When you ride a rollercoaster for the first time you feel a surge of emotions that grab, terrify, and haunt you all at once – well, at least at the start. But once you get over that first drop, that first mind bending, gut wrenching drop, you suddenly realize that your life isn’t over. And not only is your life not over, it’s also exciting anticipating what else is around the corner.  When the adrenaline takes over, the fear of the impending disaster dissipates.

That’s what pregnancy was for me. I had the initial fear seeing the digital test flash “pregnant.” That fear wasn’t because it wasn’t planned – technically, we did plan. We got married, bought the nice house in a subdivision, and had a fantastic waiting period of five years so that we could explore married life without kids. The fear was the feeling of “oh no, what have we done?!”

And I wasn’t the only one who felt it! My husband had that look on his face when I showed him the test. He didn’t jump around with joy or even smile; he just looked at me with an expression of confusion and worry that settled somewhere closer to acceptance. You would have thought we were two fifteen year olds still in high school with no life achievements. But what mattered most wasn’t our initial reaction. What mattered was the journey we were embarking on together as husband and wife. The excitement hit us quickly enough, along with the extreme nausea and vomiting that plagued me for months.

My husband always wanted a beautiful baby girl. That was his desire from the start. I don’t have to explain how happy he was when the ultrasound tech told us what we were having. We decided to have a nice small and intimate reveal party, just for the grandparents. We got the idea to get cute pink build-a-bears to give to the prospective grandmothers and we revealed our daughter’s name along with the due date. It was exciting and wonderful.

But life always has a drop waiting around the corner. It never fails: impending doom lurks, waiting for its next victim. It wouldn’t be a journey if it didn’t have obstacles. So that is what I first thought when my OB/GYN called me to come to the office exactly one week after the reveal party. But I could have never prepared myself for the words “positive for Down syndrome.” I kept thinking, how could this be? My husband and I were both still in our twenties and healthy, with no family history of anything more than diabetes. This couldn’t happen to us! I stared at my husband, and he had the look of suffocation, as if the room had been stripped of oxygen. We rushed home to do research, to ease our minds into believing that the prenatal test was inaccurate or wrong. We even grasped at the straw of someone in a lab mixing my blood with someone else’s. Our parents reassured us that it was a faulty test, it happened all the time in the eighties and early nineties. My husband held fast to thoughts of positivity, but I ventured into the realm of realism very early because I knew that life always gives you something that you perceive to be unfair and unbearable. That drop was unbearable.

The twist and turns came in the next few months with the fantastic ultrasound test that showed no signs of Down syndrome at all on our little one. But of course, me being the president of the realm of realistic notions, I couldn’t allow myself to be too relieved. But could anyone really blame me? I mean if my child was to be born with Down syndrome, wouldn’t I, as her mother, need to be there for her? If the doctor pulled her from my womb and the true visualization of her features set in, and she bore obvious signs of that extra chromosome, I would still reach for my child and hold her tighter than a mother bear.

My husband and parents could step out of the room and regain their composures, while going through the stages of grief all the way to acceptance and unconditional love. But me, being momma, I needed to go through that ahead of time, so when my baby girl was handed to me the only thing she would feel was my undying and unwavering love for her.

I did the only thing I could do: I prayed. Not to take away any disabilities or deformities. How could I? How could I be so presumptuous to ask God to make my life any easier than the next person’s? No one has it easy. No, instead I prayed for a healthy beautiful baby girl. And I spent hours telling God “thank you.” I was grateful that I could conceive, and that I had a great husband who also would love our daughter unconditionally. I was thankful for the roof over my head and the qualities that my loving parents instilled in me, because during my pregnancy there was barely a week that went by without hearing about a woman killing or abandoning the baby she didn’t want. I was thankful to have compassion and natural human affection. I spent hours crying and speaking my peace with God, knowing that no matter how different she might be, my daughter was a direct gift from Him and I knew that I only wanted what was best for my child, which is to be better than me. That is what all parents truly want.

When the delivery was over, so was that ride of loops and drops. Because when they handed me my little girl all I saw were her perfections, no flaws. And my husband thanked me for bringing our child into the world. Even now, two years later he still thanks me, and I still thank God because he answered my prayers.

This entire ordeal taught me many lessons about life and our ability to make it harder than it needs to be. Sometimes we ourselves are the disasters we try so hard to avoid. It’s our thinking and our mindset that end up getting the best of us and turning something that can be conquered into a mountain of pain. I learned that you don’t have to be a saint to put trust in a higher power to guide you. I could have allowed the fear of the unknown to destroy me, to cause me to become so paralyzed that I lost my ability to avert a disaster. We all have that ability, regardless of what life sends our way. Beauty is in the eye of the beholder, but also what we perceive as a catastrophe is ultimately left up to our own interpretations.  

Now I am on a new rollercoaster ride. New twists, turns, and drops, each one filled with thoughts of fear and despair. But this ride is called motherhood. Every day I am forced to reset my thinking and my viewpoint on things. I remind myself that it is my choice as to whether something is a mountain or a molehill. Do I choose to wallow in negative thoughts of impending doom or do I look for the way out of the tunnel, the light that is always at the end? Because when I look at my life over the past couple of years, every disaster that has come my way has made my family and me stronger and more versatile. And every blessing that has come our way is received with gratitude and graciousness.

Do I see everything through rose colored glasses now? Not in the least. I was and will always be a realist. Seeing life for what it is will constantly require an endless readjusting of our minds. The truth is, we never truly stop riding the rollercoaster. We can only hope to learn how to enjoy it as much as possible. If we don’t, we are doomed to see every event as something to cower in front of. You don’t get to know when it is coming, and you don’t get to know what it will be, but you do get to choose how it will affect your life: mountain or molehill? I choose to see the twists and turns of my pregnancy as the blessing they always have been. My daughter has no real health issues or problems, no heart defects and no developmental delays. She is healthy and beautiful, with a smile that will bring the world to its knees. All that I truly wanted was for my baby girl to be healthy and smart. She is beyond everything I could have dreamed possible. When I look into her eyes, I am aware that she may have difficult days ahead, but she will have many happy ones, and on her worst day she is still better than I am.

Quite obviously, divine humor is not by me, as the title and byline may imply. I also sense a few wrinkled brows among our readers. Can humor be divine? The question is not unreasonable: the prophets of our Lord certainly had little to laugh about. Moreover, religion has hardly been the stuff to engender a smile or a giggle.

Enter the Dalai Lama, who is seen to giggle a great deal. One wonders why. A plausible answer could be that His Royal Highness is exceedingly nervous in the face of an impossible world. Hence the giggle. I also have a delightful book on my shelves by one Christmas Humphries. It is all about Zen Buddhism. Mr. Humphries offers a dedication to his wife who, I quote, “laughed in all the right places.” Mr. Humphries informs us of the concept of the sound of one hand clapping and we are reminded of our own Queen Elizabeth who exercises the notion at all times as she waves regally to her subjects when out driving in her state carriage. She may be giving half measure, but her subjects respond with two hands in full.

But divine humor…? Why not? We are informed that God is the sponsor of all life and all endeavor; thus, why not, indeed, divine humor?

It has occurred to this writer that we may wish to consider divine charisma. Naturally, one cannot actually purchase divine charisma, and nor can one use magic to conjure it up! However, and please bear with me, I would suggest, nay insist, that one can be instrument in manifesting it.

My explanation may hopefully point to something we adults are happy to make – or at least bring on a smile.

I speak, here, of babies, and would contend that they could easily lead us to a point of enlightenment.

Being a parent is in reality about as high as you can consciously go. I say in reality because we are talking about involvement with another human being. This not about me; this is about we. This means you, the aspirant, and your baby, your spiritual teacher.

I’ve been thinking about Zen. Don’t worry, that was the cosmic giggle you just heard, too. Zen is about doing what you do. Am I right? George Bernard Shaw’s, “He who can does, he who cannot, teaches,” just about sums it up (not that you are supposed to sum things up, but even so…). Forget teachers and teaching. Shaw obviously didn’t mean them, or that. GBS was into Zen, but he didn’t know it. The Japanese Zen master, Dr. Suzuki, may have been enlightened but could not have put it better. On the other hand, Dr. Suzuki would probably not have bothered.

Please consider the advantage of transcending this world. Your baby could help.

