Top 20 of 2020

It's been quite the year of challenges! Through it all we've persevered and looked for ways we could make life better for someone, somewhere; a new momma today, a baby tomorrow, children along the way. It is our hope that you or someone you know has been empowered or uplifted or encouraged or helped this year through the work of Peaceful Parenting. It has been tough to not see you in person this year at the many expos and events we typically host, but we look forward to an even sweeter reunion when we can attend across the nation once again. 'Till then, we have gathered the Top 20 Most Read items at DrMomma during 2020. Check out those you missed, share your favorites, and pass on the love we pray comes through in our gentle parenting advocacy and education. 💖 

With this post we'd also love to showcase some of your beautiful families. If you'd like to share a photo for our 2020 Peaceful Parenting collage, drop it to this post on Facebook, into the Peaceful Parenting Community with a note that it's for the 2020 collage, or email ContactDrMomma@gmail.com

 

Top 20 of 2020

20. Take Mom's Picturehttp://www.drmomma.org/2019/07/take-moms-picture.html

19. Mama, You are Home to Mehttp://www.drmomma.org/2018/11/mama-you-are-home-to-me.html

18. Cry It Out - What is the 'It'? http://www.drmomma.org/2020/01/cry-it-out-what-is-it.html

17. The Placenta Does Not Age or Fail Post-Dateshttp://www.drmomma.org/2018/03/the-placenta-does-not-age-or-fail-post.html

16. Children Should Sleep Near Parents Until Age 5http://www.drmomma.org/2009/07/co-sleeping-children-should-sleep-with.html

15. What Should a 4 Year Old Know? http://www.drmomma.org/2011/11/what-should-4-year-old-know.html

14. Neonatal Infant Circumcision [A Video for Healthcare Professionals]http://www.drmomma.org/2011/01/neonatal-circumcision-video-for.html

13. Plastibell Infant Circumcisionhttp://www.drmomma.org/2009/08/plastibell-infant-circumcision.html

12. Your Body Within One Hour of Drinking Sodahttp://www.drmomma.org/2008/01/your-body-within-1-hour-of-drinking.html

11. Fetal Lungs Protein Release Triggers Labor to Beginhttp://www.drmomma.org/2008/01/fetal-lungs-protein-release-triggers.html

10. MRI Studies: The Brain Permanently Altered by Infant Circumcisionhttp://www.drmomma.org/2009/10/mri-studies-brain-permanently-altered.html

9. Newborn Nursing: Frequent, Lengthy, Normalhttp://www.drmomma.org/2019/10/newborn-nursing-frequent-lengthy-and.html

8. "Babywise" Linked to Dehydration, Failure to Thrive - http://www.drmomma.org/2009/12/babywise-linked-to-babies-dehydration.html 

7. Intact or Circumcised: A Significant Difference in the Adult Penishttp://www.drmomma.org/2011/08/intact-or-circumcised-significant.html

6. Why African Babies Don't Cryhttp://www.drmomma.org/2010/09/why-african-babies-dont-cry.html

5. Breastfeeding in Mongoliahttp://www.drmomma.org/2009/07/breastfeeding-in-land-of-genghis-khan.html

4. Fetal Ejection Reflexhttp://www.drmomma.org/2016/07/fetal-ejection-reflex.html

3. Turn Your Crib into a CoSleeperhttp://www.drmomma.org/2010/01/turn-your-crib-into-cosleeper.html

2. Lactation Cookies: Increasing Milk Supplyhttp://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html

#1 Most Read item at DrMomma in 2020: 

Sleeping Babies Need Mom Beside Themhttp://www.drmomma.org/2009/12/sleeping-babies-need-mom-beside-them.html




Winter Solstice: A Time for Rest, Reflection, Rebirth


Artwork by Jessica Boehman, Illustrator 

Life is being drawn into the earth, painlessly descending down into the very heart of herself. And we, as natural human animals, are being called to do the same -- the pull to descend into our bodies, into sleep, darkness, and the depths of our own inner caves continually tugging at our marrow. But many find the descent into their own body a scary thing indeed; fearing the unmet emotions and past events that they have stored in the dark caves inside themselves, not wanting to face what they have so carefully and unkindly avoided.

This winter solstice time is no longer celebrated as it once was, with the understanding that this period of descent into our own darkness was so necessary in order to find our light. That true freedom comes from accepting with forgiveness and love what we have been through, and vanquishing the hold it has on us, bringing the golden treasure back from the cave of our darker depths.

This is a time of rest and deep reflection, a time to wipe the slate clean as it were and clear out the old so you can walk into spring feeling ready to grow and skip without a dusty mountain on your back and chains around your ankles tied to the caves in your soul. A time for the medicine of story, of fire, of nourishment and love. A period of reconnecting, relearning and reclaiming of what this time means brings winter back to a time of kindness, love, rebirth, peace and unburdening instead of a time of dread, fear, depression and avoidance.

This modern culture teaches avoidance at a max at this time; alcohol, lights, shopping, overworking, over spending, bad food, and consumerism. And yet the natural tug to go inward, as nearly all creatures are doing, is strong, and people are left feeling as if there is something wrong with them --  that winter is cruel and leaves them feeling abandoned and afraid.

