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5 Days in the NICU – A Mother’s Perspective

Greetings.

I recently received an Obstetrics Unit Survey inquiring about my experiences during a maternity stay with your hospital last month.  My personal care was largely pleasant and a significant improvement over my experience delivering my daughter at another local hospital.  However, it was my experiences during my son’s time in the nursery that have prompted me to write you this letter.

My son was born on 7/14/2016 12:10pm at 38 weeks gestation, and soon indicated signs of oxygen insufficiency.  The cord was quickly cut and he was whisked over to the exam cart, where he was put on oxygen.  Soon after, he was taken to the nursery with my husband following closely behind.  I joined the 2 of them in the nursery and learned that a chest X-ray had revealed nothing conclusive regarding the source of his oxygen problems, and they had put him on 2 intravenous, broad-spectrum, prophylactic antibiotics due to concerns regarding my 36-hour ruptured membrane, while awaiting the additional results of a 48 hour culture.

I expressed deep concern regarding the administration of any antibiotic, unless absolutely necessary.  I informed them that I was well aware of the infection risks associated with my ruptured membrane and took special care to mitigate the risks by limiting exams, etc.  However, my pleas went unheard and the intravenous antibiotics were continued.  It was explained to me that if his symptoms were the result of an infection, the 48 hour culture result window could prove too late to administer them effectively.  And since conventional medicine does not acknowledge the inherent risks of antibiotic administration, it is seen as a harmless preventative measure.

Please refer to the following PubMed references.

I spent nearly every waking moment at my son’s bedside during the 5 days he was in your care, and I overheard an explanation similar to ours conveyed to virtually every parent – that of the necessity of prophylactic antibiotics for their infant, regardless of the circumstances.  While I appreciate your fervor in proactively treating a potential infection, antibiotics are hardly innocuous and pose potential chronic, long-term health consequences that we arguably do not yet fully understand – especially when administered early in life.  (Incidentally, all of my son’s tests regarding an infection were negative.)

There were a number of other concerns I witnessed in relation to the care of infants in the nursery, which compelled me to spend every moment I could with my son and to personally introduce myself to the nurse who would be caring for him during their 12 hour shift, as well as the NP and neonatal MD currently on staff.  Suffice it to say that the level of care and attention he received varied greatly, depending on the individual assigned to him and their current workload.

My son was successfully taken off of oxygen the same day he was born, but kept in the nursery an additional 4 days while being weaned off of the IV and then treated for minor jaundice.  We have learned based on studies of babies born via C-section vs. vaginally that an infant’s early microbial environment strongly influences their subsequent intestinal colonization.  Such studies have also demonstrated the preferential species of Mom’s, Dad’s, and their home’s native bacterial diversity over that of a hospital environment (especially in cases where antibiotic administration has destroyed the colonization received during birth).  Consequently, I would expect an infant to be released to go home as soon as it is deemed safe, especially if Mom has already been discharged.  However, my experience did not reflect that standard and I witnessed another mother have a heated discussion with the NP and neonatal MD regarding the discharge of her daughter from the nursery.  Ultimately, your staff conceded and allowed the parents to take their infant home as requested.

In your effort to achieve a truly ‘Baby Friendly‘ status, I would advise you to thoroughly evaluate the likelihood of an infection and the associated risks of antibiotic administration before deciding on a course of action, and release an infant once the critical health issues are resolved.  In addition, you might explore opportunities for additional individuals to help with feeding and soothing the infants, in circumstances where the nurses are too overwhelmed to do an effective job on their own.

I appreciate your time and attention regarding these matters, and you are welcome to contact me via this email address or telephone at XXX-XXX-XXXX if you would like to discuss them further.

Warmly,

-Tracy Sterling

allergies

Battle of the ‘Sensies’ – The Rotation Diet

Perhaps the most confounding problem surrounding extreme food/chemical sensitivities is that the very nutrient rich whole foods intended to heal – can make us incredibly ill!  My daughter is a ‘Sensie’.  Her food and chemical sensitivities are extensive, too many to count or track.  My husband jokes that she’s allergic to carbon, and perhaps they don’t make ‘this stuff’ on her planet.  (Incidentally, only the parents of sick kids are allowed to crack jokes on the topic.)

Ultimately we’ve had to remove all detergents, lotions, soaps, oils, even certain fabrics and we use only the mildest forms of soaps on necessary things like her dishes, the carpet, etc.  When it comes to food, that is an entirely separate epic battle.  I finally came to conclusion that it was not a matter of IF she reacted to a food, but WHEN.  I had heard the term ‘Rotation Diet’ before and never gave it much thought until it occurred to me that we had been able to successfully trial foods on her for a day, sometimes even up to a week before they generated a reaction.  So what if I fed her the same thing for only 24 hours, switched the menu, and then did not feed her those items again for a couple days?  Nothing else was working, so why not give it a shot?

spinIn a nutshell, this is how a rotation diet works:  All foods are placed into various categories and you only eat foods from a particular set of categories for a select period of time (usually 24 hours).  Then you select foods from a different set of categories for the following 24 hours, and so on.  Eventually you circle around and repeat the cycle, usually every 4-8 days.  I decided I had enough variety to cover 4 days worth of different category meals, and make them healthy and balanced.  I have to say it was quite liberating building her Rotation Menu.  Never before had I been able to select foods without hyper-analyzing their food chemical or allergen content potential, only to typically dismiss them as an option.  Instead, I was actually able to consider the health benefits and variety – it was fantastic!

