowest rates of SIDS and other sleep-related accidents.12 Accidental bedsharing is riskier than planned bedsharing.22 A side-car attached to the bed can be a good option – baby is close enough for touching and feeding, yet separate enough to avoid rollovers and exhaled breath of smokers. A safe crib for the baby in the bedroom is safer than baby sleeping unattended in another room.
  • Adults should never lie down with a baby on a sofa or in a recliner, even “just for a minute” – the threat of suffocation, entrapment or dropping the baby is high especially when (not if) the adults falls asleep.23 If a sofa or recliner is the only option for sleep, the adult can lean back and tie the baby securely onto their chest with a scarf, shawl or soft carrier so their arms aren’t holding the baby when the adult dozes off.
  • Wearing a baby many hours a day in a soft-tie-on carrier or sling is a great way for everyone to nap, and helps baby’s motor development besides. Baby’s face should be fully visible and her head should be close enough to kiss. This babywearing guide has information on how to safely wear an infant.

The 4 big questions

1. When will the baby sleep through (longer) the night?

Probably not for many months. Welcome to parenthood! (Sorry, biology rules!)

Babies are growing faster in the early months than they ever will, and need food and comfort very often for normal physical, emotional, and psychological development. A famous scientist described the first 9 months of a baby’s “outside” life as the period of “external gestation.24” The best way to get enough sleep is for parents to plan to safely bedshare with their breastfed baby, and take naps with the baby. (see the Safe Sleep Seven and “Sweet Sleep25 for more information.)

Beware of “sleep training” programs, books and advice, which have a long sad history.26 New strong evidence of baby’s biological and emotional needs suggests that babies remain highly stressed even when the parents think sleep training “worked,” with serious long-term negative consequences for the baby. Babies cry because they need to be touched held, fed, rocked, and nurtured, and simply cannot meet their own needs for any of those comforts.

2. When will the mom sleep like she did before she got pregnant?

The research definition of “sleeping through the night” range is inconsistent and arbitrary.27 Parents can make up any definition they want when quizzed about the baby “sleeping through.” A useful (and vague) response: “Of course the baby is a good sleeper.”

3. Will parents ever have sex again?

Beds aren’t the only places where sex can happen.

4. Will parents ever get the baby out of their bed?

Babies who bedshare get their emotional needs met sooner and more fully than those who sleep separately.28 All babies are inconvenient for a while.

Where can parents get more information?

What do you talk about with families in order to prepare them for parenting a newborn? How do you find the balance between providing accurate information and not “frightening” them with the realities of newborn sleep patterns. Have you read this new book? Would you recommend this book to families who are desiring more information about how to provide a safe sleep environment for their breastfeeding newborn? – SM

