Mommypotamus 2015-07-04T02:53:12Z http://www.mommypotamus.com/feed/atom/WordPress Heather http://www.mommypotamus.com <![CDATA[Wild Vanilla No. 2 Solid Perfume Recipe]]> http://www.mommypotamus.com/?p=35110 2015-06-30T17:03:46Z 2015-06-30T15:56:15Z With a serious smile and a thick Puerto Rican accent . . . The island doctor spoke fifteen words I’ll never forget. “I have to make sure you’re not drunk, not crazy  . . . . and you don’t have syphillis.” It was my wedding day, and I had no idea what was ahead – the [&hellip

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IMG_1275-001

With a serious smile and a thick Puerto Rican accent . . .

The island doctor spoke fifteen words I’ll never forget.

“I have to make sure you’re not drunk, not crazy  . . . . and you don’t have syphillis.”

It was my wedding day, and I had no idea what was ahead – the laughter, the difficulty, the invasion of little people who always need to potty as soon as we hop in the car (even though they juuuuust went.)

Though I love my vanilla and sandalwood recipe, I’ve been craving something lighter lately – something that reminds me of carefree days, sun-drenched shores, salty air and live music drifting through beachside tiki huts. This blend of vanilla, citrus, and woodsy undertones does the trick. I’ve named it No. 2 to avoid confusion with the first one – I hope you love it!

solid-perfume-recipe

Wild Vanilla No. 2 Solid Perfume Recipe

Makes approximately .75 ounces. I filled three of these reusable tins with this recipe.

Ingredients

 

* Certain oils, such as lime, can cause skin to burn more easily in the sun. The amount of lime essential oil in this recipe is 0.7%, which according to Essential Oil Safety is not enough to cause photo sensitivity.

Instructions

To Make

Melt beeswax in a double boiler over low heat. Once it is fully melted stir in jojoba – remove from the stove top as soon as the wax and oil are thoroughly blended. The mixture should be just warm at this point, which is important before moving on to the next step because essential oils can be damaged by excessive heat. Stir in essential oils and pour into a silicone mold, storage tin, locket or whatever your heart desires!

Shelf Life

Up to two years. Store in a tightly closed container in a cool place.

 Safety Consideration

According to Aura Cacia, the dilution ratio of vanilla absolute in jojoba oil in their product is 3-5%. This would mean that 18 drops of vanilla oil roughly equal one drop of vanilla absolute. In calculating the overall dilution of this recipe I’ve made this adjustment and estimated that the total dilution is about 10%.

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Heather http://www.mommypotamus.com <![CDATA[Sweet And Sour Chicken Recipe from the Paleo Takeout Cookbook]]> http://www.mommypotamus.com/?p=35111 2015-07-02T06:38:11Z 2015-06-26T17:08:57Z So, you love takeout . . . but not the MSG and corn syrup it contains? Yeah, me too. Back when I finally made the connection between processed food and the health challenges I was facing, I walked away and never looked back. Okay, I looked back a little. Because while certain flavors were easy to recreate [&hellip

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paleo-sweet-and-sour-chicken-recipe

So, you love takeout

. . . but not the MSG and corn syrup it contains? Yeah, me too. Back when I finally made the connection between processed food and the health challenges I was facing, I walked away and never looked back.

Okay, I looked back a little. Because while certain flavors were easy to recreate at home, some seemed to involve one part science, two parts magic pixie dust (which, sadly, seems to be in short supply on Amazon), and three parts throwing my hands in the air and wondering what went wrong.

Then last week a surprise copy of Paleo Takeout arrived in my mailbox, and I literally squealed with delight when I pulled it out of the envelope. Written by Russ Crandall, a world traveling U.S. Navy serviceman and who writes at The Domestic Man, Paleo Takeout is the cheaters guide to Chinese, Thai, Indian, Italian, Mexican, Korean, Japanese, Vietnamese and Greek food – at least the American versions of them we’re used to. And of course, there’s a section for American classics like buffalo wings, chili fries, fish tacos and fried chicken in a bucket.

With over 200 recipes, there are plenty of reasons to love this book. Here are mine:

Why I ♥ Paleo Takeout

He’s on #teamwhiterice

And potatoes, and dairy, which is great for this nursing mama. Of course, each recipe has substitution options for those who want or need to avoid these ingredients.

It’s fridge-to-face in under an hour

And I’m not just talking about one entree, either. Russ explains his technique for making Egg Drop Soup, Sweet & Sour Chicken, Vegetables in White Sauce, and Baked Cauliflower rice in an hour by filling “hands-off time on one dish with some hands-on time on another dish.” It’s a method that can be adapted as needed, and kids can help!

There’s also a guide in the back to help you quickly figure out which meals can be made:

  • In 30 minutes
  • In an hour
  • Ahead of time for easy weeknight dinners

It has all of my favorites

We’re talking Mongolian Beef, Kung Pao Pork (or chicken), Bam Bam Shrimp, Spring Rolls, Moo Shu Pork, Pepper Steak, Orange Chicken, Hot and Sour Soup, Szechuan Beef, etc. And that’s just the Chinese section! There’s also Chicken Teriyaki, Tom Kha Gai, Pad Thai, Chicken Tikka Masala, Tandoori Chicken, Tempura Shrimp, Miso Ramen and more.

Russ has graciously given me a recipe to share with you guys today – enjoy!

(Click here to order Paleo Takeout)

paleo-sweet-sour-chicken-recipe

Sweet And Sour Chicken Recipe From Paleo Takeout

In Russ’ words:

“It is probably not surprising to read that while this dish is served in Chinese restaurants in many Western countries, it doesn’t really exist in China. There are several sauces served in China that incorporate both sweet and sour tastes, the most common being from the Hunan province, but they’re a far cry from what you can get at your local Chinese-American restaurant. The reality is that this is more of an American dish than a Chinese one.

On the flip side, the Chinese have their own interpretation of Western tastes—like flying fish roe and salmon cream cheese stuffed-crust pizza (at the Hong Kong Pizza Hut). I think it’s a fair trade.”

Serves: 4 | Prep Time: 10 Min | Cook Time: 30 Min

Sauce Ingredients

  • 1 cup chicken broth
  • 1/4 cup apple cider vinegar
  • 3 tbsp honey
  • 2 tbsp tomato paste
  • 1 tbsp tamari
  • 1/2 tsp sea salt
  • 1/4 tsp garlic powder
  • 1/4 tsp ground ginger
  • 1/4 tsp white pepper

Nugget Ingredients

  • 2 tbsp expeller-pressed coconut oil
  • 1/4 cup tapioca or arrowroot starch
  • 1 tsp sea salt
  • 1 tsp white pepper
  • 2 lbs boneless, skinless chicken breasts, cut into bite-sized chunks
  • 2 large eggs, beaten

Slurry Ingredients

  • 1 tbsp arrowroot starch
  • 1 tbsp cold water
  • 1/2 tsp sesame seeds, to garnish
  • 2 green onions, sliced, to garnish

Instructions

1. In a saucepan, combine the sauce ingredients. Bring to a simmer over medium-low heat, then reduce the heat to low to gently simmer as you prepare the rest of the meal; stir occasionally.

2. Preheat your oven to 250°F. In a wok or skillet, warm the coconut oil over medium heat. Combine the tapioca starch, salt, and pepper, then toss the chicken pieces with the starch mixture. With your fingers, dip a starchy chicken piece in the beaten eggs, shake off the excess egg, and then add to the oil. Repeat until you have filled your skillet, being careful not to overcrowd the chicken pieces. Fry the chicken until cooked through, flipping every 2 minutes, about 6 to 8 minutes per batch. As you finish each batch, place the cooked pieces on a plate lined with paper towels; put them in the oven to stay warm. You should be able to cook the chicken pieces in 3 or 4 batches, depending on the size of your skillet.

3. Once the chicken is cooked through, finish the sauce. Taste the sauce and add more salt or pepper if needed. If the sauce is too dark and strong tasting, add a little chicken broth to thin it out. At this point, the sauce should be about as thick as tomato soup and should have a sharp but not overwhelming flavor.

4. In a small bowl, stir together the arrowroot starch and cold water to create a slurry. Raise the sauce temperature to medium; once bubbling, add half of the slurry and stir until thickened, adding more slurry if needed. Remove from the heat.

5. Toss the chicken pieces with the sauce, then garnish with sesame seeds and green onions. Serve over Basic Steamed Rice  or Cauliflower Rice. (See below for recipes)

Basic Steamed Rice

Serves: 6 | Prep Time: 15 Min | Cook Time: 25 Min

  • 2 cups medium-grain (Calrose), jasmine, or long-grain white rice
  • 2 1/2 cups water or Beef or Chicken Broth 
  • 1 bay leaf (optional)

1. Rinse the rice until the water runs clear, then drain and place in a stockpot. Add the water or broth, cover, and soak for 10 minutes.

