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What are your vitamin K plans? - Page 2

post #21 of 49
Quote:
Originally Posted by LightForest View Post

Did anyone see the finale of 30 Rock where they spoof mommy message boards? SUCH a friggin hilarious example of an innocent question bringing up button-pushing issues... It's right at the beginning of the show, if anyone wants to see it on hulu...

 

Now, back to the discussion...

lol.gif  Haven't seen it, but I can imagine!

 

 

 

I want to clarify, though, that my issue isn't necessarily with the medical procedures or even the recommendation of certain procedures.  It is when the government gets involved in these very personal decisions...FORCING medical procedures on the masses.  That's where my af.gif comes in.

post #22 of 49
Thread Starter 
Quote:
Originally Posted by jodieanneanton View Post
It is when the government gets involved in these very personal decisions...FORCING medical procedures on the masses.  That's where my af.gif comes in.

 

What I find even more mind boggling is that so many procedures are NOT required, but for whatever reason patients believe they are. There's something weird going on with our relationships with content specialists when we just assume that the things they tell us are the required rules of behavior.

 

Vitamin K is a tricky one because the requirements vary by state in the US, and just because a state has requirements does not mean that state is clear on ramifications for not following their requirements (as Chapsie mentioned). (I can't help but mention that even if your state "requires" something, it is still possible to find a care provider who will honor the patient's informed decision making process - this has been my experience with both of my births now, living in two different states. I know that this doesn't respond to the real issues - I am by no means indicative of the masses when it comes to how I make medical decisions - but I am by no means fatalistic when it comes to how I view my chances of getting the type of care I want. (Sorry - I know that was horribly worded. Hope you get the point though....))

 

Spughy's observations about the differences in our health care systems really struck a chord with me - I do feel that the way the US system is currently run does a lot to feed into all of the trickle-down issues that are being discussed here.

post #23 of 49

I find many things about the US systems mind-boggling.  It's kind of odd participating on MDC because even though we're very close, culturally and geographically (I can see Washington State from my living room! - said in a Sarah Palin voice) and many of us Canadians have similar views on "mainstream" health care and parenting and so on, our approach to it is so different and our relationship to government is so different.  Just yesterday I was talking to a friend after an appointment and expressing my gratitude for the fact that I *could* see this person, and she really helped me, and it didn't cost me anything, and felt generally all warm and fuzzy about our hospital and our medicare/social services system and everything.  At the same time, it's nowhere NEAR perfect, but the quibbles I have with it are more implementation and the focus given to treatment rather than prevention generally... sorry I'm rambling.  The point is, Canadian attitudes towards government tend to swing between "thank goodness this service is available" and "damn that is a really annoying form" and "jayzus I've been on hold for 3 hours why can't they hire more people" with annual forays into "good lord I paid HOW much tax?" - there's not too much "OMG the government is FORCING ME TO DO STUFF I DON'T BELIEVE IN" and only the real fringe elements tend to concern themselves overmuch with government forces sticking bureaucratic noses into personal business.  We're not universally pleased with the way government runs (understatement of the year) but our negative feelings are much more disdain and disgust (and usually mild at that, although our dear Prime Minister is trying his best to enhance those feelings) rather than fear and loathing.

 

We also have some checks and balances in place that prevent the degree of litigiousness that you guys "enjoy" although again, we're nowhere near perfect and doctors here are highly motivated to avoid dipping into the malpractice insurance.  That might help a bit too.  Also, no Fox News. winky.gif

post #24 of 49

Something interesting to note... (I will try to find the website where I found it in my research about vitamin k.)

 

Vernix is naturally high in vitamin K and newborn skin very easily absorbs substances (which is why you can't use many homeopathic oils on babies, for example).  So, another source of natural vitamin k would be rubbing the baby's vernix into the skin rather than washing/rubbing it off!  Pretty neat!

post #25 of 49
Quote:
Originally Posted by jodieanneanton View Post

I looked up the law in TX, withlittlelungs.  It is not illegal to refuse the antibiotic eye ointment.  The law is worded in the way that it makes it a misdemeanor for healthcare worker to not administer it, not for the parent to refuse it.  