References

1. Montgomery-Downs HE, Stremler R, Insan SP. Postpartum Sleep in New Mothers and Fathers. Open Sleep Journal. 2013;6(Suppl 1: M11):87-97.
2. Doan T, Gay CL, Kennedy HP, Newman J, Lee KA. Nighttime Breastfeeding Behavior Is Associated with More Nocturnal Sleep among First-Time Mothers at One Month Postpartum. J Clin Sleep Med. 2014;10(3):313-319.
3. Doan T, Gardiner A, Gay CL, Lee KA. Breast-feeding Increases Sleep Duration of New Parents. J Perinat Neonatal Nurs. Jul-Sep 2007;21(3):200-206.
4. Bergman NJ. Neonatal stomach volume and physiology suggest feeding at 1-h intervals. Acta Paediatr. May 10 2013.
5. Rivkees SA. Emergence and influences of circadian rhythmicity in infants. Clin Perinatol. Jun 2004;31(2):217-228, v-vi.
6. Feldman R, Rosenthal Z, Eidelman AI. Maternal-Preterm Skin-to-Skin Contact Enhances Child Physiologic Organization and Cognitive Control Across the First 10 Years of Life. Biol Psychiatry. Jan 1 2014;75(1):56-64.
7. Feldman R, Singer M, Zagoory O. Touch attenuates infants’ physiological reactivity to stress. Dev Sci. Mar 2010;13(2):271-278.
8. Hofer MA. Psychobiological Roots of Early Attachment. Current Directions in Psychological Science. April 1, 2006 2006;15(2):84-88.
9. Ward TC. Reasons for Mother-Infant Bed-Sharing: A Systematic Narrative Synthesis of the Literature and Implications for Future Research. Matern Child Health J. Jul 2 2014.
10. Zhang K, Wang X. Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis. Leg Med (Tokyo). May 2013;15(3):115-121.
11. Dwyer T, Ponsonby AL. Sudden infant death syndrome and prone sleeping position. Ann Epidemiol. Apr 2009;19(4):245-249.
12. Hauck FR, Thompson JMD, Tanabe KO, Moon RY, Vennemann MM. Breastfeeding and Reduced Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics. June 13, 2011 2011.
13. Moon RY, Fu L. Sudden infant death syndrome: an update. Pediatr Rev. Jul 2012;33(7):314-320.
14. Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EM, Fleming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. Bmj. 2009;339:b3666.
15. Ball HL, Moya E, Fairley L, Westman J, Oddie S, Wright J. Bed- and sofa-sharing practices in a UK biethnic population. Pediatrics. Mar 2012;129(3):e673-681.
16. van der Vaart H, Postma DS, Timens W, et al. Acute effects of cigarette smoking on inflammation in healthy intermittent smokers. Respir Res. 2005;6:22.
17. Tong EK, England L, Glantz SA. Changing Conclusions on Secondhand Smoke in a Sudden Infant Death Syndrome Review Funded by the Tobacco Industry. Pediatrics. March 1, 2005 2005;115(3):e356-366.
18. American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics. March 1, 2012 2012;129(3):e827-e841.
19. Mosko S, Richard C, McKenna J. Infant arousals during mother-infant bed sharing: implications for infant sleep and sudden infant death syndrome research. Pediatrics. Nov 1997;100(5):841-849.
20. US Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General,; 2011.
21. Richardson HL, Walker AM, R SCH. Influence of Swaddling Experience on Spontaneous Arousal Patterns and Autonomic Control in Sleeping Infants. J Pediatr. Mar 12 2010.
22. Volpe LE, Ball HL, McKenna JJ. Nighttime parenting strategies and Sleep-related risks to infants. Social Science & Medicine. 2012(0).
23. Kendall-Tackett K, Cong Z, Hale T. Mother–Infant Sleep Locations and Nighttime Feeding Behavior: U.S. Data from the Survey of Mothers’ Sleep and Fatigue. Clinical Lactation. 2010;1(Fall 2010):27-31.
24. Montagu A. Touching: the Human Significance of the Skin. Third ed. New York: Harper & Row; 1986.
25. La Leche League International, Wiessinger D, West D, Smith LJ, Pittman T. Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family. New York: Random House – Ballantine Books; 2014.
26. Middlemiss W, Granger DA, Goldberg WA, Nathans L. Asynchrony of mother–infant hypothalamic–pituitary–adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early human development. 2012;88(4):227-232.
27. Adams SM, Jones DR, Esmail A, Mitchell EA. What affects the age of first sleeping through the night? J Paediatr Child Health. Mar 2004;40(3):96-101.
28. McKenna JJ, Mosko SS. Sleep and arousal, synchrony and independence, among mothers and infants sleeping apart and together (same bed): an experiment in evolutionary medicine. Acta Paediatr Suppl. Jun 1994;397:94-102.

About Linda J. Smith, MPH, IBCLC, LCCE, FACCE

© Linda J. Smith

© Linda J. Smith

Linda J. Smith, MPH, IBCLC, LCCE, FACCE, is a lactation consultant, childbirth educator, author, and internationally-known consultant on breastfeeding and birthing issues. Linda is ILCA‘s liaison to the World Health Organization’s Baby Friendly Hospital Initiative and consultant to INFACT Canada/IBFAN North America. As a La Leche League Leader and Lamaze-certified Childbirth Educator, she provided education and clinical support to diverse families over 40 years in 9 cities in the USA and Canada. Linda has worked in a 3-hospital system in Texas, a public health agency in Virginia, and served as Breastfeeding coordinator for the Ohio Department of Health. Linda was a founder of IBLCE, founder and past board member of ILCA, and is a delegate to the United States Breastfeeding Committee from the American Breastfeeding Institute. Linda holds a Masters Degree in Public Health and is currently an Adjunct Instructor at the Boonshoft School of Medicine at Wright State University in Dayton, Ohio. She owns the Bright Future Lactation Resource Centre, on the Internet at www.BFLRC.com.

