When you’ve survived Hyperemesis Gravidarum, you hold your baby and thank God that you made it, and that your baby made it, and that you’re both alive. You survived. Then you kind of forget about it, or try to, at least, while you get on with feeding your baby, changing her and learning to be a mother. You kind of assume that Hyperemesis Gravidarum is gone, and you hope that that’s the end of it.
I did, both times.
And for Ameli it was. She’s suffered no ill fate from this ghastly condition. I assumed the same would be true for her sister, born two and a half years later. But things were different. During my pregnancy with her I was already running on depleted supplies, and the sickness was worse, and when I started throwing up blood at 10 weeks, I went on medication because by 12 I couldn’t get out of bed without fainting. That’s not an ideal way to look after an almost two year old.
The medication I was on – Ondansetron, also known as Zofran – wasn’t specifically tested in pregnancy and my doctor wasn’t happy about giving it to me, but I showed him information about it being used for Hyperemesis Gravidarum in the US, and he agreed. He prescribed three tablets a day, but I took one in the morning so that I could eat something at least, which would carry me through the day. Anecdotal evidence mentioned incidence of deformities and I didn’t want to take any chances.
Aviya was born at home in water at 42+5, a perfect baby girl.
At 10 months and 8 days she rolled off a bed, but seemed okay. She was a bit cranky for a few days and cried whenever we tried to pick her up, but on investigation she seemed totally fine. (My mother is a remote areas nurse practitioner, and my brother is a medical student, so they should know.) At 10 months and 10 days she took her first step on Christmas day, but even so… something wan’t right.
I finally took her to Perth’s Children’s Hospital where they said that she had broken something – her clavicle or scapula, I can never remember. We treated it, and went about our business. After all, we were in Perth for my mother, who was dying of cancer. I never thought much of it again, only fearing for Aviya’s health whenever my mother commented on a blue ring around her mouth, saying that I had to get her heart checked out when I got back to England.
Months passed, we found ourselves back in England, trying to find a normal life again. Ameli started back at nursery, Aviya was running around, engaging in the world, doing the things that one year’s olds do. Her first tooth appeared, and then her second tooth appeared and as happens with these things, so did her third and fourth. Our girl was doing great. Until one day I had a piercing pain in my nipple as she tried to nurse!
Her tooth had chipped! No, not chipped broken! It looked like a vampire fang! I felt awful! How could I not have noticed a fall that did that to her tooth! We went to the dentist and had it filed down, a traumatic experience for her, for sure. Not a week later, guess what? Her second tooth did the same. Broken! I was glad her arm had broken in Australia and not England. At least there’s no medical record of it here. I mean, a broken bone and two broken teeth? I know what I’d be thinking.
Well, we took her to the dentist again, and again with the third tooth and again for the fourth. And again, and again. It was only when we discovered two abscesses in her mouth that the dental staff started to take it very seriously. They were going to put her on a waiting list for our area’s special care unit, but an hour later I got a call to say they were going to transfer her to a hospital in London to be seen sooner.
Then the guilt sets in. The dentist said I should stop breastfeeding because that’s what’s causing the tooth decay (but not for the other teeth in her mouth?) Clearly, I’ll not be taking the advice to wean.
We brush her teeth, but probably not long enough.
Maybe I feed her the wrong things.
A bit of reading, and it turn out that – anecdotally of course – HG babies often have weaker enamel on their first four teeth due to malnutrition in the mother (or something like that). She loses these teeth now, but her adult teeth should be fine. With removing them, however, there may be problems with her teeth descending as the ‘tunnel’ for them isn’t there. So she won’t lose her front teeth either. There’ll be nothing for the memory box.
But there’s maybe more.
While reading about all this, I found something else, slightly more alarming: again anecdotally, of course, but there are a number of babies who had Ondansetron/Zofran who also developed heart problems – thinking about my mother’s comments about the blue ring.
Well. Nothing’s proven. But it’s a worry.
So my little girl has her first ever course of antibiotics for the abscesses.
And we wait.
We wait for the GP appointment for the referral for the scan or whatever they do for her heart. Then we wait for the referral for her dental surgery. Then we wait and see what else life throws our way.
And whatever else Hyperemesis Gravidarum takes.
