Blog Archives

 

By Rosanne Gephart

Adapted from Huff Post’s “Ten things I want my 10-
year-old daughter to know”

1. It is not your job to keep the people you love
happy.  Not your parents, not your siblings, not your
friends. The hard truth is that you can’t, anyway. Work
on being honest, kind, and true to yourself. Those are
at least obtainable!

2. Take care of your body, you only get one!  Be
active: run, jump, climb, hike and eat well. Try to get
outside everyday. Clean air and exercise clear the
mind and heal the soul. Overcoming physical
challenges builds character and enhances your sense
of well being.

3. Share your passions and talents. You may be
shy, embarrassed, or worried, that your family or
friends will be judgmental or tease you for what you
love to do or feel passionate about. The world needs
more passionate people who share their talents. This
is hard to realize, but essential.

4. It is okay to disagree with others. Your point of
view is important.  Everyone is entitled to an opinion.
The opinion of others, while different from yours, does
not dilute or make your opinion less. All things do not
require agreement. Respect the opinion of others as
they should respect yours. You do not need to prove
you are correct.  Your perspective is both valid and
valuable.  Don’t shy away from expressing it. You can
always change your mind! Perspectives change

5. Your physical looks do not define who you
are. You are the product of two unique individuals
who love the cleft of your chin, your eyes that remind

them of an elder, and your skin is the color of your
ancestors. You are unique, someone purely you. The
body is merely a case for the true you that is within.
The clouds of society’s beauty myth may manifest in
your self-consciousness, those clouds cannot hide the
shinning of your personality. You will define whom
you are by what you do and how you act.

6. Learning is essential.  Read, explore, and learn
all you can about this world. Fiction, non-fiction,
mystery, what ever suits you! It is a way to escape,
essential for growing the mind, and will open up
treasures of the world and the world of imagination.

7. You are not your parents or your siblings. You
are your own person, entirely and completely.
Separation, from those who where part of your
childhood is one of the fundamental tasks of
adolescence. You will follow your own path, make
your own mistakes and have your own victories!

8. It is almost never about you. What I mean is that
when people act in a way that hurts or makes you feel
insecure, it is almost certainly about something
happening inside of them, and not about you. Unkind
words and actions can slice at your heart, even if your
head knows otherwise.  It helps to remember that,
almost always, other people are struggling with their
own demons, insecurities, and burdens.

9. There is no single person who can be your
everything. Be very careful about bestowing this
power on any one person.  All of us sometimes feel a
gnawing loneliness or emptiness. Trying to fill that ache

with other people (or with anything else, like
food, alcohol, and other numbing behaviors like staring

at cell phones/devices) will not help.  You
will feel let down, and, worse, that loneliness will still
be there. Instead, do something for others.
Community service often gives a great sense of
“making a difference”. Happiness comes from within.

10. Your parents (those who raised you) tried to
do their best.  Parents can be impatient and
fallible. They too are human and make mistakes.
They love you, even if they did not always act like it.
They tried to give you the best start they could.
Parenting is learned as you go, often through
mistakes and tears. Nearly all parental figures wish
they could have done better.

 

On May 6th 2018 concerned members of the public along with doulas, midwives, educators, nurses, midwives, physicians and other birth and pregnancy care providers joined together to show solidarity for the March For Moms Rally in Washington DC. Approximately 100 people gathered at Howarth Park in Santa Rosa to play, sing, have lunch, and learn more about local birth support for families.

Organizations participating in the event included the Sonoma County Public Health Nurses, Thrive Birth Center, Santa Rosa Birth Center, Doula Care Collective, Acorn Chiropractic Care, The Luma Center, Sonoma County WIC, Packages for Premies, The Cailin Faith Foundation, Sonoma County Babywearing Enthusiasts, and Abundance Massage. Clementine from Amazing Face Painting And Entertainment Services was on hand for face painting. The local band Buck Thrifty played a groovy set with their acoustic string trio under the gazebo. The North Bay Motorcycle Club even made an appearance to deliver a mountain of diapers that were then given away to families in need.

The Sponsoring organization, Improving Birth, will use the funds raised at the marches to launch its Mother Friendly Hospital Initiative, which will help health care facilities implement policies to lower induction rates for healthy pregnancies, lower interventions, and lower cesarean section rates. To learn more about the Mother Friendly Hospitals Initiative program visit www.motherfriendly.org.

The March for Moms is an annual event in May, come join us in 2019 to celebrate our local families and birth community!

 



The United States has the highest maternal mortality rate of any industrialized country, and the rate continues to climb. American Indian/Alaskan Native and non-Hispanic Black women are 3-4 times more likely to die from childbirth- or pregnancy-related causes compared to non-Hispanic White women.

YOU can help change this!

