Criteria for provider referrals

Recently, I had a conversation with a doctor about the hows and whys of how I choose which care providers to refer families to. They can be OBs, Family Med docs, Midwives, Pediatricians, Chiropractors, LCs, Birth and Postpartum Doulas, and Dentist, as well as a variety of other specialties. So, when I decide which names to give to a family, I do so based on the following criteria:

  1. Where is the provider located? Whenever possible, I try to find the most appropriate professional as close to the family geographically as possible. In some cases, it can be difficult to find certain specialties in certain geographic areas, so I may have to explain to the family why they might need to travel an extra distance to get care.
  2. What kind of training and qualifications does this professional have?Again, I want to make sure that the professionals have an adequate amount of experience.  I’m slightly hesitant to refer families to brand-new doulas, for example, because I’ve seen too many families left in the lurch when a doula wasn’t able to make it to a birth. I also want to know that the professionals have actual experience working with families with a specific situation. It’s always a good sign to me if they have gone to get extra training in a certain field, such as a chiropractor being Webster Certified.
  3. Do I feel comfortable with the how knowledgeable the provider is? While I’m not a doctor or a chiropractor, there are certain things that can clue me in to the quality of care they can give the families I work with. Accurate breastfeeding knowledge is one huge thing I pay attention to; sorry, it’s just not ok when they (especially chiros) start telling breastfeeding moms that they can only eat a perfect diet. Talk about #firstworldproblems! Car seats is another  issue that indicates the quality of a provider’s care. Any doctor who still tells parents to turn baby around at 1 year or 20 pounds is IMMEDIATELY removed from my list of who I can comfortable refer to; that hasn’t been appropriate for at least 5 years. Another red flag for me is when a provider can’t handle the basics, like getting measuring effacement backwards. If I, as a doula or educator, know the basics better than they do…well, that’s not good.  Extra negative bonus points if their lack of knowledge results is serious harm to mom or baby. Again, the doula should not know what’s wrong 3 hours before the OB figures it out.
  4. Do they quote actual studies? I may not know every study by heart, but I’m very good at recognizing absolute BS. IF they make up “studies” to try to seem evidence based, but in fact are making recommendations that do not match official guidelines of their professional orgs, that’s just not OK.
  5. Are they ethical? Do they behave with integrity? Do they charge a fair amount, or are they overpriced (and do they keep jacking up their rates)? Do they treat moms and babies with respect? Do they treat other professional with respect? I have no leeway for anyone that isn’t ethical.
  6. Do families have positive feedback? This is important. The experience that families have with the professionals to whom they are referred is a critical reflection on BabyLove. If I consistently hear good feed back and families are seeing positive results, then those providers end up getting a LOT more referrals from me.
  7. Do they reciprocate? In this heavily saturated market, I know that there are usually a lot of options. However, if a provider NEVER refers families to me, that’s just plain rude, and they can expect the same in return. It’s just common sense. I also try very hard to avoid the omnipresence habit of being “cliquey” when it comes to my network. Substance over style, I say.

I think all of these things are fair, and it has taken awhile to get down to a list I feel good about. I’ve been very excited to add good providers to my list in the last couple of months, too, and always love sitting down with any new professionals to chat and to see if they would be a good addition to my list.

Thoughts? Questions? Concerns? Leave ‘em below!

Warmly,

Veronica

 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

The real co-sleeping dangers

dangerous baby sleep

Today is Friday. I don’t usually blog on a Friday, but I saw something this morning on social media that was so blatantly dangerous and disturbing, I needed to speak up.

If I had dug around my box of old family pictures for awhile, I could have posted, for #ThrowbackThursday, one picture that still upsets me to this day: it’s a picture of my dad, sleeping on the couch, with me as a teeny tiny baby on his chest. It’s not like he knew it was dangerous, but as I always tell parents a) He did the best he could with the information he had and b) Now we know better, so we do better.

So, here’s the thing: While maybe their message is well meaning, when the “never sleep with your baby”, “back to sleep”, and “don’t breastfeed while drunk” messages get pushed and pushed and pushed by the powers that be, it discourages and blurs the lines about what is safe and what really isn’t. If you pay attention to the headlines, you’ll notice that two things ARE truly leading to the deaths of babies: Parents sleeping with babies in couches and chairs, and parents falling asleep on a couches or chairs while drunk or on drugs (legal or not).

What, really then, is dangerous?