Did you have Hyperemesis Gravidarum? How has it affected your child or your life since having a child?
There’s an advert on television in the UK at the moment for a laundry sanitiser that actually makes me angry every time I see it.
Did you know that germs lurk on your clothes? Your CLOTHES my friend! Like, RIGHT NEXT TO YOUR BODY! Or worse, RIGHT NEXT TO THE BODY OF THE CHILD YOU SAY YOU LOVE!!!! Oh me oh my. Please, use this chemically created product with a long list of ingredients that are unpronounceable and probably have effects on the environment and quite possibly on the skin too*. After all, you do love your family and want the best for them, don’t you?
Apologies for the sarcasm. It’s how I deal with things that make me angry enough to shout at no one in particular.
So if you’re a real believer in business, you’re thinking ‘they wouldn’t sell it if it was bad for you’. Yip. You’re right. Just like nicotine and saturated fats. Oh wait.
So here’s the thing: This particular brand of unnamed Laundry Sanitiser (I’m just a mama. I don’t need no trouble. You can find out who they are on your own.) lists as its ingredients:
I’m no scientist or chemist, so let’s break it down with a little help from our friend Doctor Google.
5% Non-Ionic Surfactants: To my untrained eye, at least, they don’t specify which chemical group of non-ionic surfactants are used, so here’s a general summary of the environmental effects of non-ionic surfactants from the European Textile Service Association Eco Forum Website:
Formerly this group was widely used for cleaning and laundering. Now it has been replaced to a great extent due to the negative environmental effects.
During the biological degradation, alkyl phenol ethoxylates bare transformed to alkyl phenols, e.g. nonyl phenol ethoxylate (NPEO) degrades to nonyl phenol (NP), which is known to be toxic and have hormone like effects.
P.S. “The impacts of nonylphenol in the environment include feminization of aquatic organisms, decrease in male fertility and the survival of juveniles at concentrations as low as 8.2 microg/l. Due to the harmful effects of the degradation products of nonylphenol ethoxylates in the environment, the use and production of such compounds have been banned in EU countries and strictly monitored in many other countries such as Canada and Japan”.[1. Nonylphenol in the environment: a critical review on occurrence, fate, toxicity and treatment in wastewaters Environ Int. 2008 Oct;34(7):1033-49. doi: 10.1016/j.envint.2008.01.004. Epub 2008 Feb 20.]
Disinfectant: not sure what they’re using here. The fact that they don’t tell us what it is worries me. The main one used in the US has been Triclosan for many years, but many studies are showing areas of concern.
Parfum: This is a tricky one. There doesn’t seem to be a specific description of what this is. Parfum is, apparently, industry code for as many as 3,000 chemicals used to make products smell “nice”.[2. David Suzuki Foundation A very interesting blog post on the topic]
The safety of Butylphenyl Methylpropional has been evaluated by the Research Institute for Fragrance Materials Expert Panel (REXPAN). Based on this evaluation, an International Fragrance Association (IFRA) Standard has been established. The IFRA Standard restricts the use of Butylphenyl Methylpropional in fragrances because of potential sensitization.[3. http://www.cosmeticsinfo.org/ingredient/butylphenyl-methylpropional Cosmetics Info – The Science And Safety Behind Your Favourite Products]
What does sensitization mean?
Sensitization to chemicals can be defined as changes in the organism, usually the immunochemical system, by exposure to a chemical such that further chemical exposure leads to recognition by the organism. Such recognition will lead to a response that is marked by a greater reaction at lower doses than what would be observed in non-sensitized individuals. This is usually called hypersensitivity (Turner-Warwick, 1978).
