Ramdan - Fasting with Child (ren)

This is a re-post from last year's Ramadan. The information is still the same and insha'Allah of benefit to some of you. Thank so much for all of your well wishes. Ya Sin and I are enjoying our lie-in. I hope to return to this space more regularly soon!  An early Ramadan Mubarak to all of you. Please keep us in your du'as. 

Ramadan's many lights and gifts will be here in a matter of weeks. One of the questions I am often asked by pregnant and nursing women is whether or not they should fast in Ramadan. This post is not meant to encourage or discourage women from fasting, rather it is to provide information that can help mothers stay healthy if they decide to undertake even a few days of fasting.

Many women say that they would rather fast when everyone else is fasting instead of making their fasts up later. If you are one of those women, I hope this can help prepare you physically for the fast of Ramadan. Studies conducted about pregnant women fasting in Ramadan have found no adverse outcomes in the baby's birth weights, length, and head circumference. The fast of Ramadan also has not been found to adversely effect milk supply in lactating women, although it can alter the content of breast milk, but without affecting infant growth.

Pregnancy can be a challenging time to fast depending on when the fast falls in your gestation. Nina Planck, a real food expert and author, has written a wonderful book called Real Food for Mothers and Babies that breaks up pregnancy's nutritional needs by trimester. Planck says that in the first trimester, when the organs of your baby are developing, your embryo needs minerals to become a strong fetus. The bones and muscles are doing most of the growing in the second trimester, so your baby needs calcium and protein rich foods. In the third trimester, the eyes, brain, and nervous system are rapidly developing; fats high in Omega 3's will aid this growth.

If we base our Ramadan diet on Planck's demarcations, what are the best foods to nourish you and baby in each trimester? Fasting in Ramadan offers us only a few exchanges with food, so we need to make each of these encounters nutrient dense and filled with what our growing babes need. You will notice a theme throughout my recommendations and that is good fats and protein. Good fats include, coconut oils, olive oils, fish oils, butter, and tallow. Your baby's development needs cholesterol. You need good fats and protein to support this. This duo also supports mother's in their health and well being through pregnancy, therefore you will see multiple mentions of healthy fats and proteins.

In the first trimester many women often need to eat constantly to keep nausea at bay. Others do better with no food. Either way, your baby has to grow. If you choose to fast during this time, I really like a few foods to help you out. Much of nausea comes from hunger. When you eat, eat foods filled with protein and good, healthy fats. For the suhoor, the morning meal before dawn, try any of the following:

• Smoothies with egg yolks, coconut oil, milk, and yogurt and lots of fresh fruit. The fruit will give you plenty of the micro-nutrients which your baby's organs need and the yolks, oils, and yogurt will give you good fats and proteins for fuel throughout the fast.
• Eggs are a great suhoor meal for pregnant women. Make an omelette with lots of vegetables -- again this will give you a mix of micro-nutrients and protein.
• Oatmeal with lots of butter, cream, milk, or coconut milk. Add nuts and fruits for a complete suhoor.
• I do recommend eating at least three times a day in Ramadan, the suhoor meal, an iftar meal, and then again about an hour before going to bed. This still provides the same caloric intake, albeit not at the regular times you usually eat.

The first trimester is a big adjustment. Take it easy and don't push yourself to exhaustion. Read my post on the first trimester, where you will find many tips that you can do while fasting. I personally think essential oils, like lavender, ginger, and geranium go a long way in helping with nausea, fasting or not. Also, fresh air can alleviate nausea for many women. Get out and go for a walk right before you break the fast.

When Ramadan falls in the second trimester, it is perhaps the easiest time for you to fast while pregnant; the nausea has mostly passed, and you have regained some of your energy but don't yet feel uncomfortable from the weight of your baby. Here are some general tips for fasting and breaking your fast in the second trimester.

• If you can, try to switch your nights and days. During the day, stay inactive and rest as much as you can. If you need to do anything active, like clean or cook, wait until shortly before the sun sets so that you can eat and drink soon after.
• Try fasting every other day.
• Do gentle exercises like yoga, tai chi, or walking shortly before the sun sets.
• Don't skimp out on sleep! This is hard in Ramadan, especially during the summer months, but try your best not to exhaust yourself.
• Because protein and calcium are important this trimester, be sure to include lots of protein rich foods in your meals. Meats, broths, eggs, and lentils are wonderful and healthy choices.
• Calcium rich snacks can be eaten between iftar and bedtime. Almonds, warmed milk with cinnamon, ginger and a pinch of sugar, yogurt with fruit.
• Dates, the traditional food to break the fast with, are an excellent way of revitalizing the body after a day of fasting. High in potassium, iron, anti-oxidants, and other minerals, they are also perfect as a second trimester treat.

The third trimester is perhaps the trickiest time to fast. There have been studies that have found that fasting in late pregnancy causes a state of 'accelerated starvation.' We should know that our bodies are working hard during this time; the baby's nervous system is developing connections between neurons, its brain folds are forming rapidly, and its gaining more and more motor control each day. All this while it is packing on half a pound every week. All of this requires an enormous amount of caloric input, so it makes sense that this trimester would be a difficult time to abstain from food. Also, labor could begin at any moment in this trimester. Beginning labor with a caloric deficit is adding an extra challenge to the challenging physical task of labor. Despite that, some women will fast. Whether or not you fast, here are foods that help build healthy brains for your baby:

• Try eating fish when you break your fast. Fish is easy to prepare and full of healthy fats well suited for growing noggins. Check out Seafood Watch for more information on which fish is best for you and the environment.
• I love herbal infusions in pregnancy. They are especially great for women facing the great task of birth, and subsequent mothering. Alfalfa, red raspberry leaf, nettles, and oatstraw are wonderful third trimester choices. Drink them mixed or separately. They contain an amazing amount of minerals and micro-nutrients, all of which saturate your tissues and muscles with nutrients that help them work efficiently in labor.
• Egg yolks, butter, whole fat milk, and all other foods rich in cholesterol can be considered brain food. So go ahead and have eggs and toast with lots of butter for suhoor. Your baby will be smarter;)!

