Re: [ozmidwifery] Sun baths
Hi Leigh, and Hello Lynne,
Having been in the "homebirthing" game for
almost 15 yrs, I have had only one babyin three different states
whohas had to go under the lights and that was with one Mother who didn't
seek any "help" from myself or any other midwife colleague. Went straight
to a major tertiary centre and the baby was popped straight under the
lights. (that would have been 6 years ago, that baby also had
Downs.) Whether that had something to do with the jaundice? as there were no
oxytocics nor any other form of drug.
Have felt that lack of intervention certainly
has a major play in lack of jaundice in the home, cetainly tend to agree
withLynne.
Yes, I have heard of the theory Denise
mentions, and that also is a theory I can not remember where I obtained the
information.
Therefore this theory has
definitelyaffected my practice for years and having just finished in a
Womens' Unit, where the Paediatrician and I tended to be
non-interventionists, if the jaundice was only apparent after 3 days
then there was no intervention taken. Out of the 27 births in the
unit, there were no cases of jaundice before 3 days and yes the babies
were near sunlight, and sorry to say only 1 of the babies
successfully escaped any type of oxytocics, one has to wonder if it a lot
of SBR'S are carried out due to tradition and fear!! Whose going to do more
research??? Just a few thoughts for my first time on ozmidwifery.
Nice to chat.! Karen.
- Original Message -
From:
Leigh Evans
To: [EMAIL PROTECTED]
Sent: Thursday, July 17, 2003 7:37
AM
Subject: Re: [ozmidwifery] Sun
baths
I would have to agree with this .
Leigh
- Original Message -
From:
Lynne Staff
To: [EMAIL PROTECTED]
Sent: Sunday, July 13, 2003 8:12
PM
Subject: Re: [ozmidwifery] Sun
baths
I haven't heard this theory before, Denise, but
have to put on this post that I have noticed, as have homebirth colleagues
of mine, that there is a very low incidence of jaundice in infants born at
home. Between us we think the rare use of oxytocics, any medications in
labour, early and frequent feeding - there's probably more. Any other
homebirth midwives want to comment on this?
- Original Message -
From:
Denise Hynd
To: [EMAIL PROTECTED]
Sent: Monday, July 14, 2003 5:24
AM
Subject: Re: [ozmidwifery] Sun
baths
Dear mary
Your comment
I also wonder if we haven't been seduced into being a bit paranoid
about jaundice?
Reminded me of hearing at a breastfeeding confernece here a few years
ago of preliminary studies being done in the States (USA) by (?)
Prof G (?) which was exploring the benefits of levels jaundice as it is
physiological to a degree and there is a theory that this may be of
benefit to the developing immune systems and many babies who have some
physiological jaundice have lower rates of infections in infancy and
childhood.
Does any one else heard of this
theory??Denise
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 4:11
AM
Subject: Re: [ozmidwifery] Sun
baths
Thanks for that information Lois, My understanding was that we
needed 620 NM of light waves for effectiveness. Johnson says "
exposing the baby's skin to sunlight".. does this mean direct
through the glass or indirect through the glass or direct sunshine or
indirect near the window?As you say, it is very difficult to
quantify the number of nanometers in the various seasons in
Australia. I also wonder if we haven't been seduced into being a
bit paranoid about jaundice? What is the range of nanometers of
the bililights that are currently used for treatment? When I was
researching it for my research proposal, the research seemed to be going
away from the causes of jaundice and the simple solutions, into the area
of drug control of SBRs. That area doesn't seem to have
taken off and I wonder what the latest research says? MM
- Original Message -
From:
Lois
Wattis
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003
12:56 PM
Subject: Re: [ozmidwifery] Sun
baths
Hi again - interesting to get info related to
the northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
Irevisited my text books
before posting my bit on ozmid about natural light for
treating physiological jau
Re: [ozmidwifery] Sun baths
I would have to agree with this .
Leigh
- Original Message -
From:
Lynne Staff
To: [EMAIL PROTECTED]
Sent: Sunday, July 13, 2003 8:12 PM
Subject: Re: [ozmidwifery] Sun
baths
I haven't heard this theory before, Denise, but
have to put on this post that I have noticed, as have homebirth colleagues of
mine, that there is a very low incidence of jaundice in infants born at home.
Between us we think the rare use of oxytocics, any medications in labour,
early and frequent feeding - there's probably more. Any other homebirth
midwives want to comment on this?
- Original Message -
From:
Denise Hynd
To: [EMAIL PROTECTED]
Sent: Monday, July 14, 2003 5:24
AM
Subject: Re: [ozmidwifery] Sun
baths
Dear mary
Your comment
I also wonder if we haven't been seduced into being a bit paranoid
about jaundice?
Reminded me of hearing at a breastfeeding confernece here a few years
ago of preliminary studies being done in the States (USA) by (?) Prof
G (?) which was exploring the benefits of levels jaundice as it is
physiological to a degree and there is a theory that this may be of benefit
to the developing immune systems and many babies who have some physiological
jaundice have lower rates of infections in infancy and childhood.
Does any one else heard of this
theory??Denise
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 4:11
AM
Subject: Re: [ozmidwifery] Sun
baths
Thanks for that information Lois, My understanding was that we needed
620 NM of light waves for effectiveness. Johnson says " exposing the
baby's skin to sunlight".. does this mean direct through the glass
or indirect through the glass or direct sunshine or indirect near the
window?As you say, it is very difficult to quantify the number of
nanometers in the various seasons in Australia. I also wonder if we
haven't been seduced into being a bit paranoid about jaundice? What
is the range of nanometers of the bililights that are currently used for
treatment? When I was researching it for my research proposal, the
research seemed to be going away from the causes of jaundice and the
simple solutions, into the area of drug control of SBRs. That area
doesn't seem to have taken off and I wonder what the latest research
says? MM
- Original Message -
From:
Lois
Wattis
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 12:56
PM
Subject: Re: [ozmidwifery] Sun
baths
Hi again - interesting to get info related to
the northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
Irevisited my text books before
posting my bit on ozmid about natural light for treating physiological
jaundice - just to check my facts. The use of natural light this
way ismentioned in PGB. Johnston's book "The Newborn Child" (my
text from my mid studies) pp181,and 187. Johnson states "exposing
the baby's skin to sunlight effectively reduces the bilirubin
level but is impractical for treatment in the UK."
