Canadian Pediatric Society no longer recommends this practice from the late 1800's (it is now 2017)9/6/2017 What is that eye ointment babies get after birth and why do they get it? It is erythromycin and it is for prevention of severe eye infections in newborn babies. This routine practice has become outdated and no longer recommended. This might be a topic you would like to have a conversation with your care provider about. Neonatal ophthalmia (NO) is a relatively common infant illness & is defined as conjunctivitis occurring within the first four weeks of life. This term originated from cases caused by N gonorrhoea, but the term now currently refers to any conjunctivitis in this age group. In most instances, neonatal ophthalmia is a mild illness and can easily be treated case by case once infectious conjunctivitis is determined & distinguished from eye discharge secondary to blocked tear ducts and from conjunctivitis due to exposure to some kind of irritants or chemicals. The exception to this is ophthalmia due to infection with N gonorrhoea. Those cases are quite dangerous for infants.  Historically, the purpose of prophylaxis treatment with Silver Nitrate at birth was for neonatal ophthalmia eye infections due to N gonorrhoea. But when I say historically, I mean the late 1800's!
A lot has changed in Canada since then and the Canadian Pediatric Society is no longer recommending routine prophylaxis for neonatal ophthalmia. The primary reason is that N. gonorrhoea strains isolated in Canada are showing considerable resistance to the treatments routinely used and there are no recent studies of the efficacy of ophthalmia prophylaxis with these treatments. You can see the position statement, complete recommendations from the CPS and the history of NO, risk factors & legal considerations depending on where in Canada you live on the Canadian Paediatric Society website. Doulas have become increasingly popular over the years. The popularity has grown in Regina due to the benefits of expectants parents having a doula and that more people becoming doulas, making more doulas available for families. Doulas benefit anyone who feels they would like to receive additional support, regardless of how or where they choose to give birth and with whom they choose to do so with. Looking for a doula can be an overwhelming task. How can you know when you have found the doula for you? Have you identified factors that are important to you or maybe you don't know where to start with that? I am going to highlight a few things that might be important factors.  During prenatal visits your doula should be able to help you figure out what is important to you. You, and your experience, should be the doulas priority. My goal as a doula is to provide comprehensive care, along with the team you have put in place, to cover your own birthing needs. In order to do that, we figure out what is important to you we spend time prenatally discussing many things - things you might not think impact your birth experience, but things I know from my experience as a doula, that do make a difference. I have developed consistency in my communication with each client that helps me to connect with you and then equip you with the tools and information to meet those goals. I can help you navigate through the many different childbirth education options, provide informational and evidenced-based resources to add to your confidence and empower your decision-making. I have exceptional relationships with local resources for whatever you may need during pregnancy and parenting that is beyond my scope as a doula or an IBCLC. Prenatal appointments occur as needed, giving you that vital one-on-one support. Typically you would meet 2 times for about 2 hours each time. Telephone and email communication is encouraged between appointments and after care provider appointments. I go on call immediately for you and am available to you from the minute you hire me. I do not wait until 38 weeks to go on call for you and I remain on call past 42 weeks, if needed. Babies are unpredictable and so well I do book other clients based on the average woman delivering between 38-42 weeks, I am on call before and beyond those weeks. Once you are in labour my role is to empower you & encourage confidence in communication with your birthing team. Remember, I will have provided information & tools to help you make your decisions in your pregnancy for the time of birth, so you are confident in your ability to do this. I will provide emotional reassurance, physical comfort and informational support from the beginning of your labour. I will stand by your side during active labor and stay with you while you greet your baby into the world, providing reassurance. I am a support for partners, as well. Partners are the primary support & I will continue to support the partner in that role. This is your experience and a doula is simply a secondary support person for your whole birth team. If there is no primary support person, or your support team does not want to be the primary support, or simply needs a break, a doula will step into that role. I will stay with you during your first breastfeeding experience to provide assistance and encouragement. I will then come see you again to check in and how things are going and provide additional support where needed 24-48 hours after the birth or sooner if requested. I can provide additional hours of postpartum care and exceptional breastfeeding support, if requested. I do have a variety of packages available to ensure you are getting what you need. Don't wait to get the support you desire for yourself and your family & get the best care possible during this time. Contact me to book a one hour complimentary consult to learn more about how I will do my very best to ensure the most positive of experiences you can have. You can fill in the form below or just give me a call at 306-550-6143.
Earlier this week you might have seen my Facebook Live discussing what I am calling a guise for breastfeeding support. What is really happening when the sponsorship of events is by pump companies or formula companies/pharmaceutical companies.
