Count Your Baby's Kicks

Counting kicks is easy to do.  It's important too! According to the information posted at CounttheKicks.org, counting can save your baby's life. 

When you start your 3rd trimester, it’s time to start counting.

 Here’s how you do it:

  • Count the Kicks every day, preferably at the same time.
  • Pick your time based on when your baby is usually active, such as after a snack or meal.
  • Make sure your baby is awake first; walking, pushing on your tummy or having a cold drink are good wake-up calls.
  • To get started, sit with your feet up or lie on your side. Count each of your baby’s movements as one kick, and count until you reach 10 kicks.  After a few days you will be to see a pattern for your baby.  
  • Most of the time it will take less than a half-hour, but it could take as long as two hours.
  • Log your recorded times using our Count the Kicks App or a kick chart.

Why count kicks? The research is clear it could save your baby's life:


Research Citations

Click the links below to learn more.

Reduction of Late Stillbirth

Holm Tveit JV SE, Stray-Pedersen B, Bordahl PE, Flenady V, Fretts R, Froen JF: Reduction of late stillbirth with the introduction of fetal movement information and guidelines - a clinical quality improvement. BMC Pregnancy Childbirth 2009, 9(32).

Fourteen hospitals in Norway participated in this study which aimed to improve care by providing written information to pregnant women about Decreased Fetal Movement and to provide guidelines on Decreased Fetal Movement to health care providers. There was an overall decrease of stillbirths by 1/3, with no increase of preterm births, or need for neonatal care.

ACOG Committee on Practice Bulletins with the Assistance of Ruth C Fretts: ACOG practice bulletin: Clinical management guidelines for Obstetrician-Gynecologists 102 03/2009: Obstet Gynecol 113: 748-761

Fretts R , Duru U: New indications for antepartum testing: Making the case for antepartum surveillance or timed delivery for women of advanced maternal age. Semin Perinatol 32:312-317, 2008 [PubMed-indexed for MEDLINE]

Froen JF, Heazell A, et al: Fetal movement assessment. Semin Perinatol 32:243-246, 2008 [PubMed-indexed for MEDLINE]

Froen JF, Tveit JV, et al: Management of decreased fetal movements. Semin Perinatol 32: 307-311, 2008 [PubMed-indexed for MEDLINE]

Fretts R: Stillbirth: Common causes and prevention strategies. Forum 25: 8-1-, 2007 [PubMed-indexed for MEDLINE]

Guidelines for Perinatal Care, 6th Edition, 2007, American Academy of Pediatrics and American College of Obstetricians and Gynecologists, page 114 (under paragraph entitled Assessment of Fetal Movement): "The perception of 10 distinct movements in a period of up to 2 hours is considered reassuring. After 10 movements have been perceived, the count can be discontinued for that day."

Reddy U: Prediction and prevention of recurrent stillbirth. Obstet Gynecol 1151-1164, 2007 [PubMed-indexed for MEDLINE]

Froen JF: A kick from within-fetal movement counting and the cancelled progress in antenatal care. J Perinat Med 32:13-24, 2004 [PubMed-indexed for MEDLINE]

Study of Maternal Observations and Memories of Stillbirths (MOMS Study)

5000 moms with stillbirths participated in answering questions regarding their pregnancy. 50% of the moms reported gradual decreased fetal movement several days prior to death. 56% of moms reported that this decreased movement was the first reason to believe that there was something wrong.

Fetal Movement Intervention Assessment (FEMINA)

FEMINA8 (Fetal Movement Intervention Assessment) is an ongoing international research collaboration to improve pregnancy outcome through better understanding of reduced fetal activity. Froen previously reported that 50% of mothers waited more than 24 hours without any fetal activity before contacting their doctor – 30% waited more than 48 hours.

Stillbirth Collaborative Research Network (SCRN)

Dr. Uma Reddy from the National Institute of Health (NIH), is leading the Stillbirth Collaborative Research Network (SCRN). This 5 year study will determine the incidence of stillbirth, determine risk factors and uncover the causes of stillbirth using a standard protocol that will review clinical history, protocols for pathologic examinations of the fetus and placenta.

It’s a great way to bond with your baby. Most importantly, it could save your baby’s life.


