Breastmilk Comparision

Breastmilk is the ideal food for infants. Human milk contains all the right ingredients - protein, carbohydrates, fats, vitamins, minerals, and water - in just the right balance. No formula can make that claim. Infant formula manufacturers attempt to artificially duplicate human milk. Formula feeding is a practice that is relatively recent - about 60 years - compared to the beginning of humankind (not to mention all other mammals) relying on breast milk.

Formula does not contain the disease-fighting factors or the digestive enzymes that breast milk has. The nutrients in formula are more difficult for a baby to digest and absorb than the nutrients in human milk, requiring the baby to handle excess waste. Some formulas may have a less than optimal composition by containing too much salt and/or not enough cholesterol, fats, lactose, zinc, and iron, among other nutrients. Did you know…

Formula-fed babies have a greater risk of:

Ear Infections

Diarrhoea/constipation

Pheumonia

SIDS (Sudden Infant Death Syndrome)

Children who were formula-fed have a greater risk of

Obesity

Diabetes

Astma and allergies

Cancer

Increasing awareness that feeding baby's breast milk is beneficial and is an important promotion goal

 

 

 

 

 

 

 

Galatagogues

List of Galactagogues - Herbs that Increase Breastmilk Production

A galactagogue is an herb that is used to help increase breastmilk production in nursing mothers.

Lactogenic foods

- Carrot seeds, beet and yam.

- Beet leaves, spinach, chicory and other dark green leafy vegetables.

- Plain Oats and oat straw capsules or liquid extract.

  Below is a list of some of the more effective and popular ones and some important information about each:

Fenugreek - one of the best and strongest herbs for increasing milk production. When taken in very large amounts, Fenugreek is also used for lowering blood sugar levels, and is, therefore, not recommended for use by diabetics or those who are on strict insulin regimens to regulate their blood sugar levels. It also works on the digestive system, and in a small percentage of people, it may cause gas in either the mother or baby. Many mothers of adopted babies have successfully used this herb to help establish a breastmilk supply to feed their adopted babies. Fenugreek is not recommended for use during pregnancy as it can cause uterine activity.  Fenugreek must be used with consistency for best results, otherwise it can negatively affect or decrease milk production.

Goat’s Rue - Goat's Rue is a powerful herb for stimulating milk production and increasing the flow of breastmilk. It has been shown to increase milk production by 50% in many cases, and may also stimulate the development of the mammary glands themselves. This herb is safe for use during pregnancy. This herb is one of the main ingredients of the Nursing Tea/Nursing Tincture. It can be used as a single herb by itself, or to use along with or to add to the Nursing Tea/Tincture when something a little stronger is needed.

Fennel - this herb is great for increasing breastmilk production, and at the same time is also extremely helpful in relieving symptoms of gas or upset stomach. It is the perfect herb to take in conjunction with Fenugreek, when gas is a problem. This is also one of the main ingredients of the Nursing Tea/Nursing Tincture, as well as the Tummy Tea/Tummy Tincture which is specifically formulated for gas, colic, reflux and indigestion.

Red Raspberry Leaf - also one of the ingredients of the Nursing Tea/Nursing Tincture. It not only helps to increase breastmilk production, but it also will help the uterus recover after birth, as it is a uterine toner. Red Raspberry Leaf is incredibly high in vitamins and minerals, including  Niacin (a B vitamin), which has been said to be helpful in relieving symptoms of Reynaud's Syndrome.

Vitex - although this herb is a prolactin-inhibitor, it has traditionally been used, and is proven in case studies, to actually increase breastmilk production in nursing mothers. Its main function is that of balancing hormones, therefore, this herb is very helpful for women who are experiencing hormonal imbalances, such as PMS symptoms, while breastfeeding.  Note:  Vitex use may re-start the menses in nursing women.

Alfalfa - a great herb for increasing breastmilk production while providing the body with lots of good vitamins and minerals. It is very high in Vitamin K in particular, which helps to staunch bleeding. Many midwives encourage all their clients to take Alfalfa for at least six weeks before birth, and for several months afterwards, to help avoid hemorrhage at the birth, and to help the body recover and make plentiful breastmilk afterwards. (Alfalfa is also an ingredient in the Nursing Tea/Nursing Tincture. Note: This herb is not recommended for use by those on blood-thinning medications due to its high levels of Vitamin K.

