May 29, 2009

a rainbow party

Sophie's birthday party was a blast. The forecast said mostly cloudy with a chance of rain, which around here usually means it will be raining, but we got lucky - by the time her party rolled around, it was sunny and hot.



Nana made her birthday dress (with matching bloomers!) and since it buttoned down the back, she actually kept it on for most of the party.



There were rainbow sugar cookies, rainbow playdough party favors, and rainbow ric rac around the punch glasses (otherwise known as jelly jars). My mom made beautiful (and delicious) rhubarb-raspberry punch.



There was lots of running, jumping, screaming (in joy), playing...



Bubble blowing....



Nana and Papa made her a teepee out of bamboo poles and covered with all her new silkies.

And here is her fruit pizza!




Play Dough:

1 cup flour
1/2 cup salt
2 teaspoons cream of tartar
1 cup water
1 tablespoon vegetable oil

Combine ingredients in a saucepan and place over medium heat. S
tir constantly until a ball forms; remove from heat and knead for a few minutes. Add food coloring and knead until the color is even.


Bubbles:

5 cups water
14 oz. Dawn dish soap (eco-friendly soap doesn't work)
1/2 cup corn syrup

Mix. Dip. Blow.
We used egg dippers (for dyeing Easter eggs) for wands - just use pliers to complete the circle.

May 27, 2009

at the playground

For a toddler, this place is heaven.







And I admit it... I went down a few slides too!

May 25, 2009

baby longies



I love how these little pants turned out! I'm making a pair of big-girl longies for Sophie now... with NO backside increases! She's completely out of diapers now (knock on wood), and I've even loaned my entire cloth diaper stash to her little cousin. It makes me a little bit sad to not be using those diapers anymore.

We've had a lucky string of hot (for Juneau), sunny days - Sophie's birthday party was a huge success, it was sunny and she and all her friends played outside in the yard for hours. She blew out the candle on her "cake" all by herself. Instead of a cake I made a fruit pizza with a sugar cookie crust, plain yogurt sauce, lots of cut up fruit, and honey drizzled over the top, and I forgot to take a picture of it! Can you believe it?

Pictures of the party coming soon...

May 22, 2009

birth story

It’s May 22nd, 2007, 3:00 in the morning when I wake up. I feel some mild cramps, like I’m about to get my period; only I’m pregnant, so that can’t be. I get up, go to the bathroom, and by the time I come back to bed I feel normal again. It takes me an hour to fall back asleep because I can’t stop thinking about those cramps. I’m not due for another two weeks – could something be wrong? I’m scheduled to have an ultrasound later this morning to confirm position of the baby, and number of babies – the day before, my midwife had been unsure when she felt feet on opposite sides of my belly, and heartbeats on both sides also. Maybe I’m just worried about that – it’s my first ultrasound, and even though I know it’s highly unlikely to discover twins at 38 weeks, it’s still a nerve-wracking thought.

I get the cramps again in half an hour, and half an hour after that, until it’s time to go to my ultrasound appointment. My mom is going with me. I sign in and wait for my name to be called. After what seems like forever I’m called into a room, weighed, and then asked to give a urine sample. I pee into the little cup like I have so many times since becoming pregnant, but this time there is something different – I’ve lost my mucus plug. A funny feeling creeps into my belly. I know that losing your mucus plug is a sign of impending early labor, and along with the cramps I’ve been having all morning it’s even more of a sign; but my due date is still two weeks away, and young first-time moms like me never go early. I shake it off and go back to the room where the ultrasound technician is waiting for me.

The ultrasound gel, which the tech assures me won’t be cold, is too hot and it burns the skin on my belly. My mom sees me flinch and she knows the gel is too hot, but I don’t say anything to the tech and so she doesn’t either. I haven’t seen a doctor my whole pregnancy and for some reason being here, in a medical clinic, makes me nervous. I feel like I need to stay on the doctor’s “good side” and not complain. Soon, though, I forget about the hot gel as I focus on the blurry black-and-white image moving across the screen. I can’t see a baby at all, but as the technician points out ribs, heart, and head I start to make sense of it. Sure enough, it’s only one baby, head down in perfect position – it must have been doing the splits the day before.

