Feeling snotty? There's a reason!

Wednesday, September 16, 2020

 

Mucus Production & Pregnancy

Doesn't sound awesome, but doesn't sound too bad, does it?

You're probably thinking a runny nose and you're not too gar off, but it can also look like ear infections and sinus infections. During pregnancy, your hormones rage (duh!), but the specific surges in estrogen does helpful things like increasing blood supply to your vaginal area and creating your mucus plug.

Since you're pregnant, you can't take most medications. Even if you could, many people choose to limit medication consumption during pregnancy and nursing. So what are you to do? Just be a walking snot factory for 9+ months? No, not at all. Like everything else, you have some choice here on your approaches.

Here are a few remedies to clear mucus:
- Drinking lots of water
- Adding electrolytes to your water
- Eating garlic + onions
- Cutting down (consider eliminating) dairy
- Netti pot
- Drinking hot liquids
Turmeric health shot
- Eating soup
- Rest, rest, rest
- Acupuncture

You may also experience ear infections. Here are some remedies:
- Check in with your doctor (you may require an office visit)
- Mullein Garlic (purchased at whole foods, ear drops)
- Eating garlic + onions
- Avoid dairy
- Turmeric health shot
- Netti pot
- Hydrate!!!

A neat trick that I learned recently from a nurse was to bend over and put your head below your heart. If the stuffiness drains and the throbbing stops, it is due to pregnancy. If it doesn't drain and the throbbing doesn't stop (or gets worse) it's most likely stopped up and could be a possible ear infection. *This in no way constitutes medical advice, diagnosis, or a cure and should not be taken as such*

If you get a fever, no matter how tiny, check in with your healthcare provider. Be sure to avoid colloidal silver as it is bit safe for pregnant or nursing people.

Pregnancy changes everything in your body...and I mean everything. Right down to your sinuses, your baby is already controlling you in every sense. Now that you know you have a reason to nap and decline Friday night's invite to supper club, do it. Take advantage of growing this tiny human. Take the time to honor the messages your body is sending you (rest, hydration, and slowing down).

You only get to experience this pregnancy once. Stop and enjoy it.


Don’t forget to join our private Facebook group and follow us on Instagram at @tranquilitybyhehe or @the.birth.lounge!


Heartburn in Pregnancy

Wednesday, September 9, 2020

 

Heartburn in Pregnancy

Why does it happen?

Heartburn is incredibly common and will plague between 17%-45% of pregnant people (Vazquez JC. Heartburn in pregnancy. BMJ Clin Evid. 2015;2015:1411. Published 2015 Sep 8.).

This happen because of two hormones: progesterone and relaxin. They are responsible for relaxing the muscles in your body during pregnancy to allow for growth and stretching in order to accommodate your baby. This causes your esophagus and the sphincter that keeps it closed to relax as well. Also, as your baby grows your “real estate” gets smaller and smaller.

With this change, your stomach gets squished which forces stomach acid back up into your esophagus. Not pleasant, but there are ways to combat this physical change and discomfort!

First, what not to do!

  • Do not stop eating. Your baby needs to be nourished. Not eating will actually increase your stomach acid making your heartburn worse.

  • Do not munch on antacids (TUMS, Rolaids) like candy as this has been linked to calcification of the placenta*. This means your placenta will begin to develop these very hard, rocklike spots and obviously this is not healthy for your baby. Also too much calcium can block iron absorption so be mindful of that. Many actiacids use aluminum as an active ingredient such as aluminum hydroxide or aluminum carbonate and should be avoided in pregnancy. Antiacids can cause constipation and due to the high sodium bicarbonate in some formulas, it can elevate your blood pressure which is not great for anyone at risk for preeclampsia.

What to do? (Please check with your provider before using/adopting these remedies): 

  • Begin with eating smaller meals. I recommend also snacking every hour with just a handful of something light, but filling like almonds, popcorn, 3-5 crackers, a handful of grapes or blueberries, a bowl of strawberries or watermelon, a hard-boiled egg, etc. Eating smaller meals will benefit you in several ways: it will allow your belly to digest before adding more since the space is limited, it will provide you and your baby consistent fuel (and energy), and it will support stable blood sugar. Along with eating small meals is eating slow. Do not scarf down your dinner in 10 minutes flat and be shocked that your heartburn is out of control. Your tummy just can’t digest that amount of food consumed in a matter of minutes at once anymore.

  • Drink a glass of milk. Milk can coat the inside of your stomach and help dilute the stomach aid. Yogurt can do the same thing for you! You can also try a shot of Apple Cider Vinegar, eating ginger or sipping ginger tea, a spoonful of honey or chamomile tea with honey.

  • Papaya Enzymes. Caution here because papaya FRUIT (vs. the extracted enzyme) is contraindicated as a possible cause of pre-term labor. The caveat here is that it’s UNRIPE papaya fruit but since you don’t ever really know the ripeness of fruit you purchase in the store, it’s best to stay away altogether (unripe papaya has also been linked to miscarriage in a few studies when consumed in the first trimester).

  • - Orange Peel Extract: I have never heard of this and have never recommended this, but this is a very interesting article and the sources are provided at the bottom. 

  • Stay hydrated. Rather than downing a glass of water once an hour, it’s better to consume liquids consistently throughout the day. The recommended amount of water for an average pregnancy and average sized female is 8-10 cups (equal to 65-80 ounces or 2-2.4 liters).

  • Avoid laying down after eating. You should not lie down for at least 45-60 minuets after eating. This is most difficult after dinner so I say find an activity that requires you to be upright—either standing or sitting. If you lie down too soon, the stomach acid that is working to digest the food in your stomach will slip right up and you might even feel nauseas or find yourself throwing up.

  • Avoid eating right before bed. I always say if you can eat 2 hours before bed, then that’s enough, but some doctors would say you shouldn’t eat anymore than 3 hours before bed. I believe this truly depends on your body and only you will know what that time is for you. However, try not to eat super hearty meals before bed because this will have your stomach working in overdrive. If you need to eat right before bed (trust me, I feel you), I recommend something water based like grapes, watermelon, or celery. These are easy things to digest, but be mindful that the sugar from the grapes and watermelon may spike your blood sugar or make your baby have a dance party.