Staying hydrated is actually a bigger concern than caloric intake for fasting pregnant and nursing women. Abstaining from water all day can be a real challenge while pregnant and/or nursing. I suggest that when you eat in the morning and in the evening, drink an electrolyte drink, preferably not Gatorade as it has tons of sugar and other undesirable preservatives. Try this mixed in your water. Coconut water is another refreshing way to replenish your electrolytes. Vitamin Water and Re-Charge are also good choices. Electrolytes help the water replenish and hydrate you. Without them it often seems that the water just rushes through you!


Nursing and fasting is often more difficult than pregnant while fasting. That is simply because while nursing, you also have to change diapers, push the stroller, and carry and nurse the baby. There is more work involved! All of the above recommendations can apply to nursing women. Along with a few of these:

• Add one tablespoon of coconut oil a day. You can eat it directly off the spoon. Lauric acid is the main ingredient in coconut oil. Lauric acid is a medium chain fatty acid, the primary component in breast milk. This can help keep your breast milk full of the nutrients your baby deserves.
• Focus on hydration. You will feel thirsty due to the hormones of breastfeeding, primarily prolactin. When you are not fasting, always keep a bottle of water with you and electrolytes are a must. The above mentioned studies have found that lactating women hydrate more than non-lactating women in Ramadan. Remember that and drink to thirst.
• Stay away from the fried offerings always so present at iftar gatherings. Often they are fried in unhealthy fats full of trans-fats. Trans-fats are easily transferred to breast milk. Be mindful of healthy fats and fulfill your fat cravings in other healthier ways such as butter, meats, fish, and eggs.

Ramadan, however, is not only about the physical fast. Fasting also takes place on the spiritual plane. Fast from the fast-paced world for your baby's sake. Slow down and retreat deep into the stillness of spiritual practices and a beautiful remembrance. This more than anything is what nourishes mothers and babies, whether or not they fast during Ramadan. I pray you all have a blessed month full of vast openings and a renewed closeness to God. Please remember me in your prayers.

What Gets the Baby In...A Birth Story

"What gets the baby in, gets the baby out"

-Ina May Gaskin - founder of modern American midwifery

"...sexuality is a whole.  The same hormones are involved in the different episodes of sexual life such as intercourse, childbirth, and lactation....The final phase of each sexual event is always an 'ejection reflex': sperm ejection reflex, foetus ejection reflex, milk ejection reflex. 

-Michel Odent from The Farmer and the Obstetrician

I was awoken at around 2 am by a phone call from Kim (you can read her awesome rendition of giving birth here)  Expecting her second baby any day, I was waiting for her phone call.  

"I couldn't sleep so I had sex.  After we were done, my contractions started coming every five minutes.  I swear, I wasn't trying to bring on labor!"  Kim laughingly told me. I listened through a couple of contractions then told her to change positions, maybe try a shower and call me in half an hour to see if things slowed down, or picked up, or what.  I was thinking that things would peter out after her hormones calmed down.  Oh, how I love to be proven wrong.

My somewhat rule is that if the dad calls you during labor, it's go time.  About twenty minutes later, the phone rang.  Mike's Irish lilt turning serious told me that things were picking up and it looked like labor.  I could hear Kim moaning through a contraction in the background. Wonderful!  I told him to call the doula, and that I would get myself and my things together and head over.   

As  I was approaching the lights and wonder that is crossing the Bay Bridge in the wee hours, the doula called.  My other somewhat rule (because can birth really have rules?) is that if the doula calls, I better step on it.  Britt informed me that Kim was indeed active and that they just wanted to make sure that I was on my way.  Yes, I was, ten minutes I said.  I went as fast as feels safe over a bridge and through city streets.  

It was a lovely night to be born, a chill, crisp March evening.  Entering Kim's birth space was truly magical.  Kim is an artist. She makes each and every thing she does an act of beauty, creation, and meaning.  From our first visit her birth space and how it looked was of utmost importance to her and her husband.  She came through.  The tub had been moved into their living space. Candles, with inspiring collages and quotes from Kim's myriad friends, filled the room with love and light.  Music, which I never would have pegged as birth music, but suited the moment perfectly livened the mood.  Kim was on the bed hands and knees.  I threw my things down to say hello and have a quick listen.  As soon as I did that Kim let out a deep, sonorous yet guttural sound signalling that the power of birth was moving through her. My midwife ears heard it and I peeked at her perineum, indeed it was bulging with a soul determined to take it's place in the family, and soon!  

Kim made it clear that she wanted in the tub.  She was so relaxed and in control, yet totally surrendered. She had a vision of her birth, and she was going to make it happen if at all possible.  We moved her into the tub with the head sooo low! It was the perfect ending to a whirlwind labor.  The contractions slowed a wee bit, just in time to wake big sister.  Kim moved to hands and knees in the water.  With a couple of pushes, her son's head was out, witnessed by all in attendance, including her two year old pajama footed daughter.  I reached down to help with the body and sweep him through to mama's waiting arms.

And just like that, it was done, a circle of love completed.  Truly Kim's birth was an illustration that birth is not separate from sexuality, that it draws from it, and intimately relies on it.   It was an honor to see, and a privilege to so clearly observe a truth about women's bodies and their hormones, we are indeed vessels of love. 

Secret Weapon(s) against Thrush

 

There it is, my secret weapon against thrush, particularly thrush diaper rash. A spray bottle, some water, and some tea tree, or sometimes called melaleuca, essential oil.  Spray it on after wiping and let it soak in. It is naturally anti fungal and works wonders.  I use about 5 drops to 1 cup of filtered water.  This would also work for nipples infected with thrush, just spray it on after feeding and let air dry.  Reapply as needed.  