I want to be *explicitly clear* that this is NOT about individuals. This is not about the idea or execution of such events. This is not about women supporting or not supporting women. This is not about businesses who chose to plan events. This is not about businesses who participate in events. This is fully about the sponsorship by the companies covered by the WHO Code. (and I promise you they all know about the WHO Code and how that impacts their relationships). So, what is the WHO Code?
The WHO Code is the common wording used to refer to the International Code of Marketing of Breastmilk Substitutes. The Code was adopted by World Health Assembly and UNICEF in 1981. Since that time, a number changes have been made with the Code.
The purpose of the Code is to protect breastfeeding, to protect all mothers and babies, regardless of their desired feeding methods, and to prevent aggressive marketing practices that often interfere with mothers meeting their own breastfeeding goals. Infant formula, feeding bottles, and artificial nipples are the main products that fall within the scope of the Code. Breast pumps are not under the scope of the Code BUT some pump companies violate the code because they market bottles and artificial nipples. Again, the Code only applies to the marketing of these items–it does not affect whether they are sold or used. Confusing, right? What did I have to say?Confused? Of course you are!
The Code itself can be confusing, but then try to figure of which companies are WHO code Compliant and which are not is a whole other task. Companies come in and out of compliance all the time. Something that commonly happens is large companies merge, or enter into marketing relationships with each other and they also acquire departments from other companies with buying, selling and trading.
Then we have to consider who are the "kid" companies and who are the "parents"? Companies who are owned by Code violators are considered the same as their parent company. You really have to dig deep to find out a lot of this info, but if you start goggling different brands of formula, medications, infant supplies, etc you start to see that there are a lot of kid companies and just a few parents. The parent companies, of course, want to keep their smaller companies WHO Code violating record clean so that health care workers who have to adhere to the WHO Code can still have relationships with these companies, while the parent company gains benefits. They can also give items and samples not covered by the WHO Code and maintain compliance. But in the end, they are still violators. As an IBCLC, I need to educate people about the WHO Code and marketing. What I am encouraging people to do, all across Canada, is to just keep their eyes open a little bit to who is hosting events, who is sponsoring events, what is that relationship like, who is providing the educational piece & decide if the information being given is evidence based and helping mothers meet their breastfeeding goals or if the information might be slanted. You will see a large variety of how these events take place and some will be absolutely ok and some are going to have questionable practices. 
This is not about you and it is not about me.
Again, none of this is personal. None of the individuals involved did anything "wrong". It is not an individual issue. This is a nation wide issue. If one baby store is approached to host an event, any baby store could be being asked. If any doula is asked to be at an event, it could've been any doula they approached. If any nurse is involved, it could be any nurse approached, It happens to doctors, chiropractors, pharmacists, or even IBCLC's. It is anybody who is nice and kind and is buying into the idea of hosting an events for moms to offer support and companionship and education. That in itself is a fabulous idea and needs to happen! I will say people are ALLOWED to do this. As an IBCLC, I choose to adhere to the Code so I will not participate I do let people know that if that is breastfeeding matters to someone else in their profession, they can choose to adopt to follow the WHO Code. I am not here to tell anybody how to run their own business. They CAN participate and have relationships like this if they chose to. But I will always protect breastfeeding in my community. True breastfeeding support does not come from WHO Code Violators.
I want this to be heard by everyone because if the doula/nurse/doctor/pharmacist or IBCLC, asked to participate this time walked away, the companies will just go to find another one. This also applies to educational events for professionals so not only do we look down, we have to look up. I want parents to hear this so if they go to an event they can also see who is providing the funding for the event and the information. Eyes open! Do you remember that time I told you to throw away the Lanolin? (You’re welcome) I am here again suggesting you keep again breastfeeding old faithful on the shelf! At bare minimum before taking fenugreek to help an unsteady to low supply keep that bottle of fenugreek sealed until some further investigation as to why you might need something to boost supply is started.  Should I use fenugreek to post my breastmilk supply? We are starting to learn that fenugreek may not actually help a supply but also can be quite harmful for many mothers who are struggling with a low supply, depending on why the supply is low. The very reason supply is low can be a contraindication for use of fenugreek. For your own safety, you need to know the reason for the low supply, before taking fenugreek. Of particular awareness would be mothers with thyroid concerns, PCOS, IGT, diabetes, insulin resistant type health concerns. Women who has just had babies may not aware of or have an official diagnosis because until that time they have been mostly healthy. Sometimes it is not until the stress of a pregnancy and birth and early postpartum has an impact on the body that women start to feel unwell. And they might not even feel unwell, but just not be making a full supply. Producing milk is not a necessary part of living, so if the body has stressors, often production is suppressed. Breastfeeding truly is a time in life where a mother needs to take care of herself in order to be able to take care of the baby.