Never fall asleep with your baby while on a couch or in a chair

Never share bed space with your baby if you smoke

Do not fall asleep with your baby if you’ve been drinking

Do not share sleep space with your baby if you are on any kind of sleep medication

Waterbeds and sagging mattresses are very dangerous sleep spaces for babies

Do not share sleep space with your baby on a bed that is pushed up against a wall

Do not allow pets or older children to share the same sleep space with you and your baby

If you want a good handout to share with patients or family members, the always-amazing Kathleen Kendall-Tackett has a PDF on her website on safe sleep. She also has this really great video you can watch:

The reality is, it’s not uncommon for mothers to fall asleep while breastfeeding at 3am. They are exhausted, eyelids droop shut, and….zzzzzzzzz.  It happens. BUT…if you’re going to fall asleep while nursing, make sure that if it does happen it’s in the safest situation possible: On a firm mattress without heavy blankets, no pets, that your hair is tied back, and you are not under the influence of anything.

Listen, accidents can and do happen. It’s imperative that parents make safe choices for their kids. While so much of parenting seems like you can just make whatever choice you want, there are a few things that are not negotiable:

Always use properly-installed car seats and seat belts for your child, and make sure whatever method of child restraint you are using is appropriate for his or her age, height, and developmental stage.

Lock up your guns if you have young children. (Yeah, I went there. I don’t care.)

Don’t leave a baby or toddler unattended in the bathtub or around pools, lakes, or rivers.

Don’t put infant car seats on top of shopping carts, restaurant high chairs, chairs, tables, or anything else that’s not the car seat base in the car or compatible stroller.

Don’t parent while very intoxicated.

Don’t sleep with your baby on the couch.

Don’t sleep with your baby while sitting in the chair.

OK. Sorry. Soapbox done. Carry on, and make safe choices. Your child’s life depends on it.

 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

UPDATED: Four (now 6) Convertible Car Seats to Consider

What Convertible Car Seats Buy now

Update 7/10/14: New car seats are always coming out, so I wanted to make sure to take a look at some of the new options out there. Diono has added three more seats to their lineup. You can see a handy comparison chart here I’ve added the Ranier to the list below. Additionally, after doing a couple of checks on Graco MySize 65s, I’m adding it to the list below. I’m still irked with Graco, but this is a good seat.

I got an email from a mom asking about the kinds of convertible car seats I recommend.  So, I’m going to finally write a post about it.  This is the number one question I get asked when it comes to car seats, so I guess it’s time I addressed it.

First, though, some caveats and disclaimers: 

There is no right right car seat for everyone.  You need to pick a car seat that works for your budget, that will fit your child and, especially in the case of convertible car seats, will fit in your car.  Additionally, I do not make any money on the sale of any brands that I will list below.  This is just my opinion based off of 4 years of experience. These are not listed in any specific order, either.

#1- The Recaro ProRide 

I like the ProRide for a few reasons. It’s got some of the highest limits both forward and rear facing. This means it’s going to do a good job of keeping your child rear facing for a long time and allowing your child to stay forward-facing in a 5 point harness for as long as possible.

  • Cost: $220-$260
  • Rear-facing limits: 5-40lbs and 49″
  • Forward-facing limits: 20-65lbs and 22.5″ when seated
  • Dimensions: 27-29″H x 19″W x11″D
  • Weight: 20lbs
  • Expiration: 6 years from date of manufacture
  • Other features: Side-impact protection, Adjustable head support, Recline level indicator, no-rethread harness adjustment

#2- Diono RadianRXT

Things I love about this car seat include it’s steel frame, that you can use the LATCH to anchor it to up to 80 pounds, that it’s also a booster, that it’s narrow frame means you can fit three into the back seat of many cars, and that you can tether it rear-facing. Yes, it’s a little pricey, but it’s the only car seat you really need to ever buy (in theory).

  • Cost: $250-320
  • Rear-facing limits: 5-45lbs and 44″
  • Forward-facing limits: 20-80lbs and 57″
  • Dimensions (HxWxD):28.5″H x 17″W x 16″D
  • Weight: 26.15lbs
  • Expiration: 8 years from date of manufacture in harness mode, 9 years in booster mode
  • Other features: Side-impact protection, Adjustable head support, Expandable sides, Adjustable cup holder

#3- Combi Coccoro

While the two seats I listed above are FABULOUS at being able to be used for the long-term, if you have a smaller car or 2 kids in the back seat of your 4 door car (or, in a 2 door car), then you might need a seat that’s more compact so it’ll actually fit in your backseat rear-facing. This is also a really nice, lightweight seat.

  • Cost: $175-$210
  • Rear-facing limits: 3-33 lbs. and 40″
  • Forward-facing limits: 20-40lbs and 40″
  • Dimensions: 17″ L x 15.50″ W x 28.25″ H
  • Weight: 11.75 lbs.
  • Expiration: 7 years from date of manufacture
  • Other features: Side-impact protection, Can be tethered rear and forward facing, starts at a very low birth weight, a very good seat for preemies, buckle has a visual cue to tell you it’s buckled correctly

#4- Evenflo SureRide DLX

For families looking for a cost-effective option, this is a good seat.  It has some features of the more expensive seats above, like high height limits in the forward facing position.  It does not have some of the nicer features of the other seats, and it can’t be tethered in a rear-facing position.  Also, you’ll find it’s missing some of the “ease of use” features the other seats have. But I will say I do like Evenflo seats and was thrilled to find this seat.