2. Bring to a boil over high heat. Don’t lift the lid to check the rice; instead, listen for the sounds of bubbling or the lid rattling.

3. Reduce the heat to low and simmer until the water has evaporated, about 10 to 15 minutes. Again, don’t lift the lid, but instead listen for a faint hissing sound, which indicates that the pot is dry.

4. Turn on the heat to high for 30 seconds to dry out the bottom of the rice, then remove from the heat. Leave the pot covered for 10 minutes, then remove the lid, fluff the rice with a spoon, and serve.

Steamed Cauliflower Rice

Serves: 4 | Prep Time: 5 Min | Cook Time: 10 Min

  • 1 head cauliflower, cut into large chunks
  • 1 tbsp ghee or expeller-pressed coconut oil
  • 1 tbsp water
  • sea salt

1. In batches, pulse the chopped cauliflower in a food processor until it is the consistency of rice or couscous, about 10 to 15 pulses.

2. In a large skillet over medium heat, warm the ghee for 1 minute, then stir in the cauliflower. Sauté until sizzling, then add the water, cover, reduce the heat to low, and simmer until softened, 4 to 6 minutes. Season with salt to taste and either serve or let cool for use in other dishes.

(Click here to order Paleo Takeout)

Photos reprinted with permission from Paleo Takeout: Restaurant Favorites Without The Junk written by Russ Crandall (Victory Belt Publishing, © 2015)

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Heather http://www.mommypotamus.com <![CDATA[DIY Leave-In Conditioner]]> http://www.mommypotamus.com/?p=35198 2015-06-24T16:09:20Z 2015-06-23T18:21:07Z Coconut is the Swiss Army Knife of beauty products Its oil can be used to make this three-ingredient shampoo bar, homemade deodorant, tooth whitener, lotion bars, and even shaving cream. Oh, and body butter. (And, hey, you can just rub it on as a lovely body oil.) But as a leave-in conditioner? Yeah, not so much [&hellip

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diy-leave-in-conditioner

Coconut is the Swiss Army Knife of beauty products

Its oil can be used to make this three-ingredient shampoo bar, homemade deodorant, tooth whitener, lotion bars, and even shaving cream.

Oh, and body butter. (And, hey, you can just rub it on as a lovely body oil.)

But as a leave-in conditioner? Yeah, not so much . . . it’s just too heavy for most people. Fortunately, coconut milk softens and conditions without weighing hair down, and only takes minutes to make. Just spritz it on clean, damp hair and you’re good to go. I hope you love this recipe as much as I do!

diy-leave-in-conditioner-recipe

DIY Leave-In Conditioner Spray

Ingredients

  • 1/4 cup distilled water (or tap water that has been boiled for 5 minutes and allowed to cool)
  • 1 tablespoon canned coconut milk or 2 tablespoons homemade coconut milk (For this purpose, canned tends to work a little better)
  • Up to 10 drops essential oil*

*Choosing An Essential Oil For Your Leave-In Conditioner

  • Though most often recommended for oily hair due to their astringent qualities, a small amount of tea tree or rosemary essential oil can be helpful for maintaining freshness. Rosemary also boosts shine. (Where to buy tea tree, where to buy rosemary)
  • Lavender is one of my favorite nourishing oils for normal/dry hair (Where to buy lavender essential oil)
  • Vanilla resin just smells amazing, especially with the light coconut scent of this conditioner. It doesn’t have any properties that would assist in keeping the conditioner fresh, though, so I would pair it with another oil. (Here’s what I use)
  • I also love this anti-age blend because it smells like honeysuckle. (It’s pricey, though!)

Equipment

2 oz. spray bottle

To Make

If using canned coconut milk: Whisk together coconut milk, water, and essential oils (if using) and pour mixture into a spray bottle. To save the rest of the coconut milk for future batches, use an ice cube tray to freeze it in 1 tablespoon increments.

If using homemade coconut milk: After straining the coconut milk as described here, whisk it together with water and essential oils (if using). Place mixture in the fridge for a couple of hours. As it cools a thin layer of cream will harden on the top. Remove mixture from the fridge, give it a whir in the blender, and then pour it into a spray bottle.

To Use

Shake well before using. Spritz through damp hair and comb through.

Storage

Store in the refrigerator. Because it doesn’t not contain any preservatives, I make small batches and use within about a week.

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Heather http://www.mommypotamus.com <![CDATA[Why I Declined Routine Sonograms]]> http://www.mommypotamus.com/?p=884 2015-06-20T22:04:57Z 2015-06-19T12:52:45Z I don’t know about you, but my impression of sonograms . . . Going into my first pregnancy was that they were important for three reasons: 1. Making sure potential problems are detected to ensure the best possible outcome 2. Bonding + getting to show off baby’s first pic 3. Knowing what color to paint the nursery [&hellip

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Sonogram-risks

I don’t know about you, but my impression of sonograms . . .

Going into my first pregnancy was that they were important for three reasons:

1. Making sure potential problems are detected to ensure the best possible outcome

2. Bonding + getting to show off baby’s first pic

3. Knowing what color to paint the nursery

Then one day, during a conversation with my chiropractor at a routine visit, five words changed everything. I was bubbling over with excitement about finding out, and she slipped in five words.

It’s fun to wait, too.

Really, what’s fun about WAITING?

So I asked, and she pointed me to research that made me think more deeply about my decision. Today I’m going to share that research, along with insights from other healthcare providers, including doctors and midwives.

Now,  please keep in mind that – as I wrote in my posts on the Vitamin K shot, Glucola, being GBS positive, and other birth related subjects – “Best Boo-Boo Kisser South Of Puckett’s Gas Station” is about as official as things get for me professionally.  I am not a doctor, this is not medical advice, and your decision is completely up to you. If you need some convincing on this, read my full disclaimer where I say it over and over again.

So what did I get wrong?

During the conversation with my chiropractor – who went on to become a doula, midwife and dear friend who helped me birth my winter solstice baby and the boom boom thomp boy  – I discovered pretty quickly that I’d made some inaccurate assumptions. First, statistically speaking routine sonograms do not improve birth outcomes. (source) Second, I assumed that the technology carried virtually no risk – wrong again.

Oh and that third one about the color of my baby’s nursery? She ended up cosleeping with us using these safety guidelines, and the only person that slept in the nursery was our cat.

ultrasound-dangers

What is ultrasound, exactly?

Originally used by the military to detect submarines via SONAR, ultrasound technology bounces ultra high frequency sound waves off the tissues, bones, etc. of a baby in the womb, then uses the pattern created by the different surfaces to generate an image.

According to Lauren Feder, MD, “Modern ultrasound energy intensities are higher than ultrasound of earlier decades. In obstetrics the following ultrasounds and energy exposures are used:

  • Standard scan. The standard scan is used on the abdomen after early pregnancy. Provides a brief pulse ultrasound of lower exposure
  • Trans Vaginal ultrasound. Used in early pregnancy. High exposure levels due to close proximity of probe to early developing fetus . . .
  • Doppler ultrasound. Used by many obstetricians and midwives in stethoscopes, they provide relatively low exposure level.
  • Fetal monitors: used in late pregnancy and during labor to monitor baby and heart level.
  • 3-D Ultrasound. To generate 3-D images of the developing fetus. High level of exposure.
  • 4-D or Dynamic 3-D Ultrasound: Uses specially designed scanners to look at the face and movements of the baby. High level of exposure.
  • Fetal Echocardiography: Uses ultrasound waves to assess the baby’s heart in suspected congenital heart defects.” (emphasis mine)

Wait, isn’t it just like a high-tech camera?

No. Unlike a camera which can take pictures without producing any changes in the subject photographed, sonograms can “promote cell growth, cell destruction, alter membrane fluidity (e.g., poke temporary holes in cell membranes), and alter a cell’s activity such as causing a neuron to fire” explains Dr. Manuel Casanova, a neuroscientist at the University of Louisville, adding that “It turns out it’s not just a picture after all.” (source)

What are the risks of ultrasound?

That’s a question doctors and researchers seem to be struggling with. The last devices used in a large, controlled human epidemiological studies were developed before 1991 – their acoustic output upper limit was 94 mW/cm2. Ultrasound devices now in use can have an acoustic output of up to 720 mW/cm2, which is more than seven times higher.

