Is my baby ready for solids?

Is my baby ready for solids? 

This is a quick check list to know for sure. If YES to all of the above, your little one may be ready to begin babyled weaning (i.e. consumption of the first non-milk items).

If no to even one, waiting a little longer may be best. Watch your baby, not the dates or the calendar (except for age minimums). There is no harm in delaying the starting of solids for a baby who is otherwise nursed/fed on cue around the clock, and there are many benefits (immunity, development, gut health) up to a certain point, and when it is done in baby's own perfect timing.

Additional good reading on this topic and more: 

Baby Matters (the science behind why waiting matters): http://astore.amazon.com/peacefparent-20/detail/0975317040

Take Charge of Your Child's Health (chapter on breastfeeding, and chapter on starting solids/natural weaning): http://astore.amazon.com/peacefparent-20/detail/156924653X

Natural Family Living (chapter on breastfeeding/starting solids): http://astore.amazon.com/peacefparent-20/detail/0671027441

Our Babies, Ourselves (sections that address breastfeeding and weaning throughout humanity and around the world today): http://astore.amazon.com/peacefparent-20/detail/0385483627

How Weaning Happens (an oldie but goodie!): http://astore.amazon.com/peacefparent-20/detail/0912500549 

Babyled Weaning: http://astore.amazon.com/peacefparent-20/detail/161519021X

Parents with little ones moving into their weaning days are welcome to join the Babyled Weaning Group on Facebook: FB.com/groups/Babyled

Breastfeeding moms are welcome to join: FB.com/groups/Breastfed

*****

The Webster Technique: Chiropractic Care During Pregnancy and Birth

By Jeanne Ohm, DC
International Chiropractic Pediatric Association (ICPA) Executive Coordinator
ICPA: http://icpa4kids.com

Chiropractic care benefits all aspects of your body's ability to be healthy. This is accomplished by working with the nervous system - the communication system between your brain and body. Doctors of Chiropractic work to correct spinal, pelvic and cranial misalignments (subluxations). When misaligned, these structures create an imbalance in surrounding muscles and ligaments. Additionally, the resulting nerve system stress may affect the body's ability to function optimally.

The Webster technique is a specific chiropractic analysis and diversified adjustment. The goal of the adjustment is to reduce the effects of sacral subluxation/ SI joint dysfunction. In so doing neuro-biomechanical function in the pelvis is improved.

Dr. Larry Webster, founder of the International Chiropractic Pediatric Association discovered this adjustment as a safe means to restore proper pelvic balance and function. This specific sacral analysis can be used on all weight bearing individuals to determine S/I joint dysfunction/ sacral subluxation and is therefore applicable for the entire population. The assessment includes heel flexion to buttocks, with restricted flexion indicating the affected SI joint. Correction is made with a diversified, sacral adjustment. It is used on all weight bearing individuals presenting with this biomechanical restriction. Common symptoms include (but are not limited to) low back pain, sciatic neuralgia, and symptoms associated with sacral subluxation and/or S/I joint dysfunction.

The ICPA recognizes that in a theoretical and clinical framework of the Webster Technique in the care of pregnant women, sacral subluxation may contribute to difficult labor for the mother (i.e., dystocia). Dystocia is caused by inadequate uterine function, pelvic contraction, and baby mal-presentation. The correction of sacral subluxation may have a positive effect on all of these causes of dystocia.

In this clinical and theoretical framework, it is proposed that sacral misalignment may contribute to these three primary causes of dystocia via uterine nerve interference, pelvic misalignment, and the tightening and torsion of specific pelvic muscles and ligaments. The resulting tense muscles and ligaments and their aberrant effect on the uterus may prevent the baby from comfortably assuming the best possible position for birth.

In regards to pregnant mothers, Dr. Webster reported that when a mother sought care and her baby was in a breech position, the restoration of pelvic neuro-biomechanics with this adjustment also frequently facilitated optimal fetal positioning. There are cases published in the chiropractic literature that support this theory. More research is needed and is currently underway by the ICPA.

The obstetric literature has determined that correct positioning of the baby in-utero affect birth outcome and decrease the potential for undue stress to the baby's developing spine and nerve system. Obstetric literature has determined the importance of normal pelvic neuro-biomechanics including uterine function and pelvic alignment for the prevention of dystocia (difficult birth). It has also determined that correct positioning of the baby in-utero affects birth outcome and decreases the potential for undue stress to the baby's developing spine and nerve system.

Chiropractic literature has determined the significance of sacral adjustments in normalizing pelvic neuro-biomechanics. It is therefore considered prudent that this specific sacral analysis and adjustment be used throughout pregnancy to detect and alleviate sacral imbalance and optimize pelvic neuro-biomechanics in the mother. Because of the particular female adaptations from the increase of hormones, weight gain and postural adaptations, pregnant mothers have a greater chance of sacral subluxation and neuro-biomechanical imbalance than the general population. Additionally, because of the effect the chiropractic adjustment has on all body functions by reducing nerve system stress, pregnant mothers may have significant benefit by having their spines checked regularly throughout pregnancy, optimizing health benefits for both the mother and baby.

Further Resources

The International Chiropractic Pediatric Association offers classes of instruction and awards qualified attendees a Certificate of Proficiency in the Webster protocol. Only those doctors on our site maintain recognized certification status for the Webster protocol.

Parents: to find a Certified D.C. in your area, visit our Membership Directory: http://icpa4kids.com/locator/index.htm

To read research about this technique visit: http://icpa4kids.org/Chiropractic-Research/Webster-Technique/

To read about the history of the technique, see the following two resources: http://icpa4kids.com/about/webster_technique_history.htm

http://icpa4kids.org/Chiropractic-Research/the-webster-technique-results-from-a-chiropractic-practice-based-research-program.html

Questions about the Webster Technique (Pathways for Family Wellness): http://pathwaystofamilywellness.org/Chiropractic/questions-about-the-webster-technique.html

Doctors: to attend a Proficiency Workshop, visit our schedule for Seminars: http://icpa4kids.com/seminars/

Dr. Jeanne Ohm's "Perinatal Care" seminar offers Webster Certification: http://icpa4kids.com/seminars/Schedule_Ohm.php

Expecting mothers are welcome to join either of these Facebook groups:
Birthing: FB.com/groups/Birthing (more holistic)
Pregnant Moms Due this Year: FB.com/groups/DueDateGroup (more mainstream)

*******

Reasons to Skip Swaddling

By Wendy Priesnitz for Natural Child Magazine
Shared with permission.

