Tag: babies

  • New FAQs address healthcare workers questions on breastfeeding and COVID-19

    New FAQs address healthcare workers questions on breastfeeding and COVID-19

    Mothers and healthcare workers who support them have many questions and concerns about whether it is safe for mothers with confirmed or suspected COVID-19 to be close to and breastfeed their babies during the pandemic.

    To address their questions, WHO has released a list of Frequently asked questions: Breastfeeding and COVID-19. The FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection when COVID-19 is suspected and draws upon other WHO recommendations on infant and young child feeding.

    The FAQs aim to provide information to healthcare workers supporting mothers and families in maternity services and community settings, and communicate how the interim guidance should be implemented. Additionally, the FAQs provide information about the protective effects of breastfeeding and skin-to-skin contact, and the harmful effects of inappropriate use of infant formula milk.

    Accompanying the FAQs is a decision tree which provides step-by-step guidance to health workers on how to support mothers with confirmed or suspected COVID-19 to breastfeed. It provides advice on what to do if mothers are not well enough to breastfeed, as well as appropriate hygiene measures for mothers, including wearing a medical mask if available, to reduce the possibility of the COVID-19 virus being spread to her infant.

    Benefits of breastfeeding outweigh potential risks

    The COVID-19 virus has not been detected in the breastmilk of any mother with confirmed and suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding. Researchers continue to test breastmilk from mothers with the infection.

    WHO recommends that all mothers with confirmed or suspected COVID-19 continue to have skin-to-skin contact and to breastfeed. In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother. Skin-to-skin contact, including kangaroo mother care, reduces neonatal mortality, especially for low birth weight newborns.

    While infants and children can contract COVID-19, they are at low risk of infection. The few confirmed cases of COVID-19 in young children to date have experienced only mild or asymptomatic illness.

    WHO’s recommendations on the care and feeding of infants whose mothers have confirmed or suspected COVID-19 aim to improve the immediate and lifelong survival, health and development of their newborns and infants. These recommendations consider the likelihood and potential risks of COVID-19 in infants and also the risks of serious illness and death when infants are not breastfed or when infant formula milk are used inappropriately.

    WHO’s Q&A on breastfeeding and COVID-19 also provides additional infection prevention advice to mothers with confirmed or suspected COVID-19.

    New FAQs address healthcare workers questions on breastfeeding and COVID-19
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    https://www.who.int/news-room/detail/28-04-2020-new-faqs-address-healthcare-workers-questions-on-breastfeeding-and-covid-19

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  • What matters to women in the postnatal period?

    What matters to women in the postnatal period?

    The right to a positive maternity healthcare experience at every stage 

    Each pregnancy is unique and clinical needs can change across the pregnancy, childbirth and postnatal periods. One thing that never changes is the right to a positive experience at every stage. 

    Achieving the best possible physical, emotional, and psychological outcomes for every individual and newborn requires health systems to take a human rights-based approach: not only preventing maternal death and morbidity, but prioritising person-centred
    care and well-being.

    WHO is developing new guidelines for a positive experience of postnatal care, due to be published next year. To inform these guidelines and ensure that postnatal services can better meet the needs of women and their babies, WHO undertook a qualitative
    systematic review on what matters to women in the postnatal period.

    Joys and challenges in the postnatal period

    There is limited research about values and preferences in the postnatal period, defined by WHO as the first six weeks after childbirth. Studies have often focused on the results of specific postnatal interventions, rather than on the individuals who use
    them. 

    ‘What matters to women in the postnatal period: A meta-synthesis of qualitative studies,’ published in PLOS ONE, gives long-overdue respect to the authority of women’s own experiences. The authors review first-hand data from 15 countries
    and 36 studies published after the year 2000 relating to women’s beliefs, expectations and values at this significant time of life.  

    These studies affirm that a positive postnatal experience can result in joy, self-confidence and enhanced capacity to thrive as both a person and a parent.

    They are also vocal about the potential challenges of adjusting to a ‘new normal’ following childbirth, including changes in self-identity, relationships, and sexual behaviour.

