As Bob Dylan once sang, "The times, they are a-changin'." But what happens when the ways we take care of our babies change? How do parents keep themselves updated with all things maternity - especially if their pregnancies are spread over an extended period of time.
As Bob Dylan once sang, "The times, they are a-changin'." But what happens when the ways we take care of our babies change? How do parents keep themselves updated with all things maternity - especially if their pregnancies are spread over an extended period of time. "Even five years is a long stretch of time, and a lot of things can happen," said Dr. Stephen Hersey, a primary-care physician at Nationwide Children's Hospital. "I call that a 'parent do-over.' " So parents (or grandparents!), if you're experiencing the parent do-over, we talked to local experts about what changes and updates they've seen when it comes to the best pregnancy and baby practices. Pregnancy and Pre-Natal Care When Beth Byorth, a Dublin mother of six (whose children's ages range from 10 to 22) was expecting her first child, she recalls having just one ultrasound during her pregnancy. "I think you did your one ultrasound to find the heartbeat and estimate the due date, and that was the real reason, unless you had complications," Byorth said. Now, parents have been checking in on their future family member using 3D and even 4D ultrasounds several times during the course of the nine months. Dr. Stuart Jones, the chairman of obstetrics and gynecology at Riverside Methodist Hospital, has been practicing for 24 years and noted the changes in technology. "The amount of definition we see now…we can see so much clearer," Jones said. "We've gone from pictures that look like searching for subs under the ocean to picking up more anomalies." Testing while babies are in the womb has also seen advancements, said Jones: "There's now a huge difference from giving you only a risk to giving you accuracy." For example, the Alpha-Fetoprotein (AFP) blood test that looked at one single level of AFP to check the risk of Down syndrome has been expanded to the AFP4, which tests four different levels. Jones explained that this creates less false positives. The MaterniT21, which also can check for Down syndrome, debuted in early 2012 and is 99 percent accurate, said Jones. While diet guidelines have stayed relatively similar over the years, expectant moms have a few new rules to follow. Higher mercury levels mean a limit of two servings of fish a week, something that wasn't regulated previously. And don't think moms can get away with the old idea that they are eating for two and should double the caloric intake. "The doctor always told me, 'You still have to eat healthy,'" said Byorth. "That was the status quo." Other foods to watch for? Jones now tells women to stay away from cold-cut meats (due to possible listeria bacteria growth) and to look out for unpasteurized foods. But caffeine is now considered okay in small doses. Delivery Hoping to have the baby while Grandma and Grandpa are visiting? While it's exciting to have extended family around for the birth day, accommodating a visiting relative's presence is not a reason to induce labor. Jones said there never used to be a protocol for induction but, increasingly, parents began scheduling induced labors for dates convenient to them and visitors. That has definitely changed. "We realized inductions for social reasons were not the best, because it was doing so without a true medical reason," Jones said. "There's a greater chance for the baby to end up in a special-care nursery due to (incomplete) lung development. You don't want to induce before 39 weeks." Barbara Poole, a certified nurse midwife at Berger Hospital in Circleville, has noticed a shift in natural births since she began working as a midwife in 1993. "I started out with a group of women that wanted natural things, no pills," Poole said. "Now this generation knows no pain, because they take medicine for everything. You have to get used to the natural changes to the body. It's uncomfortable, but something you get used to because it won't last forever." The instant fix can come in the form of an epidural, which still has a high rate of occurrence, according to Jones. However, the ingredients in an epidural have morphed to let the mother feel a little pressure during labor. Of course, the type of pregnancy can also determine whether or not an epidural is used. "I was always very lucky, with very easy deliveries," Byorth said. "I did no epidural for the first three. When the twins came along, I had one because there is always a chance of one turning." Post-Delivery Once the bundle of joy arrives, it's becoming increasingly common for a mother to use "kangaroo care," a process that allows them to bond with the child skin-to-skin right from the womb. "Before, we clamped the cord right away and (pulled) the baby away from mom," Jones said. "We learned that babies transition better now if we delay the cord clamping to get blood back to the baby." Also on the plus side for women, they are bouncing back quicker than ever after delivery and relying less on bed rest. What used to be a week in the hospital has been reduced to just a couple of days (unless a C-section delivery warrants a longer stay). However, one negative post-delivery symptom on the rise is post-partum depression, which Jones said is being diagnosed in 15 percent of moms. Riverside tries to detect warning signs of depression early on by giving new moms a questionnaire after the delivery to see how they are feeling. Poole works with patients to help them understand they need to expect the unexpected when it comes to the whole idea of pregnancy, delivery and motherhood. "We could create five birth plans and the sixth one is the one that's going to happen," she said. "Same thing with babies. You have an idea of an imaginary baby, and then you get your real baby and they are going to be different, I guarantee." Bringing Home Baby Food and safety and equipment, oh my! Once baby is home, there's still so much to remember. For feeding, Hersey encourages the mother and child to breastfeed exclusively if possible for the first six months of life. But, according to Hersey, recent research has indicated that babies who are exclusively breastfed can lack Vitamin D. While the child is still being breastfed, they should take a daily multi-vitamin in the form of infant drops. There has been no change in the policy that non-liquid food should not be introduced to children less than 6 months old. Hersey explained that another policy that has not changed addresses the position in which babies should sleep. In order to avoid Sudden Infant Death Syndrome, "babies up to 6 months of age should sleep in a clutter-free area, preferably in a crib, on their back and facing up," Hersey said. As you transition your child from a bassinet to a crib (after the first 1 to 2 months of life), choose a crib that has been manufactured within the last five years. "There have been some issues in the past with the spaces in the crib slats," Hersey said "Parents can be comfortable if it's been made in that five-year range." And when you're ready to take a drive, remember this new information regarding car seats: "All children up to the age of 2 years should sit in a rear-facing seat," Hersey said. "This has been a change from the previous recommendation that children up to 1 year should sit rear-facing." Resources Jones suggests seeing your doctor before you actually get pregnant, and then using the available literature to remain informed. OhioHealth has a Women's Health application for expectant moms, which can be accessed from a tablet or smartphone. Check reputable websites like healthychildren.org (from the American Academy of Pediatrics) for reliable information. And Hersey stressed the importance of having a good relationship with your pediatrician after baby is born. "Follow up with those well visits," he said. "That's really where you can get current, up-to-date recommendations."