Regarding the specific lighting requirement -
"exposing the skin to blue light of wavelength 400-500 nmand in an
intensity of 4-10 microwatts/cm2 converts the bilirubin in the
superficialcapillaries to harmless water soluble metabolites which
are then excreted in the urine and bowel". I don't know how to
quantify/measure the nm's of natural daylight in various states or
seasons in Australia, however I don'tthink it's necessary.
The value of exposure to INDIRECT'white' daylight in a well lit
room toconvert unconjugatedbilirubin into conjugated water
soluble bilirubin for excretion is well documented. Exposure of
the head and shoulders, maybe chest in atemperature-controlled
environmentis usually sufficient to stimulate the process, in
combination with frequent feeding.
Home and hospital rooms vary in how much light
they get, but often it's only a matter of rearranging where the baby is
located in the room which makes the difference. I'm sure there are
hospital midwives out there who encourage women to put their baby's cot
on the opposite side of the bed just to take advantage of the natural
light in the room to minimise or treat physiological jaundice the
natural way, just as I did when I worked in the hospitals.
Attention to this type ofearlytreatmentwi
Re: [ozmidwifery] sun baths for jundice
Marilyn, I hope it was not taken the wrong way that I used your email as an example I thought it was a good way to open a topic that I am interested in. I personally still used sunlight indirectly with my 3rd baby especially my most recent (4th) baby he was starting to become jaundiced before he was 24 hrs old (he had a very puple face/head after birth so expected some form of jaundice), but as I had been discharged fromBirth Centrebefore this he was alert, awake often, feeding well (my milk was comming inwhen he was 1.5 days old... ample supply), weeing pooing etc I never returned to hospital just went for quick walks outside found a nice spot inside while he slept. Yet, because of the way we were taught as midwifery students I don't actually recommend this to women in hospital (there are a few reasons why but unable to explain at this moment). Anyway, sorry if it was taken the wrong way (just in case). BTW I love reading your posts, along with everyone elses... I am learning so much from you all also learning to challenge my ways of thinking doing things. If it wasn't for this list I may never have sought out Birth Centre care, known the joys of water birth having my family involved etc, etc. I owe this list for many things (positive). Tina H. Brisbane. - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 5:26 PM Subject: Re: [ozmidwifery] sun baths for jundice I was talking about Seattle, Washington where the sunlight is very very different than here. A sun bath in Seattle is a very different thing to a sunbath in Townsville, Cairns or probably anywhere except Hobart in Australia. Neverhless i took it for granted it would be indirect sun. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 2:51 AM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care, lost 10% in first week, milk took a good 7 days to really come in once it did baby made a slow but steady weight gain. WE, the midwives were somewhat anxious, but paed was ok with it doing homevisits and sun baths for baby (trust me the UV index in Seattle is not to be worried about). Long story, sorry. So yes the milk did come in just later. marilyn - Original Message - From: Lynne Staff To: [EMAIL PROTECTED] Sent: Thursda
Re: [ozmidwifery] sun baths for jundice
No worries, I didn't think anything except that i hadn't completely explained what i was thinking, probably too tired at the end of a shift to complete the thought. It's a good topic and we all unearthed the scarcity of actual evidence on it. Always interesting. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] Sent: Monday, July 14, 2003 5:20 AM Subject: Re: [ozmidwifery] sun baths for jundice Marilyn, I hope it was not taken the wrong way that I used your email as an example I thought it was a good way to open a topic that I am interested in. I personally still used sunlight indirectly with my 3rd baby especially my most recent (4th) baby he was starting to become jaundiced before he was 24 hrs old (he had a very puple face/head after birth so expected some form of jaundice), but as I had been discharged fromBirth Centrebefore this he was alert, awake often, feeding well (my milk was comming inwhen he was 1.5 days old... ample supply), weeing pooing etc I never returned to hospital just went for quick walks outside found a nice spot inside while he slept. Yet, because of the way we were taught as midwifery students I don't actually recommend this to women in hospital (there are a few reasons why but unable to explain at this moment). Anyway, sorry if it was taken the wrong way (just in case). BTW I love reading your posts, along with everyone elses... I am learning so much from you all also learning to challenge my ways of thinking doing things. If it wasn't for this list I may never have sought out Birth Centre care, known the joys of water birth having my family involved etc, etc. I owe this list for many things (positive). Tina H. Brisbane. - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 5:26 PM Subject: Re: [ozmidwifery] sun baths for jundice I was talking about Seattle, Washington where the sunlight is very very different than here. A sun bath in Seattle is a very different thing to a sunbath in Townsville, Cairns or probably anywhere except Hobart in Australia. Neverhless i took it for granted it would be indirect sun. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 2:51 AM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and
Re: [ozmidwifery] Sun baths
I haven't heard this theory before, Denise, but
have to put on this post that I have noticed, as have homebirth colleagues of
mine, that there is a very low incidence of jaundice in infants born at home.
Between us we think the rare use of oxytocics, any medications in labour, early
and frequent feeding - there's probably more. Any other homebirth midwives want
to comment on this?