Lactivism - New Book Questions Breastfeeding Advantages

I was listening to NPR the other day when I heard this story about the new book by political scientist Courtney Jung, Lactivism. Throughout the interview, Ms. Jung made statements that made my blood boil. While there may be bits of research out there that question the advantages of breastfeeding, the vast majority of it supports nursing as highly beneficial to both mother and baby. That does not mean every woman can or should nurse and I don't know many breastfeeding advocates who believe that every woman should or can. In 20 years as a birth worker, I have rarely seen the kind of pressure that Ms. Jung describes being exerted on women to nurse at all cost. Generally I see the opposite. Women are encouraged to try it (after generations of being told not to) and then given very little support to continue if or when it gets rough. The book and Ms. Jung's statements are often misleading non-science and opinion. I found the NPR conversation with Ms. Jung decidedly one-sided. What are your thoughts?

Click here to listen:

http://www.scpr.org/programs/airtalk/2015/12/31/45762/political-scientist-looks-at-forces-behind-turning/

Harper's Magazine: The Case Against Pregnancy Bed Rest


The Bed-Rest Hoax

The case against a venerable pregnancy treatment

By Alexandra Kleeman

After just a couple of days on bed rest, the material of your body begins to feel different: softer, heavier, a burden to the bone beneath. The thud of the heart in the chest feels deeper: each beat shifts your frame a little. Even though you haven’t used your back for anything, it aches — and when you twist into a new position the ache swivels along with the muscles, can’t be left behind. You fall asleep throughout the day but can’t sleep through the night, and when you bend a limb at the joint, it’s not the transparent sensation you’re used to — you can feel the muscles tugging, the socket creaking in protest. Your body becomes more present, weaker, and more vulnerable: you are aware of it as though it were an alarm that has not yet gone off but could at any moment.

This summer, I checked myself into a progressive Catholic convent in the Pacific Northwest to observe the effects of five days of bed rest on my body and mind. My plan was to spend all but thirty minutes of each day in a small room with framed Bible verses on the walls, lying on my back or side on a spartan twin-size cot. In the thirty minutes I was allowed out of bed, I would shower, take bathroom breaks, or fetch food from the communal kitchen to bring back and eat in bed. In the final moments before my experiment began, I stretched the inner muscles of my thighs and blinked in the warm sunlight. I tried to take pleasure in feeling ordinary, normal, mobile.

Though five days is a relatively short bed-rest regimen, the first week is when some of the most dramatic changes to the body occur. Deconditioning of the cardiovascular system begins within forty-eight hours. The amount of circulating blood decreases, the heart’s total output drops, and the body uses less and less oxygen. Within five days of immobilization, the arteries narrow and stiffen, and the interior lining of the blood vessels becomes less able to flex and tighten.


Illustrations by Shonagh Rae

The body scales itself down rapidly to meet the reduced physiological demands of its new state and then pauses. Eventually, over weeks, bone density decreases and muscle volume declines. Actin and myosin, the proteins that make up muscle, break down into free-floating nitrogen that is flushed from the body through the kidneys. Simply standing up can cause fainting, since the body is no longer used to pumping blood against the pull of gravity.

Hundreds of thousands of years of evolution have enabled us to walk upright, a task few other mammals can manage — sheep and rabbits often lose consciousness or die when held vertical. But the more time a body spends away from plumb, the greater its difficulty in readapting to normal life. For this reason, bed rest is used as an analogue for space travel in NASA experiments: the effect of weightlessness on human bodies can be simulated on Earth by putting subjects to bed at a six-degree negative incline. Prolonged rest is an extreme physiological challenge, a new environment for the body to navigate.

What I’ve described sounds like a sort of bodily erosion, a slow injury or gentle decay, but it also happens to be one of the most commonly prescribed treatments in the United States for pregnant women at risk of preterm birth. Each year as many as 700,000 pregnant women are prescribed some form of bed rest: from several hours a day to round-the-clock immobilization with breaks only to use the bathroom. For some types of high-risk pregnancy, the mother-to-be is hospitalized and prohibited from getting up to relieve or clean herself, from standing, or even from sitting propped up in bed. Strict bed rest — whether at home or in a hospital — often means that a woman has to forfeit exercise, income, and normal domestic tasks such as caring for her family or maintaining her home.

The practice continues despite a growing body of clinical evidence showing that strict bed rest offers no benefits to the fetus or to the mother. It has not been proved effective in treating gestational hypertension, preeclampsia, a shortened cervix, spontaneous abortion, or impaired fetal growth. The hazards of bed rest, on the other hand, are well substantiated: patients may suffer from bone loss, blood clots, muscle atrophy, weight loss, and psychological malaise. Enrollment in one study, in which women carrying twins were randomly admitted to the hospital for bed rest or assigned outpatient care with no activity restriction, was halted midway because of concerns about a possible detrimental effect to the hospitalized group.