Now, if it is really really important to you to decline the eye treatment (which is for preventing blindness in the infant in the case that the mother is positive for certain STDs), you have the right to do so.  After reading several threads on various forums, it seems like people have mixed results with declining in the state of Texas.  Some just have to sign a form to decline with no problems. I have also seen stories of CPS being called (though I have seen nothing about infants being taken away). <--I realize this is all anecdotal.  I just wanted to clarify that the law does not prevent you from declining this treatment.  Your course of action will have to do with your comfort level, of course.  There is also nothing that stops you from wiping off as much ointment as you can after application, though this does not prevent all antibiotic exposure, it'd be a better option than nothing.  I also like Melany's advice of delaying eye ointment until as late as possible or at least after nursing is established.

luxlove.gif Thanks for this Jodie! I actually looked this up, too, after my post but didn't have time to update. I left the "no antibiotic eye ointment" in my birth plan and added a line stating I will sign any paperwork necessary. If they really start fighting with me about it and we decide to end the battle, I am going to have it delayed as long as possible and we are wiping those babies' eyes ASAP!!

 

post #26 of 49
Quote:
Originally Posted by spughy View Post
 Also, no Fox News. winky.gif

BEST EVER.

post #27 of 49

Okay, finally had time to check out that article you posted, Jodie, and look into neonate blood composition and whatnot.

 

Unfortunately that article starts out completely wrong, as far as I can tell.  Newborns do NOT have thin blood.  On the contrary, neonate hematocrit is normally *higher* than adult levels (45-65% being normal for newborns, adults 40% for women and 45% for men).  This makes for increased blood viscosity and the exact opposite of "thin blood", and with extra blood cells cells floating around, if viscosity WERE a factor in the stem cells from the cord blood moving throughout the body (which is by no means certain, that doesn't really make any sense to me) then neonates SHOULD have lower blood viscosity, but they don't.

 

Secondly, vitamin K is not administered to "thicken" blood, only to increase its clotting ability.  In the absence of damage, vitamin K does nothing to the viscosity of the blood - the body only clots blood when damage occurs, to prevent blood loss.   Even high levels of vitamin K do not turn blood to "sludge" - hyperviscosity actually IS a recognized problem in neonates, occurring more often in pre-term and small-for-gestation babies, and can be accompanied by brain damage and other symptoms.  There is no suspected link between vitamin K at birth and hyperviscosity.

 

The article is also pretty inaccurate about the use of warfarin and the management of vitamin K in "older people".  Actually, it's people who have cardiac issues, and it's to *prevent* clots that can easily turn into strokes, and variances in vitamin K can make it extremely difficult to gauge the dosage of the warfarin so it is tightly controlled through diet so the warfarin works and does not cause hemorrhages.  I am well-versed in THIS aspect of vitamin K because my mother was treated for a congenital heart defect some time ago and I helped her do the research on it so she could understand what was going on, and why she was put on warfarin and beta-blockers and why if she wanted to eat kale she had to eat it every day.  Vitamin K is *controlled* not restricted through diet - patients are generally advised to limit intake but above all else, to keep it *steady* day-to-day.  I don't think this is particularly actually even relevant to the discussion of administering vitamin K to babies, however, and it's a bit of a red-herring argument thrown in there besides being misleading and a bit wrong.

 

Now, all that having been said - I did some additional reading and am coming to think that I will probably opt to have vit K on hand but will only use it if the birth is traumatic, uses instruments, or we can't delay cord clamping for any reason. 

 

If you want a BETTER article (despite the source) with which to argue against routine vitamin K use, I would recommend this one.  I should say that I am very much not a fan of anti-vaccination organizations, however this article has nothing to do with vaccines, is well-written, and seems to be exhaustively researched (although some other time when I am not completely pooped, I will go back and have a look at the numbers and studies behind the claims that the vit K shot puts vit K plasma levels up so extremely high in neonates - that seems a bit off to me).  But the rest of it is pretty good, and correlates well with the position papers of the CPS and several BC midwives (if the conclusions reached are slightly different, mostly due it seems to differing opinions and interpretations of the same studies).

post #28 of 49
Great work ladies. I just love enquiring minds, particularly when it's a topic I wanted to research! No pregnancy brains on this thread for sure smile.gif

Any mass medication campaign gets my back up immediately and while I know there will be lives saved in some cases, I don't agree that dosing the entire population is best practice. (Vaccines are my personal bearbug, more because of the unnatural injection into muscle and cost-saving preservatives, though I understand the principle of herd immunity in eradicating disease. Fluoridation of public water is also shocking.)
The thought of injecting a tiny newborn with a massive dose of Vit K is anathema to every ounce of my instinct and intellect. I also believe there is a reason why newborns have a particular level of Vit K, especially if that's normal across the board. Very interesting about the vernix, Jodie! A good reason to delay bathing. With DS, I opted for the oral form but wasn't too happy about it. His birth was traumatic though, as forceps and ventouse were used.
Hopefully, there will be no reason to require clotting factor this time but I might get a nature-identical form to administer in small amounts if needed.
I'm going to refuse the eye ointment too.