Happy to be out of there, and relieved that there is in fact only one baby about to enter the world from inside of me, my mom and I linger before returning to our respective obligations. The day is hot for May and the sun is shining, and I bask in the sunshine outside a café where we splurged on ice cream bars. Eventually, ice cream gone, my mom goes back to work and I go to class to take my last final exam of the year. It’s perfect timing, really.

In class as I finish up my final I feel the cramps again – stronger now, but I still ignore them. I head home and start filling out the birth plan worksheet my midwives gave me weeks earlier – I’m still not even half way done with it, but when a few friends call I tell them to come on over. They show up with henna dye and in my lazy state of mind I agree to a belly-painting session in the front yard. As soon as I lay down on my back my lazy state of mind goes out the window as I get another cramp, this time much stronger than the ones before. I talk it over with myself mentally and agree to call them contractions from now on, but still I don’t say anything. What if this isn’t the real thing? I’m not due for two weeks, after all.

Belly painting accomplished, I waddle up to the porch as my friend’s mom stops by to say hi. Getting out of the car, she takes one look at me and informs me that my baby is going to come soon – she can tell, she says, by the way I’m holding myself. The baby is very low and I can feel the head engaged in my pelvis. I start to take notice of when the contractions come, and it’s down to every ten minutes now. Tonight is the last in a series of classes on labor that my midwife is giving at the birth center, and my mom picks me up to go with me.

When we get there at 6:00, there is only one car parked in the parking lot – my midwife’s. It’s such a nice day that no one else has showed up for the class. I tell her about my mucus plug and the contractions I’ve been having all day, and we go into an exam room so she can check me, “just in case.” She tells me I’m 2cm dilated – when I look at her, she translates: “go home, pack your bag, and call me when you can’t talk through a contraction. You’re having a baby tonight!”

I’m still in such denial that it’s my mom that reminds me I have yet to pick up any supplies for after the baby is born, and so on the way home we stop at the store to buy pads, yogurt, cereal, and other easy foods. My mom starts to think about what was on her grocery list at home since she’s already here, but I (a little too forcefully) remind her that walking around a grocery store is not a fun place to have a contraction. At home I lay on the bed while my mom goes through my things, trying to pack a bag for me, all the while telling me how she told me weeks ago that I should pack my bag now rather than wait until it’s too late. Everything she’s saying goes right over my head as I try to be comfortable. Nothing is working: lying on the bed, sitting on the couch, walking, listening to my iPod. I’m curled up in the fetal position on my bed when all of a sudden I feel heat seep down my leg. I jump up and more fluid gushes. Running to the bathroom, I shout at my mom that my water just broke.

She wants to call my midwife now, but for some reason I’m still in denial that I’m really in labor. I tell her not yet, I can wait a little longer; but with the next contraction I start crying and she makes the call – I can’t talk to tell her not to. My midwife has to find child care and she’ll meet us at the birth center in half an hour. At 9:00 we pull into the birth center parking lot again, and I have to stop twice for contractions before I can make it into a birth room down the hall. My midwife checks me immediately after my next contraction, and is amazed when she finds me 8cm dilated and 70% effaced. She tells my mom, “I guess you guys really do have fast labors!”

I feel like I’m helpless, stuck inside of a contraction – I need to get on top of it somehow. My midwife fills the Jacuzzi tub and I crawl into it. The water feels amazing, and I imagine this must be how my baby feels inside the womb. With each contraction I press my body against the side of the tub. When the contractions are at their peak I lose grip mentally and start to pant; my midwife is kneeling next to me on the other side of the tub with her head pressed against mine, telling me to breathe deeply, breathe down to my baby. I pull myself back on top of the contraction and ride it out. It seems like the Doppler is making another contraction come, because as soon as one ends and my midwife listens to the baby, another one starts immediately – soon I realize that I am starting to fight against my body and I need to push.

