Saturday, February 28, 2015

Infant Reflux on the Rise?

Infant Reflux on the Rise ?
By Richard Pass, RN,BS Director, Save A Little Life, inc.

When doing my pediatric CPR and family emergency workshop I often hear parents concern over episodes where the infant seems to stop breathing, causing tremendous fear for that family. In some instances a 9-1-1 call is made, particularly when the baby “turns blue” (a cardinal sign of low oxygen). These episodes are frequently associated with feeding which increases the perception that a choking event is underway.

Because of these very real fears many parents visit their pediatrician’s office and want answers. According to a recently published article in the Journal Pediatrics, there has been an alarming increase in the diagnosis of “infant reflux.” Among other things, this has been the cause of a huge increase in treatment, principally with the prescribing of acid suppressing medications (Pepcid, Zantac, etc.) for these infants.

What Is Reflux?

Taber’s medical dictionary defines reflux as “a return or backward flow.” Consequently, the terms (reflux and regurgitation) are often used interchangeably. Various studies reveal that a major percentage of the infant population in the U.S. (40-70%) has some form of reflux event. In many cases these events are noted when a baby “spits up” during feeding. There are, however, numerous occasions when I have heard parents tell me that some form of regurgitation can happen during non feeding times.

The rapidly growing infant usually ingests volumes of food (breast milk/formula, etc.) that on a per kilogram basis are much greater than larger children or adults. Because of this relative high volume and a relatively shorter esophagus (stomach tube) a “spillover effect” can occur. Many pediatricians believe this to be “physiologic reflux” as opposed to “reflux disease.”

Episodes of this spillover can occur infrequently or multiple times a day. This puts many parents and care providers on constant alert, often causing significant
anxiety, including fear of feeding the infant. Several medical studies suggest that the situation is self-resolving in approximately 95% of infants by 12-15 months of age.

Reflux and the incidence of apnea
Without question, the issue of effective breathing during these episodes is of primary concern to the parents I speak with. So, what is the relationship here? In depth studies looking at the relationship of regurgitation and apnea (cessation of breathing) consider the physiologic factors. Basically, “apnea is linked to a reflex in the larynx (near or around the air passages) cause respiratory pauses, airway closure, and swallowing immediately after regurgitation to the upper airway.” The consequences of these episodes are usually minimal to non-existent. Yet, as mentioned earlier, some infants have prolonged apnea, turn blue and on some occasions begin to lose consciousness. These are clearly the most unusual but cause the most panic in the parent or care provider.

Getting the Right Diagnosis
It is far too simple to assume that if an infant has episodes of reflux/regurgitation, that they in fact have GERD. There are specific diagnostic markers that your physician will look for before making this diagnosis. In the meantime, there has been a skyrocketing in the use of the aforementioned medications to treat the symptoms of reflux. One belief is that parents are so affected by the promotion of medications (usually seen on T.V. for the adult population) for this disorder that they demand a prescription and, in fact, often feel that the baby is under- treated if they leave the office without one. It turns out that the F.D.A. has not approved the use of these medications, specifically for the infant population.

In the meantime, what can parents do to assure that their baby is safe?

The most common recommendations tend to include:
- Propping the infant at a somewhat higher angle while feeding
- Increase the time between feeding and going down for nap/sleep
- Place some risers at the head of the infant’s crib (several inches at least)
- Keep a “spitting up” or reflux log that you can refer to when speaking with your pediatrician

In those very rare instances when breathing stops and the infant turns bluish in color (either face, lips, etc.) you should be prepared to stimulate the infant by using a modified “airway obstruction” position, and use some patting to their back when they are turned in a head down position. This stimulation is most likely what will get a response, even though this is not a true airway obstruction event.

Finally, be prepared for the most unusual of events . . . . Where a baby has prolonged loss of breathing. This may require the initiation of CPR in rare cases.

Haven’t taken a pediatric CPR course recently? A Mother's Haven offers the Save A Little Life CPR and Family Safety Class right here in the heart of the San Fernando Valley.