If only thrush really were combated with a spray bottle! Thrush is a fungus that doesn't seem to want to relocate once established.  It just wants to take up more and more space.  Thrush, or yeast, is often an under diagnosed reason for sore nipples. If you have sore nipples despite good milk transfer, and a comfortable latch, try looking at some of the remedies below, it just might cure those ouchy nipples!If your baby has a diaper rash that won't go away despite preventative measures, and looks more like red raised bumps than just redness, your baby could have a diaper rash caused by yeast.  Infants can get yeast in their mouth as well.  This is identified by white, plaque-like spots that don't go away when wiped off. If your baby is struggling with either of those, try the list below and see if it doesn't help. 

Photo Credit

• Dietary changes are the first line of defense, namely, cutting out all sugars and refined carbs.  When you are nursing it can be hard to eat good, wholesome food all of the time. Sometimes sugar seems like the quickest way to acquire energy to get the next thing done, but it never pays off.  Yeast thrives off of sugar and will continue to prosper in a body fed with sugar.  Sugar substitutes are often okay during the time you are killing off the yeast, also known as candida.  Maple syrup, honey, raw agave nectar, and coconut palm sugar can be okay for some women, but use your common sense and listen to your body. You will usually notice a flair up almost immediately if you are taking in too much sugar. Babies too, must cut out sugar in their diet while attempting to kill any yeast.  For them this would be no fruits or grains if they are on solids, if not, they will benefit from your new found sugar freedom!
• Probiotics are beneficial bacteria that crowd out the yeast in your system.  They can be taken in supplemental form, which if the situation is chronic, is warranted, or in food form.  Either way increase your intake. Yogurt, kefir, sauerkraut, lactofermented vegetables, fermented pickles (see picture, yum!) and kombucha, all contain yeast fighting probiotic strains. Saccharomyces boulardii is a particular probiotic strain that excels at fighting yeast.  As a nursing mother battling with yeast, I highly recommend adding this to your regimen. If not a broader spectrum probiotic will do too.  Infants and babies can also benefit from probiotic supplements.
• Diluted grapefruit seed extract on your nipple, and/or baby's diaper rash, s is also a great way to beat thrush. Check out this article for more detailed information on how exactly to dilute the grapefruit seed extract, how to apply, and what type is most effective. 
• The homeopathic remedy Borax is another way to ward off yeast.  It can be given to both mother and baby.  The best way to take it is to dissolve a couple of pellets in a glass of water.  Sip on this water throughout the day.  It's also the easiest way to give it to babies. If they are young enough you can put it in an eyedropper for them.  
• Yin Care is a blend of Chinese herbs that are a powerhouse of antifungal, antimicrobial plants.  This can be used anywhere candida lurks. It also can heal sore nipples caused by bacteria as well.  Yin Care is excellent for tons of skin conditions from eczema to hives.  I highly recommend keeping a bottle in your house. A little bottle goes along way as it has to be diluted before use.  It can be applied with a spray bottle, a cotton ball, or a gauze pad. 
• Finally, thyme essential oil is a great anti-fungal.  Dilute a few drops in a teaspoon of oil and apply to nipples or diaper rash (just use one or two drops for the diaper rash as it is powerful stuff). 

This is by no means a comprehensive list, but a few effective measures you can take in your battle against yeast.  Arm yourself with a spray bottle, cut out sugar, and be firm, you will come out victorious!!

This post was featured in Healthy Home Economist's Monday Mania.

The Healing Hour

No matter what type of birth you have, the first hour after birth is meant to be savored. Both mother and baby have made it. The hard work is over and the instinctual acts of attachment and bonding are about to begin. Baby has so much work to do, learn to breathe, digest, find the food, etc..but these lessons have not begun yet. Think of this hour as an exhale, a big exhale after the bated breath of labor. No one needs to intervene, weigh, assess, or even show the baby where he is to get his nourishment from. Mom and baby know exactly what they are doing, it is a state of expansion after the contraction(s) of labor.

Recently, a fellow midwife deemed this hour, 'the healing hour'. Labor is a huge event, mother and child each feeling the grandness, and difficulty of it, well, they just need a moment to catch their breaths. An hour is not an exact measurement, but I find it nice to really try to guard that sixty minutes closely. Today's world moves fast enough, it impinges on every area of our life as it is, birth should be an exemption. For one hour, no visitors, no texts, no phone calls. Take advantage of the biological imperatives so firing in these moments, the baby's alert state, her large searching eyes, mother's oxytocin level the highest it will be in her life, take these and so many other reasons and fall in love. It is a love that cannot be weighed, swaddled, assessed, but one that in the moments after birth is begging to happen.

If this isn't enough reason to keep antsy nurses and fidgety midwives at bay, here are some more by the legendary Michel Odent. I have summed them up and clarified in certain instances. The full article can be found here.

1. Baby needs to breathe. Who is a better teacher of this, mom or incubator?

2. A short but crucial period, that will never be repeated. Ethologists have observed this period in birds and mammals and have concluded that it should never be disturbed. Why do we disturb it?

3. The first hour as the beginning of lactation. Babies have instincts too. Place them tummy to tummy between mom's breasts and watch them find their own nourishment. Also skin to skin has been shown to increase success in breastfeeding.


4. Metabolic adaptation. Babies use less of their precious glucose and fat when on mother. They use more when screaming from across the room, or being passed around to relatives. They can enter hour 2.


5. Thermoregulation. Babies stay warmer on mom, and they also learn how to keep themselves warm when sleeping near her. The womb didn't have great temperature variations, so they must adapt to the extremes on the outside and it takes awhile for them to be able to do that.

6. The bacteria. When placed skin to skin baby starts to colonize mom's bacteria, the bacteria he/she will be living with, and already has antibodies to from it's time in the womb. This is extremely important for babies future health.


7. "The greater the social need for aggression and an ability to destroy life, the more intrusive the rituals and beliefs are in the period surrounding birth." Wow! No comment!


I keenly remember each of my children in this first hour, both unique and different, yet I still see it in them now. These moments you can't have back. Talk to your midwife or doctor about this hour before you deliver. Tell them you want to postpone the weighing and measuring and any assessments until afterwards. Have a no cell phone rule in this hour. Everyone can wait, but your baby is present now, and he is looking for his mother, he is looking for home.