Inhulation of the antigen/allergen in an individual previously sensitized leads to an allergic reaction, such as rhinitis or conjunctivitis. If the skin is sensitized, as in allergic contact dermatitis, then contact will cause an oedematous response and/or a rash. Pulmonary (airway) sensitization manifests itself through bronchial constriction or obstruction (Davies and Blainey, 1983; Hetzel and Clark, 1983; Ramsdale et al., 1985). Some chemicals can produce different types of “allergy’. There are various known and hypothesized mechanism for sensitization. There are also host susceptibility factors, including genetic predisposition, which will play a role in sensitization and in disease manifestation (Turner-Warwick, 1978; Gregg, 1983).[4. Key Concepts: Chemical Sensitization Michael D. Lebowitz]
Citronellol: naturally occuring scent ingredient derived from plants such as rose, used to mask other scents. Not considered to be toxic, bioaccumulative or toxic or harmful. Often used in beauty products. Interestingly, it still has a score of 5/10 on the EWG hazard chart.[5. <a href=”http://www.ewg.org/skindeep/ingredient/701389/CITRONELLOL/“>Citronellol</a> – Environmental Working Group]
Hexyl Cinnamal: naturally occurring and synthetic ingredient, it is associated with allergic reactions. While not believed to be toxic, bioaccululative or harmful, it is a possible human immune system toxicant or allergen and is banned or restricted in the EU.[6. <a href=”http://www.ewg.org/skindeep/ingredient/702841/HEXYL_CINNAMAL/“>Hexyl Cinnamal</a> – Environmental Working Group]
2.40 g Dialkyl (C8-10) Dimethylammonium Chloride:
Didecyldimethylammonium chloride is an antiseptic/disinfectant, which is used in many biocidal applications. They cause disruption of intermolecular interactions and dissociation of lipid bilayers. They are Broad spectrum Bactericidal and Fungicidal. They can be used as Disinfectant Cleaner for Linen recommended for use in hospitals, hotels and industries . It is also used in Gynaecology, Surgery, Ophthalmology, Pediatrics, OT, for the sterilization of surgical instruments, endoscopes and surface disinfection. [7. http://en.wikipedia.org/wiki/Didecyldimethylammonium_chloride>Dimethylommonium Chloride – Wikipedia]
Benzyl-C 12-18-Alkyldimethyl Chloride:
ADBAC is highly toxic to fish , very highly toxic to aquatic invertebrates , moderately toxic to birds and slightly toxic to mammals. Concentrated solutions (10% or more) are toxic to humans, causing corrosivity/irritation to the skin and mucosa under prolonged contact times, and death if taken internally in sufficient volumes
Several studies claim to have identified allergic reactions to benzalkonium chloride, although a clear distinction has not been drawn between irritation and a genuine allergic response involving immune system. Studies have been based on individuals rather than statistically significant groups. It is still widely used in eyewashes, nasal sprays, hand and face washes, mouthwashes, spermicidal creams, and in various other cleaners, sanitizers, and disinfectants.[8. <a href=”http://en.wikipedia.org/wiki/Benzalkonium_chloride“> Benzalkonium_chloride </a> Wikipedia lists a host of reference articles related to the above. ]
Unless we’re talking about a child with a terrible immune related disease, where there may be justification for over-sanitising, you do not need to fill the waterways and environment with toxins. And even if you do, do some research before hand to be sure that the ingredients in this product aren’t going to make matters worse.
But let’s say none of the ingredients in this product put you off, because, let’s say that they’re all in ‘suspected safe’ quantities and concentrations. Let’s say you really like the idea of a product that can help kill germs and protect against flu or feaces on your child’s clothing.
HOW EFFECTIVE IS IT REALLY?
One study concluded that washing at 60°C (140°F) for 10 minutes is sufficient to decontaminate hospital uniforms and reduce the bacterial load and that items left in the pockets are decontaminated to the same extent and that uniforms become recontaminated with low numbers of principally gram-negative bacteria after laundry but that these are effectively removed by ironing. (MRSA is only removed with added antibacterial liquid though).[9. Effectiveness of Low-Temperature Domestic Laundry on the Decontamination of Healthcare Workers’ Uniforms, N. Lakdawala, MSc; J. Pham, MRes; M. Shah, MSc; J. Holton, PhD, FRCPath Infection Control and Hospital Epidemiology, Vol. 32, No. 11 (November 2011), pp. 1103-1108]
Two groups of families with at least 1 pre-school aged child were given identical cleaning materials, one with antibacterial properties, and one without. They were followed for 48 weeks and checked for a variety of conditions. No significant differences between the 2 groups were found in reports of symptoms, which included rhinorrhea (26.8%), cough (23.2%), fever (11%), sore throat (10.2%), vomiting (2.6%), and diarrhea (2.5%). Fewer than 1% of the households reported any skin symptoms. Within most subgroups, such as young children, children attending day care, and persons working outside the home, no differences were found between the 2 groups. Interestingly, persons with chronic disease or poor health in the antibacterial product group were more likely to have fever, rhinorrhea, and cough.