Whereas in actual fact winter is so kind. Yes, she points us in her quiet soft way toward our inner self, toward the darkness and potential death of what we were, but this journey, if held with care, is essential.

She is like a strong teacher that asks you to awaken your inner loving elder or therapist, holding yourself with awareness of forgiveness, and allowing yourself to grieve, to cry, rage, laugh, and face what we need to face in order to be freed from the jagged bonds we wrapped around our hearts, in order to reach a place of healing and light without going into overwhelm.

Winter takes away the distractions, the noise, and presents us with the perfect time to rest and withdraw into a womb-like love, bringing fire and light to our hearth.

-Brigit Anna McNeill

Read more from McNeill: https://brigitannamcneill.com

Mabel, age 12, creates her fantastic rendition of Jessica Boehman's original.
Note the extra books - little lamb must be making a run to the library for more!
Follow more of Boehman's work on Facebook: FB.com/HansMyHedgehog


• Peaceful Parenting on Facebook: FB.com/PeacefulParenting
• Peaceful Parenting Community: FB.com/groups/ExplorePeacefulParenting



Momma's Night Before Christmas


Mother's Love painting by Kolongi. Art work available here.

Twas' the night before Christmas,
when all through the abode

Only one creature was stirring -
and she was cleaning the commode.


The children were finally sleeping,
all snug in their beds,

While visions of presents,
flipped through their heads.


Daddy was snoring in front of the TV,

With a half-constructed bicycle up on his knee.

So only Momma heard the reindeer hooves clatter,
Which made her sigh, "NOW what's the matter?"

With toilet bowl brush still clutched in her hand,

She descended the stairs, and saw the old man.

He was covered in ashes, which fell with a shrug.

"Oh great..." muttered Mom, now cleaning the rug.


"Ho-Ho-Ho!!" bellowed Santa, "I'm glad you're awake.

Your gift was especially hard to make."

"Thank you Santa, but all I want's time alone."

"Exactly!!" he chuckled, "And I've made you a clone."


"A clone?" Mom asked, "What good is that?

Run along now, Santa. I've no time for a chat."

But it was Momma's twin!
Same hair, same eyes - same double chin.

"She'll cook, she'll dust, she'll mop every mess.
You'll relax, take it easy, and get some good rest."
"Fantastic!!" Mom cheered. "My dream come true!
I'll read. I'll write. I'll sleep a whole night through!"


From the room above, the youngest began to fret.
"Momma?! I need you. I'm scared and I'm wet."
The clone replied, "I'm coming, sweetheart."

"Hey," Mom smiled, "She knows her part."


The clone changed the small one, and hummed a sweet tune,

As she bundled the child, in a blanket cocoon.

"You're the best momma ever. I really love you."

The clone smiled and sighed, "And I love you, too."


Mom frowned and said, "Sorry, Santa, no deal.

That's
my child's love that she's trying to steal."
Smiling wisely Santa said, "To me it is clear,

Only one loving mother is needed 'round here."


Mom kissed her child, and tucked her into bed.

"Thank you, dear Santa, for clearing my head.

I sometimes forget it won't be very long,

When they'll be too old, for my sweet mothering song."


The clock on the mantle began to chime.

Santa whispered to the clone, "It works every time."

And with the clone clung close to his side,
Santa said, "Goodnight.
Merry Christmas, Momma! You'll be alright."


~Original Author ("The Night Before Christmas for Moms") Unknown; 
  Revised Poem (2009) by Danelle Day


Soleil Life Photography



*******

Christmas To Do List


This Christmas... 

 Be present. 
 Wrap someone in a hug.
Send peace. 
 Donate food. 
 Be the light. 

 ðŸŽ„❤️🎄❤️




12 Breastfeeding Days of Christmas


Not too many better ways to ring in the "12 days of Christmas" than with the Best for Babes Foundation's 12 Breastfeeding Days of Christmas (composed in 2009 and slightly updated this holiday season). Please take a moment to visit the Best for Babes site for a detailed explanation of each of these twelve life-changing gifts and take a look into how they can help "rebuild our shattered breastfeeding infrastructure."


12 Breastfeeding Days of Christmas


On the first day of Christmas 
There stood before me,
A mother wanting to breastfeed!

On the second day of Christmas 
There stood before me, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the third day of Christmas, 
There stood before me, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the fourth day of Christmas, 
There stood before me, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the fifth day of Christmas 
There stood before me, 
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the sixth day of Christmas, 
There stood before me, 
Six great IBCLCs, 
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the seventh day of Christmas 
There stood before me, 
Seven partners protecting, 
Six great IBCLCs, 
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the eighth day of Christmas 
There stood before me, 
Eight friends a-helping, 
Seven partners protecting, 
Six great IBCLCs, 
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the ninth day of Christmas 
There stood before me, 
Nine celebs a-nursing, 
Eight friends a-helping, 
Seven partners protecting, 
Six great IBCLCs, 
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the tenth day of Christmas, 
There stood before me, 
Ten nursing nooks, 
Nine celebs a-nursing, 
Eight friends a-helping, 
Seven partners protecting, 
Six great IBCLCs,
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the eleventh day of Christmas 
There stood before me, 
Eleven strangers cheering, 
Ten nursing nooks, 
Nine celebs a-nursing, 
Eight friends a-helping, 
Seven partners protecting, 
Six great IBCLCs, 
Five Baby-Friendly Hospitals, 
Four FABM MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