Nettle - a similar herb to Alfalfa. Helps to enrich the milk.
(Also a Nursing Tea/Nursing Tincture ingredient.)

Blessed Thistle - also known as "Our Lady's Milk Thistle". It increases breastmilk while helping to alleviate mild forms of postpartum depression. It is a bitter herb (known as a digestive bitter), which is healthful for the liver and digestion. Although it is an effective herb for increasing milk production, it is no longer included in the Nursing Tea. Many customers found it to be too bitter and did not like the taste, therefore hesitated to use the tea. We do have Blessed Thistle available as a single herb in the tincture form.

Borage - traditionally used to help balance the adrenals as well as increase breastmilk production. It is not for use on a long-term basis, and because it contains an alkaloid that can be hard on the liver, it is not one of the herbs that is recommended for nursing mothers/babies.

Hops - used in many cultures for years to help with breastmilk production. You've heard women say that they "breastfed their babies on beer"? The Hops is why. Beer from other countries has Hops that are helpful, but our beer here in this country is not as effective. It is the dark German beers that tend to have the right ingredients or the right quality of Hops. Hops is not on the list of favorite herbs recommended for increasing breastmilk production, however, because it can be quite sedating and it can cause depression with prolonged use

Oxytocin

Oxytocin is a powerful mammal hormone. When we hug or kiss a loved one, oxytocin levels drive up. It also acts as a neurotransmitter in the brain. In fact, the hormone plays a huge role in pair bonding. Prairie voles, one of nature's most monogamous species, produce oxytocin in spades. This hormone is also greatly stimulated during sex, birth, breast feeding.

In women, it is released mainly after distension of the cervix and vagina during labour, and after stimulation of the nipples, facilitating birth and breastfeeding, respectively. Oxytocin is released during orgasm in both sexes. In the brain, oxytocin is involved in social recognition and bonding, and might be involved in the formation of trust between people. Virtually all vertebrates have an oxytocin-like nonapeptide hormone that supports reproductive functions and a vasopressin-like nonapeptide hormone involved in water regulation.

Oxytocin is also released during the physical stimulation of a woman’s nipples. The release of oxytocin creates feelings of contentment, reduces anxiety and increases feelings of security and calm.
Naturally, due to these factors, there is much evidence that the oxytocin is important to mother-baby bonding as it enables an increase trust and decrease in fear.

Skin-to-Skin

Skin -to-skin contact  is a method of caring for newborn babies that involves putting the newborn on the mothers' chest skin-to-skin. Skin-to-skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their needs for oxygen, and keeps them more stable in other ways as well.

Your bare chect is the best place for your baby to adjust to life outside the womb. Your baby smells you, hears you, feels you and gets to know you.

When babies are held skin-to-skin after birth, data shows that they are:

• Hap­pier. A baby fusses less and is less agi­tated when placed naked (not wrapped in a blan­ket) on the mother’s chest imme­di­ately after birth, as well as later in the recov­ery room. (If the room is chilly, a blan­ket can be draped over both mother and baby.)
• More sta­ble. A mother’s body helps to reg­u­late her baby’s tem­per­a­ture, heart and breath­ing rate, and blood sugar level.
• More likely to breast­feed. The first hour or two after birth is usu­ally a quiet but alert time for a new­born, and many babies intu­itively “crawl” to their mother’s nip­ple and latch on with lit­tle or no help. This laid-back posi­tion allows you to use your hands to guide your baby, sup­port him, or express a few drops of colostrum to draw his atten­tion to the breast.