Obedience is the keyword, but it will go against the grain. Nobody wants to be obedient. We figure that to have a life, we need an opinion; we need to call the shots. But if having babies is what you do, you need to rethink, maybe unthink, the rules.

Did you ever consider obeying your baby?

“What can he mean?” you will be forgiven for asking. But that’s the point. Your baby is already working on you and is getting you nicely softened and shaped. Already your brain is dissolving in a mental meltdown. Suddenly you are feeling about things. Thinking is sort of a long way away, like your thoughts are down a deep well. You are no longer really thinking at all. It’s suddenly all a ghost-like echo of things learned, and all pretty irrelevant at that. Congratulations! You have a head that is full, however, of awful awareness. The trick is to turn the awfulness into positive action.

You are suddenly Mr. and Mrs. Awareness. You watch your baby because, let’s be honest, you can’t drag your eyes away, anyway. And that goes for visitors, too. Everybody is suddenly on their best behavior when a baby is nigh. Ladies utter goo-goo stuff, waggling fingers. Men stand around in the background, awkwardly, looking worried, thinking about doing a second job. The baby is socking out waves of something or other that is indefinable but real. This is charisma of the highest order. The baby has caught your attention, has got you focused and it isn’t even trying. One lopsided toothless grin, and you are going to fall apart. Your baby has got God on his or her side.

Somebody once said, “The real children of God know not what they do.”

Here is the message. Imagine your baby carrying that kind of charisma right on into adulthood. Well, we have all probably countenanced the notion of never growing up. But could you accept the idea that babies are already grown up, and that we adults have sometimes (sorry about this) simply hung around, done maturity in reverse, and accumulated a lot of juvenile junk?

It goes like this. You are gazing at your baby and you hate the idea of your baby growing up and having all of those “experiences” that the experts tell you are necessary for someone to become old and adjusted. An old Hindi proverb puts it thus: “Living life through experience is the most bitter of ways.” It means you are constantly reaching back into the past to find answers for today. Come on, can you imagine your baby smoking a cigarette? Do you want your baby to experience hardship, divorce, anger, being overweight? Do you want your baby to use bad language, or become a neighborhood flirt, or a kid who steals cars?

As an aside, this is not just social criticism I’m putting out because I must quickly state that this writer is as guilty as the rest in respect of just about all of the areas of human misdemeanor mentioned above. I feel better already.

OK, you don’t want your baby to have or experience all of the crud that makes life difficult. You don’t want your baby to smoke a cigarette because the idea is appalling. This is your baby’s way of telling you to stop smoking. Moreover, the baby hasn’t uttered a word. Hey, if that isn’t Zen, what then? It is all because your baby is not communicating in the usual way. Your baby has touched your feelings, nay, even your conscience. Babies are holy, that’s all. But they don’t know that they are holy and that makes them even holier.

Babies make us aware of what is bad for us. One exchange with a mystic I read went like this: “Do you love humankind?” asked the mystic. “Indeed I do,” replied the aspirant. “Then why,” said the mystic, “do you treat yourself so badly?”

What is happening, if you go along with the idea, is that the baby is helping you to clean up your act. This, by any reckoning has to be good. But there is an ongoing issue at stake and it is extremely appealing. If you can clean up your act you won’t have to give your baby any crud, or unmanageable appetites, later.

Right! Obey your baby and get transcended. Your in-laws may hate you, but you will not be adding a jot of personal chaos to our world. Your baby will grow up loving you, even if you don’t deserve it.

One thing I would counsel: never, ever, try to let your baby know what you know. Your baby won’t get it because a baby’s outflow of charisma is not of his or her own volition. Pressed to converse (assuming your baby has acquired a language before leaving the cot), the retort would be, “Oh, this is simply what I do.”

It all means that charisma from the right source, and exercised in a natural—may I suggest baby-like—way, could be the stuff of salvation.

We are all aware of the danger of walking the thin line between satire and sarcasm. Much of what we call humor is of the mind. It is calculated and often alludes to, and takes advantage of, the failings of others. One senses the sly wink and nudge when allusion is used. The certainty that the recipient of humor is part of the act, is in collusion. In such a case we become allies in negativity.

To be honest, a baby may not definitely make us laugh, although they often do, but they can easily bring about the rosy warmth that we love, which is, of course, the result of love. We are no longer talking about a jokey existence, but we must agree that a baby can lighten our day. A baby can, even, make humor possible. Babies have that special something that soon, unfortunately, gets lost to adults. Moreover, and as already mentioned, they don’t know that they are doing it. It means that their charisma must be the benefit of grace.

Radon is one of the noble gases in the periodic table. It is the heaviest, naturally occurring one among them. Due to its size, it is the most likely to establish compounds with other elements, compared to the other noble gases. However, its radioactivity easily breaks the bonds that are established between Radon and other elements. Thus, Radon has very few known compounds.

Radon forms in the radioactive decay chain of Uranium, which then forms Thorium, then Radium, and finally Radon. Radon condenses to form a solid that glows with yellow light due to its radioactivity. The half-life of Radon changes depending on the isotope at hand, but the longest half-life detected is around 92 hours.

Radon naturally occurs underground, and does not dissolve much in water or other liquids there. When it leaks above surface in the form of gas, it tends to accumulate in the not-well-ventilated parts of the houses, e.g. basements. Exposure to Radon gas is linked with cancer, and so it is considered as a health hazard. On the other side, the hot springs that contain trace amounts of Radon gas are used rarely to cure heart disease.

The following is an allegorical story in the form of a letter about how Radon develops in nature.

I am the only survivor from a quadruplet. One of my sisters survived only 108 minutes after birth. The death of the second one followed about half hour later. I spent my childhood with my only remaining sister. Our mother was not there either, because she had died while giving birth to us.

As we were growing into our adolescence, we shared many secrets with my sister, be them adventurous or romantic. She was a sister, a close friend, and sometimes a mom. When she died in her flourishing age, I not only lost my third sister but also lost a mom for the second time.

Since then, without bothering myself whether they are friend or foe, I let people approach me. I show affinity to them so much so that I am considered as the most sociable noble. When they start enjoying the beauties displayed on me, I am stressed by my need of privacy and security. And, I easily push everyone away by intimidating them with the very beauties they were attracted to.

So, life has been a bottomless solitude for me… Yes, being alone is part of being noble, and I need my privacy in my ivory tower. But I’d rather not have impenetrable walls between me and people.

What a discrepancy! I have a habit of intimidating people to push them away, but I am complaining from an endless solitude at the same time… Why am I like this? It feels as if there is an unknown person in me, over which I have no control, who is doing things using my body. Should I cry for help: I am stolen!

I thought about this a lot. Was it a psychological inheritance I received from the family? You know that my mother died when giving birth to me and that my sisters followed her. My grandmother also died when giving birth to my mother, and my grand-grandmother died when giving birth to my grandmother. I don’t know if it is this strangeness that makes me instinctively seek solitude, so much so that my husband could not stand me. I told him that our relationship could only survive in the polar cold places, and he said he can stay cold but not in a place where there is no one else. Eventually, our marriage ended, after which I realized that I was pregnant.

But life goes on, you know, whether you are a noble who pathetically seeks solitude, or if your mother died when giving birth to you, or if you are a pregnant mom left to herself… “The great gears of life turn with irresistible momentum. You either keep pace with it, or get smashed in it.” That’s what my mother said in her letter to me. And that letter is all I have of her. Though, however much I would like her to be with me, and share my joys of success and sorrows of failure. Maybe she would reveal precious life lessons to me, or whisper her secrets into my ear. Maybe she would reprimand me sometimes… Not a single moment lived with her, not even a smack… I wished that this not be the lot of my baby, but how?

I thought of Prophet Abraham’s wife, Hagar. Alarmed by her baby’s cries, she had rushed between two distant hills in search of finding some people to come for help. God had replied to her efforts by creating a spring in the middle of the desert, just near her, and guiding travelers there.

Following Hagar’s example, I tried taking refuge near people so that my baby would not be in a lonely world. In order not to disturb them, I chose their least used places. But people cast me out of there, lest I contract some illness. I tried fancy yellow dresses to make myself look friendly. But, instead of becoming friends, they put me in glass chambers. I tried to help people with some of their diseases, but except a few, they shunned me since I was too risky to be adopted into medical practice.