I’m sorry… can I just repeat that last sentence again?
Persons with chronic disease or poor health given antibacterial cleaners were more likely to have fever, rhinorrhea and cough.
Maybe their lowered immunity wasn’t able to protect them against all the chemicals and toxins in the products?
Still not convinced?
Here’s an excerpt from the CDC Website – That’s the Center for Disease Control and Prevention:
“An essential part of preventing the spread of infection in the community and at home is proper hygiene. This includes hand-washing and cleaning shared items and surfaces. Antibacterial-containing products have not been proven to prevent the spread of infection better than products that do not contain antibacterial chemicals. Although a link between antibacterial chemicals used in personal cleaning products and bacterial resistance has been shown in vitro studies (in a controlled environment), no human health consequence has been demonstrated. More studies examining resistance issues related to these products are needed.
The Food and Drug Administration (FDA) Nonprescription Drugs Advisory Committee voted unanimously on October 20, 2005 that there was a lack of evidence supporting the benefit of consumer products including handwashes, bodywashes, etc., containing antibacterial additives over similar products not containing antibacterial additives.”
Which leads nicely to another concern that has been raised with excessive use of antibacterial cleaners: the creation of superbugs.
The UK Cleaning Products Industry Association unsurprisingly says no, antibacterial products aren’t to blame – antibiotics are.
A variety of different studies have been done on the link between antibacterial cleaners and the creation of super bugs, most of them by Dr. Stuart Levy, a microbiologist at Tufts University, but in reality it is inconclusive. What we do know for sure though, is that antibacterial cleaners clean the good bacteria along with the bad, causing weakness in the immune system. More research is required to find out for sure – but you can imagine no one’s rushing to fund that research.
1) Antibacterial products have not been shown to have any positive effect on consumer health
2) Antibacterial products contain a host of chemicals, many of which have detrimental side effects to health, and more specifically, can cause extra illness in people with an already low immune system.
3) The antibacterial products you wash down the drain end up in the waterways, in our food, and in our environment, killing good bacteria along with the bad, and potentially causing a rise in bacteria resistant to antibiotics. Those you rub on your skin pass through into your unborn baby – you know, the one you’re staying away from cheese, coffee and sushi for.
SO, WHAT CAN WE DO?
Considering that there’s no difference in the health benefit of using antibacterial products over just washing with water and non-antibacterial soap, you may as well use something that’s not detrimental to you or the environment – like tea tree oil. EEK! You say. THAT HIPPY STUFF DOESN’T WORK?!
“Tea tree oil in a topical formulation might eliminate organisms from carriage sites such as the hairline, axilla, nares, groin and perineum, and incorporation of tea tree oil in hand-washing formulations may reduce the transmission of many multi-resistant organisms associated with nosocomial infections.”[12.<http://jac.oxfordjournals.org/content/45/5/639.full> Time–kill studies of tea tree oils on clinical isolates</a> ukcpi.org ]
You can find similar information for Lavender too.
If you’d like to swap to more natural, chemical free cleaners, see these posts below for wonderful products you can use at home:
Of course, many of these recipes still include chemicals, but these are no where near as toxic to us, our children or our environment as the anti-bacterial options we’re being led to believe we really need, for the sole purpose of someone else’s financial gain.
Continuing on the Contraceptive Options series, today we have Lauren sharing with us why her and hubby, Sam, love using condoms. Lauren writes at Hobo Mama and is co-founder of the Natural Parents Network, and it’s a huge honour for me to be hosting her interesting (and amusing) post. I hope you enjoy it too!
I would like to present to you … the condom.
Not any particular condoms, either, just male condoms in general.
I’d like to recommend them to you for their consideration as a birth-control method for male-female sexual couples interested in preventing pregnancy, due to their many benefits:
Economical — in my own comparisons with other birth-control methods, condoms are a frugal choice.
Compatible — since they’re non-hormonal, you can use them while breastfeeding or in preparation for trying to conceive, and they won’t interfere with tracking your cycle.
Convenient — less mess. Don’t make me over-explain that.