The practice of wrapping newborn infants tightly in blankets that restrict movement of their limbs is an ancient one, happening even before Biblical times. Its popularity has ebbed and flowed, but it is still routinely practiced in many hospitals, and is making a comeback among some parents, either in the form of a tight blanket that holds the baby’s arms and legs straight, or a looser form of wrapping that keeps the arms free. There are, increasingly, commercial “baby swaddles” and other swaddling paraphernalia, as well as YouTube videos to teach parents how to swaddle correctly.

Swaddling is done for many reasons, including warmth, the prevention of scratching, and to calm crying and fussiness in hospital nurseries and at home. Unfortunately, swaddling seems to conflict with the emotional care that is the basis of attachment parenting and other conscious ways of being with children, in addition to having some physical problems. Here are some reasons not to swaddle your newborn.

1. A baby cries for a reason and the parent’s job is to quickly determine the reason for the cry and solve the problem with milk, attention, pain relief, motion, a dry diaper, a temperature change, or whatever is required – with the priority on fixing the situation, not on stopping the noise. Wrapping an infant up tightly might lessen her crying, but it might also make her feel abandoned and stressed, rather than relaxed and content.

2. Swaddling leads newborns to sleep more and deeper. That will provide a welcome respite for tired parents, but it will also interfere with skin-to-skin bonding, and lessen the frequency of feeding, slowing weight gain and increasing dehydration.

3. Swaddled babies look so warm and cozy. However, they can become dangerously overheated – not only because of the effect of the blanket, but because they can’t wave their arms and legs around to cool themselves off.

4. Babies need skin-to-skin contact. Those who don’t get it feel profound stress. Skin-to-skin contact can also reduce the stress of being born. As well as helping regulate a newborn’s temperature, skin-to-skin contact also helps stabilize his breathing, hormone levels, and heart rate.

5. One purpose of swaddling is to soothe the newborn by reminding her of the womb. However, a fetus has freedom of movement in utero that is not possible when swaddled. Her post-birth freedom to wiggle toes and fingers (and put them in her mouth) and wave arms and legs is part of the developmental process and helps develop both muscle control and the nervous system. Recent studies have shwon that movement helps improve cognitive functioning in people of all ages, and infants are at a stage of rapid cognitive development. They can't explore how their bodies work when swaddled. 

6. Swaddling has been implicated in Sudden Infant Death Syndrome (SIDS). (It’s also believed by some that swaddling lowers the risk of SIDS because it prevents a baby from rolling onto his stomach, which has been linked to SIDS, and prevents him from covering his face with a blanket as he squirms.) While a swaddled newborn might stay in the position in which he was laid down, older swaddled babies have been known to flip themselves over and get stuck in the face-down position. Overheating has also been linked to SIDS.

7. Swaddling can contribute to dysplasia of the soft hips of newborns, which can lead to problems with the joint later in life. According to the International Hip Dysplasia Institute, “Sudden straightening of the legs to a standing position can loosen the joints and damage the soft cartilage of the socket.”

8. The risk of upper respiratory infections can be increased by the hampered ability to breathe deeply when infants are tightly swaddled. In one study, published in the American Journal of Public Health, the risk of developing respiratory infections increased fourfold in swaddled infants.

One of the swaddlers is advertised in this way: “The first several months of Baby’s arrival can be quite tough on the sturdiest of new parents. The [product] has been proven to greatly extend sleep periods between feedings...allowing Mom and Dad more extended rest, enhanced relaxation, and peace of mind.” I think there are more empathetic ways to soothe our babes.

Wendy Priesnitz is the editor of Natural Child Magazine. She is also the editor of Natural Life Magazine and Life Learning Magazine, the author of twelve books, and a journalist with over 35 years experience. She is the mother of two adult daughters.

Related Reading:

Baby Sleep Resource Page

CoSleeping Group

To witness infant genital cutting: to witness sexual assault

"It is virtually impossible to witness infant genital cutting and not recognize this act as a form of sexual assault." -Danelle Frisbie

The two most common forms of unnecessary infant genital cutting currently in practice in the United States include male circumcision by Gomco Clamp and male circumcision by Plastibell. If you've not previously witnessed how these surgeries take place, often without anesthesia, we invite you to research further, beginning with linked resources and videos below. 

Gomco: SavingSons.org/2011/01/neonatal-circumcision-video-for.html

Plastibell: DrMomma.org/2009/08/plastibell-infant-circumcision.html

Related Reading: 

The Plastibell Lie SavingSons.org/2012/03/plastibell-lie.html

The Perils of Plastibell Circumcision: A Mythical "No Cutting, No Risk" Method DrMomma.org/2010/05/the-perils-of-plastibell-circumcision.html

Baby Dies Post Plastibell DrMomma.org/2007/06/baby-dies-post-plastibell-circumcision.html

Massive Infection Takes Over Body After Plastibell Circumcision DrMomma.org/2009/11/massive-infection-takes-over-body-after.html

The biggest lie told to parents (a registered nurse speaks) SavingSons.org/2016/04/the-biggest-lie-told-to-parents.html

If this stained circumstraint could talk... SavingSons.org/2012/06/if-this-stained-circumstraint-could.html

Intact vs. Circumcised Outcome Statistics DrMomma.org/2010/01/cut-vs-intact-outcome-statistics.html 

Death From Circumcision DrMomma.org/2010/05/death-from-circumcision.html

Should I Circumcise? The pros and cons of infant circumcision: SavingSons.org/2014/12/should-i-circumcise-pros-and-cons-of.html

*******

Whose Body, Whose Rights? Award Winning Circumcision Documentary

Whose Body, Whose Rights? Examining the Ethics and Human Rights Issue of Infant Male Circumcision is an award-winning documentary, as seen on PBS, and now available for viewing in full online. Recipient of the Creative Excellence award at the 1996 U.S. International Film and Video Festival, Honorable Mention at the 1996 Philadelphia Film Festival, and Best of Festival at the First Annual Stark Video and Film Festival (1997), this film may be purchased on DVD here.

This program was dedicated in 1995 to the American pioneers who worked to protect boys and girls from genital mutilation: Joseph Lewis, Marilyn Milos, Rosemary Romberg, and Edward Wallerstein.

Copyright © 1995, Dillonwood Productions, 56 minutes, color. Contact Producer: CircHarmSurvey@gmail.com

A note to physicians:

Finding My Voice: No Questions Left Unanswered

By Brian Brown © 2017
Read more from Brown at Intact Connecticut, Intact Pride, the Intact Vegan Network, and join him along the SOS Odyssey touring intact rallies.

