Why you should favour free motricity for your baby

Free motricity consists in letting your child acquire skills on his own. Therefore, you must not get him used to being in an environment that would make him dependent: banish baby walking frames and baby bouncers, do not hold his hands to teach him how to walk, etc.

Nile60, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons

This approach favours your child’s normal and natural growth. By giving him more freedom and autonomy he can develop self-confidence and will be less dependent on adults. He will also have less frustrations and will be convinced he can do simple things on his own, such as walking.

Moreover, this technique allows you to save money that you would have spent in useless items that go against the natural growth of your child.

How to do it?

  • Put a carpet on the floor and place toys on it if you wish. Then keep an eye on your child and intervene as little as possible so that he can safely start exploring his body.
  • Encourage your child to follow his exploring by motivating him when he tries something and by congratulating him when he succeeds.

The Baby Blues

What are the baby blues and how to be prepared for them?

The baby blues correspond to an episode of intense depression that affects around 60% of women who gave birth. Why do they happen? What are their differences with the postpartum depression?

What are the baby blues?

The baby blues generally occur on the third day of diapers, i.e 3 days after delivery, but if you experienced a tough delivery, you may notice them even sooner. They consist in a hormonal, emotional and existential “storm” and are linked to the accumulation of several phenomena: physical tiredness, hormonal fluctuations, psychological upheaval…

How long do they last?

The baby blues only last a few days, disappear without any intervention and do not require any treatment. A quick and favorable evolution is favoured by the attitude of the mother’s relatives and that of the caregivers who reassure and support the new mom.

Beyond 10 days of baby blues, it is rather an early postpartum depression.

What are the differences with the postpartum depression?

The baby blues generally consist in short and minor psychological troubles while the postpartum depression is longer and more serious.

The latter can occur anytime during the first year of the baby’s life but happens very often between the sixth and the ninth week after childbirth.

The postpartum depression affects 10 to 15% of mothers.

This significant depressive episode demands multidisciplinary treatments for both mother and child. Indeed, the mother sometimes needs medical care that combine psychological counselling and an antidepressant and anxiolytic treatment.

The baby blues are a normal phenomenon that can disappear under 10 days with the relatives’ support. However, if the depression remains beyond 10 days, don’t hesitate to mention it to the nursing staff.

Fundal pressure

Fundal pressure: a practice still in use while already banned

Why is fundal pressure performed and why is it important to quit using it?

What is fundal pressure?

It corresponds to the action by which a caregiver pushes downward at the top of the uterus of the woman who is giving birth. The expected purpose of this act is to speed up childbirth.

Why is this obstetric practice banned?

There are several health risks to both mother and child.

Risks for the mom:

  • Stomach pain and bruises,
  • Rib fracture,
  • Perineal lacerations (body part going from the top of the vagina to below the anus),
  • Spleen injuries (an organ that regulates blood),
  • Liver injuries

As for the baby, he or she risks a decreased:

  • Pulse,
  • Reactivity,
  • Skin colour,
  • Muscle tone,
  • Breathing,

Is fundal pressure still practiced?

Even though it is forbidden in France since 2007, it is still done by caregivers, doctors and midwives. Indeed, even though there are no official figures in France, according to a survey of 20,000 women conducted by the CIANE (a group of French organisations working on matters related to pregnancy and childbirth):

One in five women declared that caregivers used fundal pressure during delivery to help the baby’s expulsion.

This fundal pressure practice is an act that absolutely needs to be prohibited because of its high number of risks for both mother and child.

The episiotomy

Episiotomy: a practice that must be dramatically reduced

An episiotomy is a practice that very often makes the headlines in the news. Why is it practiced and why is it debated?

What is an episiotomy?

An episiotomy is an incision made in the perineum during childbirth. It is often done at an angle over a length from 1.19 to 1.58 inches (3-4 cm).

Why is it performed?