Oh my God, despite all my efforts, my baby was going to come into a solitary world like her mom’s. I knew I was going to be alone when giving birth, and so was my baby. There was a sour smile on my face every time I thought of her…

But maybe… Maybe one day, God would guide travelers here, and she could join them, and prosper wherever she ends up with. Maybe she would have a stable family, and become the mother of many. And I hope, even in her well-established state then, she could still keep her lineage at heart, from our grandest grandmother all the way down to her mother: Uranium, Thorium, Radium, and, me, Radon.

What could I do to make sure that my daughter holds on to her past? Could I write a letter, just like my mother left to me? Maybe that was a good option, since I inherited from my mother all the letters left from mother to daughter starting with the grandma Uranium. Yes, I could abide by the tradition of letters, and tell my daughter how much I loved her even before I could hold her in my arms. I could tell her that she had appeared in my dark night like a bright star, although she was yet in my womb. Maybe this way, she could feel at ease when with people, unlike her mother. She could make real friends and be happy with them, even if I won’t see her once.

Yes, I won’t see you, sweetie. It is what the doctors told while giving me your glad tidings: that I had cancer, and that my body would not sustain a birth. I had to choose between carrying you and a life without you. I chose to live with you, my precious, even if that meant the end of my life when yours bloomed. When you are going to be reading this letter, I’ll be watching you with your aunts. Shine and make us smile with your beauty.

Love,
Your mom Radon

Happy start

Your blood type is one of the least important matters in your life unless you are in a medical situation where blood transfusion is needed. It also matters when you decide to have a baby. This is when your doctor says, “Let’s see what your blood tells us about your pregnancy and child.” Incompatibility of parents’ blood types may be a cause for some health problems in the baby which are serious but not without cure.

Blood typing

Identifying a blood type is a simple procedure. A, B, and O are the three blood antigens – immune proteins. These antigens compose the four main blood types by making different combinations: A, B, AB, and O. Rhesus (D antigen) is also another factor that goes along with typing. The D antigen is basically another inherited immune protein in our blood and is used for further classification of blood types. It is categorized as Rh positive for people who have D antigen, and Rh negative for people without it. The prevalence of the D antigen differs among populations: Caucasians 15%, African Americans 8%, and East Asian populations less than 1%. The difference among populations is again due to inheritance.

Some races and ethnicities have a higher percentage of certain blood types presumably for protection from diseases endemic in their area. A good example of this would be the lack of the Duffy blood type in some malaria endemic areas of Africa which is considered to be the reason for “a distinct survival advantage.” The “absence of the Duffy antigen provides a measure of protection against malaria. The percentage of people lacking the Duffy antigen is much higher in these locations than in areas not endemic for malaria” (Scientific American).

D antigen exists in both females and males but it is especially important in pregnant females. Naturally, D negative people don’t make antibodies to attack D antigen. The person has to encounter Rh (D) positive blood in order to start producing anti-D antibodies. Bleeding during labor is the main reason for the Rh (-) mother to start making antibodies. Even small amounts of Rh (+) blood from the fetus can flame the process. Therefore, it is important to consider the possibility of a fetus being Rh (+). If the dad is Rh (-), the fetus will be Rh (-), and there will be no issues regarding anti-D production in the mother. If the dad is Rh (+) there is still a small possibility that fetus may be Rh (-), yet there is no way to predict it. So, if the mother is Rh (-) and father is Rh (+), medical professionals take precautions to prevent the mother from making anti-D antibodies.

What is the problem if the mother makes anti-D? Most of the time it is the mixing of the fetus’ blood with the mother’s blood during labor that starts antibody production, the first baby is not affected. Once sensitized, it takes approximately one month for Rh antibodies in the maternal circulation to equilibrate in the fetal circulation and therefore the upcoming pregnancies carry the risk of the destruction of the baby’s red blood cells (RBCs). Destruction of the RBCs is called hemolysis, and the disease caused by destruction of fetal RBCs is the hemolytic disease of the fetus and newborn (HDFN).

An untreated pregnancy may have up to a 16% risk of future fetuses developing HDFN for the next pregnancies. The sensitization process is as follows: sensitized Rh antibodies of the mother cross the placenta and find Rh spots on fetal RBCs. They then coat them and, in a way, trigger the destruction. The more RBCs are destroyed, the more the hemoglobin of the fetus drops, trying to compensate for the loss. RBC production at the bone marrow, spleen, liver, and some other sites is increased. As the fetal anemia becomes severe, less oxygen is carried in the blood so tissues start showing signs of hypoxia (lack of oxygen). Damage caused by hypoxia leads to fluid accumulation in various spaces and the deadly condition called hydrops fetalis occurs. It is basically the swelling of the baby due to the reasons mentioned above.

Whether a primary immune response occurs depends upon several factors besides the volume of fetal blood to which the mother was exposed. These variables include the frequency of fetomaternal transfusion and whether the mother and fetus are ABO compatible. Both the immunogenicity of the fetal RBCs and the immunogenic response capacity of the mother play a role in the development of the condition. Interestingly, some patients, like those with AIDS, may not form Anti-Ds. In addition, the incidence of Rh incompatibility in the Rh-negative mother who is also ABO incompatible (the mother has different ABO blood type than the father) is reduced dramatically to 1-2% and is believed to occur because the mother’s serum contains antibodies against the ABO blood group of the fetus. The few fetal red blood cells that are mixed with the maternal circulation are destroyed due to ABO difference before Rh sensitization can proceed to a significant extent. 

Let’s emphasize one point before proceeding further: Anti-D production can be important in anyone who needs blood transfusions for certain diseases. Yet, we can choose which blood to give to the patient and obviously prefer the most compatible blood we have available. The problem arising in pregnant patients is due to the fact that we have no control over baby’s blood type, and the mother’s body can identify the baby as a foreign object at any time during pregnancy. The whole purpose of identification and treatment is to make the incompatible baby unseen by the fighting cells of the mother.

Screening and prevention of anti-D production

Every pregnant woman is screened for blood type and antibody titers at the beginning of pregnancy. If she is Rh (-) as mentioned above, she gets a second screening at 28 weeks to measure the titers of anti-D. If the titer is low, she gets an intramuscular shot called Rh immunoglobulin (RhIg) which is, interestingly, anti-D itself. Some theories suggest that it coats the fetus’ red blood cells and shields it from the mother’s immune system; yet none of these theories is proven. We still don’t know how giving the anti-D from an outside source keeps the mother’s immune system from producing its own anti-D antibodies that actually cause the hemolysis.

RhIg is produced from Rh (-) males and post-menopausal females. These donors are purposefully injected with Rh (+) blood and then measured for anti-D antibody production. The ones that have enough anti-D in their blood are harvested regularly to collect immunoglobulins that contain anti-D.

When harvesting is done, not only are anti-D immunoglobulins collected but also some others, too. That is why the RhIg might cause some side effects and allergic reactions and must be given under doctor’s control.

A second RhIg shot is done within 72 hours of birth. If the routine guidelines are followed and RhIg shots are properly administered, there is less than a 0.1% possibility of seeing the disease in the following pregnancies.

Prevention of hemolysis in the situation of anti-D antibody presence

At the 28 weeks’ screening, if the titer is high, it implies that the woman has already encountered Rh (+) blood at some stage of her life, possibly in a previous pregnancy. Then comes the hard part of preventing the fetus from developing the disease.

The first step is trying to diagnose if the fetus is Rh (+). An Rh (-) fetus will not need any more testing or follow-up. Paternal blood type can be used to estimate the likelihood of the fetus’ blood type, yet misattributed paternity issues make it difficult for clinicians to trust on the typing results of the father. Therefore, more tests are usually done to confirm the fetus’ Rh status rather than solely trusting on the father’s Rh type.

The most common method used for Rh typing of a fetus is cell free DNA testing (cfDNA). Cells of the fetus can be detected in the mother’s blood as early as 38 days of gestation. Usually maternal plasma is sampled at 10 weeks and reverse transcriptase PCR is used to get the fetal Rh status from the DNA.

CfDNA is routinely done to every pregnant patient, at least in some European countries. But in the USA, it depends on the patient’s wishes and is not under routine prenatal care.

If it is not possible to perform cfDNA, an aminocentesis (getting a sample of the baby’s amnion fluid) is the second option. Nevertheless, it is associated with comparably high risk of losing the pregnancy, so it is reserved for high titer, high risk pregnancies.