    What is a positive postnatal experience? 

    A positive postnatal experience for a woman will be one that responds to her specific context and preferences. 

    It will provide the confidence, knowledge and skills women need in the weeks following childbirth, supporting them to adjust to any changes in their intimate relationships and build new family ones. Women will be better equipped to navigate physical and
    emotional challenges and to experience the dynamic achievement of personal growth. 

    This should be a shared responsibility, not a solitary one. Community has a critical role in enabling a positive postnatal experience, including partners, family and elders.

    It is crucial that healthcare providers meet each woman’s needs, as well as those of their babies. 

    Supporting choices and rights to improve postnatal health outcomes

    There are an estimated 303 000 maternal deaths annually, according to recent WHO figures. Most of these deaths occur postnatally. 

    The postnatal period is therefore a vital opportunity to improve both maternal and neonatal health and wellbeing: supporting healthy behaviors, providing life-skills education, facilitating breastfeeding, counselling women about family planning options,
    supporting good mental health, preventing and treating childbirth-related complications. 

    Health care systems that empower individuals by supporting their values, preferences and rights are fundamental to improving maternal and newborn health outcomes. 

    WHO’s guidance for positive maternity care

    WHO has recently released recommendations on antenatal care for a positive pregnancy experience, and on intrapartum care for a positive childbirth experience.

    These publications made important clinical updates, including an increase from four to eight recommended antenatal contacts, and a revision to the decision-making process for interventions to accelerate labour. 

    They also uphold every woman’s right to a positive maternity care experience: one where her pregnancy does not erase her competency, autonomy and right to participate in decision-making for her own care and the care of her newborn. 

    Women’s choices and rights to sexual and reproductive health care, including maternity care, should be respected at every stage of the continuum of maternal and newborn care. This is true across all income settings, as well as in humanitarian settings
    and during public health emergencies.

    When WHO’s postnatal guidelines are released next year, they will complete the maternity care series built around what matters to women.

    Rather than dividing care into three periods of antenatal, intrapartum and postnatal, these publications can be used to establish a model in which health systems support women, their baby and wider network physically, psychologically, socially and emotionally
    through this significant life event. 

    Other resources

     

    What matters to women in the postnatal period?
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    https://www.who.int/news-room/detail/22-04-2020-what-matters-to-women-in-the-postnatal-period

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  • RACE SUICIDE

    RACE SUICIDE

    A favorite argument of certain opponents of scientific Birth Control is that such teachings and modes of conduct tend toward Race Suicide, and the consequent weakening and final destruction of the human race by means of “bleeding it white” by draining from it its normal supply of children. Those who hold this view argue that if Birth Control methods become popular, and sanctioned by the law and public opinion, then the race will eventually die out and disappear from the face of the earth. Some vary the argument by insisting that those nations favoring Birth Control would suffer decline and gradual extinction at the hands of other nations opposed to scientific methods of regulating the number and frequency of offspring. This is a serious charge against Birth Control, which if proved would probably serve to array all right-thinking persons against it.

    But the advocates of Birth Control seriously and positively controvert and deny the validity and truth of this argument. On the contrary they claim that scientific Birth Control would not only keep up the population of all countries, or any country, to a normal standard proportionate to its ability to sustain properly such population, but will also act to render that population stronger and better, physically, mentally and morally, and far more efficient in every way owing to improved quality of the stock. The first requisite is met by the reduction of the death rate to meet the decreasing birth-rate; and the second requisite is met by the improvement of the stock by proper rearing and training made possible by the decreased size of the average family. Birth control serves to eliminate the waste caused by excessive infant mortality, and to thus fully counterbalance the decreased birth rate.