  • Sleep Elevated. You can achieve this several ways. You can purchase a wedge pillow or you can stuff rolled up towels (or a yoga mat) under the top of your mattress to create an angle at your head. This will prevent stomach acid from going back into your esophagus while you’re lying flat.

  • Chew sugarless gum after eating dinner (or any large meal). This is a very interesting one, but it works similarly to giving a baby with acid reflux (or just really bad spit up) a pacifier after feeding them (before burping) to keep them sucking. This continuous sucking, despite not eating, keeps their gastrointestinal system activated which keeps them digesting longer and we generally see a decrease in spit up. Same with adults, but our gastrointestinal system is activated by chewing since we are not infants anymore. The chewing gum will keep your stomach activated. The increased saliva might also help to neutralize the stomach acid.

  • Speak with your doctor. They may suggest a H2 blocker like Tagamet or Zantac. Be mindful that long term use of these have been linked to pH unbalance in your stomach and gut.

*CALCIFICATION OF THE PLACENTA

  • - This is a condition where the placenta begins to harden (calcify) in specific spots. These spots are indicators of the “age” or “ efficiency” fo the placenta meaning the more calcification the “older” and less efficient your placenta is considered to be. 

  • - This is a great informational article but provides no evidence-based citations or any real sources. 

  • - It’s not regulated by the FDA nor has it been evaluated by any formal study that it is safe to consume daily TUMS during pregnancy. 

  • - The Placenta is in charge of filtering all calcium that crosses the blood-brain barrier. If there is too much, your placenta will actually hold the extra calcium —causing calcification of the placenta. Calcification of the placenta has been associated with pre-term labor. TUMS should never be taken at the same time as prenatal vitamins due to a possible adverse interaction between the two. 

  • - Calcium Carbonate is the active ingredient in antacids and too much calcium has been shown to block iron absorption. Iron is extremely important in pregnancy. Your body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to your tissues. During pregnancy, you need up to double the “normal” recommended dose to increase the red blood cells to in-turn increase the oxygen levels reaching your baby. 

  • - There are a few studies that show (one of these is as a journal of veterinarian medicine—not too far off as we generally test on rats, pigs, or rabbits for pregnancy related research) an almost toxic level of calcium in fetal blood compared to mothers. Read more about these studies  here or here.

  • - Another product similar to TUMS, called Tame the Flame, is provided by Healthy Mama. 

  • - It is possible that magnesium or Vitamin D can help offset the potential “overdose” of calcium.

Calcium During Pregnancy:


Remember: It is not our job to tell clients what they should and shouldn’t take during pregnancy. Our responsibility is to share with them the potential risks, the sources we have available, and alternatives choices they have as options to consider.

If you are looking for more resources and support surrounding diet and nutrition in pregnancy - join us in The Birth Lounge to have an informed pregnancy and confident birth experience!

7 Slippery Slopes of Labor

Wednesday, September 2, 2020

7 Slippery Slopes of Labor

How to stay in control during labor is one of the most FAQs that I receive on a daily basis! Good news! So many of the “unknowns” of birth can be alleviated with the proper education and preparation! 

But there is a catch here! The catch is.. how you prepare is uber important. Meaning you can read all the books that you have been told to read, but if you're not reading the right books, then it's really not going to prepare you. You can take all of the childbirth ed classes that your hospital has to offer. But, if your hospital isn't presenting you with all of the options during the childbirth ed course, and they're only presenting you with options that they want you to know, this prevents you from being able to truly make an informed and confident choice. 

Being able to freely make a decision after open discussion with your doctor is what we call shared decision making. This means you, your medical team and your support people come together to do exactly what it sounds like-- making a decision after sharing suggestions, opinions, and alternative options. It is important that the birthing parent shares their fears and concerns at this point, too!With this, the birthing person should feel supported and safe in their decisions. You want your medical team to feel like we are choosing a safe and reasonable option, as well! You should also feel confident that you are making the right choice and your medical team should feel comfortable with the choice made. 

Nature’s Role 

Remember that nature is always going to play a role in birth. That's life; nature will always play a role in everything we do and we can’t control that. But, as far as being able to control labor, you can control 90% of it (the part that isn’t dependent on nature). I like to think about labor as seven different categories that you can control 100%. These are places that I call the slippery slopes of birth

The Slippery Slopes of Birth 

These are seven places of your birth story that you can control, but if you aren’t preparing intentionally and you don't prepare in the correct way with the correct information (research-backed information), then you risk going down one of the slippery slopes. Each of these 7 categories is a mountain that you can conquer (control) or you can slip down during labor. 

Here's the thing, it's not about having a straight arrow birth when making your birth plan. It won’t be this A to B type route. There will always be what I like to call ‘loop-di-loo’s’ along the way! Knowing how to control these seven places in labor is mey and we will do this by showing you the variables and the normal variations of labor and birth. This enables you to understand what's normal and what is a cause for concern, what are worrisome numbers and what is expected with typical labor patterns. With this understanding, you will be able to have educated discussions with your doctor to find what option is best for you. You will be able to ask the right questions using the right words to feel informed about all of your choices. 

There are some things in birth that no matter how hard we try, we're not going to be able to control. And, that is the nature piece. That's literally the only piece of this journey that we can’t control. But, you want your birth to unravel how it's supposed to and your job is not to control it. (Remember, birth is a very natural thing) You're safe to have your baby and your job is to relax so your body can do its job. Your job is to be so prepared and so informed and have done all the research so that if you run into any of those variables, you know how you can react and what your options are--in each of those situations.

Again, it's not about controlling your labor, your birth experience. It is about controlling the seven places that you have ultimate control and allowing nature to take control of the rest. We will prepare for and react to whatever nature throws your way. 

The CONTROL Method

Communication. Options. Navigating labor. Team. Research. Opinions. Location. 

Let's just take the first one C, communication. Ideally throughout your pregnancy, as you're meeting with your provider (whether you see one provider the entire time or you see a rotation of providers), you should be setting boundaries along the way. You can gently do this through communication. Let's say, for example, you have a very strong preference to do whatever you can to avoid a C-section and otherwise you’re really open to a lot of things. 

