MAYD to Birth: At Your Doorstep

Promoting gentle, empowering mother journies…

Should I Renew My CLC?

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Back in 2010 I completed the Certified Lactation Counselor training through Healthy Children. I wrote about it on the blog, and a few weeks later I found out via mail that I had passed the test and could indeed call myself a CLC.

In the two years since, I haven’t really done much with this certification, besides use those letters after my name for a few short-term consulting projects. I know the limitations of the CLC and I am not going to start a business providing breastfeeding support because I took a week-long training program. But I also do like being able to say I have a credential.

So do I bother to complete the continuing education requirements in order to recertify? I only need 18 hours and I have ten months to get it done. There are a few options for doing it online, like through Lactation Education Resources, which has a ton of classes that sound interesting, like The Politics of Breastfeeding. There are also classes I can do at my own pace through Healthy Children‘s Learn at Home modules. They have some courses I’d be interested in taking too, like Concerns about Infant Formula and The Role of Donor Milk in the Reduction of Infant Mortality and Morbidity.

But this don’t come cheap. I’ve already invested about $600 to take the CLC course and recertifying isn’t free either. All of those courses cost money and are worth varying amounts of contact hours. The cheapest I can do this for is about $265, and that’s if I get in on the early bird special for recertification.

Is anyone else in the same boat as me? Is it worth keeping a credential I may or may not use for the next three years? Since I’m already in so deep, do I continue to spend a few hundred bucks every few years in order to call myself a CLC? What would you do?

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No Poo – Revisited

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Let’s talk No Poo again. It’s been 13 months since I’ve regularly used shampoo.  I get lots of questions about  how it’s going. Time for an update.

In case you have no idea what I’m talking about, here is  original post.  My recipe is there, too.

My hairdresser has finally gotten used to my routine and has admitted that my hair and scalp are much healthier.  This is my routine now:

I’m only using the baking soda mixture followed with the apple cider vinegar mixture about twice a month now.  My scalp is almost never itchy any more. When I used shampoo, by about day 3 to 5, it felt a little itchy.  Remember, my hair is super dry.  I have no oil.  At all.  I can easily get away with this.  Side note:  I never did find the aloe vera to add to my ACV rinse.  Oh well.

When I need to “start over” with my hair, I just do a cold rinse, scruntch in my conditioner, followed up with squeezing in some clear gel.  I squeeze and scrunch it until no water comes out.

The very important “plop”

Then, I add my plop.  My version, which seems to be working for me, is to use a big t-shirt and lay it out flat.  I tip my head upside-down, place all my hair at the top of my head, then twist and wrap both sides of the shirt, tucking it in to the back of the t-shirt/towel.  I look like Princess Leah with the plop on my head. I leave it on as long as possible, even a couple of hours.  The longer, the curlier.

The only thing I use the blow dryer for is my bangs.  Some people use a diffuser, but I don’t.  I just let my hair air dry.  I try not to touch it much while it’s drying, but if I do, it’s just to scrunch it.

My hairdresser says not to tell anyone this because it’ll put her out of business, but she said that my color stays better and that my hair feels really different – better. I think it kills her to admit that because she was so opposed to me doing No Poo.

I was so intimidated in the beginning of my No Poo journey because I wanted to know exactly when to do the rinses, what formulas, etc.  Everyone told me to give it time and I’d figure out what works and what doesn’t.  They were right.  I’ve met a couple of people that have done No Poo for a long time and they have been helpful with different techniques and tips.

Curlier to the root & more volume

Just this week I learned of a place in Ft. Worth called The Curly Tree.  She does a curly haircut when your hair is DRY, not wet.  I’m totally going.  I feel like I’m cheating on my hairdresser (we’ve been together for almost 8 years!), but as one of the no-pooers said to me, it’s like leaving your OB for someone better for you.  I have more anxiety over the possibility of leaving my hairdresser than I ever did over leaving my OB!

People always ask me about doing No Poo when they have oily hair.  I really don’t know.  The only reason I do it – do I dare admit, with a Diet Mountain Dew in hand – that I couldn’t care less about the chemicals?  I just heard that the No Poo makes your hair curlier.  That’s why I do it.  If I had straight oily hair, I wouldn’t care about No Poo.

Yes, it’s true, I’m not crunchy.  Maybe chewy.  Maybe.

Good News!!!!

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Unless you live in the United States, Suriname, Liberia, Tonga, Western Samoa, Papua New Guinea, or Palau...

Questionnaire for Birth Professionals

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Questionnaire for birth professionals (self awareness)

Ask yourself the question and then write down the answer(s) that pop into your head. Don’t figure it out. There are no right or wrong answers. What pops into your head may open up some awareness of your subconscious fear of birth.