Serial titers are done to predict the disease. If the pattern shows an increase and reaches a critical titer, then the pregnancy becomes more of a high-risk pregnancy, one complicated by severe anemia.

If the fetus is at risk of severe anemia, a Doppler study must be done to assess middle cerebral artery (MCA) blood flow. As the anemia increases, peak systolic velocity (PSV) increases. When MCA-PSV indicates high risk, fetal hemoglobin levels must be measured by taking blood from the umbilical cord (the cord between fetus and mother) to determine the degree of anemia. If the criteria for severe anemia are met, the fetus is transfused with RBCs. The transfusion is usually done between 18 and 35 weeks. Before 18 weeks, the fetus is too small, and after 35 weeks, the fetus is just too big. Hemoglobin tests are repeated every two weeks until the baby is delivered.

More research on the way

Let’s mention this incredible fact again in case you missed it: what hurts the baby is Anti-D antibodies made by the mother. What we give to the mother to prevent this disaster is the Anti-D antibody (RhIg) made by some unknown donor. When the mother does it herself, the fetus gets harmed; when it is given from an outside source, it protects the fetus. Despite all the research, we still have no idea how this miracle works. Yet more studies are on the way to enlighten us on how RhIg functions.

A happy ending

Routine prenatal care is essential in screening and prevention of HDFN. Simple tests and treatments can easily lower the possibility of acquiring the condition. Each subsequent pregnancy after the first affected pregnancy is likely to find the fetus suffering from more severe hemolytic disease, and at an earlier gestational age. For this reason, pregnant women must consent to screening and receiving RhIg. Any type of bleeding must be reported to the doctor immediately.

Your blood type doesn’t affect you from having healthy babies. Just a little bit of awareness and taking the appropriate precautions recommended by your doctor can lead you to the happy ending of a 9-month journey.

References

Scientific American. “Why do people have different blood types?” Mar 7, 2005.
Uptodate.com
Medscape.com

Some of the food we take in are used for our body heat. The amount of food reserved for heat is maximum in babies, which goes down as the child grows.

Food taken in in the form of carbohydrates, fat, and proteins are broken down to be captured by ATP (adenosine triphosphate) molecule. Energy is converted into ATP to be fueled to where it is needed. This conversion takes place in the mitochondrion, a membrane-bound organelle, during which almost 35% of energy is transformed to heat. The energy-protein synthesis in ATP are utilized for various functions like muscle contraction, transportation of some materials from external and inner organelle membranes, secretions from glands, forming the rest state potential for nerves, and conveying the signals across nerve fibers. During these functions another 38% of energy is released as heat. Thus a total of 73% of energy is converted to heat, while body functions consume only the remaining 27%, a great majority of which is also turned into heat through muscle movements and friction in tissues.

Other factors that increase body heat are shiver, heart pumping blood, friction in the veins, lungs expanding and contracting during breathing, tissue surfaces rubbing against each other, stomach and intestine activities. All of these contribute to maintaining the body heat at a certain level. Deeper tissues in our body are kept at ± 0,6 0C. Exercise and being nervous may contribute to increase in body heat, and obviously extreme cold outside would decrease it.

Metabolism is the combination of two kinds of chemical reactions: constructive metabolism and destructive metabolism. For example, the synthesis of proteins from amino acids is constructive metabolism, and the breakdown of proteins to amino acids and then to energy is destructive metabolism. When our metabolism increases, the body heat is also increased.

While under psychological conditions like pressure, excitement, and fear, metabolism increases, sympathetic nerves are triggered, and adrenaline and noradrenaline hormones from suprarenal gland are secreted into the blood. These will further increase the metabolism and body heat (chemical thermogenesis).

Another group of hormones that is effective on chemical thermogenesis is thyroid hormones (T3 and T4). When we feel cold, the secretion of TRH (Thyrotropin-releasing hormone) from hypothalamus is increased. This hormone is brought through blood veins to pituitary front lobe to start TSH (thyroid stimulant hormone) secretion. TSH has a role to increase the secretion of T3 and T4. These two hormones generate a rise in metabolism and thus body heat.

The brown fat tissue has a key role that relates metabolism increase to body heat. This issue is found in large amounts in the newborn babies, especially in their back on the upper half of the spine, and is functional for almost two years. What distinguishes this type of fat from white fat tissue are its unique qualities for the protection of the baby from hypothermia. In babies, the sympathetic system, adrenaline and noradrenaline hormones, and thyroid hormones (T3 and T4) increase the burning of food in mitochondria found in the brown fat tissue with oxygen. As opposed to other tissues, ATP is not produced as a result of this process in brown fat tissue. All the energy found in fat is transformed to heat.

Brown fat tissue is visible in some babies in between their shoulder blades. As the child grows, he or she can feel the changes in temperature and becomes strong enough to dress up, brown fat tissue disappears and is no longer visible. It is such a miracle that babies who are weak and in need of help are protected from cold and death with the wondrous capabilities given to the brown fat tissue.

Upon the birth of her first child, the author took it upon herself to bestow an important blessing. Twenty-five years later, she used that blessing to help another new mother take her first steps into parenthood.

The story begins in the ninth month of my pregnancy, as I was reading a book entitled Special Delivery. While reading the detailed instructions on how to have a home birth, my curiosity was piqued by the author’s sharing of a “personal touch.” She described it as her “Persian tradition,” and explained the importance of blessing a newborn. This was something I had never heard of in my whole life.

At the time, I was not a practicing Muslim, even though I had been raised by Muslims parents (and grandparents). Despite the fact that I was the second generation born in America, I grew up without a mosque, because there were none in all of New England – at least not until 1964. Moreover, I had never been a part of any Muslim community.

That meant there was no place for me (or my parents) to learn about my religion, Islam. Consequently, like most Americans, I knew very little. But, there was one word in the book that was familiar to me. From my upbringing, I recognized the word, “Allah,” the word for God in Arabic.

The author stated that most babies are blessed by an imam, or a man in the family, such as a father, grandfather, or husband. But since I was having my child as a single parent, isolated from my family, and had no knowledge of what an imam was or did, I immediately considered the difficulty of my situation in a new light.

As I read on, I realized that there was something urgent at stake here. The author explained that if the baby heard the call to prayer as soon as h/she was born, there would be an immediate recollection of having just been in the presence of God, before birth. By reinforcing this memory at birth, the child’s iman (faith) would be guaranteed for the rest of his life. The tradition and its aim were similar to a Christening. Knowing this, I began to covet the blessing for my child, trusting that he would grow up believing in the Creator, who had gifted this life to me.

I carefully read the author’s how-to instructions about whispering in the baby’s right ear at birth and learned the “call to prayer,” which was in italics in the book:

(Allah whoo Akbar) God is the great
I bear witness that there is no god but One God
I bear witness that Muhammad is the messenger of God
Come to prayer
Come to success
God is the greatest
There is no god but One God

Unencumbered by cultural taboos or religious traditions, I decided to do the blessing myself. I wanted my child to hear this word, Allah, and thus, renew his relationship with God, a relationship that I had somehow neglected to develop during my childhood and early twenties.

The fact that this book came into my possession at the exact time I was preparing to give birth seemed to be Divine intervention. This strengthened my faith when I needed it most. Imagine, I thought, to have missed a moment that comes but once in a lifetime.

The Importance of Blessing a Newborn: Carried forward 25 years later

One day, during my chaplaincy residency at Brigham & Women’s hospital, where I was studying to become a Muslim chaplain, I was called to the room of a young Muslim woman on the maternity floor. Asma was 20 years old, with a soft brown complexion and dark curly hair that framed a sweet, round face. When I walked in, she was sitting up in bed. Unlike most new mothers who had just given birth and are tired but radiant, Asma was just plain tired. Her beautiful face was marred by a deeply troubled expression. With no baby present and no visitors, the room was lonely, joyless, and dark.

Asma asked me to arrange for the imam in the hospital to bless her newborn baby. I went downstairs and proceeded to check the imam’s schedule, only to learn that the patient would be leaving the hospital before he came on duty.

On my way back to tell Asma about the scheduling problem, I was intercepted by her social worker outside the room. She informed me that Asma was not married, and that she was in physical danger from her boyfriend. The social worker had just been advising Asma not to move in with the boy, once discharged from the hospital, because he had been violent on several occasions in the past. My colleague let me know that Asma would be better off moving in with her grandmother, who had offered a room for her and the baby, and that this was her best choice right now, even if it was only temporary.

