Monday, December 27, 2010

VBAC With Multiples IS Possible!

"In women with twins a trial of labor after a previous cesarean section is a safe and effective alternative to routine repeat cesarean delivery."1


(note for those watching video--TTTT is twin-to-twin transfusion and IUGR is intra-uterine growth restriction)

"A French study... suggested that Caesarean delivery more than triples a woman's risk of dying in childbirth compared with a vaginal birth."

http://www.homebirth.org.uk/vbactwins.htm

http://www.radmid.demon.co.uk/twins.htm

"When a cesarean is necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. With half the cesareans being performed deemed unnecessary by WHO, the risks these mothers and babies are exposed to are avoidable and costly."

"An analysis in Great Britain revealed that women were 5.5 times more likely to die of an elective cesarean, than a vaginal birth (9 versus 2 per 100,000). A Dutch study found that [ceareans] caused seven times more deaths than vaginal births (28 versus 4 per 100,000)."

"Vaginal delivery when a first twin is vertex and a second is nonvertex (breech) is a safe alternative to cesarean section, according to a study presented at the HGO World Congress of Gynecology and Obstetrics."2

"In selected cases vaginal delivery of triplet gestations can be accomplished without increased maternal or neonatal morbidity and mortality and may significantly decrease maternal hospital stay and postoperative morbidity. (Am J Obstet Gynecol 1998;179:1133-5.)"3


1. http://www.ajog.org/article/S0002-9378%2896%2970274-0/abstract

2. http://www.thefreelibrary.com/If+second+twin+is+breech,+vaginal+delivery+still+safe%3A+study+of+107...-a0112542267 and http://findarticles.com/p/articles/mi_m0CYD/is_1_39/ai_112542267/

3. http://www.ajog.org/article/S0002-9378%2898%2970119-X/abstract

Please remember that I had a cesarean myself and that I do not post this in ignorance to the procedure nor without compassion to those who have undergone it. This is merely informational to present that [attempted] vaginal birth is a viable and safe option for twins and some triplets, even if they are a VBAC. I am not a doctor and this does not substitute for medical advice.

Wednesday, December 22, 2010

Children Live Here (a poem)

I wrote this this morning while I was lying in bed, trying to decide if I wanted more sleep or wanted to get up. It popped into my head, so my decision was made for me by my muse--get up and write!



image courtesy of stockxchng


Children Live Here

When we welcome you here today
We hope that you enjoy your stay
But one thing we ask you hold dear
Please remember: children live here

There are toys on the floor
Some marks on the door
Clothes scattered in the hall
And marker on the wall
We'll repaint it someday
But we have no time today

There are things in the sink
A Barbie skating rink
This stuff doesn't bother us
And real friends don't raise a fuss
They know the reason is clear
Yes, they know children live here

Instead of cleaning the wall
We went out and learned about Fall
In lieu of the porch being swept
I held the baby who slept
Those clothes were for dress up
While I cleaned a bigger mess up
And the noise tells everyone near
There's no doubt children live here

The happy laughter means more
Than seeing all of the floor
And please respect those kids
For this home is hers and his
We hold our family dear
And you knew children live here.


image courtesy of stockxchng



Since I've been asked many times for permission to print this--anyone may print and share this as they like as long as they give proper credit to me :) My pseudonym is H.S. Hines or H.S. Kallinger for author credit.

Friday, December 17, 2010

Risks To Baby From Cesarean Section Birth

Originally published Nov 6, 2008 at 12:08 AM on Cafemom

So, I read a surprising comment today--someone believing the risk of amniocentesis outweighs the risk of a cesarean to the baby. She said that a cesarean has its risks, but amnio could be the end of the world.

Do people really think a cesarean is that SAFE? I'm sorry, but it's not. And while, yes, the risks to mom are higher than risks to baby, just because those risks are frightening and include horrific infections, infertility, death, etc. does not make the risks to baby insignificant (and they are still greater than to a baby born vaginally and include a 3x increase in risk in death).

Here's just the short list, so you don't have to drag through all the papers and sources I have.

Welcome to the world 1

image courtesy of stockxchng

Risks to baby from cesarean section birth

Breathing problems[1]

weakened immune system[2]

digestive problems[3]

fetal injury[4]

diabetes (risk is 20% greater for babies born by c-birth)[5]

asthma (risk is 50% greater)[6]

neonatal depression (from anesthesia)[7]

hospital borne infections (rate is higher due to the longer stay after a c-birth)[8]

neonatal mortality (risk rises from .62 to 1.77)[9]

and increased risk of SIDS[10]

Low APGARS[11]


There's the list of the most common side effects. I know that most people aren't aware of them, so that's why I compiled a list here. I couldn't find a comprehensive list anywhere else. I may expand this journal with a short synopsis of each condition at a later date.

My daughter was born by cesarean, beautifully, APGARS of 9, no side effects that we know of. But that doesn't negate that these risks are real and any baby born by cesarean could be affected in one of the ways above. It's important to be informed about the potential risks in any procedure being performed on you or your baby.


Baby Born

image courtesy of stockxchng


[8]Pai, Madhukar. 2000. “Medical Interventions: Caesareans Sections as a Case Study.” Economic and Political Weekly 35 (31): 2755-2761.

Friday, December 3, 2010

What You Should Know About Shoulder Dystocia


Photo courtesy of stockxchng

This is something that my doctor loved to threaten me with when I was carrying Lilly. It was ridiculous because 1. my daughter was perfectly normal sized and 2. I had no intention of birthing on my back, which is the primary cause of problems, and my doctor knew this and had agreed to it. She was just angry that I wouldn't consent to an unnecessary induction for her convenience.

What is Shoulder Dystocia? It's a very rare and serious complication in which baby's shoulders get stuck that affects babies of all sizes, though it occurs slightly more frequently in babies that are over 9lbs. It's still rare, however, and not something that you should spend time worrying about. There is no way to accurately predict it ahead of time and any provider talking about it is likely looking for the bigger paycheck that comes with a cesarean birth (the difference? vaginal birth: $10K, cesarean birth: $25K and a VBAC costs more than a regular vaginal birth, thus, it's always in an OBs best financial interest to go for a cesarean--though it's NOT in mom's OR baby's, as mom is 5.5 times more likely to die and baby is 3 times more likely to die and complications of less serious natures are far more frequent as well).

So, doctors love to say, "Your baby is too big," (usually based on faulty ultrasound data, despite the fact that ultrasounds can be wrong by 2lbs or even more and become useless in determining size after week 20). The reason is usually shoulder dystocia. Many techniques have been used over the years, including just killing the baby, though the most success has been found in the easiest technique to date--the Gaskin Maneuver. The Gaskin Maneuver consists of having mom roll onto all fours (or assisting if necessary). During the process, many babies become dislodged and pop right out. If this doesn't happen, then the doctor actually has better access to help wiggle the baby around until the shoulder releases and the rest of baby is born (Woods or Rubin maneuver).

Most obstetricians don't even know that this maneuver exists, though most midwives are trained in it. In one study, it was shown to be effective in 83% of use without any further maneuvers. No maternal or perinatal mortality occurred. Morbidity was noted in only four deliveries: a single case of postpartum hemorrhage that did not require transfusion (maternal morbidity, 1.2%), one infant with a fractured humerus and three with low APGAR scores (neonatal morbidity, 4.9%).

Many doctors use traction (pulling on baby's head) or fundal pressure (where the nurse climbs on the bed and jumps down onto your stomach) before anything else and these are not only the least effective techniques, but dangerous to mother and baby.

The McRoberts maneuver (where mom's legs are brought up as far back toward her stomach as possible, which realigns the pubic bone and can slip baby's shoulder out) should be tried first and if failing, suprapubic pressure (where the doctor or nurse makes a fist and pushes hard on the baby's shoulder just above the pubic bone) can be applied. Next, the Gaskin maneuver should be performed and if that fails, then Woods and Rubin maneuvers can be tried.

McRoberts is effective in 39.5% of cases and in 58% with the addition of the suprapubic pressure. These methods can cause serious injury to the mother (McRoberts can injure mom's legs, particularly the femur and hips), but are typically safe to the baby. Woods does not have an available statistic for effectiveness and can break the baby's humerus. The Rubin maneuver is the opposite of Woods and requires less traction and causes significantly less injury.

Australia is currently training doctors in fracture of the clavicle, which has been dismissed until now as so dangerous to the baby and difficult to perform that it should not be used. However, it is used in some cases and can be lifesaving for baby. It's a severe emergency procedure that should not be attempted until all others have failed.