1. With regard to having babies, what my mother said is_______________________________
2. With regard to having babies, what my father said is_________________________________
3. With regard to having babies, what I learned in school is _____________________________
4. With regard to my clients, what I have done that doesn’t meet my standards is ____________________________________________________________________
5. With regard to my birth practice, what I would be willing to forgive myself for is _____________________________________________________________________
6. With regard to pregnancy/birth, my biggest fear is________________________________________________________
7. How I feel when I’m standing in the lobby of a hospital is ______________________________
8. What I know about my own birth is_______________________________________________
9. If I could go back to the womb and re-create my own birth experience, I would: (write out all the elements of your fantasy ideal birth)
10. If I had beautiful, ecstatic births happening in my practice, who might be wrong? Who might be upset?
11. Some ways that I could be nicer to myself are _________________________________________

Seeking Donations for A Virtual Baby Shower!

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I’ve been longing to get in some volunteer hours for quite some time now. I’ve mulled over joining various organizations that provide mother-to-mother breastfeeding support, but with my full-time job and my kids’ activities, I just don’t have the time to dedicate to it at this stage in my life. So I joined Hands on Broward, a local organization that matches people who want to volunteer with one-shot projects that mesh with their interests and skills. You pick the day and time and place you want to volunteer, put in your hours and volunteer again when you have the time. This is really the ideal situation for me now, and there are so many worthy local projects I can give my time to. I’m so excited about many of the opportunities available, and the first one I’ve chosen to be a part of is a baby drive for a non-profit called We Pass the Blessings.

Every year, We Pass the Blessings holds several events to provide goods and services to the community, including an annual health fair, a baby shower and holiday toy drive. I’ve decided to collect baby items for their Community Baby Shower for low income moms and moms-to-be, which will be held in March in Ft. Lauderdale. I really want to help this great cause and I just might have a small agenda and want to make sure that they get some breastfeeding related supplies.

Now, normally I would just put a bin in at work and ask people to donate, but I can’t at my current position. So that’s where you all in my network come in! I know that times are not that great for any of us, but I was hoping that some of you who are able to, would choose to help out some moms in need in South Florida.

So! We Pass the Blessings is asking for the following:

  • New and gently used baby clothes (size newborn to 3T)
  • Blankets
  • Diapers & diaper bags
  • Infant feeding sets
  • Health care sets (shampoo, lotion, etc) and Safety/First Aid kits
  • Pacifiers and teethers
  • New or gently used infant bath tubs, high chairs, strollers
  • Donations in any amount via Paypal on their site
I’m asking you to also consider donating:
  • Nursing pads
  • Nipple cream
  • Manual breast pump
  • Nursing pillow
  • Nursing cover
  • Baby carrier
To that end I’ve created a Wish List on Amazon where you can purchase items directly and have them shipped to me. I’ll package everything up and deliver it, along with my own donations. I’ll take pictures of everything and update you here. I hope to also be able to attend the Baby Shower and take some pictures there too. If you have gently used baby items you’d like to ship, please contact me at Blacktating at gmail and put Virtual Baby Shower in the subject line and I will send you the shipping address. Of course if you have any other questions for me, you can feel free to email me as well. 
The drive will be short: I’d like everything to arrive here by March 1 so I can make the drop on Saturday, March 2. 
You may be wondering why I didn’t add an Ergo or Moby or *insert your favorite organic/sustainable/reusable product here* but I really wanted to keep every item under $40. If you are feeling generous, by all means, donate something more expensive. But I know those items aren’t within everyone’s reach and I didn’t want anyone to not chip in because they couldn’t afford to.
I appreciate all of you even reading this and considering it. I hope I can collect a ton of items for these women. Let’s make it happen!

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Corporate self-interest and cost control

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So the report into Mid-Staffordshire NHS Trust is public, and it makes for grim reading for the public and a valediction for many coal-face, NHS workers. For anyone about to become an inpatient it must make them feel extremely nervous. When in hospital you are basically reliant on the care provided for you by the staff, so to read that patient deaths were caused by neglecting the basic standards and that patients were left unfed, unwashed and unmedicated, must be horrifying. At this point is it easy to dump all the blame on those who physically failed to provide care, in this case nurses, but hallelulah, the report then goes on to get to the crux of the matter by finding fault with the Trust Board and the Local Health Authority and then recognising that the Department of Health is ‘remote from the reality of the service at the front line’.
Here is the author of the report speaking at a press conference, he graphically enumerates the failings at Mid-Staffordshire, neglect that makes me shudder, failures in compassion and caring, a culture where patient care was obviously not the top priority. Some of this may well be down to a few front-line workers, to a culture within that institution that has been allowed to continue without investigation, and yes, there should have been investigation, many patients and their relatives had made complaints. Why would this situation been allowed to continue? Lack of leadership, I’m going to qualify that, lack of effective leadership but, being a clinical NHS worker, the words which leap out are ‘Insufficient staff to deliver effective patient care’, ‘a focus on reaching targets, achieving financial balance…. at a cost of delivering acceptable standards of care’.