- Original Message -
From:
Denise Hynd
To: [EMAIL PROTECTED]
Sent: Monday, July 14, 2003 5:24 AM
Subject: Re: [ozmidwifery] Sun
baths
Dear mary
Your comment
I also wonder if we haven't been seduced into being a bit paranoid about
jaundice?
Reminded me of hearing at a breastfeeding confernece here a few years ago
of preliminary studies being done in the States (USA) by (?) Prof G (?)
which was exploring the benefits of levels jaundice as it is physiological to
a degree and there is a theory that this may be of benefit to the developing
immune systems and many babies who have some physiological jaundice have lower
rates of infections in infancy and childhood.
Does any one else heard of this
theory??Denise
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 4:11
AM
Subject: Re: [ozmidwifery] Sun
baths
Thanks for that information Lois, My understanding was that we needed
620 NM of light waves for effectiveness. Johnson says " exposing the
baby's skin to sunlight".. does this mean direct through the glass or
indirect through the glass or direct sunshine or indirect near the
window?As you say, it is very difficult to quantify the number of
nanometers in the various seasons in Australia. I also wonder if we
haven't been seduced into being a bit paranoid about jaundice? What is
the range of nanometers of the bililights that are currently used for
treatment? When I was researching it for my research proposal, the
research seemed to be going away from the causes of jaundice and the simple
solutions, into the area of drug control of SBRs. That area
doesn't seem to have taken off and I wonder what the latest research
says? MM
- Original Message -
From:
Lois
Wattis
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 12:56
PM
Subject: Re: [ozmidwifery] Sun
baths
Hi again - interesting to get info related to the
northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
Irevisited my text books before
posting my bit on ozmid about natural light for treating physiological
jaundice - just to check my facts. The use of natural light this way
ismentioned in PGB. Johnston's book "The Newborn Child" (my text
from my mid studies) pp181,and 187. Johnson states "exposing the
baby's skin to sunlight effectively reduces the bilirubin level but
is impractical for treatment in the UK."
Regarding the specific lighting requirement -
"exposing the skin to blue light of wavelength 400-500 nmand in an
intensity of 4-10 microwatts/cm2 converts the bilirubin in the
superficialcapillaries to harmless water soluble metabolites which
are then excreted in the urine and bowel". I don't know how to
quantify/measure the nm's of natural daylight in various states or seasons
in Australia, however I don'tthink it's necessary. The value
of exposure to INDIRECT'white' daylight in a well lit room
toconvert unconjugatedbilirubin into conjugated water soluble
bilirubin for excretion is well documented. Exposure of the head and
shoulders, maybe chest in atemperature-controlled
environmentis usually sufficient to stimulate the process, in
combination with frequent feeding.
Home and hospital rooms vary in how much light
they get, but often it's only a matter of rearranging where the baby is
located in the room which makes the difference. I'm sure there are
hospital midwives out there who encourage women to put their baby's cot on
the opposite side of the bed just to take advantage of the natural light
in the room to minimise or treat physiological jaundice the natural way,
just as I did when I worked in the hospitals. Attention to
this type ofearlytreatmentwill savemany babies
fromthe heel pricks forSBR collections ('just to check'), and
possibly from separation and Mothers' associated anxiety, interuptions to
feedings and so onrelated toartificial
phototherapy. Just my two bob's worth! Cheers,
Lois
- Original Message -
From:
Debbie Slater
To: [EMAIL PROTECTED]
Sent:
RE: [ozmidwifery] Sun baths
Hi
folks, have to wade in on this one :-)
Certainly much much less overt physiological jaundice in my private
practice.
One
theory/explanation about bilirubin in newbornsthatI've come across
is that bilirubin is an antioxident and mops up all the free radicals liberated
by the birthing process and if you do bilirubin levels on all babies, all of
them have some.
Overt
physiological jaundice and deepening of same is very much to do with inadequate
attachment/poor colostrum transfer and with homebirth/private
practicemother/baby dyads, early B/F with excellent attachment is the norm
as the mothers are very well prepared for the realities of what to do and how it
worksbabies guts are well stimulated, meconium is passed easily and early;
the entire range of normal physiological processes and cellular interactions
with feeding are optimally initiated and maintained. Women understand
normal newborn behaviour/feeding patterns and feed their babies to rhythm rather
that reading their babies signals as unsettled or troublesome those first few
nights. All of which allows babies to adapt to extrauterine life and its
demands in the optimal way.
Note:
I'm not talking here about those factors such as blood incompatibilies,
bruising, prematurity, infectionetc etc that impact upon the neonates
physiology. I'm talking about healthy term newborn babies.
As far
as over reacting to physiological jaundice - kernicterus is a worry with sick
and premature babies - the blood brain barrier is not robust in these
infants. For full term, healthy babies, there is greater tolerance - less
need to do those heel prick levels when the baby is active, alert and feeding
and the baby is slightly jaundiced- my criteria is thewhites of eyes
being yellow(and there are shades of that aren't there?) - and the levels
are always lower than one thinks they would be. My criteria of light bath
is being near an open window, not sun and kept warm, out of breeze.
On home maternity visiting runs, making sure from day0the infant is
getting excellent/optimal transfer of milk/colostrum helps avoid much of these
concerns.
Can
anyone tell me what makes the UV from "lights" ok for babies skin
health?
warmly, Carolyn Hastie
-Original Message-From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of Lynne
StaffSent: Sunday, 13 July 2003 8:13 PMTo:
[EMAIL PROTECTED]Subject: Re: [ozmidwifery] Sun
baths
I haven't heard this theory before, Denise, but
have to put on this post that I have noticed, as have homebirth colleagues of
mine, that there is a very low incidence of jaundice in infants born at home.