The Gaskin maneuver is most criticized due to it requiring the mother to be able to roll over and support herself on her hands and knees--something that is difficult, if not impossible, to do with a normal epidural. That's the only criticism, however, that is keeping it from being more widely studied and implemented.

The evidence from the literature on shoulder dystocia shows clearly that shoulder dystocia cannot be predicted with any degree of accuracy and it cannot be prevented by any specific strategies or maneuvers. Half of the babies in the Gaskin study were not larger than average and many were in the 5lb range. The worst outcomes did occur in the 'macrosomic' (larger than 10lbs) category. However, 'macrosmia' is not a sole cause nor does it always lead to shoulder dystocia. In fact, over 90% of macrosomic babies can be delivered vaginally without incident.

Perhaps in those "birth plan creators" that are available all over the internet that include sections on emergency births, preferences on maneuvers should be included in the event of shoulder dystocia. It's unlikely that doctors would be open to this, however, despite evidence of effectiveness and safety of the procedure, simply because they have no experience with it.

The best thing you can do as a pregnant woman is to be educated and if your doctor brings up the issue, discuss it with him/her. Eve if they don't, it might be useful to know their typical management of shoulder dystocia in case of emergency and their willingness to attempt maneuvers with less risk to mother and baby, even if unconventional, before the more dangerous, riskier maneuvers. It's also important to stay calm and follow your care provider's direction if the complication does arise.

Maneuver illustrations:

Traction:



McRoberts:


suprapubic pressure:


Woods Screw Maneuver:


Rubin Maneuver:

Gaskin Maneuver:

Tuesday, November 30, 2010

Musing on Gestational Diabetes

For all intents and purposes, this blog refers to Type A1 gestational diabetes only: "abnormal oral glucose tolerance test (OGTT) but normal blood glucose levels during fasting and 2 hours after meals; diet modification is sufficient to control glucose levels"1



photo courtesy stockxchng

So, you're in the sixth month of pregnancy and the doctor says that at your next appointment, you are going to be tested for gestational diabetes. She explains that you are going to be given a drink an hour before blood is drawn to see if you have GD. She doesn't give you much other information. At some offices, you will be sent home with the glucola (sometimes you even get to pick your flavor), while at others, you go in the day of testing, an hour before, and are given the drink.

Let's say you're in the second group, like I was the first time. So, on the day of, you get up and have breakfast as usual. A couple hours later, you go in and you get your drink. You choke it down (I thought it tasted fine, but many women complain of the taste) and then go sit in the chairs to wait for your test. You go to the phlebotomist's chair and she either draws a vial of blood or pricks your finger, depending on the office. You get your bandaid and go home (probably craving something high in protein or a lot of water).

You go in for your next appointment to find out you failed the test. Next, you are told that you'll have to take the fasting three hour test. You are given a date and you fret and worry about what this means. Your doctor assures you that many women who fail the one hour test pass the three hour test.

So, on the day of, you go in, your stomach growling, possibly having a return of the dreaded morning sickness because your blood sugar is so low. They take your blood and send you off with your drink. You choke it down (it's even worse this time) and are informed that if you throw up or consume anything else, you automatically fail and have to do it again. You can have as much water as you want, though.

You go sit in the chairs and read a book or magazine for the next hour, or watch a movie on a portable DVD player. You get your blood taken again. Then back to the chairs. At this point, you may be feeling dizzy and faint. You reach your chair gratefully and try hard to distract yourself against how crummy you're feeling. The second hour takes forever to pass, but you get there and have your blood drawn again. At this point, you may feel irritable and nauseated. You don't want to do this again, though, so you desperately try to not throw up. Just one more hour. Maybe you have some water. You probably need to pee. The baby's hyper and the rolling around and elbowing you in the stomach is not helping your nausea. You pick up your book or movie and put it down, unable to concentrate. You space off. You finally get back to reading or watching and find out that you made it. One last poke and the vampire is done with you.

You bolt from the office right for the nearest fast food to appease the baby, who is sucking all the nutrients from your starved body. Food at last!! You find out at the follow up appointment that you failed. You're told your numbers: 80, 195, 156, 120. These numbers probably don't mean a lot to you, especially since you're devastated and wondering what this all means to you. No more crackers in the morning? No cake at your baby shower?

You're told that you just need to monitor your sugar and diet and see a nutritionist and that there is no reason to worry. You are now high risk and will probably have a huge baby who will need bottles to stabilize him after he's born, but it's okay. The doctor will perform a cesarean to save you from this all if she needs to. You should probably try to pump some milk to prepare if you don't want the hospital to give your baby a bottle.

Now, let's examine what you should have questioned in the above scenario.

"...you get up and have breakfast as usual."

The day of your one hour test, you should be careful about your breakfast. Avoid carbohydrates as much as you can--absolutely no juice or soda pop! If you drink coffee, it should be black. If you drink tea, the same thing. The absolute best thing for you is to only drink water. Even milk is full of sugar. No bananas! They may seem like an innocent fruit, but they are a sugar-spiking fiend in the least diabetic of people! Have some eggs and bacon. Not the healthiest breakfast, no, but you need protein to break down blood sugar in your body. Have a handful of raw almonds, too (or any natural nut of your choice).

"You go sit in the chairs and read a book or magazine for the next hour, or watch a movie on a portable DVD player."

Don't sit! If you have a long drive to the doctor after drinking your glucola, then go an hour early and drink it there. Walk around the office. Jog. Do some light exercise that you would normally do. But whatever you do, don't just sit there. Your body won't burn the carbs properly just by sitting. Don't worry about what other people think about it, lead by example or at least just protect your own body.

If you fail the one hour test still, there isn't a lot you can do for the three hour test, except to remain active throughout, no matter how crappy you feel. You can avoid a lot of carbs the day before it, but you need to keep your blood sugar as level as possible.

Next, know your numbers! The list of numbers I gave before indicates someone who does not have diabetes. In fact, they were almost exactly my numbers. The first is a normal fasting glucose number, then the second is a high spike that isn't an abnormal reaction to the amount of glucola that they give you. The third is one point above fail, which is a faster sugar drop than they are looking for, but they look solely at numbers, not at pattern. The final number is more than just a passing number--it's a pass with flying colors. Again, this pattern should be seen as a sign of insulin working pretty well, but it's a definite fail. If the numbers had looked like this:

95, 200, 165, 145

Then you most definitely have a problem.

Now, it's not a bad thing to follow a healthy diabetic diet with a failed test and to monitor your sugar, particularly if you've had symptoms (extreme thirst, dizziness, nausea) to identify problem areas. Me, I found out that I was waking up borderline hypoglycemic (70mg/dl) if I didn't have a chocolate cake at bedtime each night. Yes, Little Debbie and I had a standing appointment. She didn't spike me and I didn't feel like crap when I woke up in the morning. Win-win. Medicinal chocolate, lol.

Now, where it is dangerous is the assumption that any level of glucose intolerance (including just being intolerant to the stupid test) will negatively impact the baby. Let's start with "big baby".

First, as recently as the early 1900s, a 10lb baby received congratulations to the mother for growing such a 'healthy baby' and a 6lb baby was received in hushed tones and worries about such a small baby being born. Sometimes the mother was even scolded for 'starving' her baby (even though 6lbs is a valid weight, as is 10lbs). Now, the average is 7.5lbs, but that's hardly a cutoff. After all, women can birth nearly 14lb babies naturally.2 Many women that I've known report that their bigger, 9-11lb babies were actually easier than their smaller (6-8lb) ones! Not always, of course--my best friend's mom had problems with her nearly 12lb baby in that she tore six ways to Sunday, but her others were 11-something, 10-something and a couple of 9lbers and she didn't have problems.

A lot of the worry about big babies comes from shoulder dystocia. This is a very rare complication that can occur in babies of any size, but is considered higher risk in babies of larger sizes. The true risks of shoulder dystocia include: malpositioned baby, mother in the lithotomy position or otherwise on her back and/or tailbone and any monitoring or drugs that limit mother's movement (if you're going to get an epidural, make sure it's the lowest dose they can do or that it's turned off long before pushing!). If you suspect a large baby, it's important to have a provider who knows the Gaskin Maneuver,3 which has been shown quite successful and is pretty easy--just roll mom onto all fours. From that position, if baby is not released by the act of rolling over, some otherwise difficult maneuvers become much easier to perform to attempt to dislodge baby. If unsuccessful, mom can be rolled back and the usual "nurse jumps on the fundus" maneuver that most OBs use exclusively, can be performed. This is very dangerous for the baby, so it should be left as a last resort. However, a cesarean is not needed in most cases and never to just prevent the possibility of a rare incidence.