For years I have been writing about staff shortages and paperwork but in The Safety of Services blog entry I highlighted the government and DoH as being culpable for many failings within the NHS. In fact, reading it now, 5 years after I wrote it as a response to a report from the King’s Fund, I am truly depressed to see how nothing has changed. Substitute NHS for Maternity Services and you have the skeleton of today’s report.

There is a tiny piece of self-satisfaction, knowing that I can sit at home, tapping away in my spare time and come up with an immature version of an official report but there is also huge sadness. It just goes to show that those who are a position to influence and drive positive change in the NHS never listen to front-line workers as what I write thousands voice.



Human Breast Milk Contains PLURIPOTENT Stem Cells!

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Last September, during the Bi-Annual Meeting of the International Society for Research in HumanMilk and Lactation occurred in gorgeous Trieste, Italy one could hear a pin drop when Prof. FoteiniHassiotoupresented her and colleagues’ ground-breaking work on human stem cells in breastmilk.
Most of us are familiar with embryonic stem cell research as potentially revolutionary for regenerative medicine and human health. This is because during embryonic development, all of our adult tissues derive from three initial germ layers – the endoderm, the mesoderm, and the ectoderm. In this way embryonic stem cells are pluripotent, which means that the cells have the potential to develop into any of the ~200 cell types in our body.

However, significant controversy surrounds embryonic stem cell research, limiting research effort on this topic. Adult stem cells exist, but they are generally more limited in terms of the types of cells they can become- known as multipotent. Although the presence of adult stem cells had been known to occur in mammary tissue, the presence of stems cells in breast milk was established by Cregan and collegues in 2007. Their initial research suggested that these cells were multipotent and could develop into a limited number of subsequent cell types.  In 2010, the multipotent features of stem cells in breast milk were confirmed by researchers in India (Patki et al. in 2010).
art by Sarah Wray
Dr. Hassiotou and colleagues have now established that pluripotent stem cells are active in the lactating breast and can be non-invasively collected from breast milk (2012). Embryonic stem cells have a “core-circuitry of self-renewal” through the transcription of particular genes (OCT4, SOX2, NANOG, SSEA4, & three transcription factors (TFs)) (Hassiotou et al., 2012). Human breastmilk stem cells (hBSC) show similar patterns of gene activity that allow for the stem cells to replicate. Most excitingly, in vitroinvestigation of hBSC revealed that cells differentiated into cell types of all three germ layers, suggesting pluripotency. For example, hBSC can become neural cells and cells that express insulin, including many others!

Hormonal cues during pregnancy and lactation seemingly activate the stem cells within the mammary gland- hBSC were not found in the breasts of women who were non-pregnant or non-lactating.

In general, discussion of stem cells usually turns to regenerative medicine. Proponents for developing stem cell therapies hypothesize that stem cells could be used to treat patients with Type I diabetics whose islet cells in the pancreas no longer produce insulin. However, from a developmental biological perspective, I am most intrigued about what these hBSC may do when ingested by the infant. Hassiotou and colleagues suggest that hBSC may behave similarly to immunofactors in the infant, crossing into the infant’s bloodstream and playing a role in tissue repair and development.
The discovery of pluripotent stem cells in human milk is a game changer, whether your perspective is regenerative medicine or developmental biology. Research on pluripotent stem cells can now potentially rely on hBSC collected non-invasively, reducing reliance on human embryonic stem cell research. Within the neonate, these stem cells ingested via breastmilk may contribute to developmental programming for health and metabolism later in life. We can further hypothesize that stem cells in breastmilk may be critically important for tissue development and repair in pre-term and NICU infants. Although there are only a handful of studies on this topic, the implications of this discovery can not be overstated. I know I am not alone among my colleagues in eagerly anticipating the next discoveries in human breastmilk stem cells.