Easy — less chance of user error than remembering to take a pill every day at the same time or schedule an appointment for a shot or other procedure. I mean, yes, some prep is needed, but that’s what practice is for.
Effective — somewhere around 90-98%. More on that later, but suffice it to say — no “oops” babies here so far!
Reversible — want another baby? You got it.
Now, obviously male condoms are also a great choice for preventing (potential or known) sexually transmitted diseases, so if you know you need to use condoms with your partner, then keep on keeping on. I also cannot guide you if you need to use a particular method of birth control for medical reasons. This article’s more for people in a committed male-female relationship who want to prevent pregnancy, are monogamous, and could or do use a different method of birth control but could consider condoms instead.
OK, so, my back story. This is firmly in the TMI category, but you knew that going in, yes? And using “going in” right there just made me giggle. Ah, writing about sex…
I started out my marriage on the birth control pill. I have severe acne, and one thing dermatologists loved to prescribe me was antibiotics. The antibiotics gave me a recurring yeast infection. And I do mean recurring. It turned out part of the reason was that my husband Sam and I were passing it back and forth to each other. Whoops! So my gynecologist told me we should start using condoms to protect each other.
Now, I have to explain that Sam and I come from a rather conservative religious background, and condoms were just not the done thing. Condoms were for … well, loose people. It took having them “prescribed” to me by a doctor for us to feel comfortable buying and using them. That seems quaintly squeamish in retrospect, but so it was. In fact, I’m kind of embarrassed to even mention this, but maybe it will help someone else also feel comfortable considering them.
It took awhile for Sam to get used to the difference in sensitivity, but once he did there were no problems. In fact, if you want sex to last longer (hint, hint), a condom can slow things down a little if the man’s not used to them. But, seriously, Sam doesn’t really even notice the difference now, and I never felt a difference (yes, even with those “ribbed for her pleasure” varieties), so if you or your man has tried condoms and found them awkward, give it at least several occasions before you rule them out. Think of it as an experiment. For science. Really test it out.
So, anyway, we used condoms off and on when I was having my little flare-ups due to my medication. The turning point, though, was when Sam got laid-off, we had to buy our own health insurance, and I started to reevaluate the cost of all of our medical care. Which brings me to Point #1:
Ed Note: In the UK, health care is free to residents, so doctor’s visits fees for contraceptives don’t apply, nor do the cost of the contraceptives. Condoms can be bought over the counter, and are quite expensive, but if you’re really hard up – no pun intended – you can get them free from your local clinic. I know ours will give you up to 30 free condoms every 90 days. (I just saw the sign on the door. Really.)
I compared birth control pills to condoms and realized even my generic pill on tri-monthly mail order was costing me about $0.50 a pop, plus doctor’s visits every six months for a refill at around $90 a visit. Assuming I would still go to the doctor yearly (or, ahem, every other year … or so) for a checkup if I weren’t on the pill, let’s add only $90 a year to the cost of pills, which makes the per-item cost more like $0.75. You can easily find condoms at drugstores and supermarkets in bigger packs that run about $0.50 a condom. If you don’t mind a little further searching, we were able to find condoms at Big Lots (unexpired, major brands) and on Amazon for more like $0.22 a condom or as low as $0.11 apiece. So, assuming we weren’t having sex multiple times every day (and, true confessions here, we weren’t), condoms were a lot more economical a decision. And just think, if you know the exact cost, you can decide how much sex is worth to you at any given opportunity. “Not tonight, honey. I’d rather save the 11 cents.” (In case you’re wondering, I also switched from dermatologically prescribed acne methods to over-the-counter ones that were cheaper and more effective. Funny how that works.)
If you’re using a different medical type of pregnancy prevention, your costs will vary, depending on how your insurance treats the visit, what the cost is for the procedure, and how often you need to see a health professional. Apparently, for instance, an IUD runs about 5-0 every five or ten years (depending on the type). Let’s say Sam and I have sex three times a week (yes, let’s say that, since it ain’t happening with a young baby right now) — over the course of five years, with the cheapest condoms, that would be $85.80. Ten years would still be cheaper than an IUD, at $171.60 See? Cheap. Now, if you can get reimbursed or deduct the cost of healthcare, that might mitigate the financial factor, since condoms are not considered a medical purchase. You’ll have to weigh out all the options for yourself and your family’s budget.