Shortly after I graduated high school, I met my first love. He came from a strict family. My family was different - my parents were newly divorced, and I found my rebellion by piercing various parts of my face and bleaching my hair blond. We were literally from different sides of the world - but together we seemed to work.

One difference that I was unprepared for was the most private part of our bodies. He had something that I did not. In my youthful naivety, I sincerely believed that this was merely because he was a different race. I legitimately assumed that this 'extra' thing that he had was just something that Asians had and White Americans did not. During this time, I passed health class in high school but was still none the wiser, because this was never addressed.

Alex went off to college and we eventually parted ways. It was years later that I learned the truth about his body; and it was an ugly truth about my own.

We were not different at all - I had this part also at one point, but it had been taken away from me.

I knew without question that his body was normal - not mine.

I briefly found solace in pretending I was normal. I used to hang out in internet chat rooms and pretend that I was intact. To lie to these strangers whom I would never meet absolved me of ever dealing with my own reality.

It was years later that my next door neighbor was having a baby boy. She and I were very close at the time and she reached out for advice. She was the first person that I ever shared my story with -- in its entirety -- with very personal, intimate details. Her response, after I confided everything to her, is one that I will never forget: "We are doing it, no questions asked." It was that point that I realized my own personal experiences would never truly matter until her husband was willing to deal with his own issues.

I needed the courage to continue to speak up, to press on, to educate, to make real change. This is something I am so thankful to have found in Intact Rhode Island. They empowered me in this way so that there are no longer any "No questions asked..." statements. I am providing the answers to these questions -- whether they are asked or not.

I am Intact Connecticut and despite widely spread efforts to hide the truth, I am not afraid of misconceptions about the male body anymore.

Also by Brown: 

Olympic Circumstraint Patent and Origin

Coming Out Twice

Men Speak on Genital Autonomy

*******

Catheterization Without Retraction

By Adrienne Carmack, M.D. board-certified urologist, in practice in Texas, and author of The Good Mommy's Guide to Her Little Boy's Penis and Marilyn Fayre Milos, R.N. Executive Director of Genital Autonomy America, California.

Catheterization Without Retraction
Canadian Family Physician. 2017 Mar; 63(3): 218–220.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349724/

Over the past century, numerous boys born in Canada and the United States have been circumcised. (1) However, this trend is changing, with neonatal circumcision being performed less commonly than in years past. (2,3) Because of these historical practices, many physicians and nurses have limited experience treating patients with intact foreskins and engage in ill-advised procedures such as premature foreskin retraction for purposes of “hygiene” or catheterization. Premature retraction of the foreskin can lead to tearing of healthy tissue, which is painful and increases the risk of preputial scarring and infection. (4–6) We describe a method for catheterization in which premature retraction of the foreskin is not necessary.

Technique

The foreskin should first be gently manipulated to determine if the meatus can be easily visualized. Pressure used for this should be gentle to avoid tearing of tissues, similar to the amount of pressure that would be used when spreading the labia to visualize the meatus of a girl. If the natural attachments of the foreskin to the glans (head of the penis) remain, the foreskin should not be forced back to expose the meatus.

If the foreskin can be gently moved such that the glans and meatus can be seen, catheterization can be performed under direct vision using a sterile technique. The foreskin should never be retracted past the point where it has already naturally separated. (7)

If the meatus cannot be seen, the genitals can be prepared and draped in a sterile manner without retraction. The catheter can then be lubricated and gently inserted through the foreskin opening and guided into the meatus, much like an intravenous catheter is guided into a vein by feel. Gentle pressure with the thumb along the dorsal aspect and the fingers along the ventral surface of the penis can keep the catheter from slipping between the glans and inner lining of the foreskin into the preputial space (Figure 1).

When catheterization is being performed for the purpose of collecting a urine specimen, the foreskin should also not be forcibly retracted. In both boys with an intact prepuce and girls, the initial urine obtained during catheterization should be discarded, as this will contain preputial and periurethral flora. The latter urine should be saved for culture. (8)

Discussion

An understanding of the normal anatomy and development of the foreskin illustrates why the technique of catheterization without retraction is an important skill for health care practitioners. Physiologic phimosis is the normal state of young boys. (9) This finding is characterized by a closed preputial outlet with the inner mucosa of the foreskin beginning to evert through the preputial opening, which is healthy with no scarring. The glans cannot be seen without retraction. This is in contrast to pathologic phimosis, in which the glans and meatus can often be seen, as the scarred ring of the preputial orifice is held open and no mucosa is visible at the preputial outlet. (10)

In a Danish study, 8% of healthy boys aged 6 to 7 still had complete physiologic phimosis preventing visualization of the meatus, and only 23% of boys this age had fully retractable foreskins. (11) In a Japanese study, 84.3% of boys aged 6 months to 1 year had a tight ring preventing any retraction, and this decreased gradually with time to 40% at ages 1 to 2 years, 28% at ages 3 to 4 years, 20% at ages 5 to 7 years, 16% at ages 8 to 10 years, and 8.6% at ages 11 to 15 years. (12)

The term phimosis is Greek and means “a muzzling.” Physiologic phimosis simply means the foreskin cannot be retracted and the glans is “muzzled.” Ballooning during urination is a common finding and part of the normal developmental process of foreskin separation. (10) It occurs because the opening of the immature foreskin is not yet lax enough to accommodate a full urine stream or passage of the glans through it. The foreskin and glans separate naturally as the child develops, has erections, and manipulates his foreskin. When a young boy manipulates his foreskin naturally, he tends to pull his foreskin away from his body, not toward it, as is done with retraction. As he gets older and more curious, he begins to pull his foreskin toward his body as well. (10) In most boys, physiologic phimosis resolves naturally by the end of puberty. (11)

The foreskin and glans are connected by the balanopreputial lamina, a membrane similar to the synechial membrane that connects the nail bed and the fingernail. The balanopreputial lamina is sometimes called the synechia. This membrane and the small preputial opening prevent retraction in boys with normal physiologic phimosis. The attachment might be forcefully disrupted, just as the fingernail can be torn from the nail bed, but this causes pain, is unnecessary, and can lead to infection, scarring, adhesion formation, or iatrogenic phimosis. There is no functional need for the glans to be exposed, and there is a protective effect of having the foreskin attached to and covering the glans.