Visit us at:
16101 Ventura Blvd. Suite 230
Encino, CA. 91436
p. (818) 380-3111 w.

Friday, February 27, 2015

Prepared Childbirth Intensive at A Mother's Haven

Your body already knows how to give birth - it just needs some preparation.

This one day intensive class provides women and their partners with vital information to prepare them for childbirth. This class covers various relaxation techniques as well as options for pain interventions.

Some topics include:

* Overview of Labor and Delivery/Anticipatory Signs
* What to Pack
* Relaxation/Neuromuscular Disassociation Exercises
* How to distinguish signs of true labor
* Stages of Labor
* Breathing & Comfort Techniques
* Analgesics and Anesthesia
* Cesarean Birth
* Pushing Techniques
* Delivery of Baby
* Delivery of Placenta/Clean-up
* Postpartum and Recovery

You can register for this childbirth class by calling (818) 380-3111 or by going to the online registration page.

We recommend the one-day intensive class for second-time moms who want a review or first-time moms who can't make it to the 4-week series class.

Visit us at:
16101 Ventura Blvd. Suite 230
Encino, CA. 91436
p. (818) 380-3111 w.

Friday, February 6, 2015

Pump Rentals at A Mother's Haven

If you're pumping constantly throughout the day — perhaps because you or your baby isn't able to breastfeed — you'll need the most efficient pump around: a heavy-duty hospital-grade model with a double collection kit. These pumps have a rapid suck-and-release cycle that draws milk from your breasts at about the same rate as a nursing baby.

A Mother's Haven carries top of the line hospital grade pumps for your breastfeeding needs. The Medela Symphony breast pump rents for $4 per day with a two-week minimum. You can also rent on a month-to-month basis for $75 per month, or you can save money by committing to a longer term ($195 for three months (save $30), $300 for six months (save $150), etc). No deposit is required - just your driver's license and a credit card number on file.

Please call us at (818) 380-3111 to reserve your rental pump! It's best to bring in all of your pumping supplies when you rent your hospital-grade pump so that we can double check that you have everything that you'll need, and we can show you how all the pump parts go together. We'd hate for you to get home and not be able to pump!

We rent pumps from our boutique & educational center in Encino (16101 Ventura Blvd, Ste 230) to new moms all over the San Fernando Valley and Los Angeles County - as close as Sherman Oaks, Studio City, Reseda, Van Nuys, & Tarzana, and as far as away as Woodland Hills, Porter Ranch, Northridge, Toluca Lake, Lake Balboa, Sylmar, North Hollywood, Glendale, Valley Village, and Burbank.

We also sell the Medela breast pump spare parts and accessories, such as the pump tubing, breast shields, bottles, freezer bags, etc.

Visit us at:
16101 Ventura Blvd. Suite 230
Encino, CA. 91436
p. (818) 380-3111 w.

Our YouTube Debut - Medela Symphony Breast Pump

We're starting video series to explain common questions that new moms have.  Our first video is about how to put together all of the pump parts for your Medela Symphony hospital-grade pump - from the membrane caps, to the tubing, to the breastshields and bottles.  All those little parts can be a bit confusing, especially when you're a sleep-deprived new mom!  So watch the video and see how everything fits together!

We rent out the Medela Symphony hospital-grade pumps on a weekly or monthly basis. Rental pumps are only $75 per month. We also sell all of the extra parts including (but not limited to) tubing, bottles, freezer bags, etc. Whatever questions you have about your pump, come on in and we'll help you out!

If you have more questions about milk supply, how to manage pumping & going back to work, etc, come in for our Breastfeeding & Pumping Support Group on Tuesday mornings at 10am. Only $10 for drop-in!

We're also going to be making some videos about how to use the different baby carriers (Moby Wrap, Ergo, BECO, Baby K'Tan, etc).  If you have any other questions that are easier explained through demonstration, comment below and we'll add it to our video series!

Visit us at:
16101 Ventura Blvd. Suite 230
Encino, CA. 91436
p. (818) 380-3111 w.