  • Cost: $85-$110
  • Rear-facing limits: 5-40 lbs. and 40″
  • Forward-facing limits: 22-65lbs and 54″
  • Dimensions: 24” High x 18.5” Wide x 28” Long for rear-facing; 28” High x 18.5” Wide x 20” Long in forward-facing mode
  • Weight: 10.5 lbs.
  • Expiration: 6 years from date of manufacture
  • Other features: Side-impact protection, made in the USA, fold-down cupholder

#5- Diono Rainier (NEW!)

As much as I love the Radians, The new Rainier has a few things up on them. First, the lifespan of use is 12 years from date of PURCHASE, whereas the Radians are good for 10 years from date of manufacture. The Rainier is also a little more padded and has higher weight limits. The one downside is that the Rainiers are wider, so you can’t get 33 in the backseat of a smaller car.

  • Cost: $290
  • Rear-facing limits: 5-50 lbs. and 44″
  • Forward-facing limits: 20-90 lbs and 57″
  • Dimensions: 16 x 17 x 28.7 inches
  • Weight: 28.4 lbs.
  • Expiration: 12 years from date of purchase
  • Other features: Also a high back booster, can be tethered rear-facing, folds for travel

#6- Graco MySize 65 (New!)

OK, I do like this seat. I like that you can adjust the harness without un-installing the seat. I like that there are 2 separate sets of lower anchor straps so you don’t have to move the lower anchor straps when you go from rear-facing to forward facing. I like the recline settings. The infant insert is nice, too. The main downside is the lower height limit for forward facing.

  • Cost: $180
  • Rear-facing limits: 4-40 lbs. and 44″
  • Forward-facing limits: 20-65 lbs and 49″
  • Dimensions: Overall Height: 26″ x Width: 22.3″ x Depth: 19.3″
  • Weight: 19.34 lbs
  • Expiration: 6 years from date of manufacture (stamped on back)
  • Other features: integrated cup holder, ease of install, upgraded LATCH connectors

 

I was originally going to write about 5 seats, until I realized… I couldn’t find a 5th to stick up here.  That doesn’t mean that the other seats aren’t good seats.  It just means that there might be certain things, like difficult installation instructions or obnoxious quirks that leave me feeling lukewarm about them.  And remember, you DO NOT NEED an infant-only seat.  You will absolutely need to buy a convertible car seat, period, end of story.  Consider buying one really awesome convertible car seat and skip the expensive, limited-use infant seat.

So those are my thoughts, and they are only my thoughts. Do you have questions?  Throw ‘em in the comment section below!

Warmly,

Veronica (a proud Child Passenger Safety Technician)

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

5 Items to Avoid on Your Baby Registry

what to avoid on baby registry

I’ve been getting lots and lots of questions lately on if I had good resources about registries,  and you know what?  I don’t.  The truth is, there are millions, if not billions, spent on advertising to new parents.  What do you actually need? Well, a car seat is a must (though you don’t need to buy an infant-only car seat with a handle. A convertible car seat works just fine too).  Your baby needs a safe place to sleep.  Clothes are good.  And diapers?  Well, you might want to check out how much diapers cost before you decide if you’ll go cloth versus disposables.  There are some things, though, that shouldn’t go on your registry, period.

1) A Boppy

Why you should avoid it: Originally marketed as a way to elevate baby while playing on the floor, it quickly seemed like it was a necessity for breastfeeding moms.  Truth be told, it leaves a huge gap by moms’ stomachs, it isn’t high enough to bring baby all the way up to breast, and it’s better for baby to be at a 45 degree angle (or more) when feeding.  Would you be able to drink while lying on your side? Nope. So don’t make your baby do that, either.

A better choice: Instead of a nursing pillow, add some lactation support to your wish list.  Have friends or family members buy you some prepaid time with a lactation pro in your home that you can call for help.  It’ll be way better than a pillow, I promise.

2) Crib Bumpers

Why you should avoid it: Well, for one, the AAP has warned against using them for many years now.  They are a SIDS risk.  The  city of Chicago made it illegal to sell them. Older babies can use them as a step and can fall out of their cribs. I’ve never quite understood what we thought they were going to do, anyway.  I mean, it’s not like your baby is going to get a running start and crack his or her head on the inside of the crib rails, will he?  Nope.

A better choice: Have people buy you some gift cards for restaurants that offer take out or that deliver.  That way when the pre-made meals run out, of if you just can’t handle having one more lasagna, you have a way to feed yourself.