Between us we think the rare use of oxytocics, any medications in labour,
early and frequent feeding - there's probably more. Any other homebirth
midwives want to comment on this?
- Original Message -
From:
Denise Hynd
To: [EMAIL PROTECTED]
Sent: Monday, July 14, 2003 5:24
AM
Subject: Re: [ozmidwifery] Sun
baths
Dear mary
Your comment
I also wonder if we haven't been seduced into being a bit paranoid
about jaundice?
Reminded me of hearing at a breastfeeding confernece here a few years
ago of preliminary studies being done in the States (USA) by (?) Prof
G (?) which was exploring the benefits of levels jaundice as it is
physiological to a degree and there is a theory that this may be of benefit
to the developing immune systems and many babies who have some physiological
jaundice have lower rates of infections in infancy and childhood.
Does any one else heard of this
theory??Denise
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 4:11
AM
Subject: Re: [ozmidwifery] Sun
baths
Thanks for that information Lois, My understanding was that we needed
620 NM of light waves for effectiveness. Johnson says " exposing the
baby's skin to sunlight".. does this mean direct through the glass
or indirect through the glass or direct sunshine or indirect near the
window?As you say, it is very difficult to quantify the number of
nanometers in the various seasons in Australia. I also wonder if we
haven't been seduced into being a bit paranoid about jaundice? What
is the range of nanometers of the bililights that are currently used for
treatment? When I was researching it for my research proposal, the
research seemed to be going away from the causes of jaundice and the
simple solutions, into the area of drug control of SBRs. That area
doesn't seem to have taken off and I wonder what the latest research
says? MM
- Original Message -
From:
Lois
Wattis
Re: [ozmidwifery] Sun baths
Dear Carolyn
That is the underlying physiology of the theory I
hav heard that there is a safe and even beneficial level of jaundice as
bilirubin is an antioxidant
Thank you for that
Denise
- Original Message -
From:
Heartlogic
To: [EMAIL PROTECTED]
Sent: Sunday, July 13, 2003 4:01 AM
Subject: RE: [ozmidwifery] Sun
baths
Hi
folks, have to wade in on this one :-)
Certainly much much less overt physiological jaundice in my private
practice.
One
theory/explanation about bilirubin in newbornsthatI've come across
is that bilirubin is an antioxident and mops up all the free radicals
liberated by the birthing process and if you do bilirubin levels on all
babies, all of them have some.
Overt physiological jaundice and deepening of same is very much to do
with inadequate attachment/poor colostrum transfer and with homebirth/private
practicemother/baby dyads, early B/F with excellent attachment is the
norm as the mothers are very well prepared for the realities of what to do and
how it worksbabies guts are well stimulated, meconium is passed easily and
early; the entire range of normal physiological processes and cellular
interactions with feeding are optimally initiated and maintained. Women
understand normal newborn behaviour/feeding patterns and feed their babies to
rhythm rather that reading their babies signals as unsettled or troublesome
those first few nights. All of which allows babies to adapt to
extrauterine life and its demands in the optimal way.
Note: I'm not talking here about those factors such as blood
incompatibilies, bruising, prematurity, infectionetc etc that impact
upon the neonates physiology. I'm talking about healthy term newborn
babies.
As
far as over reacting to physiological jaundice - kernicterus is a worry with
sick and premature babies - the blood brain barrier is not robust in these
infants. For full term, healthy babies, there is greater tolerance -
less need to do those heel prick levels when the baby is active, alert and
feeding and the baby is slightly jaundiced- my criteria is
thewhites of eyes being yellow(and there are shades of that aren't
there?) - and the levels are always lower than one thinks they would be.
My criteria of light bath is being near an open window, not sun and kept warm,
out of breeze. On home maternity visiting runs, making sure from
day0the infant is getting excellent/optimal transfer of
milk/colostrum helps avoid much of these concerns.
Can
anyone tell me what makes the UV from "lights" ok for babies skin
health?
warmly, Carolyn Hastie
-Original Message-From:
[EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]On Behalf Of Lynne
StaffSent: Sunday, 13 July 2003 8:13 PMTo:
[EMAIL PROTECTED]Subject: Re: [ozmidwifery] Sun
baths
I haven't heard this theory before, Denise, but
have to put on this post that I have noticed, as have homebirth colleagues
of mine, that there is a very low incidence of jaundice in infants born at
home. Between us we think the rare use of oxytocics, any medications in
labour, early and frequent feeding - there's probably more. Any other
homebirth midwives want to comment on this?
- Original Message -
From:
Denise Hynd
To: [EMAIL PROTECTED]
Sent: Monday, July 14, 2003 5:24
AM
Subject: Re: [ozmidwifery] Sun
baths
Dear mary
Your comment
I also wonder if we haven't been seduced into being a bit paranoid
about jaundice?
Reminded me of hearing at a breastfeeding confernece here a few years
ago of preliminary studies being done in the States (USA) by (?)
Prof G (?) which was exploring the benefits of levels jaundice as it is
physiological to a degree and there is a theory that this may be of
benefit to the developing immune systems and many babies who have some
physiological jaundice have lower rates of infections in infancy and
childhood.
Does any one else heard of this
theory??Denise
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 4:11
AM
Subject: Re: [ozmidwifery] Sun
baths
Thanks for that information Lois, My understanding was that we
needed 620 NM of light waves for effectiveness. Johnson says "
exposing the baby's skin to sunlight".. does this mean direct
through the glass or indirect through the glass or direct sunshine or
indirect near the window?As you say, it is very difficult to
quantify the number of nanometers in the various seasons in
Australia. I also wonder if we
Re: [ozmidwifery] Sun baths
Hi again - interesting to get info related to the
northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
Irevisited my text books before posting
my bit on ozmid about natural light for treating physiological jaundice - just
to check my facts. The use of natural light this way ismentioned in
PGB. Johnston's book "The Newborn Child" (my text from my mid studies) pp181,and
187. Johnson states "exposing the baby's skin to sunlight effectively
reduces the bilirubin level but is impractical for treatment in the
UK."