    The advocates of Birth Control assert that the natural instinct of parenthood, the love of children, and the desire for offspring and the perpetuation of the family name and stock, are too firmly rooted and grounded in human nature to be seriously affected by such knowledge and practice on the part of the race. They point to the fact that in many families in which intelligent modes of Birth Control are favored, and in which the size of the family has been limited to a few children, the children are, as a rule, better cared for and provided for, better reared and better educated, than in the case of families in which children are brought into the world without thought or reason, and without the possibility of proper care and rearing. Birth Control, say its advocates, will not do away with children, but will merely regulate their number to rational limits, and at appropriate intervals between births. Moreover, it is claimed, that while the birth-rate in such families may be smaller, the death-rate is also smaller. And, at the last, it is the number of children that survive that counts with the race, not those who merely are born.

    The fact that many persons consult physicians for a cure for sterility, and go to great trouble and expense to further the bearing of children, and the fact many childless couples adopt children rather than to have a childless home, are evidence of the fact that there is no danger of the parental instinct dying out. It is the experience of physicians generally that the patients who desire information regarding scientific contraceptive methods are usually those who already have as many children as they can well take care of, and not those who wish to escape parenthood in toto.

    We are constantly reminded that the size of the average family is much smaller than it was a hundred years ago—but still the race is rapidly increasing, owing to the decreased death-rate resulting from a better knowledge of hygiene and medicine. Moreover, it is positively asserted that the “old time large family” frequently had one father but several mothers—the husband marrying several times in order to replace with a new life the old wife who had broken down and died from overwork and excessive childbearing.

    It is claimed that in Holland, in which Birth Control is recognized by law, and where it is legally sanctioned and even encouraged among those who are not able to support large families, statistics show that the population is increasing more rapidly than before, owing to the decreased mortality of infants and young children arising from the better care of those who are born.

    Dr. Robinson says on this point: “Here we have a whole country, Holland, in which the prevention of conception is legally sanctioned, in which the use of preventives is practically universal—and is this country dying out? On the contrary, it is increasing more rapidly than before, because we have this remarkable and gratifying phenomenon to bear in mind, that wherever the birth-rate goes down, the death rate goes down pari passu, or even to a still greater degree. This can be proven by statistics from almost every country in the world. For instance, in 1910 the birth-rate in Holland was 32, and the mortality 18; in 1912 the birth-rate fell to 28, but then the mortality rate fell still lower, namely to 12, so we see an actual gain in population, instead of a loss. And the physical constitution of the people has been improving * * *. And in New Zealand, where the sale of contraceptives is practically free, the birth rate is now 20, and the mortality rate is 10. Does that look like race suicide? On the contrary, there is a steady increase at the rate of ten per cent, while sickness and death of children, with their attendant economic and emotional waste, are reduced to a minimum.”

    Not only are the children of small families as a rule better cared for, from economic reasons easy to discern, but it is also a fact that the health of the mothers is far better, and consequently the health of the children when born is better than the average. One has but to look around him upon the families who boast of having had eight, ten, and twelve children born to them, to see what a frightful average percentage of deaths of infants and young children is present, and which brings down the number of the survivors.

    Dr. Alice Hamilton, in “The Bulletin of the American Academy of Medicine,” for May, 1910, reports that she has investigated the families of 1,600 wage workers, and found the following death rate per 1,000 birth among them, viz.:

    Families of 4 children and less 118 deaths per 1,000 births
    Families of 6 children 267 deaths per 1,000 births
    Families of 7 children 280 deaths per 1,000 births
    Families of 8 children 291 deaths per 1,000 births
    Families of 9 children or more 303 deaths per 1,000 births

    Dr. Hamilton sums up her investigation as follows:

    “Our study of the poorer working class shows that child mortality increases proportionately as the number of children increase, until we have a death rate in families of 8 children and over which is two and a half times as great as that in families of 4 children and over.”

    The facts above mentioned, and other facts of the same nature which will be disclosed in the progress of our consideration of the matter in the present book, have evidently been overlooked, deliberately or otherwise, by the fanatics in this country and in Europe who have been preaching to the people that a falling birth-rate means a decaying nation. Careful students of sociology now dismiss altogether the statement so often made that a falling birth-rate means “an old and decaying community.” The Germans for years have contemptuously been making this remark about France, but today they have been forced to recognize an unexpected vitality in the French, while, in fact, their own birth-rate has been falling more rapidly than that of France.