Human Studies

In her book, Gentle Birth, Gentle Mothering, Sarah Buckley, M.D. discusses problems with several “gold-standard” randomized, controlled human studies which reported no difference in outcomes between scanned and unscanned children other than a higher incidence of left-handedness in boys. (Left-handedness is normal for some children, but is under certain circumstances “marker of damage or disruption to the developing brain,” she explains. )

In her words, it is “difficult to gain reassurance from these trials because, for example, in the Swedish study, 35 percent of the supposedly unexposed group actually had a scan (69),” and in the trial which found that scanning did not have a negative impact the exposure time was only three minutes. In other words, the control group in the the Swedish study was not a true control group, and the second study is not representative of clinical practice. (The typical scan is about 30 minutes.)

Dr. Buckley does mention several other studies worth noting, though:

  • “A large UK study found that healthy mothers and babies randomized to two or more Doppler scans to check the placenta, beginning in midpregnancy, had more than double the risk of perinatal death compared to babies unexposed to Doppler. (66)” (source, emphasis mine)
  • Another Australian study suggest that Doppler ultrasound may actually increase the likelihood of developing a condition it’s used to detect. Babies who were randomly selected to receive “five or more Doppler ultrasounds during pregnancy were more likely than babies . . .  [randomly selected to receive] . . . routine (pulsed) ultrasound to develop intrauterine growth retardation (IUGR) – a condition that ultrasound is often used to detect. (64) This may be related to higher exposure levels with Doppler, as more IUGR has been found in high-exposure animal studies, but not in lower-exposure human studies using pulsed ultrasound.” (source)
  • Also discussed are several “Single or small studies that have shown that possible adverse effects include . . . preterm labor or miscarriage (26) (62), low birth weight (63) (64), poorer condition at birth (65), perinatal death (66), dyslexia (67), delayed speech development (68), and non-right handedness (69) (70) (71) (72)” – which as mentioned before is completely normal in many individuals, but may also indicate a disruption in brain development for some who were originally predisposed to right-handedness.

Animal Studies

Yale Researchers: Ultrasound impairs brain development in mice

In this study headed by Dr. Pasko Rakic of Yale University, researchers found that mice who were exposed to 30 minutes of continuous ultrasound in utero showed impaired brain development. Dr. Rakic noted that “the ultrasound parameters and total exposure time are comparable with or below those used by commercial medically nonindicated prenatal ultrasound videos.” Now, it’s tempting to think . . .

But those are mice! Mice aren’t people!

However, there’s a good reason to pay attention to this study. According to this article in Midwifery Today, neurodevelopmental defects in rats and other mammals should be of concern to expecting mothers “Because, as Cornell University researchers proved in 2001, brain development proceeds in the same manner ‘across many mammalian species, including human infants.’ The team found ’95 neural developmental milestones’ that helped them pinpoint the sequence of brain growth events in different species.(15) Therefore, if repeated experiments show that elevated heat caused by ultrasound damages fetal brains in rats and other mammals, one can logically assume that it can harm human brains, too. (3)”

Other Animal Studies To Consider

There are so many studies available, many which suggest caution, and some which indicate relative safety. Here are a few that Dr. Buckley mentions in Gentle Birth, Gentle Mothering:

  • One study “found brain hemorrhages in mouse pups exposed in the womb to pulsed ultrasound at doses similar to those used on human babies.”
  • “Other researchers found that a single ten-minute pulsed ultrasound exposure in pregnancy affected the locomotor and learning abilities of mouse offspring in adulthood, with a greater effect from longer exposure time.”
  • A study “involving newborn rats, who are at a similar stage of brain development to humans at four or five months in utero, suggested that pulsed ultrasound may damage the myelin that covers nerves (50), indicating that the nervous system may be particularly susceptible to damage from this technology.”
  • “Other experts in this area have expressed concern in relation to heating of the developing central nervous system, whose tissues are sensitive to damage by physical agents including heat. Barnett, a biomedical physicist, notes that heating of the fetal brain is more likely after the first trimester (three months), as the skull bone is more developed and can reflect and concentrate the ultrasound waves. (44)”

Do routine ultrasounds improve birth outcomes?

According to this meta-analysis, “Routine ultrasound scanning does not improve the outcome of pregnancy in terms of an increased number of live births or of reduced perinatal morbidity.” Several other studies support these findings.

Here’s an analysis of additional published research which concludes that “No routine ultrasound screening protocol improves outcomes (Haws et al. 2009). It can be surmised from other research that this is due to the incredible inaccuracy of ultrasound. A recent study found a full third or 34% of ultrasound fetal weight estimates to be outside of the expected +10% to -10% range (Hargreaves 2011). Another study from 2011 found that 1 in 23 (4%) of first trimester ultrasounds in which the woman was told there was no viable pregnancy were wrong and the fetus was fine and the pregnancy went to term (Abdallah et al. 2011). Ultrasound technology cannot reliably predict the presence of a nuchal cord, tell whether a nuchal cord is tight or determine anything regarding the likelihood of hypoxia, IUGR or stillbirth (Cohain 2010). Use of 3D Doppler color ultrasound specifically done to look for a cord in labor detected only 35% of cords around the neck, 60% of cords that were twice around the neck and had a 20% false positive rate, meaning the results said there was a cord around the neck in 20% of fetuses when there wasn’t (Bolten et al. 2009).”

The desire to ensure that “baby is okay” was certainly a powerful draw to sonograms for me. However, according to research collected by Sarah J Buckley, M.D.:

“[W]hile many women are reassured by a normal scan, RPU [routine prenatal sonograms] actually detects only between 17 and 85 percent of the 1 in 50 babies that have major abnormalities at birth. A recent study from Brisbane showed that ultrasound at a major women’s hospital missed around 40 percent of abnormalities, with most of these being difficult or impossible to detect. Major causes of intellectual disability such as cerebral palsy and Down’s syndrome are unlikely to be picked up on a routine scan, as are heart and kidney abnormalities.” (source)

There is also the risk of a “false positive,” which causes needless worry for some families.

Any special considerations for birth center or home births?

Care providers often strongly recommend that individuals who plan to birth out of the hospital have one scan to check for organ abnormalities. Though ultrasound does deliver both false positives and false negatives, if abnormalities are suspected and/or confirmed via additional testing, a hospital birth will likely be recommended so that care can be given immediately after delivery. (This section has been added due to input from a pediatrician and sonographer – thank you!)

Is it possible to minimize the risks of sonograms?

Ultrasound equipment keeps track of two readings to minimize as much risk as possible: the thermal index (TI) and mechanical index (MI). It is up to the sonographer to make sure the TI and MI stay within recommended ranges during ultrasound, but unfortunately many do not even know how to locate this information.

According to this article published at Contemporary OBGYN, “Unfortunately, the level of knowledge regarding ultrasound safety issues appears to be less than desirable. In a 2005 survey of attendees of European postgraduate obstetric ultrasound courses, only 22% and 11% of the participants could explain the TI and MI, respectively, and only 28% could locate this information on the ultrasound screen.33 A similar survey of American ultrasound operators conducted in 2007 revealed comparable results: 17.7% and 3.8% of the participants could describe the TI or MI, respectively, and 20.8% could locate this information on the display.” (emphasis mine)

If an ultrasound is planned, it might be wise to discuss in advance whether or not the sonographer has appropriate safety knowledge and enough experience to perform a thorough scan quickly. In Gentle Birth, Gentle Mothering, Dr. Buckley also suggests that parents have both the referring doctor and sonographer fill out this form to keep for the baby’s records. You can find a printable version of it here.

risks-ultrasound

So did you get an ultrasound, Mommypotamus?

Yes.

After everything I just shared you may be surprised to read that, so I’ll explain. When I was pregnant with my oldest, I underwent Doppler ultrasound (via a Sonicaid) to hear my baby’s heartbeat for the first time. Though magical in some ways, I remember noticing my belly physically grow warm during the procedure and asking if that was okay and normal. A few weeks later when I spoke with my chiropractor, I learned about the possible thermal effects of ultrasound and decided to forego future ultrasounds unless medically indicated.

For me, that meant waiting many more weeks to hear my baby’s heartbeat again using an old-fashioned fetoscope (a stethoscope for your belly.)

My labor with her was long, and though my midwives were excited about using their water-friendly fetoscope while I worked through contractions in the birth pool, they found that that they weren’t able to reliably pick up baby’s heartbeat. It could have been a defect in the scope or just inexperience, but regardless there came a point when they said that I either needed to get out of the tub and let them check on the baby or let them use the Doppler. Moving wasn’t really an option at the moment, so I let them use the Doppler. Wanting to honor my wishes as much as possible, they checked very quickly as needed (which was twice I think) while they encouraged and supported me.

With #2, the boom boom thomp baby, I opted out of all ultrasounds until birth, where I again allowed very brief use of the Doppler as needed.

And the bullseye baby? Well, I birthed him before anyone realized I’d made my way through transition, so no Doppler was needed.