Enjoyed this post? Check Out Top Ten Highlights from Mammals Suck, Year 1!
Cregan MD, Fan Y, Appelbee A, Brown ML, Klopcic B, Koppen J, Mitoulas LR, Piper KM, Choolani MA, Chong YS, Hartmann PE. 2007. Identification of nestin-positive putative mammary stem cells in human breastmilk. Cell Tissue Res. 329(1):129-36.
Hassiotou F, Beltran A, Chetwynd E, Stuebe AM, Twigger AJ, Metzger P, Trengove N, Lai CT, Filgueira L, Blancafort P, Hartmann PE. 2012. Breastmilk is a novel source of stem cells with multilineage differentiation potential. Stem Cells. 30(10):2164-74. doi: 10.1002/stem.1188.
Patki S, Kadam S, Chandra V, Bhonde R.  2010. Human breast milk is a rich source of multipotent mesenchymal stem cells. Hum Cell. 23(2):35-40.
A previous version of this post appeared in SPLASH! Milk Science Update

Gina and her men

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Read Gina’s story on her blog at Quote from the story that I love: “It was the most amazing feeling reaching down, catching our baby and bringing him to my chest. No one other than Cody and I touched our baby, that was very special to me. He snuggled on my chest and Cody told me how proud he was of me and I told Jaxon how proud I was of him.”

Birthing the Placenta in the early days of Canada

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I’m a little hesitant to post the following because of the undertones of colonial disdain but I’m going to go ahead because this is the source of my conviction about the 30 Minute Third Stage. If this story can be used as a cautionary tale for midwives and physicians, I think it’s important to share it. Please read it with a sympathetic view to the time and place.

From CBC Radio “Ideas” program “Doctoring the Family
By David Cayley and Jutta Mason

(beginning of excerpt) David Cayley (announcer): It is clear that pre-medical birth cultures, both Native and non-Native, had many resources to deal with difficulties, but the picture is naturally not without its shadows and isolated cases of shocking cases of incompetence are easy enough to find. Rita Dobois, for example, recalls that although native midwives were usually very cautious about manual extraction of the placenta, she did encounter one very striking exception.

Rita Dobois: The placenta, they didn’t like to pull on it. Now, there was another case here in Manitoba that one of my friends went to and they did a terrible job there. Now, that midwife was known in the community as not being a very good midwife, and she did a delivery on a young woman, a woman who was about 19-20 years old and it was her first baby, and the placenta did not come away fast enough for her liking, and she went in after the placenta. It was very strange, I was quite surprised that she apparently took the placenta and whatever she got and put it into a cloth and put it on the lady’s abdomen and sent the patient in to Norway House, to the doctor, because she was still bleeding. When the doctor opened the cloth, he almost died of shock because there was the uterus, the cervix, the bladder and part of the bowel. She had taken everything out. She had yanked it all out—everything. And that was something that we could not understand, because we had never seen this happen.

So, this nurse said that she was sent in there for the next period. It was freeze up in the fall. She said there were two babies delivered and this midwife insisted that she do the delivery. So she thought well, I’m going to be there, I’m going to see this thing. And so she was there for the delivery and she said it was really an amazing thing because she had never heard a midwife or seen a midwife do this. As soon as the baby was born, I mean just as fast as a wink, her hand was going in to pull out the placenta because the woman was going to die if the placenta wasn’t out. And at one point, the nurse said to her, if you don’t take your hands away from there I’m going to hit you over the head right now and knock you out, because you’re going to kill this lady. And this woman got really upset because she thought that what she was doing was really the right thing to do. And so they got a clock and they sat there and watched the clock. And this nurse kept saying to her, take your hands away, it’s not 30 minutes yet, it’s not 30 minutes. And so finally in 30 minutes, the placenta separated and delivered by itself, and this woman was absolutely amazed.

So, when the nurse asked around the community, you know, how much experience this woman had, they said not a lot, but they thought that she wasn’t that bad. So then when they had the second delivery, Lenore said to this woman, well, you’re going to do the delivery, but there’s the clock and I’m telling you, if you touch that woman before 30 minutes I’m going to really sock you a good one. And so she said the woman just sat there and waited and watched the clock and watched the nurse for fear that she was going to get a clobbering. And in 30 minutes, the placenta separated and came away nicely, and this woman was amazed. She said, you’ve got magical powers. She said no, but she said I bought this clock and it’s yours, and you watch it. And she said, the next time there’s a delivery, even if I’m not here, you expect me to clobber you if you touch her before 30 minutes. And this woman was really amazed, she just couldn’t believe that 30 minutes was like a magic number. Because to her, as soon as the feet were out, you had to go in there and pull out the placenta, right away, quick. . . There was this terrible fear of losing the patient to hemorrhage. We’ve never seen that anywhere else. (end of excerpt)

Related link: 30 Minute Third Stage