The Big Stretch - A Film Review

The Big Stretch, an Australian DVD, has done what many other childbirth DVD's fail to do - it has given the voice and authority of women, to women rather than experts. Twelve mothers tell how pregnancy, labor and postpartum 'stretched' them physically, emotionally, and spiritually. As a mother myself, I found most of their insights incredibly apt and useful. There are first time mothers, sixth time mothers and everything in between. Although all of them used midwives and had home births (but one, who tells with raw emotion what a hospital transfer was like for her), that is not the point of the video, in fact home birth is never directly mentioned or promoted.

From conception to operating on little sleep, mothering is a reworking of most of our internal structures, literally and metaphorically. It takes a lot of you to welcome another being into the world. As one woman said in the film, " I feel like I just went from being a girl to being a woman." That's a beautiful and desirous thing. For it's straight talk on labor pains, breastfeeding, and postpartum emotions, I recommend this for first time moms. For the real anxieties associated with subsequent mothering (will I be able to do it?, how will the other kids cope?), I recommend this for experienced moms.

The setting is lush, green and tropical, fertile actually - an appropriate setting for a film on birthing women! There is a lot of nudity in the film, nudity that doesn't have to do with birthing women. I'm not sure the reason for this, maybe the tropical environment. Or maybe it was to push the limits of the viewer, to 'stretch' our boundaries so to speak, which is something this film does quite well. The Big Stretch forces women to step into the shoes of mothers and walk with them for a spell, listen to their fears and triumphs, laugh and marvel at what they become, and in so doing, honor what we as mother's can also become; stretched, still ourselves, but larger, languid, and less rigid.

Hakima Midwifery is Expanding Services!!

I'm so excited to announce that I am now offering two new services at Hakima Midwifery. In July I took a grueling exam, passed, and am now officially an IBCLC, or an International Board Certified Lactation Consultant!! I am so excited to be working with moms and babes to help cement their breastfeeding relationship. I do in home lactation consultations as well as Skype visits. Skype visits are great for women overseas, or in areas where lactation consultations are not available. They are also great for follow up visits. Here is more information about the visits.

After having my second water birth, I am an even bigger water birth aficionado. So much so, that I have decided to rent out birth tubs. And not just any birth tubs, eco birth tubs! They are the same tub I delivered my little girl in, and they are just so amazing. There is no harmful plastics, no off gassing, and the sides are so firm, offering the laboring mama wonderful support. Here is the link with tons more information.

Thanks all for your support. Please contact me with any questions and spread the good word!

Mom I Am

I couldn't find an author to credit for this poem, so whoever you are, thank you! This is humorous and right on. Enjoy, and enjoy your weekend!!

Dr. Seuss for Nursing Moms

Would you nurse her in the park?
Would you nurse him in the dark?
Would you nurse him with a Boppy?
And when your boobs are feeling floppy?

I would nurse him in the park,
I would nurse her in the dark.
I’d nurse with or without a Boppy.
Floppy boobs will never stop me.

Can you nurse with your seat belt on?
Can you nurse from dusk till dawn?
Though she may pinch me, bite me, pull,
I will nurse her `till she’s full!

Can you nurse and make some soup?
Can you nurse and feed the group?
It makes her healthy strong and smart,
Mommy’s milk is the best start!

Would you nurse him at the game?
Would you nurse her in the rain?
In front of those who dare complain?
I would nurse him at the game.
I would nurse her in the rain.

As for those who protest lactation,
I have the perfect explanation.
Mommy’s milk is tailor made
It’s the perfect food, you need no aid.

Some may scoff and some may wriggle,
Avert their eyes or even giggle.
To those who can be cruel and rude,
Remind them breast’s the perfect food!

I would never scoff or giggle,
Roll my eyes or even wiggle!
I would not be so crass or crude,
I KNOW that this milk’s the perfect food!

We make the amount we need
The perfect temp for every feed.
There’s no compare to milk from breast-
The perfect food, above the rest.

Those sweet nursing smiles are oh so sweet,
Mommy’s milk is such a treat.
Human milk just can’t be beat.

I will nurse, in any case,
On the street or in your face.
I will not let my baby cry,
I’ll meet her needs, I’ll always try.
It’s not about what’s good for you,
It’s best for babies, through and through.

I will nurse her in my home,
I will nurse her when I roam.
Leave me be lads and ma’am.
I will nurse her, Mom I am.

Good Bacteria

This article came out a few months back, but time has not diminished my amazement! Of the myriad species specific qualities that breastmilk possesses, one of the more fascinating is the 'probiotic' qualities. A newborn, born with a very sterile gut, lands in a world full of bacteria, good and bad. The probiotic qualities of breastmilk, or the good bacteria in breastmilk, sufficiently protect newborns from a host of sometimes lethal gastrointestinal diseases. The recently discovered, bifidobacterium longus, passes through breastmilk to the infant, and on its way out, coats the babies intestine with a protective coating, thereby serving the role of stomach acid, a substance babies don't yet possess much of. This coating acts as a decoy to potential bacteria and viruses, coaxing it to bypass the baby's gut.

Dr. E. Stephen Buescher, a pediatrician and scholar of breastmilk's many anti-infective and ant-inflammatory qualities, has an interesting theory as to why this protective coating not only benefits the gut, but also may contribute to the dramatic reduction in ear infections in breastfed infants. He had an exclusively breastfed son who spit up, a lot. After watching a plethora of spit up episodes, ones that sometimes exited the nasal orifices, he reasoned that the breastmilk when spit up was coating the upper respiratory tract with all of it's soothing and protective qualities, just like it coats the intestine. Embrace the spit up. It's better than an ear infection!

Scientists are beginning to understanding that breastmilk can serve as a lesson plan for how to nourish and protect the human body against pathogens, not just in babies. It is after all a food, specifically designed for humans, and the most vulnerable, swiftest growing of humans. The researchers aren't sure what happens, or where these bifidobacterium bacteria hide out in adults. But probiotic supplementation in America is a booming business, sales of it tripled between 1994 and 2003. Perhaps we could save our children some money in their future, by breastfeeding them now. As one of the researchers so eloquently summed it up, "It’s all there for a purpose, though we’re still figuring out what that purpose is,” Dr. Mills said. “So for God’s sake, please breast-feed.”