If you're worried about a big baby and tearing--let me tell you, as someone who's had both a cesarean and a terrible, messy tear with my VBAC, that a tear is preferable to recovering from abdominal surgery. Especially with a dependent infant!

The next risk for a baby in regards to gestational diabetes is elevated blood sugar leading to crash at birth. If mom's sugars are well-regulated, this isn't actually a risk. Some researchers believe that much of the elevated sugar accompanied by no symptoms is actually natural stores in the maternal bloodstream as backup for the baby and doesn't actually go to the baby.4 However, in cases of controlled sugars, there is no excess to cause the spike that leads to the crash and it's more likely that the fasting during labor may be a bigger risk to the baby (eat during labor, ladies, regardless of 'hospital policy' or diabetes status! It matters!), leaving baby born with low blood sugar. Bring baby straight to breast from birth to help with this.

The real risk of being diagnosed with gestational diabetes is that your chances of cesarean skyrocket because management may lead to risk factors for pre-eclampsia. Also, many women are not properly counseled or are told to "avoid carbs" (very dangerous for both mom and baby! Diabetics take in more carbs than you are probably aware!) or go straight on insulin (also dangerous, as taking insulin with no need can lead to an insulin coma).

So, before you just blindly consent to the test, ask your doctor or midwife what options are available. If you are in a low risk category, request being allowed to skip. If you cannot, ask what other forms of testing are available that would be easier on your body and your baby if you fail the one hour test (and do not consent to the fasting one hour test--it's outdated). Find out how your practitioner will respond if you fail the tests and if they start talking about cesareans--get another doctor. I still, to this day, regret not following that advice. Also find out hospital policy as to what they will do to your baby, particularly if you plan on breastfeeding.

In the end, non-insulin-dependent gestational diabetes is really not a cause for concern--at least not regarding birth. Don't freak out and don't let yourself be 'managed' into unnecessary surgery.

Like many women, after I was diagnosed with gestational diabetes, I never showed any symptoms and my sugar never spiked into the danger zone. The worst it got was after my baby shower, where I had ice cream cake, fruit pizza and bread rolls. It was no higher than expected in a non-diabetic after that fair, either! My baby was the exact same weight at 42 weeks as her sister at 39weeks, 6 days (who I did not have GD with).

Knowing this is important as well to know that not all women diagnosed with GD are at risk for Type 2 diabetes, despite the media hype to the contrary.

If you'd like to avoid the risk altogether, you might consider Dr. Brewer's Diet which is available for many dietary needs.



1.Gabbe S.G., Niebyl J.R., Simpson J.L. OBSTETRICS: Normal and Problem Pregnancies. Fourth edition. Churchill Livingstone, New York, 2002
2. CTV News: B.C. Family Welcomes Very Big Bundle of Joy
3. The Gaskin Maneuver and The Farm Midwives: Dystocia
4. "Gestational Diabetes: Myth or Metabolism?" by Joy Jones, RN (p. 59)

Friday, November 26, 2010

You're Doing It Wrong!



Men aren't as helpless as most women think. And the helplessness they display is not imprinted on the Y chromosome, no matter how much we've convinced ourselves otherwise. The fact is that men are trained to be helpless--usually by the very people who most want their help: women.

I'm not talking about domestic duties (although many men act like the trash magically gathers itself and that they might blow up the washing machine if they have to try to use it) but in being an equal partner in parenting.

Now the defeatism usually starts in that first year when most babies are programmed to automatically want Mommy for everything. If Mom's breastfeeding, this typically means that when it comes to feeding (which, in the first two months, seems to be every waking moment!) Daddy IS helpless. The things he can do at those times promote more of a bond with Mom than Junior (and is that a bad thing? Staying bonded with Mom?). However, feeding is hardly the end-all of parenting a new baby and most women don't breastfeed or at least don't do it exclusively. Dirty diapers are not the only other thing that babies need taken care of, either.

However, the really defeating thing comes when Mom says, "Here, let me do it." There's a learning curve, ladies! We had to do it, so does he! Also, guess what? There's not just one single way to do everything.

I know that's hard to hear. It's hard for me to deal with, personally. I hear my husband taking care of the kids and I want to run in and correct this or that and despite what he'd say to the contrary, I actually have been practicing restraint lately and letting him just do it.

Now, some things, he's always been a pro at--like diapers and dressing the kiddos--but he had an advantage: a baby sister. I was the last born in my immediate family and until I was holding my own, I never touched a new born baby. My sister called me in to help out with her second and I loved it, but she was already a few weeks old before I actually held her. I did learn some tricks to colic, though, that were nice and useful! But for real baby care, of course she did most of it and mainly when I wasn't there.

My husband, however, was right there with his little sister for it all. He even did his share, since he was an older child when she was born. So he came with more confidence and expereience than the average man--and yet, he was just as nervous as any new father and felt just as clueless as to what to do with himself.

Now, I'm not going to sacrifice the baby by just leaving her with him (she was a nursing maniac and wanted nothing to do with him, poor guy--it's no wonder he ended up feeling helpless!), so he didn't get thrown into the deep end like many men who become baby pros do.

It was really later, though, as he was building up his confidence because she started wanting to spend time with him (as everyone had assured that she would!) that I started breaking it down. Correcting small little things, "Oh, I don't do it that way." "You're taking too long, let me do it." "Oh, no, you're doing it wrong!" I don't know why. I just don't seem to know how to walk away and let him do it, so I hover and watch, (which, let's admit, is like watching someone with a different video game style playing--you want to take over and show them how it's really done). Instead, lately, I've started forcing myself to find other things to do when I've asked him to help out or if the kids have asked him.

But it doesn't start when baby comes home. It starts long before that, when our husbands were boys and somebody's sons. First, the gender boxing. "Boys can't wear pink." "Boys can't play with dolls (and if they do, we must call them action figures)." Boys even often get kicked out of playing house in pretty much all forms. They might wander their way into a play kitchen.

Now I don't know if this attitude is as widespread as it was when I was a kid, because I live in this neat little bubble where the vast majority of my friends are against gender boxing. I still have some that were raised with and cling to the idea of boys toys vs. girls toys, but they are the minority now.

This continues later as boys grow into young men. Girls in the family are often sent to look after siblings and do domestic duties while boys are sent to look after cars and do yard maintenance (which leads to the feminine version of helplessness where women think they can't change a tire or mow the lawn). It's becoming more popular to let boys in on the domestic duties (especially since most major chefs are men and men need to pick up after themselves, too) and teach girls car care, but mainly, boys are still not included in the child care development.

This discrepancy can really be seen in one of the first teen jobs: babysitting. Now, while I know parents who'd take a boy babysitter who's known to be responsible, this isn't true in most homes. Even most homes who say they'd hire a boy to babysit, if offered the choice between two inexperienced teens, one male and one female, they are going to pick the girl. Women are just identified as more nurturing and boys are held with the misandrist view that they're unpredictable and dangerous.

I happen to know someone who's first husband lost his virginity to his babysitter when he was 10. So, uh, yeah... nurturing... And yet, more people would be horrified if the gender was reversed--somehow, it's okay for a 10 year old boy to decide to have sex with a 16 year old girl, but the other way around? They're both statutory and they're both just as harmful for the 10 year old.

But that's beside the point. This all leads to men having less training when the kids get in in a lot of homes, but certainly not all! I've seen homes where the women had less experience, most definitely. Sometimes even in these, though, the men are made helpless by that mama bear instinct.

It bothers me a lot when a group of women is talking about their husbands and one brings up a situation she wants to change where the group response is, "What do you expect? He's a man!"

That is just as wrong as a woman going into a new profession, stumbling and having the men say, "What do you expect? She's a woman!" Oh, there the tempers fly! Misogyny cannot be let go, but blaming a gender for the inefficiencies of its individuals who happen to have a Y chromosome? That's fine. Actually, that's called misandry and it's not fine.

It's damaging. It damages the men who are just left to flounder, unaware that they could learn the very skills they have been told men just aren't any good at. It damages our sons, who hear this garbage and grow up believing that's just how it is. It damages marriages who crumble because women have been taught that they're supposed to do everything. It damages women who really are left to carry more burden than they can handle and don't know that it's okay to ask their husband for help and to let him learn and let him make mistakes. We made them, too.