On the twelfth day of Christmas, 
There stood before me, 
Twelve supportive employers, 
Eleven strangers cheering, 
Ten nursing nooks, 
Nine celebs a-nursing, 
Eight friends a-helping, 
Seven partners protecting, 
Six great IBCLCs, 
Five Baby-Friendly Hospitals, 
Four (FABM) MDs, 
Three support groups, 
Two doula/midwives, 
And a mother wanting to breastfeed!

 Mary nurses Baby Jesus in this 16th century oil painting by Andrea Solario
for similar images see: Breastfeeding Baby Jesus

Nursing mothers are welcome to join the Breastfeeding Group. Note that this group is pro-baby, pro-natural weaning, pro-nursing-in-public, and WHO compliant in guidelines (i.e. no advertising of artificial baby feeds).


~~~~


Don't Force Your Child to Sit on Santa's Lap

By Brianne Collecchio
Originally at ChildUp.com


Your Christmas tree is decorated, the lights are up, and you’ve started to tackle your list of Christmas gifts. It’s time to take the children to the mall to see Santa. In your mind you’ve envisioned adorable photos of a smiling child posing happily with Old Saint Nick. You’ve thought about how many copies you’ll need to send out to proud grandparents. Your child is excited to see the man in red, already compiling a huge catalogue of toys to ask for. But when your child gets to the front of the line and comes face to face with Santa, he’s terrified! There’s no way he’s going to get anywhere near the man, let alone sit on his lap.

A child can develop a fear of Santa or other costumed characters at any point in childhood. Maybe your daughter loved Santa for the first three years of her life, and all of a sudden just the mention of his name has her running to her room. Children have extremely short memories, so each year when Christmas rolls around it’s like they are discovering Santa for the first time.

There are many reasons why children might be afraid of Santa. He has a big white beard that covers most of his face, and when a young child sits on his lap sometimes all they can see is that great white beard. It can be pretty intimidating not to be able to see his face.

A lot of children experience separation anxiety. When a parent sees Santa, they think of a jolly old man who brings children presents. When a toddler sees Santa, they’re experiencing mom and dad putting them on a stranger’s lap and walking away. That’s terrifying!

A toddler’s mind is also growing and developing so quickly—especially their imaginations. They are learning so much about the world so fast, but they still do not have the ability to distinguish between fantasy and reality. To that child Santa is a large stranger with a booming voice, and they are being left with him. That’s pretty intense.

Don’t force your child to take a picture with Santa or meet him if he or she is too afraid—just wait until next year. It’s not fair to subject your child to that level of anxiety just for a picture—and it won’t even be a good picture. Forcing your child to meet Santa can cause your child to associate that panic, fear, or discomfort with all things holiday related, and the last thing you want is a child who has a panic attack every time they hear Jingle Bells.

Telling your child not to be afraid of Santa can make him or her feel bad about themselves. Instead, be supportive. Let your child know that nothing bad will happen to him or her and that you will be right there with them. Offer to go see Santa first or have your picture taken with him to show your child that they will be fine.

Try to recognize if your child is truly afraid, or is just shy. Stay out of the line and watch some of the other children go first and hear their interactions. It’s very possible that they will see the other children enjoying themselves and change their mind.

If your child will absolutely not go anywhere near Santa, try to look at the bright side—it means that your child has an inner stranger-danger awareness. Value that alarm! There are far worse things in life than a child who is afraid to sit on Santa’s lap. Maybe you won’t get that adorable photo to send the grandparents, but you won’t get one of your child screaming either. Take it slow. There’s always next year.



Brianne Collecchio is a registered early childhood educator and runs Busy Bees Home Childcare in Guelph.

Baby It's Cold Outside Lyrics Rewritten



Couple rewrites 'Baby It's Cold Outside' to emphasize importance of consent 
As shared at CNN by Alexandra King | Read more from King

A couple from Minnesota has re-imagined the classic Christmas song "Baby It's Cold Outside" for a 21st-century audience, changing the song's lyrics to emphasize the importance of consent. Singer-songwriters Lydia Liza and Josiah Lemanski, both from Minneapolis, said they were inspired to rework the song after bonding over a mutual dislike of the original's lyrics, which were penned in 1944 by Frank Loesser.

The duet features a man trying to dissuade a woman from leaving a party despite her repeated protestations that she has to go home. "What's in this drink?" is one of the female lines. "What's the sense in hurtin' my pride?" implores the male voice. The song's seeming disregard for the woman's desire to leave never sat well with Lemanski or Liza. "I've always had a big problem with the song. It's so aggressive and inappropriate," said Lemanski, 25.

Liza, 22, said she felt the same way as her boyfriend. "We started thinking of the open-ended questions that song has," she said. "You never figure out if she gets to go home. You never figure out if there was something in her drink. It just leaves you with a bad taste in your mouth."

So Wednesday night, the couple decided to write a complete set of new lyrics. "We wrote the whole thing in an hour and then we went back and used my little demo-recording microphone and did that in 15 minutes," Liza recalled. And though the melody is still the same, the lyrics strike an entirely new chord.