When I was trying to decide on a breastfeeding-friendly birth control, going back to condom use was a no-brainer. Since they’re an entirely non-hormonal barrier method, there’s no interference with milk supply and no transference to the baby. If you need a hormonal method, your doctor or midwife can point you toward hormonal methods that work better with breastfeeding, but I personally didn’t want to risk it. There are also other barrier methods, but the benefits of condom usage for me outweigh the other methods.
I also appreciated condoms when we were preparing for conception, which was incidentally around the same time as I stopped using my birth control pills for other reasons. As I weaned off the pills, I was able to see my true cycle emerging and I began to take my morning basal body temperature and chart my fertility symptoms. It was fascinating to me to see what my true fertility cycle was like. That honestly is the biggest factor in my not returning to a hormonal method of birth control. I hate the idea of masking my cycles again. I don’t know if this is simply an emotional reason, because I was happy enough on hormonal birth control before, but since becoming a mother, it’s been brought home to me how delightful and intriguing is the cycle of ovulation and bleeding, and I enjoy seeing it unfold as it’s meant to. I mean, I don’t enjoy every moment, but I don’t feel like interfering with it anymore. This is a personal thing, I do understand!
If you’re on other medications, you might find a barrier method a better fit for you as well. For instance, that combo of antibiotics and birth control pills? Not really a good one, after all. If you’re on any other treatments along with hormonal birth control, be sure to ask about any incompatibilities.
I seriously love how condoms make cleanup easy. And, here, just to extend the please-stop-talking-now factor, they can be beneficial when having sex during a period. Just saying.
Condoms come with instructions printed on the box. Follow the instructions. You’ll be fine. They’re cheap, so you can afford to throw one or two away as you learn.
Follow the warnings, too. Don’t put them on inside out. (Learning the difference between inside out and right side out was our steepest learning curve.) Don’t reuse them. Be cautious when taking them off — let the man grasp the edge before withdrawing and hold it on. And that’s about it.
Somewhat related, I’ve heard the Diva Cup and other menstrual cups can be incompatible with some women’s IUDs, which would be my next choice in birth control if I didn’t heart condoms so much. To me, that’s reason enough to stick with condoms, because making my period easy is worth it to me.
When Sam and I were first comparing birth control effectiveness, condoms were way down our list because of some reported effectiveness rates of 85 percent or so. That’s a huuuuge window of potential failure. Well, it turns out there are two types of birth control statistics: There’s what would happen in a lab, and what happens in the real world. The reason real-world condom effectiveness stats are sometimes laughably low is because people get to self-report their method of birth control. So, a person gets pregnant and is asked, “What’s your method of birth control?” She says, “Condom,” and that gets reported as a condom failure, even if she didn’t use a condom for the act where she got pregnant. So a more reliable effectiveness rating for unexpired condoms that are properly used and used every time would be around 98%. A lot depends on user error, in other words, rather than true condom failure. We’ve never had a condom break; only a few times have we had a slippage moment when withdrawing, and for only one of those times was pregnancy a concern. (This was very recently, just after the birth of our second son, and seemed to be the universe laughing at us for having finally stolen a moment to get it on.) I know you can’t go with what one person’s experience is with condoms as to their effectiveness, but all I can say is we got pregnant right away not using them.
You can add spermicide or use spermicidal condoms to boost the effectiveness factor, though for us that wasn’t an option, as Sam was allergic to the spermicide most commonly available in the US. (Speaking of allergies, if latex is a problem, there are non-latex condoms available.) We had a really tough time finding an alternate spermicide and gave up — with no unforeseen consequences to show for it. Then again, we are in a committed relationship and know we could handle having a baby at an unexpected moment, so remember to follow all condom precautions and consider spermicide if you’re very worried.
Another huge plus to me about condoms is they’re immediately reversible. Some hormonal methods, particularly injections like Depo Provera, can take a loooong time to clear your system and return your fertility. (I once used injections and had major hormonal withdrawal coming off them, with bizarre bleeding patterns.) Whereas, with condoms, if you want to try for another baby, you can do so on the turn of a dime. Which is, incidentally, exactly what we did rather spontaneously for our second baby — once again, we got pregnant our first try.