Yes, sometimes we had our mothers, sisters, aunts, random other women in our lives standing over us and correcting us. But most of us have the strength to say, "I'm glad that worked for you, but this is what works for me." Men aren't taught to communicate that way. Most end up angry, hurt, resentful and not knowing how to express that in a way that doesn't blow up in their faces or just assuming that they really can't do it.

Obviously, not all men are like this, just as not all women are. But this is the average family. And it doesn't have to be.

Men can wear their babies, dress them, bathe them, give them solids when they're six months or older, play with them, do tummy time and Gymboree with them. Oh, yes, they can! They can hold them close and make rumbling noises in their chest that we can't and that babies find soothing. He can take Junior to the potty in a super-hurry because she's got to go NOW! He can gather up toys and decide how the playroom is arranged and pick out the kids' clothes (and it's not the end of the world if his fashion sense is different from ours). He can wipe their face differently, he can put their socks on after their pants and their hat on before their shirt and it still all ends up on there. He can brush their teeth and play video games with them, etc.

Dad can do it. And if we're lucky enough to have a husband who wants to (even if just to try), or even is just willing to try, we darn well need to let him.

Friday, November 12, 2010

Breastfeeding Isn't Easy

I see comments all the time about how "it was just too hard" as though the mothers who continued breastfeeding had it easy. Because sore nipples, plugged ducts, mastitis, feedings every 1-2 hours, dealing with flow issues and upset tummies as a result, worrying about supply because there's no ounce markers, having to change one's diet to adjust for baby's intolerance(s) or allergies, feeding sessions lasting up to three hours, cracked nipples, bleeding nipples and blood blisters, scathing remarks/glares if we dare feed our babies out of our own house and in some cases, supplemental feeding systems... are easy?

Honestly, though, who said parenting was easy? And taking shortcuts may not be cheating in the traditional sense, but it cheats baby out of the benefits of the standard of care. Not just nursing, but in all aspects of parenting. "You aren't managing a convenience, you're raising a human being."

045.jpg kisses picture by Xakana

I'm not looking for your story about why it was so much harder for you than my friend who doesn't make 50% of the supply she needs to exclusively nurse and yet doesn't use bottles. Or me, who had a baby who screamed at the sight of my breast, weak suck, latch issues, one side preference, etc. Or blood blisters, choking from overactive letdown, living in horrible pain postponing surgery to get to a point where my baby would have enough of my milk to get through it... Or the mom friends I have with PCOS. Or those who've had to adjust their medications for breastfeeding-friendly ones. Those who live in daily pain trying to reach a minimum goal of nursing before going on medications or having surgery that would make it all better.

I've heard all the stories and I know moms who really couldn't do it (I have friends that even I would have/did encourage to stop for both mom and baby's sanity/health) and moms who did it when no one else believed they could--because they refused to take "no" for an answer.

The whole point of this is that it's NOT always easy with floods of happy hormones. I don't enjoy nursing. I enjoy the benefits, sure, and how deliriously happy it makes my kids. I don't notice any "special bond" or go to la la happy hormone land. I don't do it for me.


Inspired by HeidiLJ

Less than 2% of women don't make enough milk to exclusively breastfeed. That doesn't mean they shouldn't breastfeed at all, just that they need to supplement. Even that can be done at the breast now. Less than 5% can't do that for other reasons (mastectomy, medications, psychological trauma, etc.). But the number of mothers who bottle feed is closer to 40% that goes up the closer to a year you get. The number of women who nurse to the recommended 2 year minimum is only like 12%.So those who even make it half way (one year) is only like 35%. So all of those women have a reason to be proud--out of the 93%-95% that should have nursed that long, they were the ones who did. I'm not saying that bottle feeding is never okay or even necessary! I'm just saying that parenting isn't easy and there are more options than most people even know!

Friday, November 5, 2010

One Becomes Many

Every one counts. Sometimes, when we try to share the information we've learned, even if it's lifesaving (such as simply sliding up the chest clip on an infant in his car seat or pulling the straps tight), it's rejected. And sometimes, someone thanks you because they just didn't know. Other times, you receive no thanks, or even get cursed. Some of those people think angry thoughts about you for a little while and forget you forever after. Others are angry until they realize that what you said is not only true, but that you only meant to help.

Dr. Martin Luther King, Jr. once said, 'The first question which the priest and the Levite asked was: "If I stop to help this man, what will happen to me?" But... the good Samaritan reversed the question: "If I do not stop to help this man, what will happen to him?"'

Recommending "first do no harm" is so often met with disdain, sarcasm, dismissal, defensiveness ("Well, that's the way it was for me and I'M fine!"--often from people who are anything but) and outright hostility. It makes no sense and it's discouraging. Sometimes one wonders why to even keep trying. Well, with much thanks to Danielle at Peaceful Parenting for sharing a story that explains why we do keep trying, I'm passing this story along:


Image courtesy ~foureyestock

From The Star Thrower by anthropologist and writer, Loren Eiseley (1907-1977)


Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out, "Good morning! May I ask what it is that you are doing?"

The young man paused, looked up, and replied, "Throwing starfish into the ocean."

"I must ask, then, why are you throwing starfish into the ocean?" asked the somewhat startled wise man.

To this, the young man replied, "The sun is up and the tide is going out. If I don't throw them in, they will die."

Upon hearing this, the wise man commented, "But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can't possibly make a difference!"

At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, "It made a difference for that one."



Note: This is a true story that Eiseley wrote about. He was the 'wise man' walking the beach before his morning writing session. He encountered this young man throwing starfish back into the ocean and was forever impacted by the experience. His story is told in many forms, in many places - but rarely is credit given to Eiseley as the original author and subject of the narrative.



Another discouraging thought many people have is: "How does my voice matter? I'm only one person." This is from anything in life that we want to see change. Yes, you are one person. Just as the person who shared their knowledge with me was just one person. Now we're two. From there, many hear our words and if just one person listens to each of us, we are four. Then eight. Sixteen. Thirty-two. I think you can continue the math. Rarely, though, does one person only affect one person.

Look at a teacher in a classroom--a typical classroom of an average of 20 students. Every year or even twice a year if high school. For twenty years of teaching, that is 400-800 kids. I had a microbiology teacher who imparted life wisdom that was actually usable in addition to the science. He taught me about Shettles and delayed cord clamping and the importance of avoiding debt (except for home ownership) because he thought it would be interesting to us. I don't know how many of my classmates listened, but I did. I pass that information along to people who pass it along.

One person is only one person when their voice is silent. Gandhi said, "Nearly everything you do is of no importance, but it is important that you do it," and "Non-cooperation with evil is as much a duty as is cooperation with good." Voltaire said, "Stand upright, speak thy thoughts, declare The truth thou hast, that all may share; Be bold, proclaim it everywhere: They only live who dare." As well as, "The instruction we find in books is like fire. We fetch it from our neighbours, kindle it at home, communicate it to others, and it becomes the property of all." Dr. King said, "History will have to record that the greatest tragedy of this period of social transition was not the strident clamor of the bad people, but the appalling silence of the good people."

They were all "one person." I'm not saying that we will become famous for spreading the information, just that "one person" doesn't mean a lot, because all groups are made up of a lot of "one person".

"
Almost always, the creative dedicated minority has made the world better." -Dr. MLK, Jr.

"Be the change you wish to see in the world." -Mohandas Gandhi

Monday, November 1, 2010

Anniversary!

Today is my 6th year wedding anniversary with my husband. We have been a couple for 9 years now.

When I met his home for the first time (don't seem to have any scans of us together when we first met):

a pic of him when we first met, before the one above:


When I brought him back here:


Our wedding (handfasting):

guest book:


The altar (each bowl had one of each element: air, earth, fire, water):

water, fire, earth, air:


Me, the bride (that's a parrot play gym we built from PVC in the background, lol):

The women of the wedding (back: two bridesmaids, me, my maid of honor. front: my nieces: jr. bridesmaid and flower girl)

The men (and female groomsman--DH's little sister) of the wedding: Groomsmen, best man (DH was his best man, too) and groom:

fire's moment in the ceremony:

our hands, tied (how many people actually 'tie the knot?' LOL):

The kiss:

and the cake:

cards:

Friday, October 29, 2010

Happy Halloween! (Ghost Stories)

image courtesy of my husband's pumpkin carving skillz

I originally posted this as a contest entry for Halloween stories. Everything here is completely true to the best of my knowledge and represents paranormal experiences I've had--just in time for Halloween!