Nursing on Both Sides

And because I love this life

I know I shall love death as well.

The child cries out when

From the right breast the mother

Takes it away, in the very next moment

To find in the left one

Its consolation.


-Rabindranath Tagore
from Gitanjali

Labor Popsicles and Lactation Cookies

Eid Mubarak! Maybe because the past few days have been all about food, I've decided to bring you a food post, replete with recipes! Let's start with the labor pops. This is a simple way to stay both hydrated, and nourished throughout labor. Many women experience nausea with contractions, and these labor pops are a great way to head that off. The coolness is also refreshing and easy to take in.

You'll need:

1-2 oz of dried red raspberry leaf
1 quart of water
Quart size jar with lid
Honey and lemon to taste
2-3 1mg calcium tablets
ice tray

To make the labor pops, steep 1-2 ounces of red raspberry leaf in a quart of water for at least 20 minutes up to four hours. Strain and sweeten with lots of honey and lemon, these will add much needed calories and lemon can help ease the nausea (as well as the red raspberry leaf). Crush the calcium tablets and add to the tea. Calcium is a muscle relaxant and can help with some aches and pains during labor. Pour the mixture into the ice tray. When labor commences, eat throughout the labor. They really are easy to eat when nothing else sounds to good!


Lactation cookies purportedly can increase and/or maintain milk supply. I find them more of an excuse to eat cookies, but, oh what a great excuse! They are also nice to just have around to snack on, or take with you while on the go; an easy way to up your calorie intake while nursing. And they happen to taste really, really good. Here is a recipe that I like and that makes enough to feed everyone in your house. Just don't tell them they are 'lactation cookies'!

• 1 cup butter
• 1 cup sugar
• 1 cup firmly packed brown sugar
• 4 tablespoons water
• 2 tablespoons flax seed meal
• 2 eggs
• 1 teaspoon vanilla
• 2 cups flour
• 1 teaspoon baking soda
• 1 teaspoon salt
• 3 cups oats
• 1 cup chocolate chips
• 2 -4 tablespoons brewer's yeast

1. Preheat oven to 350°.
2. Mix the flaxseed meal and water and let sit for 3-5 minutes.
3. Beat butter, sugar, and brown sugar well.
4. Add eggs and mix well.
5. Add flaxseed mix and vanilla, beat well.
6. Sift together flour, brewers yeast, baking soda, and salt.
7. Add dry ingredients to butter mix.
8. Stir in oats and chips.
9. Scoop onto baking sheet.
10. Bake for 12 minutes.
11. Let set for a couple minutes then remove from tray.

I hope you enjoy these recipes as much as I have! Finally, here's a beautifully portrayed home birth of one Leo Hart. Scroll down to see the video, it's well worth it. Have a great weekend!
















photo: watermelon and cucumber popsicles by rakka and cookies by ilmungo

Mother Roasting

Please check out my article entitled, "Mother Roasting" at Rhythm of the Home's fabulous and inspiring online parenting/craft magazine. My article contains a how-to on preparing a nurturing postpartum gift basket, or experience for you or a friend. It also speaks a bit about postpartum practices worldwide, where warmth and nourishing of new mothers and babies is an art form.

There are some intriguing articles and craft tutorials from this season's edition that I can't wait to dive into. If you've been directed here from Rhythm of the Home, welcome and thanks for visiting!

World Breastfeeding Week

Piknikas by c r z

Happy World Breastfeeding Week! Every year, the first week in August is World Breastfeeding Week. Among other things, the purpose of this week is to highlight the ten steps to successful breastfeeding, which are part of the Baby Friendly Hospital Initiative. The World Health Organization and UNICEF started this initiative in 1991 to encourage hospitals to engage in birth and immediate postpartum practices which encourage exclusive breastfeeding. Of the 19,000 facilities worldwide, the US has a mere 63.

If a hospital birth is in your future, I strongly encourage you to consult this list of the US Baby Friendly hospitals and deliver there. At the birth center, we take our transfers to one of two Baby Friendly hospitals in the Bay Area. It is a display of excellence in maternity care. Women and babies are treated as they should be, an inseparable dyad (unless, of course, medically indicated). Because un-medicated, natural, vaginal births have higher rates of success in regards to initiating breastfeeding, these hospitals tend to support natural births, and offer less interventions. Here are the 10 steps to successful breastfeeding:

1. Have a written breastfeeding policy that is routinely communicated to all healthcare staff.

2. Train all healthcare staff in skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within an hour of birth.

5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.

6. Give newborn infants no food or drink other than breast milk, unless medically indicated.

7. Practice rooming-in - allow mothers and infants to remain together 24 hours a day.

8. Encourage breastfeeding on demand.

9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.


Sounds an awful lot like what we do at a home birth!! Maybe that's why our exclusive breastfeeding rates this past year were 99% at 'discharge' and 85% at six months, well above the national average. Enjoy the rest of the week and pat yourself on the back if you're breastfeeding. Way to go mom!!

The Frog Leg Position

Sling Baby by N.R.


Dear readers, I'm so sorry for my absence these days! I am in the midst of studying for a big exam, not to mention being mama to my new babe! I hope you are enjoying the hot summer. My exam is over at the end of the month, so in the meantime, a little tidbit on baby wearing. Enjoy!

Soon after my daughter was born I received this sling as a gift. Besides being a phenomenal (and pretty!) way to carry your baby, it comes with a slew of information on the benefits and justifications for baby wearing. One of the most fascinating arguments for why babies should be carried is simply physical. They title it, The Frog Leg Position. The idea is that babies physical bodies are a sign to us that they should be carried, rather than bumped around in their car seat all day. And, that their frog legs are developmentally geared towards being carried. Their rounded backs, frog legs, and palmar grasp reflex, are cues to us clueless parents, "Carry me!"