Regarding the specific lighting requirement - "exposing
the skin to blue light of wavelength 400-500 nmand in an intensity of 4-10
microwatts/cm2 converts the bilirubin in the superficialcapillaries to
harmless water soluble metabolites which are then excreted in the urine and
bowel". I don't know how to quantify/measure the nm's of natural daylight
in various states or seasons in Australia, however I don'tthink it's
necessary. The value of exposure to INDIRECT'white' daylight in a
well lit room toconvert unconjugatedbilirubin into conjugated water
soluble bilirubin for excretion is well documented. Exposure of the head
and shoulders, maybe chest in atemperature-controlled environmentis
usually sufficient to stimulate the process, in combination with frequent
feeding.
Home and hospital rooms vary in how much light they
get, but often it's only a matter of rearranging where the baby is located in
the room which makes the difference. I'm sure there are hospital midwives
out there who encourage women to put their baby's cot on the opposite side of
the bed just to take advantage of the natural light in the room to minimise or
treat physiological jaundice the natural way, just as I did when I worked in the
hospitals. Attention to this type
ofearlytreatmentwill savemany babies fromthe heel
pricks forSBR collections ('just to check'), and possibly from separation
and Mothers' associated anxiety, interuptions to feedings and so onrelated
toartificial phototherapy. Just my two bob's
worth! Cheers, Lois
- Original Message -
From:
Debbie
Slater
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 2:37
PM
Subject: [ozmidwifery] Sun baths
Lois wrote:Hi Tina, my understanding is that
normal bright 'white' daylight in a well lit room is adequate to facilitate
the conversion of bilirubin in it's fat soluble form stored in the tissue, to
the water soluble form, which is then returned to the bloodstreamfor
processing through the GI system for excretion.I was always told
just to put babies in a well-lit room (and this was in the lukewarm sunlight
of the northern hemisphere - London to be exact).This is just from a
mother's perspective.Debbie
Slater
Re: [ozmidwifery] Sun baths
Thanks for that information Lois, My understanding was that we needed 620
NM of light waves for effectiveness. Johnson says " exposing the baby's
skin to sunlight".. does this mean direct through the glass or indirect
through the glass or direct sunshine or indirect near the window?As you
say, it is very difficult to quantify the number of nanometers in the various
seasons in Australia. I also wonder if we haven't been seduced into being
a bit paranoid about jaundice? What is the range of nanometers of the
bililights that are currently used for treatment? When I was researching
it for my research proposal, the research seemed to be going away from the
causes of jaundice and the simple solutions, into the area of drug control of
SBRs. That area doesn't seem to have taken off and I wonder what the
latest research says? MM
- Original Message -
From:
Lois
Wattis
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 12:56
PM
Subject: Re: [ozmidwifery] Sun
baths
Hi again - interesting to get info related to the
northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
Irevisited my text books before
posting my bit on ozmid about natural light for treating physiological
jaundice - just to check my facts. The use of natural light this way
ismentioned in PGB. Johnston's book "The Newborn Child" (my text from my
mid studies) pp181,and 187. Johnson states "exposing the baby's skin to
sunlight effectively reduces the bilirubin level but is impractical for
treatment in the UK."
Regarding the specific lighting requirement -
"exposing the skin to blue light of wavelength 400-500 nmand in an
intensity of 4-10 microwatts/cm2 converts the bilirubin in the
superficialcapillaries to harmless water soluble metabolites which are
then excreted in the urine and bowel". I don't know how to
quantify/measure the nm's of natural daylight in various states or seasons in
Australia, however I don'tthink it's necessary. The value of
exposure to INDIRECT'white' daylight in a well lit room toconvert
unconjugatedbilirubin into conjugated water soluble bilirubin for
excretion is well documented. Exposure of the head and shoulders, maybe
chest in atemperature-controlled environmentis usually sufficient
to stimulate the process, in combination with frequent feeding.
Home and hospital rooms vary in how much light they
get, but often it's only a matter of rearranging where the baby is located in
the room which makes the difference. I'm sure there are hospital
midwives out there who encourage women to put their baby's cot on the opposite
side of the bed just to take advantage of the natural light in the room to
minimise or treat physiological jaundice the natural way, just as I did when I
worked in the hospitals. Attention to this type
ofearlytreatmentwill savemany babies fromthe
heel pricks forSBR collections ('just to check'), and possibly from
separation and Mothers' associated anxiety, interuptions to feedings and so
onrelated toartificial phototherapy. Just my two
bob's worth! Cheers, Lois
- Original Message -
From:
Debbie
Slater
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 2:37
PM
Subject: [ozmidwifery] Sun baths
Lois wrote:Hi Tina, my understanding is
that normal bright 'white' daylight in a well lit room is adequate to
facilitate the conversion of bilirubin in it's fat soluble form stored in
the tissue, to the water soluble form, which is then returned to the
bloodstreamfor processing through the GI system for
excretion.I was always told just to put babies in a well-lit
room (and this was in the lukewarm sunlight of the northern hemisphere -
London to be exact).This is just from a mother's
perspective.Debbie
Slater
Re: [ozmidwifery] Sun baths
Dear mary
Your comment
I also wonder if we haven't been seduced into being a bit paranoid about
jaundice?
Reminded me of hearing at a breastfeeding confernece here a few years ago
of preliminary studies being done in the States (USA) by (?) Prof G (?)
which was exploring the benefits of levels jaundice as it is physiological to a
degree and there is a theory that this may be of benefit to the developing
immune systems and many babies who have some physiological jaundice have lower
rates of infections in infancy and childhood.