100 Reasons to Breastfeed

 

 

1. The World Health organization and UNICEF recommend it!
2. The South African Paediatric Association promotes breastfeeding

3. Breast milk is more digestible than formula

4. Breastfeeding reduces a mother's risk of breast cancer

5. Baby's suckling helps shrink mother's uterus after childbirth

6. Formula feeding increases baby girls' risk of developing breast cancer in later life

7. Formula Feeding is associated with lower I.Q.

8. Breast milk is always ready and comes in a nicer package than formula does

9. Breast milk helps pass meconium

10. Breast milk contains immunities to diseases and aids in the development of baby's immune system.

11. Breastfeeding satisfies baby's emotional needs and increases bonding between mother and baby

12. Breast milk provides perfect infant nutrition

13. Breastfeeding reduces a mother's risk of developing ovarian cancer

14. Nursing helps mom lose weight after baby is born

15. Pre-term milk is specially designed for premature infants

16. Breastfeeding protects against Crohn's disease (intestinal disorder)

17. Formula feeding increases risk of children developing diabetes

18. Breastfeeding baby helps decrease insulin requirements in diabetic mothers

19. Breastfeeding may help stabilize progress of maternal endometriosis

20. Baby's suckling helps prevent post-partum haemorrhage in mother

21. Breastfeeding reduces a mother's risk of developing endometrial cancer

22. Formula feeding increases chances of baby developing allergies

23. Breast milk lowers risk of baby developing asthma

24. Formula feeding increases baby's risk of otitis media (ear infections)

25. Formula feeding may increase risk of sudden infant death syndrome (SIDS)

26. Breastfeeding protects baby against diarrheal infections

27. Breastfeeding protects baby against bacterial meningitis

28. Breastfeeding protects baby against respiratory infections

29. Formula fed babies have a higher risk of developing certain childhood cancers

30. Breastfeeding decreases chances of developing rheumatoid arthritis

31. Breastfeeding decreases child's chances of contracting Hodgkin’s disease

32. Breastfeeding protects baby against some vision defects

33. Breastfeeding decreases chances of osteoporosis  

34. Breast milk aids in proper intestinal development

35. Cow's milk is an intestinal irritant

36. Formula-fed babies are more at risk for obesity in later life

37. Breastfed babies have less chance of cardiopulmonary distress while feeding

38. Breastfed babies have less chance of developing ulcerative colitis

39. Breast milk protects against haemophilus b. bacteria

40. Breastfed babies require shorter pre- and post-surgical fasting

41. Breastfeeding results in less sick days for parents

42. Breastfeeding enhances vaccine effectiveness

43. Breastfed babies have less chance of developing necrotizing enterocolitis

44. Breastfeeding contributes to optimal child spacing

45. Breastfeeding is easier than using formula

46. Breast milk is free

47. Formula is expensive

48. Formula costs the government (and taxpayers) millions of  rands

49. Breastfed babies require fewer doctor visits

50. Breast milk always has the right proportions of fat, carbohydrates and protein

51. Breast milk acts like a natural tranquilizer for baby

52. Breastfeeding acts like a natural tranquilizer for mom

53. Breast milk tastes better than formula

54. Breastfed babies are healthier over-all

55. Breastfed babies are less likely to die before their third birthday

56. Breast milk is always the right temperature

57. Breastfeeding mothers spend less time and money on doctor visits

58. Fewer waste packaging products

59. No bottles to tote

60. Breastfeeding may lower the risk of developing high cholesterol

61. No need to refrigerate

62. Cow's milk is designed for baby cows, while human milk is designed for human babies

63. Breast milk aids in the proper development of a baby's gastrointestinal tract

64. Breast milk provides natural pain relief for baby

65. Human milk is the perfect food for a sick infant

66. A breastfeeding mom gets more sleep

67. Babies that nurse are happier at night

68. More sleep for dad

69. Less equipment to maintain and store

70. Less equipment to buy  

71. Breast milk has never been recalled due to manufacturing problems

72. Fresh breast milk is never contaminated with bacteria

73. No need to worry about which brand is better

74. No need to worry about adding contaminated water

75. Breastfed babies get fewer stomach infections

76. Facilitates proper dental and jaw development

77. Breastfed babies have less tooth decay

78. Less money spent on corrective orthodontia

79. Better speech development

80. Less chance of baby getting eczema

81. Breastfed babies have great skin

82. Less spit-up

83. Breastfeeding is better for premature infants

84. Breast milk contains no genetically engineered materials

85. Breast milk contains no synthetic growth hormones

86. Lack of breastfeeding associated with multiple sclerosis in later life

87. Less chance of inguinal hernia

88. Better cognitive development for low birth weight babies