Because the foreskin protects the glans penis and urethral meatus, premature exposure of the glans, as occurs after circumcision, commonly leads to meatal stenosis, in which a substantial part of the circulatory system in the glans penis is damaged (the frenular artery), and the glans tissue is exposed, denuded, and inflamed, which can lead to ulceration and subsequent scarring of the urethral opening. This inflammation and ulceration are caused by disruption of the normal attachment between the glans and foreskin, the absence of the protective foreskin, interruption in the normal circulatory system, or blisters from ammonia burns. (13–15) The blisters and ulceration at the opening of the urethra are caused by contact of urine-soaked diapers with the urethral meatus, which is no longer protected by the foreskin.

Retracting the foreskin of a prepubescent boy with physiologic phimosis, although still a common recommendation by many health care practitioners, has been shown to increase problems such as scarring and infection. These might result in iatrogenic pathologic phimosis and lead to a higher likelihood of circumcision being performed at a later date. (16)  If the prepuce is unable to retract, there is nothing to clean under. The foreskin should not be retracted for cleaning until the foreskin has naturally separated and the child can do this himself. In fact, the owner of the foreskin should be the first person to retract his foreskin. Forceful retraction causes microtears that can lead to pathologic phimosis. (10)

An additional danger of premature retraction is paraphimosis, a condition in which the retracted foreskin becomes stuck behind the glans penis, cutting off circulation and leading to ischemia and possibly penile gangrene if not treated promptly. Retracting the foreskin and cleansing with soap, commonly believed to be important for proper hygiene, not only exposes the child to the risks of premature foreskin retraction, but also to the risks of infection such as balanitis, which has been shown to be associated with the use of soap on the delicate mucosal tissues of the male genitalia. (17) Soap dries out mucosal tissue and should never be used on the glans or inner foreskin. The foreskin should be left alone until it demonstrates the ability to retract. (10) Once this is possible, foreskin care is simple: retract (gently and only to the extent possible), rinse, replace. Warm water and fingertips adequately clean the tissue.

Besides false beliefs about hygiene, one of the main reasons boys are subject to premature foreskin retraction is that many health care professionals believe that the foreskin must be retracted to obtain a clean specimen for urine culture. Fortunately, this is not the case. With proper technique, as described above, urine specimens can be obtained from boys with intact foreskins without exposing these patients to the risks of premature foreskin retraction. Although the focus of this article is on a technique for catheterization, it must be remembered that catheterization is an intervention that carries risks. The risks of catheterization include discomfort and introduction of bacteria into the urinary tract, which could lead to infection. Indications for catheterization include the need to monitor urine output for medical management, emptying the bladder in patients who are unable to do so, introducing contrast material for imaging procedures such as a voiding cystourethrogram, and obtaining a urine specimen for analysis in patients who are unable to provide one.

If a patient can reliably void into a collection container, catheterization for monitoring urine output can be avoided. Patients who cannot empty their bladders have the options of clean intermittent catheterization, indwelling urethral catheterization, and suprapubic catheter placement. Other options for collection of a urine specimen for analysis and culture include a midstream voided sample and suprapubic aspiration, and these should be considered when determining the optimal approach for specimen collection.8 Suprapubic aspiration is significantly more painful than urethral catheterization in premature male infants (P < .001). (18) Contamination is possible with catheterized samples as it is with voided samples.19 This suggests that catheterization for urine specimen culture should be reserved for those patients who are unable to provide a voided specimen into a clean container, and suprapubic catheterization should only be used if previous efforts to obtain a specimen have resulted in contamination.

Conclusion

In boys with intact prepuces and physiologic phimosis, catheterization without retraction minimizes potential long-term problems and is an effective technique. Understanding how to catheterize without direct vision of the meatus and discarding the initial urine if culture is desired allow this procedure to be performed with high validity and minimal risk of iatrogenic problems for the child.

References

1. Weiss H, Polonsky J, Bailey R, Hankins C, Halperin D, Schmid G. Male circumcision. Global trends and determinants of prevalence, safety and acceptability. Geneva, Switz: World Health Organization, Joint United Nations Programme on HIV/AIDS; 2007.

2. Maeda JL, Chari R, Elixhauser A. Circumcisions performed in U.S. community hospitals, 2009. Rockville, MD: Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality; 2012. Available from: www.hcup-us.ahrq.gov/reports/statbriefs/sb126.jsp. Accessed 2015 Jun 15.

3. Fetus and Newborn Committee, Canadian Paediatric Society Neonatal circumcision revisited. CMAJ. 1996;154(6):769–80. [PMC free article] [PubMed]

4. Kaplan GW, McAleer . Structural abnormalities of the genitourinary tract. In: Mac-Donald MG, Mullett MD, Seshia MMK, editors. Avery’s neonatology. Pathophysiology and management of the newborn. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. p. 1088.

5. Roberton NRC. Care of the normal term newborn baby. In: Rennie JM, Roberton NRC, editors. Textbook of neonatology. 3rd ed. Edinburgh, UK: Churchill Livingstone; 1999. pp. 378–9.

6. American Academy of Pediatrics . Newborns: care of the uncircumcised penis. Guidelines for parents [pamphlet] Elk Grove Village, IL: American Academy of Pediatrics; 1984.

7. Lacroix LE, Vunda A, Bajwa NM, Galetto-Lacour A, Gervaix A. Catheterization of the urethra in male children [video] N Engl J Med. 2010;363(14):e19. [PubMed]

8. Schaeffer AJ, Schaeffer EM. Infections of the urinary tract. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walshurology. 9th ed. Philadelphia, PA: Saunders-Elsevier; 2007. pp. 238–9.

9. Smeulders N, Wilcox DT. Urology. Disorders of the kidney and urinary tract. In: Rennie J, editor. Rennie & Roberton’s textbook of neonatology. 5th ed. London, UK: Churchill Livingstone–Elsevier; 2012. p. 949.

10. McGregor TB, Pike JG, Leonard MP. Pathologic and physiologic phimosis. Approach to the phimotic foreskin. Can Fam Physician. 2007;53:445–8. [PMC free article] [PubMed]

11. Oster J. Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child. 1968;43(228):200–3. [PMC free article] [PubMed]

12. Kayaba H, Tamura H, Kitajima S, Fujiwara Y, Kato T, Kato T. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol. 1996;156(5):1813–5. [PubMed]

13. Canning DA, Nguyen MT. Evaluation of the pediatric urology patient. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed. Philadelphia, PA: Saunders-Elsevier; 2007. p. 3215.