My experience with the paranormal began as a child. I was always 'sensitive' to unseen things and was good at predicting small events, like phone calls and things that people were going to say.

When I was 12, I had a best friend (who was basically my ONLY friend at the time) and we both became sick and missed school. We saw each other at the Boys and Girls club and she asked me to come home with her. Afraid of getting in trouble (and afraid of going a new place without anyone knowing where I was), I begged off and went home.

At home, I talked with her on the phone for a while and taught her "American Pie" ("This will be the day that I die") after "Paint It Black" and some other oldies. She loved them. At the end of the call, she had to go take her medicine and we sang American Pie one last time.

That night, I had terrible dreams about fire and trying to find her.

The next day, my mom came home and said, "Heather, it's April..."

I just looked up and said, "Is she dead?"

There had been a fire and because of the cough medicine she took, she never woke up. Her mother lost both her daughters that night (her sons survived) partly because of the burglar bars on their windows. April was 12, like me and her sister was in high school.

Then there was the terribly haunted house I lived in in high school (a toaster once flew across the kitchen at my mom's head while I was in the living room, coming to the kitchen--it flew outward by about 2' right at her from on top of the fridge to where she was cooking at the stove and there were people who absolutely refused to set foot in our house--they would get to the threshold and freeze, uncomfortable and then leave... amongst too many other stories). My best friend was the only person comfortable with being downstairs alone at night there. There was one ghost on the stairs that kept any others from coming up.

On to when my husband and I first met in person (we met online months before). He flew here and then flew us down to New Orleans to meet with more friends from our online group. While there, we stayed in an Inn in Geismar. We had one jacket and hung it on the single coat rod. Randomly, it would slide back and forth along the totally level rod. We checked everywhere and there was no draft, no airflow at all to move it. And it slid both ways.

Going back a way, I was on a family vacation with a friend, coming back from Colorado (to Missouri) when it became late and we pulled into this small town to find a place to sleep. I could see shapes moving out in the darkness and this pervasive sense of Wrong filled me with terror and the need to leave. Immediately.

I started telling my friend we couldn't stay there, we had to get away, get away now. Her walkie talkie buzzed on and her parents (in a separate vehicle) said, "Your sister is freaking out and says we have to leave. We're thinking we might want to find another town to stay in tonight."

My friend confirmed that I was acting the exact same way and thankfully her parents were spiritual people who believed us. I don't remember what town it was, just a small one in KS before we got to Salina, which is where we ended up staying. But in two separate vehicles, her little sister and I saw and felt the exact same thing. She described exactly what I had.

And for my last ghost story... In the last house we lived in before this one, there was one night where I felt this incredibly disturbing feeling. I felt sick and terrified and knew exactly where it was coming from--like hearing a sound, only with a completely different sense.

I felt it moving around the house and locked the doors in fear. Then this scratching sound started on the back porch door (enclosed porch--the door was non-functional--we used it as a library). I was freaking out and staring at the source of the sound and then a banging started against it. I touched the glass of the door with my left hand that led to the porch and jerked my hand back. There were scratches up and down my left arm. I started praying frantically and it faded away.

When my husband (then fiance) got home, I had him look and there were scratches on my arm and my shoulder where I couldn't see.

I warded the house after that. In this one, there's some disturbing negative sense that both I and my youngest feel toward the back porch/back yard, but the house is basically neutral.

Well, there's a short summary of many of the ghost stories I've lived personally. Happy Halloween!
image again courtesy of my husband's pumpkin carving skillz

Alternative Vaccine Refusal Form

This was written in response to many parents being asked to sign "vaccine refusal waivers" (don't ever sign one, by the way!) to offer if asked to sign. While most pediatricians wouldn't appreciate being handed this, it's hardly fair that we're expected to appreciate being handed a piece of paper that says that we agree with their assessment that we're taking a greater risk by not vaccinating. Obviously, if we are refusing, we DON'T agree. This summarizes very nicely why many people choose not to vaccinate. Thanks to Kathryn E. Rateliff for compiling it and all the bloggers who keep passing it on!

image courtesy of ~darkland-stock




REFUSAL OF RECOMMENDED VACCINES

Patient Name_______________________________ Birthdate_______________

As the parent/guardian of __________________________, I have investigated the risks and benefits of the following vaccines and diseases. I am aware that there are documented cases of people contracting diseases for which they are clinically fully immunized and that the manufacturers of the vaccines do not guarantee 100% efficacy. I am also aware that VAERS (Vaccine Adverse Events Reporting System) documented cases of over 54,000 adverse reactions from vaccines in a 20-month period. The Vaccine Injury Compensation Program (The Vaccine Court) received 366 new petitions for compensation between 1/5/04 and 3/30/04. The National Vaccine Injury Fund, created in 1986 to compensate families of vaccine-damaged children, had paid out over 1.4 billion dollars in compensation 1986 to 10/21/04.

POLIO: I have been informed of the risk of my child developing paralytic disease and meningitis associated with poliomyelitis. I understand that even under epidemic conditions, natural polio produces no symptoms in over 90% of those exposed to it.(1) I understand that there have been no cases of wild polio in the US in the last 20 years and that those cases which have been documented have been caused by the vaccine.(2)
I understand the following side effects for the vaccine are possible:
Killed virus polio: temperature of *102° in up to 38%, sleepiness, fussiness, crying, decreased appetite, vomiting, Guillain-Barré Syndrome and allergic reaction in those allergic to neomycin, polymyxin B and streptomycin. Precautions include those who have had a previous negative reaction, pregnant women, and possibly those with HIV/AIDS or otherwise compromised immune systems.
Live virus polio: Reactions include contraction of polio by those who have received the virus and by those who have come into contact with body fluids and wastes of the immunized person. Paralytic symptoms may follow contraction of polio. Live virus is reportedly shed for up to 8 weeks after the inoculation. Guillain-Barré Syndrome has also been noted. Not recommended for use in households where someone has a compromised immune system, for pregnant women, or where a previous reaction has been reported.(3)
Killed virus Ipol® is grown on monkey kidney cells, contains formaldehyde, and triple antibiotics. Poliovax® is grown on cells from an aborted baby, contains formaldehyde, cow serum and triple antibiotic solution.(4) The monkey kidney cells used in the original killed polio vaccine contains SIV-40 and has been found in tumor cells of children whose parent's were vaccinated against polio using the contaminated virus.(5) The live vaccine is grown on monkey kidney cells, antibiotics and calf serum.

HEMOPHILUS INFLUENZAE B: I have been informed of the risk of my child developing meningitis (although this vaccine will not protect the child from meningitis from all other forms such as pneumococcus, and meningococcus, viruses, and fungi), pneumonia, and infections of the blood, joints, bone, and soft tissue associated with Hemophilus Influenzae B. I understand that this disease is most likely in children up to 15 months of age and is fatal in 3-6% of children who contract it. Incidence of this disease today is low and the vaccine has not proven to be highly effective in 41% of cases, according to some studies.(6) Treatment is available.
The vaccine is often combined with the DPT which has the highest reaction rate of any vaccine available today. Reactions include: contracting HIB, localized pain, erythema and induration, fever >100.6°, irritability, lethargy, anorexia, rhinorrhea, diarrhea, vomiting, cough, when administered alone. Reactions occurred in up to 30% of patients. When administered in conjunction with the DPT, reactions include local tenderness erythema and induration, fever >100.8°, irritability, drowsiness, anorexia, diarrhea, vomiting, persistent crying, seizures, urticaria, hives, renal failure, Guillain-Barré Syndrome and death. Reactions occurred in up to 77.9% of patients.(7)
The vaccine contains yeast, thimerosal (mercury derivative), and diphtheria toxoid when given alone.(8)