3) Sleep positioners

Why you should avoid it: Originally touted as a way to prevent SIDS, the AAP expressly warned against using them in their updated guidelines from 2011.  Though, honestly, since that happened, I don’t see them much on store shelves anymore.  Still, some mom might tell you that you have to have one…but you don’t.

A better choice:  How about asking for gift cards for a grocery store that delivers?  Doesn’t that sound nice? Heck, I would like them even now.

4) Wipes Warmer

Why you should avoid it: Two words: fires and infections.  Wipe warmers have been known to overheat and start on fire.  And even if that extreme scenario doesn’t play out, the warm, wet environment is a hotbed of germs and can lead to infections.

A better choice: Let’s see….in the middle of the night, some Netflix streaming might be really nice.  Throw a gift subscription on your list.

5) A Baby Bjorn (the classic model)

Why you should avoid it: Any baby carrier that places all of baby’s weight on his or her crotch can case bruising, numbness, tingling, and even hip dysplasia.  Think about it…would you want to hang in that position for hours on end? Probably not.

A better choice: Let’s see: a wrap carrier, a ring sling, a mei tai, a soft structured carrier….anything that has your baby sitting in the carrier, not dangling.  Unsure about your options? Well, we have a class to help!

As I was pulling out our old, icky wipe warmer (Yep, I make mistakes, too.  We used that wipe warmer until my 10 day old son ended up in the ER with a UTI.), I found an old white noise machine.  And while I didn’t list it above, you DO want a noise machine.  Trust me.  When that first thunderstorm hits and your baby sleeps through it?  You’ll thank me.

Simplicity is key.  Also, you’ll be glad to eliminate the clutter in your home.

Warmly,

Veronica

 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Used car seats: Are they safe?

used car seat

When parents face the arrival of a new baby, the number of things they feel like they need to buy can be overwhelming.  Things like clothes, diapers of some sort, and a safe place to sleep are a must.  Lots of things, like bouncy seats and jumperroos seem necessary, but are actually just extras that are nice to have.  If you can get those “nice things” for free as hand me downs, that’s great.  But what about car seats? Can you use used car seats?  Well, best practice is always to get a new seat.  Typically, newer seats have more safety features, they are usually easier to install, and they are just cleaner, for goodness sake.  But of you REALLY are dead set on using a previously used car seat, you must keep all these things in mind:

  • Can you ABSOLUTELY verify the history of a seat? If your sister is giving you a car seat she used, you would probably know if she was ever in a car crash with that car seat. You would have heard about the car accident when it happened.  However, if you are getting a seat from a friend of a friend? Maybe not.  And buying a seat at ANY garage sale or from a thrift store? Horrible idea. It’s amazing what people will rationalize when it comes to selling used car seats at a garage sale.  Your child is more important than saving a few bucks.
  • Are all the pieces there and in working order?  I have had people bring in previously used seats that are missing buckles, with cracked shells, or broken chest clips.  Sometimes you can order these missing pieces, but let’s get real:  If the seat is broken, it’s not safe.  Simple as that. You’ve worked really hard to heave a healthy baby, so don’t put thriftiness ahead of your child’s safety.  If the seat you have isn’t safe, get a new seat. Period.
  • Does the seat have labels you can read? If you can’t read the model name, number, or manufactured on date, you simply have no idea if the seat is too old to use, nor can you check if the seat had a recall issued.
  • Is the seat too old to use? Most seats have an expiration date 5 or 6 years after the date of manufacture. (A few brands have a 7 or 9 year expiration date.) Always check with the manufacturer, but if it’s expired, the manufacturer had determined that the seat can’t be assured to work in a crash.  Don’t use an expired car seat.  And if the seat will expire before your child will grow out of it, keep in mind, you WILL need to purchase a new seat when that seat expires.
  • Has the seat been recalled? When you get a new seat, you should take the little postcard it comes with, fill it out, and send it in. If it’s someone else’s seat, you will want to go online and check to make sure there wasn’t a recall issued since the seat was purchased.
  • Lost Manual? Check online. Car seat manuals are easy to lose.  Whenever there is a question on how and where to use a seat, a tech’s answer is to always check the manual. We can’t do that if it’s not there. So go find the manufacturer’s website and print out a new one…and don’t lose it.

If you do end up with a damaged or expired car seat, you have two options. You can destroy the seat and dispose of it in your normal garbage (as you see in the photo above).  You can also go to a recycling facility that will accept car seats. There may be a fee for this, though.

Lately, I’ve had some push back from parents and pediatricians when it comes to the subject of using used, unsafe seats.  I hear that “a used seat is better than no seat”….but no. There are plenty of resources for families who TRULY can’t afford a new seat.  We are happy to help families figure out their options, and can even be a resource for care providers who don’t know what options families have. If you have a used seat (or a new seat) and want to make sure it’s being installed and used correctly, schedule your individual car seat check with us today.  It’s worth every penny!

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.