The decision to have a sonogram (or not)

. . . . is a very personal one. A lot of health care providers feel that one sonogram at 20 weeks to rule out detectable problems carries a minimal amount of risk. Some feel they are more important when home birth is planned since the detection of certain abnormalities would make it unsafe to birth at home. Others express concern that neuronal migration changes observed in the Yale study may be similar to neuron growth patterns observed in individuals with autism. And finally, some have questions about research coming out of China which suggests that it may be wise to aim for lower exposure times when ultrasound is called for.

I am beyond thankful for the midwives who helped me determine when the benefits outweighed the risks for my situation, and of course the chiropractor who encouraged me to think more deeply about the decision in the first place. I shared this information not to convince you to do one thing or another, but pass along the information I found useful in my decision making process.

Though it is not for everyone, I discovered that in my case my chiropractor-turned-midwife was right – it was fun to be surprised!

ultrasound-risks

Did you/will you have a routine ultrasound? Why or why not?

Photo Credit: Travis Isaacs

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Heather http://www.mommypotamus.com <![CDATA[Beard Oil Recipe – Makes Scruff Kissable!]]> http://www.mommypotamus.com/?p=35116 2015-06-17T14:39:30Z 2015-06-15T17:44:29Z “Somewhere between having children and buying a minivan, 7am became sleeping in.” ~ Clint Edwards Pops. Dada. Ye old man. Whatever it is that we call fathers these days, the definition now seems to include activities such as: A) Explaining repeatedly that no, a man does not live inside the ATM machine and hand out free [&hellip

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beard-oil-recipe

“Somewhere between having children and buying a minivan, 7am became sleeping in.”

~ Clint Edwards

Pops. Dada. Ye old man. Whatever it is that we call fathers these days, the definition now seems to include activities such as:

A) Explaining repeatedly that no, a man does not live inside the ATM machine and hand out free money

B) Googling “lego nasal extraction”

C) Wearing a toddler while chasing a pregnant goat in a chicken dome (or maybe that’s just my family)

Heh. 

Now, I don’t know about you, but I didn’t really know what romance was until the night my husband whispered “Let me walk the baby back to sleep” at 4am.

Parenting alongside him is the hardest, most rewarding thing I’ve ever done, which is why on special days – or any day really – I try to look for ways to tell him how much I love him. Like making him beard oil. Because sadly, there’s no Hallmark card for “I want to kiss you everyday of my life but your scruffy beard is giving me road rash.” (You really need to get on that, Hallmark!)

While we wait on that card, here’s a recipe for beard oil that your man will love. If he has a beard, that is. And likes kisses. And smelling yummy. (And, um, kisses.)

It softens and tames beard scruff while leaving behind a faint masculine scent. Annnnd, best of all it’s easy to make.

Oh, and if you’re looking for . . .

An amazing idea for Father’s Day that doesn’t require a trip to the mall, check out MELT, a PG-rated (fully clothed!) online couples massage course. It’s 20% off through June 21st – I signed Daddypotamus and I up last week and I’m going to surprise him with it on Father’s Day. (If you see him mums the word, okay?)

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Also, if you’re not a DIYer there’s time to pick up Honest Amish beard balm – it’s made with organic and natural butters and waxes + wild crafted essential oils.

Now Let’s Talk Manly Scents

Here are a few of my favorite essential oil blends:

Woodsman

Smooth & Mysterious

Light & Fresh

Sustainably harvested sandalwood, cedarwood, tea tree, and citrus oils are also popular additions. Keep in mind, though, that citrus oils must be used in very low concentrations or they can cause photosensitivity. Okay now, on to the recipe!

Beard Oil Recipe - Sadly, there’s no Hallmark card for “I want to kiss you every day of my life but your beard is giving me road rash.” Fortunately, there IS this recipe for super easy beard oil that softens beards and nourishes skin.

Beard Oil Recipe

Ingredients

Equipment

Old 30 ml essential oil bottle or dropper bottle, washed and dried

To Make

In a measuring cup, mix carrier oil and essential oils together. Pour into bottle and store in a cool, dark place.

To Use

The amount needed varies depending on the size and texture of the beard, but most beard aficionados recommend working in a dime-sized amount in to a freshly-washed (slightly damp) face first thing in the morning. Just rub between the palms and massage into the beard, then comb if desired. It takes about half an hour for the oils to absorb, so don’t freak out if it feels a little greasy at first. Enjoy a softer, more kissable beard! Or enjoy kissing the one wearing it. :)

Other Great Gift Ideas For Men

hair-pomade-recipe

 

This hair pomade recipe adds texture while delivering light/medium hold. Works best with short hair. Husband tested and approved. :)

bay-rum-aftershave-recipe

Clean and woodsy with spicy notes and a hint of citrus, this bay rum aftershave recipe is as manly as it gets. Use the leftover rum to make hot buttered rum!

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Heather http://www.mommypotamus.com <![CDATA[Tartar Sauce Recipe]]> http://www.mommypotamus.com/?p=35054 2015-06-14T01:59:53Z 2015-06-11T15:57:20Z In My House . . . This quick ketchup practically makes recipe fails launch themselves into the mouths of the littlest potami, but Daddypotamus is not a superfan. His favorite condiments all center around one quality – creaminess. Whether it’s homemade ranch dressing, chipotle mayo or tartar sauce served over paleo crab cakes, creamy wins every time. This [&hellip

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tartar-sauce-recipe

In My House . . .

This quick ketchup practically makes recipe fails launch themselves into the mouths of the littlest potami, but Daddypotamus is not a superfan. His favorite condiments all center around one quality – creaminess. Whether it’s homemade ranch dressing, chipotle mayo or tartar sauce served over paleo crab cakes, creamy wins every time.

This real food version of tartar sauce holds a lot of memories for Daddypotamus – long ago cafeteria dinners with his grandma where a balanced meal consisted of fried fish, steamed corn, macaroni, and a dinner roll.  Not exactly well-balanced, but the memories of dinners with grandma are priceless.

As a boy, Daddypotamus wasn’t an adventurous eater. But you could get him to try almost any seafood with a dab of tartar sauce. Though he’s pretty much willing to try anything these days, there’s still a certain magic to this beloved staple. I hope your family loves it as much as we do.

tartar-sauce-recipe-dill-relish

Tartar Sauce Recipe

Ingredients

  • 1 cup mayo (I would use the avocado oil version of this recipe or this paleo mayo from Thrive Market)
  • 1/4 cup white onion, diced
  • 1/4 cup dill pickle relish
  • 1-2 teaspoons dijon mustard (omit if using the pre-made mayo – it has just the perfect amount of tang for this recipe)
  • salt and pepper to taste

Instructions

Mix all ingredients together and serve.

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Heather http://www.mommypotamus.com <![CDATA[Paleo Crab Cake Recipe]]> http://www.mommypotamus.com/?p=24971 2015-06-16T02:14:33Z 2015-06-10T16:15:20Z Most days Daddypotamus and I stick to . . . Local fare, like egg drop soup made from the treasures left by our girls in the henhouse, but when he wants to see me do my happy dance (which sadly, is a cross between the funky chicken and macarena), he brings home something special. Like crab. And crab. Oh, [&hellip

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paleo-crab-cake-recipe-gluten-free

Most days Daddypotamus and I stick to . . .

Local fare, like egg drop soup made from the treasures left by our girls in the henhouse, but when he wants to see me do my happy dance (which sadly, is a cross between the funky chicken and macarena), he brings home something special.

Like crab. And crab. Oh, and crab.

Because, yeah, seafood is my love language. 

Daddypotamus knows that, which is why he put two pounds of crab and a vat of clarified butter in front of me on the night he asked me to marry him, and why he’s put up with my sometimes hilariously disastrous attempts to recreate real-food versions of old restaurant favorites. (Purple fondue, anyone?)

Fortunately, his patience has paid off in the form of blackened shrimp and scallop fondue, shrimp bisque, blackened salmon with pineapple salsa, shrimp creole, and now crab cakes.

As you may have noticed, seafood is not cheap, so it’s taken years to get things right. Fortunately, now that we save more on staples with Thrive Market we can prepare more special meals while staying within our budget.

This recipe is an ode to my particular love for the the moist, tender texture of authentic Maryland crab cakes dipped in creamy tartar sauce. The secret is coconut flour, which keeps them together without the heaviness of breadcrumbs. Full of lemon zest and bright, fresh herbs, we love them served over lettuce with homemade tartar sauce on the side. (Recipe coming tomorrow!)

paleo-crab-cake-recipe

Crab Cake Recipe (Gluten-Free, Paleo)

Yield: 10 crab cakes Active Time: 15 minutes Total Time: 20 minutes

Ingredients

Directions

Combine the crab meat in a large bowl with the mayonnaise, mustard, lemon juice and zest, coconut aminos, apple cider vinegar, spices, salt, and herbs. Mix gently with your hands until well combined, taking care not to break up the lumps of crab up too much. Mix in egg and coconut flour. Refrigerate mixture for 30 minutes to an hour so flavors can combine.
Just before cooking, preheat oven to 350 degrees and line a baking sheet with parchment paper.