"I really can't stay/Baby I'm fine with that" opens the song, as the lyrics recall the original's format of a woman leaving a party. Except in Liza and Lemanski's version, she does so without protest, the man helps her get home safely and the fictional couple makes a date the next day at The Cheesecake Factory. "I ought to say no, no, no," sings Liza. "You reserve the right to say no," croons Lemanski. And as for that dubious "What's in this drink?" line. It's still there. Except, in the new version, the question is actually answered -- by Lemanski, who responds with the oh-so-now ""Pomegranate La Croix" (obviously). "I thought we were just doing like a really good, cool, funny thing and it just felt right," Liza said. "And emphasizing consent is one of the causes that I've always really been behind because I don't think I can think of one friend of mine who's a woman who hasn't been in dangerous situations with men. I've always cared about this so much," she added.

After the duo uploaded the song to SoundCloud, the couple found that what started out as a shared gripe between a boyfriend and girlfriend also resonated with the public at large. "We've heard a lot of people say, 'Wow, we never actually paid attention to the lyrics before -- this is awful!'" said Liza. The couple also said they hoped the song would raise awareness of the need for consent, given the problem of sexual assault on college campuses. "It's not just a rare thing -- it happens all the time, everywhere. Every day. And I'm afraid for my sister. And I'm afraid for my friends. And I hope that this song gets people thinking about it," Lemanski said.

Liza added that she hoped that the song would inspire others to take action to help prevent violence against women. "I hope it will be on people's minds and that people will donate to charity or do some volunteer work at shelters or sexual assault centers. Like, if you think about this and you think it's a problem, definitely step out of your comfort zone and do something and help someone," she said.

And having successfully designated their re-imagined "Baby It's Cold Outside" as an unofficial anthem for the importance of consent, the couple joked that there were some other candidates for the Liza and Lemanski treatment. "A lot of people have suggested a bunch of songs, like Ella Fitzgerald's 'She Didn't Say Yes, She Didn't Say No' and Robin Thicke's 'Blurred Lines,'" said Liza. "We'll just do a whole album," she laughed.


Lydia and Josiah perform 'Baby It's Cold Outside' - with updated lyrics: 




Baby It's Cold Outside - New Lyrics 

I really can't stay/Baby I'm fine with that

I've got to go away/Baby I'm cool with that

This evening has been/Been hoping you get home safe

So very nice/I'm glad you had a real good time

My mother will start to worry/Call her so she knows that you're coming

Father will be pacing the floor/Better get your car a-humming

So really I'd better scurry/Take your time

Should I use the front or back door?/Which one are you pulling towards more?

The neighbors might think/That you're a real nice girl

Say, what is this drink?/Pomegranate La Croix

I wish I knew how/Maybe I'll help you out

To break this spell/I don't know what you're talking about

I ought to say no, no, no/you reserve the right to say no

At least I'm gonna say that I tried/you reserve the right to say no

I really can't stay/...Well you don't have to

Ah, but it's cold outside...

I've got to get home/Do you know how to get there from here?

Say, where is my coat/I'll go and grab it my dear.

You've really been grand/We'll have to do this again

Yes, I agree/How 'bout the Cheesecake Factory?

We're bound to be talking tomorrow/Text me at your earliest convenience

At least I have been getting that vibe/Unless I catch pneumonia and die

I'll be on my way/Thanks for the great night!

Bye/Bye--Drive Safe Please.
Don't watch that episode of 'Breaking Bad' without me/I won't, I'll save that for you!


Lydia and Josiah discuss their rendition of "Baby It's Cold Outside" further:



*******


Female Genital Mutilation (FGM) Bill of the United States


Until March 30, 1997, baby girls in the United States could be legally circumcised. With the enactment of the Federal Female Genital Mutilation Bill, cutting a child's genitals who is known to be born female is prohibited by law, barring real and existing medical necessity to perform cutting or surgery on her genitals. The same protection under law is not currently granted to baby boys or intersex children.


Learn more about the history of female circumcision in the United States:
http://www.DrMomma.org/2009/09/history-of-female-circumcision-in.html


18 U.S.C. United States Code
Title 18 - CRIMES AND CRIMINAL PROCEDURE
PART I - CRIMES CHAPTER 7 - ASSAULT
Sec. 116 - Female genital mutilation
From the U.S. Government Printing Office, www.gpo.gov

§116. Female genital mutilation

(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years shall be fined under this title or imprisoned not more than 5 years, or both.

(b) A surgical operation is not a violation of this section if the operation is—
(1) necessary to the health of the person on whom it is performed, and is performed by a person licensed in the place of its performance as a medical practitioner; or
(2) performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.

(c) In applying subsection (b)(1), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual.

(Added Pub. L. 104–208, div. C, title VI, §645(b)(1), Sept. 30, 1996, 110 Stat. 3009–709.)

Effective Date 

Section 645(c) of div. C of Pub. L. 104–208 provided that: “The amendments made by subsection (b) [enacting this section] shall take effect on the date that is 180 days after the date of the enactment of this Act [Sept. 30, 1996].”

Congressional Findings

Section 645(a) of div. C of Pub. L. 104–208 provided that: “The Congress finds that—

“(1) the practice of female genital mutilation is carried out by members of certain cultural and religious groups within the United States;