30 Rock finale! Ha, just watched it. Gawd, are there really mothers that intimidating out there? I'm gonna miss that show.
post #29 of 49
Thread Starter 
Quote:
Originally Posted by SlimP View Post

30 Rock finale! Ha, just watched it. Gawd, are there really mothers that intimidating out there? I'm gonna miss that show.

 

Having lived on the Upper West Side ("UWS") when I had my first, I can vouch for the high snark factor of some of those Manhattan-based mommy boards. People would just say the meanest stuff on there! Of course, she was exaggerating, but there was truth in it for sure.

post #30 of 49

We will not be doing vit k unless our midwife feels the birth is extra traumatic to our little girl in some way.  We will not be doing the eye ointment at all.

post #31 of 49
Quote:
Originally Posted by SlimP View Post

Fluoridation of public water is also shocking.

yeahthat.gif

post #32 of 49

Jodie,

 

There is no actual insert with the Vit K injection at work, but here are some pictures of the box that it comes it:

 

 

 

post #33 of 49
Thread Starter 

Chapsie - I'm glad you posted those pics - now I know that's the same type I ordered with my homebirth kit!

post #34 of 49

FWIW, my MWs (HB CNMs) discussed this today.  They are both very into the "evidence" and (as it follows) VERY low-intervention and fine with people declining anything, but this was their thinking...

 

They feel that Vitamin K is useful not so much as an essential for all babies (like, they're not of the belief that babies are born "Vit K deficient," regardless of their seemingly "low" numbers).  However, they do feel it is useful as a prophylactic for those ~1-in-1000 babies with clotting issues, which they don't feel can be predicted.  Therefore, they don't feel it matters so much whether the birth ends up being "traumatic" or not.  My takeaway is that they basically recommend it (and don't care for the oral dose b/c of the taste and lack of info on best dosage).  They DEFINITELY, HIGHLY recommend it if you're planning on circ'ing, though.  (There are a couple of other Jewish women in my March group who will be circ'ing, though I have decided against it.)  

 

Just another data point.

 

FWIW, they also discussed the eye ointment today and that, they seemed more meh about.  They don't carry it routinely, but are happy to administer it if you pick up the script for them.  They will also be happy to test you for G/C infections at any time.  I think I will go ahead and get tested at my next appointment (almost 38 weeks)-- not that I "have" to do either, but I'd rather do that than have the ointment.  FWIW, it has nothing to do with my not "trusting" DH-- it's more of a CYA thing.  It's just that Dr. Mom did a lot of early AIDS research in the early '80's, so...  I guess it always bugs me when people are offended by the mere suggestion (just a fact, 99.99% of the time) that you can only really ever know your own personal sexual history.  Now-- don't get me wrong.  When HCPs act like you're lying, or condescend to you about STIs-- that's 100% uncool.  But there's something really peeving about women who claim they KNOW, without a SHADOW OF A DOUBT, that their husband couldn't POSSIBLY be cheating.  I mean...  I "know" that, too.  And I'm not the least bit suspicious of DH, we're very close and spend almost every waking hour together.  But...  shrug.gif  I guess I'm just not one for big absolute pronouncements.  Okay, off my soapbox!  I'm still taking a slight risk by getting tested at 38 weeks and probably having sex with DH after that, but I'm also under no illusion that I am "protected" beyond a shadow of a doubt-- that's all.  

post #35 of 49
Thread Starter 

Buko, I did the same thing as you during my last pregnancy regarding the eye ointment. Got tested for G/C (thank you so much for introducing that abbreviation to me - i always trip up over the spelling shy.gif ), came back negative, and felt fine skipping the eye goo. I was living in a state where I believe it was "required" - but I don't recall anyone ever asking if we'd had it (or vit K) (and DD did end up transferring after birth for a weeklong stay in the NICU).

