REFRESHER CLASS ANNOUNCEMENT

August 10, 2009

2 night childbirth refresher is scheduled for Sunday August 19th and Sunday August 23rd. 7:30-9:30 pm.

Please contact Carrie@birthteacher.com to register.


Don’t wash the baby!

July 7, 2009

 Vernix, that cheesy, white substance found on newborn humans and immediatley washed off during “baby’s first bath” in the hospital,  has been found to contain AWESOME bactieria fighting properties!! Just read the article to see how you can protect your newborn from hospital-borne infections and disease. Vernix has also been shown to contain GBS-killing antimicrobial components! Think twice about dousing your baby in Johnson’s soap!

Vernix caseosa as a multi-component defence system based on polypeptides, lipids, and their interactions.

Full study found here: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2315785

Vernix caseosais a white cream-like substance that covers the skin of the foetus and the newborn baby. Recently, we discovered antimicrobial peptides/proteins such as LL-37 in vernix, suggesting host defence functions of vernix. In a proteomic approach, we have continued to characterize proteins in vernix and have identified 20 proteins, plus additional variant forms. The novel proteins identified, considered to be involved in host defence, are cystatin A, UGRP-1, and calgranulin A, B and C. These proteins add protective functions to vernix such as antifungal activity, opsonizing capacity, protease inhibition, and parasite inactivation. The composition of the lipids in vernix has also been characterized and among these compounds the free fatty acids were found to exhibit antimicrobial activity. Interestingly, the vernix lipids enhance the antimicrobial activity of LL-37 in vitro, indicating interactions between lipids and antimicrobial peptides in vernix. In conclusion, vernix is a balanced cream of compounds involved in host defence, protecting the foetus and newborn against infection.

Discussion:

