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Your Baby

A Kinder, Gentler C-Section Birth

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When it comes to having a baby, whether a woman delivers vaginally or by cesarean section, the one thing they have in common is the desire parents have to hold their newborn.

Many women who have had a cesarean section will tell you that the surgical procedure left them feeling like they missed the pivotal moment in giving birth; the physical connection between mother and child.

Oftentimes, the baby is whisked away moments after birth leaving the mother without her newborn.

While C-sections have leveled off in the last couple of years, they are still up 500% since 1970. The reasons for cesarean delivery have changed dramatically from ancient to modern times.

The origins of the cesarean birth are somewhat clouded in mystery, but according to the U.S. National Library of Medicine, “… the initial purpose was essentially to retrieve the infant from a dead or dying mother; this was conducted either in the rather vain hope of saving the baby's life, or as commonly required by religious edicts, so the infant might be buried separately from the mother. Above all it was a measure of last resort, and the operation was not intended to preserve the mother's life. It was not until the nineteenth century that such a possibility really came within the grasp of the medical profession.”

These days C-sections are performed for a variety of reasons. In most cases, doctors perform cesarean sections when problems arise either for the mother or baby or both during birth. However, there are also times when possible health issues are known ahead of time and a C-section can be scheduled to prevent complications.

For the most part, the procedure hasn’t changed much since it began being used in modern times.

During a planned traditional C-section, the woman is given medications to dry the secretions in her mouth, her lower abdomen is washed with an antiseptic solution and possibly shaved. She is given an anesthetic and a screen is placed in front of her face to keep the surgical field sterile – blocking her view of the delivery. She may or may not be able to hold her baby immediately after birth.

A new approach to C-section deliveries may offer some families an option they never dreamed possible.

Doctors and nurses at the Center for Labor and Birth at Brigham and Women’s Hospital (BWH) have developed new procedures to make the C-section more family-centered. Dr. William Camann, Director of Obstetric Anesthesiology, explained that the goal of the family-centered cesarean, or “gentle-C,” is to make the delivery as natural as possible.

For example, Dr. Camann realized that by using both clear and solid sterile drapes, obstetricians could switch the solid drape for the clear one just before delivery and allow mom to see her baby being born.

“We also allow mom a free arm and place the EKG leads on her back so that she is able to hold, interact, and provide skin-to-skin contact with her baby in the moments following the birth,” said Camann, who teamed up with BWH registered nurse Kathy Trainor, to make this option available to patients and their families.

Skin-to-skin touch isn’t just an emotional fulfillment for the mother, research has shown that normal term newborns that are placed skin-to-skin with their mothers immediately after birth do better physically and psychologically as well.

“Allowing mom and baby to bond as quickly as possible after the delivery makes for a better transition for the baby, including better temperature and heart rate regulation, increased attachment and parental bonding and more successful rates of breast feeding,” Trainor said.

With the updated procedure, dads can also hold and touch their newborn. 

Camann acknowledges that changes in the traditional cesarean section require some readjusting from the hospital medical staff.

“It requires (doctors and nurses) to just think a little bit differently than the way they have usually done things,” Camann said. “Once they see this, they usually realize it’s really not that difficult.”

Nationwide, the procedure is starting to take hold as more hospitals begin offering the "gentle-C".

Camann says that the procedure isn’t recommended for every C-section birth. He also emphasizes that it’s not in any way meant to promote more C-sections.

 “We would all like to do fewer C-sections. But there are women who need a C-section for various medical reasons and if you do need a cesarean, we want to make this a better experience,” he said.

Sources: http://healthhub.brighamandwomens.org/the-gentle-cesarean-a-new-option-for-moms-to-be#sthash.hxehc5es.dvbG5DgD.dpbs

A. Pawlowski, http://www.today.com/parents/family-centered-gentle-c-section-turns-birth-surgery-labor-or-2D80542993

http://www.webmd.com/baby/features/what-to-expect-cesarean-delivery

Your Child

Your Kindergartener’s First Day at School

2:00

Whether it’s your little one’s first time, or your child is a seasoned pro, the first day of school brings both excitement and apprehension. It’s not only kids who are slightly hyperventilating… parents are too. Why? Because school is a big deal!

Let’s start with Kindergarten. It doesn’t get much cuter than to see the excitement on a kindergartner’s face on the first day of school.  Between experiencing a certain amount of separation anxiety and their first taste of independence, these little ones are spinning in multiple directions. That’s one reason mom or dad needs to keep their cool - you can cry in the car on the way home.

