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When, at 38 years old, I heard four heartbeats at our first ultrasound, I imagined not the patter of little feet across a crowded house, but my own death: the chaos of the delivery room, blood hemorrhaging from me as doctors raced to save one, two, three, maybe even four babies, each weighing no more than a cantaloupe, each no bigger than a guinea pig.


My heart raced, my breath seized. It was the first time I’d had a clear threat to my life.

“I don’t want to die,” I cried into my husband’s arms.

“You’re not going to die,” he reassured me.

 

 

Chances were good that I or my babies would not make it out of that pregnancy alive. Besides the risks associated with my advanced age, those of carrying multiple babies were numerous and high:

Miscarriage in quadruplet pregnancies is about 25 percent, neonatal mortality can be as high as 30 percent, and, according to the British organization Human Fertilisation and Embryology Authority, maternal death occurs twice more frequently in quadruplet pregnancies than in singleton ones.

It’s fortunate that I didn’t know at the time that my chances of death were probably higher, given that the U.S. has the highest risk of maternal death of all developed countries in the world.

I cried when I heard these statistics on NPR’s Morning Edition, which detailed a young mother’s sudden death. I was driving to work, having slept very little the night before, when memories of my high-risk pregnancy flooded back – of having lost the fourth baby in the twelfth week, of having almost lost the other three to Twin-to-twin Transfusion Syndrome in the seventeenth week, of experiencing the worst pain in my life after a caesarian, and finally of the weeks and months after when I could hardly make it through the days.

All of it could have gone so wrong.

“We don’t pay enough attention,” the NPR article states. Indeed, we don’t.

When my babies were several months old, a woman from my Facebook triplet mothers support group posted late at night asking about strange symptoms she’d been having. Very few of us saw the post. Even fewer answered her. We were busy feeding three crying babies, or enjoying rare sleep, or worrying about emerging cold symptoms in our premature infants whom doctors had labeled “immune-compromised.” We overlooked her concerns because we were absorbed in our own.

She died the next day from delivery complications. Our group felt so guilty. We had dismissed her, we thought. We hadn’t shouted from across the country, “Go in right now! Go demand care!”

I could have easily been her. I could have been just as overlooked. In the weeks that followed delivery, doctors rarely asked how I was feeling, except to note whether I had started making enough milk to feed three babies. The survival emphasis was on those monitored around the clock, fed by tubes, watched over by nurses, measured and prodded and weighed.

The mother of newborn triplets, I had no idea what to expect from my own body, which felt sent through the thrashers. I bled heavily and cramped consistently, though I thought nothing of it. In the hospital, the nurses had told me that my overly-stretched uterus would need to shrink – and it would be painful.

I felt like sludge, unable to focus, often losing my balance. But I was pumping around the clock and recovering from major abdominal surgery. I had no objective measure by which to judge what kind of tired was appropriate. Still, I had an instinct that something was wrong.

I made an appointment with my OBGYN, insisting that my healing wasn’t normal, that my cramps felt off. I was right. I had developed a rare delayed post-op uterine infection, which (if I had let go and allowed my doctor to rely on standard protocols) could have killed me.

Luckily, I was not overlooked. Luckily, I live in a thriving metropolis with access to excellent doctors, like my obstetrician, who had also spotted signs of pre-eclampsia late in my pregnancy and admitted me for an early delivery. Luckily, my husband works for a large corporation and we have comprehensive insurance, which paid for bi-weekly visits to maternal fetal medicine. Luckily, I listened to my body and advocated for my care.

Not all women are so lucky.

I shudder to think what kind of care we would have received had we lived in a rural area, if we’d had lesser insurance, if we’d been labeled as having too many pre-existing conditions. I shudder to think what would have happened to me and my babies if we’d been poor.

Would any of us have made it? Would this Mother’s Day have happened? The statistics say no. Our system’s neglect of mothers suggests no.

 

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Going back to work after having a baby is hard. Regaining your footing in a world where working mothers are so often penalized is tough, and (just like most things during the postpartum period) it takes time.

The challenges we face as working women returning from a maternity leave can be so different from those we faced before, it can feel like we're starting over from scratch. But mothers will not be deterred, even if our return to the working world doesn't go exactly as planned.

We are resilient, as Serena Williams proved at Wimbledon this weekend.