Since your main goal here is to have a vaginal delivery, we want to gently be saying this throughout your prenatals with your provider or providers, so that they start to get the idea of your birth goals. This sets the tone for your birth in pregnancy. The more direct you are with your doctor, the less room for error. In communicating your goals, you’re providing them with constant reminders over time, so that they're less likely to forget during your labor. This also ensures this doctor is a good fit for you and can support you in your goals. Communicating before you’re in labor prevents us from having to have this conversation during labor because your team already understands your birth goals. That boundary has already been set. 

You can see how this is a slippery slope if we don't do the very tiny steps of setting these boundaries and communicating during your prenatals, asking the right questions, using the right words, getting really right down to the bottom of your provider's thoughts and your goals, but also finding that happy middle ground. One last thought: making your goals clear before you’re in labor is incredibly helpful should you have a provider you've never met attend your labor.

Let’s chat about R. Doing the research before allows you to have a solid foundation of understanding about what common practices are in the birth world and what the evidence says about each of those practices. These are certainly things that you don't want to be making big decisions about during labor. These will be things that are going to impact the way your birth goes now or the way that your birth goes down the line a bit. Making decisions on whether you want an IV placed or whether you can eat during labor isn’t what you’re going to want to be doing while you’re also trying to use your mental and cognitive energy to focus on your contractions. 

One of the best things you can do to take control of your birth is to plan for all of those variables and learn those normal variations in labor so that you know what's normal versus what is concerning during labor. The research you do leading up to your birth gives YOU all the power. You know what to expect, what your options are, what is considered ‘not normal,’ and what to do if your labor does take a ‘not normal’ turn! 

It’s All Connected.

If we look closely, we can see how it's all intertwined. It starts with communication, then understanding your options at each stage. Those two allow you to navigate labor and your team + your research allow you to stay in control from start to finish. Finally, when you control for the opinions in your inner circle and the place you give birth, you greatly increase your chances of achieving your birth goals! 

Now, sometimes you're going to have to advocate harder for yourself than other times, but in labor, that’s really a nonnegotiable. You have to speak up for yourself. It is a must. If you're going to stay in control, you have to speak up. Period. You have to absolutely speak up for yourself and advocate for your birth goals in order to stay on track for reaching your dream birth. 

If you find that your doctor is giving you pushback on your birth goals and they don't really have a lot of flexibility-- it's really worth considering if this is the right doctor for you. If they are inflexible in your pregnancy, it's unlikely that once labor begins that there's a lot of change in that department. So, if you're already feeling that tension, it is worth thinking about finding a provider that is better aligned with you. This goes back to the core value of T, team. 

Remember that there are so many outdated policies in women's health. Like, you know, one of my favorite examples to talk about is the policy restricting food and liquids during labor women. The research is very clear that birthing people should be able to eat and drink during labor, even with an epidural. Like, the science is very, very clear about this. There are so many things that hospital policies have not caught up to the research. This is very important for you to know, and this is exactly what the control method teaches you. This is all part of the research you will do along the way (or, in The Birth Lounge, I’ve done the research for you!). It's up to you to know what your hospital policies are, but the birth lounge will break it down further so that you know how to look into those policies to ensure that they are based on the latest research. (There's no doubt they're based in research, but it is possible and highly likely that they are based on outdated research, meaning from the 1990s. Your hospitals are not intentionally trying to treat you poorly. Many hospitals just haven't revisited the research and their policies in ages.) 

The Birth Lounge teaches you how to have these conversations with your provider so that no matter what happens in your birth, you are the one in control. You will understand how to identify the control, you know how to take the control and you know how to remain in control.

When Seconds Matter in Birth

Wednesday, August 26, 2020

When Seconds Matter in Birth

When folks think of birth, it is oftentimes scenes from movies, tv shows, or stories from friends that pop into our heads. Almost immediately, we also think of the pain, physical labor, and probably lots of drugs that we are accustomed to thinking are required to get through this process of birthing a child. As society has molded us to believe this, we have slowly handed over control--but to no fault of our own. Part of staying in control during situations is being able to have enough information that you can make an informed and educated next step. 

If you aren’t prepared to face the variables and normal variations of labor then thinking about your next move may make you realize that you’re not sure what your options are! This can strike a sudden and very uncomfortable fear. You worry something will go wrong and you won’t know what to do. But, you can know what to do and it all comes down to the way in which you prepare for your birth.

So... let’s dive into what to do! 

But first, let’s talk about what happens when there is monetary incentive and a very well-known ‘cascade of interventions.’ What happens when your nurse is tired and your doctor recommends a c-section after 4 hours of no cervical change because it’s 4:30am and the anesthesiologist is having a particularly busy night? This is when it comes down to a matter of one conversation. This is when it comes down to a matter of minutes of you digging deep into the preparation you did for this exact moment!

The reason that your preparation matters so much is because the preparation you do will give you tools for your birth toolbox. If you have been given biased or “watered-down” childbirth education, then you will not have been given all of the tools available to you--only what your source of childbirth education wants you to know. 

For example, imagine you are being given training on tools that you can use to build a box. You don’t know this, but the person teaching you doesn’t love to use nail guns and prefers to use good ole’ nails and hammers “because it’s safer.” During training, they will not share about the nail guns they have in the utility closet because they don’t want you using them. However, you know you are someone who knows how to be safe with a nail gun, sees the efficiency, and calculates how much more productive you’d be with a nail gun vs. nails and a hammer. Even still, you don’t have the option to use a nail gun because you were never even afforded the right of knowing a nail gun was available. It the time that it took you to bi8ld 2 boxes you could have built 5 and avoided the blisters on your hands! 

The same is true with childbirth education courses. If your childbirth education course only teaches you about unmedicated labor or epidural use, then they are robbing you of understanding the gamut of options you have along the spectrum of pain relief! With the proper intentional education, you can have your dream birth and avoid a c-section! 

This is where you will do one of three things: You will hand over the control, take the control, or you will keep the control. 

Identifying the control, taking the control, & remaining in control is key. 

Identifying control is asking what are my choices, what are my opinions about this, what do I think about this decision happening to my body? (To be clear your opinion is the only opinion that matters. You have the final say over your body and your baby. You should consider your provider’s professional opinion, but ultimately you are in control if you want to be). 