Pushing, I think, is ridiculous. To push is excruciating, but not to push is impossible. There’s just no way around it. I struggle with myself to open up and push at the same time; it takes a couple of contractions, but now they are coming one after the other with only a second’s rest in between. I have read about how the baby crowning feels like a “ring of fire,” and as I stretch to what feels like the absolute limit I hear Johnny Cash, “Ring of Fire,” playing in my head. My midwife tells me to reach down and feel my baby’s head, and I touch thick, silky-soft hair. It is only now, when I feel the baby’s head, that it really sinks in to me – I’m actually having a baby. And I’m having the baby right now – another push and the head is out. I’m too tired to push the rest of the baby out right away, I have to wait for the next contraction. It comes and I feel myself tear, but I absolutely do not care as my midwife lifts my baby out of the water and onto my chest.

The baby splutters, coughs once and cries once, and then its eyes open and it lies on my chest just looking around. I have not found out the sex, and secretly I want a girl very badly, but everybody that I know have told me that they think it will be a boy. Now that the time has actually come, I’m almost afraid to find out. I quickly hold the baby out and look – it’s a girl! I’m so happy and relieved, but just to make sure, I have to look again.

Sure enough, my Sophie Carolyn was born at 11:04pm on May 22nd, 2007 - 7lbs, 12oz, 20 in long.

Happy birthday Sophie!

May 10, 2009

research paper: vitamin d in pregnancy

Vitamin D is a fat-soluble vitamin that has recently jumped into the forefront of health and nutrition. Previously thought of as a vitamin needed only in small amounts to prevent rickets in children, vitamin D deficiency is now recognized as important for much more than just bone health. Vitamin D status is important for everybody, but it is especially important during pregnancy, because low maternal vitamin D stores may contribute to problems such as low birthweight and small for gestational age babies (a serious problem in the United States) and an increased risk later on for many other diseases.

Vitamin D is not a simple vitamin but a prohormone, a complex molecule that plays many important roles in the body. These roles, in addition to the main function of regulating mineral salt deposition in bones, include regulation of body metabolism, mood, blood pressure, and immune function – maybe even protection against some forms of cancer (Wardlaw & Hampl, 2007). Vitamin D is synthesized in the skin when the right wavelength of sunlight is available, and it is found in a few foods such as cod liver oil and fortified milk. Unfortunately, these two routes of acquisition are seldom sufficient for vitamin D needs, especially for people living in northern climates (defined as above 42 degrees north latitude – a line between northern California and Boston, Massachusetts) and in climates with frequent cloud cover preventing the absorption of ultraviolet light from the sun (National Institutes of Health [NIH], 2008). Location and climate are not the only factors that can limit vitamin D synthesis from the sun; genetics and cultural practices can also play a role. Australian researchers Grover and Morley (2001) reported that among pregnant women who were either dark-skinned or regularly wore a veil, 80% were below reference values for vitamin D.

Insufficient amounts of vitamin D in the body can cause rickets (bone malformation) in children, osteomalacia (bone softening) in adults, and can contribute over a lifetime to the chance of developing osteoporosis in later life. Other health effects caused or influenced by inadequate vitamin D supply in the general population include muscle weakness and inflammation (NIH, 2008). In pregnancy, having an adequate supply of vitamin D is especially important because of the health impacts on the developing fetus. Mothers who do not have an adequate supply of vitamin D cannot provide their baby with an adequate supply of vitamin D. A study by Bodnar, Simhan, and Powers (2007) reports in the Journal of Nutrition that in pregnant women who were vitamin D deficient, newborns were either as deficient as their mother or more deficient (in some cases by as much as 16%) than their mother. This data was taken from women living in northern latitudes of the United States who used prenatal vitamins (which presumably provided vitamin D) as directed by their doctor.