It is performed during delivery when the vaginal opening is too small for the baby to come out or when the mother’s anus is too close to the vagina.

It is not a trivial surgery and even though it can ensure that delivery goes well, it also implies many risks for the mother such as:

  • An increased pain during and after childbirth,
  • Infections,
  • Development of abscesses (pus ball on the skin surface),
  • Difficulties to refrain from urinating and defecating,
  • Pain during sexual relations,
  • Lacerations around the vagina.

Why is the episiotomy controversial?

Today in France, 20% of women giving birth get an episiotomy.

Depending on maternity hospitals in France, this rate varies from 0.5% (in Besançon) to more than 50% in about forty hospitals, even reaching 65% in some places.

Yet, since 1996, WHO (World Health Organisation) stated the objective of 10% as a “normal” rate of episiotomy and all rates above 30% are considered “not justified”.

Finally, if the episiotomy is medically justified, it can prevent severe lacerations around pelvis and/or pudendum, but if it is not, the mother risks complications without any benefit for her health or her child’s.

In light of the health risks for the mother, the episiotomy must be limited to the cases where it is really useful.

Immediate cord clamping at birth

Immediate or delayed cord clamping? What does it change?

Cord clamping is an act practiced in different ways that can have a serious impact on the newborn’s health during his first days of life.

What is cord clamping?

At birth, the newborn is still attached to his mother through the umbilical cord (which is part of the placenta). To separate the baby from it, it is necessary to pinch the umbilical cord to stop blood circulation before cutting it.

This is what is called the umbilical cord “clamping” and “clamp” is the name of the tool used.

What is the difference between a delayed and an immediate cord clamping?

A cord clamping is considered “immediate” when it is done less than one minute after the baby’s birth and “delayed” when it is done more than 3 minutes after, or when blood pulses naturally stop inside the umbilical cord.

An immediate clamping involves health risks for the baby: it will reduce his blood quantity during the first weeks (that is called anaemia). The newborn will be weaker and more exposed to diseases and infections because immediate cord clamping denies the baby the blood from the placenta, creating an iron-deficiency. Newborns who lack blood can also suffer from lungs, intestines, heart or even brain function problems.

A delayed clamping allows to reduce or even avoid these problems: it is the practice recommended by WHO.

A delayed clamping has no negative impact for the newborn. If you are told that an immediate cord clamping needs to be done to avoid any disturbance of the umbilical cord pH exam, studies have shown that it only changes the umbilical cord pH by 0.01 points.

Therefore, always practice a delayed clamping, except for exceptional cases when the baby is in danger and needs to be rescued or resuscitated.

Delayed clamping is always to be preferred in normal deliveries.

Baths given to the baby in the delivery room

Should you have your baby given a bath upon his arrival?

Or should you let him covered with the fluids of the mother’s womb?
Learn about vernix caseosa, a protective layer naturally created by the mother and its protective role for the baby.

In the delivery room, a bath is given to the newborn child to wash him from the delivery germs but also to put him in a familiar liquid environment, just as in his mom’s womb. It also allows the father to participate and to have a first contact with his baby.

However, it has been shown that a baby is born with a protective layer called vernix caseosa: the more the baby is premature, the more he has vernix caseosa on his body, and the more the baby is overdue, the less he will have this layer at birth.

What is vernix caseosa?

It is a coating that protects and hydrates the baby’s skin and that is so efficient that scientists try to reproduce it to heal the burns unit.

When a bath is given to the newborn child in the delivery room, this layer is removed from his skin. This action exposes it to risks of dryness, dehydration and micro-lesions.It is important to know that during his first month, the newborn’s skin is immature and needs maximum protection. It is therefore necessary to limit the number of baths given during the baby’s first month of life.

WHO acknowledges that newborn babies must not be given a bath. Yet, they make an exception for religious practices but still recommend waiting at least 6 hours before bathing the baby because it will endanger his skin and also because he might get cold. If the baby is cold, he will consume energy that will cause a drop in his blood sugar levels. He will then have difficulty sleeping and won’t eat properly.