Heat a tablespoon of coconut oil in a skillet over medium heat. Form crab batter into fairly compact 1/4 cup patties and when oil is hot, taking turns, carefully place crab cakes in pan and fry until browned, about 3 minutes. Carefully flip crab cakes and fry on other side until golden brown, about 3 minutes. Place on baking sheet and put in oven to cook through, 5 minutes. Serve with homemade tartar sauce or lemon on the side.

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Heather http://www.mommypotamus.com <![CDATA[Homemade Edible Finger Paint]]> http://www.mommypotamus.com/?p=34973 2015-06-30T20:38:39Z 2015-06-08T17:08:37Z Remember when our kids were born . . . And we were going to do ALL THE THINGS? Like, play Mozart at breakfast to prime their brains for a baby pilates session conducted exclusively in French? And then life happened and two years later we find ourselves saying things like “why are you wearing two left [&hellip

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homemade-finger-paint-recipe

Remember when our kids were born . . .

And we were going to do ALL THE THINGS? Like, play Mozart at breakfast to prime their brains for a baby pilates session conducted exclusively in French? And then life happened and two years later we find ourselves saying things like “why are you wearing two left shoes?” and yelling “MAYDAY! MAYDAY!” through a baby monitor?* 

Yeah, me too.

These days, life is a blur of early morning snuggles and texting my husband photos of random items our toddler jams in the dishwasher when I’m not looking. And art, because there’s something magical about how quiet the room gets when everyone in engrossed in their own creative project.

The thing is . . .

My toddler’s favorite mode of participation seems to be, um, eating the supplies, which limits what we can use.

Inspired by one of my favorite books, Tinkerlab, I recently worked out a completely edible homemade finger paint recipe that only requires two ingredients. Although in the past we’ve used regular flour and gluten-free flour to make things like homemade play dough, my gluten-free attempts at paint were either gritty or difficult to work with. And then I got an idea – YOGURT. It works beautifully, and is pretty tasty too depending on what you use as coloring. The littlest potami gives turmeric a thumbs up for consistency but a thumbs down for flavor. He thought the red was pretty yummy, though!

finger-paint-recipe-homemade

homemade-edible-finger-paint

Oh, and if you love this recipe make sure to check out my homemade edible face paint and moon sand. They’re super easy to make and perfect for fostering creative play.

edible-finger-paint-recipe

finger-paint-recipe-edible

“You can’t use up creativity. The more you use, the more you have.”

~ Maya Angelou

* My friends’ husband really yelled “MAYDAY” over a dirty diaper years ago, and I still giggle about it. However, though I used a baby monitor with both of my older kids I decided not to use it with my third baby after learning more about EMFs. Everyone will have their own comfort level, but I just wanted mention it for those who are looking into pro’s/con’s.

Just two ingredients! #fingerpaintrecipe

Homemade Finger Paint (Using Spices For Color)

Ingredients

  • 1/4 cup yogurt or sour cream
  • 1 teaspoon – 1 tablespoon powdered spice  (or more if desired, see below for ideas)
  • A smidge of honey – Optional. Use if you want your kids to enjoy taste testing as they go (where to buy honey)

Yellow

Use turmeric for the most intense color, but be sure to cover your work surface because it stains. It will also tint little hands slightly but fade pretty quickly. (Ironically, it stains skin but whitens teeth. True story.) Mustard can be used to create a light yellow.

Green

Chlorella (or gorilla, as the potami call it), spirulina, or other green powdered herb/spice/plant like unrefined stevia

Pink/Red

Dried ground freeze dried rapberries (I grind mine in this coffee grinder), beetroot powder, or hibiscus powder

To Make

Add yogurt to a small bowl and mix in your powdered color one teaspoon at a time until you reach the intensity you prefer. For yellow, I used 1 tablespoon turmeric to color 1/4 cup yogurt. Only 1 teaspoon of chorella was needed to reach a rich, green color. For red I used natural food dye because I was out of beetroot powder – see below for instructions! Add optional honey if desired.

Homemade Finger Paint (Using Natural Food Dye For Color)

If possible, I recommend using powdered coloring because it thickens the yogurt and is more budget friendly. However, in a pinch natural food coloring will work!

Ingredients

  • 1/4 cup yogurt
  • natural food coloring – add as much as desired (I use this brand)
  • A smidge of honey – Optional. Use if you want your kids to enjoy taste testing as they go (where to buy honey)

Instructions

Mix until the paint reaches the color intensity that you prefer. Add optional honey if desired.

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Heather http://www.mommypotamus.com <![CDATA[Holistic Care For The Rh-Negative Mama]]> http://www.mommypotamus.com/?p=35013 2015-06-04T18:14:22Z 2015-06-04T17:55:45Z Bubble Wrap When raising kids, sometimes it seems like the best option, you know? Last week we had a family photo shoot scheduled, so naturally my toddler gave himself a black eye the night before. (This has happened to you, too, right?) As parents, we do everything we can to keep our kids safe and [&hellip

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holistic-approach-rh-negative-pregnancy

Bubble Wrap

When raising kids, sometimes it seems like the best option, you know? Last week we had a family photo shoot scheduled, so naturally my toddler gave himself a black eye the night before. (This has happened to you, too, right?)

As parents, we do everything we can to keep our kids safe and healthy. Unfortunately, in some cases there is no clear cut path, and we have to trust ourselves to make hard decisions. Take, for example, the RhoGAM shot.

While it’s now possible to determine with 99% accuracy whether the baby you are carrying is Rh-negative or positive, questions still remain about what to do if baby is positive. According to the FDA, RhoGAM has been shown to have adverse effects on the fetus in animal studies and has not been adequately studied for safety in humans. (source) No studies have been conducted on potential long-term effects.

On the other hand, if a child develops rhesus disease it “can cause a range of problems, from mild jaundice to severe rhesus haemolytic disease, which in the worst cases can result in the death of the baby. Although a far greater proportion of babies suffering from rhesus disease survive nowadays as a result of advances in care, they may require blood transfusions, early delivery or intensive care.” (Anti-D in Midwifery, p.4)

In my previous post I discussed many of the factors parents might consider in deciding what approach to take, along with thoughts on how certain obstetric/birth procedures may increase a mother’s risk of sensitization. Today I’m going to keep the promise I made at the end of that post and discuss dietary and lifestyle choices that some midwives believe may reduce the likelihood of sensitization.

The idea is that these choices “work towards maximizing the physiological potential of the woman’s body” and therefore increase her chances that potentially-risky interventions will not be necessary. (Anti-D in Midwifery, p.101)

As always, please keep in mind that I am not a doctor, this is not medical advice, and your choices are completely up to you. If you need some convincing on this, read my full disclaimer where I say it over and over again.

Now, in order to understand why maximizing physiological potential may be key, we first need to discuss . . .

The Labor Trifecta

As you probably already know, there are three stages of labor. The first is where you put curlers in your hair and lip gloss on because you are going to do this thing with style, the second is after you’ve passed through the puke vortex, hallucinated a few smurfs, stomped around like an elephant, asked your husband to draw a bullseye on your bottom, and are ready to push that sweet little babe out.

The final stage of labor, of course, is when you look at your midwife/doctor and say “WHY CAN”T I JUST BE DONE NOW??” when they remind you that you still have to deliver your placenta.

Placenta Physiology 101

As it turns out, many midwives consider the third stage as the period in which interference with the birth process carries the most risk of sensitization. In most cases of normal physiological birth, the placenta will go through a specific detachment process that is believed by some experts  to offer some protection against fetomaternal hemorrhage. Basically, there are two sides to a placenta – the mother’s has her blood and the baby’s has his/her blood. The mother’s side is responsible for detachment, not the baby’s. When the mother’s side initiates detachment it bleeds slightly. Unfortunately, improper detachment may cause bleeding on they baby’s side of the placenta, which could cause the baby’s blood to enter the mother’s bloodstream.

That’s the short version, of course. Here’s a detailed explanation from Dr Sara Wickham PhD, RM, MA, PGCert, BA(Hons), author of Anti-D in Midwifery.