Babies who are born deficient in vitamin D have lower birthweights and tend to remain smaller throughout life. Low birthweight is associated with a wide range of complications that can be lasting, including breathing difficulties, heart problems, and increased risk of infection (March of Dimes Foundation, 2009). A recent study showed that children whose mothers had insufficient levels of vitamin D during pregnancy had lower bone mass and mineralization both at birth and at a follow-up study nine years later (Gale et al., 2008), indicating that vitamin D deficiencies can prevent children from reaching their full potential. In a study completed in 1980 Brooke et al. showed that babies born to mothers in the control group (those not receiving vitamin D supplements) were twice as likely to be labeled “small for gestational age,” and they were more likely to have larger-than-normal fontanelles (or “soft spots”) which the authors thought was indicative of incomplete skull ossification during gestation. The authors recommended that all pregnant women be given supplements of at least 1,000 IU of vitamin D daily, but they received little attention at the time.

In addition to being smaller, vitamin D deficient babies also have an increased risk for a wide range of diseases later in life that may be linked to the innate immune system. These are mostly chronic, slowly developing diseases such as Type I and Type II diabetes, schizophrenia, autoimmune disorders such as multiple sclerosis and rheumatoid arthritis (Wagner, Taylor, & Hollis, 2008), and maybe even neural tube defects such as spina bifida (Hollis & Wagner, 2006).

The circulating form of vitamin D in the blood, called 25(OH)D, is utilized directly by many cells in the body, including monocytes and macrophages, important immune system components. Tissue cells such as prostate, breast, colon, lung, and keratinocytes (in the skin, hair, and nails) also have direct receptors for 25(OH)D, and there has been speculation about whether all body cells may contain receptors for vitamin D (Wagner, Taylor & Hollis, 2008). Vitamin D acts in the tissue cells to modulate cell proliferation (important in cancer), differentiation, and apoptosis (programmed cell death, also important in cancer) (NIH, 2008). Vitamin D is known to have a regulatory effect on the immune system, and high levels of vitamin D are associated with reduced risk of autoimmune diseases (Hyppönen, 2005).

Preeclampsia, a serious complication of pregnancy, may be related to autoimmune diseases and may be influenced by vitamin D status (Hyppönen, 2005). Preeclampsia causes the mother’s blood pressure to rise and may be fatal to the mother, the baby, or both. Preeclampsia is not uncommon, affecting about 10% of pregnancies in the United States and causing 18% of maternal deaths in the United States. Preeclampsia causes babies to be born prematurely because of the danger to both mother and baby if pregnancy is continued, thereby causing a wide range of lasting health problems (Preeclampsia Foundation, 2008). Preeclampsia is more common in women with a history of autoimmune disorders, and some research has already shown that women with adequate levels of vitamin D before and during pregnancy have lower incidences of preeclampsia (Hyppönen, 2005).

The current recommendations for vitamin D intake were made 40 years ago, and were based on the amount of vitamin D contained in a teaspoon of cod liver oil. This amount was thought to be sufficient based only on anecdotal evidence and before it was possible to measure blood levels of 25(OH)D, the usable form of vitamin D in the body (Hollis & Wagner, 2006). The recommendation for pregnancy of 400 IU per day has been shown in numerous studies to either have no effect on blood serum levels of 25(OH)D or to actually decrease circulating levels of 25(OH)D. This explains why women taking prenatal vitamins as directed are still deficient in vitamin D. The upper limits for vitamin D of 2,000 IU per day were also set somewhat arbitrarily based on reports of vitamin D toxicity from the 1920’s, when researchers gave children between 3,000,000 and 18,200,00 IU of vitamin D a day, extreme pharmacological doses (Wagner, Taylor & Hollis, 2008). One brief exposure of the entire body to sunlight can synthesize up to 25,000 IU of vitamin D, and several studies have given subjects up to 10,000 IU of vitamin D daily with no adverse effects (Hollis & Wagner, 2006). It has been found that in most people, between 1,000 and 5,000 IU of vitamin D daily will raise blood levels of 25(OH)D to normal, adequate levels (Wagner, Taylor & Hollis, 2008).

