Midwife and wise woman Ronnie Falcao has discussions on every conceivable birth/pregnancy/parenting/human-being topic imaginable-----http://www.gentlebirth.org/archives/bestcare.html

Epidural Drugs Responsible for Meningitis - RECALL!

The Food and Drug Administration released a list of 34 different drugs that included steroids, epidural anesthetics used to block pain during childbirth, and surgery and saline solutions that are compounded to make different medications.

Anyone who has received epidural injections since July 1 should watch for symptoms of meningitis . Health officials say the most common symptoms are worsening headache, fever, stiff neck, trouble walking or falling and progressing back pain.


Decisions regarding any and all procedures that are typically done to newborns in the hospital can be difficult to make. I try to emphasize to parents that although I consider these to be parenting issues and therefore something about which a doula (or anyone else) shouldn't voice an opinion, I feel that informed consent about these procedures is just as vital as it is around labor and birth issues. Most of us aren't aware of the facts and data around some common procedures, so here are a few things I've found:

Erythromycin eye ointment mandatory for newborns?

It is routine procedure in hospitals to administer a prophylactic eye ointment to all newborns as a preventative measure against Gonorrheal and Chlamydia infections of the eye. Both silver nitrate and erythromycin do produce inflammation, redness and irritation of the eyes as well as blurred vision for 12-48 hours following administration.

Chlamydia: Two-12% of the general female population is infected with Chlamydia trachomatis with rates as high as 20% among high risk populations. 85% of cases of Chlamydia are asymptotic. Depending on the test method chosen, tests for Chlamydia range from 80-100% accurate.
A baby born to an infected, untreated mother has a 30-50% chance of becoming infected during a vaginal birth via contact with an infected cervix. Symptoms of infant eye infection occur 5-12 days after birth and include discharge, swelling and inflammation. Most cases clear on their own. Blindness resulting from Chlamydia eye infection is rare however scarring and vascularization of the eye may occur. If infection develops oral erythromycin is recommended to clear the infection.

Gonorrhea: Babies born to mothers infected with Gonorrhea are also at risk for develop an eye infection. 33% of babies born to infected mothers will also be infected or colonized with Gonorrhea. Symptoms of a Gonorrhea eye infection appear 2-5 days after birth (more immediately if the baby was infected in utero) and include severe swelling of the eyelids followed by copious discharge. If treatment is delayed severe complications such as ulcerations, deep inflammation and blindness may result.
Because Gonorrhea infections are so frequently asymptotic (80%), and compliance among high risk populations is low, it has become the standard of care to administer prophylactic eye treatment. It should be noted that sometimes a Gonorrhea infection is present in a cyst within the vagina or cervix which makes it undetectable by standard testing procedures. However, during birth these cysts can burst resulting in an infection which can be passed to your baby.

Choices in newborn eye care:
-Do nothing. If you and your partner have recently tested negative for Chalmydia and Gonorrhea you have the option of forgoing prophylactic eye treatment, washing the eyes with sterile water immediately following birth and observing for any signs of infection. Should an infection develop appropriate antibiotic treatment should follow immediately.
-Another option would be to wash the eyes gently with an Echinacea infusion followed by maternal intake of Echinacea tincture to pass through her breastmilk to her baby.
-Follow the American Academy of Pediatrics recommendation to administer prophylactic eye ointment within 1-3 hours of birth.




Thoughts on Swaddling

--"We feel very strongly that infants' hands and arms should never be swaddled downward. This is a very unnatural position. The preterm infant in the womb is in flexion much of the time and uses hands and arms to reach across midline, bring the hand and fingers to the mouth, suck on them, grasp and clasp hand to hand, and to the umbilical cord, grasp and holds onto the head, the shoulders, etc. etc. This all sets up neurosensory feedback loops that the immature nervous system counts on in order to mature the flexor-extensor balance and mutual inhibition and activation. Hands should always be free to reach the face and mouth and to mutually grasp one another. Hands and mouth are innervated from closely adjacent regions in somato-sensory cortex; and they function in complement and concert with one another.  The palmar grasp response elicits mouth opening (palmar mental grasp reflex) which activates and facilitates sucking. Primate newborns hold on effectively with hands feet and mouth to nipple to their mothers.

Flexion and rounded shoulders with midline mutual inhibition of over-activation and upset, supports breathing, sleep etc.

It is a prerequisite for successful feeding. When the hands become flaccid, sucking no longer should be initiated until tone has returned into the hands (and feet for that matter).

I trust this is helpful and validates your clinical sense and intuition.

Let me know if I may be of further assistance."-- Heidi

Heidelise Als, PhD
Associate Professor of Psychiatry (Psychology)
Harvard Medical School
Director, Neurobehavioral Infant and Child Studies
Children's Hospital Boston
Enders Pediatric Research Laboratories
320 Longwood Avenue, EN-107
Boston, MA 02115
Ph: 617-355-8249
Fax: 617-730-0224