    Nor is it true that a falling birth-rate means a falling population. The French birth-rate has been steadily falling for a number of years, yet the French population has been steadily increasing all the time, though less rapidly than it would had not the death-rate been abnormally high. It is not the number of babies born that counts, but the net result in surviving children. An enormous number of babies are born in China; but an enormous number die while still babies. So that it is better to have a few babies of good quality than a large number of indifferent quality, for the falling birth-rate is more than compensated by the falling death-rate. In England, as the statistics show, while the birth-rate is steadily falling, the population has been steadily growing.

    Small families and a falling death-rate are not merely no evil—they are a positive good. They are a gain for humanity. They represent an evolutionary rise in Nature and a higher stage in civilization. We are here in the presence of a great fundamental principle of progress which has been working through life from the beginning.

    At the beginning of life on the earth, reproduction ran riot. Of one minute organism it is estimated that, if its reproduction were not checked by death or destruction, in thirty days it would form a mass a million times larger than the sun. The conger-eel lays fifteen million eggs, and if they all grew up, and reproduced themselves on the same scale, in two years the whole sea would become a wriggling mass of eels. As we approach the higher forms of life, reproduction gradually dies down. The animals nearest to man produce few offspring, but they surround them with parental care, until they are able to lead independent lives with a fair chance of surviving. The whole process may be regarded as a mechanism for slowly subordinating quantity to quality, and to promoting the evolution of life to even higher stages.

    This process, which is plain to see on the largest scale throughout living nature, may be more minutely studied, as it acts within a narrower range, in the human species. Here we statistically formulate it in the terms of birth-rate and death-rate; by the mutual relationship of the two courses of the birth-rate and death-rate we are able to estimate the evolutionary rank of a nation, and the degree in which it has succeeded in subordinating the primitive standard of quantity to the higher and later standard of quality.

    Especially in Europe we can investigate this relationship by the help of statistics which in some cases extend back for nearly a century. We can trace the various phases through which each nation passes, the effects of prosperity, the influence of education and sanitary improvement, the general complex development of civilization, in each case moving forward, though not regularly and steadily, to higher stages by means of a falling birth-rate, which is to some extent compensated by a falling death-rate, the two rates nearly always running parallel, so that a temporary rise in the birth-rate is usually accompanied by a rise in the death-rate, by a return, that is to say, towards the conditions which we find at the beginning of animal life, and a steady fall in the birth-rate is always accompanied by a fall in the death-rate.

    It is thus clear that the birth-rate combined with the death-rate constitutes a delicate instrument for the measurement of civilization, and that the record of their combined curves registers the upward or downward course of every nation. The curves, as we know, tend to be parallel, and when they are not parallel we are in the presence of a rare and abnormal state of things which is usually temporary or transitional.

    A study of the statistics of European countries furnishes us with evidence of the facts above stated. It is instructive to perceive how closely the birth-rate and the death-rate of the several European countries agree. It is perceived that the eight countries of Europe which register the highest birth-rate are the identical countries registering the highest death-rate. This is as might be expected, for a very high birth-rate seems fatally to involve a very high death-rate. The study of the following table may prove interesting—it certainly is instructive. In the following table the European countries having the highest birth-rate are stated in the order of rank according to size of such rate; and the countries having the heaviest death-rate are stated in the order of their rank in size of such rate:

    Highest European Birth-Rate.  Highest European Death-Rate.
    Russia. Russia.
    Roumania. Roumania.
    Bulgaria. Hungary.
    Serbia. Bulgaria.
    Hungary. Spain.
    Italy. Serbia.
    Austria. Austria.
    Spain. Italy.

    Moreover, Japan, with a rather high birth-rate, has the same death-rate as Spain; and Chile, with a still higher birth-rate, has a higher death rate than Russia. So, we see, that among human peoples we find the same laws prevailing as among animals, and the higher nations of the world differ from those which are less highly evolved precisely as the elephant differs from the herring, though within a narrower range, that is to say, by producing fewer offspring and taking better care of them.

