The new royal family

You certainly do not need Birth Story to fill you in on the birth on Monday of Prince George Alexander Louis, heir to the British throne.

New royal familyThe 8 pound 6 ounce Prince of Cambridge was born on July 22, 2013. For our purposes, it's interesting that his dad was present at the birth. It is not ground-breaking, though, as Prince Charles was the first to break with tradition and attend William's birth in 1982.

Charles' dad, Prince Philip, played squash in another part of Buckingham Palace during Charles' birth, but men did not typically attend their children's birth at the time.

When William married Kate Middleton three years ago, I wrote extensively about past British royal births of the 20th century, which you can see in my archives from late April of 2011.

The births of British royalty have historically twined together with the latest birthing practices, and so, for the purposes of Birth Story, they are important. Let's reconvene here later in the summer and look at begin to look at some of those junctures.

Photo from today.com

Trimming preterm deliveries

Staying in the womb until 39 weeks of gestation can make a big difference in a baby's life.

Thankfully, that discovery is making its way into the everyday practice of medicine,  according to papers presented at the recent meeting in New Orleans of the American College of Obstetricians and Gynecologists.Pregnant Graffiti

Almost two-thirds of the country's hospitals with a registered labor and delivery unit have put policies in place  to discourage births before 39 weeks, according to a new study conducted by researchers at the Perelman School of Medicine at the University of Pennsylvania.

Researchers contacted all 2,641 U.S. hospitals with LD departments, and heard back from 2,367 of them. Two thirds of responding hospitals have such a policy.

Sixty-nine percent of those reported that they strictly enforced the policy, the study's authors reported. More than half (53%) of the hospitals that do not have a policy in place to discourage births before 39 weeks said "not medically indicated births" before term went against their standard of care.

In March, ACOG reminded physicians and hospitals that babies should not be delivered before 39 weeks gestation without a good medical reason. Serious ealth risks, and even higher mortality rates, have been established for babies born even in the 37th and 38th weeks of gestation.

The results of the Penn study "show that most hospitals do recognize the issues with early elective delivery, or non-medically indicated delivery prior to 39 weeks, and are adopting policies to prevent the practice,” said Nathaniel G. DeNicola, MD, Robert Wood Johnson Clinical Scholar at  Perelman, and lead author on the study.

Pregnant Graffiti by Petteri Sulonen

A lucky pair of scissors

One of the luckier babies of 2012 was little Maddalena Douse of Lewes, East Sussex, England, who was born last summer at the Royal Sussex Hospital in Brighton.Baby scissors

Maddalena was born at 23 weeks, and weighed only 382 grams, or about 13 1/2 ounces. According to a story in The Sun, a baby weighing less than a pound would not have been considered viable, and the hospital would not have been likely to use extraordinary measures to keep her alive.

However, at her first weigh-in, Maddalena wound up on the scale with a pair of scissors that went unnoticed. Their weight brought her up to that lucky pound. Only when she was already on a ventilator to help her breathe did the hospital staff discover the difference the scissors had made in her weight.

The little girl went home just before Christmas and "is expected to grow into a healthy child," according to the article.

“We never thought we’d ever bring Maddalena home,” said Kate Douse, Maddalena's mother, according to The Sun. “She now weighs 5½ [pounds] and is getting stronger by the day. She’s our little miracle and we’re so glad to have her home in time for Christmas.”

Maddalena had a twin, Isabella, who did not survive.

“Call the Midwife”

Birth Story could hardly ignore the debut of a new PBS series called Call the Midwife, an import from England. I watched the first episode last night, and I expect I'll be a regular viewer.

I didn't love the first episode of Call the Midwife, though. I thought it romanticized birth on the low end of the social order in London in 1957, even though it begins with two women fighting on a street in the tough East End.

This episode of "Call the Midwife" features a woman who had 25 children, and that made me wonder what the record is for offspring from one woman.

Well, here it is — 69.