So there it is. I wanted to speak up for a method Sam and I have found enjoyable and beneficial to us, in case anyone else is in the same “condoms are icky” category we were in when we first married! Or, even if you’re more mature than that, if you’ve just never seriously considered condoms as a feasibility, give them another thought. They’re plenty easy, way cheap, and have low interference with your body other than just catching those determined little swimmers.
Have you used condoms? What do you like and not like about them?
Lauren blogs at Hobo Mama about natural and attachment parenting and is the co-founder of Natural Parents Network. She lives and writes in Seattle with her husband, Sam, four-year-old son, Mikko, and nine-month-old baby, Alrik.
During my pregnancy with Ameli, I learned everything I could about everything pregnancy and birth related! I wrote a book full of notes, typed it all up and kept it with my birth plan so that if I had to have a justification for my decisions at any point, I’d have it on hand. I was blessed with an amazing midwife who didn’t even question my choices, so I never needed them, but here are my notes on Vitamin K… maybe you’ll find them useful. These notes formed the basis of my decision and are only intended to provide reference materials to start you off on your own research.
Vitamin K is routinely given because:
“The problem of bleeding into the brain occurs mainly from 3 to 7 weeks after birth in just over 5 out of 100,000 births (without vitamin K injections); 90% of those cases are breastfed infants because formulas are supplemented with unnaturally high levels of vitamin K. Forty percent of these infants suffer permanent brain damage or death.”Linda Folden Palmer, DC in International Chiropractic Pediatric Association Newsletter September/October 2002 Issue
Vitamin K may be needed when:
Premature clamping of the umbilical cord deprives babies of up to 40% of their natural blood volume, including platelets and other clotting factors
The use of vacuum extractor or forceps causes bruising or internal bleeding, which uses up the baby’s available clotting factors
Antibiotics are used in the birth, as they inhibit the baby’s generation of clotting factors.
There are alternatives to a vitamin K shot:
For breastfed infants, an oral vitamin K preparation (Konakion MM) given in 3 doses of 2mg at birth, 7 days, and 30 days of life results in higher plasma vitamin K concentrations than a single injected dose at birth (although my current midwife doesn’t agree with this statement). The preparation must be Konakion MM, which contains lecithin and glycocoholic acid; vitamin K require emulsification and the presence of bile salts for its absorption.
For formula fed infants, formula contains enough vitamin K that no supplement should be necessary.
Arguments against the routine use of vitamin K – three main observations (Falcao):
Nature seems to go to a lot of trouble in regulating the baby’s vitamin K levels: the level at birth gradually rises over the eight days following birth to a higher level. It is almost as if nature very specifically wants the baby to have a specific level of clotting factors at birth, followed by a higher level of clotting factors a week after the birth.
This may be related to the fact that in a physiological birth, where the baby gets all the blood from the placenta, the baby’s blood is a little thicker; this is especially true in the 72 hours following birth, since the babies naturally become a little dehydrated until the mother’s milk changes to a higher volume flow, so the blood is thicker.
There has been some association between vitamin K injection and childhood leukaemia. (Parker) Theoretical observations are that precise levels of vitamin K are required to regulate the rate of cell division in newborns and that excessive levels of vitamin K disrupt this regulatory process, thus increasing the possibility of leukaemia and other childhood cancers. (While a few studies have refuted this suggestion, several tightly controlled studies have shown this correlation to be most likely1,2.The most current analysis of six different studies suggests it is a 10% or 20% increased risk. This is still a significant number of avoidable cancers.3)
Research shows that babies who contract meningitis are more likely to die if they have higher clotting factors. It’s not clear whether this is due to genetic factors or whether it applies to all babies who receive vitamin K. ( I can’t find any actual links to this research, despite it being mentioned all over the web!)
The warning label on Vitamin K injections is pretty scary too:
Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of Phytonadione. Typically these severe reactions have resembled hypersensitivity or anaphylaxis, including shock and cardiac and/or respiratory arrest. Some patients have exhibited these severe reactions on receiving Phytonadione for the first time. The majority of these reported events occurred following intravenous administration, even when precautions have been taken to dilute the Phytonadione and to avoid rapid infusion. Therefore, the INTRAVENOUS route should be restricted to those situations where another route is not feasible and the increased risk involved is considered justified.