To quote from the Didymos booklet, "....infants are especially adapted to being carried on and against our body. Thus, it is possible to make a statement about the carrying position: with widespread flexed legs, slightly rounded back and oriented towards the carrying adult." This is a good proof to me that babies were created to be carried. Ever try stuffing a baby in their car seat, they don't fit so well. And they don't like it!

Recently, there have been a spate of sling recalls. Mothering magazine addressed the issue in an hour long podcast found here. Slings are becoming increasingly popular in America and with that popularity, there has been an increase in sling manufacturers. Most of the slings recalled are the slings newer to the baby wearing market, the slings that have not withstood the test of time.

There are so many benefits to wearing your baby. I recall being in Senegal, where women wear their babies on their backs constantly, starting from the day they leave the birthing clinic until they are about two, and not being able to hear a baby cry at all. In the middle of the rural Senegalese street, you couldn't hear a pin drop, much less a baby cry. I would attribute much of this to the ubiquitous baby wearing. Strollers and car seats would be greeted with riotous laughter there. Here are some more great benefits that result from baby wearing. This is a picture of my son as a babe, being carried by one of the midwives, Khadija, in Senegal. See how much he liked it!! I hope you and your babies enjoy lots of baby wearing, those days go so fast. Here's a good website with lots of different types of slings, and the pros and cons of each. I'll be back regularly in a couple of weeks. Thanks!!

A Noisy Postpartum

crying-baby by bbuanach



After I had my daughter, my midwife checked both of us out, and satisfied with the health of me and my girl, tucked us snuggly into bed to rest. She then walked down to our local coffee shop and picked everyone up a latte. I got freshly picked wildflowers in lieu of the caffeine. We then proceeded to snack on fresh berries, cheese and crackers while chatting. There was a soft morning breeze blowing through my window and I could hear the pigeons cooing.

That was after my home birth. If I had had a hospital birth, it would've not only looked different, but it would have sounded different. My labor would have been accompanied by at the very least, the thumping rhythm of the fetal monitor, the beep of aforementioned monitor when the paper ran out, and the constant introductions of nurses, doctors, and pediatricians. My postpartum room most likely would have been shared with another mother, who may or may not have had a slew of visitors, and who may or may not have had a penchant for television watching. And again, there would be a new face and name introducing itself, at least every 12 hours or so. The coffee would have been terrible, and the flowers an elevator's ride away.

That's to mention nothing of the cries of not only my baby, but possibly my roommates baby too. Recent findings are now claiming that the noise of the hospital can be detrimental to health, not to mention recovery from birth. Take a look at this brilliant study and analysis of the decibel level of labor and delivery, and postpartum units in American hospitals. I love her idea of a postpartum lounge for new mothers to congregate in after they birth their babies. Although, I think even this might be a bit much for new mothers - it takes a considerable amount of energy to interact with strangers, especially in the precious moments after one has a baby. Still, I think that her nod towards other postpartum cultural practices, and their strict emphasis on calm, quiet, and rest for the new mother and baby, is an important and lacking one here in America. For most women here, it's back to 'normal' at about seven days postpartum. In contrast look at these practices from around the world.

• In Sudan mothers are treated to 40 days of rest, and beautification, treatment very similar to what a new bride in Sudan receives. They are served a fenugreek pudding, believed to encourage breast milk production and make one fat, something desired in Sudan! The treatment is thought to allow them to exit their 40 days feeling beautiful and rested.
• In Indonesia, the mother does not enter the kitchen or wash until the umbilical cord has shriveled and fallen. This ensures rest for her. The husband does not sleep for three days as he must guard the mother and baby. How about that for a taste of sleep deprivation for the partner!
• In India trained women come to the house and perform warm oil massages for mother and baby. It is believed to reduce colic in infants and preserve a woman's life long health. They also believe in resting for 40 days. Their are many special foods associated with the postpartum period.
• It is Holland I believe, who takes the cake for postpartum care. There a women receives a kraamverpleegsters, a postpartum nurse, who comes to the house all day long for eight days. This is paid for by the government. She helps with everything from breastfeeding, advising on infant care, to laundry and cooking! She even manages the flow of visitors.

With all of this care, I'd be surprised if a baby ever cried in these countries! I hope that hospital administrators and anyone involved with postpartum mothers, would look at the above examples for inspiration and guidance on how mothers should be valued. Ask any mother what she wants, and I hedge that a good portion of them would say, "Some peace and quiet". Wishing that for you and yours!

Ina May's Guide to Breastfeeding

I realize that there have been a few breastfeeding posts in a row, but seeing as I'm spending much of my days and nights doing just that, I guess it's on the brain. Recently, I read Ina May's Guide to Breastfeeding. Ina May is a woman's woman. Reading her is like having a chat with your auntie about breastfeeding. She peppers her writing with illuminating anecdotes and funny asides.

Ina May's Guide to Childbirth is famous for its birth stories and one of the best aspects of this book, is it's breastfeeding stories. There are breastfeeding triumphs and losses, long unheard of stories of wet nursing, nursing multiples tales, and more. These are stories that allow women to see that breastfeeding is above all, simple and accessible. It is almost like reading about a different time and place, but these stories all take place in the here and now. Ina May is a student of cultures, and the stories, or "forgotten lore" as she calls them, are no accident. For, it is from lack of these stories in our lives, that Americans have lost so much knowledge of breastfeeding.

The highlight of the book is a chapter entitled "Nipplephobia". It is a brilliant and humorous analysis of why Americans, unlike other cultures, are so uptight about a woman's breasts being used for anything other than sex. This prudishness gives way to a dislike of breastfeeding in general. Nipplephobia is defined, identified, and cured in this chapter. She looks at other cultures and their examples to lead the way towards healing America's nipplephobia. I am especially fond (and I guess somewhat flattered), that towards the end of the chapter she cites examples from Muslim cultures where women who are covered head to toe, still have no trouble breastfeeding their baby, when their baby is hungry. One such example is from a male friend of hers who lived with a group of Bedouins during the '60's. Here is his experience in a culture where women covered head to toe:

"...but what really had an effect on me was the time when one of these Bedouin women raised her robes, exposing her breasts to me as she fed her baby. She acted as if everything were perfectly all right. It was only I who was taken by surprise. I realized that in cultures in which women breastfeed their babies, everyone in that culture grows up seeing breasts being used as they are meant to be. They have a natural attitude toward them. It's only in cultures like ours, where you almost never see a woman breastfeeding, that breasts become the object for something else, usually something to lust after."