“The placenta is a complex and intricate organ which is designed to act as a ‘buffer’ between maternal and fetal circulations, allowing oxygen, carbon dioxide, nutrients and waste substances to pass between the two without the mixing of blood itself. This is achieved by the development of villi, tree like protrusions formed in the placenta which sit next to the maternal vessels, allowing the substances to cross via specialized cells and membranes . . .  The placenta plays an incredible role in the growth of a baby, and remains in situ until after the baby is born, when it then separates from the uterine wall and is itself ‘birthed’ during what has become known as ‘the third stage of labour.’

. . . Once the baby is born, the uterus reduces in size and the placental site is also made smaller. This causes the placenta to be squeezed, and some of the maternal blood in the placenta moves into the uterine veins, causing the uterus to become tense . . . At the same time, some of the fetal blood in the placenta is passed to the baby, enabling the placental wall to thicken further in preparation for separation.

As uterine contractions recommence, a few of the congested maternal vessels burst and the small amount of blood which is released causes the placenta to become detached from the uterine wall. This maternal blood causes the spongy lining of the placenta to separate from the uterine wall, and the ‘living ligature’ effect of the uterine fibres seals the maternal vessels and begins the process of healing. The blood that is lost is maternal; midwives will confirm from experienced that the newly born placenta does not bleed from the attachment site.” (p.87-88)

She adds that:

“The physiology of the third stage itself also offers clues to confirm the protective nature of this process. Not only does the physiological mechanism prevent fetal blood from being released from the placental site, but the maternal blood may also act as a cleansing mechanism to prevent transplacental haemorrhage. Any fetal blood which had seeped from the placenta may be washed away (through the cervix and vagina) by the maternal blood, thus adding a further protective mechanism against transplacental haemorrhage.” (p. 90) Unfortunately, according to Dr. Wickham, deep tears or an episiotomy may negate the “washing away” protective mechanism.

How can I encourage optimal placental separation?

If it were me, I’d avoid the interventions listed in this article, since they may increase the risk of sensitization. In addition, I would:

  • Do everything possible to avoid an episiotomy, including discussing my desires with my care provider, doing perineal massage prior to birth, and considering a water birth. (Some studies suggest it may reduce the likelihood of tearing. It’s unclear why, but it may be because the water softens the perineum and allows it to stretch more easily.) (source) I also loved Jamie’s approach shared in the comments of my previous post, which was that when the baby crowned, she waited and let “let everything stretch out instead of tear.” (Thanks, Jamie!)
  • Ask my care provider to allow me to catch my baby and not to touch me, the cord, or the baby unless absolutely necessary until I’m ready to deliver the placenta – and only then to catch the placenta. (Some midwives believe that even touching the cord while it pulses can disrupt blood flow from the placenta to the baby.)
  • Ask that my attendants wait patiently for me to feel the urge to push out my placenta in whatever position is most comfortable for me. No fundal massage to “help” the placenta be expelled or directing me to push. Cut the cord after the placenta is delivered.

In addition, I would consider the following proactive self-care approaches. As with any pregnancy, sometimes we do all the “right things” and something still doesn’t play out like we’d hoped. However, it’s always good to take steps to optimize our health as well as our baby’s. Here are some ideas you may find helpful:

Nutrition

Obviously, right? According to Dr. Wickham, “Optimal nutrition during pregnancy was cited as being of benefit in strengthening the placental bed and reducing the chance of feto-maternal haemorrhage. Midwives felt women should concentrate on whole foods, fresh, raw vegetables, pulses and seafood.” Some evidence even suggests that healthy fats such as omega fatty acids may promote “healthy uteroplacental blood flow.” (Anti-D in Midwifery, p.105) Likewise, certain foods such as caffeine, food additives and alcohol may deplete the body of minerals needed to create a strong placenta.

I personally followed an adapted Weston A. Price pregnancy diet that excluded grains during my last two pregnancies. (The first included grains.)

Supplements

Before RhoGAM was developed, citrus bioflavinoids were “shown to strengthen placental attachment and increase strength of blood vessels (Jacobs, 1956, 1960, 1965). The research also showed that these substances could improve the outcomes of babies born to women who had already become isoimmunized.” (Anti-D in Midwifery, p.106) I personally look for whole-food forms of biflavinoids and vitamin C – you can find a list of what I use on my resources page.

Certain herbs such as red raspberry leaf are thought to strengthen and tone the uterus. In one study, mama’s who consumed red raspberry leaf had fewer birth interventions such as artificial rupture of membranes, forceps delivery and cesarian sections. They were also less likely to experience both pre and post gestation (source) I included it in my pregnancy tea recipe along with vitamin C rich rosehips and iron-rich nettle.

Magnesium was mentioned as potentially supporting placenta strength. Dr. Wickham also mentions few foods and supplements that may support optimal immune function, such as garlic elderflower and echinacea.

Avoiding Toxins

Fluoride

“While fluoride is accepted as being potentially toxic to all of us (Colquhoun and Mann, 1986; Hirzy, 1999), it is seen as a particular danger to pregnant women because it may interfere with the formation of collagen in the placental wall. The evidence collated by Hirzy (1999) suggests that fluoride has a negative impact on bone formation. While it has proven impossible to find studies that specifically report effects of fluoride on placental formation, women and midwives may feel that there are enough parallels between musculoskeletal and placental formation to warrant further consideration of rhesus-negative women’s fluoride intake during pregnancy.” (Anti-D in Midwifery, p.106)

Xenoestrogens

Chemicals that mimic estrogen in the body are thought by some to disrupt the delicate balance of hormones that ebb and flow throughout pregnancy. It may be beneficial to opt for glass containers instead of plastic wrap and homemade personal care products instead of store-bought ones that contain synthetic chemicals and preservatives.

I’ve put together a list of beauty recipes to get you started here.

Breastfeeding

Women are considered “immunosuppressed” during pregnancy, although some argue that it’s a selective adaptive response rather than the pathological form of immunosuppression we see in other cases. If that’s the case, some people believe that the hormones which facilitate breastfeeding extend this “immunosuppressed” state, thus possibly reducing her likelihood of forming antibodies.

When I first came across this idea I wondered if it contradicted recommendations for immune supporting herbs and such during pregnancy. Do we want to “boost” the immune system or suppress it? I think this is a great discussion to have with your midwife or doctor. Like naturally produced oxytocin vs. synthetic oxytocin, it may be about respecting the body’s ability to regulate itself and simply providing gentle building blocks that it may need along the way.

Placenta Consumption – A practice in need of more research

Also, one theory worth noting is that placenta consumption may modify a woman’s immune response in a beneficial way.

“A very interesting adaptive theory is that consuming placenta may actually affect the mother’s immune system, by suppressing her body’s inclination to create antibodies as a response to antigens present in the baby’s blood. As an example, women who are negative for the Rh antigen can have difficulty supporting a subsequent pregnancy if her first baby is positive for the Rh antigen. Her body can create anti-Rh antibodies, which then attempt to fight off the next pregnancy if the next baby is Rh-positive, mistakenly recognizing it as a threat. Placentophagia may actually cause a suppression of this response, allowing her to have successful subsequent pregnancies. Human women who are Rh-negative are often encouraged to get a shot of Rhogam, a vaccine that blocks the creation of high levels of these antibodies. Mammals may have adapted their own antidote over thousands of generations, simply by practicing placentophagy.” (source 1, source 2)

I personally do not think there is enough research on this subject and I am not certain that placenta consumption is safe for rh-negative women, but I do believe this subject deserves further research. I have read reports that thousands of rh-negative women have consumed their encapsulated placenta with no negative effects, but I have been unable to verify this independently through studies or primary sources. (If you have experience or knowledge regarding placenta consumption in rh-negative women please share it below!)

What would you add to this list?

holistic care for the rh-negative mama

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Heather http://www.mommypotamus.com <![CDATA[Should I Get A RhoGAM Shot?]]> http://www.mommypotamus.com/?p=34435 2015-06-06T20:06:47Z 2015-06-03T18:35:59Z They call him the man with the golden arm When asked about his track record of 1000+ blood donations, James Harrison simply says “An hour of your time is a lifetime for someone else.” It’s true, especially for him. You see, Mr. Harrison is Rhesus negative, and his blood has been used for decades to combat [&hellip

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rhogam-risks-benefits

They call him the man with the golden arm

When asked about his track record of 1000+ blood donations, James Harrison simply says “An hour of your time is a lifetime for someone else.”

It’s true, especially for him. You see, Mr. Harrison is Rhesus negative, and his blood has been used for decades to combat a potentially deadly condition affecting babies born to Rhesus negative mothers. It comes in the form of a shot given during pregnancy or just after birth, typically referred to as RhoGAM in the United States and Anti-D in other parts of the world.

So what exactly is RhoGAM, and when should it be used?