I think “breastfeeding issues” are sometimes breastfeeding issues but I also think that often time struggling with breastfeeding is just a symptom of something else. Paying attention to your supply as an indiction of something else, might actually help you understand more about your body and its personal needs. This is not to say there are not good herbal options for supply, because there are. It is matter of knowing what is happening with your supply and body and having a health history taken or worked up, so that the right herbal for each individual can be chosen/suggested. It might just be fenugreek for you. But, there is a good chance there is something better. For some people, pregnancy is easy, and they enjoy it, but pregnancy can be tough. Morning sickness, hormonal ups and downs, weight gain, constipation, swollen ankles, heartburn and a plethora of other discomforts, and that's before the pain of childbirth! Why would someone go through all of that for a complete stranger? If you have never considered becoming a Surrogate Mother, and are not in a position to need the help of surrogacy to become a parent, you may be wondering why anyone would want to become a surrogate. We find there are four main reasons the people we work with want to give the amazing gift of parenthood to others!  People become Surrogate Mothers because they want to “Pay It Forward”. “It” can be anything. Most of the Surrogate Mothers I have talked to over my years of involvement in surrogacy choose to become Surrogate Mothers because they want to spread the good and love in the world. These amazing women just want to be a source of light in the lives of others. I cannot think of a more beautiful way to perpetuate positivity. Women choose to become Surrogate Mothers because they believe everyone deserves a chance to be a parent. I have found many people who are called to surrogacy are warriors for social justice. They see how difficult it is for those seeking the assistance of a Surrogate Mother to become parents. Their hearts break for the single Intended Parents, gay couples that are desperate to become fathers, older couples who have yet to experience the joy of parenthood, cancer survivors, and others who have been struggling to adopt or have children on their own. Egg Donors and Surrogate Mothers are the balance that can tip the scales of inequality for Intended Parents. Having experienced and overcome infertility, people become Surrogate Mothers to give the gift they have been given. Some of the Surrogate Mothers I have worked with or spoken to have decided to pursue surrogacy because they required the assistance of an Egg Donor or Sperm Donor to become a parent but were able to carry their baby. Others fought long, and hard battles with Infertility and by chance became pregnant. Their empathy and compassion for others is strong, having experienced infertility themselves. A woman may choose to become a Surrogate because she loves motherhood and being pregnant. Some people abhor being pregnant and view it as a necessary means to an end. Others have never felt more beautiful than when they are with child. Combine that with the joys of being a parent, even when it's the most thankless, draining job in the world, being a parent is incredibly rewarding. For some, choosing to become a surrogate is as simple as wanting to enjoy pregnancy but being finished having children of their own and wanting to help others experience parenthood, too! Surrogacy in Canada is altruistic. This means that everyone who chooses to be a Surrogate Mother in Canada does so out of the goodness of their heart. One cannot be compensated for their surrogacy journey (although all related expenses will be reimbursed). Surrogate Mothers are truly giving a gift that cannot be repaid. I am constantly in awe of the Egg Donors and Surrogate Mothers I meet. Their selflessness becomes a miracle for others. They truly give the gift of life. A surrogacy consultant with Proud Fertility, our guest blogger Nathan Chan has made it his life work to help people fulfill their family dreams. Watch the video below to hear Candice's story with surrogacy. Mary Poppins has quite the bag and all things considered it could make a fairly decent doula bag! There are a few items I would leave out of my doula bag, if I was Mary Poppins. The first one would be her coat rack. I am quite certain I can find a place for my coat at the hospital or a clients home. I can probably do without a plant, but hey, if you want a plant in your hospital room to make it a little more homelike, you can bring one…I won’t complain. Although, keep in mind, you might get some flowers gifted to you after you deliver your baby. Mary Poppins even brought her own lights. Lights are important, but again, I am not worried about the lighting at the hospital or your home. Even if you want dim lights, the doctors and midwives have flashlights - yes, they do! Speaking of lights, some people like to have some flameless candles to create a nice ambience. I do have some in my doula bag, but as an FYI, they are a few dollars at the $1 Store.  