PERTUSSIS: I have been informed of the risk of my child developing whooping cough, pneumonia, convulsions, inflammation of the brain, and death associated with pertussis. I understand the disease is rarely fatal, with a 99.8% recovery rate. It is most serious and life-threatening in children under 6 months old, but there are adequate methods of treatment available.(9)
The vaccine is most often given in conjunction with diphtheria and tetanus as the DPT or as the DaPT.
Pertussis vaccine may cause: fevers >106, pain swelling, diarrhea, projectile vomiting, excessive sleepiness, high--pitched screaming, inconsolable crying bouts, seizures, convulsions, collapse, shock, breathing problems, brain damage and SIDS. One in 600 suffer a severe reaction in one study (10) and 1 in 875 suffered shock-collapse and convulsions.(11) Those in the 2nd study were only tracked for the first 48 hours following immunization. A more recent study indicates that 1 in 100 react with convulsions, collapse, or high-pitched screaming and 1 in 3 of those cases sustained permanent brain damage.(12) In a study of 103 children who died of SIDS, 70% died within 3 weeks of the DPT vaccine and 37% of those died within the first week.(13)
The DaPT is recommended as a safer option for vaccination. Side effects of the DaPT were only tracked for 72 hours and included: tenderness, erythema, induration, fever >102.2°, drowsiness, fretfulness, vomiting, upper respiratory infection, diarrhea, rash, febrile seizures, persistent or unusual crying, lethargy, hypronic-hyporesponsive episode, urticaria, anaphylactic shock, convulsions, encephalopathy, mono- and polyneuropathies and death.(14) Not recommended for children under 15 months or for those who have not had 3 injections of the DPT.
Either form of the vaccine contains thimerosal (mercury derivative), formaldehyde, and aluminum phosphate.(15)

DIPHTHERIA: I have been informed of the risk of my child developing paralysis, heart failure, or respiratory failure associated with diphtheria. I have also been informed that there have only been 5 cases reported annually since 1980.(16) I am also aware that diphtheria is rarely fatal and treated with antibiotics and bed rest. (17)
The Diphtheria component is most often given within the DPT or DaPT and includes the same side effects and reactions as those listed for pertussis.

TETANUS: I have been informed of the risk of my child developing fatal neuromuscular disease related to tetanus. I understand that the incidence of tetanus is low, and there is an antitoxin, should we decline the immunization. I understand that contracting tetanus does not provide life-long immunity, and neither does the vaccine. I understand that to prevent more severe reactions from the vaccine, the tetanus component has been so significantly "diluted" that it is clinically ineffective.(18) I understand that the death rate for properly treated cases of tetanus may be as high as 20%.(19)
Side effects of the tetanus vaccine alone include: high fever, pain, recurrent abscess formation, inner ear nerve damage, demyelinating neuropathy, anaphylactic shock and loss of consciousness.(20)
Tetanus given in the DPT or DaPT shot include the same side effects and reactions as those listed for pertussis.

RUBEOLA (MEASLES): I have been informed of the risk of my child developing pneumonia, encephalitis (inflammation of the brain), degenerative disease of the nervous system with convulsions (subacute sclerosing panencephalitis) related to rubeola. I understand the death rate for measles is .03 in 100,000.(21) I understand that since 1984, over 55% of documented, confirmed cases of measles have been in fully immunized persons.(22)
I understand that the greatest risk of the measles vaccine may be to push the incidence of this disease into the late teens and adulthood where it is more likely to be fatal or cause more adverse and long-term effects.(23)
The measles vaccine is a live vaccine, and carries the risk that it will cause the patient to contract measles. Other adverse reactions include: stinging or burning at the injection site, anaphylaxis, fever up to one month following injection, rash, cough, rhinitis, erythema multiforme, lymphadenopathy, urticaria, diarrhea, febrile convulsions, seizures, thrombocytopenia, purpura, vasculitis, optic neuritis, retrobulbar neuritis, papillitis, retinitis, encephalitis and encephalopathy, ocular palsies, Guillain-Barré Syndrome, ataxia, and subacute sclerosing panencephalitis.(24)
Measles vaccine is most often given as a part of the MMR which includes the following side effects: burning or stinging at injection site, malaise, sore throat, cough, rhinitis, headache, dizziness, fever, rash, nausea, vomiting, diarrhea, erythema, induration, tenderness, lymphadenopathy, parotitius, orchitis, nerve deafness, thrombocytopenia, purpura, allergic reactions, urticaria, polyneuritis, arthralgia, arthritis, anaphylaxis, vasculitis, otitis media, conjunctivitis, febrile convulsions, seizures, syncope, erythema multiforme, optic neuritis, retrobulbar neuritis, papillitis, retinitis, encephalitis and encephalopathy, ocular palsies, Guillain-Barré Syndrome, ataxia, subacute sclerosing panencephalitis,(25) and a recent study from Europe indicates that there may be a link between the MMR (measles/mumps/rubella) vaccine and autism and irritable bowel syndrome.(26)
Measles vaccine contains chick embryo cells, neomycin, sorbitol and hydrolyzed gelatin. MMR contains all live vaccines, chick embryo, cells from aborted babies, neomycin, sorbitol and hydrolyzed gelatin.(27)

MUMPS: I have been informed of the risk of my child developing inflammation of the testicles, joints, kidneys, and/or thyroid, and hearing impairment related to mumps. I understand that mumps is rarely harmful in childhood, and that most of the above risks occur when mumps is contracted in adolescence or adulthood.(28)
I understand that there is a Mumps vaccine which poses the following risks: contraction of mumps from the live vaccine, burning or stinging at the injection site, anaphylaxis, cough, rhinitis, fever, diarrhea, vasculitis, parotitis, orchitis, purpura, urticaria, erythema multiforme, optic neuritis, retrobulbar neuritis, syncope, encephalitis, febrile seizures, and nerve deafness.(29)
Mumps is usually given in the MMR and may cause those side effects and adverse reactions as noted in the measles section above.
Mumps vaccine is live and should not be given to pregnant women. It is cultured in chick embryos and contains sorbitol and hydrolyzed gelatin.(30)

RUBELLA (GERMAN MEASLES): I have been informed of the risk of my child developing inflammation of the brain or joints, and of the risk of birth defects (including eye defects, heart defects, deafness, mental retardation, growth failure, jaundice, and disorders of blood clotting) in infants born to mothers who contract rubella during pregnancy, related to rubella. Therefore, I understand that the greatest risk to my child may be if she never contracts rubella as a child, but when she is pregnant and it damages her unborn child. If she contract rubella in childhood, she is immune for life, and prior to the vaccine 85% of the population was immune.(31) I understand that if she is not immune as an adult, she can choose to take the vaccine prior to becoming pregnant. I understand that many of those who contract rubella have been immunized (up to 80%). (32)
Adverse reactions from the vaccine among teenage girls is 5-10% and 30% in adult women.(33) Adverse reactions include: contracting rubella from the live virus in the vaccine, burning or stinging at the site, lymphadenopathy, urticaria, rash, malaise, sore throat, fever, headache, dizziness, nausea, vomiting, diarrhea, polyneuritis, arthralgia, arthritis, local pain and inflammation, erythema multiforme, cough, rhinitis, vasculitis, anaphylaxis, syncope, optic neuritis, retrobulbar neuritis, papillitis, Guillain-Barré Syndrome, encephalitis, thrombocytopenia, purpura, and Chronic Fatigue Syndrome. (34)
Rubella is most often administered in the MMR and may cause those side effects and adverse reactions listed under measles.
Rubella is cultured on the tissue of an aborted child. This child was the 27th child aborted and tested by researchers due to exposure to rubella in a pregnant woman. It contains neomycin, sorbitol and hydrolyzed gelatin.(35)

HEPATITIS B: I have been informed of the risk of my child developing Hepatitis B viral infection which can cause chronic inflammation of the liver leading to cirrhosis, liver cancer, and possibly death. I understand that my child's risk of developing Hepatitis B is low if I am not a carrier or infected, if my child does not engage in promiscuous sex or use drugs. I understand that there is antibiotic treatment for HepB and that most of those who contract it recover.(36) I understand that the HepB vaccine only contains strains of HepB and is not effective against HepA, C, D, E, F, or G.
I understand that the HepB vaccine has the following side effect and adverse reactions: induration, erythema, swelling, fever, headache, dizziness, pain, prutitus, ecchymosis, sweating, malaise, chills, weakness, flushing, tingling, hypotension, flu-like symptoms, upper respiratory illness, nausea, anorexia, abdominal pain and cramping, vomiting, constipation, diarrhea, lymphadenopathy, pain or stiffness in muscles and joints, arthralgia, myalgia, back pain, rash, urticaria, petechiae, sleepiness, insomnia, irritability, agitation, anaphylaxis, angioedema, arthritis, tachycardia/palpitations, bronchospasm, abnormal liver function tests, dyspepsia, migraine, syncope, paresis neuropathy, hypothesis, paresthesis, Guillain-Barré Syndrome, Bell's Palsy, transverse myelitis, optic neuritis, multiple sclerosis, thrombocytopenia, eczema, purpura, herpes zoster, erythema modosum, alopecia, conjunctivitis, keratisis, visual disturbances, vertigo, tinnitus, earache, and dysuria.(37) The studies only followed patients for 4 days post-vaccination.
The most commonly used HepB vaccine contains thimerosal, although a relatively new release does not contain thimerosal. The vaccine also contains: aluminum hydroxide, yeast protein, and phosphate buffers.(38)