14. Elder JS. Abnormalities of the genitalia in boys and their surgical management. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 9th ed. Philadelphia, PA: Saunders-Elsevier; 2007. p. 3749.

15. McGrath K. The frenular delta. A new preputial structure. In: Denniston GC, Hodges FM, Milos MF, editors. Understanding circumcision. A multi-disciplinary approach to a multidimensional problem. New York, NY: Springer; 2001. pp. 199–206.

16. Metcalfe PD, Elyas R. Foreskin management. Survey of Canadian pediatric urologists. Can Fam Physician. 2010;56:e290–5. Available from: www.cfp.ca/content/56/8/e290.full.pdf+html. Accessed 2017 Feb 2. [PMC free article] [PubMed]

17. Birley HD, Walker MM, Luzzi GA, Bell R, Taylor-Robinson D, Byrne M, et al. Clinical features and management of recurrent balanitis; association with atopy and genital washing. Genitourin Med. 1993;69(5):400–3. [PMC free article] [PubMed]

18. Badiee Z, Sadeghnia A, Zarean N. Suprapubic bladder aspiration or urethral catheterization: which is more painful in uncircumcised male newborns? Int J Prev Med. 2014;5(9):1125–30. [PMC free article] [PubMed]

19. Lau AY, Wong SN, Yip KT, Fong KW, Li SP, Que TL. A comparative study on bacterial cultures of urine samples obtained by clean-void technique versus urethral catheterization. Acta Paediatr. 2007;96(3):432–6. [PubMed]


Related Reading

Urine Samples and Catheter Insertion for Intact Boys: http://www.drmomma.org/2011/12/urine-samples-and-catheter-insertion.html

Using a Catheter Without Retraction: My Nurse Did It, and So Can Yours! http://www.savingsons.org/2013/01/using-catheter-without-retraction-my.html

How the Foreskin Protects Against UTIs: http://www.drmomma.org/2009/12/how-foreskin-protects-against-uti.html

UTI and Circumcision Resources: http://www.savingsons.org/2014/11/uti-resource-page.html

7 Nursing Skills That You've Already Mastered as a Mom

Being a mom is a wonderful thing. It is also a great learning experience. While not all mothers consider taking up a career in nursing, there are numerous nursing skills that mothers learn even without going to class. These skills are necessary for the survival of their young one and the well being of the entire family. Here are several skills that mothers learn that are also applicable when one is considering becoming a nurse.

1) Communication Skills

As a mother, you must have sharp communication skills. You need to communicate with everyone on behalf of your child. Also, you must anticipate the needs your child has and find out how to solve the issues. There is also the need to vary your communication skills, depending on who you are speaking to and what you are speaking to them about. As a nurse, one must be able to speak, listen, and intervene when the need arises. They must also communicate with the patient and their families about their health status. Their main task is to anticipate the needs a patient has and be their advocate.

2) Empathy

A mother has to show love and care to their children. You need to feel the pain and joy your kids are feeling even when your day is not so great. Also, you should constantly encourage them to achieve more and do better. A mother also needs to care about the dreams and passions of her children and has to notice their unique talents. Caring is a central part of nursing and benefits the nurse and the patient. As a nursing intervention, empathy allows patients to feel at ease with the nurses to allow them to find and treat any health problems they may have. It is also a great way for nurses to understand their patients and allow them to have the freedom to approach them when they have problems.

3) Detail Oriented

A mother gets to know that her child is not as active as he usually is before everyone else. She also notices the slightest fever cases without having to take a thermometer. Also, a mom makes note of the changes in the weather and protects her child from their extremes. This is a skill that makes mothers the best nurses. In the medical field, a small error can cost you a life. That is the reason why a career in medicine is one of the most stressful one. A nurse or doctor who is not keen with details can mix up procedures and treatments and compromise the health of a patient, not to mention their lives. A great nurse, just like a mother, manages patients without skipping necessary steps or making errors.

4) Great Interpersonal Skills

Mothers tend to be great listeners. Toddlers have numerous stories to tell and a mother must remember all the friends their child introduces them to and their favorite things. In listening, the mother must actively participate in the story being told to make the child feel appreciated. This is a critical skill in nursing that mothers tend to learn almost by default. A nurse helps to alleviate the stress and prevents the development of depression symptoms by being great friends to their patients. They listen to stories about the patient’s life, friends, and family. With time, the patient will open up to the nurse and tell them when they are stressed and if they are in pain. With that, the nurse can prevent psychological problems and keep their patients happy throughout the treatment. It also allows patients to be more open to the treatment plans chosen by both the doctor and patients. Mothers are also able to notice issues with their family members by just speaking to them.

5) Enduring Physical Strain

Right from the time a child is born, a mother has to sacrifice their sleep to feed the baby, clean the house, and ensure that other children in the household are ready for school or bed on time. Mostly, when the child is still an infant, mothers tend to get less than 6 hours of sleep a day. However, they still manage to do all the house chores and take care of their children without complaining. Nurses work for long periods. Most of the time, they are on their feet moving from one patient to another. Sometimes, a nurse will work double shifts, which extend to almost 20 hours each day. They also have to lift objects or people in their work. This is stressful on their bodies. Just like mothers, only fit nurses can keep up with the demands of the job and still do error-free jobs.

6) Flexibility

Mothers learn to forgo everything and focus on their kids. Even in the middle of the night, a mother will wake up to feed her child and check up on them. A nurse must always be ready to report to work when needed. There are often medical emergencies that require a nurse to go to the hospital suddenly even at odd hours of the night. Just like moms, nurses too are required to work overtime to complete their tasks.

7) Respect for Rules and People

Mothers must respect each of their children because they are all different. They must also respect their spouses and create rules in the household that should be followed and respected. A great nurse also shows respect for people and rules. They remain impartial, mindful, and respectful when dealing with people from different cultures and norms.

4 Tips to staying full when starting Nutrisystem

You’ve probably had enough of being overweight, and have made the decision to live a healthier lifestyle. The first step you took was to become more active. You’ve started to exercise and you are now seeing the fruits of your labor.

You’re also now mindful of the calories you are consuming every day. To make it easier for you, there are companies that offer prepackaged meals that have already been portioned. One example of that is Nutrisystem, which has already boasted of many success stories who availed of their meal plans. Don’t be discouraged if you think the plan might be expensive as there are Nutrisystem.com deals, coupons and promotions available for you.