It’s been 1-2 months now on the new rotation diet consisting of purees, meat/vegetable broths, and oils.  I’ve had to tweak the menu a bit to suit her tastes, but so far things are going really well.  It certainly has not been an overnight change, but there are consistent subtle improvements.  Her appetite has been fantastic (eating has been an issue for us in the past), her bowel movements have become normal and healthy, and her moods and sleeping are improved, too.  I’ve even been able to start using shea butter as a lotion on her!  After receiving the thumbs up from both her integrative MD and ND on my food choices, I thought I would share the menu in the chance it is helpful to other Sensies out there, and those of you with Sensie little ones.

There are a few basic guidelines I kept in mind when selecting her menu:

  • No gluten, legumes (including soy), or dairy (except camel’s milk).  Whoa, wait…did I just read ‘camels milk’?  Weird I know, but it’s different in some very significant ways from cow’s and goat’s dairy, and you can read more on that topic here.
  • Low Glutamates and low Histamine – That means I stuck with 2-4 hour meat stocks rather than bone broths (more on that here).  Everything is made fresh (when possible), then frozen immediately, and consumed within 8 days (2 rotations).
  • A healthy balance of Omega 3/6/9 – Fats are so critical! 1  Generally, Americans get way too much Omega 6 (vegetable fats) and not enough Omega 3. 2  Everyone is different, but a good rule of thumb is a 4 to 1 ratio of Omega 6 to Omega 3 fats.  (Western diets typically consume a ratio of 16 to 1 – Omega 6 to Omega 3 fats!)  If you’re vegan/vegetarian or feed your child a vegan/vegetarian diet, please keep this ratio in mind and seek out appropriate and sufficient sources of Omega 3 fats.  (Check out this informative video for more facts on scientists’ recent erroneous vilification of saturated fats.  Incidentally, it is my personal opinion that the adjustment of Omega 3 to Omega 6 ratio accounts for the immediate improvement many people experience when initially adopting a Paleo diet.)
  • Low oxidative stress (high in antioxidants)
  • Alkaline
  • I did not introduce food items to which she had previously demonstrated an acute/immediate reaction (such as spinach and corn).
Day 1Day 2Day 3Day 4
Carrot/Celery & Banana PureeChard & Pear & Avocado PureeSquash/Zucchini & Peaches/Cherry PureeKale/Broccoli/Collard Greens & Sweet Potato & Wild Blueberry/Strawberry Puree
Carrot/Celery JuiceChard BrothSquash/Zucchini BrothKale/Broccoli/Collard Greens/Sweet Potato Broth
Bison BrothLamb BrothTurkey Broth (replaced chicken following lab results indicating low Tryptophan)Camel's Milk
Hemp Seed OilOlive OilFish Oil (Carlsons)Sunflower Oil

I also have plans to introduce crackers from the Anti-Grain apple, squash, and sweet potato flours, because they conveniently fit in 3 different food categories.

Some tips on preparation:

  • All produce gets a thorough washing in an ACV and water bath.  I also use this opportunity to inspect the produce and remove any ‘unhealthy’ looking parts.
  • Purees – Gently cook produce at 250 degrees with just a wee bit of water, for as long as it takes to get slightly soft.  Remember ‘low and slow’, when it comes to cooking to ensure we preserve as many of the delicate enzymes and nutrients as possible.  Be sure to include the liquid left behind from baking in your puree because it’s packed full of nutrients!  Many of the fruits can be blended as-is and don’t require any cooking.
  • Whenever possible I juice the produce rather than preparing a broth, for a much more nutrient rich option.
  • Removing the skin/seeds and ensuring adequate ripeness will reduce the phenol (food chemical) content of the produce.
  • Try to stick with organic/non-GMO produce and organic/grass-fed meat and dairy products whenever possible.  Check out your local farmers market for regional options which can be more budget-friendly than the natural grocery stores.
  • Wild blueberries are higher in antioxidants than farmed blueberries.

My preferred tools for the job(s):

  • Food Categories Guide
  • Nutri Ninja – I love this for the purees.  Its quick, powerful, and very easy to clean!  I also use it to make my own smoothies.  I do not believe the containers are BPA free so be sure the contents have cooled to room temperature or colder before you blend.  Another tip is to slowly add the liquid in between mixing, this will help break up the fibers and also ensure you don’t get a puree that’s too watered down.
  • Breville Juicer – I don’t have a lot of experience with juicers, but wanted something that was BPA free and did not heat the juice in any way.  My only complaint is that this thing is a pain to clean.
  • Pyrex Cookware – It’s glass and made in the USA.