As we parted, my thoughts turned to my own life, long ago: a single mother, a new baby, a lonely and difficult situation, and the book, Special Delivery. I knocked and entered the room, finding Asma sitting up in bed, her face still absent of joy or relief, and with no baby present once again. I explained that the imam was unable to do the blessing due to the scheduling conflict. I asked if she knew anyone else in her family who could do it; maybe a father or brother, another imam?

Asma started to cry silently and spoke in a small voice, “No. There isn’t anyone.” Pausing to dry her eyes, “But I want it done. It’s important to me. Can you do it?”

I had done the blessing before, at the request of new parents. And, I would have done it for Asma, if the baby had been present, and if my own schedule had permitted it. But I had no time either. Asma was scheduled to be discharged within the hour. Then, I had a better idea.

I said, “Asma, I’m sorry, but I don’t have time to do the blessing because my shift is almost over. But, let me tell you something. I think you should do it yourself.”

This elicited a big negative reaction, “But I can’t do it. I don’t know how to. I can’t do it. She pleaded with me, “Can’t you do it, please?”

“Asma, do you plan to raise this child to be a Muslim?”

“Absolutely,” she said, listening now.

“Okay, then. Since this is your child, your responsibility, and you are planning to raise her as a Muslim, you can take the responsibility. As her mother, you will always be the most important person in her life, and as the Prophet Muhammad (pbuh) said, ‘the mother is a child’s first teacher.’ You can do the blessing yourself, right here and now.”

Tentatively, Asma acquiesced, “Yes… but… will you show me how to do it?”

“Asma,” I said, looking into her frightened eyes, “I will show you how to do it. You, Asma, will give your child this most important blessing. Are you ready to learn?”

Asma paused, thoughtfully, and when she finally spoke, it was with a new resolve,

“Okay. I mean, yes, I’m ready. I want to do it.”

After explaining how the blessing was done, I asked Asma where she was planning to go when she left the hospital. I noticed that she had perceptibly changed, perhaps empowered by the simple idea that she could bless her own baby.

Without hesitating, she said, “I think I’m going to my grandmother’s house. It’s really nice there, and I love my grandmother. I’ll only stay for the first few weeks, so she can help me with my baby. She paused to restate her decision, “Yeah. I can’t wait to go there.”

Upon seeing her beautiful face, wearing a smile for the first time, I affirmed, “That sounds like a great idea, Asma. I’m sure you’re going to be a wonderful mother.”

We all say Inshallah to that!

Let me back up here a little. About two years ago, just before I received my doctoral degree, I had started looking for jobs. My wife and I had already spent about six years in the same Midwestern city, and we wanted to move to another region of the country. I sent about 100 job applications to various universities and companies, regardless of location. However, nothing came out of those applications, save for two interviews. Eventually, I ended up receiving a job offer from an academic institution to which I never applied. This college happened to be in the same city we already lived.

Interestingly, we had changed my wife’s doctor just a few months before the delivery. Our previous physician worked at a different hospital system, which had a neo-natal intensive care unit but not nearly as good as the one that admitted my daughter. My wife and I, without knowing what was going to happen, were apparently guided by someone Who knew what was going to happen. Our seemingly unintentional choices – including having only a single job option – eventually led to my daughter receiving care at the best medical facility possible.

“We will try and delay the delivery as much as possible,” said one of the high-risk pregnancy doctors, and then added, “each minute in the mother’s womb is gold for the further development of organs.” They admitted that there is no technology in the world that can provide the same ideal conditions as exist in the mother’s womb. These conditions include breathing (oxygen intake), feeding, and even the comfort of the baby. My wife and I could do nothing but pray and wait. In the meanwhile, we decided to name our daughter Meryem, which is the Turkish version of Mary.

About 48 hours after hospital admission, we were told that delivery could no longer be delayed. I did not want to leave my wife alone in the delivery room, even though I suffer from mild blood phobia (hemophobia). I tried to condition myself to the sight of some blood and a baby that would weigh only around a pound. However, the first look at our baby was quite a shock to me! Her skin was purplish red and quite transparent, revealing blood vessels. Later, we learnt that keratinization of the skin is not usually complete until the 25th week of gestation. Also, fat layers under the skin usually do not develop until this stage. The combination of these two factors not only made Meryem’s skin translucent, but also meant that she did not have a strong skin that would protect her from hot or cold, and high or low moisture levels. She would need to be kept in an incubator. As soon as Meryem was born, she was immediately taken to the adjacent room where a crew of about ten started working on her. She was first weighed and then intubated. This last procedure involved inserting a tube into her lungs, which would deliver oxygen and move out carbon dioxide with the help of a ventilator.

That is how our one pound and one ounce (480 grams) baby was born. According to our doctors, Meryem tried to breathe on her own, which was a rather surprising development. They also did not forget to reiterate that anything could happen at any time. My wife fell asleep after the stressful delivery, so I decided to visit Meryem as soon as possible, considering that I might not see her again. She was taken to the neonatal intensive care unit (NICU) of the hospital in her incubator.

I was in a different world when I entered Meryem’s NICU room. I was greeted by different alarm sounds, numerous screens displaying different graphs and numbers, and different equipment generating a lot of noise. Little Meryem was wiggling in her incubator, as if she wanted to tell us she was not comfortable, but she was not complaining. I was allowed to touch her, but only through the small window of her incubator, which was protecting her from infections and other environmental factors. I also whispered the call the prayer (adhan and iqama) to her ears, and then her name, which is a tradition in Islam. The latest technology and a number of well-trained healthcare personnel were serving her in lieu of the perfectly designed amniotic sac and placenta. Yet again, I was warned to prepare for the worst outcome. Under these thoughts, I said good-bye to Meryem and went to my wife’s room. This is how our six-month adventure in the hospital started.

Our initial days at the hospital were quite challenging. We were given a list of complications that Meryem could endure, some of which could be fatal. A few of these possible complications were: various bacterial and viral infections, lung and breathing problems, intraventricular hemorrhage (bleeding in the brain), periventricular leukomalacia (white matter brain injury), patent ductus arteriosus (a blood vessel failing to close), necrotizing enterocolitis (tissue death in the bowels), chronic lung disease, retinopathy of prematurity (blindness), and deafness. Moreover, some of these complications could lead to other complications such as cerebral palsy, impairments in ambulation, speech problems, cognitive problems, physical and mental disabilities, and even death.

Meryem had a tube inserted from her mouth going deep into her lungs; this tube was connected to a breathing machine (oscillator or ventilator). The effectiveness of her breathing was periodically checked. Since she could not be fed at this stage, an IV line was providing her fluids and a little bit of nutrition. She also needed blood transfusions to replace the blood that was lost during various tests. Due to various infiltrations in her body and her immature immune system, she was vulnerable to infections, which would rarely happen in the mother’s womb. As a matter of fact, Meryem would have to deal with a number of bacterial and fungal infections, including pneumonia, in the hospital. A couple of these infections were quite severe and would lead us to think that we were losing her.

In order to accelerate lung growth, Meryem was administered steroids. However, steroid treatment caused a steep increase in her blood sugar levels. Meryem’s doctors told us that they would have to stop feeding her because of elevated blood sugar. That would mean Meryem would not be able to gain weight and thus her lungs would not develop. In fact, Meryem lost about two ounces (60 grams) during this period and ended up weighing only 11 ounces (420 grams). This vicious cycle reminded us of the extraordinarily ordinary system in the mother’s womb, where everything functions perfectly in order. A number of the brightest neonatologists in the country were using the latest technology and doing their best to treat Meryem. And they were admitting that a procedure they would perform to correct a dysfunction would lead to a dysfunction in another organ or system. All these developments made us marvel even further at what a perfect environment for child development a mother’s womb is!

Another distinctive example of this magnificent design is the closing of the ductus artery in newborns. Since oxygen is provided to babies through the umbilical cord in the uterus, babies do not really breathe, and do not, hence, use their lungs. It would be inefficient for the blood to go through the lungs in unborn children. As such, a blood vessel, called the ductus channel, carries the blood towards the aorta, bypassing the lungs in the unborn. However, since babies have to start breathing and use their lungs right after delivery, an open ductus channel would be problematic, as blood needs to be oxygenated in the lungs before being sent to the aorta. Hence, after a short period following delivery, the ductus channel closes “on its own.” In premature babies, medication or surgical treatment is required to close the ductus. If not closed in time, edema (fluid accumulation) can occur in the lungs and other organs.