89. Better social development

90. Decreased risk of baby developing urinary tract infections

91. Suckling optimizes hand-to-eye coordination

92. Breastfeeding protects mothers against anemia (iron deficiency)

93. Breastfeeding mothers spend less money on menstrual supplies

94. Breastfeeding is a self confidence booster for mom

95. Breast milk may help combat eye infections

96. Breastfeeding may lower blood pressure in childhood

97. No worry about latest ingredient discovered to be missing from formula

98. Much nicer diaper changes

99. Breastfed babies smell fantastic

100. It's what breasts were designed for!

Rhogam Anti-D - A review of the evidence

I find the Rhogam arguments very interesting. I was thinking earlier that I should do a post about what it means to have a negative blood type during pregnancy and what the rhogam shot does.  Rhogam is blood from someone else. They still often make them with mercury. Each Rhogam shot contains the antibodies of several different donors pooled together which increases the liklihood of viruses slipping through undetected to the RhoGam recipient. It is virtually impossible to test and screen out all the various viruses that could be present in the donor blood! I am sure there's people in the medical community who don’t know what it’s all about! If you should questioned the nurse who gave a woman the shot  it would be beyond her scope of understanding. I think everybody should read Anti-D in Midwifery: Panacea or Paradox by Sara Wickham.

In the US in 1960's, Rh disease caused about 10,000 perinatal deaths each year, plus uncounted miscarriages. It's rare now, but only because of the conscientious use of Rhogam to keep women from becoming sensitized, and the aging of the pre-rhogam women out of their fertile years. It is common knowledge that every person has a blood type identified as either “O”, “A”, “B”, or “AB”. In addition to this primary blood type, a person’s blood is either Rh positive or Rh negative. This is known as the Rh factor. The Rh factor refers to a protein that may or may not be found on the surface of an individual’s red blood cells. A person who has this protein present in her blood is Rh positive and a person who does not is Rh negative.

Here is the argument: RH- blood does not like RH+ blood. If RH- blood comes in contact with enough RH+ blood, the RH- blood will begin producing antibodies to fight off the RH+ blood because it sees it as a foreign and dangerous invader. It is a natural response like an immunity response. If an RH- woman is pregnant with an RH- baby, everything is wonderful and honky dory. If both the mother and father are RH-, then the baby will also be RH-, however, physcians may very well treat the pregnancy with the assumption that the baby is RH+ anyway, on the chance that the mother may have been messing around, etc. In some European countries, they do not give the rhogam shot at all during pregnancy unless there is trauma that could increase the risks of blood interaction  eg. such as a car accident. In those countries, they give the rhogam shot after delivery

The rhogam shot puts antibodies into your blood stream letting the RH- blood know there is no need to produce antibodies, because they are already there (from the shot).  Sara Wickham's book on the topic is a great start. Here is her article that I like to share with you.  While the postnatal administration of anti-D immunoglobulin to rhesus negative woman who have given birth to a rhesus positive baby has been considered by many as an acceptable and beneficial routine intervention for the last thirty years, the question of whether it is appropriate to offer routine antenatal administration of this product has been hotly debated for almost as long. There is little question that women who experience potentially sensitising events in pregnancy should be given appropriate information and offered this as an option. Rather, the debate concerns the issue of so-called 'silent' feto-maternal transfusion - the existence (or otherwise) of which phenomena forms part of the basis for arguments in favour of routine antenatal prophylaxis.

The debate surrounding the routine administration of anti-D during pregnancy began in 1969, when Zipursky and Israels suggested that antenatal anti-D administration may prove to reduce the rate of sensitisation. Bowman and Pollock (1978) followed this up with the specific recommendation that anti-D should be administered to all rhesus negative women at 28 weeks to prevent sensitisation in pregnancy. The debate continued throughout the 1980s and 1990's, with opinions divided between those who saw antenatal anti-D as a wholly beneficial intervention, which would save babies, and those who urged caution for a variety of reasons. Antenatal anti-D has been offered routinely in some countries, including the USA and Germany, for a number of years. Yet Britain's first active discussion of the debate occurred in 1997, when a consensus conference decided to recommend routine antenatal administration in the UK; an issue which is currently being debated on practical, professional and political levels.