In support of the national  March for Moms in Washington DC and orchestrated in conjunction with  Improving Birth, we will bring together businesses, healthcare providers, family support services, and local families to spread awareness and provide solutions. There will be booths with information, free samples, family fun activities, food, and guest speakers. The open mic will allow families to share what they think needs to be done to make change in health care for moms and babies.

Rally To Improve Birth & Community Picnic

Howarth Park

630 Summerfield Road in Santa Rosa

11am-3pm (rally starts at 11:00 am, speakers begin at 1pm) 

The event is free.

For more information or to reserve a booth contact:
Megan Sweetman (707) 806-8817

Is my baby getting enough milk??

All mothers who breastfeed want to be successful, but have a nagging fear that they
may not be making enough milk. There are constantly wondering…”How do I know
my bay is getting enough??”

If your baby is back to birth weight by 2-3 weeks you can be reassured….also for
babies who are less than a month old, ask your self these questions:

  • Is the baby having several bowel movements (BMs) in 24
    hours that are mustard yellow with curds in them?
  • Are your baby’s BMs more than a smear?
  • Is the baby wetting 5 – 7 diapers in 24 hours?
  • Do your breasts feel full before feeding and softer after feeding?
  • Is the baby eating at least 8 times in 24 hours?
  • Do you hear swallowing or drinking when the baby is
    breastfeeding?
  • Does the baby seem satisfied after a feeding?
  • Has the baby started gaining 1/2 – 1 ounce per day?
  • Is it comfortable to breastfeed?

If the answer is NO to any of these questions……seek help from a
Lactation Specialist or Board Certified Lactation Consultant. This person
can get your breastfeeding back on track and teach you additional
time honored ways of knowing your baby is doing well.

http://www.ilca.org/why-ibclc/falc
www.betterbeginingsforbabies.org

Rosanne Gephart, MSN, NP, CNM

“My baby cries SO much! How do I know if something is really wrong?

Babies cry for lots of reasons: because they are hungry; because they want their
diaper changed; because something is poking them; because they need to burp or
pass gas; because they want to be picked up and held; because they want to have a
change of scenery or perhaps just because they are babies and don’t know what they
want! Sometimes they cry and you can not figure out what they want or need! This
is frustrating for new parents….and for baby too.

Medical professionals often suspect colic “if a baby cries more than 3 hours a day,
more than three days a week, for more than three weeks”. This is not too helpful to
the parents who are home with a screaming baby….even for one day crying for more
than three hours!!

Most babies go through phases in which they cry more. Newborns are born to be
demanding….it is survival. They must demand feeding frequently to get the mothers
milk supply to come in (first week) and then at regular intervals to keep up with
growth. Newborns demand to be close and beheld because to not be would go
against their will to survive. Since crying is a form of communication, new parents
(especially first time parents) have to learn the language of their baby. In the first
month this means trying “everything”. Going through a list in your head….or written
down for those who are so sleepy they can not even remember what day it is!
Remember 20% of all parents with a baby think their baby may “have it”, the
dreaded “colic”. Most often, they are first time parents, since they have limited
experience and tend to be more anxious and less confident.

Try This:

Is baby hungry?….offer breast, or if bottle feeding offer, formula or
breastmilk by the Paced Bottle Feeding Method:

This method results in a happier, less gassy baby…while breast IS best, Paced
feeding is better than having the baby suck the feeding down as fast as possible.
Paced Bottle Feeding results in less gas, less overfeeding, and a more satisfying
experience for the baby.

Does baby have a gas bubble? Breastfeeding babies may not need burping,
but some do….so try. If there is an air bubble, it may come up later with breast milk,
or formula with it. Some babies really need to not be laid flat after a feeding. Amore
up right or reclined position helps them to avoid regurgitation of ½ of their
feeding….which they often do with little or no effort!

Does baby need a change? Some babies do not like being wet or soiled….of
course they do not like being changed either!

Perhaps there is too much stimulation. Loud noises, music, visitors. Often
baby will “shut down” and sleep during big events….only to be up all night crying.
Babies have different levels of comfort with stimulation. Look for patterns and then
help your baby by avoiding over stimulation. Some babies love those white noise
machines or the Lub Dub recording of the mothers heart beat….better would be
your heart beat! Remember, on the biological level, survival is being with your
mother.

Does you baby like being swaddled? Held? It is normal…all infants mammals
respond with great protest if mom is not close by….learn to carry your baby and
recruit dad, grandparents, aunties, to do the same. You will not spoil your baby!
Babies who have their needs met as babies actually grow to be more confident
children.

Is your baby too warm? Often fear of the baby getting cold will cause parents
to over heat the baby. Dress the baby in layers. Hands and feet are usually cooler
than the rest of the baby. If the baby’s scalp is perspiring….he/her is too hot!

