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Sunday, 17 November 2013 04:53

Elimination Communication

For decades there has been an on-going debate among parents about "diapering" babies. Some try to be environmentally friendly by using cloth diapers while others enjoy the ease and convenience of using disposables. There is also a third segment that keep their babies clean and dry without using diapers at all; these parents tune in to their babies' elimination signals and hold their infants over a receptacle where their babies deposit their waste. The idea of infants using toilets may seem unusual to many people, but this practice is not new and is fairly common in Asia, Africa and some parts of South America.
Similar to the way parents know when their babies are hungry, sleepy, gassy, or scared parents can learn when their babies are signalling their need to eliminate. Infants will often pause while nursing, squirm, or become fussy for no apparent reason to signal their need to relieve themselves. When the baby signals, the parent holds the baby over the toilet, sink, or potty and cues the baby to eliminate. It is not unusual for a baby to be labelled colicky when he is actually being persistent about his desire to avoid soiling himself.
Parents can also use common timing patterns. For example, babies often eliminate upon waking from a nap, shortly after nursing, and when their diapers are removed. If a parent doesn't notice her baby making any obvious signals to eliminate, she may begin by holding her baby over the sink or toilet during these common times that most babies need to go. With practice, parents develop an intuition or a feeling that their babies need to eliminate. Sometimes parents even sense a "phantom pee" moments before the baby actually urinates. A parent may feel a sudden warmth, as if the baby has urinated on her arm or lap right before it actually occurs. Parents can learn to hold their infants over a toilet in time to make the catch.
Elimination Communication (EC) can be initiated any time from birth up to 18 months. It requires patience, commitment, and effort just like many other attachment parenting styles. EC is a parenting choice that strengthens the bond between parent and child, promoting a deeper connection between parents and their babies through enhanced communication. 
For more information and support visit Diaper Free Baby.
Published in Child Health
Monday, 04 November 2013 19:58

Experience vs Information: Your Choice

This post started out as a piece on optimal cord clamping, but has become a whole new beast. (Optimal, or delayed cord clamping is the process whereby the umbilical cord is left to cease pulsating before cutting). I read and I researched, after which time, this article changed tracks. I don’t need to tell you the pros and cons of delayed cord clamping. You can read all about it on the websites listed below. After which time you can make your own mind up. 

Could this be my shortest ever blog post? No, what all this lead me towards is the fact that in so many cases, women are not given factual evidence-based information to make a choice. Often it is the experience of others that leads us toward making our decisions, when it should be the combination of experience and information. 

It is in our nature to want others to have the benefit of our own experiences. Informed choice happens when we consider the experience of others and combine it with scientifically proven, evidence-based information. Sharing experience is a vital way to keep ideas flowing. Experience, or the stories that we tell, should serve as a motivation to gather more information on a particular topic; people usually make choices based on what is best for them. Being that individuals are unique, this will vary from person to person. I have made different choices in all four of my births. Many of them ill informed, but all of them mine. I hope to share my experience, tell you a story, then give you some information so that you can make your choice. First, a non-birth related example:

My husband is the sort of person who falls in love with a new product, and immediately wants others to experience the same revolution that he has. If something makes his life easier, cheaper or gives him pleasure, he shares his experience with all around him. When we were first married, we bought an “upside down” fridge. He would show all his friends the said upside down fridge, spout the benefits on not having to bend down to get vegetables, and marvel at the convenience of the mighty upside down design. Despite his enthusiastic sales attempts, I don't think any of the afore mentioned friends jumped aboard the upside down fridge revolution. I am sure that they looked at them, but made their choice based on what suited them and their family and not solely on the eloquent ramblings on my husband. Simply put, they listened to his experience, did their own research and make the choice that was right for them. 

So often advice is based on the experience of others, and not the evidence and information available. Many women that I speak to don’t know that they have a choice in regards to management of the umbilical cord after birth. The World Health Organization (WHO) recommends an actively managed third stage of labor, (another choice here, as you can request natural or physiological third stage) but recommends that after the birth of most infants, regardless of gestational age or weight, the cord should be left for 1 to 3 minutes before clamping.  

When I discussed my preference for a natural third stage with my fourth child, my caregiver refused. She told me that there are too many risks of postnatal hemorrhage, and that she would “not allow it.” We went back and forward over the issue of delayed cord clamping and a natural third stage. Eventually she “allowed” me to have optimal cord clamping if I would agree to an actively managed third stage. Interestingly, I have learnt while researching optimal cord clamping, that what I fought my caregiver for is exactly what the WHO recommends should be standard practice. It was her experience that women having their fourth + baby were are greater risk for hemorrhage. I accepted her expertise and experience as my sole source of information. 

I don’t want to underplay the importance of closely monitoring the third stage of labor. I understand in many cases, administration of an oxytocin based drugs has saved lives. In my circumstance, had I done my own research, and searched for evidence-based information, I would have refused active management. I was very low risk, regardless of the fact it was my fourth birth. I am left wondering how many birth related choices are influenced by experience instead of evidence. I was educated, informed and proactive, but still managed to be persuaded to do things differently based on the words that were spoken to me, and the manner in which they were delivered.

You always have choices. Don't let anyone take them away. You wouldn't go out and buy an upside down fridge simply because my husband, or even a well versed fridge expert told you they are the bomb. You might use his experience to motivate you go out and learn more about them; hey, you might even go out and buy one. Choice is always there, beware of advice and experience that disguises itself as information, and it truly becomes yours. 

Over to you now- make your choice. Here is some evidence-based information on optimal cord clamping and different options for the management of the third stage of labour. 

Midwife thinking - the placenta the essential resuscitation equipment

Dr Sarah Buckley on the third stage of labour

Published in Birthing Facts

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