Meryem had a severe edema problem. In order to address the unclosed ductus and edema issues, Meryem’s doctors gave her medication as soon as possible. We were told that if the drug did not work, they would have to take route B and surgically close the ductus. Even though the surgery per se did not bear significant risk to Meryem, we were concerned about the side effects of anesthesia. I read articles which suggested that the use of anesthesia agents in such little babies could cause heart and brain problems. We continued praying right away for a successful drug treatment. Unfortunately, the medication did not work. Meryem’s doctors sought our permission to perform the surgery, as they did not want to lose time. They also explained to us that a second drug treatment could be tried, which would have a very low success rate. Weighing our options and considering the risks of anesthesia, we asked the doctors to administer the medication for a second time and asked our friends to join us in praying for Meryem. The next day, our doctors were quite surprised; Meryem’s ductus was closed.

During the long days at the hospital, we read about prematurity, how a preterm baby was different from a term baby, and discussed all of this with my wife. We were simply amazed by the new information we have acquired on the splendidly designed development of a baby. We always looked at newborns and deliveries as something relatively ordinary. We never felt the need to think in depth about these issues before. After elaborating for hours on the perfection of the development of a baby, we came to an agreement that it would be impossible for us to accept speculations about how this all would happen “on its own.” We felt the great urge to seek refuge in the Owner of this magnificent system, and send our prayers to Him. We also asked for prayers from friends, relatives and spiritual individuals, who in our opinion had a closer relationship with the All-Knowing. We believed that, because of these prayers, Meryem would remain immune to major complications that I mentioned before, despite the pessimistic predictions of our doctors. Many times, we saw the surprise in our doctors’ eyes after an unpredicted positive outcome.

One of these surprising developments was about Meryem’s sight. Devices that made Meryem breathe had to use air that contained up to 80% oxygen. As you may know, the air we breathe has 21% oxygen. The high levels of oxygen premature babies need to inhale, due to their immature lungs, usually cause complications in the eyes. We were informed that Meryem had a very high chance of needing an eye surgery to prevent blindness (retinopathy of prematurity). In fact, one of our doctors (let’s call her Dr. Smith) would explain this likelihood by saying that, “I will eat my hat if Meryem is discharged from the hospital without an eye surgery!” Dr. Smith was actually a devout believer. Hoping that she would understand, we told Dr. Smith that we would maintain our trust in God, and keep praying. She reminded us about her strong belief in God, but also told us not to be hopeful. Just before Meryem was discharged from the hospital, we had a big cookie made in the shape of a hat, since we thought that Dr. Smith would have a hard time chewing on a leather hat. Yes, Meryem did not require an eye surgery! Dr. Smith approached this gesture quite humbly and thanked us for the reminder. She went on to say that she would keep the cookie as long as possible as it would remind her of the power of prayers.

After about a six-month stay at the hospital, Meryem was discharged on a cold day in March. These months had been a really tough period where we had to face many unknowns. The concern of losing Meryem, not being able to hold her for a long time, the risks of many complications, driving back and forth between home and the hospital countless times, receiving a call from the hospital in the middle of the night – all these tested our faith.

“Then, surely, with hardship comes ease
Surely with hardship comes ease”

We remembered and prayed this word of God, as many times as possible during this entire ordeal. We felt that having faith helped us a great deal to stay calm and conscious, especially when we had to make difficult decisions.

Meryem is about four years old now. Except a few minor issues, she is quite healthy. Pediatric specialty doctors who saw her, especially right after the discharge, would be surprised to see her so healthy. In particular, Meryem’s neurologist, after telling her that we believed the prayers were the primary reason she survived, would say, “I agree, as we cannot really explain her good condition only with science and medicine.”

Many immature babies cannot survive even though all necessary treatments are applied and heartfelt prayers are made. This does not mean their prayers are not heard, nor would we think otherwise if we were to lose Meryem. Prayer is a duty upon all of us to show our thanks for all the blessings we have been granted. The fruit of these prayers (in addition to doing fully what must be done) can either be an immediate one in this world or a postponed one in the life to come, and we may not know what good may come out of what seems ugly on the outside. The poet Nimah Nawwab puts it so well:

“God gives answers in three ways: He says YES and gives you whatever you Want. He says NO and gives you something Better. He says WAIT and gives you the Best.”

Sleep, baby, sleep
Your father tends the sheep
Your mother shakes the dreamland tree
And from it fall sweet dreams for thee
Sleep, baby, sleep
Sleep, baby, sleep.^[1]

Babies are such cute bundles of joy. They are simply adorable and very innocent. The birth of a baby is a miraculous event, and all babies deserve to be loved, no matter where they are born.

Lullabies are love songs written for them. Parents sing lullabies to their precious loved ones to send them sweetly into their dreams. In almost every culture, lullabies are inspirations and prayers for precious little children. Such songs hand down the hopes and dreams of parents, from generation to generation.

“Hush-a-bye” is a lullaby with a story behind it. It was collected by Alan Lomax, who learned it from his mother, who took it from North Carolina to Texas after the Civil War^[2]. It was originally sung by an African American slave. The “lambie” symbolizes the slave-mother’s child, for whom she is unable to care because she is too busy taking care of her owner’s child, to whom the song is being sung. The lullaby’s sourness is cleverly hidden in the comparison between the two children: one is a protected white child growing up privileged and the other is a black baby, left defenseless in nature^[3].

Hush-a-bye, don’t you cry,
Go to sleepy little baby.
When you wake, you’ll have cake,
And all the pretty little horses.

Black and bay, dapple and grey,
Coach and six little horses,
Hush-a-bye, don’t you cry,
Go to sleepy little baby.
Hush-a-bye, don’t you cry,
Go to sleepy little baby,
When you wake, you’ll have cake,
And all the pretty little horses.

Way down yonder, down in the meadow,
There’s a poor wee little lamby.
The bees and the butterflies pickin’ at its eyes,
The poor wee thing cried for her mammy.

Hush-a-bye, don’t you cry,
Go to sleepy little baby.
When you wake, you’ll have cake,
And all the pretty little horses.

Other than being musical stories, lullabies are also beautiful gifts from a parent’s heart to a baby’s ear. Every parent around the world sings a delightful lullaby in her native tongue to relax their child. Lullabies are great examples of how we show love in similar ways all around the world. There is no difference between us and the people on the other end of the world when it comes to our affection for our babies. We all love our babies and open our hearts to them with these songs. There are different lyrics or different rhythms, but they express the same love, support, and concern for the little human beings.

For example, in an Armenian lullaby, a mother says:

The south wind rocks you back and forth
Let the stars converse with you
And the sun and moon calm you
The wild deer will offer its milk
Sleep, sleep.^[5]

And an Azerbaijani lullaby goes as follows:

Every passing bird, every river
Says lay-lay to you my baby
In our most joyful and beautiful motherland
You are my pride and joy
You are my soul that is within my own soul
Your breath is so clean and innocent
Like the light wind in the field.^[6]

Although there is a long history of conflict between the two south Caucasus countries, there is no difference in a parent’s compassion and warm wishes for their children. They both pick nature up as their babies’ playmates and want them to grow up within that nature. Both of the lullabies can comfort a baby with a familiar voice.

Below are two lullabies from Israel and an Arabic country, Morocco. Would you be able to tell which one is from which country?

The first one is:

Sleep, my little girl, sleep
Sleep, my darling one, sleep
Daddy has gone off to work.
To work, to work he’s gone.
He’ll be back when the moon rises
With a gift for his little one.^[7]

And the other one is:

Sleep my baby
Until the meal’s ready.
And if it isn’t,
The neighbor’s will be.

Sleep my baby
Until your mommy’s arrived
The bread is on the table
The sweets are on the tray.^[8]

The former is from Israel and the latter from Morocco, but universal love is embedded into the message of both lullabies. They both touch our hearts. They are both very special in every way. No stereotypes, no wars, no hatred is passed on to babies; only love, and peace, are fostered in lullabies. Thus, lullabies provide an excellent tool to teach children to love all creatures. They allow the sharing of emotions that are filtered and softened by mothers’ heart. When people comfort their babies or make them feel more secure by singing them a lullaby, they also teach them the biggest life lessons. Lullabies smoothly whisper the essentials of life, the common needs of all human beings to babies’ ears.