Babies, Breastfeeding, Childbirth Education, Guest Posts, Infant Attachment, Newborns, Parenting an Infant , , , , ,

You’re Invited to Lamaze International’s Next Twitter Chat: Prenatal Fitness

August 19th, 2014 by avatar
perinatal fitness

CC http://flickr.com/photos/cumidanciki/7807501656

Won’t you consider joining Lamaze International’s President Elect, Robin Elise Weiss, as she hosts our next Twitter Chat on Thursday, August 21, 2014 at 9:00-10:00 PM EST.  The topic to be discussed is prenatal fitness and you can find the party at #LamazeChat.  You will want to put this event on your own calendar as well as share with your clients and students via social media, so everyone can benefit from the fast moving discussion that will no doubt be filled with facts and information that everyone can use.

Perinatal Fitness expert Catherine Cram, M.S.,  owner of Comprehensive Fitness Consulting shares some tips that will be discussed further during the Twitter chat. Childbirth educators may find it useful to share this information when discussing fitness and exercises in your childbirth classes.

• The key to getting the greatest benefits with prenatal exercise for both mom and baby are to continue to workout to the end of the pregnancy.

• Research has shown that women who continue to exercise throughout pregnancy gain less weight, have reduced complications during labor and delivery and return to pre-pregnancy weight faster than those that don’t exercise.

Tips for sticking with exercise during all trimesters:

• Try to include several types of exercise, from walking to swimming or biking and mix it up so mothers don’t overwork muscles and joints.

• Break up workouts into two sessions of a shorter duration if fatigue makes it tough to maintain the usual routine.

• The exercise intensity level should stay within a range that feels challenging, but not so hard that a mother is out of breath.  We use what’s called the “talk test” with prenatal exercise, which simply means that a mother should be able to carry on a conversation while exercising, and if she can’t, then she is working too hard.

• As pregnancy progresses it’s as if women are wearing a backpack that gets heavier each week.  Keep this in mind when workouts seem to be getting harder- the workout is a lot tougher even at the same intensity at 30 weeks than at 15 weeks. Modify routines as needed to keep workout level within safe limits.

• Make sure to add some upper body strength training to the workout.  Mothers will need that strength for all the lifting required with baby care.  Keep in mind that all someone needs to do for strength gains is one set of 10-12 repetitions of a weight.  Exercise bands are a great way to do strength training, and they’re inexpensive and easy to use.

• Buddy up with a friend for fitness sessions. Encourage class members to plan exercise sessions together outside of class.  They will be a lot more successful with maintaining a fitness routine when they are partnered or in a fitness group, and it makes the time go a lot faster.

twitter logoTwitter Chats are a fun way to connect with both families and other educators from all over, learn more about the topic, Prenatal Fitness, share resources and enjoy a pleasant discussion.  Robin Weiss is a skilled facilitator who makes every Twitter Chat she hosts a totally enjoyable event. New to participating in a Twitter chat? Check out this article for information on how to participate and get the most out of your experience. Don’t be shy about jumping in.  Your participation will be totally welcomed! See you August 21st at 9PM EST!  Tweet, tweet!

