Aspen Birth Center Blog

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Aspen Birth Center Blog

Quick Antiviral Treatment of Influenza-is Critical

January 5, 2018

Influenza activity, predominantly from A(H3N2), has increased significantly in recent weeks, according to the Centers for Disease Control and Prevention (CDC), which issued a health advisory Wednesday. Given the characteristics of this season's flu, the CDC is recommending, in addition to the flu vaccine for prevention, increased use of neuraminidase inhibitor (NAI) antivirals for treatment.

Quick treatment is crucial and "should not be delayed even for a few hours to wait for the results of testing," according to the advisory. Treatment works best when started within 2 days of onset but has shown benefit for some patients even when initiated later.

Focus on treatment is important because in past seasons, Quick read more or view full article A(H3N2) has been linked with more deaths and hospitalizations in people aged 65 years and older and young children than in other groups. Also, this year's vaccine effectiveness may be as low as last year's, at 32% for A(H3N2), the CDC says.

The advisory reminds clinicians that all inpatients and all high-risk patients (whether inpatient or outpatient) who are suspected of having or confirmed to have influenza should be treated.

Those groups include the following:

  • Patients with severe, complicated, or progressive illness, including outpatients with severe or prolonged progressive symptoms or those who develop pneumonia;

  • Children under age 2 years or people 65 years and older, as well as people younger than 19 years who are receiving long-term aspirin therapy;

  • American Indians/Alaska natives;

  • Women who are pregnant or within 2 weeks postpartum;

  • People with suppressed immune systems;

  • Extremely obese people (body mass index of at least 40); and

  • Those living in long-term care facilities.


Treatment is also indicated when flu is suspected or confirmed for "persons with chronic pulmonary (including asthma), cardiovascular (except hypertension alone), renal, hepatic, hematological (including sickle cell disease), and metabolic disorders (including diabetes mellitus), or neurologic and neurodevelopment conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability [mental retardation], moderate to severe developmental delay, muscular dystrophy, or spinal cord injury)," the CDC advises.

To more effectively treat patients quickly, the CDC says providers may consider setting up phone triage lines or write antiviral prescriptions without testing and before an office visit when treatment is deemed necessary over the phone.

Three NAIs are approved by the US Food and Drug Administration and recommended for the 2017-2018 season: oseltamivir; zanamivir; and peramivir.

Article: CDC Advisory: Flu Increasing, Be Ready With Antivirals - Medscape - Dec 28, 2017. Read Less
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Sharing is Caring- but is it safe?

December 12, 2017

Milk Sharing
The sharing of human milk has existed since the beginning of time. Mothers have either breastfed
children who were not biologically related to them or expressed and shared milk with a child other than their own. In early times if a baby did not receive human milk they died as there were no safe alternatives. In more modern times breastmilk substitutes have been developed for those times when a mother is unable or unwilling to breastfeed or provide enough of her breastmilk. So how can we safely give our babies human milk?

What are the risks associated with informal human milk sharing?
Human milk, when shared outside milk banks that follow accepted Quick read more or view full article guidelines, does not provide the same safety guarantees and the possibility of serious adverse consequences cannot be ruled out.
The main risks of sharing milk are that it is contaminated with pathogenic bacteria as a result of suboptimal collection, storage and transportation or that it contains viruses as a result of the mother having unknown infections which may be transmitted via the milk.

These include viral infections such as:

  • HIV,
  • Hepatitis
  • HTLV

(Human T Lymphotropic Virus).  Harmful bacteria ingested in large quantities through breastmilk may lead to Viruses such as HIV and HTLV in breastmilk can cause serious illnesses, some of them manifesting severe infections including septicemia, several years after contamination. Screening of donors, milk testing and appropriate pasteurization, as routinely done in human milk banks, greatly reduces the risks associated with sharing breastmilk. In addition, the shared milk may contain medications taken by the mother as well as alcohol, nicotine, drugs and other contaminants.