Immune Dysfunction: Where Does it Come From?

DNAMethylationStudies are consistently showing that DNA Methylation controls the triggers of all things immune system related, effectively determining the onset of an infinite number of conditions.  These conditions can be the result of an overactive immune system (food/chemical sensitivities, EE, MCAD, Autoimmune disorders) or a weakened immune system (viral infections, cancer, bacterial overgrowth).  Immune Dysfunction can also include neurological implications (NeuroImmune) including Autism, ADHD, ALS, Alzheimer’s, and vertigo.

Treating the immediate symptomatic conditions is important, but treating the root of the conditions by correcting DNA Methylation pathways within the body is equally important in order to ensure long term healing.  Treatments which only consider the immediate symptom and jeopardize DNA Methylation are ultimately counterproductive.  Typically those practitioners who are well versed in functional medicine consider the entire system when evaluating treatment options, so as not to do long term harm for the sake of short term good.

The practice of optimizing DNA Methylation pathways is still a relatively new concept and difficult to pin down, given the bio-individuality of each patient.  The dose and timing of a supplement that is optimal for me, may not be the dose, timing or even type of supplement that is optimal for my daughter.  Even though we share much of the same DNA, her individual experiences and exposures will alter which of her problematic genes are expressing/activated (a concept known as epigenetics).

DNA testing can serve as a good starting point, but you will need a practitioner to interpret the results and conduct appropriate laboratory testing to help determine which of your genes may be expressing and how to proceed with treatments.  The MTHFR variant is the most well-known DNA Methylation gene, but it is only one of many which influence the productivity of DNA Methylation pathways.

The real conundrum:  How are these compromised DNA Methylation pathways affecting our children so early in life?  Are these fully expressed genes being transferred maternally as-is to our children?  Or are they suffering from the implications of the gene expression in Mom (food/chemical sensitivities, nutrient deficiency, reduced oxidation, etc.) during pregnancy and immediately following birth?  How long after birth do the genes potentially become activated, or silenced?  One thing seems certain; the best prevention is ensuring a healthy DNA Methylation cycle in mom and dad before conception and during pregnancy.

Infantile GERD and DNA Methylation

infantrefluxCould infantile GERD be at end of a long chain of of events caused by impaired DNA Methylation?  First things first; what is DNA Methylation?  Without launching into a rather long and technical description, let’s just suffice it to say that it is critical to many fundamental cellular processes and it’s very bad when DNA Methylation does not function correctly.  How bad?  Impaired methylation has been implicated in the incidence of Rheumatoid arthritis, osteoarthritis, severe food allergies, cancer, HIV, mitochondrial disorders, Multiple Sclerosis, Parkinson’s, migraines, heavy metal accumulation, hormonal deficiencies, low thyroid, and infectious overgrowth such as viruses and Candida, as well as various Neuroimmune Disorders such as Autism, depression, and  ADHD.

Of the myriad of symptoms which now seem to plague our infants, Gastroesophageal reflux disease (GERD) seems to remain among the most prevalent.  And since we still don’t know the cause of infantile GERD, I thought I would investigate the potential link between it and DNA Methylation compromise.  What a surprise when I discovered a number of studies which found that the treatment of GERD with melatonin, and a particular blend of vitamins and amino acids (all of which support methylation), improved GERD more effectively than the PPI medication Omeprazole (Prilosec)!  And all without the side effects associated with suppressing one’s stomach acid.

Coincidence?  Maybe, but I doubt it.  I would certainly welcome additional research into this intriguing development.  Perhaps infantile GERD may serve as an early-warning indicator of this silent, sneaky, and often debilitating condition.

Rheumatoid arthritis and osteoarthritis, severe food allergies, mitochondrial disorders, Multiple Sclerosis, Parkinson’s, migraines, heavy metal accumulation, hormonal deficiencies, low thyroid, and infectious overgrowth such as viruses and Candida can all be impacted by impaired methylation – See more at: http://www.betterhealthguy.com/methylation#sthash.lPJaQYZb.dpuf
Rheumatoid arthritis and osteoarthritis, severe food allergies, mitochondrial disorders, Multiple Sclerosis, Parkinson’s, migraines, heavy metal accumulation, hormonal deficiencies, low thyroid, and infectious overgrowth such as viruses and Candida can all be impacted by impaired methylation – See more at: http://www.betterhealthguy.com/methylation#sthash.lPJaQYZb.dpuf
Rheumatoid arthritis and osteoarthritis, severe food allergies, mitochondrial disorders, Multiple Sclerosis, Parkinson’s, migraines, heavy metal accumulation, hormonal deficiencies, low thyroid, and infectious overgrowth such as viruses and Candida can all be impacted by impaired methylation – See more at: http://www.betterhealthguy.com/methylation#sthash.lPJaQYZb.dpuf