 

 

 

Childbirth Education, Lamaze International, News about Pregnancy , , , , , ,

Marketing and Blogging with Respect; Avoid Plagiarism

August 14th, 2014 by avatar

Today on Science & Sensibility, Andrea Lythgoe, LCCE shares information on the importance of having a) a website that is created using text and images that you have the right to use; b) marketing material that does the same and c) how to share the great resources, articles and blog posts you find in your internet travels so that you are complying with the law and are respectful of the work of others.   Look for future posts in the series on using materials legally in your classroom.  Previous posts in the the Series: Finding and Using Images and Copy can be found here and here. – Sharon Muza, Science & Sensibility Community Manager

As someone who is both a writer and a photographer, typically on the topic of birth, I am happy to share my creative work online in many formats and locations.  My intent is to provide information that others find both useful and informative.  I enjoy sharing my work very much.  What I don’t enjoy is finding out that someone, someplace, on the “World Wide Web” has, with a simple copy and paste command, stolen my original work.

This theft of creative property is called plagiarism. Plagiarism is where you take the creative work of others and pass it off as your own  Content theft is when you take the work and keep the by-line intact.  In the years that I have been working as a birth professional, I have found my work copied word-for-word, or maybe slightly altered, on other web sites. I have found my pictures and images copied and used without permission. It is important for people to understand that is not OK. And it is illegal.

Writing is protected by copyright law. You cannot simply find someone who “says it better” than you think you could and use the copy and paste feature on your computer, tablet or smartphone. Not even as a placeholder until you come back and replace it with your own writing or image. If you want to have some placeholder wording as you design your site, do what the professionals do and use this.

Your business website

Your website and marketing materials need to represent YOU. They need to be who you are, and how you run your business. In these days when the birth services market is pretty well saturated in a lot of areas around the country, the only way to stand out is by selling YOU. No one else can be you. And copying someone else’s words, design or images is not who you are.  As unbelievable as it might seem, there have been circumstances where people have copied another professional’s “About Me” page, with the only change being the original author’s children’s names replaced with their own.

Maybe writing is not your strength. I can understand that. We all have weaknesses and things that we can’t do no matter how hard we try. Two of mine are chemistry and surfing! And that’s OK. You can hire someone (or if you’re lucky, use a friend or spouse who has the skills) to turn your own thoughts and ideas into nicely worded text. But you – and only you – should first sit down with paper and pen and make notes about what you want to say. Make a list of words that appeal to you – words that you feel describe the work you do, why you do it, and what experience you hope your clients will have when working with you. Write a list of facts about yourself you want your clients to know about you.  Think about how you might turn one of those qualities into a short anecdote to include in your “about me” page. Maybe this exercise will take a few days or weeks before you’re even ready to get started working with a writer who can help you turn your jumble of ideas into paragraphs. If it takes time, that is okay.

If you find you have absolutely no ideas to give to your writer, then you may need time to do some evaluating about where you want to go. In order to have a successful business, you need to have your own vision and direction for the business. In the words of a birth photographer, Leilani Rogers: “If you are lacking direction in your business and can’t articulate how you feel about things or how you want to run your business then you are not ready to own one.”

The work of articulating your business vision to your clients through the written word is not an easy one, but it is worth it. Not only will you maintain professional integrity, you will have the opportunity to carefully consider and refine your business in the process.

Your blog content

A blog is a great way to boost the search engine optimization (SEO) of your web site and keep potential clients returning to your site. It is important that your blog and any resources you post on your web site be entirely your own work. You’ll come across lots of interesting articles you may want to share with your readers, but ethically, you need to direct your readers to the original source, and not republish on your site. Giving credit, and then pasting the entire article is not enough. Republishing (or as some call it “cross posting” or “reblogging”) without permission is not acceptable. Writers create original content for many reasons and one of those is to bring traffic to their own site, and keeping readers on your site reading someone else’s material is stealing readers from them.

How to properly share an article or blog post

There are many ways to do this responsibly:

  • You can have a regular feature where you share interesting things you come across. I do this every Wednesday on my own blog.
  • Another common method is to share a small (1-2 paragraph) excerpt with your thoughts and comments on the article, and then direct your reader to the article to read more. A great example of this can be found on Evidence Based Birth here.
  • You could also contact the author of the article and ask to do a short Q&A on the article (by phone or email) that you could publish and then link to the original article. Science and Sensibility does this frequently when we feature a new study.
  • Another way to share is to use topical lists. Have a list of recommended reading on going past your due date. Another list on deciding about induction. Another about breastfeeding resources, etc. Adding a small blurb (1-2 sentences) about what the reader can expect to find there or why you included it in the list is helpful to your readers. Birth and Baby Matters has an example of a topically organized link list.