Giving a bath to the baby in the delivery room is therefore not recommended.

It is also advisable to limit the number of baths during the first month.

The systematic practice of airway oro/nasopharyngeal suctioning at birth

Is the airway oro/nasopharyngeal suctioning a really necessary practice?

The suctioning of the baby’s discharge is almost systematic at birth. But is it a good thing?

What is airway oro/nasopharyngeal suctioning?

This practice consists in the insertion of a probe in the newborn’s mouth or nose in order to clear the airway, to ensure esophageal permeability and to identify any kind of deficiency.

Is it necessary?

Airway oro/nasopharyngeal suctioning is not essential if the baby is in good health and has a good muscle tone.

Indeed, this practice isn’t always beneficial for the baby, particularly because he will be stressed out about being taken away from his mother. Moreover, since the newborn is wet, he might get cold even if he is placed on a heating table and the person who best regulates the baby’s body temperature is his mother with the skin-to-skin contact.

The fact of putting probes in the baby’s nose or mouth represents an intrusive action that can irritate him. There are also risks of edema for the newborn, i.e swelling risks that would block his nose and prevent him from breathing correctly.

As for the airway oropharyngeal suctioning, it may cause nausea and hurt the baby, bringing him difficulties to drink afterwards. As our pediatrician said, caregivers shall suck on 5 cm into the baby’s mouth but with stress they often go until 10 cm and suck stomach gastric fluid, an important nutrient fluid that helps regulate the baby’s blood sugar levels.

Thus, it is not normal to systematically use airway oro/nasopharyngeal suctioning for a baby at birth.

This practice could be avoided for healthy babies with a good muscle tone to protect them from potential side effects.

Skin-to-skin contact

Skin-to-skin contact with the baby at birth: a must for his well-being.

Skin-to-skin is highly recommended within the first two hours following delivery. It is also advisable to do it regularly during the baby’s first two weeks.

What is skin-to-skin contact?

Skin-to-skin contact consists in placing the naked newborn on one of the parents’ naked chest or belly from his very first moment of life. As our pediatrician said, it’s up to the mom to do the skin-to-skin contact during the first moments of her baby’s life, especially because her body temperature is ideal but also because she is capable of increasing it naturally by 1°C if her baby is cold. Of course, this won’t prevent the father from doing skin-to-skin contact with his child afterwards.

This practice has many other benefits for the baby: it will reduce his stress hormones and increase his well-being hormones and also allow him to receive good bacteria from the mother’s skin which help protect the baby from infections. In fact, it is recommended not to bathe the newborn on the first day and even during the following days. The white coating that recovers the baby at birth is called vernix caseosa: it naturally hydrates his skin. Skin-to-skin contact also facilitates the baby’s breastfeeding, sleep and the stabilization of his sleep-wake cycle.

But skin-to-skin contact also has benefits for the parents. Indeed, it soothes them by reducing their stress hormones. Parents become aware of the importance of the moment and start really relaxing. Finally, it will reinforce their parenting skills and intensify the bonding with their baby.

Skin-to-skin contact can last up to two hours – so you got to take your time.

All practices like nose and mouth aspirations, shortening the cord or the first checks like weighing have no interest in the first two hours following delivery if the newborn is in good health. Thus, in general, the privileged moment of an immediate and without interruption skin-to-skin contact is recommended.

Témoignage d’une maman de jumelles

Par Chloé, stagiaire à l’ABO et sœur jumelle

Dans cet article, j’ai souhaité vous parler de l’expérience de la grossesse gémellaire vécue par ma mère, qui a accouché de ma sœur et moi en juin 2000, afin de rassurer les futurs parents de jumeaux sur cette grossesse particulière.

