Wednesday, December 30, 2009


I'm nestled under four blankets. One satiny light brown sheet, one densely woven cream sheet, one thick cotton comforter with a delicate white and beige pattern, and one Christmas colored quilt.

My toes are still cold. Silence dances around me, welcoming my wound up mind to unfold her wings and take refuge in the dimly lit stillness. My children are all asleep, and my spouse is out. And it's very late.

Beside me lays a tiny chubby angel. A princess. A wise looking miniature queen, with sweetly pursed lips with a sweet dribbly ribbon of her mother's milk still resting between them at the corners. Her hands are like soft fluttery butterflies, and every now and again, some naughty dream startles her and the warm velvet fingers search until they come to rest on my side, and then relax back into a sweet slumber. I revel in the glorious ability to bring such total and instant comfort. Delicious happy tears pour into my heart, and my soul becomes dizzy, intoxicated with the power to bring such a perfect being this kind of comfort.

I'm away from the persons who would suggest that my hands are too full, or that I should be terribly stressed out. Tucked into a cozy dream, we're safe from the fussy business of the daytime. I needn't pretend to be less happy than I am to fulfill some silly social contract. I'm happy. I'm blissfully happy. Deliriously intoxicated and in love with the perfect soft breather nestled against my side. My only worry is that I may never be able to sustain this kind of bliss, and that the rest of life will be bittersweet in the light of this recollection.

I love being a mother. With every fiber of my being, even in my moments of greatest failure, I'm so very happy. Even if it tests my limits and rends my heart in ways I'd never before imagined, I'm hopelessly addicted. I only wonder how I got so lucky as to have strayed into such happiness; I who once vowed I never wanted to give birth or take a child to my breast. Motherhood has turned me into such an awe-stricken and joyfully humble servant of humanity, and all I can do is weep tears of happy gratitude at it's feet.

Saturday, December 19, 2009

Miss Eva is now 9 months old, and is such a relaxed, happy, curious, friendly little cuddler. She totally steals our hearts every day!

She can crawl now (started at 7.5 mo), and has almost 6 teeth! :oO The teeth are a total shocker to me, as her sisters didn't have a tooth until they were 10mo. :P She loves to dance to music, and is pulling up on the furniture. Today, I found her climbed up on the first step of her sister's bathroom stool! She loves pulling all the tupperware out of my bottom cabinet, and banging on my metal mixing bowls with a spoon. She adores my parent's West Highland Terrier, and tries to follow her around with her mouth open to get puppy kisses...ewwie! She has a steady, easy going spirit, and is really into trying new foods these days. Carrots and mung beans are big favorites, as are bananas and tangerines.

She's a solid sleeper, and is such a good natured little punkin, even while she's cutting 3 teeth at a time. She tends to wake up in the morning with a big grin on her face, ready to explore. She hates being deterred from something she's trying to reach, and doesn't like waiting for the next bite of food, either, hehe.

Evie loooves to talk! She signs "hungry" and "puppy" and waves byebye. Her words are just astounding me...

She can say: mama, dada, sisseh (sissy), hungry, "hi dada", "is good!", good, byebye, puppa (puppy), beh-beh (baby), hnn-guh! (hungry), E-deh! (Esther), dis (this, what's this) and ball. :O)

Monday, December 7, 2009

Article about Delayed Cord Clamping

Good article about why the cord should not be clamped/cut until it stops pulsating after birth.


"Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial(7)
Randomized 72 VLBW infants (< p =" 0.03)" p ="">
The Influence of the Timing of Cord Clamping on Postnatal Cerebral Oxygenation in Preterm Neonates: A Randomized, Controlled Trial (8)
Randomized 39 preterm infants to immediate clamping vs. 60-90 second delay, and examined fetal brain blood flow and tissue oxygenation. Results showed similar blood flow between groups, but increased tissue oxygenation in the delayed group and 4 and 24 hours after birth.
Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomized controlled trial(9)
Randomized 476 infants to immediate or 2 minute delayed clamping and followed them for 6 months. Delayed clamped babies had higher MCVs (81 vs. 79.5), higher ferritins (50.7 vs. 34.4), and higher total body iron. Effects were greater in infants born to iron deficient mothers. Delayed clamping increased total iron stores by 27-47mg. A follow up study showed that lead exposed infants with delayed clamping also had lower serum lead levels than immediate clamped infants, likely due to iron mediates changes in lead absorption.
A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints(10)
Infants delivering at 30 to 36 weeks gestation randomized to immediate vs. 1 minute delay. Delayed group had higher RBC volumes (p = 0.04) and hematocrits (p < p =" 0.03)">
Immediate versus delayed umbilical cord clamping in premature neonates born <>

Randomized 60 infants to clamping at 5-10 seconds vs. 30-45 seconds. Delayed clamping infants had higher BPs and hematocrits. Infants <>
And that’s just some of it. I’ll be happy to send you an Endnote file with a pile more of you’d like it. If the burden of proof is on us to prove that immediate clamping is good, that burden is clearly not met. And furthermore, there is strong evidence that delaying clamping as little as 30 seconds has measurable benefits for the infant, especially in premature babies and babies born to iron deficient mothers.

So basically, we should be doing this. I’m going to try to effect some change in my department, but there are a lot of things that need to happen for us to change as a general culture. It can’t just be the OBs. L and D nurses and pediatricians need to buy in as well.

Some people will argue that premature babies need to be brought to the warmer right away for resucitation. I don’t know the answer to this, but it’s worth study. One might think that it is important to intubate a very premature baby right away, but I have to wonder if that intact cord will be better at delivering oxygen to the baby for 30-60 seconds than the premature lungs. Particularly in cases of fetal respiratory acidosis, there is strong logical argument that a baby might be better resuscitated by unwrapping the cord and letting it flow a bit than trying to oxygenate it through its lungs. Until that placenta is detached, you have a natural ECMO system. Why not use it? Certainly there are exceptions to this logical argument, abruption being the biggest one, and perhaps even severe pre-eclampsia and other poor feto-maternal circulation states.

I wonder at times why delayed cord clamping has not become the standard already; why by and large we have not heeded the literature. It is sad to say that I believe it is because the champions of this practice have not been doctors, but midwives, and sometimes we are influenced by prejudice. Clearly, midwives and doctors tend to have some different ideas about how labor should be managed, but in the end data is data. We championed evidence based medicine, but tend to ignore evidence when it comes from the wrong source, which is unfair. It is fair to critique the research and the methods used to write it, but it shouldn’t matter who the author is. In this case, Mercer and other midwives have done the world a favor by scientifically addressing this issue, and their data deserves serious consideration.

To quote Levy et al (12) “Although a tailored approach is required in the case of cord clamping, the balance of available data suggests that delayed cord clamping should be the method of choice.” We ought to heed this advice better. Like episiotomy, this change in practice may take awhile, but we should get it started. I’m going to work on it myself. How about you?"

Friday, December 4, 2009

We made our advent wreath today!

We collected some rosemary, pine and cedar today and tied them to an antique embrodery hoop to make our little advent wreath. (We went small this year, maybe we'll be more ambitious next year!) The rosemary was blooming little purple pretty! <3 The girls wanted to paint their faces in celebration, so Esther was a bird and Nomi, of course, was a cat.

We'll have to do double duty on the candle lighting each Sunday, since we got to a late start this year, but I think they'll enjoy it a lot. We also got our Christmas tree up! I'll have to post pictures of that later. :O)