Talking about the essentials of life, the adversities in life are a fact that the children must also be prepared for. But even when talking about the negative aspects of life, lullabies introduce them gently. An intelligent lullaby from Turkey passes along good wishes to a child, but also teaches a valuable lesson.

Dandini dandini dastana
Into the garden the calves did stray.
Gardener quickly chases them away.
Don’t let them eat the cabbages,
Huuu huuu huuu

Dandini dandini danadan
A moon is born from a mother’s womb,
God has not withheld anything from him
May God protect him from the Evil Eye
Huuu huuu huu hu

Dandini dandini danayli
May our pots be coated with tin
May my daughter be a bride in a mansion
And my son dwell in a palace
Huuu huuu huu hu.^[4]

In this lullaby, a mother’s desire for her son not to get married to a girl she does not approve is hidden beneath the lyrics in an amazingly clever way. The calf symbolizes the son and the garden represents life, while the gardener is the father, and cabbage is the girl that is not approved of by the boy’s mother. So the mother wants the father to keep that girl away.

There are lullabies like the one above that are very personal and private, in which the narrator expresses how she really feels and thinks about certain issues while telling her stories. Such songs can help a parent express their own emotions more clearly, too, especially when they are unable to share them with others. Thus, lullabies soothe and help not only the babies but also the adults.

Lullabies are helpful to put babies to sleep and are useful for adults to enjoy the time that is spent with their children. A lullaby’s magic comes to life in a parent’s voice. These gentle melodies allow parents, who are a child’s first teachers, to impart valuable lessons in a soothing way. A personal message or story is planted elegantly into the lyrics. A loving parent embraces their precious baby with a beautiful lullaby. Plenty of joy, peace and love fill up the room at night when a loving voice smoothly sings:

Goodnight moon, goodnight stars and goodnight my little angel,
Close your eyes and open them to sweet dreams my sweetheart…

References

¹ http://www.romantic-lyrics.com/lullabylyrics/sleepbabysleep.shtml

² http://kids.niehs.nih.gov/lyrics/prettyhorses.htm

³ http://www.robertbohm.com/publications/3.html

⁴ http://lullabiesofeurope.wetpaint.com/page/Lullabies+(Turkish)

⁵ http://en.wikipedia.org/wiki/Lullabies_of_Armenia

⁶ http://en.wikipedia.org/wiki/Lullaby

⁷ http://www.hebrewsongs.com/song-numinumi.htm

⁸ http://www.mamalisa.com/?t=es&p=1249&c=168

The newborn babies who are fed with infant formulas are becoming sick more frequently and are four times more prone to Sudden Infant Death Syndrome (SIDS) as compared to babies who are breast-fed. The statistical analyses made in the US have shown that, if fed solely by breast milk instead of infant formulas, deaths of at least 9000 infants will be prevented annually. A vitally important feature of the breast milk is that its contents are being dynamically and precisely formulated in direct proportion to the development and as per the needs of the baby, whereas baby foods and formulas do not have such a feature. The taurine amino acid, which is vital for the development of the brain and eye, are abundantly available in the breast milk.

The breast milk, which is recommended to breast-feed for up to two years, is special because of its various aspects: it has a unique chemical composition; the lightly yellow-colored alkaline milk (colostrum) generated right after giving birth is very helpful in protecting the newborns from infections and diseases; mammary (milk) glands operate on a very fine time adjustment and they have a perfect developmental coordination; its prevention against lymphoma, which is a kind of cancer, and its feature of leading cancerous cells to programmed cell death (apoptosis); adjustment of the quantities of minerals and trace elements in milk-generating cells of the mother in accordance with the needs of and in proportion to the growth of the infant; breast-feeding has positive effect on the infant’s IQ development.

Nevertheless, newly conducted researches have been yielding fresh findings and new wisdoms (truths) regarding the breast milk.

The tens of researches conducted on the breast milk till now have all indicated and proved that breast-feeding for a period of 7 to 12 months will positively add to the healthy development of infants’ bodily organs along with their IQ development. There are a number of different factors which contribute to infants’ IQ development and breast-feeding is just an important one among them. The positive contributions of breast-feeding to an infant’s IQ development may be better observed if the infant is raised within a genetically and environmentally healthy medium.

A steady brain development and its positive contribution to an infant’s IQ are related to the molecules such as Docosahexaenoic acid (DHA), Omega-3 fatty acid, Arachidonic acid (AA), Cholesterol and Taurine Amino Acid that are sufficiently found in the breast milk. The breast milk is even more useful for a healthy development of the infant’s social intelligence. According to IQ measurements, the IQs of children who have been breast-fed for periods of 7 to 9 months are found to be 6 points higher than those who have been breast-fed for less than a month.

A mother becomes like an innately secure shelter for the infant during breast-feeding as the secretion of the oxytocin hormone in the mother’s mammary glands is increased during her physical touch to the baby. Though motherly love and compassion are immaterial sentiments, a corporeal hormone is deemed a contributor to the attachment of love between mother and child. Breast milk is also rich in cholecystokinin (CCK), a hormone that acts as somniferous both in the mother and the infant. Thus, breast-fed infants more easily sink into sleep and this favorably contributes to infants’ healthy growth while enabling mothers to take rest. Mothers who are complaining that their children are not easily sinking into sleep can thus try to breast-feed them more frequently and for longer durations.

Breast milk versus allergens

Parallel to babies’ development, their foods also diversify. In order for foods other than breast milk given to the infant for the first time not to cause any sort of allergic reaction, that foodstuff should not be recognized as strange and unfamiliar, and this depends on the degree of sensitivity of that infant’s immune response mechanism. Therefore, whether breast milk has any role in the baby becoming accustomed to potentially allergenic foodstuff is being researched on experimental animals. When lactoglobulin is fed to baby rats, which are highly prone to activating allergic response, together with baby food and with breast milk respectively, the one which is fed as blended with the breast milk has not caused any allergic response while the one which is fed as blended with baby food has caused powerful allergic responses (1). In conclusion, it has been proved that, not the baby foods, but only the breast milk plays an important role in activating an immune response in babies.

It has also been found that, in order to ensure healthy intestinal development in newborn babies, only breast milk should be provided in the early stages after birth. As breast milk forms a protective shield against bacteria and viruses, it eliminates the need for response activation of the immune system during the early stages following birth. Moreover, breast milk also causes growth of Lactobacillus bifidus in the newborn’s intestines which prevent formation of pathogenic bacteria. The oligosaccharides in the breast milk are favorable stimulants for growth of Lactobacillus bifidus and also function as adhesive molecules. A resemblance of lock and key model has been observed between the oligosaccharides of the breast milk and the carbohydrates over the epithelial cells of the intestines. This implies that oligosaccharides of the breast milk function as free-floating receptors over the pathogenic microorganisms of various nature. They prevent adsorption of microbes over epithelial cells of the intestines and hence form a preventive shield against infections.

Oligosaccharides and Necrotizing Enterocolitis (NEC)

The enterecolitis which causes necrosis is a most widespread and fatal intestinal disease, being observed at a rate of 85% in premature babies. Insufficiency of oxygen in epithelial cells of the intestines due to various factors is an important reason for its happening. Insufficiency of oxygen in the intestines deforms the healthy functioning of epithelial cells bringing the medium susceptible for infections due to which the necrosis beginning on mucosa membrane of the intestines may develop down to the depth of the intestines’ innermost layer. Roughly 10-26% of all the infant deaths being observed in the newborn intensive care units of US hospitals are occurring due to Necrotizing Enterocolitis (NEC). This happens very rarely in infants who are breast-fed.

A series of controlled researches have been conducted on baby rats for the purpose of understanding the causes of Necrotizing Enterocolitis (NEC). These baby rats have been sorted out in three separate groups as the ones fed only by breast milk, the ones fed only by baby food and the ones fed by baby food blended with oligosaccharides of breast milk. Animals in all three groups have been exposed to hypoxia (deprivation of adequate oxygen supply) for three consecutive days and their intestinal tissues have been analyzed at the end of the fourth day.