Does any one else heard of this
theory??Denise
- Original Message -
From:
Mary
Murphy
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 4:11
AM
Subject: Re: [ozmidwifery] Sun
baths
Thanks for that information Lois, My understanding was that we needed 620
NM of light waves for effectiveness. Johnson says " exposing the baby's
skin to sunlight".. does this mean direct through the glass or indirect
through the glass or direct sunshine or indirect near the window?As you
say, it is very difficult to quantify the number of nanometers in the various
seasons in Australia. I also wonder if we haven't been seduced into
being a bit paranoid about jaundice? What is the range of nanometers of
the bililights that are currently used for treatment? When I was
researching it for my research proposal, the research seemed to be going away
from the causes of jaundice and the simple solutions, into the area of drug
control of SBRs. That area doesn't seem to have taken off and I
wonder what the latest research says? MM
- Original Message -
From:
Lois
Wattis
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 12:56
PM
Subject: Re: [ozmidwifery] Sun
baths
Hi again - interesting to get info related to the
northern hemisphere.. (thanks Debbie and Marilyn), compared to
Australia.
Irevisited my text books before
posting my bit on ozmid about natural light for treating physiological
jaundice - just to check my facts. The use of natural light this way
ismentioned in PGB. Johnston's book "The Newborn Child" (my text from
my mid studies) pp181,and 187. Johnson states "exposing the baby's
skin to sunlight effectively reduces the bilirubin level but is
impractical for treatment in the UK."
Regarding the specific lighting requirement -
"exposing the skin to blue light of wavelength 400-500 nmand in an
intensity of 4-10 microwatts/cm2 converts the bilirubin in the
superficialcapillaries to harmless water soluble metabolites which are
then excreted in the urine and bowel". I don't know how to
quantify/measure the nm's of natural daylight in various states or seasons
in Australia, however I don'tthink it's necessary. The value of
exposure to INDIRECT'white' daylight in a well lit room
toconvert unconjugatedbilirubin into conjugated water soluble
bilirubin for excretion is well documented. Exposure of the head and
shoulders, maybe chest in atemperature-controlled environmentis
usually sufficient to stimulate the process, in combination with frequent
feeding.
Home and hospital rooms vary in how much light they
get, but often it's only a matter of rearranging where the baby is located
in the room which makes the difference. I'm sure there are hospital
midwives out there who encourage women to put their baby's cot on the
opposite side of the bed just to take advantage of the natural light in the
room to minimise or treat physiological jaundice the natural way, just as I
did when I worked in the hospitals. Attention to this type
ofearlytreatmentwill savemany babies fromthe
heel pricks forSBR collections ('just to check'), and possibly from
separation and Mothers' associated anxiety, interuptions to feedings and so
onrelated toartificial phototherapy. Just my two
bob's worth! Cheers, Lois
- Original Message -
From:
Debbie
Slater
To: [EMAIL PROTECTED]
Sent: Saturday, July 12, 2003 2:37
PM
Subject: [ozmidwifery] Sun
baths
Lois wrote:Hi Tina, my understanding is
that normal bright 'white' daylight in a well lit room is adequate to
facilitate the conversion of bilirubin in it's fat soluble form stored in
the tissue, to the water soluble form, which is then returned to the
bloodstreamfor processing through the GI system for
excretion.I was always told just to put babies in a well-lit
room (and this was in the lukewarm sunlight of the northern hemisphere -
London to be exact).This is just from a mother's
perspective.Debbie
Slater
Re: [ozmidwifery] sun baths for jundice
My understnding is that normal window glass has a UV rating of 10 and that 10 mins at a time was o.k. I wonder if anyone really knows, or if we are all just guessing. It would be really good to have an AFFORDABLE portable BiliLight unit. MM - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 5:51 PM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care, lost 10% in first week, milk took a good 7 days to really come in once it did baby made a slow but steady weight gain. WE, the midwives were somewhat anxious, but paed was ok with it doing homevisits and sun baths for baby (trust me the UV index in Seattle is not to be worried about). Long story, sorry. So yes the milk did come in just later. marilyn - Original Message - From: Lynne Staff To: [EMAIL PROTECTED] Sent: Thursday, July 10, 2003 2:14 PM Subject: Re: [ozmidwifery] whats happening ? Hi Jan Must be something in the water - I had3 t/f to hosp as well in the past 2 months. One - a primigravida - C/B after BP shot through the roof antenatally and SROM at 37 weeks. She did labour, but for whatever reason, her body did not open, and her BP sneaking up higher and higher despite Mg So4 and hydrallazine. Home now but lactation did not establish and she has tried everything. Is anyone aware of MgSo4 or hydrallazine having an impact on lactation? Another had the most amazing labour - had been labouring for quite some time before she called (as she and partner had been happy working together). First baby. After some time I asked if I could examine her - something wasn't right - she had the most awful back pain and the babe was not OP - the head VERY deep in the pelvis and had been for some weeks prior to birth. Head was +2 and covered with lower segment. Looking for cervix and finally located it very high and anterior behind the right obturator foramen. Pinhole in size and the lower segment/cervix paper thin. No wonder she had this dreadful backache. I began to massage the tine hole in her cervix very gently - within 5 mins had opened to 3-4. Another 2 hrs later, still awful backache (imagine the stretch on her posterior ligaments), and still the same. Some more gentle massage and the cervix opened to 5-6. Into bath, but backache absolutely unbearable after another hour. Penney asked me to massage again, but my short little
Re: [ozmidwifery] sun baths for jundice