Even so, bed rest remains a routine therapeutic intervention for pregnancy, with up to 95 percent of obstetricians reporting that they’ve prescribed it for their patients. Decades after the treatment fell out of favor for other conditions, pregnancy is the last remaining medical territory to which bed rest can lay claim. It is now the domain of those physi cally incapable of movement — those, for example, who have broken all their limbs — and expectant mothers.

READ THE FULL ARTICLE AT HARPER'S MAGAZINE



Source: http://harpers.org/archive/2015/12/the-bed...

The Mama Sherpas / A Great Documentary About How to Get the Birth You Want

Looking for a film that offers hope for better, less intervention heavy birth in the hospital and is NOT all about home birth or midwives? Ricki Lake and Abbey Epstein, the producers of The Business of Being Born and the documentary Breastmilk are back at with The Mama Sherpas, a documentary focused entirely on birth in the medical setting. But you won't just see the emergency C-section here -- you'll see that, yes, but also a water birth, a VBAC, a vaginal breech delivery all safely achieved. Check out Jessica Hartshorn's review in Parents Magazine by clicking on the URL or scrolling down the page:

http://www.parents.com/blogs/parents-perspective/2015/07/20/pregnancy/getting-the-birth-you-want-can-the-mama-sherpas-help/

"There is the way you picture your birth going, and then the way itactually goes, and rarely are those two the same.

But the premise of a new documentary called The Mama Sherpasis that maybe, perhaps, our country can inch toward a model where mothers work with both midwives and doctors to have births that are more comfortable, calm, and less of a surprise than, say, the emergency C-sections we so frequently hear about, or the induced births.

Because the documentary is executive-produced by Ricki Lake and Abby Epstein, the team behind The Business of Being Born (and the executive producers of the documentary Breastmilk) I first thought The Mama Sherpas might be another championing of home births and natural-everything. But it's entirely focused on several medical centers where doctors and midwives work side-by-side, in medical settings. There is always an emergency team on the premises if needed, which is reassuring as you watch, for instance, a woman attempt (successfully!) a vaginal breech birth.

Related: Is a Certified Nurse-Midwife Right for You?

The film chronicles plenty of mamas' labors—yes, there is a C-section, and yes, there is a water birth, and everything in between. The director, Brigid Maher, was motivated to do the film on her quest for a VBAC, a vaginal birth after having had a Caesarean, and she is entirely understanding of the fact that there is a time and place for every kind of medical intervention. Her objection is to women being pushed into a birth they don't want strictly for the convenience of the doctors and hospital staff. And her love of midwives seems to come from the fact that they are able to devote more time and patience to educating their clients, explaining when something is necessary and when it is a choice.

The takeaway, if you're pregnant or planning to have another baby, is that finding a midwife who will assist your birth is, at the very least, likely to give you more options than you would probably have working only with doctors and nurses whose job is to standardize the births they facilitate.

Use the firm to be inspired to ask questions, and to appreciate that perhaps we can all have a little more control of our births than we think. It will be available on DVD ($19.99) and iTunes($4.99 to rent) tomorrow, July 21. In the meantime you can watch the trailer or check them out on Facebook to follow the rollout of the film."

Jessica Hartshorn has been an editor at American Baby magazine for 17 years and yet is still sort of shocked when watching video footage of babies being born.

Never EVER Shake a Baby - A NYT Article Every New Parent Should Read

Shaken Baby Syndrome: A Diagnosis That Divides the Medical World - The New York Times

SEPT. 13, 2015
By CLYDE HABERMAN, New York Times

Perhaps no crime staggers the mind, or turns the stomach, more than the
murder of a baby, and so it is not a surprise when law enforcement comes
down hard on the presumed killers. Often enough, these are men and women
accused of having succumbed to sudden rage or simmering frustration and
literally shaken the life out of a helpless infant who would not stop crying or
would not fall asleep.
Shaken baby syndrome has been a recognized diagnosis for several
decades, though many medical professionals now prefer the term abusive head
trauma.