Dangers of excess Vitamin K:
When a baby is born gently, without any intervention, antibiotic, or trauma, and no apparent bruising, and is breastfed, there is no need for Vitamin K. Administering vitamin K to these babies – especially if they are formula fed – can lead to excess Vitamin K, which in turn may lead to newborn jaundice.
Signs Suggesting Need for Vitamin K after birth:
bleeding from the umbilicus, nose, mouth, ears, urinary tract or rectum
any bruise not related to a known trauma
pinpoint bruises called petechiae
black tarry stools after meconium has already been expelled
bleeding longer than 6 minutes from a blood sampling site even after there has been pressure on the wound
symptoms of intracranial bleeding including paleness, glassy eyed look, irritability or high pitched crying, loss of appetite, vomiting, fever, prolonged jaundice.
(This list is written by Jennifer Enoch. Midwifery Today. Issue 40.)
Keep the umbilical cord attached until it stops pulsing. Do not cut it prematurely, as average transfusion to the newborn is equivalent to 21% of the neonate’s final blood volume and three quarters of the transfusion occurs in the first minute after birth. (As Vitamin K doesn’t cross the placenta, this should make no difference to Vit K levels, but will help with iron levels etc.)
When breastfeeding (or just before starting), make sure to eat plenty of leafy greens or take a vitamin K supplement – vitamin K does not cross the planceta in pregnancy, but does enter breast milk in feeding. Anti-acids (used for heartburn) decrease the absorption of Vitamin K in the body – bare this in mind if you have lots of indigestion during pregnancy and be sure to increase with Vitamin K intake from around 38 weeks of pregnancy, as this will help prevent against haemorrhaging too.
Nettles are rich in Vitamin K – made into a tea you’ll get everything you need. Otherwise try a Nettle soup.
My conclusion on this sensitive matter, based on the information available to the public and its potential impact on my own family, is thus:
Nature says a baby doesn’t need large amounts of Vitamin K, but that delayed cord clamping and the transfer of oxygenated blood gives the child enough resources to cope with the effects of a ‘normal’ birth. If the mother has been consuming Vitamin K in some form or another, it will immediately begin transferring through her colostrum, which is rich in Vitamin K and breastmilk and by eight days of age, baby will have the ‘right’ amount of Vitamin K (and since formula is fortified with vitamin K, formula fed babies shouldn’t require it at all) – since the disease it is meant to prevent doesn’t tend to occur until between 3 and 7 weeks I personally question the need for the injection.
At the same time, bleeding kills almost 2 in 10,000 babies, and this is the closest I could find to statistics as todeaths from the injections ** although we know that they have occurred. It says so on the label. So really, the conclusion is inconclusive.
Every parent has to make their own decisions on this, but for me and mine, we’ve decided against vitamin K injections unless something in the birth necessitates it. We’ve also decided to follow natural alternatives, such as breastfeeding and a high maternal Vitamin K intake and to keep a close eye on the signs of bleeding as described above.
** The FDA database contained a total of 2236 adverse drug reactions reported in 1019 patients receiving vitamin K by all routes of administration. Of the 192 patients with reactions reported for intravenous vitamin K, 132 patients (69%%) had a reaction defined as anaphylactoid, with 24 fatalities (18%%) attributed to the vitamin K reaction. There were 21 patients with anaphylactoid reactions and 4 fatalities reported with doses of intravenous vitamin K of less than 5[emsp4 ]mgs. For the 217 patients with reactions reported due to vitamin K via a non-intravenous route of administration, 38 patients had reactions meeting the definition of anaphylactoid (18%%), with 1 fatality (3%%) attributed to the drug.
L. Parker et al., “Neonatal vitamin K administration and childhood cancer in the north of England: retrospective case-control study,” BMJ (England) 316, no. 7126 (Jan 1998): 189-93.
S.J. Passmore et al., “Case-control studies of relation between childhood cancer and neonatal vitamin K administration,” BMJ (England) 316, no. 7126 (Jan 1998): 178-84.
E. Roman et al., “Vitamin K and childhood cancer: analysis of individual patient data from six case-control studies,” Br J Cancer (England) 86, no. 1 (Jan 2002): 63-9