VARICELLA (CHICKENPOX): I have been informed of the risk of my child developing chicken pox which could potentially result in pneumonia, secondary skin or generalized infections, or, if caught during pregnancy, birth defects in the baby. I understand chicken pox is generally benign in children, but results in significant lost hours at work for parents. Chicken pox in adults often manifests as shingles, a chronic and painful condition. I also understand that contracting chicken pox later in life may increase my risk for herpes simplex.
Side effects and adverse reactions for the chicken pox vaccine include: contracting chicken pox from the live vaccine (27%), pain and redness at site, swelling, erythema, rash, pruritus, hematoma, induration, stiffness, upper respiratory illness, cough, irritability/nervousness, fatigue, disturbed sleep, diarrhea, loss of appetite, vomiting, otitis, diaper rash/contact rash, nausea, eye complaints, chills, lymphadenopathy, myalgia, lower respiratory illness, headache, teething, malaise, abdominal pain, other rash, allergic reactions including rash and hives, stiff neck, heat rash/prickly heat, arthralgia, eczema/dry skin/dermatitis, constipation, itching, pneunonitis, febrile seizures, and cold/canker sore.(39)
Varicella vaccine is cultured on cells from aborted babies, and guinea pig cell cultures. It contains live virus, monisodium glutamate (msg), sucrose, phosphate, processed gelatin, neomycin and fetal calf serum. (40)

HEPATITIS A (HAV): I have been informed of the risk of my child developing HAV which could potentially result in prolonged or relapsed hepatitis, but will not result in chronic hepatitis disease. (41) HAV usually causes mild "flu-like" illness, jaundice, severe stomach pains and diarrhea; and, in rare cases may result in death. Infection confers lifelong immunity. (42) I understand that the CDC admits that good personal hygiene (handwashing) and proper santitation can prevent HAV. (43)
HAV infection is spread by contaminated water or food, infected food handlers, unsanitary conditions following natural disasters, ingestion of raw or undercooked shellfish, institutionalized individuals, children not yet toilet trained, blood transfusions or sharing needles with infected people. Transmission is most likely in developing countries where sanitation is poor and infection rate of children under 5 is 90%. Fatality rate is less than .6% overall, and 70% of those in patients over 49 years, many of whom have underlying liver disease. (44) Other at-risk populations include those living on American Indian reservations and in Alaskan Native villages, homosexually active men, IV drug users, people using clotting factor concentrates and international travelers. (45)
Side effects and adverse reactions from the vaccine include: injection-site soreness, headache, fever, malaise, induration, redness, swelling, fatigue, anorexia, nausea, pruritis, rash, utricaria, pharyngitis, upper respiratory tract infections, abdominal pain, diarrhea, dysgeusia, vomiting, arthralgia, elevated cratine phosphokinase, myalgia, lymphadenopathy, hypertonic episodes, insomnia, photophobia, and vertigo. (46)
Aborted fetal tissue is an ingredient in the Havrix® Hep A vaccine, as is formaldehyde, aluminum hydroxide and 2-phenozyethanol.(47)
There is currently a combination Hep A and B vaccine, Twinrix®, being tested in the UK. (48) Twinrix is grown in human cell cultures, contains 2-phenoxyethanol, neomycin sulfate, polysorbate, tromentamol and formaldehyde. (49)

PNEUMOCOCCAL: I have been informed of the risk of my child developing pneumococcal disease which could result in meningitis, blood infection, pneumonia and/or ear infections. Iunderstand studies indicate that this vaccine may only decrease ear infections by 9%, and only result in a 20% reduction in chronic ear infections and ear tube insertion in that group.
I understand that my child has a 7.5:5,000 chance of deveoping this disease if he or she is under age 2 and a 1:5000 chance of developing it if over age 2. Risk factors for developing this disease are: immunoglobulin deficiency, nephrotic syndrome, Hodgkin's disease, congenital or acquired immunodeficiency, some upper respiratory infections, splenic dysfunctions, splenectomy or organ transplant. This vaccine (PCV) was originally marketed for immunocompromised children. (50) This vaccine is contraindicated to children with thrombocytopenia, coagualtion disorders, or sensitivity to diphtheria toxoid.(51)
Possible side effects and complications from the vaccine include: erythema, induration, tenderness, interference of limb movement, inflamation, fever, irritability, drowsiness, restless sleep, decreased appetite, vomiting, diarrhea, fussiness, rash, hives, bronchitis, asthma, pneumonia, otitis media (ear infection), sepsis, seizure, anaphylaxis and death.(52) Recipients were followed for 3 days and almost 10% of the subjects made a visit to the emergency room in the follow-up period. There were 8 cases of SIDS in the 17,066 subjects involved in the trial.(53) Note: Children in the studies' control group received another experimental vaccine, so there have been no trial studies done with children who received no vaccine.(54)
Prevnar contains .125 mg of aluminum sulfate, protein polysaccharides from 7 strains of strep. pneumoniae bacteria, diphtheria toxin, casamino acids, yeast extract. Studies indicate that it may interfere with the safety and efficacy of other vaccines.(55)

FLU: I have been informed of the risk of my child developing influenza, which could result in hospitalization for respiratory complications, pneumonia and death. I understand less than 175 people died from the flu in the US during 2003. I understand that there is no guarantee that the flu strains chosen for this year will be the flu strains that are active this year. I understand that from 1999 - 2003, 70 - 80% of the sniffles, fevers, and body aches did not test positive for influenza regardless of the flu strain used.
The most common reactions to injected flu vaccines, which begin within 12 hours of vaccination and can last several days are: fever, fatigue, painful joints and headache. The most serious reaction that has been associated with flu vaccine is Guillain-Barré Syndrome (GBS), which occurs most often within two to four weeks of vaccination. GBS is an immune mediated nerve disorder characterized by muscle weakness, unsteady gait, numbness, tingling, pain and sometimes paralysis of one or more limbs or the face. Recovery takes several months and can include residual disability. Less than 5 percent of GBS cases end in death. Brain and nerve disorders such as encephalopathy, optic neuritis, partial facial paralysis, and brachial plexus neuropathy as well as vasculitis also have been reported following the flu vaccine, although a definite causal relationship has not been established. (56) A tenfold increase in Alzheimer's disease exists for those who receive the flu vaccine five years in a row. (57)
FluMist: Reported adverse effects in children include runny nose, nasal congestion, cough, sore throat, headache, irritability, decreased activity, fever, chills, muscle aches, and vomiting. In adults the most common side effects were runny nose, cough, sore throat, headache, muscle aches, fever, chills and tiredness or weakness. Other adverse events that occurred in children were abdominal pain, asthma, bronchitis, conjunctivitis, viral syndrome, otitis media (middle ear infection), and wheezing or shortness of breath.(58)
Fluzone is propagated in chick embryos. It contains formaldehyde, sucrose, polyethylene glycol, sodium phosphate, salt and thimerosal.(59) Fluvirin is prepared in chicken eggs and contains thimerosal, neomycin, polymyxin, and phosphate-buffered saline. (60)
FluMist is a live vaccine propagated in chicken eggs, and contains potassium phosphate, sucrose (table sugar) and monosodium glutamate (MSG). (61)