Milk banks: Mother's Milk Bank of Colorado-Website

Breastmilk is especially critical for the healthy survival of very low birth weight, premature  and sick infants. Mothers of these infants may be unable to provide sufficient human milk for their needs particularly in the early days following the baby’s birth. Milk banks affiliated  with EMBA and HMBANA follow rigorous protocols to screen donors, test, process and dispense the donated milk and to provide safe donor human milk to these infants.
Story about how to donate: click here to watch a video link about donating milk
To be eligible as a milk donor, one must:

  • Be confident in her milk supply and produce milk in excess of her own baby’s needs
  • Be willing to donate a minimum total of 150 ounces throughout her time as a donor with us
  • Not have any medical condition that prohibits her from giving blood
  • Be in excellent health without any chronic illnesses or history of major medical issues or cancer, including leukemia
  • Have no history of hepatitis after age 11 or positive tuberculosis tests
  • Be a non-smoker and refrain from using tobacco or marijuana products of any kind
  • Have not received blood or blood products or organ or tissue transplants in the past 12 months
  • Have no history of intimate contact with anyone at risk for HIV/AIDS
  • Not be taking vitamin supplements that exceed 2000% Daily Value (DV)
  • Take only approved medications and herbal supplements/teas. Mothers’ Milk Tea, fenugreek and any lactation support product containing fenugreek or other herbs is NOT compatible with donating.
  • Not have any medical condition that prohibits her from giving blood (there are exceptions to this rule – please contact us if this applies to you).
  • Consume less than 24 ounces of caffeinated beverages a day (2-3 cups of coffee)
  • Wait 12 hours after drinking any alcoholic beverage to collect milk to donate
  • Be motivated to practice exceptional hygiene and carry out careful milk collection and storage methods
  • Be willing to undergo blood testing
  • Be less than 18 months postpartum when collecting the milk

There are some exceptions to these guidelines. If you would like to discuss your eligibility,
please contact- 
Mother's Milk Bank at 303.869.1888 or toll-free at 877.458.5503.

Information shared by Human Milk Banking Association of North America-
and Mother's Milk Bank of Denver
Heather Knott, RN-IBCLC



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New Dad: What You Can Do To Make Breastfeeding Better For Your Partner

October 31, 2017
Spoiler alert: you don’t have boobs.

Well, you don’t have functional ones. This puts you in a tricky position during breastfeeding: you want to be there for your partner while she tackles this very serious task, and also provide relief from all the difficult parts of the process — the soreness, the frustration, the lack of sleep. That being said, you also don’t want to overstep your bounds during this important mother-child time. To offer some clarity, we reached out to several women who kindly shared the best things their partners did to help their nursing go a bit smoother. However, you pitch in, understand that your practical and emotional support during breastfeeding is a vital part of the process.  

Quick read more or view full article /> 1. Figure Out What She Needs
Granted, this can be easier said than done when it’s 4 AM and you’re on 20 minutes of sleep, but divining your partner’s needs is one of the most important things all moms expressed. Laurie, a mom from New York, says her husband asked gently probing questions to figure out what his role would be during her nursing. Does the mom want bonding and cuddling? Does she miss something from her life before becoming a mom in particular? With answers to these sorts of questions, “you can work as a team to make the best of her breastfeeding journey,” Laurie said.

2. Don’t Press Too Hard
Nursing doesn’t come easy for every mom. The process can make many feel frayed or even inadequate if a baby won’t latch. Several moms we spoke with said it’s their partner’s duty to feel out the room and understand when a mom needs some alone time. Pennsylvania mom Hazel recalled being such a stressed out breastfeeder that the best thing her her husband did was to leave her alone and stop watching her fail. And she added: “Don’t make her feel like a failure if you need to supplement...” she said.

3. Keep The Older Kids Occupied
All moms were adamant that dads on their second or third kid have a critical job during nursing: keeping the older kids out of mom’s hair so she can concentrate on the little one. Connecticut mom Claire said she appreciated it the most when her partner would be sure to take the kids somewhere else while she was breastfeeding. “Get the other kids out of the house so mom can relax and have some downtime,” she recommended.

4. Have Snacks And Drinks at The Ready
Moms need to eat extra after giving birth — the general recommendation is to eat 500 calories more per day than they did before becoming pregnant. Unfortunately, nursing leaves little time for elaborate meals. Colorado mom Laura said the number one thing her husband did for her was to always have snacks and water at the ready. Whatever snacks you pick, make sure they’re ready to eat with one hand.