Some schools offer parents and children a “get to know your school” pre-school visit. If you and your child have the opportunity to visit the school in advance – take it!

The more familiar your child is with the school, the better at calming his or her anxieties on the first day. It’s also good for mom and dad to be acquainted with the teacher and the lay out of the school before your little one starts class.

On the big day, try and arrive a little early. Introduce yourself and your child to the teacher.

Help your little one get the lay of the land. Show him where the bathroom is and explain that they can go anytime they need to- but they will need to ask the teacher first. Also mention that sometimes accidents happen, and that teachers know this. Some schools will ask parents to bring an extra set of underwear and clothing to be kept in the child’s locker for such occasions.

Lunchtime is going to be an unfamiliar experience for these first-timers. You can ease their fears by taking them to the school cafeteria and letting them know that their teacher will tell them when it’s time for lunch. Explain how some children will bring their lunch from home, and some will get their lunch from the cafeteria line. Let them know that they will get to sit with the other children in their class.

Another tip to help your child understand how lunchtime will work is by taking her to a cafeteria-style restaurant before the school year begins. Explain how once they start school, lunchtime will be kind of like eating at a cafeteria. It can also be a good time to talk about healthy food choices.

If you’re going to pack a lunch for your child, begin a couple of weeks before school starts and practice the routine. You can get their input on what kinds of foods they might like and experiment with some healthy choices to see which ones they like the best.

You can also explain that there may be a naptime during the day. They don’t have to actually go to sleep, but they may get a chance to lie down on a cot and rest.

Let your child know that either you or another caregiver will pick them up from school at a certain time. If your child rides the bus, explain the process and how the adults will make sure they are kept safe.

Also, have a backup plan in case someone is going to be late or cannot pick your child up. Give the school a list of people you will allow to pick up your child when you can’t make it.

When it’s time to say goodbye, smile, wave and encourage your child to have a great day. The more relaxed you are, the less threatened your child will feel. Some children get very clingy and start crying – it’s a natural first-day-at-school- reaction to unfamiliar surroundings and circumstances. This may go on for a week or so. Teachers are pros at helping parents say good-bye. Enlist their help. Also know that some kids head off to class without even looking back. It's not a reflection on you- it's just that some personalities are always excited about a new adventure. 

As the school year progresses there will be lots of conversations about school and all the changes it brings. Remember to stay positive and give easy to understand information that correlates to your child’s age.

Stay informed on how your child is doing at school. You may want to set up a meeting with his or her teacher on a regular basis.

Once you’ve said good-bye and you’re out of the school building -go ahead and fall apart. It’s natural for parents to have some of the same emotions that their child is having. Your little one is growing up and has just passed an important milestone in life. You have too.

Source: Ruth A. Peters, Ph.D.

http://today.msnbc.msn.com/id/14244318/ns/today-back_to_school/t/tips-calm-your-childs-first-day-jitters/#.TlPNHHO1lvE

Your Teen

Teens Join Parents in E-Cigarette Concerns

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While much has been written about the connection between teen e-cigarette use and increased tobacco use, little has been said about teens and their views on the topic. A new U.S. poll ask teens about their opinions on whether e-cigarettes should basically have the same type of government controls as other tobacco products.

The poll found that many teens share the same health concerns about e-cigarettes that their parents do.

"We found overwhelming public support of state efforts to keep e-cigarettes out of the hands of minors," poll director Dr. Matthew Davis, a professor of pediatrics and internal medicine at the University of Michigan, said in a university news release.

More than 75 percent of teens aged 13 to 18 and parents believe e-cigarette use should be restricted in public areas and that the devices should carry health warnings and be taxed like regular cigarettes, according to the national survey conducted by C.S. Mott Children's Hospital. The hospital is part of the Ann Arbor-based university system.

The poll also noted that 81 percent of teens and 84 percent of parents believe that allowing minors to use e-cigarettes will encourage them to use other tobacco products.

E-cigarettes can come in candy-like flavors, sometimes enticing adolescents that may not have considered tobacco use before.  In this poll, more teens (71%) than adults (64%) believed that the candy and fruit flavored e-cigarettes should be banned.  About half of the teens and parents said that think it is too easy for minors to purchase e-cigarettes.