She also cites Norway's example of moving towards a pro-breastfeeding culture, and gives reasons why they were able to do so while we weren't. It is a thought provoking chapter. The book as a whole is great with lots of information and tips about breastfeeding in the early days to weaning. The last two chapters, "Shared Nursing, Wet Nursing and Forgotten Lore" and the previously mentioned "Nipplephobia", are what makes this book so unique and memorable.

Nurslings

I remember when my oldest was a newborn, feeling that a divine grace was permeating our house and our beings. It felt as if angels wings were enclosed over us, creating a nest of safety and peace. As a midwife, I encounter that same sentiment when doing the postpartum visits, there is a deep sense of contentment and joy in the house, and all emanating from this one tiny, bundled creature! Recently, I came across this hadith which might provide a clue as to what that feeling exemplifies. In one hadith (sayings of the Prophet) the Prophet (pbuh) said, “If it weren’t for nursing children, bent-over old people and grazing animals, catastrophe would descend upon you like a flood” (Heysemi, Mecmau’z-Zevaid, X, 227). Thus, he pointed out that “sabiler” (babies in the nursing stage) are the first factor preventing divine wrath." The first factor in preventing divine wrath, isn't that amazing?

The following is a public service announcement from Puerto Rico encouraging breastfeeding. I think it is such a visual image of the grace and beauty that flows between a mother and her nursling. It shows babies of all ages and toddlers nursing. I could not imagine a public service announcement like this in America, our culture is so obsessed with breasts as a sexual image that we could never air something like this on television. But how effective it would be if we could...






The following is a trailer for a film, Formula Fed America, which portrays the low rates of breastfeeding in America in the context of a public health crisis. And if we look at the above hadith, I suppose we could think of it as a spiritual crisis as well!

Babies Suck

Pacifiers at Frederiksberg Have by zaxer

Babies do suck, as attested to by the pacifier tree above, lots of them, and they seem to like it. This interesting article in Salon, follows the history of pacifier use, and the subsequent guilt it evokes in parents. I would advise skipping pacifiers for at least the first month or so, not because of nipple confusion, but because it can inhibit a mom's milk supply. The more the baby sucks on something besides the mother, the less signals her brain and body are receiving to produce milk. If you have sore nipples and all of that non-nutritive sucking is giving you blisters, try offering your clean finger nail side down. If you ultimately decide on a pacifier go for a BPA-free one with a silicone nipple. If your baby is in the NICU, pacifiers have been shown to be useful in extending the breastfeeding relationship. I think to extend that conclusion, as he does in the article, to full term, vigorous and healthy breastfed infants is fallacious. In the end pacifier use, like all parenting issues, is a personal decision.

If you'd like to learn more about the wonderful pacifier tree tradition that they have at this Denmark park, read here. It's such a sweet tradition, and shows what meaning these tots give to their pacifiers, what a strong attachment!

Latching On

In follow up to my post about the dismal US breastfeeding statistics reported in the Washington Post, there is a new documentary film out titled, 'Latching On'. I haven't seen it yet, but it is a brilliant idea. She discusses her sister's experience as a breastfeeding mother, beginning in Germany where she delivered her baby and where women breastfeed anywhere and everywhere, and ending in New York City, where spotting a breastfeeding mother is as rare as spotting a unicorn.




I'm always proud of my Muslim sisters who overcome sometimes great odds to breastfeed their children. When I travel to the Muslim world, I am also surprised at how openly women in these modest cultures breastfeed their children. Even in the stricter countries, where gender segregation is imposed in public, breastfeeding is still the norm. This study from Australia compared breastfeeding rates amongst Australian, Vietnamese, and Turkish women in Australia. Turkish women had the highest rates of breastfeeding initiation. I pray that this is a legacy we can leave the world with, that breastfeeding children, is a norm and a divine duty of the mother, and that it does not have to be difficult or even hidden.

Poem - Morning Song

Mother and Child by Koshyk

Morning Song

Love set you going like a fat gold watch.
The midwife slapped your footsoles, and your bald cry
Took its place among the elements.

Our voices echo, magnifying your arrival. New statue.
In a drafty museum, your nakedness
Shadows our safety. We stand round blankly as walls.

I'm no more your mother
Than the cloud that distills a mirror to reflect its
own slow
Effacement at the wind's hand.

All night your moth-breath
Flickers among the flat pink roses. I wake to listen:
A far sea moves in my ear.

One cry, and I stumble from bed, cow heavy and floral
In my Victorian nightgown.
Your mouth opens clean as a cat's. The window square

Whitens and swallows its dull stars. And now you try
Your handful of notes;
The clear vowels rise like balloons.

-Sylvia Plath (1932-1963)



There was a study released in Pediatrics on Monday that says if American women were to breastfeed exclusively for six months, that nearly 900 infant lives and billions of health care dollars would be saved each year. Only 12% of American women exclusively breastfeed at six months. This article in the Washington Post details many of the benefit of breastfeeding and mentions how birth practices affect breastfeeding outcomes, "The pediatrics academy says babies should be given a chance to start breast-feeding immediately after birth. Bartick said that often doesn't happen, and at many hospitals newborns are offered formula even when their mothers intend to breast-feed. " That first hour or so is so important for many interactions between mother and infant, breastfeeding included. Ask for help from your midwife or hospital staff if you are unsure of how to get the baby on, it really can ease the way for so much if the baby can have at least one go at the breast in the first hour or so. Breastfeeding is often viewed as a choice in this country, but in terms of public health, it really should be looked at similar to seat belts, you are far better off with it than without it.