So what else can you do? After you have looked for all of the possible logical causes consider these options:

Distraction: Go for a walk with the baby. In a stroller perhaps…place the baby on a
light weight baby blanket so it is easier to get the baby out of the stroller and into
bed. Babies love being out side.

Motion: Swings, rockers, baby chairs that vibrate, even a car ride can do the trick!
One mom told me she set up the car seat on top of the dryer trying to mimic the car
where the baby loved to sleep!

Colic Holds: Hold the baby in a position that the tummy is supported, like across
your forearm. This can help the baby to pass gas also.
Infant massage: Some babies love massages and will sleep 2-3 hours after a
massage. Sometimes it is mom who needs the massage!

Bath: The bath is a love/hate relationship….sometimes they start off like torture, but
once settled in the warm water….they love it. Try taking a bath with your baby…you
both will feel better. This is a common trick to getting an older child ready for bed. The routine of the bath prepares them for getting ready to sleep.

Probiotics: A study published in December 2017 has helped medical care providers
realize that probiotics can help some babies with colic. Most health insurances will
pay for probiotics, if they are ordered by your health care provider. The increased use of antibiotics in birth has increased the need for babies to be supplemented with
normal bacteria that helps with digestion. Both mom and baby can take probiotics.

Get help and support from other mothers: Mom’s groups, breastfeeding support
groups, even just meeting other mothers at the park or play ground can help you
learn things that other mothers have done to help with a fussy baby.

Rosanne Gephart, MSN, NP, CNM

Girls today are facing many challenges. Some are unique (cyberspace,
digital access in and out of the home) some challenges are similar, but
coming at an early age. Those issues and expectations that were once
those of teenagers are now in the grammar schools and on the
playgrounds. Girls often sacrifice kindness and charity for popularity.
The cultural feminine beauty standards are now being applied to 8
year olds. As girls approach adolescence, their self-esteem often
plummets when compared to boys. Rachel Simmons is an author of
three books on girlhood and cofounder of Girls Leadership, a national
nonprofit that provides training, education, and workshops to girls and
the adults who support them. She states, “girls are at their fiercest
and most authentic prior to puberty.”;

Parents, family and friends can prepare young women for the trials of
being a teenager by helping them develop critical skills early on.
http://www.rachelsimmons.com/books-and- tv/

Here are some skills that help:

1. How to have respect for the feelings of others and
express her own feelings

We need to teach girls emotional intelligence. That skill, says
Simmons, means having the ability to describe and express the
full range of human emotion. But when girls are taught to value
being happy and liked over all, they often suppress or can’t
acknowledge more difficult experiences.

Instead, adults need to demonstrate how to “flex the muscle of
expressing their strongest feelings,” says Simmons. We can do
that by modeling our own emotions using words like sad,
nervous, excited, scared, angry, frustrated, and confused.

Simmons also recommends parents “authorize” their daughters’;
emotions: “When your girls express authentic emotions — even if
they’re difficult — you take them seriously. You don’t deny them or
challenge them.”

2. How to feel self-compassion

Girls get a lot of messages that it’s important to please others, says
Simmons. So when they experience a setback, it often feels like letting
someone else down and loosing their approval. On top of that,
research shows that adolescent girls may be exposed to more
interpersonal stress than boys. That makes them more likely to focus
on negative feelings, putting them at greater risk for depression.
To help prevent this cycle of suffering, Simmons recommends parents
teach their daughters how to deal with failure. This means teaching a
girl how to practice self-compassion in a moment of crisis. Instead of
criticizing herself harshly, she should practice self-kindness and
remember that we all have to deal with disappointment. By realizing
others share that experience, she’ll be better prepared to treat herself
compassionately and develop resilience. Parents can demonstrate this
by using self-compassion and looking at failure as an opportunity to
learn from the situation.

3. How to develop a positive relationship with her body

Lost in a sea of selfies and reality television, girls might not know
how to view themselves beyond objects of desire. One way to
help them develop more complete and positive relationships with
their bodies is to introduce them to sports. Physical activity gives
them an opportunity to see their bodies as capable of strength
and stamina, rather than being defined by appearance only.
Research shows that sports can directly affect a girl’s self-
perception and self-confidence.

But even girls who feel physically capable and confident might still feel
ashamed of their bodies and their sexuality. Simmons recommends
talking with girls about their bodies from toddlerhood. Parents should
know and use the right names for genitalia and do their best to
“represent sex as a healthy, beautiful experience that should be had
with joy and consent.” That means talking about personal space
boundaries and what consent means early on and emphasizing that a
girl’s body belongs to her alone.