For those who are starting Nutrisystem, one effect might be the feeling of being hungry all the time since you are consuming fewer calories than what you were used to consuming. To combat that, here are some tips you can follow so that you will not be tempted to snacking on unhealthy food.

1. Eat some fiber – because fiber takes longer to digest compared to other nutrients, it helps you to feel full longer than other food and nutrients. Instead of the usual and typical breakfast meal of cereal, why not opt to eat a fiber-rich meal of warm oatmeal? Studies have proven that fiber, particularly oatmeal eaten during breakfast can actually make the person eat fewer calories during lunch by as much as 30 percent. Instead of indulging in sweets and French fries for a snack, you can also opt for fiber-rich smoothies or bars instead so that you can stay full longer. Do your research on what snacks you can eat so that your diet while using the Nutrisystem will not be affected and you can keep working toward your goal.

2. Drink water before you eat your meals – make it a habit to drink water before you start your meal. Studies suggest that the ideal volume of water to take is about 16 ounces. When you consume this much water, studies show that you can lose more weight than people who do not do this habit. Because you drank a lot of water, your stomach will feel full already and there is no temptation to add more food to your meals.

3. Concentrate on just eating during meal time – one of the problems in the world today is that there is too much distraction around us. For example, it is rare to sit down to a meal without the possibility of watching TV or having your phone beside you. You are less likely to savor and enjoy your meal when you are also doing another task. Keep away from doing things like reading newspapers or looking through your email during meals and focus on enjoying your food instead.

4. Use smaller plates – when you only have a small portion of food on a big plate, your brain thinks that you want to eat more because of how little food there is on your plate. Switch to smaller plates so that your brain will think that you are still eating a lot even though you are eating less.

Jobs in the Medical Field

So you want to work with medical patients, but do not desire the years of medical school required to become an M.D.? No worries. There are many jobs in the field of medicine and health that don’t require practitioners to be doctors. All the same, these jobs do require intense skills, training and knowledge. But there are a plethora of ways to be involved in the medical field and help people heal. 

Registered Nurses

There are many different types of nurse positions out there. A registered nurse (RN) To become a nurse practitioner, nurse anaesthetist, or nurse midwife, you’ll need a Masters degree. Nurse practitioners can practice family medicine, prescribe medicines, and diagnosis illnesses. Nurse anaesthetists help a patient before and after surgery, and nurse midwives aid women through the process of childbirth. Nurses may also become Visiting Nurses, who provide in-home health care for patients. RNs usually require a Bachelors degree, Associates degree, or diploma from an accredited institution.

Medical Technologists

These are the folks in the “lab.” Medical technologists, also known as medical laboratory scientists, analyze and test blood, skin, swab samples, urine, fecal matter and all sorts of other bodily fluids and tissues to help diagnose diseases. They work in a lab and use advanced equipment that they operate and maintain. Medical technologists usually hold a Bachelor’s degree and have completed an internship.

Pharmacists

Pharmacists have to know the composition, effects, and side effects of commonly prescribed medications. Pharmacists often counsel patients who are using medicines for the first time or who have chronic illnesses, and pharmacists also are equipped to give routine vaccinations. A pharmacist may work with the same clients for years and get to know them. Many people will turn to their pharmacist for basic medical questions rather than consult a doctor. Pharmacists do get to use the title “Dr,” even though they aren’t MDs. Their doctorate is called a Pharm.D.

Physician Assistants

Physician assistants (PAs) practice medicine as part of a team and are supervised by doctors and/or surgeons. They can examine, diagnose, and treat patients, counseling them on how to maintain their health, writing a prescription for a CPAP machine, or recommending a visit to a specialist. PAs are required to have a Masters degree. They learn along the medical model but complete their qualifications in less time than a full medical degree--their training is based on the fast-track training of physicians developed during WWII.

Medical Manager

A medical or health services manager is in charge of the logistical and administrative side of things. They plan, coordinate, and direct medical care. Medical managers may run a whole facility, or they may run just one department. It’s essential that medical and health services managers know the rapidly-changing world of healthcare laws, regulations, and technologies. While medical managers and health services managers may not work as directly with the patients in a clinic, they are essential to making the patient experience an effective one. These jobs require the minimum of a Bachelor’s degree, although higher-level professionals often hold Masters and Doctorates.

A DAY AT THE SPA: The Revitalizing Power of Beauty

Women are one of the most delicate creations of God. Many love to be pampered and flattered. One way of making the woman in your life feel special is getting some sumptuous and lavish treatments at the spa.

Every woman in the world has the right to relax and unwind from the hectic routines at work or nerve shattering day looking after the kids. Women, especially mothers, do need a break. And what can be more appropriate and rewarding than as day at the spa?

Spas are as common as the number of people using smart phones these days. This is because more people are getting aware of the fact that how important it is to look good in order to feel good.

In this fast progressing world, people must not hesitate in spending money on their appearance or basic beauty regimes which in the longer run will bring much affection and fondness towards them.

Out of all the beauty treatments manicure and pedicure are the most basic and desired ones. Manicures are treatments for hands while pedicures are treatments for the feet. A well maintained pair of hands and feet can be a treat for the sore eyes. Anyone can fall for you if you have soft, neat and presentable hands and feet with clean and trimmed nails.

The exposure to sun may cause our exposed body parts to go inadequately and awfully tan. These mani-pedi treatments let the dead skin get removed by soaking them into soapy water and then gently massaging them to let the tiredness of the day wear off. It involves cutting, shaping of nails and cuticles in order to attain more of a fancy look. Later, in the end the nails are adorned with your choice of nail color to give it a finishing look.

Then comes the skin. Skin is the largest organ that the human body possesses. One needs to take care of the skin more than anything on our body, since it’s the most exposed part and it gives a lasting impression of one’s self. There are several facials and skin treatments that you can ask for, and the aestheticians treat you according to your skin type, tone and texture.

Skin treatments are the talk-of-the-town these days. Which include skin whitening treatments, Singapore underarm whitening treatments, unwanted facial hair removal treatments, botox, lip fillers can be found at the boutique spas.

Such skin treatments make your skin glow, shine and radiate for elongated period of time without making much of an effort post treatments. For example: seductively whitened underarms may not abstain you from wearing sleeveless tops or be embarrassed due to blackened skin exposure.

Full body herbal massages are imperative due to such hectic lifestyle to de-stress one’s self. The attending masseuse are well trained and are familiar with the pressure points which help in un winding the tiredness your body had accumulated over the period of time.