    So, when we get to the root of the matter, the whole question of “Does Birth Control tend toward Race Suicide?” becomes clear, and we are able to answer, positively, “It certainly does not; on the contrary it tends toward Race Progress and Race Betterment.” We see that there is really no standing ground in any country for the panic-monger who bemoans the fall of the birth-rate, and storms against small families. The falling birth-rate is a world-wide phenomenon in all countries that are striving toward a higher civilization along lines which Nature laid down from the beginning. We cannot stop it if we would, and if we could we should be merely impeding civilization. It is a movement which rights itself and tends to reach a just balance.

    Instead of trying to raise the birth-rate by offering a bonus on babies as has been proposed in some quarters, it would be saner and better calculated for the betterment of the race to offer a bonus upon young men and women who attained maturity with a definite high standard of physical and mental development. As a writer on the subject has well said: “But we need not therefore fold our hands and do nothing. There is much still to be effected for the protection of motherhood and the better care of children. We cannot, and should not, attempt to increase the number of children born; there is still far more misery in having too many babies than in having too few; a bonus on babies would be a misfortune, alike for the parents and the State. But we may well work for the better quality of babies. There we should be on very safe ground. More knowledge is necessary so that all would-be parents may know how they may best become parents, and how they may, if necessary, best avoid it. Procreation by the unfit should be, if not prohibited by law, at all events so discouraged by public opinion that to attempt it would be considered disgraceful. Much greater public provision is necessary for the care of mothers during the months before, as well as in the period after, the child’s birth. Along such lines as these we may hope to increase the happiness of the people and the strength of the State. We need not worry about the falling birth-rate.”

    The more that one intelligently examines the argument against Birth Control based upon fear of Race Suicide, the more one becomes convinced that not only is there “nothing to it,” but that every fact brought to light in the inquiry reveals itself in the nature of proof of the desirability of Birth Control as a factor of Race Evolution, rather than evidence to the contrary. Therefore, the more inquiry and investigation that such argument brings forth, the stronger is the case disclosed for Birth Control, and the greater the amount of public opinion created in its favor.

    In all considerations of the general question of Race Suicide, one must take note of the general question of Eugenics or Human Breeding. This because the sound breeding of the race operates in a direction diametrically opposed to Race Suicide, while unsound breeding operates directly in favor thereof.

    When we consider the general subject of Eugenics we touch upon the highest ground, and are concerned with our best hopes for the future of the world. There can be no doubt that Birth Control, considered as a phase of Eugenics, is not only a precious but also an indispensable instrument in moulding the coming man to the measure of our developing ideals. Without Birth Control we are powerless in the face of the awful evils which flow from random and reckless reproduction. With it we possess a power so great that some persons have professed to see in it a menace to the propagation of the race, amusing themselves with the idea that if people possess the meansto prevent the conception of children they will never have children at all. It is not necessary to discuss such a grotesque notion seriously.

    The desire for children is far too deeply implanted in mankind and womankind alike ever to be rooted out. If there are today many parents whose lives are rendered wretched by large families and the miseries of excessive child-bearing, there are an equal number whose lives are wretched because they have no children at all, and who snatch eagerly at any straw which offers the smallest promise of relief to the craving. Certainly there are people who desire marriage, but—some for very sound and estimable reasons and other for reasons which may less well bear examination—do not desire children at all.

    For the class of married people who do not desire children at all, contraceptive methods, far from being a social evil, are a social blessing. For nothing is as certain as that it is an unmixed evil for a community to possess unwilling, undesirable parents. Birth Control would be an unmixed blessing if it merely enabled us to exclude such persons from the ranks of parenthood. We desire no parents who are not competent and willing parents. Only such parents are fit to father and to mother a future race worthy to rule the world.

    It is sometimes said that the control of conception, since it is frequently carried out immediately upon marriage, will tend to delay parenthood until an unduly late age. Birth Control has, however, no necessary result of this kind, and might even act in the reverse direction. A chief cause of delay in marriage is the prospect of the burden and expense of an unrestricted flow of children into the family; and it is said that in Great Britain, since 1911, with the extension of the use of contraceptives, there has been a slight but regular increase not only in the general marriage rate but also in the proposition of early marriage. The ability to control the number of children not only enables marriage to take place at an early age, but also makes it possible for the couple to have at least one child soon after marriage. The total number of children are thus spaced out, instead of following in rapid succession.