Parents who are uncomfortable discussing sex and the body
communicate those feelings to their daughter.  “When girls feel
uncomfortable with their bodies,” says Simmons, “they can also
disconnect from how they are really feeling and worry more about how someone else is feeling, or what they want, instead.”

4. How to learn from friendships

Girls are frequently told that friendships are paramount, and that may
be why they can be so singularly focused on those relationships.
Relationships help girls learn to assert themselves, compromise, and
set boundaries.

Parents should view friendships as an opportunity to show girls what
healthy relationships look like and how they can relate to others and
themselves. Girls may need to demonstrate this for their friends.
One example might be helping your daughter respond when her friend
does’t save a seat for her on the swing. Ask her what choices she had
in the situation and help her role-play an assertive response.
Encouraging her to communicate honestly and reasonably assert
herself, says Simmons, provides her with skills that she’ll need to push
for a raise as an adult.

These important skills aren’t easy to master, but the more chances a
girl has to practice them under the guidance of a trusted adult, the
more likely she’ll feel confident and self-assured as a teenager.

Rosanne Gephart, MSN, NP, CNM

North Bay Wildfires: Protect Your Family’s Health

By Megan Kaun and Nichole Warwick, 10/23/2017

The North Bay Fires have dramatically increased the toxicity of our local environment. Children are particularly vulnerable. This document summarizes expert recommendations for reducing exposure & supporting health.  Please consult your health care provider for customized recommendations.

REDUCE EXPOSURE 

Avoid Contaminated Areas

  • Monitor air quality at www.airnow.gov
  • Keep children and pets indoors, keep windows closed when air quality poor

Protect Body from Exposure

  • Protect Your Lungs with a properly fitted mask (N95 or N100)
  • Cover your body fully and change clothes often

Clean Home Inside & Out

  • An expert in emergency restoration services can help with smoke damage
  • HEPA Vacuum EVERYTHING
  • Wipe all hard surfaces (floors, walls, ceilings) with damp microfiber wipes
  • Pause and repeat cleaning as needed
  • Never use harsh chemicals or deodorizers, which make air quality worse
  • Wash off hard surfaces outside especially windows, porches & walkways

Maintain Indoor Air Quality

  • Run multiple HEPA air purifiers or move single unit from room to room, change filters often
  • Replace filter in HVAC system
  • Remove shoes and contaminated clothing outside
  • Bathe and wash hair before bed

SUPPORT HEALTH 

Relieve Exposure Symptoms

  • Soothe throat with herbal tea, throat spray, lozenges, honey
  • Open breathing passages and calm nerves with diffused essential oils, and herbal teas, tinctures, and syrups

Build Natural Immunity

  • Eat healthy, fresh foods
  • Take probiotic supplements and fermented foods
  • AVOID inflammatory foods like sugar, fried/processed foods, and alcohol
  • Boost immunity with Vitamin C, Zinc, B vitamins, and herbal preparations

Detoxify Gently

  • Drink lots of water, take electrolytes
  • Pooping helps! Use magnesium, flax seed, and acacia fiber
  • Choose high fiber, fresh foods
  • Take warm baths with epsom salts
  • Take safe herbal supplements like activated charcoal, chlorella, etc.

Enhance Self Care Practices

  • Seek support from family, friends, and mental health care providers
  • Gentle massage, yoga, and good posture promote good circulation and endorphins for healing
  • Take time to rest & love yourself!

MANAGE INDOOR AIR QUALITY & OUTDOOR CONTAMINATION

These house cleaning techniques will help minimize toxic dust particles resulting from wildfire smoke and ash. If your house has indoor smoke damage, consider hiring a professional, smoke remediation may be covered by your insurance company. Steam cleaning fibrous surfaces like couches and carpets, and professional ozone treatment or re-painting the walls (after cleaning and sealing) may also be needed. Cleaning outdoors prevents cross contamination.

PHASE 1: CLEAN-UP (2 DAYS OR MORE)

Step 1: Vacuum EVERYTHING with a well-functioning HEPA vacuum

NEVER use a broom or non-HEPA vacuum cleaner.  These stir particles back into the air, worsening air quality.  See the Shark Rotator Professional and Consumer Reports guide (http://tinyurl.com/y939fbez).  Vacuum all surfaces (walls, ceilings, floors, etc) that came in contact with the smoke. For fibrous surfaces (carpets, couches, etc), vacuum a surface multiple times in multiple directions.  Empty your vacuum outside.

Step 2: Wipe down all hard surfaces with damp microfiber wipes

Use a dilute solution of water and dish soap, Citrasolv, or Benefect’s Atomic Cleaner, a small squirt per gallon. Reusable microfiber wipes should be washed in hot water with laundry detergent.  Attach microfiber wipes to a mop to clean floors, walls, and ceilings. Avoid TSP, bleach, and harsh chemicals as they add toxicity to your home.