“(2) the practice of female genital mutilation often results in the occurrence of physical and psychological health effects that harm the women involved;

“(3) such mutilation infringes upon the guarantees of rights secured by Federal and State law, both statutory and constitutional;

“(4) the unique circumstances surrounding the practice of female genital mutilation place it beyond the ability of any single State or local jurisdiction to control;

“(5) the practice of female genital mutilation can be prohibited without abridging the exercise of any rights guaranteed under the first amendment to the Constitution or under any other law; and

“(6) Congress has the affirmative power under section 8 of article I, the necessary and proper clause, section 5 of the fourteenth Amendment, as well as under the treaty clause, to the Constitution to enact such legislation.”


Related Reading:

Male and Female Circumcision
http://www.DrMomma.org/2011/04/male-and-female-circumcision.html

Similar Attitudes and Misconceptions
http://www.DrMomma.org/2010/06/fgmmgm-similar-attitudes-misconceptions.html

History of Female Circumcision in the United States
http://www.DrMomma.org/2009/09/history-of-female-circumcision-in.html

UK Fails to Halt Female Circumcision
http://www.DrMomma.org/2009/12/uk-fails-to-halt-female-genital.html

FGM on the Rise in the United States
http://www.newsweek.com/fgm-rates-have-doubled-us-2004-304773

FGM in United States Fact Sheet
http://www.equalitynow.org/FGM_in_US_FAQ

Women and Girls at Risk in the United States
http://www.prb.org/Publications/Articles/2015/us-fgmc.aspx

America's Underground Female Genital Cutting Crisis
http://www.thedailybeast.com/articles/2014/06/11/america-s-underground-female-genital-mutilation-crisis.html

Female Genital Cutting is a U.S. Problem Too
http://www.npr.org/sections/goatsandsoda/2015/07/21/424984178/female-genital-mutilation-is-a-u-s-problem-too

Intact: Healthy, Happy, Whole community for learning

Peaceful Parenting Community
FB.com/groups/ExplorePeacefulParenting



♥    ♥    ♥    ♥    ♥





Sleep Training: A Review of Research



The following is a list of resources (articles/websites/books) for research-based information on infant sleep, night time parenting, baby crying, need for nourishment and comfort at night, and physiological body and brain responses to 'controlled crying,' 'cry it out,' or 'sleep training' methods. Also see psychological conditioning studies on the brain, immune system, development and learned helplessness (which occurs among babies whose care-givers utilize these methods).

"Crying-it-out does not lead to 'sleeping through the night' - it results in learned helplessness."
-Danelle Frisbie

Articles:
(in alphabetical order)

Adventures in Ezzoland


Ask the Experts: Sleep Training

Babies Aren't Soldiers

Babies Breathe Better During Sleep When Rocked

Baby Dreams [poem] 

Baby Sleep: A Review of Research [with links to articles]

Babies: Not Designed to Sleep Alone

Becoming Wise to Babywise [The Ezzo Method, "Growing Kids God's Way"]

Biological Imperatives: Why Babies Do Not and Should Not Sleep Alone

Breastfeeding in Bed: Miranda Kerr and Orlando Bloom Introduce Baby Flynn

Breastfeeding, Nightwaking: Protection from SIDS

The Case for Cue Feeding

The Con of Controlled Crying

Confessions of a Failed Babywiser

Confessions of an Accidental Cosleeper

CoSleeping Success! 

Crying It Out Causes Brain Damage

The Dangers of Cry It Out (2012)

The Dangers of Leaving Baby to Cry It Out (CIO) (2009)

Dangers of Your Baby 'Crying It Out'

Diverse Contexts of Human Infancy

Dr. William Sears on Growing Kids God's Way/Babywise

Dr. Sears on Babywearing (improves infant sleep, reduces crying and colic)

Excessive Crying Harmful to Babies

Healthy Infant Sleep

Hush Little Baby... [artwork]

I Will Carry You [poem]

Kangaroo Mother Care Saves 2lb Baby (the importance of touch and being held for babies; being close to mom even while asleep)

Milk Drunk (sleeping by baby makes night time parenting much easier!)

Night Time Parenting: A Practical Approach for the Reduction of Attachment Disorders and the Promotion of Emotionally Secure Children

Night Waking Protects Against SIDS

The No-Cry Sleep Solution

On Becoming Elderwise: Caring for Grandma God's Way

Our Bed [poem]

Peacefully Parented Babies Grow to Be Smarter, Kinder Kids  

Peaceful Parenting: Following Your Instincts

Pediatric Nurse and Former Ezzo Parent

Primal Love and Mothering

Reason 742 to Share Sleep

Rooting While at Rest [poem]

The Science of Sharing Sleep 

Seven Benefits of CoSleeping

Shaking a Crying Baby Causes Brain Damage

She's Not 'High Needs' - She's Vivacious! 



Websites:


Ezzo Information Website

Jay Gordon (Sleep: Changing Patterns in the Family Bed)

Parents Against Babywise (Facebook Page)


To connect with other parents and get in on Sleep Forums:
SafeBedSharing.Org

William Sears (31 Ways to Help Your Baby Sleep)


Books:

The No-Cry Sleep Solution

The Baby Sleep Book

Gentle Birth, Gentle Mothering

The Baby Bond

The Science of Parenting

Our Babies, Ourselves

Why Love Matters

Nighttime Parenting

The Natural Child: Parenting from the Heart

The No-Cry Sleep Solution for Toddlers & Preschoolers

Natural Family Living

The Baby Book

The Continuum Concept: In Search of Happiness Lost

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The Placenta Does Not Age or Fail Post-Dates


"A review of the available evidence indicates that the placenta does not undergo a true aging change during pregnancy. There is, in fact, no logical reason for believing that the placenta, which is a fetal organ, should age while the other fetal organs do not: the situation in which an individual organ ages within an organism that is not aged is one which does not occur in any biological system. The persisting belief in placental aging has been based on a confusion between morphological maturation and differentiation and aging, a failure to appreciate the functional resources of the organ, and an uncritical acceptance of the overly facile concept of 'placental insufficiency' as a cause of increased perinatal mortality."