    It is only of late years that the eugenic importance of a considerable interval between births has been fully recognized, as regards not only the mother—this has long been recognized—but also the children. The very high mortality of large families has long been known, and their association with degenerate conditions and with criminality. However, of recent years, evidence has been obtained that families in which the children are separated from each other by intervals of more than two years are both mentally and physically superior to those in which the interval is shorter. Investigators have found that children born at only a short interval after the birth of a previous child are notably defective, even at the age of six, in a large percentage of cases; and when compared with children born at a longer interval, or with first children, they are, on the average, three inches shorter and three pounds lighter. These are facts of the most vital significance.

    Thus when we calmly survey, in however summary a manner, the great field of life affected by the establishment of voluntary human control over the production of the race, we can not see a cause for anything but hope. It is satisfactory that it should be so, for there can be no doubt that we are here facing a great and permanent fact in civilized life. With every rise in civilization, indeed with all evolutionary progress whatever, there is what seems to be an automatic fall in the birth-rate. That fall is always normally accompanied by a fall in the death-rate, so that a low birth-rate frequently means a high rate of natural increase, since most of the children born survive.

    Thus in the civilized world of today, notwithstanding the low birth-rate which prevails as compared with earlier times, the rate of increase in the population is still appalling—nearly half a million a year in Great Britain, over a million in Austro-Hungary, and three-quarters of a million in Germany. When we examine this excess of births in detail we find among them a large proportion of undesired and undesirable children. There are two alternative methods working to diminish this proportion: the method of regulating conception under the methods of scientific Birth Control, or the bungling substitutes for the same, on the one hand, and the method of preventing live births after conception by means of the abominable practice of abortion.

    There can be no doubt about the enormous extension of the practice of abortion in all civilized countries, even although some of the extravagant estimates of its frequency in countries, the United States for example, be discarded as unwarranted. The burden of bearing excessive children on the overworked and underfed mothers of the working classes becomes at last so intolerable that almost anything seems better than another child. As a woman in Yorkshire once said to an English investigator of this evil: “I’d rather swallow the druggist’s shop and the man in it, than have another kid.”

    A community which takes upon itself the responsibility of encouraging abortion lays itself open to severe criticism. And it must be admitted that just as all those who work for Birth Control are really diminishing the frequency of abortion, so every attempt to discourage Birth Control promotes abortion. We have to approach this problem calmly, in the light of Nature and reason. We have each of us to decide on which side to range ourselves. For it is a vital problem concerning which we cannot afford to be indifferent.

    There is no desire here to exaggerate the importance of Birth Control. It is not a royal road to the millennium of the race; and like all other measures which the course of progress forces us to adopt, it has its disadvantages. But fairness and honest thought should admit freely that so far as is concerned the question of its being a factor toward Race Suicide, we must pronounce a verdict of “Not Guilty” upon Birth Control. On the contrary, the contrary course of teaching and practice, if carried to their full logical conclusion, would inevitably bring the race to such a stage of degeneracy, and retrogression to primitive type, that a fate far worse than suicide would befall the human race. For the race, as well as the individual, may commit “suicide” and an end to its career, not only by a will-not-to-live but also by a will-to-degenerate.

    The face of Birth Control is set toward the rising sun of Race Betterment, not toward the setting sun of Racial Decline. Its ideas are those of Race Life, not of Race Death. It bids the race not to perish, but rather to live on in greater strength, happiness, and efficiency. Birth Control is in full accord with the Racial Will-to-Live, and not opposed to it. All humanity, all civilization, all human progress, call upon us to take our stand upon this vital question of Birth Control. And, as a writer has well said, in doing so we shall each of us be contributing, however humbly, to that “one far-off event, to which the whole creation moves.”

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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