High end spas and beauty parlors have the above services as a la carte or an entire day for treatments can be booked. Consisting of a combination of balanced treatments so that you may get a flavor of all the treatments in one go.

One should make it a point to take time out for them, out of the frenzied lifestyle that we are bound to spend these days. It not only helps in being exceedingly productive but also de clutters the thought process.

What You Should Know About Organic Parenting

What You Should Know About Organic Parenting 

Parents today spend a significant amount of time and effort to give their children all the best they can. Unfortunately, in most cases this can lead to the interference in their development, responsibility, and lack of the leadership skills. Is choosing mindful parenting a key to successful upbringing, or is there something else you should pay your attention to? If you are willing to know what can help you to understand your little baby, and to succeed in being a friend to your child, then our practical tips will help you to make up your mind and consider all the pros and cons of natural parenting.

Risk is not something you have to avoid all the time 

We live in a world, where danger surrounds us everywhere every time. Being aware of it, we are trying to do our best to protect our children from everything that can hurt from the first day of their living. However, many European scientists have proven the fact that if a youngster doesn’t play with his peers and hasn’t scraped his knee at least once in his life, then he will have to struggle with various phobias and complexes in adult life. A child has to fall several times to understand that nothing serious has happened. If parents exclude all the risks from child’s life, it may result in the kid becoming arrogant, selfish and having low-esteem in future.

Over-helping can play tricks 

As a parent, it is in our nature to help our closest when they are in need. But is it good for them? Do we rush for giving our children help? Modern generation has not developed a life skill which many previous generations used to have earlier, we are trying to help our children with everything they do, sometimes taking too much care of them, so that we deprive them of making their own decisions and solving problems on their own. Sooner or later, the child gets used to having helping hand all the time, but he won’t find it in real life later, thus he won’t be adapted to an actual life.

When praising is not an option 

Over-praising is another problem you may face while parenting. Of course, everybody wants our babies to stay happy all the time and have high self-esteem, but excessive praising can lead to very serious problems. Having seen they are praised for everything they do, children can start cheating and telling a lie just to be given credit. Although mindful praising is always good for a child development, too much of it, especially if a kid hasn’t done anything to deserve it, in the early stage of child development can result in taking for granted a praise by him/her in adult life.

Sharing your experience with a child is natural 

Sometimes the intelligence of a child is treated to be enough to consider he/she as a mature person, who is ready to face real-life problems. If you also think so, then you are totally wrong. If your child is gifted somehow, that doesn’t mean that he is already independent and can do everything on his own. We must allow our children to spread their wings and get their own experience, but we can also share with them our experience and practical wisdom. One tip? Tell your children about EssayVikings to improve their marks. The golden rule is not to transform your piece of advice into the parental didactic lesson, but to have a friendly talk with them.

Having progressive parents are something many children will really appreciate during the whole process of their development, though it is not always very easy to do. Parenting is treated to be one of the hardest things in the world to do by many people, because there are no exact parental patterns you can use while upbringing your child. Frankly, I do not have an exact plan for you to follow to grow the smartest and cutest kid ever, all you need to know is you must learn how to listen and understand your child better yourself, giving them enough support. Just do not forget that every child is an individual and needs to be treated in a special way. 


5 Traveling Tips Every Traveler Should Know

The list for traveling tips, tricks and hacks is endless. As people travel, experience and grow, they have more to share with the rest. Traveling is all about enjoying and exploring yourself, while you take a break from the routine.

While you're out doing so, you don't want to be stuck with unforeseen circumstances. Which is why, we have compiled a list of traveling tips that will prepare you well for your upcoming holiday.

1. Keep your First Aid Traveling Kit

No. We're not talking about the conventional band-aids, gauze, scissors, ointments and medicines. (Hell Yeah that's important too). Here, we refer to your ultimate travel essentials: chargers, headphones, and sleep masks.

Another tip is to always carry replaceable items while travelling. Whether its your original branded headphones or chargers, or your diamond rings, don't risk losing these valuables by taking them with you. Instead, look for cheaper replacements, that don't spoil your trip, if misplaced. For example, if you are not comfortable carrying your expensive headsets with you, you can easily find a good pair of earphones for $50 or less.

2. Always Review Flights Baggage Policy

If you're a frequent traveler, you must have figured this out for yourself by now. However, if you're a first time traveler, you need to be very careful when it comes to airline baggage policy. Most of the time, this varies according to your travel destination.

Look for what bag dimensions are allowed, luggage allowance, what quantity of liquids, creams or lotions, you can carry with you, and what exactly do they categorize as liquids and solids. This saves your time in security clearances by not having to open each and every one of your suitcases.

3. Don't Keep Valuables at One Place

While many people would suggest carrying a travel wallet with you, to keep all your belongings at one place, travel experts beg to differ. Since travel experts roam around the world, they're aware of the misfortunes that can occur, theft being on top of the list.

Most people keep their passports in their travel wallets too. Losing your passport means ruining your entire trip. One way to tackle that is by storing your important documents and cash at different locations, instead of keeping them together. If you have a bad memory, you can always note this down in your smartphone.

4. Get Travel Insurance

While many people argue over the benefit of travel insurance, truth is that it has got you covered while you're in crisis. Depending on the package you select, travel insurance covers for any injuries and accidents during your journey. On top of that, some insurance companies cover for flight cancellation or missed flights as well.

Many travel insurances even allow you to avail 24 hour emergency services abroad. Sure, it can not avoid the misfortunes from taking place, but getting monetary compensation for your loss is the best thing you could ask for, in such times.

5. Stay in Hostels instead of Hotels

Hotels across the world offer similar standards of service so you might not be able to live and experience the culture of your travel destination to the fullest, by staying in one. Therefore, we advise, that if you're not on a trip solely for luxury and comfort, you stay in hostels and apartments. 

Secondly, if you're traveling on a budget, you don't need to bear the additional expense of hoteling. Since you'll only be spending little time (probably to sleep and store bags only) in whatever accommodation you decide on, why not go for the cheaper one?

You can always download apps like AirBnB to look for reasonably priced apartments, guesthouses and hostels and save yourself a generous amount.

Tips for Maintaining a Happy and Healthy Family Home

Maintaining a healthy and happy family home can be a challenge when you’re looking after small children, doing the school run, working, cleaning endless clothes, packing lunches, making dinner, and ensuring the pet dog has a walk each day. Below are some vital tips to help ensure your family home runs as smoothly as possible so more time can be spent on the things you can all enjoy together, such as long walks in the country or takeout and film nights.