 

I totally agree with you Buko on the CYA thing when it comes to STD testing. There's no reason in the world to just take it on faith that any given person is free of an STD. As I often need to remind myself, to assume is to make an A$$ of U and ME.

post #36 of 49

Just to point out, there are some medical conditions that make conception difficult and require assistance, and would preclude extramarital affairs, and if one has a partner who suffers from one of these conditions, one might be justified in concluding that one is not at risk for STDs. 

post #37 of 49
Quote:
Originally Posted by spughy View Post

Just to point out, there are some medical conditions that make conception difficult and require assistance, and would preclude extramarital affairs, and if one has a partner who suffers from one of these conditions, one might be justified in concluding that one is not at risk for STDs. 


Right, that's why I said 99.99% of the time, although realistically it's probably more like 99-99.9% of the time.  I mean, your male partner might be a paraplegic under your care, or you might spend 24 hours a day with him, etc., etc.  It's just that in all the cases I've seen women get indignant, that was not the case.  They were just "sure."  Like I said, I'm as "sure" as I think just about anyone could be (outside of those special circumstances)...  But I realistically know that I can never truly know, and it's no skin off my back to get tested-- I feel it can only be positive.  (Well, from a physical consequences POV.)  At least... the very idea doesn't offend me (nor DH), and I am not in denial about the risks involved (be they very small, which I believe they are).  It, just, like... kinda offends me when some women are so insistent, because it almost feels judgey and alienating to other women.  I can't quite articulate it, but it's like thinking of oneself as different from "those sort of people."  Which bugs me.  It can happen to anyone.  And people who have STIs, who are cheated on, etc., are not a "certain kind of person."

 

(Obviously, again-- it's very uncool for HCPs to treat women and partners like liars, potential ticking time bombs, etc., and I am all for informed refusal of basically any intervention or test.  It's just the righteous insistence, in the absence of very special circumstances, that bugs me.)    

post #38 of 49
Thread Starter 

buko, your post also reminds me that *I* (and surely plenty of other women out there?) am no virgin blossom plucked from the hinterland by my one true love... 

 

it strikes me as somewhat archaic when a woman acts as if the only way she could have contracted an std is from her husband... is being sexually pure at marriage really still that much of a "thing" for women? (dude, i cannot fathom...) (no offense to those who value this choice - I just had no clue it was a common choice.)


Edited by LightForest - 2/13/13 at 6:38pm
post #39 of 49
Quote:
Originally Posted by LightForest View Post

buko, your post also reminds me that *I* (and surely plenty of other women out there?) am no virgin blossom plucked from the hinterland by my one true love... DH and I have had an awesome relationship for a good long time now, but prior to meeting him I had plenty of other experiences, with plenty of other people! I know it was a long time ago, but it's still good to just get tested to know that my prior activities didn't gift me with any stds!

 

it strikes me as somewhat archaic when a woman acts as if the only way she could have contracted an std is from her husband... is being sexually pure at marriage really still that much of a "thing" for women? (dude, i cannot fathom...) (no offense to those who value this choice - I just had no clue it was a common choice.)

 

 

I know that here (Ohio...hospitals/birth centers) women are routinely tested for C/G at their first prenatal appt.  So, ointment in the eyes for EVERY baby (Even those whose mothers tested negative) seems rather... I don't know... ridiculous?  And since the babies of all women who tested negative at the 12 wk appt are "treated," it does seem like someone is being accused of infidelity (or irresponsibility if single and having sex without protection).  shrug.gif

post #40 of 49
Thread Starter 
Quote:
Originally Posted by jodieanneanton View Post

 

I know that here (Ohio...hospitals/birth centers) women are routinely tested for C/G at their first prenatal appt.  So, ointment in the eyes for EVERY baby (Even those whose mothers tested negative) seems rather... I don't know... ridiculous?  And since the babies of all women who tested negative at the 12 wk appt are "treated," it does seem like someone is being accused of infidelity (or irresponsibility if single and having sex without protection).  shrug.gif

 

That's just ridiculous! Sounds to me like the system is just duplicating efforts... Whenever I hear something like that I assume it's either to make a little extra $$ from your insurance provider or to cover their butts in case they drop the ball on one or the other test/treatment? Personally, I don't think any health care provider gives a hoot WHO I'm sleeping around with (so long as I'm not spreading STDs, perhaps)... Why would they care about infidelity for the sake of infidelity?

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