Ma mère a eu une grossesse qu’elle qualifie de « parfaite ». Elle a été très bien suivie par un gynécologue obstétricien qui lui a fait passer des examens complets tous les mois. Les soignants qui se sont occupés d’elle, de ma sœur et de moi ont vraiment été à son écoute. De plus, elle est restée en bonne santé et nous nous sommes bien développées et étions de poids normaux. Cela a permis que l’accouchement soit réalisé une semaine avant le terme.

L’accouchement s’est déroulé par césarienne car la position de ma sœur ne permettait pas un accouchement par voie basse. Tout s’est bien passé pour ma mère comme pour nous.

Pour ce qui est des jours et mois qui ont suivi notre naissance, ma mère a été très bien entourée par notre famille et proches et reconnaît que cela a été d’une grande aide pour elle et mon père. Elle a pu ainsi garder un bon moral. Elle a simplement été fatiguée durant les 2 premiers mois, comme n’importe quel autre jeune parent. Pour elle, tout n’a été « que du bonheur ».

Futurs parents de jumeaux, soyez donc rassurés, la grossesse gémellaire peut aussi bien se passer. Ma mère a eu cette chance. Si ce n’est pas le cas, et que vous en ressentez le besoin, vous pouvez contacter notre ligne d’écoute et solliciter les professionnels de santé qui s’occupent de vous.

« Ma grossesse et mon accouchement se sont très bien passés et honnêtement je ne pouvais pas rêver mieux pour mes filles, mon mari et moi-même. »

Citation de ma maman

Se préparer pour la naissance de jumeaux

Découvrir que l’on attend des jumeaux peut être déroutant et faire se creuser la tête à l’idée d’avoir à tout gérer en double. Pour être plus serein, l’arrivée de jumeaux dans la famille, ça se prépare ! 

En ce qui concerne le suivi médical, il va être plus poussé que celui pour une grossesse unique. Les examens (échographie, prise de sang…) sont les mêmes mais ils sont réalisés plus régulièrement.

Pour préparer la naissance de jumeaux, la mère dispose de 12 semaines de congé prénatal et 22 semaines de congé postnatal (donc 34 semaines en tout, contre 16 pour une grossesse unique).

En plus des 3 jours de congé de naissance, le père ou le coparent dispose de 32 jours de congé depuis le 1er juillet 2021 (contre 25 pour une naissance unique). Passée cette période, si sa présence est encore nécessaire, un arrêt de travail peut être envisagé. C’est un véritable investissement sur l’avenir qui va permettre le bon démarrage des premiers mois de vie des enfants.

Voici une liste non exhaustive de conseils pour préparer l’arrivée de vos jumeaux : 

  • Veillez à garder une alimentation équilibrée et à manger 2 voire 3 fois mieux : vous prendrez juste le poids utile au bon déroulement de la grossesse,
  • Veillez à garder un équilibre entre repos et activité physique douce afin d’aller le plus loin possible dans la grossesse,
  • Renseignez-vous sur les aides disponibles : la CAF peut subventionner une aide au ménage ou une prime de naissance multiple ; les Centres Médico Sociaux (anciennement PMI) peuvent envoyer des professionnels chez vous pour vous aider et vous conseiller,
  • Rejoignez des forums d’entraide de parents de jumeaux pour de précieux conseils (par exemple Jumeaux et plus),
  • Faites une liste de naissance et anticipez les dépenses en matériel de puériculture : favorisez le matériel d’occasion (meilleur pour la santé des bébés et pour la planète) que vous pouvez trouver auprès des associations de soutien,
  • Identifiez vos besoins et sollicitez vos proches pour y répondre (bon pour un massage, bon pour 1h de repassage, bon pour un repas, bon pour 1h de ménage…).

Après la naissance, osez demander de l’aide. Vos proches et amis se feront un plaisir de vous aider et cela fera de vous de meilleurs parents ! Pour prendre soin de vos enfants, laissez vos proches prendre soin de vous en retour. 

“Il faut tout un village pour élever un enfant.”

Proverbe africain