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Placenta keychain (fun gift for the birth advocate in your life): https://amzn.to/2PxBF2n

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_______

Fox, Harold. Aging of the placenta. Archives of Disease in Childhood - Fetal and Neonatal Edition 1997;77:F171-F175. Full text: http://fn.bmj.com/content/77/3/F171

It is widely believed that during the relatively short duration of a normal pregnancy the placenta progressively ages and is, at term, on the verge of a decline into morphological and physiological senescence.1-3 This belief is based on the apparent convergence of clinical, structural, and functional data, all of which have been taken, rather uncritically, as supporting this concept of the placenta as an aging organ with, all too often, no distinction being made between time related changes and true aging changes. I will review some of these concepts and consider whether the placenta truly undergoes an aging process. For the purposes of this review an aging change is considered to be one which is intrinsic, detrimental, and progressive and which results in an irreversible loss of functional capacity, an impaired ability to maintain homeostasis, and decreased ability to repair damage.

Morphological changes

The placenta is unusual in so far as its basic histological structure undergoes a considerable change throughout its lifespan. For some time it has been customary to describe the appearances of the placental villi in terms of their changing appearance as pregnancy progresses, comparing, for instance, typical first trimester villi with those in third trimester placentas. It has often been implied that this changing appearance is an aging process, but it is now recognized that this temporal variability in villous appearances reflects the continual development and branching of the villous tree (fig 1) In recent years the relation between the growth of the villous tree and the villous histological appearances has been formally codified5-8with identification of five types of villi (fig 2).


Figure 1 Diagrammatic representation of a peripheral villous tree, showing a large central stem villus: the lateral branches from this are the mature intermediate villi from which the terminal villi protrude.


Figure 2  Representation of the peripheral branches of a mature villous tree together with typical cross sections of the five villous types. The figures are reproduced from Haines & Taylor. Textbook of Obstetrical and Gynaecological Pathology. 4th Edn. 1995, by kind permission of Churchill Livingstone and Professor P Kaufmann.

1 Mesenchymal villi 

These represent a transient stage in placental development and they can differentiate into either mature or immature intermediate villi. They comprise the first generation of newly formed villi and are derived from trophoblastic sprouts by mesenchymal invasion and vascularisation. They are found mainly in the early stages of pregnancy but a few may still be found at term They have complete trophoblastic mantles with many cytotrophoblastic cells and regularly dispersed nuclei in the syncytiotrophoblast: their loose, immature-type stroma is abundant and contains a few Hobauer cells, together with poorly developed fetal capillaries.

2 Immature intermediate villi 

These are peripheral extensions of the stem villi and are the predominant form seen in immature placentas. These villi have a well preserved trophoblastic mantle in which cytotrophoblastic cells are numerous; the syncytial nuclei are evenly dispersed and there are no syncytial knots or vasculo-syncytial membranes. They have an abundant loose stroma that contains many Hofbauer cells: capillaries, arterioles, and venules are present.

3 Stem villi 

These comprise the primary stems which connect the villous tree to the chorionic plate, up to four generations of short thick branches and further generations of dichotomous branches. Their principal role is to serve as a scaffolding for the peripheral villous tree, and up to one third of the total volume of the villous tissue of the mature placenta is made up of this villous type, the proportion of such villi being highest in the central subchorial portion of the villous tree. Histologically, the stem villi have a compact stroma and contain either arteries and veins or arterioles and venules; superficially located capillaries may also be present.

4  Mature intermediate villi 

These are the peripheral ramifications of the villous stems from which most terminal villi directly arise. They are large (60–150 Ξm in diameter) and contain capillaries admixed with small arterioles and venules, the vessels being set in a very loose stroma which occupies more than half of the villous volume. The syncytiotrophoblast has a uniform structure, no knots or vasculo-syncytial membranes being present. Up to a quarter of the villi in a mature placenta are of this type.

5 Terminal villi 

These are the final ramifications of the villous tree and are grape-like outgrowths from mature intermediate villi. They contain capillaries, many of which are sinusoidally dilated to occupy most of the cross sectional diameter of the villus. The syncytiotrophoblast is thin and the syncytial nuclei are irregularly dispersed. Syncytial knots may be present and vasculo-syncytial membranes are commonly seen. These terminal villi begin to appear at about the 27th week of gestation and account for 30–40 per cent of the villous volume, 50 per cent of the villous surface area, and 60 per cent of villi seen in cross section at term.