While sharing other content is helpful, writing your own content is even better! Next time you find yourself speaking passionately and knowledgeably on a topic, turn it into a blog post! Next time you write a particularly eloquent comment on a Facebook question, turn it into a blog post! Go to an interesting conference, share it with your readers like Deena Blumenfeld did. Sharing your own opinions and knowledge helps establish you as an expert in the eye of the reader. And that is a plus to potential students!

If you’ve found yourself doing it incorrectly and you have content on your site that is not your own, please immediately take it down. You can replace those posts with your own thoughts and a small teaser quote with a link in a very short amount of time. It shows that you are professional and are also complying with the law.

What if you find your original material posted elsewhere?

With a simple Google search, or by using sites like Copyscape, it is very quick and easy for incidents of plagiarism to be caught. Back when I taught at a midwifery college, if I suspected a student of plagiarism, I could generally find the source within a minute or two. Using someone else’s creative property is not flattery; rather it is hurtful, disrespectful and illegal.

If you are a writer and find that someone has posted your work without permission, your first step will be to contact the site owner and request it be removed. A firm approach suggesting an alternate way to share the information, with a deadline helps them to know you mean business.

If that is ineffective, you may be able to file a DCMA Takedown request with the site’s host. This is a U.S. law, but many hosting companies internationally still comply. You’ll need to determine where they host their site. I find the database at www.whois.com to be helpful with this. Then do a web search for the hosting company’s web site. Most sites have a Takedown request form on their page. Depending on the hosting company’s policies, they may take down just the content you reported, or they may take down the infringer’s entire site! (Another reason to stay on the right side of copyright law!)

Resources to help create a unique website

10 Rules for Writing About Me Pages - Great list of things to do – and what not to do! – and lots of examples.

Four Steps To Finding Your Writing Voice
 - Excellent advice from a middle school English teacher. Her whole site is full of good tips, so browse around!

How to Write Effective Website Content - Pretty much exactly what the title says. Make sure you read all the way down to the “best practice tips”, because that’s where the best tips are.

How to Decide What to Blog About - I love the focus on the reader’s experience and needs in this one.

Blog Topic Generator - This is an interesting tool, it gives you some interesting titles if nothing else.

Have you found an effective and legal way to share information with others via your website and blog?  Have you found your own material used without permission?  How did you handle it and how did it make you feel?  Please share your ideas, thoughts, resources and suggestions in our comments section. – SM

About Andrea Lythgoe

Andrea Lythgoe

Andrea Lythgoe

Andrea Lythgoe is a doula, hospital-based Lamaze childbirth educator, birth photographer, and former instructor at the Midwives College of Utah. She is the author of the website UnderstandingResearch.com where she aims to help those just beginning to read research to understand the language of research. Her interest in research started while attending the University of Utah, where she made ends meet by working on a large randomized controlled trial and earned a degree in community health. Andrea served on the Board of Directors for the Utah Doula Association for over 10 years. She lives and practices in the Salt Lake City, Utah area. Andrea can be reached through her website.

 

 

Childbirth Education, Guest Posts, Series: Finding and Using Images and Copy , , , ,

Teaching Childbirth Education Classes While Pregnant – An LCCE Educator’s Experience

August 12th, 2014 by avatar

By Katherine Steen, BS, MAIS, LCCE

Childbirth educators may work in this field at many points in their life.  They may be childless, they may have young children or their children may be out on their own. I believe one of the most interesting times to be a childbirth educator is when you yourself are pregnant and expecting a baby.  To be teaching on the topic of labor and birth to pregnant families at the exact time that you are also preparing for your own labor and birth can create some interesting class dynamics.  I asked my friend and colleague Katherine Steen, LCCE, to share what her experience has been like teaching classes while she prepares to welcome her second little one  Here is her story! – Sharon Muza, Community Manager, Science & Sensibility

CC  (BY-NC-SA) flickr photo by J. McPherskesen: http://flickr.com/photos/jmcphers/4276103110

CC (BY-NC-SA) flickr photo by J. McPherskesen: http://flickr.com/photos/jmcphers/4276103110

As educators, we work hard to minimize bias in our teaching. However, there is no hiding the fact that teaching birth classes while pregnant changes one’s perspective. I began my career as a childbirth educator about a year after my first child was born. In January 2014, I learned I was pregnant with my second child. Here are a few of my experiences.