Step 3: Clean outside

Use a shop vacuum or broom to remove ash from hard surfaces. Wash down everything especially pathways, decks and  porches where ash has accumulated. Wash down the surface of the house especially around doors and windows to prevent cross contamination. Always wear eye protection and an N95 or N100 mask and remove outer clothes before entering the house.

Step 4: Pause and Repeat Steps 1, 2 and 3 as Necessary

Cleaning will stir up dust. Pause one day for airborne dust to resettle. Heavily smoked spaces may require multiple cycles of Step 1/2. A test is to leave, run the heater for 8 hours, and return. If smell persists clean again or consider professional help. A test for clothes is to put them in a garbage bag, bring to a smoke free area, and open bag to smell for smoke. Household items (furniture, rugs, etc.) may need to be removed from the home and cleaned separately.

PHASE 2: MAINTAIN HEALTHY INDOOR AIR QUALITY (1 YEAR OR MORE)

Outdoor contamination may continue for a long time due to construction activities.

Run HEPA air purifiers in each room where you spend time.

A HEPA air purifier can clean a single room but does not have a far reach.  Move HEPA purifiers from room to room for better coverage and change filters frequently in heavily smoked areas.

Remove shoes and contaminated clothes before entering home.

Soot and ash will attach to shoes and clothing.  Remove shoes and outer layers outside.

Continue routine cleaning with HEPA vacuum and microfiber wipes. 

Regular cleaning will help keep dust and toxin levels low indoors. SUPPORT HEALTH WITH DIET, SUPPLEMENTS, AND HABITS

Relieve Exposure Symptoms

  • Soothe throat: Throat Coat Tea, Throat Quencher Spray, Kids Throat TLC, Marshmallow Root, Slippery Elm, Aloe, Fennel, Sinus Oil
  • Open breathing passages/calm the cough:  Lavender essential oil (diffuse or put in mask, honey, lozenges, Cough Quiet, Kids Cough, Calm Breathing Tea, Healthy Lungs Tea, Old Indian Wild Cherry Syrup, Lung Expectorant Tincture, Serious Cough Tincture, Herbal Respiratory Relief, Calm Breathing Tea, Deep Lung Tincture, Clear Lungs Capsules, Breathe Mushrooms, Kick-Ass Sinus, Mental Clarity essential oil
  • Calm nerves: Chamomile tea, Kids Calm, Stress Recovery Essential Oil, Calm Tincture, Rescue Remedy, Five Flower Essence, Mental Clarity Essential Oil, Stress Recovery essential oil, Calm Calm Tincture, Post-Trauma Essence, Nervous System Tonic, Relax Smelling Salts

Build Natural Immunity

  • Probiotic supplements/fermented foods: 
  • Boost immunity: Vitamin C, Zinc, Activated B vitamins, Daily Immune Mushroom capsules, Stamets 7 Mushroom capsules, Astragalus tea, Reishi tea/capsules, Synergy Green Powder, Adaptive Strategy tincture

Detoxify Gently

  • Naturally detoxifying foods: Broccoli, cauliflower, kale, Brussels sprouts, cabbage, collard greens, spinach, beets, asparagus, apricots, plums, pumpkins, squash, and sweet potatoes
  • Safe herbal detoxification: Herbal Detox Tincture, Lymph Mover Tincture, Seaweed Bath, Good Samaritan essential oil, activated charcoal, chlorella, turmeric, milk thistle/artichoke capsules

Emotional Support for Children

  • Supporting Your Child Through The Wildfire Disaster: http://tinyurl.com/y7tjhzlx
  • Talking to Children About Disasters: http://tinyurl.com/zc6ohg6
  • Talking With Kids About News: http://tinyurl.com/jrthqb2
  • Children’s Book: Once I Was Very Very Very Scared by Chandra Ghosh Ippen: http://tinyurl.com/y7ks723c
  • Art and creativity promote relaxation and offer children an opportunity to express themselves and their experiences. Put on some music, dance, play, make art, make music, sing, get creative. Creativity heals.

AUTHOR BACKGROUND AND ADDITIONAL INFORMATION

Megan Kaun is a civil and environmental engineer, living in the Hidden Valley Estates neighborhood in Santa Rosa, which was mostly destroyed by the Tubbs fire.  Her home survived, but the neighborhood is devastated.  Prior to the fires, Megan was working on a number of initiatives in Sonoma County to reduce toxic exposure risks to the community, in collaboration with Sonoma County Conservation Action (SCCA), Better Beginnings, Santa Rosa School District, Santa Rosa Water, and County of Sonoma Agencies.  She also works on landscape and park design to decrease maintenance costs and reduce use of synthetic herbicides.