The pattern of development of the villous tree is therefore as follows: During the early weeks of pregnancy all the villi are of the mesenchymal type. Between the 7th and 8th weeks mesenchymal villi begin to transform into immature intermediate villi and these subsequently transform into stem villi. Development of additional immature intermediate villi from mesenchymal villi gradually ceases at the end of the second trimester, but these immature intermediate villi continue to mature into stem villi and only a few persist to term as growth zones in the centres of the lobules. At the beginning of the third trimester mesenchymal villi stop transforming into immature intermediate villi and start transforming into mature intermediate villi. The latter serve as a framework for the terminal villi which begin to appear shortly afterwards and predominate at term.

This progressive elaboration of the villous tree results in a predominance of terminal villi in the mature placenta. Such villi have been conventionally classed as “third trimester villi” and a comparison of their structure with the predominant type of villi in the first trimester— immature intermediate villi—has led many to suggest that as pregnancy progresses the villous trophoblast becomes irregularly thinned and the cytotrophoblast regresses, changes interpreted as being of an aging nature. The villous cytotrophoblast, which is a stem cell for the trophoblast, does not in reality regress, because the absolute number of these cells in the placenta is not decreased at term and in fact continues to increase throughout pregnancy. The apparent sparsity of these cells is due to their wider dispersion within a greatly increased total placental mass.9 10 The focal thinning of the villous syncytiotrophoblast apparent in many terminal villi has often been cited as evidence of syncytial senescence. These thinned areas are, in reality, the “vasculo-syncytial membranes”11 which, although formed in part by mechanical stretching of the trophoblast by ballooning capillary loops,12 never the less differ enzymatically and ultrastructurally from the non-membranous areas of the syncytium and are areas of the syncytiotrophoblast specifically differentiated for the facilitation of gas transfer.13 These membranes are therefore a manifestation of topographic functional differentiation within the trophoblast.

The interlinked, but separate, processes of maturation of the villous tree and functional differentiation of the trophoblast result in a predominant villous form that is optimally adapted for materno-fetal transfer diffusion mechanisms: the morphological changes substantially increase trophoblastic surface area14 and a significantly reduce the harmonic mean of the diffusion distance between maternal and fetal blood,15 with a resulting increase in the conductance of oxygen diffusion.16

It is not mere pedantry to distinguish between maturation, which results in increased functional efficiency, and aging, which results in decreased functional efficiency. In this respect it is worth noting that a proportion of placentas from women with severe pre-eclampsia look unusually mature for the length of the period of gestation: this is usually classed as “premature aging” but it would be more accurate to regard the changes as being due to accelerated maturation, this being a compensatory mechanism to increase the transfer capacity of the placenta in the face of an adverse maternal environment.

It has to be admitted that the control mechanisms of placental maturation are unknown. There are many agents thought to be of importance in the control of placental growth, including cytokines, growth factors, oncogenes, prostaglandins and leucotrienes,17-20 but it far from clear as to whether control of growth can be equated with control of maturation. However, villous development, certainly in the later stages of pregnancy, does seem to be driven principally by proliferation of endothelial cells and capillary growth.21 Vascular endothelial growth factors are present in placental tissue22 and the suggestion that hypoxia may stimulate angiogenesis,23 and thus have a significant role in placental development, would corroborate the accelerated placental maturation seen in some cases of maternal pre-eclampsia.

Placental growth 

It has long been maintained that placental growth and DNA synthesis cease at about the 36th week of gestation and that any subsequent increase in placental size is due to an increase in cell size rather than to an increase in the number of cells.24Simple histological examination of the term placenta will, however, serve to refute this view, because immature intermediate villi are often present in the centres of lobules and these clearly represent a persistent growth zone. Furthermore, total placental DNA content continues to increase in an almost linear manner until and beyond the 42nd week of gestation.25 This finding agrees with autoradiographic and flow cytometric studies that have shown continuing DNA synthesis in the term organ,26-28 and with morphometric investigations that have shown persistent villous growth, continuing expansion of the villous surface area, and progressive branching of the villous tree up to and beyond term.14 29

Placental growth certainly slows, but clearly does not cease, during the last few weeks of gestation, although this decline in growth rate is neither invariable nor irreversible, because the placenta can continue to increase in size if faced with an unfavourable maternal environment, such as pregnancy at high altitude, or severe maternal anaemia, while the potential for a recrudescence of growth is shown by the proliferative response to ischaemic syncytial damage. Those who contend that a decreased placental growth rate during late pregnancy is evidence of senescence often seem be comparing the placenta with an organ such as the gut, in which continuing viability depends on a constantly replicating stem cell layer producing short-lived postmitotic cells. A more apt comparison would be with an organ such as the liver, which is formed principally of long-lived postmitotic cells and which, once an optimal size has been attained to meet the metabolic demands placed on it, shows little evidence of cell proliferation while retaining a latent capacity for growth activity. There seems no good reason why the placenta, once it has reached a size sufficient to adequately meet its transfer function, should continue to grow, and the term placenta, with its considerable functional reserve capacity, has more than met this aim.