The wife of Feodor Vassilyev (1707–c.1782), a peasant from Shuya, Russia (they didn't even keep track of her name!) had 27 "confinements," in which she gave birth to 16 pairs of twins, seven sets of triplets and four sets of quadruplets.

On mandatory breastfeeding

Many people mocked supermodel Gisele Bundchen as a "boob" and a "twit" a couple of years ago when she said the law should require mothers to breastfeed for at least six months. It turns out Bundchen may just have been a little ahead of her time.

As of this summer, hospitals in New York City will no longer make formula available to new mothers and babies unless it is medically indicated, or promote its use in any way. "Latch On NYC" is an initiative of the city's mayor, Michael Bloomberg.

"Motherhood" by Mary Cassatt

Studies have been piling up in recent years that show that breast-fed babies  do better in a number of ways than bottle-fed babies. Still, fewer than one-third of babies are consuming only breast milk at 3 months, and nearly four-fifths of babies have stopped breastfeeding altogether before the recommended minimum of one year. 

And as Linda Lowen wrote recently on About.com,

Part of the problem is that we like our swag -- our goodie bags packed with toys and samples and coupons. Hospitals give these out as a matter of course, and as new moms we're eager for it.

The swag started with the formula companies. And they knew exactly what they were doing. They were hooking women at an emotional and vulnerable time, and from there they reeled us in.

Taking the free samples of formula away from new moms in hospitals protects them from the manufacturers who make it so easy to start a baby off on formula, rather than on the breast, Lowen wrote.

But even some breastfeeding proponents are protesting the new methods for giving breast-feeding a leg up in the nursery. Some women say mothers are already feeling the effects of Latch On NYC, which will go into effect Sept. 3.

New NYC mom Jacoba Urist wrote in a Wall Street Journal blog about her experience trying to have her baby fed with formula at the New York University Medical Center, where she had given birth, so she herself could sleep through the night. Nurses twice said they couldn't find any formula, and brought Urist her baby in the middle of the night to breastfeed, she wrote.

After Sept. 3, lack of cooperation, if such it was among those nurses, will turn to rules in NYC. "With each formula bottle a mother requests, she’ll get a lactation lecture about why she should use breast milk instead," Urist writes of Latch On NYC. She supports breastfeeding in general and does it herself, but thinks the new rules themselves will "prey on women in the days (sometimes hours) after they deliver a baby."

Kara Spak, a new mother and my former colleague at the Chicago Sun-Times, made an especially compelling case for leaving formula-feeding moms in peace, in a recent commentary about Latch On NYC in the Sun-Times.

Spak, who is perhaps best known nationally for winning more than $85,000 as a contestant on Jeopardy in 2010, wrote that she intended to breastfeed, but her baby wasn't thriving on breast milk. Ultimately, she had to choose between her baby's health and the breast-feeding ideal. She began feeding her new daughter formula, and continues to do so.

After that traumatic beginning, when Spak talked with her friends with babies, all of whom were committed breast-feeders, it turned out that all of them had had problems nursing, she said.

And that's the travesty here, or one of them, anyway. As Alissa Quart reported in her recent New York Times op-ed piece, "The Milk Wars,"

For most women, there is little institutional support for breast-feeding. According to the Bureau of Labor Statistics, only 11 percent of private-sector workers get paid family leave through their employers. Once mothers go back to work, there are few places where they can pump milk for later use.

Jane Brody's NYT column in response to Quart's piece, "The Ideal and the Real of Breastfeeding," gave readers a look at this longtime health writer's own rocky experience with nursing many years ago, plus a survey of studies and anecdotal evidence that makes it clear that, while breast might be best, it isn't for everyone.

On a more positive note, this year's "Big Latch-On," completed just this weekend, attracted 8,862 nursing babies (and their moms) in 23 countries, a new record.

And check out Birth Story's previous posts on breastfeeding.

Image: Motherhood by Mary Cassatt