Fourteen percent of parents and 9 percent of teens said they have tried or currently use e-cigarettes, and 42 percent of teens said they know other teens that have used e-cigarettes.

All U.S. states except Michigan and Pennsylvania restrict e-cigarette sales to minors.

"Just as we are seeing declines in smoking of conventional cigarettes, there has been rapid growth in use of electronic cigarettes among youth. Our poll indicates that both parents and teens agree that e-cigarettes pose several concerns," Davis said.

"We found overwhelming public support of state efforts to keep e-cigarettes out of the hands of minors," he added.

Although teens in this survey believe e-cigarettes should be regulated, according to a recent report from the U.S. Centers for Disease Control and Prevention, use among middle and high school students tripled between 2013 and 2014.

As e-cigarette use becomes more popular, it seems that teens and parents may be getting in sync on this topic.

"Some people may be surprised that teenagers' views are remarkably consistent with what parents think about e-cigarettes," Davis said. "The strong level of agreement between parents and teens suggests that both groups are concerned about the health hazards of e-cigarettes."

Source: Robert Preidt, http://consumer.healthday.com/cancer-information-5/tobacco-and-kids-health-news-662/teens-and-parents-share-e-cigarette-concerns-survey-705275.html

Parenting

Parental Suicide Attempts Linked to Increase Risks in Kids

2:00

Currently, there’s a recharged debate on whether suicide should ever be considered an acceptable option for someone. Some people say that it is never acceptable. Others believe that there are times when suicide is a valid option depending on the circumstances of the person’s life.

Whatever your personal belief, suicide happens; and when it does it often leaves a messy trail of depression and heartbroken sadness with those left behind.

Studies have shown that suicide can run in families, but few studies have looked at the pathways by which suicidal behavior is transmitted in families.  Those studies suggest that families, who have a history of mood disorders such as clinical depression and bipolar disorder, have an increase in suicide attempts and suicide.

A new study looked at what other factors could also be instrumental in family-related suicide attempts. It found that a suicide attempt by a parent increases the odds nearly 5-fold that a child of that parent will also attempt to take their own life.

But exactly why that happens still needs more exploration say researchers involved in the latest study.

"What that really means is that there is still part of this (family) transmission that we haven't figured out," said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh School of Medicine.

Brent and a team of coauthors followed the children of parents with mood disorders for nearly six years.  The study included 701 offspring  (ages 10 to 50) of 334 people with mood disorders, 191 of whom had also made a suicide attempt.

Researchers found that of the 701 children, 44 (6.3 percent) had attempted suicide before the study and 29 (4.1 percent) attempted suicide during the study follow-up.

Brent and his colleagues write in JAMA Psychiatry that parental history of a suicide attempt conveys a nearly five-fold increased odd of suicide attempt in children at risk for mood disorder, even after adjusting for the familial transmission of mood disorder.

The good news, according to Brent, is that there are treatments for mood disorders and impulsive aggression that may help some people.

According to the Centers for Disease Control and Prevention (CDC), about 1 million American adults report having made a suicide attempt within the last year.

The CDC also says that among young people ages 15 to 24, there are 100 to 200 suicide attempts for every one completed suicide.

Brent said that the children of people with a history of suicide attempts should not be excessively concerned about the study's finding of increased risk to them. "It's still extremely rare," he said.

"I think it's just a wakeup call," Brent said. "Just like if you have a family history of breast cancer or colon cancer. You'd be vigilant of that."

Children’s suicide attempts and suicide are always a serious matter. These days there are a variety of reasons why adolescents and young adults consider suicide; everything from being bullied to losing a first love. This research specifically looks at children that have mood disorders and suicide attempts within the core family.

According to the American Foundation for Suicide Prevention (AFSP), more than 90% of people who take their own lives have an underlying mental disorder at the time of their death. Many times, that disorder was never identified.

The disorders most often associated with suicide are depression, bipolar disorder, and schizophrenia. Substance abuse, either on its own or in combination with another mental disorder, can also be a factor when someone takes their own life.

Their website, https://www.afsp.org, and the National Suicide Prevention Lifeline, http://www.suicidepreventionlifeline.org, both offer excellent background articles and resources for families who are experiencing this situation.

Sources: Andrew M. Seaman, http://www.reuters.com/article/2014/12/31/us-suicide-parent-children-risk-idUSKBN0K917E20141231

http://archpsyc.jamanetwork.com/article.aspx?articleid=2048844

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