It has been observed that, while symptoms of enterecolitis in intestines of those fed solely by breast milk were the least, and in intestines of the ones fed by baby food blended with oligosaccharides of breast milk were relatively low, but in intestines of those fed only by baby food were extremely high. Medical reports too indicate that Necrotizing Enterocolitis (NEC) is quite rare in breast-fed babies for the oligosaccharides of breast milk prevent formation of this disease. What is amazing is that the oligosaccharides and the complex glycans which play preventive roles against infections are abundantly available in breast milk whereas they are not found in baby foods (2). Although galacto-oligosaccharides which are similar to oligosaccharides of the breast milk are being added into most baby foods, they have not served as preventive against necrotizing enterocolitis. Molecular researches are presently being conducted as to how oligosaccharides of breast milk do function in favor of prevention (2).

It has also been verified by researches that breast-feeding of the infants is having favorable effects on their development of a sense of taste and on likes and dislikes of foods during their childhood years. In a recently conducted research, sour, sweet, mildly sour, salty, bitter and tasteless foods have been given to infants who are being breast-fed, cow milk-fed and baby food-fed and their reactions to these foods have been observed and evaluated. Those who were fed by baby food made a lesser grimace and also preferred more soury and bitter foods (12). When these babies were later offered normal foods, they replied only for the tastes of foods which were similar to the foods they were previously given. Moreover, their facial expressions were lesser and insufficient in terms of differentiation of unpleasant tastes. Basically, the contents of baby foods and nutrients affect children’s future responses to those foods and nutrients and their taste perception ranges (3).

Breast milk conduces to expression of differing genes in infant’s intestines

A reply to discussions on “whether breast milk or readymade baby foods” is given by researchers of the University of Illinois. Of the 22 healthy infants, the researchers fed 12 with breast milk and 10 with readymade baby food for a certain period of time and later analyzed the messenger RNAs (mRNA) in the intestine cells collected from their stools. These mRNAs have been exposed to a number of molecular tests, being later analyzed and compared. The results have disclosed that gene groups different from each other were being activated in intestines of the infants who were being fed by breast milk and baby foods. Genes of intestines that were expressed differently as foods of infants were diversified (4). Moreover, such a different reading, that is, revealing of the genes’ potential was not limited to only a couple of genes. Contents of baby foods and nutrients have been influential on the expression of hundreds of genes. The most striking outcome was that, while the data encoded by the gene that was assigned for revealing response of the genes being exposed to hypoxia (deprivation of adequate oxygen supply) was properly expressed and activated in infants who were fed by breast milk, the data encoded by such genes of the infants who were fed by baby foods was not being described and read. Thus, the probability of developing of enterecolitis (inflammation of the intestines) due to hypoxia (deprivation of adequate oxygen supply) was increasing. It has been understood that preference of feeding the newborns with either breast milk or baby foods plays a significant role in disclosing the data of about 140 genes which stimulate quick development of their intestinal and immune systems. In other words, the genes which are assigned for preservation of the immune system and thus for strengthening the infants against diseases are being easily expressed in the intestines of infants fed by breast milk but not of the ones fed by baby foods (4).

Finally, it is vitally important to feed the infants in hospitals’ newborn units more with breast milk in order to stop the developing of Necrotizing Enterocolitis (NEC). It has been understood that reading and suppression of the genes which are assigned for arrangement of particularly stomach-intestine functions are being arranged depending upon both development and epigenetical mechanisms as, for instance, the environmental factors that influence nutrition. This assertion shows that, while future studies will shed light on how to make ingredients of baby foods more similar to those of breast milk, it will never be substituted by any other nutrient.

Hamza Aydin is a freelance writer from Turkey with PhD degree in biology.

Notes

1. Katie L. Tooley et al. (2009). Maternal Milk, but not Formula, Regulates the Immune Response to ?-Lactoglobulin in Allergy-Prone Rat Pups. Journal of Nutrition, Vol. 139, No. 11, 2145–2151, November 2009.
2. Bode,L., Goth,K., Guner,Y. et al.(2010). Human milk oligosaccharides prevent Necrotizing Enterocolitis in neonatal rats. FASEB J. 2010 24:206.3 [Meeting Abstract]
3. Mennella, J. A. Et al. (2009). Early milk feeding influences taste acceptance and liking during infancy. Am J Clin Nutr. Vol. 90, No. 3, 780S-788S.
4. Chapkin, S.R. et al. (2010). Noninvasive stool-based detection of infant gastrointestinal development using gene expression profiles from exfoliated epithelial cells. The American Journal of Physiology, Gastrointestinal and Liver Physiology. Volume 298, Issue 5. May 2010.

How is uterus to be placed in the frontier abdomen?

In order for a baby to survive, a suitable space in which it will be fed and protected is necessary. Therefore, the uterus is in the best location as it is, and its equivalent cannot be maintained in the belly. Let us consider that births would really happen through the belly. If the uterus, where a baby develops in 40 weeks, were placed in the belly, then a set of problems would appear. The opening of the uterus would be turned toward the abdomen wall, and thus there would be no strong bonds to tie it up with the surrounding area. In this case we cannot place the intestines, mesenteric blood vessels, aorta, and the net of nerves in connection to them in any way. If the uterus were in the belly, it would unavoidably pressurize the stomach, liver, spleen, and other internal organs, as the mass inside a pregnant woman grew. This could obviously pose a lethal threat for both the mother and the baby.

How would the birth process begin?

If the uterus were anywhere else than its present position, it would contradict the physiology of birth. The fetus assumes three different positions along the developmental process: as it begins to be formed the head is up and the feet are down. At the sixth month, the baby assumes a horizontal position. When the birth draws near, feet and the hips are positioned on top and the head is turned downward, closer to the opening of the uterus. As the head gets closer to the opening, mechanical pressure increases. Thus, signals for the birth are sent to the brain so that the relevant hormone aid is sent in response. With the effect of the hormones, the uterus begins to contract in order to dispose of the being inside. As the opening of the uterus enlarges, the contractions increase. With its mechanical help, the sacro-coccigeal joint makes a 2-cm stretch to give way and with the support of the pubis bone in front, the birth is realized. If human birth was to occur through the belly, then how would the process—including the brain, pituitary gland, and adrenal glands—be triggered with mechanical pressure without the help of gravitation? If the uterus is placed inside the belly vertically, then a tube or similar opening is needed for a way out from between the legs. Even if there is mechanical pressure and the hormones to facilitate birth are secreted, then what way will the baby move? How can birth be realized through the soft-walled belly without any mechanical support at all? If human birth were possible through the belly without any support from the bones, the duration of birth would be much greater. In addition, as the size of the baby increased, a high positive pressure would be needed in order to balance the effect of gravity. However, the more a belly grows, the weaker its muscles become. If birth would ever be possible through the belly, then the mother would have to deliver her baby by lying prone in order to prevent the soft tissue to be torn. In addition certain flora (beneficial microorganisms) need to be placed to the birth channel in order to prevent relevant complications. Should the genital organ be transferred to the navel? For the best protection against complications, the baby’s head need to be in horizontal position as if it were swimming. The effect of gravitation applies different pressures on the baby’s head while the mother stands, sits, and lies in a supine position. In this case, by which force would the head be directed toward the opening in the frontal abdomen wall to start the birth process? The three different positions of a fetus along its development will never be possible in a uterus located in the belly. Then the fetus would dangle like a tree leaf under the effect of gravitation.

The easiness of normal physiological birth

A form of birth through the belly, a cesarean delivery is only realized in the face of certain anomalies. Although some women assume cesarean as a painless form of birth, findings adds to the cons of cesarean. Accordingly, rate of allergic asthma in cesarean-born children is found six times higher in comparison to others. It is thought that during normal birth, the baby receives some of the microorganisms on the mother’s genital organ and the immune system forms antidote against them, which provides protection against asthma.

Strapping up the uterus?

As the baby develops in a period which lasts more than nine months, the uterus gradually grows. In the mean time, it is necessary to fix the uterus with sound bonds so that it becomes resistible to shakes. Counting in both sides, 14 pieces of bonds fixes the uterus to the bones (ilium, ischium, pubis, sacrum) around the hips. Were the uterus to be in the belly, how could we find such sound structure to support the bonds?

To conclude, God Almighty could have created our body in a different form, and He would have shaped our anatomy accordingly, which would then provide the best means for an ideal birth. Thus, it is nonsensical to seek errors in our present biological makeup in order to dishearten the faithful in their belief. Leaving aside such speculations, one cannot help but admire the perfect arrangement in human anatomy when considered from the perspective of wisdom.

Arslan Mayda is a medical doctor at Sifa Hospital, Izmir, Turkey.