Nichole Warwick is a mother, psychologist and educator working to create a healthy and sustainable schools initiative in Sonoma County. She works collaboratively with Daily Acts and the Jonas Family Fund as an Environmental Health Program Innovator, researching the impacts of environmental toxics on children’s health and collaborating with experts in the field to support healthier and more sustainable schools in Sonoma County.  Nichole currently serves on the Ceres Community Project’s Board of Directors as Secretary and Chair of the Youth Leadership Committee. She is passionate about children and the environment, and she devotes her life to nurture and protect both.

CONTACT INFO FOR INFORMATION ENHANCEMENTS

This document was developed quickly as a guide for Sonoma County residents looking for ways to protect themselves in the aftermath of October 2017 wildfires.  We are looking for opportunities to expand and improve these guidelines.

Contact information:

Megan Kaun, [email protected], Cell: (773) 677-1639

Nichole Warwick, [email protected], Daily Acts: (707) 789-9664

Indoor cleaning and air quality contributions from Dave Osborn, expert in residential and commercial emergency restoration services ([email protected] 707-337-7878) and John Banta, CIH (Certified Industrial Hygienist), co-author of Prescriptions for a Healthy Home. Full text on cleaning recommendations:

http://www.neilnathanmd.com/how-to-clean-effectively-by-john-banta-cih/

Better Beginnings for Babies is hosting a:

Drop-in Prenatal Care and Breastfeeding Clinic
Thursday 10/12 from 10am – 4pm
Bridges Pregnancy Clinic and Care Center
750 Mendocino Ave Unit 1 in Santa Rosa

Stay tuned for more days and times.

Call (707) 575-9000 or (707) 902-3031

We have an OBGYN and at least one CNM

We are also accepting donations at Bridges and looking for diapers, especially size 5-6 and pull-ups. Baby wipes, formula, maternity clothes, and anything you think might help, we will distribute.

Other things people need at shelters in Santa Rosa include:

Hearing aid batteries
Kids Robitussin/Tylenol
Adult sweatpants
Prune juice
Visine
Masks

MEG MCCONAHEY, THE PRESS DEMOCRAT

http://santarosapressdemocrat.ca.newsmemory.com/publink.php?shareid=1bb9df9a4

 

With her first two kids, Erika Viramontes was determined to breastfeed. And both girls took to it like little champs from the first time theyemerged into the world.

But baby sister Abigail, who arrived a month ago, just didn’t seem to be catching on. Sisters Luz, 10, and Maryellen, 4, tease that the baby, a tiny mite still less than 7 pounds, with a thatch of thick dark hair, is just being “lazy.”

In truth, some babies and their moms need help, particularly after a cesarean birth like Abigail’s, with the disruption and physical trauma that come with it. That’s what brought a tearful Viramontes to the “Breastfeeding Cafe.” You can’t get a latte here, but moms can get help serving the best milk possible to their babies.

The cafe is a free drop-in program in Santa Rosa. Twice a week, mothers of infants who are having trouble latching on or who need some advice, can relax on a comfy couch or upholstered chair in a homey, living room like setting, and join a support circle. It includes professional help from nurses and lactation specialists as well as other mothers going through the same challenges to getting their babies to feed as nature intended.


“When I gave birth to Abigail, she was dropping a lot of weight and I was having trouble with my milk supply,” said Viramontes, a soft-spoken woman from Forestville, who breastfed one daughter until she was 5 and the other until she was 2.

But Abigail was delivered by C-section, which contributed to a lower milk supply. Viramontes said she was suffering postpartum depression, exacerbated by not being able to feed her baby.

While breastfeeding is completely natural, it doesn’t always go smoothly. Babies don’t take to it for various reasons. And because a woman’s milk production is tied to how much an infant feeds, any disruption can lead to less milk for baby and a higher likelihood that a new mom may start supplementing with formula, or give up on breastfeeding altogether, said Roseanne Gephart, who runs the cafe through a non-proft organization she founded called Better Beginnings, aimed at providing support for women at birth and with nursing their babies.

A nurse-midwife and nurse practitioner who has been bringing babies into the world for more than 30 years in Sonoma County, Gephart founded the The Santa Rosa Birth Center, (formerly the Womens Health and Birth Center), one of the first out-of-hospital birthing centers in the state. Although she sold it several years ago, she volunteers her time to Better Beginnings, troubleshooting, coaching and encouraging nursing mothers out of the belief that breastmilk is the foundation for a healthy start in life.

At the cafe, which is open Mondays and Fridays from 9:30 a.m. to 11 a.m., women get both practical information and emotional support. As they settle in they are served a special tea and cookies with ingredients that are good for milk production. Any nursing mother is invited to come by at no charge. Babies are weighed before they feed and after, to see that they’re getting the requisite 1 1/2 to 2 ounces of milk. If not, Gephart or another volunteer lactation specialist, try to get to the bottom of the problem.