Vitamin D is no longer a simple vitamin to be easily overlooked. It is an important prohormone that regulates many body systems and can decrease the risk of some common diseases, many of which have no cure. Many people worldwide and most people residing in northern climates do not have sufficient levels of vitamin D, and cannot achieve sufficient levels through diet and sun exposure alone. Most people would benefit from taking a vitamin D supplement in order to maximize health. During pregnancy sufficient levels of vitamin D are especially important in order to provide the developing baby with the vitamin D it needs. Pregnant women should make sure to take a vitamin D supplement of at least 1,000 IU per day of vitamin D to reduce the risk of giving birth to a low birthweight or small for gestational age baby, to reduce the baby’s later risk for disease, and possibly to reduce the risk of developing preeclampsia during pregnancy.




SOURCES

Bodnar, L.M., Simhan, H.N., & Powers, R.W. (2007). High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. Journal of Nutrition, 137(2), 447-452.

Brooke, O.G., Brown, I.R., Bone, C.D., Carter, N.D., Cleeve, H.J., Maxwell, J.P., et al. (1980). Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth. British Medical Journal, 280(6216), 751-754.

Gale, C. R., Robinson, S.M., Harvey, N.C., Javaid, M.K., Jiang, B., Martyn, C.N., et al. (2008). Maternal vitamin D status during pregnancy and child outcomes. European Journal of Clinical Nutrition, 62, 68-77.

Grover, S.R., and Morley, R. (2001). Vitamin D deficiency in veiled or dark-skinned pregnant women. Medical Journal of Australia, 175, 251-252.

Hollis, B. W., and Wagner, C. L. (2006, April 25). Nutritional vitamin D status during pregnancy: reasons for concern. Canadian Medical Association Journal, 174(9), 1287-1290.

Hyppönen, E. (2005, July). Vitamin D for the Prevention of Preeclamsia? A Hypothesis. International Life Sciences Institute, 63(7), 225-232.

March of Dimes Foundation (2009). Low Birthweight. Retrieved April 20, 2009 from http://www.marchofdimes.com/professionals/14332_1153.asp#head5.

National Institutes of Health: Office of Dietary Supplements (2008). Dietary Supplement Fact Sheet: Vitamin D. Retrieved April 18, 2009 from http://ods.od.nih.gov/factsheets/vitamind.asp.

Preeclampsia Foundation (2008). About Preeclampsia. Retrieved April 20, 2009 from http://www.preeclampsia.org/about.asp.

Wagner, C. L., Taylor, S. N., and Hollis, B. W. (2008). Does Vitamin D Make the World Go ‘Round’? Breastfeeding Medicine, 3(4), 239-250.

Wardlaw, G.M., and Hampl, J. S. (2007). Perspectives in Nutrition (7th ed.). New York: McGraw-Hill.

May 04, 2009

ta-da! the diaper wrap

Finally, a finished object. It's the WHW Plain Diaper Wrap (Ravelry link), and I love it. I will definitely make this pattern again. And next time I will definitely do buttons instead of velcro (you don't know how many times I stabbed myself trying to sew that velcro on...).



After I finished sewing on the main front piece of velcro, I pinned on the pieces for the sides and thought about a laundry tab, and realized something was not right. Checked the pattern and yep - I put the wrong side of velcro on the front.



The "soft" side (what are the different sides of velcro really called?) is supposed to be on the front so that when you put the laundry tab on it will be the soft side, since it will most likely be up against baby's skin.



So sorry Mikaela, but you're going to be hand-washing this one. There's no way I'm re-doing all that velcro.

Coming soon in the knitting lineup.... Picky Pants for the Birth Center' s fundraiser, another pair of Fetching for my mom, another pair of Picky Pants for Sophie (it's almost her birthday!), and a sweater for my dad.