Why Offer Antenatal Anti-D?
Proponents of routine antenatal administration base their arguments around evidence that suggests that current protocols for the administration of anti-D do not prevent all cases of isoimmunization. They feel that routine antenatal administration is the best way forward in moving closer to one hundred per cent protection from isoimmunization. For example, Hughes et al (1994) carried out research in Scotland, and concluded that, in 53 of the 80 babies with rhesus disease, this had been caused by the failure of the current guidelines to protect against maternal isoimmunization.

The effectiveness of the antenatal anti-D programme in Derbyshire - where women having their first baby are already offered antenatal anti-D at 28 and 34 weeks of pregnancy - was evaluated by Mayne et al (1997), who showed a fall in the mean overall sensitisation rate from 1.12 per cent in 1988-91 (before the onset of the antenatal programme) to 0.28 per cent in 1993-95. Another research study by McSweeney et al (1998) not only provides evidence in support of antenatal administration, but also highlights part of the argument against this. While these researchers estimate that over 80 per cent of women who became isoimmunized might not have experienced this had they been offered antenatal anti-D, they also found that professionals failed to offer anti-D in 48 per cent of cases where women experienced potential sensitising events in the antenatal period. This is one of the strongest arguments against the administration of routine antenatal anti-D.

The fact that most of the studies of this nature that are cited in support of routine antenatal anti-D are retrospective proves problematic. The use of women's case notes in such research is known to cause difficulties; many aspects of care are not always well documented by professionals and this can lead to bias in the results of the study. For instance, if a clinician had not documented the occurrence of a potentially sensitising event, or perhaps not even asked the woman about these, then it would look as if the woman had experienced silent fetomaternal haemorrhage if she then became isoimmunized.
Much of the evidence cited in this area, although interesting and useful in other ways, does not look at the effectiveness of antenatal anti-D in the light of prospective, randomised controlled trials. Only two antenatal anti-D trials of any real size and quality have been conducted - although it should be noted that neither of these was single or double blinded.

 Lee and Rawlinson (1995) gave women in the treatment group two doses of 50 micrograms (250 international units) of anti-D at 28 and 34 weeks, and showed no statistically significant difference between their outcomes and women in the group who had not received antenatal anti-D. However, researchers in Huchet et al's (1987) study gave a larger dose of anti-D (500 international units) at 28 and 34 weeks and showed a clear reduction in the incidence of isoimmunization at between two and twelve months, although no data which considered subsequent pregnancy in those women were available. In response to this data, Cochrane reviewers concluded that there was still a need for consideration of other issues, such as cost and supply of anti-D (Crowther and Kierse 1999). Of course, we should bear in mind that, even if we feel that the evidence shows antenatal anti-D administration to be effective, this does not necessarily mean it is necessary or beneficial for all women; this is another issue entirely.

Is there Evidence for Caution?
There are two main arguments against the routine administration of antenatal anti-D; although cost is a major issue, this will not be considered here - discussion of this can be found in Wickham (2001). The first of these arguments concerns the difficulty there exists with trying to establish how effective antenatal anti-D would be when there are still questions and problems regarding the current program of routine postnatal administration and antenatal administration in response to a potentially sensitising event. Ghosh and Murphy's (1994) Scottish study showed that just over 30 per cent of women who had experienced an antenatal sensitising event had not been offered anti-D. Tovey (1983) showed that 22 per cent of the women in his study became sensitised as a result of 'failure of administration' and Howard et al (1997) also propose that closer adherence to the 1991 recommendations might further reduce the incidence of isoimmunization. Their study found that only 20 per cent of women who had experienced abdominal trauma had been offered anti-D and only 95 per cent adherence to the recommendations in the area of postnatal administration.

Clearly, it is not helpful to begin an antenatal programme if a proportion of the women who are becoming sensitised during pregnancy are facing this as a result of professional failure to offer anti-D after a potentially sensitising event. Rather than subjecting all women to antenatal anti-D because some clinicians fail to offer this to the women that really need it, we need to consider how this trend can be reversed. We also need to establish how may women are becoming sensitised as a result of failure to implement the current guidelines, and not include these woman in figures which are being used to promote the uptake of routine antenatal prophylaxis.