“It’s a community like how it used to be like in biblical days when they had the red tent and women would surround younger women and teach them and guide them into motherhood,’ said Emily Lewis, 37, who wound up at the cafe after delivering her first baby by C-section.

“It was … definitely a difficult experience to get him out. His heart rate dropped. All around it was a traumatic experience and him not latching on was the icing on the cake.”

There is something both reassuring and soothing about getting one-on-one help from other women bent on their success.

“They all sat there and listened to me and my feelings and frustrations of not being able to have the baby nursing. They worked with me hands on,” said Lewis. “It was like having a mother or an aunt. I immediately felt their empathy. They were so supportive it gave me hope.”

Gephart donates her time to a cause she believes is vitally important to get babies off to a good start in life.

Ninety percent of mothers in California start out breastfeeding their newborns, according to a “Breastfeeding Report Card” issued by the U.S Centers for Disease Control. But by the time their babies are six months old, the number of moms still breastfeeding has fallen to less than 60 percent, a dropoff that dismays Gephart, who knows that many of them stop far short of six months.

“The number of women in Sonoma County who start out breastfeeding is probably more like 96 percent. But by two weeks after delivery a huge percentage have quit because they have had problems and they haven’t been able to get help,” Gephart lamented.

The American Academy of Pediatricsrecommends that women give their babies breast milk exclusively for the first six months, and then as a supplement to solids until they are a year. The World Health Organization goes even further, recommending that all babies be breastfed for as long as possible.

“It sets them up for a healthy life,” says Gephart, “There are no detriments.”

Breast milk contains antibodies that help babies fight off viruses and bacteria. Breastfeeding also lowers an infant’s risk of developing asthma or allergies. Studies have shown babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses and diarrhea. It also protects a baby against constipation, cancer, diabetes, tooth decay, and Sudden Infant Death Syndrome (SIDs), according to the Sonoma County Department of Health Services.

Many hospitals and birth centers and clinics do provide breastfeeding support for new moms, both immediately after birth and through clinics once they’re discharged. And women with the income to pay for it can hire their own lactation consultants. But the services are not consistently available when needed, either in the hospital or post-discharge. It’s is particularly hard for low-income mothers, said Gephart, even just getting there and at the right time. And time is of the essence to keep the milk supply up and to provide the perfect nutrition and protections available in human breast milk.

Lewis said she received a lot of support from the lactation consultant at Sutter Santa Rosa hospital. But her baby still hadn’t mastered latching on. She went to a clinic sponsored by Sutter for extra help after she got out of the hospital.

“There were so many women in there Ididn’t get that one-on-one care. It took an hour and a half for someone to help me. It was so frustrating,” Lewis said.

Then she found out about Better Beginnings. Gephart, who is on call at all hours, came to her home, right afer getting off a plane.

“She [made a] cutout in one of my husband’s shirts and put the baby in it and had me lean back in the chair with the baby in the shirt on my chest so he felt comforted, like the womb,” she said.

Lewis used a breast pump and finally at 3 1/2 weeks, her son latched on. By nine months he was a robust 23 pounds and is in the 89th percentile for weight.

Better Beginnings functions primarily with volunters, who are nurses, board certified lactation consultants, lactation specialists (who go through a three-day program for training) and doulas — women trained to provide support, coaching and encouragement during childbirth. For women who find themselves going into labor without a partner or coach available, Better Beginnings has an “In-a-Pinch” Doula Service. They will send an emergency doula to help them through. Donations are appreciated from those who can pay, but there is no set charge for the services.

“We do make sure our clients qualify for Medi-Cal,” said Amy Popplewell, a Better Beginnings doula who is completing the pre-requisites to enter a graduate program for nurse midwifves.

There are a number of studies that show a reduction in complications from births when you have a doula present. Most important for our clients, if someone is low income and can’t afford one, but really wants one, we’d like to be there for them if a mom is along and scared and in the hospital. Having someone there is just invaluable. They can look to me and I’ll be their rock in the room.”

Gephart and her team believe women are often up against multiple forces that sabotage breastfeeding. Some clinics and doctors are rightfully concerned that a baby gets enough nutrition, so they encourage supplementing with formula. But it’s a baby’s nursing that increases the milk supply to meet its needs, she said.

“The hospitals are trying harder. But there’s a lack of support from the time a mother leaves the hospital or the birth center until she comes in for her two-weekvisit or for the baby’s one-month checkup,” said Gephart. “A whole bunch of moms start adding forumala. And the minute you start adding artificial baby milk you start seeing a decrease in the benefit of breastfeeding and a decrease in the mother’s milk. It’s a supply-and-demand thing.”