Hi Tina, my understanding is that normal bright 'white' daylight in a well lit room is adequate to facilitate the conversion of bilirubin in it's fat soluble form stored in the tissue, to the water soluble form, which is then returned to the bloodstreamfor processing through the GI system for excretion. I encourage all parents toassist the processing of physiological jaundice in the early days of their baby's life by having the baby in the best lit room during daylight hours. I advise them to follow the best natural light in the house as the day passes,maximising thebaby's exposureto indirect natural (white) daylightparticularly if the baby is visibly jaundiced. Of course, the other important signs are monitored closely too - feeding well and frequently, wee-ing (noting colour of urine), poo-ing, not too sleepy etc. I find early attention to assisting the natural physiological process utilising natural light minimises the incidence and severity of physiological jaundice in most cases. I do not recommend 'sun bathing' in direct sunlight indoors or outdoors, especially here in WA where even winter direct sun through glass can be very hot.Regards, Lois - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 5:51 PM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care, lost 10% in first week, milk took a good 7 days to really come in once it did baby made a slow but steady weight gain. WE, the midwives were somewhat anxious, but paed was ok with it doing homevisits and sun baths for baby (trust me the UV index in Seattle is not to be worried about). Long story, sorry. So yes the milk did come in just later. marilyn - Original Message - From: Lynne Staff To: [EMAIL PROTECTED] Sent: Thursday, July 10, 2003 2:14 PM Subject: Re: [ozmidwifery] whats happening ? Hi Jan Must be something in the water - I had3 t/f to hosp as well in the past 2 months. One - a primigravida - C/B after BP shot through the roof antenatally and SROM at 37 weeks. She did labour, but for whatever reason, her body did not open, and her BP sneaking up higher and higher despite Mg So4 and hydrallazine. Home now but lactation did not establish and she has tried everything. Is anyone aware of MgSo4 or hydrallazine having an impact on lactation? Another had the most amazing labour - had been labouring for quite some time before she called (as she and partner had been happy working
Re: [ozmidwifery] sun baths for jundice
Hi this is Marilyn: Personally, i think we have become overcautious re the sun. Not at all denying the realationship with skin cancer but it really is true people even in the northern hemispere have started covering up so much they are getting rickets: this is true I've seen it. Especially if they don't drink milk or milk substitutes fortified with Vitamin D (which I don't think they are here: who would think it necessary??). I am sure it is some kind of legal issue probably around the lines of if we recommend 10 min sun baths in indirect sun then maybe 20 min is better etc... I remember when my mum was midwifing back in the 60's the hospital nursery had windows which could be opened to let the sun in for jaundiced babies: sunshine works, it's just that sun exposure is also dangerous as is too much exposure to UV lights but I guess we can control UV light exposure. My mind is just boggling as how complicated we can make simple things. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 2:51 AM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care, lost 10% in first week, milk took a good 7 days to really come in once it did baby made a slow but steady weight gain. WE, the midwives were somewhat anxious, but paed was ok with it doing homevisits and sun baths for baby (trust me the UV index in Seattle is not to be worried about). Long story, sorry. So yes the milk did come in just later. marilyn - Original Message - From: Lynne Staff To: [EMAIL PROTECTED] Sent: Thursday, July 10, 2003 2:14 PM Subject: Re: [ozmidwifery] whats happening ? Hi Jan Must be something in the water - I had3 t/f to hosp as well in the past 2 months. One - a primigravida - C/B after BP shot through the roof antenatally and SROM at 37 weeks. She did labour, but for whatever reason, her body did not open, and her BP sneaking up higher and higher despite Mg So4 and hydrallazine. Home now but lactation did not establish and she has tried everything. Is anyone aware of MgSo4 or hydrallazine having an impact on lactation? Another had the most amazing labour - had been labouring for quite some time before she called (as she and partner had been happy working together). First baby. After some time I asked if I could examine her - something wasn't right - she had the most awful back pain and the babe was not OP - the head VERY deep in the pelvis and had
Re: [ozmidwifery] sun baths for jundice
I was talking about Seattle, Washington where the sunlight is very very different than here. A sun bath in Seattle is a very different thing to a sunbath in Townsville, Cairns or probably anywhere except Hobart in Australia. Neverhless i took it for granted it would be indirect sun. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 2:51 AM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care, lost 10% in first week, milk took a good 7 days to really come in once it did baby made a slow but steady weight gain. WE, the midwives were somewhat anxious, but paed was ok with it doing homevisits and sun baths for baby (trust me the UV index in Seattle is not to be worried about). Long story, sorry. So yes the milk did come in just later. marilyn - Original Message - From: Lynne Staff To: [EMAIL PROTECTED] Sent: Thursday, July 10, 2003 2:14 PM Subject: Re: [ozmidwifery] whats happening ? Hi Jan Must be something in the water - I had3 t/f to hosp as well in the past 2 months. One - a primigravida - C/B after BP shot through the roof antenatally and SROM at 37 weeks. She did labour, but for whatever reason, her body did not open, and her BP sneaking up higher and higher despite Mg So4 and hydrallazine. Home now but lactation did not establish and she has tried everything. Is anyone aware of MgSo4 or hydrallazine having an impact on lactation? Another had the most amazing labour - had been labouring for quite some time before she called (as she and partner had been happy working together). First baby. After some time I asked if I could examine her - something wasn't right - she had the most awful back pain and the babe was not OP - the head VERY deep in the pelvis and had been for some weeks prior to birth. Head was +2 and covered with lower segment. Looking for cervix and finally located it very high and anterior behind the right obturator foramen. Pinhole in size and the lower segment/cervix paper thin. No wonder she had this dreadful backache. I began to massage the tine hole in her cervix very gently - within 5 mins had opened to 3-4. Another 2 hrs later, still awful backache (imagine the stretch on her posterior ligaments), and still the same. Some more gentle massage and the cervix opened to 5-6. Into bath, but backache absolutely unbearable after another hour. Penney
Re: [ozmidwifery] sun baths for jundice