Taking the control simply looks like speaking up and making a decision. This is where your ability and confidence to advocate for yourself needs to be strong. Sometimes you have to advocate harder for yourself than other times, but in labor it is a must if you are going to stay in control. 

Remaining in control means understanding and “enforcing” (for lack of a better term??) informed consent and shared-decision making. You can remain in control by holding strong boundaries that you are the final say, you want to be involved in decisions and discussions, and you are only interested in evidence-based care (you are always free to ask your providers for research on things they are suggesting) regardless of hospital policy. Remember, there are many outdated policies in women’s health, for example, restricting food and liquids during labor or inducing for going past your due dates. It is up to you to know what your hospital’s policies are and to look into the policies to make sure they are based on the latest research. (To be clear: hospitals are not intentionally treating you poorly--many polices aren’t revisited often so the research has surpassed the policies and the policies haven’t caught up yet). 

Hand over: This is where so many people find themselves. I’m going to tell you how to get yourself out of this fearful handing over of control of your birth situation. When you realize that you prepared in all the wrong ways, it hands over control. When you realize that what your doctor is saying is super scary and you don’t know if it’s evidence-based or not, it hands over control. When you realize that you’re not sure if low amniotic fluid is something to be worried about or not, that hands over control. The fear sets in and you are willing to do whatever your provider suggests. This is not being in control of your labor. The remedy to this is preparing for the variables in birth. Birth comes in so many normal variations, but it’s up to you to know what those are so you can advocate for yourself (and your normal labor!). 

Take the control: This one is the action option! Once you find yourself scared and wondering if what they are saying is truly your only choice, you have a few options. You can reach out to your doula if you have one, ask for 20 minutes to think things over, or you can log into The Birth Lounge app and look up the research for whatever is being discussed. The lounge won’t give you the answer or suggest what to do, but it will give you the science behind the option so you can have an informed and confident discussion with your provider. The Birth Lounge will also give you the alternatives you have for that scenario so you can ask your provider about those, as well. 

Keep the control: This option is the product of intentional and comprehensive childbirth education. You know the definition of failure to progress is no cervical change in SIX hour but only after reaching 6cm. Anything before 6cm should not be considered failure to progress by definition. You also will have the confidence and the words to use to advocate for 2+ more hours so your labor can progress. You will also understand and know what you need to do next: hydrate, movement, don’t be on your back. This will all be second nature to you because you prepared intentionally for all the normal variations of labor with The Birth lounge. 

Control is everything in labor. You can be in control or you can let someone else be, the choice is yours. The way you prepare determines whether you are in control or someone else is during your labor. You should be preparing for all the variables and variations of birth so you know what is normal and what is not. You should also go into labor understanding how to 

One more thing before we go, let’s break down Informed Consent. The ‘informed’ piece of this phrase means you are informed of all of your options plus the risks and benefits of each option. The ‘consent’ piece requires that you have the freedom to choose any option without any influence, persuasion, or coercion. Both must be present for care to meet the requirements of ‘informed consent.’ 

The way you prepare for birth matters. If you don’t know what to expect, then you don’t know how to prepare. If you don’t know what’s normal, then you don’t know what’s concerning. I have always loved the comparison of preparing for a baby and preparing for a wedding. Folks prepare for weddings months in advance (sometimes more than 1 year!), yet for something so major and life changing as birth, we prepare for a 2 hour childbirth ed course sponsored by your hospital (be mindful who is teaching your curriculum and that it’s not biased). Even for marathons--folks prepare for months to run marathons, yet for something as physical as birth we prepare for maybe a 4 week series, 1 hour each week. 

Be intentional about the way you prepare for your baby. Understand your hospital policies and the research surrounding maternal health practices. Know the normal variables and variations of labor so you also know what is concerning. Explore your options so thoroughly that you are confident in the choices you have made for yourself and can have informed conversation with your provider about your choices. Deliberately put together a team of people and providers that support your individual birth goals and understand how you wish to be supported in this process. 

When seconds matter, you want to be able to remain in control and rely on your research-backed decisions to keep you and your baby safe.

The Birth Lounge will share The CONTROL Method. I will show you how you can control the most essential parts of labor and the choices made along the way to achieve your dream birth. No two birth plans are the same and we account for that individuality. Your birth goals are unique to you and The CONTROL Method will teach you how to identify, take and maintain the control throughout all variables and variations of birth. 


- HeHe

What is Early Intervention?

Wednesday, August 19, 2020

What is Early Intervention?

You’ve spent months preparing for your baby’s delivery and navigated the forever changing ups and downs of pregnancy and labor. Now baby is here. They are growing more each day, and you find yourself continuously questioning their development. Often comparing them to other similarly aged children and asking questions like “Should my baby be walking by now?” or “Should they be talking more?”. These questions don’t have a hard answer because every child will develop different skills on their own time and with practice. But this does not mean you have to navigate it alone. Early Intervention is an available program designed to help support families and their child’s development. 

What is Early Intervention?


Early Intervention is a publicly funded program meant to service children and their families from birth-3 years, who present with developmental delays or disabilities or are at risk for developmental delays due to a medical diagnosis or socioeconomic factors, for example. Early Intervention is free or low cost depending on the state you live in, and offers a wide range of services. These services are based on your child and family’s needs and can include services from a speech language pathologist, physical therapist, occupational therapist, developmental specialist, nurse, social worker, etc. Although Early Intervention is offered in every US state, services will differ slightly depending on where you live. If you feel you could benefit from Early Intervention services, check out your states specific EI program information with a quick google search. 

How do I get Early Intervention Services?


You may be interested in Early Intervention services for a number of reasons. Maybe a family member made a comment, or a daycare teacher expressed some concerns. It could be that although you are not worried, you would like some reassurance that their development is on track. In order to receive continuous support from Early Intervention, you must qualify for their services. You can self-refer by calling the program directly, or request that your doctor put in the referral for you. You DO NOT need a referral from a doctor to be evaluated by your state’s Early Intervention program. 

How do I qualify for Early Intervention Services?