When I picked up a copy of Anti-D in Midwifery, written by Dr Sara Wickham PhD, RM, MA, PGCert, BA(Hons), I hoped to discover black and white answers to those questions. What I walked away with instead is a deep respect for the choices that Rhesus negative women must make, and the desire to see more (and better) research in this area. In this post I’m going to share what I’ve learned so far – I hope you find it helpful!

Please keep in mind that – as I wrote in my posts on the Vitamin K shot, Glucola and being GBS positive – “Best Boo-Boo Kisser South Of Puckett’s Gas Station” is about as official as things get for me professionally.  I am not a doctor, this is not medical advice, and your decision is completely up to you. If you need some convincing on this, read my full disclaimer where I say it over and over again.

Special Note: Normally posts like this draw from many different sources. This one is unique because it relies mostly on Anti-D in Midwifery, with just a few updates based on research that became available after it went to print. If you are a midwife or birth worker, I highly recommend investing in her book. There is so much valuable information covered on best care practices that will not be covered in this article. 

Also, both British and American spellings are used in this article depending on whether I am quoting Dr. Wickham or sharing my thoughts. Feel free to read quotes from Dr. Wickham with a lovely accent – I do!

What does it mean to be Rhesus negative?

You already know about the four blood types, right? Well, in addition to being A, B, AB or O, we’re all also either rhesus positive or rhesus negative. What this means is that some of us have rhesus proteins in our blood (which makes us positive) and some don’t (making us negative). Of the rhesus proteins, the D factor is the most common. That’s what we’ll be discussing in this post.

Caucasians are the most likely to be rhesus factor D negative (RhD-). About 15% of the population lacks the protein.

Some people believe that the lack of rhesus D factor is an indication of alien heritage. I’m personally going with the genetic mutation theory. :)

what-is-rh-negative

What is Rhesus D incompatibility?

Though normally the blood of a mother and baby do not mix during pregnancy – the placenta acts as a mediator that transports nutrients and waste without intermingling – problems can occur if blood does mix when a woman is Rh-negative.

If the baby is RhD-positive, the mother’s immune system will react to the presence of the rhesus D protein by creating antibodies against it – a process called sensitization.

What if my baby is also Rhesus negative?

If your baby is Rh negative there is no risk of sensitization.

Can I find out if my baby is Rhesus negative before he/she is born?

If your husband is also Rh-negative your baby will also be Rh-negative. You can request a blood test to find out his Rh status.

Also, Sequenom Laboratories recently released a fetal Rh D genotyping test that is 99% accurate when performed in the first trimester. The test is performed using just the mother’s blood, and the only downside is that additional analysis is sometimes needed if you’re having a girl, which means that you’ll know the sex of your baby if you require additional testing. I’m a fan of surprises, but I personally would ask for this test if I was Rh-negative.

One test said I was rh-positive and another said I am rh-negative. What happened?

Here’s the deal: The D antigen is composed of many parts which have been historically referred to as a mosaic. Some people have parts of the mosaic but not all – these individuals are said to have “partial D” expression. If an individual with partial D status encounters the blood of a Rh D-positive individual, their immune system will react to the parts of the mosiac they don’t carry in their blood.

On the other hand, some people who are classified as rhesus negative actually have the full mosiac, only in smaller quantities than typical Rh D-positive individuals. Theoretically, these individuals should not make anti-D since they possess all parts of the mosiac. (source) In the past individuals with weak D were considered functionally Rh-positive, but recent changes in guidelines have re-classified them as negative as a precaution. This is because there is a very small chance they could have a reaction. However, the only published report I could find of a weak D individual having a reaction to the rhesus D protein was in the case of autoimmunity. In other words, they were reacting to their own proteins, not someone else’s. (source)

I am rh-negative. What happens if I become sensitized?

If sensitization happens during the birth process, any future rhesus-positive babies the mother becomes pregnant with will be affected. This is because “the antibodies are able to cross the membrane at the placenta (even though the actual blood cannot) and may attack the rhesus proteins in the baby’s blood. This can cause a wide range of problems, from mild jaundice to severe rhesus haemolytic disease, which in the worst cases can result in the death of the baby. Although a far greater proportion of babies suffering from rhesus disease survive nowadays as a result of advances in care, they may require blood transfusions, early delivery or intensive care.” (Wickham p.4)

Firstborn children are not usually affected unless the mother was sensitized prior to the pregnancy through a blood transfusion or pregnancy loss. However, if sensitization occurred early in the pregnancy for some reason and was not treated, rhesus disease can occur.

What are some potentially sensitizing events?

  • The birth process (Birth interventions may significantly increase the rate of sensitization. More on this later.)
  • Abdominal trauma, such as from a car accident or serious fall
  • Abdominal surgery, such as a cesarean section
  • Placenta abruptio or placenta previa, both of which can cause placental bleeding
  • External version (breech repositioning)
  • Obstetric procedures such as amniocentesis, fetal blood sampling, or chorionic villus sampling (CVS)
  • Miscarriage, ectopic pregnancy, or in utero death after 8 weeks of fetal age (when fetal blood cell production begins)
  • Partial molar pregnancy involving fetal growth beyond 8 weeks
  • Blood transfusion (if blood is mismatched)
    (source)

How can I know if a sensitizing event has occurred?

A flow cytometry test can be done to determine whether feto-maternal hemorrhaging has occurred.

Can I request a RhoGAM shot if I suspect I have experienced a potentially sensitizing event?

Yes, you can.

How does Rhogam work?

Rhogam is made from the blood of Rh-negative individuals who have intentionally “infected” themselves with Rh D factor in order to produce antibodies. The antibodies are then injected into the mother with the goal of neutralizing any Rh D factor that has leaked into the mother’s bloodstream. If caught in time, the Rh D will be neutralized before her immune system reacts.

Does rhogam really work?

Yes, but not in 100% of cases. Experimental models also suggest the possibility that in rare instances it may intensify a woman’s immune reaction instead of suppress it. (source)

What are the risks of RhoGAM?

RhoGAM is a Class C pregnancy drug, which means that “Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.” (source)

“The known and documented side effects listed by the manufacturers and pharmaceutical guidelines include local inflammation, malaise, chills, fever and, rarely, anaphylaxis. Some women have reported suffering an intensely irritating rash covering all or a large par of their body following administration of anti-D. Further concerns include those of immune system compromise and the issue of some pharmaceutical companies using a mercury-based preservative, which some women are actively choosing to avoid because of potential toxicity.” (Wickham p.7)

A note on mercury: In the U.S. all RhoGAM shots are labeled as mercury-free. However, as the FDA states here, vaccines labeled as mercury-free may still contain trace amounts. This is because companies use it in the manufacturing process and then filter out as much as they can. Though RhoGAM is not a vaccine, it is my understanding that it may contain trace amounts as well due to similar manufacturing processes.

“The second issue is that of blood-borne infections. Anti-D is a blood product, and as such as the potential to carry such infections. The risks of anti-D in this area are compounded by the fact that the blood used to make the product is pooled, so blood from one infected donor may end up in several hundred doses of the product. Several years ago, over 3000 women in Ireland contracted hepatitis C from infected anti-D (Miesel et al., 1995), and HIV has also been transmitted through anti-D (Dumasia et al., 1989). While both of these viruses are now screened for and would be rendered harmless by the purification processes involved, the most pressing concern relates to the presence of as yet unknown viruses, which may not be killed by current treatments. We can clearly only screen for and treat anti-D for those viruses that we know about and have the effective means to treat.” (Wickham p. 7, emphasis mine)

Are there any additional risks related to receiving RhoGAM while pregnant?

Possibly. This study which suggests that in some experimental models, passive antibody treatments like RhoGAM have actually done the opposite of what they’re intended to do. In other words, they intensified the immune response upon exposure rather than canceling it out.

She also points out that “about 10 percent of the anti-D given to the mother will cross the placenta to the baby (Hughes-ones et al., 1971; Urbaniak, 1998). Studies have shown that this causes a portion of babies to test positive for antiglobulins (via a direct Coombs test) after they are born (Bowman and Pollock, 1978; Tovey et al., 1983; Herman et al., 1984). The few studies that have looked at this have suggested that, while babies may suffer some anaemia, this does not require treatment in the immediate postnatal period. Although Romm (1999) points out that the manufacturers of anti-D clearly state that this should not be given to babies, nobody has considered whether there are long-term consequences of this. It should be remembered that unborn babies will also be exposed to the risks that women face, such as that of virus transmission. Is it also possible that a baby could suffer the equivalent of an anaphylactic reaction? If this is a possibility, how would this manifest, and is there any way we would be able to treat it before it was too late?” (Wickham p. 45-46)

What are the risks of not using RhoGAM?