The reason i called the indirect sun exposure of a jaundiced baby a "sunbath" was to get the parents to take the babies clothes off. Being in a naturally well lit room isn't going to be of much help for jaundice if the baby is covered from head to toe. In Seattle, especially in winter, this meant getting the room heated so that the baby didn't get cold for the few minutes of indirect sun. It also meant illiminating drafts. Because of the ambient temperature alone, you would never take an unclothed baby outside for a sunbath! Obviously in Australia, especially in the tropics, the reverse is true, and of course you need to protect the baby from overexposure to the sun. The baby I was referring to was in fact jaundiced from head to toe, quite yellow scrotum, but parents declined bililights. They did have one window that got reasonable light for some of the day. Daylight at the time of the year this baby was born (late November) was from 10am until 4pm. Not much. Most houses in Seattle were quite dark without artificial light, so it was important to know just how much natural light got into the room. In this case sufficient light since the baby started breastfeeding well, and the jaundice was eliminated by day 10. It is important to know the type of homes babies are living in. In North America for some reason the homes I lived in and visitedwere quite dark without artificial light, I remember noticing this right from the get go. Don't have any idea why this is but at least in my experience itwas so. Dark enough that you had to turn a light on to read in the middle of the day. Australian homes again, the ones I have lived in and the ones I've visited are by contrast very well lit by natural light, so so long as the baby is warm, a few minutes without clothes, inside, should be sufficient. marilyn - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 12:26 AM Subject: Re: [ozmidwifery] sun baths for jundice I was talking about Seattle, Washington where the sunlight is very very different than here. A sun bath in Seattle is a very different thing to a sunbath in Townsville, Cairns or probably anywhere except Hobart in Australia. Neverhless i took it for granted it would be indirect sun. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 2:51 AM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paed
Re: [ozmidwifery] sun baths for jundice
just to be picky, the sun's rays in Hobart are a lot stronger than those say in Melbourne or Sydney. I spent many childhood christmas's there getting thoroughly sunburnt. It has something to do with the angle the sun shines I believe. However, anywhere these days you can feel the difference in the rays from how they were 30 years ago. I had to be very vigilant with my North American niece when she lived with us for 3 months. Her concept of time in the sun for a tan was substantially longer than she could do here in Sydney. Robin From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 12:26 AM Subject: Re: [ozmidwifery] sun baths for jundice I was talking about Seattle, Washington where the sunlight is very very different than here. A sun bath in Seattle is a very different thing to a sunbath in Townsville, Cairns or probably anywhere except Hobart in Australia. Neverhless i took it for granted it would be indirect sun. marilyn - Original Message - From: M T Holroyd To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Friday, July 11, 2003 2:51 AM Subject: [ozmidwifery] sun baths for jundice Hi, just aquick question after Marilyn talked of sun baths for jaundice (below). What is the latest info on this? When I had my daughter in Townsville 9+ years ago I was told when she developed jaundice to sun her religously in am pm for a few days between SBR's. I was told this again when my second child was born (7 years ago), but this time in sunlight filtered by window. Then when he was8 months old I started my midwifery education (in Townsville) we were taught that it was no longer safe we were not to advise parents to do this (due to high skin cancer rates in N.Q). What is common practice regarding this. I have come across midwives still recommeding to sun. Tina H. Brisbane - Original Message - From: Marilyn Kleidon To: [EMAIL PROTECTED] Sent: Saturday, July 12, 2003 1:00 AM Subject: Re: [ozmidwifery] whats happening ? Hi Lynne: yes it is weird how transfers can cluster sometimes. Exhausting. Regarding the Mg SO4 and BP, one young woman I worked with in Seattle developed high BP after we made the hospital transfer(we transferred for maternal exhaustion, she had been labouring hard for 2 days and was still 3cm, BP had been stable at home, no other sx except that she had had heartburn/reflux throughout the pregnancy and i have wondered since if this masked any epigastric pain) anyway BP went from 120/70 at home to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after the epidural but while we were awaiting the stat liver function tests which the ob ordered "just in case" actually apologising for ordering them as we all thought the elevated BP wasdue to the stress of the transfer.She had HELLP syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs and pushed her baby out in between vomitting from the Mg SO4. There was thick to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in hospital 3 days on meds until her bloods were normal and BP stable, baby very jaundiced really should have had phototherapy but parents declined and went home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under paediatric care, lost 10% in first week, milk took a good 7 days to really come in once it did baby made a slow but steady weight gain. WE, the midwives were somewhat anxious, but paed was ok with it doing homevisits and sun baths for baby (trust me the UV index in Seattle is not to be worried about). Long story, sorry. So yes the milk did come in just later. marilyn - Original Message - From: Lynne Staff To: [EMAIL PROTECTED] Sent: Thursday, July 10, 2003 2:14 PM Subject: Re: [ozmidwifery] whats happening ? Hi Jan Must be something in the water - I had3 t/f to hosp as well in the past 2 months. One - a primigravida - C/B after BP shot through the roof antenatally and SROM at 37 weeks. She did labour, but for whatever reason, her body did not open, and her BP sneaking up higher and higher despite Mg So4 and hydrallazine. Home now but lactation did not establish and she has tried everything. Is anyone aware of MgSo4 or hy
Re: [ozmidwifery] sun baths for jundice
Hi. It sounds as tho we are all just guessing and extrapolating on anecdotal practices. I once wrote a research proposal for just such a study but couldn't get the money for the SBR path tests that would be needed. (I was only an undergrad student) There is a subject ripe for the picking! Cheers, MM