Depending on the state you live in, your child will be evaluated using their version of a developmental assessment tool. Based on the assessment and a family intake meeting, your child will either be eligible or not eligible for EI services. Eligibility requirements and duration of services will also vary by state and may look different for each family. If you are eligible and accept services, you will then create an EI plan that is individually created to meet your family and child’s specific needs. Services are always optional and you never need to feel obligated to accept them. Early Intervention does not work for everyone. It is important the family is open and committed to services in order to make the difference.

When should I reach out to an Early Intervention program?


Early Intervention is available for families who qualify with a child age birth- 3 years old. This age range is specific because it captures them at that optimal age where their brains are continuously developing and shaping. Your infant or toddler is learning through play and social interactions and the earlier we can support these experiences, the most potential there is for success. There is no wrong time to refer to an Early Intervention program or to get help for your child. If your child is 3 years or older and you are concerned with their development, contact your Local Education Agency (LEA) for information and services! 

How should I go about finding out about Early Intervention services local to me?

The CDC lists out resources by state here. As well, Autism Speaks lists out similar contact information here, but if Autism is your specific concern may be a good resource to start from. 

Post written by Caitlin LeBeau, TBH Team Member, Developmental Specialist, & Doula

What Does Low Amniotic Fluid Really Mean?

Wednesday, July 29, 2020

What Does Low Amniotic Fluid Really Mean?

Recently a client brought up low amniotic fluid concerns after a prenatal appointment. After a deep dive into this with them, we thought we'd circle back to our community here and chat low amniotic fluid (Otherwise known as: Oligohydramnios) and inductions. The standard practice in the U.S is to jump to induction if a full term mother experiencing an otherwise normal pregnancy is reported to have low amniotic fluid. You know we are all about the facts here, so let's dig in.

Is low amniotic fluid a valid reason for induction?

'A recent review of the literature (Rossi & Prefumo 2013) found that in term or post-term pregnancies oligohydramnios (with an otherwise healthy pregnancy/baby) was not associated with poor outcomes. However, it was associated with increased risk of obstetric interventions… probably because the diagnosis leads to intervention.' Check out the evidence on Low Amniotic Fluid and why inducing for this reason may not be the best answer when it’s used as a “blanket statement” solution. For example, "There is a lack of evidence supporting induction for oligohydramnios in ‘low risk’ pregnancies ie. when there is nothing else ‘abnormal’ going on with mother or baby (QuiƱones et al 2012). Driggers et al. (2004) concluded that: “evidence is accumulating that in the presence of an appropriate-for-gestational age fetus, with reassuring fetal well-being and the absence of maternal disease, oligohydramnios is not associated with an increased incidence of adverse perinatal outcome.’’

So quick recap, even if you are one of the rare true cases of low amniotic fluid, (see below for how accurate fluid testing can be!)  there is no current evidence that low amniotic fluid at full term in an otherwise normal pregnancy shows poor outcomes for the mother or infant.  However, the use of inductions for low amniotic fluids alone does show an increased risk for a Cesarean section for the mother.  You need to make sure you are keeping the lines of communication open with your provider if you are diagnosed with low amniotic fluid in your prenatal care. 

( Also, here is a bit of information showing that inducing for due dates actually usually causes more harm than good if there is not a solid, medically founded reason for it. )

What can cause low amniotic fluids?

There are factors such as dehydration, broken waters, placental complications, past due pregnancies, medications, infant health conditions, the fetus swallows more of the fluid as the pregnancy progresses, etc. which can impact fluid levels. As well, you should remember that your fluid levels fluctuate throughout the day normally, so a report of low fluid levels can sometimes be addressed by increasing water intake.

How do they test your fluids?

You want to ensure they are using the "deepest vertical pocket" method to measure fluid, and not the outdated "amniotic fluid index," which is a 1-25 scale and what is typically used. ACOG no longer endorses the AFI, instead it endorses the DVP method because it reduces unnecessary intervention without additional risk to the baby. It is important to remember as well that testing used to measure your amniotic fluid catches only 10% of all cases of true low amniotic fluid accurately (Gilbert 2012). Low fluids can be a sign that something is wrong with the mother, the placenta or with the baby genetically, but it can also be dehydration or normal fluid fluctuation throughout the day. To increase the accuracy of your results, try to drink two liters of water before your appointment to keep your fluid levels up and lay on your left side during or before the testing to get the deepest measure.

The Final Word

You are responsible for you birth. You are responsible for planning and educating yourself. You are responsible for speaking up and using your voice. You are responsible for keeping the line of communication open with your provider when it counts.  Make sure you are making informed decisions about your care. 

You can do this. 

If you are concerned about having an unwanted c-section or being feared into decisions that are not based in evidence and science, let us help! Join The Birth Lounge to have an informed and confident birth experience, push for less than one hour, and avoid a c-section!


Post written by Kristin, TBH Team Member & Doula

Delayed Cord Clamping & Jaundice

Wednesday, July 15, 2020

Delayed Cord Clamping

Delayed Cord Clamping is a hot topic in the birth world! It is something that almost every client wants to have pretty lengthy conversations about. Per usual, when I research this for clients, I went a little overboard! I’m going to share what you need to know about one of the biggest questions about delayed cord clamping: does it cause jaundice?

Delayed Cord Clamping has been shown to increase iron stores in newborns, increase red blood cells, and it gives your placenta enough time to drain which returns 30% of your baby’s blood back to them. ACOG and The World Health Organization recognize delayed cord clamping as positive! 

I want you to have all the information so you can make whatever choice feels most aligned to you should you find yourself facing the questions of jaundice. The myth that delayed cord clamping causes jaundice is an antiquated belief and has since been strongly debunked. I wanted to give you the spectrum of research and resources for you to sift through on your own. Feel free to share these with your provider, too. I found a lot of information so here it is:

