By Nina Lakhani in New York| Mon 17 Aug 2020 16.47 EDT
"Black babies have a greater chance of survival when the hospital doctor in charge of their care is also black, according to a new study.
In the US, babies of color face starkly worse clinical outcomes than white newborns.
Earlier research from the Centers for Disease Control and Prevention (CDC) published last year shows that black babies are more than twice as likely to die before reaching their first birthday than white babies, regardless of the mother’s income or education level.
While infant mortality has fallen overall in the past century thanks to improvements in hygiene, nutrition and healthcare, the black-white disparity has grown.
Multiple interrelated factors which contribute to these disparities include structural and societal racism, toxic stress and cumulative socioeconomic disadvantages.
The new study published in the Proceedings of the National Academy of Sciences suggests the race of the attending doctor also plays an important role.
Researchers reviewed 1.8m hospital birth records in Florida from 1992 to 2015, and established the race of the doctor in charge of each newborn’s care.
When cared for by white doctors, black babies are about three times more likely to die in the hospital than white newborns.
This disparity halves when black babies are cared for by a black doctor.
Strikingly, the biggest drop in deaths occurred in complex births and in hospitals that deliver relatively more black babies, suggesting institutional factors may play a role.
The study found no statistically significant link between the risk of maternal mortality – which is also much higher for black and brown women – and the race of the mother’s doctor.
Why race concordance is so important in black infant mortality requires further research, but it may enhance trust and communication between doctor and mother, and black doctors may be more attuned to social risk factors and cumulative disadvantages which can impact neonatal care, according to Brad Greenwood, lead author from George Mason University in Virginia.
Unconscious racism among white doctors towards black women and their babies may also be at play.
For white newborns, the race of their doctor makes little difference to their chances of survival.
Despite the stark findings, black women seeking a black doctor to minimize the risk to their babies will struggle as the medical workforce remains disproportionately white. Only 5% of doctors are black, according to the Association of American Medical Colleges."
By Carmela K Baeza, MD, IBCLC| Art By Ken Tackett
"Some dyads (mother-infant pair) start their breastfeeding relationship in harsh circumstances. Frequently, due to medicalized births and unfavorable hospital routines, there are so many interferences to initiate breastfeeding that by the time mother and baby arrive home they are already using bottles and formula – despite mother having desired to exclusively breastfeed.
These mothers often feel that they do not make enough milk and that their babies prefer the bottle. They will make comments like “my baby doesn't like my breast”, “I cannot make enough milk”, “the more bottles I give my baby, the less she likes me”, and so on. This can become the road into postpartum depression.
Those mothers who are intent on breastfeeding will often look for support, and may find it in a midwife, a lactation consultant or a breastfeeding support group. These health care professionals or counselors may offer the mother to work on her milk production by expressing milk from her breasts (either with her hands or with a pump) and feeding that milk to the baby, as well as putting baby on the breast.
And this is what we call triple breastfeeding.
Imagine: mother puts baby at her breast. Baby suckles for an hour and a half, falling asleep frequently. Mother will tickle him, speak to him, encourage, often to little avail. After an hour and a half, mother will unlatch the baby (he never seems to come off on his own), put him in the crib, set up her breast pump and begin pumping, going for at least 15 minutes on each breast. Halfway through, the baby wakes up and cries – he´s hungry. But he was just on the breast for almost two hours! Mother turns off the pump (and so little milk has come out!) and feeds her baby a bottle of formula. She cries. She feels exhausted, useless, and unable to meet her baby´s needs. She has not left the house for days, because she is immersed in a never-ending cycle of breast-pumping-feeding."
July 4, 2019
By Lana Hallowes
"How awesome are these NICU nurses? They are going about their important tasks while babywearing the bubs they care for when their parents aren’t able to."
"The photos, shared by Kangatraining Austrailia show the hardworking nurses in Neonatal Intensive Care Unit (NICU) in Germany doing what they do best-loving and caring for needy babies.
As any babywearing mama, or dad, will know, all babies love to be held close and carried, with the movement soothing them and often putting them to sleep."