I also wanted to share a link of a UK publication entitled Mum and Muslim magazine. They have just come out with their first issue and there are some interesting articles up. Go check it out!

The Family Bed

by Kenny Moller


The midwives have cleaned up and left, or you're finally home from the hospital, a family unto yourselves. And it's finally here,the first night alone with your baby. It's exhilarating and all too real, this little creature is yours from now until forever, and somewhere you have the inkling that your life will never be the same, for better or worse. You are ready to curl up and get some much deserved sleep, but what do you do with, and where do you put the baby?


Co-sleeping, or family bed as it is sometimes called, is the practice of an infant sleeping in the same bed as the parent. In the West, co-sleeping is a controversial phenomenon. It stems from incidents in Europe during the 16th-18th centuries where mothers, with no access to birth control and usually suffering extreme poverty, would smother their infants by overlaying. It resulted in co-sleeping with an infant being outlawed in much of Europe, and a permanent aversion in the Western psyche to the family bed.


In other parts of the world, where mothers often have little money for cribs and fully accessorized nurseries, the family bed is the norm. Even in the developed world in countries such as, China, Sweden, Chile, Denmark, and Japan bed sharing is the norm. Helen Ball, an anthropologist specializing in parent-infant behavior, found that in the UK up to 75% of families co-slept, but did not report this to their doctor or midwife. Another study in the United Arab Emirates, which looked at changes in childbirth and parenting over three generations of women, found that birth attendants, breastfeeding length, medication and labor during childbirth, all changed across generations, except for the family bed, this remained a constant amongst Emirati women over time.


SIDS, which stand for Sudden Infant Death Syndrome, is often cited as a reason to avoid the family bed. In the United States, SIDS is the leading cause of death in infants past one month of age. Yet there are many reasons why SIDS occurs, none of which holds the entire solution to the prevention of SIDS. So far, the 'Back to Sleep' campaign has been successful in countries like America and New Zealand at reducing the SIDS rates. Of great interest, is that in countries with the lowest rates of SIDS, such as Japan and China, they also report the highest numbers of co-sleeping. The concern with co-sleeping and SIDS is that the infants will be smothered, an age old concern, not well validated by today's science.


Researcher James McKenna has found that mother and infant dyads sharing the same bed display an inordinate amount of sensitivity to each other throughout the night. In his Mother-Baby Behavioral Sleep Laboratory, he found that mothers usually adopted a protective position, on their sides facing their infants throughout the night, increasing the amount of face to face time with their infant. This is stimulating to the infant and believed to stimulate infant respiration,believed to be a protective factor against SIDS. He has also found that the mother regulates the baby's breathing, heart rate, temperature, and that babies had greater daily weight gain when they slept side by side with their mothers.


This is to say nothing of breastfeeding and its relationship to co-sleeping. Bed-sharing is strongly associated with better breastfeeding outcomes. One of the beauties of breastfeeding is it's relationship to mom's sleep, there is no getting up to make bottles in the middle of the night, the food is always ready and the right temperature. Not that bottle feeding mamas are more or less exhausted than their breastfeeding counterparts, all moms work at night, but it does make nighttime infinitely easier if all you have to do is roll over and nurse. In answer to a question on co-sleeping on the Islamic forum, Sunnipath, one teacher answered: "I don't know of any specific Islamic injunction about co-sleeping. There is absolutely no problem with having your baby in the bed with you. In fact, if you're breastfeeding, which, according to Shaykh Muhammad ibn Adam al-Kawthari, is a religious and moral responsibility toward your child, then it makes a lot of sense to co-sleep. " It does just make sense!


Nothing is absolutely foolproof however, and sadly, babies do succumb to SIDS even while co-sleeping. May Allah protect all of our children. Here is a list compiled by Dr. James McKenna, excerpted from Mothering magazine, of how to increase the safety of co-sleeping:

• For parents who smoke, drink, or are unusually heavy sleepers, or use any kind of drugs that inhibit arousal from sleep, co-sleeping on the same surface with a baby is not recommended, said McKenna. For these parents, having their child sleep on a separate surface near them, such as a cradle or bassinet, will protect the baby from overlaying while still providing the baby with many of the same benefits as cosleeping.
• Make sure the surface your baby sleeps on is firm. "There are many adult mattresses that can match the stiffness of CPSC recommendations," McKenna said. Avoid waterbeds, lambskins, and other soft bedding for your baby. Stuffed animals and toys should be kept out of the baby's sleep environment.
• Don't give pillows to babies or young toddlers, and keep their faces away from your pillow. Keep blankets away from babies' faces, too.
• Cosleeping babies are kept warmer than solitary sleeping babies, so they need lighter blankets and pajamas. (Being too warm may be a factor in SIDS.)
• Toddlers should not be allowed to sleep next to infants, said McKenna, because "They are too unaware of the dangers their bodies pose." Instead, either the infant or the toddler can sleep on a separate surface next to the family bed—the infant in a cosleeper, crib, or bassinet; the toddler in a toddler bed or mattress on the floor.
• Headboards, footboards, and side rails can be unsafe, especially if a baby is left alone in bed with these trappings. One of the most dangerous situations for young children is getting their heads wedged in furniture, said McKenna. He suggested making sure the child's head can't fit between the side rail and any surrounding surfaces. If a parent is using a crib as a sidecar, make sure the two mattresses are on the same level and held tightly together, so there is no space that a baby could slip into. If a bed is up against a wall, ensure that there are no gaps in which a child's head can get trapped. Another option is to put the mattress right on the floor, so that side rails are not necessary to prevent a baby from falling off the bed.
• Do not sleep on the sofa with your baby, or leave a sleeping baby alone 
on a sofa.
• Do not leave a baby unattended in an adult bed. The benefits of the family bed exist only when the parents are there with the child; if the parents want some adult time while baby sleeps, the child should be put somewhere else—such as a crib, bassinet, or mattress on the floor—until the parents are ready for him to join them, McKenna said.

If you are interested in reading more about co-sleeping, Mothering magazine is having a sale on all of their Sleep Resources. Wishing you and yours many a good night's sleep!