First Trimester

Physical Challenges

Unlike my first pregnancy, I experienced nausea this time around, which made teaching difficult at times. I did my best to nibble during teaching to ward off the queasies and wore long sleeves to hide my Sea Bands. My second biggest challenge was fatigue. I normally teach 3.5 hour classes on Saturdays in a facility where it takes me about an hour on each end to set up and clean up. By the time I got home, I was ready for a nap. Unfortunately, my 4 year old did not always share my enthusiasm for sleep. A third challenge was transportation to and from class. I was used to riding the bus or my bike 12 miles round trip since we are a one car family, but was physically unable to, thanks to the nausea and fatigue. This meant I relied on my partner to drop me off and pick me up for class each week.

Breaking the News

Because I experienced a miscarriage previously, I was hesitant to reveal my pregnancy to my students until after the first trimester. Once I revealed my pregnancy, I began to get questions from students about my choices of provider and birth place. I am hesitant to reveal things about my choices as I don’t want to impose my values on them, but if a student asks me one on one I am generally inclined to tell them the truth. At the time, I was able to say I had not decided (which was true). It was most interesting when I began having reunions for series I taught early in the year when I revealed to students that I was pregnant while teaching their series. They reassured me that they couldn’t tell how tired and nauseous I had been and were quite excited for me.

Following My Own Advice

When it came time to pick a provider, I had a different perspective than in my first pregnancy. Not only were my needs and interests different at this point in my life, but I had a wealth of knowledge about evidence based maternity care and a broader perspective on the variations of pregnancy and birth to consider. In interviewing providers, I brought a copy of the Groopman-Hartzband Medical Mindset Spectrums (a worksheet created by Kim James and Laurie Levy, adapted from Your Medical Mind: How to Decide What is Right for You, by Groopman and ) to discuss and asked about experiences/protocols for long, slow labors, premature rupture of membranes, and pregnancies that proceed into the 41st week. When a concern arose during off hours, I found myself thinking about what I would say to my students if they were in my position. Would I tell them to page their provider or call in the morning?

Second Trimester

Increased Empathy and Concern

While I physically felt better in my second trimester, the reality of our parallel life experiences continued to factor into my teaching. The first change I noticed was that I had much more empathy for pregnancy discomforts and decision making challenges. Suddenly the reality of my students became more real for me and I found myself physically feeling their twinges. I had so many opportunities to access pregnant women, postpartum families, and their scary (and wonderful) stories and my attitude toward their experiences was split.

On the one hand, I felt increasing non-attachment to their birth choices. Whereas previously I had felt disappointed when a birth did not meet a student’s expectations or when families at a reunion struggled with breastfeeding or had highly interventive births, I began to hear beauty and joy in birth stories that did not go according to plan. As long as a family was satisfied with the experience, I considered it a success. I began to envision alternate realities for my own birth and come to terms with the idea that it could go any number of ways and still be a great experience.

On the other hand, my concern and empathy for those who had scary experiences was magnified. For example, when one of my students gave birth prematurely, the situation seemed so much more relevant to me as our due dates were only a few weeks apart. Or when a family shared the story of their baby’s lengthy NICU stay due to oxygen deprivation during the birth process, my heart was heavy.

I also began to lead a postpartum support group during this time and took to heart the pregnancy, breastfeeding, and birth challenges the women in the group faced. In all of these situations, I simply did my best to hide the tears that sometimes arose without warning and tried to focus on supporting their journeys. It was good practice for me to minimize sharing my personal experience and encourage the mothers to tap into their intuition and share ideas with each other.

Third Trimester

Don’t forget to eat, drink, pee, and sit down!