Functional activity 

There have been few vertical studies of placental function throughout pregnancy, but there is no evidence that any of the major indices of placental function decline—namely, proliferative, transfer, and secretory capacities.30 As already remarked, the diffusion conductance of the organ is increased, largely as a result of morphological changes, but there is considerable evidence that specific placental carrier mediated transfer systems are also augmented.20 The placental production of hormones continues unabated until term: the synthesis of human chorionic gonadotrophin declines towards the end of the first trimester but this is clearly due to a gene switch which results in progressively increasing secretion of human placental lactogen.

The placenta also retains its full proliferative capacity until term as shown by its ability to repair and replace, as a result of proliferation in the villous cytotrophoblastic cells, of a villous syncytiotrophoblast that has been ischaemically damaged in women with severe pre-eclampsia.13

Clinical factors 

The single most important factor leading to a belief in placental senescence has been the apparently increased fetal morbidity and mortality associated with prolonged pregnancy, this traditionally being attributed to “placental insufficiency” consequent on senescence of the organ.1 31 In the past it was thought that about 11% of pregnancies extended to or beyond the 42nd week of gestation32 33 : the introduction of a routine ultrasound examination in early pregnancy reduced the incidence of prolonged pregnancies to about 6%34 and it has even been claimed that with very accurate dating studies the incidence of truly prolonged gestations does not exceed 1%.35 This casts some doubt on the validity of a great deal of the historical information about the risks and ill effects of prolonged pregnancy, but it is never the less widely accepted that perinatal mortality increases after the 42nd week of gestation.36

Any increase in perinatal mortality after the 42nd week of gestation is due, in part, to the high incidence of fetal macrosomia: 10% of infants from prolonged pregnancies weigh over 4000 g and 1% over 4500 g and these fetuses are at particular risk of complications such as shoulder dystocia. The presence of this large number of macrosomic fetuses is a clear indication that, in this subset at least, the placenta continues to function well beyond the 40th week of gestation and remains capable of sustaining untrammelled fetal growth.

The classic clinical syndrome of the “postmature” infant1 31 is not commonly seen today but seems to be clearly related to the development of oligohydramnios. There is no doubt that amniotic fluid volume tends to decrease in a proportion of prolonged pregnancies39 and that oligohydramnios is associated with a high incidence of fetal heart rate decelerations.36 This has been attributed by some to cord compression,40 41 but one study, while confirming that cord compression is common in prolonged pregnancies, was unable to correlate such compression with fetal acidosis.42 It is often assumed, and indeed commonly stated, that the decline in amniotic fluid volume in these cases is an indication of “placental insufficiency” but, in reality, there is no evidence that in late pregnancy the placenta plays any part in the production of amniotic fluid or in the control of amniotic fluid volume. 43

The two most potent causes of increased morbidity in prolonged pregnancy are therefore clearly unrelated to any change in placental functional capacity. Examination of placentas from prolonged pregnancies shows no evidence of any increased incidence of gross placental abnormalities, such as infarcts, calcification, or massive perivillous fibrin deposition. The most characteristic histological abnormality, found in a proportion of cases but certainly not in all, is decreased fetal perfusion of the placental villi.13 The fetal villous vessels are normal in placentas from prolonged pregnancies44 and Doppler flow velocimetry studies have, in general but not unanimously, indicated that there is no increased fetal vascular resistance in such placentas.45-47 The decreased fetal perfusion is therefore probably a consequence of oligohydramnios, because umbilical vein flow studies have shown that fetal blood flow to the placenta is often reduced in cases of oligohydramnios.48

It has to be admitted that the pathophysiology of prolonged pregnancy has not been fully elucidated. It seems, however, quite clear that any ill effects which may befall the fetus in prolonged gestations can not be attributed to placental insufficiency or senescence.

Conclusions 

A review of the available evidence indicates that the placenta does not undergo a true aging change during pregnancy. There is, in fact, no logical reason for believing that the placenta, which is a fetal organ, should age while the other fetal organs do not: the situation in which an individual organ ages within an organism that is not aged is one which does not occur in any biological system. The persisting belief in placental aging has been based on a confusion between morphological maturation and differentiation and aging, a failure to appreciate the functional resources of the organ, and an uncritical acceptance of the overly facile concept of “placental insufficiency” as a cause of increased perinatal mortality.

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Stokes HJ, Roberts RV, Newnham JP (1991) Doppler flow waveform velocity analysis in post-date pregnancies. Aust N Z J Obstet Gynaecol 31:27–30.

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