It is defined by a constellation of symptoms known as the triad: brain
swelling, bleeding on the surface of the brain and bleeding behind the eyes.
For years, those three symptoms by themselves were uniformly accepted as
evidence that a crime had been committed, even in the absence of bruises,
broken bones or other signs of abuse. While many doctors, maybe most, still
swear by the diagnosis, a growing number have lost faith. Not that they doubt
that some babies have been abused. But these skeptics assert that factors other
than shaking, and having nothing to do with criminal behavior, may sometimes explain the triad.

Has the syndrome been diagnosed too liberally? Are some innocent
parents and other caretakers being wrongly sent to prison? Those questions, at
the complex intersection of medicine and the law, can stir strong emotions
among doctors, parents and prosecutors. They shape this first installment in a
new series of Retro Report, video documentaries that explore major news
stories of the past and their enduring consequences.


The video’s starting point is a Massachusetts criminal case that
introduced the concept of shaken baby syndrome to many Americans: the 1997
murder trial of Louise Woodward, an 18-year-old British au pair accused of
having shaken an 8-month-old boy, Matthew Eappen, so aggressively that he
died. Matthew also had injuries that may have predated Ms. Woodward’s
joining the Eappen family in Newton, outside Boston. The focus, however, was
on the triad of symptoms. To prosecution witnesses, they proved that the baby
had been shaken violently, his head hitting some hard surface.


Throughout, Ms. Woodward insisted on her innocence. But a jury in state
court found her guilty of second-degree murder, and she was sentenced to a
prison term of 15 years to life. Within days, though, the trial judge called the
murder conviction an injustice. He knocked down the charge to involuntary
manslaughter, reducing the young woman’s sentence to time already served,
279 days. Many in Massachusetts and beyond were outraged. Nonetheless, Ms.
Woodward was free to return to England.


The “nanny murder trial,” as headline writers called it, had an unfortunate
subplot. In some quarters of public opinion, Matthew’s mother, Deborah
Eappen, stood figuratively in the dock as well. A doctor — like her husband,
Sunil Eappen — she found herself under the sort of attack many working
women face to this day. The case, a New York Times article said in 1997, “put a
spotlight on the backlash against working mothers who consign their children
to the care of others.”


But the dominant issue was child abuse. Shaken baby syndrome is but one
aspect of this phenomenon. It is a topic in which statistics can be elusive
because reported episodes may not reflect the full extent of the problem. That
said, a report issued in April by a division of the Department of Health and
Human Services estimated that in 2013, more than 1,500 children in the
United States, or four a day, died from various forms of abuse or neglect.
Nearly three-fourths of the victims were under the age of 3. (Various studies
over the years have suggested that a serious threat to a small child’s well-being
is the presence of the mother’s live-in boyfriend.)


In the Woodward trial, a key prosecution witness was Dr. Patrick Barnes,
a neuroradiologist then at Children’s Hospital in Boston, now at Stanford
University. “I was adamant that it had to be child abuse, shaken baby
syndrome,” Dr. Barnes told Retro Report.


But after the trial, he rethought his testimony and in effect became a
penitent. He is now convinced that the diagnosis has been invoked too readily
in criminal cases and that other causes might explain any bleeding and brain
swelling. They include infections, earlier injuries from accidental falls and
even strokes that occurred in utero. Other doctors who share his outlook
question whether just shaking an infant, without resorting to other forms of
violence, could in fact produce the triad’s telltale signs. Testing that thesis,
though, may verge on the impossible: Who in the name of responsible science
is about to shake a roomful of babies to see what happens?
Without question, Dr. Barnes said, abuse exists, “and we have to do our
duty to protect children.” But families need protection, too, he said, and in
some criminal cases, “there is no doubt that errors have been made and
injustices have resulted.” Were he able to testify again in the Woodward trial,
he said, he would say that the medical findings do not confirm abuse and that
the baby’s injuries “could have been accidental.”