I, just like Mary Poppins, have in my doula bag. A nice pair of dedicated runners for the hospital are in my bag. Mary Poppins has a mirror in her bag and I sure could use a mirror in my bag. It would be perfect for that moment the baby is crowning and a mother wants to look. Hold on, wait, that hasn’t happened. I have yet to have a mother giving birth who wants to see…. Now, of course, I know some moms would want to but in my experience it is not super common. Again, if that is something you think you might want to try in your birth, lets chat about it and make a plan about who should bring the mirror, just like the plant. That tape measure Mary Poppins has in her bag is amazing and I would love one! I mean imagine being able to measure up people I am going to work intimately with and be told all about their personality. Wow, what a benefit that would be to me and to my clients. Wait, hold on. I do often have a tape measure in my doula bag…with my knitting. Yes, I pack knitting into my doula bag. What? Why on earth would I have knitting? We can talk about that later in another blog post. Back to this tape measure idea. I don't have a tape measure that will tell me easily what your personality is, but I do however have a tool that will help me discover more about your personality and help me connect with you to make our work together easier and a little more flawless. The “Your Birth Experience” (YBE) program allows me to connect with you, identify your needs and then equip you with the resources necessary to achieve your goals. This leave mothers and their families empowered to envision their ideal birth, prepare for that birth and ultimately achieve the birth experience they desire. That’s pretty close to the magical tape measure, right? It is close enough for me. So far you now know my doula bag has a few tea lights, running shoes, knitting and a tape measure. That tape measure isn't the good personality one - that comes from our prenatal meetings. That is all I have in my doula bag? Don't I have a rebozo, massage balls, TENS machines, birth balls? Nope. I do have some gum, some cash for parking, some hair ties and some snacks. Why some simple? Largely, infection control. For real, I don't want to disinfect birth balls and I surely don't want to clients sharing “dirty” ones. I don't want to have to wash beautiful fabrics in harsh chemicals made for industrial disinfection standards. I sure can do some neat stuff with a hospital sheet that I can get at the hospital and then leave at the hospital to have cleaned properly, just like the birth balls. Massage balls and TENS machines…what can be bad there? Nothing is really bad, but I prefer to not place an object between my clients and I. I find a better connection with direct contact and that increases endorphins which are great for labour. Again, if clients know they want to try a TENS machine or like the porcupine balls, I can help them use ones that they likely already own. What I do have that cannot be packed into a bag is my years of experience and my confidence. Relief comes to my clients simply by my being present, much of the time. Clients know they can count on me to be present for them. I am a familiar face they know already and our relationship is solely focused on me helping them have a positive experience. They are presented with a bendy straw in a cup of water to juice, before they even knew they were thirsty. I am leading them to the washroom to pee and get that bladder out of the way of babies path because they didn’t realize they needed to pee. I am lightly touching and stroking their feet to remind them to relax their WHOLE body. I am that voice in their ear telling them that they can and are “doing it” when they feel like you are not being strong. The thing is, people don't give birth every day, (truth be told, I don't attend birth everyday), but I do support women giving birth more often than the average person will give birth. I have been alongside many others before. Each experience is different and no path looks the same, but they are similar enough that I can follow the flow and go alongside and help women through it. They can say things like “Is this normal?” or “what else can I do?” or “what did that nurse/doctor/midwife mean?”. I will reassure them things are normal and they are doing great, I will make suggestions about what else they might want to do, or reassure them what they are doing is perfect & I will help them understand what the care providers are doing or saying. I can help the partner and encourage them just as much (maybe more, maybe less) as I do a labouring woman. My doula bag started out full of items, and honestly, I could have taken a small suitcase on wheels to births when I first started because I felt like I needed to bring it all. I how know that to "bring it all", we need to do more work in the time before labour, and when I “bring it all” now, I am bringing our conversations, unique goals, unique desires, unique choices and my confidence, my experience and can be “tricky” just like Mary Poppins. I am confident I can pull stuff out of thin air that will help me meet your needs without carrying a lot of baggage. If you would like to explore the idea of having a doula support you during your birth, I would love to hear from you. You have all heard about the Baby Box, right? Well, Saskatchewan, it is here!  What else do you need to do? You need to next visit Baby Box University. Register for free and complete the Saskatchewan syllabus to get your certificate. You need to bring your Baby Box University certificate of completion to claim your Baby Box! You can print your Certificate OR take a screen shot. If you are unable to attend, you can give your Certificate to someone else to pick up on your behalf. The Baby Box itself includes a mattress, waterproof cover and fitted 100% cotton sheet as well as childcare products to help you welcome your new baby. Make arrangements to pick up, please Newborn babies are dirty business and believe it or not that white substance on newborn babies is good for them and shouldn’t be washed away! Here are 15 things you might not already know about vernix: 