On her visit to the cafe, Erika Viramontes is coached how to hold baby Abigail so her whole body is facing her mother. She’s taught how to listen to make sure the baby is swallowing.

Meanwhile, there is a room for her daughters to play and Gephart, like a nurturing grandmother, has made a berry crisp for her, filled with nutrients like oats that help produce milk.

“It is my gift to the world, seeing these kids grow up has been just wonderful. I’m trying to make a difference, one baby at a time,” said Gephart, who also is a board-certified lactation consultant.

The cafe is held in space donated by Bridges, a prenatal clinic in Santa Rosa. But the two organizations are not affiliated. Gephart said Better Beginnings is nonreligious and operates on a small budget of about $10,000 a year, with donations supporting insurance and incidentals and to reimburse some doulas, although most wind up donating their time.

She’s hoping to encourage women who have benefited from the help to come back and provide peer support.

“In the old days, women would meet at the well,” Gephart said. “Everybody had to go to the well to get their water, The babies were tied on. Everyone would sit at the well and say, ‘How is your baby doing?’ There’s lots of that still going on now, but it’s underground.”

Lewis said she’s already made connections with other breastfeeding moms and hopes to do more.

“It was nice to have been a support to these women. I got a couple of phone numbers. One text messaged me and I was able to give her information that was given me, about drinking mother’s milk tea. It felt good just enccouraging her and being part of a community and support system during that time of struggle.”You can reach Staff Writer Meg McConahey at [email protected] com or 707-521-5204. On Twitter @ megmcconahey.

 

 

 

 

Last month, the American Medical Association published a Viewpoint in it’s Journal explaining recommendations for exercise during pregnancy. Here are some key points from the statement. Always check in with your health care provider for personalized recommendations for your pregnancy. 

1. It is safe to exercise throughout your entire pregnancy– The JAMA Viewpoint states that moderate-intensity aerobic and resistance exercise is not associated with an increased risk of preterm birth or low birth weight in women with uncomplicated, singleton pregnancies. The Viewpoint also clarifies that it is safe to start exercising for the first time while pregnant, even if you have been previously sedentary, and that exercise is safe for pregnant women with health issues including high blood pressure, gestational diabetes, or overweight/obesity. Research has found that it is safe to exercise right up to the end of your pregnancy.

  1. Exercise will help you prevent excess weight gain during your pregnancy– Gaining too much weight while you’re pregnant is common no matter what your pre-pregnancy weight was. Research shows that women who exercise during their pregnancy are less likely to gain more weight than is recommended. Not exceeding weight gain recommendations will help you maintain a healthy weight after your pregnancy.
Pre-Pregnancy BMI Recommended Weight Gain

During Pregnancy*

<18.5 28-40 pounds
18.5-24.9 25-35 pounds
25.0-29.9 15-25 pounds
>30.0 11-20 pounds

*Singleton. Recommendations vary for women carrying twins, etc.

  1. Exercise lowers health risks for your and your baby– Regular exercise during pregnancy lowers risk of gestational diabetes, preeclampsia, cesarean delivery, pain in the back and pelvic girdle, and urinary incontinence. Exercise also lowers risk of newborn macrosomia (large birth weight) which is linked to childhood obesity.
  1. During pregnancy you should exercise at moderate-intensity– Research has found that moderate-intensity aerobic and resistance exercise is both safe and powerfully beneficial during pregnancy, but what does moderate-intensity mean? Moderate-intensity means that you keep your heart rate between 60-80% of your maximum heart rate. To determine your maximum heart rate, subtract your age from 220.  If you don’t have a heart rate monitor, you can use the “talk-test” as an approximate for moderate intensity. If you can’t comfortably talk, you are working too hard. If you can sing, you may be at low-intensity and can pick up the pace a bit. Your goal is to be able to talk but not sing. Brisk walking, aerobic dance, stationary biking, swimming or water aerobics are examples of moderate intensity aerobic exercise. Avoid exercise that takes you above moderate-intensity heart rate, increases your risk for dehydration, or raises your body temperature, like long-distance running, hot yoga, or lifting heavy weights.
  1. You should aim for at least 150 minutes of moderate-intensity aerobic exercise each week– This breaks down to at least 20 to 30 minutes most days of the week. Try not to let two days in a row pass without engaging in aerobic exercise.  Studies have found it is safe to engage in moderate-intensity aerobic exercise for up to 90 minutes at a time while pregnant, but do make sure to keep yourself hydrated while you work out. It is also recommended to perform moderate-intensity resistance training two to three times per week.

Choose an exercise you enjoy and get started today. You and your baby will reap the benefits for years to come!

Lindsay Pasdera, MS RDN

1234