  • - Delayed cord clamping could cause "slight risk" according to this article. It also shares that it is incredibly beneficial for preterm babies and the increased Iron levels that I mentioned are supportive of developmental outcomes! 
  • "No association" between DCC and jaundice levels according to this article It’s important to note that this study had less than 500 participants. With that, it did produce strong results
  • - On the other side of the ‘delayed cord clamping causes jaundice’ argument is the delayed cord clamping "prevents neonatal jaundice" as seen in this article. The thought is that as the 30% of remaining blood in the placenta and cord return to the baby, so does the correct amount of vitamins, minerals, and other elements that prevent jaundice. 
  • Dr. Jack Newman I have been following him for 6 years (longer than I've been in birth work because I was the Lead Teacher of an infant program and most children were breastfed and/or bottle-fed breast milk. His research makes so much sense to me. He is Canadian so sometimes American Dr's may scoff at the research. It's yours to take in and just have in your toolbox once your baby gets here. He shares how the endocrine system of a newborn works. My Masters is in Human Development and Family Studies so it makes a lot of sense in that regard. I believe his work is much more nursing-parent led than many American approaches. 
  • - Infant "Intact Resuscitation" There's pretty strong research that I forgot to mention while we were on the topic of delay cord clamping and that is that there's a strong association between DCC and infants spontaneously resuscitating themselves if there are any breathing issues. This is especially important when we think about using narcotic medical pain relief. Your body is designed to resuscitate your baby's body. You can see the obvious push back in this study as doctors say they weren't able to reach for the right tools (would that be the case for anything else? That would probably be looked into, if so.) or they had poor access to the baby which I'm not sure what that means because they should be right behind/in front of you and the article didn't define that part. This push might be due to panic, or due to the doctors not truly trusting the natural process of intact resuscitation, or due to it not being widely taught in medical school! 

Know what the research says. Have discussions with your provider before birth. Put your preferences on a birth plan so all medical staff are aware. Hire a doula or assign your partner to double check whichever provider attends your birth is abiding by your wishes as long as it is safe. 

If you are looking for more resources and support in pregnancy - join us in The Birth Lounge to have an informed pregnancy and confident birth experience!

How to Pick the Best Baby Bath

Wednesday, July 8, 2020

How to Pick the Best Baby Bath 

There's a few things to know about bath time with children! First and foremost, babies don't like baths to begin with. Some do, but for the most part babies less than 8-12 weeks don't love bath time. With that being said, bath time plays a crucial role in your routines. First, it is an anchor. An "anchor" is a point in time of day or an action that happens at the same time each day. For example, when a child eats lunch, they come to learn and expect that nap time follows. If there is one parent in the house who returns home at a similar time each day, that will become an "anchor" for the children in the home and they will learn that this anchor means the day is coming to a close, dinner is next, and bedtime is soon. 

Bath time will serve this same purpose for your child. Not necessarily a newborn, but whether you take a full-blown bath every night or not, having your child's body safely submerged in warm water will do wonders for their sensory system and provide them with this anchor in their day. A warm bath is also the answer to a baby (older than 8 weeks) that won't stop crying. Usually, a warm bath will be a reset. With this in mind, you want to be mindful of two things:
  • - Growth Spurts: You want to make this a place that children can come to relax--especially because you will use the tub as a place of comfort for so many growth spurts (teething, gas, the first vomiting or diarrhea, when your baby can't/won't sleep because they are learning to crawl, the first ear infection, etc). This means making it a place that your baby doesn't feel overstimulated. Adults tend to give tiny humans a bazillion toys in the bath (which is okay if the bath is at a time of day that engaging their brain is the goal), but sometimes less is more. 
  • - Exploratory Play: The bath will be a place that as your baby grows, so does your time spent doing baths. With the right balance of safety and freedom to play, your cold can share with you their imagination, expressive and receptive language skills, and their ability to pick up on routines. The bath can be a place that you share intentional toys like colors and numbers or letters. Maybe you talk about shapes and sizes with various sizes of cups that, also, share cause and effect (pouring). You’ll be able to see associations that your child has picked up like swimming like a fish or spitting like a fountain! We’ve set the foundation for the bathtub to be a place of comfort and safety for them, now let them shine! Keeping safety in mind, this non-slip mat and this faucet cover are definitely two must-haves for any baby that is rolling over or mobile! 

Mold/Mildew

Most families we support never have any problem with mold or mildew growing on a baby tub. However, you aren't the first parent to question this! There's been a lot of success in using a vinegar (1/3), Water (2/3) and lemon juice (1 tablespoon) mix in a spray bottle. When you get done with the bath, you simply spray the tub with the mix and let it dry. If you're worried about the vinegar and lemon juice on your baby's skin, you can simply give it a once over with the shower head before filling up the baby tub! 

The Best Baby Tubs

I’ve narrowed it down to my top two picks (and a crowd favorite) plus why those are my top choices! You have a few options when it comes to bathtubs for your tiny human! If there’s one thing I have learned from working with hundreds of families over the last 10 years, it is that there is no one-size fits all in anything… and I mean nothing. When it comes to picking the right tub for your baby, there are so many options. We often get asked about 3 things when it comes to tubs and babies--preventing mold, making sure it can grow with your child, and storing that is easy/compact. While there are no “easy to store” baby baths, there are these handy hooks that you can hang in your shower so you can hang the baby bath. This allows the baby bath to drip dry, too, if wet fabric is really icky to you like it is to me! 

  • Summer Infant is a great brand! I like this one because it sort of grows with your child! It supports their development of sitting up, too! I really love that this one can go on the countertop (for a newborn) or directly in the bath. It can be easily hung with the hooks mentioned above.
  • - Next up is Angelcare. This is a super common one. It doesn't grow with your child, but it does allow them to sit up (once they are to that stage) which is nice! I love the minimalistic look of this one. It hangs beautifully with the hooks mentioned above, too. 
  • - We also have gotten great feedback about this foam flower bath that sits conveniently in your sink! We’ve also gotten the question, “How long will my baby be able to fit in it?” Parents report anywhere from 4-8 months, but I think 4-6 month is probably more realistic. Remember how I mentioned that your baby was going to want to be on the move--well, the sink won't be able to accommodate that very well. 

Head, Shoulders.. Knees & Elbows??

Something that folks never consider is where you will be giving this little baby a bath! For a newborn, on the kitchen counter or even in the kitchen sink is totally fine, but that won't last long because before you know it, your babe will be too big to fit! This means you will be moving to a bathroom in your home. With that, you are going to be spending a lot of time on the floor. As your baby grows, you will find yourself spending more and more time on bath time (remember the exploratory play). 