In previous studies, we have characterized antimicrobial peptides and polypeptides in vernix [7, 8]. In the present study we demonstrate the presence of many more proteins of immunological importance in vernix. Among the most abundant proteins now characterized are cystatin A, calgranulin A, ubiquitin, and UGRP-1, which are all implicated in innate immunity of humans. Vernix lipids were now also characterized in which antimicrobial activity was detected, in particular for free fatty acids. In addition, our results indicate that lipids may contribute to a favourable microenvironment in vernix by interacting with antimicrobial components such as LL-37. Our characterization of proteins, lipids and their interactions suggest that vernix is a complex innate defence barrier, protecting the foetus and the newborn from infectious microbes, in an apparently crucial manner, since the adaptive immunity of newborns is immature. The antimicrobial property of vernix may also act to facilitate colonization by the normal flora following birth and to block the colonization of unwanted microbes or pathogens. For example psoriasin, which is identified in vernix, directly kills E. coli but not Staphylococcus aureus [33, 34]. The shedding of the vernix in late pregnancy may suggest that the level of protection has to be adjusted to allow proper colonization of the normal flora.
Several proteins now identified are expressed in skin such as cystatin A, profilaggrin, psoriasin and calgranulin C. Due to the close contact of vernix and amniotic fluid, they share some of the same components. This is now shown regarding calgranulin A and B, proteins previously known to be present in amniotic fluid [35]. The origin of UGRP-1 may be the lungs, and a transfer of this protein to vernix may occur via the amniotic fluid. Blood may be another source of the identified proteins in vernix. Using mass fingerprinting, we identified not only α- and β- haemoglobin but also γ-haemoglobin. During the last two trimesters of pregnancy the foetus produces γ-haemoglobin, which is replaced by β-haemoglobin after birth, enabling an efficient transfer of oxygen from the blood of the mother to the foetus. Thus, the γ-haemoglobin detected in vernix originates from the foetus.
Calgranulin A, B, and C, and psoriasin all belong to the S100 family of calcium binding proteins. The S-100 family of proteins has 2 calcium binding motifs of the EF-hand type [36]. These proteins have been shown to exhibit chemotactic properties and may play a role in the pathogenesis of epidermal diseases [36]. Notably, an N-terminal fragment of profilaggrin, with sequence similarity to the two EF-hands [37], was also identified in vernix.
Calprotectin is an antifungal and antibacterial complex consisting of a heterodimer of calgranulin A and calgranulin B [38]. Both subunits were identified, revealing that the active holoprotein is present in vernix. Accordingly, the crude peptide/protein extract of vernix exhibited good antifungal activity. However, after separation of the protein extract by RP-HPLC we could not detect any antifungal activity in the collected fractions (data not shown). Our interpretation of this difference is that the two subunits of calprotectin have been separated upon HPLC, leading to loss of activity. Calprotectin is suggested to kill microbes by chelating zinc, thereby depriving microbes of an essential metal ion [39]. This mode of action has also been described for lactoferrin and psoriasin, the latter being a major E. coli-killing compound in human skin [33].
Calgranulin C was first identified on the surface of onchoceral worms in human subcutaneous nodules [40]. It is proposed to be released by activated neutrophils and thereby attack and kill nematodes [40]. Thus, the presence of calgranulin C in vernix contributes to the protective role of vernix.
Cystatin A is a protease inhibitor that is mainly expressed by epithelial and polymorphonuclear cells [41, 42]. Cystatin A is also a minor cross-linking component of the cornified cell envelope [43] and a part of the mechanical barrier of the skin. Unlike cystatin C, cystatin A has not been shown to possess any direct antimicrobial effect. However, cystatin A has been suggested to be a first line protector against cysteine proteases released from infectious micro-organisms and parasites [44]. Thus, cystatin A could have a dual role in the innate defence of the foetus.
Our results reveal that UGRP-1 (HIN-2/SCGBA2) is one of the major proteins in vernix, whereas UGRP-2 (HIN-1 /SCGBA1) is not as abundant. These proteins are both expressed at high levels in neonatal lungs by different subsets of secretory cells within the surface and glandular epithelia [45]. UGRP-1 has been shown to bind bacteria and to the macrophage scavenger receptor MARCO [46], indicating opsonizing properties. In the lungs of mice the expression of UGRP-1 is upregulated by IL-10 [47], while it is downregulated by IL-5 [48], suggesting that UGRP-1 is a target of anti-inflammatory pathways. In vernix, we have characterised three novel forms of UGRP-1, which are N-terminally differently processed. These forms may have altered binding affinities to bacteria, leading to enhancement of the opsonizing spectra.
Vitamin A has been detected at high levels in vernix [49] and is proposed to serve as a nutritional depot of vitamin A. Vitamin A is secreted from the amniotic epithelium into the amniotic fluid, and is taken up by vernix [49]. Our results show that transthyretin is present in vernix, a protein that binds to the retinol binding protein, which in turn binds vitamin A.
Like lipids previously isolated from human stratum corneum and sebum [50, 51], our results demonstrate inhibitory effects of the free fatty acids in vernix against the Gram-positive bacterium B. megaterium. We also demonstrate that palmitoleic acid (C16:1) and linoleic acid (C18:2), known to exhibit potent antimicrobial activity [14, 52], are a considerable part of the total free fatty acids. The long-chain unsaturated fatty acids found in vernix (C20 to C22 in table 2 ) are also antimicrobial and the activity is enhanced with an increase of the number of double bonds [15]. Like antimicrobial peptides [53], fatty acids and monoacylglycerols disintegrate the lipid envelope of viruses [15] and bacterial plasma membranes [12, 16].
Considering the high lipid content of vernix (10%) [3], it seems possible that lipids influence the function of other components of vernix. It has been demonstrated that other factors such as salts and pH, influence the conformation of the human cathelicidin LL-37 [23]. Therefore we speculate that the lipid fraction of vernix can exhibit similar functions. Under our experimental conditions, lipids isolated from vernix enhanced the antimicrobial potency of LL-37. Thus, LL-37 can be active in a lipid-rich environment.
When studying the antimicrobial activity in peptide/protein extracts of vernix, we found a high antimicrobial activity against bacteria and fungi. The most active antibacterial compound against E. coliand GBS in these samples was isolated and identified as chlorhexidine. Chlorhexidine is a microbicidal substance of vaginal cream used as a lubricant during vaginal examination prior to delivery. For this reason, some of the vernix samples were found to contain chlorhexidine. We noted that the samples with E. coli activity.
In conclusion, we have characterized proteins and lipids that add novel protective functions to vernix, such as antifungal properties, opsonizing features, protease inhibiton, and parasite inactivation. In addition, the antimicrobial action of LL-37 can be potentiated by the lipids in vernix in vitro, stressing the importance of the microenvironment for the function of antimicrobial components.
 