It is not just midwifery and obstetric departments which are failing to offer anti-D. Huggon and Watson (1993) sampled 29 women who arrived in accident and emergency departments following a threatened miscarriage. Only eight women were tested to establish their blood group on admission and none of those women who were rhesus negative were offered anti-D. Gilling-Smith et al (1997) built on this small-scale study and researched 88 accident and emergency units, which treated women who experienced bleeding in early pregnancy. Seventy seven of these failed to administer anti-D when this was appropriate, and 37 per cent reported not even having access to Kleihauer testing to determine whether a woman had experienced a larger bleed than would be covered by the standard dose.

What are the Risks?
The second argument against routine antenatal anti-D concerns the potential risks of this, both to the woman and to her unborn baby (who will not herself benefit from this - anti-D effectively being a protective measure for her siblings). The fact that there has been no research investigating the effects of anti-D on the unborn child is one of the factors of concern to those currently calling for caution (Gaskin 1989, Coombes 1999). Gaskin (1989) cites several potential risk factors where babies are exposed to anti-D, including immune system compromise and potential problems during later reproduction for rhesus negative baby girls exposed to anti-D in utero.

Two further potential risks of antenatal anti-D are discussed in the medical literature; this does not, however, mean that these are the only possible risks; there may be others not yet predicted. The first risk is that of augmentation; or enhanced anti-D immunisation (Urbaniak 1998), where a woman who is given passive anti-D during the antenatal period could, upon exposure to rhesus positive cells (via transplacental haemorrhage) mount a primary immune response to these.

The second concern is the effect of passive anti-D on the unborn baby. There has been no systematic study, which looks at the short and long-term side effects of anti-D in babies (Urbaniak 1998). Although Gaskin's (1989) evidence concerning immune system compromise seems to have been ignored, other risks to the baby have been discussed in the literature. Some of these concern the fact that about ten per cent of the anti-D given to the mother will cross the placenta to the baby (Hughes-Jones et al 1971, Urbaniak 1998). Studies have shown that this causes a proportion of babies to test positive for antiglobulins (via a direct Coombs test) after they are born (Tovey et al 1983, Bowman and Pollock 1978, Herman et al 1984). The few studies which have looked at this have suggested that, while babies may suffer some anaemia, this does not require treatment in the immediate postnatal period.

Although Romm (1999) points out that the manufacturers of anti-D clearly state that this should not be given to babies, no-one has considered the question of whether there are long term consequences of this. It should be remembered that unborn babies will also be exposed to the risks which women face, such as that of virus transmission (Wickham 2000). This can only be exacerbated by the fact that the optimal dose of antenatal anti-D is not known; women and babies may be exposed to more of this product than they need.

Debating the Issues
In 1997, a Consensus Conference was held so that a group of experts could determine national recommendations for antenatal anti-D administration. These experts gathered to assess the evidence, including many of the studies here and make recommendations to the Royal College of Obstetricians and Gynaecologists and the Royal College of Physicians of Edinburgh. This group included haematologists, obstetricians, general practitioners and even a medical journalist. Significantly, a number of groups were not represented; no consumer-focused childbirth organisations or childbearing women were invited for their opinions, and there was no clinical midwifery representation on the group. This may seem undemocratic to some, as it is women who receive the product and usually midwives who inform them of the issues and administer it.

In relation to current failures of implementation, the conference noted their concern that; 'there is abundant evidence that the recommendations are not being fully applied.' (Urbaniak 1998: 1). They did not, however, feel that this issue warranted further investigation before making the decision to recommend routine antenatal anti-D. Another recommendation concerned the suggestion that, 'information leaflets concerning the recommendations should be given to RhD negative women and their partners'. This may be an issue which the midwifery profession needs to debate in relation to informed choice and the need for balanced information; the vast majority of the information leaflets currently available - mostly donated by the pharmaceutical companies producing anti-D - are biased towards women's acceptance of anti-D rather than the facilitation of informed choice. If more midwives became involved in the process of writing and evaluating this kind of information, women may have more of a foundation upon which to make their choices.

