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Wed, 26 Jul 2006 08:49:09 -0400 |
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I agree that high risk mothers need the option of hospital care, but we
should still do what we can to make hospital care more responsive to the
needs of the newborn for contact with his or her mother, and promote as
much autonomy as possible for birthing moms. As well as educating staff
to help with breastfeeding. I have the utmost respect for those of you
that are working so hard to see that these things happen at your
institution.
Remember though that neonatal encephalopathy (babes without any gag,
blink or suck reflexes, with altered level of consciousness, etc) is not
necessarily a result of birth asphyxia. We used to think it was, but the
terminology has been changed to reflect the new understanding that the
brain injury could have happened any time.
I have one little one in my practice who clearly had a prenatal event
(mom noticed she stopped moving as much, her doc took her seriously and
checked it out, the baby's reactivity was poor, they delivered by rapid
Cesarean and the baby has bilateral brain injury. She's progressing, but
definitely has motor issues, and perhaps cognitive ones as well).
Another babe that I'm seeing with a colleague had a beautiful home
birth, no distress, but a few hours after birth the midwife did not like
how he looked and transported him to the hospital with his mom. He
started seizing and had the whole scary gamut of encephalopathy
symptoms. He is recovering well, and has just begun breastfeeding at
about 5-6 mos. Yet another child had a prenatal stroke and has mild CP
and had seizures until he had half his hippocampus removed on the
injured side.
Catherine Watson Genna, IBCLC NYC
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