HUMAN PAPILLOMAVIRUS (HPV): I have been informed of the risk of developing HPV. HPV is a sexually-transmitted disease that can cause genital warts, and it’s most severe stage, cervical cancer. I understand that there are more than 100 forms of HPV and that the currently available vaccine only covers four of the strains; current screening for HPV looks for 13 "high risk" strains. The CDC estimated that 20 million people in the US had HPV and many strains cause no harm. (62) I understand current research shows that most women will quickly clear the infection on their own, and very few will develop pre-cancerous or cancerous lesions. Use of the vaccine will not cure HPV infection, and the duration of the longest HPV vaccine studies covered less than 50% of the time it takes to progress from CIN 2 or 3 levels to cervical cancer, so 100% efficacy cannot realistically be proven. (63) HPV vaccination does not take the place of routine Pap screens. (64)
The most common reactions to the HPV vaccines were pain, swelling, redness and itching at the injection site. More than 90% of vaccine test subjects and more than 85% of subjects receiving the aluminum-containing placebo experienced at least one of these reactions. (65) Other reactions from the vaccine included: systemic fever, nausea, nasopharyngitis, dizziness, diarrhea, vomiting, myalgia, cough, upper respiratory tract infection, malaise, arthralgia, insomnia and nasal congestion. More severe reactions included headache, gastroenteritis, appendicitis, pelvic inflammatory disease, asthma, pulmonary embolism, sepsis, arrhythmia, juvenile arthritis, rheumatoid arthritis, lupus, arthritis and reactive arthritis. There were also statistically higher levels of birth defects in women who got pregnant within 30 days of receiving the vaccine and in more than 30 cases of birth defects in women who became pregnant after 30 days from either Gardasil® or the aluminum-containing placebo. (66)
Gardasil® is currently the only HPV vaccine approved for use and contains 225mcg of aluminum hydroxyphosphate sulfate, sodium chloride, L-histidine, polysorbate 80, sodium borate, water, and proteins from HPV strains 6, 11, 16 and 18 grown in yeast fermentation medium. (67)

Reference List
1. M. Burnet and D. White, The Natural History of Infectious Disease (Cambridge, 1972), p. 16.
2. Strebel, et al, "Epidemology in the U.S. One Decade After the Last Reported Case of Indigenous Wild Virus Associated Disease," Clinical Infectious Diseases, (Center for Disease Control, February 1992), pp. 568-79.
3. Physician's Desk Reference (PDR), 50th Edition; Medical Economics, 1996, p. 1388-1390.
4. Ibid, p. 885-886 and 891-892.
5. J. Butel, et al; "Molecular Evidence of Simian Virus 40 Infections in Children", The Journal of Infectious Diseases ; September 1999;180:884-887.
6. PDR, 50th Edition, p. 872-875.
7. Ibid.
8. Ibid.
9. Richard Moskowitz, M.D., "Immunizations: The Other Side," Mothering, (Spring1984),p. 34.
10. Immunization: Survey of Recent Research, (United States Department of Health and Human Services, April 1983), p. 76.
11. "Nature and Rates of Adverse Reactions Associated with DPT and DT Immunizations...," Pediatrics, Volume 68, No. 5 (November 1981).
12. Walene James, Immunization the Reality Behind the Myth, (South Hadley, Massachusetts: Bergin & Garvey, 1988), p. 14.
13. W.C. Torch, "Diptheria-pertussis-tetanus (DPT) immunization: A potential cause of sudden infant death syndrome (SIDS)," (Amer. Academy of Neurology, 34th Annual Meeting, Apr 25 - May 1, 1982), Neurology 32(4), pt. 2.
14. PDR, p. 875-879 and 892-895.
15. Ibid.
16. Robert Mendelsohn, M.D., How to Raise A Healthy Child...In Spite of your Doctor (Chicago: Contemporary Books, 1984), p.223.
17. Ibid. 244-246
18. Isaac Golden, Ph.D., Vaccination? A Review of Risks and Alternatives, (Geelong, Victoria, Australia: Arum Healing Centre, 1991), p. 31
19. Richard Moskowitz, M.D., "Immunizations: The Other Side," Mothering, (Spring1984),p. 34.
20. Isaac Golden, Ph.D., Vaccination? A Review of Risks and Alternatives; p. 71
21. R. Mendoholson; How to Raise a Healthy Child; p. 217.
22. John Frank Jr., M.D., et al. "Measles Elimination - Final Impediments," 20th Immunization Conference Proceedings, May 6-9, 1985, p. 21.
23. Infectious Diseases (January 1982), p. 21.
24. PDR, p. 1610-1611.
25. DR, p. 1687-1689.
26. Sara Solovitch, "Do vaccines spur autism in kids?", San Jose Mercury News, 5/25/99.
27. PDR, p. 1687-89, 1610-1611.
28. Richard Moskowitz, M.D., "Immunizations: The Other Side," Mothering, (Spring1984),p. 35.
29. PDR, 1708-1709.
30. Ibid.
31. R. Mendoholson; How to Raise a Healthy Child; p. 218.
32. Dr. Beverley Allan, Australian Nurses Journal, (May 1978).
33. Hannah Allen, Don't Get Stuck: The Case Against Vaccinations..., (Oldsmar, FL: Natural Hygiene Press, 1985), p. 144.
34. DR, p. 1697-1699.
35. Ibid and Attenuation Of RA 27/3 Rubella Virus in WI-38 Human Diploid Cells; Amer J Dis Child vol 118 Aug 1969 and Studies of Immunization With Living Rubella Virus ; Arch J Dis Child vol 110 Oct 1965.
36. John Hanchette, "Safety of controversial hepatitis B vaccine at center of debate" Gannett News Service, 5/18/99.
37. PDR, p. 1744-1747, 2482-2484.
38. Ibid.
39. PDR, p. 1762-1765.
40. Ibid.
41. CDC Viral Hepatitis A - Fact Sheet, 9/29/00; www.cdc.gov/ncidod/diseases/hepatitis/a/fact.htm
42. CDC Hepatitis A Vaccine Vaccine Information Statement; 8/25/98
43. CDC Hepatitis A Facts, 11/16/00
44. Mosby's GenRX®, 10th Ed., Hepatitis A Vaccine (003158) as posted on MDConsult website
45. CDC Hepatitis A Vaccine Vaccine Information Statement; 8/25/98 and CDC Hepatitis A Vaccine Vaccine Information Statement; 8/25/98
46. Mosby's GenRX@, Hepatitis A Vaccine
47. Ibid.
48. "Combined hepatitis A/B vaccine offers fast protection," Reuters Health, 4/12/00
49. Vaccines and Their Ingredients, 6/24/99; www.909shot.com
50. Michael Horwin, MA; "Prevnar: A Critical Review of a New Childhood Vaccine" 9/19/00.
51. Prevnar package insert, Wyeth Lederle, 2/17/00
52. Ibid.
53. Horwin; "Prevnar: A Critical Review"
54. Dr. Erdem Cantekin, Ph.D.; "Pneumocaoccal Vaccine and Otitis Media", NVIC's 2nd Intl. Public Conference, 9/8/00.
55. Horwin; "Prevnar: A Critical Review"
56. Physician's Desk Reference (PDR), 53rd Edition; Medical Economics, 1999, p. 2326, 3464
57. Dr. Russell Blaylock, MD; "The Truth Behind the Vaccine Coverup" 9/22/04; www.mercola.com/2004/sep/22/blaylock_vaccine_coverup.htm
57. Fluzone 2003-2004 Formula, Aventis Product information as of July 2003
58. Dr. Sherry Tenpenny, DO, "FluMist Vaccine: Nothing to Sneeze At!" 10/23/2003; www.nmaseminars.com .
59. Influenza Virus Vaccine Live, Intranasal FluMist 2003-2004 Formula, Package Insert (Circular) June 16, 2003.
60. "New Preservative Free Flu Vaccine Approved" http://www.accessdata.fda.gov/psn/transcript.cfm?show=10
61. Dr. Sherry Tenpenny, DO, "FluMist Vaccine: Nothing to Sneeze At!"
62. CDC HPV Fact Sheet, http://www.cdc.gov/std/HPV/STDFact-HPV.htm
63. Dr. Clayton Young, MD, FACOG, "OBGYN Against ACIP HPV Vaccine Decision," 6/27/2006
64. CDC HPV Fact Sheet, http://www.cdc.gov/std/HPV/STDFact-HPV.htm
65. Merck Professional Privider Information Sheet: Gardasil® [Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recominant Vaccine. www.Merck.com
66. Daron G Ferris, "Facing the Future: The Impact of HPV Vaccination on Adolescent Health," and "An Update of Clinical Trial Results With Preventative HPV Vaccines" http://www.medscape.com/viewprogram/5334
67. Merck Professional Privider Information Sheet: Gardasil® [Quadrivalent Human Papillomavirus (Types 6, 11, 16, 18) Recominant Vaccine. www.Merck.com

Complied by Kathryn E. Rateliff, CCD, CCM, CCCE, GSM, PE, BFE
October, 1999 and most recently revised August 10, 2006

Questions and comments can be addressed to her at: titus2ed@aol.com.