Once again, teaching was physically challenging. I began to place a chair or birth ball close to the front of the room in an effort to remind myself to sit down periodically. I filled my plate at the beginning of each class with the snacks the students brought and made sure my water bottle was close at hand. I often found myself joking with students as we met in the restroom during every break as well as before and after class.

CC  (BY-NC-SA) flickr photo by mandaloo: http://flickr.com/photos/mandaloo/4762404381

http://flickr.com/photos/mandaloo/4762404381

Figuring out what to wear while teaching was also a challenge. Even before I was pregnant, I taught in short sleeves year round because I have no control over the temperature at my sites. Lately, keeping cool has been even more challenging because this summer has been quite warm by Seattle standards. I went through several sizes of maternity khakis and finally decided they were too hot. I switched to skirts, but discovered how difficult it is to demonstrate lunges without flashing the class. I started having my doula/cbe observers demo for me in addition to assisting students. I cannot quite bring myself to teach in shorts, though I did resort to sandals a few times. And then there was the day I discovered I had outgrown all my bras.

Brain Farts

Between teaching two series at once (something I rarely do) and being pregnant, I had any number of moments when I found myself asking my students if we talked about something in a previous class because I honestly couldn’t remember. And forgetting the words for things. Like what’s that pushing position when you are not quite sitting, not quite lying down? Well, at least I showed them what it looks like. And then there was the week I read the snack schedule wrong and reminded the families to bring snack a week early. Thank goodness my students are on top of things and e-mailed me to clarify.

Memories

One last thing that I didn’t anticipate was how I would start to remember more clearly my postpartum experience as my pregnancy progressed. One evening, I found myself describing some of the physical and emotional realities of that difficult time in far greater detail than I am usually capable. I paused to look at my students’ faces and saw pure shock. I want to adequately prepare them for the challenge that awaits as well as the range of experiences that are normal during postpartum, but I don’t want to scare the pants off them. I ended the class and nobody moved. Somehow I came up with a quick, confidence boosting statement and they began to gather their things. Did I go too far? My trusty observer seemed to think they would recover.

Here I sit with one more class to teach before taking some time off to welcome baby. I will not miss spending two hours every Saturday schlepping my materials up three floors and moving furniture. I will miss building rapport with students and am looking forward to three class reunions in a few months.

What has been your experience of teaching while pregnant? What are the joys and challenges for you? Please share your experiences and discuss with me in the comments section.

About Katherine Steen

© Katherine Steen

© Katherine Steen

Katherine Steen, BS, MAIS, LCCE, has been teaching childbirth classes since 2012. She currently teaches for the Great Starts program of the Parent Trust for Washington Children in Seattle, WA. Prior to the birth of her daughter, she spent 10 years working as an educator in zoological parks. In addition to teaching birth classes, she loves to cook, garden, read and spend time outdoors. Her current fitness endeavors are water aerobics and prenatal yoga. She is expecting her second child in September 2014.

Childbirth Education, Guest Posts, Lamaze International , , ,

It’s World Breastfeeding Week! Test Your Knowledge of Evidence Based Breastfeeding Information

August 7th, 2014 by avatar
© Annie Stoner

© Annie Stoner

In recognition of World Breastfeeding Week 2014, Science & Sensibility invites you to take this quick little quiz on breastfeeding information to check how up to date you are on current, evidence based breastfeeding practices.  As discussed in our earlier post this week, celebrating World Breastfeeding Week, childbirth educators play a key support role in providing families with accurate breastfeeding information as part of a thorough childbirth education curriculum.

Staying up to date with the newest information can be difficult to do.  But it is imperative.  There are many sources of misleading or inaccurate breastfeeding information available, and students and families should rely on childbirth educators to help with providing the proper resources.  Take our quick quiz to see if you can answer some questions on breastfeeding information that has changed in the past few years. Follow the links provided with each answer if you need more information! Then share in the comments section below what you do to stay current on breastfeeding topics. What are your favorite breastfeeding continuing education resources?  Let us know!

 

Babies, Breastfeeding, Childbirth Education, Newborns , , , ,