Where do we go from here?
The Royal College of Midwives (RCM 1999) and the UKCC (Coombes 1999) have raised concerns about the guidelines advocating the use of anti-D in the antenatal period; specifically the lack of testing of the product for routine use and the lack of sound evidence which suggests that antenatal administration is beneficial. Coombes (1999) is also among those who have highlighted the fact that around 40 per cent of the 100,000 or so women who would receive antenatal anti-D each year in the UK would be carrying rhesus negative babies, and therefore would have received this unnecessarily. Should paternal blood testing be one of the options which women should be offered at this time? Women who are pregnant with their last child are also among those who would not benefit from antenatal anti-D. Should it become routine practice for midwives to discuss these issues with women in relation to their personal need for anti-D?

Many questions remain in this area, which suggest the need for midwives to become more involved in this debate. Is there enough sound evidence to support the routine antenatal administration of anti-D, or should midwives - as women's advocates - be concerned about this prospect? How can the issues be addressed and the remaining questions answered in such a way that we know that the options we are offering women are beneficial rather than harmful and based on what is truly optimal for those women rather than being deemed necessary as a result of our own failures in other areas? More than ever, midwives need to be able to explain and discuss the evidence with the women who face this decision. Whatever recommendations are put in place, either locally or nationally, women have a right to make their own informed choices and midwives have a duty to enable these choices to be freely made.


Source: Sara Wickham

by

Bachelor of Midwifery

A one and only three year Bachelor of Midwifery program should be offered in South Africa and the rest of the world  which should prepares any midwife to offer primary health care to women during pregnancy, through childbirth and in the first six weeks of their babies’ lives. Such a curriculum should emphasize normal birth options at home, a birth centre, clinic or hospital and the alternative therapies open to women.

Basic Anatomy and Body Systems

The midwife needs to have in-depth knowledge of basic anatomy, specifically, relating to women and infants, as well as an understanding of the female reproductive system and fetal growth and development. Midwives must monitor the health of the mother, fetus and infant; therefore, they need to know the specifics of how each of the body systems work and how to determine potential problems. They need to be able to regulate and monitor the body systems of the mother, fetus and infant.

Procedures during Pregnancy and Childbirth

Before becoming a midwife, it is essential to have proven knowledge and skills dealing with every aspect of pregnancy, labor and delivery. Midwives must know how to tell a normal pregnancy from one with the potential for complications. They need to know how to recognize complications, how to handle complications and when to refer the mother for medical intervention. Midwives need to be trained in proper sterilization procedures, umbilical cord care, premature or past-due labour and newborn infant care. In addition to being trained for a normal birth, the midwife must be properly trained and prepared to deal with any complication that could arise with the mother or the infant during pregnancy, through labor and delivery or within the first six months to a year after birth.

Nutrition during Childbirth and Pregnancy

The approach to healthy nutrition during pregnancy we advocate is simple.  Understanding the physiologic changes that underlie the nutritional demands of pregnancy can help present basic guidelines for eating, without suggesting that we become rigid and bogged down by rules. Guidelines are based on the changes your body goes through while pregnant and the needs these changes pressent. The midwife also needs to have training in proper antenatal, postnatal, foetal and infant nutrition.

Breastfeeding

Midwives need to know the basics of lactation including normal lactation, nutrition for lactation, problems with lactation and how to increase or decrease lactation. They need to understand infant behavior with regards to lactation and suckling, as well as be able to identify and correct problems with latching on or suckling. Midwives must be able to help the mother and infant with lactation, suckling and nutrition issues.

Counseling and Support Services

The midwife provides basic counseling and support services in order to ensure the overall well-being of the mother and her family. Basic training in counseling and mental health is necessary for the midwife to identify mental, emotional or psychological stress and to effectively help and support the mother and family throughout the childbearing year. Midwives also need to have knowledge in family system and cultural differences in order to meet the needs of the family.

Adult Education and Communication

Midwives need a minimal amount of training and skills in teaching and educating adults. The midwife provides education on pregnancy, birth, infant care and postpartum care to the mother and her family. The midwife must be able to effectively communicate and educate the family members based on their individual needs and educational level