She lost to Angelique Kerber in the final, just 10 months after welcoming daughter Alexis Olympia and recovering from a physically and emotionally traumatic birth experience.

Williams didn't get her eighth Wimbledon title this weekend, but when we consider all the challenges she (and all new moms) faced in resuming her career, her presence was still a huge achievement.

"It was such an amazing tournament for me, I was really happy to get this far!" Williams explained in an emotional post-match interview.

"For all the moms out there, I was playing for you today. And I tried. I look forward to continuing to be back out here and doing what I do best."

The loss at Wimbledon isn't what she wanted, of course, but Williams says it does not mean there won't be wins in her near future.

"These two weeks have showed me I can really compete and be a contender to win grand slams. This is literally just the beginning. I took a giant step at Wimbledon but my journey has just began."

When asked what she hopes other new moms take away from her journey, Williams noted her postpartum recovery was really difficult, and hopes that other moms who face challenges early in motherhood know that they don't have to give up on whatever dreams they have for themselves, whether it involves working or not.

"Honestly, I feel like if I can do it, they can do it. I'm just that person, that vessel that's saying, 'You can be whatever you want to be.' If you want to go back to workand to me, after becoming a mom, I feel like there's no pressure to do that because having a child is a completely full-time job," she said.

"But to those that do want to go back, you can do it, you can really do it."

Thank you, Serena. You may not have won, but this was still a victory.

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Since baby Crew became the newest member of Chip and Joanna Gaines' family three weeks ago, his proud parents have been keeping the world updated, sharing sweet snaps of their youngest and even giving us a glimpse into his nursery.

Now, Chip Gaines is showing off a pic that proves there is nothing cuter than a floppy, sleepy baby.

"My heart is full..." the proud father of five captioned the photo he posted on his Instagram and Twitter accounts.

Earlier this week Crew's mama shared how she gets him so sleepy in the first place, posting an Instagram Story showing how she walks around the family's gardens on their Waco, Texas farm to lull her newborn boy to sleep.



The couple are clearly enjoying every single moment of Crew's babyhood. As recently as 7 days ago Chip was still sporting his hospital bracelet. Joanna says with each child he's worn his maternity ward ID until it finally wears off. We can't blame Chip for wanting to make the newborn phase last as long as possible.

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It was a changing table must-have a generation ago, but these days, many parents are forgoing baby powder, and now, the leading manufacturer of the sweet smelling powder was dealt a big financial blow.

Johnson & Johnson was just ordered to pay almost $4.7 billion to 22 women who sued, alleging baby powder caused their ovarian cancer.

A St. Louis jury says the women are right, but what does The American Academy of Pediatrics say about baby powder?

It was classified "a hazard" before many of today's parents were even born

The organization has actually been recommending against baby powder for years, but not due to cancer risks, but inhalation risks.

Way back in 1981 the AAP declared baby powder "a hazard," issuing a report pointing out the frequency of babies aspirating the powder, which can be dangerous and even fatal in the most severe cases.

That warning didn't stop all parents from using the powder though, as its continued presence on store shelves to this day indicates.

In 1998 Dr. Hugh MacDonald, then the director of neonatology at Santa Monica Hospital and a member of the American Academy of Pediatrics Committee on Fetus and Newborn, told the Los Angeles Times "Most pediatricians recommend that it not be used," adding that the consensus at the time was that "anybody using talcum powder be aware that it could cause inhalation of the talc, resulting in a pneumonic reaction."

Recent updates

A 2015 update to the AAP's Healthy Children website suggests the organization was even very recently still more concerned about the risk of aspiration than cancer risks like those alleged in the lawsuit. It suggests that parents who choose to use baby powder "pour it out carefully and keep the powder away from baby's face [as] published reports indicate that talc or cornstarch in baby powder can injure a baby's lungs."

In a 2017 interview with USA Today, Dr. David Soma, a pediatrician with the Mayo Clinic Children's Hospital, explained that baby powder use had decreased a lot over the previous five to eight years, but he didn't believe it was going to disappear from baby shower gift baskets any time soon.

"There are a lot of things that are used out of a matter of tradition, or the fact it seems to work for specific children," he said. "I'm not sure if it will get phased out or not, until we know more about the details of other powders and creams and what works best for skin conditions—I think it will stick around for a while."