One of the more exhaustive studies of shaken baby syndrome’s legal
ramifications was conducted by The Washington Post and journalists from the
Medill Justice Project at Northwestern University. In March, they published
their analysis of about 1,800 abuse cases across the country that had reached
resolution since 2001. Far more often than not — 1,600 cases — the result was
a conviction. But the researchers found that in 200 cases, a substantial
number, charges were dropped or dismissed, defendants were acquitted or
convictions were overturned. The Retro Report video examines one such
instance, involving Quentin Stone, a California man whom a jury last year
cleared of charges that he had violently shaken his 3-month-old son to death.
Not that the medical establishment is starting to line up on Dr. Barnes’s
side. Far from it. Dr. Robert W. Block, a former president of the American
Academy of Pediatrics, stands firmly by the diagnosis, telling Retro Report
that abusive head trauma is supported by decades of observation.
The divisions within the medical world run so deep that they pain a
towering figure on this issue: Dr. A. Norman Guthkelch, a British doctor who
in 1971 found a connection between baby-shaking and brain injury. “There are
cases where people on both sides, both of whom I admire equally, are barely
able to speak to one another, and that’s a shame,” Dr. Guthkelch, who turned
100 this month, told NPR in 2011. Yet he, too, has come to believe that the
syndrome is applied too loosely in some criminal cases.


As the debate continues, Louise Woodward has carved out a new life in
Shropshire, in central England, where she teaches dance. Married, she has a
baby of her own now, a girl born 20 months ago. Even before her pregnancy,
she was quoted as telling The Daily Mail: “I know there are some people
waiting for me to have a baby so they can say nasty things. It upsets me, but
that is not going to stop me leading my life. I am innocent. I have done nothing
wrong.”


The videos with this article are part of a documentary series presented by The
New York Times. The video project was started with a grant from Christopher
Buck. Retro Report has a staff of 13 journalists and 10 contributors led by Kyra
Darnton. It is a nonprofit video news organization that aims to provide a
thoughtful counterweight to today’s 24/7 news cycle. Previous episodes are at
nytimes.com/retroreport. To suggest ideas for future reports, email
retroreport@nytimes.com.
© 2015 The New York Times Company

The Bottom Line: NEVER, EVER shake a baby. If you feel frustrated or overwhelmed by your baby's crying, call someone -- a friend, a family member or other helpful connection. Learn more about the Purple Period Program athttp://dontshake.org/sbs.php?topNavID=4&subNavID=32&navID=170

Go to http://www.nytimes.com/2015/09/14/us/shaken-baby-syndrome-a-diagnosis-that-divides-the-medical-world.html?hp&action=click&pgtype=Homepage&module=mini-moth&region=top-stories-below&WT.nav=top-stories-below&_r=0 

 

Understanding the Purple Period of Crying

Learn more about why your newborn may be crying at http://www.purplecrying.info/

The Period of PURPLE Crying begins at about 2 weeks of age and continues until about 3-4 months of age. There are other common characteristics of this phase, or period, which are better described by the acronym PURPLE. All babies go through this period. It is during this time that some babies can cry a lot and some far less, but they all go through it.

Scientists decided to look at different animal species to see if they go through this developmental stage. So far, all breast feeding animals tested do have a similar developmental stage of crying more in the first months of life as human babies do.

When these babies are going through this period they seem to resist soothing. Nothing helps. Even though certain soothing methods may help when they are simply fussy or crying, bouts of inconsolable crying are different. Nothing seems to soothe them.

During this phase of a baby's life they can cry for hours and still be healthy and normal. Parents often think there must be something wrong or they would not be crying like this. However, even after a check-up from the doctor which shows the baby is healthy they still go home and cry for hours, night after night. "It was so discouraging," said one dad. "Our baby giggles and seems fine during the day and almost like clockwork, he starts crying around 6 pm. He is growing and healthy, so why does he cry like this?"

Often parents say their baby looks like he or she is in pain. They think they must be, or why would they cry so much. Babies who are going through this period can act like they are in pain even when they are not.

In my own case, I know my son was not sick. He was in the top percentile for growth, he giggled and was happy other times Then he would start to cry, and cry, and cry. The doctor kept telling me he is just fine.

After learning all of this, we decided we needed to share this information with other parents. We had to take this information and put it into a statement that told the story about this phase in a baby's life. Dr. Ronald Barr, a developmental pediatrician who has likely done more studies on infant crying than anyone in the world, came up with the phrase the Period of PURPLE Crying. His idea was to explain this phase to parents of new babies so they would know it was normal and they would be encouraged that it would come to an end.

The acronym PURPLE is used to describe specific characteristics of an infant's crying during this phase and let parents and caregivers know that what they are experiencing is indeed normal and, although frustrating, is simply a phase in their child's development that will pass. The word Period is important because it tells parents that it is only temporary and will come to an end.

- See more at: http://purplecrying.info/what-is-the-period-of-purple-crying.php#sthash.B5sNGrz5.dpuf