Women's Mental Health At Key Stages In Life
Photo: Katherine Streeter for NPR
Menopause Can Start Younger Than You Think: Here's What You Need To Know
By Emily Vaughn & Rhitu Chatterjee
"Would you recognize the signs that your body is going through the big hormonal changes that lead to menopause? Here's what to look for-and what you can do about it."
"Sarah Edrie says she was about 33 when she started to occasionally get a sudden, hot, prickly feeling that radiated into her neck and face, leaving her flushed and breathless. "Sometimes I would sweat. And my heart would race," she says. The sensations subsided in a few moments and seemed to meet the criteria for a panic attack. But Edrie, who has no personal or family history of anxiety, was baffled.
She told her doctor and her gynecologist about the episodes, along with a few other health concerns she was starting to notice: Her menstrual cycle was becoming irregular, she had trouble falling asleep and staying asleep, and she was getting night sweats. Their response: a shrug.
It wasn't until Edrie went to a fertility clinic at age 39 because she and her partner were having trouble conceiving that she got answers. "They were like, 'Oh, those are hot flashes. It's because you're in perimenopause,' " she says.
If you haven't heard the term "perimenopause," you're not alone. Often when women talk about going through menopause, what they're really talking about is perimenopause, a transitional stage during which the body is preparing to stop ovulating, says Dr. Jennifer Payne, who directs the Women's Mood Disorders Center at Johns Hopkins University."
HOW PUBERTY, PREGNANCY AND PERIMENOPAUSE AFFECT MENTAL HEALTH
Listen to the four podcasts below:
"January 14, 2020 • NPR's Morning Edition explores the key reproductive shifts in women's lives — puberty, pregnancy and perimenopause — and how the changes during those times could impact mental and emotional health."
"January 16, 2020 • Women with a history of depression and anxiety are at a higher risk of having a flare-up during the time leading up to menopause. And getting doctors to take the issue seriously can be challenging."
"January 15, 2020 • Nearly 1 in 7 women suffers from depression during pregnancy or postpartum. But very few get treatment. Doctors in Massachusetts have a new way to get them help."
"January 17, 2020 • NPR's Rachel Martin talks to menopause expert Dr. JoAnn Pinkerton, division director of the Midlife Health Center at the University of Virginia, who answers listeners' questions."
Photo: via Sarah DiGregorio
"My daughter’s health needs changed the way I think about food, control and pleasure."
By Sarah DiGregorio
"If eating is about pleasure, at least for me, cooking is about control. Knowing how to make onions sizzle gently in oil and start to go limp, then transparent, then light brown, then sweet and dark. It’s a transformation that’s entirely predictable, a product of muscle and sense memory. If I pay attention in the kitchen, if I am careful, nothing goes wrong.
When I was pregnant, I worked at Food & Wine magazine. Editing recipes, the biggest part of my job at the time, is a meticulous and satisfying exercise in imagining all the mistakes that could be made in a kitchen and then trying to prevent them.
It was 90 degrees out as my stomach started to swell, but in the office we were cooking and tasting crunchy escarole salads, potato gratin, roasts and gravy, butter cookies and layer cakes. Summer at a monthly cooking magazine is about Thanksgiving, and then the holidays.
I liked to think of my daughter growing plump and happy and smart on everything I ate. Though I’d cut out alcohol, raw fish and cured meats, I ate everything else the test kitchen produced, imagining that this was the embryonic beginning of giving her a healthy, pleasurable relationship with food and her body. “Eating for two” is an irritating phrase, but I saw it as the first benefit of being alive that I could share with her.
Despite my well-laid plans, it turned out the placenta was failing.
My daughter was not, actually, living the fetal high life. My body was keeping all that good food for itself — the snow-white slice of coconut layer cake, the bitter sautéed winter greens. First she fell off her growth curve and then, a fetus slowly starving, her body ground to a halt. She was not safe inside me, so the doctors took her out nearly 12 weeks early, an emaciated, shivery bundle, a 1-pound 13-ounce creature of skin and bones."