Talc-based baby powder is the kind alleged to have caused ovarian cancer in the lawsuit (which Johnson & Johnson plans to appeal), but corn starch varieties of baby powder are also available and not linked to increased cancer risks as alleged in the case.


Bottom line: If you are going to use baby powder on your baby's bottom, make sure they're not getting a cloud of baby powder in their face, and if you're concerned, talk to your health care provider about alternative methods and products to use on your baby's delicate skin.

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In the days since a The New York Times report revealed a resolution meant to encourage breastfeeding was blocked by U.S. delegates at the World Health Assembly, breastfeeding advocates, political pundits, parents, doctors—and just about everyone else—have been talking about breastfeeding, and whether or not America and other countries are doing enough to support it.

The presidents of the American Academy of Pediatrics and the American College of Obstetricians say the controversy at the World Health Assembly reveals that mothers need more support when it comes to breastfeeding, while others, including The Council on Foreign Relations, suggest the national conversation needs more nuance, and less focus on the "breast is best" rhetoric.

The one thing everyone agrees on is that parents need more support when it comes to infant feeding, and in that respect, the controversy over the World Health Assembly resolution may be a good thing.

In their joint letter to the editor published in the New York Times this week, the presidents of the American Academy of Pediatrics and the American College of Obstetricians, Dr. Colleen Kraft and Dr. Lisa Hollier urge "the United States and every country to protect, promote and support breast-feeding for the health of all women, children and families."

The doctors go on to describe how breastfeeding "provides protection against newborn, infant and child infections, allergies, asthma, inflammatory bowel disease and sudden infant death syndrome," and note the health benefits to mothers, including reduced risks for "breast cancer, ovarian cancer, diabetes, hypertension and heart disease.

"Helping mothers to breastfeed takes a multifaceted approach, including advancing public policies like paid family leave, access to quality child care, break time and a location other than a bathroom for expressing milk," say Kraft and Hollier.

Certainly such policies would support breastfeeding mothers (and all mothers) in America, but some critics say framing the discussion around domestic policy is a mistake, because the World Health Assembly resolution is a global matter and women and babies in other parts of the world face very different feeding challenges than we do here at home.

In an op-ed published by CNN, Gayle Tzemach Lemmon, an adjunct senior fellow at the Council on Foreign Relations suggests the laudable goal of breastfeeding promotion can backfire when mothers in conflict-riddled areas can't access formula due to well-meaning policy. Lemmon points to a 2017 statement by Doctors Without Borders calling for fewer barriers to formula distribution in war-torn areas.

"International organizations like UNICEF and the World Health Organization (WHO) promote breastfeeding ... and provide infant formula, but only by prescription. We believe that distributing infant formula in a conflict situation like Iraq is the only way to avoid children having to be hospitalized for malnutrition," Manuel Lannaud, the head of Doctors Without Borders Iraq mission wrote.

The various viewpoints presented this week prove that infant feeding is not a black and white issue, and policy debates should not be framed as formula versus breast milk—there is more nuance than that.

A recent study in the Journal of Pediatrics found opting to supplement with formula after first breastfeeding improves outcomes for infants and results in higher rates of breastfeeding afterward, and while the benefits of breastfeeding are numerous, they are sometimes overstated. Another recent study published in the journal PLOS Medicine found breastfeeding has no impact on a child's overall neurocognitive function by the time they are 16. Basically, parents should not be shamed for supplementing or choosing to use formula.

This, according to Department of Health and Human Services says national spokesperson Caitlin Oakley is why the HHS opposed the original draft of the breastfeeding resolution at the World Health Assembly (although critics and the initial NYT report suggest the United States delegation were acting in the interests of infant formula manufacturers).

"Many women are not able to breastfeed for a variety of reasons, these women should not be stigmatized; they should be equally supported with information and access to alternatives for the health of themselves and their babies," Oakley said in a statement.

That's true, but so is everything the presidents of the American Academy of Pediatrics and the American College of Obstetricians presented in their op-ed, and that's why the U.S. should support breastfeeding policy.

Here's another truth: This is an issue with many perspectives and many voices. And we need to hear them all, because all parents need support in feeding their babies, whether it's with a breast, a bottle or both—and we're not getting it yet.

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