 
Acknowledgements:
This work was supported by grants from The Icelandic Research Fund for Graduate Students, The Swedish Foundation for International Cooperation in Research and Higher Education (STINT), and The Swedish Research Council (no. 11217, 13X-3532). We thank Ella Cederlund, Carina Palmberg, Marie Ståhlberg, Gunvor Alvelius, and Monica Lindh for excellent assistance. We also thank Milan Chromek and Annelie Brauner, for the GBS strain.

Childbirth Classes

May 5, 2009

I’d be a fool if I didn’t post my next series of Childbirth Classes here!!

Beginning Tuesday 5/12-6/16. We’re metting at 7:30pm at my home. I will have several guest speakers this time. This 6 week series will be a “mixed bag” of both home and hospital birthers.

please see the website for more detail. It’s been recently updated: www.birthteacher.com

zraesboy23


First C-section

May 5, 2009

I’ve recently attended my first C-section as a doula and it was quite the event.

The mama and her family worked so hard and for so long, but as it is in many places and with induced births (even the medically necessary ones) sometimes a surgical birth is necessary.

Parents are doing well, baby is a ray of light. Everyone is recovering!

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Home births ‘as safe as hospital’

April 16, 2009

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

http://news.bbc.co.uk/2/hi/health/7998417.stm

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

FROM THE TODAY PROGRAMME

More from Today programme

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

The NHS is simply not set up to meet the potential demand for home births

Louise Silverton
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital

RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”


MOre MOthers Opting to Eat their Own Placentas

March 20, 2009

http://cbs4.com/health/mothers.eat.placenta.2.908100.html

Giving birth can take a toll on new mothers, especially after the baby arrives. Studies have shown nearly a quarter of all new moms experience some degree of postpartum depression. To combat the symptoms, some women have chosen a controversial approach – the ingestion of the human placenta.

Sage Khouerie admitted she was concerned about giving birth after the age of 40. So the 41-year old chose to ingest her placenta to avoid postpartum symptoms; the action of doing so is called placentaphagy.

“I was 40 when I delivered. I thought ‘Wow, this could be a little tougher on me than a younger woman and I want to be open to anything that would make it easier’,” said Khouerie.

The placenta, an organ about the size of a dinner plate, delivers nutrients from the mother to the child during gestation. Some mothers have chosen to eat it after childbirth, while others have cooked it and ground it into pill form.

Naeemah Jones is a doula (an assistant who provides various forms of non-medical support in the childbirth process) who helps new moms understand the benefits of the process. She feels ingestion of the placenta can decrease the negative symptoms that can occur after childbirth.

“Hair loss, a very small amount of breast milk,” said Jones, “(placentaphagy) helps produce more breast milk, it get the balance of the hormones together, it’s like a happy pill for the moms.”

Laura Taylor, 36, has three children but only chose to ingest her placenta after giving birth to her third child.

“So when I took them this time, I never had such a wonderful recovery after having a baby,” said Taylor.

While most mammals eat their own placenta, no studies have been done on the health benefits of human placentaphagy. Still, it’s growing in popularity. Jones says “now new parents are doing their homework, they are finding out they have choices.”

Research has shown that the practice is safe as long as mothers ingest their own placenta. There are some alternative medicines that include human placentas but those should be avoided due to a high risk factor.

(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)


LOCAL PREGNANCY FAIR

March 7, 2009

Who wants to meet me? Who needs to interview 6-10 doulas in the same day at the same place?

The perfect place to meet all the local birth professionals in one place! There will be massage therapists, midwives, Child Birth Educators and Doulas and other associated vendors.

Saturday, March 14 11-2pm
Baby Depot at the Citadel Mall.

THIS IS A FREE EVENT

Find a variety of Resources for Expectant Parents! Information on your New baby, pregnancy, Labor, Birth and more!!

Free Resource Guide: Birth and Beyond 2009 Provided by Colorado Springs Birth Newtwork

Enter to Win a prize courtesy of Baby Depot!

I’m giving away an asian style carrier:

xxsling