The more time you spend during bath time, the more your knees and elbows take the blow... literally. This bathtub knee pad can be super helpful! You can always use towels, too! This is Knees and Elbows in one

Finally, remember when I mentioned that your child will learn to love bath time? Well, this means you will need to provide them with a safe space to do all that exploration! Usually around 6-8 months we see children put up a fight to be able to move about in the tub. Your gut instinct is probably to stop this because we associate water with young infants as a danger.. but what if instead, you slowly gave your child more room to safely explore? I recommend getting an inflatable toddler tub that is cushy and you can control how much water (and how many toys) are in there with your baby. In order to be "ready" for a toddler tub, your child must be able to sit by themselves. A child should never be left unsupervised without water, but eventually, you'll be able to sit on the floor or the toilet and they won't need your hands-on assistance! Following that, they will start to explore the toddler tub.. but with time, they will start to ask to get out to have the freedom of the whole tub. If you want a quick, handy fix for this--a laundry basket works just as well, but requires you to fill the entire tub rather than just the toddler tub. For examples, google "babies in laundry basket bathtubs."

If you are worried about ensuring the water is a safe temperature, this bath thermometer is a quick and easy way to see just how hot the bath is before putting your baby in!

If you are looking for more resources and support surrounding diet and nutrition in pregnancy - join us in The Birth Lounge to have an informed pregnancy and confident birth experience!

Heartburn in Pregnancy

Thursday, June 25, 2020

Heartburn in Pregnancy

Why does it happen?

Heartburn is incredibly common and will plague between 17%-45% of pregnant people (Vazquez JC. Heartburn in pregnancy. BMJ Clin Evid. 2015;2015:1411. Published 2015 Sep 8.).

This happen because of two hormones: progesterone and relaxin. They are responsible for relaxing the muscles in your body during pregnancy to allow for growth and stretching in order to accommodate your baby. This causes your esophagus and the sphincter that keeps it closed to relax as well. Also, as your baby grows your “real estate” gets smaller and smaller.

With this change, your stomach gets squished which forces stomach acid back up into your esophagus. Not pleasant, but there are ways to combat this physical change and discomfort!

First, what not to do!

  • - Do not stop eating. Your baby needs to be nourished. Not eating will actually increase your stomach acid making your heartburn worse.

  • - Do not munch on antacids (TUMS, Rolaids) like candy as this has been linked to calcification of the placenta*. This means your placenta will begin to develop these very hard, rocklike spots and obviously this is not healthy for your baby. Also too much calcium can block iron absorption so be mindful of that. Many actiacids use aluminum as an active ingredient such as aluminum hydroxide or aluminum carbonate and should be avoided in pregnancy. Antiacids can cause constipation and due to the high sodium bicarbonate in some formulas, it can elevate your blood pressure which is not great for anyone at risk for preeclampsia.

What to do? (Please check with your provider before using/adopting these remedies): 

  • - Begin with eating smaller meals. I recommend also snacking every hour with just a handful of something light, but filling like almonds, popcorn, 3-5 crackers, a handful of grapes or blueberries, a bowl of strawberries or watermelon, a hard-boiled egg, etc. Eating smaller meals will benefit you in several ways: it will allow your belly to digest before adding more since the space is limited, it will provide you and your baby consistent fuel (and energy), and it will support stable blood sugar. Along with eating small meals is eating slow. Do not scarf down your dinner in 10 minutes flat and be shocked that your heartburn is out of control. Your tummy just can’t digest that amount of food consumed in a matter of minutes at once anymore.

  • - Drink a glass of milk. Milk can coat the inside of your stomach and help dilute the stomach aid. Yogurt can do the same thing for you! You can also try a shot of Apple Cider Vinegar, eating ginger or sipping ginger tea, a spoonful of honey or chamomile tea with honey.

  • - Papaya Enzymes. Caution here because papaya FRUIT (vs. the extracted enzyme) is contraindicated as a possible cause of pre-term labor. The caveat here is that it’s UNRIPE papaya fruit but since you don’t ever really know the ripeness of fruit you purchase in the store, it’s best to stay away altogether (unripe papaya has also been linked to miscarriage in a few studies when consumed in the first trimester).

  • - Orange Peel Extract: I have never heard of this and have never recommended this, but this is a very interesting article and the sources are provided at the bottom. 

  • - Stay hydrated. Rather than downing a glass of water once an hour, it’s better to consume liquids consistently throughout the day. The recommended amount of water for an average pregnancy and average sized female is 8-10 cups (equal to 65-80 ounces or 2-2.4 liters).

  • - Avoid laying down after eating. You should not lie down for at least 45-60 minuets after eating. This is most difficult after dinner so I say find an activity that requires you to be upright—either standing or sitting. If you lie down too soon, the stomach acid that is working to digest the food in your stomach will slip right up and you might even feel nauseas or find yourself throwing up.

  • - Avoid eating right before bed. I always say if you can eat 2 hours before bed, then that’s enough, but some doctors would say you shouldn’t eat anymore than 3 hours before bed. I believe this truly depends on your body and only you will know what that time is for you. However, try not to eat super hearty meals before bed because this will have your stomach working in overdrive. If you need to eat right before bed (trust me, I feel you), I recommend something water based like grapes, watermelon, or celery. These are easy things to digest, but be mindful that the sugar from the grapes and watermelon may spike your blood sugar or make your baby have a dance party.

  • - Sleep Elevated. You can achieve this several ways. You can purchase a wedge pillow or you can stuff rolled up towels (or a yoga mat) under the top of your mattress to create an angle at your head. This will prevent stomach acid from going back into your esophagus while you’re lying flat.

  • - Chew sugarless gum after eating dinner (or any large meal). This is a very interesting one, but it works similarly to giving a baby with acid reflux (or just really bad spit up) a pacifier after feeding them (before burping) to keep them sucking. This continuous sucking, despite not eating, keeps their gastrointestinal system activated which keeps them digesting longer and we generally see a decrease in spit up. Same with adults, but our gastrointestinal system is activated by chewing since we are not infants anymore. The chewing gum will keep your stomach activated. The increased saliva might also help to neutralize the stomach acid.

  • - Speak with your doctor. They may suggest a H2 blocker like Tagamet or Zantac. Be mindful that long term use of these have been linked to pH unbalance in your stomach and gut.