5. Act As Her Breast Pump Pit Crew
If mom’s using a pump, you can provide valuable technical support by making sure all parts and accessories are cleaned and laid out properly. New Jersey mom Ellen said her husband was integral by helping to clean the breast pump components to ensure it was ready whenever she needed it.  After her maternity leave ended, Ellen said that her husband would lay the gear out the night before so in the morning she could grab it and go to work. 

6. Be a Human Book on Tape
California mom of three Ami recalled that when she had her first child her husband would bring the baby to her bed for the late night feedings and stay to read from their copy of What to Expect When You’re Expecting. “It was wonderful to have the company and companionship,” she said. “Breastfeeding an infant at 3 a.m. can be very lonely and isolating. Having a partner who is willing to sit up with you and keep you company makes a huge difference.”

7. Give Mom the Gift of Quiet
Remember the above advice about figuring out what mom wants? Well, not every mom is going to want you to whisper encouragement in their ear as they spend the wee hours of the morning with an infant latched to their teat. Some appreciate a little space and it’s your job to build it. In those scenarios, what you can do is give mom a space of her own. “I treasured my alone time nursing late at night in the rocker before I went to bed and the baby was nursing asleep,” said Dawn, a mom from Vermont. “[My partner] Josh made sure I was all set up with remote, books, snacks, tea, water, etc.”

8. Be Ready to Listen
When mom is breastfeeding she’s going to encounter problems that you can’t solve. And that will be hard because you will want to provide solutions. But all moms said that it’s integral to let her vent and be a patient, sympathetic listener and cool it on any MacGyver-ing you might have planned. “If she complains, it’s because breastfeeding is so hard,” said New York mom Lauren.“Listen first,” Lauren declares. 

Author: Adam Bulger writes for Fatherly
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Posted by Heather Knott, RN-IBCLC and Childbirth Educator
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Moms-to-be Can Protect Against Newborn Whooping Cough

October 4, 2017

In 2012, as whooping cough continued its deadly comeback, the U.S. Centers for Disease Control and Prevention recommended that women get vaccinated against the bacterial infection during each pregnancy.

A new CDC study finds that the preventive measure works. The vaccine, called Tdap (tetanus, diphtheria, and pertussis), cut the risk of whooping cough, or pertussis, by 78 percent in babies younger than two months whose mothers got inoculated in their third trimester of pregnancy.

The study, published Thursday in Clinical Infectious Diseases, used data from 2011 through 2014 on
babies younger than two months from six states. Among babies who developed whooping cough despite their mothers’ vaccination, 90 percent had mild cases and did not require hospitalization. While the latest findings Quick read more or view full article are heartening, only about half of pregnant women in the U.S. are getting the vaccine, the CDC said.

Babies cannot be vaccinated against whooping cough until they’re 2 months old. The respiratory illness induces such uncontrollable fits of coughing that it can be deadly for babies, who can stop breathing, have seizures, develop pneumonia, or suffer brain damage. Pediatrician Paul A. Offit, a vaccine expert at Children’s Hospital of Philadelphia, said: “Babies under 2 months old are only going to be protected by their mother, who passes antibodies on to the child. So we have to do a better job of educating women. I think obstetricians can do a better job, too.”

“Women have such a great opportunity to help protect their babies before they enter the world by getting Tdap,” Nancy Messonnier, director of the CDC’s center for immunization and respiratory diseases, said in a news release. “This study reinforces CDC’s recommendation.”

Before the introduction of whooping cough vaccine in the 1940s, more than 200,000 cases a year were reported in the U.S. By 1965, that number plummeted to fewer than 10,000 a year. But the disease made a comeback in the 1990s, as the newer “acellular” vaccine containing only cellular material but not whole cells was phased in. While it is safer and has fewer side effects than the old version, studies have found that its protective effects wane more quickly than originally expected.

Each year since 2010, tens of thousands of cases of whooping cough have occurred and up to 20 babies have died. So far this year, more than 11,000 cases have been reported.

published by The Inquirer-Philadelphia Daily News

Heather Knott, RN-IBCLC

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