Sensitization “can cause a range of problems, from mild jaundice to severe rhesus haemolytic disease, which in the worst cases can result in the death of the baby. Although a far greater proportion of babies suffering from rhesus disease survive nowadays as a result of advances in care, they may require blood transfusions, early delivery or intensive care.” (Wickham p.4)

Is there anything I need to know about studies on RhoGAM?

YES. First, all of the clinical trials on rhogam were conducted during the late 60’s and early 70’s – a time in which birth was considered inherently dangerous by many, if not most, practitioners. Interventions such as induction, episiotomies, anesthesia, cord clamping, etc. were routine in many cases – a reality which some evidence suggests may have increased the rate of sensitization reported. We’ll discuss more about why later on, but first let’s talk about the studies themselves.

Of the nine major clinical trials conducted:

  • We don’t know who paid for seven out of nine of them. Of the two we do know about, both were paid for by pharmaceutical companies. As mentioned in this article, funding bias is a well-documented phenomenon in which the outcomes of studies tend to support the interests of those who paid for it.
  • Seven out of nine were not double-blind. Of the two that were, one did not have an appropriate number of subjects.
  • Six out of nine were either not randomized or only quasi-random. This raises concerns that patients could have been cherry-picked to influence the study outcome.

This is not to say that RhoGAM isn’t beneficial in some instances – clearly it is. However, questions remain regarding whether the benefits were exaggerated (either knowingly or unknowingly) and whether a low-intervention birth might reduce sensitization risk. (Again, more on that later.)

What is the optimal dosage?

We don’t know. The standard dose in the UK, France, Ireland  and Canada is about 100mg, while the standard dose in the United States is 300 mg. Other than France, most European countries give between 200-300 mg. At a lower dosage there are concerns that if the bleed is large there will not be enough RhoGAM in the bloodstream to cancel it out. At higher dosages there are concerns of increased anaphylactic and other reactions. (Wickam p.26)

What is the likelihood that I will need RhoGAM?

“Overall, the average rate of isoimmunization of women in control groups was 7.5  percent (186/2488), which implies that around 90 percent of the rhesus-negative women who give birth to a rhesus positive baby remain unaffected.” (Wickham p.17)

Or to “put it another way, any given woman has a 1 in 4000 chance of losing a subsequent baby from rhesus disease if she does not have routine antenatal anti-D. [For you non-British folks, this means routine RhoGAM shots during pregnancy.] This does not, of course, mean that [a routine RhoGAM shot during pregnancy] will offer her total protection from this outcome, just as the current postnatal programme offers no absolute guarantee.”

Has there been any research on the long-term health effects of anti-D for mother or baby?

No.

Did you know there's a new test that can help you decide whether or not to get the RhoGAM shot while pregnant?

Do I need RhoGAM during my first pregnancy?

According to Dr. Wickham, sensitization “will not affect a woman’s first baby unless iso-immunization has occurred previously (such as from a mismatched blood transfusion, or at the time of an abortion or miscarriage). However, if rhesus antibodies are produced, subsequent rhesus-positive babies may be affected because the antibodies are now able to cross the membrane at the placenta (even though actual blood cannot) and may attack the rhesus proteins in the baby’s blood.”

To clarify, firstborn children are not usually affected unless the mother was sensitized prior to the pregnancy through a blood transfusion or pregnancy loss. However, if sensitization occurred early in the pregnancy for some reason and was not treated, rhesus disease can occur. It’s very rare, though. Here’s the math:

As mentioned previously, the rate of sensitization in control groups is estimated at about 10%, meaning that 90% of Rh-negative women who gave birth to a Rh-positive baby did not experience an immune reaction. Of the 10% that were affected, 86 out of 100 experienced sensitization at birth. That means out of the 10% that may become sensitized, just 14% of those individuals will experience sensitization before the birth process.

Do medical interventions increase the likelihood of fetomaternal hemorrhage?

Certain obstetric procedures, such as amniocentesis, fetal blood sampling, or chorionic villus sampling, are known to increase the likelihood of maternal and fetal blood mixing. However, many midwives believe that other procedures may have similar effects.

When interviewing midwives for her book, Dr. Wickham found the following procedures were of concern:

Ultrasounds

“Ultrasonography was felt to be a risk factor for transplacental haemmorhage in two ways. The first concerns the potential trauma that may be caused to the placenta by the movement of the transducer over the abdomen. Midwives noted that a number of women have their placenta attached to the anterior wall of their uterus, which is where the transducer is moved during the scan. It was argued that the pressure applied to the transducer in order to visualize the relevant parts of the uterus, baby and placenta might in some cases cause a small part of the placenta to separate from the wall of the uterus, and thus cause bleeding from fetal vessels into the maternal circulation.”

As we’ll discuss later, normal detachment of the placenta during birth does not cause bleeding from the fetal side. Wickham also points out that bleeding may only occur if the placenta is not optimally healthy, but also suggests that a baby’s tendency to “jump around” or thrash during an ultrasound may increase the likelihood that a small amount of damage is done to the placenta or cord, which might result in fetomaternal hemorrhage. (Wickham p.79)

Synthetic Oxytocin (Pitocin)

Thoughts on how synthetic oxytocin might cause fetomaternal hemorrhaging are twofold. First, it tends to create unnaturally strong contractions, which may cause the placenta to separate too early. In most cases of normal physiological birth, the placenta will go through a specific detachment process that is thought by some to reduce the likelihood of fetomaternal hemorrhage. Basically, there are two sides to a placenta – the mother’s and the baby’s. The mother’s side is supposed to detach and bleed rather than the baby’s. Early detachment may cause bleeding on they baby’s side of the placenta, which would cause the baby’s blood to enter the mother’s bloodstream.

Second, Pitocin reduces a woman’s production of natural oxytocin, which facilitates placental detachment. The problem here is that if the placenta manages to stay intact through Pitocin-induced contractions, it may then have difficulty detaching at the appropriate time because the woman’s natural regulation of oxytocin has been disrupted.

Intrauterine Catheters

“It is logical that any instrument inserted into the uterus, even with extreme care, may cause slight trauma to the placenta; slight trauma may be all that is needed for fetomaternal bleeding to occur during birth.” (Wickham p.81)

Episiotomy

Episiotomies inhibit a woman’s natural production of oxytocin, which is vitally important for optimal placental separation.

Fundal Pressure

“Fundal pressure may occur either deliberately, where the attendants push on the fundus to attempt to expedite the birth of a baby or the placenta, or accidentally, where the woman is asked to adopt a position which puts unnecessary pressure on the top of her uterus. Again, midwives suggested that this could interfere with placental attachment and physiology, and potentially cause fetomaternal transfusion.” (Wickham p.82)

Directed Pushing

Unlike instinctive pushing, “non-physiological pushing is thought to lead to an increase in intrauterine pressure, which may in turn cause trauma to the placental site or possibly the rupture of small vessels. Directed pushing usually involves the Valsalva manouvre, where the woman is instructed to take a deep breath and push for as long as she can. The fact that the Valsalva manouvre was originally invented as a method for forcibly removing pus from the ear would support the idea that this could create enough force to cause trauma elsewhere in the body.” (Wickam p.82)

Local and Epidural Anaesthesia

Most anesthetics contain vasodilators, which cause blood vessels to widen. “These vasodilators may be carried through the body, potentially causing the dilation of vessels in and around the placenta. Dilation of these vessels may then lead to the escape of blood from fetal vessels,” especially if this occurs around the time the placenta is separating.  (Wickham p.83)

The use of anesthesia also often increases a woman’s need for other interventions that may make her more susceptible to fetomaternal hemorrhaging.

Cord Traction

“The use of controlled cord traction was also seen as potentially harmful; again, the effect of an attendant pulling on the cord may be to cause parts or all of the placenta to separate before this would have occurred physiologically, with the same result. The pressure of an attendant’s hand on the uterus, a procedure routinely used with controlled cord traction to ‘guard’ the uterus from being inverted, may also affect the delicate physiology of placental separation or cause fetal vessels to burst.” (Wickham p. 90)

Cord Clamping

“Early clamping may force blood back into the placenta which increases the likelihood of antibody sensitization for RH negative mothers who have an RH positive infant.” (source) It has been suggested that even touching the cord to see if it has stopped pulsing may disrupt the delicate process of transfusion from placenta to baby.

Are there any ways I can reduce the likelihood of becoming sensitized?

Though there haven’t been any formal studies on steps that can be taken to reduce sensitization risk, some midwives suggest certain supplements and lifestyle changes that may strengthen the placenta and support the immune system.

Click here to read my follow-up post on their recommendations.

Did you/would you get a RhoGAM shot? Why or why not?

The post Should I Get A RhoGAM Shot? appeared first on Mommypotamus.

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