I think we can agree vernix is pretty amazing. What is a Lactation Consultant, LC, IBCLC? The term lactation consultant or LC has become the known, accepted title for a professionals with expert knowledge in breastfeeding. They may work with moms and babies to address breastfeeding issues and concerns. They may also teach classes, assist with establishing breastfeeding one on one, and promote and protect breastfeeding through policy, procedure within health care and government. Origin of the term “Lactation Consultant The accepted term for “IBCLC” or International Board Certified Lactation Consultant in many geographical areas is "LC" or Lactation Consultant because, as you can see, that term is a mouthful. “LC” is not trademarked and does not hold the professional standard like “IBCLC” does, so one will occasionally find a practicing LC who is not an IBCLC. Consumers (mothers and families) and other professionals (doulas and doctors) need to be aware of this. As well, not all those who work as “lactation consultants” in health centres or breastfeeding support centres are IBCLCs. Some employers encourage employees to pursue the credential but don’t mandate it for employment. Many times, nurses with some basic breastfeeding education fill these jobs. Why is this IBC part so important? The International Board of Lactation Consultant Examiners (IBCLE) awards the title of International Board Certified Lactation Consultant to only the candidates who meet the comprehensive pathway requirements and pass an international exam. This allows IBLCE to establish the highest standards in lactation and breastfeeding care worldwide and to certify only the individuals who meet these standards.  Breastfeeding education, support, clinical management Breastfeeding alphabet soup I’d like to explain some of the breastfeeding alphabet soup by using the birthing support alphabet soup, as people seem to relate to that. All the roles are important, but they provide their own distinct scope, responsibilities, and abilities. They can all work together to provide comprehensive support. Primary roles of the individual bodies As you can see, I’ve broken this down into three primary roles. 1. Education 2. Support 3. Clinical management Education Educators teach you about the normal and expected processes of childbirth and breastfeeding. They typically call themselves childbirth educators and lactation educators. They teach the normal process of birth and what you can expect when having a baby, as well as encourage and promote breastfeeding. This information helps you make decisions, helps you know if you are on track, gives you references for getting the birth and breastfeeding relationships you want, and helps answer your questions. Educators typically teach community classes in group settings. Support Support people are typically those who have additional training in supporting mother, baby, and family during crucial times: birth and breastfeeding. They’re typically doulas and La Leche League (LLL) leaders. Doulas are usually paid professionals, and LLL is a mother-to-mother peer support group. These roles offer the encouragement and motivation you need to get through the processes of birth and breastfeeding. They are well versed in normal and expected outcomes. They know to watch for red flags to ensure they can guide you further if you have come outside the normal, expected process. Their job is to provide physical and emotional support, encouraging you to ask questions of your caregivers to make sure you’re well informed about what occurs. They have resources and guidelines to reassure you that you’re indeed in the realm of normal, and if things deviate from normal, they can point you in the direction of more resources. Clinical management Lastly, we have the clinical management professionals. These are the folks responsible for the clinical and medical bits of the scenario. They look at the facts and figures, big picture, and red flags to rule in or out the things that are not in the normal and expected category and then make management plans from there. They have the clinical experience of things that fall outside normal and how to manage them. Working together All of these people have a place in the realm of support and caregiving; what’s important is they know their role and responsibility and respect the others’. Where it becomes problematic is when the client receives something different from what she expected to receive. Sometimes, this occurs because the roles of each provider isn’t clear to her, and she might conclude that one person isn’t performing a role properly. Let’s look at how this might apply to IBCLCs specifically. In our example, a mother assumes that a breastfeeding educator* is an IBCLC. She notices that despite consulting with the helper, her breastfeeding issue remains unresolved. She decides to seek more help through a La Leche League leader, who determines that the issue is outside her scope and recommends an IBCLC. The mother insists that she already saw an IBCLC, but received no help. *this person could also be staff at a breastfeeding clinic or nurse who comes to her home This example is typical, and it hurts all support people. The educator gets a bad rep because she didn’t help. The LLL leader is helpless because the needs were outside her scope. The IBCLC profession gets a bad rep because the client misunderstood the different roles and expectations. Clients need to know clearly what their expectations are and who can best meet those expectations based on role, scope, and experience. I want to be asked and welcome being asked these questions! I want you to go and look at the IBLCE website to see what IBCLC's are all about and verify I am indeed and IBCLC and see what scope and standards are laid in place for my profession. I welcome the same questions about being a doula! I would love to see a blog about midwives and how they are different from doulas and childbirth educators (wink, wink, nudge, nudge midwives). All breastfeeding and lactation professionals have a responsibility to work together to ensure mothers have accurate information, so they can receive the support and encouragement they need as efficiently and as quickly as possible. |
Kim Smith
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