*CALCIFICATION OF THE PLACENTA

  • - This is a condition where the placenta begins to harden (calcify) in specific spots. These spots are indicators of the “age” or “ efficiency” fo the placenta meaning the more calcification the “older” and less efficient your placenta is considered to be.

  • - This is a great informational article but provides no evidence-based citations or any real sources. 

  • - It’s not regulated by the FDA nor has it been evaluated by any formal study that it is safe to consume daily TUMS during pregnancy.

  • - The Placenta is in charge of filtering all calcium that crosses the blood-brain barrier. If there is too much, your placenta will actually hold the extra calcium —causing calcification of the placenta. Calcification of the placenta has been associated with pre-term labor. TUMS should never be taken at the same time as prenatal vitamins due to a possible adverse interaction between the two.

  • - Calcium Carbonate is the active ingredient in antacids and too much calcium has been shown to block iron absorption. Iron is extremely important in pregnancy. Your body uses iron to make hemoglobin, a protein in the red blood cells that carries oxygen to your tissues. During pregnancy, you need up to double the “normal” recommended dose to increase the red blood cells to in-turn increase the oxygen levels reaching your baby. 

  • - There are a few studies that show (one of these is as a journal of veterinarian medicine—not too far off as we generally test on rats, pigs, or rabbits for pregnancy related research) an almost toxic level of calcium in fetal blood compared to mothers. Read more about these studies  here or here.

  • - Another product similar to TUMS, called Tame the Flame, is provided by Healthy Mama. 

  • - It is possible that magnesium or Vitamin D can help offset the potential “overdose” of calcium.

Calcium During Pregnancy:


Remember: It is not our job to tell clients what they should and shouldn’t take during pregnancy. Our responsibility is to share with them the potential risks, the sources we have available, and alternatives choices they have as options to consider.

If you are looking for more resources and support surrounding diet and nutrition in pregnancy - join us in The Birth Lounge to have an informed pregnancy and confident birth experience!

5 Resources to have an Informed Pregnancy & Birth

Wednesday, June 17, 2020

5 Resources to Have an Informed Pregnancy & Birth 


“Being informed”...what does that even mean in a day and age where influencers have more power than traditional marketing and every stay-at-home mom can start a vlog to grow a following of thousands without ever taking off her yoga pants or washing her hair. It’s hard to know who is actually qualified to talk about whatever they’re sharing and who is just being paid to share their latest gluten-free pasta and organic face mask. 


When it comes to pregnancy and birth, it can be a million times more challenging to navigate all the information coming from every direction. Everyone will have an opinion about all the things all the time, so go ahead and brace yourself. The best thing you can do as an expectant parent is to educate yourself on your options and what the data says is safe and appropriate care. We’ve gathered the 5 best resources to help you navigate pregnancy, birth, and postpartum with evidence-based information and empowering education. 


  1. - Evidence-Based Information: Evidence Based Births This should be your first step when you are faced with a decision about your pregnancy or your birth. Rebecca Dekker received her Master of Science in Nursing and her Doctor of Philosophy in Nursing from the University of Kentucky. She publishes articles that compile research and stats for all things pregnancy and birth. If you are pregnant, this could very well be your most used resource. 

  2. - Book: Expecting Better This is a must-read for all expecting parents. Dr. Emily Oster is an economist that has compares “standard practice” and what the data actually shows to disprove typical recommendations in today’s labor and delivery units (and even before!). Emily lays out the numbers so simply that you walk away understanding questions you didn’t even know you had to begin with. Professor Oster breaks down the most controversial topics like eating sushi and deli meat while pregnant. She even tackles drinking coffee and newborn vaccinations! You won’t find a clearer picture of what the science says than Expecting Better

  3. - Book: Crib Sheet Dr. Emily Oster wrote a second book that is a “data-driven guide to the early years” and you know we had to give it a review. She, again, delivers the most interesting statistics that leave you feeling dumbfounded as to why we have some of the current recommendations we have today. She is tackling topics like birth weight, circumcision, and sleep training. Professor Oster delivers this evidence-based material in digestible forms that leaving your feeling empowered to make the best decision for you. 

  4. - Community: The Birth Lounge One of the biggest (and best!) pieces of advice someone can share with an expectant parent is to find a village BEFORE their baby arrives. Connecting with other expecting or new parents will be a game changer for pregnancy, birth, and postpartum. Ask any human that has ever had a baby and they will tell you that the support system around you (in-person and online) is everything and that’s exactly what The Birth Lounge provides! This is an online space that connects you to other expectant parents so you can begin to prepare for your birth together. The Birth Lounge steps you through preparing for your birth and planning for your tiny human’s arrival. 

  5. - Podcast: The Informed Pregnancy Podcast Doctor Elliot Berlin is an award winning prenatal chiropractor, childbirth educator and birth doula. Dr. Berlin hosts a podcast that serves as a platform for birth professionals (medical doctors, doulas midwives, alternative medicine doctors) to share casually and openly about their experiences in the field and their opinions on various topics.  This podcast is fascinating and is binge-worthy on all accounts. 


You have ¾ of a year, 40 weeks, 9 months, 280 days (roughly) to prepare for your baby. In this time, you can explore all of your options, create the perfect plan and find the confidence you need to achieve your ideal birth. There’s no rush if you start making small decisions now and gradually approach the “scarier” topics. Start small by watching gentle birth videos or reading birth stories. The only way to turn scary topics tiny topics that you’re confident about is educating yourself on how you can stay in control of these scary situations. Knowing what choices you have will help remind you that you are in control. Take the time to connect with a community before your baby arrives. These people will help support and encourage you when you need it most plus give you advice when you have no clue where else to turn. Seek out support in understanding what the science says and what standard practice looks like at your birth place. Sit down and think about the choices you need to make and explore the options you have for each one. Be intentional with putting together a birth team that understands your preferences and will support you in those. 


Nature has given you the time to learn. We’ve given you the resources to explore. Now, jump in and get ready for the journey of a lifetime! Becoming a parent will change you at your core and you will experience a love like no other. Knowing how to best support your baby (and yourself) in this time doesn’t have to be stressful, we’ve made it easy. 


If you are concerned about having an informed birth or being feared into decisions that are not based in evidence and science, let us help! Join The Birth Lounge to have an informed and confident birth experience, push for less than one hour, and avoid a c-section!

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