1. Create systems that work for you.

Write lists of events coming up each week, including birthdays and special occasions so nothing gets missed. Create online shopping orders and set a designated delivery time each week to take the pressure off having to get to the shops. Write age-appropriate chore lists for the children so that everyone is involved in keeping your home nice. Organize regular special treats together, such as Friday night being family pizza night, where everyone has dinner together and shares the good and bad parts of their week.

2. Have reliable and trustworthy people to turn to when things go wrong or for home improvements. 

Every family needs local and honest tradespeople they can call when the unexpected happens, such as a leaking roof or a broken boiler. Use the internet to help you find the best reliable and insured local plumber closest to you. Try to get at least three quotes for a job so you can be confident you’re getting the best deal, and always check references and credentials.

3. Clear out the clutter. 

It’s easy for jobs to accumulate when you’ve got children. Suddenly the minimalist spare bedroom has turned into a haven for odd socks, old clothes, unused appliances, unwanted Christmas presents and broken toys. Why not take the Marie Kondo approach and ask yourself if an object sparks joy in you. Be ruthless with those that don’t, and donate them instead to the local charity shop, thereby clearing out your house and helping a local cause in one.

4. Get to know your neighbors. 

The prominence of online social networks has created societies where people can be very involved with online communities and yet feel isolated in their day-to-day existence. Making personal connections to those who live close to us is a wonderful way to foster a sense of community, which can be especially important when you have a young family. After a sleepless night with a new baby, having a neighbor ask how you are or invite you in for a cup of coffee can be a lifeline. Being able to pop round to a neighbor’s to borrow a cup of sugar or asking a neighbor to feed your cat while you’re away all help provide a sense of belonging. Why not organize a street party or a local charity fundraising event, so that everyone can meet each other in a friendly and relaxed way?

5. Be kind to yourself. 

Bringing up children, working and maintaining a happy home while surviving on little sleep and balancing finances can be challenging, so don’t beat yourself up about the little things. Let perfection go and instead focus on health and happiness and what that means to you and your family.

5 ways that you can protect your children’s future

Starting a family is an incredibly rewarding experience. If your children mean the world to you, it is likely that you spend a lot of time thinking about their future. They may not appreciate this now, but further down the line, they will be glad to have a parent who cares so much. In life, it is impossible to know what is going to happen next. This can make it extremely difficult to have a clear plan for the future. However, there are some areas where it is always best to be prepared. Below are five ways that you can protect your children’s future.

Set up a savings account

If you want to ensure that your children don’t have to struggle through any dramatic lifestyle changes, you will need to set up a savings account. This is one of the best ways to be certain that you can always provide for your little ones. Try to contribute to your savings account on a regular basis and keep it separate from your current account. This is essential if you are going to build up a significant amount of money.

Don’t take anything for granted

If you have been involved in an accident, it is important that this doesn’t have a negative impact on your family unit. For instance, struggling through Atlanta car accidents, could involve dealing with huge costs or life-changing injuries. Instead of letting this interfere with your family life, you should seek out professional help. This will ensure that you can protect your finances and speed up your recovery process.

Look out for scholarships

Many parents dream of the proud moment when they get to send their child off to college. However, unless you have unlimited funds, this can also be a source of great worry. That is why you should always be on the lookout for scholarship opportunities. There may be a scholarship out there that perfectly suits your child’s talents. Alternatively, if you do your research early on, you could encourage your little one to take up an activity that the top colleges are attracted to.

Teach your children healthy habits

Don’t forget to think about the health of your children. Teach them the benefits of eating a balanced diet and enjoying plenty of exercise. This will help them to lead a long and happy life. Instead of being forced to break bad habits, you will have taught them how to make appropriate lifestyle choices.

Discuss your children’s feelings

In order to raise well-rounded adults, you will need to discuss your child’s emotions on a regular basis. Your children should always be able to come to you when they are struggling. If they bottle up all of their emotions, this could have a negative effect on their future relationships and life choices. However, if they understand how to work through their feelings, they will be better equipped to deal with the stresses and strains of the big wide world.

Why Infrastructure Matters

Politicians like to talk about their support for infrastructure. They mean support for new roads, new buildings, and even new utilities. Basically, they’re supporting the physical structures and organizations that help us function as a society. If you want to get a crowd to applaud, it’s common to support “new infrastructure.” Crowds eat that up, because new construction often means new jobs. And who doesn’t like creating more jobs?

Infrastructure matters in other ways as well. It doesn’t have to be a gigantic new office building to be a part of the infrastructure. Think of your office. It has infrastructure as well. One part of that infrastructure is your company’s IT team. The company definitely needs IT to operate, right? IT also needs a few things to make sure they’re contributing as much as possible to the company. For instance, the DevOps movement in IT is a response to the need for a quicker, more efficient infrastructure. It gets a bit complicated, but think of tech infrastructure like a highway. If the highway is crowded all day and every day, it’s possible that new lanes need to be opened up, or maybe a new road needs to be constructed. Information that can’t be moved fast enough is the equivalent of a traffic jam. Traffic jams are frustrating. They cost time and money. When you’re stuck in one, you need to find a solution, even if it means taking the nearest exit and using the back roads.

A company that can’t or won’t update its infrastructure is asking its employees to carry a big burden. They’re saying, “Yes, we’re not going to give you all the tools you need to succeed, but we still expect you to succeed anyway. It’s our fault, but we’re going to blame you if things go wrong. And things will probably go wrong.”

Think of the pipes in your home. If they’re operating like they’re supposed to, the water and sewage goes through smoothly. Your toilets flush correctly. The water runs strong when you turn on the shower. But if there’s a clog, you need to get that fixed. A refusal to do so means you’re weakening your infrastructure in the long-term for the sake of perceived short-term gains. That rarely works out as well as you think it well.

In short, a company without a solid infrastructure is selling both itself and its employees short. You need to show your employees that you care enough to give them a foundation to succeed. If not, it’s like you’re asking your employees to drive to work, but without using any roads.

An investment in infrastructure takes money, and a lot of companies don’t like to spend money, but this is one thing you really can’t cheap out on. Many big cities are struggling to adapt to growing populations, largely because their roads are old and they don’t have much in the way of public transit. In fact, the government in general has made a habit lately of talking plenty about infrastructure upgrades, but not doing anything when the rubber hits the (poorly maintained road). Don’t be like that. Invest where it counts. It’ll make for a much smoother ride.